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1.
BMC Res Notes ; 14(1): 77, 2021 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-33640022

RESUMO

OBJECTIVE: The objective of this study was to determine the proportion of extended spectrum ß-lactamase producing gram-negative bacteria (ESBL-GNB) colonizing patients admitted at Mazimbu hospital and Morogoro Regional hospital, in Morogoro, Tanzania. Rectal colonization with ESBL-GNB increases the risks of developing bacterial infections by extra-intestinal pathogenic ESBL-GNB. RESULTS: Of the 285 patients investigated, 123 (43.2%) carried ESBL-GNB in their intestines. Five of the 123 ESBL positive patients were colonized with two different bacteria, making a total of 128 ESBL producing isolates. Escherichia coli (n = 95, 74.2%) formed the majority of ESBL isolates. The proportion of CTX-M-1 group genes among ESBL isolates tested was 94.9% (93/98). History of antibiotic use (OR: 1.83, 95% CI: 1.1-3.2, P = 0.03), being on antibiotic treatment (OR: 2.61, 95% CI: 1.5-4.53, P = 0.001), duration of hospital stay (OR: 1.2, 95% CI: 1.1-1.3, P < 0.001) and history of previous admission (OR: 2.24, 95% CI: 1.2-4.1, P = 0.009) independently predicted ESBL-GNB carriage.

2.
Sci Rep ; 10(1): 18490, 2020 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-33116166

RESUMO

Upper-respiratory tract infections (URTI) are the leading causes of childhood morbidities. This study investigated etiologies and patterns of URTI among children in Mwanza, Tanzania. A cross-sectional study involving 339 children was conducted between October-2017 and February-2018. Children with features suggestive of URTI such as nasal congestion, dry cough, painful swallowing and nasal discharge with/without fever were enrolled. Pathogens were detected from nasopharyngeal and ear-swabs by multiplex-PCR and culture respectively. Full blood count and C-reactive protein analysis were also done. The median age was 16 (IQR: 8-34) months. Majority (82.3%) had fever and nasal-congestion (65.5%). Rhinitis (55.9%) was the commonest diagnosis followed by pharyngitis (19.5%). Viruses were isolated in 46% of children, the commonest being Rhinoviruses (23.9%). Nineteen percent of children had more than 2 viruses; Rhinovirus and Enterovirus being the commonest combination. The commonest bacteria isolated from ears were Staphylococcus aureus and Pseudomonas aeruginosa. Children with viral pathogens had significantly right shift of lymphocytes (73%-sensitivity). Majority (257/339) of children were symptoms free on eighth day. Viruses are the commonest cause of URTI with Rhinitis being the common diagnosis. Rapid diagnostic assays for URTI pathogens are urgently needed in low-income countries to reduce unnecessary antibiotic prescriptions which is associated with antibiotic resistance.

3.
Int J Pediatr ; 2020: 9303216, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33014079

RESUMO

Diarrhea is the commonest cause of morbidity and mortality in many resource-limited countries including Tanzania among children below five years of age. A significant number of diarrhea cases associated with severe dehydration are still being reported among children despite five years of rotavirus vaccine implementation in Tanzania necessitating the need to investigate other causes of diarrhea in this population. This study is aimed at determining the prevalence of human adenovirus infection and associated factors among rotavirus-vaccinated children with acute diarrhea in Mwanza, Tanzania. A cross-sectional study was conducted from June to August 2017 involving 137 children less than two years of age admitted with acute diarrhea in the health facilities located in Mwanza, Tanzania. Sociodemographic and other relevant information were collected using standardized rotavirus surveillance tool adopted from WHO. Stool specimens were collected and tested for human adenovirus antigen using immunochromatographic tests. Data were analyzed by using STATA version 13. The median age of enrolled children was 12 (IQR 8-17) months. The prevalence of human adenovirus was found to be 46 (33.6%, 95% CI: 25-41). By multivariable logistic regression analysis, only prolonged duration of diarrhea (OR: 1.619, 95% CI: 1.142-2.295, p = 0.007) was found to predict human adenovirus infection among rotavirus-vaccinated children with acute diarrhea. A significant proportion of rotavirus-vaccinated children with prolonged acute diarrhea have adenovirus infection. There is a need to consider other viral pathogens as potential cause of diarrhea especially in this postrotavirus vaccination period.

