Digital Commons Network^™

Cervical Cancer In Northern Tanzania–What Do Women Living With Hiv Know, Dorah Mrema, James Samwel Ngocho, Alex Mremi, Maryam Amour, Rogathe Machange, Benjamin C Shayo, Julius P Alloyce, Evaline Ndosi, Beatus T Shirima, Device Fande, Rahma Shehoza, Emmanuel Balandya, Bruno Sunguya, Stephen E Mshana, Alfred K Mteta, Eligius Lyamuya, John Bartlett, Blandina T Mmbaga

Faculty, Staff and Students Publications

BACKGROUND: Cervical cancer (CC) is more prevalent in women living with human immunodeficiency virus (HIV) infection compared to the general population. The magnitude is high among all countries burdened with HIV-Tanzania is no exception. Despite the unprecedented risk, women living with HIV (WLHIV) may not be aware of the risk and might have unfounded beliefs thereof. This study aimed to determine the knowledge, awareness, and beliefs on CC screening among WLHIV attending a clinic at the Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania.

METHODS: This hospital-based cross-sectional study was conducted among 327 WLHIV attending care and treatment clinic (CTC) …

Does Digital Literacy Empower Adolescent Girls In Low- And Middle-Income Countries: A Systematic Review, Salima Meherali, Komal Abdul Rahim, Sandra Campbell, Zohra S. Lassi

School of Nursing & Midwifery

Background: The vast majority (90%) of the world's adolescents aged 10-19 live in low- and middle-income countries (LMICs); and in those resource-limited settings, girls face distinct challenges across multiple health, social, and economic domains. Gender equality and girls' empowerment are key goals in their own right and are central to all other development goals. Digital literacy is a great enabler for the empowerment of young girls. This systematic review aims to assess the range and nature of digital literacy interventions implemented to empower adolescent girls in LMICs and identify evidence about adolescent girls' access and use of digital technologies in …

Action Leveraging Evidence To Reduce Perinatal Mortality And Morbidity (Alert): Study Protocol For A Stepped-Wedge Cluster-Randomised Trial In Benin, Malawi, Tanzania And Uganda, Joseph Akuze, Kristi Sidney Annerstedt, Lenka Benova, Effie Chipeta, Jean-Paul Dossou, Mechthild M. Gross, Hussein Kidanto, Bruno Marchal, Helle Mölsted Alvesson, Andrea B. Pembe

Obstetrics and Gynaecology, East Africa

Background: Insufficient reductions in maternal and neonatal deaths and stillbirths in the past decade are a deterrence to achieving the Sustainable Development Goal 3. The majority of deaths occur during the intrapartum and immediate postnatal period. Overcoming the knowledge-do-gap to ensure implementation of known evidence-based interventions during this period has the potential to avert at least 2.5 million deaths in mothers and their offspring annually. This paper describes a study protocol for implementing and evaluating a multi-faceted health care system intervention to strengthen the implementation of evidence-based interventions and responsive care during this crucial period.

Methods: This is a cluster …

Effect Of 3 Days Of Oral Azithromycin On Young Children With Acute Diarrhea In Low-Resource Settings: A Randomized Clinical Trial, Antibiotics For Children With Diarrhea (Abcd) Study Group, Tahmeed Ahmed, Farah Naz Qamar, Mohammad Tahir Yousafzai, Shahida Qureshi, Sadia Shakoor, Rozina Thobani, Aneeta Hotwani, Furqan Kabir, Jan Mohammed

Department of Paediatrics and Child Health

Importance: World Health Organization (WHO) guidelines do not recommend routine antibiotic use for children with acute watery diarrhea. However, recent studies suggest that a significant proportion of such episodes have a bacterial cause and are associated with mortality and growth impairment, especially among children at high risk of diarrhea-associated mortality. Expanding antibiotic use among dehydrated or undernourished children may reduce diarrhea-associated mortality and improve growth.
Objective: To determine whether the addition of azithromycin to standard case management of acute nonbloody watery diarrhea for children aged 2 to 23 months who are dehydrated or undernourished could reduce mortality and improve linear …

