Prevalence, incidence and seroconversion of HIV and Syphilis infections among pregnant women of South Africa.

BACKGROUND: Pregnant women in South Africa suffer from HIV and syphilis infections resulting in negative pregnancy outcomes. Little is known about the prevalence, incidence, seroconversion, and associated risk factors for those attending a midwife run obstetric unit. METHODS: A retrospective cohort study was undertaken among pregnant women attending antenatal clinic from January to December 2018. Logistic regression was conducted to determine the risk factors for HIV and syphilis. RESULTS: The prevalence of HIV and syphilis were 44.3% (95% confidence interval [CI]; 41.6:46.7) and 3.8% (95% CI; 3.1:4.1), respectively. The seroconversion and incidence for HIV were 4.0% (95% CI; 3.6:4.6) and 17.1 per 100 person-years, and for syphilis 2.6% (95% CI; 2.3:2.8) and 10.9 per 100 person-years, respectively. Significant predictors for HIV prevalence were ages: ages < 20 years, Odds ratio (OR) = 0.11 (p < 0.05), ages 20-24 years, OR = 0.19 (p < 0.05) and ages 25-29 years, OR = 0.38 (p < 0.05); gestational age: second trimester, OR = 0.68 (p < 0.05) and non-reactive syphilis, OR = 0.45 (p < 0.05). Age was the predictor for HIV incidence or seroconversion (age < 20 year, OR = 0.12, p = 0.01). Predictors for syphilis were ages < 20 years, OR = 0.11 (p < 0.05), ages 20-24 years and HIV status. Gestational age > 27 weeks were nine times (OR = 9.2, p = 0.03) more likely to seroconvert to syphilis. CONCLUSIONS: The present study found high rates of seroprevalence, seroconversion and incidence of HIV and syphilis among pregnant women.

Incidence, trends and risk factors for perineal injuries of low-risk pregnant women: Experience from a midwife run obstetric unit, South Africa.

Pregnant women experience perineal injuries during childbirth. The objectives of this cross-sectional retrospective study were to estimate the incidence, trends, and risk factors for perineal injuries of women who had childbirths from January 2013 to December 2017. We used logistic regression to identify risk factors for all injuries, episiotomy, and obstetric anal sphincter injury (OASI) measured by odds ratios (OR). A total of 5547 women showed gradual decreases of episiotomy from 17.6% in 2013 to 7.6% in 2017 (p <0.05). Perineal injuries were reduced from 33.3% in 2013 to 28.9% in 2017 (p <0.05). The risk factor for any perineal injury were younger ages, term pregnancy, and nil parity (p,0.05). Advanced gestational age, nil parity, and previous vaginal births were risk factors for episiotomy. However, birth weight of baby was significantly associated with OASI. Episiotomy and overall perineal injury rates were commendable. Training to midwives is needed to improve perineal care and maintain good practices during delivery.

Infant feeding practices among HIV-positive mothers at Tembisa hospital, South Africa.

BACKGROUND: Despite the nutritional, physiological and emotional benefits of breastfeeding, HIV-positive mothers cannot practise exclusive breastfeeding for six months because of a range of influences on their feeding choice - thereby creating a caveat for morbidity in infants. AIM: This study explored factors influencing the infant feeding choice of HIV-positive mothers at a peri-urban hospital in Tembisa, South Africa. METHODS: This study was qualitative and was conducted among 30 purposefully selected postnatal HIV-positive mothers at Tembisa hospital, Gauteng, from May to June 2011. In-depth interviews were conducted mainly in isiZulu and Sepedi which were then transcribed into English. An open coding system of analysis was used for thematic analysis. RESULTS: Nurses significantly influenced the feeding choices of new mothers - sometimes with inconsistent information. The grandmothers of infants also influenced the new mothers' feeding options, in some cases with the new mother coming under duress. Other relatives like the sisters and aunts of mothers appeared to significantly affect feeding choices. The time frames expressed for the initiation of a supplementary diet were as follows: before 1 month, at 1 month and at 4 months. The main reason was the belief that infants required more than breast milk as sustenance during this period. CONCLUSION: In the postnatal hospital setting of this study, the feeding choices of mothers were influenced by nursing personnel. Nursing personnel could marry the influential 'authority' they have with correct and consistent information, in order to change feeding behaviour. Significant 'others' like grandmothers and other relatives also influenced decisions on infant feeding. As such, family dynamics need to be considered when encouraging breastfeeding.

Alcohol use amongst learners in rural high school in South Africa.

BACKGROUND: Drinking behaviour by adolescents is a significant public health challenge nationally and internationally. Alcohol use has serious challenges that continue to deprive adolescents of their normal child growth and development. Drinking is associated with dangers that include fighting, crime, unintentional accidents, unprotected sex, violence and others. AIM: The aim of the study is to investigate drinking patterns, and factors contributing to drinking, amongst secondary school learners in South Africa. METHOD: The sample included 177 male (46.6%) and 206 female (53.4%) respondents in the age range from 15­23 years, selected by stratified random sampling. RESULTS: The results indicated that 35.5% of male and 29.7% of female respondents used alcohol. Both male and female respondents consumed six or more alcohol units (binge drinking) within 30 days; on one occasion the consumption was 17.5% and 15.9% respectively. It was found that alcohol consumption increases with age, 32.2% of 15­17 year-olds and 53.2% of 18­20 year-olds consumed different types of alcohol. It was deduced that 28.9% respondents reported that one of the adults at home drank alcohol regularly, and 9.3% reported that both their parents drank alcohol daily. It was found that 27.6% of the respondents agreed that friends made them conform to drinking. The tenth and eleventh grade reported 15.2% of male and 13.9% of female respondents were aware that alcohol can be addictive. CONCLUSION: This study found that age, gender, parental alcohol use and peer pressure were found to be the major contributing factors to alcohol use amongst learners Prevention campaigns such as introducing the harmful effects of alcohol use amongst learners are of utmost importance in reducing alcohol use amongst learners in South Africa.