scholarly journals Trauma unit management and outcomes at an urban tertiary hospital in sub-Saharan Africa: a descriptive study

2021 ◽  
Vol 21 (4) ◽  
Author(s):  
Tonny Stone Luggya ◽  
Annet Alenyo Ngabirano ◽  
Richardson Sarah ◽  
John Osire ◽  
Lilian Achieng ◽  
...  

Background: Injuries are a neglected burden despite accounting for 9% of deaths worldwide which is 1.7 times that of hiv, tb and malaria combined. Trauma remains overlooked as research and resources are focused on infectious diseases. Ugandawith limited trauma epidemiological data has one of the highest traumatic injury rates. This study describes demographics, management and outcomes of patients admitted to mulago hospital trauma unit. Materials and methods: This study was a retrospective record review from july 2012 to december 2015. A data collected included age, time and vitals of admission plus interventions, management and outcomes after which it was analyzed. Results: 834 patient records were reviewed. The predominant age group was 18-35 and 86% of the patients were male. 54% of the patients presented during day and majority of the admission had gcs of less than 8. Antibiotics were given to 467 patients with mechanical ventilation (301) and intubation (289) as the frequent interventions done. 52% of admitted patients were discharged and 40% died. Conclusion: Most admissions’ were of youthful age and had severe head injuries (gcs<8). 56% received antibiotics with frequent interventions beig mechanical ventilation and intubation. 52% of admitted patients were discharged and 40% died. Keywords: Trauma; trauma care; emergency care; head injury.

2018 ◽  
Vol 3 (3) ◽  
pp. 104 ◽  
Author(s):  
Valentine Erulu ◽  
Mitchel Okumu ◽  
Francis Ochola ◽  
Joseph Gikunju

The black mamba (Dendroaspis polylepis) ranks consistently as one of the most revered snakes in sub-Saharan Africa. It has potent neurotoxic venom, and envenomation results in rapid onset and severe clinical manifestations. This report describes the clinical course and reversal of effects of black mamba envenomation in a 13-year-old boy in the Jimba area of Malindi. The victim presented to Watamu Hospital, a low resource health facility with labored breathing, frothing at the mouth, severe ptosis and pupils non-responsive to light. His blood pressure was unrecordable, heart rate was 100 beats per minute but thready, his temperature was 35.5 °C, and oxygen saturation was 83%. Management involved suction to clear salivary secretions, several hours of mechanical ventilation via ambu-bagging, oxygen saturation monitoring, and the use of South African Vaccine Producers (SAVP) polyvalent antivenom. Subcutaneous adrenaline was used to stave off anaphylaxis. The victim went into cardiac arrest on two occasions and chest compressions lasting 3–5 min was used to complement artificial ventilation. Hemodynamic instability was corrected using IV infusion of ringers lactate and normal saline (three liters over 24 h). Adequate mechanical ventilation and the use of specific antivenom remain key in the management of black mamba envenomation.


2021 ◽  
Vol 1 (2) ◽  
pp. 34-41
Author(s):  
A Dieng ◽  
AD Faye ◽  
MM Ndiaye ◽  
G Diop ◽  
A Bouazé ◽  
...  

INTRODUCTION: Oral cavity cancers are now a public health problem according to WHO epidemiological data. There are several risk factors or factors associated with cancers of the oral cavity but they vary according to geographic regions. OBJECTIVE: The objective of this study was to identify factors associated with cancers of the oral cavity in Sub-Saharan African populations through a systematic literature review. METHODOLOGY: Using the data available for the period from January 1980 to December 2019, a synthesis of the literature was carried out. The literature localization strategy included an electronic search of the MEDLINE, EMBASE and GOOGLE SCHOLAR databases from 1980 to 2019 and a manual search of the list of references of articles identified by snowballing. The data were extracted independently by two researchers on an Excel© spreadsheet. Parameters collected from each study were author, country, type of study, period of study, size, age, gender, and factors studied. RESULTS: Out of 1,318 articles found, 24 were selected. The data contained 17,290 patients including 8,229 men, i.e. a male / female sex-ratio of 0.91. Factors studied were tobacco, alcohol, diet, infection, genetics and social factors. CONCLUSION: The results reported showed that several factors are associated with the occurrence of oral cavity cancers in Sub-Saharan Africa. There is a need to conduct further studies with more structured methodologies for more convincing results.


2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
T. Makumbi ◽  
M. Galukande ◽  
A. Gakwaya

Introduction. Mastalgia is a common breast condition among women referred to breast clinics worldwide. Whereas the prevalence is known in the Western world and Asia, the prevalence of the disease is unknown in many African countries. The aim of this study therefore was to determine the prevalence and describe factors associated with mastalgia among women attending a tertiary hospital in sub-Saharan Africa. Methods. A cross-sectional study was done in Kampala, Uganda. Mastalgia was defined as self-reported breast pain (unilateral or bilateral) for a period not less than two months. A pretested questionnaire was used to collect the data and statistical analysis was performed using SPSS version 11. Ethical approval was obtained. Results. Out of the 1048 women who presented to the breast clinic during the study period, 168 (16%) were diagnosed with mastalgia in the absence of breast cancer. Noncyclical and cyclical mastalgia were 22/168 (13%) and 5/168 (3%), respectively. The onset of noncyclical category as compared to the cyclical type of mastalgia was observed to manifest before 24 years of age (P=0.006). Conclusion. Mastalgia was a common condition among women in this sub-Saharan African setting as is elsewhere. The early onset mastalgia in this sub-Saharan African study requires further exploration for determination of its risk factors.


2013 ◽  
Vol 21 ◽  
pp. S163-S164
Author(s):  
M. Doualla Bija ◽  
H. Luma ◽  
E. Temfack ◽  
E. Gueleko ◽  
F. Kemta ◽  
...  

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 191
Author(s):  
Silungile Moyo ◽  
Ronald Thulani Ncube ◽  
Hemant Deepak Shewade ◽  
Solwayo Ngwenya ◽  
Wedu Ndebele ◽  
...  

Background: Zimbabwe is one of the countries in sub-Saharan Africa disproportionately affected by human immunodeficiency virus. In the “treat all” era, we assessed the gaps in routine viral load (VL) monitoring at six months for children (0-9 years) and adolescents (10-19 years) newly initiated on anti-retroviral therapy (ART) from January 2017 to September 2018 at a large tertiary hospital in Bulawayo. Methods: In this cohort study using secondary data, we considered first VL done within six to nine months of starting therapy as ‘undergoing VL test at six months’. We classified repeat VL≥1000 copies/ml despite enhanced adherence counselling as virally unsuppressed. Results: Of 295 patients initiated on ART, 196 (66%) were children and 99 (34%) adolescents. A total 244 (83%) underwent VL test at six months, with 161 (54%) virally suppressed, 52 (18%) unsuppressed and 82 (28%) with unknown status (due to losses in the cascade). Switch to second line was seen in 35% (18/52). When compared to children, adolescents were less likely to undergo a VL test at six months (73% versus 88%, p=0.002) and more likely to have an unknown VL status (40% versus 22%, p=0.001). Conclusion: At six months of ART, viral suppression was low and losses in the cascade high.


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