South African Journal of Child Health - Volume 2, Issue 2, 2008
Volume 2, Issue 2, 2008
Author Nonhlanhla P. KhumaloSource: South African Journal of Child Health 2 (2008)More Less
In the very first issue of the South African Journal of Child Health (SAJCH) in March 2007 we attempted to justify starting yet another medical journal to join the plethora of world medical literature. In a country where children constitute the majority of our population of over 40 million, the lack of a peer-reviewed paediatrics journal was long overdue. Most people would not argue against the need for peer-reviewed journals to publish high-quality manuscripts that not only report and stimulate original research but ultimately improve patient care.
Author George SwinglerSource: South African Journal of Child Health 2, pp 36 –37 (2008)More Less
Every year more than 10 million children die before they turn 5, and African children have the best chance of doing so. Thirty of the 31 countries globally with the highest mortality rates are in sub-Saharan Africa. How do we respond to that? We may think that research is a luxury when African health resources are so limited, but the more limited the available resources, the more research evidence is needed to guide hard choices on how to use those resources. Unfortunately African and other low- and middle-income countries have less of a research evidence base than industrialised countries on which to draw, and African children seem to have been systematically ignored even by the countries in which they live.
Author A. VenterSource: South African Journal of Child Health 2 (2008)More Less
In September 1996, just over ten years ago, I moved to Bloemfontein as the new Head of the Department of Paediatrics and Child Health there. The Department happened to be the host of the SAPA Congress that year, and the Congress was to be held in the Medical School of the University of the Free State.
Child PIP : making mortality meaningful by using a structured mortality review process to improve the quality of care that children receive in the South African health systemSource: South African Journal of Child Health 2, pp 38 –42 (2008)More Less
The Child Healthcare Problem Identification Programme (Child PIP) uses the mortality review process to assess the quality of care that children receive in the South African health system, and to suggest solutions for improvement. This paper describes the origins, growth and development of Child PIP over the last 5 years, and provides an overview of the findings and recommendations to date.
Source: South African Journal of Child Health 2, pp 43 –45 (2008)More Less
Introduction. Hepatitis A is a vaccine-preventable infection, common in children in the Western Cape.
Objectives. To describe childhood hepatitis A morbidity and mortality at Tygerberg Children's Hospital, a level two and three referral hospital in the Western Cape, South Africa.
Methods. Serological tests with positive hepatitis A IgM were identified from the Tygerberg Hospital virology laboratory database from 2001 to 2004. Medical records were reviewed if identified sera came from children younger than 13 years. The cases were cross-referenced with the paediatric gastroenterology database. Data collected included demographics, clinical and laboratory information, outcome, notification and primary prophylaxis.
Results. 184 subjects were identified, comprising 117 males and 67 females with a median age of 69 (range 5 - 152) months. Two patients had hepatic failure and both died. Ten (5%) had known hepatitis A contacts but received no post-exposure prophylaxis, and only 31 (17%) were notified. A small percentage of patients were also positive for hepatitis B, hepatitis C and HIV. The median population incidence of serologically proven hepatitis A infection was 45.4/100 000/year, higher than the 20/100 000 advocated as a threshold for introducing vaccination into the immunisation schedule.
Limitations. Incidence data calculated from prospective studies are usually more reliable than those from retrospective studies.
Conclusions. This study confirms that hepatitis A is a serious risk to young children in the Western Cape, with significant morbidity and mortality. In addition, a sizeable number of cases were preventable. In order to determine the burden of disease and make recommendations about vaccination, the national incidence of hepatitis A must be assessed.
Source: South African Journal of Child Health 2, pp 46 –49 (2008)More Less
Aim. To review the surgical management of sialorrhoea (submandibular duct transposition with or without bilateral excision of the sublingual salivary glands : the 'drooling procedure', DP) at Red Cross War Memorial Children's Hospital, Cape Town.
