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COP27 Climate Change Conference: urgent action needed for Africa and the world COP27气候变化大会:非洲和世界需要采取紧急行动
Pub Date : 2023-01-16 DOI: 10.4314/cajm.v68i7-12.1
IT Gangaidzo
No abstract.
没有摘要。
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引用次数: 0
Clinical characteristics and outcome of children admitted with bronchiolitis at Sally Mugabe Hospital, Harare, Zimbabwe 津巴布韦哈拉雷萨利穆加贝医院收治的毛细支气管炎儿童的临床特征和结局
Pub Date : 2023-01-16 DOI: 10.4314/cajm.v68i7-12.2
MD Kasekete, P. Kuona, C. Timire, JK Chun, K. Nathoo, H. Mujuru
Main Objective: To document clinical characteristics and outcomes of patients admitted with bronchiolitis at the Children's Hospital, Harare March 2018 to February 2019. Study Design: A hospital based analytical cross sectional study. Study Setting: The study was conducted at the Children's Hospital, Sally Mugabe Hospital. Materials and Methods: Children aged 2months to 2 years hospitalised with bronchiolitis Results: A total of 206 children were recruited. Mean age was 5.4 (SD ±4.3) months with 148 (72%) less than six months.  The male to female ratio of 1.8:1. Only 15% of the children were born preterm (85%). The main symptoms were cough (91%), rhinorrhoea (69%) and hot body (66%). Thirteen percent had a comorbid condition. Physical examination findings were mainly tachypnoea (89%) and hypoxia (83%). A severe modified Tal (mTal) score was noted in 116(56%) children at admission and 51(25%) still had a severe mTal score when repeated within 12 hours of admission. The median length of hospital stay was 4 days (IQR 3; 6) and 90(44%) children had a prolonged stay (>4 days). Only 3 (1.5%) children died. A high repeat mTal score, wasting, hypoxia and expiratory/inspiratory wheezes, were associated with a prolonged hospital stay.  (p= 0.025, p= 0.004, p=0.001, p= 0.007 respectively). Conclusion: Majority of children admitted with bronchiolitis were less than 6 months of age. There was a male predominance. Bronchiolitis causes high morbidity but low mortality in children from this low-income setting.
主要目的:记录2018年3月至2019年2月在哈拉雷儿童医院收治的毛细支气管炎患者的临床特征和结局。研究设计:一项基于医院的分析横断面研究。研究环境:该研究在Sally Mugabe医院的儿童医院进行。材料和方法:2个月至2岁的毛细支气管炎住院儿童。结果:共招募206名儿童。平均年龄5.4 (SD±4.3)个月,其中小于6个月的148例(72%)。男女比例为1.8:1。只有15%的儿童早产(85%)。主要症状为咳嗽(91%)、流涕(69%)、体热(66%)。13%的人有合并症。体格检查主要表现为呼吸急促(89%)和缺氧(83%)。116例(56%)患儿入院时出现严重的改良Tal (mTal)评分,51例(25%)患儿入院后12小时内再次出现严重的Tal评分。中位住院时间为4天(IQR 3;有90例(44%)患儿住院时间延长(4 ~ 4天)。仅有3名(1.5%)儿童死亡。高重复tal评分、消瘦、缺氧和呼气/吸气喘息与住院时间延长有关。(p= 0.025, p= 0.004, p=0.001, p= 0.007)。结论:绝大多数毛细支气管炎患儿年龄小于6个月。男性占优势。毛细支气管炎在低收入地区的儿童中发病率高,但死亡率低。
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引用次数: 0
Investigating gains in TB detection during rollout of Genexpert MTB/Rif universal access to drug susceptibility testing algorithm in Manicaland, Zimbabwe, 2017-2018 调查2017-2018年在津巴布韦Manicaland推出Genexpert MTB/Rif普遍可及药敏试验算法期间结核病检测方面的进展
Pub Date : 2023-01-16 DOI: 10.4314/cajm.v68i7-12.3
K. Zvinoera, M. Mukuzunga, V. Kampira, J. Mutsvangwa, S. Mharakurwa
