UWCScholar :: Browsing by Author "van Wyk, Brian Eduard"

Browsing by Author "van Wyk, Brian Eduard"

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Adolescent mental wellness: A systematic review protocol of instruments measuring general mental health and well-being
(BMJ Publishing Group, 2020) Orth, Zaida; van Wyk, Brian Eduard
Introduction The promotion of mental health well-being among global adolescent populations is of great public health and social significance. This is particularly true for adolescents living with chronic illnesses as studies have shown that these populations are at higher risk for developing mental health problems. There is vast recognition of the need for age and culturally appropriate interventions to promote mental well-being and prevent mental health problems. In stark contrast, there is a dearth of relevant measures of mental well-being for adolescents. Our proposed systematic review aims to identify measures of mental well-being and to assess content, psychometric properties and relevance to adolescent populations. Methods and analysis The systematic review methodology will be guided by the seven steps proposed by Eggar, Davey and Smith.
The comparison of teen clubs vs. standard care on treatment outcomes for adolescents on antiretroviral therapy in Windhoek, Namibia
(Hindawi, 2020) Munyayi, Farai K.; van Wyk, Brian Eduard
Adolescents living with HIV (ALHIV) are challenged to adhere to antiretroviral therapy (ART) and achieve and maintain virologic suppression. Group-based adherence support interventions, such as adherence clubs, have been shown to improve long-term adherence in ART patients. The teen club intervention was introduced in 2010 in Namibia to improve treatment outcomes for ALHIV by providing adherence support in a peer-group environment. Adolescents who have completed the full HIV disclosure process can voluntarily join the teen clubs. The current study compared treatment outcomes of ALHIV receiving ART at a specialized paediatric HIV clinic between 1 July 2015 and 30 June 2017 in Windhoek, Namibia. Methods. A retrospective cohort analysis was conducted on routine patient data extracted from the electronic Patient Monitoring System, individual Patient Care Booklets, and teen club attendance registers. A sample of 385 adolescents were analysed: 78 in teen clubs and 307 in standard care. Virologic suppression was determined at 6, 12, and 18 months from study start date, and compared by model of care, age, sex, disclosure status, and ART regimen. Comparisons between adolescents in teen clubs and those receiving standard care were performed using the chi-square test, and risk ratios were calculated to analyze differences in ART adherence and virologic suppression.
The effects of teen clubs on retention in HIV care among adolescents in Windhoek, Namibia
(OpenJournals Publishing AOSIS (Pty) Ltd, 2020) Munyayi, Farai K.; van Wyk, Brian Eduard
Adolescents living with HIV (ALHIV) are notably underserved by the national HIV programmes globally because of their unique needs. Of particular concern is limited access to and availability of adolescent-friendly antiretroviral therapy (ART) services, which contribute to poor retention in care in many sub-Saharan African countries. A Teen Club intervention was introduced in 2010 in Windhoek, Namibia, to improve retention in care among ALHIV through psychosocial support in a peer-group environment. Objectives: To compare the effects of the Teen Club intervention against standard care on retention in HIV care amongst adolescents at a Paediatric ART clinic. Method: A retrospective cohort analysis of adolescents aged 10-19 years receiving ART between July 2015 and June 2017 was conducted. Routine patient data were extracted from an electronic database and patient registers. A sample of 385 participants was analysed: 78 in the Teen Club and 307 in standard care. Retention was measured by assessing attendance to prescribed clinic visits up to 24 months. Comparisons were assessed with the Chi-square test, and Kaplan-Meier survival analysis was conducted to analyse differences in retention rates. Results: The overall retention rate at 24 months among all adolescents was 90.1%, with no statistically significant difference between those in Teen Club (91%) and those in standard care (89%) (p = 0.956). Younger adolescents (10-14 years) had better retention rates at 24 months compared to older adolescents (15-19 years) (94% vs. 86%; p = 0.016).
