Medical journal of Zambia最新文献

{"title":"Strengthening Health Education Professionals Workforce In Zambia Symposium","authors":"Mjz Special Issue Shepiz","doi":"10.55320/mjz...254","DOIUrl":"https://doi.org/10.55320/mjz...254","url":null,"abstract":"MJZ Special Issue - SHEPIZ","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90587990","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":"Postpartum Typhoid Intestinal Perforation","authors":"A. O. Lawal, J. Dare, Hafsoh Olabinjo, A. Adenuga, Balogun Olayinka, Ishaq Aremu","doi":"10.55320/mjz.49.2.1135","DOIUrl":"https://doi.org/10.55320/mjz.49.2.1135","url":null,"abstract":"Background: Typhoid fever remains a highly contagious and multi-systemic infection caused by salmonellae typhi, and like other gastro-enteric infection, it poses a higher risk of morbidity and mortality during pregnancy as a result of the physiological changes associated with pregnancy as well as concerns of antibiotic safety in pregnancy. The occurrence of typhoid perforation in pregnancy may be easily confused for other causes of acute abdomen in pregnancy. \u0000We report the presentation, management and outcome of a 25 year old postpartum woman who presented with typhoid intestinal perforation in a resource limited environment. She had an emergency exploratory laparotomy and was managed post operatively in the ICU but clinically deteriorated and subsequently died on the third post-operative day secondary to multiple organ failure from severe sepsis. \u0000Typhoid perforation in pregnancy is a rare presentation, a high index of suspicion, and early intervention, would reduce the incidence of morbidity and mortality associated with this disease condition.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82968429","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":"Clinical Audit of Stillbirths at a Faith-Based Secondary Health Centre in Ibadan, Nigeria: A Six-Year Review","authors":"O. Ogunbode, Mobolaji Philip Oyeyiola, A. Arowojolu","doi":"10.55320/mjz.49.2.1067","DOIUrl":"https://doi.org/10.55320/mjz.49.2.1067","url":null,"abstract":"Objective: The determine the prevalence of stillbirth and identify associated factors among pregnant women. \u0000Method: This was a retrospective audit of two hundred and twenty-five stillbirth deliveries at Our lady of Apostle, Catholic Hospital, Oluyoro, Oke-Offa, Ibadan, Nigeria, between January 1, 2013, and December 31, 2018. Data was extracted from hospital records for socio-demographic characteristics, obstetric factors, complications, and outcomes of pregnancy. Data analysis was done using SPSS version 20 and the level of statistical significance was set at p < 0.05. \u0000Results: The stillbirth rate was 27.75 per 1000 births. More than half (129; 57.4%) were macerated. The ratio of stillbirth rate among the booked and unbooked parturients was 1:21. The common causes of stillbirths were hypertensive disorders in pregnancy (24.9%) and anaemia in pregnancy (20.4%) while the least were congenital anomalies (1.0%) and gestational diabetes mellitus (1.0%). \u0000Conclusion: This study confirmed that most of the stillbirths were due to unsupervised or poorly supervised pregnancies. There is need to ensure quality antenatal care services for the early detection and management of risk factors in order to reduce the burden of stillbirths.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83924914","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":"Kristen Rat Sarcoma Viral Oncogene Mutations in Colorectal Carcinomas at the University Teaching Hospital in Lusaka, Zambia","authors":"E. Shilika, Stepfanie N Siyumbwa, Maurice Mwale, P. Julius","doi":"10.55320/mjz.49.2.1113","DOIUrl":"https://doi.org/10.55320/mjz.49.2.1113","url":null,"abstract":"Background: The second leading cause of cancer-related deaths worldwide is colorectal cancer. With an incidence rate of 4.8 per 100,000, this is Zambia’s sixth most prevalent cancer; \u0000  \u0000Methods: This laboratory-based, cross-sectional study examined the frequency of Kirsten rat sarcoma viral oncogene homolog (KRAS) mutation and its association with prognostic factors in colorectal carcinoma cases from the University Teaching Hospital-Adult Hospital (UTHs), Lusaka, Zambia; \u0000  \u0000Results: Thirty (30) formalin-fixed paraffin-embedded (FFPE) samples collected between June 2017 and June 2018 were sent to the Lancet laboratories and analyzed for KRAS mutations (codons 12 and 13). One FFPE block did not meet the inclusion criteria and was excluded. The demographic and clinicopathological data were analyzed using STATA 12. Males outnumber females by 20 to nine. The average age of the patient was 45 ± 16 years. The rectum was the location of 44.8% of the tumors, with the majority being conventional adenocarcinoma (CAC) (65.6 %). All cases (100%) had advanced-stage (stages 3 and 4) disease; however, only 27.6% of patient tumors exhibited lymphovascular invasion. KRAS mutation was detected in 11 (37.9%) cases and mainly in left-sided tumors (62.5%). KRAS mutations were only detected in CAC and serrated adenocarcinoma subtypes. No significant associations were observed between the KRAS mutation status and tumor or patient’s clinical and sociodemographic factors; \u0000  \u0000Conclusion: We advocate for incorporating KRAS mutation testing into the standard of care for treating colorectal cancer.