African Journals Online
The Central African Journal of Medicine

ABSTRACTS (Vol.45. No.3.)

Central African Journal of Medicine, Vol. 45, No. 3, 1999, pp 54-56

Use of packed red cells in a major hospital in Harare, Zimbabwe

EA Abayomi, G Zibwe, JO Adewuyi, A Mandisodza, AZ Cakana

Objectives: To document the current pattern of packed red cell (PC) usage and the crossmatch to transfusion ratio (C/T ratio) in a major city teaching hospital in Harare, Zimbabwe.

Design: Restropective, (audit).

Setting: Harare Central Hospital, a 1 200 bed multidisciplinary hospital located in Harare, Zimbabwe.

Main Outcome Measures: Amount of PC ordered and proportion collected for the year 1995. Quantity of PC used by different medical specialities.

Results: In 1995 a total of 8 292 PC were collected from Harare Hospital blood bank. This translates to an average PC usage for a 1 200 bed hospital of seven units per hospital bed per year.
Only 48.5% of PC crossmatched was collected with a C/T ratio of 2.1:1. Revenue loss of Z$478 434 is estimated to have occurred due to expired units and resource wastage from uncollected cross matched units. The largest consumer of PC was the Department of Gynaecology, followed by Surgery and Paediatrics.

Conclusion: Regular auditing of blood usage is recommended to promote the efficient use of PC in accordance with accepted international standards and local guidelines and practice.

Central African Journal of Medicine, Vol. 45, No. 3, 1999, pp 56-59

Kangaroo care for well low birth weight infants at Harare Central Hospital Maternity Unit - Zimbabwe.

RA KAMBARAMI, O CHIDEDE, DT KOWO

Objective: To describe the experience in a newly established Kangaroo Care Unit (KCU) at a tertiary level hospital and to identify factors associated with poor outcome in this unit.

Design: Cross sectional study.

Setting: Kangaroo Care Unit at Harare Central Hospital, Zimbabwe.

Subjects: Mothers admitted to the KCU and their well preterm infants.

Main Outcome Measures: Discharge home or referral back to the Neonatal Unit (NNU) for conventional care.

Results: 613 mother infant pairs were studied from May 1994 to December 1996. The median age for all mothers was 23 years (Q₁ =15, Q₃ =26). Fifty four percent of the infants were female. Median age at admission to KCU was 12 days (Q₁ = 1, Q₃ = 25). Seventy two percent of infants were discharged home from the KCU. The rest (28%) were referred back to NNU for conventional care. The odds of being referred back to the NNU were significantly higher if the infant was male OR=1.82 (95% CI: 1.25 to 2.66); if the birth weight was < 1 500 gms OR=1.52 (95% CI: 1.04 to 2.22); if the admission weight to the KCU was < 1500grams OR= 2.16 (95% CI: 1.42 to 3.29) or if the age on admission to KCU was 14 days or more OR =2.15 (95% CI: 1.44 to 3.29). These factors remained significant after adjusting for confounding. Mother's age, parity, booking status or whether admission was during the cold months or not had no significant bearing on the outcome in this unit. Reasons for referral back to NNU included apnoea (27%); respiratory distress (27%); aspiration pneumonia (18%); neonatal jaundice (8%); poor feeding (7%); ill mother (5%); sepsis (4%) and diarrhoea (3%).

On multivariate analysis birth weight was the strongest predictor for being referred back to the NNU OR= 10.753 (95% CI: 6.026-19.186).

Conclusion: Establishment of a KCU at a tertiary level hospital is feasible. Kangaroo care for well preterm infants is suitable for most mothers and their preterm infants. Infants were more likely to be referred back for convetional care if they were male, very low birth weight and if the age at admission was greater than two weeks. Further studies are needed to determine the long term survival of these infants.

Central African Journal of Medicine, Vol. 45, No. 3, 1999, pp 60-64

Use of alcohol and tobacco among secondary school teachers in Zimbabwe

AH EIDE, T BUTAU, SW ACUDA

Objective: To measure the prevalence and frequency of alcohol and tobacco use among secondary school teachers in Zimbabwe.

Design: Cross sectional survey.

Setting: 17 secondary schools in Harare, Mashonaland East and West and Matabeleland North Provinces (including Bulawayo).

Subject: 442 secondary school teachers, of whom half were males.

Main Outcome Measures: Prevalence of self-reported experience with alcohol and tobacco, frequency of alcohol use, alcohol type preferences and use of alcohol and tobacco by age and school type.

Results: Prevalence of alcohol was significantly higher among teachers at private schools as compared with the other school categories. Smoking varied between the school types for women but not for men. Except for private schools, both tobacco and alcohol prevalence among female teachers were significantly lower than for male teachers. Of the male teachers 44.6 % and 64.1% of female teachers reported never drinking; 38.6 % of male teachers and 8.2 % of female teachers reported drinking every day or at least weekly. Alcohol type preferences varied in general across school categories and between male and female teachers.

