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PubMed2000

Knowledge, self-efficacy and behavioural intent towards AIDS prevention behaviours among culturally diverse secondary school pupils in South Africa.

OBJECTIVE: To investigate knowledge, self-efficacy, and behavioural intent towards AIDS prevention behaviours among culturally diverse secondary school pupils in South Africa. DESIGN: Randomised study. SETTING: Three urban secondary schools in Pietersburg, South Africa. PARTICIPANTS: Three hundred and sixty six Grade 11 secondary school pupils, comprising 150 (41%) males, and 216 (59%) females, aged 17 to 24 years (mean age 19.3 years, SD=2.6). The three cultural groups were 142 Blacks, 112 Whites and 112 Asians. MAIN OUTCOME MEASURES: The questionnaire included items on socio-economic and family background, knowledge about HIV, perceived self-efficacy and behavioural intent regarding AIDS preventive behaviours. RESULTS: Overall, the participants showed an adequate level of AIDS knowledge. However, there was considerable inaccuracy regarding AIDS transmission myths or how AIDS cannot be transmitted. The different cultural groups generally felt most self-efficacious regarding how to protect themselves from becoming infected (75-90%) and least self-efficacious on knowing where to go for information on AIDS (72-74%). Generally, participants reported a high behavioural intent. The Whites stand second in knowledge and more or less second in self-efficacy and behaviour intent. The Blacks stand third in knowledge and more or less second in self-efficacy and behaviour intent. CONCLUSION: Culturally diverse knowledge, self-efficacy and behavioural intent towards AIDS prevention was found among White, Black and Asian pupils, which should inform a culturally sensitive and appropriate AIDS health promotion programme in South Africa.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Dental caries in six, 12 and 15 year old Venda children in South Africa.

BACKGROUND: Oral diseases is still a major problem in most developing countries. Within the Republic of South Africa, there remains areas where few or no studies have been done on the oral health status. The emerging district health system with decentralisation of health services to address past inequity in health care in South Africa also provides compelling case for data collection at regional levels. OBJECTIVES: To assess the prevalence and severity of dental caries of school children; determine the caries patterns of the study population and to provide useful data for the planning of oral health services in this region. DESIGN: Descriptive analytical study. SETTING: School children in the Donald Fraser Health District, Venda in the Northern province, Republic of South Africa. SUBJECTS/METHODS: A total of 519 school children in the age groups 6, 12 and 15 years were examined by a calibrated examiner for dental caries using WHO diagnostic criteria. Both the schools, which were divided into rural and peri-urban locations and the children that participated were randomly selected. RESULTS: A mean dmft(sd) of 2.68(3.29) in six year olds and a mean DMFT (sd) scores of 0.61(1.50) and 1.26 (2.18) were recorded in the 12 and 15 year olds respectively. In the six year olds the upper anterior teeth showed highest susceptibility to caries, clearly indicating that black children suffer from early infant caries. At ages of 12 and 15 the mandibular molars were the teeth most affected. The decayed component constituted the main part of the dmft and DMFT scores. Ninety-nine percent of these lesions were untreated and the restorative care was almost nil. CONCLUSION: An important finding was the doubling of the mean DMFT from the 12-year-olds to 15-year olds and the caries levels for all age groups was higher than the provincial average. The treatment required were mostly extractions and simple fillings, the majority of which could be managed by dental auxiliaries using the Atraumatic Restorative Treatment Technique. This study indicates that preventive oral health measures should be implemented on the younger age groups in order to control dental caries.

Adolescent↗
PubMed1976

Intracranial neoplasms in children: a comparison of North America, Europe, Africa, and Asia.

Series of intracranial neoplasms in childrem from four continents (North America, Europe, Africa, and Asia) are presented and their histopathological distributions are compared. Findings include a proportion of craniopharyngiomas in Japan and Africa about double that of other areas, with a relative deficit of medulloblastomas. Pinealomas also occurred approximately three times as often in Japan and Africa as elsewhere. A incidence of ependymomas in India double that of other parts of the world was noted. Astrocytomas were the most frequently occurring neoplasms in all series except the Japanese. Possible interpretations of the differences among the series, as well as proposals for further investigation, are discussed.

