Clinical outcomes of hospitalised COVID-19 patients at Mthatha Regional Hospital, Eastern Cape, South Africa: A retrospective study
- Kaswa, Ramprakash, Yogeswaran, Parimalaranie, Cawe, Busisiwe
- Authors: Kaswa, Ramprakash , Yogeswaran, Parimalaranie , Cawe, Busisiwe
- Date: 2021
- Subjects: COVID-19 Diabetes Hypertension Diseases Article
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/7330 , vital:53402 , xlink:href="https://doi.org/10.4102/safp.v63i1.5253"
- Description: Background: Coronavirus disease 2019 (COVID-19) is a public health crisis that threatens the current health system. The sudden expansion in the need for inpatient and intensive care facilities raised concerns about optimal clinical management and resource allocation. Despite the pressing need for evidence to make context-specific decisions on COVID-19 management, evidence from South Africa remained limited. This study aimed to describe the clinical characteristics and outcomes of COVID-19 hospitalised patients. Methods: A retrospective cross-sectional study design was used to evaluate the clinical outcomes of hospitalised adult patients (≥ 18 years old) with laboratory-confirmed COVID-19 illness at Mthatha Regional Hospital (MRH), Eastern Cape. Results: Of the 1814 patients tested for COVID-19 between 20 March 2020 and 31 July 2020 at MRH, two-thirds (65.4%) were female. About two-thirds (242) of the 392 patients (21.6%) who tested positive for this disease were hospitalised and one-third (150) were quarantined at home. The mean age of the patients tested for COVID-19 was 42.6 years and there was no difference between males and females. The mean age of hospitalised patients was 55.5 years and the mean age of hospitalised patients who died (61.3 years) was much higher than recovered (49.5 years). Overall, 188 (77.6%) hospitalised patients had clinical comorbidity on admission. Diabetes (36.8%) and hypertension (33.1%) were the most common comorbidities amongst COVID-19 hospitalised patients. Conclusion: The majority of the patients who were hospitalised for COVID-19 were elderly and had high baseline comorbidities. Advance age and underlying comorbidities (diabetes, hypertension and HIV) were associated with high mortality in hospitalised COVID-19 patients. Keywords: COVID-19, diabetes; hypertension; hospitalised; co-morbidity.
- Full Text:
- Date Issued: 2021
- Authors: Kaswa, Ramprakash , Yogeswaran, Parimalaranie , Cawe, Busisiwe
- Date: 2021
- Subjects: COVID-19 Diabetes Hypertension Diseases Article
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/7330 , vital:53402 , xlink:href="https://doi.org/10.4102/safp.v63i1.5253"
- Description: Background: Coronavirus disease 2019 (COVID-19) is a public health crisis that threatens the current health system. The sudden expansion in the need for inpatient and intensive care facilities raised concerns about optimal clinical management and resource allocation. Despite the pressing need for evidence to make context-specific decisions on COVID-19 management, evidence from South Africa remained limited. This study aimed to describe the clinical characteristics and outcomes of COVID-19 hospitalised patients. Methods: A retrospective cross-sectional study design was used to evaluate the clinical outcomes of hospitalised adult patients (≥ 18 years old) with laboratory-confirmed COVID-19 illness at Mthatha Regional Hospital (MRH), Eastern Cape. Results: Of the 1814 patients tested for COVID-19 between 20 March 2020 and 31 July 2020 at MRH, two-thirds (65.4%) were female. About two-thirds (242) of the 392 patients (21.6%) who tested positive for this disease were hospitalised and one-third (150) were quarantined at home. The mean age of the patients tested for COVID-19 was 42.6 years and there was no difference between males and females. The mean age of hospitalised patients was 55.5 years and the mean age of hospitalised patients who died (61.3 years) was much higher than recovered (49.5 years). Overall, 188 (77.6%) hospitalised patients had clinical comorbidity on admission. Diabetes (36.8%) and hypertension (33.1%) were the most common comorbidities amongst COVID-19 hospitalised patients. Conclusion: The majority of the patients who were hospitalised for COVID-19 were elderly and had high baseline comorbidities. Advance age and underlying comorbidities (diabetes, hypertension and HIV) were associated with high mortality in hospitalised COVID-19 patients. Keywords: COVID-19, diabetes; hypertension; hospitalised; co-morbidity.
