scholarly journals Out-of-hospital cardiac arrests in the city of Cape Town, South Africa: a retrospective, descriptive analysis of prehospital patient records

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049141
Author(s):  
Willem Stassen ◽  
Craig Wylie ◽  
Therese Djärv ◽  
Lee A Wallis
Keyword(s):  
South Africa ◽  
Response Times ◽  
Descriptive Analysis ◽  
Cape Town ◽  
Epidemiological Data ◽  
Spontaneous Circulation ◽  
Western Cape ◽  
Term Outcome ◽  
Public And Private ◽  
Middle Income

ObjectivesWhile prospective epidemiological data for out-of-hospital cardiac arrest (OHCA) exists in many high-income settings, there is a dearth of such data for the African continent. The aim of this study was to describe OHCA in the Cape Town metropole, South Africa.DesignObservational study with a retrospective descriptive design.SettingCape Town metropole, Western Cape province, South Africa.ParticipantsAll patients with OHCA for the period 1 January 2018–31 December 2018 were extracted from public and private emergency medical services (EMS) and described.Outcome measuresDescription of patients with OHCA in terms of demographics, treatment and short-term outcome.ResultsA total of 929 patients with OHCA received an EMS response in the Cape Town metropole, corresponding to an annual prevalence of 23.2 per 100 000 persons. Most patients were adult (n=885; 96.5%) and male (n=526; 56.6%) with a median (IQR) age of 63 (26) years. The majority of cardiac arrests occurred in private residences (n=740; 79.7%) and presented with asystole (n=322; 34.6%). EMS resuscitation was only attempted in 7.4% (n=69) of cases and return of spontaneous circulation (ROSC) occurred in 1.3% (n=13) of cases. Almost all patients (n=909; 97.8%) were declared dead on the scene.ConclusionTo our knowledge, this was the largest study investigating OHCA ever undertaken in Africa. We found that while the incidence of OHCA in Cape Town was similar to the literature, resuscitation is attempted in very few patients and ROSC-rates are negligible. This may be as a consequence of protracted response times, poor patient prognosis or an underdeveloped and under-resourced Chain of Survival in low- to middle-income countries, like South Africa. The development of contextual guidelines given resources and disease burden is essential.

Opposition Growth in Dominant Party Systems: Coalitions in South Africa

2013 ◽  
Vol 49 (2) ◽  
pp. 290-312 ◽  
Author(s):  
Danielle Langfield
Keyword(s):  
South Africa ◽  
Party System ◽  
Cape Town ◽  
Party Systems ◽  
Western Cape ◽  
Western Cape Province ◽  
Dominant Party ◽  
Party Strategies ◽  
Party Elites ◽  
Dominant Parties

What is responsible for the decline of democratically dominant parties and the corresponding growth of competitive party systems? This article argues that, despite a ruling party's dominance, opposition forces can gain by winning important subnational offices and then creating a governance record that they can use to win new supporters. It focuses on South Africa as a paradigmatic dominant party system, tracing the increased competitiveness of elections in Cape Town and the surrounding Western Cape province between 1999 and 2010. These events show how party strategies may evolve, reflecting how party elites can learn from forming coalitions.

scholarly journals Spiritual care practices in hospices in the Western cape, South Africa: the challenge of diversity

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ronita Mahilall ◽  
Leslie Swartz
Keyword(s):  
South Africa ◽  
Spiritual Care ◽  
Resource Constraints ◽  
Care Service ◽  
Western Cape ◽  
Group Discussions ◽  
Middle Income ◽  
Care Services ◽  
African Context ◽  
Care Practices

Abstract Background South Africa is a very diverse middle-income country, still deeply divided by the legacy of its colonial and apartheid past. As part of a larger study, this article explored the experiences and views of representatives of hospices in the Western Cape province of South Africa on the provision of appropriate spiritual care, given local issues and constraints. Methods Two sets of focus group discussions, with 23 hospice participants, were conducted with 11 of the 12 Hospice Palliative Care Association registered hospices in the Western Cape, South Africa, to understand what spiritual care practices existed in their hospices against the backdrop of multifaceted diversities. The discussions were analysed using thematic analysis. Results Two prominent themes emerged: the challenges of providing relevant spiritual care services in a religiously, culturally, linguistically and racially diverse setting, and the organisational context impacting such a spiritual care service. Participants agreed that spiritual care is an important service and that it plays a significant role within the inter-disciplinary team. Participants recognised the need for spiritual care training and skills development, alongside the financial costs of employing dedicated spiritual care workers. In spite of the diversities and resource constraints, the approach of individual hospices to providing spiritual care remained robust. Discussion Given the diversities that are largely unique to South Africa, shaped essentially by past injustices, the hospices have to navigate considerable hurdles such as cultural differences, religious diversity, and language barriers to provide spiritual care services, within significant resource constraints. Conclusions While each of the hospices have established spiritual care services to varying degrees, there was an expressed need for training in spiritual care to develop a baseline guide that was bespoke to the complexities of the South African context. Part of this training needs to focus on the complexity of providing culturally appropriate services.

