The epidemiology and prehospital care of motorcycle crashes in a sub-Saharan African urban center.

Objective: Road traffic crashes (RTCs) are common among motorcyclists in Kigali, Rwanda. The Service d'Aide Medicale Urgente (SAMU), a prehospital ambulance service, responds to many of these crashes. We aimed to describe motorcycle-related RTCs managed by SAMU.

Challenges in the Recognition and Management of Acute Kidney Injury by Hospitals in Resource-Limited Settings.

Introduction: Acute kidney injury (AKI) is prevalent in low- and middle-income countries (LMIC) and is associated with significant morbidity and mortality, particularly among hospitalized patients. Successful strategies for the prevention and management of AKI in these countries are dependent on the capacity of primary care centers to provide optimal initial management of patients at risk for this disorder.

Methods: From December 2018 to February 2019, using mixed methods, we assessed hospital capacity and the knowledge of clinicians relevant to the prevention, diagnosis, and management of AKI in Rwanda.

The science of art: Leonardo Da Vinci and facial plastic surgery.

Purpose Of Review: Leonardo Da Vinci possessed one of humanity's greatest minds, known for exploring the boundaries of art and science. The discipline of facial plastic surgery also relies on art and science for its advancement. This review focuses on key elements of Leonardo Da Vinci's work, and how they relate to concepts within facial plastic surgery.

Medical student satisfaction and confidence in simulation-based learning in Rwanda - Pre and post-simulation survey research.

Introduction: Simulation-based learning (SBL) has been shown to effectively improve medical knowledge, procedural proficiency, comfort with undertaking taught tasks, inter-professional communication, teamwork and teaching skills. This study aimed to evaluate Rwandan medical students' attitudes, satisfaction and confidence level with SBL.

Methods: Fifth year medical students at the University of Rwanda were given a short course on paediatric acute care using simulation.

The Initial Prehospital Management of Traumatic Brain Injuries in Kigali, Rwanda.

Introduction: Traumatic brain injuries (TBIs) are an important cause of mortality and disability around the world. Early intervention and stabilization are necessary to obtain optimal outcomes, yet little is written on the topic in low- and middle-income countries (LMICs). The aim is to provide a descriptive analysis of patients with TBI treated by Service d'Aide Medicale Urgente (SAMU), the prehospital ambulance service in Kigali, Rwanda.

Community- and Hospital-Acquired Infections in Surgical patients at a Tertiary Referral Hospital in Rwanda.

Background: Extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) are increasing in globally. The aim of this study was to compare community-acquired infections (CAIs) and hospital-acquired infections (HAIs) and determine the rate of third-generation cephalosporin resistance and ESBL-PE at a tertiary referral hospital in Rwanda.

Methods: This was a cross-sectional study of Rwandan acute care surgery patients with infection.

The INVICTUS rheumatic heart disease research program: Rationale, design and baseline characteristics of a randomized trial of rivaroxaban compared to vitamin K antagonists in rheumatic valvular disease and atrial fibrillation.

Background: Rheumatic heart disease (RHD) is a neglected disease affecting 33 million people, mainly in low and middle income countries. Yet very few large trials or registries have been conducted in this population. The INVICTUS program of research in RHD consists of a randomized-controlled trial (RCT) of 4500 patients comparing rivaroxaban with vitamin K antagonists (VKA) in patients with RHD and atrial fibrillation (AF), a registry of 17,000 patients to document the contemporary clinical course of patients with RHD, including a focused sub-study on pregnant women with RHD within the registry.

Parents as carers on a neonatal unit: Qualitative study of parental and staff perceptions in a low-income setting.

Unlabelled: Aim To determine parents' experiences on a neonatal unit in a low-income country, how they and staff perceive the role of parents and if parents' role as primary carers could be extended.

Background: A busy, rural district hospital in Rwanda. Rwandan neonatal mortality is falling, but achieving Sustainable Development Goal target is hampered by trained staff shortage.

Proboscis Lateralis: A Unique Window into Nasal Embryology.

Proboscis lateralis is a rare congenital nasal deformity often associated with other nasal or ocular deformities. This anomaly offers a unique window into nasal embryology.

Integration of Chronic Oncology Services in Noncommunicable Disease Clinic in Rural Rwanda.

Background: In rural sub-Saharan Africa, access to care for severe non-communicable diseases (NCDs) is limited due to myriad delivery challenges. We describe the implementation, patient characteristics, and retention rate of an integrated NCD clinic inclusive of cancer services at a district hospital in rural Rwanda.

