Pan African Medical Journal最新文献

{"title":"Fetal demise due to stab wound with umbilical cord transection: a case report.","authors":"Skander Abid, Dhekra Toumi, Ghada Abdelmoula, Mohamed Amine Mesrati, Abdeljalil Khlifi, Haifa Bouchahda","doi":"10.11604/pamj.2025.51.32.47368","DOIUrl":"10.11604/pamj.2025.51.32.47368","url":null,"abstract":"<p><p>Intrauterine fetal demise due to penetrating abdominal trauma is rare, and complete umbilical cord transection is exceptionally uncommon. We report the case of a 29-week pregnant woman who sustained multiple abdominal stab wounds, leading to fetal death and complete transection of the umbilical cord. The maternal and fetal risks associated with trauma rise significantly with gestational age. Despite advances in emergency care, management of trauma in pregnancy remains complex and lacks standardized protocols. A multidisciplinary approach in specialized settings is essential to improve maternal and fetal outcomes. This case is reported due to its rarity and to underscore the importance of early recognition and coordinated intervention in traumatic injuries during pregnancy.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"51 ","pages":"32"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual hydrocephalus from retrocerebellar arachnoid cyst sparing the fourth ventricle.","authors":"Devyansh Nimodia, Sakshi Dudhe","doi":"10.11604/pamj.2025.51.30.45626","DOIUrl":"https://doi.org/10.11604/pamj.2025.51.30.45626","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"51 ","pages":"30"},"PeriodicalIF":1.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Epidemiology of sleep disorders in rural northern Bénin in 2022].","authors":"Mendinatou Agbetou, Christian Tandjiekpon, Elfried Salanon, Oyéné Kossi, Hermionne Loko, Jennifer Mapaga Nyangui, Thierry Adoukonou","doi":"10.11604/pamj.2025.51.60.47451","DOIUrl":"10.11604/pamj.2025.51.60.47451","url":null,"abstract":"<p><strong>Introduction: </strong>sleep disorders are diverse and increasingly common among Africans, but their true prevalence is little known on the continent. The objective of this study was to determine the prevalence of sleep disorders and factors associated with sleep quality in rural areas of Nikki, Bénin, in 2022.</p><p><strong>Methods: </strong>this was an analytical cross-sectional study of subjects aged at least 18 years in the commune of Nikki in 2022. Patients were selected by two-stage random sampling. Sleep disorders were diagnosed on the basis of validated scales such as the Pittsburgh Sleep Quality Questionnaire, the Berlin Questionnaire, the Epworth Score, the Restless Legs Syndrome Questionnaire, the Insomnia Severity Index and the Munich Parasomnia Screening Questionnaire.</p><p><strong>Results: </strong>at the end of the study, 879 participants were included. Females predominated, with a sex ratio (F/H) of 1.9. Sleep quality was poor in 52.21% of cases. The prevalence of insomnia was 9.44%, restless leg syndrome 21.39% and daytime sleepiness 21.16%. Sleep apnea syndrome was present in 2.50% of participants. Male gender and active smoking were associated with poor sleep quality, with p=0.03 and p=0.021, respectively.</p><p><strong>Conclusion: </strong>sleep disorders are common in Nikki's rural area, requiring mass screening campaigns to reduce the burden.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"51 ","pages":"60"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fever of unknown origin: multidrug-resistant <i>Escherichia coli</i> presenting as infectious spondylodiscitis.","authors":"Emanuel Narvaez Gallifa, Eliseo Alejandro Aguillon Garcia","doi":"10.11604/pamj.2025.51.27.48065","DOIUrl":"https://doi.org/10.11604/pamj.2025.51.27.48065","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"51 ","pages":"27"},"PeriodicalIF":1.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to effective sample management in viral load testing in Machakos County, Kenya: a convergent parallel mixed-method study.","authors":"Christine Mutewa Kathinzi, Peter Kariuki Njenga, Joseph Kiplangat Mutai","doi":"10.11604/pamj.2025.51.26.46991","DOIUrl":"10.11604/pamj.2025.51.26.46991","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;viral load (VL) monitoring is a critical component of HIV management, yet systemic and logistical barriers compromise the quality and reliability of VL sample management in many low- and middle-income countries. In Machakos County, Kenya, these challenges persist, contributing to a relatively low viral suppression rate of 81% and achievement of UNAIDS 95-95-95 strategy. This study determined barriers to effective VL sample management in Machakos County, Kenya, with a focus on equipment maintenance, human resource capacity, and supply chain performance across public and private facilities.