Abstract:

Background: Clusters of suspected typhoid cases were recorded in Kadoma City between February 2014 and April 2014. The clusters were at a camp for uniformed forces, a public hospital and a private hospital. Concern by Kadoma residents necessitated the need to investigate the sudden increase in suspected typhoid cases. We then set out to describe the clusters in terms of person, place and time, identify the possible causative organism and source of infection.

Methods: A descriptive cross sectional study was conducted. Interviews with 34 randomly selected cases from the three clusters were done. Municipal water samples were collected for quality analysis. We collected stool specimens and hand swabs from kitchen staff at the 2 hospitals. We also collected kitchen working surface swabs and conducted a sanitary survey.

Results:  Males constituted 56% of the cases. Abdominal pains (32%), diarrhoea (29%) and fever (21%) were common among cases with a positive stool culture. Loss of appetite (26%), abdominal pains (26%) and diarrhoea (24%) were common among cases confirmed by the Widal test. The water treatment plant had quality control measures in place. Two out of 8 hand swabs had E coli isolated and 1 had Salmonella typhi isolated. Four cooks were shedding Salmonella typhi in stool. No faecal coliforms were isolated in the water samples. There were numerous sewer blockages at the uniformed forces camp.

Conclusion: The outbreak was propagated. Food handlers were shedding Salmonella typhi. Hand washing practices were poor. We recommended that the food handlers be removed from the kitchen and monitored. Sewer blockages in the compounds were attended to. Continued surveillance of cases and mobilization of resources in the City was also done.

Keywords: Typhoid fever, Clusters, Kadoma City, Zimbabwe

References:

[1]. Crump J A, Luby S P, Mintz E D (2004) The Global burden of typhoid fever Bulletin World Health Organization 82 346-353.

[2]. Crump J.A, Mintz E D (2010) Global trends in typhoid and paratyphoid fever Clinical Infectious Diseases vol 50 (2) pages 241-246.

[3]. Guidelines for the Investigation and Management of typhoid fever in Zimbabwe (2010). Ministry of Health and Child Care Zimbabwe

[4]. James Chin (2000) Control of Communicable diseases Manual17^th edition American Public Health Association

[5]. Maponga B, Chirundu D, Gombe NT, Tshimanga M, Shambira G, Takundwa L (2013) Risk factors for contracting watery diarrhea in Kadoma City Zimbabwe 2011 Available at http://www.biomedcentral.com/1471-2334/13/567 Accessed May 2014.

[6]. Standards Association of Zimbabwe (1997) Zimbabwe Standards Specification for Water for Domestic Supplies 560

Abstract:

This non-experimental, cross-sectional descriptive study assessed the “awareness, perception and implementation of focus antenatal care (FANC) among health care providers working in mother care clinics and hospitals in Benue State, Nigeria”. The target population comprised all skilled health care providers working in all the mother care clinics and hospitals in Benue State. The sample size consisted of 195 respondents who were selected using the convenient sampling technique after stratified sampling method. The demographic data obtained from the distributed questionnaire were analyzed using pie chart, and bar graph. Data collected were presented in frequency and percentage. Mean scores were used to analyze the data. 2.50 was chosen as the bench mark (≥2.5 as criteria of acceptance). Inferential statistics (chi-square) [x²] was used to test the hypothesis at 0.05 level of significance. Findings revealed that health care providers are aware of FANC in their hospitals/clinics. Result also shows that health workers have positive perception about FANC. The health workers have tried to implement most of the activities under FANC, but some important ones such as assessment for referral, screening and some tests were not properly implemented. There were no major factors militating against the implementation of FANC in hospitals/clinics in Benue State. The hospitals/clinics do not want to implement FANC because it may deter the quantity of visits that contributes to the earning of the hospital/clinics. Hence, they are unwilling neither to implement the recommended four visits of FANC nor to educate the mothers about FANC. Based on the results, the researchers recommend that government should enforce the full implementation of FANC in all the other care hospitals/clinics in Benue State because of its significant impact on the quality care for expectant mothers. Thus, ensures a complication free pregnancy and child birth. The health care providers should implement all other activities under FANC such as assessment for referral, and some important screening and tests as these activities are also very important at ensuring complication free pregnancy and child birth. Health workers should try to educate the mothers on the importance of FANC so that they can embrace it since it has been proven to be the best approach to ANC.

