Impact of age on antimicrobial prescriptions in hospitalized children at three academic centres in South Africa: a point prevalence survey.

Antimicrobial resistance is a global threat in children, and the emergence of multi-drug-resistant organisms is of concern. This secondary analysis of an antimicrobial point prevalence survey (PPS) in children evaluates the impact of age on antimicrobial use. The mean antimicrobial prescriptions were assessed in neonates, infants, young children (1-5 years), school-going children (6-12 years), and adolescents (13-15 years) from a cross-sectional PPS at three academic hospitals between September 2021 and January 2022.

Antibiotic and antifungal use in paediatric departments at three academic hospitals in South Africa.

Objectives: South Africa implemented a National Strategic Framework to optimise antimicrobial stewardship in 2014; however, there is limited data on how this has affected prescribing, especially to children treated in academic centres.

Methods: We conducted a point prevalence survey using the World Health Organization (WHO) methodology to evaluate antibiotic and antifungal prescribing practices in paediatric departments at three academic hospitals in South Africa.

Results: We recorded 1946 antimicrobial prescriptions in 1191 children, with 55.

Healthcare-associated Infections Drive Antimicrobial Prescribing in Pediatric Departments at Three Academic Hospitals in South Africa.

Background: The prevalence of antimicrobial prescriptions for healthcare-associated infections (HAI) in South Africa is largely unknown. This study aimed to estimate the point prevalence of pediatric antibiotic and antifungal usage in 3 South African academic hospitals.

Methods: This cross-sectional study included hospitalized neonates and children (0-15 years).

Annual Tuberculosis Preventive Therapy for Persons With HIV Infection : A Randomized Trial.

Background: Tuberculosis preventive therapy for persons with HIV infection is effective, but its durability is uncertain.

Objective: To compare treatment completion rates of weekly isoniazid-rifapentine for 3 months versus daily isoniazid for 6 months as well as the effectiveness of the 3-month rifapentine-isoniazid regimen given annually for 2 years versus once.

Design: Randomized trial.

The Cape Town Declaration on Vaccines 2012: Unlocking the full potential of vaccines in Africa.

Delegates at the first International African Vaccinology Conference noted, with dismay, that many African children have limited access to existing and new vaccines as a consequence of weak immunisation programmes, lack of political will, and high vaccine prices. This inequality is a denial of the African child her basic right to a healthy life, and jeopardises long term economic growth on the continent. In addition, there is insufficient emphasis in Africa on adolescent and adult immunisation.

Advocating for efforts to protect African children, families, and communities from the threat of infectious diseases: report of the First International African Vaccinology Conference.

One means of improving healthcare workers' knowledge of and attitudes to vaccines is through running vaccine conferences which are accessible, affordable, and relevant to their everyday work. Various vaccinology conferences are held each year worldwide. These meetings focus heavily on basic science with much discussion about new developments in vaccines, and relatively little coverage of policy, advocacy, and communication issues.

Vaccine trials in the developing world: operational lessons learnt from a phase IV poliomyelitis vaccine trial in South Africa.

Background: Conducting vaccine trials in developing nations is necessary but operationally complex. We describe operational lessons learnt from a phase IV poliomyelitis vaccine trial in a semi-rural region of South Africa.

Methods: We reviewed operational data collected over the duration of the trial with respect to staff recruitment and training, participant recruitment and retention, and cold chain maintenance.

Randomized trial of type 1 and type 3 oral monovalent poliovirus vaccines in newborns in Africa.

Background: The Global Polio Eradication Initiative aims to eradicate wild poliovirus by the end of 2012. Therefore, more-immunogenic polio vaccines, including monovalent oral poliovirus vaccines (mOPVs), are needed for supplemental immunization activities. This trial assessed the immunogenicity of monovalent types 1 and 3, compared with that of trivalent oral poliovirus vaccine (tOPV), in South Africa.

'Communicate to vaccinate' (COMMVAC). building evidence for improving communication about childhood vaccinations in low- and middle-income countries: protocol for a programme of research.

Background: Effective provider-parent communication can improve childhood vaccination uptake and strengthen immunisation services in low- and middle-income countries (LMICs). Building capacity to improve communication strategies has been neglected. Rigorous research exists but is not readily found or applicable to LMICs, making it difficult for policy makers to use it to inform vaccination policies and practice.

Developing vaccinology expertise for Africa: six years and counting.

There exists high quality evidence showing that interactive educational meetings and workshops can improve healthcare worker performance. This evidence formed the basis for establishing the annual African Vaccinology Course in 2005 at the University of Cape Town in South Africa. The course, which is designed to develop vaccinology expertise for Africa, covers relevant basic sciences pertaining to vaccine-preventable diseases such as epidemiology, immunology and microbiology; discusses specific vaccine-preventable diseases; provides information on vaccine safety, vaccination strategies and evaluation of vaccines; discusses new vaccines in the pipeline; and promotes vaccine advocacy.

