South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde[JOURNAL]
Sun
200 papers
The role of mental health in obesity management.
Mawson K, Barnard EJ, Lubbe J … +2 more , Conradie-Smit M, May W
S Afr Med J · 2025 Nov · PMID 41378653 · Publisher ↗
RECOMMENDATIONS 1. We recommend regular monitoring of weight, glucose and lipid profile in people with a mental health diagnosis who are taking medications associated with weight gain (Level 3, Grade C). 2. Healthcare pr...
RECOMMENDATIONS 1. We recommend regular monitoring of weight, glucose and lipid profile in people with a mental health diagnosis who are taking medications associated with weight gain (Level 3, Grade C). 2. Healthcare providers can consider both efficacy and effects on body weight when choosing psychiatric medications (Level 2a, Grade B). 3. Metformin and psychological treatment, such as CBT, should be considered for prevention of weight gain in people with severe mental illness who are treated with antipsychotic medications associated with weight gain (Level 1a, Grade A).
Assessment of people living with obesity.
Murphy A, Diab PN, Goedecke JH … +2 more , Conradie-Smit M, May W
S Afr Med J · 2025 Nov · PMID 41378652 · Publisher ↗
RECOMMENDATIONS • We suggest that HCPs involved in screening, assessing and managing PLWO use the '5As' framework to initiate the discussion by asking for their permission and assessing their readiness to initiate treatm...
RECOMMENDATIONS • We suggest that HCPs involved in screening, assessing and managing PLWO use the '5As' framework to initiate the discussion by asking for their permission and assessing their readiness to initiate treatment (Level 4, Grade D, Consensus). • HCPs can measure height and weight and calculate BMI in all adults (Level 2a, Grade B), and measure waist circumference in individuals with a BMI 25 - 35 kg/m2 (Level 2b, Grade B). • We suggest that a comprehensive history to identify root causes of weight gain as well as complications of obesity and potential barriers to treatment be included in the assessment (Level 4, Grade D). • We recommend measurement of blood pressure in both arms, fasting glucose or glycated haemoglobin and lipid profile to determine cardiometabolic risk and, where appropriate, alanine transaminase to screen for metabolic dysfunction-associated steatotic liver disease in PLWO (Level 3, Grade D). • We suggest that HCPs consider using the Edmonton Obesity Staging System to determine the severity of obesity and guide clinical decision-making (Level 4, Grade D).
Enabling participation in activities of daily living for people living with obesity.
Conradie-Smit M, Bhana SA, May W
S Afr Med J · 2025 Nov · PMID 41378651 · Publisher ↗
RECOMMENDATIONS 1. We recommend that HCPs ask PLWO if they have concerns about managing self-care activities such as bathing, getting dressed, bowel and/or bladder management, skin and/or wound care, foot care (Level 3,...
RECOMMENDATIONS 1. We recommend that HCPs ask PLWO if they have concerns about managing self-care activities such as bathing, getting dressed, bowel and/or bladder management, skin and/or wound care, foot care (Level 3, Grade C). 2. We recommend that HCPs assess falls risk in PLWO, as this could interfere with their ability to participate in physical activity and their interest in doing so (Level 3, Grade C).
Prevention and harm reduction of obesity (clinical prevention).
Bayat Z, Lubbe J, Conradie-Smit M … +1 more , May W
S Afr Med J · 2025 Nov · PMID 41378650 · Publisher ↗
KEY MESSAGES FOR HEALTHCARE PROVIDERS • Obesity is a complex chronic disease in which abnormal or excess body fat (adiposity) impairs health, increases the risk of long-term medical complications, and reduces lifespan. •...
