Corrigendum: Access to healthcare by undocumented Zimbabwean migrants in post-apartheid South Africa.

No abstract available.

Prevalence of Wheezing and Its Association with Environmental Tobacco Smoke Exposure among Rural and Urban Preschool Children in Mpumalanga Province, South Africa.

BACKGROUND: This study aimed to investigate the prevalence of wheezing and its association with environmental tobacco smoke exposure among rural and urban preschool children in Mpumalanga province, South Africa, an area associated with poor air quality. METHODS: In this study, parents/caregivers of preschool children (n = 3145) completed a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Data were analysed using multiple logistic regression models. RESULTS: The overall prevalence of Wheeze Ever was 15.14%, with a higher prevalence in urban preschoolers than rural preschoolers (20.71% vs. 13.30%, p < 0.000). Moreover, the total prevalence of Asthma Ever was 2.34%. The prevalence was greater in urban preschoolers than in rural preschoolers (3.92% vs. 1.81%, p < 0.001). In the final adjusted model, both urban- and rural-area children who lived with one or more people who smoked in the same household (WE: OR 1.44, 95% CI 1.11-1.86) (CW: OR 2.09, 95% CI 1.38-3.16) and (AE: OR 2.49, 95% CI 1.12-5.54) were found to have an increased likelihood of having Wheeze Ever, Current Wheeze, and Asthma Ever as compared to those who lived with non-smokers. CONCLUSIONS: The implementation of smoking limits and prohibition is crucial in areas that are frequented or utilized by children. Hence, it is imperative for healthcare providers to actively champion the rights of those who do not smoke within the society, while also endorsing legislative measures aimed at curtailing the extent of tobacco smoke exposure.

Access to healthcare by undocumented Zimbabwean migrants in post-apartheid South Africa.

BACKGROUND:  Zimbabwean undocumented migrants rely on the South African public health care system for treatment of non-communicable and communicable diseases, surgery and medical emergency services. A gap remains to understand undocumented migrant experiences at a time when accessing public healthcare has been topical in South Africa. AIM:  This article aimed to describe and understand the experiences, challenges and health-seeking alternatives of undocumented Zimbabwean migrants in accessing healthcare services in Nellmapius in Pretoria. SETTING:  The study was conducted at Nellmapius in Pretoria. METHODS:  A qualitative descriptive research design was used. Structured interviews with 13 undocumented migrants were conducted by applying purposive and snowballing sampling techniques. The data were thematically analysed. RESULTS:  Migrants reported that the attitudes by healthcare officials suggest unwillingness to provide services to undocumented migrants, aggravating their vulnerability and perennial illness. Migrants faced challenges of discrimination, a lack of professional service delivery, a lack of financial capacity to pay for services and a lack of documentation evoking health-seeking alternatives. CONCLUSION:  Migrants continue to face challenges while accessing subsidised health care. This study confirms that medical xenophobia is generally present in the public health care centres, at least for the sampled undocumented Zimbabwean migrants. The majority of undocumented migrants cannot afford to pay for private healthcare.Contribution: The findings of this study inform national, provincial and local healthcare facilities to be ethical and provide dignified quality healthcare to undocumented migrants in line with international practices.

Association between Outdoor and Indoor Air Pollution Sources and Atopic Eczema among Preschool Children in South Africa.

