Browsing by Subject "disease"

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    Open Access
    Genomic medicine in Africa: promise, problems and prospects
    (BioMed Central Ltd, 2014) Wonkam, Ambroise; Mayosi, Bongani
    Remarkable progress has been made in using genomic information to determine how genes are regulated, and how they interact with each other and with the environment to control complex biochemical functions of living organisms in health and disease [1]. This information will have major benefits for the prevention, diagnosis and management of many diseases, including communicable and genetic diseases. In Africa, where infectious diseases are highly prevalent, research on pathogen genomes has enhanced our understanding of disease transmission, virulence mechanisms and avoidance of host defenses [2]. It is anticipated that this information will enable the development of new diagnostic tests, vaccines and therapeutic agents; it is also likely to lead to new approaches for vector control, and reveal why individuals and populations vary in their susceptibility to infectious diseases [1].
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    Improving access to surgery in low- and middle-income countries through improved emergency and essential surgical care provision at district hospitals
    (2025) Westwood, Jessica; Park-Ross, Jocelyn; Duys, Rowan
    Surgical conditions contribute to one-third of the global burden of disease, yet many individuals in low- and middle-income countries (LMICs) lack access to emergency and essential surgical care. In South Africa, 86% of the population resides within 2-hours of a district hospital equipped with basic surgical capabilities. Improving access to emergency and essential surgical care at these district hospitals could reduce morbidity and mortality related to surgical conditions. However, detailed knowledge of the surgical capacity at district hospitals is limited. Madwaleni District Hospital is a 180-bed rural hospital in the Eastern Cape province of South Africa. Surgery at the facility is provided by a diverse team of doctors, ranging from community service medical officers to family medicine specialists. This study aims to describe the volume and breadth of emergency and essential surgical services provided at Madwaleni Hospital in order to inform and enable future improvements in the surgical system. Methods: A retrospective audit of the district hospital surgical service was conducted. Data were extracted from the theatre register between January 2016 and December 2022. Data included patient demographics, surgical procedures, and surgical providers. A quantitative descriptive analysis was performed. Results: A total of 2616 surgical procedures were performed over the 7-year study period. The average monthly theatre volume grew from 27 procedures per month in 2016 to 41 procedures per month in 2022. Theatre utilisation averaged one theatre case per day over the study period. Caesarean sections predominated, accounting for 82% of all surgical cases. An expanding basket of care was observed, with 13 unique procedures performed in the first year and 12 unique procedures added during the next six years. These included obstetric, gynaecological, orthopaedic, urological and general surgical procedures. Family medicine registrars and family physicians performed the most procedures per person. Conclusion: District hospitals offer a vital opportunity to close the gap between the met and unmet need for surgery in LMICs. However, quality data describing emergency and essential surgical care at district hospitals in South Africa is scarce. This study demonstrates the capacity and opportunity to expand surgical services at rural district hospitals.
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    The Health Stigma and Discrimination Framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas
    (BioMed Central, 2019-02-15) Stangl, Anne L; Earnshaw, Valerie A; Logie, Carmen H; van Brakel, Wim; C. Simbayi, Leickness; Barré, Iman; Dovidio, John F
    Abstract Stigma is a well-documented barrier to health seeking behavior, engagement in care and adherence to treatment across a range of health conditions globally. In order to halt the stigmatization process and mitigate the harmful consequences of health-related stigma (i.e. stigma associated with health conditions), it is critical to have an explicit theoretical framework to guide intervention development, measurement, research, and policy. Existing stigma frameworks typically focus on one health condition in isolation and often concentrate on the psychological pathways occurring among individuals. This tendency has encouraged a siloed approach to research on health-related stigmas, focusing on individuals, impeding both comparisons across stigmatized conditions and research on innovations to reduce health-related stigma and improve health outcomes. We propose the Health Stigma and Discrimination Framework, which is a global, crosscutting framework based on theory, research, and practice, and demonstrate its application to a range of health conditions, including leprosy, epilepsy, mental health, cancer, HIV, and obesity/overweight. We also discuss how stigma related to race, gender, sexual orientation, class, and occupation intersects with health-related stigmas, and examine how the framework can be used to enhance research, programming, and policy efforts. Research and interventions inspired by a common framework will enable the field to identify similarities and differences in stigma processes across diseases and will amplify our collective ability to respond effectively and at-scale to a major driver of poor health outcomes globally.