KEY MESSAGES FOR HEALTHCARE PROVIDERS • Obesity is a complex chronic disease in which abnormal or excess body fat (adiposity) impairs health, increases the risk of long-term medical complications, and reduces lifespan. • Obesity arises from a complex interplay of genetic, biological, behavioural, psychosocial and environmental factors, and can develop via slow and steady weight gain over an extended period, or from rapid bursts of weight gain. • Obesity prevention should take place in a range of settings that access whole populations or high-risk groups. The individual-based approach to prevention is primarily used by healthcare providers and targets those with the highest level of risk of obesity. The population-based approach addresses the behavioural, sociocultural and environmental factors that contribute to non-communicable diseases in populations, including obesity. • Primary care clinicians have an important role in early identification of people living with obesity. Regular assessments of body weight are needed to catch early weight gain. (See the chapters 'Assessment of people living with obesity' and 'Primary care and primary healthcare in obesity management'.) • Primary care clinicians should initiate discussion around weight gain early and contemplate interventions that consider its complex causes, providing guidance beyond 'eat less and move more'. • Many medications are associated with weight gain side-effects that can contribute to long-term weight gain. The risks and benefits of such medications should be weighed up for each specific person before prescribing. • Excess pregnancy weight gain and post-pregnancy weight retention are significantly reduced with behavioural interventions. Primary care clinicians should counsel women attending prenatal care not to exceed pregnancy weight gain guidelines, in the course of dietary, physical activity and psychological interventions during prenatal visits. • Health benefits of smoking cessation outweigh the cardiovascular consequences associated with smoking cessation-related weight gain. • Short-term behavioural interventions (generally 6 months or less) aimed at preventing weight gain during young adulthood, menopause, smoking cessation and breast cancer treatment have not yet been shown to be effective. • Longer-term interventions are likely to be needed to properly examine strategies for preventing weight gain for many of these high-risk groups and in the general population.
The science of obesity.
May W, Goedecke JH, Conradie-Smit M
S Afr Med J · 2025 Nov · PMID 41378649 · Publisher ↗
KEY MESSAGES • Obesity arises from a complex interplay of genetic, biological, behavioural, psychosocial and environmental factors. • Obesity has a strong genetic component, with twin studies indicating a 50 - 80% concor...
KEY MESSAGES • Obesity arises from a complex interplay of genetic, biological, behavioural, psychosocial and environmental factors. • Obesity has a strong genetic component, with twin studies indicating a 50 - 80% concordance in body mass index (BMI) and regional fat distribution. A Swedish study on identical twins raised apart found no correlation between BMI and their adoptive families but a strong correlation with their biological twin, despite being raised in separate households. • The regulation of appetite, body weight and energy balance is highly complex, governed by a network of hormonal signals from the gut, adipose tissue and other organs, as well as neural signals that shape eating behaviours. Many of these signalling pathways are disrupted in people living with obesity. • Since body weight is homeostatically regulated, weight loss triggers physiological adaptations that promote weight regain. These include a decrease in energy expenditure, and hormonal changes that enhance appetite while reducing satiety. • Adipose tissue influences the central regulation of energy homeostasis, and excess adiposity can become dysfunctional, with production of proinflammatory cytokines and associated metabolic health complications. • Individual variations in body composition, fat distribution and function result in a highly variable threshold at which excess adiposity begins to negatively affect health. • Emerging research in obesity science has widened to include brown fat, the gut microbiome, immune system regulation, and the intricate mechanisms that regulate body weight. • Obesity can be classified as primary, secondary and genetic obesity. • In the current management of primary obesity, prevention (the path in) and treatment (the path out) need to be distinctly separated. • Effective primary obesity treatment requires an integrated approach that addresses the non-modifiable cause (increased appetite) together with modifiable contributors (poor diet quality, increased stress, poor sleep, reduced physical activity and increased sedentary behaviour). Behavioural modification and psychological support provide additional benefit. • Effective treatment in genetic and secondary obesity requires treatment of the underlying causes along with modification of the contributors.
Epidemiology of adult obesity.
Goedecke JH, Hellig J, Conradie-Smit M … +2 more , May W, Cois A
S Afr Med J · 2025 Nov · PMID 41378648 · Publisher ↗
RECOMMENDATIONS 1. Healthcare providers should recognise and treat obesity as a chronic disease, caused by abnormal or excess body fat accumulation (adiposity) that impairs health, with increased risk of premature morbid...
