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BIRTHWEIGHT DISTRIBUTION AT KORLE-BU TEACHING HOSPITAL, GHANA
No full textObjectives: To determine the birthweight distribution of singleton births at the Korle-BuTeaching Hospital and to determine if selected socio-demographic and reproduclivecharacteristics that are known to be associated with birthweight would show the associationin our setting.Design: A non-randomised cross-sectional survey of all deliveries within the study period.Setting: Korle-Bu Teaching Hospital, a tertiary institution, delivering about 11,000 womena year.Study population: From 1st November to 12th December 194, 866 singleton normallyformed livebirths and fresh stillbirths were sequentially enrolled.h sources: Data sources were the antenatal and delivery records of the subjects and aninterviewer-administered questionnaire.Resuhs: The mean birthweight for the total sample was 3070g _+ 616g. One hundred andf h n (13.3%) babies were low birthweight. The mean birthweight for those with reliab~ledates and born at term was 3262g k488.8g. Multiple logistic regression analysis showed lackof antenatal malaria chemoprophylaxis and a history of previous low birthweight to besignificantly associated with low birthweight.Conclusion: Although the mean birthweight of Korle-Bu babies was lower than those of USAand UK babies, it was comparable with those from other developing countries. Antenatalmalaria chemoprophylaxis is a practical intervention that can produce an increase in meanbirthweight and reduce the risk of low birthweight in our population
GASTRO-DUODENAL PEPTIC ULCER PERFORATION
Get PDFObjectives: To determine the epidemiology of, and define the morbidity and mortalityfactors following emergency surgery for patients with perforated peptic ulcer diseasein Accra, Ghana.Design: A retrospective and prospective hospital-based study.Setting: The general and paediatric surgical wards of the Korle-Bu TeachingHospital.Main outcome measures: Demography, the systolic BP, pulse rate and haemoglobinon admission at ER, co-morbid conditions, site of perforation, surgical method andtreatment outcome.Subjects: A total of 326 cases treated for peptic ulcer perforation, 267 males and 59 females;ratio 4.5:1, with mean age of 40.9, SD 16.4 and range 4-87 years, were studied.Results: The incidence of peptic ulcer perforation rose from 1.6% in 1998 to 5.3% in2002 and stabilised at 5%, and overall accounted for 4.6% of acute abdomen. Co-morbidconditions were present in 48 (18.2%) of cases. Ulcerogenic substance intake was in177 (67%) patients. One hundred and twenty two (46.2%) patients reported to hospitalwithin 24 hours of perforation. There were 287 (88%) duodenal, 22 (7.1%) prepyloric,and 19(4.9%) type 1 gastric ulcer perforations. Simple closure with omental patch wasperformed in 299(94.3%), truncal vagotomy and drainage in 10 (3.2%), and Billroth IIpartial gastrectomy in seven (2.2%). Post-operative complications occurred in 62 (19%);overall mortality was 36 (11%). Logistic regression analysis of the patients clinicalvariables showed that age less that 60 years (p-value, OR and 95% CI; 0.002, 3.964 and1 .668-9.420), duration of perforation of more than 24 hours before admission (p-value,OR and 95%CI; 0.011,2.471 and 1.228-4.971), alcohol intake (p-value, OR and 95%CI;0.009, 2.543 and 1.259-5.135) and resectional surgery (p-value, OR and 95%CI; 0.000,8.25E and 74204908.138-9162648048.1) were statistically significant in determining postoperativecomplications. Age 60 years and above (p-value, OR and 95%CI; 0.018,4.359and 1.284-14.802), alcohol intake (p-value, OR and 95%CI; 0.042, 3.238 and 1.046- 10.021)and resectional surgery (p-value, OR and 95% CI; 0.000, 1.20E and 938112920.94- 1.54E+11) were the factors that showed statistical significance in determining post-operativemortality.Conclusion: Perforated peptic ulcer disease is emerging as a frequent cause of acuteabdomen in our centre and affects the youth commonly. Age 60 years and above,duration of perforation for more than 24 hours before admission, alcohol intake andresectional surgery were the variables that showed statistical significance in predictingpost-operative morbidity and/or mortality
Polio Outbreak Response in Ethiopia
