Plant species from the Euphorbiaceae (spurge) family used for medicinal purposes in Zimbabwe: a review / Especies de plantas de la familia Euphorbiaceae (tártago) utilizadas con fines medicinales en Zimbabue: una revisión

The present review was aimed at documenting medicinal uses of species of the Euphorbiaceae family in Zimbabwe. Literature was collected from online databases such as BioMed Central, W eb of Science, Springerlink, Google Scholar, Scielo, PubMed, Science Direct, ACS Publications, Scopus and JSTOR. This study showed that 29 species are used to manage human and animal diseases in Zimbabwe. These species are used against 49 medical condition s, mainly as ethnoveterinary medicine (21 use reports), and traditional medicine against respiratory (23 use reports), gastro - intestinal (14 use reports), male reproductive (11 use reports), antenatal and postpartum (10 use reports each) and sexually trans mitted infections (9 use reports). Acalypha brachiata , Bridelia cathartica , B. mollis , Croton megalobotrys , Euphorbia ingens , E. matabelensis , Flueggea virosa , Monadenium lugardiae , Pseudolachnostylis maprouneifolia , Ricinus communis and Spirostachys afric ana have the highest number of medicinal uses. There is need to unravel the therapeutic potential of the family through further ethnopharmacological research.

La p resente revisión tuvo como objetivo documentar los usos medicinales de especies de la familia Euphorbiaceae en Zimbabwe. La literatura se recopiló de bases de datos en línea como BioMed Central, Web of Science, Springerlink, Google Scholar, Scielo, PubMed, Science Direct, ACS Publications, Scopus y JSTOR. Este estudio mostró que se utilizan 29 especies para el tratamiento de enfermedades humanas y animales en Zimbabwe. Estas especies se utilizan para tratar 49 condiciones médicas, principalmente como medici na etnoveterinaria (21 informes de uso), y medicina tradicional para enfermedades respiratorias (23 informes de uso), gastrointestinales (14 informes de uso), reproductivas masculinas (11 informes de uso), prenatales y posparto (10 informes de uso cada una ) e infecciones de transmisión sexual (9 informes de uso). Acalypha brachiata , Bridelia cathartica , B. mollis , Croton megalobotrys , Euphorbia ingens , E. matabelensis , Flueggea virosa , Monadenium lugardiae , Pseudolachnostylis maprouneifolia , Ricinus communi s y Spirostachys africana son las especies con mayor número de usos medicinales. Es necesario desvelar el potencial terapéutico de esta familia a través de futuras investigaciones etnofarmacológicas.

Epidemiology and trends in the uptake of refractive error services in Harare, Zimbabwe: a hospital-based retrospective study

Aim The study aimed to determine the epidemiology and evaluate the trends in the uptake of refractive error services in Harare. Methods A clinic-based retrospective study at the Greenwood Park Eye Centre and its three subsidiaries was conducted from January 1, 2015 to December 31, 2020. Results 12,216 patients' records were retrieved, out of which 1074 (8.79%) had refractive error cases. The prevalence of visual impairment at presentation was 5.80% [95% CI: 5.39 ­ 6.23]. Among those with refractive error, the sample prevalence of visual impairment before correction was 41.30% [CI: 38.3 ­ 44.3, 95%], and 2.20% [95% CI: 1.4 ­ 3.3] after correction. There was inconsistency in the percentage utilization of refractive error services, with the highest being 42.60% in 2015. Refractive error types were related to age, employment position, and type of visual impairment prior to refractive error treatment. Conclusion There was a low percentage of refractive error services uptake in urban Zimbabwe.

