https://library.adhl.africa/handle/123456789/11250 2026-04-07T07:19:13Z https://library.adhl.africa/handle/123456789/12445 Cerebrovascular diseases in Africans Levy, F. L. It is the belief of many doctors working in Africa that circulatory disorders in the atherosclerotic sense are not as common as in Europe. I have that same opinion for several reasons. In the first place we rarely see arteriosclerosis at post mortem examination and when we do so at our neuropathology sessions everyone crowds around to see the specimen. It is our impression however that when a vessel is affected by arteriosclerosis, and it is the basilar artery whose branches seem primarily involved, the involvement is of a very severe kind.Secondly I have never once explored the carotid bifurcation of an African patient for stroke and yet it is not an uncommon operation in Europe. This is not because our physicians are unaware of the condition of localized atherosclerosis, the majority of younger patients suffering an apparent cerebral thrombosis are subjected to arteriography, but none to date have required a cleaning out of the carotid bifurcation or of other accessible portions of the carotico-vertebral system. Finally, ruptured cerebral aneurysm and sub-arachnoid haemorrhage are less commonly seen than the size of the population would lead one to expect. It is of course therefore only an impression but I believe that age for age the arteriosclerotic rate is lower in Africans than it is in Europeans. Circulatory disorders in the atherosclerotic sense in Africa 1970-01-01T00:00:00Z https://library.adhl.africa/handle/123456789/12446 Factors associated with staffing of medical doctors and nurses in rural areas in Zambia Munachonga, M.E., creator; Siziya, S., creator To determine factors associated with staffing of doctors and nurses in rural health institutions in Zambia. A cross sectional study was conducted among qualified medical doctors and nurses, and student doctors and nurses. The study was done in all the three Central hospitals in Zambia (namely: Kitwe Central Hospital, Ndola Central Hospital, and the University Teaching Hospital), Kasama General Hospital, and Chinsali District Hospital. All doctors, nurses and students found at the stations at the time of interviews were requested to take part in the study. Willingness to work in rural areas for at least five years. Totals of 133 qualified staff (doctors and nurses) and 97 students were recruited into the study. Among practicing doctors and nurses, age and marital status were the only factors that were significantly associated with the outcome in a multivariate analysis. At each birthday qualified staff were 8% (OR=1.08, 95%CI [ 1.00,1.16], p=0.046) more likely to be willing to work in rural areas for at least five years. Qualified staff who were single were 55% (OR=0.45, 95%CI [0.21, 0.97], p=0.043) less likely to be willing to work in rural areas for at least five years compared to those who were married. This paper discusses factors associated with staffing of doctors and nurses in rural settings in Zambia that may not have been considered before. 2008-01-01T00:00:00Z https://library.adhl.africa/handle/123456789/11262 The Zambia Health Information Digest July - September 2005 Mwansa., J.C. L., Editor; Bowa, Kasonde, Editor; Mweemba, Nora, Editor; Makondo, Francina, Editor This edition of the Zambia Health Information Digest is dedicated to Traditional Medicine. Traditional medicine has become even more prominent because of the high prevalence of HIV in Zambia. With a number of traditional healers making claims that they can cure HIV infection. The digest is therefore justified to address this subject. Our feature article is a study done by Dr Gretchen Birbeck on traditional medicine and the care of epilepsy patients. The World Health Organisation fact sheet on Traditional Medicine is also included in the Features section. In the News section and Abstract section are some news items and abstracts respectively on the subject. World Health Organisation defines Traditional Medicine as "the total combination of knowledge and practices, whether explicable or not, used in diagnosing, preventing or eliminating physical mental or social diseases and which may exclusively on past experience and observation handed down from generation to generation, verbally or in writing„. Trends in the use of traditional and complementary medicine are on the increase in many developed and developing countries. The WHO estimates that about 80% of people living in rural areas in developing countries depend on traditional medicine for their health care needs. The importance of traditional medicine has been recognised by the Alma-Ata Declaration of 1978 as a means to help achieve health for all. The African Union Heads of State Summit, which was held in Lusaka in 2001, declared 2001 -2010 as the decade for traditional medicine. The 50"` Session of the Regional Committee for the WHO African Region held in Ouagadougou, Burkina Faso in 2000 adopted