bluuebunny/crossref_metadata_2025 huggingface dataset:
Postoperative nausea and vomiting at a tertiary care hospital in north-western Tanzania
Authors: Chalya Phillipo L. , Mhewa Onesmo Z. , Mabula Joseph B.
Published: June 2021

Background: Postoperative nausea and vomiting is one of the most distressing morbidities associated with surgery. This descriptive prospective study was conducted to determine the incidence, predictors and management of postoperative nausea and vomiting among patients attending a tertiary hospital in north-western Tanzania.Methods: The study was conducted in the surgical wards and intensive care unit of Bugando Medical Centre in Mwanza, Tanzania between January 2013 and December 2013. The study population included adult patients aged ≥18 years, classified as ASA I and who were scheduled for elective surgeries under general or region anaesthesia. Patients were assessed preoperatively, intraoperatively and postoperatively.  A questionnaire was administered to each patient in order to collect the information on demographic characteristics, estimated patient’s body mass index, smoking  status, prior history of motion sickness or post-operative nausea and vomiting (PONV), type and duration of surgery/anaesthesia, intraoperative pethidine use, postoperative pain and timing of oral intake.Results: A total of 348 patients (age=18-76 years) were included in the study. The male to female ratio was 1.4: 1. The incidence of postoperative nausea and vomiting was 41.4%. Age group 21-30, female gender, history of PONV, general anaesthesia and intraoperative pethidine were the main predictors of PONV (p < 0.001). Only forty-five (31.3%) out of the 144 patients who reported their episodes of PONV received any medications.Conclusion: The incidence of PONV among surgical patients at Bugando Medical Centre is unacceptably high and the predictors of postoperative nausea and vomiting within 24 hours included being a young adult, female, having history of PONV, been under general anaesthesia and intraoperative pethidine. It is recommended that patients with increased likelihood of developing postoperative nausea and vomiting should be given anti-emetic prophylaxis and other preventive measures.
Access to child health services in Orumba North Local Government Area of Anambra State, Nigeria
Authors: Igwe Ijeoma , I'Aronu Ngozi , Onyeneho Nkechi G.
Published: June 2021

Background: As the world transits from the era of millennium development goals to that of sustainable development goals, an examination of the access to primary health care services in the previous era is germane to adequate planning and delivery of effective service in the emerging era. The objective of this study was determine factors associated with the use of primary health care (PHC) facilities for the health needs of children in Anambra State, NigeriaMethods: A cross sectional survey of 600 randomly selected mothers (15-49 years) was conducted in Orumba North local government area of Anambra State. An interviewer-based questionnaire, designed to provide information on the socio-demographic characteristics of the respondents as well as their child rearing experiences was used. The questionnaire also provided data on the women’s use of immunization services. The perceptions on government health services were also examined to understand how they influence compliance.Results: More of non-demographic attributes like the mothers’ perceptions and past experiences with the health services influenced utilization more than the demographic attributes. Satisfactory experiences with health service influenced utilization (χ2=168.478; p<0.001).  Those with good perception (95.4%) used the PHC facilities more (χ2=198.032; p<0.001).Conclusion: Irrespective of the socio-demographic backgrounds of the mothers, they all have feelings and react to situations they encounter daily. There is need to improve the experiences mothers get from encounter with the PHC facilities so as to improve on the perception and increase use of the facilities.
Blood utilization in elective surgery in a tertiary hospital in Dar es Salaam, Tanzania
Authors: Akoko Larry O. , Joseph Alex B.
Published: June 2021

Background: There has been an observation of blood being unnecessarily requested even for surgeries that will not require transfusion. Furthermore, some patients have been denied surgery due to lack of blood causing surgical list disruptions and inconveniency to patients and their families. This study was carried out to determine the status of blood utilization practices at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania.Methods: A descriptive cross-sectional study was carried out for a period of eight months. Data on blood requisition and usage was collected on a structured questionnaire, and analyzed for Cross-match to Transfusion (C/T) ratio, Transfusion probability (%T), and Transfusion Index (TI). For those procedures that showed more than two indices to be significant, a Maximum Surgical Blood ordering Schedule MSBOS was proposed.Results: Blood was over ordered for 76% of the patients while over eight percent of the patients had haemoglobin levels over 10g/dl. Only amputation, laparotomy for malignancies, pneumonenctomy, and bowel resection for malignancy had at least two of the transfusion indices showing significant blood utilization for general surgery cases.  For urological cases, only Cystectomy for bladder cancer and nephrectomy had at least two of the indices showing significant blood utilization. In the remaining cases, blood utilization was inefficient suggesting cross-matching of blood was unnecessary, which resulted in loss of nearly 73% of technician’s working hours and USD 425 for the study period.Conclusion: There is existence of over ordering of blood in this hospital. Blood ordering practices needs to be reviewed to minimize over ordering of blood. All the three indices showed inefficient use of blood in most of the operations. But even so, utilization can still be improved in some of the operations which showed significant utilization.
Risk factors associated with pre-term birth in Dar es Salaam, Tanzania: a case-control study
Authors: Mahapula Fanaka A. , Kumpuni Kitindi , Mlay Joyce P. , Mrema Theresia F.
Published: June 2021

