scholarly journals COVID-19: A comparative study of severity of patients hospitalized during the first and the second wave in South Africa.

2021 ◽  
Author(s):  
Caroline I Maslo ◽  
Angeliki Messina ◽  
Anchen Laubscher ◽  
Mande Toubkin ◽  
Liza Sitharam ◽  
...  
Keyword(s):  
South Africa ◽  
Length Of Hospital Stay ◽  
Severe Illness ◽  
Eastern Cape ◽  
Icu Mortality ◽  
Mechanically Ventilated ◽  
Hospitalised Patients ◽  
Second Wave ◽  
D Dimer ◽  
Overall Mortality

Abstract Background South Africa has experienced two waves of COVID-19 infections, the second of which was inter alia attributed to the emergence of a novel SARS-CoV2 variant, 501Y.V2. This variant possibly has increased virulence and may be associated with increased mortality. The objective of this study was to determine if patients admitted in the second wave had more severe illness and higher mortality than those admitted in the first. Methods We analysed and compared the characteristics, biological severity markers, treatments, level of care and outcomes of patients hospitalised in a private hospital in the Eastern Cape Province, South Africa. Results Compared to the first wave, patients admitted in the second were older and less likely to have co-morbidities. In contrast, the D-dimer and interleukin-6 (IL-6) levels were significantly higher. Despite this, significantly less patients were admitted to ICU and/or were mechanically ventilated. The total length of hospital stay was identical in both groups. Whereas the overall mortality was not significantly higher during the second wave, the ICU mortality was. Those that died in the second wave were older than those in the first wave. Multivariable logistic regression showed that being admitted during the second wave was an independent risk factor for mortality. Conclusion This study appears to confirm previous reports that the 501Y.V2 variant is possibly more virulent as indicated by the higher levels of D-dimer and IL-6, the slight increase in mortality of hospitalised patients and the higher ICU mortality in the second wave.

scholarly journals Prospective cohort study of mortality in very low birthweight infants in a single centre in the Eastern Cape province, South Africa

2021 ◽  
Vol 5 (1) ◽  
pp. e000918
Author(s):  
Isabel A Michaelis ◽  
Ingeborg Krägeloh-Mann ◽  
Ncomeka Manyisane ◽  
Mikateko C Mazinu ◽  
Esme R Jordaan
Keyword(s):  
South Africa ◽  
Cohort Study ◽  
Birth Weight ◽  
Mortality Rate ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Low Birthweight ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Overall Mortality

BackgroundNeonatal mortality is a major contributor worldwide to the number of deaths in children under 5 years of age. The primary objective of this study was to assess the overall mortality rate of babies with a birth weight equal or below 1500 g in a neonatal unit at a tertiary hospital in the Eastern Cape Province, South Africa. Furthermore, different maternal-related and infant-related factors for higher mortality were analysed.MethodsThis is a prospective cohort study which included infants admitted to the neonatal wards of the hospital within their first 24 hours of life and with a birth weight equal to or below 1500 g. Mothers who consented answered a questionnaire to identify factors for mortality.Results173 very low birth weight (VLBW) infants were recruited in the neonatal department between November 2017 and December 2018, of whom 55 died (overall mortality rate 32.0%). Twenty-three of the 44 infants (53,5%) with a birth weight below 1000 g died during the admission. One hundred and sixty-one mothers completed the questionnaire and 45 of their babies died.Main factors associated with mortality were lower gestational age and lower birth weight. Need for ventilator support and sepsis were associated with higher mortality, as were maternal factors such as HIV infection and age below 20 years.ConclusionThis prospective study looked at survival of VLBW babies in an underprivileged part of the Eastern Cape of South Africa. Compared with other public urban hospitals in the country, the survival rate remains unacceptably low. Further research is required to find the associated causes and appropriate ways to address these.

Laparotomy for Abdominal Stab Wound With Combined Omental and Organ Evisceration: 10-Year Experience From a Major Trauma Centre in South Africa

2021 ◽  
pp. 000313482110318
Author(s):  
Victor Kong ◽  
Cynthia Cheung ◽  
Nigel Rajaretnam ◽  
Rohit Sarvepalli ◽  
William Xu ◽  
...  
Keyword(s):  
South Africa ◽  
Small Bowel ◽  
Large Bowel ◽  
Major Trauma ◽  
Stab Wound ◽  
Length Of Hospital Stay ◽  
Trauma Centre ◽  
Major Trauma Centre ◽  
The Mean ◽  
Overall Mortality

