Pan African Medical Journal Research Articles

Retraction: "Sudden transient blindness following ureteroscopy: an uncommon complication of a common procedure (a case report) (Pan African Medical Journal. 2024;47:201. doi: 10.11604/pamj.2024.47.201.42952)".

[This retracts the article DOI: 10.11604/pamj.2024.47.201.42952.].

Systematic Mapping of Research on Vaccine-Preventable Diseases in Children in Sub-Saharan Africa: A Decennial Scientometric Analysis.

Vaccine-preventable diseases (VPDs) remain a significant public health challenge, particularly in sub-Saharan Africa. The high burden of VPDs in this region necessitates the need for continued investigation and intervention. This paper presents a bibliometric analysis of research on VPDs in children in sub-Saharan Africa in the last 10 years to capture the current state of research in the field. This study used a systematic search for articles published between 2013 and 2022 in the Web of Science Core Collection database and, subsequently, scientometric techniques for data analyses and interpretation. Annual scientific production of publications on the research of VPDs in children in sub-Saharan Africa increased from 2013 to 2019 and then gradually declined. South Africa had the most VPD studies (n = 148; 16.2%), followed by Nigeria, Ghana, Kenya, The Gambia, Malawi, Ethiopia, and the Republic of Congo. The Vaccine journal published the most. The Pan African Medical Journal was the most frequent destination journal based in Africa. The commonly studied pathogens were Streptococcus pneumoniae and Haemophilus influenzae. Research productivity increased exponentially in the pre-COVID era and declined in the past two years, so more VPD research in this region is needed.

COVID-19 u Africi: Ekonomsko i socijalno tumačenje (2019-2022)

The COVID-19 pandemic has caused a lot of challenges to the globalized world. Globally, it has decimated over six million lives. Since 2019, it has shook the world in many respects, especially, it disrupted economies and societies and halted the majority of human endeavor. Commentaries and reports from the World Health Organization (WHO) and the media showed an alarming situation that could be damning in low and middle income countries. Economic pundits and global public health experts also anticipated doom and gloom for African countries. However, in terms of mortality, the Americas, Europe and Asia have suffered more losses. Irrespective of these loses in Europe, Africa’s case needs better appreciation within our contemporary historical discourse. The burgeoning challenge of the COVID disease and mortalities arising thereby, among other things, necessitated the introduction of policies based on the WHO’s historical understanding of how the world has dealt with pandemics in the past. Some of the strategies that were deployed to fight the pandemic included hand washing under running water with soap, the use of alcohol based hand sanitizers, the wearing of nose masks, social distancing, self-isolation as well as partial and complete lockdowns of states and communities. The major economic disruption really came about as a result of many lockdown policies that were implemented by several countries in Africa without proper reference to their own societal contexts. These issues notwithstanding, it is important to emphasize that the extent of the impact on different communities differed to a large extent, even though there were similar levels of the nature of the infection and the general economic outlook among the global community. This current contribution on the COVID-19 discourse used political economy and economic shock as bases to highlight the extent of the impact of the disease by highlighting examples from respective countries in Africa, namely, Ghana, Cameroon, Ethiopia, Algeria and South Africa. In particular, the impact of policies like lock-down on some of these African countries are highlighted for further discussions in future empirical research. The study relied on contemporary historical evidence from multidisciplinary sources on health, economics, policy, and other related studies on epidemiology, public health, health education and promotion, reports and sources from the World Health Organization (WHO). Specifically, the authors have used published research in Lancet, the International Journal of Infectious Diseases, BMJ Global Health, Frontiers in Public Health and the Pan African Medical Journal. The others were African Development Review, Transportation Research Interdisciplinary Perspectives, Africa Spectrum and International Journal of Financial Research including several other empirical researches. In attempting a social and economic interpretation based on contemporary historical sense, the findings of this present study suggest that African political actors or leaders should make persistent or steady efforts to strengthen the economies of their states to lessen economic shocks and social costs that come about as a result of pandemics such as the COVID-19. It also identified the fact that within the globalized space, application of policies from other countries including international organizations should not be devoid of context.

