Lymphoedema Evidence Library › Topics › Services in South Africa
Services in South Africa
Services and the South African context
21 sources
Evidence in one minute
- LAOSA (founded 2012) certifies therapists with ≥135 hours of training and keeps a national practice register; its 2018 position statement defines lymphoedema, staging, diagnosis, CDT, compression classes, contraindications and surgery for SA use and argues for Prescribed Minimum Benefit status. Davey 2018
- Workforce (2014): ~67 certified therapists, <10% in the public sector; no official BCRL guideline; garments and bandages rarely available in public hospitals; medical aids pay little. Proposed pathway: every newly diagnosed breast cancer patient measured before treatment; symptomatic patients at clinics to trained staff and home-based carers. Marco 2014
- Burden: no SA prevalence data; 530 000–1.06 million is an extrapolation of an uncited “WHO 2014” 1–2% figure — do not quote as data (revised 2026-10-09). Davey 2014
- Practice realities: OT-made garments of unknown pressure, long custom lead times, adherence problems, cellulitis admissions. Vivian 2019
- Service models: Lymphoedema Framework service template (UK), Dutch expert-centre chronic-care model inside the ILF surgery document, Canadian Lymphedema Framework with accredited online training. Lymphoedema Framework 2007 · International Lymphoedema Framework 2012 · Canadian Lymphedema Framework 2023
- Historic SA surgical literature (lymphangiography 1966–1971, secondary lymphoedema 1970) — citation only. Abramowitz 1970
- Mayrovitz/Davey research programme (Florida, 2005–2014): Suzi (Humen) Davey — later a member of the LAOSA position-statement panel, based in Hillcrest, KwaZulu-Natal — co-authored the tissue dielectric constant and pneumatic compression studies. Mayrovitz 2014 · Fife 2012
Update 2026-10-08 — downloaded evidence
- LMIC burden: after breast cancer treatment, arm lymphoedema prevalence ~27%; no South African cohort in the meta-analysis. Torgbenu 2020
- Self-care training is effective and suits limited therapist capacity. Douglass 2016
- Rural residence increased chronic BCRL in PREVENT — relevant to SA access. Boyages 2023
- LVA economics: not cost-effective from a health-service perspective in the Netherlands. Kleeven 2026
Appraisal update 2026-10-09
- SA opinion pieces appraised (JBI text and opinion): Marco 2014 4/6 (workforce figure from LAOSA, not a survey; staging non-standard); Davey 2014 3/6 (author founded LAOSA, which the article promotes). Marco 2014 · Davey 2014
- Ebrahim 2009 now read (free on SciELO SA): HIV-associated Kaposi lymphoedema with popliteal HIV thrombosis and gangrene in a 34-year-old Durban man — a local differential diagnosis. Ebrahim 2009
- Swedish practice (Nikolaidis 2013): early education and measurement after node surgery, compression first, MLD only as a self-massage trial — a model for scarce therapist time. Nikolaidis 2013
Gaps
No SA epidemiology, cost or outcome data; no SA guideline on surgery; LAOSA's planned consensus document (2018) not held.
How the evidence points
| High | Mod. | Low | V. low | None | |
|---|---|---|---|---|---|
| Positive | 0 | 0 | 1 | 0 | 0 |
| Null or negative | 0 | 0 | 1 | 0 | 0 |
Sources on this page with a comparison, by the result of their primary outcome and the GRADE certainty of their main finding (Mod. = Moderate, V. low = Very low, None = not graded). Context sources are not counted. How direction is decided.
All 21 sources
Loading 21 sources…