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Coronavirus disease 2019 (COVID-19) Situation Report – 66
No full textThree new countries/territories/areas from the Region of the Americas [1], and African Region [2] have reported cases of COVID-1
Distinctive Features of Surface-Anchored Proteins of Streptococcus agalactiae Strains from Zimbabwe Revealed by PCR and Dot Blotting
No full textPost print original as published on http://cvi.asm.org/The distribution of capsular polysaccharide (CPS) types and subtypes (serovariants) among 121 group B
streptococcus (GBS) strains from Zimbabwe was examined. PCR was used for the detection of both CPS types
and the surface-anchored and strain-variable proteins C , C , Alp1, Alp2, Alp3, R4/Rib, and Alp4. The R3
protein was detected by an antibody-based method using monoclonal anti-R3 antibody in dot blotting. The CPS
types detected, Ia (15.7% of strains), Ib (11.6%), II (8.3%), III (38.8%), V (24.0%), and nontypeable (1.7%), were
essentially as expected on the basis of data from Western countries. The type V strains showed distinctive
features with respect to protein markers in that Alp3 was detected in only 6.9% of the isolates while R3 occurred
in 75.9% and R4/Rib occurred in 37.9% of the isolates. R3 occurred nearly always in combination with one of
the alpha-like (Alp) proteins, and it was the third most common of the proteins studied. These results show
that type V GBS strains from Zimbabwe differed from type V strains from other geographical areas and also
emphasize the importance of the R3 protein in GBS serotyping and its potential importance in the immunobiology
of GBS, including a potential role in a future GBS vaccine
Use of culture methods for recovery of atypical mycobacteria from stools of AIDS patients
No full textObjective: To establish recovery rates of atypical mycobateria from stools of suspected AIDS patients using culture media. Design: Laboratory evaluation of recovery rates, contamination rates, optimum exposure time and optimum concentration of alkali used for decontamination. Setting: The study was conducted in Harare, Zimbabwe at two medical institutions: Beatrice Road Infectious Diseases Hospital (BRIDH) (a tuberculosis referral hospital) and Mashambanzou Care Unit (MCU) (a homebased care centre). Subjects: A total of 386 stool specimens from suspected AIDS patients from the two health institutions plus 81 stool specimens from clinically healthy patients were collected. The number of patients from MCU was 144 (49 females, 95 males) and 242 from BRIDH (119 males, 123 females). Main Outcome Measure: The main goals were to determine optimum exposure time and optimum concentration of alkali used in decontamination and to identify the culture medium with the best recovery rates of atypical mycobacteria. Results: Optimum recovery of atypical mycobacteria was achieved on Peizer TB medium after treating stool specimens with 4% sodium hydroxide for 35 minutes. In addition, the use of Kirchner’s medium improved isolation rates, although with a slight increase in contamination at levels of 2.9%. Conclusion: A stool specimen can be used to recover atypical mycobacteria in suspected AIDS patients. Recovery is achieved using Peizer TB medium at a concentration of 4%. Varying the exposure time of the stool specimen to the decontaminating alkali and incorporating anti fungal agents and antibiotics into the medium, improves recovery of atypical mycobacteri
A study to determine the relationship between prevalence of late stage diagnosis of cervical cancer and number of comorbid illness in women aged 65 years and above in Zimbabwe
No full textThe elderly are currently the fastest growing population worldwide. Illnesses arising
with advancing age, like hypertension, diabetes mellitus, dementia, Alzheimer’s and vascular disorders are complicating cervical cancer diagnosis in elderly women. This descriptive, correlational study was done to explore the relationship between prevalence of late stage diagnosis of cervical cancer and number of comorbidities in women aged 65 years and above in Zimbabwe guided by Betty Neuman’s Systems Model. Non-probability sampling was used to recruit and interview 68 women aged 65 years and above with cervical cancer from Parirenyatwa Hospital and Spilhause Clinic at Harare Hospital. Data analysis was done using the Statistical Package for Social Sciences (SPSS), The Pearson’s Correlation coefficient and simple regression to describe demographic characteristics and dependent and independent variables. Study findings indicated that the average number of comorbidities suffered by elderly women before late stage cervical cancer diagnosis was 2.03 with a mean comorbidity score of 9.03 out of 38 using a modified Charleson Comorbidity Index. The prevalence of late stage diagnosis was 0.661. Pearson’s correlation coefficient showed a positive and
