Digital Commons Network^™

Connecting Aga Khan University's Nine Campus Libraries Across Three Continents Through A Shared Library System, Ashraf Sharif, Normand Demers

Libraries

The Aga Khan University (AKU) is the only university in the developing world that is serving through its eleven campuses spread across eight countries and three continents. It has a network of nine libraries, although small in size, in four developing courtiers in two regions (South Asia and East Africa). The university has recently implemented a library management system to integrate all nine libraries in four counties using a single shared database. The purpose of this paper is to share our experience of implementing the industry standard-base state-of-the-art library system. The geographical location of AKU libraries and multilingual collections makes …

Akhuwat Issue No. 91, Aga Khan University

AKHUWAT Newsletters

• Independence Day Celebrated at AKU
• Independence Day Celebrated at AKU
• TKN Initiatives The impact TKN Volunteers can make
• Face to Face with Greg Moran
• Provost
• Aga Khan University
• Proud to Announce
• Aspire Recognition of Excellence Awards for Medical College, Pakistan
• Quality and Safety Update
• JCIA Library of Measures Dashboard
• Service Excellence
• Hospital Management Asia (HMA) 2013 Awards
• AKU-IED Pakistan Celebrates its 20th Anniversary
• AKU-IED MEd graduates Excel in Federal Public Service Commission examination
• Shakeout Drill Held
• Workshop on Emotional Development of Children
• Working Creativity with Challenging and Emotionally Wounded Young People
• Congratulations
• Secondary Hospitals
• About our Greatest Assets
• Retirements

Research Outlook Issue - 6, The Aga Khan University

Department of Research Archives

This inaugural issue of Research Outlook (October 2013) highlights research achievements and initiatives across Aga Khan University. It features groundbreaking biomedical studies, educational innovations, archaeological collaborations, and updates from various departments, reflecting AKU’s growing role as a global research leader.

Research Outlook : Issue 6, October 2013, Office Of Research & Graduate Studies

Office of Research and Graduate Studies

Content

- In Our Time

- Cockroaches can Fight Deadly Infections

- Global Burden of Childhood Diarrhoea and Pneumonia

- Research in the News

- The Clinical Trials Unit

- AKU Research Themes for the Faculty of Health Sciences

- Book Launch : Putting an Imprint on Ideas

- Book Reviews

- Mathematics Education In Rural Communities

- An Assessment of the Quality of the Nursing Examination Boards and MidwiferySchools

- Pre-creating History in the Muslim Tradition

- Annual Research Institute 2012

- AKU-IED Pakistan's International Conference - 2012

- Research Fundinig and Output - 2012

Increasing Caesarean Section Rates Among Low-Risk Groups: A Panel Study Classifying Deliveries According To Robson At A University Hospital In Tanzania, Helena Litorp, Hussein Kidanto, Lennarth Nystrom, Elisabeth Darj, Birgitta Essén

Faculty of Health Sciences, East Africa

Background Rising caesarean section (CS) rates have been observed worldwide in recent decades. This study sought to analyse trends in CS rates and outcomes among a variety of obstetric groups at a university hospital in a low-income country.

Methods We conducted a hospital-based panel study at Muhimbili National Hospital, Dar es Salaam, Tanzania. All deliveries between 2000 and 2011 with gestational age ≥ 28 weeks were included in the study. The 12 years were divided into four periods: 2000 to 2002, 2003 to 2005, 2006 to 2008, and 2009 to 2011. Main outcome measures included CS rate, relative size of …

Dementia Prevalence Estimates In Sub-Saharan Africa: Comparison Of Two Diagnostic Criteria, Stella Maria Paddick, Anna R. Longdon, Aloyce Kisoli, Catherine Dotchin, William K. Gray, Felicity Dewhurst, Paul Chaote, Raj Kalaria, Ahmed Jusabani, Richard Walker

Faculty of Health Sciences, East Africa

Background:

We have previously reported the prevalence of dementia in older adults living in the rural Hai district of Tanzania according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria. The aim of this study was to compare prevalence rates using the DSM-IV criteria with those obtained using the 10/66 diagnostic criteria, which is specifically designed for use in low- and middle- income countries.

