Factors Affecting Cotrimoxazole Prophylactic Therapy Compliance in HIV Patients Attending a Care and Treatment Clinic at Bugando Medical Centre in Mwanza, Tanzania

Introduction: Cotrimoxazole Prophylactic Therapy (CPT) compliance lowers the risk of opportunistic infections and other Acquired Immune Deficiency Syndrome (AIDS)-related diseases. The aim of this study was to examine factors that influence compliance with CPT among HIV patients in the Care and Treatment Clinic (CTC) at Bugando Medical Centre (BMC) in Mwanza, Tanzania. Methods: A descriptive cross-sectional study was conducted at the BMC between April 1, 2021, and June 30, 2021. Data were collected using face-to-face interviews and a semi-structured questionnaire. Data are presented in frequency, percentages, and cross-tabulation tables. A P-value of less than 0.05 was considered statistically significant. Results: The prevalence of compliance with CPT by self-reported measurement was 158 (63.7%). Most CPT-compliant participants were more likely to have a spouse who is familiar with CPT, have a family member who is aware of their HIV status, and be aware of the benefits of CPT. The majority of participants who complied with CPT were more likely to have experienced counseling during refill, felt that the length of time spent seeing doctors for treatment was reasonable, and received accurate information from them. Conclusion: Most adult HIV patients attending CTC at BMC were reported to be in compliance with CPT. These findings suggest that improving social support and patient-provider communication may be effective strategies for improving compliance with CPT among HIV patients.

Knowledge of Risk Factors for Hypertension among University Students in Northwestern Tanzania: A Cross-Sectional Study

Introduction: Obesity, excessive alcohol use, cigarette smoking, a lack of physical activity, stress, and an unhealthy diet are modifiable risk factors linked to hypertension. Non-modifiable risk factors for hypertension include older age and a family history of hypertension. The purpose of this study was to assess university students’ knowledge of hypertension risk factors. Methods: This was a cross-sectional study conducted at St. Augustine University of Tanzania. A pre-tested, semi-structured questionnaire was used to collect data. Out of a total score of eight, a score of four or more was considered good knowledge, and a score of less than four was considered poor. All sociodemographic characteristics were included in logistic regression to calculate the adjusted odds ratio. Results: A total of 390 undergraduate students participated in this study. Most of the participants 266 (68.2%) identified stress as a risk factor for hypertension. The median (IQR) knowledge score was 2 (2 - 3). Overall, only 43 (11.0%) of the participants had good knowledge of risk factors for hypertension. However, none of the sociodemographic factors were associated with a good level of knowledge of risk factors for hypertension. Conclusion: Our findings highlight poor knowledge of modifiable and non-modifiable risk factors for hypertension among university students in northwestern Tanzania. Only stress and older age were known by more than half of the students as risk factors for hypertension. To reduce the burden of hypertension, it is crucial for prevention and control programs to target improving university students’ knowledge of risk factors for hypertension.

Prevalence, Grades and Management of Prostate Cancer among Men Attending Oncology Unit at Bugando Medical Centre Mwanza, Tanzania

Background: Prostate cancer is the second most frequent cancer in men after lung cancer, it accounts for 3.8% of all deaths caused by cancer in men worldwide. This study aimed at determining the prevalence, grades and management of prostate cancer among male patients admitted with cancer at Oncology Department of Bugando Medical Centre. Methodology: This was a hospital-based retrospective cross-section study that retrieved data from 384 medical files of male patients admitted with cancer in Oncology wards at Bugando Medical Centre from January 2017 to December 2020. Results: The prevalence of prostate cancer was 39.84% (153 of 384 male patients). The mean age of patients with prostate cancer was 64.85 years ± 14.59 years. Two third of the patients’ prostate cancer were graded at presentation and of these, 52.58% (51 of 97) were having a high grade prostate cancer of Gleason scores 8, 9 or 10. Treatment involved hormonal therapy, chemotherapy and Radiotherapy whereby 49.48% (n = 190) were treated with hormonal therapy (Goserelin and Bicalutamide), 32.03% (n = 123) with combination of hormonal and chemotherapy, (Goserelin, bicalutamide and docetaxel or paclitaxel), 15.69% (n = 60) with combination of radiotherapy and hormonal therapy and 2.6% (n = 11) with chemotherapy alone (Docetaxel). Conclusion: The study found high prevalence of prostate cancer among male patients, majority with high grade form and limited options of treatment. Frequent screening and awareness programs should be conducted to enable early detection to reduce its morbidity and mortality. Patient on treatment should be followed up to determine their response to treatments.

