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1.
Drug Safety ; JOUR:1171-1172, 45(10).
Article in English | EMBASE | ID: covidwho-2085698

ABSTRACT

Introduction: The South African Health Products Regulatory Authority (SAHPRA) utilises various AEFI reporting tools to monitor vaccine safety in the country. In 2020, SAHPRA in collaboration with the National Department of Health's (NDoH) Expanded Programme on Immunisation (EPI), joined the African Union Smart Safety Surveillance programme, as one of four pilot countries, to introduce an electronic adverse event following immunisation (AEFI) reporting system (Med Safety App) for healthcare professionals and consumers [1]. On 17/05/2021, the NDoH introduced its national COVID-19 vaccination programme. SAHPRA launched a microsite during 2021, to provide feedback to the public on AEFI with the COVID-19 vaccines. Objective(s): To provide an overview of COVID-19 vaccine safety surveillance and describe causality assessment outcomes for serious AEFI reported during the first year of COVID-19 vaccine administration. Method(s): All severe and/or serious AEFI are investigated by provincial EPI surveillance teams, followed by causality assessment conducted by the National Immunisation Safety Expert Committee (NISEC), using the World Health Organization (WHO) methodology [2]. Causality assessment outcomes are classified based on the final diagnoses determined during the assessment by NISEC according to WHO categories, seriousness, Medical Dictionary for Regulatory Activities (MedDRA) system organ class and patient demographics. Data were collected retrospectively from the SAHPRA COVID-19 AEFI microsite and the EPI national AEFI database. Result(s): By 01/04/2022, 33,063,221 COVID-19 vaccine doses had been administered, with 5 815 spontaneous AEFI reports (0.0173%) submitted. Of these, 2,571 (0.008%) were reported as serious. Spontaneous reporting of AEFI increased significantly compared to pre-COVID-19 vaccine introduction. The most frequently reported AEFIs were side effects already listed in the product information. No safety concerns were raised based on causality assessment outcomes for 273 serious cases analysed by 01/04/2022. Over two thirds of these cases were classified as coincidental (70.7%) as cardiac-, respiratory- or vascular disorders (MedDRA system organ class), with 12.1% classified as vaccine product related (see table below). The presentation will include all causality assessments conducted up to 31/08/2022, and more detailed information about causality assessed cases will be available in the public domain at the time of the conference and will be included in the presentation. Conclusion(s): Vaccine safety surveillance and monitoring trends of reported AEFI are vital measures to ensure that the benefits of immunisation are maintained in the interest of public health and efficient vaccination programmes. Transparent communication with the public is important to maintain public confidence in vaccines and prevent all AEFI being misinterpreted as caused by the vaccine.

2.
South African Geographical Journal ; 104(3):276-290, 2022.
Article in English | CAB Abstracts | ID: covidwho-2077330

ABSTRACT

South Africa is set to implement a universal health care system, called National Health Insurance (NHI). The country is plagued by inequality at various levels, and the NHI will attempt to provide more equitable access to health. A national online COVID-19 survey in 2020, measured respondents' favour or not of such a system. Multivariate logistic regression identified unique determinants of perception of NHI among urban residents (total respondents 12,682) in South Africa. Data were benchmarked using 2019 mid-year population estimates. Results showed that the majority (77.5%) of urban residents were in favour of NHI in South Africa. Furthermore, township (aOR = 1.36, 95% CI [1.10-1.69], p = 0.005) and informal settlement (aOR = 1.55, 95% CI [1.09-2.20], p = 0.016) residents were significantly more likely to be in favour of NHI than those residing in inner cities. This research sheds light on urban people's perception of the NHI system for South Africa. The findings showed, respondents were mostly in favour of the NHI. It is recommended that the question of NHI be repeated in future research, during a time when knowledge of the COVID-19 pandemic has broadened and to a population with more representative education levels.

