G. Ahaneku, C. Osuji, O. Oguejiofor, B. Anisiuba, V. Ikeh, J. Ahaneku
Background : Rapid transition from rural to urban lifestyle in Africa has been associated with increasing cardiovascular disease burden and thus, the need for continuous reevaluation of cardiovascular risk factors in African slums which have been shown to harbor 40 to 80% of urban residents cannot be over emphasized. Objectives : To evaluate hypertension and obesity in a typical urban slum in South East, Nigeria. Design : Cross-sectional community based study. Setting : A typical urban slum in Enugu State, Eastern Nigeria. Subjects : One hundred and ninety one volunteers from the slum. Results : The mean age of the entire participants in this study was 44.1 ± 16.2 years while their mean BMI was 25.1 ± 5.2 Kg/m2. Their mean systolic BP was 128.8 mmHg ± 22.2 and 79.0mmHg ± 12.9 for mean diastolic BP. Both systolic and diastolic blood pressure (BP) increased as age group increased peaking at the age group 55- 74 years and then dropping after 75 years. Mean BMI peaked at 35- 54 years and then started dropping as age increased. In the entire community, 29.3% of the participants had hypertension (males: 42.1 %, females: 23.9%), 25.1% had isolated systolic HBP (ISH) while 22.0% had isolated diastolic HBP (IDH). In the general population, the general prevalence of HBP and ISH increased as age group increased. IDH increased as age increased peaking at 55- 74 year age group (34.1%) and then dropped thereafter (≥75; ISH=10.0%). Among the females, HBP prevalence increased across board as age increased but among the males, it increased with age and peaked at 55-74 year age group (61.1%) and then dropped (≥75; HBP= 57.1%). The prevalence of obesity in the community was 13.1% (males; 5.3%, females; 16.4%). None of those ≥75 years had obesity. Obesity prevalence was highest in those 35-54 years old (17.6%) and least in those 15- 34 years old (9.1%). Generally and within all age groups, females had higher obesity prevalence than the males. For the males, Obesity was highest in those 55-74 years (11.1%) while for the females, it was highest in those 35-54 years (23.0%). Prevalence of HBP increased with BMI getting to more than double fold in those found to be obese. 26% of the participants (20.8% of males and 31.3% of females) who were found to have hypertension had prior knowledge of it. Conclusion : Hypertension and obesity are on the increase in Nigeria and degree of ignorance about these major cardiovascular risk factors has remained very high.
{"title":"Blood Pressure and Obesity Index Assessment in a Typical Urban Slum in Enugu, Nigeria","authors":"G. Ahaneku, C. Osuji, O. Oguejiofor, B. Anisiuba, V. Ikeh, J. Ahaneku","doi":"10.4314/EAMJ.V92I4","DOIUrl":"https://doi.org/10.4314/EAMJ.V92I4","url":null,"abstract":"Background : Rapid transition from rural to urban lifestyle in Africa has been associated with increasing cardiovascular disease burden and thus, the need for continuous reevaluation of cardiovascular risk factors in African slums which have been shown to harbor 40 to 80% of urban residents cannot be over emphasized. Objectives : To evaluate hypertension and obesity in a typical urban slum in South East, Nigeria. Design : Cross-sectional community based study. Setting : A typical urban slum in Enugu State, Eastern Nigeria. Subjects : One hundred and ninety one volunteers from the slum. Results : The mean age of the entire participants in this study was 44.1 ± 16.2 years while their mean BMI was 25.1 ± 5.2 Kg/m2. Their mean systolic BP was 128.8 mmHg ± 22.2 and 79.0mmHg ± 12.9 for mean diastolic BP. Both systolic and diastolic blood pressure (BP) increased as age group increased peaking at the age group 55- 74 years and then dropping after 75 years. Mean BMI peaked at 35- 54 years and then started dropping as age increased. In the entire community, 29.3% of the participants had hypertension (males: 42.1 %, females: 23.9%), 25.1% had isolated systolic HBP (ISH) while 22.0% had isolated diastolic HBP (IDH). In the general population, the general prevalence of HBP and ISH increased as age group increased. IDH increased as age increased peaking at 55- 74 year age group (34.1%) and then dropped thereafter (≥75; ISH=10.0%). Among the females, HBP prevalence increased across board as age increased but among the males, it increased with age and peaked at 55-74 year age group (61.1%) and then dropped (≥75; HBP= 57.1%). The prevalence of obesity in the community was 13.1% (males; 5.3%, females; 16.4%). None of those ≥75 years had obesity. Obesity prevalence was highest in those 35-54 years old (17.6%) and least in those 15- 34 years old (9.1%). Generally and within all age groups, females had higher obesity prevalence than the males. For the males, Obesity was highest in those 55-74 years (11.1%) while for the females, it was highest in those 35-54 years (23.0%). Prevalence of HBP increased with BMI getting to more than double fold in those found to be obese. 