Gweru Provincial Hospital

BackgroundPatients with non-ST-segment elevation myocardial infarction (NSTEMI) often have three vessel disease (TVD). The Thrombolysis in Myocardial Infarction (TIMI) risk score is a commonly used bedside tool for risk stratification; however, its diagnostic accuracy for predicting TVD remains uncertain. Therefore, this study was conducted to assess the diagnostic performance of the TIMI score in the prediction of TVD among patients with NSTEMI with coronary angiography as the reference standard.Material and methodsA total of 185 patients with NSTEMI were included in this cross-sectional study. TIMI risk scores were assessed on admission, and the patients underwent coronary angiography. Diagnostic performance was then evaluated using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).ResultsThe mean age of the cohort was 62.78±9.29 years, and 70.3% were male patients. TVD was angiographically validated in 85.4% of patients. Using a TIMI score > 4, the sensitivity was 71.5%, specificity 66.7%, PPV 92.6%, and NPV 28.6%. Post hoc analysis revealed significantly higher TIMI scores in patients with TVD (p<0.001), male patients (p=0.032), diabetics (p=0.041), and urban residents (p=0.028).ConclusionThe TIMI score demonstrates moderate diagnostic performance for predicting TVD in patients with NSTEMI, with high PPV but low NPV. It could be a useful preliminary screening method; however, it cannot substitute angiography for a final, definite diagnosis.

Little is known about the burden of silicosis in Africa, despite extensive mining and construction operations in the region putting numerous people at risk. The implementation experience and costs of case-finding for occupational lung disease in resource-limited settings are also currently unknown. We describe the first-ever silicosis case-finding project in rural Rwanda using chest X-ray, symptom questionnaires, and spirometry. This was coupled with routine noncommunicable disease case-finding for diabetes and hypertension. We performed an ingredient-based analysis of the costs of all case-finding activities. In 2022, over 25 days, 1,032 mine workers were included in the program, of which 1,014 (98.3%) completed silicosis case-finding activities. The total cost of the program was estimated to be US$38,656, representing a cost of US$37.49 per person. We conclude that conducting large-scale occupational lung disease case-finding is clinically and economically feasible in resource-limited settings and can be effectively integrated with routine noncommunicable disease case-finding.

Introductionwhen the first cases of COVID-19 were reported in Zimbabwe in March 2020, the local outbreak was characterised by an insidious increase in national caseload. This first wave was mainly attributable to imported cases, peaking around July 2020. By October 2020, the number of cases reported daily had declined to less than 100 cases per day signalling the end of the first wave. This pattern mirrored the global trends. In December 2020, reports of new COVID-19 variants emerged and coincided with the beginning of the second wave within the ongoing pandemic. This paper reports on the analysis conducted on the new wave of COVID-19 beginning December 2020 to January 2021. The objective of this study was to document the evolving presumptive second wave of the COVID-19 pandemic in Zimbabwe from December 2020 to January 2021.Methodsthis is a retrospective analysis of secondary data extracted from the daily situation reports published by the Ministry of Health and Child Welfare, Zimbabwe and World Health Organization Country Office, Zimbabwe. The period under consideration started from 1st December 2020 to 31st January 2021.Resultsthere was a 333% increase in the number of confirmed COVID-19 cases starting 1st December 2020, to 31st January 2021. These new cases were mainly attributed to community transmission though there were a few imported cases. There was a 439% increase in the absolute number of deaths; however, the case fatality rate remained low at 3.6%, and comparable to that from other countries. Harare, Bulawayo and Manical and provinces accounted for 60% of the case burden, with the other seven provinces only accounting for 40%. By mid-January, the number of incident COVID-19 cases started to decline significantly, to levels similar to the residual levels seen during the first wave.Conclusionthe second wave, which lasted a period of less than 2 months, had a steep rise and sharp decline in the incident cases and fatalities. The steep rise was attributable to increased mobility, with a consequent increase in the chains of community transmission. The declines, noted from mid-January 2021, may be partly attributable to a strict national lockdown, though more in-depth exploration of the drivers of transmission is needed to tailor effective interventions for future control. Differentiated strategies maybe needed according to the case burdens in the different provinces. In anticipation of further waves, the introduction of safe and effective vaccines might be the game changer if the vaccines are widely availed to the population to levels adequate to achieve herd immunity. Meanwhile, infection prevention and control guidelines must continue to be observed.

