Fifty years of building a healthy nation through research and innovation.
Authors: Gray G PMID: 32252859 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

Knowledge generation via publications on hypertension prevalence in population-based studies conducted in sub-Saharan Africa over 30 years: 1990 - 2019.
Authors: Peer N, George C, Kengne AP Abstract Hypertension prevalence in sub-Saharan Africa (SSA) is high, is rising and has emerged as the most prevalent cardiovascular disease risk factor. Research is required to provide evidence-based findings to prioritise hypertension prevention and control. This systematic review aims to describe the distribution of and trends in scientific outputs on hypertension prevalence in population-based studies in SSA over the last three decades. Relevant English-language articles documenting hypertension prevalence in population-based studies in SSA, published between 1 January 1990 ...
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

Moving towards universal health coverage: Strengthening the evidence ecosystem for the South African health system.
Authors: Mathews C, Goga A, Loveday M, Zembe W, Daviaud E, Siegfried N, Lewin S Abstract Health policy and systems research (HPSR) guides health system reforms and is essential for South Africa (SA)'s progress towards universal coverage of high-quality healthcare. For HPSR evidence to inform and strengthen health systems, it needs to flow efficiently between evidence producers, evidence synthesisers, evidence processers and disseminators and evidence implementors in an evidence ecosystem. A substantial body of evidence for health systems strengthening is generated in SA, and this informs national and international ...
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

Challenges to improve antenatal and intrapartum care in South Africa.
This article provides some exciting solutions to these health system barriers. PMID: 32252862 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

Gathering the evidence and identifying opportunities for future research in climate, heat and health in South Africa: The role of the South African Medical Research Council.
Conclusions. High and low temperatures in SA are already associated with mortality annually; these impacts are likely to increase with a changing climate. Critical cross-sectoral research will aid in understanding and preparing for temperature extremes in SA. PMID: 32252863 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

The role of the South African Medical Research Council in reducing lead exposure and preventing lead poisoning in South Africa.
Authors: Mathee A, Naicker N, Von Schirnding Y Abstract Even at low levels in blood, lead has been associated with reduced IQ scores, behavioural problems, learning impediments, aggression and violent behaviour. Since the 1980s, the South African Medical Research Council (SAMRC) has been investigating the sources of exposure to lead in South Africa (SA), the groups at highest risk of lead poisoning and a selection of the myriad associated health and social consequences. SAMRC research evidence contributed to the phasng out of leaded petrol, restrictions on lead in paint and other interventions. Subsequently, childh...
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

Looking back, moving forward: 50 years of South African Medical Research Council alcohol-related publications.
Conclusion. The SAMRC has contributed substantially to the growing field of alcohol research in SA, but gaps in areas such as alcohol policy evaluation, alcohol and its association with TB and cancer, and interventional research, are evident. PMID: 32252865 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

HIV research in South Africa: Advancing life.
Authors: Gray G, Doherty T, Mohapi L, Coetzee J, Hopkins KL, Malahleha M, Lazarus E, Dietrich J, Pillay-van Wyk V, Laher F Abstract South African (SA) researchers have made both national and global contributions to HIV prevention and treatment. Research conducted in SA has contributed markedly to improved survival in HIV-infected infants, children and adults. The translation of clinical research into practice has enabled the curtailment of paediatric HIV in SA. Along with international collaborators, SA has made pivotal contributions to biomedical prevention modalities including medical male circumcision and oral a...
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

HIV/AIDS mortality trends pre and post ART for 1997 - 2012 in South Africa - have we turned the tide?
Conclusion. The number of HIV/AIDS deaths has almost halved since the ART rollout. Of concern is the high mortality in men 45 years and older and the high mortality of men compared with women in the older ages by 2012; this gap has increased with age. Treatment and prevention programmes should strategise how to target men. PMID: 32252867 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

Tuberculosis research in South Africa over the past 30 years: From bench to bedside.
Authors: Warren R, Ismail N, Chegou NN, Theron G, Walzl G, Malherbe ST, Kinnear CJ, Van der Spuy GD, Goosen W, Miller MA, Diacon AH, Van Helden PD Abstract The South African Medical Research Council Centre for Tuberculosis Research has a rich history of high-impact research that has influenced our understating of this hyper-epidemic which is further exacerbated by the emergence and spread of drug-resistant forms of the disease. This review aims to summarise the past 30 years of research conducted in the Centre which has influenced the way that tuberculosis (TB) is diagnosed and treated. The review includes the deve...
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

