Determinants of knowledge, attitudes, and practices of frontline health workers during the first wave of COVID-19 in Africa : a multicenter online cross-sectional study
Background: During its first wave of COVID-19 infection in sub-Saharan Africa, there was insufficient understanding of the pandemic among frontline health workers. This study was carried out to determine the knowledge, attitude, and practices (KAP) of frontline health workers (HWs) towards COVID-19 in Africa and their related factors. Methods: This was a multicenter online cross-sectional study conducted between April 2020 and July 2020 using a Google survey link among frontline HWs involved in the COVID-19 response in 26 African countries. Bivariate and multivariate logistic regression were used to analyse the determinants of KAP. Data were analyzed using STATA ver 16; all tests were…
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Chronic pain among children with cerebral palsy attending a Ugandan tertiary hospital : a cross-sectional study
Background Children with cerebral palsy (CP) frequently experience chronic pain. The burden and severity of such pain is often underestimated in relation to their other impairments. Recognition and awareness of this chronic pain among children with CP constitute the cornerstone for caretakers and clinicians to improve the quality of life of those children. This study aimed to determine the prevalence of chronic pain among children with CP, and the factors associated. Methods A cross-sectional study of children with CP, aged 2-12 years, attending the CP rehabilitation clinic and Pediatric Neurology Clinic at Mulago Hospital, Uganda from November 2017 to May 2018. A detailed history and…
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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,…
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Effects of pre‐operative isolation on postoperative pulmonary complications after elective surgery : an international prospective cohort study
We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall…
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An early warning mobile health screening and risk scoring app for preventing in-hospital transmission of COVID-19 by health care workers : development and feasibility study
Background: Hospitals have been identified as very high-risk places for COVID-19 transmission between health care workers and patients who do not have COVID-19. Health care workers are the most at-risk population to contract and transmit the infection, especially to already vulnerable patients who do not have COVID-19. In low-income countries, routine testing is not feasible due to the high cost of testing; therefore, presenting the risk of uncontrolled transmission within non-COVID-19 treatment wards. This challenge necessitated the development of an affordable intermediary screening tool that would enable early identification of potentially infected health care workers and for early…
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SARS-CoV-2 vaccination modelling for safe surgery to save lives : data from an international prospective cohort study
Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in…
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Alobar holoprosencephaly in mining‐related areas of the Eastern region of the Democratic Republic of the Congo : a case series
Background Recent case reports described three cases of holoprosencephaly (HPE) in the area with high mining-related pollution of the southern region of the Democratic Republic of the Congo (DRC). We reported two male neonates with clinically diagnosed HPE in the localities of Fizi and Kitutu, two mineral areas in the Eastern region of the same country (DRC), where artisanal surface mining is predominant with high exposure to radiation and heavy metals from mining. Cases presentations Two newborns from adult and multigravida mothers without pregnancy complication. The birth weights were 3,200 g and 2,500 g, respectively, and the malformations noticed were essentially the single median…
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Factors associated with hospital outcomes of patients with penetrating craniocerebral injuries in armed conflict areas of the Democratic Republic of the Congo : a retrospective series
Introduction Penetrating craniocerebral injuries (PCCI) are types of open head injuries caused by sharp objects or missiles, resulting in communication between the cranial cavity and the external environment. This condition is deemed to be more prevalent in armed conflict regions where both civilians and military are frequently assaulted on the head, but paradoxically their hospital outcomes are under-reported. We aimed to identify factors associated with poor hospital outcomes of patients with PCCI. Methods This was a retrospective series of patients admitted at the Regional Hospital of Bukavu, DRC, from 2010 to 2020. We retrieved medical records of patients with PCCI operated in the…
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A supraclavicular ALK-positive anaplastic large-cell lymphoma initially misdiagnosed and yet successfully treated with wide excision and adjuvant chemotherapy : a case report
Background ALK-positive Anaplastic Large-Cell Lymphomas (ALCL) are chemo-sensitive cancers; combination of histologic and immunophenotypic or genetic studies remains the main strategy to prevent their unnecessary surgical excision as they can mimic soft-tissues sarcomas in histology. In sub-Saharan Africa, however, availability and affordability of immunophenotypic studies, especially extended immunohistochemistry (IHC) tests, constitute major limitations for accurate diagnoses. The case presented herein is an example of a heavy surgical management resulting from an initially inaccurate diagnosis, but eventually treated successfully. Case presentation A 15-year-old female patient…
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Health-related quality of life of adolescents with sickle cell disease in sub-Saharan Africa : a cross-sectional study
Background Sickle cell disease (SCD) is a chronic hematologic disease associated with increased morbidity and mortality. Hemoglobinopathies are the most prevalent genetic disease globally, and SCD is estimated to affect 0.7% of Ugandan. The disease may adversely impact on the quality of life of sickle cell patients. This study aimed to evaluate the health related quality of life (HRoL) of adolescents with SCD. Methods This was a mixed-methods study of adolescents with sickle cell disease and their caretakers living in Kampala city, Uganda. All children aged 8–17 years with homozygous sickle cell disease attending the sickle cell clinic at Mulago Hospital during the study period were…
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