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Anaemia and iron deficiency in peri-urban school children born in a National HIV Prevention Programme in Zimbabwe: A cross sectional study
No full textObjective'. To determine the prevalence of anaemia, iron deficiency and iron deficiency anaemia in school children who were born in a national HIV prevention programme. Design'. This was a community based cross-sectional study. Setting: A resource poor peri-urban setting with high prevalence of HIV infection. Subjects: School aged children six to 10 years old who were bom in a national mother-to-child HIV prevention programme. Main Outcome Measures: Haemoglobin (Hb), serum Ferritin (F) and serum Transferrin receptor (sTfR) levels. Results: Three hundred and eighteen children were recruited including 21 HIV positive. The prevalence of anaemia (Hb 8.3pg/L) were 15%, 4% and 2% respectively. When a higher cut-off for ferritin of 30 micrograms per litre was applied to adjust for high infection disease burden, iron deficiency prevalence increased to 32% and iron deficiency anaemia increased to 5%. Anaemia was 4.9 (C.I 1.9-12.4) times more likely to occur in HIV infected children compared to the HIV uninfected children. Maternal HIV status at birth was not related to presence of anaemia in the school children. Conclusion: Anaemia was of mild public health significance in this cohort of children. Iron deficiency anaemia contributed less than a quarter of the cases of anaemia. HIV infection was an important determinant for presence of anaemia. Therefore continued efforts to eliminate paediatric HIV infection as a way of reducing anaemia in children are essential
Investigation into the pharmacodynamics of ethanol as a nerve blocking agent
No full textEthanol is a known nerve-blocking agent, yet its clinical use is minimal. This is partly due to
unclear dosage levels and not enough knowledge of its pharmacodynamics and overwhelming
dominance of its psychomotor properties. This research intended to investigate into the
pharmacodynamics of ethanol as a nerve blocking agent, try and establish an effective dose that
can be used clinically, as well as comparing its effects on various parts of the motor unit.
A total of 105 sciatic nerve – gastrocnemius muscle specimens were isolated from frogs, Xenopus
laevis. Ethanol at concentrations of 40%, 55% and 70%, each at doses of 1.5g/kg, 2.0g/kg and
2.5g/kg body weight (BW) was administered intraperitoneally, intramuscularly (into the
gastrocnemius) and topically (onto the sciatic nerve). Using EPIC system to monitor muscle
contractions, action potential and/or electromyogram the nerve block effects of each dose /
concentration combination were assessed. The effects on the nerve, neuromuscular junction and
muscle were assessed separately and compared, then as a single unit.
Results showed that intraperitoneally administered ethanol had no effect on neuromuscular
function. Intramuscular injections took 2.5 to 9.0 minutes to attain complete paralysis, and lasted
for 29.5 to 61.0 minutes, depending on concentration and dose (>/= 55%; >/= 2.0g/kg BW).
Topically applied ethanol took 15 to 30 seconds to block the nerve completely, depending on the
concentration (>/= 40%). The blockade lasted for 5 to 10 minutes. Intramuscularly injected
ethanol reduced the amplitude of indirectly elicited electromyography more than the directly
evoked one.
It was concluded that to achieve a complete and sustained ethanol nerve block, at least 55%
concentration, 2.0g/kg BW dose and intramuscular route are required. The duration of blockade
depends on concentration and dose administered. Ethanol affects both nerve and muscle. The
effect is more pronounced and instant on the nerve than on muscle
SIDE LAB MANUAL
No full textThe laboratory has become more essential in the clinical
examination of patients. However there has been a
tendency for the clinician to relegate even simple tests to
specialist laboratory workers. This has its disadvantages.
First, the clinician has less insight into the meaning and
potential errors of the test. Second, depending on the main
lab the test results may become available later than if the
tests were done in a ward side-lab. Finally, the side-lab
tests may be the only results available to the clinician
during an emergency at night
Factors Associated with Contracting Malaria in Ward 29 of Shamva District, Zimbabwe, 2014
No full textFactors associated with 1st line ART failure among patients at Newlands Clinic, Harare
No full textFirst line ART treatment failure occurs when drugs being administered for the treatment of HIV are no longer able to kill the virus i.e. virus would have developed resistance to the drugs. This study sought to determine factors associated with 1st line treatment failure among patients taking ART at Newlands clinic, Harare.
Materials and methods:
An unmatched 1:1 case control study was conducted at Newlands Clinic. Patients who had been on ART for at least 6 months were eligible for study participation. Questionnaires were used to collect data and a review of patient records was done.
