bluuebunny/crossref_metadata_2025 huggingface dataset:
New insights into the genesis of pyroducts of The Galápagos islands, Ecuador
Authors: Kempe Stephan F.J. , Middleton Greg , Addison Aaron , Toulkeridis Theofilos , Hoese Geoffrey
Published: June 2021

There has been little research on the genesis and development of pyroducts (or lava tubes) originating from Gala´pagos volcanoes. Pyroducts are responsible for the lateral, post-eruptive transport of lava because they are highly effective as thermal insulators. After eruptions terminate, these conduits often become accessible as caves. In March 2014 the 16th International Symposium on Vulcanospeleology brought a large group of vulcanospeleological specialists to the Islands. During the meeting a number of pyroducts were visited and studied in context on the island of Santa Cruz and around Isabella’s Sierra Negra volcano in the western, most active, part of the Gala´pagos. The longest of the caves, Cueva del Cascajo, about 3 km in length, was partly surveyed and nine other caves were visited. Structural features such as thickness of roof, evidence of downcutting, presence of oxbows, secondary ceilings, lavafalls, collapses and pukas were particularly studied for evidence they reveal about developmental stages of pyroducts. The resulting data show that the pyroducts were formed by "inflation" with the primary roof consisting of uninterrupted paŻhoehoe sheets. No pyroducts were identified that developed by the crusting-over of channels. The studies strongly confirm inferences drawn from other hot-spot related islands, such as Hawai’i.
Effects of virgin olive oil phenolic compounds on health: solid evidence or just another fiasco?
Authors: Castellano J.M. , Perona J.S.
Published: June 2021

Current research suggests that virgin olive oil (VOO) phenolics are potent preventive and therapeutic agents against metabolic diseases associated with inflammation and oxidative stress. Evidence-based medicine requires these effects be proved in randomized controlled trials (RCT), which are then assessed in meta-analyses, to ensure that the alleged health benefits really proceed in humans. The available evidence is limited to the ability of VOO phenolic compounds to protect lipoproteins from oxidation and to reduce systolic pressure in hypertensive individuals. No RCT assessing the effects of VOO phenolics on diabetes and neurodegenerative diseases have been performed, and those focused on osteoarthritis and cancer provided very scarce information. Therefore, RCT in extensive and diverse population groups, with different disorders and phenolic doses adjusted to usual VOO consumptions are necessary to achieve high quality scientific evidence before nutritional recommendations can be given to the general public.
Old Sundanese Inscriptions: Renewing the Philological Approach*
Authors: Gunawan Aditia , Griffiths Arlo
Published: June 2021

Old Sundanese inscriptions had already been studied by the end of the 19th century by the Dutch scholars, and post-Independence Indonesian scholars have continued to make occasional contributions. However, the epigraphic corpus still leaves many problems without a compelling solution, while the available editions are of uneven quality. This article’s objective is to present new editions of fifteen Old Sundanese inscriptions, based on direct reading from the original artefacts and on newly made photos and estampages, and to interpret the contents of these inscriptions by renewing the philological approach, pioneered by some Dutch scholars in the 19th century, of making systematic use of Old Sundanese sources preserved in manuscripts, in order to elucidate the meaning of the inscriptions. Our study shows that the inscriptions are related to the social and political contexts of the Sunda region from the late 15th into the 16th century, and that they are predominantly commemorative in nature rather than being records of contemporary events.
Ontologias do Antropoceno : Crise climática, respostas sociopolíticas e tecnologias emergentes
Authors: Carvalho António , Ferreira Vera , Matos Ana Raquel
Published: June 2021

O Antropoceno é uma época geológica proposta para ilustrar o impacto humano no sistema terrestre, exemplificado pelas alterações climáticas. Recorrendo a literatura no âmbito dos estudos de ciência e tecnologia, este artigo reflete sobre a heterogeneidade ontológica do Antropoceno, analisando como diferentes respostas sociais, políticas e tecnológicas são mobilizadas para fazer face aos desafios das alterações climáticas. O artigo analisa três estudos de caso que ilustram a heterogeneidade ontológica do Antropoceno : políticas europeias e nacionais em matéria de ação climática ; o movimento de transição, focado em ações à escala local para a descarbonização das sociedades ; a geoengenharia como tecnologia emergente de manipulação climática. Neste trabalho argumentamos que a diversidade de visões, práticas e intervenções associadas aos estudos de caso reforçam o carácter político e controverso do Antropoceno, colocando novos desafios às ciências sociais.
An Example of Entrepreneurship in Women's Education
Authors: Şan Selda , Yılmaz Ali , Subaşı Selen , Mohammed Saif
Published: June 2021

The organization of Akhism (Ahilik) is an example of non-formal education, established on Anatolian soil in the 13th century. With its women's branch—Bajiyan-ı Rum/Bacılık/sisterhood—it aims to educate women professionally and helps women contribute to society. It is expected from women and men to be good and moral individuals, tradesmen, craftsmen, or traders. By doing their jobs well, they managed to achieve economic stability in society. Women were given the opportunity to have entrepreneurial characteristics in the community and to do their best in line with their own abilities. Akhism/Bacılık system affected the Turkish states and education systems established on Anatolian lands. The effect also continues today. In this chapter, which is a literature review, what the Akhism/Bajiyan-ı Rum system is, its place in the vocational education of women, and its effect on today were discussed.
Challenges Facing Women in the Mining Area of Bojanala District of South Africa
Authors: Mafora Gaontebale Audrey , Rena Ravinder
Published: June 2021

