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- ItemForeign body of the spleen from percutaneous entry(Elsevier, 2019) Mungazi, S.G.; Ndebele, W.; Zimunhu, T.; Magara, M.; Mbuwayesango, B.; Muchuweti, D.; Muguti, E.G.; Gwini, G.; Gandanhamo, D.Foreign body (FB) aspiration and ingestion are fairly common in children. Sharp foreign bodies may also enter the body by penetration. In penetrating foreign bodies, commonly skin and the gastrointestinal tract are the affected organs. An impacted foreign body in the spleen is rare. The diagnosis can be challenging without a history of penetration. Herein, we report a case of an infant with a sewing needle that accidentally punctured the spleen after penetrating through the skin of the subscapular area. A history of FB penetration and imaging were essential to confirm the diagnosis. The sewing needle was successfully removed laparoscopically.
- ItemReducing maternal mortality: a 10-year experience at Mpilo Central Hospital, Bulawayo, Zimbabwe.(De Gruyter, 2023) Ngwenya, S.; Mhlanga, S.; Moyo, S.; Lindow, S.W.Objectives: Maternal mortality is one of the major Sustainable Development Goals (SDGs) of the global health community. The aim of the SDG 3.1 is to reduce global maternal mortality ratio considerably by 2030. The objective of this study was to document the epidemiological trends in maternal mortality for Mpilo Central Hospital. Methods: This was a 10 year retrospective study using readily available data from the maternity registers. The International Classification of Diseases-Maternal Mortality (ICD-MM) coding system for maternal deaths was used. Results: The maternal mortality ratio (MMR) declined from 655 per 100,000 live births in 2011 to 203 per 100,000 live births by 2020. The commonest groups of maternal mortality during the period 2011–2020 were hypertensive disorders, obstetric haemorrhage, pregnancy-related infection, and pregnancies with abortive outcomes. There were 273 maternal deaths recorded in the period 2011–2015, and 168 maternal deaths in the period 2016–2020. There was also a decline in maternal deaths due to obstetric haemorrhage (53 vs. 34). Maternal deaths due to pregnancy-related infection also declined (46 vs. 22), as well as pregnancies with abortive outcomes (40 vs. 26). Conclusions: There was a 69% decline in the MMR over the 10 year period. The introduction of government interventions such as malarial control, the adoption of life-long Option B+ antiretroviral treatment for the pregnant women, the training courses of staff, and the introduction of strong clinical leadership and accountability were all associated with a significant decline in the causes of maternal deaths.
- ItemThe 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.
- ItemMay Measurement Month 2021: an analysis of blood pressure screening results from Zimbabwe(2024) Gwini, R.; Beaney, T.; Kerr, G.; Poulter, N.R.; Mwembe, D.; Chifamba, J.The May Measurement Month 2021 campaign in Zimbabwe was aimed at assessing the frequency of hypertension and improving awareness among the population of the sequelae of elevated blood pressure (BP). Participants aged 18 years and above were recruited at outdoor booths to fill out a questionnaire and provide three BP measurements with 1-min intervals. Of the 2094 participants, over one-third (37.3%) were hypertensive, half of hypertensives (49.7%) were aware they had elevated pressure, and less than half (45.0%) of the hypertensive patients were on antihypertensive medications. Increasing age was directly proportional to hypertension with a large leap from 9.5 to 27.7% between the 18–29 and 30–39 age groups. Hypertension remains a major public health challenge in Zimbabwe. Improving access to preventive health screening services as well as treatment facilities is essential to early detect and control hypertension.
- ItemThe Potentials of a Maternal Mobile Wallet: a Qualitative Case Study on Opportunities and Challenges From Zimbabwe(2020-12-30) Nyati-Jokomo, Z.,; Dabengwa, I.M.; Chikoko, L.; Makacha, L.; Nyapwere, N.; Makanga, P.T.Background: There are no systems put in place regarding mobile money for maternal savings in Zimbabwe. Therefore, this paper aims to highlight: (a) existing strategies and experiences about maternal savings in Kwekwe District and, (b) examine the implications of household dynamics and current savings behaviour towards the feasibility of implementing the RoadMApp Maternal Healthcare Mobile Wallet (MHMW). Methods: Out of the 49 health facilities in Kwekwe, 2 hospitals (rural and urban), 4 rural health centres, 2 peri-urban, and 2 urban clinics were purposively selected for the study. Participants were recruited from these health facilities. 193 people took part in the study, through 11 Focus Group Discussions, 17 In-Depth Interviews, and 3 Community Meetings. The Socio ecological Model’s categories are applied to interpret the results taking into consideration the barriers and enablers of maternal savings. Results: There is a paucity of information on strategies for maternal savings in Kwekwe District, Zimbabwe. The critical enabler for the implementation of an MHMW could be the use of existing community structures, like the burial societies and other savings clubs. Some of the essential barriers include low access to mobile phones, inadequate network coverage, power outages, a general lack of saving culture by communities, and the hyperinflationary environment in the country. Conclusion: Although, the socio-economic status of households may be the best predictor of maternal savings, ancillary factors such as financial literacy, educational level, cultural norms, and religion will help to understand the psychosocial reasons why communities engage in maternal savings. When implementing an MHMW, specific attention should be paid to individual and community/institutional level factors such as subsidies/interests on amounts saved, enforcing financial discipline, building local level mobile network infrastructure, and relying on locally available persons/systems.