Browsing by Subject "Afrique du Sud"

Now showing 1 - 4 of 4
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    Do South African medical students of rural origin return to rural practice?
    (2003) de Vries, Elma; REID, Steve
    OBJECTIVES: To investigate the career choices of medical graduates of rural origin in the South African context, and to determine what proportion of rural-origin graduates are currently practising in a rural area. DESIGN: This is a retrospective descriptive study. Doctors' addresses at the time of graduation were compared with their current addresses in terms of rural/urban classification, and a questionnaire survey was done. SUBJECTS: Sample A consisted of a cohort of doctors who graduated in 1991 and 1992. Sample B consisted of the 1994-1996 graduates of two medical schools. OUTCOME MEASURES: Percentage of rural-origin graduates in rural practice. RESULTS: In sample A 14.4% were rural-origin students. When comparing addresses, it was found that 38.4% of rural-origin graduates are currently practising in rural areas, compared with 12.4% of urban-origin graduates (p < 0.001). The questionnaire data showed that 45.9% of the rural-origin respondents are in rural practice, compared with 13.3% of the urban-origin respondents (p = 0.001). In sample B, 41.61% of the rural-origin graduates are in rural practice compared with 5.08% of urban-origin graduates (p < 0.001). CONCLUSION AND RECOMMENDATIONS: The findings suggest that the South African situation is similar to that in other countries, with rural-origin medical students more likely to choose rural careers than urban-origin students. Rural-origin graduates are also more likely to choose general practice. It is recommended that the selection criteria of the medical faculties be reviewed with regard to rural origin, and that the career aspirations of applicants to medical school be taken into account in selection, particularly with regard to primary care or general practice.
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    Quality of asthma care: Western Cape Province, South Africa
    (2009)
    Asthma is the eighth leading contributor to the burden of disease in South Africa, but has received less attention than other chronic diseases. The Asthma Guidelines Implementation Project (AGIP) was established to improve the impact of the South African guidelines for chronic asthma in adults and adolescents in the Western Cape. One strategy was an audit tool to assist with assessing and improving the quality of care. Methods. The audit of asthma care targeted all primary care facilities that managed adult patients with chronic asthma within all six districts of the Western Cape province. The usual steps in the quality improvement cycle were followed. Results. Data were obtained from 957 patients from 46 primary care facilities. Only 80% of patients had a consistent diagnosis of asthma, 11.5% of visits assessed control and 23.2% recorded a peak expiratory flow (PEF), 14% of patients had their inhaler technique assessed and 11.2% were given a self-management plan; 81% of medication was in stock, and the controller/reliever dispensing ratio was 0.6. Only 31.5% of patients were well controlled, 16.3% of all visits were for exacerbations, and 17.6% of all patients had been hospitalised in the previous year. Conclusion. The availability of medication and prescription of inhaled steroids is reasonable, yet control is poor. Health workers do not adequately distinguish asthma from chronic obstructive pulmonary disease, do not assess control by questions or PEF, do not adequately demonstrate or assess the inhaler technique, and have no systematic approach to or resources for patient education. Ten recommendations are made to improve asthma care.
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    The burden of imported malaria in Gauteng Province
    (2010) Weber, Ingrid B; Baker, Lee; Mnyaluza, Joy; Matjila, Maila J; Barnes, Karen; Blumberg, Lucille
    OBJECTIVES: To describe the burden of malaria in Gauteng Province, and to identify potential risk factors for severe disease. DESIGN: We conducted a prospective survey of malaria cases diagnosed in hospitals throughout Gauteng from December 2005 to end November 2006. OUTCOME MEASURES: Malaria frequency, severity, and treatment. Results. We identified 1 701 malaria cases; 1 548 (91%) were seen at public sector hospitals and 153 (9%) at private hospitals; 1 149 (68%) patients were male. Median age was 27 years (range 1 month - 89 years). Most (84%) infections were acquired in Mozambique. Disease severity did not differ by age or sex. Patients who were South African-born were more likely to have severe disease (OR=1.43 (1.08 - 1.91)), as were patients who experienced a delay >48 hours between onset of symptoms and diagnosis or treatment (OR=1.98 (1.48 - 2.65)). While most patients appropriately received quinine, only 9% of severe malaria cases received the recommended loading dose. CONCLUSIONS: The incidence of malaria in Gauteng was higher than previously reported, emphasising the need to prevent malaria in travellers by correct use of non-drug measures and, when indicated, malaria chemoprophylaxis. Disease severity was increased by delays between onset and treatment and lack of partial immunity. Providers should consult the latest guidelines for treatment of malaria in South Africa, particularly about treatment of severe malaria. A change in drug policy to artemisinin combination therapy for imported uncomplicated malaria in non-malaria risk provinces should be strongly considered.
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    Women doctors in medical professional organisations in South Africa – a report by the Women in Medicine Workgroup
    (2003) Kane-Berman, Jocelyne; Hickman, Rosemary
    OBJECTIVES: To determine the level of representation of women doctors in medical professional organisations in South Africa historically and currently, and if not adequate, to ascertain the reasons for women's limited participation in medico-political activities. DESIGN: A descriptive study of the membership of South African medical professional organisations and their executive structures. OUTCOME MEASURES: The number and percentages of women doctors as members and at executive level in medical professional organisations compared with the number of registered women practitioners. RESULTS AND CONCLUSIONS: Women are inadequately represented at all levels in the great majority of organisations for which information was provided. In view of the rapidly increasing number of women doctors the profession and its professional bodies need to take active steps to promote the participation of women in these organisations.