3.
Drug Safety ; 45(10):1171-1172, 2022.
Article in English | ProQuest Central | ID: covidwho-2046196

ABSTRACT

Introduction: The South African Health Products Regulatory Authority (SAHPRA) utilises various AEFI reporting tools to monitor vaccine safety in the country. In 2020, SAHPRA in collaboration with the National Department of Health's (NDoH) Expanded Programme on Immunisation (EPI), joined the African Union Smart Safety Surveillance programme, as one of four pilot countries, to introduce an electronic adverse event following immunisation (AEFI) reporting system (Med Safety App) for healthcare professionals and consumers [1]. On 17/05/2021, the NDoH introduced its national COVID-19 vaccination programme. SAHPRA launched a microsite during 2021, to provide feedback to the public on AEFI with the COVID-19 vaccines. Objective: To provide an overview of COVID-19 vaccine safety surveillance and describe causality assessment outcomes for serious AEFI reported during the first year of COVID-19 vaccine administration. Methods: All severe and/or serious AEFI are investigated by provincial EPI surveillance teams, followed by causality assessment conducted by the National Immunisation Safety Expert Committee (NISEC), using the World Health Organization (WHO) methodology [2]. Causality assessment outcomes are classified based on the final diagnoses determined during the assessment by NISEC according to WHO categories, seriousness, Medical Dictionary for Regulatory Activities (MedDRA) system organ class and patient demographics. Data were collected retrospectively from the SAHPRA COVID-19 AEFI microsite and the EPI national AEFI database. Results: By 01/04/2022, 33,063,221 COVID-19 vaccine doses had been administered, with 5 815 spontaneous AEFI reports (0.0173%) submitted. Of these, 2,571 (0.008%) were reported as serious. Spontaneous reporting of AEFI increased significantly compared to pre-COVID-19 vaccine introduction. The most frequently reported AEFIs were side effects already listed in the product information. No safety concerns were raised based on causality assessment outcomes for 273 serious cases analysed by 01/04/2022. Over two thirds of these cases were classified as coincidental (70.7%) as cardiac-, respiratory- or vascular disorders (MedDRA system organ class), with 12.1% classified as vaccine product related (see table below). The presentation will include all causality assessments conducted up to 31/08/2022, and more detailed information about causality assessed cases will be available in the public domain at the time of the conference and will be included in the presentation. Conclusion: Vaccine safety surveillance and monitoring trends of reported AEFI are vital measures to ensure that the benefits of immunisation are maintained in the interest of public health and efficient vaccination programmes. Transparent communication with the public is important to maintain public confidence in vaccines and prevent all AEFI being misinterpreted as caused by the vaccine.

4.
2022 IST-Africa Conference, IST-Africa 2022 ; 2022.
Article in English | Scopus | ID: covidwho-2030553

ABSTRACT

The global spread of corona virus has had a significant impact on the basic education systems across the world. Nation states and various government departments had to invent means for remote schooling particularly to ensure continuation of learning amidst the pandemic. One of the widely used means of teaching and learning adopted across the world was the use of mobile technologies for remote learning and content sharing. This directly tested the teachers and learners' resilience in using mobile technologies for teaching and learning. A scoping literature review was conducted to identify technology and pedagogical factors which affected the use of technology for teaching and learning during 2020 school closure. The findings of the literature review identify access to mobile technologies, pedagogical factors like effective usage of technology for teaching and learning, and connectivity as the main barriers for schools in rural areas. Findings from this exercise are used as factors to be considered when building a resilience framework for introducing and using mobile technologies in South African rural schools. The purpose of undertaking such a task is to complete a continuous evaluation of the need to develop a resilience framework and guidelines for the introduction and use of mobile technologies in South African rural schools. © 2022 IST-Africa Institute and Authors.

5.
S Afr Med J ; 111(11): 1078-1083, 2021 11 05.
Article in English | MEDLINE | ID: covidwho-1534499

ABSTRACT

BACKGROUND: Estimates of prevalence of anti-SARS-CoV-2 antibody positivity (seroprevalence) for tracking the COVID-19 epidemic are lacking for most African countries. OBJECTIVES: To determine the prevalence of antibodies against SARS-CoV-2 in a sentinel cohort of patient samples received for routine testing at tertiary laboratories in Johannesburg, South Africa. METHODS: This sentinel study was conducted using remnant serum samples received at three National Health Laboratory Service laboratories in the City of Johannesburg (CoJ) district. Collection was from 1 August to 31 October 2020. We extracted accompanying laboratory results for glycated haemoglobin (HbA1c), creatinine, HIV, viral load and CD4 T-cell count. An anti-SARS-CoV-2 targeting the nucleocapsid (N) protein of the coronavirus with higher affinity for IgM and IgG antibodies was used. We reported crude as well as population-weighted and test-adjusted seroprevalence. Multivariate logistic regression analysis was used to determine whether age, sex, HIV and diabetic status were associated with increased risk for seropositivity. RESULTS: A total of 6 477 samples were analysed, the majority (n=5 290) from the CoJ region. After excluding samples with no age or sex stated, the model population-weighted and test-adjusted seroprevalence for the CoJ (n=4 393) was 27.0% (95% confidence interval (CI) 25.4 - 28.6). Seroprevalence was highest in those aged 45 - 49 years (29.8%; 95% CI 25.5 - 35.0) and in those from the most densely populated areas of the CoJ. Risk for seropositivity was highest in those aged 18 - 49 years (adjusted odds ratio (aOR) 1.52; 95% CI 1.13 - 2.13; p=0.0005) and in samples from diabetics (aOR 1.36; 95% CI 1.13 - 1.63; p=0.001). CONCLUSIONS: Our study conducted between the first and second waves of the pandemic shows high levels of current infection among patients attending public health facilities in Gauteng Province.


