Causative pathogens and antibiotic resistance in community-acquired urinary tract infections in central South Africa
CONCLUSIONS: As expected, E. coli comprised most of the isolates, with a higher than expected number of Klebsiella isolates cultured. The susceptibility of E. coli to commonly prescribed oral antibiotics has decreased in the research setting, which mirrors a global trend. This study provides data showing that TMP-SMX and nitrofurantoin can be used safely as alternatives to first-line ciprofloxacin in CAUTIs in central SA.PMID:33944722 | DOI:10.7196/SAMJ.2021.v111i2.14905 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: J L Fourie F M Claassen J J Myburgh Source Type: research

One in four die from acute infectious illness in an emergency department in Eastern Cape Province, South Africa
CONCLUSIONS: Among adults with suspected acute infectious illness in Mthatha, SA, 30-day mortality was concerningly high. Mortality was highest in patients with concomitant HIV infection. In particular, vital sign assessment to identify possible sepsis in this cohort is crucial, as it affects mortality to a meaningful extent, yet is often unavailable. Future research is needed on the management of sepsis in low-resource settings, particularly in HIV-positive individuals.PMID:33944723 | DOI:10.7196/SAMJ.2021.v111i2.14619 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: A Jenson A Rao P Mda B Cawe J Iruedo T Dubula D Stead R Rothman B Hansoti Source Type: research

Examining the reliability of ICD-10 discharge coding in Red Cross War Memorial Children's Hospital administrative database
CONCLUSIONS: Reliability of administrative ICD-10 discharge data from RCWMCH is poor. Inadequacies regarding the employment of dedicated and/or adequately trained coding personnel may significantly contribute to the problem and should be addressed.PMID:33944724 | DOI:10.7196/SAMJ.2021.v111i2.14686 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: A Daniels R Muloiwa L Myer H Buys Source Type: research

Non-vaccine serotype pneumococcal carriage in healthy infants in South Africa following introduction of the 13-valent pneumococcal conjugate vaccine
CONCLUSIONS: The pneumococcal carriage prevalence described in our study varied across the age groups and was lower compared with other African studies that looked at pneumococcal carriage post PCV. The study gave insight into the common NVTs encountered at two immunisation clinics in Gauteng. Given that pneumococcal carriage precedes disease, common colonisers such as 15B/C and 35B may be sufficiently prevalent in carriage for expansion to result in significant disease replacement.PMID:33944725 | DOI:10.7196/SAMJ.2021.v111i2.14626 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: Z Skosana A Von Gottberg S Olorunju T Mohale M Du Plessis T Adams N Mbelle Source Type: research

Non-communicable disease comorbidities in KwaZulu-Natal Province, South Africa
CONCLUSIONS: The study reported a higher burden of comorbid hypertension and diabetes among vulnerable populations in Mpumza, SA, particularly women, the obese, and those with a low level of education. In addition, control of comorbidities was low. Developing appropriate interventions to improve control of comorbidities can reduce the risk of macrovascular and microvascular diseases in this population.PMID:33944726 | DOI:10.7196/SAMJ.2021.v111i2.14744 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: S B Kushitor O A Sanuade L Baatiema M K Kushitor E K Afrifa-Anane R B Awuah Source Type: research

The burden of hypertension in KwaZulu-Natal Province, South Africa: A 6-year perspective
CONCLUSIONS: Screening, diagnosis, treatment initiation and chronic management of HPT occur mainly at rural clinic level. The SA government needs to heed these findings and redirect resources (staffing and equipment) to this level. The prevalence of obesity was highest at rural healthcare facilities (clinics more than hospitals). More needs to be done to combat the obesity pandemic if we are to win the battle against NCDs (HPT and diabetes mellitus). A significant number of patients aged <40 years are being screened for HPT, which bodes well for the province, as early diagnosis and treatment of HPT are vital to prev...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: S Pillay D Pillay R S Pillay Source Type: research

Are adults just big kids? Can the newer paediatric weight estimation systems be used in adults?
CONCLUSIONS: None of the evaluated weight estimation methodologies was accurate enough for use in adult weight estimation. The Mercy and PAWPER XL-MAC methodologies both showed significant promise for use in adult weight estimation, but need further refinement. Although patient self-estimates were similarly accurate to those found in previous studies, they were not an accurate option; self-estimations would remain the first choice if the patient was able to provide such an estimation. The Broca index and Buckley method cannot be recommended owing to their poor performance.PMID:33944728 | DOI:10.7196/SAMJ.2021.v111i2.15061 ...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: O Akinola M Wells P Parris L N Goldstein Source Type: research

