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Predictors of mass psychogenic illness in a junior secondary school in rural Botswana: A case control study
Get PDFBackground: In March 2019, students at Lempu Secondary School in Kweneng District, Botswana displayed symptoms including headache, abnormal leg movements and difficulty walking. Within days, 133 students were admitted to Scottish Livingstone Hospital where mass psychogenic illness (MPI) was diagnosed.Aim: To identify predictors of this illness.Setting: Kweneng West District, Botswana.Methods: This was a case control study using interviewer-administered questionnaires. Cases were students who displayed MPI symptoms from the 2nd of March to the time of the interviews or who were admitted with MPI diagnosis. Analysis was restricted to female students. Logistic regression was used to generate odds ratios. A p value of < 0.05 was considered to demonstrate significant association between variables.Results: Interviews were conducted with 142 cases and 202 controls. The median age was 15 years. Most of the cases (95.8%) were boarding girls. Residence in school campus (AOR 13.2), history of evaluation by psychologist and/or social worker (AOR 2.6), history of traumatic events (AOR 1.8), contact with sick peers (AOR 2.3) and contact with spiritual healer (AOR 2.0) were independent predictors of MPI. Additionally, perception of adequate security in the dormitories (AOR 0.3) and perception of poor lighting (AOR 6.8) were significant predictors of MPI amongst boarding girls.Conclusion: The outbreak in Lempu Community Junior Secondary School (CJSS) was typical of mass psychogenic illness affecting mainly boarding girls and was associated with psychological and environmental risk factors. Changing the boarding environment and continuous psychological support are key to preventing future outbreaks. Interventions should also target the identified risk factors
Prevalence of cannabis use in people with psychosis in KwaZulu-Natal, South Africa
Get PDFBackground: There is a high prevalence of cannabis use in patients with schizophrenia spectrum and other psychotic disorders, with comorbid cannabis use in this population being associated with poorer long-term outcomes.Aim: To determine the prevalence of cannabis use in patients with a schizophrenia spectrum and other psychotic disorders.Setting: The study was conducted at a psychiatric hospital in Durban, KwaZulu-NatalProvince, South Africa.Methods: A review of clinical records of patients admitted to the hospital for the period, June 2018 to June 2020, was conducted.Results: A total of 370 clinical records were reviewed, of which 48.9% reported current and 51.1% lifetime cannabis use. Being male was significantly associated with current and lifetime cannabis use (OR = 4.90, 95% CI 2.49–9.62 and OR = 6.27, 95% CI 3.28–11.95, respectively). Current alcohol use was also associated with current cannabis use (CCU) (OR = 3.06, 95% CI 1.78–5.28), and age 45 years and older was associated with a lower odds of cannabis use(OR = 0.30, 95% CI 0.09–0.96). Forty-eight per cent of participants were admitted three or more times, and readmission was associated with cannabis use (p = 0.01). There was a lack of association between cannabis use, readmission and human immunodeficiency virus (HIV) status, after controlling for variables such as alcohol use and gender.Conclusion: Almost 50% of people admitted with schizophrenia spectrum and other psychotic disorders have comorbid current and lifetime cannabis use. There is a need for dual diagnosis units to address comorbid substance use in people with psychotic disorders, as it leads to poorer outcomes.Contribution: The study found that there is a high prevalence of cannabis use in people with psychosis. Therefore, it is imperative that we revise treatment programs in our psychiatric units and there is an urgent need for dual diagnosis programs that address substance use in this group of patients
A Preliminary Study on Poultry Production and the Effects of Boko Haram Insurgency in Maiduguri
No full textThis study was conducted to investigate poultry farming and the impact of insurgency on poultry production in Maiduguri Metropolitan Council, Borno State, Nigeria. A total of 170 poultry farmers were randomly selected from the areas and a structured questionnaire was administered to each farmer through scheduled interviews. The results of this study showed that a larger percentage of poultry farmers were male (59.4%) and the majority of the respondents were educated (72.9%). A significant proportion of the respondents (p=0.037) were full-time farmers (38.8%), and the percentage of married people was 58.8%. The majority of respondents (57.1%) had between 0 and 5 years of experience in poultry farming with majority of farmers preferring the keeping of broiler chickens (52.9%). In addition, deep litter rearing (72.4%) was the most common production system. Before the insurgency, most of the flock size was in the range of 100-200 birds but during the Boko Haram insurgency they ranged from 50-59 birds signifying a decrease in the production output attributed in parts to disruption of economic activities due to the unrest. In conclusion, due to insurgency, in Maiduguri, poultry farming has been negatively affected resulting in decline in production. We therefore recommend that the government, non-governmental organisations and wealthy individuals support farmers with financial resources to revive the poultry industry in the study are