The objective of the study was to investigate the association between outdoor and indoor air pollution sources and atopic eczema among preschool children in South Africa. A cross-sectional design, following the International Study of Asthma and Allergies in Childhood (ISAAC) Phase III protocol, was applied. The study was conducted in Mabopane and Soshanguve Townships in the City of Tshwane Metropolitan Municipality in Gauteng, South Africa. A total population of 1844 preschool children aged 7 years and below participated in the study; 1840 were included in the final data analysis. Data were analyzed using multilevel logistic regression analysis. The prevalence of eczema ever (EE) and current eczema symptoms (ESs) was 11.9% and 13.3%, respectively. The use of open fires (paraffin, wood, or coal) for cooking and heating increased the likelihood of EE (OR = 1.63; 95% CI: 0.76-3.52) and current ESs (OR = 1.94; 95% CI: 1.00-3.74). Environmental tobacco smoke (ETS) exposure at home increased the likelihood of EE (OR = 1.66; 95% CI: 1.08-2.55) and current ESs (OR = 1.61; 95% CI: 1.07-2.43). Mothers or female guardians smoking cigarettes increased the likelihood of EE (OR = 1.50; 95% CI: 0.86-2.62) and current ESs (OR = 1.23; 95% CI: 0.71-2.13). The use of combined building materials in homes increased the likelihood of EE, and corrugated iron significantly increased the likelihood of current ESs. The frequency of trucks passing near the preschool children's residences on weekdays was found to be associated with EE and current ESs, with a significant association observed when trucks passed the children's residences almost all day on weekdays. Atopic eczema was positively associated with exposure to outdoor and indoor air pollution sources.

Case-crossover study for the association between increased hospital admissions for respiratory diseases and the increase in atmospheric PM2.5 and PM2.5-bound trace elements in Pretoria, South Africa.

Outdoor PM2.5 was sampled in Pretoria, 18 April 2017 to 28 February 2020. A case-crossover epidemiology study was associated for increased PM2.5 and trace elements with increased hospital admissions for respiratory disorders (J00-J99). The results included a significant increase in hospital admissions, with total PM2.5 of 2.7% (95% CI: 0.6, 4.9) per 10 µg·m-3 increase. For the trace elements, Ca of 4.0% (95% CI: 1.4%-6.8%), Cl of 0.7% (95% CI: 0.0%-1.4%), Fe of 3.3% (95% CI: 0.5%-6.1%), K of 1.8% (95% CI: 0.2-3.5) and Si of 1.3% (95% CI: 0.1%-2.5%). When controlling for PM2.5, only Ca of 3.2% (95% CI: 0.3, 6.1) and within the 0-14 age group by 5.2% (95% CI: 1.5, 9.1). Controlling for a co-pollutant that is highly correlated with PM2.5 does reduce overestimation, but further studies should include deposition rates and parallel sampling analysis.

Health risk assessment of PM2.5 and PM2.5-bound trace elements in Pretoria, South Africa.

Exposure to outdoor air pollutants poses a risk for both non-carcinogenic and carcinogenic respiratory disease outcomes. A standardized health risk assessment (US EPA) utilizes air quality data, body mass and breathing rates to determine potential risk. This health risk assessment study assesses the hazard quotient (HQ) for total PM2.5 and trace elemental constituents (Br, Cl, K, Ni, S, Si, Ti and U) exposure in Pretoria, South Africa. The World Health Organization (WHO) air quality guideline (5 µg m-3) and the yearly South African National Ambient Air Quality Standard (NAAQS) (20 µg m-3) were the references dosages for total PM2.5. A total of 350 days was sampled in Pretoria, South Africa. The mean total PM2.5 concentration during the 34-month study period was 23.2 µg m-3 (0.7-139 µg m-3). The HQ for total PM2.5 was 1.17, 3.47 and 3.78 for adults, children and infants. Non-carcinogenic risks for trace elements K, Cl, S and Si were above 1 for adults. Seasonally, Si was the highest during autumn for adults (1.9) and during spring for S (5.5). The HQ values for K and Cl were highest during winter. The exposure to Ni posed a risk for cancer throughout the year and for As during winters.

Temperature modifies the association between air pollution and respiratory disease mortality in Cape Town, South Africa.

The aim of this 10-year study was to investigate whether and how temperature modifies the association between daily ambient PM10, NO2, SO2 air pollution and daily respiratory disease mortality in Cape Town. A time-stratified case-crossover epidemiological design was applied. Susceptibility by sex and age groups (15-64 years and ≥65 years) was also investigated. On days with medium Tapp levels, NO2 displayed a stronger association with respiratory mortality than PM10 or SO2. Females appeared to be more susceptible to NO2 at medium Tapp levels to males. The 15-64-year-old age group seemed to be more vulnerable to NO2 and PM10 at medium Tapp levels compared to the elderly (≥65 years). At high Tapp levels, females were more susceptible to PM10. The 15-64-year-old group were more vulnerable to NO2 and SO2. The results can be used in present-day early warning systems and in risk assessments to estimate the impact of increased air pollution and temperature.

