Southern African Journal of Infectious Diseases最新文献

{"title":"Colistin use in a carbapenem-resistant <i>Enterobacterales</i> outbreak at a South African neonatal unit.","authors":"Ilhaam Abrahams,&nbsp;Angela Dramowski,&nbsp;Kedisaletse Moloto,&nbsp;Lizel Lloyd,&nbsp;Andrew Whitelaw,&nbsp;Adrie Bekker","doi":"10.4102/sajid.v38i1.487","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.487","url":null,"abstract":"<p><strong>Background: </strong>Colistin is increasingly prescribed for neonates with carbapenem-resistant <i>Enterobacterales</i> (CRE) infections.</p><p><strong>Objectives: </strong>We described patient demographics, infection episodes, treatment and clinical outcomes, colistin related adverse events and relatedness of isolates in neonates with clinically confirmed or clinically suspected CRE infections.</p><p><strong>Method: </strong>The authors retrospectively reviewed culture-confirmed and clinically suspected culture-negative CRE infections at a South African neonatal unit during a CRE outbreak.</p><p><strong>Results: </strong>Fifty-three neonates (median gestational age 29 weeks and birth weight 1185 g) were included. Twenty-three of 53 neonates (43%) had culture-confirmed CRE (17 received colistin; 6 died without receiving colistin) and 30 (57%) received colistin for clinically suspected CRE infection but were ultimately culture-negative. Prior respiratory support and surgical conditions were present in 37/53 (70%) and 19/53 (36%) neonates, respectively. Crude mortality was high (20/53; 38%) with no significant difference between culture-confirmed CRE versus clinically suspected culture-negative CRE groups (10/23 [44%] vs 10/30 [33%]; <i>p</i> = 0.45). Hypomagnesaemia (10/38; 26%) and hypokalaemia (15/38; 40%) were frequent; acute kidney injury was rare (1/44; 2%). Three CRE infection clusters were identified by genotypic analysis of 20 available isolates (18 [90%] <i>bla</i> _NDM-1 [New Delhi metallo-beta-lactamase], 2 [10%] <i>bla</i> _OXA [oxacillinase]-48).</p><p><strong>Conclusion: </strong>Neonates receiving colistin therapy were predominantly preterm, with multiple risk factors for infection. Colistin-associated electrolyte derangement was frequent. Over one-third of neonates died. <i>Bla</i> _NDM-1 was the most frequent carbapenemase gene identified in the outbreak isolates.</p><p><strong>Contribution: </strong>Colistin was safely used during an <i>Enterobacterales</i> outbreak in predominantly premature and surgical neonates. The mortality was high.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"487"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9237809","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":"Performance of the school-based human papillomavirus vaccine uptake in Tshwane, South Africa.","authors":"Tladi D Ledibane,&nbsp;Neo R Ledibane,&nbsp;Moliehi Matlala","doi":"10.4102/sajid.v38i1.492","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.492","url":null,"abstract":"<p><strong>Background: </strong>Human papillomavirus (HPV) vaccine is an effective preventive measure against HPV infection and HPV-associated cervical cancer. South Africa introduced its HPV vaccination programme in 2014.</p><p><strong>Objectives: </strong>The authors assessed the uptake of HPV vaccine in the school-based HPV vaccination programme in Tshwane Health District for the year 2019 and compared the vaccine uptake (VU) between fee-paying and no-fee public schools.</p><p><strong>Method: </strong>The study method was cross-sectional, using routine electronic health records of the HPV vaccination programme. The study population included all Grade 4 school-girls between the ages of 9 and 14 years who attended public schools in 2019 in the Tshwane Health District.</p><p><strong>Results: </strong>The pooled VU for the Tshwane Health District was 72.0%, considerably lower than the target of 80.0%. The number of girls who received dose one and dose two in 2019 was 16 122 (73.0%) and 15 734 (71.0%), respectively, excluding the catch-up figures. In addition, 82.2% of fee-paying schools achieved VU of above 80% versus 65.5% of no-fee schools (<i>p</i> = 0.022).</p><p><strong>Conclusion: </strong>The lower than target levels of VU for HPV among girls in Tshwane Health District, particularly in those attending no-fee schools, is concerning. Interventions should be adopted to optimise programme performance so as to achieve the target VU of 80%.</p><p><strong>Contribution: </strong>This study showed the need to strengthen sensitisation and social mobilisation efforts, particularly among no-fee schools to improve the VU.