Search PubMed⌕ Search

Biomedical subjects

S Siziya

Publications and source records attributed to S Siziya.

At least 19 recordsLinked to original sources
PubMed1998

Secular changes in rates of respiratory complications and diarrhoea among measles cases.

It has been observed that the occurrence of respiratory complications and diarrhoea among measles cases has changed over time but this change has not been quantified. A study was carried out in the city of Gweru, Zimbabwe, to quantify these changes. Rates of respiratory complications and diarrhoea among measles cases were determined in each year for the period 1968-89. It was found that mean rates of respiratory complications and diarrhoea during 1968-78 were 17.2 per cent (95 per cent CI = 11.6-22.8) and 5.2 per cent (95 per cent CI = 0-11) respectively while during 1979-89, mean rates of respiratory complications and diarrhoea were 6.5 per cent (95 per cent CI = 1-12.1) and 16.4 per cent (95 per cent CI = 10.1-22.0) respectively. Analysis of variance (ANOVA) to determine the main effects and the interaction showed that the main effects were not statistically significant (F = 0.01, d.f.1,2 = 1,40, p = 0.935; and F = 0.13, d.f.1,2 = 1,40, p = 0.725 respectively) Meanwhile the interaction term of complications and period was statistically significant (F = 15.7, d.f.1,2 = 1,40, p < 0.001). It was concluded that a change in rates of respiratory complications and diarrhoea had occurred among measles cases. It is suggested that the increase in vaccination coverage in 1979-89 and the shift in age at infection to older age groups in the same period may have brought about this change through selective suppression of respiratory complications among measles cases.

Age Distribution↗
PubMed1998

Seroprevalence of human immunodeficiency virus type 1 infection in childhood malignancy in Zimbabwe.

OBJECTIVES: To determine the association between malignancy and the Human Immunodeficiency Virus type 1 (HIV-1) infection in children. DESIGN: Case series. SETTING: The Paediatric Oncology Unit at Parirenyatwa Teaching Hospital. SUBJECTS: 76 consecutive newly diagnosed cases of malignancy between May 15 and November 15 1997. MAIN OUTCOME MEASURES: HIV serostatus. RESULTS: 27 out of 64 children were HIV seropositive, giving a seroprevalance rate of 42.2% (95% CI 30.1 to 54.3%). The four commonest diagnosed malignancies were non-Hodgkin's lymphoma (22.4%), acute lymphoblastic leukemia (19.7%), Wilm's tumour (19.7%) and Kaposi's sarcoma (15.8%). These tumours accounted for 77.6% of all malignancies. Nine of a total of 17 patients with non-Hodgkin's lymphoma were HIV positive and all 12 patients with Kaposi's were also HIV positive. No cases of Burkitt's lymphoma were seen. Although there was increased incidence of non-Hodgkin's lymphoma (NHL) compared to previous years, there was no significant association with the HIV serostatus. A significant association between Kaposi's sarcoma (KS) and HIV serostatus was observed (p < 0.001). Children with KS were more likely to be HIV seropositive. Children with acute lymphoblastic leukemia (ALL) and Wilm's tumours (WT) were 83 and 88% less likely to be HIV seropositive, respectively. CONCLUSIONS: HIV has transformed the pattern of childhood malignancy in Zimbabwe. The two tumours mostly affected are NHL and KS.

Age Distribution↗
PubMed1998

Health status of the children in a high density town near Harare, Zimbabwe.

OBJECTIVES: To determine the health status of the children for conditions associated with poverty. DESIGN: Cross sectional. SETTING: Households in Chitungwiza, a dormitory town of Harare, Zimbabwe. SUBJECTS: 181 children less than five years of age in 1990 and 162 in 1993. MAIN OUTCOME MEASURES: Nutritional status and illness experienced by children. RESULTS: A total of 191 (90.0%) mothers breast fed for more than a year. Thirty two (24.2%) children more than six months old in 1990 and 24 (18.9%) in 1993 were offered less than three meals a day. Illnesses were most common (90.9%) in children aged six to 11 months old and decreased after this. Diarrhoea and coughs accounted for most of this excess (87.9%). Coughs alone affected 33.8% of children of all ages. Knowledge of making rehydration sugar/salt solution was wrong in 23.9% of mothers. Appropriate immunization was given to 85% of children in 1993. Twenty one (14.9%) children in 1990 and 15(12.2%) in 1993 were under 80% weight for age. Thirteen (8.7%) children in 1990 and 16 (10.8%) in 1993 were stunted. CONCLUSION: Breast feeding was generally satisfactory but the number of meals offered to a fifth of the children aged more than six months was inadequate. Instructions for making rehydration sugar/salt solution, on composition and quantity to be given should be made easily available so that the rate of mothers with wrong knowledge of making the sugar salt solution could be decreased. Children of age six to 11 months need to be kept warm to avoid coughs and need to be brought up in hygienic conditions to avoid diarrhoea.