Knowledge, attitude and practices on notifiable diseases among environmental health practitioners in the City of Johannesburg: A cross-sectional study.

Background: Notifiable diseases, a public health challenge in low- and middle-income countries, require mandatory reporting and play a significant role in disease prevention and control. Environmental health practitioners are responsible for reporting and investigating notifiable diseases. Aim: The study aimed to assess the knowledge, attitude and practices on notifiable diseases among environmental health practitioners within a metropolitan municipality. Setting: The study was conducted in the seven regions of the City of Johannesburg in Gauteng province, South Africa. Methods: A cross-sectional and descriptive study was used. One hundred and thirty-five participants were randomly sampled. The data were collected using a semi-structured questionnaire and analysed using version 27 of the Statistical Package for the Social Sciences (SPSS) software. All ethical considerations such as permissions, ethical clearance and informed consent were observed throughout the study. Results: The majority of participants (n = 64; 47.4%) were aged between 30 and 39 years and had a BTech/Honours degree (n = 106; 78.5%). A total of 106 (78.5%) participants had received formal training, while 83.7% (n = 113) of the participants understood notifiable diseases. Years of experience had a significant negative correlation with the 'need to report notifiable diseases' (r = -0.193; p = 0.025). Conclusion: The results could facilitate a knowledge improvement programme that includes a structured training programme and standard operating procedures. The study results cannot be generalised to the whole country; hence, the recommendation of a national survey on similar phenomena should be considered. Contribution: The study findings could assist in improving the role of environmental health services in reporting and investigating notifiable diseases.

Perceptions and attitudes of black men in a rural district of South Africa towards depression and its treatment.

BACKGROUND: Depression is a major contributor to the overall global burden of disease, impacting social life, family life and occupational functioning if left untreated. Despite its high prevalence and morbidity, the evidence suggests that men are hesitant to seek help, with a large percentage remaining undiagnosed. This study aimed to determine the attitudes and perceptions related to depression and its treatment amongst black men in a rural district of South Africa. METHODS: The design used was an exploratory descriptive qualitative design. Participants were selected by purposive sampling. Individual semistructured interviews were conducted, which were audio-recorded and transcribed verbatim. The data were subsequently analysed thematically to develop themes and subthemes. RESULTS: Participants described depression as a psychological problem associated with lack of sleep, loneliness, feeling unwanted, increased stress, deep sadness, weight loss, forgetfulness, crying over small things and lack of concentration. Collectively, the interviews with participants showed a good understanding of the psychosocial determinants of depression but exposed a lack of awareness of its biological determinants. A large proportion (n = 13; 68.4%) of participants reported not having knowledge of available services in their area for people seeking treatment for depression. Barriers to help-seeking behaviours were fear of social stigma, fear of expressing their feelings, gender norms and stereotypes and lack of trust in others. CONCLUSION: Interventions such as support groups and mental health awareness programmes to counteract personal perceptions may help to improve and expand the effectiveness of depression treatment. The results highlight the future need to raise awareness of depressive symptoms and expand health outreach programmes.

Registered nurses' perspectives on barriers of cervical cancer screening in Swaziland: a qualitative study.

INTRODUCTION: cervical cancer is highly preventable and curable if diagnosed and treated early, however, it is still the leading cause of death among women. Despite efforts to increase cervical cancer screening, its uptake is still low. The purpose of the study was to investigate the perspectives of registered nurses on barriers of cervical cancer screening in Swaziland. METHODS: an exploratory qualitative design was used for the study. Face to face in depth interviews were conducted with 15 registered nurses using an interview guide. The study was conducted in four clinics from both the private and public sectors, which were purposively sampled. Interviews were captured using an audio recording device, they were transcribed verbatim and then analysed using thematic analysis. RESULTS: four themes emerged which were deterrents to cervical cancer screening. These were perceived client barriers, health care system related barriers, nurse related barriers and the nature of the procedure. CONCLUSION: these barriers to service provision need to be addressed by extensive health education to women as well as the cervical cancer screening programme to provide all resources required to increase the uptake of screening.

