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Barriers To Timely Disclosure Of Hiv Serostatus: A Qualitative Study At Care And Treatment Centres In Dar Es Salaam, Tanzania, Neelam Akber Ismail Jan 2020

Barriers To Timely Disclosure Of Hiv Serostatus: A Qualitative Study At Care And Treatment Centres In Dar Es Salaam, Tanzania, Neelam Akber Ismail

Master of Family Medicine

Introduction: Disclosure of HIV status is important for HIV prevention and maintenance of health for People living with HIV (PLWHIV), their spouses and the community. Despite the benefits of disclosure, there are PLWHIV who delay in disclosing their status thus increasing the risk of transmission of the disease. Objective: This study aimed at determining the barriers to timely disclosure of HIV serostatus among HIV seropositive individuals in Dar es Salaam and what motivated them to disclose. Methods: A qualitative descriptive study using in depth individual interviews was conducted. Ten participants attending the care and treatment centres took part. Qualitative content …


Lack Of Cd8+ T-Cell Co-Localization With Kaposi’S Sarcoma- Associated Herpesvirus Infected Cells In Kaposi’S Sarcoma Tumors, Salum J. Lidenge, For Yue Tso, Owen Ngalamika, Jaydeep Kolape, John R. Ngowi, Julius Mwaiselage, Charles Wood, John T. West Jan 2020

Lack Of Cd8+ T-Cell Co-Localization With Kaposi’S Sarcoma- Associated Herpesvirus Infected Cells In Kaposi’S Sarcoma Tumors, Salum J. Lidenge, For Yue Tso, Owen Ngalamika, Jaydeep Kolape, John R. Ngowi, Julius Mwaiselage, Charles Wood, John T. West

Nebraska Center for Virology: Faculty Publications

Despite the close association between Kaposi’s sarcoma (KS) and immune dysfunction, it remains unclear whether tumor infiltrating immune cells (TIIC), by their absence, presence, or dysfunction, are mechanistically correlated with KS pathogenesis. Therefore, their potential capacity to serve as prognostic biomarkers of KS disease progression or control is unclear. Because epidemic-KS (EpKS) occurs with HIV-1 co-infection, it is particularly important to compare TIIC between EpKS and HIV-negative African endemic-KS (EnKS) to dissect the roles of HIV-1 and Kaposi Sarcoma-associated herpesvirus (KSHV) in KS pathogenesis. This cross-sectional study of 13 advanced KS (4 EnKS, 9 EpKS) patients and 3 healthy controls …


Prevalence Of Kaposi's Sarcoma-Associated Herpesvirus And Transfusion-Transmissible Infections In Tanzanian Blood Donors, Salum J. Lidenge, Tara Tran, For Yue Tso, John R. Ngowi, Danielle M. Shea, Julius Mwaiselage, Charles Wood, John T. West Jan 2020

Prevalence Of Kaposi's Sarcoma-Associated Herpesvirus And Transfusion-Transmissible Infections In Tanzanian Blood Donors, Salum J. Lidenge, Tara Tran, For Yue Tso, John R. Ngowi, Danielle M. Shea, Julius Mwaiselage, Charles Wood, John T. West

Nebraska Center for Virology: Faculty Publications

Objective: Kaposi's sarcoma-associated herpesvirus (KSHV) is the causative agent for Kaposi's sarcoma (KS), one of the most common cancers in Tanzania. We have investigated KSHV prevalence and factors associated with KSHV infection in Tanzania.

Methods: This is a cross-sectional study of voluntary blood-donors from Dar es Salaam, Tanzania. Plasma was screened for KSHV, HIV-1, HBV, HCV and Treponema pallidum (syphilis). Associations between KSHV sero-status and risk factors were analyzed. Odds ratios (OR) and 95% confidence intervals (CI) are reported to evaluate risk factors of KSHV infection. All tests were 2-tailed, and P-values <0.05 were considered statistically significant.

