2026-03-27
Hloniphile Mthiyane, Bonolo Mashishi, Mamodiane A. Patjane, Ntwanano Honwana, Nishi Prabdial-Sing, Lucia Hans, Nonhlanhla Mbenenge, Bhaveshan Reddy, Avania Bangalee, Florette K. Treurnicht
Background: The hepatitis C virus (HCV) testing algorithm used in South African laboratories involves two tests; a serology test to detect anti-HCV antibodies and a confirmatory test to detect the presence of HCV ribonucleic acid (RNA). These tests usually require consecutive blood samples taken at more than one hospital visit, leaving patients with inconclusive diagnosis for weeks. Objectives: This study aimed to describe the prevalence and proportion of HCV seropositive cases where diagnostic opportunities were missed among patients who attended public healthcare facilities in Johannesburg, South Africa. Method: This descriptive study was conducted as a retrospective analysis of laboratory data from the Department of Medical Virology, National Health Laboratory Service, Johannesburg, South Africa. Patients for whom HCV diagnosis were requested from 2017 to 2021 were included in the study. Results: Over the five-year period, a total of 212 670 patients were tested for HCV antibodies and 8575 (4.04%) tested positive. The HCV seropositivity was recorded for 74.8% (6421/8575) of males compared to females (23.6%; 2030/8575; p < 0.001). Only 25% (2183/8575) of HCV seropositive patients had a linked HCV RNA quantitative PCR test result. Conclusion: Despite an overall HCV seroprevalence of 4% in this study, only one quarter received a definitive diagnosis. This highlights that most patients are lost to follow-up because of the two-step diagnostic process, which requires them to return to the health facility for confirmatory tests. Contribution: The study highlights the need to adopt HCV reflex testing as the standard in South Africa to meet the 2030 elimination targets.
2026-02-18
Koena J. Moabelo, Phetho Mangena, Musa E. Setati, Mokibe J. Nchabeleng
Background: The emergence of the novel coronavirus disease 2019 (COVID-19), in late 2019 in Wuhan City, has led to a global outbreak of COVID-19, culminating in the declaration of a pandemic by the World Health Organization. Objectives: The aim of the study was to evaluate the factors predicting the outcome in patients with COVID-19 infection. Method: This was a retrospective study using secondary data of patients admitted with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) polymerase chain reaction (PCR) results at Pietersburg Hospital between 01 March 2020 and 31 March 2021, which were extracted from DATCOV portal. Results: There were 444 eligible study participants, of which 225 (50.7%) were female and 219 (49.3%) were male patients. Their median age was 57 years. A total of 159 (36%) in-hospital deaths related to COVID-19 infection were reported. Using the logistic regression model, two predictor variables, age and intensive care unit (ICU) admission were independently associated with mortality. An increase in patient’s age per year, increased the odds of dying. The ICU admission had a three-fold odds for non-survival. In-hospital mortality was associated with shorter length of hospitalisation because of disease severity and late patient presentation, with a median duration of 4 days (interquartile range [IQR] 2.0–9.0). Conclusion: Age and ICU admission were significantly related to non-survival, with hypertension being the common factor in all deaths reported. Contribution: The study emphasises the importance of pandemic preparedness and strengthening healthcare services to protect vulnerable groups such as the elderly population.
2026-02-16
Carla Theron, Maja van Aswegen, A’ishah da Costa, Heather Finlayson, Gugu Kali, Angela Dramowski
Background: There are limited data on antimicrobial prescribing quality in paediatric wards in African hospitals. Objectives: This study aimed to assess the quality of antimicrobial prescribing. Method: We conducted weekly point prevalence surveys (PPSs) (15 March 2025 – 05 April 2025), assessing antimicrobial use and prescribing quality in neonatal and paediatric medical wards at Tygerberg Hospital, Cape Town, South Africa. Inpatients with active antimicrobial prescriptions at 08:00 on PPS days were included, collecting data on demographics, antimicrobials, prescription quality and time to administration (hangtime) using electronic surveys. Results: We reviewed 842 prescription charts, of which 237 (28.1%) included antimicrobial agents (23.3% neonates vs 34.4% paediatric patients; p < 0.001). Antimicrobial use was highest in the neonatal intensive care unit (58.5%) and lowest in neonatal wards (20.0%). Most antimicrobial therapy was empiric (89.0%), with pneumonia (49.2%) leading in paediatric patients and sepsis (43.2%) in neonates. Ceftriaxone (20.9%) dominated paediatric use, while ampicillin (20.4%) and meropenem (16.7%) predominated in neonates. Overall, 49.8% of agents were ‘Access’, 49.3% ‘Watch’ and 0.9% ‘Reserve’ from the World Health Organization ‘AWaRe’ classification. The intravenous route of administration predominated (79.0%). Median treatment duration was 5 days (interquartile range [IQR] 5–7 days). In patients with sepsis, the median hangtime was 109 min (IQR 30 min – 205 min), with only 23.2% initiated within 60 min. Prescription quality was suboptimal: allergies were documented in 37.1%, infection source in 29.0% and stop dates in 38.0%. Conclusion: Antimicrobial prescribing in these neonatal and paediatric wards showed frequent use of broad-spectrum agents, delayed administration and incomplete documentation. Contribution: The findings highlight the need for improved stewardship practices to promote timely, appropriate and well-documented antimicrobial use.