Please note: SAMA has developed and maintained this repository of Clinical Practice Guidelines for the benefit of our members, in an attempt to facilitate access to locally developed and implemented guidelines. SAMA is not responsible for the contents of guidelines, nor the updating or correctness of guidelines themselves. We endeavour to ensure that all guidelines presented are the most up to date.
COVID-19 Guidelines
Note: These guidelines are drawn from the collective of guidelines available from the National authorities as well as specific societies which have generated guidelines for their constituencies.
The National Institute of Communicable Diseases Guidelines (NICD)
The NICD has a wealth of information, frequently asked questions, standard forms and other details on their COVID-19 Toolkit page, which is updated frequently:
https://www.nicd.ac.za/diseases-a-z-index/covid-19/covid-19-resources/- NICD Guidelines for case-finding, diagnosis, management and public health response in South Africa
https://www.nicd.ac.za/wp-content/uploads/2020/03/NICD_DoH-COVID-19-Guidelines-10March2020_final.pdf
- Department of Health Environmental Health Guideline – targeted at Environmental health practitioners, including handling of human remains
https://www.nicd.ac.za/wp-content/uploads/2020/03/COVID-19-ENVIRONMENTAL-HEALTH-GUIDELINE-1.pdf
- NICD COVID-19 Quick Reference for health workers:
- Clinical management of suspected or confirmed COVID-19 disease
The Critical Care Society of Southern Africa (CCSSA)
- Critical Care Management of Patient Confirmed with COVID-19
- Personal Protective Equipment (PPE) for Critical Care Providers during the COVID-19 Pandemic
- Principles of Airway Management
https://criticalcare.org.za/wp-content/uploads/2020/03/COVID-19-Principles-of-airway-management.pdf
- Covid-19 Joint Statement – The Critical Care Society Of Southern Africa (Ccssa) And The South African Society Of Anaesthesiologists (Sasa)
https://criticalcare.org.za/wp-content/uploads/2020/03/Joint-statement-CCSSSA-and-SASA.pdf
The Resuscitation Council of South Africa
- Resuscitation Considerations
http://resus.co.za/wp-content/uploads/RCSA_CPR_Covid-19.pdf
South African Society of Obstetrics and Gynaecology
- Royal College of Obstetrics and Gynaecology: COVID-19 in Pregnancy
https://docs.mymembership.co.za/docmanager/05850f4e-4b42-48f8-bcdb-44622edfc8dd/00149145.pdf
South African Society of Anaesthesiologists
- SASA has published multiple position statements, comments and guidelines on their website at:
https://www.sasaweb.com/ContentDetails/ContentDetails#?ContentId=79&SubMenuType=1
SASA has recommended that clinicians use the following website for critical care management guidelines of Covid 19 patients.
COVID-19 Person Under Investigation(PUI) Form
Federation of Infectious Diseases Societies of Southern Africa (FIDSSA)
The Federation of Infectious Diseases is made up by several societal members, all of which have their own special interests in infectious diseases. The Federation was formed from an amalgamation of existing societies representing infectious diseases (Infectious Diseases Society of Southern Africa -IDSSA), sexually transmitted diseases, (Sexually Transmitted Diseases Society of Southern Africa -STDSSA), infection control (Infection Control Society of South Africa -ICSSA) antimicrobial surveillance (National Surveillance Forum NASF) which became the South African Society of Clinical Microbiology (SASCM) in 2009 and travel medicine (The South African Society of Travel Medicine SASTM). The Southern African Society of Paediatric Infectious Diseases (SASPID) has also joined.
Guidelines are published online and in the South African Journal of Epidemiology and Infection (SAJEI).
