Journal articles: 'Bulawayo (Zimbabwe) – Medical care'

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Svodziwa, Mathew, and Faith Kurete. "Cohabitation among Tertiary Education Students: An Exploratory Study in Bulawayo." Human and Social Studies 6, no. 1 (March 1, 2017): 138–48. http://dx.doi.org/10.1515/hssr-2016-0009.

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Abstract Cohabiting has been associated with a number of problems including sexually transmitted diseases and HIV and AIDS, abortions, sexual abuse and violence, low academic performance, increased cost of medical care and unwanted pregnancies. However, there is little documented information on the extent and the factors influencing cohabitation among the youth and especially among tertiary education students. This study therefore sought to fill this gap by investigating factors that lead to the prevalence and practice of cohabitation by tertiary education students. The research adopted the interpretivist philosophy. The qualitative research methodology was employed in order to understand in greater detail the behaviors, attitudes, opinions, and beliefs of the respondents on cohabitation among tertiary education students. The study used the survey research design. Primary research was conducted using questionnaire surveys that were administered to tertiary education students who participated at the Tertiary Education Sports Association of Zimbabwe in July 2016. There were 100 questionnaires distributed and 78 questionnaires were returned making 78% response rate. The respondents were randomly sampled to participate in the study. The study reflects that cohabitation among the Tertiary education students is quite common. The study noted that it is mostly caused by lack of accommodation, problems with roommates, lack of privacy and the need to be close and intimate with one's lover. In results cohabitation exposes students to premarital sex and other consequences such as unwanted pregnancies, abortion, complications and sexually transmitted infections. The study recommends that tertiary education students should be enlightened during orientations about the dangers of cohabitation. Parents should be encouraged to visit their children and find where and whom they live with while in school.

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Chaibva, Cynthia N., Valerie J. Ehlers, and Janetta H. Roos. "Audits of adolescent prenatal care rendered in Bulawayo, Zimbabwe." Midwifery 27, no. 6 (December 2011): e201-e207. http://dx.doi.org/10.1016/j.midw.2010.07.009.

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Nyakutombwa, Content P., Wilfred N. Nunu, Nicholas Mudonhi, and Nomathemba Sibanda. "Factors Influencing Patient Satisfaction with Healthcare Services Offered in Selected Public Hospitals in Bulawayo, Zimbabwe." Open Public Health Journal 14, no. 1 (April 20, 2021): 181–88. http://dx.doi.org/10.2174/1874944502114010181.

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Introduction: Patient satisfaction with health care services is vital in establishing gaps to be improved, notably in public health facilities utilised by the majority in Low and Middle-Income Countries. This study assessed factors that influenced patient satisfaction with United Bulawayo Hospitals and Mpilo Hospital services in Bulawayo in Zimbabwe. Methods: A cross-sectional survey was conducted on 99 randomly selected respondents in two tertiary hospitals in Bulawayo. Chi-squared tests were employed to determine associations between different demographic characteristics and patient satisfaction with various services they received. Multiple Stepwise Linear regression was conducted to assess the strength of the association between different variables. Results: Most of the participants who took part in the study were males in both selected hospitals. It was generally observed that patients were satisfied with these facilities' services, symbolised by over 50% satisfaction. However, patients at Mpilo were overall more satisfied than those at United Bulawayo Hospitals. Variables “received speciality services,” “average waiting times,” and “drugs being issued on time” were significant contributors to different levels of satisfaction observed between Mpilo and United Bulawayo Hospitals. Conclusion: Generally, patients are satisfied with the services and interactions with the health service providers at United Bulawayo Hospitals and Mpilo Hospitals. However, patients at Mpilo were more satisfied than those at United Bulawayo Hospitals. There is generally a need to improve pharmaceutical services, outpatient services, and interaction with health service provider services to attain the highest levels of patient satisfaction.

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PALMIERE, ANDREW, and MIRIAM GRANT. "Unequal Balance: HIV/AIDS and Health Care Programmes in Bulawayo, Zimbabwe." South African Historical Journal 45, no. 1 (November 2001): 154–77. http://dx.doi.org/10.1080/02582470108671406.

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Moyo, Idah, and Margaret Macherera. "The experiences of sex workers accessing HIV care services in Bulawayo, Zimbabwe." African Health Sciences 21, no. 2 (August 2, 2021): 593–602. http://dx.doi.org/10.4314/ahs.v21i2.14.

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Background: Although sub-Saharan African countries have rolled out massive HIV treatment and care programmes, there is little evidence of these having embraced key population groups particularly female sex workers. Due to the criminalisation of sex work in countries like Zimbabwe, research on HIV and its impact on this group is sparse. The absence of an enabling environment has hindered access to HIV care and treatment services for female sex workers. Objectives: To gain an in-depth understanding of the experiences of female sex workers accessing HIV care and treatment services to enhance programming and planning for this key population group. Methods: This study was qualitative and phenomenological. Data saturation determined the sample size of 20 participants. Data was collected using in-depth interviews that were audio recorded, transcribed, and subjected to thematic content anal- ysis. Results: Our findings demonstrate varying dynamics between the private and public sector HIV care services for sex work- ers, with facilitators and barriers to access to care. Conclusion: Health workers need sensitization and training in the provision of differentiated care. For effective linkage to and retention in care an enabling environment is critical. Keywords: Linkage to care; retention in care; enabling environment; facilitators; barriers.

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Ngwenya, Solwayo. "Stillbirth rate and causes in a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe." Tropical Doctor 48, no. 4 (August 8, 2018): 310–13. http://dx.doi.org/10.1177/0049475518789030.

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A global concern is to end preventable stillbirths by the year 2030. The objective of this study was to document the stillbirth rate and causes of stillbirths in a low-resource setting. This was a retrospective descriptive study carried out at Mpilo Central Hospital, a tertiary teaching referral government hospital in Bulawayo, Zimbabwe during the period January to December 2016. There were 8801 live births and 268 stillbirths (rate: 30.5/1000). The majority(81.3%) were macerated. Pre-term labour, pre-eclampsia, eclampsia and abruptio placenta accounted for 51.1%. In 29.9%, the cause could not be identified. A high proportion of macerated stillbirths were unexplained; hence this calls for a renewed focus on community-based approaches to reduce delays in seeking care. Investment in robust diagnostic means and further training of healthcare workers to improve case definition are both urgently required.

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Makoni, Talent M., Pruthu Thekkur, Kudakwashe C. Takarinda, Sinokuthemba Xaba, Getrude Ncube, Nonhlahla Zwangobani, Julia Samuelson, et al. "Linkage of voluntary medical male circumcision clients to adolescent sexual and reproductive health (ASRH) services through Smart-LyncAges project in Zimbabwe: a cohort study." BMJ Open 10, no. 5 (May 2020): e033035. http://dx.doi.org/10.1136/bmjopen-2019-033035.