Africa↗
PubMed1998

Situation analysis of HIV/AIDS epidemic in sub-Saharan Africa.

At the end of 1997 about twenty one million persons were living with HIV/AIDS in sub-Saharan Africa, representing almost two third of the world's total. Three broadly defined areas, which include countries with severe epidemics and others with epidemics at their intermediate stage, account for almost 90% of all current HIV infections in tropical Africa. According to World Health Organization (WHO), the current data show very high increases in HIV/AIDS incidence as well as serious underreporting of the disease in the last five years. Sub-Saharan Africa has been particularly hard hit by the disease because of a combination of poor social and health education and also because of other endemic sexually transmitted diseases which significantly increase the chance of HIV transmission.

Adolescent↗
PubMed1997

Telehealth in Africa.

This paper deals with the developments of the project "Telehealth in Africa", to establish a link between more European reference Hospital Centers and some African Hospital Centers, connected with Peripheral Units of Assistance, to transmit and receive health diagnostic images, etc. The project has been developed by the European Collaboration Group for Telemedicine in developing countries which was created in collaboration with ITU (International Telecommunication Union). A demonstration of telehealth from Milan (Italy), Toulouse (France), to Abidjan (Ivory Coast, Africa) and Midrand (South Africa) proves that it is possible for a diverse group of intergovernmental organizations, non-governmental organizations and the private sector to work together for the benefit of all participants and, most of all, for developing countries.

Africa↗
PubMed1998

The African monogenean gyrodactylid genus Macrogyrodactylus Malmberg, 1957, and the reporting of three species of the genus of Clarias gariepinus in South Africa.

Three different species of the genus Macrogyrodactylus Malmberg, 1957, collected from the gills and skin of Clarias gariepinus (Burchell, 1822) from the Middle Letaba Dam and Mokgoma-Matlala Dam in South Africa were examined and identified. This is the first record of a species of the genus in South Africa. The three species are M. congolensis (Prudhoe, 1957)--found on the skin, M. clarii Gussev, 1961 and M. karibae Douellou & Chishawa, 1995--found on the gills. The last species is elevated to the status of a species having been described previously as a subspecies of M. congolensis. The present study presents and discusses the value of some of the taxonomic characters which can be used to differentiate the species of the genus. The shape and size of the sclerites of the haptor are found to be the most reliable characters. Only four species of the genus, namely M. polypteri and the three above-named species are regarded to be valid. Three species, namely M. latesi Paperna, 1969, M. anabantii Paperna, 1973 and M. ctenopomii Paperna, 1973 are regarded as species inquirenda. Generic diagnoses, measurements and illustrations of the sclerites of the four valid species are presented and a key for their differentiation is provided. The development of the gyrodactylid population on C. gariepinus during the filling of the Middle Letaba Dam in South Africa is discussed.

Animals↗
PubMedDate not supplied

[On Setaria spp; (Nematoda, , Filarioidea, Setariidae) from the peritoneal cavity of equine spp.: two new sub-species, Setaria equina theilerae from wild Zebra of Africa, and Setaria equina dafaallai from horse and donkey of southern Sahara area (author's transl)].

1) Setaria equina (Abildgaard, 1789) is from the Horse and Donkey of Eurasia (and of America and the coastal stripe of North Africa). 2) Setaria equina theilerae n.sub.sp. is from the Zebra of Africa. 3) Setaria equina defaallai n.sub. sp. is from the Horse and the Donkey of southern Sahara area of the Ethiopean Region of Africa, from the Nile valley till to the western coast. 4) Crossing between S. equina and S. e. theilerae may be possible, as their host spp. does with the resultant bastard offspring experimentally.

Africa↗
PubMed1998

Adolescent pregnancy and reproductive health in Transkei (rural South Africa).