4.
Int J Pediatr ; 2020: 3264923, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32908552

RESUMO

Clostridium difficile causes a million of illnesses each year worldwide and can affect people of all ages. Limited data exist on the prevalence of C. difficile infections (CDI) among children below five years of age in developing countries. This study is aimed at determining the prevalence, associated factors, and outcome of the Clostridium difficile infection among children with diarrhea attending a tertiary hospital in Mwanza, Tanzania. Stool samples were collected and cultured anaerobically to isolate Clostridium difficile, followed by C. difficile toxin A and B assay and ribotyping. A total of 301 children with diarrhea were enrolled. A total of 22 (7.31%, 95% CI: 0.89-0.95) nonrepetitive stool samples were positive for Clostridium difficile. Eighteen (81%) of C. difficile isolates were toxigenic, and 16 (72.7%) had unknown ribotypes. Independent predictors of positive C. difficile were as follows: positive HIV status, hospital stay of more than four days, high stool leukocyte count, and watery stool. Clostridium difficile-positive children had significantly higher median duration of the diarrhea than those without C. difficile. Clinicians should consider C. difficile as a possible cause of diarrhea in children living in developing countries and institute appropriate management to prevent associated morbidities and mortalities. Furthermore, there is a need of joint effort to improve C. difficile diagnosis and surveillance in developing countries to establish the unknown epidemiology of CDI in these countries.

5.
Int J Pediatr ; 2020: 8326348, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32963556

RESUMO

Background: Toxoplasma gondii infection during pregnancy is associated with serious neonatal complications, including hydrocephalus. In many high-income countries, T. gondii screening and treatment during the antenatal period are routinely carried out to prevent associated complications, whereas in most low-income countries, there is no routine screening of T. gondii during pregnancy. Despite the parasite being common in Tanzania, there is a paucity of information on the prevalence of T. gondii and cranial ultrasound patterns among children with hydrocephalus. Methods: An analytical cross-sectional hospital-based study involving 125 infants with hydrocephalus attending the Bugando Medical Centre (BMC) was conducted between May 2017 and February 2018. Sociodemographic and other relevant information was collected using a pretested data collection tool. Venous blood samples were collected, and sera were used for the detection of specific T. gondii antibodies by indirect enzyme-linked immunosorbent assay (ELISA) as per manufacturer's instructions. Data were analysed using STATA version 13 software. Results: The mean age of enrolled children was 4.8 ± 3.5 months. Out of 125 infants with hydrocephalus, 29 (23.2%, 95% CI: 21-36) were seropositive for T. gondii-specific IgG antibodies. By multiple generalized linear model analysis, being male (aRR = 1.1, 95% CI: 0.9-1.5, p = 0.049), higher birth order (aRR = 1.2, 95% CI: 1.0-1.5, p = 0.023), consumption of fish meat (aRR = 1.6, 95% CI: 1.2-2.3, p = 0.003), and using other methods of cooking meat than boiling (aRR = 1.7, 95% CI: 1.1-2.5, p = 0.015) were independent risk factors for T. gondii IgG seropositivity. Obstructive hydrocephalus was significantly more common among T. gondii-seronegative infants compared to IgG-seropositive infants (31.3% [30/96] vs. 13.8% [4/29]; p = 0.049). Conclusions: A significant proportion of infants with nonobstructive hydrocephalus are T. gondii IgG seropositive, and this is predicted by male gender, increase of birth order, consuming fish, and using other methods of cooking meat than boiling. These facts highlight the importance of continuing health education for pregnant women regarding T. gondii transmission and the need to follow-up their infants so that appropriate counselling and management can be provided.

6.
Arch Public Health ; 78: 76, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32832080

RESUMO

Background: The World Health Organisation (WHO) recommends the vaccination against Hepatitis B virus in all infants and children up to the age of 18 years. In addition, adults in high-risk groups should also be vaccinated. This study investigated the prevalence and factors associated with Hepatitis B Virus (HBV) infections among health professional students in the city of Mwanza, Tanzania in order to provide data that can assist in devising prevention and control strategies in this special group. Methods: A cross-sectional study involving health professional students of the Catholic University of health and Allied Sciences was conducted between April and July 2016. Hepatitis B surface antigen was detected using rapid antigen test while the anti-hepatitis B surface antibodies(anti-HBs) were quantified using Enzygnost Anti-HBs II assay and anti-HBV core antibodies tested using enzyme immunoassay. Results: A total of 1211 health professional students with median age of 22 interquartile range (IQR):21-24 years were enrolled. The slighlty majority (57.5%) of these students were males and 475(39.2%) were in clinical practices. Out of 1211 students, 37 (3.1%) were Hepatitis B surface antigen positive. Of 1174 students tested for anti-HBs, 258 (22%) had titres > 10 IU/L indicating HBV immunity. The median anti-HBs titres was 47.7 IU/L(IQR:16-3-113). A total of 230(89.2%) students among those who were positive for anti-HBs were also positive for HBV core antibodies indicating HBV natural infections. Male sex (adjusted odd ratio(AOR):1.77, p < 0.000), being married (AOR:1.82, p = 0.002) and being in clinical practices (AOR:1.39, p = 0.028) independenlty predicted anti-HBs positivity. Conclusion: A significant proportion of health professional students was naturally immune to Hepatitis B virus. There is a need to measure anti-HBs in order to reduce the cost of unnecessary vaccination especially in the countries with high endemicity of HBV.