Rolling back malaria in Africa - challenges and opportunities to winning the elimination battle.
Authors: Maharaj R, Kissoon S, Lakan V, Kheswa N Abstract A high-level review was conducted of the literature pertaining to the challenges and opportunities for eliminating malaria on the African continent. Although malaria mortality and morbidity are on the decline, the disease remains one of public health importance. Africa has invariably borne the brunt of the disease, recording the highest number of cases and deaths. However, with greater emphasis being placed on the disease by the international community, partnerships have developed to boost malaria elimination efforts on the continent. One such initiative is ...
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

First social impact bond for the SAMRC: A novel financing strategy to address the health and social challenges facing adolescent girls and young women in South Africa.
Authors: Abdullah F, Naledi T, Nettleship E, Davids EL, Van Leeuw L, Shangase S, Ramburuth M, Majola N, Dudley L, Nyirenda M, Mathews C, Kredo T, Kinghorn A, Gray G, De Witt S Abstract A social impact bond (SIB) is an innovative financing mechanism to attract investors to social programmes traditionally funded by governments. In this article, in celebration of the 50th anniversary of the South African Medical Research Council (SAMRC), the authors describe the SAMRC's first foray into this new world of financing through a SIB to improve the health and quality of life of adolescent girls and young women (AGYW). The A...
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

Reducing homicide through policy interventions: The case of gun control.
Authors: Matzopoulos R, Prinsloo M, Bradshaw D, Abrahams N Abstract Injuries impose a fourth major disease burden on the South African population, which is driven in particular by the high incidence of interpersonal violence. There was a significant decline in mortality from interpersonal violence between 1997 and 2012, and research conducted by South African Medical Research Council (SAMRC) researchers has ascribed much of this decline to a decrease in firearm homicide. In the present brief review, we summarise South African research on fatal and non-fatal firearm injuries, with a particular focus on research cond...
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

Burden of disease in South Africa: Protracted transitions driven by social pathologies.
This article reflects the mortality trends in pre-and post-apartheid South Africa (SA), and describes efforts to improve vital statistics, innovations to fill data gaps, and studies to estimate the burden of disease after adjusting for data deficiencies. The profound impact of HIV/AIDS, particularly among black African children and young adults, is striking, within a protracted epidemiological transition and the current reversals of multiple epidemics. Over the next 20 years, it will be important to sustain and enhance the country's capacity to collect, analyse and utilise cause of death data. SA needs to support developme...
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

The impact of health programmes to prevent vertical transmission of HIV. Advances, emerging health challenges and research priorities for children exposed to or living with HIV: Perspectives from South Africa.
Authors: Goga A, Slogrove A, Wedderburn CJ, Feucht U, Wessels J, Ramokolo V, Bhana A, Du Plessis N, Green RJ, Pillay Y, Sherman G Abstract Over the past three decades, tremendous global progress in preventing and treating paediatric HIV infection has been achieved. This paper highlights the emerging health challenges of HIV-exposed uninfected (HEU) children and the ageing population of children living with HIV (CLHIV), summarises programmatic opportunities for care, and highlights currently conducted research and remaining research priorities in high HIV-prevalence settings such as South Africa. Emerging health cha...
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

Neonatal, infant and child health in South Africa: Reflecting on the past towards a better future.
Authors: Goga A, Feucht U, Zar HJ, Vanker A, Wiysonge CS, McKerrow N, Wright CY, Loveday M, Odendaal W, Ramokolo V, Ramraj T, Bamford L, Green RJ, Pillay Y, Nannan N Abstract Although the neonatal mortality rate in South Africa (SA) has remained stagnant at 12 deaths per 1 000 live births, the infant and under-5 mortality rates have significantly declined since peaking in 2003. Policy changes that have influenced this decline include policies to prevent vertical HIV transmission, earlier treatment of children living with HIV, expanded immunisation policies, strengthening breastfeeding practices, and health policies...
Source: South African Medical Journal - April 8, 2020 Category: African Health Tags: S Afr Med J Source Type: research

