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?Department of Medicine

??????????????????Division of Pulmonology? 

The Division of Pulmonology at Tygerberg Hospital, part of the Faculty of Medicine and Health Sciences at Stellenbosch 中国体育彩票, is engaged in comprehensive education, research, and clinical services related to both respiratory health and critical care. Key clinical focus areas include the comprehensive management of respiratory pathologies, spanning across primary and sub-specialist levels, state of the art diagnostic and therapeutic interventions, and management of complex critically ill patients requiring multi-organ support in conjunction with our team of intensivists.

Below is an overview, structured according to the specified categories.


TEACHING AND LEARNIN????G

Undergraduate offe?ring

The Division of Pulmonology is involved in teaching undergraduate medical students throughout their 6 years of training. They are involved in laying down the theoretical foundations during the formative years and guiding clinical exposure in the latter years of internal medicine training. Students gain exposure to various aspects of pulmonology, including the diagnostic tests more specific to the discipline, such as chest radiology, pulmonary function testing and endobronchial procedures. They are also guided in the clinical management of pulmonology patients and rotate through our sub-specialist clinics where they experience the wide array of South African respiratory pathologies.

Postgraduate offer??ing

Postgraduate training includes structured rotational programmes for medical registrars specializing in internal medicine and for pulmonology fellows sub-specializing in adult pulmonology. Both these emphasize hands-on clinical experience and advanced training in respiratory medicine directed at either the physician or pulmonologist level. Training within pulmonology is parallelled by training in critical care with the goal of competence in the management of complex medical or surgical patients requiring advanced organ support and ancillary therapies.

The Division boasts one of the continent's most advanced bronchoscopic suites with state-of-the-art equipment. Fellows are competent in an array of advanced endobronchial and transthoracic diagnostic procedures upon completion of training. Research opportunities to further academic progress through master's and doctoral studies are also supported by the Division.

Structured learning activities, as well as examination readiness and preparation, are built into these rotations and provide the platform for our candidates to complete their training at the highest standard.

The Division emphasizes collaboration and mentorship, fostering a supportive environment for both clinical practice and research. This structured approach to education, research, and clinical service underscores the Division's commitment to advancing the field of pulmonology and critical care and improving patient outcomes at Tygerberg Hospital.

Short cours?es

The Division may offer short courses aimed at healthcare professionals seeking to enhance their knowledge and skills in specific areas such as development of research skills and thoracic ultrasound. Many leadership and management courses are also available to Divisional staff through the university.


RESEARC?H

Research within the Division focuses on several key areas, including:

  • Lung cancer diagnosis and screening
  • Management of pleural diseases
  • Asthma and Chronic Obstructive Pulmonary Disease (COPD)
  • HIV and its impact on lung health
  • Interstitial lung diseases
  • Post-tuberculosis lung disease and pulmonary hypertension
  • Critical care

The Division has initiated many collaborative research projects, including the first dedicated post-tuberculosis clinic in South Africa, aiming to address long-term complications associated with TB. Publications from the Division cover a range of topics in pulmonology, contributing to the global understanding of respiratory diseases and their management.

 

All research endeavours 2020 - 20?24

Our research interests include lung cancer, post TB lung disease, pulmonary hypertension, artificial intelligence, infectious and pleural diseases, preoperative assessment of lung resection candidates, applied transthoracic ultrasound, interventional pulmonology, critical care and more recently COVID-19.

 