South African guideline for the management of community-acquired pneumonia in adults 2017
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506119/pdf/jtd-09-06-1469.pdf
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5506119/
Updated recommendations for the management of upper respiratory tract infections in South Africa
Pocket Guide to antimicrobial prescribing in South Africa 2015
Local Guidelines on FIDDSA Website
Antimicrobial Prescribing
- Prevention and Containment of Antimicrobial Resistance 2019
- Western Cape Academic Hospitals Antimicrobial Recommendations 2013
- Guideline for Daptomycin use in South Africa - 2017 Update
HIV & STIs
- See Guidelines from HIV Clinicians Society Below
Infectious Diseases
- Acute meningitis in children and adults in South Africa (FIDSSA 2013)
- Influenza Healthcare Workers Handbook (NICD 2011)
Microbiology and Infection Control
Please note that many of these guidelines are now old and might be outdated
- Carbapenems - Appropriate use (SAMJ 2004)
- Isolation precautions in hospitals (ICSSA 2001)
- Nosocomial infections- Prevention & Management (FIDSSA 2005)
- Guideline for the optimal use of blood cultures (2010)
Miscellaneous
National Department of Health Guidelines
National Department of Health Standard Treatment Guidelines and Essential Medicines Lists (Primary Health Care, Adults and Children Hospital level and Tertiary and Quaternary care are available at: www.health.gov.za/index.php/component/phocadownload/category/197
The National Department has also Issued multiple other guidelines on specific issues and diseases, falling under the Ideal Clinic Program and on the Ideal Clinical website www.idealhealthfacility.org.za :
(Go to the Documents Tab - access number 5: Guidelines)
- 1. Integrated Clinic Disease Management compliant package of clinical guidelines:
- Adult Primary Care Guide 2016 - 2017
- Standard Treatment Guidelines and Essential Medicine List for Paediatrics - 2017
- Standard Treatment Guidelines and Essential Medicine List for Primary Health Care - 2018
- Abbreviated Standard Treatment Guidelines and Essential Medicine List for PHC 2018
- Standard Treatment Guidelines and Essential Medicine List for Hospitals - 2015
- Integrate Management of Childhood Illness Chart Booklet - 2014
- Newborn Care Charts - Management of sick and small newborns in hospitals (Version 1, 2014)
- Integrated Management of Childhood illness (2014)
- 2. National Priority Health Conditions
- Guidelines for Maternity Care 2016
- Management of Drug-Resistant Tuberculosis 2013
- Management of type 2 Diabetes 2014
- National Guideline Updated Management of Hypertention in Adults at PHC level 2006
- National Guidelines for PMTC of HIV & Management of HIV in Children Adolescents and Adults 2015
- National Guidelines Management of TB in children 2013
- National TB management guidelines 2014
- Nationl IPC Guideline for TB MDR and XDR 2015
- Sexually Transmitted Infections Management Guidelines 2015
Additional Department of Health Clinical Guidelines include:
Guidelines for the prevention of malaria in South Africa- 2017
National guidelines for the treatment of malaria in South Africa- 2018
Addendum To The South African Guidelines For The Prevention And Treatment Of Malaria Updated 2018 (March 2019)
Guidelines for Healthy eating information for nutrition educators - 2014
Guidelines for the management of tuberculosis, HIV and STIs in correctional facilities - 2013
Food-based Dietary Guidelines for South Africa - 2013
Infant and young Child feeding policy - 2013
National contraception and family planning policy and service delivery guidelines - 2012
National Contraception Clinical Guidelines - 2012
Vaccinators Manual: Immunization that works - 2012
South African National Guidelines for Medical Male Circumcision - 2016
Leprosy control in South Africa - 2011
- https://www.nicd.ac.za/index.php/leprosy/
- https://www.nicd.ac.za/assets/files/Leprosy Control in SA 2011.pdf
Guidelines for the management, prevention and control of meningococcal disease in South Africa - 2011
National Institute for Communicable Diseases (NICD) and National Health Laboratory Service (NHLS)
The NHLS has also published some useful guidelines on their website.
