East African medical journal
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Diabetic ketoacidosis is the most common hyperglycaemic emergency in patients with diabetes mellitus, especially type 1 diabetes. It carries very high mortality in sub-Saharan Africa, both in the treated patients and those who are presenting to hospital with diabetes for the first time. ⋯ Although mortality and morbidity from diabetic ketoacidosis remains high in sub-Saharan Africa, improved healthcare systems and reliable insulin supply can reverse the trend, at least, to a large extent. Individuals and populations need empowerment through education, nutrition and poverty eradication to improve self-care in health and living with diabetes.
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To examine existing information on the recent influenza outbreaks in order to create awareness of a possible influenza pandemic and to suggest future research areas in developing control strategies in Kenya. ⋯ Influenza is a highly contagious, acute respiratory disease that may spread rapidly and pervasively through a population. Due to the diversity of susceptible reservoirs of influenza viruses and the interspecies transmission recently reported, a mutated strain of the virus to which people have no immunity could cause an influenza pandemic once the virus gains efficient and sustained human-to-human transmission. The fear that avian influenza could be a precursor to the next pandemic is real and inevitable, given the extremely high case-fatality ratio among confirmed cases and that genetic sequencing of influenza A (H5N1) viruses from human cases in Thailand and Vietnam show resistance to the antiviral medication amantadine and rimantadine. This calls for a high level of preparedness to avoid a public health emergency. Nowhere is this paradigm more real than in Africa.
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Review
Complementary factors contributing to the rapid spread of HIV-I in sub-Saharan Africa: a review.
To examine and establish complementary factors that contribute to the alarmingly high prevalence of HIV-1 in sub-Saharan Africa (SSA) in order to create awareness and suggest possible measures to avert the spread of the pandemic. ⋯ There are many reasons why the spread of HIV-1 in SSA has not been declining over the years. Main risk factors for HIV-1 infection and AIDS disease in SSA were found to include poverty, famine, low status of women in society, corruption, naive risk taking perception, resistance to sexual behaviour change, high prevalence of sexually transmitted infections (STI), internal conflicts and refugee status, antiquated beliefs, lack of recreational facilities, ignorance of individual's HIV status, child and adult prostitution, uncertainty of safety of blood intended for transfusion, widow inheritance, circumcision, illiteracy and female genital cutting and polygamy. It is suggested that control programmes both local and donor-driven seeking to mitigate the spread of HIV-1 in SSA should take into account the apparent multiplicity of sub-Saharan African cultures and beliefs, some of which augment the spread of HIV-1.
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Editorial Comment Review
Safe motherhood in Africa: achievable goal or a dream?
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To review the findings of safe motherhood intervention studies conducted in African settings. ⋯ More than a decade after the launching of the Safe Motherhood Initiative, there exists little evidence regarding which interventions will reduce maternal mortality levels in African settings. Intervention studies conducted in Africa have identified several low-tech improvements in emergency obstetric services which improve maternal outcomes and deserve replication and testing in a variety of settings. Further operational research should be conducted to identify and test other promising safe motherhood interventions, in particular interventions designed to reduce the important proportion of maternal mortality associated with unsafe termination of pregnancy.