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Chiti L De Bont J Fransen J Kane RA Mwase M Southgate VR Vercruysse J 《Journal of comparative pathology》2000,122(2-3):229-233
Post-mortem examination of an adult male Jack Russell dog from Zambia revealed that it was heavily infected with schistosomes. The dog had been admitted, with a history of retching, 4 days before its death. At necropsy, the liver was found to be enlarged, with multiple pin-point yellowish-white foci scattered diffusely throughout the organ. Multiple pin-point recent and old haemorrhages were seen on the mucosal surface of the gastrointestinal tract, particularly in the stomach and proximal duodenum. Large numbers of schistosome worm pairs and eggs were found in all mesenteric, gastric and hepatic veins. Histological examination of the intestines, mesenteric lymph nodes, liver, spleen, pancreas, stomach and lungs revealed numerous strongly fibrotic, encapsulated, epithelioid-giant cell granulomata containing dead, degenerating and viable eggs. A few examples of the Splendore-Hoeppli phenomenon were also detected. The eggs collected at necropsy had a terminal spine and an average length and breadth of 187.6+/-14.1 microm and 57. 3+/-4.1 microm, respectively. DNA analysis of female worms indicated that the schistosomes were either Schistosoma haematobium or a hybrid of Schistosoma mattheei and S. haematobium. 相似文献
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Caitlin M. Walsh Takondwa Mwase Manuela De Allegri 《The International journal of health planning and management》2020,35(6):1571-1592
Health sector strategic plans are health policies outlining health service delivery in low- and middle- income countries, guiding health sectors to meet health needs while maximizing resources. However, little research has explored the formulation of these plans. This study utilized qualitative methods to explore the formulation of Malawi's Health Sector Strategic Plan II, including processes utilized, actors involved, important contextual factors and the use of evidence-based decision-making. Thirteen semi-structured key informant interviews with health policy actors were conducted to explore perceptions and experiences of formulating the policy. Data analysis used an inductive-deductive approach and interpretation of the data was guided by an adapted version of the Walt and Gilson Health Policy Triangle. Our results indicate that HSSP II formulation was complex and inclusive but that the Ministry of Health may have given up ownership of the formulation process to development partners to ensure their continued involvement. Disagreements between actors centered around inclusion of critical services in the Essential Health Package and selection of performance-based financing as purchasing strategy. Resource constraints and the Cashgate Scandal are critical contextual elements influencing the formulation and content of the policy. Evidence-based decision-making contributed to the plan's development despite respondents' divergent opinions regarding evidence availability, quality and the weight that evidence carried. The study raises questions regarding the roles of policy actors during health policy formulation, the inclusivity of health policy processes and their potential influence on government ownership of health policy, as well as the use of evidence in developing health sector strategic plans. 相似文献
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Ethel M’kandawire Kennedy Choongo John Yabe Maxwell Mwase Ngonda Saasa Shouta M. M. Nakayama Nesta Bortey-Sam Claudia A. Blindauer 《Bulletin of environmental contamination and toxicology》2017,99(1):108-116
Zambia’s Kafue River receives wastes from various sources, resulting in metal pollution. This study determined the degree of contamination of 13 metals (Al, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Cd, Hg and Pb) in Kafue River sediment and the associated ecological risks at six sites in three different seasons. The level of contamination for most metals showed significant site and seasonal differences. The contamination factor and pollution load index indicated that concentrations of most metals particularly copper (Cu), cobalt (Co), manganese (Mn) and arsenic (As) were very high at sites within the Copperbelt mining area. The geoaccumulation index showed an absence of anthropogenic enrichment with Cd and Hg at all the study sites and extreme anthropogenic enrichment with Cu at sites in the Copperbelt mining area. Potential ecological risk showed that Cu and As were likely to cause adverse biological effects to aquatic organisms in the Copperbelt mining region of the Kafue River. 相似文献
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Background
Studies conducted in developed countries using economic models show that individual- and household- level variables are important determinants of health insurance ownership. There is however a dearth of such studies in sub-Saharan Africa. The objective of this study was to examine the relationship between health insurance ownership and the demographic, economic and educational characteristics of South African women. 相似文献6.
Meghan Prin Takondwa Itaye Sarah Clark Rohesh J. Fernando Felix Namboya Gregor Pollach Nyengo Mkandawire Julia Sobol 《World journal of surgery》2016,40(11):2635-2642
Background
The provision of critical care services is essential to healthcare systems and increasingly a global health focus, but many hospitals in sub-Saharan Africa are unable to meet this need. Intensive care unit (ICU) mortality in this region is high, but studies describing the provision of critical care services are scarce.Methods
This was a retrospective cohort study of all patients admitted to the ICU at Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, between September 1, 2013, and October 17, 2014. We summarized demographics, clinical characteristics, and outcomes, and analyzed factors associated with mortality.Results
Of 390 patients admitted to ICU during the study, 44.9 % of patients were male, and the median age was 22 years (IQR 6–35) years. Although most patients (73.1 %) were admitted with surgical diagnoses, the highest mortality was among patients admitted with sepsis (59.3 %), or obstetric (44.7 %) or medical (40.0 %) diagnoses. Overall ICU mortality was high (23.6 %).Conclusions
There is a shortage of data describing critical care in low-resource settings, particularly in sub-Saharan Africa. Surgical disease comprises the majority of ICU utilization in this study site, but medical and obstetric illness carried higher ICU mortality. These data may guide strategies for improving critical care in the region.7.
Takondwa Zuze Matthew S. Painschab Ryan Seguin Evarista Kudowa Bongani Kaimila Edwards Kasonkanji Tamiwe Tomoka Bal Mukunda Dhungel Maurice Mulenga Maria Chikasema Blessings Tewete Asekanadziwa Ntangwanika Sarah Chiyoyola Fred Chimzimu Coxcilly Kampani Robert Krysiak Nathan D. Montgomery Yuri Fedoriw Satish Gopal 《Infectious agents and cancer》2018,13(1):22
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Eyob Zere Matshidiso Moeti Joses Kirigia Takondwa Mwase Edward Kataika 《BMC public health》2007,7(1):78
Background
Growing scientific evidence points to the pervasiveness of inequities in health and health care and the persistence of the inverse care law, that is the availability of good quality healthcare seems to be inversely related to the need for it in developing countries. Achievement of the Millennium Development Goals is likely to be compromised if inequities in health/healthcare are not properly addressed. 相似文献9.
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