Digital Commons Network^™

Secondhand Smoke Exposure Is Independently Associated With Stroke Among Non-Smoking Adults In West Africa., Akinkunmi Paul Okekunle, Osahon Jeffery Asowata, Adekunle G. Fakunle, Onoja Matthew Akpa, Fred S. Sarfo, Albert Akpalu, Kolawole Wahab, Reginald Obiako, Morenikeji Komolafe, Philip Adebayo

Internal Medicine, East Africa

Background: Stroke is a leading cause of disability and mortality worldwide, but little is known about the contribution of secondhand smoke exposure (SHSE) to stroke epidemiology among indigenous Africans.

Objective: To evaluate the association of SHSE with stroke among indigenous Africans. Methods We analyzed the relationship of SHSE with stroke among 2990 case-control pairs of adults who had never smoked (identified in the SIREN study) using conditional logistic regression at a two-sided P < 0.05.

Results: Multivariable-adjusted odds ratio and 95% confidence interval; 1.25 (1.04, 1.50; P = 0.02) revealed SHSE was positively associated with stroke independent of stroke subtypes.

Conclusion: …

In-School Adolescents’ Loneliness, Social Support, And Suicidal Ideation In Sub-Saharan Africa: Leveraging Global School Health Data To Advance Mental Health Focus In The Region, Richard Gyan Aboagye, Bright Opoku Ahinkorah, Abdul-Aziz Seidu, Joshua Okyere, James Boadu Frimpong, Manasi Kumar

Brain and Mind Institute

Introduction: Adolescent and youth mental health problems are increasingly becoming an area of concern in global health. Young people in sub-Saharan Africa experience significant adversities and systemic challenges despite technological advancements and demographic transition that the region is experiencing. We examined the nexus between experiences of loneliness, low social support, and presence of suicidal ideation among in-school adolescents in sub-Saharan Africa.

Method: A total of 19,119 in-school adolescents from eight countries in sub-Saharan Africa were included in this study. Suicidal ideation was the main outcome variable and loneliness, and social support were the explanatory variables. Percentages were used to summarise …

Prevalence And Sociodemographic Profiles Of Grand Multipara In Abu Dhabi, United Arab Emirates, Zainab Taha, Farid El Ktaibi, Aysha Ibrahim Al Dhaheri, Dimitrios Papandreou, Ahmed Ali Hassan

All Works

The literature shows that grand multipara mothers are major contributors to poor maternal and perinatal health compared to multipara mothers. Data regarding parity profiles are essential, especially in rapidly transforming countries such as the United Arab Emirates (UAE). This study aimed to investigate the prevalence and factors associated with multipara mothers compared to multipara mothers in Abu Dhabi, UAE. The data were collected from seven health care centers located in Abu Dhabi.From1818 enrolled mothers, the prevalence of grand multipara was 135(7.4%, 95% Confidence Interval (CI) = 7.2, 7.6). In logistic regression analysis, factors associated positively with grand multipara were a …

Inspire : Vol 5, Issue 9, Department Of Medicine

INSPIRE – Department of Medicine Archives

• Message from the Chair
• Medicine at National and International Forums
• AKU – Flood Relief Task force
• DoM Grand Rounds – Dr Tazeen Jafar
• 2nd AKU Inter-professional certificate course in liver disease
• In-depth featuring Assistant Professor Endocrinology section Dr Sarah Nadeem
• Poem Section
• What are Academics Around the World Reading This Month?
• Publications

Diagnostic Challenge Of Perimenopause Molar Pregnancy In A 52-Year-Old Lady: Case Report, Willbroad Kyejo, Davis Rubagumya, Gregory Ntiyakuze, Nancy Matillya, Munawar Kaguta, Miriam Mgonja, Lynn Moshi

Family Medicine, East Africa

Introduction and importance: Gestational trophoblastic disease is an uncommon group of pregnancy-related dis- orders, with a course of trophoblastic proliferation, including hydatidiform mole (Agha et al., 2020), invasive and metastatic mole, choriocarcinoma, placental-site trophoblastic tumor, and epithelial trophoblastic tumor. Choriocarcinoma and trophoblastic tumor of the placenta are the most important tumors associated with pregnancy.