- Full Text:
- Date Issued: 2021
Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study
- O’Mahony, Don, Adedayo, Temitope, Adeleke, Olukayode
- Authors: O’Mahony, Don , Adedayo, Temitope , Adeleke, Olukayode
- Date: 2021
- Subjects: Physicians Erythrocytes--Transfusion Article
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/7989 , vital:57871 , xlink:href="https://doi.org/10.4102/phcfm.v13i1.2889"
- Description: Background: Unnecessary blood transfusion exposes recipients to potential harms. Aim: The aim of this study was to describe blood transfusion practice and explore doctors’ attitudes towards transfusion. Setting: A hospital providing level 1 and 2 services. Methods: A mixed-methods study design was used. In the cross-sectional descriptive component, a sample was taken from patients transfused over a 2-month period. Blood use was categorised as for medical anaemia or haemorrhage, and appropriate or not. The qualitative component comprised a purposeful sample for focus group and individual semistructured interviews. Results: Of 239 patients sampled, 62% were transfused for medical anaemia and 38% for haemorrhage. In the medical anaemia group, compliance with age-appropriate transfusion thresholds was 69%. In medical anaemia and haemorrhage, 114 (77%) and 85 (93.4%) of recipients had orders for ≥ 2 red blood cell (RBC) units, respectively. In adults ≥ 18 years old with medical anaemia, 47.1% of orders would have resulted in a haemoglobin (Hb) > 8 g/dL. Six doctors participated in focus group and eleven in individual interviews. There was a lack of awareness of institutional transfusion guidelines, disagreement on appropriate RBC transfusion thresholds and comments that more than one RBC unit should always be transfused. Factors informing decisions to transfuse included advice from senior colleagues, relieving symptoms of anaemia and high product costs. Conclusion: Most orders were for two or more units. In medical anaemia, doctors’ compliance with RBC transfusion thresholds was reasonable; however, almost half of the orders would have resulted in overtransfusion. The attitudes of doctors sampled suggest that their transfusion practice is influenced more by institutional values than formal guidelines. Keywords: red blood cell transfusion; doctors’ attitudes; doctors’ practice; transfusion thresholds; overtransfusion; descriptive study; qualitative study.
- Full Text:
- Date Issued: 2021
- Authors: O’Mahony, Don , Adedayo, Temitope , Adeleke, Olukayode
- Date: 2021
- Subjects: Physicians Erythrocytes--Transfusion Article
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/7989 , vital:57871 , xlink:href="https://doi.org/10.4102/phcfm.v13i1.2889"
- Description: Background: Unnecessary blood transfusion exposes recipients to potential harms. Aim: The aim of this study was to describe blood transfusion practice and explore doctors’ attitudes towards transfusion. Setting: A hospital providing level 1 and 2 services. Methods: A mixed-methods study design was used. In the cross-sectional descriptive component, a sample was taken from patients transfused over a 2-month period. Blood use was categorised as for medical anaemia or haemorrhage, and appropriate or not. The qualitative component comprised a purposeful sample for focus group and individual semistructured interviews. Results: Of 239 patients sampled, 62% were transfused for medical anaemia and 38% for haemorrhage. In the medical anaemia group, compliance with age-appropriate transfusion thresholds was 69%. In medical anaemia and haemorrhage, 114 (77%) and 85 (93.4%) of recipients had orders for ≥ 2 red blood cell (RBC) units, respectively. In adults ≥ 18 years old with medical anaemia, 47.1% of orders would have resulted in a haemoglobin (Hb) > 8 g/dL. Six doctors participated in focus group and eleven in individual interviews. There was a lack of awareness of institutional transfusion guidelines, disagreement on appropriate RBC transfusion thresholds and comments that more than one RBC unit should always be transfused. Factors informing decisions to transfuse included advice from senior colleagues, relieving symptoms of anaemia and high product costs. Conclusion: Most orders were for two or more units. In medical anaemia, doctors’ compliance with RBC transfusion thresholds was reasonable; however, almost half of the orders would have resulted in overtransfusion. The attitudes of doctors sampled suggest that their transfusion practice is influenced more by institutional values than formal guidelines. Keywords: red blood cell transfusion; doctors’ attitudes; doctors’ practice; transfusion thresholds; overtransfusion; descriptive study; qualitative study.
