http://localhost:8080/xmlui/handle/123456789/65 2026-10-23T09:34:21Z 2026-10-23T09:34:21Z Munyonga, Nelia N. http://localhost:8080/xmlui/handle/123456789/5331 2026-10-23T09:30:26Z 2025-01-01T00:00:00Z

Title: Prevalence of HELLP Syndrome in Association with Preeclampsia at Gweru Provincial Hospital 2024–2025 Authors: Munyonga, Nelia N. Abstract: HELLP syndrome (Haemolysis, Elevated Liver Enzymes, and Low Platelets) is a severe form of preeclampsia that poses significant risks to maternal and fetal health. Despite medical advancements, HELLP syndrome remains underdiagnosed and poorly understood in many healthcare settings, leading to delays in intervention and adverse outcomes. This research aimed to bridge the gap in knowledge by examining clinical indicators, risk factors, and effective management strategies to improve early diagnosis and treatment. The objectives of the study were; to determine the prevalence of HELLP syndrome in pregnant women admitted at Gweru Provincial Hospital, identify the risk factors associated with HELLP syndrome, and evaluate current screening and management practices related to HELLP syndrome in maternity care. This study employed a quantitative, descriptive, cross-sectional design based on retrospective review of medical records from Gweru Provincial Hospital from 2024-2025. The prevalence of HELLP syndrome in pregnant women admitted at Gweru Provincial Hospital was found to be 17.4%. The data above showed that as the number of patients with HELLP syndrome and have family history of the syndrome were increasing with the age and were the most prevalent with 24 pregnant women which constituted 72.7% of the total HELLP cases. The results showed that chronic hypertension was very much associated with HELLP syndrome with 91.0% patients had chronic hypertension and HELLP syndrome. Also the study indicated a significant correlation between advanced maternal age, family history of preeclampsia or HELLP syndrome, and chronic hypertension with the incidence of HELLP syndrome. While AST/GOT and platelet count are more effective screening tools for HELLP syndrome than ALT/GPT, the management of this condition required an approach that considered individual patient factors. The study recommended that Gweru Provincial Hospital should implement targeted screening programs for older pregnant women and improving access to prenatal care services to ensure early detection and management of potential complications especially HELLP syndrome.

2025-01-01T00:00:00Z Zumbani, Melinda S. http://localhost:8080/xmlui/handle/123456789/5330 2026-10-23T09:03:41Z 2025-01-01T00:00:00Z

Title: Evaluation of Sample Rejection Rates in the Biochemistry and Hematology Departments at Parirenyatwa Group of Hospitals: A Retrospective Review from January 2024 to December 2024 Authors: Zumbani, Melinda S. Abstract: The efficacy and reliability of clinical laboratory services are foundational to patient safety and appropriate clinical decision-making, necessitating robust Quality Management Systems (QMS). Sample rejection, primarily due to pre-analytical errors, represents a critical failure in the total testing process, leading to delayed diagnoses, increased healthcare costs, and the potential for adverse patient outcomes. This retrospective observational study aimed to comprehensively assess the magnitude and causes of sample rejection at the Parirenyatwa Group of Hospitals (PGH) over a 12-month period (January to December 2024), focusing on the Clinical Chemistry and Hematology departments. The study pursued three specific objectives: to determine the overall rejection rate, identify the most common pre-analytical causes and compare rejection rates between the two major laboratory sections. Utilizing a systematic random sampling procedure for a sample size of N=385 from historical laboratory records, the data were subjected to descriptive analysis to calculate rates and frequencies of error. The results revealed a critically high overall sample rejection rate of 8.0% across both departments, substantially exceeding the international quality benchmark of less than 2% recommended by the World Health Organization. Biochemistry recorded a marginally higher rate (8.3%) compared to Hematology (7.7%). Analysis of rejection reasons confirmed that the problem is overwhelmingly pre-analytical in nature, with the three leading causes being clotted samples (31.1%), hemolyzed samples (21.3%), and insufficient sample volume (18.0%). The majority of rejected specimens originated from inpatient wards. The minimal 0.6% difference in rejection rates between Hematology and Biochemistry is a pivotal finding, suggesting that the root causes are systemic, primarily related to inconsistent phlebotomy techniques, training deficits, and lack of rigorous supervision across the hospital rather than being confined to specific departmental processes. In conclusion, the high and unsustainable sample rejection rate at PGH demands urgent, hospital-wide intervention to safeguard diagnostic quality. Key recommendations include strengthening mandatory phlebotomy training and periodic competency assessments, enhancing quality control and supervision within inpatient wards— the main source of errors—and implementing stricter sample labelling and identification protocols. Addressing these systemic pre-analytical vulnerabilities is essential for improving laboratory efficiency, reducing costs, and ultimately supporting optimal patient management and clinical outcomes.