A study of adolescent unmarried pregnancy was conducted in 1994 in the Transkei, Eastern Cape (South Africa). Data included a survey of 2,290 married and unmarried women, ages 15 to 49 years, and qualitative data collected from adolescents, parents and family planning officials. While only 11 percent of women were ever-married by age 19 years, 43 percent have had children. Marriage is late, with 64 percent of women 20-24 years never-married, a marked departure from universal and early marriage regarded as characteristics of most african societies. The recent South African political economy has contributed to the predominance of unmarried child-bearing in South Africa. For more than a century black men were recruited to work in cities, while by law, women and children had to remain in rural areas. This policy promoted a norm of unmarried women (possibly the largest in Africa) and a general acceptance of child-bearing outside marital unions.

Adolescent↗
PubMed1999

Assessing the use of nuclear medicine technology in sub-Saharan Africa: the essential equipment list.

OBJECTIVE: The primary aim of the survey was to determine the core equipment required in a nuclear medicine department in public hospitals in Kenya and South Africa, and evaluate the capital investment requirements. METHODS: Physical site audits of equipment and direct interviews of medical and clinical engineering professionals were performed, as well as examination of tender and purchase documents, maintenance payment receipts, and other relevant documents. Originally, 10 public hospitals were selected: 6 referral and 4 teaching hospitals. The 6 referral hospitals were excluded from the survey due to lack of essential documents and records on equipment. The medical and technical staff from these hospitals were, however, interviewed on equipment usage and technical constraints. Data collection was done on-site and counter-checked against documents provided by the hospital administration. RESULTS: A list of essential equipment for a nuclear medicine department in sub-Saharan Africa was identified. Quotations for equipment were provided by all major equipment suppliers, local and international. CONCLUSION: A nuclear medicine department requires eight essential pieces of equipment to operate in sub-Saharan Africa. Two additional items are desirable but not essential.

Africa South of the Sahara↗
PubMed1999

Universal pattern of RpoB gene mutations among multidrug-resistant isolates of Mycobacterium tuberculosis complex from Africa.

SETTING: Multidrug-resistant tuberculosis (MDR-TB) presents an increasing burden in Southern Africa. Rapid diagnostic tests for drug resistance to rifampicin have been developed based on mutation analysis of the rpoB gene. However, geographic differences of underlying mutations have recently been suggested. OBJECTIVE: Drug-resistant strains of Mycobacterium tuberculosis complex from Africa were analysed for geographic differences in frequency and location of rpoB mutations. DESIGN: A random sample of rifampicin-resistant strains was collected from 87 patients with pulmonary MDR-TB treated in 12 hospitals from six different regions of South Africa. In addition, 18 isolates of M. tuberculosis complex from Namibia, Sierra Leone, and Uganda, including 13 isolates of M. africanum, were analyzed. Point mutations were detected by direct sequence analysis of the rpoB gene. RESULTS: Missense mutations were identified for 91 isolates (87%). Double mutations were present in eight (8%) MDR-TB isolates, two of which carried one mutation outside a previously described diagnostic region. We found no geographic differences regarding the frequency and pattern of single rpoB gene mutations. CONCLUSION: Our results confirm that molecular genetic analysis of rifampicin resistance based on a core region within the rpoB gene is universally applicable to strains of M. tuberculosis complex from different geographic regions.

Africa↗
PubMed1999

Progress toward measles elimination--Southern Africa, 1996-1998.

Despite routine measles vaccination coverage of >70% in southern Africa during the early 1990s, low-level endemic transmission and periodic epidemics of measles continued. Since 1995, six southern African nations (Botswana, Malawi, Namibia, South Africa, Swaziland, and Zimbabwe) have launched measles-elimination initiatives in accordance with the recommendations of the World Health Organization (WHO) African Regional Office (AFR). Strategies include programs to 1) achieve routine vaccination coverage of > or =95% with one dose of measles vaccine administered at age 9 months; 2) implement a one-time national catch-up measles vaccination campaign to interrupt indigenous transmission of measles; 3) implement periodic national follow-up measles campaigns to maintain interruption of measles transmission; and 4) establish case-based measles surveillance with laboratory confirmation. This report presents preliminary data about the progress toward measles elimination in the six southern Africa countries.