Role development and extension for radiographers in computed tomography: Literature review findings and their application to Zimbabwe

Computed Tomography(CT) technology has evolved into avital diagnostic tool in modern medical practice, leading to the development and extension of the CT radiographer's role. While some countries have made progress in developing and extending radiographers' roles in CT, resource-constrained settings like Zimbabwe have been slower to implement these changes. The purpose of this review is to inform role changes for radiographers in Zimbabwe and similar settings by reviewing the literature on role development and extension for radiographers in CT. The review explores the concepts of role development and extension, emphasizing the necessity for changes in radiographers' roles in CT due to factors such as radiologists shortages, cost containment, quality improvement needs and technological advancements. It also addresses the opposition to role development and extension, emphasizing the fundamental impetus for these changes should be to provide high-quality and effective patient-centered care. The paper delves into specific areas of role development and extension for radiographers in CT, including intravenous (IV) cannulation and contrast media administration, performing CT colonoscopy examinations, reporting on CT brains, and the significance of research and clinical audit in CT. It underscores the potential benefits of these expanded roles, such as improved patient care, workflow efficiency, and the workload of radiologists, as well as advancements in education, service delivery, and technological innovations. The review underscores the need for further research to ensure evidence-based implementation of role development and extension for radiographers in CT. Embracing these changes and providing the necessary support and training can lead to improved patient care, address skill shortages, and advance the radiography profession in resource-constrained settings like Zimbabwe.

Comparison of the disease burden of schistosomiasis globally and in China and Zimbabwe / 中国血吸虫病防治杂志

Objective To investigate the trends in the disease burden of schistosomiasis worldwide and in China, and Zimbabwe from 1990 to 2019, so as to provide insights into the formulation of the schistosomiasis control strategy in Zimbabwe. Methods Based on Global Burden of Disease Study 2019 (GBD 2019) data sources, the age-standardized prevalence, mortality, disability-adjusted life year (DALY) rate of schistosomiasis were compared in the world, China, and Zimbabwe and the trends in the disease burden of schistosomiasis from 1990 to 2019 were investigated using Joinpoint regression analysis. In addition, the associations between the burden of schistosomiasis worldwide and in China and Zimbabwe from 1990 to 2019 and socio-demographic index (SDI) were examined using Pearson correlation analysis. Results The age-standardized prevalence, mortality, and DALY rate of schistosomiasis were 1 804.95/105, 0.14/105 and 20.92/105 in the world, 707.09/105, 0.02/105 and 5.06/105 in China, and 2 218.90/105, 2.39/105 and 90.09/105 in Zimbabwe in 2019, respectively. The global prevalence, mortality, and DALY rate of schistosomiasis appeared a tendency towards a rise followed by a decline with age in 2019, while the prevalence and DALY rate of schistosomiasis appeared a tendency towards a sharp rise followed by a fluctuating decline in both China and Zimbabwe, and the mortality of schistosomiasis appeared a tendency towards a rise. The age-standardized prevalence [average annual percent change (AAPC) = −1.31%, −2.22% and −6.12%; t = −20.07, −83.38 and −53.06; all P values < 0.05)] and DALY rate of schistosomiasis (AAPC = −1.91%,−4.17% and −2.08%; t = −31.89, −138.70 and −16.45; all P values < 0.05) appeared a tendency towards a decline in the world, China and Zimbabwe from 1990 to 2019, and the age-standardized mortality of schistosomiasis appeared a tendency towards a decline in the world and China (AAPC = −3.46% and −8.10%, t = −41.03 and −61.74; both P values < 0.05), and towards a rise followed by a decline in Zimbabwe (AAPC = 1.35%, t = 4.88, P < 0.05). In addition, Pearson correlation analysis showed that the age-standardized prevalence (r = −0.75, P < 0.05), mortality (r = −0.73, P < 0.05), and DALY rate of schistosomiasis (r = −0.77, P < 0.05) correlated negatively with SDI in the world, China and Zimbabwe from 1990 to 2019. Conclusions The disease burden of schistosomiasis appeared a remarkable decline in China from 1990 to 2019, and the prevalence of schistosomiasis showed a tendency towards a decline in Zimbabwe from 1990 to 2019; however, the mortality and DALY rate of schistosomiasis in Zimbabwe topped in the world. A schistosomiasis control strategy with adaptations to local epidemiology and control needs of schistosomiasis is needed to facilitate the elimination of schistosomiasis in Zimbabwe.

