bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and factors associated with dental anxiety among primary school teachers in Ngara District, Tanzania
Authors: Minja Irene K. , Jovin Anord C. , Mandari Godbless J.
Published: June 2021

Background: Dental anxiety has been associated with several negative effects on patients and communities’ oral health. The objective of this study was to assess the prevalence and factors associated with dental anxiety among primary school teachers in Ngara district, Tanzania.Methods: This descriptive cross-sectional study utilized self-administered questionnaire to collect socio-demographic and behavioural details. A Kiswahili version of the Modified Dental Anxiety Scale (MDAS) was used to assess dental anxiety.Results: The Kiswahili version of MDAS showed good face validity and reliability with standardized Cronbach’s alpha coefficient of 0.86. The prevalence of high dental anxiety (MDAS≥ 19) was 1.2%. A significant higher percentage of schoolteachers with dental anxiety was observe among those with low education; who visited a dentist at least once in the past two years; and those who visited the dentist when having a dental problem. Sex, age, marital status and perceived oral health status did not show a significant difference.Conclusion: The Kiswahili version of MDAS showed acceptable psychometrics. The prevalence of dental anxiety among school teachers in a rural district of Ngara in Tanzania was low. To maintain the low prevalence of dental anxiety and subsequently reducing it, oral health education and promotion on preventive dental heath seeking behaviours is advocated.
The reference range of serum magnesium substance concentration among healthy young adults at Makerere University College of Health Sciences 2012
Authors: Okwi Andrew L. , Bimenya Gabriel S. , Tumwine Lynette K. , Othieno Emmanuel , Okot Julius , Ibingira Charles
Published: June 2021

Background: Magnesium is the second most abundant intracellular cation, with only a small proportion of the body’s content being in the extracellular fluid. It is required for the active transport of other cations such as calcium, sodium and potassium across the membrane by active transport system. It is also needed for many intracellular metabolic pathways. This study was carried to establish the reference intervals for serum magnesium substance concentration among healthy medical students in Uganda.Methods: This was purposive study in which ante-cubital venous blood samples were drawn without stasis from 60 healthy, natively Ugandan pre-clinical medical students and analysed without delay using Cobasintegra 400/700/800 automated analyser which flagged each result using the in-built seemingly temperate reference range of 0.65-1.05 mmol/L.Results: The distribution of serum magnesium substance concentration was unimodal, leptokurtic, and positively skewed with empirical range of 0.86 – 1.32 mmol/L. There was no result flagged as low. Twenty-six out of sixty (43.3%) results were flagged as high values while none approached 2.0 mmol/L, considered the threshold of hypermagnesaemia symptoms. Using the central 95 percentile, the reference range was set as 0.81 – 1.29 mmol/L which is higher and slightly broader than the 0.65 – 1.05 mmol/L often quoted for populations in temperate regions and in-built in automated analysers exported even to the tropics.Conclusion: Reference ranges were higher in the studied healthy young adults in Uganda than those in the temperate regions. Effort should therefore be made to enable our laboratories establish their own reference values.
The role of nontuberculous mycobacteria in the diagnosis, management and quantifying risks of tuberculosis in Tanga, Tanzania
Authors: Hoza Abubakar S. , Lupindu Athumani M. , Mfinanga Sayoki G. M. , Moser Irmgard , König Brigitte
Published: June 2021

Background: The role of nontuberculous mycobacteria (NTM) in tuberculosis (TB) diagnosis is well documented in many developing settings. However, this has not been the case in many resource poor settings like Tanzania. This study aimed at understanding the role of NTM in the diagnosis and management of TB in resource poor settings of Tanzania.Methods: A cross‑sectional study was conducted in Tanga, Tanzania. Patients with symptoms suggestive of TB self-referred to health care facilities were recruited. Two sputum samples were collected for standard direct smear microscopy. Culture was performed using BacT/Alert 3D system, Löwenstein-Jensen and Gottsacker slopes. Identification of Mycobacterium tuberculosis and NTM was done by using GenoType®MTBC and GenoType®CM/AS, respectively.Results: A total of 372 patients were involved in the study. Eighty-one (21.8%) patients were diagnosed as having M. tuberculosis by the isolation of the organism from cultures of sputum. Further analysis of culture showed that 8.1% (30/372) were NTM with 7/372 (1.9%) cases of NTM classified as pulmonary tuberculosis (PTB) patients. Ziehl Neelsen stain had a sensitivity of 68.8% and produced 10 false negative results. On the other hand, Fluorescence stain had a sensitivity of 85.7% and gave seven false negative samples when compared with culture results. Weight loss (p = 0.0001), fatigue (p = 0.003), fever (p = 0.038) and night sweats (p = 0.004), young population (18-40 years) (p = 0.0352), males (p = 0.0025) were important risk factors for TB. Four out of 30 NTM diagnosed by culture received first line anti‑TB treatment suggesting that a good proportion of patients (4/65, 6.2%) were mistreated as TB patients.Conclusion: Inefficient screening of TB patients in resource poor settings and prevalent increase of NTM may contribute to over diagnosis of TB cases. The need to integrate NTM diagnosis in the routine management of TB is urgently needed for designing effective tuberculosis prevention and control strategies in the country.
Characteristics of violence against women in Campina Grande, north-eastern Brazil
Authors: Nobrega Lorena Marques , Cavalcante Gigliana Maria Sobral , Bernardino Italo de Macedo , Granville-Garcia Ana Flávia , Ferreira Efigênia Ferreira , D'Avila Sergio
Published: June 2021