26% of the participants (20.8% of males and 31.3% of females) who were found to have hypertension had prior knowledge of it. Conclusion : Hypertension and obesity are on the increase in Nigeria and degree of ignorance about these major cardiovascular risk factors has remained very high.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVE To study the incidence of tetanus during the last 50 years in Sengerema, Tanzania. DESIGN Analysing the annual reports in the only district hospital, focusing on the number of admissions and mortality for tetanus and malaria. SETTING Sengerema Hospital, Sengerema district, Tanzania. SUBJECT Number of admissions and mortality in Sengerema Hospital due to tetanus. INTERVENTIONS In the seventies and eighties a vaccination campaign was started end organised in order to cover the whole district and to provide immunity for tetanus. MAIN OUTCOME MEASURES From 1962 to 2012, we analysed the incidence and fatality rate of tetanus. RESULT One hundred and fifteen admissions in the sixties, increasing to 183 in the seventies, dropping to 30 in the nineties. For the last ten years 18 patients with tetanus were seen in the only district hospital. Then last year no admissions for tetanus were registered. The number of deaths due to tetanus decreased simultaneously, during the last decade a single fatality case was reported. CONCLUSION During the last decades, we have witnessed the disappearing of tetanus in Sengerema Hospital. The incidence of tetanus can be reduced significantly or eliminated by an effective immunisation programme, even in rural Tanzania.
{"title":"TETANUS NEARLY ELIMINATED AFTER 40 YEARS OF VACCINATION IN RURAL SENGEREMA DISTRICT, TANZANIA.","authors":"D. Melkert, L. Kahema, P. Melkert","doi":"10.4314/eamj.v91i7","DOIUrl":"https://doi.org/10.4314/eamj.v91i7","url":null,"abstract":"OBJECTIVE\u0000To study the incidence of tetanus during the last 50 years in Sengerema, Tanzania.\u0000\u0000\u0000DESIGN\u0000Analysing the annual reports in the only district hospital, focusing on the number of admissions and mortality for tetanus and malaria.\u0000\u0000\u0000SETTING\u0000Sengerema Hospital, Sengerema district, Tanzania.\u0000\u0000\u0000SUBJECT\u0000Number of admissions and mortality in Sengerema Hospital due to tetanus.\u0000\u0000\u0000INTERVENTIONS\u0000In the seventies and eighties a vaccination campaign was started end organised in order to cover the whole district and to provide immunity for tetanus.\u0000\u0000\u0000MAIN OUTCOME MEASURES\u0000From 1962 to 2012, we analysed the incidence and fatality rate of tetanus.\u0000\u0000\u0000RESULT\u0000One hundred and fifteen admissions in the sixties, increasing to 183 in the seventies, dropping to 30 in the nineties. For the last ten years 18 patients with tetanus were seen in the only district hospital. Then last year no admissions for tetanus were registered. The number of deaths due to tetanus decreased simultaneously, during the last decade a single fatality case was reported.\u0000\u0000\u0000CONCLUSION\u0000During the last decades, we have witnessed the disappearing of tetanus in Sengerema Hospital. The incidence of tetanus can be reduced significantly or eliminated by an effective immunisation programme, even in rural Tanzania.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. K. Mukthar, A. Maranga, S. J. Kulei, R. Chemoiwa
OBJECTIVE To determine the uptake ana factors associated with the uptake of modern contraceptives among women of reproductive age (15-49 years) attending Maternal Child Health and Family Planning Clinics/Units in Rift Valley Provincial Hospital in Kenya. DESIGN A descriptive cross-sectional study. SETTING Rift Valley Provincial hospital which is a level five health facility situated in Nakuru County, Kenya. SUBJECTS Women of reproductive age (15-49 years) who were attending Maternal Child Health and Family Planning Clinics at the Rift Valley Provincial Hospital. The respondents were identified by systematic random sampling RESULTS Modern contraceptive uptake is over ninety percent (90.4, n = 218). The factors that are significantly associated with uptake of modern contraceptives are perceived convenience to use modern contraceptives (OR 0.39, CI: 0.16 - 0.93, p value- 0.04), experience of unmet needs of contraception (OR 0.08, CI: 0.03 - 0.2, p value- 0.001), history of a modern contraception discontinuation (OR 5.5, CI: 1.7 - 9.2, p value- 0.036) and knowledge of modern contraceptives (OR 19.1, CI: 12.3 - 27.5, p value-0.001). Conclusion: This study concluded that uptake of modern contraceptive is relatively high in Nakuru, Kenya and there is need for programmes to focus more on the client of modern contraceptive and the attributes of the modern contraceptives in up-scaling the uptake of modern contraceptives.