significant relationship between prevalence of late stage diagnosis of cervical cancer and number of comorbidities (r = .431, p < 0.01). This result means that the higher the number of comorbidities in elderly women, the later the stage of presentation with cervical cancer. There is need to focus early screening of cervical cancer efforts on elderly women to promote early detection and treatment. The effect of the independent variable is indicated by significant R² = 0.186 (b = 0.289). This result explains that the number of comorbidities suffered before cervical cancer diagnosis causes 18.6% of the prevalence of late stage diagnosis of cervical cancer. Further research is needed to clarify other factors leading to late stage diagnosis of cervical cancer in elderly women aged 65 years and above in Zimbabwe
Risk Factors for Cervical Precancer Lesions among Women Attending Cervical Cancer Screening Clinics in Harare, 2013
No full textBackground: Cervical cancer is the most common cancer in women in Zimbabwe. Preliminary analysis of the prevalence of precancer lesions of the cervix in Harare City revealed that the prevalence is around 7%. This is relatively high compared to those in the southern African region (3%). If the burden of the cervical cancer is to be reduced then risk factors for the precancer cervical lesions (precursor to cancer) for women in Harare have to be established. Methods: A total of 180 women who were attending Visual Inspection with Acetic acid and Cervicography (VIAC) clinics in Harare were enrolled in a case control study. A case was a woman 18 and above years with histologically confirmed cervical dysplasia. Data on demographic characteristics and risk factors for precancer lesions of the cervix were obtained with consent and these were then compared between the cases and controls. Results: The significant risk factors were having more than one sexual partner (OR=1.9; 1.21-3.72), being HIV positive (OR 8.4; 4.17-17.09), early sexual debut (<15years) (OR=3.4; 1.18-9.8), a previous history of any form of STI (OR= 3.06; CI= 1.64-5.69) and being single (OR=2.30; 1.12-6.56). HIV infection was found to have an effect modification for the association of sexually transmitted infections (STIs) and precancer lesions. History of genital warts appeared to have the strongest association (OR=4.29; CI= 1.37-13.40) with precancer lesion compared to other forms of STIs. Conclusion: The association of precancer lesions and HIV, STIs suggest that there is need to reduce the prevalence of HIV and STIs if the prevalence of the cervical precancer lesions is to be reduced. To achieve this strengthening health education on use of barrier methods to prevent STIs and HIV is required and there is need for integration of HIV services with cervical cancer screening for early detection in these women at higher risk
A case report of the use of inflow occlusion and moderate hypothermia for a pulmonary valvotomy: Anaesthetic and surgical management
No full textPulmonary valvotomy was one of the earliest cardiac operations attempted.1 Indeed the success with which it was done did much to dispel the myths of the impossibility of operating on the heart, and ushered in the subsequent advances in cardiac surgery. This is a report of a recent case, followed by a discussion of the relative merits of different techniques
The relationship between factors that influence men, aged 20-50 years’ perceptions and their participation in PMTCT programmes in Gwanda urban
No full textPerception may negatively or positively influence men’s participation in PMTCT, which can lead to a rise in the morbidity and mortality rates among family members (father, mother and babies). The purpose of the study was to examine the relationship between the factors that influence men’s perceptions and their participation in PMTCT (Prevention of mother to child transmission of HIV) at Gwanda Urban. Health Belief Model was used to provide a theoretical framework. Eighty men aged 20 to 50 years were selected using simple random sampling. An interview schedule consisting three sections demographic, men’s participation in PMTCT programmes and men’s perceptions of PMTCT was developed. Data was analysed using Pearson correlation coefficient test and simple regression analysis. The study findings showed a Pearson coefficient test of (r = .285, p < .05). this shows that there was a weak positive correlation between men’s participation and men’s perception of PMTCT. The results of the study show that the men’s perceptions have a weak effect on the men’s participation in PMTCT programme. R squared indicates that the men’s perception of PMTCT accounts for 8% variance in men’s perception in PMTCT programmes. It was recommended that clients be empowered to be responsible for making decicionss about their health
Screening of some Traditional Medicinal Plants from Zimbabwe for Biological and Anti-microbial Activity
No full textIn Zimbabwe medicinal plants play a critical role in the healthcare delivery system. Ethnobotanical surveys of five districts from the Matebeleland and Manicaland regions of Zimbabwe were done and most commonly used and endangered plant species used in traditional medical practice were selected. From twelve plants 20 extracts were prepared from the various plant parts and extracted by solvent extraction and freeze dried. The extracts were then screened for phytochemical constituents and biological activity using standard techniques.