Objective: To investigate any gains made in Tuberculosis (TB) case detection during Genexpert MTB/Rif universal access to Drug Susceptibility Testing (DST) Algorithm roll out in Manicaland Zimbabwe, 2017 to 2018. Design:  Retrospective study design. Setting: The study setting was the eastern province in Zimbabwe called Manicaland which has 304 health facilities served by 15 Genexpert testing sites. Participants: Total of 36 056 Mycobacterium Tuberculosis (MTB) results generated from 15 Genexpert sites were enrolled. Interventions:  The intervention was the universal access Genexpert MTB/Rif algorithm rollout. Early TB detection occurs with Genexpert MTB/Rif because it has lower limit of detection compared to less superior smear microscopy, which was replaced as roll out occurred. Main Outcome Measures: Semi quantitative MTB/Rif test results and the rifampicin resistance pattern. Results: The study revealed that 5769/36056 (16%) were analysed using targeted MTB diagnostic algorithm versus 30286/36056 (83.7%) analysed using universal access to Drug Susceptibility Testing (DST) MTB diagnostic algorithm. Among the positives the percentage positivity contributed by the semi quantitative measure of between MTB detected trace and MTB detected low was 1043 out of 2222(46.9%), suggesting early TB detection. There was a statistically significant increase in Rifampicin (RR) detection. Conclusion: As roll out occurred more tests were analysed using the superior diagnostic tool Genexpert MTB/Rif, thus addressing early TB detection. There was statistically significant more rifampicin resistance detected during roll out.
目的:调查2017年至2018年在津巴布韦马尼卡兰推出的Genexpert MTB/Rif普及药物敏感性测试(DST)算法期间,在结核病(TB)病例检测方面取得的任何进展。设计:回顾性研究设计。环境:研究环境是津巴布韦东部的马尼卡兰省,该省有304个卫生设施,由15个Genexpert检测点提供服务。参与者:共有36 056个结核分枝杆菌(MTB)结果来自15个Genexpert位点。干预措施:干预措施是通用Genexpert MTB/Rif算法的推出。Genexpert MTB/Rif进行早期结核病检测,因为与不太优越的涂片显微镜相比,它的检测极限较低,后者在推出时被取代。主要结果指标:半定量MTB/Rif测试结果和利福平耐药性模式。结果:研究显示,5769/36056(16%)使用靶向MTB诊断算法进行分析,而30286/336056(83.7%)使用通用药物敏感性测试(DST)MTB诊断方法进行分析。在阳性病例中,半定量测量MTB检测痕迹和MTB检测低之间的阳性率为1043(2222)(46.9%),表明早期检测到结核病。利福平(RR)的检测有统计学意义的增加。结论:随着推广的进行,使用高级诊断工具Genexpert MTB/Rif对更多的测试进行了分析,从而解决了结核病的早期检测问题。在推广过程中检测到的利福平耐药性具有统计学意义。
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引用次数: 0
Clinical profiles, healthcare given and hospital outcomes of children hospitalised for acute asthma at a tertiary hospital in Harare, Zimbabwe: a 2010-2020 chart review 津巴布韦哈拉雷一家三级医院急性哮喘住院儿童的临床概况、医疗保健和住院结果:2010-2020年图表审查
Pub Date : 2022-12-14 DOI: 10.4314/cajm.v68i1.3
P. Magwenzi, S. Rusakaniko, E. Sibanda, F. Gumbo
Background: Acute asthma is among the commonest medical emergencies that cause repeated presentation to the emergency department and hospitalisation. Several guidelines exist on the management of acute asthma in children. Despite this, evidence from high income countries suggests that practice deviates from standard of care. In low-income countries including most African countries there is paucity of data on the clinical profiles, healthcare given and hospital outcomes of children hospitalised for acute asthma. Objectives: This retrospective chart review reports on the clinical profiles, health care given and hospital outcomes of children presenting with acute asthma at a tertiary hospital. Materials and Methods: A retrospective chart review was done on consecutive case files of patients hospitalised for acute asthma in the period January 2010 to December 2020. A standardized electronic data collection tool (REDCap) was used for data abstraction. The data was uploaded onto a REDCap server then onto an excel spreadsheet.  