Student's Journal of Health Research Africa
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Prevalence and associated factors of severe malaria-hemoglobinuria among children below 15 years: A retrospective cross-sectional study at a tertiary regional referral hospital in Uganda.
Full text linkBackground:
The World Health Organization (WHO) report of 2022 showed that Uganda accounted for 5.1% of the global case burden. Severe malaria presenting with hemoglobinuria is characterized by tea coloured urine, jaundice, and anemia. This study aimed to understand the prevalence and associated factors of severe malaria-hemoglobinuria among children below 15 years admitted to a tertiary hospital in Uganda.
Methods:
A retrospective study that involved reviewing patient files of children aged 15 years and below admitted at Kayunga regional referral hospital in Uganda during 2023. Data was extracted using a standardized checklist developed according to the WHO 2015 clinical surveillance criteria for severe malaria. Sociodemographic, clinical, and laboratory data were collected and analyzed using Stata 18. Logistic regression analysis was used to evaluate the factors associated with severe malaria-hemoglobinuria. A p-value <0.05 indicated statistical significance.
Results:
The prevalence of severe malaria-hemoglobinuria was 27.7% with the majority (48.2%) in the age group of 5-9 years. Males were the majority (54.7%). The associated factors of severe malaria-hemoglobinuria were hyperparasitemia (p-value=<0.001), convulsions (p-value=0.051), and anemia (p-value=0.012). The mortality rate among the study participants was 1.4%. The average hospitalization duration for patients was 3 days. There was no difference in mortality and duration of hospital stay among patients who received standard treatment alone versus those who received an adjuvant like steroids.
Conclusions:
The prevalence of severe malaria-hemoglobinuria was 27.7% higher than in earlier studies in central Uganda, with the overall mortality rate of 1.4%. Hyperparasitemia, anemia, and convulsions were the associated factors. The higher prevalence among children aged 5 and above highlights the need for enhanced surveillance and targeted interventions in this age group to improve outcomes in similar settings.
Recommendation:
Further prospective studies are recommended to explore causal relationships and optimize care strategies
The overlooked triad: interrelationship between diabetes mellitus, diabetic foot, and acute diarrhoea. A systematic review of clinical and pathophysiological correlates.
Full text linkBackground:
Diabetes mellitus (DM) and its complications, particularly diabetic foot disease (DFD), substantially increase morbidity through vascular, immune, and microbiome dysfunction. Acute diarrhoeal illnesses, including Clostridioides difficile infection (CDI), antibiotic-associated diarrhoea (AAD), and cholera, can further destabilize metabolic and infectious trajectories in diabetic patients. Despite this overlap, integrated evidence on their interrelationship remains limited.
Objective:
To systematically evaluate current evidence on (1) the role of diabetes as a risk factor for CDI and other diarrhoeal diseases; (2) the impact of antibiotic exposure and metabolic instability on outcomes; (3) the potential protective effect of metformin therapy; and (4) the broader clinical implications for diabetic foot and inpatient management.
Methods:
Following PRISMA-2020 guidelines, open-access observational studies were identified in PubMed, DOAJ, PMC, Google Scholar, and OpenAIRE up to July 2025. Eligible studies included adults (≥18 years) with DM experiencing diarrhoeal illness. Outcomes analyzed were CDI incidence or recurrence, AAD occurrence, in-hospital mortality, and length of stay (LOS). Quality was assessed using the Newcastle–Ottawa Scale (NOS).
Results:
Six studies (2011–2024) met the inclusion criteria. Diabetes independently increased CDI risk and recurrence (OR ≈ 2.0–2.5), with antibiotic and PPI exposure as key cofactors. “4C” antibiotic use in diabetic foot ulcer patients quintupled CDI risk. Metabolic decompensation, such as diabetic ketoacidosis (DKA), significantly elevated mortality (5.8 % vs 2.7 %) and LOS. Conversely, metformin therapy reduced CDI odds by ~42 %, likely through gut-microbiota modulation. Diabetic patients with cholera showed prolonged hospitalization (IRR ≈ 2.0) without excess mortality. NOS scores (6–8/9) indicated moderate–high methodological quality.
Conclusion:
Diabetes amplifies susceptibility and worsens outcomes of CDI and related enteric infections, while metformin may offer partial protection. Incorporating glycaemic optimization, antibiotic stewardship, and microbiome-preserving strategies into diabetic care could mitigate infection-related morbidity and healthcare burden
Histopathological Spectrum of Gastric Biopsies in Patients with Chronic Dyspepsia: A Cross-Sectional Observational Study.
Full text linkBackground:Chronic dyspepsia remains one of the most common gastrointestinal complaints, with etiologies ranging from benign inflammatory changes to premalignant and malignant conditions.
