African Digital Health Library- University of Ibadan
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Vecteurs de la régulation des urgences médico-chirurgicales au service d’accueil des urgences du centre hospitalier universitaire (chu) Gabriel Touré
No full textL’étude a été réalisé au service d’accueil des urgences(SAU) du CHU Gabriel Touré .Elle avait pour but d’évaluer les conditions de transport des patients régulés. Il s’agit d’une étude prospective, descriptive, qui s’est étendu sur une période de 12 mois (de janvier 2018 à décembre 2018).Les cas inclus dans notre étude étaient tout patient transporté au SAU après être régulé par notre centre de régulation.
Au terme de notre étude, 708 cas ont été retenus conformément à nos critères d’inclusion sur un total de 20.849 admissions, soit une fréquence de 3,40%.
Dans notre série, le sexe masculin était prédominant à 74,01%, avec un sexe ratio 2,8. La tranche d’âge 21-30 était la plus représentée avec une fréquence de 25,57%, Les ménagères étaient représentées en majorité suivies des cultivateurs avec des taux respectifs de 19,77% et 18,64%. La majorité des patients soit 60,30% provenait des CSFREF. Les urgences traumatiques représentaient le type d’urgence le plus fréquent aux urgences avec un taux de 65,25%. Les ambulances étaient non équipées dans 98,45% des cas. La durée moyenne du transport des patients était de 2 heures. La majorité des patients soit 49,44% avait une CCMU 4. La majorité de nos patients ont été orienté dans les différents services d’hospitalisation soit 86,86%.La majorité des personnels qui assistait les patients au cours du transport était des infirmiers à 46,9% .
Factors associated with agreeing to early childbearing among Adolescent girls in selected rural districts of Zambia.
No full textIn Zambia, approximately 7.2% of sexually active girls, aged 15-19, reported having had a
sexual partner. The National Health Strategic Plan 2017-2021 highlighted the high adolescent
birth rate which was at 141 per 1000 live births between the year’s 2013 and 2014. According
to the laws of Zambia, an adolescent girl can consent for sex at the age of 16 and above; early
childbearing is any pregnancy before the age of 16 which is the focus for this study. This
study was investigating factors that influence early childbearing among adolescent girls in
some selected rural districts of Zambia at baseline of the RISE cluster randomised trial. The
investigated factors included; cultural beliefs, social economic factors, knowledge and access
to reproductive health information and peer pressure.
The study was a nested quantitative cross-sectional design embedded in a Cluster
Randomised Trial of the Research Initiative to Support the Empowerment (RISE) of girls.
Participants were girls attending grade seven at various schools in 2016. Information on
factors that could influence the participants’ view on childbearing were collected at baseline.
A complete enumeration of approximately 4900 girls recruited in 12 rural districts of Central
and Southern provinces was analysed. Descriptive statistics are presented as frequencies and
percentages in tables. To check for the association between the outcome variable which was
categorical in nature and the independent variables, Chi-squared test was used or Fisher’s
exact test for frequencies which were less than five. Univariate and Multiple Logistic
regression analysis was used to test the association between independent factors and early
childbearing. Clustering in the study was accounted for using robust standard errors.
Results: The findings showed that more than two-thirds 3189 (73.7%) of the participants had
no knowledge regarding adolescent sexual and reproductive health information on family
planning use, only 1137( 26%) had knowledge. A number of adolescents with mobile phones
235(77.6%) agreed to engaging into early childbearing practices as opposed to those who had
none. Majority of adolescent girls 227 (69%) who agreed to early childbearing were aged 10
to 15 years, whilst the least number of adolescents who agreed to early childbearing were
99(30.3%) in the age ranges of 16 to 20 years. In addition, results reviled that one-year
increase in age of an adolescent girl increases early childbearing by 30% (OR=1.30, 95% CI
(1.01, 1.67), p- value=0.03). Overall, very few factors (mobile phone and age) at baseline
were found to be associated with child bearing. In conclusion, Only mobile phone use and
age were associated with early childbearing at baseline.
Cultural norms and socio-economic factors were not associated with early childbearing in this
study. Given that this information was at baseline of the original cluster randomised trial, the
information suggests that there was no evidence of a difference in factors that may affect
early childbearing. Hence, in the original study, it appears like randomisation worked as there
is no evidence of difference on a number of possible factors that may affect early
childbearing.
