There is advanced consensus on the anthropogenic roots of climate change. Extreme weather events, including storms of increased intensity or frequency, heatwaves, floods and droughts, as well as rising sea levels and crop failure, are among the most significant associated environmental and public health challenges. Such climate and environmental changes place at risk the fundamental human resources for health, such as shelter, clean water, air quality, and food security and quality. Environmental health practitioners (EHPs) have for decades played a critical role in monitoring and controlling the quality and health of the human environment. They now have an equally important role to play with regard to adaptation strategies and measures to protect communities against the challenges of climate variability at a grassroots level.
It was disconcerting, not to say frightening, to see that at the time of writing, only weeks after the launch of the national campaign of human papillomavirus (HPV) vaccination of grade 4 girls in South African (SA) public schools, a number of countries had put a moratorium on HPV vaccines. The Japanese government has done so more recently. Austria has rejected the inclusion of HPV in its vaccination schedule. The Green Party MPs at the European Parliament are preparing to call for a moratorium in France.
The evasive response of Apffelstaedt et al. with regard to the actual mammographic reporting methodology that forms the basis of their research highlights concerns reflected in our letter and raises clinical, ethical and scientific questions.
Once again the nation is outraged by the now familiar annual tale of how a number of initiates undergoing traditional male circumcision in several provinces have paid with permanent disability, or the ultimate penalty of death, for taking part in cultural practices that have outlived their value in today's South Africa. While we respect the rights of people to engage in culturally important initiation practices, it is unacceptable that every year during the winter months a large number of initiates continue to die or be maimed for life.
Cervical cancer, caused by human papillomavirus (HPV) infection, is highly prevalent in sub-Saharan Africa. The estimated annual incidence of cervical cancer is 35/100 000 women, with 22.5/100 000 associated deaths. This is in stark contrast to the 6.6/100 000 cases and 2.7/100 000 deaths reported in developed countries such as the USA, where HPV vaccination has been available since 2006.
The point-of-care (POC) GeneXpert MTB/RIF detects Mycobacterium tuberculosis (MTB) and drug resistance in under 2 hours and was hailed a 'game-changer' for tuberculosis (TB) control. Recent results from Evaluating a New Diagnostic Trial (EXTEND) show that while implementing the GeneXpert had more confirmations of TB than sputum microscopy, levels of loss to follow-up and mortality were not reduced in the GeneXpert group. These results are discouraging. However, GeneXpert was not used as a true POC service. Using the diagnostic at POC, where results are handed to patients at the time and place of sample collection, may yield different outcomes.
South Africa (SA)'s drug-susceptible (DS) tuberculosis (TB) 'tap' may have been turned down a few notches by the sustained HIV/AIDS testing and antiretroviral therapy (ART) campaign, but a growing number of dying, drug-resistant (DR) TB sufferers are desperately awaiting the approval of drugs known to be effective.
A nationally co-ordinated strategy is urgently needed to avoid the discharge of highly contagious 'therapeutically destitute' tuberculosis (TB) patients back into a careless void, with uniquely tailored solutions including home-based or community care, plus multidisciplinary teams in modern-day sanatoria.
Private healthcare organisations across the country are strategising on whether or when to take on the government, which has promulgated a law that effectively allows the Director-General of Health to tell their members where they can ply their trade or set up facilities and equipment.
The South African (SA) healthcare system is organised around the needs of just about every stakeholder except the patient, with a highly fragmented, 'siloed' approach where integrated care is the exception and not the rule, says Discovery Health CEO Jonny Broomberg.
Postmortem blows the whistle on the sometimes inhumane conditions in facilities meant to provide relief and care. Immense suffering results from mismanagement of systems and resources. The situation is worsening as doctors, afraid for their own mental and physical health, walk away from medicine.
It is with great sadness that the Department of Obstetrics and Gynaecology at the University of Cape Town announces the death on 12 July 2014 of Emeritus Professor Boet Dommisse, who headed the Department from 1991 until he retired in 1996. Boet was born in Cape Town and obtained his MB ChB from UCT in 1953, the same year he married his wife Anne.
The South African Menopause Society (SAMS) consensus position statement on menopausal hormone therapy (HT) 2014 is a revision of the SAMS Council consensus statement on menopausal HT published in the SAMJ in May 2007. Information presented in the previous statement has been re-evaluated and new evidence has been incorporated. While the recommendations pertaining to HT remain similar to those in the previous statement, the 2014 revision includes a wider range of clinical benefits for HT, the inclusion of non-hormonal alternatives such as selective serotonin reuptake inhibitors and serotonin noradrenaline reuptake inhibitors for the management of vasomotor symptoms, and an appraisal of bioidentical hormones and complementary medicines used for treatment of menopausal symptoms. New preparations that are likely to be more commonly used in the future are also mentioned. The revised statement emphasises that commencing HT during the 'therapeutic window of opportunity' maximises the benefit-to-risk profile of therapy in symptomatic menopausal women.
The current legislative framework in South Africa (SA) supports adoption as the preferred form of care for children with inadequate or no parental or family support. There are an estimated 3.8 million orphans in SA, with approximately 1.5 - 2 million children considered adoptable. As a means of improving services, newly drafted adoption guidelines from the National Department of Social Development will in future require both non-profit and private sector adoption agencies to obtain a medical report on a child prior to placement. However, no local guidelines specify what an appropriate medical examination entails or how it should be reported. For the purposes of proposing and developing such guidelines, an open forum was convened at the Institute of Pathology, University of Pretoria, in March 2013. These 'Recommendations for the medical evaluation of children prior to adoption in South Africa' emanate from this meeting.
Legislation concerning mandatory reporting of child abuse in South Africa has been in effect since 2010, with the promulgation of amendment 41 of 2007 to the Children's Act of 2005. This article explores mandatory reporting legislation in an attempt to improve the reporting practices of healthcare professionals in South Africa.
In a Texas case the court granted a husband an order for the removal of life support from his brain-dead pregnant wife after a hospital tried to keep her on it until the fetus was born. In South Africa the court would have issued a similar order, but for different reasons. Here, unlawfully and intentionally subjecting a pregnant corpse to life-support measures to keep a fetus alive against the wishes of the family would amount to the crime of violating a corpse.
Ebola virus disease (EVD) is one of the most feared diseases known to mankind. This is because of the high mortality rate (up to 90%) associated with the disease, and also its propensity for person-to-person spread through close contact with infected tissues and body fluids of affected persons, particularly in the unprotected home-care setting and during preparation of bodies for burial, while spread is amplified in hospitals with poor infection control practices. The disease has nevertheless remained rare since its initial description in 1976, with no more than 2 000 cases diagnosed before 2014. This is why the current outbreak of EVD in West Africa is of particular concern.