Colorectal cancer in a patient with intestinal schistosomiasis: a case report from Kilimanjaro Christian Medical Center Northern Zone Tanzania.
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ABSTRACT:
SUBMITTER: Herman AM
PROVIDER: S-EPMC5541651 | biostudies-other | 2017 Aug
REPOSITORIES: biostudies-other
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Project description:BACKGROUND:Schistosomiasis is a neglected tropical disease that continues to cause morbidity and mortality in Sub Saharan Africa. Due to its endemicity, co-infection with malaria is common. The diseases cause anaemia and impaired nutritional status among children. We investigated the prevalence of intestinal schistosomiasis and its association with malaria, anaemia and nutritional status among school children. METHODS:This was a cross sectional survey among 830 children in Nyamikoma village along Lake Victoria in Tanzania. A pre-tested questionnaire was used to collect socio-demographic data, history of drug use, and clinical data. Two faecal samples were collected on two consecutive days and analyzed using thick smears Kato Katz method. Diagnosis of malaria was done by malaria rapid diagnostic test, and haemoglobin concentration was determined using HemoCue. Nutritional status was assessed by anthropometric measurements. RESULTS:The overall prevalence of intestinal schistosomiasis was 90.6% (95% CI = 88.6% - 92.6%). Intensity of infection was light 24.1% (200/830), moderate 38.4% (319/830) and heavy 28.1% (233/830). Pre-adolescents (≤12 years) were more infected with intestinal schistosomiasis (93.2%) than adolescents (>12 years) (84.7%) (p < 0.001). Prevalence of malaria was 1.7% (14/824), and that of intestinal schistosomiasis-malaria co-infection was 1.6% (13/824). The overall prevalence of anaemia was 24.6% (95%CI = 18.7% - 30.5%). Severe anaemia was found in 2.3% (19/824) of study participants. The prevalence of stunting and wasting were 29.0% and 11.3%, respectively. On both univariate and multivariate regression analysis, only lower age was significantly associated intestinal schistosomiasis infection, but not anemia, malaria, stunting or wasting. However among those infected, a negative binomial regression analysis indicated independent significant association of male sex, loose stool consistency, and stunting with high eggs count/gram of stool. CONCLUSIONS:Despite several rounds of annual mass praziquantel administration, intestinal schistosomiasis is highly prevalent among school children particularly in younger children living in the study area. Biannual targeted mass praziquantel treatments or alternative regimens may be considered in future in the study area to redress the situation.
| S-EPMC7001966 | biostudies-literature
Project description:BackgroundBlood transfusion saves many people every year that would otherwise have died. The present study aimed to provide an update and insightful information regarding prevalence of the common Transfusion-Transmitted Infections (TTIs) and associated factors among blood donors in Tanzania.MethodsThis was a cross-sectional study involving retrospectively collected data of blood donors from the Tanzania Northern Zone Blood Transfusion Center between 2017 and 2019. Descriptive statistics were performed to describe characteristics of the blood donors. Univariable and multivariable logistic regression analyses were performed to determine association between prevalence of TTIs and socio-demographic factors. P-value <0.05 was considered statistically significant.ResultsA total of 101, 616 blood donors were included in the present study of which 85,053(83.7%) were males while 16,563 (16.3%) were females. Of all participants, the majority 45,400 (44.7%) were aged between 18 and 25 years; 79,582 (78.3%) were voluntary non-remunerated donors while 22,034 (21.7%) were replacement donors. The vast majority of them 99,626 (98%) were first time blood donors while 1990 (2%) were multiple donors. The overall prevalence of TTIs was 10.1% (10,226 out of 101,616) of which the leading was HBV accounting for 5.1% (5,264 out of 101,616). Being a replacement donor was associated with all the four types of TTIs: HIV (AOR = 1.22, 95% CI = 1.10-1.35), HBV (AOR = 1.35, 95% CI = 1.27-1.44), HCV (AOR = 1.28, 95% CI = 1.12-1.46), and syphilis (AOR = 1.33, 95% CI = 1.20-1.48).ConclusionsOur study has demonstrated that Tanzania has relatively high prevalence of TTIs compared to some countries in Sub-Saharan Africa. HBV infection seems to be the most common infection among blood donors and replacement blood donors are at a higher risk of harboring the commonest TTIs among blood donors.
| S-EPMC7990303 | biostudies-literature
Project description:Listeria monocytogenes strain:medical patient | isolate:medical patient Genome sequencing
| PRJNA814010 | ENA
Project description:We use a Master Regular-based precision cancer medicine framework to predict drug sensitivity to tumors.
