Morbidity and Mortality following Traditional Uvulectomy among Children Presenting to the Muhimbili National Hospital Emergency Department in Dar es Salaam, Tanzania

Sawe, Hendry R.; Mfinanga, Juma A.; Ringo, F.H.; Mwafongo, Victor; Reynolds, Teri; Runyon, Michael S.

doi:10.1155/2015/108247

Cited by 12 publications

(31 citation statements)

References 16 publications

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“…The most common reason for traditional uvulectomy is upper respiratory infection. [14] Sawe et al [7] in their study reported that the final diagnosis in patients who were Section: Dentistry brought to hospital following uvulectomy included pneumonia, malaria, severe anaemia, malnutrition, tuberculosis and bronchitis. Majority of the participants in the current study had awareness regarding traditional treatment modalities for managing a diseased uvula.…”

Section: Discussionmentioning

confidence: 99%

“…The reported traditional methods that were known included smearing the uvula with local herbs and cutting the uvula with a sharp edged instrument. Use of sharp objects which are unsterile has been documented in various literatures [2,4,6,7,17] and use of local herbs has likewise been documented. [2,18] Almost half of the participants were aware of traditional methods used in treating what was perceived to be a diseased uvula.…”

Section: Discussionmentioning

confidence: 99%

“…[4,5] Unlike the uvulopalatoplasty performed by an otolaryngologist to treat snoring or obstructive sleep apnea, the traditional uvulectomy is performed by traditional healers, elderly laymen and barbers using either a pair of scissors, sickle shaped knife, a reed fork, twisted strands of horsehair, and/ or a hot knife. [4,6,7] In Tanzania, apart from uvulectomy, other misbelief existing about the oral health especially of children is regarding teething and its associated symptoms. Teething is defined as a physiological process by which a tooth moves from its site of Section: Dentistry development within the jaws to its final functional position in the oral cavity.…”

Section: Introductionmentioning

confidence: 99%

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Beliefs about Traditional Uvulectomy and Teething: Awareness and Perception among Adults in Tanzanian Rural Setting

Owibingire¹,

Kamya²,

Sohal³

2018

AIMDR

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Background: Teething has been associated with varieties of childhood illnesses. Traditional uvulectomy has been an ongoing practice in some societies. Both teething and traditional uvulectomy have strong linkage to beliefs, values and practices. This study aimed at documenting the awareness and perception of society regarding traditional uvulectomy and beliefs about teething in Tanzania. Methods: A cross sectional study was conducted in central region of Tanzania, encompassing adult population, who were obtained by stratified two stage sampling technique. The oldest person per household was interviewed. A questionnaire consisting of questions regarding traditional uvulectomy and beliefs about teething was used to collect data. Analysis of data was done using computer program SPSS version 19 whereby the level of significance for Chi-square was set at p-value of ≤ 0.05. Results: A total of 371 participants were included and of these, 90.3% believed that long uvula may cause ill health. The notion of prolonged cough indicates unhealthy uvula was found in 86.8% of participants. With regard to teething, 60.6% considered a child born with teeth means a curse in family. Symptoms that are perceived to be caused by teething include diarrhoea (84.6%) and fever (54.4%). Other reported symptoms include drooling of saliva, crying vomiting and irritability. Conclusion: Majority of society members still link illnesses in children with either elongated uvula and/or teething. Awareness on traditional ways of treating diseased uvula may be detrimental as people's awareness tends to influence their practice. Deliberate efforts should be put forward to educate pregnant women during their visits to antenatal and natal clinics especially in the rural areas regarding oral health of children.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Beliefs about Traditional Uvulectomy and Teething: Awareness and Perception among Adults in Tanzanian Rural Setting

Owibingire¹,

Kamya²,

Sohal³

2018

AIMDR

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“…Investigators from Carolinas Medical Center have a history of successful enrolment of MNH ED patients in several prior and ongoing investigations. [57][58][59][60][61] Our institution also has direct ties to MBH in Cameroon, where one of our study authors previously served as the chief of paediatrics. Current and former personnel from MBH have successfully collaborated on numerous national and international research investigations.…”