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ObjectivesWHO recommended strengthening the linkages between various HIV prevention programmes and adolescent sexual reproductive health (ASRH) services. The Smart-LyncAges project piloted in Bulawayo city and Mt Darwin district of Zimbabwe established a referral system to link the voluntary medical male circumcision (VMMC) clients to ASRH services provided at youth centres. Since its inception in 2016, there has been no assessment of the performance of the referral system. Thus, we aimed to assess the proportion of young (10–24 years) VMMC clients getting ‘successfully linked’ to ASRH services and factors associated with ‘not being linked’.DesignThis was a cohort study using routinely collected secondary data.SettingAll three VMMC clinics of Mt Darwin district and Bulawayo province.Primary outcome measuresThe proportion of ‘successfully linked’ was summarised as the percentage with a 95% CI. Adjusted relative risks (aRR) using a generalised linear model was calculated as a measure of association between client characteristics and ‘not being linked’.ResultsOf 1773 young people registered for VMMC services, 1478 (83%) were referred for ASRH services as they had not registered for ASRH previously. Of those referred for ASRH services, the mean (SD) age of study participants was 13.7 (4.3) years and 427 (28.9%) were out of school. Of the referred, 463 (31.3%, 95% CI: 30.0 to 33.8) were ‘successfully linked’ to ASRH services and the median (IQR) duration for linkage was 6 (0–56) days. On adjusted analysis, receiving referral from Bulawayo circumcision clinic (aRR: 1.5 (95% CI: 1.3 to 1.7)) and undergoing circumcision at outreach sites (aRR: 1.2 (95% CI: 1.1 to 1.3)) were associated with ‘not being linked’ to ASRH services.ConclusionLinkage to ASRH services from VMMC is feasible as one-third VMMC clients were successfully linked. However, there is need to explore reasons for not accessing ASRH services and take corrective actions to improve the linkages.

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DeCelles, Jeff, Rebecca B. Hershow, Zachary A. Kaufman, Katherine R. Gannett, Thandanani Kombandeya, Cynthia Chaibva, David A. Ross, and Abigail Harrison. "Process Evaluation of a Sport-Based Voluntary Medical Male Circumcision Demand-Creation Intervention in Bulawayo, Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 72 (October 2016): S304—S308. http://dx.doi.org/10.1097/qai.0000000000001172.

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Tsang, Eileen Yuk-ha, Shan Qiao, Jeffrey S. Wilkinson, Annis Lai-chu Fung, Freddy Lipeleke, and Xiaoming Li. "Multilayered Stigma and Vulnerabilities for HIV Infection and Transmission: A Qualitative Study on Male Sex Workers in Zimbabwe." American Journal of Men's Health 13, no. 1 (January 2019): 155798831882388. http://dx.doi.org/10.1177/1557988318823883.

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Male sex workers are marginalized in most societies due to intersectional stigma between prostitution and homosexuality. In Zimbabwe, a proliferation of male sex workers in major cities such as Harare and Bulawayo has been reported. However, there is a shortage of studies that explore their lives. The current qualitative study aims to describe the practices of sex work, life contexts, and HIV risks and vulnerabilities based on in-depth interviews among 15 male sex workers in Bulawayo. Our studies suggest that the stigma against male sex workers comes from diverse sectors including culture (“homosexuality is un-African, introduced by the Whites”), religion (“same sex is a sin before the God”), law and police (“homosexuality is illegal in Zimbabwe. Engaging in it can send one to prison”), media (“the media is hostile to sex workers particularly men as we are regarded as abnormal and unclean”), and their family (“should they get to know about it, they will disown me”). In this context, male sex workers were excluded from national HIV prevention and treatment programs. They had limited knowledge and many misconceptions about HIV. The stigma and discrimination from health-care providers also discouraged them from health seeking or HIV testing. The non-disclosure to female partners of convenience and sexual relations further increased their vulnerabilities to HIV infection and transmission. Current efforts to address the HIV epidemic should pay attention to male sex workers and tackle the intersecting stigma issues. male sex workers need support and tailored HIV prevention and treatment services to improve their HIV prevention practices, health, and well-being.

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Ngwenya, Bigboy, Jacques Oosthuizen, Martyn Cross, and Kwasi Frimpong. "Emerging heat-related climate change influences; a public health challenge to health care practitioners and policy makers: Insight from Bulawayo, Zimbabwe." International Journal of Disaster Risk Reduction 27 (March 2018): 596–601. http://dx.doi.org/10.1016/j.ijdrr.2017.10.012.

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Mbanga, Joshua, Atida Sibanda, Sekai Rubayah, Fiona Buwerimwe, and Kudakwashe Mambodza. "Multi-Drug Resistant (MDR) Bacterial Isolates on Close Contact Surfaces and Health Care Workers in Intensive Care Units of a Tertiary Hospital in Bulawayo, Zimbabwe." Journal of Advances in Medicine and Medical Research 27, no. 2 (July 9, 2018): 1–15. http://dx.doi.org/10.9734/jammr/2018/42764.

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Mangombe, Aveneni, Philip Owiti, Bernard Madzima, Sinokuthemba Xaba, Talent M. Makoni, Kudakwashe C. Takarinda, Collins Timire, et al. "Does peer education go beyond giving reproductive health information? Cohort study in Bulawayo and Mount Darwin, Zimbabwe." BMJ Open 10, no. 3 (March 2020): e034436. http://dx.doi.org/10.1136/bmjopen-2019-034436.

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ObjectivePeer education is an intervention within the voluntary medical male circumcision (VMMC)–adolescent sexual reproductive health (ASRH) linkages project in Bulawayo and Mount Darwin, Zimbabwe since 2016. Little is known if results extend beyond increasing knowledge. We therefore assessed the extent of and factors affecting referral by peer educators and receipt of HIV testing services (HTS), contraception, management of sexually transmitted infections (STIs) and VMMC services by young people (10–24 years) counselled.DesignA cohort study involving all young people counselled by 95 peer educators during October–December 2018, through secondary analysis of routinely collected data.SettingAll ASRH and VMMC sites in Mt Darwin and Bulawayo.ParticipantsAll young people counselled by 95 peer educators.Outcome measuresCensor date for assessing receipt of services was 31 January 2019. Factors (clients’ age, gender, marital and schooling status, counselling type, location, and peer educators’ age and gender) affecting non-referral and non-receipt of services (dependent variables) were assessed by log-binomial regression. Adjusted relative risks (aRRs) were calculated.ResultsOf the 3370 counselled (66% men), 65% were referred for at least one service. 58% of men were referred for VMMC. Other services had 5%–13% referrals. Non-referral for HTS decreased with clients’ age (aRR: ~0.9) but was higher among group-counselled (aRR: 1.16). Counselling by men (aRR: 0.77) and rural location (aRR: 0.61) reduced risks of non-referral for VMMC, while age increased it (aRR ≥1.59). Receipt of services was high (64%–80%) except for STI referrals (39%). Group counselling and rural location (aRR: ~0.52) and male peer educators (aRR: 0.76) reduced the risk of non-receipt of VMMC. Rural location increased the risk of non-receipt of contraception (aRR: 3.18) while marriage reduced it (aRR: 0.20).ConclusionWe found varying levels of referral ranging from 5.1% (STIs) to 58.3% (VMMC) but high levels of receipt of services. Type of counselling, peer educators’ gender and location affected receipt of services. We recommend qualitative approaches to further understand reasons for non-referrals and non-receipt of services.

