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Sliwa K, Zühlke L, Kleinloog R, Doubell A, Ebrahim I, Essop M, Kettles D, Jankelow D, Khan S, Klug E, Lecour S, Marais D, Mpe M, Ntsekhe M, Osrin L, Smit F, Snyders A, Theron JP, Thornton A, Chin A, van der Merwe N, Dau E, Sarkin A. Cardiology-cardiothoracic subspeciality training in South Africa: a position paper of the South Africa Heart Association. Cardiovasc J Afr 2017; 27:188-193. [PMID: 27841903 PMCID: PMC5783290 DOI: 10.5830/cvja-2016-063] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 05/18/2016] [Indexed: 11/17/2022] Open
Abstract
Over the past decades, South Africa has undergone rapid demographic changes, which have led to marked increases in specific cardiac disease categories, such as rheumatic heart disease (now predominantly presenting in young adults with advanced and symptomatic disease) and coronary artery disease (with rapidly increasing prevalence in middle age). The lack of screening facilities, delayed diagnosis and inadequate care at primary, secondary and tertiary levels have led to a large burden of patients with heart failure. This leads to suffering of the patients and substantial costs to society and the healthcare system. In this position paper, the South African Heart Association (SA Heart) National Council members have summarised the current state of cardiology, cardiothoracic surgery and paediatric cardiology reigning in South Africa. Our report demonstrates that there has been minimal change in the number of successfully qualified specialists over the last decade and, therefore, a de facto decline per capita. We summarise the major gaps in training and possible interventions to transform the healthcare system, dealing with the colliding epidemic of communicable disease and the rapidly expanding epidemic of non-communicable disease, including cardiac disease.
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Affiliation(s)
- Karen Sliwa
- Hatter Institute for Cardiovascular Research in Africa, MRC Inter-University Cape Heart Group, Department of Medicine, Faculty of Health Sciences, University of Cape Town; Soweto Cardiovascular Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
| | - Liesl Zühlke
- Departments of Paediatric Cardiology and Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Robert Kleinloog
- Cardiothoracic Surgery, Ethekwini Hospital and Heart Centre, Durban, South Africa
| | - Anton Doubell
- Division of Cardiology, Faculty of Medicine and Health Sciences, Stellenbosch University and Tygerberg Hospital, Tygerberg, South Africa
| | - Iftikhar Ebrahim
- Netcare Unitas Hospital, Lyttleton Manor, Pretoria, South Africa
| | - Mohammed Essop
- Division of Cardiology, Baragwanath Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Dave Kettles
- St Dominic's Hospital, and Frere Hospital, East London, South Africa
| | - David Jankelow
- Netcare Linksfield Hospital, Linksfield West, Johannesburg, South Africa
| | - Sajidah Khan
- Department of Cardiology, Faculty of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - Eric Klug
- Netcare Sunninghill Hospital, Sunninghill, Johannesburg, South Africa
| | - Sandrine Lecour
- Hatter Institute for Cardiovascular Research in Africa, Department of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - David Marais
- Division of Chemical Pathology, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Martin Mpe
- Mediclinic Heart Hospital, Arcadia, Pretoria, South Africa
| | - Mpiko Ntsekhe
- Department of Cardiology, Faculty of Health Sciences, University of Cape Town, South Africa
| | - Les Osrin
- Zuid-Afrikaans Hospital, Muckleneuk and Department of Cardiology, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Francis Smit
- Department of Cardiothoracic Surgery, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Adriaan Snyders
- Wilgers Medical Consortium, Die Wilgers, Pretoria, South Africa
| | - Jean Paul Theron
- Interventional Cardiology Unit, Netcare Union Hospital, Alberton, South Africa
| | - Andrew Thornton
- Netcare Sunninghill Hospital, Sunninghill, Johannesburg, South Africa
| | - Ashley Chin
- Department of Cardiology, Faculty of Health Sciences, University of Cape Town, South Africa
| | | | - Erika Dau
- South African Heart Association, Tygerberg, South Africa
| | - Andrew Sarkin
- Department of Cardiology, Faculty of Health Sciences, Steve Biko Academic Hospital and University of Pretoria, South Africa
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