Vol 136 No 1569: 3 February 2023

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Issue Summary

Editorial

SUMMARY

Assessment of unmet secondary elective healthcare need—itself in need of acute care in Aotearoa New Zealand

Phil Bagshaw, John D Potter, Andrew Hornblow, Ben Hudson, Les Toop, M Gary Nicholls, Chris Frampton, Sue Bagshaw, Robin Gauld, Frank Frizelle

The unmet need for primary (GP) health care is measured each year as part of the New Zealand Health Survey. By contrast, Unmet Secondary Elective Healthcare Need (USEHN)—non-urgent hospital treatment - has never been appropriately measured by the New Zealand Government or our Ministry of Health. Many countries have accepted that routine surveys of USHEN are vital measures of how well their healthcare systems are functioning and are necessary for international benchmarking. We in Aotearoa New Zealand have a new healthcare system, and its new Ministry of Health has yet again made deliberate efforts to frustrate the measurement of USEHN by obfuscation and a petty attempt at avoidance of media attention to this issue. It is to be hoped that this type of approach does not augur badly for the future transparency and honey needed to improve our ailing health care system.

Article

SUMMARY

Effective and respectful interaction with Māori: How the regulators of health professionals are responding to the Health Practitioners Competence Assurance Amendment Act 2019

Susan Shaw, Keith Tudor

The 2019 amendment of the HPCA explicitly references the cultural competency of practitioners and effective and respectful interaction with Māori. This analysis explored the extent to which RAs have incorporated cultural competence into professional competencies three years after this amendment. The majority of the RAs have yet to integrate references to engaging with Māori in this way into their professional competencies.

Article

SUMMARY

Celestial risk factors in groin hernia repair and random statistical association: a nationwide register-based study

Camilla Christophersen, Siv Fonnes, Jason J Baker, Kristoffer Andresen, Jacob Rosenberg

This study found that surgeons’ zodiac sign significantly affected the risk of recurrence after surgical repair of groin hernias, and surgeons born under the Sagittarius seemed to perform better than Capricorn, Pisces, Aries, Taurus, Cancer and Virgo. However, this exemplifies that statistical analyses might reveal random statistical associations that should be interpreted with a grain of salt.

Article

SUMMARY

A comprehensive methodology report for maternity and perinatal mortality research in the New Zealand integrated data infrastructure

Esti C de Graaff, Lynn Sadler, Lesley McCowan, Robin Cronin, Ngaire Anderson

In Aotearoa New Zealand, national datasets are commonly used for pregnancy research, although data availability and understanding of data quality are often lacking. This paper provides a detailed breakdown of New Zealand’s national pregnancy data collection and quality, and proposes a more standardised method for its use, while offering recommendations for future improvements. By doing this we hope to contribute to the quality of pregnancy studies in New Zealand. Ultimately, with the aim to improve the outcomes for all mothers and babies in Aotearoa New Zealand.

Article

SUMMARY

COVID-19 among University of Otago students living in North Dunedin households in the first half of 2022: was the prevalence underestimated?

Polly Tenci, Lianne Parkin, Samantha Grace, Bryony Harrison, Judd Irving, Luke Jarvie, Eric Johnson, Tze Koon Ler, Georgia Malcolm, Kristy Watson

COVID-19 began to spread through the University of Otago student population in Dunedin in mid-February 2022, and reported case numbers rose rapidly between late February and early March. The University, residential colleges, and the Otago University Students’ Association mounted huge operations to provide support (including food and care packages) for hundreds of students self-isolating in colleges and flats. While good mechanisms were established in colleges and other supported accommodation for identifying and reporting COVID-19 cases, anecdotal reports suggested that students living in flats might have been less likely to report positive COVID-19 test results to the University, or to upload their positive rapid antigen test (RAT) results to My Covid Record. We conducted short interviews at 135 randomly selected North Dunedin flats in which at least one resident was a University of Otago student and found that COVID-19 was very common between the start of Flat Orientation Week (14 February) and the end of Semester 1 (week beginning 30 May) – 94.1% of households had at least one confirmed COVID-19 case during that period and about three quarters (73.6%) of residents had tested positive. We also found there was considerable under-reporting of cases with just under two thirds (60.4%) of University of Otago student cases notifying the University that they had COVID-19 and two thirds (66.9%) of all cases with a positive RAT uploading their result to My Covid Record.

Article

SUMMARY

Specialist medical toxicologist consultations provided by the New Zealand National Poisons Centre, 2018–2020

Adam C Pomerleau, Paul Gee, D Michael G Beasley, Eeva-Katri Kumpula

Medical (or clinical) toxicology is a field of medical practice focussed on the treatment of poisoning in all its forms. There have been very few medical toxicologists in Aotearoa New Zealand historically, yet free 24/7 access to these specialists is available to medical practitioners across the country through the National Poisons Centre. This study describes consultations with NPC medical toxicologists from 2018–2020 and finds increasing numbers of consultations, involving a wide range of poisonings. The growing utilisation suggests healthcare professionals derive value from this consultation service for the care of their patients.

Viewpoint

SUMMARY

A case of purpura fulminans attributed to trimethoprim-sulfamethoxazole

Yassar Alamri, Ignatius Chua, Nicholas M Douglas

Trimethoprim-sulfamethoxazole is a commonly used antibiotic. To the best of our knowledge, this is the first report of purpura fulminans associated with exposure to trimethoprim-sulfamethoxazole. We review the literature for mechanistic explanations of this potentially life-threatening idiosyncratic complication.

Clinical Correspondence

SUMMARY

Manifestation of anterior necrotising scleritis and reactive infectious mucocutaneous eruption after COVID-19: a case report

Vince MT Wilkinson, Kris Sweetapple, Rachael L Niederer, Corina M Chilibeck

This case report illustrates two rare complications of COVID-19 infection that occurred in an otherwise healthy, double-vaccinated patient. Necrotising scleritis is an uncommon condition where severe inflammation causes rapid destruction of the sclera (the white shell of the eye), which can lead to exposure of the underlying layers of the eye and risk of vision loss. Reactive Infectious Mucocutaneous Eruption typically occurs after or during an infection and presents as mucositis, such as ulcerations of the mouth, lips, genitals, and conjunctiva. Early treatment with high dose steroids allowed for a rapid recovery with no further complications.

Editorial