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Mugauri, Hamufare, Hemant Deepak Shewade, Riitta A. Dlodlo, Sithokozile Hove, and Edwin Sibanda. "Bacteriologically confirmed pulmonary tuberculosis patients: Loss to follow-up, death and delay before treatment initiation in Bulawayo, Zimbabwe from 2012–2016." International Journal of Infectious Diseases 76 (November 2018): 6–13. http://dx.doi.org/10.1016/j.ijid.2018.07.012.

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Gomera, Sheron. "Facing the truth." Global Journal of Psychology Research: New Trends and Issues 10, no. 2 (September 30, 2020): 201–9. http://dx.doi.org/10.18844/gjpr.v10i2.4792.

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The purpose of the study was to explore the process of human immunodeficiency virus (HIV) disclosure to children living with perinatal HIV at Mpilo Opportunistic Clinic (OI) in Bulawayo Metropolitan Province. The qualitative approach was used to study the topic and a phenomenological research design was used to describe the process of disclosure to children living with perinatal HIV. Data were collected through in-depth interviews. The data collected revealed that the HIV status disclosure to adolescents was difficult for caregivers, which caused the disclosure to be done later than recommended by the Ministry of Health and Child Care Zimbabwe. This had a significant negative impact on the psychological well-being of children who also struggled to disclose their status to others. The study revealed that the HIV counsellors lacked skills to counsel on psychological issues. The researcher recommended that psychologist be integrated in the formulation of an HIV manual and be employed at OI clinics to counsel children and caregivers. Keywords: Perinatal HIV, children, psychosocial, OI clinic.

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Rödlach, Alexander, Riitta A. Dlodlo, and Zanele E. Hwalima. "Perceptions of HIV, AIDS and tuberculosis among patients on antiretroviral therapy in Bulawayo, Zimbabwe: implications for the provision of HIV and TB care services." African Journal of AIDS Research 11, no. 2 (June 2012): 99–112. http://dx.doi.org/10.2989/16085906.2012.698076.

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Hunt, Jenny, Katherine Bristowe, Sybille Chidyamatare, and Richard Harding. "‘So isolation comes in, discrimination and you find many people dying quietly without any family support’: Accessing palliative care for key populations – an in-depth qualitative study." Palliative Medicine 33, no. 6 (March 12, 2019): 685–92. http://dx.doi.org/10.1177/0269216319835398.

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Background: Ensuring palliative care for all under a new global health policy must include key populations, that is, lesbian, gay, bisexual, transgender and intersex (LGBTI) people, and sex workers. Accessibility and quality of care have not been investigated in lower and middle-income countries where civil rights are the weakest. Aim: To examine the accessibility to, and experiences of, palliative care for key populations in Zimbabwe. Design: Qualitative study using thematic analysis of in-depth interviews and focus groups. Setting/participants: A total of 60 key population adults and 12 healthcare providers and representatives of palliative care and key population support organisations were interviewed in four sites (Harare, Bulawayo, Mutare and Masvingo/Beitbridge). Results: Participants described unmet needs and barriers to accessing even basic elements of palliative care. Discrimination by healthcare providers was common, exacerbated by the politico-legal-economic environment. Two dominant themes emerged: (a) minimal understanding of, and negligible access to, palliative care significantly increased the risk of painful, undignified deaths and (b) discriminatory beliefs and practices from healthcare providers, family members and the community negatively affected those living with life-limiting illness, and their wishes at the end of life. Enacted stigma from healthcare providers was a potent obstacle to quality care. Conclusion: Discrimination from healthcare providers and lack of referrals to palliative care services increase the risk of morbidity, mortality and transmission of infectious diseases. Untreated conditions, exclusion from services, and minimal family and social support create unnecessary suffering. Public health programmes addressing other sexually taboo subjects may provide guidance.

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Cowan, Frances M., Calum B. Davey, Elizabeth Fearon, Phillis Mushati, Jeffrey Dirawo, Valentina Cambiano, Sue Napierala Mavedzenge, et al. "The HIV Care Cascade Among Female Sex Workers in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 74, no. 4 (April 2017): 375–82. http://dx.doi.org/10.1097/qai.0000000000001255.

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Napierala, Sue, Sungai Tafadzwa Chabata, Elizabeth Fearon, Calum Davey, James Hargreaves, Joanna Busza, Phillis Mushati, et al. "Engagement in HIV Care Among Young Female Sex Workers in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 79, no. 3 (November 2018): 358–66. http://dx.doi.org/10.1097/qai.0000000000001815.

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Munongo, E., G. Mungwadzi, R. Vohra, C. Herrforth, and K. M. Lunney. "Needs Assessment of Emergency Medical Care in Zimbabwe: Preliminary Results from a Survey of Primary Care Physicians." African Journal of Emergency Medicine 3, no. 2 (June 2013): 83. http://dx.doi.org/10.1016/j.afjem.2012.09.007.

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Choguya, Naume Zorodzai. "Traditional and Skilled Birth Attendants in Zimbabwe: A Situational Analysis and Some Policy Considerations." Journal of Anthropology 2015 (May 18, 2015): 1–11. http://dx.doi.org/10.1155/2015/215909.

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The paper focuses on the situational analysis of traditional birth attendants (TBAs) and skilled birth attendants (SBAs) in Zimbabwe. Against a background of a frail health care system, characterised by a shortage in skilled professionals, increased cost of medical care, and geographic and economic inaccessibility of health care centres among others, TBAs have remained a life-line for especially many rural women in maternal health care provision. Moreover, TBAs have also found their way into the urban areas of Zimbabwe. The shift in international policy and health funding toward skilled birth attendants (i.e., an accredited health professional) has materialized into concerted government efforts to increase numbers of both midwifery training institutions and midwives themselves. The call for SBAs, though a worthy ideal, is out of touch with the lived realities of pregnant women in low resource settings such as Zimbabwe. The study is concerned with situational analysis of TBAs and SBAs in maternal health care service provision in Zimbabwe analysing and evaluating policy considerations.

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Mudhovozi, Pilot, Simba Mugadza, and Levison Maunganidze. "Medical Health Care Practitioners’ Views on Collaboration with Psychologists in the City of Harare (Zimbabwe)." Journal of Social Sciences 44, no. 1 (July 2015): 91–94. http://dx.doi.org/10.1080/09718923.2015.11893465.

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Mtapuri-Zinyowera, Sekesai, Memory Chideme, Douglas Mangwanya, Owen Mugurungi, Stephano Gudukeya, Karin Hatzold, Alexio Mangwiro, Gaurav Bhattacharya, Jonathan Lehe, and Trevor Peter. "Evaluation of the PIMA Point-of-Care CD4 Analyzer in VCT Clinics in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 55, no. 1 (September 2010): 1–7. http://dx.doi.org/10.1097/qai.0b013e3181e93071.

