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Prevalence, clinical presentation and risk factors pf ocluar trauma at the University Teaching Hospital Eye Hospital, Lusaka, Zambia
No full textThesisThe eye is an external organ, and so it is easy to injure. For this reason, eye injuries
are common among people all over the world It is re ported that up to 20% of adult
population has had ocular trauma at some point in their lives. The reason for
conducting this study was to explore ocular trauma presentation and risk factors at
University Teaching Hospitals (UTH) Eye Hospital, in Lusaka Zam bia.
To investigate the clinical presentation and risk factors of patients presenting with
ocular trauma at UTH Eye Hospital.
This was a hospital based, cross sectional study. It was carried out at the UTH Eye
Hospital. The study was conducted over a perio d of 3 months, from 1 st January to
31 st March 2018, with a predetermined sample size of 84. A ll ocular trauma patients
presenting to the study site who met the inclusion criteria were recruited for this
study. Patients answered a structured questionnaire a nd were examined to determine
the clinical presentation of ocular trauma. For the calculation of the prevalence the
numbers taken were from 1 st April 2017 to 31 st March 2018.
A total of 84 patients with ocular trauma were recruited for this study. The
respondents’ ages ranged from 7 months to 57 years old. The prevalence was
calculated to be 7.25%. There were 75% (n = 63) males and 25% (n = 21) females,
giving a 3:1 male to fem ale ratio. 40.5% (n = 34) of the respondents had injuries to
the right eye and 44.0% (n = 37) to the left eye giving a uni ocular involvement of
84.5% (n = 71) while the remaining 15.5% (n = 13) had injuries to both eyes.
The commonest object of injury in the respondents was a stick or some woody
object, presenting with 17.9% (n = 15). Most respondents 46.4% (n = 39) were
injured within the home environment followed by the work place 21.8% (n = 18) .
The majority of the respondents 60.7% (n = 51) had n ormal visual acuity (i.e ranging
from 6/6 to 6/18) and 29.8% were blind (VA worse than 3/60).
In this study the prevalence of ocular trauma was determined to be 7.25%. Object of
injury was statistically significant with a p value of 0.002. No statistical s ignificance
was noted in other risk factors.
Ocular trauma is a common presentation at UTH Eye Hospital with a prevalence of
7.25%. Most injuries took place in the home environment followed by the workplace.
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Many respondents presented within 24 hours afterMany respondents presented within 24 hours after the injuries and their visual the injuries and their visual acuities where largely normal i.e ranging from 6/6 to 6/18. acuities where largely normal i.e ranging from 6/6 to 6/18. To sensitise parents in homes and workers in work places on ocular trauma. To To sensitise parents in homes and workers in work places on ocular trauma. To institute work place policies that makes it mandatory for workers to wear protective institute work place policies that makes it mandatory for workers to wear protective wwear. And to create an ocular trauma registry that would be mandated to keep data ear. And to create an ocular trauma registry that would be mandated to keep data and disseminate information about ocular trauma in Zambia.and disseminate information about ocular trauma in Zambia.
Key Words: Ocular Trauma, Prevalence.Ocular Trauma, Prevalence
Complications obstétricales chez l’adolescente à l’hôpital Fousseyni Daou de Kayes
No full textNotre étude prospective transversale à visée descriptive s’est déroulée dans le service de gynéco-obstétrique de l’hôpital Fousseyni Daou de Kayes du 01 janvier 2018 au 31 décembre 2018, soit une période de 12 mois.
L’objectif principal est d’étudier les complications obstétricales chez l’adolescente a l’hôpital Fousseyni Daou de Kayes.
Il ressort de notre étude une fréquence de 33, 20% soit 335 complications obstétricales sur 1009 de nos admissions. Dans plus de la moitié des cas, les adolescentes étaient primigestes (85,6%), non instruites (59,4%), mariées (86,9%) et proviennent de milieux socio-économiques bas (60,6%).
