2,564 results match your criteria: "School of Public Health and Family Medicine.[Affiliation]"

Psychosocial challenges impact patients' ability to remain on antiretroviral therapy lifelong, magnified by disorganized health-systems and healthcare worker (HCW) attitudes. To address this, Médecins Sans Frontières and the Department of Health developed the Welcome Service intervention, to provide person-centered care at re-engagement after HIV treatment interruption. Implemented in Khayelitsha, South Africa, between August 2020 and February 2021, the intervention aimed to reorganize triage, optimize clinical and counselling services and address HCW attitudes.

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Background: Adolescent sexual and reproductive health (ASRH) interventions are underfunded in Ghana. We explored stakeholder perspectives on innovative and sustainable financing strategies for priority ASRH interventions in Ghana.

Methods: Using qualitative design, we interviewed 36 key informants to evaluate sustainable financing sources for ASRH interventions in Ghana.

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Early Online: Vol. 114 No. 4.

S Afr Med J

March 2024

Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of Cape Town, South Africa.

Maternal healthcare in South Africa faces huge private and public health systems challenges. A key challenge for policy makers is how to address the inappropriate patterns of obstetric care in the private sector and how to mobilise private sector resources to serve the broader population dependent on the public sector, without replicating those patterns of inappropriate care. Developing and implementing new obstetric care models that address these challenges and lend themselves to public private engagements could play a vital role in efforts to improve obstetric care in the country.

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South African healthcare reforms towards universal healthcare - where to next?

S Afr Med J

March 2024

Clinton Health Access Initiative, Pretoria, South Africa.

The National Assembly approval of the National Health Insurance (NHI) Bill represents an important milestone, but there are many uncertainties concerning its implementation and timeline. The challenges faced by the South African healthcare system are huge, and we cannot afford to wait for NHI to address them all. It is critical that the process of strengthening the health system to advance universal healthcare (UHC) begins now, and there are several viable initiatives that can be implemented without delay.

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Decriminalising and legalising medical assistance in dying.

S Afr Med J

February 2024

Family practice in Uitenhage; advisor in the medical insurance/ managed care industry; chairman of SAMA East Cape branch; SAMA federal councillor; elected member of the HPCSA.

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Article Synopsis
  • Disengagement from antiretroviral therapy (ART) care significantly impacts the health of people living with HIV, preventing viral load suppression and leading to illness.
  • A comprehensive search of studies conducted between 2015 and 2022 identified 21 research projects that analyzed various reasons for disengagement, with a focus on different populations, primarily in African contexts.
  • The most common reasons included socio-economic challenges, unexpected life events, side effects of ART, and the perception of limited benefits, with findings highlighting the importance of underlying vulnerabilities and the triggers that lead to disengagement.
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Climate adaptation strengthens and builds the resilience of health systems to future climate-related shocks. Adaptation strategies and policies are necessary tools for governments to address the long-term impacts of climate change and enable the health system to respond to current impacts such as extreme weather events. Since 2011 South Africa has national climate change policies and adaptation strategies, yet there is uncertainty about: how these policies and plans are executed; the extent to which health policies include adaptation; and the extent of policy coherence across sectors and governance levels.

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Background: Each year an estimated 2.3 million newborns die in the first 28 days of life. Most of these deaths are preventable, and high-quality neonatal care is fundamental for surviving and thriving.

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Tuberculosis (TB) and non-communicable diseases (NCD) share predisposing risk factors. TB-associated NCD might cluster within households affected with TB requiring shared prevention and care strategies. We conducted an individual participant data meta-analysis of national TB prevalence surveys to determine whether NCD cluster in members of households with TB.

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Article Synopsis
  • Climate change is heightening the risk of drought in sub-Saharan Africa, where high HIV prevalence exists, potentially increasing HIV transmission through various social and economic mechanisms.
  • Data from HIV surveys in 2016 across five countries were analyzed, linking survey data with local drought conditions to explore how drought affects poverty, sexual behaviors, and HIV acquisition.
  • Findings indicate that drought increased poverty levels in rural areas and was associated with higher rates of risky sexual behaviors, especially among women, leading to a significantly greater likelihood of recent HIV infection in drought-affected rural women.
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Aim: This study sought to describe the epidemiology of burns and factors associated with prolonged hospital stay among adult patients admitted in the Queen Elizabeth Central Hospital burns unit.

Methods: All files of patients aged at least 17 years and admitted in the Queen Elizabeth Central Hospital burns unit between 1 June 2007 and 31 May 2017 with acute burns, were reviewed. Data on socio-demographic characteristics, injuries sustained, comorbidities, length of hospital stay, and clinical outcomes were extracted from the files.