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"492"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9252878","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":"Prevalence of <i>Staphylococcus</i> spp. from human specimens submitted to diagnostic laboratories in South Africa, 2012-2017.","authors":"Themba T Sigudu,&nbsp;James W Oguttu,&nbsp;Daniel N Qekwana","doi":"10.4102/sajid.v38i1.477","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.477","url":null,"abstract":"<p><strong>Background: </strong>Although staphylococci are commensals of the skin and mucosa of humans and animals, they are also opportunistic pathogens. Some coagulase-negative <i>Staphylococcus</i> spp. (CoNS), such as <i>S. haemolyticus</i> and <i>S. epidermidis</i>, are reported to be zoonotic.</p><p><strong>Objectives: </strong>The prevalence of coagulase positive (CoPS), CoNS and coagulase-variable <i>Staphylococcus</i> spp. isolated from human clinical cases in South Africa was investigated.</p><p><strong>Method: </strong>Retrospective records of 404 217 diagnostic laboratory submissions from 2012 to 2017 were examined and analysed in terms of time, place and person.</p><p><strong>Results: </strong>Of the 32 different species identified, CoPS were the most frequently isolated (74.7%), followed by CoNS (18.9%). Just over half (51.2%) of the <i>Staphylococcus</i> isolates were from males, while females contributed 44.8%. Patients aged 0-4 years contributed the most (21.5%) isolates, with the highest number coming from KwaZulu-Natal (32.8%). Urinary specimens accounted for 29.8% of the isolates reported. There was no variation in the number of <i>Staphylococcus</i> isolates reported in the autumn (25.2%), winter (25.2%), spring (25.1%) and summer (24.5%) seasons.</p><p><strong>Conclusion: </strong>This study demonstrated the diversity of <i>Staphylococcus</i> spp. isolated from humans and the magnitude of infection, with the most predominant species being <i>S. aureus</i> and <i>S. epidermidis.</i></p><p><strong>Contribution: </strong>Although most isolates were CoPS, the isolation of CoNS seen in this study suggests a need to improve infection control measures in a South African context. More research is needed to investigate the determinants of the observed variations in the study.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"477"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9237810","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":"Men's utilisation of sexual and reproductive health services in low- and middle-income countries: A narrative review.","authors":"Mpumelelo Nyalela,&nbsp;Thembelihle Dlungwane","doi":"10.4102/sajid.v38i1.473","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.473","url":null,"abstract":"<p><strong>Background: </strong>Men have poor access to sexual and reproductive health (SRH) services globally, particularly in low- and middle-income countries (LMICs). Nevertheless, in LMIC and high-income countries (HICs), low SRH utilisation happens on account of several factors, such as individual, health system-related, and sociocultural factors. Identifying and addressing men's SRH service underutilisation remains essential to improving their sexual health and averting higher mortality and early morbidity associated with poor health seeking behaviour (HSB) among men.</p><p><strong>Aim: </strong>This narrative review identifies factors influencing whether men do or do not utilise SRH services in LMICs.</p><p><strong>Setting: </strong>We report on articles published in LMICs: Africa, Asia and South America.</p><p><strong>Method: </strong>In this narrative review, we searched for quantitative and qualitative articles published between 2004 and 2021 from international databases, including Google Scholar, ScienceDirect, EBSCOhost, Scopus, PubMed, Medline, and reference lists of retrieved published articles.</p><p><strong>Results: </strong>A total of 2219 articles were retrieved, from which 36 met the inclusion criteria. Factors contributing to poor uptake of SRH services by men included: a lack of access and availability of SRH services, poor health-seeking behaviour among men, and SRH facilities not being perceived as 'male-friendly spaces'. Furthermore, our review reveals that decreased use of SRH services is attributed to factors such as a lack of focus on men's SRH.</p><p><strong>Conclusion: </strong>The current underutilised state of SRH services calls for urgent implementation of evidence-based interventions. Identifying men's SRH service inhibitors and enablers will assist programme managers and policymakers in designing SRH services tailored to their sexual health needs.