Chronic subdural haematoma associated with pre-eclampsia: case report and review of the literature.

Pre-eclampsia complicates approximately 5-8% of all pregnancies and may have adverse long-term effects on both mother and child. Chronic atraumatic subdural haematoma as a complication of severe pre-eclampsia, in the absence of clotting factor abnormalities, is a very rare condition. We present the case of a 30-year-old Moroccan woman who had a pregnancy 10 years previously, with an uneventful delivery. She presented with pre-eclampsia complicating a 29-week-old pregnancy. A few days preceding maternity unit admission the patient complained of headaches and malaise. Her blood pressure at admission was 150/120mmHg and subsequently was treated with doses of methyldopa and magnesium sulphate. Her condition worsened with a loss of consciousness 24 hours later and was transferred to the neurosurgical unit. A brain computerized tomography (CT) scan revealed a left-sided subdural haematoma and the patient underwent surgery, with a good postoperative outcome. This article highlights the occurrence of neurological complications due to pre-eclampsia/eclampsia that require particular neurosurgical attention, its treatment and prognosis. We also review the literature regarding this pathology.

A rare case of adult medulloblastoma with spinal metastasis.

Medulloblastoma is a relatively common malignant brain tumor of childhood and relatively rare in adulthood, with a propensity for neuraxial spread via cerebrospinal fluid pathways. Osseous extraneural metastasis is uncommon and when it happens, radiologic findings are of sclerotic (60%), lytic (35%), and mixed patterns (5%) (Algra et al. (1992)). In this paper, we present a case of medulloblastoma metastiaszing to the lumbar spine and describe the magnetic resonance appearance, with emphasis on the image findings mimicking spondylodiscitis.

Evaluation of the cost-effectiveness of pyramidal, modified pyramidal and monoscreen traps for the control of the tsetse fly, Glossina fuscipes fuscipes, in Uganda.

Several trap designs have been used for sampling and control of the tsetse fly, Glossina fuscipes fuscipes, Newstead (Diptera: Glossinidae) based on preferences of individual researchers and program managers with little understanding of the comparative efficiency and cost-effectiveness of trap designs. This study was carried out to evaluate the cost-effectiveness of four commonly used trap designs: monoscreen, modified pyramidal and pyramidal, relative to the standard biconical trap. The study was performed under high tsetse challenge on Buvuma Island, Lake Victoria, Uganda, using a 4 x 4 Latin square design replicated 3 times, so as to separate the trap positions and day effects from the treatment effect. A total of 12 trap positions were tested over 4 days. The monoscreen trap caught significantly higher numbers of G. f. fuscipes (P<0.05) followed by biconical, modified pyramidal and pyramidal traps. Analysis of variance showed that treatment factor was a highly significant source of variation in the data. The index of increase in trap catches relative biconical were 0.60 (pyramidal), 0.68 (modified pyramidal) and 1.25 (monoscreen). The monoscreen trap was cheaper (US$ 2.61) and required less material to construct than pyramidal trap (US$ 3.48), biconical and the modified pyramidal traps (US$ 4.06 each). Based on the number of flies caught per meter of material, the monoscreen trap proved to be the most cost-effective (232 flies/m) followed by the biconical trap (185 flies/m). The modified pyramidal and the pyramidal traps caught 112 and 125 flies/m, respectively.

Endemic stability for Theileria parva infections in Ankole calves of the Ankole ranching scheme, Uganda.

A population-based study was carried out on the Ankole ranching scheme in south-west Uganda with the aim of determining the endemic status of Theileria parva infections. For this purpose, the age-related sero-prevalence of T. parva and the specific calf mortality associated with the parasite were assessed. Blood samples were collected from 931 Ankole calves of up to 12 months of age from 81 randomly selected herds. The relationship between rainfall pattern and whole-body Rhipicephalus appendiculatus counts was determined. The influence of tick control practices on East Coast fever-related calf mortality, and sero-positivity were also determined. A significant (r2 = 0.76, P = 0.000) association between R. appendiculatus counts and rainfall was observed. There was no significant (P > 0.05) association between theileriosis-related calf mortality, sero-positivity and the different tick control practices. Antibody prevalence based on the PIM ELISA was above 70% among calves of 6 months of age in 96% in all the herds. Theileria parva-related calf mortality determined by repeated herd visits and farm records ranged between 0 % and 5.4 %. It was concluded that endemic stability for theileriosis, caused by T. parva, existed in the study area, and that the risk of the occurrence of economically important outbreaks of East Coast fever in indigenous cattle was regarded as minimal under the prevailing conditions.

