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An investigation of factors associated with antenatal care attendance in Gauteng in 2015
(South African Medical Association, 2024-06) Mostert, J.; Webb, Elizabeth M.; Girdler-Brown, B.V. (Brendan); Ngcobo, Sanele
BACKGROUND : Many studies have shown that South African women tend to initiate antenatal care late in their pregnancies. This presents challenges in the provision of quality healthcare to both mother and child. There are several studies on the social and cultural reasons for late booking. However, understanding the factors in a woman's choice to initiate antenatal care is important in informing healthcare strategies and policies.
METHODS : This study was an analytical cross-sectional study of household and general health factors associated with attendance of antenatal care by pregnant women in Tshwane in 2015. It was a secondary data analysis from complete data sampling households registered on AitaHealth™. Univariate and multivariate logistic regression was used to assess which factors are associated with antenatal care attendance.
RESULTS : The age of the head of the household was a significant factor in the attendance of antenatal care. The odds of attending antenatal care were 3.3, 2.1 and 1.8 times higher in households where the head of the household was 30 - 39 years of age, 20 - 29 or 40-49 years of age, respectively, than when between 10-19 years of age. Factors that increased the odds of attending antenatal care were living in households that had electricity and piped water, and running a business from home. Residing in a permanent dwelling and being food secure increased the odds of antenatal care attendance.
CONCLUSION : The identified health and household factors should inform policies and programmes geared towards improving services around antenatal care provision.
A randomised trial comparing preoperative administration of single-dose kefazolin to kefazolin plus metronidazole as prophylactic antibiotics at caesarean section
(South African Medical Association, 2024-06) Lanfel, R.; Snyman, L.; Seopela, Louisa; Jahn, G.; Becker, Piet J.
BACKGROUND : Caesarean section is a life-saving procedure which is associated with high rates of maternal and neonatal complications. It has been estimated that globally, 29.7 million births occur by caesarean section annually. The risk of postpartum infection is estimated to be five to ten times higher compared with normal vaginal delivery. Pregnancy-related sepsis was listed as a top-six cause of maternal mortality in the South African Saving Mothers report between 2017 and 2019. Multiple trials have been conducted in an attempt to optimise administration of prophylactic antibiotics in an effort to reduce postpartum infection and maternal sepsis, and current practice guidelines suggest that there is sufficient evidence that extended-spectrum antibiotics, in combination with kefazolin, result in reduction of postpartum infections
OBJECTIVES : To investigate the effect of perioperative administration of kefazolin alone compared with kefazolin plus metronidazole on postpartum infection in women undergoing caesarean section at Kalafong Provincial Tertiary Hospital, Pretoria, South Africa
METHOD : All patients undergoing emergency or elective caesarean section were randomised and then sequentially numbered in opaque sealed envelopes, which were placed in the caesarean section operating theatre. The intervention group received kefazolin and a sealed envelope with metronidazole. The control group received kefazolin and a sealed envelope with normal saline
RESULTS : A total of 57/1 010 patients (5.64%) had surgical site infections, of which 27 (5.33%) were in the control group, and 30 (5.96%) were in the intervention group (p=0.66). Two patients in each arm (0.40% in the intervention arm and 0.39% in the control arm) underwent laparotomy procedures, while three women (0.60%) in the intervention arm and four women (0.79%) in the control arm underwent hysterectomy procedures. There were no statistically significant differences in all the measured secondary outcomes between the two groups
CONCLUSION : The overall sepsis rate in this study was 5.64%. Postpartum infection is multifactorial and there are multiple factors that can be addressed in strengthening the sepsis care bundle. We do not recommend the addition of metronidazole to kefazolin as prophylaxis at caesarean section.
Improving health informatics competencies : a scoping review of the components of health informatics academic programs
(Sage, 2024-10) Chikware, Arthur B.; Roman, Nicolette V.; Davids, Eugene Lee
Various terms describe Information and Communications Technology (ICT) use in healthcare, including Health Informatics (HI). HI use in healthcare is expected to positively impact healthcare through healthcare cost reduction and improve healthcare accessibility and decision-making. However, the effective application and use of technology in healthcare requires appropriate HI competencies. This research explored what constitutes health informatics education programs to improve health professionals’ competencies. This review was conducted according to the PRISMA-ScR guidelines. Twenty articles made the final inclusion from a total of 577. The articles were extracted from seven databases, namely, Academic Search Complete, Elsevier (SCOPUS), Science Direct, SAGE, MEDLINE, ERIC, and Springer. The research found HI education-related content in various healthcare education programs, including medicine, dentistry, pharmacy, nursing, physiotherapy, occupational therapy, and dietetics. There were instances where HI was applied in interprofessional education, with other allied health professions such as psychology, radiology, and HI programs. Furthermore, profession-specific content such as nursing and medical informatics was identified. The content in computer literacy and Electronic Health Records seems applicable across multiple disciplines. However, HI curricula found for healthcare professions were insufficient for a distinguishable benchmark for HI education in academic disciplines of the healthcare professions.