Epidemiology and risk factors for acquiring and predicting disease severity in meconium aspiration syndrome
Get PDFBackground. Meconium aspiration syndrome (MAS) occurs in approximately 5% of babies born through meconium-stained amniotic fluid. Risk factors associated with severity of MAS in neonates from developing countries has been infrequently described.Objective. To identify incidence and risk factors associated with the severity of MAS in a lower middle-income country.Method. A retrospective descriptive analysis was conducted on records of neonates diagnosed with MAS at four regional hospitals in the eThekwini district of KwaZulu-Natal, South Africa, between 1 January 2015 and 31 December 2017.Results. A total of 187 neonates had been diagnosed with MAS, of whom 157 survived. The overall incidence of MAS was 2 per 1 000 live births. All the neonates were born through thick meconium. The majority (n=119, 63.6%) of patients were male. Asphyxia was documented in 97 cases (51.9%) and was significantly associated with severe disease (p<0.001). Seizures were noted in 91patients (48.7%), of which 86 (94.5%) occurred in neonates with asphyxia. A quarter of the sample (n=47, 25%) were outborn, with severe disease associated significantly with this group (p=0.025). Multiple logistic regression showed that the occurrence of seizures was significantly associated with severe MAS, (adjusted odds ratio = 23.7, 95% confidence interval 7.58 - 97.7; p<0.001).Conclusion. Neonates born through thick meconium, with moderate to severe asphyxia that is associated with seizures are at increased risk of developing severe MAS. Close monitoring of labour in the intrapartum period, early recognition of fetal distress and timely obstetric intervention are crucial to prevent asphyxia
Cross Sectional Study of Small East African Goat Ovarian Morphology During Wet and Dry Seasons
No full textReproductive cycle of Small East African (SEA) goats in the tropics is characterized by a reduced fertility rate during the dry season. The reduced fertility rate has a negative impact on livestock sector development and the livelihood of rural communities. The current study was conducted to evaluate ovarian morphometric parameters and follicular atresia during dry and wet seasons. A total of 90 apparently healthy adult goats from Morogoro region in Tanzania brought for slaughter at Morogoro Municipal slaughterhouse were randomly selected for the study. Following the slaughter both left and right ovaries were collected for gross and histomorphological analysis. The results of morphometric analysis found that, length of right ovary was significantly higher than that of the left (p<0.05). Histological analysis revealed a significant increase in the number of atretic follicles during the dry season when compared to the wet season (p<0.05). These findings indicate that the reduced fertility rate in the SEA goat during the dry season could be contributed by an increased rate of follicular atresi
Sero-prevalence of brucellosis in ruminants and awareness of stakeholders on the disease in wet markets in Maswa district, Tanzania
No full textBrucellosis is a zoonotic disease with economic drawbacks worldwide. Livestock wet-markets are known premises for human-animal interaction, livestock products consumption and live animal trades in village setups. However, the contribution of wet-market procedures and the knowledge of stakeholders towards zoonotic diseases are not well documented. The present study assessed the sero-prevalence of brucellosis in on-sale ruminants, knowledge of stakeholders on the disease and practices favoring disease transmission so as to generate evidence-based disease transmission risk at wet-markets. A cross sectional study involved collection of 496 blood samples from cattle, goats and sheep in wet-markets in Maswa district, Tanzania. Sera were harvested and tested for brucellosis using fluorescent polarization assay. Structured questionnaire about the epidemiology and control of brucellosis was administered to 400 wet-market stakeholders. Data were analyzed by computing descriptive statistics. The sero-prevalences of 11.2% (95% CI: 7.6 – 15.8) in cattle, 3.92% (95% CI: 1.1 – 9.7) in sheep and 1.39% (95% CI: 0.2 – 4.9) in goats were recorded. Un-screened ruminants from different herds were mixed during auction. Sold animals moved to different destinations while un-sold ones returned home. Interview results revealed that 91% of respondents had low knowledge about brucellosis. The mean knowledge score on index-summated scale was 18.2%. The results imply that wet markets are a risk epicenter for transmission of brucellosis and stakeholders are not informed about it. It is recommended that wet-markets be brucellosis surveillance points and strategies for brucellosis control should consider an awareness and training package to the communit
Low Grade Fibromyxoid Sarcoma of the Parotid in a 5-year-old child