</p><p><strong>Contribution: </strong>Despite numerous global interventions to motivate men, the findings provide insight into the underutilisation of SRH services. The study also reveals the inadequate comprehensive investigation of men's SRH service utilisation, especially older men, to comprehend men's problems fully. Further research needs to be conducted on SRH issues, including vasectomy, mental health, and chronic conditions related to sexual and reproductive health. The analysis can assist SRH policymakers and program managers in strengthening the policies to motivate men to engage better with SRH services.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"473"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9812381","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":"Intensive care unit nurses' knowledge, attitudes and practices of COVID-19 infection prevention and control.","authors":"Onga Bangani,&nbsp;René English,&nbsp;Angela Dramowski","doi":"10.4102/sajid.v38i1.478","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.478","url":null,"abstract":"<p><strong>Background: </strong>Intensive care units (ICUs) had to rapidly adapt infection prevention and control (IPC) practices during the coronavirus disease 2019 (COVID-19) pandemic.</p><p><strong>Objectives: </strong>To determine ICU nurses' COVID-19 IPC-related knowledge, attitudes, practices, and perceptions.</p><p><strong>Method: </strong>A mixed-methods study was conducted at the Groote Schuur Hospital ICU, Cape Town, South Africa (20 April 2021 and 30 May 2021). Participants completed anonymous, self-administered, knowledge, attitudes and practices (KAP) questionnaires. Individual interviews were conducted regarding nurses' lived experiences and perceptions of COVID-19 IPC in critical care.</p><p><strong>Results: </strong>In total, 116 ICU nurses participated (93.5% response rate) including 57 professional nurses (49%), 34 enrolled nurses (29%) and 25 enrolled nursing assistants (22%); young females (31-49 years) predominating (<i>n</i> = 99; 85.3%). Nurses' overall COVID-19 IPC knowledge scores were moderately good (78%); professional nurses had greater knowledge of COVID-19 transmission (<i>p</i> < 0.001). Intensive care unit nurses' attitude scores towards COVID-19 IPC were low (55%), influenced by limited IPC training, insufficient time to implement IPC and shortages of personal protective equipment (PPE). Respondents' scores for self-reported COVID-19 IPC practices were moderate (65%); highest compliance rates were for hand hygiene after touching patient surroundings (68%). Only 47% ICU nurses underwent N95 respirator fit-testing despite working in a COVID-19 ICU.</p><p><strong>Conclusion: </strong>Regular COVID-19 IPC training is needed to equip ICU nurses with the knowledge and skills to prevent healthcare-associated COVID-19 transmission. Enhanced IPC training and consistent PPE availability may support more favourable attitudes and better IPC practices. Comprehensive IPC and occupational health support should be offered to ensure ICU nurses' wellbeing during pandemics.</p><p><strong>Contribution: </strong>Enhanced IPC training and consistent PPE availability may support better attitudes and IPC practices.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"478"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10318607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817934","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":"Prescribing patterns of echinocandins in adult patients in a private hospital in Gauteng, South Africa.","authors":"Anja Grey,&nbsp;Rianda Joubert,&nbsp;Stephan Steyn,&nbsp;Marlene Julyan","doi":"10.4102/sajid.v38i1.470","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.470","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, the leading cause of invasive candidiasis and the fourth leading cause of hospital-acquired infections are the Candida species (spp.) group. One of the most important tools in fighting such drug-resistant fungi is the appropriate use of antifungal agents.</p><p><strong>Objectives: </strong>The study aimed to determine echinocandins' general prescribing patterns and how they are associated with the treatment period.</p><p><strong>Method: </strong>A quantitative, observational, and descriptive was used, and included patients receiving antifungal treatment in a private hospital in Gauteng, South Africa between 01 January 2015 to 31 December 2015.