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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.
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.

3.
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.

4.
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.

5.
J Cancer Epidemiol ; 2020: 4274682, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32849872

RESUMO

Background: A high mortality has been reported during the first ninety days of cancer therapy and is more pronounced in patients with febrile neutropenia. The Bugando Medical Center oncology department offers cancer diagnosis and treatment services to the population of the Lake Zone of Tanzania with limited data on the outcome within 90 days of therapy. Here, we report the 90-day mortality and factors associated with it among cancer patients attending the oncology department of the tertiary hospital in Tanzania. Methodology. Enrolled participants underwent baseline physical examinations, and their functional status was assessed using Karnofsky score. On each clinic visit, full blood picture was taken and patients were investigated for infections. Data were entered in the Microsoft Excel, cleaned and coded and then transferred to STATA version 13 for analysis. Results: A total of 102 participants were included in the final analysis. Their median age was 50 years (38-60). The majority of the study participants were females 76 (75%), and 82 (80.4%) had primary school education. The majority of the patients had solid cancer 96 (94.1%). A total of 12 (11.8%) patients died within 90 days of starting therapy. Low hemoglobin level at the start of cancer therapy, Karnofsky score below 80%, and using 5-fluorouracil-containing therapy were statistically significantly found to be associated with mortality within 90 days of therapy among cancer patients. Conclusion: One tenth of cancer patients at Bugando Medical Center do not survive within 90 days of therapy; the mortality is significantly high among anemic patients, with poor performance status, on 5-fluorouracil regimen, and diagnosed with head and neck cancer, necessitating close follow-up of these patients.

6.
Antimicrob Resist Infect Control ; 9(1): 58, 2020 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-32375857

RESUMO

BACKGROUND: Multidrug resistance (MDR) is a major clinical problem in tertiary hospitals in Tanzania and jeopardizes the life of neonates in critical care units (CCUs). To better understand methods for prevention of MDR infections, this study aimed to determine, among other factors, the role of MDR-Gram-negative bacteria (GNB) contaminating neonatal cots and hands of mothers as possible role in transmission of bacteremia at Bugando Medical Centre (BMC), Mwanza, Tanzania. METHODS: This cross-sectional, hospital-based study was conducted among neonates and their mothers in a neonatal intensive care unit and a neonatology unit at BMC from December 2018 to April 2019. Blood specimens (n = 200) were sub-cultured on 5% sheep blood agar (SBA) and MacConkey agar (MCA) plates. Other specimens (200 neonatal rectal swabs, 200 maternal hand swabs and 200 neonatal cot swabs) were directly inoculated on MCA plates supplemented with 2 µg/ml cefotaxime (MCA-C) for screening of GNB resistant to third generation cephalosporins, r-3GCs. Conventional biochemical tests, Kirby-Bauer technique and resistance to cefoxitin 30 µg were used for identification of bacteria, antibiotic susceptibility testing and detection of MDR-GNB and screening of potential Amp-C beta lactamase producing GNB, respectively. RESULTS: The prevalence of culture confirmed bacteremia was 34.5% of which 85.5% were GNB. Fifty-five (93.2%) of GNB isolated from neonatal blood specimens were r-3GCs. On the other hand; 43% of neonates were colonized with GNB r-3GCs, 32% of cots were contaminated with GNB r-3GCs and 18.5% of hands of neonates' mothers were contaminated with GNB r-3GCs. The prevalences of MDR-GNB isolated from blood culture and GNB r-3GCs isolated from neonatal colonization, cots and mothers' hands were 96.6, 100, 100 and 94.6%, respectively. Significantly, cyanosis (OR[95%CI]: 3.13[1.51-6.51], p = 0.002), jaundice (OR[95%CI]: 2.10[1.07-4.14], p = 0.031), number of invasive devices (OR[95%CI]: 2.52[1.08-5.85], p = 0.031) and contaminated cot (OR[95%CI]: 2.39[1.26-4.55], p = 0.008) were associated with bacteremia due to GNB. Use of tap water only (OR[95%CI]: 2.12[0.88-5.09], p = 0.040) was protective for bacteremia due to GNB. CONCLUSION: High prevalence of MDR-GNB bacteremia and intestinal colonization, and MDR-GNB contaminating cots and mothers' hands was observed. Improved cots decontamination strategies is crucial to limit the spread of MDR-GNB. Further, clinical presentations and water use should be considered in administration of empirical therapy whilst awaiting culture results.

