Health services satisfaction and medical exclusion among migrant youths in Gauteng Province of South Africa: A cross-sectional analysis of the GCRO survey (2017−2018)
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ABSTRACT:
SUBMITTER: Akokuwebe M
PROVIDER: S-EPMC10686501 | biostudies-literature | 2023 Jan
REPOSITORIES: biostudies-literature
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Project description:In addition to increasing access to fresh and affordable produce, home gardening enhances food security. This notwithstanding, there is no evidence of studies that have investigated factors correlated with home gardening in Gauteng Province (GP), South Africa. The present study investigated home gardening across the GP. Retrospective data of residents of GP (n = 30002) collected by the Gauteng City Region Observatory were used. A binary logistic regression was employed to determine factors correlated with home gardening. Overall participation in home gardening was low (12.37%). If a respondent was a resident of the poorest areas, resided in a house received under the Rural Development Programme, had a borehole/well as the main source of water, belonged to a social club, received a social grant, was >65 years, and rated his/her health as poor, then they were more likely to participate in home gardening. Factors that were negatively correlated with home gardening included if the respondent rented from private individuals and if the respondent's health status prevented him/her from doing daily work. The low participation levels in home gardening observed suggest the failure of the current policies geared at fostering home gardening in the province. Policy makers and relevant authorities should target identified groups to improve participation in home gardening.
| S-EPMC7967462 | biostudies-literature
Project description:BackgroundUniversal health coverage (UHC) for all people, regardless of citizenship, is a global priority. Health care providers are central to the achievement of UHC, and their attitudes and behaviour could either advance or impede UHC for migrants. Using a social exclusion conceptual framework, this study examined the perspectives of health care providers on delivering health services to migrants in public health facilities in Gauteng Province, South Africa.MethodsWe used stratified, random sampling to select 13 public health facilities. All health care providers working in ambulatory care were invited to complete a self-administered questionnaire. In addition to socio-demographic information, the questionnaire asked health care providers if they had witnessed discrimination against migrants at work, and measured their perspectives on social exclusionary views and practices. Multiple regression analysis was used to identify predictors of more exclusionary perspectives for each item.Results277 of 308 health care providers participated in the study-a response rate of 90%. The participants were predominantly female (77.6%) and nurses (51.9%), and had worked for an average of 6.8 years in their facilities. 19.2% of health care providers reported that they had witnessed discrimination against migrants, while 20.0% reported differential treatment of migrant patients. Exclusionary perspectives varied across the different items, and for different provider groups. Enrolled nurses and nursing assistants were significantly more exclusionary on a number of items, while the opposite was found for providers born outside South Africa. For some questions, female providers held more exclusionary perspectives and this was also the case for providers from higher levels of care.ConclusionHealth care providers are critical to inclusive UHC. Social exclusionary views or practices must be addressed through enabling health policies; training in culture-sensitivity, ethics and human rights; and advocacy to ensure that health care providers uphold their professional obligations to all patients.
| S-EPMC7769451 | biostudies-literature
Project description:Invasive Rattus species are carriers of haemotropic Mycoplasmas (haemoplasmas) globally, but data from Africa are lacking. Using a PCR-sequencing approach, we assessed haemoplasma prevalence and diversity in kidney and buccal swabs collected from three invasive Rattus species (Rattus rattus, R. norvegicus and R. tanezumi) in Gauteng Province, South Africa. Whilst the overall sequence-confirmed haemoplasma prevalence was 38.4%, infection rates in R. rattus (58.3%) were significantly higher (χ2 = 12.96; df = 2; n = 99 p < 0.05) than for R. tanezumi (14.3%). Differences between host sex (χ2 = 3.59 × 10−31; df = 1; n = 99; p = 1.00) and age (χ2 = 4.28; df = 2; n = 99; p = 0.12) were not significant. Whilst buccal (1.01%) and ectoparasite positivity (2.13%) were low, these results suggest that multiple transmission routes are possible. Three phylogenetically distinct lineages, consistent with global rat-associated strains described to date, were detected, namely, ‘Candidatus Mycoplasma haemomuris subsp. Ratti’, and two Rattus-specific haemoplasmas that are yet to be formally described. These results expand the known distribution of invasive rat-associated haemoplasmas and highlight the potential for pathogen co-invasion of new territories together with invading rodent hosts.
