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Bacterial Contamination of Medical Doctors and Students White Coats at Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

ABSTRACT: Background. Microbial transmission from patient to patient has been linked to transient colonization of health care workers attires. Contamination of health care workers' clothing including white coats may play a big role in transmission of microbes. Study Objective. This study was conducted to determine the type of bacterial contamination on the white coats of medical doctors and students and associated factors. Methods. A cross-sectional study with purposive sampling of the bacterial contamination of white coats was undertaken. Demographic variables and white coats usage details were captured: when the coat was last washed, frequency of washing, washing agents used, and storage of the white coats. Swabs were collected from the mouth of left and right lower pockets, sleeves, and lapels of white coat in sterile techniques. Results. Out of 180 participants involved in the current study, 65.6% were males. Most of the coats were contaminated by staphylococci species and other bacteria such as Gram negative rods. Conclusion and Recommendations. White coats are potential source of cross infection which harbour bacterial agents and may play a big role in the transmission of nosocomial infection in health care settings. Effort should be made to discourage usage of white coats outside clinical areas.

SUBMITTER: Qaday J

PROVIDER: S-EPMC4745394 | biostudies-other | 2015

REPOSITORIES: biostudies-other

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Bacterial Contamination of Medical Doctors and Students White Coats at Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Qaday Josephat J Sariko Margaretha M Mwakyoma Adam A Kifaro Emmanuel E Mosha Dominick D Tarimo Richard R Nyombi Balthazar B Shao Elichilia E

International journal of bacteriology 20151104

Background. Microbial transmission from patient to patient has been linked to transient colonization of health care workers attires. Contamination of health care workers' clothing including white coats may play a big role in transmission of microbes. Study Objective. This study was conducted to determine the type of bacterial contamination on the white coats of medical doctors and students and associated factors. Methods. A cross-sectional study with purposive sampling of the bacterial contamina ...[more]

PMID: 26904746

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Project description:BackgroundWorldwide prevalence of dyslipidemia in HIV-infected children on antiretroviral medications (ARVs) is rising due to extensive use of treatment during their entire lives. Dyslipidemia is the potential side effect of ARVs, especially in individuals taking protease inhibitors. The objective of this study was to determine the prevalence of dyslipidemia in HIV-infected children on ARVs receiving care at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania.MethodsThis was a cross-sectional hospital-based study conducted from September 2015 to May 2016 at KCMC. HIV-infected children and adolescents less than 17 years on ARVs for more than 6 months were enrolled. Blood samples were taken to determine levels of triglycerides (TGs), total cholesterol, lipoproteins (including low-density lipoprotein (LDL) and high-density lipoprotein (HDL)), CD4+ T cells, and viral load (VL). Anthropometric measurements were used to assess nutritional status. SPSS 20.0 was used for analysis. Logistic regression estimated odds ratio (OR) and 95% confidence interval (CI), and P value <.05 was considered significant. Written consent was obtained from parents/guardians on behalf of their children and assent for older children.ResultsA total of 260 participants were included in the study; the median age at HIV diagnosis was 3 (interquartile range (IQR) = 1-6) years. The overall prevalence of dyslipidemia was 46.5% with hypercholesterolemia (⩾200 mg/dl) of 11.2%, HDL (<35 mg/dl) of 22.7%, LDL (⩾130 mg/dl) of 7.7%, and hyperglyceridemia (TG ⩾150 mg/dl) of 12.3%. Children aged between 6 and 12 years at HIV diagnosis had 2.7 times higher odds of developing dyslipidemia compared with younger age at diagnosis (OR = 2.7; 95% CI = 1.1-6.6). Patients with advanced (OR = 6.4; 95% CI = 1.5-27.1) or severe (OR = 9.8; 95% CI = 1.2-76.5) HIV-associated immunodeficiency at diagnosis had higher odds of developing dyslipidemia. Protease inhibitor use was associated with higher odds of developing dyslipidemia (OR = 3.1; 95% CI = 1.4-7.1).ConclusionLate diagnosis of HIV at 6 years of age or more, advanced, or severe immunosuppression, and the use of protease inhibitors were independent predictors of dyslipidemia in children on ARVs after 6 months of treatment, and with low HDL levels observed most commonly. Monitoring lipid profiles in children, especially those on protease inhibitors and with advanced/severe immunosuppression at diagnosis, may help in preventing future complications.

