Prevalence of severe acute malnutrition and its effect on under-five mortality at a regional hospital in South Africa

Introduction: Severe acute malnutrition (SAM) is an important global and national public health concern. It contributes tounder-five mortality but is also largely a preventable disease. Objective: This study aimed to assess the prevalence of and mortality associated with SAM. Design: A retrospective review of hospital files was conducted. Setting: Dora Nginza Hospital, Eastern Cape, South Africa was the site of the study. Subjects: The study included children from 6 to 59 months of age admitted to the paediatric ward between January 1, 2018 and December 31, 2018. Children with chronic disease were excluded. Ethics approval was granted by Walter Sisulu University (053/2019). Outcome measures: Anthropometric, co-morbid and outcomes data were retrieved and analysed. Results: A total of 1 296 children were included in the study, 93 with SAM. The prevalence of SAM was 7.2%. Children with SAM had a median age of 16 months (IQR 11­25). Gender distribution was 52 (56%) females and 41 (44%) males. The inpatient mortality rate for children with SAM was 6.5%. Children with SAM were at significantly increased risk of mortality (RR 5.97, 95% CI 3.1­11.6, p-value < 0.0005). Three factors were significantly associated with mortality: nutritional oedema, sepsis, and hypokalaemia. Conclusion: The prevalence of SAM at Dora Nginza Hospital is high, and children with SAM are at significantly increased risk of mortality. Specific risk factors for mortality include sepsis, urinary tract infection, nutritional oedema and hypokalaemia. Modifiable factors associated with SAM and SAM-related mortality need to be targeted urgently to improve outcomes.

Quality of nursing care of surgical patients at the regional hospital of Ngaoundere

Introduction. One way of assessing the quality of healthcare is to study the satisfaction of patients about the care which is provided by nursing personnel of surgical units. The aim of the study was to assess the healthcare quality provided to patients, and how satisfied they are with focus on the sociodemographic factors that can affect the patients' nursing at the Regional Hospital of Ngaoundere. Patients and methods. This was a cross sectional transversal prospective study that was carried in n the surgery unit of the Regional Hospital of Ngaoundéré from September to December 2015. Our tools were a questionnaire and observational audit. Our study variables were the knowledge and attitudes of patients in relation to aesthesia and surgery, and the level of satisfaction in all its dimensions during the various stages of the perioperative interventions. Results. Within three (03) months, we have got and handled a sample if sixty (60) patients, using a questionnaire that enabled us to record 3.75 for the total amount of satisfaction and 75% for the total rate. The technical competences were the highest proportion with a total rate of 91.8%, 92.6% for the esteem (respect) and 84.4% for the staff characteristics. But supporting was less, with 47.5%. Conclusion. Our results emphasize some factors that should be improved to provide a better nursing quality care plan to patients during surgical operations

Factors contributing to neonatal admissions and outcomes at Effia Nkwanta regional hospital: January to December 2015

Objectives: To investigate factors contributing to neonatal admission outcomes at Effia Nkwanta Regional Hospital (ENRH) Method: All neonatal admissions to the Neonatal & Intensive Care Unit (NICU) of the hospital that were entered into the DHIMS2 database were extracted and complemented with additional information from patients' folder review. The data from the two sources were merged and analysed using SPSS version 21. Univariate and multivariate regression analysis was performed to identify factors associated with admission outcomes, taking statistical significance as p < 0.05. ARC-GIS version 10.1 was used to describe the geospatial distribution of health facilities referring to ENRH. Setting: Neonatal & Intensive Care Unit of ENRH Participants: All neonates admitted to NICU between January and December 2015. Intervention: None Results: Nine Hundred and Ninety-Three out of the 1150 neonatal admissions were entered into DHIMS2. Fifty-two percent were males, 57.3% were delivered through Caesarean Section, 72% were admitted within 2 days of birth, and 56.8% had normal birth weight. FiftyEight percent of the neonates were delivered at the ENRH, whilst 39.9% were referred from health facilities located within Sekondi-Takoradi Metropolis. At 1 minute, only 14% of the neonates had normal Apgar score (8-10), and this improved to 50% at 5 minutes. The main causes of neonatal admission were birth asphyxia 21.0%, followed by prematurity 17.5%, neonatal jaundice 17.1% and neonatal sepsis 14.5%. The death rate was 18% with more than 80% of the deaths occurring during the early neonatal period. More than 80% of deaths were due to four admission diagnoses: birth asphyxia, prematurity, neonatal jaundice, neonatal sepsis. Factors associated with adverse admission outcome are: low birth weight, delivery by Caesarean Section and low Apgar score at 5 minutes. Conclusions: The institution of appropriate interventions to reduce or manage the four major causes of adverse neonatal admission outcomes will significantly reduce neonatal mortality in the hospital

A retrospective study of lower limb cellulitis in a regional hospital in Ghana

Background: Cellulitis is a non-necrotizing inflammation of the dermis of skin and subcutaneous tissues. Lower limb cellulitis is a common cause of hospitalization in Ghana but scarcely reported. Objective: To document management and outcomes of lower limb cellulitis at the Ashanti Regional Hospital in Ghana. Materials and Methods: Retrospective review of patients admitted to the Ashanti Regional Hospital with a diagnosis of lower limb cellulitis from November 2016 to October 2018. We reviewed patients' clinical records for data on patient demographics, risk factors, clinical presentation, treatment modality and outcome of cellulitis. A p-value of less than 0.05 was considered to be statistically significant. Results: Eighty two (82) patients with lower limb cellulitis were admitted over the study period. There were 47 (57.3%) females and 35 (42.7%) males. The mean age of patients was 38.8 years (standard deviation 21.6065). Among females, the majority, 10 (21.3%) were in the 6th decade whilst the majority, 9 (25.7%) of males were in the 4th decade. All the patients presented with swelling of the lower limb involving the left lower limb in 38(46.3%) and right in 44(53.7%) cases. The leg was the most common location involved 60 (73%). The mean duration of swelling prior to admission was 5. 2 days (SD 3.196). Antibiotics treatment resulted in complete resolution in 29 (35.4%) cases and complications in 53 (54.5%), cases requiring surgical treatment in 31(58.5%) patients. Conclusion: Lower limb cellulitis had a high complication rate influenced by duration of symptoms prior to hospitalization and antibiotic therapy

Joint MoH/SIDA assessment of multidisciplinary training schools : phase 1: assessment of health manpower; education and cost aspects

In the Specific Agreement on Health Sector Co-operation between Sweden and Zimbabwe 1988.90; it was agreed taht SIDA would support construction of one additional Multidisciplinary Training School on condition that a joint assessment satisfactorily establishes cost effectiveness of such a school. This joint assessment should look into the social and economic cost effectiveness of another multidisciplinary school with regard to physical investment cost; running costs; management; relevance of training; selection of trainees; deployment of trainees in rural health service; as well as in relation to long term manpower needs and development priorities in implementing the decentralized primary health care service that Zimbabwe has established through its Health with Equity policy. In this agreement a tantative allocation of initially 4.0 millions SEK was made for the purpose of building one more Multidisciplinary Training School. Terms of Reference (see Appendix 5) for the assessment was prepared jointly by Ministry of Health SIDA. The assessment should be a joint effort between Ministry of Health and two consultants (Health Manpower Development and Construction) provided by SIDA. [abstract terminated]