Results: The overall KSHV seroprevalence was 56.9%. Significantly …


Viral And Immunological Analytes Are Poor Predictors Of The Clinical Treatment Response In Kaposi’S Sarcoma Patients, Salum J. Lidenge, For Yue Tso, Yasaman Mortazavi, John R. Ngowi, Danielle M. Shea, Julius Mwaiselage, Charles Wood, John T. West Jan 2020

Viral And Immunological Analytes Are Poor Predictors Of The Clinical Treatment Response In Kaposi’S Sarcoma Patients, Salum J. Lidenge, For Yue Tso, Yasaman Mortazavi, John R. Ngowi, Danielle M. Shea, Julius Mwaiselage, Charles Wood, John T. West

Nebraska Center for Virology: Faculty Publications

Kaposi’s sarcoma-associated herpes virus (KSHV) is the etiologic agent for Kaposi’s sarcoma (KS). The prognostic utility of KSHV and HIV-1 (human immunodeficiency virus) viremia as well as immunological parameters in clinical management of participants with KS is unclear. The objective of this study was to investigate viral and immunological parameters as predictors of KS treatment responses in participants with KS from sub-Saharan Africa (SSA). Plasma KSHV-DNA, HIV-1 viral load, total anti-KSHV antibody, KSHV-neutralizing antibody (nAb), cytokine/chemokine levels, and T-cell differentiation subsets were quantified before and after KS treatment in 13 participants with KS and in 13 KSHV-infected asymptomatic control individuals. …


Revisiting Caroli Syndrome In A Tanzanian Patient, Casmir Wambura, Munish Sharma, Salim Surani Jan 2020

Revisiting Caroli Syndrome In A Tanzanian Patient, Casmir Wambura, Munish Sharma, Salim Surani

Internal Medicine, East Africa

Caroli disease and Caroli syndrome are two rare congenital diseases of the intrahepatic bile ducts. Caroli syndrome is characterized by the saccular dilatation of intrahepatic bile ducts associated with congenital hepatic fibrosis. It is rarely diagnosed in childhood. We hereby describe a case of Caroli syndrome in a young Tanzanian female who had abdominal pain and distension since childhood. Her history suggested the presence of portal hypertension possibly from congenital hepatic fibrosis. The diagnosis was reached based on ultrasound, computed tomography (CT) scan of the abdomen, and magnetic resonance cholangiopancreatography (MRCP)


Understanding Male Perpetrated Intimate Partner Violence And Women’S Demands For Condom Use, Linda Musu Edwards Jan 2020

Understanding Male Perpetrated Intimate Partner Violence And Women’S Demands For Condom Use, Linda Musu Edwards

Walden Dissertations and Doctoral Studies

Sub-Saharan Africa is host to more than 70% (25.5 million) of people with HIV/AIDS. More than half of the reported cases of people living with HIV/AIDS are women who are twice as likely to contract HIV than males in sub-Saharan Africa. The purpose of this study guided by the Theory of Planned Behavior was to determine if a relationship between female demands for male partner condom use and male perpetrated intimate partner violence (MPIPV) in opposite sex cohabitating or married couples, as well as examine the relationship between the risk factors of age, education level, socioeconomic status, history of MPIPV, …


The Coulter Principle: For The Good Of Humankind, Marshall Graham Jan 2020

The Coulter Principle: For The Good Of Humankind, Marshall Graham

Theses and Dissertations--History

The atomic bombings of Hiroshima and Nagasaki in August 1945 made Wallace H. Coulter abruptly comprehend the critical need for rapid and accurate blood-cell counts in providing care for victims of radiation exposure. This thesis documents the unwritten story of his journey from that comprehension through his invention and implementation of the Coulter Principle, its commercialization in the first widely available automated blood-cell counter, and elaboration of that ground-breaking counter into increasingly sophisticated instrumentation for analysis not only of blood cells, but of particles involved in many other scientific disciplines. International cold-war politics and the burgeoning of increasingly powerful nuclear …


Prevalence And Factors Associated To Incidental Prostate Carcinoma Among Patients Undergoing Turp For Benign Prostatic Enlargement., Isaac Herman Mawalla Jan 2020

Prevalence And Factors Associated To Incidental Prostate Carcinoma Among Patients Undergoing Turp For Benign Prostatic Enlargement., Isaac Herman Mawalla