Introduction Combined omental and organ evisceration following anterior abdominal stab wound (SW) is uncommon and there is a paucity of literature describing the management and spectrum of injuries encountered at laparotomy. Methods A retrospective study was undertaken on all patients who presented with anterior abdominal SW involving combined omental and organ evisceration who underwent laparotomy over a 10-year period from January 2008 to January 2018 at a major trauma centre in South Africa. Results A total of 61 patients were eligible for inclusion and all underwent laparotomy: 87% male, mean age: 29 years. Ninety-two percent (56/61) had a positive laparotomy whilst 8% (5/61) underwent a negative procedure. Of the 56 positive laparotomies, 91% (51/56) were considered therapeutic and 9% (5/56) were non-therapeutic. In addition to omental evisceration, 59% (36/61) had eviscerated small bowel, 28% (17/61) had eviscerated colon and 13% (8/61) had eviscerated stomach. A total of 92 organ injuries were identified. The most commonly injured organs were small bowel, large bowel and stomach. The overall complication rate was 11%. Twelve percent (7/61) required intensive care unit admission. The mean length of hospital stay was 9 days. The overall mortality rate for all 61 patients was 2%. Conclusions The presence of combined omental and organ evisceration following abdominal SW mandates laparotomy. The small bowel, large bowel and stomach were the most commonly injured organs in this setting.

scholarly journals Clinical outcomes of hospitalised COVID-19 patients at Mthatha Regional Hospital, Eastern Cape, South Africa: A retrospective study

2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Ramprakash Kaswa ◽  
Parimalaranie Yogeswaran ◽  
Busisiwe Cawe
Keyword(s):  
South Africa ◽  
Clinical Outcomes ◽  
Cross Sectional Study ◽  
Regional Hospital ◽  
Sudden Expansion ◽  
Eastern Cape ◽  
Cross Sectional ◽  
Health Crisis ◽  
Hospitalised Patients ◽  
The Mean

Background: Coronavirus disease 2019 (COVID-19) is a public health crisis that threatens the current health system. The sudden expansion in the need for inpatient and intensive care facilities raised concerns about optimal clinical management and resource allocation. Despite the pressing need for evidence to make context-specific decisions on COVID-19 management, evidence from South Africa remained limited. This study aimed to describe the clinical characteristics and outcomes of COVID-19 hospitalised patients.Methods: A retrospective cross-sectional study design was used to evaluate the clinical outcomes of hospitalised adult patients (≥ 18 years old) with laboratory-confirmed COVID-19 illness at Mthatha Regional Hospital (MRH), Eastern Cape.Results: Of the 1814 patients tested for COVID-19 between 20 March 2020 and 31 July 2020 at MRH, two-thirds (65.4%) were female. About two-thirds (242) of the 392 patients (21.6%) who tested positive for this disease were hospitalised and one-third (150) were quarantined at home. The mean age of the patients tested for COVID-19 was 42.6 years and there was no difference between males and females. The mean age of hospitalised patients was 55.5 years and the mean age of hospitalised patients who died (61.3 years) was much higher than recovered (49.5 years). Overall, 188 (77.6%) hospitalised patients had clinical comorbidity on admission. Diabetes (36.8%) and hypertension (33.1%) were the most common comorbidities amongst COVID-19 hospitalised patients.Conclusion: The majority of the patients who were hospitalised for COVID-19 were elderly and had high baseline comorbidities. Advance age and underlying comorbidities (diabetes, hypertension and HIV) were associated with high mortality in hospitalised COVID-19 patients.

scholarly journals CARDIOVASCULAR INVOLVEMENT AND MORTALITY WITH NEW COVID-19 VARIANTS

2021 ◽  
Vol 54 (3) ◽  
pp. 244-248
Author(s):  
Muharrem Said Cosgun
Keyword(s):  
Critical Illness ◽  
Myocardial Injury ◽  
Situational Awareness ◽  
Length Of Hospital Stay ◽  
Myocardial Damage ◽  
Epidemiological Data ◽  
Severe Illness ◽  
Cardiovascular Involvement ◽  
Polymerase Chain ◽  
Second Wave

