M. Bwalya, Ndanji Ivy Chikasa, O. Bwanga, Ziche Makukula, Ngosa Chanda, Ernest Chanda, Kelvin Chitarnya
Medical imaging plays a significant role in the detection of foetal anomalies, such as the Pentalogy of Cantrell (POC). POC is a congenital anomaly involving five or fewer body malformations: ectopia cordis (EC), tetralogy of fallot (TOF), sternal defects, diaphragmatic defects, and abdominal wall defects. The commonly used imaging modality in the detection of POC during pregnancy is ultrasound because it uses non-ionising radiation, is cheap, and is available in most medical facilities. We report a rare case of POC from a medical imaging standpoint in Zambia. Two obstetric ultrasound scans were performed in the 3rd trimester. The initial scan revealed, among other things, unappreciated abdominal contents, while the second scan revealed a foetal heart sited partially external to the thoracic cavity, with external herniation of the liver and bowels. Our case was classified as incomplete POC because not all five main malformations were present. This case report highlights the importance of having well-organised obstetric ultrasound imaging services both in urban and rural parts of the country to improve antenatal care. ABBREVIATIONS EC - Ectopia Cordis IUFD - Intrauterine Foetal Death POC - Pentalogy of Cantrell TOF - Tetralogy of Fallot VSD - Ventricular Septal Defect
{"title":"Medical Imaging of Pentalogy of Cantrell: A Case Report from Zambia","authors":"M. Bwalya, Ndanji Ivy Chikasa, O. Bwanga, Ziche Makukula, Ngosa Chanda, Ernest Chanda, Kelvin Chitarnya","doi":"10.55320/mjz.49.1.1110","DOIUrl":"https://doi.org/10.55320/mjz.49.1.1110","url":null,"abstract":"Medical imaging plays a significant role in the detection of foetal anomalies, such as the Pentalogy of Cantrell (POC). POC is a congenital anomaly involving five or fewer body malformations: ectopia cordis (EC), tetralogy of fallot (TOF), sternal defects, diaphragmatic defects, and abdominal wall defects. The commonly used imaging modality in the detection of POC during pregnancy is ultrasound because it uses non-ionising radiation, is cheap, and is available in most medical facilities. We report a rare case of POC from a medical imaging standpoint in Zambia. Two obstetric ultrasound scans were performed in the 3rd trimester. The initial scan revealed, among other things, unappreciated abdominal contents, while the second scan revealed a foetal heart sited partially external to the thoracic cavity, with external herniation of the liver and bowels. Our case was classified as incomplete POC because not all five main malformations were present. This case report highlights the importance of having well-organised obstetric ultrasound imaging services both in urban and rural parts of the country to improve antenatal care. \u0000ABBREVIATIONS \u0000EC - Ectopia Cordis \u0000 \u0000IUFD - Intrauterine Foetal Death \u0000POC - Pentalogy of Cantrell \u0000TOF - Tetralogy of Fallot \u0000VSD - Ventricular Septal Defect","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79322776","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}
Infants and young children are commonly referred for medical imaging for suspected aspirated or inhaled foreign bodies (Fbs). FB aspirations are potentially life-threatening and immediate diagnosis and treatment are vital to avert fatalities.Chest radiography is the first-line imaging method indicated to evaluate suspected aspirated FB. This can be supplemented withothermedical imaging modalities, such as fluoroscopy, computed tomography (CT), and magnetic resonance imaging (MRI). However, the lack of specialised medical imaging modalities in developing countries impends timely diagnosis of aspirated FB. We report a case of a 7-year-old girl with airway metallic FB not visible on the initial chest radiograph. This case report highlights the challenges low-income health institutions are facing in the diagnosing of airway FBs and other complicated conditions which require advanced imaging. In the absence of specialised medical imaging modalities, radiographers and clinicians should have high indexes of suspicion to avert deaths. In addition, specialised training of radiographers in the absence of radio lo gists might contribute to improved patient outcomes.
