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14 December 2022 | Story André Damons | Photo André Damons
Dr Michael Pienaar, Senior Lecturer and specialist in the UFS Department of Paediatrics and Child Health being presented to the acting Chancellor by his supervisor Prof Stephen Brown.

A lecturer from the University of the Free State (UFS) says the need to improve the care of seriously ill children is a vital part of reducing preventable deaths and diseases, and this led him to investigate the use of artificial neural networks to develop models for the prediction of patient outcomes in children with severe illness. The study was done for his PhD thesis. 

This forms the basis for the PhD thesis of Dr Michael Pienaar, Senior Lecturer and specialist in the UFS Department of Paediatrics and Child Health, called, The Development and Validation of Predictive Models for Paediatric Critical Illness in Children in Central South Africa using Artificial Neural Networks. His thesis reports the development and testing of several machine learning models designed to help healthcare workers identify seriously ill children early in a range of resource-limited settings. Combining a systematic literature search and Delphi technique with clinical data from 1 032 participants, this research led to significant progress towards implementable models for community health workers in clinical practice.

Care for critically ill children is a mission and calling 

Dr Pienaar graduated with a PhD specialising in Paediatrics on Monday (12 December) during the Faculty of Health Sciences’ December graduation ceremony. It took him three years to complete this degree. His supervisor was Prof Stephen Brown, Principal Specialist and Head of the Division of Paediatric Cardiology in the Department of Paediatrics and Child Health in the Faculty of Health Sciences at the UFS. Prof Nicolaas Luwes and Dr EC George were his co-supervisors. 

“I have been working in paediatric critical care since 2019 and see the care of critically ill children as my mission and calling in life. At the outset of the project, I was interested in approaches to complex phenomena and wanted to investigate new methods for tackling these in healthcare. 

“I have been interested in technology since childhood and in collaborating with other disciplines since I joined the university in 2019. Machine learning seemed like a great fit that could incorporate these interests and yield meaningful clinical results,” explains Dr Pienaar the reason why he chose this topic for his thesis.

He hopes that, in time, this work will lead to the implementation of integrated machine learning models to improve care and clinical outcomes for children in South Africa. From a scholarship perspective, he continues, his hope is that this work draws interest to this field in clinical research and encourages a move towards incorporating these new methods, as well as skills in areas such as coding and design in the armamentarium of a new generation of clinicians.

Medicine chooses you

According to Dr Pienaar, he always had broad interests, of which medicine is one. “I am very grateful to have found my way in medicine and am humbled and privileged to be allowed to walk with children and their families on a difficult and important journey. I believe this profession will choose you and put you where you are needed if you give it time and are prepared to listen.”

He describes graduating as a complicated ending to this period of his life and the beginning of a next chapter. He was humbled by the graduation ceremony. 

“It was wonderful to graduate with undergraduates and postgraduates in my profession – I felt great pride and solidarity joining these new colleagues and specialists in taking the oath. I am certainly relieved, proud, excited, and happy. I am also very grateful to the university, my promotors, colleagues, friends, and family for supporting me through this process. I must confess, it is also slightly bittersweet, I loved working on this and do miss it, but look forward to the next exciting project. 

“I would like to thank my Head of Department, Dr (Nomakhuwa) Tabane, my supervisors, my family and friends once again. I would also like to acknowledge and thank the National Research Foundation (NRF) as well as the University of the Free State for their assistance with funding this research.”

News Archive

UFS cardiac team leading with project
2017-05-31

 Description: Cardiac team read more Tags: Cardiac team read more

Prof Peter Schultheiss of the Charité University in Berlin,
Germany, visited the Robert WM Frater Centre for
Cardiovascular Research at the UFS for a study regarding
cardiomyopathy, a significant cause of fatal heart failure
among Africans. From the left are Dr Glen Taylor,
Dr Danie Buys, Prof Makoali Makatoko,
Prof Schultheiss and Prof Francis Smit.
Photo: Rulanzen Martin

A team of cardiac doctors associated with the Robert WM Frater Cardiovascular Research Centre at the University of the Free State’s (UFS) Faculty of Health Sciences has commenced with a pioneering research project regarding idiopathic dilating cardiomyopathy.  

An Afrocentric research focus
Prof Francis Smit, Head of the Department of Cardiothoracic Surgery at the UFS and Head of the Frater Centre, describes dilating cardiomyopathy as a heart muscle disease that is quite common, particularly among people of African descent. The disease weakens the heart muscle, which in turn leads to heart failure.

“To date there is no curable treatment for this condition and 50% of patients that have shown heart failure, died within a period of five years. The causes of this condition have been unknown in the majority of patients. But over the past few years major strides have been made where virus infections of the heart muscle or myocarditis have been identified as a possible underlying cause. Various genetic diseases are also linked to it,” says Prof Smit.

International collaborations ensure success
According to Prof Smit, the project is being run in conjunction with Prof Heinz-Peter Schultheiss of the Charité University and the Institute for Cardiac Diagnostics and Therapy in Berlin, Germany.

“We have been working on the project over the past 18 months and I have twice visited Prof Schultheiss in Germany. He is now visiting us in Bloemfontein. We have established a collaborative project focused on patients in central South Africa”.
Prof Schultheiss is a world leader regarding the diagnosis, pathology and treatment of dilating cardiomyopathy, says Prof Smit.

“He brings a lifetime of research experience to Bloemfontein and is internationally renowned as the father of myocardial or heart muscle biopsies.

“His pioneering work on the discipline has led to diagnostic accuracy that has induced purposeful and personalised treatment of dilating cardiomyopathy and has brought about dramatic changes in some subsets of patients’ life expectancy and their cure.”

Solving problems close to home
According to Prof Mokoali Makatoko, Head of the Department of Cardiology, there are more than 1500 new cases of heart failure identified annually at the Universitas Academic Hospital, of which approximately 30% are attributed to cardiomyopathy. “With the use of endomyocardial biopsies the team hopes to treat viruses unique to Southern Africa as well as other underlying causes of dilating cardiomyopathy.”

Prof Stephen Brown, Head of Paediatric Cardiology at the Universitas Academic Hospital, says children suffering from this disease never reach a mature age and those under his supervision will also be undergoing these tests. Various other departments at the UFS will also participate in this project. Profs Makatoko and Brown did the first four endomyocardial biopsies under the management of Prof Schultheiss during the past week. The results will be available in the coming weeks after which the project will be officially launched and patient recruitment will start in earnest.

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