Background: Violence against women can have serious consequences, where these victims are affected physically, psychologically, and socially. The aim of this study was to shed light on the sociodemographic characteristics and the characteristics of the conflict suffered by the female victims of violence, who were referred to a forensic medicine and dentistry service in an industrialized city in North-eastern Brazil. Methods: This study was performed in Campina Grande, Paraiba State (PB), Brazil, involving the analysis of 1704 reports of physical aggression in 2010; 883 reports involving female victims were selected. Sociodemographic data of the victims, circumstances of events, and characteristics of injuries were investigated. Data analysis included descriptive statistics, and chi-square test (p <0.05). Results: The sample consisted of young women, with mean age of 29.3 years, mostly unmarried, with little education, and mostly not working. The most frequent aggressor was a male known to the victim. The events were mostly a result of non-instrumental aggression, causing multiple injuries. There was statistically significant difference between whether the aggressor was or was not a family member and marital status of the victim (p<.001), and a significant difference between the use of instrument in the conflict and the presence of facial injuries was found (p<.001). Young women accounted for a high proportion of victims of physical violence. A high percentage of facial traumas was observed. Conclusion: Given the consequences of such trauma and its prevalence, it is important that future studies be conducted to highlight the risk factors, and to develop policies to combat violence against women.
Knowledge, practice and factors associated with poor compliance with universal precautions among healthcare workers at Bugando Medical Centre, Mwanza, Tanzania
Authors: Chalya Getrude , Chalya Phillipo L. , Mbunda Fidelis
Published: June 2021

Background: Healthcare workers (HCWs) are exposed to blood-borne infections by pathogens, such as HIV, and Hepatitis B and C viruses, as they perform their clinical activities in hospitals. Compliance with universal precautions has been shown to reduce the risk of exposure to these pathogens. This aimed at assessing the knowledge, practices and factors associated with poor compliance to universal precautions among HCWs at Bugando Medical Centre in Mwanza, Tanzania.Methods: This was a cross sectional study carried out from December 2014 to February 2015.Results: There were 200 participants including 62 (31.0%) doctors, 74 (37.0%) nurses, laboratory personnel 34 (17.0%) and 29 (14.5%) auxiliary HCWs. More than three quarters (82%) of participants had adequate knowledge of uni­versal precautions. There was statistically significant difference between knowledge of universal precautions and sex, job category, working experience (≥ 5 years) and previous training on universal precautions. Out of 200 HCWs, 154 (77.0%) practiced universal precautions. Working experience (≥ 5 years) and previous training on universal precautions were significantly associated with good practice of universal precautions (P < 0.001). There was a strong correlation between knowledge and compliance (practice) with universal precautions (r=0.76, p<0.001). Factors associated with poor compliance with universal precautions included lack of personal protection equipment (69.5%), lack of knowledge (65.0%), emergency situations (63.0%), presumption that patient is not infected with HIV or HBV (59.0%), time constraints (53.0%), heavy workload (48.0%) and absence of penalties (34.0%).Conclusion: There was adequate knowledge and a fair level of compliance among HCWs towards universal precautions. These findings sug­gest that training of health care workers to increase their knowledge about blood-borne pathogens and universal precau­tions could improve their compliance and thus reduce health care workers’ risk of blood-borne patho­gen exposure.
Risk factors for mortality among tuberculosis patients on treatment at Bugando Medical Centre in north-western Tanzania: a retrospective cross-sectional study
Authors: Gunda Daniel W. , Kilonzo Semvua B. , Bulegesi Salum M. , Mpondo Bonaventura C.T. , Shao Elichilia R.
Published: June 2021

Background: Tuberculosis (TB) is still an important cause of morbidity and mortality worldwide. Though it can effectively be treated, still a significant proportion of patients die on the course of their treatment. The objective of this study was to determine the outcome and risk factors of mortality among patients diagnosed with TB in a tertiary hospital in north-western Tanzania.Methods: A retrospective cross sectional study was done among all patients diagnosed with TB between January and December 2015 at Bugando Medical Centre. Information of demographic characteristics, smear positivity, haemoglobin concentration, HIV status, CD4 counts for HIV positive patients and treatment outcomes were collected and analysed. TB treatment outcomes as dead or alive were calculated and logistic regression was done to determine the factors associated with increased risk of death of patients on anti-TB treatment.Results: In total 701 patients were diagnosed with TB during the study period. Of these, 361 (51.5%) were males with a median age of 38 (IQR 27- 47) and 421 (60.06%) were younger than 40 years. Majority of the participants 409 (58.35%) had smear positive pulmonary tuberculosis and about half of patients (51.07%) tested positive for HIV. Of the enrolled patients 610 (87.02%) were alive at the end of TB treatment while 91 (12.98%) died in the course of treatment. The odds of deaths of patients on anti-TB treatment were strongly associated with male sex, HIV co infection and severe anaemia.Conclusion: The proportion of patients who die from TB treatment at BMC is high, with an increased risk of death among HIV co-infected, older than 40 years and severely anaemic patients. Improvement of strategies for early diagnosis and prompt treatment of TB patients will potentially improve treatment outcome.
Quality of drug prescription in primary health care facilities in Mwanza, north-western Tanzania
Authors: Mambile Giveness , Konje Eveline , Kidenya Benson R. , Katabalo Deogratias , Marwa Karol
Published: June 2021

