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Aku Newsletter : June 2002, Volume 3, Issue 1, Aga Khan University

The Aga Khan University Newsletters

No abstract provided.

Communicating About Aids-Changes In Understanding And Coping With Help Of Language In Urban Kagera, Tanzania, Aldin Mutembei, Maria Emmelin, Joe Lugalla, Lars Dahlgren

Institute for Educational Development, East Africa

Faced with the problems of HIV/AIDS, people have to find ways to communicate around them. The aim of this paper is to mirror changes over time in the Kagera people's social cognition regarding HIV/AIDS, using their own language as a tracer of this process. Focus group discussions and personal and group interviews conducted during 1992 to 1995 in urban Bukoba, Kagera, constitute the basis for an analysis of metaphorical expressions in use since 1985. Pronounced uncertainty is later transformed into a deeper understanding of the pandemic and an increased disposition to cope with the situation. Knowledge about the socio-linguistic expressions …

Acridine Orange For Malaria Diagnosis: Its Diagnostic Performance, Its Promotion And Implementation In Tanzania, And The Implications For Malaria Control, J. Keiser, J. Utzinger, Zul Premji, Y. Yamagata, B.H. Singer

Pathology, East Africa

One hundred years ago, Giemsa's stain was employed for the first time for malaria diagnosis. Giemsa staining continues to be the method of choice in most malarious countries, although, in the recent past, several alternatives have been developed that exhibit some advantages. Considerable progress has been made with fluorescent dyes, particularly with Acridine Orange (AO). The literature on the discovery, development and validation of the AO method for malaria diagnosis is reviewed here. Compared with conventional Giemsa staining, AO shows a good diagnostic performance, with sensitivities of 81.3%-100% and specificities of 86.4%-100%. However, sensitivities decrease with lower parasite densities, and …

An Analysis Of Anemia And Child Mortality, B.J. Brabin, Zul Premji, F. Verhoeff

Pathology, East Africa

The relationship of anemia as a risk factor for child mortality was analyzed by using cross-sectional, longitudinal and case-control studies, and randomized trials. Five methods of estimation were adopted: 1) the proportion of child deaths attributable to anemia; 2) the proportion of anemic children who die in hospital studies; 3) the population-attributable risk of child mortality due to anemia; 4) survival analyses of mortality in anemic children; and 5) cause-specific anemia-related child mortality. Most of the data available were hospital based. For children aged 0-5 y the percentage of deaths due to anemia was comparable for reports from highly malarious …

Aga Khan University Progress Report 2000-2001, Aga Khan University

The Aga Khan University Reports Archives

• Foreword
• Aga Khan University
• University Focus
• University in the Community
• Research and Development Highlights
• Seminar and Conference Highlights
• Major University Partners and Supporters
• New Facilities
• Financial Information
• University Overview
• University Governance and Board of Trustees

Acute Haemolysis In Childhood Falciparum Malaria, H. Ekvall, P. Arese, F. Turrini, K. Ayi, F. Mannu, Zul Premji, A. Bjorkman

Pathology, East Africa

Acute haemolysis associated with clinical episodes of high-level Plasmodium falciparum parasitaemia was studied in 20 children from an holoendemic area (coastal Tanzania). The change in blood haemoglobin (Hb) concentration ranged from -46 to +5 g/L during the 72-h observation period and was linearly related to maximum parasitaemia. Balance studies between loss of blood Hb, increase in plasma Hb and appearance of Hb in the urine indicated that extravascular clearance of red cells was the predominant mode of erythrocyte clearance. Most subjects, however, showed minor signs of intravascular haemolysis. The plasma Hb was ≪1% of blood Hb and haemoglobinuria was detected …

Hemoglobin Concentration In Children In A Malaria Holoendemic Area Is Determined By Cumulated Plasmodium Falciparum Parasite Densities, H. Ekvall, Zul Premji, S. Bennett, A. Bjorkman

Pathology, East Africa

In malaria holoendemic areas children are anemic, but the exact influence of falciparum malaria on hemoglobin (Hb) concentration remains largely unsettled. Prospective data were therefore collected in children < 24 months of age during five months in a Tanzanian village. Children with mean asymptomatic parasitemia ≥ 400/μl had lower median Hb levels during the study than those with mean density < 400/μl. The difference was 9.7 g/L (95% confidence interval [CI] 2.8-17). In children with one or more clinical malaria episodes, the median Hb was 8.3 g/L (95% CI 0.9-16) lower than those without episode. If early treatment failure was recorded, the immediate effect on Hb was particularly important with a mean drop of 17 g/L. Interestingly, at study-end the Hb concentration represented a function of the area under the parasitemia curve (AUPC) during the previous five months, adjusting for age. In conclusion, stepwise deterioration in median Hb levels was found by asymptomatic parasitemia, clinical malaria episode, and most significantly, treatment failure.

