Central African Journal of Medicine

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Postpartum Haemorrhage (PPH) is the most common cause of maternal mortality globally, leading to a woman's death every seven minutes. In Zimbabwe, there has been a 300% increase in the Maternal Mortality Ratio (MMR) between 1994 and 2010 and the MMR was estimated at 960 maternal deaths per 100,000 live births in 2012.2-3 Overall, 14% of all maternal deaths in Zimbabwe are due to PPH. Ensuring prompt access to high-quality prevention and treatment of PPH for all women who deliver is an essential strategy to combat PPH-related morbidity and mortality and to make progress toward reaching Millennium Development Goal 5, the reduction of maternal mortality by three-quarters by 2015...

Background: High negative appendicectomy rates are no longer acceptable with improvements in imaging techniques and clinical prediction rules. The use of ultrasound and CT scan in addition to clinical assessment and blood investigations has greatly reduced the negative appendicectomy rate to less than 10%. Objectives: The aim of the study was to determine the negative appendicectomy rate at the two major teaching hospitals in Harare and to evaluate the accuracy of the Alvarado score and ultrasound scan in diagnosing acute appendicitis...

Background: Acid base alterations occur during laparoscopy with carbon dioxide insufflation. The purpose of this study was to investigate the effects of low tidal volume ventilation on acid base status during pneumoperitonium. Materials and Methods: 30 patients undergoing laparoscopic surgery under General Anaesthesia were ventilated with tidal volume of 6 ml/kg and respiratory rate of 12 breaths/minute. Arterial blood gas analysis was done before, during and after C02 pneumoperitoneum...

Background: Among HIV-infected children ear infections are recurrent and chronic, which may lead to hearing loss. Objective: To determine the prevalence, cause and severity of hearing impairment among HIV-infected children aged 5-17 years attending for HIV care in Harare. Design and Setting: An analytical cross-sectional survey conducted at Newlands Clinic, an opportunistic infections clinic in Harare. Materials and Methods: Participants underwent a standardised otoscopic examination of the ear and Pure Tone Audiometry (PTA)...

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Background: The establishment of a credible, defensible and acceptable “formal competency based ophthalmology training curriculum for undergraduate medical and dental students” is fundamental to program recognition, monitoring and evaluation. The University of Zimbabwe College of Health Sciences (UZ-CHS) has never had a formal ophthalmology training curriculum for medical graduates since its inception. This has cast doubts on the quality of medical graduates produced with regards to delivery of basic primary eye care in the community...

Objectives: To determine the number of patients with intussusception treated at HCH over a 10 year period. To describe the ages and sex of children operated for intussusceptions. To determine if there is seasonal variation in the number of cases presenting to HCH. To determine the type and method of treatment of intussusception at HCH. Design: This was a descriptive retrospective study. Theatre records were inspected to identify eligible patients. Information regarding sex, age, anatomical subtype and procedure performed was recorded...

Objectives: To determine whether earlier application of the Non-pneumatic Anti-Shock Garment (NASG) at clinic level compared to the referral hospital level reduces maternal morbidity and mortality and recovery time from shock due to severe Obstetric Haemorrhage (OH) and to determine the safety of the NASG when applied at clinic level. Design: A cluster Randomized Controlled Trial (RCT) Setting: Harare and Parirenyatwa Referral Hospitals (RH) in Harare and the twelve Harare City Council clinics that offer maternity care...

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Introduction: Rheumatic heart disease is still a common problem in Zimbabwe. It has a significant mortality rate due to heart failure, stroke or endocarditis. Timely surgical interventions can reduce mortality. An echocardiography audit was performed to determine the proportion of patients referred for echocardiography who had a diagnosis of rheumatic heart disease, the pattern of valvular involvement and the presence of surgical indications on echocardiography. Objective: To determine the number of echocardiograms done in 2012 and the proportion with a diagnosis of rheumatic heart disease...

