scholarly journals The Burden of Hand Injuries at a Tertiary Hospital in Sub-Saharan Africa

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
P. Makobore ◽  
M. Galukande ◽  
E. Kalanzi ◽  
S. C. Kijjambu
Keyword(s):  
Road Traffic ◽  
Tertiary Hospital ◽  
Hand Injuries ◽  
Sub Saharan Africa ◽  
Trauma Patients ◽  
The Road ◽  
Injury Occurrence ◽  
Sub Saharan ◽  
On The Road

Background. Hand injuries are common worldwide and lead to heavy financial losses in terms of treatment, job loss, and time off duty. There is paucity of data on hand injuries in sub-Saharan Africa. The aim of this study was to determine the burden and early outcomes of hand injuries at a tertiary hospital.Method. A descriptive prospective study. Eligible patients were recruited over 5 months and followed up for four weeks. Pain, nerve function, and gross functions of the hand were assessed.Results. In total 138 patients were enrolled out of 2940 trauma patients. Of these, 122 patients returned for follow-up. The majority of the patients were males (83%). Mean age was 26.7 years (SD 12.8). The commonest places of injury occurrence were the workplace (36%), home (28%), and on the road (traffic crushes) (23%). Machines (21.3%) were the commonest agent of injuries; others were knives (10%) and broken glass (10%). Sixty-three (51%) patients still had pain at one month.Conclusions. Hand injuries accounted for 4.7% of all trauma patients. Road traffic crushes and machines were the commonest causes of hand injuries. Men in their 20s were mostly involved. Sensitization for prevention strategies at the workplace may be helpful.

African population growth will add to traffic woes

2016 ◽  
Keyword(s):  
Population Growth ◽  
Urban Infrastructure ◽  
Sub Saharan Africa ◽  
Content Type ◽  
Economic Productivity ◽  
The Road ◽  
Sub Saharan ◽  
On The Road ◽  
Exponential Population Growth ◽  
Ssa Countries

Significance The twin processes of urbanisation and middle class growth have driven a rapid increase in vehicles on the road, leading to gridlock in many cities across sub-Saharan Africa (SSA). Excessive traffic on the continent undermines economic productivity by abbreviating work hours, increasing transit costs and contributing to a range of environmental and health problems. Impacts Projected exponential population growth in SSA will add pressure to already-strained urban infrastructure. Lack of law enforcement, poor roads and reckless driving will likely keep SSA countries among the most dangerous for driving. Radical measures to relocate populations away from urban centres would face stiff resistance.

scholarly journals Outcomes of Dorsal and Ventral Buccal Graft Urethroplasty at a Tertiary Hospital in Uganda

ISRN Urology ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
S. Kaggwa ◽  
M. Galukande ◽  
H. Dabanja ◽  
H. Luweesi
Keyword(s):  
Success Rate ◽  
Buccal Mucosa ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
Team Approach ◽  
Sexually Transmitted ◽  
Urethral Strictures ◽  
Sub Saharan ◽  
A Prospective Study

Purpose. Although the use of buccal mucosa in substitution urethroplasty has been practiced for some years, it has not been free of controversy over which surgical technique is the most appropriate to use. There is paucity of data in Sub-Saharan Africa about its success; this study presents the outcomes of dorsal and ventral buccal graft urethroplasty at a sub-Saharan tertiary hospital. Methods. This is a prospective study in which buccal mucosa was used for ventral and dorsal grafts; followup was up to two years. All patients provided informed written consent for the procedures. Results. Seventy-two patients with bulbar urethral strictures underwent buccal graft one-stage urethroplasty. Mean age was 55 years; etiology of the strictures was postinflammatory due to urethritis from sexually transmitted infections 97% (70/72) and trauma 3% (2/72). Buccal mucosa grafts were harvested from the cheek using a two-team approach. Grafts were placed on the ventral and dorsal urethral surfaces in 32 and 40 cases, respectively; the success rate was 84 and 80%, respectively. Repeated urethroplasty was successfully done among 10% (7/72) and patients reported resolution of symptoms in the follow-up period. Conclusion. There was no difference between dorsal and ventral onlay buccal graft outcomes for bulbar urethral strictures. The success rate was 80 to 84%.

