Background Surgical Site Infections (SSIs) are among the leading causes of the postoperative complications. This study aimed at investigating the epidemiologic characteristics of orthopedic SSIs and estimating the underreporting of registries using the capture-recapture method. Methods This study, which was a registry-based, cross-sectional one, was conducted in six educational hospitals in Tehran during a one-year period, from March, 2017 to March, 2018. The data were collected from two hospital registries (National Nosocomial Infection Surveillance System (NNIS) and health information management database (HIM)). First, all orthopedic SSIs registered in these sources were used to perform capture-recapture (N = 503). Second, 202 samples were randomly selected to assess patientsc haracteristics. Results Totally, 76.24% of SSIs were detected post-discharge. Staphylococcus.aureus (11.38%) was the most frequently detected bacterium in orthopedic SSIs. The median time between the detection of a SSI and the discharge was 17 days. The results of a study done on 503 SSIs showed that the coverage of NNIS and HIM was 59.95% and 65.17%, respectively. After capture-recapture estimation, it was found that about 221 of orthopedic SSIs were not detected by two sources among six hospitals and the real number of SSIs were estimated to be 623 ± 36.58 (95% CI, 552-695) and under-reporting percentage was 63.32%. Conclusions To recognize the trends of SSIs mortality and morbidity in national level, it is signi cant to have access to a registry with minimum underestimated data. Therefore, according to the weak coverage of NNIS and HIM among Iranian hospitals, a plan for promoting the national Infection prevention and control (IPC) programs and providing updated protocols is recommended.

Background: Healthcare-associated infections (HCAIs) are a well-known public health threat; however, published data on the endemic burden of HCAIs in sub-Saharan Africa are limited. This study aimed to determine the prevalence of primary bloodstream infection (PBSI), surgical site infection (SSI), lower respiratory tract infection (LRTI) and urinary tract infection (UTI) at Kimberley Hospital Complex (KHC), Northern Cape.Methods: A one-day pointprevalence survey was conducted between February 2016 and March 2016 on all patients admitted to 15 selected wards at KHC. The Standardised Centers for Disease Control and National Nosocomial Infection Surveillance Systems criteria were used.Results: A total of 326 patients were surveyed and the overall HCAI prevalence rate was 7.67%. This included 4.60% SSIs, 1.53% UTIs, 0.92% PBSIs and 0.92% LRTIs. Patients with HCAI stayed a mean of 20.8 days compared with 9.1 days for the remaining patients. Almost 75% (n = 240) of the surveyed patients had one or more recognised risk factors. The most isolated microorganism among the 11 microorganisms isolated was Klebsiella pneumoniae (36.4%). Half (54.5%) of the isolated organisms were resistant to penicillin. At the time of the survey, 42.0% of all the patients were on antimicrobials of which amoxicillin/clavulanic acid was most commonly prescribed (29.9%). Conclusion: The overall HCAI prevalence rate found in KHC is encouraging, but the prevalence of SSI is of concern. Further studies are needed to identify risk factors and target this as an area where preventative interventions can be implemented.

