WSU COLLABORATIVE STUDY FINDS HIGH PREVALENCE OF CRITICAL ILLNESS IN AFRICAN HOSPITALS

Eastern Cape hospitals, including the Nelson Mandela Academic Hospital (NMAH) in Mthatha, were part of a groundbreaking study involving 20, 000 patients from 180 hospitals across the African continent.

According to the study, there is a very high mortality rate of critically ill patients across the continent, with the burden of critical illnesses among in-hospital patients being approximately 25% higher than those reported in similar studies from high-income countries.

In Africa, 12.5% of hospital in-patients are critically ill, and among them, 21% die within seven days, compared to 2.7% of non-critically ill patients.

“Critical illness can be defined as a state of ill health with vital organ dysfunction and a high risk of imminent death if care is not provided. This includes low blood pressure, irregular breathing, and low levels of consciousness, amongst others,” said the head of Department of Anaesthesiology, Professor Busisiwe Mrara,

She added, “Our findings suggest a high incidence of preventable deaths from critical illness in Africa. In many cases, the provision of basic critical care through the equitable and systems-based implementation of essential emergency and critical care may have a substantial impact on these preventable patient deaths.”

NMAH, serving 3.5 million people, operates with approximately 700 beds, yet only eight are dedicated to intensive care, underscoring the shortage of life-saving resources in the region.

The study presented that approximately 69% of critically ill patients are cared for in general hospitals wards rather than in high-dependency or intensive care units.

Additionally, 56% of critically ill patients do not receive the essential emergency and critical care they need to save their lives, such as oxygen, intravenous fluids, and correct positioning.

“critical care services are quite expensive, especially the intensive care unit, where beds cost about R20,000 in private care, and in low- and middle-income countries, the cost is unaffordable. So, we need research like this to identify ways of managing critical illnesses in their early stages before patients get sick enough to need ICU,” said Mrara.

Commenting on the findings, Mrara noted the widespread shortage of resources across hospitals in the African continent.

These include critical gaps in infrastructure, equipment, staffing, training, treatment guidelines, consumables, and drugs required to manage critically ill patients effectively.

Mrara further noted that studies like this highlight the widespread nature of the issue rather than confining it to a single hospital, underscoring the need for global recognition.

This perspective positions the problem as an international priority for resource mobilisation rather than attributing it to local inefficiencies.

Recognising this urgency, the WSU Faculty of Medicine and Health Sciences launched a global public health initiative in 2024, to identify threats early and implement preventive measures, reducing the strain on local healthcare systems.

This initiative aligns with the United Nations Sustainable Development Goal 3: Good Health and Well-being.

“There are also outreach programmes on the supply and distribution of critical resources, such as oxygen and essential medical equipment, across all hospitals in the province, not just tertiary institutions. This outreach ensures that healthcare workers are not only well-trained but also supported with the necessary tools to deliver quality care,” said Mrara.

She added, “by working closely with the Department of Health, the faculty helps shape policies and strategies to enhance patient care and strengthen the province’s overall healthcare system.”

Published in the peer-reviewed journal The Lancet, the study was a collaboration between researchers from WSU’s Department of Internal Medicine, Surgery, Obstetrics & Gynaecology, Anaesthesiology, the University of Cape Town, Muhimbili University of Health and Allied Sciences (Tanzania), Queen Mary University of London, and the National Institute for Health and Care Research (NIHR) Global Health Group in Perioperative and Critical Care.

By Ongezwa Sigodi