Animals↗
PubMed1998

Challenges posed by changes in measles transmission patterns.

OBJECTIVE: To quantify changes in measles transmission patterns. DESIGN: Analysis of measles surveillance data. SUBJECTS: All measles cases identified in 1988. MAIN OUTCOME MEASURES: Proportion of cases in age group 60 to 119 months, proportions of vaccinated and unvaccinated cases in age group 60 to 119 months, and occurrence of cases in schools. RESULTS: Measles vaccination coverage was 91%. Incidence rate of measles was 205 per 100,000 population. The age group 60 to 119 months accounted for 49% of all reported cases and 68% of cases in this age group were vaccinated. There were measles epidemics in schools and these were associated with occurrence of secondary cases in younger siblings in the community. Case fatality rate and mortality rate were 0.4% and one per 100,000 population respectively. CONCLUSION: High measles transmission in children of school going age could spill into the community through generation of secondary cases among younger siblings and this could result in high morbidity and mortality in this vulnerable group. It is recommended that either revaccination at school entry or mass vaccination campaigns be carried out in affected age groups at schools to reduce occurrence of epidemics.

Age Distribution↗
PubMed1998

Study of psychiatric consequences of closed head injury at the Kenyatta National Hospital.

This was a study to compare the psychiatric consequences of closed head injury (CHI) in 37 patients with 39 demographically similar patients with fractured lower limb injury (FLLI), aged 16-55 years. The outcome measures were the Clinical Interview Schedule-Revised, the Bender Gestalt Test and the WHO AUDIT Core for alcohol abuse. The final diagnoses were made according to DSM-III-R diagnostic criteria. The findings indicated that CHI patients suffered more psychiatric consequences than FLLI controls (OR = 4.07; 95% CI = 1.30:13.14; p = 0.013). Depression and anxiety disorders were the most common problems encountered in these subjects.

Adolescent↗
PubMed1997

Peripheral neuropathy in individuals with HIV infection in Zimbabwe.

Peripheral neuropathy is associated with HIV infection. The prevalence and types of peripheral neuropathy encountered in a randomly-selected HIV infected African population at different stages of disease were investigated. HIV positive individuals were categorized into 1 of 3 groups: asymptomatic, symptomatic and AIDS. HIV negative individuals formed the control group. Nerve conduction data were obtained using standard electrophysiological procedures and CD4+ levels were measured. The type of neuropathy was determined from the history, clinical presentation and electrophysiological abnormalities. The prevalence of peripheral neuropathy was 44%: subclinical neuropathy (SCN) accounted for 56%, acute inflammatory demyelinating polyneuropathy (AIDP) for 15% and distal symmetrical polyneuropathy (DSPN) for 22% of cases of neuropathy. SCN was found in all categories whereas AIDP predominated in the symptomatic category and DSPN in individuals with AIDS. The pattern and frequency of neuropathies seen in our African population is similar to that reported from other continents.

Adult↗
PubMed1997

HIV infection in malnourished children in Harare, Zimbabwe.

A descriptive study was undertaken to compare the pattern of socio-demographic features, nutritional profile and presenting features of HIV infected and uninfected children with malnutrition. A total of 140 children aged above 15 months admitted to the paediatric wards, Harare Hospital from December 1993 to February 1994 were studied. Sixty eight (48.6%) children were found to be HIV seropositive and 72 negative. The socio-demographic features were similar in both groups. Marasmus and marasmic kwashiorkor were predominant in the HIV infected children, whilst the majority (64%) of the children in the HIV uninfected group had kwashiorkor (p = 0.001). Pneumonia, lymphadenopathy, chronic discharging ears and oral thrush were significantly more frequent in the HIV infected than in the non HIV infected children (p < 0.01). Factors predictive of HIV infection were marasmus (OR 2.72, 95% CI 1.04-8.10), generalised lymphadenopathy (OR 2.77, 95% CI 1.16-6.64), oral thrush (OR 2.72, 95% CI 1.16-6.37) and discharging ears (OR 6.05, 95% CI 1.89-19.42) with a sensitivity of 57.6% (95% CI 45.7%-69.5%), specificity of 71.4% (95% CI 60.8% 82.0%). The high prevalence of HIV infection among the malnourished children emphasises the impact of the HIV epidemic on childhood nutritional morbidity.