Background: Preterm birth remains one of the most serious problems in obstetrics care. Its aetiology is complex and multifactorial. This study was carried out to determine risk factors for preterm birth in Dar es Salaam City in Tanzania.Methods: This case-control study was conducted in three municipal hospitals namely, Amani, Mwananyamala and Temeke in Dar es Salaam. It involved 377 pairs of women with preterm birth (cases) and term birth (controls). Eligible women who agreed to participate and who signed the consent form completed a short interview regarding demographic and lifestyle factors, had their baby examined for maturity, and had their medical records abstracted. All cases and controls were interviewed face-to-face using a specially designed questionnaire. Multivariate logistic regression after controlling for potential confounders was used to measure the strength of associations between preterm birth and related factors.Results: Several significant risk factors associations with pre-term birth were multiple pregnancies (AOR = 8.6; 95%CI 4.5-16.5; p-value <0.001), untreated vaginal discharge (AOR = 5.2; 95%CI 1.1-24.4; p-value 0.034), public prenatal care (AOR = 2.1; 95%CI 1.1-4.1; p-value 0.017), untreated urinary tract infection (AOR = 2.7; 95%CI 1.2-6.1; p-value 0.016), complication during pregnancy (AOR = 2.7; 95%CI 1.3-5.3; p-value 0.004), cervical incompetence (AOR = 11.6; 95%CI 1.1-121.5; p-value 0.04), polyhydramnios (AOR = 8.3; 95%CI 1.7-40.2; p-value 0.008), and lack of antenatal visits  (AOR = 5.1; 95%CI 1.4-17.8; p-value 0.042).Conclusion: This study has identified several risk factors for preterm birth in the city of Dar es Salaam. It is important that planners design community-based interventions to address complications from preterm birth.
Health care worker’s perception about the quality of health care at the outpatient department in Mwananyamala Hospital in Dar es Salaam, Tanzania
Authors: Khamis Kudra , Njau Bernard
Published: June 2021

Background: Quality of care is a complex issue influenced by many factors. It is fundamental in assessing health care delivery in health facilities in developing countries. Health care workers’ perceptions help policy makers and planners to identify bottlenecks in the system to improve utilisation and sustainability of health care services in the population. The objective of this study was to explore health care workers’ perception about the quality of health care delivered at the outpatient department in Mwananyamala Hospital in Dar es Salaam, Tanzania.  Methods: A cross-sectional qualitative study was conducted from April to May 2013.  Results: Health care workers’ mentioned extrinsic as well as intrinsic factors, which may influence the quality of health care services. Extrinsic factors included poor physical infrastructure, unavailability of medical equipment and/or essential drugs and poor staffing levels. Intrinsic factors mentioned were motivation for health care workers and workplace training opportunities.Conclusion: Multiple factors influencing perceived quality of health care Mwananyamala hospital have been identified to include physical infrastructure, availability of medical equipment and essential medicines, staffing levels, remuneration and promotion.
Prevalence of Schistosoma mansoni and soil transmitted helminths and factors associated with uptake of preventive chemotherapy among school children in Sengerema District in north-western Tanzania
Authors: Bukindu Florah , Morona Domenica , Mazigo Humphrey D.
Published: June 2021

Background: The control of intestinal schistosomiasis and soil transmitted helminths (STH) in Tanzania focuses on reducing morbidities through the treatment of infected and at risk populations, especially schoolchildren with praziquantel (PZQ) and albendazole (ALB). However, in some areas, the uptake of interventions is low. The objective of this study was to determine factors associated with the uptake of preventive chemotherapy and, secondarily, the prevalence of Schistosoma mansoni and soil-transmitted helminths' infections in Sengerema District of north western Tanzania.Methods: This cross-sectional study was conducted among 625 randomly selected school children aged 8-18 years from Sengerema district. A questionnaire was used to collect information on the reported uptake of PZQ/ALB. Single stool samples were collected, processed and examined for the presence of eggs pf S. mansoni and soil-transmitted helminths using Kato Katz technique.Results: The self-reported uptake of preventive chemotherapy was 95.6% (95%CI; 92.78-98.49). Provision of food (AOR= 25.25, 95%CI: 5.28-120.49, p<0.001) and information about the anti-helminthic drug prior to taking it (AOR =14.24, 95%CI: 3.23-62.72, p<0.001) were associated with a high reported uptake of preventive chemotherapy. The overall prevalence of S. mansoni and geometrical mean of eggs per gram (EPG) of faeces were 36.64% (95%CI: 21.55 -62.29) and 229.47 EPG (202.73-259.86). The prevalence of STH was 10.88% (95%CI; 7.52-15.75).Conclusion: The high reported uptake of preventive chemotherapy was associated with provision of food and information about the drugs prior to their administration. However, S. mansoni and soil-transmitted infections are still a public health concern in the study area. Integrating health education in mass drug administration campaigns will allow provision of other complementary public preventive measures to reduce the burden of these infections.
Accessibility of services for early infant diagnosis of Human Immunodeficiency Virus in sub-Saharan Africa: a systematic review
Authors: Bwana Veneranda M. , Frimpong Christiana , Simulundu Edgar , Mfinanga Sayoki G. , Mboera Leonard E.G. , Michelo Charles
Published: June 2021

Background: Early Infant Diagnosis (EID) of Human Immunodeficiency Virus (HIV) is one of the major interventions for HIV and AIDS in sub-Saharan Africa. However, the coverage is still lower than the recommended levels. The objective of this review was to systematically assess factors associated with accessibility of EID services in sub-Saharan Africa.Methods: Scientific engines were searched from library catalogues and public databases. The review included free full text articles in English published from 1996 to 2015 and fitting to the objectives of the study.Results: A total of 1,039,715 results appeared on the databases after initial searching. Of these, 48 eligible articles were identified and reviewed. From 2004 to 2014, the proportion of HIV exposed infants who received a virological test within the first 2 months of life in sub-Saharan Africa varied from 3 to 58%, far below the 80% recommended level by the World Health Organization. EID services were not available in more than 30% of health facilities in most sub-Saharan African countries. Factors associated with accessibility of EID services included parents with low formal education level, maternal unemployment, geographical relocation, religious beliefs, lack of paternal support, insufficient awareness of HIV control and prevention services, poor compliance to prevention of mother to child transmission services, lack of general knowledge of HIV transmission, stigma and discrimination, inadequate human resource for health, weak infrastructure, inadequate supplies of laboratory materials and late feedback of HIV test results.Conclusion: Availability and accessibility of EID services in sub-Saharan Africa is still low despite the investment made during the past decade. Both individual and institutional factors affect the availability and accessibility of the services. It is important that these factors are urgently addressed to improve EID services.
Knowledge, attitudes and practices of parents on child sexual abuse and its prevention in Shinyanga district, Tanzania
Authors: Mlekwa Fredrick M. , Nyamhanga Tumaini , Chalya Phillipo L. , Urassa David
Published: June 2021

Background: The role of parents in preventing child sexual abuse in the community in low-and-middle income countries has not been adequately emphasized. The objective of this study was to assess parents’ knowledge, attitudes and practices on child sexual abuse and its prevention in Shinyanga district, Tanzania in order to strengthen child protection.  Methods: This was a cross-sectional study conducted during July 2015. Multistage cluster sampling technique was employed to obtain study participants from a list of sampling frame. Parents with children below 18 years old were randomly selected to form a study population. A quantitative technique using structured questions was used to assess parents’ knowledge, attitude and practices about preventing child sexual abuse.Results: A total of 384 respondents were included in the study. The majority (95.6%) of respondents had high knowledge regarding prevention of child sexual abuse.  Majority (98.7%) of the respondents had positive attitudes on preventing child sexual abuse. However, only about a quarter (27.3%) of respondents had good practices on protection and prevention of child sexual abuse.Conclusion: Knowledge and attitudes of parents on child sexual abuse prevention was high in the study area.  However, the practices of parents on child sexual abuse prevention were poor. Therefore, a public education programme is needed for parents, with the ultimate aim of protecting children from the preventable harm and trauma of sexual abuse in rural communities of Tanzania.
Prevalent use of herbs for reduction of labour duration in Mwanza, Tanzania: are obstetricians aware?
Authors: Dika Haruna I. , Dismas Mauki , Iddi Shabani , Rumanyika Richard
Published: June 2021

Background: The use of herbs during pregnancy and labour is rapidly increasing because the herbs are considered to be natural and therefore free of risks.  Despite of this perception, a number of herbs have been reported to have negative effects to the new-borns and the mothers.  Therefore, this study aimed to determine the prevalence and factors associated with the use of herbs during labour among women in Mwanza, Tanzania.Methods: The study involved women who delivered at Bugando Medical Centre and Sekou Toure Hospital in Mwanza, north-western Tanzania. Data were collected using questionnaires.  Comparison of prevalence of herb use by various factors was done. Results: A total of 178 women were involved in the study. The mean age of participants was 26.6 ± 5.4 years. The prevalence of herb use was found to be 23.0%. The use of herbs was significantly associated with marital status (p = 0.011) and the use during previous deliveries (p = 0.000).Conclusion: The study findings signify that, about a quarter of women in Mwanza use herbs during childbirth and the use encourages recurrent use of these herbs in subsequent pregnancies. A large scale survey is recommended to determine the extent of use of traditional herbs during pregnancy and childbirth countrywide. Studies to determine the toxic profile of the herbs which are used are also needed so as to address the matter to the community.
Malaria surveillance and use of evidence in planning and decision making in Kilosa District, Tanzania
Authors: Mboera Leonard E.G. , Rumisha Susan F. , Mlacha Tabitha , Mayala Benjamin K. , Bwana Veneranda M. , Shayo Elizabeth H.
Published: June 2021

