African
Journals Online
The Central African Journal of
Medicine
ABSTRACTS (Vol.46. No
2.)
The Central African Journal of
Medicine, Vol. 46, No. 2 pp. 27-31
ORIGINAL ARTICLES
Effects of Zimbabwe Defence Forces training
programme on body composition and reproductive hormones
in male army recruits
C R SEWANI-RUSIKE, K S M T MUDAMBO, G TENDAUPENYU, C
DZUDA, A TAFIRENYIKA, E ZENDA
Abstract
Objectives: To investigate the effects of a
four month endurance training programme on body
composition and reproductive hormone levels.
Design: PRE and POST training comparative
study.
Setting: Zimbabwe Military Academy, Gweru,
Zimbabwe.
Subjects: 77 male recruit volunteers
participating in the Zimbabwe Defence Forces cadet
training programme.
Main Outcome Measures: Percent body fat, fat
free mass, body mass index, total serum testosterone,
luteinising hormone (LH) and follicule stimulating
hormone (FSH) compared using the paired t-test.
Results: There was a significant decrease in
all parameters measured after four months of endurance
training. Decreases in body composition parameters were
54% in percent body fat, 6% in fat free mass, and 13% in
body mass index. There was a dramatic 58% drop in
testosterone, 60% drop in LH and 15% drop in FSH after
four months of endurance training.
Conclusions: The Zimbabwe Defence Forces cadet
training programme, an endurance training programme
induces a state of negative energy balance in trainees.
This results in a decrease in fat free mass due to
gluconeogenic utilisation of muscle protein as energy
source for muscle activity. There is impaired
hypothalamic-pituitary-testicular axis function as
evidenced by the state of hypogandal-hypogonadism ((low
testosterone, LH and FSH). This may be attributed to: 1.
Gonadotrophin releasing hormone pattern generator
malfunction due to the stress of intense physical
activity and 2. Withdrawal of energy expenditure from
reproductive machinery as a way of conserving energy for
more vital processes in the prevailing state of energy
starvation.
The Central African Journal of
Medicine, Vol. 46, No. 2 pp. 32-7
A community based study of HIV in women in rural
Gutu District, Zimbabwe 1992 to 1993
C NILSES, G LINDMARK, S MUNJANJA, L NYSTRÖM
Abstract
Objectives: To estimate the prevalence of HIV-1
infection and its relation to socio-economic and
obstetric history factors.
Design: A cross sectional study.
Setting: 12 randomly selected villages in rural
Gutu District, Zimbabwe.
Subjects: All women of fertile age (15 to 44
years) in the selected villages were invited to
participate. In total 1 213 women were interviewed and
examined. On average 75% and 81% of those eligible in
1992 and 1993 respectively participated (range for
villages 57 to 87%).
Main Outcome Measures: HIV sero-positivity.
Results: HIV prevalence was high, 21.9%. Single
women below 20 years had the lowest prevalence (7.6%),
while the highest (30.0%) was found in married women aged
20 to 29 years. Using a case-referent approach, women
divorced, widowed or separated had twice as high risk of
being HIV positive as single women (Odds Ratio (OR) =
2.03;95% confidence interval (CI) 1.40 to 2.93). There
was a huge difference in the prevalence of HIV between
villages, from 8.4 to 32.8%, thus the risk of having HIV
in the two villages with the highest prevalence was more
than five times higher (OR=5.21 and 5.31 respectively)
than in the village with the lowest. The multivariate
logistic regression confirmed the findings of an
increased risk for women aged 20 to 39 years as compared
with women 15 to 19 years, and for women that were
divorced, widowed or separated as compared with single.
It is also confirmed that the huge difference in the
prevalence found between wards was statistically
significant.
Conclusion: Women contract HIV early in
marriage. Young men's risk behaviour needs to be
addressed and women must be aware of their risks before
marriage.
The Central African Journal of
Medicine, Vol. 46, No. 2 pp. 38-41
Is antenatal antibody screening worthwhile in
the Zimbabwean population?
A Z CAKANA, L NGWENYA
Abstract
Objectives: To determine the incidence of
clinically significant allo-antibodies in antenatal care
(ANC) patients, and make recommendations on laboratory
management of such cases in similar settings in Zimbabwe.
Design: A retrospective study.
Setting: Harare Central Hospital, a tertiary
medical centre in Harare.
