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Musculoskeletal pain and backpack usage among school children in Nairobi County, Kenya 肯尼亚内罗毕县学龄儿童的肌肉骨骼疼痛和背包使用情况
Q4 Medicine Pub Date : 2017-01-01 DOI: 10.4314/EAMJ.V94I6
S. Ogana, J. Osero, L. Wachira
Background: School children travel to and from school on daily basis. Active transportation such as walking, running and cycling contribute significantly to the increase in physical activity, health, and wellbeing in children. However, there has been a growing concern on the effect of carrying heavy backpack on the health of school going children who are at an important developmental stage of their lives. Objective: To determine the prevalence of musculoskeletal pain linked to backpack use and associated ergonomic factors among pupils in Nairobi City County in Kenya. Design: Descriptive cross-sectional study. Setting: Primary schools in Nairobi County Subjects: 379 school-going children Results: The study results indicate that a significant number of pupils (73.6%) complain of musculoskeletal pain. Low back pain (25.1%) was the most prevalent musculoskeletal pain followed by neck pain (16.9%). There was a significant association (p=0.001) between backpack weight-to-schoolchild body weight (BTSW %) and the presence of musculoskeletal pain. The proportion of pupils carrying school bag weighing more than 15% of their body weight was 28%. Conclusion: Prevalence of musculoskeletal pain related to backpack usage among Kenyan school going children is high. School children who carry backpacks that weigh more than 15% of their body weight (BTSW %) are at risk of experiencing musculoskeletal pain.
背景:学生每天都要往返于学校。步行、跑步和骑自行车等积极的交通方式对增加儿童的身体活动、健康和福祉有重大贡献。然而,人们越来越关注背沉重的书包对处于人生重要发展阶段的上学儿童健康的影响。目的:确定在肯尼亚奈洛比市郡小学生中与背包使用相关的肌肉骨骼疼痛患病率和相关的人体工程学因素。设计:描述性横断面研究。研究对象:379名在校儿童。结果:研究结果表明,相当多的学生(73.6%)抱怨肌肉骨骼疼痛。腰痛(25.1%)是最常见的肌肉骨骼疼痛,其次是颈部疼痛(16.9%)。背包重量与学龄儿童体重之比(BTSW %)与肌肉骨骼疼痛存在显著关联(p=0.001)。携带书包重量超过体重15%的学生比例为28%。结论:肯尼亚学龄儿童中与背包使用相关的肌肉骨骼疼痛患病率很高。小学生携带的书包重量超过其体重的15% (BTSW %),有经历肌肉骨骼疼痛的风险。
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引用次数: 2
Risk and prevalence of type 2 diabetes mellitus in patients with major mental health disorders 2型糖尿病在严重精神健康障碍患者中的风险和患病率
Q4 Medicine Pub Date : 2017-01-01 DOI: 10.4314/eamj.v94i8
K. Akinlade, V. Lasebikan, O. Satope, S. Rahamon
Background: The bi directional association between major mental health disorders (MMHD) and diabetes mellitus (DM) is well established. Presently, there is little information on the risk and prevalence of DM in Nigerians with MMHD. Objective: To determine the risk and prevalence of DM in Nigerians with MMHD. Design: Cross-sectional study Setting: New World Psychiatry Hospital, Ibadan, Nigeria Subjects: Plasma levels of glucose was determined after an overnight fast and at 120 minutes (2-h PG) of a standard 75-g oral glucose tolerance test in 124 patients with MMHD. Thereafter, normoglycaemia, pre-diabetes and diabetes were defined using the American Diabetes Association criteria. Also, the risk of developing DM within 10 years was assessed using the Finnish Diabetes Association DM Risk Assessment Form. Results: Seventy eight (62.9%), 37 (29.8%) and 9 (7.3%) of the patients had normoglycaemia, pre-diabetes and DM respectively. Only 2 patients had high diabetes risk score. There was progressive rise in 2-h PG level as the diabetes risk score increases. The mean 2-h PG was significantly higher in moderate-and-high risk group combined (MHR) compared with the low risk (LR) group. Also, the proportion of patients with pre-diabetes increased progressively from LR through MHR. Conclusion: Dysglycaemia is not a rare occurrence in Nigerians with MMHD and it appears to be more prevalent in them than in the Nigerian general population. Also, high diabetes risk score could be a strong indication for glucose tolerance testing.