Assessment of occupational health and safety practices at government mortuaries in Gauteng Province: a cross-sectional study.

INTRODUCTION: hospital mortuaries are responsible for the receipt and storage of deceased people. This exposes mortuary workers to a variety of health and safety hazards, which include physical, chemical, ergonomics, biological and psychosocial hazards/stressors. The aim of this study was to assess occupational health and safety practices (OHS) among government mortuary workers in Gauteng province. METHODS: a cross-sectional descriptive study design was conducted between the year 2017 and 2018. A convenient sampling technique was used to sample 11 government hospitals in Gauteng Province. A total of 46 employees participated in the study. Data was collected using structured questionnaires and observational checklists. Ethical clearance and permission to conduct the study were obtained prior to the commencement of the study. Data was analyzed using Statistical Package for the Social Science (SPSS) version 25 software. RESULTS: thirty-one (67%) of the respondents did not know the concept of hazard. Observations indicated that 5 out of 11 (45%) facilities were well maintained with only 2 (18%) of the facilities had the participants wearing the required PPE on duty. There was no association between working experience and having a knowledge of the existing hazards. However, there was a high correlation (P<0.05) between training and adherence to safe practices. CONCLUSION: the OHS practices were poor amongst operational employees. The study highlights the significance of developing and implementing Occupational Health and Safety programmes. We recommend that these programmes should focus on occupational health and safety education, training, supervision, medical surveillance and monitoring strategies must be developed and implemented.

High blood pressure and exposure to dust from gold mine dumps among the elderly in South Africa: A cross-sectional study.

Objective: To investigate whether high blood pressure was associated with living close to a mine dump among the elderly in South Africa. Study design: This was a cross-sectional study conducted among the elderly in communities 1-2 km (exposed) and 5 km or more (unexposed), from five pre-selected mine dumps in Gauteng and North West provinces of South Africa. Methods: Structured interviews were conducted with 2397 elderly, using a previously validated ATS-DLD-78 questionnaire from the British Medical Research Council. Results: The prevalence of high blood pressure was 57.51% in the exposed and 46.66% in the unexposed communities, respectively. Results from the multiple logistic regression analysis showed that having high blood pressure was significantly associated with living in exposed communities (AOR = 3.04, 95% CI: 2.41-3.83, P < 0.001). Other significant risk factors were being an previous and current tobacco smoker, age group, tertiary level of educational attainment, and having a history of occupational exposure to dust and chemical fumes. Conclusion: The findings of this study suggest that there are high levels of blood pressure among the elderly residing in communities located near mine dumps in South Africa.

Allergy and Household Living Conditions among Adolescents Living near Gold Mine Tailing Dumps in the Gauteng and North West Provinces of South Africa.

This quantitative exploratory baseline study aimed to investigate whether allergy among adolescents was associated with household living conditions, including living near gold mine tailing dumps in South Africa. A questionnaire based on the International Study of Asthma and Allergies was used to collect information on allergy and household risk factors among adolescents (n = 5611). A chi-square test was applied to determine the relationship between community (exposed/unexposed) and confounding variables. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CI) were calculated using univariate and multiple logistic regression analysis (LRA) to estimate the likelihood of having doctor-diagnosed allergies. The overall prevalence of doctor-diagnosed allergies was 25.5%. The exposed communities had a higher prevalence of doctor-diagnosed allergies (26.97%) compared with the unexposed (22.69%) communities. The study found an association between doctor-diagnosed allergy and having fungus in the house, being female, currently having pets in and around the house, residing in the community for more than three years and living in communities located close to gold mine tailing dumps. Actions to implement buffer zones between gold mine tailing dumps and communities would support Sustainable Development Goals 3 (health) and 11 (sustainable cities and communities), while failing to address the current potential identified risk factors may pose a significant public health challenge. Local policymakers should also apply the precautionary principle to protect the health of children, especially with the location of human settlements relative to air pollution sources.