Micronutrient And Iron Supplementation And Effective Anti-Malarial Treatment Synergistically Improve Childhood Anaemia, H. Ekvall, Zul Premji, A. Bjorkman

Pathology, East Africa

The control of childhood anaemia in malaria holoendemic areas is a major public health challenge for which an optimal strategy remains to be determined. Malaria prevention may compromise the development of partial immunity. Regular micronutrient supplementation has been suggested as an alternative but its effectiveness remains unsettled. We therefore conducted a randomised placebo-controlled intervention trial with 207 Tanzanian children aged 5 months to 3 years on the efficacy of supervised supplementation of low-dose micronutrients including iron (Poly Vi-Sol with iron) three times per week, with an average attendance of ≥ 90%. The mean haemoglobin (Hb) level increased by 8 g/l …

Acute Adenolymphangitis Due To Bancroftian Filariasis In Rufiji District, South East Tanzania, D.B. Gasarasi, Zul Premji, P.G.M. Mujinja, R. Mpembeni

Pathology, East Africa

A longitudinal prospective surveillance for acute adenolymphagitis (ADL) was carried out in three villages in Rufiji district. A sample population of 3000 individuals aged 10 years and above was monitored fortnightly for a period of 12 months. The annual incidence of ADL was found to be 33 per 1000 population and was significantly higher in males than females (52.7/1000 and 18.7/1000 respectively). ADL episodes were more frequent in the age group of 40 years and above. Individuals with chronic manifestations seemed to be more vulnerable to ADL attacks with 62.2% of the total episodes occurring in this group. Furthermore, individuals …

Current Clinical Efficacy Of Chloroquine For The Treatment Of Plasmodium Falciparum Infections In Urban Dar Es Salaam, United Republic Of Tanzania, Zul Premji, C. Makwaya, J.N. Minjas

Pathology, East Africa

Reported is the use of a 14-day WHO protocol, which takes into account the clinical, parasitological and haematological responses to antimalarial drugs, to determine the efficacy of chloroquine in the treatment of uncomplicated malaria in young children (n = 200) in urban Dar es Salaam. Chloroquine failure was found in 43% of the children. Of these, 12.5% were considered to be early treatment failures and were given a single dose of sulfadoxine-pyrimethamine. Fever subsided in all children treated with sulfadoxine-pyrimethamine and there were no parasitological failures. In addition, children treated with sulfadoxine-pyrimethamine because of early treatment failure with chloroquine had …

Clinical Quality Management Conference Karachi, Pakistan – June 4-5, 1999, Nadeem Mustafa Khan

Nadeem Mustafa Khan Archives

• Conference Appraisals
• Conference Appraisals – Comments
• Attendees of the Clinical Quality Management Conference
• Breakout Sessions I & II
• Quality Measures and Indicators
• Information for Participants
• Objectives and Expectations
• The Aga Khan Health Network

Social And Cultural Factors Affecting Rates Of Regular Retreatment Of Mosquito Nets With Insecticide In Bagamoyo District, Tanzania, P.J. Winch, A.M. Makemba, V.R. Makame, M.S. Mfaume, M.C. Lynch, Zul Premji, J.N. Minjas, C.J. Shiff

Pathology, East Africa

Insecticide-treated mosquito nets have an impact on mortality and morbidity in young children under controlled conditions. When integrated into larger control programs, there is the danger that rates of regular retreatment of the nets with insecticide will drop, greatly limiting their effectiveness as a public health intervention. In Bagamoyo District, Tanzania, rates of retreatment dropped significantly when payment for the insecticide was introduced. A series of neighbourhood (hamlet) meetings were held in all study villages to discuss people's concerns about the insecticide and ways to increase rates of retreatment. Although changes were made in the procedure for retreatment, rates of …

Development, Change, And Poverty In The Informal Sector During The Era Of Structural Adjustments In Tanzania, Joe Lugalla