Background: Since 2001, Tanzania has been making concerted efforts to strengthen its Integrated Disease Surveillance and Response system. In this system, malaria is one of the priority diseases that are to be reported monthly. The objectives of this study were to (i) assess malaria surveillance system at facility and district levels to identify key barriers, constraints and priority actions for malaria surveillance strengthening; and (ii) to explore the use of evidence in health planning and decision making at these levels.Methods: The study was carried in Kilosa District in central Tanzania, during October 2012 and involved health facility workers and members of the district health management team. The existing information system on malaria was evaluated using a structured questionnaire and check list. Data collection also involved direct observations of reporting and processing, assessment of report forms and reports of processed data.Results: Three district officials and 17 health facility workers from both public and private health facilities were interviewed. Of the 17 informants, 15 were familiar with disease surveillance functions. A good percentage (47%, 8/17) received training on disease surveillance during the previous two years. Public transport and motorcycles were the main means of reporting epidemiological information from facility to district level. Most of the health facilities (93%, 14/15) faced difficulties in submitting reports due to lack of resources and feedback from the district authority. Analysis of malaria data was reported in 52.9% (9/17) of the facilities, but limited to malaria incidence per age groups. Challenges in data analysis included unavailability of compilation books; lack of computers; poor data storage; incomplete recording; lack of adequate skills for data analysis; and increase in workloads. Data at both facility and district levels were mainly used for quantification and forecasting of drug requirements.Conclusion: Malaria surveillance system in Kilosa district is weak and utilization of evidence for planning and decision making is poor. Capacity strengthening on data analysis and utilization should be given a priority at both facility and district levels of the health systems in Tanzania.
Life threatening arrhythmias: Knowledge and skills among nurses working in critical care settings at Muhimbili National Hospital, Dar es Salaam, Tanzania
Authors: Ruhwanya Dinnah I. , Tarimo Edith A.M. , Ndile Menti
Published: June 2021

Introduction: A life threatening arrhythmia is a medical condition that requires immediate intervention, or it can cost a patient’s life. However, there is limited understanding of nurses’ knowledge and skills in identification and care provided to patients with life threatening arrhythmias in Tanzania.  The objective of this study was to assess knowledge and skills of nurses in identifying life threatening arrhythmias and the required patient care.Methods: A descriptive cross-sectional study was conducted to assess the knowledge and skill level of nurses in identification of life threatening arrhythmias and the required patient care, as well as exploring the barriers in acquiring and implementing particular knowledge and skills. A convenient sample of 141 nurses working in critical care areas at Muhimbili National Hospital, were recruited.Results: The majority (44%) of the participants were 31-40 years old and more than three quarters were females. The majority (60%) scored highly when tested about their knowledge of life threatening arrhythmia identification. However, the majority of nurses (84.4%) scored poorly when being observed on their skills. A total of 116 (82.3%) nurses were able to identify asystole on an electrocardiogram strip, and demonstrated a high level of knowledge (95%) in the nursing care of patients in asystole. Although they demonstrated poor skills in general, nurses were competent (97.9%) in electrode placement on the patient’s chest before connecting the patient to the cardiac monitor. The overwhelming workload was identified by many (68.8%) as the major barrier in acquiring and implementing knowledge and skills.Conclusion: Although the majority of the participants scored highly in their level of knowledge regarding life threatening arrhythmias, they scored poorly in most of the observed skills when identifying and treating this patient group. It is important that hospital administration take into consideration the identified areas of deficiency and work to improve the skills among nurses and enhance optimal care of patients.
Impact of asymptomatic Plasmodium falciparum on haematological parameters of pregnant women at first antenatal visit in South-western Nigeria
Authors: Obebe Oluwasola O. , Falohun Olufarati O. , Olajuyigbe Olaitan O. , Lawani Mike A. , Ajayi Olubunmi A.
Published: June 2021

Background: Pregnant women in malaria-endemic areas are at high risk of Plasmodium falciparum infection and its complications. This study investigated the impact of asymptomatic P. falciparum on haematological parameters of pregnant women at first antenatal visit in south-western Nigeria.Methods: Hospital-based cross-sectional evaluation of 130 asymptomatic pregnant women was conducted. Plasmodium infection was diagnosed using Giemsa-stained blood smear microscopy and rapid diagnostic test, while haemoglobin levels (Hb), Packed Cell Volume (PCV), white blood cells (WBC) count, red blood cell (RBC), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC) were determined using semi-automated haematology analyser.Results: Multigravid pregnant women presented more during their second trimester. Overall malaria prevalence in the sampled population was 14.6%. Prevalence of malaria parasitaemia was highest (68.4%) in the second trimester. P. falciparum infected pregnant women had significantly lower mean values of packed cell volume (PCV), haematocrit (Hb), and total white blood cell (WBC) compared to non-infected  individuals  (t = -4.07, p= 0.001; t = 3.30, p = <0.001; t = -2.77, p <0.001).Conclusion: There is asymptomatic P. falciparum infection in the study area and this may form a reservoir for transmission. Pregnant women infected with malaria parasites exhibited important changes in haematocrit level, haemoglobin concentration, and total white blood cells. Use of anti-malaria therapy and insecticide-treated bed net would result in greater haematological benefits.
Development partner support to the health sector at the local level in Morogoro region, Tanzania
Authors: Frumence Gasto M. , Chebet Joy , Callaghan-Koru Jennifer A. , Mosha Idda , Chitama Dereck , Killewo Japhet , Winch Peter
Published: June 2021