{"title":"Is It Possible to Miss a Metallic Airway Foreign Body on a Chest Radiograph? Imaging Case Report from Zambia","authors":"O. Bwanga, M. Mulenga, Ethel C Jere, J. Sichone","doi":"10.55320/mjz.49.1.1111","DOIUrl":"https://doi.org/10.55320/mjz.49.1.1111","url":null,"abstract":"Infants and young children are commonly referred for medical imaging for suspected aspirated or inhaled foreign bodies (Fbs). FB aspirations are potentially life-threatening and immediate diagnosis and treatment are vital to avert fatalities.Chest radiography is the first-line imaging method indicated to evaluate suspected aspirated FB. This can be supplemented withothermedical imaging modalities, such as fluoroscopy, computed tomography (CT), and magnetic resonance imaging (MRI). However, the lack of specialised medical imaging modalities in developing countries impends timely diagnosis of aspirated FB. We report a case of a 7-year-old girl with airway metallic FB not visible on the initial chest radiograph. This case report highlights the challenges low-income health institutions are facing in the diagnosing of airway FBs and other complicated conditions which require advanced imaging. In the absence of specialised medical imaging modalities, radiographers and clinicians should have high indexes of suspicion to avert deaths. In addition, specialised training of radiographers in the absence of radio lo gists might contribute to improved patient outcomes.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72805067","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: This study aimed to determine the prevalence of dental fear and its related factors among patients managed in a pediatric dental clinic of a university hospital in Tanzania. Material and Methods: This was a cross-sectional study carried out at the paediatric dental clinic of the Muhimbili University of Health and Allied Sciences(MUHAS) between November 2018 and April 2019. It included all paediatric dental patients aged between 6 and 12 years. A questionnaire used in this study captured information regarding patient's socio-demographic characteristics and the number of previous visits to the dental clinic. A fifteen-item Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) was used to assess the dental fear status in these pediatric patients. Results: A total of 223 paediatric dental patients aged between 6 years and 12 years were included in the study. The mean age of participants was 9.52 ± 1.74 years with a male to female ratio ofl: 1.04. The means CFSS-DS score was 31.1 ± 8.57. Fear scores were high for Injections (3.37 ± 1.13), a stranger's touch (2.81 ± 1.08) and choking (2.69 ± 0.99). The presence of dental fear was found to be significantly associated with the parents' education level (p=0.001) and previous dental visits (p < 0.001 ). Conclusion: The results of this study suggest that the prevalence of paediatric dental fear was low among the participants of this study. The education level of parents and previous dental visits were determinants of dental fear in children. Injections, being touched by strangers, and choking were the common fear-provoking factors.
{"title":"Dental fear and its related factors among patients managed in a paediatric dental clinic of a university hospital in Tanzania","authors":"K. Sohal, Matilda Mtaya-Mlangwa, Sakina Essajee","doi":"10.55320/mjz.49.1.1100","DOIUrl":"https://doi.org/10.55320/mjz.49.1.1100","url":null,"abstract":"Objective: This study aimed to determine the prevalence of dental fear and its related factors among patients managed in a pediatric dental clinic of a university hospital in Tanzania. \u0000Material and Methods: This was a cross-sectional study carried out at the paediatric dental clinic of the Muhimbili University of Health and Allied Sciences(MUHAS) between November 2018 and April 2019. It included all paediatric dental patients aged between 6 and 12 years. A questionnaire used in this study captured information regarding patient's socio-demographic characteristics and the number of previous visits to the dental clinic. A fifteen-item Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) was used to assess the dental fear status in these pediatric patients. \u0000Results: A total of 223 paediatric dental patients aged between 6 years and 12 years were included in the study. The mean age of participants was 9.52 ± 1.74 years with a male to female ratio ofl: 1.04. The means CFSS-DS score was 31.1 ± 8.57. Fear scores were high for Injections (3.37 ± 1.13), a stranger's touch (2.81 ± 1.08) and choking (2.69 ± 0.99). The presence of dental fear was found to be significantly associated with the parents' education level (p=0.001) and previous dental visits (p < 0.001 ). \u0000Conclusion: The results of this study suggest that the prevalence of paediatric dental fear was low among the participants of this study. The education level of parents and previous dental visits were determinants of dental fear in children. Injections, being touched by strangers, and choking were the common fear-provoking factors.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78809026","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}
