SummaryDeaths following surgery are the third largest contributor to deaths globally, and in Africa are twice the global average. There is a need for a peri‐operative research agenda to ensure co‐ordinated, collaborative research efforts across Africa in order to decrease peri‐operative mortality. The objective was to determine the top 10 research priorities for peri‐operative research in Africa. A Delphi technique was used to establish consensus on the top research priorities. The top 10 research priorities identified were (1) Develop training standards for peri‐operative healthcare providers (surgical, anaesthesia and nursing) in Africa; (2) Develop minimum provision of care standards for peri‐operative healthcare providers (surgical, anaesthesia and nursing) in Africa; (3) Early identification and management of mothers at risk from peripartum haemorrhage in the peri‐operative period; (4) The role of communication and teamwork between surgical, anaesthetic, nursing and other teams involved in peri‐operative care; (5) A facility audit/African World Health Organization situational analysis tool audit to assess emergency and essential surgical care, which includes anaesthetic equipment available and level of training and knowledge of peri‐operative healthcare providers (surgeons, anaesthetists and nurses); (6) Establishing evidence‐based practice guidelines for peri‐operative physicians in Africa; (7) Economic analysis of strategies to finance access to surgery in Africa; (8) Establishment of a minimum dataset surgical registry; (9) A quality improvement programme to improve implementation of the surgical safety checklist; and (10) Peri‐operative outcomes associated with emergency surgery. These peri‐operative research priorities provide the structure for an intermediate‐term research agenda to improve peri‐operative outcomes across Africa.

In high-income countries, preoperative anaemia has been associated with increased postoperative morbidity and mortality. [1] Preoperative anaemia is a common problem, with three large database studies in Europe and America estimating the prevalence to be between 25% and 30%. [2-4] Anaemia is also associated with increased perioperative blood transfusions, a practice independently associated with morbidity and mortality. [5] Growing evidence supports increasingly restrictive transfusion strategies in surgical and critical care patients, and as a result allogeneic transfusions can no longer be considered an appropriate isolated management strategy for surgical patients with preoperative anaemia. [6,7] Furthermore, the demographics of the South African (SA) surgical population differ significantly from those of the populations in which the morbidity associated with preoperative anaemia has been described. SA non-cardiac surgical patients are younger, have fewer non-communicable diseases, and undergo significantly more urgent and emergency This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Diabetes mellitus (DM) is a common condition, affecting an estimated 15.5 million people in Africa. Importantly, the prevalence of DM across the continent is expected to double by 2045. [1] Since 2015, this condition has been ranked as the second most common cause of natural death in South Africa (SA), and its impact on healthcare provision is substantial. [2] Accurate assessment of prevalence is difficult owing to the high burden of undiagnosed DM (estimated at 69% in Africa) and the lack of large population studies. [1] In SA, the prevalence of DM is estimated to be between 5.4% and 9.2%. [1,3] There are limited data reporting the prevalence of DM in Western Cape Province, SA, and information with regard to elective surgical patients is minimal. Many studies have shown that DM, especially if poorly controlled, is associated with an increased risk of perioperative complications and mortality. [4-9] In SA, insulin-dependent surgical patients are twice as likely as non-diabetics to die in hospital. [10] Objectives The primary objective of this study was to establish the prevalence of DM in patients presenting for elective surgery over a 1-week period in six Western Cape hospitals. This included patients with a previous diagnosis of DM, and those with a new diagnosis based on screening capillary blood glucose (CBG) testing and a confirmatory elevated glycated haemoglobin (HbA1c) level. The secondary objectives were to assess: (i) the glycaemic control of known diabetics presenting for This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.