Papers by Rangarirai Makuku
Journal of Public Health Policy, Aug 17, 2022
The World Health Organization (WHO) recognizes a critical shortage of health workers as a growing... more The World Health Organization (WHO) recognizes a critical shortage of health workers as a growing global crisis. The shortage persists despite local and global efforts to recruit health workers ethically. Unequal migration of healthcare professionals, most often from low to high-resource countries, overwhelmingly defeats the objective of achieving Universal Health Coverage (UHC). If not addressed, especially given emerging global pandemics like COVID-19, the critical shortage of health workers could decimate vulnerable public health systems. This Viewpoint describes the Root-Stem Model, a six-stage process of strategic factors affecting work life that could help policymakers address the challenge of brain-drain among healthcare workers in low-income countries. Keywords Universal Health Coverage • Low-income countries • Brain-drain • Health workforce retention • Human resources for health • Root-Stem Model • Human resource management Key messages • Critical shortage of healthcare workers driven by brain-drain is a growing global health crisis with important public health effects in low-resource settings. • The Root Stem Model (RSM) of workforce retention uses a multistage cyclic process encompassing education, recruitment, job training, work environment, remuneration, and investment of work gains, and resources for analyzing work life and opportunities for improvement.
Journal of Orthopaedic Surgery and Research, Apr 10, 2022
Background: Templating is a preoperative planning procedure that improves the efficiency of the s... more Background: Templating is a preoperative planning procedure that improves the efficiency of the surgical process and reduces postoperative complications of total hip arthroplasty (THA) by improving the precision of prediction of prosthetic implant size. This study aimed to evaluate the accuracy of the preoperative cup and stem size digital 2D templating of THA with mediCAD ® software and find the factors that influence the accuracy, such as indication for surgery, patients' demographics, implant brand, and the assessors' grade of education. Methods: We retrospectively retrieved 420 patient template images of all patients who underwent THA between March 2018 and March 2021. Templating of all included images was processed using mediCAD ® software a day before surgery by a newcomer physician to hip arthroplasty course (PGY-2 orthopedic resident or hip surgery fellow). Preoperative templating cup and stem sizes were compared with the actual inserted implant sizes. Result: After excluding ineligible patients, this study included 391 patients, 193 (49.4%) males and 198 (50.6%) females with a mean age of 43.3 ± 14.9. The average cup sizes predicted before and after surgery were 52.12 ± 14.28 and 52.21 ± 15.05 respectively, and the mean delta cup size (before and after surgery) was 2.79 ± 2.94. The delta stem size before and after surgery has a mean value of 1.53 ± 1.49. The acetabular cup components, measured within ± 0, ± 1, and ± 2 sizes, were 28.9%, 63.9%, 83.1% accurate, respectively. The femoral stem design component measured within ± 0, ± 1, and ± 2 sizes were 27.2%, 61.0%, 78.6% accurate, respectively. Wagner Cone ® stem brand, DDH patients, and females showed significantly higher accuracy of stem size templating. Revision THA has the lowest accuracy in terms of cup size templating. The compression of accuracy rate between resident and fellow revealed no significant differences. Also, no significant difference was detected between the accuracy of templating performed in the first months with the second months of the arthroplasty course period. Conclusion: Our study showed that under mentioned condition, templating using mediCAD ® has acceptable accuracy in predicting the sizes of femoral and acetabular components in THA patients. Digital software like mediCAD ® remains favorable because of the short learning curve, user-friendly features, and low-cost maintenance, leading to level-up patient care and THA efficacy. Further studies are necessary for clarifying the role of the assessor's experience and expertise in THA preoperative templating.