Energy drink consumption in young subjects: a growing problem

The present letter to editor comments the manuscript “Sholeye O, Akinyemi O, Oyewole B. Caffeinated beverage consumption among adolescents in Sagamu, Nigeria: implications for health promotion. Pan African Medical Journal. 2022 Mar 14;41:202. doi: 10.11604/pamj.2022.41.202.31696” presenting some data on consumption of energy drinks among medical students during COVID-19 pandemic.

Hypertension among adults enrolled in HIV care in northern Tanzania: comorbidities, cardiovascular risk, and knowledge, attitudes and practices.

Cite this articlePreeti Manavalan et al. Hypertension among adults enrolled in HIV care in northern Tanzania: comorbidities, cardiovascular risk, and knowledge, attitudes and practices. Pan African Medical Journal. 2022;41(285). 10.11604/pamj.2022.41.285.26952Introductionthe epidemiology of non-communicable diseases (NCDs) among people living with HIV (PLHIV) in sub-Saharan Africa is poorly described. In this observational study we examined a cohort of hypertensive PLHIV in northern Tanzania and described comorbidities, cardiovascular risk, and hypertension knowledge, attitudes and practices.Methodsconsecutive patients attending an HIV clinic were screened for hypertension; those who met hypertension study criteria were enrolled. Participants completed a hypertension knowledge, attitudes and practices survey, and underwent height, weight, and waist circumference measurements and urine dipstick, fasting blood sugar, and lipid panel analyses. Kidney disease was defined as 1+ proteinuria, diabetes mellitus was defined as fasting glucose >126mg/dL, and 10-year atherosclerotic cardiovascular disease (ASCVD) risk was defined per the Pooled Cohorts Equations.Resultsof 555 screened patients, 105 met hypertension criteria and 91 (86.7%) were enrolled. The prevalence of diabetes mellitus, kidney disease, and overweight or obesity was 8.8%, 28.6%, and 86.7%, respectively. Almost all participants (n=86, 94.5%) had two or more medical comorbidities. More than half (n=39, 52.7%) had intermediate or high 10-year risk for an ASCVD event. While only 3 (3.3%) participants were able to define hypertension correctly, most would seek care at a medical facility (n=89, 97.8%) and take medication chronically for hypertension (n=79, 87.8%).Conclusionwe found a high burden of medical comorbidity and ASCVD risk among hypertensive PLHIV in northern Tanzania. Integration of routine NCD screening in the HIV clinical setting, in combination with large-scale educational campaigns, has the potential to impact clinical outcomes in this high-risk population.