Use of herbal, complementary and alternative medicines among pregnant women in Makoni District, Zimbabwe / Uso de medicinas a base de hierbas, complementarias y alternativas entre mujeres embarazadas en el distrito de Makoni, Zimbabwe

Use of herbal, complementary and alternative medicines during pregnancy, labour and delivery is common in Zimbabwe. This study aimed at documenting herbal, complementary and alternative medicines used during pregnancy in Makoni District in Zimbabwe. Snowballing was used to select 66 participants which included herbalists (45.5%), traditional birth attendants (18.2%), traditional healers (15.2%), and assistant traditional healers and herbal medicine vendors (10.6% each). Pregnant women in the study areaused a total of 47 plant species from 27 families, and 14 non-plant products as herbal, complementary and alternative medicines by. A total of 26 medical cases were treated with the majority of medicinal plants and non-plant products, used to dilate or widen the birth canal (55.3%) and to augment labour or speed up the delivery process (46.8%). This study showed that herbal, complementary and alternative medicinesplay an important role in the provision of basic health care in Zimbabwe.

El uso de medicinas a base de hierbas, complementarias y alternativas durante el embarazo, el trabajo de parto y el parto es común en Zimbabwe. Este estudio tuvo como objetivo documentar las medicinas a base de hierbas, complementarias y alternativas utilizadas durante el embarazo en el distrito de Makoni en Zimbabwe. Se utilizó bola de nieve para seleccionar a 66 participantes que incluían herbolarios (45,5%), parteras tradicionales (18,2%), curanderos tradicionales (15,2%) y asistentes de curanderos tradicionales y vendedores de hierbas medicinales (10,6% cada uno). Las mujeres embarazadas en el área de estudio utilizaron un total de 47 especies de plantas de 27 familias y 14 productos no vegetales como medicinas a base de hierbas, complementarias y alternativas. Un total de 26 casos médicos fueron tratados con la mayoría de plantas medicinales y productos no vegetales, utilizados para dilatar o ensanchar el canal del parto (55,3%) y para aumentar el parto o acelerar el proceso de parto (46,8%). Este estudio mostró que las medicinas a base de hierbas, complementarias y alternativas desempeñan un papel importante en la prestación de atención médica básica en Zimbabwe.

Migrações sul-sul: a recente onda de imigrantes zimbabweanos em Tete - Moçambique (2007-2016) / South-south migration: the recent wave of Zimbabwean immigration in Tete − Moçambique (2007-2016) / Migraciones sur-sur: la reciente ola de inmigrantes zimbabuense en Tete − Mozambique (2007-2016)

O objetivo deste artigo é analisar a dinâmica das migrações internacionais sul-sul a partir do estudo de caso da recente imigração de zimbabweanos para a província de Tete, Moçambique, historicamente uma região de emigração. Nesse sentido, examinamos as características sociodemográficas desses novos imigrantes, assim como as condições e motivações individuais, familiares e estruturais subjacentes ao fluxo migratório. Para tanto, combinamos dados quantitativos provenientes do Censo moçambicano de 2007 e dos registros de trabalhadores imigrantes da Direção Provincial de Trabalho, Emprego e Segurança Social, com entrevistas semiestruturadas junto aos imigrantes zimbabweanos em Tete. Os resultados indicam uma multiplicidade de fatores que contribuíram para a recente onda de imigração em Tete, com destaque, além das motivações econômicas e de subsistência familiares, para aspectos sociais e culturais relacionados à longa tradição da mobilidade intrarregional na África Austral, facilitada por fronteiras relativamente porosas e fortes laços culturais, linguísticos e de parentesco. Discutimos, também, como a instalação de megaprojetos de mineração com capital brasileiro, em Tete, contribuiu para torná-la atrativa como destino migratório, num contexto em que se assistiam violentas ondas de xenofobia contra imigrantes na África do Sul, principal destino das migrações na região.

