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.

Common Preventable Health and Social Problems Encountered by Elderly in Shinyanga Region in the Northern Part of Tanzania

Background: In Tanzania elders are respected as repositories of inherited wisdom, experienced and principal decision makers in the community. However, evidence shows that such repositories are no longer considered important in most societies. As a result elders are neglected with some mistreatment in terms of provision of health and social services for instance;at times they get denied and ignored of their obvious rights, ignoring their retirement benefits and the rights onto free social services as per the Tanzania National Ageing Policy of 2003. Elders are therefore faced with physical, psychological and geriatric social suffering. It is on this basis that this study tries to explore the common preventable health and social problems encountered by elderly in Shinyanga Region in northern part of Tanzania. Methods: Across sectional community based study of 465 subjects randomly selected was done in three wards of Kahama District. The district was selected randomly out of 8 districts of Shinyanga Region, structured questionnaires with both closed and opened endower used;the information was collected from house to house and other information collected from health facilities within the wards as every ward had one public health facility;subjects (respondents) were obtained using purposive sampling technique aiming at elderly with 60 years of age and above. Results: Kahama district has a population of approximately 36,014 of which 1500 (4%) are in the elderly age group of 60 years and above. The study population was 465 which is 30% (465/1500) of the geriatric population of Kahama. Among this group 5% were female while 41% were male and 53% (248/465) were married. 64% (297/465) were taking care of themselves, 32% (150/465) cared by relatives and 4% (18/465) cared by the community. Among the respondents, 40% (185/465) were affected by HIV/AIDs in one way or another either living with orphans whose parents died of HIV/AIDS or asking care of the infected patients within the family. It was also found that 73% of the geriatrics were not exempted from medical treatment fees so they had to pay for their medical care. However, only 32% were aware of getting free treatment and 61% of the study populations were not satisfied with the medical care provided at the public health facilities. The common diseases affecting this age group are: Eye problem 59% (273/465);Arthritis 52% (241/465);Dental problems 27% (124/465);Hypertension 23% (107/465);Backache 22% (105/465);Malaria 28% (132/465);Hearing problems 26% (121/645);Urinary tract Infection 35% (165/465);Depression 8% (36/465). Dementia was also a problem though we had no tools to confirm the diagnosis;some of the geriatrics had more than two diseases. Conclusion: The majority of the elderly age group in Kahama District are not aware of their rights that they deserve free treatment according to Tanzania policy, furthermore for assessment and screening of health problems. A majority of the elderly die prematurely due to preventable diseases and more than half of the diseases affecting geriatrics are preventable.

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.

Outcome and Effectiveness of Inpatient Care of Malnourished under Five Children in District Hospitals of Mwanza Region, North Western Tanzania

Background: Malnutrition is a disease affecting commonly children from 0 to 5 years of age. In Tanzania it is still a problem with a prevalence of 36% and 28% mortality. Objective: This study aimed to compare the outcome and effectiveness of therapeutic regimes used by different district hospitals in the management of malnutrition of under five years old children in Mwanza Region. Methods: Patient charts were reviewed collecting social demographic attributes, diagnosis, type of therapeutic regimen given and treatment outcome. Results: The prevalence of malnutrition was found to be 30% with case fatality rate (CFR) of 8.8%, for the health facilities using WHO regime while 29% CFR for those using traditional regimen. The use of recommend malnutrition screening tests was generally poor. Conclusion: Malnutrition is still a public health problem with high mortality rate in Tanzania which is mainly caused by failure to use the WHO regimen. There is a need to use the available screening methods and recommended regimens to avert this.

A Retrospective Study on the Unseen Epidemic of Road Traffic Injuries and Deaths Due to Accidents in Mwanza City—Tanzania

Backgrounds: Sixty percent of the global deaths and injuries occur in the developing world and mostly are due to Road traffic accidents (RTAs). Looking at the etiological related factors which include carelessness of the driver, condition of the vehicle or motorcycle, poor condition of roads, risky behavior of the driver, most of these factors can be prevented to some extent. This study therefore, determined the pattern of cases and deaths due to traffic road accidents in Mwanza City Tanzania. Methods: In this retrospective study, records, registers and case notes in the surgical ward and causality, medical records and central police station from 2009 to 2012 were used. The study focused on the two referral hospitals (Sekouture regional hospital and Bugando Medical Center). Results: There were 3450 cases due to accidents reported at both centers (Sekouture regional hospital and Bugando Medical Center of which 3224 (93.4%) had complete information for analysis. 2225 (69%) were male and 999 (31%) were female, and the most affected group were male. Among the RTAs 2809 cases (87%) were due to motor cycle accidents which were the leading cause of RTAs with case fatality rate of 5% while motor vehicle has case fatality rate of 24% which is 5 times that of motor cycle. Conclusion: Among all RTAs the leading cause of injuries is Motor cycle traffic accidents followed by motor vehicle. RTAs are on increase particularly the motor cycle traffic accidents and have claimed a good number of innocent people’s lives however most of them are preventable, therefore driving course to be introduced to motor cycle drivers emphasizes on the road posters signal, rules and regular checkup of their motor cycles especially commercial motor cycle.