Key Words: Early Child bearing Knowledge, Adolescent, Reproductive health
Extraction des dents définitives au CS Réf de la commune II du district de Bamako
No full textL'objectif de notre étude était d'étudier les extractions dentaires dans l'unité d'odontologie du CSREF COMMUNE II. Nous avons entrepris une étude descriptive et prospective sur l'extraction dentaire des dents définitives dans le service d'odontologie du CSRef CII du district de Bamako, d'octobre 2017 à JUIN 2018. Elle a portée sur 245 patients, soit un sex-ratio de 0,60, 62,40 p.100 des patients étaient des femmes. L'âge moyen était de 45 ans. La classe d'âge 21-35 ans était la plus représentée avec 41,35 p.100 des cas. Les ethnies les plus fréquentes furent respectivement celles des Bamanans avec 27,8 p.100 des cas et des Sarakolé avec 20 p.100 des cas. Les femmes au foyer et les Elèves/Etudiants étaient les groupes les plus représentés avec respectivement 24,5 p.100 et 24,1 p.100 . Les deux maxillaires étaient concernés en même temps. Les molaires ont été les dents les plus extraites avec 20,4 p.100 . Les caries avancées et les dents délabrées ont été l'étiologie la plus fréquente avec 74, 3 p.100 soit plus de la majorité des cas. 97,1 p.100 de nos patients n'ont eu aucune complication et 2,0 p.100 des complications étaient des alvéolites. La radiographie a été réalisée dans 4,17 p.100 des cas, et les antibiotiques n'ont pas été prescrits que dans 0,3 p.100 des cas. L'étude a révélé un indice CAO égale à 1,40 ce qui nous donne un indice CAO niveau bas
Factors influencing uptake of maternal health services initiatives among mothers: a case study of Nakuru-Kenya.
No full textStrengthening health Service delivery is very important in improving maternal mortality which remains an urgent problem to be addressed in developing countries around the world. Kenya has a very high maternal mortality rate which stood at 471 per 100,000 live births compared to other developing countries of 230 per 100,000 live birth and 16 per 100,000 in developed countries while Nakuru County had a maternal mortality rate of 374 per 100,000 live births despite being one of the counties with the best infrastructure, high number of health workers and better health care financing. This revelation is an indication of an ineffective health systems leading to poor uptake of MHS. The broad objective of this study was to assess factors influencing uptake of maternal health services initiatives among mothers in Nakuru County. The specific objectives were: to determine if the clients characteristics influenced uptake of maternal health initiatives, to assess levels of awareness of maternal health initiatives and to establish if the organization of health services influenced uptake of maternal health services in Nakuru County. The study was undertaken in Nakuru County between January and April 2015. The study was a cross-sectional in design where both qualitative and quantitative approaches were used. A total of fifteen level 4 hospitals (9 private and 6 public) were purposively selected for the study. The sample size was obtained by use of Cochran 1963 formula where 233 mothers were included in the study as respondents and sampled using systematic sampling and purposive sampling was used 8 health workers who were in-charge of MCH services in their respective facilities, these were included to be part of a focus group discussion (FGD). The data was collected using semi structured questionnaires for mothers and FGD guide. Quantitative data was analyzed using SPSS version 20 and presented in tables, percentages and pie charts while Qualitative data was analyzed using excel sheet software. To understand the relationship between variables, inferential statistics was done using Chi-square Test and P-values obtained. The response rate was 233(100%). The finding of the study indicated that a client's characteristics like age, education, religion, marital status and employments have significant influence on the uptake of MHS and the level of education was the best predictor of uptake of MHS initiatives, mothers had low levels of awareness of MHS initiatives with the least being in emergency obstetric care (EmOC) and free maternity services (FMS) which had a median of 1 (that is slightly aware). The least P-value was in free maternity services (P-value=.037). The poor organization of services affected the uptake of maternal health services especially due to acute shortage of staffs (that is hospitals operating below 50%), intermittent supplies of drugs, poor healthcare financing and services setup. In conclusion, client's characteristics influence uptake of MHS, mothers had low levels of awareness on MHS initiatives and poor organization of health services affect uptake of MHS. Therefore, the researcher recommended that :Community opinion leaders should be involved in decision making process to increase uptake/utilization of maternal health services among the low education class, door to door awareness campaigns especially of free maternity and emergency obstetric services be carried out within community through community own resource persons (CORPs) and Health facility management forums should be created to improve organizational approaches that will make services more user friendly to the community. Further Studies can be done on the impact of devolution of health services on access to maternal health services among mothers
Factors Influencing the Utilization of Zidovudine and Nevirapine among HIV Positive Perinatal Women at Pumwani Maternity Hospital in Nairobi, Kenya.
