Background: Metabolic syndrome is a burgeoning global concern that predisposes individuals to cardiovascular diseases and shares a complex bidirectional relationship with type 2 diabetes mellitus (T2DM). Its prevalence and associated risk factors among T2DM patients vary across populations depending on diagnostic criteria. Aim: This study aimed to determine the prevalence, components and predictors of metabolic syndrome among T2DM patients. Setting: The medical outpatient department of Nelson Mandela Academic Hospital, Mthatha, Eastern Cape province, South Africa. Methods: A cross-sectional study was conducted among 142 patients with T2DM. Data on demographic, anthropometric, haemodynamic and biochemical parameters were collected using a structured questionnaire. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. Variable-specific standardised descriptive and inferential statistics were computed using SPSS 29. Results: The prevalence of metabolic syndrome was 83.8%, with high rates among females (90.3%). Among males, hypertension (84.2%) and low high-density lipoprotein cholesterol (88.6%) were the most common components, whereas females exhibited higher rates of abdominal obesity (98.1%), hypertriglyceridaemia (83.3%) and dyslipidaemia (84.2%). Abdominal obesity was the predominant risk component (129 [90.8%]). Poor glycaemic control was evident with 111 (83.5%) participants having a glycosylated haemoglobin of 7% or higher. Predictors of metabolic syndrome were obesity in males (odds ratio [OR]: 28.34, 95% confidence interval [CI]: 2.23–359.80, p = 0.010) and dyslipidaemia in females (OR: 59.06, 95% CI: 3.46–1007.16, p = 0.005). Conclusion: Metabolic syndrome was highly prevalent, with abdominal obesity as the predominant risk component. Obesity and dyslipidaemia were significant predictors, and diabetes remained poorly controlled in a large proportion of patients. Contribution: This study is the first to report on the prevalence, main risk components and predictors of metabolic syndrome among T2DM patients in a typical rural South African population.

Background/Objectives: The concept of learning organisations, which rely on research-based evidence and emphasise employees’ continuous learning and professional development, is essential for effectively managing change and enhancing the quality of services. To better understand the effects of implementing learning organisation principles in hospital settings, this study aimed to compare the perceptions of selected health professionals regarding learning organisations across five sub-districts in South Africa’s Eastern Cape province. Methods: This study employed a quantitative, cross-sectional survey design to collect data from selected health professionals in 9 hospitals in Eastern Cape province. Results: Overall, the study showed wide variations in how different healthcare professionals perceived the commitment and communication of department leaders regarding the importance of learning. Key findings showed that 90.9% of dentists agreed that department leaders communicate the importance of learning. In comparison, 68.8% of allied health professionals and 56.5% of pharmacists agreed that department leaders communicated the importance of learning; 21.7% of pharmacists and 25% of allied health professionals disagreed. Conclusions: The study has highlighted significant disparities in the perceptions of selected hospital-based health professionals toward introducing a learning organisation in healthcare facilities. This divergence points to the need for tailored approaches in communicating and implementing LO strategies within hospital settings to ensure that all health professionals are equally engaged and that the benefits of continuous learning are fully realised across disciplines.

Epidemiological data on gastroesophageal reflux disease (GERD) reveal variations in prevalence rates and risk factors, which are still to be elucidated in the South African setting. Population-specific data are needed to contribute to the understanding of the pathophysiology of GERD. This study aims to determine GERD’s prevalence and associated risk factors among Mthatha residents. A descriptive cross-sectional study was carried out with a systematically sampled 353 adults attending the outpatient department of a secondary health care facility using the standardized GERD questionnaire (GerdQ) for screening and diagnosis. Descriptive and inferential statistics were performed with the aid of SPSS version 26. The prevalence of GERD was 32.0 percent (CI: 27.3% to 37.0%). Only 6.5 percent had an 89% likelihood of having GERD. Over half (53.1%) had GERD with little effect on day-to-day activities. The most common symptoms were heartburn at 49.6 percent, sleep disturbance at 34.8 percent, chest pain at 32.3 percent, and regurgitation at 32.3 percent, and were mild in most of them. Hypertension (OR = 3.0, CI: 1.5–6.4, p = 0.003) and eating more than three meals a day (OR = 4.2, CI: 1.9–9.2, p < 0.0001) were the major risk factors for GERD. The GERD rate of one in every three people is higher than the global rate of one in every six. The association of GERD with hypertension requires consideration of screening for GERD in patients with hypertension. Community education on proper dietary habits and the consequences of excess daily meals is needed to interrupt the development of GERD in the current population.

