Pan African Medical Journal最新文献

Introduction: low- and middle-income countries (LMICs) disproportionately bear 90% of global mortality from trauma, yet robust emergency medical services (EMS) are often lacking to address the prehospital injury burden. Training lay-first responders (LFRs) is the first step toward formal (EMS) development in (LMICs). However, a gap remains as LFR first aid kit supply usage, appropriateness, and decay rates have yet to be studied but remain critical information for building sustainable LFR programs.

Methods: we trained and equipped 101 LFRs in Kakamega County, Kenya in December 2023. During 3-month follow-up post-training, LFRs were surveyed with a 24-question multiple choice and free-response cross-sectional survey. Survey items included LFR demographics, patient encounters, first aid kit supplies usage, supply appropriateness, and local capacity for re-supply. Demographic data, usage statistics, appropriateness of current and potential kit additions, and local manufacturing capacity were collected and analyzed. Likert scales were utilized for categories consisting of "recommendation", "potential recommendation", and "not recommended" based on 100% - 75.0%, 74.9% - 60%, and 59.9% - 0% agreement, thresholds used in prior Delphi studies and meta-analyses. The survey design followed the Checklist for Reporting of Survey Studies (CROSS) guidelines to ensure quality standards.

Results: of 101 total LFRs, 82 participated (82/101= 81.2% response rate). Participating LFRs were 80.5% men, and 65.9% had transportation-related occupations. LFRs reported 394 assisted incidents over three months (median= 4.0, IQR: 3.0, 5,0). Gloves, gauze/bandages, and towels were the most used supplies employed in 88.9%, 61.3%, and 34.7% of incidents, respectively. For current first aid kit item appropriateness, LFRs reached a consensus agreement on gloves (92.7%), gauze/bandages (91.5%), and towels (79.3%). For potential first aid kit additions, LFRs recommended alcohol wipes/hand sanitizer (89.0%) and tape (77.2%) but did not recommend water bottles or traffic cones. Lay-first responders (LFRs) agreed (90.2%) on the importance of local supply production and desired a streamlined resupply protocol.

Conclusion: a survey on first aid kit supplies usage and appropriateness from Western Kenya demonstrated materials for body substance isolation, wound care, and hemorrhage management are critical to supply. Organized protocols for local materials resupply are essential to ensure program sustainability and continuity.

Introduction: nearly 80% of hospital patients called for a peripheral intravenous catheter (PIVC) for important medications and fluid therapies. Peripherally inserted intravenous cannulation is the most common procedure done in patient care delivery. Even though insertion of IV cannula is essential and common, there are different limitations starting from insertion without vibrant indication to improper management and care of these devices. Patients can experience multiple adverse events during the insertion. The objective of this study was to investigate the care of peripheral intravenous cannulation by nurses and midwives in the Amhara Region, Ethiopia, 2022.

Methods: an institutional-based cross-sectional study was conducted. Data was collected using structured interviewer-administered questionnaires plus an observational checklist. A simple random sampling technique was used to select 415 nurses and midwives. Data were entered using Epi Data version 3.1 and analyzed using SPSS version 25. Bi-variable and multivariable analyses were conducted to examine the association between independent and outcome variables.

Results: the findings of this study revealed that 4.9% of respondents had good practice for the care of peripheral intravenous cannulation. Work experience (AOR= 7.269, 95% CI= 1.68, 31.40), having special training on care of peripheral intravenous cannulation (AOR= 10.12, 95% CI= 4.32, 19.45) and presence of protocol guideline (AOR=3.31, 95% CI= 2.83, 12.87) were significantly associated with good practice on the care and maintenance of peripheral intravenous cannulation.

Conclusion: findings showed that poor peripheral intravenous cannulation practice and care which was predicted by work experience, existence of guidelines, and training. As a result, Nurses and midwifes must keep up to speed with focused in-service training, access, and/or follow thorough protocol guidelines for the management of peripheral intravenous cannulation.

[This retracts the article DOI: 10.11604/pamj.2024.47.201.42952.].

[This retracts the article DOI: 10.11604/pamj.2024.47.99.40899.].

Oculomotor nerve palsy presents the greatest challenge in clinical treatment among the other cranial nerves that innervate extraocular muscle. With a complex technique of periosteal fixation using Callahan suture commonly used, a simpler and more effective technique is demanded to be proven. Here we present a case of paralytic exotropia due to oculomotor nerve palsy on a 32-year-old male along with evidence supporting our decision of surgical management. A 32-year-old male with a chief complaint of squint in both eyes was examined at an outpatient eye clinic. The patient had congenital isolated partial oculomotor nerve palsy and the examination revealed severe ptosis on both eyes with 40 prism diopter exotropia and no limitation in the forced duction test. The patient's posterior segment examination showed normal results, and a diagnosis of bilateral paralytic exotropia due to isolated partial oculomotor nerve palsy was considered. The patient underwent a 7.5 mm rectus lateral recession with a 6 mm rectus medial resection on his right eye, with a promising result after a 3-week follow-up. When treating paralytic strabismus resulting from isolated oculomotor nerve palsy, a combination of medial rectus resection and lateral rectus recession yields good results and long-term stability.

Introduction: malnutrition and micronutrient deficiencies are pressing health concerns, particularly among the elderly. As this population is vulnerable to nutritional imbalances, understanding the prevalence and contributing factors is crucial for designing targeted interventions. This pilot study focuses on assessing the extent of these issues among elderly people attending a geriatric center in the University College Hospital, Ibadan.

