ABSTRACT
BACKGROUND: Approximately 10% of coronavirus disease 2019 (COVID-19) patients will experience long COVID. There is no study of long COVID in mild COVID-19 patients in South Africa. This study aimed, firstly, to describe the prevalence of long COVID in mild COVID-19 patients in Cape Town, and, secondly, to document the impact of COVID-19 on patients' well-being, work, and their access to long COVID treatment. METHODS: In this retrospective cross-sectional study, a random sample of adults diagnosed with mild COVID-19 were called two months post-diagnosis. The participants telephonically completed a standardised survey describing their long COVID symptoms, missed workdays, and health-seeking behaviour. Medical records were reviewed for comorbidities, original COVID-19 symptoms, and treatment. RESULTS: It was found that 60% of patients with mild COVID-19 had ≥ 1 long COVID symptom, while 35% had ≥ 3 ongoing symptoms for two months. Dyspnoea and fatigue were the most common symptoms. The findings revealed that 52% of employed patients missed work and 25% of patients self-reported non-recovery from their COVID-19. Moreover, 24% of patients consulted a clinician for long COVID, but only 7% of patients received long COVID care in the public sector. Of the 17% of patients requiring additional help for long COVID, 56% were interested in assistance by text message or telephonic consultation. CONCLUSION: Over a half of mild COVID-19 patients experienced at least one long COVID symptom for two months and nearly 20% needed additional medical treatment. Very few patients utilised the public sector for long COVID treatment. There is a great need for long COVID treatment in public healthcare services and patients are receptive to remote care.
Subject(s)
COVID-19 , Adult , COVID-19/complications , Cross-Sectional Studies , Follow-Up Studies , Humans , Retrospective Studies , SARS-CoV-2 , South Africa/epidemiology , Post-Acute COVID-19 SyndromeABSTRACT
BACKGROUND: HIV prevalence is increasing among South African youth, but HIV counselling and testing (HCT) remains low. Adolescent pregnancy rates are also high. OBJECTIVES: Innovative strategies are needed to increase HIV and pregnancy screening and prevention among youth. METHOD: The Desmond Tutu HIV Foundation Youth Centre (DTHF-YC) offers integrated, incentivised sexual and reproductive health (SRH), educational and recreational programmes. We compared HCT and contraception rates between the DTHF-YC and a public clinic (PC) in Cape Town to estimate the impact of DTHF-YC on youth contraception and HCT utilisation. RESULTS: In 2015, females < 18 years had 3.74 times (confidence interval [CI]: 3.37-4.15) more contraception visits at DTHF-YC versus PC. There were no differences in the contraception and adherence was suboptimal. DTHF-YC youth (aged 15-24 years) were 1.85 times (CI: 1.69-2.01) more likely to undergo HCT versus PC, while male youth were 3.83 times (CI: 3.04-4.81) more likely to test at DTHF-YC. Youth were a third less likely to test HIV-positive at DTHF-YC versus PC. Female sex, older age, clinic attendance for contraception and sexually transmitted infections (STIs), redeeming incentives and high DTHF-YC attendance were all independent factors associated with increased HCT. CONCLUSION: Youth were significantly more likely to access SRH services at DTHF-YC compared with the PC. The differences were greatest in contraception use by female adolescents < 18 years and HCT by male youth. Increased HCT did not increase youth HIV case detection. Data from DTHF-YC suggest that youth-friendly healthcare providers integrated into community youth spaces may increase youth HCT and contraception rates.
ABSTRACT
OBJECTIVE: To determine the cost of rotavirus and all-cause diarrhoea in Vellore, India. METHODS: Parents of children <5 years of age accessing clinics, emergency rooms, or hospitals for acute diarrhoea completed a questionnaire detailing healthcare utilisation, medical and non-medical expenditures, and lost income. Faecal samples were screened for rotavirus and medical records were examined. Costs were estimated for inpatient and outpatient resource consumption, stratified by facility. RESULTS: Total societal costs of a hospitalised diarrhoeal episode were Rs 3278.50 (US$ 80.80) at a large referral hospital and Rs 1648.60 (US$ 40.60) at a smaller community hospital. Costs for rotavirus positive or negative gastroenteritis were similar. Median household expenditures per diarrhoeal episode at the referral and the community hospitals equalled 5.8% and 2.2% of the annual household income, respectively. CONCLUSIONS: Diarrhoeal disease in children constitutes a considerable economic burden. An appropriately priced and effective rotavirus vaccine may provide significant economic savings for the Indian household and healthcare system.