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3202
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Category
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1
Toolboxes
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2
Strategies for skills acquisition and work for people with disabilities
Thabo Mbeki Development Trust for Disabled People, Disabled People South Africa, and Human Sciences Research Council
International Labour Organization
(2007)
C2
A report submitted to the International Labour Organization, Geneva
In support of the African decade of disabled persons | 1st January 199 - 31st of December 2009
International Conference on AIDS and STIs in Africa (ICASA) 2013 | 7th – 12th December | Cape Town, South Africa
ACT to provide for employment equity; and to provide for matters incidental thereto.
A long and healthy life for all South Africans
My Dad Take's Part in the Family
THE RIGHT TO EDUCATION FOR CHILDREN WITH DISABILITIES ALLIANCE
Watermeyer, B., Stuurman, C., McKinney, E., et al
R2ECWD & Inclusive Education South Africa
(2017)
C2
Alternative Report to the UN Committee on the Rights of Persons with Disabilities in response to South Africa’s Baseline Country Report of March 2013 on the UN Convention on the Rights of Pers
...
ons with Disabilities, with particular reference to the provisions of Article 24
more
The purpose of this guideline is to explain to healthcare professionals and administrative employees what their records management obligations are in terms of the National Archives and Records Service of South
...
Africa
more
This document shall provide guidance to Traditional Health Practice on the management of the COVID 19 and the steps taken by Government to address the pandemic.
The aim of the Annual Inspection Report is to present findings of public sector health establishments inspected by the OHSC to monitor compliance with the National Core Standards (NCS) during the 2016/2017 financial year in South
...
Africa.
The NCS define fundamentals for quality of care based on six dimensions of quality: Acceptability,Safety, Reliability, Equity, Accessibility, and Efficiency.
The NCS structured assessment tools were used to collect data during inspections across the seven domains namely: Patient Rights; Patient Safety, Clinical Governance and Clinical Care; Clinical Support Services; Public Health; Leadership and Governance; Operational Management and Facilities and Infrastructure. A total of 851 routine inspections were conducted with 201 of these facilities re-inspected. Inspection data was captured on District Health Information System (DHIS) data entry forms and exported for analysis to Statistical Analysis Software (SAS) version 9.4.
more
Booklet.The Road to Health booklet is an initiative of the South African Department of Health. The booklet should be taken to each clinic visit and filled in by a healthcare provider as a record of your child’s clinic visits and immunisations.
Background: Traumatic stress may arise from various incidents often leading to posttraumatic stress disorder (PTSD). The lifetime prevalence of PTSD is estimated at 1% – 2% in Western Europe, 6% – 9% in North America and at just over 10% in countries exposed to long-term
violence. In
...
South Africa, the lifetime prevalence for PTSD in the general population is estimated at 2.3%.
Aim: To examine the prevalence of posttraumatic stress symptomatology and related psychological functioning in a community sample of adolescents.
Setting: Low-socioeconomic communities in KwaZulu-Natal.
more
Guide to access the National AMR Surveillance Dashboard
This document gives you a step by step guide on running group sessions for people with schizophrenia and their caregivers in your community
South African Health Review 2019
recommended
22nd edition
The purpose of the SAHR has always been to analyse and assess progress and challenges in key areas of the health system, and to propose recommendations for improvement. We are pleased to continue this tradition in the 2019 edition, which presents a unique collection of perspectives on
...
the key challenges in implementing universal health coverage (UHC) in South Africa, as analysed by experts in various fields.
Each of the 20 chapters deals with aspects of the UHC journey, dedicated towards an equitable and inclusive national health system that leaves no-one behind. While some authors describe the fundamental changes and practical considerations required to reconfigure the country's health system, others have reflected on specific programmatic areas and have made recommendations from a National Health Insurance (NHI)/UHC lens.
more
Antimicrobial resistance(AMR) poses a serious threat to human, animal and environmental health. Implementing ethical practice guidelines on how to use antimicrobials effectively and responsibly within the pig industry will contribute in reducing and preventing antimicro
...
