Central African Journal of Medicine https://www.ajol.info/index.php/cajm <p>The <em>Central African Journal of Medicine</em> is a quarterly refereed general medical journal which seeks to promote the practice and science of medicine in Africa. Emphasis is placed on general medical topics, reflecting common and important conditions in the region. The journal also covers related medical fields. Submissions are encouraged in the form of research articles, reviews, case reports and letters.</p> Central African Journal Of Medicine en-US Central African Journal of Medicine 0008-9176 Copyright for articles published in this journal is retained by the journal. Plasma Cystatin C based renal function assessment among adolescent and young adults failing antiretroviral treatment (ART) on a tenofovir based-ART in Harare, Zimbabwe https://www.ajol.info/index.php/cajm/article/view/224868 <div class="page" title="Page 1"> <div class="layoutArea"> <div class="column"> <div class="page" title="Page 1"> <div class="layoutArea"> <div class="column"> <p><strong><em>Objective</em></strong><strong>: </strong><span style="font-weight: 400;">To assess renal function using plasma CystatinC (CysC) among adolescent and young adult&nbsp; PLWH failing a </span><span style="font-weight: 400;">Tenofovir Disoproxil Fumarate </span><span style="font-weight: 400;">(TDF)</span><span style="font-weight: 400;">-</span><span style="font-weight: 400;">containing Antiretroviral Therapy (ART) regimen with&nbsp; no clinical signs of kidney disease.&nbsp;</span></p> <p><strong><em>Design</em></strong><strong>: </strong><span style="font-weight: 400;">Retrospective cohort laboratory analysis.&nbsp;</span><span style="font-weight: 400;"><br></span></p> <p><strong><em>Participants</em></strong><strong>: </strong><span style="font-weight: 400;">Adolescents and young adults aged 10-24 years with VL&gt;400 copies/ml enrolled in an </span><span style="font-weight: 400;">adherence intervention cohort.&nbsp;</span><span style="font-weight: 400;"><br></span></p> <p><strong><em>Setting</em></strong><strong>: </strong><span style="font-weight: 400;">Parirenyatwa Hospital Family Care Centre &amp; Harare City Health Clinics. </span></p> <p><strong><em>Materials and Methods</em></strong><strong>: </strong><span style="font-weight: 400;">The Human Cystatin-C Test CYSC2, (test ID 0</span><span style="font-weight: 400;">‑ </span><span style="font-weight: 400;">139) kit was used for the&nbsp; immunoturbidimetric quantification of CysC in human plasma on the COBAS INTEGRA400 system. </span></p> <p><strong><em>Main Outcome Measures</em></strong><strong>: </strong><span style="font-weight: 400;">Renal function status at week 36.Mild impaired renal function was defined by </span><span style="font-weight: 400;">2 2&nbsp;</span><span style="font-weight: 400;">eGFR&lt;90mL/min/1.73 m with moderate to severe renal dysfunction defined by eGFR&lt;60mL/min/1.73 m .&nbsp; </span></p> <p><strong><em>Results</em></strong><strong>: </strong><span style="font-weight: 400;">We enrolled 139 participants; 86% completed follow-up of 36 weeks. Mean or Standard Deviation&nbsp; (SD) age was 18.38 (2.99) years. Median duration on TDF-containing ART was 3.03 years (IQR 1.47</span><span style="font-weight: 400;">-</span><span style="font-weight: 400;">4.73).&nbsp; Median or I</span><span style="font-weight: 400;">nterquartile Range </span><span style="font-weight: 400;">(IQR) plasma CysC concentration was 0.78 (0.71-0.87) mg/L. There was no&nbsp; significant correlation between plasma CysC with age (r=0.0785), weight (r=-0.1181), height (r=0.0310) and&nbsp; </span><span style="font-weight: 400;">2 </span><span style="font-weight: 400;">BMI (r=-0.0977). About 67% had impaired renal function (eGFR&lt;90 mL/min/1.73 m ) at endpoint, a&nbsp; significant increase from 51% at enrolment (p=&lt;0.0001).&nbsp;&nbsp;</span></p> <p><strong><em>Conclusions</em></strong><strong>: </strong><span style="font-weight: 400;">There is a high burden of impaired renal function in adolescent and young adult patients on&nbsp; tenofovir containing ART in Harare Zimbabwe with asymptomatic renal disease. The decline in renal&nbsp; function over 36 weeks reported in this cohort was significant and concerning. Enhanced renal monitoring is&nbsp; recommended for these patients. CysC is a reliable marker of renal function independent of age and </span><span style="font-weight: 400;">anthropometric measurements.&nbsp;</span></p> </div> </div> </div> </div> </div> </div> T. J. Mtisi V. Kouamou R. Mashingaidze-Mano G. D. Morse C. E. Ndhlovu Copyright (c) 67 1-6 1 7 The blood group as determinant of endurance in running a comparison between sedentary blood group O and non-blood group O individuals https://www.ajol.info/index.php/cajm/article/view/224949 <p><em><strong>Background</strong></em>: Beyond their traditional relevance (blood transfusion and organ transplants), recent data has shown that blood groups have a role to play in endurance during physical activity.