Introduction: Metastatic breast cancer is a common presentation in Tanzania. Estrogen-receptor (ER)-positive tumors are known to metastasize to the bones and require hormonal treatment as first-line therapy. Challenges with accessing immunohistochemistry services can delay information on breast cancer subtypes, further delaying treatment with effective hormonal therapy. Objectives: This study aimed to assess the pattern of distribution of metastatic lesions in patients with metastatic breast cancer and evaluate its association with their hormone and HER-2 status, which could help provide recommendations on the use of front-line hormone therapy in areas where access to immunohistochemistry is a challenge. Methods: A retrospective study covering histologically confirmed breast cancer patients in 2020 with metastatic lesions and complete medical records at Ocean Road Cancer Institute. Clinical information on the number, state and sites of metastasis, presence of symptoms and treatment received, and pathological variables, including histology, ER, PR and HER-2 status, were documented. Results: Forty-nine (96.1%) of 51 patients analysed were female, with a mean age of 49.5 years. 47% presented with up-front metastatic disease. Lung was the most common metastatic site (76.5%) followed by bone/spine (53%). About half the patients had multiple sites involved. ER-positive tumors accounted for 47%, PR positive for 31% and HER-2 positive 39.2%. ER-positive tumors were more likely to present as a recurrence than up-front metastasis. ER-positive tumors were significantly more likely to be associated with bone and spine metastasis (59%) compared to ER-negative tumors (29%) Conclusion: The clinical and pathological features of MBC in Tanzanian women are similar in many ways to those in other African regions. However, the ER positivity rate is lower. This study found a significant association between ER-positive tumours and skeletal metastasis, which has implications for the up-front treatment of these patients, especially where access to immunohistochemistry can be a challenge.
{"title":"Metastatic patterns and hormone receptor status among breast cancer patients in Tanzania","authors":"N. Dharsee, M. Haule, Queen Tarimo","doi":"10.4314/thrb.v25i2.13","DOIUrl":"https://doi.org/10.4314/thrb.v25i2.13","url":null,"abstract":"Introduction: Metastatic breast cancer is a common presentation in Tanzania. Estrogen-receptor (ER)-positive tumors are known to metastasize to the bones and require hormonal treatment as first-line therapy. Challenges with accessing immunohistochemistry services can delay information on breast cancer subtypes, further delaying treatment with effective hormonal therapy.\u0000Objectives: This study aimed to assess the pattern of distribution of metastatic lesions in patients with metastatic breast cancer and evaluate its association with their hormone and HER-2 status, which could help provide recommendations on the use of front-line hormone therapy in areas where access to immunohistochemistry is a challenge.\u0000Methods: A retrospective study covering histologically confirmed breast cancer patients in 2020 with metastatic lesions and complete medical records at Ocean Road Cancer Institute. Clinical information on the number, state and sites of metastasis, presence of symptoms and treatment received, and pathological variables, including histology, ER, PR and HER-2 status, were documented.\u0000Results: Forty-nine (96.1%) of 51 patients analysed were female, with a mean age of 49.5 years. 47% presented with up-front metastatic disease. Lung was the most common metastatic site (76.5%) followed by bone/spine (53%). About half the patients had multiple sites involved. ER-positive tumors accounted for 47%, PR positive for 31% and HER-2 positive 39.2%. ER-positive tumors were more likely to present as a recurrence than up-front metastasis. ER-positive tumors were significantly more likely to be associated with bone and spine metastasis (59%) compared to ER-negative tumors (29%)\u0000Conclusion: The clinical and pathological features of MBC in Tanzanian women are similar in many ways to those in other African regions. However, the ER positivity rate is lower. This study found a significant association between ER-positive tumours and skeletal metastasis, which has implications for the up-front treatment of these patients, especially where access to immunohistochemistry can be a challenge.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"93 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140754609","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}
Remilekun Akinrinmade, B. Ogunba, Opeyemi Racheal Dagunro, Esther Mercy Amanam
Introduction: Psychosocial care is the process by which caregivers meet the needs of infants in terms of adequate nutrition, emotional, social, mental and healthcare for promoting healthy growth and development. This study, therefore, aimed to assess the influence of psychosocial care during complementary feeding among mothers. Methodology: It was a cross-sectional design, and the sample size was statistically calculated to arrive at 385 mothers. A structured and self-administered questionnaire collected information on socio-economic status and psychosocial care during complementary feeding practices. WHO feeding indicators were used to assess the feeding practices of the mothers. Data were analysed using both descriptive statistics and inferential statistics. Results: The study showed that 52.1% of respondents were between 20 and 29 years old, 88.1% were married, and others were single or divorced mothers. The feeding indicator showed that 21.5% of respondents met the Minimum Adequate Diet. Half of the respondents (50%) monitored the amount of food consumed by the children, while 12.4% encouraged the children to finish the food served. There was an insignificant relationship between maternal psychosocial care and complementary feeding practices (χ2; p>0.05), whereas there was a significant association between maternal psychosocial care and maternal age (χ2; p=0.043) as well as religion (χ2; p=0.031). Conclusion: The study concluded that mothers who had advanced in age had better maternal psychosocial care during complementary feeding than the younger mothers. Therefore, maternal nutrition education on complementary feeding and care during infants’ feeding should be encouraged during antenatal and post-natal clinics.
