Data protection, data management, and data sharing: Stakeholder perspectives on the protection of personal health information in South Africa

The Protection of Personal Information Act (POPIA) 2013 came into force in South Africa on 1 July 2020. It seeks to strengthen the processing of personal information, including health information. While POPIA is to be welcomed, there are concerns about the impact it will have on the processing of health information. To ensure that the National Health Laboratory Service [NHLS] is compliant with these new strict processing requirements and that compliance does not negatively impact upon its current screening, treatment, surveillance and research mandate, it was decided to consider the development of a NHLS POPIA Code of Conduct for Personal Health. As part of the process of developing such a Code and better understand the challenges faced in the processing of personal health information in South Africa, 19 semi-structured interviews with stakeholders were conducted between June and September 2020. Overall, respondents welcomed the introduction of POPIA. However, they felt that there are tensions between the strengthening of data protection and the use of personal information for individual patient care, treatment programmes, and research. Respondents reported a need to rethink the management of personal health information in South Africa and identified 5 issues needing to be addressed at a national and an institutional level: an understanding of the importance of personal information; an understanding of POPIA and data protection; improve data quality; improve transparency in data use; and improve accountability in data use. The application of POPIA to the processing of personal health information is challenging, complex, and likely costly. However, personal health information must be appropriately managed to ensure the privacy of the data subject is protected, but equally that it is used as a resource in the individual’s and wider public interest.

Computer Management Design and Optimization of City Smart Medical Laboratory Service

In order to optimize the computer management of smart medical laboratory services and find the optimal solution, we conducted experiments on the laboratory computers of hospitals in this city based on the RBF neural network, which provided references for other researchers. Through the collection of relevant data, this article summarizes and analyzes the existing medical laboratory research, summarizes the existing problems and development directions of the current laboratory, uses the RBF neural network to modify these models, and innovatively achieves a hospital laboratory computer management optimization system with the characteristics of high efficiency, low energy consumption, and fast response. The experimental results prove that the computer management and optimization of laboratory services are optimized through the RBF neural network, and the efficiency of computer management design and optimization is greatly improved. It is about 20% higher than traditional medical laboratory. This shows that the computer management design and optimization of smart medical laboratory services designed by RBF neural network can play an important role in the construction of hospital laboratories.

Ebolavirus Disease (EVD)

Ebola virus disease (EVD) is a rare but severe, often fatal hemorrhagic illness occurring either sporadically or with large local outbreaks originating in (western) Africa. The virus is first transmitted from wild animals to humans (hunters; food handlers) followed by human-to-human transmission via blood or via body secretions. The average EVD case fatality rate is around 50% (range: 25% to 90% in past outbreaks). Community engagement is key to successfully controlling outbreaks using several interventions (case management, prevention and control practices, surveillance and contact tracing, good laboratory service, safe and dignified burials and social mobilization). Early supportive care with rehydration and symptomatic treatment improves survival. Two monoclonal antibodies (Inmazeb and Ebanga) were approved for the treatment of Zaire ebolavirus (Ebolavirus) infection in adults and children by the FDA in late 2020. Two vaccine regimens to protect against EVD were recently licensed and helped control outbreaks in Guinea and the Democratic Republic of the Congo (DRC).

Ebola

Ebola virus disease (EVD) is a rare but severe, often fatal hemorrhagic illness occurring either sporadically or with large local outbreaks originating in (western) Africa. The virus is first transmitted from wild animals to humans (hunters; food handlers) followed by human-to-human transmission via blood or via body secretions. The average EVD case fatality rate is around 50% (range: 25% to 90% in past outbreaks). Community engagement is key to successfully controlling outbreaks using several interventions (case management, prevention and control practices, surveillance and contact tracing, good laboratory service, safe and dignified burials and social mobilization). Early supportive care with rehydration and symptomatic treatment improves survival. Two monoclonal antibodies (Inmazeb and Ebanga) were approved for the treatment of Zaire ebolavirus (Ebolavirus) infection in adults and children by the FDA in late 2020. Two vaccine regimens to protect against EVD were recently licensed and helped control outbreaks in Guinea and the Democratic Republic of the Congo (DRC).

