Data management and dispensary: missing link contributing to antiretroviral loss to follow-Up in Lejweleputswa District
- Moatlhodi, Charlotte Motshele
- Authors: Moatlhodi, Charlotte Motshele
- Date: 2022-09
- Subjects: Health services administration , Drug monitoring , Antiretroviral agents
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26973 , vital:66207
- Description: Background and aim: The widespread use and access to Anti-Retro Viral Treatment (ART) world-wide has contributed to full preventive and therapeutic benefits. An estimated amount of 68percent of HIV positive people received ART in South Africa (SA) as of 2018. However, reports from TIER.Net and DHIS (District Health Information System), indicate that the retention of patients on ART (specifically first line triple combination therapy Tenofovir Emtricitabine Efavirenz (TEE)) continues to decline. Meanwhile, data on TEE dispensed from the dispensary shows increasing quantities patients across the Free State province on a monthly basis. The aim of this study is to determine factors contributing to the discrepancy between Fixed Dose Combination (FDC) TEE dispensing data and patients on FDC TEE captured on TIER.Net and Health Patient Registration System (HPRS), as a means of improving identification and monitoring of patients that carry the potential risk of being lost to subsequent follow-ups (ART collection / clinical visits). Methods: A retrospective, quantitative, and descriptive record review of 382 medical records of HIV positive patients, along with TIER.Net and Health Patient Registration System (HPRS) reports, was conducted at five primary healthcare (PHC) facilities, each representing the five sub-districts found in Lejweleputswa district using a self-designed data collection tool. Descriptive statistics was used to summarise and present data. Results: Sixty five percent the TEE collected from the dispensary was captured on TIER. Net. It could not be determined on none of the medical records whether or not the administrative clerk captured dispensed TEE on the same date of collection from the dispensary on TIER.Net. Subsequently, the actual date of capturing the TEE dispenses on TIER.Net following collection of the treatment from the dispensary could also not be determined. The overall data on TEE dispensed/collected from the dispensary the same was not the same as the data captured on TIER.Net. Thirty five percent of patients were reported to have collected their ART according to dispensary data than that reported on TIER.Net. Eighty percent of the TEE collected from the dispensary was captured on HPRS. Eighty percent of facilities had an area and computer dedicated for HPRS and TIER.Net but none had a backup computer in cases of theft/breakage. None of the facilities had access to back up connectivity, a manual capturing process in the form of paper-based head count registers was instead utilised as back-up. Conclusion: The following factors were found to contribute to the discrepancy between the TEE dispensing data, TIER.net and HPRS: Poor records keeping, unauthorised dispensing of prescriptions, poor data management, delays and non-capturing of ART medical records and infrastructural and human resource challenges that exist in the data management of the patient medical records. There is a need to address these gaps in order to improve reliability of dispensary data, as well as reports from TIER.Net and HPRS, in order to streamline the identification and monitoring of patients at risk of becoming lost to follow-up. , Thesis (MPA) -- Faculty of Health Sciences
- Full Text:
- Date Issued: 2022-09
- Authors: Moatlhodi, Charlotte Motshele
- Date: 2022-09
- Subjects: Health services administration , Drug monitoring , Antiretroviral agents
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/26973 , vital:66207
- Description: Background and aim: The widespread use and access to Anti-Retro Viral Treatment (ART) world-wide has contributed to full preventive and therapeutic benefits. An estimated amount of 68percent of HIV positive people received ART in South Africa (SA) as of 2018. However, reports from TIER.Net and DHIS (District Health Information System), indicate that the retention of patients on ART (specifically first line triple combination therapy Tenofovir Emtricitabine Efavirenz (TEE)) continues to decline. Meanwhile, data on TEE dispensed from the dispensary shows increasing quantities patients across the Free State province on a monthly basis. The aim of this study is to determine factors contributing to the discrepancy between Fixed Dose Combination (FDC) TEE dispensing data and patients on FDC TEE captured on TIER.Net and Health Patient Registration System (HPRS), as a means of improving identification and monitoring of patients that carry the potential risk of being lost to subsequent