{"title":"Maternal Psychosocial care and Child feeding practices","authors":"Remilekun Akinrinmade, B. Ogunba, Opeyemi Racheal Dagunro, Esther Mercy Amanam","doi":"10.4314/thrb.v25i2.3","DOIUrl":"https://doi.org/10.4314/thrb.v25i2.3","url":null,"abstract":"Introduction: Psychosocial care is the process by which caregivers meet the needs of infants in terms of adequate nutrition, emotional, social, mental and healthcare for promoting healthy growth and development. This study, therefore, aimed to assess the influence of psychosocial care during complementary feeding among mothers.\u0000Methodology: It was a cross-sectional design, and the sample size was statistically calculated to arrive at 385 mothers. A structured and self-administered questionnaire collected information on socio-economic status and psychosocial care during complementary feeding practices. WHO feeding indicators were used to assess the feeding practices of the mothers. Data were analysed using both descriptive statistics and inferential statistics.\u0000Results: The study showed that 52.1% of respondents were between 20 and 29 years old, 88.1% were married, and others were single or divorced mothers. The feeding indicator showed that 21.5% of respondents met the Minimum Adequate Diet. Half of the respondents (50%) monitored the amount of food consumed by the children, while 12.4% encouraged the children to finish the food served. There was an insignificant relationship between maternal psychosocial care and complementary feeding practices (χ2; p>0.05), whereas there was a significant association between maternal psychosocial care and maternal age (χ2; p=0.043) as well as religion (χ2; p=0.031).\u0000Conclusion: The study concluded that mothers who had advanced in age had better maternal psychosocial care during complementary feeding than the younger mothers. Therefore, maternal nutrition education on complementary feeding and care during infants’ feeding should be encouraged during antenatal and post-natal clinics.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"144 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140754254","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}
Samwel Sylvester Msigwa, Shuang Hong, Veronica Lyimo, Elizabeth Marealle
Background: Chiari I malformations (CM-I) and Primary Empty Sella syndrome (PESS) are rare disorders of structural defects within a skull. Headache is the most common presenting symptom in both conditions. However, CM-I and ESS comorbidity in patients with severe headaches is yet to be reported. Case description: The patient was a 38-year-old woman with a one-year history of headaches at various localisations (occipital and bilateral frontal) preceded by mood agitation. Physical examination was significant for obesity. Magnetic resonance imaging (MRI) revealed a 6.4 mm cerebellar tonsil descent through the foramen magnum and hypointense (CSF-filled) flattened sella. The lipid panel showed elevated cholesterols (total) and low-density lipoprotein (LDL) levels. She was medically managed, with no report of symptoms relapses at one-month and two-month follow-ups. Conclusion: This is the first report on comorbid CM-I and PESS in adults presenting with cephalalgia. PESS and CM-I co-occurrence may present with mixed headache localisation; careful history-taking and imaging are mandatory for diagnosis confirmation. Future extensive studies are warranted to analyse the pathophysiological interplay between these two rare disorders.
{"title":"Headache to a Patient with the Coexistence of Chiari I Malformations and Primary Empty Sella Syndrome: A Case Report la Syndrome: A Case Report","authors":"Samwel Sylvester Msigwa, Shuang Hong, Veronica Lyimo, Elizabeth Marealle","doi":"10.4314/thrb.v25i2.18","DOIUrl":"https://doi.org/10.4314/thrb.v25i2.18","url":null,"abstract":"Background: Chiari I malformations (CM-I) and Primary Empty Sella syndrome (PESS) are rare disorders of structural defects within a skull. Headache is the most common presenting symptom in both conditions. However, CM-I and ESS comorbidity in patients with severe headaches is yet to be reported.\u0000Case description: The patient was a 38-year-old woman with a one-year history of headaches at various localisations (occipital and bilateral frontal) preceded by mood agitation. Physical examination was significant for obesity. Magnetic resonance imaging (MRI) revealed a 6.4 mm cerebellar tonsil descent through the foramen magnum and hypointense (CSF-filled) flattened sella. The lipid panel showed elevated cholesterols (total) and low-density lipoprotein (LDL) levels. She was medically managed, with no report of symptoms relapses at one-month and two-month follow-ups.\u0000Conclusion: This is the first report on comorbid CM-I and PESS in adults presenting with cephalalgia. PESS and CM-I co-occurrence may present with mixed headache localisation; careful history-taking and imaging are mandatory for diagnosis confirmation. Future extensive studies are warranted to analyse the pathophysiological interplay between these two rare disorders.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"24 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140753352","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 prevalence of syphilis among pregnant women in Somalia has been poorly studied, despite its significant impact on maternal and fetal health. In Somalia, the last syphilis study was conducted approximately 30 years ago, leaving a critical knowledge gap regarding the current epidemic of syphilis among pregnant women. Materials and methods: From January 2023 to April 2023, a hospital-based cross-sectional study was conducted on maternal and child health. A total of 300 pregnant women were included in the study, and the seroprevalence of syphilis was determined using the Venereal Disease Research Laboratory. This one-step quick diagnostic test cassette was used as the preliminary screening tool, and Positive results were confirmed using the full chemiluminescence immunoassay (CLIA) analyzer MAGLUMI. A structured questionnaire was used to collect demographic characteristics and knowledge regarding syphilis transmission and mother-to-child transmission. SPSS Version 27.0 was used to analyze the gathered data. Statistical significance was set at p < 0.05. Results: Overall, 5.3% (16/300) of pregnant women had syphilis seroprevalence. Seroprevalence rates were higher in women aged 24-34 (50.0%). There were significant relationships between syphilis infection and education (p < 0.000), occupation (p < 0.000), and residence (p = 0.002). Furthermore, a significant majority of pregnant women (78%) were unaware of syphilis transmission routes and its correlation to HIV risk (81.7%). Stillbirths constituted 23.3% of pregnancy-related problems, whereas 17% of pregnant women had a prior record of blood transfusions. Conclusions: The study found an alarming syphilis seroprevalence in pregnant women, especially in certain demographic groups. The lack of knowledge of syphilis transmission and its effects highlights the necessity for targeted education. Improved prenatal care, health awareness, and effective prevention should lessen the effects of syphilis on mother and newborn health.
