Background. The incidence and mortality rates of prostate cancer (PCa) are disproportionately on the increase among South African Black men. Recent studies show a greater net benefit of ...prostate-specific antigen (PSA) screening of Black men compared with the general population. There are, however, knowledge, attitude and practice (KAP) gaps among primary healthcare providers (HCPs) and users (Black men) on PCa screening. Likewise, there is scarcity of research on strategies to address these gaps. Objective. This study sought to determine complementing strategies to enhance the approach to PCa screening of African men in the Free State, South Africa, from the perspectives of primary HCPs and users. Methods. This study utilized a three-round modified Delphi survey to achieve its aim. Consensus was determined by an a priori threshold of ≥ 70% of agreement. Results. The survey involved a multidisciplinary panel of 19 experts. The consensus was reached on 34 items (strategies) to enhance the approach to PCa screening in the study setting. Community health education strategies were proffered, relating to relevant topics, methods and venue of delivery, and persons to deliver the education. Continuing education topics and methods of instruction were suggested for primary HCPs. Conclusion. In view of the existing KAP gaps in PCa screening among primary HCPs and users (Black men), an expert consensus was determined, on complementing strategies to enhance the approach to PCa screening of South African Black men in the study setting.
Background
In South Africa, the rate of histologically diagnosed prostate cancer is 40.1 per 100 000 in whites and 14 per 100 000 in blacks. However, blacks have limited access to diagnostic ...facilities and present late with an advanced disease. Knowledge about prostate cancer in the South African male population is necessary in order to increase the acceptance of early prostate cancer screening.
Objective
This study assessed the knowledge of prostate cancer among men attending the urology outpatient clinic at a tertiary hospital in South Africa.
Methods
A cross-sectional study was conducted from February to March 2010. A structured questionnaire was administered to participants using consecutive sampling of eligible patients and consisted of sections on sociodemographic details and knowledge about prostate cancer. A total of 346 males, 35 years of age and older, participated in the study.
Results
The majority of the respondents (n = 258; 75.0%) were black, married (n = 220; 64.0%), from the Free State Province (n = 320; 92.8%), and had access to television (n = 248; 71.7%). Only 38 (11.0%) knew the three main symptoms and signs associated with prostate cancer. Level of school education, race and language were statistically significantly associated with level of knowledge whereas age and marital status were not.
Conclusion
More than half (54.4%) of the respondents had not heard of prostate cancer. The majority of men who had heard of prostate cancer had a moderate level of knowledge. The factors significantly associated with level of knowledge need to be considered in educational campaigns, prostate cancer screening and treatment.
Background Prostate cancer (PCa)-related incidence is on the increase, with black South African men presenting disproportionately with aggressive disease. Recent studies show a greater net benefit of ...prostate-specific antigen (PSA) screening of black men compared with the general population. This scoping review provides an overview of available research on strategies that have enhanced PCa screening awareness and practice in the African setting.Methods Relevant databases were searched to identify 2010–2021 studies. Following scoping review guidelines, data were extracted, summarised and quantitatively analysed.Results Of the 21 articles included, 19 were from the United States. Nine were published within the last five years and 14 were pre-test/post-test. Most articles evaluated the effect of health-promoting strategies on awareness and practice of PCa screening among black men. Community-oriented strategies enhanced awareness and practice of PCa screening. Healthcare providers and community members, including PCa survivors, participated in the strategies’ planning, development and implementation. Topics that improve PCa knowledge and clear cultural misconceptions were addressed, targeting public spaces unique to these men. Prostate cancer health education methods were diverse, comprehensive, user friendly and culturally sensitive.Conclusion More research on strategies to enhance PCa screening awareness and practice among African men is needed, as this is scarce. Strategies enhancing PCa screening awareness and practice among African men are community oriented and entail health education methods, topics, presenters and venues. These strategies can be adopted in the South African setting.Contribution This study recommends strategies to enhance the awareness and practice of PCa screening among African men.