Results:
A total of 464 participants were enrolled into the study. Median age of cases was 33.5 (Q1= 17, Q3 =45) and 37 for controls (Q1=27.5, Q3=37). Females represented 58.1% of study population and 41.9% were males. Median duration on ART for cases was 3.1 years (Q1=2.01, Q3=4.7 years) and 2.9 years for controls (Q1=1.96, Q3= 4.64). Independent risk factors associated with treatment failure were: Not being married (AOR= 1.8: 95% CI 1.01- 3.21), ART commencement by private doctor (AOR =
11
4.86: 95% CI 2.11- 11.2), WHO stage 3 / 4 at ART commencement (AOR=2.08: 95% CI 1.21- 3.57), poor adherence to treatment (AOR=1.73: 95% CI 1.01-3.21) and CD
An investigation into the dimensions that result in poor growth in short-term insurance broking firms in Zimbabwe: The case of Perpro Insurance Brokers
No full textThe insurance industry remains an integral part of the wider economy because of the resource mobilisation role that it plays thus facilitating savings and investment. In recent years the chronic economic challenges affecting the country have not spared this sector. Insurance brokers play an intermediary and facilitatory role between insurance companies and consumers of insurance. Their growth is a good indicator of the good health or lack of it of the whole insurance industry. It is against this background that this research was founded. In undertaking this research, there are specific concepts that underpinned it. Firstly, effort was put on finding out how skills base affect the growth potential of broking companies particularly at Perpro Insurance Brokers. The research also looked at the concept of return on investments as this constitutes a significant revenue source for brokers. In a poorly performing economy like Zimbabwe’s, the returns from investment have remained subdued and there was need to find out how the growth of brokers has been affected by the returns on offer. It also looked at the regulatory environment in so far as it affects the ability of brokers to grow their functions in the industry. The fourth and final concept was on corporate governance. This subject has assumed international importance of late and it was important to conceptualise this study around the issues of corporate governance. The methodology used to acquire information from relevant sources was qualitative using semi-structured interviews and an interview guide. Previous studies focused much on the poor growth dimensions in insurance companies and not on brokers and they relied on quantitative methodology. This research has gone further to take a more comprehensive approach by using the qualitative methodology as it explains how and why the concepts and dimensions cause the poor growth in the broking fraternity. In terms of conclusions, it came out that good skills base is an important ingredient in the growth of brokers and in particular at Perpro. Because of insufficient skills base, the returns on investments have been low. It also emerged that the regulatory environment has not assisted brokers to achieve the growth that they can potentially achieve. Lack of implementation of existing regulatory tools was identified in this research as a dimension of the poor growth in this industry sub sector
Land use/ land cover changes and stakeholders: Investigating sustainable natural resources management options for an a1 farm a case study of Essexdale farm in Marondera district, Zimbabwe
No full textThe tracking of the land use/land cover changes that took place in Essexdale Farm (a communal resettlement area in Marondera District of Zimbabwe) from the period 1985 to 2012 was conducted using the two methods: the Normalised Difference Vegetation Index (NDVI) Trend Analysis and the calculation of changes in proportions of the land use/land cover classes. Four land classes: woodland, cropland, wooded grassland and wetland, were considered. The analysis of the stakeholder management framework was conducted using both the formal and informal survey methods to offer an explanation for the observed trends in the land cover changes. The NDVI Trend Analysis results revealed that there is evidence of woodland and wetland degradation as was shown by the decrease in the NDVI values of the corresponding land classes from 1985 to 2012. There was however insignificant change in the trend analysis of the cropland and wooded grassland land classes. There was a general increase in the proportion of land under woodland from 1985 to 2012. However the effects of the Fast Track Land Reform process were evidenced by an increase in the proportion of the cropland at the expense the woodland.
Deforestation was identified by the stakeholders to be the main environmental problem and its contributing factors being the cutting down of trees for tobacco curing, clearing land for cultivation, selling of firewood to neighbouring towns and poverty. The clearing of land for cultivation under the post 2000 era, during the Government of Zimbabwe’s Fast-Track Resettlement Programme, emerged as the main contributing factor. It was also noticed that the conversion of the woodland to cropland and wooded grassland was more pronounced from 2000 to 2005 than was for 2006 to 2012. It was observed that there are now more than 265 families on Essexdale Farm, a figure which is almost double the carrying capacity of 136 families pegged by the land use planners in the Ministry of Lands and Rural Resettlement, Marondera district. There are also illegal settlers (who are not recorded in the official farm register at the District Offices) farming on marginal land.
