Glycemic control and complications of type 1 diabetes among children in Tanzania.

INTRODUCTION: Knowledge on Type 1 Diabetes (T1D) in sub-Saharan Africa is scarce. This study aimed at assessing microvascular complications of Type 1 diabetes in young patients. METHOD: A retrospective study based on medical recordings from 2010-2016 was done. 604 children and young adults with T1D were recruited from five hospitals with pediatric diabetes clinics. 559 patients aged 2-35 years with known date of birth were included. Clinical data on retinopathy and neuropathy were analyzed. There was no information on renal function/ nephropathy. RESULTS: Most data were missing. There was documentation on HbA1C, plasma glucose and complications in less than half of the patient files. Of those with registered HbA1c values (42.2%), 36% had HbA1c > 12.5%. There was high prevalence of retinopathy (21.5%) and neuropathy (29.4%) in spite of short mean duration of diabetes (6.2 ± 4.1 years). CONCLUSION: Many patients with T1D in Tanzania have poor metabolic control. Microvascular complications are common already after a short duration of diabetes, but the results have to be interpreted with great caution because of study limitations. Better pediatric diabetes care as well as increased awareness of diabetes is needed. Studies in resource-poor countries need careful planning, if possible with prospective design.

Incidence, prevalence and clinical manifestations at onset of juvenile diabetes in Tanzania.

Better knowledge on incidence, prevalence and clinical manifestations is needed for planning diabetes care in Sub Saharan Africa. AIMS: To find a crude incidence/prevalence of diabetes in children and young adults in a low resource setting, classify the diabetes and audit the health record keeping. METHODS: A retrospective observational study based on medical recordings 2010-2016. Target population was children and adolescent registered in Changing Diabetes in Children (CDiC) or Life for a Child (LFAC) programs for children with T1DM and diagnosed at 5 diabetes clinics in three geographical regions of Tanzania. 604 patients' files were available from five hospitals. RESULTS: 336/604 files covered patients <15 years of age at diagnosis. The prevalence of diabetes <15 years of age ranged from 10.1 to 11.9 per 100,000 children and the annual incidence 1.8-1.9/100,000 children, with peak incidence at 10-14 years. A lot of data were missing. The great majority of the patients presented with typical signs and symptoms of T1D, 83.7% with plausible ketoacidosis (DKA). CONCLUSIONS: Diabetes incidence and prevalence is still low. T1D seems to dominate with very high frequency of DKA at diagnosis. Increased awareness of diabetes both in health care and community is needed.

Herpes simplex virus type-specific antibodies detected by indirect and competition ELISA. Comparison of sera from patients with carcinoma of the uterine cervix, age matched controls and patients with recurrent genital herpes.

A total of 85 human sera (32 from patients with carcinoma of the uterine cervix, 32 from matched controls, and 21 from patients with recurrent genital herpes) were tested in two different ELISAs for detection of HSV type-specific antibodies. The prevalence of HSV type 2 specific antibodies in the three groups were 69, 37 and 71% respectively. The prevalence of HSV type 1 specific antibodies in the three groups were 88, 75 and 76% respectively. Analysis of IgG and total antibodies gave identical results.

Isolation and characterisation of two strains of Herpesvirus hominis type 1 from fallopian tubes.

Herpesvirus hominis type 1 (HSV-1) was isolated from fallopian-tube biopsies of two women who were using an intra-uterine contraceptive device; the strains were isolated on different dates and at different hospitals. Both the isolates were shown to be HSV-1 by restriction-enzyme analysis, polypeptide profiles and indirect immuno fluorescence; the two isolates could not be distinguished by these tests, but the tests distinguished them from HSV-1 strain 71-15 and HSV-2 strain 333. The viruses were again isolated from samples of fallopian-tube tissue stored in liquid nitrogen, and their polypeptide and restriction-enzyme profiles were the same as those in the initial isolates. Virus was not isolated from fallopian-tube samples obtained from other IUD patients undergoing surgery at the same two hospitals at the same time.

Incidence of herpes simplex virus types 1 and 2 isolated in patients with herpes genitalis in Sheffield.

Thirty-one strains of herpesvirus (HSV), isolated from patients presenting with the clinical features of herpes genitalis, were typed by polypeptide analysis of virus proteins in sodium dodecyl sulphate polyacrylamide gels. Nineteen (61.3%) of the isolates were shown to be HSV type 1 and 12 (38.7%) HSV type 2. There was no obvious difference in the incidence of HSV-1 in primary or recurrent infections and no apparent correlation between the genital site of isolation and virus type. The high incidence of genital HSV-1 infection in this group of patients is probably due to the increased practice of oro-genital contact and has possible implications for the future development of drugs and vaccines in the control of genital herpes.