背景:重度精神健康障碍(MMHD)与糖尿病(DM)之间的双向关联已被证实。目前,关于尼日利亚MMHD患者患糖尿病的风险和患病率的信息很少。目的:确定尼日利亚MMHD患者患糖尿病的风险和患病率。设计:横断面研究设置:尼日利亚伊巴丹新世界精神病院受试者:124例MMHD患者在禁食过夜和进行标准75克口服葡萄糖耐量试验120分钟(2小时PG)后测定血浆葡萄糖水平。此后,根据美国糖尿病协会的标准定义了正常血糖、糖尿病前期和糖尿病。此外,使用芬兰糖尿病协会糖尿病风险评估表评估10年内患糖尿病的风险。结果:正常血糖78例(62.9%),糖尿病前期37例(29.8%),糖尿病前期9例(7.3%)。仅有2例患者糖尿病风险评分较高。随着糖尿病风险评分的增加,2 h PG水平逐渐升高。中高危组(MHR)的平均2小时PG明显高于低危组(LR)。此外,糖尿病前期患者的比例从LR到MHR逐渐增加。结论:血糖异常在尼日利亚MMHD患者中并不罕见,而且在他们中比在尼日利亚一般人群中更为普遍。此外,高糖尿病风险评分可能是葡萄糖耐量测试的有力指标。
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引用次数: 3
Evaluating compliance to Kenya national cancer guidelines on diagnosis and staging of breast cancer at Kenyatta national hospital 评估肯雅塔国立医院对肯尼亚国家乳腺癌诊断和分期指南的遵守情况
Q4 Medicine Pub Date : 2017-01-01 DOI: 10.4314/EAMJ.V94I7
S. Miima, A. Muturi, D. Ojuka, A. Ndung’u
Background : In Kenya, breast cancer is one of the most prevalent diseases among women. Early diagnosis and stage-directed treatment are vital in reducing morbidity and mortality associated with it. The Kenya National Cancer Guidelines (KNCG) was developed in 2013. Utility of the guidelines is expected to improve early detection, timely diagnosis, harmonize and standardize treatment of cancer. This study sought to assess whether health care providers at Kenyatta National Hospital are utilizing the guidelines in diagnosis and staging of breast cancer. Study objective : To evaluate adherence to KNCG on diagnosis and staging of breast cancer. Study design : Retrospective descriptive study was conducted within five months. Study subjects : Two hundred and fifty (250) patients’ records with diagnosis of breast cancer between September 2013 and September 2015. Results : Most patients were female 95.6 % with mean age of 47.5±15.5 years. Duration from referral point to index breast clinic review was 10.9±11.1 days. Duration from index breast clinic review to surgery was 64.0 ±114.4 days. Documentation on findings from clinical assessment varied between 24.8 to 86.4%. Documentation on radiological assessment of the breast varied between 3.6 to 35.2% whereas for metastatic assessment varied between 3.6 to 64.0 %. Laboratory investigations documentation varied between 8.4 to 94.8% whereas pathologic diagnosis and tumour biology documentation varied between 3.6-62.4%. American joint cancer committee- tumour, node and metastasis (AJCC-TNM) staging was documented in 16 % of the records reviewed. Conclusion : From this study, triple assessment for breast cancer was incomplete and inconsistent which could result in negatively impacting management of these patients. Every effort should be put in place to track as well as prioritize patients with breast cancer in terms of investigations and surgical interventions in a timely manner. Clinical, radiologic and pathologic assessment must adhere to KNCG and be accurately documented. Clinician should undergo knowledge, attitude and practice (KAP) survey on KNCG so as to identify possible gaps and institute measures aimed at compliance which ultimately could improve care of patients with breast cancer at KNH.
