Tanzania Journal of Health Research

Headache to a Patient with the Coexistence of Chiari I Malformations and Primary Empty Sella Syndrome: A Case Report

2024-02-27T09:33:37+00:00

Background: Chiari I malformations (CM-I) and Primary Empty Sella syndrome (PESS) are rare disorders of structural defects within a skull. Headache is the most common presenting symptom in both conditions. However, CM-I and ESS comorbidity in patients with severe headaches is yet to be reported.

Case description: The patient was a 38-year-old woman with a one-year history of headaches at various localisations (occipital and bilateral frontal) preceded by mood agitation. Physical examination was significant for obesity. Magnetic resonance imaging (MRI) revealed a 6.4 mm cerebellar tonsil descent through the foramen magnum and hypointense (CSF-filled) flattened sella. The lipid panel showed elevated cholesterols (total) and low-density lipoprotein (LDL) levels. She was medically managed, with no report of symptoms relapses at one-month and two-month follow-ups.

Conclusion: This is the first report on comorbid CM-I and PESS in adults presenting with cephalalgia. PESS and CM-I co-occurrence may present with mixed headache localisation; careful history-taking and imaging are mandatory for diagnosis confirmation. Future extensive studies are warranted to analyse the pathophysiological interplay between these two rare disorders.

Antimicrobial Resistance among neonates with neonatal Sepsis in Morogoro, Tanzania

2024-01-14T13:59:48+00:00

Background: Neonatal sepsis increases neonatal morbidity and mortality in low- and middle-income countries. However, the prevalence of neonatal sepsis, etiological agents, and antimicrobial resistance patterns have not been documented in areas with the highest neonatal mortality rates in Tanzania.

Aim: This study aimed to investigate the prevalence of neonatal sepsis, identify the primary causative agents, and understand their resistance patterns at Morogoro Regional Hospital.

Methods: The study involved 252 admitted neonates at Morogoro Regional Hospital and was carried out between March and June 2019. Clinical and demographic information for each neonate was collected using a standardized questionnaire. Blood samples were obtained from all 252 neonates, and 50 swabs were randomly taken from neonates with umbilical pus discharge. The samples were cultured using aseptic techniques on blood, chocolate, and MacConkey agar. The identification of the causative agents relied on the characteristics of colony morphology, gram staining, and biochemical tests. Antimicrobial resistance patterns were determined using the disc diffusion method with Muller Hinton agar against Ampiclox, Erythromycin, Gentamycin, Nalidixic acid, Ciprofloxacin, Norfloxacin, Ofloxacin, Kanamycin, Co-trimoxazole, Cephalexin, Ceftriaxone, and Amikacin.

Results: The prevalence of neonatal sepsis, as determined through blood culture, was 40 % (102 /252). The predominant bacteria isolated from blood cultures were E. coli 31 %, Staphylococcus aureus 23 %, and Citrobacter spp 16%. Around 50% of the gram-negative bacteria resisted Ceftriaxone, a third-generation cephalosporin. Both gram-negative bacteria and Staphylococcus aureus displayed resistance to Ampiclox.

Conclusion: E. coli, Staphylococcus aureus, and Citrobacter spp. were shown to be the most frequent bacteria in neonatal sepsis in Morogoro. Many isolates were Ampicillin-resistant. Neonatal sepsis is common in Morogoro, highlighting the need for innovative neonatal care and preventative techniques.

Patterns of head and neck lesions among HIV/AIDS patients on highly active antiretroviral therapy at Dodoma Regional Referral Hospital in Tanzania

2023-10-31T09:28:21+00:00

Introduction: Head and neck lesions associated with Human Immunodeficiency Virus are considered to occur in over 50% of HIV- positive patients and occur in nearly 80% of all patients with acquired immunodeficiency syndrome. The introduction of highly active antiretroviral therapy has led to a remarkable reduction in the global burden of such lesions. Suppose such lesions are undiagnosed or untreated on a prompt basis. In that case, they may cause morbidity and mortality since some lesions, for example, head and neck cancers may interfere with vital functions of life such as respiration, deglutition, and speech. This study determined head and neck lesions among HIV/AIDS patients in Tanzania.

Methods: This was a hospital-based descriptive cross-sectional study that recruited 222 HIV/AIDS patients at a care and treatment clinic at Dodoma Regional Referral Hospital. Physical examination and laboratory investigations (histopathology, viral load and CD4 counts) were collected and data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. P-value<0.05 was statistically significant.

