African Journals Online
The Central African Journal of Medicine

ABSTRACTS (Volume 45. No.6.)

The Central African Journal of Medicine, Vol. 45, No.6, 1999, pp: 136-140

Iron and alcohol content of traditional beers in rural Zimbabwe

T SAUNGWEME, H KHUMALO, E MVUNDURA, VM MOYO, VR GORDEUK, TA ROUAULT, ZAR GOMO, IT GANGAIDZO

Objectives: To determine the concentrations of iron and alcohol in traditional beer, as well as how these may be related to the brewing process.

Design: Cross sectional study.

Setting/Subjects: Rural communities living in four of Zimbabwe's nine provinces,

Main Outcome Measures: Ionic iron concentration and alcohol concentration in 94 different types of alcoholic beverages prepared in rural areas, and 18 commercially produced beers.

Results: The commonest types of traditional beer were a seven day beverage called 'doro rematanda ', a by-product of this seven day beer called 'muchaiwa,' and a one-day beverage called 'chikokiyana'. Methods of preparation were similar in the four provinces. Median (Q_l,Q₃) ionic iron concentrations were 52 (31 to 75) mg/L for the seven-day beer (n= 51), 24 (18 to 36) mg/L for muchaiwa (n= 30) and 21 (17 to 63) mg/L for chikokiyana (n= 13). In contrast, ionic iron concentrations in 12 samples of commercially prepared clear beers were 0.1 mg/L and in commercial opaque beer were 3.6 mg/L. Mean (SD) alcohol concentration in traditional beer was 4.1 g/100 ml (| 0.873) compared to 2.8 g/100 ml | 1.394) in the muchaiwa and 3.6g/100ml (| 1.445 ) in the one day brew, chikokiyana. Mean alcohol concentrations in the three commercial beers are reportedly 3.5 g/100 ml in the opaque beer (Scud), and 4.7 to 5.0 g/ml in clear beer (Zambezi and Castle lagers).

Conclusions: Several preparation methods lead to traditional fermented beverages with very high iron concentrations. Measures to prevent dietary iron overload should include all of these beverages in their scope.

Central African Journal of Medicine, Vol. 45, No. 6, 1999, pp 141-144

Bioavailability of rifampicin in a separate formulation and fixed dose combination with isoniazid NIH: a case for a fixed dose combination (FDC) for the treatment of tuberculusosis

NZ NYAZEMA, P RABVUKWA, J GUMBO, P NDUDZO, C CHITEMERERE

Objectives: To study and compare the bioavailability of rifampicin (RIF), in two locally manufactured formulations; an FDC and a separate formulation and an imported FDC formulation.

Design: Open within subjects, single blind cross over study.

Interventions: Each volunteer subject, acting as their own control, received the two fixed dose combinations and the separate formulation with the same amount of 450 mg RIF.

Main Outcome Measures: Cmax (peak drug concentration achieved), Tmax (time at which peak drug concentration is achieved), T_el (biological half-life of elimination) and area under the curve (AUC) for zero to 10 hours and zero to infinity. These are obtained from plotting plasma concentration against time.

Results: There was a significant difference in the Cmax between free and RIF combined with INH (6.1 and 7.6 mg/l respectively) and no significant difference in the other parameters measured, of the local products. Comparison of the local products and imported product showed no significant difference in AUC but significant differences in T_el, C max and Tmax (p= 0.003, 0.041 and 0.025 respectively).

Conclusion: The Zimbabwe manufactured and the German products had "demonstrable bioavailability" as defined by the International Union Against Tuberculosis and Lung Diseases (IUATLD). The local manufacturer appeared to have the technological capability to produce a registrable combined RIF/INH table to be used in the treatment of tuberculosis and to prevent the irrational use of RIF.

Central African Journal of Medicine, Vol. 45, No. 6, 1999, pp 144-147

Aero-allergen sensitisation patterns amongst atopic Zimbabwean children

RA KAMBARAMI, F MARECHERA, EN SIBANDA, ME CHITIYO

Objective:To characterise children presenting with atopic conditions using the RAST test.

Design:Retrospective descriptive study

Setting:General paediatric clinic in the private sector.

Subjects:84 children aged below 12 years, who had the RAST test, who presented to a general paediatric clinic between 1993 and 1998 with atopic conditions for care.

Results:The median age for all children in the study was 52 months. Forty-eight were male and 36 female. Eczema (33.9%) was the most frequent clinical diagnosis especially in those less than 24 months of age, followed by asthma (25.5%), allergic conjunctivitis (24.0%) and allergic rhinitis (15.6%). Total IgE was not statistically significantly associated with clinical diagnosis(p=0. 889), age of the child (p=0. 102), gender (p=0.687) or absolute eosinophil count (p=0.3 18). The commonest allergens identified were dust mite (Dermarophygoides pteronissinus and D farinae) and Bermuda grass. While antibody reaction to weeds, particularly plantain, were also common, these reactions were mostly mild to moderate. Allergy to cats and moulds was rare.

Conclusion: In the absence of routine testing for specific allergens avoidance of dust mite and Bermuda grass seem important strategies in the management of difficult children with atopy. There is need for a prospective study to shed more light on the allergens that cause these common atopic conditions in our environment.