Objective: To determine the histological effects of different frequencies of loading in a healing Achilles tendon following partial rupture. Design: Experimental laboratory study. Setting: University of Zimbabwe, Department of Physiology, Animal house. Subjects: Sixty female Sprague-Dawley rats. Intervention: Partial tenotomies of the right Achilles tendon were performed surgically. From day 1 post operatively, the animals were allocated to treadmill running at different frequencies (once (OD), two (BD), three (TDS) and four (QID) times daily) up to 21 days...

Objective: To determine etiology and risk factors of meningitis in patients admitted a tertiary referral Hospital in Harare. Design: Cross-Sectional Study. Setting: Urban Referral Health Facility. Subjects: Patients suspected of having Meningitis admitted at Parirenyatwa Hospital were consecutively consented and recruited into the study until sample size accrual. Main Outcome Measures: Prevalence of pathogens associated with Meningitis...

Introduction: Postnatal depression is a common cause of morbidity but is rarely diagnosed or managed in busy primary care settings in most resource limited countries like Zimbabwe. Objectives: This study sought to determine the prevalence of postnatal depression and establish factors associated with postnatal depression. Methods: The study utilized a cross-sectional descriptive design where 295 consenting women (mean age=25.4 years; SD= 5...

OBJECTIVES: To determine occupational therapy needs of adolescents and young adults with cerebral palsy living in an urban setting, to identify participation levels in activities of daily living and social activities, to identify factors influencing participation and to determine the contribution of occupational therapy in participating in these activities. DESIGN: Descriptive cross-sectional. SETTING: Community rehabilitation outreach points in Epworth, Mufakose, Glenview, Dzivarasekwa, Mabvuku and Norton...

Phenytoin toxicity masquerading as deterioration of neurological symptoms caused by interaction with chloramphenicol is a very rare but real risk. To the authors’ knowledge only one such case occurring in humans has been reported in the English literature. No case of clinical phenytoin toxicity occurring at less than double the serum phenytoin therapeutic levels, occurring as a result of chlorampenicol interaction has been documented, hence our report. A 17 year old man, whose frontal subdural empyema had been drained, had his seizures well controlled on phenytoin...

INTRODUCTION: The International Classification of Functioning, Disability and Health (ICF) is a framework that provides a detailed outline of the information that should be included in patient records. Whilst the World Federation of occupational therapists and the World Confederation of Physiotherapists have recommended use of this framework in clinical practice, the extent to which Zimbabwean therapists are applying this framework in patients' assessment and treatment is unknown. OBJECTIVE: This study was conducted to determine the extent to which the ICF framework is being applied in recording information on patient assessment and treatment by occupational therapists and physiotherapists in Zimbabwe...

INTRODUCTION: Farming is a physically laborious occupation and farm workers are at risk of developing musculoskeletal complaints. OBJECTIVE: To determine the work related musculoskeletal complaints among farm workers at an agricultural college in Zimbabwe. METHODS: A descriptive cross-sectional study was conducted using a sample size of 30 farm workers. Convenience sampling was used to select participants. Interviewer-administered questionnaires were used to assess the occupational hazards and the occurrence of musculoskeletal symptoms among farm workers...

OBJECTIVE: To determine the prevalence of HIV among persons with physical disabilities in Rwanda. DESIGN: Across-sectional HIV diagnostic study. SETTING: A national referral rehabilitation centre in Rwanda. SUBJECTS: Persons aged 5 to 49 years with lower or upper limb impairments that were obtaining rehabilitation services at the centre. INTERVENTION: Blood samples were collected from the subjects who voluntarily accepted to participate in the study...

BACKGROUND: Co-infections have become significant causes of morbidity and mortality in Human Immunodeficiency Virus (HIV) infected people. Due to shared routes of transmission, co-infection of HIV with Hepatitis B (HBV) and/or Hepatitis C (HCV) should be expected. In Zimbabwe, screening for both viruses in HIV infected people prior to treatment is not routinely practised despite the World Health Organisation (WHO) guidelines (2013) prioritising treatment where these co-infections exist...