Case findings: A 52-year-old woman Para 2 Living 3, 3 years post-menopausal presented with prolong per vaginal bleeding for five weeks accompanied by lower abdominal pain. Diagnosis of gestational trophoblastic disease (choriocarcinoma type) was made by using beta HCG, radiology, and histology report. Patient underwent total …

Capacity Building Among Nursing And Midwifery Professional Associations In East Africa, Stephen Ruhmel, Eunice Ndirangu, Joseph Mwizerwa, Ahmed Sarki, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Background: Despite improvements in educational opportunities, policy changes, and pay raises in the nursing and midwifery professions in East Africa, poor working conditions, few professional development opportunities, and a general lack of respect for these professions predominate. These issues contribute to a low quality of care among a population with a high burden of communicable diseases. Health professional associations may help to address these challenges by providing a voice for nurses and midwives.

Objective: This study evaluated the impact of a 5-year programme focused on strengthening nurses’ and midwives’ professional associations in East Africa. Methods: This study used …

Urinary Schistosomiasis And Its Potential For Cancer And Hepato-Renal Function Alterations Among The Residents Of Asejire Dam, South-Western Nigeria, Omowumi O. Adewale, Monsurat O. Odebode, Maryam O. Mustapha, Oluwatosin A. Adetuyi, Monsuru A. Adeleke

Tanzania Journal of Science

Urinary schistosomiasis is of public health significance in sub-Saharan Africa with its prevalence being linked to carcinogenesis. However, there is a paucity of data to support this relationship. This study explored the prevalence and intensity of Schistosoma haematobium infections and its associations with cancer and hepatorenal function alterations in villages along the Asejire dam in the State of Osun, Nigeria. Urine samples from 152 consented participants (aged 18–75 years) from four communities were collected and examined for Schistosoma haematobium using the microscopy method. The blood serum of randomly selected infected and non-infected individuals (10 per group) was screened for tumor, …

“Do Not Detach The Placenta From My Baby's Cord” - Lotus Birth Case Series From Tanzania Tertiary Hospital, Willbroad Kyejo, Davis Rubagumya, Christian Mwalo, Lynn Moshi, Munawar Kaguta, Miriam Mgonja, Shweta Jaiswal

Family Medicine, East Africa

Introduction: Lotus birth is seldom practiced, with its prevalence being not well documented. There is no clear existing guideline or pathway for this practice. Safety in delivery as well as caring for newborn and her mother is of paramount importance. Hence, clarity for Lotus delivery in any set up is indispensable.

Cases findings: We have described on case series approach to women who opted to delivery without detachment of placenta. We have described delivery characteristics, neonatal clinical course, cord, and placenta manage- ment. In year 2022 at our center, we have received two cases of lotus delivery.

Conclusion and …

Pregnancy Following Robot-Assisted Laparoscopic Bilateral Endometriotic Cystectomy Rare Case Report Of Endometriosis Stage Iv, Willbroad Kyejo, Ally Zain Ismail, Brenda Moshi, Gregory Ntiyakunze, Nancy Matillya, Munawar Kaguta

Family Medicine, East Africa

Introduction and importance: Endometriosis is a common cause of infertility in women. In this case report we explain successful conception in deep-infiltrating ovarian endometriosis following robot-assisted surgery and androgenic agonist treatment.

Case presentation: A 38-year-old current Para 2, Living 2 presented 8 years ago with chronic lower abdominal pain, dysmenorrhea, and delayed conception. Advance endometriosis was highly suspected from the history and examination. Robot-assisted laparoscopic partial cystectomy was performed for the deep-infiltrating ovarian endometriosis. She was then discharged with postoperative androgenic agonists and with timed intercourse, she got pregnant within 9 months.

Clinical discussion: Advanced endometriosis (Stage III or …

Factors Shaping Good And Poor Nurse-Client Relationships In Maternal And Child Care: A Qualitative Study In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Columba Mbekenga, Eunice Ndirangu, Constance Shumba

School of Nursing & Midwifery, East Africa

Background: Evidence indicates that poor nurse‐client relationships within maternal and child health (MCH) continues to impact trust in formal healthcare systems, service uptake, continuity with care and MCH outcomes. This necessitates contextualized innovative solutions that places both nurses and clients at the forefront as agents of change in optimizing intervention designs and implementation. This study explored nurses and clients’ perspectives on the factors shaping nurse‐client relationships in MCH care to generate evidence to guide subsequent steps of human centered design (HCD) that involve designing effective strategies for improving therapeutic relationships in Shinyanga, Tanzania.