References:

[1]. Agboola, A (2006). Textbook of Obstetrics and Gynaecology for Medical Students. Second Edition. Heinemann Educational Books (Nigeria) Plc

[2]. Agus, Y. and Horiuchi, S. (2012) Factors influencing the use of Antenatal care in Rural West Sumatra, Indonesia. BMC pregnancy and childbirth 2012;12:9 

http://doi:10.1186/1471-2393-12-9

[3]. Amosu, A.M, Degun A.M., Thomas, A.M., Olanrewaju, M.F. Babalola Oyerihde A.O., Omeonu, P.E. Ola, O.O., and Nwogwugwu, S. (2011) A Study on the Acceptance and practice of Focused Antenatal care by Healthcare providers in the South-West Zone of Nigeria. Archives of applied Science Research vol 3. Issue 1 pp 484-491.

[4]. Bandac L. (2013) Barriers to utilization of focused Antenatal care among pregnant women in Ntchisi District in Malaria Retrieved from

 https://tampub.uta.filbitstream/handle/.../gradu06772.pdf?.../

[5].  Boller, C., Wyss, K., Mtasiwa, D. and Tanner, M. (2003) “Quality and comparison of Antenatal care in public and private provider in the united republic of Tanzania. Pubmed Bull World Health Organ 2003; 81:116-122.

[6]. Campbell, O.M and Graham, W.J. (2006) “Strategies of reducing Maternal Mortality: Gelting on with what works pubmed 2006; 368:1284-1299. http://doi:10.1016/So140-6736(06) 69381-1.

[7]. Courad, P., Schmid, G., Tientrebeogo, J., Moses, A., Kirenga, S., Neuhann, F., Muller, O., and Sarker, M. (2011) Compliance with Focused Antenatal Care Services: Do Health Workers in Rural Burkina Faso, Uganda and Tanzania Paform all ANC procedures? Tropical Medicine &Intenational Health Journal vol.17,issue 3 pp 300-307.

http://doi: 10.1111/j.1365-3156.2011.02923.x

[8]. Ekabua J., Ekabua K., and Njoku C. (2011) proposed framework for making focused Antenatal care services Accessible: A review of the Nigerian setting ISRN obstetrics and Gynecology vol 2011:2011:253964.

http://doi 10.5402/2011/253964.

[9]. Funmi, A (2014). Reproductive Health for All Ages. Third Edition. Bosem Publishers Nig. Ltd., Akure, Ondo State.

[10]. Gaym, A. (2009) “Antenatal Care” Retrieved from: 

www.slideshare.net/cdhnmj/antenatal-care-24694184.

[11]. Gross, K., Schellenberg, J.A., Kessy, F., Pfeiffer, C., and Obrist, B (2011) Antenatal care in practice: An Exploratory study in Antenatal care clinics in the kilombero Valley South – Eastern Tanzania.

[12]. Marshall, J. E and Raynor, M.D (2014). Myles Textbook for Midwives. Sixteenth Edition. International Edition. Churchill Livingstone, Elsevier

[13]. Shaikh, F. (2016) “Antenatal Care” Retrieved from: www.lumhs.edu.pk/dfhc/ppt/Antenatal_Care.ppt

[14]. UK Essays (2016) Determinants and implications for Focused Antenatal care interventions. Retrieved from: 

Https://www.uk essays.com/…/determinants-and-implications-for-focused-antenatal-car.

