East African medical journal最新文献

{"title":"Factors associated with rota virus diarrhea in the post vaccine period as seen at Moi Teaching and Referral Hospital, Kenya","authors":"P. Nyagah, C. Onyambu, N. Kimani, M. Wambugu, A. Aywak","doi":"10.4314/eamj.v94i9","DOIUrl":"https://doi.org/10.4314/eamj.v94i9","url":null,"abstract":"Background: Academic dishonesty, or cheating as commonly expressed, is an age-old practice that is widespread across the whole world. The Kenyan experience is anecdotal with limited studies, especially in medical schools. This study shares the experience of medical students about this challenging vice.Objective: To determine the level and forms of academic dishonesty in Moi University, School of Medicine.Design: Cross-sectional study using self-administered questionnaire.Setting: The School of Medicine, Moi University, Eldoret-Kenya.Subjects: One hundred and fifty-six students in the clinical (4th, 5th and 6th) years of study.Results: Eighty percent of the students were aware of academic dishonesty, 75% had witnessed it in progress while 60.9% confessed to participating in it. The proportion of dishonest students varied with year of study and those previously exposed to academic dishonesty in secondary school and males were more likely to be involved. A majority (72.6%) of those engaged in academic dishonesty believed that their classmates were also doing it. The leading forms of academic dishonesty were signing nominal rolls for absent friends and cheating in examinations using illegal notes and electronic access to information.Conclusion: Academic dishonesty is prevalent with the majority of those involved believing that their classmates are also into the practice. The leading forms of academic dishonesty include both traditional analog and modern digital methods.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could acanthamoeba keratitis be more common in non-contact lens-wearing Nigerians than reported? Evidence from Abakaliki","authors":"C. Ogbonnaya, B. Ukwah","doi":"10.4314/EAMJ.V95I9","DOIUrl":"https://doi.org/10.4314/EAMJ.V95I9","url":null,"abstract":"Background: Although acanthamoeba keratitis (AK) is more common in contact lens wearers, there have been many reports in those who do not wear contact lenses, especially in developing countries and particularly among agricultural workers and manual labourers. Available literature suggests that acanthamoeba keratitis is not a common cause of corneal ulcer in Nigeria. This might be due to a low index of suspicion as a result of low use of contact lens by the general population in Nigeria. Perhaps a routine search for the amoebic organism in corneal scrapings may actually reveal more cases of AK than reported among non-contact lens wearers. Despite the lack of sophisticated laboratory facilities, in resource-constrained settings, for definitive diagnosis of this amoebic organism in corneal scrapings, several stains are available for the detection of amoebic cysts in samples. However, the modified Field’s stain, which is readily available, gives a very good colour contrast as compared with other stains, and has been found to be very useful for the early detection. This study is therefore aimed at presenting the utility of modified Fields stain for the rapid diagnosis of acanthamoeba keratitis with a view to highlighting the need to routinely search for amoebic organism in patients with corneal ulcers, particularly in agrarian communities with muddy farmlands; using a readily available simple stain such as the modified Field’s stain.Objectives: To demonstrate the utility of modified Field-stain in the microscopic diagnosis of acanthamoeba keratitis in a resource –constrained setting.Materials and Methods: This is a cross sectional descriptive study of all consenting corneal ulcer patients managed at the FETHA eye clinic over a 4-month period (May to August 2015). Acanthamoeba diagnosis was based on Giemsa and modified Field’s staining techniques. Potassium hydroxide (KOH) wet mount and Gram′s stain were used for diagnosis of fungi and bacteria respectively, before culture results were available.Results: The microbial diagnoses were staphylococcus aureus (37.5%), Fungal keratitis (fusarium spp. and aspergilus, 25%) and acanthamoeba (25%). None of the patients ever used contact lenses.Conclusion: The use of modified Field-stain in the microscopic examination of corneal ulcer scrapings yielded a high microscopic diagnosis of acanthamoeba among the corneal ulcer patients seen at Federal Teaching Hospital Abakaliki. It is recommended that a larger study be done to confirm the usefulness of the modified Field’s stain in the diagnosis of acanthamoeba keratitis.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70524196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience with Jadelle Contraceptive Implant in obese and overweight women in south-eastern Nigeria","authors":"B. Chigbu, S. Onwere, A. Nwokoro, O. Ezenobi","doi":"10.4314/EAMJ.V95I3","DOIUrl":"https://doi.org/10.4314/EAMJ.V95I3","url":null,"abstract":"Objective: High mortality is attributed to Lassa fever in Nigeria, making it a disease of great public health importance. In the last 3 years (2015- 2018), the disease has continued to be on the increase. This study examined the retrospective view of Lassa fever outbreak in the last six years (2012-2017) in order to ascertain the spread of the disease. Methodology: Data on Lassa fever from 2012 – 2017 was used for this study. The data was collected, collated and SPSS was used to analyze the data in line with the set objectives.Results: The findings confirmed increase in the spread of Lassa fever in many states of Nigeria. Young people are more affected by the disease and more males than females are also more affected in the ratio of 3:2. The disease is spread throughout the year; and the attack rate and case fatality rate remain high especially in Edo, Ondo and Ebonyi states. Timeliness and completeness report data were barely 80% indicating poor data reporting system as all cases ought to be completely and timely reported in order to detect early and follow up on an unusual trend of disease occurrence. Conclusion: From the findings in this study, Lassa fever is still on the increase in Nigeria. Continuous surveillance and vibrant case management should be employed by all tiers of health care. The government should ask for assistance from other countries to fight Lassa fever to a halt.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uterine torsion in pregnancy: Case presentation and review of literature","authors":"O. A. Magembe","doi":"10.4314/EAMJ.V95I2","DOIUrl":"https://doi.org/10.4314/EAMJ.V95I2","url":null,"abstract":"Objectives : Palliative care is a fundamental human right, but many people have no access. This study aimed to increase access to palliative care in 10 publicly funded former provincial and level 5 hospitals in Kenya. Design : Progress was tracked for seven years, between 2011 and 2017. Data collected using annual hospital submissions to the Ministry of Health, surveys with more than 600 people undergoing training and interviews with 125 key informants. Quantitative data were analysed using t-tests at the 95% level of confidence. Qualitative data were analysed using narrative theme analysis. Setting : Kenya Interventions : The interventions included creating national guidelines, requiring hospitals to offer palliative care, training professionals, setting up clinical placement sites, supervision visits, and engaging community volunteers, traditional leaders and the media to raise awareness. Main outcome measures: Number of people accessing palliative care in 10 former provincial and level 5 hospitals. Results: Combining national and hospital-based initiatives increased access to palliative care. Within two years, the number of people receiving palliative care in provincial hospitals doubled. The number of people helped decreased after national support was reduced but was still five times higher than baseline (5408 in 2017 compared to 854 in 2011, 533% increase). Conclusion: Resource-poor countries can increase access to palliative care. Success factors in Kenya were; government support, national coordination and empowering local hospitals and communities. Palliative care can be provided in all levels of care even in limited resource setting. Integration is sustained since services are incorporated into existing facilities and budgets.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of hepatitis C surface antigenemia among HIV-infected individuals in Aba, South Eastern, Nigeria","authors":"A. Ngwogu, K. Ngwogu, P. Onyemachi","doi":"10.4314/EAMJ.V95I5","DOIUrl":"https://doi.org/10.4314/EAMJ.V95I5","url":null,"abstract":"Background: In order for health institutions in Nigeria to contribute towards the eradication of the spread of the deadly hepatitis C virus (HCV) infection, there is need for regular routine screening of all newly diagnosed human immunodeficiency virus (HIV) patients as is done for hepatitis B virus (HBV). This would enable care providers and policy makers appreciate the burden of an otherwise neglected disease condition and know where to focus as they distribute the limited resources.Objective: To evaluate the seroprevalence of HCV among newly diagnosed HIV patients.Design: A hospital based prospective study.Setting: The Abia State University Teaching Hospital (ABSUTH), Aba in South Eastern Nigeria.Subjects: Three hundred and six confirmed HIV positive adult patients who presented newly at the HIV treatment unit of the hospital between 1st March and 1st June 2016.Results: The age of the patients ranged from 6-70 years with a mean of 36±10.2 years among the 306 newly diagnosed HIV patients within the studied period. The highest prevalence of HIV infection was seen between the age ranges of 30-39 years (38.20%) while the lowest prevalence was seen between the age ranges of 0-19 years (4.60%). Male prevalence of the studied population was 34.30%, giving a male to female ratio of 1:2. Age group with highest prevalence of HCV (37.5%) was 30-39 years while patients aged less than twenty ( 0.05). Prevalence of HCV among the patients with a CD4 count greater than 350 was 33.30%.Conclusion: The study showed that HCV infection is relatively common in HIV –infected individuals. It is recommended that routine screening for HCV alongside HBV should be done for all HIV seropositive individuals even in resource limited settings.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prune Belly syndrome: Case Report","authors":"M. K. Koigi, K. Kamau","doi":"10.4314/EAMJ.V95I4","DOIUrl":"https://doi.org/10.4314/EAMJ.V95I4","url":null,"abstract":"Despite typical gross features of Prune Belly syndrome, this case posed immediate diagnostic challenge at birth, depicting paucity of comprehensive knowledge on congenital malformations. Prenatal ultrasound had not been done. Neonatal death was due to the malformations and birth asphyxia. Inadequacies in management of congenital malformations and providing support systems to the parents also emerged. A need for screening and training on prenatal anomalies becomes obvious. In addition, psycho-social and medical support systems should be put in place for the parents in order to enhance preparedness in care.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic resistance in bacteria isolated from indigenous slaughter chicken in Nairobi, Kenya","authors":"A. Igizeneza, L. Bebora, P. N. Nyaga, L. W. Njagi","doi":"10.4314/EAMJ.V95I10","DOIUrl":"https://doi.org/10.4314/EAMJ.V95I10","url":null,"abstract":"Background: Indigenous chicken, which end-up being consumed by humans, are normally raised free-range in villages; feeding from the ground which could easily be contaminated by substances, including bacteria, brought-in by flood water during heavy rains. The infected chickens may then serve as sources of the bacterial strains to humans who handle and/or consume them. If these bacteria are pathogenic to humans and resistant to antibiotics, it will be difficult to treat the resultant human diseases using the particular antibiotic(s).Objective: To establish antibiotic susceptibility/resistance patterns of bacteria isolated from intestines of slaughtered indigenous chickens after heavy rains in Nairobi, Kenya.Design: This was a cross-sectional study.Subjects: Bacterial isolates from chicken intestinal-content obtained from three slaughterhouses in Nairobi.Methodology: Antibiotic susceptibility testing was carried out on Escherichia, Staphylococcus and Streptococcus using disc diffusion technique.Setting: Laboratory testing at the University of Nairobi Bacteriology laboratory.Results: Escherichia isolates were highly resistant to Ampicillin, Sulphamethoxazole and Amoxicillin at 100%, 93.3%, 93.3% respectively; 13.3% were resistant to Gentamycin, while all were susceptible to Ciprofloxacin. Staphylococcus isolates were resistant to Clindamycin at 73.3%, Tetracycline at 46.7%, Chloramphenicol at 40%, but all were susceptible to Sulphamethoxazole and Erythromycin. Streptococcus isolates were resistant to Sulphamethoxazole, Clindamycin, Erythromycin, Tetracycline, Chloramphenicol at 93.3%, 86.7%, 60%, 60% and 53.3% respectively; the three isolates showed multidrug resistance.Conclusion: The study showed that antibiotic resistance is still a threat to the lives of animals/humans, if the resistance gets transferred to pathogenic bacteria it will be difficult to cure the disease caused by antibiotic resistant pathogens. It is therefore, recommended that, before prescribing antibiotics, antibiotic susceptibility testing should be done. Also, prudent usage and disposal of antibiotics is recommended in order to reduce development and transfer of resistance within and across bacteria.