Methods: In 2006, the Rwandan Ministry of Health at Rwinkwavu District Hospital (RDH) and Partners In Health established an integrated NCD clinic focused on nurse-led care of severe NCDs, within a single delivery platform.

The burden of unintentional drowning: global, regional and national estimates of mortality from the Global Burden of Disease 2017 Study.

Background: Drowning is a leading cause of injury-related mortality globally. Unintentional drowning (International Classification of Diseases (ICD) 10 codes W65-74 and ICD9 E910) is one of the 30 mutually exclusive and collectively exhaustive causes of injury-related mortality in the Global Burden of Disease (GBD) study. This study's objective is to describe unintentional drowning using GBD estimates from 1990 to 2017.

Barriers to Surgical Care at a Tertiary Hospital in Kigali, Rwanda.

Background: The disproportionate distribution of surgical resources across the globe has left many in low- and middle-income countries without proper care. Patients often have complex surgical problems that are worsened by delayed presentation. We aim to describe barriers to surgical care at a tertiary hospital in Kigali, Rwanda.

Prehospital epidemiology and management of injured children in Kigali, Rwanda.

Introduction: Paediatric injuries are a major cause of mortality and disability worldwide, yet little information exists regarding its epidemiology or prehospital management in low-income and middle-income countries. We aimed to describe the paediatric injuries seen and managed by the prehospital ambulance service, Service d'Aide Medicale d'Urgence (SAMU), in Kigali, Rwanda over more than 3 years.

Methods: A retrospective, descriptive analysis was conducted of all injured children managed by SAMU in the prehospital setting between December 2012 and April 2016.

Using the World Society of Emergency Surgery (WSES) Triage Tool to Evaluate Timing of Emergency Surgery in Rwanda.

Background: Access to timely and safe emergency general surgery remains a challenge in sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study has the following objectives: (1) to compare the actual time to surgery (aTTS) to the ideal time to surgery among patients undergoing emergency surgery and (2) to explore the use of home to emergency department time (HET) as a new measurement indicator for time from symptoms onset to admission at ED at a referral hospital.

Methods: We performed a retrospective review of emergency general surgery cases performed at the Centre Hospitalier Universitaire de Kigali in Rwanda between June 1 and November 31, 2016.

From Preparedness to Recovery: Learning Lessons Of COVID-19 Outbreak from China.

At the end of December 2019, the Chinese public health authorities reported several cases of acute respiratory syndrome in Wuhan City, Hubei province, China. Chinese scientists soon identified a novel coronavirus as the main causative agent. The disease is now referred to as coronavirus disease 2019 (COVID-19), and the causative virus is called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

Applying the Exploration Preparation Implementation Sustainment (EPIS) Framework to the Kigali Imbereheza Project for Rwandan Adolescents Living With HIV.

Background: Sub-Saharan African adolescents living with HIV face challenges to antiretroviral therapy (ART) adherence. Poor mental health drives nonadherence but can be improved with cognitive behavioral therapy (CBT). CBT delivered by peers may strengthen effects while building capacity for sustainment in low-income countries.

Implementing the liberalized abortion law in Kigali, Rwanda: Ambiguities of rights and responsibilities among health care providers.

Objective: Rwanda amended its abortions law in 2012 to allow for induced abortion under certain circumstances. We explore how Rwandan health care providers (HCP) understand the law and implement it in their clinical practice.

Design: Fifty-two HCPs involved in post-abortion care in Kigali were interviewed by qualitative individual in-depth interviews (n =32) and in focus group discussions (n =5) in year 2013, 2014, and 2016.

Validation of a wearable biosensor device for vital sign monitoring in septic emergency department patients in Rwanda.

Objective: Critical care capabilities needed for the management of septic patients, such as continuous vital sign monitoring, are largely unavailable in most emergency departments (EDs) in low- and middle-income country (LMIC) settings. This study aimed to assess the feasibility and accuracy of using a wireless wearable biosensor device for continuous vital sign monitoring in ED patients with suspected sepsis in an LMIC setting.

Methods: This was a prospective observational study of pediatric (≥2 mon) and adult patients with suspected sepsis at the Kigali University Teaching Hospital ED.

Improving Tracheostomy Care in Resource-Limited Settings.

Objectives: Tracheostomy care in leading pediatric hospitals is both multidisciplinary and comprehensive, including generalized care protocols and thorough family training programs. This level of care is more difficult in resource-limited settings lacking developed healthcare infrastructure and tracheostomy education among nursing and resident staff. The objective of this study was to improve pediatric tracheostomy care in resource-limited settings.