IntroductionInjury rate among mining workers in Zimbabwe was 789/1000 workers in 2008. The proportion of severe occupational injuries increased from 18% in 2008 to 37% in 2009. We investigated factors associated with severe injuries at the mine.MethodsAn unmatched 1:1 case-control study was carried out at the mine, a case was any worker who suffered severe occupational injury at the mine and was treated at the mine or district hospital from January 2008 to April 2010, a control was any worker who did not suffer occupational injury during same period. We randomly selected 156 cases and 156 controls and used interviewer administered questionnaires to collect data from participants.ResultsMajority of cases, 155(99.4%) and of controls 142(91%) were male, 127(81.4%) of cases and 48(30.8%) of controls worked underground. Majority (73.1%) of severe occupational injuries occurred during night shift. Underground temperatures reached 500C. Factors independently associated with getting severe occupational injuries included working underground (AOR = 10.55; CI 5.97-18.65), having targets per shift (AOR = 12.60; CI 3.46-45.84), inadequate PPE (AOR= 3.65 CI 1.34-9.89) and working more than 8 hours per shift (AOR = 8.65 CI 2.99-25.02).ConclusionHaving targets exerts pressure to perform on workers. Prolonged working periods decrease workers’ attention and concentration resulting in increased risk to severe injuries as workers become exhausted, lose focus and alertness. Underground work environment had environmental hazards so managers to install adequate ventilation and provide adequate PPE. Management agreed to standardize shifts to eight hours and workers in some departments have been supplied with adequate PPE.
Background In Zimbabwe, repair of obstetric fistula was established as a public health intervention in 2015. The aim of this study was to assess the quality life of obstetric fistula survivors before and after surgical repair of the fistula. Methods A longitudinal, before and after cohort study was conducted using the WHOQOL-BREF tool to assess quality of life before and after surgical treatment of obstetric fistula. The tool assess general health, experience of life in general, physical health, psychological health, social and environmental health. Data were analyzed using SPSS version 16.0 for descriptive measures and significance. Results Of the 29 women who came for obstetric fistula repair at the center in November and December 2019, 26 were enrolled into the study. All participants had transvaginal fistula repair and 24 had successful repair i.e. the fistulas were closed. Two of them still had stress incontinence by the time of data collection. The post treatment mean scores, using the WHOQOL assessment tool, on physical, psychological, social, environmental and general health significantly improved from the pretreatment mean scores. There was no significant change in some facets of the quality of life domains such as financial resources, opportunities for participation in leisure activities and dependence on medicines. Conclusions This study concluded that surgical treatment of obstetric fistula improves the quality of life of survivors significantly and recommends that untreated fistula survivors be identified and linked to care and treatment.
The advent of Covid-19 pandemic adversely affected many programs worldwide, public health, including programming for obstetric fistula were not spared. Obstetric fistula is an abnormal connection between the vagina and the bladder or the rectum resulting from obstetric causes, mainly prolonged obstructed labour. Zimbabwe has two obstetric fistula repair centers. Because the program uses specialist surgeons from outside the country, the repairs are organized in quarterly camps with a target to repair 90 women per quarter. This study aimed at assessing the impact of restrictions on movement and gathering of people brought about by the Cocid-19 pandemic and to characterize participants of the camp which was held in the midst of the Covid-19 pandemic at Mashoko Hospital. Specifically it looked at how Covid-19 pandemic affected programming for obstetric fistula repair and characterized participants of the fistula camp held in November to December 2020 at one of the repair centers. A review of the dataset and surgical log sheets for the camp and national obstetric fistula dataset was conducted. Variables of interest were extracted onto an excel spreadsheet and analyzed for frequencies and proportions. Data were presented in charts, tables and narratives. The study noted that Covid-19 pandemic negatively affected performance of fistula repairs greatly with only 25 women repaired in 2020 as compared to 313 in 2019. Ninety women were called to come for repairs but 52 did not manage to attend due to reasons related to the restriction of the Covid-19 pandemic lockdown. Two thirds of those women suffered from urinary incontinence while the other third had fecal incontinence. The successful repair rate was 92%. This study concluded that the pandemic greatly affected programming of fistula repair in the country and recommended the Ministry of Health and Child Care to institute measures to resume programming as soon as the situation allows.
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