Student's Journal of Health Research Africa
Not a member yet
1618 research outputs found
Sort by
A prospective cross-sectional observational study of the prevalence and risks for laryngospasm in paediatric patients in four government-funded hospitals in KwaZulu-Natal, South Africa.
Full text linkBackground:
Laryngospasm (LS) is a common paediatric anaesthetic respiratory adverse event associated with serious complications if not detected and treated timeously.
Methods:
A prospective observational cross-sectional study was conducted from 15 May to 4 August 2023 in four government-funded hospitals in KwaZulu-Natal, South Africa. The primary outcome measure was the prevalence of laryngospasm, and a further aim was to identify associated factors, using binary logistic regression analyses.
Results:
905 participants were recruited. Mean patient age was 4.2 (SD ± 3.7) years. Most children were ASA physical status I and II (77.7%), presenting for elective surgery. The commonest comorbidity was an ‘airway anomaly’ (12.8%), followed by current or recent upper respiratory tract infection (URTI) in 11.6% of patients. The prevalence of laryngospasm was 10.1% and most occurred at emergence (54.9%). And 69.2% of children with LS had desaturation <91%. Risks independently associated with LS were age (2 to 5 years; adjusted odds ratio [aOR] 2.15, p0.026), an URTI (aOR 2.58, p=0.004), absence of a specialist in theatre (aOR 11.67, p<0.001), inhalational induction (aOR 10.21, p=0.004) or co-induction (aOR 6.34, p=0.020), use of a supraglottic airway device(SGAD) (aOR 2.17, p=0.022), inadequate depth of anaesthesia (aOR 13.98, p<0.001), non-use of neuromuscular blocker (aOR 4.64, p=0.010), and airway (aOR 2.27, p=0.031) and urological surgeries (aOR2.75, p=0.013. No children had a serious complication, although two children were admitted to high care.
Conclusion:
The prevalence of LS in this study was 10-fold higher than in high-income countries, and the presence of a specialist anaesthetist is protective, indicating the importance of training in the reduction of perioperative critical events in children.
Recommendations:
Anaesthetists should be aware of the independent risk associated with laryngospasm as identified in this study and ensure such children are managed by a specialist anaesthesiologist
Factors influencing exclusive breastfeeding among lactating mothers aged 15-19 years attending the postnatal clinic at Entebbe regional referral hospital in Wakiso district. A cross-sectional study.
Full text linkBackground.
EBF is a global health priority due to its proven benefits for both infant survival and maternal well-being; however, its practice remains minimal in many regions, particularly among adolescent mothers. This study determined the factors influencing exclusive breastfeeding among lactating mothers aged 15-19 years attending the postnatal clinic at Entebbe regional referral hospital in Wakiso district.
Methodology.
A quantitative descriptive cross-sectional study design was used to select 36 mothers using a simple random sampling method, collecting data using a structured questionnaire. Data was analyzed using SPSS computer programs for presentation of tables and figures. Responses for open-ended questions were summarized and given themes before tallying them for analysis.
Results.
18(50%) of the study participants were self-employed, and 52.8% of the respondents were Baganda tribe. 20(55.6%) of the respondents reported to receive breastfeeding counselling at the health facility, 28(77.8%) of the respondents that their hospital stays when receiving proper breast-feeding education and support was sufficient, 26(72.2%) of the respondents said there was no any promotion of formula supplementation at the health facility, 20(55.6%) of the respondents had 3 and more antenatal visits, 18(50%) of the respondents reported that sometimes cultural or social background affect the decision to exclusively breastfeed and 18(50%) of the respondents were never concerned about the image of their babies due to EBF.
Conclusion.
Health facility support, particularly through antenatal counseling and hospital policies that discourage formula supplementation, plays a key role in promoting EBF.
Recommendation.
Providing follow-up EBF counseling after hospital discharge, through phone calls or community health workers, to assist adolescent mothers in maintaining EBF
Pattern and risk factors of acute respiratory infections in children under five years: A hospital-based cross-sectional observational study.
Full text linkBackground:
Acute respiratory infections (ARIs) remain one of the leading causes of morbidity and hospitalization among children under five years, particularly in low- and middle-income countries. Identifying demographic, environmental, and nutritional risk factors is essential to guide preventive strategies and optimize health outcomes.
Objectives:
To determine the clinical pattern and assess the key risk factors associated with acute respiratory infections in children under five years of age attending a tertiary care hospital.
Methods:
A hospital-based observational study was conducted among 100 children aged below five years clinically diagnosed with ARI. Data were collected using a structured proforma covering demographic details, clinical presentation, nutritional and immunization status, and environmental conditions. Statistical analysis was performed using descriptive measures and percentage distribution.