RECOMMENDATIONS 1. Healthcare providers should recognise and treat obesity as a chronic disease, caused by abnormal or excess body fat accumulation (adiposity) that impairs health, with increased risk of premature morbidity and mortality (Level 2b, Grade B). 2. The development of evidence-informed strategies at the health system and policy level should be directed at managing obesity in adults (Level 2b, Grade B). 3. Continued longitudinal national and regional surveillance of obesity that includes self-reported and measured data (i.e. heights, weights, waist circumferences) should be conducted on a regular basis (Level 2b, Grade B).
Reducing weight bias in obesity management, practice and policy.
Hellig J, Nieuwoudt C, Conradie-Smit M … +1 more , May W
S Afr Med J · 2025 Nov · PMID 41378647 · Publisher ↗
RECOMMENDATIONS 1. HCPs should assess their own attitudes and beliefs regarding obesity and consider how their attitudes and beliefs may influence care delivery (Level 1a, Grade A). 2. HCPs should recognise that internal...
RECOMMENDATIONS 1. HCPs should assess their own attitudes and beliefs regarding obesity and consider how their attitudes and beliefs may influence care delivery (Level 1a, Grade A). 2. HCPs should recognise that internalised weight bias (bias towards oneself) in PLWO can affect behavioural and health outcomes (Level 2a, Grade B). 3. HCPs should avoid using judgemental words (Level 1a, Grade A), images (Level 2b, Grade B)[2] and practices (Level 2a, Grade B)[13] when working with PLWO. 4. We recommend that HCPs avoid making assumptions that an ailment or complaint a patient presents is related to their body weight (Level 3, Grade C).
The ethics and law of medical AI in South Africa: Balancing innovation with responsibility.
Ngcobo M
S Afr Med J · 2025 May · PMID 41378646 · Publisher ↗
The rapid integration of artificial intelligence (AI) into medical practice presents both transformative opportunities and profound ethical and legal challenges. In South Africa, a country with a dual healthcare system a...
The rapid integration of artificial intelligence (AI) into medical practice presents both transformative opportunities and profound ethical and legal challenges. In South Africa, a country with a dual healthcare system and significant disparities in access to medical services, AI holds the promise of revolutionising healthcare delivery by enhancing diagnostic accuracy, improving patient outcomes, and mitigating resource constraints. However, the deployment of medical AI also raises critical ethical concerns regarding patient autonomy, informed consent, data protection, and accountability. From a legal standpoint, South Africa must navigate a complex regulatory terrain to ensure that AI aligns with constitutional rights and statutory obligations while fostering innovation. This article explores the legal and ethical dimensions of medical AI in South Africa, arguing for a balanced approach that encourages technological advancement without compromising fundamental principles of medical ethics and patient rights.
Data privacy and protection in AI-driven healthcare.
Mahomed S
S Afr Med J · 2025 May · PMID 41378645 · Publisher ↗
The concept of keeping health data private is constantly being tested, as what constitutes health data has grown significantly, now including massive amounts of personal information from a variety of sources, such as gen...
The concept of keeping health data private is constantly being tested, as what constitutes health data has grown significantly, now including massive amounts of personal information from a variety of sources, such as genomic data, radiological images, medical records, and non- health data converted into health data. These numerous sources of data, collectively termed 'biomedical big data' (BD), comprise a health data ecosystem that has altered the landscape of health research. BD, which is often referred to as the 'new oil', provides a natural blueprint for artificial intelligence (AI) to thrive and to generate and advance knowledge exponentially. However, while the need for data grows, data breaches are on the rise, specifically in the healthcare sector. The rise in local data breaches underscores the urgent need to translate paper into practice by strengthening systems and enforcing the ethico-legal framework governing the processing of data in SA, including ways in which to efficiently handle its misuse. This involves ensuring the adoption of ethically sound practices, adaptable infrastructure, and robust governance that is specific to the SA context.
