Papers by stephane tshitenge
Article, 2024
The study assessed the quality-of-life (QOL) and its relationship with sociodemographic factors a... more The study assessed the quality-of-life (QOL) and its relationship with sociodemographic factors and geriatric syndromes among older adults residing in Botswana's Central Mahalapye subdistrict. This was a cross-sectional study. To assess geriatric syndromes, the survey used the brief-assessment-tool-for-comprehensive-geriatric-assessment (BAT for CGA), as well as the World Health Organisation Quality-of-Life-Questionnaire-Short-Version (WHOQOL-BREF) to assess the QOL domains. We used a multivariate linear regression model to find out how external factors, like geriatric syndromes and sociodemographic factors, affect the QOL score across different domains. The study encompassed a grand total of 414 older adult individuals. Except for the physical domain of the WHOQOL-BREF, senior participants in this study reported a high QOL, as most average scores across multiple domains of the WHOQOL-BREF exceeded 50%. Frailty impacted negatively in self-perception of QOL, self-perception of health, and WHOQOL-BREF social and environmental domains (β=-.124, t=-2.543, p=.011, β=-.258, t=-4.991, p=<.001, β=-.190, t=-4.198, p=<.001, β=-.170, t=-3136, p=.002, and β=-.147, t=-3.129, p=.002, respectively). While osteoporosis impacted negatively on self-perception of QOL, self-perception of health, WHOQOL-BREF psychological, social, and environmental domains (β=-.104, t=-2.426, p=.016, β=-.117, t=-2.378, p=.008, β=-.211, t=-4.916, p=<.001, β=-.137, t=-2.934, p=.004, and β=-.287, t=-6.437, p=<.001, respectively). High education level had a positive impact on self-perception of QOL (β=.165, t=3.566, p<.001), and living with a partner impacted positively on self-perception of QOL (β=.216, t=5.196, p<.001) and self-perception of health (β=.167, t=3.488, p<.001). We suggest that more research be done to make sure that the BAT for CGA tool works correctly in rural Africa.
South African Family Practice, Jul 10, 2017
Background: About 37 million people are living with human-immunodeficiency-virus (HIV) worldwide,... more Background: About 37 million people are living with human-immunodeficiency-virus (HIV) worldwide, with 2.6 million co-infected with the hepatitis B virus (HBV). HBV infection causes 650 000 deaths annually worldwide. Botswana has a high prevalence of HIV and a growing population of patients on highly active antiretroviral therapy (HAART). This study aimed to determine the prevalence of HIV-HBV co-infection amongst HAART eligible adult patients in some rural settings in Botswana. Methods: A cross-sectional study was conducted amongst HAART eligible adult patients at 15 HAART clinics in the Mahalapye, Ngami and Serowe Health Districts of Botswana, from August to October 2015. A total of 132 were recruited; of these 118 consented and were tested for HBsAg reactivity using Elisa. Results: Six (5.1%, 6/118) patients from the three rural health districts were HIV-HBV co-infected, with three in the 20-29 age group. The association between sex and HIV-HBV co-infection status was not statistically significant; p = 1.00. Conclusion: The finding of 5.1% HIV-HBV co-infection prevalence in some rural settings of Botswana was similar to results from one study conducted in a Botswana urban centre, while another previous similar study reported prevalence as being twice as high. This finding may call for prioritisation of pre-HAART HBV screening and early HAART initiation for all HIV-infected patients.
South African Family Practice, Feb 15, 2017
Background: About 37 million people are living with human-immunodeficiency-virus (HIV) worldwide,... more Background: About 37 million people are living with human-immunodeficiency-virus (HIV) worldwide, with 2.6 million co-infected with the hepatitis B virus (HBV). HBV infection causes 650 000 deaths annually worldwide. Botswana has a high prevalence of HIV and a growing population of patients on highly active antiretroviral therapy (HAART). This study aimed to determine the prevalence of HIV-HBV co-infection amongst HAART eligible adult patients in some rural settings in Botswana. Methods: A cross-sectional study was conducted amongst HAART eligible adult patients at 15 HAART clinics in the Mahalapye, Ngami and Serowe Health Districts of Botswana, from August to October 2015. A total of 132 were recruited; of these 118 consented and were tested for HBsAg reactivity using Elisa. Results: Six (5.1%, 6/118) patients from the three rural health districts were HIV-HBV co-infected, with three in the 20-29 age group. The association between sex and HIV-HBV co-infection status was not statistically significant; p = 1.00. Conclusion: The finding of 5.1% HIV-HBV co-infection prevalence in some rural settings of Botswana was similar to results from one study conducted in a Botswana urban centre, while another previous similar study reported prevalence as being twice as high. This finding may call for prioritisation of pre-HAART HBV screening and early HAART initiation for all HIV-infected patients.