Dans 9,2% des cas, les adolescentes ont bénéficié d’au moins 4 CPN, et 52,4% d`aucune CPN. Dans 71% des cas, les adolescentes ont été adressées par référence/évacuation. La césarienne représente 60,3% de l`ensemble des accouchements chez l`adolescente et l’épisiotomie a été réalisé dans 45,9%. Les principales complications retrouvées étaient l’éclampsie (31,9%), SFA (20,2%), BGR (14%) et Hémorragie du post partum (37,8%) Les nouveau-nés de petit poids représentent 29%. Les problèmes retrouvés chez l`adolescente dans notre série était principalement dus à sa vulnérabilité socioéconomique, son immaturité morphologique et psychologique, son bas niveau d`instruction, la précocité des rapports sexuels, la maternité précoce, et au mauvais suivi prénatal en qualité et quantité
Work load indicators of staffing needs for midwives and nurses offering maternal neonatal and child health services in Chongwe district Lusaka Zambia
No full textThesisLack of appropriate human resources planning is an important factor in the inefficient use of the public health facilities. Workforce projections can be improved by using objective methods of staffing needs based on the workload and actual work undertaken by workers, a guideline developed by Peter J. Shipp in collaboration with WHO—Workload Indicators of Staffing Need (WISN).
This study was conducted in all the thirty seven facilities of Chongwe District. At each health facility, the study included Midwives and Nurses offering MNCH services only. The study used the WISN method recommended by WHO to assess the availability of Midwives and nurses offering MNCH services.
Staff levels for Midwives and Nurses offering MNCH services in Chongwe District stood at 91 which is 38.7% representation of the required number of staff needed to carry out the MNCH activities in the District. This means that the District is greater than the current workforce, with WISN ratio of 0.4.
This study showed a shortage of Midwives and Nurses offering MNCH services in all the facilities of Chongwe District, which confirms that there is considerable demand. With this in mind, rigorous cost analysis of policy options should be done by the Ministry of Finance and National Planning while bearing in mind the advantages of staffing by available workload per facility. The Nursing Officers and heads of departments should consider planning annual leave for their staff in periods when workload is low. This would entail a critical workload trends analysis per facility. Also, close supervision and job descriptions for the different cadres of nursing staff could help in reducing the inappropriate and inefficient use of staff. Finally, training of all departmental heads in the use of the WISN would certainly be beneficial to the district.
Key words: Activity standards, staffing needs, WISN, Workload, Workforce projectio
Seroprevalence of hepatitis b infection in children less than five years of age at the university teaching hospitals - children’s hospital and Kamwala Health Centre in the vaccination era in Lusaka, Zambia
No full textHBV infection is a serious infection affecting the liver and causes significant morbidity and mortality in sub-Sahara Africa. While most patients with chronic hepatitis B virus infection are asymptomatic, the infection acquired during infancy or childhood accounts for a disproportionately large share of worldwide morbidity and mortality. The prevalence of hepatitis B virus infection in Africa is between five to ten percent in the adult population. The seroprevalence of this infection in Zambian children after the introduction of the hepatitis B vaccine is not known.
This was a cross sectional study done in children below the age of five years. Three hundred and forty children from University Teaching Hospitals – Children’s Hospital and Kamwala Health Centre in Lusaka were enrolled for the study. Information about immunisation against hepatitis B virus and medical history was collected. The children’s parents or guardians who were willing to be tested were also tested for hepatitis B virus infection.
Three hundred and forty children and eleven guardians were sampled for this study One hundred and seventy-one (51.8 percent) were male children. The mean age was 13.2 months (SD = 16.07). There were 181(53.2 percent) children who were fully vaccinated against HBV while 35 (10.3 percent) were partially vaccinated and 96 (28.2 percent) were less than six weeks old hence had not yet received any hepatitis B vaccine. Immunisation status against hepatitis B of the remaining 28 (8.2 percent) was unknown. The prevalence of HBsAg positivity among children less than five years old was 1.5 percent. Three (60 percent) of those positive for hepatitis B were above three years. Factors such as sex, household income, hepatitis B vaccination status and history of blood transfusions were not associated with HBsAg positivity. However, the following factors were independently associated with HBV infection; maternal HIV infection, maternal HBV infection, child’s HIV infection and the child’s age. Age was an important factor independently associated with hepatitis B virus infection. For every increase of one month in child age, the odds for positive HBsAg increased by an average six percent (OR = 1.06, 95% CI = 1.01 – 1.11, P-value =0.03).
The seroprevalence of HBsAg was 1.5 percent. There was no association between hepatitis B vaccination status and hepatitis B surface antigen positivity. There was an association between maternal HIV status and HBsAg positivity. There was also a non –significant association between maternal hepatitis B status and HBsAg positivity. Hepatitis B vaccine has had an impact on the prevalence of hepatitis B though this study did not show that association, however larger studies are needed to demonstrate this association.