Quality of Care for Adult Inpatients with Malaria in a Tertiary Hospital in Uganda

2020 ◽  
Author(s):  
Ronald Kiguba ◽  
Charles Karamagi ◽  
Sheila M. Bird
Keyword(s):  
Quality Of Care ◽  
Severe Disease ◽  
Malaria Diagnosis ◽  
Tertiary Hospital ◽  
Sub Saharan Africa ◽  
Timely Initiation ◽  
Sub Saharan ◽  
Malaria Microscopy

Abstract Background: Prompt detection and appropriate treatment of malaria prevents severe disease and death. The quality of care for adult malaria inpatients is not well documented in sub-Saharan Africa, particularly in Uganda. We sought to describe the patterns of malaria diagnosis and treatment among adult inpatients admitted to the medical and gynaecological wards of Uganda’s 1790-bed Mulago National Referral Hospital from December 2013 to April 2014.Methods: A prospective cohort of 762 consented inpatients aged >18 years was assembled. Proportions of inpatients who received preadmission and in-hospital antimalarials, missed Day 1 dosing of hospital-initiated antimalarials and/or had malaria microscopy done were determined. Multivariable logistic regression was used to identify risk-factors for missed Day 1 dosing of antimalarials.Results: One in five (19%, 146/762) inpatients had an admitting or discharge malaria diagnosis or both; with median age of 29 years (IQR, 22 to 42 years). Microscopy was requested in 77% (108/141) of inpatients with an admitting malaria diagnosis; results were available for 46% (50/108), of whom 42% (21/50) tested positive for malaria parasitaemia. Only 13% (11/83) of inpatients who received in-hospital injectable artesunate (AS) or quinine (Q) received follow-up oral artemether-lumefantrine (AL); only 2 of 18 severe malaria cases received follow-up oral AL. Injectable AS only (47%, 47/100) was the most frequent hospital-initiated antimalarial followed by injectable Q only (23%, 23/100). A quarter (25%, 25/100; 95% CI: 17% to 35%) of inpatients missed Day 1 dosing of hospital-initiated antimalarials. Each additional admitting diagnosis was more than two-fold likely to increase the odds of missed Day 1 dosing of in-hospital antimalarials (aOR = 2.6, 95% CI: 1.52-4.56; P-value = 0.001).Conclusions: Half the malaria microscopy results were not available; yet, the rate of testing was high. The majority of inpatients initiated on injectable AS or Q did not receive the recommended follow-up treatment of oral AL. One in four inpatients delayed to initiate hospital antimalarials by at least one calendar day. The hospital should encourage prompt availability of malaria test-results to promote the timely initiation and completion of antimalarial treatment, thereby improving the quality of care for hospitalized malaria patients in Uganda.

A Groundwork Based Novel Routing Protocol for Vehicular Ad hoc Networks

2017 ◽  
Vol 7 (11) ◽  
pp. 121
Author(s):  
Amolkirat Singh ◽  
Guneet Saini
Keyword(s):  
Routing Protocol ◽  
Packet Loss ◽  
Secure Communication ◽  
Vehicular Ad Hoc Networks ◽  
Ad Hoc ◽  
Road Traffic ◽  
Traditional Approach ◽  
Unexpected Events ◽  
The Road ◽  
On The Road

Many people lose their life and/or are injured due to accidents or unexpected events taking place on road networks. Besides traffic jams, these accidents generate a tremendous waste of time and fuel. Undoubtedly, if the vehicles are provided with timely and dynamic information related to road traffic conditions, any unexpected events or accidents, the safety and efficiency of the transportation system with respect to time, distance, fuel consumption and environmentally destructive emissions can be improved. In the field of computer and information science, Vehicular Ad hoc Network (VANET) have recently emerged as an effective tool for improving road safety through propagation of warning messages among the vehicles in the network about potential obstacles on the road ahead. VANET is a research area which is in more demand among the researchers, the automobile industries and scientists to discover about the loopholes and advantages of the vehicular networks so that efficient routing algorithms can be developed which can provide reliable and secure communication among the mobile nodes.In this paper, we propose a Groundwork Based Ad hoc On Demand Distance Vector Routing Protocol (GAODV) focus on how the Road Side Units (RSU’s) utilized in the architecture plays an important role for making the communication reliable. In the interval of finding the suitable path from source to destination the packet loss may occur and the delay also is counted if the required packet does not reach the specified destination on time. So to overcome delay, packet loss and to increase throughput GAODV approach is followed. The performance parameters in the GAODV comes out to be much better than computed in the traditional approach.

