Browsing by Author "Esterhuizen, T. M."

Now showing 1 - 7 of 7
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    Calcium channel blockers for people with chronic kidney disease requiring dialysis
    (Cochrane, 2014) Esterhuizen, T. M.; Mugendi, G. A.; Strippoli, G. F. M.; Mutua, F. M.
    This is the protocol for a review and there is no abstract. The objectives are as follows: This review aims to look at the benefits and harms of CCB for people with CKD requiring dialysis.
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    High prevalence of cardiovascular risk factors in Durban South African Indians : the Phoenix Lifestyle Project
    (Health & Medical Publishing Group, 2016) Prakaschandra, D. R.; Esterhuizen, T. M.; Motala, A. A.; Gathiram, P.; Naidoo, D. P.
    Background. Previous studies show a high prevalence of cardiovascular (CV) risk factors in South African (SA) Asian Indians, with the emergence of premature coronary artery disease in young Indian subjects. Objective. To determine the prevalence of CV risk factors in this population. Methods. This was a cross-sectional study of randomly selected adults aged 15 - 64 years from the suburb of Phoenix in Durban, KwaZulu-Natal Province, SA. All participants had demographic, anthropometric and biochemical measurements using the modified World Health Organization (WHO) STEPwise survey methods. Hypertension, obesity, lipid abnormalities and diabetes mellitus (DM) were diagnosed using WHO criteria. Age-standardised frequencies for glycaemic indices were calculated according to the WHO standard world population distribution. Results. Of the 1 428 subjects who responded (response rate 72.1%), complete data for analysis were available on 1 378 (1 001 women). The mean age was 45.5 (standard deviation 13) years. There were high prevalences of hypertension (47.5%), DM (20.1%), total body obesity (raised body mass index) (32.4%) and increased waist circumference (73.1%). The ‘thin-fat’ Asian phenotype (isolated abdominal obesity) was found in only 4.8% of participants. High prevalences of total body obesity (32.1%), increased waist circumference (31.3%) and insulin resistance (28.2%) were documented in the youngest age group. Over half of the males and 14.6% of females were current smokers. Diabetic dyslipidaemia was found in 61 subjects (4.4%). In multivariate analysis, age, triglycerides and waist circumference measurement were significant independent risk factors associated with DM and, together with fasting glucose, also predicted hypertension. Conclusion. Compared with Asian Indian subjects with similar environmental exposure in previous studies, the magnitude of change in risk factor prevalence over the past two decades has been of epidemic proportions.
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    The impact of a change in referral pathway on a paediatric short-stay ward in Cape Town, South Africa
    (Health and Medical Publishing Group, 2016) Finlayson, Heather; Smit, L.; Esterhuizen, T. M.; Kruger, Mariana
    Background. The opening of the new Khayelitsha District Hospital in April 2012 coincided with a change in referral pathway to Tygerberg Hospital (TBH) for children requiring specialist care. Objective. To determine the disease burden impact of the referral pathway change on paediatric short-stay ward admissions at TBH. Methods. A retrospective cohort study, analysing routine health information as captured in ward admissions registers over two similar seasonal periods: 1 April - 30 September 2011 (prior to referral change) and 1 April - 30 September 2012 (post referral change). Results. Paediatric short-stay ward admissions remained similar, but a statistically significant increase in the number of admissions from Khayelitsha sub-district (SD) (p<0.001) was seen. The median age was 13 months over the two time periods. Children from Khayelitsha (median age 9.49 months for 2011 and 5.2 months for 2012) were, however, significantly younger than those from other SDs (median age 26.31 months in 2011 and 26.44 months in 2012) (p=0.001). Khayelitsha children were more likely to require admission to a TBH paediatric ward (p<0.001, adjusted odds ratio (aOR) 0.57), while children from other SDs were more likely to be discharged home or transferred to a district hospital (p<0.001, aOR 1.75). Respiratory illnesses accounted for the majority of admissions during both time periods (54% in 2011 and 51% in 2012). Conclusion. Children from Khayelitsha were significantly younger and more likely to be admitted to a TBH inpatient ward compared with other SDs. These findings necessitate a review of current health service resource allocation.
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    Predictors of treatment success in smoking cessation with varenicline combined with nicotine replacement therapy v. varenicline alone
    (Health & Medical Publishing Group, 2018-01) Noor, F.; Koegelenberg, C. F. N.; Esterhuizen, T. M.; Irusen, E. M.
    Background. Identification of the predictors of treatment success in smoking cessation may help healthcare workers to improve the effectiveness of attempts at quitting. Objective. To identify the predictors of success in a randomised controlled trial comparing varenicline alone or in combination with nicotine replacement therapy (NRT). Methods. A post-hoc analysis of the data of 435 subjects who participated in a 24-week, multicentre trial in South Africa was performed. Logistic regression was used to analyse the effect of age, sex, age at smoking initiation, daily cigarette consumption, nicotine dependence, and reinforcement assessment on abstinence rates at 12 and 24 weeks. Point prevalence and continuous abstinence rates were self-reported and confirmed biochemically with exhaled carbon monoxide readings. Results. The significant predictors of continuous abstinence at 12 and 24 weeks on multivariate analysis were lower daily cigarette consumption (odds ratio (OR) 1.86, 95% confidence interval (CI) 1.21 - 2.87, p=0.005 and OR 1.83, 95% CI 1.12 - 2.98, p=0.02, respectively) and older age (OR 1.52, 95% CI 1.00 - 2.31, p=0.049 and OR 1.79, 95% CI 1.13 - 2.84, p=0.01, respectively). There was no difference in the predictors of success in the univariate analysis, except that older age predicted point prevalence abstinence at 12 weeks (OR 1.47, 95% CI 1.00 - 2.15, p=0.049). The findings were inconclusive for an association between abstinence and lower nicotine dependence, older age at smoking initiation and positive reinforcement. Conclusion. Older age and lower daily cigarette consumption are associated with a higher likelihood of abstinence in patients using varenicline, regardless of the addition of NRT.
