RESUMEN
BACKGROUND: Type 2 diabetes mellitus (T2D) is a public health challenge, affecting 90% of all patients with diabetes, globally. Compliance to treatment guidelines among healthcare professionals (HCPs) is low, thus resulting in inadequate quality of patient care and poor health outcomes among patients. AIM: To examine the availability of equipment, guidelines, screening and education offered to patients with T2D and compare between clinics and community health centres (CHCs). SETTING: Tshwane Metropolitan Municipality, Gauteng Province, South Africa. METHODS: A cross-sectional descriptive study utilised a self-administered questionnaire to collect data from nurses and doctors responsible for treating patients with T2D, from May to June 2022. About 250 eligible HCPs were recruited during routine morning meetings in 22 clinics and six CHCs. RESULTS: More than 80% of HCPs reported having basic equipment except for ophthalmoscopes, Snellen charts (67%), tuning forks (64%), electrocardiograms (ECG) (46%) and monofilaments (12%). SEMDSA guidelines were reported by 16% of the participants, Diabetic Foot Care Guidelines were reported by 54% and Dietary Guidelines for Diabetic Patients by 55%. Furthermore, 91%, 71% and 69% of HCPs reported that ECG, microalbumin-creatinine and foot examinations were not always performed, respectively. About 66% and 17% always offered individual educational and group sessions, respectively. CONCLUSION: Equipment availability and compliance with treatment guidelines, patient education and screening of chronic complications are inadequate.Contribution: The study highlights the poor adherence to treatment guidelines and inadequate equipment in health facilities. These shortcomings could lead to missed opportunities for early diagnosis of complications and ultimately poorer patient outcomes.
Asunto(s)
Diabetes Mellitus Tipo 2 , Calidad de la Atención de Salud , Humanos , Diabetes Mellitus Tipo 2/terapia , Sudáfrica , Estudios Transversales , Femenino , Masculino , Encuestas y Cuestionarios , Adhesión a Directriz/estadística & datos numéricos , Centros Comunitarios de Salud , Persona de Mediana Edad , AdultoRESUMEN
Background: Chronic infection with hepatitis B virus (HBV) is a major public health concern in South Africa. Hepatitis B virus is a highly infectious blood-borne virus causing liver disease. Healthcare workers (HCWs) are at high risk of occupational exposure. Objectives: This study aimed to investigate HBV vaccination amongst HCWs at a tertiary academic hospital in Gauteng province, South Africa. Method: Self-administered questionnaires were used to collect data from 500 consecutively sampled HCWs. Data were analysed using Stata version 12. Results: A total of 460 HCWs participated in the study. Most were women (68.7%), < 40 years of age (66.9%) and worked for < 10 years (66.0%). Almost 50.0% were either doctors or medical students and 40.3% were nurses or student nurses. Most HCWs in the age group of < 30 years (79.4%) had received at least 1 dose of HB vaccine. Prevaccination immunity screening was conducted on 17.5% of the HCWs, and only 11.0% reported to be protected against HBV. About 49.0% of HCWs were fully vaccinated. Post-vaccination immunity testing was conducted on 15.1%, and 24.0% of HCWs paid for vaccinations. Nursing staff and those with > 10 years of work experience were 2.5 and 2.6 times more likely to be vaccinated, respectively. Cleaning staff were less likely to be vaccinated. Conclusion: Although not all HCWs were fully vaccinated, our study found a higher proportion of fully vaccinated HCWs than previously reported in Gauteng Province. It is recommended that HB vaccination be promoted and a local vaccination policy, aligned with the national policy, be developed and implemented for all HCWs at the tertiary academic hospital.