<strong>How to cite this article:</strong> Hugo JFM, Couper ID, Thigiti J, Loeliger, S. Equity in health care: Does family medicine have a role? Afr J Prm Health Care Fam Med. 2010;2(1), Art. #243, 3 pages. DOI: 10.4102/ phcfm.v2i1.24

<strong>How to cite this article:</strong> Reid S, Mash B. Names and roles for the generalist doctor in Africa. Afr J Prm Health Care Fam Med. 2010;2(1), Art. #242, 5 pages. DOI: 10.4102/ phcfm.v2i1.24

Background: Fever and diarrhea are among the common morbidities that do occur during infancy and are sometimes wrongly associated with teething by the community. Some societies practice gum lancing, ordinarily referred to as gum cutting, as a remedy for the “teething diarrhoea”. These myths have a potential of giving false security with the belief that these symptoms are part of the teething process, and so medical attention may not be sought when necessary. There are few studies focusing on the outcome of such practices despite their known potential dangers. Objective: To describe various methods of gum lancing and clinical presentation, management and outcome of gum lancing among the Akamba people as seen in Kangundo District Hospital. Method: One hundred and fifteen infants/children who were brought to the hospital with a positive history of gum lancing. Results: The common presenting complaints were persistent diarrhoea (74.0%), fever (44.3%), difficulty in breathing (27.8%) and refusal to feed (20.9%). 58.3% cases warranted admission and these included severe dehydration and shock (47.8%), severe and very severe pneumonia (40.3%), meningitis (26.9%) and generalized sepsis (17.9%). There were a total of 7 mortalities (6.1%), 3 on arrival and 4 within the pediatric ward. Invasive gum lancing procedures and delayed seeking of medical attention were associated with severe disease and poorer outcomes. Conclusion: The impact of gum lancing is of both a public health and economic significance. It is associated with unfavorable outcome if prompt measures are not put in place. There is need to conduct community sensitization and educate caregivers on the truths of teething and dangers of gum lancing as well as seeking health services for fever and diarrhoea. Use of broad-spectrum antibiotics and adequate rehydration are necessary in management of the victims.

BackgroundHuman immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) is associated with cognitive impairment which affects psychomotor speed. Psychomotor slowing is a predictor of dementia and death in people living with HIV and AIDS. The purpose of this study was to assess the relationship between HIV disease stage and psychomotor speed neurocognitive score which will add to the body of knowledge required to manage patients with HIV and AIDS.ObjectiveTo determine the relationship between psychomotor speed neurocognitive score and the HIV disease stage in adults at initiation of care.SettingThis study was conducted at Kangundo Sub-county hospital comprehensive care centre.MethodsThis was a cross-sectional study. All HIV seropositive patients aged 18 to 50 years recently initiated into care were studied. A pretested questionnaire was used to collect data. The World Health Organization (WHO) stage was used during data collection to classify study participants into asymptomatic and symptomatic groups. The grooved pegboard test was used to obtain psychomotor speed neurocognitive scores. Descriptive statistics were used to summarise data. Mann–Whitney U test, Spearman’s rho and multiple linear regression were employed in the analysis; p-value of 0.05 was considered significant.ResultsThe WHO stage did not have a significant effect on the psychomotor speed neurocognitive score (p ≥ 0.05). The CD4 count had a significant effect on psychomotor speed neurocognitive score (p = 0.001).ConclusionsThere was a significant correlation between CD4 counts and psychomotor speed neurocognitive score. Efforts should be made to ensure that the CD4 counts of people living with HIV and AIDS do not continue to fall after initiation into care in order to preserve psychomotor function.

Introduction: Hypertension is a key precursor to cardiovascular and renal disease globally. According to WHO, Prevalence of hypertension was about 40 % globally in 2015 and 45% in Sub Saharan Africa in 2015. Despite much emphasis on treatment of the syndrome, the related blood pressure control remains poor or inadequate. Objective: The study sought to establish the patient related barriers to adequate blood pressure control among adult hypertensive patients in Kiambu Count Hospital in Kenya. Methods: A cross -sectional descriptive study method approach was used to examine sample of 330 patients selected through consecutive sampling technique in the medical outpatient chronic disease clinic. Multivariate logistic regression analysis was used to determine variables associated with inadequate or poorly controlled hypertension among adult patients. Results: Most of the patients were females (71.5%). However, the presence of inadequate blood pressure control was significantly higher among males (P-value= 0.009). Regularly taking of hypertension drugs for the last 6 months was significantly associated with adequate blood pressure control (p-value=0.033). The other barriers including single status, inadequate knowledge, employment and time duration since diagnosis of hypertension did not significantly affect blood pressure control status. Discussion: Males were 54% more likely to have inadequate blood pressure control compared to females (AOR=0.543; 95%CI=0.323-0.914). Patients with low adherence to treatment were 11% more likely to have inadequate blood pressure control than those with high adherence rate (AOR=1.093; 95%CI=0.224-5.332) though the association was not significant (p-value=0.912). Conclusion: Male gender was a major barrier to adequate blood pressure control. Patients who well adhered to treatment scheme for a duration of six months preceding the study had their blood pressure better controlled than those who did not. Male hypertensive patients need to be followed up to ensure they adhere to drug treatment in order to reduce the rates of inadequate blood pressure control and other related complications.