scholarly journals Clinical Experience With Severe Acute Respiratory Syndrome Coronavirus 2–Related Illness in Children: Hospital Experience in Cape Town, South Africa

2020 ◽  
Author(s):  
Marieke M van der Zalm ◽  
Juanita Lishman ◽  
Lilly M Verhagen ◽  
Andrew Redfern ◽  
Liezl Smit ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
South African ◽  
Clinical Data ◽  
Cape Town ◽  
Respiratory Support ◽  
Hospitalized Children ◽  
Middle Income ◽  
Middle Income Countries ◽  
Hiv Exposed ◽  
New Diagnosis

Abstract Background Children seem relatively protected from serious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)–related disease, but little is known about children living in settings with high tuberculosis and human immunodeficiency virus (HIV) burden. This study reflects clinical data on South African children with SARS-CoV-2. Methods We collected clinical data of children aged <13 years with laboratory-confirmed SARS-CoV-2 presenting to Tygerberg Hospital, Cape Town, between 17 April and 24 July 2020. Results One hundred fifty-nine children (median age, 48.0 months [interquartile range {IQR}, 12.0–106.0 months]) were included. Hospitalized children (n = 62), with a median age of 13.5 months (IQR, 1.8–43.5 months) were younger than children not admitted (n = 97; median age, 81.0 months [IQR, 34.5–120.5 months]; P < .01.). Thirty-three of 159 (20.8%) children had preexisting medical conditions. Fifty-one of 62 (82.3%) hospitalized children were symptomatic; lower respiratory tract infection was diagnosed in 21 of 51 (41.2%) children, and in 11 of 16 (68.8%) children <3 months of age. Respiratory support was required in 25 of 51 (49.0%) children; 13 of these (52.0%) were <3 months of age. One child was HIV infected and 11 of 51 (21.2%) were HIV exposed but uninfected, and 7 of 51 (13.7%) children had a recent or new diagnosis of tuberculosis. Conclusions Children <1 year of age hospitalized with SARS-CoV-2 in Cape Town frequently required respiratory support. Access to oxygen may be limited in some low- and middle-income countries, which could potentially drive morbidity and mortality. HIV infection was uncommon but a relationship between HIV exposure, tuberculosis, and SARS-CoV-2 should be explored.

scholarly journals The importance of context in early autism intervention: A qualitative South African study

Autism ◽  
2017 ◽  
Vol 22 (8) ◽  
pp. 1005-1017 ◽  
Author(s):  
Jessy Guler ◽  
Petrus J de Vries ◽  
Noleen Seris ◽  
Nokuthula Shabalala ◽  
Lauren Franz
Keyword(s):  
Autism Spectrum Disorder ◽  
South African ◽  
Health Workers ◽  
Contextual Factors ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Middle Income ◽  
Middle Income Countries ◽  
Treatment Type ◽  
Low And Middle Income

The majority of individuals with autism spectrum disorder live in low- and middle-income countries and receive little or no services from health or social care systems. The development and validation of autism spectrum disorder interventions has almost exclusively occurred in high-income countries, leaving many unanswered questions regarding what contextual factors would need to be considered to ensure the effectiveness of interventions in low- and middle-income countries. This study qualitatively explored contextual factors relevant to the adaptation of a caregiver-mediated early autism spectrum disorder intervention in a low-resource South African setting. We conducted four focus groups and four in-depth interviews with 28 caregivers of young children with autism spectrum disorder and used thematic analysis to identify key themes. Eight contextual factors including culture, language, location of treatment, cost of treatment, type of service provider, support, parenting practices, and stigma emerged as important. Caregivers reported a preference for an affordable, in-home, individualized early autism spectrum disorder intervention, where they have an active voice in shaping treatment goals. Distrust of community-based health workers and challenges associated with autism spectrum disorder-related stigma were identified. Recommendations that integrate caregiver preferences with the development of a low-cost and scalable caregiver-mediated early autism spectrum disorder intervention are included.

The Oxford Handbook of the South African Economy

2021 ◽  
Keyword(s):  
South Africa ◽  
South African ◽  
Economic History ◽  
Economic Policies ◽  
The South ◽  
Economic Sectors ◽  
Middle Income ◽  
Strategic Issues ◽  
Middle Income Countries ◽  
Depth Analysis

While South Africa shares some characteristics with other middle-income countries, it has a unique economic history with distinctive characteristics. South Africa is an economic powerhouse with a significant role not only at the southern African regional and continental levels, but also as a member of BRICS. However, the country faces profound developmental challenges, including the ‘triple challenges’ of poverty, inequality and unemployment. There has been a lack of structural transformation and weak economic growth. Ongoing debates around economic policies to address these challenges need to be based on rigorous and robust empirical evidence and in-depth analysis of South African economic issues. This necessitates wide-ranging research, such as that brought together in this handbook. This volume intends to provide original, comprehensive, detailed, state-of-the-art analytical perspectives, that contribute to knowledge while also contributing to well-informed and productive discourse on the South African economy. While concentrating on the more recent economic challenges facing the country, the handbook also provides historical and political context, an in-depth examination of strategic issues in the various critical economic sectors, and assembles diverse analytical perspectives and arguments that have implications for policymaking.