The prevalence of serum antibodies to tick-borne infections in Mbale District, Uganda: the effect of agro-ecological zone, grazing management and age of cattle.

Between August and October 2000, a cross-sectional study was conducted in smallholder dairy farms in Mbale District, Uganda to assess the prevalence of ticks and tick-borne diseases under different grazing systems and agro-ecological zones and understand the circumstances under which farmers operated. A questionnaire was administered to obtain information on dairy farm circumstances and practices. A total of 102 farms were visited and sera and ticks were collected from 478 animals. Sero-prevalence of tick-borne diseases was determined using an enzyme-linked immunoassay. Acaricides were used indiscriminately but the intensity of their use varied with the grazing system and zone. Cattle from different farms mixed for various reasons. During the dry seasons farmers have to get additional fodder from outside their farms that can result in importation of ticks. The prevalence of ticks and serum antibodies to tick-borne infections differed across the grazing systems and zones. The highest serum antibody prevalence (>60%) was recorded in the lowland zone under the free range and tethering grazing systems. The lowest tick challenge and serum antibody levels (<50%) were recorded in the midland and upland zones under a zero-grazing system. These findings suggest that endemic stability to East Coast Fever, babesiosis and anaplasmosis is most likely to have existed in the lowland zone, particularly, under the tethering and free-range grazing systems. Also, endemic stability for babesiosis existed in the upland zones. Endemic instability for East Coast Fever existed in the midland and upland zones. These structured observational studies are instrumental in planning of control strategies for ticks and tick borne diseases since production systems and the cattle population at high risk of the diseases in the district have been identified.

The impact of tick control on the productivity of indigenous cattle under ranch conditions in Uganda.

The impact of tick control on the productivity of indigenous cattle was investigated in three herds of East African shorthorn Zebu and Zebu x Ankole (Nganda) breeds, maintained under three tick management systems practised under ranch conditions: twice-a-week dipping, once-a-month dipping, and no tick control. The milk production and the growth rates of pre-weaned and post-weaned calves were monitored once a month over a period of 34 months. Milk offtake was 23% higher during the heavy rainy seasons than in the long dry seasons. Twice-a-week dipping increased the milk offtake by 21% in the second year of study and prolonged the duration of lactation in cows. Similarly, twice-a-week dipping increased the pre-weaning growth rate by 39% in the second year of study, but had no significant effect on the post-weaning growth rate. Generally, the growth rate of calves were greatest during the heavy rainy seasons and least during the long dry seasons. These results provide a basis for assessing the losses under different tick management systems in the various production systems.

Population dynamics of ticks on indigenous cattle in a pastoral dry to semi-arid rangeland zone of Uganda.

Studies on seasonality and population dynamics of ticks on indigenous cattle and their crosses (calves) were carried out in Buruli Ranching Scheme, Nabiswera, Luwero district of Uganda on three treatment groups of animals: group 1 (twice a week dipping), group 2 (once a month dipping) and group 3 (no tick control). During this study, four major species of ticks of economic importance were recorded in decreasing order of abundance: Rhipicephalus appendiculatus, Rhipicephalus evertsi evertsi, Amblyomma variegatum and Boophilus decoloratus. Of these ticks, a seasonal pattern of activity was only observed in R. appendiculatus ticks, with peak activities occurring during rainy seasons. Greater numbers of ticks were recorded on cows than calves in the three treatment groups, with the exception of A. variegatum where the reverse occurred. The mean numbers of ticks per animal were highly significantly different (p < 0.01) when group 1 animals were compared with group 2 and 3 animals. However, no significant differences (p > 0.05) were observed in mean tick numbers between group 2 and 3 animals. Highly significant differences (p < 0.01) were observed in mean tick numbers on cows and calves (more than 12 months old) in different calving seasons. The state of lactation only affected tick counts on cows in group 1; significantly more ticks (p < 0.01) were observed in lactating than non-lactating cows. Furthermore, significantly greater (p < 0.05) numbers of ticks (with the exception of B. decoloratus) were recorded during the second year of study (March 1992-May 1993) than the first year (January 1991-February 1992), despite lower rainfall during the former period.

