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                  <text>Jurnal Internasional Afrika vol. 11 issue 2 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 2 2021&#13;
African Journal of Emergency Medicine&#13;
Trauma patients at the Helderberg District Hospital emergency centre, South Africa: A descriptive study </text>
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                <text>District hospitals&#13;
Wounds and injuries&#13;
Physical trauma&#13;
Emergency care&#13;
Emergency health services&#13;
South Africa</text>
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                <text>Introduction: Trauma is a substantial component of South Africa’s burden of disease. District hospitals provide&#13;
primary trauma care for a large proportion of this trauma burden, although most studies are in specialised or&#13;
tertiary settings. The aim was to evaluate the profile of physical trauma patients attending the emergency centre&#13;
at Helderberg District Hospital, Cape Town.&#13;
Methods: An observational descriptive study was conducted between 1 January and 30 April 2019. Patients with&#13;
trauma were identified from a register and systematically sampled to achieve a sample size of 377. Retrospective&#13;
data from medical records was collected and analysed in the Statistical Package for Social Sciences.&#13;
Results: Of the 14,873 patients attending the emergency centre 24.6% were trauma related and 381 folders were&#13;
analysed. Of these patients 30.4% were female and 69.6% male with an average age of 27.8 years. Over 60% of&#13;
patients used an ambulance to get to the hospital. Sundays were the busiest days with 23.9% of all cases.&#13;
Intentional trauma accounted for 45.4% of cases and accidental injuries 49.1%. The commonest mechanisms&#13;
were sharp injuries (27.6%), falls (22.0%) and blunt trauma (19.4%). Intentional trauma made up more than half&#13;
of all trauma in males, was more prevalent than accidental trauma between 20 and 60 years and resulted in a&#13;
higher proportion of admissions.&#13;
Conclusion: There were high levels of intentional trauma, especially involving young males over the weekend,&#13;
mostly with sharp objects. This trauma burden resulted in high numbers of admissions and transfer to tertiary&#13;
hospitals. Family physicians and other generalists need to be well trained in trauma resuscitation and stabilisation.&#13;
District hospital need to be appropriately equipped and supplied to manage trauma. Further research is&#13;
needed to identify underlying modifiable factors that can be addressed through community-orientated&#13;
interventions.</text>
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                <text>Trevor Marle, Robert Mash</text>
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                <text>www.elsevier.com/locate/afjem</text>
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                <text>28 March 2021</text>
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                <text>peri irawan</text>
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                <text>english</text>
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        <name>District hospitals Wounds and injuries Physical trauma Emergency care Emergency health services South Africa</name>
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        <name>Jurnal Internasional Keperawatan</name>
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                  <text>Jurnal Internasional Afrika vol. 11 issue 2 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 2 2021&#13;
African Journal of Emergency Medicine&#13;
Spectrum of urological emergencies and surgical interventions in a single tertiary health center</text>
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          <element elementId="49">
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                <text>Urology&#13;
Emergency&#13;
Spectrum&#13;
Conditions</text>
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                <text>Babatunde K. Hamza , Muhammed Ahmed, Musliu Adetola Tolani, Mudi Awaisu,Ahmad Tijjani Lawal, Nasir Oyelowo, Ahmad Bello, Hussein Yusuf Maitama </text>
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                  <text>Jurnal Internasional Afrika vol. 11 issue 2 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 2 2021&#13;
African Journal of Emergency Medicine&#13;
Results from the implementation of the World Health Organization Basic Emergency Care Course in Lagos, Nigeria </text>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
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                <text>Medical education&#13;
Basic emergency care&#13;
Short training courses&#13;
Emergency medicine in Nigeria</text>
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                <text>Background: The emergency care of time-sensitive injuries and illnesses is increasingly recognized as an essential&#13;
component of effective health care systems. However, many low- and middle-income countries (LMICs) lack&#13;
healthcare providers formally trained in the care of emergency conditions. The Disease Control Priorities 3&#13;
project estimates that effective emergency care systems could avert up to half of all premature deaths in LMICs.&#13;
