Browsing by Author "Sebitloane, Hannah Motshedisi."

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An audit of perinatal mortality at King Edward VIII Hospital, Durban.
(2016) Frank, Nadiya.; Ibrahim, T.; Sebitloane, Hannah Motshedisi.
Abstract not available.
Diagnostic evaluation of the BD Affirm™ VPIII assay as a point-of-care test for the diagnosis of bacterial vaginosis, trichomoniasis and candidiasis in a population of pregnant women from South Africa.
(2020) Dessai, Fazana.; Sebitloane, Hannah Motshedisi.; Abbai, Nathlee Samantha.
OBJECTIVE: Untreated Sexually Transmitted Infections (STIs) and Bacterial vaginosis (BV) pose a serious health risk to mother and child. Limited data exist on the use of the BD Affirm VPIII assay as a point-of-care test. This study compared the BD Affirm VPIII assay to the BD MaxTM Vaginal assay (reference test) for the detection of BV, Trichomonas vaginalis, and Candida spp. The prevalence of single and co-infections are also reported here. METHODS: The study enrolled 273 pregnant women from King Edward VIII hospital in Durban. Socio-demographic, sexual behaviour and clinical data were collected from all consenting women. The women provided two self-collected vaginal swabs for testing. The swabs were tested using the BD Affirm VPIII assay and the BD MaxTM Vaginal assay. The prevalence of BV, trichomoniasis and candidiasis was calculated as the percentage of women who tested positive for BV, T.vaginalis and Candida infection and 95% confidence intervals (CIs) were calculated for these percentages using the formulas for calculating CIs for proportions. The number of co-infections was calculated using chi-square analysis. The diagnostic accuracy of the BD AffirmTM VPIII assay compared to the BD Max assay was assessed through the calculation of sensitivity, specificity, Negative Predictive Value (NPV) and Positive Predictive Value (PPV) and their respective 95% confidence intervals. RESULTS: In this study population, 85% of the participants were unmarried; however, 84% reported having a regular partner, and 96.3% did not use a condom regularly. The prevalence of Bacterial Vaginosis, Candidiasis and Trichomoniasis was 49.4%, 57.2% and 10.3%, respectively. A large proportion of women (78.8%) in this study did not have a discharge despite being positive for one or more pathogens. The BD AffirmTM VPIII assay showed a moderate sensitivity (79.8%) and specificity (80.3%) for diagnosing BV in all participants. The assay had an excellent specificity for Candida and T. vaginalis of 97.4% and 100.0%; respectively, however, it exhibited poor sensitivities of 52.9% and 42.4%, respectively. CONCLUSION: Our findings show a higher prevalence of Bacterial Vaginosis in antenatal attendees than previously reported, while the prevalence of Candidiasis and Trichomoniasis was in keeping with previous reports. The high number of asymptomatic infections detected is of concern and indicates the need for the re-evaluation of the syndromic management approach, especially in the antenatal population. The BD AffirmTM VPIII assay was found to be unsuitable as a screening test for vaginal infections in pregnancy. The assay performed better as a confirmatory test and may serve useful if used in conjunction with other clinical parameters such as vaginal pH.
High prevalence and incidence of asymptomatic sexually transmitted infections during pregnancy and postdelivery in KwaZulu Natal, South Africa.
(Wolters Kluwer., 2015) Moodley, Dhayendre.; Moodley, Prashini.; Sebitloane, Hannah Motshedisi.; Soowamber, Deepak.; McNaughton-Reyes, Heather Luz.; Groves, Allison K.; Maman, Suzanne.
Abstract available in pdf.
Maternal complications in HIV infected women receiving combination antiretroviral treatment in a resource constraint setting.
(2017) Sebitloane, Hannah Motshedisi.; Moodley, Jagidesa.
Abstract in PDF file.
Peripartum hysterectomy audit at Port Shepstone Regional Hospital, South Africa : a five year review.
(2017) Phinzi, Sibusiso Blessing.; Sebitloane, Hannah Motshedisi.