This chapter examined the Marikana Massacre and its effects on women of the deceased and those who sustained injuries. It also covers the challenges of the women in the Bojanala District of South Africa. The chapter also addresses the disparities and inequalities experienced by women in the mining industry. Forty women participants were part of the study. The data was gathered through questionnaires, oral interviews, and observations. The analysis revealed that more women were affected by the massacre and has deepened their level of poverty. The government provided interventions, but the findings revealed that the incident has left participants with scars, loss of income, and dissatisfaction. The chapter recommended some possible measures to improve the situation of women because of the Marikana Massacre and poverty in the area.
Additional eLearning Considerations Around the Instructor's Philosophical Belief Systems
Authors: Andrews Sharon K. , Lacher Lisa , Dunnavant Todd
Published: June 2021

The instructor is an integral member of the educational environment through leading, facilitating, and supporting the development of a learning community. This is integrally important within an elearning environment, wherein motivational engagement is a potentially more nuanced environment due to the differentiation in time, space, and place. The instructor's philosophical belief systems highlight the potential for transformative social learning environments that directly impact the instructional design of the course, differentiating enhancements towards supporting user experience, as well as highlighting the potential for transformative impacts within learning environments as well as the holistic learning community. Advancing an enhanced understanding around the instructor's philosophical beliefs around the teaching and learning process strengthens not only the efforts of the instructor towards critical pedagogical understandings, but also the larger learning environment that includes the impact of the virtual world upon the digital connections that undergird communities of learning.
A Study on Tools and Techniques of Big Data Analytics for Text Summarization From Multi-Documents
Authors: Aruldoss Martin , Travis Miranda Lakshmi
Published: June 2021

Multi-document summarization extracts and summarizes the information without affecting its original context from the different sources of documents. It has been carried out using extractive text summarization and abstractive text summarization. Extractive summarization extracts summaries from verbatim lines, and abstractive summarization extracts new lines of summary from the source documents. Abstractive summarization is an advanced technology compared to extractive summarization. This research studies extractive summarization of multi documents from internet resources using word frequency counting and with maximum coverage using K-means clustering. In an internet search, the search algorithm shows the results from different websites using crawling and indexing. However, the search and text summary take place from hundreds, thousands, maybe millions of documents. To handle and manipulate these huge amounts of information, big data and its techniques are applied widely. This research also addresses big data techniques and tools that are available for multi-document summarization.
Digital Transformation of SMEs in the Energy Sector to Survive in a Post-COVID-19 Era
Authors: Musti K. S. Sastry , Kapali David
Published: June 2021

This chapter emphasizes the digital transformation of small and medium scale enterprises (SMEs) in the energy sector that specifically engage in the business of solar water heaters (SWH) to survive and even to stay competitive in the post-COVID-19 era. A novel framework is suggested for digital transformation of SMEs. This framework first divides the major activities into layers, analyses the needs of customers, suggests a stage-wise transformation, and provides ample opportunities for development of smart applications. With this approach, SMEs can significantly automate their processes and thus stay relevant in the challenging times that are likely to occur in the post-COVID-19 era. Digital transformation process will pose its own challenges to SMEs as they lack financial resources and skilled workforce. A few suggestions have been made to mitigate such challenges, and then prospects for further work are provided.
Entrepreneurial Innovative Business Strategies for COVID-19 Impact Minimization to Enhance Sustainability
Authors: Tubulingane Booysen Sabeho
Published: June 2021

The COVID-19 outbreak has caused a global health emergency and economic slowdown. The negative impact of COVID-19 has mostly been experienced by entrepreneurs. This is because entrepreneurs in the COVID-impacted sectors such as tourism are likely to lose 50% to 80% of their turnover. As a result, businesses around the world need to come up with sustainable and innovative solutions to avoid economic disruptions due to pandemics like COVID-19. To remain sustainable, businesses redirected their production to products and services that contributed to the fight against COVID-19. Thus, businesses adopted modern work practices that are based on deliverable rather than time spent at workplaces. Globally, many companies have turned to ICTs to deliver their products and services to customers using online platforms. This chapter argues that businesses need insurances that cover financial losses due to pandemic outbreaks. Hence, universities need to take the lead in research to advise businesses on the strategies to be undertaken during a crisis like COVID-19.
Entrepreneurial Orientation and Business Growth
Authors: Mashingaidze Mugove , Bomani Mapeto , Derera Evelyn
Published: June 2021

The chapter investigated the influence of the entrepreneurial orientation dimensions (i.e., risk-taking, innovativeness, and proactiveness) on SME growth in Masvingo, Zimbabwe. A quantitative research approach using a structured questionnaire was adopted for gathering data. A simple random technique was employed to identify the respondents from the urban area of Masvingo. Descriptive statistics and multiple regression analysis were utilised for data analysis. The results showed that risk-taking and proactiveness have a significant positive impact on business growth while innovativeness had an insignificant negative effect on SMEs' business growth. The chapter recommends more effective training programmes on entrepreneurial orientation and entrepreneurship before providing financial assistance. Furthermore, SMEs should focus on innovation to gain high financial returns. Future research could focus on the mediating variables between entrepreneurial orientation and business growth relationships within and beyond the COVID-19 pandemic.
Evolution of the Firm Structure in the Post-COVID-19 Era
Authors: Aydogan Yigit
Published: June 2021