Background: Low socioeconomic status has generally been associated with adverse birth outcomes worldwide. Adverse birth outcomes significantly contribute to perinatal morbidity and mortality worldwide with some literatures showing conflicting results. At Women and New-born Hospital in Zambia, this relationship had remained unclear among women who experienced poor neonatal outcome; hence the study was done to explore this association between socioeconomic status and adverse birth outcomes. Methods: A retrospective cohort study was conducted. Secondary data from ZAPPS study that had been collected prospectively between August 2015 and September 201 7 was retrieved. Altogether, 1,450 participants' information was retrieved, out of which 1,084 data records were set out for analysis after excluding those not meeting eligibility criteria. Socioeconomic status was an explanatory variable which was estimated using the standardized wealth score derived from principal component analysis of 14 variables. The wealth quintiles were further categorised into poor and not poor. Response variables were low birth weight, preterm birth and small for gestation age. SPSS version 21 was used for data analysis and p value< 0.05 was significant Results: This study found the incidences of SGA, LBW and preterm births to be 164, 124 and 13 5 per 1000 live births respectively. In survival analysis, the proportion of babies who survived LBW among mothers who were poor was lower (82.9%) compared to babies born to rich mothers (87.5%) (p-value = 0.189). Furthermore, the proportion of babies who survived SGA for the poor was lower (79 .1 % ) compared to babies born to none poor mothers (85.8%) (p-value = 0.032) and preterm birth for the poor (78.4%) compared to babies born to mothers who were rich (83 .6%) (p-value = 0.022). In multiple Cox regression analysis socioeconomic status was not a significant risk factor for SGA ( aHR = 1.08; 95% CI; p=0.099), LBW and preterm birth (aHR = 1.17; 95% CI; p= l.41). However, male babies (aHR = 1.80; 95% CI; p=0.012), domestic violence or abuse during pregnancy (aHR = 3.48; 95% CI [1.59 - 7.34]; p = 0.002) and maternal anaemia (aHR = 2.1; 95% CI; p = 0.019) were risk factors for SGA while prior preterm birth ( aHR = 2.02; 95% CI; p = 0.002), HIV infection (aHR = 1.22; 95% CI; p = 0.040) and anaemia (aHR = 1.37; 95% CI; p = 0.009) were predictors of preterm delivery. Conclusion: There was no statistically significant association between low socioeconomic status and adverse birth outcomes although being pregnant with a male baby, HIV infection, anaemia and prior preterm birth were significantly associated with SGAand preterm.
{"title":"Association of socioeconomic status with adverse birth outcomes at the Women and Newborn Hospital of the University Teaching Hospitals in Lusaka, Zambia","authors":"Agripa Lungu, L. Kasonka, B. Vwalika","doi":"10.55320/mjz.49.1.1098","DOIUrl":"https://doi.org/10.55320/mjz.49.1.1098","url":null,"abstract":"Background: Low socioeconomic status has generally been associated with adverse birth outcomes worldwide. Adverse birth outcomes significantly contribute to perinatal morbidity and mortality worldwide with some literatures showing conflicting results. At Women and New-born Hospital in Zambia, this relationship had remained unclear among women who experienced poor neonatal outcome; hence the study was done to explore this association between socioeconomic status and adverse birth outcomes. \u0000Methods: A retrospective cohort study was conducted. Secondary data from ZAPPS study that had been collected prospectively between August 2015 and September 201 7 was retrieved. Altogether, 1,450 participants' information was retrieved, out of which 1,084 data records were set out for analysis after excluding those not meeting eligibility criteria. Socioeconomic status was an explanatory variable which was estimated using the standardized wealth score derived from principal component analysis of 14 variables. The wealth quintiles were further categorised into poor and not poor. Response variables were low birth weight, preterm birth and small for gestation age. SPSS version 21 was used for data analysis and p value< 0.05 was significant \u0000Results: This study found the incidences of SGA, LBW and preterm births to be 164, 124 and 13 5 per 1000 live births respectively. In survival analysis, the proportion of babies who survived LBW among mothers who were poor was lower (82.9%) compared to babies born to rich mothers (87.5%) (p-value = 0.189). Furthermore, the proportion of babies who survived SGA for the poor was lower (79 .1 % ) compared to babies born to none poor mothers (85.8%) (p-value = 0.032) and preterm birth for the poor (78.4%) compared to babies born to mothers