Central African Journal of Medicine, Vol. 45, No. 6, 1999, pp 148-154

The impact of an inadequate municipal water system on the residents of Chinhoyi town, Zimbabwe

U SCHWARTZ, S SIZIYA, M TSHIMANGA, P BARDUAGNI, TL CHAUKE

Objective: To assess the use and impact of the water reticulation system in Chinhoyi on its residents.

Design: Cross sectional and case series studies.

Setting: Chinhoyi town.

Subjects: 600 Chinhoyi residents.

Main Outcome Measures: Practices and perceptions of Chinhoyi residents on the water system, and distribution of water-related diseases per area of residence.

Results: Out of 600 respondents, 565 (99.3%) had access to piped water and 558 (98.0%) to flush toilets. Breakdowns of water supply and functioning of toilet facility were reported by 308 (77.0%) and 110(28.0%) respondents in the previous six months, respectively. Main complaints of Chinhoyi residents were about low water quality (36.2%), inadequate sewage system (313%) and environmental pollution (26.5%). Cases of water-related diseases were not associated with natural water bodies.

Conclusions: Chinhoyi residents have good access to the municipal water and an adequate sanitation system. However, low quality of the water, frequent system breakdowns and the degradation and loss of amenity of the environment impair their quality of life.

Central African Journal of Medicine, Vol. 45, No. 6, 1999, pp 155-156

CASE REPORT

Tuberculosis liver abscess in an HIV-infected patient

JH DAY, VJ ROBERTSON,IR TERNOUTH

Case Report

A 22 year old woman presented with a three week history of mid-abdominal pain, vomiting and watery diarrhoea associated with lower back pain. She had received courses of doxycycline, trimethroprim-sulfamethoxazole and chloramphenicol without improvement. She was found to be thin and pale with a fever of 39.9 degree C and oral thrush. There were no findings of note in the chest. Tender hepatomegaly was palpable 5 cm below the right costal

Central African Journal of Medicine, Vol. 45, No. 6, 1999, pp 156-158

CASE REPORT

Hardly a harmless analgesic

K BHAGAT, K TISOCKI

Introduction

Membranous nephropathy (MN), the most common cause of nephrotic syndrome in adults, is usually idiopathic, with an identifiable cause in only about 20% of cases.¹ Causes of secondary MN include various auto-immune diseases, neoplasms, infections, and drugs such as gold or penicillamine. Although minimal-change glomerulopathy associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDS) is a well established clinical entity,2,3 the association between NSAID use and MN is less well known.

A review of the literature revealed 14 separate cases of MN associated with NSAID use.4-7 In each case, other known causes of MN were excluded, and prompt resolution of the nephrotic syndrome was noted after cessation of NSAID therapy. The reported NSAIDs include diclofenac, ibuprofen, ketoprofen, phenylbutazone and sulindac.

We report here our experience with a case of MN and discuss the possible pharmacological/toxicological mechanisms of how NSAIDs might cause this pathology.

Central African Journal of Medicine, Vol. 45, No. 6, 1999, pp 158-165

EDITORIAL, CONTINUED HEALTH EDUCATION FOR THE PRACTITIONER and LETTERS TO THE EDITOR

EDITORIAL ABSTRACT

The need for a regular comprehensive health surveillance on industrial workers

M TANDAYI, EE OS IM, HM CHINYANGA

The movement of people during some of their daily occupations and activities releases an amount of dust into the air. Even dust that has settled on floors and flat surfaces is made airborne by air currents. Of greater concern is the dusty environment caused by the operations within the workplace, such as handling of dusty materials, machining, cutting, drilling, milling, rock blasting and pounding. Fortunately, a lot ofthe dust is harmless except when present in high concentrations when it can cause some discomfort. At such levels it is termed 'nuisance dust'. However, some form of dusts are distinctly harmful, giving rise to impairment of lung function and pneumoconiosis (dust-induced changes in the lung).

CONTINUED HEALTH EDUCATION FOR THE PRACTITIONER ABSTRACT

Oh no, not Nitric Oxide!

K BHAGAT

Nitric oxide (NO) is a unique, endogenous regulatory molecule that is involved in a wide variety of physiological processes in multiple organ systems. This simple gas functions as a cellular messenger in a broad range of biological activities that include blood pressure regulation, immuno-modulation and neurotransmission. It has also been implicated in a number of homeo static functions in the cardiovascular system: it is a significant determinant of basal vascular tone and, in addition is thought to regulate myocardial contractility and platelet aggregation. Dysregulation of NO mediated effects have been implicated in the pathogenesis of essential hypertension, atherosclerosis, and the hypotension associated with septic shock. This review will focus on these multiple effects of NO in the cardiovascular system.

LETTERS TO THE EDITOR - Abstracts

Hypotension and bedside leukocyte reduction filters

Kathryne C Zoon and Janet Woodcock, Elizabeth D Jacobson, Dr ME Chitiyo

Dear Sir,
This is to alert you to the possibility that patients who receive blood products transfused through a bedside leukocyte reduction filter may develop a precipitous drop in blood pressure. These reactions have a rapid onset. In some cases, patients also develop respiratory distress and shock. In most situations, the reactions resolve when the transfusion is discontinued and when appropriate medical intervention is performed.

Uses and misuses of percentages

Dr Seter Siziya

Dear Sir,
Percentages are widely used in many disciplines including the health professions.¹ A percentage is a rate per hundred.² Rates are common measures of the extent of diseases/conditions in a population. In a percentage, the numerator is part of the denominator. The symbol for percentage is %.