Journal of clinical neonatology, 2022
Objective: The objective of this study is aimed at investigating and evaluating respiratory patte... more Objective: The objective of this study is aimed at investigating and evaluating respiratory patterns between infants hospitalized with brief resolved unexplained event (BRUE) and the control group. Methods: A convenient sampling method was used to select 52 patients presented at an urban, tertiary, and teaching pediatric hospital fitting the American Academy of Pediatrics' criteria of a lower-risk BRUE from December 2019 to December 2020. A random probability sampling method was used to select 52 patients as a control group. A NINIX apnea monitoring device was used to record respiratory time patterns and analyzed with SPSS 25. Results: A total of 104 participants participated in the study. Our study found that inspiration time (0.31 ± 0.04), expiratory time (0.93 ± 0.14), respiratory rate (38.48 ± 4.38), body temperature (37.11 ± 0.20), and heart rate (137.90 ± 6.60) were not statistically different between both groups. Mean birth weight in the control group and BRUE were respectively (3.43 ± 0.39, 3.23 ± 0.35). Mean gestational age in the control and BRUE groups were respectively (38.94 ± 1.01, 39.0 ± 1.04). Mean postnatal age in the control and BRUE groups were respectively (17.19 ± 6.07, 17.32 ± 7.35). Birth weight (P = 0.08) was statistically significant between both groups. In one patient, we recorded breath arrest for more than 20 s. Conclusion: There were no significant differences in respiratory patterns between infants hospitalized with BRUE and the control group. Low birth weight and low APGAR score are possible risk factors for infants experiencing BRUE, and more investigations are required to establish underlying causes.
Integrative Cancer Therapies
The ketogenic diet (KD) was initially used in 1920 for drug-resistant epileptic patients. From th... more The ketogenic diet (KD) was initially used in 1920 for drug-resistant epileptic patients. From this point onward, ketogenic diets became a pivotal part of nutritional therapy research. To date, KD has shown therapeutic potential in many pathologies such as Alzheimer’s disease, Parkinson’s disease, autism, brain cancers, and multiple sclerosis. Although KD is now an adjuvant therapy for certain diseases, its effectiveness as an antitumor nutritional therapy is still an ongoing debate, especially in Neuroblastoma. Neuroblastoma is the most common extra-cranial solid tumor in children and is metastatic at initial presentation in more than half of the cases. Although Neuroblastoma can be managed by surgery, chemotherapy, immunotherapy, and radiotherapy, its 5-year survival rate in children remains below 40%. Earlier studies have proposed the ketogenic diet as a possible adjuvant therapy for patients undergoing treatment for Neuroblastoma. In this study, we seek to review the possible ro...
Emerging Integrative Therapies, 2023
The ketogenic diet (KD) was initially used in 1920 for drug-resistant epileptic patients. From th... more The ketogenic diet (KD) was initially used in 1920 for drug-resistant epileptic patients. From this point onward, ketogenic diets became a pivotal part of nutritional therapy research. To date, KD has shown therapeutic potential in many pathologies such as Alzheimer's disease, Parkinson's disease, autism, brain cancers, and multiple sclerosis. Although KD is now an adjuvant therapy for certain diseases, its effectiveness as an antitumor nutritional therapy is still an ongoing debate, especially in Neuroblastoma. Neuroblastoma is the most common extra-cranial solid tumor in children and is metastatic at initial presentation in more than half of the cases. Although Neuroblastoma can be managed by surgery, chemotherapy, immunotherapy, and radiotherapy, its 5-year survival rate in children remains below 40%. Earlier studies have proposed the ketogenic diet as a possible adjuvant therapy for patients undergoing treatment for Neuroblastoma. In this study, we seek to review the possible roles of KD in the treatment of Neuroblastoma.
Pharmacological Reports
The original version of this article unfortunately did not list Mickael Essouma as a co-author wh... more The original version of this article unfortunately did not list Mickael Essouma as a co-author who has been involved in the drafting and approving of the manuscript.
Journal of International Medical Research
Tissue banking programs fail to meet the demand for human organs and tissues for transplantation ... more Tissue banking programs fail to meet the demand for human organs and tissues for transplantation into patients with congenital defects, injuries, chronic diseases, and end-stage organ failure. Tendons and ligaments are among the most frequently ruptured and/or worn-out body tissues owing to their frequent use, especially in athletes and the elderly population. Surgical repair has remained the mainstay management approach, regardless of scarring and adhesion formation during healing, which then compromises the gliding motion of the joint and reduces the quality of life for patients. Tissue engineering and regenerative medicine approaches, such as tendon augmentation, are promising as they may provide superior outcomes by inducing host-tissue ingrowth and tendon regeneration during degradation, thereby decreasing failure rates and morbidity. However, to date, tendon tissue engineering and regeneration research has been limited and lacks the much-needed human clinical evidence to trans...
