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The iron status of Zimbabwe blood donors
No full textBackground Transfusion medicine is a distinct and expanding discipline with a vital role in the health care system, according to the permanent secretary in the ministry of health and child welfare. In Zimbabwe the number of people who failed the copper sulphate test (haemoglobin screening test) shot up from 1249 in 2011 to 2360 in 2012 (89% increase). Failing this screening test is caused among other things by low haemoglobin levels which in turn are caused by low iron levels in the body. Checking haemoglobin levels alone is not enough to check the status of the donors, but a complete iron profile is necessary to ascertain the actual status of the blood donors. Aim To find out the iron status of blood donors in Zimbabwe. Materials and Methods A cross sectional study was done on 190 blood donors at the National Blood Service Zimbabwe (NBSZ). Left over samples were analysed for serum iron, serum ferritin, TIBC (total iron binding capacity) and transferrin saturation at Premier Clinical Laboratory. Donors recruited into the study ranged from first time donors to donors who had donated up to 8 times in the past two years. Results
A total of 190 (109 males and 81 females) blood donors participated in this study. The median age was 23 years and the inter quartile range was 19.0-27 years. The range of the age was from 16 years to 67 years. The median number of donations was 4 and the interquartile
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range was 5-6 units over the two year period under study. The median serum iron levels was 13 μmol/L with the inter quartile ranges from 10.0-17.8 μmol/L. For ferritin the median value was 30 ng/ml with the inter quartile ranges from 18.0-56.8 ng/ml. The median for TIBC was 74.1 μmol/L with the inter quartile ranges from 63.3-82.3 μmol/L. For transferrin saturation the median was 17.6 μmol/L with the inter quartile ranges from 12.0-26.9 %. The statistical analysis was done by the ANOVA test. As for serum ferritin levels there was statically significant differences in the mean ferritin levels between group 1 and groups 6,7 and 8 (p<0.01) for men. For females there was statistically significant difference in the mean ferritin levels between the control group and group 6 and 7 (p <0.05). The overall prevalence of iron deficiency in the study population was 13.2% and the prevalence of reduced iron stores was 37.4 %. Conclusion These findings suggest that repeated blood donation causes a reduction in the iron stores of the blood donors in Zimbabwe and there is need to include biochemical markers, (serum iron, serum ferritin, TIBC and transferrin saturation) in the screening of blood donors, especially from the fifth unit
Effectiveness of short message services reminder on childhood immunization programme in Kadoma- a randomized control trial, 2013
No full textIntroduction: Globally, non-attendance for immunization appointments remains a challenge to healthcare providers. Adoption of short message services has been shown to enhance attendance in medical setting. A review of the 2011 consolidated monthly return form (T5) for Kadoma City reveals that the annual OPV1, Pneumococcal 1, and Pentavalent 1 coverage at 6weeks was 74% and for OPV2, Pneumococcal 2, and Pentavalent 2 was 84% at 10weeks. The coverage for OPV3, Pentavalent3 and Pnemococcal3 was 74% at 14weeks. The immunization coverage was less than the district target of 90% for all the antigens at 6, 10 and 14 weeks. The study was conducted to determine the effectiveness of short message services reminders on immunization programme for Kadoma City.
Methods: A Randomized Control Trial was conducted at Kadoma City Clinics. Woman who delivered in Kadoma and are residence of Kadoma City were recruited into the study within 72hours after delivery. In the intervention group Short Message Service reminders were sent at 6, 10 and 14 weeks. In the non-intervention no message reminders were used. Data were collected using a standardized interviewer administered pretested questionnaire. Data were collected in phases that are; soon after delivering, at 6, 10 and 14 weeks. Data were entered and analysed using Epi Info 7TM (CDC August 2012). The data were displayed on frequency tables, the means of continuous data were calculated and also contingency tables were used to analyze categorical data.