背景:在肯尼亚,乳腺癌是妇女中最普遍的疾病之一。早期诊断和分阶段治疗对于降低与之相关的发病率和死亡率至关重要。肯尼亚国家癌症指南(KNCG)于2013年制定。该指南的应用有望提高癌症的早期发现、及时诊断、协调和标准化治疗。本研究旨在评估肯雅塔国家医院的卫生保健提供者是否在乳腺癌的诊断和分期中使用了该指南。研究目的:评价KNCG对乳腺癌诊断和分期的依从性。研究设计:在5个月内进行回顾性描述性研究。研究对象:250例2013年9月至2015年9月诊断为乳腺癌的患者。结果:患者以女性居多,占95.6%,平均年龄47.5±15.5岁。从转诊点到指标乳腺临床复查的时间为10.9±11.1天。从指数乳房临床复查到手术时间为64.0±114.4天。临床评估结果的文献记录在24.8%到86.4%之间。乳房放射学评估的记录在3.6%至35.2%之间,而转移性评估的记录在3.6%至64.0%之间。实验室调查文件的差异在8.4 - 94.8%之间,而病理诊断和肿瘤生物学文件的差异在3.6-62.4%之间。美国联合癌症委员会-肿瘤,淋巴结和转移(AJCC-TNM)分期在16%的记录中被记录。结论:从本研究来看,乳腺癌的三重评估是不完整和不一致的,这可能会对这些患者的管理产生负面影响。应该尽一切努力跟踪乳腺癌患者,并对其进行优先排序及时进行调查和手术干预。临床、放射学和病理学评估必须遵循KNCG并准确记录。临床医生应接受KNCG的知识、态度和实践(KAP)调查,以发现可能存在的差距,并制定措施,最终改善KNH乳腺癌患者的护理。
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引用次数: 1
Determinants of the use of modern contraceptives in Baringo County 巴林戈县使用现代避孕药具的决定因素
Q4 Medicine Pub Date : 2017-01-01 DOI: 10.4314/eamj.v95i7
F. Jaguga, A. Mwangi, M. Mahugu, R. Songole, B. Gakinya, D. Ayuku, D. Kinyanjui, E. Kwobah, L. Atwoli
Background: Modern contraceptive methods form a critical pillar in maternal health provision and population control initiatives. The Kenyan government promotes the use of family planning through provision of these services at various health facilities across the country. Baringo County has a prevalence rate of 33.1% for modern contraceptives use among women aged 15-49 while the national average is 53.2%. Consequently, many women in this county remain vulnerable to unplanned pregnancy and unsafe abortions.Objective: The determinants of the uptake of modern contraceptives in Baringo County in Kenya using data from the Kenya Demographic and Health Survey of 2014 (KDHS, 2014) were evaluated. Design: A probit model was used to statistically explore the factors that influence uptake of modern contraceptives. Results and Conclusion: Level of education, number of children, and interaction with a health service provider, marital status, religious beliefs and income level were statistically significant in determining the uptake of modern contraception by women of reproductive age in Baringo County. A woman with secondary and/or a higher level of education, of middle or higher income and with knowledge about family planning from a healthcare facility had a higher probability of taking up modern contraceptives. It was recommended that poverty alleviation measures combined with increased access to formal education will positively influence the attitudes of women in the reproductive ages to embrace modern contraceptive methods.
背景:现代避孕方法是提供孕产妇保健和人口控制举措的关键支柱。肯尼亚政府通过在全国各地的各种卫生设施提供这些服务来促进计划生育的使用。巴林戈县15-49岁妇女使用现代避孕药具的普及率为33.1%,而全国平均水平为53.2%。因此,这个国家的许多妇女仍然容易遭受计划外怀孕和不安全堕胎的伤害。目的:利用2014年肯尼亚人口与健康调查(KDHS, 2014)的数据,对肯尼亚巴林戈县采用现代避孕药具的决定因素进行评估。设计:采用probit模型统计探讨影响现代避孕药具使用的因素。结果与结论:教育水平、子女数量、与卫生服务提供者的互动、婚姻状况、宗教信仰和收入水平在决定巴林戈县育龄妇女采用现代避孕方法方面具有统计学意义。受过中等和(或)高等教育、中等或较高收入、从保健机构获得计划生育知识的妇女更有可能使用现代避孕药具。会议建议,减轻贫穷的措施与增加接受正规教育的机会相结合,将对育龄妇女接受现代避孕方法的态度产生积极影响。
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引用次数: 3
Prevalence, heterogeneity of asymptomatic malaria infections and associated factors in a high transmission region 高传播地区无症状疟疾感染的流行、异质性及相关因素
Q4 Medicine Pub Date : 2017-01-01 DOI: 10.4314/EAMJ.V94I12
J. Mangeni, D. Ongore, A. Mwangi, J. Vulule, W. O'Meara, A. Obala