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    Research involvement among undergraduate health sciences students : a cross-sectional study
    (BioMed Central, 2017-10-16) Bovijn, J.; Kajee, N.; Esterhuizen, T. M.; Van Schalkwyk, S. C.
    Background: The development of research capacity among undergraduates is an important intervention in countering the documented decrease in medical and health sciences researchers. The literature on undergraduate research generally emanates from smaller scale studies that have been conducted in high income countries, with a focus on medical students. This cross-sectional study was conducted in a Sub-Saharan country, included a population of medical and allied health professions (AHP) students, and aimed to improve our understanding of the factors influencing undergraduate student research. Methods: A questionnaire was distributed to all students enrolled in an undergraduate programme at the Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa (including Medicine and four AHP programmes). Data was collected on a number of demographic characteristics and on 3 major outcome-themes: “voluntary research involvement”, “self-perceived research competence” and “future research participation”. Associations between characteristics and outcome themes were explored. Results: In total, 1815 students participated in the study (response rate 80.2%). Of all the demographic variables, discipline (AHP programmes vs. Medicine), male gender and prior undergraduate experience in a science degree were significantly associated with voluntary research involvement. Significantly higher levels of self-perceived research competence and greater interest in future research participation, were seen among participants from AHP programmes; males; and those with previous or current voluntary research involvement. Ethnicity and geographic background were not significantly associated with any of our outcomes. Conclusions: Our results offer important new evidence in support of the imperative to diversify the research work-force, in Sub-Saharan Africa and globally. Enhanced efforts aimed at achieving better academic representation in terms of gender, ethnicity, geographical and socio-economic backgrounds are strengthened by the findings of this study. Potential student researchers represent an important group amenable to further intervention. Further research may be required to explore the factors that determine the progression from interest to future participation in research.
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    Risk of cardiovascular disease among teachers in Cape Town : findings of the South African PaCT pilot study
    (Health & Medical Publishing Group, 2016) Laurence, E. C.; Volmink, J.; Esterhuizen, T. M.; Dalal, S.; Holmes, M. D.
    Background. The accelerating epidemic of cardiovascular disease (CVD) and other non-communicable diseases (NCDs) highlights the need to establish long-term cohort studies in Africa. Objective. The Partnership for Cohort Research and Training (PaCT) seeks to study NCDs in South Africa (SA), Uganda, Tanzania and Nigeria on a long-term basis. Pilot studies at each site have tested feasibility. The SA site additionally studied the prevalence of CVD risk factors and categorised participants’ 10-year predicted risk of a cardiovascular event. Methods. We enrolled teachers from 111 public schools in the Metro South Education District in Cape Town, SA, between January 2011 and May 2012. Participants completed a self-administered questionnaire and biological measurements, and chose post or email for 6-month follow-up. Results. The participation of schools was permitted by 53.2% of principals, and 489 of 1 779 teachers agreed to participate. Of teachers willing to participate in the follow-up, 52% were retained, three-quarters by post and a quarter by email. Their mean age was 46.3 years and 70.3% were female. The prevalence of CVD risk factors was high and featured hypertension (48.5%), hypercholesterolaemia (20.5%), smoking (18.0%), diabetes (10.1%) and chronic kidney disease (10.4%), while 84.7% were overweight or obese. Of the participants, 18.7% were at high risk of a heart attack or stroke within 10 years. Conclusion. Establishing a cohort study among teachers has challenges but also opportunities for addressing CVD, which will soon impose a substantial burden on Cape Town’s education system.
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    The utility of hand-held mobile spirometer technology in a resource-constrained setting
    (Health & Medical Publishing Group, 2019) Du Plessis, E.; Swart, F.; Maree, D.; Heydenreich, J.; Van Heerden, J.; Esterhuizen, T. M.; Irusen, E. M.; Koegelenberg, C. F. N.
    Background. Mobile phone-linked spirometry technology has been designed specifically for evaluating lung function at primary care level. The Air-Smart Spirometer is the first mobile spirometer accepted in Europe for the screening of patients with chronic respiratory diseases. Objectives. To prospectively assess the accuracy of the device in measuring forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) in a South African population, and to investigate the ability of the device to detect obstructive ventilatory impairment. Methods. A total of 200 participants were randomly assigned to perform spirometry with either the mobile spirometer connected to a smartphone or the desktop spirometer first, followed by the other. The FEV1/FVC ratio as well as the absolute FEV1 and FVC measurements were compared, using each participant as their own control. A Pearson correlation and Bland-Altman analysis were performed to measure the agreement between the two devices. We defined obstructive ventilatory impairment as FEV1/FVC <0.7 measured by desktop spirometry in order to calculate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the Air-Smart Spirometer. Results. There was a strong correlation between the absolute FEV1 and FVC values and FEV1/FVC ratio measured with the mobile Air-Smart Spirometer and more conventional pulmonary function testing, with r=0.951, r=0.955 and r=0.898, respectively. The Air-Smart Spirometer had a sensitivity of 97.6%, specificity of 74.4%, PPV of 73.0% and NPV of 97.8% for obstructive ventilatory impairment. Conclusions. The mobile Air-Smart Spirometer compared well with conventional spirometry, making it an attractive and potentially affordable tool for screening purposes in a primary care setting. Moreover, it had a high sensitivity and NPV for obstructive ventilatory impairment.