The experiences of transgender female sex workers within their families, occupation and the health care system
(University of the Western Cape, 2018) Vickerman, Shelley Ann; Bawa, Umesh; van Wyk, Brian Eduard
There is a dearth of scholarly literature surrounding transgender female sex workers (TFSW) within South Africa. Their voices are often marginalised and not adequately heard in the literature and in a society that generally views gender as a fundamental element of the self, determining their subject positions against binaried heteronormative gender ideals. This process of the ‘othering’ of TFSW, is exacerbated by the moralistic judging of their occupation of sex work. This has left many TFSWs vulnerable to emotional abuse such as being socially stigmatised, discriminated against and socially isolated. The literature further echoes vulnerability to physical violence, such as hate crimes, rape, heightened HIV infection, homelessness, police brutality and murder. The current study aimed to explore the subjective experiences of TFSW within their families, occupations and the healthcare system within the Cape Town metropole, South Africa. The study was framed within an intersectional feminist epistemological position, highlighting intersecting identities that marginalise groups of people. Informant driven sampling was used in the case of this study where a total of eleven participants were individually interviewed using a semi-structed approach – interviews ranged from 35-90 minutes. The data collected was subsequently analysed using thematic analysis and the three themes that emerged were: transgender female (TGF), Sex work and HIV. Family rejection and abuse based on participants non-conforming gender identity was expressed by participants. Repressive home circumstances led to many opting to live on the street. Participants described being introduced to sex work through a network of other homeless TFSW, also described as ‘Sisters’ (who fulfil the role of family) as a means of survival. Sex work for TGFs is a particularly dangerous job, as sex workers run the risk of being exposed as TGFs, often resulting in severe physical harm for some. To cope with their severe realities of violence and homelessness, many reported turning to substances, such as alcohol and methamphetamine. A total of ten participants described being HIV positive and adherence was very poor among the group. This could be attributed to stigmatisation from health workers, substance use and homelessness. This group of women, though vulnerable and structurally oppressed, displayed exceptional resilience. It is suggested that further research should be conducted on this group in the South African context for a clearer understanding of their needs and improved policy, as well as interventions for TFSW.
HIV/AIDS competent households: Interaction between a health-enabling environment and community-based treatment adherence support for people living with HIV/AIDS in South Africa
(Public Library of Science, 2016) Masquillier, Caroline; Wouters, Edwin; Mortelmans, Dimitri; van Wyk, Brian Eduard; Hausler, Harry; Van Damme, Wim
In the context of severe human resource shortages in HIV care, task-shifting and especially community-based support are increasingly being cited as potential means of providing durable care to chronic HIV patients. Socio-ecological theory clearly stipulates that–in all social interventions–the interrelatedness and interdependency between individuals and their immediate social contexts should be taken into account. People living with HIV/AIDS (PLWHA) seldom live in isolation, yet community-based interventions for supporting chronic HIV patients have largely ignored the social contexts in which they are implemented. Research is thus required to investigate such community-based support within its context. The aim of this study is to address this research gap by examining the way in which HIV/ AIDS competence in the household hampers or facilitates community-based treatment adherence support. The data was analyzed carefully in accordance with the Grounded Theory procedures, using Nvivo 10. More specifically, we analyzed field notes from participatory observations conducted during 48 community-based treatment adherence support sessions in townships on the outskirts of Cape Town, transcripts of 32 audio-recorded indepth interviews with PLWHA and transcripts of 4 focus group discussions with 36 community health workers (CHWs). Despite the fact that the CHWs try to present themselves as not being openly associated with HIV/AIDS services, results show that the presence of a CHW is often seen as a marker of the disease. Depending on the HIV/AIDS competence in the household, this association can challenge the patient’s hybrid identity management and his/her attempt to regulate the interference of the household in the disease management. The results deepen our understanding of how the degree of HIV/AIDS competence present in a PLWHA’s household affects the manner in which the CHW can perform his or her job and the associated benefits for the patient and his/her household members. In this respect, a household with a high level of HIV/AIDS competence will be more receptive to treatment adherence support, as the patient is more likely to allow interaction between the CHW and the household. In contrast, in a household which exhibits limited characteristics of HIV/ AIDS competence, interaction with the treatment adherence supporter may be difficult in the beginning. In such a situation, visits from the CHW threaten the hybrid identity management. If the CHWhandles this situation cautiously and the patient–acting as a gate keeper– allows interaction, the CHW may be able to help the household develop towards HIV/AIDS competence. This would have a more added value compared to a household which was more HIV/AIDS competent from the outset. This study indicates that pre-existing dynamics in a patient’s social environment, such as the HIV/AIDS competence of the household, should be taken into account when designing community-based treatment adherence programs in order to provide long-term quality care, treatment and support in the context of human resource shortages.