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80622438","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":"The Maternal factors and short term outcomes associated with episiotomy during vaginal delivery at Women and Newborn Hospital , Lusaka, Zambia","authors":"Rowshan Jahan Urmee, B. Vwalika","doi":"10.55320/mjz.49.2.978","DOIUrl":"https://doi.org/10.55320/mjz.49.2.978","url":null,"abstract":"Background: An episiotomy is a surgically planned incision on the posterior vaginal wall   and perineum performed during the second stage of labour to facilitate the delivery of the neonate. The practice has been used for many decades in the belief that it offers benefit to   the mother and the neonate. With the objective of protecting the pelvic floor and preventing fetal trauma, during the birth, its routine use was widely accepted in the past, principally in woman in her first delivery. However, it is not free from complications which include iatrogenic injury to the anal canal, perineal pain and excess bleeding. This study was therefore conducted to explore the short term maternal outcomes and factors associated with episiotomy. \u0000  \u0000Methodology: An unmatched case control study was conducted in postnatal wards of Women and New-born hospital in Lusaka, Zambia between November 2019 and April 2020 with convenient sample for the cases and systematic sample for the controls. A semi-structured interviewer administered questionnaire was used and 102 participants (cases) who had episiotomy performed were recruited while 204(controls) were without episiotomies. \u0000  \u0000Results: A total of 306 (102 are cases and 204 are control) were included. Age was found to be a good predictor of episiotomy in that those younger than 18 years were more than seven times likely to have an episiotomy (AOR=7.65; 95%CI 1.36-18.21; p=0.035). It was also found out that primi gravidas were five times likely to have an episiotomy performed compared to parous women (OR=4.96; 95%CI 2.58-9.52; p<0.001). Out of those delivered by a midwife, 73(28.3%) participants had an episiotomy performed compared to 29(60.4%) delivered by a medical officer. Multivariate regression it was shown that being delivered by a midwife was protective against an episiotomy (OR=0.260; 95%CI 0.14-0.49; p=0.001). Out of the 102 participants who had an episiotomy, only two had third degree tear extension. It was also noted that 99 out of 102 (97%) participants who had an episiotomy experienced post-delivery perineal pain compared to 94 out of 204(46%) of those who had no episiotomies. In univariate analysis, it was found that post-delivery perineal pain was associated with episiotomy (p<0.001). It was further found that those who had an episiotomy performed were about 4 times likely to experience perineal pain post- delivery (OR=3.8; 95%CI 1.2-12.3). The mean blood loss among those who has had no episiotomy was 230mls compared to 270mls among those who had an episiotomy. However, post-delivery blood loss was found to be a poor predictor of an episiotomy (OR=0.998; 95%CI 0.991-1.006; p=0.670). \u0000  \u0000Conclusion: Maternal factors associated with episiotomy included age, parity, method of induction, and the personnel conducting the delivery Short term maternal outcomes of episiotomy were perineal tear extension, excess blood loss and post-delivery perineal pain. It was found that 8.5% of women had undergone an episio","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"150 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85098969","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":"Characteristics and Surgical Repair Outcomes of Obstetric Fistula Patients Managed at a Teaching Hospital in Zambia: A Retrospective Cross Sectional Study","authors":"M. Imakando, C. Michelo, Tapiwa Mkandawire, L. Kasonka","doi":"10.55320/mjz.49.2.1132","DOIUrl":"https://doi.org/10.55320/mjz.49.2.1132","url":null,"abstract":"Background \u0000The obstetric fistula is a chronic maternal morbidity of global public health concern. The condition is preventable and in most cases treatable. Surgical repair is the mainstay of treatment with varying degrees of success. The aim of this study was to determine the characteristics, surgical outcomes and factors influencing surgical outcomes of women presenting with obstetric fistulas at a Teaching Hospital in Lusaka, Zambia. \u0000Methods \u0000A retrospective review of medical records for all women who underwent obstetric fistula repair surgery at Women and Newborn Hospital from 2017 to 2019.  