Browsing by Author "De Villiers, Pierre J. T."
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- ItemAn analysis of the appropriate use of the Caledon ambulance service in the Overberg : a short report(Health & Medical Publishing Group, 1995-11) Frank, Selby A.; De Villiers, Pierre J. T.The objective of this study was to determine the possible extent of the inappropriate use of the ambulances of the Caledon station of the Overberg Regional Services Council. The trip sheets of the ambulances for the period 1987-1990 were retrospectively analysed, and the appropriateness of calls prospectively determined over a 7-month period. The results showed that the vast majority of calls (68%) were of a non-emergency nature, and that only 34% of the trips warranted the use of a fully equipped emergency vehicle. Various cost-containment measures are suggested.
- ItemCompliance of St Joseph’s Hospital Roma, Lesotho with the National Tuberculosis Programme of Lesotho, 2007 and 2008(AOSIS Publishing, 2014-09) Samuel, Oladoyinbo O.; De Villiers, Pierre J. T.Background: In 2009 Lesotho had an estimated TB prevalence of 696 cases/100 000 population − the 4th highest in the world. This epidemic was characterised by high rates of death, treatment failure and unknown treatment outcomes. These adverse outcomes were attributable to a high rate of TB and/or HIV co-infection and weaknesses in the implementation of Lesotho’s National Tuberculosis Programme (NTP). This study was conducted in St Joseph’s Hospital, Roma (SJHR) to assess the implementation of the NTP. Method: Records of 993 patients entered into the SJHR TB register between 2007 and 2008 were reviewed. Patients’ treatment details were extracted from the register, validated and analysed by STATA 10.0. Results: Of 993 patients registered: 88% were new patients, 37% were diagnosed on sputum smear microscopy alone, 35% were diagnosed on sputum smear microscopy with chest X-ray, whilst 25% were diagnosed on chest X-ray alone. In addition: 33% were sputum smear positive, 45% were sputum smear negative, and 22% had extra-pulmonary TB. As to treatment outcome: 26% were cured, 51% completed treatment, and 51% converted from sputum smear positive to sputum smear negative over six months, whilst 16% died. Regarding HIV, 77% of patients were tested for HIV and 59% had TB and/or HIV coinfection. Of ten NTP targets only the defaulter and treatment failure rate targets were met. Conclusion: Whilst only two out of ten NTP targets were met at SJHR in 2007–2008, improvements in TB case management were noted in 2008 which were probably due to the positive effects of audit on staff performance.
- ItemA description of patients with recurrence of pulmonary tuberculosis in a tuberculosis hospital, Ermelo(AOSIS OpenJournals, 2011) Akapabio, Ubon S.; De Villiers, Pierre J. T.Background: Retreatment TB (tuberculosis) is a serious category of pulmonary TB with a treatment outcome that could include MDR-TB (multidrug resistant TB). In the Msukaligwa municipality of Mpumalanga Province, South Africa, the burden of TB is high with poor treatment outcome indicators, thus creating some preconditions for retreatment TB. Knowledge of the characteristics of the patients and related health system factors would help in designing interventions to improve the care for patients, the adherence to medication and the prevention of retreatment TB. Aim of the study: The aim was to describe the occurrence, characteristics and management outcome of retreatment pulmonary tuberculosis in patients in a TB hospital in Ermelo. Objectives: The specific objectives were to describe the socio-demographic, behavioural and clinical factors related to recurrence of TB in patients; to determine the contribution of defaulting treatment to recurrence of TB in the study population; to identify the prevalence of resistance to TB medication amongst patients with retreatment TB; and to identify treatment outcomes in patients who have been followed up for the duration of retreatment TB. This study was set in the 58-bed TB hospital in Ermelo. The study design was cross-sectional and descriptive, and the study population comprised of patients admitted with TB at the Ermelo TB hospital between 01 January 2005 and 31 December 2007. Data were collected from the patients’ medical records and the TB registers by using a predesigned form. Data were analysed with Microsoft Excel Spreadsheet at the Centre for Statistical Consultation at the University of Stellenbosch. Results: All of the 388 patient records with retreatment TB, which formed 19.6% of TB patients admitted between 2005 and 2007, were reviewed. This comprised 66% male patients with a mean age of 41.4, and 34% female patients with a mean age of 35.3. They were mostly unemployed, and 93% had a primary education; 43% were unmarried and 34% were married. Retreatment TB was diagnosed with sputum smear microscopy in 71%, with a bacilli load of 3+ in 45% of the patients. Almost three-quarters (74%) of the patients have been afflicted by TB, 1–3 years before the episode under study. Retreatment TB categories were: ‘after treatment completed’, 69%; ‘default’, 19%; ‘after cure, 8%, and ‘treatment failure’, 4%. The majority, that is, 98% (169/172) of patients tested, had a HIV-positive status; the median CD4 cell count was 106 cells/μL at the time of retreatment, and very few (5%) were on ART (antiretroviral drug treatment). Drug resistance to primary TB drugs was as follows: Rifampicin (16%), Isoniazid (29%), Ethambutol (19%), and Streptomycin (23%). The treatment outcomes for those for whom data were available were: ‘successful’ (49.1%), ‘death’ (23.8%); and ‘treatment default’ (22.9%). MDR-TB caused complications in 3.3% of the patients. Conclusion: The majority of the retreatment TB patients were male patients with an average age of 41, and unemployed. More than two-thirds of the patients had completed TB treatment previously, and defaulting treatment accounted for less than one-quarter of retreatment categories. The process of care was better in terms of the diagnosis of TB with sputum smear. Improvement in the documentation of key factors such as smoking, alcohol, drug use amongst patients and co-morbidity, as well as counselling and testing for HIV and provision of ARTs, is required. Treatment outcomes with regard to successful outcomes should be monitored and improved.
- ItemThe migration of South African graduates to Canada : a survey of medical practitioners in Saskatchewan(Medpharm Publications, 2000) Van der Vyver, J. D.; De Villiers, Pierre J. T.Aim of study: To determine the socio-demographic profile of South African doctors who have permanently emigrated to Saskatchewan, Canada, and to find out why they left, how they have adapted and if they intend returning to South Africa. Study design: A cross-sectional postal survey. Method: All South African qualified medical practitioners in Saskatchewan with permanent registration (N=2 l8) were mailed anonymity-assure questionnaires.A second mailing was sent to non-respondents. Results: A 59% (N= 107) response was elicited with 35 returned-to-sende. Most doctors (79%) had left South Africa after 1990. Most (58%) qualified at Afrikaans medium medical schools in South Africa. The male to female ratio was 88: | 2. Seventy-four percent 74%) of respondents were general practitioners. Prior to emigration, 67% of respondents were employed in the South African public service. Most doctors (59%) earned between R525 000 and R876 000 per year in Canada. Violence was the most important reason for leaving South Africa, followed by perceived economic problems in South Africa and adverse working conditions at State health facilities. Adaptation and positive adjustments in a newly acquired country and lifestyle were evident. Returning to South Africa does not seem likely unless crime and violence diminish substantially. Conclusion: Most emigrants were male, recently qualified from all the major medical schools in South Africa, with equal Afrikaans and English speaking proportions.They left mainly because of fear for their personal security and poor working conditions in the South African public health sector.They are well settled in their new country, earn above average incomes in Canada and are very unlikely to return.