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.

Impact of Praziquantel on Schistosomiasis Infection and the Status of Proteinuria and Hematuria among School Children Living in Schistosoma mansoni-Endemic Communities in Northwestern Tanzania

The aim of the study was to assess the effect of praziquantel (PZQ) treatment on hematuria, proteinuria and the status of eGFR following treatment in school children infected with S. mansoni. A cohort study among 6 - 13 years old children was conducted in the Lake Zone region of Tanzania to assess S. mansoni infection using a circulating cathodic antigen (CCA), Kato Kartz while urine dipstick to screen for urine protein levels and red blood cells. A blood sample was taken for every child to determine creatinine levels and later a status of estimated glomerular filtration rate (eGFR). The prevalence of S. mansoni infection was 64%, 46%, and 24% at baseline, 6 months, and 1 year respectively using CCA test. There was a 62.5% reduction in S. mansoni infection from baseline (p S. mansoni using CCA test, reductions in proteinuria, and hematuria in school children in Tanzania. There was complete remission in eGFR < 90 ml/min/1.73 m2 from 3.9% to 0% at 6 months. This suggests that praziquantel is effective, but there is still a need for integrated strategies to minimize reinfections.

Prevalence and Predictors of Hemodialysis Inadequacy among Patients on Maintenance Hemodialysis in Mwanza, Tanzania

Introduction: The burden of chronic kidney disease (CKD) is rapidly increasing in Tanzania. There is a rapid expansion of hemodialysis (HD) services to meet this demand. The quality of HD services, which is usually termed HD inadequacy, is under-reported. Therefore, the objective of this study was to determine the prevalence of HD inadequacy using two equations, urea reduction ratio (URR) and Kt/V and its associated factors. The correlation between URR and Kt/V for the diagnosis of HD inadequacy is also determined. Materials and Methods: This was a prospective longitudinal study conducted from March to July 2021 in 98 patients with CKD who underwent maintenance HD at Bugando Medical Centre in Mwanza, Tanzania. Demographic, laboratory, and clinical information was collected and analyzed. The HD inadequacy was estimated by using both the URR and the Kt/V equations. The correlation between the two equations was analyzed by using Cohen’s kappa. Results: The majority (69.4%) of the study participants were male and the mean age was 59 (48 - 68) years. The median hemoglobin level was 10 (8.9 - 11.2) g/dl, and the pre-dialytic urea was 15 (10.6 - 21.3) mmol/L. The prevalence of HD inadequacy was 36 (36.7%). The predictors of HD inadequacy were older age (>50 years) (OR = 3.6, 95 % CI 1.0 - 12.6, p = 0.04), moderate or severe anemia (OR = 4.7, 95 % CI 1.5 - 14.4, p = 0.006) and short duration of HD (OR = 3.1, 95 % CI 1.0 - 9.1, p = 0.04). There was a strong agreement between URR and Kt/V in the diagnosis of HD inadequacy (Kappa = 0.887). Conclusion and Recommendations: HD inadequacy is common, and most predictors can be prevented. Clinicians should use a personalized approach in making sure that anemia is appropriately treated and HD prescription is adhered to for better clinical outcomes among patients with HD.

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.

Histopathological Patterns and Early Postoperative Complications among Patients with Surgically Treated Thyroid Diseases at Bugando Medical Centre, Mwanza, Tanzania

Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, dietary and environmental factors. Histopathological patterns of surgically treated thyroid diseases play an important role in early diagnosis and management of these diseases. There is, however, limited published data regarding histopathological reports on thyroid disease in our local setting. This study aimed to determine the histopathological patterns and highlight early postoperative complications among patients with surgically treated thyroid diseases at Bugando Medical Centre (BMC). Methods: This was a longitudinal study involving all patients with surgically treated thyroid diseases seen at BMC over a period of 6 months from October 2019 to March 2020. Results: A total of 84 patients were studied. Females outnumbered males by a female to male ratio of 11:1. The median age of patients was 44 [IQR, 35 - 54] years old, the youngest was 14 years old and the oldest was 76 years old. Colloid goiter was the most common non-neoplastic lesion accounting for 34 (44.7%) patients. Among the neoplastic lesions, follicular adenoma was the most commonly encountered benign pathologies (n = 16;21.1%), while papillary carcinoma was the most commonly encountered malignancy (n = 4;50%). Following thyroidectomy, 12 (14.3%) patients developed early complications, of which hemorrhage sometimes requiring blood transfusion was the leading intra/postoperative complications accounting for 4 (33.3%) patients. Other complications include temporary recurrent laryngeal nerve palsy 2 (16.7%), surgical site infection 2 (16.7%) and tracheomalacia, bronchospasm, thyroid abscess and respiratory obstruction in 1 (8.3%) patient each, respectively. In this study, malignant thyroid lesion (p Conclusion: This study demonstrated that colloid goiter was the most common non-neoplastic lesion, and on the neoplastic category, follicular adenoma was the most common benign lesion, while papillary carcinoma was the most frequent malignant lesion.

Larvicidal efficacy of monoterpenes against the larvae of Anopheles gambiae

Objective:To evaluate the larvicidal efficacy of eight volatile components of essential oils against 3rd instar larvae of Anopheles gambiae s.s.Methods:Larvicidal effects of each compound were evaluated in both laboratory and semi-field trials.Stock solution was prepared and serial dilutions were made in six concentrations for each compound.A total of 20 larvae were exposed to larvicides for each replicate and monitored at intervals of 12,24,48 and 72 h.Larvae monitoring was done on basis of dead and live larvae in all intervals.Results:All assayed compounds were larvicides and presented varying degrees of larval toxicity,with LC50 values ranging from 1.28 to 1 938.92 mg/L depending on the treatment time(12,24,48 or 72 h).(-)-Perillyl alcohol presented the strongest larvicidal activity towards Anopheles gambiae larvae,with LC_(50) values of 73.60,18.36,1.72 and1.28 mg/L after 12,24,48 and 72 h of exposure,respectively.The next strongest were(-)-isopulegol(LC_(50)= 135.10,49.39,34.39 and 20.22 mg/L) and(-)-carvone epoxide(LC_(50)= 168.86,124.74,80.84 and 23.46 mg/L).After 12,24 and 48 h of treatment,hydroxydihydrocarvone was the least toxic compound,with LC_(50) values of 1 938.92,1 172.18 and 401.03 mg/L,respectively.Conclusions:The data obtained in this study suggest that all evaluated monoterpenes,especially(-)-perillyl alcohol,have remarkable larvicidal effects and may be considered as potential sources for the development of suitable natural larvicides for mosquito management programs.Further small-scale field trials should be conducted.

Hepatitis B and Hepatitis C among Human Immunodeficiency Virus Infected Patients at a District Hospital in Mwanza, Tanzania

Human immunodeficiency virus (HIV), hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections have been a major public health problem. HIV patients with HBV and HCV infection are at high risk of liver diseases which is associated with increased mortality. This study aims at determining the prevalence of hepatitis B surface antigen (HBsAg), HCV antibodies and HBV antibodies (anti-HBsAg) among HIV seropositive adults attending care and treatment clinic at Sengerema district hospital in Mwanza, Tanzania. A cross-sectional hospital based study was conducted between February and March 2017 among 243 HIV adult patients at Sengerema designated district hospital, Mwanza, Tanzania. Socio-demographic and other relevant information were collected using pre-tested questionnaires. Detection of HBsAg and HCV antibodies was done by commercial rapid immunochromatographic test while the detection of anti-HBsAg was done using enzyme linked immunosorbent assay. Data were analyzed by using STATA version 13. The median age of the study participants was 43, interquartile range (IQR): 37 - 51 years. The majority 172 (70.8) of study participants were female and the majority (88%) of participants had CD4 count of greater than 200 counts/μl. The prevalence of HBsAg, HCV antibodies and anti-HBsAg were 26/243 (10.7%, 95% confidence interval [CI]: 7 - 14), 20/243 (8.2%, 95% CI: 4.7 - 11.6) and (100/243) 41.2%, 95% CI: 35 - 47, respectively. Co-infection with HCV (OR: 4.45, 95% CI: 1.51 - 13.21, P = 0.007) was independenlty found to predict HbsAg positivity. History of blood transfusion (OR: 2.34, 95% CI: 1.08 - 5.06, P = 0.028) was significantly associated with anti-HBsAg among HIV infected individuals while, the rate of anti-HBsAg was found to decrease by 2.02 IU/L in a year increase in age. About one tenth of HIV infected individuals are co-infected with HCV and HBV with more than one third being positive for anti-HBsAg. There is a paramount need to emphasize the need for regular screening and proper management of these patients to reduce associated complications in resource limited countries where these infections are common.