Performance In Mortality Prediction Of Saps 3 And Mpm-Iii Scores Among Adult Patients Admitted To The Icu Of A Private Tertiary Referral Hospital In Tanzania: A Retrospective Cohort Study, Nadeem Kassam, Eric Aghan, Samina Somji, Omar Aziz, James Orwa, Salim R. Surani

Internal Medicine, East Africa

Background: Illness predictive scoring systems are significant and meaningful adjuncts of patient management in the Intensive Care Unit (ICU). They assist in predicting patient outcomes, improve clinical decision making and provide insight into the effectiveness of care and management of patients while optimizing the use of hospital resources. We evaluated mortality predictive performance of Simplified Acute Physiology Score (SAPS 3) and Mortality Probability Models (MPM0-III) and compared their performance in predicting outcome as well as identifying disease pattern and factors associated with increased mortality.

Methods: This was a retrospective cohort study of adult patients admitted to the ICU of the …

Residency Training On The Frontlines Of The Covid-19 Pandemic - A Qualitative Study From Tanzania, Mariam Noorani, Hussein Manji, Elizabeth Mmari, Samina Somji, Nahida Z. Walli, Sherin Kassamali, Shabbir Adamjee, Nancy Matillya, Hanifa Mbithe, Aliasger Nagri, Neelam Ismail

Paediatrics and Child Health, East Africa

Introduction: the Coronavirus Disease 2019 pandemic has affected residency training globally. The aim of this study was to understand how the pandemic affected teaching and learning in residency programs in low resource settings where residents and faculty were working on the front line treating patients with the disease.

Methods: this qualitative study enrolled residents and faculty from the Aga Khan University in Tanzania who were providing front line care during the pandemic. Purposeful sampling was used and data was collected using focus group discussions and in-depth interviews between August and September 2020. Analysis was done using qualitative content analysis.

Results: …

Barriers To Timely Disclosure Of Hiv Serostatus: A Qualitative Study At Care And Treatment Centers In Dar Es Salaam, Tanzania, Neelam Ismail, Nancy Matillya, Riaz Ratansi, Columba Mbekenga

Family Medicine, East Africa

Introduction: Disclosure of Human Immunodeficiency Virus (HIV) status is important to prevent the spread of HIV and maintain the health of people living with HIV, their spouses, and the community. Despite the benefits of disclosure, many people living with HIV delay disclosing their status to those close to them thereby increasing the risk for disease transmission. This study aimed to determine the barriers to timely disclosure of HIV serostatus for people living with HIV in Dar es Salaam, Tanzania, and identify what motivated disclosure.

Methods: A qualitative descriptive study using in-depth individual interviews was conducted with10 participants attending …

Smart Watch Detection Of Supraventricular Tachycardia (Svt): First Case From Tanzania, Nadeem Kassam, Omar Aziz, Eric Aghan, Samina Somji, Hanifa Mbithe, Mustaafa Bapumia, Robert Mvungi, Salim Surani

Internal Medicine, East Africa

Smartwatches like the Apple Watch have been on the rise worldwide and their use is gaining popularity in developing countries. Their ability to detect dysrhythmias is well documented. Present practice discourages the use of these devices as a diagnostic tool. Nevertheless, atypical findings from these devices should be clinically investigated. This case demonstrates an eventual diagnosis of supraventricular tachycardia (SVT) based on an Apple watch alert which was subsequently confirmed by electrophysiological evaluation.

Factors Associated With Mortality Among Hospitalized Adults With Covid-19 Pneumonia At A Private Tertiary Hospital In Tanzania: A Retrospective Cohort Study, Nadeem Kassam, Eric Aghan, Omar Aziz, Hanifa Mbithe, Kamran Hamid, Reena Shah, Salim Surani, James Orwa, Samina Somji

Internal Medicine, East Africa

Background: The emergence of the novel coronavirus disease 2019 (COVID-19) has caused millions of deaths worldwide. There has been paucity of data for hospitalized African patients suffering from COVID-19. This study aimed to identify factors associated with in-hospital mortality in patients suffering from COVID-19 in Tanzania.

