University of Zimbabwe

About: University of Zimbabwe is a education organization based out in Harare, Harare, Zimbabwe. It is known for research contribution in the topics: Population & Acquired immunodeficiency syndrome (AIDS). The organization has 4378 authors who have published 6800 publications receiving 160720 citations. The organization is also known as: UZ & University College of Rhodesia and Nyasaland.

Determinants of perinatal mortality in Marondera district, Mashonaland East Province of Zimbabwe, 2009: a case control study

Abstract: Background: Marondera District recorded perinatal mortality ratios of 58.6/1000 and 64.6/1000 live births in 2007 and 2008 respectively. These ratios were above provincial averages of 32/1000 and 36/1000 during the same periods. We determined factors associated with perinatal mortality in Marondera District. Methods: A 1:2 unmatched case control study was carried out from June to August 2009. A case was any mother in Marondera District who had a stillbirth or early neonatal death from 01/08/2008 to 31/07/2009. A control was any mother whose baby survived the perinatal period during the same period. We calculated Odds Ratios and their 95% confidence intervals. Results: We interviewed 103 cases and 206 controls. Primary or no maternal education [OR=5.50 (3.14-9.33)] labor complications [OR=7.56 (4.38-13.06)], home delivery [OR=7.38 (4.03-13.68)] and preterm delivery [OR=15.06 (8.24-27.54)] increased the risk for perinatal mortality. Antenatal care booking [OR=0.19 (0.10-0.34)], having a gainfully employed husband [OR=0.36 (0.20-0.63)] and living within 5km of a health facility [OR=0.41 (0.22-0.78)] reduced the risk. Independent determinants of perinatal mortality included being apostolic [AOR=3.11 (1.05-9.18)], having a home delivery [AOR 7.17 (2.48-20.73)], experiencing labor complications [AOR=8.99 (3.11-25.98)], maternal HIV infection [AOR=5.36 (2.02-14.26)], antenatal care booking [AOR=0.32 (0.18-0.87)] and birth weight below 2500g [AOR=9.46 (3.91-27.65)]. Conclusion: Labor complications, belonging to apostolic sect, having a home delivery, maternal HIV infection, low birth weight and antenatal care booking were independently associated with perinatal mortality. Health worker training in emergency management of obstetric and neonatal care was initiated. Marondera District started holding perinatal mortality meetings. Key words: Perinatal mortality, determinants, neonatal death

Progress, challenges, and new opportunities for the prevention of mother-to-child transmission of HIV under the US President's Emergency Plan for AIDS Relief

Abstract: In June 2011, the Joint United Nations Programme on HIV/AIDS, the US President's Emergency Plan for AIDS Relief (PEPFAR), and other collaborators outlined a transformative plan to virtually eliminate pediatric AIDS worldwide. The ambitious targets of this initiative included a 90% reduction in new pediatric HIV infections and a 50% reduction in HIV-related maternal mortality--all by 2015. PEPFAR has made an unprecedented commitment to the expansion and improvement of prevention of mother-to-child HIV transmission (PMTCT) services globally and is expected to play a critical role in reaching the virtual elimination target. To date, PEPFAR has been instrumental in the success of many national programs, including expanded coverage of PMTCT services, an enhanced continuum of care between PMTCT and HIV care and treatment, provision of more efficacious regimens for antiretroviral prophylaxis, design of innovative but simplified PMTCT approaches, and development of new strategies to evaluate program effectiveness. These accomplishments have been made through collaborative efforts with host governments, United Nations agencies, other donors (eg, the Global Fund for AIDS, Tuberculosis, and Malaria), nongovernmental organizations, and private sector partners. To successfully meet the ambitious global targets to prevent new infant HIV infections, PEPFAR must continue to leverage the existing PMTCT platform, while developing innovative approaches to rapidly expand quality HIV services. PEPFAR must also carefully integrate PMTCT into the broader combination prevention agenda for HIV, so that real progress can be made toward an "AIDS-free generation" worldwide.

Detailed clinical and ultrasound examination of children and adolescents in a Schistosoma mansoni endemic area in Kenya: hepatosplenic disease in the absence of portal fibrosis.

