"How do you experience having a son who is undergoing the circumcision rite?" The study revealed cultural circumcision as a "sacred religious practice" with five themes, namely (a) readiness of Xhosa families to engage in the circumcision ritual, (b) the act of circumcision and preparation for manhood, (c) the importance of symbolic purity during the circumcision ritual, (d) celebrating acquired manhood, and (5) aspects of manhood and the rejection of clinical care. Secondary to this are health promotion recommendations made for individuals involved in this ritual.

BackgroundTB and HIV are the most prevalent communicable diseases of major public health importance in the populations of sub-Saharan African countries, and an estimated 30 % of HIV infected persons have dual infection with TB. TB is the leading cause of death in HIV infected individuals, and HIV co-infected TB patients have multiple individual, disease specific and treatment related factors that can adversely affect their treatment outcomes. There is lack of evidence on the individual patient outcomes of HIV co-infected TB patients who receive anti-TB treatment. It is relevant to understand the differential patient outcomes of HIV co-infected TB patients and identify the factors that are associated with these outcomes.MethodsA comparative analysis was done on the data from a random sample of 575 TB patients who were enrolled for TB treatment from January 2013 to December 2013 at eight health facilities in Ethiopia. A descriptive analysis was done on the data, and chi-square test and logistic regression analysis was conducted to compare TB treatment outcomes based on HIV status and to identify factors associated with these outcomes.ResultsOut of a total of 575 TB patients enrolled into the study, 360 (62.6 %) were non-HIV infected, 169 (29.4 %) were HIV co-infected, and 46 (8 %) had no documented HIV status. The overall treatment success rate was 91.5 % for all the study participants. HIV co-infected TB patients have a treatment success rate of 88.2 % compared with 93.6 % for non-HIV infected study participants (P = 0.03). HIV co-infected TB patients had a significantly higher rate (11.8 % versus 6.4 %, P = 0.03) of unfavourable outcomes. The cure rate was significantly lower (10.1 % versus 24.2 %, P = 0.001) and the death rate higher in HIV co-infected TB patients (8.3 % versus 2.5 %, P = 0.014). Age and TB classification were significantly associated with treatment outcome. No association was found with starting ART, Cotrimoxazole prophylactic treatment or enrolment in HIV care.ConclusionsThere is high TB treatment success rate among patients who have been treated for TB, but the treatment success rate and the cure rate in HIV co-infected TB patients is lower than that observed in non-HIV infected patients. Patients with advanced age and those with smear positive pulmonary TB have unfavourable treatment outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1967-3) contains supplementary material, which is available to authorized users.

Male circumcision is practiced in South Africa among the Xhosa people as a rite of passage from boyhood to manhood. The manhood status achieved after the ritual accords men power and authority in the community over women and uncircumcised men. Therefore, uninitiated men experience great pressures to get circumcised. We describe the experience of newly initiated Xhosa men in East London, South Africa. Interpretive phenomenology was used as the inquiry of choice. Data were collected through focus group discussions in which 14 men participated. The theme of marginalization of uninitiated Xhosa males emerged with two categories: (a) rejection, and (b) lack of respect. The participants revealed that uninitiated men are rejected by the community, their own families, friends, and women. We frame the discussion around the concept of stigma. Acknowledging that uninitiated males are stigmatized can help mitigate stigma, and in turn, the incidence of medical complications from botched circumcisions.

After the democratization of South Africa in 1994, the health-care system was reorganized in accordance with the primary health-care philosophy advocated by the World Health Organization. This was accompanied by a process of deinstitutionalization of mental health-care services, which has led families to become the main providers of care to individuals with mental illness. This study explores the experiences of informal family caregivers of persons with mental illness in a rural area in South Africa. Data were collected through eight individual semistructured interviews of informal caregivers who cared for relatives with mental illness and collect medications monthly at a community clinic in the Makhuduthamaga local municipality in Limpopo, South Africa. A qualitative research design was used, which was explorative, descriptive, and contextual. The data analysis revealed four major themes: (i) experiences of providing for physiological/physical needs; (ii) experiences of providing for emotional needs; (iii) experiences of providing for security needs; and (iv) experiences associated with the medical health-care programme. The study revealed that the experiences of family caregivers were conceptualized negatively, although the interview questions were intentionally neutral. This is believed to be due to the cultural explanatory models of mental illness prevalent in this region of South Africa. It is suggested that to increase compliance with medication, reduce relapse, and mitigate stigma associated mental illness, medical professionals need to incorporate aspects of cultural explanatory models into their explanations of the causes of illness.

The aim of this study was to explore professional nurses' perception of nursing mentally ill patients in a tertiary hospital in Durban. An explorative, qualitative, descriptive and contextual design was followed as the basis for conducting the study. The above-mentioned research design was achieved through field work conducted in an urban-based general hospital. A sample of 12 professional nurses was selected from a population of 800 professional nurses employed in this setting using a purposive sampling technique. This sample size was determined by saturation of data as reflected in repeating themes. Both individual phenomenological semistructured interviews and field notes in the form of observations were used as methods of data collection. The field work was conducted without any preset theoretical framework of reference by using bracketing and intuiting. During interviews, participants were asked only one research question, namely: 'How do you perceive nursing mentally ill patients in your unit or ward?' Communication skills were employed to encourage participants to verbalize their perception of nursing mentally ill patients in a general hospital setting. A tape recorder was used to collect data and the data was transcribed verbatim. Data collected was analysed following the descriptive method of Giorgi (1986). Coding was carried out by the researcher and an independent expert who is a psychiatric nursing specialist and a qualitative research expert. After data analysis, the results were reflected within universal categories of the Nursing for the Whole Person Theory in order to give them structure. The four themes that emerged from the findings are: perception of self, perception of a patient, perception of feelings that hinder nursing the mentally ill, and perception of the environment. The measures for ensuring trustworthiness proposed by Guba (Lincoln Y.S. & Guba E.G. (1985) Naturalistic Inquiry. Sage, Beverly Hills) were used as the basis for ensuring reliable and valid findings. The perception of nursing mentally ill people within a general hospital setting was negative and affected the intellectual and the affective component of the nurses' psychological functioning within their internal environment. It was recommended that nurses' knowledge and skills should be increased and that they should be given emotional support in terms of counselling.