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Alikali, Moses. "The attitudes and activities of pastors and faith leaders in Zimbabwe on the use of family planning methods among their members." Christian Journal for Global Health 4, no. 2 (July 11, 2017): 66–74. http://dx.doi.org/10.15566/cjgh.v4i2.188.

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Background Faith leaders are important gatekeepers in disseminating reproductive health messages and influencing positive behavior change within communities. Faith leaders are seen as the most powerful, visible, and reachable form of authority, even trusted more than governments or non-profit organizations. In addition to providing counsel and advice aimed at enhancing health and wellbeing of the worshippers, faith leaders also play an important role in advocating and influencing what is taught in schools and what services are provided in healthcare facilities. Because of this influence, faith leaders often have an unparalleled opportunity—indeed, a moral obligation—to prioritize conversations about family planning, advocating, and closing the contraception gap. The overall objective of this study was to ascertain the attitude and activities of pastors and faith leaders in Zimbabwe on the use of family planning methods among their members. The result revealed that some faith leaders believed that spreading information about family planning education was the responsibility of the government and tended to avoid such responsibility. However, through training on family planning advocacy, much can be achieved. Methods Qualitative study methods were used to better understand the attitude and activities of pastors and faith leaders in Zimbabwe on the use of family planning methods among their members. The participants of this survey were drawn from 8 of 10 provinces in Zimbabwe, which include: Bulawayo, Harare, Manicaland, Mashonaland Central, Mashonaland East, Mashonaland West, Masvingo, and Matabeleland North. Paper-based questionnaires were answered by 24 pastors and 26 faith leaders in Zimbabwe (Table 1) through personal face-to-face meetings, while interviews were conducted with a select few pastors and faith leaders. The samples were drawn from randomly selected churches in Zimbabwe. Data was analyzed using Epi info 7 and Microsoft Excel. Results Generally, the pastors and faith leaders understood the benefits of longer birth intervals for the health of their members and their children, and the need for them to be involved in family planning awareness. However, both seemed slow to incorporate family planning into their programs. The faith leaders indicated an interest in being a part of various forms of campaigns to promote family planning if they could be equipped with correct information on family planning. Many strongly believed family planning to be of great importance to them and their families in situations where their financial incomes were low, and that family planning could reduce the rate of abortion. A majority agreed family planning was in agreement with their religious beliefs. Some felt their members had basic information on family planning methods, but only 44 percent of the faith leaders actually counseled their members on family planning methods from time to time. Although many would like to be part of those who create awareness in their various places of worship, only 28 percent of them had the right information on family planning through training. Conclusion One major factor for the limited involvement of faith leaders in family planning awareness is their lack of correct information on family planning. The gap can be narrowed by organizing family planning advocacy training workshops. Networks such as Africa Christian Health Association Platform (ACHAP), the Islamic Medical Association of Zimbabwe (IMAZ), Zimbabwe Association of Church-Related Hospitals (ZACH), and Zimbabwe Council of Churches (ZCC) can also be leveraged to disseminate and accelerate the spread of family planning information.

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Patel, Vikram, Charles Todd, Mark Winston, Fungisai Gwanzura, Essie Simunyu, Wilson Acuda, and Anthony Mann. "Common mental disorders in primary care in Harare, Zimbabwe: Associations and risk factors." British Journal of Psychiatry 171, no. 1 (July 1997): 60–64. http://dx.doi.org/10.1192/bjp.171.1.60.

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BackgroundThis study aimed to investigate the associations for common mental disorders (CMD) among primary care attenders in Harare.MethodThis was an unmatched case-control study of attenders at primary health clinics, general practitioner surgeries and traditional medical practitioner clinics; 199 cases with CMD as identified by an indigenously developed case-finding questionnaire, and 197 controls (non-cases), were interviewed using measures of sociodemographic data, disability, care-giver diagnoses and treatment, explanatory models, life events and alcohol use.ResultsCMD was associated with female gender (.=0.04) and older age (.=0.02). After adjustment for age, gender and site of recruitment, CMD was significantly associated with chronicity of illness; number of presenting complaints; beliefs in “thinking too much” and witchcraft as a causal model; economic impoverishment; infertility; recent unemployment; an unhappy childhood for females; disability; and consultations with traditional medical practitioners and religious priests.ConclusionsMental disorders are associated with female gender, disability, economic deprivation, and indigenous labels of distress states.

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Munyati, S. S., T. Dhoba, E. D. Makanza, S. Mungofa, M. Wellington, J. Mutsvangwa, L. Gwanzura, et al. "Chronic Cough in Primary Health Care Attendees, Harare, Zimbabwe: Diagnosis and Impact of HIV Infection." Clinical Infectious Diseases 40, no. 12 (June 15, 2005): 1818–27. http://dx.doi.org/10.1086/429912.

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TODD, C., V. PATEL, E. SIMUNYU, F. GWANZURA, W. ACUDA, M. WINSTON, and A. MANN. "The onset of common mental disorders in primary care attenders in Harare, Zimbabwe." Psychological Medicine 29, no. 1 (January 1999): 97–104. http://dx.doi.org/10.1017/s0033291798007661.

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Background. This study aimed to investigate the onset and predictors of common mental disorders (CMD) in primary-care attenders in Harare, Zimbabwe.Method. Two (T1) and 12-month (T2) follow-up of a cohort of primary-care attenders without a common mental disorder (N=197) as defined by the Shona Symposium Questionnaire (SSQ), recruited from primary health care clinics, traditional medical practitioner clinics and general practitioner surgeries. Outcome measure was caseness as determined by scores on the SSQ at follow-up.Results. Follow-up rate was 86% at 2 months and 75% at 12 months. Onset of CMD was recorded in 16% at T1 and T2. Higher psychological morbidity scores at recruitment, death of a first-degree relative and disability predicted the presence of a CMD at both follow-up points. While female gender and economic difficulties predicted onset only in the short-term, belief in supernatural causation was strongly predictive of CMD at T2. Caseness at both follow-up points was associated with economic problems and disability at those follow-up points.Conclusions. Policy initiatives to reduce economic deprivation and targeting interventions to primary-care attenders who are subclinical cases and those who have been bereaved or who are disabled may reduce the onset of new cases of CMD. Closer collaboration between biomedical and traditional medical practitioners may provide avenues for developing methods of intervention for persons with supernatural illness models.

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Patel, Vikram, Charles Todd, Mark Winston, Essie Simunyu, Fungisai Gwanzura, Wilson Acuda, and Anthony Mann. "Outcome of common mental disorders in Harare, Zimbabwe." British Journal of Psychiatry 172, no. 1 (January 1998): 53–57. http://dx.doi.org/10.1192/bjp.172.1.53.