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Results: A total of 305 participants were recruited into the study. A total of 152 participants received the short message services as immunization reminders while 153 did not receive the short message reminders. The immunization coverage in the intervention group was 97% and in the non-intervention group was 82% at 6 weeks (p<0.001). At 10 weeks the immunization coverage was 96% and 80% in the intervention and non-intervention group respectively (p<001). Immunization coverage at 14 weeks for OPV3, Penta3 and PCV3 was 95% in the intervention group and 75% in the non-intervention group (p<0.001). The proportion of those who did not delay in receiving OPV1, Penta1 and PCV1 was 82% in the intervention group and 18% in the non-intervention group. The proportion of those who did not delay in receiving OPV3, Penta3 and PCV3 was 81% in the intervention group and only 8% in the non-intervention group. The median delay in the intervention group was 0 days (Q1=0; Q3=0) whilst the median delay in the non-intervention group was 10 days (Q1=6; Q3=17).
Conclusion: The immunization coverage in the intervention group was significantly higher than in the non-intervention group. There is a difference on the immunisation coverage among those receiving short message service reminders and routine immunisation health education and those receiving routine immunisation health education only. The overall increase in the immunization coverage can be attributed to the use of short message reminders in this study
Factors influencing dietary patterns in Mt Darwin: a rural population of Zimbabwe, 2013.
No full textIntroduction: Overweight and obesity are major risk factors for a number of chronic diseases, including diabetes, cardiovascular diseases (CVD) and cancer. CVD are increasing throughout the world and cause 16.7 million deaths each year. In Zimbabwe, hypertension is the top leading cause of outpatient chronic conditions and its proportion to the overall burden is 48.9%. In Mt Darwin hypertension (51.4%) remains the chronic condition with the highest burden. Eating a healthy diet such as high fruits and vegetables, low fat and low salt have been shown to substantially reduce CVD and increase quality of life. This study sought to determine factors influencing dietary patterns in Mt Darwin district.
Methods: The study was an Analytic Cross Sectional study and the sample size was 350. Data was collected by an Interviewer Administered Questionnaire targeting people in Mt Darwin that are over the age of 18 years. Multistage sampling was done. Epi info version 3.5.1 was used to create frequencies and proportions were calculated as well as Odds ratios to determine associations. Multivariate Logistic regression analysis was done to identify independent risk factors and to control for confounding variables.
Results: Three hundred and fifty (350) participants were included in the study. Being male or female [POR=3.97; 95% CI (2.28-6.89)], preferring fatty foods [POR= 2.1; 95% CI (1.11-3.99)], adding salt to served food [POR=0.42; 95% CI (0.26 -0.67)], boiling food as a method of preparation [POR=1.65; 95% CI (1.05-1.59)], and perceiving that a big body means one is healthy [POR=0.56; 95% CI (0.36-0.96)] were significantly associated with dietary patterns. Being male or female [AOR=0.23; 95% CI (0.13-0.40)], boiling food as a method of preparation [AOR=1.69; 95% CI (1.03-2.76)] and preferring fatty foods [AOR=2.56; 95% CI (1.29-5.06)], remained significant on logistic regression analysis.
Conclusion and Recommendations: Unhealthy dietary patterns have been found to be prevalent in Mt Darwin, especially among women. Taste and food preference, and image and body size were factors influencing dietary patterns in this study. Health education messages of diet should encompass all social and cultural context issues around food, including correction of myths
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
Determinants of Post Natal Care Uptake in Bikita District, Masvingo Province, 2011
No full textPostnatal care (PNC) gives an opportunity to detect medical problems of the
mother and neonate and reduce morbidity and mortality. In 2010 PNC uptake in Bikita was
43%. This study was conducted to determine factors associated with low PNC uptake in
Bikita.
