African Journals Online
The Central African Journal of Medicine

ABSTRACTS (Vol.45. No.2. )

Central African Journal of Medicine, Vol. 45, No. 2, 1999, pp 26-30

Haematologic features of the Human Immunodeficiency Virus (HIV) infection in adult Zimbabweans

JO ADEWUYI, AM COUTTS, AS LATIF, H SMITH, AE ABAYOMI, AA MOYO

Objective: To describe the haematologic features of the HIV infection in adult Zimbabweans and compare the features in the different clinical stages of the disease.

Design: Descriptive cross sectional study.

Setting: Parirenyatwa Hospital, a tertiary and referral medical centre in Harare, and the blood donor clinics of the Blood Transfusion Service in Harare.

Subjects: Patients attending HIV outpatients clinics or receiving inpatient care at Parirenyatwa Hospital and asymptomatic persons donating blood at the BTS Harare.

Main Outcome Measures: Full blood counts and bone marrow cell counts and morphology.

Results: Blood cytopenia was found in 47.5% of adults with HIV infection. The most frequent abnormalities were lymphopenia (31.5%); anaemia (30.8%); neutropenia (29.6%); thrombocytopenia (24.7%); eosinophilia (23.5%) and leucopenia (11.7%). Frequency of anaemia in the AIDS and symptomatic groups (43.4% and 24.5% respectively) was greater than in the carriers (6.7%), while the frequency of other cytopenias and of eosinophilia was about the same in all groups. There was also a general lack of association between the severity of haematologic abnormalities and the clinical stage of the disease.

Conclusion: Severe haematologic changes occur frequently in HIV infection and AIDS but routine full blood count may not be helpful in the monitoring of the disease or the prediction of onset of AIDS.

Central African Journal of Medicine, Vol. 45, No. 2, 1999, pp 30-33

Visual inspection of the cervix as a primary means of cervical cancer screening: results of a pilot study

ZM CHIRENJE, T CHIPATO, J KASULE, S RUSAKANIKO, L GAFFIKIN, P BLUMENTHAL, H SANGHVI

Objective: To measure the effectiveness of unaided visual inspection (UVI) of the cervix as a primary means of cervical cancer screening.

Design: A cross sectional study.

Setting: Five primary health care clinics in Mashonaland Province, Zimbabwe.

Subjects: 1 000 women.

Main Outcome Measures: 1 000 women attending primary health care clinics were screened for cervical cancer by six qualified nurses. An unlubricated bivalve speculum was inserted into the vagina under good light to visualize the cervix and a cervical cytology specimen was obtained followed by visual inspection of the cervix stained by 4% acetic acid. All women found to have abnormal cervices by visual inspection and/or by cervical cytology report were scheduled for colposcopy examination at Harare Central Hospital.

Results: 236 (23.6%) women had an abnormal cervical appearance after application with 4% acetic acid, out of which 157 (15.7%) were reported abnormal by cytology. True disease as defined by positive colposcopy and positive cytology was confirmed in 38 (3.8%) women. The sensitivity of UVI using colposcopy and cytology as a reference standard was 68.4%, specificity was 3.4%.

Conclusion: The results of this study suggest that naked eye inspections of the cervix after application of acetic acid is a practical alternative to cervical cytology in screening for cervical cancer in countries with few resources like Zimbabwe.

Central African Journal of Medicine, Vol. 45, No. 2, 1999, pp 35-40

Heteromorpha trifoliata (Dombwe) accelerates acetic acid-induced peptic ulcers : a preliminary study in the rat

EE OSIM, T MAREDZA, PVV PRASADA RAO, B NHANDARA, B ADEYANJU, ZJ DURI

Objectives: To investigate the effect of H. trifoliata on: (a) acetic acid-induced ulcers, (b) food intake, (c) water intake, (d) weight gain, (e) gastric acid secretion in rats.

Design: Comparative study.

Setting: Laboratory.

Subjects: 20 female Sprague Dawley rats (220 to 250g) with acetic acid-induced peptic ulcers randomly assigned to test and control groups (n=10). The test rats were allowed water and normal rat diet comprising 20% H. trifoliata (>Dombwe) and >Imfe nkulu= in Shona and Ndebele respectively) for 17 days after ulceration while control rats were allowed water and normal rat diet for 17 days after ulceration. Thirty six other rats were prepared to study the effect of H. trifoliata on gastric and acid secretion stimulated by histamine, gastrin and carbachol.

Main Outcome Measures: Photographs of the gross anatomy and hisotology of test and control rat stomachs were taken. Daily food and water intake, weekly weight gain and gastric acid secretion were measured in the test and control rats.

Results: 17 days following the consumption of the H. trifoliata containing diet, macroscopically, no ulcers were found on the outer surface of the stomach walls of test rats. However, histological examination revealed traces of ulcer at the sites where ulcers were induced previously. In contrast, 70% of the control rats still had ulcers on the surface of their stomach walls. Histological examination showed massive denuded mucosa and submucosa at the ulcer sites which are signs of severe ulceration. Food intake in both groups was not significantly different except during the first three days when test rats consumed significantly less food (p< 0.01) than control rats. Daily water intake and weekly weight gain were also not significantly different in the test and control groups. H. trifoliata had no significant effect on gastric acid secretion stimulated by histamine, gastrin and carbachol.