Academic and Scientific Authorship Practices: A Survey Among South African Researchers

2018 ◽  
Vol 13 (4) ◽  
pp. 412-420 ◽  
Author(s):  
Elsie Breet ◽  
Jan Botha ◽  
Lyn Horn ◽  
Leslie Swartz
Keyword(s):  
South African ◽  
Empirical Studies ◽  
High Income ◽  
Middle Income ◽  
Perceived Ability ◽  
Middle Income Countries ◽  
Scientific Authorship ◽  
Level Of Agreement ◽  
Low And Middle Income

Empirical studies of authorship practices in high-income countries have been conducted, while research on this issue is scarce in low- and middle-income countries. A survey was conducted among South African researchers who have published in peer-reviewed journals, to explore their understanding of and ability to apply academic authorship criteria. A total of 967 researchers participated in the survey; 88% of respondents had knowledge of academic authorship criteria, while only 52% found it easy to apply the criteria. More respondents experienced disagreement regarding who qualifies for coauthorship compared with authorship order (59% vs. 48%). Disagreement was mostly linked to different ways of valuing or measuring contributions. Level of agreement with academic authorship criteria was higher than the perceived ability to apply the criteria.

scholarly journals ‘I Waited for It until Forever’: Community Barriers to Accessing Intellectual Disability Services for Children and Their Families in Cape Town, South Africa

2020 ◽  
Vol 17 (22) ◽  
pp. 8504
Author(s):  
Siyabulela Mkabile ◽  
Leslie Swartz
Keyword(s):  
South Africa ◽  
Intellectual Disability ◽  
Cape Town ◽  
Disability Services ◽  
Structured Interviews ◽  
Middle Income ◽  
Middle Income Countries ◽  
Qualitative Research Design ◽  
Interview Guide ◽  
Children With Intellectual Disability

Background: Intellectual disability is more common in low- and middle-income countries than in high-income countries. Stigma and discrimination have contributed to barriers to people with intellectual disability accessing healthcare. As part of a larger study on caregiving of children with intellectual disability in urban Cape Town, South Africa, we interviewed a sub-group of families who had never used the intellectual disability services available to them, or who had stopped using them. Methods: We employed a qualitative research design and conducted semi-structured interviews to explore the views and perspectives of parents and caregivers of children with intellectual disability who are not using specialised hospital services. We developed an interview guide to help explore caregivers’ and parents’ views. Results: Results revealed that caregivers and parents of children with intellectual disability did not use the intellectual disability service due to financial difficulties, fragile care networks and opportunity costs, community stigma and lack of safety, lack of faith in services and powerlessness at effecting changes and self-stigmatisation. Conclusion: Current findings highlight a need for increased intervention at community level and collaboration with community-based projects to facilitate access to services, and engagement with broader issues of social exclusion.

scholarly journals The Participation of Children with Intellectual Disabilities: Including the Voices of Children and Their Caregivers in India and South Africa

2020 ◽  
Vol 17 (18) ◽  
pp. 6706
Author(s):  
Shakila Dada ◽  
Kirsty Bastable ◽  
Liezl Schlebusch ◽  
Santoshi Halder
Keyword(s):  
South Africa ◽  
Intellectual Disabilities ◽  
South African ◽  
Middle Income ◽  
African Languages ◽  
Middle Income Countries ◽  
Child Reports ◽  
Children’S Participation ◽  
Child Assessments ◽  
Children's Participation

There is a shortage of research on the participation of children with intellectual disabilities from middle-income countries. Also, most child assessments measure either the child’s or the caregiver’s perceptions of participation. Participation, however, is an amalgamation of both perspectives, as caregivers play a significant role in both accessing and facilitating opportunities for children’s participation. This paper reports on both perceptions—those of children with intellectual disabilities and those of their caregiver, in India and South Africa. A quantitative group comparison was conducted using the Children’s Assessment of Participation and Enjoyment (CAPE) that was translated into Bengali and four South African languages. One hundred child–caregiver dyads from India and 123 pairs from South Africa participated in the study. The results revealed interesting similarities and differences in participation patterns, both between countries and between children and their caregivers. Differences between countries were mostly related to the intensity of participation, with whom, and where participation occurred. Caregiver and child reports differed significantly regarding participation and the enjoyment of activities. This study emphasises the need for consideration of cultural differences when examining participation and suggests that a combined caregiver-and-child-reported approach may provide the broadest perspective on children’s participation.

