Analysis of the Editorial Process of the Multidisciplinary Rural Development Journal Tropicultura

Tropicultura is a multidisciplinary journal which aims mainly at releasing research results relevant to rural development in developing countries and at improving the investigation capacities of the researchers who submit manuscripts to its editorial board. The operating process of the journal and its consequences on its output during the period 2002- 2009 were analysed by considering mainly the factors influencing the duration of the editorial work and the final acceptance of the manuscripts. The factors taken in consideration were: the field of research, the geographic origin of the data analysed, the language of writing and the country of origin of the authors. The available data were analysed using descriptive statistic methods. They were also subjected to parametric and non parametric comparisons. A total of 1,034 papers have been submitted during the investigated period to Tropicultura in different fields of rural development research, with a large proportion of papers in agronomy sensu lato (60%), and livestock production (19%). Most of the papers submitted (85.1%) came from Sub-Saharan Africa, followed by North Africa (11.2%), Asia (1.6%), Latin America (0.6%) and Europe (0.3%). The rate of acceptance (27.4%) was very low compared to other journals, mainly because of a poor design of the works or inappropriate research topics. The average time for final decision was 355 days. The non parametric classification analysis retained as major determinants for the acceptance of papers for publication in decreasing order of influence: (i) time before final decision, (ii) language, (iii) continent, (iv) Belgian cooperation priority countries, (v) Belgian cooperation partner countries, and (vi) the field of research. The data obtained are discussed in the light of the literature related to the editorial process of other scientific journals, taking into account the peculiarities of Tropicultura related to its history and to the history of the rural development actions of the Belgian cooperation. This analysis highlighted a series of possible improvements at the level of the operating process of the journal which should enable it to better achieve its goals

Outcomes for patients with rheumatic heart disease after cardiac surgery followed at rural district hospitals in Rwanda

Background In sub-Saharan Africa, continued clinical follow-up, after cardiac surgery, is only available at urban referral centres. We implemented a decentralised, integrated care model to provide longitudinal care for patients with advanced rheumatic heart disease (RHD) at district hospitals in rural Rwanda before and after heart surgery. Methods We collected data from charts at non-communicable disease (NCD) clinics at three rural district hospitals in Rwanda to describe the outcomes of 54 patients with RHD who received cardiac valve surgery during 2007–2015. Results The majority of patients were adults (46/54; 85%), and 74% were females. The median age at the time of surgery was 22 years in adults and 11 years in children. Advanced symptoms—New York Heart Association class III or IV—were present in 83% before surgery and only 4% afterwards. The mitral valve was the most common valve requiring surgery. Valvular surgery consisted mostly of a single valve (56%) and double valve (41%). Patients were followed for a median of 3 years (range 0.2–7.9) during which 7.4% of them died; all deaths were patients who had undergone bioprosthetic valve replacement. For patients with mechanical valves, anticoagulation was checked at 96% of visits. There were no known bleeding or thrombotic events requiring hospitalisation. Conclusion Outcomes of postoperative patients with RHD tracked in rural Rwanda health facilities were generally good. With appropriate training and supervision, it is feasible to safely decentralise follow-up of patients with RHD to nurse-led specialised NCD clinics after cardiac surgery

Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1% (3.3-4.8), 3.9% (2.6-5.1) and 3.6% (2.0-5.2), respectively). Surgery performed >= 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5% (0.9-2.1%)). After a >= 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0%), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms >= 7 weeks from diagnosis may benefit from further delay