Effect of adult day care centre attendance on hypertension management.

BACKGROUND:  Hypertension (HT) silently threatens one in three adults, especially older adults, who struggle with blood pressure (BP) control because of limited health access, poor adherence to medication and failure to make lifestyle changes. This increases their risk for heart disease, kidney failure and dementia. Fortunately, adult day care centres (ADCCs) offer hope. These community facilities provide daytime care, including health support services, social activities and exercise. This study investigated the perceived effect of adult daycare centre attendance on BP control and treatment adherence. METHODS:  A mainly descriptive study at MUCPP Community Health Centre (CHC) in Bloemfontein, South Africa, between July 2020 and September 2020, used questionnaires researchers completed during interviews. The researchers approached 372 hypertensive patients of a minimum of 60 years old and at least 2 years since being diagnosed. RESULTS:  Of the 90 who attended ADCCs, 71.1% had controlled hypertension compared to 51.4% of those who did not. While treatment adherence showed no difference, a positive association between ADCC attendance and BP control is evident. CONCLUSION:  The findings suggest a promising link between ADCC attendance and improved BP control in older adults with hypertension. Adult Day Care Centres warrant further exploration as it seems to be an encouraging support intervention for this vulnerable population.Contribution: This study highlights the positive impact ADCCs have on hypertension management in older adults, urging increased physician awareness and patient referrals.

Corrigendum: Diabetes Knowledge, Attitudes, and Practices in adults with type 2 diabetes at primary health care clinics in Kimberley South Africa.

No abstract available.

Psychologists' experiences with telepsychology during the COVID-19 pandemic in South Africa.

Background: During the COVID-19 pandemic, South African psychologists started to use telepsychology to continue providing services. However, diverse factors may influence psychologists' decisions regarding the use of telepsychology. Aim: To investigate South African psychologists' experiences with using telepsychology during the COVID-19 pandemic. Setting: Health Professions Council of South Africa (HPCSA)-registered psychologists practising in South Africa. Methods: A quantitative, cross-sectional study was conducted. Psychologists were invited to complete an online survey on the REDCap platform. Convenience sampling was used for respondent selection (n = 179). The study explored demographic variables, telepsychology use, changes in psychotherapy format, guidelines, ethical considerations, training, socio-economic factors, and individual patient and psychotherapist factors. Descriptive statistics, including categorical variables (frequencies and percentages) and numerical variables (medians and percentiles) were utilised for the data analysis. A bivariate analysis with backward selection was subsequently used, and significant variables were integrated into the logistic regression model. Results: Most respondents (84.8%) used telepsychology, with 72.8% considering it a positive experience. Private psychologists used electronic means for delivering services significantly more than public sector psychologists. The public sector psychologists had more challenges relating to changes in the therapeutic format, additional training requirements and technology access. Conclusion: During the COVID-19 pandemic, psychologists turned to telepsychology as a valuable tool for providing services while navigating the unique challenges it presented. Contribution: This study provides insights into the utility of telepsychology in the South African context during COVID-19. It underscores the experiences, importance of guidelines, and needs regarding training and technology access among psychologists.

Diabetes Knowledge, Attitudes, and Practices in adults with type 2 diabetes at primary health care clinics in Kimberley South Africa.

BACKGROUND:  Diabetes mellitus (DM) is a common non-communicable disease associated with significant morbidity and mortality globally. It poses a huge public health and economic challenge. People with diabetes need to have adequate knowledge, attitudes and practice (KAP) to prevent complications from diabetes. This study aims to evaluate the KAP towards diabetes among type 2 diabetes mellitus (T2DM) patients attending primary healthcare clinics in Kimberley. METHODS:  A cross-sectional analytical, quantitative questionnaire-based study was done using a convenient sampling method in Sol Plaatje Municipality, Kimberley, Northern Cape. RESULTS:  A total of 363 type 2 diabetic patients took part in the study. Most of the participants (62.0%) were females. Most had good knowledge (67.5%), while 64.5% of the participants showed good attitudes towards diabetes. However, only 35.8% of the participants had good practices towards diabetes. There was a significant association between the participant's level of education and (1) knowledge and (2) practice, with p-values of 0.002 and 0.0075, respectively. No significant association was found between the participant's level of education and attitudes towards diabetes (p = 0.2416). CONCLUSION:  This study demonstrated good diabetes-related knowledge and attitudes but inadequate practices among participants. Educational programmes to assist patients with diabetes to improve their practice towards diabetes should be encouraged and implemented.Contribution: This study will help to create awareness of the need for people with diabetes to improve their practices towards diabetes.

Prevalence and trends of advanced HIV disease among antiretroviral therapy-naïve and antiretroviral therapy-experienced patients in South Africa between 2010-2021: a systematic review and meta-analysis.

