Introduction

The South African Prostate Cancer Screening Guidelines

Prostate cancer (PCa) is the most widespread non-cutaneous cancer found in males and ranks as the fifth leading cause of death globally. In South Africa (SA), PCa is the predominant solid organ cancer detected, regardless of ethnic background, and its prevalence in southern Africa has increased by ~60% during the past 15 years. Black SA men typically receive a diagnosis at a more advanced stage and exhibit a higher histological grade compared with SA men of other ethnic backgrounds.

Cystic echinococcosis: The parasitic tale of a sinister cystic disease

Cystic echinococcosis (CE) is a zoonotic disease caused by the parasitic tapeworm Echinoccocosis granulosus sensu lato. It is endemic in South America, China, Turkey, India, Australia, and Middle and Eastern European countries, with prevalence rates of up to 10% in endemic populations. In Africa, the reported prevalence of CE is as low as 1.7%, a figure that grossly underestimates the disease burden. Similarly, there is a paucity of epidemiological data for South Africa (SA). Although Wahlers et al. conservatively estimated ~135 – 140 new cases of CE annually in SA, the same authors raised concerns after analysing data from the National Health Laboratory Service suggesting that annual numbers are steadily increasing. Since CE mainly affects the poorer and more disadvantaged population, cases are likely to be underdiagnosed and underreported, and the development of new drugs and other treatment modalities is slow.

Liver cystic echinococcosis: A retrospective study on the demographics and clinical profile of patients managed at a single tertiary institution in central Eastern Cape Province, South Africa

Hydatid disease, also known as cystic echinococcosis (CE), is a parasitic zoonotic infection caused by the tapeworm Echinococcus granulosus sensu lato. Dogs are the definitive hosts and humans the accidental hosts in the parasite life cycle. CE occurs worldwide and is endemic in China, India, Australia, Turkey, and Middle Eastern, South American and Eastern European countries, where the prevalence can reach 10%. There are an estimated 2 - 3 million cases; however, owing to a paucity of epidemiological studies, it is believed that prevalence rates are grossly underestimated in endemic areas. The World Health Organization has aimed to eliminate this disease by 2030. In South Africa (SA), there is a paucity of epidemiological data on CE, specifically CE of the liver, which is the most commonly affected organ. In 2011, Wahlers et al. conservatively estimated the burden of human CE infection in SA to be ~137 cases per year in eight of the nine provinces (KwaZulu-Natal was excluded). The present study aimed to describe the demographic and clinical profiles of patients with liver CE at a single tertiary hospital in Eastern Cape Province, SA.

Will South Africa meet the Sustainable Development Goals target for maternal mortality by 2030?

The Sustainable Development Goals (SDGs) agreed by most members of the United Nations (UN) in 2015 for achievement by 2030 set various targets for selected health outcomes. The SDG target for maternal mortality that countries are expected to reach by 2030 is no more than 70/100 000 live births. There is global concern that the early decline in maternal mortality has slowed. According to the UN, a pregnant woman dies from preventable causes every 2 minutes, with the global maternity mortality ratio in 2020 being 223 per 100 000 live births. The Goalkeepers Report notes that between 2000 and 2015, the annualised rate of decline was 3%, but that this reduced to only 0.5% between 2016 and 2022.

Characteristics, clinical manifestations and management of leprosy in KwaZulu-Natal, South Africa: A 20-year retrospective study

Leprosy, also known as Hansen’s disease, is a chronic infection caused by Mycobacterium leprae and Mycobacterium lepromatosis. It has been historically associated with ancient biblical references and has been recognised as a neglected tropical disease (NTD) by the World Health Organization (WHO). Notably, leprosy stands as a significant infectious cause of disability in the developing world. The disease is primarily transmitted through droplet spread and typically manifests cutaneous and peripheral neurological signs. Systemic involvement may extend to various body parts, including the eyes, respiratory mucosa, skeletal system, testes and liver. Without proper treatment, leprosy can lead to permanent disability and disfigurement.

Resilience in the time of crisis: A review of the maternal, perinatal and reproductive health effects of COVID-19 in South Africa

International literature predicted increases in maternal and perinatal mortality during the COVID-19 pandemic if routine and emergency maternity services were not maintained or used by pregnant women. The pandemic started in South Africa (SA) during the first quarter of the 2020/21 financial year (FY) and there were four waves; quarter 1 (Q1) (April - June 2020) and Q2 (July – September 2020) constituting the first wave, with the peak of infections in July; Q3 (October - December 2020) and Q4 (January - March 2021) constituting the second wave, with the peak in January 2021. Qs 1 and 2 of FY 2021/2022 constituted the third wave, with the peak in July 2021, and Qs 3 and 4 of FY 2021/2022 the fourth wave, with the peak in January 2022. The Alpha variant of the SARS-CoV-2 virus predominated in wave 1, the Beta variant in wave 2, the Delta variant in wave 3 and the Omicron variant in wave 4.

The prevalence of malaria in the five districts of Limpopo Province, South Africa, 2015 - 2017

Malaria is an important public health problem in the world, with nearly half of the world’s population at risk. Globally, malaria cases ranged between 212 and 247 million during 2015 - 2022. Between 2015 and 2022, malaria cases recorded in Africa ranged between 200 and 234 million. Sub-Saharan African (SSA) countries have a high incidence of malaria infection throughout different seasons, with Plasmodium falciparum being the most prevalent malaria species, accounting for 99% of estimated malaria cases. However, malaria is also caused by other mosquito-borne parasites of the Plasmodium species, namely P. malariae, P. ovale, P. vivax and P. knowlesi. Imported malaria cases have increased between 2011 and 2016 due to increased air travel over the past decades and population movements worldwide. South Africa (SA) has reported an increase in the number of imported malaria cases from neighbouring malaria-endemic countries. Imported malaria is defined as malaria presenting in a country other than that in which it was acquired. During the period 2010 to 2014, imported malaria cases accounted for ~47.6% of malaria cases reported nationally, with the majority originating from Mozambique and Zimbabwe. 

Accreditation

Health Professions Council of South Africa

MDB015/MPDP/038/206

3 Clinical

Certification

Attempts allowed: 2

70% pass rate





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South African Medical Journal - May 2024 Vol 114 No 5