Subject(s)
Antibodies, Viral/immunology , COVID-19/epidemiology , SARS-CoV-2/isolation & purification , Adolescent , Adult , Age Distribution , Aged , Aged, 80 and over , COVID-19/immunology , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Prevalence , SARS-CoV-2/immunology , Sentinel Surveillance , Seroepidemiologic Studies , South Africa/epidemiology , Young Adult
6.
Open Public Health Journal ; 14(1):388-398, 2021.
Article in English | EMBASE | ID: covidwho-1511928

ABSTRACT

Introduction: People’s confidence in the health system's capability in managing the COVID-19 pandemic can determine public support, risk perceptions, and compliance to the required behaviors during the pandemic. Therefore, this paper investigated people’s perception of health system capability to manage the COVID-19 pandemic in different spatial areas across the country using data from an online survey. Methods: Multivariate logistic regression models were used to examine factors associated with people’s perception of the health system capability to manage the COVID-19 pandemic at the national and provincial levels. Spatial comparative analysis was conducted to contrast spatial density indicators of the number of hospitals, hospital beds, and ICU beds per given population across various provinces. Results: Findings showed that South Africans had low confidence in the health system capability, with only two in five (40.7%) reporting that they thought that the country’s health system was able to manage the COVID-19 pandemic. Sex and knowledge on COVID-19 were significantly associated with the people’s perception of the health system capability to manage the pandemic at the national level and in four of the nine provinces. Conclusion: Overall, the findings of this study clearly highlight challenges facing the country’s health system, both perceived or real, that needed to be addressed as part of the preparation for the COVID-19 pandemic. Timeous implementation of a countrywide National Health Insurance (NHI) system is now more critical than ever in improving healthcare outcomes of the South African population beyond the existence of the COVID-19 epidemic.

7.
S Afr Med J ; 110(10): 968-972, 2020 09 07.
Article in English | MEDLINE | ID: covidwho-1362733

ABSTRACT

The SARS-CoV-2 pandemic has challenged the provision of healthcare in ways that are unprecedented in our lifetime. Planning for the sheer numbers expected during the surge has required public hospitals to de-escalate all non-essential clinical services to focus on COVID-19. Western Cape Province was the initial epicentre of the COVID-19 epidemic in South Africa (SA), and the Cape Town metro was its hardest-hit geographical region. We describe how we constructed our COVID-19 hospital-wide clinical service at Groote Schuur Hospital, the University of Cape Town's tertiary-level teaching hospital. By describing the barriers and enablers, we hope to provide guidance rather than a blueprint for hospitals elsewhere in SA and in low-resource countries that face similar challenges now or during subsequent waves.


Subject(s)
Coronavirus Infections/diagnosis , Coronavirus Infections/therapy , Hospitals, University/organization & administration , Pneumonia, Viral/diagnosis , Pneumonia, Viral/therapy , Tertiary Care Centers/organization & administration , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Electronic Health Records/organization & administration , Emergency Service, Hospital/organization & administration , Humans , Intensive Care Units/organization & administration , Materials Management, Hospital , Pandemics , Patient Care Team , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Secondary Care Centers , South Africa/epidemiology
8.
S Afr Med J ; 111(5): 402-404, 2021 04 06.
Article in English | MEDLINE | ID: covidwho-1256983

ABSTRACT

The World Health Organization (WHO) has urged countries to conduct tuberculosis (TB) prevalence surveys to better understand the burden of TB and to enable the WHO to conduct global estimates. Until the report from the first-ever prevalence survey in South Africa (SA), the country had to rely on WHO estimates. The recently published report on the SA TB prevalence survey provides important estimates of the burden of TB disease as well as information on health-seeking behaviour. This review notes the key findings of the 2018 prevalence survey. The high prevalence of TB in SA continues to be a major cause for concern, and calls for a significantly improved response to reach the End TB targets set by the WHO.