who were rich (83 .6%) (p-value = 0.022). In multiple Cox regression analysis socioeconomic status was not a significant risk factor for SGA ( aHR = 1.08; 95% CI; p=0.099), LBW and preterm birth (aHR = 1.17; 95% CI; p= l.41). However, male babies (aHR = 1.80; 95% CI; p=0.012), domestic violence or abuse during pregnancy (aHR = 3.48; 95% CI [1.59 - 7.34]; p = 0.002) and maternal anaemia (aHR = 2.1; 95% CI; p = 0.019) were risk factors for SGA while prior preterm birth ( aHR = 2.02; 95% CI; p = 0.002), HIV infection (aHR = 1.22; 95% CI; p = 0.040) and anaemia (aHR = 1.37; 95% CI; p = 0.009) were predictors of preterm delivery. \u0000Conclusion: There was no statistically significant association between low socioeconomic status and adverse birth outcomes although being pregnant with a male baby, HIV infection, anaemia and prior preterm birth were significantly associated with SGAand preterm.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78356854","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. I. Muma, Godfrey Mwelwa, Anne Buglass, F. Mwacalimba, David Mwitumwa, Chishimba Chibwe, Wendy Musonda, Foster Maambo, Beauty C. Mulonda, Moses Lisulo, Faith Labouschagne, Phyllis Moonga
Objective: Kabwe District is largely an urban town in the Central Province of Zambia. We aimed to determine the prevalence of refractive errors and visual impairment in primary and secondary school learners in this District. Method: A cross-sectional survey of 41 primary and secondary schools in Kabwe District. The examination included visual acuity (VA) testing, cycloplegic retinoscopy with subjective refinement if indicated, ocular motility testing and anterior segment and fundus examinations in visually impaired children. Results: There was an estimated total of 32,971 learners who were eligible to participate of which 23,915 (72.5%) were enrolled into the survey. Of the 2,424 learners examined by the mobile ophthalmic team, 418 were refracted representing 17.2 %. Of the 418 learners refracted, 359 were diagnosed with refractive errors and prescribed spectacles. The mean spherical equivalent in the right eyes was 0.57 diopter (D) (95% confidence interval [CI], 0.49 - 0.75), and the mean spherical equivalent in the left eyes was 0.59 (95% CI, 0.50 - 0.71). The prevalence of hyperopia was 0.9% (95% CI, 0.4 - 1.3; 207 subjects), and the prevalence of myopia was 0.5% (95% CI, 0.1-1.0; 119 subjects). The majority of learners (98.3%; 95% CI, 97.0 -99.0) had normal unaided binocular VA (at least 6/9 in their better eye). The overall prevalence of any visual impairment (presenting VA 6/9 in the better eye) was 1.7% (95% CI, 1.0 -2.5; 418 subjects) and the overall refractive error prevalence was 1.5% (95% CI, 1.0 -2.3; 359 subjects). In multivariate logistic regression analysis, age (P 0.001) was a significant predictor and female gender (P 0.06) was a borderline significant predictor of the presence of any visual impairment. Conclusions: Visual impairment is not a public health concern in this school-aged population in Kabwe District. The prevalence of uncorrected significant refractive errors among learners is not too high to justify a regular school eye screening programme in schools in Kabwe District.
{"title":"Extraordinarily Low Prevalence of Refractive Error and Visual Impairment in Primary and Secondary School Learners in Kabwe District, Zambia","authors":"K. I. Muma, Godfrey Mwelwa, Anne Buglass, F. Mwacalimba, David Mwitumwa, Chishimba Chibwe, Wendy Musonda, Foster Maambo, Beauty C. Mulonda, Moses Lisulo, Faith Labouschagne, Phyllis Moonga","doi":"10.55320/mjz.49.1.1103","DOIUrl":"https://doi.org/10.55320/mjz.49.1.1103","url":null,"abstract":"Objective: Kabwe District is largely an urban town in the Central Province of Zambia. We aimed to determine the prevalence of refractive errors and visual impairment in primary and secondary school learners in this District. \u0000Method: A cross-sectional survey of 41 primary and secondary schools in Kabwe District. The examination included visual acuity (VA) testing, cycloplegic retinoscopy with subjective refinement if indicated, ocular motility testing and anterior segment and fundus examinations in visually impaired children. \u0000Results: There was an estimated total of 32,971 learners who were eligible to participate of which 23,915 (72.5%) were enrolled into the survey. Of the 2,424 learners examined by the mobile ophthalmic team, 418 were refracted representing 17.2 %. Of the 418 learners refracted, 359 were diagnosed with refractive errors and prescribed spectacles. The mean spherical equivalent in the right eyes was 0.57 diopter (D) (95% confidence interval [CI], 0.49 - 0.75), and the mean spherical equivalent in the left eyes was 0.59 (95% CI, 0.50 - 0.71). The prevalence of hyperopia was 0.9% (95% CI, 0.4 - 1.3; 207 subjects), and the prevalence of myopia was 0.5% (95% CI, 0.1-1.0; 119 subjects). The majority of learners (98.3%; 95% CI, 97.0 -99.0) had normal unaided binocular VA (at least 6/9 in their better eye). The overall prevalence of any visual impairment (presenting VA 6/9 in the better eye) was 1.7% (95% CI, 1.0 -2.5; 418 subjects) and the overall refractive error prevalence was 1.5% (95% CI, 1.0 -2.3; 359 subjects). In multivariate logistic regression analysis, age (P 0.001) was a significant predictor and female gender (P 0.06) was a borderline significant predictor of the presence of any visual impairment. \u0000Conclusions: Visual impairment is not a public health concern in this school-aged population in Kabwe District. The prevalence of uncorrected significant refractive errors among learners is not too high to justify a regular school eye screening programme in schools in Kabwe District.