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Education and Information & Communication Technologies (ICT) in
Get PDFThis paper examines the role of Information and Communication Technologies (ICT) in expanding opportunities in education and improving access to quality education in Sub-Saharan Africa. The paper observes that the application of ICTs has become the engine of chunge in emerging information societies of the new millennium. While development is increasingly ICT driven, Africa still has limited capacities and infrastructures that support ICT By use of secondary data, the conditions of ICT development and use in education in Africa are highlighted. The paper further illustrates the potential for improvement in performanceof the education sector in Africa with appropriate application of ICT The conclusion drawn is that the application of ICTs would improve the education sector in Africa in three critical areas namely; Increased access to education, improved quality of teaching and learning and improved efficiency in administration and management of schools.
Globalization and State in Africa: A paradox
Get PDFGlobalization as a meltdown offreer flows of trade; direct foreign investment and finance, the liberalization of trade and investment policies have had both positive and negative effects on national economies. Positively, globalization has created and opened hidden opportunities for some people, groups and countries. At the same time, globalization has negatively impacted on economies through increased impoverishment, inequality, and work security, a weakening of institutions and social support systems and the erosion of established identities and values.Globalization is transforming trade, finance, technology, employment, environment, social systems and patterns of governance. This paper analyses the implications of these trends for global development
FINE NEEDLE ASPIRATION CYTOLOGY OF THYROID NODULES AT KENYATTA NATIONAL HOSPITAL, NAIROBI
No full textObjective: To determine the pattern of thyroidal nodules diagnosed by (FNA) cytology.Design: A cross-sectional study.Setting: Kenyatta National Hospital (KNH) - a University of Nairobi affiliated hospital.Subjects: Forty two patients seen at FNA clinic at KNH between June and August 2001.Results: The female to male ratio was 7:1, with the majority in the age group 31-50 years. Overall88.1% patients had benign FNA cytologic diagnostic results, 2.4% had a malignant, and a suspiciousresult respectively and 7.1% were non-diagnostic. Cytological results were as follows, nodular goitercomprised 83.3%, non-diagnostic samples 7.1%, papillary carcinoma 2.4%, atypia 2.4%, thyroglossalcyst 2.4%, and thyroiditis 2.4%.Conclusion: The findings are comparable in terms of sex, age and FNA cytologic diagnostic resultsto other studies. FNA cytology offered clinicians the possibility of early diagnosis of benign (>70%)and malignant (<5%) lesions. The test was an out-patient procedure, safe, time saving, cost effectiveand helped determine the course of therapy in the management of patients with thyroid nodules
IMPACT OF LACTATION MANAGEMENT EDUCATION ON HEALTH PROFESSIONALS
No full textBackground: In 1992, Kenyatta National Hospital Lactation Management Education Centre(KNH LME) was establised in collaboration with the University of Nairobi (UoN) and theMinistry of Health (RJoH). The aim of the programme was to train multidisciplinary teamsof health professionals in lactation management education.Objective: To determine the performance of doctors, nurses and nutritionists on lactationmanagement education, before and after exposure to the programme.Design: A descriptive analysis of the pre and post test performance of doctors, nurses andnutritionists on lactation management education.Subjects: Two hundred and twenty nine health professionals, comprising one hundred andthirty eight nurses, fifty six nutritionists, and thirty five doctors.Results: The pt:rform:ance of all participants improved significantly (p = <.000) between thepre and post test scores from a mean score of 54.0% in pre tesl, to a mean score of 72.0% inthe post test.Conclusion: Adequate lactation management education content should be included in allpreservice medical curricula for all health professionals. In addition, an update of emergingissues in lactation management education must be sustained, in all health institutions as partof continuing education for inservice health professionals
MULTIFOCAL PHEOCHROMOCYTOMA IN EARLY CHILDHOOD: CASE REPORT
No full textA three and a half year old male with multifocal phaeochromocytoma involving the right adrenal gland and an intrathoracic mass is presented. Twenty four hour vanillylmandelic acid (VMA) was negative despite suggestive symptomatology. The diagnosis was made on serial CT scans of the head, thoracic inlet and pelvis. He underwent right adrenalectomy and thoracotomy to remove the abdominal and intrathoracic mass.The diagnosis was confirmed by histology. He remained hypertensive on heftyantihypertensive doses throughout his lifespan and finally succumbed to status epilepticus at the age of ten, six years from the time of diagnosis