bial resistance within the pig industry of South Africa. Members of Pig Vet Society (PVS) SA hereby commit themselvesto put these guidelines into good use in order to preserve the future and effectiveness of antimicrobials. PVS aims to be the leader in prevention of antimicrobial resistance and to encourage the pig industry to work together in achieving this.
more
The era of effective antibiotics is coming to a close. In just a few generations, many “miracle medicines”have been beaten into ineffectiveness by the bacteria they were intended to eradicate. Bacteria quickly adapt to the presence of antibacterial agents in order
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to survive. The misuse of antibiotics,which is an international problem, only exacerbates the steady evolution of resistance. In August 2010, the journal Lancet Infectious Diseases posed the question "Is this the end of antibiotics?" documentingthe rapid spread of multidrug-resistant bacteriaand predicting that 10 years remain in the useful life of many agents.
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7 Stages
Does the patient meet the case definition for a COVID-19 case?
Nation Institute for Communicable Diseases - Division of the National Health Laboratory Service
Department: Health Republic of South Africa
(2020)
C2
Persons with acute respiratory illness with sudden onset of at least one of the following: cough, sore throat, shortness of breath or fever [≥ 38°C (measured) or history of fever (subjective)] irrespective of admission status AND In the 14 days prior to onset of symptoms, met at least one of the
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following epidemiological criteria: Were in close contact1 with a confirmed2 or probable3 case of SARS-CoV-2 infection; OR Had a history of travel to areas with presumed ongoing community transmission of SARS-CoV-2; (Visit WWW.NICD.AC.ZA for an updated case definition). OR Worked in, or attended a health care facility where patients with SARS-CoV-2 infections were being treated. OR Admitted with severe pneumonia of unknown aetiology.
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Request for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing
Nation Institute for Communicable Diseases, South Africa
Department: Health Republic of South Africa
(2020)
C3
Person under investigation (PUI) form for coronavirus disease 2019 (COVID-19): Request for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing
and
COVID-19 Contact line list
COVID-19 Daily Symptom monitoring Tool
Nation Institute for Communicable Diseases, South Africa
Department: Health Republic of South Africa
(2020)
C2
Complete for contact of a confirmed Coronavirus disease 2019 (COVID-19) case
COVID-19 Environmental Health Guidelines
Nation Institute for Communicable Diseases, South Africa
Department: Health Republic of South Africa
(2020)
C2
This document aims to guide Environmental Health Services (EHS) on key roles related to the management of the outbreak.
This guide should be read in conjunction with the guideline for case finding, diagnosis, management and public health response in Sout
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h africa and the standard operating procedures on Novel Corona Virus -19 (COVID-19).
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Coronavirus disease 2019 (COVID-19) Quick Reference for Health Workers Case
Centre for Respiratory Diseases and Meningitis, South Africa
National Institute for Communicable Diseases (NICD)
(2020)
C2
On the 31st December 2019, the World Health Organization (WHO) China country office reported a cluster of pneumonia cases in Wuhan City, Hubei Province of China now known to be caused by a novel virus. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been confirmed as the causative v
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irus of Coronavirus disease 2019 (COVID-19). Cases have now been identified in over 100 countries including South Africa.
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SARS-CoV-2 (COVID-19) Specimen Submission form
Centre for Respiratory Diseases and Meningitis, South Africa
Nation Institute for Communicable Diseases
(2020)
C2
For SARS-CoV-2 testing only
Coronavirus disease 2019 (COVID-19) Frequently Asked Questions
Centre for Respiratory Diesease and Meningitis, South Africa
Department: Health Republic of South Africa
(2020)
C2
1. What is COVID-19?
2. Who is at most risk for COVID-19?
3. What is the risk of COVID-19 infection in humans in South Africa?
4. How is COVID-19 transmitted?
5. What are the signs and sym
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ptoms of COVID-19 infection in humans?
6. How is COVID-19 diagnosed?
7. How is COVID-19 infection treated?
8. How can COVID-19 infection in humans be prevented?
9. What measures have been put in place in South Africa to minimise the risk of transmission should cases be imported?
10. Should I travel now?
11. Who can I contact for more information?
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Infection prevention and control of COVID in ports
Nation Institute for Communicable Diseases, South Africa
Department: Health Republic of South Africa
(2020)
C2
Overview
• How are diseases transmitted from person to person?
