Browsing by Author "Parry, Charles D H"

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    A comparative analysis of pharmacists’ perspectives on codeine use and misuse – a three country survey
    (BioMed Central, 2018-03-27) Carney, Tara; Wells, John; Parry, Charles D H; McGuinness, Padraig; Harris, Richard; Van Hout, Marie C
    Background The misuse of codeine is of increasing concern in a number of countries, particularly as this relates to over -the-counter pain and cough relief medication, and is also supplied as a prescription medicine. The study aimed to obtain and analyse the opinions and experience of pharmacy staff with regard to codeine misuse. Methods A cross-sectional web-based survey of pharmacy staff’s perspectives on this issue was administered through professional or regulatory bodies and completed by samples drawn in South Africa (n = 124), Ireland (n = 464) and the United Kingdom (n = 129). Results The majority of participants reported combination codeine-containing products as most popular, but significantly more pharmacy staff in South Africa reported codeine-containing cough syrups as most commonly popular (X2 = 122.7(2), p < 0.001). Codeine use was also seen significantly more of a public health problem in South Africa than in the other two countries (X2 = 7.6(2), p = 0.02). There was no difference across countries in the level of codeine misuse reported by pharmacy staff. Further findings indicate that professional training and education is desired, with unequivocal findings for the need for greater codeine control (X2 = 12.0(2), p = 0.002). Conclusion In conclusion, there were some inter-country differences, but overall the findings seem to suggest that pharmacists across all three countries view codeine misuse as a problem among their customers. Recommendations centre on risk management, surveillance and staff training.
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    Heavy drinking and contextual risk factors among adults in South Africa: findings from the International Alcohol Control study
    (BioMed Central, 2018-12-05) Trangenstein, Pamela J; Morojele, Neo K; Lombard, Carl; Jernigan, David H; Parry, Charles D H
    Abstract Background There is limited information about the potential individual-level and contextual drivers of heavy drinking in South Africa. This study aimed to identify risk factors for heavy drinking in Tshwane, South Africa. Methods A household survey using a multi-stage stratified cluster random sampling design. Complete consumption and income data were available on 713 adults. Heavy drinking was defined as consuming ≥120 ml (96 g) of absolute alcohol (AA) for men and ≥ 90 ml (72 g) AA for women at any location at least monthly. Results 53% of the sample were heavy drinkers. Bivariate analyses revealed that heavy drinking differed by marital status, primary drinking location, and container size. Using simple logistic regression, only cider consumption was found to lower the odds of heavy drinking. Persons who primarily drank in someone else’s home, nightclubs, and sports clubs had increased odds of heavy drinking. Using multiple logistic regression and adjusting for marital status and primary container size, single persons were found to have substantially higher odds of heavy drinking. Persons who drank their primary beverage from above average-sized containers at their primary location had 7.9 times the odds of heavy drinking as compared to persons who drank from average-sized containers. Some significant associations between heavy drinking and age, race, and income were found for certain beverages. Conclusion Rates of heavy drinking were higher than expected giving impetus to various alcohol policy reforms under consideration in South Africa. Better labeling of the alcohol content of different containers is needed together with limiting production, marketing and serving of alcohol in large containers.
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    Injury-related behaviour among South African high-school students at six sites
    (2006) Flisher, Alan J; Ward, Catherine L; Liang, Holan; Onya, Handsome; Mlisa, Nomfundo; Terblanche, Susan; Bhama, Susan; Parry, Charles D H; Lombard, Carl J
    Objectives. To document and compare prevalence rates of adolescent injury-related risk behaviours at six sites in South Africa. Design. The identical self-administered instrument was used at all sites. Prevalence rates (with 95% confidence intervals) were calculated taking the multistage cluster sampling strategy into account. Setting and subjects. In Cape Town, Durban, Port Elizabeth and Mankweng participants were drawn from either grades 8 or 9, and grade 11, while in Queenstown and Umtata they were drawn from grade 11 only. We selected 39 schools in Cape Town and Durban, 33 in Port Elizabeth and 20 in each of the rural areas. Outcome measures. Road-related risk behaviour, violence, and suicide attempts. Results. Across the sites there were high rates of risk behaviour in all domains. For example, in the 12 months preceding the survey an estimated 52.8% of grade 11 males in Cape Town had travelled in the front seat of a motor vehicle without a seatbelt, 33.0% of grade 8 males in Mankweng had bullied others, while 44.5% of the same group had been bullied, and 18.6% of females in Port Elizabeth had attempted suicide. Rates were lower in rural areas for behaviour involving motor vehicles, but there were no consistent urban-rural findings for violence-related behaviour. Females were at higher risk of suicidal behaviour and males were at higher risk of other injury-related behaviour. Conclusions. There is a need for effective interventions to reduce the extent of injury-related risk behaviour in adolescents in urban and rural settings.
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    “Knowledge I seek because culture doesn’t work anymore … It doesn’t work, death comes”: the experiences of third-generation female caregivers (gogos) in South Africa discussing sex, sexuality and HIV and AIDS with children in their care
    (2021-03-09) Simmonds, Jane E; Parry, Charles D H; Abdullah, Fareed; Burnhams, Nadine H; Christofides, Nicola
    Background Sexual reproductive health communication between parents and children has been shown to promote safer sexual choices. In many South African households, third-generation female caregivers, often grandmothers or other older females, locally known as gogos, are primary caregivers of children due to parents being deceased or absent. Subsequently, the responsibility of talking about sex and related issues has shifted to these gogos. This study explored the experiences of gogos living in Alexandra, Johannesburg on talking about sex, sexuality and HIV and AIDS with children aged 10–18 years that are in their care. Methods Ten primary caregivers were purposively selected. Data were collected through in-depth individual interviews. Thematic analysis was performed and inductive codes and themes identified. Results All gogos selected found it difficult to discuss sex, sexuality and HIV and AIDS due to culture and traditional values impacting on personal experiences as well as generation and gender barriers. Perceived low self-efficacy due to low levels of knowledge and limited skills in speaking about sex, sexuality and HIV and AIDS also contributed to low levels of sexual reproductive health communication. Conclusions This study highlights the need for interventions that focus on improving gogos’ knowledge about sexual reproductive health in addition to providing them with the skills to talk about sex, sexuality and HIV and AIDS with children in their care.
