http://dspace.lamu.edu.zm:8080/handle/123456789/11 2026-10-13T04:20:40Z http://dspace.lamu.edu.zm:8080/handle/123456789/2909 Title: Medical Imaging of Pentalogy of Cantrell: A Case Report from Zambia Authors: Bwalya, Mubanga; Chikasa, Ndanji Ivy; Bwanga, Osward; Makukula, Ziche; Chanda, Ngosa; Chanda, Ernest; Chitamya, Kelvin Abstract: Medical imaging plays a significant role in the detection of foetal anomalies, such as the Pentalogy of Cantrell (POC). POC is a congenital anomaly involving five or fewer body malformations: ectopia cordis (EC), tetralogy of Fallot (TOF), sternal defects, diaphragmatic defects, and abdominal wall defects. The commonly used imaging modality in the detection of POC during pregnancy is ultrasound because it uses non-ionizing radiation, is cheap, and is available in most medical facilities. We report a rare case of POC from a medical imaging standpoint in Zambia. Two obstetric ultrasound scans were performed in the 3rd trimester. The initial scan revealed, among other things, unappreciated abdominal contents, while the second scan revealed a foetal heart sited partially external to the thoracic cavity, with external herniation of the liver and bowels. Our case was classified as incomplete POC because not all five main malformations were present. This case report highlights the importance of having well-organized obstetric ultrasound imaging services both in urban and rural parts of the country to improve antenatal care. Description: This Journal article can be found at : DOI: 10.55320/mjz.49.1 2022-08-05T00:00:00Z http://dspace.lamu.edu.zm:8080/handle/123456789/200 Title: Observed and Expected Incidence of Cervical Cancer in Lusaka and the Southern and Western Provinces of Zambia, 2007 - 2012 Authors: Kalima, Mulele; Lishimpe, Kennedy; Meza, Jane L.; Watanabe-Galloway, Shinobu; Msadabwe, Susan C.; Mwaba, Catherine K.; Shibemba, Aaron L.; Banda, Lewis; Wood, Charles; Chamberlain, Robert M. Abstract: Cervical cancer is increasing but underestimated in developing countries. We calculated the observed and expected incidence of cervical cancer in Lusaka and Southern and Western provinces of Zambia. Data for 2007-2012 was obtained for the 3 provinces. Data included age, residence, year of diagnosis, marital status, occupation, HIV, stage, radiotherapy and chemotherapy. Expected incidence in Southern and Western provinces was calculated based on observed incidence for Lusaka province, adjusting for HIV. Crude and age-standardized incidence rates (ASR) in Lusaka were 2-4 times higher than incidence in the other 2 provinces. Lusaka had a rate of 54.1/105 and ASR of 82.1/105 in the age group 15-49. The Southern province had a rate of 17.1/105 and ASR of 25.5/105; Western province rate of 12.3/105 and ASR rate of 17.2/105. The observed cervical cancer incidence rates in the Southern and Western provinces were lower than the rate in Lusaka, possibly due to the uncertainty of underreporting/under-diagnosis or actual lower risk for reasons yet unclear. HIV seroprevalence rate in patients from the 3 provinces were 46 – 93% higher than seroprevalence in the respective general populations. Description: This article can be accessed on https://ijgc.bmj.com/content/25/1/98.info 2015-01-01T00:00:00Z http://dspace.lamu.edu.zm:8080/handle/123456789/199 Title: 1.5 Tesla Magnetic Resonance Imaging to Investigate Potential Etiologies of Brain Swelling in Pediatric Cerebral Malaria Authors: Potchen, Michael J.; Kampondeni, Samuel D.; Seydel, Karl B.; Haacke, Mark E.; Sinyangwe, Sylvester S.; Mwenechanya, Musaku; Glover, Simon J.; Milner, Danny A.; Zeli, Eric; Hammond, Colleen A.; Utriainen, David; Lishimpi, Kennedy; Taylor, Terrie E.; Birbeck, Gretchen L. Abstract: The hallmark of pediatric cerebral malaria (CM) is sequestration of parasitized red blood cells in the cerebral microvasculature. Malawi-based research using 0.35 Tesla (T) magnetic resonance imaging (MRI) established that severe brain swelling is associated with fatal CM, but swelling etiology remains unclear. Autopsy and clinical studies suggest several potential etiologies, but limitations of 0.35 T MRI precluded optimal investigations into swelling pathophysiology. A 1.5 T MRI in Zambia allowed for further investigations including susceptibility-weighted imaging (SWI). SWI is an ideal sequence for identifying regions of sequestration and microhemorrhages given the ferromagnetic properties of hemozoin and blood. Using 1.5 T MRI, Zambian children with retinopathy-confirmed CM underwent imaging with SWI, T2, T1 preand post-gadolinium, diffusion-weighted imaging (DWI) with apparent diffusion coefficients and T2/fluid attenuated inversion recovery sequences. Sixteen children including two with moderate/severe edema were imaged; all survived. Gadolinium extravasation was not seen. DWI abnormalities spared the gray matter suggesting vasogenic edema with viable tissue rather than cytotoxic edema. SWI findings consistent with microhemorrhages and parasite sequestration cooccurred in white matter regions where DWI changes consistent with vascular congestion were seen. Imaging findings consistent with posterior reversible encephalopathy syndrome were seen in children who subsequently had a rapid clinical recovery. High field MRI indicates that vascular congestion associated with parasite sequestration, local inflammation from microhemorrhages and autoregulatory dysfunction likely contribute to brain swelling in CM. No gross radiological blood brain barrier breakdown or focal cortical DWI abnormalities were evident in these children with nonfatal CM. Description: This article can be accessed on https://www.ajtmh.org/view/journals/tpmd/98/2/article-p497.xml?tab_body=contributor-notes-display 2018-01-01T00:00:00Z http://dspace.lamu.edu.zm:8080/handle/123456789/135 Title: Need for Image Reporting by Radiographers in Zambia Authors: Bwanga, Osward; Mulenga, Joseph; Chanda, Ernest Abstract: There is a critical shortage of radiologists in Zambia, with only 5 serving the entire population of approximately 17 million. For this reason, most hospitals, especially in rural areas have no radiologist services. This leaves most diagnostic imaging examinations unreported. In order to bring imaging services closer to the families who stand as a point of care, this article addresses the ways and possibilities of having reporting radiographers assisting radiologists in reporting on plain film radiographs. It has further evaluated evidence and research on how this undertaking has worked well in other countries. The article ends by recognising that with postgraduate training in image interpretation and reporting, radiographers (both diploma and degree holders) in Zambia can effectively report on plain film radiographs; thereby improving access to this service for the majority of patients. Description: This Article can also be accessed on https://mjz.co.zm/index.php/mjz/article/view/560 2020-01-22T00:00:00Z