Institute for Educational Development, East Africa

This article focuses on periods of economic crisis and structural adjustments in Tanzania, when the informal sector changed both quantitatively and qualitatively. It highlights that the traditional view that the informal sector accommodated the unemployed, the poor, the unskilled, as well as utilizing family labour and local resources, was questionable in most of the sub-Saharan countries which were experiencing a severe economic crisis and have adopted structural adjustment policies (SAPs). The author suggests that policy programs aimed at promoting the informal sector should acknowledge the fact that the crisis, as well as SAPs, have forced not only the poor, but …

Mosques Against Malaria, M.S. Mfaume, P.J. Winch, A.M. Makemba, Zul Premji

Pathology, East Africa

In a community-based malaria control project covering a predominantly Muslim population in the United Republic of Tanzania, difficulty was encountered in motivating people to have their mosquito nets reimpregnated with insecticide at six-monthly intervals. Education on this subject was therefore provided in mosques during Friday noon prayers. People who attended these services considered them an appropriate forum for discussing health concerns and viewed them as a credible source of information.Insecticide-impregnated bednets help to control the spread of the malaria parasite Plasmodium falciparum. The Bagamoyo Bednet Project is a community-based scheme to develop a sustainable system for the distribution and promotion …

Economic Reforms And Health Conditions Of The Urban Poor In Tanzania, Joe Lugalla

Institute for Educational Development, East Africa

This paper examines the impact of economic reforms, namely Structural Adjustment Policies (SAPs), on the health conditions of the Tanzanian urban poor. My conclusion is that these policies have had detrimental effects on the living conditions of the urban poor. Thus, SAPs are contributing to the deterioration of health conditions among these people rather than improving them. SAPs are affecting these people in a variety of ways. First, by affecting negatively the development of the urban environment, SAPs are destroying the environmental conditions on which the poor depend for their existence and survival. Secondly, by impacting the provision of urban …

Treatment Practices For Degedege, A Locally Recognized Febrile Illness, And Implications For Strategies To Decrease Mortality From Severe Malaria In Bagamoyo District, Tanzania, A.M. Makemba, P.J. Winch, V.M. Makame, G.L. Mehl, Zul Premji, J.N. Minjas, C.J. Shiff

Pathology, East Africa

Malaria remains one of the chief causes of mortality among young children in sub-Saharan Africa. Verbal autopsies for cases of childhood mortality in Bagamoyo District, Tanzania demonstrated that degedege, a locally defined illness of children characterized by fever and convulsions, is frequently treated by traditional healers. To investigate this further, an ethnographic study was carried out in one village that included in-depth interviews with 14 traditional healers and 3 focus groups with parents. Parents and traditional healers were unanimous in their conviction that degedege requires traditional treatments, at least initially, and that these treatments are effective. While traditional healers do …

The Aga Khan Health Services - International Newsletter No. 56, Aga Khan University

The Aga Khan Health Services Archives

• Priorities of Infant and Maternal Mortality
• Towards Total Quality Management in Health Care
• Appointments at AKU
• Paponditi Women's Group
• Islamic Medicine: The Role of Private Practitioners
• AKHSP Students Secure Top Positions
• Nurdin Ajania Community Empowerment through Awareness
• Nurdin Ajania
• AKU Faculty Honoured
• New Shoes for Nina
• Scourge of AIDS costing $ 90 Billion Annually
• Moments of Inspiration
• Health care at its very best

The Aga Khan Health Services - International Newsletter No. 53, Aga Khan University

The Aga Khan Health Services Archives

• Theme of International Nurses Day at AKUMC
• Training in the Management of HIV/AIDS Patients
• Community Health: From the People for the People
• Nuri Sinuff Wins Award for Work with Eskimos
• Recent Visitors To The AKUMC
• Dr. John H. Bryant — The Role of a Third World University
• Dr. John H. Bryant
• Al-Zahrawi’s Tenth Century Surgical Treatise
• Aslam's New Lease on Life
• Nairobi Health Exhibition Promotes Disease Prevention
• Nursing Seminar — a renewed commitment

The Aga Khan Health Services - International Newsletter No. 43, Aga Khan University