Project description:BackgroundPreterm birth is a public health problem particularly in low- and middle-income countries especially in sub-Saharan Africa. It is associated with infant morbidity and mortality. Survivor of preterm suffers long term health consequences such as respiratory, hearing and visual problems as well as delivering preterm infants. Preterm birth also tends to recur in subsequent pregnancies. Little is known about recurrent rate of preterm birth and associated factors in Tanzania. This study aimed to determine the recurrence rate of preterm birth and associated factors among women who delivered at Kilimanjaro Christian Medical Centre (KCMC), in Northern Tanzania.MethodsA historic cohort study was designed using maternally-linked data from KCMC medical birth registry. Women who delivered 2 or more singletons were included. A total of 5,946 deliveries were analysed. Recurrence of preterm birth and associated risk factors were estimated using multivariable log-binomial regression model with robust standard error to account for repeated births from the same mother.ResultsOverall recurrent rate of preterm birth was 24.4%. The recurrence of early preterm birth was higher compared to late preterm birth (26.2% vs. 24.2%). Similar pattern of recurrence was observed for spontaneous and medically indicated preterm birth (13.5% vs. 10.9%, respectively). Previous preterm birth (RR;1.85, 95% CI: 1.49, 2.31), preeclampsia (RR;1.46, 95% CI: 1.07, 2.00), long inter-pregnancy interval (RR;1.22, 95% CI: 1.01, 1.49) and clinical subtypes (RR = 1.37, 95% CI: 1.00, 1.86) were important predictors for recurrent preterm birth.ConclusionRecurrence of preterm birth remains higher in this population. The rate of preterm recurrence was dependent of gestational age and sub-clinical subtype. Other factors which were associated with recurrence of preterm birth were previous preterm birth, preeclampsia and long inter-pregnancy interval. Early identification of high risk women during prenatal period is warranted.

Project description:BackgroundChoosing a medical specialty is an important, complex, and not fully understood process. The present study investigated the factors that are related to choosing and rejecting medical specialties in a group of students and recent medical doctors.Methodology and findingsA cross-sectional survey of 1,223 medical students and doctors was performed in Brazil in 2012. A standardized literature-based questionnaire was applied that gathered preferable or rejected specialties, and asked questions about extracurricular experiences and the influence of 14 factors on a Likert-type scale from 0 to 4. Specialties were grouped according to lifestyle categories: controllable and uncontrollable, which were subdivided into primary care, internal medicine, and surgical specialties. Notably, the time period of rejection was usually earlier than the time period of intended choice (p < 0.0001, χ(2) = 107.2). The choice mainly occurred during the internship period in medical school (n = 466; 38.7%). An overall large frequency of participation in extracurricular activities was observed (n = 1,184; 95.8%), which were highly associated with the respective medical area. Orthopedic surgery had the highest correlation with participation in specialty-specific organized groups (OR = 59.9, 95% CI = 21.6-166.3) and psychiatry was correlated with participation in research groups (OR = 18.0, 95% CI = 9.0-36.2). With regard to influential factors in controllable lifestyle specialties, "financial reason" (mean score ± standard deviation: 2.8 ± 1.0; median = 3) and "personal time" (3.1 ± 1.3; median = 4) were important factors. In primary care, these factors were less important (1.7 ± 1.3 and 1.7 ± 1.5, respectively; median = 2 for both), and higher scores were observed for "curricular internship" (3.2 ± 1.1, median = 4) and "social commitment" (2.6 ± 1.3, median = 3).ConclusionThe present findings provide important insights into developing strategies to stimulate interest in specialties based on the needs of the Brazilian healthcare system.

Project description:BackgroundNeurophobia is the fear of neurosciences held by medical students and doctors. The present study aims to identify whether Neurology is considered a difficult subject by medical students and non-specialist doctors from Sri Lanka and evaluate reasons for such perceived difficulties.MethodsThe study was conducted from May-June 2008. One hundred non-specialist doctors from the Colombo South Teaching Hospital and 150 medical students from the University of Sri Jayewardenepura were invited for the study. Data were collected by a pre-tested expert-validated self-administered questionnaire, designed to assess the degree of perceived difficulty, confidence, interest and knowledge of Neurology as compared to other subjects. It also evaluated reasons and probable strategies to overcome the perceived difficulties and/or lack of interests.ResultsAll non-specialist doctors and 148 medical students responded to the questionnaire (response rate-99.2%). The most favourite subject among medical students and non-specialist doctors were Cardiology and Endocrinology respectively, while Neurology was ranked third. In all participants the current level of interest was most for Cardiology (3.52±1.36), while Neurology was the least interesting specialty for majority of medical students (18.5%) and non-specialist doctors (25.0%). The current level of knowledge among medical students was most for Cardiology (3.12±0.86), while Neurology (2.53±0.96) was ranked fifth. The most difficult specialty for majority of medical students (50.0%) and non-specialist doctors (41.7%) was Neurology. All the participants were least confident when dealing with patients with headache (2.20±0.81), numbness of feet (2.07±0.79) and dizziness (2.07±0.78) when compared to dealing with other non-neurological complaints. The commonest reasons 'why Neurology was felt to be a difficult subject' were; the need to know basic neuro-anatomy and having a complex clinical examination. Participants' felt that clinical/hospital based teaching (3.49±0.65), case discussions (3.45±0.68) and teaching aids (3.10±0.89) would be the most important teaching strategies to improve their competency in Neurology.ConclusionNeurology is considered a difficult subject by undergraduates and non-specialist doctors of Sri Lanka. The main reason for the perceived difficulty was the lack of understanding of basic sciences and deficiencies in clinical teaching. This lack of confidence could have a significant impact on patient care.