• What are the principles of infection prevention and control
• What IPC measures are other countries / organisations recommending for the transport industry/workers?
• How can we apply this knowledge to protect us while w
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e protect our country?
• Administrative controls = screening and awareness, people flow, health promotion
• Environmental controls = ventilation, airflow
• Personal protective equipment = use of masks, gloves, hand hygiene
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Higher Education in a time of Coronavirus
- Technical and Vocational Education and Training (TVET Colleges)
- Universities
- National Development of Learnerships, Employment Skills an Labour Assessment (INDLELA)
- National Skills Fund (NSF)
- Department of Higher Education and Training (DHET)
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staff
Accessed: 02.05.2020
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The Department of Basic Education recognises the need to help parents and guardians get through this lockdown period as effectively as possible. This simple set of guidelines is designed to provide advice and strategies to help parents support their children at this time
Here you can find guidelines, posters, borchures in different local languages published by the Ministry of Health, South Africa
“Wearing masks is important. We want to recommend widespread use of masks. We are recommending that people can use cloth masks, just make sure there’s a three layer kind of thing.”Dr Zweli Mkhize, Minister of Health
available in: Xitsonga, Tshivenda, Siswati, Setswana, Sesotho, Sepedi, isiZul
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u, isiXhosa, isi Ndebele, Afrikaans
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Flowchart for management of children with suspected / confirmed COVID-19 infection.
COVID-19 Response. Let's stop the spread!
recommended
24 May 2021; Guidance for vaccinators on how to store, prepare, draw up and administer COVID-19 vaccines Updated May 2021 · Western Cape Edition
Practical Approach to Care Kit: Vaccine
12 February 2021
24 May 2021
21 May 2021. he Practical Approach to Care Kit – PACK – is used by nurses, doctors and community health workers in their everyday work to care for patients at the clinic and in the community – PACK Adult, PACK Adolescent, PACK Child and PACK Community.
PACK Adult is also known as APC (Adult P
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rimary Care) outside of the Western Cape. Both form part of the the Ideal Clinic initiative: www.idealhealthfacility.org.za
PACK Home is designed for people seeking more information about how to care for their own health and the health of their family at home.
Available in English, Afrikaans and isiXhosa
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21 May 2021. PACK Home: Information and advice for the home
Available in English, Afrikaans and isiXhosa
21 May 2021. Iinkcukacha neengcebiso ezilungiselelwe emakhaya:
Available in English, Afrikaans and isiXhosa
COVID-19 Resources for the Public
recommended
Posters & Infographics on different topics, i.e: vaccination, people with high risk of severe Covid-19, for families, work, school, hand hygiene, care at home, public transport
District Health Management Information System (DHMIS) - Standard Operating Procedures Facility Level
This document provides SOPS to ensure appropriate data and information management at health facilities. These SOPs are an updated version of the 2013 SOPs. These SOPs aim to clarify the responsibilities and procedures for effective management of aggregated routine health service data
This editorial will consider the often heralded and sometimes belittled Surgical Safety Checklist (SSCL) for its general benefits, potential utility, and range of evidence attesting to its value in quality and safety improvement.
The aim of the SATG was to produce a triage scale for use throughout South Africa. The group was multi-disciplinary and comprised doctors, nurses and paramedics. The result of the SATG’s activitie
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s is the South African Triage Scale (SATS), a physiology and symptom based scale which prioritises into one of four colours and can be used in hospital Emergency Centres as well as in the pre-hospital setting. The SATS has been validated in the public, private health care setting as well as pre-hospital.
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The cervix is the lower, narrow end of the uterus (the hollow, pear-shaped organ where a foetus can grow). The cervix leads from the uterus to the vagina (birth canal) below.
Cervical cancer is the 2nd most common cancer among South African women
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, but the cancer women die of most in our country. Women in South Africa have a 1 in 42 lifetime risk of cervical cancer (NCR 2019).
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Updated Treatment Guidelines
Quick reference guide
Side-By-Side: Campaign Toolkit for implementers
Phila, National Department of Health South Africa
National Department of Health South-Africa
(2018)
CC
In 2018, the National Department of Health launched the Side-By-Side campaign for pregnant women and caregivers of children under five years, with the goal of ensuring that all children receive the nurturing care and protection they need to reach their full potential.