WhatsApp-propriate? A retrospective content analysis of WhatsApp use and potential breaches in confidentiality among a team of doctors at a district hospital, South Africa
CONCLUSIONS: Non-anonymised patient identifiers were found in 3.3% of messages, constituting the potential for breaching patient confidentiality. While WhatsApp groups have significant utility in co-ordinating aspects of clinical care, resource allocation, as well as social and administrative functions, the safe use of WhatsApp should be promoted to ensure that patient confidentiality is maintained.PMID:33944729 | DOI:10.7196/SAMJ.2021.v111i2.14453 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: G D Meyer N Meyer J D Du Toit P A Mans B D Moffett Source Type: research

The adjunctive use of carbimazole during radioactive iodine treatment reduces the cure rate of Graves' disease
CONCLUSIONS: Adjunctive carbimazole treatment decreased the RAI cure rate of Graves' disease significantly.PMID:33944730 | DOI:10.7196/SAMJ.2021.v111i2.14522 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: F Docrat T Mokoena V O L Karusseit A O Ankrah Source Type: research

The readability of informed consent forms for research studies conducted in South Africa
CONCLUSIONS: Two-thirds of the ICFs from this study fail to meet the SA readability standard, a result matched by using alternative readability formulas. Readability can be improved with simple techniques and by actively monitoring readability metrics.PMID:33944731 | DOI:10.7196/SAMJ.2021.v111i2.14752 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: A E Fischer W D F Venter S Collins M Carman S T Lalla-Edward Source Type: research

Ivermectin for COVID-19: Promising but not yet conclusive
S Afr Med J. 2021 Jan 12;111(3):13187. doi: 10.7196/SAMJ.2021.v111i3.15522.NO ABSTRACTPMID:33944732 | DOI:10.7196/SAMJ.2021.v111i3.15522 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: R Van Rensburg E H Decloedt H Reuter A Parker N Schrueder S Lahri Source Type: research

Barriers to the representation of researchers from developing countries in international health and potential strategies to address these
S Afr Med J. 2021 Mar 2;111(3):13228. doi: 10.7196/SAMJ.2021.v111i3.15534.ABSTRACTLetter by Haribhai on article by Moodley (Moodley K. Research imperialism resurfaces in South Africa in the midst of the COVID-19 pandemic - this time, via a digital portal. S Afr Med J 2020;110(11):1068-1069. https://doi.org/10.7196/SAMJ.2020.v110i11.15285).PMID:33944733 | DOI:10.7196/SAMJ.2021.v111i3.15534 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: S Haribhai Source Type: research

Blood shortage in COVID-19: A crisis within a crisis
S Afr Med J. 2021 Mar 2;111(3):13226. doi: 10.7196/SAMJ.2021.v111i3.15525.NO ABSTRACTPMID:33944734 | DOI:10.7196/SAMJ.2021.v111i3.15525 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: T D Malange T Atia Source Type: research

The COVID-19 pandemic and traffic accidents
S Afr Med J. 2021 Mar 2;111(3):13227. doi: 10.7196/SAMJ.2021.v111i3.15531.NO ABSTRACTPMID:33944735 | DOI:10.7196/SAMJ.2021.v111i3.15531 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: R Mungmunpuntipantip V Wiwanitkit Source Type: research

Stroke care: Leaps in addressing the shortfall with some Angels to the rescue
S Afr Med J. 2021 Mar 2;111(3):196-197. doi: 10.7196/SAMJ.2021.v111i3.15103.NO ABSTRACTPMID:33944736 | DOI:10.7196/SAMJ.2021.v111i3.15103 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: A Bryer Source Type: research

