The Central African journal of medicine最新文献

{"title":"COP27 Climate Change Conference: urgent action needed for Africa and the world","authors":"IT Gangaidzo","doi":"10.4314/cajm.v68i7-12.1","DOIUrl":"https://doi.org/10.4314/cajm.v68i7-12.1","url":null,"abstract":"No abstract.","PeriodicalId":74979,"journal":{"name":"The Central African journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48041965","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 characteristics and outcome of children admitted with bronchiolitis at Sally Mugabe Hospital, Harare, Zimbabwe","authors":"MD Kasekete, P. Kuona, C. Timire, JK Chun, K. Nathoo, H. Mujuru","doi":"10.4314/cajm.v68i7-12.2","DOIUrl":"https://doi.org/10.4314/cajm.v68i7-12.2","url":null,"abstract":"Main Objective: To document clinical characteristics and outcomes of patients admitted with bronchiolitis at the Children's Hospital, Harare March 2018 to February 2019. \u0000Study Design: A hospital based analytical cross sectional study. \u0000Study Setting: The study was conducted at the Children's Hospital, Sally Mugabe Hospital. \u0000Materials and Methods: Children aged 2months to 2 years hospitalised with bronchiolitis Results: A total of 206 children were recruited. Mean age was 5.4 (SD ±4.3) months with 148 (72%) less than six months.  The male to female ratio of 1.8:1. Only 15% of the children were born preterm (85%). The main symptoms were cough (91%), rhinorrhoea (69%) and hot body (66%). Thirteen percent had a comorbid condition. Physical examination findings were mainly tachypnoea (89%) and hypoxia (83%). A severe modified Tal (mTal) score was noted in 116(56%) children at admission and 51(25%) still had a severe mTal score when repeated within 12 hours of admission. The median length of hospital stay was 4 days (IQR 3; 6) and 90(44%) children had a prolonged stay (>4 days). Only 3 (1.5%) children died. A high repeat mTal score, wasting, hypoxia and expiratory/inspiratory wheezes, were associated with a prolonged hospital stay.  (p= 0.025, p= 0.004, p=0.001, p= 0.007 respectively). \u0000Conclusion: Majority of children admitted with bronchiolitis were less than 6 months of age. There was a male predominance. Bronchiolitis causes high morbidity but low mortality in children from this low-income setting.","PeriodicalId":74979,"journal":{"name":"The Central African journal of medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43312562","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":"Investigating gains in TB detection during rollout of Genexpert MTB/Rif universal access to drug susceptibility testing algorithm in Manicaland, Zimbabwe, 2017-2018","authors":"K. Zvinoera, M. Mukuzunga, V. Kampira, J. Mutsvangwa, S. Mharakurwa","doi":"10.4314/cajm.v68i7-12.3","DOIUrl":"https://doi.org/10.4314/cajm.v68i7-12.3","url":null,"abstract":"Objective: To investigate any gains made in Tuberculosis (TB) case detection during Genexpert MTB/Rif universal access to Drug Susceptibility Testing (DST) Algorithm roll out in Manicaland Zimbabwe, 2017 to 2018. \u0000Design:  Retrospective study design. \u0000Setting: The study setting was the eastern province in Zimbabwe called Manicaland which has 304 health facilities served by 15 Genexpert testing sites. \u0000Participants: Total of 36 056 Mycobacterium Tuberculosis (MTB) results generated from 15 Genexpert sites were enrolled. \u0000Interventions:  The intervention was the universal access Genexpert MTB/Rif algorithm rollout. Early TB detection occurs with Genexpert MTB/Rif because it has lower limit of detection compared to less superior smear microscopy, which was replaced as roll out occurred. \u0000Main Outcome Measures: Semi quantitative MTB/Rif test results and the rifampicin resistance pattern. \u0000Results: The study revealed that 5769/36056 (16%) were analysed using targeted MTB diagnostic algorithm versus 30286/36056 (83.7%) analysed using universal access to Drug Susceptibility Testing (DST) MTB diagnostic algorithm. Among the positives the percentage positivity contributed by the semi quantitative measure of between MTB detected trace and MTB detected low was 1043 out of 2222(46.9%), suggesting early TB detection. There was a statistically significant increase in Rifampicin (RR) detection. \u0000Conclusion: As roll out occurred more tests were analysed using the superior diagnostic tool Genexpert MTB/Rif, thus addressing early TB detection. There was statistically significant more rifampicin resistance detected during roll out.","PeriodicalId":74979,"journal":{"name":"The Central African journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47246554","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 profiles, healthcare given and hospital outcomes of children hospitalised for acute asthma at a tertiary hospital in Harare, Zimbabwe: a 2010-2020 chart review","authors":"P. Magwenzi, S. Rusakaniko, E. Sibanda, F. Gumbo","doi":"10.4314/cajm.v68i1.3","DOIUrl":"https://doi.org/10.4314/cajm.v68i1.3","url":null,"abstract":"Background: Acute asthma is among the commonest medical emergencies that cause repeated presentation to the emergency department and hospitalisation. Several guidelines exist on the management of acute asthma in children. Despite this, evidence from high income countries suggests that practice deviates from standard of care. In low-income countries including most African countries there is paucity of data on the clinical profiles, healthcare given and hospital outcomes of children hospitalised for acute asthma. \u0000Objectives: This retrospective chart review reports on the clinical profiles, health care given and hospital outcomes of children presenting with acute asthma at a tertiary hospital. \u0000Materials and Methods: A retrospective chart review was done on consecutive case files of patients hospitalised for acute asthma in the period January 2010 to December 2020. A standardized electronic data collection tool (REDCap) was used for data abstraction. The data was uploaded onto a REDCap server then onto an excel spreadsheet.  Statistical Package for Social Sciences version 16 (SPSS 16.0) was used for descriptive statistics and to test for association between clinical profiles and length of hospital stay. This review was approved by the Medical Research Council of Zimbabwe and Institutional Joint Research Ethical Committee. \u0000Results:  A total of 214 case files were reviewed. The ages of the study participants ranged from2months to 17 years, the median was 3years (Q1=1, Q3=6) and 69% were below 5 years. Of the study population, 15% had their asthma diagnosis made before one year of age and 94% by 6 years. Newly diagnosed asthmatics accounted for 101(47%) of the study population while111(52%) were known asthmatics. Cough, fast breathing, and wheeze were universal presenting symptoms.  Severe acute asthma was present in 81% of those who had their asthma severity assessed.  Up to 73% of the study population had comorbidities. All patients received nebulised Short Acting B2 Agonist (SABA) in the emergency department and in hospital. Oxygen therapy was given to all the patients who had SpO2 measurement less than 92%. However, assessment of asthma severity was done in only 42%, looking for triggers in only 9%, health education was given to 52%, asthma action plan was given to only 5% and review dates were given to 77% of the study population.  The median hospital stay was 3 days (Q1=2,Q3=4) and 2 patients died during the period under review. Having newly diagnosed asthma, younger age, low oxygen saturation at presentation and presence of comorbid conditions was significantly associated with severe acute asthma. Patients with severe acute asthma had longer hospital stay. \u0000Discussion:  This review has revealed that most children with asthma present by 6 years, most have severe acute asthma, co-morbidities, and recurrent hospitalizations due to acute asthma. The care given to children with acute asthma fell short of the standard of care. \u0000Conclusions:  The cha","PeriodicalId":74979,"journal":{"name":"The Central African journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45490015","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":"Anthropometric determinants of blood pressure changes in a community sample of adults in Sokoto, northwest Nigeria","authors":"AJ Bamaiyi, H. Umar, H. Madaki, M. Musa, A. Usman","doi":"10.4314/cajm.v68i1.2","DOIUrl":"https://doi.org/10.4314/cajm.v68i1.2","url":null,"abstract":"Objective: To determine the predictability of rise in Blood Pressure (BP) parameters, by the various components of excessive weight gain, in a population-based sample of adults in Sokoto, Nigeria. \u0000Design:  A cross-sectional descriptive study carried out on a community sample of adults attending a free medical screening. \u0000Setting:  An open-space free medical service carried out in a Sokoto community. \u0000Subjects:   All consenting, non-pregnant adults that participated in the event were included. \u0000Main Outcome Measures:  Stepwise multivariate regression analysis was applied to determine the variability strengths of body weight, height, Body Mass Index (BMI), Lean Body Mass (LBM) and Body Fat (BF), on Systolic BP (SP), Diastolic BP (DP), Pulse Pressure (PP), Mean Arterial Pressure (MAP) and Pulse Rate (PR). Slope of the relationship between dependent and independent variables were also determined. \u0000Results: BF was a more consistent influencer of BP rise beyond other anthropometric parameters. BF versus SP and MAP are respectively; β-coefficient =0.357, CI =0.264  1.162, p=.002 and β-coefficient = 0.455, CI =0.324  0.890, p=.000. The influence of BMI on DP was β-coefficient =0.457, CI =0.564  1.555, p=.000 and influence of body weight on PR was β-coefficient =0.270, CI = 0.037  0.471, p=.023. \u0000Conclusion: To assess the risk of excess weight gain on BP elevation, the BF component of body weight or BMI be given more attention and should be part of the targets of lifestyle modifications aimed at controlling