AI in medicine: Hype, hope, and the path forward.
Daryanani AE, Ehrenfeld JM
S Afr Med J · 2025 May · PMID 41378644 · Publisher ↗
Artificial intelligence (AI) is rapidly transforming healthcare, with applications ranging from diagnostics and predictive analytics to administrative automation. AI holds immense potential to enhance clinical efficiency...
Artificial intelligence (AI) is rapidly transforming healthcare, with applications ranging from diagnostics and predictive analytics to administrative automation. AI holds immense potential to enhance clinical efficiency and improve patient outcomes; however, its integration into medical practice is not without challenges. Physicians remain divided; some view AI as a powerful tool for augmenting medical decision-making, while others question its reliability, ethical implications, and impact on the physician-patient relationship. This article examines the promise and limitations of AI in medicine, addressing critical concerns surrounding bias, liability, regulatory uncertainty, and physician adoption. It explores how AI is currently being used in healthcare, the barriers preventing its seamless integration, and the governance structures needed to ensure its responsible deployment.
AI and its application within UK healthcare: British Medical Association perspective.
Norcliffe-Brown D, McCartney F
S Afr Med J · 2025 May · PMID 41378643 · Publisher ↗
This paper is based on a talk given by Dominic Norcliffe-Brown of the British Medical Association (BMA) to the South African Medical Association on 28 November 2024, which explained the BMA policy paper 'Principles for A...
This paper is based on a talk given by Dominic Norcliffe-Brown of the British Medical Association (BMA) to the South African Medical Association on 28 November 2024, which explained the BMA policy paper 'Principles for Artificial Intelligence (AI) and its application in healthcare'. The policy paper provides further detail on the information discussed below.
The role of AI in transforming healthcare in South Africa.
Janneker W
S Afr Med J · 2025 May · PMID 41378642 · Publisher ↗
South Africa's healthcare system struggles with resource constraints, workforce gaps, and rising disease burdens. Artificial intelligence (AI) offers a scalable solution - enhancing diagnostics, drug discovery, and clini...
South Africa's healthcare system struggles with resource constraints, workforce gaps, and rising disease burdens. Artificial intelligence (AI) offers a scalable solution - enhancing diagnostics, drug discovery, and clinical decision-making while optimising hospital efficiency. Success depends on interoperable data, bias-aware AI models trained on local datasets, and robust ethical frameworks. Learning from China's AI health strategy and leveraging BRICS collaboration, South Africa must prioritise a unified digital health infrastructure to ensure equitable, secure AI adoption. Responsible implementation can augment clinical expertise and improve care standards across public and private sectors.
Bridging the gap in rural and underserved areas through AI-enabled solutions.
Mnyaka LJ
S Afr Med J · 2025 May · PMID 41378641 · Publisher ↗
Healthcare disparities between urban and rural populations remain one of the most pressing challenges in global health. In underserved areas, patients face numerous obstacles, including a lack of healthcare infrastructur...
Healthcare disparities between urban and rural populations remain one of the most pressing challenges in global health. In underserved areas, patients face numerous obstacles, including a lack of healthcare infrastructure, long distances to medical facilities, shortages of skilled professionals, and limited access to real-time medical resources. These challenges result in poor health outcomes, higher mortality rates, and increased disease burden in rural communities. However, artificial intelligence (AI) is emerging as a transformative tool in addressing these healthcare gaps. By leveraging AI-driven solutions, we can create sustainable and scalable healthcare models that improve access, enhance the quality of care, and optimise resources for underserved populations. This article explores how AI is revolutionising rural healthcare, with a focus on the practical applications that can make a meaningful difference.
Designing a universal electronic health record system: Creating a reliable national health database for AI and its application in healthcare in South Africa.
Nodikida M, Henney A
S Afr Med J · 2025 May · PMID 41378640 · Publisher ↗
Abstract loading — click title to view on PubMed.