This article analyses the dynamics of international South-South migration through the case study of the recent immigration of Zimbabweans to the province of Tete, Mozambique, historically a region of emigration. We examine immigrants' socio-demographic characteristics, as well as the individual, family and structural conditions and motivations underlying this new migration flow. The analysis combines quantitative data from the 2007 Mozambican Census and administrative records for immigrant workers from the Provincial Directorate of Labour, Employment and Social Security, with semi-structured interviews with Zimbabwean immigrants in Tete. The results indicate a multiplicity of factors that contributed to the recent wave of immigration in Tete. In addition to economic and subsistence motivations, social and cultural aspects related to the long tradition of intra-regional mobility in Southern Africa, facilitated by relatively porous borders and strong cultural, linguistic and kinship ties, seem to be important. We also discussed how the installation of mining megaprojects with Brazilian capital in Tete, contributed to its appeal as a migrant destination, in a context in which violent waves of xenophobia against immigrants were occurring in South Africa, the main destination for migrants in the region.

El objetivo de este artículo es analizar la dinámica de la migración internacional sur-sur a partir del estudio de caso de la reciente inmigración de zimbabuenses a la provincia de Tete, Mozambique, históricamente una región de emigración. En este sentido, examinamos las características sociodemográficas de estos nuevos inmigrantes, así como las condiciones y motivaciones individuales, familiares y estructurales inherentes a este flujo migratorio. Para este fin, combinamos datos cuantitativos del censo de Mozambique de 2007 y registros de trabajadores inmigrantes de la Dirección Provincial de Trabajo, Empleo y Seguridad Social, con entrevistas semiestructuradas con inmigrantes zimbabuenses en Tete. Los resultados indican una multiplicidad de factores que contribuyeron a la reciente ola de inmigración en Tete, entre los que se destacan, además de las motivaciones económicas y de subsistencia familiar, aspectos sociales y culturales relacionados con la larga tradición de movilidad intrarregional en el sur de África, facilitada por fronteras relativamente porosas y por fuertes lazos culturales, lingüísticos y de parentesco. También discutimos cómo la instalación de megaproyectos mineros con capital brasileño en Tete contribuyó con su atractivo como destino migratorio, en un contexto en el que se asistía a violentas oleadas de xenofobia contra inmigrantes en Sudáfrica, el principal destino de las migraciones en la región.

A path toward disability-inclusive health in Zimbabwe Part 2: A qualitative study on the national response to COVID-19

Background: People with disabilities are at higher risk of adverse coronavirus disease 2019 (COVID-19) outcomes. Additionally, measures to mitigate COVID-19 transmission have impacted health service provision and access, which may particularly disadvantage people with disabilities. Objectives: To explore the perspectives and experiences of people with disabilities in accessing health services in Zimbabwe during the pandemic, to identify perceived challenges and facilitators to inclusive health and key actions to improve accessibility. Methods: We used in-depth interviews with 24 people with disabilities (identified through purposive sampling) and with 10 key informants (from expert recommendation) to explore the impact of COVID-19 on access to health care. Interviews were transcribed, coded and thematically analysed. We used the disability-inclusive health 'Missing Billion' framework to map and inform barriers to inclusive health care during COVID-19 and disparities in outcomes faced by people with disabilities. Results: People with disabilities demonstrated good awareness of COVID-19 mitigation strategies, but faced difficulties accessing COVID-19 information and health services. Challenges to the implementation of COVID-19 guidelines related to a person's functional impairment and financial ability to do so. A key supply-side constraint was the perceived de-prioritisation of rehabilitation services. Further restrictions on access to health services and rehabilitation decreased an individual's functional ability and exacerbated pre-existing conditions. Conclusion: The immediate health and financial impacts of the COVID-19 pandemic on people with disabilities in Zimbabwe were severe. Government departments should include people with disabilities in all communications and activities related to the pandemic through a twin-track approach, meaning inclusion in mainstream activities and targeting with specific interventions where necessary.

