Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “SOUTH AFRICA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources
PubMed2006

Asbestos-related disease in South Africa: the social production of an invisible epidemic.

South Africa was the third largest exporter of asbestos in the world for more than a century. As a consequence of particularly exploitative social conditions, former workers and residents of mining regions suffered--and continue to suffer--from a serious yet still largely undocumented burden of asbestos-related disease. This epidemic has been invisible both internationally and inside South Africa. We examined the work environment, labor policies, and occupational-health framework of the asbestos industry in South Africa during the 20th century. In a changing local context where the majority of workers were increasingly disenfranchised, unorganized, excluded from skilled work, and predominantly rural, mining operations of the asbestos industry not only exposed workers to high levels of asbestos but also contaminated the environment extensively.

Adolescent↗
PubMed2006

Challenges to microbicide introduction in South Africa.

Qualitative research was conducted in South Africa to determine perceptions about intra-vaginal microbicides in order to better understand the socioeconomic, cultural and structural contexts for the support of future introduction of this new HIV prevention method. Focus group discussions and in-depth interviews were conducted at community, health service, and policy levels of inquiry. The main study site was a black working class urban area close to Cape Town. "Desperation" in response to the HIV/AIDS epidemic, rape, sexual coercion and unplanned consensual sex emerged as major reasons to support microbicides, while concerns about the partial effectiveness of microbicide protection and its hypothetical nature elicited a more cautious approach. Other key findings included the likelihood that microbicides would be "mainstream", the possible impact on sexual practices and gender norms, issues of condom substitution/migration and potential avenues for education and distribution. We found that microbicides have the potential to meet diverse needs beyond that suggested by prior research. This included a desire for products that could protect against HIV infection following rape, sexual coercion and unplanned sex, and the finding that a wider range of people than previously suggested would potentially use microbicides. The challenge for microbicide introduction will be to develop products that can meet diverse needs not only in South Africa, but also in the broader global context.

Adolescent↗
PubMed2006

Medical student education in emergency medicine: new model from South Africa.

Emergency medicine is a new specialty in South Africa. Postgraduate training, degrees and diplomas have been introduced and this should make a significant difference, in due course, to emergency care in the country. The University of the Witwatersrand, Johannesburg, South Africa, like many universities in Australia, embarked upon a Graduate Entry Medical Programme. This implied significant curriculum change and gave opportunity for the development of formal emergency medicine training for students, for the first time. After considerable debate over the needs of the graduate in South Africa a new block was developed, called the Acute and Perioperative Care block. This encompasses forensic medicine, emergency medicine, trauma and anaesthetics. The training is integrated and progressive. No similar programme has been detected elsewhere. At the end of the first year there is considerable satisfaction on the part of both teachers and students and many of the students, finding the module exciting, have indicated a wish to become involved in emergency medicine in the future. The structure of the course is laid out and might be of relevance to colleagues with an interest in medical education.

Anesthesia↗
PubMed1982

Tuberculosis in the 1980s, with particular reference to South Africa.

Tuberculosis is a major health problem in South Africa. More than 40 000 new cases are notified annually and there is good evidence that this represents only a proportion of all patients with active disease. Despite the fact that approximately R35 million is spent on tuberculosis control in South Africa each year. In the 1970s our death rate from this disease probably approximated that which pertained in the UK in the 1940s just before antituberculosis drugs came into general use. Current concepts in tuberculosis and its control are reviewed and the suggestion made that a specialized task force be set up to improve control measures in South Africa.

Black or African American↗
PubMed2002

Patients' beliefs: do they affect tuberculosis control? A study in a rural district of South Africa.

SETTING: A rural district of South Africa. OBJECTIVES: To describe the beliefs and experiences about tuberculosis of patients and community members and to suggest how these affect presentation to health services and treatment adherence. DESIGN: A descriptive study using structured interviews with individual patients, and focus group interviews with patients and community groups. RESULTS: There is a strong belief in this community that tuberculosis is the result of breaking cultural rules that demand abstinence from sex after the death of a family member and after a woman has a spontaneous abortion. People believe that the resulting disease can only be treated by traditional healers. This delays presentation to hospitals or clinics. There is also a belief in a 'western' type TB that can spread from sufferers or is due to environmental pollution or to smoking or alcohol excesses. A number of factors were cited that influenced adherence to treatment. These included the stigma of TB, the belief that there should be abstinence from sex while on treatment, difficulties accessing health services, long waits and unacceptable health worker attitudes. CONCLUSIONS: With the increasing rates of tuberculosis in South Africa, strenuous measures are needed to implement a good control programme that will increase the cure rate of tuberculosis patients. The results of this study suggest the need for health workers to learn about local beliefs that may influence presentation and adherence, and for traditional and western health workers to collaborate.