follow-ups (ART collection / clinical visits). Methods: A retrospective, quantitative, and descriptive record review of 382 medical records of HIV positive patients, along with TIER.Net and Health Patient Registration System (HPRS) reports, was conducted at five primary healthcare (PHC) facilities, each representing the five sub-districts found in Lejweleputswa district using a self-designed data collection tool. Descriptive statistics was used to summarise and present data. Results: Sixty five percent the TEE collected from the dispensary was captured on TIER. Net. It could not be determined on none of the medical records whether or not the administrative clerk captured dispensed TEE on the same date of collection from the dispensary on TIER.Net. Subsequently, the actual date of capturing the TEE dispenses on TIER.Net following collection of the treatment from the dispensary could also not be determined. The overall data on TEE dispensed/collected from the dispensary the same was not the same as the data captured on TIER.Net. Thirty five percent of patients were reported to have collected their ART according to dispensary data than that reported on TIER.Net. Eighty percent of the TEE collected from the dispensary was captured on HPRS. Eighty percent of facilities had an area and computer dedicated for HPRS and TIER.Net but none had a backup computer in cases of theft/breakage. None of the facilities had access to back up connectivity, a manual capturing process in the form of paper-based head count registers was instead utilised as back-up. Conclusion: The following factors were found to contribute to the discrepancy between the TEE dispensing data, TIER.net and HPRS: Poor records keeping, unauthorised dispensing of prescriptions, poor data management, delays and non-capturing of ART medical records and infrastructural and human resource challenges that exist in the data management of the patient medical records. There is a need to address these gaps in order to improve reliability of dispensary data, as well as reports from TIER.Net and HPRS, in order to streamline the identification and monitoring of patients at risk of becoming lost to follow-up. , Thesis (MPA) -- Faculty of Health Sciences
- Full Text:
- Date Issued: 2022-09
Effect of fluoroquinolones antibiotics on vancomycin and oxacillin resistant staphylococcus species in Eastern Cape Province
- Authors: Soyege, Oludotun
- Date: 2012
- Subjects: Staphylococcus aureus , Quinolone antibacterial agents , Fluoroquinolones
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/25349 , vital:64212
- Description: This study shows the susceptibility profile of some Staphylococcus species isolated from commensal Staphylococci in Nkonkobe municipality, South Africa. A total number of 120 Staphylococcal isolates were screened for their susceptibilities to various classes of antibiotics such as Aminoglycoside (Gentamycin), Aminoglycoside (Kanamycin), Macrolide (Erythromycin), Tetracycline (Minocycline), Anti-tuberculous (Rifampicin), Lincosamides (Clindamycin), Cephalosporin and Fluoroquinolones in general. During the study, 32 (26percent) the test organisms were susceptible to both methicillin and vancomycin, while 12 (10percent) had co-resistance to the antibiotics. Furthermore, Gentamycin (an Aminoglycoside) had a relatively high potency against the isolates with 107 (89.17percent) of the bacteria being susceptible to it, while 10 (8.33percent) were resistant. On the other hand, Erythromycin (a Macrolide) was active against 72 (60percent) of the isolates, while 5 (4.17percent) and 74 (61.67percent) of the isolates yielded intermediate and resistant responses respectively. In addition , 51 (42.5percent) of the isolates were susceptible to rifampicin, while 1 (0.83percent) and 17 (14.17percent) were intermediate and resistant respectively. Ten percent of the isolates screened for their antibiotic susceptibility pattern in this study were positive for mecA gene among the vancomycin-oxacillin resistant strains while van gene was not detected in any of the isolates. This shows how the synergy of both vancomycin and oxacillin contribute to some resistance nature of Staphylococci. In order to overcome this resistance attributes of Staphylococci, to the commonly used antibiotics as discussed under this context, various types of fluoroquinolones were tested. The result shows that less than 10percent of the isolates were generally resistant to the fluoroquinolones except against Nalidix acid to which all the isolates were resistant. Other antibiotics had relatively higher resistance patterns as observed for minocycline (39.51percent), clindamycin (12.75percent), gentamycin (12.31percent) and vancomycin (12.3percent). The new generation fluoroquinolones including Gatifloxacin, Levofloxacin, Moxifloxacin and Ciprofloxacin to which less than 5percent of the bacteria are resistant gives some clinical advantage over the Methicillin and Vancomycin resistant strains. About 31percent of the isolates had multiple antibiotic resistance index of ≥1 and suggests animals in the community as potential reservoirs of antibiotic resistance determinants in the environment. Data obtained in this study is of epidemiological importance and valuable for disease control. , Thesis (MSc) -- Faculty of Science and Agriculture, 2012