Background Prostate cancer (PCa) ranks high in terms of morbidity and mortality, especially in Africa. Prostate-specific antigen (PSA) screening remains a practical method of screening for and ...thereby detecting PCa early, especially among African men who are more negatively affected. Modifiable risk factors for PCa are mostly behavioural and lifestyle. Understanding community-specific determinants is important when developing health promotion interventions.Objective This study aimed to determine the profile of African men with PCa in the Free State, South Africa.Method A cross-sectional descriptive study was conducted using case record information and self-administered questionnaires among 341 African men with PCa attending the oncology and urology clinics of a tertiary hospital.Result Participants’ median age at diagnosis was 66 years. Only 76 (22.3%) participants had ever heard of PCa prior to being diagnosed with the disease, 36 (47.4%) of whom had ever had screening performed. The majority (n = 298, 87.4%) were symptomatic;<50% sought medical help within six months. At diagnosis, 133 (39.0%) men presented with stage T3 or T4 disease, 75 (22.0%) with metastatic disease and 84 (24.6%) with Gleason score ≥ 8. Factors associated with advanced and high-grade disease included smoking, decreased sunlight exposure and physical activity, relatively increased ingestion of dairy products and red meat. Factors associated with early stage and low-grade disease included relatively increased ingestion of fruits, vegetables and fish.Conclusion Advanced and high-grade PCa disease is not uncommon among men ≥ 60 years in this study setting. Certain modifiable risk factors associated with advanced disease were established in this study. The majority had lower urinary tract symptoms (LUTS) prior to PCa diagnosis, but they were of poor health-seeking behaviour. Although there seems not to be a systematic delay in the definitive diagnosis and initiation of treatment for PCa, there is a need to improve on health education and awareness in the study setting.
Background Prostate cancer is topmost in terms of incidence and mortality among men in sub-Saharan Africa, including South Africa. Prostate cancer screening is beneficial only to certain categories ...of men, making a rational screening approach necessary.Aim This study aimed to assess the knowledge, attitudes and practice (KAP) regarding prostate cancer screening among primary health care (PHC) providers in the Free State, South Africa.Setting Selected district hospitals, local clinics and general practice rooms.Methods This was a cross-sectional analytical survey. Participating nurses and community health workers (CHWs) were selected through stratified random sampling. All available medical doctors and clinical associates were approached to participate, totalling 548 participants. Relevant information was obtained from these PHC providers using self-administered questionnaires. Both descriptive and analytical statistics were computed using Statistical Analysis System (SAS) Version 9. A p-value<0.05 was considered significant.Results Most participants had poor knowledge (64.8%), neutral attitudes (58.6%) and poor practice (40.0%). Female PHC providers, lower cadre nurses and CHWs had lower mean knowledge scores. Not participating in prostate cancer–related continuing medical education was associated with poor knowledge (p<0.001), negative attitudes (p = 0.047) and poor practice (p<0.001).Conclusion This study established appreciable KAP gaps relating to prostate cancer screening among PHC providers. Identified gaps should be addressed through the preferred teaching and learning strategies suggested by the participants.Contribution This study establishes the need to address KAP gaps regarding prostate cancer screening among PHC providers; therefore necessitating the capacity-building roles of district family physicians.
Introduction: The objective of this study was to compare a double-layer running suture re-anastomosis urethral stricture repair with early catheter removal to the conventional interrupted suture ...re-anastomosis after excision of a bulbar urethral stricture. Methods: A consecutive series of patients with bulbar urethral stricture were enrolled in the study. The patients were randomized into two groups according to an odd/even serial number distribution. Patients’ medical records were analyzed for demographics, stricture characteristics, and lower urinary tract obstructive symptoms. The outcomes were based on the presence/absence of obstructive voiding symptoms, and retrograde urethrography (RGU) performed on the first post-operative day in Group 1 and in both groups (Groups 1 and 2) at six weeks after surgery. Flexible urethroscopy was only performed on specific cases where RGU was unclear both pre- and post-operatively or when clinical recurrence was suspected. The minimum follow-up (FU) was 18 months. Success was defined as no need for subsequent dilatation, direct vision internal urethrotomy (DVIU), or urethroplasty. Results: A total of thirty-six patients with a mean age of 45 years (range 20 to 69 years) with bulbar urethral stricture were included in this study. Group 1 and Group 2 included 19 and 17 patients, respectively. Two patients were lost during randomization and subsequently to FU. The average stricture lengths were comparable between the two groups according to the retrograde urethrogram: 1.20 cm (range 0.6 to 2) in Group 1 and 1.27 cm (range 0.5 to 2.4) in Group 2, respectively (p = 0.631). The success rate for Group 1 was 90% after a mean follow-up of thirty-six months (range 20 to 40), which was clinically significant compared to the 71% in Group 2 after a mean FU of thirty-three months (range 19 to 40; p = 0.0218; 95% CI: 0.462–41.5766). Conclusions: Anastomotic urethroplasty (AR) performed with a double layer re-anastomosis had a cure rate comparable to the conventional anastomosis with interrupted sutures after a follow-up of eighteen months and longer. The urethral catheter can be safely removed within twenty-four hours after the excision of stricture and double-layer re-anastomosis.
