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62Nd Annual Academic Day 29 August 2018 62Ste Akademiese 62nd Annual Academic Day 29 August 2018 62ste Akademiese Jaardag 29 Augustus 2018 ABSTRACTS / ABSTRAKTE 1 ABSTRACTS / ABSTRAKTE Theme 1 - Health Systems Strengthening / Tema 1 – Gesondheidsisteme Versterking Abstracts / Abstrakte p3 Theme 2 - Infectious Diseases / Tema 2 - Infeksiesiektes Abstracts / Abstrakte p20 Theme 3 - Mental Health and Neurosciences / Tema 3 – Geestesgesondheid en Neurowetenskappe Abstracts / Abstrakte p65 Theme 4 - Non-communicable Diseases / Tema 4 – Nie-oordraagbare Siektes Abstracts / Abstrakte p92 Theme 5 - Maternal and Child Health / Tema 5 – Moeder- en Kind Gesondheid Abstracts / Abstrakte p117 Theme 6 – Perioperative Sciences / Tema 6 – Perioperatiewe Wetenskappe Abstracts / Abstrakte p141 Theme 7 - Violence, Injuries, Trauma and Rehabilitation / Tema 7 – Geweld, Beserings, Trauma en Rehabilitasie Abstracts / Abstrakte p154 The contents of this section are published as received / Die inhoud van hierdie afdeling is gepubliseer soos dit ontvang is 2 Theme 1 / Tema 1 Health Systems Strengthening/ Gesondheidsisteme Versterking 3 ORAL PRESENTATIONS / REFERATE ABSTRACT NUMBER / ABSTRAKNOMMER: 1 Burden and profile of spinal pathology at a major tertiary hospital in the Western Cape, South Africa Sanesh Miseer (Division of Orthopaedic Surgery, Department of of Surgical Sciences, Faculty of Medicine and Health Sciences, Tygerberg) Background Spinal pathology in the Western Cape is managed at three tertiary level hospitals. The Tygerberg Hospital Orthopaedic Spinal Unit is responsible for the management of spinal pathology in the hospital’s catchment area. However, the Unit’s overall burden of disease and resource use is unclear.AimThe first aim was to investigate the overall burden and clinical profile of spinal pathology presenting to Spine Unit over a one-year period. The second aim was to determine resource use associated with spine pathology admissions.MethodsOverall burden was investigated by performing a retrospective review of all patients admitted to the Spine Unit between 2016-2017. Demographic and clinical data was collected and patients were assigned to one of five spinal pathology sub-groups. Resource use was determined by length of hospital stay, waiting times and advanced imaging and theatre usage.ResultsOverall burden was comprised of 349 individual patients and 376 admissions, including readmissions. Trauma (51%) and infection (24%) accounted for the majority of admitted pathology. Motor vehicle accidents (MVA’s) were the primary mechanism of injury accounting for 48% of spine trauma. Tuberculosis (TB) was the causative organism in 87% of spinal infections with 44% HIV co-infection. Hospital resource use was considerable with 92% of spine patients requiring advanced imaging, a median operating time of 3h 36min and a median hospital stay of 19 days. Infection and malignancy sub-groups had the longest waiting times for advanced imaging and theatre with a median wait of 14-16 days, accounting for approximately 62% of the typical total hospital stay.ConclusionsThe Spine Unit experienced a substantial patient burden requiring significant hospital resources. Reduced in-patient waiting times and upskilling of orthopaedic services at secondary hospitals represent key areas for health system strengthening. However, multi-sectoral strategies are required to effectively address our high burden of preventable spinal pathology. ABSTRACT NUMBER / ABSTRAKNOMMER: 2 Effectiveness of Physiotherapy versus Standard Medical Care on Pain, Disability, Kinesiophobia and Pain Catastrophization in Adult Patients with Non-Specific Acute Low Back Pain: A Systematic Review and Meta-analysis Carla Maritz (Stellenbosch University), Chane' van Straaten (Stellenbosch University), Courtney-Jade Nel* (Stellenbosch University), Linzette Morris (supervisor) (Stellenbosch University), Lizaan Johannes (Stellenbosch University), Petro Rossouw (Stellenbosch University), Tine' Kitshoff (Stellenbosch University) ObjectiveThe objective of this systematic review is to identify and evaluate the best available evidence for improving pain, disability, fear-avoidance behaviour and pain catastrophization in individuals experiencing non-specific acute LBP.Methods and AnalysisA comprehensive search strategy was conducted within the following seven databases: Cochrane Library, EBSCO Cinahl, EBSCO SportDiscus, PEDro, Pubmed, Science Direct and Scopus. No date limit was applied. The PEDro score was used for methodological appraisal and the National Health and Medical Research Council (NHMRC) Evidence Hierarchy for determining the strength of the evidence. Three reviewer pairs evaluated the relevant articles according to the inclusion criteria and extract relevant data. Ethics approval was not