{"title":"Seroprevalence of Syphilis among Pregnant Women Attending Antenatal Care in Yaqshiid District, Mogadishu, Somalia","authors":"Abdirasak Sharif Ali, Abdirahman Hussein Elmi","doi":"10.4314/thrb.v25i2.20","DOIUrl":"https://doi.org/10.4314/thrb.v25i2.20","url":null,"abstract":"Background: The prevalence of syphilis among pregnant women in Somalia has been poorly studied, despite its significant impact on maternal and fetal health. In Somalia, the last syphilis study was conducted approximately 30 years ago, leaving a critical knowledge gap regarding the current epidemic of syphilis among pregnant women.\u0000Materials and methods: From January 2023 to April 2023, a hospital-based cross-sectional study was conducted on maternal and child health. A total of 300 pregnant women were included in the study, and the seroprevalence of syphilis was determined using the Venereal Disease Research Laboratory. This one-step quick diagnostic test cassette was used as the preliminary screening tool, and Positive results were confirmed using the full chemiluminescence immunoassay (CLIA) analyzer MAGLUMI. A structured questionnaire was used to collect demographic characteristics and knowledge regarding syphilis transmission and mother-to-child transmission. SPSS Version 27.0 was used to analyze the gathered data. Statistical significance was set at p < 0.05.\u0000Results: Overall, 5.3% (16/300) of pregnant women had syphilis seroprevalence. Seroprevalence rates were higher in women aged 24-34 (50.0%). There were significant relationships between syphilis infection and education (p < 0.000), occupation (p < 0.000), and residence (p = 0.002). Furthermore, a significant majority of pregnant women (78%) were unaware of syphilis transmission routes and its correlation to HIV risk (81.7%). Stillbirths constituted 23.3% of pregnancy-related problems, whereas 17% of pregnant women had a prior record of blood transfusions.\u0000Conclusions: The study found an alarming syphilis seroprevalence in pregnant women, especially in certain demographic groups. The lack of knowledge of syphilis transmission and its effects highlights the necessity for targeted education. Improved prenatal care, health awareness, and effective prevention should lessen the effects of syphilis on mother and newborn health.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"37 25","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140752183","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}
S. Mathias, K. Isangula, A. Kahwa, G. Kimaro, Esther Ngadaya, Lucy Mwenda, Grace Soka, Frank Erick, Caritas Kitinya, Doreen Deogratias, F. Donard, Prince Mutalemwa, S. Mfinanga
Background: Access to essential health commodities is fundamental to healthcare system efficacy. These commodities are vital in delivering health services and form integral elements within the World Health Organization's strengthening framework, encompassing the six foundational building blocks. Regrettably, there has been a global increase in shortages and stockouts of essential health commodities in recent years. Objective: The study aimed to identify factors influencing the availability of essential health commodities throughout all levels of the supply chain in Tanzania. Methods: A cross-sectional that employed qualitative and quantitative data collection techniques. Quantitative data were analyzed using STATA version 16, while Qualitative data were thematically analyzed. Results: Factors contributing to stockouts of essential commodities at the national level include increased demand, delayed shipments from donors, decreased funding commitments, delayed disbursement of funds, global shortages, inadequate governance, debt within the Medical Stores Department, donor dependency for vertical program commodities, and long lead times by Medical Stores Department suppliers. At the Regional and District levels, such factors include a shortage of human resources, lack of Electronic Medical Records, limited interoperability of information systems, poor quality of logistics data, inadequate use of data for decision-making, and poor inventory management. At the healthcare facility level, they include an overwhelming number of exempted clients, which reduces facility revenues. Conclusion: More efforts are still needed to address both the upstream and downstream challenges needed to ensure sustainable access and availability of essential health commodities at service delivery points as a pathway for improving health sector performance.