7.
J Orthop Surg Res ; 15(1): 95, 2020 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-32138758

RESUMO

BACKGROUND: Culture results of fluid/pus from sinuses or open wound are not reliable in establishing the causative agent of osteomyelitis due to the high chances of contamination of superficial contaminants. Bone fragments obtained during surgery have been recommended as ideal sample to establish pathogens causing osteomyelitis. This study investigated pathogens causing osteomyelitis among patients undergoing orthopedic surgical treatment at Bugando Medical Centre. METHODS: A cross-sectional hospital-based study was conducted from December 2017 to July 2018 among 74 patients with osteomyelitis who underwent surgical treatments at Bugando Medical Centre, Mwanza, Tanzania. Bone fragments were collected using sterile 10 ml of in-house prepared brain heart infusion broth (Oxoid, UK) during surgery. Specimens were processed according to standard operating procedures within an hour of collection. Data were analyzed using STATA 13.0. RESULTS: The median age of study participants was 12 with inter quartile range of 8-20 years. The majority 45 (60.8%) of participants were male. All 74 non-repetitive bone fragment specimens had positive culture, of which 17 had dual growth of bacteria resulting to 91 bacterial isolates. Out of 91 isolates, 63 (85.1%) were Staphylococcus aureus (S. aureus) of which 18 (28.6%) were confirmed to be methicillin resistant Staphylococcus aureus strains. Fever was significantly associated with Staphylococcal osteomyelitis (100% vs. 79.6%, p = 0.029). CONCLUSION: About one third of cases of Staphylococcal osteomyelitis in the current study were caused by methicillin resistant Staphylococcus aureus. There is a need of tailoring antibiotic management of osteomyelitis based on culture and sensitivity results for the better treatment outcome of the patients.

8.
Pan Afr Med J ; 37: 241, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33552359

RESUMO

Accuracy in the diagnosis is a key step to identify HIV infected individuals for appropriate management. Insufficient supply of manufacturer´s buffers in relation to the number of strips per kit has negative impact on patient´s results hence improper patient´s management. In resource limited settings, some laboratory staff use different substitute buffers which has never been validated on their reliability. This study aimed at comparing the performance of 0.85% saline and SD-Bioline manufacturer´s buffer in detection of HIV antibodies. A total of 220 whole blood specimens: 110 HIV positive specimens from patients attending care and treatment center (CTC) and 110 HIV negative specimens from blood donors were re-tested for HIV status using SD-Bioline HIV rapid test using manufacturer´s buffer and 0.85% saline separately. Data and laboratory results were recorded in Microsoft excel sheet followed by analysis using STATA version 13. For all tested samples, the level of agreement between 0.85% saline and manufacturer´s buffer was 98.64% (kappa=0.9727). The value of kappa indicates very good agreement between 0.85% saline and manufacturer´s buffer. In incidents where manufacturer´s buffer is not sufficient, 0.85% saline can give reliable results. Further studies to evaluate the suitable buffer for other rapid tests for HIV and other diseases are recommended especially in resource limited settings.


Assuntos
Sorodiagnóstico da AIDS/métodos , Doadores de Sangue , Anticorpos Anti-HIV/sangue , Infecções por HIV/diagnóstico , Tampões (Química) , Infecções por HIV/sangue , Humanos , Reprodutibilidade dos Testes , Cloreto de Sódio/química
9.
Afr Health Sci ; 20(1): 4-13, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33402887

RESUMO

Background: Infections caused by Extended spectrum beta lactamase (ESBL) producing bacterial are global challenge. There is limited information on the magnitude of bacteriospermia, ESBL producing Gram-negative bacteria (GNB) causing bacteriospermia and factors associated with male infertility. This study determined magnitude of bacteriospermia, ESBL-GNB and other factors association with infertility among presumptive infertile men in Mwanza, Tanzania. Methods: A cross-sectional hospital-based study was conducted between May 2017 and July 2018 among 137 presumptive infertile men. Semen specimens were self-collected by masturbation into clean, sterile and none-spermicidal containers and processed following laboratory standard operating procedures (SOPs). Data analysis was done using STATA 13.0. Results: Gram-negative bacteria were predominantly isolated (86.4%), of which 31.6% were ESBL producers. In a total 44 bacteria were isolated from semen culture. The blaCTX-M gene was detected in 75% of phenotypically confirmed ESBL producers. Infertility was independently found to be associated with abnormal spermatozoa morphology (OR (95%CI): 14.48(3.17-66.05)) and abnormal spermatozoa motility (OR (95%CI): 0.05(0.01-0.24)). However, neither bacteriospermia (OR (95%CI): 0.86(0.29-2.59)) nor ESBL bacteriospermia (OR (95%CI): 0.13(0.01-1.22)) was found to be associated with infertility. Conclusion: One third of bacteriospermia is due to ESBL-producers with history of antibiotic use being protective factor for infertility. Abnormal spermatozoa morphology and poor spermatozoa forward motility independently predicted infertility.


