1358 research outputs found
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Spatial and temporal heterogeneity of woody vegetation along park boundary and the possible causes: A case study of Umfurudzi Game Park and adjacent communal lands
No full textAlthough national parks have been established across Africa to protect areas from deforestation
and to conserve biodiversity, they are not immune to disturbances outside and inside their
boundaries. A study on spatial and temporal heterogeneity of woody vegetation was carried out
along the boundary of Umfurudzi Game Park. Sampling was done at the four corners of the park.
The study considered soil factors as determinants of woody species distribution. Data were
analysed in Genstat software package, Microsoft Excel and Past software Package. Marked
differences in woody vegetation structure and composition and soil characteristics were observed
along Umfurudzi Park boundary. The differences were attributed to both human and natural
factors. A progressive increase in vegetation disturbances within the buffer zone was noted for
the period 1985-2010. Agriculture was concluded to be the main possible cause of vegetation
disturbances along Umfurudzi Park boundar
The relationship between perceived quality of provider initiated testing and counselling service and disclosure among urban antenatal mothers aged 18 – 40 years in Makoni district
No full textAntenatal mothers on the PMTCT programmes appear to be having problems in disclosing their HIV status. The purpose of this descriptive correlational study was to examine the relationship between perceived quality of PITC service and disclosure among urban antenatal mothers aged 18 to 40 years in Makoni district. King’s model of Goal Attainment was used to guide this study. A sample of 80 participants was recruited using the convenience sampling method. Data were collected using face to face interviews and structured questionnaires developed by the investigator. The research instruments comprised the Demographic Data Questionnaire, The Disclosure Questionnaire and the Perceived Quality of PITC Services Questionnaire. Data analysis was done using the SPSS computer software package. The results showed that the partial disclosure pattern was the most common for 65 (81.3%) of the participants. The level of disclosure was generally low. A total of 71 (88.8%) scored low level disclosure scores of between 1 and 10 out of 14. The perceived quality of PITC services was average for 43 (53.8%) of the sample. Pearson correlation analysis showed a statistically non significant and weak person correlation coefficient (r = .193). Although not statistically significant, the correlation analysis showed a weak linear relationship and therefore confirmed that to some extent, perceived quality of PITC services have a linear association with level of disclosure. Therefore, as perceived quality of PITC increases. Level of disclosure also increases. Existing PITC services need to be strengthened to increase the level of disclosure. In addition, further research is necessary to identify more causes for the low levels of disclosure
The relationship between CYP2D6 polymorphisms and Tardive Dyskinesia in black Zimbabwean psychotic patients on typical antipsychotics
No full textCYP2D6 polymorphisms have been associated with different drug efficacies and adverse effect profiles including Tardive Dyskinesia (TD). The occurrence of these polymorphisms has also been noted to be different amongst different racial or ethnic groups. In Asians and Caucasians CYP2D6*10 and CYP2D6*3, *4 and *5 have been positively associated with TD respectively. In Africans no clear relationships with the prevalent reduced function CYP2D6 genotypes has been shown.
The objective of this study was to determine whether occurrence of TD is associated with the most prevalent reduced function CYP2D6 genotypes in black Zimbabweans – CYP2D6*17 and *29. AIMS scoring and CYP2D6 genotyping was carried out on patients exposed to first generation or typical antipsychotic medications at Parirenyatwa Annexe and Harare Psychiatric units in an unmatched case control study.
The main outcome measures were CYP2D6*17 and *29 genotypes. The relationship between TD and mutant CYP2D6*17 homozygote and heterozygote genotypes was not statistically significant with p values of 0.740 and 0.442 in the haloperidol exposed and 0.587 and 0.150 in those exposed to haloperidol, FD and CPZ respectively. No CYP2D6*29 result could be determined due to a failure in genotyping for this SNP. The results presented suggest no association between the major reduced function CYP2D6 allele *17 and TD in black psychotic Zimbabwean patients
Investigation of the effect of STALANEV (stavudine, lamivudine and nevirapine) treatment on serum lactate levels in adults attending BRIDH and WIDH opportunistic infections clinics in Harare
No full textHuman Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) have become a significant public health problem in Zimbabwe, threatening the socio-economic fibre of the country and placing a tremendous strain on the capacity of the health sector to respond to the needs of the population. Antiretroviral therapy (ART) has reduced morbidity and mortality due to HIV and AIDS. Although it has also improved the quality of life of people living with HIV and AIDS, concern has risen due to its association with challenges such as impaired glucose metabolism, insulin resistance, lactic acidosis, osteopenia and dyslipidemia. Although World Health Organization (WHO) has recommended phasing out stavudine in all ART regimens due to its association with mitochondrial toxicity thereby leading to lactic acidosis, Zimbabwe has continued to use it due to the limited resources available. This study assessed the development of hyperlactatemia in patients on antiretroviral therapy containing stavudine, lamivudine and nevirapine(STALANEV) attending Wilkins Infectious Diseases Hospital (WIDH) and Beatrice Road Infectious Diseases Hospital (BRIDH) OI clinics in Harare.