- Full Text:
- Date Issued: 2021
Doctors’ practice and attitudes towards red blood cell transfusion at Mthatha Regional Hospital, Eastern Cape, South Africa: A mixed methods study
- Mabunda, Sikhumbuzo A, O’Mahony, Don, Adedayo, Temitope, Adeleke, Olukayode
- Authors: Mabunda, Sikhumbuzo A , O’Mahony, Don , Adedayo, Temitope , Adeleke, Olukayode
- Date: 2021
- Subjects: Physicians Erythrocytes--Transfusion Article
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/7216 , vital:53088 , xlink:href="https://doi.org/10.4102/phcfm.v13i1.2889"
- Description: Background: Unnecessary blood transfusion exposes recipients to potential harms. Aim: The aim of this study was to describe blood transfusion practice and explore doctors’ attitudes towards transfusion. Setting: A hospital providing level 1 and 2 services. Methods: A mixed-methods study design was used. In the cross-sectional descriptive component, a sample was taken from patients transfused over a 2-month period. Blood use was categorised as for medical anaemia or haemorrhage, and appropriate or not. The qualitative component comprised a purposeful sample for focus group and individual semistructured interviews. Results: Of 239 patients sampled, 62% were transfused for medical anaemia and 38% for haemorrhage. In the medical anaemia group, compliance with age-appropriate transfusion thresholds was 69%. In medical anaemia and haemorrhage, 114 (77%) and 85 (93.4%) of recipients had orders for ≥ 2 red blood cell (RBC) units, respectively. In adults ≥ 18 years old with medical anaemia, 47.1% of orders would have resulted in a haemoglobin (Hb) > 8 g/dL. Six doctors participated in focus group and eleven in individual interviews. There was a lack of awareness of institutional transfusion guidelines, disagreement on appropriate RBC transfusion thresholds and comments that more than one RBC unit should always be transfused. Factors informing decisions to transfuse included advice from senior colleagues, relieving symptoms of anaemia and high product costs. Conclusion: Most orders were for two or more units. In medical anaemia, doctors’ compliance with RBC transfusion thresholds was reasonable; however, almost half of the orders would have resulted in overtransfusion. The attitudes of doctors sampled suggest that their transfusion practice is influenced more by institutional values than formal guidelines. Keywords: red blood cell transfusion; doctors’ attitudes; doctors’ practice; transfusion thresholds; overtransfusion; descriptive study; qualitative study.
- Full Text:
- Date Issued: 2021
- Authors: Mabunda, Sikhumbuzo A , O’Mahony, Don , Adedayo, Temitope , Adeleke, Olukayode
- Date: 2021
- Subjects: Physicians Erythrocytes--Transfusion Article
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/7216 , vital:53088 , xlink:href="https://doi.org/10.4102/phcfm.v13i1.2889"
- Description: Background: Unnecessary blood transfusion exposes recipients to potential harms. Aim: The aim of this study was to describe blood transfusion practice and explore doctors’ attitudes towards transfusion. Setting: A hospital providing level 1 and 2 services. Methods: A mixed-methods study design was used. In the cross-sectional descriptive component, a sample was taken from patients transfused over a 2-month period. Blood use was categorised as for medical anaemia or haemorrhage, and appropriate or not. The qualitative component comprised a purposeful sample for focus group and individual semistructured interviews. Results: Of 239 patients sampled, 62% were transfused for medical anaemia and 38% for haemorrhage. In the medical anaemia group, compliance with age-appropriate transfusion thresholds was 69%. In medical anaemia and haemorrhage, 114 (77%) and 85 (93.4%) of recipients had orders for ≥ 2 red blood cell (RBC) units, respectively. In adults ≥ 18 years old with medical anaemia, 47.1% of orders would have resulted in a haemoglobin (Hb) > 8 g/dL. Six doctors participated in focus group and eleven in individual interviews. There was a lack of awareness of institutional transfusion guidelines, disagreement on appropriate RBC transfusion thresholds and comments that more than one RBC unit should always be transfused. Factors informing decisions to transfuse included advice from senior colleagues, relieving symptoms of anaemia and high product costs. Conclusion: Most orders were for two or more units. In medical anaemia, doctors’ compliance with RBC transfusion thresholds was reasonable; however, almost half of the orders would have resulted in overtransfusion. The attitudes of doctors sampled suggest that their transfusion practice is influenced more by institutional values than formal guidelines. Keywords: red blood cell transfusion; doctors’ attitudes; doctors’ practice; transfusion thresholds; overtransfusion; descriptive study; qualitative study.