SAGE Open Medicine, 2022
Objectives: This study aimed to investigate the psychological impact of the COVID-19 outbreak on ... more Objectives: This study aimed to investigate the psychological impact of the COVID-19 outbreak on healthcare workers across multiple hospitals in different districts in Botswana. Methods: We conducted a cross-sectional study in five public-funded hospitals from three districts in Botswana from 1 June 2020 to 30 October 2020. We used the neuroticism subscale of the 44-item Big Five Inventory, Patient Health Questionnaire, the Oslo 3-item Social Support Scale, the Anxiety Rating Scale, and the 14-item Resilience Scale to obtain data from 355 healthcare workers. Results: The participants’ mean age (standard deviation) was 33.77 (6.84) years. More females (207, 59%) responded than males (144, 41%). Anxiety and depression were experienced by 14% and 23% of the participants, respectively. After multiple regression analyses, neuroticism predicted depression ( B = 0.22; p < 0.01) and anxiety disorder ( B = 0.31; p < 0.01). Lower educational status ( B = −0.13; p = 0.007) predicted anxi...
The Journal of Contemporary Dental Practice, 2014
Objective To assess knowledge, attitudes and practices among the dental graduate in relation to h... more Objective To assess knowledge, attitudes and practices among the dental graduate in relation to healthcare ethics and law. Materials and methods A cross-sectional study design was employed using a self-administered questionnaire. A 15 item questionnaire about law and ethics was devised; tested and made available to all levels of gradates including teaching staff, postgraduates and intern at dental college in Bengaluru. A total of 116 graduates participated, with a response rate of 96.5% (n = 112). Results Seventy-six percent of the participants said that they are legally bound to treat all the patients who approach them for the treatment. Nearly 32% of the participants have mentioned the various other reasons for the rejection apart from the reason like HIV+, poor patients and patients with the contagious disease. Conclusion The study points to the need for appropriate training among graduates including the professional staffs and other graduates, and to devise means to sensitize th...
African Journal of Primary Health Care & Family Medicine
How to cite this article: Tshitenge ST, Nthitu JM. COVID-19 frontline primary health care profess... more How to cite this article: Tshitenge ST, Nthitu JM. COVID-19 frontline primary health care professionals' perspectives on health system preparedness and response to the pandemic in
African Journal of Primary Health Care & Family Medicine, 2018
Intimate partner violence is a common social problem which causes considerable relationship stres... more Intimate partner violence is a common social problem which causes considerable relationship stress and results in significant morbidity and mortality of the victims. Botswana, like many other countries in sub-Saharan Africa, has tried to address the problem of intimate partner violence with legislations prescribing punitive measures for the perpetrators and protection for the victims. The effectiveness of these measures in reducing the prevalence of intimate partner violence is doubtful. This article is to motivate for an alternative primary preventive approach to the problem as a more pragmatic option.
African Journal of Primary Health Care & Family Medicine, 2014
Aim: The present study aimed: (1) to evaluate the proportion of each diabetic foot (DF) risk cate... more Aim: The present study aimed: (1) to evaluate the proportion of each diabetic foot (DF) risk category, according to the International Working Group on the Diabetic Foot (IWGDF) consensus, in patients attending the diabetic clinic in Selebi Phikwe Government Hospital (SPGH) and (2) to examine some of the factors that may be associated with the progression to higher risk categories such as anthropometric measurements, blood pressure, glycosylated haemoglobin (HbA1c) and lipid profile.Methods: A retrospective, cross sectional chart review of patients who had attended the diabetic clinic in SPGH from January 2013 to December 2013 was performed. Patients were included if they had undergone a foot examination. Patients with amputation due to accident were excluded. The DF risk category was assessed by determining the proportion of patients in each of four risk categories, as described by the IWGDF consensus.Results: The study encompassed 144 records from patients reviewed for foot examina...