Case-Control Studies↗
PubMed1997

Measles complications: the importance of their management in reducing mortality attributed to measles.

OBJECTIVE: To determine the effect of rates of complications among cases and management of complicated cases on measles case fatality rates. DESIGN: Measles disease surveillance. SETTING: City of Gweru, Department of Health. SUBJECTS: Children aged zero to 15 years. MAIN OUTCOME MEASURES: Case fatality rates. RESULTS: Measles case fatality rates declined from 47.6 in 1967 to zero in 1989. Between 1967 and 1978 respiratory infections were the predominant complications (66.5%), while after 1979 diarrhoea was the predominant complications (60.6%). A significant partial correlation coefficient was observed between rates of mortality among complicated cases and case fatality rates (r = 0.89, df = 20, p < 0.001). CONCLUSION: Good management of complicated cases may have contributed towards the decline in measles case fatality rates.

Adolescent↗
PubMed1997

Cancer of the skin in Zimbabwe: an analysis based on the Cancer Registry 1986 to 1992.

OBJECTIVES: To determine whether skin cancers are increasing. DESIGN: Cancer Registry series. SETTING: Cancer Registry Office in Harare, Zimbabwe. This registry serves the referral hospitals in Harare and Bulawayo. SUBJECTS: All cancer patients (9,029 males, 8,730 females) notified from 1986 to 1992. MAIN OUTCOME MEASURE: Proportion of skin cancer to the total cancers notified. RESULTS: The limitations of the Cancer Registry were noted. In Black Zimbabweans, skin cancers increased from 381 (11% of all notifications) in 1986 to 1,346 (29.7% of all notifications) in 1992. The increase was due to an increase in Kaposi's sarcoma in both men and women although the number notified in women was a quarter of that notified in men. In White Zimbabweans, there was a significant increase in basal cell carcinoma in men and this cancer increased with age from 6.52 per 1,000 population in people 30 to 54 years to 25.04 per 1,000 in those over 54 years of age. CONCLUSION: Our findings show that the number of people with skin cancers is on the increase probably due to the AIDS epidemic and also the aging of the White population, with implications for the demand for health care for treating these cancers in a health service working on a very tight budget.

Adult↗
PubMed1997

Malaria in Zimbabwe: comparisons of IFAT levels, parasite and spleen rates among high, medium and lower altitude areas and between dry and rainy seasons.

OBJECTIVES: To study the extent of malaria prevalence among children at various elevations above sea level and in children during the dry and rainy seasons in Zimbabwe. DESIGN: Cross sectional. SETTING: Primary and secondary schools. SUBJECTS: The number of children (aged about eight years in Grade Three and 13 years in Form One) examined in November 1992 was 103 in Chitungwiza (above 1,200 m), 94 in Gokwe (900 to 1,200 m) and 96 in Sasame (under 900 m). In April 1993 it was 86 in Chitungwiza, 78 in Gokwe and 81 in Sasame. MAIN OUTCOME MEASURE: Indirect Fluorescent Antibody Test (IFAT) levels, parasite and spleen rates. RESULTS: No splenomegaly was detected in children in schools above 900 m. While no parasitaemia was detected in children in schools above 1200 m, one (0.6%, 95% CI to -0.6 to 1.7) child and 37 (20.9%, 95% CI 14.9 to 26.9) children in schools between 900 and 1,200 m and below 900 m, respectively, had parasitaemia. The IFAT levels were lowest in children in areas above 1,200 m and increased significantly with decreasing altitude (x2 for linear trend 332, p < 0.001). The parasite rate in the rainy season (39.5%, 95% CI 28.9 to 50.2) was significantly (p < 0.001) higher than that in the dry season (5.2%, 95% CI 0.8 to 9.7). No significant differences in the IFAT levels (p = 0.208) and in the spleen rates (p = 0.180) were observed between the dry and rainy seasons. Sixty five percent of all children in schools above 1,200 m visiting rural areas used no protective measures against malaria. All children in schools under 900 m reported that their homes were sprayed, but very few other prophylactic measures (seven children used antimalarial drugs and 15 children used a net) were reported. CONCLUSIONS: Malaria acquisition is uncommon above 900 m and the people in these areas are highly vulnerable to malaria.

Adolescent↗
PubMed1997

Education, occupation and health status of people of age five years or more living in a high density urban area in Zimbabwe.

OBJECTIVE: To find out the education, occupation and health status of people aged five years or more living in a high density urban area in Zimbabwe. DESIGN: Cross sectional. SETTING: Households in Chitungwiza. SUBJECTS: Persons of age five years or more available in a household at the time of the survey. In 1990 and 1993, 822 and 1,023 people were surveyed, respectively. MAIN OUTCOME MEASURES: Educational level, employment, rate of smoking, nutritional status, blood pressure level, and rate of disability. RESULTS: After the age of 24 years, more males than females were observed in both periods. A much higher proportion (x2 = 20.34, df = 1, p < 0.001) of women were in informal employment in 1993 (28.6%) than in 1990 (12.9%). Meanwhile, about an equal proportion of men were in the informal sector in both periods (12.0% and 10.4% in 1990 and 1993, respectively). For females of age 15 years or more, fewer (40.8%) had attained secondary education than males (76.4%) in 1990 (x2 = 50.2, df = 1, p < 0.001). Overall, 208 (36.1%) men and eight (1.3%) women of age 15 years or more smoked. Raised blood pressure for both sexes increased significantly with age (x2 for linear trend = 20.21 for men and 65.81 for women, df = 1, p < 0.001 for both sexes). More women of age 45 years or more had raised blood pressure than men (x2 = 4.67, df = 1, p = 0.031). Many more women (8.0%) than men (0.7%) had a Ponderal Index of greater than 27 (x2 = 19.33, df = 1, p < 0.001). A total of 12 (1.5%) persons were disabled. CONCLUSION: Raised blood pressure and obesity mainly affected women and interventions to improve their health is recommended.

Adolescent↗
PubMed1997

Comparison of protection afforded by single measles vaccination and late revaccination schedules.

An intervention study compared the protection afforded vaccinees by single measles vaccination and late revaccination schedules in 1990-94. During the intervention a single revaccination (after initial vaccination at nine months of age) was applied to children at any point in time between 12 and 23 months of age. Cases of measles aged 10-23 months were identified through an active surveillance system and in this period 5, 11 and 11 cases of revaccinated, single vaccination and unvaccinated children were identified. Measles incidence rates were 392.2-415.6 (mean = 405.6, SD = 6.7), 75.4-112.1 (median = 91.7, SD = 13.3) and 12.8-15.2 (mean = 13.9, DS = 0.99) per 100,000 population in children who were unvaccinated, with single vaccination and revaccinated respectively. Relative risk of contracting measles in children who were unvaccinated or with single vaccination was 26.5-32.5 (mean = 29.4, SD = 2.3) and 5.8-8.8 (mean = 6.8, SD = 1.2) respectively compared with revaccinated children. Vaccine efficacies that were determined were 73-81% (mean = 77.2, SD = 2.9) and 96.2-96.9% (mean = 96.6, SD = 0.27) for single vaccination and late revaccination schedules respectively. It was concluded that late revaccination affords vaccinees better protection than single vaccination through improvement in vaccine.

Age Factors↗
PubMed1997

Housing conditions in a high density town near Harare, Zimbabwe.

OBJECTIVES: To determine the living conditions of people and to compare the results with census figures. DESIGN: Cross sectional. SETTING: A high density dormitory suburb of Harare, Zimbabwe. SUBJECTS: 108 stands containing 293 households were surveyed in 1990 and 90 stands containing 454 households in 1993. MAIN OUTCOME MEASURE: Crowding index. RESULTS: An average increase of five people per stand in the three years to an average of 15 to 18 people on each stand was observed, allowing 16.4 to 19.6 m2 per person. Although the number of households living in one room increased from 101 (48.6%) in 1990 to 243 (72.5%) in 1993, the actual number of people per room did not increase. The Chitungwiza population was older than the overall population in Zimbabwe with an increased proportion of men of working age. About one tenth (10.8%) of heads of households who were resident for more than 20 years were still lodgers and 77.0% of these heads of households maintained that they still had a rural home. About three quarters (76.4%) of households had no kitchen and 74.1% of all households cooked on paraffin stoves or occasionally wood fires. CONCLUSION: Many new rooms had been built on the stands leading to overcrowding with possible implications for health.

Adolescent↗
PubMed1996

Importance of schistosomiasis in the Isoka district of Zambia: a prerequisite for its control using community participation.

The opinion has long been held that only by treating cases individually could diseases be controlled or eradicated. This view has been adopted from time immemorial and has failed miserably in, for instance, the control of schistosomiasis. This paper presents views of the head teachers on the prominence of schistosomiasis in the Isoka district, Zambia, as a step towards their involvement in a community mediated programme for the control of schistosomiasis. Information was sought on the importance of schistosomiasis in the district by means of two questionnaires, one distributed to head teachers, and the other to school children. Lack of clean water was considered to be the leading factor by 71 (82.6%) teachers. Generally, schistosomiasis was not considered to be a prominent disease in the district. Nevertheless, teachers from highly infected areas ranked schistosomiasis as a health problem higher than those teachers from schools with lower prevalences (P = 0.002). The implications of these results to implementing a district wide schistosomiasis control programme covering both infected and uninfected areas are discussed.