Master of Medicine in General Surgery

Background: Prostate carcinoma carries higher morbidity and mortality when diagnosed late. Prostate cancer screening is paramount, however, there are no specific clinical signs for early-stage prostate cancer. As an independent variable, prostate-specific antigen is an established predictor of cancer. Incidental prostate cancer is detected by histological examination of resected biopsy tissue that had been previously diagnosed as benign. In the current PSA-use era the prevalence of incidental prostate cancer ranges from 1.4 to 13%. The prevalence in Tanzania as published by Gunda et al was 21.71%. This is alarmingly high. However, in his study, patients with high prostate-specific antigens were …


Perceptions Of Surgeons On Surgical Antibiotic Prophylaxis Use At Aga Khan Hospital, Dar Es Salaam., Elizabeth Elibariki Mmari Jan 2020

Perceptions Of Surgeons On Surgical Antibiotic Prophylaxis Use At Aga Khan Hospital, Dar Es Salaam., Elizabeth Elibariki Mmari

Master of Medicine in General Surgery

Introduction: Surgical site infections are a major cause of morbidity and mortality among operated patients. The use of antibiotic prophylaxis in prevention and reduction of incidence of surgical site infection is widespread. 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 medications 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 …


Correlates Of Poor Medication Adherence In Chronic Psychotic Disorders, Martha Sajatovic, Carol Blixen, Michelle E. Aebi, Betsy Wilson, Christopher J. Burant, Kristin A. Cassidy, Jennifer B. Levine Jan 2020

Correlates Of Poor Medication Adherence In Chronic Psychotic Disorders, Martha Sajatovic, Carol Blixen, Michelle E. Aebi, Betsy Wilson, Christopher J. Burant, Kristin A. Cassidy, Jennifer B. Levine

Faculty Scholarship

Background Chronic psychotic disorders (CPDs) occur worldwide and cause significant burden. Poor medication adherence is pervasive, but has not been well studied in sub-Saharan Africa. Aims This cross-sectional survey of 100 poorly adherent Tanzanian patients with CPD characterised clinical features associated with poor adherence. Method Descriptive statistics characterised demographic and clinical variables, including barriers to adherence, adherence behaviours and attitudes, and psychiatric symptoms. Measures included the Tablets Routine Questionnaire, Drug Attitudes Inventory, the Brief Psychiatric Rating Scale, the Clinical Global Impressions scale, the Alcohol Use Disorders Identification Test and Alcohol, Smoking and Substance Involvement Screening Test. The relationship between adherence …


Effect Of Unmaskes On Delivering Difficult News Among Residents, Karishma Sharma Jan 2020

Effect Of Unmaskes On Delivering Difficult News Among Residents, Karishma Sharma

Master of Medicine in Internal Medicine

Background: Effective delivery of difficult news to patients and family has been shown to improve the physician-patient relationship, quality of care, and overall patient satisfaction. However, delivery of difficult news (DDN) remains a challenging task for even the most experienced providers. Little has been studied about delivery of difficult news by resident physicians in the sub-Saharan setting. We developed a 4-minute, easily accessible, graphic video using the mnemonic UNMASKES to help improve delivery of difficult news by resident physicians at our institution and their patients. Objective: To determine the impact of a short training video called UNMASKES in helping resident …


Utility Of Glasgow-Blatchford Scoring System In Identification Of Low Risk Patients With Upper Gastrointestinal Bleeding In Emergency Departments In Dar Es Salaam Hospitals, Tanzania, Selestin D. Mpiri Jan 2020

Utility Of Glasgow-Blatchford Scoring System In Identification Of Low Risk Patients With Upper Gastrointestinal Bleeding In Emergency Departments In Dar Es Salaam Hospitals, Tanzania, Selestin D. Mpiri

Master of Medicine in Internal Medicine

Background: Acute upper gastrointestinal bleeding (UGIB) remains a common cause of visits to the Emergency Department (ED). To stratify the risk of complications, rebleeding, need for clinical intervention, or death, several clinical scores are in use. Glasgow-Blatchford Score (GBS) is an excellent risk assessment tool and has shown to accurately identify patients with a low risk of death or requiring intervention. In urban Tanzania, there is a lack of standardized protocol and a well-validated risk assessment tool for analyzing patients presenting with UGIB symptoms. Good performance of GBS score and its use will help to reduce unnecessary emergency endoscopies and …


