SSMJ November 2024
Editorials
As the global leaders meet in Baku, Azerbaijan, for the 29th session of the Conference of the Parties to the United Nations Framework Convention on Climate Change (COP29), the communities of Unity State in South Sudan know what climate change means. The people of this region find themselves trapped in a vicious cycle of environmental destruction, human suffering, and a growing public health disaster.
News, Reports and Policy
Nearly a century after launching proactive, eradicative efforts, Egypt, a North African nation of ancient and modern significance, became certified malaria-free on the 20th of October, 2024 by the World Health Organisation (WHO).
Obituary: Dr Stephen Cizario Odu Hakim
The South Sudan Medical Journal is looking for volunteers to join its Editorial team
Clinical Guidance
No documents found.
Research
The South Sudan health sector strategic plan indicates that only 1.2% of women aged 15-49 years have their need for family planning met, and the contraceptive prevalence rate of 6% is lower than the rate of 17% in the whole of sub-Saharan Africa. The use of modern contraceptives contributes to women’s health and reduces maternal mortality related to pregnancy and childbirth complications globally. The study investigated the utilization of modern contraceptives among women of reproductive age (WRA) in Terekeka County of South Sudan.
Hepatitis B is a viral disease caused by the hepatitis B virus (HBV). This virus increasingly infects the population each year. The evidence focusing on the validity of a research tool in the South Sudan context is scant. This study examined the validity of the questionnaire for prevalence and risk factors of HBV infection among women of reproductive age in South Sudan.
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (MTB) or Koch’s bacillus. It remains a global public health emergency and a leading cause of death. In 2022, it ranked as the second leading cause of mortality from a single pathogen after COVID-19, far exceeding deaths caused by HIV/AIDS. Algeria reported an incidence rate between 53 and 88 per 100,000 in 2017.
The use of improvised explosive devices (IED) poses a significant threat, particularly in low- and middle-income countries. These homemade explosives incorporate certain objects that create unique injury patterns that present diagnostic and therapeutic challenges. This study examines the maxillofacial wounds and patterns of Boko Haram IED victims treated at the University of Maiduguri Teaching Hospital (UMTH). Understanding the different wounding patterns these injuries cause and management options will help with proper planning and management.
University students are particularly vulnerable to mental health illnesses. Access to mental health services in Sudan is limited. Digital mental health presents a promising approach that young people widely accept. The study aimed to assess the attitude of university students in Sudan toward digital mental health.
Chronic hepatitis B affects about 240 million people worldwide, with significant complications including liver fibrosis and hepatocellular carcinoma. We aimed to study the prevalence of liver fibrosis and its associations among people with hepatitis B at Mbarara Regional Referral Hospital (MRRH).
Case Reports
Spontaneous intracerebral haemorrhage is a stroke subtype that is associated with high morbidity and mortality due to mass effect raised intracranial pressure, and injury to the surrounding brain tissue. We report a case of a 35-year-old female with a massive left parietal intracerebral haemorrhage of sudden onset followed by rapid neurological deterioration due to the mass effect. An urgent brain ComputedAxial Tomographic (CT) scan, and basic laboratory tests were obtained. Supportive treatment with intravenous fluids and management of physiological parameters were planned but could not be instituted due to the rapid deterioration of the patient’s condition. A risk factor could have been previously undetected and uncontrolled. Hypertension through vascular abnormalities such as a burst aneurysm or arterio-venous malformation were possible. She died within an hour of presentation to the hospital. We conclude that prompt diagnosis and management of intracerebral haemorrhage is a significant challenge in South Sudan due to limited awareness, facilities, and late presentation of stroke.
A high index of suspicion and early intervention could avert loss of vision and other complications associated with organic intraorbital foreign bodies, which are often difficult to diagnose with radiographs. We report the case of a 12-year-old female with a large intraconal wooden foreign body that had remained quiescent for one year following left orbital trauma. She complained of a history of gradual loss of vision, painful proptosis, and discharging orbital fistula for three months prior to presentation. Orbital ultrasonography and CT scan failed to show an intraorbital abscess or foreign body. However, an explorative orbitotomy revealed an intraconal foreign body measuring 5x1x0.2cm with associated granulomatous inflammation. Her psychological symptoms improved following surgery, though her vision remained unchanged.
