Browsing by Author "Jones, B."

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    Determinants of eclampsia in women with severe preeclampsia at Mpilo Central Hospital, Bulawayo, Zimbabwe
    (Elsevier, 2021-07-15) Ngwenya, S.; Jones, B.; Mwembe, D.; Nare, H.; Heazell, A.E
    Objective: Globally, preeclampsia is a significant contributor to adverse maternal outcomes. Once women develop eclampsia, they face considerable risks especially in countries with limited resources to deal with such a life-threatening complication. This study was carried out to investigate determinants of eclampsia in pregnant mothers with severe preeclampsia. Study design. This institutional based study was completed at Mpilo Central Hospital, a quaternary referral unit from 1st January 2016 – 31st December 2018. In this study, pregnant women with severe preeclampsia/eclampsia were the study participants. The independent variables included socio-demographic and clinical characteristics, and maternal outcomes. Multivariable logistic regression analyses were used to determine independent association with p < 0.05 taken as statistically significant with 95% Confidence Interval (CI). Main outcome measure. Eclampsia. Results: Development of eclampsia was more frequent in women aged 14–19 years compared to women aged ≥ 35 years (adjusted odds ratio (AOR) 6.64, 95% CI 1.20–22.06, p = 0.02) and in primiparous women compared to women with parity ≥ 3 (AOR 2.76, 95% CI 1.48–5.15, p = 0.001). Eclampsia was more frequent in women with diastolic blood pressure of 131–150 mmHg (AOR 5.48, 95% CI 1.05–28.75, p = 0.04), and ≥ 150 mmHg (AOR 5.78, 95% CI 1.05–31.78, p = 0.04) compared with those with diastolic blood pressure of ≤ 110 mmHg. Symptoms of visual disturbances were also associated with eclampsia (AOR 2.13, 95% CI 1.08–4.18, p = 0.03). Conclusions: This study has identified independent determinants of eclampsia which can be used to identify which women should receive magnesium sulphate prophlyaxis or more intensive monitoring to prevent deterioration in maternal condition.
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    Stability Analysis and Optimal Control of a Limnothrissa Miodon Model with Harvesting
    (Discrete Dynamics in Nature and Society, 2022-05-05) Mutasa, F.K.; Jones, B.; Hove-Musekwa, S.D.; Tendaupenyu, I.H.; Nhiwatiwa, T.; Ndebele-Murisa, M.R.
    We construct a theoretical, deterministic mathematical model of the dynamics of Limnothrissa miodon with nutrients, phytoplankton, and zooplankton and investigate the effect of harvesting on the population density of Limnothrissa miodon in a lake. For the autonomous model, results from local stability analysis are in agreement with numerical simulations in that the coexistence equilibrium is locally stable, provided certain conditions are satisfied. The coexistence equilibrium is globally unstable if it is feasible. Numerical results show that a stable limit cycle exists for the nonautonomous model. Optimal control results show an optimal harvesting monthly effort of 15394 boat nights which corresponds to 505 fishing units, showing that there is overcapacity in Lake Kariba. A maximum sustainable annual catch of 34669 tonnes is obtained and simulation results show that Limnothrissa miodon abundance is more closely related to nutrient inflow than to harvesting.
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    The prevalence of and risk factors for stillbirths in women with severe preeclampsia in a high-burden setting at Mpilo Central Hospital, Bulawayo, Zimbabwe
    (De Gruyter, 2022) Ngwenya, S.; Jones, B.; Mwembe, D.; Nare, H.; Heazell, A.E.P.
    Stillbirth remains a global public health issue; in low-resource settings stillbirth rates remain high (>12 per 1,000 births target of Every Newborn Action Plan). Preeclampsia is major risk factor for stillbirths. This study aimed to determine the prevalence and risk factors for stillbirth amongst women with severe preeclampsia at Mpilo Central Hospital. A retrospective cross-sectional study was conducted of women with severe preeclampsia from 01/01/2016 to 31/12/2018 at Mpilo Central Hospital, Bulawayo, Zimbabwe. Multivariable logistic regression was used to determine risk factors that were independently associated with stillbirths. Of 469 women that met the inclusion criteria, 46 had a stillbirth giving a stillbirth prevalence of 9.8%. The risk factors for stillbirths in women with severe preeclampsia were: unbooked status (adjusted odds ratio (aOR) 3.01, 95% (confidence interval) CI 2.20–9.10), frontal headaches (aOR 2.33, 95% CI 0.14–5.78), vaginal bleeding with abdominal pain (aOR 4.71, 95% CI 1.12–19.94), diastolic blood pressure ≥150 mmHg (aOR 15.04, 95% CI 1.78–126.79), platelet count 0–49 × 109/L (aOR 2.80, 95% CI 1.26–6.21), platelet count 50–99 × 109/L (aOR 2.48, 95% CI 0.99–6.18), antepartum haemorrhage (aOR 12.71, 95% CI 4.15–38.96), haemolysis elevated liver enzymes syndrome (HELLP) (aOR 6.02, 95% CI 2.22–16.33) and fetal sex (aOR 2.75, 95% CI 1.37–5.53). Women with severe preeclampsia are at significantly increased risk of stillbirth. This study has identified risk factors for stillbirth in this high-risk population; which we hope could be used by clinicians to reduce the burden of stillbirths in women with severe preeclampsia.