In this chapter, small and medium enterprises in Turkey have been analyzed in a timely manner to provide insight into their post-COVID-19 performance. The analysis starts with a snapshot of the firm structure and firm size distribution in Turkey. A brief overview of the course of the COVID-19 pandemic in Turkey has been provided. The policy responses to the economic effects of the health crisis have been discussed. SMEs' medium-term dynamics have been tabulated using the data of opening and closing firms during the first months of the pandemic. Several surveys conducted with SMEs during the pandemic by public and private organizations have been combined to match the business owners' expectations to policy responses. To assess the public response to the shock and the solutions, the stock market performance of SMEs has been compared with large firms using stock market indices of XKOBI, XPGIP, and XU100.
Mitigation of COVID Strategies Comparison Between United States and Europe
Authors: Barrachina Mercedes , Barrachina Lucia
Published: June 2021

The COVID-19 pandemic started in China at the end of 2019; however, during 2020, it has spread to more than 188 countries causing very hard times. Europe and the United States have followed different strategies to fight the virus. The differences between those areas in relation with the pandemic could be named shortly as for example the additional time that the United States had to prepare everything against the pandemic compared to Europe, as the American government had around three weeks in comparison to Europe to plan the strategy against the pandemic. The density of population is also an example of the differences between those areas as the United States has a lower population density compared to Europe, and this is another key fact affecting the spreading of COVID-19. The main objective of the study is to compare the different measures adopted by each region and analyze the impact they have in the economy and in small and medium businesses. Specific conclusions about the impact of the measures adopted will be extracted, and some lessons could be obtained from those conclusions.
Post-COVID Indigenous Women Entrepreneurship
Authors: Saiz-Alvarez Jose Manuel , Castillo-Nazareno Uriel Hitamar , Matute de León Jessica Silvana , Alcívar-Avilés María Teresa
Published: June 2021

Despite its great importance within the indigenous communities of Ecuador, the number of studies carried out on the Kichwa (Quichua)-Puruha indigenous population is minimal: the majority of those that have been undertaken are related to archaeological issues. The purpose of this chapter is to shed light on the socioeconomic and cultural traits of female entrepreneurship in the Kichwa (Quichua)-Puruha indigenous group and how this relates to the Sumak Kawsay (Harmonious Life) in the region of Chimborazo, one of the most impoverished provinces of Ecuador. In order to achieve this goal, a mixed methodology has been applied made up of focus groups, in-depth interviews, questionnaires, and hours of direct observation. The results show that indigenous female entrepreneurs belonging to the Kichwa (Quichua)-Puruha ethnic group living in the Chimborazo region are guided by four concepts—relationship, correspondence, reciprocity, and complementarity—and on five principles related to national culture and which are related to sustainable development.
An Enhanced Security Measure for Multimedia Images Using Hadoop Cluster
Authors: Mohan Prakash , Kuppuraj Balasaravanan , Chellai Saravanakumar
Published: June 2021

Information are generated over the internet for every second. These information are not fully secured. To increase the security of these information send over the internet there are two methods Cryptography and Steganography are combined to encrypt the data using RSA algorithm as well as to hide the data in multimedia image in Hadoop Cluster. Features of the resultant image such as color are extracted and stored separately in Hadoop cluster to enhance security. Then combining features of the Stenographic image for secret image retrieval, which has been then split into image and secret information. At last, decrypting the secret information, we retrieve the actual information. Application of this system in Hadoop will increase the speed of execution of the process.
Biofuels, Hybrid and Mitigations of Greenhouse Gases Emissions: Scenario Perspective for Algerian Transport Sector by 2050
Authors: Bencheikh Kamel , Settou Noureddine
Published: June 2021

The expanding and highly greedy Algerian transport sector is totally depending on petro-products, due to the rising numbers of automobile fleets and the excessive dependence on road transportation. Irrecoverable Greenhouse gases GHGs emitted by this sector are constantly increasing. As a result, consumption of diesel and gasoline reached record levels. Consequently, there is a strong need of cleaner, eco-friendly and economically viable alternative fuels. Biofuels, electric, compressed natural gas CNG, liquefied petroleum gas LGP vehicles, are expected to play a crucial role in meeting energy and environmental policies targets. In this paper, the Algerian transport sector perspectives and Greenhouse gases mitigations, in different shaped scenarios based on semi-empirical models, are analyzed and discussed. For adequate policy shaped in a scenario, in 2050, annual Algerian consumption could decrease up to 35%, 43% of CO2 emissions and 73% of NOx emissions could be mitigated compared to no-intervention scenario. These promising findings indicate the huge potential of resource diversification on the transportation sector. Therefore, implementing such policies is fundamental for a durable Algerian’s transportation sector transition policy.
Mechanical Properties of Al 6063 Processed with Equal Channel Angular Extrusion under Varying Process Parameters
Authors: Azeez T.M. , Mudashiru Lateef O. , Asafa T.B. , Adeleke A.A. , Ikubanni Peter Pelumi
Published: June 2021

