Minimum incidence of congenital talipes equino-varus (CTEV) and post treatment evaluation of residual deformities in a population in Zimbabwe.

OBJECTIVE: To determine the minimum incidence (MI) of congenital talipes equino-varus (CTEV) in children; evaluate the association between CTEV and other congenital anomalies, and to assess the presence of residual deformities after conservative management at the physiotherapy department of Harare Central Hospital (HCH), Zimbabwe. DESIGN: A three year retrospective study. SETTING: Physiotherapy Department, HCH, Harare, Zimbabwe. SUBJECTS: Eighty-two children with CTEV who were assessed and treated at HCH Physiotherapy Department from January 1994 to December 1996. MAIN OUTCOME MEASURE: MI of club foot and degree of correction of the club foot after conservative management of the deformity by the physiotherapist. RESULTS: An MI rate of about 0.9 per 1000 was found over a three year period. It was also found that 30.5% of these children had other associated congenital abnormalities. There was no significant association between gender and severity of deformity (P = 0.326). A significant association between the severity of CTEV and the presence of other associated congenital deformities was found (P = 0.013). 91% of the feet were found to have a satisfactory result of treatment using the Wynne Davis scoring system (WDSS). 52% of the patients with residual deformity after discharge from physiotherapy presented with limitation in ankle and sub-talar movements. This study also indicated that children with grade 2 type of deformities were more likely to have other congenital abnormalities than those with grades 1 or 3. CONCLUSION: The MI of CTEV in the studied population was found to be lower than other countries. The WDSS indicated that a great majority of the feet examined scored above average score.

Preliminary study of body mass index and its relationship to percent body fat in Harare, Zimbabwe.

OBJECTIVES: The aims of this paper were to document the body mass index (BMI) and anthropometric characteristics of the city of Harare urban dwellers of Zimbabwe. To investigate the relationship between BMI, sum of skin folds (SSF) and percent body fat (PBF). DESIGN: Cross sectional study. SETTING: Designated fitness awareness locations in the city of Harare during the 1998 physiotherapy awareness week. SUBJECTS: The participants were 140 apparently healthy adults, males (n = 71) and females (n = 69). MAIN OUTCOME MEASURE: Body Mass Index. RESULT: The minimum and maximum values of BMI were 17.7 and 33.3 for men, 17.6 and 47.8 for women. BMI was not found to increase with aging but PBF on the contrary did. The mean BMI value for the males and females was 24.89 +/- 3.18 and 27.8 +/- 5.89 respectively. There was no significant difference in mean BMI between sexes (p = 0.331). Weight was also similar by gender (p = 0.4691). In both sexes, the BMI showed a significant positive correlation with PBF, SSF, body weight and age (for males r = 0.721, 0.731, 0.900, 0.369, p < 0.01 respectively; and in females r = 0.786, 0.804, 0.940, 0.404 and p < 0.01 respectively). CONCLUSION: Women were found to have higher BMI, PBF, SSF than their male counterparts. On the average, men were found to be taller, with no significant difference in weight. There was a linear relationship between BMI and PBF, and all the variables investigated except age and stature in both sexes. Because of the differences of environment and industrialisation, estimation of BMI should involve such factors as ethnicity, race, gender and age.

Problems, struggles and some success with spinal cord injury in Zimbabwe.

Spinal cord injury is a common occurrence in Zimbabwe and carries with it a high morbidity and mortality. In the past almost all patients discharged from hospital were dead within a year. Reasons for this high mortality are presented. The establishment of the National Rehabilitation Centre has had a profound impact on the survival of these individuals as well as on improving their quality of life. The results of a retrospective survey on the mortality and life situation of individuals with spinal cord injuries sustained through trauma are presented. However major unresolved problems are inadequate housing, lack of financial support, practically no prospect of employment and depression compounded by boredom.

Provision of physiotherapy services at the sixth All Africa Games.

The provision of physiotherapy services to guest nations by the host nation, Zimbabwe, at the sixth All Africa Games is examined. There was a high rate of pre-existing injury. Ice, the Cryocuff, and ultrasound were the most frequently used tools, and should be made available to physiotherapists at all multisport events. It is recommended that collection of epidemiological data be standardised to allow comparison between events.

The use of pain measurement scales in the Zimbabwean context.

OBJECTIVE: Although pain intensity is difficult to assess and quantify, different assessment tools have been developed for this purpose. The most widely used are verbal and numerical pain rating scales. This study aimed to establish the reliability in the Zimbabwean setting of four standardised scales. DESIGN: The study used a prospective, descriptive cross sectional design. SUBJECTS: The subjects were 40 females inpatients of the two government maternity units in Harare who had undergone caesarian section, one to three days prior to participation. MAIN OUTCOME MEASURES: Each subject responded twice to four scales, the Visual Analogue, the Box Numerical, the Hewer and the McGill verbal descriptive scales with a one hour interval between each response. RESULTS: The Spearman's rank correlation showed significant positive correlations between each pain rating scale for the whole sample for the first responses. There were non significant correlations between the first and second responses for each scale for those with seven years or less years of education. There were positive significant correlations between first and second responses on each scale for those with more than seven years of education. CONCLUSIONS: Both the numerical and verbal scales measure the same construct of pain experience. The scales are reliable when used with the more educated of the Zimbabwean population. It is recommended that the scales should not be used on a population who have less than seven years of education. More research is needed to determine the validity of pain scales within the Zimbabwean context.