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Pan Afr Med J ; 37: 148, 2020.
Article in English | MEDLINE | ID: covidwho-1022216


As coronavirus disease (COVID-19) cases continue to increase in Africa, healthcare workers (HCWs) have a high risk of being infected and the risks may be higher among those who work closely with patients. The risks of HCW infections can be mitigated with adequate precautions within healthcare facilities, especially with the use of personal protective equipment (PPE). We highlight and contextualise the findings of a Cochrane review on the type of PPE that protects best, the best way to put PPE on (donning) or to remove PPE (doffing) and how to train HCWs to use PPE. The review found low-certainty of evidence that full body PPE offer more protection, but HCWs may be faced with difficulty during donning and doffing. Following standard guidelines may be helpful in reducing infection and increasing compliance among HCWs. Video training and simulations may be better methods for training on the correct use of PPE than traditional methods of teaching. Countries must, therefore, ensure that HCWs undergo compulsory training on the correct use of PPE; regardless of their professional category. Of the 24 studies included in this review, none was conducted on the African continent. There is thus an urgent need for well conducted studies on the experiences of HCWs using full-body covering PPE within the African context. Such studies could lead to tailored interventions that will improve the proper use of PPE among HCWs.

Pan Afr Med J ; 35(Suppl 2): 119, 2020.
Article in English | MEDLINE | ID: covidwho-962486


There is currently no approved pharmaceutical product for the treatment of COVID-19. However, antibiotics are currently being used for the management of COVID-19 patients in many settings either treat to co-infections or for the treatment of COVID-19 itself. In this commentary, we highlight that the increased rates of antimicrobial prescribing for COVID-19 patients could further worsen the burden of antimicrobial resistance (AMR). We also highlight that though AMR is a global threat, Africa tends to suffer most from the consequences. We, therefore, call on African countries not to lose sight of the possible implications of the treatment of COVID-19 on AMR and a need to redouble efforts towards the fight against AMR while dealing with the pandemic.

Anti-Bacterial Agents/therapeutic use , Drug Resistance, Bacterial , Africa , Humans
BMJ Open ; 10(8): e039455, 2020 08 30.
Article in English | MEDLINE | ID: covidwho-737538


INTRODUCTION: The outbreak of the SARS-CoV-2 virus causing COVID-19, declared a global pandemic by the WHO, is a novel infection with a high rate of morbidity and mortality. In South Africa, 55 421 cases have been confirmed as of 10 June 2020, with most cases in the Western Cape Province. Coronavirus leaves us in a position of uncertainty regarding the best clinical approach to successfully manage the expected high number of severely ill patients with COVID-19. This presents a unique opportunity to gather data to inform best practices in clinical approach and public health interventions to control COVID-19 locally. Furthermore, this pandemic challenges our resolve due to the high burden of HIV and tuberculosis (TB) in our country as data are scarce. This study endeavours to determine the clinical presentation, severity and prognosis of patients with COVID-19 admitted to our hospital. METHODS AND ANALYSIS: The study will use multiple approaches taking into account the evolving nature of the COVID-19 pandemic. Prospective observational design to describe specific patterns of risk predictors of poor outcomes among patients with severe COVID-19 admitted to Tygerberg Hospital. Data will be collected from medical records of patients with severe COVID-19 admitted at Tygerberg Hospital. Using the Cox proportional hazards model, we will investigate the association between the survival time of patients with COVID-19 in relation to one or more of the predictor variables including HIV and TB. ETHICS AND DISSEMINATION: The research team obtained ethical approval from the Health Research Ethics Committee of the Faculty of Medicine and Health Sciences, Stellenbosch University and Research Committee of the Tygerberg Hospital. All procedures for the ethical conduct of scientific investigation will be adhered to by the research team. The findings will be disseminated in clinical seminars, scientific forums and conferences targeting clinical care providers and policy-makers.

Coronavirus Infections , Hospitalization , Hospitals , Pandemics , Pneumonia, Viral , Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/therapy , Coronavirus Infections/virology , Disease Outbreaks , Female , HIV Infections/complications , Humans , Male , Medical Records , Pneumonia, Viral/epidemiology , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Proportional Hazards Models , Prospective Studies , Public Health , Research Design , South Africa/epidemiology , Survivors , Tuberculosis/complications