a strategy for promoting the role of traditional medicine in health systems, and declared 31st August as the African Traditional Medicine Day. Many countries face challenges in promoting the role of Traditional Medicine especially those of property rights, `standards, quality and efficacy of traditional medicines` research, promotion and protection of medicinal plants. WHO therefore urges countries to develop national policies, legal and regulatory frameworks` to create enabling environment for large scale manufacturing of sale and effective traditional medicines, protection of intellectual property rights and traditional medicine knowledge. The Government of the Republic of Zambia is committed to the promotion or traditional medicine. The Health Reforms have been inclusive of the traditional medicine, whereby a Traditional Medicine Coordination Unit was created in the health sector and the Ministry of Health is in the process of developing a policy on traditional medicine. This edition of the Zambia Health Information Digest is dedicated to Traditional Medicine. 2005-07-01T00:00:00Z https://library.adhl.africa/handle/123456789/11307 Zambia health information digest. Mwansa, J.C. L.,editor; Mweemba, Nora, editor; Bowa, Oliver, editor; Kanyengo, W. Christine, editor This issue carries a selection of articles on the all-important subject of HIV/AIDS and the different efforts and progress being made towards arresting the pandemic. The main feature article however, is on Obstructive Sleep Apnea (OSA). The word "apnea" derives from the Greek, and literally means "without breath." In obstructive sleep apnea, the throat collapses during sleep causing sufferers to snort and gasp for breath. People with severe cases may have hundreds of these episodes every night, causing daytime sleepiness and possibly increasing their risk of high blood pressure and heart problems. These breathing interruptions can occur hundreds of times per night, and place significant strain on the heart and cardiovascular system. Each interruption can last from 10 seconds to a minute or longer. To lean more about this sleep disorder go to [http://www.itonsil.com]. There is a wealth of information on sleep disorders and there are a number of sites that give sources of valuable information on this subject. One of such sites is the Sleep Medicine homepage found at [http://www.users.cloud9.nev~thoxpy/sleep.htm], which lists resources regarding all aspects of sleep including, the physiology of sleep, clinical sleep medicine, sleep research, federal and state information, patient information, and business-related groups. This issue carries a selection of articles on the all-important subject of HIV/AIDS and the different efforts and progress being made towards arresting the pandenric. 2004-07-01T00:00:00Z https://library.adhl.africa/handle/123456789/11382 The treatment of tibial diaphysial bone defects in adults Izhar, U. H., creator Twenty cases of established non-union of the tibial diaphysis with bone defects ranging from 2.5 centimetres to 7.5 centimetres (mean 3.5 centimetres), were treated between 1976 to 1981. In six cases complications were compounded by bilateral femoral shaft `fractures and multiple other injuries. Previous operative attempts for reconstruction had been! made on three cases. Average period from reconstructive operation to union was twenty three weeks with a range for eight to seventy-two weeks. Pormanont limb shortening occurred in all the cases ranging from 2.5 centimetres to 7.5 centimetres (mean 3.5cms). Among the various remedial techniques used obtaining union in nineteen cases, Posteroatoral tibio-fibular synostosis emerged as the beet Salvage procedure in our environment with minimal hospitalisation and complications. This paper reports various techniques found useful in the treatment of complicated nonunion with the tibial diaphysial bone defects in adults. 1983-07-01T00:00:00Z https://library.adhl.africa/handle/123456789/11282 The value of procalcitonin and C-reactive protein as early markers of bacteraemia among patients with haematological malignancies receiving chemotherapy: a cross-sectional study Kingsley, M. Kamvuma, creator; Sumbukeni, Kowa, creator; Kaile, Trevor , creator; Masenga, Sepiso K., creator; Hamooya, Benson M., creator; Musalula, Sinkala, creator; Simakando, Marah, creator The immune system of patients with haematological malignancies is suppressed during chemotherapy. This renders them vulnerable to frequent infections especially of the bacterial type. Timely diagnosis of these infections is difficult, because a severe infection may be asymptomatic or manifest only in the form of fever or malaise. There is need for laboratory markers that can detect an infectious process at an early stage. This study was aimed at determining the value of using Procalcitonin (PCT) and C reactive protein (CRP), for early diagnosis of infection in patients with haematological malignancies receiving chemotherapy. Methods: This was a cross sectional study