94 research outputs found
Treatment of young children with HIV infection: Using evidence to inform policymakers
No full textPMCID: PMC3404108This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Causes of septicemia and characteristics of babies admitted with provisional diagnosis of septicemia to the neonatal intensive care unity at the University Teaching Hospital, Lusaka
No full textNeonatal septicemia is a common cause of admission to the Neonatal Intensive Care Unit (NICU) at the University Teaching hospital (UTH) in Lusaka, Zambia, accounting for twenty percent of admissions, and is the third commonest cause of mortality. Financial constraints at the UTH do not allow for blood cultures to be done routinely on all babies admitted to the NICU with diagnosis of septicemia, and therefore more often than not, these babies are treated empirically with crystalline penicillin and gentamycin as first line drugs. Use of crystalline penicillin and gentamycin as first line antibiotics in UTH is based on literature, which states that Group B HemolyticStreptococcus and Escherischi Coli are the common pathogens isolated in most neonatal nurseries. A cross sectional descriptive study was carried out at the NICU UTH, Lusaka, Zambia, between 1*' December 1997 and 31^' March 1998, on babies admitted to the neonatal wing with provisional diagnosis of septicemia. This study looked at the pathogens causing septicemia and their drug sensitivity pattern, and also at the obstetric, neonatal factors and the clinical features in these babies. During the study period, 219 babies were admitted to NICU with diagnosis of septicemia. 100 babies were recruited for the study, and of these 25% were from UTH postnatal wards, 57.8% were referred from the clinics and 17.2% were straight from home. The majority of babies in this study (72.8%) were term. Average birth weight was 2.7 kilogram body weight with a male to female ratio of 1.4: 1.Thirty (32.6%) babies had positive blood cultures. The commonest organisms isolated from blood were Coagulase negative staphylococcus (CNS) (36.7%), Klebsiella pneumoniae (23.3%), and Staphylococcus aureus (23.3%). Salmonella species were isolated from 2 babies (6.7%), and other isolates were Pseudomonas aeruginosa (3.3%), Escherischi coli (E.coli) (3.3%) and Streptococcus species (3.3%). Fourteen babies (47%) presented with early onset sepsis, while 16 (53.3%) presented with late onset sepsis. Coagulase negative staphylococcus and Staphlococcus aureus were the commonest organisms isolated in babies with early onset disease whilst Klebsiella pneumoniae was commonest in those with late onset disease.In vitro sensitivity showed that all the organisms isolated were sensitive to cefotaxime. Thirteen percent of Klebsiella organisms were sensitivity to gentamycin, while Staphylococcus aureus, showed 100% sensitivity to cloxacillin. Salmonella species were resistant to all the antibiotics tested including chloramphenicol and were only sensitive to cefotaxime.
Significant obstetric factors for confirmed septicemia were, delivery at home, and when age of mother was below 20 years. Gestational age and birthweight were not significant neonatal factors, but male sex was significantly associated with confirmed septicemia. Clinical features like fever, poor feeding, respiratory distress and jaundice were the commonest presenting symptoms in the babies studied, however convulsions, poor feeding and umbilical sepsis presented more commonly in those babies with confirmed septicemia than unconfirmed septicemia, but there was no statistical difference.There was no difference in mortality rates between babies with confirmed septicemia and those with unconfirmed septicemia, 16.6% and 16.1% respectively. Case fatality rate in babies with CNS infection was 9.1% and 14.3% in those with Klebsiella infection. There were no deaths among the babies with Staphylococcus aureus.
According to this study, Coagulase negative staphylococcus. Staphylococcus aureus and Klebsiella pneumoniae were the commonest organisms isolated. Group B Streptococcus (GBS) and Escherischi Coli were not common isolates in these babies, the majority of whom came from the Lusaka urban clinics. Therefore continued use of crystalline penicillin and gentamycin as first line antibiotics needs to be reviewed. Cefotaxime should be the drug of choice and should be made available at all times and cloxacillin should be added to cover for Staphylococcus infections
A process evaluation for the HIV/AIDS project for the Mbekweni Area Development Programme
No full textIncludes bibliographical references (leaves 56-59).This dissertation is a process evaluation of Mbekweni Area Development Programme (MADP)'s HIV/AIDS project. The MADP is a programme that is implemented by World Vision South Africa. The aim of the process evaluation was to assess whether the HIV/AIDS project was implemented as intended. HIV/AIDS is a global problem, particularly prominent in South Africa. It has negatively affected families and communities resulting in increased social and economic burdens. The HIV/AIDS project at MADP uses prevention and care programmes to mitigate the impact of HIV/AIDS in targeted areas of Mbekweni. In order to achieve this aim, the project uses the following programme activities: home visitation, home-based care, life skills, material support and awareness campaigns. To conduct the process evaluation, programme records, interviews with three key informants and questionnaires with 35 programme staff were used to assess the programme?s implementation. Findings from the evaluation show that the programme activities are largely being implemented as intended by the organisation. The HIV/AIDS project is being delivered to the intended beneficiaries and all the activities are being implemented as intended by the organisation. However, to improve the effectiveness of the project a structure
Erratum to: Risky Sex and HIV Acquisition Among HIV Serodiscordant Couples in Zambia, 2002–2012: What Does Alcohol Have To Do With It?