Background: The Tanzanian health sector receives large amounts of funding from multiple international development partners to support a broad range of population-health interventions. However, little is known about the partners’ level of commitment to sustain funding, and the implications of uncertainties created by these funding mechanisms.  This study had the following objectives: 1) To present a theoretical model for assessing funding commitments by health development partners in a specified region; 2) to describe development partner funding commitments against this framework, using a case study example of Morogoro Region, Tanzania; and 3) to discuss policy considerations using this framework for district, regional and national level.Methods: Qualitative case study methodology was used to assess funding commitments of health-related development partners in Morogoro Region, Tanzania. Using qualitative data, collected as part of an evaluation of maternal and child health programs in Morogoro Region, key informants from all development partners were interviewed and thematic analysis was conducted for the assessment. Results: Our findings show that decisions made on where to commit and direct funds were based on recipient government and development partner priorities. These decisions were based on government directives, such as the need to provide health services to vulnerable populations; the need to contribute towards alleviation of disease burden and development partner interests, including humanitarian concerns. Poor coordination of partner organizations and their funding priorities may undermine benefits to target populations. This weakness poses a major challenge on development partner investments in health, leading to duplication of efforts and resulting in stagnant disease burden levels.Conclusion: Effective coordination mechanisms between all stakeholders at each level should be advocated to provide a forum to discuss interests and priorities, so as to harmonize them and facilitate the implementation of development partner funded activities in the recipient countries.
Attendance of male partners to different reproductive health services in Shinyanga District, North western Tanzania
Authors: Chibwae Alfred , Kapesa Anthony , Jahanpour Ola , Seni Jeremiah , Basinda Namanya , Kadelya Emmanuel , Konje Evelyne , Nyanza Elias Charles , Ngallaba Sospatro , Dewey Deborah
Published: June 2021

Background: Male involvement in reproductive health (RH) services in Africa has been associated with improved maternal and child health outcomes. The objective of this study was to determine the prevalence and factors affecting male partner attendance to available reproductive health services in Shinyanga district, north-western Tanzania.Methods: A house to house survey using a structured questionnaire was conducted among randomly selected married men. Additional in-depth interviews were conducted among married men found attending RH services. Factors that motivates the uptake of locally available RH services together with their partners were explored.Results: A total of 204 men participated in the study, 94.4 % (193/204) of them reported to have ever attended the RH service with their female partners at least once whereas 50.6% (103/204) of them attended at least thrice. Three quarters (154/204) attended HIV counselling and testing (VCT) and 63% (129/204) attended antenatal services (ANC). Reported attendance to sexually transmitted infections (STIs/STDs), prevention of HIV transmission from mother to child (PMTCT), and reproductive health cancer services were all less than 13%.  The male partners age group (25-34 years; χ2=9.347, df =3 p-value < 0.001), female partner invitation to HR services (χ2= 29.901, df=1, p-value <0.001) and having less than 2 children (χ2= 6.201, df= 2, p-value < 0.05) were associated with higher RH service attendance. Only 20% (4/20) of married men attended RH because they expected better health outcomes in their presence whilst majority attended because they were summoned or just happen to be at the clinic for other purposes.Conclusion: The male attendance to RH services together with their female partners’ in rural Shinyanga was mainly focused ANC and VCT. Most of men attended because were verbally invited by their partners. Education on couple communication empowerment among women attending RH clinics could sustainably improve attendance to all RH services.
Diagnostic utility of abdominal ultrasound in the evaluation of abdomino-pelvic lesions at Bugando Medical Centre in Mwanza, Tanzania
Authors: Binde Mohamed S. , Kasanga Godrey , Chalya Phillipo L. , Mahalu William
Published: June 2021

Background: Despite the fact that abdominal ultrasound has been widely used in many centres in Tanzania as a primary diagnostic imaging for patients with abdomino-pelvic lesions, its diagnostic utility has not yet been assessed in Tanzania, and therefore its use as an alternative diagnostic tool in patients with abdomino-pelvic lesions is not justified. This study aimed to determine the utility of abdominal ultrasound in the diagnosis of abdomino-pelvic lesions in our local setting.Methods: This was a cross sectional study to evaluate the diagnostic utility of abdominal ultrasound in patients presenting with abdomino-pelvic lesions at Bugando Medical Centre between January 2017 and July 2017. Abdominal ultrasonographic findings were cross-tabulated against operative findings (the gold standard). Then, the sensitivity, specificity, accuracy, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracy were calculated to determine the diagnostic utility of abdominal ultrasound.Results: A total of 146 patients (M: F ratio = 1: 2.2) were studied. The mean age at diagnosis was 39.3 years. The diagnostic utility of abdominal ultrasound in terms of sensitivity, specificity, PPV, NPV and accuracy were 39.4-100%, 0-100%, 64.7-100%, 0-100% and 40.8-100% respectively.  The kappa statistic (қ) showed good to excellent agreement with the operative findings, the gold standard (қ = 0.75-1.00).Conclusion: The diagnostic utility of abdominal ultrasound in detecting abdomino-pelvic lesions is much lower than that seen in developed countries, hence, abdominal ultrasound is not a reliable tool in detecting abdomino-pelvic lesions at Bugando Medical Centre and therefore its use should be supplemented with abdominal CT scan in selected cases.
Serological evidence of chikungunya and malaria co-infection among febrile patients seeking health care in Karagwe district, Tanzania
Authors: Kinimi Edson , Patrick Bisimwa N. , Misinzo Gerald
Published: June 2021

