Mpilo Central Hospital

Cattle and pig farming play a critical role in sustaining livelihoods and ensuring food security in Sub-Saharan Africa. However, diseases and conditions leading to carcasses and offal condemnation at abattoirs are significant threats. This study sought to address gaps in recent data relating to the causes of carcass and offal condemnations in cattle and pigs at selected abattoirs in the Matabeleland region of Zimbabwe and the resulting economic losses. Meat inspection condemnation records for the period 2017 to 2022 were accessed from the Veterinary Public Health Department in Bulawayo. A total of 402,668 cattle and 55,177 pigs were slaughtered during this period. Pigs had significantly higher organ condemnation rates than cattle (4–12% vs. 0.5–1.6%). The liver was the most condemned organ in cattle, mainly due to fasciolosis, while the lungs were most condemned in pigs, primarily from contamination. Partial and whole carcass condemnations were more common in cattle (1,957, 0.5% of carcasses examined) than pigs (28, 0.05% of carcasses examined), mostly due to Taenia saginata and Taenia solium cysticercosis, respectively. Economic losses were estimated at USD 551,038 for cattle and USD 21,252 for pigs. Our study provides insights into important zoonotic and food safety issues in livestock production in Zimbabwe and baseline data to inform interventions to reduce condemnations and associated economic losses.

The Coronavirus Disease 2019 (COVID-19) posed significant health policy challenges, particularly for low-income countries, where policymakers faced both direct threats from the virus and social and economic harm owing to lockdown measures. We present a holistic contextualized case study of the direct and indirect impacts on women and children, highlighting disparities across socioeconomic, age, and gender groups. We utilized multiple data sources, including primary and secondary data from 28 in-depth interviews, six focus group discussions, and 40 household interviews, as well as data from government reports, District Health Information Software version 2 (DHIS2), and published research. A conceptual framework was devised to hypothesize causal pathways and guide the analysis of results. The findings indicate that the pandemic not only had direct effects, on morbidity and mortality, but also more severe indirect impacts, including job losses and limited access to healthcare, including maternal and child healthcare services, due to measures put in place to control it, which were exacerbated by well-known but inadequately considered preexisting political and economic challenges. The most severe indirect effects on healthcare services availability and wider livelihoods fell on the poorest segments of society, further widening the age and gender inequalities. Policymakers faced significant challenges in managing the direct and indirect harm of COVID-19, including short- and long-term effects and their unequal distribution across society. We conclude that the indirect effects of COVID-19 were at least as harmful, if not more so, than the direct impacts, especially for women and children. In the future, it is highly recommended to establish specific protocols and guidance for maternal and child health service access, including strategies that reduce barriers to social support.

Postpartum depression is a common and serious mental health problem which is associated with maternal distress and negative consequences for the offspring. Research confirms the presence of differences in the prevalence of postpartum depression in different social groups. The aim of this study was to compare the severity of maternal symptoms in Poland and Zimbabwe and to identify risk factors occurring in both groups. The survey was conducted in 2022 among mothers who gave birth at the Department of Neonatology and Rare Diseases and at the Mpilo Central Hospital Maternity Clinic. The Edinburgh Postnatal Depression Scale was used to assess the risk of postnatal depression. A total of 945 patients were included. The study indicated statistically significant differences in the percentage of women with an increased risk of postpartum depression, with the percentage for the Polish group being 13.54 % and the Zimbabwean group 35.74 %. For the Zimbabwean group, the risk of depression was associated with a problem in obtaining breastmilk and these were women in informal partnerships or those without a stable partner. In the group of Polish patients there was evidence of a correlation between increased risk and having a stable, non-formalised relationship. According to the analysis, women in Zimbabwe are more likely to be at risk of postpartum depression than Polish women. PPD remains an important issue in obstetric practice, and it is necessary to sensitize health care personnel to the risk of PPD to make timely and appropriate clinical interventions.

Globally, persons with disabilities are faced with unemployment and reduced income opportunities. Barriers to employment tend to be severe for women with disabilities who occupy marginalized positions in labor markets. 'Livelihood occupations' are conceptualized for this review to denote everyday activities that are done for subsistence and survival, and to broaden presentations of activities normally termed 'work', 'employment', 'job' or 'productivity' that people do to earn money and non-monetary gain. This scoping review, undertaken as part of a broader interpretive phenomenological analysis of livelihood occupations of women with disabilities, maps research on the subject of livelihood occupations for women with disabilities. The Arksey and O'Malley framework and PRISMA extension for scoping reviews were utilized to guide the five stage scoping strategy used to screen and select sources. Data from selected sources were synthesized using deductive qualitative content analysis to fit experiential components into equity categories determined a-priori from the Equitable Total Rewards model, to determine if these experiences connote equity or lack thereof. Nineteen sources, mainly from high income countries, are identified. Aspects of benefit and career inequity were largely evident in the experiences of the women across all sources. There is considerable lack of research on experiences of livelihood occupations in low and middle income countries contexts justifying further research. Women with disabilities report experiencing inability to realize career goals and occupational choice.

