Incidence and patterns of congenital talipes equinovarus (Clubfoot) deformity at Queen Elizabeth Central Hospital, Banter, Malawi

Background: Clubfoot is one of the most common externally visible congenital deformities recorded in Sub Saharan Africa. The main objective of this study was to assess the overall incidence of clubfoot deformity in neonates born at Queen Elizabeth Central Hospital (QECH) in Malawi.Methods: A prospective study of all congenital anomalies presenting at the neonatal unit of QECH was started on 1st November 2000. All neonates with congenital anomalies born at or referred to QECH were enrolled in the study. The patterns of clubfoot with respect to gender, side of deformity, association with other congenital anomalies, maternal demographic characteristics and maternal obstetric history were recorded.Results: The total number of births at QECH during the study period was 16877. The number of children with clubfoot deformity recorded was 64 or 1 in 496 births, translating to 2 per 1000 births at QECH. The male to female sex ratio was 1.3:1. One child was a true hermaphrodite. Forty-seven (73%) of the children had bilateral clubfeet. Among the 17 children with a unilateral club foot the right side was involved in 12 (71%) of the children. Twenty-two (34.4%) of children had other associated congenital anomalies or a syndrome diagnosis. Neurotube defects were the commonest anomalies associated with clubfeet.Recommendation: The study should be continued and expanded to other hospitals and also to traditional birth attendants in order to establish the true incidence of clubfoot in Malawi

An audit of congenital anomalies in the neonatal unit of Queen Elizabeth Central Hospital. One-year study period: 1st November 2000 to 31st October 2001

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Wood utilization efficiency and acceptability of fried and smoked fish from Lake Malawi

Processing fish and fish products ensures longer shelf life, reduced post-harvest losses, better nutrition and organoleptic qualities, and attracts better market prices. However, traditional smoking, which is a common fish processing method in Malawi, is becoming difficult due to the huge volumes of wood used in the face of rapid loss of forests. Recently, fish processors have also started frying freshly caught fish as a way of processing before sale. This study compared the efficiency of wood utilization between the traditional smoking kiln, the Food and Research Institute smoking kiln (FRISMO), the modified smoking kiln and frying for Engraulicypris sardella and Copadichromis species. The processed fish were tested for consumer acceptability. The amount of wood for smoking Copadichromis species was 0.98, 1.24, 1.42 and 1.84 kg/kg of fish processed with the modified, FRISMO, traditional kilns and frying, respectively. These values were, however, not significantly different (P ⩾ 0.05). More wood (P<0.05) was used in frying E. sardella (5.83 kg/kg) than FRISMO (1.01), modified (0.98) and traditional kilns (1.81). Mean sensory scores of smoked Copadichromis species (7.4±0.2) and E. sardella (7.0±0.2) were higher in the modified kiln (P<0.05) than the FRISMO (6.2±0.2 and 7.3±0.2) and the traditional kiln (7.0±0.2 and 6.1±0.2), respectively. Sensory scores were significantly higher (8.3±0.2) and (7.9±0.2) (P<0.05) for fried Copadichromis species and E. sardella, respectively, than those for the smoking methods (FRISMO (6.2±0.2), modified kiln (7.8±0.2), traditional kiln (7.0±0.2) for E. sardella and FRISMO (7.3±0.2), modified kiln (7.9±0.2), and traditional kiln (6.1±0.2) for Copadichromis species). It is concluded that the modified kiln followed by the FRISMO kiln are more economical in terms of wood use efficiency as compared to frying. Fried fish, however, is highly acceptable by consumers compared to smoked fish. Based on the study results, mass adoption of less wood demanding fish processing methods such as the use of the modified and FRISMO kilns could help in reducing deforestation and should be promoted among fish processors.Keywords: Smoking, frying, Copadichromis species, Engraulicypris sardella, wood usag

Improvements in Blast Fragmentation Models Using Digital Image Processing

One of the fundamental requirements for being able to optimise blasting is the ability to predict fragmentation. An accurate blast fragmentation model allows a mine to adjust the fragmentation size for different downstream processes (mill processing versus leach, for instance), and to make real time adjustments in blasting parameters to account for changes in rock mass characteristics (hardness, fracture density, fracture orientation, etc). A number of blast fragmentation models have been developed in the past 40 years such as the Kuz-Ram model [1]. Fragmentation models have a limited usefulness at the present time because: 1. The input parameters are not the most useful for the engineer to determine and data for these parameters are not available throughout the rock mass. 2. Even if the input parameters are known, the models still do not consistently predict the correct fragmentation. This is because the models capture some but not all of the important rock and blast phenomena. 3. The models do not allow for ‘tuning’ at a specific mine site. This paper describes studies that are being conducted to improve blast fragmentation models. The Split image processing software is used for these studies

An Evaluation of the Performance and Acceptability of Three LED Fluorescent Microscopes in Zambia: Lessons Learnt for Scale-Up

The World Health Organization recommends the roll-out of light-emitting diode (LED) fluorescent microscopes (FM) as an alternative to light microscopes in resource-limited settings. We evaluated the acceptability and performance of three LED FMs after a short orientation among laboratory technicians from government health centers in Zambia. Sixteen technicians with varied light microscopy experience were oriented to FMs and divided into groups; each group read a different set of 40 slides on each LED FM (Primo Star iLED™, Lumin™, FluoLED™) and on a reference mercury-vapor FM (Olympus BX41TF). Slide reading times were recorded. An experienced FM technician examined each slide on the Olympus BX41TF. Sensitivity and specificity compared to TB culture were calculated. Misclassification compared to the experienced technician and inter-rater reliability between trainees was assessed. Trainees rated microscopes on technical aspects. Primo Star iLED™, FluoLED™ and Olympus BX41TF had comparable sensitivities (67%, 65% and 65% respectively), with the Lumin™ significantly worse (56%; p<0.05). Specificity was low for trainees on all microscopes (75.9%) compared to the experienced technician on Olympus BX41TF (100%). Primo Star iLED™ had significantly less misclassification (21.1% p<0.05) than FluoLED™ (26.5%) and Lumin™ (26.8%) and significantly higher inter-rater reliability (0.611; p<0.05), compared to FluoLED™ (0.523) and Lumin™ (0.492). Slide reading times for LED FMs were slower than the reference, but not significantly different from each other. Primo Star iLED™ rated highest in acceptability measures, followed by FluoLED™ then Lumin™. Primo Star iLED™ was consistently better than FluoLED™ and Lumin™, and performed comparably to the Olympus BX41TF in all analyses, except reading times. The Lumin™ compared least favorably and was thought unacceptable for use. Specificity and inter-rater reliability were low for all microscopes suggesting that a brief orientation was insufficient in this setting. These results provide important data for resource-limited settings to consider as they scale-up LED FMs