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Factors associated with the nutritional status of children from primary schools in Chitungwiza: Secondary data analysis
No full textBackground: Studies have shown high morbidity and mortality in primary school going children due to malnutrition. Few studies have looked at nutritional status of primary school going children in Chitungwiza and factors associated to this are poorly described. The aim of the present study was to assess common ailments and identify predictors of malnutrition in primary school children in Chitungwiza in order to enforce corrective and preventive measures.
Methods: A secondary analysis of data obtained from the child health survey done at four selected primary schools in Chitungwiza in 2006 was used to assess the nutritional status of 241primary school going children in the area. Nutritional status was assessed using anthropometric measurements. The predictors of nutritional status were determined using logistic regression models.
Results: 241primary school going children aged between 8 and 11 years took part in the study. Tooth decay was the most common health problem with prevalence of 32% followed by skin disease with prevalence of 19.9% and then vision with prevalence of 10.4% and 9.5% for right and left eyes respectively. Overall 54% were stunted, 62.4% were wasted and 38.1% were underweight. In the multivariate analysis, age of a child, education of mother, body mass index of a child and education of father (p<0.05) were found to be independently associated with nutritional status of primary school going children in Chitungwiza.
Conclusion: Dental caries, skin diseases and vision were the most common health problems among primary school going children in Chitungwiza. Wasting was identified as the most common condition of malnutrition among these children. The study identified age of a child, education of mother, body mass index of a child and
education of a father as predictors of malnutrition among primary school going children in Chitungwiza
The relationship between knowledge levels of complications of hypertension and health seeking behaviours among hypertensive patients aged 46-45 years at Parirenyatwa group of hospitals
No full textThis correlational study was premised on the basis that increasing knowledge levels of
complications of any disease directly translates into concomitant health seeking behaviors. A sample of 80 hypertensive patients, conveniently selected, aged between 45 and 65 years at a major referral hospital, Parirenyatwa Group of Hospitals in
Zimbabwe, was used to determine any potential relationship between knowledge levels of complications of hypertension and health seeking behaviors. A questionnaire, which was divided into three sections, was used to collect data during the month of April 2014. Approval to carry out the study was granted by the study site and relevant research ethics committees. A written informed consent was obtained from prospective participant. Data was collected using a questionnaire. Descriptive statistics such as frequencies, percentages and means were used to analyze demographic data, health seeking
behaviors and knowledge levels of complications of hypertension. Inferential statistics, in particular Pearson’s correlation analysis and linear regression analysis were used to determine the relationship between knowledge levels of complications of hypertension at 5% significance level. Findings showed that there is a weak, positive statistically significant correlation between knowledge levels of complications of hypertension and health seeking behaviors (r=0,345**, R2 = 11.9%, p<0.01). This prompts a need to increase public awareness on hypertension, its complications and other hitherto neglected non communicable diseases (NCD’s) in Zimbabwe. Medical-surgical nurses are therefore implored to vigorously educate hypertensive patients and the community in
general, about complications of hypertension thereby increasing patients’ knowledge levels hence improving health seeking behaviors
Factors associated with respiratory distress in the newborn, Harare maternity hospital, 2013
No full textIntroduction: Globally, 4 million babies die each year in the first four weeks of life, the
neonatal period. Neonatal deaths account for nearly 40% of deaths worldwide in children less than five years old. Neonatal Respiratory Distress is among the leading causes of neonatal morbidity and mortality. Previous studies at Harare Maternity Hospital have shown that a ratio of one to three newborns admitted to the neonatal unit was diagnosed with respiratory distress.
The objective of this study was to assess factors associated with contracting respiratory distress in the newborn at Harare Maternity Hospital.
Methods: An unmatched 2: 1 case-control study (70 cases and 140 controls) was conducted at Harare Maternity Hospital, where all single deliveries occurring during the period under study constituted our study population. A case was defined as any live birth diagnosed with respiratory distress at birth. A control was defined as any live birth with no diagnosis of respiratory distress at birth. All cases on a day were recruited; controls were randomly selected using lottery method. A semi-structured questionnaire was administered to collect data from mothers. Data was extracted from delivery registers and maternity patient record.