Methods: This was a single center, retrospective, observational cohort study in adult patients hospitalized with confirmed COVID-19 infection. Demographics, clinical pattern, laboratory and radiological investigations associated with increased odds of mortality were analyzed.

Results: Of the 157 patients, 107 (68.1%) patients survived and 50 (31.8%) died. Mortality was highest in patients …

Perceptions Of Surgeons On Surgical Antibiotic Prophylaxis Use At An Urban Tertiary Hospital In Tanzania, Elizabeth Mmari, Eunice Pallangyo, Authar Ali, Dereck A. Kaale, Isaac Mawalla, Muzdalfat Abeid

General Surgery, East Africa

Background: Surgical Site Infections are a major cause of morbidity and mortality among operated patients. In spite of the accessibility of universal and national guidelines for surgical prophylaxis, recent studies surveying the present routine of prophylaxis have demonstrated overutilization of a wide range antibacterial medication for a single patient. Few studies have shown qualitatively factors influencing this and perceptions of surgeons on surgical antibiotic prophylaxis use. Unfortunately, none of these studies have been done in Tanzania.

Objective: To describe the perceptions of surgeons on surgical antibiotic prophylaxis use at an urban tertiary hospital.

Methods: A qualitative study …

Maternal Health Care Professionals’ Experiences And Views On The Use Of Obstetric Ultrasound In Rwanda: A Cross-Sectional Study, Ingrid Mogren, Joseph Ntaganira, Jean Paul Semasaka Sengoma, Sophia Holmlund, Rhonda Small, Lan Pham Thi, Hussein Kidanto, Matilda Ngarina, Cecilia Bergström, Kristina Edvardsson

Obstetrics and Gynaecology, East Africa

Background: This study, undertaken in Rwanda, aimed to investigate health professionals’ experiences and views on the following topics: current clinical guidelines for ultrasound from second trimester at the clinic, regional and national levels, and adherence to clinical guidelines; medically indicated ultrasound examinations; non-medical use of ultrasound including ultrasounds on maternal request; commercialisation of ultrasound; the value of ultrasound in relation to other clinical examinations in pregnancy; and ultrasound and medicalisation of pregnancy.

Methods: A cross-sectional design was adopted. Health professionals providing antenatal care and delivery services to pregnant women in 108 health facilities were invited to complete a survey, which …

Effect Of Lowering Tube Potential And Increase Iodine Concentration Of Contrast Medium On Radiation Dose And Image Quality In Computed Tomography Pulmonary Angiography Procedure: A Phantom Study, Justin E. Ngaile, Peter K. Msaki, Evarist M. Kahuluda, Furaha M. Chuma, Jerome M. Mwimanzi, Ahmed Jusabani

Imaging & Diagnostic Radiology, East Africa

The aim of the study was to examine the effect of lowering tube potential and increase iodine concentration on image quality and radiation dose in computed tomography pulmonary angiography procedure. The pulmonary arteries were simulated by three syringes. The syringes were filled with 1:10 diluted solutions of 300 mg, 350 mg and 370 mg of iodine per millilitre concentration in three water-filled phantoms simulating thin, intermediate and thick patients. The phantoms were scanned at 80 kVp, 110 kVp and 130 kVp and 0.6 second rotation time using a 16 slice computed tomography (CT) scanner. The tube current was either fixed …

Translation And Validation Of Training Needs Analysis Questionnaire Among Reproductive, Maternal And Newborn Health Workers In Tanzania, Tumbwene Mwansisya, Columba Mbekenga, Kahabi Isangula, Loveluck Mwasha, Eunice Pallangyo, Grace Edwards, James Orwa, Michaela Mantel, Micheal Mugerwa, Leonard Subi, Secilia Mrema, David Siso, Edna Selestine, Marleen Temmerman

School of Nursing & Midwifery, East Africa

Background: Continuous professional development (CPD) has been reported to enhance healthcare workers’ knowledge and skills, improve retention and recruitment, improve the quality of patient care, and reduce patient mortality. Therefore, validated training needs assessment tools are important to facilitate the design of effective CPD programs.

