Diarrhoeal diseases are associated with high morbidity and mortality, especially in children less than five years of age in many low- and middle-income countries (LMICs). This cross-sectional convergence mixed-method study explored water, sanitation and hygiene challenges as the important contributors to childhood diarrhoea in rural Tanzania. The study involved questionnaire survey (N=340), key informant interviews (KII) (n=10) and eight focus group discussions (FDG) (n=61). Prevalence of diarrhoea was 22.2% and 18.7% in Sanza and Iwondo Wards, of Manyoni and Mpwapwa Districts respectively. Improved houses (iron roof and baked brick walls) were more common in Sanza, while 80% of the houses in both wards had earth floor. Water sources in dry period and frequency of sharing water sources with animal were significantly different between wards (P<.001). Boiling drinking water was uncommon, practised by only 5.2% and 8.6% of the households in Sanza and Iwondo, respectively. More than 95% of the households in both wards used traditional pit latrines, and latrine sharing was more common in Iwondo than in Sanza (P=.035). The themes from KII and FGD were: knowledge of occurrence and causes of diarrhoea, water safety, hand-washing, availability of improved sanitation services, keeping chickens inside the house overnight, health effects associated with keeping chickens inside the house and knowledge of occurrence and causes of diarrhoea. Mixed methods analysis through merging data sets revealed poor community knowledge on the causes of childhood diarrhoea, ineffective hand washing, seasonal variation of drinking water sources and high human-chicken interactions. Prevention and control of gastrointestinal infections in resource-poor settings should promote the use of cheap and locally available resources and feasible practices in response to the existing challenges related to water and sanitation services, financial constraints, economic activities, and cultural practices.
{"title":"Hygiene Practices, Water Supply, Sanitation, and Childhood Diarrhoea in Resource-Poor Settings of Rural Central Tanzania: A Mixed-Method Study","authors":"Elpidius Rukambile, Gary Muscatello, Msafiri Kalloka, Brigitte Bagnol, Darryl Stellmach, Robyn Alders","doi":"10.24248/easci.v5i1.75","DOIUrl":"https://doi.org/10.24248/easci.v5i1.75","url":null,"abstract":"Diarrhoeal diseases are associated with high morbidity and mortality, especially in children less than five years of age in many low- and middle-income countries (LMICs). This cross-sectional convergence mixed-method study explored water, sanitation and hygiene challenges as the important contributors to childhood diarrhoea in rural Tanzania. The study involved questionnaire survey (N=340), key informant interviews (KII) (n=10) and eight focus group discussions (FDG) (n=61). Prevalence of diarrhoea was 22.2% and 18.7% in Sanza and Iwondo Wards, of Manyoni and Mpwapwa Districts respectively. Improved houses (iron roof and baked brick walls) were more common in Sanza, while 80% of the houses in both wards had earth floor. Water sources in dry period and frequency of sharing water sources with animal were significantly different between wards (P<.001). Boiling drinking water was uncommon, practised by only 5.2% and 8.6% of the households in Sanza and Iwondo, respectively. More than 95% of the households in both wards used traditional pit latrines, and latrine sharing was more common in Iwondo than in Sanza (P=.035). The themes from KII and FGD were: knowledge of occurrence and causes of diarrhoea, water safety, hand-washing, availability of improved sanitation services, keeping chickens inside the house overnight, health effects associated with keeping chickens inside the house and knowledge of occurrence and causes of diarrhoea. Mixed methods analysis through merging data sets revealed poor community knowledge on the causes of childhood diarrhoea, ineffective hand washing, seasonal variation of drinking water sources and high human-chicken interactions. Prevention and control of gastrointestinal infections in resource-poor settings should promote the use of cheap and locally available resources and feasible practices in response to the existing challenges related to water and sanitation services, financial constraints, economic activities, and cultural practices.","PeriodicalId":11398,"journal":{"name":"East Africa Science","volume":"331 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135419939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Regan Zenas Shayo, Nsiande Lema, Mecky I. N. Matee
Background: In Tanzania, little is known about the proportion of Multi-drug resistance (MDR) Gram-negative bacteria contamination on Automated Teller Machine (ATMs) surfaces. The study aimed to determine the proportion of MDR Gram-negative bacteria contamination on ATMs surfaces, antimicrobial resistance patterns as well as associated factors. Methodology: A cross-sectional study was conducted between January and March -2021 in Dar es Salaam, involving 298 ATMs. Cultures were performed on Mac-Conkey agar while antimicrobial susceptibility was done using the Kirby Bauer disc diffusion method with Klebsiella pneumoniae ATCC 700603 and Escherichia coli ATCC 25922 used as controls. Data analysis was done using STATA version 15.1. Chi-square and Modified Poisson regression was used to assess factors associated with MDR contamination. Data was presented as prevalence ratio (PR) and 95% Confidence Interval. A p-value of <.05 was considered statistically significant. Results: More than half (55.4%) of ATMs in Dar es Salaam are contaminated with Gram negative bacteria, mostly by Klebsiella pneumoniae 18.5% (31/168). The highest level of resistance was observed against ampicillin (68.9%). About one-third (34.5%) of the isolates were MDR. About 35.7% were Extended-Spectrum Beta-Lactamases (ESBL) producers while 19.6% were quinolone/ fluoroquinolones-resistance. Risk factors for contamination of ATMs included highly populated location such as; Ubungo (PR adjusted = 3.62, 95%CI = 1.58-8.30, P=.002), Kigamboni (PR adjusted = 2.78, 95%CI = 1.20-6.42, P=.017), and Temeke (PR adjusted = 2.75, 95%CI = 1.04-3.72, P=.023), and less frequent cleaned ATMs (PR adjusted = 1.98, 95%CI = 1.04-3.73, P=.04). Conclusions: More than half of ATMs in Dar es Salaam are contaminated with Gram-negative and one-third of them with MDR bacteria, especially those located in highly populated areas and those that are less frequently cleaned. This calls for interventional measures regarding public awareness of ATMs as potential vehicles for the transmission of infectious agents.