Simultaneous occurrence of Kaposi sarcoma and tuberculosis; Kaposi sarcoma and lymphoma in the same lymph node: a report on two HIV-positive patients from Zimbabwe

Abstract Reports of simultaneous infections and neoplasms in patients with acquired immune deficiency syndrome (AIDS) are occasionally seen in the literature. However, coexistent lymphoma with tuberculosis, and Kaposi sarcoma (KS) with tuberculosis occurring in the same lymph node is rare. Coexistent lesions pose diagnostic difficulties. In this article, we report two HIV-positive patients from Zimbabwe who displayed KS and tuberculosis; KS and diffuse large B-cell lymphoma in the same lymph node. We found only one similar case presentation in the literature, which was reported in India.

Antibiotic Resistance Patterns and Virulence Factors of Coagulase Negative Staphylococcus Associated with Urinary Tract Infections in Bulawayo Province, Zimbabwe.

Aims: To determine the antibiotic resistance patterns and virulence factors of coagulase negative Staphylococcus (CoNS) associated with urinary tract infections (UTIs). The virulence factors assayed for were the atl E and ica AB genes. The prevalence of the antibiotic resistance gene, mec A, was also determined. Place and Duration of Study: Southern Pathology Clinical Laboratories and the National University of Science and Technology microbiology department, between December 2012 and March 2015. Methods: A total of 754 urine samples were analyzed for bacteria by standard procedures. From these, 126 isolates were positively identified as CoNS. Antimicrobial susceptibility testing of the isolated CoNS was done using the disc diffusion method.The polymerase chain reaction (PCR) was also carried out to detect the presence of the mec A, ica AB and atl E genes. Results: Antibiogram profiles showed that CoNS had high prevalences of resistance to nalidixic acid (88.1%), cotrimoxazole (72.2%) and oxacillin (69.8%).There were however high prevalences of sensitivity to nitrofurantoin (79.4%) and gentamycin (68.3%). A total of 106 (84%) isolates were resistant to three or more antibiotics and 12 multi-drug resistance patterns were observed. The most common pattern (resistance to nalidixic acid, ampicillin, oxacillin, tetracycline and cotrimoxazole) was exhibited by 33 isolates. A total of 40 CoNS isolates were then used to determine the prevalence of the mec A, ica AB and atl E genes. PCR results showed that most isolates 25/40 (62.5%) were positive for the mec A gene. The ica AB and atl E were detected in 32.5% and 25% of the isolates respectively. All isolates which were positive for both the mec A and ica AB genes showed resistance to multiple antibiotics. Conclusion: There is emerging antibiotic resistance in CoNS that cause UTI’s. The occurrence of both the mec A and ica AB genes in CoNS isolates may lead to an increase in antibiotic resistance.

Diagnosis of Multi-drug Resistant Tuberculosis Mutations Using Hain Line Probe Assay and GeneXpert" A Study Done in Zimbabwe.

