South African Medical Journal - October 2023 Vol 113 No 10

Introduction

Prevention of vertical transmission of HIV in Khayelitsha, South Africa: A contemporary review of services after 20 years

It has been 20 years since Western Cape Province (WC), South Africa (SA), launched its first vertical transmission of HIV prevention (VTP) pilot programme in Khayelitsha, an urban township 50 km from Cape Town city  centre.  The  programme,  supported  by  Médecins  sans  Frontières,  provided  antenatal  voluntary  counselling  and  testing  in  primary  care  obstetric  facilities  with  short-course  zidovudine  (AZT)  from  36  weeks’  gestation.

Ocular manifestations of HIV infection at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

Since the initial description of ophthalmic disease in HIV-positive individuals more than 38 years ago, there have been many studies describing the spectrum of HIV-associated eye pathology.  In the pre-highly active antiretroviral therapy (HAART) era, HIV-related ocular disease was extremely common and estimated to affect 70 - 80% of HIV-infected patients at some point during their illness.  The  ocular  manifestations  of  HIV  are  protean  and  may  involve  the  adnexa,  as  well  as  the  anterior  and  posterior  segments  of  the  eye.  Anterior segment involvement includes tumours and external infections, while posterior segment involvement manifests as HIV retinopathy and opportunistic infections of the retina and the choroid.

Prevalence and outcome of acute kidney injury in burn victims at a tertiary centre in Cape Town, South Africa

Burn injuries are common worldwide, totalling 7.1 million injuries annually, with an estimate death toll of 250 000 patients worldwide.  Low- to middle-income countries (LMICs) account for 90% of this total, according to the latest epidemiological data. In these LMICs, burn injuries are usually associated with poor socioeconomic status, with flame burns accounting for the majority of burns in these populations.

Burn injuries in KwaZulu-Natal Province, South Africa: Quantifying the healthcare burden

Burn injuries are a significant contributor to global annual mortality and continue to be a leading cause of disability-adjusted life-years.  It is estimated that 300 000 lives are lost each year to burns, with millions of survivors experiencing persistent negative physical and psychological sequelae.  It is estimated that 70% of burn injuries occur in low- and middle-income countries (LMICs) and affect those of lower socioeconomic status disproportionally.  High-income countries (HICs) have experienced a significant decrease in mortality related to burn injuries through medical advancements in the second half of the 20th century, but LMICs have not seen the same results.

Impact of COVID-19 lockdown on low birthweight in Soweto, South Africa

In March 2020, the World Health Organization (WHO) declared the novel coronavirus (COVID-19) outbreak a global pandemic. Within a few months, the virus had spread across the globe, with over 5.5 million confirmed cases and 350 000 deaths by the end of May 2020.  Two years later, fuelled by five variants of concern (Alpha, Beta, Gamma, Delta and Omicron), there had been over 505 million confirmed cases and 6 million deaths. In order to limit the spread of the virus, governments across the globe implemented lockdowns of varying severity, restricted movement within and between   countries, implemented curfews, closed   schools   and   universities and suspended a large number of formal and informal social and economic activities.

Evaluation of the accuracy of the Asantéassay as a point-of-care rapid test for HIV-1 recent infections using serum bank specimens from blood donors in South Africa, July 2018 - August 2021

The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that the number of people living with HIV infection in South Africa (SA) is 7 500 000 (95% CI 7 000 000 - 8 200 000), and HIV incidence in SA is reported to be 4.19% (95% CI 3.74 - 4.67). UNAIDS announced the 90-90-90 strategy in 2014, which has now been revised to the 95-95-95 strategy, to end the AIDS epidemic by 2030 by achieving a target of 95% diagnosis among all people living with HIV, with 95% of those who have been diagnosed receiving antiretroviral treatment (ART) and 95% of those on treatment to be virally suppressed.

Outcomes of burns patients in a developing country: A single centre’s experience

Burns constitute a major public health problem, especially in low- and middle-income countries, where over 95% of all burn deaths occur, with Africa contributing 15% of global burn mortality. The consequences of burn injuries are not only limited to patients’ physical health: they also affect social, economic and physiological domains of a patient’s life. Most burns involving 25% of the total body surface area (TBSA) can be managed without critical care.  However, as the burn size increases above this point, especially in young, old, or medically frail patients, mortality increases sharply unless critical care support is provided.