African
Journals Online
The Central African Journal of
Medicine
ABSTRACTS (Vol.45.
No.8)
Central African Journal of Medicine,
Vol. 45, No. 8, 1999, pp 195-198
Hepatitis B virus infection among pregnant women
delivering at Harare Maternity Hospital, Harare Zimbabwe,
1996 to 1997
S MADZIME, M ADEM, K MAHOMED, GB WOELK, S MUDZAMIRI,
MA WILLIAMS
Abstract
Objective: To determine the prevalence
of hepatitis B virus (HBV) carrier and infectivity status
among women delivering at Harare Maternity Hospital.
Design: A serological survey study of
pregnant women admitted for labour and delivery.
Setting: Harare Maternity Hospital, Harare,
Zimbabwe between June 1996 and June 1997
Subjects: A random sample of 1 000 women,
delivering at the hospital during the study period agreed
to participate in the study. Serum samples were available
for 984 women.
Main Outcome Measures: HBV carriage status
was determined by the presence o fhepatitis B surface
antigen (HBsAg) by enzyme immunoassay (EIA). Maternal HBV
infectivity status was determined by testing all HBsAg
positive women for the presence of hepatitis e surface
antigen (HBeAg) using EIA.
Results: Overall 246 (25%) women
were identified as carriers of HBV (95% confidence
interval 22 to 28%). The frequency of HBV carriers did
not vary with maternal age, parity or marital status.
Only a positive prior history of spontaneous abortion was
associated with an increased prevalence of HBV carriage
status. Eight of the 246 (3.3%) women identified as HBV
carriers tested positive for HBeAg. Hence, 0.8% of the
entire study population was found to be at high risk of
transmitting HBV to their newborns.
Conclusions: Our results demonstrate a high
prevalence of HBV carriage among women giving birth at
Harare Maternity Hospital. None of the demographic
variables studied were important predictors of HBV
carriage status. The high carriage rate and low
infectivity rates suggest that HBV infection is likely to
be acquired by horizontal, rather than by vertical means
of transmission. Given the scarcity of financial
resources, routine testing of mothers for HBsAg may not
be feasible. Our results suggest, however, that mass
vaccination of all infants, irrespective of maternal HBV
carriage status, may be the most effective approach to
HBV prevention and control in Zimbabwe.
Central African Journal of Medicine,
Vol. 45, No. 8, 1999, pp 198-203
A comparison of nutritional indices of children in
Chitungwiza, Zimbabwe, with the international reference
standard
LON NYIRONGO, J CHIDEME-MARADZIKA, G WOELK, GN
CHAPMAN, S SIZIYA
Abstract
Objectives: To examine the hypothesis
that, the fifth, 50th and 95th percentiles of the weights
and heights of primary school children of Chitungwiza
Municipality, (a town 30 km south west of Harare,
Zimbabwe), did not differ from those of the NCHS
reference population of children.
Design: A descriptive cross sectional
study.
Setting: Chitungwiza Municipality.
Subjects: Primary school children aged five
to 16 years
Main Outcome Measures: Height for age <
90%, weight for height < 80% and the comparability of
mean weights and heights between the study children and
the NCHS reference children.
Results: Low rates were found for height
for age <90% (stunting) and for weight for height
<80% (wasting) among the Chitungwiza children, 3.5%
(95% CI 2.8%, 4.7%) and 1.9% ( CI 0.9%, 3%),
respectively. The differences between age and sex matched
pairs of the sample mean heights and reference mean
heights, and of the sample mean weights and reference
mean weights at the fifth, 50th and 95th percentiles,
were significant. Chitungwiza children consistently
dropped below the NCHS mean weight and height for all
three percentiles.
Conclusion: This study has demonstrated
that stunting and wasting is low among Chitungwiza
primary school children but that the spread of their
heights and weights lies lower than the spread of the
heights and weights of the NCHS reference children.
We recommend that wider cross sectional and longitudinal
anthropometric assessments in a nation wide sample of
primary school children be carried out to shed more light
on the growth potential of Zimbabwean children.
Central African Journal of Medicine,
Vol. 45, No. 8, 1999, pp 204-209
Knowledge and practices of family planning in
Zimbabwe
U SCHWARTZ, M TSHIMANGA, LK SHODU
Abstract
Objective: To assess the level of
knowledge and use of family planning in Zimbabwe.
Design: Cross sectional study.
Setting: All eight provinces and two major
cities in Zimbabwe.
Subjects: Women of child bearing age (15 to
49 years, 6 083 respondents).
Main Outcome Measures: Number of live
births, knowledge of contraceptive methods, previous,
current and intention for future use of contraceptives,
method related problems.
Results: The contraceptive prevalence rate
was 59.6% (CI 95% 58.4 to 60.9). The median number
oflive births was two (Q1=l, Q3=4)
among all women, and seven (Q1=6, Q3=8)
among women aged 40 to 49 years. Of 6 083 women
interviewed, 5 849 (96.2%) knew at least one method of
modern family planning, and 4 743 (78.0%) had ever used a
contraceptive in their life. Health concerns were the
main reason for both discontinuation (28.5%) and
postponement (22.8%) of contraceptive use.
Conclusions: As compared to the 1991 Mother
and Child Health Survey, knowledge and coverage of family
planning services have improved further, and the
introduction of injectable contraceptives has proved a
success. Areas which need attention include the groups
with high parity that remain under served, the low
Central African Journal of Medicine,
Vol. 45, No. 8, 1999, pp 209-212
Malignant colorectal tumours in patients 30 years
and below: a review of 35 cases
AZ SULE, BM MANDONG
Abstract
Objective: To review malignant
colorectal tumour arising in patients 30 years and below.
Design: Retrospective cross sectional
descriptive study.
