Hepatitis C virus in Zimbabwe

A research article on the prevalence of the Hepatitis C virus in ZimbabweLiver disease is an important cause of morbidity and mortality in Zimbabwe, accounting for more than six per cent of the deaths in three medical wards of Harare Central Hospital (IT Gangaidzo, 1994, unpublished observations). In western countries, HCV infection is the most common cause of chronic viral hepatitis and ranks a slight second below chronic alcoholism as a cause of cirrhosis, liver failure and hepatom

Responding to salinity in a rural African alluvial valley aquifer system : to boldly go beyond the world of hand-pumped groundwater supply?

Effective response to groundwater salinity in the developing world may critically safeguard drinking-water supplies. Groundwater resources throughout rural Africa are exploited by a vast and increasing number of hand-pumped boreholes for community supply. Our research in TA Ngabu (Shire Valley), Southern Malawi aims to: define groundwater-salinity problem occurrence within its semi-arid alluvial-valley aquifer setting and rural developing-world context; critique current capacity to respond; and, to discuss future response options - in particular considering the need to explore alternative options that boldly go beyond the world of hand-pumped groundwater supply. Salinity problem definition was achieved through survey of 419 hand-pumped boreholes that revealed widespread brackish groundwater causing non-potable (unpalatable) drinking-water supplies. Persistent non-functionality or abandonment of boreholes was typically ascribed to salinity. Whilst salinity is conceptualised to arise from shallow-groundwater evaporation, formation-evaporite dissolution and faulted-area upwelling, sparse data locally renders attribution of salinity sources to individual boreholes difficult. There is a significant need to better resolve the vertical distribution of salinity. Problem response capacity was hampered by multiple factors, including, sector inertia, low drilling costs compromising water-point integrity, and lack of technical vision for alternatives. Various recommendations are made to improve response capacity continuing to work at the hand-pump supply scale. However, in areas where salinity is significant, exploring the feasibility of other options is advocated in conjunction with technical capacity development. Groundwater options may utilise high borehole yields possible from alluvial aquifers, grossly under-exploited by hand pumps. Groundwater at depth, albeit of unknown quality typically, or pipeline transfers of probable good-quality groundwater from valley-margin units, should be considered. Surface-water pipeline supplies may be viable for (growing) population centres. Canal-fed irrigation schemes (pending for the area), should be multiple-use, protective of groundwater and embrace pipeline drinking-water supply and managed-aquifer-recharge opportunities. Advancing desalination technologies, although presently unaffordable, should be kept under review

Track D Social Science, Human Rights and Political Science

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138414/1/jia218442.pd

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran