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PubMed1985

Composition of the essential oil of Ocimum canum grown in Rwanda.

The essential oil from leaves and flowers of Ocimum canum Sims, growing wild in Rwanda, was investigated by LSC, GLC and GC-MS. All samples were characterized by a high content of linalool (60-90%). Neither camphor nor citral and methyl cinnamate, compounds reported to be characteristic for different types of O. canum, could be detected. All monoterpene hydrocarbons were present in minor amounts (less than 1.5%). The oil samples with the lowest linalool content consisted of relatively large amounts of sesquiterpene hydrocarbons such as bergamotene (about 10%) and beta-caryophyllene (about 5%). Oct-1-en-3-ol and 3-octanol were the only oxygen-containing components, besides linalool, that amounted to more than 1% in most of the oil samples.

Chemical Phenomena↗
PubMed1988

Productivity of the small East African goat and its crosses with the Anglo-Nubian and the Alpine in Rwanda.

Data from a research station in the central African country of Rwanda relating to purebred Small East African (SEA) goats, Anglo-Nubian x SEA and Alpine x SEA goats were analysed. Both SEA (598 days) and Alpine crosses (557 days) were younger at first kidding than the Anglo-Nubian crosses (766 days). There were no differences among genotypes in kidding interval which averaged 343 days nor did they differ in litter size (1.75). Mortality to 150 days (17.8%) was significantly higher in the Anglo-Nubian crosses than in Alpine crosses with the SEA being intermediate and not differing from either. Birth weights of individual kids were significantly lighter for purebred SEA (2.35 kg) than for Anglo-Nubians (2.68 kg) which were significantly lighter than the Alpine crosses (2.89 kg). Total litter weight at 150 days was significantly lower for SEA (14.5 kg) than for Alpine (18.8 kg), the Anglo-Nubian (16.9 kg) not differing significantly from either. Female postpartum weights differed significantly among genotypes, SEA being lightest (37.5 kg), Alpine crosses (42.1 kg) intermediate and Anglo-Nubian crosses (51.4 kg) heaviest. Productivity indices (total weight of live young at 150 days per kg of dam per year) averaged 442 g and did not differ among genotypes.

Age Factors↗
PubMed2004

Fishing line suture: cost-saving alternative for atraumatic intracutaneous skin closure--randomized clinical trial in Rwanda.

Experience with the use of nylon fishing line for surgical sutures has been reported from several African countries. A recent publication suggested that fishing line and an injection needle may provide an atraumatic suture that is especially suitable for intracutaneous skin closures. This article provides further empirical support for such alternative technology. We describe a randomized, blinded clinical trial conducted in Butare (Rwanda) with 220 cutaneous wounds closed by intracutaneous sutures, with either the homemade suture or a commercial nylon thread (Ethilon). We compared the clinical outcomes as well as the costs of those two materials. There are no significant differences between the two sutures in terms of clinical findings or in the reported ease of use by the surgeons. The cost of a homemade atraumatic suture is US $0.07, which is less than one-thirtieth the cost of the commercial thread. The advantage of the commercial thread is the assurance of quality. We consider whether this quality assurance justifies the large price difference, and if the homemade suture should be recommended to surgeons in countries where the costs of surgical material often remain an obstacle for life-saving operations.

Adult↗
PubMed1994

The social impact of HIV infection on women in Kigali, Rwanda: a prospective study.

In Rwanda, a central African country, the prevalence of HIV infection now exceeds 30% in urban adults. This study identifies the social services and counseling needs of women who are already infected with the HIV virus, the outcome after disclosure of the woman's HIV test result to her partner and estimates the social support available to the women from their partners and relatives. Fifty-five HIV-positive women in Kigali were interviewed in 1988 and 47 of this group were interviewed again in 1991. The social services most needed by the women in 1988 were housing, employment and money. By 1991, the women prioritised food, housing and money as their current needs and food, childcare and money were their future needs in the event they became ill. The preferred sources of support in 1988 were individual counseling and women's support groups. By 1991, the preferred sources of support were individual counseling and their priest. In 1988, almost 75% of the women did not expect a supportive reaction from their partners after disclosure of the test result. In 1991, acceptance, understanding and sympathy were the most common reactions of the partners after disclosure. However, 8 (21%) had not told their partner their test result. After disclosure, 18 of the 37 partners were subsequently tested. Of those tested, 75% were HIV-positive and 25% were HIV-negative. Condom use was almost twice as high when the partner was informed of the test result, although in couples overall, a third were not using condoms despite knowing the test result.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1985

Screening of medicinal plants of Rwanda for acaricidal activity.

