South African Family Practice最新文献

{"title":"Evaluation of the management of high-risk obstetric patients living with epilepsy: A retrospective study from KwaZulu-Natal, South Africa.","authors":"Sumeshni Birbal, Frasia Oosthuizen, Urisha Naidoo","doi":"10.4102/safp.v68i2.6223","DOIUrl":"10.4102/safp.v68i2.6223","url":null,"abstract":"<p><strong>Background: </strong>Epilepsy affects approximately 60 million individuals worldwide, with women comprising nearly 50% of the cases. Physiological changes during pregnancy can alter anti-epileptic drug (AED) pharmacokinetics and seizure thresholds, necessitating close therapeutic drug monitoring (TDM). Uncontrolled maternal seizures increase the risk of maternal morbidity, foetal hypoxia and miscarriage. Several AEDs have a known teratogenic potential, highlighting the importance of adherence to clinical guidelines to optimise maternal and foetal outcomes.</p><p><strong>Methods: </strong>A retrospective quantitative study was conducted at a high-risk obstetrics clinic in a public tertiary hospital in KwaZulu-Natal, South Africa, using clinical records from a 5-year period. Of 131 cases, N = 90 met the inclusion criteria. Data were extracted into Microsoft Excel® and analysed using SPSS® (v29). Descriptive and inferential analyses (chi-square, Fisher's exact, Spearman's correlation, Mann-Whitney U and logistic regression) were used to assess the associations between variables.</p><p><strong>Results: </strong>Sodium valproate was prescribed to 60% of patients in the cohort. Folic acid supplementation was documented in 70% of cases (n = 63). Sodium valproate use was significantly associated with polytherapy (p = 0.007). Therapeutic drug monitoring was performed in 56.7% of patients and prenatal ultrasounds in 67.8%. A strong correlation was observed between the total admission frequency and seizure-related admissions (Spearman's ρ = 0.74, p  0.001).</p><p><strong>Conclusion: </strong>The study identified gaps in care, including suboptimal AED selection, limited TDM, inconsistent ultrasound use, frequent polytherapy and increased admissions from poor seizure control. Addressing these may improve the safety and effectiveness of epilepsy management in pregnancy.Contribution: This study contributes novel, context-specific evidence on real-world epilepsy management during pregnancy. It identifies critical gaps in clinical practice, AED selection and therapeutic monitoring.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"68 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the President's Desk: Part 1, 2026.","authors":"Tasleem Ras","doi":"10.4102/safp.v68i1.6320","DOIUrl":"10.4102/safp.v68i1.6320","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"68 1","pages":"6320"},"PeriodicalIF":1.4,"publicationDate":"2026-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retrospective analysis of a surgical service in a rural district hospital in the Eastern Cape.","authors":"Jessica M Westwood, Jocelyn Park-Ross, Rowan Duys","doi":"10.4102/safp.v68i1.6226","DOIUrl":"10.4102/safp.v68i1.6226","url":null,"abstract":"<p><strong>Background: </strong>District hospitals (DHs) are essential providers of surgical care in low- and middle-income countries. Despite recommendations to strengthen DH surgical services, data on South African DH surgical capacity remain limited. This study describes the volume, scope and workforce of surgical services at a rural Eastern Cape DH over 7 years.</p><p><strong>Methods: </strong>A retrospective audit of all surgical procedures (January 2016-December 2022) was conducted using theatre register data. Patient demographics, procedure type and surgical provider were extracted to analyse trends in surgical volume, scope and workforce.</p><p><strong>Results: </strong>A total of 2616 operations were performed, predominantly in females (97%), with a median age of 25 years. Statistical process control analysis showed a significant upward shift in the mean monthly surgical volume from 27 to 41 procedures. The surgical scope expanded from 14 different types of procedures in 2016 to 25 in 2022, covering obstetrics, gynaecology, general surgery, orthopaedics and urology. Caesarean sections accounted for 82% of procedures. Family medicine registrars and specialists performed the highest number of procedures per person.</p><p><strong>Conclusion: </strong>Surgical services expanded in both volume and scope, demonstrating the capacity of district-level facilities to meet essential surgical needs.Contribution: This study provides rare longitudinal data on rural South African DH surgical services, highlighting the critical role of decentralised family medicine training and senior staffing in supporting surgical expansion and strengthening district-level care.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"68 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life and associated determinants of chronic pain among patients attending a primary healthcare clinic in Gqeberha: A cross-sectional study.","authors":"Kemi D Dele-Ijagbulu, Febisola I Ajudua, Busisiwe Cawe","doi":"10.4102/safp.v68i1.6218","DOIUrl":"10.4102/safp.v68i1.6218","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a major global health challenge that impairs quality of life through physical disability, psychological distress, and socioeconomic burden. Despite its prevalence, limited research examines its multidimensional impact in South African primary healthcare. This study evaluated the quality of life and factors influencing chronic pain in patients attending a primary healthcare clinic in Gqeberha, South Africa.