Exploring Measures to Improve Utilisation of the Central Chronic Medicines Dispensing and Distribution Programme in the Sekhukhune Primary Healthcare Facilities

Sekopa Ragosebo Portia, Netangaheni Robert Thinavhuyo

Background: The Central Chronic Medicines Dispensing and Distribution (CCMDD) programme was launched in South Africa to support patients on long-term treatment by making it easier for them to access their medication. However, its utilisation in primary healthcare facilities within Sekhukhune has faced significant difficulties, affecting both healthcare workers and patients.

Aim: The purpose of this study was to explore and describe measures that would help to improve utilisation of the CCMDD programme in the Sekhukhune district primary healthcare facilities of Limpopo Province.

Setting: The research took place across nine primary healthcare facilities within the Sekhukhune District of Limpopo Province.

Method: The study utilised the qualitative research approach with an explorative descriptive research design. A total of forty-five (45) one-on-one semi-structured interviews were carried out with nurses overseeing the CCMDD programme in Sekhukhune primary healthcare facilities, as well as with patients living with chronic illnesses who are enrolled in the programme. The collected data was analysed using thematic analysis.

Results: The study identified several key measures to enhance the effectiveness of the CCMDD programme in Sekhukhune District, Limpopo Province. These include establishing proper channels of communication, increasing government recruitment of nursing personnel, conducting awareness campaigns, providing ongoing staff training, consistently delivering health education, and implementing systems to track patients who miss their medication collections.

Conclusion: The utilisation of the CCMDD programme could be highly beneficial for both chronic patients and nurses within Sekhukhune District PHC facilities, if proper measures to improve the programme are effectively implemented.

Contribution: The study would help to improve the utilisation of the CCMDD programme by refining key operational aspects, including client enrolment procedures, medication packaging and dispensing processes, SMS communication, and the delivery system to designated pick-up points.

A Literature Review on Recommendations to Improve Utilisation of the CCMDD Programme in Sekhukhune District PHC Facilities

Sekopa Ragosebo Portia, Netangaheni Thinavhuyo Robert

Background: An unpredicted growth of patients requiring access to long-term therapies has been experienced over the past decades in South Africa which put strains on existing resources. Public health facilities are overcrowded due to the high volume of patients with chronic conditions are relying on free services for collection of their medications. The National Department of Health has introduced Central Chronic Medicines Dispensing and Distribution programme in 2014, to provide chronic patients with alternative ways to collect their medications.

Aim: To describe recommendations for the utilisation of the CCMDD programme in Sekhukhune primary healthcare facilities.

Methods: An integrated literature review was conducted and PICO framework was adopted as searching strategy to extract studies. Studies were extracted from databases such as CINAHL, Academic Search Ultimate, PubMed, Google, and WHO websites. Data was analysed thematically as documented by Whittemore & Knafl. 

Findings: Ten studies that include six qualitative studies and four guidelines were extracted. Three themes that support recommendations for the utilisation of the CCMDD programme were formed during data analysis. These themes include training healthcare workers on DSD models, provision of information and health education on DSD models, and tracing of clients.

Conclusions: The utilisation of the CCMDD programme could be improve through staff training, provision of information and health education and tracing of clients.

Contribution: The findings of this study would contribute to the development of guidelines to improve CCMDD programme which would add to effective utilisation of the programme within Sekhukhune District PHC facilities.

Magnitude of Tuberculosis in Children Aged Under 18 Years at Amana Regional Hospital in Dar es Salaam from 2022 and 2024

Sonia Nada Edward Sokoine , Dimple Prakash Sonigra, Julieth Elizeus Nyamiti

Background: Tuberculosis (TB) remains a significant public health challenge among children, particularly in resource-limited settings like Sub-Saharan Africa. Despite global efforts to reduce its burden, childhood TB is often under-diagnosed and under treated, especially in regions with high HIV prevalence.

Objective: This study aimed to determine the prevalence and associated factors of TB among children under 18 years at Amana Regional Hospital in Dar es Salaam, Tanzania, from 2022 to 2024.

Design and Setting: A retrospective cross-sectional study was conducted, analyzing medical records of children diagnosed with TB at Amana Regional Hospital between 2022 and 2024. Data on socio-demographic characteristics, symptoms, diagnostic methods, HIV status, and treatment initiation were extracted from TB clinic registries and analyzed using descriptive statistics in SPSS version 26.0.

Participants: A total of 382 children were included in the study. Of these, 57.6% were male and 42.4% female. The majority were aged 2–5 years (31.1%) and resided in urban areas (57.6%). Inclusion criteria were children under 18 years with confirmed TB diagnosis through microscopy or Gene-Xpert, while exclusion criteria included children without documented confirmation or incomplete records.

Primary and Secondary Outcome Measures: Primary outcome measure: prevalence of confirmed TB among children under 18 years during the study period. Secondary outcome measures: socio-demographic distribution of TB cases, presenting symptoms, diagnostic methods used, HIV co-infection rates, and proportion of children initiating TB and ARV treatment.

Results: Of the 382 children studied, 68.3% (n=261) were diagnosed with TB, with a higher prevalence among males (57.6%) and the 2-5-year age group (31.1%). Urban residence was predominant (57.6%), and common symptoms included persistent cough (65.7%) and fever (52.1%). Microscopy (52.6%) and Gene-Xpert (39.0%) were the primary diagnostic tools [5]. HIV co-infection was observed in 20.7% of cases, with 65.5% of TB-positive children initiating treatment [26].