Descriptive analysis was done. Fischer’s exact test was used to measure association between surgical outcomes and variables in the model. \u0000Results \u0000In total, 18 out of 29 records of patients who underwent fistula repair were retrieved and analyzed. Ages ranged from 15 to 47 years, mean age 29years. Over two thirds (72.23%) were multiparous, and over 3/4ths (77.8%) underwent caesarean section in the antecedent pregnancy. Success rate for fistula repair was 83% at 2 weeks post-operative. Study findings were inadequate to show a significant association between successful repair and factors in the model. \u0000Conclusion \u0000Majority of women presenting with obstetric fistula were multiparous with a history of prolonged labour, delivery by cesarean section and poor birth outcomes. The success rate for obstetric fistula repair at Women and Newborn Hospital was 83% at 2weeks postoperative. Further studies are needed to assess long-term outcomes and factors influencing surgical outcomes.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78888202","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":"Oral Health of Vegetarians is a Neglected Aspect of Stomatological Research: A Reflection based on PubMed Evidence","authors":"K. Kanmodi, L. Nnyanzi, O. Sulaiman, C. Adetunji","doi":"10.55320/mjz.49.2.1119","DOIUrl":"https://doi.org/10.55320/mjz.49.2.1119","url":null,"abstract":"The vegetarians form one-fifth of the global population. The vegetarians are a peculiar group of people; existing body of scientific evidence shows that they are a highly vulnerable group of people when it comes to oral diseases. The oral health of vegetarians is a critical aspect of dentistry; however, current evidence—based on PubMed database search—shows a dearth of literature on this thematic area. This research area has been neglected in the field of stomatological research.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81249456","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":"Perceptions and Willingness to Undertake Transvaginal Sonography by Women at the Sally Mugabe Central Hospital, Zimbabwe","authors":"B. Chinene, L. Mutandiro, L. Mudadi, Paridzai Nyawani","doi":"10.55320/mjz.49.2.1093","DOIUrl":"https://doi.org/10.55320/mjz.49.2.1093","url":null,"abstract":"Introduction: Patient’s opinions are an important facet of guideline development. There is little that is known about Zimbabwean women perceptions and willingness to undergo Transvaginal Sonography (TVS) and there are no specific guidelines to guide its use. \u0000Aim: To evaluate the perception and willingness to undergo TVS among women attending Obstetrics and Gynaecology clinic at Sally Mugabe Central Hospital in Harare, Zimbabwe. \u0000Methods: A cross-sectional survey using a structured questionnaire was conducted between 1 and 30 June 2022. A total of 170 women attending the obstetrics and gynaecology clinic at Sally Mugabe Central Hospital were randomly selected to participate in the study. \u0000Results: Majority of women (81.76%) had no previous TVS experience, with an equally large proportion (60.84%) not having seen a TVS probe before. Most of the women would prefer female sonographers (85.37%) to conduct the examination. In addition, about 58% of the participants concurred that a chaperone should be present. Less than half of the females (47.93%) were eager to have a TVS done on them. Equally, just 45% of the females said they would encourage others to have a TVS scan. The difference in willingness to undergo a TVS study stratified by employment status was statistically significant (chi square 7.26, p = 0.03). \u0000  \u0000Conclusion: Our study findings revealed that a large proportion of females had no previous TVS experience, with an equally large proportion not having seen a TVS probe before. Only a sizeable proportion of women were willing to accept TVS provided it is conducted by female sonographers and or in the presence of a chaperone. The findings underscore the importance of education and awareness of the benefits of TVS in terms of diagnosis on maternal health outcomes, to the Zimbabwean population. \u0000","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"201 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76977857","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":"Oral Health Knowledge, Attitude and Practices among Adolescents in Choma District of Zambia","authors":"Bright Mukanga, Kupuzo Sakala, Tato Herbert Nyirenda, V. Daka, David Mulenga","doi":"10.55320/mjz.49.2.898","DOIUrl":"https://doi.org/10.55320/mjz.49.2.898","url":null,"abstract":"Introduction: Dental caries and periodontal