NICD Diseases A-Z list
NICD-NHLS handbook for diagnosis of foodborne illness clusters / outbreaks - 2016
EPI Diseases Surveillance Guideline 3 rd Edition (2015) Guidelines for Detecting, Reporting, Investigating and Responding to EPI Priority Diseases - 2015
Healthcare workers guidelines on rift valley fever (RVF) - 2011
Recommendations pertaining to the use of influenza vaccines and influenza antiviral drugs - 2016
Allergy SA (ALLSA)
The diagnosis of asthma in children: An evidencebased approach to a common clinical dilemma - 2018
Asthma treatment in children: A pragmatic approach
https://allsa.org/wp-content/uploads/2019/03/Asthma-treatment-in-children-a-pragatic-approach.pdf
Guideline For Diagnostic Testing In Allergy - Update 2014
https://allsa.org/wp-content/uploads/2018/03/Guideline-diagnostic-testing-in-allergy.pdf
Chronic Rhinitis in South Africa: update 2013
www.samj.org.za/index.php/samj/article/view/6972/5136
Allergic Rhinitis in South Africa: 2012 Guidelines
https://allsa.org/wp-content/uploads/2018/03/Allergic-Rhinitis-SA-guideline-2012.pdf
National Pathology Group
The National Pathology Group has a guideline which it issues relating to the use of appropriate laboratory investigations. This may be freely accessed at :
www.npg.co.za/images/2013-12_NPG_Coding_Guidelines_V5191213.pdf
www.pathology.co.za/images/2013-12_NPG_Histology_Coding_GuidelinesV2.pdf
The website also contains recommendations for pathology testing for several conditions:
www.pathology.co.za/B_CommonSenPath.asp
Additionally the following international sites are of value: ARUP Laboratories: A national reference laboratory: www.aruplab.com Lab Tests Online : labtestsonline.org Royal College of Pathologists of Australasia: www.rcpa.edu.au/Home
National Osteoporosis Foundation of South Africa (NOFSA)
- Guidelines on Diagnosis and Management of Osteoporosis
- Recommendations for the acute and long-term medical management of low trauma Hip Fractures
- Atypical Femoral Fractures
- Vertebral factures
Pain SA
Guide to the Treatment of Cancer Pain in South Africa 2015
painsa.org.za/wp-content/uploads/2016/02/A5-Guide-to-treatment-of-Cancer-Pain-2015.pdf
Clinical practice guidelines for management of neuropathic pain: expert panel recommendations for South Africa 2010
painsa.org.za/wp-content/uploads/2015/05/clinical.pdf
Spinal cord stimulation for the management of pain: Recommendations for best clinical practice 2013
painsa.org.za/wp-content/uploads/2015/03/00046199.pdf
CSouth African guideline for the use of chronic opioid therapy for chronic non-cancer pain 2014
South African National Blood Service (SANBS)
Clinical Guidelines for the use of Blood products in South Africa - 2014
South African Society of Psychiatrists
Treatment Guidelines for Psychiatric Disorders - 2013
sajp.org.za/index.php/sajp/issue/view/10
South African Addiction Medicine Society
Guidelines for the pharmacological management of Alcohol Use Disorder - 2016
South African guidelines for the management of opioid dependence - 2015
SA Heart Association
Guidelines
SA Heart® subscribes to the guidelines issued by the European Society of Cardiology. The ESC Clinical Practice Guidelines can be viewed and downloaded from the ESC website guidelines page.
You can also download an app to view the pocket guidelines together with interactive tools (algorithms, calculators, charts, scores...) from this site.
SA Heart® publishes position papers or commentary on guidelines for local circumstances where appropriate.
South African dyslipidaemia guideline consensus statement: 2018 update A joint statement from the South African Heart Association (SA Heart) and the Lipid and Atherosclerosis Society of Southern Africa (LASSA)
http://www.samj.org.za/index.php/samj/article/view/12479
Guideline: Management of Pulmonary Hypertension (2015)
Position Statement Prevention of Infective Endocarditis Before Dental Procedures (available with member login only)
Guideline: Diet for prevention of cardiovascular disease (2013)
Guideline: Bridgepoint CTO (2014)
Position Statement: Renal denervation (No date)
The SA Heart® - Hypertension Society update on renal denervation.
Read more
Guideline: Cardiac imaging with Cardiac CT and MRI (No date)
The rapid advance in the field of cardiac imaging has necessitated guidelines for the performance and interpretation of these newer imaging modalities.
Read more
Guideline: Paediatric echocardiography in South Africa (2007)
This document provides guidelines for standards of practice in paediatric transthoracic echocardiography in South Africa. Paediatric echocardiography is not a substitute for a proper clinical opinion and such studies are best performed as part of an assessment by a paediatric cardiologist.