Communication regarding routine childhood vaccination.
Authors: Cooper S, Burnett RJ, Sambala EZ, Schmidt BM, Wiysonge CS Abstract Vaccine hesitancy is an emerging problem in South Africa (SA), which threatens to erode the country's immunisation achievements. Communication interventions may be an effective strategy for addressing vaccine hesitancy. We highlight a Cochrane review of qualitative evidence that explored parents' views and experiences of communication regarding childhood vaccinations, and provide implications for practice that are relevant to the SA context. The findings suggest that healthcare providers (HCPs) play a central role in childhood vaccination a...
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Interventions for preventing unintended pregnancies among adolescents.
Authors: Davids EL, Kredo T, Mathews C Abstract South Africa (SA) has an increasingly high rate of unintended pregnancies among adolescents, which are coupled with poor contraception knowledge. We highlight a systematic review that evaluated the effects of prevention interventions for unintended adolescent pregnancies, and provide implications for practice that are relevant to the SA context. The findings suggest the need for multifaceted interventions that are aligned with adolescent sexual and reproductive health best practices to address the unmet contraception knowledge gap, as well as unintended pregnancies am...
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Plasma efavirenz concentration inversely correlates with increased risk of cytomegalovirus infection in HIV-infected pregnant women.
CONCLUSIONS: HIV treatment disrupts the balance between host and co-infecting microbes. Reduced or subtherapeutic levels of antiretroviral drugs, which could be exacerbated by genetic polymorphisms in drug metabolism genes and non-adherence, predispose infected individuals to an increased risk of CMV infection in pregnancy. PMID: 31865936 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Medicine-use evaluation of doxazosin prescribing to inform formulary recommendations.
CONCLUSIONS: MUEs are an untapped resource for medication-use monitoring and practice improvement. MUEs offer a distinct, cost-effective approach to improve medicine use in all settings. This MUE revealed a relatively minor concern with doxazosin prescribing. MUEs can be beneficial to inform formulary changes and re-evaluate medication-use restrictions. PMID: 31865937 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Fasting plasma glucose and risk factor assessment: Comparing sensitivity and specificity in identifying gestational diabetes in urban black African women.
CONCLUSIONS: Universal screening using FPG ≥4.5 mmol/L had greater sensitivity and specificity in identifying GDM-affected women and required fewer women to undergo a resource-intensive diagnostic OGTT than risk factor-based selective screening. A universal screening strategy using FPG ≥4.5 mmol/L may be more efficient and cost-effective than risk factor-based selective screening for GDM in black SA women. PMID: 31865938 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Control of rheumatoid arthritis with conventional disease-modifying antirheumatic drugs in a tertiary hospital in central South Africa.
CONCLUSIONS: Control of RA at this institution is suboptimal compared with national and international standards. The main contributors to poor control appear to be problems relating to dispensing of medication and inadequate escalation of therapy by doctors. Most of the concern with the dispensing of medication lies with the poor availability of DMARDs in peripheral unit pharmacies. These factors are remediable and should be attended to. PMID: 31865939 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Dose-related adverse events in South African patients prescribed clofazimine for drug-resistant tuberculosis.
CONCLUSIONS: There is an association between dose-weight interaction and adverse events. The odds of any adverse event occurring were higher when low-weight patients (<50 kg) received high-dose CFZ (≥200 mg). Gastrointestinal and skin-related adverse events were more common when high-dose CFZ was used in patients weighing <50 kg. Chest pain was reported in patients receiving high- and low-dose CFZ, irrespective of weight, and may be a symptom of cardiac toxicity. Plasma concentrations of CFZ may be affected by drug-drug interactions, so active drug safety monitoring including electrocardiograms is recommen...
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

We need to target trauma: A prospective observational study in Eastern Cape Province, South Africa.
CONCLUSIONS: From the proportion of presenting individuals sampled, we can conclude that a large proportion of care delivered in ECs in the Eastern Cape is for trauma. Local clinical capacitation efforts must focus on trauma training. PMID: 31865941 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