Phytochemical screening was carried out using TLC (Thin Layer Chromatography) where UV detection was at 254 and 365nm followed by confirmatory tests. Three of the plant extracts contained alkaloids, five had anthraquinone derivatives, five had coumarins, eight had cardiac glycosides and flavonoids, fifteen had saponins and sixteen contained tannins. Saponins and tannins were the most abundant phytochemicals found. These phytochemical groups and isolated chemical compounds may be responsible for the various biological activities observed by traditional healers in ethnopharmacology.
Total phenolic contents were determined by the Folin-Ciocalteu method and the antioxidant activity was evaluated by DPPH (2, 2-diphenyl picrylhydrazyl) using â-carotene as reference. A high total phenolic content was observed for P. africanum bark 0.438±0.00424 and lowest for V. infausta leaves with 0.0048±0.00255TAE. Some extracts had high antioxidant activity: P. africanum leaves, bark, and roots had 97.6±0.354%, 96.3±0.354% and 96.40±0.00% respectively. The lowest antioxidant value was recorded in V. infausta roots with 39.7 ± 0.212%. Most plants showed great potential for use as antioxidants.
Brine shrimp lethality tests were used to predict potential cytotoxic activity of the plant extracts. Most of the extracts were non-toxic with LC50 values ranging from 1000 to 4000 µg/ml compared to the known toxic plant Nerium oleander used as a positive control with LC50 value of 142±68.2 µg/ml. V. infausta leaves (338±23.4 µg/ml), root (416±28.3 µg/ml) and P. angolensis bark (478±29.7 µg/ml) were moderately safe and should be used with caution. Plants showing significant toxicity to Artemia salina may have potential use as anti-tumour drugs.
Antimicrobial activity was carried out on selected microorganisms and fungal strains by the agar well diffusion method. Antibacterial activity was assessed against Staphylococcus aureus, Streptococcus Group A (Gram positive bacteria) and Escherichia coli, Pseudomonas aeruginosa (Gram negative bacteria). The fungi used were Candida albicans and Aspergillus niger. Activity was measured as a radius in mm to give a zone of inhibition. In general, the gram positive bacteria were more sensitive to the plant extracts compared to the gram negative bacteria. Out of the runs done for all the bacterial strains; 28 plant extracts showed no activity against the strains at the different concentrations used. The root extracts of X. caffra, P. angolensis and P.africanum were highly active (about 10mm radius) against E. coli. P. africanum root extract was also highly active against P. aeruginosa. A. stenophylla leaves were inactive against S. aureus, E. coli and P. aeruginosa. 65% of the extracts did show activity against Candida albicans and Aspergillus niger. The highest zone of inhibition was shown by D. anomala tuber against C. albicans; reading of 5.5±0.58mm and P. africanum bark 4.0±0.82mm.The lowest values were recorded from C. anisata leaves and L. edulis leaves against A. niger; readings of 1.00±0mm and 1.00±0.58mm respectively.
The results from these studies indicated that most of the commonly used traditional medicinal plants have merit for use in traditional medical practice as they have shown zones of inhibition on various microorganisms tested, meaning they are potential antimicrobial agents and so should be preserved and harvested with care
Negative appendicectomy: evaluation of ultrasonography and Alvarado score
No full text1.1 BACKGROUND
High negative appendicectomy rates are no longer acceptable with improvements in imaging techniques and clinical prediction rules. The use of ultrasound and CT scan in addition to clinical assessment and blood investigations has greatly reduced the negative appendicectomy rate to less than 10%. The aim of this study was to assess the negative appendicectomy rate at the two University Teaching Hospitals in Harare.
1.2 OBJECTIVES
The aim of the study was to determine the negative appendicectomy rate at the two major teaching hospitals in Harare and to evaluate the accuracy of the Alvarado score and ultrasound scan in diagnosing acute appendicitis.