required due to the nature of the study design.ResultsA total of nine articles were included. Total sample size consisted of 993 participants, 508 in the physiotherapy group and 486 in the standard medical care group. The mean age in the studies ranged from 33.3 to 41.4 years. Both male and female participants were included. The study reported on the effect of physiotherapy to standard medical care. In the short term period the meta-analysis showed that physiotherapy was significantly more effective in reducing pain than standard medical care [95% CI, -0.90 to -0.12, p=0.01]. When measuring disability, the 4 meta-analysis found no significant difference but did favour physiotherapy at all time-intervals. For the other two outcomes, no significant findings were found. ConclusionThe results obtained in this review found no significant difference between physiotherapy versus standard medical care. However, in general physiotherapy was favoured in the outcomes measured. It is therefore recommended, that within the short-term period, patients should seek physiotherapy treatment opposed to standard medical care, in order to prevent chronicity and therefore prevent the need for mid to long term intervention. ABSTRACT NUMBER / ABSTRAKNOMMER: 3 Factors associated with non-attendance of scheduled occupational and physiotherapy outpatient follow-up appointments at the Western Cape Rehabilitation Centre (WCRC) Andrea Boon (Stellenbosch University), Lize Eloff (Stellenbosch University), Megan Carelse (Stellenbosch University), Michaela Stewart (Stellenbosch University), Minal Zaidi (Stellenbosch University), Zani Naudé (Stellenbosch University) Introduction: Occupational therapists and physiotherapists use follow-up appointments, to continue and monitor the effectiveness and outcome of therapy intervention. Patients with physical impairments are assisted by therapists to prevent and manage secondary complications and to maintain their functionality. Attendance of follow-up appointments are essential in the treatment process, as non- attendance has negative implications for both the patient and healthcare facility. Objectives: The objectives of this research were to 1) provide a description of the characteristic factors of attending and non-attending patients with scheduled occupational therapy and physiotherapy appointments at outpatient clinics at the Western Cape Rehabilitation Centre and 2) to determine the association between non-attendance and identified covariates. Methodology: A retrospective, cross-sectional study of all outpatients with a scheduled appointment between January 2017 and December 2017 at Western Cape Rehabilitation Centre was conducted in which a period census was used to sample patients (n =837). Descriptive statistics was used to report the research results and additionally, logistic regression was employed to determine the adjusted odds ratio for the association between non-attendances and identified characteristic factors. Ethical clearance was obtained from the Undergraduate Research Ethics committee at Stellenbosch University prior to data collection. Results and conclusion: The current study provides useful insights into the factors associated with non-attendance of outpatients to scheduled occupational therapy and physiotherapy appointments at the Western Cape Rehabilitation Centre and contributes to limited research on the topic in a South African context. Factors that had a significant association with non-attendance included hospital classification, diagnostic category and impairment according to ICD 10 coding. Further studies are needed to determine the reasons for non-attendance at institutions such as Western Cape Rehabilitation Centre which will assist the institutions in implementing solutions to reduce high rates of non-attendance. ABSTRACT NUMBER / ABSTRAKNOMMER: 4 Lost to follow-up: Challenges to conducting orthopaedic research in South Africa De la Rey Badenhorst (Tygerberg orthopaedic department), Elsabé Britz (Tygerberg orthopaedic department), Mariliza Burger (Tygerberg orthopaedics research department), Nando Ferreira (Tygerberg orthopaedic department) Loss-to-follow-up presents a major concern for treating physicians and researchers. The aim of this study was to describe potential factors contributing to the loss-to-follow-up experienced in orthopaedic patients attending the sole public orthopaedic service provider within the Northern Cape Province in South Africa.Patients who underwent ankle fracture surgery at Kimberly Provincial hospital were included in this study. Demographic information of all patients that were admitted for ankle fracture surgery between January 2012 and July 2013 were captured and reviewed. (ECUFS NR 50/2012)Two- hundred-and-sixty-eight patients (male: n=112 (42%); female: n=156
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