Candida Colonization among Neonates with Low Birth Weight: There Is Much More to Explore

Background and Objectives: Candida colonization in neonates with low birth weight is reported to be the first step for invasive candidiasis. This study was designed to describe the patterns of Candida spp. colonizing neonates with low birth weight in Mwanza, Tanzania to provide baseline information for future studies in this field. Methodology: The hospital based cross sectional study was conducted between January 2019 and April 2019 among neonates with low birth weight. Clinical and social demographic data were collected using interview guide questionnaire. Oral and umbilical rectal swabs were collected on the first and seventh day of life to assess Candida spp. colonization status. Data were analyzed using STATA version 13 following the study objectives. Results: A total of 320 neonates with median body weight of 1600 [IQR 1000 - 2000] grams were enrolled. Prevalence of Candida spp. colonization on either oral, umbilical or rectum was 16.2% (52/320). A total of 34 (10.6%) and 41 (12.8%) neonates were colonized by Candida spp. on the first day and seventh day of life, respectively. Of 34 neonates colonized on the first day of life, 23 (67.7%) were still being colonized on the seventh day. Candida albicans 38 (73.1%), was the predominant species detected followed by Candida glabrata 10 (19.2%). Conclusion: The prevalence of Candida spp. colonization among neonates with low birth weight is within the reported range and is mainly due to Candida albicans. Future studies are highly needed to explore the role of colonization and subsequent Candida spp. infections.

Household Survey on Access to Medicines Used for the Treatment of Diarrhoea in Musoma Municipal Council, Tanzania

Background: Access to medicines is part of the human right to health. According to WHO, access to medicine is measured by how easily households obtain medicines for acute and chronic conditions including diarrhoea through household surveys. Diarrhoea is among the top ten leading causes of death. Anti-diarrhoea medicines save lives but, should be available and obtainable to do so. The objectives of this study were to determine anti-diarrhoea medicines used by households, their sources and factors affecting their accessibility in Musoma Municipal. Methods: A cross-section survey was conducted in Musoma Municipal Council, Mara, Tanzania. The lottery method of simple random sampling was used to select three wards and pick three streets from each ward. The study population was 255 household heads from households selected by systematic random sampling from each street. A structured questionnaire was used to obtain information from household heads. Results and Discussion: Males (51.8%) had more diarrhoea illnesses than females (48.2%). Distinctive household heads (52.6%) had primary education. The majority, (79.1%) of all diarrhoea patients were recommended/prescribed anti-diarrhoea medicines. Of those whom anti-diarrhoea medicines were prescribed/recommended, 63.5% adhered to the prescriber’s/dispenser’s instructions and obtained and used anti-diarrhoea medicines. The most frequent source of anti-diarrhoea medicines was ADDO (38%). Widely used anti-diarrhoea medicines were antimicrobials (77.5%) followed by ORS (17.5%). Reasons not to seek or obtain anti-diarrhoea medicines were;Patient started feeling better (56.3%), Alternative treatment (26%), Financial reasons (10%), Decided medicines weren’t needed (3.5%), Distance from source (2.2%), Reactions to medicine (1%). Utilization of primary health care services was only 21.5%. Under-fives were mostly prescribed with antimicrobials (62.5%) than ORS (31.2%) and Zinc (6.3%) in mild to moderate dehydration contrary to Standard treatment guidelines (STG) in Tanzania. Conclusion: Anti-diarrhoea medicines are moderately easily obtainable in Musoma Municipal (50% of all diarrhoea patients obtained medicines). Alternative treatment (26%) and financial reasons (10%) were vivid factors hindering access. Treatment of diarrhoea in under-five years old is not adhered to in Musoma Municipal (use of 62.5% of antimicrobials and only 31.2% of ORS in mild diarrhoea cases).