Methods:

In phase I, 1,198 people aged 70 and older were screened for dementia. A stratified sample of 296 was then clinically assessed for dementia according to the DSM-IV criteria. In addition, …

Sickle Cell Disease In Pregnancy: Trend And Pregnancy Outcomes At A Tertiary Hospital In Tanzania, Projestine S. Muganyizi, Hussein Kidanto

Faculty of Health Sciences, East Africa

SCD in pregnancy is associated with increased adverse fetal and maternal outcomes. In Tanzania where the frequency of sickle cell trait is 13% there has been scanty data on SCD in pregnancy. With progressive improvement in childhood survival the burden of SCD in pregnancy will increase. We analyzed all deliveries at Muhimbili National Hospital (MNH) from 1999 to 2011. Fetal and maternal outcomes of SCD deliveries were compared with non-SCD. Data were analyzed using IBM SPSS statistics version 19. Chi square and Fisher Exact tests were used to compare proportions and the independent t-test for continuous data. To predict risks …

Risk Of Childhood Asthma In A Tropical African Urban Setting: A Case - Control Study At The Aga Khan Hospital, Dar-Es-Salaam, Tanzania, Lynda C. Koech

Master of Medicine in Family Medicine

Objective: To determine the modifiable and non-modifiable risk factors for childhood asthma in children aged between two and 15years in a tropical urban East-African setting. Methods: Hospital based case-control study matched for age + two months and sex. Data were obtained from parents of cases and controls using a structured interviewer-administered questionnaire. The study sample consisted of 226 cases of two to 15years old, with physician-confirmed asthma, who met a set of defined clinical criteria and 226 controls with no previous diagnosis or symptoms of asthma matched by sex and age (+two months). The Risk Factors included in this study …

Perception Of Final Year Undergraduate Medical Students Towards Family Medicine In Dar Es Salaam, Tanzania, Eric Luggar Aghan

Master of Medicine in Family Medicine

Primary health care was identified as the ideal model of health care delivery during the Alma Atta conference in USSR in 1978. The World Health Organization urged member countries to adopt it as a model of health care service delivery to their people. Since then many countries have adopted a primary health care model including Tanzania. In countries such as Cuba and Costa Rica where primary health care has successfully been implemented, access to affordable and quality health care service to all has resulted in lowered morbidity, mortality, improved quality and longevity of life. The success story behind primary health …

Mentoring For Educational Change An East African Case Study, Tashmin Khamis, Marilyn Chapman

Faculty of Health Sciences, East Africa

In 2012, a partnership was begun between Aga Khan University (AKU) and Academics Without Borders Canada (AWBC). In the initial project, three mentors from AWBC worked with nursing faculty on three East African campuses of AKU with a focus on developing more interactive teaching skills and scholarship. Following this four-month project, two of the mentors continued to work with nursing faculty to develop capacity. The relationship between AKU and AWBC has been formally extended with the initiation of several new projects, all centred on strengthening the student learning experience.

A Viewpoint Of Tanzania E-Commerce And Implementation Barriers, George S. Oreku, Fredrick Mtenzi, Ali Al Dahoud

Institute for Educational Development, East Africa

The growing rate of ICT utilization particularly the Internet and mobile phones has influenced at an exponential rate online interaction and communication among the generality of the populace. However, with the enormity of businesses on the Internet, Tanzania is yet to harness the opportunities for optimal financial gains. This study is exploratory in nature as it attempts to unveil the prospects of e-commerce implementation, participation, motivation and opportunity to the developing countries like Tanzania where by the domestic market is very big to ensure the growth of agricultural sector. The paper proposes to investigate the ability of consumers to purchase …

Usefulness Of Plasmodium Falciparum-Specific Rapid Diagnostic Tests For Assessment Of Parasite Clearance And Detection Of Recurrent Infections After Artemisinin-Based Combination Therapy, B. Aydin-Schmidt, M. Mubi, U. Morris, M. Petzold, B.E. Ngasala, Zul Premji, A. Bjorkman, A. Martensson

Pathology, East Africa

Background: Rapid diagnostic test (RDT) is an important tool for parasite-based malaria diagnosis. High specificity of RDTs to distinguish an active Plasmodium falciparum infection from residual antigens from a previous infection is crucial in endemic areas where residents are repeatedly exposed to malaria. The efficiency of two RDTs based on histidine-rich protein 2 (HRP2) and lactate dehydrogenase (LDH) antigens were studied and compared with two microscopy techniques (Giemsa and acridine orange-stained blood smears) and real-time polymerase chain reaction (PCR) for assessment of initial clearance and detection of recurrent P. falciparum infections after artemisinin-based combination therapy (ACT) in a moderately high …