Objectives:
To determine the histopathological spectrum of gastric mucosal lesions in patients presenting with chronic dyspepsia and to evaluate the correlation of H. pylori infection with histopathological patterns.
Methods:
This cross-sectional observational study was conducted on 50 patients with chronic dyspepsia who underwent upper gastrointestinal endoscopy at a tertiary care hospital. Gastric biopsies were obtained primarily from the antrum and processed for histopathological examination using hematoxylin and eosin staining. Modified Giemsa stain was used for the detection of H. pylori. Data were analyzed using descriptive statistics and chi-square test, with p < 0.05 considered significant.
Results:
The mean age of the study population was 44.6 ± 12.4 years, with a male-to-female ratio of 1.3:1. The antrum was the predominant site of biopsy (68%). Chronic non-specific gastritis (44%) was the most common histological finding, followed by chronic active gastritis (22%), reactive (chemical) gastropathy (6%), atrophic gastritis (4%), intestinal metaplasia (4%), and gastric adenocarcinoma (4%). Helicobacter pylori was detected in 28% of cases, showing a statistically significant association with chronic active and atrophic gastritis (χ² = 9.84; p = 0.021). Overall, inflammatory lesions constituted 78%, premalignant lesions accounted for 8%, and malignant lesions comprised 6% of the total biopsies.
Conclusion:
Chronic gastritis, predominantly involving the antrum, was the leading cause of dyspepsia. The significant association of H. pylori with chronic active and atrophic gastritis highlights its pivotal role in gastric mucosal injury and carcinogenic transformation.
Recommendations:
Routine gastric biopsies with H. pylori detection should be incorporated in all patients with persistent dyspepsia. Early eradication therapy, histological surveillance for atrophic or metaplastic changes, and lifestyle modifications may reduce progression to malignancy
Anaesthetic management and surgical debridement of Fournier’s gangrene in a 65-year-old male in acute decompensated heart failure in a resource-limited tertiary hospital: A case report.
Full text linkEmergency surgical interventions in patients with significant cardiovascular comorbidities present complex anaesthetic challenges, particularly in resource-limited settings. Fournier’s gangrene is a rapidly progressive necrotising infection that requires urgent surgical debridement. This further complicates the management of severe cardiac dysfunction.
This case report presents the anaesthetic management of a 65-year-old male patient with Fournier’s gangrene and acute heart failure. He had dilated cardiomyopathy with an ejection fraction of 26%, with comorbid atrial fibrillation, obesity, hypertension, diabetes, and sepsis. He presented in respiratory distress, renal impairment, and, functionally, New York Heart Association Class IV.
A right radial arterial line and an internal jugular central line were inserted, with a low-dose dobutamine infusion initiated before induction. He was induced slowly with etomidate and midazolam, with fentanyl and lignocaine given for blunting the sympathetic response. Sevoflurane was used for maintenance of anaesthesia, with inotropic support in the form of adrenaline added intra-operatively. Fluid requirements were 11.7ml/kg. He remained intubated and transferred to the ICU, where inotropes were weaned off, and respiratory recovery was achieved. He improved and was followed up post-operatively over a period of three months.
The case illustrates that optimal outcomes are achievable in patients with severe heart failure and sepsis through careful pre-operative optimisation, judicious induction, appropriate inotropic support, and postoperative critical care, in a resource-limited environment
platelet-rich plasma versus topical 5% minoxidil in the treatment of androgenetic alopecia: A comparative observational study.
Full text linkBackground:Androgenetic alopecia is the most common cause of patterned hair loss in both men and women and has a significant psychosocial impact. Platelet-rich plasma (PRP) therapy has gained attention as a regenerative treatment, while topical 5% Minoxidil remains the conventional first-line therapy.
Objectives:
To compare the efficacy and safety of PRP therapy versus topical 5% Minoxidil in patients with androgenetic alopecia over 12 weeks.
Methods:
This comparative observational study included 50 patients with androgenetic alopecia, allocated into two groups: PRP (n = 25) and topical 5% Minoxidil (n = 25). PRP was administered through four intradermal sessions at three-week intervals, while Minoxidil was applied twice daily for 12 weeks. Outcomes assessed were change in hair density (hairs/cm²), patient satisfaction using a 5-point Likert scale, dermatologist global assessment, and adverse effects. Statistical analysis was performed, with p < 0.05 considered significant.