Results: Of all the 222 patients recruited in this study, 26 (11.7%) had head and neck lesions. Most patients with head and neck lesions were females (57.6%). Half of the patients (50.0%) were between 40 and 59 years old. About 21 (80.8%) patients were diagnosed with HIV/AIDS within two years, and 22 (84.6%) were initially diagnosed with CD4 counts less than 200 cells/μL. The most common head and neck lesion was oral candidiasis (46.2%) and others were cervicofacial lymphadenitis (15.4%), head and neck squamous cell carcinoma (laryngeal and hypopharyngeal) (11.5%), sinonasal Kaposi’s sarcoma (7.7%), odontogenic abscess (7.7%) and aphthous ulcers (7.7%) and the least encountered head and neck lesion was a ranula in 3.8% of patients. Similarly, a significant association was found between the occurrence of head and neck lesions with viral load, CD4 counts, duration since a patient was diagnosed with HIV/AIDS, presence of comorbid illness, alcohol consumption and cigarette smoking.

Conclusions: The prevalence of head and neck lesions among HIV/AIDS patients on HAART was low. Females outnumbered males in terms of being affected by head and neck lesions. Oral candidiasis was the most common head and neck lesion. Head and neck (laryngeal and hypopharyngeal) squamous cell carcinoma was the predominant subtype of malignant lesions in HIV/AIDS patients on HAART.

Maternal Psychosocial care and Child feeding practices

2023-10-31T10:03:12+00:00

Introduction: Psychosocial care is the process by which caregivers meet the needs of infants in terms of adequate nutrition, emotional, social, mental and healthcare for promoting healthy growth and development. This study, therefore, aimed to assess the influence of psychosocial care during complementary feeding among mothers.

Methodology: It was a cross-sectional design, and the sample size was statistically calculated to arrive at 385 mothers. A structured and self-administered questionnaire collected information on socio-economic status and psychosocial care during complementary feeding practices. WHO feeding indicators were used to assess the feeding practices of the mothers. Data were analysed using both descriptive statistics and inferential statistics.

Results: The study showed that 52.1% of respondents were between 20 and 29 years old, 88.1% were married, and others were single or divorced mothers. The feeding indicator showed that 21.5% of respondents met the Minimum Adequate Diet. Half of the respondents (50%) monitored the amount of food consumed by the children, while 12.4% encouraged the children to finish the food served. There was an insignificant relationship between maternal psychosocial care and complementary feeding practices (χ2; p>0.05), whereas there was a significant association between maternal psychosocial care and maternal age (χ²; p=0.043) as well as religion (χ²; p=0.031).

Conclusion: The study concluded that mothers who had advanced in age had better maternal psychosocial care during complementary feeding than the younger mothers. Therefore, maternal nutrition education on complementary feeding and care during infants’ feeding should be encouraged during antenatal and post-natal clinics.

Food Environment Facing School Children in Public Primary Schools in Morogoro Municipality

2024-02-12T10:52:25+00:00

Introduction: The study focused on examining the overall food environment influencing the dietary choices of school children in public primary schools in Morogoro Municipality. Four primary schools—Magadu, SUA, Mlimani, and Kikundi—were purposively sampled to represent the broader school landscape in the municipality. SUA and Mlimani were in urban and peri-urban areas, Magadu represented peri-urban settings, and Kikundi was in the town center. Data collection involved administering a structured questionnaire to 97 school children, selected through convenient sampling based on their availability on the day of data collection.

Results showed that most children were aware of healthy foods (62.9%) but demonstrated lower awareness of unhealthy foods (52.6%). Only 52% of children brought food from home, while the majority purchased items from vendors around the school premises. The most consumed junk foods included biscuits (83.5%), chips (75.3%), chocolates (74.2%), and fried buns (72.2%). Notably, school regulations or bylaws governing the sale of food to children were absent.

Discussion: The findings suggested that children were more conscious of healthy foods than unhealthy options, possibly leading them to consume the latter unknowingly. The study emphasized the prevalence of unhealthy food consumption among school children and highlighted the absence of regulatory measures in place. Addressing these issues could promote healthier dietary habits among school children in Morogoro Municipality.

Clinical profile, treatment modalities and outcomes among patients with upper aero-digestive tract emergencies at Bugando Medical Centre, Mwanza, Tanzania

2023-09-22T18:26:46+00:00

Background: Upper aero-digestive tract emergencies (UADTEs) are common in our setting and can be life-threatening and challenging to otolaryngologists. However, there is a paucity of clinical studies on these emergencies. This study aimed to determine the clinical profile, treatment modalities and outcomes of upper aero-digestive tract emergencies at Bugando Medical Centre (BMC), Mwanza, Tanzania.

Methods: Between January and May 2019, a cross-sectional study involving patients presenting with a clinical diagnosis of UADTEs was conducted at BMC.

