Low tuberculosis case detection in Gokwe North and South, Zimbabwe in 2006.

BACKGROUND: Case detection is an important component of tuberculosis control programmes. It helps identify sources of infection, treat them, and thus break the chain of infection. OBJECTIVE: To determine the reasons of low tuberculosis case detection in Gokwe Districts, Zimbabwe. METHODS: A descriptive cross sectional study was conducted. We used interviewer administered questionnaire for nurses and patients, checklists, key informant interviews. RESULTS: Thirty-eight nurses, forty-two patients and seven key informants were interviewed and 1254 entries in tuberculosis register were reviewed. Nurses correctly defined pulmonary tuberculosis, listed signs and symptoms, preventive measures and methods of tuberculosis diagnosis. Exit interviews showed 9/42 (21%) of patients presenting with cough were asked to submit sputa for examination and asked about household contacts with tuberculosis. About 27% of patients who were sputum positive in the laboratory register were not recorded in the district tuberculosis register. This contributed to the high proportion of early defaulters among tuberculosis suspects. CONCLUSION: Low tuberculosis case detection was because nurses were not routinely requesting for sputum for examination in patients presenting with a cough or history of previous treatment for cough. Nurses should routinely request for sputum for examination in patients presenting with a cough or history of recent treatment for cough.

Factors associated with contracting sexually transmitted infections among patients in Zvishavane urban, Zimbabwe; 2007.

BACKGROUND: Sexually transmitted infections (STIs) remain a major public health problem in Zimbabwe. In Zvishavane, STI increased from 66 per 1,000 in 2002 to 97 per 1,000 in 2005, a 31% increase in cases. OBJECTIVE: To determine the factors associated with contracting sexually transmitted infections (STI) among patients in Zvishavane. METHODS: A frequency matched case control study was conducted. Cases were persons above 15 years diagnosed with STI at three health facilities in Zvishavane urban. Controls were patients who visited the same facilities for other ailments. We interviewed 77 cases and 154 controls. RESULTS: Both cases and controls were knowledgeable about STI. Risk factors for men included sex under the influence of alcohol OR=7.11 (95% CI 2.42-20.85), relationships less than one year, OR= 9.33 (95% CI 3.53-24.70), no condom use at first intercourse OR=5.17 (95% CI 1.64-16.25) and paying for sex OR= 23.65 (95% CI 6.23-89.69). For females the risk factors were non-use of condom at first intercourse OR=2.49 (95% CI 1.02-6.04) and relationships less than one year OR=3.19 (95% CI 1.41-7.23). Significant differences in attitudes were evident among cases and controls. CONCLUSION: Knowledge of STI did not provide protection from STI diagnosis. Limiting the number of partners, consistent condom use, and fidelity are important for both men and women.

Low Tuberculosis Case Detection in Gokwe North and South; Zimbabwe in 2006

Background: Case detection is an important component of tuberculosis control programmes. It helps identify sources of infection; treat them; and thus break the chain of infection. Objective: To determine the reasons of low tuberculosis case detection in Gokwe Districts; Zimbabwe. Methods: A descriptive cross sectional study was conducted. We used interviewer administered questionnaire for nurses and patients; checklists; key informant interviews. Results: Thirty-eight nurses; forty-two patients and seven key informants were interviewed and 1254 entries in tuberculosis register were reviewed. Nurses correctly defined pulmonary tuberculosis; listed signs and symptoms; preventive measures and methods of tuberculosis diagnosis. Exit interviews showed 9/42 (21) of patients presenting with cough were asked to submit sputa for examination and asked about household contacts with tuberculosis. About 27of patients who were sputum positive in the laboratory register were not recorded in the district tuberculosis register. This contributed to the high proportion of early defaulters among tuberculosis suspects. Conclusion: Low tuberculosis case detection was because nurses were not routinely requesting for sputum for examination in patients presenting with a cough or history of previous treatment for cough. Nurses should routinely request for sputum for examination in patients presenting with a cough or history of recent treatment for cough

Behavioural factors associated with cutaneous anthrax in Musadzi area of Gokwe North, Zimbabwe.

OBJECTIVES: To determine behaviour factors for contracting human cutaneous anthrax among residents of Musadzi area. DESIGN: We conducted a matched case-control study for age, sex, and village. SETTING: A rural community in Musadzi area of Gokwe North district. SUBJECTS: We interviewed 35 cases and 35 controls. A case was defined as any resident/visitor of Musadzi, diagnosed with anthrax between 9 September and 10 November 2004. A control was any resident who had not been diagnosed with anthrax and had no lesions suggestive ofanthrax on day of the interview. MAIN OUTCOME MEASURES: Behaviour factors associated with contracting anthrax. RESULTS: In September 2004, cattle were reported to be dying in Musadzi area. Bacillus anthracis was positively identified in a blood smear from some of the carcasses. The attack rate among humans was 5%. Risk factors associated with contracting anthrax were: skinning of animals that had died from unknown causes AOR=3.8 (95% CI:1.3-10.7); preparation of the meat for cooking (AOR=3.1 (95% CI:1.16-8-4); preparation of the meat for drying AOR=2.7 (95% CI: 1.0081-7.4); belonging to a religious or ethnic sect that allow handling of meat from animals that had died from unknown causes (AOR=5.2 (95% CI: 1.8-14.8). CONCLUSION: The human anthrax outbreak was secondary to an anthrax epizootic occurring in cattle. The Ministry of Health activated the local zoonotic committee, carried out anthrax awareness campaigns, supervised the destruction of carcasses, disinfected potentially contaminated sites and introduced a participatory health education tool on anthrax. The veterinary department quarantined and vaccinated cattle.

Schistosomiasis infection among school children in the Zhaugwe resettlement area, Zimbabwe April 2005.

OBJECTIVES: To investigate the prevalence and factors associated with contracting schistosomiasis in Zhaugwe resettlement area of Shurugwi district. DESIGN: Cross sectional study. STUDY SETTING: The community in the Zhaugwe resettlement area of Shurugwi district, Midlands Province, Zimbabwe. SUBJECTS: School children in primary and secondary levels. MAIN OUTCOME MEASURES: Prevalence of schistosomiasis infection, risk factors for contracting schistosomiasis. RESULTS: Prevalence of S. haematobium and S. mansoni was 68% and 0.2%, respectively. Participating in watering the respondents' household garden (O.R = 8.1, 95% CI 1.65 to 40.2), fetching water for the home garden (O.R=3,96 95% CI 1.38 to 11.32), fishing with their legs in the water (O.R = 3.1 95% CI 1.6 to 5.8), bathing in the river or stream (O.R = 3.1 95% CI 1.68 to 5.8) were found to be statistically significantly associated with contracting schistosomiasis infection. Fishing with legs immersed in water, having a garden at home, and swimming in the river were positively associated with infection. Those who reported blood in their urine were 16 times more like to be positive for S. haematobium than those without. Vector snails were present at all water contact sites. CONCLUSION: Schistosomiasis is a major public health problem in the area. We recommend mass treatment of all school children in all other schools in the area. The community should be encouraged to cultivate Phytoloca dedocandra for snail control.