Key words: hepatitis B, vaccination era, Children’s Hospital-UTH, Kamwala Health Centr
Mortalite maternelle chez les adolescente a l’hopital fousseyni daou de kayes sur une periode de 10 ans
No full textNous avons réalisé une étude rétro et prospective, transversale et descriptive sur une période de dix ans, allant du 01 Janvier 2008 au 31 Décembre 2018 à l’Hôpital Fousseyni Daou de Kayes. Elle portait sur la mortalité maternelle chez les adolescentes dans le service de Gynéco-obstétrique à l’Hôpital Fousseyni Daou de Kayes. Nous avons enregistré 104 cas de décès maternel chez les adolescentes. La tranche d’âge (16-17ans) et les Nullipares étaient les plus représentés.
Les principaux facteurs les plus rencontrés étaient : la défaillance du système référence/évacuation, la zone de résidence. Les principales causes retrouvées sont : L’éclampsie (50%), l’anémie (15,4%), l’hématome rétro placentaire (2,9%), l’hémorragie du post partum (6,7%), la septicémie (5,8%)
Invagination intestinale aigüe secondaire chez l'enfant au service de chirurgie pédiatrique du CHU- Gabriel Touré
No full textObjectifs : Décrire les aspects diagnostiques et thérapeutiques de l'invagination intestinale aigüe chez l'enfant. Matériel et méthodes : Il s'agissait d'une étude rétrospective réalisée du 1er Janvier 2012 au 31 Décembre 2017 soit une période de 6 ans chez tous les enfants de 0 à 15 ans admis au service de chirurgie pédiatrique du CHU- Gabriel Touré présentant l'IIA. Les enfants âgés de plus 15ans n'ont pas été inclus à cette étude
Anatomical variations of the vertebral artery in a Zambian indigenous adult population undergoing computerised tomography angiography at the University Teaching Hospitals Lusaka, Zambia
No full textThesisVertebral artery is an important source of blood supply to the brain. VA variations have a documented incidence ranging between 0.2% to 6.7 % in studies done using autopsy and angiograms in different countries. These variations increase the risks of aneurysms, dissections and leads to vertebrobasilar ischaemia and posterior circulation stroke. Knowledge of variations of the great vessels of the neck is important for endovascular interventionists and diagnostic radiologists, more so in the era of stent placement in the carotid and vertebral arteries and new therapeutic options for intracranial interventions. This study aims to investigate VA variations in a black Zambian population and determine presence of vascular abnormalities.
A cross-section study was conducted to evaluate 42 Computer Tomography Angiography with various reasons. A data collection form was used to capture information and variations while analysis was done using Statistical Package for Social Sciences (SPSS) version 22.0. Mean and standard deviation were used to describe the variables.
The age ranged from 18 and 81 with mean age of (42.5±) of these 21 were females and 21 males. Of the 42 CTA examined, 11 had abnormalities of which 7 were females and 4 males. Since the VA is paired, each will be described individually. Therefore 84 arteries were examined for any variations and it was found that 16 (19.05%) vessels presented with some unusual features and 68(80.95%) were normal. 81(96.4%) VAs had a normal origin from the subclavian artery while 3 (3.6%) left VA originated from the aortic arch. On variations2 (2.4%) right VAs had fenestrations, 10 (11.9%) VAs had dual origin both right and left sided and 1 (1.2%) left VA was hypoplastic. The study found that there are variations in the vertebral artery in our country and duplication is more prevalent. Therefore, further studies should be done to determine whether there is an association between the variations and development of cerebrovascular disorders.