No full textBackground: Ethiopia had been polio-free for almost four years until December 2004. However, between December 2004 and February 2006, 24 children were paralysed as a result of infection with wild poliovirus imported from the neighbouring country of Sudan. In response, the country has attempted to document the impact of various response measures on the containment of wild poliovirus transmission.Objectives: This study aims at systematic and epidemiological assessment of the extent of the outbreak, its determinants, and the lessons learned as well as the implications for future control strategies to interrupt wild poliovirus transmission.Design: A cross-sectional study design with qualitative and quantitative data collection approaches was used to conduct the epidemiologic assessment.Subjects: All confirmed wild poliovirus cases, and reported acute flaccid paralysis cases in close proximity to the confirmed polio cases were the study subjects. Child caretakers and health service providers were interviewed as part of the investigation.Results: Between December 2004 and February 2006, eight children from Tigray Regional State, nine children from Amhara Regional State and seven children from Oromia Regional State were paralysed as a result of infection with wild poliovirus type 1. Genetic sequencing demonstrated two separate importations to Ethiopia. Risk factors that may have facilitated spread of the outbreak within the country included gaps in vaccination coverage and interruption of the cold chain system, gaps in acute flaccid paralysis surveillance performance, high population mobility, poor environmental sanitation, crowded living conditions and unsafe drinking water. In response to the outbreak, Ethiopia conducted detailed outbreak investigations within two days of confirmation of the index cases. Large-scale, house-to-house vaccination campaigns were also implemented. As a result, the three regions interrupted the wild poliovirus transmission within the regions withinone year of confirmation of the index case.Conclusion: Outbreak response activities were successful in interrupting the imported wild poliovirus transmission in Tigray, Amhara and Oromia Regional States of Ethiopia within a oneyear period of time. In Ethiopia, programme strategies should be intensified to contain further spread and prevent future importation of wild poliovirus. Large-scale immunisation campaigns should reach every child, including those isolated by geography, poverty and security
VISCERAL LEISHMANIASIS IN NORTHERN ETHIOPIA
No full textBackground: Visceral leishmaniasis (VL) has been well documented by the Medecins sans Frontieres (MSF) VL treatment programmeme in the Tigray region of Ethiopia, but reports are limited from other facilities in this region where this disease continues to cause substantial morbidity and mortality.Objective: To describe the clinical manifestations and treatment outcomes of VL in a government hospital in Axum, Ethiopia.Design: Retrospective analysis of 111 patients treated for visceral leishmaniasis.Setting: Saint Mary’s Hospital, Axum, Ethiopia.Subjects: One hundred and Eleven patients treated for visceral leishmaniasis in a government hospital in Axum, Ethiopia.Results: All patients were male and most reported travel history to Humera, a known endemic area. Patients presented with classic signs and symptoms, including fever, weight loss, splenomegaly and anaemia. Almost one third (15/53) of patients who underwent HIV testing had a positive result. Crude death rate at six months was 13.5 per 100 patients (95% CI: 6.7 - 20.3 per 100patients). Presence of HIV and other co-infections were associated with increased risk of death.Conclusions: Clinical manifestations and treatment outcomes in this setting were comparable to that of the MSF programmeme in Tigray, Ethiopia and highlight the importance of HIV testing for patients presenting with visceral leishmaniasis
MAXILLARY INCISOR ROOT FORMS IN ORTHODONTIC PATIENTS IN NAIROBI, KENYA