African men are less likely to participate in prostate cancer (PCa) screening, which may be beneficial to some of them. Gaps in knowledge, cultural factors and beliefs are associated with their ...screening intentions.
To determine the knowledge, cultural factors and screening intentions of African males regarding PCa screening.
The study was conducted among African men attending randomly selected primary healthcare clinics in the Free State province.
An analytical, cross-sectional survey using self-administered questionnaires developed in line with the Theory of Planned Behaviour constructs.
Of the 389 respondents, 18.3% had ever been screened for PCa with prostate-specific antigen (PSA) testing and 6.2% by digital rectal examination (DRE). About a quarter (24.4%) of the respondents had knowledge scores ≥ 50%. Factors associated with greater intent to screen for PCa were lower degree of fear/apprehension of PCa screening (mean score = 2.03;
< 0.001), higher perceived benefits of PCa screening (mean score = 2.69;
= 0.002), lower perceived situational barriers to PCa screening (mean score = 2.03;
= 0.006) and higher perceived risk of getting PCa (mean score = 2.66;
= 0.024).
The observed low level of knowledge and practice of PCa screening among the respondents could be enhanced through PCa awareness strategies targeted at these men or those that could influence their decision making, especially healthcare providers. Factors that enhance screening intentions should be promoted.
This study improves on the scarce literature on factors associated with African men's PCa screening intention.
Background: Prostate cancer (PCa) ranks high in terms of morbidity and mortality, especially in Africa. Prostate-specicfi antigen (PSA) screening remains a practical method of screening for and ...thereby detecting PCa early, especially among African men who are more negatively affected. Modiafible risk factors for PCa are mostly behavioural and lifestyle. Understanding communityspecicfi determinants is important when developing health promotion interventions.Objective: This study aimed to determine the profile of African men with PCa in the Free State, South Africa.Method: A cross-sectional descriptive study was conducted using case record information and self-administered questionnaires among 341 African men with PCa attending the oncology and urology clinics of a tertiary hospital.Result: Participants' median age at diagnosis was 66 years. Only 76 (22.3%) participants had ever heard of PCa prior to being diagnosed with the disease, 36 (47.4%) of whom had ever had screening performed. The majority (n = 298, 87.4%) were symptomatic; < 50% sought medical help within six months. At diagnosis, 133 (39.0%) men presented with stage T3 or T4 disease, 75 (22.0%) with metastatic disease and 84 (24.6%) with Gleason score ≥ 8. Factors associated with advanced and high-grade disease included smoking, decreased sunlight exposure and physical activity, relatively increased ingestion of dairy products and red meat. Factors associated with early stage and low-grade disease included relatively increased ingestion of fruits, vegetables and fish.Conclusion: Advanced and high-grade PCa disease is not uncommon among men ≥ 60 years in this study setting. Certain modifiable risk factors associated with advanced disease were established in this study. The majority had lower urinary tract symptoms (LUTS) prior to PCa diagnosis, but they were of poor health-seeking behaviour. Although there seems not to be a systematic delay in the definitive diagnosis and initiation of treatment for PCa, there is a need to improve on health education and awareness in the study setting.
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