Results:
The majority of cases occurred in the 1–3-year age group (46%), with males (58%) slightly predominating. Upper respiratory tract infections (64%) were more frequent than lower respiratory infections (36%). The most common presenting symptoms were cough (94%), fever (86%), and nasal discharge (72%). Undernutrition was identified in 42% of children, and 58% belonged to the lower socioeconomic class. Major risk factors included indoor air pollution (68%), overcrowding (52%), passive smoking (36%), and lack of exclusive breastfeeding (46%). Incomplete immunization was observed in 28%, and low birth weight (<2.5 kg) in 34%. ARI incidence peaked during the monsoon and winter months (62%). The mean hospital stay was 4.6 ± 2.1 days, with full recovery in 92% of cases and no mortality reported.
Conclusion:
Acute respiratory infections in children were predominantly associated with modifiable risk factors such as undernutrition, indoor air pollution, overcrowding, and incomplete immunization. Most cases were mild and preventable through early intervention.
Recommendations:
Community-level interventions such as promoting exclusive breastfeeding, complete immunization, improvin
Prevalence and Clinical Correlates of Chronic Kidney Disease Among Hospital Admissions in KwaZulu-Natal: A Cross-Sectional Retrospective Laboratory Data Analysis
No full textBackground: Chronic kidney disease (CKD) is a non-communicable disease that causes a significant global health burden yet is commonly underdiagnosed among hospitalised patients, particularly in acute care facilities. Timely diagnosis is crucial in preventing disease progression and poor prognosis due to complications.
Aim: This study aimed to estimate the prevalence of CKD among hospital admissions and assess its relationship with clinical diagnoses and ward distribution, laboratory parameters in a referral hospital in South Africa.
Methods: A retrospective observational analysis was conducted using laboratory records from RK Khan Hospital in KwaZulu-Natal. All patients with documented serum creatinine levels and estimated glomerular filtration rates (eGFRs) were included in the study. CKD was defined as eGFR < 60 mL/min/1.73 m², calculated using either the MDRD or CKD-EPI equations. Demographic data, ward allocation, clinical diagnoses, and laboratory parameters were analysed descriptively.
Results: Analysis of the complete dataset (n=56) revealed that 39 patients (69.6%) met the criteria for CKD (eGFR < 60 mL/min/1.73m²). The highest prevalence was observed in the 45–59 age group (40%). The study population had a mean age of 47.5 years (range, 19-64 years). Admissions were primarily to the Intensive Care Unit (57.1%), followed by the outpatient and emergency departments. Among CKD patients, the most common comorbid diagnoses were pneumonia and septicaemia. Severe renal impairment (eGFR < 30 mL/min/1.73m²) was present in 28.6% of cases, and frequent electrolyte disturbances, including hyperkalemia and metabolic acidosis, were observed.
Conclusion: CKD is notably prevalent among hospitalized patients, particularly those admitted with infectious diseases or critical illnesses. These observations underscore the importance of systematic renal function surveillance and timely therapeutic interventions in high-risk clinical settings, such as intensive care units and emergency departments. The integration of standardized CKD screening protocols into routine hospital care may help mitigate disease progression and improve clinical outcomes
Knowledge, Attitude and Practice of Pharmacovigilance among Prescribers in a Tertiary Care Hospital
Full text linkBackground:Pharmacovigilance plays a pivotal role in ensuring medication safety by detecting, assessing, and preventing adverse drug reactions (ADRs). Despite being a professional and ethical responsibility, ADR reporting remains suboptimal worldwide, particularly among undergraduate prescribers.
Objectives:To assess the level of knowledge, attitude, and practice regarding pharmacovigilance among MBBS student prescribers in a tertiary care hospital and to identify key barriers contributing to under-reporting of ADRs.
Methods:A descriptive, cross-sectional, questionnaire-based study was conducted among 150 MBBS students actively involved in prescription writing during clinical postings. Data were collected using a validated 20-item KAP questionnaire covering fundamental concepts of pharmacovigilance, attitudes toward ADR reporting, reporting practices, and perceived barriers. Data were analyzed using descriptive statistics and presented as frequencies and percentages.
Results:Among the participants, 112 (74.7%) were aware of the term pharmacovigilance, and 98 (65.3%) correctly identified its primary objective as the detection and prevention of ADRs. A positive attitude was observed, with 124 students (82.7%) acknowledging ADR reporting as a professional obligation and a vital component of patient safety. However, practical engagement was limited, as only 18 students (12%) had ever reported an ADR. The major barriers identified were lack of knowledge regarding reporting procedures (44.6%), difficulty in diagnosing ADRs (32%), time constraints (14%), and non-availability of reporting forms (9.3%).