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80819944","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}
{"title":"Is Ending Fistula within a Decade Achievable for Zambia?","authors":"Eugine Kunda","doi":"10.55320/mjz.49.1.1105","DOIUrl":"https://doi.org/10.55320/mjz.49.1.1105","url":null,"abstract":"Commentary","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"297 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72508347","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}
P. Mukomena, Wamundila Kawana, Malika Taufiq, Oliver Sutherland, Sally Trollip
Bckground: Myositis has been reported to be associated or triggered by viruses. Genetic and environmental factors are documented risk for myopathies. Viruses have also been shown to modify the clinical course of auto-immune diseases.We therefore report a case of SARS-Cov-2 infection in a 26-year-old female black Zambian patient with proximal myopathy. Case Presentation: We present the case of a 26-yearold chemical factory worker with severe acuterespiratory distress syndrome corona virus 2 (SARS-cov-2) infection and proximal myopathy. She presented to a local private hospital with fever, weakness and flu-like symptoms after being exposed to a colleague diagnosed with SARS-cov-2 infection at the time Zambia declared the July 2021 third wave of SARS-cov-2pandemic. She also reported difficulties in climbing stairs, had Raynaud's phenomenon, proximal myopathy, classic dermatomyositis features, symptoms ofsystemic sclerosis, raisedcreatine phosphokinase (CPK), and a positive nasopharyngeal PCR test for SARS-Cov-2 infection. Conclusions: We presented, for the first time in Zambia, the case of a patient with SARS-Cov-2 infection and severe proximal myopathy secondary to newly diagnosed dermatomyositis and overlap systemic sclerosis. The myopathy appeared to have been worsened by SARS-Cov-2 viral infection.
{"title":"SARS-Cov-2 Infection and severe proximal myopathy secondary to dermatomyositis and overlap systemic sclerosis: A Case Report from Zambia","authors":"P. Mukomena, Wamundila Kawana, Malika Taufiq, Oliver Sutherland, Sally Trollip","doi":"10.55320/mjz.49.1.1106","DOIUrl":"https://doi.org/10.55320/mjz.49.1.1106","url":null,"abstract":"Bckground: Myositis has been reported to be associated or triggered by viruses. Genetic and environmental factors are documented risk for myopathies. Viruses have also been shown to modify the clinical course of auto-immune diseases.We therefore report a case of SARS-Cov-2 infection in a 26-year-old female black Zambian patient with proximal myopathy. \u0000Case Presentation: We present the case of a 26-yearold chemical factory worker with severe acuterespiratory distress syndrome corona virus 2 (SARS-cov-2) infection and proximal myopathy. She presented to a local private hospital with fever, weakness and flu-like symptoms after being exposed to a colleague diagnosed with SARS-cov-2 infection at the time Zambia declared the July 2021 third wave of SARS-cov-2pandemic. She also reported difficulties in climbing stairs, had Raynaud's phenomenon, proximal myopathy, classic dermatomyositis features, symptoms ofsystemic sclerosis, raisedcreatine phosphokinase (CPK), and a positive nasopharyngeal PCR test for SARS-Cov-2 infection. \u0000Conclusions: We presented, for the first time in Zambia, the case of a patient with SARS-Cov-2 infection and severe proximal myopathy secondary to newly diagnosed dermatomyositis and overlap systemic sclerosis. The myopathy appeared to have been worsened by SARS-Cov-2 viral infection.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85113591","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}
Condyloma acuminata, commonly known as genital warts, is a sexually transmitted infection. We have been seeing a surge in the paediatric population with no discernable thought of sexual abuse. this scenario begs for answers. HPV infection is a real burden in the Lower Middle-Income Countries, requiring the urgent attention it deserves. Soon or later we may be seeing HPV associated malignancies at a much younger age due to the double burden of the Human Immunodeficiency Virus. A molecular epidemiological study on our patients or community is warranted.