{"title":"THE UPTAKE OF MODERN CONTRACEPTIVES AMONG WOMEN OF REPRODUCTIVE AGE ATTENDING MATERNAL CHILD HEALTH AND FAMILY PLANNING (MCH/FP) CLINICS.","authors":"V. K. Mukthar, A. Maranga, S. J. Kulei, R. Chemoiwa","doi":"10.4314/EAMJ.V91I12","DOIUrl":"https://doi.org/10.4314/EAMJ.V91I12","url":null,"abstract":"OBJECTIVE\u0000To determine the uptake ana factors associated with the uptake of modern contraceptives among women of reproductive age (15-49 years) attending Maternal Child Health and Family Planning Clinics/Units in Rift Valley Provincial Hospital in Kenya.\u0000\u0000\u0000DESIGN\u0000A descriptive cross-sectional study.\u0000\u0000\u0000SETTING\u0000Rift Valley Provincial hospital which is a level five health facility situated in Nakuru County, Kenya.\u0000\u0000\u0000SUBJECTS\u0000Women of reproductive age (15-49 years) who were attending Maternal Child Health and Family Planning Clinics at the Rift Valley Provincial Hospital. The respondents were identified by systematic random sampling\u0000\u0000\u0000RESULTS\u0000Modern contraceptive uptake is over ninety percent (90.4, n = 218). The factors that are significantly associated with uptake of modern contraceptives are perceived convenience to use modern contraceptives (OR 0.39, CI: 0.16 - 0.93, p value- 0.04), experience of unmet needs of contraception (OR 0.08, CI: 0.03 - 0.2, p value- 0.001), history of a modern contraception discontinuation (OR 5.5, CI: 1.7 - 9.2, p value- 0.036) and knowledge of modern contraceptives (OR 19.1, CI: 12.3 - 27.5, p value-0.001). Conclusion: This study concluded that uptake of modern contraceptive is relatively high in Nakuru, Kenya and there is need for programmes to focus more on the client of modern contraceptive and the attributes of the modern contraceptives in up-scaling the uptake of modern contraceptives.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective : To obtain information on societal attitude to the issues of family planning, unwanted pregnancy, abortion, adoption of children and laws relating to them. Design : Focused group discussions. Setting : Twelve subgroups in the urban and rural areas of Ogun State, Nigeria were identified, and focus group sessions held for each subgroup. Subjects : Males and females, with their ages ranging from 15 years to above 50 years drawn from different segments of the community. Intervention : A set of guidelines/questions for the FGD were developed, field-tested and used. Main outcome measures : Rich information on such relevant issues as family planning, unwanted pregnancy, abortion and adoption of children, and the laws relating to them.. Results : Participants felt that there was high prevalence of unwanted pregnancy and abortion particularly among youths. They had high level of awareness of contraceptives and attributed its low use to negative side-effects, high cost and provider bias. More Christians than Muslims favoured planning of pregnancies. Majority of the respondents had negative perception of induced abortion. Some of them supported abortion if the education of the young girl would be disrupted, if paternity of pregnancy is in dispute, or if it would save the family from shame as in rape or incest. Participants supported the enactment of laws that would make adoption of unwanted children easier. Conclusion : There is a need for policymakers to address the issue of abortion and unwanted children, and enact acceptable abortion and adoption laws to protect the rights of women and children in Nigeria.