Background: Although current reports have shown a reduction in malaria cases, the disease still remains a major public health problem in Kenya. In most endemic regions, the majority of infections are asymptomatic which means those infected may not even know and yet they remain infectious to the mosquitoes. Asymptomatic infections are a major threat to malaria control programs since they act as silent reservoirs for the malaria parasites.Objective: The study sought to determine the prevalence of asymptomatic malaria infections, whether they show heterogeneity spatially, across age groups and across time as well as their determinants in a high transmission region.Study Design: This was part of a larger prospective cohort study on malaria indices in the HDSS.Study Setting: The study was conducted in the Webuye Health and Demographic Surveillance Site in Bungoma East Sub-County.Study Subjects: Quarterly parasitological surveys were conducted for a cohort of 400 participants from randomly selected households located in known fever “hotspots” and “coldspots”. Follow-up of all the participants continued for a period of one year. Generalized estimating equations were used to model risk factors associated with asymptomatic parasitemia.Results: Of the total 321 malaria infections detected during the five cross-sectional surveys conducted over the period of one year, almost half (46.3%) of these were asymptomatic. Overall, most of the asymptomatic cases (67%) were in households within known fever “hotspots”. The proportion of infections that were asymptomatic in the coldspots were 73.1%, 31.8%, 13.3%, 55.6% and 48.2% during the first, second, third, fourth and fifth visits respectively. In the known fever “hotspots”, the proportion of infections without symptoms was 47.7%, 48.5%, 35%, 41.3% and 47.5% during the first, second, third, fourth and fifth visits respectively. Factors associated with asymptomatic malaria include; the village one lives: people living in village M were twice likely to be asymptomatic (A.O.R: 2.141, C.I: 0.03 - 1.488), age: children aged between 6 to 15 years were more than twice likely to be asymptomatic (A.O.R: 2.67, C.I. 0.434 - 1.533) and the season: infections during the dry season (January) were less likely to be asymptomatic (A.O.R: 0.26, C.I: -2.289 - 0.400).Conclusion: The prevalence of asymptomatic infections in this region is still very high. The highest proportion of asymptomatic infections was registered in a fever coldpspot village which may explain why the village is a fever coldspot in the first place. There is a need for active surveillance to detect the asymptomatic cases as well as treat them in-order to reduce the reservoir. Targeting interventions to the asymptomatic individuals will further reduce the transmission within this region.
背景:虽然目前的报告显示疟疾病例有所减少,但该疾病仍然是肯尼亚的一个主要公共卫生问题。在大多数流行地区,大多数感染是无症状的,这意味着感染者甚至可能不知道,但他们仍然对蚊子具有传染性。无症状感染是疟疾控制规划的主要威胁,因为它们是疟疾寄生虫的无声宿主。目的:本研究旨在确定无症状疟疾感染的流行情况,它们是否在空间上、跨年龄组和跨时间上表现出异质性,以及它们在高传播地区的决定因素。研究设计:这是一项关于HDSS疟疾指数的大型前瞻性队列研究的一部分。研究环境:本研究在邦戈马东部副县的Webuye健康和人口监测站进行。研究对象:对来自已知发热“热点”和“冷点”的随机选择家庭的400名参与者进行了季度寄生虫学调查。对所有参与者的随访持续了一年。使用广义估计方程来模拟与无症状寄生虫病相关的危险因素。结果:在一年期间进行的五次横断面调查中发现的321例疟疾感染中,几乎一半(46.3%)是无症状的。总体而言,大多数无症状病例(67%)发生在已知发热“热点”地区的家庭中。第1次、第2次、第3次、第4次和第5次就诊时无症状感染者比例分别为73.1%、31.8%、13.3%、55.6%和48.2%。在已知发热“热点”地区,第1次、第2次、第3次、第4次和第5次就诊时无症状感染者比例分别为47.7%、48.5%、35%、41.3%和47.5%。与无症状疟疾相关的因素包括;居住的村庄:M村居民无症状的可能性为2倍(A.O.R: 2.141, C.I.: 0.03 ~ 1.488),年龄:6 ~ 15岁儿童无症状的可能性为2倍以上(A.O.R: 2.67, C.I.: 0.434 ~ 1.533),季节:旱季(1月)感染无症状的可能性较小(A.O.R: 0.26, C.I.: -2.289 ~ 0.400)。结论:该地区无症状感染者的流行率仍然很高。无症状感染者比例最高的是热冷点村,这可以解释为什么该村首先是一个热冷点。需要积极监测,发现无症状病例并进行治疗,以减少水库。针对无症状个体的干预措施将进一步减少该区域内的传播。
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引用次数: 6
Incidence and risk factors for surgical site infection following emergency laparotomy at Kenyatta National Hospital 肯雅塔国家医院急诊剖腹手术后手术部位感染的发生率和危险因素
Q4 Medicine Pub Date : 2016-11-14 DOI: 10.4314/EAMJ.V93I8
S. E. Miima, J. S. Oliech, P. Ndaguatha, E. Opot
Background: The incidence of surgical site infection (SSI) following emergency abdominal operation contributes to significant morbidity. There are patient-related as well as perioperative risk factors that seem to contribute to this incidence. This study determined incidence and risk factors following emergency bowel surgery at Kenyatta National Hospital. Objective: To determine incidence and risk factors of surgical site infection following emergency laparotomy at Kenyatta National Hospital. Design: Prospective cross sectional study. Subjects: One hundred and twenty (120) Patients, 13 years and above scheduled to undergo emergency laparotomy. Results: Overall incidence of SSI was 30.8% with male patients having infection rate of 20.8%, while patients who consumed alcohol had infection rate of 5.8%. Incidence of SSI was highest in patient who had preoperative duration of 48 hours at 12% and intraoperative duration of 90 minutes at 7.5%. Dirty wounds accounted for 60% with infection rate of 26.7%. Patients with ASA score of 1 had infection rate of 23.3%, with patients who received perioperative transfusion having infection rate of 6.6%. Conclusion: Overall incidence of SSI is high, majority of patients were male who were young with ASA score of one had highest rate of infection. Prolonged preoperative and intraoperative duration, dirty wounds and perioperative transfusion was associated with increased rate of SSI. Surveillance on SSI by surgical team, public health education on alcohol and cigarettes consumption, prompt surgical intervention and judicial use of blood could reduce incidence of SSI.
背景:急诊腹部手术后手术部位感染(SSI)的发生率是重要的发病因素。有患者相关的以及围手术期的危险因素似乎有助于这一发生率。本研究确定了肯雅塔国家医院紧急肠道手术后的发生率和危险因素。目的:了解肯雅塔国立医院急诊剖腹手术后手术部位感染的发生率及危险因素。设计:前瞻性横断面研究。研究对象:120名13岁及以上的患者,计划接受紧急剖腹手术。结果:SSI总发病率为30.8%,其中男性患者感染率为20.8%,饮酒患者感染率为5.8%。术前48小时的SSI发生率最高,为12%,术中90分钟的SSI发生率最高,为7.5%。脏创面占60%,感染率26.7%。ASA评分为1的患者感染率为23.3%,围手术期输血患者感染率为6.6%。结论:SSI总体发病率较高,以男性为主,ASA评分为1分的患者感染率最高。术前和术中时间延长、伤口脏污和围手术期输血与SSI发生率增加有关。外科团队对SSI的监测、对烟酒消费的公共卫生教育、及时手术干预和合理用血可以降低SSI的发生率。
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引用次数: 0
ASSESSMENT OF THE KNOWLEDGE AND PRACTICES OF EXCLUSIVE BREASTFEEDING AMONGST THE BREASTFEEDING MOTHERS IN ADJUMANI DISTRICT, WEST NILE. 评估西尼罗州亚祖玛尼区母乳喂养母亲的纯母乳喂养知识和做法。
Q4 Medicine Pub Date : 2016-11-01
A P Adrawa, D Opi, E Candia, E Vukoni, I Kimera, I Sule, G Adokorach, T O Aliku, E Ovuga

Background: Despite national policy guidelines advocating exclusive breastfeeding for the first six months of life to promote and accelerate child survival, the proportion of women exclusively breastfeeding for the first six months has remained small.

Objective: To describe the knowledge and practices of mothers regarding exclusive breastfeeding in a semi-urban Ugandan population.

Design: A descriptive cross-sectional study.

Setting: Semi-urban Ugandan population in four parishes in Adjumani District, the West Nile region of Uganda.