[15]. United Nations (2009) “the Millennium Development goals Report” retrieved from: http://www.un.org/millenniumgoals

[16].  WHO (2001). WHO Antenatal Care Randomized Trial: Manual for the Implementation of the New Model. Geneva: World Health Organizatio. WHO/RHR/01.30.

[17]. Yengo, M.L (2009) “Nurses” perception About the Implementation of FANC services in District Facilities of dares Salaam University of South Africa – Ndyomugyenyi, R., Neema, S., and Magnussen, P (1998) the use of Formal and informal services for Antenatal care and Malaria treatment in rural Uganda. Health policy and planning vol. 13 pp. 94-102.

Abstract:

The roles and responsibilities of clients in managing non-communicable diseases (NCDs) remain vital. Diabetes mellitus is a chronic disease that affects people from underdeveloped, developing and developed countries despite stages of economic and social development. Diabetes self-management education (DSME) is an ongoing process of facilitating the knowledge, other skills necessary for self-care and incorporating the critical processes such as the needs affected goals and care guided by evidence-based standards.

The overall goals of the article supported informed decision-making, self-care behaviors, problem-solving and collaborated with health care teams to improve clinical outcomes, enhanced health status and the quality of life living with diabetes. The self-care management model was designed to help clients living with the disease. The model provided supports and educated client on how to best adjust their lifestyle practices to sustain healthy living. The nursing process used as an assessment tool for designing the model. A client-friendly action plan and a simple take home card used to chart the way forward in managing self-care.

References:

[1]. American Association Diabetes. (2009). Standards of Medial Care in Diabetes. Diabetes Care., Pp. 32.

[2].  American Association of Diabetes Educators. (2008). AADE7 Self-Care Behaviors. Diabetes Educ., Pp. 445-449.

[3]. American College of Endocrinology., (2002). The American association of clinical endicrinologist guidelines for the management of diabetes mellitus: the AACE system of diabetes self-management. Endocr Pract., Pp. S41-S84.

[4].  Attridge, M. C. (2014). Culturally appropriate health education for people in ethnic minority groups with type 2 diabetes mellitus. (3) Cochrane Database Syst. Rev., Pp. 9. CD006424. doi: 10 1002/14651858. CD006424. pub3.

[5]. Barlow, J. W. (2002). Self-management approaches for people with chronic illness: A review. Patient Education and Counseling., Pp. 177-187.

[6]. Cooper, H. B. (2003). Paitents' perspectives on diabetes health care education. Health Educ Res., Pp. 191-206.

[7]. Frost, J. G. (2014). A qualitative synthesis of diabetes self-management strategies for long term medical outcomes and quality of life in the UK. BMC Health Serv Res., Pp. 348. doi. 10. 1186/1472-6963-14-348.

[8]. Goodall, T. &. (1991). Self-management of diabetes mellitus: a critical review. Health Psychol., Pp. 1-8.

[9]. Goodall, T. &. (1991). Self-management of diabetes mellitus: a critical review. Health Psychol., Pp. 1-8.

[10]. Grady, J. E. (2011.). Using message framing to achieve long-term behavioral change in persons with diabetes. Apply Nurs Res., Pp. 22-28.

[11]. Hendra, J. &. (1997). Improving the care of elderly diabetic patients: the final report of the St. Vincent joint task force. Age and Aging., Pp. 3-6.

[12]. Kater, A. S. (2010). Barriers to insulin initiation: the Translating Research Into Action for Diabetes insulin starts project. Diabetes Care., Pp. 33 (4): 733-735.

[13]. Matricciant, L. &. (2015). Who cares about foot care? Barriers and enablers of foot self-care practices among non-institutionalized older adults diagnosed with diabetes: an integrative review. Diabetes Educ., Pp. 106-17.

[14]. Mc Nabb, W. (1997). Adherence in diabetes: can we define it and can we measure it? Diabetes Care., Pp. 215-218.

[15]. Mensing, C. B., & cahy, K. &. (2006). National standards for diabetes self-management education. Diabetes Care., Pp. 29 (Suppl 1): S78-S85.