Knowledge Of Inhaler Use Among Medical Officers In The Management Of Asthma In Children In Dar Es Salaam, Tanzania, Hannah Moore Jan 2020

Knowledge Of Inhaler Use Among Medical Officers In The Management Of Asthma In Children In Dar Es Salaam, Tanzania, Hannah Moore

Master of Medicine in Family Medicine

Background: The inhaled route is the preferred first line method for administration of asthma medication. It is however documented that oral and intravenous routes are the commonly adopted methods of administering asthma medication in children, and the knowledge of the use of inhalers and inhaler devices has not been well documented in middle and low-income countries. Knowledge of inhaler technique among medical personnel ensures effective education of its use to patients to provide the desired results in managing asthma in children. Studies in developing countries have demonstrated a generally low level of knowledge of inhaler use among Medical Doctors and …


Health Systems Predictors And Trends Of Access To Vaccinations In 9 Sub-Saharan African Countries, Mirfin Mpundu Jan 2020

Health Systems Predictors And Trends Of Access To Vaccinations In 9 Sub-Saharan African Countries, Mirfin Mpundu

Walden Dissertations and Doctoral Studies

The purpose of this ecological quantitative study was to examine the predictors of health systems building blocks and their interactions in improving access and uptake of immunizations in nine sub-Saharan African countries. Immunization rates in this region remain lower than global targets leading to preventable diseases and mortality. Using the systems approach, the study examined the relationships among five independent variables: quality of service delivery, governance, vaccine supply, health financing, socioeconomic factors and the dependent variable, access to immunizations. Datasets from the WHO and UNICEF were used. Analysis included a series of descriptive statistics, logistic and linear regression, and correlations. …


How The Cervical Microbiota Contributes To Cervical Cancer Risk In Sub-Saharan Africa, Cameron Klein, Crispin Kahesa, Julius Mwalselage, John T. West, Charles Wood, Peter C. Angeletti Jan 2020

How The Cervical Microbiota Contributes To Cervical Cancer Risk In Sub-Saharan Africa, Cameron Klein, Crispin Kahesa, Julius Mwalselage, John T. West, Charles Wood, Peter C. Angeletti

Nebraska Center for Virology: Faculty Publications

Despite ongoing efforts, sub-Saharan Africa faces a higher cervical cancer burden than anywhere else in the world. Besides HPV infection, definitive factors of cervical cancer are still unclear. Particular states of the cervicovaginal microbiota and viral infections are associated with increased cervical cancer risk. Notably, HIV infection, which is prevalent in sub-Saharan Africa, greatly increases risk of cervicovaginal dysbiosis and cervical cancer. To better understand and address cervical cancer in sub-Saharan Africa, a better knowledge of the regional cervicovaginal microbiome is required This review establishes current knowledge of HPV, HIV, cervicovaginal infections, and the cervicovaginal microbiota in sub-Saharan Africa. Because …


The Kaposi’S Sarcoma-Associated Herpesvirus (Kshv) Gh/Gl Complex Is The Predominant Neutralizing Antigenic Determinant In Kshv-Infected Individuals, Yasaman Mortazavi, Salum J. Lidenge, Tara Tran, John T. West, Charles Wood, For Yue Tso Jan 2020

The Kaposi’S Sarcoma-Associated Herpesvirus (Kshv) Gh/Gl Complex Is The Predominant Neutralizing Antigenic Determinant In Kshv-Infected Individuals, Yasaman Mortazavi, Salum J. Lidenge, Tara Tran, John T. West, Charles Wood, For Yue Tso

Nebraska Center for Virology: Faculty Publications

Kaposi’s sarcoma-associated herpesvirus (KSHV) is the etiological agent of Kaposi’s sarcoma (KS), one of the most prevalent cancers of people living with HIV/AIDS in sub-Saharan Africa. The seroprevalence for KSHV is high in the region, and no prophylactic vaccine against the virus is available. In this study, we characterized the antigenic targets of KSHV-specific neutralizing antibodies (nAbs) in asymptomatic KSHV-infected individuals and KS patients with high nAbs titers. We quantified the extent to which various KSHV envelope glycoproteins (gB, ORF28, ORF68, gH, gL, gM, gN and gpK8.1) adsorbed/removed KSHV-specific nAbs from the plasma of infected individuals. Our study revealed that …