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BackgroundLittle is known about the outcome of common mental disorders (CMD) in primary care attenders in low income countries.MethodTwo and 12 month (T1 and T2) follow-up of a cohort of cases of CMD (n=199) recruited from primary health, traditional medical practitioner, and general practitioner clinics in Harare, Zimbabwe. The Shona Symptom Questionnaire (SSQ) was the measure of caseness.ResultsThe persistence of case level morbidity was recorded in 41% of subjects at 12 months. Of the 134 subjects interviewed at both follow-up points, 49% had recovered by T1 and remained well at T2 while 28% were persistent cases at both T1 and T2. Higher SSQ scores, a psychological illness model, bereavement and disability predicted a poor outcome at both times. Poorer outcome at T1 only was associated with a causal model of witch-craft and an unhappy childhood. Caseness at follow-up was associated with disability and economic deprivation.ConclusionsA quarter of cases of CMD were likely to be ill throughout the 12 month follow-up period. Targeting risk groups for poor outcome for interventions and policy interventions to reduce the impact of economic deprivation may provide a way of tackling CMD in primary care in low income countries.

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Williams, H., and A. P. Reeler. "Teaching Zimbabwean Medical Students an Awareness of Hidden Psychological Disorder in an Urban Outpatient Setting." Tropical Doctor 19, no. 2 (April 1989): 52–54. http://dx.doi.org/10.1177/004947558901900203.

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A one-week attachment to an urban primary health care clinic was introduced into the eight-week psychiatric teaching block for fourth (penultimate) year medical students at the University of Zimbabwe. Its objective was to alert students to underlying psychological disorder in patients presenting, at primary health care level, with physical symptomatology. Students were required to screen patients using a 20-item questionnaire, take a psychosocial history of all high-scoring patients, and make one home visit. The attachment proved both popular and valuable, and it is anticipated that this will now become an integral part of the psychiatric teaching block.

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Musarandega, Reuben, Rhoderick Machekano, Memory Chideme, Cephas Muchuchuti, Angela Mushavi, Agnes Mahomva, and Laura Guay. "PMTCT Service Uptake Among Adolescents and Adult Women Attending Antenatal Care in Selected Health Facilities in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 75, no. 2 (June 2017): 148–55. http://dx.doi.org/10.1097/qai.0000000000001327.

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Foster, Geoff, Joanna Orne-Gliemann, Hélène Font, Abigail Kangwende, Vhumani Magezi, Tonderai Sengai, Simba Rusakaniko, Bridget Shumba, Pemberai Zambezi, and Talent Maphosa. "Impact of Facility-Based Mother Support Groups on Retention in Care and PMTCT Outcomes in Rural Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 75 (June 2017): S207—S215. http://dx.doi.org/10.1097/qai.0000000000001360.

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Mutowo, Mutsa P., Paula K. Lorgelly, Michael Laxy, Andre M. N. Renzaho, John C. Mangwiro, and Alice J. Owen. "The Hospitalization Costs of Diabetes and Hypertension Complications in Zimbabwe: Estimations and Correlations." Journal of Diabetes Research 2016 (2016): 1–9. http://dx.doi.org/10.1155/2016/9754230.

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Objective. Treating complications associated with diabetes and hypertension imposes significant costs on health care systems. This study estimated the hospitalization costs for inpatients in a public hospital in Zimbabwe.Methods. The study was retrospective and utilized secondary data from medical records. Total hospitalization costs were estimated using generalized linear models.Results. The median cost and interquartile range (IQR) for patients with diabetes, $994 (385–1553) mean $1319 (95% CI: 981–1657), was higher than patients with hypertension, $759 (494–1147) mean $914 (95% CI: 825–1003). Female patients aged below 65 years with diabetes had the highest estimated mean costs ($1467 (95% CI: 1177–1828)). Wound care had the highest estimated mean cost of all procedures, $2884 (95% CI: 2004–4149) for patients with diabetes and $2239 (95% CI: 1589–3156) for patients with hypertension. Age below 65 years, medical procedures (amputation, wound care, dialysis, and physiotherapy), the presence of two or more comorbidities, and being prescribed two or more drugs were associated with significantly higher hospitalization costs.Conclusion. Our estimated costs could be used to evaluate and improve current inpatient treatment and management of patients with diabetes and hypertension and determine the most cost-effective interventions to prevent complications and comorbidities.

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Chevo, Tafadzwa, and Sandra Bhatasara. "HIV and AIDS Programmes in Zimbabwe: Implications for the Health System." ISRN Immunology 2012 (January 26, 2012): 1–11. http://dx.doi.org/10.5402/2012/609128.

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This paper analyzes the implications of HIV and AIDS prevention, treatment, and care programmes on the health system in Zimbabwe. The programmes have been spearheaded by various stakeholders that include the public and private sectors, nongovernmental organizations, formal and informal institutions, and intergovernmental organizations. There has been a tremendous increase of the programmes as they adapt to local contexts, accommodate new funders, and changes in population attitudes, and expectations in the country. Through a comprehensive literature review, this paper focuses on Behaviour Change, the Antiretroviral Therapy, Home-Based Care, Prevention to Mother To Child Transmission and Voluntary Counselling and Testing programmes and services in relation to the components of the health system that include health service delivery, human resources, finance, leadership and governance, and the medical products and technologies. Thus far, the implications are uneven throughout the health system and there is need to integrate the HIV and AIDS programmes within the health system in order to achieve positive heath outcomes.

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Foster, Geoff, Abigail Kangwende, Vhumani Magezi, Talent Maphosa, Richard Mashapa, Fadzai Mukora-Mutseyekwa, Angela Mushavi, Simba Rusakaniko, Bridget Shumba, and Pemberai Zambezi. "Cluster Randomized Trial on the Effect of Mother Support Groups on Retention-in-Care and PMTCT Outcomes in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 67 (November 2014): S145—S149. http://dx.doi.org/10.1097/qai.0000000000000325.

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Joseph, Jessica, Tendai Gotora, Alison S. Erlwanger, Angela Mushavi, Simukai Zizhou, Nyasha Masuka, Caroline E. Boeke, and Alexio-Zambezi Mangwiro. "Impact of Point-of-Care CD4 Testing on Retention in Care Among HIV-Positive Pregnant and Breastfeeding Women in the Context of Option B+ in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 75 (June 2017): S190—S197. http://dx.doi.org/10.1097/qai.0000000000001341.

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Okunade, Kehinde, Kennedy Bashan Nkhoma, Omolola Salako, David Akeju, Bassey Ebenso, Eve Namisango, Olaitan Soyannwo, et al. "Understanding data and information needs for palliative cancer care to inform digital health intervention development in Nigeria, Uganda and Zimbabwe: protocol for a multicountry qualitative study." BMJ Open 9, no. 10 (October 2019): e032166. http://dx.doi.org/10.1136/bmjopen-2019-032166.