[16]. Norris, S. L. (2002). Self-management education for adults with type-2 diabetes: a meta-analysis of the effect on glycemic control. Diabetes Care., Pp. 1159-1171.

[17]. Paterson, B. &. (2000). Developmental evolution of expertise in diabetes self-management. Clin Nurs., Pp. 402-419.

[18]. Richard, A. &. (2011). Delineation of self-care and associated concepts. Journal of Nursing Scholarship., Pp. 255-264.

[19]. Seuring, T. A. (2015). The economic costs of type 2 diabetes: a global systematic review. Pharmacoeconomics., Pp. 811-31.

[20]. Shobhana, R. B. (1999). Patients' adherence to diabetes treatment. Assoc Physicians India., Pp. 1173-1175.

[21]. t'Hart, L. S.-B. (2010). Combined risk allele score of eight type 2 diabetes genes is associated with reduced first-phase glucose-stimulated insulin secretion during hyperglycaemic clamps. Diabetes., Pp. 59: 287-292.

[22]. Turner, R. C. (2005-2012). For the UK Prospective Diabetes Study (UKPDS) Group. Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). JAMA., Pp. 281 (21).

[23]. Williams, G. F. (1998). Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care., Pp. 1644-1651.

[24]. World Health Organization. (1998). List of Basic Terms. Health Promotion Glossary., Pp. 4.

Abstract:

The diabetic foot is considered one of the most devastating complications of diabetes. Diabetic foot is defined as a foot affected by ulceration. It is associated with neuropathy and or peripheral arterial disease of the lower limb. Health education is a combination of learning experiences designed to help people; by increasing their knowledge and influencing their attitudes to improve well-being. The aims of nursing interventions in diabetic foot care- to enhance patients care and services through health promotion, prevention, and patient-centered care. Nurses play vital roles in achieving these goals by providing health care, educating, consulting, being transformational leaders, researching and advocating for patients. However, this action plan focused on the roles of nurses in diabetic foot prevention and care and identified some of the challenges faced. The main goal of the article- to provide health services and to improve the physical, emotional, mental, socio-cultural and spiritual needs of clients.

Education on the basics of foot care, how to perform the physical examination and educating clients on the importance of wearing the right shoes are fundamental areas. Developing educational programs for each client and their families, teaching on the importance of follow-up checks, monitoring of blood glucose at a specified interval, the primary principles of diabetic care and prevention of complications are vital roles of a nurse.

On the other hand, minimizing the risk of the recurrence of the wound is vital. Therefore, by managing contributing systemic factors such as hypertension, hyperlipidemia, obesity, heart conditions or renal insufficiency is crucial. DFU are classified based on the features of the wound and tissues involvement. The study focused on the importance of complying with self-foot care the prevention of complications and the roles of the nurse in the process.

Method: An evaluative study was completed using the nursing process. The monofilament test a method used for the screening process. Educational sessions were conducted and practical demonstrations on the importance of self-foot care. Cases were referred for further management based on the needs identified. Many tables were used to aid in the teaching processes.

Results: All clients visited for follow-up checks were knowledgeable on the importance of compliance with care and ably demonstrated foot examination. 20% of the clients reported difficulties encountered with complying to care due to socioeconomic challenges. Notably, there were no newly diagnosed cases.

Conclusion: Nurses’ roles remained the key factors in managing, caring, educating, advocating and helping clients in modifying their lifestyle practices.

Keywords: Diabetic foot, diabetic foot ulcer, education, compliance.

References:

[1].  Abu-Qamar, M. (2014). Knowledge and practice of foot self-care among Jordians with diabetes - An interview-based survey. Journal of wound care. , Pp. 247-254.

[2]. Berlanga, J. (2013). "Heberprot-P: a novel product for treating advanced diabetic foot ulcer". . MEDICC Review. , PP. 11-15.