A review of geriatric injuries at a major trauma centre in South Africa.
CONCLUSIONS: Geriatric trauma in SA is relatively rare, but will increase as the population ages. There is a high incidence of assault as a mechanism, highlighting the fact that elderly people are a vulnerable group. Managing these patients is challenging and is associated with significant morbidity and mortality. PMID: 31865942 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Amikacin-resistant Acinetobacter species mediated by the aphA6 gene associated with clinical outcome at an academic complex hospital in KwaZulu-Natal Province, South Africa.
CONCLUSIONS: Most tested Acinetobacter isolates were susceptible to amikacin, underscoring the crucial role of this antibiotic in the treatment of MDR Acinetobacter spp. in our hospital. The emergence of XDR isolates is of serious concern and necessitates close monitoring and surveillance. PMID: 31865943 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Analysis and comparison of cumulative antibiograms for the Charlotte Maxeke Johannesburg Academic Hospital adult intensive care and high-care units, 2013 and 2017.
CONCLUSIONS: Appropriate selection of empirical antimicrobial therapy should be guided by the ICU-specific antibiogram. The recommended empirical antimicrobial therapy at the CMJAH ICU/HCU based on the antibiogram analysis would include ertapenem to cover the Enterobacteriaceae. Amikacin is recommended for empirical treatment of suspected pseudomonal infections. Additional empirical antimicrobial therapy for Gram-positive organisms is not routinely advocated, and empirical antifungal therapy with amphotericin B or micafungin is only appropriate in patients at high risk for invasive candidiasis. PMID: 31865944...
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

A multicentre prospective observational study of the prevalence of preoperative anaemia and iron deficiency in adult elective surgical patients in hospitals in Western Cape Province, South Africa.
CONCLUSIONS: Preoperative anaemia was common in this study, and more than half of the affected patients had moderate to severe anaemia. Iron deficiency was responsible for almost 40% of cases. Iron supplementation was under-utilised in the preoperative period as a means of increasing haemoglobin. The introduction of system-wide policies would empower perioperative physicians to mitigate the risk associated with preoperative anaemia in the Western Cape. PMID: 31865945 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

The burden of depression and anxiety among medical students in South Africa: A cross-sectional survey at the University of Cape Town.
CONCLUSIONS: Nearly one in four students reported depression/anxiety diagnoses and were on psychotropic medication, significantly more than age-based expectations. Even more screened positive for risk of depression/anxiety. Our findings indicate that medical students, particularly females, are at a significantly increased risk of depression and anxiety disorders. Results suggest that the 2016 student protests may have had a direct impact on the mental state of students. Multidisciplinary efforts should be targeted at initiatives to strengthen mental wellbeing and institutional culture around mental health. These efforts ma...
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Role of clinical informatics in the implementation of universal health coverage.
Authors: Maimela TCR, Mutshekwane MN, Basu D PMID: 31865947 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

'Getting out of the dark': Implications of load shedding on healthcare in South Africa and strategies to enhance preparedness.
Authors: Laher AE, Van Aardt BJ, Craythorne AD, Van Welie M, Malinga DM, Madi S Abstract Power failures and the lack of a robust contingency plan could prove catastrophic in any healthcare environment, with varied and far-reaching consequences. In 2003, a 28% rise in both accidental and non-accidental deaths was recorded in the USA as a result of mass power outages. For every day with a power outage lasting longer than 2 hours, hospital mortality has been estimated to increase by 43%. PMID: 31865948 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Child health, infant formula funding and South African health professionals: Eliminating conflict of interest.
Authors: Lake L, Kroon M, Sanders D, Goga A, Witten C, Swart R, Saloojee H, Scott C, Manyuha M, Doherty T Abstract Despite clear evidence of the benefits of exclusive and continued breastfeeding for children, women and society, far too few children in South Africa (SA) are breastfed. One of the major impediments to improving this situation is the continued and aggressive marketing of breastmilk substitutes (BMSs) and infiltration of the BMS industry into contexts with exposure to health professionals. In this article we, as academics, practitioners and child health advocates, describe contraventions of the regulati...
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Is it time for South Africa to end the routine high-dose vitamin A supplementation programme?
Authors: Coutsoudis A, Sanders D, Dhansay MA, Van Stuijvenberg ME, Benn CS Abstract In accordance with World Health Organization guidelines, South Africa (SA) introduced routine periodic high-dose vitamin A supplementation (VAS) in 2002. These guidelines were developed after research in the 1980s and 1990s showed the efficacy of VAS in reducing childhood mortality. However, two recent studies in low- to middle-income countries (2013 and 2014) have shown no effect of high-dose VAS on mortality. Additionally, there is no clear research evidence that 6-monthly doses of vitamin A result in a sustained shift in serum re...
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