scholarly journals Fatal drowning in the Western Cape, South Africa: a 7-year retrospective, epidemiological study

2018 ◽  
Vol 25 (6) ◽  
pp. 529-534 ◽  
Author(s):  
Colleen Jayne Saunders ◽  
Robyn Adriaanse ◽  
Abigail Simons ◽  
Ashley van Niekerk
Keyword(s):  
South Africa ◽  
Young Adult ◽  
Low Income ◽  
Western Cape ◽  
Middle Income ◽  
Registration System ◽  
Drowning Prevention ◽  
Adult Men ◽  
Context Specific ◽  
Public Holidays

IntroductionDrowning is a neglected public health threat in low-income and middle-income countries where the greatest drowning burden is observed. There is a paucity of drowning surveillance data from low-resource settings, particularly in Africa. Understanding local epidemiological factors will enable the development of context-specific drowning prevention initiatives and the appropriate allocation of resources.AimThe primary aim of this study was to describe the epidemiology of fatal drowning in the Western Cape, South Africa.MethodThis retrospective study describes fatal drowning incidents captured in the Western Cape vital registration system between 2010 and 2016. Data were obtained from the Forensic Pathology Services of the Western Cape Government. One-way analysis of variance was performed to detect a trend in mean drowning mortality rates between 2010 and 2016. χ2 tests for independence were performed to detect differences in the distribution of variables between groups.ResultsA total of 1391 fatal drownings occurred in the Western Cape between 2010 and 2016, with an age-adjusted drowning mortality rate of 3.2 per 100 000 population. Rates were fourfold higher in men compared with women. Children, particularly young children aged 0–4 years, and young adult men between 20 and 34 years of age were identified to be at high risk of fatal drowning. Drowning occurred predominantly in large, open bodies of water with concentrations in summer and public holidays.ConclusionsThe Western Cape drowning prevention strategy should prioritise interventions to reduce drowning in children and young adult men, with a targeted focus on festive periods such as public holidays.

scholarly journals Substitute Behaviors following Residential Substance Use Treatment in the Western Cape, South Africa

2021 ◽  
Vol 18 (23) ◽  
pp. 12815
Author(s):  
Deborah Louise Sinclair ◽  
Steve Sussman ◽  
Maarten De Schryver ◽  
Cedric Samyn ◽  
Sabirah Adams ◽  
...  
Keyword(s):  
South Africa ◽  
Substance Use ◽  
Self Report ◽  
Substance Use Treatment ◽  
Targeted Prevention ◽  
Service Users ◽  
Western Cape ◽  
Satisfaction Scale ◽  
Middle Income ◽  
Brief Assessment

The dynamics of substitute behaviors and associated factors remain poorly understood globally, and particularly in low- and middle-income contexts. This prospective study describes the prevalence and types of substitute behaviors as well as predictors, correlates, and motivations associated with substitution in persons (n = 137) admitted to residential substance use treatment in the Western Cape province of South Africa. The brief assessment of recovery capital, overall life satisfaction scale, and an adapted version of the addiction matrix self-report measure were completed during and post-treatment. Results indicate that substitutes were employed consciously for anticipated appetitive effects, for time-spending, (re)connecting with others, and enjoyment. At follow-up, 36% of service users had substituted their primary substance(s) with another substance or behavior; 23% had relapsed and 40% had maintained abstinence. While some service users may be especially vulnerable to developing substitute behaviors, targeted prevention and intervention efforts can reduce this risk.

scholarly journals Progress towards the 2020 targets for HIV diagnosis and antiretroviral treatment in South Africa

2017 ◽  
Vol 18 (1) ◽  
Author(s):  
Leigh F. Johnson ◽  
Rob E. Dorrington ◽  
Haroon Moolla
Keyword(s):  
South Africa ◽  
Antiretroviral Treatment ◽  
Routine Data ◽  
Hiv Positive ◽  
Western Cape ◽  
Hiv Diagnosis ◽  
Public And Private ◽  
North West ◽  
South Africans ◽  
Northern Cape