BACKGROUND: Despite the significant progress made in South Africa in getting millions of individuals living with HIV into care, many patients still present or re-enter care with Advanced HIV Disease (AHD). We aimed to estimate the prevalence of AHD among ART-naive and ART-experienced patients in South Africa using studies published between January 2010 and May 2022. METHODS: We searched for relevant data on PubMed, CINAHL, Scopus and other sources, with a geographical filters limited to South Africa, up to May 31, 2022. Two reviewers conducted all screening, eligibility assessment, data extraction, and critical appraisal. We synthesized the data using the inverse-variance heterogeneity model and Freeman-Tukey transformation. We assessed heterogeneity using the I2 statistic and publication bias using the Egger and Begg's test. RESULTS: We identified 2,496 records, of which 53 met the eligibility criteria, involving 11,545,460 individuals. The pooled prevalence of AHD among ART-naive and ART-experienced patients was 43.45% (95% CI 40.1-46.8%, n = 53 studies) and 58.6% (95% CI 55.7 to 61.5%, n = 2) respectively. The time trend analysis showed a decline of 2% in the prevalence of AHD among ART-naive patients per year. However, given the high heterogeneity between studies, the pooled prevalence should be interpreted with caution. CONCLUSION: Despite HIV's evolution to a chronic disease, our findings show that the burden of AHD remains high among both ART-naive and ART-experienced patients in South Africa. This emphasizes the importance of regular measurement of CD4 cell count as an essential component of HIV care. In addition, providing innovative adherence support and interventions to retain ART patients in effective care is a crucial priority for those on ART.

Factors associated with antiretroviral treatment failure among people living with HIV on antiretroviral therapy in resource-poor settings: a systematic review and metaanalysis.

BACKGROUND: Despite the increase in the number of people accessing antiretroviral therapy (ART), there is limited data regarding treatment failure and its related factors among HIV-positive individuals enrolled in HIV care in resource-poor settings. This review aimed to identify factors associated with antiretroviral treatment failure among individuals living with HIV on ART in resource-poor settings. METHODS: We conducted a comprehensive search on MEDLINE (PubMed), Excerpta Medica Database (EMBASE), Cochrane Central Register of Controlled Trials (CENTRAL), World Health Organization's (WHO's) library database, and Latin American and Caribbean Health Sciences Literature (LILACS). We included observational studies (cohort, case-control, and cross-sectional studies) where adolescents and adults living with HIV were on antiretroviral treatment regardless of the ART regimen. The primary outcomes of interest were immunological, virological, and clinical failure. Some of the secondary outcomes were mm3 opportunistic infections, WHO clinical stage, and socio-demographic factors. We screened titles, abstracts, and the full texts of relevant articles in duplicate. Disagreements were resolved by consensus. We analyzed the data by doing a meta-analysis to pool the results for each outcome of interest. RESULTS: Antiretroviral failure was nearly 6 times higher among patients who had poor adherence to treatment as compared to patients with a good treatment adherence (OR = 5.90, 95% CI 3.50, 9.94, moderate strength of evidence). The likelihood of the treatment failure was almost 5 times higher among patients with CD4 < 200 cells/mm3 compared to those with CD4 ≥ 200 CD4 cells/mm3 (OR = 4.82, 95% CI 2.44, 9.52, low strength of evidence). This result shows that poor adherence and CD4 count below < 200 cells/mm3 are significantly associated with treatment failure among HIV-positive patients on ART in a resource-limited setting. CONCLUSION: This review highlights that low CD4 counts and poor adherence to ART were associated to ART treatment failure. There is a need for healthcare workers and HIV program implementers to focus on patients who have these characteristics in order to prevent ART treatment failure. SYSTEMATIC REVIEW REGISTRATION: The systematic review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration number: 2019 CRD42019136538.

Analytical methods used in estimating the prevalence of HIV/AIDS from demographic and cross-sectional surveys with missing data: a systematic review.

BACKGROUND: Sero- prevalence studies often have a problem of missing data. Few studies report the proportion of missing data and even fewer describe the methods used to adjust the results for missing data. The objective of this review was to determine the analytical methods used for analysis in HIV surveys with missing data. METHODS: We searched for population, demographic and cross-sectional surveys of HIV published from January 2000 to April 2018 in Pub Med/Medline, Web of Science core collection, Latin American and Caribbean Sciences Literature, Africa-Wide Information and Scopus, and by reviewing references of included articles. All potential abstracts were imported into Covidence and abstracts screened by two independent reviewers using pre-specified criteria. Disagreements were resolved through discussion. A piloted data extraction tool was used to extract data and assess the risk of bias of the eligible studies. Data were analysed through a quantitative approach; variables were presented and summarised using figures and tables. RESULTS: A total of 3426 citations where identified, 194 duplicates removed, 3232 screened and 69 full articles were obtained. Twenty-four studies were included. The response rate for an HIV test of the included studies ranged from 32 to 96% with the major reason for the missing data being refusal to consent for an HIV test. Complete case analysis was the primary method of analysis used, multiple imputations 11(46%) was the most advanced method used, followed by the Heckman's selection model 9(38%). Single Imputation and Instrumental variables method were used in only two studies each, with 13(54%) other different methods used in several studies. Forty-two percent of the studies applied more than two methods in the analysis, with a maximum of 4 methods per study. Only 6(25%) studies conducted a sensitivity analysis, while 11(46%) studies had a significant change of estimates after adjusting for missing data. CONCLUSION: Missing data in survey studies is still a problem in disease estimation. Our review outlined a number of methods that can be used to adjust for missing data on HIV studies; however, more information and awareness are needed to allow informed choices on which method to be applied for the estimates to be more reliable and representative.