Healthcare worker perspectives on adaptations to differentiated anti-retroviral therapy delivery during COVID-19 in South Africa: A qualitative inquiry.

During the COVID-19 pandemic, the South African Centralized Chronic Medicines Dispensing and Distribution (CCMDD) programme, adapted to include extended 12-month antiretroviral therapy (ART) prescriptions, 3-months ART refills and earlier eligibility criteria at 6-months after ART initiation. We aimed to explore the experiences of healthcare workers (HCWs) in implementing these adaptations, and to understand the overall impact of COVID-19 on CCMDD. We conducted semi-structured in-depth interviews with HCWs in eThekwini District clinics, KwaZulu-Natal, South Africa.

Effectiveness of the BNT162b2 vaccine in preventing morbidity and mortality associated with COVID-19 in children aged 5 to 11 years: A systematic review and meta-analysis.

A rapid systematic review, based on Cochrane rapid review methodology was conducted to assess the effectiveness of two 10μg doses of BNT162b2 vaccine in preventing morbidity and mortality associated with COVID-19 in children aged 5 to 11 years. We searched the Cochrane Library COVID-19 study register, the COVID-NMA living review database and the McMaster University Living Evidence Synthesis for pre-appraised trials and observational studies up to 7 December 2022. Records were screened independently in duplicate.

Is South Africa closing the health gaps between districts? Monitoring progress towards universal health service coverage with routine facility data.

Background: South Africa is committed to advancing universal health coverage (UHC). The usefulness and potential of using routine health facility data for monitoring progress towards UHC, in the form of the 16-tracer WHO service coverage index (SCI), was assessed.

Methods: Alternative approaches to calculating the WHO SCI from routine data, allowing for disaggregation to district level, were explored.

Improving policies and practices for the extemporaneous compounding of oral liquid dosage forms in Saudi Arabian hospitals.

Background: Pharmacists rely heavily on available reference material to guide the extemporaneous compounding of medicines. Extemporaneous compounding for individual patients has traditionally not been closely regulated, but is necessary in every setting.

Objective: To assess the adequacy of the evidence and recommend changes for the master formulae (MFs) used in the extemporaneous compounding manual at five Ministry of National Guard Health Affairs (MNGHA) tertiary care institutions in Saudi Arabia.

South African HIV self-testing policy and guidance considerations.

The gap in HIV testing remains significant and new modalities such as HIV self-testing (HIVST) have been recommended to reach key and under-tested populations. In December 2016, the World Health Organization (WHO) released the Guidelines on HIV Self-Testing and Partner Notification: A Supplement to the Consolidated Guidelines on HIV Testing Services (HTS) and urged member countries to develop HIVST policy and regulatory frameworks. In South Africa, HIVST was included as a supplementary strategy in the National HIV Testing Services Policy in 2016, and recently, guidelines for HIVST were included in the South African National Strategic Plan for HIV, sexually transmitted infections and tuberculosis 2017-2022.

Candidates for inclusion in a universal antiretroviral regimen: are lamivudine and emtricitabine interchangeable?

Purpose Of Review: Lamivudine (3TC) and emtricitabine (FTC) are the most widely used antiretroviral medications worldwide and are considered by the WHO to be interchangeable. This article reviews evidence supporting interchangeability of 3TC and FTC and considerations for future use.

Recent Findings: Three randomized trials have directly compared the safety and efficacy of 3TC and FTC against identical backbone regimens.

Revision of the International Pharmaceutical Federation's Basel Statements on the future of hospital pharmacy: From Basel to Bangkok.

Purpose: The processes used to revise the 2008 Basel Statements on the future of hospital pharmacy are summarized, and the revised statements are presented.

Methods: The process for revising the Basel Statements followed an approach similar to that used during their initial development. The Hospital Pharmacy Section (HPS) of the International Pharmaceutical Federation (FIP) revised the 2008 FIP Basel Statements in four phases, including a survey of hospital pharmacists worldwide, an internal review, online forums, and a face-to-face "World Café" workshop in Bangkok, Thailand.