7.
BMC Infect Dis ; 20(1): 152, 2020 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-32070308

RESUMO

BACKGROUND: Brucellosis is a zoonotic disease transmitted to humans through contact with infected animals, animal products or consumption of infected dairy products. Brucella infection during pregnancy is of special interest due to association with adverse pregnancy outcomes. This study determined the seroprevalence and factors associated with Brucella infection among pregnant women around the human-wildlife-livestock interface area in Ngorongoro ecosystem, Northern Tanzania. METHODS: A facility-based cross-sectional study was conducted between May and June 2018 at six health facilities that provide antenatal services. Pregnant women receiving antenatal care were invited to participate. A structured questionnaire was used to collect socio-demographic and obstetric characteristics in addition to behavior and practices related to the occurrence of human brucellosis. The presence of serum immunoglobulin against Brucella was determined using Rose Bengal Plate Test (RBPT). The positive samples were further assayed for the presence of IgG and IgM using The enzyme-linkedimmunosorbent assay. Bivariate analysis was conducted to determine the variables associated with Brucella seropositivity. Multivariable logistic regression analysis was performed to examine the factors independently associations with Brucella seropositivity after adjustment for other explanatory variables. RESULTS: A total of 313 participants were enrolled in the study. The overall seroprevalence of Brucella infection was 10.9% (34/313) determined by Rose Bengal plate test. Of 34 positive individuals, 27(79.4%) and 8(23.5%) were positive in the ELISA specific for IgG and IgM Brucella antibodies respectively. Regular contact with manure (AOR 3.16, 95%CI 1.27-7.83) and preference for animal fresh milk (AOR 3.80, 95% CI 1.23-11.69), raw meat (AOR 2.58, 95% CI 1.14-5.81) and raw animal blood (AOR 2.71, 95% CI 1.15-6.35) increased the odds of being Brucella seropositive. Contact with the animal placenta were not associated with Brucella seropositivity after adjustment. CONCLUSION: This study has found that brucellosis is an important public health problem among pregnant women in areas with interactions of humans; livestock and wildlife. The risk of infection increased with the regular contact with manure and preference of raw foodstuffs like animal blood, meat, and milk. We emphasize the need for interventional strategies to reduce the risk of exposure.


Assuntos
Brucelose/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , Animais , Animais Selvagens , Anticorpos Antibacterianos/sangue , Estudos Transversais , Ecossistema , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Gado , Esterco , Carne , Leite , Gravidez , Complicações Infecciosas na Gravidez/microbiologia , Resultado da Gravidez , Cuidado Pré-Natal , Fatores de Risco , Estudos Soroepidemiológicos , Inquéritos e Questionários , Tanzânia/epidemiologia , Zoonoses/epidemiologia
8.
Afr Health Sci ; 19(2): 1858-1865, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31656468

RESUMO

Background: A significant proportion of newborns in the developing countries are born with congenital anomalies. Objective: This study investigated congenital infections due to Rubella virus, Toxoplasma gondii, Treponema pallidum among presumed normal neonates from full term pregnant women in Mwanza, Tanzania. Methods: Sera from mothers were tested for Treponema pallidum and Toxoplasma gondii infection while newborns from mothers with acute infections were tested for T. pallidum and T. gondii, and all newborns were tested for Rubella IgM antibodies. Results: A total of 13/300 (4.3 %) mothers had T. pallidum antibodies with 3 of them having acute infection. Two (0.7 %) of the newborns from mothers with acute infection were confirmed to have congenital syphilis. Regarding toxoplasmosis, 92/300 (30.7 %) mothers were IgG seropositive and 7 had borderline positivity, with only 1/99 (1%) being IgM seropositive who delivered IgM seronegative neonate. Only 1/300 (0.3 %) newborn had rubella IgM antibodies indicating congenital rubella infection. Conclusion: Based on these results, it is estimated that in Mwanza city in every 100,000 live births about 300 and 600 newborns have congenital rubella and syphilis infections, respectively. Rubella virus and T. pallidum are likely to be among common causes of congenital infections in developing countries.


Assuntos
Complicações Infecciosas na Gravidez/epidemiologia , Vírus da Rubéola/imunologia , Rubéola (Sarampo Alemão)/congênito , Rubéola (Sarampo Alemão)/epidemiologia , Sífilis Congênita/epidemiologia , Toxoplasma/imunologia , Toxoplasmose Congênita/epidemiologia , Treponema pallidum/imunologia , Adolescente , Adulto , Anticorpos Antivirais/sangue , Estudos Transversais , Feminino , Sangue Fetal/imunologia , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/imunologia , Cuidado Pré-Natal , Prevalência , Rubéola (Sarampo Alemão)/diagnóstico , Vírus da Rubéola/isolamento & purificação , Estudos Soroepidemiológicos , Sífilis/complicações , Sífilis/epidemiologia , Sífilis Congênita/diagnóstico , Tanzânia/epidemiologia , Toxoplasma/isolamento & purificação , Toxoplasmose/complicações , Toxoplasmose/epidemiologia , Toxoplasmose Congênita/diagnóstico , Treponema pallidum/isolamento & purificação , População Urbana
9.
BMC Pregnancy Childbirth ; 19(1): 392, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664945

