South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Wound infections following cytotoxic snakebites are common. Bites from Naja nigricincta nigricincta (an African spitting cobra) usually present as severe dermonecrosis spreading within the subdermal fascia layer. ⋯ We report the case of a 2½-year-old boy who presented with infective (Proteus vulgaris) necrotising fasciitis after an N. n. nigricincta bite, resulting in multiple-organ failure and death. A P. vulgaris with the same antibiotic profile was cultured from the mouth of the snake.
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Erratum.
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We summarise a Cochrane review of qualitative evidence that explored parents' views and practices around routine childhood vaccination, and provide implications for research and practice that are relevant to the South African (SA) context. Many public health interventions to encourage vaccination are informed by an assumption that vaccine hesitancy is due to a lack of knowledge or irrational forms of thinking. The findings from this review suggest that childhood vaccination views and practices are complex social processes that are shaped by multiple factors and carry a variety of meanings. As such, we suggest that biomedical approaches must be supplemented by more nuanced and sociopolitically informed strategies for enhancing and sustaining childhood vaccination practices in SA.
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The majority of maternal deaths in South Africa (SA) occur as a result of non-pregnancy-related infections (NPRI). Pregnancy is a known risk factor in severe COVID‑19, increasing the burden of NPRI in SA. In this study, we describe the prevalence, profile and clinical outcomes of pregnant women with COVID‑19 admitted to a tertiary facility. ⋯ COVID‑19-related mortality in our cohort was higher than that seen internationally, likely due to differences in background maternal mortality rates and difficulty in accessing care.
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Organ and tissue donation depends on non-transplant clinicians to identify and timeously refer potential donors and to counsel families compassionately about the prognosis at end of life. Organ donation referral is often felt to be beyond the capacity of district-level hospital services. In this case series, we report on four referrals from a geographically remote, public sector district-level hospital, and review the identification, referral and consent process of potential donors after brain death, and also donors after circulatory death. For the one successfully consented donor we report on the donor work-up and management, and the outcome of the organ recovery and organ allocation process.