Background and Aims: Tuberculosis (TB) is a global public health problem and one of the leading causes of death. Worldwide, 31% of all estimated new TB cases are from Africa. Zimbabwe is one of the 22 high TB burden countries. Multi-drug resistant TB (MDR-TB) poses challenges in TB control, hence the need for rapid laboratory diagnosis of MDR-TB for optimal treatment and reducing spread. The study aim was to investigate genetic mutations associated with MDR-TB isolates from various Harare clinics using the GeneXpert MTB/RIF® by Cepheid and Genotype MTBDRplus, to improve the diagnosis and management of MDR-TB. Methods: Samples from adults aged 16 years and older, recruited from several polyclinics in the southern suburbs of Harare were used for our study. All laboratory tests prior to this study had been carried out at Biomedical research and training institute’s level three bio-safety TB laboratory from January 2008-August 2012. Ethical approval was sought from BRTI Institutional review board. A total of 69 (37 MDR-TB and 32 non MDR-TB) archived isolates processed on Genotype MTBDRplus (Hains) and corresponding 39 sputum were processed on the GeneXpert. Mutations on rpoB, katG and inhA genes were observed. The gold standard was culture. Diagnostic accuracy of both methods and their level of agreement were calculated. Results: Of the 37/69 isolates screened by culture for MDR-TB, 88.4% were confirmed by MTBDR® plus line probe assay (Hains). Within the 39 isolates tested using the Xpert MTB/RIF (GeneXpert) assay 12 were true MDR-TB. Over 8 single nucleotide polymorphisms were observed on the three genes conferring Rifampicin and Isoniazide drug resistance. The Hains and GeneXpert had an almost perfect agreement with a kappa value of 0.82. Conclusion: Genetic markers can be used in the diagnosis of MDR-TB, to complement phenotypic methods such as culture. Using the commercial methods, Hains and GeneXpert, 88.4- 94.2% of drug resistance maybe detected. Furthermore, we recommend sequencing so as to identify novel mutations and to design a kit that is custom made for the population.

Unintended consequences of regulating traditional medicine.

The World Health Organization (WHO) has the noble goals of advancing traditional medicine and simultaneously promoting the regulation and professionalization of traditional healers. However, such regulation has the unintended consequence of withholding power from traditional practitioners. This review explores this concept through a historical analysis of traditional medicine in both India and Zimbabwe. During the post-colonial period in both countries, traditional medicine contributed to the creation of national identity. In the process of nationalizing traditional medicine, regulations were set in place that led to a rise in the university-style teaching of traditional healing. This period of professionalization of traditional healers resulted in certain types of traditional medicine being marginalized, as they were neither included in regulation nor taught at university. Since then, the current era of globalization has commoditized traditional healing. Private industries like ZEPL and Dabur have rapidly and vastly altered the role of traditional healers. Consumers can now buy traditional medication directly from companies without visiting a healer. Additionally, disputes over patents and other intellectual property rights have led to important questions regarding ownership of certain plants traditionally known for healing properties. Through regulation and commercialization of traditional medicine, healers have lost some of their independence to practise.

Farmacovigilancia en pacientes con el virus de inmunodeficiencia humana/sida en un hospital de Zimbabwe / Drug surveillance in patients with HIV/AIDS in a hospital of Zimbabwe

Se realizó un estudio descriptivo y prospectivo de 171 pacientes con virus de inmunodeficiencia humana/sida, tratados con antirretrovirales desde abril hasta diciembre de 2008 en el Hospital de Bindura de la provincia de Mashonaland Central (Zimbabwe), a fin de evaluar las reacciones adversas a estos fármacos. Los integrantes de la casuística recibieron combinaciones de dosis fijas y triples de medicamentos prescritos para combatir ese proceso morboso. Se encontró que el sexo femenino fue el más afectado, que 13,4 % experimentaron efectos medicamentosos no deseados y que la mayoría de las reacciones adversas fueron de causalidad probable y de significación clínica moderada. El personal farmacéutico desempeña una función importante en el seguimiento terapéutico de estos portadores.

A descriptive and prospective study was conducted in 171 patients with HIV/AIDS treated with antiretroviral drugs from April to December 2008 in Bindura Hospital of Central Mashonaland province (Zimbabwe), in order to evaluate the adverse reactions to these drugs. Patients of the case material received combinations of fixed and triple doses of medications prescribed to control the disease process. It was found that females were the most affected, 13,4 % experienced undesirable drug effects and most adverse reactions were of probable causation and moderate clinical significance. The pharmacy staff play an important role in therapeutic follow up of these carriers.

The 2008 Cholera Epidemic in Zimbabwe: Experience of the icddr,b Team in the Field.