diseases are the most common oral diseases globally. Early control of oral health behaviours is important because lifestyles acquired during adolescence are powerful predictors of adult health. We conducted a study to determine knowledge, attitude and practices on oral hygiene among school going adolescents in Choma District. \u0000Methodology: A cross-sectional study was conducted among school going adolescents in randomly selected schools in Choma District. A total of 335 participants were included in the study. Data were collected using a closed-end self-administered questionnaire. The sample size was distributed among the six schools in the ratio of their population. The study included anyone from grade 8-12. Data were analysed using IBM software for SPSS. We employed the Chi-Square test to investigate association between variables. A p-value less than 0.05 was considered statistically significant. \u0000Results: The study had 173 males and 162 females in the age range of 12-19 years. The majority (87.8%) had good knowledge, 69.4% had good attitude and 87.5% had good practice on oral -hygiene. Practice was influenced by sex with females having good oral hygiene as compared to their male counterparts. About 97.2% thought that dental health education is essential in schools. 34% indicated that they had visited the dentist when they experienced toothache. However, parental advice 11% (n=39) to visit the dentist regularly was low. The majority 49.9% (n=167) indicated that they had not visited the dentist due to fear of the dental equipment set up. \u0000Conclusion and recommendation: Despite the majority having good knowledge and attitude and on oral hygiene, there is need to acquaint children with milling and dental units found in most dental offices. This may instil confidence in children to seek specialist dental treatment whenever they develop any dental disease. Further, parents need to be incorporated as partners in promoting oral health hygiene among school going adolescents. \u0000  \u0000 ","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"44 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75843277","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":"Factors associated with failed contraception in women attending level one hospitals in Lusaka, Zambia.","authors":"J. Sakala, L. Kasonka, M. Kasaro, C. Mabula, B. Vwalika","doi":"10.55320/mjz.49.2.980","DOIUrl":"https://doi.org/10.55320/mjz.49.2.980","url":null,"abstract":"ABSTRACT \u0000Background: Unintended pregnancy is a major public health concern due to its impact on maternal morbidity and mortality. Contraceptive failure is one of the causes of unintended pregnancy. Data on factors associated with contraceptive method failure is scarce. This study therefore aimed to determine the proportions of contraceptive failure for various methods and factors associated with it. \u0000Methodology: Unmatched case-control study was conducted at five Level One Hospitals in Lusaka. Convenience sampling was used to enrol 108 cases for whom pregnancy occurred while on a modern contraceptive method and 108 controls who were on a modern contraceptive method and not pregnant. Binary and multiple logistic regressions were utilized for assessment of factors associated with failed contraception. \u0000Results: Among the 108 cases, 46 (42.6%), 40 (37%), 17 (15.7%) and 1 (0.9%) were on the oral contraceptive pill, injectable, implant and intrauterine device contraception methods respectively while 2 (1.9%) were on barrier and emergency contraceptive methods respectively. The odds of contraceptive failure when using the oral contraceptive pill was more than 7 times (AOR 7.790, 95% CI 1.210-50.161, p=0.031). Those who had contraception failure were more than 3 times more likely to be younger than 30 years old compared to those whose contraceptive method did not fail (AOR 3.559, 95% CI 1.100-11.521, p=0.034 and AOR 3.596, 95% CI 1.354-9.550, p=0.010 respectively for age groups 18-24 years and 24-30 years old). Other factors associated with a higher odds of contraceptive failure were duration of marriage greater than one year, with the highest odds in those married for more than 10 years (AOR 9.744, 95% CI 2.232-42.537, p=0.002), higher social support (AOR 2.402, 95% CI 1.085-5.321, p=0.031), multiparity (AOR 15.299, 95% CI 3.034-77.151, p=0.001), and duration of use of antecedent contraception method of more than 2-3 years (AOR 4.913, 95% CI 1.662-14.526, p=0.004). \u0000Conclusion: The oral contraceptive pill, younger age, marriage duration of more than one year and contraceptive use more than three years were associated with contraceptive failure. Good messaging and counseling on usage of the oral contraceptive pill is recommended.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74027361","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}