BackgroundHealth beliefs related to pregnancy and childbirth exist in various cultures globally. Healthcare practitioners need to be aware of these beliefs so as to contextualise their practice in their communities.ObjectivesTo explore the health beliefs regarding pregnancy and childbirth of women attending the antenatal clinic at Chawama Health Center in Lusaka Zambia.MethodThis was a descriptive, cross-sectional survey of women attending antenatal care (n = 294) who were selected by systematic sampling. A researcher-administered questionnaire was used for data collection.ResultsResults indicated that women attending antenatal care at Chawama Clinic held certain beliefs relating to diet, behaviour and the use of medicinal herbs during pregnancy and post-delivery. The main beliefs on diet related to a balanced diet, eating of eggs, okra, bones, offal, sugar cane, alcohol consumption and salt intake. The main beliefs on behaviour related to commencement of antenatal care, daily activities, quarrels, bad rituals, infidelity and the use of condoms during pregnancy. The main beliefs on the use of medicinal herbs were on their use to expedite the delivery process, to assist in difficult deliveries and for body cleansing following a miscarriage.ConclusionWomen attending antenatal care at the Chawama Clinic hold a number of beliefs regarding pregnancy and childbirth. Those beliefs that are of benefit to the patients should be encouraged with scientific explanations, whilst those posing a health risk should be discouraged respectfully.

Background: South Africa is aiming to achieve herd immunity against the coronavirus disease 2019 (COVID-19) by the first quarter of 2022. The success of the COVID-19 vaccination roll-out depends primarily on the willingness of the population to take the vaccines.Aim: This study aimed to examine the willingness to take the COVID-19 vaccine, along with the factors of concern, efficacy and preferences of the individual, which may increase the willingness to be vaccinated.Setting: This study was conducted at the University of the Witwatersrand, Johannesburg, amongst adult students and academic and professional staff.Methods: A cross-sectional online survey from 27 July 2021 to 14 August 2021 was conducted. We performed descriptive and inferential analysis to determine the factors associated with willingness to take the COVID-19 vaccine.Results: A total of 2364 participants responded to a survey link and 82.0% were students, 66.8% were in the 18–29 years age band and females represented 64.0%. A total of 1965 participants (83.3%) were willing to receive a COVID-19 vaccine, the most preferred vaccines were Pfizer (41%) and JJ (23%), local pharmacy (29%) and General Practitioner (GP) (17%) were the preferred places for vaccination and the trusted sources of information on COVID-19 vaccines were the general practitioners (40.6%) and specialists (19.2%). Perceptions that vaccines are safe (adjusted odds ratio [aOR] = 31.56, 95% confidence interval [CI]: 16.02–62.12 for affirmative agreement) and effective (aOR = 5.92, 95% CI: 2.87–12.19 for affirmative agreement) were the main determinants of willingness to taking a COVID-19 vaccine.Conclusion: It is imperative to reinforce the message of COVID-19 vaccine safety and efficacy and to include the GPs and the community pharmacies in the vaccination roll-out in South Africa.

Background: Sexual history taking for risk behavior contributes to improving health outcomes in primary care. Giving the high numbers of people living with AIDS, every patient in South Africa should be offered an HIV test, which implies that a comprehensive sexual history must be taken. Aim: To describe the optimal consultation process, as well as associated factors and skills required to improve disclosure of sexual health issues during a clinical encounter with a doctor in primary health care settings in North West province, South Africa. Methods: This qualitative study, based on grounded theory, involved the video-recording of 151 consultations of adult patients living primarily with hypertension and diabetes. This article reports on the 5 consultations where some form of sexual history taking was observed. Patient consultations were analyzed thematically, which entailed open coding, followed by focused and verbatim coding using MaxQDA 2018 software. Confirmability was ensured by 2 generalist doctors, a public health specialist and the study supervisors. Main Outcome Measure: Sexual history was not taken and patients living with sexual dysfunction were missed. If patients understand how disease and medication contribute to their sexual wellbeing, this may change their perceptions of the illness and adherence patterns. Results: Sexual history was taken in 5 (3%) out of 151 consultations. Three themes emerged from these 5 consultations. In the patient-doctor relationship theme, patients experienced paternalism and a lack of warmth and respect. The consultation context theme included the seating arrangements, ineffective use of time, and privacy challenges due to interruptions and translators. Theme 3, consultation content, dealt with poor coverage of the components of the sexual health history. Conclusion: Overall, sexual dysfunction in patients was totally overlooked and risk for HIV was not explored, which had a negative effect on patients' quality of life and long-term health outcomes. The study provided detailed information on the complexity of sexual history taking during a routine consultation and is relevant to primary health care in a rural setting.

