The Pan African medical journal
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in 2012, pneumococcal conjugate vaccine (PCV), rotavirus vaccine and a second dose of measles-containing vaccine (MCV2) were introduced into the Expanded Program on Immunization (EPI) in Ghana. According to Ghana's EPI schedule, PCV and rotavirus vaccine are given in the first year of life and MCV2 in the second year of life (2YL) at 18 months. Although coverage with the last doses of PCV and rotavirus vaccine reached almost 90% coverage within four years of introduction, MCV2 coverage did not rise above 70%. The World Health Organization Global Measles and Rubella Strategic Plan established a 2020 milestone to achieve at least 95% coverage with the first and second doses of measles-containing vaccine in each district and nationally. We developed a project to address challenges to delivery of immunizations and other child health services at the 18-month visit and throughout the 2YL. ⋯ challenges encountered with the establishment of an immunization visit beyond the first year of life included knowledge gaps among caregivers, high dropout rates between MCV1 and MCV2 in all study regions, and a lack of defaulter tracing systems in most healthcare facilities providing childhood immunizations. Targeted strategies that promote behavioral, cultural, and policy changes are needed to strengthen 2YL child health service delivery and improve vaccination coverage.
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Normal adnexal torsion is rare during pregnancy. We here report the case of a 22-year old patient presenting with acute lateropelvic pain associated with a 2-month history amenorrhea. Exploratory laparotomy showed severe ischemia due to torsion in a normal ovary. ⋯ Ultrasound examination after 3 weeks showed normal pregnancy. Ovarian torsion is an emergency that should not be ignored in pregnant women with acute pelvic pain. Conservative treatment is the gold standard and proper management is necessary to avoid possible maternal and fetal complications.
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Cat-scratch disease (CSD) is a common cause of chronic benign lymphadenopathy in the child and the young adult. Bartonella henselae is the agent responsible for this disease. Common symptoms include regional lymphadenopathy associated with fever. We report a clinically atypical and potentially misleading case of a 18-year old girl with CSD revealed by elbow abscess.
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Multicenter Study
Use of cellular phone contacts to increase return rates for immunization services in Kenya.
In Kenya, failure to complete immunization schedules by children who previously accessed immunization services is an obstacle to ensuring that children are fully immunized. Home visit approaches used to track defaulting children have not been successful in reducing the drop-out rate. ⋯ Use of phone contacts for follow-up is a feasible and cost-effective method for tracking defaulters. This approach should complement traditional home visits, especially for caregivers without phones. Given communication-related reasons for defaulting, it is important that immunization programs scale-up community education activities. A system for health facilities to share details of defaulting children should be established to reduce "false defaulters".
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Case Reports
Percutaneous placement of the peripheral catheter to the subclavian vein for a VA shunt.
Hydrocephalus is a common neurosurgical pathology that affects people of all ages and especially the pediatric population. It can be very often a life threatening condition that pediatric neurosurgeons must deal with. ⋯ Because of hydrocephalus being a lifelong condition, it is almost in daily practice dealing with cases of shunt failures for a number of reasons. Herewith we present a 4 year old child with multiple ventriculo-peritoneal shunt revision surgeries and ventriculo-atrial failure due to distal catheter malfunction that was treated with percutaneous placement of the peripheral catheter in the subclavian vein.