BackgroundVision impairment (VI) services aim to mitigate the effect of VI and provide opportunities for visually impaired individuals to actively participate in their daily activities.ObjectivesTo determine optometrists’ perceptions regarding VI services in public hospitals within Limpopo province, South Africa.MethodA descriptive, quantitative, cross-sectional study was conducted between January and August 2023 across 37 public hospitals, using a structured questionnaire. Data obtained from the participants’ responses were analysed to describe the level of VI services.ResultsThe study sample included 65 optometrists with 71% female, yielding a response rate of 83%. Over 90% of the participants were aware of the World Health Organization definition of VI. The majority of participants (54%) reported referring patients with VI to a hospital multidisciplinary team, while less than 50% provided optimal spectacle correction. The main barriers to providing VI services were: the lack of assistive devices (97%), and equipment (95%), poor access (80%), insufficient space (66%), and the lack of training (66%). The primary barriers to the uptake of VI services were the lack of awareness (86%) and the cost of VI services (80%).ConclusionThe provision of VI services in Limpopo province is currently limited. The factors contributing to the limited VI services are avoidable; therefore, efforts to enhance the availability of equipment, access and provision of comprehensive VI services are crucial to improving the quality of life for affected individuals utilising public hospitals in Limpopo province.ContributionThe study describes the optometrists’ perceptions of VI services in public hospitals.

In this article, I reflect on my continuing journey of becoming an autism self-advocate and how this has extended to advocate for the broader neurodiverse community. I aimed to provide an academic analysis of the value of autism self-advocacy with special reference to building resilience to confront discrimination and advocating for equal opportunities, support and inclusion. My autoethnographic reflections are fused with those of my co-constructors to present critical incidents that defined my journey of becoming an internationally recognised advocate for autism. Education has been the transformative force that has changed my life, granting me opportunities to advocate for my broader neurodiverse community on various local and international platforms and guiding me to create an ecosystem of family and professionals who continuously support me and others who are neurodiverse. My advocacy, which aims at raising autism awareness, has changed the perceptions of the community of practice as well as others with an interest in supporting and including individuals living with autism in a significant way. A network of care and support is required to sustain autism self-advocacy and to build on it to advocate for the broader neurodiverse community. This demonstrates the need for educating stakeholders to raise their expectations for autistic children and adults and for teachers and psychologists to continue supporting families and children with Autism Spectrum Disorder (ASD) to realise their full human potential.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease requiring interprofessional collaborative care because of its varied manifestations. This study explores the experiences of individuals living with SLE regarding the communication and collaboration among their healthcare providers. This study aimed to explore the communication dynamics that shape treatment experiences and well-being in SLE care. A qualitative multiple case study design was used, with thematic analysis of semi-structured interviews from six people living with SLE. Three primary themes emerged: the necessity of cohesive healthcare teams, the centrality of client-centred care and the significant challenges posed by fragmented healthcare systems. The study highlights the need for integrated care models to enhance communication and coordination among healthcare providers. This research adds empirical insights into the communication dynamics within medical teams managing SLE, advocating for client-centred and systemic improvements in care coordination.

[This corrects the article DOI: 10.4102/ajod.v13i0.1461.].

Parents of Deaf or hard-of-hearing (DHH) children are faced with a plethora of overwhelming decisions concerning their children, particularly during the early stages of development. Among these decisions are those concerning assistive devices and the modes of communication for their child. The aim of this study was to explore the perceptions of parents of DHH children towards the various modes of communication for their children within the South African context. The study adopted a Q-methodology research design. Participants rated statements according to what they least and most agree with and then answered follow-up questions concerning the statements. Participants were also invited to participate in a live, one-on-one, semi-structured interview with the researcher. Data were analysed through both qualitative and quantitative statistics. Thematic analysis was adopted to analyse the qualitative data, while factor analysis through Ken-Q analysis was used for quantitative data. Although 66% of participants thought that sign language allows DHH children to communicate more freely, 88% agreed that a DHH child should always learn to speak if they can. In terms of decision-making, 88% reported the issue of stigma or marginalisation and 88% cited the lack of Deaf schools as barriers in their decision-making. The study's findings provide valuable insights into the complex interplay of factors influencing communication mode decisions for DHH children in South Africa. These insights are crucial for developing inclusive and effective communication strategies that consider individual needs, societal norms and access to support services.

Children with disabilities encounter obstacles attaining basic education. Significantly, previous studies on South Africa have shown that up to 70% of the children with disabilities are out of school. Despite efforts to support inclusive education through White Paper 6 policy, the deployment of resources and transformation of the education sector has been a slower process. The main objective of the article is to explore the challenges of basic education faced by children with disabilities in South Africa. The study was conducted during the COVID-19 pandemic using a qualitative research methodology. The data were collected using key informant interviews through online media platforms. The data analysis was conducted using computer-aided software in the form of ATLAS.ti 8. This study established several challenges faced by special needs schools, especially in the rural areas. These include a limited number of special needs schools, scholar transport, enrolment, lack of psychosocial and expert support, sanitation and infrastructure and the impact of COVID-19 pandemic on children with disabilities. The article concludes that even though White Paper 6 focusses on Special Needs Education in South Africa, there remains poor policy implementation to ensure inclusivity for learners with disabilities. The research provides an understanding of the challenges faced by children with disabilities to assist policy makers with recommendations and areas of concern to improve policy implementation of the White Paper 6 in South Africa.