Artificial Intelligence in Healthcare: Benefits and Challenges.
Dhai A
S Afr Med J · 2025 May · PMID 41378639
Abstract loading — click title to view on PubMed.
Maternal near miss and maternal mortality and their determinants among pregnant women at a rural tertiary centre in the Eastern Cape Province, South Africa: A cross-sectional study.
Kama A, Buga G, Nanjoh M
S Afr Med J · 2025 Aug · PMID 41378638 · Publisher ↗
BACKGROUND: Maternal near miss (MNM) is a significant entity in the assessment of the quality of obstetric care, particularly at institutional level. It renders possible the assessment of events surrounding a woman survi...
BACKGROUND: Maternal near miss (MNM) is a significant entity in the assessment of the quality of obstetric care, particularly at institutional level. It renders possible the assessment of events surrounding a woman surviving what would otherwise have been a fatal outcome during childbirth or within 42 days post termination of pregnancy. The World Health Organization (WHO) introduced a tool that eases the identification of such cases and the interventions that were offered during their care. There have been several assessments of maternal deaths within South Africa (SA), but no audit of maternal near-miss cases has been carried out in rural Eastern Cape Province. OBJECTIVES: To establish the period prevalence of MNM and mortality index, and to compare near-miss cases with maternal mortality and to identify their risk factors and causes. METHODS: A prospective cross-sectional study was carried out at Nelson Mandela Academic Hospital, a rural tertiary hospital in the Eastern Cape Province, over a 6-month period between January 2019 and June 2019. All cases that met the WHO criteria for MNM, together with maternal mortality cases, were identified and included in the study. RESULTS: There was a total of 1 706 live births, 228 maternal near-miss cases and 24 maternal death cases. The institutional severe maternal outcome ratio was 147/1 000 live births, with an overall mortality index of 9.5%. The MNM ratio (MNMR) was 133.6/1 000 live births, the maternal mortality ratio was 1 406.8/100 000 live births and the MNM/maternal mortality ratio (MNMR/MMR) was 9.5:1. The stillbirth rate was found to be 95.0/1 000 births. The leading causes of MNM were eclampsia (47.8%), abruptio placentae (19.7%) and postpartum haemorrhage (8.3%), and the leading causes of maternal death were eclampsia (29.2%), puerperal sepsis (25%) and postpartum haemorrhage (12.5%). CONCLUSION: The MNMR and the MMR found in this study were comparable with other reports from sub-Saharan Africa, although these ratios were notably higher than in urban areas within SA. The conditions that resulted in the highest fatality rate were potentially preventable, namely eclampsia and puerperal sepsis. Many patients with life-threatening conditions were low-risk patients, and this emphasises the need for more vigilant surveillance of patients during the antenatal, intrapartum and postpartum periods.
Penicillin remains an effective agent against Group A Streptococcus in low- and middle-income countries: A systematic review and meta-analysis of antibiotic resistance and associated genes.
Rampersadh K, Salie T, Engel K … +2 more , Moodley C, Engel M
S Afr Med J · 2025 Aug · PMID 41378637 · Publisher ↗
BACKGROUND: Driven by the extensive use of antibiotics, antibiotic resistance has become an issue globally, in both hospital and community settings. Limited access to laboratory diagnostic testing often results in undete...
