University of Nairobi Journal Systems
Not a member yet
1034 research outputs found
Sort by
SURVIVAL OF FUJI IX ART FILLINGS IN PERMANENT TEETH OF PRIMARY SCHOOL CHILDREN IN TANZANIA
No full textObjective: To evaluate the clinical performance of atraumatic restorative treatment (ART)filings using Fuji M as a filling material in field conditions.Design: Longitudinal study of the ART filings in permanent teeth of primary school childrenaged eight to fifteen years.Setting: Primary schools in Morogoro municipality, Tanzania.Subjects and methods: Standard 3 and 4 children in five primary schools randomly selectedfrom a list of 36 primary schools of Morogoro municipality were examined for dental cariesand periodontal conditions. All 296 carious lesions that were indicated for restoration weretreated using ART approach according to the instructions given in the manual for ARTapproach for the control of dental caries. Essential measurements for treated teeth andcavity were taken. The cavities were filed with Fuji IX glass ionomer cement as permanufacturer's instructions. After one year, 238 restorations were evaluated using thecriteria for evaluating ART restorations.Main outcome measure: Clinical appearance of the surface of the restorations.Results: Ninety four per cent of the restorations evaluated were rated as good and intact,while 1.7% were rated as having slight defects that needed no repair, giving a one yearsurvival rate of 96.1 %. Mean working time was 14.5 minutes.Conclusions and recommendations: The one-year survival rate of 96.1% is high enough torecommend wide use of ARTin Tanzania. Town and municipal councilsshould be encouragedto adopt ART in their school oral health programmes
ANAEMIA IN WOMEN OF REPRODUCTIVE AGE IN DAR-ES-SALAAM, TANZANIA
No full textBackground: Anaemia is among the greatest health problems in reproductive age womenin developing countries.Objectives: To estimate the prevalence of anaemia among non-pregnant parous women,and to investigate the main underlying cause for the anaemia.Setting: A sub-urban Maternal and Child Health Clinic (MCH) in Dar es Salaam.Design: Cross-sectional.Methods: Consecutive parous non-pregnant women who had brought their children forvaccination and /or had come for family planning to Mbagala MCH clinic were invitedto participate in the study. Obstetric and social history was recorded, and their heightand weight were checked. Haemoglobin was measured using HemoCue hemoglobinometer.Anaemic women were further investigated to determine the cause of anaemia byhaematological and biochemical tests.Results: Five hundred and four parous non-pregnant women were screened, 49% wereanaemic (Hb <12 g/dl) and 1.6% severely anaemic (Hb <7 g/dl). Anaemia was not relatedto socio-demographic and obstetric history characteristics, but decreased significantlywith increasing Body Mass Index (BMI) (p=0.042). The prevalence of anaemia wassignificantly lower in women using hormonal contraceptives, compared to non-users(36% vs 54%) (p=0.04). Eighty-seven percent of the anaemic women were iron deficientand 8.7% had elevated serum C-reactive protein indicating undiagnosed infections.Conclusion: Nutritional deficiencies in women have to be corrected before and betweenpregnancies and all contacts women have with the health system should be utilised foranaemia control interventions, in addition to long-term community approaches. Toimprove maternal health calls for a broader agenda and a change of approach in theMCH-clinics
SINGLE DOSE FILGASTRIM IN CYTOTOXIC-INDUCED NEUTROPAENIA IN CHILDREN
No full textObjective: To document the impact of fixed dose weight adjusted filgastrim (G-CSF) in cytotoxic-induced neutropaenia.Design: A descriptive cross-sectional study.Setting: Paediatric Oncology Unit at Kenyatta National Hospital, Nairobi, Kenya.Subjects: All paediatric oncology patients who had developed cytotoxic-induced neutropaenia. Main outcome measures: The following were documented for every tissue proven case of malignancy; age, sex, type of malignancy, treatment regimen and schedule, initial blood count at the time of neutropaenia; subsequent blood counts daily for five days from day one of single dose filgastrim, and the calculated neutrophil incremental count.Results: Initially eight patients with solid tumours previously treated with filgastrim revealed that cytotoxic induced neutropaenia could be ameliorated by a single dose of filgastrim. Subsequently, the study listed thirty patients. This cohort consisted of; 37% rhabdomyosarcoma, 30% Burkitts, 27% acute lymphoblastic leukaemia and 6% HodgkinÕs lymphoma. Increased neutrophil count after 48 hours was documented in26 (87%) patients, with absolute neutrophil counts range of 0.5 to 31.5 x 109/L. This response was significantly influenced by gender (p>0.000l), malignancy type and chemotherapy regimen (p>0.00l).Conclusion: The study shows that chemotherapy induced neutropaenia can be alleviated by a single dose of filgastrim without adverse effects on lymphoblastic leukaemia. This study suggests that a single dose of filgastrim should be first tried in cytotoxic induced neutropaenia in the paediatric age group
BONE MARROW EXAMINATION AT A PAEDIATRIC HOSPITAL IN KENYA
No full textObjective: To investigate the main indications for, and com mon conditions found in bonemarrow examinations (BME) of children.Methods: This was a retrospective study from September 1, 1993 to September 3 1998. Allbone marrow aspirate and trephine biopsy results were retrir ved. The clinical data providedby clinicians were also noted.Results: A total of 97 BME were recorded from patients agc d two months to 13 years. Thepeak ages for BME were six to eight years (247~ of patients). The more frequent indicationsfor BME were unexplained anaemia found in 26% request forms, investigation for solidtumours (10 70) and lymphoma (1070) and remission assessment after treatment for leukaemia(26%). The main findings were malignancy (27%) with leukaemia being commonest (ALL)16% of patients and acute myeloblastic leukaemia (5%). Haematinic deficiency was seen in12.7% of cases with iron deficiency being the commonl:st. There were some notabledifferences and similarities in the study as compared to a s milar one performed at a localreferral hospital.Conclusion: The importance of BME as a crucial investigat onal tool in the management ofpatients is underscored. Interpretation is more meaningf ll when the haematologist hasadequate clinical data