Methods: A cross-sectional survey was conducted using self-administered questionnaires. Participants were healthcare workers in reproductive, maternal, and neonatal health (RMNH) from seven hospitals, 12 health centers, and 17 dispensaries in eight districts of Mwanza Region, Tanzania. The training needs analysis (TNA) tool that was used for data collection was adapted and translated into …

Clinical Presentations Associated With Adverse Outcomes Among Patients Admitted With Dengue At A Tertiary Hospital In Dar Es Salaam., Nakiganda John Mkasa

Master of Medicine in Family Medicine

Introduction Dengue is one of the most important mosquito viral borne infections caused by four viral serotypes (DENV 1-4). In 2019 WHO named dengue as among the top ten global threats due to an increase in the number of cases worldwide. Tanzania is among the countries in Africa with multiple outbreaks; 2010, 2013-2014, and 2019. Dengue has variable clinical presentations ranging from nonspecific such as fever, joint pain, and fatigue to more serious such as hemorrhage and shock. Dengue can result in adverse outcomes such as ICU admissions and prolonged hospital stays. Clinical presentations associated with adverse outcomes have been …

Patients’ Perceptions And Understanding Of Pre-Operative Informed Consent In Tertiary Care Setting- Dar-Es-Salaam, Steven Michael Esanju

Master of Medicine in General Surgery

Background: Informed consent under the ethical principle of autonomy demonstrates patient’s agreement to have procedure/intervention done to them. Considering its importance in safeguarding human rights and autonomy, it is now mandatory to take informed consent before any surgery/procedure. Many studies have questioned whether informed consent is being taken in tr ue spirit that ensures proper understanding of the disclosed information or it is just adhered to as a medico legal formality. Globally, studies have demonstrated that majority of patients do not fully understand even small matters regarding their health i ncluding diagnosis, treatment modalities and possible associated risks, because of …

Secondary Hyperparathyroidism And Its Clinical And Biochemical Associated Factors In Patients On Maintenance Hemodialysis In Dar Es Salaam, Doris Samwel

Master of Medicine in Internal Medicine

Background: Chronic kidney disease affects 13.6% of adult people in Tanzania. Secondary hyperparathyroidism is associated with an increase in disability-adjusted life years, cardiovascular mortality, and all-cause mortality worldwide especially in patients on maintenance hemodialysis. Justification: In Tanzania, there is a lack of prevalence data of secondary hyperparathyroidism and the factors associated with it. Knowing the factors associated with it will help in the early screening of our patients and intervene early before its complications arise. Objectives: This study aimed to assess the magnitude of secondary hyperparathyroidism and its association with clinical and biochemical variables and further to measure the association …

Knowledge, Attitudes And Practice Of Venous Thromboembolism Risk Assessment Among Surgical Doctors In Tanzania, Biswalo Mugeta Yango

Master of Medicine in General Surgery

Introduction Surgical patients are at increased risk of venous thromboembolism due to the nature of their conditions and treatments. The incidence ranges from 61.3% to 64.9% in developed countries, compared to 43% in Africa. Although venous thromboembolism is fatal, it is potentially preventable. Physician-implemented risk assessment models reduce events by 70%. No country in sub-Sahara Africa has implemented a national venous thromboembolism risk assessment guideline. The subsequent burden is probably a reflection of low awareness and knowledge, negative attitudes, and substandard practice among physicians towards risk assessment. Justification In the current study, we assessed Tanzanian surgical doctors' knowledge, attitudes, and …

The Contribution Of Dysphagia To Acute Stroke Morbidity And Mortality In Nigeria: A Prospective Study, O O. Olajide, Philip Adebayo, F T. Taiwo, M O. Owolabi, A Ogunniyi

Internal Medicine, East Africa

Background: The assessment of time-trend morbidity and mortality in acute stroke is critical to clinical policy decisions and resource allocation.

