Epidemiological study of drug use in urban and rural secondary schools in Zimbabwe

An epidemiological survey of drug abuse among Zimbabwe's secondary school going youthsIn this survey a total of2 783 secondary school students of both sexes, mean age 15,5 years, from randomly selected schools in both rural and urban areas of Zimbabwe were studied using a self report questionnaire. The results strongly indicated that drug use was quite prevalent among the students. The main drugs involved, in descending order, were: alcohol, tobacco, inhalants (solvents), amphetamines and cannabis. Others included mandrax, tranquilisers, sedatives and the hallucinogen mudzepete. No students reported use of heroin, cocaine, LSD or opium. Drug use increased with age and involved both sexes, the problem being more acute in the urban schools. A differential use pattern is revealed, implying valuable information for targeted prevention efforts

Psychosocial and emotional morbidities after a diagnosis of cancer: Qualitative evidence from healthcare professional cancer patients

This inquiry aimed to; (1) examine the psychosocial and emotional sequelae associated with cancer patient-hood experience in healthcare professionals (HCPs) in Uganda, (2) generate evidence to inform clinical and nursing practice about the needs of HCP patients with cancer. This was a qualitative phenomenological study. The study was conducted among HCP cancer patients and survivors recruited from oncology and palliative care settings in Uganda. Data were collected via audio-taped, face-to-face or telephone open-ended interviews. Interviews were transcribed verbatim. Thematic analysis was used. Eight HCP cancer patients and survivors participated in the study. Their mean age was 56 years, range 29-85 years. Three major themes emerged: (1) From a healthcare provider to a patient, (2) Socioeconomic challenges, and (3) Coping and support strategies. [Abstract copyright: © 2022 The Authors. Nursing Open published by John Wiley & Sons Ltd.

The effects on mortality of brief interventions for problem drinking: a meta-analysis.

Aims Brief interventions for problem drinking may result in decreased mortality rates. Long-term follow-up studies of brief interventions do not produce a clear answer to the question as to whether these interventions reduce mortality or not. Methods We conducted a meta-analysis of randomized studies comparing brief interventions with a control group, using the fixed-effects model. A systematic literature search produced four studies in which the mortality status of subjects was verified at follow-up. Six more studies reported some deaths at follow-up but did not verify mortality in death registers, and 22 further studies did not report the mortality status of the included subjects. Findings The pooled relative risk (RR) of dying was 0.47 for the four studies with verified mortality rates (95% CI: 0.25, 0.89). The pooled RR of all 32 studies was comparable (RR = 0.57; 95% CI: 0.38, 0.84), as were the RRs of several other subsamples of studies. The prevented fraction was 0.33 in the studies with verified mortality rates. Conclusions Although the overall death rate was low in the population of problem drinkers, brief interventions do appear to reduce mortality

Prevalence and correlates of alcohol dependence disorder among TB and HIV infected patients in Zambia.

OBJECTIVES: To determine the prevalence and correlates of alcohol dependence disorders in persons receiving treatment for HIV and Tuberculosis (TB) at 16 Primary Health Care centres (PHC) across Zambia. METHODS: 649 adult patients receiving treatment for HIV and/or TB at PHCs in Zambia (363 males, 286 females) were recruited between 1st December 2009 and 31st January 2010. Data on socio-demographic variables, clinical disease features (TB and HIV), and psychopathological status were collected. The Mini International Neuropsychiatric Interview (MINI) was used to diagnose alcohol dependence disorder. Correlates of alcohol dependence were analyzed for men only, due to low prevalence in women. Univariable and multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI), using general estimating equations to allow for within-PHC clustering. RESULTS: The prevalence of alcohol dependence was 27.2% (95%CI: 17.7-39.5%) for men and 3.9% (95%CI: 1.4-0.1%) for women. Factors associated with alcohol dependence disorder in men included being single, divorced or widowed compared with married (adjusted OR = 1.47, 95%CI: 1.00-2.14) and being unemployed (adjusted OR=1.30, 95%CI: 1.01-1.67). The highest prevalence of alcohol dependence was among HIV-test unknown TB patients (34.7%), and lowest was among HIV positive patients on treatment but without TB (14.1%), although the difference was not statistically significant (p=0.38). CONCLUSIONS: Male TB/HIV patients in this population have high prevalence of alcohol dependence disorder, and prevalence differs by HIV/TB status. Further work is needed to explore interventions to reduce harmful drinking in this population