Materials and methods: A 1:1 unmatched case control study was conducted. A case was
defined as a woman who attended at least one antennal care visit and did not attend first( 10
day) PNC visit. A control was a woman who attended both antenatal care and first (10 day)
PNC visit. Random sampling was used to select cases and controls from ANC and PNC
registers at health centres. An interviewer administered questionnaire using constructs of the
Health belief model was used. Focus group discussions were conducted with women who
were not study participants who had come for ANC and PNC. A check list was used to asses
availability of resources for use in PNC. Epi Info 3.5.1 was used to analyse data. Qualitative
data was coded , grouped and analysed manually.
Results: One hundred and fifty cases and 150 controls were recruited. Independent factors
associated with non-uptake of PNC were; practicing seclusion until umbilical cord fell off,
[AOR 3.43,( 95%CI: 1.73-6.81)], residing in village/resettlement [AOR 3.71(95%Cl: 1.30-
9.90)],delivering at home [AOR 6.0(95%CI: 3.50-12.71)], staying more than 5km from
health centre [AOR 1.73(95%CI: 1.03:2.89)],. Factors associated with PNC uptake were
secondary/tertiary level of education [AOR 0.25 (95%CI: 0.11-0.73)] and ability of mother
to attend PNC within 48 hours after at home delivery [AOR 0.60(95%CI: 0.21:0.96)].
Discussion and Conclusion : Delivering at home may lead to transmission of HIV from
mother to child if the mother is HIV positive due to non swallowing of Nevirapine during
delivery. Death of mother and neonate may occur due to lack of medically skilled assistance.
Construction of more waiting mothers shelters may increase the number of institutional
deliveries and prevent maternal and neonatal deaths. As a result of the findings of this study
Save the Children UK has been approached to assist in the construction of waiting mothers’
shelters at Chikuku and Bikita rural hospital.Introduction: Postnatal care (PNC) gives an opportunity to detect medical problems of the
mother and neonate and reduce morbidity and mortality. In 2010 PNC uptake in Bikita was
43%. This study was conducted to determine factors associated with low PNC uptake in
Bikita.
Materials and methods: A 1:1 unmatched case control study was conducted. A case was
defined as a woman who attended at least one antennal care visit and did not attend first( 10
day) PNC visit. A control was a woman who attended both antenatal care and first (10 day)
PNC visit. Random sampling was used to select cases and controls from ANC and PNC
registers at health centres. An interviewer administered questionnaire using constructs of the
Health belief model was used. Focus group discussions were conducted with women who
were not study participants who had come for ANC and PNC. A check list was used to asses
availability of resources for use in PNC. Epi Info 3.5.1 was used to analyse data. Qualitative
data was coded , grouped and analysed manually.
Results: One hundred and fifty cases and 150 controls were recruited. Independent factors
associated with non-uptake of PNC were; practicing seclusion until umbilical cord fell off,
[AOR 3.43,( 95%CI: 1.73-6.81)], residing in village/resettlement [AOR 3.71(95%Cl: 1.30-
9.90)],delivering at home [AOR 6.0(95%CI: 3.50-12.71)], staying more than 5km from
health centre [AOR 1.73(95%CI: 1.03:2.89)],. Factors associated with PNC uptake were
secondary/tertiary level of education [AOR 0.25 (95%CI: 0.11-0.73)] and ability of mother
to attend PNC within 48 hours after at home delivery [AOR 0.60(95%CI: 0.21:0.96)].
Discussion and Conclusion : Delivering at home may lead to transmission of HIV from
mother to child if the mother is HIV positive due to non swallowing of Nevirapine during
delivery. Death of mother and neonate may occur due to lack of medically skilled assistance.