No full textThe article Risky Sex and HIV Acquisition Among HIV Serodiscordant Couples in Zambia, 2002–2012: What Does Alcohol Have To Do With It?, written by Dvora Joseph Davey, William Kilembe, Kristin M. Wall, Naw Htee Khu, Ilene Brill, Bellington Vwalika, Elwyn Chomba, Joseph Mulenga, Amanda Tichacek, Marjan Javanbakht, W. Scott Comulada, Susan Allen, Pamina M. Gorbach, was originally published Online First without open access. After publication in volume 21, issue 7, pages 1892–1903, the author decided to opt for Open Choice and to make the article an open access publication. Therefore, the copyright of the article has been changed to © The Author(s) [Year] and the article is forthwith distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits use, duplication, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made
Diarrhea is a Major killer of Children with Severe Acute Malnutrition Admitted to Inpatient Set-up in Lusaka, Zambia
No full textAbstract Introduction Mortality of children with Severe Acute Malnutrition (SAM) in inpatient set-ups in sub-Saharan Africa still remains unacceptably high. We investigated the prevalence and effect of diarrhea and HIV infection on inpatient treatment outcome of children with complicated SAM receiving treatment in inpatient units. Method A cohort of 430 children aged 6-59 months old with complicated SAM admitted to Zambia University Teaching Hospital's stabilization centre from August to December 2009 were followed. Data on nutritional status, socio-demographic factors, and admission medical conditions were collected up on enrollment. T-test and chi-square tests were used to compare difference in mean or percentage values. Logistic regression was used to assess risk of mortality by admission characteristics. Results Majority, 55.3% (238/430) were boys. The median age of the cohort was 17 months (inter-quartile range, IQR 12-22). Among the children, 68.9% (295/428) had edema at admission. The majority of the children, 67.3% (261/388), presented with diarrhea; 38.9% (162/420) tested HIV positive; and 40.5% (174/430) of the children died. The median Length of stay of the cohort was 9 days (IQR, 5-14 days); 30.6% (53/173) of the death occurred within 48 hours of admission. Children with diarrhea on admission had two and half times higher odds of mortality than those without diarrhea; Adjusted OR = 2.5 (95% CI 1.50-4.09, P Conclusion Diarrhea is a major cause of complication in children with severe acute malnutrition. Under the current standard management approach, diarrhea in children with SAM was found to increase their odds of death substantially irrespective of other factors.</p
Teacher Education versus Teacher Training: Epistemic Practices and Appropriate Application of both Terminologies
No full textIn this article, the author presents a practice-based approach, of an analysis of two concepts; teacher education and teacher training, to preparing candidates for quality teaching. The emphasis is on understanding the meaning of the two terms based on what educational thinkers have come to understand and appreciate as the reasoning behind each one of them. Thus, the author delimited himself to what is meant when the two terms are used rather than providing empirical data on the quality of teachers produced as a result of which term is used in teacher preparation. The philosophical stance in this article is that the meaning of these concepts influences the design of learning experiences for prospective teachers, the framing of their curriculum, and the attitudes teacher educators will have in the preparation process. Others may actually be tempted to think anyone can teach since they assume teaching is innate or natural. However, the author explains the necessity and urgency of teacher education and training if quality teachers are to be produced so as to achieve effective curriculum implementation in schools
Teacher education versus teacher training: epistemic practices and appropriate application of both terminologies.
No full textIn this article, the author presents a practice-based
approach, of an analysis of two concepts; teacher
education and teacher training, to preparing candidates
for quality teaching. The emphasis is on understanding
the meaning of the two terms based on what educational
thinkers have come to understand and appreciate as the
reasoning behind each one of them. Thus, the author
delimited himself to what is meant when the two terms
are used rather than providing empirical data on the
quality of teachers produced as a result of which term is
used in teacher preparation. The philosophical stance
in this article is that the meaning of these concepts
influences the design of learning experiences for
prospective teachers, the framing of their curriculum,
and the attitudes teacher educators will have in the
preparation process. Others may actually be tempted
to think anyone can teach since they assume teaching
is innate or natural. However, the author explains the
necessity and urgency of teacher education and training
if quality teachers are to be produced so as to achieve
effective curriculum implementation in schools
Tick and Tick-Borne Pathogens: Molecular and Immune Targets for Control Strategies
No full textThis eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contac
Tick and Tick-Borne Pathogens: Molecular and Immune Targets for Control Strategies
No full textThis eBook is a collection of articles from a Frontiers Research Topic. Frontiers Research Topics are very popular trademarks of the Frontiers Journals Series: they are collections of at least ten articles, all centered on a particular subject. With their unique mix of varied contributions from Original Research to Review Articles, Frontiers Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area! Find out more on how to host your own Frontiers Research Topic or contribute to one as an author by contacting the Frontiers Editorial Office: frontiersin.org/about/contac
African circulation (over 30|p0|sE) and its relation to El-Nino/Southern Oscillation
No full textThis thesis was scanned from the print manuscript for digital preservation and is copyright the author.
Researchers can access this thesis by asking their local university, institution or public library to
make a request on their behalf. Monash staff and postgraduate students can use the link in the References field
- …