A Study Protocol to Determine Heat-Related Health Impacts among Primary Schoolchildren in South Africa.

Climate models predict that the global average temperature of Earth will rise in the future. Studies show that high classroom temperatures can affect the ability of the student to learn and function. It is important to understand the impact that heat will have on the health, wellbeing, and academic performance of learners, as they spend a significant amount of time in classrooms compared to any other environment. A follow-up panel study among 20 public primary schools in the Gauteng province (South Africa) will be carried out, in which Grade 4 learners will be selected to complete an hourly heat-health symptom questionnaire. A Cambridge Neuropsychological Test Automated Battery (CANTAB) test will be used to determine their memory and attention span. A nursing practitioner will measure body weight, height, and temperature. Lascar data loggers will be used to measure indoor classroom temperature. School principals will complete a questionnaire on existing school coping mechanisms and policies in place that help deal with hot weather conditions. This is the first study to quantitatively assess the effects of heat on learners' health, well-being and school performance in South Africa. The outcomes of this study will enable policymakers and public officials to develop appropriate school heat adaptation and mitigation measures and will assist in channeling their resources where it is most needed.

Knowledge and practice of birth preparedness and complication readiness among pregnant women attending antenatal clinic in Openzinzi Hciii, Adjumani District, Uganda.

INTRODUCTION: Every day, approximately 830 women globally die from pregnancy-child birth related complications and all maternal deaths are mainly due to the three phases of delay usually experienced in maternal care which originates from inadequate or lack of birth and emergency preparedness. Despite the benefit of Birth Preparedness and Complications Readiness (BPACR) in the reduction of the three phases of delay and thus reduction of maternal deaths and complications, no study has been conducted in Adjumani district to assess the knowledge and practice of birth preparedness and complication readiness, thus our objective was to assess the knowledge and practice of Birth Preparedness and Complications Readiness (BPACR) among pregnant women attending antenatal clinic at Openzinzi Health Centre (HC) III in Adjumani District. METHODS: A descriptive cross sectional study design with a sample of 80 respondents was used for the study. Simple random sampling was used to select the respondents in the study area. A research administered questionnaire was used for data collection. RESULTS: Most of the respondents (27.5%) were in the age group of 26-35 years. The majority 43.75% ended at primary level of education, 50% were unemployed, and the majority 71.25% and 70% knew identifying skilled birth attendants and health facilities respectively as components of BPACR. 76.25% of the respondents mentioned vaginal bleeding and 62.5% over vomiting as danger signs in pregnancy while 12.5% did not know any danger sign in pregnancy. 76.25% identified place for skilled birth, 66.25% identified skilled birth attendant, and only 15% identified blood donor. CONCLUSION: The practice of BPACR was poor among the pregnant women attending antenatal care at Openzinzi Health Centre III in Adjumani District. The knowledge about BPACR was higher among the educated respondents involved in the study.

Assessing implementation modalities of mhealth intervention on pregnant women in Dschang health district, West region of Cameroon.

INTRODUCTION: Every 90 seconds, a woman dies of complications related to pregnancy and childbirth, resulting in more than 340,000 maternal deaths a year. Antenatal care (ANC) and postnatal care (PNC) are significant determinants of maternal health and, particularly, safe motherhood. Antenatal care is an important predictor of safe delivery and provides health information and services that can improve the health of women and infants. mHealth broadly encompasses the use of mobile telecommunication and multimedia technologies as they are integrated within increasingly mobile and wireless health care delivery systems. This study aimed at assessing the acceptable implementation modalities of mHealth intervention on pregnant Women in Dschang health district, West Region of Cameroon.ng ba. METHODS: This was a cross sectional descriptive study in the Dschang health district, West region of Cameroon. Key informants were all pregnant women from 18 years and above and a total of 372 pregnant women were included. This study was carried out from March to July 2017. RESULTS: Majority of the women, that is, 252(67.74%) were married, 117(31.45%) declaredtheir status as being single, while 3(0.81%) were devorced. Out of the 335 women that declared wanting an mHealth intervention, 41.79% of this number preferred SMS texts in the afternoon, 111(33.13%) in the evening, 46(13.73%) anytime and 38(11.34%) in the morning hours. A total of 83.33% women confirmed using telephone services. CONCLUSION: This study reveals that cell phones would be the acceptable medium of providing pregnancy and postpartum support to women in the Dschang health district. This is justified by the fact that a vast majority of women interviewed had access to a cell phone and referred to it as their desired and accepted means of communication.