Study design and methods
One hundred and eighty (180) adults aged 20-60 years who were HIV infected and were about to be initiated on STALANEV at WIDH and BRIDH OI clinics were recruited into this prospective cohort study. All the participants were antiretroviral naïve before entering the study and were commenced on first line regimen of STALANEV and then
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followed over a period of 4 months. The serum lactate levels of these participants were determined at enrolment (before commencing ART), after 2 months and 4 months on STALANEV treatment.
Results
Out of a total of 176 participants who completed the study, 95 (54.0%) developed hyperlactatemia over the 4-months follow-up period i.e. their serum lactate levels exceeded 2.5mmol/l. Eleven (6.8%) developed mild lactic acidosis i.e. their serum lactate levels exceeded 3.5mmol/l but were less than 4.0mmol/l. Serum lactate levels of 81 (46.0%) participants remained within the normal levels (0.5-2.5mmol/l) although there was an increase over the 4 months follow-up period. In all the participants, the mean difference between the serum lactate levels at baseline and 2 months after ART initiation was 20% whilst the one between 2 months and 4 months was 33%. A high increase of 59% was obtained between baseline serum lactate levels and the serum lactate levels after the 4 months follow-up period.
Conclusion
In this study population, STALANEV treatment led to an increase in serum lactate levels thereby, posing a danger for the development of lactic acidosis
Distal Hypospadias Repair: Comparison of Snodgrass versus Modified Mathieu Procedures: A Randomized Clinical Trial
No full textBackground
Hypospadias is defined as the presence of abnormal meatal opening along the ventral aspect of the penile shaft or into the perineum. Of the many operative techniques for distal hypospadias repair, two techniques have particularly attracted the attention: the Snodgrass (TIP) and the Modified Mathieu Procedure (MMP). The effectiveness of the two techniques in terms of success and complication rates remains controversial.
Objectives
The primary objective of the study is to compare the success rates between the two procedures, MMP (Modified Mathieu Procedure) versus TIP (Tubularised incised plate, Snodgrass).
The secondary objectives of the study are:
1. To compare the complication rates between the two procedures.
2. To compare the operative time between the two procedures.
Methods
Eligible boys were randomly assigned with equal probability to undergo one of the techniques of hypospadias repair: the Snodgrass procedure (tubularized incised plate technique, TIP) or the modified Mathieu procedure (parameatal based flap, MMP). We enrolled 118 patients, 59 in each arm, from January 2006 to February 2008. The patients were assessed at the first dressing at day seven and discharged. They were reviewed monthly up to three months post operatively and the complications, namely stenosis (MS), urethral stricture (US), urethrocutaneous fistula (UCF), urethral diverticulum (UD), penile curvature (PC) and wound breaking (WB) were recorded. Success was defined as the absence of the mentioned complications.
Findings
In this study, 83 patients were enrolled. They were aged between 2 years and 13 years, mean age 7.5 years. The success rates were 68.29%, 95% CI (54.20-84.5) for TIP versus 74.35%, 95% CI (57.18-89.91) for MMP. The following complications were recorded: MS (9.75%), US (14.65%), UCF (9.75%) for TIP versus MS (5.12%), US (5.12%), UCF (7.69%), UD (5.12%) for MMP. The complication rates were 34.14%, 95% CI (20.08-50.59) for TIP versus 23.07%, 95% CI (11.13-39.33) for MMP. The mean operative time was 90 ± 24minutes versus 110 ± 25 minutes (P0.05) for TIP and MMP respectively.
Conclusion
The difference of success rates between the two interventions was not statistically significant. The same conclusion was reached in terms of complication rates between the two techniques. The mean operative time was shorter for TIP as compared to the MMP. Both techniques are equally used. The choice being influenced by surgeon’s skills
Evaluating factors associated with failed induction of labour in patients undergoing induction with titrated oral misoprostol at Harare hospital maternity
No full textThe 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.