Adolescent↗
PubMed2005

"Other patients are really in need of medical attention"--the quality of health services for rape survivors in South Africa.

OBJECTIVE: To investigate in the South African public health sector where the best services for rape survivors were provided, who provided them, what the providers' attitudes were towards women who had been raped and whether there were problems in delivering care for rape survivors. METHODS: A cross-sectional study of facilities was carried out. Two district hospitals, a regional hospital and a tertiary hospital (where available) were randomly sampled in each of the nine provinces in South Africa. At each hospital, senior staff identified two doctors and two nurses who regularly provided care for women who had been raped. These doctors and nurses were interviewed using a questionnaire with both open-ended and closed questions. We interviewed 124 providers in 31 hospitals. A checklist that indicated what facilities were available for rape survivors was also completed for each hospital. FINDINGS: A total of 32.6% of health workers in hospitals did not consider rape to be a serious medical condition. The mean number of rape survivors seen in the previous six months at each hospital was 27.9 (range = 9.3-46.5). A total of 30.3% of providers had received training in caring for rape survivors. More than three-quarters of regional hospitals (76.9%) had a private exam room designated for use in caring for rape survivors. Multiple regression analysis of practitioner factors associated with better quality of clinical care found these to be a practitioner being older than 40 years (parameter estimate = 2.4; 95% confidence interval (CI) = 0.7-5), having cared for a higher number of rape survivors before (parameter estimate = 0.02; 95% CI = 0.001-0.03), working in a facility that had a clinical management protocol for caring for rape survivors (parameter estimate = 2; 95% CI = 0.12-3.94), having worked for less time in the facility (parameter estimate = -0.2; 95% CI = -0.3 to -0.04) and perceiving rape to be a serious medical problem (parameter estimate = 2.8; 95% CI = 1.9-3.8). CONCLUSION: There are many weaknesses in services for rape survivors in South Africa. Our findings suggest that care can be improved by disseminating clinical management guidelines and ensuring that care is provided by motivated providers who are designated to care for survivors.

Adult↗
PubMed2005

HIV/AIDS in South Africa: a review of sexual behavior among adolescents.

South Africa has a fast-growing HIV/AIDS rate, with the highest prevalence among young people (15 to 24 years), especially females. This paper is a comprehensive analytical review of available research concerning the sexual behavior of adolescents in South Africa. It offers insight into HIV infection among adolescents and provides an important base for educational interventions aimed at behavior change and reducing further transmission. The most important conclusion is that, despite the research (however limited) that has been done, there has been no significant change in the rate of infection among adolescents in South Africa. A new generation of behavioral interventions, involving both factual knowledge and life skills to promote behavioral risk reduction, is recommended.

Acquired Immunodeficiency Syndrome↗
PubMed1997

A survey of professional activities of psychiatrists in South Africa.

To obtain information about practicing psychiatrists in South Africa, a questionnaire was mailed in 1993 to all 378 registered psychiatrists, of whom 210 (55.6 percent) responded. After selected data for nonrespondents were obtained, information was available for 357, or 94.4 percent of registered psychiatrists. Of the 261 psychiatrists practicing in South Africa, 147 (56.3 percent) were in full-time private practice. There were 6.4 psychiatrists per million population, with large discrepancies between provinces. Only 7 percent of psychiatrists spent any time working in rural areas, and only 10.8 percent could communicate in one or more African languages. These findings emphasize the magnitude of the challenge of developing a primary mental health care system in postapartheid South Africa.

Confidence Intervals↗
PubMed1999

Fortress South Africa and the deconstruction of apartheid's migration regime.

South Africa's new democratic government inherited a system of cross-border migration management rooted in the abusive practices of the past. Under apartheid, employers such as mining companies and White farmers, were exempted from normal immigration legislation. The result was legislation and practices that are in direct conflict with the new government's commitment to transparency, equality, accountability, and fundamental human rights. The practices permitted by this system have continued after 1994. This paper documents the continuities in international migration policy and practice between the old and new South Africa and highlights the dilemmas which the government faces in transforming inherited policy. The paper critically analyzes the regulatory framework of the bilateral labor agreements and the Aliens Control Act. The paper then highlights policy proposals that contravene the discourse of the fortress and assesses, pessimistically, the likelihood of their implementation before the 1999 elections.