1.3 DESIGN
Prospective observational, cross sectional study
1.4 SETTING
Parirenyatwa Group of Hospitals and Harare Central Hospital, in Zimbabwe
1.5 MATERIALS AND METHODS
A total of 206 patients undergoing appendicectomy at the two major teaching hospitals in Harare were included in this study between June 2012 and May 2013. Information recorded included: age, sex, clinical features, investigations and treatment. Alvarado score was calculated from the data in the case notes and ultrasound scan results were also captured. All appendices removed at operation were sent for histopathological examination. Appendicitis was confirmed at histology. The positive predictive value of Alvarado score and sensitivity and specificity of ultrasound scan were calculated.
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1.6 RESULTS
The overall negative appendicectomy rate was 16.5%. The negative appendicectomy rate for men was 13.3% and that for females was 29.9%. The negative appendicectomy rate for Parirenyatwa Group of Hospitals was 19.0% and that for Harare Central Hospital was 12.1%. The mean age for the study was 28 years (SD 12.8). Appendicitis was diagnosed commonly in the second and third decades of life. Sensitivity of ultrasound scan in diagnosing acute appendicitis was 89.5% with a positive predictive value of 77.2%. Females were 2.6 times more likely to have an ultrasound scan done to diagnose appendicitis than males. Alvarado score had a sensitivity of 95.3% with a positive predictive value of 90.3%.
1.7 CONCLUSION
Negative appendicectomy rate (16.5%) at the two University Teaching Hospitals in Harare is relatively high when compared with modern trends. Alvarado score had a high sensitivity (95.3%) and predictive value (90.3%). Ultrasound scan had a high sensitivity (89.5%) and a relatively low predictive value (77.2%) in diagnosing acute appendicitis. Regular use of these assessment modalities should contribute substantially to reduction in the negative appendicectomy rate in our practice
Socio-cultural realities of following through with prevention of mother- to- child transmission of HIV programme in Chiota district Zimbabwe: Implications for elimination of paediatric infection
No full textThe study assessed the social and cultural realities of following through with prevention of mother-to-child transmission of HIV during the postnatal and breastfeeding period in a rural community in Zimbabwe and its implications on elimination of paediatric infection. The assumption was that paediatric HIV infection was not only through mother to child transmission but other social and cultural practices. Following through with PMTCT was conceptualised as the mother’s ability to adhere to ART, exclusive breastfeeding for six months and protecting the baby from getting infected through having protected sex among other factors. The study was conducted in Chiota District, one of the districts with a pronounced HIV burden. A sequential model combining both qualitative and quantitative methods was used for the study. Qualitative data were obtained through in-depth interviews/narratives with mothers on the PMTCT programme from two rural health facilities, (n=15). Focus group discussions were conducted with community members (n=231), and key informant interviews with the health staff (n=8). Quantitative data were collected through a cross sectional survey of breastfeeding women (n=103) accessing PMTCT interventions. Qualitative data were analysed thematically whilst STATA version 11 was used for quantitative data analysis where descriptive statistics, bivariate and multivariate regression analyses were done.
Cultural practices, community, self and institutional stigma affected the effectiveness of the PMTCT programme. The prevalence of adherence to ART among the mothers was 82.5%. Only 6.8% of the mothers exclusively breastfed for the first six months. The major reasons for non-exclusive breastfeeding were the mother’s belief that the milk was unsafe (66%), inadequate (55%) and breastfeeding was not practical (67%). Risky traditional practices during PMTCT included ‘treatment’ of fontanelle by inserting the father’s male organ in the mouth of the child, toning of the girl child’s sexual libido through rubbing the father’s penis on the child’s vagina, improvement of eyesight and sense of hearing through use of mother’s milk among other practices. These practices exposed babies to bodily fluids like semen, precum, breastmilk and vaginal fluids, which are known to contain HIV.
Culturally embedded practices, self, community and institutional stigma compromised the ability of mothers to adhere to PMTCT. Evidence from this study suggests that culture plays a major role in following through with PMTCT. This calls for taking cognisance of culture in designing HIV programmes. There is a need for further research on PMTCT during the postnatal period. Programmes should be cognisant that a ‘onesize fits all’ approach does not work as women are different.The Southern African Consortium for Research Excellence (SACORE