http://hdl.handle.net/10386/177 Thu, 02 Apr 2026 09:41:42 GMT 2026-04-02T09:41:42Z http://hdl.handle.net/10386/5397 Evaluation of nursing' antimicrobial prescribing practices and use in selected public primary health care facilities in the North-West Province, South Africa Motseatsea, Valentia Pretty Mosima Background: Antimicrobial Resistance (AMR) poses a significant threat to global health, primarily driven by inappropriate antimicrobial prescribing practices. This study aims to evaluate the effectiveness of Antimicrobial Stewardship (AMS) activities at the primary healthcare (PHC) level. The primary aim was to evaluate the appropriateness of nurses’ antimicrobial prescribing practices and determine the availability of antimicrobial stewardship activities in PHC settings. Methods: The study employed a mixed-methods approach, analysing 366 prescriptions for appropriateness in Phase 1. Descriptive data analysis was performed using SPSS. In Phase 2, fifteen (15) In-depth interviews were conducted with professional nurses, but only twelve (12) were included for analysis. These were analysed verbatim to derive themes related to their understanding of antimicrobial prescribing practices. A pilot study and cross-checking were conducted to ensure the validity and trustworthiness of the results. Results: The majority (89%, n = 326) of the prescriptions were deemed inappropriate. Identified issues included incomplete diagnoses (65%, n = 211) and unjustified use of antimicrobials (7%, n = 23). The identified matters included undocumented dose strengths (86%, n = 438), incorrect dosing (10%, n = 34), and undocumented therapy duration (85%, n = 434) among the 509 prescribed antimicrobials. Qualitative findings revealed six key themes: nurses' understanding of antimicrobial resistance, challenges in antimicrobial prescribing, health education and patient interaction, professional training and confidence, access to resources and guidelines, and awareness of antimicrobial stewardship (AMS). Additional concerns emerged, including the personal use of antimicrobials by nurses and non-adherence to the Standard Treatment Guidelines and Essential Drug List Guidelines, which suggested treatment durations. While some nurses reported clinical support and accessibility to pharmacists, this was inconsistent and often limited to stock management, with the underutilisation of pharmacists for clinical guidance noted. Conclusions: The study concludes that inappropriate antimicrobial prescribing is prevalent in PHC due to systemic and personal challenges that nurses face, potentially contributing to antimicrobial resistance.Recommendations: Key recommendations include expanding the role of Sub-District Pharmacists and infection control practitioners (ICP) to include surveillance, incorporating antimicrobial discussions in pharmaceutical and therapeutics committee meetings, initiating AMS activities at the PHC level, prioritising nurse training on antimicrobials and guidelines, and addressing staffing issues to alleviate workload pressures. Thesis (M. Pharm. (Pharmacology)) -- University of Limpopo, 2025 Wed, 01 Jan 2025 00:00:00 GMT http://hdl.handle.net/10386/5397 2025-01-01T00:00:00Z http://hdl.handle.net/10386/5392 Clinical and dermoscopic features of acral melanocytic nevi in African Patients, Pietersburg Hospital Molapo Ramolapo Antony Background: Acral melanocytic nevi (AMN) of volar skin are common in Asians, Africans, Caucasians and Indians. Some cutaneous melanomas arise from AMN, and it is difficult to determine which nevus will become malignant clinically. Dermoscopic evaluation of nevi has been used to describe various patterns, some of which have been found to be associated with melanoma. Most of these studies were conducted in Caucasians and hence a paucity of literature in Africans. Objective: To describe the clinical and dermoscopic features of acral melanocytic nevi in African patients at Pietersburg Hospital. Methodology: A quantitative, cross-sectional method was used in the study. A total of 269 adult African patients with AMN were examined. The findings were recorded photographically, and descriptive statistics were used to organise the data. The Chi-squared test was used to test for associations. Results: A total of 269 patients were enrolled. The age ranged between 18 and 87 years and the mean was 37.1 years. Females were 67%, and males 33%. Majority (99.26%) AMN were macules, more commonly observed on the right palm (54.6%). Commonest colours were brown (84.4%) and black (14.9%). Dermoscopically, the commonest patterns were: parallel furrow pattern (59.9%), globular pattern (10.0%), fibrillar pattern (9.7%) and homogeneous pattern (8.6%). The fibrillar pattern was found to be higher in females (p=0.016), than in males. Conclusion: The parallel furrow pattern was most prevalent, followed by the globular and homogeneous patterns in the study. A rare arciform clinical morphology was reported in two AMN (0.74%). Thesis (M. Med. (Dermatology)) -- University of Limpopo, 2025 Wed, 01 Jan 2025 00:00:00 GMT http://hdl.handle.net/10386/5392 2025-01-01T00:00:00Z http://hdl.handle.net/10386/5378 The experiences of caregivers on the use of herbal medicine among children at a local district hospital in Mopani District, Limpopo Province Masete, Judith Background Children under the age of five are frequently treated with