BACKGROUND: Driven by the extensive use of antibiotics, antibiotic resistance has become an issue globally, in both hospital and community settings. Limited access to laboratory diagnostic testing often results in undetected resistance, which may only be detected once empiric treatment fails. There have been numerous reports on the increase of antibiotic resistance in group A Streptococcus (Strep A), particularly macrolide resistance. OBJECTIVES: To document the prevalence of antibiotic resistance in Strep A in low- and middle-income countries (LMICs) to the most widely used antibiotics. Where possible, resistance data were correlated with emm typing data. METHODS: We employed an extensive search strategy to identify studies in LMICs reporting on Strep A susceptibility to commonly prescribed antibiotics. Inclusion criteria required that isolates underwent emm typing. Two reviewers independently extracted data and assessed quality; statistical analyses, including meta-analysis using Stata software, evaluated the association between AMR and emm subtypes, and heterogeneity was assessed with Cochrane's Q and I2 statistics. RESULTS: Fifty studies met the eligibility criteria and were included in this review. A range of phenotypic resistance testing methods was employed across the studies, the most common being disc diffusion. Three studies exclusively used molecular testing. For the Strep A antimicrobial resistance (AMR) quantitative synthesis, 23 commonly used antibiotics were included in the meta-analysis. Increased resistance was observed among the macrolides (erythromycin, clindamycin, azithromycin), clarithromycin and tetracycline. Differences were observed in resistance patterns across emm types, with emm1, emm12 and emm60 showing higher resistance rates to tetracycline and erythromycin. The ermB (57.60%) and tetM (52.18%) genes were the most prevalent AMR genes among the studies. No resistance to penicillin, amoxicillin/clavulanic acid, cefotaxime, cefuroxime, linezolid, ofloxacin or teicoplanin was reported. CONCLUSION: This review comprehensively characterises the latest evidence on the prevalence of antibiotic resistance in Strep A in LMICs. Strep A in LMICs continues to be highly susceptible to antibiotics in vitro, primarily to penicillins. Strep A macrolide resistance patterns in LMICs are similar to those observed in high-income countries. The findings of this review may serve to inform effective treatment decisions and public health interventions.
Nocardia species epidemiology and susceptibility profiles from 2019 to 2022 in South Africa.
Thomas T, Lowe M, Le Roux K … +1 more , Strydom KA
S Afr Med J · 2025 Aug · PMID 41378636 · Publisher ↗
BACKGROUND: Nocardia species cause infections in humans, from localised to disseminated disease. They constitute a public health threat owing to the lack of sufficient information about them. In South Africa (SA), the la...
BACKGROUND: Nocardia species cause infections in humans, from localised to disseminated disease. They constitute a public health threat owing to the lack of sufficient information about them. In South Africa (SA), the last publication on this organism was in 2010. Predominant species types and antibiotic susceptibilities may have changed over this period. OBJECTIVE: To address the knowledge gap surrounding Nocardia species and their antibiotic susceptibilities in SA. METHODS: This was a retrospective and cross-sectional study. Data were collected from the Central Data Warehouse (CDW) of the National Health Laboratory Service (NHLS) on suspected Nocardia species from 1 January 2019 to 31 December 2022. Organism speciation was performed using 16S rRNA sequencing and antibiotic susceptibility testing (AST) by the broth microdilution (BMD) method. Data analysis included patient age, sample types from which the organism was cultured, distribution in the various SA provinces, species types and species AST profiles, including a record of trimethoprim-sulfamethoxazole (TMP/SMX) non-susceptibility. RESULTS: One hundred and sixty-five positive culture results were analysed. The majority of positive cultures (28%, n=46) were from the 30 - 39-year age group. The organism was predominantly cultured from pus samples (31%, n=51). The top two provinces from which the largest numbers of isolates were submitted were Gauteng (69%, n=114) and Western Cape (18%, n=30) provinces. Two percent (n=4) of isolates were not sequenced, and 18% (n=30) of isolates lacked AST results. Twenty-nine percent (n=47) of the Nocardia species that were sequenced could not be speciated using 16S rRNA sequencing. The top two species country-wide were N. abscessus complex (25%, n=42) and N. cyriacigeorgica (18%, n=29). Approximately 90% (n=121) of all isolates tested were TMP/SMX susceptible. CONCLUSION: The predominant isolation of Nocardia species from pus samples suggests that the majority were deep-seated infections. The most common Nocardia species types and the AST profiles have changed over time. The study highlights the need for alternative methods for the speciation of this organism.