Background: Drug therapy can improve a patient’s quality of life and health outcomes if only used properly. However, data on prescription quality at primary health care facilities in Tanzania is scanty. The objective of this study was to assess the quality of drug prescriptions in selected health care facilities in two districts of Mwanza, Tanzania.Methods: This descriptive cross-sectional study was carried out in Ilemela and Nyamagana districts in Mwanza, Tanzania. The study included 20 randomly selected public and private health care facilities. A random sample of the patient records in each facility was included. From each patient record, the latest prescription was assessed. Information assessed and recorded included prescribing indicators, frequency of prescription error, various formulations and groups of drugs prescribed. Prescribers were interviewed on factors affecting prescribing practices.Results: A total of 570 prescriptions were studied. The average number of drugs prescribed per encounter was 2.8. The percentage of encounters with an antibacterial agent prescribed was 33.8% and injections constituted 7.9% of cases. Prescriptions by generic name were 85.8% while 90.6% of drugs prescribed were from the national essential drug list. Antibacterial agents, analgesics and antimalarial agents accounted for 75.3% of all drugs prescribed. Of all prescriptions, 485 (85.1%) had at least an error. A total of 1,177 errors were made. Errors of omissions accounted for the majority (99.3%) of all errors. The most commonly observed missing prescription particulars were the drug strength (23.2%) and patient weight (22.2%).  The average number of drugs per encounter was higher in private facilities (3.2) than in public facilities (2.4) (P <0.0001). The range of drugs per prescription was also higher in private (1-7) than in public facilities (1-5) (P<0.0001). There were statistically significant differences in the distribution of various drug groups prescribed between public and private facilities and between health centres and dispensaries (P <0.001 and 0.027, respectively).Conclusion: Prescribing of higher number of drugs than the WHO recommendations and overuse of antibiotics is still a problem at health care facilities in Mwanza Tanzania. The frequency of occurrence of prescription errors found during the study was considerably high.
The use of 0.01M phosphate buffered saline as detection buffer for Alere Determine® HIV rapid test in resource limited settings
Authors: Mirambo Mariam M. , Mushi Martha F. , Shilewangwa Ley , Minja Caroline A. , Kidenya Benson R. , Majigo Mtebe , Mshana Stephen E.
Published: June 2021

Insufficient supply of manufacture’s buffers/diluents in relation to the number of strips per kit has been found to have negative impact on patients’ results. Some laboratories personnel tend to use diluents from other rapid tests manufacturers such as Bioline, Unigold as well as malaria rapid diagnostic test (MRDT). This study aimed at evaluating the use of 0.01M phosphate buffered saline (PBS) as detection buffer for Alere Determine® HIV rapid test. This study was carried out at Bugando School of Medicine in Mwanza, Tanzania. A total of 300 whole blood specimens; 150 HIV positive specimens from patients attending Care and Treatment Centreand 150 HIV negative specimens were retested for HIV status using Alere Determine® HIV rapid test employing normal Alere buffer and 0.01M PBS as buffer.Of the total specimens tested; 150 (100%) of HIV positive were positive by using both Alere buffer and 0.01M PBS while 150(100%) of HIV negative samples were negative by both Alere Determine® and 0.01M PBS. The agreement between 0.01M PBS and Alere Determine® buffer was 100%. The value of kappa indicates perfect agreement between 0.01M PBS and Alere Determine® buffer (100%). A 0.01M PBS is recommended as alternative detection buffer for Alere Determine® in cases of insufficient supply. Further investigation to evaluate the suitable buffer for other rapid tests for HIV and other diseases is recommended especially in resource limited settings.
Serological profiles of Herpes simplex virus type 2 among HIV negative population in Mwanza City, Tanzania
Authors: Mirambo Mariam M. , Isdori Chrispus , Mshana Stephen E.
Published: June 2021

Herpes simplex virus type-2 (HSV-2) is the major cause of genital ulcer diseases (GUD) consequently a significant factor for the acquisition and transmission of human immunodeficiency virus (HIV). Despite its importance there is paucity of data regarding the magnitude of HSV-2 in non-HIV infected population in middle-and-low income countries. This study was designed to determine the seroprevalence of specific HSV-2 antibodies among non-HIV population in Mwanza City, Tanzania.  A total of 174 non-HIV infected individuals were enrolled and tested for HSV-2 IgM and IgG antibodies using one step HSV-2 rapid Test. The median age of study participants was 28 years (IQR= 23-36 years).  Of the 174 enrolled individuals, 22 (12.6%, 95% CI: 7.6-17.5) were HSV-2 IgG seropositive while none of the participants was HSV-2 IgM seropositive. This study shows that a significant proportion of non-HIV infected population is seropositive for HSV-2 antibodies. This might increase the risk of becoming infected with HIV and other sexually transmitted infections.
Prevalence and risk factors for HIV among people aged 50 years and older in Rombo district, Northern Tanzania
Authors: Swai Scolastica J. , Damian Damian J. , Urassa Sarah , Temba Beatrice , Mahande Michael J. , Philemon Rune N. , Msuya Sia E.
Published: June 2021