Journal of Public Health Policy
The World Health Organization (WHO) recognizes a critical shortage of health workers as a growing... more The World Health Organization (WHO) recognizes a critical shortage of health workers as a growing global crisis. The shortage persists despite local and global efforts to recruit health workers ethically. Unequal migration of healthcare professionals, most often from low to high-resource countries, overwhelmingly defeats the objective of achieving Universal Health Coverage (UHC). If not addressed, especially given emerging global pandemics like COVID-19, the critical shortage of health workers could decimate vulnerable public health systems. This Viewpoint describes the Root-Stem Model, a six-stage process of strategic factors affecting work life that could help policymakers address the challenge of brain-drain among healthcare workers in low-income countries. Keywords Universal Health Coverage • Low-income countries • Brain-drain • Health workforce retention • Human resources for health • Root-Stem Model • Human resource management Key messages • Critical shortage of healthcare workers driven by brain-drain is a growing global health crisis with important public health effects in low-resource settings. • The Root Stem Model (RSM) of workforce retention uses a multistage cyclic process encompassing education, recruitment, job training, work environment, remuneration, and investment of work gains, and resources for analyzing work life and opportunities for improvement.
BMC Pediatrics
Background Several individual studies from specific countries have reported rising numbers of ped... more Background Several individual studies from specific countries have reported rising numbers of pediatric COVID-19 cases with inconsistent reports on the clinical symptoms including respiratory and gastrointestinal symptoms as well as diverse reports on the mean age and household exposure in children. The epidemiological characteristics of COVID-19 in children are not fully understood, hence, comprehensive meta-analyses are needed to provide a better understanding of these characteristics. Methods This review was conducted in Medline, Scopus, Cochrane library, Embase, Web of Science, and published reports on COVID-19 in children. Data were extracted by two independent researchers and a third researcher resolved disputes. STATA software and the random-effect model were used in the synthesis of our data. For each model, the heterogeneity between studies was estimated using the Q Cochrane test. Heterogeneity and publication bias were calculated using the I2 statistic and Egger’s/Begg’s t...
Pharmacological Reports
The use of antiviral COVID-19 medications can successfully inhibit SARS-CoV-2 replication and pre... more The use of antiviral COVID-19 medications can successfully inhibit SARS-CoV-2 replication and prevent disease progression to a more severe form. However, the timing of antiviral treatment plays a crucial role in this regard. Oral antiviral drugs provide an opportunity to manage SARS-CoV-2 infection without a need for hospital admission, easing the general burden that COVID-19 can have on the healthcare system. This review paper (i) presents the potential pharmaceutical antiviral targets, including various host-based targets and viral-based targets, (ii) characterizes the first-generation anti-SARS-CoV-2 oral drugs (nirmatrelvir/ritonavir and molnupiravir), (iii) summarizes the clinical progress of other oral antivirals for use in COVID-19, (iv) discusses ethical issues in such clinical trials and (v) presents challenges associated with the use of oral antivirals in clinical practice. Oral COVID-19 antivirals represent a part of the strategy to adapt to long-term co-existence with SA...
Journal of Orthopaedic Surgery and Research
Background Templating is a preoperative planning procedure that improves the efficiency of the su... more Background Templating is a preoperative planning procedure that improves the efficiency of the surgical process and reduces postoperative complications of total hip arthroplasty (THA) by improving the precision of prediction of prosthetic implant size. This study aimed to evaluate the accuracy of the preoperative cup and stem size digital 2D templating of THA with mediCAD® software and find the factors that influence the accuracy, such as indication for surgery, patients’ demographics, implant brand, and the assessors’ grade of education. Methods We retrospectively retrieved 420 patient template images of all patients who underwent THA between March 2018 and March 2021. Templating of all included images was processed using mediCAD® software a day before surgery by a newcomer physician to hip arthroplasty course (PGY-2 orthopedic resident or hip surgery fellow). Preoperative templating cup and stem sizes were compared with the actual inserted implant sizes. Result After excluding ine...