Adolescent↗
PubMedDate not supplied

Measures for increased nutrition and utilization of non-conventional food resources during disasters in Africa.

The basic causes of the poor performance of the food and agricultural sector in the different parts of Africa are external, internal, and natural. The general recession in the Continent limits the capacity of the respective countries to import food to supplement inadequate domestic production and supplies. There are a number of nutritious food resources, both cultivated and gathered in the different ecological zones of Africa, whose production and consumption can be increased to ensure adequate food security and a nutritious diet, especially during disasters. These food resources could include: cereals, legumes, fruits, vegetables, fish, and insects. These food resources already are available over wide geographical areas in Africa and are utilized or utilized to a limited extent. Therefore, strategies to increase food supply, eradicate hunger and malnutrition, and keep people alive in times of disasters should have as a priority, the cultivation and consumption of non-conventional food resources in the respective communities and countries.

Africa↗
PubMed1999

[Epidemic typhus in Africa].

Epidemic typhus is caused by a small strictly intracellular virus named Rickettsia prowazekii, a member of the Rickettsial family. It is transmitted to man by the body louse, Pediculus humanus. Although now rare in Western countries, exanthematic typhus remains common in the Southern hemisphere due to poverty, inadequate clothing hygiene, and poor socioeconomic conditions. In Africa, outbreaks have historically occurred in Burundi, Rwanda, southwest Ouganda, and Ethiopia. The largest outbreak of epidemic typhus since the World War II was reported in Burundi where ongoing civil war since October 1993 has forced 10 p. 100 of the population of Burundi to live in cold, promiscuity, and malnutrition of makeshift refugee camps. The purpose of this report based on our two-year experience working with this unfortunate population is to describe the characteristics of this disease in Africa where the epidemic form had become rare until recently. Indeed political unrest as well as numerous civil wars are now epidmiological factors favorizing outbreaks of epidemic typhus at any time. This overview also provides an opportunity to recall epidemiological, bacteriological, and clinical aspects of typhus as well as diagnosis and treatment of the disease in the context of Africa.

Africa↗
PubMedDate not supplied

Current extent of disasters in Africa.

The people oFf Africa are exposed to a wide range of disasters that seriously have aggravated the Continent's economic situation. Economic losses and human sufferings from drought, desertification, locust infestation, infectious diseases, epidemics, and armed conflicts are the dominant disasters that the people in the African countries face, and they have rendered the population utterly vulnerable. Disasters have aggravated Africa's economic situation. The cumulative effect of disasters include loss of property, injury, death, mounting food import bills, health hazards, environmental degradation, backward economic development, displaced people, refugees, and nutritional deficiency. Today, 175 million Africans out of a total population of 744 million people (23.5%) are suffering from chronic hunger; this is an increase of 50% from 25 years ago. In many African countries, up to half of the population suffers from absolute poverty. It is projected that Africa will be the only Continent to continue with the current level of poverty for another decade.

Africa↗
PubMed1975

Problems associated with the control of rodents in tropical Africa.

As elsewhere in the world, rodents are responsible for very considerable economic losses in tropical Africa because of their depredations on both growing crops and stored food products. Unfortunately, few accurate data are available on the extent of these losses but there is evidence that they are considerable. The public health importance of rodents, both as reservoirs and vectors of disease in tropical Africa, is also great; plague, leptospirosis, murine typhus, and Lassa fever are among the diseases associated with rodent hosts. Scientifically based rodent control programmes have been carried out in very few areas of Africa and there is urgent need for studies and demonstrations on rodent control in both urban and rural areas. The problems likely to be encountered are reviewed and methods of control proposed.

Africa↗
PubMed1999

Early communication intervention within a community-based intervention model in South Africa.