{"title":"Anogenital Condyloma Acuminata In A Toddler: The Dilemma Of Sexual Abuse Versus Non-Abuse.","authors":"M. Malumani, Owen Ngalamika","doi":"10.55320/mjz.49.1.1004","DOIUrl":"https://doi.org/10.55320/mjz.49.1.1004","url":null,"abstract":"Condyloma acuminata, commonly known as genital warts, is a sexually transmitted infection. We have been seeing a surge in the paediatric population with no discernable thought of sexual abuse. this scenario begs for answers. HPV infection is a real burden in the Lower Middle-Income Countries, requiring the urgent attention it deserves. Soon or later we may be seeing HPV associated malignancies at a much younger age due to the double burden of the Human Immunodeficiency Virus. A molecular epidemiological study on our patients or community is warranted.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75645854","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}
Fair Banji Mwiinga, Twaambo Mwiza, Elezia Mercy Banda
Introduction: Substance abuse is increasingly becoming a public health threat associated with varying health and social implications. Healthcare professionals are crucial in the management of substance abuse disorders, and their knowledge and perspectives towards substance abuse clients influences the care that these clients receive. Locally, there is scanty data on the knowledge and perspectives of health care providers towards substance abuse clients in Solwezi District. Objectives: The objectives of this study were to assess knowledge and perspectives of health care providers towards substance abuse clients at Solwezi General Hospital in Solwezi District. Materials & methods: A hospital-based cross sectional study was adopted for this study. Data collection was done using a self-administered semi-structured questionnaire adapted from previous studies. The SPSS software version 20.0 for Windows was used for data analysis using descriptive statistics and the Chi-square test for inference at the 0.05 level of significance. Results: The mean age of respondents was found to be 28.76 years. A female predominance over males was noted with a ratio of close to 5:1. Seventy-seven percent of respondents were Nurses by profession (77.3%), with the majority having attained Diploma as the highest level of education (60%). Overall, knowledge of substance abuse, screening tools and interventions for substance abuse was good. Variations in respondents’ perception of which health care provider was responsible for the assessment and management of substance abuse clients were noted. Priority on substance abuse cases was found to be low in 51% of the respondents, and several barriers to effective management of substance abuse were identified including lack of knowledge (41.4%), lack of manpower (20%), lack of specialized facilities (10%) and poor patient cooperation (16%). Statistically significant associations were found between respondent’s knowledge and interest to work with substance abuse clients; as well as between respondent’s education and priority placed on substance abuse cases. Conclusion: Health care providers exhibited adequate knowledge about substance abuse. However, low priority over substance abuse cases was reported, and attributed to a number of factors. This therefore calls for more training in substance abuse, particularly assessment and management of substance abuse clients in order to optimize health services rendered to substance abuse clients. Key words: Substance abuse, Clients, Knowledge, Perspectives, Health care providers
药物滥用正日益成为与各种健康和社会影响相关的公共卫生威胁。医疗保健专业人员在药物滥用障碍的管理中至关重要，他们对药物滥用客户的知识和观点影响这些客户接受的护理。在当地，关于保健提供者对索尔韦齐区药物滥用客户的知识和看法的数据很少。目的:本研究的目的是评估索尔韦齐区索尔韦齐总医院的卫生保健提供者对药物滥用病人的知识和观点。材料与方法:本研究采用以医院为基础的横断面研究。数据收集采用自管理的半结构化问卷，该问卷改编自以往的研究。采用SPSS 20.0 for Windows软件进行数据分析，采用描述性统计和卡方检验，在0.05显著性水平上进行推断。结果:调查对象平均年龄28.76岁。女性比男性占优势，比例接近5:1。77%的受访者是护士(77.3%)，其中大多数获得了文凭作为最高教育水平(60%)。总的来说，药物滥用的知识，筛选工具和药物滥用的干预措施是好的。注意到答复者对哪个保健提供者负责评估和管理药物滥用客户的看法存在差异。51%的受访者认为对药物滥用案件的重视程度较低，并确定了有效管理药物滥用的几个障碍，包括缺乏知识(41.4%)、缺乏人力(20%)、缺乏专业设施(10%)和患者合作不佳(16%)。被调查者的知识与与药物滥用客户合作的兴趣之间存在统计学上显著的关联;以及被告的受教育程度和对药物滥用案件的重视程度之间的关系。结论:卫生保健提供者对药物滥用有充分的了解。然而，据报告，药物滥用案件的优先程度较低，这可归因于若干因素。因此，这需要在药物滥用方面进行更多培训，特别是对药物滥用客户的评估和管理，以便优化向药物滥用客户提供的保健服务。关键词:药物滥用，案主，知识，观点，卫生保健提供者