All publications 2020 – 2024

Peer-Reviewed Publications

  1. Allwood BW, Bennji S. Crazy Paving in Pulmonary Alveolar Proteinosis. N Engl J Med. 2020;382(3):27
  2. Decloedt EH, Reuter H, Allwood B, Parker A, Koegelenberg CFN, Blockman M, Taljaard J. Benefit v. risk when using chloroquine in patients with severe COVID-19 disease. S Afr Med J. 2020 Apr 2;110(5):12903.
  3. Koslow M, Bennji SM, Griffith-Richards S, Ahmad K, Johnson GB, Ryu JH, Nathan SD, Allwood BW. A 48-Year-Old South African Woman with Rheumatoid Arthritis and Lung Nodules. Chest. 2020 May;157(5): e151-e155.
  4. Shaw JA, Louw EH, Koegelenberg CFN. Lung Ultrasound in COVID-19: Not Novel, but Necessary. Respiration. 2020;99(7):545-547.
  5. Corcoran JP, Psallidas I, Gerry S, Piccolo F, Koegelenberg CF, Saba T, Daneshvar C, et al. Prospective validation of the RAPID clinical risk prediction score in adult patients with pleural infection: the PILOT study. Eur Respir J. 2020 Jul 16;2000130.
  6. Parker A, Karamchand S, Schrueder N, Lalla U, Koegelenberg CFN, et al. Leadership and early strategic response to the SARS-CoV-2 pandemic at a COVID-19 designated hospital in South Africa. S Afr Med J. 2020;110(6):463-465
  7. van Zyl-Smit R, Feldman C, Richards G, Abdool-Gaffar S, Lalloo U, Kalla I, Koegelenberg CFN, Dheda K. South African Thoracic Society statement on obstructive airways disease and COVID-19. Afr J Thorac Crit Care Med 2020;26(3):10.7196/AJTCCM. 2020.v26i3.111.
  8. Lalla U, Allwood BW, Louw EH, Nortje A, Parker A, Taljaard JJ, Moodley D, Koegelenberg CFN. The utility of high-flow nasal cannula oxygen therapy in the management of respiratory failure secondary to COVID-19 pneumonia. S Afr Med J 2020;110(6):432. 
  9. Parker A, Shaw J, Karamchand S, Lahri S, Schrueder N, Chothia MY, Mowlana A, Lalla U, Allwood BW, Koegelenberg CFN, Taljaard JJ. HIV and SARS-CoV-2 co-infection: The diagnostic challenges of dual pandemics. S Afr Med J 2020;110(6):473-475
  10. Mazaza A, Lalla U, Taljaard JJ, John TJ, John KG, Slabbert J, Koegelenberg CFN. The aetiology of severe community-acquired pneumonia requiring intensive care unit admission in the Western Cape Province, South Africa. Afr J Thoracic Crit Care Med 2019;26(1):5-7
  11. Allwood BW, Maasdorp E, Kim GJ, Cooper CB, Goldin J, van Zyl-Smit RN, Bateman ED, Dawson R. Transition from Restrictive to Obstructive Lung Function Impairment During Treatment and Follow-Up of Active Tuberculosis. Int J Chron Obstruct Pulmon Dis. 2020 May 11; 15:1039-1047
  12. Brett S, Irusen EM, Koegelenberg CFN. Pulmonary scarring and its relation to primary lung cancer. Afr J Thoracic Crit Care Med 2020;26(1):8-11
  13. Mhlana N, Koegelenberg CFN. The impact of age at presentation on lung cancer staging.  Afr J Thoracic Crit Care Med 2020;26(2):29-31
  14. Parker A, Koegelenberg CFN, Moolla SM, Louw EH, A Mowlana, A Nortjé, R Ahmed, N Brittain, U Lalla, B W Allwood, H Prozesky, N Schrueder, J J Taljaardet al. High HIV prevalence in an early cohort of hospital admissions with COVID-19 in Cape Town, South Africa. S Afr J Med 2020;110(10):982-987
  15. Allwood BW, Stolbrink M, Baines N, Louw E, Wademan DT, Lupton-Smith A, Nel S, Maree D, Mpagama S, Osman M, Marx FM, Hoddinott G, Lesosky M, Rylance J, Mortimer K. Persistent chronic respiratory symptoms despite TB cure is poorly correlated with lung function. Int J Tuberc Lung Dis. 2021 Apr 1;25(4):262-270
  16. Moodley K, Allwood BW, Rossouw TM. Consent for critical care research after death from COVID-19: Arguments for a waiver. S Afr Med J. 2020 May 26;110(7):629-634.
  17. Boulle A, Davies MA, Hussey H, Koegelenberg CFN, et al. Risk factors for COVID-19 death in a population cohort study from the Western Cape Province, South Africa. Clin Infect Dis. Clin Infect Dis. 2021 Oct 5;73(7): e2005-e2015.
  18. Allwood BW, Koegelenberg CF, Irusen E, Lalla U, Davids R, Chothia Y, Davids R, Prozesky H, Taljaard J, Parker A, Decloedt E, Jordan P, Lahri S, Moosa R, Schrueder N, Du Toit R, Viljoen A, English R, Ayele B, Nyasulu P; COVID-19 Research Response Team. Clinical evolution, management and outcomes of patients with COVID-19 admitted at Tygerberg Hospital, Cape Town, South Africa: a research protocol. BMJ Open. 2020 Aug 30;10(8): e039455. doi: 10.1136/bmjopen-2020-039455.
  19. Allwood BW, van der Zalm MM, Amaral AFS, Byrne A, Datta S, Egere U, Evans CA, Evans D, Gray DM, Hoddinott G, Ivanova O, Jones R, Makanda G, Marx FM, Meghji J, Mpagama S, Pasipanodya JG, Rachow A, Schoeman I, Shaw J, Stek C, van Kampen S, von Delft D, Walker NF, Wallis RS, Mortimer K. Post-tuberculosis lung health: perspectives from the First International Symposium. Int J Tuberc Lung Dis. 2020;24(8):820-828
  20. Irusen EM. The Global Initiative for Asthma 2019 recommendation for mild asthma - A critique. S Afr Fam Pract. 2020.5;62(1): e1-e4.
  21. Parker A, Louw EH, Lalla U, Koegelenberg CFN, Allwood BW, Rabie H, Sibeko SI, Taljaard JJ, Lahri S. Multisystem inflammatory syndrome in adult COVID-19 patients. S Afr Med J 2020;110(10):957-958.
  22. Wiese OJ, Allwood BW, Zemlin AE. COVID-19 and the renin-angiotensin system (RAS): A spark that sets the forest alight? Med Hypotheses. 2020 Nov; 144:110231. doi: 10.1016/j.mehy.2020.110231.
  23. Irusen EM, Malange T. Pharmacotherapy of chronic obstructive pulmonary disease: Therapeutic considerations with a focus on inhaled corticosteroids. S Afr Fam Pract. 2020 Dec 8;62(1): e1-e6.
  24. Moolla MS, Parker A, Parker MA, et al. Staff testing for COVID-19 via an online pre-registration form. S Afr J Infect Dis. 2021; 36(1): a232
  25. Moolla MS, Broadhurst A, Parker MA, et al. Implementing a video call visit system in a coronavirus disease 2019 unit. Afr J Prm Health Care Fam Med. 2020; 12(1): a2637.