Background: Sexual dysfunction contributes to personal feelings of loss and despair and being a cause of exacerbated interpersonal conflict. Erectile dysfunction is also an early biomarker of cardiovascular disease. As doctors hardly ever ask about this problem, it is unknown how many patients presenting for routine consultations in primary care suffer from symptoms of sexual dysfunction.Aim: To develop an understanding of sexual history taking events, this study aimed to assess the proportion of patients living with symptoms of sexual dysfunction that could have been elicited or addressed during routine chronic illness consultations.Setting: The research was carried out in 10 primary care facilities in Dr Kenneth Kaunda Health District, the North West province, South Africa. This rural area is known for farming and mining activities.Methods: This study contributed to a broader research project with a focus on sexual history taking during a routine consultation. A sample of 151 consultations involving patients with chronic illnesses were selected to observe sexual history taking events. In this study, the patients involved in these consultations completed demographic and sexual dysfunction questionnaires (FSFI and IIEF) to establish the proportions of patients with sexual dysfunction symptoms.Results: A total of 81 women (78%) and 46 men (98%) were sexually active. A total of 91% of the women reported sexual dysfunction symptoms, whilst 98% of men had erectile dysfunction symptoms. The youngest patients to experience sexual dysfunction were a 19-year-old woman and a 26-year-old man. Patients expressed trust in their doctors and 91% of patients did not consider discussion of sexual matters with their doctors as too sensitive.Conclusion: Clinical guidelines, especially for chronic illness care, must include screening for sexual dysfunction as an essential element in the consultation. Clinical care of patients living with chronic disease cannot ignore sexual well-being, given the frequency of problems. A referral to a sexual medicine specialist, psychologist or social worker can address consequences of sexual dysfunction and improve relationships.

We report patterns of genetic variation based on microsatellite, allozyme and mitochondrial control region markers in nyala from geographic locations sampled in South Africa, Mozambique, Malawi and Zimbabwe. Highly significant differences were observed among allele frequencies at three microsatellite loci between populations from KwaZulu-Natal, Limpopo and Malawi, with the Malawi and KwaZulu-Natal groupings showing the highest differentiation ðR ST ¼ 0:377Þ: Allozyme frequencies showed minor, non-statistically significant regional differences among the South African populations, with maximum F ST values of 0.048-0.067. Mitochondrial DNA analyses indicated a unique haplotype in each location sampled. Since none of these indices of population differentiation showed significant correlation to absolute geographic distance, we conclude that geographic variation in this species is probably a function of a distribution pattern stemming from habitat specificity. It is suggested that translocations among geographically distant regional populations be discouraged at present, pending a more elaborate investigation. Transfer of native individuals among local populations may, however, be required for minimizing the likelihood of inbreeding depression developing in small captive populations.

Background: Sexual history taking seldom occurs during a chronic care consultation and this research focussed on consultation interaction factors contributing to failure of screening for sexual dysfunction.Aim: This study aimed to quantify the most important barriers a patient and doctor experienced in discussing sexual challenges during the consultation and to assess the nature of communication and holistic practice of doctors in these consultations.Setting: The study was done in 10 primary care clinics in North West province which is a mix of rural and urban areas.Methods: One-hundred and fifty-five consultation recordings were qualitatively analysed in this grounded theory research. Doctors and patients completed self-administered questionnaires. A structured workplace-based assessment tool was used to assess the communication skills and holistic practice doctors. Template analysis and descriptive statistics were used for analysis. The quantitative component of the study was to strengthen the study by triangulating the data.Results: Twenty-one doctors participated in video-recorded routine consultations with 151 adult patients living with hypertension and diabetes, who were at risk of sexual dysfunction. No history taking for sexual dysfunction occurred. Consultations were characterised by poor communication skills and the lack of holistic practice. Patients identified rude doctors, shyness and lack of privacy as barriers to sexual history taking, whilst doctors thought that they had more important things to do with their limited consultation time.Conclusion: Consultations were doctor-centred and sexual dysfunction in patients was entirely overlooked, which could have a negative effect on biopsychosocial well-being and potentially led to poor patient care.

Background: To the best of our knowledge no studies have been conducted to assess the relationship between food insecurity and poor glycaemic control in diabetic patients in peri-urban settings of the South African context.Aim: The study aimed to assess food insecurity and its relationships with glycaemic control and other patient characteristics amongst diabetic patients attending Jabulani Dumani Community Health Centre.Setting: The study was conducted in a primary healthcare facility in the south sub-district of Ekurhuleni health district, the Gauteng province, South Africa.Methods: This was a cross-sectional descriptive study involving 250 patients. Data were collected by using an interview-administered Household Food Insecurity Access Scale questionnaire. Descriptive and inferential statistical analyses by using Stata 14.0 statistical software were performed. Chi square and logistic regression tests assessed the association between socio-demographic characteristics, glycaemic control and food insecurity.Results: Amongst 250 recruited participants, 82.4% were above 50 years, 64% women, 88.8% South African citizens and 42.4% had a household size of ≥ 5 people. Sixty-four percent and 69.9% were classified as having food insecurity and poor glycaemic control, respectively. On further analysis, food insecurity was associated with unemployment (adjusted odds ratio [AOR] = 2.94; 95% confidence interval [CI]: 1.51–5.75), being a South African citizen (AOR = 1.60; 95% CI: 0.66–3.86), household size of ≥ 5 people (AOR = 1.77; 95% CI: 0.98–3.19) and uncontrolled glycaemic level (AOR = 5.38; 95% CI: 2.91–9.96).Conclusion: Food insecurity in diabetic patients constitutes a serious challenge for glycaemic control. It is critical for healthcare providers in primary care settings to ensure screening for early identification and management of food insecurity and take measures to prevent poor glycaemic control.

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