Nigeria, a lower-middle income country of nearly 200 million people in Sub-Saharan Africa, could save&#13;
approximately 100,000 lives per year with an effective emergency care system. The World Health Organization&#13;
developed the Basic Emergency Care (BEC) course to train frontline healthcare workers in the management of&#13;
emergency conditions in low resource settings. In this study we describe our work implementing the BEC course&#13;
Nigeria.&#13;
Methods: This study was designed as a mixed methods research analysis comparing pre- and post- course examination&#13;
results and surveys to evaluate participant knowledge acquisition and levels of confidence with&#13;
management of various emergency conditions. Thirty-two participants were involved in the course which took&#13;
place over four days at the Lagos University Teaching hospital. Quantitative data was analyzed using Stata 14.2&#13;
(College Station, TX). Paired data sets were analyzed using McNemar’s chi-squared. Unpaired data sets were&#13;
analyzed using a Wilcoxon signed-rank test.&#13;
Results: Post-course test scores showed significant improvement (p-value &lt;0.001) as compared to pre-course. The&#13;
average pre-course test score was 73% and average post-course score was 86.5%. Pre- and post-course questionnaires&#13;
demonstrated significantly increased confidence in managing emergency conditions and agreement&#13;
with course objectives.&#13;
Conclusions: The WHO Basic Emergency Care (BEC) course successfully increased the knowledge and confidence&#13;
of frontline emergency care providers in Nigeria. The course was well received by participants. Future study&#13;
should focus on BEC course scalability and long-term knowledge retention.</text>
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                <text>Ayobami Olufadeji , Agnes Usoro , Chukwudi E. Akubueze , Benjamin O. Aiwonodagbon , Jonathan Strong , Sean M. Kivlehan , Babatunde Akodu</text>
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                <text>www.elsevier.com/locate/afjem</text>
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                <text>10 February 2021</text>
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            <description>An entity responsible for making contributions to the resource</description>
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        <name>Jurnal Internasional Keperawatan</name>
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        <name>Medical education Basic emergency care Short training courses Emergency medicine in Nigeria</name>
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                <text>Jurnal Internasional Afrika vol. 11 issue 2 2021&#13;
African Journal of Emergency Medicine&#13;
Response to “Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent seizures and a severe metabolic acidosis”</text>
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                <text>Response to “Ethylene glycol poisoning: A diagnostic challenge in a patient with persistent&#13;
seizures and a severe metabolic acidosis”</text>
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                <text>Smit and colleagues describe a commendable treatment of an&#13;
extremely ill patient with ethylene glycol (EG) poisoning with severe&#13;
metabolic acidosis [1]. The case also highlights the diagnostic difficulties&#13;
with EG poisoning. These difficulties are not unique to Africa.&#13;
Most hospitals in the US lack on-site capability to measure EG concentrations.&#13;
In the few that can measure EG, the laboratory procedure takes&#13;
several hours, so we also rely upon other clues [2].&#13;
In addition to the anion gap, the osmolal gap, and the presence of&#13;
calcium oxalate crystals in the urine, the unmeasurably high lactate&#13;
concentration (reported as &gt;30 mmol/L) is another useful clue for EG&#13;
poisoning. There are two common laboratory methods for measuring&#13;
lactate. Point-of-care devices (including blood gas analyzers) use lactate&#13;
oxidase while hospital laboratories often use a method using lactate&#13;
dehydrogenase. Lactate oxidase uses both lactate and glycolate as substrates&#13;
and cannot distinguish between the two. In contrast, lactate dehydrogenase&#13;
is specific for lactate. A very high point-of-care lactate&#13;
suggests EG poisoning [3]. If both tests are available, a discrepancy&#13;
between the two resulting in a much higher apparent lactate concentration&#13;
by the lactate oxidase method than by the lactate dehydrogenase&#13;
method (the “lactate gap”) is highly specific to EG poisoning.&#13;
Another option is to employ an assay using glycerol dehydrogenase&#13;
[4,5]. In the US, a veterinary diagnostic product (Catachem Inc., Oxford&#13;
CT, USA) offers qualitative and quantitative measurement of EG in dogs.&#13;
This provides a rapid and sensitive test for ethylene glycol. The test&#13;
correlates well with gas chromatography–mass spectrometry (GC–MS)&#13;
but has but has not reached widespread clinical use in humans [5].&#13;
One test which emergency physicians must avoid is urinary fluorescence&#13;
ultraviolet light (Wood’s lamp). Although automotive antifreeze/&#13;
coolant liquids contain fluorescein (to assist mechanics in finding&#13;
radiator leaks), normal urine and some plastic urine containers also&#13;
