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- Bertram, Melanie Y., et al.
(författare)
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Reducing the sodium content of high-salt foods : Effect on cardiovascular disease in South Africa
- 2012
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Ingår i: SAMJ South African Medical Journal. - Pretoria : South African Medical Association. - 0256-9574 .- 2078-5135. ; 102:9, s. 743-745
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Tidskriftsartikel (refereegranskat)abstract
- Background. Average salt intake in South African (SA) adults, 8.1 g/day, is higher than the 4 - 6 g/day recommended by the World Health Organization. Much salt consumption arises from non-discretionary intake (the highest proportion from bread, with contributions from margarine, soup mixes and gravies). This contributes to an increasing burden of hypertension and cardiovascular disease (CVD). Objectives. To provide SA-specific information on the number of fatal CVD events (stroke, ischaemic heart disease and hypertensive heart disease) and non-fatal strokes that would be prevented each year following a reduction in the sodium content of bread, soup mix, seasoning and margarine. Methods. Based on the potential sodium reduction in selected products, we calculated the expected change in population-level systolic blood pressure (SBP) and mortality due to CVD and stroke. Results. Proposed reductions would decrease the average salt intake by 0.85 g/person/day. This would result in 7 400 fewer CVD deaths and 4 300 less non-fatal strokes per year compared with 2008. Cost savings of up to R300 million would also occur. Conclusion. Population-wide strategies have great potential to achieve public health gains as they do not rely on individual behaviour or a well-functioning health system. This is the first study to show the potential effect of a salt reduction policy on health in SA.
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- Biagio, L., et al.
(författare)
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Paediatric otitis media at a primary healthcare clinic in South Africa
- 2014
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Ingår i: SAMJ South African Medical Journal. - 0256-9574 .- 2078-5135. ; 104:6, s. 431-435
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: No published studies on the prevalence of paediatric otitis media at primary healthcare clinics (PHCs) in South Africa (SA) are available. OBJECTIVE: To examine the point prevalence of otitis media in a paediatric population in a PHC in Johannesburg, SA, using otomicroscopy. METHODS: A sample of 140 children aged 2 - 16 years (mean 6.4; 44.1% females) were recruited from patients attending the PHC. Otomicroscopy was completed for each of the participants' ears by a specialist otologist using a surgical microscope. RESULTS: Cerumen removal was necessary in 36.0% of participants (23.5% of ears). Otitis media with effusion was the most frequent diagnosis (16.5%). Chronic suppurative otitis media (CSOM) was diagnosed in 6.6% of children and was the most common type of otitis media in participants aged 6 - 15 years. Acute otitis media was only diagnosed in the younger 2 - 5-year age group (1.7%). Otitis media was significantly more prevalent among younger (31.4%) than older children (16.7%). CONCLUSION: CSOM prevalence, as classified by the World Health Organization, was high. Consequently diagnosis, treatment and subsequent referral protocols may need to be reviewed to prevent CSOM complications.
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- De Beer, L, et al.
(författare)
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Linking employee burnout to medical aid provider expenditure
- 2013
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Ingår i: SAMJ South African Medical Journal. - Cape Town : Medical Association of South Africa. - 0256-9574 .- 2078-5135. ; 103:2, s. 89-93
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Tidskriftsartikel (refereegranskat)abstract
- Background. Healthcare has become a major expense. Burnout and its connection with psychological and physical health is well researched, yet little research has been done on the connection between burnout and financial outcomes, specifically as indicated by the costs incurred by medical aid providers as a result of members' claims. Objective. To investigate the connection between employee burnout and medical aid claims and expenditure data in a sample from the private sector. Method. A cross-sectional design was used. The sample comprised 3 182 participants. The available objective medical aid expenditure data connected with each participant were: total insured benefits, general practitioner visits, specialist visits, general practitioner insured benefits, and claims for medicine. A low and a high burnout group were extracted, based on comorbidity of the two core components of burnout. Analysis of covariance (ANCOVA) was then applied to investigate the differences in estimated marginal means of the expenditures on the low and the high burnout contrast groups, while controlling for age and gender. Results. The high burnout group frequented a general practitioner more often, and the medical aid provider expenditure was nearly double that of the low burnout group, on all the variables. Specialist visits did not show a significant result. Conclusion. High burnout is associated with a higher expenditure by a medical aid provider, compared with low burnout, per member. Stakeholders should therefore address burnout to reduce expenditure and promote health.
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- Hofman, Karen J, et al.
(författare)
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Setting priorities for health in 21st century South Africa
- 2010
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Ingår i: SAMJ South African Medical Journal. - 0256-9574 .- 2078-5135. ; 100:12, s. 798-800
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Tidskriftsartikel (refereegranskat)abstract
- The Priority Cost Effective Lessons for Systems Strengthening - South Africa (PRICELESS SA) intends to be catalytic, to show where gains in efficiency can be gained at reasonable cost, and to stimulate further work along these lines. Ultimately, it is hoped that policy makers and health care providers will value and incorporate this approach into future planning for health services at both the national and at the district level.