Youth living with HIV are at higher risk than adults of disengaging from HIV care. Differentiated models of care such as community delivery of antiretroviral therapy (ART) may improve treatment outcomes. We investigated outcomes across the HIV cascade among youth accessing HIV services in a community-based setting. This study was nested in a cluster-randomised controlled trial (CHIEDZA: Clinicaltrials.gov, Registration Number: NCT03719521) conducted in three provinces in Zimbabwe and aimed to investigate the impact of a youth-friendly community-based package of HIV services, integrated with sexual and reproductive health services for youth (16-24 years), on population-level HIV viral load (VL). HIV services included HIV testing, ART initiation and continuous care, VL testing, and adherence support. Overall 377 clients were newly diagnosed with HIV at CHIEDZA, and linkage to HIV care was confirmed for 265 (70.7%, 234 accessed care at CHIEDZA and 31 with other providers); of these 250 (94.3%) started ART. Among those starting ART at CHIEDZA who did not transfer out and had enough follow up time (>6 months), 38% (68/177) were lost-to-follow-up within six months. Viral suppression (HIV Viral Load <1000 copies/ml) among those who had a test at 6 months was 90% (96/107). In addition 1162 clients previously diagnosed with HIV accessed CHIEDZA; 714 (61.4%) had a VL test, of whom 565 (79.1%) were virally suppressed. This study shows that provision of differentiated services for youth in the community is feasible. Linkage to care and retention during the initial months of ART was the main challenge and needs concerted attention to achieve the ambitious 95-95-95 UNAIDS targets.

Esophageal intubation is a common accident and failure to detect it can result in fatality. The objective of this study is to suggest the primary the auscultation of the epigastric area as mean of rapid diagnosis of esophageal intubation. A cross sectional study was carried out at the N’djili hospital in Kinshasa from June to September 2020. The sampling was randomly made and two groups of the population were selected. In the study group, the endotracheal intubation was indirectly confirmed by the absence of borborygmi on auscultation of the of epigastric area whereas in the control group, it was confirmed by the presence of vesicular murmur in armpits. After intubation, the investigator counted the time from the moment the chest piece of the stethoscope was placed in the armpit to confirm tracheal intubation or on the epigastric area to rule out esophageal intubation. The chest compression was also performed to check fogging of endotracheal tube. The time counted was the time between the placement of the chest piece of the stethoscope and the diagnosis of esophageal intubation. Seven cases of esophageal intubation were recorded out of sixty-two patients intubated. The average time for diagnosing esophageal intubation was 15 ± 5.6 seconds in the study group and 24 ± 3.2 seconds in the control group (Z= 8.035; p &lt; 0.0001). Based on the time recorded, the primary auscultation of the epigastric area can quickly detect esophageal intubation as opposed to the auscultation of the armpit. “The sign the cross” could be used as chronogram to confirm tracheal placement of the tube.

La Organización Mundial de la Salud (OMS) informa que ocurren 1.1 millones de casos de tuberculosis (TBC) en niños &lt;15 años. En Chile se observa un aumento de casos en el tiempo. La pandemia por SARS-Cov2 ha implicado una disminución de la pesquisa y un retardo de la atención y diagnóstico de TBC. Se presenta dos casos clínicos de tuberculosis en adolescentes. El primero corresponde a un adolescente con una tuberculosis pulmonar de difícil y tardío diagnóstico, habiéndose descartado inicialmente TBC por estudio molecular y PPD no reactivo. El segundo caso corresponde a un adolescente con una tuberculosis pulmonar y extrapulmonar de diagnóstico tardío, de 8 meses de evolución, posterior a un cuadro leve de Covid.

A phytobezoar occurring in the stomach is uncommon. The most frequent symptoms are dyspepsia, abdominal pain, nausea and vomiting. It is an important differential to remember in those patients with risk factors for developing phytobezoars, as phytobezoars can be managed conservatively in most cases.

Abstract Background: On 27th March the Zimbabwean government declared the Covid-19 pandemic a ‘national disaster’. Travel restrictions and emergency regulations have had significant impacts on maternity services, including staff shortages, resource stock-outs, and closure of antenatal clinics. Estimates of the indirect impact of Covid-19 on maternal and perinatal mortality expect it to be considerable, but little data is yet available.This study aims to examine the impact of Covid-19 and lockdown control measures on non-Covid outcomes in a government tertiary level maternity unit in Bulawayo, Zimbabwe, by comparing maternal and perinatal morbidity and mortality before and after lockdown was implemented.Methods: This is a retrospective, observational study, using a cross-sectional design to compare routine monthly maternal and perinatal statistics three months before and after Covid-19 emergency measures at Mpilo Central Hospital.Results: Between January-March and April-June 2020, average monthly deliveries fell from 747 to 681 and Caesarean section rates from 29.8% to 26.6%. Women with unbooked pregnancies presenting in labour almost doubled from 4.4% to 8%. There was no substantial change, however, in maternal mortality or severe maternal morbidity (post-partum haemorrhage (PPH), uterine rupture, severe preeclampsia/eclampsia), stillbirth rate or special care baby unit (SCBU) admission. There was a small increase in early neonatal death (ENND) from an average of 18.7 to 24.0 deaths per month.Conclusion: Maternal and perinatal outcomes must continue to be monitored to assess the impact of Covid-19 and lockdown measures as the epidemic in Zimbabwe unfolds. Despite the vulnerability of the healthcare system, the resilience and commitment of maternity units and healthcare workers to providing care in the most difficult circumstances should not be underestimated.