Results:
Baseline demographic and clinical parameters were comparable between groups. At 12 weeks, the PRP group demonstrated a significantly greater increase in mean hair density (18.4 ± 4.6 hairs/cm²) compared with the Minoxidil group (10.2 ± 3.9 hairs/cm²; p < 0.01). Patient satisfaction scores were higher in the PRP group (4.1 ± 0.7) than in the Minoxidil group (3.2 ± 0.8; p < 0.01). Moderate to marked clinical improvement was observed in 68% of PRP-treated patients compared with 36% in the Minoxidil group. Adverse effects were mild and transient in both groups.
Conclusion:
PRP therapy showed superior improvement in hair density and patient satisfaction compared with topical 5% Minoxidil over 12 weeks, with good tolerability.
Recommendations:
PRP may be considered an effective therapeutic option for early to moderate androgenetic alopecia, either as monotherapy or as an adjunct to topical Minoxidil. Larger studies wit
The prevalence of Neisseria gonorrhoeae in KwaZulu-Natal: A retrospective cross-sectional analysis of laboratory-confirmed cases.
Full text linkBackground:
Neisseria gonorrhoeae remains a public health challenge in South Africa. This challenge is exacerbated by antimicrobial resistance and under-reporting, especially among women and neonates. Surveillance targets adult populations. Neonatal infections are rarely documented. Reliance on syndromic treatment without laboratory confirmation leads to undetected infections and the spread of resistant strains. This results in adverse long-term health outcomes and increased healthcare costs. Laboratory data from the National Health Laboratory Service provides a complementary source for surveillance.
Aim:
To describe the demographic, temporal, and facility-level distribution of laboratory-confirmed N. gonorrhoeae cases in KwaZulu-Natal during 2024.
Methods:
A retrospective cross-sectional analysis of all laboratory-confirmed cases of N. gonorrhoeae diagnosed at public healthcare facilities in KZN between January 2024 and December 2024. Data included patient age, sex, specimen source, healthcare facility, diagnosis date, and temporal trends were summarised using descriptive statistics. GeneXpert® CT/NG assay was used for laboratory confirmation.
Results:
Twenty-two laboratory-confirmed cases were identified. The median patient age was 26 years. Interquartile Range: 4 days–47 years, with neonates (<10 days old) comprising 27% (n = 6) of cases. Males accounted for 55% (n = 12). McCord’s Hospital reported the highest proportion (45%) (n = 10) of cases, followed by Addington Hospital (18%) (n = 4). A temporal cluster occurred in July 2024, affecting 27% (n = 6) of cases. Most specimens were pus samples (81%; n = 18).
Conclusions:
The high proportion of neonatal cases indicates failures in antenatal screening and prevention of mother-to-child transmission, leading to ophthalmia neonatorum. Facility clustering suggests unequal diagnostic capacity across KZN. Reliance on syndromic management may mask the true burden and economic impact of the disease.
Recommendations:
Strategic integration of laboratory-confirmed data can complement syndromic approaches, improve surveillance strategies, and inform targeted public health interventions
Relationship between Tei index and prognosis in patients with non-ST-segment elevation myocardial infarction: A prospective cohort study.
Full text linkBackground:
Non-ST-segment elevation myocardial infarction (NSTEMI) constitutes a diverse subgroup of acute coronary syndromes characterised by inconsistent short-term outcomes. Early prognostic evaluation is crucial for enhancing management techniques. The Tei index, a Doppler-derived myocardial performance indicator, combines systolic and diastolic ventricular function and might provide additional prognostic value.
Objective:
To assess the correlation between the Tei index and in-hospital clinical outcomes in individuals with non-ST-segment elevation myocardial infarction.
Methods:
This prospective cohort research comprised 160 patients diagnosed with non-ST-segment elevation myocardial infarction. Transthoracic echocardiography was conducted within 48 hours of admission to ascertain the Tei index. Patients were monitored during hospitalisation for negative clinical outcomes.
Results:
Greater Tei index values were strongly linked to greater rates of heart failure, arrhythmias, cardiogenic shock, longer hospital stays, and deaths in the hospital. In multivariate analysis, the Tei index was identified as an independent predictor of negative in-hospital outcomes.
Conclusion:
The Tei index is a straightforward, non-invasive echocardiographic metric that autonomously forecasts short-term outcomes in individuals with non-ST-segment elevation myocardial infarction.
Recommendations:
Regular measurement of the Tei index during the initial echocardiographic assessment of patients with non-ST-segment elevation myocardial infarction may enhance risk classification and inform early therapeutic decision-making
A cross-sectional study on knowledge of the lactating mothers aged 15- 19 towards exclusive breastfeeding in the postnatal clinic at Wakiso Health Centre IV.
Full text linkBackground.