{"title":"Contamination of Automated Teller Machines Surfaces with Multi-drug Resistance Gram-negative Bacteria in Dar es Salaam, Tanzania","authors":"Regan Zenas Shayo, Nsiande Lema, Mecky I. N. Matee","doi":"10.24248/easci.v5i1.78","DOIUrl":"https://doi.org/10.24248/easci.v5i1.78","url":null,"abstract":"Background: In Tanzania, little is known about the proportion of Multi-drug resistance (MDR) Gram-negative bacteria contamination on Automated Teller Machine (ATMs) surfaces. The study aimed to determine the proportion of MDR Gram-negative bacteria contamination on ATMs surfaces, antimicrobial resistance patterns as well as associated factors. Methodology: A cross-sectional study was conducted between January and March -2021 in Dar es Salaam, involving 298 ATMs. Cultures were performed on Mac-Conkey agar while antimicrobial susceptibility was done using the Kirby Bauer disc diffusion method with Klebsiella pneumoniae ATCC 700603 and Escherichia coli ATCC 25922 used as controls. Data analysis was done using STATA version 15.1. Chi-square and Modified Poisson regression was used to assess factors associated with MDR contamination. Data was presented as prevalence ratio (PR) and 95% Confidence Interval. A p-value of <.05 was considered statistically significant. Results: More than half (55.4%) of ATMs in Dar es Salaam are contaminated with Gram negative bacteria, mostly by Klebsiella pneumoniae 18.5% (31/168). The highest level of resistance was observed against ampicillin (68.9%). About one-third (34.5%) of the isolates were MDR. About 35.7% were Extended-Spectrum Beta-Lactamases (ESBL) producers while 19.6% were quinolone/ fluoroquinolones-resistance. Risk factors for contamination of ATMs included highly populated location such as; Ubungo (PR adjusted = 3.62, 95%CI = 1.58-8.30, P=.002), Kigamboni (PR adjusted = 2.78, 95%CI = 1.20-6.42, P=.017), and Temeke (PR adjusted = 2.75, 95%CI = 1.04-3.72, P=.023), and less frequent cleaned ATMs (PR adjusted = 1.98, 95%CI = 1.04-3.73, P=.04). Conclusions: More than half of ATMs in Dar es Salaam are contaminated with Gram-negative and one-third of them with MDR bacteria, especially those located in highly populated areas and those that are less frequently cleaned. This calls for interventional measures regarding public awareness of ATMs as potential vehicles for the transmission of infectious agents.","PeriodicalId":11398,"journal":{"name":"East Africa Science","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135419934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Chronic kidney disease (CKD) remains a public health concern of 21st century. Each year, over million people die from CKD resulting from the lack of proper diagnosis and treatment of this terrible disease of the urinary system. Non-communicable diseases (NCDs) cause roughly 60% of all deaths worldwide. There is insufficient data in Rwanda for the management of kidney diseases and other NCDs for all health facilities. Renal substitution therapy appears to be the best solution for long–suffering patients with end-stage renal illness who want to survive. The study’s purpose was to find out the serum creatinine and blood urea nitrogen (BUN) concentrations among kidney transplanted patients at King Faisal Hospital of Rwanda, and to show the consequences linked with the transplantation of kidney. Methods: This was a retrospective study carried from November 2018 to December 2019. The data were collected from medical records at King Faisal Referral Hospital, and analysed with SPSS version 22. Results: BUN and serum creatinine concentrations ranged from 77.4 to 93.5% and 67.8 to 87.1%, respectively. BUN levels that were abnormally high ranged from 3.2 to 19.4%, while creatinine levels that were abnormally high ranged from 6.5 to 29.0%. BUN and creatinine levels that were abnormally low, ranged from 0.0 to 6.5 and 3.2 to 9.7%, respectively. Diabetes mellitus affected 19.35% of the study population, hypertension affected 35.48%, and antibodymediated rejection affected 6.45%. Conclusion: The slight change in biochemical parameters may be a problem after kidney transplantation. There should be a monitoring of biochemical parameters tests to prevent the post kidney transplantation complications.
