Medicine

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    A study to determine the outcomes of laparoscopic appendicectomies at the university teaching hospital, Zambia.
    (The University of Zambia, 2019) Parekh, Rajesh
    Several studies have demonstrated the superiority of Laparoscopic appendicectomy in the management of acute appendicitis. Acute appendicitis has been managed solely by open appendicectomy at UTH. This was the first study that looked at the management of acute appendicitis by laparoscopy here at UTH. The aim of this study was to determine the outcomes of laparoscopic appendicectomy at the University Teaching Hospital. This was a prospective cohort study that included patients that were diagnosed with acute uncomplicated appendicitis. All patients admitted between August 2015 to March 2016 were included in the study. Variables analyses were patients data (age, gender, previous surgery, WBC count, symptoms, signs, symptoms), operating time, intra\post operative complications, and length of stay. A total of 9 laparoscopic appendicectomies were performed during the study period. The patients had a average age of 31.8 years, and were predominantly female (70%). One case was converted to open appendicectomy and was not included in the laparoscopic data group. The mean operative time for the procedure was 75.5 min (range 50-110min). The length of stay was on average 2.3 days (range 2-3 days), the patients in the study had no complications noted during the period of follow up. No patient developed an intra abdominal abscess during the study period. Laparoscopic appendicectomy for uncomplicated acute appendicitis resulted in good surgical outcomes in this institution when compared to the regional statistics as reference point. It may be used as a preferred technique in patients presenting with uncomplicated appendicitis or where the diagnosis is equivocal . Laparoscopic appendicectomy is recommended especially for the young female patients in our setting.
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    Knowledge, screening and reporting practices of health professionals towards gender based violence among women in Kabwe district, Zambia.
    (The University of Zambia, 2020) Soko, Jennipher N. Akebu
    Identification of victims of gender based violence and reporting GBV to legal authorities are key steps in management of gender based violence. The purpose of the study was to examine the knowledge, screening and reporting practices of Health Professionals towards gender based violence in the form of physical abuse from an intimate partner among women in Kabwe District. A quantitative cross-sectional study was conducted with 207 Health professionals (19 doctors, 43 Clinical officers and 145 Nurse/Midwives) from 6 randomly selected clinics and 1 hospital in Kabwe district. Nurse/midwives were randomly while doctors and Clinical Officers were conveniently selected. A structured questionnaire was used to collect data and analysed using SPSS version 20. Chi-square test was used to determine association between the independent (Demographic variables, knowledge levels) and dependent variables (Screening and reporting). The statistical significance was set at 5% (0.05) and confidence interval was set at 95%. Majority, 79.9% of the respondents had high knowledge level on gender based violence. Screening for and reporting cases of gender based violence to legal authorizes were low, 54% and 31.4% respectively among the Health professionals. Screening and reporting practices of the respondents were inadequate, 83.6% and insufficient, 87.0% respectively. A statistically significant relationship was observed between respondents‟ profession and their screening practices for gender based violence (p – 0.020), training and reporting practices of gender based violence (P – 0.039), knowledge levels on gender based violence and their reporting practices (p – 0.022). Knowledge levels of health professionals were high despite the majority not been trained in gender based violence. However, their screening for and reporting practices of gender based violence to legal authorities were insufficient and inadequate respectively. Training / ongoing sensitization in gender based violence is recommended to improve the situation. More research is required to establish factors contributing to the Health professionals‟ insufficient screening for and inadequate reporting practices of GBV to legal authorities despite the HPs having high levels of knowledge on GBV.
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    Health related quality of life among cervical survivors in Lusaka district, Zambia.
    (The Univewrsity of Zambia., 2020) Moonde, Chisaji
    Health Related Quality of Life is an essential health outcome for improving clinical care and determining targets of intervention for managing cervical cancer survivors. In Zambia the number of cervical cancer survivors is increasing owing to the recent advancement in cancer treatment. However, little is known and documented on HRQoL among CCS. This study determined HRQoL among CCS. A cross-sectional study involving 83 cervical cancer survivors with histologically-diagnosed cervical cancer was conducted at Cancer Diseases and University Teaching Hospitals in Lusaka, Zambia from October 2019 to December 2019. An interview schedule containing questions from the European Organization for Research and Cancer treatment core 30 and Cervical 24 questionnaires version 4 and self - structured questions were used to collect data. The study was approved by the University of Zambia Biomedical Research Ethics Committee and the National Health Research Authority. Data was analyzed using Statistical Package for Social Sciences Version 25 with confidence level set at 95%. The chi- square test and linear regression were applied in testing for associations. The total score of the questionnaire in the domains of HRQoL range from 0 to 100, with higher scores (≥ 66.7%), indicating a good HRQoL. The mean score for overall HRQoL was 60.9 (SD=21.4). Better scores were observed in the domains of physical, functional and psychological wellbeing with mean and standard deviations as follows: 71.4 (SD 26.5), 68.2 (SD 26.5), 69.1 (SD 22.8) respectively. Social wellbeing domain presented with the worst score 57.9 (SD 21.4). Time point of treatment and stage of cancer at diagnosis were found to be statistically significant in association with overall Health Related quality of Life after a linear regression test. Cervical cancer survivors experience good physical, functional and psychological wellbeing, while they perform poorly in the social wellbeing and overall HRQoL due to a large proportion of patients presenting with advanced stages of cervical cancer at diagnosis, financial challenges associated with the disease and treatment and poor family support. The researcher recommends that there is need to include HRQoL assessment in routine management of cervical cancer survivors to enhance their quality of life. In addition, the researcher also recommends that a similar study to be conducted using random sampling to validate the findings of the present study.
