South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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The SARS-CoV-2 pandemic has challenged the provision of healthcare in ways that are unprecedented in our lifetime. Planning for the sheer numbers expected during the surge has required public hospitals to de-escalate all non-essential clinical services to focus on COVID-19. ⋯ We describe how we constructed our COVID-19 hospital-wide clinical service at Groote Schuur Hospital, the University of Cape Town's tertiary-level teaching hospital. By describing the barriers and enablers, we hope to provide guidance rather than a blueprint for hospitals elsewhere in SA and in low-resource countries that face similar challenges now or during subsequent waves.
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While adolescent mothers' postpartum return to school offers long-term benefits, returning too early in the absence of sufficient support may impede the healthy development of their children. This study assessed the rates of adolescent mothers' return to school in South Africa (SA) and examined how many months after birth school-aged girls resumed schooling. Two independent studies recruited 1 114 adolescent mothers in Eastern Cape Province and Durban, respectively. ⋯ Our findings indicate a mismatch between SA's national policy recommendations and actual return patterns, showing that a large proportion of mothers returned to school much earlier than advised. This study also highlights a particular need to amend school policies that support early-returners and their children. Additional research on the needs of mother-child dyads and studies on the impact of different timescales on educational and health outcomes are needed to further inform policy and practice regarding adolescent mothers' return to school.
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Streptococcus agalactiae or group B streptococcus (GBS) is a significant cause of neonatal sepsis. Intrapartum antibiotic prophylaxis is recommended for pregnant women identified to be rectovaginally colonised between 34 and 37 weeks' gestational age to decrease the risk of invasive disease in their newborns. An effective multivalent GBS vaccine may prevent a broader scope of GBS-associated diseases, such as GBS early-onset disease, GBS late-onset disease, spontaneous abortion, stillbirth and maternal bacteraemia. Serotype distribution of GBS isolates is essential to determine the efficacy of such a vaccine. ⋯ GBS-colonising isolates remain susceptible to penicillin, which remains the drug of choice for intrapartum antibiotic prophylaxis and treatment of invasive disease in newborns. Macrolides should only be used if clinically indicated due to the high prevalence of intermediate resistance. A pentavalent GBS vaccine currently in phase I trials should provide coverage for 97% of the isolates identified in this study.