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- Kidanto, Hussein L., et al.
(författare)
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Risks for preterm delivery and low birth weight are independently increased by severity of maternal anaemia
- 2009
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Ingår i: SAMJ South African Medical Journal. - 0256-9574 .- 2078-5135. ; 99:2, s. 98-102
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To estimate the effect of the severity of maternal anaemia on various perinatal outcomes. Design. A cross-sectional study. Setting. Labour Ward, Muhimbili National Hospital, Dar es Salaam, Tanzania. Methods. The haemoglobin of eligible pregnant women admitted for delivery between 15 November 2002 and 15 February 2003 was measured. Data on socio-demographic characteristics, iron supplementation, malaria prophylaxis, blood transfusion during current pregnancy, and current and previous pregnancy outcomes were collected and analysed. Anaemia was classified according to the World Health Organization (WHO) standards: normal - Hb >= 11.0 g/dl; mild - Hb 9.0 - 10.9 g/dl; moderate - Hb 7.0 - 8.9 g/dl; and severe - Hb <7.0 g/dl. Logistic regression analysis was performed to estimate the severity of anaemia. The following outcome measures were used: preterm deliver), (<37 weeks), Apgar score, stillbirth, early neonatal death, low birth weight (LBW) (<2 500 g) and very low birth weight (VLBW) (<1 500 g). Results. A total of 1 174 anaemic and 547 non-anaemic women were enrolled. Their median age was 24 years (range 14 - 46 years) and median parity was 2 (range 0 - 17). The prevalence of anaemia and severe anaemia was 68% and 5.8%, respectively. The risk of preterm delivery increased significantly with the severity of anaemia, with odds ratios of 1.4, 1.4 and 4.1 respectively for mild, moderate and severe anaemia. The corresponding risks for LBW and VLBW were 1.2 and 1.7, 3.8 and 1.5, and 1.9 and 4.2 respectively. Conclusion. The risks of preterm delivery and LBW increased in proportion to the severity of maternal anaemia.
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- Nematswerani, N., et al.
(författare)
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Understanding the impact of the COVID-19 pandemic on healthcare services for adults during three waves of COVID-19 infections: A South African private sector experience
- 2023
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Ingår i: SAMJ SOUTH AFRICAN MEDICAL JOURNAL. - 0256-9574 .- 2078-5135. ; 113:4, s. 1156-1164
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Tidskriftsartikel (refereegranskat)abstract
- Background. Since the onset of the COVID-19 pandemic, healthcare resources have been repurposed to focus on COVID-19. Resource reallocation and restrictions to movement that affected general access to care may have inadvertently resulted in undue disruptions in the continuum of care for patients requiring non-COVID-19 healthcare services. Objectives. To describe the change in pattern of health service use in the South African (SA) private sector. Methods. We conducted a retrospective study of a nationwide cohort of privately insured individuals. An analysis of claims data was performed for non-COVID-19 related healthcare services provided from April 2020 to December 2020 (year 1 of COVID-19) and April 2021 to December 2021 (year 2 of COVID-19) relative to the same period in 2019 prior to the COVID-19 pandemic in SA. Over and above plotting the monthly trends, we tested for statistical significance of the changes using a Wilcoxon test given the non-normality of all the outcomes. Results. Between April and December 2020, relative to the same period in 2021, and also relative to the same period in 2019, we found a 31.9% (p<0.01) and a 16.6% (p<0.01) reduction in emergency room visits, respectively; a 35.9% (p<0.01) and 20.5% (p<0.01) reduction in medical hospital admissions; a 27.4% (p=0.01) and 13.0% (p=0.03) reduction in surgical hospital admissions; a 14.5% (p<0.01) and 4.1% (p=0.16) reduction in face-to-face general practitioner consultations for chronic members; a 24.9% (p=0.06) and 5.2% (p=0.54) reduction in mammography for female members; a 23.4% (p=0.03) and 10.8% (p=0.09) reduction in Pap smear screenings for female members; a 16.5% (p=0.08) and 12.1% (p=0.27) reduction in colorectal cancer registrations and an 18.2% (p=0.08) and 8.9% (p=0.07) decrease in all oncology diagnoses. Uptake of telehealth services throughout the healthcare delivery system increased by 5 708% in 2020 compared with 2019, and 36.1% for 2021 compared with 2020. Conclusion. A significant reduction in emergency room visits, hospital admissions and utilisation of primary care services was observed since the start of the pandemic. Further research is required to understand if there are long-term consequences of delayed care. An increase in the use of digital consultations was observed. Research on their acceptability and effectiveness may open new modalities of care, which may have cost- and time-saving benefits.
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