bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brugada-like syndrome presenting with monomorphic ventricular tachycardia and Brugada-type electrocardiogram unmasked by fever in an infant: a case report
Authors: Kilonzo Semvua B. , Ringo Faith , Steven Humphrey , Mpondo Bonaventura T. , Meda John R. 
Published: June 2021

Brugada syndrome is an autosomal-dominant arythmogenic genetic disorder associated with mutation in the SCN5A gene. We report a case of 3-month-old Tanzanian male who was admitted at Muhimbili National Hospital in Dar es Salaam, Tanzania with severe pneumonia, high fever and monomorphic ventricular tachycardia. The patient was treated with intravenous Amiodarone. In addition, oxygen, parenteral antibiotics, antipyretics and intravenous fluids were also given. About 2 hours and 20 minute later the child stabilized. An ECG obtained shortly after termination of ventricular tachycardia showed the typical J-point and coved ST elevation typical of Brugada type I pattern. To the best of our knowledge, this is the first paediatric case with Brugada-type ECG to be reported in Sub-Saharan Africa. This case emphasizes the need to increase awareness among clinicians of clinical and genetic arythmogenic disorders. Multiple ECGs during and after febrile disorders should be performed in children who exhibit extreme tachycardia or signs of cardiac failure.
Clinicopathological pattern of benign breast diseases among female patients at a tertiary health institution in Tanzania
Authors: Chalya Phillipo L. , Manyama Mange , Rambau Peter F. , Kapesa Anthony , Ngallaba Sospatro E. , Masalu Nestory , Mabula Joseph B. 
Published: June 2021

Background: Benign breast diseases are a neglected entity in developing countries despite the fact that they constitute the majority of breast complaints. There is a paucity of published information regarding benign breast diseases in Tanzania. This study describes our experience in the management of benign breast diseases outlining the clinicopathological pattern and treatment modalities of these diseases in our local setting.Methods: This prospective descriptive study was conducted between November 2009 and March 2013 at Bugando Medical Centre in Tanzania on female patients aged 10 years and above presenting with benign breast diseases.Results: A total of 346 female patients with benign breast diseases were studied. The majority of patients, 255 (73.7%) were younger than 30 years. Breast lump was the most frequent presentation in 67.6% of patients. Fibroadenoma 95 (60.0%) was the most frequently diagnosed benign breast disease followed by fibrocystic changes (19.0%). Out of 295 patients who had histopathological examination, 64 (21.7%) had proliferative lesions. Of these, 18 (28.1%) had proliferative lesions with atypia while 46(71.9%) had proliferative lesions without atypia. Eight (2.6%) patients were HIV positive with the median CD 4+ count of 258 cells/μl. The majority of patients, 295(85.2%) underwent surgical treatment of which lumpectomy was the most common procedure performed. Conclusion: Benign breast diseases are more common than malignancies in our environment and occur mainly in young women less than 30 years of age and were mostly fibroadenoma and fibrocystic change. Though premalignant lesions of proliferative lesions with atypia were less common in this study, it is advisable that all cases of breast lesions should be carefully evaluated to exclude possibility of breast cancer.
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.
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 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.
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.