The identification and spatial distribution of hotspots of tuberculosis occurrence in South Africa.

Objective: Prior research has shown strong evidence of spatial clustering of tuberculosis across a range of contexts. Identifying the spatial patterning of infectious diseases such as tuberculosis is crucial as it allows for targeted intervention strategies, directing healthcare resources efficiently to areas where tuberculosis incidence is concentrated. This is especially true for low- and middle-income countries that typically experience greater resource constraints relative to their Global North counterparts.

An ICT-enabled community oriented primary care intervention in mining communities during COVID-19 (2019-2022): perceived changes in the role and place of community health workers.

Background: This is a study of service provider perceptions of the place, role and practices of CHWs in a four-year, large-scale private sector funded, public service ICT-enabled COPC intervention with rural and remote mining communities. Like all South African communities, apart from large mining house employees and some contractors, most people use available public healthcare services and private traditional as well as limited allopathic private sector providers. In addition to the limitations of facility centred primary healthcare and a fragmented health care system, the many negative health effects of mining on the communities, go unattended.

The socio-demographic profile of family physician graduates of blended-learning courses in India.

Context: India's lean cadre of 250,000 general practitioners and 30,000 government doctors has limited options to update themselves. Since 2006, Christian Medical College (CMC) Vellore has run blended-learning programs in family medicine, namely, postgraduate diploma in family medicine (PGDFM) and master in medicine in family medicine (M.MED FM) training more than 3000 doctors.

Incidence, risk factors and diagnostic accuracy of clinical palpation in picking up post-void residual urine in postnatal women.

Purpose: To determine the incidence of covert and overt postpartum urinary retention after vaginal delivery and the associated risk factors for postpartum urinary retention. To determine how well clinical examination by abdominal palpation correlates with ultrasound findings of urinary retention.

Methods: Patients after delivery were screened with ultrasound and examined clinically to check for retention of urine after voiding.

Strategies for primary HPV test-based cervical cancer screening programme in resource-limited settings in India: Results from a quasi-experimental pragmatic implementation trial.

Background: In order for low and middle income countries (LMIC) to transition to Human Papilloma Virus (HPV) test based cervical cancer screening, a greater understanding of how to implement these evidence based interventions (EBI) among vulnerable populations is needed. This paper documents outcomes of an implementation research on HPV screening among women from tribal, rural, urban slum settings in India.

Methods: A mixed-method, pragmatic, quasi-experimental trial design was used.

Opioid use and HIV treatment services experiences among male criminal justice-involved persons in South Africa: a qualitative study.

Background: Opioid use disorder (OUD) is overrepresented among people with criminal justice involvement; HIV is a common comorbidity in this population. This study aimed to examine how formerly incarcerated men living with HIV and OUD in South Africa experienced HIV and OUD services in correctional facilities and the community.

Methods: Three focus group discussions were conducted with 16 formerly incarcerated men living with HIV and OUD in Gauteng, South Africa.

A pre-experimental design evaluation of brief harm reduction interventions to improve coping self-efficacy of carers of people with substance use disorder.

Background: Globally, the rise in the number of people living with a substance use disorder (SUD) carries a multitude of individual and social health implications for carers and their families, often impacting negatively on their quality of life. Considered from a harm reduction approach, SUD is understood as a chronic protracted, complex health and social condition. From the extant literature, there is no evidence of the harm reduction approach being applied to address the needs of carers/family members who carry the burden of SUD care.

Individual differences in selective attention and engagement shape students' learning from visual cues and instructor presence during online lessons.

Although some researchers recommend minimizing extraneous visual information in multimedia lessons, others have demonstrated that features such as visual cues and instructor videos can enhance learning. However, variability in selective attention skills may influence students' ability to benefit from these additional features. This study investigated links between college students' selective attention skills and their learning from video lessons that varied in the use of visual cues and the instructor video.

Association of methylenetetrahydrofolate reductase gene polymorphisms with vitamin B12 deficiency and adverse perinatal outcomes among pregnant women of rural South India - a cross sectional longitudinal study.

Objectives: To determine the occurrence of gene polymorphisms and to study their association with vitamin B12 deficiency and adverse perinatal outcomes among a cohort of pregnant women from Kaniyambadi block, Tamil Nadu.

Methods: 120 consecutive pregnant women who were ≤20 weeks of gestational age from the 82 villages of Kaniyambadi block were recruited. Genomic DNA was isolated from the peripheral blood.

Infrastructural Inequality and Household COVID-19 Vulnerability in a South African Urban Settlement.

COVID-19 has highlighted the importance of household infrastructure in containing the spread of SARS-CoV-2, with Global South urban settlements particularly vulnerable. Targeted interventions have used area or dwelling type as proxies for infrastructural vulnerability, potentially missing vulnerable households. We use infrastructural determinants of COVID-19 (crowding, water source, toilet facilities, and indoor pollution) to create an Infrastructural Vulnerability Index using cross-sectional household data (2018-2019) from Mamelodi, a low-income urban settlement in South Africa.

Targeting prostate lesions on multiparametric MRI with HDR brachytherapy: Optimal planning margins determined using whole-mount digital histology.

Purpose: Multiparametric magnetic resonance imaging (mpMRI) has demonstrated the ability to localize intraprostatic lesions. It is our goal to determine how to optimally target the underlying histopathological cancer within the setting of high-dose-rate brachytherapy (HDR-BT).