背景：获得基本卫生商品是提高医疗保健系统效率的基础。这些商品对提供医疗服务至关重要，是世界卫生组织加强框架的组成部分，包括六个基本组成部分。令人遗憾的是，近年来全球范围内基本卫生用品的短缺和缺货现象日益严重：本研究旨在确定影响坦桑尼亚各级供应链中基本卫生用品供应的因素：方法：采用定性和定量数据收集技术进行横断面研究。定量数据使用 STATA 16 版进行分析，定性数据则进行专题分析：在国家层面，导致基本商品缺货的因素包括：需求增加、捐助方发货延迟、资金承诺减少、资金支付延迟、全球短缺、管理不善、医药仓储部内部债务、捐助方对纵向计划商品的依赖以及医药仓储部供应商交货时间过长。在地区和县一级，这些因素包括人力资源短缺、缺乏电子病历、信息系统的互操作性有限、物流数据质量差、决策数据使用不足以及库存管理不善。在医疗机构层面，这些因素包括过多的豁免客户，从而减少了医疗机构的收入：仍需做出更多努力，应对上游和下游的挑战，以确保在服务提供点可持续地获取和提供基本医疗商品，以此作为改善卫生部门绩效的途径。
{"title":"Factors Affecting the Availability of Essential Health Commodities in Tanzania with a Special Focus on the Tracer Commodities","authors":"S. Mathias, K. Isangula, A. Kahwa, G. Kimaro, Esther Ngadaya, Lucy Mwenda, Grace Soka, Frank Erick, Caritas Kitinya, Doreen Deogratias, F. Donard, Prince Mutalemwa, S. Mfinanga","doi":"10.4314/thrb.v25i2.11","DOIUrl":"https://doi.org/10.4314/thrb.v25i2.11","url":null,"abstract":"Background: Access to essential health commodities is fundamental to healthcare system efficacy. These commodities are vital in delivering health services and form integral elements within the World Health Organization's strengthening framework, encompassing the six foundational building blocks. Regrettably, there has been a global increase in shortages and stockouts of essential health commodities in recent years.\u0000Objective: The study aimed to identify factors influencing the availability of essential health commodities throughout all levels of the supply chain in Tanzania.\u0000Methods: A cross-sectional that employed qualitative and quantitative data collection techniques. Quantitative data were analyzed using STATA version 16, while Qualitative data were thematically analyzed.\u0000Results: Factors contributing to stockouts of essential commodities at the national level include increased demand, delayed shipments from donors, decreased funding commitments, delayed disbursement of funds, global shortages, inadequate governance, debt within the Medical Stores Department, donor dependency for vertical program commodities, and long lead times by Medical Stores Department suppliers. At the Regional and District levels, such factors include a shortage of human resources, lack of Electronic Medical Records, limited interoperability of information systems, poor quality of logistics data, inadequate use of data for decision-making, and poor inventory management. At the healthcare facility level, they include an overwhelming number of exempted clients, which reduces facility revenues.\u0000Conclusion: More efforts are still needed to address both the upstream and downstream challenges needed to ensure sustainable access and availability of essential health commodities at service delivery points as a pathway for improving health sector performance.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"21 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140754831","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}
Introduction: Head and neck lesions associated with Human Immunodeficiency Virus are considered to occur in over 50% of HIV- positive patients and occur in nearly 80% of all patients with acquired immunodeficiency syndrome. The introduction of highly active antiretroviral therapy has led to a remarkable reduction in the global burden of such lesions. Suppose such lesions are undiagnosed or untreated on a prompt basis. In that case, they may cause morbidity and mortality since some lesions, for example, head and neck cancers may interfere with vital functions of life such as respiration, deglutition, and speech. This study determined head and neck lesions among HIV/AIDS patients in Tanzania. Methods: This was a hospital-based descriptive cross-sectional study that recruited 222 HIV/AIDS patients at a care and treatment clinic at Dodoma Regional Referral Hospital. Physical examination and laboratory investigations (histopathology, viral load and CD4 counts) were collected and data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. P-value<0.05 was statistically significant. Results: Of all the 222 patients recruited in this study, 26 (11.7%) had head and neck lesions. Most patients with head and neck lesions were females (57.6%). Half of the patients (50.0%) were between 40 and 59 years old. About 21 (80.8%) patients were diagnosed with HIV/AIDS within two years, and 22 (84.6%) were initially diagnosed with CD4 counts less than 200 cells/μL. The most common head and neck lesion was oral candidiasis (46.2%) and others were cervicofacial lymphadenitis (15.4%), head and neck squamous cell carcinoma (laryngeal and hypopharyngeal) (11.5%), sinonasal Kaposi’s sarcoma (7.7%), odontogenic abscess (7.7%) and aphthous ulcers (7.7%) and the least encountered head and neck lesion was a ranula in 3.8% of patients. Similarly, a significant association was found between the occurrence of head and neck lesions with viral load, CD4 counts, duration since a patient was diagnosed with HIV/AIDS, presence of comorbid illness, alcohol consumption and cigarette smoking. Conclusions: The prevalence of head and neck lesions among HIV/AIDS patients on HAART was low. Females outnumbered males in terms of being affected by head and neck lesions. Oral candidiasis was the most common head and neck lesion. Head and neck (laryngeal and hypopharyngeal) squamous cell carcinoma was the predominant subtype of malignant lesions in HIV/AIDS patients on HAART.
