The rate and cost of hospitalisation in children with sickle cell anaemia and its implications in a developing economy

Background: There is paucity of data on the cost and rate of hospitalization in children with sickle cell anaemia (SCA) in most developing nations.Objective: To estimate the rate and cost of hospitalization in children with SCA in Nigeria and evaluate the economic burdens on their families.Methods: The number and duration of hospitalizations; estimated aggregate family’s monthly income, cost of care and percentage of the mean annual income spent on hospitalization for each respondent were obtained using a structured questionnaire.Results: The mean age of the 73 children was 61.1(44.3) months; M:F was 1:1.6. They had 183 admissions (average of 2.5(1.9) admissions per child per year). The mean family monthly income was $250.37, while the average cost of care per hospitalization per subject was$132.67. The total cost of care during the year was $24,278.37. About one-third of the caregivers spent at least 10% of their estimated annual income as total cost of hospitalization.Conclusion: The rate and the cost of hospitalization for children with SCA and the percentage of income spent on hospitalization were too high in our environment. Government should strengthen the National Health Insurance Scheme and subsidise the cost of care to these children.Key words: Children, Cost, Hospitalization, Sickle Cell Anaemi

Profile and professional expectations of medical students in Mozambique: a longitudinal study

<p>Abstract</p> <p>Introduction</p> <p>This paper compares the socioeconomic profile of medical students registered at the Faculty of Medicine of Universidade Eduardo Mondlane (FM-UEM), Maputo, for the years 1998/99 and 2007/08.</p> <p>Case study</p> <p>The objective is to describe the medical students' social and geographical origins, expectations and perceived difficulties regarding their education and professional future. Data were collected through questionnaires administered to all medical students.</p> <p>Discussion and evaluation</p> <p>The response rate in 1998/99 was 51% (227/441) and 50% in 2007/08 (484/968).</p> <p>The main results reflect a doubling of the number of students enrolled for medical studies at the FM-UEM, associated with improved student performance (as reflected by failure rates). Nevertheless, satisfaction with the training received remains low and, now as before, students still identify lack of access to books or learning technology and inadequate teacher preparedness as major problems.</p> <p>Conclusions</p> <p>There is a high level of commitment to public sector service. However, students, as future doctors, have very high salary expectations that will not be met by current public sector salary scales. This is reflected in an increasing degree of orientation to double sector employment after graduation.</p

The training and professional expectations of medical students in Angola, Guinea-Bissau and Mozambique

<p>Abstract</p> <p>Background</p> <p>The purpose of this paper is to describe and analyze the professional expectations of medical students during the 2007-2008 academic year at the public medical schools of Angola, Guinea-Bissau and Mozambique, and to identify their social and geographical origins, their professional expectations and difficulties relating to their education and professional future.</p> <p>Methods</p> <p>Data were collected through a standardised questionnaire applied to all medical students registered during the 2007-2008 academic year.</p> <p>Results</p> <p>Students decide to study medicine at an early age. Relatives and friends seem to have an especially important influence in encouraging, reinforcing and promoting the desire to be a doctor.</p> <p>The degree of feminization of the student population differs among the different countries.</p> <p>Although most medical students are from outside the capital cities, expectations of getting into medical school are already associated with migration from the periphery to the capital city, even before entering medical education.</p> <p>Academic performance is poor. This seems to be related to difficulties in accessing materials, finances and insufficient high school preparation.</p> <p>Medical students recognize the public sector demand but their expectations are to combine public sector practice with private work, in order to improve their earnings. Salary expectations of students vary between the three countries.</p> <p>Approximately 75% want to train as hospital specialists and to follow a hospital-based career. A significant proportion is unsure about their future area of specialization, which for many students is equated with migration to study abroad.</p> <p>Conclusions</p> <p>Medical education is an important national investment, but the returns obtained are not as efficient as expected. Investments in high-school preparation, tutoring, and infrastructure are likely to have a significant impact on the success rate of medical schools. Special attention should be given to the socialization of students and the role model status of their teachers.</p> <p>In countries with scarce medical resources, the hospital orientation of students' expectations is understandable, although it should be associated with the development of skills to coordinate hospital work with the network of peripheral facilities. Developing a local postgraduate training capacity for doctors might be an important strategy to help retain medical doctors in the home country.</p