Subjects: Patients attending the ANC clinic at
Harare Central Hospital.
Main Outcome Measures: Blood group tests,
allo-antibody screen, development of haemolytic disease
of the newborn.
Results: 3000 patients were grouped and
screened and 96.7% were found to be Rhesus positive, 0.5%
were Rhesus D positive and 2.8% were Rhesus negative. An
overall antibody incidence of 1.7% (n=50) was obtained,
1.0% (n=30) of which were strongly positive and 0.7%
(n-20) were so weakly positive so that no antibodies
could be identified. Antibodies identified from those
patients with strongly positive antibody screen were
anti-D 13,3% (n=4), anti-E6.7% (n=2), anti-Jsb 3,2%
(n=1), anti-Lea 23,3% (n=7) and anti-Leb 20% (n-6).
Antibodies of unknown specificity were detected from 20%
(n=6) of the patients. Four (13,3%) of specimens were
insufficient for antibody identification.
Clinical records of those patients with a strongly
positive anti-body screen were examined and anti-D and
anti-Jsb were observed to have caused severe to fatal
Haemolytic Disease of the Newborn (HDN). The four anti-D
positive cases resulted in two still births and two
jaundiced babies. The single anti-Js positive antibody
case resulted in an intra-uterine death. Antibodies that
are generally considered of no clinical significance did
not cause HDN in this study.
Conclusion: Anti-D remains the most important
allo-antibody causing HDN, regardless of the availability
of anti-D immunoglobulin for prophylaxis. Only Rhesus D
negative women and those who have clinically significant
antibodies need have repeat antibody screens during the
rest of the pregnancy. In line with the current policy of
screening all patients at booking, the policy on repeats
is not clear and was not evident in this study.
The Central African Journal of
Medicine, Vol. 46, No. 2 pp. 41-3
Osteosarcoma in Ga-Rankuwa hospital: a 10 year
experience in an African population
M N MUTHUPHEI, M T MARIBA
Abstract
Objectives: This is a clinicopathological
correlation of cases of osteosarcoma diagnoses and
treated at Ga-Rankuwa Teaching Hospital.
Design: A retrospective study.
Settings: Department of Orthopaedics and
Anatomical Pathology at Ga-Rankuwa/MEDUNSA Academic
complex, a tertiary referral centre.
Subjects: 66 patients with a diagnosis of
osteosarcoma.
Main Outcome Measures: Records of the bone
tumour registry were reviewed and cases of osteosarcoma
were identified. Slides were retrieved and the diagnoses
confirmed in all cases. Information pertaining to
clinical presentation and patients' survival was obtained
from the clinical records.
Results: The patients' ages ranged from nine
years to 75 years with a mean of 19.7 yeas (median 17
years). Most cases occurred around the knee and the male
to female ratio was 2.7:1. The five year survival rate
was 7.5% and only 25.8% survived for one year.
Conclusion: Our patients present with advanced
disease leading to poor survival.
The Central African Journal of
Medicine, Vol. 46, No. 2 pp. 44-5
CASE REPORT
Ileo-caecal tuberculosis mimicking colonic
tumour – case report
A U MUKHTAR
Abstract
A case of ileocaecal tuberculosis simulating a colonic
tumour is reported. A 43 year old male patient presented
with abdominal pain, weight loss, fever and right iliac
fossa mass. Laboratory investigations and ultrasonography
were not specific. Laparotomy with ileocaecal resection
was carries out and histopathological examination
confirmed the diagnosis of tuberculosis
The Central African Journal of
Medicine, Vol. 46, No. 2 pp. 46-54
REVIEW ARTICLE
Trends in cancer pain management
K BHAGAT, H M CHINYANGA
Abstract
Background: Pain is a prevalent symptom in cancer
patients, affecting up to 50% of patients undergoing
active cancer treatment and up to 90% of those with
advanced disease. Although adequate relief can be
achieved in the majority of cancer patients, pain is
often treated inadequately in traditional settings and
sometimes even under the management of more specialise
units.
In this review the authors use their experience and
that of others to review the evaluation and diagnosis of
pain syndromes and the principles of management. This is
keeping with increasing recognition by bodies such as the
World Health Organisation and other governmental agencies
who have recognised the importance of pain management as
part of routine cancer care. Conducting a comprehensive
assessment, competently providing analgesic drugs, and
communicating with the patient and family allow effective
management of pain in the cancer patient.
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