Conclusion: The study reveals a mixed picture of smoking and alcohol drinking among secondary school teachers. Relatively high levels of beer drinking among men as well as the particularly high levels of use programmes among private school teachers may constitute negative influence on the habits of students. This aspect should not be ignored when designing school-based prevention of substance use programmes among school children in Zimbabwe.

Central African Journal of Medicine, Vol. 45, No. 3, 1999, pp 64-68

People's perceptions about malaria transmission and control using mosquito repellent plants in a locality in Zimbabwe

N LUKWA, NZ NYAZEMA, CF CURTIS, GL MWAIKO, SK CHANDIWANA

Objective: To assess peoples' perceptions and knowledge about malaria transmission and control with special reference to the use of plants as mosquito repellents.

Design: Cross sectional study.

Setting: Mandeya ward "A" (33^o E and 18^o 30' S), Honde Valley, Zimbabwe.

Subjects: 226 household heads present when interview was conducted.

Main Outcome Measures: Mosquito control methods, spraying coverage, plants used to repel mosquitoes and reasons for using them.

Results: 215 (95.0%) of the respondents' homes had been sprayed and their understanding of malaria transmission was not related to compliance with the National Malaria Control Programme (NMCP). Taking mosquito control measures was related to knowledge of malaria transmission, with 24 (75.0%) of those who did not know, taking no measures of their own. The use of plants was mentioned by 50 (23.5%) of the respondents and the reasons given were that they were cheap 43 (86.0%), effective five (10.0%) and locally available two (4.0%). The plant which was mentioned as being used by all age groups was L. javanica 25 (50.0%) and the other plants were used to a lesser extent. Forty six (92.0%) of the people said that they had used plants for mosquito control. The leafy part of the plant was used by 43 (86.0%) and a fresh preparation 43 (86.2%) gave better protection than a dry one. The plants were crushed and applied on the skin by eight people (14.6%), burnt by 36 people (72.8%) and used in their original form by six people (12.6%) and used once per by day 42 people (84.0%).

Conclusions: One of the important points to emerge from this study is that, despite widespread knowledge about the morbidity of malaria, understanding about its prevention was generally low and this has negative implications on an integrated control programme.

Central African Journal of Medicine, Vol. 45, No. 3, 1999, pp 68-70

Oestrogen transdermal patches for post partum depression in lactating mothers - a case report

DE BALL, P MORRISON

Oestrogen transdermal patches are now being used in the prophylaxis and treatment of post partum depression. Oestrogens are known to have potential adverse effects on breastfed infants. This case describes jaundice and poor weight gain in the child of a lactating mother prescribed oestrogen transdermal patches. There is a need for caution in the use of this therapy in breast feeding mothers and health professionals should be alert for problems.

Central African Journal of Medicine, Vol. 45, No. 3, 1999, pp 70-76

Plague epidemiology and control in eastern and southern Africa during the period 1978 to 1997

BS KILONZO

Human plague is one of the important re-emerging zoonotic diseases threatening public health in some African, Asian and South American countries. During the period 1978 to 1997, Africa reported the largest numbers of plague cases and deaths in the world. During the decade 1978 to 1987, 19 countries reported 10 537 cases. Ten of the countries and 41.9% of the reported cases were in Africa. At least 14.5% of the cases reported in Africa died. Similarly, during the decade 1988 to 1997, 22 countries, 12 of which were in Africa, reported a total of 17 674 cases and 1 465 deaths. Of these, 11 711 cases of which 9.6% died, were reported from Africa.

Central African Journal of Medicine, Vol. 45, No. 3, 1999, pp 77-79

Letters To The Editor, and
Continued Health Education For The Practitioner

Abstract:-

Letters To The Editor:- Radical radiotherapy

When one talks of radical radiotherapy one is talking of radiotherapy being given with a curative intent.¹
A 'dose' of 6 000 cGy (1 cGy = 1 rad) is not always a curative dose. When one refers to 'dose' other people should not view this 'dose' in isolation - one should consider the overall time taken during the delivery of this dose and also the number of treatments (called fractions).²

Continued Health Education For The Practitioner:-
Anatomical basis for pressure on the common peroneal nerve

An attempt was made to explain the anatomical basis for the pressure on the common peroneal nerve which may lead to loss of sensation and "foot drop". By using available cadavers during routine dissections, it was observed that the attachments of the peroneus longus muscle on the head of the fibula are, in most cases, tendinous, and blended with the crural fascia and lateral (fibular) ligament, thereby, forming an inelastic band arching over the common peroneal nerve. In some other cases, the reflected fibres of the biceps femoris tendon, anterior tibiofibular ligament and iliotibial tract constituted a fibrous bridge over the nerve. The least occurrence was that of the nerve piercing the thick and inelastic anterior crural septum.