Clinical Presentation and Treatment Outcomes of Pregnancy-Related Acute Kidney Injury among Pregnant Women Admitted at the Benjamin Mkapa Hospital in Tanzania

Background: Globally, PRAKI is among the leading causes of death in pregnant women. The prevalence, causes and outcome of this condition vary among countries due to differences in environmental, socioeconomic, and health delivery systems. The common causes that have been reported in several studies are PIH, Haemorrhages and Sepsis while the outcomes may be either complete renal recovery, progression to CKD and hence dialysis dependency or death. This study aimed at determining clinical presentation and treatment outcomes of Pregnancy-Related Acute Kidney Injury in Pregnant women admitted at the Benjamin Mkapa Hospital, Dodoma, Tanzania. Results: Out of 4007 pregnant women who were admitted to the maternity ward 51 pregnant women were found to have PRAKI. Of those with PRAKI, 74.5% were between 21 to 25 years. The leading causes of PRAKI were PPH 12 (23.53%), Eclampsia 12 (23.53%), and pre-eclampsia 12 (23.5%). Hemodialysis therapy was provided to 22 (43.1%) patients, 15 (29.4%) individuals recovered spontaneously with medical management and 14 (27.5%) missed haemodialysis therapy due to various reasons. The mortality due to PRAKI was 17 (33.3%). Conclusion and Recommendation: Pre-eclampsia/eclampsia and post-partum haemorrhage were found to be the main causes of PRAKI. The mortality related to PRAKI is high and Hemodialysis therapy is vital help to prevent deaths for pregnant women with PRAKI. Pregnant women who develop acute kidney injury should be followed closely and a nephrologist should be consulted early. Early referral should be done by the lower level facilities for all at-risk pregnant women to a specialized multidisciplinary health facility.

Patient Safety Efforts in Tanzania: A Rapid Review of Two-Decades Efforts (2002-2022) to Inform Interventions towards Attainment of 2030 Targets

Introduction: The need to address the problem of patient safety has been a focus of World Health Assembly (WHA) meetings of 2002, 2019 and 2021. The 2019 WHA Resolution urged the Member States to take action on patient safety. We aimed to review patient safety efforts in Tanzania from 2002 to 2022 to inform improvement efforts towards the 2030 target. Methods: A rapid literature review was conducted between January 2002 and April 2022. We searched Google, PubMed and PubMed Central in April and May 2022 using the following search terms: PubMed—“patient safety Tanzania”, “blood safety in Tanzania”, “safe surgery Tanzania”, and “healthcare-associated infections Tanzania”;Google—“blood safety in Tanzania”, injection safety in Tanzania”, “infection prevention and control”, “radiation safety in health facilities in Tanzania”;and PubMed Central—“injection safety in Tanzania. Results: The search identified 4160 articles, of which 4053 were removed in initial screening;21 were duplicates, giving 86 relevant articles for full screening. Of the 86 articles, 04 were removed after the full screening, hence remaining with 82 articles. Among the 82 eligible articles, 27 are on IPC, 26 on safe surgery, 12 on blood safety, 07 on radiation safety, 06 on injection safety, and 02 on medication safety. One article was relevant to—blood safety, IPC and injection safety;and one article was relevant to—IPC and injection safety. Conclusion: Most of the eligible literature was on IPC and safe surgery, followed by blood safety, radiation safety, injection safety and medication safety. The literature on IPC has highlighted the need to strengthen efforts to address AMR. Findings from the implementation of the safe surgery 2020 intervention warrants for its scale-up to other zones. There is a need to strengthen hemovigilance and pharmacovigilance functions;and strengthen quality management and assurance systems and regulatory functions to ensure radiation safety.