Institutional Effectiveness for Drought Early Warning, Early Action and Early Finance in Kenya

This case study focuses on drought conditions to analyse the early warning, early action and early finance initiatives required to reduce disaster impacts in Kenya. It particularly follows the ongoing multi-season Horn of Africa drought (2014-2022) where Kenya is located. The case study further investigates the effectiveness of governance and institutional arrangements in place, such that socially inclusive systems and processes for responding to climate change can be developed and implemented

Depression in Zimbabwe: a community approach to prevention and treatment

A position paper on primary health care for the management of mental health in Zimbabwe.This paper reports on a process whereby research findings, generated by a collaborative project between primary health care workers and a University team, were utilized by a community to formulate local plans for the prevention and management of depression. Action-oriented research, with a high level of community participation, follows on directly from the Declaration of Alma-Ata1 and has been called Health Systems Research (HSR). The principle of HSR is that it should be useful and have a direct focus on solving practical and relevant problems.2 Priorities should be generated by health workers and by the community rather than purely by academics and as much as possible of the research should be carried out by those already working at ground level. Results should lead to implementable recommendations and the research is not complete until those recommendations are underway

Serious Adverse Drug Reactions to Long-Term Oral Liquid Morphine in Patients with Chronic Pain: A Cross-Sectional Survey in Palliative Care

Barbara Duncan,1 Germanus Natuhwera,1,2 Doris Nassuuna,3 Roselight Katusabe,1 Hanif Kasozi,1 Wilson Acuda2 1Clinical Department, Hospice Africa Uganda, Kampala, Uganda; 2Education Department, Institute of Hospice and Palliative Care in Africa, Kampala, Uganda; 3Research Department, International Rescue Committee, Kampala, UgandaCorrespondence: Germanus Natuhwera, Email [email protected]; [email protected]: Behaviour suggestive of addiction in some patients on long-term oral liquid morphine (OLM) caused concern amongst the Hospice Africa Uganda clinical team and prompted the survey. This survey aimed to identify serious adverse drug reactions to long-term OLM in patients with chronic pain receiving palliative care.Methods: In Phase 1, the database of patients receiving palliative care at Hospice Africa Uganda was analyzed to find patients taking OLM from 12.7.2017 to 19.10.2017. A purposive review of their medical records was undertaken to identify those on long-term OLM. Phase 2 was conducted between 12.6.2018 and 23.10.2018. All patients on long-term OLM were offered biopsychosocial and spiritual assessment by a pain specialist (BD) to determine whether they were experiencing any serious adverse drug reactions. Phase 3 immediately followed phase 2 assessment. The pain specialist discussed with the participant any medication changes (including OLM) or other therapies to facilitate holistic management of pain for the individual.Results: In phase 1, 653 patients on OLM were identified. Phase 2 identified 49 patients who were on long-term OLM. Thirty-four patients agreed to participate in the assessment with the pain specialist. Of the 34 participants, 24 had chronic non-cancer pain and two had chronic cancer pain. Eight cancer survivors had incidental chronic non-cancer pain. Serious adverse drug reactions were identified in four participants with chronic non-cancer pain. Two cases of addiction, one case of opioid hyperalgesia, and one probable diversion of morphine.Conclusion: To our knowledge, the study identified the first documented cases of addiction to OLM in sub-Saharan Africa. Future research involving a larger multicenter sample, longitudinal, and qualitative designs is needed. Education of healthcare practitioners prescribing opioids should put equal emphasis on management of chronic non-cancer pain as do chronic cancer pain to minimize the risk of serious adverse reactions.Keywords: chronic pain, opioids, oral liquid morphine, palliative care, serious adverse drug reaction

Epidemiological study of drug use in urban and rural secondary schools in Zimbabwe

In this survey a total of2 783 secondary school students of both sexes, mean age 15,5 years, from randomly selected schools in both rural and urban areas of Zimbabwe were studied using a self report questionnaire. The results strongly indicated that drug use was quite prevalent among the students. The main drugs involved, in descending order, were: alcohol, tobacco, inhalants (solvents), amphetamines and cannabis. Others included mandrax, tranquilisers, sedatives and the hallucinogen mudzepete. No students reported use of heroin, cocaine, LSD or opium. Drug use increased with age and involved both sexes, the problem being more acute in the urban schools. A differential use pattern is revealed, implying valuable information for targeted prevention efforts