herbal remedies, a grim reality that can occasionally be lethal. Although herbal therapies are widely regarded as safe treatments, their effectiveness is unknown, and their negative effects particularly for children are likely to differ from person to person. Purpose The purpose of the study was to determine the experiences of caregivers on the use of herbal medicine among children at a local district hospital in Mopani District, Limpopo Province . Study methods The study employed non-purposive probability sampling . one-to-one semi-structured interviews using an interview guide were conducted on 14 participants and the collection of field notes via consented audio recordings were the methods employed in this qualitative study. Interpretive phenomenology design was used for data analysis. This study has illustrated a phenomenological aspect of caregivers' attitudes towards the use of herbal medicine among children that is influenced by cultural customs, perceived advantages, and risk awareness. Results Most participants highlighted the effectiveness of herbal medicines, particularly in treating childhood illnesses such as “lekone” and headaches, often turning to these alternatives when modern medicine proves to be insufficient. Although most caregivers are aware of the risks and benefits, the regulatory issues remain a concern. Conclusion The study has proven that most caregivers rely on herbal medicines for the well-being of their children and for the treatment of ailments. Therefore , the mass illegal accessibility of herbal medicine specifically in rural areas, should be prevented by establishing and updating the rules and regulations on herbal medicines distribution. Thesis (M. Nursing) -- University of Limpopo, 2025 Wed, 01 Jan 2025 00:00:00 GMT http://hdl.handle.net/10386/5378 2025-01-01T00:00:00Z http://hdl.handle.net/10386/5375 Exploring the management modalities for a paediatric population presenting with binocular vision anomalies in public health care facilities in Limpopo Province, South Africa Maribeng, Ennie Raesibe Background and aim: Misdiagnosing and mismanaging accommodative and vergence anomalies can result in patients experiencing a poor quality of life due to poor visual status, particularly in the paediatric population. As a result, periodic binocular vision assessment is critical in the lives of children, mainly during their early growth. The current study aims to determine the management modalities used by the optometrists in the public health sectors on paediatric population presenting with binocular vision anomalies in Limpopo Province, South Africa. A thorough understanding of paediatric binocular vision management modalities by public-sector optometrists may help inform health policy and practices. Methods: A cross-sectional descriptive and quantitative research method was adopted for the current study. Using purposive sampling, 98 optometrists practicing in theselected 43 public hospitals within the Limpopo Province were included as participants. Participants completed online self-administered questionnaires that included demographics, self-reported clinical competencies, management modalities and the availability of clinical resources. Descriptive (frequency counts, percentages) and inferential statistics (Pearson correlation) were used to analyse the data using SPSS version 29.0. Results: More than half (56.5%) of the participants reported to have competencies in diagnosing and managing binocular vision anomalies. The most common mode of management used was spectacles (69%), and was reported to be a successful mode of treatment by 80.8% of the participants. Drugs and contact lenses were the least preferred management methods used by 1.4% of the participants. The lack of both appropriate equipment and the requisite competencies were identified as the primary reason for non-management of binocular vision anomalies by 49.8% and 41.9% of the participants, respectively. In addition, 62.9% of the participants had not attended any continuous professional development (CPD) activity within the preceding six months. Most hospitals are equipped with ophthalmoscopes, trial frames, distance and near charts, but have limited number of equipment designed for diagnosing binocular vision anomalies.Conclusions: Half the participants demonstrated their ability to diagnose and manage paediatric binocular vision disorders. Most participants reported to lack the necessary training for binocular vision management. Periodic training for practicing optometrists in the public health sector on paediatric binocular vision anomalies is essential for ensuring quality optometric services. By attending relevant training, optometrists in public hospitals will learn the latest modalities to treat paediatrics binocular vision anomalies that will improve paediatrics quality of life. It is imperative that the government prioritise the provision of instruments for binocular vision assessment and management in all public health facilities to facilitate the efficient and effective diagnosis and management of paediatric binocular vision disorders. This practice of binocular vision will enhance the quality of optometric services both in the Limpopo Province and throughout South Africa. Thesis (M.Optom.) -- University of Limpopo, 2025 Wed, 01 Jan 2025 00:00:00 GMT http://hdl.handle.net/10386/5375 2025-01-01T00:00:00Z