Results
A total of 210 mothers were interviewed. The median age was 28 years for mothers of cases (Q1 22; Q 2 30), 26 years for those of controls(Q 121; Q 3 30). Factors associated with respiratory distress in the newborn were: Prolonged rupture of the membranes for more than 24 hours before onset of labour (OR 6.9; 95% CI 2.57-18.67; p <0.0001 ); Gestational age below 37 weeks (OR 5.74; 95% CI 2.60-12.68; p 0.0001); Low birth weight (less than 2500 grams) (OR 9.75; 95% CI 4.11-23.10; p <0.0001 ).
Conclusion
Prolonged rupture of the fetal membranes for more than 24 hours before onset of labour was found to be an independent risk factor for respiratory distress in the newborn at Harare Maternity Hospital. Meanwhile, further studies are needed in order to investigate on the causes of premature rupture of the membranes
Fournier's Gangrene: outcome analysis at three tertiary hospitals in Harare Zimbabwe
No full textBackground: Fournier’s gangrene is a potentially life threatening, infective necrotizing fasciitis of the external genitalia and perineum. The average world mortality rate is between 20 – 30%. The factors associated with mortality are not universally accepted and have not been described in our environment.
Main objective: To determine the disease related mortality rate and factors associated with mortality among patients admitted with a clinical diagnosis of Fournier’s gangrene at 3 tertiary hospitals in Harare, Zimbabwe. .
Study Design: A prospective observational descriptive study on 51 consecutive patients with a clinical diagnosis of Fournier’s gangrene managed at 3 tertiary hospitals in Harare, Zimbabwe over a 2 year period.
Materials and Methods: The study was done after approval by the relevant regulatory boards and after obtaining informed consent from the patients. Data on demographics, clinical history and physical examination, vital signs and laboratory values on admission were recorded on a designed data collection sheet. All patients received intravenous broad spectrum antibiotics and fluid resuscitation and surgical debridement. The number and time to first surgical debridement and any additional surgical procedures
performed were recorded. The patients were followed up from admission till discharge from hospital or death. The patients were stratified according to outcome, whether dead or alive and comparison between survivors and non survivors was done to determine factors associated with mortality using chi squared or Fischer exact test for categorical variables and student t test for comparison of the means. Binary multiple regression analysis was performed to determine independent factors associated with mortality.
Results: The disease related hospital mortality rate was 27% (14/51). The median hospital stay was 15 days. The median age of the 51 patients was 43 years. The patients that did not survive were significantly older than those that survived (58.36 + 21.04 vs 42.76 + 14.40 years)(p=0.021). The presence of at least one comorbity was associated with an increased mortality (p=0.007).HIV was the commonest risk factor
accounting for 36% of the cases Neither the presence of HIV nor diabetes mellitus was assocaited with mortality. Renal failure at presentation was signficantly associated with mortality, with a rate of 70% among patients.(p=0.001). The urogenital tract source of infection was associated with increased mortality (p=0.01) while a cutaneous source was associted with survival. (p=0.003). E coli and staphylococcus aures were the commonest pathogens isolated. A delay in first surgical debridement beyond 24 hours from time of admision was signficantly associated with an increased mortality (p=0.04).The number of debridement did not differ significantly between survivors and non survivors. A body surface area involvement of > 5% and abdominal involvement was also signficantly associated with higher mortality. The admitting clinal and biochemical parameters signficantly associated with non survivors were a high respiratory rate, low haemoglobin, hyperkalemia, elevated blood urea nitrogen and elevated creatinine. There was no factor that was independently associated with mortality after multiple
logistic regression analysis.
Conclusion: Fournier’s gangrene remains a potentially fatal condition in our enviroment with a mortality rate of 27%. On univariate analysis an older age, presence of renal failure on admission, a urogenital source of infection, severe sepsis, abdominal involvement, anemia, hyperkalemia and delay in surgical debridement is associated with mortality in our enviroment. The presence of HIV and diabetes mellitus and number of surgical debridement does not seem to affect mortality in our enviroment
Risk factors for mortality in low birth weight infants at Harare hospital (maternity unit)
No full textBackground: Research evidence highlights that in low income countries half the infants born before 32 weeks gestation continue to die. More than 75% preterm infant deaths can be prevented without ICU care as these infants die from preventable causes such as hypothermia and hypoglycemia. According to WHO estimates, Zimbabwe is one of the 11 countries with a high preterm birth rate of over 15%.