Background: It is estimated that over ten percent of the 36.7 million people living with HIV (PLWHIV) globally, are those aged ≥50 years. The objective of this study was to determine the prevalence and risk factors for HIV among adult aged 50 years and above in Rombo district, northern Tanzania.Methods: This cross sectional study was conducted from April to June 2015 among older adults aged ≥50 year in Rombo district. Interviews were conducted to collect information on socio-demographic characteristics, reproductive and sexual health characteristics of the participants, knowledge on HIV transmission, prevention and risk perception and on awareness and knowledge on voluntary and counselling testing services. In addition, a blood sample was taken for HIV diagnosis.Results: A total of 600 people were enrolled. Their age ranged from 50 to 90 years with mean of 64.9 (±SD 10.3) years. The HIV prevalence was 1.7% (n=10) and it was higher among women (2.1%) than men (1.3%). Sixty-percent (n=350) were knowledgeable on HIV transmission and only 40% (n=216) on HIV prevention. In bivariate analysis, age of partner <50 years, ever use of condoms, poor knowledge on HIV prevention and perception of risk on HIV were significantly associated with HIV. However, only partner’s age of <50 years remained significant after controlling for confounders.Conclusion: HIV prevalence and overall knowledge on its transmission among older adults in this rural population were low. There is a need for strategies to improve HIV preventive knowledge and testing in this group in order to continue keeping the transmission at low levels.
Asymptomatic malaria and associated factors among blood donors in Mwanza, Tanzania
Authors: Morona Domenica , Msemwa Betrand , Zinga Maria M. , Mushi Martha F. , Mirambo Mariam M. , Mshana Stephen E.
Published: June 2021

Background: Blood transfusion saves life of patients with severe anaemia. However, blood transfusion can transmit blood-borne parasites. Despite malaria being endemic in Tanzania, there is limited information on asymptomatic malaria among blood donors. This study determined the prevalence and associated factors of asymptomatic malaria among blood donors at the Lake Zone Victoria Blood Transfusion Centre in Mwanza, Tanzania.Methods: A cross-sectional study was conducted between March and April 2016 among blood donors without any symptoms of malaria. During blood donation, samples were collected from each participant. Malaria parasites were detected microscopically from Giemsa stained thin and thick smears and by the use of malaria rapid diagnostic test (MRDT).Results: A total of 150 blood donors participated in this study. The median age of participants was 20 (IQR: 18-27) years. Malaria prevalence by microscopy was 5.3% (95% CI: 1.7-8.8) while by MRDT was 8% (95% CI: 3.6-12.3). Malaria mean parasite density was 12mps/200WBC. Only individuals who reported using mosquito nets were found to be protected from getting asymptomatic malaria on multivariate logistic regression analysis (OR: 0.04, 95% CI: 0.01-0.25, P<0.001).Conclusion: A considerable proportion of blood donors in Mwanza, Tanzania are infected with P. falciparum which poses a risk for transmission to blood recipients including malaria vulnerable groups like pregnancy woman and children. Screening donated blood for malaria parasites is recommended in malaria endemic areas to prevent possible fatal consequences.
Factors associated with child sexual abuse in Tanzania: a qualitative study
Authors: Ezekiel Mangi J. , Kisanga Felix , Mosha Idda H. , Anaeli Amani , Kamazima Switbert R. , Mpembeni Rose , Muhondwa Eustace P.
Published: June 2021

Background: Child sexual abuse (CSA) is one of the most pervasive occurrences which are reported all over the world. It often goes unnoticed and undocumented due to surrounding taboos; its sensitivity in nature and affects the less powerful population. Anecdote information is available on the nature and extent of sexual abuse among children in Tanzania. The aim of this study was to explore factors, forms, context of abuse and perpetrators of child sex abuse in selected regions of Tanzania.Methods: Key informant interviews were conducted among adults including parents of the victims to explore factors associated with sexual abuse of children under 10 years old in Tanzania. The interview guide centred on factors for child sexual abuse, the type of perpetrators and the context into which these abuses take place.Results: There were incidences of child sexual abuse in Tanzania and the major forms were anal and vaginal penetration, and the most affected were girls. The abuses were rarely reported due to shame and embarrassment faced by the affected children and parents. The causes of child sexual abuse were poverty, ambitions and moral degradation, myths and beliefs, urbanization, foreign culture and poor parental care. Incidents of CSA were reported to occur in perpetrators’ homes and in semi-finished housing structures, madrassa and recreational venues where children can freely access entertainment by watching movies. These acts were committed by people in position of power, close relationship and trusted by the children. Contexts where child sexual abuses occur included overcrowded living spaces and social activities that go on late into the night.Conclusion: We recommend for strengthened interventions at different levels within the society to address the root causes and different contexts in which child sex abuse occurs. Increased awareness of the root causes should go hand in hand with measures to encourage parents and survivors to report incidents to relevant authorities timely as they occur.
Prevalence and associated factors of late HIV diagnosis in north-western rural Tanzania: a cross sectional study
Authors: Gunda Daniel W. , Kaganda Rashid A. , Bakshi Fatma A. , Kilonzo Semvua B. , Mpondo Bonaventura C.
Published: June 2021

