Incompleteness and Misclassification of Maternal Deaths in Zimbabwe: Data from Two Reproductive Age Mortality Surveys, 2007-2008 and 2018-2019.

Introduction: We implemented two cross-sectional reproductive age mortality surveys in 2007-2008 and 2018-2019 to assess changes in the MMR and causes of death in Zimbabwe. We collected data from health institutions, civil registration and vital statistics, the community, and surveillance. This paper analyses missingness and misclassification of deaths in the two surveys.

'ARVs are a constant reminder of lost freedom, whereas for others, they are liberating': understanding the treatment narrative among people living with HIV (PLHIV) in Malawi and Zimbabwe-a qualitative study.

Objective: The aim of the research was to understand what drives and motivates young women living with HIV in their treatment journeys, as well as their key influencers. The findings will assist in appreciating their obstacles to treatment and constructing the most effective ways to convey fresh messages to them. These insights will contribute to the messaging developed for a campaign across sub-Saharan Africa, primarily Malawi and Zimbabwe.

Integrating 3HP-based tuberculosis preventive treatment into Zimbabwe's Fast Track HIV treatment model: experiences from a pilot study.

Introduction: Tuberculosis (TB) causes one-third of HIV-related deaths worldwide, making TB preventive treatment (TPT) a critical element of HIV programmes. Approximately 16% of people living with HIV (PLHIV) on antiretrovirals in Zimbabwe are enrolled in the Fast Track (FT) differentiated service delivery model, which includes multi-month dispensing of antiretrovirals and quarterly health facility (HF) visits. We assessed the feasibility and acceptability of utilizing FT to deliver 3HP (3 months of once-weekly rifapentine and isoniazid) for TPT by aligning TPT and HIV visits, providing multi-month dispensing of 3HP, and using phone-based monitoring and adherence support.

Effect of anesthesia administration method on apgar scores of infants born to women undergoing elective cesarean section.

Background: Neonatal health at delivery as measured by apgar scores is an important outcome. This study was done to assess the impact of anesthesia on Apgar 1-minute and 5-minute scores of infants delivered through elective cesarean section in Zimbabwe.

Methods: We carried out a secondary analysis of data from the Efficacy of Tranexamic Acid in Preventing Postpartum Hemorrhage (ETAPPH) clinical trial in Zimbabwe.

Accessibility and utilization of antenatal care services in sub-Saharan Africa during the COVID-19 pandemic: A rapid review.

Control measures for the COVID-19 pandemic brought unprecedented challenges to health care delivery. Some countries in sub-Saharan Africa (SSA) stopped the provision of essential health care except for those services that were deemed emergencies or life-threatening. A rapid review was conducted on March 18, 2022, on the accessibility and utilization of antenatal care services in sub-Saharan Africa during the COVID-19 pandemic.

Maternal, Sexual and Reproductive Health in Marginalised Areas: Renewing Community Involvement Strategies beyond the Worst of the COVID-19 Pandemic.

The COVID-19 pandemic and resultant lockdowns have brought unprecedented challenges for Maternal, Sexual and Reproductive Health (MSRH) services. Components of MSRH services adversely affected include antenatal, postnatal, and newborn care; provision of family planning and post-abortion care services; sexual and gender-based violence care and prevention; and care and treatment for sexually transmitted infections including HIV. Resuscitating, remodeling or inventing interventions to restore or maintain these essential services at the community level, as a gateway to higher care, is critical to mitigating short and long-term effects of the COVID-19 pandemic on essential MSRH.

Acceptability of Community-Based Tuberculosis Preventive Treatment for People Living with HIV in Zimbabwe.