Results: Of 487 ENT emergencies seen during the study period, 128 (26.3%) patients had UADTEs. Males outnumbered females by a ratio of 1.5: 1. Their median age at presentation was 5 [range, 2-40] years. The major causes of UADTEs were foreign body ingestion, head and neck tumours, foreign body aspiration and cut-throat injuries that were seen in 56(43.8%), 33(25.8%), 25(19.5%) and (3.9%), respectively. The most frequent presentations were dysphagia 81(63.3%), difficulty in breathing 61(47.7%) and odynophagia 56(43.8). Age ≤ 40 years (p=0.02), prolonged duration to treatment (p=0.04) and low blood oxygen saturation (SPO2) (p=0.04) were significantly associated with poor outcomes following esophagoscopy. In addition, delayed duration to treatment (p=0.01) and foreign body ingestion (p=0.001) were significantly associated with prolonged hospital stay.

Conclusion: UADTEs are common at BMC and constitute a significant cause of otorhinolaryngological admission with foreign bodies in the aerodigestive tract as the most typical cause of these emergencies. Most of these injuries can be prevented through public enlightenment campaigns. Early detection and management of UADTEs is essential to reduce morbidity and mortality associated with these emergencies.

Knowledge on the Risk Factors for Diabetic Foot Syndrome and Self-Foot Care Practices among Diabetic Patients at Muhimbili National Hospital in Dar es Salaam, Tanzania: A Cross-Sectional Study.

2023-12-07T13:28:58+00:00

Background: Evidence indicates diabetic patients have more than 15 times increased risk of non-traumatic foot disabilities. Patients' knowledge of the potential risk factors and self-care practices anticipate better self-management.

Objective: This study aimed to assess patients’ knowledge of the risk factors for diabetic foot syndromes and reported self-foot care practices at Muhimbili National Hospital.

Methods: A hospital-based quantitative cross-sectional study design was conducted in June and December 2022. A random sampling technique was applied to recruit 140 diabetic patients at an outpatient clinic. The Guided Interview questionnaire was used to obtain data. Data were analyzed using SPSS version 25.

Result: The reported history of foot ulceration was 42(30%). Participants did not identify Smoking 106 (78.4%), foot soring/fungus 101(72.1%), and toenail ingrowth 96(68.3%) as potential contributors/risks for foot ulceration. Participants 93(66.4%) had an Inadequate knowledge score on the risk factors for Diabetic Foot Syndrome. The gender(male) (AOR: 3.71, 95%CI, 1.513-9.114, P=0.004169), education (secondary level) (AOR: 0.179, 95%CI: 0.045-0.70, P=0.0139), and history of foot ulceration (have not experienced foot ulcer) (AOR: 5.5, 95%CI: 2.14-14.165, P=0.000403) were significant associated to Inadequate knowledge score. Washing the foot with warm water and drying between the toes [daily] 84(60.4%) received poor response. Of the participants, 97(69.3%) had Good self-foot care practices. The duration of Diabetic illness (more than five months and less than one year) (AOR: 19.025, 95%CI: 2.716-133.293, P=0.003) and history of foot ulceration (have not experienced foot ulcer) (AOR: 3.377, 95%CI: 1.218-9.366, P=0.019) were significantly associated to Poor self-foot care practices.

Conclusion: The finding reveals inadequate knowledge of risk factors for diabetic foot syndromes and poor self-care practices. It gives insight into the respective authorities to develop a comprehensive rehabilitative therapy, focusing on foot health education and addressing every aspect affecting their quality of life.

Nutritional Status Among Head and Neck Cancer Patients, Tanzania

2023-11-28T09:25:56+00:00

Background: Nutrition in cancer patients is a challenge as various mechanisms can lead to poor nutrition status, and this contributes to poor prognosis and quality of life. In developing countries, before one concludes that cancer is the culprit to malnutrition, one has to rule out access to food. The Head and Neck region is involved with the intake and initial processing of the food. Therefore, the presence of a tumor in any subsite directly affects nutritional status.

Aim: This study aimed to establish nutritional adequacy among Head and Neck Cancer patients accessing services at a tertiary hospital in Tanzania.

Method: The study was cross-sectional descriptive. Patients with head and neck cancer attended from 1^st August 2022 to 31^st January 2023 were recruited. Information about access to food was collected and nutrition was measured by anthropometric measurements and biochemical tests (serum albumin levels). After data collection, the correctness was checked by running frequency tables and analyzed by Statistical Package for the Social Sciences (SPSS) version 26.

Results: The study involved a total of 113 participants aged from 15 to 93 years with a mean age of 51.81+/-17.439 years. There were 74 males and 39 females, making a ratio of 1.9:1. Most participants had laryngeal tumours (46%). 85.6% of patients had advanced disease, stage IV (52.2%).17% of patients had pre-existing dietary risk, and 36.3% had severe malnourishment at presentation. In this study,75% of patients with oropharyngeal tumours had malnutrition, followed by hypopharyngeal and nasopharyngeal tumours, each with 66.7%. Stage IV patients were severely malnourished (57.6%) which was statistically significant.

