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1.
Afr J Prim Health Care Fam Med ; 13(1): e1-e8, 2021 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-34476971

RESUMO

BACKGROUND: Despite many initiatives made by the National Department of Health through the Minister of Health, the provision of quality health care services remains a serious challenge in South Africa, especially in public rural clinics. AIM: The study aims to determine the perceptions of professional nurses on the factors affecting the provision of quality health care services at selected public primary health care clinics in rural areas of the Capricorn District, Limpopo Province. SETTING: The study was conducted at selected public primary health care clinics in rural areas of the Capricorn District, Limpopo Province. METHODS: This study utilised a quantitative method, descriptive and a cross-sectional study conducted for three months at the selected public primary health care clinics. A structured self-administered questionnaire was used to collect data from 155 professional nurses who met the selection criteria. Data were analysed using Statistical Package for Social Sciences programme version 26.0. RESULTS: The results of 155 professional nurses were only 116 (74%) and reported that the use of modern technology such as electronic blood pressure, sonar machines and pulse reading computers improves the quality of health care services. Also 129 (84%), 124 (77%) and 118 (76%) reported that they were overwhelmed by the workload, the staff attitude and cleanliness of the clinic, respectively, which all affect the quality of health care services rendered. Moreover, only about 29 (19%) were satisfied with the salary they earned. CONCLUSION: Despite the effort and interventions put in place by the Department of Health with regard to the Ideal Clinic Realisation and Maintenance in response to the current deficiencies in the quality of primary health care services and to lay a strong foundation for the implementation of National Health Insurance. The quality of health care services is still hindered by several factors such as an overwhelming workload, the attitude of the staff and cleanliness in the work environment, poor infrastructure and the professional nurses perceive the environment as lacking equipment.


Assuntos
Enfermeiras e Enfermeiros , Serviços de Saúde Rural , Atitude do Pessoal de Saúde , Estudos Transversais , Humanos , Percepção , África do Sul , Carga de Trabalho
2.
Afr J Prim Health Care Fam Med ; 13(1): e1-e6, 2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34342480

RESUMO

BACKGROUND: Diabetes is an enormous, growing clinical and public health problem, which together with hypertension contributes significantly to the high risk of cardiovascular diseases (CVDs) globally. AIM: To examine the indirect and direct effects of risk factors simultaneously as a network of multiple pathways leading to diabetes in the rurally based adult population (aged 15+) using a household survey. METHODS: This investigation was based on a predictive model using a cross-sectional community-based study to identify the direct and indirect effects of diabetes risk factors in the Dikgale Health and Demographic Surveillance System (HDSS) consisting of 15 villages, with 7200 households and a total population of approximately 36 000. Fasting blood glucose and total cholesterol were measured using ILAB 300 with the following cut-off values: high fasting blood glucose 7 mmol/L and triglycerides 1.70 mmol/L. RESULTS: A total of 1407 individuals were interviewed, of whom 1281 had their blood pressure (BP) measured. The conceptual model was validated by the goodness-of-fit indexes (comparative fit index [CFI] = 1.00, Tucker Lewis index [TLI] = 1.041, root mean square error of approximation [RMSEA] = 0.001). Hypertension had the strongest direct effect of 0.0918 on diabetes, followed by age (0.0039) and high waist circumference (-0.0023). Hypertension also mediates the effects that high waist circumference (0.0005) and triglycerides (0.0060) have on diabetes status. CONCLUSION: The results in this study confirm the conceptual model considered in the risk factors for diabetes and suggest that hypertension, age and high waist circumference are the key variables directly affecting the diabetes status in the South African rural black population. The direct effect of triglycerides on diabetes suggests mediation by some measured factor(s).


Assuntos
Grupo com Ancestrais do Continente Africano/estatística & dados numéricos , Diabetes Mellitus/epidemiologia , Hipertensão/epidemiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Vigilância da População , Fatores de Risco , África do Sul/epidemiologia , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-33187051

RESUMO

Metabolic syndrome (MetS) is a cluster of metabolic conditions that aggravate the likelihood of cardiovascular diseases and type 2 diabetes mellitus. This study was aimed to identify the best obesity index to determine MetS. This was a cross-sectional study and part of Ellisras Longitudinal Study where 593 (289 males and 304 females) adults aged 22-30 years took part. Confirmatory factor analysis was used to test the single-factor models of MetS defined by mid arterial pressure, fasting blood glucose, triglycerides and commonly selected obesity indices such as Neck circumference (NC), Body mass index (BMI), Waist circumference (WC) and Waist to height ratio (WHtR) as indicators of MetS. It was found that a single model fit built based on WC and WHtR suggested a better fit index than NC and BMI in males, whereas, a model built on NC obtained a better fit index for females than other factor models. In conclusion, the result of the present study suggests that in rural Ellisras adult's, WC and WHtR are the best obesity indices for determining MetS in males and NC in females than other indices. Hence, longitudinal studies are recommended to allow causality to be drawn between obesity indices and MetS.