African Journal of Primary Health Care & Family Medicine, 2014
Background: The Mahalapye district health management team (DHMT) conducts regular audits to evalu... more Background: The Mahalapye district health management team (DHMT) conducts regular audits to evaluate the standard of services delivered to patients, one of which is the prevention of mother-to-child-transmission (PMTCT) programme. Xhosa clinic is one of the facilities in Mahalapye which provides a PMTCT programme.Aim: This audit aimed to identify gaps between the current PMTCT clinical practice in Xhosa clinic and the Botswana PMTCT national guidelines.Setting: This audit took place in Xhosa clinic in the urban village of Mahalapye, in the Central District of Botswana.Methods: This was a retrospective audit using PMTCT Xhosa clinic records of pregnant mothers and HIV-exposed babies seen from January 2013 to June 2013.Results: One hundred and thirty-three pregnant women registered for antenatal care. Twenty-five (19%) knew their HIV-positive status as they had been tested before their pregnancy or had tested HIV positive at their first antenatal clinic visit. More than two-thirds of ...
South African Family Practice, 2015
Sustainable and aggressive population-based programmes on hypertension awareness, prevention, tre... more Sustainable and aggressive population-based programmes on hypertension awareness, prevention, treatment and control are key to the successful control of this epidemic. The objective of the study was to determine to what extent hypertension and risk factors for its development were prevalent in the Kang village community in Botswana, and specifically to assess its prevalence in the adult population and its relationship with high blood pressure, anthropometric measures and lifestyle factors, i.e. diet and the use of tobacco products and alcohol. Method: A population-based cross-sectional study was conducted on 161 adult residents of Kang aged 18 years and older from November to December 2008. A questionnaire adapted from the World Health Organization stepwise approach to the surveillance of chronic disease was used for the data collection. Results: The prevalence of hypertension in the adult population of Kang was found to be 32% (95% confidence interval: 25-40). There was no significant sex difference in the prevalence rate in men (28%) versus women (34%), (p = 0.59). Hypertension was more prevalent in the overweight group than in the normal-weight group (p = 0.3), in the obese group than in the normal-weight group (p = 0.002), and in the obese group than in the overweight group (p = 0.04). Conclusion: This study showed that hypertension affected almost a third of the adult population of Kang, and was significantly associated with overweight and obesity.
African Journal of Primary Health Care & Family Medicine
Intimate partner violence is a common social problem which causes considerable relationship stres... more Intimate partner violence is a common social problem which causes considerable relationship stress and results in significant morbidity and mortality of the victims. Botswana, like many other countries in sub-Saharan Africa, has tried to address the problem of intimate partner violence with legislations prescribing punitive measures for the perpetrators and protection for the victims. The effectiveness of these measures in reducing the prevalence of intimate partner violence is doubtful. This article is to motivate for an alternative primary preventive approach to the problem as a more pragmatic option.
Pan African Medical Journal
African Journal of Primary Health Care & Family Medicine, Jul 26, 2016
, reviewed and scored each selected case record that was compared with the scores previously attr... more , reviewed and scored each selected case record that was compared with the scores previously attributed to the nurse triage. Results: From the 315 case records, both the nurse triage and the panel of expert triage assigned the majority of cases in the routine category (green), 146 (46%) and 125 (40%), respectively, or in the urgent category (yellow), they assigned 140 (44%) and 111 (35%) cases, respectively. Overall, there was an adequate agreement between the nurse triage and the panel of expert triage (k = 0.4, 95% confidence interval: 0.3-0.5), although the level of agreement was satisfactory. Conclusion: Findings of the study reported that the profile of the priority-level categories in MDH-ED was made in the majority of routine and urgent patients, only the routine and the emergency patients were seen within the targeted time and they had a satisfactory level of reliability (between 0.4 and 0.6).
In the title of this article initially published, the spelling of 'Traige Tool' was unintentional... more In the title of this article initially published, the spelling of 'Traige Tool' was unintentionally misprinted as 'Triage Toll'.
African Journal of Primary Health Care & Family Medicine
Background: The World Health Organization aims to reduce tuberculosis (TB) mortality rate from 15... more Background: The World Health Organization aims to reduce tuberculosis (TB) mortality rate from 15% in 2015 to 6.5% by 2025.Aim: This study determined the profile of TB and human immunodeficiency virus (HIV) co-infected patients who died in Mahalapye District, Botswana, while on anti-TB medication and the factors that contributed to such outcome.Setting: The study was conducted in the Mahalapye Health District in Botswana.Methods: This was a cross-sectional study that reviewed patient records from the Mahalapye District Health Management Team Electronic Tuberculosis Register from January 2013 to December 2015.Results: The majority of the TB and HIV co-infected patients were on antiretroviral therapy (ART) (486 [81.63%]) or were initiated cotrimoxazole preventive therapy (CPT) (518 [87.2%]) while taking anti-TB treatment. Seventy-three (13.6%) TB and HIV co-infected patients died before completing anti-TB treatment. Three-quarters (54 [74.4%]) of patients who died before completing an...