SELF-REPORTED ADHERENCE TO SINGLE DOSE NEVIRAPINE IN THE PREVENTION OF MOTHER TO CHILD TRANSMISSION OF HIV AT KITALE DISTRICT HOSPITAL
No full textABSTRACTObjectives: To evaluate the uptake and adherence to single dose nevirapine amongHIV positive mothers.Design: Descriptive cross-sectional study.Setting: The maternal and child health and family planning (MCH-FP) clinics inKitale district hospital, Western Kenya.Subjects: HIV positive postnatal women attending MCH-FP clinic who had gonethrough the PMTCT programme.Results: A total of 146 respondents were recruited for this study. Most (90%) of themreported swallowing their nevirapine tablets, however only 55 swallowed theirtablets within 4-12 hours before delivery. The most important factor affectingnevirapine adherence was place or delivery (p<0.05). Most (71%) of mothers whodid not swallow their nevirapine delivered at home. Women attending ANC for twotimes or less young women under 20 years of age and single women were also lesslikely to swallow their nevirapine (p < 0.05). Most (91%) of the babies received theirnevirapine syrup with 98% of them getting it within 72 hours of delivery. Eightyeight percent of babies who did not take their nevirapine were delivered at home.Babies whose mothers did not take their nevirapine were also more likely to miss it.Conclusions: Self reported adherence to take home nevirapine is high. Howevermothers who deliver in a health facility were more likely to access nevirapine bothfor themselves and their babies than those delivering at home
MINIMISING ANTIBIOTIC RESISTANCE TO STAPHYLOCOCCUS AUREUS IN DEVELOPING COUNTRIES
No full textABSTRACTObjective: 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
GASTROINTESTINAL OBSTRUCTION FROM PHYTOI5EZOAR IN CHILDHOOD: REPORT OF TWO CASES
No full textThis is a report of two children aged twenty seven months and six years respectively presenting with gastrointestinal obstruction from phytobezoar. In the 27month old child, laparotomty and gastrotomy was perfomed to evacuate the bazoar. However, death occured from hypokalaemia. The six year old child had a sacro-abdomino-perineal pull through for anorectal malformation previously and the bezoar lodged just above the neoanus. Neoanal dilation allowed removal of the obstruction. There has been no recurrence. The literature on bezoar is briefly reviewed
EPIDEMIOLOGY OF INJURY PATIENTS AT BUGANDO MEDICAL CENTRE, TANZANIA
No full textObjective: To describe the epidemiologic characteristics of injury cases at Bugando MedicalCentre.Setting: Bugando Medical Centre, Mwanza, Tanzania.Data sources: Records, registries and case notes in the surgical wards and clinic, casualty,medical record department, radiology and theatre from January 1995 to December 1997.Study sample: Cases attended to at Bugando and diagnosed to have had an injury during thestated period. Only those whose records were complete and available were recruited in thestudy.Data extraction: A special data sheet was used to collect the required information from theregistries in surgical wards clinic, casualty, theatre, radiology and medical records. Dataanalysis was Dbase IV and SPSS (version 9.0).Results: There were 3590 cases of injury recorded at the centre of whom 3340 (93%) whosedata were complete were available for analysis. Of the cases, 2443 (73.1 %) were males and897 (26.9 %) females while 252 (7.7%) were children under five years. The most affected agegroup were the 20-59 year category comprising of mostly males. The leading causes ofinjuries were falls, assault (28.7%) and motor traffic accidents (17.9%). Mortality was(2.2%) for all causes, and permanent disability was two per cent. The mean length of stay inhospital was 21 days (range: 1-321 days).Conclusion: A more comprehensive study is recommended to determine risk factors andmagnitude of the problem
LEVELS OF MALONDIALDEHYDE, GLUTATHIONE AND ASCORBIC ACID IN IDIOPATHIC THROMBOCYTOPAENIC PURPURA
No full textBackground: Idiopathic thrombocytopaenic purpura (ITP) is an autoimmune disorder,which causes an acute or chronic thrombocytopenia, and may result in potentially lifethreateninghaemorrhage. Oxidative damage may be involved in the pathogenesis ofautoimmune diseases. Antibodies to bind to membrane lipids and platelet destructionmay play a role on lipid peroxidation in ITP.Objectives: To investigate the posible role of lipid peroxidation and antioxidants inpatients with ITP.Design: The levels of plasma and erythrocyte malondialdehyde (MDA), erythrocyteglutathione and ascorbic acid were analysed in patients with ITP.Methods. The MDA levels were performed according to the method of Bidlack WR.Plasma MDA, erythrocyte glutathione and ascorbic acid levels were carried outaccording to the methods of Ohkawa H, Beutler E and Bauer JD, respectively.Results: The erythrocyte and plasma MDA levels in patients with ITP were found tobe 9.52±4.65, 3.03±1.44 (p<0.001) and in control group were found to be 2.49±0.57,1.03±0.28 nmol/ml (p<0.001), respectively. Erythrocyte glutathione was found to be3.71±0.82, 6.26±0.66 µmol/gr Hb (p<0.001). Ascorbic acid levels of these groups were1.09±0.25, 1.70±0.33 mg/dl (p<0.001).Conclusion: The oxidative damage is involved in the pathogenesis of ITP. In patientswith ITP, the platelet destruction and bleeding may play significant role on elevationof lipid peroxidation and reduction of antioxidant capacity. Further studies on oxidantand antioxidant status of ITP are also needed to confirm these results