IN THE HEART OF IT: A RARE PRESENTATION OF DISSEMINATED CRYPTOCOCCUS

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Since the emergence of highly active antiretroviral therapy (HAART), incidence cryptococcosis has fallen. We discuss a rare presentation of disseminated cryptococcosis. CASE PRESENTATION: A previously well 31 year old woman presented with 3 weeks of nausea, vomiting & headache. She was sent to hospital when she developed dizziness & palpitations after a positive HIV test was found on an outpatient visit. Examination revealed diffuse adenopathy. Urine was positive for opiates, cannabinoids & barbiturates. Non-contrast computed tomography head revealed no acute abnormalities, but abdomen/pelvis found abdominal & retroperitoneal lymphadenopathy. On day 2, she developed diaphoresis, cold extremities with HR160bpm, BP89/53mmhg, RR44bpm, SpO289% & T100F. She was intubated & put on vasopressors. She subsequently had 3 PEA cardiac arrests with return of spontaneous circulation after several minutes. Bedside transthoracic echocardiogram (TTE) revealed a severely hypokinetic dilated right ventricle (RV) & underfilled left ventricle (LV). Bedside transesophageal echocardiogram noted hyperdynamic apex, akinetic base & echogenic material within the right pulmonary artery, concerning for a pulmonary embolism. Hemodynamic instability was refractory to thrombolytics & she was placed on veno-arterial ECMO. She was empirically given vancomycin, piperacillin-tazobactam & clindamycin/primaquine. Blood cultures were later positive for yeast, so caspofungin & fluconazole added. Follow-up TTE showed minimal improvement in RV or LV function. On day 3, after 24 hours off sedation, pupils were dilated & brainstem reflexes absent. Apnea test confirmed brain death. After expiration, HIV viral load was found to be 528,000 copies/ml (reference range: not detected), CD4 was <20 cells/mcl (490-1740cells/mcl), & Cryptococcus neoformans was isolated, with titer ≥1:2560 (normal: negative). DISCUSSION: Cryptococcosis is the most common fungal disease in HIV, but its incidence has decreased in the US. Earlier HIV diagnosis & HAART explain this. It most commonly affects the nervous system. Occasionally, blood cultures are positive indicating disseminated disease. We postulate that pulmonary vascular occlusion can occur due to disseminated cryptococcal infection. Cryptococcomas are extremely rare solid tumor-like masses which have been reported to invade the central nervous system & the skin. Our suspicion for this is high given her poor response to TPA & significant fungemia which likely led to right heart failure & cardiovascular collapse. Literature review identified one other such case. More common sequelae include meningitis or pulmonary involvement. Amphotericin B & Flucytosine represent the most potent therapy for severe disease. CONCLUSIONS: Cardiopulmonary collapse from right heart failure with disseminated cryptococcus is extremely rare. Early diagnosis & treatment of HIV remains the most important tool. REFERENCE #1: Bramantono, B., Danial, A., & Hadi, U. (2020). A case of an AIDS patient with Cryptococcus neoformans infection. The Pan African medical journal, 36, 88. https://doi.org/10.11604/pamj.2020.36.88.20406 REFERENCE #2: Gültaşli NZ, Ercan K, Orhun S, Albayrak S. MRI findings of intramedullary spinal cryptococcoma. Diagn Interv Radiol. 2007 Jun;13(2):64-7. PMID: 17562509. REFERENCE #3: Sperry BW, Howard EW, Gitterman S, Panza JA. A case of cryptogenic dyspnea: disseminated cryptococcosis. Am J Med. 2014 Aug;127(8):707-10. doi: 10.1016/j.amjmed.2014.04.007. Epub 2014 Apr 21. PMID: 24769024. DISCLOSURES: No relevant relationships by Janeen Grant-Sittol, source=Web Response No relevant relationships by Lena Makartian, source=Web Response No relevant relationships by Priya Patidar, source=Web Response No relevant relationships by Rani Sittol, source=Web Response

Gliosarcomas: A Rare Case Report at Viet Duc University Hospital and Review of the Literature