Qualitative and quantitative detection of SARS-CoV-2 RNA in untreated wastewater in Western Cape Province, South Africa
S Afr Med J. 2021 Jan 28;111(3):198-202. doi: 10.7196/SAMJ.2021.v111i3.15154.ABSTRACTRecent studies have shown that the detection of SARS-CoV-2 genetic material in wastewater may provide the basis for a surveillance system to track the environmental dissemination of this virus in communities. An effective wastewater-based epidemiology (WBE) system may prove critical in South Africa (SA), where health systems infrastructure, testing capacity, personal protective equipment and human resource capacity are constrained. In this proof-of-concept study, we investigated the potential of SARS-CoV-2 RNA surveillance in untreated was...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: R Johnson C J F Muller S Ghoor J Louw E Archer S Surujlal-Naicker N Berkowitz M Volschenk L H L Br öcker G Wolfaardt M Van der Walt A M Mutshembele S Malema H C Gelderblom M Muhdluli G Gray A Mathee R Street Source Type: research

Statement on analysis and interpretation of clinical human gastrointestinal microbiome testing using next-generation sequencing in South Africa
S Afr Med J. 2021 Mar 2;111(3):203-205. doi: 10.7196/SAMJ.2021.v111i3.15336.ABSTRACTAdvances in DNA sequencing technologies and computational tools over the past few years have led to vast improvements in the metagenomic analysis of the human microbiota. While this has also significantly improved our understanding of the role of the host-microbiome interaction in health and disease, the current clinical expectation is that testing, particularly of the gastrointestinal biome, can be used to diagnose, manage and treat patients. The authors outline the available technologies and highlight current limitations of these techniqu...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: J M Wojno E Du Toit A Deffur A Brink Source Type: research

Role of vaccines in preventing influenza in healthy children
S Afr Med J. 2021 Mar 2;111(3):206-207. doi: 10.7196/SAMJ.2021.v111i3.14478.ABSTRACTThe role of an influenza vaccine is to minimise illness and death. Vaccines provide good protection against influenza strains and significantly reduce time off work. However, the recommendation for use depends on the efficacy, effectiveness and safety of the vaccines. We highlight a Cochrane review that sought to determine the efficacy, effectiveness and safety of seasonal influenza vaccines in healthy children, and provide implications for practice for vaccination of children. The findings suggest that influenza vaccines play a key role in...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: E Z Sambala S Cooper B-M Schmidt S Walaza C S Wiysonge Source Type: research

Saved by the pump: Two successful resuscitations utilising emergency department-initiated extracorporeal cardiopulmonary resuscitation in South Africa
S Afr Med J. 2021 Mar 2;111(3):208-210. doi: 10.7196/SAMJ.2021.v111i3.15366.ABSTRACTExtracorporeal life support is the utilisation of advanced techniques to sustain circulatory and/or ventilatory functions in critically ill patients when standard therapies fail. It is well established in developed countries. There is increasing literature supporting its application in refractory cardiac arrest with a potential reversible cause, a procedure also known as extracorporeal cardiopulmonary resuscitation (eCPR). Two cases where eCPR was successfully utilised in a busy (>30 000 visits per year) private South African emergen...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: N Vlok K A Hedding M A Van Dyk Source Type: research

The impact of obesity on the cellular and molecular pathophysiology of COVID-19
S Afr Med J. 2020 Dec 14;111(3):211-214. doi: 10.7196/SAMJ.2021.v111i2.15398.ABSTRACTEmerging evidence reveals a strong association between COVID-19 and obesity in terms of disease severity, need for hospitalisation and risk of mortality. In this review, we discuss cellular and molecular mechanisms potentially contributing to the pathophysiology of COVID-19 in obese patients. Understanding the relationship between COVID-19 and obesity is pertinent for the clinical management of these patients.PMID:33944741 | DOI:10.7196/SAMJ.2021.v111i2.15398 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: P Dhanraj R Pitere M S Pepper Source Type: research

Shortfall in stroke care: A study of ischaemic stroke care practices in a South African metropole
CONCLUSIONS: The two stroke units at the level 3 hospitals adhered most closely to the recommended SA stroke guideline. Elsewhere, ischaemic stroke care varied widely across general medical wards at all hospital levels. Adherence to the guideline was influenced by factors such as limited access to diagnostic investigations, patient delays in receiving medical attention, and shortages of staff. Monitoring systems for continuous evaluation of the quality of acute and post-acute stroke services are needed. The shortfall in compliance with recommended stroke treatment guidelines could lead to worse outcomes and exposure to lit...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: V Mandizvidza L London A Bryer Source Type: research