Statistical Package for Social Sciences version 16 (SPSS 16.0) was used for descriptive statistics and to test for association between clinical profiles and length of hospital stay. This review was approved by the Medical Research Council of Zimbabwe and Institutional Joint Research Ethical Committee. Results:  A total of 214 case files were reviewed. The ages of the study participants ranged from2months to 17 years, the median was 3years (Q1=1, Q3=6) and 69% were below 5 years. Of the study population, 15% had their asthma diagnosis made before one year of age and 94% by 6 years. Newly diagnosed asthmatics accounted for 101(47%) of the study population while111(52%) were known asthmatics. Cough, fast breathing, and wheeze were universal presenting symptoms.  Severe acute asthma was present in 81% of those who had their asthma severity assessed.  Up to 73% of the study population had comorbidities. All patients received nebulised Short Acting B2 Agonist (SABA) in the emergency department and in hospital. Oxygen therapy was given to all the patients who had SpO2 measurement less than 92%. However, assessment of asthma severity was done in only 42%, looking for triggers in only 9%, health education was given to 52%, asthma action plan was given to only 5% and review dates were given to 77% of the study population.  The median hospital stay was 3 days (Q1=2,Q3=4) and 2 patients died during the period under review. Having newly diagnosed asthma, younger age, low oxygen saturation at presentation and presence of comorbid conditions was significantly associated with severe acute asthma. Patients with severe acute asthma had longer hospital stay. Discussion:  This review has revealed that most children with asthma present by 6 years, most have severe acute asthma, co-morbidities, and recurrent hospitalizations due to acute asthma. The care given to children with acute asthma fell short of the standard of care. Conclusions:  The cha
背景:急性哮喘是最常见的医疗紧急情况之一,导致反复出现在急诊室和住院。关于儿童急性哮喘的管理有若干指导方针。尽管如此,来自高收入国家的证据表明,这种做法偏离了护理标准。在低收入国家,包括大多数非洲国家,缺乏关于因急性哮喘住院儿童的临床概况、医疗保健和住院结果的数据。目的:回顾性分析某三级医院急性哮喘患儿的临床概况、卫生保健和住院结果。材料和方法:对2010年1月至2020年12月期间急性哮喘住院患者的连续病例档案进行回顾性图表回顾。采用标准化电子数据收集工具(REDCap)进行数据提取。数据被上传到REDCap服务器,然后上传到excel电子表格。使用社会科学统计软件包第16版(SPSS 16.0)进行描述性统计,并检验临床概况与住院时间之间的关联。这项审查得到了津巴布韦医学研究理事会和机构联合研究伦理委员会的批准。结果:共审查214份病例档案。研究参与者的年龄从2个月到17岁不等,中位年龄为3岁(Q1=1, Q3=6), 69%的患者年龄在5岁以下。在研究人群中,15%的人在1岁之前诊断出哮喘,94%的人在6岁之前诊断出哮喘。在研究人群中,新诊断的哮喘患者占101例(47%),已知哮喘患者占111例(52%)。咳嗽、呼吸急促和喘息是普遍的症状。在接受哮喘严重程度评估的患者中,有81%存在严重急性哮喘。高达73%的研究人群有合并症。所有患者均在急诊科和医院接受了短效B2激动剂(SABA)雾化治疗。SpO2测量值小于92%的患者均给予氧疗。然而,只有42%的人进行了哮喘严重程度评估,只有9%的人寻找诱因,52%的人接受了健康教育,只有5%的人接受了哮喘行动计划,77%的研究人群接受了审查日期。中位住院时间为3天(Q1=2,Q3=4),在本研究期间有2例患者死亡。新诊断的哮喘患者,年龄较小,出现时血氧饱和度低以及存在合并症与严重急性哮喘显著相关。严重急性哮喘患者住院时间较长。讨论:本综述显示,大多数儿童在6岁前出现哮喘,大多数有严重的急性哮喘、合并症和因急性哮喘而反复住院。对患有急性哮喘的儿童的护理达不到护理标准。结论:图表审查可作为纠正干预的基础,包括;临床决策算法的发展,卫生工作者的教育,卫生设施的能力和指导未来的研究。