{"title":"Knowledge and perspectives of health care providers towards clients with substance abuse at Solwezi General Hospital in Solwezi District","authors":"Fair Banji Mwiinga, Twaambo Mwiza, Elezia Mercy Banda","doi":"10.55320/mjz.48.4.936","DOIUrl":"https://doi.org/10.55320/mjz.48.4.936","url":null,"abstract":"Introduction: Substance abuse is increasingly becoming a public health threat associated with varying health and social implications. Healthcare professionals are crucial in the management of substance abuse disorders, and their knowledge and perspectives towards substance abuse clients influences the care that these clients receive. Locally, there is scanty data on the knowledge and perspectives of health care providers towards substance abuse clients in Solwezi District. Objectives: The objectives of this study were to assess knowledge and perspectives of health care providers towards substance abuse clients at Solwezi General Hospital in Solwezi District. Materials & methods: A hospital-based cross sectional study was adopted for this study. Data collection was done using a self-administered semi-structured questionnaire adapted from previous studies. The SPSS software version 20.0 for Windows was used for data analysis using descriptive statistics and the Chi-square test for inference at the 0.05 level of significance. Results: The mean age of respondents was found to be 28.76 years. A female predominance over males was noted with a ratio of close to 5:1. Seventy-seven percent of respondents were Nurses by profession (77.3%), with the majority having attained Diploma as the highest level of education (60%). Overall, knowledge of substance abuse, screening tools and interventions for substance abuse was good. Variations in respondents’ perception of which health care provider was responsible for the assessment and management of substance abuse clients were noted. Priority on substance abuse cases was found to be low in 51% of the respondents, and several barriers to effective management of substance abuse were identified including lack of knowledge (41.4%), lack of manpower (20%), lack of specialized facilities (10%) and poor patient cooperation (16%). Statistically significant associations were found between respondent’s knowledge and interest to work with substance abuse clients; as well as between respondent’s education and priority placed on substance abuse cases. Conclusion: Health care providers exhibited adequate knowledge about substance abuse. However, low priority over substance abuse cases was reported, and attributed to a number of factors. This therefore calls for more training in substance abuse, particularly assessment and management of substance abuse clients in order to optimize health services rendered to substance abuse clients. Key words: Substance abuse, Clients, Knowledge, Perspectives, Health care providers","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75039178","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}
T. Ajani, C. Elikwu, M. Ajani, C. Anaedobe, T. Oluwasola
Background: Urinary tract infections (UTI) is commoner in females and mainly caused by Gram Negative bacilli. The emergence of Extended – spectrum beta lactamases (ESBL) has made its treatment difficult especially in the community because of limited therapeutic options. This study was undertaken to determine the prevalence of ESBL-producing Gram negative bacilli causing UTI among females in Babcock University Community; evaluate the associated risk factors and to determine the prevalence of the associated genes among the ESBL isolates. Methods: A descriptive cross-sectional study of which 200 female participants with clinical UTI were recruited in Babcock University Community. Pretested interviewer–based structured questionnaire was used to obtain the socio-demographic and risk factors. Mid-stream urine was also collected for evaluation of ESBL- producing Gram-negative bacilli. DNA extraction was done for ESBL positive isolates and SHV, TEM, CTX-M and OXA ESBL genes were detected by PCR. SPSS Version 23.0 was used for data analysis. Results: The 200-urine samples tested from the participants yielded 33-Gram negative bacilli isolates. Out of these 33 isolates, 17/33(51.5%) were ESBL-producers giving prevalence rate of 8.5% among the participants. The distribution of the ESBL genes among the ESBL isolates was as follows: SHV 12/17(70.6%), TEM 4/17(23.5%), CTX-M 3/17(17.6%) and OXA 5/17(29.4%). No associated risk factors were found. Conclusion: All the four types of ESBL genes evaluated were present among the participants. Routine screening for ESBL for Community acquired UTI is necessary to curb treatment failure.