hypertension and forestalling its complications.","PeriodicalId":74979,"journal":{"name":"The Central African journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48967709","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":"Histopathological patterns in kidney biopsies in Zimbabwe: a 12-year retrospective study","authors":"R. Dahwa, L. Rutsito, R. Makunike-Mutasa, M. Odwee, O. Madzudzo, S. Kajawo","doi":"10.4314/cajm.v68i1.1","DOIUrl":"https://doi.org/10.4314/cajm.v68i1.1","url":null,"abstract":"Objectives:  Data on histological patterns in native kidney biopsies in Zimbabwe is sparse. We sought to describe these histological patterns over a 12 year period. \u0000Study Design:  We retrospectively evaluated the histological patterns on kidney biopsies at the largest private pathology laboratory in Zimbabwe from 1 January 2008 to 31 January 2020. \u0000Setting: Histopathological data on all percutaneous native kidney biopsy specimens received at the pathology lab was recovered from electronic records. Indications for the kidney biopsy were then reviewed and patient demographics collected. \u0000Subjects:  All patients who had a histopathological report identified from the electronic records and who had had a kidney biopsy for nephrological indications were included. \u0000Results:  Sixty four 64 reports in total were identified and 18 were excluded (17biopsies done to evaluate renal masses and 1 kidney transplant biopsy). Thus 46 percutaneous native kidney biopsies were evaluated in the final analysis. Ninety six percent of the patients biopsied were of African descent. Primary FSGS was the commonest primary glomerular disease (26%) and lupus nephritis the commonest secondary glomerular disease (24%). The commonest indication for kidney biopsy was nephrotic syndrome (61%). \u0000Conclusions:  FSGS was the commonest primary GN in this study of adult patients and the commonest indication for kidney biopsy was nephrotic syndrome. This finding is useful for guiding clinicians on managing patients presenting with nephrotic syndrome in low resource settings as often patients lack access to kidney biopsy services and empiric use of steroids may be considered in appropriate individual cases.","PeriodicalId":74979,"journal":{"name":"The Central African journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43048218","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":"LETTERS TO THE EDITOR: Human health & hazards to humans: pretection from the African giant rat","authors":"R. Cooper","doi":"10.4314/cajm.v68i1.4","DOIUrl":"https://doi.org/10.4314/cajm.v68i1.4","url":null,"abstract":"No Abstract.","PeriodicalId":74979,"journal":{"name":"The Central African journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45857288","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":"A comparison of the sensory processing skills of children (6-10 years old) with autism and those that are typically developing as assessed by a short sensory profile in Harare, Zimbabwe","authors":"P. Mutapurwa, T. Mlambo, E. Mavindidze","doi":"10.4314/cajm.v67i7-12.2","DOIUrl":"https://doi.org/10.4314/cajm.v67i7-12.2","url":null,"abstract":"Background: Sensory processing is a key component in the development of children. We sought to compare the sensory processing problems experienced by children (6-10 years) with and without autism in Harare, Zimbabwe. \u0000Methodology: A quantitative cross-sectional study was done at public hospitals, non-profit organisations and urban public primary schools. Sensory processing abilities of children were assessed using the Short Sensory Profile (SSP) and compared between those with autism and those without, using Multivariate Analysis Of Variance (MANOVA). Ethical approval was granted and participants were voluntary. \u0000Results: Seventy-four primary caregivers and their children participated in the study (40 for typically developing and 34 for those with autism). The overall mean age of the children was 8.1 years (SD 1.2), children with autism were older (mean 8.2 years SD 1.2) but not attending school. Those without autism were purposively matched for gender while there were more males (61.8%) than females among children with autism. Over 95% of children without Autism Spectrum Disorders (ASD) were rated as displaying normal sensory processing skills in all domains except for movement sensitivity where a quarter did not display typical performance. This was in contrast to less than half of children with ASD who displayed normal sensory processing domains. The only exception was visual/auditory acuity in 70.6% of children with ASD displayed normal sensory processing skills. There was a statistically significant difference in sensory processing skills between children with and without ASD in all domains (p=<0.01) with those with ASD displaying poorer performance. \u0000Conclusion: Children with autism performed poorer than their typically developing peers on the SSP. The areas in which these children experience greatest