Prevalence and Factors Associated with Rotavirus Infection among Vaccinated Children Hospitalized for Acute Diarrhea in Mwanza City, Tanzania: A Cross Sectional Study

Introduction: Rotavirus infection is a leading cause of severe diarrhea culminating to dehydration among children under five years of age. Understanding trends and factors that could assist towards devising effective preventive strategies of Rotavirus infection beyond vaccination is crucial. Objectives: This study was done in an attempt to determine the prevalence and associated factors of Rotavirus infection among vaccinated children aged between 6 weeks and 24 months admitted with acute diarrhea Mwanza, Tanzania. Material and Methods: Across sectional study involving vaccinated children aged 6 weeks to 24 months was conducted in three selected hospitals from July 2017 to January 2018. Socio-demographic and other relevant clinical information were collected using a standardized data collection tool adopted from WHO Rotavirus surveillance tool. Rotavirus infection from the stool was detected using an enzyme immunoassay. Data were analyzed using STATA version 13. Results: A total of 301 vaccinated children with acute diarrhea with a median age of 12 [IQR: 8 - 17] months were enrolled. Nine (3.0%) and 292 (97.0%) had received one dose and two doses of Rotavirus vaccine, respectively. The prevalence of Rotavirus infection was 74 (24.6%) [95% CI: 20.0 - 29.8]. Independent predictors of Rotavirus infection were: dry season (OR 6.9;95% CI: 2.9 - 16.0;p < 0.001), 3 ≥ children indwelling in the same house (OR 2.1;95% CI: 1.1 - 4.2;p = 0.043) and vomiting (OR 3.6;95% CI 1.1 - 12.6;p = 0.045). Children with Rotavirus infection had a significantly shorter hospital stay than those without Rotavirus infection (3 [2 - 4] days versus 3 [3 - 5] days;p = 0.0297). Conclusions: The prevalence of Rotavirus infection has declined among vaccinated children in Mwanza, Tanzania with significant decrease in the hospital stay. Dry seasons, three or more children indwelling in the same house and vomiting were independent predictors of Rotavirus infection. There is a need to sustain the coverage of rotavirus vaccination in low-income countries in order to significantly reduce associated morbidity and mortality.

Barriers in the Transition of Care for Heart Failure Patients Attending Clinics in Mwanza City, Tanzania

Introduction: Transition of care strategies have shown to improve quality of lives of heart failure patients, but it has little implemented in clinical settings. Objective: To evaluate context-specific perceived barriers and experiences of heart failure patients during their admission and after they were discharged from hospital. Methods: A cross-sectional qualitative study was conducted among 13 heart failure patients at two large referral hospitals in northwestern Tanzania. In-depth interviews among heart failure patients, in line with the Consolidated Criteria for Reporting Qualitative research checklist, were used to collect data. Interviews were audio recorded, transcribed, and translated into English. Results: Three key barriers were identified, as well as possible solutions that could improve the transition of care for heart failure patients. These include strengthening healthcare provider communications, organizing medication management, and assisting with follow-up appointments. Conclusion: The barriers identified are real and challenging in clinical resource- limited settings. Findings suggest they can be overcome when realistic and tailor-made interventions are in place.

Antiviral Therapy Eligibility and Low Treatment Coverage among Hepatitis B Virus Infected Patients in Tanzania

Introduction: Limited access to treatment is a crucial factor contributing to the suboptimal control of hepatitis B virus (HBV) infection, especially in sub-Saharan African countries such as Tanzania. The eligibility for antiviral therapy is typically determined based on the extent of HBV replication and liver damage. However, there is insufficient data available regarding the actual treatment needs and the overall characteristics of HBV-infected individuals in Tanzania. Therefore, the aim of this study is to fill this knowledge gap and provide valuable insights to aid in the planning of treatment programs. Materials and Methods: We conducted a cross-sectional study at Bugando Medical Centre in northwest Tanzania, examining the data of 340 patients who were diagnosed with chronic HBV infection and attending the hepatitis clinic. Data on sociodemographic, clinical, and investigation details were collected through electronic files and subsequently analyzed. The eligibility for HBV antiviral treatment was assessed using the criteria established by the World Health Organization (WHO). Results: Out of the 340 patients included in the study, the majorities were males 252 (74.1%) and had a median age of 36 years. Most patients came from outside of Mwanza city. Twenty-percent had significantly elevated alanine transaminase, and over one-third had high DNA levels (>2000 IU/L). The prevalences of liver cirrhosis and significant liver fibrosis were 15% and 15.3%, respectively. None of the patients were on antiviral therapy for hepatitis B. A total of 64 (18.8%) patients met the criteria for treatment eligibility. Male sex, older age, residing outside Mwanza city, and anemia (all with p Conclusion and Recommendations: The significant number of HBV-infected patients is suitable for antiviral therapy but none of them have initiated the treatment. The significance of these findings is to emphasize the need for enhancing hepatitis B services in Tanzania.