Infants and toddlers with special needs within the developing context in South Africa are not currently receiving adequate early communication intervention services. The development of a model for service delivery to this population is imperative for the successful implementation of early communication intervention in the developing context in South Africa. The basic model of early intervention service delivery provides a theoretical basis for early intervention service delivery but has certain limitations when applied to the developing context in South Africa. Community-based intervention is proposed as an avenue for the delivery of health care services within primary health care although constraints in the application of community-based intervention exist. An integrated model of early communication intervention service delivery within community-based intervention is proposed and illustrated by presenting a case example.

Child, Preschool↗
PubMed2000

Ethics in the practice of psychiatry in South Africa.

OBJECTIVE: To determine attitudes with regard to ethics in the practice of psychiatry in South Africa. DESIGN: Cross-sectional survey. METHOD: The study utilised clinical vignettes, with gender and race of the patient as potential modifying variables in diagnosis and management. Open-ended questions pertaining to potential abuses were included. SETTING AND SUBJECTS: Questionnaires were mailed to all practising psychiatrists in South Africa in 1993 and 1994. OUTCOME MEASURES: Responses to questionnaire. RESULTS: A 40% response rate was obtained (N = 73). Patient race and gender did not influence diagnosis or have a marked impact on the prescription of treatment. Pressure from the patient's family on the psychiatrist did alter case management, as did the psychiatrist's age and gender in some instances. Racial discrimination, sexual misconduct and economic abuses were the most frequently cited areas of observed abuse. CONCLUSION: The development of an ethical framework for the practice of psychiatry in South Africa would appear to be of critical importance.

Adolescent↗
PubMedDate not supplied

[Preventing the transmission of HIV-1 from mother to child in Africa in the year 2000].

African women of childbearing age are particularly vulnerable to HIV infection, and this has led to an increase in the number of pediatric HIV infections reported due to the risk of mother-to-child transmission (MTCT) of HIV during pregnancy, delivery and breastfeeding. Various approaches to preventing MTCT have been, or are being, evaluated in developing countries, especially in Africa. New data from these trials are becoming available and have implications for population-based intervention programs that require urgent consideration. We performed a critical review of 18 randomized trials and other relevant studies from developing and industrialized countries, to assess public health perspectives and to identify new research issues. Most African results relate to trials of antiretroviral drugs (ARVs) given to mothers during the last month of pregnancy, and for up to one week after delivery, and to the neonate during the first week of life, or simpler and shorter regimens. They indicate that zidovudine treatment, with or without lamivudine, and nevirapine treatment given alone, reduce transmission during the first six months of life by 30 % to 50%. Preliminary results suggest that zidovudine treatment is effective in the long term. One randomized study showed that the replacement of breast feeding with breast milk substitutes was effective at reducing the overall risk of MTCT. Antiseptic disinfection and micronutrient supplementation have been shown to reduce maternal and infant mortality and morbidity, but not the MTCT of HIV. Voluntary, confidential HIV counseling and testing for pregnant women, a short course of peripartum ARVs and alternatives to breast feeding such as early weaning and breast milk substitutes from birth, are currently the best means of reducing the MTCT of HIV in Africa. Pilot programs based on these findings are currently being implemented in several African countries. Prevention of the MTCT of HIV should also be considered as part of the wider management of maternal and infant health during prenatal, delivery and postnatal care. Several complementary issues require further investigation. Some results, such as the long-term efficacy of a short course of ARVs once the mother has finished breast feeding, and the long-term safety of these treatments, require confirmation. Further studies are required into the prevention of postnatal transmission, particularly in light of the unknown consequences of different feeding options and the possibility of post-perinatal prophylaxis with ARVs. The reduction of MTCT of HIV in Africa is a true challenge in efforts to control the HIV pandemic, but recent progress in the identification of effective treatments provides some hope. Large-scale implementation of these new treatments is required, and should provide practical information and perhaps identify more potent, and possibly cheaper, strategies.

Acquired Immunodeficiency Syndrome↗