  26. Rood J, Davids R, le Roux A, du Plessis M, Parker A, Allwood BW, Prozesky HW, Koegelenberg CFN, Taljaard JJ. Metabolic alkalosis in hospitalised COVID-19 patients: A window to the pathogenesis? S Afr Med J. 2020;110(11):13109
  27. Calligaro GL, Lalla U, Audley G, Gina P, Miller MG, Mendelson M, Dlamini S, Wasserman S, Meintjes G, Peter J, Levin D, Dave JA, Ntusi N, Meier S, Little F, Moodley DL, Louw EH, Nortje A, Parker A, Taljaard JJ, Allwood BW, Dheda K, Koegelenberg CFN. The utility of high-flow nasal oxygen for severe COVID-19 pneumonia in a resource-constrained setting: A multi-centre prospective observational study. Lancet EClinicalMedicine. 2020 Oct 6:100570.
  28. Bruce-Brand C, Allwood BW, Koegelenberg CFN, Lalla U, Louw E, Diacon AH, Schubert PT. Postmortem lung biopsies from four patients with COVID-19 at a tertiary hospital in Cape Town, South Africa. S Afr Med J. 2020;110(12):1195-1200.
  29. Meghji J, Mortimer K, Agusti A, Allwood BW, Asher I, Bateman ED, Bissell K, Bolton CE, Bush A, Celli B, Chiang CY, Cruz AA, Dinh-Xuan AT, El Sony A, Fong KM, Fujiwara PI, Gaga M, Garcia-Marcos L, Halpin DMG, Hurst JR, Jayasooriya S, Kumar A, Lopez-Varela MV, Masekela R, Mbatchou Ngahane BH, Montes de Oca M, Pearce N, Reddel HK, Salvi S, Singh SJ, Varghese C, Vogelmeier CF, Walker P, Zar HJ, Marks GB. Improving lung health in low-income and middle-income countries: from challenges to solutions. Lancet. 2021;397(10277):928-940
  30. Jaravaza DR, Lalla U, Zaharie SD, de Jager LJ. Unusual Presentation of Atrial Myxoma: A Case Report and Review of the Literature. Am J Case Rep. 2021;3;22: e931437
  31. Allwood BW, Byrne A, Meghji J, Rachow A, van der Zalm MM, Schoch OD. Post-Tuberculosis Lung Disease: Clinical Review of an Under-Recognised Global Challenge. Respiration. 2021;100(8):751-763.
  32. Bezuidenhout MC, Wiese OJ, Maasdorp E, Moodley DL, Davids MR, Koegelenberg CFN, Lalla U, Khine-Wamono AA, Zemlin AE, Allwood BW. Correlating arterial blood gas, acid-base and blood pressure abnormalities with outcomes in COVID-19 intensive care patients. Annals of Clinical Biochemistry 2021;58(2):95-101.
  33. Beukes A, Shaw JA, Diacon AH, Irusen EM, Koegelenberg CFN. The utility of pleural fluid lactate dehydrogenase to adenosine deaminase ratio in pleural tuberculosis. Respiration. 2021;100(1):59-63.
  34. Riou C, du Bruyn E, Stek C, Daroowala R, Goliath RT, Abrahams F, Said-Hartley Q, Allwood BW, Hsiao NY, Wilkinson KA, Arlehamn CSL, Sette A, Wasserman S, Wilkinson RJ, HIATUS consortium. Relationship of SARS-CoV-2-specific CD4 response to COVID-19 severity and impact of HIV-1 and tuberculosis coinfection. J Clin Invest. 2021; 131(12): e149125..
  35. Broadhurst AGB, Lalla U, Taljaard JJ, Louw EH, Koegelenberg CFN, Allwood BW.
    The diagnostic challenge of pneumocystis pneumonia and COVID-19 co-infection in HIV. Respirol Case Rep 202122;9(4): e00725
  36. Masekela R, Koegelenberg CFN, Gray DM. Guidance to the applicability of the Global Lung Initiative spirometry reference equations for South African populations. S Afr Med J 2021;111(2):17-18
  37. Lalla U, Irusen EM, Allwood BW, Taljaard JJ, Koegelenberg CFN. A severity-of-illness score in patients with tuberculosis requiring intensive care. S Afr Med J 2021;111(3):245-249
  38. Shaw JA, Allwood BW. Post-tuberculosis lung disease: Exposing the elephant in the room. Afr J Thorac Crit Care Med. 2021 Jun 23;27(2):10.7196
  39. Shaw JA, Koegelenberg CFN.  Xpert MTB/RIF on pleural biopsy in suspected pleural TB: Does it add anything other than cost? Afr J Thoracic Crit Care Med 2021;27(1):4
  40. Louw EH, Shaw JA, Koegelenberg CFN. New insights into spontaneous pneumothorax: A review. Afr J Thoracic Crit Care Med 2020;26(1):18-22.
  41. Cilliers JD, Eindhoven SC, Koegelenberg CFN, Irusen E, Bruce-Brand C, Allwood BW. Pulmonary manifestations of IgG4?related disease in a South African patient. Afr J Thoracic Crit Care Med 2021;27(1):29-31
  42. Moolla MS, Reddy K, Fwemba I, Nyasulu PS, Taljaard JJ, Parker A, Louw EH, Nortje A, Parker MA, Lalla U, Koegelenberg CFN, Allwood BW. Bacterial infection, antibiotic use and COVID-19: Lessons from the intensive care unit. S Afr Med J 2021 Apr 15;111(6):575-581.
  43. Ngah V, Maud P, Baines N, Mistry R, Schrueder N, Koegelenberg CFN, Irusen EM, Mortimer K, Allwood B. Respiratory presentations to acute services at a tertiary hospital in South Africa. S Afr Med J. 2021 Nov 5;111(11):1104-1109
  44. Buckley AM, Griffith-Richards S, Davids R, Irusen EM, Nyasulu PS, Lalla U, Allwood BW, Louw EH, Nortje A, Pitcher RD, Koegelenberg CFN. Relative sparing of the left upper zone on chest radiography in severe 中国体育彩票 pneumonia. Respiration 2021;100(8):811-815
  45. du Plessis EM, Lalla U, Allwood BW, Louw EH, Nortje A, Parker A, Taljaard JJ, Ayele BT, Nyasulu PS, Koegelenberg CFN. Corticosteroids in critical COVID-19: Are all corticosteroids equal? S Afr Med J 2021;111(6):550-553.
  46. G?ker E, Altwairgi A, Al-Omair A, Tfayli A, Black E, Elsayed H, Selek U, Koegelenberg C. Multi-disciplinary approach for the management of non-metastatic non-small cell lung cancer in the Middle East and Africa: Expert panel recommendations. Lung Cancer. 2021;158:60-73
  47. Kotze LA, Beltran CGG, Lang D, Loxton AG, Cooper S, Meiring M, Koegelenberg CFN, Allwood BW, Malherbe ST, Hiemstra AM, Glanzmann B, Kinnear C, Walzl G, du Plessis N. Establishment of a Patient-Derived, Magnetic Levitation-Based, Three-Dimensional Spheroid Granuloma Model for Human Tuberculosis. mSphere 6: e00552-21.
  48. Dheda K, Charalambous S, Karat AS, von Delft A, Lalloo UG, van Zyl Smit R, Perumal R, Allwood BW, Esmail A, Wong ML, Duse AG, Richards G, Feldman C, Mer M, Nyamande K, Lalla U, Koegelenberg CFN, et al. A position statement and practical guide to the use of particulate filtering facepiece respirators (N95, FFP2, or equivalent) for South African health workers exposed to respiratory pathogens including Mycobacterium tuberculosis and SARS-CoV-2. Afr J Thorac Crit Care Med. 2021 Oct 22;27(4):10.7196
  49. Mpagama SG, Msaji KS, Kaswaga O, Zurba LJ, Mbelele PM, Allwood BW, Ngungwa BS, Kisonga RM, Lesosky M, Rylance J, Mortimer K. The burden and determinants of post-TB lung disease. Int J Tuberc Lung Dis. 2021 ;25(10):846-853
  50. Shaw JA, Koegelenberg CFN. Pleural Tuberculosis. Clin Chest Med. 2021 Dec;42(4):649-666
  51. Moolla MS, Whitelaw A, Decloedt EH, Koegelenberg CFN, Parker A. Opportunities to enhance antibiotic stewardship: colistin use and outcomes in a low-resource setting. JAC Antimicrob Resist. 2021 Nov 17;3(4): dlab169. 
  52. Lalloo UG, Kalla IS, Abdool-Gaffar S, Dheda K, Koegelenberg CFN, Greenblatt M, Feldman C, Wong ML, van Zyl-Smit RN; Asthma Working Group of the South African Thoracic Society. Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society - 2021 update. Afr J Thorac Crit Care Med. 2021 Dec 31;27(4):30-43
  53. Moolla MS, Lahri S, Parker A, et al. Going where the data are: Connecting to Trello for daily statistics in the COVID-19 era and beyond. S Afr Med J. 2021; 111(11): 1032-1033
  54. Menzies NA, Quaife M, Allwood BW, Byrne AL, Coussens AK, Harries AD, Marx FM, Meghji J, Pedrazzoli D, Salomon JA, Sweeney S, van Kampen SC, Wallis RS, Houben RMGJ, Cohen T. Lifetime burden of disease due to incident tuberculosis: a global reappraisal including post-tuberculosis sequelae. Lancet Glob Health. 2021 Dec;9(12): e1679-e1687. doi: 10.1016/S2214-109X(21)00367-3. Erratum in: Lancet Glob Health. 2022;10(3):e336.
  55. Botha CJ, Oosthuizen K, Shaw JA, Allwood BW, Irusen EM, Koegelenberg CFN. Medical management of large and multiple pulmonary echinococcal cysts. Int J Tuberc Lung Dis. 2021;25(12):1035-1037
  56. Lalla U, Koegelenberg CFN, Allwood BW, et al Comparison of patients with severe COVID?19 admitted to an intensive care unit in South Africa during the first and second wave of the COVID?19 pandemic. Afr J Thoracic Crit Care Med 2021;27(4):156-162.
  57. Huber RM, Cavic M, Kerpel-Fronius A, Viola L, Field J, Jiang L, Kazerooni EA, Koegelenberg CF, et al. Lung Cancer Screening Considerations During Respiratory Infection Outbreaks, Epidemics or Pandemics: An IASLC Early Detection and Screening Committee Report. J Thorac Oncol. 2022;17(2):228-223
  58. Shaw JA, Wilken E, Allwood BW, Irusen EM, Koegelenberg CFN. Autologous Blood Patch Pleurodesis for the Management of a Persistent Air Leak after Secondary Spontaneous Pneumothorax. Respiration. 2022;101(4):417-421
  59. Zemlin AE, Allwood B, Erasmus RT, Masha TE, Chapanduka ZC, Jalavu TP, Ngah V, Sigwadhi LN, Koegelenberg CF, et al. Prognostic value of biochemical parameters among severe COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa. IJID Regions 2022;2: 191-197
  60. Curry BD, van T Wout E, Maasdorp E, Nortje A, Irusen EM, Maree D, Koegelenberg CFN, Allwood BW. Correlation between lung function tests and peak oxygen consumption in post-TB lung disease. Int J Tuberc Lung Dis. 2022;26(3):259-267.
  61. Kotze LA, van der Spuy G, Leonard B, Penn-Nicholson A, Musvosvi M, McAnda S, Malherbe ST, Erasmus M, Scriba T, Koegelenberg CFN, Allwood BW, Walzl G du Plessis N. Targeted Gene Expression Profiling of Human Myeloid Cells from Blood and Lung Compartments of Patients with Tuberculosis and Other Lung Diseases. Front. Immunol. 2022;13:839747
  62. Parker MA, Moola MS, Paris GE, Koegelenberg CFN. Staging and operability of primary lung cancer in Western Cape Province, South Africa. Afr J Thoracic Crit Care Med 2022;28(1):20-24.
  63. Eknewir S, John TJ, Bennji SM, Koegelenberg CFN. The utility of endobronchial ultrasound-guided transbronchial needle aspiration in a community with a high HIV and tuberculosis burden. Afr J Thoracic Crit Care Med 2022;28(1):25-27
  64. Boy DP, Shaw JA, Koegelenberg CFN. Ultrasound-guided pleural biopsy. Eurasian J Pulmonol 2022;24:000-0 [EPub]
  65. Allwood BW, Koegelenberg CF, Ngah VD, et al. Predicting COVID-19 outcomes from clinical and laboratory parameters in an intensive care facility during the second wave of the pandemic in South Africa. IJID Reg. 2022;3:242-247
  66. Parker A, Boloko L, Moolla MS, Ebrahim N, Ayele BT, Broadhurst AGB, Mashigo B, Titus G, de Wet T, Boliter N, Rosslee MJ, Papavarnavas N, Abrahams R, Mendelson M, Dlamini S, Taljaard JJ, Prozesky HW, Mowlana A, Viljoen AJ, Schrueder N, Allwood BW, Lalla U, Dave JA, Calligaro G, Levin D, Maughan D, Ntusi NAB, Nyasulu PS, Meintjes G, Koegelenberg CFN, Mnguni AT, Wasserman S. Clinical features and outcomes of COVID-19 admissions in a population with a high prevalence of HIV and tuberculosis: a multicentre cohort study. BMC Infect Dis. 2022;22(1):559
  67. Irusen EM. Sarcoidosis - time for a clinical refresher! Afr J Thorac Crit Care Med. 2022;28(4):10.7196
  68. Benbarka SS, Shubert PT, Irusen EM, Allwood BW, Koegelenberg CFN. The utility of chest ultrasound-guided fine-needle biopsy in the diagnosis of plasmacytoma. Afr J Thorac Crit Care Med. 2022;28(4):10.7196
  69. Abdulgader SM, Okunola AO, Ndlangalavu G, Reeve BWP, Allwood BW, Koegelenberg CFN, Warren RM, Theron G. Diagnosing Tuberculosis: What Do New Technologies Allow Us to (Not) Do? Respiration 2022;101(9):797-813.
  70. Bhikoo R, Koegelenberg CFN. Lung cancer in people living with HIV: a different kettle of fish? Afr J Thoracic Crit Care Med 2022;28(2):50
  71. Koegelenberg CFN, van Zyl-Smit RN, Dheda K, et al. Position Statement on Endoscopic lung volume reduction in South Africa: 2022 Update? Afr J Thoracic Crit Care Med 2022;28(2): 75-81
  72. Singh S, Allwood BW, Chiyaka TL, Kleyhans L, Naidoo CC, Moodley S, Theron G, Segal LN. Immunologic and imaging signatures in post tuberculosis lung disease. Tuberculosis (Edinb). 2022 Sep;136:102244. doi: 10.1016/j.tube.2022.102244
  73. Broadhurst ABG, Allwood BW, Botha CJ, Galligaro G, Lee C, Gopalan PD, Koegelenberg CFN, et al. The Optimal Management of the Patient with COVID-19 Pneumonia: HFNC, NIV/CPAP or Mechanical Ventilation. Afr J Thoracic Crit Care Med 2022;28(3): 119-128
  74. Zemlin AE, Sigwadhi LN, Wiese OJ, Jalavu TP, Chapanduka ZC, Allwood BW, Tamuzi JL, Koegelenberg CF, et al. The association between acid-base status and clinical outcome in critically ill COVID-19 patients admitted to intensive care unit with an emphasis on high anion gap metabolic acidosis. Ann Clin Biochem 2022 Nov 7;45632221134687 [Epub]
  75. Chapanduka ZC, Abdullah I, Allwood B, Koegelenberg CF, et al. Haematological predictors of poor outcome among COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa. PLoS One . 2022;17(11):e0275832.
  76. Sigwadhi LN, Tamuzi JL, Zemlin AE, Chapanduka ZC, Allwood BW, Koegelenberg CF, et al. Latent Class Analysis: An innovative approach for identification of clinical and laboratory markers of disease severity among COVID-19 patients admitted to the Intensive Care Unit. IJID Reg.2022;5:154–162
  77. Moolla MS, Maponga T, Moolla H, Kollenberg E, Anie S, Moolla A, Moodley D, Lalla U, Allwood BW, Schrueder N, Preiser W, Koegelenberg CF, Parker A. A tale of two waves: Characteristics and outcomes of COVID-19 admissions during the omicron-driven 4th wave in Cape Town, South Africa and implications for the future. IJID Reg. 2022 Nov 24. doi: 10.1016/j.ijregi.2022.11.008
  78. Swanepoel J, Zimri K, van der Zalm MM, Hoddinott G, Palmer M, Doruyter A, De Beer G, Kleynhans L, Johnson SM, Jongen V, Wademan D, Mcimeli K, Jacobs S, Swanepoel R, Van Zyl G, Allwood BW, Malherbe S, Heuvelings C, Griffith-Richards S, Whittaker E, Moore DAJ, Schaaf HS, Hesseling AC, Seddon JA. Understanding the biology, morbidity and social contexts of adolescent tuberculosis: a prospective observational cohort study protocol (Teen TB). BMJ Open. 2022;12(12):e062979
  79. Nyasulu PS, Ayele BT, Koegelenberg CF, et al. Clinical characteristics associated with mortality of COVID-19 patients admitted to an intensive care unit of a tertiary hospital in South Africa.  PLoS One 2022 Dec 30;17(12):e0279565.
  80. Louw E, Baines N, Maarman G, Osman M, Sigwadhi L, Irusen E, Koegelenberg C, et al. The prevalence of pulmonary hypertension after successful tuberculosis treatment in a community sample of adult patients. Pulm Circ. 2023 Jan 1;13(1):e12184.
  81. Irusen E. Chest radiographic interpretation - an essential competency for Africa. Afr J Thorac Crit Care Med.29(1):10.7196/AJTCCM.2023.v29i1.893..
  82. Shaw JA, John TJ, Koegelenberg CFN, Da Silva M, Allwood BW, Weich H. Issues in Medicine. S Afr Med J. 2023;113(2):65-68.
  83. Rozman A, Koegelenberg CFN. Prediction of Time to Repeat Therapeutic Thoracentesis in Pleural Effusions: We Still Haven't Found What We're Looking for! Respiration. 2023;102(5):331-332
  84. Moolla MS. Equipoise between surgical and bronchoscopic approaches to lung volume reduction in COPD. Afr J Thoracic Crit Care Med. 2023; 29 (2): 82.
  85. Domingo C, Garcia G, Gemicioglu B, Van GV, Larenas-Linnemann D, Neffen H, Poachanukoon O, Sagara H, Berend N, Pizzichini E, Irusen E, Aggarwal B, Eken V, Levy G. Consensus on mild asthma management: results of a modified Delphi study. J Asthma. 2023;60(1):145-157.
  86. Riou C, du Bruyn E, Kim GHJ, da Costa I, Lee J, Sher A, Wilkinson RJ, Allwood BW, Goldin J. Derivation of a high-resolution CT-based, semi-automated radiographic score in tuberculosis and its relationship to bacillary load and antitubercular therapy. Eur Respir J. 2023;62(3):2300600.
  87. Moolla MS, Doruyter A, Allwood BW. Bridging the gap: Communicating the results of ventilation: perfusion scans to clinicians. Afr J Thorac Crit Care Med. 2023 Aug 3;29(2):10.7196/AJTCCM.2023.v29i2.1231.
  88. Sundaralingam A, Aujayeb A, Jackson KA, Pellas EI, Khan II, Chohan MT, Joosten R, Boersma A, Kerkhoff J, Bielsa S, Porcel JM, Rozman A, Marc-Malovrh M, Welch H, Symonds J, Anevlavis S, Froudrakis M, Mei F, Zuccatosta L, Gasparini S, Gonnelli F, Dhaliwal I, Mitchell MA, Fjaellegaard K, Petersen JK, Ellayeh M, Rahman NM, Burden T, Bodtger U, Koegelenberg CFN, Maskell NA, Janssen J, Bhatnagar R. Investigation and outcomes in patients with nonspecific pleuritis: results from the International Collaborative Effusion database. ERJ Open Res. 2023 Apr 11;9(2):00599-2022.
  89. Almubarek M, Boy DP, Lalla U, Allwood BW, Irusen EM, Koegelenberg CFN. Rapidly progressive respiratory failure due to antisynthetase syndrome related interstitial lung disease. Respirol Case Rep. 2023 Apr 12;11(5):e01141.
  90. du Bruyn E, Stek C, Daroowala R, Said-Hartley Q, Hsiao M, Schafer G, Goliath RT, Abrahams F, Jackson A, Wasserman S, Allwood BW, Davis AG, Lai RP, Coussens AK, Wilkinson KA, de Vries J, Tiffin N, Cerrone M, Ntusi NAB; HIATUS consortium; Riou C, Wilkinson RJ. Effects of tuberculosis and/or HIV-1 infection on COVID-19 presentation and immune response in Africa. Nat Commun. 2023;14(1):188.
  91. Goolam N, Bhikoo R, Koegelenberg CFN, Lalla U. Fatal sequelae of hydrogen sulphide poisoning. Respirol Case Rep. 2023 Apr 20;11(5):e01144.
  92. Jalavu TP, Sigwadhi LN, Kotze MJ, Yalew A, Ngah V, Tamuzi JL, Chapanduka ZC, Allwood BW, Koegelenberg CF, et al. An investigation of the correlation of vitamin D status and management outcomes in patients with severe COVID-19 at a South African tertiary hospital. IJID Reg. 2023 Jun 1. doi: 10.1016/j.ijregi.2023.05.007. Epub ahead of print
