South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Better integration of HIV and sexually transmitted infection (STI) prevention and treatment services is needed to accelerate progress towards the goal of zero new HIV infections. ⋯ In a population at risk of HIV transmission, there was a high burden of recent infection and unsuppressed VLs. Incorporating pre-exposure prophylaxis, ART initiation and adherence support into STI services will be necessary for progress towards eliminating HIV transmission.
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In the context of a shortage of medical specialists, a medical referral app, designed for use on smartphones, was launched in 2014 for use by doctors in the public health service in South Africa. ⋯ This study documents the scale-up of a mobile phone consultation and referral app from pilot phase to significant growth in use across a resource-constrained healthcare system. In a large proportion of cases, advice was given to the referring doctor by means of the app, frequently obviating the need for a specialist appointment or patient transfer. This finding demonstrates that a mobile app has the potential to reduce the need for face-to-face specialist visits, thereby improving the use of scarce medical resources.
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COVID-19 has been reported to affect a variety of organs. We report a case of constrictive pericarditis in a patient who had contracted the SARS-CoV-2 virus. Other possible causes such as tuberculosis and metabolic causes were considered, but excluded by special investigations.
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Doctors' organisations have called for special legislation regarding the criminal charging of doctors for culpable homicide, and the need for special medical malpractice courts to deal with the huge increase in the number of medical malpractice cases. However, there are very few criminal prosecutions, because the prosecuting authorities generally accept that doctors do not intend to kill their patients, and are only likely to charge them for intentional or very serious deviations from the standard of a reasonably competent doctor in their profession. Doctors are also generally not held liable for mere errors of judgement. ⋯ Doctors need not fear making admissions during mediation proceedings in civil matters, because legislation provides that such admissions and evidence may not be used in subsequent civil actions. The Chief Justice can also issue a practice directive that all presiding officers must appoint medicolegal experts as assessors in medical malpractice cases. The medical profession can assist the process by arranging a panel of such experts who can be called upon to serve as assessors by the courts.