scholarly journals Comparison of Antimicrobial Resistant Neisseria gonorrhea to Ceftriaxone and Ciprofloxacin using Partial Proportional Odds Model for patients seen at the University Teaching Hospital in Lusaka, Zambia

2019 ◽  
Author(s):  
PRISCILLA KAPOMBE ◽  
LUNGOWE SITALI ◽  
PATRICK MUSONDA
Keyword(s):  
Risk Factors ◽  
Teaching Hospital ◽  
Susceptibility Testing ◽  
Proportional Odds Model ◽  
University Teaching ◽  
Proportional Odds ◽  
Neisseria Gonorrhea ◽  
Partial Proportional Odds Model ◽  
The University ◽  
Ethical Clearance

Abstract Background Neisseria gonorrhea, the causative agent of Gonorrhea, has developed antibiotic resistance to the “last-line” Cephalosporin’s, Quinolones and Macrolides which is cause for concern. In Zambia, despite recommendations of discontinued use, Ciprofloxacin is used for treatment. The lack of an active surveillance system, appropriate and structured data management and analysis tools magnifies the problem because resistance patterns cannot be monitored. The study aimed to ascertain effectiveness of Ciprofloxacin a Quinolone in comparison with Ceftriaxone a Cephalosporin, in treatment of Gonorrhea using Susceptibility testing; and to identify possible risk factors associated with resistance. Methods Study design was parallel non-inferior quasi experimental study. Patients at the University Teaching Hospital with discharge and Gonorrhea symptoms who gave consent, were recruited. Fishers Exact Test for associations was used. Data was analyzed using Ordinal logistic regression as the Susceptibility was at 3 levels; Susceptible, Intermediate or Resistant with an assumed Ordinal nature. Proportionality assumption was checked, and when violated Partial Proportional Odds Model was used instead. Results A total of 104 isolates were obtained. The overall proportion of patients who had Susceptible, Intermediate and Resistant results were: 49 (47.1%), 55 (52.9%) and 0 (0) for Ceftriaxone and 70 (68.0%), 10 (9.7%) and 22 (22.3%) for Ciprofloxacin respectively. Adjusted estimates in partial Proportional Odds model showed that, Males were 4.1 (95% CI; 1.8, 9.4, p-value=0.001) times more likely to have Intermediate or Susceptible results compared to Resistance than females, or they were more likely to have Susceptible compared to Resistance or Intermediate result compared to females. Ciprofloxacin was 70% less likely than Ceftriaxone of having susceptible or intermediate results compared to resistance and this could be as high as 90% and as high as 40% p-values <0.001). Conclusion Level of Ciprofloxacin resistance detected from the Susceptibility testing, shows it is not an effective treatment for Gonorrhea. Ceftriaxone remains a satisfactory option for first-line treatment of Gonorrhea at UTH. Risk factors identified to be associated with resistance in this study were being female and use of Ciprofloxacin. Ethical Clearance Ethical clearance was obtained from University of Zambia Biomedical Ethics Research Committee (UNZABREC Ref # 033-06-17).

scholarly journals Associated risk factors of underweight among under-five children in Ethiopia using multilevel ordinal logistic regression model

2021 ◽  
Vol 21 (1) ◽  
pp. 362-72
Author(s):  
Nigussie Adam Birhan ◽  
Denekew Bitew Belay
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Proportional Odds Model ◽  
Proportional Odds ◽  
Under Five ◽  
Single Level ◽  
Under Five Children ◽  
Under Nutrition ◽  
Partial Proportional Odds Model ◽  
Associated Risk Factors