Background: Despite scaling up of HIV and treatment services to improve the outcome of people living with HIV, still a high proportion of patients seek out medical attention at late stages of the disease. This contributes to late initiation of ART and poor clinical outcome especially in sub Saharan Africa. The literature on magnitude of this problem in Tanzania is still scarce. This study aimed to determine the prevalence and associated factors of delayed HIV diagnosis in rural Tanzania.Methods: This was a cross sectional study, involving newly diagnosed adult HIV patients sent in for care and treatment linkage. Information regarding age, sex, WHO stage, type of opportunistic condition, HIV testing service and on diagnosis CD4 counts were all collected. On diagnosis CD4 counts <200cells/µl was coded as Late HIV diagnosis. The proportion of with Late HIV diagnosis was calculated and logistic regression modal was used to determine the degree of association of different variables at 95%CI.Results: In total 649 patients were included in this study. The median age of the study participants was 45.5 years most of them being females 396 (61.02%). The median CD4 count was 168 cells/µl and majority of our study participants 468 (72.11%) were in WHO clinical stage 3&4.  Overall 385 (59.32%) were found to have Late HIV diagnosis where 303 (78.70%) had stage 3&4 AIDS defining illness (OR=2.2, p<0.001). Male patients were predominantly affected (OR=1.4, p=0.035), who were more likely to be tested following PITC service (OR=30, p<0.001).Conclusions: Late HIV diagnosis is prevalent in our setting with high prevalence of most of the stage 3&4 AIDS defining illnesses. Male patients are predominantly affected as late presenters. There is a need to strengthen and extend the available Provider Initiated Testing and Counselling activities to primary health care level.
Magnitude and factors associated with overweight and obesity among adolescents in in semi-rural area of Babati District, Tanzania
Authors: Tluway Furahini D. , Leyna Germana H. , Mmbaga Elia J.
Published: June 2021

Background: Childhood and adolescent overweight and obesity have increased dramatically in recent years. We assessed the burden and factors associated with overweight and obesity among adolescents in a semi-rural district of Babati in Tanzania.Methods: A school-based descriptive cross-sectional survey was conducted among adolescents attending secondary schools. Anthropometric measurements were taken using standard procedures. A Food Frequency Questionnaire and the International Physical Activity Questionnaire were adapted to assess dietary and physical activity patterns, respectively.Results: A total of 619 students were included in the analysis. The mean age and body mass index of the respondents were 16.7±1.68 years and 19.9±3.16 kg/m², respectively. The overall prevalence of overweight and obesity was 9.2% with more girls being overweight and obese than boys (P<0.0001). In the Generalized Estimating Equations (GEE) models, girls (Odds Ratio [OR] = 5.6; 95% Confidence Interval [CI]: 1.97, 15.72]); unhealthy diet (OR = 2.2; 95% CI: 1.32, 3.63); vigorous physical activity (OR = 2.2; 95%CI: 1.34, 3.56) and physical inactivity (OR = 1.7; 95%CI: 1.08, 2.79) were independent predictors of overweight or obesity.Conclusion: The prevalence of overweight and obesity was modest. Female sex, unhealthy diet and physical inactivity were significantly predictive. There is a need for interventions in obesity to have a broader target audience to include adolescents and residents of rural areas. Primary preventive interventions are needed.
The burden and management of self-inflicted injuries at a tertiary care hospital in Mwanza, Tanzania
Authors: Chandika Alphonce B. , Chalya Phillipo L. , Hauli Kiyeti A. , Rambau Peter F. , Mwakanyamale Adela A. , Gilyoma Japhet M.
Published: June 2021

Background: Self-inflicted injuries are a serious but neglected public health problem in developing countries and contribute significantly to the global injury burden. There is a paucity of published data regarding self-inflicted injuries in Tanzania.  This study describes the aetiology, patterns and treatment outcome of these injuries in Mwanza, Tanzania.Methods: This was a combined retrospective and prospective study of self-inflicted injury patients who were managed at Bugando Medical Centre in Mwanza between February 2007 and April 2014. Data were collected using a pretested and coded questionnaire and analysed using SPSS computer software version 17.0Results: A total of 136 patients (M: F = 3.3: 1) were enrolled into the study. The median age was 30 years. Psychiatric illness (30.9%) was the most common risk factor for self-inflicted injuries. Self-poisoning (35.3%) was the most frequent mechanism of self-inflicted injuries. This was followed by cutting/stabbing and jumping from heights in 23.5% and 20.6% of patients, respectively. The trunk was the most frequent (31.9%) body region affected. Open wounds were the most (4.2%) common type of injuries sustained. The majority (72.1%) of patients were treated surgically. The complication rate was 50.7% and it was significantly associated with delayed presentation (p= 0.012). The median hospital stay was 12 days. Patients with long bone fractures and those who had surgical site infection stayed longer in the hospital (p < 0.001). The mortality rate was 22.8%. Late presentation (>24 hour), severe injuries (KTS II ≤ 6) and presence of surgical site infections were the main predictors of mortality (p<0.001).Conclusion: Self-inflicted injuries are an emerging but neglected public health problem in Mwanza, Tanzania and contribute to unacceptably high morbidity and mortality. Addressing the root causes of self-inflicted injuries may reduce the incidence of these injuries in our environment.
Seroprevalence of hepatitis E among restaurant food handlers in Ibadan, Nigeria
Authors: Fowotade Adeola , Oluseyi Akande , Gbaja Adebimpe T. , Ogunleye Victoria O. , Ajayi Ayomide , Kehinde Aderemi O.
Published: June 2021