Construction of more waiting mothers shelters may increase the number of institutional
deliveries and prevent maternal and neonatal deaths. As a result of the findings of this study
Save the Children UK has been approached to assist in the construction of waiting mothers’
shelters at Chikuku and Bikita rural hospital
Fetomaternal outcomes of pregnant women admitted with malaria at Parirenyatwa hospital and in Mashonaland East province of Zimbabwe
No full textINTRODUCTION
There are 300million to 500million people who are infected with malaria worldwide every year and the disease kills about 3million yearly. 90% of the cases occur in Sub-Saharan Africa where HIV is also prevalent. Malaria is one of the major contributing factors to fetal and maternal morbidity and mortality causing severe anemia, cerebral malaria, renal failure, miscarriage, stillbirth and low birth weight. Zimbabwe has made significant achievements in reducing the incidence of malaria in the general population according to the data from the Ministry of Health and Child Welfare Department of Malaria Control but the disease burden remains high[Figure 1]. Malaria is the fifth leading cause of maternal mortality in Zimbabwe [6]. However, there is limited data on the impact of the disease on high risk groups like pregnant women in Zimbabwe.
This was done as a cross sectional descriptive survey to evaluate the effect of malaria on pregnant women and their fetuses.
OBJECTIVE
Main objective
1) To evaluate maternal and fetal outcomes of malaria in pregnancy
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Other objectives
1) To assess factors which influence maternal and fetal outcomes.
METHOD
A cross sectional descriptive survey was done on pregnant women admitted with malaria over a period of 8 months (September 2011-April 2012).
An interviewer administered questionnaire was used to gather information on women admitted in the antenatal or labour ward with a diagnosis of malaria.
District hospitals (Mutoko, Murewa, Mudzi) in moderate to high seasonal malaria transmission located in Mashonaland East Province of Zimbabwe and one tertiary hospital, Parirenyatwa Hospital, were identified for the survey.
RESULTS
Of the 103 cases of malaria in pregnancy studied, there were 2(2%) maternal deaths, 6(6%) cases of severe anaemia and two cases of cerebral malaria. Maternal adverse outcome were influenced by booking status, human immunodeficiency virus(HIV) status, use of intermittent presumptive therapy(IPT), insecticide treated bed nets(ITNS) and late presentation to hospital. Ninety three cases were discharged from hospital without major complications.
There were 24(23%) live term babies, 10(10%) preterm deliveries, 10(10%) cases of low birth weight, 6(6%) stillbirths, 9(9%) miscarriages and two cases of threatened miscarriages. Fifty two percent of the participants were still pregnant when they were
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discharged from hospital. There was under utilization of IPT (45%) and ITNs (45%) by participants.
CONCLUSION
Malaria infection had adverse effects on both mother and foetus. It was associated with maternal mortality and morbidity. Anaemia, cerebral malaria and maternal death were the main maternal complications encountered in this survey. Maternal adverse outcomes were influenced by booking status, HIV status, use of IPT, ITNS and time taken to present to hospital after onset of disease. There was significant fetal wastage (15%) resulting from miscarriages (9%) and stillbirths (6%). Malaria infection was also associated with low birth weight (28%) and preterm delivery (10%).
The survey also revealed that there was underutilization of prevention strategies (IPT and ITNs) by 45% of participants which was mainly due to failure to book or late booking for antenatal care (ANC). Case management was generally according to standard guidelines but participants were not adequately investigated in terms of other parameters such as complete blood count and renal function
An investigation into the psychosocial implications of Oculocutaneous Albinism. a case study of Manicaland Albino Association.
No full textThe study sought to investigate the psychosocial implications of oculocutaneous albinism (OCA)
among members of the Manicaland Albino Association in Mutare urban. The study was
anchored on four objectives that were: to establish the psychosocial challenges that members of
the Manicaland Albino Association are facing in Mutare urban, to establish the attitudes and
beliefs associated with oculocutaneous albinism among members of the Manicaland Albino
Association in Mutare urban, to explore the extent of stigma and discrimination among members
of the Manicaland Albino Association in Mutare urban and finally to establish the coping
strategies being employed by members of the Manicaland Albino Association in Mutare urban.