2022-09-06 | GSE212377 | GEO
Project description:BackgroundEndomyocardial fibrosis (EMF) is a rare and underdiagnosed cause of restrictive cardiomyopathy. Its aetiology is not yet defined and could be caused by the influence of different clinical factors that seem to combine with genetic aspects of individuals susceptible to an inflammatory process that leads to formation of fibrosis.Case summaryWe describe a case of a 50-year-old man from the northeastern region of Brazil, where there is high prevalence of schistosomiasis. He presented to our centre with symptoms of right heart failure. The echocardiogram showed normal left ventricular ejection fraction. Right ventricular had normal systolic function but in the apical region was filled with a homogeneous and hypoechoic image causing obliteration and restriction of the apex. The late gadolinium enhancement with cardiac magnetic resonance showed diffuse and heterogeneous subendocardial fibrosis in the right ventricle apex consistent with EMF, but declined endocardiectomy.DiscussionThis report presents an interesting case of EMF and schistosomiasis simultaneously. The hypothesis of parasitosis as a probable cause of EMF was raised by helminth-induced hypereosinophilia. Complementary imaging tests such as magnetic resonance imaging and echocardiography, in addition to clinical and epidemiological suspicion, are essential for its diagnosis. Early surgical resolution becomes crucial for long-term survival.
| S-EPMC9356724 | biostudies-literature
Project description:BackgroundLarge scale implementation of new strategies and healthcare delivery standards in academic medical centers (AMCs) requires training of healthcare workforce at different stages of their medical career. The patient-centered medical home (PCMH) model for healthcare delivery involves adoption by all members of the healthcare workforce, including seasoned professionals and trainees. Though widely known, the PCMH model has been implemented sporadically at large AMCs and methods to implement the model across healthcare workforce have not been well-documented.MethodsTo meet all PCMH standards and achieve sustainable level 3 recognition, the authors implemented in 2014-2015 a multi-pronged approach that capitalized on existing educational infrastructure among faculty, residents, and medical students. Within 18 months, the authors applied new interdisciplinary practices and policies, redesigned residency training in continuity practices and extensively modified medical school curricula.ResultsThese innovative transformational education efforts addressed the six PCMH standards for faculty, residents, and undergraduate medical students. Faculty played a major role as system change agents and facilitators of learning. Residents learned to better understand patients' cultural needs, identify 'at-risk' patients, ensure continuity of care, and assess and improve quality of care. Medical students were exposed to PCMH core standards throughout their training via simulations, training in the community and with patients, and evaluation tasks. By implementing these changes across the healthcare workforce, the AMC achieved PCMH status in a short time, changed practice culture and improved care for patients and the community. Since then, the AMC has been able to maintain PCMH recognition annually with minimal effort.ConclusionsSuccessful strategies that capitalize on existing strengths in infrastructure complemented by innovative educational offerings and inter-professional partnerships can be adapted by other organizations pursuing similar transformation efforts. This widespread transformation across the healthcare workforce facilitate a deep-rooted change that enabled our academic medical center to sustain PCMH recognition.