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引用次数: 0
Anthropometric determinants of blood pressure changes in a community sample of adults in Sokoto, northwest Nigeria 尼日利亚西北部索科托成人社区样本中血压变化的人体测量决定因素
Pub Date : 2022-12-14 DOI: 10.4314/cajm.v68i1.2
AJ Bamaiyi, H. Umar, H. Madaki, M. Musa, A. Usman
Objective: To determine the predictability of rise in Blood Pressure (BP) parameters, by the various components of excessive weight gain, in a population-based sample of adults in Sokoto, Nigeria. Design:  A cross-sectional descriptive study carried out on a community sample of adults attending a free medical screening. Setting:  An open-space free medical service carried out in a Sokoto community. Subjects:   All consenting, non-pregnant adults that participated in the event were included. Main Outcome Measures:  Stepwise multivariate regression analysis was applied to determine the variability strengths of body weight, height, Body Mass Index (BMI), Lean Body Mass (LBM) and Body Fat (BF), on Systolic BP (SP), Diastolic BP (DP), Pulse Pressure (PP), Mean Arterial Pressure (MAP) and Pulse Rate (PR). Slope of the relationship between dependent and independent variables were also determined. Results: BF was a more consistent influencer of BP rise beyond other anthropometric parameters. BF versus SP and MAP are respectively; β-coefficient =0.357, CI =0.264  1.162, p=.002 and β-coefficient = 0.455, CI =0.324  0.890, p=.000. The influence of BMI on DP was β-coefficient =0.457, CI =0.564  1.555, p=.000 and influence of body weight on PR was β-coefficient =0.270, CI = 0.037  0.471, p=.023. Conclusion: To assess the risk of excess weight gain on BP elevation, the BF component of body weight or BMI be given more attention and should be part of the targets of lifestyle modifications aimed at controlling hypertension and forestalling its complications.
目的:在尼日利亚索科托的一个基于人群的成人样本中,通过体重过度增加的各种成分来确定血压(BP)参数升高的可预测性。设计:一项横断面描述性研究,以参加免费医疗筛查的成年人为社区样本。背景:在索科托社区开展的开放空间免费医疗服务。受试者:包括所有同意参加该活动的未怀孕成年人。主要结果指标:采用逐步多元回归分析来确定体重、身高、体重指数(BMI)、瘦体重(LBM)和体脂(BF)、收缩压(SP)、舒张压(DP)、脉压(PP)、平均动脉压(MAP)和脉率(PR)的变异强度。还确定了因变量和自变量之间关系的斜率。结果:BF对血压升高的影响比其他人体测量参数更为一致。BF与SP和MAP分别为;β-系数=0.357,CI=0.264 1.162,p=.002,β-系数=0.455,CI=0.324 0.890,p=.000。BMI对DP的影响为β系数=0.457,CI=0.564,1.555,p=0.000;体重对PR的影响为α系数=0.270,CI=0.037,0.471,p=0.023。结论:为了评估血压升高时体重增加过多的风险,应更多地关注体重或BMI的BF成分,并应将其作为生活方式改变的目标之一,以控制高血压并预防其并发症。
{"title":"Anthropometric determinants of blood pressure changes in a community sample of adults in Sokoto, northwest Nigeria","authors":"AJ Bamaiyi, H. Umar, H. Madaki, M. Musa, A. Usman","doi":"10.4314/cajm.v68i1.2","DOIUrl":"https://doi.org/10.4314/cajm.v68i1.2","url":null,"abstract":"Objective: To determine the predictability of rise in Blood Pressure (BP) parameters, by the various components of excessive weight gain, in a population-based sample of adults in Sokoto, Nigeria. \u0000Design:  A cross-sectional descriptive study carried out on a community sample of adults attending a free medical screening. \u0000Setting:  An open-space free medical service carried out in a Sokoto community. \u0000Subjects:   All consenting, non-pregnant adults that participated in the event were included. \u0000Main Outcome Measures:  