Mechanical properties of extruded aluminum are known to significantly depend on the process parameters such as temperature, numbers of extrusion pass and extrusion load among others. This implies that these properties can be influenced by tuning the process parameters. Herein, the effects of these parameters on the tensile strength and hardness of aluminum 6063 series were investigated by using equal channel angular extrusion (ECAE). Experiments were designed using Design Expert software. Analysis of variance (ANOVA) was then used to investigate the main and interactions effects of the process parameters. An empirical mathematical model was generated that shows the relationship between the input and output variables using response surface methodology. Temperature was found to be the most significant factor while extrusion load was the least factor that influenced the hardness and tensile strength which were the output factors. There was a significant increase in tensile strength and hardness after extrusion at different mix of factors. The optimum input variable was discovered at 1020.58 kN, 489.67°C and 3 numbers of extrusion passes.
Randomly Dispersed Coated Composites Study by Statistical Approach and Numerical Homogenization Method
Authors: Fedaoui Kamel , Boutaani Mohammed Said , Bourebbou Amor , Chaibainou Laid , Boukhobza Abdelyamine
Published: June 2021

The aim of this work is the computation of effective elastic properties of 3D 3-phase random heterogeneous coated materials. For that, a new expression of the integral range for 3-phase random coated heterogeneous materials is used. The computation is achieved using a representative microstructure with non-overlapping inclusions. Numerical simulations is used under periodic boundary conditions (PBC) and kinematic uniform boundary conditions (KUBC) prescribed over Representative Volume Element (RVE). The obtained effective elastic properties are compared with different analytical models as Hashin and Shtrikman bounds and the n+1 phase model. Using the statistical methods, a new extension of the integral range for 3-phase coated materials is proposed.
Influence of Calcined Clay on the Strength Characteristics and Microstructure of Recycled Aggregate Concrete for Sustainable Construction
Authors: Olofinnade Oluwarotimi Michael , Oyawoye Isaac T.
Published: June 2021

Utilization of concrete wastes as aggregate in conventional concrete is regarded as a promising way of achieving sustainability within the built-up environment. This study investigated the performance of high strength concrete produced using recycled aggregate (RCA) with the addition of calcined clay in the concrete mixes. The recycled aggregate was sourced from concrete rubbles and treated by soaking in water, while calcined clay was sourced from the pilot pozzolana plant of the Nigerian Building and Road Research Institute (NBRRI). The recycled concrete aggregates were used as a replacement for coarse aggregate at levels of 0, 20, 40, 60, 80 and 100%, using a mix ratio of 1:1:2 at a constant water-binder ratio of 0.25. Superplasticizer was added to ensure the workability of the mixes. The calcined clay was added at 15 and 20% partial replacement for cement in the mixes. Physical and chemical properties of the materials used were determined, while the workability of the concrete mixes was examined using the slump. The compressive strength of the hardened concrete was determined after 7, 28 and 56 days of curing using 100 mm cube samples. Scanning Electron Microscope (SEM) was used to evaluate the morphology of selected concrete. Results showed that soaking of the recycled aggregate in water limit the water absorption rate of the RCA aggregates in the mixes, while the addition of calcined clay was observed to slightly reduce the workability of the concrete mixes. A reduction trend in compressive strength was noticed as the percentage of recycled aggregate increases, however, a significant increase in compressive strength was observed with the addition of calcined clay at 15% cement replacement. An optimum concrete mix containing 20% recycled aggregate and 15% calcined clay showed improve performance compare to the other mixes. The implication of these results suggests that recycled concrete aggregate can be used for the production of sustainable structural concrete.
Mechanical Behaviour of Cement-Bound Gravels by Experiment-Based 3D Multi-Scale Modelling: Application to Non-Hazardous Waste Incineration Bottom Ashes Aggregates for Use in Road Engineering
Authors: Sow Libasse , Bernard Fabrice , Kamali-Bernard Siham
Published: June 2021

This paper presents a hierarchical multi-scale modelling approach devoted to investigating the mechanical behaviour of cement-bound gravels. Material studied is based on Non-Hazardous Waste Incineration (NHWI) bottom ashes. The elastic moduli of NHWI particles have been previously determined by an original indentation campaign never conducted so far on these types of aggregates. The results of the experimental campaign serve as input data to the developed numerical strategy. The modelling is based on the definition of Representative Elementary Volumes (REV) considering all the heterogeneities of the material. The "virtual laboratory" set up made it possible to determine the mechanical parameters characterizing the gravel treated with 3% of cement. The high value obtained of the internal friction angle (76 °) gives the material a good bearing capacity. The classification in mechanical classes 3 and 4 when the Young's modulus of the NHWI particles varies from 20 to 80 GPa proves the feasibility of the reuse of this type of industrial by-products in this sector of activity. The present modelling approach is validated by means of comparisons with experimental results of the literature.
Lost to follow up and clinical outcomes of HIV adult patients on antiretroviral therapy in care and treatment centres in Tanga City, north-eastern Tanzania
Authors: Makunde Williams H. , Francis Filbert , Mmbando Bruno P. , Kamugisha Mathias L. , Rutta Acleus M. , Mandara Celine I. , Msangeni Hamis A.
Published: June 2021