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.

Characterisation of larval habitats,species composition and factors associated with the seasonal abundance of mosquito fauna in Gezira,Sudan

Background:Larval source management(LSM),which requires an understanding of the ecology and composition of the local mosquito fauna,is an important parameter in successful vector control programmes.The present study was conducted to understand the distribution of larval habitats,species composition and factors associated with the seasonal abundance of mosquito larvae in Gezira irrigation Scheme in Gezira state,central Sudan.Methods:Cross-sectional larval surveys were carried out in the communities of Barakat(urban)and El-Kareiba(semi-urban),in Wad Madani,Gezira.A standard dipper was used for sampling larvae in all possible breeding sites and enamel bowls were employed for larvae sorting.Habitats were characterised using physical features and all larvae specimens were identified morphologically.Results:A total of 331 larval habitats were surveyed,out of which 166 were found to be positive breeding sites for Anopheles(56.78%),Culicinae(29.67%)and Aedes(13.55%)species.A total of 5525 larvae collected were categorised as Culex(2617,47.37%),Anopheles(2600,47.06%)and Aedes(308,5.57%).There was a high number of positive habitats during the rainy season,while the lowest proportion was reported during the hot dry season,in both study sites(Barakat[χ^(2)=10.641,P=0.0090],El-Kareiba[χ^(2)=23.765,P=0.0001]).The main breeding site for Anopheles larvae was leaking water pipes(51.5%),followed by irrigation channels(34.2%),hoof prints(6.4%),tyre tracks(5.5%)and water tanks(2.4%).A logistic regression analysis showed that the abundance of Anopheles larvae was reduced by the presence of predators(backswimmers,tadpoles)and grass cover.Adult productivity(number of adult females emerged/m2)was not homogeneousfor all habitats;the highest productivity was found in irrigation channels(0.78 females/m2)for Anopheles,and in septic tanks(2.86 females/m2)for Culicinae and(0.86 females/m2)for Aedes.Anopheles arabiensis was found to be the dominant Anopheles species.This study documented the presence of An.funestus in central Sudan for the first time.Conclusions:Maintaining leaking water pipes and adopting intermittent irrigation are recommended for LSM,as these surveyed habitats represent the main source of maintaining the local mosquito population during the hot dry season.

Detection of Schistosoma mansoni DNA using polymerase chain reaction from serum and dried blood spot card samples of an adult population in North-western Tanzania

Background:Real-time polymerase chain reaction(PCR)is a sensitive and specific method for diagnosing schistosomiasis.However,this method should be performed in a laboratory,usually located distant from the sample collection site.Therefore,it is important to have fast sampling preservation methods,which allow simple transport prior to DNA extraction and amplification.The aim of this study was to verify if blood samples applied to filter paper are suitable for analysis of Schistosoma mansoni DNA by real-time PCR.Methods:A cross-sectional study was conducted among 100 study participants aged 17 to 70 years in a fishing village on the southern shore of Lake Victoria,fanzania.Serum samples and ethylenediaminetetraacetic acid(EDTA)-anticoagulated whole blood for preparation of dried blood spots(DBS)were collected to test for Schistosoma mansoni infection by real-time PCR.A combined diagnostic reference of positive results of serum-based real-time PCR and the Kato-Katz(KK)method was used for analysis.Sensitivity and negative predictive value(NPV)were calculated.The Wilcoxon signed-rank test was chosen to compare the mean cycle threshold(Ct)values from serum and DBS.Results:According to the reference,92.5%S.mansoni positive samples were determined.The serum-based real-time PCR performed excellently with 95.4%sensitivity,whereas the DBS-based real-time PCR showed a low sensitivity(45.4%).The Ct-values were significantly higher in DBS(median:37.3)than in serum samples(median:27.5,P<0.001),reflecting a lower parasite-specific DNA load on the filter cards.With increasing egg counts,an increase in sensitivity was observed for all methods.The POC-CCA test and the serum-based real-time PCR showed a sensitivity of 100%for medium and severe infections.The DBS real-time PCR showed a sensitivity of only 85.7%even for severe infections.Conclusions:DBS-based real-time PCR did not provide good results in our study and therefore should not be recommended or must be tested concerning temperature of storage,storage duration,use of different filter papers and extraction methods before it is used in future studies.In contrast,our results showed that the POC-CCA test is a sensitive and precise test for detecting S.mansoni infections.