African Digital Health Library (ADHL) - Zambia
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The African Digital Health Library (ADHL), Zambia node, makes available health related content ranging from theses, dissertations, and Ministry of Health reports from Zambia.
ADHL currently operates in 5 Sub Saharan African Countries and is supported by the medical librarians. It is a collaborative effort among medical librarians at major universities in sub Saharan Africa and is funded by the office of Global AIDS/US Department of State. The Zambian node is managed through the University of Zambia (UNZA) Medical Library.
For more information, please contact Celine Mwafulilwa at: cmwafulilwa@unza.zm
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Browsing African Digital Health Library (ADHL) - Zambia by Author "Ahmed, Y."
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- ItemFactors associated with infertility among women attending the gynaecology clinic at University Teaching Hospital, Lusaka, Zambia(Medical Journal of Zambia, 2017) Kalima-Munalula, N. M.; Ahmed, Y.; Vwalika, B.The objective of this study was to investigate and determine the factors associated with infertility in women attending the gynaecology clinic at the University Teaching Hospital (UTH) in Lusaka, Zambia. Using an unmatched case-control study design, women attending the gynaecology clinic for infertility were enrolled. Controls were randomly selected from women in the labour ward. An investigatoradministered questionnaire was used to collect data. Bivariable analysis was used to determine association between infertility and demographic and previous gynaecological history. Odds ratios were used to determine statistical significance. Associations with a p<0.05 were further analysed by multivariable logistic regression. Results: One hundred and thirty women were selected as cases and 260 were selected as controls. Overall, primary infertility was found to be affecting 50/130 (38.4 percent) of the women while secondary infertility was found in 80/130 (61.5 percent). In bivariate analyses, the following variables were statistically significant at the 95% CI level: age group (20-29y OR 2.39; 30-39y OR 8.42); marital status (married OR 1.16; single OR 0.017); partner's consumption of alcohol (OR 2.80); frequency of menses (irregular OR 2.27; regular 3.81); whether they'd ever been pregnant (never been OR 151) having had an manual vacuum aspiration (MVA) (OR 0.24); having had a pelvic infection or operation (OR 0.18). In multivariable logistic regression analysis, five factors were independent and statistically significant correlates of infertility: age at menarche, frequency of menses, having a pelvic procedure done, and having an MVA done. Conclusion: The problem of primary infertility at UTH was similar to that reported in other sub-Saharan countries. Secondary infertility was more prevalent than primary infertility. Infertility was found to be most prevalent among women aged 30-39 years. Of the factors studied, having had a pelvic procedure or an MVA was significantly related to being infertile. The most commonly ordered investigations were hormonal, HSG, USS and semenalysis.
- ItemFeto-Maternal Outcomes of Term Assisted Breech Deliveries at the University Teaching Hospital, Lusaka, Zambia(Medical Journal of Zambia, 2018-05) Vwalika, B.; Ahmed, Y.; Kasela, J.Breech presentation occurs when the fetus presents with buttocks or feet first. Globally, the incidence of breech is 3-4% at term. The safest mode of delivery for most breeches at term is still controversial despite extensive research. The aim of this study was to determine the feto-maternal outcomes of assisted term breech deliveries at the University Teaching Hospital (UTH). Methods: A cross sectional study was conducted in 73 pregnant women with term breech admitted to the labor ward that delivered vaginally. Data was collected by administering a structured questionnaire and from medical records. The Pearson's chi-squared test was used for comparison of proportions between groups. One multivariate logistic regression was used to determine associations with neonatal intensive care unit (NICU) admission and also a second one associations with type of breech. Results: The mean age of the participants was 30.6 ± 5.5 (range 18-41) years. The mean gestational age at delivery was 38.6 weeks and mean parity was 3.4, with a 5% history of previous breech. The average levels of asphyxia measured by Apgar score were 7.1 at 1 minute, 8.1 at 5 minutes and 8.6 at 10 minutes. The average fetal weight was 3200g, with 10% admissions to Neonatal intensive care unit(NICU). For the maternal outcomes, one participant had postpartum haemorrhage (PPH), and one participant had an episiotomy and none had symphysiotomy. On multivariate analysis, NICU admission was associated with lower Apgar score at 1 minute. Babies that were not admitted to NICU had 90% reduced odds for low Apgar score < 7 [Adjusted Odds Ratio (OR) = 0.10, 95% Confidence Interval (CI) = 0.004 – 0.24, P-value < 0.01. Also, on multivariate analysis, type of breech was associated with lower Agpar score at 5 minutes. Compared to footling breech, patients with extended breech had 97% reduced odds for low Apgar score < 7 (OR 0.03, 95% CI 0.004 – 0.22, p-value < 0.01). Patients with complete breech had 85% reduced odds for lower Apgar score < 7 (OR 0.15, 95% CI 0.05 – 0.44, pvalue < 0.01). Discussion and Conclusion: Feto-maternal outcomes of assisted term vaginal breech deliveries at UTH were favourable with low levels of asphyxia, neonatal admissions to NICU, and need for blood transfusion. Therefore, breech vaginal delivery at term may still be a viable option at UTH as demonstrated by this study.