The Aga Khan Health Services Archives

• Health Network's Five Year Plan Announced
• Afghan Refugees Benefit from AKU-IRC Collaboration
• Hospital and Nursing Administrators Develop Network Nursing Strategy in Mombasa
• Paediatric Conference in Quetta
• Kabir Mitha—A Multisectorial Approach to Improving Quality of Life in Rural India
• Junagadh Primary Health Care Project
• AKU Faculty and Students Participate in International Health Project in Indonesia
• Cardiologist from America Volunteers Service at AKUMC
• AKU Faculty News
• Alumnus Award
• Islamic Miniature Paintings in Medical Manuscripts
• Plugged-in Healthcare— Computers to Safeguard Your Health

The Aga Khan Health Services - International Newsletter No. 42, Aga Khan University

The Aga Khan Health Services Archives

• Pakistan's First Drug and Poison Information Service at Aga Khan University Hospital
• Canadian Minister Visits AgaKhan University Medical Centre
• Primary Health Care Orientation for Volunteers
• Local Community Responds Enthusiastically to Health Exhibition
• Dr. Tajuddin A. Manji Honoured
• Professor Nimrod O. Bwibo —Building Bridges Between Medical Colleges in Third World Countries
• School Children Participate in Kisumu Primary Health Care Project
• Appointments at Aga Khan Hospitals
• First Regional Physicians Conference in Kenya
• Jalal H. Jamal Appointed on the Board of Muhimbili Medical Centre in Dar-es-Salaam
• Medical Ethics in Islam
• Aga Khan University Faculty Attends World Health Assembly
• Pakistan Desperately Needs its Med …

The Aga Khan Health Services - International Newsletter No. 39, Aga Khan University

The Aga Khan Health Services Archives

• International Support for Research on Infant Diarrhoea at AKU
• Canada Donates Neonatal Equipment to Dar-es-Salaam Hospital
• Aga Khan Hospital in Dar-es-Salaam Celebrates Silver Jubilee
• Nurses Brush Up on Communication Skills
• Diarrhoea and Nutrition Unit Commissioned
• Health Fair—89
• Against all Odds— Ahmed’s Fight for Survival
• Research Awards for Faculty
• George P. Purvis —Networking The Health Services
• A Unique Distinction for Dr. Sheikh Arshad Saeed
• Canadian Consultants visit Tanzania
• The Role of Mohtasib in Public Health
• Health Status Improves at Kisumu Primary Health Care Project
• Food-Based Oral Rehydration Therapy For Management Of Diarrhoea
• Aga Khan Investing in Health Care
• Monumental Architecture: Morally …

The Aga Khan Health Services - International Newsletter No. 38, Aga Khan University

The Aga Khan Health Services Archives

• Networking Benefits Begin
• Nursing Conference in Dar-es-Salaam Focus on Quality Assurance
• New Appointments in Kenya and Tanzania Health Services
• Prince Aly Khan Hospital
• Posters Promote Health Awareness in Kisumu
• Surgeon General's Award for Dr. John Bryant
• Management Workshops in Tanzania
• Joseph de Mora —Challenges of Health Care in the Developing World
• Bridging the Gap— Linking People, Place’s and Services
• Symposium on Health Care in the Developing World in Canada
• “Patron for the Day") at Prince Aly Khan Hospital
• The Role of Mohtasib in Public Health
• Video Campaign on Prevention of Heart Diseases in Asian Communities in London
• Struggling for Equity …

Conflicts And Politics In Urban Planning In Tanzania, Joe Lugalla

Institute for Educational Development, East Africa

This paper tries to discuss two important issues. First, it examines the conflict between ideology and actual urban planning in Tanzania. It is argued that via the Arusha-Declaration,Tanzania showed the intention of building an egalitarian society based on the principles of Ujamaa (socialism), hence one expected that an attempt to transform some colonial structures in order to suit the socialist aspiring nation could be in the agenda in Tanzania. This has never been the case at the level of urban planning. The paper argues that the gap between theory and practice exists because Tanzania's socialist theory itself is weak, and …

The State, Law And Urban Poverty In Tanzania, Joe Lugalla

Institute for Educational Development, East Africa

This paper is about the state, law and urban poverty in Tanzania. The paper examines how the state in Tanzania has been trying to solve the problem of urban poverty. The main argument is that the state's conception of urban poverty is not realistic. The urban poor are seen as responsible for their poverty. This is confirmed by the kind of coercive policies, legislation and other measures which have been instituted by the state in order to solve the problem. The paper argues that due to lack of a critical analysis of the causes of poverty, the state has been …