Cost-minimization analysis of imipenem/cilastatin versus meropenem in moderate to severe infections at a tertiary care hospital in Saudi Arabia.

Aim: The aim of this study was to compare the costs of management of moderate to severe infections in patients treated with imipenem/cilastatin (IC) and meropenem (MEM). Pharmacoeconomic studies in Saudi Arabia are scarce. The current hospital formulary contains 2 carbapenems: IC and MEM.

The Darwin Awards: sex differences in idiotic behaviour.

Sex differences in risk seeking behaviour, emergency hospital admissions, and mortality are well documented. However, little is known about sex differences in idiotic risk taking behaviour. This paper reviews the data on winners of the Darwin Award over a 20 year period (1995-2014).

Are new models needed to optimize the utilization of new medicines to sustain healthcare systems?

Medicines have made an appreciable contribution to improving health. However, even high-income countries are struggling to fund new premium-priced medicines. This will grow necessitating the development of new models to optimize their use.

AGREE to disagree: critical appraisal and the publication of practice guidelines.

Treatment guidelines are important in influencing public policy, promoting distributive justice and advocating better healthcare delivery for those in need. With an increased frequency in publication of clinical guidelines in South Africa, there is a heightened responsibility to ensure the application of due process throughout their development and publication. The need for consensus opinion is critical in the application of evidence-based medicine principles, and clinical guidelines contribute fundamentally towards the process of decision making and prioritisation.

Medicines shortages-unpicking the evidence from a year in South Africa.

Although medicines shortages are a persistent and challenging problem for all health systems, the reasons for such shortages vary considerably between settings. Understanding the range of problems encountered, and the specific reasons for each medicines shortage event, may help to identify the most appropriate systems-wide responses. South Africa's health system is, at this point, still clearly divided between a better-resourced private sector and an overwhelmed public sector.

Comparative efficacy of Lamivudine and emtricitabine: a systematic review and meta-analysis of randomized trials.

Introduction: Lamivudine and emtricitabine are considered equivalent by several guidelines, but evidence of comparable efficacy is conflicting.

Methods: We searched two databases up to June 30 2013 to identify randomized and quasi-randomized trials in which lamivudine and emtricitabine were used as part of combination antiretroviral therapy for treatment-naïve or experienced HIV-positive adult patients. We only included trials where partner drugs in the regimen were identical or could be considered to be comparable.

The medical use of cannabis for reducing morbidity and mortality in patients with HIV/AIDS.

Background: The use of cannabis (marijuana) or of its psychoactive ingredient delta-9-tetrahydrocannabinol (THC) as a medicine has been highly contested in many settings.There have been claims that smoked or ingested cannabis, either in its natural form or artificial form (pharmaceutically manufactured drug such as dronabinol), improves the appetites of people with AIDS, results in weight gain and lifts mood, thus improving the quality of life.

Objectives: The objectives of this review were to assess whether cannabis (in its natural or artificially produced form), either smoked or ingested, decreases the morbidity or mortality of patients infected with HIV.

Surveillance of antimicrobial resistance in resource-constrained settings - experience from five pilot projects.

Objective: The rapid increase in antimicrobial resistance (AMR) among bacteria is a major public health concern. The WHO Global Strategy for Containment of Antimicrobial Resistance proposed that model systems be developed for AMR surveillance and for monitoring antimicrobial use.

Methods: Pilot projects were established in three sites in India and two in South Africa to collect monthly AMR data on target bacteria for at least 12 months.

Surveillance of community antimicrobial use in resource-constrained settings--experience from five pilot projects.

Objective: To investigate the feasibility of surveillance of antimicrobial use in the community in resource-constrained settings. Overuse and misuse of antimicrobial medicines is contributing to the development of resistance. The WHO Global Strategy for Containment of Antimicrobial Resistance recommends surveillance of use at all levels of the health sector but this is not done in most low and middle income countries.