{"title":"Patterns of head and neck lesions among HIV/AIDS patients on highly active antiretroviral therapy at Dodoma Regional Referral Hospital in Tanzania","authors":"Z. Abraham, Irene Daudi, A. Kahinga","doi":"10.4314/thrb.v25i2.2","DOIUrl":"https://doi.org/10.4314/thrb.v25i2.2","url":null,"abstract":"Introduction: Head and neck lesions associated with Human Immunodeficiency Virus are considered to occur in over 50% of HIV- positive patients and occur in nearly 80% of all patients with acquired immunodeficiency syndrome. The introduction of highly active antiretroviral therapy has led to a remarkable reduction in the global burden of such lesions. Suppose such lesions are undiagnosed or untreated on a prompt basis. In that case, they may cause morbidity and mortality since some lesions, for example, head and neck cancers may interfere with vital functions of life such as respiration, deglutition, and speech. This study determined head and neck lesions among HIV/AIDS patients in Tanzania.\u0000Methods: This was a hospital-based descriptive cross-sectional study that recruited 222 HIV/AIDS patients at a care and treatment clinic at Dodoma Regional Referral Hospital. Physical examination and laboratory investigations (histopathology, viral load and CD4 counts) were collected and data was analyzed using Statistical Package for Social Sciences (SPSS) version 23. P-value<0.05 was statistically significant.\u0000Results: Of all the 222 patients recruited in this study, 26 (11.7%) had head and neck lesions. Most patients with head and neck lesions were females (57.6%). Half of the patients (50.0%) were between 40 and 59 years old. About 21 (80.8%) patients were diagnosed with HIV/AIDS within two years, and 22 (84.6%) were initially diagnosed with CD4 counts less than 200 cells/μL. The most common head and neck lesion was oral candidiasis (46.2%) and others were cervicofacial lymphadenitis (15.4%), head and neck squamous cell carcinoma (laryngeal and hypopharyngeal) (11.5%), sinonasal Kaposi’s sarcoma (7.7%), odontogenic abscess (7.7%) and aphthous ulcers (7.7%) and the least encountered head and neck lesion was a ranula in 3.8% of patients. Similarly, a significant association was found between the occurrence of head and neck lesions with viral load, CD4 counts, duration since a patient was diagnosed with HIV/AIDS, presence of comorbid illness, alcohol consumption and cigarette smoking.\u0000Conclusions: The prevalence of head and neck lesions among HIV/AIDS patients on HAART was low. Females outnumbered males in terms of being affected by head and neck lesions. Oral candidiasis was the most common head and neck lesion. Head and neck (laryngeal and hypopharyngeal) squamous cell carcinoma was the predominant subtype of malignant lesions in HIV/AIDS patients on HAART.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"76 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140752753","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}
Introduction: Studies on the effect of feeding practices and sucking habits on malocclusion traits in the primary dentition of pre-schoolchildren from developing countries are scarce. Purpose: Assessing the association of feeding and sucking habits with malocclusion traits, and the association of malocclusion traits with observed oral functional problems. Methods: It was a cross-sectional survey of children aged 3-5 years residing in Kinondoni and Temeke Districts of Dar es Salaam region in Tanzania. Data was analyzed using Statistical Package for Social Scientists, SPSS version 21.0. Univariate analysis was applied to generate frequencies of different variables. Cross tabulations and Chi-square statistics were used to assess bivariate relationships and multivariate analyses were performed by multiple logistic regression. Results: Most pre-schoolchildren (82.5%) were breastfed for less than two years. A history of non-nutritive sucking habits was reported in 28.1% of the children, mostly in boys than girls (33.6% versus 21.8%, respectively. The current non-nutritive sucking habits were reported in 17.8% of the participants. Overall, malocclusion traits were most significantly seen in children who were breastfed for less than two years, compared with those who were breastfed for two years or more (48.5% versus 27.3%, respectively). The presence of various malocclusion traits was significantly found among most of the children who had a history of non-nutritive sucking habits, compared with those who had never performed the habits (65.9% versus 38.6 %, respectively). In the logistic regression analyses, children who were breastfed for a shorter duration (<2 years), their probability of being found with different traits of malocclusion in the primary dentition was almost three times that for those who were breastfed for a longer duration (≥ two years). Also, children who were not actively performing non-nutritive sucking habits were less likely to have an open bite compared with those who were actively performing non-nutritive sucking habits. An open bite in children was significantly associated with speech problems (p<0.01) and swallowing with tongue thrusting (p=0.000). Conclusion and recommendations: Most of the children who were breastfed for a shorter duration and children who had non-nutritive sucking habits were found with various malocclusion, compared with those who were breastfed for a longer duration and those who had no non-nutritive sucking habits. It is crucial to recommend exclusive breastfeeding for up to 6 months and continuation of breastfeeding practice, possibly for up to 2 years of age due to its nutritional, immunological, and stomato-gnathic system developmental benefits.