Gliosarcoma is a rare biphasic subtype of glioblastoma with the poor prognosis, principally affects adults; males are more frequently affected, with a male-to-female ratio of 1.8/1. Gliosarcomas are usually located in the cerebral hemispheres, involving the temporal, frontal, parietal, and occipital lobes in decreasing order of frequency. Rarely, gliosarcomas occur in the posterior fossa, lateral ventricles, or spinal cord. A case study: A 32-year-old woman presented with persistent nausea and headache. The preoperative diagnosis was Ependymoma in the right lateral ventricle of the brain. The patient underwent surgical resection of the tumor followed by external radiotherapy, and chemotherapy treatment. Histologic description: The tumor was made up of spindle cells with hyperchromic large nuclei and pink cytoplasm intermingled with large cells with markedly pleomorphic nuclei and abundant cytoplasm along with prominent mitotic activity. Tumour cells revealed positive staining for Ki67 (25%), Oligo2 (focal), GFAP (focal), SMA (focal); negative immunoreactivity for EMA, CD34, Bcl-2, TTF1. Pathological diagnosis: Gliosarcoma, grade IV. Conclusions: Gliosarcoma is an extremely rare neoplasm with an aggressive biological behavior. In terms of histopathology, gliosarcomas are characterized by a biphasic tissue pattern with alternating areas displaying glial and mesenchymal differentiation. &#x0D; Keywords&#x0D; Gliosarcoma, glioblastoma multiforme, brain neoplasm.&#x0D; References&#x0D; [1] World Healh Organization, WHO Classification of Tumors of the Central Nervous System, International Agency for Research on Cancer (IARC) 69372 Lyon Cedex 08, France, 2016. [2] F. A. Hashmi, A. Salim, M. Shamim, M. Bari, Biological Characteristics and Outcomes of Gliosarcoma, The Journal of the Pakistan Medical Association, Vol. 68, No. 8, 2018, pp. 1273-1275. [3] P. Giglio, M. R. Gilbert, Encyclopedia of the Neurological Sciences (Second Edition), MA: Academic Press/Elsevier, Waltham, 2014. [4] R. K. Kevin, M. Anand, S. M. John, Adult Gliosarcoma: Epidemiology, Natural History, and Factors Associated with Outcome, Neuro Oncol, Vol. 11, No. 2, 2009, pp. 183-191, https://doi.org/10.1215/15228517-2008-076. [5] L. Han, X. Zhang, S. Qiu et al., Magnetic Resonance Imaging of Primary Cerebral Gliosarcoma: A Report of 15 Cases, Acta Radiologica, Vol. 49, No.9, 2008, pp. 1058-1067, doi:10.1080/02841850802314796. [6] D. N. Louis, H. Ohgaki, O. D. Wiestler et al., The 2007 WHO Classification of Tumours of the Central Nervous System, Acta Neuropathologica, Vol. 114, No. 2, 2007, pp. 97-109, doi:10.1007/s00401-007-0278-6. [7] L. Seth, P. Arie, I. James et al., Greenfield’s Neuropathology (Ninth Edition), CRC Press, Boca Raton, Florida, 2015. [8] L. Cervoni, P. Celli, Cerebral Gliosarcoma: Prognostic Factors, Neurosurgical Review, Vol. 19, No. 2, 1996, pp. 93-96, https://doi.org/10.1007/bf00418077. [9] J. Pardo, M. Murcia, G. Felip et al., Gliosarcoma: A Rare Primary CNS Tumor. Presentation of Two Cases, Reports of Practical Oncology &amp; Radiotherapy, Vol. 15, No. 4, 2010, pp. 98-102, https://doi.org/10.1016/j.rpor.2010.05.003. [10] J. Lutterbach, R. Guttenberger, A. Pagenstecher, Gliosarcoma: A Clinical Study, Radiotherapy andOncology, Vol. 61, No. 1, 2001, pp. 57-64,https://doi.org/10.1016/S0167-8140(01)00415-7. [11] B. K. Kleinschmidt, T. Tihan, F. Rodriguez, Diagnostic Pathology: Neuropathology (Second Edition), Elsevier, Philadelphia, 2016. [12] H. F. Irwin, W. G. Sidney, Sarcoma Arising in Glioblastoma of the Brain, Am J Pathol, Vol. 31, No. 4, 1955, pp. 633-653. [13] A. S. Awadalla, A. M. A. Essa, H. H. A. Ahmadi et al., Gliosarcoma Case Report and Review of the Literature, The Pan African Medical Journal, Vol. 35, No. 26, 2020, https://doi.org/10.3109/02841869709001353.&#x0D; &#x0D; &#x0D; &#x0D;

Comments on "Ileosigmoid knot in a patient with Down syndrome: a unique surgical emergency" by Boussaidane S et al. (Pan Afr Med J. 2021;38: 8).

Ileosigmoid knotting (ISK) is the wrapping of ileum or sigmoid colon around the other structure causing a double-loop intestinal obstruction. Both ISK and ISK complicating mental retardation are very rare clinical entities. In this commentary, I would like to discuss some details of ISK complicating mental retardation regarding to a published paper in The Pan African Medical Journal.

Hypertension in children in sub-Saharan Africa: primordial prevention is crucial

Hypertension in children in sub-Saharan Africa: primordial prevention is crucial

Corrigendum: Neglected tumor in a female with albinism.

This corrigendum corrects article “Neglected tumor in a female with albinism” and its publication references ie The Pan African Medical Journal. 2017;28:195. doi:10.11604/pamj.2017.28.195.14122.

Reaction to Mohamed Said Nakhli et al. concerning the article: "When the axillary block remains the only alternative in a 5 year old child". The Pan African Medical Journal. 2015;21:36

Le bloc axillaire chez l'enfant est une technique facile et recommandée chez l'enfant. Sa réalisation chez un enfant présentant une hépatite A aigue n'est pas démunie de risques surtout lorsqu'il est associé à une sédation au propofol avec du remifentanil. De même, la présence d'un kyste hydatique unique laisse la possibilité de l'anesthésie générale avec ventilation uni pulmonaire.

