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The relationship between knowledge of breast self-examination and practices regarding breast self-examination among women aged 25 – 49 years at Mbare family services clinic in Harare, Zimbabwe
No full textWorldwide, breast cancer is the most frequently diagnosed cancer in women and it is the leading cause of cancer deaths among women (Jemal, Ward, Center, Siegel and Thun). In Zimbabwe, the proportion of women dying from breast cancer is 1 in 28. The breast cancer rates are higher than those for any other cancers besides lung cancer (Chokunonga, Borok, Chirenje, Nyakabau and Rukainga, 2009). The purpose of the study was to examine the relationship between knowledge of breast self-examination and practices regarding breast self-examination among women aged 25 to 49 years at Mbare Family Services Clinic in Harare, Zimbabwe. The Health Promotion Model was used to guide the study. A non-experimental descriptive correlational study design was used. A simple random sample of 85 women who visited Mbare Family Services Clinic in Harare, Zimbabwe was used. A structured interview questionnaire comprised of demographic data, knowledge of breast self-examination and practices of breast self-examination. A pilot study was conducted. Data was analysed using the statistical package for social sciences (SPSS/CP). Data was analysed using descriptive statistics, inferential statistics and the Pearson‟s Correlation Coefficient. The study findings showed a strongly positive linear relationship between knowledge of breast self-examination and practice of breast self-examination. The r = 0.668 indicating that as knowledge improves the practice of breast self-examination improves. The regression analysis was done R2 = .446 which implies that the effect of knowledge accounts for 44.6% of the variation on the practice of breast self-examination
The geography of diabetes and vascular occlusive disease in relation to chromium
No full textPrima facie evidence is presented that, where naturally occuring chromium in water supplies occurs, it is associated with a lower prevalence of diabetes and a lower incidence of mortality from vascular occlusive disease.
It is postulated that increased prevalence of such disease in a population is associated with chromium 3 deprivation. This results from consumption of highly refined cereal foods which are known to have most of the chromium content removed with the fibre. Water chromium may mitigate these effects
Prevalence of post-tuberculosis airflow obstruction in patients who have completed pulmonary tuberculosis treatment at two infectious disease hospitals in Zimbabwe
No full textTuberculosis (TB) is a major cause of death worldwide. About two thirds of patients develop impaired pulmonary function after completion of pulmonary TB treatment. It seems a high proportion of TB deaths are due to post-TB chronic airflow obstruction but data is lacking to support this assertion.
Research question- What is the prevalence of post-tuberculosis airflow obstruction in patients who have completed pulmonary tuberculosis treatment at Wilkins and Beatrice Road Infectious Diseases Hospital (BRIDH)?
Primary objective-
To determine the prevalence of post-tuberculosis airflow obstruction in patients who have completed pulmonary tuberculosis treatment at Wilkins and BRIDH hospitals.
Secondary objectives-
1 To identify factors that may influence lung function outcomes in post-TB patients.
2 To identify the pattern of spirometry values among post-TB patients.
Design, Setting and Participants
The study was a cross-sectional study at Wilkins and BRIDH hospitals in patients who had completed 6 months of anti-TB treatment.
Sample size- Three hundred and twenty-seven patients.
Methods
Spirometry was done in patients who had completed 6 months of anti-TB treatment. Participants were recruited from Wilkins and BRIDH hospitals after an informed consent. Eligible were adults aged 18-65 years who have completed 6 months of anti-TB treatment. Those with a history of smoking, occupational exposure, asthma, COPD, interstitial lung disease and bronchiectasis were excluded.
Results
The prevalence of post-tuberculosis airflow obstruction was 65.7%. Restriction probable was found in 14.4% and normal spirometry in 19.9% of the participants. Female sex (p=0.020) and recurrent episodes of TB (p=0.026) were associated with development of post-TB airflow obstruction.
Conclusion
There is a high prevalence of post-tuberculosis airflow obstruction, with moderate obstruction according to the GOLD criteria being most prominent. Recurrent episodes of TB and female sex were associated with development of post-TB airflow obstruction
Vitamin A status of term and preterm infants delivered at Harare Central Hospital and fed exclusively on breast milk
No full textObjective: To investigate the vitamin A status of pregnant mothers, lactating mothers, preterm and term infants who were being fed exclusively on breast milk. Design: Systematic/cross sectional. Setting: Vitamin A research laboratory, animal science research laboratory, University of Zimbabwe, and Harare Central Hospital
Quality of life among adult patients living with HIV/AIDS taking antiretroviral drugs
No full textBackground: Zimbabwe’s response to the HIV/AIDS pandemic in terms of prevention, testing, counseling and treatment has been commendable but inadequate in terms of provision of rehabilitation services to HIV-infected individuals.
Objectives: To determine the prevalence and extent of activity limitations and participation restrictions (disabilities) experienced by adults living with HIV/AIDS who are on Antiretroviral drugs (ARVs) and the factors associated with quality of life as assessed by the International Classification of Functioning, Disability and Health (ICF).