Stepwise multivariate regression analysis was applied to determine the variability strengths of body weight, height, Body Mass Index (BMI), Lean Body Mass (LBM) and Body Fat (BF), on Systolic BP (SP), Diastolic BP (DP), Pulse Pressure (PP), Mean Arterial Pressure (MAP) and Pulse Rate (PR). Slope of the relationship between dependent and independent variables were also determined. \u0000Results: BF was a more consistent influencer of BP rise beyond other anthropometric parameters. BF versus SP and MAP are respectively; β-coefficient =0.357, CI =0.264  1.162, p=.002 and β-coefficient = 0.455, CI =0.324  0.890, p=.000. The influence of BMI on DP was β-coefficient =0.457, CI =0.564  1.555, p=.000 and influence of body weight on PR was β-coefficient =0.270, CI = 0.037  0.471, p=.023. \u0000Conclusion: To assess the risk of excess weight gain on BP elevation, the BF component of body weight or BMI be given more attention and should be part of the targets of lifestyle modifications aimed at controlling hypertension and forestalling its complications.","PeriodicalId":74979,"journal":{"name":"The Central African journal of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48967709","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}
引用次数: 0
Histopathological patterns in kidney biopsies in Zimbabwe: a 12-year retrospective study 津巴布韦肾活检组织病理学模式的12年回顾性研究
Pub Date : 2022-12-14 DOI: 10.4314/cajm.v68i1.1
R. Dahwa, L. Rutsito, R. Makunike-Mutasa, M. Odwee, O. Madzudzo, S. Kajawo
Objectives:  Data on histological patterns in native kidney biopsies in Zimbabwe is sparse. We sought to describe these histological patterns over a 12 year period. Study Design:  We retrospectively evaluated the histological patterns on kidney biopsies at the largest private pathology laboratory in Zimbabwe from 1 January 2008 to 31 January 2020. Setting: Histopathological data on all percutaneous native kidney biopsy specimens received at the pathology lab was recovered from electronic records. Indications for the kidney biopsy were then reviewed and patient demographics collected. Subjects:  All patients who had a histopathological report identified from the electronic records and who had had a kidney biopsy for nephrological indications were included. Results:  Sixty four 64 reports in total were identified and 18 were excluded (17biopsies done to evaluate renal masses and 1 kidney transplant biopsy). Thus 46 percutaneous native kidney biopsies were evaluated in the final analysis. Ninety six percent of the patients biopsied were of African descent. Primary FSGS was the commonest primary glomerular disease (26%) and lupus nephritis the commonest secondary glomerular disease (24%). The commonest indication for kidney biopsy was nephrotic syndrome (61%). Conclusions:  FSGS was the commonest primary GN in this study of adult patients and the commonest indication for kidney biopsy was nephrotic syndrome. This finding is useful for guiding clinicians on managing patients presenting with nephrotic syndrome in low resource settings as often patients lack access to kidney biopsy services and empiric use of steroids may be considered in appropriate individual cases.