This module introduces the “Vaccinator’s Manual”, a guideline for vaccinators. The aim of the manual is to update EPI guidelines to include all the changes since the third edition of the Vaccinators Manual (2008)
The target audience for this training course is non-clinicians such as Home Based Carers, Community Caregivers, Youth Care Workers, Peer educators, Community Health Workers etc. primarily those who will be providing adherence counselling to clients with HIV, TB, Hypertension and Diabetes. This group
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of non-clinicians play a vital role in helping to reduce the workload of nursing staff. Amongst others, non- clinicians educate clients and provide emotional support in a manner that makes each client feel like they are receiving focused, individual attention. Non-clinicians are often in close contact with communities and, therefore, able to understand and play a role in alleviating health service barriers in the community.
Facility managers may also be part of the target audience in order to ensure that they understand the components of the minimum package of interventions to support linkage, adherence and retention in care.
Further, their attendance seeks to ensure that non-clinicians receive necessary assistance and support when they have to implement what they have learned back into their workplaces.
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STANDARD OPERATING PROCEDURES
PARTICIPANT GUIDE
This Participant Guide has been designed to assist health facilities and community based non-clinicians to develop skills to provide linkage to care, adherence and retention in care services for chronic conditions
The Ideal Clinic Realisation and Maintenance (ICRM) programme was initiated by the National Department of Health in July 2013 in order to systematically improve primary health care (PHC) facilities and the quality of care they provide. The Ideal Clinic framework/dashboard sets out the standards for
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PHC facilities to provide good-quality health services. An Ideal Clinic is defined as a clinic with good infrastructure, adequate staff, adequate medicines and supplies, good administrative processes, and sufficient adequate bulk supplies. Applicable clinical policies, protocols and guidelines are adhered to, and it harnesses partner and stakeholder support.
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The Ideal Clinic manual has been developed to assist managers at various levels of healthcare service provision to correctly interpret and understand the requirement for achieving the elements as depicted in the Ideal Clinic framework/dashboard. It can therefore be regarded as a reference document w
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hich guides the managers to determine the status of Ideal Clinic framework/dashboard elements in a facility.
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Integrated Management of Childhood Illness (IMCI) is an integrated approach to child health that focuses on the holistic well-being of the child. IMCI aims to reduce death, illness and disability, and to promote improved growth and development among children under five years of age. IMCI includes bo
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th preventive and curative elements that are implemented by families and communities as well as by health facilities.
This booklet contains useful information on childhood sickness and offers practical guidance on diagnosis and treatment of said illnesses. it is divided into 2 parts, one for infants (new born until 2 months) and from 2 months to 5 years. It also includes:
Antiretroviral Therapy ART) treatment for children
Skin problems
Counselling the mother or caregiver on infant and you child feeding
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A implementation Matrix approved by the Cabinet of the Government of South Africa
Updated Guidelines
Antimicrobial resistance (AMR) is a multifaceted, international public health problem, which poses a direct threat to the safety of the population of South Africa. A national response is required to
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complement the development of a global plan, as articulated in the WHO’s draft resolution EB134/37 “Combating antimicrobial resistance including antibiotic resistance”, adopted by theWorld Health Assembly in May 2014. The overuse of antimicrobials is driving resistance. A return to appropriate, targeted antimicrobial use in humans, animals and the environment is critical if we are to conserve the antimicrobial armamentarium. Various interventions have been put in place to address antimicrobial resistance in South Africa. However, these are insufficient to effectively tackle the threat faced by the country. The strengths of the current system are outweighed by its weaknesses.
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The strategic framework gives guidance to public and private health facilities and health workers on compliance with standards relating to IPC practices. To further assist health facilities to implement the IPC strategic framework, this practical implementation manual has been developed in parallel
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to accompany the document.