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;a convergent parallel mixed-methods design was employed across 71 health facilities (61 public, 10 private) served by four VL hubs: Machakos Level 5, Matuu Level 4, Athi River Level 4, and Kangundo Level 4 hospitals. Quantitative data was collected from 205 healthcare workers using structured questionnaires. Descriptive statistics, Fisher's Exact Test, and Odds Ratios (OR) with 95% Confidence Intervals (CI) assessed associations between barriers and sample management outcomes. Qualitative data was obtained through 38 key informant interviews with clinicians from Comprehensive Care Clinics and Maternal and Child Health units (public n=32, private n=6). Transcripts were thematically analyzed using Braun and Clarke's framework, and a word cloud visualized common terms. Findings were triangulated for contextual depth. Ethical approval was obtained from the Kenya Medical Research Institute- Scientific Ethics Review Unit, with clearance from the Machakos County Department of Health. Informed consent was obtained and confidentiality were strictly maintained.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;among the VL hubs assessed, 88.8% reported having a designated VL focal person, and 73.2% indicated that couriers had received some form of training. Despite these structural provisions, critical technical gaps persisted. Only 6.8% of facilities had calibrated centrifuges, 2.4% conducted preventive maintenance, and 2.4% calibrated their temperature monitoring devices-pointing to widespread neglect of equipment quality assurance protocols. Further, 58.5% of facilities reported incidents of sample freezing, often attributable to inconsistent cold chain practices. These deficits were not isolated but interrelated, collectively undermining the integrity of VL sample handling. Bivariate analysis revealed statistically significant associations between effective sample management and calibrated temperature devices (OR: 3.4; 95% CI: 1.6-7.0; p = 0.01), absence of sample freezing (OR: 2.8; 95% CI: 1.3-6.2; p= 0.03), and trained couriers (OR: 1.5; 95% CI: 0.9-2.7; p= 0.06), accentuating the importance of technical reliability alongside human resource readiness. The VL hubs with preventive maintenance showed significantly higher odds of effective sample management (OR: 4.5; 95% CI: 2.0-10.1; p&lt; 0.001). Only 5.4% of facilities rep","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"51 ","pages":"26"},"PeriodicalIF":1.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"United States aid cut: alternatives for sustainable financing for health.","authors":"Gafar Bolaji Alawode, Abdul-Rahman Akintomiwa Ajibola, Michael Ajayi","doi":"10.11604/pamj.2025.51.23.47930","DOIUrl":"10.11604/pamj.2025.51.23.47930","url":null,"abstract":"<p><p>Recent United States (US) foreign aid cuts, notably through Executive Order 14169 signed on January 20, 2025, have disrupted health programs in low- and middle-income countries (LMICs), threatening progress in combating HIV/AIDS, tuberculosis, and malaria. With 37 LMICs relying on US aid for over 10% of their health budgets, the funding pause has led to closures of critical health facilities, such as 200 in Afghanistan, impacting 1.84 million people. This commentary explores sustainable financing solutions, emphasizing the Debt-to-Health Swap (D2H), where debt is forgiven in exchange for health investments. Successful D2H examples include Spain´s agreements with Cameroon, Ethiopia, and the Democratic Republic of Congo, which bolstered HIV, TB, and malaria programs. Additional mechanisms like climate financing, through initiatives like the Green Climate Fund, and health taxes are proposed, though challenges like high debt servicing costs, exceeding 3% of GDP in LMICs by 2024-persist. The commentary urges LMICs and regional bodies, such as the African Union, to advocate for D2H in global forums, integrating it into debt relief discussions to enhance health system resilience. By fostering collaboration between creditors, health organizations, and governments, D2H can unlock resources for infectious diseases, maternal health, and climate-related health risks, ensuring sustainable development.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"51 ","pages":"23"},"PeriodicalIF":1.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migration of African healthcare professionals: the need for equitable healthcare worker migration.","authors":"Estifanos Haimanot, Mishra Kartik, Hanif Miah","doi":"10.11604/pamj.2025.51.24.47894","DOIUrl":"10.11604/pamj.2025.51.24.47894","url":null,"abstract":"<p><p>Healthcare professional migration has been a major issue in the African healthcare system. This is due to push factors such as economic instability, inadequate work conditions, insufficient support, and a lack of infrastructure, which have all contributed to the increased migration rates in sub-Saharan countries. On the contrary, pull factors like optimal work conditions, better work-life balance, and financial benefits have attracted African healthcare workers to settle abroad, where this issue has been exacerbated during the post-pandemic COVID-19 era. It is crucial for governments, healthcare organizations, and stakeholders to invest in proper resources, training, and autonomy to better support the working conditions and rights of African healthcare workers. Governments, Non-Governmental Organizations (NGOs), healthcare organizations and stakeholders must utilize a global agenda and implement policies, partnerships, and technological solutions for a more equitable, accessible, and dependable healthcare system.