Project description:Morphological and molecular analyses of plant-parasitic nematodes (PPN) from 12 sugarcane plantation sites of Tanganyika Planting Company (TPC) Limited in Kilimanjaro region of Tanzania revealed the presence of six PPN genera, i.e. Helicotylenchus, Hemicycliophora, Pratylenchus, Rotylenchulus, Scutellonema, and Tylenchorhynchus. The genera with the highest densities and present in virtually all samples were Pratylenchus and Rotylenchulus, and the most important species appeared to be R. parvus, P. zeae, T. crassicaudatus, and T. ventrosignatus. A total sequences of 11 partial ITS, 15 D2-D3 of 28S, and 6 partial 18S of rRNA gene, and 7 partial COI gene of mtDNA of these species were obtained in this study. Morphology and molecular data comparisons between the Tanzanian R. parvus and the South African R. parvus indicated that R. parvus is a cryptic species complex. Based on the results of morphological and molecular analyses of T. crassicaudatus and T. agri from China, Haiti, Indonesia, Iran, Niger and the USA, T. agri syn. n. is proposed as a junior synonym of T. crassicaudatus.Morphological and molecular analyses of plant-parasitic nematodes (PPN) from 12 sugarcane plantation sites of Tanganyika Planting Company (TPC) Limited in Kilimanjaro region of Tanzania revealed the presence of six PPN genera, i.e. Helicotylenchus, Hemicycliophora, Pratylenchus, Rotylenchulus, Scutellonema, and Tylenchorhynchus. The genera with the highest densities and present in virtually all samples were Pratylenchus and Rotylenchulus, and the most important species appeared to be R. parvus, P. zeae, T. crassicaudatus, and T. ventrosignatus. A total sequences of 11 partial ITS, 15 D2-D3 of 28S, and 6 partial 18S of rRNA gene, and 7 partial COI gene of mtDNA of these species were obtained in this study. Morphology and molecular data comparisons between the Tanzanian R. parvus and the South African R. parvus indicated that R. parvus is a cryptic species complex. Based on the results of morphological and molecular analyses of T. crassicaudatus and T. agri from China, Haiti, Indonesia, Iran, Niger and the USA, T. agri syn. n. is proposed as a junior synonym of T. crassicaudatus.

Project description:BackgroundRetention of Human Resources for Health (HRH), particularly doctors at district level is a big challenge facing the decentralized health systems in poorly resourced countries. Tanzania, with 75% of its population in rural areas, has only 26% of doctors serving in rural areas. We aimed to analyze the experiences regarding the retention of doctors at district level in Tanzania from doctors' and district health managers' perspectives.MethodsA qualitative study was carried out in three districts from June to September 2013. We reviewed selected HRH documents and then conducted 15 key informant interviews with members of the District Health Management teams and medical doctors working at the district hospitals. In addition, we conducted three focus group discussions with Council Health Management Team members in the three districts. Incentive package plans, HRH establishment, and health sector development plans from the three districts were reviewed. Data analysis was performed using qualitative content analysis.ResultsNone of the districts in this study has the number of doctors recommended. Retention of doctors in the districts faced the following challenges: unfavourable working conditions including poor working environment, lack of assurance of career progression, and a non-uniform financial incentive system across districts; unsupportive environment in the community, characterized by: difficulty in securing houses for rent, lack of opportunities to earn extra income, lack of appreciation from the community and poor social services. Health managers across districts endeavour to retain their doctors through different retention strategies, including: career development plans, minimum financial incentive packages and avenues for private practices in the district hospitals. However, managers face constrained financial resources, with many competing priorities at district level.ConclusionsRetention of doctors at district level faces numerous challenges. Assurance of career growth, provision of uniform minimum financial incentives and ensuring availability of good social services and economic opportunities within the community are among important retention strategies.

Dataset Information

Bacterial Contamination of Medical Doctors and Students White Coats at Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Publications

Bacterial Contamination of Medical Doctors and Students White Coats at Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

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