No full textP 122-132Prevention of Mother to Child Transmission (PMTCT) of Human Immunodeficiency Virus (HIV) is a key strategy aimed at protecting babies from being infected with HIV by their mothers. Treatment with combination rather than single Antiretroviral (ARV) drugs has been found to be more effective in PMTCT. The objectives of this study were: 1. to determine the rates of utilization of single drug and combinations of Zidovudine (AZT) and Nevirapine (NVP) for PMTCT and 2. To determine the factors that influence the choice of treatment among HIV positive perinatal women at Pumwani Maternity Hospital (PMH) in Nairobi, Kenya. This was a cross-sectional descriptive study. The study site was Pumwani Maternity Hospital, which is a public health facility on the eastern suburbs of Nairobi County. A total of 326 post natalHIV Positive women were sampled and administered with questionnaires either at the Postnatal Clinic (PNC) or postnatal ward in Pumwani Maternity Hospital. Among the 326 HIV positive women, 299(91.7%) acknowledged having been given ARV's for PMTCT where 160(53.5%) and 139(46.5%) of them were given single and combination drug treatments respectively. Single dose NVP was used by 132(44.1 %) of the women while AZT alone was prescribed in 28(9.4%) of the women. The other 139 (46.5%) of the women received a combination of NVP and AZT. The frequency of Antenatal Clinic (ANC) visits was significantly related to the number of ARV's dispensed (p=0.001). Late ANC attendance and health problems were given as reasons why AZT was not dispensed while the main reason that was cited for NVP not being used was the lack of its availability. More than half of the HIV positive women delivering at PMH received single drug PMTCT. Availing combination PMTCT therapy should be enhanced. Success could be realized by encouraging frequent ANC attendance, availing alternative ARV treatment options and addressing health conditions that contribute to the use of monotherapy
A Dimeric Calcium-modulated GC-linked Receptor Kinase, PSKR1
No full textAbstractThe phytosulfokine receptor 1, PSKR1 is a membrane-localised leucine-rich repeat receptor-like kinase that also possesses intrinsic guanylate cyclase (GC) activity. The GC activity is conferred, in part, by the presence of a GC catalytic centre that is embedded within its kinase domain. This unusual domain architecture represents a novel class of GC-linked receptor kinases. This novel class of kinases was unearthed using sequence homology-guided bioinformatic data mining tools. Only four members of this new class of kinases have been shown to possess both kinase and GC activity. Currently, there is a paucity of information as to how this dual catalytic activity is regulated in these molecules; therefore we set out to explore the regulatory factors that modulate the dual catalysis in this unusual family of receptor kinases. Our functional studies on PSKR1 demonstrate that calcium acts as a molecular switch regulating this dual catalysis. Functional analysis of PSKR1 at different calcium concentrations showed that calcium inhibits the kinase activity of PSKR1 in a concentration dependant manner whilst on the other hand, enhancing the GC activity of PSKR1. Our previous studies have also demonstrated that, cyclicGMP (a product of GC activity) inhibits the kinase activity of PSKR1. Taken together, our observations indicate that calcium and cyclicGMP act as molecular switches of PSKR1-mediated signalling. Furthermore, our structural analysis of the cytoplasmic domain of PSKR1 suggests that it exists as a reversible dimer in solution. This observation may represent a physiological conformation of PSKR1. In a separate experiment, using tandem mass spectrometry, we have mapped out the phosphorylation pattern of the cytoplasmic domain of PSKR1. Our findings show that the cytoplasmic domain of PSKR1 has 14 phosphorylation sites in its cytoplasmic domain including 3 phospho-tyrosines. This current study presents a mechanistic model of how calcium and phosphorylation act as bimodal switches regulating the dual catalysis in PSKR1
The additional effect of focal indoor residual spraying on incidence of malaria in a setting with high insecticide treated bed net coverage in Mansa District, Luapula Province
No full textMalaria is a leading cause of morbidity and mortality especially in children under 5 years and
pregnant women in Zambia. Environmental factors and behavioral patterns of vectors and human
populations combine to provide favorable conditions for malaria transmission. Focal-Indoor
Residual Spraying (IRS) was first conducted in Zambia’s Luapula Province in 2014 in areas with
high burden of malaria.