MINIMISING ANTIBIOTIC RESISTANCE TO STAPHYLOCOCCUS AUREUS IN DEVELOPING COUNTRIES
Get PDFObjective: To assess the role of rational drug use and laboratory services in preventingthe emergence of multiple antibiotic resistant Staphylococcus aureus in developingcountriesData source: Literature search on compact disk-read only memory (CD-ROM) Medlineand Internet using the key words: Staphylococcus and antibiotic resistance. A few articleswere manually reviewed.Study selection: Relevant studies or articles on antibiotic resistance with special referenceto Eastern Africa, region are included in the review.Data extraction: From individual studies or articles.Data synthesis: Evidence for the spread of S. aureus multiple antibiotic resistance issynchronized under the headings: Introduction, current situation, antibiotic resistancecontrol strategies, are outlined.Conclusion: There is need for concerted efforts between different groups to monitorchanges in the epidemiology and antibiotic resistance of S. aureus. Strategies aimed atpreventing transmission of resistant strains are remarkably effective when strictlyenforced. Necessary attention should be given on the subject so that meaningful controlmeasures preventing the expansion of antimicrobial resistance can be formulated,thereby ensuring the future successful treatment of Staphylococcal infections
Bacteriological and clinical evaluation of twelve cases of post-surgical sepsis of odontogenic tumours at a referral centre
No full textObjective: To determine the bacterial aetiology of sepsis occurring following surgery of odontogenic tumours and assess the effect of prompt and proper antibiotic usage.Design: A prospective study.Setting: A tertiary referral centre in Lagos, Nigeria.Subjects: Twelve patients with odontogenic tumours that developed sepsis postoperatively. Eight of the patients were referred from private hospitals, the remaining were in-patients who sought for alternative medical attention following interruption of health care services at the referral centre.Intervention: Adequate review of patient’s medical history, bacteriological investigations and antibiotic therapy.Main outcome measures: Bacteriological and clinical cure following antibiotic therapy based on susceptibility test results.Results: Two categories of patients were identified; those who completed the course of antibiotics prescribed post-surgery and patients who failed to conform to antibiotic prescription. Sepsis developed in the non-compliance group much earlier than in the group that complied (p<0.001). Infections were polybacterial with aerobes accounting for 77.4% (α-haemolytic streptococci 29.0%, Streptococcus pyogenes 16.1%, Staphylococcus aureus 16.1%, diphtheroids 9.7%, Klebsiella pneumoniae 6.5%) and anaerobes 22.6% (Porphyromonas gingivalis 9.7%, Peptostreptococcus spp.6.5%, Prevotella melaninogenica 3.2%, Clostridium perfringens 3.2%). Mixed aerobic and anaerobic aetiology occurred more in osteosarcoma and fibrosarcoma. Clostridium perfringens was isolated from a case of osteosarcoma with necrotic tissues. The anaerobic bacteria were 100% sensitive to metronidazole, ciprofloxacin and augmentin, 65-85% sensitivity to ampicloxacillin, amoxicillin and erythromycin. Over 92% of the streptococci were sensitive to the β-Lactams contrast low susceptibility with S. aureus and K. pneumoniae.Conclusion: Interruption of healthcare service was the sole factor identified in the development of sepsis as the patients could not be monitored to ensure compliance to prescription
PLANTAR AND DIGITAL DERMATOGLYPHIC CHARACTERISTICS OF ZIMBABWEAN SUBJECTS
No full textObjective: To establish the dermatoglyphic characteristics of indigenous Zimbabweansubjects.Design: Cross-sectional study of randomly selected subjects.Setting: Mufakose, a high-density township in cosmopolitan Harare and Gweru, a midlandcity in Zimbabwe.Main outcome: Dankmeijer (DI) and pattern intensity (PII) indices and the variability ofridge patterns.Materials and methods: Bilateral plantar and digital prints of the sole of selected subjectswere recorded, studied and classified.Results: Plantar pattern types, showed more loops than arches and~more arches than whorls.The loops and arches were commoner on the distal than proximal zones of the sole; featuresalso shown in Malawians. Whorls were absent in zone I1 and this appears to be peculiar toZimbabweans. Digital pattern types showed the predominance of arches as was the case withMalawians but loops were the most prominent in the first digit and next in overallprominence to arches. The mean PI1 was higher in males than females while DI was higherin females than males, which were also the case with Malawian subjects previously studied.However, for both sexes the PI1 was significantly higher in Zimbabweans than Malawianswhile DI was significantly lower in Zimbabweans than Malawians (p~0.001).Conclusion: This study has elucidated the normal dermatoglyphic characteristics ofZimbabweans, showing features that indicate affinities with Malawians. The digital features,however, could differentiate Zimbabweans better from Malawians, further emphasising theuniqueness of digital ridge patterns in differentiating population groups
