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The South African (SA) guidelines for cardiac patients for non-cardiac surgery were developed to address the need for cardiac risk assessment and risk stratification for elective non-cardiac surgical patients in SA, and more broadly in Africa.
The
...
guidelines were developed by updating the Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment
and Management for Patients Who Undergo Non-cardiac Surgery, with a search of literature from African countries and recent publications. The updated proposed guidelines were then evaluated in a Delphi consensus process by SA anaesthesia and vascular surgical experts.
The recommendations in these guidelines are:
1. We suggest that elective non-cardiac surgical patients who are 45 years and older with either a history of coronary artery disease, congestive cardiac failure, stroke or transient ischaemic attack, or vascular surgical patients 18 years or older with peripheral vascular disease require further preoperative risk stratification as their predicted 30-day major adverse cardiac event (MACE) risk exceeds 5%
(conditional recommendation: moderate-quality evidence).
2. We do not recommend routine non-invasive testing for cardiovascular risk stratification prior to elective non-cardiac surgery in adults (strong recommendation: low-to-moderate-quality evidence).
3. We recommend that elective non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease should have preoperative natriuretic peptide (NP) screening (strong recommendation: high-quality evidence).
4. We recommend daily postoperative troponin measurements for 48 - 72 hours for non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease, i.e. (i) a baseline risk >5% for MACE 30 days after elective surgery (if no preoperative NP screening), or (ii) an elevated B-type natriuretic peptide (BNP)/N-terminal-prohormone B-type natriuretic peptide (NT-proBNP) measurement before elective surgery (defined as BNP >99 pg/mL or a NT-proBNP >300 pg/mL) (conditional recommendation: moderate-quality evidence).
Additional recommendations are given for the management of myocardial injury after non-cardiac surgery (MINS) and medications for comorbidities.
more
Health Care Resource Utilization in Adults Living With Type 1 Diabetes Mellitus in the South African Public Health Sector: Protocol for a 1-Year Retrospective Analysis With a 5-, 10-, and 25-Year Pro
Bhana, S.; Naidoo, P.; Pillay, S.; et al.
Jornal of Medical Internet Research JMIR Publication Published on 13.2.2023 in Vol 12 (2023)
(2023)
CC
Type 1 diabetes mellitus (T1DM) is less common than type 2 diabetes mellitus but is increasing in frequency in South Africa. It tends to affect younger individuals, and upon diagnosis, exogenous insulin is essential for survival. In South
...
Africa, the health care system is divided into private and public health care systems. The private system is well resourced, whereas the public sector, which treats more than 80% of the population, has minimal resources. There are currently no studies in South Africa, and Africa at large, that have evaluated the immediate and long-term costs of managing people living with T1DM in the public sector.
more
20 YEARS OF STRATEGIC HIV AND PUBLIC HEALTH DATA . beThe completion of the 6th South African National HIV Prevalence, Incidence and Behaviour Survey (SABSSM) report, coincides with the celebration of 30 years of democracy in South Africa; and marks
...
20 years of conducting nationally representative household-based surveys by the Human Sciences Research Council (HSRC), its collaborators and donors. Since its inception in 2002, the SABSSM series has emerged as one of the HSRC’s leading scientific contributions to the country’s HIV and AIDS response (1), providing essential data to monitor the HIV epidemic, the impact of the HIV program in South Africa, and to inform strategies for epidemic control in the National Strategic Plan for HIV, TB and STIs (NSP), now in its fifth edition. Using scientific evidence from SABSSM and other key sources, the NSP guides the country’s response, under the leadership of the South African AIDS Council (SANAC) and the National Department of Health (NDoH), with focus on equitable access to biomedical interventions, addressing the structural and social behavioural drivers of the epidemic, and targeting populations disproportionately affected by HIV; such as, black Africans, key populations and adolescent girls and young women (AGYW) aged 15–24 years (2).
