AA 2005 Supplementum 1

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Browsing AA 2005 Supplementum 1 by Author "Meulemans, Herman"

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    Healthcare-seeking behaviour among clinic-based tuberculosis patients
    (University of the Free State, 2005) Matebesi, Zacheus; Meulemans, Herman; Timmerman, Christiane
    English: This study investigated the factors influencing recourse to healthcare in a sample of 220 tuberculosis (TB) patients. Data collection was by means of face-to-face interviews. Patients sought help mainly from primary healthcare clinics (46%) and private doctors (40%). The mean patient delay was seven weeks, with only 21% of patients seeking professional healthcare within less than two weeks. The results show that lack of awareness of TB and use of a home remedy were significantly associated with a delay of longer than two weeks in seeking healthcare. These findings indicate an urgent need to educate communities on the signs and symptoms of TB, as well as the need to attend designated health facilities for early diagnosis and proper treatment.
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    Social capital and community TB care in the Free State, South Africa
    (University of the Free State, 2005) Meulemans, Herman; Van Ouytsel, Jeff; Rigouts, Leen; Mortelmans, Dimitri; Heunis, Christo; Matebesi, Zacheus; Van Rensburg, Dingie
    English: Where do TB patients turn for help in the South African health care system? Do they go to a clinic or a community health centre for ambulant treatment, thus retaining contact with their families and local communities? Or are they hospitalised, which means that they can no longer perform their normal duties? In order to answer these questions, a data set was compiled on the basis of oral interviews with a stratified random sample of 310 pulmonary TB patients in the Free State province. A logistic regression analysis of the data revealed that TB patients who can rely on an extended network of relationships, with relatively large amounts of social capital at their disposal, generally make use of clinic treatment and community TB care. Clinics play a central role in TB control programmes, not only as a locus of treatment, but also as a point from which patients can be referred to higher echelons in the healthcare system.
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    TB control: a matter of lifestyle
    (University of the Free State, 2005) Verbergt, Greet; Foblets, Marie-Claire; Meulemans, Herman
    English: In the West, TB was controlled before there was medication on the market. In South Africa this is far from the case: the inheritance of apartheid, poverty among certain social groups, and an exponential increase in HIV/AIDS make TB control almost impossible. The co-existence of two medical traditions (the Western medical system and traditional healing) exacerbates the challenge of finding effective measures for TB control. This paper aims to understand the underlying patterns of the persistant spread of this disease. Its point of reference is Max Weber’s notion of Stilisierung des Lebens, or lifestyle, in which the dialectic process of “chance” and “choice” plays an important role. In the category of chance, much can be done by policy-makers to create successful healthcare programmes, such as DOTS within TB control. Policy-makers, however, are not the only players responsible. Individuals must also take responsibility by opting for the chances provided. Even then, the spectre of the past may continue to bedevil the health outcomes of South Africans as they endeavour to build a new nation.
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    Tuberculosis control in South Africa: reasons for persistent failure
    (University of the Free State, 2005) Van Rensburg, Dingie; Janse van Rensburg-Bonthuyzen, Ega; Heunis, Christo; Meulemans, Herman
    English: This study reviews the origins and spread of tuberculosis in South Africa in the international context. It shows that TB is far from being under control, despite the availability of effective technology. Five arguments offer explanations for this failure. First, control strategies fail to eradicate the macro-conditions that create a breeding ground for TB. Secondly, new disease conditions — especially HIV/AIDS and MDRTB — confound efforts at control. Thirdly, the health system and its priorities are insufficiently focused and resourced to cope with TB. Fourthly, healthcare staff responsible for TB care are often weak links in the chain of control. Fifthly, TB patients fail due to ignorance, delay in seeking care, and non-adherence to treatment regimens. TB consequently remains a major public health challenge, today more than ever in its protracted history.