consisting of sixty eight (68) patients with haematological malignancies. Data from each participant including sex, age, clinical and laboratory data were collected after obtaining informed consent. Blood specimens were then collected for measurement of PCT, CRP and bacteriological analysis. Patients were divided into two groups; those with a culture positive and negative result. PCT and CRP concentrations were compared between groups using t-test and nonparametric statistical tests respectively. The area under ROC curve, sensitivity, specificity, likelihood ratio, and Spearman's correlation coefficient were also calculated. Results: A total of 14 (20.6%) microorganisms were isolated, of which 10 were gram-positive bacteria and 4 were gram-negative bacilli. The mean values of PCT which were 6.1ng/mL in the bacteraemia group and 5.1ng/mL in the non-bacteraemia group, p=0.023 and median CRP values were 24.2 (6.4348.15) in the bacteraemia and 23.5 (6.03-75.44) in the non-bacteraemia group, p=0.832. The area under curves was 0.52 (95% CI=0.57-0.84) for CRP and 0.70 (95% CI=0.35-0.69) for PCT. PCT value of greater than 4.7 ng/mL is diagnostic for infections (sensitivity 86%, specificity 54%) while that of CRP was 21mg/mL with the sensitivity and specificity of 64% and 44% respectively. Elevated levels of PCT as well as fever were significantly associated with bacteraemia. This article evaluates the value of PCT and CRP, in early diagnosis of bacterial infections in patients with haematological malignancies on chemotherapy. 2018-04-01T00:00:00Z https://library.adhl.africa/handle/123456789/11369 Haemosiderosis osteoporosis and scurvy Lowenthal, M. N., creator; Siddorn, J. A., creator; Fine, J., creator; Patel, R. P., creator A case of haemosiderosis, osteoporosis, vertebral collapse and scurvy occurring in a Zambian African male is described in detail. This paper describes a case haemosiderosis, osteoporosis, vertebral collapse and scurvy of which is believed to be the first one reported from Zambia and possibly the first from outside South Africa. 1967-04-01T00:00:00Z https://library.adhl.africa/handle/123456789/11354 Choice of place for childbirth: prevalence and correlates of utilization of health facilities in Chongwe district, Zambia Hazemba, A.N., creator; Siziya, S., creator The objective of this article is to determine the prevalence and correlates for utilization of health facilities for childbirth in a rural Chongwe district, Zambia. A cross sectional study was carried among 250 mothers who had delivered babies within one year prior to the survey. A Backward multiple logistic regression method was used to determine independent predictors for utilization of health services for childbirth. A4l¢z.J3 0#fcome Me¢sz4rcs.. Percent utilization of health facilities. A total of 250 mothers were recruited into the study, of whom the majority were below the age of 25 year (41.2%) antenatal were married (84.0%). A third (32.8%) of the mothers were not able to read and write. The rate of health facility utilisation for childbirth was 428%. Independent predictors for utilisation of a health facility were place of last childbirth, and knowledge that traditional birth attendants (TBAs) are given none food items (excluding money) after assisting delivery. Compared to mothers who delivered their last pregnancy at a health facility, mothers who had their last childbirth at home were 85% (AOR=0.15, 95%CI [0.10, 0.22]) less likely to deliver their current pregnancy at a health facility. Knowledge that a TBA was given none food items (excluding money) after assisting delivery was negatively associated with delivery at a health facility (AOR=0.55, 95%CI [0.37, 0.83]). Conclusion.. The importance of giving birth at a health facility should be communicated to mothers who give birth at home, during postnatal visits or clinic outreach sessions. This paper describes a study to determine factors associated with the utilization of health facilities for childbirth in a rural setting of Chongwe district in Zambia. 2008-04-01T00:00:00Z https://library.adhl.africa/handle/123456789/11265 The human resources for health crisis in Zambia: Deaths, departures, demoralising conditions of service and disinterested diaspora. Kachimba, J.S., Creator; Mwaba, P., Creator For over a decade, the health sector in Zambia has given us a 91 impse of the night mare unfolding in the sub-Saharan region,a consequence of not investing in the training of staff to man our hospitals and care for our people. Zambia is facing a human resources for health (HRH) crisis that threatens the attainment of the millennium development goals (MDGs). In our lead article, Miti elucidates the issue of HRH that is neglected and yet critical to combating the health crisis . We add our voice to the numerous voices that have been raised, both local and international, in addressing the imbalances that exist in health care delivery in the developed north and developing south. It does not require a mathematical genius to realise