Inequity in the distribution of non-communicable disease multimorbidity in adults in South Africa: An analysis of prevalence and patterns
(Frontiers Media, 2022) Roomaney, Rifqah A.; van Wyk, Brian Eduard; Cois, Annibale
The present study examined the prevalence and patterns of noncommunicable disease multimorbidity by wealth quintile among adults in South Africa. The South African National Income Dynamics Study Wave 5 was conducted in 2017 to examine the livelihoods of individuals and households. We analysed data in people aged 15 years and older (N = 27,042), including self-reported diagnosis of diabetes, stroke, heart disease and anthropometric measurements. Logistic regression and latent class analysis were used to analyse factors associated with multimorbidity and common disease patterns.
Knowledge and awareness of human papillomavirus and intention with regard to human papillomavirus vaccine uptake by female tertiary students in the Eastern Cape province
(MedPharm, 2013) van Wyk, Brian Eduard; Chikandiwa, Admire
In 2008, two human papillomavirus (HPV) vaccines, Cervarix and Gardasil, were licensed for use in South Africa. Initial models showed that vaccination could lead to an approximate 70% decline in cervical cancer cases. This paper describes the knowledge, awareness and health beliefs about HPV and the HPV vaccine, and the intentions of female tertiary students with respect of being vaccinated with the latter. An observational, descriptive and analytical cross-sectional survey was conducted among 150 female tertiary students at a university in the Eastern Cape province in this regard. Knowledge and awareness of HPV and the HPV vaccine were poor. Only 22.7% of the students were aware of HPV and that an HPV vaccine was available in South Africa. However, most respondents (80%) reported a willingness to be vaccinated. Being aware of the existence of a Papanicolaou smear, higher knowledge of HPV, higher perceived vaccine effectiveness and higher perceived severity of HPV infection were significantly associated with increased willingness to be vaccinated. There is a need for education on HPV and its vaccination in South Africa. An effective vaccine marketing strategy should emphasise the effectiveness of the vaccine, the susceptibility of women to contracting HPV and the severity of being infected with the human immunodeficiency virus.
Prevalence of multimorbidity in South Africa: A systematic review protocol
(BMJ Publishing Group, 2020) Roomaney, Rifqah A.; van Wyk, Brian Eduard; Turawa, Eunice Bolanle
Introduction Multimorbidity has increased globally over the past two decades, due to ageing populations and increased burden of non-communicable diseases (NCDs). In a country like South Africa, with a growing burden of NCDs and a high prevalence of HIV, information on multimorbidity can improve planning for healthcare delivery and utilisation, and reduce costs in the context of constrained health resources. This review aims to synthesise prevalence studies on multimorbidity, and identify dominant clusters and trends of multimorbidity in South Africa. Methods and analysis We will search electronic bibliographic databases (PubMed, Scopus, JSTOR, POPLINE, PsycINFO, ScienceDirect, Web of Science and CINAHL), and the reference lists of included articles. Two researchers will independently screen title and abstracts, and then full text to identify studies published before and in 2020 that report on prevalence of multimorbidity in South Africa. Risk of bias assessments will be done for each study. Information on the prevalence of multimorbidity and disease clusters will be extracted from each study.
Realist evaluation of the antiretroviral treatment adherence club programme in selected primary healthcare facilities in the metropolitan area of Western Cape Province, South Africa: a study protocol
(BMJ, 2016) Mukumbang, Ferdinand C.; Van Belle, Sara; Marchal, Bruno; van Wyk, Brian Eduard
INTRODUCTION: Suboptimal retention in care and poor treatment adherence are key challenges to antiretroviral therapy (ART) in sub-Saharan Africa. Communitybased approaches to HIV service delivery are recommended to improve patient retention in care and ART adherence. The implementation of the adherence clubs in the Western Cape province of South Africa was with variable success in terms of implementation and outcomes. The need for operational guidelines for its implementation has been identified. Therefore, understanding the contexts and mechanisms for successful implementation of the adherence clubs is crucial to inform the roll-out to the rest of South Africa. The protocol outlines an evaluation of adherence club intervention in selected primary healthcare facilities in the metropolitan area of the Western Cape Province, using the realist approach. METHODS AND ANALYSIS: In the first phase, an exploratory study design will be used. Document review and key informant interviews will be used to elicit the programme theory. In phase two, a multiple case study design will be used to describe the adherence clubs in five contrastive sites. Semistructured interviews will be conducted with purposively selected programme implementers and members of the clubs to assess the context and mechanisms of the adherence clubs. For the programme’s primary outcomes, a longitudinal retrospective cohort analysis will be conducted using routine patient data. Data analysis will involve classifying emerging themes using the contextmechanism- outcome (CMO) configuration, and refining the primary CMO configurations to conjectured CMO configurations. Finally, we will compare the conjectured CMO configurations from the cases with the initial programme theory. The final CMOs obtained will be translated into middle range theories. ETHICS AND DISSEMINATION: The study will be conducted according to the principles of the declaration of Helsinki (1964). Ethics clearance was obtained from the University of the Western Cape. Dissemination will be done through publications and curation.