Conclusion and recommendation: Laryngeal tumours are common in men and are related to advanced age. Most of the patients with Head and Neck Cancer (HNC) had severe malnourishment. Management of head and neck cancer should also address malnutrition which contributes to poor prognosis and quality of life.

Compliance to Recommended Prevention and Management Practices among Type 2 Diabetes Patients in Morogoro Municipality, Tanzania

2023-09-30T13:21:24+00:00

Introduction: Diabetes-related complications are the significant causes of morbidity and mortality among type 2 diabetes patients. The complications can be reduced by practicing and maintaining several preventive measures. The present study aims to assess compliance and factors associated with recommended management practices and prevention of complications among type 2 diabetes patients in selected health facilities in Morogoro Municipality, Tanzania.

Methods: A hospital-based cross-sectional study was conducted from February to May 2023 among 140 patients, including patients who were diagnosed with diabetes for at least three months prior to the study. Data were collected through face-to-face interviews using a structured questionnaire, which included patients’ characteristics and a previously validated Summary of Diabetes Self-care Activities questionnaire to assess patients' compliance with recommended practices. A multivariable regression analysis was employed to identify factors associated with compliance with recommended practices.

Results: The mean age of the respondents was 59 ±12.08 years and 65% were females. Among 140 patients, 91.4% (n=128) had poor or unsatisfactory self-care practices with an overall mean of 3.81± 2.08 days per week for diabetes management. The recommended practices with good or satisfactory performance were non-smoking, non-alcohol drinking and prescribed medication. In contrast, unsatisfactory performance was observed for self-monitoring of blood glucose with a mean of physical activity. Multiple regression analysis showed that co-morbidity (AOR 4.5; 95% CI:1.14-18.02) and being employed (AOR 4.4; 95% CI:1.25-15.44) independently predict self-care practices.

Conclusion and recommendation: Compliance with self-monitoring of blood glucose, physical exercise and dietary practices were found to be low among type 2 diabetes patients, which could increase the risk of complications. Nutritional and lifestyle counselling and the use of peer groups should be emphasized to improve compliance with recommended practices.

Risk factors of delayed developmental milestones among infants attending RCH clinics in Dodoma region. A cross-sectional study

2024-02-07T09:59:17+00:00

Background: Delayed Developmental Milestones are defined as slow to attain typical developmental milestones in one or more developmental areas. This study aimed to assess risk factors of delayed developmental milestones among infants in the Dodoma Region.

Methods: We conducted a health facility-based cross-sectional descriptive study using the pathways developmental screening tool. A total of 262 mothers with their children were enrolled, the study population were all neonates delivered at the study sites during the study period. Three data collection methods were utilized to obtain information for this study: observation, interviewer-administered questionnaires, and documentary review. Ethical approval was obtained from the Ethical Review Board of the University of Dodoma SAS version 9.4 was used for data analysis. The association between developmental status and factors was assessed with Chi-square and binomial logistic regression.

Results: Notably, infants born with birth asphyxia were more likely three times to develop delayed developmental milestones as opposed to those without birth asphyxia [adjusted risk ratio =3.22, 95%, [1.97, 5.46], probability value= <.0001]. Birth weight was significantly associated with delayed developmental milestones; infants who were born with a birth weight of ≥4000gm had more risk of developing delayed developmental milestones compared to those with a birth weight of 2500-3999gm [adjusted risk ratio 0.48, 95%, [0.26, 0.92], probability value = 0.0256]. Regarding mode of delivery, the risk of developing delayed developmental milestones was less among infants born via caesarean section compared to those who were born via spontaneous vaginal delivery [adjusted risk ratio 0.47[0.18, 0.99], probability value = 0.0461].

Conclusion: Delayed developmental milestones are a burden in developing countries. The risk factors are known, and they are based on the individual to the community level; birth asphyxia was identified as a possible risk factor that has been reported in many studies and has an impact on children's development.

Perception of Health Workers on the Integration of Mental Health Care with HIV Services in Primary Health Care Centres in Ogun East Senatorial District, Nigeria: A qualitative study

2023-08-14T08:59:19+00:00

Background: People Living with HIV/AIDS have an increased incidence of mental health disorders as compared to the general population, and there exists an enormous gap between the demand and supply of mental health services, particularly in low- and middle-income countries.

Aim/Objective: This study aimed to assess the association between HIV and mental health and the knowledge and perception of health workers on their integration in Primary Health Care Services in Ogun East Senatorial District, Nigeria

Methodology: Four Focused Group Discussions were conducted among 27 PHC workers in Highly Active Antiretroviral Therapy (HAART)-enabled centres of Ogun East senatorial district, Nigeria using a focused group guide designed according to study objectives. Data were analyzed using a thematic analysis approach.