  93. Allwood BW, Joubert L, Janson J. Chronic thromboembolic pulmonary hypertension: More options, more awareness. Afr J Thorac Crit Care Med. 2023 Sep 19;29(3):10.7196/AJTCCM.2023.v29i3.1496
  94. Rachow A, Ivanova O, Bakuli A, Khosa C, Nhassengo P, Owolabi O, Jayasooriya S, Ntinginya NE, Sabi I, Rassool M, Bennet J, Niemann S, Mekota AM, Allwood BW, Wallis RS, Charalambous S, Hoelscher M, Churchyard G. Performance of spirometry assessment at TB diagnosis. Int J Tuberc Lung Dis. 2023;27(11):850-857.
  95. Allwood BW, Manie S, Stolbrink M, Hunter L, Matthee S, Meintjes G, Amosun SL, Pecoraro A, Walzl G, Irusen E. Pulmonary hypertension in adults completing tuberculosis treatment. Afr J Thorac Crit Care Med. 2023;29(3):10.7196
  96. Shaw JA, Meiring M, Snyders C, Everson F, Sigwadhi LN, Ngah V, Tromp G, Allwood B, Koegelenberg CFN, et al. Immunologic and vascular biomarkers of mortality in critical COVID-19 in a South African cohort. Front Immunol. 2023 Jul 3;14:1219097. doi: 10.3389/fimmu.2023.1219097
  97. Menzies NA, Allwood BW, Dean AS, Dodd PJ, Houben RMGJ, James LP, Knight GM, Meghji J, Nguyen LN, Rachow A, Schumacher SG, Mirzayev F, Cohen T. Global burden of disease due to rifampicin-resistant tuberculosis: a mathematical modeling analysis. Nat Commun. 2023;14(1):6182.
  98. van Zyl AGP, Allwood BW, Koegelenberg CFN, Lalla U, Retief F. The effect of inhaled nitric oxide on shunt fraction in mechanically ventilated patients with COVID-19 pneumonia. Afr J Thorac Crit Care Med. 2023;29(2):10.7196/AJTCCM.2023.v29i2.279
  99. Porcel JM, Bielsa S, Civit C, Koegelenberg CFN, Labarca G, Mei F, Maskell N, Bhatnagar R. Clinical characteristics of chylothorax: results from the International Collaborative Effusion database. ERJ Open Res. 2023;9(5):00091-2023.
  100. van Heerden JK, Louw EH, Thienemann F, Engel ME, Allwood BW. The prevalence of pulmonary hypertension in post-tuberculosis and active tuberculosis populations: a systematic review and meta-analysis. Eur Respir Rev. 2024;33(171):230154
  101. Bhikoo R, Allwood BW, Irusen EM, Koegelenberg CFN. Lung Cancer Presents at a Younger Age and Is Less Likely to be Curable in People Living with HIV. Respiration. 2024;103(1):47-50.
  102. Maartens DJ, Moolla MS, Ndaba S, Vlok SSC, Hendricks F, Koegelenberg CFN, van Wyk AC. Thoracic SMARCA4-deficient undifferentiated tumour: Diagnostic challenges and potential for misdiagnosis in small tissue samples. Respirol Case Rep. 2023;11(11):e01238. doi: 10.1002/rcr2.1238.
  103. Parker A, Broadhurst AGB, Moolla MS, Amien L, Ahmed R, Taljaard JJ, Meintjes G, Nyasulu P, Koegelenberg CFN. A point-prevalence study of body mass indices in HIV-positive and HIV-negative patients admitted to hospital with COVID-19 in South Africa. Afr J Thorac Crit Care Med. 2023 Sep 19;29(3):10.7196/AJTCCM.2023.v29i3.660
  104. Stolbrink M, Ozoh OB, Halpin DMG, Nightingale R, Meghji J, Plum C, Allwood BW, Jayasooriya S, Mortimer K; Chronic Respiratory Diseases Medicines Survey Investigators Collaboration. Availability, cost and affordability of essential medicines for chronic respiratory diseases in low-income and middle-income countries: a cross-sectional study. Thorax. 2024;79(7):676-679
  105. Mashigo A, Parker A, Lalla U, Allwood BW, Moolla, MS, Lovelock T, Koegelenberg CFN. An outbreak within an outbreak: The impact of infection prevention and control strategies on hospital acquired infections and the occurrence of multidrugresistant organisms during the COVID?19 pandemic. S Afr Med J 2023;113(12):e971.
  106. Shaw JA, Louw EH, Koegelenberg CFN. A practical approach to the diagnosis and management of malignant pleural effusions in resource-constrained settings. Breathe (Sheff). 2023 Dec;19(4):230140.
  107. Thomson H, Baines N, Huisamen T, Koegelenberg CFN, Irusen EM, Mapahla L, Allwood BW. A new understanding of clinical patterns in post-TB lung disease. Int J Tuberc Lung Dis. 2024 Mar 1;28(3):115-121.
  108. Allehebi A, Al-Omair A, Mahboub B, Koegelenberg CF, Mokhtar M, Madkour AM, Al-Asad K, Selek U, Al-Shamsi HO. Recommended approaches for screening and early detection of lung cancer in the Middle East and Africa (MEA) region: a consensus statement. J Thorac Dis. 2024 Mar 29;16(3):2142-2158
  109. Singh N, Koegelenberg CFN. Smoking cessation for hospitalised inpatients: Butt where do we begin? Afr J Thorac Crit Care Med. 2024 ;30(2):e2379.
  110. Fredericks I, Irusen EM, Allwood BW, Koegelenberg CFN. The impact of the COVID-19 pandemic on lung cancer presentation at a high-volume tertiary referral centre in South Africa. Afr J Thorac Crit Care Med. 2024 Jul 4;30(2):1031.
  111. Coussens AK, Zaidi SMA, Allwood BW, et al. Classification of early tuberculosis states to guide research for improved care and prevention: an international Delphi consensus exercise. Lancet Respir Med. 2024 Jun;12(6):484-498
  112. Allwood BW, Nightingale R, Agbota G, et al. Perspectives from the 2nd International Post-Tuberculosis Symposium: mobilising advocacy and research for improved outcomes. IJTLD Open. 2024;1(3):111-123
  113. Irusen EM, Meiring D, Koegelenberg CFN. Asthma-COPD overlap and asthma progressing to COPD: Are we using the right diagnostic approaches and pathways? Respirology. 2024 Sep;29(9):756-758
  114. Phogole CM, de Jong J, Lalla U, Decloedt E, Kellermann T. 2024. In vitro optimization of crushed drug-sensitive antituberculosis medication when administered via a nasogastric tube. Microbiol Spectr 12:e02876
  115. Nxumalo ZZ, Irusen EM, Allwood BW, Tadepalli M, Bassi J, Koegelenberg CFN. The utility of artificial intelligence in identifying radiological evidence of lung cancer and pulmonary tuberculosis in a high-burden tuberculosis setting. S Afr Med J. 2024 May 31;114(6):e1846