In order to comprehend oculocutaneous albinism as a disability and its psychosocial implications
the study utilized the social model of disability as its theoretical foundation. Data was gathered
using the simple random sampling technique to target 30 respondents with OCA.The study
purposively identified 3 key informants which included the chairperson of the Manicaland
Albino Association, the coordinator of the National Association of Non-governmental
Organizations Mutare and the Department of Social Services head Mutare. Additional data also
came from the purposively selected 2 focus group discussions, one with persons with albinism
and the other with care facilitators. Employing the Rosenberg self esteem scale, 30 respondents
were interviewed to measure their self esteem scores. The study established that psychosocial
challenges faced by persons with OCA include stigma and discrimination and they have
influenced the society behaviour and attitudes towards them. Some of the psychosocial
challenges confronting persons with OCA manifested themselves in the marriage institution
whereby they were finding it complicated to establish steady marriage partnerships owing to the
myths and misconceptions aggravated by a society that is yet to entirely comprehend the
condition. The condition for women with OCA was further compounded by gender dynamics.
Findings on the marital status, level of self esteem, educational level and types of employment
points to the fact that institutional discrimination as conceived by the social model of disability is
negatively affecting the quality of life of persons with OCA. The study established that stigma
and discrimination provoked emotions like anger and crying and in some cases it leads to
depression. The study established that in face of these challenges persons with OCA engage
coping strategies that range from emotional release and social support from the church,
individuals and other non religious organisations. The research established that the family plays a
critical role in accommodating persons with OCA. From the study 100% of the respondents felt
that the family understands and appreciate the condition. The study concluded that persons with
OCA do face psychosocial challenges hence it came up with recommendations that will
challenge the stigma and discriminations faced by persons with OCA.This include an aggressive
awareness campaign on the rights of persons with OCA and the amendment of the Disabled
Persons Act (chapter 17.01) that will enable persons with OCA to have a legal backing in an
effort to address issues of social exclusion
Remote sensing patterns of net primary productivity in the Great Limpopo Transfrontier Conservation Area (GLTFCA) in relation to land use and land tenure
No full textNet Primary Productivity (NPP) is an important indicator of ecosystem health and its
estimation and understanding of factors determining its spatial and temporal variations is
critical. Previous studies have mainly attributed NPP variations to biophysical factors.
However, the influence of these factors is particularly evident at large spatial/global scales.
At small spatial/local/landscape scales, complexity is encountered as biophysical factors tend
to account for no or less variance in NPP. In addition, it is difficult to consider some aspects
of human management systems such as land-use/land tenure in relation to NPP variations on
a global scale analysis than on a local scale analysis. To this end, it is predicted that land use
and land tenure would dominate explanation of NPP variations at local scales. Thus, in this
study, at the local scale, particularly in a high intensive system of a Southern African
savanna-the Great Limpopo Transfrontier Conservation Area (GLTFCA), the hypothesis that
land-use/land tenure types influence NPP variations was tested. However, it is important to
quantify NPP in order to test the abovementioned hypothesis. Thus firstly, this study tested
the extent to which a combination of remote sensing and geographic information system
(GIS) modelled shortwave radiation (SWR) can be used to estimate NPP in a Southern
African savanna. Results showed that NPP can successfully be mapped using a combination
of Moderate Resolution Imaging Spectroradiometer (MODIS) data and GIS modelled SWR.
One-way analysis of variance (ANOVA) statistical test was then used to test for group mean
NPP differences among the different land-use/land tenure types of the GLTFCA. Results
showed that land-use/land tenure types significantly (P=0.000, F(4:42056)=180.162, One-
Way ANOVA, Tukey HSD Post Hoc Analysis) explain NPP variations at landscape scales
even better than biophysical factors. Furthermore, results showed that biophysical factors
remain essential in explaining NPP variations even at local scales. These results exhibited the
intricacies that exist between the biophysical and human induced factors in explaining NPP
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variations within ecological landscapes. Also, the findings of this study suggest the
importance of human management systems, in this instance, land-use/land tenure factors, as
an agent of environmental change through its effect on NPP variations in African savannas.RP-PCP Research Platform (RPPCP
grant/Project ECO#1, the French Embassy in Zimbabwe and CIRAD Zimbabw
A value chain analysis of flue cured virginia leaf tobacco in Zimbabwe
No full textTobacco is undoubtedly the major agricultural export crop for Zimbabwe raking in close to a billion United States dollars in 2012. Flue Cured Virginia tobacco remains one of the few economically viable options for Zimbabwe after maize and cotton have been greatly crippled by low prices originating predominantly from world market price distortions. Tobacco production in Zimbabwe is therefore a valuable resource for the country and maintaining a favourable pattern in production becomes a priority for the Government of Zimbabwe.