Educational Exigencies Of The 21st Century: Implications For Teacher Education Programmes In East Africa, Peter Kajoro, Hellen Chirure, Irene Simiyu

Institute for Educational Development, East Africa

Questions about what constitutes effective teacher education compatible with today’s changing educational demands have been frequently raised. This article is an overview of ideas about the elements of effective teacher education in view of the 21st century demands. Drawing on literature and the authors' knowledge of teacher education in the East African context, the article argues the case for the different elements of effective teacher education program that would help the region, and perhaps, by extension, other developing countries, meet their educational obligations in the 21st century. The paper also highlights the theoretical underpinnings of these elements and their implications …

Validation Of The Ottawa Ankle Rules At A Tertiary Teaching Hospital: A Cross-Sectional Study, Mark Karanja Tharao

Master of Medicine in General Surgery

Introduction: Ankle joint and foot injuries are among the commonest injuries seen at the Accident and Emergency Department of any hospital. Within the United States it is the second most common musculoskeletal injury seen by physicians. Assessment of these injuries is done clinically and when deemed necessary a radiograph is requested. Studies have shown that radiographs are ordered in over 95% of cases yet the prevalence of fractures is in the range of 15-20%. This means that more than 80% of patients are exposed to unnecessary radiation. The Ottawa ankle rules have been designed to reduce the need for performing …

Prolonged Sexual Abstinence After Childbirth: Gendered Norms And Perceived Family Health Risks. Focus Group Discussions In A Tanzanian Suburb, Columba Mbekenga, Andrea B. Pembe, Elisabeth Darj, Kyllike Christensson, Pia Olsson

School of Nursing & Midwifery, East Africa

Background: Prolonged sexual abstinence after childbirth is a socio-cultural practice with health implications, and is described in several African countries, including Tanzania. This study explored discourses on prolonged postpartum sexual abstinence in relation to family health after childbirth in low-income suburbs of Dar es Salaam, Tanzania.

Methods: Data for the discourse analysis were collected through focus group discussions with first-time mothers and fathers and their support people in Ilala, Dar es Salaam, Tanzania.

Results: In this setting, prolonged sexual abstinence intended at promoting child health was the dominant discourse in the period after childbirth. Sexual relations after childbirth involved the …

The Effectiveness Of Educational Support To Orphans And Vulnerable Children In Tanzania And Uganda, Mary Shann, Malcolm Bryant, Mohamad Brooks, Paul Bukuluki, Denis Muhangi, Joe Lugalla, Gideon Kwesigabo

Institute for Educational Development, East Africa

Little evidence is available to assist policy makers and donors in deciding what kinds of programs in developing countries are more likely to be effective in supporting the entry and continuation of OVC in secondary schools. This is particularly important for females whose education has direct bearing on child mortality in the next generation. This study gathered four kinds of educational outcome measures in two East African countries ravaged by the AIDS/HIV pandemic. The goal was to determine whether direct scholarship aid to individual students versus various forms of block grants would be more effective in promoting lower rates of …

Malaria Diagnosis And Treatment Practices Following Introduction Of Rapid Diagnostic Tests In Kibaha District, Coast Region, Tanzania, M. Mubi, D. Kakoko, B. Ngasala, Zul Premji, S. Peterson, A. Bjorkman, A. Martensson

Pathology, East Africa

Background: The success of the universal parasite-based malaria testing policy for fever patients attending primary health care (PHC) facilities in Tanzania will depend highly on health workers' perceptions and practices. The aim of this study was, therefore, to assess the present use of malaria diagnostics (rapid diagnostic tests (RDTs) and microscopy), prescription behaviour and factors affecting adherence to test results at PHC facilities in Kibaha District, Coast Region, Tanzania.

Methods: Exit interviews were conducted with fever patients at PHC facilities and information on diagnostic test performed and treatment prescribed were recorded. Interviews with prescribers to assess their understanding, perceptions and …

Temporal Trends Of Molecular Markers Associated With Artemether- Lumefantrine Tolerance/Resistance In Bagamoyo District, Tanzania, M. Malmberg, B. Ngasala, P.E. Ferreira, E. Larsson, I. Jovel, A. Hjalmarsson, M. Petzold, Zul Premji, J.P. Gil, A. Bjorkman, A. Martensson

Pathology, East Africa

Background: Development and spread of Plasmodium falciparum resistance to artemisinin-based combination therapy (ACT) constitutes a major threat to recent global malaria control achievements. Surveillance of molecular markers could act as an early warning system of ACT-resistance before clinical treatment failures are apparent. The aim of this study was to analyse temporal trends of established genotypes associated with artemether-lumefantrine tolerance/resistance before and after its deployment as first-line treatment for uncomplicated malaria in Tanzania 2006.