Subjects: The breastfeeding mothers with infants aged 3-12 months.

Results: Of the 385 breastfeeding mothers surveyed, 62.6% (241/385) and 53.5% (206/385) knew the exact meaning and the recommended duration of exclusive breastfeeding respectively. Nearly 68.6% (264/385) initiated breastfeeding within one hour after delivery and only 42.1% (162/385) exclusively breastfed their babies in the first six months of life. For the mothers who initiated non-breast milk feeds before the first six months of birth, most stated the following reasons: 'advice from the home', 'did not know the appropriate time', baby got thirsty and baby was crying at the sight of food'.

Conclusion: This study revealed low levels of knowledge and practice of the recommended duration of exclusive breastfeeding among the breastfeeding mothers. Continuous breastfeeding awareness campaigns are needed to improve knowledge and practice of exclusive breastfeeding among breastfeeding mothers.

背景:尽管国家政策指导方针提倡在生命最初六个月纯母乳喂养,以促进和加速儿童生存,但前六个月纯母乳喂养的妇女比例仍然很小。目的:描述在乌干达半城市人口的母亲关于纯母乳喂养的知识和做法。设计:描述性横断面研究。背景:居住在乌干达西尼罗河地区亚祖玛尼区四个教区的半城市乌干达人口。研究对象:3-12个月婴儿的母乳喂养母亲。结果:385名接受调查的母乳喂养母亲中,62.6%(241/385)和53.5%(206/385)的母亲分别知道纯母乳喂养的确切含义和推荐的母乳喂养时间。近68.6%(264/385)的妇女在分娩后一小时内开始母乳喂养,只有42.1%(162/385)的妇女在婴儿出生后的头六个月内进行纯母乳喂养。对于那些在出生前6个月就开始非母乳喂养的母亲来说,大多数人说的原因是:“家里的建议”,“不知道合适的时间”,宝宝口渴,宝宝一看到食物就哭。结论:本研究揭示了母乳喂养母亲对推荐纯母乳喂养时间的知识和实践水平较低。需要持续开展提高母乳喂养意识的运动,以提高母乳喂养母亲对纯母乳喂养的认识和做法。
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引用次数: 0
Pathogenic E.coli and other pathogenic gram negative enteric strains from foecal samples of children without diarrhoea living in Mukuru slums, Nairobi 来自内罗毕穆库鲁贫民窟无腹泻儿童粪便样本的致病性大肠杆菌和其他致病性革兰氏阴性肠道菌株
Q4 Medicine Pub Date : 2016-10-10 DOI: 10.4314/eamj.v93i7
P. Impwi, Peris Wambugu, A. Kimang’a, S. Kariuki
Background: Diarrhoea remains a major public health problem among children and adults in developing nations such as Kenya. The risk of infection is higher in children due to their developing immunity, relatively poor hygiene and habits especially those living in informal settlements where water supply and sanitation are inadequate. Objectives: To determine the prevalence of selected enteric pathogens from children without diarrhoea attending two clinics in Mukuru as well as the anti-microbial resistance patterns, and pathogenicity of E. coli isolated. Design: A cross sectional study. Setting: Mukuru slum, Nairobi County. Subjects: Three hundred and twenty two children of ages five and below. Results: Mukuru Kwa Njenga; E. coli 34.6%, Salmonella spp. 1.3%, Shigella 0.7%,  Citrobacter spp. 2.3%, Klebsiella spp. 5.3%, Proteus spp. 7.0%, No growth 2.3%. Mukuru Kwa Reuben; E. coli 63.4%, Salmonella 0.6%, Shigella 0.6%, Citrobacter spp. 1.2% ,Klebsiella spp. 14.3%, Proteus spp. 16.1%, No growth 3.7%. No significant difference among the organisms isolated in both clinics (p = 0.982). Ampicillin, Amoxycillin/ Clavulanic, cefoxitin had high resistance, while gentamicin was 100% susceptible. 46.6% E. coli isolates were positive for at least one of the eight virulence genes tested. Conclusion: Salmonella , Shigella and pathogenic E.coli associated with diarrhoea and presence of resistance genes were identified in foecal samples of children without diarrhoea living in Mukuru informal settlements in Nairobi. The major concern from the findings of this study was the emerging high resistance of E.coli that was observed to cephamycin (Cefoxitin).