more
NLM Launches Emergency Access Initiative, Granting Free Access to Books and Journals for Healthcare Professionals Fighting Ebola Outbreak. The National Library of Medicine (NLM) Emergency Access Initiative (EAI) has been activated to support healthcare professionals working on the Ebola public healt
...
h emergency in West Africa.
more
Practical recommendations to the attention of healthcare professionals and health authorities regarding the identification of and care delivered to suspected or confirmed carriers
Superior Health Council
(2014)
of highly contagious viruses (of the Ebola or Marburg type) in the context of an epidemic outbreak in West Africa
The scale of West Africa’s Ebola epidemic has been attributed to the weak health systems of affected countries,
their lack of resources, the mobility of communities and their inexperience in dealing with Ebola. This briefing for African Affairs a
...
rgues that these explanations lack important context. The briefing examines responses to the outbreak and offers a different set of explanations, rooted in the history of the region and the political economy of global health and development. To move past technical discussions of “weak” health systems, it highlights how structural violence has contributed to the epidemic. As part of this, local people – their beliefs, concerns and priorities – have been marginalised. Both the crisis response and post-Ebola ‘reconstruction’ will be strengthened by acknowledgment of its long term structural underpinnings and from a more collaborative inclusion of local people.
more
Ebola Outbreak in West Africa: Impact on Health Service Utilisation in Sierra Leone
Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited inf
...
ormation on the prevalence of BU–HIV coinfection. Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
more
Nigeria is Africa’s most populous nation and accounts for nearly one quarter of the continent’s maternal, newborn and child deaths. In the spirit of the global Countdown to 2015 for Maternal, Newborn and Child Health and the Nigerian Saving One
...
Million Lives Initiative, these state data profiles have been designed to prompt and inform policy and programme action.
Without data there can be no accountability. Without accountability we risk making no progress for Nigeria’s women and children. The data included in these profiles come mainly from large-scale, periodic household surveys. Continued efforts are needed to strengthen civil registration, vital statistics and health management information systems, as well as the institutional capacity to gather and use these data.
Updated from 2011, these data profiles can be used to compare progress in different areas, identify opportunities to address specific coverage gaps, and monitor implementation.
more
Uganda is Africa's largest refugee-hosting country and ranks fifth globally. Over the decades, Uganda has hosted refugees from nations including South Sudan, the Democratic Republic of Congo, Eritrea, Somalia, Sudan, Burundi, and Rwanda. As of early
...
2024, it hosts 1 600 000 refugees, primarily in refugee settlements in northern and southwestern Uganda, and in Kampala City. Thirteen districts accommodate 94% of these refugees.
The World Health Organization (WHO) and Uganda’s Ministry of Health conducted a joint review mission to provide a comprehensive overview of the health system's response. The aim was to understand service delivery challenges and identify opportunities to further support Uganda in strengthening health system capacity and ensuring continued access to health services for refugees, migrants and host communities.
more
The Zambia Civil Society and Communities. CCM Shadow Report
Phiri, F., F. Mwanza, and C. Mulwanda
Eannaso; The Global Fund; AIDS Accountability, et al.
(2017)
CC
The Anglophone Africa Civil Society and Communities CCM Shadow Report and Scorecard Initiative
WHO Regional Office for Africa
Community feedback considered in this report was collected through information received from Community Engagement and Accountability (CEA) focal points,as well as through primary data collection,in 10 African countries.Red Cross and Red Crescent National Society CEA focal points were asked to share
...
the main rumours, observation, beliefs, questions or suggestions they are hearing in their countries andto grade them according to their frequency. Focal points from the following countries provided information this way: Botswana, Burundi, Cameroon, Niger, South Africa.
more
As informações comunitárias consideradas no presente relatório foram obtidas através dos dados fornecidos pelos pontos focais de participação e responsabilização comunitárias (Community Engagement and Accountability–CEA), bem como através da recolha de dados primários, em dezpaíses af
...