Background: Chikungunya is an emerging mosquito-borne viral illness of major public health concern and is becoming a common infection in many geographical areas of Tanzania. This study was carried out to determine the incidence of malaria and chikungunya infections among febrile patients seeking medical care in Karagwe district, Tanzania.Methods: Febrile patients were enrolled into the study at Nyakahanga district designated hospital and Kayanga heath centre in May and June 2015. Questionnaires were administered to collect clinical and socio-demographic characteristics of patients. All participants were tested for malaria using malarial rapid diagnostic test and those tested positive by mRDT were confirmed by microscopy. Both outpatients tested malaria positive and negative were further screened for immunoglobulin M (IgM) and G (IgG) antibodies for chikungunya using enzyme-linked immunosorbent assay.Results: A total of 400 febrile patients were enrolled in the study. Out of 400 febrile outpatients tested for malaria, 116 (28.75%) tested positive with mRDT. Microscopy confirmed presence malaria parasites in 112 (96.55%) of the malaria RDT-positive. The overall seroprevalence of chikungunya infection was 24.25% (97/400). Out of those chikungunya seropositive subjects, 89 (91.75%) had no malaria. Co-infection rate of chikungunya and malaria was found to be 7.14% (8/112).Conclusions: Our findings confirmed the existence of chikungunya and malaria co-infection among febrile patients seeking health care in Karagwe district. Chikungunya should be considered in the differential diagnosis of malaria for appropriate case management and in order to monitor the public health burden and to inform possible preventative and control measures.
Aetiological spectrum, injury characteristics and treatment outcome of multiple injuries at a tertiary care hospital in Tanzania
Authors: Issa Abdul , Mbelenge Nkinda , Chalya Phillipo L. , Gilyoma Japhet M.
Published: June 2021

Background: Multiple injuries constitute a public health problem and contribute significantly to high morbidity, mortality and long-term disabilities worldwide. This study describes the etiological spectrum, injury characteristics and treatment outcome of multiple injuries at a tertiary care hospital in Tanzania.Methods: This was a descriptive prospective study involving multiple injury patients admitted to Bugando Medical Centre (BMC) from March 2013 to June 2013 inclusive.Results: Out of 712 trauma patients who were admitted to BMC during the study period, 150 (21.1%) had multiple injuries. Their male to female ratio was of 2.3:1. The majority of patients were in the second decade of life. Road traffic accidents (RTAs) were the most common (93.3%) cause of injury. The majority of patients, 142 (94.7%) sustained blunt injuries. Twelve (8.0%) patients had pre-hospital care. The limbs (89.2%) and the head (78.7%) were the most common body regions injured. The majority of patients (85.3%) sustained severe injuries (ISS ≥ 16). Out of 150 patients, 46 (30.7%) had 65 missed injuries. A total of 142 (94.7%) patients were treated surgically. Wound debridement (87.3%) was the most common surgical procedure performed. The complication and mortality rates were 54.7% and 38.7%, respectively. The overall median length of hospital stay (LOS) was 23 days. Co-morbid illness, HIV positivity, CD4 count (≤ 200 cells/μl), severe trauma (ISS ≥ 16), admission Systolic Blood Pressure < 90 mmHg, missed injuries and surgical site infection significantly influenced mortality (P < 0.001). Patients who developed complications and those who had long bone fractures stayed longer in the hospital (p < 0.001).Conclusion: Road traffic accidents remain a major cause of multiple injuries at BMC and contribute significantly to unacceptably high morbidity and mortality. Urgent preventive measures targeting at reducing the occurrence of road traffic accidents is necessary to reduce the incidence of multiple injuries in our centre.
Evaluation of the wound healing activity of formulated ointments and water preparation from Sida rhombifolia leaf extract
Authors: Francis Patrick , Masimba Pax J. , Mwakigonja Amos R.
Published: June 2021

Background: Several plants including Sida rhombifolia Linn. (Malvaceae) which are said to be used by traditional health practitioners in Tanzania for wound treatment have not yet been evaluated. The objective of this study was to investigate the ointment formulation of S. rhombifolia leaves for its potential wound healing activities.Methods: Wound healing activity of S. rhombifolia leaves was investigated in mice using 50%, 33% and 25% formulated 80% ethanolic leaves extract ointment and water preparations. Excisional and incisional wound-induction models were used with 6 albino mice in each group. The wound diameter (for contraction assessment), duration of re-epithelisation in days, percentage tensile strength as well as the degree of collagenisation and fibrosis were investigated.Results: S. rhombifolia leaves extract had significant mean percentage wound closure for all ointment formulations used and for the water preparation from day 7. A significant percentage tensile strength on day 10 for all formulations used was observed. The 50% ointment had a mean of 64.1±1.7 (p=1.2-09), 33% ointment had a mean of 64.0±3.2 (p=2.4-08) and the 25% ointment had a mean of 53.1±4.0 (p=1.3-06). A remarkable fibrosis and collagenisation for the 50% ointment and the water preparation was observed.Conclusion: The formulated ointments and the water preparations of S. rhombifolia leaves have a potential benefit in enhancing wound healing. A bioassay guided fractionation is recommended to allow identification of its active compound(s) with wound healing activity for drug development.
Prevalence of asymptomatic malaria infections in selected military camps in Tanzania
Authors: Kalinga Akili , Kavishe Reginald A. , Ishengoma Deus S , Kagaruki Gibson , Mweya Clement , Mgata Saidi , Mahikwano Lucas , Mwanziva Charles , Kamau Edwin , Hickman Mark , Waters Norman , Kreishman-Deitrick Mara , Temu Lucky , Chiduo Sarah , Mswanya Christopher , Amoo George , Ohrt Colin , Vesely Brian
Published: June 2021