Mycoplasma Co-Infection Is Associated With Cervical Cancer Risk, Cameron Klein, Kandali Samwel, Crispin Kahesa, Julius Mwaiselage, John T. West, Charles Wood, Peter C. Angeletti Jan 2020

Mycoplasma Co-Infection Is Associated With Cervical Cancer Risk, Cameron Klein, Kandali Samwel, Crispin Kahesa, Julius Mwaiselage, John T. West, Charles Wood, Peter C. Angeletti

Nebraska Center for Virology: Faculty Publications

Tanzania faces one of the highest cervical cancer burdens in the world. Recent work has suggested that the bacterial family Mycoplasmataceae is associated with higher levels of human papillomavirus (HPV), human immunodeficiency virus (HIV), and pre-cancerous cervical lesions. Mycoplasmataceae infection in Tanzania is not well understood, especially when considering the differences between sexually transmitted species of Mycoplasmataceae. To establish the prevalence of common Mycoplasmataceae cervical infections and evaluate their relationship with risk factors for cervical cancer, 1160 Tanzanian women responded to an epidemiological questionnaire and were tested for HIV, HPV, cervical lesions, Mycoplasma genitalium, Mycoplasma hominis, Ureaplasma spp., and Lactobacillus …


Prevalence Of Overweight/Obesity, Anaemia And Their Associations Among Female University Students In Dubai, United Arab Emirates: A Cross-Sectional Study, Haleama Al Sabbah Jan 2020

Prevalence Of Overweight/Obesity, Anaemia And Their Associations Among Female University Students In Dubai, United Arab Emirates: A Cross-Sectional Study, Haleama Al Sabbah

All Works

© The Author(s), 2020. Published by Cambridge University Press on behalf of The Nutrition Society. The present study assessed the associations of overweight, obesity and anaemia with selected lifestyle factors, total body fat and abdominal obesity among female university students in Dubai. A total of 251 female students from a national university in Dubai participated in the present study. Weight, height, waist circumference, Hb level and total body fat percentage were measured. Participants also completed a self-reported questionnaire that included items related to the factors of obesity, anaemia and lifestyle. The study was approved by the University Ethical Committee. Almost …


Histopathological Diagnosis Of Diseases Affecting Amphibians Inhabiting Kihansi Gorge, Tanzania, Joshua J Malago Dec 2019

Histopathological Diagnosis Of Diseases Affecting Amphibians Inhabiting Kihansi Gorge, Tanzania, Joshua J Malago

Tanzania Journal of Science

Kihansi gorge is a natural habitat to Kihansi spray toad (KST), Nectophrynoides asperginis. The toad is extinct in its natural habitat partly due to diseases. Efforts to successfully re-introduce it are primed by awareness and mitigation of prevalent diseases at the gorge. This study aimed at exploring the prevalent amphibian diseases at and around Kihansi gorge. A total of 182 individuals from Petropedetes yakusini (n = 60), Nectophrynoides tornieri (n = 60) and Leptopelis uluguruensis (n = 62) species were collected, humanely sacrificed, fixed in formalin, routinely processed, sectioned, stained with haematoxylin and eosin and analysed for diseases by histopathology. …


Chemical Composition And Behavioural Responses Of Male And Female Bactrocera Dorsalis To Their Volatile Emissions, Fikira Kimbokota Dec 2019

Chemical Composition And Behavioural Responses Of Male And Female Bactrocera Dorsalis To Their Volatile Emissions, Fikira Kimbokota

Journal of Humanities and Social Sciences

Bactrocera dorsalis, (Tephritidae) presented a grave threat to a broad range of fruit and vegetables in the tropics, including Tanzania. Bactrocera dorsalis is among the most destructive tephritid fruit fly, causing devastating loss of fruits especially mango. Insects use olfactory cues to locate hosts, oviposition sites and mating, in which pheromones are believed to be a strong cue used by insect to locate their mates. However, due to their high ability to adapt and occupy different ecological niches into various agroecological zones, there is a need to evaluate pheromonal composition from time to time to improve their control strategies. Therefore, …