ricanos.Os pontos focais de CEA das Sociedades Nacionais da Cruz Vermelha e do Crescente Vermelho foram convidados a partilhar os principais rumores, comentários, crenças, perguntas ou sugestões registados nos seus países e a classificá-los em função da respetiva frequência. Os pontos focais dos países enumerados abaixo forneceram informações desta forma: Botsuana, Burundi, Camarões, Níger, África do Sul.
more
Medical Learning Hub
recommended
Medical Learning Hub is a product of Tech Care for All, a social impact company that owns and commercializes digital health solutions across Africa and Asia.
Eastern and Southern Africa
The Lab identifies, develops, and launches sustainable finance
instruments that can drive billions to a low-carbon economy. The
2019 Global Lab Cycle targets four specific sectors across
mitigation and adaptation: blue carbon in marine & coastal
ecosystems; sustainable agriculture for smallholde
...
rs in West and
Central Africa; sustainable energy access; and sustainable cities
more
New Drugs for Human African Trypanosomiasis: A Twenty First Century Success Story
Dickie, E.A.; Giordani, F.; Gould, M.K.; Mäser, P.; Burri, C.; Mottram, J.C.; Rao, S.P.S.; Barrett, M.P.
MDPI Tropical Medicine and Infectious Disease
(2020)
CC2
The twentieth century ended with human African trypanosomiasis (HAT) epidemics raging across many parts of Africa. Resistance to existing drugs was emerging, and many programs aiming to contain the disease had ground to a halt, given previous succes
...
s against HAT and the competing priorities associated with other medical crises ravaging the continent. A series of dedicated interventions and the introduction of innovative routes to develop drugs, involving Product Development Partnerships, has led to a dramatic turnaround in the fight against HAT caused by Trypanosoma brucei gambiense. The World Health Organization have been able to optimize the use of existing tools to monitor and intervene in the disease. A promising new oral medication for stage 1 HAT, pafuramidine maleate, ultimately failed due to unforeseen toxicity issues. However, the clinical trials for this compound demonstrated the possibility of conducting such trials in the resource-poor settings of rural Africa.
more
Gambiense human African trypanosomiasis is a deadly infectious disease affecting West and Central Africa, South Sudan and Uganda, and transmitted between humans by tsetse flies. The disease has caused several major epidemics, the latest one in the 1
...
990s. Thanks to recent innovations such as rapid diagnostic tests for population screening, a single-dose oral treatment and a highly efficient vector control strategy, interruption of transmission of the causative parasite is now within reach. If indeed gHAT has an exclusively human reservoir, this could even result in eradication of the disease. Even if there were an animal reservoir, on the basis of epidemiological data, it plays a limited role. Maintaining adequate postelimination surveillance in known historic foci, using the newly developed tools, should be sufficient to prevent any future resurgence.
more
Human African trypanosomiasis (HAT) is a lethal neglected tropical disease (NTD) transmitted by the bite of infected tsetse flies. The disease is also known as “sleeping sickness”. During the 20th century it caused enormous suffering in the endemic areas in sub-Saharan
...
Africa. HAT transmission last soared in the late 1990s, triggering a renewed, coordinated and very successful control effort. In this paper, we present achievements towards HAT elimination, with a focus on the WHO road map targets for 2020. In particular, reported cases continue to decline, from over 30,000 cases per year at the turn of the century to 663 cases in 2020. Despite the impact of the COVID-19 pandemic, HAT surveillance was largely sustained, and the network of health facilities able to diagnose and treat the disease further expanded. Looking to the future, the World Health Organization (WHO) set bold new targets for HAT in its 2021–2030 road map for NTDs, namely: the elimination of transmission of gambiense HAT, which occurs in western and central Africa, and the elimination as a public health problem of rhodesiense HAT, which is found in eastern and southern Africa. The strong commitment of national health authorities and the international community will be essential if these goals are to be achieved.
more