Setting: Jos University Teaching Hospital,
Jos, Nigeria.
Subjects: A total of 35 patients 30 years
and below.
Main Outcome Measures: Occurrence of
malignant colorectal tumours tends to be higher among men
and women over age 65 years and more common among
Whites than Blacks. The disease rarely presents in the
young population and the prognosis is usually
unfavourable. This may be due to a delay in the diagnosis
because colorectal cancer is not usually considered first
in this age group.
Interventions: 15 patients had
abdomino-perineal excision of the rectum, two right
hemicolectomy, one left hemicolectomy, two anterior
resection and six had colostomy and biopsy.
Results: Altogether, 149 patients were
treated for large bowel cancer. From then, 35 (23.6%)
given a yearly incidence of 3.5 were 30 years old or
younger. The mean age was 25 (STD ± 6) years, while the
M:F ratio was 1.2:1. Weight loss, bloody mucoid
diarrhoea, tenesmus and an anorectal mass were common
clinical features present for more than six months. The
rectum was involved in 24 patients (68.6%) and
adenocarcinoma either well/moderately well differentiated
or poorly differentiated was the predominant histological
type. All the cancers except four were advanced at first
presentation and treatment was merely palliative with
only 30% of those treated and followed up still alive at
six months. Complications of surgery were considered
minor with the exception of the pelvic abscesses and
deaths were due to the effects of the disease.
Conclusions: This study illustrates that
colorectal cancer is not rare, as it was previously
believed. Presentation is commonly late and prognosis
poor. In this age group, malignant colorectal tumours
should frequently be considered in the differential
diagnosis of bowel symptoms. The importance of the
prudence of the general practitioner is thus emphasized.
Central African Journal of Medicine,
Vol. 45, No. 8, 1999, pp 213-217
CASE REPORT
Traumatic intracranial aneurysms following
penetrating stab wounds to the head: two unusual cases
and review of the literature.
N NATHOO, SS NADVI
Abstract
Two patients with rare complications of traumatic
intracranial aneurysms following penetrating cranial stab
wounds are described. One patient had a good outcome
despite a secondary rupture of a traumatic proximal
middle cerebral artery aneurysm, while the second patient
had a traumatic basilar biflurcation artery aneurysm. To
our knowledge neither the survival from a secondary
rupture of a traumatic intracranial aneurysm, nor the
development of a basilar bifurcation aneurysm secondary
to a transcranial stab wound has been described
previously. Furthermore, this is the first report of the
technique of deep hypothermic cardiac arrest utilized to
treat a traumatic false aneurysm.
Traumatic intracranial aneurysms are a rare clinical
entity, most often diagnosed after rupture and often
resulting in fatal haemorrhage. A high index of suspicion
needs to be maintained when managing patients with
transcranial stab wounds. Early surgical intervention
improves outcome by preventing initial aneurysmal rupture
or rebleeding.
Central African Journal of Medicine,
Vol. 45, No. 8, 1999, pp 217-220
CASE REPORT
Not everything acid-fast is Mycobacterium
tuberculosis - a case of Nocardia
K BHAGAT, H IBRAHIM, K NAIK
Abstract
We report a case of a 47 year old woman who presented
with a history of motor convulsions and a three month
history of an increasingly painful and progressively
enlarging mass on the right side of her back.
Neurological examination revealed generalised wasting and
a right sided hemiplegia. A biopsy of the mass was taken
for microbiology which reported growing branching gram
positive rods after three days of incubation. A
mycological diagnosis of Nocardia asteroides was
made. An MRI scan revealed extensive infiltration of the
fungal mass into extending from the base of the skull to
fifth cervical vertebra.
Central African Journal of Medicine,
Vol. 45, No. 8, 1999, pp 220-224
REVIEW ARTICLES
Current treatment and future prospects for the
management of acute coronary syndromes
K BHAGAT
Abstract
The impact of ischaemic heart disease on the burden of
cardiovascular disease continues to escalate worldwide.
Although international statistics suggest a levelling off
in Western world, in the less industrialised parts of the
world the effects of this diases are only beginning to be
documented. Nonetheless, rapid advances have been made in
the diagnosis and management of the acute coronary
syndromes (the term which encompasses the protean
clinical manifestations of the ischaemic process). The
therapeutic strategies discussed in this article cover
two broad subjects that have been found to be critical in
the evolution of the disease:- i. interfering with the
haemostatic balance by retarding the thrombotic process;
ii. modifying local and systemic vasoconstricting
stimuli.
Central African Journal of Medicine,
Vol. 45, No. 8, 1999, pp 224-229
CONTINUED HEALTH EDUCATION FOR THE PRACTITIONER
: Hypertension in pregnancy-1
and
NOTES AND NEWS : The history of the
Central African Journal of Medicine 1953 to 1999
CONTINUED HEALTH EDUCATION FOR THE PRACTITIONER
- Abstract
Hypertension in pregnancy - 1
K MAHOMED
This review is aimed at clinicians working in a
country like Zimbabwe, with limited health care
resources. The management of the condition includes early
detection, control of blood pressure, monitoring for
maternal and foetal complications with timely delivery by
the most appropriate route.
NOTES AND NEWS - Abstract
The history of the Central African Journal of Medicine
1953 to 1999
Professor Herbert M Chinyanga, MSc, MD, FRCPC,
Chairman of CAJM Board of Directors
The Central African Journal of Medicine Company was
founded in 1953 and registered in 1954 in accordance with
the then existing company act. Its purpose was to assist
medical personnel in central Africa find a place to
publish the results of their research endeavours as well
as an avenue to disseminate their clinical observation
and updates. Since its first publication 46 years ago, to
the present, the journal has attracted research papers
from as far afield as Nigeria in West Africa, China, Hong
Kong, the middle east and all the SADC states.
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