Background: Hepatitis E virus (HEV) is one of the causative agent of acute viral hepatitis in humans. HEV is an important public health disease in many parts of the world because it is transmitted faeco-orally.  Majority of the documented studies on hepatitis E virus in Nigeria have focused on pregnant women and animal handlers with limited data among food handlers. Thus the current study aimed at investigating the prevalence of HEV infection among food handlers operating within the premises of a tertiary care facility.Methods: One hundred and seventy seven (177) food handlers were screened using commercial Enzyme-Linked Immuno-Sorbent Assay (ELISA) to detect IgM antibodies to Hepatitis E. A semi-structured questionnaire was used to assess risk factors for HEV infection.Results: HEV IgM antibodies were detected in 16 (9.0%) of the participants. Age-specific HEV IgM seroprevalence appeared to decrease with age, however there were no significant differences in HEV IgM seropositivity regarding age (P=0.251), gender (P = 0.231), marital status (P=0.735) and religion (P = 0.906). Significant risk factors for HEV IgM seropositivity included source of water for drinking (P=0.03) and the use of soap for hand washing (P=0.02).Conclusion: Our findings suggest that HEV remains a public health problem, as the virus circulates at low but considerable levels especially among food handlers; thus posing a threat to potential contacts. Proper hand washing practices as well as provision of portable water are important factors for the control of Hepatitis E.
High rate of drinking water contamination due to poor storage in squatter settlements in Mwanza, Tanzania
Authors: Mushi Martha F. , Mpelasoka Oswald E. , Mazigo Humphrey D. , McLeod Laura , Moremi Nyambura , Mirambo Mariam M. , Mshana Stephen E.
Published: June 2021

Background: Drinking water of acceptable quality is supposed to be free from faecal coliform and chemical substances that may be hazardous to human health. Water treatment and safe storage at the household level has been advocated as effective means of ensuring safe drinking water. This study was undertaken to determine the microbiological quality of the drinking water at household level in the squatter settlements in the city of Mwanza, Tanzania.Methods: A cross-sectional study was conducted between June 2014 and September 2014.  A total of 15 randomly selected water sources (tap) and 207 households’ drinking water samples from these sources were studied to ascertain level of water contamination using Membrane Filtration Method. Pre-tested questionnaire was used to collect demographic and other data regarding water treatment and storage.  Data were entered, cleaned and analysed using STATA Version 11.Results:  All 15 samples from tap used as water sources were found to be free of indicator organism (Escherichia coli) while 109 (52.66%) of drinking water samples from 207 households were found to be contaminated with E. coli.  All contaminated drinking water samples were from containers with no cover and spigot. Conclusions: There is a significant level of deterioration of water quality from the source to the drinking cup. Efforts to ensure quality storage methods for drinking water should be addressed at household level.
Teething induced fever in a 9-month old child: a case report
Authors: Dika Haruna I. , Iddi Shabani , Kayange Neema
Published: June 2021

The association between teething and fever has attracted considerable interest because studies have reported controversial results. These discordant results have posed a challenge in the management of fever occurring during teething.  The objective of this paper is to supplement previous studies which showed association between teeth eruption and fever and highlight mismanagement of teething induced fever. A 9-month old baby girl presented with fever during teeth eruption. Despite of no malaria parasites seen on blood slide and lack of features and laboratory investigations suggestive of urinary tract infection or bacteremia, the child was treated with antimalarial drugs and prescribed antibiotics. This case study demonstrates that unrecognized teething induced fever leads to unnecessary use of anti-malarial drugs and antibiotics.  We recommend paediatricians to consider teething as one of the causes of fever among children.
HIV seroprevalence and factors affecting clinical outcomes among patients with surgical acute abdomen in selected hospitals in Mwanza, north-western in Tanzania
Authors: Sravanam Praveen , Massenga Alicia , Bugimbi Merchades , Mirambo Mariam M , Chalya Phillipo L.
Published: June 2021

Background:  HIV infection has been reported to be prevalent in patients with surgical acute abdomen. This study aimed to establish HIV seroprevalence among patients with surgical acute abdomen and to identify factors affecting clinical outcomes among these patients at a tertiary care hospital in Tanzania Methods: This was a prospective cross-sectional study of patients with surgical acute abdomen admitted to three selected hospitals in Mwanza between February 2016 and July 2016.Results: Out of the 106 patients (M: F = 1.5:1) included in the study, 15 (14.2%) were HIV positive. Of these, nine were males and 6 were females. Surgical site infection was the most common postoperative compilation and was found to be significantly higher in HIV positive patients with CD 4+ count below 200 cells/μl (p<0.001). The median length of hospital stay (LOS) was 16 days. There was no significant difference in LOS between HIV positive and negative patients (p=0.791). Mortality rate was 13.2% and it was significantly higher in patients with advanced age (> 65 years), pre-existing medical illness, delayed presentation (>48 hours), HIV positivity, high American Society of Anesthetists class, surgical site infections (p< 0.001).Conclusion: This study has shown that HIV infection is prevalent among patients with surgical acute abdomen in our setting. Factors influencing the clinical outcome of these patients need to be addressed, in order to deliver optimal patient care and improve their treatment outcome.
Asymptomatic bacteriuria among pregnant women attending antenatal care at Kilimanjaro Christian Medical Centre in Northern Tanzania
Authors: Mwei Moses K. , Mchome Bariki , John Beatrice , Maro Eusebious
Published: June 2021