Scaling up of Antiretroviral (ARV) drugs is crucial and should be a perpetual venture in developing countries in-order to increase the survival period of HIV/AIDS individuals. In Tanzania, information on the rate of patients considered as lost to follow up during treatment with ARVs is scarce. The objective of this study was to determine the rate of lost to follow up and treatment outcome among patients attending two care and treatment clinics (CTCs) in Tanga City in north-eastern Tanzania. A descriptive observational study was carried out on cohorts from Tanga AIDS Working Group and Bombo Regional Hospital. The total number of patients identified as “lost to follow up” were 89 of which 14 (15.7%) died. Among those who died, 3 (21.4%) died between the second week and 3 months after ARV initiation. Of those still alive (84.3%; 75/89), 25% (19/75) were still on ARVs, whereas 47 (62.7%) self transferred to other CTCs. Proper patient documentation with actual residence address is a crucial aspect for adherence. Similarly, frequent prompt tracing of patient should be part of any drug interventional programme linking   facility and communities.
Reduction of HIV transmission rates from mother to child in the era of antiretroviral therapy in the Lake Victoria zone, Tanzania
Authors: Mirambo Mariam M. , Simon Celine , Kajura Alphaxard , Kidenya Benson , Majigo Mtebe , Mshana Stephen E.
Published: June 2021

Background: Since the introduction of prevention of mother to child transmission (PMTCT) in Tanzania, HIV infection rates have been reduced in different regions across the country. However, there is limited published data from the Lake Victoria zone of Tanzania regarding the effectiveness of various regimens used for PMTCT. This study was done to assess the effectiveness of antiretroviral therapy in preventing mother to child transmission of HIVMethods: Infants aged ≤18 months born to HIV positive mothers undertaking PMTCT programme and those with no intervention program from Mara, Kagera, Mwanza and Shinyanga were tested for HIV-1 DNA polymerase chain reaction (PCR). Data were analysed using STATA version 10.0 to assess factors associated with outcome.Results: A total of 1,005 study subjects were enrolled in the study. Of these 55% (554/1005) were females. Majority (82.6%; 830/1005) of the infants studied were aged 1-6 months. The median age of the infant studied was 3 months (IQR 2-4). Out of 1005 non-repetitive samples; 61(6.1%) were HIV-1 DNA PCR positive. Positive dried blood spots (DBS) rates by region were 6.4%, 5.9%, 5.6% and 5.1% in Mwanza, Mara, Kagera and Shinyanga, respectively. During pregnancy interventions, the positive rate for women with no therapy was 12.6% and for zidovudine alone was 5.4% while for triple antiretroviral therapy was 0.5%. Women who were in highly active antiretroviral therapy (HAART) during pregnancy had significantly lower positive rate than those without HAART treatment (p=0.001). Of 755 infants who received nevirapine, 3.9% were DBS positive compared to 12.8% of those who didn’t receive nevirapine (p=0.001).Conclusion: The use of antiretroviral therapy in the PMTCT programme is effective in reducing HIV transmission from mother to child.
Prevalence of Hepatitis B surface antigen among pregnant women attending antenatal clinic at Nyamagana District Hospital Mwanza, Tanzania
Authors: Mirambo Mariam M. , Mbena Peter B. , Mushi Martha F. , Mtebe Majigo , Moremi Nyambura , Seni Jeremiah , Mshana Stephen E.
Published: June 2021

In developing countries there is no routine screening of hepatitis B virus (HBV) infection among pregnant women resulting into limited data on its magnitude. The objective of this study was to determine the prevalence and risk factors associated with active HBV infection among pregnant women attending antenatal clinic (ANC) in Mwanza City, Tanzania. A total of 211 pregnant women were serially enrolled between May and July 2014. Hepatitis B surface antigen (HBsAg) was determined using a rapid Immuno-chromatographic assay. The median age of the study population was 23 years (IQR 20-29 years).  Of 211 pregnant women, 61.6% (130/211) were multigravidae. Eight (3.8%) of the pregnant women were positive with HBsAg. There was a significant difference in prevalence between primigravidae and multigravidae (0.8% vs. 8.6%, p=0.017). Active hepatitis B infection among pregnant women in Mwanza city is low and associated with multigravidity. Despite low prevalence of acute hepatitis B infection routine screening of HBsAg and anti HBsAg antibodies, coupled with the vaccination of those at risk should be introduced to prevent hepatitis B infection complications.
The types, incidence and demographic distribution of benign oral and maxillofacial neoplasms among patients attending Muhimbili National Hospital in Tanzania, 2008-2013
Authors: Moshy Jeremiah R. , Sohal Karpal S.
Published: June 2021