    Textbook Chapters:
  1. Shaw JA, von Groote-Bidlingmaier, Koegelenberg CFN. Transthoracic Ultrasound in ERS Respiratory Medicine handbook 3rd Ed; Editors Palange P and Rhode G; P160-167
  2. Shaw JA, Ahmed L, Koegelenberg CFN. Effusions related to tuberculosis. In: Maskell NA, Lauren CB, Lee YCG, et al. Pleural Disease (ERS Monograph), Sheffield, European Respiratory Society, 2020; pp 179-192
  3. Shaw, J.A., Irusen, E.M., Koegelenberg, C.F.N., 2022. Pleural Effusion: Tuberculous Effusion. In: Janes, S.M. (Ed.), Encyclopaedia of Respiratory Medicine, vol. 4. Elsevier, Academic Press, pp. 423–436.
  4. Shaw, J.A., Irusen, E.M., Koegelenberg, C.F.N., 2022. Pleural Interventions: Closed Pleural Biopsy. In: Janes, S.M. (Ed.), Encyclopaedia of Respiratory Medicine, vol. 4. Elsevier, Academic Press, pp. 566–577.
  5. Shaw JA, Gonzalez AV, Koegelenberg CFN, Diacon AH. Image-guided thoracentesis, chest tube drainage, and closed pleural biopsy. In: Maskell N, Feller-Kopman D, Lee G (ed). Textbook of Pleural Disease, 4th Ed. 2024 
  6. Shaw JA, von Groote-Bidlingmaier, Koegelenberg CFN. Transthoracic Ultrasound in ERS Respiratory Medicine handbook 4th Ed; Editors Palange P and Rhode G 