RESUMO

BACKGROUND: Sexually transmitted infections (STIs) is a global health problem with increased risk and morbidities during pregnancy. This study investigated the magnitude of viral STIs among pregnant women from three rural hospitals/clinics providing antenatal care in Mwanza region, Tanzania. METHODS: Between February and May 2018, a total of 499 pregnant women were enrolled and tested for Human immunodeficiency virus (HIV), Herpes simplex virus-2 (HSV-2), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) using rapid immunochromatographic tests and for syphilis using non-treponemal and treponemal antibody test. RESULTS: The median age of enrolled women was 25 (IQR: 22-31) years. Seventy eight (15.6, 95% CI: 12-18) of women tested had at least one sexually transmitted viral infection. Specific prevalence of HIV, HBV, HCV, HSV-2 IgG and HSV-2 IgM were found to be 25(5.0%), 29(5.8%), 2(0.4%), 188(37.7%) and 24(4.8%), respectively. The odds of having viral infection was significantly high among women with positive T. pallidum serostatus (adjusted odd ratio (aOR): 3.24, 95%CI; 1.2-85). By multivariable logistic regression analysis, history of STIs predicted HSV-2 IgM seropositivity (aOR: 3.70, 95%CI: 1.43-9.62) while parity (aOR: 1.23, 95%CI: 1.04-1.46) predicted HBV infection and syphilis positive results (aOR: 8.63, 95%CI: 2.81-26.45) predicted HIV infection. CONCLUSION: A significant proportion of pregnant women in rural areas of Mwanza region has at least one sexually transmitted viral infection which is independently predicted by positive T. pallidum serostatus. The strengthening and expansion of ANC screening package to include screening of STIs will ultimately reduce the viral STIs among pregnant women hence reduce associated morbidities and mortalities.


Assuntos
Infecções por HIV , Complicações Infecciosas na Gravidez , Saúde da População Rural/estatística & dados numéricos , Doenças Sexualmente Transmissíveis , Sífilis , Viroses , Adulto , Feminino , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Humanos , Gravidez , Complicações Infecciosas na Gravidez/classificação , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Doenças Sexualmente Transmissíveis/classificação , Doenças Sexualmente Transmissíveis/diagnóstico , Doenças Sexualmente Transmissíveis/epidemiologia , Sífilis/diagnóstico , Sífilis/epidemiologia , Sorodiagnóstico da Sífilis/métodos , Sorodiagnóstico da Sífilis/estatística & dados numéricos , Tanzânia/epidemiologia , Treponema pallidum/isolamento & purificação , Viroses/classificação , Viroses/diagnóstico , Viroses/epidemiologia
10.
J Pregnancy ; 2019: 7917894, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31316835

RESUMO

Background: Hepatitis B and hepatitis C viruses (HBV and HCV) are life-threatening infections of public health importance due to their association with cirrhosis and hepatocellular carcinoma. Despite HBV being moderately endemic in many low-income countries, there is no routine HBV vaccination among child bearing aged women making them at risk of transmitting infections to the foetus during pregnancy. This study investigated the seroprevalence of antihepatitis B surface antibodies (anti-HBs) and HCV antibodies among pregnant women in Mwanza city to provide data that can be used in devising preventive strategies. Methods: A cross-sectional hospital-based study involving 339 pregnant women was conducted between June and July 2017. Data were collected using structured data collection tool. Detection of anti-HBs was performed using enzyme immunoassay while qualitative rapid immunochromatographic tests were employed to detect HCV antibodies. Data was analyzed by using STATA version 13. Results: The mean age of the study participants was 25.6±5.8 years. The prevalence of anti-HBs was 85/339 (25.1%, 95% CI: 20.4-29.6) while that of HCV antibodies was 1/333 (0.3%, 95% CI: 0.1-0.4). By univariate logistic regression analysis, increase in age (OR: 1.04, 95% CI: 1.00-1.09, P=0.03), unknown HIV status (OR: 0.3, 95% CI: 0.11-0.79, P=0.035), and multigravidity (OR: 2.12, 95% CI: 1.18-3.8, P=0.038) were significantly associated with anti-HBs seropositivity. Conclusion: A significant proportion of pregnant women have anti-HBs while the seroprevalence of HCV is low among pregnant women in the city of Mwanza. Routine screening of HBV among pregnant women coupled with appropriate management should be emphasized in developing countries. Further studies to determine seroprevalence of HCV are recommended across the country.