2025-01-01T00:00:00Z Shumba, Lenah http://localhost:8080/xmlui/handle/123456789/5329 2026-10-23T08:59:12Z 2025-01-01T00:00:00Z

Title: D-Dimer Levels and Their Impact on Predicting COVID-19 Disease Progression: A Retrospective Study at Diagnostic Laboratory, Zimbabwe from December 2019–December 2020 Authors: Shumba, Lenah Abstract: The COVID-19 pandemic, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is frequently associated with a hypercoagulable state often reflected by elevated D-dimer levels. This retrospective observational cohort study aimed to evaluate the prognostic utility of D-dimer levels upon patient presentation for predicting subsequent COVID-19 disease progression and overall patient outcomes in a Zimbabwean healthcare context. The study analyzed existing medical records of COVID-19 positive patients tested at the Diagnostic Laboratory Services (DLS) in Bulawayo, Zimbabwe, between December 2019 and December 2020.Data collected included demographic information, D-dimer values, and COVID-19 disease progression, with patients stratified by ward (Casualty, Isolation, High Dependency Unit, and Intensive Care Unit ) to assess severity.Results showed a clear correlation between elevated D-dimer values and increased disease severity. A Receiver Operating Characteristic (ROC) curve analysis was used for predicting severe disease yielded a strong Area Under the Curve (AUC) of 0.881. The optimal D-dimer cutoff value to predict severe COVID-19 was found to be 1.12 μg/mL. Using this cutoff would correctly capture 82% of severe patients (sensitivity). A logistic regression further confirmed D-dimer as a strong predictor, showing that higher D-dimer values were associated with a sharply increased probability of severe disease. In conclusion, this study demonstrates that D dimer is a valuable, readily accessible biomarker for rapid risk stratification. This early, effective stratification can facilitate the timely implementation of intensified monitoring, appropriate anti coagulation strategies, and ultimately contributing to improved clinical outcomes and survival rates within the Zimbabwe healthcare system.

2025-01-01T00:00:00Z Gatiya, Joyleen http://localhost:8080/xmlui/handle/123456789/5328 2026-10-23T08:39:17Z 2025-01-01T00:00:00Z

Title: Prevalence, Clinical Distribution, and Antifungal Resistance Patterns of Candida Species Isolated from Patients at Parirenyatwa Group of Hospitals from 2023 to 2025 Authors: Gatiya, Joyleen Abstract: Candida infections are increasingly recognized as a major public health concern, particularly in immunocompromised patients such as those undergoing chemotherapy, living with HIV, or experiencing vaginal and gestational health complications. At Parirenyatwa Group of Hospitals, the absence of routine species-level identification and antifungal susceptibility testing (AST) poses a significant challenge to effective treatment. This study aimed to determine the local prevalence, species distribution, and antifungal resistance patterns of Candida isolates. A combined retrospective (January 2023–July 2025) and prospective (April 2025–October 2025) study was conducted, analyzing 271 patient samples. Of these, 91 (33.6%) were Candida positive. Candida albicans accounted for 56.0% (n=51), while non albicans Candida (NAC) species made up 44.0% (n=40). The majority of isolates were obtained from patients with urinary tract infections (14.3%), those attending antenatal care (13.2%), and patients undergoing chemotherapy (12.1%). Prospective antifungal susceptibility testing, which is not routinely performed at Parirenyatwa, was conducted on 20 isolates using the EUCAST Kirby-Bauer disc diffusion method. Alarmingly high resistance to fluconazole was observed, with 90.0% (n=18/20) of isolates being resistant. Resistance was high in both C. albicans (63.6%) and NAC species (88.9%). Although females (n=49) had slightly more infections than males (n=42), statistical analysis (p=0.9955) showed no significant gender based difference. The predominance of NAC species and the near-total resistance to fluconazole indicate that empirical fluconazole therapy is unreliable and likely to fail in this setting. These findings emphasize the urgent need for routine Candida species identification and antifungal susceptibility testing to guide appropriate therapy and inform updates to local treatment guidelines. Additionally, strengthened infection prevention and control measures are crucial to limit the spread of drug-resistant Candida infections and improve patient outcomes.

2025-01-01T00:00:00Z