scholarly journals Evaluation of factors and patterns influencing the 30-day readmission rate at a tertiary-level hospital in a resource-constrained setting in Cape Town, South Africa

2019 ◽  
Vol 109 (3) ◽  
pp. 164 ◽  
Author(s):  
R Dreyer ◽  
A J Viljoen
Keyword(s):  
South Africa ◽  
Readmission Rate ◽  
Cape Town ◽  
Tertiary Level ◽  
Resource Constrained ◽  
Level Hospital

scholarly journals Compliance with surgical antibiotic prophylaxis guidelines: a prospective descriptive study at a tertiary level hospital in Cape Town, South Africa

2020 ◽  
pp. 300-305
Author(s):  
D Schuster ◽  
JJ Fagan ◽  
M Flint ◽  
W Basera ◽  
O Porrill ◽  
...  
Keyword(s):  
South Africa ◽  
Antibiotic Prophylaxis ◽  
Cape Town ◽  
Binary Logistic Regression ◽  
Primary Objective ◽  
Tertiary Level ◽  
Cross Sectional ◽  
Surgical Antibiotic Prophylaxis ◽  
Inappropriate Antibiotics ◽  
Level Hospital

Background: The aim of surgical antibiotic prophylaxis (SAP) is to prevent surgical site infection (SSI) by administering an appropriate antimicrobial agent perioperatively. However, SAP may be associated with adverse effects and incurs added costs. The primary objective of this prospective study is to establish whether clinicians are adhering to existing perioperative antibiotic prophylaxis guidelines in terms of indication, dosage and timing of SAP. Secondary objectives are to determine the proportion of patients receiving inappropriate antibiotics, and to evaluate correct practice concerning re-dosing and duration of SAP. Methods: A cross-sectional prospective audit of the anaesthetic records and prescription charts of surgical patients was conducted at Groote Schuur Hospital, a tertiary level teaching hospital in Cape Town, South Africa, over a period of one week. Data were collected by anaesthetists – blinded to the study objectives – and the investigators; then captured on Excel spreadsheets and compared to existing SAP guidelines. Descriptive statistics and binary logistic regression were used for analysis. Results: Of the 192 patients consented, 180 questionnaires were completed for data analysis. The median age of participants was 44.5 years (IQR: 31.5–58), with a preponderance of females (58.7%). SAP was administered in 149 cases (82.8%) and withheld in 31 (17.2%). This was appropriate in 91.9% (137/149) and 77.4% (24/31) respectively. Twelve patients (6.7%) received inappropriate antibiotics and in seven (3.9%) it was inappropriately withheld. Of the 156 patients who should have received SAP, choice of drug was correct in 121 (77.6%), dosage in 110 (70.5%) and timing in 87 (55.8%). Absolute compliance was achieved in 44.4% (80/180). Errors were mostly related to timing, re-dosing and duration of SAP. Conclusion: Anaesthetists and surgeons at Groote Schuur Hospital demonstrate variable adherence to surgical antibiotic prophylaxis guidelines. Interventions aimed at improving compliance are warranted.

scholarly journals A retrospective study assessing the clinical outcomes and costs of acute hepatitis A in Cape Town, South Africa

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Jenna Patterson ◽  
Susan Cleary ◽  
Sheetal P. Silal ◽  
Gregory D. Hussey ◽  
Annabel Enoch ◽  
...  
Keyword(s):  
South Africa ◽  
Clinical Outcomes ◽  
Hepatitis A ◽  
Cape Town ◽  
Adult Patients ◽  
Cost Driver ◽  
Tertiary Level ◽  
Paediatric Patients ◽  
Study Population ◽  
The Cost

Abstract Background While some evidence has been demonstrated the cost-effectiveness of routine hepatitis A vaccination in middle-income countries, the evidence is still limited in other settings including in South Africa. Given this, the evidence base around the cost of care for hepatitis A needs to be developed towards considerations of introducing hepatitis A vaccines in the national immunisation schedule and guidelines. Objectives To describe the severity, clinical outcomes, and cost of hepatitis A cases presenting to two tertiary healthcare centers in Cape Town, South Africa. Methods We conducted a retrospective folder review of patients presenting with hepatitis A at two tertiary level hospitals providing care for urban communities of metropolitan Cape Town, South Africa. Patients included in this folder review tested positive for hepatitis A immunoglobulin M between 1 January 2008 and 1 March 2018. Results In total, 239 folders of hepatitis A paediatric patients < 15 years old and 212 folders of hepatitis A adult patients $$\ge$$ ≥ 15 years old were included in the study. Before presenting for tertiary level care, more than half of patients presented for an initial consultation at either a community clinic or general physician. The mean length of hospital stay was 7.45 days for adult patients and 3.11 days for paediatric patients. Three adult patients in the study population died as a result of hepatitis A infection and 29 developed complicated hepatitis A. One paediatric patient in the study population died as a result of hepatitis A infection and 27 developed complicated hepatitis A, including 4 paediatric patients diagnosed with acute liver failure. The total cost per hepatitis A hospitalisation was $1935.41 for adult patients and $563.06 for paediatric patients, with overhead costs dictated by the length of stay being the largest cost driver. Conclusion More than 1 in every 10 hepatitis A cases (13.3%) included in this study developed complicated hepatitis A or resulted in death. Given the severity of clinical outcomes and high costs associated with hepatitis A hospitalisation, it is important to consider the introduction of hepatitis A immunisation in the public sector in South Africa to potentially avert future morbidity, mortality, and healthcare spending.