{"title":"Induced Abortion in Nigeria","authors":"M. A. Lamina","doi":"10.4314/EAMJ.V91I6","DOIUrl":"https://doi.org/10.4314/EAMJ.V91I6","url":null,"abstract":"Objective : To obtain information on societal attitude to the issues of family planning, unwanted pregnancy, abortion, adoption of children and laws relating to them. Design : Focused group discussions. Setting : Twelve subgroups in the urban and rural areas of Ogun State, Nigeria were identified, and focus group sessions held for each subgroup. Subjects : Males and females, with their ages ranging from 15 years to above 50 years drawn from different segments of the community. Intervention : A set of guidelines/questions for the FGD were developed, field-tested and used. Main outcome measures : Rich information on such relevant issues as family planning, unwanted pregnancy, abortion and adoption of children, and the laws relating to them.. Results : Participants felt that there was high prevalence of unwanted pregnancy and abortion particularly among youths. They had high level of awareness of contraceptives and attributed its low use to negative side-effects, high cost and provider bias. More Christians than Muslims favoured planning of pregnancies. Majority of the respondents had negative perception of induced abortion. Some of them supported abortion if the education of the young girl would be disrupted, if paternity of pregnancy is in dispute, or if it would save the family from shame as in rape or incest. Participants supported the enactment of laws that would make adoption of unwanted children easier. Conclusion : There is a need for policymakers to address the issue of abortion and unwanted children, and enact acceptable abortion and adoption laws to protect the rights of women and children in Nigeria.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
O. Ebeye, L. Chris-ozoko, P. Ogeneovo, A. Onoriode
BACKGROUND Genetic variability is a common feature of many organisms. The existence of genetic variation in man is caused by many factors along with selection, migration, gene flow and genetic drift. Human genetics are known as hereditary traits, these hereditary traits include the dominant and recessive traits in humans. Most of the genes are transmitted in the Mendelian pattern and a few are transmitted through the non-Mendelian pattern. OBJECTIVE To show variation pattern in earlobe attachment, hair line distribution and presence or absence of cheek dimples and to determine prevalence of these traits among the Esan ethnic group of Southern Nigeria. DESIGN Descriptive study. SETTING The target populations for this study are the Esan ethnic group of Southern Nigeria. Esan land is bordered to the south by Benin City, to the east by Agbor City, to the north by Etsako and to the west by River Niger. SUBJECT A simple random sampling technique was used to select 400 volunteered subjects (176 males, 224 females). They were between the ages of 17-60. Their parents and grandparents were from Esan backgrounds. Data on cheek dimple (present or absent), widow's peak or straight hairline and earlobe attachment was gathered. RESULT Results showed 12.5% of Males and 21.3% of females had cheek dimples while 31.5% of males and 34.7% of female had no dimple. 29.0% Males and 40.0% females had unattached earlobe while 15.0% Males and 16.0% females had their earlobes attached. Results for widow's peak showed 14.7% males and 16.5% females had widow's peak while 29.3% males and females 39.5% didn't have a peak. The chi-squared analysis of variance showed that there is a no significant difference between gender for earlobe attachment, hair line variation and cheek dimple (p > 0.05). CONCLUSION The study concluded that these traits varies in the population but do not vary with gender.
{"title":"A STUDY OF SOME MORPHOGENETIC TRAITS AMONG THE ESAN ETHNIC GROUP OF NIGERIA.","authors":"O. Ebeye, L. Chris-ozoko, P. Ogeneovo, A. Onoriode","doi":"10.4314/eamj.v91i11","DOIUrl":"https://doi.org/10.4314/eamj.v91i11","url":null,"abstract":"BACKGROUND\u0000Genetic variability is a common feature of many organisms. The existence of genetic variation in man is caused by many factors along with selection, migration, gene flow and genetic drift. Human genetics are known as hereditary traits, these hereditary traits include the dominant and recessive traits in humans. Most of the genes are transmitted in the Mendelian pattern and a few are transmitted through the non-Mendelian pattern.\u0000\u0000\u0000OBJECTIVE\u0000To show variation pattern in earlobe attachment, hair line distribution and presence or absence of cheek dimples and to determine prevalence of these traits among the Esan ethnic group of Southern Nigeria.\u0000\u0000\u0000DESIGN\u0000Descriptive study.\u0000\u0000\u0000SETTING\u0000The target populations for this study are the Esan ethnic group of Southern Nigeria. Esan land is bordered to the south by Benin City, to the east by Agbor City, to the north by Etsako and to the west by River Niger.\u0000\u0000\u0000SUBJECT\u0000A simple random sampling technique was used to select 400 volunteered subjects (176 males, 224 females). They were between the ages of 17-60. Their parents and grandparents were from Esan backgrounds. Data on cheek dimple (present or absent), widow's peak or straight hairline and earlobe attachment was gathered.\u0000\u0000\u0000RESULT\u0000Results showed 12.5% of Males and 21.3% of females had cheek dimples while 31.5% of males and 34.7% of female had no dimple. 29.0% Males and 40.0% females had unattached earlobe while 15.0% Males and 16.0% females had their earlobes attached. Results for widow's peak showed 14.7% males and 16.5% females had widow's peak while 29.3% males and females 39.5% didn't have a peak. The chi-squared analysis of variance showed that there is a no significant difference between gender for earlobe attachment, hair line variation and cheek dimple (p > 0.05).\u0000\u0000\u0000CONCLUSION\u0000The study concluded that these traits varies in the population but do not vary with gender.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70520674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. Chemoiwa, V. K. Mukthar, A. Maranga, S. J. Kulei
