A potentially treatable cause of dementia

A research article on dementia in old age Zimbabweans.Dementia is under-diagnosed in routine clinical practice in the developing world. Symptoms are often attributed to normal ageing, even though they may be a result of underlying medical conditions. We report a case of a patient with extensive cerebral calcification due to hypoparathyroidism who was being managed for dementia. While cases of extensive calcification in parathyroid hormone disorders have been reported sporadically in the literature over the years, the current case highlights the potential diagnostic pitfalls when patients present with dementia

Progress on the elimination of viral hepatitis in Zimbabwe: A review of the policies, strategies and challenges

Very few low‐income countries have developed national plans to achieve the viral hepatitis elimination targets set in the World Health Organization (WHO) strategy. We reviewed the policy environment, strategies and challenges on the fight against viral hepatitis in Zimbabwe. The review focussed on the Ministry of Health and Child Care (MoHCC) policy documents, strategic plans and reports. We performed key informant interviews to enhance evidence generated from the document review. Twelve documents were reviewed and interviews with 10 key informants were completed. The MoHCC established a technical working group to work towards elimination of viral hepatitis. The technical working group drafted a strategic plan for elimination of viral hepatitis; however, it is still awaiting implementation. Key strategies that are working well include screening of donated blood for transfusion, safe injection practices and hepatitis B virus (HBV) three‐dose vaccination. Current challenges in the drive towards elimination of viral hepatitis include poor to non‐existent surveillance systems, lack of epidemiological data, absence of the HBV vaccine birth dose and lack of systematic screening and treatment services for viral hepatitis. In conclusion, despite political will demonstrated towards achieving viral hepatitis elimination, substantial investment and work are required to implement the strategic plan and realize significant success

Acquired Epidermodysplasia Verruciformis Due to Multiple and Unusual HPV Infection Among Vertically-Infected, HIV-Positive Adolescents in Zimbabwe

We have characterized the EV-like dermatosis of acquired HIV in 4 adolescents. Multiple HPV types were isolated in skin tissue samples, including β-HPV, but also high levels of HPV 1 and 2. ARV did not improve the EV eruption

People, Patches, and Parasites: The Case of Trypanosomiasis in Zimbabwe

Understanding the socio-ecology of disease requires careful attention to the role of patches within disease landscapes. Such patches, and the interfaces between different socio-epidemiological systems, we argue, have important implications for disease control.We conducted an interdisciplinary study over three years to investigate the spatial dynamics of human and animal trypanosomiasis in the Zambezi valley, Zimbabwe. We used a habitat niche model to identify changes in suitable habitat for tsetse fly vectors over time, and this is related to local villagers’ understandings of where flies are found. Fly trapping and blood DNA analysis of livestock highlighted the patchy distribution of both flies and trypanosome parasites. Through livelihoods analysis we explored who makes use of what areas of the landscape and when, identifying the social groups most at risk. We conclude with a discussion of the practical implications, including the need for an integrated ‘One Health’ approach involving targeted approaches to both vector control and surveillance

Patterns of Hepatitis B and C exposure, susceptibility and vaccination status among healthcare workers at Parirenyatwa Hospital, Zimbabwe

Objectives: To determine Hepatitis B vaccine coverage among healthcare workers at a tertiary hospital in Zimbabwe, and to describe the patterns of chronic HBVand HCVinfections. Design:Cross-sectional study Setting: Parirenyatwa Hospital, Subjects: Doctors and nurses Results: One hundred and fifty-two participants (48 doctors and 104 nurses) were recruited. Four were positive for HBsAg (prevalence 2.6% ,95% CI, 1.0 6.6), 142 (93.4%) were positive for anti-HBc (i.e. previously exposed to HBV), and 120 (78.9%) were positive for anti-HBs. Although 74 (48.7%) healthcare workers reported prior vaccination, only 6 (3.9%) had consistent serology. Four healthcare workers were susceptible to HBV. Doctors were more likely to be vaccinated than nurses, while nurses who trained at Parirenyatwa hospital (Odds ratio; 2.7, 95% CI 1.2 - 6.2) were more likely to be vaccinated than those from other institutions. There were no cases of HCVinfection. Conclusion: The high frequency of natural immunity to hepatitis B among healthcare workers in this study suggests that susceptibility testing should be performed before vaccination. There is need for equitable, comprehensive national policy for the prevention and treatment of viral hepatitis Zimbabwe

A potentially treatable cause of dementia

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Cryptococcus gattii: A dilemma in diagnosis and treatment in sub-Saharan Africa an area with high HIV prevalence

Sub-Saharan Africa contributes at least 70% of the global cryptococcal meningoencephalitis cases each year and the majority of cases are caused by the Cryptococcus neoformans species. We present a case of meningoencephalitis due to Cryptococcus gattii in an 18 year old apparently immunocompetent male patient from Zimbabwe

Pneumomediastinum in an HIV-infected patient with cytomegalovirus pneumonitis.

A pneumomediastinum is an unusual complication of respiratory infections in HIV-positive patients, usually reported in association with pneumocystis pneumonia. We describe a case of an HIV-positive patient with a pneumomediastinum who had cytomegalovirus pneumonitis. This is an important reminder to clinicians, since cytomegalovirus pneumonitis and pneumocystis pneumonia have a similar clinical and radiological presentation