背景:腹泻仍然是肯尼亚等发展中国家儿童和成人的一个主要公共卫生问题。儿童感染的风险较高,因为他们的免疫力正在发育,个人卫生和习惯相对较差,特别是那些生活在供水和卫生设施不足的非正式住区的儿童。目的:确定在穆库鲁两家诊所就诊的无腹泻儿童中选定肠道病原体的流行情况,以及分离出的大肠杆菌的抗微生物耐药性模式和致病性。设计:横断面研究。背景:内罗毕县穆库鲁贫民窟。研究对象:322名5岁及以下的儿童。结果:Mukuru Kwa Njenga;大肠杆菌34.6%,沙门氏菌1.3%,志贺氏菌0.7%,柠檬酸杆菌2.3%,克雷伯氏菌5.3%,变形杆菌7.0%,无增长2.3%。Mukuru Kwa Reuben;大肠杆菌63.4%,沙门氏菌0.6%,志贺氏菌0.6%,柠檬酸杆菌1.2%,克雷伯氏菌14.3%,变形杆菌16.1%,无增长3.7%。两家诊所分离的微生物无显著差异(p = 0.982)。氨苄西林、阿莫西林/克拉维兰、头孢西丁耐药较高,庆大霉素100%敏感。46.6%的大肠杆菌分离株在8种毒力基因中至少1种呈阳性。结论:在内罗毕穆库鲁非正式住区无腹泻儿童的粪便样本中发现了与腹泻相关的沙门氏菌、志贺氏菌和致病性大肠杆菌,并发现了耐药基因。本研究结果的主要担忧是观察到大肠杆菌对头孢霉素(头孢西丁)出现高耐药性。
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引用次数: 1
Imatinib mesylate in chronic myelogenous leukemia: a Congolese experience 甲磺酸伊马替尼治疗慢性粒细胞白血病:刚果经验
Q4 Medicine Pub Date : 2016-10-01 DOI: 10.4314/EAMJ.V93I10
E. Omesa, I. Kathure, E. Masini, R. Mulwa, A. Maritim, P. Owiti, K. Takarinda, O. Ogutu, R. Kosgei, T. Galgalo
Background: Chronic myeloid leukemia is a clonal myeloproliferative disorder caused by reciprocal translocation t(9;22) that induces tyrosin kinase protein. Imatinib is a selective inhibitor of this protein. Objectives: To assess responses to imatinib and outcome of Congolese patients with chronic phase chronic myeloid leukemia. Design: retrospective study. Settings: Clinical Haematology unit of Teaching Hospital in Brazzaville, Congo Subjects: Newly diagnosed patients with chronic phase chronic myeloid leukemia treated with imatinib. Results: A total of 25 males and 14 females with a mean age of 36 years at time of the diagnosis were enrolled in the study. The mean duration of the illness was 11.4 months. Imatinib induced complete hematologic response at 3 months in 100%. Major cytogenetic response was noticed in 87.18%. After a median follow up of 12 months, chronic myeloid leukemia had not progressed to the accelerated or blastic phase in an estimated 91.8% of patients and 86.6% were alive. Conclusion: Imatinib is effective in newly chronic phase chronic myeloid leukemia patient even though cytogenetic response rate are lower in Africa than western countries populations
背景:慢性髓系白血病是一种克隆性骨髓增生性疾病,由诱导酪氨酸激酶蛋白的相互易位引起(9;22)。伊马替尼是这种蛋白的选择性抑制剂。目的:评估刚果(金)慢性期慢性髓性白血病患者对伊马替尼的反应和预后。设计:回顾性研究。背景:刚果布拉柴维尔教学医院临床血液科研究对象:用伊马替尼治疗的新诊断的慢慢期慢性髓性白血病患者。结果:共有25名男性和14名女性被纳入研究,诊断时平均年龄为36岁。平均病程11.4个月。伊马替尼在3个月时100%诱导完全血液学反应。87.18%的患者出现了主要的细胞遗传学反应。中位随访12个月后,估计91.8%的慢性髓性白血病患者未进展到加速期或母细胞期,86.6%的患者存活。结论:尽管非洲的细胞遗传学应答率低于西方国家,但伊马替尼对新慢性粒细胞白血病患者是有效的
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引用次数: 11
Survivorship patterns of histopathological variants and molecular subtypes of breast cancer in a teaching hospital in Nigeria 尼日利亚某教学医院乳腺癌组织病理学变异和分子亚型的生存模式
Q4 Medicine Pub Date : 2016-09-01 DOI: 10.4314/EAMJ.V93I9
Adeniji Ka, D. Hugo, G. Rahman, T. Akande, S. Olatoke, H. Akande, K. Durowade, A. O. Durojaiye, G. Ayilara, O. Olopade