OBJECTIVE To analyse the infection prevention practices in handling of injections by nurses in Rift Valley Provincial Hospital in Kenya. DESIGN A cross-sectional observational study. SETTING Rift Valley Provincial hospital which is a level five health facility situated in Nakuru County, Kenya. SUBJECTS A sample of 386 injection procedures attributed to the nurses in Rift Valley Provincial Hospital was considered for this study. RESULTS The study established that among all the injections administered in this study, 43.7% (386) adhered to aseptic techniques. Over seventy five percent (76.9%, n = 386) of the observed injections procedures did not involve the hand-washing, 53.4% (n = 206) did not involve swabbing of a vial rubber cap with alcohol swabs and 95.1%(n = 263) involved using of multidose drug in more than one designated patient. Over ninety five percent (95.6%, n = 364) of the observed procedures involved use of sterile the syringe bit of the devices only while the rest used either clean or contaminated syringes. Around forty percent (42.2%, n = 316) of the injections preparation was done elsewhere (not at the patient bedside) before administration. Slightly over thirty five percent (36.6%, n = 386) of the injections were administered immediately upon reconstitution(at the right time). The study also established the use of aseptic techniques to reconstitute and administer was significantly related to the number of nurses to patients ratio per shift (X2(1) = 3.5: p = 0.04). CONCLUSION The findings of this study indicate that patient safety in public hospital is still relatively low. The adherence to basic infection prevention procedures/aseptic techniques in handling of injections by health workers is still a concern. The adherence to aseptic techniques in handling injections is significantly associated with the nurses to patients ratios. Therefore, it is imperative to improve nurse to patient ratio in public health facilities in Kenya.
{"title":"NURSES INFECTION PREVENTION PRACTICES IN HANDLING INJECTIONS: A CASE OF RIFT VALLEY PROVINCIAL HOSPITAL IN KENYA.","authors":"R. Chemoiwa, V. K. Mukthar, A. Maranga, S. J. Kulei","doi":"10.4314/eamj.v91i10","DOIUrl":"https://doi.org/10.4314/eamj.v91i10","url":null,"abstract":"OBJECTIVE\u0000To analyse the infection prevention practices in handling of injections by nurses in Rift Valley Provincial Hospital in Kenya.\u0000\u0000\u0000DESIGN\u0000A cross-sectional observational study.\u0000\u0000\u0000SETTING\u0000Rift Valley Provincial hospital which is a level five health facility situated in Nakuru County, Kenya.\u0000\u0000\u0000SUBJECTS\u0000A sample of 386 injection procedures attributed to the nurses in Rift Valley Provincial Hospital was considered for this study.\u0000\u0000\u0000RESULTS\u0000The study established that among all the injections administered in this study, 43.7% (386) adhered to aseptic techniques. Over seventy five percent (76.9%, n = 386) of the observed injections procedures did not involve the hand-washing, 53.4% (n = 206) did not involve swabbing of a vial rubber cap with alcohol swabs and 95.1%(n = 263) involved using of multidose drug in more than one designated patient. Over ninety five percent (95.6%, n = 364) of the observed procedures involved use of sterile the syringe bit of the devices only while the rest used either clean or contaminated syringes. Around forty percent (42.2%, n = 316) of the injections preparation was done elsewhere (not at the patient bedside) before administration. Slightly over thirty five percent (36.6%, n = 386) of the injections were administered immediately upon reconstitution(at the right time). The study also established the use of aseptic techniques to reconstitute and administer was significantly related to the number of nurses to patients ratio per shift (X2(1) = 3.5: p = 0.04).\u0000\u0000\u0000CONCLUSION\u0000The findings of this study indicate that patient safety in public hospital is still relatively low. The adherence to basic infection prevention procedures/aseptic techniques in handling of injections by health workers is still a concern. The adherence to aseptic techniques in handling injections is significantly associated with the nurses to patients ratios. Therefore, it is imperative to improve nurse to patient ratio in public health facilities in Kenya.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVES The Malawi Ministry of Health (MOH) and its immunisation partners conducted a training needs assessment in May 2013 to assess the current status of immunisation training programmemes in health training institutions, to identify unmet training needs, and to recommend possible solutions for training of health workers on a regular basis. DESIGN A cross-sectional, descriptive study. SETTING Health training institutions in Malawi, a developing country that does not regularly update its curricula to include new vaccines and management tools, nor train healthcare workers on a regular basis. SUBJECTS Researchers interviewed Malawi's central immunisation manager, three zonal immunisation officers, six district officers, 12 health facility immunisation coordinators, and eight principals of training institutions. RESULTS All health training institutions in Malawi include immunisation in their preservice training curricula. However, the curriculum is not regularly updated; thus, the graduates are not well equipped to provide quality services. In addition, the duration of the training curriculum is inadequate, and in-service training sessions for managers and service providers are conducted only on an ad hoc basis. CONCLUSION All levels of Malawi's health system have not met sufficient training needs for providing immunisations, and the health training institutions teach their students with outdated materials. It is recommended that the training institutions update their training curricula regularly and the service providers are trained on a regular basis.
{"title":"IMMUNISATION TRAINING NEEDS IN MALAWI.","authors":"A. Tsega, H. Hausi, R. Steinglass, G. Chirwa","doi":"10.4314/EAMJ.V91I9","DOIUrl":"https://doi.org/10.4314/EAMJ.V91I9","url":null,"abstract":"OBJECTIVES\u0000The Malawi Ministry of Health (MOH) and its immunisation partners conducted a training needs assessment in May 2013 to assess the current status of immunisation training programmemes in health training institutions, to identify unmet training needs, and to recommend possible solutions for training of health workers on a regular basis.\u0000\u0000\u0000DESIGN\u0000A cross-sectional, descriptive study.\u0000\u0000\u0000SETTING\u0000Health training institutions in Malawi, a developing country that does not regularly update its curricula to include new vaccines and management tools, nor train healthcare workers on a regular basis.\u0000\u0000\u0000SUBJECTS\u0000Researchers interviewed Malawi's central immunisation manager, three zonal immunisation officers, six district officers, 12 health facility immunisation coordinators, and eight principals of training institutions.\u0000\u0000\u0000RESULTS\u0000All health training institutions in Malawi include immunisation in their preservice training curricula. However, the curriculum is not regularly updated; thus, the graduates are not well equipped to provide quality services. In addition, the duration of the training curriculum is inadequate, and in-service training sessions for managers and service providers are conducted only on an ad hoc basis.\u0000\u0000\u0000CONCLUSION\u0000All levels of Malawi's health system have not met sufficient training needs for providing immunisations, and the health training institutions teach their students with outdated materials. It is recommended that the training institutions update their training curricula regularly and the service providers are trained on a regular basis.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-08-19DOI: 10.4314/EAMJ.V78I7.106705
N. Othieno-Abinya, L. Nyabola
OBJECTIVES To evaluate the frequency and severity of occurrence of vincristine-associated neurotoxicity. DESIGN A retrospective case series study. SETTING Hurlingham Oncology Clinic, Nairobi. SUBJECTS Thirty-eight patients treated for various neoplasms with vincristine containing chemotherapeutic regimens. MAIN OUTCOME MEASURES The frequency and degree of neurotoxicity when vincristine was given at the standard dose of 1.4 mg/m2. RESULTS Five patients (13.2%) developed peripheral neuropathy, one having had it even before vincristine was started. Therefore only four (10.5%) had it attributed to vincristine. Four of the patients who developed neuropathy (80%) were HIV-positive. Neuropathy grade 2 (severe) occurred in only two patients leading to discontinuation of the drug. All the neurotoxicity resolved after discontinuation of vincristine. CONCLUSION Vincristine induced neuropathy occurred but was rarely severe at a dose of 1.4 mg/m2. It appeared to be more frequent in HIV infected individuals, but controlled studies with bigger sample sizes are required to determine whether this may warrant routine capping of the dose at a maximum of 2 mg.