Diarrhoeal admissions among children aged <5 years in public sector facilities in Western Cape Province, South Africa, before and during the COVID-19 pandemic (2019 - 2021).
Kehoe K, Morden E, Zinyakatira N … +9 more , Heekes A, Jones HE, Walter SR, Jacobs T, Murray J, Buys H, Eley B, Redaniel T, Davies MA
S Afr Med J · 2025 Aug · PMID 41378635 · Publisher ↗
BACKGROUND: The COVID-19 pandemic in South Africa (SA) had several effects, including the implementation of public health and social measures (PHSM) such as mobility limitations, social (physical) distancing, mask-wearin...
BACKGROUND: The COVID-19 pandemic in South Africa (SA) had several effects, including the implementation of public health and social measures (PHSM) such as mobility limitations, social (physical) distancing, mask-wearing and hand hygiene promotion. This led to behavioural shifts, and potentially impacted the transmission dynamics of other infectious diseases, including acute diarrhoea among children. OBJECTIVE: To investigate changes in acute diarrhoea hospital admissions in children aged <5 years in Western Cape Province, SA. METHODS: We conducted a retrospective analysis of diarrhoea admissions from January 2019 to November 2021. We estimated changes in rates and trends of diarrhoea admissions during the pandemic compared with pre-pandemic periods using interrupted time series analysis, adjusting for key characteristics. RESULTS: There were 17 204 children admitted for diarrhoea during the study period, of whom 54% were male, and almost half (48%) were aged <1 year. COVID-19 PHSM were associated with a 24% step reduction in diarrhoea admissions compared with the pre-COVID-19 period (incidence rate ratio (IRR) 0.76, 95% confidence interval (CI) 0.69 - 0.84). This was followed by an average 2% per month increase in diarrhoea admission incidence during the pandemic (IRR 1.02, CI 1.01 - 1.02). CONCLUSION: There was a marked reduction in diarrhoea admissions during the strictest PHSM implementation. Interventions such as hand hygiene and physical distancing likely contributed to these observed changes. This study underscores the importance of ongoing public health interventions to mitigate diarrhoeal diseases among children and prevent hospitalisation.
Access to oncology care in western KwaZulu-Natal Province before, during and after the COVID-19 pandemic.
Walker L, Stopforth L, Naidoo L … +1 more , Ferrer S
S Afr Med J · 2025 Aug · PMID 41378634 · Publisher ↗
BACKGROUND: Timely access to oncological care is essential. International experience suggests that the COVID-19 pandemic negatively impacted this. Knowledge of the experience in South Africa is limited. OBJECTIVE: To ass...
BACKGROUND: Timely access to oncological care is essential. International experience suggests that the COVID-19 pandemic negatively impacted this. Knowledge of the experience in South Africa is limited. OBJECTIVE: To assess the effect of COVID-19-associated lockdowns on access to cancer care for public sector patients in western KwaZulu- Natal Province (KZN). METHODS: A retrospective chart review was conducted in the Oncology Department of Grey's Hospital (GHOD), a tertiary hospital in KZN, to determine times between onset of symptoms, diagnosis, first consultation at GHOD and treatment. Patient demographics were included. Patients were stratified by both date of first GHOD appointment and of biopsy with respect to the various lockdown stages. RESULTS: A total of 360 patient files over four time periods (pre COVID-19, hard and soft lockdown and post-COVID-19) were reviewed. When stratified by first GHOD appointment, only waiting time from GHOD review to treatment decreased, with all other waiting times remaining stable. The average number of new patients seen per day decreased during soft lockdown, with the proportion of patients referred from primary care facilities most affected. CONCLUSION: Despite the challenges of a global pandemic, access to GHOD care was not compromised in terms of patient waiting times. The absolute number of patients seen decreased, however, particularly those referred from primary care facilities. This study reviewed the entire COVID-19 period and shows that the impact of COVID-19 on patients who accessed care was not necessarily negative. The need for research regarding diagnosis and referral at primary and secondary care levels during the pandemic is highlighted.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe