Sub-Saharan African Journal of Medicine最新文献

{"title":"Prevalence and pattern of medical disorders in pregnancy at the time of delivery at Lagos University Teaching Hospital, Lagos, Nigeria","authors":"O. Babah, E. Owie, E. Ohazurike, O. Akinajo","doi":"10.4103/ssajm.ssajm_32_18","DOIUrl":"https://doi.org/10.4103/ssajm.ssajm_32_18","url":null,"abstract":"Objective To determine the prevalence and pattern of various medical conditions in pregnancy and also determine their impact on fetal and maternal outcome. Study Design A cross-sectional analytic study was conducted using labor ward data obtained over a period of 5 years (2013–2017). All women delivered at Lagos University Teaching Hospital, Idi-Araba, Lagos, Nigeria, with or without medical condition complicating pregnancy at the time of admission to labor ward were included in the study. Their sociodemographic parameters, nature of medical condition, fetal weight, fetal outcome, APGAR scores, and maternal outcome were extracted from the delivery register. Data analysis was done using SPSS version 23. Results The prevalence of medical conditions complicating pregnancy was found to be 24.5%. The five commonest medical conditions complicating pregnancy are hypertensive disorders of pregnancy, human immunodeficiency virus (HIV) infection, sickle cell disease, diabetes mellitus, and hepatitis. The trend has remained relatively constant in the last 5 years. Maternal mortality rate in affected women was 0.4% compared to 0.3% for women without medical disorder in pregnancy, p = 0.298; while perinatal mortality rate was 6.4 and 7.1%, respectively, p = 0.850. Conclusion Despite the high prevalence of medical disorders in pregnancy, which puts pregnancy at high risk, the maternal and perinatal outcome is comparable to that of women without any medical disorder complicating pregnancy if managed in a tertiary hospital with adequate facility for emergency obstetric care and good neonatal facility.","PeriodicalId":422598,"journal":{"name":"Sub-Saharan African Journal of Medicine","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133764472","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":"Patterns of significant and unexpected, and critical findings in surgical pathology practice in a university hospital in Nigeria: a 5-year retrospective survey","authors":"A. Liman, B. Kabir, M. Abubakar, S. Abdullahi, S. Shehu","doi":"10.4103/ssajm.ssajm_2_19","DOIUrl":"https://doi.org/10.4103/ssajm.ssajm_2_19","url":null,"abstract":"Critical values or significant and unexpected findings were introduced in anatomic pathology only recently; after showing immense success in clinical pathology practice; and it still is a subject of variation according to the differences in geographical or work setting and among pathologists and clinical specialists. It has been demonstrated that customizing the list at a given institution to address all potential diagnoses and results necessary and when framed into a policy can serve as important measures for optimizing patients’ safety. This study was conducted to demonstrate the prevalence and distribution patterns of these findings and to raise the awareness of the local pathologists and other clinicians to the evolving concept and practice of significant and unexpected values in surgical pathology. We studied the prevalence of significant and unexpected findings in surgical pathology through a retrospective review of 14,696 surgical pathology reports seen in a large tertiary hospital over a five-year period. Based on literature and our experience, we selected 10 categories of possible surgical pathology results that can justify an urgent communication with the clinician for immediate action and extracted them from the pool; they were analyzed and presented in descriptive tabular format. The study established a prevalence of 3.15% and outlined the distribution and frequency ratios of the 10 specific categories of results. The prevalence as established here was comparatively high, hence, the need for institutionalizing critical diagnoses guidelines in our surgical pathology practice as a patient safety initiative.","PeriodicalId":422598,"journal":{"name":"Sub-Saharan African Journal of Medicine","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130621487","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":"Prevalence and pattern of bacterial isolate in febrile children with sickle cell anemia in a tertiary hospital in Northern Nigeria","authors":"A. Musa, O. Ogunrinde, A. Mamman, Y. Saad, A. Ibrahim, A. Yakubu","doi":"10.4103/ssajm.ssajm_1_19","DOIUrl":"https://doi.org/10.4103/ssajm.ssajm_1_19","url":null,"abstract":"Context: Bacterial infections constitute a major cause of morbidity and mortality in children with sickle cell anemia (SCA). These children have increased susceptibility to bacterial infections, the pattern of which varies with place and time. Knowledge of local pattern of bacterial infection in SCA will facilitate empirical management. Aims: This article aims to determine the prevalence and pattern of bacterial isolates and their in vitro antibiotic sensitivities in febrile children with SCA. Settings and Design: A comparative cross-sectional study was conducted at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Methods and Material: Two hundred and thirty-two febrile children with SCA between 6 months and 15 years and another 232 febrile children with AA phenotype were investigated for bacterial infections. Blood and urine cultures were done in all the patients and other cultures were performed based on the patients’ clinical presentation. Statistical Analysis Used: Data was analyzed using Epi Info statistical software. Results: Bacterial cultures were positive in 34 (14.7%) of children with SCA and 40 (17.2%) of the controls. The three most frequently isolated pathogens among both children with and without SCA were Staphylococcus aureus (23.5%; 25.0%), Escherichia coli (23.5%; 20.0%), and Klebsiella spp. (14.7%; 17.5%). Bacterial infection was significantly more common in children less than 5 years with SCA (χ2 = 3.98, df = 1, P = 0.046). Most of the organisms isolated were sensitive to third-generation cephalosporins. Conclusions: Gram-negative bacteria were the most common isolates in febrile children with SCA. Boys less than 5 years have higher positivity rates. In children with SCA admitted with suspected bacterial infection, third-generation cephalosporins should be the antibiotic of choice for empirical treatment.","PeriodicalId":422598,"journal":{"name":"Sub-Saharan African Journal of Medicine","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114891606","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":"Can preoperative haemoglobin concentration and patients’ age predict American Society of Anesthesiologists’ scores?","authors":"S. Yakubu, S. Awwalu, Livingstone Gayus Dogara, A. Waziri, L. Ibrahim, K. Pindiga, A. Mamman","doi":"10.4103/ssajm.ssajm_22_18","DOIUrl":"https://doi.org/10.4103/ssajm.ssajm_22_18","url":null,"abstract":"Introduction The latest version of the American Society of Anesthesiologists (ASA) score approved by the ASA House of Delegates in 2014 is used preoperatively to assess patients’ physical status (PS) before administration of anaesthesia and surgery. The ASA score does not take into consideration the patients’ age, gender or results of laboratory investigations. This study was to determine any relationship between preoperative haemoglobin (Hb) concentration, age and ASA scores. Materials and Methods Clinical records of 205 patients who had elective surgeries in a tertiary hospital for more than a period of six months were analysed for patients’ ages, gender, Hb concentrations and ASA scores, retrospectively. Data were analysed using SPSS version 20.0 with level of significance set at P ≤ 0.05. Results There were 205 patients who had surgeries during the period under review with females making up 110 (53.7%). The mean Hb and ages were 12.0 ± 1.7 g/dl and 32.2 ± 19.0 years, respectively. The median (interquartile range [IQR]) ASA-PS score was 2 (0). Most of the patients were anaemic (N = 105, 51.2%), whereas 12 (5.9%) were ≥65 years. The distribution of ASA-PS scores varied significantly across age categories (KWH statistic = 25.313, df = 4, P = <0.001). Post hoc analyses revealed that ≥65-year-olds had comparable ASA-PS scores to the ≤1 year category but higher scores compared to the 2–12-, 13–18- and 19–64-years categories. Anaemic patients had higher mean rank ASA-PS scores compared to those without anaemia (111.50 vs. 94.07, MWU statistic = 4357.000, P = 0.013). Spearman correlation analyses for ASA/Hb and ASA/age were ρ = –0.161, P = 0.021 and ρ = 0.257, P = <0.001, respectively. Multiple ordinal regression analyses to predict ASA-PS scores from Hb and age were negative with Hb (estimate = –0.261, P = 0.004) but positive with age (estimate = 0.036, P = <0.001). Conclusion Higher preoperative Hb is associated with lower ASA-PS score; older patients are more likely to have higher ASA-PS scores.","PeriodicalId":422598,"journal":{"name":"Sub-Saharan African Journal of Medicine","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127580629","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":"Obituary: Dr. Adeola Davis","authors":"A. Abba","doi":"10.4103/SSAJM.SSAJM_21_19","DOIUrl":"https://doi.org/10.4103/SSAJM.SSAJM_21_19","url":null,"abstract":"He commenced the residency training program at the Ahmadu Bello University Teaching Hospital in 1991 and the senior residency training in 1993. He passed the West African College of Surgeons part II Fellowship in Oral and Maxillofacial Surgery in 1995. He was appointed by the Ahmadu Bello University as a Consultant and Lecturer I in 1996 and was promoted to the position of Senior Lecturer in 2004.","PeriodicalId":422598,"journal":{"name":"Sub-Saharan African Journal of Medicine","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124385318","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":"Comparing Frozen and Paraffin Section in the Detection of Metastases in Sentinel Lymph Node in Breast Cancer in Aminu Kano Teaching Hospital, Kano, North-Western, Nigeria","authors":"A. Sheshe, A. Muhammad, A. El-Yakub, I. Suleiman","doi":"10.4103/ssajm.ssajm_14_18","DOIUrl":"https://doi.org/10.4103/ssajm.ssajm_14_18","url":null,"abstract":"Background: Sentinel lymph node biopsy is an effective diagnostic procedure to determine the need to treat the axilla or otherwise in patients with early breast cancer to avoid its inherent complication and further morbidity. Frozen section is one of the acceptable methods of scrutinizing sentinel lymph nodes to enable decision be made intraoperatively. This study is aimed to determine the sensitivity of frozen section biopsy in the diagnosis of positive sentinel lymph nodes in patients with early breast cancer. Materials and Methods: The study was conducted in the Surgery and Pathology Departments of Aminu Kano Teaching Hospital, Kano, from September 2015 to March 2017. Consecutive patients diagnosed with early breast cancer, who met the inclusion criteria, were recruited into the study after obtaining informed consent. Early breast cancer in this study was defined as stage I (T1, N0, M0) or stage IIA (T2, N0, M0). Additional information included age, sex, menopausal status, surgical procedures, duration of surgery, and the histopathological types. Statistical and comparative analysis was made. Result: A total of 117 patients with breast cancer were seen at the General Surgery Outpatient Department during the study period. Out of these patients, 40 met the inclusion criteria and were recruited for the study. The age range of 28 to 70 years and mean age of 47.4 ± 11.6 years were recorded. Twenty-two (55%) patients were premenopausal. Eighty-two sentinel lymph nodes were harvested and analyzed. Twenty-eight (34.1%) sentinel nodes were found to be positive by frozen section, whereas 54 (65.9%) were negative. The paraffin section analysis showed that 44 (53.7%) out of 82 sentinel nodes were positive for malignancy, whereas 38 (46.3%) were negative. The sensitivity, specificity, and accuracy of frozen section were 70.8%, 100%, and 82.5%, respectively. The false-negative rate was 29.2% (P = 0.292, confidence interval = 90%). Conclusion: Frozen section biopsy of sentinel lymph node is not as effective as routine staining technique in detecting malignant cells in patients with early breast cancer.","PeriodicalId":422598,"journal":{"name":"Sub-Saharan African Journal of Medicine","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122484495","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":"Impaired cognition and normal cardiometabolic parameters in patients with type 2 diabetes in Kano, Nigeria","authors":"I. Yarube, I. Mukhtar","doi":"10.4103/SSAJM.SSAJM_19_18","DOIUrl":"https://doi.org/10.4103/SSAJM.SSAJM_19_18","url":null,"abstract":"Background: Type 2 diabetes (T2D) has been linked with impaired cognition, elevated blood pressure, and dyslipidemia. However, these findings have not been uniform. Aim: This study aimed to assess cognition and its relation with fasting blood sugar (FBS), HbA1c, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and serum levels of triglycerides, total cholesterol, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol in T2D patients. Materials and Methods: Thirty-four T2D patients attending the diabetic clinic of Murtala Mohammed Specialist Hospital, Kano, between June and December 2017 and age, sex, and level of education matched controls were recruited for the study. All participants were screened for depression using Beck’s depression inventory II. Cognitive function was assessed using Montreal Cognitive Assessment test (MoCA) version 7.3. Blood pressure was measured using mercury sphygmomanometer (Dekamet Accoson®, Harlow, Essex, UK) and Littman’s stethoscope. FBS was measured using glucometer (On Call® Plus; Alan Lab. Inc., San Diego, California, USA) after an overnight fast. HbA1c was determined using ion exchange chromatography and serum triglycerides, total cholesterol, and HDL cholesterol were determined spectrophotometrically. Data were analyzed on Statistical Package for Social Scientists version 23.0. P value ≤0.05 was considered significant. Results: Diabetic group had significantly lower MoCA score (U = 216.50, P = 0.001) compared to the controls (19.5 and 26.0, respectively). MoCA score was influenced by sex (U = 88.0, P = 0.05), level of education (X2 = 12.826, P = 0.005), and;Deg;BM;Deg;I (X2 = 8.529, P = 0.036) among diabetic patients. MoCA score was correlated with level of education of the diabetic patients (X2 = 14.664, P = 0.002). Duration of diabetes, FBS, and HbA1c had no relationship with MoCA score. The diabetic patients had statistically (U = 416.50, P = 0.048) lower serum triglycerides compared to the control group (132.5 and 155.5 mg/dl, respectively) even though both were within normal limits. Serum HDL (16.65 and 16.80 mg/dl, respectively), LDL (123.2 and 115.7 mg/dl, respectively), total cholesterol (165.20 and 164.0 mg/dl, respectively),;Deg;SB;Deg;P, DBP,;Deg;MA;Deg;P, and;Deg;BM;Deg;I were not significantly different between the two groups and were within normal limits. Conclusion: The diabetics had impaired cognition and normal cardiometabolic parameters. Routine screening for mild cognitive impairment should be employed in the management of T2D.","PeriodicalId":422598,"journal":{"name":"Sub-Saharan African Journal of Medicine","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127780184","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":"Self-inflicted genital incision: a rare case report","authors":"M. Taingson, J. Adze, S. Bature, A. Durosinlorun, Mohammed Caleb, A. Amina, Avidime Solomon, Airede Lydia","doi":"10.4103/SSAJM.SSAJM_27_17","DOIUrl":"https://doi.org/10.4103/SSAJM.SSAJM_27_17","url":null,"abstract":"Yankan gishiri, a genital cut, on the vagina for various illnesses is a harmful cultural practice. It is usually performed by traditional barbers. We report a case of Mrs. AA, a 20-year-old para 3 who presented with a history of a long-standing vaginal swelling which became painful after the patient made an incision on it. She was treated with antibiotics and analgesics, and subsequently had an anterior colporrhaphy.","PeriodicalId":422598,"journal":{"name":"Sub-Saharan African Journal of Medicine","volume":"205 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133483674","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":"Effect of obesity on self-reported pain and functional disability in patients with knee osteoarthritis in Zaria, North Western Nigeria","authors":"A. Umar, O. Adelowo, J. Okpapi, Usman B Omuya","doi":"10.4103/SSAJM.SSAJM_10_18","DOIUrl":"https://doi.org/10.4103/SSAJM.SSAJM_10_18","url":null,"abstract":"Introduction: Osteoarthritis (OA) is the most common causes of arthritis in human, with the knee joint being the most commonly affected. Knee OA patients often present with knee pain and varying degree of functional limitation in activities of daily living. The incidence and prevalence of knee OA increases with age and is poised to increase even further in tandem with an expected increase in life expectancy, rise in population age, and increased prevalence of obesity. Obesity is associated with the occurrence and severity of knee OA, and it is perhaps the most amenable of all knee OA risk factors. The contribution of obesity to pain and functional limitation in Nigerian knee OA patients is not well elucidated. This study aims at ascertaining the burden of obesity in Nigerian knee OA patients with regards to its prevalence, effects on pain, and functional disability. Materials and Methods: Between January 2010 and February 2011, 140 consenting knee OA patients were recruited consecutively, as they presented to the Rheumatology Clinic of Ahmadu Bello University Teaching Hospital, Zaria. Knee OA was diagnosed in patients using American College of Rheumatology clinicoradiographic criteria. Information was collected from patient using a pretested interviewer-administered structured question. Pain, stiffness, and functional disability were determined using Likert version of Western Ontario McMaster Universities Osteoarthritis index (WOMAC). Patients were grouped based on body mass index (BMI) into obese (BMI > 30 kg/m2) and nonobese (BMI < 30 kg/m2), and differences in pain intensity and functional disability were compared. Results: One hundred and forty knee OA patients comprised 120 females (85.7%) and 20 males (14.3%), with male–female ratio of 1:6. The mean age of patients was 59.6 ± 8.8 years. The mean BMI was 30.5 (±6.4) kg/m2. Twenty-seven (19.3%) patients had normal body weight, whereas 48.6% were obese. Mean duration of knee pain in patients was 3.5 (±2.9) years. Mean pain score and mean disability scores were 2.17 (±0.7) and 2.02 (±0.89), respectively. The mean pain score was higher in obese patients compared to nonobese (2.4 ± 0.78 vs. 1.93 ± 0.59, P = 0.000), and mean disability score was significantly higher in obese patients compared to nonobese (2.58 ± 0.79 vs. 1.78 ± 0.81, P = 0.000). There was moderate correlation between BMI and pain scores (r = 0.56, P = 0.000) and between BMI and functional disability scores (r = 0.5, P = 0.000). BMI was an independent predictor of functional disability. Conclusion: Pain and functional disability are more severe in obese and overweight knee OA patients compared to those with normal BMI, and obesity is an independent predictor of functional disability.","PeriodicalId":422598,"journal":{"name":"Sub-Saharan African Journal of Medicine","volume":"212 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131660173","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":"Neurotoxicity following snakebite and the challenges of management in an urban area—a case report","authors":"H. Muhammad, S. Halilu, M. Yakasai, Ibrahim Nashabaru, A. Habib","doi":"10.4103/SSAJM.SSAJM_7_18","DOIUrl":"https://doi.org/10.4103/SSAJM.SSAJM_7_18","url":null,"abstract":"Snakebites disproportionately affect the lower socioeconomic segments of the society, people with poorly constructed houses, and those with limited access to education and health care. Cases of snakebite are rare in urban areas. Therefore, health centers located in urban areas are sometimes unprepared for managing cases of snakebite. Potent snake antivenoms are not available, and most healthcare workers lack basic training needed for the management of snakebite. Here, we report a case of 28-year-old cleric who was rushed to the accident and emergency unit of an urban tertiary hospital on account of snakebite injury involving the left forearm. At presentation, there was history of persistent vomiting and hypersalivation. However, there was no history of bleeding from the site of bite, hematemesis, hematuria, or bleeding from any orifice. He later became confused with altered level of consciousness, developed bilateral ptosis, and broken neck sign. The patient survived after receiving intravenous polyvalent snake antivenom (EchiTab-plus; Instituto Clodomiro Picado, Costa Rica), which was incidentally purchased for laboratory experiment and not for patient care. The case highlights the challenges frequently encountered in the management of snakebite victims, especially in nonendemic areas; it also stresses the need for urban health centers to stock snake antivenom in their pharmacy and train healthcare workers in the management and care of snakebite victims.","PeriodicalId":422598,"journal":{"name":"Sub-Saharan African Journal of Medicine","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122746836","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}