During August 2008–June 2009, an estimated 95,531 suspected cases of cholera and 4,282 deaths due to cholera were reported during the 2008 cholera outbreak in Zimbabwe. Despite the efforts by local and international organizations supported by the Zimbabwean Ministry of Health and Child Welfare in the establishment of cholera treatment centres throughout the country, the case-fatality rate (CFR) was much higher than expected. Over two-thirds of the deaths occurred in areas without access to treatment facilities, with the highest CFRs (>5%) reported from Masvingo, Manicaland, Mashonaland West, Mashonaland East, Midland, and Matabeleland North provinces. Some factors attributing to this high CFR included inappropriate cholera case management with inadequate use of oral rehydration therapy, inappropriate use of antibiotics, and a shortage of experienced healthcare professionals. The breakdown of both potable water and sanitation systems and the widespread contamination of available drinking-water sources were also considered responsible for the rapid and widespread distribution of the epidemic throughout the country. Training of healthcare professionals on appropriate cholera case management and implementation of recommended strategies to reduce the environmental contamination of drinking-water sources could have contributed to the progressive reduction in number of cases and deaths as observed at the end of February 2009.

Efectividad del tratamiento antirretroviral en pacientes con virus de inmunodeficiencia humana/sida en un hospital de Zimbabwe / Effectiveness of antiretroviral therapy for patients with human immunodeficiency virus/AIDS in a hospital from Zimbabwe

Se efectuó una investigación descriptiva y prospectiva de 171 pacientes con virus de inmunodeficiencia humana/sida, que recibieron tratamiento antirretroviral desde abril hasta diciembre de 2008 en el Hospital de Bindura de la provincia de Mashonaland Central (Zimbabwe), con vistas a evaluar su efectividad; para ello se tuvo en cuenta el número de linfocitos CD4, se determinó el cumplimiento del plan terapéutico por un período de 6 meses después de indicado y se monitoreó clínicamente al paciente durante la fase de estudio. Los integrantes de la casuística comenzaron a ser tratados en las primeras 2 semanas con doble combinación (estavudina + lamivudina) y triple combinación (estavudina + lamivudina + nevirapine). El tratamiento fue cumplido por 95,32 por ciento de los pacientes, 90,06 por ciento tenía un número adecuado de linfocitos CD4 y 83,60 % mostró mejoría clínica, de donde se infirió que la efectividad terapéutica dependió del grado de cumplimiento de las prescripciones médicas y que el personal farmacéutico contribuyó decisivamente a la obtención de esos buenos resultados.

A prospective and descriptive research of 171 patients with HIV/AIDS who received antiretroviral therapy from April, 2008 to December, 2008 at Bindura Hospital from Central Mashonaland province (Zimbabwe) was carried out in order to assess its effectiveness. CD4 cells count was taken into account for this. In addition, compliance was determined for a 6-month period after being prescribed and patients were monitored during the study stage. Cases started to be treated in the first two weeks with double combination (estavudina + lamivudina) and triple combination (estavudina + lamivudina + nevirapine) 95,32 percent of patients followed the treatment, 90,06 percent had an appropriate CD4 cells count, and 83,60 percent showed clinical improvement, in which case it was inferred that therapeutic effectiveness depended on the grade of medical prescription compliance and pharmaceutical staff decisively contributed to the obtaining of those good results.

Neumotórax en pacientes con SIDA: Actualización sobre el tema / Pneumothorax in patients with AIDS: Update on the theme

La aparición de neumotórax como complicación de la neumonía por Pneumocistis carinii (PCP) en pacientes con SIDA, es muy frecuente desde los inicios de la pandemia en 1982, y comporta gran mortalidad. En este trabajo se reporta una serie de 25 pacientes con neumotórax como complicación de la Pneumocistis carinii en pacientes con SIDA, tratado por los autores durante cinco a ños de trabajo discontinuos en el cono sur africano: tres en Sudáfrica y dos en Zimbabwe. Se reportan los datos demográficos y el estado de los mismos al llegar a la sala de cirugía y su evolución después de tratados quirúrgicamente. La toracotomía fue necesaria en ocho pacientes (32 por ciento), diez pacientes necesitaron cuidados de terapia intensiva (40 por ciento), y la mortalidad global fue del 32 por ciento. Se revisa la información actualizada sobre el tema, destacando las pautas terapéuticas más aceptadas internacionalmente. Conflictos de interés: Los autores no declaran conflicto de interés con editores, patrocinadores ni otros autores.