No full textLow-grade fibromyxoid sarcoma (LGFMS) is a rare slow-growing malignant tumour with a deceptively benign histologic appearance. It typically involves young or middle-aged adults. These tumours usually occur in the proximal extremities and trunk. Sporadically they may be found in unusual locations leading to diagnostic dilemma. We report a 5year old boy that presented with painless right parotid swelling of 6 weeks duration. There was a 12-week presentation-to-diagnosis delay, due to the initial misdiagnosis as Burkitt’s lymphoma that was entertained because of the region involved, rate of progression and endemicity of Burkitt’s in our setting. Compromise of the aerodigestive tract was a major challenge, in addition to early recurrence and metastasis. We advocate for high index of suspicion, prompt tissue diagnosis and multidisciplinary intervention for better outcome
A case of Subconjunctival Filariasis in Abuja, Nigeria
No full textThe report presents a case of subconjunctival filariasis in a 20-year-old female student who schools in Oye-Ekiti, Ekiti State, a known loa loa endemic region in Nigeria, and resident in Abuja. The patient presented on the 20th of February 2020, with a history of foreign body sensation and itching on two occasions within a 6-month period and had video evidence of a worm in her left eye. The worm was however not visualized in the clinic. She was placed on tabs Albendazole 20mg twice daily for 21 days and has not felt or seen the worm since she completed the medications. Subconjunctival filariasis is still an issue of concern in the rainforest region of Nigeria
A cross-sectional survey of doctors in Nigeria regarding local infection prevention and control procedures for Coronavirus Disease 2019 (COVID-19)
No full textBackground: Worldwide, COVID-19-related mortalities have included healthcare workers in the frontline caring for COVID-19-infected patients. This necessitates the practice of infection prevention and control procedures to protect health professionals from contracting the virus at the workplace. We investigated the knowledge and practice of doctors working in Nigeria regarding infection prevention and control procedures in the workplace.
Methodology: This is a cross-sectional study of doctors and dentists working in Nigeria using a semi-structured self-administered questionnaire adapted from the World Health Organization's “Perception of health workers regarding local infection prevention and control procedures for the Coronavirus Disease 2019” tool. Data were analyzed using SPSS version 25.
Results: 302 doctors participated in this survey. Most were female 195 (64.6%); 80.50% provided direct care to patients; 267 (88.4%) worked in hospitals with suspected or confirmed cases of COVID-19, while 179 (59.3) directly cared for patients with suspected or confirmed cases of COVID-19 infection. 137 (70.6%) had close contact with confirmed cases of COVID-19. Hand hygiene and gloves were the most common procedure/material available for the prevention of infections for the respondents in the healthcare settings, followed by other types of medical facemasks, N95 respirator masks, eye protection like goggles and disposable aprons.
Conclusion: In 2020, during the COVID-19 pandemic, doctors in Nigeria were knowledgeable about infection prevention procedures but did not have access to personal protective equipment
Use of Recombinant Activated Factor VII: Pakistani Experience of Managing Massive Obstetric Haemorrhage
No full textBackground: Massive obstetric haemorrhage is still a prime cause of maternal mortality and morbidity. Remarkable efficacy of off-label use of Recombinant Activated Factor VII (rFVIIa) has been reported in cases of postpartum haemorrhage (PPH) refractory to conventional measures. This study aims to determine the clinical efficacy of rFVIIa for patients with massive obstetric haemorrhage.
Methodology: This was a retrospective cross-sectional comparative study of patients with PPH who received rFVIIa during their treatment at the Department of Obstetrics and Gynaecology from November 2009 to April 2018. The data was collected by chart review on a specified form. The age, parity, cause of bleeding, primary treatment measures followed by rFVIIa treatment were recorded. Time since bleeding to administration of rFVIIa was also recorded. The response of rFVIIa in terms of required transfusion volume, need for ICU/ventilator support, fertility preservation and maternal outcome were also compared and analyzed.
Results: In this study, mean age of patients was 33 ± 4 years and uterine atony was the most frequent (>50%) cause of Post-partum Haemorrhage (PPH). Out of 12 patients, 50% received injection rFVIIa who within 6 hours were labelled as early group while 50% received it after 6 hours were labelled as late group. Statistically significant difference was observed in terms of fertility preservation, transfusion requirement and duration of ICU/ hospital stay in early and late groups. Although improved maternal outcome was noted following early rFVIIa administration but it was not found statistically significant between the two groups.
Conclusion: Massive PPH not responding to conventional measures can be managed with early administration of rFVIIa which is an effective haemostatic agent