Maternal Healthcare Services Use In Mwanza Region, Tanzania: A Cross-Sectional Baseline Survey, James Orwa, Michaela Mantel, Micheal Mugerwa,, Sharon Brownie, Eunice Pallangyo, Loveluck Mwasha, Kahabi Isangula, Leonard Subi, Secilia Mrema, Grace Edwards, David Siso, Edna Selestine, Tumbwene Mwansisya, Columba Mbekenga, Marleen Temmerman Dec 2019

Maternal Healthcare Services Use In Mwanza Region, Tanzania: A Cross-Sectional Baseline Survey, James Orwa, Michaela Mantel, Micheal Mugerwa,, Sharon Brownie, Eunice Pallangyo, Loveluck Mwasha, Kahabi Isangula, Leonard Subi, Secilia Mrema, Grace Edwards, David Siso, Edna Selestine, Tumbwene Mwansisya, Columba Mbekenga, Marleen Temmerman

Population Health, East Africa

Background: Improving maternal health by reducing maternal mortality/morbidity relates to Goal 3 of the Sustainable Development Goals. Achieving this goal is supported by antenatal care (ANC), health facility delivery, and postpartum care. This study aimed to understand levels of use and correlates of uptake of maternal healthcare services among women of reproductive age (15–49 years) in Mwanza Region, Tanzania.

Methods: A cross-sectional multi-stage sampling household survey was conducted to obtain data from 1476 households in six districts of Mwanza Region. Data for the 409 women who delivered in the 2 years before the survey were analyzed for three outcomes: four …


Identification Of The Kaposi's Sarcoma-Associated Herpesvirus (Kshv) Surface Glycoprotein Targets Of Human Kshv-Specific Neutralizing Antibody Responses, Yasaman Mortazavi Dec 2019

Identification Of The Kaposi's Sarcoma-Associated Herpesvirus (Kshv) Surface Glycoprotein Targets Of Human Kshv-Specific Neutralizing Antibody Responses, Yasaman Mortazavi

School of Biological Sciences: Dissertations, Theses, and Student Research

Kaposi’s sarcoma-associated herpesvirus (KSHV), also known as human herpesvirus 8 (HHV-8), is the etiological agent of Kaposi’s sarcoma (KS), and is also associated with two B cell malignancies, primary effusion lymphoma and multicentric Castleman's disease. The distribution of KSHV varies globally with high prevalence in some areas of sub-Saharan Africa (SSA), where seroprevalence can be as high as 80%. It is estimated that nearly 44,000 new cases of KS emerge annually globally, with the highest incidents occurring in Africa, where KSHV is endemic. Currently, there is no prophylactic vaccine against KSHV, and efforts to develop prophylactic vaccines have been limited. …


Ada News - 11/18/2019, American Dental Association, Publishing Division Nov 2019

Ada News - 11/18/2019, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.


Systematic Review Of Doppler For Detecting Intrapartum Fetal Heart Abnormalities And Measuring Perinatal Mortality In Low‐ And Middle‐Income Countries, Marya Plotkin, Benjamin Kamala, Jim Ricca, Linda Fogarty, Sheena Currie, Hussein Kidanto, Stephanie B. Wheeler Oct 2019

Systematic Review Of Doppler For Detecting Intrapartum Fetal Heart Abnormalities And Measuring Perinatal Mortality In Low‐ And Middle‐Income Countries, Marya Plotkin, Benjamin Kamala, Jim Ricca, Linda Fogarty, Sheena Currie, Hussein Kidanto, Stephanie B. Wheeler

Obstetrics and Gynaecology, East Africa

Background: Using Doppler to improve detection of intrapartum fetal heart rate (FHR) abnormalities coupled with appropriate, timely intrapartum care in low-and middle-income countries (LMIC) can save lives.

Objective: To review studies using Doppler to improve detection of intrapartum FHR abnormalities and intrapartum care quality in LMIC health facilities.