Objective : To study the relationship of histopathological characteristics, molecular subtypes of breast cancer and survival in a low resource setting. Design : Tumours from prospectively ascertained patients newly diagnosed with breast cancer were analyzed. Formalin-fixed and paraffin-embedded sections were constructed into tissue micro-arrays and immunostained with five anti-bodies. Five molecular subtypes were determined. Settings : The study was conducted jointly in the Department of Pathology of University of Ilorin Teaching Hospital, Ilorin in Nigeria and at the University of Chicago in the United States. Subjects : The study included a total of 203 histologically confirmed breast cancer patients whose pathological specimens were processed in the Department of Pathology of University of Ilorin Teaching Hospital, Ilorin, Nigeria between January 2003 and December 2007. Results : Mean age at diagnosis was 49.2 (SO ±11.9) years. Median time from symptom onset to cancer diagnosis was six months. Median follow-up time was 8.3 months. Median tumour size at diagnosis was 6cm. The proportion of ER+, PR+, HER2+ tumours were 27%, 16% and 30%, respectively. The most common molecular subtype was basal-like (25.1%) followed by unclassified (24.0%), luminal A (20.5%), HER2+/ER( 19.3%) and luminal B (11.1 %). Luminal A and B had best prognosis while basal-like and unclassified had worst prognosis. ER+ patients had longer duration of symptoms to diagnosis (median 8 months) than ER- patients (5 months) but ER+ patients had smaller tumours (median 5cm) than ER-patients (6cm, p=0.02). Recurrence-free survival was best for stage 1 and worst for stage 4 tumours. About 32.6% of patients had locoregional and/or metastatic recurrence. Conclusions : In consecutive breast cancer cases in Nigeria, almost half of patients were triple negative. Luminal A and B subtypes had best prognosis while triple negative had worst prognosis. The delay in breast cancer diagnosis and higher proportion of late stage of breast cancer underscores need for prompt diagnosis and initiation of treatment, especially hormonal therapy for ER positive patients.
目的:探讨低资源环境下乳腺癌的组织病理特征、分子亚型与生存的关系。设计:对前瞻性确定的新诊断乳腺癌患者的肿瘤进行分析。将福尔马林固定切片和石蜡包埋切片构建成组织微阵列,并用5种抗体进行免疫染色。确定了5种分子亚型。环境:这项研究是在尼日利亚伊洛林的伊洛林大学教学医院病理科和美国芝加哥大学联合进行的。研究对象:本研究共纳入2003年1月至2007年12月在尼日利亚伊洛林伊洛林大学教学医院病理科进行病理标本处理的组织学确诊乳腺癌患者203例。结果:平均诊断年龄为49.2 (SO±11.9)岁。从症状出现到癌症诊断的中位时间为6个月。中位随访时间8.3个月。诊断时肿瘤中位大小为6cm。ER+、PR+、HER2+肿瘤比例分别为27%、16%、30%。最常见的分子亚型为基底样(25.1%),其次为未分类(24.0%)、luminal A(20.5%)、HER2+/ER(19.3%)和luminal B(11.1%)。Luminal A和B预后最好,基底样和未分类预后最差。ER+患者的症状持续时间(中位8个月)比ER-患者(5个月)更长,但ER+患者的肿瘤较小(中位5cm),比ER-患者(6cm, p=0.02)。无复发生存率在第1期是最好的,在第4期是最差的。约32.6%的患者有局部和/或转移性复发。结论:在尼日利亚连续发生的乳腺癌病例中,几乎一半的患者为三阴性。Luminal A和B亚型预后最好,三阴性预后最差。乳腺癌的诊断延迟和晚期乳腺癌比例较高,强调了及时诊断和开始治疗的必要性,特别是对ER阳性患者进行激素治疗。
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引用次数: 1
期刊
East African medical journal
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