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Southern African Journal of HIV Medicine
ISSN: (Online) 2078-6751, (Print) 1608-9693
Page 1 of 8 Editorial

The Editor’s review of articles published from August

to December 2019 in the Southern African

Journal of HIV Medicine

August 2019
Author:
David C. Spencer 1 1. Woods J, Moorhouse M, Knight L. A descriptive analysis of the role of a WhatsApp clinical
discussion group as a forum for continuing medical education in the Eastern Cape, South
Affiliation:
1 Division of Infectious Africa. S Afr J HIV Med. 2019;20(1):a982. https://doi.org/10.4102/sajhivmed.v20i1.982
Diseases, Department of
Medicine, Helen Joseph Editor’s comment: In the year following my internship (1976), I worked at Mseleni Hospital,
Hospital, University of the then a small 120-bed hospital in a remote corner of KwaZulu-Natal (KZN) province, South
Witwatersrand, Johannesburg,
South Africa Africa. For much of the time, I was the only doctor. One of the highlights was the Thursday
night radio call-in to discuss cases with colleagues at Manguzi and Bethesda, similar rural
Corresponding author: hospitals in northern KZN. I was a rookie. Darryl Hackland and Pat Garde (Bethesda) and Cliff
David Spencer, Allward (Manguzi) were my lifeline. Another was the periodic weekend fly-in of Durban-
[email protected]
based University of KZN academics who would assist with surgery and walk through the
How to cite this article: wards with me.
Spencer DC. The Editor’s
review of articles published
from August to December This observational study of the role of a WhatsApp group gives that story of a 21st-century twist.
2019 in the Southern African The goal of the authors was to assess the educational value of a WhatsApp group of 166 experienced
Journal of HIV Medicine. S Afr and inexperienced doctors in rural public hospitals and clinics in the Eastern Cape province of
J HIV Med. 2020;21(1), a1120. South Africa and to ask whether the WhatsApp discussion was helpful and whether informed
https://doi.org/10.4102/
sajhivmed.v21i1.1120 consent and privacy rules were breached. All the patients had complicated human immunodeficiency
virus/tuberculosis (HIV/TB) co-infection. The study was undertaken between January 2016 and
Copyright: July 2017. The WhatsApp groups were given a short questionnaire and asked to submit answers
© 2020. The Author. anonymously. Although 86% of respondents replied that the group had given them ‘improved
Licensee: AOSIS. This work
is licensed under the confidence and ability in managing sick patients’, and 52% said they used the guidance they had
Creative Commons received ‘all the time’, many in the WhatsApp group (n = 74/166; 45%) never actually posted a
Attribution License. response. Moreover, whilst answers such as ‘I use the guidance to manage patients’, ‘I refer to
previous WhatsApp cases’, ‘I gained new clinical insights’ and so on reached statistical significance,
that is, suggesting that clinical confidence had been increased, high odds ratios and wide
confidence intervals suggest important limitations (Table 3 in the article). Does posting patient
data risk a breach of doctor–patient ethics? Eighty-nine per cent of respondents agreed with the
fact that informed consent would be required before posting patient-related data; however, in
reality only 52% did this. And what about those registered on the programme who never appeared
to participate? Was this a valuable learning experience for them? Perhaps, an analysis of the
differences between the 50% who did not post cases and the 3% who did so frequently might
answer this question.
2. Mugusi SF, Mopei N, Minzi O. Adherence to combination antiretroviral therapy among
orphaned children in Dar es Salaam, Tanzania. S Afr J HIV Med. 2019;20(1):a954. https://doi.
org/10.4102/sajhivmed.v20i1.954

Editor’s comment: Adherence to antiretroviral therapy (ART) is examined in this cross-sectional
study of 216 Tanzanian orphans aged 2–14 years. All the children were HIV-positive and had been
on nevirapine (NVP)-based ART for a minimum of 6 months. The study was conducted from June
to September 2015. Adherence was measured in three ways: a 3-day recall of pill-taking behaviour
(caregiver questioned), the historical regularity/reliability of clinic attendance and the monitoring
Read online: of NVP-blood levels on study entry. Viral load levels are not supplied. Likely not available. On
Read online:
Scan this QR recall, 79.6% of children had not missed any doses, and 82.9% gave a history of regular clinic
Scan this QR
code with your
code with your attendance. Yet, therapeutic levels of NVP, namely ≥ 3 µg/mL, were detected in only 72.2% of
smart phone or
smart phone or
mobile device patients. On multivariate analysis, higher NVP levels were protective of unreliable clinic
mobile device
to read online.
to read online.
attendance (unadjusted odds ratios [uOR] 0.45, 95% confidence interval [CI] 0.21–0.95, p = 0.04)
http://www.sajhivmed.org.za 3 Open Access