scholarly journals A retrospective descriptive investigation of adult patients receiving third-line antiretroviral therapy in the North West province, South Africa

2020 ◽  
Vol 20 (2) ◽  
pp. 549-559
Author(s):  
Christian Rudman ◽  
Michelle Viljoen ◽  
Malie Rheeders
Keyword(s):  
Antiretroviral Therapy ◽  
Adult Patients ◽  
Second Line ◽  
First Line ◽  
Hiv Diagnosis ◽  
North West ◽  
The North ◽  
North West Province ◽  
Resistance Patterns ◽  
Third Line

Background: Greater access and prolonged exposure to ART may inevitably lead to more treatment failure and increase the need for third-line ART (TLART) in a resource-limited setting. Objective: To describe characteristics and resistance patterns of adult patients initiated on TLART in three districts of the North West province. Method: All-inclusive retrospective descriptive investigation. Demographics and clinical variables were recorded from adult patient health records (2002-2017) and analysed. Results: 21 Patients (17 females, 4 males) with median (IQR) age of 34 years (30.2-37.8) at HIV diagnosis and 45 years (39.5-47) at TLART initiation were included. Median duration (days) from HIV diagnosis to first-line ART initiation was 101 (37-367), treatment duration on first-line, second-line and between second-line failure and TLART initiation were: 1 269 (765-2 343); 1 512 (706-2096) and 71 (58-126) days respectively. High-level resistance most prevalent were: nelfinavir/r (85.7%), indinavir/r (80.9%), lopinavir/r (76.2%), emtricitabine and lamivudine (95.2%), nevirapine (76.2%) and efavirenz (71.4%). Resistance to 3 major PI mutations in 95% of patients and cross resistance were documented extensively. Conclusion: This study support the need for earlier resistance testing. It firstly reported on time duration post diagnosis on various ART regimens and secondly resistance patterns of adults before TLART was initiated in these districts. Keywords: HIV; Human immunodeficiency virus; third-line antiretroviral therapy; drug resistance patterns; salvage therapy.

scholarly journals Human Immunodeficiency Virus-1 Drug Resistance Patterns Among Adult Patients Failing Second-Line Protease Inhibitor-Containing Regimens in Namibia, 2010–2015

2018 ◽  
Vol 5 (2) ◽  
Author(s):  
Souleymane Sawadogo ◽  
Andreas Shiningavamwe ◽  
Clay Roscoe ◽  
Andrew L Baughman ◽  
Taffa Negussie ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Adult Patients ◽  
Second Line ◽  
Viral Load Monitoring ◽  
Immunodeficiency Virus ◽  
Load Monitoring ◽  
Resistance Patterns ◽  
Third Line ◽  
Emergence Of Resistance ◽  
Second Line Antiretroviral Therapy

Abstract Three hundred sixty-six adult patients in Namibia with second-line virologic failures were evaluated for human immunodeficiency virus drug-resistant (HIVDR) mutations. Less than half (41.5%) harbored ≥1 HIVDR mutations to standardized second-line antiretroviral therapy (ART) regimen. Optimizing adherence, viral load monitoring, and genotyping are critical to prevent emergence of resistance, as well as unnecessary switching to costly third-line ART regimens.

scholarly journals Second-line failure and first experience with third-line antiretroviral therapy in Mumbai, India

2014 ◽  
Vol 7 (1) ◽  
pp. 24861 ◽  
Author(s):  
Samsuddin Khan ◽  
Mrinalini Das ◽  
Aristomo Andries ◽  
Alaka Deshpande ◽  
Homa Mansoor ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Second Line ◽  
Third Line

scholarly journals Rewards: A predictor of well-being and service quality of school principals in the North-West province

2016 ◽  
Vol 15 ◽  
Author(s):  
Kamohelo Nthebe ◽  
Nicolene Barkhuizen ◽  
Nico Schutte
Keyword(s):  
Service Quality ◽  
Service Delivery ◽  
Work Engagement ◽  
School Principals ◽  
Well Being ◽  
North West ◽  
The North ◽  
Total Rewards ◽  
North West Province

Orientation: School principals have an important role to play in the quality of service delivery in schools. Evidence suggests that school principals are generally poorly compensated, which has an adverse impact on their well-being and subsequent service quality orientation.Research purpose: This study investigated whether rewards are a predictor of well-being and service orientation of school principals in the North-West province.Motivation for the study: Effective school principals are fundamental to the success of any school, which necessitates the establishment of an effective reward and remuneration system.Research design, approach and method: Quantitative research was carried out among school principals (N = 155) in four districts of the North-West province. The Total Rewards Scale, Maslach’s Burnout Inventory – General Survey, the Utrecht Work Engagement Scale and the SERVQUAL measure were administered among the principals.Main findings: The results showed that rewards are a significant predictor of the well-being and service quality of school principals. The results further showed that burnout significantly reduces the service quality of school principals. No significant relationships were found between work engagement and the service quality of school principals.Practical/managerial implications: An effective total rewards system enhances the well-being of school principals and, subsequently, their willingness and commitment to delivering quality services.Contribution: The results of this study point out some key elements that need to be considered by the Department of Education to enable quality service delivery in South African schools.

scholarly journals Experiences of mothers of sexually abused children in North-West province, post disclosure

Curationis ◽  
2016 ◽  
Vol 39 (1) ◽  
Author(s):  
Gaboipolelwe M. Masilo ◽  
Mashudu Davhana-Maselesele
Keyword(s):  
Sexual Abuse ◽  
Sexually Abused ◽  
Secondary Trauma ◽  
Emotional Pain ◽  
Abused Children ◽  
North West ◽  
South African Police Service ◽  
The North ◽  
North West Province ◽  
Sexually Abused Children

Background: Sexual violence against children is increasing at an alarming rate in South Africa. In 2010 the South African Police Service (SAPS) reported 21 538 rape cases of children under 18 years. In the North-West province (NWP) 5039 incidents of rape cases were reported in 2009. Mothers often experience emotional pain following child sexual abuse disclosure. It is seldom acknowledged that these mothers experience trauma and need support, post disclosure. The researcher has no known evidence of research conducted on the experiences of these mothers in NWP. Objective: The objective of the study was to explore and describe the experiences of mothers of sexually abused children post disclosure of the abuse. Method: The research design was qualitative, exploratory, descriptive and contextual. Purposive sampling was used to select mothers of sexually abused children aged 23 to 59 years whose children ranged from 0 to 16 years. Permission to conduct the study was sought from the Provincial Department of Health and informed consent was obtained from the mothers. Interviews were conducted with a sample of n = 17 until data saturation. Data were collected through in-depth interviews using a voice recorder and field notes to enhance triangulation. Tesch’s method of open coding was used to analyse data. Results: Findings indicated that mothers experienced emotional pain post sexual abuse. They expressed shock, anger and guilt for not noticing the abuse. They showed significant depression as a result of lack of support by stakeholders. Conclusion: Mothers experienced secondary trauma that poses social and psychological challenges with far-reaching implications.

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