目的:关于津巴布韦本地肾活检组织学模式的数据很少。我们试图在12年的时间里描述这些组织学模式。研究设计:我们回顾性评估了2008年1月1日至2020年1月31日在津巴布韦最大的私人病理实验室进行的肾脏活检的组织学模式。设置:从电子记录中恢复病理实验室收到的所有经皮肾活检标本的组织病理学数据。然后对肾活检的适应症进行审查,并收集患者的人口统计数据。受试者:所有从电子记录中获得组织病理学报告的患者,以及因肾病指征进行肾活检的患者都包括在内。结果:共发现64份报告,18份被排除在外(17份活检用于评估肾脏肿块,1份肾移植活检)。因此,在最终分析中评估了46例经皮肾活检。96%的活检患者是非洲裔。原发性FSGS是最常见的原发性肾小球疾病(26%),而狼疮性肾炎是常见的继发性肾小球病(24%)。肾活检最常见的指征是肾病综合征(61%)。结论:FSGS是本研究中成人患者最常见的原发性GN,肾活检最常见的指征是肾病综合征。这一发现有助于指导临床医生在资源匮乏的环境中管理肾病综合征患者,因为患者往往无法获得肾活检服务,在适当的个别病例中可以考虑经验性使用类固醇。
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引用次数: 0
LETTERS TO THE EDITOR: Human health & hazards to humans: pretection from the African giant rat 致编辑的信:人类健康和对人类的危害:来自非洲大鼠的预测
Pub Date : 2022-12-14 DOI: 10.4314/cajm.v68i1.4
R. Cooper
No Abstract.
没有摘要。
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引用次数: 0
A comparison of the sensory processing skills of children (6-10 years old) with autism and those that are typically developing as assessed by a short sensory profile in Harare, Zimbabwe 津巴布韦哈拉雷6-10岁自闭症儿童与正常儿童感官加工技能的比较
Pub Date : 2022-08-19 DOI: 10.4314/cajm.v67i7-12.2
P. Mutapurwa, T. Mlambo, E. Mavindidze
Background: Sensory processing is a key component in the development of children. We sought to compare the sensory processing problems experienced by children (6-10 years) with and without autism in Harare, Zimbabwe. Methodology: A quantitative cross-sectional study was done at public hospitals, non-profit organisations and urban public primary schools. Sensory processing abilities of children were assessed using the Short Sensory Profile (SSP) and compared between those with autism and those without, using Multivariate Analysis Of Variance (MANOVA). Ethical approval was granted and participants were voluntary. Results: Seventy-four primary caregivers and their children participated in the study (40 for typically developing and 34 for those with autism). The overall mean age of the children was 8.1 years (SD 1.2), children with autism were older (mean 8.2 years SD 1.2) but not attending school. Those without autism were purposively matched for gender while there were more males (61.8%) than females among children with autism. Over 95% of children without Autism Spectrum Disorders (ASD) were rated as displaying normal sensory processing skills in all domains except for movement sensitivity where a quarter did not display typical performance. This was in contrast to less than half of children with ASD who displayed normal sensory processing domains. The only exception was visual/auditory acuity in 70.6% of children with ASD displayed normal sensory processing skills. There was a statistically significant difference in sensory processing skills between children with and without ASD in all domains (p=<0.01) with those with ASD displaying poorer performance. Conclusion: Children with autism performed poorer than their typically developing peers on the SSP. The areas in which these children experience greatest impairment need to be targeted in interventions and caregivers should be equipped to address some of these problems.