Objectives: To determine the prevalence of dysphagia in acute stroke and the impact of dysphagia on short term stroke outcome (30 days post-stroke).

Methods: This was a prospective longitudinal study. Bedside screening for dysphagia modified Rankin score (MRS) and Barthel Index (BI) were performed on acute stroke patients on day 1, day 7, day 14 and day 30 after stroke to determine the frequency of dysphagia. Patients with dysphagia were then compared with age- and gender-matched controls (stroke patients without …

Outcomes Of Cardiac Surgery At The Aga Khan University Hospital Nairobi – A One Year Review, Nelly Joseph Kahamba

Master of Medicine in General Surgery

Background: Cardiovascular diseases are the number one cause of death worldwide where an estimated 17.9 million people die yearly, according to WHO. Most of this disease burden lies in the low and middle-income countries. Management of cardiovascular diseases can be medical and/or surgical. Open heart surgery is one among the major surgeries performed worldwide. It is well established in high income countries where up to 200,000 cardiac surgeries can be performed yearly. In low-income countries particularly sub-Saharan Africa where most of the disease burden is, there are about 22 centres that cater to this growing need for cardiac surgery. There …

Performance In Mortality Prediction Of Saps 3 And Mpm0-Iii Scores Among Adult Patients Admitted To The Icu Of A Private Tertiary Referral Hospital In Tanzania, Nadeem Kassam

Master of Medicine in Internal Medicine

Background Illness predictive scoring systems are significant and meaningful adjuncts of patient management in the intensive care unit. They assist in predicting patient outcomes, improve clinical decision making and provide insight into the effectiveness of care and management while optimizing the use of hospital resources. We evaluated mortality predictive performance of Simplified acute physiology score (SAPS 3) and Mortality probability models (MPM0-III) in predicting ICU outcome as well as identified disease pattern and clinical factors associated with increased mortality. Methods This was a retrospective cohort study of adult patients admitted to the Intensive Care Unit (ICU) of the Aga Khan …

Analysis Of An Obstetrics Point-Of-Care Ultrasound Training Program For Healthcare Practitioners In Zanzibar, Tanzania., Elizabeth A Hall, Danielle Matilsky, Rachel Zang, Naomasa Hase, Ali Habibu Ali, Patricia C Henwood, Anthony J Dean

Department of Emergency Medicine Faculty Papers

BACKGROUND: A point-of-care ultrasound education program in obstetrics was developed to train antenatal healthcare practitioners in rural Zanzibar. The study group consisted of 13 practitioners with different training backgrounds: physicians, clinical officers, and nurse/midwives. Trainees received an intensive 2-week antenatal ultrasound course consisting of lectures and hands-on practice followed by 6 months of direct supervision of hands-on scanning and bedside education in their clinical practice environments. Trainees were given a pre-course written exam, a final exam at course completion, and practical exams at 19 and 27 weeks. Trainees were expected to complete written documentation and record ultrasound images of at …

Intimate Partner Violence Is A Barrier To Antiretroviral Therapy Adherence Among Hiv - Positive Women: Evidence From Government Facilities In Kenya, Bornice C. Biomndo, Alexander Bergmann, Nils Lahmann, Lukoye Atwoli

Internal Medicine, East Africa

Introduction: Intimate Partner Violence (IPV) is linked to low engagement with HIV management services and adverse clinical outcomes, including poor ART adherence. In sub-Saharan Africa, studies on pregnant/postpartum women and transactional sex workers have produced divergent evidence regarding IPV’s association with poor ART adherence. We investigate this association among a broad group of women.