fluoresce and make this bedside test highly unreliable [6].</text>
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                <text>www.elsevier.com/locate/afjem</text>
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                <text>17 February 2021</text>
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                <text>PERI IRAWAN</text>
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        <name>seizures and a severe metabolic acidosis”</name>
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                <text>Jurnal Internasional Afrika vol. 11 issue 2 2021&#13;
African Journal of Emergency Medicine&#13;
Reaching further: Lessons from the implementation of the WHO Basic Emergency Care Course Companion App in Tanzania</text>
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                <text>Mobile technology&#13;
Emergency care&#13;
Implementation lessons&#13;
Tanzania</text>
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                <text>Introduction: The World Health Organization’s (WHO’s) Basic Emergency Care (BEC) course was developed to&#13;
address training gaps in low- and middle-income countries (LMICs). Simultaneously, LMICs have experienced an&#13;
unprecedented increase in the number of cell phone and internet users. We developed a mobile application&#13;
adjunct to the BEC course (BEC app) and sought to assess the reach of the BEC app.&#13;
Methods: Forty-six BEC course participants, made up of doctors and nurses from three hospital sites in Tanzania,&#13;
were given access to the BEC app with download instructions. Moderators tracked mobile access characteristics&#13;
and barriers. This is a descriptive study outlining the implementation of the BEC app and associated findings&#13;
from the process.&#13;
Results: Fewer than 10% of participants were able to independently download and use the application. The&#13;
download process revealed three key barrier areas: accessibility (no smartphone, smartphone without charge, no&#13;
access to data/WiFi to download app, increased cost of data), technical (outdated operating system, inconsistent&#13;
access to data/WiFi to run the app, insufficient phone storage), and participant-related characteristics (variability&#13;
in smartphone literary, language discordance, smartphone turnover). Of the 46 participants, 29 (63%) were able&#13;
to download and use the BEC app successfully with moderator support.&#13;
Conclusions: There is potential utility of mobile health in LMICs. However, barriers still exist to reaching the&#13;
largest possible audience for these initiatives. The importance of app compatibility with a broad range of&#13;
operating systems and limitation of the amount of data needed to download and use the app was underscored by&#13;
our study. Moreover, creative solutions are needed to facilitate large-scale roll-outs of mobile health interventions,&#13;
such as a distribution model that relies on super user and peer support rather than an individual&#13;
moderator. Additional local perspectives on the download process and the utilisation and acceptance of the&#13;
application post-implementation are needed.</text>
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            <description>An entity primarily responsible for making the resource</description>
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              <elementText elementTextId="26571">
                <text>Anya L. Greenberg , Christian C. Rose , Paulina Nicholaus , Juma A. Mfinanga , Hendry R. Sawe , Andrea G. Tenner </text>
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              <elementText elementTextId="26573">
                <text>www.elsevier.com/locate/afjem</text>
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                <text>14 April 2021</text>
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                <text>PERI IRAWAN</text>
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        <name>Jurnal Internasional Keperawatan</name>
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      <tag tagId="3579">
        <name>Mobile technology Emergency care Implementation lessons Tanzania</name>
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                  <text>Jurnal Internasional Afrika vol. 11 issue 2 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 2 2021&#13;
African Journal of Emergency Medicine&#13;
Qualitative needs assessment for paediatric emergency care in Kampala, Uganda</text>
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          <element elementId="49">
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                <text>Qualitative research&#13;
Emergency medicine&#13;
Paediatrics&#13;
Uganda</text>
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                <text>Introduction: Acute childhood illnesses, such as malaria, pneumonia, and diarrhoea, represent the leading causes&#13;
of under-five mortality in Uganda. Given that most early child deaths are treatable with timely interventions,&#13;
emergency units dedicated to paediatric populations have been established in the country. In light of recent&#13;
developments, the department of paediatrics at Makerere University requested a needs assessment in the paediatric&#13;
