Determinants of the Limpopo Province of South Africa’s Response to COVID-19: A Mixed Methods Protocol to Analyze and Share Lessons Learned

Matlala, Sogo F.; Tshitangano, Takalani G.; Sono-Setati, Musa E.; Ramalivhana, Naledzani J.; Mphekgwana, Peter M.

doi:10.3390/healthcare10050926

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…This study used secondary data kept by the Limpopo Department of Health (LDoH). Ethical issues and permission to access the data are described in the published protocol [52], which was approved by Turfloop Research Ethics Committee (TREC) at UL and was granted (TREC/293/2021: IR). The study included 15,151 patient clinical records of laboratoryconfirmed COVID-19 cases.…”

Section: Study Design and Settingmentioning

confidence: 99%

Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression

Mphekgwana,

Sono-Setati,

Mokgophi

et al. 2023

IJERPH

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Globally, the coexistence of metabolic syndrome (MetS) and HIV has become an important public health problem, putting coronavirus disease 19 (COVID-19) hospitalized patients at risk for severe manifestations and higher mortality. A retrospective cross-sectional analysis was conducted to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients using secondary data from the Department of Health in Limpopo Province, South Africa. The study included 15,151 patient clinical records of laboratory-confirmed COVID-19 cases. Data on MetS was extracted in the form of a cluster of metabolic factors. These included abdominal obesity, high blood pressure, and impaired fasting glucose captured on an information sheet. Spatial distribution of mortality among patients was observed; overall (21–33%), hypertension (32–43%), diabetes (34–47%), and HIV (31–45%). A multinomial logistic regression model was applied to identify factors and determine their relationships with hospitalization outcomes for COVID-19 patients. Mortality among COVID-19 patients was associated with being older (≥50+ years), male, and HIV positive. Having hypertension and diabetes reduced the duration from admission to death. Being transferred from a primary health facility (PHC) to a referral hospital among COVID-19 patients was associated with ventilation and less chance of being transferred to another health facility when having HIV plus MetS. Patients with MetS had a higher mortality rate within seven days of hospitalization, followed by those with obesity as an individual component. MetS and its components such as hypertension, diabetes, and obesity should be considered a composite predictor of COVID-19 fatal outcomes, mostly, increased risk of mortality. The study increases our understanding of the common contributing variables to severe manifestations and a greater mortality risk among COVID-19 hospitalized patients by investigating the influence of MetS, its components, and HIV coexistence. Prevention remains the mainstay for both communicable and non-communicable diseases. The findings underscore the need for improvement of critical care resources across South Africa.

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Section: Study Design and Settingmentioning

confidence: 99%

Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression

Mphekgwana,

Sono-Setati,

Mokgophi

et al. 2023

IJERPH

Self Cite

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“…This study used secondary data on the COVID-19 response kept by the LPDoH. The mixed-methods study protocol for the use of secondary data kept by LPDoH is reported elsewhere [ 26 ]. A quantitative study by Tshitangano et al describes, in detail, the process followed by LPDoH when collecting primary data on the COVID-19 response using a clinical mortality audit tool [ 27 ].…”

Section: Methodsmentioning

confidence: 99%

Health System- and Patient-Related Factors Associated with COVID-19 Mortality among Hospitalized Patients in Limpopo Province of South Africa’s Public Hospitals

et al. 2022

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South Africa has recorded the highest COVID-19 morbidity and mortality compared to other African regions. Several authors have linked the least amount of death in African countries with under-reporting due to poor health systems and patients’ health-seeking behaviors, making the use of clinical audits more relevant for establishing the root causes of health problems, and improving quality patient care outcomes. Clinical audits, such as mortality audits, have a significant role in improving quality health care services, but very little is documented about the outcomes of the audits. Therefore, the study sought to determine the health care system and patient-related factors associated with COVID-19 mortality by reviewing the COVID-19 inpatient mortality audit narration reports. This was a retrospective qualitative research approach of all hospitalized COVID-19 patients, resulting in death between the first and second COVID-19 pandemic waves. Thematic analysis employed inductive coding to identify themes from mortality audits from all 41 public hospitals in Limpopo Province, South Africa. Four themes with seventeen sub-themes emerged: sub-standard emergency medical care provided, referral system inefficiencies contributed to delays in access to health care services, the advanced age of patients with known and unknown comorbidities, and poor management of medical supplies and equipment, as a health system and patient-related factors that contributed to the high mortality of COVID-19 patients. There is a need to routinely conduct clinical audits to identify clinical challenges and make recommendations for health promotion, risk communication, and community engagement. We recommend reviewing and expanding the scope of practice for health-care providers during epidemics and pandemics that include aspects such as task-shifting.

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Epidemiological Characteristics of COVID-19 Inpatient Deaths during the First and Second Waves in Limpopo Province, South Africa

Tshitangano

Sono-Setati

Mphekgwana

et al. 2022

JoR

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More COVID-19 inpatient deaths occurred during the second wave when compared to the first wave in South Africa in both the public and private sectors. This study describes the characteristics of 969 COVID-19 inpatient deaths in the public sector of Limpopo Province during the first and second waves using population-based retrospective design. The results indicate that about 84% of deaths were aged 50+ years; 53.6% were females; 43% occurred in Capricorn district; 56% occurred in PUI wards; 64% had hypertension followed by diabetes mellitus; 88% manifested with shortness of breaths/respiratory distress on admission. The study concludes that as the average age among the population aged 60+ was greater among females than males, the increased death among females compared to males might be influenced by the older age of female inpatients during the first and second waves in Limpopo Province. Some COVID-19 inpatient deaths are possibly preventable if older women may be taken into consideration when planning prevention and management interventions in future pandemics.

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Determinants of the Limpopo Province of South Africa’s Response to COVID-19: A Mixed Methods Protocol to Analyze and Share Lessons Learned

Cited by 3 publications

References 7 publications

Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression

Retrospective Analysis of the Outcome of Hospitalized COVID-19 Patients with Coexisting Metabolic Syndrome and HIV Using Multinomial Logistic Regression

Health System- and Patient-Related Factors Associated with COVID-19 Mortality among Hospitalized Patients in Limpopo Province of South Africa’s Public Hospitals

Epidemiological Characteristics of COVID-19 Inpatient Deaths during the First and Second Waves in Limpopo Province, South Africa

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