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70523871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Morbidity and mortality pattern of neonates admitted into the Special Care Baby Unit of University of Port Harcourt Teaching Hospital, Nigeria","authors":"S. Okoth, O. F. Rehmani, M. Karoney, L. Diero, P. Ayuo","doi":"10.4314/EAMJ.V94I4","DOIUrl":"https://doi.org/10.4314/EAMJ.V94I4","url":null,"abstract":"Background: The neonatal mortality rate in Nigeria is amongst the highest globally and is mainly due to preventable causes such as neonatal sepsis, perinatal asphyxia and prematurity.Objective: To determine the morbidity and mortality pattern of neonates admitted into the Special Care Baby Unit (SCBU) of the University of Port Harcourt Teaching Hospital (UPTH).Study Design: This hospital based retrospective study was carried out over a one year period between September 2014 and August 2015.Setting of study: Port Harcourt is a cosmopolitan city situated in Rivers State in the southern part and Niger Delta zone of Nigeria. The Hospital is the largest tertiary hospital in the state and serves as a referral centre for other peripheral hospitals within the Niger Delta zone of Nigeria. The SCBU caters for sick new-born infants born in the hospital and sick babies referred from other centres.Subject/participants: All sick babies born within (inborn) and outside (outborn) the hospital facility were reviewed. Information on the mothers booking status, sex, age, gestational age at birth, place of birth, APGAR scores, age on admission, diagnosis and outcome of the new-borns admitted were reviewed.Results: A total of 622 babies were admitted into the SCBU of UPTH during the period under review. Of these babies, 54.5% were admitted into the inborn unit, whilst 45.5 % were admitted into the out-born unit of the SCBU. The leading causes of admissions were neonatal sepsis (33%), neonatal jaundice (14.8%), severe birth asphyxia 83 (13.3%) and prematurity (11.41%). Majority of the neonates (77.6%) were admitted within the first week of life. The overall neonatal mortality rate was 12.4%. The mortality rate of the out-born babies of 13.5% was higher than the 11.4% amongst inborn babies, however, this difference was not statistically significant (p=0.333). Neonatal sepsis (29.9%) and severe birth asphyxia (22.1%) were the leading causes of mortality in these  babies.Conclusion: The neonatal mortality rate in the SCBU of 12.4% is high. We recommend that efforts be made at strengthening the primary health care system to discourage unsupervised deliveries and improving maternal and perinatal care in our health institutions to curb these high mortalities.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45149192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infratentorial glioblastoma multiforme: Case report","authors":"M. C. Sigei, L. W. Nyaga, Julius Oyugi, C. J. Owek, I. Kibwage, O. Gachuno, W. M. Ndege, Ruth Nduati","doi":"10.4314/EAMJ.V94I2","DOIUrl":"https://doi.org/10.4314/EAMJ.V94I2","url":null,"abstract":"Glioblastoma multiforme (GBM) is the most common and most malignant form of the gliomas. The tumour accounts for 45% of  malignant primary brain and Central Nervous System (CNS) tumours, 54% of all gliomas and 16% of all primary brain and CNS tumours. We present a seven year old female child who presented with a one month history of right sided headache, progressive right sided hemiparesis, and tremor with no history of infection or trauma. Investigations included computerised tomography scanning, Magnetic Resonance Imaging, Magnetic Resonance Spectroscopy and Tractography. These revealed a homogenously hypo-dense mildly ring enhancing lesion in the right brain stem, with mass effect displacing the fourth ventricle to the left, among others. Retro sigmoid craniotomy and concurrent ventricular drain placement was performed with post-operative period being uneventful. Histopathology confirmed malignant Glioblastoma multiforme and the patient was commenced on Temozolimide and radiotherapy with satisfactory results.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/EAMJ.V94I2","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49536370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dilated cardiomyopathy in a child with hyper-immunoglobulin E syndrome","authors":"T. Alemayehu, E. Tefera","doi":"10.4314/EAMJ.V94I11","DOIUrl":"https://doi.org/10.4314/EAMJ.V94I11","url":null,"abstract":"Hyper-immunoglobulin E syndrome is a rare primary immunodeficiency. We report a 6-year-old girl diagnosed with hyper immunoglobulin E syndrome and dilated cardiomyopathy. She presented with recurrent pneumonia and chronic eczema since infancy; onychomycosis, eosinophilia, high immunoglobulin E levels, previous treatment for severe infections and dilated cardiomyopathy. She was treated with diuretics, afterload reducers, inotropes, aspirin, steroids and antibiotics. Whether the cardiomyopathy is a co-incidental finding or a result of viral myocarditis due to the recurrent chest infections she had was difficult to conclusively determine.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70522895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}