Knowledge and practice of pregnant women and health care workers on hepatitis B prevention in the Limbe and Muyuka health districts of the south west region of Cameroon.

INTRODUCTION: Hepatitis B virus (HBV) infection is a major health problem worldwide owing to its high prevalence and significant morbidity and mortality. There are about 2 billion people living with HBV worldwide and over 360 million chronic carriers. The purpose of this study was to assess the knowledge and practices of pregnant women and health care workers in the ANC and maternity units on HBV infection and its transmission. METHODS: About 270 women attending ANC and 31 health care workers were selected by convenience sampling. They were evaluated using a structured questionnaire to assess their knowledge and practices on HBV prevention and transmission. RESULTS: Pregnant women in the Limbe Health District demonstrated good knowledge but adopted poor practices whereas in the Muyuka Health District, pregnant women demonstrated poor knowledge and adopted poor practices regarding the mode of transmission and prevention of HBV infection. Health care workers in both the Limbe and Muyuka Health Districts however, demonstrated good knowledge and adopted good practices. CONCLUSION: There was a significant relationship between the knowledge and practice of pregnant women and health care workers on Hepatitis B prevention in the Muyuka Health District (P = 0.0006).

Prevalence of stillbirth at the Buea Regional Hospital, Fako Division south-west region, Cameroon.

INTRODUCTION: The study investigated the prevalence of stillbirth at the Buea regional hospital, by taking cases of pregnant women who attended antenatal clinic(s) and those who did not attend but had their deliveries at the Buea regional hospital. The study specifically estimated the prevalence of stillbirths; identified possible risk factors associated with stillbirths, and determined whether the number of antenatal clinic visits is related to the occurrence of stillbirths-because during antenatal clinic visits, pregnant women are educated on risk factors of stillbirths such as: preterm deliveries; sex of the stillbirth; history of stillbirth; history of abortion(s); what age group of mothers are more likely to have a stillbirth. METHODS: The study was a hospital based retrospective study at the maternity in which there were 3577 deliveries registered at the Buea regional hospital dated May 1st, 2014 to April 30th, 2017. With the aid of a checklist data was collected, analysed and presented with the use of tables, pie-charts and bar charts. RESULTS: The prevalence of stillbirths was 26‰; possible risk factors associated with stillbirths included: preterm deliveries; women aged 20-29 years; history of abortion(s); a history of stillbirth; sex of stillbirths were more of females than males; and insufficient antenatal clinic attendance (≤1 antenatal clinic attendance) had more stillbirths. CONCLUSION: The study established that stillbirths can occur in any woman of child-bearing age. possible risk factors associated with stillbirths included: preterm deliveries; women aged 20-29 years; history of abortion(s); a history of stillbirth; gender of stillbirths were more of females than males; and insufficient antenatal clinic attendance (≤1 antenatal clinic attendance) had more stillbirths.

Management of face presentation, face and lip edema in a primary healthcare facility case report, Mbengwi, Cameroon.

Face presentation is a rare obstetric event and most practitioners will go through their carriers without ever meeting one. Face presentation can be delivered vaginally only if the foetus is in the mentum anterior position. More than half of the cases of face presentation are delivered by caesarean section. Newborn infants with face presentation usually have severe facial oedema, facial bruising or ecchymosis. These syndromic facial features usually resolved within 24-48 hours.