Background: Despite a decrease in malaria burden reported between 2000 and 2015, an increasing trend of malaria transmission has been recently reported in some endemic countries including Tanzania. Periodic monitoring to identify pocket areas for asymptomatic Plasmodium falciparum infection   is vital for malaria elimination efforts. The objective of this study was to determine prevalence of asymptomatic malaria infections among military recruits in selected camps in Tanzania.

Methods: A cross-sectional study was conducted in 2015 at four military camps (Bulombora, Mgambo, Ruvu, and Rwamkoma) of National Service located in regions with varying malaria endemicity in Tanzania.  Finger prick blood samples collected from asymptomatic military recruits who had been at the camps for over two months were simultaneously tested using microscopy and malaria rapid diagnostic tests (mRDTs) to detect malaria parasite infections.

Results: Malaria parasite prevalence among asymptomatic recruits was 20.3% and 19.4% by microscopy and mRDT respectively. There was moderate agreement (Kappa=0.724) between microscopy and mRDT test results. A significant difference (p<0.001) of malaria parasite prevalence among the four study camps was observed; ranging from 1.9% in Bulombora to 39.4% in Rwamkoma. The geometric mean parasite density was 11,053 asexual parasites/µl and most recruits (56.8%) had 200 to 1999 asexual parasites/µl. P. falciparum was the predominant (99.2%) malaria parasite species.

Conclusion: Our study found high prevalence of asymptomatic malaria infections among military recruits in the selected camps, and this varied from one camp to another. The study has highlighted that public residence institutions such as military camps can be potential hotspots for malaria infection and therefore should not be skipped in routine national malaria surveillance system for monitoring trends of infections
Effect of atractylenolide III on interstitial cells of Cajal and C-kit/SCF pathway of rats with loperamide-induced slow transit constipation
Authors: Hao Wang , Yuxia Gong , Youran Li , Minmin Xu , Yunfe Gu
Published: June 2021

Purpose: To determine the effect of atractylenolide-III (ATL-III) on loperamide-induced slow transit constipation (STC) in a rat STC model, and to elucidate the mechanisms involved.

Methods: Male Wistar rats were divided into five groups (n=6 per group): normal control group (NG), model group, and three STC rat groups treated with different doses of ATL-III, viz, 5, 10 and 15 mg/kg. The rats were treated for 15 days. Feed consumption, fecal excretion and intestinal transit rate were determined. Nitric oxide synthase (NOS), somatostatin (SS), serotonin (5-HT), and vasoactive intestinal peptide (VIP) were measured with enzyme-linked immunosorbent assay (ELISA). The protein and mRNA expressions of C-kit, SCF, PKC, and PI-3K were assayed using Western blot analysis and realtime reverse transcription polymerase chain reaction (RT-PCR), respectively.

Results: The amount, weight, and moisture content of stool, and water consumption were significantly higher in ATL-III-treated groups than in the untreated (model) group (p < 0.05), whereas no difference was observed in feed intake. Intestinal transit rate was higher in the ATL-III-treated groups (p < 0.05). Decreased NOS, SS and VIP levels and increased 5-HT level were seen in the ATL-III-treated groups (p < 0.05). ATL-III treatment also induced increases in smooth muscle cells, neuronal cells, and mucous layer (p<0.05). Results from RT-PCR and Western blot revealed that ATL-III–treated groups had elevated c-kit, SCF, PKC, as well as PI-3K mRNA and protein expressions (p < 0.05).

Conclusion: These results suggest that ATL-III mitigates loperamide-induced STC in rats via stimulation of NOS, SS, VIP, and 5-HT secretions. It also increases smooth muscle cells, neuronal cells, and mucous layer, and regulates the signaling pathways involving PKC, PI3K, SCF, and c-kit.
Hepatotoxic and hematotoxic effects of sage oil-loaded ifosfamide nanoemulsion in Ehrlich ascites carcinomabearing mice
Authors: AlMotwaa Sahar M. , Alkhatib Mayson H. , Alkreathy Huda M.
Published: June 2021

Purpose: To investigate the hepatotoxic and hematotoxic effects of sage oil-loaded ifosfamide (IFO) nanoemulsion (NE) in Ehrlich ascites carcinoma (EAC)-bearing mice.

Methods: Ifosfamide (IFO) was loaded into a NE containing sage oil, and its hepatotoxic and hematotoxic effects were assessed in EAC-bearing mice. Female Swiss albino mice (n = 50) weighing 25 - 30 g (mean weight = 27.5 ± 2.50 g) were randomly assigned to five groups of ten mice each. With the exception of group 1, the mice were inoculated intraperitoneally (i.p.) with 2.5 × 106 EAC/mouse for 48 h. Group I served as negative control, C (-); group II served as positive control, C (+); while groups III - V were treated i.p. with 60 mg/kg IFO in 0.3mL water (free-IFO); 0.3 mL NE (SAGE-NANO), and 60 mg/kg IFO in 0.3 mL SAGE-NANO (SAGE-IFO), respectively. The treatments were administered for three days.