Conclusions: H. trifoliata does not affect daily food and water intake and weekly weight gain in rats. It also does not affect histamine, gastrin and carbachol-stimulated acid secretion in rats. However, H.trifoliata accelerates the healing of acetic acid-induced peptic ulcer in rats. This may validate the use of H. trifoliata in the treatment of peptic ulcer in humans.

Central African Journal of Medicine, Vol. 45, No. 2, 1999, pp 40-43

Cancer of the larynx in Black Africans in Jos Nigeria

OB Da LILLY-TARIAH, CO UKOLI, EJC NWANA

Objective: A clinico-pathological study of cancer of the larynx in Jos from 1983 to 1995.

Design:

Setting: Jos University Teaching University.

Subjects: 38 patients.

Results: 38 (100%) patients were seen. Thirty four (89.5%) were Black African males. Mean age was 47.7 years. Twenty nine (76.3%) smoked cigarettes and drank alcohol. Hoarseness (100%) was the commonest symptom. Mean duration of symptoms was 13.5% months. Transglottic (42.1%) was the commonest site and squamous cell carcinoma (97.4%) was the predominant histologic type.

Conclusion: There was a male preponderance. The mean age was lower than in other series. Patients often presented late. Squamous cell carcinoma was the commonest cell type.

Central African Journal of Medicine, Vol. 45, No. 2, 1999, pp 43-45

The relationship between malaria and HIV

SA TSWANA, L NYSTROM, SR MOYO, M NZARA, P BOONE

Objective: To determine if there is an association between HIV and malaria infection

Design: A cross sectional survey.

Setting: Sanyati Rural District, a malarious endemic area of Zimbabwe.

Subjects: 338 volunteers aged 15 months to 76 years.

Main Outcome Measures: Prevalence of Malaria and HIV.

Results: The prevalence of malaria and HIV was 26.6% and 26.3% respectively. There was no association between prevalence of HIV and malaria.

Conclusion: There is no association between malaria and HIV.

Central African Journal of Medicine, Vol. 45, No. 2, 1999, pp 45-47

Tuberculous orchitis co-existing with tuberculosis of the sternum - case report

OA FADIRAN, B AKINTAN, SF OLUWOLE

The sternum and testis are infrequent localisations for extra pulmonary tuberculosis. The initial response to a co-existing lesion, as this case depicted is, to implicate a malignant process of some sort. A high index of suspicion is needed to overcome this diagnostic riddle. Biopsy of the lesion and bacteriological work-up are essential ingredients of management.

Letters to the editor:
Abstract:

Confidence Interval: comments on Dr Sibanda's Letter to the editor

I read with much interest Dr Sibanda's letter to the editor (Cent Afr J Med 1999;45(1):23). It highlights the confusion surrounding the confidence intervals.

Infinite number of sample: this refers to the number of times the same study was done. The larger this number of times, the more likely that the average value of the obtained statistics will equate the parameter.

and

Chloroquine sensitivity confirmed

I would like to corroborate the findings on chloroquine efficacy of P Barduagni et al (Cent Afr J Med 1998;44(10):251-4).

In the neighbouring province of Mashonaland Central we carried out a similar study in the 1997 malaria season to establish the in vivo chloroquine resistance in patients presenting to three different centres. Our methods were the same except that we used the previous WHO guidelines on in vivo resistance studies that stipulate an examination on day 2, whereby a parasite density of more than 25% of that on day 0 qualified as early treatment failure.

Central African Journal of Medicine, Vol. 45, No. 2, 1999, pp 49-51

Testing for HIV infection and the law

TJ NYAPADI

What has prompted me to write this article is a medical practice in this country which seems to be growing unchecked. The practice to which I refer is the testing of patients for HIV by doctors without first obtaining the consent of the patients. This is happening particularly when patients are admitted for an operation, when medical reports are requested by employers, in clinics attended by expectant mothers and when treating those with sexually transmitted diseases (STDs). The main thrust of this article is to discuss the legal framework of such practice.

Central African Journal of Medicine, Vol. 45, No. 2, 1999, pp 51-53

Ethical considerations in the care of the patient with HIV/AIDS

IT GANGAIDZO, J MIELKE, JA MATENGA

Introduction

These are the proceedings of a hypothetical case presented at the Wednesday Clinical Meeting, by the Department of Medicine, Parirenyatwa Hospital. The case was based on actual life experiences that were obtained in the care of HIV/AIDS patients. The discussion was guided in such a way as to place emphasis on ethical issues and less on clinical considerations. The aim was to draw on participants' experience and practice of medicine in today's Zimbabwe. For the purpose of discussions, it was accepted that absolutely correct opinions in ethical issues of medical practice in relation to AIDS/HIV may not exist, and that the discussion was as important as any conclusions that may be reached.