Methods And Materials: Ten prostatectomy patients had pathologist-annotated mid-gland histology registered to pre-procedural mpMRI, which were interpreted by four different observers.

Functional Sodium MRI Helps to Measure Corticomedullary Sodium Content in Normal and Diseased Human Kidneys.

Background To the knowledge of the authors, urinary osmolarity is the only tool currently available to assess kidney corticomedullary gradient (CMG). Comparisons between CMG and urinary osmolarity and the use of modalities such as sodium MRI to evaluate renal disease in humans are lacking. Purpose To investigate the ability of sodium MRI to measure CMG dynamics compared with urinary osmolarity after water load in healthy volunteers and CMG in participants with kidney disease.

Demographic and socio-economic risk factors associated with self-reported TB.

The infectiousness of is known to be shaped by the human environment, with research showing positive associations with poverty, homelessness and overcrowding, among other factors. In this study, the focus is primarily on environmental health risks for TB, particularly on those associated with sociodemographic and household living conditions in South Africa. Data for this study were collected between 2014 and 2019 from a number of sites implementing community-oriented primary care (COPC) in the Gauteng Province of the country.

Induction of labor using Foley catheter with weight attached versus without weight attached: A randomized control trial.

Objective: To assess the effectiveness in preventing cesarean section for failed induction by using Foley catheter for cervical ripening in comparison to Foley catheter with a weight attached to it.

Methods: A randomized control trial conducted between November 2018 and July 2020, which looked at induction of labor with 30-ml Foley catheter in one arm and the Foley placed with a 500 ml weight attached to it in the other arm. Primary outcome was the cesarean section rate.

Feasibility, uptake and real-life challenges of a rural cervical and breast cancer screening program in Vellore, Tamil Nadu, South India.

Background: Early detection of breast and cervical cancer by organized screening has been found to reduce mortality rates in trials, but documentation of programme results and challenges is rarely done from non-trial settings. This study reports results of a population-based cancer control programme in a rural block in Vellore, Tamil Nadu, population size (116,085), targeting a population of 18,490 women aged 25-60 years, between November 2014 and March 2018.

Methods: Village-based health education sessions were conducted by social workers, using trained volunteers and health workers to motivate eligible women.

Outcomes of external cephalic version for antenatal women with breech presentation in a secondary hospital in Vellore, Tamil Nadu - a retrospective review.

Objective: Breech presentation is the most common fetal malpresentation at term, with an incidence of 3-4%. External cephalic version (ECV) is a procedure that can be offered to women with breech presentation beyond 36 weeks of gestation to convert it to cephalic presentation, reducing the risks of a vaginal breech delivery and the morbidities associated with caesarean section.

Material And Methods: We retrospectively reviewed the records of women who underwent ECV between October 2012 and June 2020 with the objectives of determining the success rate of the procedure, the mode of delivery, the maternal and neonatal outcomes, periprocedural complications and their management.

Harm reduction in an emergency response to homelessness during South Africa's COVID-19 lockdown.

Background: Caledonian Stadium, the main mass temporary shelter for homeless people in the City of Tshwane, was created as a local response to the imperatives of the novel coronavirus disease (COVID-19) National State of Disaster lockdown in South Africa. This is a case study of the coordinated emergency healthcare response provided by the University of Pretoria's Department of Family Medicine between 24 March and 6 April 2020.

Methods: This study uses a narrative approach to restory situated, transient, partial and provisional knowledge.

Willingness of people with Type 2 diabetes to start insulin therapy: Evidence from the South African Tshwane Insulin Project (TIP).

Aims: To determine factors associated with 'hypothetical willingness' to start insulin among people with Type 2 diabetes (T2DM).

Methods: A quantitative cross-sectional study with insulin-naïve T2DM patients at 23 primary care facilities in the Tshwane Metropolitan Municipality. Data collected included demographic and clinical data, willingness to start insulin, attitudes and barriers to insulin therapy.

The three-stage assessment to support hospital-home care coordination in Tshwane, South Africa.

Background: In complex health settings, care coordination is required to link patients to appropriate and effective care. Although articulated as system and professional values, coordination and cooperation are often absent within and across levels of service, between facilities and across sectors, with negative consequences for clinical outcomes as well as service load.

Aim: This article presents the results of an applied research initiative to facilitate the coordination of patient care.

Harm reduction in practice - The Community Oriented Substance Use Programme in Tshwane.

Background: The Community Oriented Substance Use Programme (COSUP) is the first publicly funded, community-based programmatic response to the use of illegal substances in South Africa. It is founded on a systems thinking, public health and clinical care harm reduction approach.

Aim: To describe the critical components, key issues and accomplishments in the initiation and delivery of evidence-based, community-oriented, substance-use health and care services.

Modelling cost benefit of community-oriented primary care in rural South Africa.

Background: Globally, rural populations have poorer health and considerably lower levels of access to healthcare compared with urban populations. Although the drive to ensure universal coverage through community healthcare worker programmes has shown significant results elsewhere, their value has yet to be realised in South Africa.

Aim: The aim of this study was to determine the potential impact, cost-effectiveness and benefit-to-cost ratio (BCR) of information and communications technology (ICT)-enabled community-oriented primary care (COPC) for rural and remote populations.