Result: Six important themes were extracted from the data in this study (Table 2); “Integration of PHC services”, “Multiple mental/psychological health challenges”, “Multiple factors as causes of mental illness”, “Diverse manifestations of mental illness”, “Necessity of incorporating HIV and Mental Healthcare into PHC services”, and “Challenges of incorporating HIV and Mental Healthcare into PHC services.”

Conclusion and Recommendation: The primary health workers identified the need to integrate mental health care into HIV care in PHCs. However, there is a need to scale up the capacity of PHCs for optimal performance in this regard.

Factors Affecting the Availability of Essential Health Commodities in Tanzania with a Special Focus on the Tracer Commodities

2023-07-26T11:30:30+00:00

Background: Access to essential health commodities is fundamental to healthcare system efficacy. These commodities are vital in delivering health services and form integral elements within the World Health Organization's strengthening framework, encompassing the six foundational building blocks. Regrettably, there has been a global increase in shortages and stockouts of essential health commodities in recent years.

Objective: The study aimed to identify factors influencing the availability of essential health commodities throughout all levels of the supply chain in Tanzania.

Methods: A cross-sectional that employed qualitative and quantitative data collection techniques. Quantitative data were analyzed using STATA version 16, while Qualitative data were thematically analyzed.

Results: Factors contributing to stockouts of essential commodities at the national level include increased demand, delayed shipments from donors, decreased funding commitments, delayed disbursement of funds, global shortages, inadequate governance, debt within the Medical Stores Department, donor dependency for vertical program commodities, and long lead times by Medical Stores Department suppliers. At the Regional and District levels, such factors include a shortage of human resources, lack of Electronic Medical Records, limited interoperability of information systems, poor quality of logistics data, inadequate use of data for decision-making, and poor inventory management. At the healthcare facility level, they include an overwhelming number of exempted clients, which reduces facility revenues.

Conclusion: More efforts are still needed to address both the upstream and downstream challenges needed to ensure sustainable access and availability of essential health commodities at service delivery points as a pathway for improving health sector performance.

Breastfeeding and non-nutritive sucking habits as covariates of malocclusion in the primary dentition among Tanzanian children: A cross-sectional study

2023-12-14T15:29:19+00:00

Introduction: Studies on the effect of feeding practices and sucking habits on malocclusion traits in the primary dentition of pre-schoolchildren from developing countries are scarce.

Purpose: Assessing the association of feeding and sucking habits with malocclusion traits, and the association of malocclusion traits with observed oral functional problems.

Methods: It was a cross-sectional survey of children aged 3-5 years residing in Kinondoni and Temeke Districts of Dar es Salaam region in Tanzania. Data was analyzed using Statistical Package for Social Scientists, SPSS version 21.0. Univariate analysis was applied to generate frequencies of different variables. Cross tabulations and Chi-square statistics were used to assess bivariate relationships and multivariate analyses were performed by multiple logistic regression.

Results: Most pre-schoolchildren (82.5%) were breastfed for less than two years. A history of non-nutritive sucking habits was reported in 28.1% of the children, mostly in boys than girls (33.6% versus 21.8%, respectively. The current non-nutritive sucking habits were reported in 17.8% of the participants. Overall, malocclusion traits were most significantly seen in children who were breastfed for less than two years, compared with those who were breastfed for two years or more (48.5% versus 27.3%, respectively). The presence of various malocclusion traits was significantly found among most of the children who had a history of non-nutritive sucking habits, compared with those who had never performed the habits (65.9% versus 38.6 %, respectively). In the logistic regression analyses, children who were breastfed for a shorter duration (<2 years), their probability of being found with different traits of malocclusion in the primary dentition was almost three times that for those who were breastfed for a longer duration (≥ two years). Also, children who were not actively performing non-nutritive sucking habits were less likely to have an open bite compared with those who were actively performing non-nutritive sucking habits. An open bite in children was significantly associated with speech problems (p<0.01) and swallowing with tongue thrusting (p=0.000).

Conclusion and recommendations: Most of the children who were breastfed for a shorter duration and children who had non-nutritive sucking habits were found with various malocclusion, compared with those who were breastfed for a longer duration and those who had no non-nutritive sucking habits. It is crucial to recommend exclusive breastfeeding for up to 6 months and continuation of breastfeeding practice, possibly for up to 2 years of age due to its nutritional, immunological, and stomato-gnathic system developmental benefits.