[3]. Bowering, C. (2001). Diabetic foot ulcers. Pathophysiology, assessment and therapy. Cam Fam Physician. , Pp. 1007-1016.

[4]. Lauterbach, S. K. (2010). Prevalence of diabetic foot syndrome and its risk factors in the UK. J Wound Care. , Pp, 19:333-337.

[5]. Naemi, R. C., & ingam, N. &. (2016). Differences in the mechanical characteristics of planter soft tissue between ulcerated and non-ulcerated foot. J Diabetes Complications.

[6]. Naves, C. (2016). The Diabetic Foot: A Historical Overview and Gaps in Current Treatment. ADV Wound Care.

[7]. World Health Organization. (2016). Global report on diabetes. Geneva.: World Health Organization.

[8].  World Health Organization. (2017). Health Education. Geneva: World Health Organization.

[9].  Singh, D. (2006). Diabetic foot: it's time to share the burden. Calicut Med J.

[10]. Tomic-Canic, M. &. (2004). Gene array technology and pathogenesis of chronic wounds. Am J Surg. , Pp, 67-72.

[11]. Waaijaman, R. (2014). Risk factors for plantar foot ulcer recurrence in neuropathic diabetic patients. Diabetic Care. , Pp. 1697-1705.

[12]. Yang, S. G. (2016). "Efficacy of Topical Recombinant Human Epidermal Growth Factor for Treatment of Diabetic Foot Ulcers. A Systematic Review and Meta-Analysis". The International Journal of lower extremity wounds. , Pp, 120-5.

Abstract:

This study was conducted to find the beliefs about caesarean section amongst women of childbearing age in UCTH Calabar, Cross River State, Nigeria. In the course of the study, five research questions and five hypotheses were formulated to direct the study. A survey method was used which is indicative in interview and discussions with people to obtain facts. The population of study was 853 pregnant women who came for antennal clinic in UCTH Calabar within the month of January 2017 with sampling size of 85 women. Accidental sampling method was used with a structured questionnaire—‘Questionnaires on beliefs about caesarean section among women of child bearing age in UCTH Calabar, Cross River State, Nigeria’. Same was administered by the researcher and his assistant and the data was analysed with mean, standard deviation, chi-square and One-way analysis of variance (ANOVA). The result revealed that there are significant influences of traditional and religious beliefs on caesarean section amongst women of childbearing age. The result further showed that there is significant difference in belief about caesarean section amongst women of childbearing age based on their educational qualifications, income status and number of children. It was recommended that there should be proper enlightenment of pregnant women over the relevance of caesarean section in the churches, communities and schools.

Keywords: Caesarean section, women of child bearing age, tradition beliefs, religious beliefs.

References:

[1]. Archibong E.I, Agan T.U (2010), Review of Policies and Programs for Reducing Maternal Mortality and Promoting Maternal Health in Cross River State, Nigeria, African Journal of Reproductive Health

[2]. A.; Templeton, A.; Van der Meulen, J. H (2013), “Impact of caesarean section on subsequent fertility: a systematic review and meta-analysis”. Human reproduction 28(7): 1943-1952. 

Doi:10.1093/humrep/det130.ISSN0268-1161.

[3]. American Congress of Obstetricians and Gynaecologists (2010). “ACOG Practice bulletin no. 115: Vaginal birth after previous caesarean delivery”. Obstetric and gynaecology 116 (2 Pt 1): 450-63. Doi: 10.1097/AOG.0b013e3181eeb251. PMID 20664418.