A series of 108 samples from 42 medicinal plants of Rwanda have been screened for acaricidal activity against the female tick Rhipicephalus appendiculatus. Two plants, Solanum dasyphyllum (fruits) and Neorautanenia mitis (roots) showed apparent acaricidal activity in the petroleum ether fraction.

Animals↗
PubMedDate not supplied

Screening of medicinal plants of Rwanda (Central Africa) for antimicrobial activity.

A series of 100 medicinal plants of Rwanda (282 plant samples) has been screened for antimicrobial activity against Bacillus subtilis, Candida albicans, Mycobacterium smegmatis, Pseudomonas aeruginosa, Salmonella gallinarum and Staphylococcus aureus. Thirty percent of the plants tested showed activity against one or more microorganisms.

Anti-Bacterial Agents↗
PubMed1989

Antimicrobial activities of some Ocimum species grown in Rwanda.

The essential oils of four Ocimum species grown in Rwanda, i.e. O. canum, O. gratissimum, O. trichodon and O. urticifolium (synonym O. suave) including some chemotypes, were screened for antimicrobial activities. Escherichia coli, Bacillus subtilis, Staphylococcus aureus and Trichophyton mentagrophytes var. interdigitale were used as test organisms. Different techniques were applied in the screening, such as the biogram and agar overlay techniques and a dilution technique yielding maximum inhibitory dilution (MID) values. Also some growth curves were determined. Although the results obtained by the diffusion techniques were rather different for some of the oil samples, all samples were found to be antimicrobially active.

Anti-Infective Agents↗
PubMed2005

Availability and use of emergency obstetric services: Kenya, Rwanda, Southern Sudan, and Uganda.

UNLABELLED: The article summarises the baseline assessments of emergency obstetric care (EmOC) carried out in Uganda, Kenya, Southern Sudan, and Rwanda in 2003 and 2004. OBJECTIVES: Our objectives were to: (1) set up program baselines on the availability and utilization of EmOC services in these countries; (2) identify gaps and obstacles in providing EmOC services; and (3) make recommendations to governments based on evidence generated. METHODS: Data were collected from clinical record reviews, provider and client interviews, observations, and focus group discussions. Either random or universal sampling was applied in the selection of health facilities assessed. Local nurses and midwives participated in the data collection and, to some extent, data processing and analysis. RESULTS: The coverage of basic EmOC services ranged 0-1.1/500,000 population compared to the UN-recommended level of 4/500,000. The coverage of comprehensive EmOC services ranged 0.5-4.3/500,000 compared to the recommended level of 1/500,000. Between 0.6% and 8.8% of all births took place in EmOC facilities, and 2.1% and 18.5% of all expected direct obstetric complications were treated. Cesarean section as a proportion of all births was between 0.1% and 1%. Shortage of trained staff especially mid-level providers, poor basic infrastructure such as lack of electricity and water supplies, inadequate supply of drugs and essential equipment, poor working conditions and staff morale, lack of communication and referral facilities, cost of treatment, and lack of accountability and proper management were identified as the main obstacles in providing 24-h quality EmOC services especially in remote and rural areas. CONCLUSIONS: Lack of basic EmOC services limits women's access to life-saving services during obstetric complications. To reduce maternal mortality ratio the states and development partners need to focus their effort to improve the coverage, quality, and utilization of EmOC services through supportive national policy, effective program strategies, increased budget allocation to maternal health program, rural infrastructure development, and regular monitoring, and evaluation of progress.

Attitude to Health↗
PubMed2006

Improving availability of EmOC services in Rwanda--CARE's experiences and lessons learned at Kabgayi Referral Hospital.

OBJECTIVE: CARE's work in Rwanda was designed to improve the functional capacity of health facilities for the delivery of EmOC services. METHODS: The project supported a comprehensive package of focused interventions that included hospital renovations, provision of essential equipment, training of staff and improvement of management systems at the Kabgayi regional referral hospital. RESULTS: There was an increased level of preparedness for emergencies and ability to manage common obstetric complications according to evidence-based practices. These changes ultimately led to increased availability, quality and use of services as demonstrated by an increase in the demand for care of obstetric complications at the facility. The met need increased from 16% at the start of the project (2001) to 25% in 2004, while the cesarean rate remained essentially the same (1.9% and 3.2%) over the same time period. There were progressive declines in the case fatality rates from 2.2% in 2001 to 1.2% in 2004. CONCLUSION: CARE's experience indicates that progress towards reducing maternal mortality requires specific efforts that support and strengthen existing health systems to provide skilled care that can save women's lives.

Delivery, Obstetric↗
PubMed2005

Trust in micro-health insurance: an exploratory study in Rwanda.

Micro-health insurance (MHI) has been proposed as an alternative to user fees to improve access to medical care without the threat of financial impoverishment. To enrol in health insurance and pay a premium, consumers should be able to trust that insurers use their funds to reimburse providers who will deliver quality care when needed. In 1998, shortly after the re-introduction of user fees, the Rwandan Ministry of Health in close collaboration with the local population developed and implemented MHI in three districts. Member benefits cover preventive and curative care in health centres and ambulance transport to the district hospital where a limited package of services is also covered by MHI. This paper examines trust-building structures and practices in MHI in Rwanda. It is an exploratory, descriptive analysis using information collected from focus groups. Findings suggest that MHI managers, providers and policy-makers need to think systematically about a wide range of initiatives that enhance trust and caring, and to design trust-building structures and practices in the consumer-insurance-provider arrangement.

Focus Groups↗
PubMed2006

Epidemiological studies on Theileriosis and the dynamics of Theileria parva infections in Rwanda.

An epidemiological analysis based on three country wide surveys was carried out to determine the prevalence of infections with Theileria spp. in Rwanda. In the 1998 dry season, a total of 264 blood samples were submitted to Theileria spp. characterisation using the 18S species-specific PCR-RFLP assay. The same samples together with 634 samples (317 samples/season) collected during the 2002 dry season and the 2003 wet season were further analysed using the p104 Theileria parva specific PCR. The results from the 18S characterisation showed the presence of four Theileria spp., namely T. parva, T. mutans, T. taurotragi and T. velifera in the field. Half of the animals had multiple Theileria spp. infections. T. parva was the most prevalent and a high correlation (94%) was found between the prevalence results using the 18S and the p104 PCR assays. The prevalence of T. parva infections was stable over time and over season but decreased significantly from the high land to the low land areas. This unexpected trend cannot be explained alone by ecology or the dynamics of the tick population in the different zones, many other components such as breed type, tick control practices and grazing system are likely to play a role. Another important finding was the fact that young animals are infected early in life in all regions except in the high land zone indicating the existence of a particular epidemiological situation in this part of the country.

Animals↗
PubMed2002

Deliveries at a district hospital in Rwanda, 1997-2000.

OBJECTIVES: To obtain data on pregnancy outcomes and maternal mortality at a district hospital in Rwanda. METHODS: All delivery records from January 1997 to December 2000 were reviewed. RESULTS: Over the 4-year period, 3408 women delivered a total of 3497 neonates, and 349 stillbirths (10%) occurred. The mean birthweight (twins excluded) was 3097 g and decreased significantly from 3160 g in 1997 to 3043 g in 2000. The prevalence of low birthweight was 12.5%. The mean age of women was 26.2 years. Cesarean section was done in 26% of deliveries at the hospital, equaling a cesarean section rate of 1.1% in the population. Nineteen maternal deaths occurred, yielding a (hospital) maternal mortality rate of 600 per 100000 live births. Uterine rupture occurred in 52 women, of whom six died (11.5%). CONCLUSIONS: Efforts to educate women at risk to deliver at a health center, and early referral of women to the hospital should be reinforced. The reduction of mean birthweight is of concern and reasons for this need to be analyzed.

Adolescent↗
PubMed1984

Acquired immunodeficiency syndrome in Rwanda.

To evaluate acquired immunodeficiency syndrome (AIDS) in central Africa a prospective study was done in Kigali, Rwanda, where Kaposi's sarcoma (KS) is endemic. During a 4 week period, 26 patients (17 males and 9 females) were diagnosed. 16 patients had opportunistic infections, associated with KS in only 2; 1 had multifocal KS alone; and 9 had clinical conditions consistent with prodromes of AIDS. All patients had severe T-cell defects characterised by cutaneous anergy, a striking decrease in the number of helper T cells, and a decreased OKT4:OKT8 ratio (mean 0.27). 21 of the 22 adult patients were living in urban centres and many of them were in the middle to upper income bracket. Most of the men were promiscuous heterosexuals and 43% of the females were prostitutes. No patient had a history of homosexuality, intravenous drug abuse, or transfusion in the previous 5 years. This study suggests that AIDS is present in central Africa as an entity probably unrelated to the well-known endemic African KS. An association of an urban environment, a relatively high income, and heterosexual promiscuity could be a risk factor for AIDS in Africa.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Climatic warming and increased malaria incidence in Rwanda.

