1358 research outputs found
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Treatment outcomes of patients on antiretrovirals after six months of treatment, Khami Clinic, Bulawayo, Zimbabwe
No full textObjective: To describe treatment outcomes of patients on anti-retrovirals at six months of treatment. Study Design: We conducted pre-intervention post intervention surveys using a pretest-post test design. Setting: Khami Municipal Clinic, Bulawayo. Subjects: We interviewed consecutive patients eligible to receive antiretroviral drugs (ARVs). All patients had a history of TB treatment and a CD4 count less than 200 cells/mm.3 Main Outcome Measures: Mean change in CD4 count, weight, body mass index, and Karnofsky performance measured before and at six months of antiretroviral treatment. Results: 72 subjects were interviewed at baseline, their median age was 38 years (Q, 32 years, Q, 43 years). Of these, 17 (24%) died before six months of treatment. Three (4%) defaulted treatment follow up. A total of 52 respondents were alive and interviewed at six months though only 50, had repeat CD4 counts at six months. Among the 50 survivors, the mean CD4 count at six months was significantly higher than at baseline (p=0.0003). There was a 4.2 point statistical significant increase in the mean weight from baseline (p=0.0005). Similarly, the mean Body Mass Index (BMI) significantly increased by 1.5 kg/m: from baseline, (p=0.001). The mean Karnofsky performance increased from 89% at baseline to 95% at six months (p=0004). The researchers noted that patients on TB treatment were being deferred antiretroviral therapy until they completed TB treatment. Conclusion: The Khami project bears testimony that even in a resource poor setting; treatment of HIV/AIDS with antiretroviral drugs is feasible. We recommend early treatment initiation for those on TB treatment in line with national guidelines
Baseline sero-survey of rubella virus prevalence in pregnant women in Harare and incidence of rubella in Zimbabwe during 2009-2011 measles outbreak.
No full textRubella virus is a teratogen that may induce foetal death or Congenital Rubella Syndrome (CRS) in the newborn. A baseline sero-survey was carried out in Harare to determine the population susceptible to Rubella virus amongst pregnant women. A descriptive cross- sectional study was carried out on pregnant women between June and July 2012, to establish baseline data on the sero-prevalence of Rubella in pregnant women in Harare. A total of 51 pregnant women at various gestational ages were recruited from Rujeko and Rutsanana antenatal clinics. Also a retrospective analytical study was carried on the laboratory surveillance data of the Zimbabwean Measles/Rubella outbreak of 2009-2011 to assses the age groups affected by Rubella virus infection and Rubella incidence. A 3-5ml blood sample was collected from each consenting subject and serum assayed for Rubella IgG/IgM antibodies by indirect ELISA test. The seroprevalence of Rubella in pregnant women was 92.2%. This study found out that 7.8% of the pregnant women were susceptible to Rubella virus infection in Harare. In this study the seroprevalence of Rubella showed some fluctuations with an increase in age and parity, thus indicating that pregnant women were probably previously exposed to natural Rubella infection since there is no vaccination in Zimbabwe. There were no significant correlations between Rubella infection and age. Although the seronegative rate of Rubella is low, this study suggests the need for detection and vaccination of seronegative women of child bearing age. I concluded that Rubella virus immunity is still ˃80% in Zimbabwe as stated by the WHO Rubella virus antibody survey
Visual inspection of the cervix as a primary means of cervical cancer screening: Results of a pilot study
No full textObjective:To measure the effectiveness of unaided visual inspection (UVI) of the cervix as a primary means of cervical cancer screening. Design: A cross sectional study. Setting: Five primary health care clinics in Mashonaland Province, Zimbabwe. Subjects: 1 000 women aged between 25 and 55 years. Main Outcome Measures: Sensitivity and specificity of UVI. Methods: 1 000 women attending primary health care clinics were screened for cervical cancer by six qualified nurses. An unlubricated bivalve speculum was inserted into the vagina under good light to visualize the cervix and a cervical cytology specimen was obtained followed by visual inspection of the cervix stained by 4% acetic acid. All women found to have abnormal cervices by visual inspection and/or by cervical cytology report were scheduled for colposcopy examination at Harare Central Hospital. Results: 236 (23.6%) women had an abnormal cervical appearance after application with 4% acetic acid, out of which 157 (15.7%) were reported abnormal by cytology. True disease as defined by positive colposcopy and positive cytology was confirmed in 38 (3.8%) women. The sensitivity of UVI using colposcopy and cytology as a reference standard was 68.4%, specificity was 3.4%. Conclusion: The results of this study suggest that naked eye inspection of the cervix after application of acetic acid is a practical alternative to cervical cytology in screening for cervical cancer in countries with few resources like Zimbabwe
Asbestosis in Rhodesia
No full textThe purpose of this study was to investigate the effects of the inhalation of asbestos on employees (mostly African) in the Rhodesian mining industry. Every effort was made to ensure that each worker investigated had been exposed to only this dust and had not worked in any other type of mine
Controversies surrounding the use of Parathyroid hormone as a marker of bone metabolism in chronic kidney disease(CKD) patients on haemodialysis in Zimbabwe: The way forward
No full textBackground
The progressive loss of renal function in chronic kidney disease (CKD) necessitates the eventual use of dialysis. Renal Osteodystrophy (ROD) is a serious complication of CKD with diverse and non-specific manifestations. Serum biochemical markers such as Parathyroid hormone (PTH) are used worldwide to monitor bone changes in patients on haemodialysis although bone biopsy has remained the gold standard. The use of PTH as a marker for bone changes has however been associated with a lot of controversies linked to its measurement and interpretation. Recommendations from several studies have been proposed on how to improve its clinical robustness in monitoring bone changes of patients on haemodialysis. Evaluation of these recommendations has however not been done extensively especially in Zimbabwe.