{"title":"Breastfeeding and non-nutritive sucking habits as covariates of malocclusion in the primary dentition among Tanzanian children: A cross-sectional study","authors":"Matlida Mtaya Mlangwa, P. Brudvik, Anne Åstrøm","doi":"10.4314/thrb.v25i2.12","DOIUrl":"https://doi.org/10.4314/thrb.v25i2.12","url":null,"abstract":"Introduction: Studies on the effect of feeding practices and sucking habits on malocclusion traits in the primary dentition of pre-schoolchildren from developing countries are scarce.\u0000Purpose: Assessing the association of feeding and sucking habits with malocclusion traits, and the association of malocclusion traits with observed oral functional problems.\u0000Methods: It was a cross-sectional survey of children aged 3-5 years residing in Kinondoni and Temeke Districts of Dar es Salaam region in Tanzania. Data was analyzed using Statistical Package for Social Scientists, SPSS version 21.0. Univariate analysis was applied to generate frequencies of different variables. Cross tabulations and Chi-square statistics were used to assess bivariate relationships and multivariate analyses were performed by multiple logistic regression.\u0000Results: Most pre-schoolchildren (82.5%) were breastfed for less than two years. A history of non-nutritive sucking habits was reported in 28.1% of the children, mostly in boys than girls (33.6% versus 21.8%, respectively. The current non-nutritive sucking habits were reported in 17.8% of the participants. Overall, malocclusion traits were most significantly seen in children who were breastfed for less than two years, compared with those who were breastfed for two years or more (48.5% versus 27.3%, respectively). The presence of various malocclusion traits was significantly found among most of the children who had a history of non-nutritive sucking habits, compared with those who had never performed the habits (65.9% versus 38.6 %, respectively). In the logistic regression analyses, children who were breastfed for a shorter duration (<2 years), their probability of being found with different traits of malocclusion in the primary dentition was almost three times that for those who were breastfed for a longer duration (≥ two years). Also, children who were not actively performing non-nutritive sucking habits were less likely to have an open bite compared with those who were actively performing non-nutritive sucking habits. An open bite in children was significantly associated with speech problems (p<0.01) and swallowing with tongue thrusting (p=0.000).\u0000Conclusion and recommendations: Most of the children who were breastfed for a shorter duration and children who had non-nutritive sucking habits were found with various malocclusion, compared with those who were breastfed for a longer duration and those who had no non-nutritive sucking habits. It is crucial to recommend exclusive breastfeeding for up to 6 months and continuation of breastfeeding practice, possibly for up to 2 years of age due to its nutritional, immunological, and stomato-gnathic system developmental benefits.\u0000 ","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"153 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140754945","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}
Helena Gemuhay, Saada Ali, Ally Kinyaga, S. Kibusi
Background: Delayed Developmental Milestones are defined as slow to attain typical developmental milestones in one or more developmental areas. This study aimed to assess risk factors of delayed developmental milestones among infants in the Dodoma Region. Methods: We conducted a health facility-based cross-sectional descriptive study using the pathways developmental screening tool. A total of 262 mothers with their children were enrolled, the study population were all neonates delivered at the study sites during the study period. Three data collection methods were utilized to obtain information for this study: observation, interviewer-administered questionnaires, and documentary review. Ethical approval was obtained from the Ethical Review Board of the University of Dodoma SAS version 9.4 was used for data analysis. The association between developmental status and factors was assessed with Chi-square and binomial logistic regression. Results: Notably, infants born with birth asphyxia were more likely three times to develop delayed developmental milestones as opposed to those without birth asphyxia [adjusted risk ratio =3.22, 95%, [1.97, 5.46], probability value= <.0001]. Birth weight was significantly associated with delayed developmental milestones; infants who were born with a birth weight of ≥4000gm had more risk of developing delayed developmental milestones compared to those with a birth weight of 2500-3999gm [adjusted risk ratio 0.48, 95%, [0.26, 0.92], probability value = 0.0256]. Regarding mode of delivery, the risk of developing delayed developmental milestones was less among infants born via caesarean section compared to those who were born via spontaneous vaginal delivery [adjusted risk ratio 0.47[0.18, 0.99], probability value = 0.0461]. Conclusion: Delayed developmental milestones are a burden in developing countries. The risk factors are known, and they are based on the individual to the community level; birth asphyxia was identified as a possible risk factor that has been reported in many studies and has an impact on children's development.