Global climatic change is expected to increase the incidence of vector-borne diseases, especially malaria. This study assessed the contribution of climate to a malaria epidemic in Rwanda, focusing on the catchment area of one health centre where diagnosis was consistent and non-climatic variables well monitored. In late 1987 malaria incidence in the area increased by 337% over the 3 previous years. The increase was greatest in groups with little acquired immunity--children under 2 years (564%) and people in high-altitude areas (501%). Case-fatality rose significantly (relative risk = 4.85, p < 0.001). 1987 also saw record high temperatures and rainfall. An autoregressive equation including lagged effects of these two variables explained 80% of the variance in monthly malaria incidence. Temperature (especially mean minimum) predicted incidence best at higher altitudes where malaria had increased most. Empirically derived relations were consistent with the estimated generation time of the disease and with the known sensitivity of the plasmodium parasite to temperature. The patterns of climatic warming between day and night and among seasons will be critical to the effect on malaria. These findings are most relevant to regions near the altitude or latitude limits of the disease, where several epidemics have lately been reported.

Altitude↗
PubMed1996

Emergency medicine education intervention in Rwanda.

STUDY OBJECTIVE: To describe the effectiveness of an emergency medical education program in a postwar developing country. METHODS: A prospective, nonrandomized interrupted time-series study was conducted in an emergency department at a national referral hospital in Rwanda immediately after the 1994 civil war. Participants included 11 medical personnel staffing the ED comprising physicians, nurses, and medical assistants. International medical relief workers in the ED identified deficiencies by directly observing routine clinical practices. On the basis of this assessment, formal training programs in trauma resuscitation, airway management, wound care, and blood/fluid precautions were conducted. Subjects were then observed 1 week and 2 months after the educational programs and scored on a standardized data-collection form. Scores before and after intervention were compared with the use of Fisher's exact test to determine program effectiveness. RESULTS: Educational interventions with statistically significantly longer term effects included wound management principles and blood/fluid precautions (before versus after intervention, P < .05). Interventions with the least sustained effect included advanced airway interventions and procedures related to trauma resuscitation. CONCLUSION: Educational seminars proved to have the greatest sustained effect on those behaviors requiring minimal equipment and noncomplex medical decisionmaking.

Clinical Competence↗
PubMed2026

Improving access to antipsychotic medications for schizophrenia in Ethiopia, Nigeria, Rwanda, and South Africa: an evidence-based global consensus.

There are disparities in access to antipsychotics for schizophrenia across different country settings. Improving access to a wider and more equitable range of medications in low-income and middle-income countries is a priority. A multidisciplinary team of international experts, including individuals with lived experience, appraised the most relevant and recent information on antipsychotics in schizophrenia and contextualised it to four African countries (Ethiopia, Nigeria, Rwanda, and South Africa) using a validated consensus methodology. We recommended a list of drugs to prioritise to guide clinical implementation and research, and market shaping. We identified key evidence gaps: little of the existing evidence comes from the countries of interest, trials generally involve highly selected populations, and the complexity of real-world settings is not reflected. However, this methodology highlights a route forward to prioritise the best available evidence on pharmacological treatments for schizophrenia at a global scale, which could also be applied to treatments for other mental health conditions.

Humans↗
PubMed1998

The psychocultural roots of genocide. Legitimacy and crisis in Rwanda.

In April 1994, the small east African nation of Rwanda became the site of one of the most violent episodes of the 20th century. Over the course of just 100 days, an embattled authoritarian state organized the slaughter of at least 850,000 Rwandans. Briefly, worldwide attention was riveted. But clichés about "age-old tribal hatreds" soon dominated discussion, conveying the impression that this was simply the latest episode in an unending cycle of violence. The truth, however, is quite different. The April genocide was in many ways unique. It was neither tribal nor age-old, and it is hardly fated to recur. Indeed, the author's premise is that if this genocide is grasped in all its psychocultural novelty and complexity, a point of Archimedean leverage can be found for interventions to avert tragedies in the future.

Anomie↗
PubMed2002

Unstable malaria transmission and maternal mortality--experiences from Rwanda.

Data on malaria in pregnancy in unstable transmission areas are scarce. We investigated malaria in pregnancy at Byumba District Hospital, Rwanda, over 3 years (January 1997-December 1999). Byumba, at an altitude of 2300 m, has low levels of malaria transmission. A malaria epidemic in February 1998 led to a fourfold increase in malaria admissions among pregnant women and to a fivefold increase in maternal deaths because of malaria. Safe Motherhood programmes should note that even in non-epidemic years malaria can cause a large proportion of maternal deaths, and that national and international responses to malaria in pregnancy need strengthening.

Adolescent↗