Study variables: type of ARV, period on ARVs, last CD4 count, physical and mental health, previous injury, use of assistive devices, having an assistant, and demographic characteristics.
Outcome variables: quality of life (total score), domain total scores, reduction and stopping of usual activities.
Methods: A cross sectional analytical study was done with 59 consenting HIV positive adults on antiretroviral drugs attending an opportunistic infection clinic. An ICF-based interview questionnaire was administered on consecutive patients.
Ethical clearance was granted.
Data Analysis: Descriptive statistics were used to describe the distributions of participants according to demographic characteristics, clinical profile and prevalence of activity limitations and participation restrictions. Multivariate analysis was done to determine the factors that predicted quality of life. Level of significance was set at 5%.
Results: The mean age of participants was 41 years (+/- 9.3), 56% were female, 54% were married and 30.5% were widowed. Median period on ARVs was 13 months (I.Q.R 3-29) and median last CD4 count was 189.5 (I.Q.R 114-278). Thirty-two (54%) were on Stalanev. About 36% and 61% had stopped or reduced their usual activities due to the illness respectively. Most affected aspects were walking (71%), fine hand use (41%), lifting & carrying objects (71%), shopping (55%), housework (55%), remunerative employment (56%) and economic self-sufficiency (79%). The support and relationships and attitudes of health professionals (86% and 88%) and immediate family (75% and 78%) were the cited major environmental facilitators. Factors statistically significantly associated with quality of life were physical health (p= 0.01), mental & emotional health (p= 0.04), and use of assistive devices (p= 0.02). Period on ARVs and last CD4 count were not statistically significantly associated with quality of life.
Conclusion: HIV-related disabilities are prevalent even among those on antiretroviral drugs and their quality of life is reduced, hence the need to scale up rehabilitation services for them
The relationship between knowledge levels and practice of dual contraception as a prevention of unplanned pregnancy, abortions, sexually transmitted infections including Human Immuno Virus
No full textUnplanned pregnancy is the major cause of induced abortion one of the leading causes of maternal mortality and morbidity in the world (Mambolea, 2012). At Morgenster mission hospital there is an increasing number of women presenting with problems related with unplanned pregnancies. This was revealed through a growing number of women aged 15 to24 years admitted following illegal abortion. Hundred thousands of women become pregnant without intending and most of them decide to end the pregnancy in abortions. The purpose of the study was to examine the relationship between knowledge levels and practice of dual contraception as a prevention of unplanned pregnancy, abortions, sexual transmitted infections including HIV infection, among women aged 15 to 24 years at Morgenster mission hospital. Health Belief Model was used to provide the theoretical frame to guide the study. A quantitative, descriptive correlational design was used in this study. A sample size of 84 women was selected using convenient sampling technique. The inclusion criteria were all women aged15 to 24 years enrolled at Morgenster mission hospital. Structured interview schedule was done for 20 to 25 minutes to participant in a private room. Descriptive inferential statistics were used to analyse data. The major findings of the participant had high knowledge on dual contraception. Mean score was 10.6, standard deviation of2. 3 and on practice of dual contraception mean score was 2.6 and standard deviation 2.1 .The findings indicated a positive significant relationship between knowledge levels and practice on dual contraception r =. 260*, p<=0.017.Regression analysis was done and regression coefficient was R squared = .068 which means 6.8% variations or change in practice of dual contraception is explained by change in knowledge levels on dual contraception. Midwifery practice should emphasize on practice of dual contraception as of unplanned pregnancy, STIs including HIV during family planning sessions
A comparative evaluation of the performance of the Viroseq HIV-1 genotyping system v2.0 against an in-house assay using specimens from the national HIV drug resistance monitoring survey, in Zimbabwe.
No full textThis study was carried out to assess the performance of the Viroseq HIV-1 genotyping
system v2.0 (Celera, Alameda, California, USA) on Zimbabwean samples at the National
Microbiology Reference Laboratory (NMRL) in Harare and to compare the results obtained
with those obtained at a World Health Organization accredited genotyping laboratory in
Entebbe, Uganda, which genotyped the same samples using an in-house method.
Study samples: Thirty eight (38) plasma samples were used in this study. They were selected
from samples stored at NMRL, which had been collected from patients eligible for
commencement on antiretroviral therapy just prior to taking antiretroviral drugs at sentinel
sites for the National HIV Drug Resistance Monitoring Survey in Zimbabwe.
Results: Viral RNA extraction and RT-PCR reactions were successful at first attempt for all
the 38 study samples. The success rates of cycle sequencing reactions using the 7 proprietary
Viroseq sequencing primer mixes on the 38 samples, at first attempt were: Primer A (81.6%),
primer B (86.8), primers C and G (84.2%), Primer D (10.5%), Primer F (73.7%) and Primer
H (94.7%). Thirty seven out of the 38 samples (97.4%) were successfully genotyped.