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IntroductionPalliative care is a clinically and cost‐effective component of cancer services in sub-Saharan Africa (SSA). Despite the significant need for palliative cancer care in SSA, coverage remains inadequate. The exploration of digital health approaches could support increases in the quality and reach of palliative cancer care services in SSA. However, there is currently a lack of any theoretical underpinning or data to understand stakeholder drivers for digital health components in this context. This project addresses this gap through engaging with key stakeholders to determine data and information needs that could be supported through digital health interventions.Methods and analysisThis is a multicountry, cross-sectional, qualitative study conducted in Nigeria, Uganda and Zimbabwe. In-depth interviews will be conducted in patients with advanced cancer (n=20), caregivers (n=15), health professionals (n=20) and policy-makers (n=10) in each of the three participating countries. Data from a total of 195 interviews will transcribed verbatim and translated into English before being imported into NVivo software for deductive framework analysis. The analysis will seek to understand the acceptability and define mechanisms of patient-level data capture and usage via digital technologies.Ethics and disseminationEthics approvals have been obtained from the Institutional Review Boards of University of Leeds (Ref: MREC 18–032), Research Council of Zimbabwe (Ref: 03507), Medical Research Council of Zimbabwe (Ref: MRCZ/A/2421), Uganda Cancer Institute (Ref: 19–2018), Uganda National Council of Science and Technology (Ref: HS325ES) and College of Medicine University of Lagos (Ref: HREC/15/04/2015). The project seeks to determine optimal mechanisms for the design and development of subsequent digital health interventions to support development, access to, and delivery of palliative cancer care in SSA. Dissemination of these findings will occur through newsletters and press releases, conference presentations, peer-reviewed journals and social media.Trial registration numberISRCTN15727711

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Patel, V., T. Musara, T. Butau, P. Maramba, and S. Fuyane. "Concepts of mental illness and medical pluralism in Harare." Psychological Medicine 25, no. 3 (May 1995): 485–93. http://dx.doi.org/10.1017/s0033291700033407.

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SYNOPSISThe Focus Group Discussions (FGD) described in this paper are the first step of a study aiming to develop an ‘emic’ case-finding instrument. In keeping with the realities of primary care in Zimbabwe, nine FGD were held with 76 care providers including 30 village community workers, 22 traditional and faith healers (collectively referred to as traditional healers in this paper), 15 relatives of patients and 9 community psychiatric nurses. In addition to the general facets of concepts of mental illness, three ‘etic’ case vignettes were also presented.A change in behaviour or ability to care for oneself emerged as the central definition of mental illness. Both the head and the heart were regarded as playing an important role in the mediation of emotions. The types of mental illness described were intimately related to beliefs about spiritual causation. Angered ancestral spirits, evil spirits and witchcraft were seen as potent causes of mental illness. Families not only bore the burden of caring for the patient and all financial expenses involved, but were also ostracized and isolated. Both biomedical and traditional healers could help mentally ill persons by resolving different issues relating to the same illness episode. All case vignettes were recognized by the care providers in their communities though many felt that the descriptions did not reflect ‘illnesses’ but social problems and that accordingly, the treatment for these was social, rather than medical.The data enabled us to develop screening criteria for mental illness to be used by traditional healers and primary care nurses in the next stage of the study in which patients selected by these care providers on the grounds of suspicion of suffering from mental illness will be interviewed to elicit their explanatory models of illness and phenomenology.

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Hakim, James Gita, Jonathan Arthur Matenga, Edward Havranek, and David Koa. "Health Workforce Development with a Focus on CVD in Zimbabwe: CHRIS Program, a Medical Education Partnership Initiative." Global Heart 6, no. 4 (December 1, 2011): 219. http://dx.doi.org/10.1016/j.gheart.2011.07.001.

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Patel, Vikram. "A view from the road: experiences in four continents." Psychiatric Bulletin 18, no. 8 (August 1994): 500–502. http://dx.doi.org/10.1192/pb.18.8.500.

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Since graduating from medical school eight years ago, I have had the chance of experiencing clinical psychiatry in four countries on four continents; Bombay and Goa, India, my home, where I trained in medicine and began my psychiatric training; Oxford and London, United Kingdom, where I acquired a taste for academic psychiatry and completed my clinical training; Sydney, Australia, where I worked in a liaison unit in a large general hospital and a community mental health centre; and now, Harare, Zimbabwe, where I am conducting a two year study on traditional concepts of mental illness and the role of traditional healers and other care providers in primary mental health care.

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Chingombe, Innocent, Munyaradzi P. Mapingure, Shirish Balachandra, Tendayi N. Chipango, Fiona Gambanga, Angela Mushavi, Tsitsi Apollo, et al. "Patient costs for prevention of mother-to-child HIV transmission and antiretroviral therapy services in public health facilities in Zimbabwe." PLOS ONE 16, no. 8 (August 18, 2021): e0256291. http://dx.doi.org/10.1371/journal.pone.0256291.

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Zimbabwe has made large strides in addressing HIV. To ensure a continued robust response, a clear understanding of costs associated with its HIV program is critical. We conducted a cross-sectional evaluation in 2017 to estimate the annual average patient cost for accessing Prevention of Mother-To-Child Transmission (PMTCT) services (through antenatal care) and Antiretroviral Treatment (ART) services in Zimbabwe. Twenty sites representing different types of public health facilities in Zimbabwe were included. Data on patient costs were collected through in-person interviews with 414 ART and 424 PMTCT adult patients and through telephone interviews with 38 ART and 47 PMTCT adult patients who had missed their last appointment. The mean and median annual patient costs were examined overall and by service type for all participants and for those who paid any cost. Potential patient costs related to time lost were calculated by multiplying the total time to access services (travel time, waiting time, and clinic visit duration) by potential earnings (US$75 per month assuming 8 hours per day and 5 days per week). Mean annual patient costs for accessing services for the participants was US$20.00 [standard deviation (SD) = US$80.42, median = US$6.00, range = US$0.00–US$12,18.00] for PMTCT and US$18.73 (SD = US$58.54, median = US$8.00, range = US$0.00–US$ 908.00) for ART patients. The mean annual direct medical costs for PMTCT and ART were US$9.78 (SD = US$78.58, median = US$0.00, range = US$0.00–US$ 90) and US$7.49 (SD = US$60.00, median = US$0.00) while mean annual direct non-medical cost for US$10.23 (SD = US$17.35, median = US$4.00) and US$11.23 (SD = US$25.22, median = US$6.00, range = US$0.00–US$ 360.00). The PMTCT and ART costs per visit based on time lost were US$3.53 (US$1.13 to US$8.69) and US$3.43 (US$1.14 to US$8.53), respectively. The mean annual patient costs per person for PMTCT and ART in this evaluation will impact household income since PMTCT and ART services in Zimbabwe are supposed to be free.

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Fitzpatrick, Megan B., Racheal S. Dube Mandishora, David A. Katzenstein, Kathy McCarty, Jenna Weber, Malaya K. Sahoo, Justen Manasa, Zvavahera Mike Chirenje, and Benjamin A. Pinsky. "hrHPV prevalence and type distribution in rural Zimbabwe: A community-based self-collection study using near-point-of-care GeneXpert HPV testing." International Journal of Infectious Diseases 82 (May 2019): 21–29. http://dx.doi.org/10.1016/j.ijid.2019.02.022.

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Dondo, Vongai, Hilda Mujuru, Kusum Nathoo, Vengai Jacha, Ottias Tapfumanei, Priscilla Chirisa, Portia Manangazira, et al. "Pneumococcal Conjugate Vaccine Impact on Meningitis and Pneumonia Among Children Aged <5 Years—Zimbabwe, 2010–2016." Clinical Infectious Diseases 69, Supplement_2 (September 5, 2019): S72—S80. http://dx.doi.org/10.1093/cid/ciz462.

