Centenary of the UCT Faculty of Health Sciences

The role of the Infectious Diseases unit at Groote Schuur Hospital in addressing South Africa’s greatest burden of disease

Mishal Pandie, Helen van der Plas, Gary Maartens, Marc Mendelson

Abstract


Background. The greatest burden of disease in South Africa (SA) comes from infectious diseases (ID), with human immunodeficiency virus (HIV) and tuberculosis (TB) dominating the health landscape. However, other infections including community-acquired and imported infections and the rise in hospital-acquired infections pose a considerable threat to public health.
Methods and objectives. We used a prospective cross-sectional study to examine the profile of patients referred to the Infectious Diseases Unit at Groote Schuur Hospital (GSH) between 2008 and 2011.
Results. A total of 2 142 patient consultations were performed, the majority at the request of secondary hospital level medical teams; 80% of patients were HIV-infected (with a median CD4 count of 128/mm3). Approximately half of antiretroviral-naïve, HIV-infected patients started antiretroviral therapy in hospital. TB, predominantly extrapulmonary, was the most common diagnosis. Imported infections, notably severe falciparum malaria, accounted for a large number of the 81 different diagnoses in HIV-seronegative patients. Over half of all patients had co-morbidity complicating their clinical presentation. In-hospital mortality was 5.8%, with overwhelming sepsis the cause in 40% of deaths, largely due to hospital-acquired infection, particularly in the HIV-infected cohort.
Conclusion. The overwhelming burden of ID in SA is revealed in this experience at GSH, a tertiary level referral hospital serving the Cape metropolitan area. The needs of the population warrant a reappraisal of human resource capacity and training in ID in SA.

Authors' affiliations

Mishal Pandie, Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town

Helen van der Plas, Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town

Gary Maartens, Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town

Marc Mendelson, Division of Infectious Diseases and HIV Medicine, Department of Medicine, University of Cape Town

Full Text

PDF (976KB) HTML

Keywords

Infectious Diseases, HIV, Tuberculosis,

Cite this article

South African Medical Journal 2012;102(6):528-531.

Article History

Date submitted: 2012-02-10
Date published: 2012-05-23

Article Views

Abstract views: 1749
Full text views: 5350

Comments on this article

*Read our policy for posting comments here