Reconstructing the deep-branching relationships of the papilionoid legumes
(Elsevier, 2013) Cardoso, D.; Pennington, R.T.; de Queiroz, L.P.; Boatwright, James S.; van Wyk, Brian Eduard; Wojciechowski, M.F.; Lavin, M.
Resolving the phylogenetic relationships of the deep nodes of papilionoid legumes (Papilionoideae) is essential to understanding the evolutionary history and diversification of this economically and ecologically important legume subfamily. The early-branching papilionoids include mostly Neotropical trees traditionally circumscribed in the tribes Sophoreae and Swartzieae. They are more highly diverse in floral morphology than other groups of Papilionoideae. For many years, phylogenetic analyses of the Papilionoideae could not clearly resolve the relation- ships of the early-branching lineages due to limited sampling. In the eight years since the publication of Legumes of the World, we have seen an extraordinary wealth of new molecular data for the study of Papilionoideae phylogeny, enabling increasingly greater resolution and many surprises. This study draws on recent molecular phylogenetic studies and a new comprehensive Bayesian phylogenetic analysis of 668 plastid matK sequences. The present matK phylogeny resolves the deep-branching relationships of the papilionoids with increased support for many clades, and suggests that taxonomic realignments of some genera and of numerous tribes are necessary. The potentially earliest-branching papilionoids fall within an ADA clade, which includes the recircumscribed monophyletic tribes Angylocalyceae, Dipterygeae, and Amburanae. The genera Aldina and Amphimas represent two of the nine main but as yet unresolved lineages comprising the large 50-kb inversion clade. The quinolizidine-alkaloid-accumulating Genistoid s.l. clade is expanded to include Dermatophyllum and a strongly supported and newly circumscribed tribe Ormosieae. Sophoreae and Swartzieae are dramatically reorganized so as to comprise mono-phyletic groups within the Core Genistoid clade and outside the 50-kb inversion clade, respectively. Acosmium is excluded from the Genistoids s.l. and strongly resolved within the newly circumscribed tribe Dalbergieae. By providing a better resolved phylogeny of the earliest-branching papilionoids, this study, in combination with other recent evidence, will lead to a more stable phylogenetic classification of the Papilionoideae.
Two-year viral load suppression among adolescents receiving antiretroviral therapy in the Cape Metropole, South Africa, 2013 - 2015: A retrospective cohort analysis
(South African Medical Association, 2020) van Wyk, Brian Eduard; Kriel, Ebrahim; Mukumbang, Ferdinand C.
Background. In 2018, 4% of all people living with HIV globally were adolescents aged 10 - 19 years. It is reported that adolescents on antiretroviral therapy (ART) are at increased risk of poor viral load suppression (VLS) compared with children and adults. Objectives. To determine the 24-month prevalence of VLS among adolescents initiated on ART in 2013 in public health facilities in the Metro District Health Services of Western Cape Province, South Africa. Methods. A retrospective cohort analysis was done on 220 adolescents initiated on ART in 2013; they were followed up for 24 months. Data were extracted from the provincial Tier.Net electronic database and patients' clinical records, and captured in Excel. SPSS statistical software was used for descriptive and inferential analysis; bivariate analysis was used to determine significance and strength of associations between VLS and various sociodemographic and clinical characteristics at 4, 12 and 24 months (with significance set at p<0.05). Results.

Browsing by Author "van Wyk, Brian Eduard"

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