International Immunopharmacology, 2022
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), as of 2019, approximately 4... more According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), as of 2019, approximately 42.2 million people have died from acquired immunodeficiency syndrome (AIDS)-related illnesses since the start of the epidemic. Antiretroviral therapy (ART) has significantly reduced mortality, morbidity, and incidence of the human immunodeficiency virus (HIV)/AIDS-defining cancers, taming once-dreaded disease into a benign chronic infection. Although the treatment has prolonged the patients' survival, general HIV prevalence has increased and this increase has dovetailed with an increasing incidence of Non-AIDS-defining cancers (NADCs) among people living with HIV (PLWH). This is happening when new promising approaches in both oncology and HIV infection are being developed. This review focuses on recent progress witnessed in immunotherapy approaches against HIV-related, Non-AIDS-defining cancers (NADCs), and HIV infection.
International Immunopharmacology, 2022
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), as of 2019, approximately 4... more According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), as of 2019, approximately 42.2 million people have died from acquired immunodeficiency syndrome (AIDS)-related illnesses since the start of the epidemic. Antiretroviral therapy (ART) has significantly reduced mortality, morbidity, and incidence of the human immunodeficiency virus (HIV)/AIDS-defining cancers, taming once-dreaded disease into a benign chronic infection. Although the treatment has prolonged the patients' survival, general HIV prevalence has increased and this increase has dovetailed with an increasing incidence of Non-AIDS-defining cancers (NADCs) among people living with HIV (PLWH). This is happening when new promising approaches in both oncology and HIV infection are being developed. This review focuses on recent progress witnessed in immunotherapy approaches against HIV-related, Non-AIDS-defining cancers (NADCs), and HIV infection.
Journal of Medical Virology
This chapter briefly describes the universal intricacies caused by the COVID-19 pandemic, from th... more This chapter briefly describes the universal intricacies caused by the COVID-19 pandemic, from the ineffectiveness of distance measures, the massive economic impacts, and the severe mental health challenges to the failure of finding a vaccine, a therapeutic agent or even accurately diagnosing the infection. The entire world is suffering, but every country is trying to combat this pandemic individually, and this deed is the main barrier that prevents reaching a peaceful end.
Coronavirus disease 2019 (COVID-19) pandemic is a global challenge. Several governments of the wo... more Coronavirus disease 2019 (COVID-19) pandemic is a global challenge. Several governments of the world have decided to take drastic actions in order to combat the spread of the disease, including the closing of air, maritime and land borders, as an extreme measure of isolation of each country/region. However, such measures had not prevented the disease from spreading globally; as COVID-19 has already spread in almost all countries. This virus's main victims are the healthcare personnel (HCP), who are physically and psychologically affected. The HCP serves as the first line of defense against this pandemic, what if we faced a significant loss in their number? And what if our HCP was going through a deep dark depression? The condition would be terrifying not only for now but also in the future. This raises the need for an intensified International collaboration, that mainly supports the HCP. We are throwing by challenging moments, and it is clear that social distancing, cooperation,...
Infection Control & Hospital Epidemiology, Apr 22, 2020
Journal of Immunology Research
Cancer immunotherapy, which reactivates weakened immune cells of cancer patients, has yielded gre... more Cancer immunotherapy, which reactivates weakened immune cells of cancer patients, has yielded great success in recent years. Among immunotherapeutic agents, immune checkpoint inhibitors have been of particular interest and have gained approval by the FDA for treatment of cancers. Immune checkpoint blockade through targeting programmed cell death protein-1 (PD-1) has demonstrated promising antitumor effects in cancer immunotherapy of many different solid and hematologic malignancies. However, despite promising results, a favorable response is observed only in a fraction of patients, and there is still lack of a single therapy modality with curative ability. In this paper, we review the current and future perspectives of PD-1/L1 blockade in cancer immunotherapy, with a particular focus on predictive biomarkers of response to therapy. We also discuss the adverse events associated with PD-1/L1/2 inhibitors, ranging from severe life-threatening conditions such as autoimmune myocarditis t...
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Papers by Rangarirai Makuku