Patients and methods. A retrospective review of the medical records of patients who had undergone a DP between 1996 and 2003, to ascertain the results of the procedure and complications. Subsequently a questionnaire was sent to all patients with a recognisable postal address to ascertain long-term satisfaction with the procedure.
Results. Forty-six patients had had a DP, and 32 of the medical records were available for analysis. In 23 cases a comment had been recorded on the result of the procedure; 18 (78%) had shown 'marked' improvement and 5 (22%) 'a little' improvement. The medical records indicated that 2 patients had had immediate postoperative problems : one patient was slow to commence oral feeding and another required a single high dose of intravenous steroids to resolve marked oedema of the floor of the mouth. In the longer term, one patient developed a ranula (a mucus inclusion cyst). Ten postal questionnaires, were returned; of these 8 reported an improvement in the symptoms.
Discussion. Short-term improvement was recorded in 78% of patients, and although only 10 questionnaires were returned, 8 of these indicated satisfaction with the procedure. It is impossible to draw conclusions, however, as the large number of patients (36 of the original 46) lost to follow-up could have had a poor outcome. There is need for prospective studies on the long-term outcome of the DP.
Source: South African Journal of Child Health 2, pp 50 –54 (2008)More Less
Introduction. Continuous noise exposure is potentially harmful to infants' auditory systems and wellbeing. Although the effects of noise on infants in a neonatal intensive care unit (NICU) have been well researched overseas, limited studies have been conducted in South Africa.
Aim. To conduct a detailed noise assessment in a state hospital NICU in the Cape metropole.
Study design and setting. Non-experimental descriptive design involving measurement, analysis and description of the noise levels and events in the NICU, Tygerberg Children's Hospital, Western Cape.
Method. Noise levels were measured over two 12-hour periods in both NICU rooms, during which observations were made to identify the sources and frequency of occurrence of NICU noises. Measurements of sound decay were made to determine whether the noise levels were a result of direct noise or reverberant noise from room reinforcements.
Results. Noise levels ranged from 62.3 to 66.7 dBA (LAeq), which exceeds American and British NICU standards (50 - 60 dBA). Staff conversations were the largest single contributor to the number of noise events. The largest single non-human contributor was monitor alarm noise. The NICU was found to be an extremely reverberant environment, suggesting that high noise levels were largely a result of reverberant room reinforcements.
Conclusion. Results highlight the need for noise reduction, which is vital to optimise newborn care, reduce acoustic trauma risks and enhance the infants' wellbeing and physiological stability in the NICU. Moreover, it is especially important to limit NICU noise levels in developing countries as premature infants in the NICU are often at increased risk for developing noise-induced sensorineural hearing loss as a result of NICU noise exposure and / or treatment with ototoxic medication and are often not routinely screened for hearing loss.
Recommendations. Practical suggestions for noise reduction in the NICU are made.
Source: South African Journal of Child Health 2, pp 56 –57 (2008)More Less
A 13-year-old girl presented to the surgical clinic at Ngwelezane Hospital with a 6-year history of a slowly growing, painless mass in her right groin. Her mother associated the growth of this mass with an earlier sharp injury to the child's groin. She had no significant previous medical history.
Author Miriam AdhikariSource: South African Journal of Child Health 2 (2008)More Less
The title of this book conveys exactly what it aims to achieve. The approach, as in all the manuals of the Perinatal Education Programme, is a simple and direct one that deals clearly with the various aspects of primary newborn care. Using the case study method with relevant questions around each clinical situation is a sound educational technique.
Source: South African Journal of Child Health 2, pp 58 –87 (2008)More Less
Allergy Society of South Africa (ALLSA)
Paediatric Neurology and Developmental Association of Southern Africa (PANDA)
South African Association of Paediatric Surgeons (SAAPS)
South African Children's Cancer Study Group (SACCSG)
JOINT South African Paediatric association (SAPA) Union of National African Paediatric Societies and Associations (UNAPSA)
South African Children's Cancer Study Group (SACCSG) South African Association of Paediatric Surgeons (SAAPS) combined session