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Severe Metabolic Acidosis and “Muti” (traditional herbal medicine) ingestion in young children

2025-10-25T01:34:22Z

Title: Severe Metabolic Acidosis and “Muti” (traditional herbal medicine) ingestion in young children Authors: Nkrumah, F. K.; Nathoo, K. J.; Gomo, Z. A.; Pirie, D. J. Abstract: Twenty infants ami young children admitted with severe metabolic acidosis and a positive history of ‘muti’ ingestion were investigated. All had accompanying gastroenteritis and significant dehydration. Biochemical data was diagnostic of high anion / gap metabolic acidosis in the majority (70 per cent). Further biochemical data indicated that lactic acidosis and pre-renal azotaemia resulting from severe hypovolaemia were likely causes of the high anion GAP metabolic acidosis. There was no evidence to suggest that the ingested muti per se was associated directly with the acidosis or acute renal failure seen in these children

Anaemia and iron deficiency in peri-urban school children born in a National HIV Prevention Programme in Zimbabwe: A cross sectional study

2026-01-06T01:03:52Z

Title: Anaemia and iron deficiency in peri-urban school children born in a National HIV Prevention Programme in Zimbabwe: A cross sectional study Authors: Kuona, P.; Mashavave, G.; Kandawasvika, G.Q.; Mapingure, M.P.; Masanganise, M.; Chandiwanda, P.; Munjoma, M.; Nathoo, K.J.; Stray-Pedersen, B. Abstract: Objective'. To determine the prevalence of anaemia, iron deficiency and iron deficiency anaemia in school children who were born in a national HIV prevention programme. Design'. This was a community based cross-sectional study. Setting: A resource poor peri-urban setting with high prevalence of HIV infection. Subjects: School aged children six to 10 years old who were bom in a national mother-to-child HIV prevention programme. Main Outcome Measures: Haemoglobin (Hb), serum Ferritin (F) and serum Transferrin receptor (sTfR) levels. Results: Three hundred and eighteen children were recruited including 21 HIV positive. The prevalence of anaemia (Hb <11.5 grams per litre), iron deficiency (F< 15 micrograms per litre) and iron deficiency anaemia (Hb < 11.5 g/L and either F <15pg/L or sTfR > 8.3pg/L) were 15%, 4% and 2% respectively. When a higher cut-off for ferritin of 30 micrograms per litre was applied to adjust for high infection disease burden, iron deficiency prevalence increased to 32% and iron deficiency anaemia increased to 5%. Anaemia was 4.9 (C.I 1.9-12.4) times more likely to occur in HIV infected children compared to the HIV uninfected children. Maternal HIV status at birth was not related to presence of anaemia in the school children. Conclusion: Anaemia was of mild public health significance in this cohort of children. Iron deficiency anaemia contributed less than a quarter of the cases of anaemia. HIV infection was an important determinant for presence of anaemia. Therefore continued efforts to eliminate paediatric HIV infection as a way of reducing anaemia in children are essential. Description: Letten Foundation

Urinary iodine excretion in pregnant women as an index of the impact of a national iodization programme

2025-11-15T02:47:52Z

Title: Urinary iodine excretion in pregnant women as an index of the impact of a national iodization programme Authors: Chinyanga, E.A.; Chidede, O.; Machisvo, A.; Choga, T.; Malaba, L.; Sibanda, N. Abstract: Objective: To evaluate the extent to which increase in iodine requirement was achieved in pregnant women who attended the antenatal clinic at Harare Central Hospital. Design: Cross sectional. Setting: Samples were collected from pregnant women attending antenatal clinic at Harare Central Hospital, and from lactating mothers and their infants. Subjects: 100 pregnant women attending the antenatal clinic at Harare Central hospital, 80 infants, 80 lactating women and 18 non-pregnant women. Main Outcome Measures: Comparison of urinary iodine excretion levels among pregnant women, lactating mothers and their infants. Result: The results indicated lower urinary iodine excretion levels for the pregnant women and lactating mothers compared to the urinary iodine excretion of the infants and the breast milk iodine content. The urinary iodine excretion level of the non-pregnant control women was median (first and third quartiles): 18.5pg/dl (30.0, 30.2pg/dl). The urinary iodine excretion level of the lactating mothers was median (first and third quartiles): 12.0 mg/dl (7.6, 19.5 mg/dl) compared to the level of the infants, median (first and third quartiles): 26.5 mg/dl (18.8, 11.5 mg/dl). A significant difference was noted between the median urinary iodine excretion levels of the mothers, and the median levels of the infants, p = 0.001. The mean milk iodine content was 21.2 ± 6.8 mg/dl. There was no correlation between breast milk iodine levels and the urinary iodine excretion levels of the infants, (p = 0.96, r = 0.006). Positive correlation was found between maternal urinary iodine excretion levels and the urinary iodine excretion levels of the infants, p = 0.016 r = 0.285. Serum FT4, and TSH levels were found to be higher for infants at six weeks after birth, (FT4 =20.91± 65pmol,L) and median TSH= 2.28 mJU/ml (1.36, 0.86)mlU/rnl, compared to levels at 12 weeks postpartum: (FT4=17.53 -*6.4pmol/L) and median TSH=2.02 mlU/ml. (0.84. 1.55)mlU/ml. The differences were not significant. Conclusion: The results indicated a significant reduction in the urinary iodine content of pregnant women, and lactating mothers which did not appear to have any relationship to the urinary iodine excretion levels of infants and iodine content of breast milk. Iodine intake needed to be raised to reflect the recent proposed recommendation.

Antibiotic use in infants hospitalised with HIV-related pneumonia in Harare, Zimbabwe

2025-10-02T01:14:56Z

Title: Antibiotic use in infants hospitalised with HIV-related pneumonia in Harare, Zimbabwe Authors: Chitsike, I. Abstract: Objective : To describe the clinical features of infants admitted with HIV-related pneumonia and to describe antibiotic use in relation to recommended treatment guidelines. Design: Case series. Setting: Paediatric medical wards of two University Teaching Hospitals, Parirenyatwa and Harare Central Hospitals. Subjects: 100 infants aged one to 1.2 months admitted with HIV-related pneumonia Main Outcome Measures: Mortality and antibiotic use in the two hospitals. Methods: Records of 100 infants admitted for 48 hours or more with features of HIV-related pneumonia were analysed for clinical features and antibiotic use. Results: 77% of patients were in the first six months of life with a peak age of two months and a median of four months (C^ = 2, Q. = 6). The median age of children admitted to Parirenyatwa hospital was 5.5 months (Q1 = 3, Q,=7) and in Harare hospital it was three months (Q, = 2, Q,= 6). The difference was statistically significant, p=0.035. Fifty four percent of cases received penicillin, aminoglycoside and cotrimoxazole and overall only 30% of prescriptions complied with Essential Drug List of Zimbabwe (EDL1Z) recommendations for treatment of severe pneumonia in children with HIV infection. The overall mortality was 27.0%. The mortality in Harare Central Hospital was 40.4% and 15.7% in Parirenyatwa. The difference was statistically significant p= 0.005. Conclusion: The difficulties in establishing the cause of the pneumonia in infants with HIV infection was a contributory factor to lack of adherence to standard treatment guidelines. In countries with a high prevalence of HIV infection and with limited resources, a clinical case definition for Pneumocystis carinii pneumonia (PCP) is required as a measure to provide treatment for infants with HIV related pneumonia which is evidence based. This approach will also promote rational antibiotic prescribing and will contain cost.