</p><p><strong>Results: </strong>Of the 146 patient files included, 102 patients (69.9%) received caspofungin and 44 patients (30.1%) were treated with anidulafungin. For the former, 99 (97.1%) patients received a loading dose (LD) of 70 mg, while 200 mg anidulafungin was only prescribed to 30 patients (68.2%). In line with maintenance dose guidelines, the majority (98.1%) of caspofungin-treated patients received 50 mg IV daily, whereas 4 (3.9%) patients were treated at higher doses (70 mg daily). Anidulafungin was administered at various maintenance doses, including 400 mg (2.3% of patients), 200 mg (52.3%), 100 mg (43.2%) and 50 mg (2.3%) IV daily.</p><p><strong>Conclusion: </strong>Our results can be utilised to produce a hospital-specific algorithm in terms of Candida-infected patients.</p><p><strong>Contribution: </strong>These findings contribute to our understanding of prescribing patterns of antifungal agents and the impact thereof on treating <i>Candida</i> spp. Infections.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"470"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10091186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9316209","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":"Ebola outbreak in Guinea, 2021: Clinical care of patients with Ebola virus disease.","authors":"Boyo C Pare,&nbsp;Alseny M Camara,&nbsp;Aminata Camara,&nbsp;Moussa Kourouma,&nbsp;Koivogui Enogo,&nbsp;Mohammed S Camara,&nbsp;Laurent Akilimali,&nbsp;Sayadi Sani,&nbsp;Eric Barte de Sainte Fare,&nbsp;Papys Lame,&nbsp;Nicolas Mouly,&nbsp;Marta Lado Castro-Rial,&nbsp;Billy Sivahera,&nbsp;Mahamoud S Cherif,&nbsp;Abdoul H Beavogui,&nbsp;Dally Muamba,&nbsp;Joachim B Tamba,&nbsp;Barry Moumié,&nbsp;Richard Kojan,&nbsp;Hans-Joerg Lang","doi":"10.4102/sajid.v38i1.454","DOIUrl":"https://doi.org/10.4102/sajid.v38i1.454","url":null,"abstract":"<p><strong>Background: </strong>Experience from the Zaire Ebolavirus epidemic in the eastern Democratic Republic of the Congo (2018-2020) demonstrates that early initiation of essential critical care and administration of Zaire Ebolavirus specific monoclonal antibodies may be associated with improved outcomes among patients with Ebola virus disease (EVD).</p><p><strong>Objectives: </strong>This series describes 13 EVD patients and 276 patients with suspected EVD treated during a Zaire Ebolavirus outbreak in Guinea in 2021.</p><p><strong>Method: </strong>Patients with confirmed or suspected EVD were treated in two Ebola treatment centres (ETC) in the region of N'zérékoré. Data were reviewed from all patients with suspected or confirmed EVD hospitalised in these two ETCs during the outbreak (14 February 2021 - 19 June 2021). Ebola-specific monoclonal antibodies, were available 2 weeks after onset of the outbreak.</p><p><strong>Results: </strong>Nine of the 13 EVD patients (age range: 22-70 years) survived. The four EVD patients who died, including one pregnant woman, presented with multi-organ dysfunction and died within 48 h of admission. All eight patients who received Ebola-specific monoclonal antibodies survived. Four of the 13 EVD patients were health workers. Improvement of ETC design facilitated implementation of WHO-recommended 'optimized supportive care for EVD'. In this context, pragmatic clinical training was integrated in routine ETC activities. Initial clinical manifestations of 13 confirmed EVD patients were similar to those of 276 patients with suspected, but subsequently non confirmed EVD. These patients suffered from other acute infections (e.g. malaria in 183 of 276 patients; 66%). Five of the 276 patients with suspected EVD died. One of these five patients had Lassa virus disease and a coronavirus disease 2019 (COVID-19) co-infection.</p><p><strong>Conclusion: </strong>Multidisciplinary outbreak response teams can rapidly optimise ETC design. Trained clinical teams can provide WHO-recommended optimised supportive care, including safe administration of Ebola-specific monoclonal antibodies. Pragmatic training in essential critical care can be integrated in routine ETC activities.</p><p><strong>Contribution: </strong>This article describes clinical realities associated with implementation of WHO-recommended standards of 'optimized supportive care' and administration of Ebola virus specific treatments. In this context, the importance of essential design principles of ETCs is underlined, which allow continuous visual contact and verbal interaction of health workers and families with their patients. Elements that may contribute to further quality of care improvements for patients with confirmed or suspected EVD are discussed.</p>","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"38 1","pages":"454"},"PeriodicalIF":0.