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"51 ","pages":"24"},"PeriodicalIF":1.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perineal endometriosis on an episiotomy scar: diagnosis based on clinical, radiological, and hormonal criteria (case report).","authors":"Abdoulrazak Egueh Nour, Chirwa Mahamoud Abdillahi, Samia Bennani, Ahmed Hared Bouh, Bouknani Nawal, Amal Rami","doi":"10.11604/pamj.2025.51.25.48002","DOIUrl":"10.11604/pamj.2025.51.25.48002","url":null,"abstract":"<p><p>Endometriosis is a chronic, non-cancerous gynecological disorder that is typically observed in women of fertile age. It describes the presence of functional endometrial components, glands and stroma outside the endometrial cavity, most often involving pelvic structures such as the ovaries, peritoneum, and uterine ligaments. Perineal endometriosis is a rare form of extrapelvic endometriosis, with an estimated incidence of between 0.3% and 1%. We report the case of a 36-year-old woman, gravida 1 para 1(G1P1), with a history of vaginal delivery and no known history of endometriosis, who presented with a painful mass located on the right perineal scar two years after undergoing a mediolateral episiotomy. The mass was associated with cyclical pain and significantly impaired quality of life. Clinical examination, combined with ultrasound and Magnetic Resonance Imaging (MRI), suggested the diagnosis of perineal endometriosis in the absence of other endometriotic lesions. As the patient declined surgery, hormonal therapy was initiated, resulting in marked symptom improvement at 8-month follow-up. Although histological confirmation was not obtained, the typical clinical presentation, evocative MRI features, and favorable response to hormonal therapy supported the diagnosis of perineal endometriosis. This under-recognized entity should be systematically considered in women of reproductive age presenting with cyclical perineal pain following episiotomy.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"51 ","pages":"25"},"PeriodicalIF":1.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A leg ulcer revealing Parkes Weber syndrome in a child.","authors":"Leila Debono, Imane Laatfa","doi":"10.11604/pamj.2025.51.22.47960","DOIUrl":"https://doi.org/10.11604/pamj.2025.51.22.47960","url":null,"abstract":"","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"51 ","pages":"22"},"PeriodicalIF":1.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of knowledge, attitude, and practice regarding statutory rape and its management among healthcare workers in emergency wards in Ibadan, Nigeria.","authors":"Million Teklay Solomon, Christopher Odianosen Aimakhu, Olugbenga Oluseun Saanu, Ines Nshimirimana, Binta Jallow, Iacane Bampoque, Agness Shimilimo, Amos M Yisa Makelele, Edmond Onidje","doi":"10.11604/pamj.2025.51.21.47295","DOIUrl":"10.11604/pamj.2025.51.21.47295","url":null,"abstract":"<p><strong>Introduction: </strong>statutory rape is a critical public health and legal issue with severe consequences for survivors in Nigeria and is related to insufficient healthcare training, hindering effective case management. This study assessed the knowledge, attitudes, and practices (KAP) of healthcare workers in emergency wards in Ibadan to identify gaps and challenges in statutory rape management.</p><p><strong>Methods: </strong>a cross-sectional study was conducted among 198 healthcare workers in Ibadan, using structured questionnaires and analyzed with descriptive statistics, t-tests, and chi-square tests.</p><p><strong>Results: </strong>the study revealed significant gaps in healthcare workers' KAP concerning statutory rape. While 81.3% of healthcare workers were aware of the term \"statutory rape,\" only 75.3% understood the legal provisions related to it, such as the legal age of consent. Doctors had significantly higher KAP scores than nurses in all domains: knowledge (p= 0.0029), attitude (p= 0.0044), and practice (p= 0.0028). Despite recognizing the severity of statutory rape (76.3%), 33.3% of healthcare workers had never managed such cases, and many reported infrequent encounters with statutory rape cases. A significant proportion (65.2%) of healthcare workers identified inadequate forensic training as a major barrier, while (83.3%) cited legal and reporting constraints, and (31%) mentioned geographical access limitations. The most commonly reported physical and psychological symptoms observed in survivors included genital injuries (93.4%), psychological trauma (86%), STDs and infections (81.3%), bleeding (85.4%), and extra-genital injuries (69.2%).</p><p><strong>Conclusion: </strong>this study highlights deficiencies in healthcare workers´ knowledge and preparedness in statutory rape case management. Strengthening forensic training, legal awareness, and healthcare-legal collaboration is essential to improving response effectiveness.</p>","PeriodicalId":48190,"journal":{"name":"Pan African Medical Journal","volume":"51 ","pages":"21"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}