Metastatic patterns and hormone receptor status among breast cancer patients in Tanzania

2024-03-15T12:10:32+00:00

Introduction: Metastatic breast cancer is a common presentation in Tanzania. Estrogen-receptor (ER)-positive tumors are known to metastasize to the bones and require hormonal treatment as first-line therapy. Challenges with accessing immunohistochemistry services can delay information on breast cancer subtypes, further delaying treatment with effective hormonal therapy.

Objectives: This study aimed to assess the pattern of distribution of metastatic lesions in patients with metastatic breast cancer and evaluate its association with their hormone and HER-2 status, which could help provide recommendations on the use of front-line hormone therapy in areas where access to immunohistochemistry is a challenge.

Methods: A retrospective study covering histologically confirmed breast cancer patients in 2020 with metastatic lesions and complete medical records at Ocean Road Cancer Institute. Clinical information on the number, state and sites of metastasis, presence of symptoms and treatment received, and pathological variables, including histology, ER, PR and HER-2 status, were documented.

Results: Forty-nine (96.1%) of 51 patients analysed were female, with a mean age of 49.5 years. 47% presented with up-front metastatic disease. Lung was the most common metastatic site (76.5%) followed by bone/spine (53%). About half the patients had multiple sites involved. ER-positive tumors accounted for 47%, PR positive for 31% and HER-2 positive 39.2%. ER-positive tumors were more likely to present as a recurrence than up-front metastasis. ER-positive tumors were significantly more likely to be associated with bone and spine metastasis (59%) compared to ER-negative tumors (29%)

Conclusion: The clinical and pathological features of MBC in Tanzanian women are similar in many ways to those in other African regions. However, the ER positivity rate is lower. This study found a significant association between ER-positive tumours and skeletal metastasis, which has implications for the up-front treatment of these patients, especially where access to immunohistochemistry can be a challenge.

Dietary diversity and Anthropometric status of students at universities in Dodoma and Morogoro regions, Tanzania

2023-10-31T14:45:04+00:00

Background: Young adulthood is a transitional period that provides an opportunity to influence immediate and future eating behavior and good nutritional status. As diets evolve during young adulthood due to changes in circumstances and the introduction of new influences, young adults are a significant population group to influence future eating behaviours and prevent the development of NCDS. There is scanty information on the relationship between dietary diversity and the nutritional status of university students in Tanzania. This study aimed to find the synergy between university students' anthropometric status and dietary diversity in Morogoro and Dodoma regions of Tanzania.

Methods: This cross-sectional study involved 247 University students in Morogoro and Dodoma regions (130 from Mzumbe University and 117 from Saint John’s University) respectively. The two Universities were purposively selected from each region. Data on Dietary diversity was collected using food groups from DDS to obtain the dietary score of each student. Anthropometric measures such as weight, height and waist circumference were done to obtain the anthropometric status of the University students.

Results: The descriptive cross-sectional study involved 247 University students. In comparative chi-square analysis, the association was found among different socio-demographic characteristics of the University students. The p-value < 0.05 was used to determine the association among the variables.

Conclusion: In conclusion, university students are a vulnerable group in developing obesity/overweight due to the transitional stage. Being overweight and obese was associated with being female, increased age and being married. High dietary diversity was also linked with abdominal obesity. Factors that can help describe and understand the anthropometric status of university students have also been identified. These include years of study, religion, and university location. Therefore, efforts to adopt good lifestyle behaviours should be sensitized amongst this sub-population to reduce the risk of developing chronic diseases in the long run.

Complete genome sequences and multidrug resistance genotypes of nontuberculous mycobacteria isolates from the Central Tuberculosis Reference Laboratory Muhimbili Tanzania

2023-11-16T10:59:51+00:00

Background: Nontuberculous mycobacteria (NTM) usually comprise a group of environmental bacteria, with emerging but elusive coinfection with tuberculous mycobacteria, causing pulmonary tuberculosis. Whole genome sequencing may give insight into potential antimicrobial resistance genotypes, giving clinicians and policymakers proper directions in clinical applications and management regimens.

Methods: WGS was performed on twenty-four gDNA isolates from archival samples at the Central Tuberculosis Reference Laboratory using the MinION Oxford Nanopore Sequencing approach. Out of twenty-four, two were confirmed to belong to the NTM group. Further analysis was done to resolve the complete genomes of two nontuberculous mycobacteria strains isolated from tuberculosis patients. We then combined phylogenomics, reference-based scaffolding and average nucleotide identity (ANI) analysis to delineate each strain's taxonomic position and corresponding features.