scholarly journals Primary caregivers perceptions  of the role of fathers in the provision of nutritional care in a resource constrained environment in Cape Town, South Africa

2019 ◽  
Author(s):  
Melissa Judith Brown ◽  
Nicolette Roman
Keyword(s):  
South Africa ◽  
Sugar Content ◽  
Cape Town ◽  
Primary Caregivers ◽  
Well Being ◽  
Resource Constrained ◽  
Nutritional Care ◽  
The Family ◽  
High Sugar Content

Abstract Background : The role of fathers has traditionally been defined as a breadwinner or provider, with men generally having lower levels of engagement in childcare tasks, especially with young children. The involvement of fathers has important consequences for child well-being, especially with regards to issues of diet/nutrition, exercise, play, and parenting behaviours. This paper seeks to explore the perceptions and limitations that primary caregivers have on fathers’ provision of care in a resource constrained community in South Africa. Methods : Data was collected through in-depth face to face interviews, with a sample of 10 primary caregivers in a resource constrained community in Cape Town, South Africa. Results : The findings reveal that there is a lack of involvement from fathers in the provision of nutritional care and that this affects mothers and grandmothers who then need to provide both the physical and emotional care to their children. These findings are based on the perspective of mothers and grandmothers and their perceived roles in the family. Conclusion : The level of lack of financial involvement from fathers has dramatically affected the participating family’s food security due to only one member in the household earning below minimum wage. This has therefore meant that the dietary needs of the family are not being met with nutritional foods, but instead by high fat and high sugar content foods. The findings also highlighted that primary caregivers want to be taught about health and nutritional food choices for a limited budget.

scholarly journals The Economic Burden of Diarrheal Disease in a Tertiary Level Hospital, Gauteng, South Africa

2010 ◽  
Vol 202 (S1) ◽  
pp. S116-S125 ◽  
Author(s):  
Una E. MacIntyre ◽  
Francois P. R. de Villiers
Keyword(s):  
South Africa ◽  
Economic Burden ◽  
Diarrheal Disease ◽  
Tertiary Level ◽  
Level Hospital

scholarly journals Primary caregivers perceptions  of the role of fathers in the provision of nutritional care in a resource constrained environment in Cape Town, South Africa

2019 ◽  
Author(s):  
Melissa Judith Brown ◽  
Nicolette Roman
Keyword(s):  
South Africa ◽  
Sugar Content ◽  
Cape Town ◽  
Primary Caregivers ◽  
Well Being ◽  
Resource Constrained ◽  
Nutritional Care ◽  
The Family ◽  
High Sugar Content

Abstract Background : The role of fathers has traditionally been defined as a breadwinner or provider, with men generally having lower levels of engagement in childcare tasks, especially with young children. The involvement of fathers has important consequences for child well-being, especially with regards to issues of diet/nutrition, exercise, play, and parenting behaviours. This paper seeks to explore the perceptions and limitations that primary caregivers have on fathers’ provision of care in a resource constrained community in South Africa. Methods : Data was collected through in-depth face to face interviews, with a sample of 10 primary caregivers in a resource constrained community in Cape Town, South Africa. Results : The findings reveal that there is a lack of involvement from fathers in the provision of nutritional care and that this affects mothers and grandmothers who then need to provide both the physical and emotional care to their children. These findings are based on the perspective of mothers and grandmothers and their perceived roles in the family. Conclusion : The level of lack of financial involvement from fathers has dramatically affected the participating family’s food security due to only one member in the household earning below minimum wage. This has therefore meant that the dietary needs of the family are not being met with nutritional foods, but instead by high fat and high sugar content foods. The findings also highlighted that primary caregivers want to be taught about health and nutritional food choices for a limited budget.

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