CLINICAL SERVICES AND SOCIAL IMPACT

Clinical ?Services


The Division offers a wide array of clinical services, including: ?
  • Comprehensive assessment and management of respiratory diseases, both on an inpatient and outpatient basis.
  • Specialized clinics for obstructive lung diseases, interstitial lung diseases, structural lung diseases, pulmonary hypertension, lung cancer and pleural diseases.
  • Advanced interventional pulmonology services, including bronchoscopy and pleural procedures.
  • Collaboration with Oncology and Surgery to manage patients spanning the disciplines.
  • Remote consultation and management of complex patients via our online referral pathway.
  • Outreach to various district level hospitals to provide consultatory support as well as upskill and strengthen skills within these services.
  • Comprehensive management of critically ill patients from all disciplines.

Social Impact Endea??vours

The Division actively engages in community outreach and education programs aimed at raising awareness about lung health, particularly in relation to TB and lung cancer prevention. These initiatives seek to improve public health outcomes and reduce the burden of respiratory diseases in the community.

 

OUR TEAM

?The team within the Division of Pulmonology comprises experienced consultants with diverse fields of interest and expertise. Key members include:

Prof Coenie Koegelenberg, the Head of Division, is nationally and internationally recognized for his work in interventional pulmonology, lung cancer and pleural diseases and has advanced many local and international guidelines through his ground-breaking work. He heads the Interventional Pulmonology Service which is the premier service on the continent.  He is a past president of the South African Thoracic Society (SATS), and currently serves on the society's executive council.

Prof Bian Allwood has been instrumental in establishing the Pulmonary Hypertension & CTEPH Service after completing a Fellowship in Pulmonary Hypertension at Massachusetts's General Hospital/Harvard, USA. He heads the Interstitial Lung Disease Service and established the first Post-Tuberculosis Lung Disease Clinic in the world. He has achieved international acclaim for his body of work in this field which continues to evolve. Prof Allwood has served on the SATS council for several years.

Dr Usha Lalla is uniquely poised as a dual specialist in Critical Care and Pulmonology. The management and training within the intensive care unit occur under her 10 years of experience and expertise as an intensivist. She is also furthering research in TB therapeutics within critically unwell patients, which greatly expands current understanding and will guide clinical management. Dr Lalla was recently elected to serve on the SATS council.

Dr Nevadna Singh has a keen interest in the interstitial lung diseases, as well as obstructive airways diseases. She is also invested in expanding the use and utility of cardiopulmonary exercise testing to improve the understanding and management of patients with complex cardiopulmonary pathology. She heads the Division's academic programme and is central to the successful training of both their physicians and pulmonologists.

Emeritus Prof Elvis Irusen has previously served as head of the division, president of the South African Thoracic Society, and the SA representative on the European Respiratory Society and GOLD. He has a particular interest in molecular and clinical aspects of asthma and COPD.

Dr Saadiq Moolla is a clinician researcher with a broad range of interests in pulmonology. His current research focus extends to post-tuberculous lung disease. He has a particular interest in technology where his work aims to bridge the gap between clinical practice and innovative digital tools to improve patient care and health systems. ??