| S-EPMC9413481 | biostudies-literature
Project description:We conducted an observational retrospective study on patients hospitalized with COVID-19, during March 05, 2020, to October 28, 2021, and developed an agent-based model to evaluate effectiveness of recommended healthcare resources (hospital beds and ventilators) management strategies during the COVID-19 pandemic in Gauteng, South Africa. We measured the effectiveness of these strategies by calculating the number of deaths prevented by implementing them. We observed differ ences between the epidemic waves. The length of hospital stay (LOS) during the third wave was lower than the first two waves. The median of the LOS was 6.73 days, 6.63 days and 6.78 days for the first, second and third wave, respectively. A combination of public and private sector provided hospital care to COVID-19 patients requiring ward and Intensive Care Units (ICU) beds. The private sector provided 88.4% of High care (HC)/ICU beds and 49.4% of ward beds, 73.9% and 51.4%, 71.8% and 58.3% during the first, second and third wave, respectively. Our simulation results showed that with a high maximum capacity, i.e., 10,000 general and isolation ward beds, 4,000 high care and ICU beds and 1,200 ventilators, increasing the resource capacity allocated to COVID- 19 patients by 25% was enough to maintain bed availability throughout the epidemic waves. With a medium resource capacity (8,500 general and isolation ward beds, 3,000 high care and ICU beds and 1,000 ventilators) a combination of resource management strategies and their timing and criteria were very effective in maintaining bed availability and therefore preventing excess deaths. With a low number of maximum available resources (7,000 general and isolation ward beds, 2,000 high care and ICU beds and 800 ventilators) and a severe epidemic wave, these strategies were effective in maintaining the bed availability and minimizing the number of excess deaths throughout the epidemic wave.
| S-EPMC10022393 | biostudies-literature
Project description:Pseudorabies (PR) is a serious disease affecting the pig industry in China, and it is very important to understand the epidemiology of pseudorabies virus (PRV). In the present study, 693 clinical samples were collected from Bartha-K61 vaccinated pigs with symptoms of suspected PRV infection between January 2017 and December 2018. All cases were referred for full clinical autopsy with detailed examination of histopathological examination, virus isolation and genetic evolution analysis of the PRV glycoprotein E (gE) gene. In addition, PRV gE antibodies in 3,449 serum samples were detected by the enzyme-linked immunosorbent assay (ELISA). The clinical data revealed that abortion and stillbirth are the most frequent appearances in pregnant sows of those cases. Histopathological examination exhibited a variety of pathological lesions, such as lobar pneumonia, hepatitis, lymphadenitis, nephritis, and typical nonsuppurative encephalitis. A total of 248 cases tested positive for the PRV gE gene. 11 PRV variants were isolated and confirmed by gE gene sequencing and phylogenetic analysis. These strains had 97.1%-100.0% nucleotide homology with the PRV reference strains. Notably, the isolated strains were highly homologous and clustered in the same branch as HSD-1/2019, which caused human acute encephalitis. Serological tests showed that the positive rate of PRV gE antibody in the 3449 serum samples collected from the Hebei Province was 46.27%. In conclusion, PRV variant strains Are high prevalence in the Hebei Province, which not only causes huge economic losses to the breeding industry but also potentially poses a threat to public health.