背景:感觉加工是儿童发展的关键组成部分。我们试图比较津巴布韦哈拉雷患有和没有自闭症的儿童(6-10岁)所经历的感觉处理问题。方法:在公立医院、非营利组织和城市公立小学进行了定量横断面研究。使用短感觉谱(SSP)评估儿童的感觉加工能力,并使用多变量方差分析(MANOVA)比较自闭症儿童和非自闭症儿童的感觉加工能力。伦理批准被授予,参与者是自愿的。结果:74名主要照顾者和他们的孩子参加了这项研究(40名是正常发育者,34名是自闭症患者)。儿童的总体平均年龄为8.1岁(SD 1.2),自闭症儿童年龄较大(平均8.2岁SD 1.2),但没有上学。没有自闭症的儿童被故意匹配性别,而在自闭症儿童中,男性比女性多(61.8%)。超过95%的没有自闭症谱系障碍(ASD)的儿童被评为在所有领域表现正常的感觉处理技能,除了运动敏感性,其中四分之一没有表现出典型的表现。相比之下,只有不到一半的ASD患儿表现出正常的感觉处理域。唯一的例外是视觉/听觉灵敏度,70.6%的自闭症儿童表现出正常的感觉处理技能。ASD患儿与非ASD患儿感觉加工技能各领域差异有统计学意义(p=<0.01), ASD患儿表现较差。结论:自闭症儿童在SSP上的表现比正常发育的同龄人差。这些儿童遭受最大损害的领域需要成为干预措施的目标,护理人员应具备解决其中一些问题的能力。
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引用次数: 0
Haematological features in babies with perinatal asphyxia in Zimbabwe 津巴布韦围产期窒息婴儿的血液学特征
Pub Date : 2022-08-19 DOI: 10.4314/cajm.v67i7-12.3
N. Mabaera, S. Mubaira, A. Mandisodza
Background: Perinatal asphyxia is failure to establish breathing at birth. It is a common cause of neonatal mortality in developing countries. Hypoxic Ischemic Encephalopathy (HIE) is the major complication of asphyxia, resulting in permanent neurological and other multi-organ damages. Some haematological changes have also been observed in patients with this disease. Objectives: The objective of this study was to investigate the haematological features in babies with perinatal asphyxia in Zimbabwe. Methodology: A prospective laboratory based cross sectional study was carried out at the Sally Mugabe Hospital Neonatal Unit from December 2018 to April 2019. Routine full blood counts on samples from babies with perinatal asphyxia on their first day of life. Peripheral blood smears were examined on all those with abnormal full blood count results. Results: Full blood counts were done on 180 babies with perinatal asphyxia of whom 103 (57%) and 77 (43%) were females and males respectively. The median white cell count and nucleated red cell count were elevated. The platelet and red cell count were decreased. Haemoglobin, haematocrit, and Mean Corpuscular Haemoglobin Concentration (MCHC) were within normal range. The Mean Corpuscular Volume (MCV) and Mean Corpuscular Haemoglobin (MCH) were increased. There was a correlation between increased nucleated red blood and white cell counts with the severity of perinatal asphyxia in the order of Asphyxia Without Hypoxic Ischemic Encephalopathy (AWHIE), Hypoxic Ischemic Encephalopathy (HIE I), HIE II, and HEI III. The most common haematological abnormalities were thrombocytopaenia 52(29%), anaemia 51(28%) and leukopaenia 28(16%). Twenty-four (47%) of anaemia patients had microcytic hypochromic anaemia. Thirty-one (47%) of 65 blood films examined exhibited immature granulocytes and 28(43%) had burr red blood cells. Conclusion: Babies with perinatal asphyxia may present with haematological abnormalities such as anaemia, thrombocytopaenia, leukocytosis and elevated nucleated red cell count as complications of sever hypoxia. Full blood count may be a useful in the effective management of perinatal asphyxia.