Africa↗
PubMed2000

Middle Stone Age human fossils from Die Kelders Cave 1, Western Cape Province, South Africa.

Die Kelders Cave 1 (DK1) preserves a thick series of Middle Stone Age (MSA) horizons that date to a fairly short temporal interval sometime between about 60 and 80 ka ago. Twenty-seven human fossils, comprising 24 isolated teeth, a mandibular fragment, and two manual middle phalanges derive from seven of the 12 layers. The vast majority are children, and all may have come from sub-adult individuals. The entire assemblage may represent a minimum of ten individuals. As might be expected for teeth of such antiquity, most of the DK1 crowns tend to be large in comparison to recent African homologues. They tend to be smaller than, albeit more similar in size to, the teeth of penecontemporaneous archaic populations from Eurasia. The majority of morphological variants displayed by the DK1 crowns characterize the teeth of recent sub-Saharan Africans, and the DK1 crowns resemble those of recent Africans in a number of traits that have been used to define a sub-Saharan African regional complex. The morphological similarities between the DK1 MSA and recent African teeth, however, do not necessarily signify a close evolutionary relationship between them, because these crowns variants appear to be plesiomorphic.

Africa South of the Sahara↗
PubMed1991

A methodology for resource allocation in health care for South Africa. Part IV. Application of South African Health Resource Allocation formula.

The primary concern of this concluding article in a series is the application of the South African Health Resource Allocation (SAHRA) formula proposed in the previous article (SAMJ 1990; 77: 456-459). Target allocations based on this formula are compared with current budgets to estimate the extent of geographical maldistribution of health care resources. Under the present health service structure, the direction of redistribution of these resources should be from the provinces to 'homelands'. A number of refinements to the crude formula, such as the introduction of a more rational regionalisation policy and accounting for the teaching commitments of academic hospitals, are considered and their effects illustrated. Despite data deficiencies and the wide range of possible technical modifications to SAHRA, the concept of basing resource allocation decisions on an internationally applied formula is worthy of public debate.

Education, Medical↗
PubMed1997

Molecular characterisation of type 1 polioviruses associated with epidemics in South Africa.

The molecular epidemiology of wild-type 1 polioviruses isolated in South Africa during 2 major poliomyelitis epidemics in the 1980s and during the pre- and inter-epidemic periods was investigated by partial sequence analysis across the VP1/2A junction. Poliovirus-specific primers were used to amplify and subsequently sequence the region of interest. Viruses belonging to different genotypes were found to have been responsible for the 2 outbreaks. The Gazankulu outbreak in 1982 was caused by a poliovirus genotype which was unique to South Africa and which circulated endemically throughout much of the country between 1980 and 1985. Two additional genotypes, imported from the Middle East and West Africa, cocirculated endemically with the South African genotype between 1982 and 1985. The 1988 epidemic in Kwazulu-Natal was attributed to an imported genotype apparently introduced into South Africa in 1985 from countries north of the border. This genotype displaced the 3 genotypes previously in circulation and continued to be transmitted within the country until 1989, when the last confirmed cases of poliomyelitis associated with wild-type viruses were documented. All circulating wild-type poliovirus strains appear to have been eliminated from South Africa.

Disease Outbreaks↗
PubMed2002

Incidence and management of acoustic neuromas in South Africa.

OBJECTIVES: To determine the extent to which the various treatment modalities are used in the management of acoustic neuromas treated in South Africa and to estimate the incidence of acoustic neuromas in South Africa. METHODS: A telephonic survey was conducted of all otorhinolaryngologists, neurosurgeons, and radiotherapy centers in South Africa to determine whether they had treated any patients with acoustic neuromas during the calendar year 2000. RESULTS: One hundred and fifteen patients with acoustic neuromas were treated in South Africa during the calendar year 2000, and 8 patients were referred to other countries for treatment. This resulted in an incidence of approximately 0.3 per 100,000 population per year. There was a marked difference in the incidence between the various racial groups: the incidence was at least 1.76 per 100,000 population per year among whites and at least 0.01 per 100,000 population per year among blacks. Of the 115 patients, 78 (68%) were treated surgically and 24 (21%) by stereotactic radiotherapy. Fourteen (12%) patients had newly diagnosed acoustic neuromas that were managed conservatively in the year concerned. The surgical approach used was middle fossa in 8 (7%) patients, retrosigmoid in 61 (53%) patients, and translabyrinthine in 9 (8%) patients. CONCLUSIONS: The majority of acoustic neuromas in South Africa were treated surgically, mainly by a retrosigmoid approach. The incidence of acoustic neuromas in South Africa was approximately 0.3 per 100000 population per year. There were significant racial differences in the incidence.

