SSMJ August 2019


Ebola outbreak: a public health emergency of international concern

After nearly one year following the re-emergence of the Ebola Virus Disease (EVD) in the Democratic Republic of Congo (DRC), the World Health Organization (WHO) has declared the Ebola outbreak as a “public health emergency of international concern”.This is only the fifth time in the history of the WHO that it has made such a declaration for the world to take notice and double its efforts at containing the disease.

Poster: flu or ebola?

News, Reports and Policy

Gunshot injuries remain high despite peace deal

Juba (ICRC) - The number of patients admitted to International Committee of the Red Cross (ICRC)-supported surgical units in South Sudan with injuries from violence remains high ten months after the signing of a peace agreement.

Clinical Guidance

No documents found.


Prevalence, clinical pattern and immediate outcomes of HIV-infected children admitted to Al Sabah Children’s Hospital, South Sudan

According to UNAIDS, approximately 36.7 million people were living with HIV globally in 2017, of which 2.1 million were children aged under 15 years. Most HIV-infected African children are never tested for HIV, although some symptoms such as non-specific generalized dermatitis, ear discharge, lobar pneumonia, and tuberculosis are associated with HIV. The prevalence of HIV for hospitalized children in Africa has ranged between (10%-12.5%). This study aimed to determine the prevalence of HIV infection, the clinical pattern of the illnesses, and the immediate outcomes of the admitted children in Al Sabah Children’s Hospital in Juba, South Sudan between January and April 2018.

The effects of maternal Body Mass Index on placental morphology and foetal birth weight: a study from Dodoma Central Region,Tanzania

The wellbeing of the foetus is influenced by a number of factors including maternal characteristics, the placenta and umbilical cord morphology and functions. The placenta is a fantastic organ yet often neglected due to its transient existence; it performs functions that are later taken on by separate organs, including the lungs, liver, gut, kidneys and endocrine glands. It is the interface between mother and foetus and influences maternal and newborn mortality. Careful examination of the placenta can shed light on the in-utero environment of the foetus and can help to explain an abnormal neonatal outcome and might have consequences for treatment

Multiple-drug resistant (MDR) tuberculosis among HIV sero-positive and sero-negative populations in Ilorin, North-Central Nigeria

Pulmonary tuberculosis (TB) is an infectious disease causing high morbidity and mortality throughout the world. In 2015, reports showed an estimated 10.4 million cases of tuberculosis globally, including 1.2 million (11%) people living with Human Immunodeficiency Virus (HIV). Recent reports showed that 57% of TB among people living with HIV was not promptly diagnosed or treated, resulting in 390,000 tuberculosis-related deaths in 2015.

Prevalence of chronic rhinosinusitis at Muhimbili National Hospital, Dar es Salaam

Chronic rhinosinusitis (CRS) has a significant impact on the quality of life. The recurrent nature of the problem presents a clinical and economic challenge in developing countries. A number of studies have been carried out to assess the prevalence of CRS. A survey in USA estimated that about 16% of the population was affected by CRS. In a Sao Paulo (Brazil) study, CRS was found in 5.51%. A Nigerian study found a prevalence of CRS of 7.3%. In North-central Nigeria, a higher prevalence was reported at 24.7% similar to reports from Canada and USA [5-8]. The maxillary sinuses have been reported in most studies as the sites predominantly affected by CRS

The acceptability of HIV testing among women receiving post abortion care

South Sudan has a relatively low prevalence of HIV/AIDS at about 2.6%, with pockets of concentration in specific geographic zones. The government’s effort in combating the disease has been hampered by ignorance about HIV, with 45% of women aged 15-49 years having no knowledge of the virus. Most feared taking the test and said it is a death sentence

Prevalence of primary Caesarean Section deliveries among primiparous and multiparous women at Iringa Regional Referral Hospital, Tanzania

Caesarean Section (CS) is the surgical procedure by which a foetus is delivered through an incision in the mother’s abdomen and uterus. It is called a primary CS when it is done for the first time on a pregnant woman. Primary CS is of particular interest because it has an influence on future modes of delivery. There is also a concern about the indication for the procedure in a woman who has never tried her pelvis for vaginal delivery. It is a global issue because CS births are increasing, with short and long term maternal and newborn implications

Case Reports

Case Report: Huge inclusion cyst as a long term complication of female genital mutilation

Female genital mutilation (FGM) is a common practice in Nigeria and is performed for religious and cultural reasons despite associated short- and long-term complications. Epidermoid inclusion cyst of the external genitalia is one of its late complications. We describe the successful management of a huge painless vulva mass measuring 10cm by 8cm in a 40-year-old woman. She had excision of the cyst with histological diagnosis of epidermal inclusion cyst. There is need for medical practitioners to have a high index of suspicion of epidermal inclusion cyst for vulva swelling especially in Nigeria where FGM is prevalent. However, public enlightenment and enforcement of laws on eradication of FGM as well as management of its complications are crucial.

Case Report: Ultra-Short Bowel Syndrome after a near-total small bowel resection for gangrene due to volvulus in a district hospital in South Sudan

The length of the small intestine ranges between 3m-10m with an average of 6.5m. It is made up of the duodenum (25cm), jejunum (1.5m), and ileum (distal three fifths). Resection of up to a third or even half is compatible with a normal life. However, survival has been reported with a small bowel length of only 45 cm. A major resection leads to the small gut syndrome of malabsorption of macro and micro nutrients. The classical symptoms are diarrhoea and those arising from malabsorption. Long term survival is enhanced with the use of parenteral nutrition but there are no publications of survival without parenteral nutrition.


Erratum August 2019

Quiz August 2019