{"title":"Assessment of Biochemical Parameters of Graft Survivors Post Renal Transplantation at King Faisal Hospital in Rwanda","authors":"Edgard Sumbiri, Cedrick Izere, Thierry Habyarimana, Callixte Yadufashije, Francois N. Niyonzima","doi":"10.24248/easci.v5i1.81","DOIUrl":"https://doi.org/10.24248/easci.v5i1.81","url":null,"abstract":"Background: Chronic kidney disease (CKD) remains a public health concern of 21st century. Each year, over million people die from CKD resulting from the lack of proper diagnosis and treatment of this terrible disease of the urinary system. Non-communicable diseases (NCDs) cause roughly 60% of all deaths worldwide. There is insufficient data in Rwanda for the management of kidney diseases and other NCDs for all health facilities. Renal substitution therapy appears to be the best solution for long–suffering patients with end-stage renal illness who want to survive. The study’s purpose was to find out the serum creatinine and blood urea nitrogen (BUN) concentrations among kidney transplanted patients at King Faisal Hospital of Rwanda, and to show the consequences linked with the transplantation of kidney. Methods: This was a retrospective study carried from November 2018 to December 2019. The data were collected from medical records at King Faisal Referral Hospital, and analysed with SPSS version 22. Results: BUN and serum creatinine concentrations ranged from 77.4 to 93.5% and 67.8 to 87.1%, respectively. BUN levels that were abnormally high ranged from 3.2 to 19.4%, while creatinine levels that were abnormally high ranged from 6.5 to 29.0%. BUN and creatinine levels that were abnormally low, ranged from 0.0 to 6.5 and 3.2 to 9.7%, respectively. Diabetes mellitus affected 19.35% of the study population, hypertension affected 35.48%, and antibodymediated rejection affected 6.45%. Conclusion: The slight change in biochemical parameters may be a problem after kidney transplantation. There should be a monitoring of biochemical parameters tests to prevent the post kidney transplantation complications.","PeriodicalId":11398,"journal":{"name":"East Africa Science","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135419936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The Laboratory investigations are very important for reaching to definitive diagnosis of diseases orientation and thus enabling optimal patient management based on informed diagnoses. Decision, and these are very difficult to obtain in the absence of reference values. In many cases, laboratory diagnosis such as haematological analyses are dependent on pre-defined locally established reference values. Objective of the study: The objective of this study was to describe ranges of haematological reference values for healthy individuals attending Ruhengeri referral Hospital in Rwanda Methodology: The cross sectional study was carried out in Northern Province at Ruhengeri referral hospital from July 2018 to September 2018. Participants were 252 healthy individuals aged less than one year to 68 years. From each participant, 4mL of blood samples were collected using K3 EDTA containers, and then analysed by Sysmex XS-500i automated haematology analyser. Results: Haemoglobin levels varied with age and sex. The level decreased with the increasing age, and males had high haemoglobin level than females (15.69g/dL versus 14.46g/dL). Minimum mean values of haematological parameters for study participants were slightly on the high side with narrow confidence intervals compared to the Manufactured Sysmex values. Conclusion: The findings may be used to define normal haematological values for Rwandan population and help physicians to better define haematological abnormalities in patients.
{"title":"Establishment of Haematological Reference Values for Healthy Individuals Attending Ruhengeri Referral Hospital in Rwanda","authors":"Ally Dusabimana, Amie de Dieu Musabyimana","doi":"10.24248/easci.v5i1.79","DOIUrl":"https://doi.org/10.24248/easci.v5i1.79","url":null,"abstract":"Background: The Laboratory investigations are very important for reaching to definitive diagnosis of diseases orientation and thus enabling optimal patient management based on informed diagnoses. Decision, and these are very difficult to obtain in the absence of reference values. In many cases, laboratory diagnosis such as haematological analyses are dependent on pre-defined locally established reference values. Objective of the study: The objective of this study was to describe ranges of haematological reference values for healthy individuals attending Ruhengeri referral Hospital in Rwanda Methodology: The cross sectional study was carried out in Northern Province at Ruhengeri referral hospital from July 2018 to September 2018. Participants were 252 healthy individuals aged less than one year to 68 years. From each participant, 4mL of blood samples were collected using K3 EDTA containers, and then analysed by Sysmex XS-500i automated haematology analyser. Results: Haemoglobin levels varied with age and sex. The level decreased with the increasing age, and males had high haemoglobin level than females (15.69g/dL versus 14.46g/dL). Minimum mean values of haematological parameters for study participants were slightly on the high side with narrow confidence intervals compared to the Manufactured Sysmex values. Conclusion: The findings may be used to define normal haematological values for Rwandan population and help physicians to better define haematological abnormalities in patients.","PeriodicalId":11398,"journal":{"name":"East Africa Science","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135419942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Chilongola, R. Mwakapuja, P. Horumpende, J. Vianney, Ahmed Shabhay, Sixbert I Mkumbaye, Hadija S Semvua, B. Mmbaga