<br><em><strong>Objective</strong></em>: To determine the influences of blood groups and muscle fibre types on endurance.<br><em><strong>Design</strong></em>: An experimental design, specifically an ex post facto design with a cohort of healthy male participants.<br><em><strong>Setting</strong></em>: The research was community based.<br><em><strong>Subjects</strong></em>: Avolunteer sample of 50 male participants from the Faculty of Medicine and Health Sciences was studied. Participants were between the ages of 20-25 years with a physical activity level of less than 4000 MET/minutes/week.Participants with a history of cardiovascular diseases, respiratory diseases and/or were taking any pharmaceutical drug were excluded.<br><em><strong>Main Outcome Measures</strong></em>: An association between blood group, muscle fibre type and endurance during exercise in sedentary individuals.<br><em><strong>Results</strong></em>: Mean age was 21.1±1.1 years. The mean height and weight were 173.88±5.80cm and 67.09±8.63kg respectively. Blood group O participants covered significantly more distance 2.45±1.03 km compared to 1.86±0.52 km covered by non-O blood group participants (*p=0.016) and spent more time on the treadmill 22.30±5.75 minutes compared to 18.03±4.01 minutes covered by the Non-O individuals (*p=0.004). There was a statistically significant association between muscle fibre composition and blood group category (*p=0.002). Most blood O participants (73%) had dominant type I muscle fibres.<br><em><strong>Conclusion</strong></em>: There is an association between the blood group and endurance. Sedentary blood group O individuals have better endurance compared to sedentary Non-O individuals. Participants with dominant type I muscles have better endurance. Agreater proportion of blood group O participants had dominant type I muscle fibres.</p> <p>&nbsp;</p> N. E. Mangwayana C. Mahachi T. Taderera V. Chikwasha Copyright (c) 67 1-6 8 13 Anxiety disorders among pre-clinical students during the COVID-19 pandemic in the Copperbelt province of Zambia https://www.ajol.info/index.php/cajm/article/view/224950 <p><em><strong>Background</strong></em>: Anxiety is one of the commonest mental health challenges facing medical students. Levels of anxiety have not been estimated among medical students in Zambia.<br><em><strong>Objectives</strong></em>: To estimate the prevalence of anxiety disorders and its associated factors among pre-clinical students during the COVID-19 pandemic in the Copperbelt province of Zambia.<br><em><strong>Materials and Methods</strong></em>: A sample size of 398 students was sampled using a 1 in 2 systematic random sampling technique. The Zung's Self-rating Anxiety Scale (SAS) was used to determine levels of anxiety. Adjusted Odds Ratios (AOR) and their 95% Confidence Interval (CI) are reported.<br><em><strong>Results</strong></em>: Altogether, 18.9% of the students rated their health poor-fair. Students who rated their health good/excellent were 51% (AOR=0.49; 95% CI [0.36, 0.66]) less likely to report anxiety disorders compared to students who reported their health as poor/fair. Students who indicated that they had chronic lung disease were 49% (AOR=1.49; 95% CI [1.10, 2.02]) more likely to report anxiety disorders compared to students who did not report chronic lung disease.<br><em><strong>Conclusion</strong></em>: Arelatively high level of anxiety disorders was observed among pre-clinical students. Chronic lung diseases and self-rated health should be considered in designing intervention to curtail anxiety in the pre-clinical student population.</p> J. Chirenda L. M. Mazaba M. Madhombiro S. Siziya Copyright (c) 67 1-6 14 18 SARS-CoV-2 infection in medical trainees after bedside exposure at a teaching hospital in Zimbabwe: case report https://www.ajol.info/index.php/cajm/article/view/224951 <p>Corona Virus Disease 2019 (COVID-19) is predominantly a pneumonic illness caused by a novel coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It has rapidly become a pandemic and has affected all facets of life with medical education not spared as well. We are presenting a case of a patient admitted with a pneumonia which turned out to be due to SARS-CoV-2 infection and subsequent transmission to exposed medical trainees. The impact of COVID-19 disease on medical education and different proposals on how medical education can proceed in the face of COVID-19 pandemic are discussed.</p> N. Mukapa M. T. Munemo M. Chiwanza L. Katsidzira R. Makunike-Mutasa Copyright (c) 67 1-6 19 23 Developing a post-graduate curriculum in forensic psychiatry in Zimbabwe https://www.ajol.info/index.php/cajm/article/view/224953 <p>No abstract.</p> W. Mangezi C. Mawoyo C. Shonai E. Aagaard Copyright (c) 67 1-6 24 27