Methods: We sampled 408 HIV-positive women receiving free ART from different types of HIV clinics at government health facilities, assessing for IPV exposure by a current partner, ART adherence rate, and other factors that affect ART adherence (e.g. education, disclosure). ART adherence rates were measured using …

The Last Frontier For Global Non-Communicable Disease Action: The Emergency Department—A Cross-Sectional Study From East Africa, Christine Ngaruiya, Mbatha Wambua, Thomas Kedera Mutua, Daniel Owambo, Morgan Muchemi, Kipkoech Rop, Kaitlin R. Maciejewski, Rebecca Leff, Mugane Mutua, Benjamin Wachira

Emergency Medicine, East Africa

Introduction: Deaths due to non-communicable diseases (NCDs) have surpassed those due to communicable diseases globally and are projected to do so in Africa by 2030. Despite demonstrated effectiveness in high-income country (HIC) settings, the ED is a primary source of NCD care that has been under-prioritized in Africa. In this study, we assess the burden of leading NCDs and NCD risk factors in Kenyan Casualty Department patients to inform interventions targeting patients with NCDs in emergency care settings.

Materials and methods: Using the WHO STEPwise approach to surveillance (STEPS) tool and the Personal Health Questionnaire (PHQ-9), we conducted a …

Alcohol Use In Tanzanians With Chronic Psychotic Disorders And Poor Medication Adherence, Emily Simon, Jennifer B. Levin, Carol Blixen, Michelle Aebi, Kristin Cassidy, Martha Sajatovic

Faculty Scholarship

Background: The burden of chronic psychotic disorders (CPDs) in sub-Saharan Africa (SSA) is significant. Poorly medically adherent patients are more likely to have worse outcomes and require more resources. However, factors impacting effective treatment of CPD in this population are unclear. Aim: Examine the relationship between alcohol use and disease management and compare alcohol risk stratification between the Alcohol Use Disorders Identification Test (AUDIT) and Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in poorly medication adherent Tanzanians with CPD. Setting: Muhimbili National Hospital and ambulatory clinics in Dar es Salaam, Tanzania. Methods: 100 Tanzanians with CPDs and suboptimal medication …

Presence Of Antibody-Dependent Cellular Cytotoxicity (Adcc) Against Sars-Cov-2 In Covid-19 Plasma, For Yue Tso, Salum J. Lidenge, Lisa K. Poppe, Phoebe B. Pena, Sara R. Privatt, Sydney J. Bennett, John R. Ngowi, Julius Mwaiselage, Michael Belshan, Jacob A. Siedlik, Morgan A. Raine, Juan B. Ochoa, Julia Garcia-Diaz, Bobby Nossaman, Lyndsey Buckner, W Mark Roberts, Matthew J. Dean, Augusto C. Ochoa, John T. West, Charles Wood

Nebraska Center for Virology: Faculty Publications

Background Neutralizing-antibody (nAb) is the major focus of most ongoing COVID-19 vaccine trials. However, nAb response against SARS-CoV-2, when present, decays rapidly. Given the myriad roles of antibodies in immune responses, it is possible that antibodies could also mediate protection against SARS-CoV-2 via effector mechanisms such as antibody-dependent cellular cytotoxicity (ADCC), which we sought to explore here. Methods Plasma of 3 uninfected controls and 20 subjects exposed to, or recovering from, SARS CoV-2 infection were collected from U.S. and sub-Saharan Africa. Immunofluorescence assay was used to detect the presence of SARS-CoV-2 specific IgG antibodies in the plasma samples. SARS-CoV-2 specific …

The Injustice Of Unfit Clinical Practice Guidelines In Low-Resource Realities, Nanna Maaløe, Anna Marie Rønne Ørtved, Jane Brandt Sørensen, Brenda Sequeira Dmello, Thomas Van Den Akker, Monica Lauridsen Kujabi, Hussein Kidanto, Tarek Mequid, Christian Bygbjerg, Jos Van Roosmalen, Dan Wolf Meyrowitsch, Natasha Housseine

