Knowledge, attitudes and practices towards lung cancer among adults in KwaZulu-Natal, South Africa: a cross-sectional survey.

Background: Lung cancer remains the number one cause of cancer mortality estimated at 1.8 million deaths. There are limited studies in resource poor countries regarding knowledge, attitudes and practices towards lung cancer. Objective: This study aimed to describe the knowledge, attitudes and practices regarding lung cancer in selected communities in KwaZulu- Natal, South Africa. Methods: An observational, analytic cross-sectional study design was conducted using a standardized questionnaire. A stratified random cluster sampling method was applied across five communities. A regression model was developed to identify the predictors of the level of knowledge. Results: About 59.9% (95% CI 52.0-67.3) of the participants reported to have heard of lung cancer. The mean knowledge score was 41.8% (95% CI 35.7-47.9%). Coughing blood was the most recognized symptom (61.0%, 95% CI 52.1-69.1). About 17% (95% CI 14.7-21.5) of participants reported to be smokers. Many respondents reported that they would go to a health centre or clinic in case they were coughing blood (72.4%, 95% CI 93.9-79.5). Less than 10% (95% CI 3.9-8.1) of participants was screened for lung cancer at the time. Gender, history of working in the chemicals industry, screening for lung cancer, and time taken to seek health care when sick were significant predictors of lung cancer knowledge. Conclusions: Public health interventions should be explored to increase the levels of community awareness regarding lung cancer, particularly focusing on the importance of screening, early diagnosis and treatment. Keywords: Lung cancer, community awareness, screening, prevention.

Reasons for inconsistent condom use by rural South African high school students.

AIM: To describe the condom use practices of high school students, compare the beliefs of students who used condoms with those who did not, investigate gender differences in condom use and identify factors that prevent condom use. METHOD: Cross sectional descriptive study of sexually active grade 10 students at 28 rural high schools who completed a self-reporting structured questionnaire. RESULTS: Of n = 353 students, mean age 17.50 y (SD 1.40), n = 249 (70.5%) males and n = 104 (29.5%) females (p < 0.005), n = 136 (38.5%) had used a condom at last sex. Students who used condoms differed from non-condom users in their beliefs that use of condoms did not imply lack of trust (p = 0.03), supported girls' requesting that their partners use condoms (p = 0.002), perceived greater social support (p < 0.005), and had more self-efficacy (p < 0.005). In the model, condom use at last sex was significantly associated with males (p = 0.03), age at first sex (p = 0.02), knowing a person infected with HIV/AIDS (p = 0.03), and condom use self-efficacy (p = 0.001). CONCLUSION: The low rate of condom use amongst these students during the AIDS epidemic is influenced by students' condom use self-efficacy, emphasizing the need for skills' training. The increasing mortality due to HIV/AIDS may be a cue that encourages condom use.

Perceptions and Attitudes of Secondary School Students in Kwazulu-Natal towards Virginity Testing

This study describes the prevalence of virginity testing (VT) amongst rural secondary school students in KwaZulu- Natal (KZN); compares the attitudes of students of both sexes to VT; the differences in attitudes between girls who would/would not undergo such testing; and explores the relationship between risky sexual behaviour and girls who underwent virginity testing. A cross sectional descriptive study was undertaken with stratified random sampling of 10 secondary schools in Ugu District; KZN. Of 846 isiZulu-speaking students whose mean age was 16.1 years (SD 2.4); 492 (58.2) were girls; of whom 286 (58.1) had undergone VT and; in total 347 (70.5 ) girls supported VT.Girls whose mothers had less formal education were more likely to have participated in VT (P-0.03) with fewer older girls participating (P=0.0003). More girls than boys considered VT to protect against sexually transmitted infections (STIs) (P=0.02); and to be empowering (P0.005); but VT received support from both sexes as a traditional cultural practice. Participation in VT failed to prevent sexual intercourse and sexually transmitted diseases or to improve rates of condom use amongst those who were sexually active. South Africa's Bill of Rights supports gender equity. At community level VT has support despite its conflicting relationship with human rights; and questionable impact on preventing HIV/AIDS

Understanding high school students' risk behaviors to help reduce the HIV/AIDS epidemic in KwaZulu-Natal, South Africa.

Of 901 rural learners (X age 16.1, SD = 2.4) at 10 randomly selected high schools in KwaZulu-Natal, South Africa, those living with a parent were less likely to drink alcohol (P < 0.0001) or use drugs (P = 0.006). Thirty percent (95% CI 26.9, 33.1) were sexually active, and 53.1% used a condom in the past 30 days. The odds of males being sexually active was 7.27 the likelihood of females (95% CI 5.2, 10.1). Only one-third of male respondents always used condoms. Of sexually active respondents, 46.5% had experienced coercive sex. More males (14.1%) than females (3.6%) smoked cigarettes (P < 0.0001). The odds of males drinking alcohol was 4.5 times that of females (P < 0.0001). Smoking, (OR 2.42, 95% CI 1.32, 4.44) and drinking, (OR 2.67, 95% CI 1.71, 4.19) among learners increased the likelihood of sexual activity. With youth at increasing risk of HIV/AIDS in KwaZulu-Natal, South Africa, interventions to reduce learners' risk behaviors are required.

An epidemiological perspective of substance use among high school pupils in rural KwaZulu-Natal.

OBJECTIVES: To investigate prevalence and the factors influencing substance use among rural high school pupils in KwaZulu-Natal in order to develop and implement intervention programmes. DESIGN: Cross-sectional study. SETTING: Twenty-eight high schools in southern KwaZulu-Natal. SUBJECTS: One thousand three hundred and eighteen grade 10 pupils. OUTCOME MEASURES: An anonymous self-reporting questionnaire was used to investigate the use of alcohol, tobacco (cigarettes), cannabis and solvents. RESULTS: Of the male scholars, 52.9% (95% confidence interval (CI): 45.4-60.3) reported ever using alcohol, 16.9% (CI: 11.5-24.0) reported using cannabis, and 13.1% (CI: 7.2-22.5) had smoked more than one cigarette daily. Among male pupils 45.5% (CI: 38.6-52.6) had inhaled benzine and 34.6% (CI: 28.0-41.8), thinners; 7.4% (CI: 3.4-15.2) had used cocaine and 4.1% (CI: 1.0-10.6), crack. Female pupils reported significantly less use of alcohol (25.5%, CI: 17.6-35.3), cannabis (2.3%, CI: 1.3-4.1), cigarettes (more than one daily) (2.0%, CI: 1.0-4.1), and inhalation of benzine (18.8%, CI: 13.8-25.2) and thinners (10.8%, CI: 7.2-16). Logistical regression indicated that the odds of smoking cigarettes increased significantly (p < 0.0005) with use of the other substances. CONCLUSION: The results of this study confirm the prevalence of multi-substance use among pupils at the majority of rural high schools in this district and the need for targeted interventions to reduce/prevent this.