Exclusive breastfeeding is when the infant receives only breast milk and no other foods or fluids, not even water, except oral rehydration solution or syrups containing vitamins, minerals, or medicines, when necessary. This study assessed the knowledge of the lactating mothers aged 15- 19 towards exclusive breastfeeding in the postnatal clinic at Wakiso Health Centre IV.
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.
25(69.4%) of the participants were aged 19 years while the least 1(2.8%), 20(55.6%) of the participants had secondary level of education, 97.2% of the participants had ever heard of EBF, 33.3% did not know the ideal period for EBF, 50% believed EBF is not sufficient for a baby up to 6 months, 25(69.4%) of the respondents mentioned nutritional benefit as the benefit of EBF and 29(91%) of the respondents reported health professional as their source of information about EBF
Conclusion.
Adolescent mothers at ERRH generally have good knowledge about exclusive breastfeeding (EBF), primarily sourced from healthcare professionals.
Recommendations.
Expanding education on EBF, especially in antenatal and postnatal care, to address misconceptions and reinforce the six-month duration as essential for infant health
Screening for Cervical Pathologies in Antenatal Women Using Pap Smear at First Visit in a Tertiary Care Hospital: A Prospective Observational Study.
Full text linkBackground
Cervical cancer remains one of the leading causes of morbidity and mortality among women in India. Despite the proven effectiveness of early detection through Pap smear screening, uptake remains limited, particularly during pregnancy a period that offers an ideal opportunity for screening and education.
Objectives
To assess the prevalence of cervical pathologies among antenatal women attending their first antenatal visit using Pap smear screening and to identify the frequency of pre-malignant and malignant cervical lesions.
Methods
This prospective observational study included 200 pregnant women attending their first antenatal visit at Niloufer Hospital, Hyderabad, between April 2021 and October 2022. After informed consent, Pap smears were collected and interpreted using the Bethesda 2001 classification. Demographic and obstetric profiles were recorded.
Results
The mean age was 26.05 ± 6.66 years; 69% were illiterate, and 57.5% were housewives. Pap smear findings revealed inflammatory smears in 37.5%, ASC-US in 10%, LSIL in 4%, and HSIL in 2.5%. Reactive cellular changes were noted in 8.5%, while 35% had normal cytology. The prevalence of pre-malignant lesions (LSIL and HSIL combined) was 6.5%. Only 3.5% of samples were unsatisfactory. Most participants were unaware of cervical screening and belonged to low socioeconomic backgrounds.
Conclusion
Pap smear screening during antenatal visits is both feasible and valuable for detecting cervical abnormalities in underserved populations. A notable prevalence of 6.5% pre-malignant lesions highlights the importance of early detection. Integrating Pap smear into routine antenatal care offers a strategic opportunity to improve awareness, initiate timely referrals, and reduce the burden of cervical cancer.
Recommendations
Integrate routine Pap smear screening into antenatal care to enhance early detection of cervical lesions, improve awareness, and ensure timely referrals, especially among underserved and low-literacy populations
Comparative study of collagen sheet versus paraffin gauze with silver sulfadiazine cream dressing for superficial partial thickness burn wounds: A Cross- Sectional Study.
Full text linkBackground
It has been observed that a major health issue that generally affects both children and adults is burns. The superficial dermal layer and the epidermal skin layer are both impacted by superficial burns. In cases of deep or full-thickness burns, deeper dermal tissues, including blood vessels and nerves, may sustain damage.
Objectives
The need to conduct the study was mainly to compare the effectiveness of collagen sheet vs SSD with paraffin gauze dressing clinically for superficial partial thickness burn management.
Materials and Methods
It was a cross-sectional study. The study was carried out at the Department of Plastic and Reconstructive Surgery, Patna Medical College and Hospital (PMCH), Patna, Bihar, India. The study took place for one year, i.e., from October 2023 to October 2024. In all, 30 participants were enrolled. Twenty patients received traditional SSD with paraffin gauze dressing, while ten patients received collagen dressing.
Results
The study included 30 patients (mean age 32.5 ± 8.4 years; 60% male, 40% female; mean burn size 8.6% TBSA), with collagen dressing showing significantly fewer dressing changes, reduced analgesic use, faster healing, and lower infection rates compared to SSD with paraffin gauze. In most cases, Group B patients needed analgesic treatment for a week or longer, whereas Group A patients needed oral analgesics for two to three days. Following three weeks of monitoring, every incision had fully healed.
Conclusion
The study found that when it came to treating superficial partial thickness burns, collagen sheet dressing worked better than SSD with paraffin gauze.
Recommendation
Collagen dressing is recommended as a superior alternative to SSD with paraffin gauze for managing superficial partial thickness burns due to its faster healing and reduced patient discomfort