Distribution of pharmaceuticals in marine surface sediment and macroalgae (ulvophyceae) around Mombasa peri-urban creeks and Gazi Bay, Kenya
(Springer, 2025-02) Wanjeri, Veronica Wayayi Ogolla; Okuku, Eric; Ngila, Jane Catherine; Ouma, Josephine; Ndungu, Patrick Gathura; patrick.ndungu@up.ac.za
Pollution in marine creeks has been increasing due to anthropogenic activities and has been a global concern. Limited research has been conducted on pharmaceuticals in marine sediment and macroalgae in African countries. In the present study, the levels of pharmaceuticals were assessed in surface sediment and different species of macroalgae (ulvophyceae; Cladophora sudanensis, Chaetomorpha crassa, Chaetomorpha indica, Enteromorpha kylinii, Ulva reticulate, Ulva lactuca and Cladophora sibugae) in Mombasa peri-urban creeks (Tudor, Makupa and Mtwapa creek) and Gazi bay during dry and wet seasons. The concentration of pharmaceuticals in the surface sediment during dry and wet seasons ranged between 0.04–686.8 ng/g and 0.01–2580.6 ng/g, respectively. The highest concentration of pharmaceuticals was observed in Tudor creek in dry and wet seasons, with a sum concentration of ∑1013 ng/g and ∑3111 ng/g, respectively. Gazi Bay was used as a reference environment for this study, and pharmaceuticals were detected in dry and wet seasons with a concentration of 0.10–686.8 ng/g and 0.18–93.5 ng/g, respectively. There was no seasonal variation in the pharmaceutical concentration during the dry and wet seasons. For macroalgae of ulvophyceae species, pharmaceutical concentration ranged below the detection limit (DL)–11059 ng/g. Compared to surface sediment, macroalgae showed a high concentration of pharmaceuticals in Tudor, Makupa and Mtwapa creeks. Tetracycline was higher in sediment and macroalgae in all the creeks than other pharmaceutical compounds. A high concentration of pharmaceuticals confirms sewage effluent into the marine environment of Mombasa peri-urban creek. Pharmaceuticals (acetaminophen, sulfamethoxazole, trimethoprim, carbamazepine and nevirapine) in sediment posed a medium (− 1 < Log10 RQ < 0) to higher risk (Log10 RQ > 0) to algae, invertebrates and fish in the dry and wet seasons. There is a need to sensitise the residents of coastal cities on the impact of sewage effluent into the marine environment and enact strict measures to limit the discharge of sewage effluents containing these contaminants into the marine environment. Nevertheless, it is recommended to conduct further research on the distribution of pharmaceuticals in the marine environment and the long-term combined impacts of these substances of these compounds on marine biota.
Just energy transition from coal in South Africa : a scoping review
(Elsevier, 2025-05) Patrick, Sean Mark; Shirinde, Joyce; Kgarosi, Kabelo; Makinthisa, Takalani; Euripidou, Rico; Munnik, Victor; sean.patrick@up.ac.za
BACKGROUND : South Africa’s just energy transition (JET) aims to reduce coal dependency and shift toward a low-carbon, sustainable energy framework. However, achieving this goal requires addressing the socio-economic, health, and environmental burdens that coal dependency has placed on communities, particularly in regions like Mpumalanga. Integrating principles of social and restorative justice is essential to ensure an equitable transition.
OBJECTIVE : This scoping review examine how South Africa's policymaking, regulatory frameworks, and public participation in the JET align with principles of social and restorative justice and global energy transition frameworks.
METHODS : A systematic literature search was conducted across Scopus, Web of Science, and PubMed to identify relevant studies on energy transition and justice frameworks. Network analysis was employed to compare South Africa’s JET strategies with global trends, focusing on indicators related to health, environmental, and socio-economic impacts.
RESULTS : Findings reveal significant challenges in South Africa’s JET, including regulatory limitations, stakeholder conflicts, and gaps in policy alignment with community needs. Although efforts to incorporate justice principles are emerging, disparities in policy implementation suggest the need for more tailored, inclusive approaches. Network analysis identified both overlaps and gaps between South Africa’s JET policies and international frameworks, particularly in areas of public health and social equity.
CONCLUSION : To achieve a balanced and inclusive energy transition, the study recommends strengthening regulatory coherence, enhancing public engagement, and implementing concrete actions for social and restorative justice. Aligning domestic policies with international commitments while addressing local socio-economic conditions is critical for South Africa’s JET to serve as a model for coal-dependent economies globally.