背景:围产期窒息是指出生时无法建立呼吸。它是发展中国家新生儿死亡的常见原因。缺氧缺血性脑病(HIE)是窒息的主要并发症,可导致永久性神经系统和其他多器官损伤。在这种疾病的患者中也观察到了一些血液学变化。目的:本研究的目的是调查津巴布韦围产期窒息婴儿的血液学特征。方法:2018年12月至2019年4月,在Sally Mugabe医院新生儿病房进行了一项前瞻性的实验室横断面研究。围产期窒息婴儿出生第一天的常规全血计数。对所有全血细胞计数结果异常的患者进行外周血涂片检查。结果:对180例围产期窒息婴儿进行了全血细胞计数,其中女性103例(57%),男性77例(43%)。中位白细胞计数和有核红细胞计数升高。血小板和红细胞计数下降。血红蛋白、红细胞压积和平均肌注血红蛋白浓度(MCHC)均在正常范围内。平均肌注量(MCV)和平均肌注血红蛋白(MCH)增加。有核红细胞和白细胞计数的增加与围产期窒息的严重程度相关,依次为无缺氧缺血性脑病窒息(AWHIE)、缺氧缺血性脑病(HIE I)、HIE II和HEI III。最常见的血液学异常是血小板减少52(29%)、贫血51(28%)和白细胞减少28(16%)。二十四名(47%)贫血患者患有微细胞低色素性贫血。在检查的65张血液胶片中,31张(47%)显示为未成熟粒细胞,28张(43%)显示为毛刺红细胞。结论:围产期窒息的婴儿可能会出现血液学异常,如贫血、血小板减少、白细胞增多和有核红细胞计数升高,这些都是严重缺氧的并发症。全血细胞计数可能有助于有效管理围产期窒息。
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引用次数: 0
Coping strategies amongst patients with spinal cord injuries in Zimbabwe 津巴布韦脊髓损伤患者的应对策略
Pub Date : 2022-08-19 DOI: 10.4314/cajm.v67i7-12.1
K. Muteti, T. Mlambo, V. Chikwasha, B. Chigonda
Background: Spinal Cord Injury (SCI) is one of the most common disabling neurological conditions managed by Occupational therapists in Zimbabwe. The coping strategies adopted by these SCI survivors and the factors associated with the adjustment have not been fully explored. Materials and Methods: A descriptive cross sectional study was done to determine the coping strategies used by SCI patients adjust to their condition. The Brief Cope Inventory and Spinal Cord Lesions Coping Strategies Questionnaire were used to gather data from SCI patients in three institutions that rehabilitate people with SCI in Zimbabwe. Ethical procedures were followed. Results: Forty three patients with SCI participated in the study. Seventy-seven percent were male and median age was 35 years (IQR 27-43). The most common cause of injury was road traffic accident (63%) followed by mining related falls. The most used coping strategies were religion (91%), acceptance (79%), positive reframing (70%) and use of emotional support (67%) which are all positive in nature. Least used coping strategies were substance abuse (2%), denial (7%) and behavioural disengagement (16%) which are all negative in nature. Male gender (p=0.034) and receiving rehabilitation at a rehabilitation centre (p=0.041) were associated with use of a positive coping strategy. Conclusion: SCI generally affect a young male population. There is a need to capitalize on the commonly used positive coping strategies and to support women and those in hospitals. There is also need to further explore factors associated with the coping strategies adopted so SCI survivors are assisted to cope positively with their injury.
背景:脊髓损伤(SCI)是津巴布韦职业治疗师治疗的最常见的致残性神经疾病之一。这些SCI幸存者所采取的应对策略以及与调整相关的因素尚未得到充分探讨。材料和方法:采用描述性横断面研究来确定SCI患者根据病情调整的应对策略。简要应对量表和脊髓损伤应对策略问卷用于收集津巴布韦三家脊髓损伤康复机构的脊髓损伤患者的数据。遵守了道德程序。结果:43例SCI患者参与了本研究。77%为男性,中位年龄为35岁(IQR 27-43)。最常见的受伤原因是道路交通事故(63%),其次是与采矿有关的坠落。最常用的应对策略是宗教(91%)、接受(79%)、积极重构(70%)和使用情感支持(67%),这些策略本质上都是积极的。最不常用的应对策略是药物滥用(2%)、否认(7%)和行为脱离(16%),这些都是负面的。男性(p=0.034)和在康复中心接受康复治疗(p=0.041)与积极应对策略的使用有关。结论:SCI通常影响年轻男性群体。需要利用常用的积极应对策略,支持妇女和住院患者。还需要进一步探索与所采取的应对策略相关的因素,以便帮助SCI幸存者积极应对他们的伤害。
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The Central African journal of medicine
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