Summaries
Although it’s a typical and loving gesture, kissing newborns carries a considerable danger because it could spread infections. Due to immature immune systems and incomplete vaccination histories, newborns are especially susceptible to respiratory viruses like influenza and respiratory syncytial virus (RSV), bacterial pathogens like Streptococcus pneumoniae and Group A Streptococcus, and cytomegalovirus (CMV). Despite the risks, many parents and other caretakers are ignorant of them and frequently permit intimate contact with guests who might be unintentionally carriers of infectious pathogens. This overview looks at the several infections that can spread by kissing, the possible effects on a newborn’s health, and the precautions experts advise taking to reduce the dangers.
Although Rapid Diagnostic Tests (RDTs) are utilized more frequently today, blood films are still the gold standard for diagnosing malaria. This is an observational study, looking at the experience of His House of Hope and Faith Hospital (HHHF) in Yei, South Sudan, in one calendar year (January to December in 2023) tracking Plasmodium falciparum (PF) and other plasmodium species. We report some simultaneous data using RDT for malaria and data regarding co-infection with Salmonella typhi (Typhoid fever).
Research is important. It adds to our knowledge base, improves practice, shows which practices are effective and which are not, provides evidence to inform policy debates, and helps us as health professionals become better practitioners. Findings from research are shared at scientific meetings, conferences, and in medical journals such as this one.
To be useful, research must be carried out ethically, with full disclosure of how the data were collected. The researchers must have used appropriate statistical methods to analyse their data. This is vital if we are to draw valid conclusions and potentially change practice.
Whether quantitative or qualitative, research generates data that requires analysis and interpretation to derive insights. Statistical tests allow researchers to calculate how much the relationship between the variables they have investigated differs from that which might be expected by chance alone. In statistical terms, whether the null hypothesis of no significant relationship is accepted or rejected. This article will consider the common types of statistical tests applied to quantitative research data and their interpretation. By the end of this paper, readers should be better informed about the choice of statistical test for their research study and how to interpret the results.
little and the study may not produce a useful result; too much and resources will be wasted. In either case, data collection may be considered unethical. This applies both to the amount of information collected about each participant and the number of participants in the study. The current article is about the latter.
A research proposal is a three-chapter document that outlines a study to be conducted for a dissertation or thesis. The three chapters of a proposal include the Introduction, a literature review on the chosen topic, and the research methodology proposed for the study. After successfully navigating the proposal process and receiving approval from the academic research team and the Research Ethics Committee, one can proceed with the actual research project. In South Sudan, all healthcare-related research proposals must be approved by the South Sudan Research Ethics Committee (SSREC) based at the Ministry of Health, as institutional committees still need to be established. Authoring a research proposal as a postgraduate medical professional in a resource-poor country like South Sudan poses challenges related to inadequate healthcare infrastructure and research facilities and limited access to the internet and medical libraries. Therefore, it is important to consider the scope of the proposed research carefully and select a clear topic that addresses a significant medical topic relevant to the population’s healthcare. This overview aims to guide medical postgraduate students in South Sudan and other resource-limited regions on their dissertation and thesis projects.
Technical expertise is often regarded as the primary driver of success in health research. While undoubtedly crucial, a growing body of evidence shows that an essential set of soft skills is just as important as technical expertise for success in educational attainment, employment, research, and earnings.[1] Success in health research involves more than excelling in statistical analysis and research procedures. Soft skills complement and enhance technical expertise.
Soft skills are personal and interpersonal attributes, behaviours, and attitudes that influence how effectively individuals interact with others and navigate research environments.[2] They include communication, teamwork, empathy, adaptability, confidence, time management, critical thinking, social aptitude, organizational skills, leadership abilities, ethical attitudes, problem-solving, self-evaluation, and delegation.