Economic growth as an underlying probable systemic driver for childhood obesity in South Africa: A Joinpoint regression and ecological analysis over 10 years
CONCLUSIONS: An increase in childhood and adolescent obesity over time was observed, while trend associations between obesity and EGIs exist.PMID:33944743 | DOI:10.7196/SAMJ.2021.v111i3.14669 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: P T Pisa N M Pisa P Chikandiwa A Chikandiwa Source Type: research

Rapid review of the effects of cloth and medical masks for preventing transmission of SARS-CoV-2 in community and household settings
CONCLUSIONS: Direct evidence for cloth and medical mask efficacy and effectiveness in the community is limited. Decision-making for mask use may consider other factors such as feasibility and SARS-CoV-2 transmission dynamics; however, well-designed comparative effectiveness studies are required.PMID:33944744 | DOI:10.7196/SAMJ.2021.v111i3.15119 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: T Chetty V Ramokolo K Rees T Kredo Y Balakrishna C Mathews N Siegfried Source Type: research

Drastic reduction of orthopaedic services at an urban tertiary hospital in South Africa during COVID-19: Lessons for the future response to the pandemic
CONCLUSIONS: COVID-19 and the associated lockdown has heavily impacted on both orthopaedic inpatient and outpatient services. Lockdown led to a larger reduction in the orthopaedic trauma burden than in international centres, but the overall reduction in surgeries, outpatient visits and hospital admissions was less. This lesser reduction was probably due to local factors, but also to a conscious decision to avoid total collapse of our surgical services.PMID:33944745 | DOI:10.7196/SAMJ.2021.v111i3.15263 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: R Waters R Dey M Laubscher R Dunn S Maqungo G McCollum M Nortje S Roche T Hilton M Held Source Type: research

A severity-of-illness score in patients with tuberculosis requiring intensive care
CONCLUSIONS: The 6-point severity-of-illness score identified patients at increased risk of death. We were able to derive and retrospectively validate a simplified 4-point score with superior predictive power.PMID:33944746 | DOI:10.7196/SAMJ.2021.v111i3.14609 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: U Lalla E M Irusen B W Allwood J J Taljaard C F N Koegelenberg Source Type: research

Costing total hip arthroplasty in a South African state tertiary hospital
CONCLUSIONS: The study showed that clinicians need to be aware of procedural costing in the current financial climate. There are still opportunities to optimise cost containment in the state sector.PMID:33944747 | DOI:10.7196/SAMJ.2021.v111i3.14931 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: A R Sekeitto A A Aden Source Type: research

High virological failure rates in HIV-1 perinatally infected children in South Africa: A retrospective cohort study
CONCLUSIONS: We observed high rates of virological failure and emergence of HIV drug resistance mutations. Despite gains made by SA in the treatment of HIV, such results challenge the country's ability to meet global targets of 90% viral suppression by 2020.PMID:33944748 | DOI:10.7196/SAMJ.2021.v111i3.15221 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: Z N Makatini J T Blackard S Mda P Miles O Towobola Source Type: research

The next generation: Pregnancy in adolescents and women living with perinatally acquired HIV in South Africa
CONCLUSIONS: In recent years, the number of pregnancies in YLPHIV has increased. A considerable proportion of pregnancies occurred in YLPHIV ≤16 years old. A high proportion of pregnancies was electively terminated. The prevalence of elevated VL and poor immunological status among pregnant YLPHIV is concerning.PMID:33944749 | DOI:10.7196/SAMJ.2021.v111i3.14987 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: K Anderson T Mutemaringa K-G Technau L F Johnson K Braithwaite E Mokotoane A Boulle M-A Davies On Behalf Of IeDEA-Sa Pediatrics Source Type: research

A simulation-based study evaluating the preparedness of interns' post-anaesthesia rotation in managing a failed obstetric intubation scenario: Is our training good enough?
CONCLUSIONS: There are concerns regarding adequate anaesthetic preparation for interns to manage a difficult/failed intubation scenario in a full-term pregnancy. Despite the Essential Steps in Managing Obstetric Emergencies (ESMOE) airway module training, which all interns should receive, a high rate of success was not achieved in this study. Simulation-based training and assessment may be a valuable tool to improve intern training and preparedness.PMID:33944750 | DOI:10.7196/SAMJ.2021.v111i3.14443 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: I Kiwalabye L Cronj é S Schoeman T Sommerville Source Type: research