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Abstract Background Streptococcus pneumoniae is a leading cause of pneumonia and meningitis in children aged <5 years. Zimbabwe introduced 13-valent pneumococcal conjugate vaccine (PCV13) in 2012 using a 3-dose infant schedule with no booster dose or catch-up campaign. We evaluated the impact of PCV13 on pediatric pneumonia and meningitis. Methods We examined annual changes in the proportion of hospitalizations due to pneumonia and meningitis among children aged <5 years at Harare Central Hospital (HCH) pre-PCV13 (January 2010–June 2012) and post-PCV13 (July 2013–December 2016) using a negative binomial regression model, adjusting for seasonality. We also evaluated post-PCV13 changes in serotype distribution among children with confirmed pneumococcal meningitis at HCH and acute respiratory infection (ARI) trends using Ministry of Health outpatient data. Results Pneumonia hospitalizations among children aged <5 years steadily declined pre-PCV13; no significant change in annual decline was observed post-PCV13. Post-PCV13 introduction, meningitis hospitalization decreased 30% annually (95% confidence interval [CI], –42, –14) among children aged 12–59 months, and no change was observed among children aged 0–11 months. Pneumococcal meningitis caused by PCV13 serotypes decreased from 100% in 2011 to 50% in 2016. Annual severe and moderate outpatient ARI decreased by 30% (95% CI, –33, –26) and 7% (95% CI, –11, –2), respectively, post-PCV13 introduction. Conclusions We observed declines in pediatric meningitis hospitalizations, PCV13-type pneumococcal meningitis, and severe and moderate ARI outpatient visits post-PCV13 introduction. Low specificity of discharge codes, changes in referral patterns, and improvements in human immunodeficiency virus care may have contributed to the lack of additional declines in pneumonia hospitalizations post-PCV13 introduction.

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Verhey, Ruth, Charmaine Chitiyo, Sandra Ngonidzashe Mboweni, Ephraim Chiriseri, Dixon Chibanda, Andy Healey, Bradley Wagenaar, and Ricardo Araya. "Optimising implementation strategies of the first scaleup of a primary care psychological intervention for common mental disorders in Sub-Saharan Africa: a mixed methods study protocol for the optimised Friendship Bench (OptFB)." BMJ Open 11, no. 9 (September 2021): e045481. http://dx.doi.org/10.1136/bmjopen-2020-045481.

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IntroductionCommon mental disorders (CMDs) are a leading cause of disability globally. CMDs are highly prevalent in Zimbabwe and have been addressed by an evidence-based, task-shifting psychological intervention called the Friendship Bench (FB). The task-shifted FB programme guides clients through problem-solving therapy. It was scaled up across 36 implementation sites in Zimbabwe in 2016.Methods and analysisThis study will employ a mixed-method framework. It aims to: (1) use quantitative survey methodologies organised around the Reach, Effectiveness, Adoption and Implementation and Maintenance evaluation framework to assess the current scaleup of the FB intervention and classify 36 clinics according to levels of performance; (2) use qualitative focus group discussions and semistructured interviews organised around the Consolidated Framework for Implementation Research to analyse determinants of implementation success, as well as elucidate heterogeneity in implementation strategies through comparing high-performing and low-performing clinics; and (3) use the results from aims 1 and 2 to develop strategies to optimise the Friendship Bench intervention and apply this model in a cluster randomised controlled trial to evaluate potential improvements among low-performing clinics. The trial will be registered with the Pan African Clinical Trial Registry (www.pactr.org). The planned randomised controlled trial for the third research aim will be registered after completing aims one and two because the intervention is dependent on knowledge generated during these phases.Ethics and disseminationThe research protocol received full authorisation from the Medical Research Council of Zimbabwe (MRCZ A/242). It is anticipated that changes in data collection tools and consent forms will take place at all three phases of the study and approval from MRCZ will be sought. All interview partners will be asked for informed consent. The research team will prioritise open-access publications to disseminate research results.

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Mudzviti, Tinashe, Marvelous Sibanda, Samuel Gavi, Charles Chiedza Maponga, and Gene D. Morse. "Implementing a pharmacovigilance program to evaluate cutaneous adverse drug reactions in an antiretroviral access program." Journal of Infection in Developing Countries 6, no. 11 (November 26, 2012): 806–8. http://dx.doi.org/10.3855/jidc.1908.

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Introduction: Cutaneous adverse drug reactions (cADRs) can cause significant morbidity and distress in patients, especially in the HIV-infected population on antiretroviral therapy. Adverse drug reaction monitoring and ascertaining causality in resource-limited settings remain serious challenges. This study was conducted to evaluate causality and measure the incidence of cADRs in HIV-infected patients on highly active antiretroviral therapy. The study was also designed to test a three-step approach in the monitoring and evaluation of ADRs in resource-limited settings. Methodology: A retrospective review of patient medical records was performed at the Parirenyatwa Family Care Centre, Harare, Zimbabwe. Cases of cADRs were reported to the Medicines Control Authority of Zimbabwe, the main drug regulating body in Zimbabwe, for assessment and causality classification. Results: We reviewed 221 randomly selected patient records to determine whether any diagnoses of cADRs were made by clinicians. Causality assessment revealed that 13.1% of cADRs were due to an offending agent in the antiretroviral therapy versus an initial incidence of 17.6% which had been determined by the physicians. Conclusions: cADRs had an incidence of 13.1% within the population under study due to non nucleoside reverse transcriptase inhibitors (NNRTIs). Most reactions were caused by the NNRTIs which contributed 72.4 % of all cADRs. A panel of experts from the drug regulatory authority can be used as an implementation based mechanism in ascertaining causality objectively in settings where resources are constrained.

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Adetunji, Oluwarantimi, Sushant Mukherjee, Emma Sacks, Andrea Ciaranello, Addmore Chadambuka, Haurovi Mafaune, Nicole McCann, and Jennifer Cohn. "Front-Line Human Resource Time-Use for Early Infant HIV Diagnosis: A Comparative Time-Motion Study at Centralized and Point-of-Care Health Facilities in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 84, no. 1 (July 1, 2020): S70—S77. http://dx.doi.org/10.1097/qai.0000000000002364.

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Madziyire, Mugove Gerald, Chelsea B. Polis, Taylor Riley, Elizabeth A. Sully, Onikepe Owolabi, and Tsungai Chipato. "Severity and management of postabortion complications among women in Zimbabwe, 2016: a cross-sectional study." BMJ Open 8, no. 2 (February 2018): e019658. http://dx.doi.org/10.1136/bmjopen-2017-019658.