Objectives
To determine which serum marker(s) of bone offers the best diagnostic and monitoring sensitivity in CKD patients on haemodialysis before and during three months on haemodialysis.
Materials and methods
A short prospective study was carried out on CKD patients admitted on haemodialysis at three selected Renal Units (Parirenyatwa, Chitungwiza, PSMI). A total of 32 patients aged 22-75 years (Mean 50.5 ± 16.5 years) were randomly selected. Study group was divided into
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those who had been on dialysis for more than three months (Group 1) and those who had been enrolled to start haemodialysis (Group 2). Serum levels of calcium, phosphate, PTH and bALP were determined over a three month period.
Results
There were significant increases in bALP (P=0.02) in group 1. A 69.6% increase in mean phosphate was observed in participants using low calcium concentration dialysate fluid.PTH and bALP showed a positive correlation at both 0.05 and 0.01 level of confidence interval using Pearson correlation 2-tailed test. Significant gender differences (P<0.05) in PTH were observed in both groups. Statistically insignificant decreases in PTH were noted for both groups.
Conclusion
The study findings have shown that PTH levels in an individual patient on haemodialysis fluctuate greatly and therefore diagnosis and monitoring of bone changes in these patients ought to be based on trends rather than a single value of PTH. The study concludes that bALP is indeed a potentially useful bone marker if we are to make headways in resolving some of the issues associated with the use of PTH alone
The role of dental practitioners in Provider Initiated HIV Counseling and Testing (PITC) for patients attending dental practices in Harare, Zimbabwe
No full textObjective: To assess the role o f Zimbabwean dental practitioners in Provider Initiated H IV Counseling and Testing (PITC). Design: A cross-sectional analytic study was conducted. A structured interviewer administered questionnaire was used to collect data from participants. Setting: Harare private and public dental practices. Subjects: Forty dental practitioners practicing in Harare and two hundred and ninety three patients attending dental practices in Harare were interviewed. Main Outcome Measures: Dental practitioners' practices on HIV counseling and testing for dental patients, acceptability of HIV testing in dental settings and missed opportunities for HIV counseling and testing in dental settings were assessed. Results and Conclusion: Half of the dental practitioners (20) interviewed reported offering HIV counseling to dental patients during their clinical duties. The majority 62% only referred their patients for HIV testing when they presented with oral manifestations of HIV infection. Seventy three percent (29) of practitioners interviewed were not aware of the Ministry of Health and Child Welfare guidelines on HIV counseling and testing. Eighty seven percent (255) of dental patients in this study reported not being counseled nor referred for HIV counseling and testing by their dental practitioner during their dental visits. More than a third (36.5%) of the dental patients experienced repeated missed opportunities for accessing HIV counseling and testing in health settings. The minimal that the dentists may need to be involved with in PITC is counseling their patients and improve referral for care. There is need for continued medical education for dentists on issues related to new HIV interventions or protocols such as PITC
Factors Associated With Developing Ophthalmia Neonatorum in Harare City, 2013
No full textIntroduction: Ophthalmia neonatorum is defined as any conjunctivitis with discharge from the eyes during the first 28 days of life. Ophthalmia neonatorum is preventable. Gonococcal ophthalmia, if untreated, may progress rapidly to corneal ulceration, perforation, corneal opacification, staphyloma formation and eventually blindness. Globally the prevalence of ophthalmia neonatorum has been on the decline. In Harare Province alone, the cases increased by a massive 65% from 1023 cases in 2010 to 1688 cases in 2011 although the total number of deliveries increased by only 8%. This study was conducted in order to determine the factors associated with developing ophthalmia neonatorum in Harare City.