Methods: Qualitative descriptive design was …

Unit Knowledge And Practice Of Emergency Nursing Interventions At A Tertiary Public Cardiac Health Center In Uganda, Harriet Namukwaya, Cliff Asher Aliga, Grace Nakate, Judith Mutyabule

School of Nursing & Midwifery, East Africa

Background: Research suggests that many of the millions of deaths and long-term disabilities resulting from acute cardiovascular events and other emergency conditions are preventable if effective emergency care services were readily available. Effective emergency care requires trained and competent staff, including registered nurses. Most educational pathways do not adequately prepare nurses to deliver sensitive health care services for those with acute illness and injury. This includes Uganda, where few capacity-building initiatives have targeted emergency nursing care delivery, leading to knowledge and practice gaps.

Purpose: This study aimed to assess emergency nursing knowledge and clinical practice at a tertiary …

Structural Elucidation And Toxicity Evaluation Of Bioactive Compounds From The Leaves And Stem Woods Of Synadenium Glaucescens Pax., David Credo, Faith Philemon Mabiki, Francis Machumi, Claus Cornett

Pharmaceutical Sciences and Research

The leaves and stem woods of Synadenium glaucescens Pax. are traditionally used for treatment of various human diseases in Tanzania. However, there is limited information on the structural elucidation and toxicity properties of bioactive compounds responsible for their pharmacological properties. Thus, this study was aimed to elucidate and evaluate toxicity properties of bioactive compounds from these parts. Separation of bioactive compounds was achieved by using column chromatographic method, whereas their structures were determined by GC-MS and NMR data and by comparing with literature spectroscopic data. Toxicity properties of isolated compounds was done by brine shrimp lethality test (BSLT) method. In …

Factors That Influence Individual And Community Behavioural Change Regarding Environmental Health, Obadia Kyetuza Bishoge, Ademola Kabir Aremu, Dickson Dare Ajayi, Sayoki Godfrey Mfinanga

Journal of Health Research

Background: Increased environmental health problems have led to a rise in concern among individuals, as well as government and non-governmental organizations to tackle them. To achieve this, there is a need for behavioural change among individuals and the community on environmental health at local to international levels. The purpose of this paper is to critically explore the factors that influence personal and community behavioural change regarding environmental health.

Method: The study is a systematic review of the literature on the factors that influence personal behavioural change regarding environmental health based on the relevant studies published between 2005 and 2020. We …

Bilateral Tubal Ectopic Gestation: Complication In A Patient With Previous Ectopic Pregnancy, Rare Case Report, Willbroad Kyejo, Davis Rubagumya, Zainab Fidaali, Ahmed Jusabani, Munawar Kaguta, Shweta Jaiswal

Family Medicine, East Africa

Introduction: Ectopic pregnancy results of implantation of conceptus outside of endometrial cavity. It remains an important cause of maternal mortality. Spontaneous bilateral tubal pregnancies are the rare form of ectopic and are considered spontaneous when no fertility treatments are involved. Case findings: A 31-year-old nulliparous woman presented at the Family Medicine Clinic with complaints of non- specific mild lower abdominal pain for 3 days and amenorrhea for 5 weeks. Transvaginal Ultrasound showed bilateral unruptured adnexa pregnancies. The trial of medical therapy was done without success and later lap- arotomy salpingostomy was done. One year later patient was able to …

The Influence Of Tai Chi Intervention On Inhibitory Function Of African College Students, Tongtong Guo, Jian Yang

International Journal of Physical Activity and Health

Inhibitory function is the core sub-function of executive function, which is mainly aimed at inhibiting the current dominant response in the cognitive process. It is embodied in the control of preventing the activation of irrelevant information, disturbing the irrelevant information, and the dominant reaction in the process. However, little research has examined the impact of Tai Chi on inhibitory function among native African students. The major purpose of this study was to conduct an experimental study on the inhibitory function of African college students through Tai Chi intervention, and to explore the non-Tai Chi local country students’ changes in the …