背景:尿路感染(UTI)在女性中较为常见，主要由革兰氏阴性杆菌引起。广谱β -内酰胺酶(ESBL)的出现使其治疗变得困难，特别是在社区，因为有限的治疗选择。本研究旨在确定巴布科克大学社区女性中引起尿路感染的产esblg革兰氏阴性杆菌的患病率;评估相关的危险因素，并确定相关基因在ESBL分离株中的流行程度。方法:在巴布科克大学社区招募200名临床尿路感染的女性参与者进行描述性横断面研究。采用预先测试的基于访谈者的结构化问卷来获得社会人口统计学和危险因素。还收集了中游尿液，以评估产生ESBL的革兰氏阴性杆菌。对ESBL阳性分离株进行DNA提取，PCR检测ESBL基因SHV、TEM、CTX-M和OXA。采用SPSS Version 23.0进行数据分析。结果:200份受试者尿液样本中分离出33株革兰氏阴性杆菌。在这33株分离株中，17/33(51.5%)是esbl生产者，在参与者中的患病率为8.5%。ESBL基因在分离株中的分布情况为:SHV 12/17(70.6%)、TEM 4/17(23.5%)、CTX-M 3/17(17.6%)和OXA 5/17(29.4%)。未发现相关的危险因素。结论:四种ESBL基因均存在于受试者中。社区获得性尿路感染的ESBL常规筛查对于抑制治疗失败是必要的。
{"title":"Assessment of extended – spectrum beta lactamases (ESBL) gene among gram-negative bacilli bacteria causing community acquired urinary tract infection among females in southwestern Nigeria","authors":"T. Ajani, C. Elikwu, M. Ajani, C. Anaedobe, T. Oluwasola","doi":"10.55320/mjz.48.4.725","DOIUrl":"https://doi.org/10.55320/mjz.48.4.725","url":null,"abstract":"Background: Urinary tract infections (UTI) is commoner in females and mainly caused by Gram Negative bacilli. The emergence of Extended – spectrum beta lactamases (ESBL) has made its treatment difficult especially in the community because of limited therapeutic options. This study was undertaken to determine the prevalence of ESBL-producing Gram negative bacilli causing UTI among females in Babcock University Community; evaluate the associated risk factors and to determine the prevalence of the associated genes among the ESBL isolates. \u0000Methods: A descriptive cross-sectional study of which 200 female participants with clinical UTI were recruited in Babcock University Community. Pretested interviewer–based structured questionnaire was used to obtain the socio-demographic and risk factors. Mid-stream urine was also collected for evaluation of ESBL- producing Gram-negative bacilli. DNA extraction was done for ESBL positive isolates and SHV, TEM, CTX-M and OXA ESBL genes were detected by PCR. SPSS Version 23.0 was used for data analysis. \u0000Results: The 200-urine samples tested from the participants yielded 33-Gram negative bacilli isolates. Out of these 33 isolates, 17/33(51.5%) were ESBL-producers giving prevalence rate of 8.5% among the participants. The distribution of the ESBL genes among the ESBL isolates was as follows: SHV 12/17(70.6%), TEM 4/17(23.5%), CTX-M 3/17(17.6%) and OXA 5/17(29.4%). No associated risk factors were found. \u0000Conclusion: All the four types of ESBL genes evaluated were present among the participants. Routine screening for ESBL for Community acquired UTI is necessary to curb treatment failure.","PeriodicalId":74149,"journal":{"name":"Medical journal of Zambia","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88723487","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}
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