A data-driven revolution is quietly unfolding in Mthatha, with Professor Thozama Dubula, a leading rheumatologist, at its centre.
Prof Dubula is spearheading the development of an electronic patient database and referral system that could transform rheumatology care across South Africa.
“We want to ensure that doctors in rural areas can manage these conditions effectively before needing to refer patients,” he explained.
For years, patient care at the Nelson Mandela Academic Hospital (NMAH) has relied almost entirely on paper records, a system that has hindered research and management.
In the Eastern Cape, diseases like arthritis, gout, and tendonitis. remain underreported and overshadowed by more visible health crises.
As Head of Internal Medicine and Pharmacology at NMAH, Prof Dubula is set to change that.
As South Africa marked Rheumatic Fever Week (1-7 August), a national awareness initiative, the professor’s Discovery Foundation Rural Institutional Award (2023/2024) is funding the development of a digital system to streamline care in remote communities.
Rheumatic fever, according to the World Health Organization (WHO), occurs when the body’s immune system overreacts to a Group A Streptococcus infection, potentially causing Rheumatic Heart Disease (RHD) if untreated.
Between 2021 and 2024, South Africa recorded an average of 824 acute rheumatic fever (ARF) cases annually, most common in children aged 5 to 14, while RHD disproportionately affects women aged 20 to 39.
Prof Dubula highlighted the challenges of the outdated system: “Since 2018, NMAH’s rheumatology clinic has operated using paper-based records. The Discovery Foundation grant will help us transition to an electronic system, making it easier to manage patient data and conduct long-term research.”
The database will collect retrospective and prospective data, particularly from districts like Lusikisiki and Matatiele, enabling clinicians to study disease trends.
“We see many referrals from these regions, and it’s unclear whether this is due to a higher prevalence of conditions like rheumatoid arthritis or because doctors in these areas are more proactive.
“This system will help us find answers,” Prof Dubula explained.
Expanding horizons
Raised in Idutywa in a close-knit rural setting, Prof Dubula’s dedication to medicine was inspired by his mother, a teacher, and his late aunt’s advocacy for local healthcare.
After training in rheumatology under Professor Giresh Moodley at King Edward VIII Hospital, he co-founded rheumatology services in Gqeberha before returning to Mthatha to bridge systemic gaps in care.
“Digitisation allows for consistent follow-ups, better risk stratification, and improved community education,” he said, emphasising its alignment with global public health efforts to prevent heart disease. He added, “With more specialists, we can see more patients and intervene earlier to prevent complications such as kidney failure or advanced RHD.”
Beyond rheumatic conditions, Prof Dubula aims to explore gout, a condition he believes is underestimated in South African clinics.
He hopes to collaborate with institutions like Groote Schuur Hospital (Cape Town) and Livingstone Hospital (Gqeberha) to build a gout patient cohort.
As a professor at Walter Sisulu University, he also trains medical students who often come from rural areas where healthcare infrastructure is limited.
“Many of our students understand these challenges firsthand. My goal is to equip them with the skills and resilience to thrive in resource-constrained environments,” he concluded.
