Browsing by Author "McCaul, M."

Now showing 1 - 5 of 5
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    Building capacity for development and implementation of clinical practice guidelines
    (Health and Medical Publishing Group, 2017) Louw, Q.; Dizon, J. M.; Grimmer, K.; McCaul, M.; Kredo, T.; Young, T.
    Robust, reliable and transparent methodologies are necessary to ensure that clinical practice guidelines (CPGs) meet international criteria. In South Africa (SA) and other low- and middle-income countries, upskilling and training of individuals in the processes of CPG development is needed. Since de novo CPG development is time-consuming and expensive, new emerging CPG-development approaches (adopting, contextualising, adapting and updating existing good-quality CPGs) are potentially more appropriate for our context. These emerging CPG-development methods are either not included or sparsely covered in existing training opportunities. The SA Guidelines Excellence (SAGE) team has responded innovatively to the need for CPG training in SA. We have revised an existing SA course and developed an online, open-access CPG-development toolkit. This Guideline Toolkit is a comprehensive guideline resource designed to assist individuals who are interested in knowing how to develop CPGs. Findings from the SAGE project can now be implemented with this innovative CPG training programme. This level of CPG capacity development has the potential to influence CPG knowledge, development, practices and uptake by clinicians, managers, academics and policy-makers around the country.
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    Interventions for improving childhood vaccination coverage in low- and middle-income countries
    (Health & Medical Publishing Group, 2015) Wiysonge, Charles S.; Young, T.; Kredo, T.; McCaul, M.; Volmink, J.
    Cochrane Corner’ in the November SAMJ highlights a Cochrane review that evaluated the effects of interventions for improving childhood vaccination coverage in low- and middle-income countries. Question: Which interventions increase the uptake of childhood vaccines in low and middle-income countries? Bottom line: Health education, home visits, and reminders probably increase the uptake of childhood vaccines in low and middle-income countries.
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    Outcomes of extremely low-birthweight neonates at a tertiary hospital in the Western Cape, South Africa : a retrospective cohort study
    (Health & Medical Publishing Group, 2021-10) Mugyenzi, Grace Musiime; Lloyd, L. G.; McCaul, M.; Van Zyl, N.; Holgate, S. L.
    Background. Neonates of extremely low birthweight (ELBW; <1 000 g) have the highest neonatal mortality in South Africa (SA). Objective. To describe the morbidity and mortality of ELBW neonates treated at a tertiary hospital in SA. Methods. This was a retrospective cohort study including all live-born ELBW neonates treated at Tygerberg Hospital between 1 January and 31 December 2016. Data were extrapolated from a prospectively collected neonatal database and patient records. Multiple logistic regression and survival analysis were performed to identify risk factors of mortality. Results. The sample included 256 neonates. The following morbidities were recorded: respiratory distress syndrome (83.2%); bronchopulmonary dysplasia (8.2%); intraventricular haemorrhage (34.5%); periventricular leukomalacia (0.6%); necrotising enterocolitis (10.5%); and retinopathy of prematurity (31.2%). The survival-to-discharge rate was 63.3%. Cause of death was documented as extreme prematurity in 41% of the inpatient deaths. Birthweight was a significant predictor of mortality (hazard ratio 0.99; 95% confidence interval 0.992 - 0.999). Of the 162 neonates who survived until discharge, 11 died following discharge. Conclusion. Morbidity and mortality rates remain high among ELBW neonates. To improve survival, resources need to be allocated to neonatal resuscitation, surfactant therapy and increasing availability of intensive-care beds.
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    Pre-hospital versus in-hospital thrombolysis for ST-elevation myocardial infarction (Review)
    (2014) Lourens, A.; Kredo, T.; McCaul, M.
    Background: Early thrombolysis for individuals experiencing a myocardial infarction is associated with better mortality and morbidity outcomes. While traditionally thrombolysis is given in hospital, pre-hospital thrombolysis is proposed as an effective intervention to save time and reduce mortality and morbidity in individuals with ST-elevation myocardial infarction (STEMI). Despite some evidence that prehospital thrombolysis may be delivered safely, there is a paucity of controlled trial data to indicate whether the timing of delivery can be effective in reducing key clinical outcomes. Objectives: To assess the morbidity and mortality of pre-hospital versus in-hospital thrombolysis for STEMI.
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    Task-shifting from doctors to non-doctors for initiation and maintenance of antiretroviral therapy
    (Health and Medical Publishing Group, 2015) Kredo, T.; McCaul, M.; Volmink, J.
    'Cochrane Corner’ in the August SAMJ offers evidence relating to articles published in this issue, namely ‘Improving access to antiretrovirals in rural South Africa – a call to action’, ‘Multimorbidity, control and treatment of non-communicable diseases among primary healthcare attenders in the Western Cape, South Africa’ and ‘Prevalence of tobacco use among adults in South Africa: Results from the first South African National Health and Nutrition Examination Survey’, and the editorial by Yach and Alexander, ‘Turbo-charging tobacco control in South Africa’.