Background: The UNAIDS targets for 2020 are to achieve a 90% rate of diagnosis in HIVpositive individuals, to provide antiretroviral treatment (ART) to 90% of HIV-diagnosed individuals and to achieve virological suppression in 90% of ART patients.Objectives: To assess South Africa’s progress towards the 2020 targets and variations in performance by province.Methods: A mathematical model was fitted to HIV data for each of South Africa’s provinces, and for the country as a whole. Numbers of HIV tests performed in each province were estimated from routine data over the 2002–2015 period, and numbers of patients receiving ART in each province were estimated by fitting models to reported public and private ART enrolment statistics.Results: By the middle of 2015, 85.5% (95% CI: 84.5% – 86.5%) of HIV-positive South African adults had been diagnosed, with little variation between provinces. However, only 56.9% (95% CI: 55.3% – 58.7%) of HIV-diagnosed adults were on ART, with this proportion varying between 50.8% in North West and 72.7% in Northern Cape. In addition, 78.4% of adults on ART were virally suppressed, with rates ranging from 69.7% in Limpopo to 85.9% in Western Cape. Overall, 3.39 million (95% CI: 3.26–3.52 million) South Africans were on ART by mid- 2015, equivalent to 48.6% (95% CI: 46.0% – 51.2%) of the HIV-positive population. ART coverage varied between 43.0% in Gauteng and 63.0% in Northern Cape.Conclusion: Although South Africa is well on its way to reaching the 90% HIV diagnosis target, most provinces face challenges in reaching the remaining two 90% targets.

van Wyk Louw, Nicolaas Petrus (1906–1970)

2018 ◽  
Author(s):  
Heilna du Plooy
Keyword(s):  
South Africa ◽  
South African ◽  
Cape Town ◽  
Western Cape ◽  
The Family ◽  
South African Literature ◽  
Literature History ◽  
Faculty Of Education ◽  
University Of Cape Town ◽  
The University

N. P. Van Wyk Louw is regarded as the most prominent poet of the group known as the Dertigers, a group of writers who began publishing mainly in the 1930s. These writers had a vision of Afrikaans literature which included an awareness of the need of thematic inclusiveness, a more critical view of history and a greater sense of professionality and technical complexity in their work. Van Wyk Louw is even today considered one of the greatest poets, essayists and thinkers in the Afrikaans language. Nicolaas Petrus van Wyk Louw was born in 1906 in the small town of Sutherland in the Western Cape Province of South Africa. He grew up in an Afrikaans-speaking community but attended an English-medium school in Sutherland as well as in Cape Town, where the family lived later on. He studied at the University of Cape Town (UCT), majoring in German and Philosophy. He became a lecturer at UCT, teaching in the Faculty of Education until 1948. In 1949 he became Professor of South African Literature, History and Culture at the Gemeentelijke Universiteit van Amsterdam. In 1960 he returned to South Africa to become head of the Department of Afrikaans and Dutch at the University of the Witwatersrand in Johanneshurg. He filled this post until his death in 1970.

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 Response times of ambulances to calls from Midwife Obstetric Units of the Peninsula Maternal and Neonatal Service (PMNS) in Cape Town

Curationis ◽  
2009 ◽  
Vol 32 (1) ◽  
Author(s):  
J.K. Marcus ◽  
S.E. Clow
Keyword(s):  
Response Times ◽  
Cape Town ◽  
Time Of Arrival ◽  
Delayed Response ◽  
Western Cape ◽  
Negative Consequences ◽  
Median Response ◽  
Levels Of Care ◽  
Wide Range ◽  
National Norms

Response times of ambulances to calls from Midwife Obstetric Units, although varied, are perceived as slow. Delays in transporting women experiencing complications during or after their pregnancies to higher levels of care may have negative consequences such as fetal, neonatal or maternal morbidity or death. An exploratory descriptive study was undertaken to investigate the response times of ambulances of the Western Cape Emergency Medical Services to calls from midwife obstetric units (MOUs) in the Peninsula Maternal and Neonatal Services (PMNS) in Cape Town. Response times were calculated from data collected in specific MOUs using a specifically developed instrument. Recorded data included time of call placed requesting transfer, diagnosis or reason for transfer, priority of call and the time of arrival of ambulance to the requesting facility. Mean, median and range of response times, in minutes, to various MOUs and priorities of calls were calculated. These were then compared using the Kruskal-Wallis test. A comparison was then made between the recorded and analysed response times to national norms and recommendations for ambulance response times and maternal transfer response times respectively.A wide range of response times was noted for the whole sample. Median response times across all priorities of calls and to all MOUs in sample fell short of national norms and recommendations. No statistical differences were noted between various priorities of calls and MOUs.The perception of delayed response times of ambulances to MOUs in the PMNS was confirmed in this pilot study.

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