Background: Clinical audit is a core component of clinical governance and quality improvement; however, its implementation across South African public health facilities remains inconsistent. Limited facility-level evidence exists on healthcare professionals’ knowledge, perceptions, and practices regarding clinical audit, particularly in rural and resource-constrained settings. Objectives: To assess knowledge, perceptions, and practices regarding clinical audit among healthcare professionals at a district hospital in Alfred Nzo District, Eastern Cape Province, South Africa, and to identify factors associated with these domains. Methods: A descriptive cross-sectional study was conducted among healthcare professionals at Madzikane kaZulu Memorial Hospital using stratified random sampling. Of the target sample of 179 healthcare professionals, 156 participated, yielding a response rate of 87.2%. Data were collected using a structured, self-administered questionnaire adapted from a validated knowledge-attitude-practice instrument and analyzed using IBM SPSS Statistics version 30. Composite domain scores were categorized as poor (< 60%), moderate (60-79%), or good (≥80%). Associations between domain scores were assessed using Spearman’s rank-order correlation, while differences across demographic groups were examined using the Mann-Whitney U and Kruskal-Wallis tests. Results: Most participants were female (69.9%) and had >6 years of professional experience (74.4%). The median knowledge score was 72.5% (interquartile range 65.0 - 78.3), with 75.0% of participants demonstrating moderate knowledge. Although 96.1% correctly identified the purpose of clinical audit as improving patient care and outcomes, only 49.3% knew the procedural steps involved, while 37.8% incorrectly perceived clinical audit as a mechanism for disciplining staff. Perceptions were predominantly neutral (73.7%; mean score 66.1%), and only 48.7% believed that audit findings were taken seriously and acted upon by management. Clinical audit practice was moderate (mean score 57.9%), and only 39.1% of participants had received formal audit training. Knowledge was moderately and positively correlated with practice (ρ=0.537; p< 0.001). Knowledge and practice scores differed significantly across age groups (p=0.032 and p=0.004, respectively), while practice also differed significantly according to years of professional experience (p=0.021). Conclusion: Healthcare professionals at this rural district hospital demonstrated moderate knowledge and practice of clinical audit, while perceptions were predominantly neutral. Important gaps were identified in procedural knowledge, formal training, and confidence that audit findings result in management action. Strengthening structured clinical audit training, feedback mechanisms, and institutional leadership may help embed clinical audit more effectively within routine clinical governance and quality-improvement activities in resource-constrained district hospitals.

Background Child mortality remains a major public health challenge in low- and middle-income countries, with Sub-Saharan Africa carrying a disproportionate share of the global burden. In South Africa, rural and under-resourced areas such as Mount Fletcher in the Eastern Cape continue to record high rates of preventable under-five deaths. The effectiveness of national and provincial health promotion strategies depends heavily on local awareness, acceptance, and participation, yet little is known about how caregivers in rural communities such as Mount Fletcher understand and experience these interventions. Objective To explore the awareness and perceptions of health promotion strategies among caregivers to reduce child mortality in Mount Fletcher, and to identify the barriers and facilitators influencing their uptake. Methods A qualitative descriptive study was conducted among 20 mothers and primary caregivers of children under five years attending Taylor Bequest Clinic in Mount Fletcher, Elundini Local Municipality. Participants were selected through purposive sampling and took part in semi-structured, audio-recorded interviews conducted in isiXhosa or English. Data were transcribed verbatim and analysed thematically using ATLAS.ti (version 8), guided by the Health Belief Model. Results Participants demonstrated good awareness of core child-survival interventions, including immunisation, exclusive breastfeeding, nutrition, hygiene, and clinic attendance, and generally held positive attitudes toward health promotion services and healthcare workers. However, participants identified substantial barriers to the uptake of these strategies, including poverty, transport costs and distance to health facilities, long clinic waiting times and staff shortages, and the continued influence of traditional and cultural beliefs on health-seeking behaviour. Conclusion Caregivers in Mount Fletcher are broadly aware of, and hold favourable attitudes toward, child health promotion strategies, but structural, economic, and cultural barriers continue to limit their consistent use. Strengthening community health worker outreach, addressing health system constraints, and engaging traditional and community leaders alongside biomedical health education may help translate existing awareness into more consistent uptake of child mortality reduction interventions in similar rural South African settings.

Background/Objectives Intrauterine contraceptive devices (IUCDs) are highly effective long-acting reversible contraceptives ; however, their utilization remains low in South Africa, particularly in rural settings of the KSD sub-district. This study aimed to explore professional nurses’ perspectives on health system and service delivery barriers influencing IUCD uptake in primary healthcare family planning services in the Eastern Cape Province. Methods This study used a qualitative, exploratory, descriptive design and included 14 purposively selected professional nurses from 4 community health centers in the King Sabata Dalindyebo subdistrict. Data were collected through semi-structured, face-to-face interviews conducted between September and 30 November 2025. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis following Braun and Clarke’s six-step approach. Results Three key themes emerged from the interviews as barriers to IUCD utilization in family planning services: limited knowledge and clinical competence, positive but conditional attitudes, and constrained clinical practices. Most participants (n = 9) reported receiving only informal IUCD training, while three had no training and only two had formal training. Knowledge gaps included uncertainty regarding insertion procedures and management of complications. Although nurses generally expressed positive attitudes towards IUCDs and recognized their effectiveness, a lack of training reduced confidence in recommending and providing the method. Conclusions Despite favorable attitudes, significant gaps in training, competence, and health system support limit IUCD service provision. Strengthening structured training, improving resource availability, and addressing organizational barriers are essential to enhancing nurses’ capacity and improving access to IUCD services in primary healthcare settings. Recommendation Enhancing structured pre-service and in-service training for Professional nurses on IUCDs is crucial to improving clinical competence and confidence in delivering health care services. Health systems should focus on ensuring adequate staffing, necessary equipment, and effective supervision to enhance the availability and quality of IUCD services in community health settings.