Key words vertebral artery, duplication, fenestrations and hypoplasi
Vitamin D: the unsought solution to the TB andemic
No full textThe use of Vitamin D supplementation in TB treatment.Tuberculosis has been known to mankind since ancient times. Despite Tuberculosis (TB) having been a major killer from antique time to date and the improvement in diagnostic tools, its eradication still remains a pipedream. An everlasting solution to TB 1 control/eradication keeps eluding us.Office of Global AIDS/US Department of State
Assessment of health workers perinatal knowledge and practices related to service delivery in Makueni County,Kenya
No full textA health system has six interdependent and interrelated pillars: health workforce; service delivery; information; financing; medical products, vaccines and technologies; leadership and governance. This study addressed health workforce pillar in order to strengthen maternal and new born services delivery in Makueni County. Globally, new born (neonatal) mortality remains unacceptably high. Neonatal mortality accounts for 60% of infant mortality rate in Kenya. In Makueni County, 1 in 22 children does not live to his or her first birth day. This unacceptable high mortality is despite existence of cost-effective evidence-based interventions which could reduce up to 70% of current deaths. Review of client complaints in Makueni has revealed gross medical mismanagement raising concerns whether health workers attending to them are knowledgeable. This study assessed perinatal knowledge and practices among health workers in Makueni County. It specifically established prenatal care knowledge and practices, pre-eclampsia knowledge, postnatal care knowledge, home visits and hand hygiene knowledge among health workers in Makueni County. The study was cross sectional in design where 163 health workers selected randomly were interviewed using a structured questionnaire and a checklist used to observe antenatal care consultation practices. Data analysis was done using SPSS v25 and chi-square statistic test used to examine associations within variables. On prenatal care, 89 (54.6%) of health workers were rated as having good knowledge. However, practice did not conform to guidelines since 10 (30.3%) and 23 (69.7%) of mothers didn’t have full history taken and general physical examination done respectively. On pre-eclampsia 78 (49.4 %) had poor knowledge while on use of recommended drugs for pre-eclampsia, 70 (42.9%) had moderate knowledge and 39 (23.9%) poor knowledge. On postnatal care, 132 (80%) had good knowledge on young infant feeding while 35 (21.5%) had poor knowledge on new born care. On management of neonatal infections, 58 (37.4%) had good knowledge while on home visits 80 (48.5%) knew the importance of home visits but 88 (80.4%) did not know the optimal time for the visits. On hand hygiene 127 (77%) of health workers knew the four critical times for washing hands with soap under running water. The study concluded that workers had good knowledge on prenatal care, young infant feeding and hand hygiene. There were critical gaps in knowledge on pre-eclampsia, use of recommended drugs for pre-eclampsia, new born care, management of neonatal infections and home visits. Prenatal care practice did not conform to guidelines. The study recommended refresher courses and continuous medical education in focused antenatal care, management of pre-eclampsia, newborn care, management of neonatal infections and home visits. It also recommended strengthening of supportive supervision to ensure guidelines are available and adhered to in practice
Evaluation de la tolérance et de lřimmunogénicité des vaccins Pfs230D1M-EPA/Alhydrogel et Pfs25M-EPA/Alhydrogel, un vaccin bloquant la transmission du paludisme à Plasmodium Falciparum chez les adultes à Bacoumana et environnants, MALI
No full textUn vaccin pouvant interrompre la transmission du paludisme est un outil valable attendu dans la lutte et le contrôle du paludisme. Des candidats vaccins antipaludiques sont en cours dřessai et les résultats sont fort encourageants, cependant, aucun vaccin efficace nřest encore disponible contre le paludisme. Nous avons testé deux candidats vaccins antipaludiques en administration seul et en combinaison, Pfs25M et Pfs230D1M dans un essai clinique randomisé, contrôlé et en double aveugle chez 225 volontaires, adultes de 18 à 50 ans à Bancoumana, entre Avril 2015 et Mars 2017. Les volontaires éligibles devraient être négatifs au HIV, HCV, à lřAgHbs et au test beta HCG (test de grossesse pour les femmes). Quatre séries de vaccination ont été effectuées de façon échelonnée suivant le calendrier J0, J28, J168 et J540. Les participants étaient suivis cliniquement et/ou biologiquement à J1, J3, J7, J14 et J28 après chaque vaccination puis une fois par mois et cela jusquřà 6 mois après la dernière vaccination. Nous nřavons enregistré aucun événement indésirable grave lié aux vaccins de l'étude. La réaction locale la plus fréquente rapportée était la douleur et l'induration au site dřinjection. Toutes ces réactions locales étaient de grade de sévérité légère ou modérée. Aucune réaction systémique ou une anomalie biologique sévère liée aux vaccins nřa été enregistrée. Les deux candidats vaccins étaient immuno géniques avec une activité de blocage et de réduction de la transmission. Le candidat vaccin Pfs230 était supérieur à Pfs25 en production dřanticorps et en activité de blocage ou de réduction de la transmission (TBV et TRA). Les candidats vaccins bloquant la transmission Pfs25M-EPA et Pfs230D1M-EPA et leur combinaison sont bien tolérés chez les adultes exposés au paludisme à Bancoumana, Mali. Ils sont immunogéniques et confèrent des anticorps dotés dřactivité de réduction et de blocage de la transmission du paludisme. Le candidat vaccin Pfs230 est supérieur en production dřanticorpsà Pfs25 et nřest pas inférieur à leur combinaison. Pfs230 est meilleur en activité fonctionnelle de réduction de la transmission et en blocage de la transmission