The impact of the COVID-19 pandemic on theatre use at the rahima moosa mother and child hospital

SARS-COV-2, the viral pathogen that resulted in the COVID-19 pandemic, was first identified by the World Health Organization (WHO) on 31 December 2019. Efforts to curb the spread of this virus, as well as the effects of viral infections and resulting complications thereof, have placed immense strain on healthcare systems throughout the world. In South Africa, a nationwide lockdown was instituted on 27 March 2020 which resulted in the suspension of all elective surgical services. The effect of this suspension of services has not been fully elucidated, but it has been postulated that a significant surgical backlog may have been created due to limited resources and massive pre-existing patient loads. Methods: We conducted a retrospective descriptive review of theatre records at the Rahima Moosa Mother and Child Hospital (RMMCH) for the time period 1 March 2019 to 28 February 2021. Results: A total of 8 176 cases amounting to 9 656 hours and 20 minutes of theatre time occurred from 1 March 2019 to 29 February 2020 (pre-COVID-19). From 1 March 2020 to 28 February 2021 (post-COVID-19), a total of 7 717 cases amounting to 9 148 hours and 2 minutes were conducted. This calculated to a 5.61% reduction in cases and a 5.26% reduction in theatre hours. There was a statistically significant reduction in theatre use both in terms of cases done and hours of theatre time after the onset of the COVID-19 pandemic. Conclusion: The onset of the COVID-19 pandemic significantly reduced the number of cases completed at the RMMCH. It also led to a significant reduction in total theatre use. Both of these findings were most pronounced in elective gynaecology and paediatric surgery services. There was, however, no statistically significant increase in intensive care unit (ICU) and high care (HC) admissions as well as mortalities for the period studied

Human Papilloma Virus, Risk Factors and Sequelae: How much do Female Adolescents in Port Harcourt Metropolis know?

Background: Human Papilloma virus (HPV) infection is the most common viral infection of the genital tract; is sexually transmitted with the highest rates observed in young women. This study assessed the level of knowledge of HPV and cervical cancer among adolescent girls in Port Harcourt metropolis, Nigeria. Methodology: A cross-sectional survey among 328 in-school female secondary school students aged 9 - 19 years, selected via multi-stage sampling. Information on socio-demographics, knowledge of HPV and cervical cancer and sexual history were collected using a self-administered, semi-structured questionnaire. Data was analyzed using SPSS version 23 and Chi square test was used to establish associations. Results: Only 38.2% and 30% had heard of cervical cancer and HPV respectively; the media being the most common source. Knowledge of transmission, risk factors, sequelae and prevention of infection was poor (75%). About 20.2% were aware of the causal association between HPV infection and cervical cancer. Some (3.1%) were sexually exposed and practiced unprotected sexual intercourse. Median age at sexual debut was 11 years. Older and private school students (15-19years) had better knowledge Conclusion: The level of knowledge of HPV, cervical cancer, their association and risk factors, among adolescent girls in Port Harcourt metropolis is poor. Some adolescents engage in sexual practices that put them at risk for HPV infection. Social media and upper primary and secondary school-based approach to HPV health promotion should be explored to provide detailed adolescent-friendly information to guide in prevention of HPV infection and cervical cancer.

Knowledge and attitudes of health workers in bouake, Cote d'ivoire on zika virus disease in the context of a global epidemic

Since January, 2012, the Pacific region has faced a heavy burden of concurrent epidemics of dengue, chikungunya, and zika virus infections. In 2016, WHO developed a global response strategic framework to ensure that zika virus is a priority and accelerated area of public health research. This study conducted in Bouaké (Côte d'Ivoire) is part of this framework. The main objective was to assess the knowledge and attitudes of health workers working there on the zika virus disease in order to consider a better preparation and response to a possible epidemic in Côte d'Ivoire. Cross-sectional study covering the period from October 2016 to March 2017 was used here. The sampling was comprehensive and included interviews with 258 persons. Subjects were interviewed using a questionnaire edited and adapted from the CAP questionnaire developed by WHO in 2016. People with prior knowledge of the zika virus disease represented 66.3% of the health workers surveyed. Their level of knowledge was insufficient in 83.5% of cases. Their attitudes were good in 51.5% of cases. In the authors' final model, the exercise structure which was adjusted to the level of education and the corporation significantly influenced health workers' attitudes toward illness. Health workers in public settings appeared to have a better attitude compared to their private colleagues (adjusted OR = 4.88; CI: 2.37-10.03; p-value:0.000). The zika virus disease has attracted the attention of the medical community during the 2014-2016 period. This attention, while mitigated by the West African Ebola virus epidemic, deserves to be highlighted.