Evaluation of the efficacy and safety of artemether-lumefantrine in the treatment of acute uncomplicated Plasmodium falciparum malaria in Nigerian infants and children

<p>Abstract</p> <p>Background</p> <p>The six-dose regimen of artemether-lumefantrine (AL) is now considered the gold standard for the treatment of uncomplicated <it>Plasmodium falciparum </it>malaria. There are few reports evaluating co-artemether in very young Nigerian infants and children. Results of the evaluation of the six-dose regimen in very young infants and children in Nigeria are presented in this report.</p> <p>Methods</p> <p>As part of a larger African study, this open label, non-comparative trial, assessed the efficacy and safety of six-dose regimen of AL tablets in 103 Nigerian infants and children weighing between five and 25 kg suffering from acute uncomplicated malaria. Treatment was administered under supervision over three days with children as in-patients. 12-lead ECG tracings were taken pre-treatment and at day 3.</p> <p>Results</p> <p>Ninety-three infants and children completed the study as stipulated by the protocol. Mean fever and parasite clearance times for the intent to treat population (ITT) were 24.9 h ± (1.28) and 26 h ± (4.14) and the corresponding figures for the per-protocol population (PP) were 19.24 h ± 13.9 and 25.62 h ± 11.25 respectively. Day 14 cure rates for the ITT and PP were 95.1% and 100% respectively while day 28 cure rates were 91.3% and 95.7% respectively. The overall PCR corrected day 28 cure rate was 95.1% for the ITT. The six-dose regimen of AL was well tolerated with no drug-related serious adverse events. Although six patients recorded a QTc prolongation of > 60 ms on D3 over D0 recording, no patient recorded a QTc interval > 500 ms.</p> <p>Conclusion</p> <p>The six-dose regimen of AL tablets is safe and effective for the treatment of acute uncomplicated malaria in Nigerian infants and children weighing between five and 25 kg.</p> <p>Trial registration</p> <p>NCT00709969</p

Metabolic inactivation of estrogens in breast tissue by UDP-glucuronosyltransferase enzymes: an overview

The breast tissue is the site of major metabolic conversions of estradiol (E(2)) mediated by specific cytochromes P450 hydroxylations and methylation by catechol-O-methytransferase. In addition to E(2 )itself, recent findings highlight the significance of 4-hydroxylated estrogen metabolites as chemical mediators and their link to breast cancer development and progression, whereas, in opposition, 2-methoxylated estrogens appear to be protective. Recent data also indicate that breast tissue possesses enzymatic machinery to inactivate and eliminate E(2 )and its oxidized and methoxylated metabolites through conjugation catalyzed by UDP-glucuronosyltransferases (UGTs), which involves the covalent addition of glucuronic acid. In opposition to other metabolic pathways of estrogen, the UGT-mediated process leads to the formation of glucuronides that are devoid of biologic activity and are readily excreted from the tissue into the circulation. This review addresses the most recent findings on the identification of UGT enzymes that are responsible for the glucuronidation of E(2 )and its metabolites, and evidence regarding their potential role in breast cancer

Efficacy of vitamin C and ethanolic extract of Sesamum indicum in promoting fertility in male Wistar rats

Aims: This study investigates the efficacy of ethanolic extract of Sesamum indicum (EES), vitamin C (VC), and EES + VC in promoting fertility and finding a possible link between their profertility effects and their antioxidant activities. Materials and Methods: Forty adult male Wistar rats [Body weight (BW) 186.56 ± 0.465 g] were randomly analyzed into four groups of ten rats each: Control, EES G (EES only), VC G (vitamin C only), and EES + VC G (EES in conjunction with vitamin C). Control was given 5 ml/kg BW/day of normal saline orally; EES G was administered 0.3 g/kg BW/day of EES; VC G was administered 15 mg/kg BW/ day of VC; while EES + VC G was administered both 0.3 g/kg BW/day of EES and 15 mg/kg BW/day of VC. All treatments were for 10 weeks. Statistical Analysis Used: Independent-sample T test was used to analyze the obtained results. Results: The results obtained showed that EES, VC, and more importantly EES + VC are capable of significantly increasing BW gain, seminal parameters, testosterone level, and body antioxidant activities. Conclusions: These findings lead to the conclusion that EES + VC as well as ESS and VC promote fertility due to both their testosterone-increasing effects and their antioxidant effects