IntroductionMost patients diagnosed with diabetes in sub-Saharan Africa (SSA) present with poorly controlled blood glucose, which is associated with increased risks of complications and greater financial burden on both the patients and health systems. Insulin-dependent patients with diabetes in SSA lack appropriate home-based monitoring technology to inform themselves and clinicians of the daily fluctuations in blood glucose. Without sufficient home-based data, insulin adjustments are not data driven and adopting individual behavioural change for glucose control in SSA does not have a systematic path towards improvement.Methods and analysisThis study explores the feasibility and impact of implementing self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes in rural Rwandan districts. This is an open randomised controlled trial comprising of two arms: (1) Intervention group—participants will receive a glucose metre, blood test strips, logbook, waste management box and training on how to conduct SMBG in additional to usual care and (2) Control group—participants will receive usual care, comprising of clinical consultations and routine monthly follow-up. We will conduct qualitative interviews at enrolment and at the end of the study to assess knowledge of diabetes. At the end of the study period, we will interview clinicians and participants to assess the perceived usefulness, facilitators and barriers of SMBG. The primary outcomes are change in haemoglobin A1c, fidelity to SMBG protocol by patients, appropriateness and adverse effects resulting from SMBG. Secondary outcomes include reliability and acceptability of SMBG and change in the quality of life of the participants.Ethics and disseminationThis study has been approved by the Rwanda National Ethics Committee (Kigali, Rwanda No.102/RNEC/2018). We will disseminate the findings of this study through presentations within our study settings, scientific conferences and publication in a peer-reviewed journal.Trial registration numberPACTR201905538846394; pre-results.

This paper discussed factors that influence choice of a university by students in Zimbabwe. A cross-sectional qualitative design involving the use of focus groups is used. The research revealed that choice of a university brand is influenced by a number of internal factors such as the quality of programmes offered by the institution, the brand name of institution, state of facilities, location of university, level of tuition fees, relationships and networks with stakeholders, and university visibility through communications. The implications are that universities should be treated as brands. The management focus should be on those attributes that form the core, tangible, augmented and potential components of the university brand. &nbsp; Key words: Brand, corporate brand management, university brand, brand attributes.

Acta PaediatricaVolume 91, Issue 5 p. 502-504 Beyond education and food: psychosocial well-being of orphans in Africa G Foster, Corresponding Author G Foster Department of Paediatrics, Mutare Provincial Hospital, Mutare, ZimbabweGeoff Foster, Department of Paediatrics, Mutare Provincial Hospital, Mutare, Zimbabwe (E-mail. [email protected])Search for more papers by this author G Foster, Corresponding Author G Foster Department of Paediatrics, Mutare Provincial Hospital, Mutare, ZimbabweGeoff Foster, Department of Paediatrics, Mutare Provincial Hospital, Mutare, Zimbabwe (E-mail. [email protected])Search for more papers by this author First published: 02 January 2007 https://doi.org/10.1111/j.1651-2227.2002.tb03266.xCitations: 37AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume91, Issue5May 2002Pages 502-504 RelatedInformation

During a 15 month period, 464 patients admitted to hospital with pelvic inflammatory disease (PID) were classified according to Monif's staging and treated following strict guidelines. Stage II, PID with peritoneal reaction, was treated with intravenous antibiotics. Stage III, PID with tubo-ovarian mass, was drained by posterior colpotomy when indicated or treated with triple antibiotics when high abdominal masses were present. Stage IV, ruptured tubo-ovarian abscess, was always surgically treated. Mortality was almost limited to patients with stage IV PID, 15% (3/20) of whom died. Morbidity included the need for laparotomy (in 1.6% (6/368) of stage II, 59.3% (45/76) of stage III, and 100% of 20 stage IV patients) and draining pus (in 6.6% (5/76) of stage III cases and 50% (10/20) of stage IV patients). This study also shows that unspecialised hospital staff are able to use Monif's staging correctly, and that acceptable results can be obtained with the limited resources that are available in most developing countries.

A survey was carried out in a maternity hospital in Gweru, Zimbabwe, in order to analyze the acceptance of Caesarean Section (C.S.). The behaviour of 210 pregnant women who had a previous C.S. was compared with that of a control group of 278 women with no history of C.S. More frequently, the former failed to attend antenatal clinic and came to the maternity hospital in an advanced stage of labour. The majority of them did not wish to have a further C.S. and did not know they were at high risk of complication. These observations have important implications for medical training and public health policy planning in African countries.