scholarly journals P014: Incidental findings in trauma whole-body CT scans: a systematic review

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S69-S69
Author(s):  
V. Tsang ◽  
K. Bao ◽  
J. Taylor
Keyword(s):  
Systematic Review ◽  
Incidental Findings ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Subsequent Treatment ◽  
Whole Body ◽  
Trauma Patients ◽  
Patient Demographics ◽  
Study Results

Introduction: Whole-body computed tomography scans (WBCT) are a mainstay in the work-up of polytrauma or multiple trauma patients in the emergency department. While incredibly useful for identifying traumatic injuries, WBCTs also reveal incidental findings in patients, some of which require further diagnostic testing and subsequent treatment. Although the presence of incidental findings in WBCTs have been well documented, there has been no systematic review conducted to organize and interpret findings, determine IF prevalence, and document strategies for best management. Methods: A systematic review was conducted using MEDLINE, PUBMED, and EMBASE. Specific journals and reference lists were hand-mined, and Google Scholar was used to find any additional papers. Data synthesis was performed to gather information on patient demographics, prevalence and type of incidental findings (IFs), and follow-up management was collected. All documents were independently assessed by the two reviewers for inclusion and any disagreements were resolved by consensus. Results: 1231 study results were identified, 59 abstracts, and 12 included in final review. A mean of 53.9% of patients had at least one IF identified, 31.5% had major findings, and 68.5% had minor findings. A mean of 2.7 IFs per patient was reported for articles that included number of total IFs. The mean age of patients included in the studies were 44 years old with IFs more common in older patients and men with more IFs than women. IFs were most commonly found in the abdominal/pelvic region followed by kidneys. Frequency of follow-up documentation was poor. The most common reported mechanisms of injury for patients included in the study were MVA and road traffic accidents (60.0%) followed by falls from >3m (23.2%). Conclusion: Although there is good documentation on the mechanism of injury, patient demographics, and type of IF, follow-up for IFs following acute trauma admission lacks documentation and follow-up and is an identified issue in patient management. There is great need for systematic protocols to address management of IFs in polytrauma patients.

scholarly journals Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care Services ◽  
Validity Assessment ◽  
Sub Saharan ◽  
Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

Analysis of Vehicle–Pedestrian Interactive Behaviors near Unsignalized Crosswalk

2021 ◽  
pp. 036119812199906
Author(s):  
Byeongjoon Noh ◽  
Dongho Ka ◽  
David Lee ◽  
Hwasoo Yeo
Keyword(s):  
South Korea ◽  
Traffic Accidents ◽  
Road Traffic ◽  
The Road ◽  
Video Footage ◽  
Premature Deaths ◽  
Vehicle Velocity ◽  
Behavioral Features ◽  
Velocity Changes ◽  
On The Road

Road traffic accidents are a leading cause of premature deaths and globally pose a severe threat to human lives. In particular, pedestrians crossing the road present a major cause of vehicle–pedestrian accidents in South Korea, but we lack dense behavioral data to understand the risk they face. This paper proposes a new analytical system for potential pedestrian risk scenes based on video footage obtained by road security cameras already deployed at unsignalized crosswalks. The system can automatically extract the behavioral features of vehicles and pedestrians, affecting the likelihood of potentially dangerous situations after detecting them in individual objects. With these features, we can analyze the movement patterns of vehicles and pedestrians at individual sites, and understand where potential traffic risk scenes occur frequently. Experiments were conducted on four selected behavioral features: vehicle velocity, pedestrian position, vehicle–pedestrian distance, and vehicle–crosswalk distance. Then, to show how they can be useful for monitoring the traffic behaviors on the road, the features are visualized and interpreted to show how they may or may not contribute to potential pedestrian risks at these crosswalks: (i) by analyzing vehicle velocity changes near the crosswalk when there are no pedestrians present; and (ii) analyzing vehicle velocities by vehicle–pedestrian distances when pedestrians are on the crosswalk. The feasibility of the proposed system is validated by applying the system to multiple unsignalized crosswalks in Osan city, South Korea.