The Pan African Medical Journal 2015--A year in review.

Since its inception in 2008, the Pan African Medical Journal (PAMJ) enjoyed an exponential growth, not only in the number and geographical diversity of submissions received, but also in the range of services offered to researchers and professionals across the broad spectrum of biomedical and public health sciences. PAMJ in 2019 is: 2705 manuscripts submitted, a cumulative number of 13874 authors from 85 countries, 994 manuscripts accepted for publication and 774 articles published. The PAMJ in 2019 is also an editorial board of 15 and 46 dedicated reviewers to whom we extend our sincere appreciation.

Systematic reviews in context: highlighting systematic reviews relevant to Africa in the Pan African Medical Journal.

Health research serves to answer questions concerning health and to accumulate facts (evidence) required to guide healthcare policy and practice. However, research designs vary and different types of healthcare questions are best answered by different study designs. For example, qualitative studies are best suited for answering questions about experiences and meaning; cross-sectional studies for questions concerning prevalence; cohort studies for questions regarding incidence and prognosis; and randomised controlled trials for questions on prevention and treatment. In each case, one study would rarely yield sufficient evidence on which to reliably base a healthcare decision. An unbiased and transparent summary of all existing studies on a given question (i.e. a systematic review) tells a better story than any one of the included studies taken separately. A systematic review enables producers and users of research to gauge what a new study has contributed to knowledge by setting the study’s findings in the context of all previous studies investigating the same question. It is therefore inappropriate to initiate a new study without first conducting a systematic review to find out what can be learnt from existing studies. There is nothing new in taking account of earlier studies in either the design or interpretation of new studies. For example, in the 18th century James Lind conducted a clinical trial followed by a systematic review of contemporary treatments for scurvy; which showed fruits to be an effective treatment for the disease. However, surveys of the peer-reviewed literature continue to provide empirical evidence that systematic reviews are seldom used in the design and interpretation of the findings of new studies. Such indifference to systematic reviews as a research function is unethical, unscientific, and uneconomical. Without systematic reviews, limited resources are very likely to be squandered on ill-conceived research and policies. In order to contribute in enhancing the value of research in Africa, the Pan African Medical Journal will start a new regular column that will highlight priority systematic reviews relevant to the continent.

Obituary: in memoriam, Dr Atashili Julius (1977-2015)

The Pan-African Medical Journal (PAMJ) regrets to announce the death of Dr. Atashili Julius on 24 October 2015 in Douala, Cameroon, at the age of 38 years. He joined the PAMJ editorial board since 2009 and was one of his most distinguished scholars.

Retraction: Redundant Publication of the article Dental caries and oral health practices among 12 year old children in Nairobi West and Mathira West Districts, Kenya. Gladwell Gathecha et al. The Pan African Medical Journal. 2012;12:42.

This retracts article Dental caries and oral health practices among 12 year old children in Nairobi West and Mathira West Districts, Kenya. Gladwell Gathecha, AnselimoMakokha, Peter Wanzala, Jared Omolo, Perry Smith. The Pan African Medical Journal. 2013;12:42.

Open access, open education resources and open data in Uganda.

As a follow up to OpenCon 2014, International Federation of Medical Students’ Associations (IFMSA) students organized a 3 day workshop Open Access, Open Education Resources and Open Data in Kampala from 15-18 December 2014. One of the aims of the workshop was to engage the Open Access movement in Uganda which encompasses the scientific community, librarians, academia, researchers and students. The IFMSA students held the workshop with the support of: Consortium for Uganda University Libraries (CUUL), The Right to Research Coalition, Electronic Information for Libraries (EIFL), Makerere University, International Health Sciences University (IHSU), Pan African Medical Journal (PAMJ) and the Centre for Health Human Rights and Development (CEHURD). All these organizations are based or have offices in Kampala. The event culminated in a meeting with the Science and Technology Committee of Parliament of Uganda in order to receive the support of the Ugandan Members of Parliament and to make a concrete change for Open Access in the country.