| S-EPMC8173877 | biostudies-literature
Project description:With growing national focus on reducing readmissions, there is a need to comprehensively assess the quality of transitional care, including discharge practices, patient perspectives, and patient understanding.To conduct a multifaceted evaluation of transitional care from a patient-centered perspective.Prospective observational cohort study, May 2009 through April 2010.Urban, academic medical center.Patients 65 years and older discharged home after hospitalization for acute coronary syndrome, heart failure, or pneumonia.Discharge practices, including presence of follow-up appointment and patient-friendly discharge instructions; patient understanding of diagnosis and follow-up appointment; and patient perceptions of and satisfaction with discharge care.The 395 enrolled patients (66.7% of those eligible) had a mean age of 77.2 years. Although 349 patients (95.6%) reported understanding the reason they had been in the hospital, only 218 patients (59.6%) were able to accurately describe their diagnosis in postdischarge interviews. Discharge instructions routinely included symptoms to watch out for (98.4%), activity instructions (97.3%), and diet advice (89.7%) in lay language; however, 99 written reasons for hospitalization (26.3%) did not use language likely to be intelligible to patients. Of the 123 patients (32.6%) discharged with a scheduled primary care or cardiology appointment, 54 (43.9%) accurately recalled details of either appointment. During postdischarge interviews, 118 patients (30.0%) reported receiving less than 1 day’s advance notice of discharge, and 246 (66.1%) reported that staff asked whether they would have the support they needed at home before discharge.Patient perceptions of discharge care quality and self-rated understanding were high, and written discharge instructions were generally comprehensive although not consistently clear. However, follow-up appointments and advance discharge planning were deficient, and patient understanding of key aspects of postdischarge care was poor. Patient perceptions and written documentation do not adequately reflect patient understanding of discharge care.
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Project description:This study was conducted to understand the epidemiology of antimicrobial resistant bacteria transmission between animals, people and environment in the greater greater Serengeti ecosystem.
| PRJEB35521 | ENA
Project description:Schistosomiasis is a parasitic disease endemic to Tanzania and other countries of the global south, which is currently being addressed through preventive chemotherapy campaigns. However, there is growing recognition that chemotherapy strategies will need to be supplemented to sustainably control and eventually eliminate the disease. There remains a need to understand the factors contributing to continued transmission in order to ensure the effective configuration and implementation of supplemented programs. We conducted a cross-sectional questionnaire, to evaluate the biosocial determinants facilitating the persistence of schistosomiasis, among 1704 Tanzanian schoolchildren residing in two districts undergoing a preventive chemotherapeutic program: Rufiji and Mkuranga. A meta-analysis was carried out to select the diagnostic questions that provided a likelihood for predicting infection status. We found that self-reported schistosomiasis continues to persist among the schoolchildren, despite multiple rounds of drug administration.Using mixed effects logistic regression modeling, we found biosocial factors, including gender, socio-economic status, and water, sanitation, and hygiene (WASH)-related variables, were associated with this continued schistosomiasis presence. These findings highlight the significant role that social factors may play in the persistence of disease transmission despite multiple treatments, and support the need not only for including integrated technical measures, such as WASH, but also addressing issues of poverty and gender when designing effective and sustainable schistosomiasis control programs.
| S-EPMC6082061 | biostudies-literature
Project description:Spatial modelling was applied to self-reported schistosomiasis data from over 2.5 million school students from 12,399 schools in all regions of mainland Tanzania. The aims were to derive statistically robust prevalence estimates in small geographical units (wards), to identify spatial clusters of high and low prevalence and to quantify uncertainty surrounding prevalence estimates. The objective was to permit informed decision-making for targeting of resources by the Tanzanian national schistosomiasis control programme. Bayesian logistic regression models were constructed to investigate the risk of schistosomiasis in each ward, based on the prevalence of self-reported schistosomiasis and blood in urine. Models contained covariates representing climatic and demographic effects and random effects for spatial clustering. Degree of urbanisation, median elevation of the ward and median normalised difference vegetation index (NDVI) were significantly and negatively associated with schistosomiasis prevalence. Most regions contained wards that had >95% certainty of schistosomiasis prevalence being >10%, the selected threshold for bi-annual mass chemotherapy of school-age children. Wards with >95% certainty of schistosomiasis prevalence being >30%, the selected threshold for annual mass chemotherapy of school-age children, were clustered in north-western, south-western and south-eastern regions. Large sample sizes in most wards meant raw prevalence estimates were robust. However, when uncertainties were investigated, intervention status was equivocal in 6.7-13.0% of wards depending on the criterion used. The resulting maps are being used to plan the distribution of praziquantel to participating districts; they will be applied to prioritising control in those wards where prevalence was unequivocally above thresholds for intervention and might direct decision-makers to obtain more information in wards where intervention status was uncertain.
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