Results: Treatment with 60 mg/kg bwt IFO (free-IFO) significantly elevated the activities of aspartate aminotransferase (AST) and alanine aminotransferase (ALT, p < 0.05). However, subsequent treatment with SAGE-IFO significantly reduced the activity of these liver enzymes (p < 0.05). The concentration of reduced glutathione (GSH) as well as the activities of catalase and glutathione reductase (GR) significantly increased, while malondialdehyde (MDA) level decreased significantly in SAGE-IFO group, when compared with free-IFO group (p < 0.05). Treatment with SAGE-IFO significantly restored white blood cell (WBC) count and platelet levels which were altered by free-IFO (p < 0.05).

Conclusion: The results obtained in this study suggest that loading IFO in sage oil-NE greatly reduces its hepatotoxicity and hematotoxicity.
Wogonoside exerts potential anti-tumor activity against bladder cancer in vivo and in vitro via regulation of GSK3β/ERK/AKT signaling pathway
Authors: Chen Jiexiang , Cao Yong , Li Yan , Tang Li , Yu Xiaolan , Xia Jiyi
Published: June 2021

Purpose: To explore the antitumor activity of wogonoside on bladder cancer, and its underlying mechanism of action.

Methods: Methyl thiazolyl tetrazolium (MTT) assay was applied to determine the anti-proliferative activity of wogonoside (2 - 128 μM) on bladder cancer 5637 cell line at various times, and the halfmaximal inhibitory concentration (IC50) was measured. The antitumor activity of wogonoside (30 mg/kg, ip) against bladder cancer 5637 cell line was evaluated in nude mice bearing human bladder cancer 5637 cells. Additionally, western blotting and enzyme-linked immunosorbent assay (ELISA) were carried out to investigate the levels of the caspase-3, caspase-9, B cell lymphoma/leukemia-2 (Bcl-2), Bcl-2 associated X-protein (Bax), phosphorylated (p)-glycogen synthase kinase (GSK)-3β, p-extracellular signal-regulated kinases (p-ERK), and p-(protein kinase B) AKT.

Results: The in vitro results revealed that wogonoside exerted anti-proliferative activity against bladder cancer 5637 cells with an IC50 of 20.59 μM (p < 0.01), in a concentration- and time-dependent manner. Furthermore, wogonoside treatment also significantly suppressed tumor volume in mice (p < 0.01). The potential mechanisms were mainly associated with apoptosis mediated by mitochondria via upregulation of caspase-3, caspase-9, and Bax levels and down-regulation of Bcl-2, p-GSK-3β, p-ERK, and p-AKT.

Conclusion: The results reveal that wogonoside has remarkable anti-tumor potentials against bladder cancer. Further translational studies are warranted to test the clinical application of this medicinal agent in bladder cancer.
Exploring Software Security Test Generation Techniques: Challenges and Opportunities
Authors: Alenezi Mamdouh , Akour Mohammed , Basit Hamid Abdul
Published: June 2021

Ensuring the security of the software has raised concerns from the research community which triggered numerous approaches that tend to eliminate it. The process of ensuring the security of software includes the introduction of processes in the Software Development Life Cycle where one of them is testing after the software is developed. Manually testing software for security is a labor-intensive task. Therefore, it is required to automate the process of testing by generating test cases by automated techniques. In this paper, we review various software security test case generation approaches and techniques. We try to explore and classify the most eminent techniques for test case generation. The techniques are summarized and presented briefly to covers all researches work that has been done in the targeted classification. Moreover, this paper aims to depict the sound of security in the current state of the art of test case generation. The findings are summarized and discussed where the opportunities and challenges are revealed narratively. Although the paper intends to provide a comprehensive view of the research in test case generation, there was a noticeable lack in the test case generation from the security perspectives
The Effect of Short Term Debt To Profitability In The Pratama Clinic of Kosasih Rajabasa (Kosasih Group)
Authors: Saputri Pertiwi Dwi Anggraeni , Fitriyana Eka , Yusoff Murni
Published: June 2021

This study aims to determine whether debt, both simultaneously and partially, affects the profitability of the Pratasih Rajabasa Primary Clinic (Kosasih Group) for the 2016-2018 periods. After conducting a regression analysis using SPSS version 23.0 it can be seen that the constant value of 12.725, which means if short-term debt (X) equals zero or fixed, then profitability (Net Profit Margin) also remains at 12.725. The coefficient of short-term debt (X) of 9,844 shows that if short-term debt has increased by one unit (1.00) then profitability (Net Profit Margin) will experience an increase or increase of 9,844. Based on the partial hypothesis test results can be seen that short-term debt has a significant effect on profitability (Net Profit Margin). This is evident from the results of the t test, where short-term debt has tcount> t table which is 2.902> 2.0322 with Sig. <α is 0.006 <0.05. Thus it can be concluded that there is a significant effect between short-term debts on profitability (Net Profit Margin) at the Pratama Kosasih Rajabasa Clinic (Kosasih Group) for the period of 2016-2018