Assuntos
Hepatite B/epidemiologia , Hepatite C/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Hepatite B/sangue , Hepatite B/diagnóstico , Anticorpos Anti-Hepatite B/sangue , Antígenos de Superfície da Hepatite B/imunologia , Hepatite C/sangue , Hepatite C/diagnóstico , Anticorpos Anti-Hepatite C/sangue , Humanos , Modelos Logísticos , Gravidez , Complicações Infecciosas na Gravidez/sangue , Complicações Infecciosas na Gravidez/diagnóstico , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Tanzânia/epidemiologia , Adulto Jovem
11.
AIDS Res Treat ; 2019: 6375714, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31275646

RESUMO

Background: Liver enzymes abnormalities have been found to be common among patients on antiretroviral treatment (ART). Apart from the effects of ART on these changes, other factors that can potentially contribute to the abnormal levels of these enzymes have been found to vary in different geographical locations. This study investigated factors associated with liver enzymes abnormalities among human immunodeficiency virus (HIV) infected individuals on ART from the Lake Victoria zone, Tanzania. Methods: A cross-sectional study involving a total of 230 sera from HIV seropositive patients from different regions of the Lake Victoria zone was carried out in July 2017. All samples with required variables/parameters such as age, sex, ART regimen, and residence were serially included in the study. Hepatitis B virus (HBV) and Hepatitis C virus (HCV) detection and liver enzymes assays (alanine transaminase (ALAT) and aspartate transaminase (ASAT)) were assessed following the standard procedures. Data were analyzed by using STATA version 13. Results: The median age of the study participants was 38 (interquartile range [IQR]:30-48) years. The overall prevalence of abnormal liver enzymes was 43.04% (99/230, 95% CI: 36.6-49.3). A total of 26.09% (60/230) had elevated ASAT while 23.9% (55/230) patients had elevated ALAT levels. ASAT levels were significantly high among patients with high HIV viral load (P= 0.002) while ALAT levels were significantly high among those coinfected with hepatitis C virus (P=0.017) and hepatitis B virus (P<0.001). Conclusion: A significant proportion of HIV seropositive individuals on ART have abnormal levels of liver enzymes, which is significantly associated with high HIV viral load and viral hepatitis. This calls for the need to emphasize screening of viral hepatitis and provision of appropriate management among HIV seropositive individuals in this setting.

12.
Afr Health Sci ; 19(3): 2351-2355, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32127804

RESUMO

Background: Despite blood transfusion being a lifesaving option, it may be associated with blood borne infections including human cytomegalovirus(HCMV). The World Health Organization recommends screening of blood products for HCMV before transfusion to pregnant women, neonates and immunocompromised patients. However, this is not routinely practised in many resource limited countries. Objective: This study aimed at determining seroprevalence of specific HCMV IgM antibodies among volunteered blood donors at the Lake Victoria zone blood transfusion centre. Methods: A total of 228 sera from volunteered blood donors were analyzed using HCMV IgM µ capture enzyme linked immunosorbent assay as per manufacturer's instructions. Data were analyzed by STATA version 13. Results: The median age of the study participants was 19 interquartile range (IQR): 18-23 years. The seroprevalence of specific HCMV IgM antibodies was found to be 23/228 (10.1%, 95% confidence interval (CI): 6-14. None of the factors was found to be associated with HCMV IgM seropositivity among blood donors. Conclusion: One out 10 blood donors in the Lake Victoria zone blood transfusion centre is acutely infected with HCMV. There is a need to consider screening of HCMV before blood transfusion particularly in resource limited countries where HCMV is endemic.


Assuntos
Doadores de Sangue , Transfusão de Sangue , Infecções por Citomegalovirus/epidemiologia , Citomegalovirus/isolamento & purificação , Adolescente , Citomegalovirus/imunologia , Feminino , Humanos , Masculino , Programas de Rastreamento , Estudos Soroepidemiológicos , Tanzânia/epidemiologia , Adulto Jovem
13.
Int J Infect Dis ; 78: 72-77, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30391418

RESUMO

OBJECTIVE: This study investigated the adverse pregnancy outcomes among pregnant women with acute Rubella infections in the city of Mwanza, Tanzania. METHODS: A longitudinal study was conducted between 2014 and 2016 among pregnant women attending antenatal clinics. Women were screened for Rubella IgG and IgM antibodies using enzyme immunoassay (EIA). IgM seropositive pregnant women were followed up until the end of the pregnancy to determine Congenital Rubella Syndrome, congenital infections and other pregnancy outcomes. RESULTS: The median age of 685 enrolled pregnant women was 23 (IQR: 19-27) years. A total of 629(91.8%) were Rubella IgG seropositive while 61 (8.9%) were IgM seropositive. The IgM seropositivity was found to decrease significantly from first trimester to third trimester, p<0.001. Forty six (83.6%) of 55 Rubella IgM seropositive women had adverse pregnancy outcomes and 6 (10.9%) delivered neonates with CRS, making the overall incidence of CRS to be 6/685 (0.87%). First trimester IgM seropositive women had significantly higher adverse pregnancy outcomes than those in second/third trimesters (70.4% vs. 35.7, p=0.01). CONCLUSION: There is one case of CRS in every 100 pregnancies necessitating additional strategies to reach a goal of elimination of CRS in developing countries.