Background: Pathological processes of oral and maxillofacial region are generally classified as benign or malignant based on specific histological criteria, including the presence or absence of necrosis, mitotic figures as well as basic understanding of the entity. The objective of this study was to determine the types, prevalence and demographic distribution of benign oral and maxillofacial tumours among patients treated at Muhimbili National Hospital in Tanzania.Methods: In this retrospective study, data on histological results of lesions of the oral and maxillofacial region were retrieved from the archives at the Department of Oral and Maxillofacial Surgery of Muhimbili National Hospital were analysed. The tumour type, age, sex, file number and histopathological diagnosis of the patient were recorded. The study covered a period of from January 2008 to December 2013. The top ten lesions with higher frequency of occurrence from January to were picked for analysis.Results: A total of 897 (males=388; females=509) histological results of patients with benign oral and maxillofacial lesions were obtained during the period under review. The age ranged from 0 to 88 years, mean age being 32.63 ± 17.1 while the age group of 20-29 and 30-39 were the most affected. A total of 136 different types of benign lesions were reported and ameloblastoma was the most common benign lesion (27.4%) followed by ossifying fibroma (18.7%), pyogenic granuloma (11.4%), pleomorphic adenoma (10.0%), and fibrous dysplasia (9.6%). Females were more affected than males, with a male to female ratio of 1:1.4 however the difference was statistically insignificant (p= 0.055).Conclusion: Ameloblastoma and ossifying fibroma were the most common oral and maxillo-facia neoplasms at Muhimbili National Hospital. The young age groups were the most affected by these lesions.
Emerging viral infectious disease threat: Why Tanzania is not in a safe zone
Authors: Mangu Chacha D. , Manyama Christina K. , Msila Henry , Sudi Lwitiho , Chaula Godlove , Ntinginya Nyanda E. , Sabi Issa , Maboko Leonard
Published: June 2021

Emerging diseases are global threat towards human existence. Every country is exposed to potentially emergence of infectious diseases. Several factor such as changes in ecology, climate and human demographics play different roles in a complex mechanism contributing to the occurrence of infectious diseases. Important aspects towards control in case of outbreaks are surveillance, preparedness and early response. Tanzania should therefore take opportunity of the calm situation currently present, to prepare. Except for HIV/AIDS, Tanzania has not experienced a major public health threat. However, the question is, is the country safe from emerging and re-emerging infectious diseases? In this article we try to explore the danger of emerging infectious disease (EID) epidemics in Tanzania and the risks attached if an outbreak is to occur. The aim is to formulate recommendations to the government, responsible authorities and general population of what can be done to improve the level of EID preparedness in the country. In conclusion, it is important to strengthen the capacity of community and healthcare staffs on how to respond to potential infectious disease outbreaks. Community-based surveillance systems should be incorporated into the national systems for early detection of public health events. It is also critical to enhance one health approach to increase cross-sectoral information sharing, surveillance and interventional strategies as regards to preparedness and response to disease outbreaks.
Trauma admissions among street children at a tertiary care hospital in north-western Tanzania: a neglected public health problem
Authors: Chalya Phillipo L. , Hauli Kiyeti A. , Kayange Neema M. , Mweteni Wemaeli , Kapesa Anthony , Ngallaba Sospatro E.
Published: June 2021

Background: Trauma among street children is an emerging but neglected public health problem in most low and middle income countries. This study was conducted to determine the incidence, etiological spectrum, injury characteristics and treatment outcome among street children and to identify the predictors of the outcome of these patients at Bugando Medical Centre in Mwanza, Tanzania.Methods: The study included street children aged <18 years. Routine investigations including haematological, biochemical and imaging were performed on admission. The severity of injury was determined using the Kampala Trauma Score II. Data on patient’s characteristics, circumstances of injury, injury characteristics, treatment offered, outcome variables, length of hospital stay and mortality were collected using a questionnaire.Results: A total of 342 street children (M: F = 6.8: 1) representing 11.5% of all paediatric injury patients were studied. The modal age group was 11-15 years (median = 12 years) accounting for 53.2% (n=182) of the patients. Assault was the most frequent (73.7%) cause of injury. More than three quarter of injuries occurred along the street. Most of patients (59.1%) presented late (>24 hours) after injury. Blunt injuries were the most common (76.0%) mechanism of injuries. Musculoskeletal (30.8%) and head (25.3%) were the most frequent body regions affected. Soft tissue injuries were the most common type of injuries affecting 322 (94.2%) cases. Majority of patients (96.5%) underwent surgical treatment of which wound debridement (97.6%) was the most common surgical procedure performed.  Complication rate was 39.5%. The median hospital stay was 6 days.  Mortality rate was 13.5% and it was significantly associated with injury-arrival time (OR =2.4, 95%CI (1.3-5.6), p = 0.002), severe injury (Kampala Trauma Score <6) (OR = 3.6, 95%CI (2.5-7.9), p = 0.001), severe head injuries (OR= 5.1, 95%CI (4.6 – 8.2), p =0.012) and surgical site infection.Conclusion: Trauma among street children is an emerging but neglected epidemic in Tanzania and contributes significantly to high morbidity and mortality. Assault was the most frequent cause of injury.  Urgent preventive measures targeting at reducing the occurrence of assault is necessary to reduce the incidence of trauma among street children in this region.
Risk factors associated with multidrug resistant tuberculosis among patients referred to Kibong’oto Infectious Disease Hospital in northern Tanzania
Authors: Lema Nsiande A. , Mbelele Peter M. , Majigo Mtebe , Abade Ahmed , Matee Mecky I.
Published: June 2021

