The profile and causes of death among medical doctors and dental surgeons in Uganda: 1986 to 2016

Background: The loss of health workers through death is of great importance and interest to the public, media and the medical profession as it has very profound social and professional consequences on the delivery of health services. Objective: To describe the profile, causes and patterns of death among medical doctors and dental surgeons in Uganda between 1986 and 2016. Methods: We conducted a retrospective descriptive study of mortality among registered medical doctors and dental surgeons. Information on each case was collected using a standard questionnaire and analyzed. Cause of death was determined using pathology reports, and if unavailable, verbal autopsies. We summarized our findings across decades using means and standard deviations, proportions and line graphs as appropriate. Cuzick's test for trend was used to assess crude change in characteristics across the three decades. To estimate the change in deaths across decades adjusted for age and sex, we fit a logistic regression model, and used the margins command with a dy/dx option. All analyses were done in Stata version 14.0 (Stata Corp, College Station, TX). Results: There were 489 deaths registered between 1986 and 2016. Of these, 59 (12.1%) were female. The mean age at death was 48.8 years (Standard Deviation (SD) 15.1) among male and 40.1 years (SD 12.8) among females. We ascertained the cause of death for 468/489 (95.7%). The most common causes of death were HIV/AIDS (218/468, 46.6%), cancer (68/468, 14.5%), non-communicable diseases (62/48, 13.3%), alcohol related deaths (36, 7.7%), road traffic accidents (34, 7.3%), gunshots (11, 2.4%), among others. After adjusting for age and sex, HIV/AIDs attributable deaths decreased by 33 percentage points between the decade of 1986 to1995 and that of 2006 to 2016 ­0.33 (­0.44, ­0.21. During the same period, cancer attributable deaths increased by 13 percentage periods 0.13 (0.05,0.20). Conclusion: The main causes of death were HIV/AIDS, cancer, non-communicable diseases, alcohol-related diseases and road traffic accidents. There was a general downward trend in the HIV/AIDS related deaths and a general upward trend in cancer related deaths. Doctors should be targeted for preventive and support services especially for both communicable and non-communicable diseases

Determination of visual portfolio for surgeons overseas assessment of surgical needs Nigeria study: Consensus generation through an e-Delphi process

Background: Surgery as a public health priority has received little attention until recently. There is a significant unmeasured and unmet burden of surgical illness in low- and middle-income countries (LMICs). Our aim was to generate a consensus among expert pediatric surgeons practicing in LMICs regarding the spectrum of pediatric surgical conditions that we should look out for in a community-based survey for Surgeons OverSeas Assessment of Surgical Needs Nigeria study. Materials and Methods: The Delphi methodology was utilized to identify sets of variables from among a panel of experts. Each variable was scored on a 5-point Likert scale. The experts were provided with an anonymous summary of the results after the first round. A consensus was achieved after two rounds, defined by an improvement in the standard deviation (SD) of scores for a particular variable over that of the previous round. We invited 76 pediatric surgeons through e-mail across Africa but predominantly from Nigeria. Results: Twenty-one pediatric surgeons gave consent to participate through return of mail. Thirteen (62%) answered the first round statements and 8 (38%) the second round. In general, the strength of agreement to all statements of the questionnaire improved between the first and second rounds. Overall consensus, as expressed by the decrease in the mean SD from 0.84 in the first round to 0.68 in the second round, also improved over time. The strength of consensus improved for 23 (74%) of the statements. The strength of consensus decreased for the remaining 8 (26%) of statements. Out of the 31 consensus-generating statements, 16 (51%) scored high agreement, 13 (42%) scored low agreement, and 2 (15%) scored perfect disagreement. Conclusion: We have successfully identified the pediatric surgical conditions to be included in any community survey of pediatric surgical need in an LMIC setting

Place de la radiologie dans la pratique des chirurgiens-dentistes sénégalais

L'odontologie a naturellement bénéficié des innovations en imagerie médicale. L'examen radiologique est devenu une partie intégrante de la prise en charge odontologique. Ce travail avait pour objectif d'évaluer la place de la radiologie dans la pratique des chirurgiens-dentistes sénégalais.Matériels et méthodes.Il s'agissait d'une étude transversale descriptive réalisée auprès des chirurgiens-dentistes exerçant dans les secteurs du privé, et du public de la région de Dakar. Des questionnaires auto-administrés ont été distribués afin de recueillir les informations suivantes : le secteur d'activité, l'importance de la radiologie dans la pratique quotidienne, l'équipement en appareil radiologique, la fréquence de prescription des examens radiologiques. Les données ont été analysées avec le test chi-deux.RésultatsAu total, 132 chirurgiens-dentistes ont répondu aux questionnaires. Parmi eux 42% exerçaient dans le secteur privé, 28% dans le public et 20% étaient des praticiens hospitalo-universitaires. Le sexe ratio était de 2,14 et la moyenne d'âge était de 37 ans ± 11.Plus de 90% des chirurgiens-dentistes accordaient une grande importance aux examens d'imagerie dans leur pratique, 6,84% une importance moyenne. Les films argentiques étaient les plus utilisés avec 75% contre 25% de récepteurs numériques. Les examens radiologiques n'étaient prescrits de manière systématique que par 6,87% des chirurgiens-dentistes alors que 64,84% les prescrivaient de manière sélective et 27% utilisaient rarement.Conclusion: Cette étude a montré une insuffisance d'équipement radiologique et une attitude inadéquate de prescription des examens radiologiques des chirurgiens-dentistes de la région de Dakar Des formations continues en radiologie dentaire s'avèrent nécessaire pour une meilleure connaissance des examens radiologiques