South African Medical Association

Clinical Guidelines

Please note: SAMA has developed and maintained this repository of Clinical Practice Guidelines for the benefit of our members, in an attempt to facilitate access to locally developed and implemented guidelines. SAMA is not responsible for the contents of guidelines, nor the updating or correctness of guidelines themselves. We endeavour to ensure that all guidelines presented are the most up to date.

COVID-19 Guidelines

Note: These guidelines are drawn from the collective of guidelines available from the National authorities as well as specific societies which have generated guidelines for their constituencies.

The National Institute of Communicable Diseases Guidelines (NICD)

The NICD has a wealth of information, frequently asked questions, standard forms and other details on their COVID-19 Toolkit page, which is updated frequently:
  • NICD Guidelines for case-finding, diagnosis, management and public health response in South Africa

  • Department of Health Environmental Health Guideline – targeted at Environmental health practitioners, including handling of human remains

  • NICD COVID-19 Quick Reference for health workers:

  • Clinical management of suspected or confirmed COVID-19 disease

The Critical Care Society of Southern Africa (CCSSA)

  • Critical Care Management of Patient Confirmed with COVID-19

  • Personal Protective Equipment (PPE) for Critical Care Providers during the COVID-19 Pandemic

  • Principles of Airway Management

  • Covid-19 Joint Statement – The Critical Care Society Of Southern Africa (Ccssa) And The South African Society Of Anaesthesiologists (Sasa)

The Resuscitation Council of South Africa

  • Resuscitation Considerations

South African Society of Obstetrics and Gynaecology

  • Royal College of Obstetrics and Gynaecology: COVID-19 in Pregnancy

South African Society of Anaesthesiologists

  • SASA has published multiple position statements, comments and guidelines on their website at:

SASA has recommended that clinicians use the following website for critical care management guidelines of Covid 19 patients.


COVID-19 Person Under Investigation(PUI) Form

COVID-19 Environmental Health Guidelines

SASA Recommendations on Personal Protective Equipment (PPE) for anaesthesia providers during the COVID-19 pandemic

Federation of Infectious Diseases Societies of Southern Africa (FIDSSA)

The Federation of Infectious Diseases is made up by several societal members, all of which have their own special interests in infectious diseases. The Federation was formed from an amalgamation of existing societies representing infectious diseases (Infectious Diseases Society of Southern Africa -IDSSA), sexually transmitted diseases, (Sexually Transmitted Diseases Society of Southern Africa -STDSSA), infection control (Infection Control Society of South Africa -ICSSA) antimicrobial surveillance (National Surveillance Forum NASF) which became the South African Society of Clinical Microbiology (SASCM) in 2009 and travel medicine (The South African Society of Travel Medicine SASTM). The Southern African Society of Paediatric Infectious Diseases (SASPID) has also joined.

Guidelines are published online and in the South African Journal of Epidemiology and Infection (SAJEI).

South African guideline for the management of community-acquired pneumonia in adults 2017

Updated recommendations for the management of upper respiratory tract infections in South Africa

Pocket Guide to antimicrobial prescribing in South Africa 2015

Local Guidelines on FIDDSA Website

Antimicrobial Prescribing


  • See Guidelines from HIV Clinicians Society Below

Infectious Diseases

Microbiology and Infection Control

Please note that many of these guidelines are now old and might be outdated


National Department of Health Guidelines

National Department of Health Standard Treatment Guidelines and Essential Medicines Lists (Primary Health Care, Adults and Children Hospital level and Tertiary and Quaternary care are available at:

The National Department has also Issued multiple other guidelines on specific issues and diseases, falling under the Ideal Clinic Program and on the Ideal Clinical website :
(Go to the Documents Tab - access number 5: Guidelines)

  1. 1. Integrated Clinic Disease Management compliant package of clinical guidelines:
    • Adult Primary Care Guide 2016 - 2017
    • Standard Treatment Guidelines and Essential Medicine List for Paediatrics - 2017
    • Standard Treatment Guidelines and Essential Medicine List for Primary Health Care - 2018
    • Abbreviated Standard Treatment Guidelines and Essential Medicine List for PHC 2018
    • Standard Treatment Guidelines and Essential Medicine List for Hospitals - 2015
    • Integrate Management of Childhood Illness Chart Booklet - 2014
    • Newborn Care Charts - Management of sick and small newborns in hospitals (Version 1, 2014)
    • Integrated Management of Childhood illness (2014)
  2. 2. National Priority Health Conditions
    • Guidelines for Maternity Care 2016
    • Management of Drug-Resistant Tuberculosis 2013
    • Management of type 2 Diabetes 2014
    • National Guideline Updated Management of Hypertention in Adults at PHC level 2006
    • National Guidelines for PMTC of HIV & Management of HIV in Children Adolescents and Adults 2015
    • National Guidelines Management of TB in children 2013
    • National TB management guidelines 2014
    • Nationl IPC Guideline for TB MDR and XDR 2015
    • Sexually Transmitted Infections Management Guidelines 2015

Additional Department of Health Clinical Guidelines include:

Guidelines for the prevention of malaria in South Africa- 2017

National guidelines for the treatment of malaria in South Africa- 2018

Addendum To The South African Guidelines For The Prevention And Treatment Of Malaria Updated 2018 (March 2019)

Guidelines for Healthy eating information for nutrition educators - 2014

Guidelines for the management of tuberculosis, HIV and STIs in correctional facilities - 2013

Food-based Dietary Guidelines for South Africa - 2013

Infant and young Child feeding policy - 2013

National contraception and family planning policy and service delivery guidelines - 2012

National Contraception Clinical Guidelines - 2012

Vaccinators Manual: Immunization that works - 2012

South African National Guidelines for Medical Male Circumcision - 2016

Leprosy control in South Africa - 2011

Guidelines for the management, prevention and control of meningococcal disease in South Africa - 2011

National Institute for Communicable Diseases (NICD) and National Health Laboratory Service (NHLS)

The NHLS has also published some useful guidelines on their website.

NICD Diseases A-Z list

NICD-NHLS handbook for diagnosis of foodborne illness clusters / outbreaks - 2016

EPI Diseases Surveillance Guideline 3 rd Edition (2015) Guidelines for Detecting, Reporting, Investigating and Responding to EPI Priority Diseases - 2015

Healthcare workers guidelines on rift valley fever (RVF) - 2011

Recommendations pertaining to the use of influenza vaccines and influenza antiviral drugs - 2016

Allergy SA (ALLSA)

The diagnosis of asthma in children: An evidencebased approach to a common clinical dilemma - 2018

Asthma treatment in children: A pragmatic approach

Guideline For Diagnostic Testing In Allergy - Update 2014

Chronic Rhinitis in South Africa: update 2013

Allergic Rhinitis in South Africa: 2012 Guidelines

National Pathology Group

The National Pathology Group has a guideline which it issues relating to the use of appropriate laboratory investigations. This may be freely accessed at :

The website also contains recommendations for pathology testing for several conditions:

Additionally the following international sites are of value: ARUP Laboratories: A national reference laboratory: Lab Tests Online : Royal College of Pathologists of Australasia:

National Osteoporosis Foundation of South Africa (NOFSA)

  • Guidelines on Diagnosis and Management of Osteoporosis
  • Recommendations for the acute and long-term medical management of low trauma Hip Fractures
  • Atypical Femoral Fractures
  • Vertebral factures

Pain SA

Guide to the Treatment of Cancer Pain in South Africa 2015

Clinical practice guidelines for management of neuropathic pain: expert panel recommendations for South Africa 2010

Spinal cord stimulation for the management of pain: Recommendations for best clinical practice 2013

CSouth African guideline for the use of chronic opioid therapy for chronic non-cancer pain 2014

South African National Blood Service (SANBS)

Clinical Guidelines for the use of Blood products in South Africa - 2014

South African Society of Psychiatrists

Treatment Guidelines for Psychiatric Disorders - 2013

South African Addiction Medicine Society

Guidelines for the pharmacological management of Alcohol Use Disorder - 2016

South African guidelines for the management of opioid dependence - 2015

SA Heart Association


SA Heart® subscribes to the guidelines issued by the European Society of Cardiology. The ESC Clinical Practice Guidelines can be viewed and downloaded from the ESC website guidelines page.

You can also download an app to view the pocket guidelines together with interactive tools (algorithms, calculators, charts, scores...) from this site.  
SA Heart® publishes position papers or commentary on guidelines for local circumstances where appropriate. 

South African dyslipidaemia guideline consensus statement: 2018 update A joint statement from the South African Heart Association (SA Heart) and the Lipid and Atherosclerosis Society of Southern Africa (LASSA)

Guideline: Management of Pulmonary Hypertension (2015)

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Position Statement Prevention of Infective Endocarditis Before Dental Procedures (available with member login only)

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Guideline: Diet for prevention of cardiovascular disease (2013)

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Guideline: Bridgepoint CTO (2014)

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Position Statement: Renal denervation (No date)

The SA Heart® - Hypertension Society update on renal denervation.
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Guideline: Cardiac imaging with Cardiac CT and MRI (No date)

The rapid advance in the field of cardiac imaging has necessitated guidelines for the performance and interpretation of these newer imaging modalities.
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Guideline: Paediatric echocardiography in South Africa (2007)

This document provides guidelines for standards of practice in paediatric transthoracic echocardiography in South Africa. Paediatric echocardiography is not a substitute for a proper clinical opinion and such studies are best performed as part of an assessment by a paediatric cardiologist.
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Guideline: Trans-catheter Aortic Valve Implantation (TAVI) (2016 - available with member login only)

The South African Heart Association (SA Heart®) together with two of its special interest groups, SASCI and SCTSSA represent the scientific, educational, socioeconomic, ethical and professional interests of South African cardiac specialists, with a combined membership of over 200 members. We are the only national organisations exclusively representing practising cardiologists and cardiothoracic surgeons.
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Accredited Training Units

Cardiology Training is offered only at universities with linked medical schools and training hospitals in South Africa. Limited training positions are available, according to government allocations in the respective provinces. 
In order to start the three year specialization course in cardiology, one has to be a qualified physician. Please apply directly to the respective heads of departments for a training post.
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Guideline: Cardiology Training

Cardiology Training follows strict guidelines. A logbook must be kept to prove proficiency in techniques, and a prescribed minimum number of each different procedure performed must be recorded. 
The College of Medicine is responsible for conducting the qualifying examination at the end of the three year course. 
You can find the cardiology syllabus and logbook requirements here.
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Treatment of Myorcardial Revascurlarisation - DES (available with member login only)

SASCI as an official Special Interest Group of the South African Heart Association subscribe to the European Society of Cardiology (ESC) guidelines. The ESC guidelines are regularly updated to include the latest appropriate Evidence Based Medicine but local guidance (comment) is...Read more

Guideline: EHRA Consensus (2017)

Antithrombotic therapy in atrial fibrillation associated with valvular heart disease: a joint consensus document from the European Heart RhythmAssociation (EHRA) and
European Society of CardiologyWorking Group on Thrombosis, endorsed by the ESC Working Group on Valvular Heart Disease, Cardiac Arrhythmia Society of Southern
Africa (CASSA), Heart RhythmSociety (HRS), Asia Pacific Heart RhythmSociety (APHRS), South African Heart (SA Heart) Association and Sociedad Latinoamericana de
Estimulacion Cardiaca y Electrofisiologoıa (SOLEACE).
Read more


Heart Failure Guidelines

South African HIV Clinicians Society

Society Interim Clinical Advice


Two documents have been developed. The first provides a quick reference and summary of the main aspects related to supporting antiretroviral therapy adherence for HIV positive adolescents and young adults. The second, this expanded version, provides more detail for those requiring additional background information, resources and references.

This document provides a quick reference and summary of the main aspects related to supporting antiretroviral therapy adherence for HIV positive adolescents and young adults.

These guidelines are intended as an update to those published in the Southern African Journal of HIV Medicine in 2014 and the update on when to initiate antiretroviral therapy in 2015. Since the release of the previous guidelines, the scale-up of antiretroviral therapy (ART) in southern Africa has continued. New antiretroviral drugs have become available with improved efficacy, safety and more robustness. The guidelines are intended for countries in the southern African region, which vary between lower and middle income.

A supplement to the National HIV Testing Services Policy 2016.

The aim of the this PrEP guideline is to explain what PrEP is, outline current indications for its use, outline steps for appropriate user selection and provide guidance to monitor and maintain PrEP users.

This document is a corrigendum to our "Guideline on the management of occupational and non-occupational exposure to the human immunodeficiency virus and recommendations for post-exposure prophylaxis: 2015 Update".

This guideline is an update of the post-exposure prophylaxis (PEP) guideline published by the Southern African HIV Clinicians Society in 2008.

These guidelines are an update of the Southern African HIV Clinicians Society's ART 2014 guidelines. The update is to the section of the adult ART guidelines relating to when ART should be initiated.

UPDATED:Algorithms which assist in managing infants with indeterminate HIV PCR results.

Update to 2007 guidance to include all types of migrants and crisis-affected populations, including those forcibly displaced. This update stresses that migration and forced displacement must NO T be used as an excuse to deny treatment. Clear recommendations are provided for states, clinicians and programme managers, civil society, donors and United Nations (UN ) agencies.

2014 update to the Society guideline on adult antiretroviral therapy.

This document is provided as an information resource for all health care workers to assist in the appropriate prescribing of antibiotics.

Guideline on mental health disorders and CNS sequelae in HIV positive children and adolescents

A reference document to assist HIV nurse and doctor clinicians in managing mental health disorders

Practical guidance on the re-introduction of anti-TB drugs and ART in HIV/TB co-infected individuals presenting with DILI

Updated to include newly available drug formulations: ABC 60mg dispersible tablets and ABC (60mg) + 3TC (300mg) tablets

Update to 2007 guidelines on the prevention, diagnosis and management of cryptoccocal meningitis among HIV-infected persons

Guidance on how to switch patients from 3 separate antiretroviral (ARV) drugs to the new, single, FDC tablet containing tenofovir (TDF), emtricitabine (FTC) and efavirenz (EFV).