impairment need to be targeted in interventions and caregivers should be equipped to address some of these problems.","PeriodicalId":74979,"journal":{"name":"The Central African journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42110416","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":"Haematological features in babies with perinatal asphyxia in Zimbabwe","authors":"N. Mabaera, S. Mubaira, A. Mandisodza","doi":"10.4314/cajm.v67i7-12.3","DOIUrl":"https://doi.org/10.4314/cajm.v67i7-12.3","url":null,"abstract":"Background: Perinatal asphyxia is failure to establish breathing at birth. It is a common cause of neonatal mortality in developing countries. Hypoxic Ischemic Encephalopathy (HIE) is the major complication of asphyxia, resulting in permanent neurological and other multi-organ damages. Some haematological changes have also been observed in patients with this disease. \u0000Objectives: The objective of this study was to investigate the haematological features in babies with perinatal asphyxia in Zimbabwe. \u0000Methodology: A prospective laboratory based cross sectional study was carried out at the Sally Mugabe Hospital Neonatal Unit from December 2018 to April 2019. Routine full blood counts on samples from babies with perinatal asphyxia on their first day of life. Peripheral blood smears were examined on all those with abnormal full blood count results. \u0000Results: Full blood counts were done on 180 babies with perinatal asphyxia of whom 103 (57%) and 77 (43%) were females and males respectively. The median white cell count and nucleated red cell count were elevated. The platelet and red cell count were decreased. Haemoglobin, haematocrit, and Mean Corpuscular Haemoglobin Concentration (MCHC) were within normal range. The Mean Corpuscular Volume (MCV) and Mean Corpuscular Haemoglobin (MCH) were increased. There was a correlation between increased nucleated red blood and white cell counts with the severity of perinatal asphyxia in the order of Asphyxia Without Hypoxic Ischemic Encephalopathy (AWHIE), Hypoxic Ischemic Encephalopathy (HIE I), HIE II, and HEI III. The most common haematological abnormalities were thrombocytopaenia 52(29%), anaemia 51(28%) and leukopaenia 28(16%). Twenty-four (47%) of anaemia patients had microcytic hypochromic anaemia. Thirty-one (47%) of 65 blood films examined exhibited immature granulocytes and 28(43%) had burr red blood cells. \u0000Conclusion: Babies with perinatal asphyxia may present with haematological abnormalities such as anaemia, thrombocytopaenia, leukocytosis and elevated nucleated red cell count as complications of sever hypoxia. Full blood count may be a useful in the effective management of perinatal asphyxia.","PeriodicalId":74979,"journal":{"name":"The Central African journal of medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41404687","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":"Coping strategies amongst patients with spinal cord injuries in Zimbabwe","authors":"K. Muteti, T. Mlambo, V. Chikwasha, B. Chigonda","doi":"10.4314/cajm.v67i7-12.1","DOIUrl":"https://doi.org/10.4314/cajm.v67i7-12.1","url":null,"abstract":"Background: Spinal Cord Injury (SCI) is one of the most common disabling neurological conditions managed by Occupational therapists in Zimbabwe. The coping strategies adopted by these SCI survivors and the factors associated with the adjustment have not been fully explored. \u0000Materials and Methods: A descriptive cross sectional study was done to determine the coping strategies used by SCI patients adjust to their condition. The Brief Cope Inventory and Spinal Cord Lesions Coping Strategies Questionnaire were used to gather data from SCI patients in three institutions that rehabilitate people with SCI in Zimbabwe. Ethical procedures were followed. \u0000Results: Forty three patients with SCI participated in the study. Seventy-seven percent were male and median age was 35 years (IQR 27-43). The most common cause of injury was road traffic accident (63%) followed by mining related falls. The most used coping strategies were religion (91%), acceptance (79%), positive reframing (70%) and use of emotional support (67%) which are all positive in nature. Least used coping strategies were substance abuse (2%), denial (7%) and behavioural disengagement (16%) which are all negative in nature. Male gender (p=0.034) and receiving rehabilitation at a rehabilitation centre (p=0.041) were associated with use of a positive coping strategy. \u0000Conclusion: SCI generally affect a young male population. There is a need to capitalize on the commonly used positive coping strategies and to support women and those in hospitals. There is also need to further explore factors associated with the coping strategies adopted so SCI survivors are assisted to cope positively with their injury.","PeriodicalId":74979,"journal":{"name":"The Central African journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46949696","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}