Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Prevalence of Dental Caries, its Associated Risk Factors and Treatment Needs among School Aged Children at Kimironko II Primary School, Kigali, Rwanda

BackgroundDental caries is still a health problem worldwide, its prevalence and incidence are associated with various factors like age, sex, social status, dietary patterns and oral hygiene habits.MethodologyA Secondary data collected from outreaches done by UR CMHS, School of Dentistry at Kimironko II Primary School was analyzed. This secondary data had been obtained using structured questionnaires with close ended questions. Clinical examination had also been done to gather information. SPSS statistical software package version 22 was used to analyse data from Community outreach done at Kimironko Primary School in August 2019.ResultsThe prevalence of dental caries of 42.4% was found among children aged 6-12 years old of Kimironko II Primary School. The researchers found the following to be statistically significantly associated with prevalence of dental caries: gender (p=0.042), dental visits (p=0.001), and use of chew sticks or miswaks (p=0.041). Females were 1.4 times more likely to develop dental caries (OR: 1.462; 95% CI: 1.16-2.017; p=0.021) and children who did not use toothpick were 2 times more likely to develop dental caries (OR: 2.149; 95%CI: 1.251-4.395; p=0.036), whereas visiting a dental practitioner was protective against dental caries (OR: 0.362, 95% CI: 0.251-0.516; p=0.001).ConclusionDental caries is prevalent among children of Kimironko II Primary School. Appropriate preventive measures should be taken to protect those found to be exposed.Rwanda J Med Health Sci 2021;4(3):341-34

Status, Needs, and Perspectives on the Practice of Endourology in Africa: a Continental Survey of 21 Reference Centers

Endourology occupies an important place in modern urological practice. Compared with conventional surgery, it offers improved safety and patients experience less severe postoperative effects. Its use requires a certain level of equipment and technical skills. In many developed countries, it has been established for years and its practice has become routine. In Africa, it is still not very practical or even non-existent in certain reference centers. This survey conducted among the heads of urology departments or training coordinators in African referral centers defines the current practice of endourology. According to the needs and perspectives identified, it is important, if not essential, to create services or reference centers specializing in endourology. The role of these centers will be to take care of patients and train urologists in technical skills. The creation of a sub-regional and international network could contribute to the development of this practice. Multi-stakeholder cooperation (inter-state, with non-governmental organizations, companies or corporations) is also necessary