Assuntos
Complicações Infecciosas na Gravidez , Rubéola (Sarampo Alemão)/congênito , Doença Aguda , Adulto , Anticorpos Antivirais/sangue , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Gravidez , Resultado da Gravidez , Rubéola (Sarampo Alemão)/epidemiologia , Adulto Jovem
14.
BMC Res Notes ; 11(1): 792, 2018 Nov 06.
Artigo em Inglês | MEDLINE | ID: mdl-30400996

RESUMO

OBJECTIVE: This study investigated the association of Brucella seropositivity and spontaneous abortions in human population in the city of Mwanza, Tanzania. RESULTS: A comparative cross sectional study which used 148 sera from women with spontaneous abortion and 250 sera from full-term delivered women was conducted in July 2017. Detection of Brucella abortus and Brucella melitensis antibodies was done using slide agglutination test. Data were analyzed using STATA version 13 software. The median age of the study participants was 25 (interquartile range 21-30) years. The overall seropositivity of Brucella antibodies was significantly higher among sera from women with spontaneous abortion than full term delivered women; (86/148, 58.1%: 95% CI 50-66 vs. 65/250, 26%: 95% CI 18-33, P < 0.001). Seropositivity of B. abortus was significantly higher among sera from women with spontaneous abortion than full-term delivered women (31.8% vs. 10.8%, P < 0.001). Women with abortion had 3.59 odds of being brucella seropositive compared to full term women (OR: 3.59, 95% CI; 2.25-5.74, P < 0.001). Seropositivity of Brucella antibodies is significantly higher among women with spontaneous abortion than full-term delivered women necessitating a need to investigate the relationship between Brucellosis and adverse pregnancy outcomes.


Assuntos
Aborto Espontâneo/sangue , Anticorpos Antibacterianos/sangue , Brucella abortus , Brucelose/sangue , Complicações Infecciosas na Gravidez/sangue , Aborto Espontâneo/epidemiologia , Adulto , Brucella abortus/isolamento & purificação , Brucella abortus/patogenicidade , Brucella melitensis/isolamento & purificação , Brucella melitensis/patogenicidade , Brucelose/epidemiologia , Estudos Transversais , Feminino , Humanos , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Tanzânia , Adulto Jovem
15.
Afr Health Sci ; 18(1): 66-71, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29977259

RESUMO

Background: Esophageal candidiasis is a common disease among patients with impaired cell mediated immunity. In the current study, we report esophageal candidiasis among patients with various co-morbidities attending the endoscopic unit at the Bugando Medical Centre. Methods: This retrospective study was conducted from June to September 2015. All data of the patients who attended the endoscopic unit between 2009 and 2014 were retrieved and analyzed. Results: A total of 622 patients who underwent oesophagogastroduodenoscopy were analyzed. A slight majority 334/622(53.7%) of patients were female. Out of 622 patients; 35(5.6%) had esophageal candidiasis. Decrease in age (OR 1.1, 95%CI; 1.0-1.1), female sex (OR 3.8, 95%CI; 1.1-13.1), drinking alcohol (OR 17.1, 95%CI; 4.9-58.9), smoking (OR 8.3, 95%CI; 1.7-41.0), antibiotic use (OR 5.7, 95%CI; 2.0-16.4), positive HIV status (OR 10.3, 95%CI; 4.6-6.0) and presence of peptic ulcer disease (OR 13.2, 95%CI; 3.5-49.0) independently predicted esophageal candidiasis. Conclusion: Patients with a history of drinking alcohol, smoking, use of antibiotics and those with chronic diseases such as peptic ulcers were at high risk of developing esophageal candidiasis. Further studies are needed to identify Candida spp. and their anti-fungal susceptibility for proper management of esophageal candidiasis in HIV and non-HIV individuals.


Assuntos
Candidíase/diagnóstico , Endoscopia do Sistema Digestório/métodos , Esofagite/microbiologia , Adulto , Idoso , Candidíase/epidemiologia , Estudos Transversais , Esofagite/diagnóstico , Esofagite/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tanzânia/epidemiologia , Centros de Atenção Terciária
16.
Int J Med Microbiol ; 308(7): 803-811, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29980372

RESUMO

The study was conducted to establish predictors of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) neonatal sepsis and mortality in a tertiary hospital, Tanzania. Between July and December 2016, blood culture was performed in neonates with clinical features of sepsis and neonates/mothers/guardians were screened for ESBL colonization. Selected isolates underwent whole genome sequencing to investigate relatedness. Logistic regression analysis was performed to determine predictors for ESBL-PE associated neonatal sepsis and mortality. Neonatal ESBL-PE sepsis was detected in 32(10.5%) of the 304 neonates investigated. Neonatal ESBL-PE sepsis was independently predicted by admission at the Intensive care Unit and positive mother and neonate ESBL-PE colonization. Deaths occurred in 55(18.1%) of neonates. Neonates infected with ESBL-PE, admitted at ICU, increased age and those transferred from other centres had significantly high mortality rates. Gram-negative bacteria formed the majority (76%) of the isolates, of which 77% were ESBL-PE. Virulent Klebsiella pneumoniae ST45 carrying blaCTX-M-15 were commonly isolated from neonates. Klebsiella pneumoniae (ST45) were the predominant cause of ESBL-PE neonatal sepsis and mortality. Improved infection control and antibiotic stewardship are crucial in controlling the spread of resistant strains. Rapid diagnostic tests to detect ESBL-PE in low-income countries are needed to guide treatment and reduce ESBL-PE-associated mortality.