Introduction: Dengue and Chikungunya have re-emerged as important diseases of global concern. Co-infections with Dengue virus (DENV) and Chikungunya virus (CHIKV) could have serious outcomes if not diagnosed and managed optimally. However, the key focal points for the maintenance of CHIKV and DENV infections and the extent of their co-infection remain poorly understood in many geo-ecologically distinct parts of Tanzania. Objective: We aimed to comparatively examine the prevalence and factors for seropositivity to DENV and CHIKV and their infection rates in humans and mosquitoes Methods: A cross-sectional study was performed in the Lower Moshi area of the Kilimanjaro region from April to July 2020. DENV and CHIKV exposure was determined by detecting IgM to the viruses using enzyme linked immunosorbent assay whereas infection was determined by real time quantitative polymerase chain reaction (RT-qPCR) assay. Results: Insecticide Treated Bed Net (ITN) use (χ2=3.504; p< 0.05), being ≥7 individuals living in the same household (χ2=4.655; p<0.05) and a recent travel to an urban destination (χ2=3.39; p< 0.05) were the only factors associated with CHIKV seropositivity. ITN use was the only factor associated with CHIKV infection (χ2=5.204; p<0.05). A recent travel to an urban destination (χ2=4.401; p< 0.05) was the only factor associated with DENV seropositivity. Five (1.5%) Ae. aegypti pools were positive for CHIKV whereas 1 (0.3%) was positive for DENV. Two Cx. pipiens, pools (1.9%) were positive for CHIKV. None of the Cx. pipiens mosquitoes was positive for DENV. No associations between DENV and CHIKV seropositivity was observed in humans but DENV infection was strongly associated with CHIKV infection (χ2 = 238.45; p<0.01). CHIKV infection was observed to be consistently higher in both, humans and mosquitoes. Conclusion: Detection of DENV and CHIKV in both humans and vector mosquitoes confirms that both viruses are actively circulating in the Lower Moshi area of Kilimanjaro region in Tanzania. Our findings point out the Lower Moshi area as a potential focal point for the maintenance of the two viruses and possibly other vector borne viruses. We call upon sustained active surveillance of arboviruses and other re-emerging infections to be better prepared for possible outbreaks by the viruses.
{"title":"Concurrent Infection With Dengue and Chikungunya Viruses in Humans and Mosquitoes: A Field Survey in Lower Moshi, Tanzania","authors":"J. Chilongola, R. Mwakapuja, P. Horumpende, J. Vianney, Ahmed Shabhay, Sixbert I Mkumbaye, Hadija S Semvua, B. Mmbaga","doi":"10.24248/easci.v4i1.62","DOIUrl":"https://doi.org/10.24248/easci.v4i1.62","url":null,"abstract":"Introduction: Dengue and Chikungunya have re-emerged as important diseases of global concern. Co-infections with Dengue virus (DENV) and Chikungunya virus (CHIKV) could have serious outcomes if not diagnosed and managed optimally. However, the key focal points for the maintenance of CHIKV and DENV infections and the extent of their co-infection remain poorly understood in many geo-ecologically distinct parts of Tanzania. Objective: We aimed to comparatively examine the prevalence and factors for seropositivity to DENV and CHIKV and their infection rates in humans and mosquitoes Methods: A cross-sectional study was performed in the Lower Moshi area of the Kilimanjaro region from April to July 2020. DENV and CHIKV exposure was determined by detecting IgM to the viruses using enzyme linked immunosorbent assay whereas infection was determined by real time quantitative polymerase chain reaction (RT-qPCR) assay. Results: Insecticide Treated Bed Net (ITN) use (χ2=3.504; p< 0.05), being ≥7 individuals living in the same household (χ2=4.655; p<0.05) and a recent travel to an urban destination (χ2=3.39; p< 0.05) were the only factors associated with CHIKV seropositivity. ITN use was the only factor associated with CHIKV infection (χ2=5.204; p<0.05). A recent travel to an urban destination (χ2=4.401; p< 0.05) was the only factor associated with DENV seropositivity. Five (1.5%) Ae. aegypti pools were positive for CHIKV whereas 1 (0.3%) was positive for DENV. Two Cx. pipiens, pools (1.9%) were positive for CHIKV. None of the Cx. pipiens mosquitoes was positive for DENV. No associations between DENV and CHIKV seropositivity was observed in humans but DENV infection was strongly associated with CHIKV infection (χ2 = 238.45; p<0.01). CHIKV infection was observed to be consistently higher in both, humans and mosquitoes. Conclusion: Detection of DENV and CHIKV in both humans and vector mosquitoes confirms that both viruses are actively circulating in the Lower Moshi area of Kilimanjaro region in Tanzania. Our findings point out the Lower Moshi area as a potential focal point for the maintenance of the two viruses and possibly other vector borne viruses. We call upon sustained active surveillance of arboviruses and other re-emerging infections to be better prepared for possible outbreaks by the viruses.","PeriodicalId":11398,"journal":{"name":"East Africa Science","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75680516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mariam Adawe, Masembe Sezalio, Hamson Kanyesigye, Rogers Kajabwangu, S. Okello, F. Bajunirwe, J. Ngonzi
Background: Uterine fibroids are the most common benign female gynecologic tumors. There are multiple risk factors, including age and reduced fertility. There is however a paucity of data on disease burden and risk factors among African populations. Objective: We determined the prevalence, clinical presentation and factors associated with uterine fibroids among women at Mbarara hospital gynecology clinic, Uganda. Methods: We conducted a cross sectional study from November 2018 to February 2019 on 319 women attending gynecology clinic. An abdomino-pelvic ultrasound scan was performed on each participant and data analyzed using Stata Version 13. Multivariable logistic regression was used to determine association between selected characteristics and uterine fibroid appearance. P value of less than 0.05 was interpreted as significant. Results: The number of women with fibroids was 90 out of 319, representing a prevalence of uterine fibroids of 28.2%. About 67 (74.4%) of the participants with fibroids were symptomatic having pelvic pain 65 (72.2%), menorrhagia 57 (63.3%), pelvic mass 20 (22.2%) and failure to conceive 9 (10%). Women in age group of 31 – 50 years (adjusted OR 4.2; 95% CI,2.0 to 8.5), those separated from their spouses (adjusted OR 4.4; 95% CI,1.8 to 10.5), overweight (adjusted OR 4.9; 95% CI, 2.6 to 9.6), obesity (adjusted OR 4.1; 95% CI,1.6 to 10.5) were more likely to be diagnosed with uterine fibroids while delayed menarche (adjusted OR 0.4; 95% CI, 0.1 to 0.8) was protective. Conclusion: The study found the prevalence of uterine fibroids to be high. Majority of patients were symptomatic at presentation with pelvic pain, menorrhagia, irregular menses and pelvic mass. Uterine fibroids cause significant morbidity among reproductive age women. The identified risk factors included overweight and age group of 31 to 50 years. We recommend Ultrasound scan in women of reproductive age attending gynecology clinic to detect uterine fibroids early in order to manage them promptly so as to prevent the associated complications.
