Distribution of hepatitis B virus infection in Namibia.

BACKGROUND: Namibia regards hepatitis B virus (HBV) infection as a public health problem and introduced hepatitis B vaccinations for infants during 2009. However, information on HBV infection in the country remains limited, and effective public health interventions may be compromised in the absence of adequate evidence-based data. Available data from the World Health Organization (WHO) estimate that 15 - 60% of the normal population in many African countries may be positive for one or more of the HBV serological markers. OBJECTIVE: To investigate the distribution of HBV infection in Namibia, using available laboratory data for 2013. METHODS: A cross-sectional descriptive study was conducted using pre-existing electronic laboratory data on HBV infection. The data were retrieved from the central Namibia Institute of Pathology laboratory in Windhoek during January - December 2013. Tests were done on the following three main groups: (i) pregnant women during routine antenatal care (ANC) visits; (ii) patients with HIV/AIDS during antiretroviral therapy clinic visits; and (iii) any other individual suspected of having HBV infection. RESULTS: Of a total of 77 238 hepatitis B surface antigen test results retrieved countrywide, 9 087 (11.8%) were positive. Of the positive results, 246/9 087 (2.7%) were in children aged 0 - 14 years, with the sexes equally affected. HBV infections increased markedly, particularly among females, in the age group 15 - 39 years, reaching a peak in the age group 30 - 34 years. Routine screening of pregnant women for HBV during ANC visits was found to be systematically conducted in only two regions, Ohangwena and Khomas. CONCLUSIONS: This study showed high proportions of positive results in pregnant women, patients with HIV/AIDS and individuals suspected of having HBV infection. The Ministry of Health and Social Services and stakeholders may wish to consider improving the routine and surveillance reporting systems for viral hepatitis and uptake of screening for pregnant women in all regions, and expanding HBV screening to other population groups. Population-based or similar studies are therefore required to determine the HBV prevalence and risk factors. This will assist Namibia in developing appropriate national viral hepatitis strategies as per WHO recommendations.

An assessment of the quality of care given to, and hygiene on patients at a teaching hospital in Namibia.

An assessment was done during 1991 to evaluate the quality of care with regard to mouth hygiene rendered to patients in a teaching hospital in Namibia. The sample was drawn from nine wards. By means of a type of quota sampling, the patients were categorised as dependent, interdependent or independent. The nursing process was used as a framework for the study. From the assessment it became evident that no policies existed with regard to oral hygiene. Planning was not in every case based on assessment, and it seemed that when planning(s) were done, it was not always implemented. Record keeping was the aspect most poorly attended to.

Meanings and expressions of care and caring for elders in urban Namibian families: a transcultural nursing study.

Since Namibia's Independence in 1990, the population of elders--persons 65 years old and older--in urban communities is growing steadily. As such, requests for home health care, health counselling, respite care and residential care for aging members of society are overwhelming nurses and the health care system. This study expands transcultural nursing knowledge by increasing understanding of generic (home-based) patterns of elder care that are practised and lived by urban Namibian families. Guided by Madeleine Leininger's theory of culture care diversity and universality and the ethnonursing research method, emic (insider) meanings and expressions of care and caring for elders in selected urban households have been transposed into five substantive themes. The themes, which depict what carring for elders means to urban families, include: 1 nurturing the health of the family, 2 trusting in the benevolence of life as lived, 3 honouring one's elders, 4 sustaining security and purpose for life amid uncertainty, and 5 living with rapidly changing cultural and social structures. These findings add a voice from the developing world to the evolving body of transcultural nursing knowledge. Synthesis of findings with professional care practices facilitates the creation of community-focussed models for provisioning culturally congruent nursing care to elders and their families in urban Namibia.

An evaluation of the quality of nursing care rendered to patients with intravenous infusions in the Windhoek Hospital Complex.

Patients on intravenous infusions are commonly seen in the Windhoek Hospital Complex. There was concern regarding the type of nursing care these patients received which led to a survey on the quality of care rendered to these patients. The findings showed that care delivered ranged from very poor to good. Some startling information became evident in that legal aspects were often ignored and that basic things such as calculating and charting the daily intake and output, were omitted. Most of these problems can be rectified through in-service education.

The quality of nursing care regarding personal hygiene of patients admitted to a selected hospital in the Kavango region.

The aim of the study was to determine the quality of nursing care regarding personal hygiene of patients admitted to a hospital in the Kavango region of Namibia. The study was prompted by repeated media reports over the radio. Commentators and listeners expressed concern over the seeming lack of adequate hygienic measures, specifically with regard to patient care. To objectively quantify and describe the extent of this problem, a single objective was stated, namely to measure the quality of nursing care with regard to patient hygiene. A descriptive survey design was chosen to explore and describe the problem. A check-list was developed to observe thirty patients (the total population) over a period of one week. The results indicated that certain aspects of hygienic care needed improvement. These aspects (parts) were the care of male patient's beards; perineal care; and mouth care. Other aspects of care were indirectly negatively influenced due to incomplete record keeping. On completion of the study recommendations were made with regard to in-service education, management and research.

Breathing system disconnexions and misconnexions. A review of some common causes and some suggestions for improved safety.

Reports of breathing system disconnexions and misconnexions suggest that such occurrences are now amongst the most frequent causes of accident or near accident during anaesthesia or lung ventilation in which equipment is involved. These reports usually blame the breathing system connectors for failing to make a secure joint but much of the evidence suggests that the choice of an unsuitable or unsatisfactory component or the manner in which it is used may be more likely to be at fault. Several previous articles in Health Equipment Information have drawn attention to these problems. The purpose of this one is to review the various types of connector that are available, to explain how some accidents have occurred, and to mention some developments intended to provide better security.