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. 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.
| S-EPMC4745394 | biostudies-other
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.
| S-EPMC7489548 | biostudies-literature
Project description:BACKGROUND:The World Health Organization (WHO) recommends early initiation of breastfeeding within 1 h as it confers many benefits to the child and prevents neonatal mortality. This study aimed to determine the prevalence and factors associated with timely initiation of breastfeeding in the Kilimanjaro region, northern Tanzania. METHODS:We analyzed secondary data for 866 participants from a population-based cross-sectional study conducted in April 2016 among mothers with children aged less than 5 years in three districts; Rombo, Same, and Moshi Municipal council in Kilimanjaro region, northern Tanzania. A multistage sampling selected study participants and interviewed using a questionnaire. The generalized linear model, with Poisson family and log-link function was used to estimate the prevalence ratios (PR) and 95% confidence intervals (CI) for factors associated with timely initiation of breastfeeding. RESULTS:The prevalence of timely initiation of breastfeeding was 71.1%. The vast majority of mothers (90.7%) gave colostrum, and less than a tenth (6.4%) gave pre-lacteal feed to their children. Adjusted for other factors, not giving children prelacteal feeds remained was significantly associated with a higher prevalence of timely initiation of breastfeeding (PR: 2.22, 95%CI 1.38, 3.56, p?=?0.001). There was no significant association between other characteristics and the likelihood of timely initiation of breastfeeding in this study. CONCLUSION:The prevalence of timely initiation of breastfeeding in the Kilimanjaro region was higher than the national estimate. The practice of not giving infants prelacteal feeds increased the likelihood of timely initiation of breastfeeding. There is a need to encourage mothers on the significance of recommended ANC visits and early initiation of breastfeeding to their infants to improve the practice.
| S-EPMC7465800 | biostudies-literature
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.
| S-EPMC7366841 | biostudies-literature
Project description:IntroductionDiabetes mellitus is one of the most common non-communicable diseases and is the fifth leading cause of death in most developing countries. Regular physical activity (PA) is strongly recommended for individuals with diabetes for its beneficial effects in improving blood glucose control and insulin sensitivity, prevention and reduction of morbidities and complications, and its cardiovascular benefits.ObjectiveTo assess the knowledge, attitude and practices of PA among patients with diabetes in the Kilimanjaro region, Northern Tanzania.Research design and methodsA cross-sectional study was conducted from June to September 2020 among 315 patients with diabetes aged 18 years and above receiving care from diabetic clinics in the Kilimanjaro region, Northern Tanzania. A systematic random sampling technique was used to select study participants who were interviewed using a modified version of the WHO-STEPS Survey for non-communicable diseases. Data were analysed using SPSS V.20. Categorical variables were summarised using frequencies and percentages, and continuous variables using means and SDs. The Χ2 test was used to compare the proportion of PA across participant characteristics.ResultsThe vast majority (94.3%) of the participants were physically active, and from our findings, most of it was contributed by work (70%) and transport-related (20%) activities. Participants had high levels of knowledge (98.4%) and positive attitudes (95.6%) towards PA. These were mainly contributed by a healthcare provider or doctors' advice (96%) on PA benefits to patients with diabetes. There was a strong statistical association (p<0.001) between knowledge and attitude towards PA with PA practice.ConclusionThe vast majority of the participants were physically active. High levels of PA were associated with a high level of knowledge and positive attitudes towards PA. Healthcare provider or doctors' advice in diabetic clinics is essential in promoting PA practice in this population and in diabetes management.
| S-EPMC8483038 | biostudies-literature
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:ObjectiveTo ascertain how the COVID-19 pandemic was perceived by oncology patients and community health workers (CHWs) and whether this contributed to disruptions in cancer care.DesignCross-sectional study using (1) structured telephone interviews with patients and (2) structured questionnaires completed by CHWs.SettingOutpatient and community care at Kilimanjaro Christian Medical Centre's Cancer Care Centre (KCMCCCC), Northern Tanzania.Participants300 oncology patients (158 men and 142 women) who had attended KCMCCCC between January and April 2020 and 78 CHWs (16 men and 62 women) in the KCMC regional palliative care network who conducted home visits to patients with cancer during the period January to April 2020.Primary outcome measuresFor patients, missed appointments and fear of COVID-19 more than postponement of their treatment. For CHWs, no primary outcome (a broad range of questions on perception of the pandemic were asked).Results30% of patients said they missed appointments due to the pandemic, the most commonly cited reasons being financial problems (37%) and fear of acquiring COVID-19 infection during travel and/or in the hospital (37%). Only 12.7% of patients said they feared COVID-19 more than postponement of cancer treatment. 88% of CHWs noticed differences in delivering home care since the start of the pandemic, with 58% saying they had noticed more patients dying and 74% saying that more patients were relying on local healers. 31% of CHWs said they feared home visits because of COVID-19 and 46% perceived patients feared home visits due to COVID-19. However, 92% felt home visits should continue.ConclusionThese results indicated that while there was a significant degree of disruption and fear around the COVID-19 pandemic, the majority of patients and CHWs did not fear of COVID-19 more than disruption to cancer care. This highlights the importance to these groups of maintaining access to vital cancer services.
| S-EPMC10123862 | 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:Objective: We posited a trade-off in iron nutrition, with iron deficiency decreasing risk for infection by depriving infectious agents of iron while increasing risk for infection by compromising immune protection. We described associations between iron deficiency and prevalent and incident infectious disease episodes and cell-mediated immunity (CMI) among 283 children in Kilimanjaro, Tanzania. Methodology: Whole blood specimens were evaluated for hemoglobin and dried blood spots (DBS) were evaluated for biomarkers of iron deficiency (transferrin receptor) and inflammation (C-reactive protein and α1-acid glycoprotein). Prevalent and incident infectious disease episodes were identified by physician's diagnosis. CMI was evaluated as delayed-type hypersensitivity to Candida albicans (DTH-Candida). Associations between iron status and elevated inflammation, prevalent infectious disease episodes and DTH-Candida were described with logistic regression models; associations between iron status and incident infectious disease episodes were described with Cox proportional hazards models. Results: Elevated inflammation and diagnosed infectious diseases were more common among children with iron-deficiency anemia (IDA, severe iron deficiency), but not significantly so. The incidence of infectious disease was lowest among children with moderate iron deficiency (iron-deficient erythropoiesis, IDE); this pattern was most apparent for respiratory infections (aHR: 0.24; p: 0.030). DTH-Candida was not compromised among children with any degree of iron deficiency. Conclusions and implications: We observed no adverse effect of iron deficiency on CMI, but did observe patterns consistent with the hypothesis that moderate iron deficiency protects against respiratory infections and may represent a nutritional adaptation to infectious disease. This suggests that interventions targeting iron deficiency should be coupled with effective infectious disease control measures.
| S-EPMC5570096 | biostudies-literature
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.
| S-EPMC7453455 | biostudies-literature