African journal of primary health care & family medicine, Jan 31, 2016
Family Medicine (FM) training is new in Botswana. No previous evaluation of the experiences and o... more Family Medicine (FM) training is new in Botswana. No previous evaluation of the experiences and opinions of residents of the University of Botswana (UB) Family Medicine training programme has been reported. This study explored and assessed residents' experiences and satisfaction with the FM training programme at the UB and solicited potential strategies for improvement from the residents. A descriptive survey using a self-administered questionnaire based on a Likert-type scale and open-ended questions was used to collect data from FM residents at the UB. Eight out the 14 eligible residents participated to this study. Generally, residents were not satisfied with the FM training programme. Staff shortage, inadequate supervision and poor programme organisation by the faculty were the main reasons for this. However, the residents were satisfied with weekly training schedules and the diversity of patients in the current training sites. Residents' potential solutions included an i...
South African Family Practice
Pan African Medical Journal
Introduction: Problem-based Learning (PBL) curricula, like all curricula, require systematic eval... more Introduction: Problem-based Learning (PBL) curricula, like all curricula, require systematic evaluation as there is a risk of implementing a dysfunctional PBL curriculum. The study intended to evaluate the PBL curriculum delivery from the perspective of the clerkship students at the University of Botswana-Faculty of Medicine. Methods: A cross-sectional study was conducted among clerkship students in Family Medicine, Paediatrics, Internal Medicine and Surgery. During a 4-week period, each respondent completed weekly a questionnaire based survey tool. The three part questionnaire consisted of demographic data, 'seven-jumps' adapted from a 'typical' PBL tool to evaluate PBL process and 11 items 'adopted 'from the Short-Questionnaire-to-Evaluate-the-Effectiveness-of-Tutors in the PBL tool to evaluate the PBL facilitation with open ended questions at the end. Results: Of the 81 eligible participants, 89% (n=72) responded. We collected back 141 (49%) forms out of the 288 expected (72 X 4 weeks). PBL first sessions took place all the time only in Family Medicine and in about 75% of the time in Pediatrics but none were conducted in the other disciplines. Overall, they evaluated the PBL process as 'good' (median= 8 /10) and the PBL facilitation as 'very good' (median=9 /10). Students appeared to have differing opinions on the preferred approach to the nature of patient problems that the PBL sessions should be structured around. Conclusion: Despite students rating PBL process as 'good' and facilitation as 'very good', PBL first sessions were not consistently undertaken.
I wish to express my invaluable and utmost gratitude to the following personalities: Almighty G... more I wish to express my invaluable and utmost gratitude to the following personalities: Almighty God who is my strength, inspirer and in whose divine intervention and purpose this project will achieve. My family and friends for the psychosocial and social support they have always provided.
African Journal of Primary Health Care & Family Medicine, Jan 27, 2020
BackgroundExtra-pulmonary tuberculosis (EPTB) accounts for about 20% of TB cases worldwide. Its d... more BackgroundExtra-pulmonary tuberculosis (EPTB) accounts for about 20% of TB cases worldwide. Its diagnosis is challenging.AimThis study meant to assess the prevalence of EPTB types, procedures to diagnose EPTB and medical officers’ (MOs) views on procedures performed in the diagnosis of EPTB over a 2-year period in Botswana.SettingThe study was conducted in 13 urban and rural facilities of 29 health districts in Botswana.MethodsThis was a cross-sectional study that reviewed patients’ TB data and administered a questionnaire to MOs.ResultsAbout 2 in 10 TB (n = 2996, 22.7%) cases were classified as EPTB. The most common site of EPTB was pleural (n = 1066, 36.7%) followed by lymph node (LN) (n = 546, 18.8%). A pleural tap was performed in 182 (17.0%) cases of pleural TB and a fine needle aspiration (FNA) in one-third (n = 160, 29.6%) of LN TB cases. There were statistical differences in work experience amongst MOs’ responses regarding their self-reported confidence to undertake basic procedures to diagnose EPTB such as pleural tap (p = 0.032) or FNA (p < 0.0001).ConclusionThis study reviewed and evaluated the proportion of EPTB and inquired about MO’s experience in managing EPTB. Despite MOs’ attendance at Botswana National Tuberculosis Programme (BNTP) TB case management (TBCM) training, the emphasis by the BNTP guidelines and availability of logistics, the execution rate of procedures to diagnose EPTB was still low in Botswana.
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Papers by stephane tshitenge