However, 14 (37.8%) of these pol region consensus sequences obtained were unidirectional.
Thirty two out of the 37 (86.5%) Viroseq genotyped samples clustered in pairs with their
corresponding sample sequences generated in Uganda with bootstrap support values ≥70
(median bootstrap support value, 97.5: range 31-99) on neighbour joining tree phylogenetic
analysis. All of the genotyped study samples were found to be HIV-1 subtype C (n=37).
Nineteen of the 37 (48.6%) genotyped samples had at least one drug resistance mutation
detected by either Viroseq or the Ugandan in-house assay. The detected mutations as reported
by the two genotyping systems were fully concordant in 11/19 (57.9%), partially concordant
in 2/19 (10.5%) and discordant in 6/19 (31.6%) of these specimens with drug resistance
mutations. Overall, all the reports generated by the two systems with or without any
mutations were 78.4% fully concordant, 16.2% partially concordant and 5.4% discordant.
Conclusions: The Viroseq system can be reliably used to genotype Zimbabwean samples by
adequately trained operators at NMRL. Sequencing Primer D is not suitable for sequencing
Zimbabwean subtype C isolates due to its high sequencing reaction failure rate
Reference values for Urea, Creatinine and Electrolytes in Zimbabwean females
No full textThe reference values for urea, creatinine and electrolytes were determined in sera of 460 African and 200 Caucasian females. All except creatinine levels are significantly different statistically. African females have lower limits for sodium, chloride while their upper limits are higher than those of Caucasian females. Reference values for potassium and anion gap are higher while those of urea and bicarbonate are lower in African than Caucasian females.
The analytes reported here are closer to gaus- sian distribution than the liver function tests - described earlier (Matarira 1984b)
Field efficiency of syphilis screening in antenatal care lessons from Gutu District in Zimbabwe.
No full textObjectives'. To determine coverage for antenatal syphilis screening in a rural area and evaluate the accuracy of on-site Rapid Plasma Reagin (RPR) tests performed by nurse-midwives.
Design: Descriptive cross sectional.
Setting'. Rural Health Centres (n=23) in the Gutu District of Zimbabwe.
Subjects: Women booking for antenatal care in the district were used to determine coverage of screening. Results from women who had an RPR test performed during a nine week period were used in assessing the accuracy of tests performed by nurse-midwives.
Intervention: On-site antenatal screening for syphilis using an RPR kit with immediate results and treatment for women who tested positive.
Main Outcome Measures: Prevalence of syphilis (positive RPR) at booking and the level of agreement between three observers (RHC nurse-midwife, medical practitioner under field conditions and medical laboratory technologist).
Results: Eighty five percent of women were screened for syphilis at the first antenatal visit and 11% had a positive RPR. Almost all (97.3%) women with a positive RPR test result were treated. The accuracy of tests performed by RHC staff was poor with a sensitivity of 40% (95% Cl 21.8 to 61.1) when compared to those done by the medical practitioner and 8.7% (95% Cl 1.5 to 29.5) when compared to those done in a laboratory. The predictive value of a positive test was 22.7% and that of a negative test was 94.9%.
Conclusion: The coverage of screening for syphilis in pregnant women in Gutu District was good but the results were unreliable. There is need for nurse-midwives, who perform the majority of RPR tests in the RHC, to receive adequate training to ensure competence in testing and to strengthen quality control procedures
The relationship between practice of self-monitoring of blood glucose and frequency of hospitalisation among patients with diabetes mellitus at Parirenyatwa hospital aged between 20-70 years.
No full textZimbabwe the population with DM is 4.8%. Cornerstone to the treatment of diabetes mellitus is self-monitoring of blood glucose which enables DM patients to actively participate in their treatment enabling continuous feedback on treatment modalities reducing frequency of hospitalisation due to acute and chronic complications of DM. Anecdotal evidence at Parirenyatwa Hospital suggests that most patients with pharmacologically treated DM inadequately monitor their blood glucose levels due to inadequate knowledge, lack of resources and visual impairments due to diabetic retinopathy. The purpose of this study was to examine the relationship between practice of SMBG and frequency of hospitalisation among patients with DM at Parirenyatwa Hospital aged 20-70 years. Orem’s self-care model provided the theoretical framework for this study. The research design utilized a descriptive correlational design. Simple random sampling was utilized to select a sample of 72 participants determined by Dobson’s formula. The study setting was Parirenyatwa Hospital Out Patients Department. A structured interview schedule was used to collect data. Data was analysed using the statistical package for social science (SPSS). Results showed that the majority of respondents (72.2%) had a low frequency of hospitalisation and only 44.4% had good practice of SMBG. The relationship between the practice of SMBG and frequency of hospitalisation showed a weak linear positive correlation (r=0.062 p<0.05) which was not significant. Nurses should pay increased attention to SMBG records, provide education and change treatment based on SMBG results. Males and those with primary education should be targeted more with health education messages on SMBG as they showed poor practice of SMBG.