Background: Multidrug resistant tuberculosis (MDR-TB) remains is an important public health problem in developing world. We conducted this study to determine risk factors associated with MDR-TB and drug susceptibility pattern to second line drug among MDR TB patients in Tanzania.Methods: Unmatched case control study was conducted at Kibong’oto Infectious Diseases Hospital in Tanzania in 2014. A case was defined as any patient whose sputum yielded Mycobacterium tuberculosis that were resistance to at least rifampin (RFP) and isoniazid (INH) whereas control was defined as those sensitive to rifampin (RFP) + isoniazid (INH).  One morning sputum sample was collected from each study subject and cultured on Löwenstein-Jensen (LJ) media for M. tuberculosis. Drug susceptibility testing of isolated M. tuberculosis was done for rifampicin, isoniazid, kanamycin and ofloxacin. A semi-structured questionnaire was used to collect socio-demographic and risk factors information for MDR-TB. Results: A total of 102 cases and 102 controls were enrolled. The predominant age group was 31- 40 years, of whom cases and controls accounted for 38 (37.3%) and 35 (34.3%) of the study subjects, respectively. Majority of participants (69% cases and 71% control) were males and self-employed (62.7% cases and 84.4% controls). More than half (52%) and approximately a quarter (24.5%) of cases and control had HIV infection, respectively. About two-thirds of cases (62.7%) were cigarette smokers compared to controls (42.2%). Previous history of TB treatment accounted for approximately three folds in cases (72.5%) and only 24.5% in controls. Risk factors independently associated with MDR-TB were previous history of treatment with first line anti-TB (OR= 3.3, 95% CI 1.7-6.3), smoking (OR=1.9, 95% CI 1.0-3.5), contact with TB case (OR=2.7, 95% CI 1.4-5.1) and history of TB. All MDR TB isolates were sensitive to kanamycin and ofloxacin.Conclusion: MDR-TB among patients referred to Kibong’oto Infectious Diseases Hospital is associated with previous history of TB contact, smoking habit, and contact with TB case. All MDR TB isolates were sensitive to the tested second line drugs, Kanamycin and Ofloxacin.
Pattern of presentation and outcome of patients treated for Fournier’s gangrene at Kilimanjaro Christian Medical Centre in Moshi, Tanzania
Authors: Mabula Paschal , Nyongole Obadia V. , Mteta Kien A.
Published: June 2021

Background: Fournier’s gangrene (FG) is a rapidly progressive and potentially fatal infective necrotizing fasciitis which affects the perineal and perianal regions as well as the external genitalia. This study aimed at evaluating the management of FG and its outcomes at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, TanzaniaMethods: This was a retrospective hospital based study involving case notes of all patients who had Fournier’s gangrene at KCMC from January 2003 to December 2013. Patients managed for Fournier’s gangrene and the medical records of the patients eligible for the study retrieved manually.Results: A total of 25case notes of patients treated for Fournier’s gangrene during the study period were reviewed. All were males and majority of them (60%) were ≥50 years (mean=57.4 years). Hypertension was the commonest reported risk factor (41%). Diabetes mellitus was reported as a risk factor in 20% of all patients with FG. These risk factors were mentioned as comorbid conditions in traumatic urethral catheterization and suprapubic catheterization. All patients received a combination treatment of wound debridement, antibiotics, fluid replacement, analgesics and daily wound dressing. The average hospital stay for patients with FG was about 25 days.Conclusion: Fournier’s gangrene at KCMC is exclusively a male disease affecting those above 50 years. Hypertension and diabetes mellitus were the common comorbid condition in patients with Fournier’s gangrene.
Prevalence and predictors of anaemia among patients presenting with kidney diseases at the University of Dodoma Hospital in central Tanzania
Authors: Meremo Afred J. , Mwashambwa Masumbuko Y. , Masalu Matobogolo B. , Kapinga Janet , Tagalile Rehema , Ngilangwa David P. , Sabi Issa
Published: June 2021

Background: Anaemia is a common complication that contributes to the burden of kidney diseases. Anaemia confers significant risk of cardiovascular disease and contributes to decreased quality of life. While the primary cause of anaemia is the inadequate production of erythropoietin by the kidneys to support erythropoiesis, other factors may contribute to anaemia. The aim of this study was to determine the prevalence and predictors of anaemia among patients presenting with kidney diseases at the haemodialysis unit of the University of Dodoma (UDOM) hospital in central Tanzania.Methodology: In this retrospective study we reviewed data of patients who presented at UDOM haemodialysis unit in Tanzania with kidney diseases as from January 2013 to June 2015. Data were descriptively and inferentially analysed using Stata version 11 software.Results: A total of 1,395 patients were involved in this study. Of these, 792 (56.8%) presented with kidney diseases, 249 (31.4%) were found to have anaemia.  The leading cause of anaemia was chronic kidney disease (CKD) 136 (54.6%), blood loss 74(29.7), haemolysis 15 (6.0%), Nutrition 13(5.2%) and others 11 (4.4%). Glomerular filtration rate of < 60 mL/min/1.73 m2 accounted for 59.1% of CKD. Median [IQR] serum creatinine level: 246 [177 – 317] μmol/L, Urea level 16[8 -24] mmol/L and haemoglobin of 9.8 [6.2 - 13.4] g/dL. Prevalence of anaemia was strongly associated with declining glomerular filtration rate (P= 0.01).Conclusion: Anaemia is very common among patients presenting with kidney diseases. These patients require a thorough evaluation to identify and correct causes of anaemia other than erythropoietin deficiency.
Socio-demographic determinants of dengue infection during an outbreak in Dar es Salaam City, Tanzania
Authors: Camara Neema , Ngasala Billy , Leyna Germana , Abade Ahmed , Rumisha Susan F. , Oriyo Ndekya M. , Mboera Leonard E.G.
Published: June 2021