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    Methamphetamine (tik) use, sexual risk, aggression and mental health among school going adolescents in Cape Town
    (2010) Pluddemann, Andreas; Flisher, Alan J; Parry, Charles D H; McKetin, Rebecca; Lund, Crick
    Methamphetamine use has become a growing problem in many regions of the world.Cape Town has shown a particularly sharp increase in use over the past six years. The aim of this thesis is to establish the extent of methamphetamine use among adolescents in Cape Town, and to investigate mental health problems and sexual risk behaviour related to methamphetamine use among adolescents. In addition the study aimed to establish whether methamphetamine use is associated with not continuing to attend high school. The results of the thesis are presented through five journal articles, which address the above aims. The articles are based on two quantitative high school surveys and an ongoing surveillance of substance abuse counselling and rehabilitation centres in Cape Town. Findings in the first paper in Chapter 3 indicate that the proportion of individuals seeking substance abuse treatment for methamphetamine related problems increased steadily from 2004 to 2006 and that in 2006 73% of adolescents in treatment for substance abuse reported methamphetamine as their primary or secondary drug. Findings of the high school surveys in Chapters 4-7 indicated that between 9% and 12% of high school students (mean age = 15) reported life-time use of methamphetamine. The second and fourth papers in Chapters 4 and 6 indicated associations between methamphetamine use and sexual risk behaviour, particularly for students who reported recent use of methamphetamine. The third paper in Chapter 5 indicated associations between methamphetamine use in the past year and mental health problems among adolescents, including aggressive behaviour, depression and higher scores on a composite measure of mental health. The fifth paper in Chapter 7 showed that life-time methamphetamine use in addition to other substances was significantly associated with high school nonattendance when other non-substance use factors (repeating a year at school and being older than the norm for current grade) were taken into account. This thesis clearly demonstrates that methamphetamine use is a significant problem in Cape Town, and that developing strategies to curb and address this problem should be given priority. The thesis presents among the first and most comprehensive studies on adolescent methamphetamine use and associated problems internationally, and to our knowledge the first publications on this problem among adolescents in Africa. For South Africa, and Cape Town in particular, the greatest concern remains the associations between methamphetamine use and sexual risk behaviour, leading to an increased exposure to HIV. Further prevention efforts targeting both methamphetamine use and sexual risk behaviour should be a high priority for government and community based prevention efforts.
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    Tobacco use and nicotine dependence among people living with HIV who drink heavily in South Africa: a cross-sectional baseline study
    (2019-12-16) Egbe, Catherine O; Londani, Mukhethwa; Parry, Charles D H; Myers, Bronwyn; Shuper, Paul A; Nkosi, Sebenzile; Morojele, Neo K
    Abstract Background People living with HIV (PLWH) who drink alcohol and use tobacco are particularly vulnerable to tobacco-induced diseases due to an already compromised immune system. This study investigated the prevalence and factors associated with tobacco use (cigarette and snuff) among PLWH who drink heavily. Methods Participants (n = 623) on antiretroviral therapy for HIV who reported heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) and AUDIT-C were recruited from six hospitals in Gauteng Province, South Africa. The Fagerström test was used to assess nicotine dependence. Chi Square tests and modified Poisson regression analyses were conducted to identify factors associated with tobacco use. Results Almost half of the participants reported ever smoking (44.0%; CI: 40.1–47.9) and about a quarter reported ever using snuff (25.5%; CI: 22.2–29.1). Current smokers and current snuff users comprised 27.3% (CI: 23.9–30.9) and 19.1% (CI: 16.2–22.3) of all participants respectively. Among current smokers, 37.9% (CI: 30.8–45.3) were moderately/highly dependent on nicotine. Current ‘any tobacco product users’ (ATPU: use cigarettes or snuff) were 45.4% (CI: 41.5–49.3) while 1.0% (CI: 0.4–2.0) currently used cigarettes and snuff. Adjusted regression analyses showed that, compared to males, females were less at risk of being: ever smokers (Relative Risk Ratio [RRR] = 0.33; CI: 0.27–0.41), current smokers (RRR = 0.18; CI: 0.12–0.25), and ATPU (RRR = 0.75; CI: 0.63–0.89) but were more at risk of ever snuff use (RRR = 5.23; CI: 3.31–8.25), or current snuff use (RRR = 26.19; CI: 8.32–82.40) than males. Ever snuff users (RRR = 1.32; CI: 1.03–1.70), current snuff users (RRR = 1.40; CI: 1.03–1.89) and ATPU (RRR = 1.27; CI: 1.07–1.51) were more at risk of reporting significant depressive symptoms. We found no significant associations between smoking status and years on ART and viral load. Conclusion There is a high prevalence of cigarette and snuff use among PLWH who drink heavily. Tobacco use cessation interventions tailored specifically for this population and according to their tobacco product of choice are urgently needed given their vulnerability to ill-health.