People with disability are a vulnerable population and are at a high risk of acquiring human immunodeficiency virus (HIV) infection. We investigated the association between severity of disability and not having knowledge of any HIV prevention method among adults in Uganda. Between January 2015 and December 2015, data were collected within a general population in Uganda, on six domains of disability based on the Washington Group Short Set on Functioning. In addition, routine data on socio-demographic factors and other HIV-related data were collected among adults aged 16 years and above. A continuum of functioning was developed: without disability, mild, moderate and severe. Bivariate and multivariate associations of disability and not knowing any HIV prevention method were fitted using logistic regression models. A total of 3331 adults (60.4% female) were included. Of these, 14.5% (n = 482) were classified as having either moderate or severe disability, and this proportion exponentially increased with age (p < 0.001). Overall, 4.2% (n = 140) reported not knowing any HIV prevention method, with a slightly higher proportion among females than males (3.1% in males, 4.9% in females). Compared to people with no disability, those with moderate or severe disability were 5 times more unlikely to know any HIV prevention methods (adjusted odds ratio = 5.45, 95% confidence interval = 3.25-9.13, p < 0.001). Additionally, the combined effect of moderate and severe disability and none/incomplete primary education increased the likelihood of not knowing HIV prevention methods over and beyond their separate effects (p < 0.001). Effective HIV prevention strategies must integrate best practices that target people with disabilities. These findings contribute to the evidence of the lack of HIV prevention knowledge among people with disabilities in general populations.

BackgroundThe epidemiology of cerebral palsy (CP) is poorly described in Ghana. These data are crucial for evidence-based intervention for children with CP in the country.ObjectivesWe aimed to describe the epidemiology of CP among children in Ghana.MethodWe established the first institution-based register of children with CP in Ghana (Ghana CP Register–GCPR). Children with confirmed CP aged < 18 years were registered following a detailed neurodevelopmental assessment. Socio-demographics, risk factors, predominant motor type and topography, gross motor function classification system (GMFCS), associated impairments, education and rehabilitation status were documented.ResultsBetween October 2018 and February 2020, 455 children were registered (mean [standard deviation {s.d.}] age at assessment: 5.9 [4.1] years). Preterm birth and low birthweight were reported in 52.0% and 21.1% children respectively. Most children (79.6%) had a pre- or perinatally acquired CP and the mean (s.d.) age of CP diagnosis was 22.2 (21.6) months. Overall, 55.9% of children had spastic tri- or quadriplegia, 60.5% had GMFCS level III–V and 70.3% had ≥ 1 associated impairment. However, 20.5% had never received rehabilitation services and 69.6% of school-aged children in the GCPR were not enrolled in schools.ConclusionThe study findings indicate a high burden of severe motor and associated impairment among children with CP in Ghana which highlights the need for tailored interventions to improve health and well-being of children with CP in the country.ContributionThe study highlights the need for interventions to improve functional outcome, health and well-being of children with CP in Ghana.

Even though adults with foetal alcohol spectrum disorder (FASD) are at risk of negative life outcomes, there is no published evidence of this in South Africa, which has the highest estimated FASD prevalence rate globally. The purpose of the study was to describe and compare the life outcomes of adults with FASD and adults without FASD in a South African rural community, 16 years after diagnosis. Participants were examined and interviewed regarding their biographical information, knowledge of FASD, information on their family, relationships, home circumstances, education, work and medical history. Adults with FASD were less likely to be in a relationship and more likely to have poor educational outcomes and to be exposed to violence as victim or perpetrator than their peers who did not have FASD. None of the participants with FASD completed secondary school successfully. No differences were found for independent living, employment, health, substance use and legal outcomes, between the foetal alcohol syndrome (FAS) or partial foetal alcohol syndrome (PFAS) and control group. While significant differences existed in certain aspects, differences are not as stark as one would expect between individuals with FASD and controls. This study highlights the importance of considering the social context in which a FASD diagnosis is made. The comparative negative impact of an FASD diagnosis and the associated challenges on life outcomes may be less pronounced in rural communities where everyone has fewer opportunities and resources. This can also make the unique needs of persons with disabilities less visible.

Multiple sclerosis (MS), fatigue is among the leading clinical symptoms. It is one of the most disabling symptoms for most MS people. This research measures the prevalence of fatigue and its impact on the physical, cognitive, and psychosocial abilities of individuals with MS in Morocco. This cross-sectional and descriptive study included 152 participants. Data were collected via an online survey using the snowball method, incorporating sociodemographic characteristics and the Arabic version of the Modified Fatigue Impact Scale. According to the results, 89.4% of respondents experienced pathological fatigue, with an average score of 65.52 (± 18.00). There was a significant relationship between pathological fatigue, age (p = 0.0324), and clinical phenotype (p = 0.041). Fatigue negatively impacted participants' physical, cognitive, and psychological capacities, with average scores of 70.38 (± 8.15), 62.28 (± 10.23), and 73.87 (± 1.86), respectively. The results of our study confirmed a high prevalence of fatigue among people with MS in Morocco. Sustained research in this field remains crucial, as it enables the formulation of strategies aimed at enhancing the quality of life for those impacted by MS. This study is the first in Morocco to examine fatigue prevalence in people with MS and its impact on their physical, cognitive, and psychosocial abilities. High fatigue levels hinder the integration of people with MS into professional and student life. The findings emphasize the need for effective symptom and fatigue management.