AbstractBackground: In recent years, the eastern coast of Africa has witnessed a number of dengue outbreaks. This study was carried out to determine socio-demographic determinants of dengue infection during the 2014 outbreak in Dar es Salaam, Tanzania. Methods: Unmatched case-control analysis of secondary data from a cross-sectional dengue investigation in three districts of Dar es Salaam in June 2014 was conducted. Febrile patients seeking care at health facilities were recruited. Cases were serologically-confirmed dengue-positive while controls were serologically-confirmed dengue-negative patients. A questionnaire was used to collect sociodemographic information. The association between sociodemographic variables and dengue infection was examined using univariate analysis and multivariate logistic regression analysis. Results: A total of 81 cases and 281 controls were included in the analysis. Majority of the cases and controls were males (64.2% versus 54.1%; P=0.137) and were >15 years of age (88.9% versus 72.9%; P =0.003). Living in Kinondoni (aOR = 4.28; 95% CI: 1.74 - 10.53); being employed (aOR = 2.06; 95% CI: 1.06-4.04); having piped water at home (aOR = 2.63; 95% CI: 1.40 - 4.95) and a recent visit of health facility (aOR = 1.94; 95% CI: 1.11 - 3.38) were significantly associated with dengue infection.Conclusions: Dengue infection in Dar es Salaam varied between the three districts and was associated with being employed, having piped water at home and a recent visit to the health facility. These findings provide primary understanding of the influence of socio-demographic factors on dengue and may be used to develop appropriate preventive interventions.
Bilateral congenital choanal atresia in a 16-year old girl at Muhimbili National Hospital, Tanzania
Authors: Saitabau Zephania , Elimath Martin , Moshi Ndeserua , Richard Enica , Ntunaguzi Daudi
Published: June 2021

Background: Bilateral choanal atresia refers to a congenital anomaly whereby a child is born with bilateral imperforate posterior nares. In most cases the diagnosis is established soon after birth. Establishment of the diagnosis requires a high index of suspicion by clinicians. The objective was thus to report an unusual case which went undiagnosed for many years and review the few available literatures.Case presentation: A 16-year old girl presented to the otorhinolaryngology clinic of Muhimbili National Hospital in Tanzania with a long standing history of bilateral nasal obstruction. The condition was reported to be present since birth and this was accompanied by mouth breathing and persistent bilateral nasal discharge. The patient also reported a history suggestive of respiratory distress after birth which necessitated oxygen therapy and difficulty in breastfeeding where she was kept on expressed breast milk during the first few weeks of life. Nasal endoscopy was done clinic and the diagnosis of bilateral congenital choanal atresia was made. Computerized tomography scan of the nose and paranasal sinuses revealed bilateral choanal atresia of mixed type. Surgical perforation of the atretic choanae without stenting was done endoscopically under general anaesthesia.Conclusion: Bilateral congenital choanal atresia is an otorhinolaryngological emergency and should be established promptly both in resource limited settings and in areas where advanced tools are in situ to prevent its morbidity and mortality if it goes unestablished.
Distribution of primary health care facilities in Mtwara District, Tanzania: availability and accessibility of services
Authors: Mremi Irene R. , Mbise Mercy , Chaula Job A.
Published: June 2021

Background: Access to health care services is a significant factor to health seeking practices that contributes to a healthy population. Improving health care accessibility is an important health priority in low-income countries. The objective of this study was to determine distribution of health care facilities and identify the high priority areas, which require more services in Mtwara, southern Tanzania.Methods: This study was carried in Mtwara Rural district of southern Tanzania and involved health care facilities. A hand held global positioning system was used to geo-reference the coordinates of all facilities. A questionnaire with both closed and open-ended questions was used to gather information from patients who attended the respective facilities. Interviews with district health officials and facility in-charges were conducted.Results:  There were 38 health in the district. Most of them were located within southern part of the district. The majority of facilities (97%) were government owned. On average each facility was serving 2,400 population. Malaria management, reproductive and child health services, family planning and integrated management of childhood illnesses were offered by all health facilities in the district. Prevention of mother to child transmission of HIV was offered by 34 (89.5%) facilities. Tuberculosis services were offered by only 3 facilities while voluntary counselling and testing of HIV and anti-retroviral treatment services were available in 15 and 10 health facilities, respectively. Only 4 facilities had laboratory and inpatients services. The majority of the staff included Medical Attendants (39%), Nurse Midwives (34%), and Clinical Officers (20%). Assistant Medical Officers and Nursing Officers each accounted for 2% of the total staff. There were no Medical Officers, laboratory technicians or pharmaceutical technicians in the district.  A total of 408 health facility clients (≥18yrs) were interviewed. Factors influencing the choice of a health facility were the availability of special services, medicine and qualified human resources.Conclusion: The majority of facilities in Mtwara are government and there is disparity in the distribution of the facilities. Availability of medicines and qualified human resources were the major factors on the preference for accessing health care services.