Transmission of respiratory viruses when using public ground transport: A rapid review to inform public health recommendations during the COVID-19 pandemic

In response to the COVID-19 pandemic, numerous countries worldwide declared national states of emergency and implemented interventions to minimise the risk of transmission among the public. Evidence was needed to inform strategies for limiting COVID-19 transmission on public transport. On 20 March 2020, we searched MEDLINE, CENTRAL, Web of Science and the World Health Organization's database of 'Global research on coronavirus disease (COVID-19)' to conduct a rapid review on interventions that reduce viral transmission on public ground transport. After screening 74 records, we identified 4 eligible studies. These studies suggest an increased risk of viral transmission with public transportation use that may be reduced with improved ventilation. International and national guidelines suggest the following strategies: keep the public informed, stay at home when sick, and minimise public transport use. Where use is unavoidable, environmental control, respiratory etiquette and hand hygiene are recommended, while a risk-based approach needs to guide the use of non-medical masks

The role of nutrition in strengthening immune system against newly emerging viral diseases: case of SARS-CoV-2

The immune system is involved in the protection of host against environmental agents such as pathogenic micro-organisms (bacteria, fungi, and viruses) and chemicals, thereby preserving the integrity of the body. To preserve organism defense mechanisms, adequate nutritional status should be maintained with appropriate intakes of calories, vitamins, minerals and water that should be continuously provided by a healthy diet. The emergence of new infectious diseases with new pathogenic properties constitutes a serious health issue worldwide. Severe acute respiratory syndrome (SARS) represents one of the most recent emerging infectious diseases, caused by a novel coronavirus member called (SARS-CoV-2), identified in Wuhan, Hubei, China in December 2019, and recognized as pandemic by the World Health Organization (WHO). The nutritional status of each COVID-19-infected patient should be assessed prior undertaking treatments. Nutritional support should be the basis of management of any infected individual. However, prevention measures remain the first priority and strategy to develop throughout proper hygiene, healthy diet and staying home

A Review of Hepatitis C Virus (HCV) and the Current Management of Genotype 1 Chronic HCV Infection

Chronic Hepatitis C virus (HCV) is the primary cause of cirrhosis; hepatocellular carcinoma (HCC); and end- stage liver disease. The addition of protease inhibitor with peginterferon alfa and ribavirin (triple therapy) for genotype 1 infected patients; are the current standard of care.Method: Data was sourced from available journals and internet based search using pubmed; medline and google search.Results: successful Treatment of Genotype 1 HCV infected patients with protease inhibitor based triple therapy has improved sustained virologic response (SVR) rates and treatment induced clearance of HCV infection.Conclusion: significant progress in the management of chronic hepatitis C genotype 1 with the introduction of protease inhibitor (PI) in 2011 with peginterferon and ribavirin has optimized sustained virologic response (SVR)

Viral Infections In Children Receiving Anticancer Chemotherapy

OBJECTIVE: To determine the presence of bacterial and viral infectious agents in children with fever during anticancer chemotherapy. DESIGN: Analysis of data obtained during a prospective cohort study. SETTING: The pediatric oncology unit of Tygerberg Children's Hospital; Cape Town. SUBJECTS: All patients up to the age of 15 years who deve- loped fever secondary to anticancer chemotherapy from February 9th 2000 to April 9th 2001. OUTCOME MEASURES: Viruses were isolated or antigens detected on venous blood samples; nasopharyngeal aspirates; throat swabs; urine and feces where possible. Blood for aerobic and anaerobic culture was obtained from an indwelling intravenous catheter and/or a peripheral vein. RESULTS: Thirty-four children were analyzed for a total of 102 febrile episodes. The absolute neutrophil count on admission was below 0.5*109/L in 57 (56) episodes and thus considered neutropenic. Thirty-five viral isolates were identified in 31 (30) febrile episodes: HSV-1 (n=14); HSV-2 (n=2); CMV (n=10); rotavirus (n=5); adenovirus (n=2); Para influenza type 3 (n=1) and hepatitis B (n=1). The blood culture was positive in 24 (24) febrile episodes. Within these; a combined viral and bacterial infection was demonstrated in 6 (6) episodes. Infections were more frequent in neutropenic compared to non-neutropenic episodes; however; this was not significant. CONCLUSIONS: Viral infections clearly are an important cause of fever in children receiving anticancer therapy and may occur together with a bacterial infection. Diagnostic tests for viral infections should be used more frequently and could be of considerable value in evaluating fever and establishing appropriate treatment in these patients