A Prospective Multicenter Randomized Study State of Humoral Immunity after a New Coronavirus Infection (COVID-19) of a Mild or Asymptomatic Course

Background.The rapid spread of COVID-19 in the world, the severity of disease, high morbidity and mortality have rightly made the COVID-19 pandemic a major threat to humanity. Therefore, one of the most urgent problems for practical health care is the issue of development of immunity for COVID-19 survivors, the possibility of re-infection, and the appropriateness of vaccination. The article presents the interim results of the study was named RESPONSE devoted to assessing the immunity for 90 days from patients that survived COVID-19 in a mild or asymptomatic course. Aims to study of the dynamics of generation of SARS-CoV-2 adhesive (S) protein neutralizing antibodies (IgG) and specificities of humoral immunity from COVID-19 survivors with light and asymptomatic form of disease in depending on gender and age. Materials and methods.Joint study by the Military Medical Academy n.a. S.M. Kirov and Laboratory Service Helix is being undertaken in the period from January 06, 2020 to August 1, 2021 on the basis of Academy clinics and Helix diagnostic centers in Saint Petersburg. The study was included 1109 males and females aged 18 to 70 (average age 38.2), who received to outpatient treatment of light and asymptomatic form of New Coronavirus Infection. All patients included in the investigation were done survey of quantitative neutralizing antibodies of class IgG to S-protein SARS-CoV-2 content in venous blood in 30, 45, 60 and 90 days from the last result of positive polymerase chain reaction with reverse transcription (OT-PCR) for determining nucleic acid SARS-CoV-2 in biological material by immunochemiluminescent analysis (LIAISON XL, DiaSorin S.p.A., made in Italy). Results.The IgG class antibody to the S-protein SARS-CoV-2 were not diagnosed 30 days after the survived infection only 0.9% of young women (1844 years) and 0.8% of men in the same age bracket. In other age groups, antibodies were defined in all participants of study. Titer of IgG gradually increases to peak concentration after 45 days, its kept at this level to the 60th day, and then it has a decreasing trend after 90 days from the onset of the disease. Conclusions.The results show the timing of generation and duration of the humoral response in survived patients COVID-19 in a mild or asymptomatic form. For 45 days, antibodies were determined in all participants of the study, reflecting the development of post-infectious humoral immunity, which was maintained in patients with the mild or asymptomatic forms of COVID-19 at least 3 months.

Measurement of C1-Inhibitor function alone is sufficient for diagnosis of hereditary angioedema

The World Allergy Organisiation/European Academy of Allergy and Clinical Immunology (WAO/EAACI) 2017/2018 guidelines recommend measuring complement4 levels, followed by C1-inhibitor level and function for diagnosis of hereditary angioedema (HAE). We analysed 6 months’ worth of data generated in our laboratory which is a specialist regional immunology service and also provides laboratory service for the Barts Health immunology department, which is a GA2LEN/HAEi-Angioedema Centre of Excellence and Reference (ACARE) and hence, investigates a large number of patients for HAE. We found that an efficient and sensitive approach for laboratory diagnosis of HAE is to only test the C1-inhibitor function. This approach had a sensitivity of 100% and reduced the cost of laboratory investigations for HAE diagnosis by 45%.

Cancer in HIV-positive and HIV-negative adolescents and young adults in South Africa: a cross-sectional study