The role of treatment delays in surgical site infection after appendicectomy in a South African rural regional hospital
CONCLUSIONS: Delays to surgery beyond 72 hours significantly increased complicated appendicitis, an important risk factor for SSI. Access to facilities with surgical capability and the use of laparoscopic surgery are modifiable risk factors for SSI.PMID:33944751 | DOI:10.7196/SAMJ.2021.v111i3.15231 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: O Swart T M Esterhuizen M Voss Source Type: research

Emergency Medicine Society of South Africa guidelines for the training and credentialing in emergency point-of-care ultrasound
S Afr Med J. 2021 May 3;111(5b):13296. doi: 10.7196/SAMJ.2021.v111i5b.15346.ABSTRACTThis is the second guideline from the Emergency Medicine Society of South Africa (EMSSA) on the use of emergency point-of-care ultrasound in South Africa. It supersedes and replaces the guidelines produced in 2009. This document contains information on the changes from the 2009 guidelines and details of the training and credentialing processes recommended by EMSSA. It also contains detailed information on the curricula of the Core Emergency Point-of-Care Ultrasound and Advanced Emergency Point-of-Care Ultrasound courses.PMID:33944752 | DOI:...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: M Wells L N Goldstein C Beringer Bridget Farham Source Type: research

When culture, traditions and public health clash: A paradigm shift urgently needed to stem the spread of COVID-19 in Zimbabwe
S Afr Med J. 2021 Mar 5;111(4):13235. doi: 10.7196/SAMJ.2021.v111i4.15637.NO ABSTRACTPMID:33944753 | DOI:10.7196/SAMJ.2021.v111i4.15637 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: T Dzinamarira G Musuka Source Type: research

Factors affecting specialist psychiatry training in South Africa: Bullying during specialist psychiatric training?
S Afr Med J. 2021 Mar 31;111(4):13255. doi: 10.7196/SAMJ.2021.v111i4.15518.NO ABSTRACTPMID:33944754 | DOI:10.7196/SAMJ.2021.v111i4.15518 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: N Beath K Moxley U Subramaney Z Zingela B Chiliza J Joska C Kotz é S Seedat Source Type: research

Surgical training in the private sector in South Africa
S Afr Med J. 2021 Mar 31;111(4):13260. doi: 10.7196/SAMJ.2021.v111i4.15613.NO ABSTRACTPMID:33944755 | DOI:10.7196/SAMJ.2021.v111i4.15613 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: D Lutrin H Etheredge J Fabian C Bouter S Tager Source Type: research

A qualitative analysis of seven ivermectin formulations in South Africa
This study qualitatively analysed seven samples of ivermectin formulations (5 tablet and 2 capsule formulations) being sold in SA for human use. The samples were analysed using a high-performance liquid chromatography instrument connected to a Sciex X500R quadrupole time-of-flight high-resolution mass spectrometer. The study found that all the samples had both the major homologues of ivermectin (B1a and B1b) and also that 4 out of the 5 tablet formulations tested had at least one additional undeclared active pharmaceutical ingredient.PMID:33944756 | DOI:10.7196/SAMJ.2021.v111i4.15630 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: Q E Bhorat A E Bhorat Source Type: research

COVID-19 vaccination: Recommendations for management of patients with allergy or immune-based diseases
S Afr Med J. 2021 Feb 8;111(4):291-294. doi: 10.7196/SAMJ.2021.v111i4.15576.ABSTRACTAs South Africa continues to battle the second wave of SARS-CoV-2 infections, the imminent arrival of vaccines against COVID-19 offers hope. Vaccine roll-out has been accompanied by heightened media coverage that has created both excitement and anxiety, reporting on the shortened timeline of vaccine trials and approvals, as well as the recent series of anaphylaxis cases associated with the two approved mRNA COVID-19 vaccines. Patients with allergic and other immune-based diseases are subgroups especially concerned about vaccine safety and e...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: J Peter Source Type: research

