1358 research outputs found
Sort by
Zimbabwe, Reproductive,Maternal, Newborn, Child Adolescent Health and Nutrition Strategy 2017-2021
No full text
Strengthening legislations as a way to combat sexual harassment at workplace and in universities in Zimbabwe
No full textEvaluation of the prevalence of retinopathy of prematurity at Parirenyatwa group of hospitals and Harare central hospital
No full textBackground: Retinopathy of prematurity is notably one of the causes of avoidable
blindness. The risk factors for the development of ROP are very low birth weight(<1500g), low gestational age (GA) (<32 weeks) and duration of oxygen
supplementation. The prevalence varies world over, with high income countries having higher figures than their low income counterparts. Zimbabwe is a low income economy, however Harare is urbanised and a significant number of preterm infants at risk of developing ROP do survive.
Objectives:
1. To establish the prevalence of ROP at PGH NICU and HCH NNU at 4-6 weeks chronological age.
2. To assess the prevalence of ROP requiring treatment and ROP not requiring treatment a 4-6 weeks chronological age.
3. To establish the risk factors associated with ROP as well as the ocular features of ROP in our neonatal units.
4. To assess the current oxygen delivery protocols for VLBW preterm babies in our neonatal units.
Study Design: Hospital based cross sectional analytical study.
Methodology: All neonates admitted in the neonatal units were screened weekly to
identify patients that met the study inclusion criteria. These infants were enrolled
into the study and examined at either the 4th, 5th or 6th week after birth. Ocular
examination findings were noted as well as the risk factors for ROP that each neonate may have been exposed to. Details of supplementary oxygen for each neonate were documented, that is duration of oxygen delivery, mode and flow rate.
A self-administered questionnaire was completed by medical personnel working in the units, to assess their current knowledge concerning oxygen delivery in VLBW preterm infants.
Results: A total of 141 premature babies were enrolled into the study. Twenty infants died and 121 were examined. Six infants were diagnosed with ROP, therefore the prevalence of ROP at 4-6 weeks chronological age was 5.0%. All the infants diagnosed with ROP
had spontaneous resolution making the prevalence of children with ROP requiring treatment 0.0%. Three out of 6 (50.0%) had stage 1 disease and 3(50.0%) had stage 2 disease. Location of the disease was as follows; Five out of 6 (83.3%) neonates had
disease in zone 3 and 1 (16.7%) had disease in zone 2.
The risk factors associated with ROP in this study were, prolonged duration of oxygen
supplementation >2 weeks, very low birth weight <1100g and EGA<30 weeks.
Seventy per cent of the medical personnel stated that they were aware of an oxygen
delivery protocol. However the SaO2 levels that they aim to maintain vary, with most
personnel aiming to maintain in the 90-95% and 95-100% ranges.
Conclusions: There are VLBW preterm infants who survive and develop ROP in our
neonatal units. It follows that the screening of all neonates at risk is essential.
Current oxygen delivery protocols must be revisited & revised by medical personnel.
Monitoring SaO2 in VLBW preterm neonates would improve with more equipment for monitoring SaO2 as well as more nursing staff
Microbiology of puerperal sepsis and its clinical implications among HIV-infected and HIV-uninfected women in a hospital sample in Zimbabwe
No full textTitle: Microbiology of puerperal sepsis and its clinical implications in a Hospital sample in Zimbabwe
Introduction: Puerperal sepsis is infection of the female genital tract occurring at any time
between the rupture of membranes or labour, and the 42nd day postpartum. Puerperal sepsis has become the leading cause of maternal death in Harare public health institutions accounting for 19% and 30% of maternal deaths for the years 2010 and 2014 respectively, from being the fourth nationwide cause at 12.3% in the year 2007. The objectives of this study were to determine the identity and antibacterial susceptibility profiles of bacteria colonizing the genital tract and blood stream, and to assess clinical
outcomes and association with HIV infection in women with puerperal sepsis.
Methodology: A prospective cohort study was conducted at Parirenyatwa and Harare
Hospitals between 02 September 2014 and 01 July 2015. Endocervical swabs and blood were collected for culture and susceptibility testing from 151 consecutive women who met the World Health Organisation criteria for puerperal sepsis. HIV sero-status, immunological status and antiretroviral therapy (ART) use were determined. Medical records were reviewed for assessment of clinical outcomes. Proportions, categorical values and means were compared using Z-test, .² test and t- test along with 95% confidence interval (CI) and p-value of <0.05.
Results: The mean age was 25.1 ±5.8years and most women were multiparous(53.6%). The majority of women had delivered at a hospital (78.1%) and by caesarean section
(57.6%). The commonest bacterial isolates were Escherichia coli (30.6%) and Klebsiella pneumoniae (15.3%). Multidrug resistant organisms (MDRO) accounted for 10.9% of the isolates. MDRO were associated with prolonged mean hospital stay 23.0days (d) compared to 10.5d in women without MDRO (p=0.009). The frequency of genital colonization with Enterobacter species was significantly higher in HIV infected (9.1%) than uninfected women (1.7%) (p=0.04). Among HIV infected women (21.9%), severe immunosuppression (CD4 500/mm³). There was a non-significant trend towards,earlier onset of sepsis; and higher rates of pelvic abscess, septic shock, wound dehiscence, peritonitis, death and need for admission into the intensive care unit (ICU)
in women with severe immunosuppression. Antiretroviral therapy use did not independently influence outcomes. Puerperal sepsis case fatality rate was 7.3%.
Conclusion: Gram negative bacilli, particularly E. coli, are the commonest bacterial isolates in puerperal sepsis. There is emergence of MDRO gram negative bacilli resistant to carbapenems, especially K. pneumoniae. MDRO and HIV associated severe immunosuppression are risk factors for prolonged hospital stay and need for surgery. Robust infection control strategies, emphasis on rational drug use and clinical culture surveillance to identify MDRO and monitor epidemiologic trends is recommended
“Judicial management as a business rescue scheme” A critique of the effectiveness of judicial management as a rescue scheme
No full textThe main thrust of the study was to ascertain the effectiveness of judicial management
procedure as a corporate rescue scheme. Thus the research unraveled the
shortcomings of the laws of insolvency in light of the objectives of insolvency laws in
particular the need to protect the interests of not only the creditors and shareholders,
but the society at large. The study was carried out in Harare targeting insolvency
practitioners as well as the use of secondary data. The qualitative research
methodology was employed because of its ability to explore and describe the
effectiveness of judicial management as a corporate rescue scheme capturing the
experiences and opinions of experts directly involved in judicial management. Thus
indepth interviews and secondary data analysis research techniques were utilized. The
overall findings confirmed that indeed judicial management procedure is flawed. It was
established that the procedure is restricted to companies only at the exclusion of any
other form of business entity. Further, those who are eligible for appointment as judicial
managers do not need to have a business management qualification which appear to
be necessary for the revival of financially distressed companies. In light of these
findings several recommendations were made chief among them the need for law
reform to enhance the effectiveness of corporate rescue procedures