Methods: Single nucleotide polymorphisms in the P. falciparum multidrug resistance gene 1 (pfmdr1) N86Y, Y184F, D1246Y and P. falciparum chloroquine transporter gene (pfcrt) K76T were analysed from …

Exploration Of In Vivo Efficacy Of Artemether-Lumefantrine Against Uncomplicated Plasmodium Falciparum Malaria In Under Fives In Tabora Region, Tanzania, D. Joseph, A.M. Kabanywanyi, R. Hulser, Zul Premji, O.M.S. Minzi, K. Mugittu

Pathology, East Africa

Background: Tanzania adopted artemether-lumefantrine (AL) as first-line drug for uncomplicated malaria in 2006. Recently, there was an anecdotal report on high malaria recurrence rate following AL treatment in in the (urban and peri-urban), western part of Tanzania. The current report is an exploratory study to carefully and systematically assess AL efficacy in the area.

Methods: Between June and August 2011, a total of 1,126 patients were screened for malaria, 33 had malaria, of which 20 patients met inclusion criteria and were enrolled and treated with standard dose of AL as recommended in the WHO protocol. Treated patients were followed …

Aku-Nama : Summer 2013, Volume 6, Issue 1, Aga Khan University Alumni Association

The Aga Khan University Newsletter and Magazine for Alumni (AKU-NAMA)

Highlights

- A Changing Relationship

- Marching Towards Healthcare

- Convocation

- Outreach Medical Camp

- Off The Beaten Path

- Campus Happenings

- Class Notes

Aku-Nama : Winter 2013, Volume 6, Issue 2, Aga Khan University Alumni Association

The Aga Khan University Newsletter and Magazine for Alumni (AKU-NAMA)

Highlights

- Alumni Association Appoints its Asia Chapter Officers

- Learning New Tricks

- The University at 30

- Reunions

- Ventures

- Campus Happenings

- Class Notes

Improved Quality Of Management Of Eclampsia Patients Through Criteria Based Audit At Muhimbili National Hospital, Dar Es Salaam, Tanzania. Bridging The Quality Gap, Hussein Kidanto, Peter Wangwe, Charles D. Kilewo, Lennarth Nystrom, Gunnila Lindmark

Faculty of Health Sciences, East Africa

Background Criteria-based audits (CBA) have been used to improve clinical management in developed countries, but have only recently been introduced in the developing world. This study discusses the use of a CBA to improve quality of care among eclampsia patients admitted at a University teaching hospital in Dar es Salaam Tanzania.

Objective The prevalence of eclampsia in MNH is high (≈6%) with the majority of cases arriving after start of convulsions. In 2004–2005 the case-fatality rate in eclampsia was 5.1% of all pregnant women admitted for delivery (MNH obstetric data base). A criteria-based audit (CBA) was used to evaluate the …

Integrating Libraries Across Continents: A Case Of Aga Khan University’S Nine Libraries In Five Countries, Ashraf Sharif

Libraries

The Aga Khan University (AKU) is perhaps the only university throughout the developing world that is serving through eleven campuses spread across eight countries and three continents. It has a network of nine libraries, although small in size, in five courtiers in three regions (South Asia, East Africa, and the UK). The university has recently implemented a library management system to integrate all libraries using single shared database.

The purpose of this study is to share Aga Khan University Libraries’ process of Integrated Library System (ILS) selection, project initiation and planning, system implementation including installation to data conversion and migration …

Experience Of Caregivers With The Survivors Of Hepatitis C, Noureen Shehzad Jiwani, Raisa B. Gul, Rubina Sultan

School of Nursing & Midwifery

Objectives: To assess and describe the experiences of those caring for hepatitis C patients in Karachi, Pakistan.

Methods: Using a qualitative approach, the study adopted a descriptive exploratory design for which 8 caregirers were selected through snowball sampling technique from different parts of Karachi. Data was collected between May and July 2010 through semi-structured interviews from the caregivers. The interviews were recorded on tape and were transcribed verbatim. The data was manually analysed for extracting themes and categories.

Results: The analyses of data led to one theme - \'deadly, dangerous, and devastating. Two associated categories could also be noted: \'perceptions …

Bethune Round Table 2012: 12th Annual Conference: Filling The Gap, A. A. Nasir, F. Niyonkuru, T. E. Nottidge, A. Olufemi Adeleye, S. Ali, E. A. Ameh, A. Bekele, I. Bonet, M. Derbew, S. O. Ekenze

Obstetrics and Gynaecology, East Africa

Background: Our aim was to highlight the impact of collaboration between 2 linked tertiary hospitals in Nigeria and India.

Methods: We conducted a review of a collaboration between the Amrita Institute of Medical Sciences and Research Centre (AIMS), Kochi, India, and the University of Ilorin Teaching Hospital (UITH), Ilorin, Nigeria, to exchange personnel for the purpose of further training from August 2007 and December 2011.

Results: One neurosurgeon, 2 pediatric surgeons and 1 orthopedic surgeon had additional exposure at AIMS for periods of 3 months to 1 year. Four neurosurgery and 3 pediatric surgery perioperative nurses have also been trained …

Aku-Nama : Summer 2012, Volume 5, Issue 1, Aga Khan University Alumni Association

The Aga Khan University Newsletter and Magazine for Alumni (AKU-NAMA)

No abstract provided.

A Comparative Analysis Of Toluidine Blue With Frozen Section In Oral Squamous Cell Carcinoma, Montasir Junaid, Moaz M. Choudhary, Zain A. Sobani, Ghulam Murtaza, Sadaf Qadeer, Naeem S. Ali, Mumtaz J. Khan, Anwar Suhail

Department of Surgery Docs

Background:Surgical excision of the primary tumor with safe margins remains the mainstay of treatment for oral cavity squamous cell carcinoma (OSCC). The standard of care for assessment of intraoperative margins is frozen section histopathology. Unfortunately the facility is not available at most centers in limited resource countries. Toluidine blue, a metachromatic dye, has been well described in clinical identification of malignant and premalignant lesion in the oral cavity. Considering this we decided to explore intraoperative use of toluidine blue staining, in comparison with frozen sections, for the assessment of tumor-free margins.

Methods:

After obtaining clearance from the in-house ethical …

Social Context Of Disclosing Hiv Test Results In Tanzania, Joe Lugalla, Stanley Yoder, Huruma Sigala, Charles Madihi

Institute for Educational Development, East Africa

This study sought to understand how individuals reveal their HIV test results to others and the ways in which social relations affect the disclosure process. The data were collected through open-ended interviews administered in Swahili to informants who had just been tested for HIV and to those who were living with HIV in Dar es Salaam and Iringa regions. Analysis shows that social relations influence the decisions individuals make about disclosure. Most people preferred to reveal their HIV status to close family members. Most also mentioned the fear of being rejected and discriminated against as major reasons for not disclosing …

Investigating Esl Teachers’ Classroom Based Assessment Practices In A Secondary School In Kenya, Grace Mukiru

Master of Education

Classroom Based assessment (CBA) is a crucial component in the ESL classroom. With this realization came the major shift toward using classroom assessment to promote learning rather than just to measure it. This study focused on developing a better understanding of ESL teachers' classroom based assessment practices in a public secondary school in Kenya. The study employed a qualitative case study design. Participants consisted of three ESL teachers .Data was collected through the qualitative semi-structured interview format, classroom observations, document analysis and informal conversations. Findings indicate that teachers have similar views about CBA being important and beneficial in assessing learners’ …

Student Teachers’ Use Of Self-Assessment In Learning Mathematics In Primary Teachers’ Colleges In Kampala District, Uganda, Richard B. Wanzala

Master of Education

Student self-assessment though acknowledged as a powerful technique for teaching and learning in higher institutions, is mostly overlooked. Student self-assessment occurs when students make judgments of their own work and performance based on evidences and explicit criteria for self-improvement. In teacher training institutions, student self-assessment is indispensable in the teaching and learning process. However, there is dismal performance and inefficiencies in learning Mathematics in colleges. This study explored student teachers’ use of self-assessment in learning of Mathematics in the two Primary Teachers’ Colleges (PTCs) in Kampala district, Uganda. For in-depth understanding of the study, literature was reviewed on studies related …