Acute Coronary Syndrome in a Young Patient with Dual Mechanical Valves and Therapeutic International Normalized Ratio - A Rare Occurrence

Patients of valvular heart disease treated with mechanical valve replacement are required to be on lifelong medication with anticoagulants. Complications may arise when adequate International Normalized Ratio (INR) control is not maintained, leading to thromboembolic events, but very few cases have been reported where these complications arise despite therapeutic INR control. We, here, highlight a case of rare fatal complication of Acute Coronary Syndrome in a one month postoperative patient of Dual Mechanical Valve Replacement with therapeutic INR, which evaded correct diagnosis due to unawareness on the part of the treating team of physicians

Assessing Public Awareness of the Malaria Vaccine in Sub-Saharan Africa

Background: Malaria infection remains one of the leading causes of death in sub-Saharan Africa. Over the years, several measures have been implemented for the prevention of malaria, including vector control with insecticide-treated nets, indoor residual spraying, and seasonal or traveling prophylactics. In 2021, the World Health Organization (WHO) approved the use of the malaria vaccine in children. We conducted a cross-sectional survey study in three sub-Saharan African countries—Uganda, Ghana, and Nigeria—to assess public awareness of the malaria vaccine among the residents of these countries. Method: A cross-sectional, web-based survey was conducted between time January 2022 and April 2022 using Qualtrics® software (Version number: April 2022; Qualtrics, Provo, UT, USA). A total of 3896 responses were analyzed using SAS OnDemand for Academics software. Linear regression model was used to assess the relationship between the demographic characteristics and awareness of the malaria vaccine, using a level of significance (alpha) of 0.05. Result: Overall, there was significant association between the level of education and public awareness of the malaria vaccine in each of the countries studied. Gender and place of residence were associated with awareness in Nigeria and Uganda, while younger respondents were more likely to be aware of the malaria vaccine in Ghana. Conclusion: Given the negative impact of lack of awareness and knowledge, misinformation and conspiracy theories on immunization programs, public health campaigns preceding the population-wide roll-out of the novel malaria vaccine should target the less-educated, and those residing in more rural areas, while assuring equitable access to the malaria vaccine across sub-Saharan Africa