Methods: In the current prospective cohort study, the researchers followed up infants less than 2000g at birth through the first 28 days of life to determine the mortality rate and age related risk factors for mortality in the follow up period.
Results: The overall mortality rate in the first 28 days was 51.2%. Mortality in the ELBW was 91.1%, VLBW – 54.4% and LBW – 28.8%. More than half the deaths (53%) happened in the first 48 hours of life predominantly in the first 12 hours. The independent risk factors for mortality in the first 12 hours of life were Respiratory Distress Syndrome (RDS), (RR 1.58 (95% CI 1.039 - 2.405) and infants born to mothers with Diabetes Mellitus (RR 2.31 (95 % CI 1.46 - 3.65). The late preterm infant had a significant risk of dying between day 3 and end of first week of life compared to other time periods (RR 3.14; 95% CI 1-18 - 4.30).
Conclusion: Our study demonstrates that neonatal mortality rate in this cohort was very high. The majority of the deaths occurred within 12 hours of birth and were largely due to extremely low birth weight. Use of life support mechanisms is very low at this unit due to resource constraints and shortage of nurses. Interventions to reduce mortality should address these issues in particular to improve treatment and monitoring during the initial critical 12 hours of life.
The effect of simvastatin and rosuvastatin on relieving the symptoms of alzheimer's disease in a mouse model
No full textBackground: Alzheimer's disease (AD) is the most common form of dementia affecting
nearly 36million people globally. None of the currently approved drugs prevent or even
slow the course of the disease.
Objective: To investigate effects of simvastatin and rosuvastatin in relieving symptoms of
AD in mice.
Methods: The design was experimental using a mice model. A total of 72 Balbc male mice
aged 8-12 weeks were divided into 9 groups with 8 mice in each group. Scopolamine
1mg/kg/day was given intraperitoneally over a period of 2 weeks to induce AD. Study
groups were control, simvastatin 5mg/kg/day, simvastatin 10mg/kg/day, simvastatin
20mg/kg/day, rosuvastatin 10mg/kg/day, rosuvastatin 20mg/d/day, rosuvastatin 40mg/kg/day and donepezil 5mg/kg/day administered by oral gavage for 2 weeks. Y-maze to assess short term memory and Novel Object Recognition test to assess cognition, short-term, intermediate and long-term memory were administered starting 24 hours after the last dose of the experimental drugs. Parametres assessed with Y-maze were total arm entries, same arm entries, alternate arm entries, percentage spontaneous arm alternations. Data were analysed using One way or Two way ANOVA with an appropriate post hoc where required. An a priori alpha level of 0,05 was set for all statistical analysis.
Results: All 8 mice in simvastatin 20mg/kg group died therefore this group was excluded from statistical analysis. There was no significant difference in the parameters used in the Y-maze test across all treatment groups. Total Arm Returns (F=0.5708, d.f. = 6; 28, p= 0,9396), Same Arm Returns (F= 0.4762, d.f= 6; 28, p=0.820), Alternate Arm Returns (F=0.4272, d,f 6,28, p= 0,8545) and percentage spontaneous alternation ( F=0,2911, d,f= 6,28, p= 0.9361). Similarly, no significant difference were noted in the time spent exploring familiar objects across the experimental groups (F=0.4578, d.f=6;28, p=0.7453). However, significant differences were noted on the time spent exploring novel objects across the treatment groups (F=5.755, d,f= 6,28, p= 0.0005). The discrimination indices were found to be different between groups (F= 8.031, d,f= 6,28, p< 0,001; Kruscal-Wallis test .2= 20,46; p=0,0023.