Assuntos
Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Infecções por Klebsiella/mortalidade , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/genética , Sepse Neonatal/mortalidade , beta-Lactamases/genética , Antibacterianos/uso terapêutico , Hemocultura , Feminino , Humanos , Recém-Nascido , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/classificação , Klebsiella pneumoniae/isolamento & purificação , Masculino , Testes de Sensibilidade Microbiana , Sepse Neonatal/microbiologia , Tanzânia , Centros de Atenção Terciária , Resultado do Tratamento
17.
PLoS Negl Trop Dis ; 12(6): e0006600, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29939991

RESUMO

INTRODUCTION: Brucellosis and leptospirosis are among neglected tropical zoonotic diseases particularly in the resource limited countries. Despite being endemic in these countries, there is paucity of information on its magnitude. This study investigated seropositivity of Brucella spp. and Leptospira spp., and associated factors among abattoir workers and meat vendors in the city of Mwanza, Tanzania. METHODOLOGY: A community based cross-sectional study was conducted in Mwanza city from May to July 2017. Socio-demographic and other relevant information were collected. Detection of Brucella spp. and Leptospira spp. antibodies were done using slide agglutination test and microscopic agglutination test, respectively. Data were analyzed using STATA version 13 Software. FINDINGS: A total of 250 participants (146 abattoir workers and 104 meat vendors) were enrolled with median age of 31 (IQR: 25-38) years. The overall, seropositivity of Brucella spp. antibodies was 48.4% (95% Cl: 42-54). Seropositivity of B. abortus was significantly higher than that of B. melitensis (46.0%, 95%Cl: 39-52 vs. 23.6%, 95% Cl: 18-28, P<0.001) while seropositivity of both species was 21.2% (95%Cl: 16-26). The seropositivity of Leptospira spp. was 10.0% (95% CI: 6-13) with predominance of Leptospira kirschneri serovar Sokoine which was detected in 7.2% of the participants. Being abattoir worker (OR: 2.19, 95% CI 1.06-4.54, p = 0.035) and long work duration (OR: 1.06, 95%CI: 1.01-1.11, p = 0.014) predicted presence of both B.abortus and B. melitensis antibodies. Only being married (p = 0.041) was significantly associated with seropositivity of Leptospira spp. Primary education was the only factor independently predicted presence of Brucella spp. antibodies among abattoir workers on sub-analysis of occupational exposure. None of factors were found to be associated with presence of Brucella spp. antibodies among meat vendors on sub-analysis. CONCLUSION: Seropositivity of B.abortus antibodies among abattoir workers and meat vendors is high and seem to be a function of being abattoir worker, having worked for long duration in the abattoir and having primary education. In addition, a significant proportion of abattoir workers and meat vendors in the city was seropositive for Leptospira kirschneri serovar Sokoine. There is a need to consider 'one health approach' in devising appropriate strategies to control these diseases in the developing countries.


Assuntos
Anticorpos Antibacterianos/sangue , Brucella/imunologia , Brucelose/epidemiologia , Leptospira/imunologia , Leptospirose/epidemiologia , Doenças Negligenciadas/epidemiologia , Exposição Ocupacional , Matadouros , Adulto , Testes de Aglutinação , Brucella/isolamento & purificação , Brucelose/microbiologia , Brucelose/prevenção & controle , Estudos Transversais , Feminino , Humanos , Leptospira/isolamento & purificação , Leptospirose/microbiologia , Leptospirose/prevenção & controle , Masculino , Doenças Negligenciadas/microbiologia , Doenças Negligenciadas/prevenção & controle , Saúde Única , Estudos Soroepidemiológicos , Tanzânia/epidemiologia
18.
Int J Infect Dis ; 70: 69-71, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29550450