Lower Sars-Cov-2 Seroprevalence Among Cancer Patients In Sub-Saharan Africa, For Yue Tso, Salum J. Lidenge, John R. Ngowi, Phoebe B. Peña, Ashley A. Clegg, Owen Ngalamika, Chacha J. Mwita, Julius Mwaiselage, Charles Wood

School of Medicine Faculty Publications

Background: Despite the high COVID-19 morbidity and mortality rates across the world, the reported rates in sub-Saharan Africa (SSA), which has a higher burden of other infectious diseases and overwhelmed healthcare systems, remain relatively low. This study aims to better understand the potential factors that contribute to this phenomenon, especially among cancer patients who are considered as a high-risk group for developing severe COVID-19. Methods: Plasma samples collected during the COVID-19 pandemic from SARS-CoV-2 unvaccinated cancer and potential blood donor populations were analyzed for SARS-CoV-2 (spike and nucleocapsid proteins) antibodies by an immunofluorescence assay. The relationships between SARS-CoV-2 seroprevalences and …

A Cross-Sectional Study Of Self-Perceived Educational Needs Of Emergency Nurses In Two Tertiary Hospitals In Nairobi, Kenya, Anthony Ndung’U, Eunice Ndirangu, Ahmed Sarki, Lilian Isiaho

School of Nursing & Midwifery, East Africa

Background: Many low- and middle-income countries lack resources for well-functioning emergency care systems. Emer- gency nurses interact with injured and critically ill patients as the first contact in many health care settings. However, insuffi- cient training limits nurses from providing ideal emergency care. The purpose of this research was to highlight educational needs specific to nurses working in 2 emergency departments in Nairobi, Kenya.

Methods: A descriptive cross-sectional study involving emer- gency units of 2 of the largest referral and teaching hospitals (Aga Khan University Hospital, Nairobi, and Kenyatta National Hospital) in Nairobi, Kenya, was conducted. Data were …

Child Disability And Family-Centred Care In East Africa: Perspectives From A Workshop With Stakeholders And Health Practitioners, Pauline Samia, Susan Wamithi, Amina Kassam, Melissa Tirkha, Edward Kija, Ayalew Moges, Arnab Seal, Peter Rosenbaum, Robert Armstrong

Paediatrics and Child Health, East Africa

Background: Our understanding of child disability has undergone major changes over the last three decades transforming our approach to assessment and management. Globally there are significant gaps in the application of these 21st century models of care. There is recognition that economic, cultural, and social factors influence transitions in care and there is need to consider contextual factors.

Objectives: A two-day workshop brought together key stakeholders to discuss current models of care and their application in the East African context. This article summarises workshop proceedings and identifies a broadly supported set of recommendations that serve to set a …

Identification And Larvicidal Efficacy Of Mosquito-Repelling Plants Used In Malaria Vector Control In South-East Benin, Camille O Tante, Armel Djenontin, Saïd Chitou, Wilfried Sewade, Pierre Agbani, Martin Akogbeto, Daniel C Chougourou

Tanzania Journal of Science

After identifying issues posed by some synthetic insecticides, the scientific community is now looking for other natural products with insecticidal and/or insect repellent characteristics. This study aimed to identify the plants of the Beninese flora known for their insecticidal and/or insect repellent effects and the indigenous techniques of their use and to evaluate the combined efficacy of extracts of a few on mosquito larvae for the control of malaria vectors in the South-East of Benin. A survey was conducted and the insecticidal effects of three combinations made from Azadirachta indica, Cymbopogon nardus and Hyptis suaveolens oils on Anopheles gambiae larvae …

Determination Of Factors That Contribute To The Prevalence Of Diarrhoea Among Children Under Five Years Of Age In Association With The Status Of Drinking Water Sources At Bububu, Zanzibar, Wahida M. Ali, Emmanuel S. Kigadye

Tanzania Journal of Science

This study aimed to determine the contributing factors for diarrhoea prevalence among children under-five years at Bububu, Zanzibar. The study applied a cross-sectional research design that used quantitative methods. Data were collected from 97 mothers/caregivers of the children. Structured questionnaires were used for assessing socio-economic factors contributing to diarrhoea. Laboratory experiments were carried out to assess the quality of drinking water sources. Most Probable Number (MPN) count per 100 ml was measured from drinking water sources. Multivariate logistic analysis was computed to assess independent factors of childhood diarrhoea. The prevalence of diarrhoea was significantly associated with; the caregiver’s level of …