Conclusion: Repeated dosing of simvastatin and rosuvastatin had no effect on memory in mice. No dose response relationship in reversing symptoms of AD with these statins was observed
Factors associated with perinatal mortality in Umguza and Bubi rural areas, 2015- the effect of maternal human immunodeficiency virus status.
No full textIntroduction: The perinatal mortality rate (PMR) is used as a proxy for the quality of maternal and child health care services accessible to women during pregnancy, delivery and the postnatal period. The PMR increased from 8.9 to 33 deaths and 21to 23 deaths per 1000 live births in Umguza and Bubi districts between the years 2010- 2014. The study seeks to understand the determinants of perinatal mortality in the two districts so that appropriate measures can be put in place.
Methods: An unmatched 1:2 case control study was conducted using a pretested interviewer administered questionnaire. A total of 73 cases and 146 controls were recruited in the study. A case was a woman who resided in Umguza and Bubi districts who had a perinatal death from January 2014 to June 2015. A control was a woman who resided in Umguza and Bubi Districts whose baby survived the early neonatal period from January 2014 to June 2015. Two focused group discussions (FGD) were done one in each district using the FGD guide. The FGD consisted of 12 women for Bubi and nine women for Umguza district.
Results: The median age of cases and controls was 22years (Q1=19; Q3=29) and 23 years (Q1=19.5; Q3=28) respectively.Gestational age of < 36 weeks OR 8.28 (3.67; 96.6), having a male baby OR 1.4 (1.09; 2.88), low birth weight of <2500g OR 1.37 (1.27; 6.96) and no antenatal care booking OR 24.6 (2.67;226.3) were independent risk factors for perinatal mortality. Antenatal booking OR 0.30 (0.14; 0.65) and secondary education were protective factors against perinatal deaths. Women’s cultural believes and poor nurse attitudes, resource shortages and patient delays were cited as contributory to perinatal mortality.
Conclusion: Gestational age of less than 36 weeks, not attending antenatal care, having a male baby and low birth weight were risk factors. The majority of perinatal deaths were
macerated. Having early neonatal deaths occurring during the first 24 hours after delivery might be indicative of the quality of neonatal care provided
Assessment of groundwater vulnerability in Norton Town, Zimbabwe.
No full textThe current threats of climate change have prompted the dependency on groundwater as a sustainable supply of domestic water. As a result, maintaining groundwater quality has remained a critical intervention for many local authorities especially in developing countries including Zimbabwe. This study assessed the vulnerability of groundwater quality within Norton Townin Zimbabwe, an urban area that dependents partly on groundwater sources for domestic water supplies.The town has a number of potential pollution sources. Potential pollution sources were digitized onGoogleEarth mapusing GIS techniques. Ground control points were collected to validate and improve the potential pollution source map. Fifteen (15) systematically selected groundwater points (8 boreholes and 7 wells) located close to potential pollution sources were chosen and water samples collected from them. Four (4) sampling campaigns were undertaken in January and February 2016. The water samples were analysed for selected water quality parameters using standard methods and compared to Zimbabwean and World Health Organization limits to assess drinking suitability. The parameters that were studied include temperature, turbidity, pH, DO, electrical conductivity, TDS, total hardness, iron, sulphates, chlorides, faecal coliform and total coliform. One-way Analysis of Variance was performed using SPSS version 23 to test for any significant differences between parameters and sites. In order to determine parameters that are important in assessing variation in groundwater quality data set, Principal Component Analysis was used. The Moving Average technique in Integrated Land and Water Information System was used to plotspatial and temporal variation of groundwater in the environment. The Aquifer Vulnerability Index Model was used for mapping the vulnerability of groundwater in Norton Town. Six parameters including hydraulic conductivity, soil media, depth to water level, aquifer media, slope and land cover were assigned weights and ratings using ILWIS Software. Statistical data grouping was implemented in order to differentiate five categorical index ranges.Results for mapping potential pollution sources showedthat, industrial activities and improper disposal