Pneumothorax as a Pneumocistis carinii pneumonia complication in patients with AIDS is very frequent since the pandemic beginnings in 1982, and it is accompanied by a high mortality. In this work we report a series of 25 patients with Pneumothorax as a Pneumocistis carinii pneumonia complication in patients with AIDS, treated by the authors during five years of discontinuous work in the Southern Africa cone: three years in South Africa and two years in Zimbabwe. We report demographic data, the status of the patients when they arrived to the Surgery Service and their evolution after surgery. Thoracotomy was needed in eight patients (32 percent), ten patients needed intensive care (40 percent), and the global mortality was 32 percent. We review the updated information on the theme, emphasizing the most accepted therapeutic guidelines at the international level.

Algunos factores biosociales y obstétricos de la enfermedad hipertensiva gravídica en el Hospital de Chitungwiza, Zimbabwe / Some biosocial and obstetric factors of gestational hypertensive disease in Chitungwiza Hospital, Zimbabwe

Se efectuó un estudio descriptivo y transversal de 181 gestantes con enfermedad hipertensiva, atendidas por los médicos cubanos en el Hospital de Chitungwiza en Zimbabwe, desde enero hasta diciembre del 2007, a fin de caracterizarles según algunos factores biosociales y obstétricos. Predominaron las embarazadas con edades entre 20-24 años y la preeclampsia, eclampsia e hipertensión crónica como formas de la hipertensión arterial, así como las captaciones tardías, la nuliparidad y el bajo peso al nacer. Se recomendó realizar estudios en otros hospitales de ese país para profundizar en las manifestaciones de este indicador y poder establecer estrategias de intervención comunitaria que disminuyan la morbilidad y mortalidad

hA descriptive and cross-sectional study was carried out in 181 pregnant women with hypertensive disease, attended by Cuban doctors at the Hospital of Chitungwiza in Zimbabwe, from January to December 2007, in order to characterize them according to some biosocial and obstetric factors. Pregnant woman between 20-24 years and preeclampsia, eclampsia and chronic hypertension as forms of arterial hypertension predominated as well as late recruitment of women, nuliparity and low birth weight. It was recommended to carry out studies in other hospitals of that country to increase knowledge of manifestations of this condition and to draw up strategies of community intervention that reduce morbidity and mortality

Anti-malaria humoral responses in children exposed to Plasmodium falciparum and Schistosoma haematobium

Antibody responses directed against the Plasmodium falciparum antigens, total extract, anti-merozoite surface protein-3 (MSP3b) and glutamate-rich protein (Glurp-R0) were studied in 42 children exposed to both Schistosoma haematobium and P. falciparum infections. The association between levels of the anti-malaria IgG subclasses and IgM with host age, sex, schistosome infection intensity and schistosome specific antibodies was studied before chemotherapeutic treatment of schistosome infections. This showed a significant negative association between schistosome infection intensity and levels of IgG1, IgG3, and IgG4 directed against malaria total extract antigen, and a positive association between levels of anti-schistosome soluble egg antigen IgG2, IgG3, and IgG4 and levels of the same subclasses directed against malaria total extract antigens. The effect of treating schistosome infections with praziquantel on malaria specific responses was also studied. This treatment resulted in increases in significant IgG4 levels against MSP3b and IgM against Glurp R0. Treatment also resulted in a significant decrease in IgG4 levels against Glurp R0. Host age, sex or pre-treatment infection intensity was not associated with the magnitude of change in the two IgG4 responses while males showed a significantly higher increase in levels of IgM. The results suggest cross reactivity between schistosome and malaria antigens in this population.