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 208 adults with chronic pain attending Walmer 14th Avenue Clinic. Data were collected using the Brief Pain Inventory, capturing demographics, pain severity, interference, relief, and management. Descriptive statistics, bivariate analysis, and multivariable logistic regression were performed using SPSS v29.</p><p><strong>Results: </strong>Participants had a mean age of 50.2 years; most were female (71.6%). Back pain was most common (43.8%), while pelvic/groin pain was most severe. Pain relief was inadequate in 74% of participants, with 15.9% reporting none. Sleep was the most affected quality-of-life domain (72% interference). Predictors of higher pain interference included pain severity (p  0.001), pain relief (p = 0.003), marital status (p = 0.004), and employment status (p = 0.005). Disease-specific treatments and adjuvant therapies provided better relief than paracetamol, nonsteroidal anti-inflammatory drugs, or opioids.</p><p><strong>Conclusion: </strong>Severe pain and inadequate relief are prevalent in primary healthcare. Improving access to adjuvant and disease-specific therapies, as well as addressing socioeconomic factors, is thus essential for enhanced patient outcomes.Contribution: This study highlights the interplay between chronic pain, sociodemographic factors, and quality of life in South African primary care and underscores the need for tailored, multimodal, resource-sensitive pain management strategies to inform policy.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"68 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Looking back to look forward: Learning from past innovations in family medicine training.","authors":"Ian Couper, Jannie Hugo, Julia Blitz, Hoffie Conradie","doi":"10.4102/safp.v68i2.6249","DOIUrl":"10.4102/safp.v68i2.6249","url":null,"abstract":"<p><p>Under the leadership of the late Professor Sam Fehrsen, the Medunsa MPraxMed, which commenced in 1979, was an innovative programme offering doctors in South Africa the unique opportunity to be trained in family medicine within the context of their workplaces. This article describes its pedagogical approach that profoundly influenced a generation of family physicians. Eight shifts in learning arose out of the programme's development and iterative renewal. These included a focus on context and real-world application, greater autonomy for students with learning being focused on their needs, modelling the doctor-patient relationship in the educator-student relationship, facilitation of learning more than teaching, offering resources rather than courses, lecturers and students being co-learners and supporting reflective action. Most of the shifts in the Medunsa MPraxMed are now recognised as good educational practice underpinned by evidence, and are still necessary today.Contribution: Current postgraduate family medicine training programmes in South Africa and beyond are offered the opportunity to reflect on what they might learn from the past approaches of the Medunsa programme.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"68 2","pages":"e1-e6"},"PeriodicalIF":1.2,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12870159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived experiences of tuberculosis patients accessing treatment during COVID-19 in Zimbabwe.","authors":"Idah Moyo, Livhuwani Tshivhase, Limkile Mpofu","doi":"10.4102/safp.v68i1.6228","DOIUrl":"10.4102/safp.v68i1.6228","url":null,"abstract":"<p><strong>Background: </strong>Despite being a preventable and curable disease, tuberculosis (TB) remains one of the deadliest infectious diseases, responsible for over a million deaths worldwide. Global efforts to eradicate TB were disturbed by the emergence of the coronavirus disease 2019 (COVID-19). Zimbabwe was not exempt from the scourge of this pandemic. Like other healthcare services that were disrupted, TB care services were affected. The objectives of this study were to explore the lived experiences of TB patients as they accessed and continued TB treatment during the COVID-19 period in Zimbabwe.</p><p><strong>Methods: </strong>An interpretative phenomenological analysis (IPA) was conducted. Fifteen TB patients accessing care at the four most populated primary healthcare facilities in Zimbabwe were purposively sampled and participated in the study. The sample size of 15 participants was determined by data saturation. Interpretative phenomenological analysis steps were followed in the data analysis process.</p><p><strong>Results: </strong>Three themes emerged: psychological effects (anxiety, fear, unintended disclosure, stigma, discrimination); support systems (healthcare facility, family, community); and TB service delivery gaps (delayed diagnosis, poor follow-up and support, inadequate health education).</p><p><strong>Conclusion: </strong>The study established that the COVID-19 pandemic affected TB service delivery and support, and follow-up with TB clients was not done. Insights from this study are crucial for strengthening the country's preparedness and response to future epidemics.Contribution: To facilitate continuity of TB care services, it is critical for decision-makers to develop context-specific intervention strategies and preparedness plans for use during pandemics and other public health emergencies.