of solid wastes and wastewater are the main causes of groundwater pollution in Norton. Descriptive statistics for the analysed groundwater parameters showed the mean values for temperature, turbidity, pH, DO, electrical conductivity, TDS, total hardness, iron, sulphates, chlorides, faecal coliform and total coliform were 25.7 °C, 6.8 NTU, 7.2, 3.66 mg/L, 580 μS/cm, 280 mg/L, 698 mg/L, 0.05 mg/L, 455 mg/L, 282 mg/L, 1015 cfu/100mL, 991 cfu/100mLrespectively. The resultsshowed that temperature, turbidity, DO, TDS, pH, chlorides, total hardness, electrical conductivity and sulphates had significant variation of parameters (spatial and temporal) explained by (p values <0.05). PCA components F1, F2, F3 and F4 had total variability of 80% with each one of the components having 36%, 24%, 11% and 9% respectively.The significant parameterswerechlorides, dissolved oxygen, electrical conductivity and feacal coliform. From the Aquifer Vulnerability IndexModel, five different vulnerability zones were established which were; very low vulnerability (index 63-73), low vulnerability (74-84), moderate vulnerability (85-95), high vulnerability (95-106) and very high vulnerability (107-126). The results showed that 17.8% of the area had very low vulnerability, 37.2% low vulnerability, 30% moderate vulnerability, 12.5% high vulnerability and 2.5% very high vulnerability. The study identified the main pollution sources as treatment plant, agriculture, landfill, onsite sanitation and industrial discharge. The study also revealed that potential pollution sources are the main causes of groundwater contamination. The results showed that groundwater sources situated in high density areas had faecal coliform counts greater than 100 cfu/100 mL which could be harmful to human health. Groundwater quality parameters (50 %) exceeded the Zimbabwean and World Health Organisation drinking water limits. At the present moment, the area shows a total of55 % very low to low vulnerability.It is therefore recommended that water from vulnerable sources be disinfected regularly before human consumption.WaterNe
Assessing the rate of sedimentation of the Lubovane reservoir and the implications on the lifespan of the Lusip Project in Sphofaneni, Swaziland
No full textAn average of 19% of the reservoir storage volumes has been lost to sedimentation in Africa. The Lubovane reservoir in Swaziland, having been commissioned in 2009, is not an exception to sedimentation as all reservoirs globally lose about 1% of their storage due to sedimentation annually. The Lubovane reservoir was constructed as part of the Lower Usuthu Smallholder Irrigation Project(LUSIP) aimed at intensifying and commercializing agriculture for smallholder farmers. The study aimed at determining the rates of sedimentation of the Lubovane reservoir, with sediment deposited from Mhlatuzane River and a canal that conveys water from the Usutu River to the reservoir. Suspended sediment concentration was determined through grab sampling 300mm below the water surface in the canal and the river. The Revised Universal Soil Loss Equation(RUSLE) combined with GIS and remote sensing were used to predict sediment yield for the Mhlatuzane micro-catchment and it was validated using data that was collected from four erosion monitoring plots. A bathymetric survey was conducted in the Lubovane reservoir to determine the sediment that has already settled in the reservoir and the annual capacity loss due to deposition of sediment. The average sediment yield was found to be 26.8, 24.3, 8.83, 29.8 and 8.99 t.ha-1.yr-1 for years 1995, 2000, 2005, 2009 and 2015 respectively. Concentration of suspended sediment was found to be 2231 mg/l and 3436 mg/l for Mhlatuzane River and the Feeder canal respectively. The sediment yield of the Mhlatuzane River derived from the sediment concentration was 2.98 t.ha-1.yr-1 and the combined sediment yield from the sediment concentration monitoring, was 0.82x106m3 leading to a 0.52% of storage capacity. The bathymetric survey data showed that there has already been 14.7x106m3 of sediment that has settled in the reservoir to date, with an annual capacity loss of 1.36%. Suspended sediment monitoring underestimated the sediment loading in the reservoir since bedload was not sampled and hence, this method cannot be used to without sampling bedload toadequately monitor siltation of the reservoir. The study then concluded that if no measures are taken to reduce sedimentation and the sedimentation rates remain at this level, the reservoir life will be reduced from 100 years (design lifespan) to 81 years.The loss of storage capacity will lead to an annual loss in 20% yield of 1.23%.WaterNe