Results: Our findings reveal that the two strains fit into the genus Mycolicibacterium, and the closest relative is Mycolicibacterium novocastrense. Coupling BacAnt and CARD-based antibiotic resistance analyses revealed multidrug-resistant genotypes of diverse spectra and mechanisms. While the BC02 strain is genetically resistant to beta-lactams, macrolides and rifamycins, the BC05 strain portrays an extended drug resistance genotype encompassing beta-lactams, macrolides, polyamines, and aminoglycosides. Both strains possess a single nucleotide polymorphism (SNP) of the RNA polymerase beta-subunit (rpoB), representing resistance to the first-line rifampicin. Additionally, the BC05 strain genetically portrays resistance to ethambutol, isoniazid and fosfomycin through mechanisms involving target alteration through SNPs, drug inactivation and efflux.

Conclusion: Our findings strongly suggest the potential implication of multidrug-resistant NTM clinical isolates in the pathogenesis of pulmonary tuberculosis.

COVID-19 vaccine hesitancy and associated factors among medical students in Tanzania: evidence from the Catholic University of Health and Allied Science, Mwanza region

2024-01-23T10:51:48+00:00

Background: Since the outbreak of COVID-19, the government of Tanzania has made efforts and initiatives to protect its citizens. These efforts and control measures are lined with WHO guidelines and the National response plan for controlling the COVID-19 outbreak. Unlike other control measures, the Vaccine remained a promised solution to end the COVID-19 pandemic. Therefore, this study aims to determine the COVID-19 hesitancy level and associated factors among medical students. Furthermore, it aims to provide valuable insights and information that can be applied in future immunization campaigns/strategies to improve vaccination rates among this particular group of future medical professionals during the pandemic.

Methods: This is an analytical cross-sectional survey conducted to assess the COVID-19 vaccine hesitancy and associated factors among 580 undergraduate medical students at the Catholic University of Health and Allied Science (CUHAS) in Mwanza region, Tanzania. Data was collected through a questionnaire and analyzed using STATA version 18.0 to extract descriptive and inferential statistics to determine the factors influencing COVID-19 vaccine hesitancy in this particular group of future medical professionals. All the statistics were obtained at a 5% significant level.

Results: The vaccine hesitancy was 75.6% (95% CI, 71.9%-79.2%). Thus, more than half of the medical student 54.3% do not trust the efficacy of the COVID-19 vaccine with AOR 2.96 (95% CI, 1.80-4.86, p-value<0.001); likewise, the safety of Vaccine AOR 0.1.89 (95% CI, 1.11-3.21, p-value=0.019). Further, students who do not prefer free riding (i.e., letting others get the vaccine and believing to get the beneficial effect of herd immunity without being vaccinated) were less likely to deny the Vaccine than those who prefer free riding AOR 0.31 (95% CI, 0.31, 0.13-0.75, p-value=0.009). Despite insignificant odds, too much politics behind the COVID-19 vaccine influences vaccine hesitancy with AOR 1.14 (95% CI, 0.61-2.15, p-value=0.676).

Conclusion: The study concludes that despite the efforts to communicate public health information to encourage people to overcome vaccine hesitancy and receive Vaccines, the reluctance to get vaccinated against COVID-19 remains higher than the acceptance rate among medical students.

Synergy and Antagonism in Antimalarial Crude Extract Combinations

2023-11-15T08:43:28+00:00

Background

Malaria accounts for around 4.8% of all recorded fatalities in Tanzania. Medicinal plants such as Caesalpinia bonducella, Azadirachta indica, and Annickia kummeriae have demonstrated promise in treating many diseases, including malaria. However, their combined activity against malaria has not been documented. Combination therapy using some medicinal plants with antimalarial activities may enhance safety and efficacy and reduce the evolution of parasite resistance.

Objectives

This study aimed to investigate antiplasmodium activities of different combinations of crude extracts from selected medicinal plants. Azadirachta indica leaves, Annickia kummeriae and Caesalpinia bonducella were extracted using dichloromethane (DCM).

Methods

An in vivo acute toxicity study of both individual and combined crude extracts was carried out according to Chinedu et al., 2015. The in vivo antiplasmodial activity of individual and combined crude extracts was performed in mice inoculated with Plasmodium berghei (ANKA strain) using Peters’s 4-day suppressive test.

Results

Individually, Caesalpinia bonducella crude extracts exhibited the highest in vivo antiplasmodial efficacy (91% parasite suppression) than A. kummeriae (73% parasite suppression) and A. indica (60% parasite suppression) at 800 mg/kg/day. The A. indica and A. summarize combinations and A. indica and C. bonducella demonstrated higher antiplasmodial activity (synergism-combination index 0.29 and 0.97, respectively) than their constituents. However, combining A. kummeriae and C. bonducella produced the lowest antiplasmodial activity (antagonism- combination index 40.67) than its extracts. The high antiplasmodial potencies (ED₅₀) demonstrated by AiAk and AiCb are significant and critical results for traditional, complementary and alternative medicine.