Conclusion:Although MBBS prescribers demonstrated satisfactory knowledge and a favorable attitude toward pharmacovigilance, actual ADR reporting practice was notably poor. This highlights a significant knowledge–practice gap that requires targeted educational and system-level interventions.
Recommendations:Incorporating structured pharmacovigilance training into the undergraduate curriculum, conducting regular hands-on workshops on ADR identification and reporting, integrating ADR reporting into routine clinical teaching, and implementing user-friendly digital reporting platforms are strongly recommended to improve reporting behavior and enhance patient safety.
Keywords: Pharmacovigilance; Adverse Drug Reactions; Knowledge–Attitude–Practice; MBBS student
Critical Review of Commercial Influences, Ethical Concerns, and Impact on Rational Healthcare
Full text linkMedical conferences in India have evolved from small academic gatherings to large-scale events attracting thousands of participants. While ostensibly serving as platforms for continuing medical education (CME) and knowledge dissemination, these conferences increasingly reflect the commercial interests of pharmaceutical companies and other healthcare industry stakeholders. This critical review examines the current landscape of medical conferences in India, analyzing the extent of pharmaceutical industry involvement, associated ethical concerns, regulatory frameworks, financial implications, and the impact on rational prescribing and healthcare delivery. Through examination of existing literature, regulatory guidelines, and documented cases from the Indian context, this article argues that many medical conferences have transformed into marketing platforms that prioritize commercial interests over genuine academic advancement, raising serious questions about medical professionalism and patient welfare
Profile of Primary Angle Closure Disease
Full text linkBackground
Glaucoma is the second most common cause of visual morbidity after Cataract. The purpose of the study is to assess the demographic and clinical profile of Primary Angle Closure Disease (PACD) and to evaluate the risk factors associated.
Method
A prospective observational study including 97 eyes of 50 patients above 40 years, with PACD at a tertiary health care centre. Aphakia, Pseudophakia, previous ocular surgery, secondary glaucoma, and ocular pathology subjects were excluded. Detailed glaucoma workup, slit-lamp examination (VH Grading), Gonioscopy, ocular biometry (Axial Length, Anterior chamber depth, lens thickness) were recorded. All patients diagnosed with PACD were prospectively categorized into three subgroups, namely Primary Angle Closure suspect (PACS), Primary Angle Closure (PAC), and Primary Angle Closure Glaucoma (PACG) using International Society of Geographical and Epidemiological Ophthalmology (ISGEO) Classification.
Results
Out of 50 subjects, 52% were males, and 58% urban residents. Mean age was 60.14±11.81 years in PACD. Out of the total 97 eyes, 39.2% (38 eyes) had PACS subtype, 38.1% (37 eyes) had PAC, and 22.7% (22 eyes) had PACG subtype. The mean standard value of axial length was22.03±0.62mm in PACS, 22.46±0.42mm in PAC & 22.41±0.71mm in PACG. Anterior chamber depth was 2.36±0.21mm in PACS, 2.33±0.12mm in PAC & 2.22±0.7mm in PACG subgroup. Lens thickness was 4.52±0.74mm in PACS, 4.54±1.07mm in PAC & 4.61±1.05mm in PACG subgroup.
Conclusion
PACS was the most common subgroup. Shallow anterior chamber, increased lens thickness, lesser axial length, and advancing age were the risk factors in PACD.
Recommendations
The present study highlights that screening of subjects can detect PACD at early stages and thus prevent potential blindness
A prospective comparative interventional study of diclofenac gel plus ormeloxifene versus diclofenac gel plus evening primrose oil in the treatment of mastalgia in benign breast diseases.
Full text linkBackground
Mastalgia, a common symptom of benign breast diseases, affects women's quality of life. This study aimed to compare the efficacy of diclofenac gel plus ormeloxifene versus diclofenac gel plus evening primrose oil in the treatment of mastalgia in benign breast diseases.
Methods
The study analyzed 100 female patients aged 18-45 with mastalgia in the Department of General Surgery at BRD Medical College, Gorakhpur, between 2023 and 2024. The patients were divided into two groups: Group A (diclofenac gel + ormeloxifene 30 mg twice weekly for 3 months) and Group B (diclofenac gel + evening primrose oil 1000 mg twice daily for 3 months).
Results
At baseline, both groups had comparable VAS scores (6.76 ± 1.45 in Group A vs. 6.40 ± 1.64 in Group B, p = 0.248). At 1 month, VAS scores decreased in both groups (4.30 ± 1.47 in Group A vs. 4.70 ± 1.66 in Group B, p = 0.205), with no significant difference. However, at 3 months, the VAS score reduction was significantly greater in Group A (1.36 ± 1.74) compared to Group B (2.84 ± 2.05) (p < 0.001), indicating superior pain relief with ormeloxifene. Intra-group analysis showed a significant reduction in pain over time in both groups (p < 0.001). A higher proportion of participants in Group A (76.00%) showed significant improvement compared to 40.00% in Group B (p = 0.001).