COVID-19: Experience of a tertiary children's hospital in Western Cape Province, South Africa
In conclusion, visible management and leadership has allowed for flexibility and adaptability to manage clinical services in various contexts. It is important to utilise staff in different roles during a crisis and to consider the different perspectives of people involved in the services. The key to success, that included very early adoption of the above measures, has been hospital staff taking initiative, searching for answers and identifying and implementing solutions, effective communication, and leadership support. These lessons are useful in dealing with second and further waves of the COVID-19 pandemic.PMID:33944758 ...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: A N Parbhoo A Numanoglu A C Argent M Franken M Mukosi M I McCulloch Source Type: research

A nurse-led intervention to improve management of virological failure in public sector HIV clinics in Durban, South Africa: A pre- and post-implementation evaluation
CONCLUSIONS: This enhanced intervention to improve VF in the public sector using a paper-based data management system failed to achieve significant improvements in first-line VF management over the standard of care. In addition to interventions that better address patient-centred factors that contribute to VF, we believe that there are substantial limitations to and staffing requirements involved in the ongoing utilisation of a paper-based tool. A prioritisation is needed to further expand and upgrade the electronic medical record system with capabilities for prompting staff regarding patients with missed visits and critic...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: H Sunpath S Pillay T Hatlen R A Murphy V C Marconi M-Y S Moosa K Naidoo M J Siedner Source Type: research

COVID-19: May hospitals in one province of South Africa reserve empty beds for patients from their province and turn down emergency requests from other provinces?
S Afr Med J. 2021 Feb 15;111(4):304-306. doi: 10.7196/SAMJ.2021.v111i4.15554.ABSTRACTThe new 501Y.V2 variant of COVID-19 has led to a rapid increase in the number of persons infected with the virus in South Africa, and state and private hospitals are having to turn patients away. Although it is common practice for patients to be transferred between provinces for specialist care, the upsurge in the COVID-19 pandemic has led to some hospitals considering reserving intensive care and critical care beds for COVID-19 patients from their province. The Constitution provides that nobody may be refused emergency medical treatment, ...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: D J McQuoid-Mason Source Type: research

Acute disseminated encephalomyelitis due to Rickettsia conorii infection
We present a case of a man with acute Rickettsia conorii infection whose diagnosis was delayed. He presented with fever, headache, an eschar and an acute paraplegia. The R. conorii IgM serum titre was 1:128. Magnetic resonance imaging showed multifocal lesions in the brain and spinal cord consistent with inflammatory demyelination. The patient responded well to doxycycline and a short course of high-dose corticosteroids. To our knowledge this is the first case of ADEM associated with Mediterranean spotted fever - we found a previous report of ADEM in a child with Rocky Mountain spotted fever, whose diagnosis of rickettsial...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: D Woolf M Jordaan G Maartens Source Type: research

Primary healthcare workers at risk during COVID-19: An analysis of infections in HIV service providers in five districts of South Africa
CONCLUSIONS: It is critical that all cadres of HCWs are protected in the workplace, including in primary care settings, where better structuresare needed to perform risk assessments and conduct outbreak investigations. CHWs and data staff may be at higher risk owing to poor infrastructure, limited power to negotiate working conditions, and limited experience of infection prevention and control. Their working conditions must be improved to reduce their risk.PMID:33944762 | DOI:10.7196/SAMJ.2021.v111i4.15434 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: K Rees J L Dunlop S Patel-Abrahams H Struthers J A McIntyre Source Type: research

Experiences of workplace bullying among academics in a health sciences faculty at a South African university
CONCLUSIONS: A combination of strategies is needed, including clear FHS policies to prevent bullying, training in bullying prevention and critical diversity, and positive practice environments.PMID:33944763 | DOI:10.7196/SAMJ.2021.v111i4.15319 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: D N Conco L Baldwin-Ragaven N J Christofides E Libhaber L C Rispel J A White B Kramer Source Type: research

Analgesic practices and predictors of use in South Africa-based runners
CONCLUSIONS: A large percentage of runners in our study displayed unsafe practices regarding analgesic use during training and competition, predominantly for perceived injury management. Importantly, the lack of education and recommendations regarding analgesics from health professionals is very concerning, as there is a risk of potentially life-threatening analgesic-induced adverse effects, especially as a high percentage were using two NSAIDs concomitantly. Knowledge of these practices, gained through this study, could allow for the development and implementation of corrective strategies to promote education and safe pra...
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: R Thorpe M Blockman T Burgess Source Type: research