Background: Malnutrition is associated with both under nutrition and over nutrition which causes the body to get improp- er amount of nutrients to maintain tissues and organ function. Under nutrition is the result of insufficient intake of food, poor utilization of nutrients due to illnesses, or a combination of these factors. The purpose of this study was to identify associated risk factors and assess the variation of underweight among under-five children of different regions in Ethiopia. Methods: Ethiopian Demography and Health Survey (EDHS-2016) weight-to-age data for under-five children is used. In order to achieve the objective of this study; descriptive, single level and multilevel ordinal logistic regression analysis were used. Results: From a total of 8935 children about 8.1% were severely underweight, 17.1% were moderately underweight and 74.8% were normal. The test of heterogeneity suggested that underweight varies among region and multilevel ordinal model fit data better than single level ordinal model. Conclusion: Educational level of mother, religion, birth order, type of birth, sex of child, mother body mass index, birth size of child, existence of diarrhea for last two weeks before survey, existence of fever for last two weeks before survey, duration of breast feeding, age child and wealth index had significant effect on underweight among under-five children in Ethiopia. The finding revealed that among the fitted multilevel partial proportional odds model, the random intercept model with fixed coefficients is appropriate to assess the risk factors of underweight among under-five children in Ethiopia. The findings of this study have important policy implications. The government should work closely with both the private sector and civil society to teach women to have sufficient knowledge, awareness and mechanisms of improving under-five under- weight for children’s wellbeing. Keywords: Underweight; Partial proportional odds model; Multilevel partial proportional odds model; under-five children.

scholarly journals Burden and Risk Factors of Chronic Kidney Disease in Children with Sickle Cell Anaemia Aged 5 – 16 Years at the University Teaching Hospital, Lusaka - Zambia

2020 ◽  
Vol 4 (3) ◽  
pp. 40-48
Author(s):  
Nchimunya Machila ◽  
◽  
Chishala Chabala ◽  
Chisambo Mwaba ◽  
Catherine Chunda-Liyoka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sickle Cell ◽  
Teaching Hospital ◽  
Sickle Cell Anaemia ◽  
Age At Diagnosis ◽  
University Teaching ◽  
Dipstick Urinalysis ◽  
The University

Background: Improved medical care has led to the improved life expectancy of sickle cell anaemia (SCA) patients hence complications associated with SCA such as chronic kidney disease (CKD) are being seen more frequently. Globally, nephropathy of varying severity occurs in 5 to 18 % of the SCA population across all age groups with a third of the adults proceeding to develop CKD while over 30 % of paediatric SCA patients have CKD in Africa. The mortality rate in SCA patients CKD is high. This study sought to determine the prevalence and risk factors of CKD in SCA, information that was not available in Zambia prior to this study. This information will guide in targeting and timing of screening for CKD in SCA in children in our population. Objectives: To determine the prevalence of haematuria, proteinuria, abnormal estimated glomerular filtration rate (eGFR), CKD, and risk factors of CKD among the steady-state SCA patients aged 5 to 16 years at the University Teaching Hospital (UTH), Lusaka. Methodology: This was a prospective cross-sectional study of 197 children aged 5 to 16 years with SCA at the UTH - Lusaka conducted from August 2014 to July 2015. Demographic and clinical data were collected using a structured questionnaire. Urine and blood samples were used to determine the urine albumin creatinine ratio (ACR) and full blood count /blood biochemistry respectively. CKD was defined and determined using the Kidney Disease Outcome Quality Initiative 2012 guidelines employing urine ACR, dipstick urinalysis and eGFR. In this study, spot urine ACR and dipstick urinalysis were done and repeated three months later if initial tests were abnormal. Data was analysed using SPSS version 21. Chi-square and t-test were used to compare proportions between groups. Relation between study variables and CKD were examined using logistic regression. Results: The mean age of the participants was 9.6 years (SD ±3.6). Male to female ratio was 1:1. The median age at diagnosis of SCA was 22 months (IQR = 44). The prevalence of haematuria, proteinuria and CKD among the study participants was 14.2%, 36% and 36 % respectively. Low haemoglobin and elevated mean corpuscular volume (MCV) were associated with CKD-AOR 0.62, 95% CI; 0.46-0.84 and 1.04, 95% CI; 1.01 – 1.08 respectively. Recurrent admissions (due to VOCs, severe anaemia and febrile illness) were also risk factors associated with CKD- AOR 0.52, 95% CI; 0.27-0.98. CKD was not associated with age at enrolment, sex, age at diagnosis of SCA, recurrent Vaso-occlusive crisis (VOCs) or abnormal liver function tests. Conclusion: The prevalence of CKD among the SCA patients at UTH- Lusaka is high (36%) with lower Haemoglobin, elevated MCV and recurrent admissions being risk factors for developing CKD. SCA patients should be screened for CKD routinely at least once a year. Interventions such as the early introduction of hydroxyurea, proactive blood transfusions and ACE inhibitors can reduce the risk of CKD and its progression to end-stage renal disease.