These implementation strategies should be read in conjunction with the National Infection Prevention and Control (IPC) Strategic Framework (2020) to support an IPC programme at health facility level towards reducing healthcare-associated infections (HAI) and antimicrobial resistance (AMR). This manual is aligned with the World Health Organization (WHO) Core Component IPC programme recommendations and highlights the essentials for developing and improving IPC at health facility level in a systematic, stepwise manner for South Africa. It supports the Framework for the Prevention and Containment of AMR in South African Hospitals (2018).
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Reviewed Essential Medicines List July 2021
Side-By-Side Videos for caregivers
Phila, National Department of Health South Africa
National Department of Health South-Africa
(2022)
CC
Video is a very effective way to communicate complex concepts – like the inter-relational models Side-by-Side rests on – quickly and effectively. Side-by-Side has a small but growing collection of videos. Download and share these videos with caregivers using your social media channels, WhatsApp,
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or show them to caregivers on a screen during in-person interactions. These videos should always be shown with sound on.
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The Department of Health (DOH) has developed a National Integrated Sexual and Reproductive Health and Rights (SRHR) Policy.1 This policy addresses the many cross-cutting issues relating to SRH service provision, drawing together the principles, rights, and guidance for planning and implementation th
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at underpin the provision of quality, comprehensive, and integrated SRHR services in South Africa. The National Integrated SRHR Policy is supported by several clinical and service delivery guidelines covering related programmatic
areas, including the National Contraception Clinical Guidelines.
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The Protection of Personal Information (POPI) Act
Confidentiality: providing and protecting information
• Health care practitioners hold information about patients that is private and sensitive.
• The National Health Act (Act No. 61 of 2003) provides that this information must not be given to
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others, unless the patient consents or the health care practitioner can justify the disclosure.
• Practitioners are responsible for ensuring that clerks, receptionists and other staff respect confidentiality in their performance of their duties.
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Viral hepatitis is defined as inflammation of the liver cells due to viral infection. The burden of liver disease in South Africa is mostly underestimated as viral hepatitis, in particular chronic i
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nfection, is a silent and neglected cause of morbidity and mortality. However, the burden of disease is likely substantial given the prevalence of chronic viral hepatitis. This burden is further compounded by the lack of screening and access to care and treatment as well as inadequate disease surveillance, human and financial resources.
The National Guidelines for the Management of Viral Hepatitis were developed, with the purpose to:
inform healthcare workers in the public and private sectors about the disease, its epidemiology in South Africa and current methods of diagnosis and therapy
strengthen the healthcare response to viral hepatitis
empower communicable diseases workers and stakeholders to make informed decisions regarding appropriate and cost effective interventions
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National Guidelines for the Treatment of Malaria - 2019
South African Malaria Elimination Committee (SAMC)
National Department of Health South Africa
(2019)
CC
These guidelines are based on the 3rd Edition of the WHO Guidelines (Published 2015) World Health Organization’s Guidelines for the treatment of malaria. Additional literature surveys have been undertaken. Factors that were considered in the choice of therapeutic options included effectiveness, sa
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fety, and impact on malaria transmission and on the emergence and spread of antimalarial drug resistance. On-going surveillance is critical given the spread of artemisinin resistance in Southeast Asia, although not yet confirmed anywhere in Africa. The guidelines on the treatment of malaria in South Africa aim to facilitate effective, appropriate and timeous treatment of malaria, thereby reducing the burden of this disease in our communities. This is essential to further reduce the malaria case fatality rates currently recorded in South Africa, to decrease malaria transmission and to limit resistance to antimalarial drugs.
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The South African (SA) guidelines for cardiac patients for non-cardiac surgery were developed to address the need for cardiac risk assessment and risk stratification for elective non-cardiac surgical patients in SA, and more broadly in
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Africa.
The guidelines were developed by updating the Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment
and Management for Patients Who Undergo Non-cardiac Surgery, with a search of literature from African countries and recent publications. The updated proposed guidelines were then evaluated in a Delphi consensus process by SA anaesthesia and vascular surgical experts.
The recommendations in these guidelines are:
1. We suggest that elective non-cardiac surgical patients who are 45 years and older with either a history of coronary artery disease, congestive cardiac failure, stroke or transient ischaemic attack, or vascular surgical patients 18 years or older with peripheral vascular disease require further preoperative risk stratification as their predicted 30-day major adverse cardiac event (MACE) risk exceeds 5%
(conditional recommendation: moderate-quality evidence).
