South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Unplanned readmission within 30 days is currently being used in high-income countries (HICs) for measuring the quality of surgical care. Surgical site infection (SSI), abdominal complaints and pain are the most common causes for such readmission. The correlation between readmission rates and mortality, increased patient volumes and complexity of surgery remains controversial. ⋯ The Department of General Surgery, Worcester Hospital, had a readmission rate comparable with that in HICs. Readmission rate is an indicator of advanced surgical pathology requiring an operative intervention of greater magnitude, often presenting as an emergency. Our results can be used to improve postoperative surveillance and ultimately improve outcomes in high-risk surgical populations. This study provides a benchmark for other regional hospitals in SA and has implications for quality-improvement programmes.
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The burden of neonatal surgical conditions is not well documented in low- to middle-income countries (LMICs). These conditions are thought to be relatively common, with a considerable proportion of neonates admitted to the neonatal intensive care unit (NICU) requiring surgical intervention. ⋯ Neonates with major surgical conditions accounted for one-third of NICU admissions in the present study. The study highlights the considerable burden placed on paediatric surgical services at a large referral hospital in SA. Paediatric surgical services, with early referral and improvement of neonatal transport systems, must be a priority in planned healthcare interventions to reduce neonatal mortality in LMICs.
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Lephalale Municipality in Limpopo Province, South Africa, has seen significant economic and industrial development owing to expansion of the coal mining and power generation sectors. This development has coincided with substantial population growth of 65% between 2001 and 2016, attributable to largely (migrant) males living in the area who, overall, outnumbered females by ~121:100. The local HIV prevalence is reported to be higher than national rates. ⋯ Lower median CD4+ counts and a dramatic increase in volumes of CD4+ tests performed from 2007 onwards revealed a high burden of advanced and very advanced HIV disease in patients accessing care in Lephalale. Viewed together with Statistics South Africa census documentation of a disproportionately high number of males compared with females living in the area, these figures suggest that improved systems are urgently needed to encourage and accommodate access to HIV care for male (migrant worker) patients living and working in emerging industrial centres.
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Institutions are increasingly using technology to augment the class learning experience of medical students. Especially in Africa, local content is key to allow insights and knowledge to emerge and build transformative capacity for students and patients. There is currently no peer-reviewed video content produced by students with the aim of providing education on orthopaedic topics for medical students and patients in this region. ⋯ Our study provides proof of concept for a new educational material creation and dissemination strategy. A low-cost local collaborative orthopaedic video project by medical students for medical students can lead to high view counts and watch time on YouTube. It is accessible to audiences in low-, middle- and high-income countries. The students' educational videos also reached a global audience consistently over a 3-year period.
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HIV testing rates have increased in recent years. Repeat testing is recommended to identify and treat new HIV infections timeously. However, there are limited data on repeat HIV testing, especially in South Africa (SA). ⋯ HIV testing and repeat testing increased over time, especially in males and in HTS. Promotion and integration of SRH services are critical to facilitate improved health-seeking behaviour and HIV testing of both male and female clients. They are also important for continued access to HTS at multiple service delivery points.