Lipodystrophy among patients on antiretroviral therapy at Harare City Opportunistic Infections Clinics, 2010
No full textObjective: To determine factors associated with lipodystrophy among patients on anti-retroviral therapy (ART) at Harare City Opportunistic Infections Clinics
Design: Unmatched 1:1 case control study
Setting: Two ART initiating and referral hospitals belonging to Harare City Health Department in Zimbabwe
Subjects: Patients aged 12 years and above on ART at Harare City health facilities for at least 18 months
Main outcome measures: Type and severity of lipodystrophy, factors associated with lipodystrophy
Results: Out of all participants females constituted 84.3% of cases and 71.9% of controls. The median duration on ART was 48 months (Q1=25; Q3=61) for cases and 35.5 months (Q1=25; Q3=46) for controls. Lipodystrophy affected the legs in 194 (92.38%) cases. The most common type in females was the mixed type (74.8%) and lipoatrophy (53.13%) in males. Of the cases 150 (71.43%) perceived their condition as severe. The median HIV Outpatients Survey (HOPS) scale for the legs and buttocks each was 3 (3; 3). When lipodystrophy developed 197 (93.81%) cases were on a stavudine based combination and 11 (5.24%) on a zidovudine based combination.
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Factors associated with lipodystrophy were a stavudine based regimen (OR=9.84; 95% CI 5.47-16.44), difference between first repeat and baseline CD4 above 400 (OR=5.18; 95% CI 1.95-13.78), age above 40 years (OR=2.47; 95% CI 1.46-4.29), duration after testing HIV positive greater than 4 years (OR=2.37; 95% CI 1.43-3.94), WHO stage at initiation above 2 (OR=2.17; 95% CI 1.29-3.66), female sex (OR=2.16; 95% CI 1.29-3.59) and a baseline CD4 below 100 (OR=2.16; 95% CI 1.29-3.59). A baseline BMI below 20 (OR=0.53; 95% CI 0.31-0.91) was protective.
Conclusion: Stavudine based regimen was the most significant factor. Patients belonging to the high risk groups should not be initiated on stavudine whilst those already on stavudin
RELATIONSHIP BETWEEN FEMALE CAREGIVERS SELF-CARE KNOWLEDGE ON PREVENTION OF MALARIA AND EPISODES OF MALARIA AMONG UNDER FIVES AT HAUNA HOSPITAL.
No full textAccording to the Zimbabwe National Health Strategy (2009) malaria ranked the highest cause of outpatient attendances accounting for all 11.5% of all attendances. Malaria was also the second cause of mortality in all age groups. The problem was the increasing number of malaria episodes in the under fives as seen from the Hospital records. In Hauna there were many children coming with repeated attacks of malaria within the same season, despite the National Malaria Control Programme in place particularly in Mutasa District. Thirty countries in Sub-Saharan Africa and Asia account for 98% of global malaria episodes and deaths (WHO, 2004). The purpose of the study was to examine the relationship between female care-givers self-care knowledge on prevention of malaria and episodes of malaria among the under fives. Orem’s Conceptual framework was used to guide this study. A descriptive correlational study design was used. Face to face structured interviews were used to collect demographic data, data on self-care knowledge and episodes of malaria, from 80 subjects who met the inclusion criteria. Data were analysed using the descriptive and inferential statistics. Pearson Correlation test was used to analyse the relationship between malaria prevention self-care knowledge and episodes of malaria and r was (r=.016; p>.01) results showed a non-significant relationship between self-care knowledge on malaria prevention and episodes of malaria. The results, therefore, did not support the premise that when self-care knowledge on malaria prevention increases, the number of malaria episodes decreases as proposed in the study. Further research is needed to establish more factors that could be impacting on malaria episodes in children and explore relationship between self-care practices and episodes. Nursing practice should strengthen information dissemination to all communities on malaria
Deposit-attracting strategies in the financial sector in a multi-currency setting: The case of commercial banks in Zimbabwe
No full textBanks in Zimbabwe are facing challenges in attracting deposits from customers due to several
reasons. The banking sector has implemented a wide range of strategies in a bid to attract
deposits. These strategies can be broadly classified as promotional, distribution and customer
relationship management. The study used the whole population of banks in Zimbabwe. The
study reveals that only a few of the strategies implemented seem to work while the rest are
ineffective. The study concludes that banks are not exhaustively using distribution strategies
and CRM strategies. The study recommends that banks should get into strategic-alliances
with local or international partners and introduce information technology frameworks and
processes in order to secure customer information and funds