{"title":"Experience with vincristine--associated neurotoxicity.","authors":"N. Othieno-Abinya, L. Nyabola","doi":"10.4314/EAMJ.V78I7.106705","DOIUrl":"https://doi.org/10.4314/EAMJ.V78I7.106705","url":null,"abstract":"OBJECTIVES\u0000To evaluate the frequency and severity of occurrence of vincristine-associated neurotoxicity.\u0000\u0000\u0000DESIGN\u0000A retrospective case series study.\u0000\u0000\u0000SETTING\u0000Hurlingham Oncology Clinic, Nairobi.\u0000\u0000\u0000SUBJECTS\u0000Thirty-eight patients treated for various neoplasms with vincristine containing chemotherapeutic regimens.\u0000\u0000\u0000MAIN OUTCOME MEASURES\u0000The frequency and degree of neurotoxicity when vincristine was given at the standard dose of 1.4 mg/m2.\u0000\u0000\u0000RESULTS\u0000Five patients (13.2%) developed peripheral neuropathy, one having had it even before vincristine was started. Therefore only four (10.5%) had it attributed to vincristine. Four of the patients who developed neuropathy (80%) were HIV-positive. Neuropathy grade 2 (severe) occurred in only two patients leading to discontinuation of the drug. All the neurotoxicity resolved after discontinuation of vincristine.\u0000\u0000\u0000CONCLUSION\u0000Vincristine induced neuropathy occurred but was rarely severe at a dose of 1.4 mg/m2. It appeared to be more frequent in HIV infected individuals, but controlled studies with bigger sample sizes are required to determine whether this may warrant routine capping of the dose at a maximum of 2 mg.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4314/EAMJ.V78I7.106705","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70516951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Adesina, Ogunlaja Oo, A. Aboyeji, Olarinoye Oa, A. Adeniran, Aa Fawole, H. J. Akande
Background : Interleukin-10, IL-2 and IFN -γ are some of the crucial cytokines associated with HIV infection and pathogenesis. While IL-2 and IFN-γ play critical roles in host resistance to infection, IL-10 inhibits the synthesis IFN-γ, IL-2 at mRNA and protein level; exacerbating damage to immune system. Objective : To determine the levels of, changes in and correlation between CD4 count, viral load, IL-10, IL-2 and IFN-γ before HAART and at six months of HAART among HIV positive patients in Kigali; with a view to understand cytokine networks particularly in relation to HAART ; and to see whether they can be used as alternative markers of the disease progression. Design : Longitudinal study. Setting : Kagugu, Kimironko, Biryogo, Gitega Health Centres and Centre Medico-Social Cornum; all located in Kigali. Subjects : Thirty three (33) HAART initiation eligible HIV positive patients including 13 women and 20 men. Results : A drop in viral load (though only a small number of patients achieved an undetectable viraemia); a recovery of CD4+ cells, a decrease in IL-10 (though it remained high for many patients especially those with unchanged viraemia); and an increase in IL-2 and IFN-γ indicated a successful HAART . A negative correlation between CD4 count and viral load and between CD4 count and IL-10 (but r 0.5 at both time points: p-values <0.05). There was no significant correlation between CD4 count, IL-2 and IFN-γ. Conclusion : Results demonstrated the down-regulatory effect of IL-10 on Th1 cytokines and that a shift from Th1 to Th2 cytokine is associated with HIV disease progression. A successful HAART results in CD4+ cells recovery, drop in viraemia and IL-10 with up-regulation of Th1 cytokines. Also, findings show potential usefulness of IL-10 as a marker of HIV disease progression.
{"title":"IMMUNOLOGICAL PROFILES IN HIV POSITIVE PATIENTS FOLLOWING HAART INITIATION IN KIGALI, RWANDA.","authors":"K. Adesina, Ogunlaja Oo, A. Aboyeji, Olarinoye Oa, A. Adeniran, Aa Fawole, H. J. Akande","doi":"10.4314/EAMJ.V91I8","DOIUrl":"https://doi.org/10.4314/EAMJ.V91I8","url":null,"abstract":"Background : Interleukin-10, IL-2 and IFN -γ are some of the crucial cytokines associated with HIV infection and pathogenesis. While IL-2 and IFN-γ play critical roles in host resistance to infection, IL-10 inhibits the synthesis IFN-γ, IL-2 at mRNA and protein level; exacerbating damage to immune system. Objective : To determine the levels of, changes in and correlation between CD4 count, viral load, IL-10, IL-2 and IFN-γ before HAART and at six months of HAART among HIV positive patients in Kigali; with a view to understand cytokine networks particularly in relation to HAART ; and to see whether they can be used as alternative markers of the disease progression. Design : Longitudinal study. Setting : Kagugu, Kimironko, Biryogo, Gitega Health Centres and Centre Medico-Social Cornum; all located in Kigali. Subjects : Thirty three (33) HAART initiation eligible HIV positive patients including 13 women and 20 men. Results : A drop in viral load (though only a small number of patients achieved an undetectable viraemia); a recovery of CD4+ cells, a decrease in IL-10 (though it remained high for many patients especially those with unchanged viraemia); and an increase in IL-2 and IFN-γ indicated a successful HAART . A negative correlation between CD4 count and viral load and between CD4 count and IL-10 (but r 0.5 at both time points: p-values <0.05). There was no significant correlation between CD4 count, IL-2 and IFN-γ. Conclusion : Results demonstrated the down-regulatory effect of IL-10 on Th1 cytokines and that a shift from Th1 to Th2 cytokine is associated with HIV disease progression. A successful HAART results in CD4+ cells recovery, drop in viraemia and IL-10 with up-regulation of Th1 cytokines. Also, findings show potential usefulness of IL-10 as a marker of HIV disease progression.","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70521175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R Baldassarre, R Mdodo, E Omonge, W Jaoko, J Baddley, P Pappas, I Aban, S Odera, A Suleh, P E Jolly
Background: Cryptococcal meningitis (CM) is an increasingly prevalent infection among HIV/AIDS patients and is becoming a leading cause of morbidity and mortality in Africa. The short-term prognosis and management of patients with CM may be improved by identifying factors leading to mortality in patients with CM.