Assuntos
Síndrome Metabólica , Obesidade , Adulto , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus Tipo 2/etiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/epidemiologia , Fatores de Risco , África do Sul/epidemiologia , Circunferência da Cintura , Adulto Jovem
4.
Artigo em Inglês | MEDLINE | ID: mdl-33066410

RESUMO

The burden of hypertension is reported to be on the rise in developing countries, such as South Africa, despite increased efforts to address it. Using a cross-sectional study design, we assessed and compared the prevalence of and risk factors associated with hypertension amongst adults aged ≥18 years in semi-urban and rural communities (1187 semi-urban and 1106 rural). Trained community health workers administered the INTERHEART Risk Score tool and performed blood pressure assessments using the MEDIC Pharmacists Choice Blood Pressure Monitor. Hypertension was defined to be a systolic blood pressure (BP) ≥ 140 mmHg and diastolic BP ≥ 90 mmHg. A multivariate logistic regression model was used to identify factors and determine their relationship with hypertension. The prevalence of hypertension amongst semi-urban and rural communities was 21% with no gender difference. In the semi-urban area, physical activity, family history, fruit intake, salty food, and eating meat were significantly associated with the odds of hypertension among women, whereas only the waist-to-hip ratio (WHR), diabetic status, and salty food were the predictors for rural women. Factors such as fried food and low fruit intake were significantly associated with the odds of hypertension among men in the semi-urban area, whereas only the WHR was significant among men in the rural area. Hypertension was found to be prevalent among semi-urban and rural adults in Limpopo Province, South Africa.


Assuntos
Afro-Americanos , Hipertensão , Adolescente , Adulto , Pressão Sanguínea , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , População Rural , África do Sul/epidemiologia , População Urbana , Adulto Jovem
5.
Children (Basel) ; 7(4)2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32252482

RESUMO

BACKGROUND: Hypertension has gained global significance and risk of cardiovascular disease, and adiposity is the most important of the conditions associated with and considered responsible for hypertension in children. Therefore, the present study aimed to determine whether indices of adiposity independently predicted blood pressure at multiple points in gender-specific groups. METHODS: This was a cross-sectional study involving 10 randomly selected primary schools within the Ellisras Longitudinal Study, and involved 1816 adolescents (876 girls and 940 boys) aged 8 to 17 years. All the anthropometric indices and blood pressures (BP) were examined according to the International Society for the Advancement of Kinanthropometry protocol. RESULTS: In an adjusted linear quantile regression analysis of boys, waist circumference (WC) was associated with BP across all multiple points of systolic blood pressure (SBP). Furthermore, the triceps skinfold site was associated with high SBP. In girls, body mass index (BMI) was significantly associated with SBP after adjustment for potential confounders. Other anthropometric indices of adiposity, including WC, biceps, and triceps skinfold sites were not associated with SBP. CONCLUSIONS: The results of the present study suggest that in black South African children, variables such as WC and triceps skinfold site may provide stronger explanatory capacity to SBP variance and systolic hypertension risk in boys than other adiposity indices; whereas in girls, only WC and BMI predict diastolic blood pressure (DBP) and SBP, respectively.

6.
Cardiovasc J Afr ; 30(3): 146-150, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31180114

RESUMO

AIM: Childhood underweight is a problem being faced by rural black South African populations but little is known about its risk factors. The aim of this study was to investigate the risk factors related to childhood underweight in rural black South African children within the area known as Ellisras. METHODS: A cross-sectional study was conducted as part of the ongoing Ellisras Longitudinal Study. The current study comprised a total of 1 811 pre-primary and primary school children (934 males and 877 females) aged between five and 16 years. The chi-squared automatic interaction detection (CHAID) decision tree model was used to identify factors and determine their relationships with childhood underweight. RESULTS: A total of 1 811 children were involved in the study, of whom about 81% were severely underweight. The CHAID model showed that the variables: nutrition, age group, gender and school level were the four main predicting variables affecting childhood underweight. Hypertension was not significantly associated with childhood underweight. CONCLUSIONS: The prevalence of childhood underweight was found to be high in children aged between five and 16 years. To address this problem, well-thought-out intervention systems are need.


Assuntos
Pressão Sanguínea , Transtornos da Nutrição Infantil/epidemiologia , Fenômenos Fisiológicos da Nutrição Infantil , Hipertensão/epidemiologia , Estado Nutricional , Saúde da População Rural , Magreza/epidemiologia , Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente/etnologia , Grupo com Ancestrais do Continente Africano , Fatores Etários , Criança , Transtornos da Nutrição Infantil/diagnóstico , Transtornos da Nutrição Infantil/fisiopatologia , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Hipertensão/diagnóstico , Hipertensão/fisiopatologia , Estudos Longitudinais , Masculino , Prevalência , Medição de Risco , Fatores de Risco , Fatores Sexuais , África do Sul/epidemiologia , Magreza/diagnóstico , Magreza/fisiopatologia
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