Browsing by Author "Sibanda, E."

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    Midwife led maternity care models: A scoping review
    (2023) Danda, G.; Chaibva, C.N.; Chauraya, Y.; Gwatiringa, C.; Chamisa, J.A.; Dabengwa, I.M.; Moyo, H.; Mantula, F.; Sibanda, E.
    Introduction: Midwife led maternity care models focus on normality, continuity of care and being cared for by trusted midwives from preconception throughout pregnancy, labour and the postnatal period. The aim of this model is to provide care either in community or hospital settings, normally to healthy women with uncomplicated pregnancies. Methods: The scoping review used search terms for the PICO components with synonyms, related terms and specialist terms were harvested from the Medical Subject Headings (MeSH)© and Embase© using Rayyan. Database searches were from PubMed, EBSCO-CINAHL, Dimensions, Web of Science, SCOPUS, and the Cochrane Library of Systematic reviews and African Journals Online (AJOL). A total of 17 058 citations were identified and 69 remained for analysis after removing duplicates and others which did not meet the criteria. Results: Of the 69 included studies, 14 were qualitative, 34 were quantitative, 19 were RCTs and 2 were mixed methods. Only 13% of the studies were from Africa and the rest were from the developed world. Six themes emerged as follows: reduced interventions in labour; positive birth outcomes; satisfaction with care; cost effectiveness of services; autonomous practice and quality midwifery services; good woman–midwife relationship and several subthemes. Discussion: Midwife-led care had a significant positive effect on physiological outcomes for women when compared to physician-led care, had reduced surgical interventions and augmentation, as well as less usage of pharmacological analgesia. This may also assist in acceptability, accessibility and availability of such a model in all maternity care units and community settings in LMICs.
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    Sensitisation to Imbrasia belina (mopane worm) and other local allergens in rural Gwanda district of Zimbabwe
    (2022) Ndlovu, V.; Chimbari, M.; Ndarukwa, P.; Sibanda, E.
    Background: The prevalence of allergic diseases is increasing in Zimbabwe and the data relate to local as well as exotic allergen sources. As entomophagy, the practice of eating insects, is a recognised source of local allergens, we sought to measure the prevalence of and risk factors for sensitisation to Imbrasia belina (mopane worm), a popular edible insect. This was investigated alongside other locally relevant allergens in a rural community in Gwanda district, south of Zimbabwe. Methods: A cross sectional study was conducted among 496 adults and children aged 10 years and above in Gwanda district, a mopane worm harvesting area in Zimbabwe. Data on individual characteristics and mopane worm exposure factors were collected using questionnaires. Sensitivity to allergens was assessed by performing skin prick tests at a local clinic using 10 different commercial allergen extracts (Stallergenes, France) and in-house extracts of mopane worm (Imbrasia belina) and mopane leaves (Colophospermum mopane). Data were analysed using Stata version 13 software. Results: The prevalence of sensitisation to at least one allergen was 31.17% (n = 144). The prevalence of atopy was higher in adults (33.33%) than in children (23.53%) (p = 0.059). The commonest inhalant allergen sources were mopane worm (14.29%), Tyrophagus putrescentiae (14.29%), mopane leaves (13.42%), Alternaria alternata (6.49%) and Dermatophagoides pteronyssinus (6.49%). Polysensitisation was demonstrated in the study population and of the 108 participants (75%) who were sensitised to two or more allergens, 66 (61%) were women. Sensitisation to mopane worm and mopane leaves often clustered with Tyrophagus putrescentiae amongst adults. Adjusted logistic regression analyses between mopane worm sensitisation and self-reported exposure variables showed that sensitisation was more likely amongst mopane worm harvesters (OR = 1.92, 95%CI = 0.77–4.79), those who cooked or roasted mopane worms during harvesting (OR = 2.69, 95%CI = 0.78–9.31) and harvesting without personal protective equipment (PPE) (OR = 2.12, 95%CI = 0.83–5.44) compared to non-harvesters. Conclusion: Atopic sensitization was common in this mopane worm harvesting community in Gwanda district of Zimbabwe. There was frequent co-sensitisation of mopane worm and mopane leaves with Tyrophagus putrescentiae in children and adults. It is important to determine the clinical relevance of our findings, particularly relating to mopane worm sensitisation.