that a Zambian nurse's salary of 110 pounds per month compares poorly to her colleagues working in the United Kingdom and earning over twenty times as much. Yet the donor community has placed a ceiling on how much must go to personal emoluments (PEs). It is paradoxical that these very donors, with the endorsement of our government, have set very ambitious MDGs. What happened to the "Health for all by the year 2000" campaign? Is it not the same international community that are signatories to the Alma-Ata Declaration, which clearly spells out health as a basic human right. There are however indications that there is a change in donor thinking. This is evident in their support of financial and non-financial incentives to keep our doctors in the rural parts of the country. Needless to say, it is easy to lash out at the donors when some of the problems we are faced with are self-inflicted. At the centre of this unfolding crisis has been our government's policies and attitude towards indigenous health staff. Previous government programmes have undermined the delivery of health in Zambia. Such actions have included the ill-conceived voluntary separation package (VSP) that led to the exodus of many Zambian nurses and the early retirement of resident doctors in 2000 following an industrial dispute. The United Kingdom and Botswana were beneficiaries of the exodus of our nurses and doctors respectively. Suffice it to say, departures and demoralising conditions of service have not been the only factors at play in this nightmare,death has accounted for a large number of health staff lost during this difficult period in our history. As Miti rightly points out, a local factor for the high attrition rates that should not be underplayed is the high mortality and morbidity among health workers from HIV/AIDS related illnesses. It has become increasingly apparent that workplace programs have overlooked hospital workers even though they too are at risk. for HIV infection, both from occupational and nonoccupational factors. What is even more of a paradox is that most of our health institutions do not have HIV/AIDS workplace policies whilst other government departments such as Education have had these in place for years. Are we living in a cocoonordenial? Why should the mortality be so high among health workers when antiretroviral drugs (ARVs) have been free for the last five years and we are the prescribers and distributors of these drugs? The consequence of all these factors that have a negative impact on health has been quite evident. We are grappling with an infant mortality rate of 95 per 100,000, matemal mortality rate of 749 per 100,000 and an HIV prevalence of 16% among adults. Gloomy as this may appear to be, lessons may be leant from countries like Cuba. This island state now boasts of sturming health achievements with many national health indicators, such as infant mortality rate, comparable to the United States and yet their econony has been struggling for decades. Under a well-structured technical assistance programme, Zambia has benefited from Cuban health personnel who have gone back to their country upon completion. Can't Zambia export its doctors and nurses in an orderly manner so that their foreign earnings are deposited in the Bank of Zambia? For example, three quarters of Egyptian foreign exchange earnings is from the export of its human resource to neighbouring oil-rich countries. The disorderly export of our human resource has led to a failure of our people to invest their earnings in Zambia and in a Diaspora disinterested in their country of birth. If only we could learn from Uganda, which makes a fortune from the foreign earnings reinvested in the country from the hundreds of thousands of Ugandans spread all over the globe. With conviction as a nation, creative management that seems to finally be in place and strategic engagement of the donor community, attainment of the MDGs may still be a reality. We all have to rise to the challenge. This article discusses the issue of Human Resource for Health that is neglected and yet critical to combating the health crisis. 2007-01-01T00:00:00Z https://library.adhl.africa/handle/123456789/11334 The Zambia health information digest July - September 2001 Bowa, O.; Kanyengo, C. W.; Makono, S.; Mwansa, J.C. L. Cervical cancer is an important women's reproductive health problem, especially in African countries where many women die from the disease each year. Unlike many cancers, cervical cancer can be prevented. The abstracts herein give information on cervical cancer, with a focus on prevention of cancer through identification and treatment of precancerous lesions as well as on treatment of invasive disease. In this issue we have also focused primarily on HIV/AIDS as it affects the educational system in the country. Its impact on education is two fold: on the teaching staff as well as the school going children. And finally we we have included an article on the Polio virus. Cervical cancer 2001-07-01T00:00:00Z