{"title":"Prevalence, clinical presentation and factors associated with Uterine fibroids among women attending the Gynecology Outpatient Department at a large Referral Hospital in Southwestern Uganda","authors":"Mariam Adawe, Masembe Sezalio, Hamson Kanyesigye, Rogers Kajabwangu, S. Okello, F. Bajunirwe, J. Ngonzi","doi":"10.24248/easci.v4i1.58","DOIUrl":"https://doi.org/10.24248/easci.v4i1.58","url":null,"abstract":"Background: Uterine fibroids are the most common benign female gynecologic tumors. There are multiple risk factors, including age and reduced fertility. There is however a paucity of data on disease burden and risk factors among African populations. Objective: We determined the prevalence, clinical presentation and factors associated with uterine fibroids among women at Mbarara hospital gynecology clinic, Uganda. Methods: We conducted a cross sectional study from November 2018 to February 2019 on 319 women attending gynecology clinic. An abdomino-pelvic ultrasound scan was performed on each participant and data analyzed using Stata Version 13. Multivariable logistic regression was used to determine association between selected characteristics and uterine fibroid appearance. P value of less than 0.05 was interpreted as significant. Results: The number of women with fibroids was 90 out of 319, representing a prevalence of uterine fibroids of 28.2%. About 67 (74.4%) of the participants with fibroids were symptomatic having pelvic pain 65 (72.2%), menorrhagia 57 (63.3%), pelvic mass 20 (22.2%) and failure to conceive 9 (10%). Women in age group of 31 – 50 years (adjusted OR 4.2; 95% CI,2.0 to 8.5), those separated from their spouses (adjusted OR 4.4; 95% CI,1.8 to 10.5), overweight (adjusted OR 4.9; 95% CI, 2.6 to 9.6), obesity (adjusted OR 4.1; 95% CI,1.6 to 10.5) were more likely to be diagnosed with uterine fibroids while delayed menarche (adjusted OR 0.4; 95% CI, 0.1 to 0.8) was protective. Conclusion: The study found the prevalence of uterine fibroids to be high. Majority of patients were symptomatic at presentation with pelvic pain, menorrhagia, irregular menses and pelvic mass. Uterine fibroids cause significant morbidity among reproductive age women. The identified risk factors included overweight and age group of 31 to 50 years. We recommend Ultrasound scan in women of reproductive age attending gynecology clinic to detect uterine fibroids early in order to manage them promptly so as to prevent the associated complications.","PeriodicalId":11398,"journal":{"name":"East Africa Science","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72739434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Urogenital schistosomiasis caused by Schistosoma haematobium (S. haematobium), remains a public health problem in Lindi region. Despite twelve rounds of praziquantel preventive chemotherapy. There is a scarcity of information on the factors perpetuating the transmission of S. haematobium in Lindi. Therefore, this study aimed to explore the urogenital schistosomiasis knowledge, attitudes, and practices among the community members in Mtama district in the Lindi region of Tanzania. Methodology: A cross-sectional study employing a qualitative approach was conducted in Mtama, Lindi in May 2021. The respondents were purposively sampled, and a total of 6 Focus Group Discussions (FGDs), 2 in each village were conducted. The FGDs were audio-recorded, transcribed verbatim, and analysed thematically to identify emerging themes. Results: Majority of respondents were aware of the endemicity of S. haematobium and the ongoing distribution of praziquantel preventive chemotherapy. Respondents had inadequate knowledge of the disease causation and the role of snails in disease transmission. Also, misconception on the modes of disease transmission was observed. Respondents had undesirable attitudes. They were against regular screening of urogenital schistosomiasis and were into the use of traditional ways of treatment to dodge screening and treatment costs. Respondents exhibited inappropriate water, sanitation, and hygienic practices (WaSH), thus perpetuating disease transmission. Conclusion: Despite the community being aware and knowledgeable of urogenital schistosomiasis, there is inadequate understanding of how the disease is transmitted, the roles of snails in S. haematobium transmission, coupled with undesirable attitudes and inappropriate practices. These potentially compromise the ongoing Government efforts to control the disease in Lindi region. Therefore, there is need to initiate a community-based health education programme targeting behaviour change.