| S-EPMC9263846 | biostudies-literature
Project description:BackgroundHousehold air pollution continues to be a major public health hazard due to the continued use of household fuel sources. Globally, approximately 4 million people die prematurely each year due to exposure to household air pollution sources. Children are more susceptible to health effects associated with air pollution because their immune systems and lungs are not fully developed.ObjectiveThe objective of the study was to investigate the association between household fuel use and current severe asthma symptoms among preschool children in Gauteng province, South Africa.MethodsThis was a cross-sectional study conducted in the City of Tshwane Metropolitan Municipality in Gauteng province, South Africa. A total of 1844 parents and guardians of preschool children completed the modified International Study of Asthma and Allergies in Childhood questionnaire. However, a total of four questionnaires were discarded due to incorrect completion. Therefore, a total of 1840 questionnaires were included in the data analysis. Data were analysed using multiple logistic regression analysis.ResultsThe prevalence of current severe asthma symptoms was 15.4%. The use of gas for cooking or heating significantly increased the likelihood of current severe asthma symptoms among preschool children (OR=3.20;95% CI 2.08 to 4.91; p<0.001). The use of open fire sources (paraffin, wood or coal) increased the likelihood of severe asthma symptoms among preschool children by 87% (95% CI 0.98 to 3.55; p=0.057).ConclusionThe study observed that using gas and open fire sources for cooking or heating was associated with current severe asthma symptoms among preschool children in Gauteng, South Africa. Household air quality regulations should be developed to mitigate child exposure to household air pollution in the study setting.
| S-EPMC11816085 | biostudies-literature
Project description:BackgroundLimitations in laboratory testing capacity undermine the ability to quantify the overall burden of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection.MethodsWe undertook a population-based serosurvey for SARS-CoV-2 infection in 26 subdistricts, Gauteng Province (population 15.9 million), South Africa, to estimate SARS-CoV-2 infection, infection fatality rate (IFR) triangulating seroprevalence, recorded COVID-19 deaths and excess-mortality data. We employed three-stage random household sampling with a selection probability proportional to the subdistrict size, stratifying the subdistrict census-sampling frame by housing type and then selecting households from selected clusters. The survey started on 4 November 2020, 8 weeks after the end of the first wave (SARS-CoV-2 nucleic acid amplification test positivity had declined to <10% for the first wave) and coincided with the peak of the second wave. The last sampling was performed on 22 January 2021, which was 9 weeks after the SARS-CoV-2 resurgence. Serum SARS-CoV-2 receptor-binding domain (RBD) immunoglobulin-G (IgG) was measured using a quantitative assay on the Luminex platform.ResultsFrom 6332 individuals in 3453 households, the overall RBD IgG seroprevalence was 19.1% [95% confidence interval (CI): 18.1-20.1%] and similar in children and adults. The seroprevalence varied from 5.5% to 43.2% across subdistricts. Conservatively, there were 2 897 120 (95% CI: 2 743 907-3 056 866) SARS-CoV-2 infections, yielding an infection rate of 19 090 per 100 000 until 9 January 2021, when 330 336 COVID-19 cases were recorded. The estimated IFR using recorded COVID-19 deaths (n = 8198) was 0.28% (95% CI: 0.27-0.30) and 0.67% (95% CI: 0.64-0.71) assuming 90% of modelled natural excess deaths were due to COVID-19 (n = 21 582). Notably, 53.8% (65/122) of individuals with previous self-reported confirmed SARS-CoV-2 infection were RBD IgG seronegative.ConclusionsThe calculated number of SARS-CoV-2 infections was 7.8-fold greater than the recorded COVID-19 cases. The calculated SARS-CoV-2 IFR varied 2.39-fold when calculated using reported COVID-19 deaths (0.28%) compared with excess-mortality-derived COVID-19-attributable deaths (0.67%). Waning RBD IgG may have inadvertently underestimated the number of SARS-CoV-2 infections and conversely overestimated the mortality risk. Epidemic preparedness and response planning for future COVID-19 waves will need to consider the true magnitude of infections, paying close attention to excess-mortality trends rather than absolute reported COVID-19 deaths.