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    Compliance with burns treatment protocal by nurses at Kabwe central hospital, Kabwe, Zambia.
    (The University of Zambia., 2020) Munjili, Bwalya
    Annually, burns result in more than 7.1 million injuries and more than 250,000 deaths worldwide, with the vast majority being in low and middle income countries. In Zambia, at Kabwe Central Hospital, burn trauma is one of the commonest causes of trauma admissions in surgical wards. To mitigate the trend, MoH in 2016 distributed infection prevention and control guidelines and burns Treatment Protocols and emphasized on the need to manage all patients with burns in accordance with national guidelines. Despite availability of guidelines, the institution is still recording unacceptably high burns (54%) infection rates. The main objective of this study was to assess the level of Compliance with Burns Treatment Protocol by nurses in Burns units at Kabwe Central Hospital. A descriptive analytical cross sectional study design was used in the study. A self-administered questionnaire was used to obtain data from 60 nurses while 55 nurses were observed using an observational checklist. Convenient sampling was used to recruit nurses for the study. SPSS version 23.0 was used for data analysis. Fisher’s exact test was used for analysis to determine the association between study variables. Level of significance was set at 5%. Findings showed that observed compliance to burns treatment protocol was very low and stood at 51%. This was despite high knowledge (100%), good management support (81.7%) and positive attitudes (100%) expressed by the majority nurses. This can be attributed to rare availability of most medical surgical supplies as reported by 78.3% of the respondents at the institution. Based on the findings the study recommend the need for the hospital to improve on the supply of resources to the burns units as most nurses reported resource inadequacy in the management of burns. There is also need of an ideal burns unit.
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    Knowledge of postpartum women on puerperal sepsis and associated factors in Choma district, Zambia.
    (The University of Zambia., 2020) Moono, Fuden
    Puerperal sepsis is the infection of the genital tract following child birth or abortion. It is a major cause of maternal morbidity and mortality and is usually within the first 42 days after child birth/pregnancy termination. Studies have shown that puerperal sepsis is the second cause of maternal morbidity and mortality during puerperium in the resource poor countries. This study aimed at assessing knowledge of postpartum women on puerperal sepsis and associated factors in Choma district, Zambia. A descriptive cross sectional study design was used to elicit information on knowledge of postpartum women on puerperal sepsis and associated factors. A sample of 246 postpartum women attending postnatal clinics at 6 days and 6 weeks at Macha Mission Hospital and five selected delivering health centres in Choma district were selected to participate in the study using simple random sampling method. Macha Mission Hospital and five (5) health centres within Choma district were purposively selected because they offer postnatal care services and are big centres (Zonal centres). A pretested interview schedule was used to collect data from the respondents. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 22 programme. Chi-square was used to test for statistically significant association between knowledge of postpartum women on puerperal sepsis and associated factors. A 95% confidence interval and a P- value of 0.05 were set to check the specificity of the tests. Binary logistic regression was used to check for combined impact of independent variables on knowledge of postpartum women on puerperal sepsis and associated factors. Findings of the study indicated that 60% of postpartum women had low knowledge on puerperal sepsis and associated factors in Choma district. Statistically significant associations were shown between knowledge of postpartum women on puerperal sepsis and distance to health facility (OR 1.893, 95% CI = [1.071, 3.347]; P= 0.020) and hygiene lessons (OR 2.879, 95% CI = [1.581, 5.243]; P= 0.001). However, there was no statistically significant association between the dependent variable and the other independent variables. The current study revealed that most postpartum women had low knowledge on puerperal sepsis in Choma district. Distance to health facility and hygiene lessons were significantly associated with Knowledge of postpartum women on puerperal sepsis. Therefore, there is need to improve puerperal sepsis awareness among postpartum women in Choma district.