Malaria and maternal mortality in Gezira-Sudan

The objectives of this study include: [1] to identify the magnitude of malaria as a cause of maternal mortality [MM] [2] to study the demographic characteristics of MM cases caused by malaria and [3] to identify the actual cause of MM due to malaria. This is a six years hospital based retrospective review of hospital records of ladies died due to malaria in Wad Medani Teaching Hospital for Obstetrics and Gynaecology [WMTHOG], form 1 January 1998 to 31 December 2003. Malaria caused 10% to 40% of MM per year. The mean age was 27.57 years, most of them were primigravidae and from rural areas. 37.8% of the deaths occurred between 28 and 36 week of gestation. The median duration of stay in hospital was two days. However 32.4% of deaths stayed for less than 24 hours that indicated severe and serious clinical presentations. The main causes of death due to malaria or its complication were: anaemia [24.3], cerebral malaria [21.6%], circulatory failure [12.51] and renal failure [8.1%]. Others were pulmonary oedema, hyperpyrexia, puerperal psychosis, abortion, severe epistaxis, cardiac arrest, black water fever, electrolyte imbalance, and hepatic failure. The study recommended effective prevention of malaria and an intensive care approach in its management

Assessment of the available obstetrical resources, all hospitals [40] in Gezira state, Sudan

This study was done for the purpose of assessing the available Obstetrical resources [materials and human] in 40 hospitals in Gezira State, Sudan. The results were used in preparing a major health project; University of Gezira Initiative for Safe Motherhood and Childhood [UGISMC].The aim of [UGISMC] is to reduce maternal mortality rate [MMR] and perinatal mortality rate [PMR] in Gezira State by 50% in 5 years [2005-0210]. are to [1] assess the available delivery resources in all hospitals [40] in Gezira State. [2] to identify deficiencies in the provision of obstetrical care particular attention was given for the availability of appropriate supplies equipments, facilities and manpower. All the hospitals in Gezira State [40] were included in this descriptive observational field survey. All major theatres, minor theatres, labour rooms were visited by the principal investigator and their resources were assessed thoroughly by direct observation, each hospital was assessed in the presence of the medical officer in charge.The relevant information were obtained and compared with the standard lists which were developed and prepared by a group of experts. In the 5 specialized hospitals all the obstetrical emergencies could managed safely,namely [Madani,Hisahisa, Alkamleen, Rufaa, and Almnagil].However, out of the 35 rural hospitals studied, in only[11/34] 33% emergencies could be managed safe, where the facilities are not adequate to deal with obstetrical emergencies and maintain safe delivery. The majority of rural hospitals are not equipped with enough facility and man power to manage obstetric emergency

Training course on delivery care and neonatal care in rural hospitals, Gezira state, Sudan

This paper describes a training course for medical officers working in the rural hospitals in Gezira State to achieve a general objective; safe management of obstetric emergencies, miscarriage and the newborn. the description of the course includes; an introduction, the specific learning objectives, a detailed plan of work, instructional methods, resources, the course timetable, evaluation methods, description of the logbook and the feedback questionnaire. This article also includes descriptions of our experience in three rounds during which 43 medical officers were trained

Malaria as an important cause of maternal mortality in Sudan

This study was performed to highlight the role of malaria in pregnancy as an important cause of maternal mortality. It reviewed the previous studies, conference presentations and postgraduate thesis. Malaria was found to be the cause of death of 10.26% to 46.7% of maternal mortality. The 1998 to 2003 records of maternal deaths of Wad Medani Obstetrics and Gynaecology Teaching Hospital [WMOGTH] was retrospectively studied. Malaria caused death of 8.82% to 39.7%. The mean age was 27.57years . most of them were primigravidae and from rural areas. 37.8% of the deaths occurred at 28-36 weeks of gestation. The mean duration of stay in hospital was 3.22 days, 32.4% of deaths stayed for less than 24 hours, this indicated severe and serious clinical presentations. The main causes of death due to malaria were anaemia [24.3%], cerebral malaria [21.6%] and circulatory failure [8.1%]. Others were pulmonary oedema, hyperpyrexia, puerperal psychosis, abortion, severe epistaxis. cardiac arrest, black water fever, electrolyte imbalance, and hepatic failure. The study recommended effective prevention of malaria and an intensive care approach in its management