- Full Text:
- Date Issued: 2012
- Authors: Soyege, Oludotun
- Date: 2012
- Subjects: Staphylococcus aureus , Quinolone antibacterial agents , Fluoroquinolones
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/25349 , vital:64212
- Description: This study shows the susceptibility profile of some Staphylococcus species isolated from commensal Staphylococci in Nkonkobe municipality, South Africa. A total number of 120 Staphylococcal isolates were screened for their susceptibilities to various classes of antibiotics such as Aminoglycoside (Gentamycin), Aminoglycoside (Kanamycin), Macrolide (Erythromycin), Tetracycline (Minocycline), Anti-tuberculous (Rifampicin), Lincosamides (Clindamycin), Cephalosporin and Fluoroquinolones in general. During the study, 32 (26percent) the test organisms were susceptible to both methicillin and vancomycin, while 12 (10percent) had co-resistance to the antibiotics. Furthermore, Gentamycin (an Aminoglycoside) had a relatively high potency against the isolates with 107 (89.17percent) of the bacteria being susceptible to it, while 10 (8.33percent) were resistant. On the other hand, Erythromycin (a Macrolide) was active against 72 (60percent) of the isolates, while 5 (4.17percent) and 74 (61.67percent) of the isolates yielded intermediate and resistant responses respectively. In addition , 51 (42.5percent) of the isolates were susceptible to rifampicin, while 1 (0.83percent) and 17 (14.17percent) were intermediate and resistant respectively. Ten percent of the isolates screened for their antibiotic susceptibility pattern in this study were positive for mecA gene among the vancomycin-oxacillin resistant strains while van gene was not detected in any of the isolates. This shows how the synergy of both vancomycin and oxacillin contribute to some resistance nature of Staphylococci. In order to overcome this resistance attributes of Staphylococci, to the commonly used antibiotics as discussed under this context, various types of fluoroquinolones were tested. The result shows that less than 10percent of the isolates were generally resistant to the fluoroquinolones except against Nalidix acid to which all the isolates were resistant. Other antibiotics had relatively higher resistance patterns as observed for minocycline (39.51percent), clindamycin (12.75percent), gentamycin (12.31percent) and vancomycin (12.3percent). The new generation fluoroquinolones including Gatifloxacin, Levofloxacin, Moxifloxacin and Ciprofloxacin to which less than 5percent of the bacteria are resistant gives some clinical advantage over the Methicillin and Vancomycin resistant strains. About 31percent of the isolates had multiple antibiotic resistance index of ≥1 and suggests animals in the community as potential reservoirs of antibiotic resistance determinants in the environment. Data obtained in this study is of epidemiological importance and valuable for disease control. , Thesis (MSc) -- Faculty of Science and Agriculture, 2012
- Full Text:
- Date Issued: 2012
The impact of HIV/AIDS on the delivery of maternal health care services of selected primary health care clinics of Peddie in the Eastern Cape Province
- Mangi, Nozuko Glenrose https://orcid.org/0000-0001-9158-8820
- Authors: Mangi, Nozuko Glenrose https://orcid.org/0000-0001-9158-8820
- Date: 2011
- Subjects: Maternal health services , Primary health care , HIV infections -- Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/24576 , vital:63209
- Description: The aim of this descriptive study was to explore the impact of HIV/AIDS on the maternal health programme at selected Primary Health Care (PHC) clinics in the Peddie sub-district, in the Eastern Cape, South Africa. This study showed that the HIV/AIDS epidemic has had major influences on the rendering of maternal health services in this sub-district. An understanding of the impact of HIV/AIDS on the delivery of the maternal health programme in the Peddie Primary Health Clinics will potentially help the District Health Service office, as well as the clinic managers and professional nurses to formulate strategies to strengthen the maternal health programme. This data will also be helpful when developing plans to cope with the heavy work-load of the clinics offering maternal health services, and to address the attitudes and concerns of the professional nurses working in the PHC clinics in this