[4]. American College of Obstetricians and Gynecologists. (2010). FAQs: Cesarean birth. Retrieved January 18, 2017, 

http://www.acog.org/~/media/For%20Patients/faq006.pdf?dmc=1&ts=20120731T1617495597 (PDF - 336 KB) [top]

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[7]. Eliot, J. (2013), cesarean section-a brief history: National Institute of Health, Health & Human Services Freedom of Information Act, NLM Customer Support, U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894. “WHO Statement on Caeserean Section Rates” (PDF). 2015. Retrieved 10th November, 2016

[8]. Jeremiah, I; Nonye-Enyidah, E and Fiebai, P; (2011), Attitudes of antenatal patients at a tertiary hospital in Southern Nigeria towards caesarean section, Journal of Public Health and Epidemiology Vol. 3(13), pp. 617-621, 29 December, 2011 http://www.academicjournals.org/JPHE DOI: 10.5897/JPHE11. 122, ISSN 2141-2316 ©2011 Academic Journals

[9]. Jeremiah I, Nonye- Enyidah E, Fiebai P. Attitudes of antenatal patients at a tertiary hospital in southern Nigeria towards Caesarean section. J Public health Epid. 2011; 3(13):617–621.

[10]. Luz Gibbons, José M. Belizán, Jeremy A Lauer, Ana P Betrán, Mario Merialdi and Fernando Althabe, (2010), The Global Numbers and Costs of Additionally Needed and Unnecessary Caesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage, Health System Financing, WHO report, 2010, P. 30

[11]. Murray, L. (2015), BabyCenter, L.L.C. 1997-2016 All rights reserved Shorten A, Chamberlain M, Shorten B, Kariminia A. Making choices for childbirth: development and testing of a decision-aid for women who have experienced previous caesarean. Patient education and counseling. 2004; 52:307–13. [PubMed]

[12]. McGrath P, Phillips E, Vaughan G. Vaginal birth after Caesarean risk decisionmaking: Australian findings on the mothers’ perspective. International Journal of Nursing Practice. 2010; 16:274–81. [PubMed]

[13]. Mojeju, JN & Uche, I. (2012),maternal mortality in Nigeria:Examination of internal methods, International Journal of Humanities and Social Sciences Vol.2 no. 20 (special issue—October, 2012)

[14]. National Survey of Family Growth, 2006–2010, National Health Statistics, 2012Alvani SM. General management. 3rd ed. Tehran (Iran): Nay Publications; 2000.

[15]. Olin, J. (2011): 7 Nursing Theories To Practice By, September 12th, 2011, Notes From The Nurses’ Station Gurol-Urganci, I; Buo-Antoun, S; Lim, C. P.; Cromwell, D. A.; Mahmood, T.

[16]. Roudsari, R L, Zakerihamidi, M and Khoei, EM, (2015), Socio-Cultural Beliefs, Values and Traditions Regarding Women’s Preferred Mode of Birth in the North of Iran, Int J Community Based Nurs Midwifery. 2015 Jul; 3(3): 165–176

[17]. Roudsari, R.; Zakerihamidi, M.; and Khoei, E. (2015), Socio-Cultural Beliefs, Values and Traditions Regarding Women’s Preferred Mode of Birth in the North of Iran, Int J Community Based Nursing and Midwifery. 2015 Jul; 3(3): 165–176

[18]. Sunday-Adeoye I & Kalu, C (2011), Pregnant Nigerian women's view of cesarean section, volume 14, issue 3, p. 276-279

[19]. Schwartz, B. (2015), Caesarean Section Don’t Count as Real Birth, Disciple of the new Dawn Church. Retrieved January, 2017.

[20].  Udy, Pam (2009), Emotional Impact of Cesareans: Midwifery today, the heart and

[21].  silence of birth Martinez, G.; Daniels, K.; & Chandra, A. (2012), Fertility of Men and Women:

[22]. Zakerihamidi, M.; Roudsari, R. and Khoei, E.(2015), Vaginal Delivery vs. Cesarean Section: A Focused Ethnographic Study of Women’s Perceptions in The North of Iran, Int J Community Based Nursing and Midwifery. 2015 Jan; 3(1): 39–50.

[23]. Ugwu, NU & Kok, B (2015), Socio-cultural factors, gender roles and religious ideologies contributing to Caesarian refusal in Nigeria, Open Peer Review reports, p. 9.