Conclusion

Therefore, these preliminary findings suggest that AiAk and AiCb are potential antiplasmodium herbal therapies. Further research should be undertaken to investigate the antiplasmodium effect of AiAk and AiCb in humans.

Factors Associated with Anthropometric Status of Primary School Children in Dodoma, Tanzania

2023-09-13T13:04:17+00:00

Background: Malnutrition in school-age children significantly affects their health, cognitive development, and educational attainment. This study aimed to assess the nutritional status of school-age children and the influence of socioeconomic, demographic, and environmental factors on their nutritional well-being. This study focused on primary focus was on primary school children in Dodoma. sought to identify children who could be at risk of malnutrition. The study intended to establish baseline data regarding the nutritional status of school children that could contribute to a comprehensive understanding of the nutritional landscape among primary school children in the region. This information could subsequently inform nutritionists and policymakers to plan interventions to improve these children's nutritional status.

Methods: A cross-sectional study involving 248 pupils was conducted in eight primary schools in Dodoma. Four schools were selected from Chamwino and Dodoma urban districts, respectively, whereby two government schools and two private schools were selected from each district. The other four schools were situated in the urban district of Dodoma, comprising two government and two private schools. The study assessed the prevalence of stunting, wasting/thinness, underweight, and overweight/obesity among primary school children. Stunting was characterized by impaired growth and development with low height for age, while underweight was defined as low weight relative to age. Wasting/thinness refers to insufficient flesh, with body weight falling below skeletal and physical standards. Overweight/obese indicates excessive fat tissue accumulation that could impact health. Data were analyzed using the WHO AnthroPlus v1.0.4 software and SPSS v26 software for Windows.

Results: Prevalence rates among the surveyed pupils were as follows: stunting (10.5%), underweight (3.6%), thinness (2.8%), and overweight/obesity (10.1%). Stunting was more prevalent in boys (13.2%) than in girls (8.2%), and it exhibited an upward trend with increasing age. The prevalence of underweight was higher in public schools (8.2%) compared to private schools (3.2%). Thinness was more common in public schools (85.7%) compared to private schools (14.3%) and was more prevalent in rural areas (57.1%) and among younger children (57.1%). Overweight/obesity was more prevalent among girls (91.0%) compared to boys (88.6%). Schools in urban areas showed a higher prevalence of overweight/obesity (90.3%) than those in rural areas (89.5%). Private schools (95.2%) had a higher prevalence of overweight/obese pupils compared to public schools (84.7%). Pupils residing in urban areas were more likely to become overweight/obese compared to their counterparts living in rural settings.

Conclusion: Significant rates of stunting, thinness, underweight, and overweight/obesity were observed among primary schoolchildren in Dodoma, Tanzania. These findings underlined the necessity to enhance nutrition interventions to improve the nutritional status of both public and private primary school pupils in Tanzania.

Seroprevalence of Syphilis among Pregnant Women Attending Antenatal Care in Yaqshiid District, Mogadishu, Somalia

2023-10-17T07:54:59+00:00

Background: The prevalence of syphilis among pregnant women in Somalia has been poorly studied, despite its significant impact on maternal and fetal health. In Somalia, the last syphilis study was conducted approximately 30 years ago, leaving a critical knowledge gap regarding the current epidemic of syphilis among pregnant women.

Materials and methods: From January 2023 to April 2023, a hospital-based cross-sectional study was conducted on maternal and child health. A total of 300 pregnant women were included in the study, and the seroprevalence of syphilis was determined using the Venereal Disease Research Laboratory. This one-step quick diagnostic test cassette was used as the preliminary screening tool, and Positive results were confirmed using the full chemiluminescence immunoassay (CLIA) analyzer MAGLUMI. A structured questionnaire was used to collect demographic characteristics and knowledge regarding syphilis transmission and mother-to-child transmission. SPSS Version 27.0 was used to analyze the gathered data. Statistical significance was set at p < 0.05.

Results: Overall, 5.3% (16/300) of pregnant women had syphilis seroprevalence. Seroprevalence rates were higher in women aged 24-34 (50.0%). There were significant relationships between syphilis infection and education (p < 0.000), occupation (p < 0.000), and residence (p = 0.002). Furthermore, a significant majority of pregnant women (78%) were unaware of syphilis transmission routes and its correlation to HIV risk (81.7%). Stillbirths constituted 23.3% of pregnancy-related problems, whereas 17% of pregnant women had a prior record of blood transfusions.

Conclusions: The study found an alarming syphilis seroprevalence in pregnant women, especially in certain demographic groups. The lack of knowledge of syphilis transmission and its effects highlights the necessity for targeted education. Improved prenatal care, health awareness, and effective prevention should lessen the effects of syphilis on mother and newborn health.