Establishing local reference intervals for full blood count and white blood cell differential counts in Cape Town, South Africa
CONCLUSIONS: Locally established, population-specific RIs are essential for the accurate interpretation of haematological indices. This study established locally derived gender-specific RIs for the Cape Town region, after exclusion of iron deficiency. These new RIs have implications for the accurate diagnoses of cytopenias, cytoses and other blood count abnormalities. Iron deficiency is common in first-time blood donors, and screening for iron deficiency using point-of-care testing should be considered.PMID:33944765 | DOI:10.7196/SAMJ.2021.v111i4.15313 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: A De Koker A R Bird C Swart J J Rogerson C Hilton J J Opie Source Type: research

Venous bicarbonate and creatine kinase as diagnostic and prognostic tools in the setting of acute traumatic rhabdomyolysis
CONCLUSIONS: Although both venous HCO3 and CK showed a weak correlation with creatinine, the former performed significantly better in predicting AKI. In a resource-constrained system, we recommend that HCO3 be measured to assess patients with crush injury and that CK be regarded as a complementary modality.PMID:33944766 | DOI:10.7196/SAMJ.2021.v111i4.14915 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: J J P Buitendag M Q Patel S Variawa J Fichardt B Mostert A Goliath D L Clarke G V Oosthuizen Source Type: research

A prospective observational study of preoperative natriuretic peptide testing in adult non-cardiac surgical patients in hospitals in Western Cape Province, South Africa
CONCLUSIONS: We strongly recommend that non-cardiac surgical patients aged ≥45 years undergoing intermediate- or high-risk non-cardiac surgery with a history of coronary artery disease/peripheral vascular disease, congestive cardiac failure, diabetes mellitus or elevated creatinine have preoperative NP testing as part of risk stratification.PMID:33944767 | DOI:10.7196/SAMJ.2021.v111i4.15226 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: C S Alphonsus M Jagga M Crowther E Coetzee G Davies Z Fullerton H A Van Zyl A Reed E Cloete J Roos F Roodt R N Rodseth B M Biccard Collaborators for EPIC2: BNP study Source Type: research

District hospital surgical capacity in Western Cape Province, South Africa: A cross-sectional survey
CONCLUSIONS: WC DH surgical capacity varied by hospital size. However, FPs could play an essential role in surgery at DHs with appropriate training, oversight and support from SAO specialists. Strategies to scale up surgical capacity include dedicated financial and human resources.PMID:33944768 | DOI:10.7196/SAMJ.2021.v111i4.15281 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: P Naidu K M Chu Source Type: research

Metabolic syndrome at 6 weeks after delivery in a cohort of pre-eclamptic and normotensive women
CONCLUSIONS: Women who developed pre-eclampsia during pregnancy had an increased chance of metabolic syndrome being diagnosed 6 weeks after delivery. Guidelines should be developed to identify women with cardiometabolic risk, so that interventions may be implemented to modify this risk before and after pregnancy.PMID:33944769 | DOI:10.7196/SAMJ.2021.v111i4.15349 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: P Ntlemo T Cronje P Soma-Pillay Source Type: research

International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa
CONCLUSIONS: INR control, as determined by TTR and proportion of TTR ≥65%, in these non-metropolitan clinics was poor. Age and hospitalisation as a marker of illness predicted poor control. There was a difference in control between groups, depending on the indication for warfarin. Evidence-based measures to improve the quality of INR control in patients on warfarin therapy need to be instituted as a matter of urgency.PMID:33944770 | DOI:10.7196/SAMJ.2021.v111i4.15171 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: D N Prinsloo T J Gould C A Viljoen W Basera M Ntsekhe Source Type: research

Preventable deaths among youth in South Africa: Measuring life expectancy in the absence of non-communicable diseases and its implications for the healthcare system
CONCLUSIONS: Urgent action needs to be taken to prevent further mortality from non-communicable causes among youth. The results of this study are important to the SA healthcare system and to public health practitioners whose aim is to reduce the strain on public resources and reduce mortality among youth. Future studies should estimate the extent of NCD mortality in households and communities with the aim of developing macro-level interventions.PMID:33944771 | DOI:10.7196/SAMJ.2021.v111i4.14790 (Source: South African Medical Journal)
Source: South African Medical Journal - May 4, 2021 Category: African Health Authors: N De Wet-Billings Source Type: research