Review of rotavirus studies in Africa: 1976-2006.

Background: Rotavirus is a common cause of severe diarrheal disease in children worldwide. Ninety percent of the associated deaths occur in sub-Saharan Africa and South East Asia. Our aim was to review the prevalence of rotavirus infection in Africa over the past 30 years.

Improving communication for immunisation in Africa: contribution of the Vaccines for Africa website.

ABOUT THE AUTHORS: C. Wiysonge is a medical epidemiologist and Vaccinology Programme Manager at the Institute of Infectious Disease and Molecular Medicine, University of Cape Town, South Africa. He previously worked for the Expanded Programme on Immunisation in Cameroon and has been a consultant on vaccines and immunisation for WHO and the GAVI Alliance.

Relationship between fluid management, changes in serum sodium and outcome in hypernatraemia associated with gastroenteritis.

Objective: To describe the relationship between fluid management, serum sodium and outcome in critically ill children with hypernatraemic gastroenteritis.

Methods: A retrospective study of 57 children with hypernatraemic gastroenteritis admitted to a paediatric intensive care unit in Cape Town, South Africa. Data were collected on fluid management, serum electrolytes and adverse outcome (seizures, new neurological deficit and mortality) and analysed using univariate and multivariate statistics.

The lactate:pyruvate ratio following open cardiac surgery in children.

Objective: To explore the relationship between lactate:pyruvate ratio, hyperlactataemia, metabolic acidosis, and morbidity.

Design And Setting: Prospective observational study in the paediatric intensive care unit (PICU) of a university hospital.

Patients: Ninety-seven children after open cardiac surgery.

Short-term mortality and implementation of antiretroviral treatment for critically ill HIV-infected children in a developing country.

Objective: To describe the short-term outcome of critically ill HIV-infected children with access to highly active antiretroviral therapy (HAART) in a developing region.

Methods: Prospective observational study conducted in a paediatric teaching hospital in Cape Town, South Africa. All children admitted to the paediatric intensive care unit (PICU) with suspected HIV infection were screened.

Hyperchloraemic metabolic acidosis following open cardiac surgery.

Aims: To describe acid-base derangements in children following open cardiac surgery on cardiopulmonary bypass (CPB), using the Fencl-Stewart strong ion approach.

Methods: Prospective observational study set in the paediatric intensive care unit (PICU) of a university children's hospital. Arterial blood gas parameters, serum electrolytes, strong ion difference, strong ion gap (SIG), and partitioned base excess (BE) were measured and calculated on admission to PICU.

Transport of critically ill children in a resource-limited setting.

Objective: To audit paediatric intensive care unit (PICU) transfer activity and transfer-related adverse events in a resource-limited setting.

Design And Setting: Twenty-two bed regional PICU of a university children's hospital in Cape Town, South Africa. Prospective 1-year audit of all children transferred directly from other hospitals.

Retropharyngeal abscess complicated by carotid artery rupture.

OBJECTIVE: To report the case of a child with a retropharyngeal abscess complicated by carotid artery rupture. DESIGN: Descriptive case report. SETTING: Pediatric intensive care unit of a children's hospital.

Mortality and the nature of metabolic acidosis in children with shock.

Hypothesis: Mortality in children with shock is more closely related to the nature, rather than the magnitude (base deficit/excess), of a metabolic acidosis.

Objective: To examine the relationship between base excess (BE), hyperlactataemia, hyperchloraemia, 'unmeasured' strong anions, and mortality.

Design: Prospective observational study set in a multi-disciplinary Paediatric Intensive Care Unit (PICU).

Correction of the anion gap for albumin in order to detect occult tissue anions in shock.

Background: It is believed that hypoalbuminaemia confounds interpretation of the anion gap (AG) unless corrected for serum albumin in critically ill children with shock.

Aim: To compare the ability of the AG and the albumin corrected anion gap (CAG) to detect the presence of occult tissue anions.

Methods: Prospective observational study in children with shock in a 22 bed multidisciplinary paediatric intensive care unit of a university childrenrsquo;s hospital.

Presentation and outcome of severe anticholinesterase insecticide poisoning.

Aims: To document the patterns of presentation and outcome of severe anticholinesterase insecticide poisoning in children requiring intensive care.

Methods: Retrospective case note review of all 5541 children admitted to the paediatric intensive care unit (PICU) of a university hospital during the 10 years from January 1990 to May 2000. Fifty four children (1%) with anticholinesterase insecticide poisoning were identified.

Severe upper airway obstruction caused by ulcerative laryngitis.

Aims: To present our experience of severe upper airway obstruction caused by ulcerative laryngitis in children.

Methods: Retrospective case note review of 263 children with severe upper airway obstruction and a clinical diagnosis of croup admitted to a paediatric intensive care unit (PICU) over a five year period.

Results: A total of 148 children (56%) underwent microlaryngoscopy (Storz 3.