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  • Intimate partner violence (IPV) is a big problem for pregnant women in South Africa and can harm both the mothers and their babies.
  • The study looked at the reasons behind IPV during pregnancy and how it connects with things like alcohol use and the risk of getting HIV.
  • Women prefer using oral PrEP for HIV prevention because it helps them feel in control, but many face challenges in getting support due to fear of being judged by others.
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In healthcare, continuity of care is a crucial element, especially for patients in the field of psychiatry who have recently been discharged from a hospital. The shift from inpatient to outpatient care poses challenges for patients and healthcare providers, including openness to treatment, competing priorities, financial insecurity, concerns and dilemmas faced by patients regarding their post-hospitalization life after improvements in symptoms, lack of social support, poor patient-doctor relationships, lack of insight, and stigma associated with mental illness. Therefore, it is vital to employ effective strategies to ensure patients receive the required care and support during this transition.

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R21/Matrix-M vaccine: optimising supply, maximising impact.

Lancet

February 2024

Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa; Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, Cape Town, South Africa; Vaccine-Preventable Diseases Programme, World Health Organization Regional Office for Africa, Brazzaville, Democratic Republic of the Congo.

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Association between tuberculosis and pregnancy outcomes: a retrospective cohort study of women in Cape Town, South Africa.

BMJ Open

February 2024

Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Article Synopsis
  • Tuberculosis (TB) significantly impacts pregnant women, increasing the risk of adverse outcomes like low birth weight, preterm birth, and other complications, contributing to maternal mortality.
  • A study of 248 pregnant women diagnosed with TB revealed that 34% experienced adverse pregnancy outcomes, with risk factors including older age, HIV status, poor TB outcomes, and late antenatal care.
  • The findings emphasize the necessity for tailored support for pregnant women with TB, highlighting the need for improved care before, during, and after TB treatment to enhance both TB and pregnancy outcomes.
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  • A study conducted on 300 people living with HIV in Northwest Tanzania found that a significant portion, 29.3%, reported current alcohol use, with 11.3% meeting criteria for alcohol use disorders (AUD).
  • The study identified that males had a higher likelihood of both alcohol use and AUD compared to females, with men being more than three times as likely to engage in alcohol use.
  • Furthermore, alcohol use was linked to a higher rate of non-adherence to antiretroviral therapy (ART), suggesting that screening for alcohol consumption in HIV care settings could improve treatment compliance.
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The increasing digitisation of personal health data has led to an increase in the demand for onward health data. This study sought to develop local language scripts for use in public sector maternity clinics to capture informed consent for onward health data use. The script considered five possible health data uses: 1.

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Background: There is currently very little research evidence on the benefits and safety of liraglutide in the management of weight regain or inadequate weight loss following metabolic and bariatric surgery. This study aimed to determine the clinical effectiveness and tolerability of liraglutide as an adjunct therapy for managing weight regain and inadequate weight loss following sleeve gastrectomy (SG).

Methods: This was a retrospective analysis of medical records conducted at a private clinic in Kuwait.

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Background: In most countries, reliable national statistics on femicide, intimate partner femicide (IPF), and non-intimate partner femicide (NIPF) are not available. Surveys are required to collect robust data on this most extreme consequence of intimate partner violence (IPV). We analysed 3 national surveys to compare femicide, IPF, and NIPF from 1999 to 2017 using age-standardised rates (ASRs) and incidence rate ratios (IRRs).

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argue that a better understanding of the complex sociopolitical drivers of distrust in vaccination will increase the potential of social media to rebuild vaccine confidence

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Reducing Initial Loss to Follow-up Among People With Bacteriologically Confirmed Tuberculosis: LINKEDin, a Quasi-experimental Study in South Africa.

Open Forum Infect Dis

January 2024

Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.

Every person diagnosed with tuberculosis (TB) needs to initiate treatment. The World Health Organization estimated that 61% of people who developed TB in 2021 were included in a TB treatment registration system. Initial loss to follow-up (ILTFU) is the loss of persons to care between diagnosis and treatment initiation/registration.

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Immunization programs worldwide have been facing challenges in keeping vaccination coverage high. Even though universally known for its robust National Immunization Program, Brazil has also faced significant challenges regarding vaccination coverage. One of the reasons for this is vaccine hesitancy, a complex, multi-causal, and context-specific phenomenon.

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Objective:  This study aimed to conduct a comprehensive 16-year analysis of years of potential life lost (YPLL) due to leading causes of death in the United States, focusing on disparities by sex, race/ethnicity, and specific causes of death using the National Center for Health Statistics (NCHS) data.

Methods:  Data from the NCHS spanning 2000-2016 were included. Age-adjusted YPLL rates per 100,000 population were analyzed, stratified by sex, race/ethnicity, and leading causes of death, including malignant neoplasms, heart disease, and cerebrovascular diseases.

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Background: Periods of droughts can lead to decreased food security, and altered behaviours, potentially affecting outcomes on antiretroviral therapy (ART) among persons with HIV (PWH). We investigated whether decreased rainfall is associated with adverse outcomes among PWH on ART in Southern Africa.

Methods: Data were combined from 11 clinical cohorts of PWH in Lesotho, Malawi, Mozambique, South Africa, Zambia, and Zimbabwe, participating in the International epidemiology Databases to Evaluate AIDS Southern Africa (IeDEA-SA) collaboration.

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