scholarly journals Extracting Road Traffic Volume in the City before and during covid-19 through Video Remote Sensing

2021 ◽  
Vol 13 (12) ◽  
pp. 2329
Author(s):  
Elżbieta Macioszek ◽  
Agata Kurek
Keyword(s):  
Travel Behavior ◽  
Traffic Management ◽  
Road Traffic ◽  
Traffic Volume ◽  
The Road ◽  
Traffic Characteristics ◽  
Annual Average Daily Traffic ◽  
On The Road ◽  
The Impact ◽  
The City

Continuous, automatic measurements of road traffic volume allow the obtaining of information on daily, weekly or seasonal fluctuations in road traffic volume. They are the basis for calculating the annual average daily traffic volume, obtaining information about the relevant traffic volume, or calculating indicators for converting traffic volume from short-term measurements to average daily traffic volume. The covid-19 pandemic has contributed to extensive social and economic anomalies worldwide. In addition to the health consequences, the impact on travel behavior on the transport network was also sudden, extensive, and unpredictable. Changes in the transport behavior resulted in different values of traffic volume on the road and street network than before. The article presents road traffic volume analysis in the city before and during the restrictions related to covid-19. Selected traffic characteristics were compared for 2019 and 2020. This analysis made it possible to characterize the daily, weekly and annual variability of traffic volume in 2019 and 2020. Moreover, the article attempts to estimate daily traffic patterns at particular stages of the pandemic. These types of patterns were also constructed for the weeks in 2019 corresponding to these stages of the pandemic. Daily traffic volume distributions in 2020 were compared with the corresponding ones in 2019. The obtained results may be useful in terms of planning operational and strategic activities in the field of traffic management in the city and management in subsequent stages of a pandemic or subsequent pandemics.

scholarly journals Persistence of mRNA indicative of Plasmodium falciparum ring-stage parasites 42 days after artemisinin and non-artemisinin combination therapy in naturally infected Malians

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Almahamoudou Mahamar ◽  
Kjerstin Lanke ◽  
Wouter Graumans ◽  
Halimatou Diawara ◽  
Koualy Sanogo ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Artemisinin Combination Therapy ◽  
Parasite Prevalence ◽  
Sub Saharan Africa ◽  
Ring Stage ◽  
Qrt Pcr ◽  
Sub Saharan ◽  
Stage Parasite ◽  
Ring Stage Parasite

Abstract Background Malaria control in sub-Saharan Africa relies upon prompt case management with artemisinin-based combination therapy (ACT). Ring-stage parasite mRNA, measured by sbp1 quantitative reverse-transcriptase PCR (qRT-PCR), was previously reported to persist after ACT treatment and hypothesized to reflect temporary arrest of the growth of ring-stage parasites (dormancy) following exposure to artemisinins. Here, the persistence of ring-stage parasitaemia following ACT and non-ACT treatment was examined. Methods Samples were used from naturally infected Malian gametocyte carriers who received dihydroartemisinin–piperaquine (DP) or sulfadoxine–pyrimethamine (SP–AQ) with or without gametocytocidal drugs. Gametocytes and ring-stage parasites were quantified by qRT-PCR during 42 days of follow-up. Results At baseline, 89% (64/73) of participants had measurable ring-stage parasite mRNA. Following treatment, the proportion of ring-stage parasite-positive individuals and estimated densities declined for all four treatment groups. Ring-stage parasite prevalence and density was generally lower in arms that received DP compared to SP–AQ. This finding was most apparent days 1, 2, and 42 of follow-up (p < 0.01). Gametocytocidal drugs did not influence ring-stage parasite persistence. Ring-stage parasite density estimates on days 14 and 28 after initiation of treatment were higher among individuals who subsequently experienced recurrent parasitaemia compared to those who remained free of parasites until day 42 after initiation of treatment (pday 14 = 0.011 and pday 28 = 0.068). No association of ring-stage persistence with gametocyte carriage was observed. Conclusions The current findings of lower ring-stage persistence after ACT without an effect of gametocytocidal partner drugs affirms the use of sbp1 as ring-stage marker. Lower persistence of ring-stage mRNA after ACT treatment suggests the marker may not reflect dormant parasites whilst it was predictive of re-appearance of parasitaemia.

Sign in / Sign up

Export Citation Format

Share Document