Read more
Guideline: Trans-catheter Aortic Valve Implantation (TAVI) (2016 - available with member login only)
The South African Heart Association (SA Heart®) together with two of its special interest groups, SASCI and SCTSSA represent the scientific, educational, socioeconomic, ethical and professional interests of South African cardiac specialists, with a combined membership of over 200 members. We are the only national organisations exclusively representing practising cardiologists and cardiothoracic surgeons.
Read more
Accredited Training Units
Cardiology Training is offered only at universities with linked medical schools and training hospitals in South Africa. Limited training positions are available, according to government allocations in the respective provinces.
In order to start the three year specialization course in cardiology, one has to be a qualified physician. Please apply directly to the respective heads of departments for a training post.
Read more
Guideline: Cardiology Training
Cardiology Training follows strict guidelines. A logbook must be kept to prove proficiency in techniques, and a prescribed minimum number of each different procedure performed must be recorded.
The College of Medicine is responsible for conducting the qualifying examination at the end of the three year course.
You can find the cardiology syllabus and logbook requirements here.
Read more
Treatment of Myorcardial Revascurlarisation - DES (available with member login only)
SASCI as an official Special Interest Group of the South African Heart Association subscribe to the European Society of Cardiology (ESC) guidelines. The ESC guidelines are regularly updated to include the latest appropriate Evidence Based Medicine but local guidance (comment) is...Read more
Guideline: EHRA Consensus (2017)
Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document from the European Heart RhythmAssociation (EHRA) and
European Society of CardiologyWorking Group on Thrombosis, endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern
Africa (CASSA), Heart RhythmSociety (HRS), Asia Pacific Heart RhythmSociety (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de
Estimulacion Cardiaca y Electrofisiologoıa (SOLEACE).
Read more
HEART FAILURE SOCIETY OF SOUTH AFRICA
Heart Failure Guidelines
South African HIV Clinicians Society
Society Interim Clinical Advice
-
Interim guidance while abacavir/lamivudine, abacavir singles, lamivudine singles and abacavir/zidovudine (2nd Line) are out of stock updated 18.07.2019
sahivsoc.org/Files/Interim%20advice%20stockouts_18.7.pdf
SOCIETY CURRENT GUIDELINES
- Appropriate clinical use of darunavir 800 mg (2018)
sahivsoc.org/Files/Appropriate%20clinical%20use%20of%20darunavir%20800%20mg.pdf - Southern African HIV Clinicians Society Guidance on the use of dolutegravir in first-line antiretroviral therapy (2018)
ahivsoc.org/Files/Guidance%20-%20dtg%20first%20line.pdf - HIV Palliative Care in HIV (2018)
sahivsoc.org/Files/HIV%20Palliative%20Care%20Guidelines%2022%20October%202018%20MR%20(003).pdf - Guidelines to support HIV-affected individuals and couples to achieve pregnancy safely: Update 2018
sahivsoc.org/Files/guidelines%2018%20oct.pdf - Guidelines for the vaccination of HIV-infected adolescents and adults in South Africa
sahivsoc.org/Files/Vaccination%20guidelines.pdf
Adherence to antiretroviral therapy in adolescents and young adults (expanded version) | 01 Aug 2017
Two documents have been developed. The first provides a quick reference and summary of the main aspects related to supporting antiretroviral therapy adherence for HIV positive adolescents and young adults. The second, this expanded version, provides more detail for those requiring additional background information, resources and references.
This document provides a quick reference and summary of the main aspects related to supporting antiretroviral therapy adherence for HIV positive adolescents and young adults.
- Adult antiretroviral therapy guidelines 2017 | 14 Jul 2017
These guidelines are intended as an update to those published in the Southern African Journal of HIV Medicine in 2014 and the update on when to initiate antiretroviral therapy in 2015. Since the release of the previous guidelines, the scale-up of antiretroviral therapy (ART) in southern Africa has continued. New antiretroviral drugs have become available with improved efficacy, safety and more robustness. The guidelines are intended for countries in the southern African region, which vary between lower and middle income.
A supplement to the National HIV Testing Services Policy 2016.