The suggested possible solutions to the environmental challenges were tree planting, environmental education and awareness campaigns and firebreak construction, as well as strict environmental law enforcement. It was noted that the practicability and the effectiveness of these environmental management strategies would only be realised in a well managed sustainable stakeholder framework. This would demand the necessary political will to initiate institutional reforms and restructuring, with the major move being to shift the A1 land resettlement mandate from the Ministry of Local Government Rural and Urban Development to the more accountable Ministry of Lands and Rural Resettlement to deal with the problem of illegal resettlements. Capacity building of the individual farmers, local leadership and staff of all the government institutes would greatly benefit the conservation initiatives, with the major task of coordinating these efforts lying with the Ministry of Environment and Natural Resources Management
Is corruption really harmful to growth? Evidence from Zimbabwean firms
No full textUsing firm level data from 599 Zimbabwean firms which were surveyed in 2011 by the World Bank, the study empirically investigated the effects of corruption on firm level economic activities in the case of firms operating in manufacturing, retail and services sectors. The research made use of Econometrics. The results from the combined sample indicate that both capital stock and labour are positively related to a firm's level of productivity. Considering the three variables of our main interest, national corruption (GLOBAL) was the only variable which was found to be positively and significantly related to a firm's productivity. This implies that, in the case of Zimbabwean firms, national corruption enhances their productivity. Overall, the result supports the hypothesis that corruption is a 'grease' which lubricates the 'squeaky wheels' of bureaucratic, rigid administration and inefficient governments particularly those of the developing world. The sectoral results show that across the three sectors, capital-labour ratio is significant and is a positive sign as expected from economic theory. The variants of corruption indicated some mixed results depending on the sector. In the case of the manufacturing sector, both global corruption and unfair courts negatively affect productivity. Whilst national corruption at national level negatively affects firm production, local corruption does not impact on firm productivity given that its coefficient is not statistically significant. The tabulated results indicate that national corruption reduces the productivity of firms who pay bribes by 0.17% when compared to firms which do not engage in such activities. For the retail sector, the impact of national corruption (GLOBAL) is insignificant, while local corruption impacts negatively and in a significant manner. The regression results indicate that local corruption positively impact on the services sector
Experiences of health science students during clinical placements at the University of Zimbabwe
No full textBackground: Clinical placement is an essential component of training in health sciences because it is where theory and practice interface. Objective: To explore experiences of health sciences students during clinical placement in terms of supervision, challenges and coping strategics. Design: It was a cross sectional survey. Setting: University ofZimbabwe, College of 1 lealth Sciences. Participants: 179 multidisciplinary health science students. Materials and Methods: A cross-sectional survey was conducted using a self-administered questionnaire. Ethical clearance was obtained. Descriptive statistics were used for analysis. Main Outcome Measures: These were perceptions of students with regard to supervision, challenges faced during clinical placement and coping strategics used. Results: 179 participants responded to the questionnaires. Participants enjoyed linking theory to practice. Perceptions on supervision were both positive and negative. Inadequate supervision and inappropriate behaviours by supervisors were some of the challenges faced. Almost 89% used stress-relieving strategies such as focusing on why they were doing the clinical placement and the importance of successful completion. Ninety-one per cent had never used cannabis/mbanje but 41% had engaged in sexual activity to cope with challenges. Conclusion: This study found that the perceptions of health sciences students about supervision clinical placement, challenges faced and the coping strategics arc almost the same as those found elsewhere. It is therefore important to plan clinical placement with the involvement of clinical educators. Recommendations: .Supervisors' workshops should be held to create a forum to discuss clinical placement issues. Follow-up of students by academics is recommended. Students should be empowered to cope with challenges
Housing cooperatives and the politics of local organization and representation in peri-urban Harare, Zimbabwe
No full textHousing cooperatives have emerged in the context of housing challenges in the urban areas as a strategy for securing low-cost housing accommodation in peri-urban Harare. They constitute vehicles that allow people to pool resources and secure tenure. The paper explains the “politics of peri-urban housing” in contemporary Zimbabwe by looking into the resurgence of these new forms of housing cooperatives. The paper compares five sites in Harare (Whitecliffe, Hatcliffe, Caledonia, and Southlea Park and Hopley in Harare South) to provide insights into the politics of peri-urban housing and security of tenure. We argue that political identity, networks, and participation have been at the core of these housing cooperatives as residents sought to secure tenure in the peri-urban areas by enhancing citizenship rights