The Impact of the Mandela-Castro Medical Collaboration Programme on Health Care Service Delivery in the Frances Baard District Hospitals in the Northern Cape Province

Research ArticleAccess to health care is a basic constitutional right in South Africa. The extreme shortage of doctors in sub-Saharan Africa is well documented, with 26 doctors per 100 000 people against a global average of 141 doctors per 100 000 people. The situation is no different in South Africa. The rural health care facilities have been facing a critical shortage of medical doctors where approximately 43% of the people in the rural areas often face greater health challenges such as having access to a mere 12% of the medical workforce in South Africa. In an attempt to address the shortage of doctors the late Presidents of South Africa and Cuba, Nelson Mandela and Fidel Castro, signed a bilateral agreement in 1996. One of the key terms of the agreement was to address the critical shortage of medical doctors in South Africa. This article reflects the findings of a study that was conducted to assess whether the Mandela-Castro Medical Collaboration Programme (MCMCP) has assisted in promoting health care service delivery in the small district hospitals in the Frances Baard District Municipality (FBDM) area in the Northern Cape Province. The period reviewed was from 2017 to 2019 because the doctors produced through the MCMCP had already been delivering health care services in hospitals of the FBDM. The research approach applied was deductive in nature and used quantitative data to generate propositions. The article provides insight into the impact of MCMCP on health care service delivery in the FBDM district hospitals, Northern Cape Province

Comparison of the AmpFire® Multiplex HPV Assay to the Xpert® HPV Assay for detection of human papillomavirus and cervical disease in women with human immunodeficiency virus: a pragmatic performance evaluation

Abstract Background Low- and middle-income countries (LMICs) account for nearly 85% of the global cervical cancer burden, yet have the least access to high-performance screening. International guidelines recommend human papillomavirus testing (HPV) as primary screening, yet implementation is inhibited by the cost of HPV testing. Atila AmpFire® HPV Assay (AmpFire) is both affordable and easy to use, and offers individual genotyping. The objective of this study was to compare the performance of the AmpFire HPV assay to the Xpert® HPV assay in detection of both HPV and clinically significant cervical disease. Methods We utilized stored cervical specimens from a prospective cohort study of women living with human immunodeficiency virus (HIV) in Botswana conducted from May to July 2018. Positive and negative percent agreement was calculated for the AmpFire and Xpert assays, as was detection of high-grade cervical dysplasia. Results 63 stored cervical specimens had detectable DNA after thawing and were included in the analysis. The positive percent agreement was 91.2% (95%CI 76.3–98.1) and negative percent agreement was 79.3% (95% CI 60.3–92.0). Six cases positive by AmpFire but negative by Xpert were HPV genotypes 35, 52 (n = 2), 58, 68, and co-infection with HPV 45 and 68. Both Xpert and AmpFire assays detected HPV in all 10 samples of women who had high-grade cervical dysplasia. Conclusions The AmpFire HPV assay demonstrated excellent analytic performance in both detection of HPV and clinically significant cervical disease. AmpFire HPV is a promising option to increase access to affordable, type-specific HPV screening for cervical cancer in LMICs