Faculty of Health Sciences, East Africa

To end the international crisis of preventable deaths in low-income and middle-income countries, evidence-informed and cost-efficient health care is urgently needed, and contextualised clinical practice guidelines are pivotal. However, as exposed by indirect consequences of poorly adapted COVID-19 guidelines, fundamental gaps continue to be reported between international recommendations and realistic best practice. To address this long-standing injustice of leaving health providers without useful guidance, we draw on examples from maternal health and the COVID-19 pandemic. We propose a framework for how global guideline developers can more effectively stratify recommendations for low-resource settings and account for predictable contextual barriers of implementation …

Fetal Heart Rate Development During Labour, Jarle Urdal, Kjersti Engan, Trygve Eftestøl, Solveig H. Haaland, Benjamin Kamala, Paschal Mdoe, Hussein Kidanto, Hege Ersdal

Faculty of Health Sciences, East Africa

Background Fresh stillbirths (FSB) and very early neonatal deaths (VEND) are important global challenges with 2.6 million deaths annually. The vast majority of these deaths occur in low- and low-middle income countries. Assessment of the fetal well-being during pregnancy, labour, and birth is normally conducted by monitoring the fetal heart rate (FHR). The heart rate of newborns is reported to increase shortly after birth, but a corresponding trend in how FHR changes just before birth for normal and adverse outcomes has not been studied. In this work, we utilise FHR measurements collected from 3711 labours from a low and low-middle …

Knowledge About Continuous Positive Airway Pressure Machine Usage Among Nurses At A Tertiary Hospital In Tanzania, Wilson Paulo Lomnyack, Tumbwene Mwansisya, Stewart Mbelwa, Kahabi Isangula, Zephania Saitabau Abraham

School of Nursing & Midwifery, East Africa

Introduction: Continuous Positive Airway Pressure (CPAP) provides an air pressure that maintains the patency of the airway in patients with a variety of breathing problems. Nurses provide the hour to hour management of patients who require CPAP. The aim of this study was to assess the knowledge of nurses about CPAP machine usage at the tertiary hospital in Tanzania which serves the largest number of patients who require CPAP.

Method: A hospital-based descriptive cross-sectional study was carried out from March to June 2019 at Muhimbili National Hospital (MNH) and Jakaya Kikwete Cardiac Institute (JKCI) where 149 nurses who consented …

High Prevalence Of Pre-Existing Serological Cross-Reactivity Against Severe Acute Respiratory Syndrome Coronavirus-2 (Sars-Cov-2) In Sub-Saharan Africa, For Yue Tso, Salum J. Lidenge, Phoebe B. Peña, Ashley A. Clegg, John R. Ngowi, Julius Mwaiselage, Owen Ngalamika, Peter Julius, John T. West, Charles Wood

Nebraska Center for Virology: Faculty Publications

Objective: Significant morbidity and mortality have occurred in the USA, Europe, and Asia due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), whereas the numbers of infections and deaths in sub-Saharan Africa (SSA) have remained comparatively low. It has been hypothesized that exposure of the population in SSA to other coronaviruses prior to the COVID-19 pandemic resulted in some degree of cross-protection against SARS-CoV-2 infection and pathogenesis. We evaluated this hypothesis by comparing SARS-CoV-2 cross-reactive antibodies in pre-pandemic plasma samples collected from SSA and the USA.

Method: Pre-COVID-19 pandemic plasma samples from SSA and the USA were collected and tested by …

The Impact Of Introducing Ambulance And Delivery Fees In A Rural Hospital In Tanzania, Corinna Vossius, Estomih Mduma, Robert Moshiro, Paschal Mdoe, Jan Terje Kvaløy, Hussein Kidanto, Sara Lyanga, Hege Ersdal

Faculty of Health Sciences, East Africa

Background Access to health care facilities is a key requirement to enhance safety for mothers and newborns during labour and delivery. Haydom Lutheran Hospital (HLH) is a regional hospital in rural Tanzania with a catchment area of about two million inhabitants. Up to June 2013 ambulance transport and delivery at HLH were free of charge, while a user fee for both services was introduced from January 2014. We aimed to explore the impact of introducing user fees on the population of women giving birth at HLH in order to document potentially unwanted consequences in the period after introduction of fees. …