Location and Size of Coronary Ostia in Normal Autopsied Hearts at the University Teaching Hospital, Lusaka, Zambia

2016 ◽  
Vol 3 (4) ◽  
pp. 199-203 ◽  
Author(s):  
Moono Silitongo ◽  
◽  
Dailesi Ndlovu ◽  
Kasonde Bowa ◽  
Krikor Erzingatsian ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
University Teaching ◽  
Coronary Ostia ◽  
The University

scholarly journals Analysis of Stress Factors for Female Professors at Online Universities

2020 ◽  
Vol 17 (8) ◽  
pp. 2958 ◽  
Author(s):  
Marialuz Arántzazu García-González ◽  
Fermín Torrano ◽  
Guillermo García-González
Keyword(s):  
Risk Factors ◽  
Time Pressure ◽  
Health And Safety ◽  
Stress Factors ◽  
University Teaching ◽  
Psychosocial Risks ◽  
Primary Stress ◽  
Information And Communication ◽  
The University ◽  
Mental Overload

The aim of this paper is to analyze the primary stress factors female professors at online universities are exposed to. The technique used for the prospective and exploratory analysis was the Delphi method. Two rounds of consultations were done with fourteen judges with broad experience in health and safety at work and university teaching who reached a consensus of opinion regarding a list of nine psychosocial risk factors. Among the most important risk factors, mental overload, time pressure, the lack of a schedule, and emotional exhaustion were highlighted. These risk factors are related to the usage and expansion of information and communication technology (ICT) and to the university system itself, which requires initiating more research in the future in order to develop the intervention programs needed to fortify the health of the affected teachers and protect them from stress and other psychosocial risks.

scholarly journals Aphakia Correction by Injection of Foldable Intra Ocular Lens in the Anterior Chamber

2013 ◽  
Vol 5 ◽  
pp. OED.S12672
Author(s):  
Kagmeni Giles ◽  
Moukouri Ernest ◽  
Domngang Christelle ◽  
Nguefack-Tsague Georges ◽  
Cheuteu Raoul ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Intraocular Pressure ◽  
Anterior Chamber ◽  
Teaching Hospital ◽  
Case Series ◽  
University Teaching ◽  
Case Series Study ◽  
The Mean ◽  
The University

We assessed the outcomes of the use of anterior chamber foldable lens for unilateral aphakia correction at the University Teaching Hospital of Yaounde. In this retrospective, non-comparative, consecutive case series study, we reviewed the records of patients who underwent an operation for aphakia correction by the means of injection of an angular supported foldable lens between January 2009 and December 2011 in the University Teaching Hospital Yaounde. Student's paired t-test was carried out to compare preoperative and postoperative visual acuity (VA) and intraocular pressure (TOP). P-values less than 0.05 were considered statistically significant. Twenty-one patients were included in the study; twelve were male (57.1%) and nine were female (42.9%). The mean age was 55.38 ± 17.67 years (range 9–75 years). The mean follow-up duration was 5.95 ± 3.14 months (range 2–12 months). The mean logMAR visual acuity was 1.26 ± 0.46 pre-operatively and 0.78 ± 0.57 post-operatively ( P = 0.003). The change in intraocular pressure was not statistically significant. Complications included intraocular hypertension (over 21 mmHg) in 3 patients (14.3%) and macular edema, pupillar ovalization, and retinal detachment in one patient each. The results indicate that injection of an angular support foldable lens in the anterior chamber is a useful technique for the correction of aphakia in eyes without capsular support. More extended follow-up, however, and a larger series of patients are needed to ascertain the effectiveness and safety of this procedure.

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