The ketamine crisis: Does South Africa have a plan B?
This article is concerned with the management of burns, which 3% of the population suffer from annually. Ketamine, acknowledged for its versatility and safety profile, remains a critical component in the medical arsenal of anaesthesiologists and clinicians treating both acute and chronic pain. In the management of burn-injured patients in particular, ketamine is the cornerstone of many analgesia protocols. However, issues pertaining to shortages of this medicine in SA warrant concern and discussion, particularly in view of the high reliance of doctors on ketamine for first-line procedural analgesia in the management of bur...
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Training South African clinician-scientists: Lessons from the University of Cape Town's intercalated programme.
We report and reflect on the programme's performance and challenges. The UCTCSTP has so far enrolled 71 students: 51 have received BMedSci Hons degrees and 4 have received Master's degrees, while there are 14 BMedSci Hons, 4 MSc and 4 PhD candidates. Graduates have produced significant research outputs, and many remain actively engaged in research. The UCTCSTP has been successful in encouraging a cohort of future clinician-scientists, but should aim to broaden and improve its appeal to address the need to transform and grow the SA clinical academic workforce. As graduates progress with their postgraduate clinical training,...
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Descriptive analysis of World Health Organization-recommended second-line antiretroviral treatment: A retrospective cohort data analysis.
CONCLUSIONS: VL suppression was high in patients on second-line treatment, but one-fifth of patients were lost to follow-up. Younger age, male sex and transfer from other treatment sites predicted poor treatment outcomes, highlighting opportunities for prioritisation of adherence interventions. PMID: 31865953 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Stillbirth risk across pregnancy by size for gestational age in Western Cape Province, South Africa: Application of the fetuses-at-risk approach using perinatal audit data.
CONCLUSIONS: There is an increased risk of stillbirth for SGA pregnancies, specifically between 33 and 40 weeks' gestation, despite fortnightly ANC visits during this time. LGA pregnancies are at an increased risk of stillbirth after 37 weeks' gestation. This high-risk period highlights potential issues with the detection of fetuses at risk of stillbirth even when ANC is frequent. PMID: 31865954 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Surveillance and comparison of antimicrobial susceptibility patterns of ESKAPE organisms isolated from patients with bacteraemia in South Africa, 2016 - 2017.
CONCLUSIONS: The key clinically important finding is the rapidly decreasing carbapenem susceptibility among Enterobacteriaceae reported in SA, irrespective of sector. In addition, the analysis provides information that could be used to monitor the effectiveness of interventions implemented at a national level under the guidance and direction of the national AMR framework. PMID: 31865955 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

The pH of lye and no-lye hair relaxers, including those advertised for children, is at levels that are corrosive to the skin.
CONCLUSIONS: The pH of all the relaxers tested was at levels deemed corrosive to the skin and may contribute to the high prevalence of alopecia in females with afro-textured hair. A review of permissible safe pH levels for cosmetic use is warranted. PMID: 31865956 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Outcome determinants of urethroplasty in the management of inflammatory anterior urethral strictures.
CONCLUSIONS: Urethroplasty remains a challenge in inflammatory urethral strictures, where stricture length was the main reason for treatment failure. PMID: 31865957 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

The accuracy of a point-of-care test among different operators using the QBC Autoread Plus Analyzer for the measurement of a basic full blood count.
CONCLUSIONS: With appropriate training, non-medical, non-healthcare lay users are able to perform a moderately complex POCT with similar accuracy as trained laboratory professionals. The focus should shift to equipment and quality management processes rather than the medical/technical qualification of the user. PMID: 31865958 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