As Zimbabwe expands tuberculosis preventive treatment (TPT) for people living with HIV (PLHIV), the Ministry of Health and Child Care is considering making TPT more accessible to PLHIV via less-intensive differentiated service delivery models such as Community ART Refill Groups (CARGs). We designed a study to assess the feasibility and acceptability of integrating TPT into CARGs among key stakeholders, including CARG members, in Zimbabwe. We conducted 45 key informant interviews (KII) with policy makers, implementers, and CARG leaders; 16 focus group discussions (FGD) with 136 PLHIV in CARGs; and structured observations of 8 CARG meetings.

Optimizing Differentiated HIV Treatment Models in Urban Zimbabwe: Assessing Patient Preferences Using a Discrete Choice Experiment.

Differentiated service delivery holds great promise for streamlining the delivery of health services for HIV. This study used a discrete choice experiment to assess preferences for differentiated HIV treatment delivery model characteristics among 500 virally suppressed adults on antiretroviral therapy in Harare, Zimbabwe. Treatment model characteristics included location, consultation type, healthcare worker cadre, operation times, visit frequency and duration, and cost.

Optimizing differentiated treatment models for people living with HIV in urban Zimbabwe: Findings from a mixed methods study.

Introduction: Zimbabwe is scaling up HIV differentiated service delivery (DSD) to improve treatment outcomes and health system efficiencies. Shifting stable patients into less-intensive DSD models is a high priority in order to accommodate the large numbers of newly-diagnosed people living with HIV (PLHIV) needing treatment and to provide healthcare workers with the time and space needed to treat people with advanced HIV disease. DSD is also seen as a way to improve service quality and enhance retention in care.

Engaging men in HIV programmes: a qualitative study of male engagement in community-based antiretroviral refill groups in Zimbabwe.

Introduction: Suboptimal male engagement in HIV programmes is a persistent challenge, leading to lower coverage of HIV testing, prevention and treatment services, and to worse outcomes for men. Differentiated service delivery models, such as peer-led community antiretroviral refill groups (CARGs), offer the opportunity to enhance patient satisfaction, retention and treatment outcomes. We conducted an exploratory qualitative study to identify facilitators and barriers to CARG participation by HIV-positive men, with inputs from recipients of HIV care, community members, healthcare workers (HCWs), donors and policymakers.

The rollout of Community ART Refill Groups in Zimbabwe: a qualitative evaluation.

Introduction: Community ART Refill Groups (CARGs) are an antiretroviral therapy (ART) delivery model where clients voluntarily form into groups, and a group member visits the clinic to collect ART for all group members. In late 2016, Zimbabwe began a nationwide rollout of the CARG model. We conducted a qualitative evaluation to assess the perceived effects of this new national service delivery model.

Giant mucinous cystadenoma: a case report.

Introduction: Giant ovarian cysts are rarely described in the literature, owing to the availability of advanced imaging technologies in developed countries leading to early treatment. In resource-limited settings, various factors lead to late presentation.

Case Presentation: We present a case of a 48-year-old black African woman with a giant mucinous cystadenoma who presented to a tertiary hospital with massive abdominal distention 5 years after being referred from a district hospital for the same problem.

A pilot study to assess the immunologic and virologic efficacy of generic nevirapine, zidovudine and lamivudine in the treatment of HIV-1 infected women with pre-exposure to single dose nevirapine or short course zidovudine and their spouses in Chitungwiza, Zimbabwe.

Objective: A pilot study to assess effectiveness of generic Nevirapine (NVP)+Zidovudine (AZT)+Lamivudine (3TC) as potent antiretroviral therapy (ART) in women exposed to either SD NVP or short course (SC) AZT through participation in prevention of mother-to-child transmission of HIV-1 (pMTCT) interventions, and their spouses.

Design: A pilot study of antiretroviral treatment of adults with AIDS.

Setting: Primary health care clinics; Seke North and St Mary's in Chitungwiza, Zimbabwe.

Chronic lymphocytic leukaemia (CLL) in Central Africans.

Objective: To document the clinical and haematological features of chronic lymphocytic leukaemia (CLL) in Central Africans.

