These guidelines form part of efforts to institutionalize the prevention and containment of antimicrobial resistance (AMR) in healthcare facilities in South ...x">Africa, as outlined in the Antimicrobial Resistance Strategic Framework and Implementation Plan. The focus of these guidelines is on two interrelated aspects of prevention of healthcare associated infections (HAIs) and their spread; and the application of antimicrobial stewardship (AMS) practices at hospital level. They aim to serve as a practical, step-by-step or ‘how-to’ guide, addressing the infection prevention and AMS components of a robust response in a hospital. They draw on
evidence from various international guidance documents and standards for interventions that have been shown to be successful in infection
prevention and AMS programmes. These interventions have been customised to the South African hospital setting based on local
experiences in the public and private health sectors. This was done through a series of workshops and requests for comment involving
country-level experts.
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sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not wel...l controlled. Standard management guidelines adapted to in-country realities are important to support optimal care. The South African Thoracic Society (SATS) first published a guideline for the management of chronic persistent asthma in 1992, which has subsequently been revised several times.
The main aim of the present document was to revise and update SATS’ statement on the suggested management of chronic asthma, based on the need to promote optimal care and control of asthma, together with the incorporation of new concepts and drug developments. This revised document reinforces optimal care and incorporates the following primary objectives to achieve the recent advances in asthma care:
• continued emphasis on the use of inhaled corticosteroids (ICS) as the foundation of asthma treatment
• to reduce the reliance on short-acting beta-2 agonist (SABA) monotherapy for asthma symptoms
• to incorporate the evidence and strategy for the use of the combination of an ICS and formoterol for acute symptom relief (instead of a SABA)
• to incorporate the evidence and strategy for the use of as-needed ICS-long-acting beta agonists (LABA) for patients with infrequent symptoms or ‘mild’ asthma
• to incorporate the evidence and strategy for the use of a long-acting muscarinic antagonist (LAMA) in combination with ICS-LABA; and
• to incorporate the evidence and strategy for the use of and management with a biologic therapy in severe asthma.
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Review
S Afr Med J 2014;104(3):174-177. DOI: 10.7196/SAMJ.7968
These guidelines form part of efforts to institutionalise the prevention and containment of antimicrobial resistance (AMR) in health care facilities in South ...ox">Africa, as outlined in the Antimicrobial Resistance Strategic Framework and Implementation Plan. The focus of these guidelines is on two interrelated aspects of prevention of healthcare associated infections (HAIs) and their spread; and the application of antimicrobial stewardship (AMS) practices at hospital level.
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The leishmaniases are a group of diseases caused by Leishmania spp., which occur in cutaneous, mucocutaneous and visceral forms. They are neglected tropical diseases (NTDs), which disproportionately affect marginalized populations who have limited a...ccess to health care. HIV co-infected patients with Leishmania infection are highly infectious to sandflies, and an increase in the coinfection rate in an endemic area is likely to increase the effective infective reservoir.
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The Adult Standard Treatment Guidelines and Essential Medicines List for Hospital Level provide a platform for transparency to enable equitable access to safe, effective, and affordable treatment options at hospital level taking into consideration <...span class="attribute-to-highlight medbox">the changing clinical needs of our population and the pragmatic implications of the introducing a new health technology.
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Low- and middle-income countries (LMICs) experience a high disease burden for epilepsy, a chronic neurological condition.The authors evaluate the cost-effectiveness of community health workers (CHWs...) to improve adherence to medication for epilepsy in South Africa. They found that utilizing CHWs to improve medication adherence was cost-effective.
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Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now ...COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
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Hypertension is referred to as a “silent killer”. Most people with hypertension are unaware of their condition as in most cases, they experience no warning signs or symptoms hence they are not identified or treated. Hypertention is associated with a number of conditions, disability, and causes o...f death. These include: strokes; myocardial infarction; end-stage renal disease; congestive heart failure; peripheral vascular disease and blindness. According to Stats SA, in 2017, hypertensive disorders resulted in 19 900 deaths with a further 44 357 deaths associated with cerebrovascular diseases and other heart diseases. This means around 30% of all deaths in 2017 were associated with increased blood pressure.
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Masangane Case Study
The Vesper Society commissioned ARHAP to do research on the integrated Masangane HIV/AIDS programme affiliated with the Morav...ian Church in Eastern Cape, South Africa. Completed in 2006, this study aimed to understand the role of the religious health assets of the Masangane ART programme for public health, as a model for a replicable response to HIV/AIDS. A crucial aspect of this research involved teasing out what value is added to this programme by its faith-based nature. Field work for this case study consisted of more than 20 key informant interviews of various stakeholders: Masangane staff and management; church leaders; health seekers; donors and health providers. Health seekers also answered 77 questionnaires and were involved in two focus groups.
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NSP Review
Engaging with South Africa’s National Strategic Plan for HIV, STIs and TB Edition 7 July – August 2013
A publication of the Treatm...ent Action Campaign and SECTION27
GeneXpert: An imperfect rollout
TB in South African prisons: Where to now?
Decentralising DR-TB care: How far along are we?
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income c...ountries that ignores LMIC resource constraints and burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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Global and regional estimates of violence against women
he report presents the first global systematic review of scientific data on the prevalence of two forms of violence against women: violence b...y an intimate partner (intimate partner violence) and sexual violence by someone other than a partner (non-partner sexual violence). It shows, for the first time, global and regional estimates of the prevalence of these two forms of violence, using data from around the world. Previous reporting on violence against women has not differentiated between partner and non-partner violence. You can download the report in different languages
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Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in c...ertain countries of Asia and Africa. It often affects people with impaired immunity, including people living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
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HTS Teologiese Studies/Theological Studies ISSN: (Online) 2072-8050, (Print) 0259-9422
The main objective of this guidance is to provide scientific advice, based on an evidence-based assessment of targeted public health interventions, to facilitate effective screening and vaccination for priority infectious diseases among newly arrive...d migrant populations to the EU/EEA. It is intended to support EU/EEA Member States to develop national strategies to strengthen infectious disease prevention and control among migrants and meet the health needs of these populations.
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The Asia Pacific Observatory on Health Systems and Policies is a collaborative partnership which supports and promotes evidence-based health policy making in the Asia Pacific Region. Based in WHO’...s Regional Office for South-East Asia, it brings together governments, international agencies, foundations, civil society and the research community with the aim of linking systematic and scientific analysis of health systems in the Asia Pacific Region with the decision-makers who shape policy and practice.
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