ArticleAfrican journal of emergency medicine : Revue africaine de la medecine d'urgence2019
A prehospital randomised controlled trial in South Africa: Challenges and lessons learnt.
Article in African journal of emergency medicine : Revue africaine de la medecine d'urgence, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed.
- Mapping the evidence on mHealth interventions for cardiovascular event care in Africa: a scoping review.Heart (British Cardiac Society) · 2025Article
- Non-urgent patients in emergency centres in Western Cape district health services.South African family practice : official journal of the South African Academy of Family Practice/Primary Care · 2025Article
- The acceptability of delayed consent for prehospital emergency care research in the Western Cape province of South Africa.PloS one · 2022Article
- Exploring Primary Care Clinicians' Views about How Best to Implement a Potential Trial around Point-of-Care Tests for Common Infections in South Africa.Diagnostics (Basel, Switzerland) · 2021Article
- Profile and management of acute coronary syndromes at primary- and secondary-level healthcare facilities in Cape Town.Cardiovascular journal of AfricaArticle
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The incidence of cardiovascular disease and STEMI is on the rise in sub-Saharan Africa. Timely treatment is essential to reduce mortality. Internationally, prehospital 12 lead ECG telemetry has been proposed to reduce time to reperfusion. Its value in South Africa has not been established. The aim of this study was to determine the effect of prehospital 12 lead ECG telemetry on the PCI-times of STEMI patients in South Africa. A multicentre randomised controlled trial was attempted among adult patients with prehospital 12 lead ECG evidence of STEMI. Due to poor enrolment and small sample sizes, meaningful analyses could not be made. The challenges and lessons learnt from this attempt at Africa's first prehospital RCT are discussed. Challenges associated with conducting this RCT related to the healthcare landscape, resources, training of paramedics, rollout and randomisation, technology, consent and research culture. High quality evidence to guide prehospital emergency care practice is lacking both in Africa and the rest of the world. This is likely due to the difficulties with performing prehospital clinical trials. Every trial will be unique to the test intervention and setting of each study, but by considering some of the challenges and lessons learnt in the attempt at this trial, future studies might experience less difficulty. This may lead to a stronger evidence-base for prehospital emergency care.
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Registered trials
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