{"title":"Risk factors of delayed developmental milestones among infants attending RCH clinics in Dodoma region. A cross-sectional studydoma region","authors":"Helena Gemuhay, Saada Ali, Ally Kinyaga, S. Kibusi","doi":"10.4314/thrb.v25i2.9","DOIUrl":"https://doi.org/10.4314/thrb.v25i2.9","url":null,"abstract":"Background: Delayed Developmental Milestones are defined as slow to attain typical developmental milestones in one or more developmental areas. This study aimed to assess risk factors of delayed developmental milestones among infants in the Dodoma Region.\u0000Methods: We conducted a health facility-based cross-sectional descriptive study using the pathways developmental screening tool. A total of 262 mothers with their children were enrolled, the study population were all neonates delivered at the study sites during the study period. Three data collection methods were utilized to obtain information for this study: observation, interviewer-administered questionnaires, and documentary review. Ethical approval was obtained from the Ethical Review Board of the University of Dodoma SAS version 9.4 was used for data analysis. The association between developmental status and factors was assessed with Chi-square and binomial logistic regression.\u0000Results: Notably, infants born with birth asphyxia were more likely three times to develop delayed developmental milestones as opposed to those without birth asphyxia [adjusted risk ratio =3.22, 95%, [1.97, 5.46], probability value= <.0001]. Birth weight was significantly associated with delayed developmental milestones; infants who were born with a birth weight of ≥4000gm had more risk of developing delayed developmental milestones compared to those with a birth weight of 2500-3999gm [adjusted risk ratio 0.48, 95%, [0.26, 0.92], probability value = 0.0256]. Regarding mode of delivery, the risk of developing delayed developmental milestones was less among infants born via caesarean section compared to those who were born via spontaneous vaginal delivery [adjusted risk ratio 0.47[0.18, 0.99], probability value = 0.0461].\u0000Conclusion: Delayed developmental milestones are a burden in developing countries. The risk factors are known, and they are based on the individual to the community level; birth asphyxia was identified as a possible risk factor that has been reported in many studies and has an impact on children's development.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"142 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140751524","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. Bhatia, A. Jazza, Shabnam Gulamabas, Zainabbas Ladha, K. Ramaiya, M. Alimohamed
Background: Antimicrobial resistance is among the top ten global threats as declared by WHO in 2019. Irrational use of antibiotics has led to the evolution of resistant microbes. There is limited data in our setting regarding microbes and their antibiotic susceptibility patterns. This study determines predominant bacterial isolates, their susceptibility pattern and current practices among prescribers regarding change of empirical to definitive treatment following antibiotic susceptibility test (AST) results. Method: A retrospective observational study involving 171 culture and AST reports of inpatients admitted between Jan-Dec 2020 in a tertiary-care hospital in Dar-es-Salaam. Results: Of 171 specimens, 52.6% were culture-positive. The frequently isolated organisms included Klebsiella species (21.1%), Escherichia coli (18.9%) and Staphylococcus aureus (14.4%). Of these, Gram-negative isolates showed high rates of resistance against third-generation cephalosporins (71.7%) whereas Gram-positive isolates showed high rates of resistance against penicillins (100%). More than half (58.1%) of the patients with positive culture had changes in antibiotics from empirical to definitive treatment that did not match the AST results. Conclusion: Varied rates of resistance to fourth-generation cephalosporin by the majority of bacterial isolates are alarming. This calls for the establishment of antimicrobial stewardship programs to cater for optimal and rational use of antibiotics by consumers and prescribers.
{"title":"Microbial prevalence and antibiotic susceptibility pattern in hospitalized patients in a tertiary care hospital","authors":"V. Bhatia, A. Jazza, Shabnam Gulamabas, Zainabbas Ladha, K. Ramaiya, M. Alimohamed","doi":"10.4314/thrb.v23i4.5","DOIUrl":"https://doi.org/10.4314/thrb.v23i4.5","url":null,"abstract":"Background: Antimicrobial resistance is among the top ten global threats as declared by WHO in 2019. Irrational use of antibiotics has led to the evolution of resistant microbes. There is limited data in our setting regarding microbes and their antibiotic susceptibility patterns. This study determines predominant bacterial isolates, their susceptibility pattern and current practices among prescribers regarding change of empirical to definitive treatment following antibiotic susceptibility test (AST) results. \u0000Method: A retrospective observational study involving 171 culture and AST reports of inpatients admitted between Jan-Dec 2020 in a tertiary-care hospital in Dar-es-Salaam. \u0000Results: Of 171 specimens, 52.6% were culture-positive. The frequently isolated organisms included Klebsiella species (21.1%), Escherichia coli (18.9%) and Staphylococcus aureus (14.4%). Of these, Gram-negative isolates showed high rates of resistance against third-generation cephalosporins (71.7%) whereas Gram-positive isolates showed high rates of resistance against penicillins (100%). More than half (58.1%) of the patients with positive culture had changes in antibiotics from empirical to definitive treatment that did not match the AST results. \u0000Conclusion: Varied rates of resistance to fourth-generation cephalosporin by the majority of bacterial isolates are alarming. This calls for the establishment of antimicrobial stewardship programs to cater for optimal and rational use of antibiotics by consumers and prescribers.