BackgroundIn 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.ObjectiveThis study assessed the knowledge of prostate cancer among men attending the urology outpatient clinic at a tertiary hospital in South Africa.MethodsA 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.ResultsThe 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.ConclusionMore 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.

Urinary tract infections (UTIs) are very common in community practice and have a major impact on morbidity, quality of life and healthcare costs. It is estimated that ~50% of women will have at least one UTI episode in their lifetime, while 20 -40% will have recurrent episodes. [1] Community-acquired urinary tract infections (CAUTIs) occur predominantly in women of child-bearing age, and less often in older men. Escherichia coli is the most common uropathogen in CAUTIs, and is cultured in 75 -95% of cases. [2] These infections are often treated with empirical broad-spectrum antibiotics, as results from urine susceptibility testing are not always readily available, or may take 3 -5 days to become available. The choice of empirical antibiotics should be based on the spectrum of organisms in a particular area and data reflecting their susceptibility to available drugs. [3] The World Health Organization (WHO) has declared antibiotic resistance to be a serious threat to public health, because of increased mortality, prolonged hospital stay, loss of prophylaxis and increased costs due to resistant organisms. [4] This global increase in the emergence of antimicrobial resistance is linked directly to the injudicious use of antibiotics by the medical and agricultural fraternities, as well as few new drugs being discovered over the past couple of decades. [5] Internationally, the increase in fluoroquinolone resistance in particular has reached alarming levels, including 20% reported for North America and northern Europe, while approaching 50% in the Mediterranean area and parts of Asia. [6] Another major concern regarding the use of fluoroquinolones is their propensity to cause collateral damage, such as adverse ecological effects, and their potential for serious neurological side-effects. [7,8] Recent studies in South Africa (SA) mirror the increase in resistance to commonly prescribed antibiotics for CAUTIs. [2,9] This establishes a need to continuously monitor the profiles of uropathogens that cause CAUTIs and their susceptibilities to empirically used antibiotics.Data on CAUTIs in central SA are limited and relate to small sample sizes. [9] The aim of this study was to determine the causative uropathogens responsible for CAUTIs in the greater Bloemfontein area in central SA, and to review their susceptibility to commonly prescribed antibiotics. Information obtained from this study has the potential to improve treatment protocols, reduce selection of resistant organisms and decrease costs. Methods SettingWe reviewed the findings of urine samples sent for microscopy, culture and sensitivity (MC&S) testing by three large primary healthcare facilities in Bloemfontein, i.e. National District Hospital casualty and outpatient clinic, Mangaung University Community This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Background: 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.Aim: To determine the knowledge, cultural factors and screening intentions of African males regarding PCa screening.Setting: The study was conducted among African men attending randomly selected primary healthcare clinics in the Free State province.Methods: An analytical, cross-sectional survey using self-administered questionnaires developed in line with the Theory of Planned Behaviour constructs.Results: 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; p  0.001), higher perceived benefits of PCa screening (mean score = 2.69; p = 0.002), lower perceived situational barriers to PCa screening (mean score = 2.03; p = 0.006) and higher perceived risk of getting PCa (mean score = 2.66; p = 0.024).Conclusion: 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.Contribution: 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-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.

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