Humans↗
PubMed1996

Myocardial dysfunction in human immunodeficiency virus infection: an echocardiographic study of 157 patients in hospital in Zimbabwe.

OBJECTIVE: To determine the prevalence and characteristics of myocardial dysfunction and other cardiac manifestations in acutely ill hospital patients infected with human immunodeficiency virus (HIV) in Zimbabwe. DESIGN: A prospective echocardiographic survey of acutely ill HIV seropositive patients. SETTING: General medical ward, Harare Central Hospital, Zimbabwe. PATIENTS: One hundred and fifty seven HIV seropositive patients admitted with various acute medical conditions over a 12 month period, January to December 1994. MAIN OUTCOME MEASURES: Detection of myocardial dysfunction and other cardiac abnormalities by cross sectional echocardiography. RESULTS: Eighty (51%) men and 77 women were studied (mean (SD) age 34.4 (8.5), range 15-60 years for males and 31.6 (9.0), range 16-65 years for females). They were all heterosexual. None was haemophiliac or an intravenous drug user. Echocardiographic abnormalities were found in 79 (50%) patients: 14/151 (9%) had dilated cardiomyopathy, 33/151 (22%) left ventricular dysfunction, 9/151 isolated right ventricular dilatation, and 30/157 (19%) pericardial disease (28 with effusions, three having tamponade). There were two cases of constrictive pericarditis and one of ascending aortic aneurysm. CONCLUSIONS: There is a high prevalence of echocardiographically detected myocardial and pericardial disease in this group of acutely ill HIV infected patients. Left ventricular dysfunction without dilatation was common, but its significance was not ascertained.

Acute Disease↗
PubMed1996

Diagnostic and cost comparisons of a questionnaire against a chemical reagent strip test in identifying high risk communities for Schistosoma haematobium infection in northern Zambia.

A comparative study was conducted in northern Zambia in order to compare both the economical and diagnostic performance of a questionnaire with that of the chemical reagent strip test in diagnosing urinary schistosomiasis with a view to replacing the more economically expensive reagent strip test with the questionnaire in the identification of high risk communities. A total of 57 schools participated in the study and each school was considered as a community. Among the symptoms and conditions of blood in urine, pain when passing urine and bilharzia for urinary schistosomiasis, blood in the urine was the best predictor for urinary schistosomiasis with 73.9 pc (95 pc CI 56.0 to 91.9 pc) sensitivity, 82.4 pc (95 pc CI 69.5 to 95.2 pc) specificity and 78.9 pc (95 pc CI 68.4 to 89.5 pc) diagnostic efficiency in the identification of schools with high levels of infection. A diagnostic questionnaire for urinary schistosomiasis was two times cheaper than the reagent strip test in economical terms. The questionnaire approach in identifying high risk communities for urinary schistosomiasis is promising and should be tried in other endemic areas.

Adolescent↗
PubMed1996

Differential human immunodeficiency virus risk factors among female general nurses, nurse midwives and office workers/teachers in Zambia.

OBJECTIVES: To determine whether the factors associated with human immunodeficiency virus (HIV) infection are the same among the general nurses, nurse midwives and office workers/teachers. DESIGN: Cross sectional. SETTING: Schools, offices and hospitals. SUBJECTS: A total of 370 consenting females from each of the study groups. MAIN OUTCOME MEASURES: HIV seropositivity, medical and behavioural risk factors for HIV infection. RESULTS: HIV seropositive general nurses were more likely to report a history of sexually transmitted disease since 1980 (OR 5.17; 95pc CI 1.60 to 15.05), particularly genital ulcer (OR 3.59; 95pc CI 1.30 to 10.85), and they were also more likely to have more sexual partners (OR 4.08; 95pc CI 1.54 to 13.11). HIV seropositive nurse midwives were more likely to have had a blood transfusion (OR 2.17; 95pc CI 1.13 to 4.14), and HIV seropositive office workers/teachers were more likely to have scarification (OR 1.66; 95pc CI 1.07 to 2.57). CONCLUSIONS: Our findings support the importance of genital ulcers, blood transfusion and scarification as risk factors for HIV intervention studies should be specifically targeted to the sector of the population under study.

Adult↗