Background Over the years the peripartum hysterectomy has become a life-saving procedure in cases of intractable postpartum haemorrhage or when medical and/or surgical conservative interventions have failed and in severe puerperal sepsis. Aim To audit the clinical management preceding peripartum hysterectomy and evaluate maternal and neonatal outcomes in patients who were done peripartum hysterectomy. Material and Methods The researcher developed a structured audit form based on specific types of pregnancy and delivery complications leading to peripartum hysterectomy. The medical records of 126 patients who had postpartum hemorrhage and 83 patients who had undergone peripartum hysterectomy from 1st January, 2010 to 31st December, 2014 (5 years), at Port Shepstone Hospital in Kwa-Zulu Natal were reviewed retrospectively. Maternal characteristics and details of the present pregnancy and delivery, hysterectomy indications, complications, postoperative complications, and maternal and neonatal outcomes were evaluated. A statistical package (SPSS version 24.0) was used to analyze the data. Results During the 5-year study period, a total of 17657 births occurred. There were 83 peripartum hysterectomy cases and 126 postpartum hemorrhage cases. The incidence for peripartum hysterectomy was 0.47% (4.7/1000 deliveries) and incidence for postpartum hemorrhage was 0.71% (7.1/1000 deliveries). In patients with PPH, post C/S peripartum hysterectomy incidence was 7.2/1000 C/S deliveries and post vaginal peripartum hysterectomy incidence was 0.65/1000 normal vaginal deliveries. There was a statistical significant relationship between peripartum hysterectomy and cesarean section delivery in the current pregnancy and previous cesarean delivery (p=0.0001 and p=0.01 respectively). Sixty two (49.2%) of 126 postpartum hemorrhage cases were unresponsive to conservative medical and surgical measures and required peripartum hysterectomy. Five patients with uterine rupture did not have any conservative management and proceeded to peripartum hysterectomy. Sixteen (19.3%) patients with sepsis were sent directly for peripartum hysterectomy.
A retrospective audit of maternal and fetal outcomes associated with fetal macrosomia (≥ 4000 g) at King Edward VIII Hospital from 1st July 2012 to 1st July 2013.
(2014) Naicker, Kiresha.; Maise, Hopolane Clifford.; Sebitloane, Hannah Motshedisi.
Abstract available in the PDF.
What are the barriers to the implementation of the Choice on Termination of Pregnancy Act 92, 1996 as amended, in Xhariep District in the Free State Province? : a view of doctors, nurses, and hospital management in three district hospitals in Xhariep.
(2010) Kgasane, N. E.; Sebitloane, Hannah Motshedisi.
Background The Choice on Termination of Pregnancy Act (CTOPA) No 92 of 1996 replaced the Abortion and Sterilization Act of 1975. It promotes reproductive rights and the choice on termination of pregnancy. It aims to reduce deaths resulting from illegal abortions. It designates District Hospitals and Community Health Centres to render Termination of Pregnancy (TOP). In the Free State there are 24 District Hospitals and ten Community Health Centres. Currently nine render TOP. None are in Xhariep District. Aim of the study The study investigated barriers to the implementation of the CTOPA in Xhariep District among doctors, nurses and managers in District Hospitals. Methodology It was descriptive in nature, and was divided into the quantitative and qualitative parts. The quantitative part targeted doctors and nurses, while thelatter targeted management. The response rate was 95%. Findings The findings are summarised below:-  Ninety five per cent of the respondents were nurses.  Infrastructural and human resource deficiencies are a barrier to the implementation of the act.  There are insufficient budgets to procure equipment, consumables and pharmaceuticals to render the service.  Training on reproductive health and TOP is not sufficient, except for family planning.  There is stigma towards TOP from the community, and peers. Its origin is religion and culture.  There is no psychosocial and management support for those willing to participate in TOP.  Respondents are willing to refer patients for TOP, and believe that women are entitled to choose whether to terminate unwanted pregnancies or not.  There are no incentives to for those willing to implement the Act, nor provincial support to the Districts. Recommendations  Train staff on reproductive health and TOP.  Hold management accountable by including TOP and the reproductive health package in their performance agreements.  Negotiate incentives for those willing to implement TOP, and recogniseTOP as a speciality in line with the Occupation Specific Dispensation.  Provide infrastructure and equipment for the implementation of TOP.  Develop a recruitment and retention strategy for professionals. The policy on community service for health professionals is a case in point.  Resource the District Health System as a vehicle for Primary Health Care Services.