Pan African Medical Journal最新文献

This reflective article examines the profound challenges faced by junior doctors in Nigeria, focusing on the pervasive lack of support from senior colleagues and the systemic failures within the healthcare system. Drawing from personal experiences, the narrative highlights how newly qualified doctors are often "left in the lurch", thrust into demanding roles with insufficient guidance, training, and resources. The consequences of this abandonment are explored, not only in terms of the personal and professional toll on junior doctors but also in the broader context of patient care and the overall efficacy of the healthcare system. The article concludes with a call for urgent reforms to address these critical issues, advocating for a more supportive and sustainable environment for the next generation of medical professionals in Nigeria.

Introduction: Gavi, the Vaccine Alliance, defined a transition roadmap for countries receiving funding support based on their income status projections. According to the latest projections, Kenya will complete their transition from vaccine funding in 2029. While eligible countries are kept informed and supported for a smooth transition process, the extent to which countries understand the significant implications of a complete end of GAVI support on immunization service delivery varies. Furthermore, whereas studies have been conducted to assess national preparedness for transition, there is a paucity of data on the understanding of subnational authorities of this process. In this study, we explored the perspectives of county-level stakeholders on Kenya's preparedness for GAVI transition.

Methods: using purposive sampling, 77 senior county officials from 15 counties were selected for in-depth interviews. Data were collected using a semi-structured interview guide, transcribed, and thematically analysed. Ethical approval for the study was granted by Moi University Institutional Ethics and Research Committee.

Results: findings reveal a consensus among respondents that both national and county governments are not fully prepared for the end of the Gavi Alliance. Concerns were highlighted around a lack of knowledge about vaccine costs, post-transition funding sources, and potential disruptions in immunization services. Respondents advocated for a phased transition, continued donor support, clear funding allocation, and legislative measures to ensure financial sustainability. Moreover, advocacy and awareness efforts, capacity building, and a robust legal framework were emphasized as essential for a smooth transition.

Conclusion: after the end of the financial support provided by Gavi Alliance, Kenya's immunization bill is expected to be significant. This study underscores the importance of effectively engaging the subnational (county) level authorities. Successful transition from Gavi's support requires a strategy that promotes awareness and improves communication regarding the expected impact of the impending transition from Gavi on sustainable immunization financing in Kenya.

The thyroid is a rare site for finding tumor metastases. Renal, colorectal, pulmonary, and mammary origin are the most frequent primary neoplasms. Clinical suspicion, early diagnosis, and active surveillance are important during follow-up. Thyroid ultrasound and fine needle aspiration thyroid ultrasound are crucial during follow-up. We present a case of a 66-year-old male who was referred to our Endocrinology and Nutrition Department of the Hospital General Universitario Santa Lucía due to a multinodular goiter. The patient had no symptoms of hyperthyroidism or hypothyroidism. No weight loss or constitutional syndrome was reported. The patient was suffering from a renal clear cell carcinoma with T3aNxM0 stage operated on using a nephrectomy technique in 2012. In a new follow-up, a positron emission tomography-computed tomography (PET-CT) scan was conducted and a multinodular goiter was found with an increase in size and metabolism at the expense of a right thyroid nodule and thyroid ultrasound and fine needle aspiration thyroid ultrasound was requested with the diagnosis of renal cell carcinoma metastasis. We present a rare case report since both metastases (thyroid and pulmonary) could be surgically intervened with curative intent and a review of the literature. This case emphasizes the importance of considering a metastatic origin when finding a thyroid nodule in a patient with a previous history of clear renal cell carcinoma even years after treatment with curative intent.

Gunshot injuries (GSI) are a major global public health problem. Our objective was to determine the patient characteristics, pattern and outcome of civilian gunshot wounds at the University College Hospital, Ibadan, Nigeria, from 2014-2018. The data of 232 patients with a diagnosis of GSI during the study period were collected and analyzed using descriptive and inferential statistics. The victims were mostly males (86.6%) and the night shifts had the highest presentations (56%). Majority of the patients (61.2%) were in the age range of 21-40 years. Armed robbery attacks were the most frequent cause of the wounds (78.9%) affecting mostly the upper and lower limbs. Eighteen (7.8%) patients died from injuries to the head, chest, abdomen and multiple parts of the body. There was a significant association between the anatomical location of the gunshot wound and mortality, p=0.017. We recommend the rigorous implementation of the Firearm Control Act and a national surveillance system for all fatal and non-fatal GSIs. There should be concerted efforts by Government and non-governmental organizations to create jobs and wealth thereby making crime less attractive.

Introduction: the epidemiological profile of oral diseases is characterised by disparities between specific groups. The purpose of this study was to assess oral health status of Baka Pygmies in Dimako, Cameroon.

Methods: we conducted a cross-sectional study from January 1 to June 14, 2021 in the Baka camps in Dimako. A total of 205 individuals aged 12 years and older were recruited using non-probabilistic, consecutive sampling. Data were collected using a semi-structured, administered questionnaire then entered with CSPro 7.5, and analyzed with SPSS version 26. Multivariate analysis was used to identify factors associated with oral diseases, using their Odds ratios and p-values. The significance threshold was set at 0.05.

Results: the most common diseases were dental caries and gingivitis, with prevalence rates of 80.4% and 64.8%, respectively. Factors associated with dental caries included age 12 to 25 years (adjusted OR=1.48; p=0.001), insufficient knowledge (adjusted OR=3.5; p=0.034), and inadequate practices (adjusted OR=1.8; p=0.013). Factors associated with gingivitis were primary education level (adjusted OR=5.2; p=0.04), approximate attitudes (adjusted OR=2.2; p=0.014) and harmful practices (adjusted OR=1.9; p=0.02).

Conclusion: dental caries and gingivitis are prevalent among the Baka Pygmies. It is necessary to strengthen their education and improve their access to oral healthcare.

Introduction: following the detection of vaccine-derived poliovirus in 2019 in Ethiopia, response activities have been conducted including strengthening disease surveillance activities.

Methods: trend analysis study design of acute flaccid paralysis and measles surveillance data for the years 2021 and 2022 for Southwest Ethiopia Region was used. The non-polio acute flaccid paralysis (AFP) rate and stool adequacy rates were used to assess the AFP surveillance. Whereas the non-measles febrile rash rate was used to assess the measles surveillance.

Results: a total of 68 AFP cases in 2022 and 49 in 2021 have been reported as of week 41 and investigated for polio analysis. All cases were discarded in 2022 and 1 cVDPV was detected in 2021. The stool adequacy rate for 2022 was 96%; whereas, 94% in 2021. The annualized non-polio AFP rate was 4.8/100,000 for 2022 and 3.8/100,000 for 2021, which the former is much higher though both met the minimum expected rate in outbreak areas of 3/100,000. A total of 155 suspected measles cases in 2022 and 38 in 2021 have been investigated for IGM analysis. In 2022, 9 and 1 in 2021 Igm positive for measles were identified. The non-measles febrile rash rate for 2022 was 4.6/100,000; whereas, 1.2/100,000 for 2021.

Conclusion: there is an improvement in the sensitivity of AFP and measles surveillance for Southwest Ethiopia Region in 2022. Sustaining high-quality measles and AFP surveillance is suggested to maintain measles and polio-free statuses.