Study on Community Acquired Pneumonia Secures Master’s Degree

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The Management of Community-Acquired Pneumonia (CAP) in Adults at a Rural Regional Hospital in KwaZulu-Natal, was the title of a study by Dr Gabriel Bondo, a Family Medicine specialist from the Democratic Republic of the Congo, who graduated with a Masters of Medicine degree in Family Medicine.

Pneumonia is one of the highest causes of mortality, particularly in South Africa where it ranks as the second leading cause.

Bondo was inspired to pursue a Master’s degree in Family Medicine while preparing to write the Health Professions Council of South Africa’s Foreign Doctors Examination at the then University of Medunsa in 2006.Bondo is currently the clinical manager at Gamalakhe Community Health Centre in Port Shepstone on the KwaZulu-Natal South Coast.

The management of CAP aligns with the Standard Treatment Guidelines (STG), Essential Medicines List (EML), and specific national guidelines.

Bondo’s study, which audited the practice of managing pneumonia at a regional hospital in KwaZulu-Natal, took place in a public sector hospital that provides care to a catchment population of 800 000, where there is a high burden of tuberculosis (TB) and HIV in the district.

The Department of Family Medicine provides outpatient services and works with the Emergency Department at the hospital. All adult medical patients with CAP who need admission are admitted through the Family Medicine Outpatients or Emergency Department.

A total of 124 patients participated in the study with the majority being younger than 65, while there were more males than females and 90% were Black Africans.

Bondo’s research found significant deviations at the Port Shepstone Hospital compared to the South African guidelines for pneumonia management. The study also highlighted a high mortality rate among patients admitted with CAP. Notably, the absence of a severity scoring tool such as CURB-65 in medical records and inconsistent antibiotic prescriptions were predominant issues. Additionally, the majority of patients were HIV positive, reinforcing the association between HIV infection and increased risk of CAP.

Recommendations from the study included implementing severity assessment tools such as CURB-65 and enhancing awareness among healthcare providers. Furthermore, it was found that regular training, feedback mechanisms, and antimicrobial stewardship programmes could facilitate guideline adherence and ultimately improve the quality of pneumonia care.

Bondo plans to pursue a doctoral degree and continue to teach Family Medicine to junior doctors in rural hospitals and Medical students at university.

Words: MaryAnn Francis

Photograph: Sethu Dlamini