African Journals OnLine
South African Family Practice

Volume 25 Number 2, 2002

Abstract 
Urinary incontinence (UI) is the involuntary leakage of urine, while overactive bladder (OAB) is characterised by frequency, nocturia and urgency, with or without incontinence. This paper provides guidelines for the management of UI and OAB, focusing on primary health care. Although UI and OAB negatively impact on the patient’s quality of life more severely than diabetes mellitus or rheumatoid arthritis, surveys have shown that more than 60% of persons with UI never mention their problem to a doctor or nurse.Therefore, the primary care setting is ideal for screening, basic evaluation, and initial management of UI and OAB. A focused history and examination will usually enable the practitioner to distinguish between the different types of incontinence, such as stress, urge (overactive bladder), mixed, overflow and continuous incontinence. It should include a vaginal examination and cough test in women, rectal examination in men, dipsticks urinalysis, and assessment of the post-void residual urine.A bladder diary filled in by the patient can be very useful. There may be reversible conditions causing or contributing to the patient’s incontinence, such as urinary tract infection. In certain cases referral to a specialist is required, e.g. patients with incontinence after previous surgery, or associated with pain or hematuria. However, many patients with symptoms of OAB or UI can be eff ectively treated at the primary care level. Management options include lifestyle modification (e.g. smoking cessation and weight loss), pelvic floor exercises, and pharmacotherapy. Overactive bladder can be treated with muscarinic antogonists such as tolterodine and oxybutinin. 

Keywords: urinary incontinence, overactive bladder, treatment, Muscarinic antagonists   

Cancer Awareness and Knowledge among Black South Africans 
Mogotlane, SM 

Abstract 
INTRODUCTION In the wake of the HIV/AIDS scourge, cancer, with its poor prognosis has emerged as another common and most dreaded disease. The late presentation of sufferers for diagnosis is cause for concern as the disease is curable if diagnosed early. The study was undertaken to explore the awareness and knowledge that black people have about cancer in view of their reported delay in presenting themselves for proper diagnosis and treatment and the high incidence of defaulting even when the diagnosis is made. 
METHODOLOGY An exploratory descriptive survey was done in selected black areas whereupon a systematic random sampling of households was done and interviews with household heads from the selected households conducted. 
RESULTS The majority (88.55%) of black people were reported to be aware of cancer, but very few (31.74%) knew about cancer. 
CONCLUSION Based on the results of the study it was concluded that more campaigns need to be staged to promote the knowledge about cancer building on the existing awareness. 

Key words: Cancer, Awareness, Knowledge, Survey, Blacks, Africans.   

Lay Beliefs And Responses Concerning HypertensionAnd Its Management In Two CulturallyDistinct Groups 
Mhlongo,SWP 

Abstract 
Objective: To determine quantitatively whether there are significant differences in lay beliefs about hypertension and its management between African- Caribbean (A.C.) living in the UK but born in the West Indian Caribbean Islands and white hypertensive patients in the UK. 
Design: Self-administered postal (and surgery) questionnaire. 
Setting: Two general practices in the Wembley / North London and Dagenham (Essex) areas.
Participants: Male and female patients aged between 35 and 69 years of age registered with the above practices and receiving treatment for hypertension. These were selected from the age/sex/disease registers. 
Interventions: None 
Main outcome Measures: African-Caribbean vs. White/Caucasian responses to the 16-item questionnaire and determining statistical significance (the P value). This was done to determine whether or not there are significant differences in lay beliefs between the two ethnic groups i.e.A.C. versus white Caucasian. 
Results: Out of 525 patients who were sent the 16-item questionnaire, there were 427 responses (238 men, 189 women). This was an 81% response rate. In terms of race, there were 224 white and 203 African-Caribbean respondents. The responses to the questions strongly suggested that there are significant ethnic differences on matters of lay beliefs regarding hypertension and its management. This quantitative study supported the findings and conclusions of a previous (1988) qualitative one by Myfawny Morgan and C.J.Watkins on the same subject. 
Conclusions: Lay beliefs appear to be extremely important amongst all cultures and it would appear that these do have an impact on how an individual views his or her medical condition and how the doctors manage it. Intercontinental and international encounters appear to be here with us to stay due to a variety of factors e.g. trade, education, sports and wars. It is therefore of utmost importance that medical practitioners bear this in mind in their encounters with patients. An acceptance of this approach by all doctors and health workers may improve compliance. 

Keywords: Hypertension, Ethnicity, Lay beliefs, Compliance, Doctors