- Full Text:
- Date Issued: 2021
Prevalence and determinants of tobacco use amongst South African adults with mental illness in the Eastern Cape
- Tindimwebwa, Linda K, Ajayi, Anthony I, Adeniyi, Oladele Vincent
- Authors: Tindimwebwa, Linda K , Ajayi, Anthony I , Adeniyi, Oladele Vincent
- Date: 2021
- Subjects: mental health mental illiness tobacco use Article
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/7278 , vital:53109 , xlink:href="https://doi.org/10.4102/sajpsychiatry.v27i0.1637"
- Description: Background: Given the physical and mental health consequences of tobacco use amongst individuals with mental illness, it was imperative to assess the burden of tobacco use in this population. Aim: This study examined the patterns and factors associated with tobacco use in individuals attending the outpatient unit. Setting: Cecilia Makiwane Hospital Mental Health Department in Eastern Cape province, South Africa. Methods: Lifetime (ever use) use and current use of any tobacco products were examined in a cross-sectional study of 390 individuals between March and June 2020. A logistic regression was fitted to determine the correlates of lifetime and current use of any tobacco products. Results: The rates of ever use and current use of tobacco products were 59.4% and 44.6%, respectively. Of the participants interviewed, lifetime tobacco use was more prevalent amongst individuals with schizophrenia (67.9%) and cannabis-induced disorders (97.3%) and lower in those with major depressive disorders (36.1%) and bipolar and related disorders (43.5%). Men were six times more likely to have ever used or currently use tobacco products in comparison to women. Also, those who had a salaried job or owned a business were over three times more likely to have ever used or currently use tobacco products compared with those receiving government social grants. Conclusions: The prevalence of tobacco use in this study was significantly higher than the general population in the Eastern Cape. Therefore, smoking prevention and cessation interventions targeted at the general population should target this often neglected sub-population in the region. Keywords: Eastern Cape province; mental health users; mental illness; South Africa; tobacco use.
- Full Text:
- Date Issued: 2021
- Authors: Tindimwebwa, Linda K , Ajayi, Anthony I , Adeniyi, Oladele Vincent
- Date: 2021
- Subjects: mental health mental illiness tobacco use Article
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/11260/7278 , vital:53109 , xlink:href="https://doi.org/10.4102/sajpsychiatry.v27i0.1637"
- Description: Background: Given the physical and mental health consequences of tobacco use amongst individuals with mental illness, it was imperative to assess the burden of tobacco use in this population. Aim: This study examined the patterns and factors associated with tobacco use in individuals attending the outpatient unit. Setting: Cecilia Makiwane Hospital Mental Health Department in Eastern Cape province, South Africa. Methods: Lifetime (ever use) use and current use of any tobacco products were examined in a cross-sectional study of 390 individuals between March and June 2020. A logistic regression was fitted to determine the correlates of lifetime and current use of any tobacco products. Results: The rates of ever use and current use of tobacco products were 59.4% and 44.6%, respectively. Of the participants interviewed, lifetime tobacco use was more prevalent amongst individuals with schizophrenia (67.9%) and cannabis-induced disorders (97.3%) and lower in those with major depressive disorders (36.1%) and bipolar and related disorders (43.5%). Men were six times more likely to have ever used or currently use tobacco products in comparison to women. Also, those who had a salaried job or owned a business were over three times more likely to have ever used or currently use tobacco products compared with those receiving government social grants. Conclusions: The prevalence of tobacco use in this study was significantly higher than the general population in the Eastern Cape. Therefore, smoking prevention and cessation interventions targeted at the general population should target this often neglected sub-population in the region. Keywords: Eastern Cape province; mental health users; mental illness; South Africa; tobacco use.
- Full Text:
- Date Issued: 2021
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