{"title":"Urogenital schistosomiasis knowledge, attitudes and practices among the community members in Lindi, Tanzania: A qualitative study","authors":"V. Mushi, D. Tarimo","doi":"10.24248/easci.v4i1.60","DOIUrl":"https://doi.org/10.24248/easci.v4i1.60","url":null,"abstract":"Background: Urogenital schistosomiasis caused by Schistosoma haematobium (S. haematobium), remains a public health problem in Lindi region. Despite twelve rounds of praziquantel preventive chemotherapy. There is a scarcity of information on the factors perpetuating the transmission of S. haematobium in Lindi. Therefore, this study aimed to explore the urogenital schistosomiasis knowledge, attitudes, and practices among the community members in Mtama district in the Lindi region of Tanzania. Methodology: A cross-sectional study employing a qualitative approach was conducted in Mtama, Lindi in May 2021. The respondents were purposively sampled, and a total of 6 Focus Group Discussions (FGDs), 2 in each village were conducted. The FGDs were audio-recorded, transcribed verbatim, and analysed thematically to identify emerging themes. Results: Majority of respondents were aware of the endemicity of S. haematobium and the ongoing distribution of praziquantel preventive chemotherapy. Respondents had inadequate knowledge of the disease causation and the role of snails in disease transmission. Also, misconception on the modes of disease transmission was observed. Respondents had undesirable attitudes. They were against regular screening of urogenital schistosomiasis and were into the use of traditional ways of treatment to dodge screening and treatment costs. Respondents exhibited inappropriate water, sanitation, and hygienic practices (WaSH), thus perpetuating disease transmission. Conclusion: Despite the community being aware and knowledgeable of urogenital schistosomiasis, there is inadequate understanding of how the disease is transmitted, the roles of snails in S. haematobium transmission, coupled with undesirable attitudes and inappropriate practices. These potentially compromise the ongoing Government efforts to control the disease in Lindi region. Therefore, there is need to initiate a community-based health education programme targeting behaviour change.","PeriodicalId":11398,"journal":{"name":"East Africa Science","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78801358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fred Ogumbo, R. Odero, B. Odhiambo, Patrick Emojong, A. Okumu, J. Nonoh, S. Wandiga, B. Guya
Background: Tuberculosis drug resistance is often associated with inadequate anti-tuberculosis treatment regimen resulting to mutations that confers resistance to anti-tuberculosis agents. This is aggravated by synergetic relationship between Tuberculosis and HIV (Human Immunodeficiency Virus). Over 25% of Global Tuberculosis deaths occur in Africa and Kenya is one of the 30 high burden countries that together account for more than 80% of the world’s TB cases. According to World Health Organization, in 2018, Multi drug resistant Tuberculosis prevalence in Kenya was 1.3% in new cases and 4.4% in retreatment cases. Kisumu County recorded the second highest HIV prevalence at 18.6% against the national prevalence of 4.5% in 2020. The extent of regional burden of DR-TB and HIV co-infection has not been exactly well-defined in Western Kenya. Methods: This was a prospective cross sectional study that aimed to explore the association between Tuberculosis drug resistance and HIV status among new and previously treated pulmonary tuberculosis cases in Kisumu County, Kenya. Tuberculosis clinical suspects were recruited into the study and classified as HIV positive or negative based on their clinical data. Sputum samples from tuberculosis clinical suspects were subjected to fluorescent microscopy, phenotypic culture and line probe assay. Results: Out of a sample of 256, response rate was 216 of which HIV positive cases were 119(55.1%) and negative were 97 (44.9%). The study found that out of 11 that were phenotypic Isoniazid resistance 8(6.7%) were from HIV positive cases while 3 (3.2%) were from HIV negative cases. Phenotypic rifampicin resistance among the HIV positive were 8 (6.7%) while HIV negative were 2 (2.1%). All the 2(1.7%) MDR cases were from HIV positive participants. The study found out that HIV status and Tuberculosis cases were significantly associated at p<.05. HIV positive cases were more likely associated with retreatment cases (OR=1.4,95CI:1.00-1.90) compared to new cases. The study found out that the common mutant probe among the HIV positive was katG MUT1 4(2.6%), while mutant probes among the HIV negative were in hA MUT1 1(0.7%), katG MUT1 1(0.7%) and roB MUT2A 1(0.7%). Wild type gene deletion among the HIV positive cases were observed in probes katG WT 3(2.1%), roB WT7, katG WT 1(0.7%) while wild type gene deletion among the HIV negative cases were inhA WT1 1(0.7%), in hA WT1/inhAWT2 1(0.7%), katG WT 1(0.7%). Conclusion: Interventions specific to HIV-endemic areas are urgently needed to block tuberculosis drug resistance transmission. Development and improvement of the efficacy of interventions will require a greater understanding of the transmission of multidrug-resistant tuberculosis in HIV-endemic settings like Kisumu County, Western Kenya.
{"title":"Isoniazid and Rifampicin Tuberculosis Drug Resistance in HIV Endemic Region of Western Kenya","authors":"Fred Ogumbo, R. Odero, B. Odhiambo, Patrick Emojong, A. Okumu, J. Nonoh, S. Wandiga, B. Guya","doi":"10.24248/easci.v4i1.57","DOIUrl":"https://doi.org/10.24248/easci.v4i1.57","url":null,"abstract":"Background: Tuberculosis drug resistance is often associated with inadequate anti-tuberculosis treatment regimen resulting to mutations that confers resistance to anti-tuberculosis agents. This is aggravated by synergetic relationship between Tuberculosis and HIV (Human Immunodeficiency Virus). Over 25% of Global Tuberculosis deaths occur in Africa and Kenya is one of the 30 high burden countries that together account for more than 80% of the world’s TB cases. According to World Health Organization, in 2018, Multi drug resistant Tuberculosis prevalence in Kenya was 1.3% in new cases and 4.4% in retreatment cases. Kisumu County recorded the second highest HIV prevalence at 18.6% against the national prevalence of 4.5% in 2020. The extent of regional burden of DR-TB and HIV co-infection has not been exactly well-defined in Western Kenya. Methods: This was a prospective cross sectional study that aimed to explore the association between Tuberculosis drug resistance and HIV status among new and previously treated pulmonary tuberculosis cases in Kisumu County, Kenya. Tuberculosis clinical suspects were recruited into the study and classified as HIV positive or negative based on their clinical data. Sputum samples from tuberculosis clinical suspects were subjected to fluorescent microscopy, phenotypic culture and line probe assay. Results: Out of a sample of 256, response rate was 216 of which HIV positive cases were 119(55.1%) and negative were 97 (44.9%). The study found that out of 11 that were phenotypic Isoniazid resistance 8(6.7%) were from HIV positive cases while 3 (3.2%) were from HIV negative cases. Phenotypic rifampicin resistance among the HIV positive were 8 (6.7%) while HIV negative were 2 (2.1%). All the 2(1.7%) MDR cases were from HIV positive participants. The study found out that HIV status and Tuberculosis cases were significantly associated at p<.05. HIV positive cases were more likely associated with retreatment cases (OR=1.4,95CI:1.00-1.90) compared to new cases. The study found out that the common mutant probe among the HIV positive was katG MUT1 4(2.6%), while mutant probes among the HIV negative were in hA MUT1 1(0.7%), katG MUT1 1(0.7%) and roB MUT2A 1(0.7%). Wild type gene deletion among the HIV positive cases were observed in probes katG WT 3(2.1%), roB WT7, katG WT 1(0.7%) while wild type gene deletion among the HIV negative cases were inhA WT1 1(0.7%), in hA WT1/inhAWT2 1(0.7%), katG WT 1(0.7%). Conclusion: Interventions specific to HIV-endemic areas are urgently needed to block tuberculosis drug resistance transmission. Development and improvement of the efficacy of interventions will require a greater understanding of the transmission of multidrug-resistant tuberculosis in HIV-endemic settings like Kisumu County, Western Kenya.","PeriodicalId":11398,"journal":{"name":"East Africa Science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90288088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Callixte Yadufashije, Liliane Muhimpundu, Lydia Mwanzia, G. Sangano
Corona Virus Disease 2019 (COVID-19) pandemic has been a public health threat of the 21st century. This pandemic has unexpectedly occurred, and countries have faced challenges to implement the preventive strategies against this unexpected killer. Pregnancy is a critical state among women, and special care should be provided to prevent pregnancy related complications as early as possible. COVID-19 pandemic has restricted services provided to pregnant women due to some prevention measures and treatment programs. Previous studies reported the high increase of obstetric complications among women infected or ever infected by COVID-19. Depression, suicidal intention, low quality of life during pregnancy, gestational hypertension and gestational diabetes mellitus, the premature rupture of membranes, miscarriage, preterm delivery, edema, maternal death, and hypoxia and other respiratory conditions were observed among women infected by COVID-19. Strategies for protecting pregnant women during pandemics should be enhanced to prevent pregnancy related complications and maternal death. There should be home health care nurses and midwives working with community health workers to assist pregnant women at home. Governments should develop policies and plans about maintaining maternal and child health during pandemics requiring travel ban and other prevention measures.