Machine Learning Approach For Cardiovascular Risk And Coronary Artery Calcification Score, C. R. Aditya, Naveen C. Sattaru, Kumaraguruparan Gopal, R. Rahul, G. Chandra Shekara, Omaima Nasif, Sulaiman Ali Alharbi, S.S. Raghavan, S. Arockia Jayadhas

School of Medical and Biological Sciences Faculty Publications and Presentations

Coronary artery calcification (CAC) could assist in the discovery of new risk elements for coronary artery disorder. CAC evaluation, on the other hand, is difficult due to the wide range of CAC in the populations. As a reason, evaluating and analysing data among research have become complicated. In the Research of Inherited Risk Factors for Coronary Atherosclerosis, we used CAC information to test the effects of different analytical methodologies on the correlation with recognized cardiovascular risk elements in asymptomatic patients. Cardiac computed tomography (CT) is also seeing an increase in examinations, and machine learning (ML) could assist with the growing …

Prevalence & Factors Associated With Acute Kidney Injury In Patients Undergoing Percutaneous Coronary Intervention At A Tertiary Healthcare Facility In Tanzania, Faisal Hooda

Master of Medicine in Internal Medicine

Background: Acute kidney injury is a potentially fatal but preventable outcome of percutaneous coronary intervention: the most plausible cause being radiocontrast-induced nephropathy; others include: pre-existing renal insufficiency from underlying illnesses and also acute renal insult caused by hypoperfusion from cardiac causes. The prevalence, associated risk factors and outcomes of AKI post-PCI are unclear and unexplored in our setting. Objectives: The study sought to determine the prevalence of acute kidney injury post-percutaneous coronary intervention at The Aga Khan Hospital, Dar es Salaam, Tanzania. Secondary objectives included: factors associated, with and outcomes of acute kidney injury (AKI) post percutaneous coronary intervention (PCI). …

Epilepsy Research In Africa: A Scoping Review By The Ilae Pediatric Commission Research Advocacy Task Force, Pauline Samia, Jane Hassell, Jessica Hudson, Azim Ahmed, Jasmit Shah, Charles Hammond, Edward Kija, Stéphane Auvin, Jo Wilmshurst

Paediatrics and Child Health, East Africa

Objective: Despite the high prevalence of epilepsy in Africa, evaluation of epi- lepsy research trends on the continent is lacking. Without establishing effective research, improvement in care for people with epilepsy cannot be effectively strategized or targeted.

Methods: A scoping review of the peer-reviewed literature on epilepsy from Africa (1989–2019) was conducted. The aim was to understand from this what areas are well researched versus underresearched based on published epilepsy topics.

Results: A total of 1227 publications were identified and assessed. A significant increase in publications occurred over the 30 years assessed. African author lead- ership was …

Authorship Representation In Global Emergency Medicine: A Bibliometric Analysis From 2016 To 2020, Stephanie Chow Garbern, Gimbo Hyuha, Catalina González Marqués, Noor Baig, Jennifer L. Chan, Sanjukta Dutta, Masuma A. Gulamhussein, Gloria Paulina López Terán, Hussein Karim Manji, Benjamin Wachira

Emergency Medicine, East Africa

Introduction: High-income country (HIC) authors are disproportionately represented in authorship bylines compared with those affiliated with low and middle-income countries (LMICs) in global health research. An assessment of authorship representation in the global emergency medicine (GEM) literature is lacking but may inform equitable academic collaborations in this relatively new field.

Methods: We conducted a bibliometric analysis of original research articles reporting studies conducted in LMICs from the annual GEM Literature Review from 2016 to 2020. Data extracted included study topic, journal, study country(s) and region, country income classification, author order, country(s) of authors' affiliations and funding sources. We compared the …

Shortness Of Breath In A Young Lady, Rare Case Report Of Thoracic Endometriosis, Willbroad Kyejo, Ally Zain Ismail, Davis Rubagumya, Rahma Bakari, Munawar Kaguta, Nancy Matillya

Family Medicine, East Africa

Introduction and importance: Endometrial glandular tissue can implant in the thorax of women suffering from endometriosis. The clinical presentation is depends on site of implantation. Complications include pneumothorax, pneumohemothorax or hemothorax.

