Common diseases
The four main areas of pathology are:
HIV and AIDS. Antenatal surveys suggest a prevalence rate of 29% in our area (in 2006). That translates to an average of 16% of people over the age of 2 years are infected! Although we have an anti-retroviral (ARV) programme with over 1000 patients started on treatment, these drugs are not yet easily accessible for many and we see many end-stage patients who we are unable to help. Fear and stigma remain significant obstacles in battling this epidemic.
Tuberculosis. This disease is rampantly out of control in our district. Although a surveillance structure exists, DOTS (directly observed treatment strategy) is not being properly implemented. The HIV/AIDS epidemic makes control of TB even more challenging. We see many patients requiring re-treatment either after previous completion or defaulting of their first treatment. Many of these patients need admission for two months of daily injections as they live far from their local clinics. We see about one case of TB resistant to either Rifampicin or Isoniazid or both per month, so we may be sitting on a multi-drug resistance time-bomb.
Maternity related. We estimate that up to 25% of woman in our catchment area still deliver at home. Having said this, there was a 54% increase in deliveries at Zithulele between 2005 and 2008! We now conduct over 1100 deliveries per year. Proper monitoring of peri-natal mortality has been conducted since August 2005. The peri-natal mortality rate at Zithulele Hospital, which averages about 42 per 1000 in rural hospitals nationally, came down to 24.6 per 1000 in 2008. It was a bit higher in 2009 again, but our average is now consistently under 30 per 1000. We hope this reflects our increased efforts, but avoidable mortality continues, specifically reflecting the relative lack of ante-natal care and poor transport infrastructure in our area.
Child Health. Major challenges in child health centre on immunisation, malnutrition and infectious disease. Infant mortality and morbidity remains relatively high as well, in part due to poor implementation of the Prevention of Mother to Child Transmission of HIV programme. We have been auditing paediatric mortality since May 2007.
In addition we see a range of diseases including bilharzia, hypertension, diabetes, cardiac disease, septic wounds, ear infections, scabies and mostly minor trauma.
HIV and AIDS. Antenatal surveys suggest a prevalence rate of 29% in our area (in 2006). That translates to an average of 16% of people over the age of 2 years are infected! Although we have an anti-retroviral (ARV) programme with over 1000 patients started on treatment, these drugs are not yet easily accessible for many and we see many end-stage patients who we are unable to help. Fear and stigma remain significant obstacles in battling this epidemic.
Tuberculosis. This disease is rampantly out of control in our district. Although a surveillance structure exists, DOTS (directly observed treatment strategy) is not being properly implemented. The HIV/AIDS epidemic makes control of TB even more challenging. We see many patients requiring re-treatment either after previous completion or defaulting of their first treatment. Many of these patients need admission for two months of daily injections as they live far from their local clinics. We see about one case of TB resistant to either Rifampicin or Isoniazid or both per month, so we may be sitting on a multi-drug resistance time-bomb.
Maternity related. We estimate that up to 25% of woman in our catchment area still deliver at home. Having said this, there was a 54% increase in deliveries at Zithulele between 2005 and 2008! We now conduct over 1100 deliveries per year. Proper monitoring of peri-natal mortality has been conducted since August 2005. The peri-natal mortality rate at Zithulele Hospital, which averages about 42 per 1000 in rural hospitals nationally, came down to 24.6 per 1000 in 2008. It was a bit higher in 2009 again, but our average is now consistently under 30 per 1000. We hope this reflects our increased efforts, but avoidable mortality continues, specifically reflecting the relative lack of ante-natal care and poor transport infrastructure in our area.
Child Health. Major challenges in child health centre on immunisation, malnutrition and infectious disease. Infant mortality and morbidity remains relatively high as well, in part due to poor implementation of the Prevention of Mother to Child Transmission of HIV programme. We have been auditing paediatric mortality since May 2007.
In addition we see a range of diseases including bilharzia, hypertension, diabetes, cardiac disease, septic wounds, ear infections, scabies and mostly minor trauma.