Antenatal Corticosteroid Use and Perinatal Mortality According to Gestational Age among Preterm Singletons Born at 27 to 34 Weeks of Gestation in Hospitals in Tanzania

Background: Antenatal corticosteroid (ACS) treatment has been proven to decrease rates of adverse perinatal outcomes when administered to pregnant women at risk for preterm delivery. Given the uncertainty about the benefit of ACS according to gestational age, we aimed to examine whether there was any benefit of ACS on perinatal mortality and respiratory distress syndrome (RDS) according to different gestational ages at birth. Methods: Secondary analysis of data from an observational prospective chart review study was conducted in four hospitals located in the Mwanza region, Tanzania. The study population consisted of singleton infants delivered between 27 and 34 weeks of gestation between July 2019 and February 2020. Sociodemographic and medical data were recorded from participants’ medical records. Results: Over an eight-month period, 838 preterm singletons were delivered between 27 and 34 weeks of gestation. Three hundred and twelve (37.2%) pregnant women received at least one dose of ACS. Among infants exposed to ACS, perinatal mortality rates were significantly lower than those without exposure at the 27th week (27.8% vs 94.4%, P < 0.001), the 29th week (13.3% vs 51.4%, P = 0.012) and the 34th week (3.0% vs 18.2%, P < 0.001). Among infants exposed to ACS, the RDS rate was significantly lower than those without exposure only at the 32nd week (9.5% vs 25.0%, P = 0.039). Conclusion: Our findings add to the literature about the benefits of ACS for preterm infants of various gestational ages in low-resource settings. Compared to unexposed infants, those exposed to ACS and born at 27th and 34th weeks of gestation experienced lower rates of perinatal mortality. Future research, especially among infants born before the 27th week of pregnancy, is a priority.

First Aid Kit Uses among Commuter Bus Attendants in Nyamagana District, Mwanza City

Introduction: Provision of prehospital care in the event of a crash is vital to prevent loss of life and other severe outcomes. However, this involves adequate first aid knowledge and skills among vehicle attendants, and most importantly, the availability of the first aid kit items and knowing their uses. The aim of this study was to determine the knowledge, availability, and use of first aid kits among commuter bus attendants. Methods: This cross-sectional study was conducted in Nyamagana district, Mwanza, Tanzania in May 2018. A total of 240 were recruited randomly and interviewed using pretested questionnaires. Data was first entered in Microsoft Excel for data cleaning and consistent checks and thereafter exported to the software STATA for analysis. Results: Findings from the study showed that 22.9% of respondents had knowledge concerning first aid practice. Only 17.9% of the participants claimed to have ever had first aid training. All commuters had incompletely equipped first aid kits. Around 30.8% of the respondents reported having practiced giving first aid. Conclusion: The majority of commuter bus attendants were found to have insufficient knowledge of first aid and first aid kits, according to the current study. No vehicle had a complete kit despite the fact that the majority of the participants believed that having a first aid kit in the vehicle was essential. The majority of participants expressed a desire to assist and learn, indicating that efforts to train commuter attendants should be undertaken and potentially save lives.

Reducing neonatal mortality and respiratory distress syndrome associated with preterm birth:a scoping review on the impact of antenatal corticosteroids in low-and middle-income countries

Background The most common cause of death among preterm infants in low-and middle-income countries is respiratory distress syndrome.The purpose of this review was to assess whether antenatal corticosteroids given to women at risk of preterm birth at≤34 weeks of gestation reduce rates of neonatal mortality and respiratory distress syndrome in low-and middle-income countries.Methods Two reviewers independently searched four databases including MEDLINE(through PubMed),CINAHL,Embase,and Cochrane Libraries.We did not apply any language or date restrictions.All publications up to April 2020 were included in this search.Results The search yielded 71 articles,10 of which were included in this review(3 randomized controlled trials,7 observa-tional studies,36,773 neonates).The majority of studies reported associations between exposure to antenatal corticosteroids and lower rates of neonatal mortality and respiratory distress syndrome.However,a few studies reported that antenatal corticosteroids were not associated with improved preterm birth outcomes.Conclusions Most of the studies in low-and middle-income countries showed that use of antenatal corticosteroids in hospitals with high levels of neonatal care was associated with lower rates of neonatal mortality and respiratory distress syndrome.However,the findings are inconclusive because some studies in low-resource settings reported that antenatal corticosteroids had no benefit in reducing rates of neonatal mortality or respiratory distress syndrome.Further research on the impact of antenatal corticosteroids in resource-limited settings in low-income countries is a priority.