Background Admission to a mental healthcare facility is not always based on the voluntary consent of the patient. Sometimes a patient is unable or unwilling to consent to admission because of his mental status and lack of insight into his mental illness. If a mentally ill person needs admission because of a threat to himself and other people, the law prescribes procedures to admit such a person into an appropriate facility for care, treatment and rehabilitation. Such admissions are called involuntary admissions. Involuntary admissions in a psychiatric hospital have financial, legal and ethical implications. In order to avoid unnecessary involuntary admissions, there is a need to determine and understand the factors causing involuntary admissions. Many previous studies have focused on the differences between patients admitted voluntarily and involuntarily. The goal of this study was to analyse the conditions responsible for the involuntary admission of psychiatric patients in the Northern Cape Province and the accuracy of the initial psychiatric assessment done by the referring general practitioners. Method This descriptive study included 199 patients admitted to West End Hospital in Kimberley for involuntary treatment during 2003. The data were extracted from clinical records and legal documentation relating to these patients. The patients' final diagnoses were extracted from the discharge summary and were based on the text revision of the fourth edition of DSM (DSM-IV-TR). Only diagnoses on axis I (clinical disorders and other conditions that may be a focus 1 clinical attention), axis II (personality disorders and mental retardation) and axis III (physical disorder or general medical condition that is present in addition to the mental disorder) were included in this study. Results Most patients were male (65.8%) and the patients' ages ranged from 16 to 67 years (mean 32 years). Patients were mostly diagnosed with schizophrenia (57.8%), while 26.6% had substance-related disorders. Few patients (5.0%) were diagnosed with mental retardation and personality disorders. A quarter (24.1%) of the patients had a general medical condition. The majority (81.4%) of patients were found "certifiable" and 77.4% were known psychiatric patients. Two-thirds of the patients were referred by general practitioners doing session for the state hospitals. The overall accuracy of psychiatric diagnosis by the referring doctors was considered correct if any of the provisional diagnoses listed by the referring (certifying) doctor matched with the final diagnosis at discharge from the hospital. Approximately half (49.5%) of the patients were diagnosed correctly by the referring doctors. Conclusion Schizophrenia and psychoactive substance-related disorders were the most important conditions leading to involuntary care in the Northern Cape. General practitioners play a major role in involuntary admission, but only made correct psychiatric diagnoses in approximately half of the patients.

Background: Dog bite injuries in humans remain a public health problem. There is limited nationally representative data on the magnitude of the problem and the epidemiological profile of dog bite injuries in South Africa. Aim:To describe the profile of dog bite injuries in patients presenting to Kimberley Hospital Complex (KHC) emergency and gateway centres. To determine the prevalence of dog bite injuries amongst all patients presenting to these centres and the compliance of mandatory notification of dog bites. Setting: Kimberley Hospital Complex emergency and gateway centres.Methods: A retrospective review of all dog bite cases who presented to KHC from August 2015 to July 2017. The total number of all patients who presented were taken into consideration for calculating the prevalence of dog bite cases.Results: During the study period, 433 dog bite cases were identified out of 107 731 patients seen at emergency and gateway centres, giving a prevalence of 0.4%. Of all cases, 62.4% were male patients and 37.6% were female patients. Most affected age group was between 10 and 19 years (19.6%). Category II exposure type accounted for the majority of the cases (59.4%). Unvaccinated dogs were incriminated in 61.9% of cases. Stray dogs were responsible for 83.1% of all injuries. More than half of the cases (47.9%) were notified by the treating doctors. Conclusion:Dog bite injuries in Kimberley were commonest in children and adolescents. The prevalence tended to decrease in adulthood with advancing age groups. Most bites resulted from unvaccinated stray dogs. Only about half of the cases were notified to the appropriate authorities. Prevalence of dog bite injuries amongst patients presenting at KHC resulted in the low rate of 0.4%. Awareness needs to be created amongst health care providers on the importance of notification of all exposure to rabies. More efforts are required at the prevention of dog bites in children and adolescents through stringent measures to limit the number of free-roaming dogs.

South Africa is a multicultural society characterised by a rich diversity of languages. As a result, many healthcare providers and their patients often do not speak the same language, which makes communication challenging. The language barriers, when present, require an interpreter to ensure accurate and effective communication between the parties. In addition to assisting in a clear exchange of information, a trained medical interpreter also acts as a cultural liaison. This is especially true when the provider and the patient come from different cultural backgrounds. Based on the patient’s needs, preferences, and available resources, clinicians should select and engage with the most appropriate interpreter. The effective use of an interpreter requires knowledge and skill. Patients and healthcare providers can benefit from several specific behaviours during interpreter-mediated consultations. This review article provides practical tips on when and how to use an interpreter effectively during clinical encounters in primary healthcare settings in South Africa.