Background:  Asymptomatic bacteriuria has been demonstrated to have adverse maternal and pregnancy outcomes precisely pyelonephritis, low birth weight, preterm premature rupture of membranes and preterm labour.Objective: This study aimed to determine the prevalence of asymptomatic bacteriuria and antibiotic sensitivity pattern among women attending antenatal clinic at Kilimanjaro Christian Medical Centre in Northern Tanzania.Methodology: We conducted analytical cross sectional study involving women attending antenatal clinic at Kilimanjaro Christian Medical Centre between October and December 2016. All women who met the inclusion criteria and gave their informed consent were invited to participate. Interviews using a questionnaire were conducted to collect socio-demographic and obstetric information while urine samples were collected for laboratory processing. Results: The prevalence of asymptomatic bacteriuria (ASB) among pregnant women in this study was 8.9%. The organisms isolated from the urine sample according to the frequency of occurrence were Escherichia coli (50%), Streptococcus pyogenes (19%), Klebsiella pneumoniae (15%), group B Streptococcus (8%), group A Streptococcus (4%) and Proteus mirabilis (4%). The rate of antibiotic sensitivity among gram negative bacteria ranged from 100% among Escherichia coli and Proteus mirabilis to ceftriaxone, while Klebsiella pneumoniae and Proteus mirabilis showed no sensitivity at all to ampicillin. Among the gram positive bacteria, erythromycin was shown to have sensitivity to group A streptococcus but no sensitivity to group B streptococcus.Conclusion: The prevalence of asymptomatic bacteriuria of 8.9% among pregnant women and the wide array of organisms isolated in this population warrant the development of protocols for routine ASB screening and exclusion of ampicillin as an antibiotic of choice in this cohort.
Intronic variants in the long non-coding RNA CDKN2B-AS1 are strongly associated with the risk of coronary artery disease in the Northern Tribes of Tanzania
Authors: Akan Gokce , Kisenge Peter , Sanga Tulizo Shemu , Mbugi Erasto , Turkcan Mehmet Kerem , Janabi Mohammed , Atalar Fatmahan
Published: June 2021

Introduction: Sub-Saharan Africa (SSA) is facing a rising epidemic of non-communicable diseases including the coronary artery disease (CAD) ranking at the top of the list. Chromosome locus 9p21.3 containing CDKN2B antisense RNA 1 (CDKN2B-AS1), identified in many genome-wide association studies for coronary artery disease (CAD), encompasses multiple single nucleotide polymorphisms (SNPs). This study aimed to conduct the first genetic study evaluating the common polymorphisms in 9p21.3 locus in Tanzanian CAD patients from different regions of Tanzania and their associations with CAD risk factors.

Material and Methods: A total of 90 patients from Northern region (N-CAD) of Tanzania and 65 patients from other regions (South, East, West and Central) (R-CAD) were included in the study. Further the biochemical analysis the genotyping of common variants was performed with the LightSNiP typing assay using qRT-PCR method. 

Results: Our analyses revealed that both genotype and allele frequencies of rs10757274, rs10757278 and rs10811656 were significantly different between the groups (p<0.05, respectively). We identified that one previously undescribed three-marker haplotype (rs1333049, rs10757274 and rs10757278) encompassing CDKN2B-AS1 was overrepresented (G-G-G, the risk haplotype, p<0.05) in N-CAD group compared to R-CAD group. The AUC of a risk model based on non-genetic factors was 0.730 (0.654-0.797) and the combination with genetic risk factors improved the AUC to 0.784 (95%CI=0.713-0.844, p<0.0001).

Conclusion: Our results identified the presence of a novel three-marker haplotype having a significant association with CAD in Northern Tanzania. Moreover, combination of the nongenetic and genetic risk models were demonstrated to indicate good diagnostic accuracy for CAD in Northern Tanzania.
Prevalence of cerumen impaction and associated factors among primary school children in Mwanza city, Tanzania
Authors: Chalya Phillipo Leo , Mabenda Shija B , BUNABE GUSTAVE , Gilyoma Japhet M , Mahalu William
Published: June 2021

Background: Cerumen impaction is a worldwide problem constituting a significant proportion of health problems in many settings and its prevalence varies. There is a paucity of published data regarding this condition in Tanzania with none from Mwanza region. The aim of this study was to determine the prevalence of cerumen impaction and associated factors among primary school children in Mwanza City and to assess the effect of cerumen impaction and its removal on hearing ability

Methods and Patients: This was a cross-sectional, community-based study of primary school children with cerumen impaction that was carried out in randomly selected primary schools in Mwanza City between December 2016 and May 2017. Multistage cluster sampling technique was employed to obtain a required number of the study population.

Results: Out of the 406 participants, ninety-five (23.4%) had cerumen impacted in their ears. Of these, 56 (58.9%) were males and 39(41.1%) were females. The mean age at presentation was 11.24±8.86 years. Ear bud abuse (83.7%) was the most common predisposing factor for cerumen impaction. Cerumen impaction was found in the right ear of 9 (9.5%) patients and in the left ear in 31 (32.6%) patients and bilateral in 55 (57.9%) of patients. The major presenting symptoms were ear itching, otalgia, hearing loss and tinnitus. Ear syringing was used to remove cerumen impaction and caused significant improvement in hearing thresholds. There were no recorded complications.

