Browsing by Author "Muloiwa Rudzani"

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    A prospective study to assess the value of liquid chromatography-tandem mass spectrometry in the management of paediatric poisoning at Red Cross War Memorial Children's Hospital, Cape Town, South Africa
    (2020) Washaya, Norbertta Nzwisisayi; Buys, Heloise; Muloiwa Rudzani
    Background: Paediatric poisoning is a common presentation to emergency departments worldwide. There is a paucity of data on the role of liquid chromatography-tandem mass spectrometry (LC-MS/MS), in the management of paediatric poisoning in low-and middle-income countries (LMICs). In high-income countries, most studies are retrospective, and few include children. Objective: The study describes the prevalence of liquid chromatography-tandem mass spectrometry confirmed paediatric poisoning at Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Methods Children admitted with suspected poisoning between 1 January 2017 and 31 December 2017, were recruited. All patients had a urine and/or blood sample sent for LC-MS/MS toxicology. Data collected included demographic data, clinical features, investigations, management, outcome and social interventions. Results 152 children, with median age of 39 (IQR 25 -61) months were enrolled of which 128 (84%) were poisoning cases. Of the 128 poisoning cases, 88 (69%) presented with a history of ingesting a known substance, 16(12%) an unknown substance and 24(19%) were cases of occult poisoning. LC-MS/MS was able to identify a substance in 92% of the cases of occult poisoning. In those who had presented with a seemingly known substance, LC-MS/MS found a different substance in 15 cases. LC-MS/MS was also able to detect multiple drugs in 40 patients. Of the poisoning cases, six (5%) cases were attempted homicide cases and 5 (4%) cases were attempted suicide cases. No children died. Individualized social interventions were instituted in poisoning cases. Emergency placement safety reasons was required in 6 children. Conclusion: When the limitations are known, LC-MS/MS is useful in identifying cases of occult poisoning; identifying patients who have ingested multiple substances and/or an unknown substance and when targeted towards child protection. As LC-MS/MS is an expensive test, it should be used judiciously in LMICs.
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    Open Access
    An umbrella review of the available evidence syntheses to inform vaccination practices and policies for the COVID-19 pandemic in Africa
    (2023) Els, Krisna; Kagina, Benjamin; Muloiwa Rudzani
    Background: In Africa, the rollout of COVID-19 vaccines lags other continents. The rollout in Africa started in the latter part of the first quarter of 2021 compared with earlier periods in high income settings. Optimal COVID-19 vaccination rollout in Africa should be guided by context-specific and up to date evidence. We conducted an umbrella review to identify, analyze and characterize the evidence syntheses that is available and has the potential to inform COVID-19 vaccination practices and policies in Africa. Methods: A systematic search for scoping reviews, systematic reviews, rapid reviews, and meta-analyses was performed in PubMed/Medline, Web of Science, Scopus (EMBASE), Epistemonikos and The Cochrane Library. Search outputs were exported to Rayyan software for screening. From the included studies, predefined outcomes were extracted and recorded on a data extraction form. Study characteristics, number and types of evidence syntheses were reported. Pooled results from the included studies were reported, including the statistical methods used. Where pooling of reported results had not been done and was feasible to do so, we conducted our own data pooling. Results: A total of 1111 papers were retrieved from all the databases. After removing duplicates and screening for inclusion, 15 papers were included: systematic reviews (n=4), systematic reviews and meta-analysis (n=7), meta-analysis alone (n=2), rapid review and meta- analysis (n=1), and a review of surveys (n=1). Results from the included studies were from 36 (66%) out of 55 African countries. The most abundant evidence was on the seroprevalence of antibodies against SARS-CoV-2 which ranged from 8.2% (95% CI: 0.8-22.3%) to 22% (95% CI 14%-31%). Conclusions: At the time of conducting this study, there was paucity of systematized evidence from majority of the African countries. Evidence syntheses gaps were evident for the incidence and severity of COVID-19 related outcomes, including hospitalization and mortality, as well as vaccine acceptance rates. Open Science Framework Registration: 10.17605/OSF.IO/PTB9W