Recommendations for HIV resistance testing for people living with HIV in the southern African region







Southern African Hypertension Society

South African Hypertension Society commentary on the American College of Cardiology/American Heart Association hypertension guidelines 2019

South African Hypertension Guideline version 2014

5th hypertension guideline published by the Southern African Hypertension Society (SAHS)

SA Society of Anaesthestioloigsts (SASA)

The South African Society of Anasethesiologists has several guidelines available for the management of pain, sedation and other areas


Sasa Pacsa Fluid Guidelines 2019

Updated Phenylephrine Shortage Guideline

Consensus statement on clear fluids fasting for elective paediatric general anaesthesia 2019

Phenylephrine shortage Guidelines 2019

SASA Practice Guidelines 2018

SASRA Guidelines 2016

South African Acute Pain Guidelines 2015

SASA Pain Guidelines 2015

SASA High Spinal Anaesthesia Guidelines 2015

South African Society of Anaesthesiologists Sedation Guidelines 2015

SAMBA Guidelines for PONV 2014

SASA Guidelines for Infection Control 2014

Southern African Arthroplasty Society

Guidelines for best practice in primary hip replacement surgery in South Africa - 2019

Guideline to good practice in total knee replacement in South Africa - 2016

SA Society of Obstetricians and Gynaceologists

Hypertensive disorders in pregnancy: 2019 National guideline

A number of guidelines are available on the SASOG webpage at:

Setting of a sterile tray (No date)

Guideline document: Cervical Cancer Screening in South Africa - 2015

Guideline for special investigations in antenatal care (No date)

HPV prophylactic vaccine (No date)

South African Society of Orthopaedic Surgeons

SA Society of Orthopaedic Surgeons

South African Gastroenterology Society (SAGES)

The SAGES website contains the Society's short positions on several pertinent issues in gastroenterology:

In addition there are links to international Guideline websites.

South African Renal Society (SARS)

Aligning to the international KDIGO Guidelines, SARS has local guidance available.

Guideline for optimal care of patients on chronic dialysis in South Africa - 2015

Guideline for chronic dialysis in children in South Africa - 2015

Guideline for the care of patients with acute kidney injury - 2015

SARS Position Statements:

SARS Statement On Use Of Generic Immunosuppressant Drugs - 2018

Haemodialysis once a week - SARS Position Statement - 2018

South African Rheumatism and Arthritis Association (SARAA)

South African recommendations for the management of rheumatoid arthritis: An algorithm for the standard of care in 2013

Several position statements relating to specific areas of the management of rheumatological conditions


Venous thromboembolism: Prophylactic and therapeutic practice guideline (2013)

Paediatric anticoagulation guidelines (2012)

South African Stroke Society

South African guideline for management of ischaemic stroke and transient ischaemic attack 2010: A guideline from the South African Stroke Society (SASS) and the SASS Writing Committee

National Guidelines

South African Spinal Cord Association

Best Practice Recommendations for Bladder Management in the Spinal Cord Afflicted Patient in South Africa 2019

South African Thoracic Society

Recommendations for Lung Cancer Screening in South Africa - 2019

South African guideline for the management of community acquired pneumonia in adults - 2017

Cystic Fibrosis consensus document - 2017

Recommendations for the management of idiopathic pulmonary fibrosis in South Africa - 2017

Recommendations for the use of endoscopic lung volume reduction in South Africa: Role in the treatment of Emphysema - 2016

Guideline for office spirometry in adults 2012 - 2013

South African tobacco smoking cessation clinical practice guideline - 2013

Recommendations for the use of bronchial thermoplasty in the management of severe asthma - 2015

Guideline for the management of acute asthma in adults: 2013 update

Guideline for the management of acute asthma in children: 2013 update

Guideline for the management of chronic obstructive pulmonary disease - 2011 update

South African guideline for the diagnosis, management and prevention of acute viral bronchiolitis in children -2010

Society of Vascular Surgery

Society for Vascular Surgery

Specialist Nuclear Physician / Nuclear Medicine

The South African Society of Nuclear Medicine officially endorses selected international guidelines. Links to all of these guidelines can be found on their website:

Wound Healing Association of Southern Africa (WHASA)

While the publications of WHASA are consensus documents, rather than guidelines, they offer valuable insights into the management of ulcers, diabetic foot and acute burns.

WHASA Consensus Document on the management of lower limb ulcers - 2016

WHASA Consensus Document on the management of diabetic foot - 2015

WHASA Consensus document on the management of acute burns - 2015

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