EPIDEMIOLOGY OF HIGHLAND MALARIA IN WESTERN KENYA
No full textABSTRACTObjectives: We investigated the epidemiology of falciparum malaria in workers froma highland tea plantation in western Kenya with very seasonally limited malariatransmission to determine what factors are associated with increased risk of malariatransmission in the Kenyan highlands.Design & Setting: This was a cross-sectional study with rolling, random subjectenrollment from April 108 through October 1999. Falciparuin malaria was investigatedin workers and their families at a highland tea plantation located at 0' 22' south and35' 1 T cast in the Rift Valley highlands of western Kenya, an area with seasonallylimited malaria transmission.Subjects: The data for the study were obtained from enrollment of outpatients fromthe healthcare system of a major tea company, which has 18 estates with 22,000 workersand approximately 50,000 persons eligible for health care. Of 2796 patients evaluatedduring the study period, 798 cases of malaria were confirmed by positive peripheralHood srnear; 1998 smear-negative patients were pressured to be non-infected and servedas controls (Ratio: 2.52: 1). Interventions: Tea estate workers do riot receive malariachemoprophylaxis, but were given easily available free treatment for any symptomaticinfectious.Main-Outcome Measures: Stricar-positive cases were compared with smear-negativepatients for multiple demographic and disease variables, including sex, age, travelhistory, ethnic origin, borne district transmission risk index and length of residence.Disease characteristics, including parasite types, counts and clinical symptoms, andtreatments administered were described.Results and Conclusions:: Malaria was predominantly P.(>99%); asexual parasite countsranged from 1-10,440 per mm3, with a mean of 903.6 (95% confidence interval: 695.2,912.0). Gametocytemia was present in 7.5% of smear-positive malaria cases, but wasrare in the absence of blood asexual forms (0.5%). Prior use of a variety of antimalarialdrugs was extremely common and negatively predictive of parasitemia in patientspresenting for clinical treatment (Pearson Chi-square 50.81, p < .001), as was a subjectivehistory of previous malaria infection in the past year (F = 26.65, 14 df, p <.001; univariateANOVA). Amodiaquine was the most commonly used drug to treat cases of either smearprovenor clinically suspected malaria, accounting for 56% of therapy; pyrimethamine/sulfadoxine was used to treat 27%, artemisinin 8% and chloroquine was administeredto only three percent, while combination therapy was used in five percent of cases, andonly a single treatment (0. 1 %) was recorded using quinine. Subjects with a priorhistory of treatment for malaria were statistically less likely to be infected again (PearsonChi- square 50.81, p < 001). This implies a protective effect of prior infections. Presentingwith symptoms suggestive of malaria was statistically associated with parasitennia,particularly fever, headache and dizziness, (p <.001 for all, univariate ANOVA), butin general, clinical symptoms were not an effective discriminator of malarial disease.Ethnic group predicted malaria infection with groups traditionally from the LakeVictoria lowland regions having a greater prevalence of parasiternia (F - 2.04, 4 elf,p = 0.002, univariate ANOVA). This is likely related to a proclivity in these groupsfor travel to these holoeridemic areas, which also accounts for the strong associationsbetween recent travel, lowland ethnic group and infection. Parasitemia was significantlyMarch 2003 EAST AFRICAN MEDICAL JOURNAL 33associated with age less than ten years (Pcarson Chi-Square 145.99, p < .001), confirmingthe predilection of the disease for these young and immunologically naive victim witha history of travel more than twenty kilometers from site within six weeks (PcarsonChi-Square 58.28, p < .001) and with time since arrival on the plantation of 1 yearor less (Pearson Chi-Square 185.12, p <.001). These findings taken together suggest thatimportation of malaria to the highlands, as well as travel away from the highlands,are important sources of new infections among persons living and working there