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9900378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9389697","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":"Prevalence and clinical manifestations of Bancroftian filariasis in northern Taraba State, Nigeria","authors":"S. O. Elkanah, Deborah S. Elkanah, D. Akafyi, S. Kela, G. Anyanwu, A. Samaila","doi":"10.4102/sajid.v37i1.250","DOIUrl":"https://doi.org/10.4102/sajid.v37i1.250","url":null,"abstract":"","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":"1 1","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43254841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vitamin D status and COVID-19 severity","authors":"Senrina Kalichuran, S. V. van Blydenstein, M. Venter, S. Omar","doi":"10.4102/sajid.v37i1.359","DOIUrl":"https://doi.org/10.4102/sajid.v37i1.359","url":null,"abstract":"Background Age, body mass index (BMI) and pre-existing comorbidities are known risk factors of severe coronavirus disease 2019 (COVID-19). In this study we explore the relationship between vitamin D status and COVID-19 severity. Methods We conducted a prospective, cross-sectional descriptive study. We enrolled 100 COVID-19 positive patients admitted to a tertiary level hospital in Johannesburg, South Africa. Fifty had symptomatic disease (COVID-19 pneumonia) and 50 who were asymptomatic (incidental diagnosis). Following written informed consent, patients were interviewed regarding age, gender and sunlight exposure during the past week, disease severity, BMI, calcium, albumin, magnesium and alkaline phosphatase levels. Finally, blood was collected for vitamin D measurement. Results We found an 82% prevalence rate of vitamin D deficiency or insufficiency among COVID-19 patients. Vitamin D levels were lower in the symptomatic group (18.1 ng/mL ± 8.1 ng/mL) than the asymptomatic group (25.9 ng/mL ± 7.1 ng/mL) with a p-value of 0.000. The relative risk of symptomatic COVID-19 was 2.5-fold higher among vitamin D deficient patients than vitamin D non-deficient patients (confidence interval [CI]: 1.14–3.26). Additional predictors of symptomatic disease were older age, hypocalcaemia and hypoalbuminaemia. Using multiple regression, the only independent predictors of COVID-19 severity were age and vitamin D levels. The patients exposed to less sunlight had a 2.39-fold increased risk for symptomatic disease compared to those with more sunlight exposure (CI: 1.32–4.33). Conclusion We found a high prevalence of vitamin D deficiency and insufficiency among patients admitted to hospital with COVID-19 and an increased risk for symptomatic disease in vitamin D deficient patients.","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46499652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 death: A novel method of improving its identification when a patient has multiple diagnoses","authors":"N. Ngene, J. Moodley","doi":"10.4102/sajid.v37i1.349","DOIUrl":"https://doi.org/10.4102/sajid.v37i1.349","url":null,"abstract":"Assigning a primary cause of death to a deceased patient who had multiple principal diagnoses including coronavirus disease 2019 (COVID-19) is challenging because of the difficulty in selecting the most appropriate cause. To proffer a solution, the authors reviewed the literature on assigning a primary cause of death. In 2015, the Nnabuike-Jagidesa (NJ) model II was devised to improve the International Classification of Diseases and related health problems, 10th revision (ICD-10) guideline on how to assign a primary cause of death. The NJ model II stipulates that when there are multiple diagnoses with no plausible explanation that one of the illnesses could have resulted in the other clinical conditions, the single most appropriate primary cause of death is the condition with the highest case fatality ratio in that setting. In the index report, the authors opine that if the case fatality ratios are similar, the following objective criteria (listed in the order of priority) should be used to assign a primary cause of death: condition with the highest infection fatality ratio, condition that was the main indication for the last acute surgical or invasive procedure performed (during the course of the same ill-health) before the death and the disease that theoretically affects the highest number of body organs. Additionally, a clinical descriptor should be used when none of the objective criteria are satisfied. This novel approach, termed the modified NJ model II, is expected to improve the objectivity and reproducibility of the assigned primary cause of death in a deceased who had multiple diagnoses, which may include COVID-19.","PeriodicalId":44007,"journal":{"name":"Southern African Journal of Infectious Diseases","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2022-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47718905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}