Conclusion
Ormeloxifene, when combined with diclofenac gel, demonstrated superior efficacy in reducing mastalgia symptoms compared to evening primrose oil, indicating its superior treatment option for benign breast diseases.
Recommendation
It recommends individualized treatment based on symptom severity, patient preference, and tolerance. Regular follow-up is recommended for pain relief, adherence, and side effects. Further large-scale studies are needed for validation and standardized treatment protocols
Knowledge, Attitude, and Practice of Fire Safety Systems and Preparedness among Healthcare Workers: A Cross-Sectional Study at a Tertiary Care Teaching Hospital in Navi Mumbai.
Full text linkBackground: Fire safety is a vital aspect of occupational health, especially in healthcare settings where the presence of vulnerable patients, complex equipment, and hazardous materials increases the risk of fire-related emergencies. Ensuring the safety of patients, staff, and infrastructure requires not only robust systems but also well-informed and adequately prepared healthcare personnel.
Objective: The primary aim of this study was to assess the level of awareness and preparedness regarding fire safety among healthcare professionals, focusing on three key domains: knowledge, attitude, and practice (KAP).
Methods: A cross-sectional, questionnaire-based study was conducted among healthcare staff in a tertiary care setting. The survey tool included items assessing participants’ theoretical knowledge (knowledge domain), perceptions and beliefs (attitude domain), and self-reported actions in simulated or real scenarios (practice domain). The collected data were analyzed to determine the proportion of correct versus incorrect responses in each domain.
Results: Out of the total participants, the attitude domain demonstrated the highest accuracy, with 77.04% of responses reflecting a positive and proactive approach to fire safety. The practice domain showed moderate accuracy (56.9%), indicating that while some practical preparedness exists, there is room for significant improvement. The knowledge domain revealed the greatest deficiency, with correct responses accounting for only 51.3%, underscoring substantial gaps in theoretical understanding of fire safety protocols such as S.A.V.E. (Shout, Activate alarm, Vacate, Extinguish) and R.A.C.E. (Rescue, Alarm, Confine, Extinguish/Evacuate).
Conclusion: Although healthcare professionals display commendable attitudes towards fire safety, there is a critical need to enhance both theoretical knowledge and practical preparedness. Regular, hands-on training programs, refresher courses, and mock drills should be implemented to foster a comprehensive fire safety culture within healthcare institutions.
Recommendations: Implement periodic fire safety training, practical simulations, and audits to strengthen knowledge, attitude, and emergency response among healthcare staff.
Association of absolute lymphocyte and cd4 T cell count ratio with outcome of HIV-negative TB meningitis patients- A longitudinal study.
Full text linkBackground
Tuberculous meningitis (TBM), the most severe form of tuberculosis, presents significant diagnostic and therapeutic challenges. Cellular immunity, particularly CD4+ T lymphocytes and absolute lymphocyte count (ALC), plays a critical role in host defense against Mycobacterium tuberculosis. However, the prognostic significance of ALC and CD4 counts in HIV-negative TBM patients remains underexplored in India.
Objective: To assess the association between absolute lymphocyte count and CD4 T cell count with clinical outcomes in HIV-negative TBM patients.
Methods
This was a longitudinal follow-up study conducted in the Department of Neurology, Himalayan Institute of Medical Sciences, Dehradun, over 2 years. A total of 53 HIV-negative adult TBM patients were enrolled and classified by TBM stage (I–III) and diagnostic certainty (definite, probable, possible) using MRC grading and Marais criteria, respectively.
Results
Among 53 patients, 23 were male and 30 were female. Females had significantly better outcomes (83.3% vs 47.8%, p = 0.006, RR = 2.36). Patients in earlier TBM stages had higher good outcomes: Stage I (85.7%), Stage II (78.7%), Stage III (30.7%) (p = 0.004). No statistically significant association was found between outcome and ALC (p = 0.424) or CD4 count group (p = 0.856), though trends favored better prognosis in patients with normal immune parameters. Duration of dexamethasone therapy and symptom onset also showed no significant impact on outcome.
Conclusion
While TBM stage and gender were significantly associated with clinical outcome, no definitive link was observed between ALC or CD4 count and prognosis in HIV-negative TBM patients. Further large-scale studies are warranted to validate the prognostic utility of immune markers in TBM.
Recommendations
To confirm the predictive significance of ALC and CD4 counts in HIV-negative TBM, future research should involve larger, multicenter cohorts.