- Southern African guidelines on the safe use of pre-exposure prophylaxis in persons at risk of acquiring HIV-1 infection | 08 Mar 2016
The aim of the this PrEP guideline is to explain what PrEP is, outline current indications for its use, outline steps for appropriate user selection and provide guidance to monitor and maintain PrEP users.
- Corrigendum: 2015 Society PEP Guidelines | 03 Mar 2016
This document is a corrigendum to our "Guideline on the management of occupational and non-occupational exposure to the human immunodeficiency virus and recommendations for post-exposure prophylaxis: 2015 Update".
This guideline is an update of the post-exposure prophylaxis (PEP) guideline published by the Southern African HIV Clinicians Society in 2008.
These guidelines are an update of the Southern African HIV Clinicians Society's ART 2014 guidelines. The update is to the section of the adult ART guidelines relating to when ART should be initiated.
- Updated: Managing indeterminate HIV PCR results | 23 Nov 2015
UPDATED:Algorithms which assist in managing infants with indeterminate HIV PCR results.
- Guidelines for the Delivery of Antiretroviral Therapy to Migrants and Crisis-Affected Persons in Sub-Saharan Africa | 17 Apr 2015
Update to 2007 guidance to include all types of migrants and crisis-affected populations, including those forcibly displaced. This update stresses that migration and forced displacement must NO T be used as an excuse to deny treatment. Clear recommendations are provided for states, clinicians and programme managers, civil society, donors and United Nations (UN ) agencies.
- Guideline on Adult Antiretroviral Therapy | 19 Dec 2014
2014 update to the Society guideline on adult antiretroviral therapy.
This document is provided as an information resource for all health care workers to assist in the appropriate prescribing of antibiotics.
- Management of mental health disorders and CNS sequelae in HIV positive children and adolescents | 18 Sep 2014
Guideline on mental health disorders and CNS sequelae in HIV positive children and adolescents
A reference document to assist HIV nurse and doctor clinicians in managing mental health disorders
Practical guidance on the re-introduction of anti-TB drugs and ART in HIV/TB co-infected individuals presenting with DILI
- 2013 ARV Dosing Chart for Children and Adolescents | 19 Aug 2013
Updated to include newly available drug formulations: ABC 60mg dispersible tablets and ABC (60mg) + 3TC (300mg) tablets
- Guideline for the prevention, diagnosis and management of cryptoccocal meningitis among HIV-infected persons: 2013 update | 07 Jun 2013
Update to 2007 guidelines on the prevention, diagnosis and management of cryptoccocal meningitis among HIV-infected persons
Guidance on how to switch patients from 3 separate antiretroviral (ARV) drugs to the new, single, FDC tablet containing tenofovir (TDF), emtricitabine (FTC) and efavirenz (EFV).
Recommendations for HIV resistance testing for people living with HIV in the southern African region
2012
2012
2011
- Management of HIV-Hepatitis B Co-Infection | 03 Jun 2011
2011
2011
- Guidelines for Antiretroviral Therapy in Children | 03 Apr 2011
2009
Southern African Hypertension Society
South African Hypertension Society commentary on the American College of Cardiology/American Heart Association hypertension guidelines 2019
https://www.hypertension.org.za/guidelines
South African Hypertension Guideline version 2014
5th hypertension guideline published by the Southern African Hypertension Society (SAHS)
https://www.hypertension.org.za/guidelines
SA Society of Anaesthestioloigsts (SASA)
The South African Society of Anasethesiologists has several guidelines available for the management of pain, sedation and other areas www.sasaweb.com
Guidelines
Sasa Pacsa Fluid Guidelines 2019
Updated Phenylephrine Shortage Guideline
Consensus statement on clear fluids fasting for elective paediatric general anaesthesia 2019
Phenylephrine shortage Guidelines 2019
SASA Practice Guidelines 2018
SASRA Guidelines 2016
- sasaapi.sasaweb.com/Document/SASRAguidelines2016_636722590664755485.pdf
- sasaapi.sasaweb.com/Document/P
South African Acute Pain Guidelines 2015
SASA Pain Guidelines 2015
SASA High Spinal Anaesthesia Guidelines 2015
South African Society of Anaesthesiologists Sedation Guidelines 2015
SAMBA Guidelines for PONV 2014
SASA Guidelines for Infection Control 2014
Southern African Arthroplasty Society
Guidelines for best practice in primary hip replacement surgery in South Africa - 2019
Guideline to good practice in total knee replacement in South Africa - 2016
SA Society of Obstetricians and Gynaceologists
Hypertensive disorders in pregnancy: 2019 National guideline
A number of guidelines are available on the SASOG webpage at: www.sasog.co.za/Professional/Guidelines
Setting of a sterile tray (No date)
Guideline document: Cervical Cancer Screening in South Africa - 2015
Guideline for special investigations in antenatal care (No date)
HPV prophylactic vaccine (No date)
South African Society of Orthopaedic Surgeons
South African Gastroenterology Society (SAGES)
The SAGES website contains the Society's short positions on several pertinent issues in gastroenterology:
In addition there are links to international Guideline websites.