Search strategy: PubMed, Web of Science, Embase, Global Health, and Scopus were searched from inception to October 2018 by combining terms for Doppler, perinatal outcomes, and FHR monitoring.

Selection criteria: Selected studies compared Doppler and Pinard stethoscope for detecting/monitoring intrapartum FHR, or described provider and maternal preferences for FHR monitoring in LMIC …


Potential Causes Of Early Death Among Admitted Newborns In A Rural Tanzanian Hospital, Robert Moshiro, Jeffrey M. Perlman, Paschal Mdoe, Hussein Kidanto, Jan Terje Kvaløy, Hege L. Ersdal Oct 2019

Potential Causes Of Early Death Among Admitted Newborns In A Rural Tanzanian Hospital, Robert Moshiro, Jeffrey M. Perlman, Paschal Mdoe, Hussein Kidanto, Jan Terje Kvaløy, Hege L. Ersdal

Obstetrics and Gynaecology, East Africa

Background: Approximately 40,000 newborns die each year in Tanzania. Regional differences in outcome are common. Reviewing current local data, as well as defining potential causal pathways leading to death are urgently needed, before targeted interventions can be implemented

Objective: To describe the clinical characteristics and potential causal pathways contributing to newborn death and determine the presumed causes of newborn mortality within seven days, in a rural hospital setting.

Methods: Prospective observational study of admitted newborns born October 2014–July 2017. Information about labour/delivery and newborn management/care were recorded on data collection forms. Causes of deaths were predominantly based on clinical diagnosis. …


Predictors For Expired Co2 In Neonatal Bag-Mask Ventilation At Birth: Observational Study, Kari Holte, Hege Langli Ersdal, Joar Eilevstjønn, Monica Thallinger, Jørgen Linde, Claus Klingenberg, Rene Holst, Samwel Jatosh, Hussein Kidanto, Ketil Stordal Oct 2019

Predictors For Expired Co2 In Neonatal Bag-Mask Ventilation At Birth: Observational Study, Kari Holte, Hege Langli Ersdal, Joar Eilevstjønn, Monica Thallinger, Jørgen Linde, Claus Klingenberg, Rene Holst, Samwel Jatosh, Hussein Kidanto, Ketil Stordal

Obstetrics and Gynaecology, East Africa

Background: Expired carbon dioxide (ECO2) indicates degree of lung aeration immediately after birth. Favourable ventilation techniques may be associated with higher ECO2 and a faster increase. Clinical condition will however also affect measured values. The aim of this study was to explore the relative impact of ventilation factors and clinical factors on ECO2 during bag-mask ventilation of near-term newborns.

Methods: Observational study performed in a Tanzanian rural hospital. Side-stream measures of ECO2, ventilation data, heart rate and clinical information were recorded in 434 bag-mask ventilated newborns with initial heart rate <120 beats per minute. We studied ECO2 by clinical factors (birth weight, Apgar scores and initial heart rate) and ventilation factors (expired tidal volume, ventilation frequency, mask leak and inflation pressure) in random intercept models and Cox regression for time to ECO2 >2%.

Results: ECO2 rose non-linearly with increasing expired tidal volume …


Bridging The Gap On Schistosomiasis: A Cross-Sectional Study Examining The Knowledge Gap And Common Attitudes And Practices Regarding S. Mansoni Infections Among Varying Education Levels In Luanda K’Otieno, Western Kenya, Kathy Zhang Oct 2019

Bridging The Gap On Schistosomiasis: A Cross-Sectional Study Examining The Knowledge Gap And Common Attitudes And Practices Regarding S. Mansoni Infections Among Varying Education Levels In Luanda K’Otieno, Western Kenya, Kathy Zhang

Independent Study Project (ISP) Collection

Background: Schistosomiasis is considered one of the most prevalent neglected tropical diseases in the world. According to the World Health Organization (WHO), the most effective strategy for schistosomiasis control is through preventive chemotherapy with praziquantel (PZQ). In order to successfully control morbidity rates, the WHO recommends mass treatment targeting high risk groups, such as school-age children and adults considered to be at risk.

