Wits Journal of Clinical Medicine has now entered into its third year of publication. On reflection, it has surpassed many of its goals in this short period. An important milestone was achieved last year when the journal was Pubmed Central accredited. The number of submissions to the journal has grown exponentially, and the journal's readership has grown significantly. The special Covid issue last year was the spark. Wits Journal of Clinical Medicine was the first journal in the country and for that matter in Africa which focused on the initial impact of Covid in South Africa. This issue sparked an increase in abstract views from 2000 to 17000, and the interest in the journal remains strong. One of the strengths of the journal is that the editorial board is completely independent, and we have a robust review system. Our online platform has been upgraded, and thus the online look and feel of the journal will be improved, making the journal more readable.
It has been a year since Covid-19 came to our shores. We have all experienced a range of emotions – from trepidation, fatigue, despair and occasionally, even exhilaration at seeing a seriously ill patient with Covid-19 walking out of the hospital doors. Just when we thought that we were getting on top of the pandemic, the virus fought back and mutated (501.V2), and was largely responsible for the second wave of Covid-19 infections. At this juncture, the editorial board felt that it would be important for the journal to host a webinar titled ‘Variants to Vaccines’ to provide health practitioners with an update on the current science on the variants and vaccines from experts in the field (Professors Shabir Madhi, Penny Moore and Charles Feldman). The webinar was held on 3 February, 2021 and was a success with over 3000 views. As a new innovation for the journal, this webinar is now available as an online video feature in this issue of the journal. Answers to the many questions following the webinar will be posted shortly in the journal as we await replies from the expert panel.
As with past issues, Wits Journal of Clinical Medicine continues to focus on aspects of Covid-19 in South Africa. Children in general are less likely to be affected by Covid-19; however, in some children with underlying conditions, a life-threatening presentation of the multisystem inflammatory syndrome in children may occur. In this issue, Saggers presents a comprehensive review of Covid-19 in children, including the multisystem inflammatory syndrome, with particular reference to this condition in South Africa. Additionally, Richards and Feldman discuss the important aspect of influenza vaccination, particularly during this ongoing Covid-19 pandemic. In keeping with the Covid-19 theme, Tilley discusses the concept of herd immunity and introduces an interesting paradigm as to how herd immunity should be viewed in South Africa.
Personalised medicine, which is sometimes interchangeably also described as precision medicine, is an emerging approach for disease diagnosis and treatment that takes into account individual variability in genes, environment and lifestyles. This approach allows for more accurate prediction of which treatment and prevention strategies for a particular disease will work in an individual. On the topic of personalised medicine in this issue of the journal, Winkler, provides a state-of-the-art review of the current knowledge base of the genetics of chronic kidney disease in sub-Saharan Africa.
Surgical outcomes are poorly documented in most developing nations, including in middle-income countries such as South Africa. Thus, the contribution by Moeng and colleagues is important in reporting their findings of surgical complications and outcomes using the Clavien–Dindo classification in a large database of over 3300 surgical patients. Similarly, there are extremely few data sets with regards to a permanent pacemaker implantation in Africa. Thus, it is also timely that Mabika and colleagues report on their 10-year experience of permanent pacemaker implantation at a large urban public hospital in South Africa.
The haematological changes in tuberculosis have been previously described. However, little is known about the haematological abnormalities in patients with tuberculosis co-infected with HIV. In this issue, Bahemia and colleagues describe the haematological abnormalities in a cohort of patients with tuberculosis co-infected with HIV and also describe the changes in those on antiretroviral therapy and those not on antiretroviral therapy. Antibiotic resistance, as in many other countries, is becoming a major health problem in South Africa. Antibiotic resistance patterns, especially in the paediatric population, are poorly documented in this country. Thus Irusen et al.'s contribution in this issue of the profile of antibiotic use in paediatric urinary tract infections is important and adds knowledge in this field.
I thank the editorial team and Wits Press in making the journal more innovative and enjoyable to read.
Pravin Manga
Editor-in-Chief
Wits Journal of Clinical Medicine