{"title":"Corona Virus Disease 2019 Pandemic Contributed to Pregnancy Devastating Outcomes in Low Income Countries","authors":"Callixte Yadufashije, Liliane Muhimpundu, Lydia Mwanzia, G. Sangano","doi":"10.24248/easci.v4i1.51","DOIUrl":"https://doi.org/10.24248/easci.v4i1.51","url":null,"abstract":"Corona Virus Disease 2019 (COVID-19) pandemic has been a public health threat of the 21st century. This pandemic has unexpectedly occurred, and countries have faced challenges to implement the preventive strategies against this unexpected killer. Pregnancy is a critical state among women, and special care should be provided to prevent pregnancy related complications as early as possible. COVID-19 pandemic has restricted services provided to pregnant women due to some prevention measures and treatment programs. Previous studies reported the high increase of obstetric complications among women infected or ever infected by COVID-19. Depression, suicidal intention, low quality of life during pregnancy, gestational hypertension and gestational diabetes mellitus, the premature rupture of membranes, miscarriage, preterm delivery, edema, maternal death, and hypoxia and other respiratory conditions were observed among women infected by COVID-19. Strategies for protecting pregnant women during pandemics should be enhanced to prevent pregnancy related complications and maternal death. There should be home health care nurses and midwives working with community health workers to assist pregnant women at home. Governments should develop policies and plans about maintaining maternal and child health during pandemics requiring travel ban and other prevention measures.","PeriodicalId":11398,"journal":{"name":"East Africa Science","volume":"119 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78085914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
V. Silago, Monica J. Manzi, Conjester I. Mtemisika, Prisca Damiano, M. Mirambo, M. Mushi
Background: Hand hygiene (HH) is a critical component of infection prevention and control (IPC) which aims at preventing microbial transmission during patient care hence reducing the burden of healthcare associated infections (HCAIs). Information on the level of HH knowledge, attitudes and practices among healthcare workers (HCWs) from low- and middle-income countries is scarce. This study determined knowledge, attitude and practices of HH among students and staff nurses in Mwanza, Tanzania. Methods: This cross-sectional hospital-based study was conducted between August and October 2020 among student and staff nurses from 2health centres, 2district hospitals, 1regional referral hospital and 1zonal referral hospital. Self-administered pretested structured questionnaires were used for data collection. All data was transferred to Microsoft excel spreadsheet for cleaning and coding, then to STATA software version 13.0 for analysis. Results: A total of 726 nurses aged 18 to 59 years with median (IQR) age of 29(24-38) years were enrolled. About 3 quarters 76.4% (555/726) of nurses had good level of knowledge on HH as most of them 88.3% (641/726) had received rigorous IPC trainings during COVID-19 pandemic. About 42.0% (305/726) of the participants reported that, the action of HH was effortless. Majority of the participants, 81.1% (589/726) practiced hand washing more than hand rubbing routinely. Being a student nurse [OR: 0.30, 95%CI: 0.21-1.44, p<.001], working in inpatient department [OR: 0.38, 95%CI: 0.27-0.55, p<.001], high level of education i.e., degree and above [OR: 1.74, 95%CI: 1.36-2.24, p<.001] and having working experience of 5 years and above [OR: 2.41, 95%CI: 1.52-3.82, p<.001] was associated with being knowledgeable of HH. Conclusion: Majority of the participants had good level of knowledge on HH because they had received rigorous training on IPC, notably HH during the global COVID-19 pandemic.
{"title":"Knowledge, Attitude and Practices of Hand Hygiene among Students and Nurses Staff in Mwanza Tanzania: A Cross-Sectional Hospital-Based Study during Global COVID-19 Pandemic","authors":"V. Silago, Monica J. Manzi, Conjester I. Mtemisika, Prisca Damiano, M. Mirambo, M. Mushi","doi":"10.24248/easci.v4i1.55","DOIUrl":"https://doi.org/10.24248/easci.v4i1.55","url":null,"abstract":"Background: Hand hygiene (HH) is a critical component of infection prevention and control (IPC) which aims at preventing microbial transmission during patient care hence reducing the burden of healthcare associated infections (HCAIs). Information on the level of HH knowledge, attitudes and practices among healthcare workers (HCWs) from low- and middle-income countries is scarce. This study determined knowledge, attitude and practices of HH among students and staff nurses in Mwanza, Tanzania. Methods: This cross-sectional hospital-based study was conducted between August and October 2020 among student and staff nurses from 2health centres, 2district hospitals, 1regional referral hospital and 1zonal referral hospital. Self-administered pretested structured questionnaires were used for data collection. All data was transferred to Microsoft excel spreadsheet for cleaning and coding, then to STATA software version 13.0 for analysis. Results: A total of 726 nurses aged 18 to 59 years with median (IQR) age of 29(24-38) years were enrolled. About 3 quarters 76.4% (555/726) of nurses had good level of knowledge on HH as most of them 88.3% (641/726) had received rigorous IPC trainings during COVID-19 pandemic. About 42.0% (305/726) of the participants reported that, the action of HH was effortless. Majority of the participants, 81.1% (589/726) practiced hand washing more than hand rubbing routinely. Being a student nurse [OR: 0.30, 95%CI: 0.21-1.44, p<.001], working in inpatient department [OR: 0.38, 95%CI: 0.27-0.55, p<.001], high level of education i.e., degree and above [OR: 1.74, 95%CI: 1.36-2.24, p<.001] and having working experience of 5 years and above [OR: 2.41, 95%CI: 1.52-3.82, p<.001] was associated with being knowledgeable of HH. Conclusion: Majority of the participants had good level of knowledge on HH because they had received rigorous training on IPC, notably HH during the global COVID-19 pandemic.","PeriodicalId":11398,"journal":{"name":"East Africa Science","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74869498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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