Materials and Methods: An unmatched 1:1 case-control study was conducted. A case was defined as any newly born baby with eye discharge in the first 28 days of life in Harare City while a control was any newly born baby in Harare City who did not develop eye discharge in the first 28 days of life. Pretested questionnaires were used to collect data and antenatal records were reviewed. 22 eye swabs were collected and analysed in the laboratory.
Results: 77 cases and 75 controls were recruited into the study. Independent factors associated with developing ophthalmia neonatorum were being born to HIV positive mother AOR 0.35 (CI 0.13-0.92), having received Tetracycline Eye Ointment (TEO) prophylaxis at birth AOR 0.21 (CI 0.07-0.50) and being born of a planned pregnancy AOR 0.38 (CI 0.17-0.87). Only 43 (28%) study participants received TEO prophylaxis. On thirteen (62%) of the eye swabs collected the microorganism isolated was resistant to tetracycline. Sixteen (73%) of the isolated microorganisms were staphylococcus species, with 8 (50%) of the staphylococcus species being resistant to tetracycline.
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Conclusion: The huge increase in the cases of ophthalmia neonatorum was partly because the majority of health workers were not giving prophylaxis and treatment according to national guidelines, and partly due to widespread resistance to tetracycline. We recommended therefore that the Ministry of Health and Child Welfare in Zimbabwe consider replacing TEO with ciprofloxacin eye ointment for use as prophylaxis against ophthalmia neonatorum
A study to determine relationship between partner support and adherence to Zidovudine among HIV positive pregnant women attending PMTCT clinic at Shurugwi hospital
No full textThere are low levels of adherence to zidovudine prophylaxis among HIV
positive pregnant women at Shurugwi District Hospital in Zimbabwe. The most likely
contributing factor to low adherence levels could be related to the level of partner
support. The purpose of this study was to determine the relationship between partner
support and adherence to zidovudine prophylaxis by HIV-positive pregnant women
attending Shurugwi PMTCT clinic. Pender’s Health Promotion Model guided the
study. A descriptive correlational design was used. A sample of eighty (82)
participants who met the inclusion criteria were selected into the study using a
systematic sampling method. Data were collected using interviewer-administered
questionnaires over a period of three (3) weeks. Data were analyzed using descriptive
and inferential statistics. The results showed that Sixty-six (80.4%) participants
demonstrated poor sub-optimal levels (<95%) of adherence to zidovudine prophylaxis
and 62 (75.6%) perceived partner support to be low. The Pearson correlation
coefficient (r=.677; p<.01) showed a strong positive significant relationship. Partner
support had an impact of 45.9% on adherence to zidovudine prophylaxis (R2 0.459).
The findings reflect that as partner support increased, adherence to zidovudine
prophylaxis among HIV-positive pregnant women increased. Midwives should
intensify partner involvement in PMTCT programmes in order to achieve optimal
(>95%) adherence to zidovudine prophylaxis among HIV-positive pregnant women
so as to be able to suppress Mother to Child Transmission of HIV
The relationship between psychosocial support and PMTCT uptake among HIV positive pregnant women at Chitungwiza Central Hospital.
No full textThe study determined the relationship between psychosocial support and uptake of PMTCT among HIV positive pregnant women at Chitungwiza Central Hospital antenatal clinic. The independent variable was psychosocial support and the dependent variable was PMTCT uptake. Neuman’s systems model guided the study. A descriptive correlation study design was employed to examine the relationship between the variables. A simple random sample of 80 subjects was recruited and interviewed using a face to face structured interview schedule. The instrument had three sections, that is, demographic questionnaire. PMTCT uptake questionnaire and a psychosocial support questionnaire. Data was analysed using the Statistical Package of Social Science (SPSS). Research questions were analysed using descriptive and inferential statistics and Pearson Product correlational coefficiency test was used to determine the relationship between psychosocial support and PMTCT uptake. The statistical significance level was set at 5% or alpha< 0.05 and the results showed a moderate positive significant relationship between psychosocial support and PMTCT uptake. (r = .484 p < .01) implying that as psychosocial support increases PMTCT uptake increases. This study should contribute to a body of knowledge on Maternal and Child Health and Midwifery practic
Heterotopic pregnancy of a ruptured ectopic pregnancy coexisting with a twin intra-uterine pregnancy: A case report
No full textA case of ruptured ectopic and twin intra-uterine pregnancy is presented. The patient had conceived following ovulation induction with clomiphene citrat