Case presentation: A 31 year old woman with history of infertility presented with shortness of breath and was found to have a significant right sided pneumohemothorax. Drainage was done followed by chemical pleurodesis using bleomycin with resolution of symptoms on her follow up.

Clinical discussion: Thoracic endometriosis tend to present with chronic or sub-acute symptoms which are nonspecific symptoms leading to late diagnosis. Video Assisted Thoracoscopic surgery offer both …

Fetal Movement Trials: Where Is The Evidence In Settings With A High Burden Of Stillbirths?, Natasha Housseine, Joyce Browne, Nanna Maaløe, Brenda Sequeira Dmello, Sam Ali, Muzdalfat Abeid, Tarek Meguid, Marcus J. Rijken, Hussein Kidanto

Obstetrics and Gynaecology, East Africa

No abstract provided.

The Impact Of Training On Self-Reported Performance In Reproductive, Maternal, And Newborn Health Service Delivery Among Healthcare Workers In Tanzania: A Baseline- And Endline-Survey, Tumbwene Mwansisya, Columba Mbekenga, Kahabi Isangula, Loveluck Mwasha, Stewart Mbelwa, Mary Lyimo, Lucy Kisaka, Victor Mathias, Eunice Pallangyo, Grace Edwards, Michaela Mantel, Sisawo Konteh, Thomas Rutachunzibwa, Marleen Temmerman

School of Nursing & Midwifery, East Africa

Background: Delivery of quality reproductive health services has been documented to depend on the availability of healthcare workers who are adequately supported with appropriate training. However, unmet training needs among healthcare workers in reproductive, maternal, and newborn health (RMNH) in low-income countries remain disproportionately high. This study investigated the effectiveness of training with onsite clinical mentorship towards self-reported performance in RMNH among healthcare workers in Mwanza Region, Tanzania.

Methods: The study used a quasi-experimental design with pre-and post-intervention evaluation strategy. The baseline was compared with two endline groups: those with intervention (training and onsite mentorship) and those without. The differences …

Interventions For Prevention Of Non-Communicable Diseases Among Adolescents Living With Hiv: A Systematic Review, Eunice Ndirangu, Constance Shumba, Peter Gatiti, Bernard Mutwiri, Amina Abubakar

School of Nursing & Midwifery, East Africa

While the uptake of antiretroviral drugs has rapidly expanded among adolescents and adults living with HIV, research evidence suggests that people living with HIV have a higher risk of non-communicable diseases (NCDs). With more than 35% of the global burden of NCDs stemming from adolescence, there is a need to comprehend the existing evidence on early prevention, detection, and disease management, especially among the at-risk population. In line with the WHO Global Action Plan, 2013–2020 and “Best Buys”, recommendations on practical interventions for NCDs prevention, this systematic review seeks to synthesise evidence on the current interventions for preventing NCDs among …

What Motivates The Choice Of Specialty Among Medical Doctors In Tanzania, Thabit Ramadhani

Master of Surgery

Background: Studies have shown there is a low specialist workforce, coupled with wide range of disparity among different specialities in the country to cater for the needs of more than 54 million Tanzanians. The theories of motivation and development have shown many theories influencing choices made by people in life. Objectives: This study aims to assess the motivation for choice of specialty among medical doctors (including registrars, residents, and specialists) in Dar es Salaam, Tanzania. Methods: A descriptive cross-sectional study was conducted at Muhimbili University of Health and Allied Sciences, Muhimbili National hospital, and the Aga Khan University Hospital Dar …

Validation Of The Kiswahili Version Of The Migraine Disability Assessment Scale In Dar Es Salaam, Tanzania, Aliasger Nagri

Master of Internal Medicine

Background: Migraine is a chronic paroxysmal neurological disorder characterized by multiphase attacks of head pain and many neurological symptoms. The MIDAS is a five (5) question-based questionnaire used in clinical practices to identify the disability caused by migraine at work, school, household or social life; with a score indicating little or no disability (0-5), mild disability (6-10), moderate disability (11-20), and severe disability (21+). Translated versions of the MIDAS scale in a number of languages has been validated. Translating and validating the Kiswahili version of the MIDAS questionnaire is essential and needed to ensure its comparability to the original English …