Conclusion: The high burden of TB among children at Amana Regional Hospital underscores the need for improved diagnostic capacity, early intervention, and integrated TB-HIV services to reduce morbidity and mortality in this vulnerable population.

Clinical Evaluation of the Diagnostic Effectiveness of Thyroid Radionuclide Imaging in Differentiating the Causes of Hyperthyroidism

Xiao-Wei Ma

Objective: To investigate the clinical value of thyroid radionuclide imaging in the differential diagnosis of the causes of hyperthyroidism and to provide scientific evidence for precise clinical diagnosis and treatment. Methods: A retrospective analysis was conducted on the clinical data of 120 patients with hyperthyroidism admitted between January 2022 and December 2023. The diagnostic performance of radionuclide imaging in differentiating the major causes—Graves’ disease, toxic multinodular goiter, and autonomously functioning thyroid adenoma—was systematically evaluated. Results: Among the 120 patients, 82 had Graves’ disease (68.33%), 25 had toxic multinodular goiter (20.83%), 10 had autonomously functioning thyroid adenoma (8.33%), and 3 had other causes (2.50%). The overall diagnostic accuracy of thyroid radionuclide imaging for differentiating the causes of hyperthyroidism reached 93.33% (112/120). The sensitivity and specificity for diagnosing Graves’ disease were 96.34% and 90.91%, respectively; for toxic multinodular goiter, 88.00% and 97.62%, respectively; and for autonomously functioning thyroid adenoma, 90.00% and 99.09%, respectively. Conclusion: Thyroid radionuclide imaging can accurately reflect the structural morphology and functional status of the thyroid gland and demonstrates excellent accuracy in the differential diagnosis of hyperthyroidism causes.

Barriers and Countermeasures to the Accessibility of Orphan Drugs from a Pharmacoeconomic Perspective

Jian-Ling Tan

This paper focuses on the pharmacoeconomic barriers affecting the accessibility of orphan drugs and proposes corresponding countermeasures. It first outlines the fundamental framework and core concepts of pharmacoeconomic evaluation, as well as the unique characteristics involved in assessing orphan drugs. It then analyzes the key economic barriers arising during research and development, production, market access, reimbursement, distribution, and clinical use. Finally, it puts forward strategies such as improving multi-level systems ensuring drug accessibility, innovating payment models, optimizing policies for research, development, and regulatory approval, and strengthening pharmaceutical management and data sharing. The objective is to enhance the accessibility of orphan drugs and provide theoretical support for relevant policy-making.

Evaluation Study on the Accuracy of PET-CT in Clinical Staging of Lymphoma

Yue Jing

Objective: To evaluate the accuracy of PET-CT in the clinical staging of lymphoma and to provide reliable evidence for the formulation of clinical treatment plans and prognosis assessment. Methods: The clinical data of 86 patients with pathologically confirmed lymphoma who received diagnosis and treatment in our hospital from March 2022 to March 2024 were retrospectively analyzed. The accuracy, sensitivity, and specificity of PET-CT were compared with those of conventional imaging in lymphoma clinical staging, and the detection of occult lesions by PET-CT was recorded. Results: A total of 86 patients were included, including 23 cases of Hodgkin lymphoma and 63 cases of non-Hodgkin lymphoma. Based on the Ann Arbor staging system, 18 cases were stage I, 25 cases stage II, 29 cases stage III, and 14 cases stage IV. The overall staging accuracy of PET-CT was 91.86% (79/86), significantly higher than that of traditional imaging (76.74%, 66/86). The corresponding diagnostic accuracy for each stage was 88.89% in stage I, 92.00% in stage II, 93.10% in stage III, and 89.29% in stage IV. Its sensitivity and specificity both exceeded 85%. In addition, PET-CT successfully identified 12 occult lesions that were not detected by conventional imaging, including 4 cases of bone marrow infiltration, 5 cases of distant lymph node metastasis, and 3 cases of extranodal involvement. Conclusion: PET-CT can accurately reflect the metabolic activity and extent of tumor dissemination, and it demonstrates superior performance over traditional imaging techniques in improving the accuracy of lymphoma clinical staging.

Efficacy Analysis of the Combination Therapy of Glibenclamide and Metformin in the Treatment of Elderly Patients with Diabetes Mellitus

Tao-Tao Yao

Objective: To investigate the clinical efficacy of the compound preparation of glibenclamide and metformin in the treatment of elderly diabetic patients. Methods: A total of 120 elderly patients (aged ≥65 years) with type 2 diabetes mellitus who were treated at our hospital from January 2022 to June 2025 were selected. Patients were randomly divided into an observation group and a control group, with 60 cases in each group. The observation group received treatment with the glibenclamide-metformin compound preparation, while the control group was treated with glibenclamide alone. The treatment duration was 12 weeks. Blood glucose control, improvement of islet function, and incidence of adverse reactions before and after treatment were compared between the two groups. Results: The observation group showed significantly better blood glucose control and greater improvement in islet function than the control group, with a lower incidence of adverse reactions (P

Integrating Psychological Support into Early Stroke Rehabilitation: A Case Study

Wei Xiang

Early rehabilitation after stroke is crucial to the comprehensive recovery of patients. Integrating psychological support into early stroke rehabilitation plays a significant role in promoting overall recovery. Timely, scientific, and full-course rehabilitation treatment is of great importance in disease management and functional recovery.