acute care unit (PACU) at Mulago National Referral Hospital, which could guide the development of a&#13;
new training curriculum for medical providers.&#13;
Methods: We administered a survey for medical providers working in the PACU at Mulago Hospital, which&#13;
assessed their self-rated comfort levels with paediatric assessment, treatment, and teamwork skills. We also&#13;
conducted focus groups with a smaller subset of medical providers to understand barriers and facilitators to&#13;
paediatric emergency and critical care.&#13;
Results: Of 35 paediatric assessment, treatment, and teamwork skills, 29 (83%) questions had the median comfort&#13;
rating of 6 or 7 on a 7-point Likert scale. The remaining 6 (17%) skills had a median comfort rating of 5 or lower.&#13;
Focus groups identified a number of major barriers to caring for critically ill children, including limited resources&#13;
and staffing, training gaps, and challenges with interprofessional teamwork. In terms of training development,&#13;
focus group participants suggested continuous training for all medical providers working in the PACU led by&#13;
local leaders.&#13;
Discussion: This study identified the need and desirability of continuous trainings in the PACU. Key components&#13;
include objective skills assessment, simulation-based scenarios, and interprofessional teamwork. Training&#13;
development should be augmented by increases in resources, staffing, and training opportunities in collaboration&#13;
with the Uganda Ministry of Health.</text>
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            <elementTextContainer>
              <elementText elementTextId="26549">
                <text>Boyoung Ahn , Ezekiel Mupere , Bel´en Irarr´azaval , Robert O. Opoka ,&#13;
Hellen Aanyu-Tukamuhebwa , Corey B. Bills , Dorothy Gingo , Nicolaus W. Glom</text>
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                <text>www.elsevier.com/locate/afjem</text>
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                <text>7 March 2021</text>
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            <elementTextContainer>
              <elementText elementTextId="26553">
                <text>PERI IRAWAN</text>
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            <description>A language of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="26555">
                <text>ENGLISH</text>
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        <name>Jurnal Internasional Keperawatan</name>
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        <name>Qualitative research Emergency medicine Paediatrics Uganda</name>
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                  <text>Jurnal Internasional Afrika vol. 11 issue 2 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 2 2021&#13;
African Journal of Emergency Medicine&#13;
Patients’ satisfaction with emergency care services in a University Teaching Hospital in South-West, Nigeria</text>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
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              <elementText elementTextId="26536">
                <text>Patient satisfaction&#13;
Emergency care&#13;
Healthcare&#13;
Emergency Centre</text>
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            <description>An account of the resource</description>
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                <text>Background: Patient satisfaction is a measure of the extent to which patients are contented with the health care&#13;
they received from their health care provider.&#13;
Objective: The goal of this study was to measure the satisfaction of patients admitted to the Emergency Centre and&#13;
to determine the factors affecting the satisfaction.&#13;
Method: A cross-sectional study was conducted over four months among patients admitted into the Emergency&#13;
Centre of the hospital. Systematic sampling method was used by trained personnel who collected the data from&#13;
the participants using a pre-tested structured questionnaire.&#13;
Result: Out of 199 patients that participated, 51.3% rated the reception at the Emergency Centre as very good&#13;
while the speed of pain control was rated as excellent by only 9.0% of the participants. The time to surgical&#13;
intervention was rated very good and excellent by 57.3% and 9.5% respectively. Comparable value was obtained&#13;
by both nurses and doctors on the overall attitude across the 5 scoring domains. Overall, 90.5% of participants&#13;
were satisfied with the services and experiences at the Emergency Centre of the hospital, however, suggested&#13;
areas of improvement include employment of more staff by 51.8%, provision of more equipment by 41.2%, and&#13;
27.6% requested for availability of more facilities.&#13;
Conclusion: A high percentage of the patients were satisfied with the overall service in our Emergency Centre&#13;
while some other areas require improvement.</text>
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            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="26538">
                <text>Olabisi Olamide Deji-Dada , Samuel Ayokunle Dada , Johnson Dare Ogunlusi, Olusoji Abidemi Solomon </text>
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            <description>A related resource from which the described resource is derived</description>