Subject(s)
Patient Acceptance of Health Care/statistics & numerical data , Tuberculosis, Pulmonary/epidemiology , Adolescent , Adult , Age Distribution , Aged , Female , Health Surveys , Humans , Incidence , Male , Middle Aged , Prevalence , South Africa/epidemiology , Tuberculosis, Pulmonary/diagnostic imaging , Tuberculosis, Pulmonary/microbiology , Tuberculosis, Pulmonary/prevention & control , Young Adult
9.
S Afr Med J ; 110(12): 1168-1171, 2020 10 08.
Article in English | MEDLINE | ID: covidwho-948164

ABSTRACT

The COVID-19 pandemic has placed significant strain on the oxygen delivery infrastructure of health facilities in resource-constrained health systems. In this case report, we describe a patient with severe COVID-19 pneumonia who was managed with high-flow nasal oxygen for 40 days, with an eventual successful outcome. We discuss the oxygen delivery infrastructure needed to offer this intervention, as well as the psychosocial impact on those undergoing treatment.


Subject(s)
Anticoagulants/therapeutic use , COVID-19/therapy , Glucocorticoids/therapeutic use , Hypoxia/therapy , Oxygen Inhalation Therapy/methods , Oxygen/supply & distribution , Patient Positioning/methods , Psychosocial Support Systems , Anti-Bacterial Agents/therapeutic use , Anxiety/psychology , Anxiety/therapy , Blood Gas Analysis , COVID-19/blood , COVID-19/physiopathology , COVID-19/psychology , Cannula , Citalopram/therapeutic use , Counseling , Dexamethasone/therapeutic use , Disease Progression , Enoxaparin/therapeutic use , Factor Xa Inhibitors/blood , Female , Healthcare-Associated Pneumonia/complications , Healthcare-Associated Pneumonia/diagnosis , Healthcare-Associated Pneumonia/drug therapy , Hematoma/chemically induced , Humans , Hypoxia/blood , Hypoxia/physiopathology , Middle Aged , Oxygen Inhalation Therapy/psychology , Patient Care Team , Patient Positioning/psychology , Piperacillin, Tazobactam Drug Combination/therapeutic use , Prone Position , Psychiatry , Resilience, Psychological , SARS-CoV-2 , Serotonin Uptake Inhibitors/therapeutic use , Severity of Illness Index , Social Work Department, Hospital , Thigh , Treatment Outcome
10.
S Afr Med J ; 110(10): 973-981, 2020 08 26.
Article in English | MEDLINE | ID: covidwho-869268

ABSTRACT

The SARS-CoV-2 pandemic has presented clinicians with an enormous challenge in managing a respiratory virus that is not only capable of causing severe pneumonia and acute respiratory distress syndrome, but also multisystem disease. The extraordinary pace of clinical research, and particularly the surge in adaptive trials of new and repurposed treatments, have provided rapid answers to questions of whether such treatments work, and has resulted in corticosteroids taking centre stage in the management of hospitalised patients requiring oxygen support. Some treatment modalities, such as the role of anticoagulation to prevent and treat potential thromboembolic complications, remain controversial, as does the use of high-level oxygen support, outside of an intensive care unit setting. In this paper, we describe the clinical management of COVID-19 patients admitted to Groote Schuur Hospital, a major tertiary level hospital at the epicentre of South Africa's SARS-CoV-2 epidemic during its first 4 months.


Subject(s)
Coronavirus Infections/therapy , Hospitals, University/organization & administration , Pneumonia, Viral/therapy , Tertiary Care Centers/organization & administration , Adrenal Cortex Hormones/therapeutic use , Anticoagulants/therapeutic use , Antimicrobial Stewardship , Betacoronavirus , COVID-19 , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/psychology , Critical Care/organization & administration , Diabetes Complications , Humans , Intubation, Intratracheal , Medical Staff, Hospital/psychology , Oxygen Inhalation Therapy , Palliative Care , Pandemics , Patient Care Team , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/psychology , Respiration, Artificial , Risk Factors , SARS-CoV-2 , Social Support , South Africa/epidemiology
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