No full textABSTRACTObjective: To evaluate, radiographically, the root forms of maxillary incisors in a sampleof patients seeking orthodontic treatment in Nairobi, Kenya.Design: A retrospective study of maxillary incisor root forms based on periapicalradiographs.Setting: A private dental clinic in Nairobi, Kenya.Materials and Methods: The study comprised 393 maxillary incisors in 100 consecutivesubjects(51 boys, 49 girls) aged 9-24 years. Intra-oral periapical radiographs of theincisors were evaluated. An index was used to categorise the roots as follows: 0=normal,1=short, 2-blunt, 3=apical bend, 4=pippete apex.Results: Normal root form was recorded in 60%, short in 12.5%, blunt in 7%, apicalbend in 13%, and pippete-apex in 7% of the roots. Sixty nine percent of the pippeteapexroots were in central incisors and 94% of the roots with apical bend were in lateralincisors. Seventy three percent of short roots were in females.Conclusion: Based on evidence from previous studies on risk of root resorption whichindicates that pipette and blunt roots are the forms mostly involved in this phenomenon,the present data imply that about 14% of the roots may have been at risk of moderateto severe resorption during fixed orthodontic treatment
PLASMA LIPID PROFILES IN NIGERIANS WITH NORMAL BLOOD PRESSURE, HYPERTENSION AND OTHER ACQUIRED CARDIAC CONDITIONS
No full textABSTRACTBackground: The attention of researchers has recently been drawn to the changing lipid pattern inthe Nigerian African because of diet and changing lifestyles. With increasing awareness of systemichypertension and the role of cholesterol in ischaemic heart disease, indiscriminate emphasis hasbeen placed on the reduction of fat intake and total calorie intake in every patient who has anyform of heart disease.Objective: To assess and demonstrate any association between abnormal lipid profile and someacquired cardiovascular diseases, which confer relevance of dietary cholesterol restriction.Design: A cross-sectional study.Setting: Cardiology clinic, University of Benin Teaching Hospital.Subjects: One hundred and twenty two patients (59 males and 63 females) who attended thecardiology clinic in the month of May 2001.Results: The results revealed significant hyperlipidaemia in three groups of Nigerian patients withacquired heart disease: the hypertensive with or without hypertensive heart disease (HHDx), thepatient with ischaemic heart disease (IHD), and those with hypertrophic cardiomyopathy (HCM).Rheumatic heart disease (RHD) and dilated cardiomyopathy (DCM) had lower cholesterol levelsthan the normotensives.Concusion: This study has demonstrated that not all acquired cardiovascular diseases are associatedwith hyperlipidaemia. Intervention studies may therefore be needed to examine the benefits oradverse effects of dietary restriction in such conditions
VALIDATION OF REPORTS OF NODULES DLSSOLUTION AITER REPEATED IVERMECTIN TREATMENT OF ONCHOCERCIASIS IN SOUTElEASTERN NIGERIA
No full textObjective: To ascertain the validity of the claims by villagers in endemic communitie insoutheastern Nigeria that repeated ivermectin treatment cause disappearance or dissdutionof onchocercal nodules.Design: From baselie epidemiological data, four communities (Amum, Aku, NzeremIkpem and Awuchinimo) were randomly chosen as the study sites. A total of 324 adults(hitherto had onchocercal nodules), aged 2 24 years from these communities were enlistedin the study. After clinical examination, each of the villager was interviewed with structured,pre-tested questionnaire. Also personal and focus group discussion was held.Results: Sixty nine (21.30%) respondents; 16.67% from Amuro, 32.26% from Aku, 19.05%from Nzerem Ikpem and 15% from Awuchnimo elaimed that their nodules graduallydissolved or disappeared. A significant (pd.05) proportion (82.61%) attributed thisphenomenon to repeated doses of ivermectin, 4.35% claimed it was not due to ivermectintherapy while 13.04% were not sure of the cause.Conclusion: The results have opened challenges in our understanding of the role ofivermectin therapy in endemic communities and calls for further studies of nodule dissolutionm other onchocerciasis endemic communities
MANAGEMENT OF TRACHEO-BRONCHIAL FOREIGN BODIES IN CHILDREN
Get PDFObjectives: To review alternative surgical and anaesthetic options in the managementof foreign bodies lodged in the tracheobronchial tree in children aged below 10 years.Design: A five year retrospective secondary data analysis.Setting: Three hospitals based in Eldoret Municipality, Kenya.Main outcome measures: Outcome variables included morbidity and mortality.Results: Of the thirty two children studied, 74.1% had bronchoscopy and 25.9%thoracotomy. The overall mortality rate was 3.3%.Conclusion: Foreign bodies in the tracheo-bronchial tree are a major cause of morbidityand mortality in children aged below 10 years. In settings where appropriate equipmentis inadequate, timely thoracotomy may be life saving