Conclusion: Cerumen impaction is a common otologic presentation in our sub-region. Ignorance with the profound abuse of cotton buds is the major predisposing factor. Health education is of the essence as treatment is simple and effective.
Giant vulva fibroma presenting as a genital mass: a case report
Authors: Ndaboine Edgar , Matovelo Dismas , Itemba Arnold , Mbulwa Cosmas
Published: June 2021

Introduction: Even though vulva fibroma is rare, it is among the solid tumors of the vulva. Its cause is unknown although it has been associated with physiological hormonal changes. We report a patient with a unique vulva fibroma which has grown to the extent of interfering with her gait and urination.

Case presentation: A 22-year-old woman presented with a genital mass which had been present for the duration of 2 years and felt embarrassed to report to the hospital early as the growth was in the genital area, with the perception of it being a sexually related illness, despite having not yet started engaging in sexual activity. On physical examination, a palpable pendulous mass of about [30 x 22] cm was seen originating from the right labia and extending to the right perineum. The mass was firm, nodulated, non-tender and had limited mobility. Surgical excision was performed under spinal anesthesia. Histologically, features suggestive of mixoid fibroma were reached after the mass was excised.  No recurrence has been observed.

Conclusion: Clinicians should be aware of this rare disease which can be associated with recurrence if there is incomplete excision. Again, the unusual finding of the genital mass can be very embarrassing to the patient affecting her psychosocial well-being. It needs to be treated immediately upon diagnosis.
A cross-sectional study on knowledge and implementation of the nursing process among nurses at Muhimbili National Hospital-Tanzania
Authors: Obonyo Happiness , Tarimo Edith A.M. , Ramadhan Fatina , Kapalata Secilia Ng’weshemi
Published: June 2021

Background: The nursing process involves a series of actions that begin with assessing the patient, identifying problems, setting goals with expected outcomes, implementing care to achieve those goals, and finally evaluating the effectiveness of the care given. Utilization of the nursing process to guide nursing care enhances the quality of patient care and outcomes for both the patient and family members. The purpose of this study was to assess the knowledge and implementation of the nursing process among nurses working at Muhimbili National Hospital, Dar es Salaam, Tanzania.

Methods: We conducted a descriptive cross-sectional study design. A convenient sample of 102 registered nurses (RN) completed a self-administered questionnaire in April 2016. Descriptive statistics and non-parametric tests were used to assess the significance levels of associated variables.

Results: Of 102 respondents, only 16 (15.7%) had high knowledge of the nursing process. Similarly, a few (11, 10.8%) respondents had a high level of practice. The majority of RN (94, 92.2%) were aware of the role of the nurses in providing care to admitted patients. However, only a few (32, 31.4%) were aware of the purpose of the nursing process. Respondents were more likely to have high knowledge in the nursing process if they had a diploma in nursing education (95% CI 0.000-0.029, p < 0.01). The small number of nurses in the ward and inadequate motivational strategies were reported to deprive the implementation of the nursing process.

Conclusion: Overall, low knowledge of the nursing process, understaffing and workload have contributed to the ineffective implementation of the nursing process.  On-the-job refresher courses are a short-term strategy that may improve the nurses’ knowledge and motivation to implement the nursing process. This study underscores the need for policymakers to advocate for the employment of a sufficient number of nurses to enable implementation of the nursing process to all admitted patients.
Stem Cells: Prospects and Potential Applications in Tanzania: A review
Authors: Russa Afadhali Denis
Published: June 2021

Stem cell technology and its application in regenerative medicine is the future gateway for the treatment of most non-communicable diseases (NCDs). As the burden of NCDs continues to rises globally, regenerating the cells, tissues and organs will be the mainstream treatment option. The world is prepared for this intriguing but promising avenue of biomedical technology and medicine but Africa is grossly lagging far behind. African governments, universities, research and health institutions need to take a leading role in empowering and mainstreaming stem cell research.  Moreover, for Africa, there is a huge potential for translating stem cell technology into clinical treatments due to the fact that there are limited treatment options for life-threatening forms of NCDs.  Some African countries have well-developed stem cell facilities and large-scale stem cell therapy centers. The use of adult stem cells in liver failure, diabetes and cardiac infarcts has shown success in some African countries. The present work reviews the status, potential and future prospects of stem cell technology and regenerative medicine in Tanzania with particular emphasis on the adult stem cells applicability into the immediate use inpatient care.  The paper also reviews the available cell identification systems and markers and moral and ethical aspects of stem cell science necessary in the translational treatment regimens.
PERFORMANCE COMPARISON OF ISLAMIC BANKS AND CONVENTIONAL BANKS IN PAKISTAN
Authors: Rizwan Rabeea
Published: June 2021

The objective of this paper is to compare and analyze the performance of Islamic Banks and Conventional Banks operating in Pakistan during the 5 year period of 2015-2019. This study utilizes the CAMEL approach to assess and compare the performance of Islamic Banks and Conventional Banks in Pakistan using a sample of banks. For the purpose of this study, we have used a sample of 4 Conventional banks and 4 Islamic Banks that are operating in Pakistan. All the relevant information for the purpose of comparison for this study was collected from the annual reports of these sample banks which were available on the respective bank’s website. The findings of this study indicate that in Pakistan, Islamic banks have performed better in terms of asset quality and earnings than the conventional banks whereas the conventional banks had a better performance in terms of liquidity, management efficiency and capital during the five-year period of consideration. The findings of the analysis also showed that Islamic banks in Pakistan have shown significant growth over the 5 year period 2015-2019.