Abstract: Hepatosplenic schistosomiasis involving organomegaly, portal fibrosis and portal hypertension has been observed in autopsy studies. Here, we have tested the hypothesis that hepatosplenic disease including organomegaly and markers of increased portal pressure can occur in school aged children in the absence of fibrosis. A case-only study of 96 children aged 7-20 years defined by ultrasound detectable hepatomegaly was undertaken in Makueni district, Kenya. A novel method of clinical examination that involved a consensus scoring by three or four examiners was used to classify children as presenting with severe or moderate hepatosplenic disease after palpation of livers and spleens. Ultrasound examination of livers and spleens was based on the Niamey protocol. Clinical measurements included spleen enlargement along the mid-clavicular and mid-axillary lines, liver enlargement along the mid-sternal (MSL) and mid-clavicular lines, as well as organ consistency. The clinical examination indicated that 9% and 60% of the children had severe or moderate hepatosplenomegaly, respectively. Amongst egg-positive children, all clinical measurements, except MSL liver enlargement, correlated with egg count, as did portal vein diameter, spleen length and liver length measured by ultrasound. Peri-portal fibrosis was not observed in any child, whereas 28% of the children were classified as having increased portal pressure according to World Health Organization criteria. There was no effect of malaria parasitaemia or hepatitis seropositvity on any of the observed parameters. These results indicate that hepatosplenic disease in school-aged children attributable to S. mansoni infection, involving hepatosplenomegaly and increased portal vein diameter, can occur in the absence of peri-portal fibrosis.

Opportunities for optimization of in-field water harvesting to cope with changing climate in semi-arid smallholder farming areas of Zimbabwe

Abstract: Climate change has resulted in increased vulnerability of smallholder farmers in marginal areas of Zimbabwe where there is limited capacity to adapt to changing climate. One approach that has been used to adapt to changing climate is in-field water harvesting for improved crop yields in the semi- arid regions of Zimbabwe. This review analyses the history of soil and water conservation in Zimbabwe, efforts of improving water harvesting in the post independence era, farmer driven innovations, water harvesting technologies from other regions, and future directions of water harvesting in semi arid marginal areas. From this review it was observed that the blanket recommendations that were made on the early conservation method were not suitable for marginal areas as they resulted in increased losses of the much needed water. In the late 1960 and 70s’, soil and water conservation efforts was a victim of the political environment and this resulted in poor uptake. Most of the water harvesting innovations which were promoted in the 1990s’ and some farmer driven innovations improved crop yields in marginal areas but were poorly taken up by farmers because they are labour intensive as the structures should be made annually. To address the challenges of labour shortages, the use of permanent in-field water harvesting technologies are an option. There is also need to identify ways for promoting water harvesting techniques that have been proven to work and to explore farmer-led knowledge sharing platforms for scaling up proven technologies.

AIDS in Africa: the implications of economic recession and structural adjustment.

Abstract: In Africa where 80% of acquired immunodeficiency syndrome (AIDS) cases are attributable to heterosexual intercourse or vertical transmission it has been assumed that infection flows from a core group of highly sexually active prostitutes to moderately promiscuous male clients and finally to relatively monogamous women of childbearing age. This assumption has led to an emphasis on modifying the behavior of individual prostitutes rather than addressing the structural factors that underlie the AIDS crisis. The latter factors include womens subordinate status in African society the disruption of rural families created by the migrant labor system and inadequate health services. Faced with few employment options many urban African women are forced to engage in prostitution to support themselves and their children. Moreover their low socioeconomic status hinders their ability to insist that male clients use condoms--the major strategy of African AIDS prevention programs. The recent economic crisis has exacerbated all these problems by increasing the population at risk through the pathways of urban migration poverty and prostitution and cuts in health services. It is essential that government initiatives go beyond the promotion of "safe sex" and confront fundamental structural issues such as the migrant labor system and womens status. Also needed is a critical reassessment of the assumption that African males are more promiscuous than males in other cultures. Biological factors such as genital ulcers and other sexually transmitted diseases may make African men and women more susceptible to contracting the AIDS virus in a single sexual encounter than their counterparts in other countries.