Methods: This cross-sectional study examined the effects of the National School-Based Deworming Programme (NSBDP) on knowledge of schistosomiasis and subsequent prevalence rates and intensity. A total of 43 residents in Luanda K’Otieno were interviewed, and 34 of …


Frequent Refresher Training On Newborn Resuscitation And Potential Impact On Perinatal Outcome Over Time In A Rural Tanzanian Hospital: An Observational Study, Estomih Mduma, Jan Terje Kvaløy, Eldar Soreide, Erling Svensen, Paschal Mdoe, Jeffrey Perlman, Caroline Johnson, Hussein Kidanto, Hege Langli Ersdal Sep 2019

Frequent Refresher Training On Newborn Resuscitation And Potential Impact On Perinatal Outcome Over Time In A Rural Tanzanian Hospital: An Observational Study, Estomih Mduma, Jan Terje Kvaløy, Eldar Soreide, Erling Svensen, Paschal Mdoe, Jeffrey Perlman, Caroline Johnson, Hussein Kidanto, Hege Langli Ersdal

Obstetrics and Gynaecology, East Africa

Objectives: Globally, perinatal mortality remains high, especially in sub-Saharan countries, mainly because of inadequate obstetric and newborn care. Helping Babies Breathe (HBB) resuscitation training as part of a continuous quality improvement (CQI) programme may improve outcomes. The aim of this study was to describe observed changes in perinatal survival during a 6-year period, while adjusting for relevant perinatal risk factors.

Setting: Delivery rooms and operating theatre in a rural referral hospital in northern-central Tanzania providing comprehensive obstetric and basic newborn care 24 hours a day. The hospital serves approximately 2 million people comprising low social-economic status.

Participants: …


Health Professionals' Experiences And Views On Obstetric Ultrasound In Vietnam: A Regional, Cross-Sectional Study, Sophia Holmlund, Pham Thi Lan, Kristina Edvardsson, Ho Dang Phuc, Joseph Ntaganira, Rhonda Small, Hussein Kidanto, Matilda Ngarina, Ingrid Mogren Sep 2019

Health Professionals' Experiences And Views On Obstetric Ultrasound In Vietnam: A Regional, Cross-Sectional Study, Sophia Holmlund, Pham Thi Lan, Kristina Edvardsson, Ho Dang Phuc, Joseph Ntaganira, Rhonda Small, Hussein Kidanto, Matilda Ngarina, Ingrid Mogren

Obstetrics and Gynaecology, East Africa

Objectives: Obstetric ultrasound is an important part of antenatal care in Vietnam, although there are great differences in access to antenatal care and ultrasound services across the country. The aim of this study was to explore Vietnamese health professionals' experiences and views of obstetric ultrasound in relation to clinical management, resources and skills.

Design: A cross-sectional questionnaire study was performed as part of the CROss Country UltraSound study.

Setting: Health facilities (n=29) in urban, semiurban and rural areas of Hanoi region in Vietnam.

Participants: Participants were 289 obstetricians/gynaecologists and 535 midwives.

Results: A majority (88%) …


Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C. Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Rabia Hussain, Najeeha Talat Iqbal Sep 2019

Vitamin D Status And Risk Of Incident Tuberculosis Disease: A Nested Case-Control Study, Systematic Review, And Individual-Participant Data Meta-Analysis, Omowunmi Aibana, Chuan-Chin Huang, Said Aboud, Alberto Arnedo-Pena, Mercedes C. Becerra, Juan Bautista Bellido-Blasco, Ramesh Bhosale, Roger Calderon, Rabia Hussain, Najeeha Talat Iqbal

Department of Pathology and Laboratory Medicine

Background: Few studies have evaluated the association between preexisting vitamin D deficiency and incident tuberculosis (TB). We assessed the impact of baseline vitamins D levels on TB disease risk.
Methods and Findings: We assessed the association between baseline vitamin D and incident TB in a prospective cohort of 6,751 HIV-negative household contacts of TB patients enrolled between September 1, 2009, and August 29, 2012, in Lima, Peru. We screened for TB disease at 2, 6, and 12 months after enrollment. We defined cases as household contacts who developed TB disease at least 15 days after enrollment of the index patient. …