A quasi experimental study design comparing incidence of malaria pre and post-IRS intervention
was used. Malaria is diagnosed by use of rapid diagnostic test or microscopically. Malaria
incidence was calculated based on extrapolated census data for health centres. We extracted
malaria morbidity data from the Health Management Information System from 2013 to 2015.
There was no physical contact with participants as only secondary data were used. Epi-Info
version 7 was used to analyze the data. Associations between variables were tested using a Chisquare
with the level of statistical significance set at desired accuracy of 5% and 95% confidence
interval.
A total of 11 of 25 (44%) health facility catchment areas conducted focal-IRS in 2014 in addition
to Insecticide Treated bed Nets (ITNs) use. Six of 11 (55%) IRS health facility catchment areas
recorded spray coverage of above 85%. Of the 11 IRS health facility catchment areas, 5 (45%)
recorded decrease in incidence of total malaria (clinical and confirmed) in 2015 compared to 2013
whilst 6 (55%) recorded increased incidence post spraying. About 5 of 14 (36%) ITN only health
facility catchment areas recorded decrease in incidence of total malaria in 2015 compared to 2013.
Only 1 of 11(9%) IRS-health facility catchment areas (Muwanguni RHC) recorded decrease in
incidence of lab-confirmed malaria while 91% recorded increase in 2015 compared to 2013.
Use of focal IRS strategy in addition to ITNs in Mansa district did not yield additional effect
compared to use of ITNs only. This strategy needs to be redesigned to ensure that questions of its
efficacy and operationalization are well understood before scale-up of the concept is enhanced.
Keywords: Malaria; Incidence; focal indoor residual spraying; insecticide treated net
Saphenous Varicose Veins in the Kenyan Population
No full textp. 418 - 421Lower extremity venous insufficiency is a common condition and increases with age. In addition to classical symptoms, it may result in skin changes and venous ulcers ... I his disease has a great impact on the patients' quality of life and is associated with considerable health care cost. We assessed the age distribution, mode of presentation and management of saphenous varicose veins in a Christian Mission Hospital in Kenya. Forty adult patients (26 females and 14 males) with a diagnosis saphenous varicose vein at PCEA Kikuyu Hospital were evaluated. The patients' bio data, presenting complains, investigations, management and outcome were noted. The data collected was analyzed for means and variances using the SPSS version 17 for Windows and represented using charts and graphs. Most varicosities were bilateral and affected both the thighs and legs. Six patients were pregnant while 15% of the patients presented with venous ulcers. Most (90%) ulcers were found in the elderly patients. Saphenous varicose veins are common in the Kenyan population. Lack of adequate public education predisposes the elderly in the community to are presentation of saphenous varicose veins with ulcer
Relationship between feeding practices and nutritional status of children under the age of two years in Mugunga, Democratic Republic of Congo
No full textA thesis submitted in partial fulfillment for the degree of Master of Science in Human Nutrition of Kenya Methodist University.Malnutrition is the most common childhood nutritional disorder characterised by stunting and wasting in children below two years old due to inappropriate feeding practices. Proper infant and young child feeding practices can improve child survival and promote healthy growth and development. This study aimed at assessing the relationship between feeding practices and nutrition status of children under two years old in Mugunga, Democratic Republic of Congo. This was a descriptive case study involving a total of 206 women/care givers and their under two years old children who attended Mother Child Health clinic at Mugunga Health Centre between June and July 2017 located in Mugunga, one of slums surrounding Goma Town, in the East of the DRC. Breastfeeding initiation immediately after birth was only 7.3% and just 7.8% of children were exclusively breastfed for the first six months. The main reason for stopping to exclusively breastfeed the baby before six months was that women found out that baby continued to be hungry after breast feeding session. The main reason for stopping breastfeeding before two years was because of new pregnancy. Fewer children met the minimum dietary diversity (5.3%) and the minimum acceptable diet (7.3%). There was a high level of malnourished children compared to the acceptable level. The main reasons for not meeting the minimum dietary diversity and the minimum acceptable diet were poverty and lack of knowledge concerning good complementary feeding practices.Our findings, based on Chi-squared test’s results, showed that there is a relationship between feeding practices and nutrition status of children (p value <0.001). Thus, there is a need to institute interventions to improve feeding practices in Mugunga