COVID-19: The role of artificial intelligence in empowering the healthcare sector and enhancing social distancing measures during a pandemic

Indiscriminatory in its spread, COVID-19 has engulfed communities from all social backgrounds throughout the world. While healthcare professionals work tirelessly testing for the virus and caring for patients, they too have become casualties of the pandemic. Currently the best way to attempt to curb the spread of the virus, echoed by almost all nation leaders, is to distance ourselves from one another socially or physically. However ideal this may seem, social distancing is not always practical in densely populated lower-income countries with many citizens below the breadline. With the majority of South Africans living in poverty, communities in overcrowded households are unable to distance themselves from one another appropriately. In addition, as a nation we struggle with high HIV and tuberculosis rates, malnutrition and an already overburdened healthcare system, emphasising the extreme vulnerability of our people. These factors, coupled with the fact that many of our healthcare professionals lack the necessary personal protective equipment to prevent them from contracting the virus themselves, highlight the gravity of the damaging repercussions that we may face in the coming months, after the complete national lockdown in force at the time of writing is lifted and we move towards a partial lockdown state. Nationally, there needs to be a shift in mindset towards exploring alternative technology-based preventive measures that may empower the healthcare sector in the long term and enhance social distancing

Bridging the Gap: Exploring the Atitudes and Beliefs of Nurses and Patients about Coexisting Traditional and Biomedical Healthcare Systems in a Rural Setting in KwaZulu-Natal

Objectives: Health care in South Africa takes place within a diverse cultural context and includes perceptions about health that strongly link to cultural beliefs and values. Biomedical healthcare professionals; particularly nurses; are exposed to and expected to cope with cultural challenges on a daily basis; with little or no training on how to do so. In this paper; we explore nurse and patient attitudes to and beliefs about how the systems of health care coexist; what issues this raises and how nurses and patients address these issues in their daily practice. Design: The study employed an exploratory; qualitative research design. Setting and subjects: Four in-depth focus group discussions were conducted with nurses and patients at a deep rural; district hospital in northern KwaZulu-Natal. Participants were selected based on their availability and willingness to contribute to the discussion. Results: Traditional and biomedical healthcare systems coexist and are used simultaneously with the healthcare-seeking pattern of patients traversing multiple systems of care. Currently; patients and nurses have developed strategies to address this by steering a pragmatic course to minimise risks; and by doing so; bridging the gap between the two healthcare mediums. Conclusion: Further research is required to understand which illnesses are primarily seen as traditional; how this gap can be effectively addressed; and how different healthcare co-delivery models can best be utilised and evaluated

Provision of Psychosocial Support for Young people Living with HIV: Voices from the Field

This review provides a synthesis of the experiences of organisations providing psychosocial support for young people living with HIV (YPLHIV) from throughout the world. Little research exists on psychosocial support for YPLHIV; with many providers uncertain about how to address their complex needs. Eighty-six organisations were sent a survey containing 15 semi-structured; open-ended questions. Sixty-eight organisations from the United States; Europe; Africa; Asia; Latin America and the Middle East responded. The survey asked what challenges the organisation's patient group face; what the organisational aims are; how; where and by whom psychosocial support is delivered; what types of psychosocial support have been effective and which have not; and what recommendations the organisation has for service provision and policy.Data were stratified by age of population; region of the world and whether youth were infected at birth or in adolescence. The problems and needs across groups were more consistent than disparate. Adherence to medication; disclosure of HIV status; issues relating to sex and lack of support networks are problems faced by all YPLHIV. Most organisations use a multi-disciplinary team of individuals to meet these needs; with particular emphasis on individual and group therapy; educational support; and skills-building programmes. The review stresses the importance of youth-centered and youth-led approaches that engage young people in the planning; implementation and evaluation of programmes. Organisations underlined the need for increased funding; capacity building and trained staff. They suggest that policy makers put more effort into understanding the distinctiveness of adolescence; particularly in the context of HIV; andchallenge them to make longer-term commitments to funding and programme support. In order for organisations to provide better services; they need further evidence of effective solutions; programme guidance and support tools; and increased collaboration and communication with one another; and with policy-makers and donors

