South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Given the elevated risk of tuberculosis (TB), including drug-resistant disease, experienced by health workers in South Africa (SA), effective workers' compensation for occupational TB is a legal right and an essential social benefit. ⋯ Affected health workers' experience of the workers' compensation system was mostly negative, adding to the burden of being ill with TB. Education of management and clinicians, improvement in communication, and timeous and regular checking of claim status and of payment of applicable compensation are required at the provincial level. Dedicated facility-based occupational health units are needed, with a staff complement of knowledgeable persons trusted by their colleagues. However, the effectiveness of the system is ultimately dependent on the ability of the Compensation Fund to register and display claims timeously and administer compensation expeditiously.
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Glycated haemoglobin (HbA1c) has been used for decades as a measure of chronic glycaemia. A simple linear relationship between HbA1c values and mean blood glucose (MBG) has been identified and led to conversion of HbA1c values into estimated average glucose (eAG) levels, following the findings of the A1c-Derived Average Glucose (ADAG) Study Group. The intention was to help patients with diabetes mellitus (DM) understand their glycaemic control better, as eAG is reported in the same units as self-monitored glucose levels. However, factors other than glycaemia have been found to affect the relationship between HbA1c and MBG. ⋯ Our findings showed an imperfect relationship between MBG levels and HbA1c values. eAG significantly overestimated MBG, and this disagreement may cause confusion among both patients and clinicians. The risk of hypoglycaemic episodes may also increase if HbA1c and eAG alone are used to intensify therapy. We recommend that the use of eAG should be validated prior to implementation in clinical practice. It would be ideal to evaluate the relationship between average glucose and HbA1c in each individual patient in order to provide more personalised diabetes care.