scholarly journals Feasibility of Pediatric Non-Invasive Respiratory Support in Low- and Middle-Income Countries

2021 ◽  
Vol 58 (11) ◽  
pp. 1077-1084
Author(s):  
Krishna Mohan Gulla ◽  
Sushil Kumar Kabra ◽  
Rakesh Lodha
Keyword(s):  
Respiratory Support ◽  
Middle Income ◽  
Middle Income Countries ◽  
Non Invasive ◽  
Low And Middle Income

scholarly journals Breastfeeding skills of full-term newborns and associated factors in a low-and-middle-income setting

2019 ◽  
Vol 19 (3) ◽  
pp. 2670-2678
Author(s):  
Esedra E Krüger ◽  
Alta AM Kritzinger ◽  
Lidia L Pottas
Keyword(s):  
South African ◽  
Early Identification ◽  
Newborn Infants ◽  
Full Term ◽  
Term Infants ◽  
Middle Income ◽  
Term Newborn ◽  
Significant Difference ◽  
Term Newborns ◽  
Hiv Exposed

Background: Normative information on the breastfeeding of term newborns may guide clinicians in early identification of breastfeeding difficulties and oro-pharyngeal dysphagia (OPD), and may support optimal breastfeeding practices. Objective: To describe breastfeeding skills of term newborn infants in a South African hospital, a lower-middle-income setting, and investigate associations between infants’ feeding and other factors.Method: One breastfeeding session of each of the 71 healthy newborn full-term infants (mean chronological age=1.9 days; mean gestation=39.1 weeks) was evaluated using the Preterm Infant Breastfeeding Behavior Scale (PIBBS), suitable for use with term newborns.Results: All participants were exclusively breastfed. Thirteen participants (18%) were HIV-exposed. There was no significant difference in the findings of the PIBBS between HIV-exposed and unexposed participants. Most newborns had obvious rooting, latched deeply onto the nipple and some of the areola, had repeated long sucking bursts (mean length=16.82 sucks/burst), and swallowed repeatedly. Most participants were in either the drowsy or quiet-alert state, which are optimal behavioural states for breastfeeding. One to two-hourly on-demand feeds was significantly associated with mothers who had normal births and did not use galactogogues to promote lactation.Conclusion: Results may be used for early identification of OPD in newborns. The findings may be useful to primary care clinicians.Keywords: Full-term, newborn, breastfeeding, feeding skills, feeding characteristics, normative data.

scholarly journals The Economic Cost of Smoking in South Africa, 2016

2020 ◽  
Author(s):  
Micheal Kofi Boachie ◽  
Laura Rossouw ◽  
Hana Ross
Keyword(s):  
South Africa ◽  
Tobacco Control ◽  
South African ◽  
Healthcare Costs ◽  
Economic Cost ◽  
Economic Costs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Productivity Losses ◽  
Premature Deaths

Abstract Introduction Chronic, noncommunicable diseases are on the rise globally, with tobacco consumption being an important contributing risk factor. These increases result in significant economic costs due to increased healthcare costs, productive lives lost, and productive days lost due to illness. Estimates of these economic costs are scarce in low- and middle-income countries. Methods Drawing on a diverse range of data sources, direct healthcare costs, and productivity losses due to illness and premature deaths were estimated using the cost-of-illness approach. The present value of lifetime earnings was used to estimate productivity losses from premature deaths. Results We estimate that 25 708 deaths among persons aged 35–74 in 2016 are smoking-attributable. The economic cost of smoking was R42 billion (US$2.88 billion), of which R14.48 billion was for healthcare costs (hospitalization and outpatient department visits). The economic cost of smoking amounted to 0.97% of the South African GDP in 2016, while the healthcare cost of smoking-related diseases was 4.1% of total South African health expenditure. The costs are lower for women because of their lower smoking prevalence. Conclusion The economic burden of smoking calls for a further scaling-up of tobacco-control interventions in South Africa. Implications This article addresses the paucity of research on the detailed economic costs of smoking in low-and middle-income countries, including South Africa. Our calculations, based on an extensive range of recent data, provide the most detailed estimate to date and include quantification of the direct and indirect costs of smoking in South Africa. We found that the magnitude of the costs related to smoking in South Africa is larger than in the previous estimates and that for every Rand received in the form of cigarette tax, society loses 3.43 Rands. This article provides an economic case for evidence-based tobacco control in South Africa.

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