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"68 1","pages":"e1-e7"},"PeriodicalIF":1.2,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12869799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paracetamol, pregnancy and law: What the Texas Tylenol case teaches SA doctors.","authors":"Suhayfa Bhamjee","doi":"10.4102/safp.v68i1.6262","DOIUrl":"10.4102/safp.v68i1.6262","url":null,"abstract":"<p><strong>Background: </strong>Recent litigation in the United States - specifically the Texas Attorney General's lawsuit against the makers of Tylenol - has reignited global concern over the safety of paracetamol use during pregnancy and its alleged link to neurodevelopmental disorders such as autism and attention deficit hyperactivity disorder (ADHD). Although South African clinical guidelines continue to endorse paracetamol as safe and essential during pregnancy, the legal implications of such international controversies warrant closer scrutiny.</p><p><strong>Methods: </strong>A narrative legal-ethical review was conducted, drawing on comparative legal frameworks, South African clinical guidelines and recent consensus statements. The article analyses the Texas Tylenol lawsuit, evaluates the evidentiary standards in South African versus US law and considers the ethical obligations of disclosure and risk communication. Sources include peer-reviewed literature, professional guidelines (e.g. Health Professions Council of South Africa [HPCSA] and South African Society of Obstetricians and Gynaecologists [SASOG]) and public health statements. No meta-analysis was performed.</p><p><strong>Results: </strong>The review found that while South African law requires a causal link for liability, international litigation can influence patient perceptions and clinical behaviour. South African guidelines continue to support paracetamol use in pregnancy, and adherence to these guidelines provides legal and ethical protection. However, practitioners may face increased patient anxiety, pressure to alter prescribing habits and the risk of defensive medicine. Ethical tensions arise between the duty to inform and the risk of fuelling misinformation.</p><p><strong>Conclusion: </strong>South African family practitioners must remain vigilant in their communication, documentation and reliance on evidence-based consensus.Contribution: By grounding clinical decisions in local guidelines and ethical reasoning, practitioners can navigate the challenges posed by global controversies while maintaining patient trust and legal defensibility.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"68 1","pages":"e1-e4"},"PeriodicalIF":1.2,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12869836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mastering your fellowship: Part 1, 2026.","authors":"Klaus B Von Pressentin, John M Musonda, Joyce Musonda, Gert Marincowitz, Selvandran Rangiah","doi":"10.4102/safp.v68i1.6209","DOIUrl":"10.4102/safp.v68i1.6209","url":null,"abstract":"<p><p>The series 'Mastering your Fellowship' provides examples of the question formats encountered in the written and clinical examinations, Part A of the FCFP (SA) examination. The series aims to help family medicine registrars (and supervisors) prepare for this examination. Model answers are available online.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"68 1","pages":"e1-e10"},"PeriodicalIF":1.2,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12869828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How being a mother has made me a better family physician.","authors":"Chantelle C Van der Bijl","doi":"10.4102/safp.v68i1.6212","DOIUrl":"10.4102/safp.v68i1.6212","url":null,"abstract":"<p><p></p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"68 1","pages":"e1-e2"},"PeriodicalIF":1.2,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12869801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tuberculosis prevention in children, adolescents, and pregnant and postpartum women in South Africa.","authors":"Mareike Rabe, Jennifer A Hughes","doi":"10.4102/safp.v68i1.6198","DOIUrl":"10.4102/safp.v68i1.6198","url":null,"abstract":"<p><p>Tuberculosis (TB), particularly drug-resistant TB (DR-TB), remains a major public health concern in South Africa (SA), with children, adolescents, and pregnant and postpartum women (CAPPW) facing heightened risks because of biological and social vulnerabilities. This article highlights the importance of a multipronged prevention framework that combines infection control measures, psychosocial support, education, and nutritional supplementation, alongside pharmacological interventions such as Bacillus Calmette-Guérin (BCG) vaccination and tailored TB preventive therapy (TPT). Drawing on national guidelines and recent academic literature, the article provides an overview of current evidence and recommendations for TPT regimens (including 6H, 3HP, 3RH, 4R, 12H, and 6LFX) and their eligibility, safety considerations, drug interactions, and formulations suitable for CAPPW. By strengthening awareness and streamlining guideline-based prevention efforts, the article equips healthcare workers to make informed, patient-centred decisions to improve treatment outcomes and ultimately reduce TB transmission in high-burden settings.</p>","PeriodicalId":22040,"journal":{"name":"South African Family Practice","volume":"68 1","pages":"e1-e6"},"PeriodicalIF":1.2,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12869830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}