| S-EPMC8689871 | biostudies-literature
Project description:BackgroundHealth care waste management is a challenge due to the composition of the waste generated within a health care facility, of which 85% is domestic waste, and at least 15% is hazardous waste or health care risk waste (has been in contact with blood, body fluids or tissues from humans and could cause disease). In this study, we evaluated the status quo of health care waste management plans (HCWMPs) and practices in public health care facilities in Gauteng Province, South Africa.MethodsA situational analysis was employed in health care facilities (HCFs) that generated more than 20 kg (N = 42) of health care risk waste (HCRW) per day. Data was collected from officials responsible for the management of health care waste using a self-administered questionnaire whilst Chief Executive Officers/ managers of the HFCs were interviewed.ResultsThe results showed that most (79.0%) of the health care waste officers (HCWOs) as well as management (84.6%) agreed to have HCWMPs in place. The majority (76.9%) of the HCFs have a dedicated person appointed to manage health care waste with the majority (67%) being environmental health practitioners. According to management, only 30.8% have formally appointed an integrated HCW committee. Only 11.7% of the HCWOs are guided by the Occupational Health and Safety Act to develop their HCWMPs with only 20.5% with health care waste minimisation strategies in place.ConclusionThe study concluded that there is limited integration of HCWMPs as inadequate health and safety aspects, environmental pollution as well as community participation was reported. The novelty of the study is to contribute to a body of knowledge, information on the establishment of an effective health care waste management system in public health care facilities and for decision-making purposes.
| S-EPMC9901131 | biostudies-literature
Project description:ObjectiveThis study aimed at evaluating diabetic control and compliance with testing guidelines, across healthcare facilities of Gauteng Province, South Africa, as well as factors associated with time to achieve control. South Africa's estimated total unmet need for care for patients with type 2 diabetes mellitus is 80%.Research design, methods and findingsThe data of 511 781 patients were longitudinally evaluated. Results were reported by year, age category, race, sex, facility and test types. HbA1C of ≤7% was reported as normal, >7 - ≤9% as poor control and >9% as very poor control. The chi-squared test was used to assess the association between a first-ever HbA1C status and variables listed above. The Kaplan-Meier analysis was used to assess probability of attaining control among those who started with out-of-control HbA1C. The extended Cox regression model assessed the association between time to attaining HbA1C control from date of treatment initiation and several covariates. We reported hazard ratios, 95% confidence intervals and p-values. Data is reported for 511 781 patients with 705 597 laboratory results. Poorly controlled patients constituted 51.5%, with 29.6% classified as very poor control. Most poorly controlled patients had only one test over the entire study period. Amongst those who started with poor control status and had at least two follow-up measurements, the likelihood of achieving good control was higher in males (adjusted Hazard Ratio (aHR) = 1.16; 95% CI:1.12-1.20; p<0.001) and in those attending care at hospitals (aHR = 1.99; 95% CI:1.92-2.06; p<0.001).ConclusionThis study highlights poor adherence to guidelines for diabetes monitoring.
| S-EPMC10431606 | biostudies-literature
Project description:River water quality is an important health issue as the water is utilised for drinking, domestic and agricultural use in developing countries. This study aimed to investigate the effect water from a major city has on the water quality of the Jukskei River that daylights in Johannesburg, South Africa. The river water samples were analysed for physio-chemical properties, microbiology, antibiotic resistance of bacterial isolates, genetic markers, and potentially toxic metals. Data analysis revealed increased electrical conductivity, total dissolved solids, and turbidity since 2010. Total Coliform and Escherichia coli detected were above the South African water quality guidelines for domestic, recreational, and irrigation purposes. Additionally, sodium, zinc, nickel, lithium, and lead exceeded the guidelines in domestic, recreational, and irrigation water. Pathogenic strains of E. coli (aEPEC, EHEC, EIEC, and EAEC) were isolated from the water. Various other potentially pathogenic organisms that have been implicated as causes of gastro-intestinal, and a wide range of other diseases, were also detected and demonstrated multiple levels of resistance to antibiotics tested. The results show that the river water is a potential health threat to downstream users. These results will feed into the environmental management action plan for Water for the Future (NGO group).
| S-EPMC8392637 | biostudies-literature