African health sciences
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African health sciences · Jun 2012
ReviewEpilepsy treatment in sub-Saharan Africa: closing the gap.
According to World Health Organization (WHO), the prevalence of epilepsy is highest in low- and lower middle-income countries, which include over eighty percent of the countries of sub-Saharan Africa, where the majority of people with epilepsy are not receiving appropriate care. In sub-Saharan Africa, shortages of trained health workers, limited diagnostic equipment, inadequate anti-epileptic drug supplies, cultural beliefs, and social stigma contribute to the large treatment gap for epilepsy. The number of people with epilepsy, particularly children, will continue to rise as a result of projected epidemiologic and demographic changes. This paper examines the state of epilepsy care and treatment in sub-Saharan Africa and discusses priorities and approaches to scale up access to medications and services for people with epilepsy.
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African health sciences · Jun 2012
Case ReportsChallenges in diagnosis and management of Cryptococcal immune reconstitution inflammatory syndrome (IRIS) in resource limited settings.
In many resource-limited settings, cryptococcal meningitis (CM) contributes up to 20% of all deaths with further complications due to Immune Reconstitution Inflammatory Syndrome (IRIS). We present a case report on a patient who developed CM-IRIS and then subsequent CM-relapse with a fluconazole-resistant organism and then later CM-IRIS once again, manifesting as cystic cryptococcomas, hydrocephalus, and sterile CSF. ⋯ The management of IRIS with corticosteroids may increase the risk of culture positive CM-relapse which may further increase the risk of recurrent IRIS and resulting complications including death. We also highlight the role of imaging and fluconazole resistance testing in patients with recurrent meningitis and the importance of CSF cultures in guiding treatment decisions.
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African health sciences · Jun 2012
Case ReportsAnaesthetic management of a super morbidly obese patient for total abdominal hysterectomy: a few more lessons to learn.
The prevalence of obesity is on the upward trend world-wide. This epidemic has challenging implications for anaesthetists, following the anthropometric changes associated with the disease. ⋯ A better understanding of the pathophysiology and complications that accompany obesity is needed to manage an obese patient under anaesthesia.
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African health sciences · Jun 2012
Antibiogram of nosocomial urinary tract infections in Felege Hiwot referral hospital, Ethiopia.
Nosocomial infections increase the cost of medical care, extend hospital stay and reflect on the morbidity and mortality of the admitted patients. Urinary tract infections (UTIs) are one of the most common nosocomial infections in humans. ⋯ Catheterization and preoperative antibiotic prophylaxis were found to be the risk factors for nosocomial infection. Effective infection prevention measures should be in place to reduce the prevalence of nosocomial UTIs.
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To determine the incidence of eclampsia and examine the maternal and fetal outcome. ⋯ The incidence of eclampsia in our hospital was very high, with corresponding high maternal and perinatal morbidity and mortality. Increased antenatal screening and use of magnesium sulphate to control convulsions will reduce the incidence and associated morbidity and mortality for both mother and fetus.