ObjectiveTo determine the spectrum of cancers in adolescents and young adults (AYAs) living with and without HIV in South Africa.DesignCross-sectional study with cancer records provided by the National Cancer Registry (NCR) and HIV records from the National Health Laboratory Service (NHLS).Setting and participantsThe NHLS is the largest provider of pathology services in the South African public sector. The NCR is a division of the NHLS. We included AYAs (aged 10–24 years) diagnosed with cancer by public health sector laboratories between 2004 and 2014 (n=8479). HIV status was obtained through record linkages and text mining.Primary and secondary outcomesWe determined the spectrum of cancers by HIV status in AYAs. We used multivariable logistic regression to describe the association of cancer in AYAs with HIV, adjusting for age, sex, ethnicity and calendar period. We imputed (post hoc) the HIV status for AYA with unknown HIV status.Results8479 AYAs were diagnosed with cancer, HIV status was known for 45% (n=3812). Of those whose status was known, about half were HIV positive (n=1853). AYAs living with HIV were more likely to have Kaposi’s sarcoma (adjusted OR (aOR) 218, 95% CI 89.9 to 530), cervical cancer (aOR 2.18, 95% CI 1.23 to 3.89), non-Hodgkin’s lymphoma (aOR 2.12, 95% CI 1.69 to 2.66) and anogenital cancers other than cervix (aOR 2.73, 95% CI 1.27 to 5.86) than AYAs without HIV. About 44% (n=1062) of AYAs with HIV-related cancers had not been tested for HIV.ConclusionsTargeted HIV testing for AYAs diagnosed with cancer, followed by immediate start of antiretroviral therapy, screening for cervical precancer and vaccination against human papilloma virus is needed to decrease cancer burden in AYAs living with HIV in South Africa.

Ensuring Standardization, Quality Management And Improvement Of Point-Of-Care Testing In The Municipal Public Health System Based Ambulatory Care And School Health Clinics In New York City

Introduction/Objective Operated under different acute care hospital clinical laboratory limited-service laboratory (LSL) licenses, our New York City five borough spanning multisite ambulatory clinics and school-based clinics have been offering various waived point-of-care tests (POCTs) and provider-performed microscopy (PPM) to the local communities. A wide range of variability existed among the clinics concerning regulatory compliance, test performance, quality control and training. To ensure standardization and quality of POCT across the health system, our laboratory service adopted and implemented a plan for systemwide LSL transfer from the acute care hospitals to ambulatory care laboratory service for centralized implementation, monitoring, and oversight of the POCT operations. Methods/Case Report Having over 60 clinics, while transferring the LSLs, we chose multi-site license with ten or more sites on each license and by phase transfer from NYSDOH. Since the commencement of the transfer, system wide our qualified laboratory personnel have been updating and providing standard operating procedures (SOP), performing quality assurance and validation of new tests/devices, providing competency assessments and helping clinical staffs maintain compliance with state and other regulatory agencies. Results (if a Case Study enter NA) After the final phase of the transfer and POCT standardization implementation in 63 clinics, currently the clinical staffs performing POCT, get expeditious training and troubleshooting in more timely manner and the providers get the results of the ordered POCTs much faster and more efficiently and overall the quality metrics get improved markedly, indicated by internal audit team. Conclusion Even though Implementation of the planned POCT standardization was initially challenging due to the vastness and complexity of our multisite ambulatory care network and later confounded by the COVID -19 pandemic effect but eventually, it helped improve patient care delivery significantly and very effectively. Expectedly, our planned transfer implementation provided standardization and ensured improved quality of POC testing across our health system.

Physicians' Satisfaction with The Service Quality of A Clinical Laboratory in Calapan City, Oriental Mindoro

Clinical laboratory service assessment is essential in improving the quality of care and guaranteeing that quality standards are achieved. Physicians are their primary clients as physicians rely extensively on laboratory findings to make reliable diagnoses. Thus, the study aimed to assess physicians' satisfaction at a clinical laboratory in Calapan City, Oriental Mindoro, Philippines, based on the quality of service they provide, by identifying which factors greatly influence physicians' satisfaction and the physicians' concerns and recommendations. The laboratory accessibility, report format, information system, turnaround time, and service provision are the five factors evaluated in this study. A mixed-method approach was utilized wherein an online survey consisting of a 5-point Likert scale, and open-ended questions were deployed using Google forms and answered by 42 physicians. IBM SPSS Statistics 22 and the MAXQDA system were used to evaluate the responses. Overall, the physicians were satisfied with the clinical laboratory's services (X=3.9762). The laboratory report format has the most significant impact on physicians' overall satisfaction and is the factor with which physicians are most satisfied. Improvement of the turnaround time is advised. Future studies, including more laboratories and participants, are suggested.