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47238137","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: Variations in the risk of malaria across locations exist but are poorly understood though identifying hotspots of malaria transmission will create opportunities for targeted interventions. Point prevalence of malaria in Rivers State was studied using Primary Healthcare Centres (PHCs) as survey points. Methods: The PHCs in Rivers State were geo-referenced using a handheld Global Positioning System (GPS) and 74 were selected across 21 local government areas using systematic grid point sampling. Blood samples were obtained from 2340 persons who consented and questionnaires were administered to obtain their demographic data. Malaria parasites in blood films were detected using the Giemsa staining technique. Data generated were analysed using SPSS 22.0 and presented using descriptive statistics. The level of relationship amongst the parameters was obtained using Chi-square. Co-ordinates of PHCs sampled and their prevalence data for malaria were entered into Microsoft Excel 2007 spreadsheet and transmitted to ArcGIS 10.8. This platform was then used to produce point prevalence infection maps of the State using geographic information systems (GIS). Survey points with malaria point prevalence values of 75% and above and cumulative prevalence of 1.97% and above were categorised as malaria transmission hot spots in the various LGAs. Results: The study recorded an overall prevalence of 56.3%, with P.falciparum as the only identified malaria parasite. Data revealed that Oyoro Model Primary Health Centre (MPHC), Arukwo Primary Health Centre, Ele Health Post (HP) and Emago HP recorded very high prevalence of 96.7%, 96%, 95.2% and 94.4% respectively, whereas MPHC Iriebe had the least prevalence. Twelve hotspots with point prevalence above 75% were identified and eight hotspots likewise with cumulative prevalence above 1.97%. Conclusion: Malaria infection remains endemic in Rivers State. This study provides malaria point prevalence maps of Rivers State which will serve as a reference to policymakers for strategic interventions in the State
背景：不同地区的疟疾风险存在差异，但人们对其了解甚少，尽管确定疟疾传播热点将为有针对性的干预措施创造机会。以初级保健中心为调查点，研究了里弗斯州疟疾的点流行率。方法：使用手持式全球定位系统（GPS）对里弗斯州的PHC进行地理参考，并使用系统网格点采样在21个地方政府区域选择74个PHC。从2340名同意的人身上采集血样，并进行问卷调查以获得他们的人口统计数据。使用Giemsa染色技术检测血片中的疟疾寄生虫。使用SPSS 22.0对生成的数据进行分析，并使用描述性统计进行呈现。参数之间的关系水平是使用卡方获得的。采样的PHC的坐标及其疟疾流行率数据被输入到Microsoft Excel 2007电子表格中，并传输到ArcGIS 10.8。该平台随后被用于使用地理信息系统（GIS）绘制该州的点流行率感染地图。疟疾点流行率值为75%及以上、累计流行率为1.97%及以上的调查点被归类为各种地方政府机构的疟疾传播热点。结果：该研究记录的总患病率为56.3%，恶性疟原虫是唯一确定的疟原虫。数据显示，Oyoro模式初级卫生中心（MPHC）、Arukwo初级卫生中心、Ele Health Post（HP）和Emago HP的患病率非常高，分别为96.7%、96%、95.2%和94.4%，而MPHC Iriebe的患病率最低。确定了12个点流行率超过75%的热点地区和8个累计流行率超过1.97%的热点地区。结论：疟疾感染在里弗斯州仍然流行。这项研究提供了里弗斯州的疟疾流行点地图，将为该州的战略干预政策制定者提供参考
{"title":"Point prevalence mapping of malaria infection in Rivers State, Nigeria","authors":"S. Egbom, F. Nduka, S. Nzeako","doi":"10.4314/thrb.v23i4.7","DOIUrl":"https://doi.org/10.4314/thrb.v23i4.7","url":null,"abstract":"Background: Variations in the risk of malaria across locations exist but are poorly understood though identifying hotspots of malaria transmission will create opportunities for targeted interventions. Point prevalence of malaria in Rivers State was studied using Primary Healthcare Centres (PHCs) as survey points. \u0000Methods: The PHCs in Rivers State were geo-referenced using a handheld Global Positioning System (GPS) and 74 were selected across 21 local government areas using systematic grid point sampling. Blood samples were obtained from 2340 persons who consented and questionnaires were administered to obtain their demographic data. Malaria parasites in blood films were detected using the Giemsa staining technique. Data generated were analysed using SPSS 22.0 and presented using descriptive statistics. The level of relationship amongst the parameters was obtained using Chi-square. Co-ordinates of PHCs sampled and their prevalence data for malaria were entered into Microsoft Excel 2007 spreadsheet and transmitted to ArcGIS 10.8. This platform was then used to produce point prevalence infection maps of the State using geographic information systems (GIS). Survey points with malaria point prevalence values of 75% and above and cumulative prevalence of 1.97% and above were categorised as malaria transmission hot spots in the various LGAs. \u0000Results: The study recorded an overall prevalence of 56.3%, with P.falciparum as the only identified malaria parasite. Data revealed that Oyoro Model Primary Health Centre (MPHC), Arukwo Primary Health Centre, Ele Health Post (HP) and Emago HP recorded very high prevalence of 96.7%, 96%, 95.2% and 94.4% respectively, whereas MPHC Iriebe had the least prevalence. Twelve hotspots with point prevalence above 75% were identified and eight hotspots likewise with cumulative prevalence above 1.97%. \u0000Conclusion: Malaria infection remains endemic in Rivers State. This study provides malaria point prevalence maps of Rivers State which will serve as a reference to policymakers for strategic interventions in the State","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42747108","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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