The Mortality of Serving African Presidents: A Lesson for the Health Profession and the Lay Public

Although Africa has the worst mortality data in the world; the picture painted by the high mortality rate of serving Africa leaders in the last five years suggests reasons and causes far beyond poor socio-economic conditions. This study examined the causes and age at death of serving African leaders; in the last five years; and draws out the lessons; for the health profession and the general public.Material and methods: An internet search of creditable websites was carried out to determine the number; causes and age at deaths of the leaders; within the study period of 2008 to 2012. The life expectancy rates of the bereaved countries were also considered.Results: A total of 13 presidential mortalities took place in the world during the study period; with 10 (76.92) involving serving African leaders. The leaders died at an average age of 66.9 +/- 7.22 years; an average of 12.1 years above the life expectancy rate of their respective countries; but less than the world average of 68 years. Most (80.00) of the leaders died from non-communicable diseases; 3 died from cardiovascular diseases; 3 died from cancer; while two were known diabetics. The remaining two leaders were killed in a violent change of government.Conclusion: The African leaders died mainly from non-communicable diseases; at an age that is below the world average. Public enlightenment campaigns and greater emphasis on patient-centered chronic care of non-communicable diseases are hereby recommended

The Prevalence of Substance Use and its Associations amongst Students Attending High School in Mitchells Plain; Cape Town

Purpose: In South Africa; there has been an increase in illicit drug trafficking and consumption and associated problems since the 1990s. Mitchells Plain in Cape Town is seen as a community battling with crime; gangsterism; unemployment; overcrowding; substance abuse and poverty. This study evaluated the actual prevalence of substance abuse amongst high school students in this community and factors associated with substance use. In particular; the study evaluated the use of tik (crystal methamphetamine); a relatively new drug. Method: A cross-sectional study was performed amongst 12 secondary schools in Mitchells Plain; Grade 8 and Grade 11 classes were randomly selected to produce a sample of 438 learners. The students completed an anonymous questionnaire that contained enquiries on substance use; demographic and school performance details; and personal and sexual risks. Results: Lifetime and annual prevalence rates were: alcohol (50.6/41.0); tobacco smoking (49.7/36.2); cannabis (32.1/21.1); crystal methamphetamine (9.2/4.6); ecstasy (4.4/2.7); mandrax (2.1/0.9); solvents (3.0/0.9) and cocaine (0.9/0.9). Illicit substance use was significantly associated with age (OR 1.6; CI 1.2-2.2); substance use by other members of the household (OR 2.8; CI 1.2-6.3); carrying a knife (OR 10.9; CI 4.2-28.8); attempted suicide (OR 3.7; CI 1.4-9.5) and higher sexual risk (OR 1.6; CI 1.2-2.3). Conclusion: The prevalence of substance use amongst adolescent students attending high schools in Mitchells Plain; Cape Town; is high for all substances relative to national and international figures. Government officials; educators and health care workers are alerted to the need for more comprehensive interventions to prevent and treat substance abuse in this and similar communities

Evaluation de la qualité des soins et services à la clinique d'urologie et d'andrologie du CHU Hubert Maga de Cotonou

Objectif: L'évaluation de la qualité des soins et services dans la pyramide sanitaire est indispensable et intégrable aux normes et standards de santé des centres hospitaliers. Le but de ce travail est d'apprécier la qualité des soins et services à la Clinique d'Urologie et d'Andrologie de Cotonou. Matériel et méthodes: Le matériel d'étude utilisé est constitué par l'équipement et les prestataires de services de la Clinique d'Urologie et d'Andrologie du CHU Hubert MAGA de Cotonou. La méthode d'étude est rétrospective. La période couverte va du 1er Janvier 2001 au 31 Décembre 2002. L'hypothèse à corréler est « l'amélioration de la qualité des soins et services passe par l'évaluation des services ». Les variables étudiées sont celles du référentiel de l'OMS. Résultats: Les normes et standards évalués à la clinique d'Urologie et d'Andrologie du CHU Hubert MAGA de Cotonou affichent des indicateurs de satisfaction variable. Les indicateurs à améliorer sont les infrastructures (44%< S <72%), le matériel médico-technique (S=75%) et l'utilisation du service (S= 50%). Les autres ont un score 65%<S<100% jugés satisfaisants. Discussion: Les normes et standards évalués sont ceux du référentiel de l'OMS. Ainsi, l'équipement dénote d'une insuffisance d'infrastructure, de matériel médico-technique, de médicaments et de consommables. La performance du personnel est satisfaisante pour sa disponibilité et sa compétence technique. L'efficacité est moyenne quant à l'utilisation de services et suffisante pour les résultats de l'évolution. L'efficience est également moyenne quant au taux d'utilisation du bloc opératoire et à la productivité. L'organisation du service est satisfaisante dans son mécanisme de gestion et dans son organisation opérationnelle. La collaboration interpersonnelle est excellente entre prestataires et utilisateurs de services. L'hygiène est satisfaisante, l'hébergement est acceptable. La restauration répond à l'attente des utilisateurs et des prestataires. Conclusion: Tous les aspects des normes et standards de santé ne sont pas abordés. Les résultats obtenus sont propres au service, à son orientation future dans la stratégie et la tactique de l'assurance qualité de soins. Oui, les normes et standards influencent la qualité des soins et services