2. We do not recommend routine non-invasive testing for cardiovascular risk stratification prior to elective non-cardiac surgery in adults (strong recommendation: low-to-moderate-quality evidence).
3. We recommend that elective non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease should have preoperative natriuretic peptide (NP) screening (strong recommendation: high-quality evidence).
4. We recommend daily postoperative troponin measurements for 48 - 72 hours for non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease, i.e. (i) a baseline risk >5% for MACE 30 days after elective surgery (if no preoperative NP screening), or (ii) an elevated B-type natriuretic peptide (BNP)/N-terminal-prohormone B-type natriuretic peptide (NT-proBNP) measurement before elective surgery (defined as BNP >99 pg/mL or a NT-proBNP >300 pg/mL) (conditional recommendation: moderate-quality evidence).
Additional recommendations are given for the management of myocardial injury after non-cardiac surgery (MINS) and medications for comorbidities.
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Health Care Resource Utilization in Adults Living With Type 1 Diabetes Mellitus in the South African Public Health Sector: Protocol for a 1-Year Retrospective Analysis With a 5-, 10-, and 25-Year Pro
Bhana, S.; Naidoo, P.; Pillay, S.; et al.
Jornal of Medical Internet Research JMIR Publication Published on 13.2.2023 in Vol 12 (2023)
(2023)
CC
Type 1 diabetes mellitus (T1DM) is less common than type 2 diabetes mellitus but is increasing in frequency in South Africa. It tends to affect younger individuals, and upon diagnosis, exogenous ins
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ulin is essential for survival. In South Africa, the health care system is divided into private and public health care systems. The private system is well resourced, whereas the public sector, which treats more than 80% of the population, has minimal resources. There are currently no studies in South Africa, and Africa at large, that have evaluated the immediate and long-term costs of managing people living with T1DM in the public sector.
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High blood pressure, or hypertension, is one of the most serious risks factors for death from heart diseases and strokes, responsible for 13% of all deaths globally. In South Africa more than 1 in 3
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adults live with high blood pressure and it is responsible for 1 in every 2 strokes and 2 in every 5 heart attacks. High blood pressure is known as a 'silent killer' because there are rarely any symptoms or visible signs to warn that blood pressure is high. That is why more than 50% of people with high blood pressure are unaware of their condition. In some cases, typically with very high blood pressure, symptoms such as headaches, visual disturbances, nose bleeds, nausea, vomiting, facial flushing and sleepiness may be experienced. Do not wait for symptoms to appear. High blood pressure becomes more likely with older age, but anyone, no matter their age, gender, fitness level or lifestyle can develop high blood pressure. Blood pressure should be measured at least once every year, so don’t delay!
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Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society – 2021 update
Lalloo, U.G.; Kalla, I.S.; Abdool-Gaffar, S. et al.
African Journal of Thoracic and Critical Care Medicine
(2021)
CC
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
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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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Long Acting Muscarinic Antagonists (LAMA) such as tiotropium and glycopyrronium are used in the management of COPD1. They have been shown to improve lung function, quality of life and exercise tolerance. They have also been associated with reduced COPD-related exacerbations, associated hospitalisati
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ons and duration of hospital stay. Both the South African Thoracic Society (SATS) and Global Initiative for Chronic Obstructive Lung Disease (GOLD), guidelines recommend the use of long acting anticholinergic drugs (or long acting beta agonists) in moderate to very severe disease as defined by lung function (FEV1). The most up to date guideline, utilizing the GRADE methodology (European Respiratory Society guidelines of 2017), confirms their superiority over long acting β agonists (LABA) as monotherapy for COPD in that LAMA's have demonstrated greater efficacy in terms of exacerbation reduction, with similar safety profile.2 These recommnedations are supported by published peer-reviewed
evidence including individual papers and Cochrane reviews.
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Diabetes is a major public health problem. The rising incidence of Diabetes Type 2 is related to the effects of urbanization and unhealthy lifestyles. Research studies show that healthy eating and regular physical activity can prevent or delay the onset of Diabetes Type 2, even in high-risk individu
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als.
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