Financial analysis of dipping strategies for indigenous cattle under ranch conditions in Uganda.

A financial analysis was performed to assess the performance of three acaricide-treatment groups of indigenous breeds (Zebu and Nganda) of cattle on a ranch in Luwero District, Uganda. The treatments were based on different frequencies: twice-a-week dipping, once-a-month dipping and no tick control. The objective was to evaluate the economic justification for intensive acaricide application for tick and tick-borne disease control in Uganda. Data were collected by monitoring cattle performance over a period of 34 months. Biological data collected included the number of cows at the beginning and end of the study, net starting liveweight, number of calves born, number of animals dying due to tick-borne diseases and other causes, number of animals sold or slaughtered and milk yield. Records of variable costs (acaricides, drugs, labour, etc.) and output prices were assembled and calculated by treatment group. Gross margin and marginal analysis were used in the financial analysis. The exchange rate in 1990-1993 was one US$ to 1200 Uganda shillings. The gross benefits obtained from animal sales, herd value and milk yield were Uganda shillings 1175, 1389 and 1311 per kg of net starting liveweight for animals dipped twice-a-week, once-a-month and not dipped, respectively. The variable costs were Ug. shs. 424, 390 and 360 per kg of net starting liveweight, respectively. Consequently, the gross margins were Ug. shs. 751, 999 and 951 per kg of net starting liveweight. Furthermore, the marginal rate of return (MRR) in changing from no tick control to once-a-month dipping was 160%, while changing from no tick control to twice-a-week dipping was negative (-313%). The above results showed that the value of increased gains in production obtained from twice-a-week dipping strategy does not offset the costs of inputs for intensive dipping. Once-a-month dipping (strategic) therefore appears to be the most-profitable tick-control strategy for the farmer. The need to conduct further studies in different livestock- production systems and to rationalise future tick control policies is discussed.

Control of tsetse flies in Uganda by dipping cattle in deltamethrin.

The effect of treating cattle with deltamethrin to control tsetse flies and ticks was investigated on 2 ranches 8 km apart in central Uganda where there is a high risk of trypanosomosis. This area had a moderate challenge of Glossina pallidipes. The cattle had very low challenge of Rhipicephalus appendiculatus, Amblyomma variegatum, Boophilus decolaratus and Rhipicephalus evertsi evertsi, due to regular treatment with dioxathion. On one ranch a dip was charged with deltamethrin to treat cattle regularly for 3 months. The other ranch was used as a control for the tsetse population, but the animals continued to be treated regularly with dioxathion using hand sprays. On the ranch using deltamethrin treatment a reduction of 96.9% in the tsetse population was recorded after 2 treatments at 2 week intervals. Total (100%) control of tsetse was achieved from the fourth treatment up to the end of the trial period. The ranch with dioxathion treatment experienced an overall tsetse reduction of 19.15% during the thirteenth to fifteenth weeks and the factors contributing to this are discussed. However, the mean apparent tsetse density of 4.83 flies/trap/day recorded at the control ranch was significantly different from the mean of 0.81 flies/trap/day (P < 0.001) at the ranch using deltamethrin treatment. It was difficult to assess the effect of this product on ticks because of lack of controls. However, there are indications that deltamethrin can also reduce tick populations and the incidence of tick-borne diseases. The possible limitations and practical implications associated with large scale use of this product in the country are discussed.