The Aga Khan University Medical Centre, Minaz Nanji, Ian Charles Stewart

The Aga Khan University Medical Centre Archives

• The Aga Khan University graduates its first class of doctors
• The Medical College
• Patient Care
• Research
• The library
• New Programmes
• Faculty Training
• The School of Nursing
• Building the nursing profession
• The Aga Khan University Hospital
• Welfare at The Aga Khan University
• Tertiary care
• The challenge of funding health care
• The Aga Khan Health Services Network
• Finance and endowments
• Major resource for Third World

Local Anaesthetic Cream For The Alleviation Of Pain During Venepuncture In Tanzanian Schoolchidren, U. Hellgren, C.M. Kihamia, Zul Premji, K. Danielson

Pathology, East Africa

The analgesic effect and the usefulness of EMLA cream 5% in connection with venous blood-sampling was investigated in 42 Tanzanian schoolchildren. Approximately 2.5 g EMLA was applied to the right cubital fossa for a minimum of 120 min. The analgesic effect was pronounced - 93% of the venepunctures were pain-free and no child experienced severe pain. No adverse reactions were observed and the children could continue normal school work during the application time.

The Aga Khan Health Services - International Newsletter No. 34, Aga Khan University

The Aga Khan Health Services Archives

• Health and Hospital Administrators Discuss Advantages of Networking
• Inter-Continental Hotels Corporation Donates $ 60,000 for Ambulances
• Training of Trainers in Kenya
• Scientist Wins Award for Research
• At the Frontlines of Health
• Aga Khan University Invited to Present Paper at World Conference on Health Education
• Muller and Phipps Donates Rs. 250,000 for Patient Welfare Programme
• Dr. Azim H. Jiwani —Ambulatory Care at Aga Khan University Hospital
• Senior Nurses Conference in Karachi
• Dr. Paula Herberg to Teach Degree Programme in Nursing
• Botany
• Aga Khan University at The World Health Assembly

The Aga Khan Health Services - International Newsletter No. 33, Aga Khan University

The Aga Khan Health Services Archives

• The Aga Khan University Hospital Volunteers Donate Rs. 50,000 to Patient Welfare Programme
• Dr. Wania's Contributions to Ophthalmology Recognised
• Management Workshop in Tanzania
• Health Activities Launched in Versova
• Workshop Initiates PHC Project in India
• Surgical Operations—From Caesarean to Eye
• Dr. Azim Jiwani Appointed Administrator of Ambulatory Care
• Aga Khan University and the Sands of Baluchistan
• The Village
• The Ending
• Azra— Breaking Old Barriers in the Community
• Baby Show—With a Difference
• Free Blood Pressure Screening at The Aga Khan University Hospital
• Senate Special Committee on Health Visits Hospital Pharmacy
• Lithotripter—New Hope for Kidney Stone Sufferers
• Setting a Worthy Example
• Substance Abuse …

The Aga Khan Health Services - International Newsletter No. 31, Aga Khan University

The Aga Khan Health Services Archives

• HRH Princess Alexandra and The Hon Angus Ogilvy Visit Aga Khan University’s School of Nursing
• Residency Programmes in Medicine, Surgery and Paediatrics Announced
• New PHC Initiative in Mombasa
• Continuing Education at Aga Khan University
• Looking Ahead Innovative Computer Applications in Primary Health Care
• Hope for Urban Poor in Karachi
• Nursing Book Fair — A Great Success in Karachi
• International Children’s Day Celebrated at Aga Khan University Hospital in Karachi
• Dr. Cornelius Walter —Partners in Health Care in Tanzania
• Theory and Sources of Pharmacology
• Students Organize Blood Donation Drive
• Information Systems Computerised at Aga Khan University Hospital
• Journal of Healthcare Material …

The Aga Khan Health Services - International Newsletter No. 30, Aga Khan University

The Aga Khan Health Services Archives

• Health Administrators Conference in Dar-es-Salaam
• Reaching Mothers in Dhaka
• “Mother of the Year” Felicitated at Annual Baby Show in Dar-es-Salaam
• Innate Healing Powers
• “Thank You, Sahib”
• Yasmin Makani —Providing Health Care is an Uphill Yet Rewarding Task
• A New Oesophagus for Samir
• Health Education for Patients at Aga Khan University Hospital
• NewAppointments
• Executive Clinic at Aga Khan University Hospital
• Preventing Mental Retardation
• Aga Khan Hospital Paediatrics: With a Technology That Says Love
• ODA Extends English Language Programme at Aga Khan University