A diabetes profile of the eight districts in the public health sector, Eastern Cape Province, South Africa.
CONCLUSIONS: The study showed an annual growth in the incidence of diabetes in the EC since 2014, and highlights the issue of an increasing burden of diabetes in the rural population. This increase is consonant with predictions by authoritative bodies on the growing burden of diabetes in Africa. The pattern of distribution highlights the deprived district of O R Tambo contradicting the well-known link between diabetes and urbanisation. PMID: 31865959 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Prevalence of low serum testosterone levels among men with type 2 diabetes mellitus attending two outpatient diabetes clinics in KwaZulu-Natal Province, South Africa.
CONCLUSIONS: There was a high prevalence of LSTT, LSFT and androgen deficiency symptoms in this study. Serum TT and FT were lower in men with T2DM than in control subjects. Risk factors associated with LSFT or LSTT included higher BMI and WC and older age. The AMS score was a poor predictor of low testosterone. More research is required locally before any screening policy can be recommended. PMID: 31865960 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

The prevalence and characteristics of moderate- to high-risk regulated and unregulated substance use among patients admitted to four public hospitals in Tshwane, South Africa.
CONCLUSIONS: Moderate- to high-risk substance use is an undetected, unattended comorbidity in the hospital setting in Tshwane, particularly among young, single, unemployed men. Clinicians should identify and respond to this need. Further research is required on the implementation of in-hospital substance use screening and treatment interventions. PMID: 31865961 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 25, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Special edition of the SAMJ devoted to cell and gene therapy.
Authors: Pepper MS PMID: 31662141 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - October 31, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Primary immunodeficiency in Africa - a review.
Conclusion. Given the unique genetic mutations reported in PID patients on the African continent and the feasibility of hematopoietic stem cell transplantation and gene therapy, increased awareness should be encouraged and new therapeutic options considered. PMID: 31662142 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - October 31, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Gene and cell therapy in South Africa: Current status and future prospects.
Authors: Ely A, Bloom K, Maepa MB, Mahlangu JN, Pepper MS, Arbuthnot P Abstract South Africa has a high disease burden resulting from communicable and non-communicable diseases. Current therapeutic interventions rarely result in a cure and the associated lifelong treatment places a considerable strain on an overburdened health sector. Gene and cell therapies present novel alternatives to disease management, offering the promise of a single treatment and a lifelong cure. Although challenges remain, investment in the field has started to bear fruit, with a number of gene and cell therapeutics reaching the market in t...
Source: South African Medical Journal - October 31, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Stem cell tourism and spinal cord injury in South Africa.
Conclusion. This study highlights the need to curb the practice of offering unethical and non-evidence-based stem cell therapy for SCI. Ethical research and treatment is encouraged as well as an effective legal framework and education of health professionals, patients and their family members and caregivers, which will avoid unrealistic expectations, bogus therapies and the potential adverse effects of non-evidence-based 'stem cell therapies' offered by clinics via the internet. PMID: 31662144 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - October 31, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Heterogeneity of cell therapy products.
Authors: Wolmarans E, Mellet J, Ambele MA, Durandt C, Pepper MS Abstract Cellular therapy has become a billion-dollar industry and is set to become one of the therapeutic pillars of healthcare in the 21st century. Adult stem cells, which include haematopoietic stem and progenitor cells (HSPCs) and mesenchymal stromal/stem cells (MSCs), is one of the major cell types currently under investigation for use in cell therapy. This review focuses on HSPCs and MSCs and discusses their heterogeneous nature and the problems faced in expanding these cells to therapeutic numbers for use in clinical applications. PMID: 3166...
Source: South African Medical Journal - October 31, 2019 Category: African Health Tags: S Afr Med J Source Type: research

Human leukocyte antigen (HLA) diversity and clinical applications in South Africa.
Authors: Mellet J, Tshabalala M, Agbedare O, Meyer P, Gray CM, Pepper MS Abstract The major histocompatibility complex, known as the human leukocyte antigen (HLA) complex in humans, forms an integral component of adaptive T cell immunity by presenting self and non-self peptides to the T cell receptor, thereby allowing clonal expansion of responding peptide-specific CD4+ and CD8+ T cells. HLA likewise forms an integral part of the innate immune response through the binding of killer-cell immunoglobulin-like receptor (KIR) molecules, which regulate the response of natural killer (NK) cells. The HLA complex is found o...
Source: South African Medical Journal - October 31, 2019 Category: African Health Tags: S Afr Med J Source Type: research