Methods: this study employs a cross-sectional design, involving a sample of elderly individuals attending a geriatric center at the University College Hospital, Ibadan. Anthropometric measurements and dietary assessments were conducted using the Mini Nutritional Assessment (MNA) tool. A structured questionnaire was used to gather information on socio-demographic factors and other medical parameters. Continuous and categorical variables were compared respectively by Student's t-test or Chi-square test respectively.

Results: in this study, findings indicated that none of the participants exhibited malnutrition. Instead, 72.7% demonstrated a normal nutritional status, while 27.3% were identified as being at risk of malnutrition. A lesser fraction had deficiency of vitamins A (10%) and D (1%). Furthermore, males aged 60-69 years and those above 80 years showed a higher likelihood of a favorable nutritional assessment compared to females.

Conclusion: the study revealed an absence of malnutrition among the elderly individuals attending the geriatric center in the University College Hospital, Ibadan. Notably, females had a higher probability of malnutrition compared to males. These findings underscore the importance of targeted nutritional interventions, especially among at-risk groups, to promote the overall well-being of this population.

Entrapped rectal foreign bodies are being encountered more frequently in clinical practice. They are most often related to sexual behavior or sexual assault. The presence of rectal foreign bodies poses a complex challenge for contemporary surgeons due to multiple factors such as the nature of the object, individual anatomy, duration since insertion, potential accompanying injuries, and degree of local contamination. Managing these cases proves challenging, typically because patients often delay presentation after multiple unsuccessful attempts at self-removal. This study aimed to report the case of a male who presented with an entrapped rectal foreign body related to his sexual behavior. As we could not extract the object with the transanal approach, he was treated by an operative method. Managing patients with rectal foreign bodies presents challenges that require a systematic approach. While most cases can be effectively managed conservatively, surgical intervention may be necessary.

Reversible cerebral vasoconstriction syndrome (RCVS) is a cerebrovascular condition marked by the diffuse, reversible narrowing of multiple segments of cerebral arteries. This syndrome predominantly affects women and most commonly presents around the age of 42. It can develop spontaneously or be induced by factors such as the postpartum period or exposure to vasoactive substances. This case report describes an uncommon presentation of RCVS in a 24-year-old woman who developed an intraparenchymal hemorrhage shortly after a spontaneous vaginal delivery, despite the absence of conventional stroke risk factors. Diagnostic imaging with digital subtraction angiography (DSA) revealed multifocal vasoconstriction in the right and left anterior and middle cerebral arteries, along with the vertebrobasilar system, an indication of RCVS. Notably, vasoconstriction improved following intra-arterial nimodipine administration. This case underscores the importance of considering RCVS in postpartum women presenting with headaches and neurological deficits, as timely magnetic resonance imaging, computed tomography (CT) angiography, or brain angiography is critical for accurate diagnosis and optimal management, ultimately reducing the risk of poor prognosis.

Introduction: since the Ministry of National Education introduced contractual recruitment in 2016, Morocco has faced significant challenges related to the well-being of its contractual teachers. This study investigates the impact of job precarity on the mental health of these teachers, specifically focusing on fatigue and psychological distress.

Methods: we collected responses from 245 contractual teachers across Morocco's 12 regions, utilizing the Individual Strength Checklist (CIS) to assess fatigue and the General Health Questionnaire (GHQ) for psychological distress. Our findings reveal that teachers' average scores on the CIS (51.7 ± 19.7) and GHQ (12.3 ± 4.6) were notably high, indicating significant job-related stress and emotional suffering.

Results: our study indicates that teachers had very high average scores on the CIS (51.7 ± 19.7) and GHQ (12.3 ± 4.6), suggesting that they experienced considerable job-related stress and emotional distress. Our research revealed that 31% of teachers reported experiencing weariness, while 26% reported experiencing psychological distress. Additionally, out of the individuals who reported experiencing chronic exhaustion, 39% specifically experienced fatigue alone, while 61% experienced both fatigue and psychological discomfort. This suggests a significant association between these two conditions.

Conclusion: the research emphasizes that Moroccan contractual teachers have a shared experience of exhaustion and mental anguish, which is worsened by the uncertainty of their job. Specific interventions are required to address and alleviate these unique effects on teachers' well-being, thereby enhancing the entire educational atmosphere.

Introduction: hepatitis B virus (HBV) infection is a serious public health problem in sub-Saharan Africa and a common cause of liver disease globally. This study aimed to determine the seroprevalence and the rate of mother-to-child transmission of HBV after the age of viability.

Methods: the study was a cross-sectional study that involved 543 eligible consenting pregnant women and newborns of Hepatitis B surface antigen (HBsAg) positive mothers. A one-step rapid HBsAg strip was used to screen eligible patients for HBV infection. Venous blood sample (5mls) was taken from every HBsAg-positive woman for Hepatitis B e Antigen (HBeAg), Hepatitis B e antibody (HBeAb), Hepatitis B core Antibody (HBcAb) and Hepatitis B surface Antibody (HBsAb). In addition, 2mls of cord blood was taken to assay for HBsAg and HBV DNA. Data was analysed using SPSS version 22.

Results: of 543 pregnant women screened, 18 (3.3%) of them were HBsAg-positive with all of them testing negative for HBeAg. HBV DNA was detected in the cord blood of 4 (22.2%) new-borns delivered while 2 (11.1%) tested positive for HBsAg; the above finding indicated that only 4 of the neonates had detectable HBV DNA (>100copies/ml) in their cord blood.

Conclusion: findings from this study demonstrate a low prevalence of HBV infection among pregnant women after the age of viability in Ogbomoso. HBV DNA analysis rather than HBsAg was shown to be more sensitive and specific in determining the risk of intrauterine infections.