Wilderness Image

Atropa Belladonna. Atropa belladonna or deadly nightshade grows wild across central and southern Europe, and southwest Asia, and is cultivated in some parts of North America. It gains its scientific name Atropa from Atropos, one of the Three Fates of Greek mythology who is synonymous with the anthropomorphism of Death. The second part of its name, Belladonna comes from its historical association with causing mydriasis to increase perceived attractiveness. The plant is notable in medical terms because it contains a number of toxic components, including hyoscine, hyoscyamine, and atropine, most concentrated in the roots of the plant. Although cases of belladonna poisonings are relatively rare,1Jaspersen-Schib R. Theus L. Guirguis-Oeschger M. Gossweiler B. Meier-Abt P.J. Serious plant poisonings in Switzerland 1966-1994. Case analysis from the Swiss Toxicology Information Centre.Schweiz Med Wochenschr. 1996; 126: 1085-1098PubMed Google Scholar with one study finding 42 cases out of 24,950 poisonings, over 29 years. Despite this, there are still multiple reports of poisonings in recent literature.2Berdai M.A. Labib S. Chetouani K. Harandou M. Atropa belladonna intoxication: a case report.The Pan African Medical Journal. 2012; 11: 72PubMed Google Scholar Belladonna poisoning is likely to present clinically as a form of the anticholinergic toxidrome.3Montoya M.A. Mavrakanas N. Schutz J.S. Acute anticholinergic syndrome from Atropa belladonna mistaken for blueberries.European Journal of Opthalmology. 2009; 19: 170-172PubMed Google Scholar Photograph by T. E. Mallinson, England.

O029 Patterns And Clinical Manifestations Of Tuberculous Myocarditis: A Systematic Review Of Cases

Tuberculosis is a rare cause of myocarditis. It is however associated with a high mortality when it occurs and is often diagnosed at post-mortem. Tuberculous myocarditis prevalence in males is twice that in females. Most of the reported cases of tuberculous myocarditis are predominantly in immunocompetent patients. Out of the reported fatalities (sudden cardiac deaths), eighty one percent (81%) occur in the ‘young’ patients (below 45years). Antituberculosis drug therapy does not appear to offer mortality benefit against sudden cardiac deaths. Pan African Medical Journal. 2015; 21:118 doi:10.11604/pamj.2015.21.118.4282 This article is available online at: http://www.panafrican-med-journal.com/content/article/21/118/full/ © Brian Nyasani Michira et al. The Pan African Medical Journal ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Pan African Medical Journal – ISSN: 19378688 (www.panafrican-med-journal.com) Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net) Review Open Access

Strengthening local health research capacity in Africa: the African Doctoral Dissertation Research Fellowship Program.

Sub-Saharan Africa suffers substantial shortages in doctorates. Yet, PhD training is key to building mastery of specific subject-matters and equipping researchers with the high-level skills needed to design, implement and evaluate development interventions and activities. This editorial describes the African Doctoral Dissertation Research Fellowship (ADDRF) Program, which was established in 2008 to enhance research capacity in Africa through the provision of doctoral fellowships and targeted training workshops to facilitate rigorous research addressing governance, equity, health and population-related issues on the continent. The Program has supported 133 doctoral students from across the region. This supplemental issue of the Pan-African Medical Journal showcases the research of 14 of these fellows.

Strengthening local health research capacity in Africa: The African Doctoral Dissertation Research Fellowship Program

Sub-Saharan Africa suffers substantial shortages in doctorates. Yet, PhD training is key to building mastery of specific subject-matters and equipping researchers with the high-level skills needed to design, implement and evaluate development interventions and activities. This editorial describes the African Doctoral Dissertation Research Fellowship (ADDRF) Program, which was established in 2008 to enhance research capacity in Africa through the provision of doctoral fellowships and targeted training workshops to facilitate rigorous research addressing governance, equity, health and population-related issues on the continent. The Program has supported 133 doctoral students from across the region. This supplemental issue of the Pan-African Medical Journal showcases the research of 14 of these fellows.