Social and Economic Consequences of HIV and AIDS on Children: Case Study of a High-Density Community in Harare; Zimbabwe

We present results from a household-based survey that was conducted in Mabvuku; a high-density community in Zimbabwe. The objective of the study was to improve understanding of social and economic consequences of HIV and AIDS on children. Children affected by HIV and AIDS (CABA) formed the treatment group while those not affected by HIV and AIDS (non-CABA) were the control group. We found that many of the differences in the socio-economic indicators that we studied between CABA and non-CABA were not significant. Therefore our results indicate a gloomy scenario for all the children. These results are consistent with existing literature which indicates that the impact of HIV and AIDS is exacerbated by poverty. Based on evidence from this paper; we conclude that programmes and interventions targeted at children should encompass both CABA and non-CABA within a framework of sustained commitment to improving the lives of these children. We hope that our findings will be used in the formulation of interventions and strategies to improve the situation of children affected by HIV and AIDS and/or living in impoverished communities

The First Human Heart Transplant and Further Advances in Cardiac Transplantation at Groote Schuur Hospital and the University of Cape Town

Christiaan (Chris) Barnard was born in 1922 and qualified in medicine at the University of Cape Town in 1946. Following surgical training in South Africa and the USA; Barnard established a successful open-heart surgery programme at Groote Schuur Hospital and the University of Cape Town in 1958. In 1967; he led the team that performed the world's first human-to-human heart transplant. The article describing this remarkable achievement was published in the South African Medical Journal just three weeks after the event and is one of the most cited articles in the cardiovascular field. In the lay media as well; this first transplant remains the most publicised event in world medical history. Although the first heart transplant patient survived only 18 days; four of Groote Schuur Hospital's first 10 patients survived for more than one year; two living for 13 and 23 years; respectively. This relative success amid many failures worldwide did much to generate guarded optimism that heart transplantation would eventually become a viable therapeutic option. This first heart transplant and subsequent ongoing research in cardiac transplantation at the University of Cape Town and in a few other dedicated centres over the subsequent 15 years laid the foundation for heart transplantation to become a well-established form of therapy for end-stage cardiac disease. During this period from 1968 to 1983; Chris Barnard and his team continued to make major contributions to organ transplantation; notably the development of the heterotopic ('piggy-back') heart transplants; advancing the concept of brain death; organ donation and other related ethical issues; better preservation and protection of the donor heart (including hypothermic perfusion storage of the heart; studies on the haemodynamic and metabolic effects of brain death; and even early attempts at xenotransplantation

Les progres therapeutiques dans la prise en charge de la drepanocytose sont-ils applicables en Afrique sub-saharienne?

L'esperance de vie des patients drepanocytaires s'est considerablement amelioree aux Etats-Unis et en Europe du fait de la penicillinotherapie preventive; des vaccinations; du depistage neonatal; de la mise au point d'une politique transfusionnelle de qualite; de l'hydroxyuree; de la detection et du traitement de la vasculopathie cerebrale; du discernement des situations redevables d'une greffe de moelle allogenique et des ameliorations des techniques de greffe. La quasi-totalite de ces soins ont un cout exorbitant en Afrique ou ils ne peuvent pas etre appliques. Pourtant; la penicilline; les vaccins; l'hydroxyuree pour le moins devraient y etre accessibles sans reserve; avec des strategies therapeutiques codifiees. Si la penicilline quotidienne et le vaccin anti-pneumococcique Pneumo 23r sont justifies; il est probable qu'il faudrait selectionner un autre vaccin conjugue que le Prevenarr qui ne couvre pas toutes les souches presentes en Afrique. Le depistage neonatal est encore tres exceptionnellement fait. La transfusion ponctuelle est en constante amelioration; mais les programmes d'echange transfusionnel; destines en particulier a prevenir les complications neurologiques; restent impossibles. Les indications de l'hydroxyuree en Afrique sont plus frequentes du fait de l'inaccessibilite de la transfusion chronique et devrait faire l'objet d'un consensus. Enfin; la greffe de moelle; seul traitement curatif a ce jour; reste l'apanage des pays du Nord; ou toutefois elle reste reservee aux enfants porteurs de formes graves et ayant un donneur intra-familial HLA-compatible