A multidisciplinary team that includes paediatric ID specialists, ID clinical fellows / senior registrars, a medical officer, nursing sisters, a social worker and lay counsellors, and a clerk.
TO CONSULT WITH THE DUTY SENIOR REGISTRAR / CONSULTANT PLEASE CONTACT THE TELEPHONE EXCHANGE: +27-21-658-5111
The PIDU is responsible for the management of HIV infection, complicated drug-susceptible TB, drug-resistant including MDR and XDR-TB, complicated or atypical infections particularly in immunosuppressed children, vaccine adverse events, the diagnosis and treatment of primary immune deficiencies, and antimicrobial stewardship including advice on the treatment of multi-drug resistant bacterial infections. The PIDU plays a role in hospital antimicrobial and infection control policy and practice, and the production of standardised treatment guidelines for paediatric infectious diseases.
Inpatient consultation / telephonic consultation: A senior registrar-consultant team is available for ad hoc consultation throughout the working week. Please direct consultation requests to the duty senior registrar. A monthly roster is available at the telephone exchange.
Antibiotic stewardship ward round: Consultant-led ward rounds are conducted every Wednesday at 12h15. The antimicrobial stewardship team includes a microbiologist, pharmacist, and ID sub-specialists and senior registrars.
ID ward round: Hospital-wide consultant-led ward rounds are conducted every Thursday at 09h00 starting in Ward B1.
Outpatient clinics are conducted in A11 on Monday morning (general ID and immunology alternating with multi-drug resistant and complex TB), Tuesday morning (HIV infection), and Friday morning (HIV infection). During HIV clinics, individual counselling and group counselling sessions are conducted by the clinic lay counsellors or clinic social worker. Outside clinic hours, a nursing sister or ID senior registrar is available to see patients on an ad hoc basis in A11. Bookings for the Monday clinic may be made through the A11 clerk, Ms Simone Twaku on extension: 5812. Clinic appointments for the HIV clinics may be made through Sister Patti Apolles on extension: 5613 or Sister Charday Mortlock-Scheepers on 5812.
Immunology consultation / investigation: The duty senior registrar (contact through telephone exchange) and Prof Eley (extension 5321 or cell: 0839477637) share clinical responsibilities for immunology.
Monthly intravenous immunoglobulin infusions: Intravenous immunoglobulin infusions are administered in the 'Day Room', ward E2, usually on Wednesday or Friday mornings. Bookings for IVIG appointments are co-ordinated by Sister Charday Mortlock-Scheepers on extension 5812. All children managed through the immunology service should be discussed with a senior registrar or immunology consultant to ensure continuity of care.
After-hours consultation: Most ID problems should be managed by the registrar and consultant on-call for general paediatrics. Specialised problems may benefit from ID consultation. An ID call roster has been incorporated into the monthly roster of the Department of Paediatrics and Child health. The on-call consultant may be contacted through the RCWMCH telephone exchange.
Paediatric outreach: The PIDU provides telephonic support to level 1 & 2 institutions in the Western Cape. The duty registrar may be contacted through the telephone exchange at Red Cross War Memorial Children’s Hospital (RCWMCH). Furthermore, the following outreach visits are conducted by the ID consultants: (1) two-monthly clinical meetings for doctors and nurses treating HIV-infected children usually at level 1 clinics in the Klipfontein sub-district, (2) monthly ward rounds/clinical meetings at New Somerset Hospital alternating with Victoria Hospital, (3) monthly antimicrobial stewardship rounds at both Mitchells Plain and Groote Schuur Hospitals and (4) monthly neonatal infectious diseases meetings at Mowbray Maternity Hospital.
Since the start of the COVID-19 pandemic all outreach activities have been suspended with exception of the Mowbray Maternity Hospital monthly neonatal infectious diseases meetings which are now conducted virtually.
Teaching and Training
Prof Eley and Dr Nuttall conducts regular lectures to 4th and 5th year medical students on ID topics including paediatric HIV infection, childhood TB and vaccine-preventable infections.
The ID consultants and senior registrars conduct periodic ID seminars for paediatric registrars and contribute to the Wednesday morning academic programme of the Department of Paediatrics and Child Health. ID ward rounds are used to educate senior house officers and paediatric registrars. Dr Nuttall and Prof Eley support various continuous medical education courses and symposia.
Sub-specialist ID training:
The paediatric ID unit at RCWMCH is registered with the Health Professions Council of South Africa as a training unit for paediatric ID sub-specialists. Trainees register with the University of Cape Town for this two-year course. Training includes clinical ID, microbiology, virology and immunology. Trainees must complete the exit examination (Cert ID (SA) Paed examination) set by the Colleges of Medicine of South Africa, a requirement for registering as an ID sub-specialist in South Africa. Prof Eley is the convenor of the training programme at RCWMCH. Refer Appendix A for a comprehensive description of the training programme.
To facilitate research training, an M Phil degree in paediatric ID was created through the Faculty of Health Sciences, University of Cape Town. In addition to the Cert ID (SA) Paed qualification, ID sub-specialist trainees can successfully complete a minor dissertation and obtain the M Phil (Paediatric Infectious Diseases) degree.
ID journal club meetings alternating with HIV clinical meetings are held every week on a Wednesday between 10h30 and 11h30 in the conference room in A11, RCWMCH.
Immunology clinical meeting is held on an ad hoc basis in the conference room in A11, RCWMCH.
Blood culture meetings are conducted virtually by the Division of Microbiology every Monday at 12h00 from C18, Groote Schuur Hospital. At these meetings, the clinical presentation and antibiotic treatment of children and adults with positive blood culture results are discussed. The on-duty ID team usually attends these meetings.
MDR-TB meetings are conducted in A11 monthly on Monday after the MDR-TB / Complex TB clinic. These meetings are led by Dr Juli Switala who is based at Brooklyn Chest Hospital.
The research activity of the PIDU focuses on HIV infection, tuberculosis and other common childhood infections. Current projects include the effectiveness and outcome of antiretroviral therapy, clinical aspects of bloodstream infection, hospital-associated infection and primary immunodeficiency diseases.
Research meetings are conducted on an ad hoc basis between the principal investigator and relevant ID staff members. Resources