South African Renal Society (SARS)
Aligning to the international KDIGO Guidelines, SARS has local guidance available.
Guideline for optimal care of patients on chronic dialysis in South Africa - 2015
Guideline for chronic dialysis in children in South Africa - 2015
Guideline for the care of patients with acute kidney injury - 2015
SARS Position Statements:
SARS Statement On Use Of Generic Immunosuppressant Drugs - 2018
Haemodialysis once a week - SARS Position Statement - 2018
South African Rheumatism and Arthritis Association (SARAA)
South African recommendations for the management of rheumatoid arthritis: An algorithm for the standard of care in 2013
Several position statements relating to specific areas of the management of rheumatological conditions
SOUTH AFRICAN SOCIETY OF THROMBOSIS AND HAEMOSTASIS (SASTH)
Venous thromboembolism: Prophylactic and therapeutic practice guideline (2013)
Paediatric anticoagulation guidelines (2012)
South African Stroke Society
South African guideline for management of ischaemic stroke and transient ischaemic attack 2010: A guideline from the South African Stroke Society (SASS) and the SASS Writing Committee
South African Spinal Cord Association
Best Practice Recommendations for Bladder Management in the Spinal Cord Afflicted Patient in South Africa 2019
South African Thoracic Society
Recommendations for Lung Cancer Screening in South Africa - 2019
South African guideline for the management of community acquired pneumonia in adults - 2017
Cystic Fibrosis consensus document - 2017
Recommendations for the management of idiopathic pulmonary fibrosis in South Africa - 2017
Recommendations for the use of endoscopic lung volume reduction in South Africa: Role in the treatment of Emphysema - 2016
Guideline for office spirometry in adults 2012 - 2013
South African tobacco smoking cessation clinical practice guideline - 2013
Recommendations for the use of bronchial thermoplasty in the management of severe asthma - 2015
Guideline for the management of acute asthma in adults: 2013 update
Guideline for the management of acute asthma in children: 2013 update
Guideline for the management of chronic obstructive pulmonary disease - 2011 update
South African guideline for the diagnosis, management and prevention of acute viral bronchiolitis in children -2010
SOCIETY FOR METABOLISM, ENDOCRINOLOGY AND DIABETES OF SOUTH AFRICA
Diabetic Guidelines: www.semdsa.org.za/Member/Guidelines
- Management of Type 2 diabetes mellitus 2017
- Diabetic Footcare Guidelines for Primary Healthcare Professionals
- Management of Diabetic Foot Ulcers
- Continuous subcutaneous insulin infusion therapy in type 2 diabetes...
- www.semdsa.org.za/Content/Images/00044085.pdf
- New guidelines for the use of insulin infusion pumps in South Africa
Other guidelines
Society of Vascular Surgery
Specialist Nuclear Physician / Nuclear Medicine
The South African Society of Nuclear Medicine officially endorses selected international guidelines. Links to all of these guidelines can be found on their website: www.sasnm.com/Guidelines
Wound Healing Association of Southern Africa (WHASA)
While the publications of WHASA are consensus documents, rather than guidelines, they offer valuable insights into the management of ulcers, diabetic foot and acute burns. www.whasa.org
WHASA Consensus Document on the management of lower limb ulcers - 2016
WHASA Consensus Document on the management of diabetic foot - 2015
WHASA Consensus document on the management of acute burns - 2015