Objectives: The presence of cardiac involvement is accepted as an indicator of morbidity and mortality in Coronavirus disease 2019 (COVID-19) patients. Therefore, this study investigates data on cardiovascular involvement and clinical outcomes between the first wave with wild virus and mutation-dominant second wave of the COVID-19 outbreak. Methodology: This was a single centre, retrospective study using and the data was collected from confirmed COVID-19 patients. Patients’ demographic and clinical characteristics, cardiovascular involvement, and the factors associated with mortality were analysed. All these data were compared between first (wild virus) and second-wave (mutant viruses) patients. Results: The study included 476 positive inpatients confirmed by a real-time polymerase chain reaction. Although the length of hospital stay was similar, the duration of intensive care units (ICUs) was longer in the second wave (6.3 ± 3.2 vs. 7.5 ± 3.5; p=0.020). The rate of severe illness (12.9 vs. 20.3%; p=0.037) and critical illness referral to ICUs (4.3 vs. 9.7%; p=0.031) was higher in the second wave than in the first. In addition, the incidence of myocardial damage was significantly higher in the second wave (4.3 vs. 10.7%; p=0.046). Conclusion: In the present study, myocardial injury, development of critical illness, and referral to the ICUs increased in correlation with the disease severity in the second wave compared to the first. Variant viruses and possibly the burden of the crowd on healthcare contribute to this situation. Therefore, epidemiological data are required to guide situational awareness as long as the pandemic remains.

Indications and practice of enteral nutrition

2014 ◽  
Vol 155 (51) ◽  
pp. 2028-2033 ◽  
Author(s):  
Judit Hallay ◽  
Dániel Nagy ◽  
Béla Fülesdi
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Enteral Nutrition ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Nutrition Therapy ◽  
Present Review ◽  
Hospitalised Patients ◽  
Impact On Treatment ◽  
Efficacy Of Treatment

Malnutrition in hospitalised patients has a significant and disadvantageous impact on treatment outcome. If possible, enteral nutrition with an energy/protein-balanced nutrient should be preferred depending on the patient’s condition, type of illness and risk factors. The aim of the nutrition therapy is to increase the efficacy of treatment and shorten the length of hospital stay in order to ensure rapid rehabilitation. In the present review the authors summarize the most important clinical and practical aspects of enteral nutrition therapy. Orv. Hetil., 2014, 155(51), 2028–2033.

Influence of Knowledge Management Practices on Public Service Delivery by Municipalities

Mousaion ◽  
2019 ◽  
Vol 37 (3) ◽  
Author(s):  
Charleen Musonza ◽  
Ndakasharwa Muchaonyerwa
Keyword(s):  
South Africa ◽  
Knowledge Management ◽  
Service Delivery ◽  
Public Service ◽  
Qualitative Data ◽  
Management Practices ◽  
Integrated System ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Public Service Delivery

This study examines the influence of knowledge management (KM) practices on public service delivery by municipalities in the Eastern Cape province of South Africa. The study sought to determine the factors that have triggered the implementation of KM practices; the effectiveness of KM practices towards public service delivery; and the extent to which KM practices have influenced public service delivery by municipalities in the Eastern Cape province of South Africa. Both quantitative and qualitative methods were employed in this study. Quantitative data were collected through a survey questionnaire administered to a sample of 202 employees at the Raymond Mhlaba Municipality in the Eastern Cape. Qualitative data were collected through observations and interviews of 2 senior managers. The data collected gave a response rate of 72 per cent. The quantitative and qualitative data were analysed descriptively and presented verbatim respectively. The results indicated that the internal and external factors included in this study have contributed to the implementation of KM practices in the municipality. Furthermore, the effective use of KM practices has increased the organisational KM initiative, as well as the provision of services such as electricity, education, transport, and social services by the municipality. The study recommends the establishment of KM awareness and the establishment of an integrated system that will assist in effective knowledge sharing, retention and acquisition across municipalities in the Eastern Cape.

Exploring the South African Government Communication on Land Expropriation without Compensation

2020 ◽  
Vol 72 (1-3) ◽  
Author(s):  
Lungisani Moyo
Keyword(s):  
South Africa ◽  
Food Security ◽  
South African ◽  
Small Scale ◽  
South African Government ◽  
Eastern Cape ◽  
The South ◽  
Land Expropriation ◽  
African Government ◽  
Government Communication

ABSTRACT This paper used qualitative methodology to explore the South African government communication and land expropriation without compensation and its effects on food security using Alice town located in the Eastern Cape Province South Africa as its case study. This was done to allow the participants to give their perceptions on the role of government communication on land expropriation without compensation and its effects on South African food security. In this paper, a total population of 30 comprising of 26 small scale farmers in rural Alice and 4 employees from the Department of Agriculture (Alice), Eastern Cape, South Africa were interviewed to get their perception and views on government communications and land expropriation without compensation and its effects on South African food security. The findings of this paper revealed that the agricultural sector plays a vital role in the South African economy hence there is a great need to speed up transformation in the sector.

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