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              <elementText elementTextId="26539">
                <text>www.elsevier.com/locate/afjem</text>
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                <text>PERI IRAWAN</text>
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            <description>A language of the resource</description>
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        <name>Jurnal Internasional Keperawatan</name>
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                  <text>Jurnal Internasional Afrika vol. 11 issue 2 2021</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 2 2021&#13;
African Journal of Emergency Medicine&#13;
Observed benefits of a major trauma centre in a tertiary hospital in Nigeria</text>
              </elementText>
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          <element elementId="49">
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            <description>The topic of the resource</description>
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              <elementText elementTextId="26525">
                <text>Trauma center&#13;
Benefits&#13;
Nigeria</text>
              </elementText>
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            <description>An account of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="26526">
                <text>Introduction: A Trauma System or its components has been shown to improve trauma services and outcome of&#13;
seriously injured patients. These organised services are non0existent or the components operate in isolation in&#13;
most African countries.&#13;
This study was done to identify the observed advances in trauma care service delivery, brought about by the&#13;
beginning of operation of a trauma centre in the capital city of a West African country.&#13;
Methodology: The operation of the trauma centre was reviewed for progress in terms of organisation of care, inhospital&#13;
care, training, and referral system and injury prevention. In addition, the challenges facing the trauma&#13;
centre were also reviewed and discussed.&#13;
Results: The trauma centre has brought about better organisation of care and specialist availability, various&#13;
training in trauma surgery, advances in referral and injury prevention. Funding is an identified threat to the&#13;
function of the centre.&#13;
Discussion: The trauma centre provided the drive for specialist training in trauma and changes in the process of&#13;
care. Funding is a threat to optimal function, as was poor inter-relatedness with other local hospitals, pre-hospital&#13;
services and rescue providers.</text>
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                <text>Usman Adamu Gwaram, Onyedika Godfrey Okoye, Oluwole Olayemi Olaomi</text>
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                <text>Jurnal Internasional Afrika vol. 11 issue 2 2021&#13;
African Journal of Emergency Medicine&#13;
Management of acute fever in children: Consensus recommendations for community and primary healthcare providers in sub-Saharan Africa </text>
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Fever&#13;
Febrile&#13;
Primary healthcare&#13;
Sub-Saharan Africa</text>
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                <text>Fever is one of the most common reasons for unwell children presenting to pharmacists and primary healthcare&#13;
practitioners. Currently there are no guidelines for assessment and management of fever specifically for community&#13;
and primary healthcare workers in the sub-Saharan Africa region. This multidisciplinary consensus guide&#13;
was developed to assist pharmacists and primary healthcare workers in sub-Saharan Africa to risk stratify and&#13;
manage children who present with fever, decide when to refer, and how to advise parents and caregivers.&#13;
Fever is defined as body temperature ≥ 37.5 ◦C and is a normal physiological response to illness that facilitates&#13;
and accelerates recovery. Although it is often associated with self-limiting illness, it causes significant concern to&#13;
both parents and attending healthcare workers. Clinical signs may be used by pharmacy staff and primary&#13;
healthcare workers to determine level of distress and to distinguish between a child with fever who is at high risk&#13;
of serious illness and who requires specific treatment, hospitalisation or specialist care, and those at low risk who&#13;
could be managed conservatively at home. In children with warning signs, serious causes of fever that may need&#13;
to be excluded include infections (including malaria), non-infective inflammatory conditions and malignancy.&#13;
Simple febrile convulsions are not in themselves harmful, and are not necessarily indicative of serious infection.&#13;
In the absence of illness requiring specific treatment, relief from distress is the primary indication for prescribing&#13;
pharmacotherapy, and antipyretics should not be administered with the sole intention of reducing body temperature.&#13;
Care must be taken not to overdose medications and clear instructions should be given to parents/&#13;
caregivers on managing the child at home and when to seek further medical care.</text>
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