Objective: To assess the clinical management and mortality associated with cryptococcal meningitis (CM) in patients with acquired immunodeficiency syndrome (AIDS) in Kenya.
Design: A retrospective study.
Setting: Kenyatta National Hospital and Mbagathi District Hospital, between August 2008 and March 2009.
Subjects: Seventy six HIV-infected patients confirmed to be CM positive.
Results: Results show that 30 (40%) of 76 patients diagnosed with CM died during hospitalisation after a median hospital stay of ten days (range, 2-73 days). Significant predictors of mortality in the univariate model were Mycobacterium tuberculosis (TB) co-infection (P = 0.04), having been diagnosed with a co-morbid condition such as diabetes mellitus, oral candidiasis and hypertension (P = 0.01), and a low median CD4+ T lymphocyte count (P < 0.001). The multivariable model revealed that male sex, previous or current anti-retroviral therapy (ART) at admission and CD4+ T lymphocyte count less than 50 were significant predictors of mortality. Conversely, a minimum of two weeks of amphotericin B treatment (P < 0.001), initiation of ART (P = 0.007) and monitoring of creatinine and electrolyte levels (P = 0.02) were significantly associated with survival in the univariate model.
Conclusions: CM-associated mortality in Kenya is high; there is an opportunity to improve the management and the short-term outcomes of hospitalised HIV positive patients with CM in Kenya.
{"title":"MORTALITY AFTER CLINICAL MANAGEMENT OF AIDS-ASSOCIATED CRYPTOCOCCAL MENINGITIS IN KENYA.","authors":"R Baldassarre, R Mdodo, E Omonge, W Jaoko, J Baddley, P Pappas, I Aban, S Odera, A Suleh, P E Jolly","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Cryptococcal meningitis (CM) is an increasingly prevalent infection among HIV/AIDS patients and is becoming a leading cause of morbidity and mortality in Africa. The short-term prognosis and management of patients with CM may be improved by identifying factors leading to mortality in patients with CM.</p><p><strong>Objective: </strong>To assess the clinical management and mortality associated with cryptococcal meningitis (CM) in patients with acquired immunodeficiency syndrome (AIDS) in Kenya.</p><p><strong>Design: </strong>A retrospective study.</p><p><strong>Setting: </strong>Kenyatta National Hospital and Mbagathi District Hospital, between August 2008 and March 2009.</p><p><strong>Subjects: </strong>Seventy six HIV-infected patients confirmed to be CM positive.</p><p><strong>Results: </strong>Results show that 30 (40%) of 76 patients diagnosed with CM died during hospitalisation after a median hospital stay of ten days (range, 2-73 days). Significant predictors of mortality in the univariate model were Mycobacterium tuberculosis (TB) co-infection (P = 0.04), having been diagnosed with a co-morbid condition such as diabetes mellitus, oral candidiasis and hypertension (P = 0.01), and a low median CD4+ T lymphocyte count (P < 0.001). The multivariable model revealed that male sex, previous or current anti-retroviral therapy (ART) at admission and CD4+ T lymphocyte count less than 50 were significant predictors of mortality. Conversely, a minimum of two weeks of amphotericin B treatment (P < 0.001), initiation of ART (P = 0.007) and monitoring of creatinine and electrolyte levels (P = 0.02) were significantly associated with survival in the univariate model.</p><p><strong>Conclusions: </strong>CM-associated mortality in Kenya is high; there is an opportunity to improve the management and the short-term outcomes of hospitalised HIV positive patients with CM in Kenya.</p>","PeriodicalId":11399,"journal":{"name":"East African medical journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2014-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4324694/pdf/nihms418844.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33056717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：