Assuntos
Antibacterianos/farmacologia , Bactérias Gram-Negativas/isolamento & purificação , Infecções por Bactérias Gram-Negativas/microbiologia , Infertilidade Masculina/microbiologia , Sêmen/microbiologia , Espermatozoides/microbiologia , Espermatozoides/fisiologia , beta-Lactamases/metabolismo , Adulto , Estudos Transversais , Bactérias Gram-Negativas/efeitos dos fármacos , Humanos , Infertilidade Masculina/epidemiologia , Masculino , Tanzânia/epidemiologia , Resistência beta-Lactâmica
10.
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
11.
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
12.
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.

13.
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
14.
Afr Health Sci ; 19(4): 3217-3224, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32127899

RESUMO

Introduction: Gram-negative bacteria are the major cause of urinary tract infections (UTI) in children. There is limited data on UTI systemic response as measured using C-reactive protein (CRP). Here, we report the association of CRP and UTI among children attending the Bugando Medical Centre, Mwanza, Tanzania. Methods: A cross-sectional study was conducted between May and July 2017. Urine and blood were collected and processed within an hour of collection. Data were analyzed using STATA version 13. Results: Of 250 enrolled children, 76(30.4%) had significant bacteriuria with 56(22.4%, 95%CI; 11.5-33.3) having gram-negative bacteria infection. There was dual growth of gram-negative bacteria in 3 patients. Escherichia coli (32.2%, 19/59) was the most frequently pathogen detected. A total of 88/250(35.2%) children had positive CRP on qualitative assay. By multinomial logistic regression, positive CRP (RRR=4.02, 95%CI: 2.1-7.7, P<0.001) and age ≤ 2years (RRR=2.4, 95%CI: 1.23-4.73, P<0.01) significantly predicted the presence of significant bacteriuria due to gram-negative enteric bacteria. Conclusion: C-reactive protein was significantly positive among children with UTI due to gram-negative bacteria and those with fever. In children with age ≤ 2 years, positive CRP indicates UTI due to gram-negative enteric bacteria.


Assuntos
Antibacterianos/uso terapêutico , Proteína C-Reativa/análise , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/imunologia , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/imunologia , Pré-Escolar , Estudos Transversais , Feminino , Infecções por Bactérias Gram-Negativas/sangue , Infecções por Bactérias Gram-Negativas/epidemiologia , Humanos , Lactente , Masculino , Testes de Sensibilidade Microbiana , Tanzânia/epidemiologia , Centros de Atenção Terciária/estatística & dados numéricos , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia
15.
Pan Afr Med J ; 23: 65, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27217889

RESUMO

INTRODUCTION: The use of the traditional herbal medicinal products (THMPs) has been increasing worldwide due to the readily availability of raw materials and low cost compared to the synthetic industrial preparations. With this trend in mind, the safety and quality of THMPs need to be addressed so as to protect the community. The present study evaluated the magnitude and risk factors associated with microbial contamination of liquid THMPs marketed in Mwanza. METHODS: A cross-sectional study was conducted in Mwanza city involving 59 participants from whom 109 liquid THMPs were collected and processed following the standard operating procedures. The data were analyzed using STATA software version 11. RESULTS: The median age (interquartile range) of participants was 35 (27-43) years, with males accounting for 36 (61%). Of 109 liquid THMPs collected, 89 (81.7%) were found to be contaminated; with predominant fecal coliforms being Klebsiella spp and Enterobacter spp. fortunately, no pathogenic bacteria like Salmonella spp and Shigella spp were isolated. There was a significant association of liquid THMPs contamination with low education level (p< 0.001), lack of formal training on THMPs (p = 0.023), lack of registration with the Ministry of Health (p = 0.001), lack of packaging of products (p < 0.001) and use of unboiled solvents during preparation of THMPs (p < 0.001). CONCLUSION: There is high contamination rate of liquid THMPs in Mwanza City which is attributable to individuals and system-centered factors. Urgent measures to provide education to individuals involved in THMPs as well as setting up policies and regulations to reinforce THMPs safety is needed.


Assuntos
Contaminação de Medicamentos , Medicina Tradicional Africana/normas , Fitoterapia/normas , Preparações de Plantas/normas , Adolescente , Adulto , Bactérias/isolamento & purificação , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Plantas Medicinais/química , Fatores de Risco , Tanzânia , Adulto Jovem
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