The study undertook to investigate the current state of tobacco production in Zimbabwe through a complete enquiry on the major tobacco players and establishing their value along the tobacco value chain. A value chain analysis into the key stakeholders was done to establish the players in the industry and their dominance. The study found out that the industry is more dominated by the contracting companies who are in most cases the buyers at the auction floors as well as at the contract floors. These contracting companies are also vertically integrated with the processing and cigarrete manufacturing companies to form a vertically integrated tobacco value chain. The study also found out that the vertically integrated value chain has the most significant share of the tobacco value chain.
The study also undertook a trend analysis into the tobacco production in Zimbabwe. Trend Analysis using t-tests and Regression analysis were employed on the time series data on tobacco production in Zimbabwe. The study found out that there was a very significant change in the number of growers over time. Similarly the study shows a very significant increase in the volume of production over time.
Finally, the study investigated whether contract farming is more cost effective than non-contract farming. The study used Gross Margin Analysis to investigate Flue Cured Virginia tobacco profit differences between contracted and non-contracted Flue Cured Virginia tobacco growers. Contract and auction performance was compared on the basis of average grower prices, cost of production, Flue Cured Virginia production volumes of as well as revenues. Results showed that there are no significant differences between average grower prices and input costs between contract and non-contracted farmers. The results further showed that there is no significant difference in the mean price between the auction and contract floors. There was insufficient data to show any significant differences in production volumes between contract and non-contract growing. There were significant differences in the revenue and profit between the two marketing arrangements. The results showed that there are higher revenue and profits when tobacco is marketed through the contract system.
Important policy messages that were drawn out of the research are that the Government of Zimbabwe should promote tobacco contract growing to boost the crop tapping into available and reasonably priced money from the contracting companies. However the study recommends that policy makers help upgrade locals to participate into the most profitable stages of the value chain through the indigenisation programs to enable locals to participate in high value functions of the value chain which are contracting, processing through to cigarette manufacturing
A study of strategies for transforming ZESA Enterprises (ZENT) into a complex adaptive system for achieving sustainable growth from 2009 to 2013
No full textThe purpose of this research is to examine how a public organisation can be transformed into complex adaptive systems (CAS) to achieve sustainable growth for the benefit of all stakeholders.
This research reviews the strategies and provides a conceptual framework of transforming a public organisation into complex adaptive systems and a conceptual framework is provided. The purpose of this dissertation is to apply organisational transformation through CAS in an organisation especially in the field of project management (construction) and manufacturing. The research explores and identifies the best approaches that the organisation can implement to achieve sustainable growth. The research was based on a case study and two divisions were under study although research information was collected from the organisation’s four divisions including the head office.
The benefits of CAS application in the organisation give management an alternative for adapting and managing, in the current turbulent environment. The findings show that the application of CAS in organisations is not a popular concept in the organisation under study. The CAS approach looks at the relationship between management, employees and the processes to achieve sustainable growth.
The research recommends that transformation strategy through complex adaptive systems will encourage continuous innovation, restructuring, application of advanced technology, improvement in communication, employee involvement, review of the organisation, application of CAS characteristics and approaches, reward teams based performance for sustainable growth
The case study contributes to the empirical body of knowledge of organisational transformation strategies through complex adaptive systems. This paper will introduce a new way of thinking to the manager on current and future issues in the field of project management and manufacturing, and move away from out-dated management model e.g. Taylor’s management model