Black People↗
PubMed2005

The nutrition and health transition in the North West Province of South Africa: a review of the THUSA (Transition and Health during Urbanisation of South Africans) study.

OBJECTIVE: To describe how urbanisation influences the nutrition and health transition in South Africa by using data from the THUSA (Transition and Health during Urbanisation of South Africans) study. DESIGN: The THUSA study was a cross-sectional, comparative, population-based survey. SETTING: The North West Province of South Africa. SUBJECTS: In total, 1854 apparently healthy volunteers, men and women aged 15 years and older, from 37 randomly selected sites. Pregnant and lactating women, those with diagnosed chronic diseases and taking medication, with acute infections or inebriated were excluded but screened for hypertension and diabetes mellitus. Subjects were stratified into five groups representing different levels of urbanisation in rural and urban areas: namely, deep rural, farms, squatter camps, townships and towns/cities. OUTCOME MEASURES AND METHODS: Socio-economic and education profiles, dietary patterns, nutrient intakes, anthropometric and biochemical nutrition status, physical and mental health indicators, and risk factors for non-communicable diseases (NCDs) were measured using questionnaires developed or adapted and validated for this population, as well as appropriate, standardised methods for the biochemical analyses of biological samples. RESULTS: Subjects from the rural groups had lower household incomes, less formal education, were shorter and had lower body mass indices than those in the urban groups. Urban subjects consumed less maize porridge but more fruits, vegetables, animal-derived foods and fats and oils than rural subjects. Comparing women from rural group 1 with the urban group 5, the following shifts in nutrient intakes were observed: % energy from carbohydrates, 67.4 to 57.3; from fats, 23.6 to 31.8; from protein, 11.4 to 13.4 (with an increase in animal protein from 22.2 to 42.6 g day(-1)); dietary fibre, 15.8 to 17.7 g day(-1); calcium, 348 to 512 mg day(-1); iron from 8.4 to 10.4 mg day(-1); vitamin A from 573 to 1246 mug retinol equivalents day(-1); and ascorbic acid from 30 to 83 mg day(-1). Serum total cholesterol, low-density lipoprotein cholesterol and plasma fibrinogen increased significantly across groups; systolic blood pressure >140 mmHg was observed in 10.4-34.8% of subjects in different groups and diabetes mellitus in 0.8-6.0% of subjects. Women in groups 1 to 5 had overweight plus obesity rates of 48, 53, 47, 61 and 61%, showing an increase with urbanisation. Subjects from group 2 (farm dwellers) showed the highest scores of psychopathology and the lowest scores of psychological well-being. The same subjects consistently showed the lowest nutrition status. CONCLUSIONS: Urbanisation of Africans in the North West Province is accompanied by an improvement in micronutrient intakes and status, but also by increases in overweight, obesity and several risk factors for NCDs. It is recommended that intervention programmes to promote nutritional health should aim to improve micronutrient status further without leading to obesity. The role of psychological strengths in preventing the adverse effects of urbanisation on health needs to be examined in more detail.

Adolescent↗
PubMed2004

The South Africa Stress and Health Study: rationale and design.

The South Africa Stress and Health Study (SASH) is a large psychiatric epidemiological survey that is currently underway in South Africa. It is a part of the World Health Organization's World Mental Health (WMH) 2000 initiative and seeks to complete interviews with a nationally representative sample of 5000 adults. The WMH initiative is obtaining population-based data on the prevalence and severity of specific psychiatric disorders, demographic and psychosocial correlates of these diagnoses, and the levels and adequacy of mental health service utilization. SASH is using the fully structured pencil and paper version of the WHO Composite International Diagnostic Interview (CIDI) to assess lifetime and 12-month rates of mental disorders using both the DSM-IV and the ICD-10 diagnostic systems. In addition, the SASH seeks to collect information on the prevalence of exposure to physical and psychological torture in South Africa and to assess the association between such traumas and specific psychiatric disorders. It will also assess a broad range of risk factors and resources that may modify the association between exposure to human rights violations and mental health.

Health Surveys↗