area. Thirty professional nurses working at 10 clinics responded to the questionnaires which elicited questions pertaining to the impact of HIV/AIDS on the rendering of their services. As part of the data gathering procedures, standardised notice boards at the PHC clinics were used to document the services rendered. The numbers of ANC clients attended to each of the clinics per week were collected in routine attendance tick registers used in the clinics for recording and monitoring statistics in the maternal health programme. The data was analysed to examine the possible impact of HIV/AIDS on maternal health services rendered by registered nurses/midwives working in the PHC clinics. The registered nurses who responded to the questionnaires (Annexure H) made several suggestions. These included the following: (i) encouraged more training (11 nurses), (ii) addition of more staff members, (iii) to have specialized staff for management of maternal HIV. Because of the study limitations such as the sample size of 10 clinics with a total of 30 nurses who were studied, the study may not be generalised to the whole of the Eastern Cape Province. The study however did provide baseline information on the impact of HIV/AIDS on the maternal health programme. The study findings were that HIV/AIDS has had an impact on the delivery of the maternal health programme due to the extra services brought about by the response to the HIV/AIDS pandemic. This study will contribute to a better understanding of the impact of HIV/AIDS on the maternal health programme at the PHC level in Peddie. The research provided insight into issues that are crucial to the delivery of maternal health programmes in rural areas. , Thesis (MCur) -- Faculty of Science and Agriculture, 2011
- Full Text:
- Date Issued: 2011
- Authors: Mangi, Nozuko Glenrose https://orcid.org/0000-0001-9158-8820
- Date: 2011
- Subjects: Maternal health services , Primary health care , HIV infections -- Africa
- Language: English
- Type: Master's theses , text
- Identifier: http://hdl.handle.net/10353/24576 , vital:63209
- Description: The aim of this descriptive study was to explore the impact of HIV/AIDS on the maternal health programme at selected Primary Health Care (PHC) clinics in the Peddie sub-district, in the Eastern Cape, South Africa. This study showed that the HIV/AIDS epidemic has had major influences on the rendering of maternal health services in this sub-district. An understanding of the impact of HIV/AIDS on the delivery of the maternal health programme in the Peddie Primary Health Clinics will potentially help the District Health Service office, as well as the clinic managers and professional nurses to formulate strategies to strengthen the maternal health programme. This data will also be helpful when developing plans to cope with the heavy work-load of the clinics offering maternal health services, and to address the attitudes and concerns of the professional nurses working in the PHC clinics in this area. Thirty professional nurses working at 10 clinics responded to the questionnaires which elicited questions pertaining to the impact of HIV/AIDS on the rendering of their services. As part of the data gathering procedures, standardised notice boards at the PHC clinics were used to document the services rendered. The numbers of ANC clients attended to each of the clinics per week were collected in routine attendance tick registers used in the clinics for recording and monitoring statistics in the maternal health programme. The data was analysed to examine the possible impact of HIV/AIDS on maternal health services rendered by registered nurses/midwives working in the PHC clinics. The registered nurses who responded to the questionnaires (Annexure H) made several suggestions. These included the following: (i) encouraged more training (11 nurses), (ii) addition of more staff members, (iii) to have specialized staff for management of maternal HIV. Because of the study limitations such as the sample size of 10 clinics with a total of 30 nurses who were studied, the study may not be generalised to the whole of the Eastern Cape Province. The study however did provide baseline information on the impact of HIV/AIDS on the maternal health programme. The study findings were that HIV/AIDS has had an impact on the delivery of the maternal health programme due to the extra services brought about by the response to the HIV/AIDS pandemic. This study will contribute to a better understanding of the impact of HIV/AIDS on the maternal health programme at the PHC level in Peddie. The research provided insight into issues that are crucial to the delivery of maternal health programmes in rural areas. , Thesis (MCur) -- Faculty of Science and Agriculture, 2011
- Full Text:
- Date Issued: 2011
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