Section: Discussionmentioning

confidence: 99%

Subdissociative intranasal ketamine plus standard pain therapy versus standard pain therapy in the treatment of paediatric sickle cell disease vaso-occlusive crises in resource-limited settings: study protocol for a randomised controlled trial

et al. 2017

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IntroductionPediatric sickle cell disease, highly prevalent in sub-Saharan Africa, carries great morbidity and mortality risk. Limited resources and monitoring make management of acute vaso-occlusive crises challenging. This study aims to evaluate the efficacy and safety of subdissociative intranasal ketamine as a cheap, readily available and easily administered adjunct to standard pain therapy. We hypothesise that subdissociative, intranasal ketamine may significantly augment current approaches to pain management in resource-limited settings in a safe and cost-effective manner.Methods and analysisThis is a multicentred, randomised, double-blind, placebo-controlled trial enrolling children 4–16 years of age with sickle cell disease and painful vaso-occlusive pain crises. Study sites include two sub-Saharan teaching and referral hospitals with acute intake areas. All patients receive standard analgesic therapy during evaluation. Patients randomised to the treatment arm receive 1 mg/kg intranasal ketamine at onset of therapy, while placebo arm participants receive volume-matched intranasal normal saline. All participants and clinical staff are blinded to the treatment allocation. Data will be analysed on an intention-to-treat basis. Primary endpoints are changes in self-report pain scales (Faces Pain Scale-Revised) at 30, 60 and 120 minutes and rates of adverse events. Secondary endpoints include hospital length of stay, total analgesia use and quality of life assessment 2–3 weeks postintervention.Ethics and disseminationThe research methods for this study have been approved by the Cameroon Baptist Convention Health Board Institutional Review Board (IRB2015-07), the Tanzanian National Institute for Medical Research (NIMR/HQ/R.8a/Vol. IX/2299), Muhimbili National Hospital IRB (MNH/IRB/I/2015/14) and the Tanzanian Food and Drugs Authority (TFDA0015/CTR/0015/9). Data reports will be provided to the Data and Safety Monitoring Board (DSMB) periodically throughout the study as well as all reports of adverse events. All protocol amendments will also be reviewed by the DSMB. Study results, regardless of direction or amplitude, will be submitted for publication in relevant peer-reviewed journals.Trial registrationClinicalTrials.Gov, NCT02573714. Date of registration: 8 October 2015. Pre-results.

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“…Uvulectomy was not endemic to Morocco, but was widely practiced in African tribes. The procedure was performed by tribal healers based on the belief that it was preventative for throat and chest infections [16] .…”

Section: Surgical Proceduresmentioning

confidence: 99%

The History of Sleep Surgery

Yaremchuk

Garcia‐Rodriguez²

2017

Sleep-Related Breathing Disorders

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Snoring and the subsequent diagnosis of obstructive sleep apnea (OSA) was a life-threatening medical condition with no available treatment until the late 20th century. An early description of OSA was provided by Charles Dickens in his 1836 novel Pickwick Papers with the description of a "fat boy" who was thought to be lazy and always falling asleep but likely displayed hypersomnolence from OSA. It was not until 1976 that Ikematsu first described uvulopalatopharyngoplasty (UPPP) as an alternative surgical treatment of "snoring," with a reported cure rate of 81%. The only other surgical procedure for OSA was permanent tracheostomy, but patients suffered from social stigma from the visible stoma with skin flaps and complications such as tracheal granulomas and tracheitis. UPPP was introduced in the USA as an alternative to permanent tracheostomy by Fujita in 1981. Since then, multiple surgical approaches and combinations of approaches have surfaced, with variable success rates.

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Morbidity and Mortality following Traditional Uvulectomy among Children Presenting to the Muhimbili National Hospital Emergency Department in Dar es Salaam, Tanzania

Cited by 12 publications

References 16 publications

Beliefs about Traditional Uvulectomy and Teething: Awareness and Perception among Adults in Tanzanian Rural Setting

Beliefs about Traditional Uvulectomy and Teething: Awareness and Perception among Adults in Tanzanian Rural Setting

Subdissociative intranasal ketamine plus standard pain therapy versus standard pain therapy in the treatment of paediatric sickle cell disease vaso-occlusive crises in resource-limited settings: study protocol for a randomised controlled trial

The History of Sleep Surgery

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