Surgical infections at a regional hospital in Gauteng: reasons for delay to care and profile of pathology

  • Nirav Patel University of the Witwatersrand
  • Pooblan Naidoo RK Khan Regional Hospital
  • Geoffrey Candy University of the Witwatersrand
  • Christine Jann-Kruger Edenvale General Hospital
Keywords: Epidemiology, surgical infection, barriers to care

Abstract

Background: Present on arrival infection is a common indication for admission of surgical patients initially managed at primary care level. We aimed to describe the demographic and disease profile of patients presenting with infection requiring surgical management, describe determinants of patients’ health-seeking behaviour, and identify barriers to care.

Methods: A prospective descriptive questionnaire-based study was conducted at Edenvale General Hospital between February 2014 and October 2016. Minors were excluded.

Results: Eighty-nine patients participated. Abscesses (26%), diabetic foot (22%), and cellulitis (16%) were the commonest categories of infection necessitating admission. The majority of patients were South African (88%), Black African (82%), males (58%), without medical aid (99%), who were not formally employed (58%), were from poor households (74%), inhabited some form of formal housing (90%), were in charge of decisions regarding personal health (80%), and first sought help at the primary care level (71%). Delay to presentation was noted in 69% of patients, and delay to referral in 46%. Age, race, history of diabetes, and main source of monthly income were significant variables in delayed presentation (p<0.05), and age and level of care on first contact in delayed referral (p<0.05) in the study sample. The most common reason for delay to presentation (84%) and referral (61%) was patients’ belief that their problem would resolve spontaneously.

Conclusions: Patients’ socio-economic status, past medical history, demographics, level of first contact with the health care system, and perceptions of their own health contributed to delays in seeking and receiving care in the study sample. These delays may be addressed by interventions that target the availability, accessibility, acceptability and affordability of health care services.

Author Biographies

Nirav Patel, University of the Witwatersrand

Department of General Surgery, Faculty of Health Sciences, University of the Witwatersrand

Pooblan Naidoo, RK Khan Regional Hospital

Department of Medicine, RK Khan Regional Hospital, Chatsworth, KwaZulu-Natal

Geoffrey Candy, University of the Witwatersrand

Department of General Surgery, Faculty of Health Sciences, University of the Witwatersrand

Christine Jann-Kruger, Edenvale General Hospital

Department of Surgery, Edenvale General Hospital, Johannesburg, Gauteng

Published
2019-03-29
How to Cite
Patel, N., Naidoo, P., Candy, G., & Jann-Kruger, C. (2019). Surgical infections at a regional hospital in Gauteng: reasons for delay to care and profile of pathology. South African Journal of Surgery, 57(1), 30-36. Retrieved from http://sajs.redbricklibrary.com/index.php/sajs/article/view/2681
Section
General Surgery