Design: Prospective descriptive analysis.

Setting: Tertiary referral teaching hospitals.

T lymphocytes among HIV-infected and -uninfected infants: CD4/CD8 ratio as a potential tool in diagnosis of infection in infants under the age of 2 years.

BACKGROUND: Serologic tests for HIV infection in infants less than 18 months do not differentiate exposure and infection since maternally acquired IgG antibodies may be detected in infants. Thus, the gold standard for diagnosis of HIV-1 infection in infants under the age of 2 years is DNA or reverse transcriptase polymerase chain reaction. There is an urgent need to evaluate alternative and cost effective laboratory methods for early diagnosis of infant HIV-1 infection as well as identifying infected infants who may benefit from cotrimoxazole prophylaxis and/or initiation of highly active antiretroviral therapy.

Racial difference between white and black Zimbabweans in the haemolytic activity of A, B, O antibodies.

Race is thought to be one of the factors determining the level of ABO antibodies. The objective of this study was to compare the haemolytic activity of anti-A and anti-B in two racial groups, Black and White Zimbabweans, living under similar conditions. Serum haemolytic activity was assessed by comparing spectrophotometrically, released haemoglobin when known A1 and B red cells were incubated in equal volumes of subjects' serum and water.

Pancytopenia in Zimbabwe.

Background: There has been little systematic study of the clinical spectrum of pancytopenia, and the optimal diagnostic approach to pancytopenia remains undefined.

Methods: The authors studied 134 hospitalized pancytopenic patients in Zimbabwe in both consecutive and nonconsecutive fashion.

Results: The most common cause of pancytopenia was megaloblastic anemia, followed by aplastic anemia, acute leukemia, acquired immunodeficiency syndrome (AIDS), and hypersplenism.

Vitamin B12 deficiency is the primary cause of megaloblastic anaemia in Zimbabwe.

In a study of the pathogenesis and clinical features of megaloblastic anaemia in southern Africa, we evaluated 144 consecutive Zimbabwean patients with megaloblastic haemopoiesis. Vitamin B12 deficiency was diagnosed in 86.1% of patients and was usually due to pernicious anaemia; isolated folate deficiency accounted for only 5.

Frequency of the sickle haemoglobin gene in Zimbabwe.

The sickle haemoglobin gene (Bs gene) frequency in Zimbabwe was determined by haemoglobin electrophoresis of cord blood samples in a discontinuous alkaline buffer system on cellulose acetate strips. Samples were collected from different regions of the country including malaria-endemic and malaria-free areas and, predominantly Shona and Ndebele speaking areas respectively. 868 samples were analysed and the Bs gene frequency at birth was found to be 0.

Characteristics of anti-A and anti-B in black Zimbabweans.

Sera from young, black, group 0 Zimbabwean blood donors were screened for anti-A and anti-B haemolysins. Nearly one fifth of the sera were found to be strongly haemolytic for either A or B cells or both. Some of the sera were titrated for agglutination in saline before and after treatment with dithiothreitol.

Megaloblastic anaemia in Zimbabwe: spectrum of clinical and haematological manifestations.

An analysis of 100 cases (43 males and 57 females) with confirmed megaloblastic anaemia is presented. The age distribution showed two peaks with 18% in the third and fourth decades and 25% in the seventh decade. Anaemia of moderate to severe degree occurred in all patients and accounted for the commonest triad of symptoms at presentation viz: weakness (73%); breathlessness (40%) and headaches (33%).

Megaloblastic anaemia in Zimbabwe: the pernicious anaemias.

This study of 16 patients with pernicious anaemia (PA) (9 males and 7 females); serves as further evidence that the disease is not as infrequent in Africans as the literature stressing its rarity in the past appears to have suggested. The age-old preconceptions about racial incidence; age of onset; and absence of adequate laboratory facilities particularly in the African setting have hitherto greatly contributed to under-diagnosis of this disorder in Africans.