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ObjectivesAbortion complications cause significant morbidity and mortality. We aimed to assess the severity and factors associated with abortion complications (induced or spontaneous), and the management of postabortion care (PAC) in Zimbabwe.DesignProspective, facility-based 28 day survey among women seeking PAC and their providers.Setting127 facilities in Zimbabwe with the capacity to provide PAC, including all central and provincial hospitals, and a sample of primary health centres (30%), district/general/mission hospitals (52%), private (77%) and non-governmental organisation (NGO) (68%) facilities.Participants1002 women presenting with abortion complications during the study period.Main outcome measuresSeverity of abortion complications and associated factors, delays in care seeking, and clinical management of complications.ResultsOverall, 59% of women had complications classified as mild, 19% as moderate, 19% as severe, 3% as near miss and 0.2% died. A median of 47 hours elapsed between experiencing complication and receiving treatment; many delays were due to a lack of finances. Women who were rural, younger, not in union, less educated, at later gestational ages or who had more children were significantly more likely to have higher severity complications. Most women were treated by doctors (91%). The main management procedure used was dilatation and curettage/dilatation and evacuation (75%), while 12% had manual vacuum aspiration (MVA) or electrical vacuum aspiration and 11% were managed with misoprostol. At discharge, providers reported that 43% of women received modern contraception.ConclusionZimbabwean women experience considerable abortion-related morbidity, particularly young, rural or less educated women. Abortion-related morbidity and concomitant mortality could be reduced in Zimbabwe by liberalising the abortion law, providing PAC in primary health centres, and training nurses to use medical evacuation with misoprostol and MVA. Regular in-service training on PAC guidelines with follow-up audits are needed to ensure compliance and availability of equipment, supplies and trained staff.

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Mukherjee, Sushant, Jennifer Cohn, Andrea L. Ciaranello, Emma Sacks, Oluwarantimi Adetunji, Addmore Chadambuka, Haurovi Mafaune, McMillan Makayi, Nicole McCann, and Esther Turunga. "Estimating the Cost of Point-of-Care Early Infant Diagnosis in a Program Setting: A Case Study Using Abbott m-PIMA and Cepheid GeneXpert IV in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 84, no. 1 (July 1, 2020): S63—S69. http://dx.doi.org/10.1097/qai.0000000000002371.

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Erlwanger, Alison S., Jessica Joseph, Tendai Gotora, Blandina Muzunze, Joanna Orne-Gliemann, Solomon Mukungunugwa, Tim Farley, and Alexio-Zambezi Mangwiro. "Patterns of HIV Care Clinic Attendance and Adherence to Antiretroviral Therapy Among Pregnant and Breastfeeding Women Living With HIV in the Context of Option B+ in Zimbabwe." JAIDS Journal of Acquired Immune Deficiency Syndromes 75 (June 2017): S198—S206. http://dx.doi.org/10.1097/qai.0000000000001347.

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Mbizvo, E. M., E. Msuya Sia, B. Stray-Pedersen, M. Z. Chirenje, M. Munjoma, and A. Hussain. "Association of herpes simplex virus type 2 with the human immunodeficiency virus among urban women in Zimbabwe." International Journal of STD & AIDS 13, no. 5 (May 1, 2002): 343–48. http://dx.doi.org/10.1258/0956462021925171.

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A cross-sectional study at two urban primary health care clinics in Zimbabwe was conducted among 393 consecutive women. The purpose was to determine the seroprevalence of herpes simplex virus type 2 (HSV-2), to identify coinfections and to determine the association between HSV-2, HIV and other sexually transmitted infections (STIs). Sera were tested for HSV-2, HIV and syphilis. Genital specimens were tested for the other STIs. The seroprevalence of ulcerative STIs tested was 42.2% for HSV-2 and 3.9% for syphilis. HSV-2 seropositive women had twice the risk of being HIV infected compared to HSV-2 seronegative women, adjusted OR=2.05 (95% CI=1.29-3.23). HSV-2 seropositivity was also associated with older age, a lower level of education, increase in the number of lifetime sexual partners and history of genital ulcers in the past six or more months. Our data suggest that in this population HSV-2 may contribute more to HIV infection than syphilis because of its high frequency. There is an urgent need for development of an effective HSV-2 vaccine.

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Mbizvo, E. M., S. E. Msuya, B. Stray-Pedersen, M. Z. Chirenje, and A. Hussain. "Cervical dyskaryosis among women with and without HIV: prevalence and risk factors." International Journal of STD & AIDS 16, no. 12 (December 1, 2005): 789–93. http://dx.doi.org/10.1258/095646205774988046.

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Women in developing countries often present for medical care with advanced cervical cancer, although this condition is preventable through regular screening and early treatment. This study sought to identify the prevalence and risk factors for cervical dyskaryosis among women in Zimbabwe with and without HIV. In a cross-sectional study, 200 consenting women were screened for cervical dyskaryosis and sexually transmitted infections (STI). The relationship between various risk factors for cervical dyskaryosis was examined. The overall prevalence of cervical dyskaryosis was high (19%), and significantly higher among HIV-infected women at 30% compared with 13% among seronegative women, with a peak at a younger age among seropositive women. Use of intravaginal herbs, practising intravaginal cleansing, being single, a history of three or more lifetime sexual partners and a history of previous STI were associated with cervical dysplasia. The high frequency of cervical abnormality lends weight to the demand for implementation of regular screening programmes and health education.

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Mushambi, Fadzai, Collins Timire, Anthony D. Harries, Hannock Tweya, Tafadzwa Priscilla Goverwa-Sibanda, Stanley Mungofa, and Tsitsi Apollo. "High post-exposure prophylaxis uptake but low completion rates and HIV testing follow-up in health workers, Harare, Zimbabwe." Journal of Infection in Developing Countries 15, no. 04 (April 30, 2021): 559–65. http://dx.doi.org/10.3855/jidc.12214.

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Introduction: Health care workers (HCWs), especially from sub-Saharan Africa, are at risk of occupational exposure to HIV. Post exposure prophylaxis (PEP) can reduce this risk. There is no published information from Zimbabwe, a high HIV burden country, about how PEP works. We therefore assessed how the PEP programme performed at the Parirenyatwa Hospital, Harare, Zimbabwe, from 2017-2018. Methodology: This was a cohort study using secondary data from the staff clinic paper-based register. The chi square test and relative risks were used to assess associations. Results: There were 154 HCWs who experienced occupational injuries. The commonest group was medical doctors (36%) and needle sticks were the most frequent type of occupational injury (74%). The exposure source was identified in 114 (74%) occupational injuries: 91% of source patients were HIV-tested and 77% were HIV-positive. All but two HCWs were HIV-tested, 148 were eligible for PEP and 142 (96%) started triple therapy, all within 48 hours of exposure. Of those starting PEP, 15 (11%) completed 28 days, 13 (9%) completed < 28 days and in the remainder PEP duration was not recorded. There were no HCW characteristics associated with not completing PEP. Of those starting PEP, 9 (6%) were HIV-tested at 6-weeks, 3 (2%) were HIV-tested at 3-months and 1 (< 1%) was HIV-tested at 6-months: all HIV-tests were negative. Conclusions: While uptake of PEP was timely and high, the majority of HCWs failed to complete the 28-day treatment course and even fewer attended for follow-up HIV-tests. Various changes are recommended to promote awareness of PEP and improve adherence to guidelines.

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Journal articles on the topic 'Bulawayo (Zimbabwe) – Medical care'

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