RESUMO

OBJECTIVES: This study investigated the prevalence and factors associated with mycobacteremia and mortality among febrile HIV infected patients in developing countries. METHODS: A hospital based cross-sectional study was conducted among febrile HIV patients admitted at Bugando Medical centre and Sekou Toure hospital between November 2016 and March 2017. Blood culture was done on BACTEC Myco/F Lytic bottles. Clinical and demographic data were collected using a pre-tested data collection tool. RESULTS: A total of 154 patients with the mean age of 41.5±12.2 were enrolled. Females formed the majority, 93 (60%) of the study participants. The prevalence of Mycobacteremia was 3.3% while that of other bacteria was 8.4%. Age (p=0.03), recent HIV diagnosis (p=0.005), not taking HAART (p=0.031) and low CD4+ count (p=0.002) were significantly associated with Mycobacteremia. Factors significantly associated with 14-day in-hospital mortality were advanced HIV infection (p<0.001), poor ART adherence (p<0.001), low CD4+ (p=0.0002) and Mycobacteremia (p=0.007). CONCLUSION: The prevalence of Mycobacteremia was low; however, it was significantly associated with mortality. Mycobacteremia should be suspected in high risk febrile HIV infected individuals followed by early appropriate treatment in order to reduce associated morbidity and mortality.


Assuntos
Bacteriemia/epidemiologia , Febre/mortalidade , Infecções por HIV/mortalidade , Infecções por Mycobacterium/epidemiologia , Adolescente , Adulto , Idoso , Bacteriemia/etiologia , Bacteriemia/mortalidade , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Mycobacterium/etiologia , Infecções por Mycobacterium/mortalidade , Prevalência , Tanzânia/epidemiologia , Adulto Jovem
19.
BMC Womens Health ; 18(1): 3, 2018 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-29298693

RESUMO

BACKGROUND: Rubella primary infection during early stages of pregnancy is associated with high risk of congenital Rubella syndrome (CRS). Prevention of CRS in the resource-limited countries requires multiple strategies. Here, we document the data on the magnitude of Rubella natural immunity among adolescent girls which is a crucial group in devising effective control strategies to prevent CRS. METHODS: A cross sectional study involving 397 adolescent girls was conducted in the city of Mwanza involving five secondary schools. Socio-demographic and other relevant information were collected using pre-tested data collection tool. Rubella IgG antibodies were determined using enzyme immunoassay. The presence of Rubella IgG titers of >10 IU/ml indicated natural immunity. RESULTS: The mean age of the study participants was 15.18 ± 1.48 years. Of 397 girls, 340 (85.6%) and 57 (14.4%) were from secondary schools representing peri-urban and rural areas, respectively. Out of 397 girls, 90.4% (95% CI: 87-93) were found to be naturally immune with median Rubella IgG antibodies titers of 56.7 IU/ml interquartile range (IQR): 40.8-137. The median Rubella IgG antibodies titers were significantly high in adolescent girls from families with high socio-economic status (63.96 vs. 47.13 IU/ml, P < 0.001) and in adolescent girls from peri-urban areas of the city (63.33 vs. 39.9 IU/ml, P < 0.001). CONCLUSION: The majority of adolescent girls in the city of Mwanza are naturally immune to Rubella virus. There is a need to compare the effectiveness of screening and vaccinating susceptible adolescent girls with the effectiveness of vaccinating all women of childbearing in controlling CRS in low-income countries.


Assuntos
Anticorpos Antivirais/sangue , Imunidade Inata , Imunoglobulina G/sangue , Síndrome da Rubéola Congênita/prevenção & controle , Rubéola (Sarampo Alemão)/imunologia , Vacinação , Adolescente , Estudos Transversais , Feminino , Humanos , Determinação de Necessidades de Cuidados de Saúde , População Rural , Classe Social , População Suburbana , Tanzânia
20.
J Trop Pediatr ; 64(6): 479-487, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-29244176

RESUMO

Parvovirus B19 (B19) can cause transient aplastic crisis and lead to acute severe anemia. This study investigated the relationship between B19 and anemia among children <5 years old in the city of Mwanza, Tanzania. An enzyme immunoassay was used to detect B19 IgM- and IgG-specific antibodies among children with various categories of anemia according to the World Health Organization (WHO) guidelines. A total of 265 children with median age of 28.5 months (interquartile range 18-39.5) were investigated. Eighty-six children (32.5%) had severe anemia. B19-specific IgM and IgG antibodies were detected in 24 (9%) and 46 (17.4%) children, respectively. Low hemoglobin (Hb) level (p = 0.031), Plasmodium falciparum infection (p = 0.001) and residing in rural areas (p = 0.025) independently predicted B19 IgM seropositivity. Acute B19 infection decreased Hb level by 1.1 g/dl (p = 0.003). In malaria endemic areas, acute B19 infections should be considered among children with severe anemia from rural areas.


Assuntos
Anemia/complicações , Anemia/virologia , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Infecções por Parvoviridae/complicações , Parvovirus B19 Humano/imunologia , Parvovirus B19 Humano/isolamento & purificação , Anemia Aplástica/epidemiologia , Anemia Aplástica/virologia , Anticorpos Antivirais/sangue , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Técnicas Imunoenzimáticas , Lactente , Recém-Nascido , Masculino , Infecções por Parvoviridae/imunologia , Reação em Cadeia da Polimerase , Tanzânia
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