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A Rare Case Report Of Tuberculosis Endometritis In A Private Hospital Dar Es Salaam, Tanzania, Willbroad Kyejo, Brenda Moshi, Daudi Gidion, Muzdalfat Abeid, Samina Somji, Munawar Kaguta, Miriam Mgonja

Faculty of Health Sciences, East Africa

Tuberculosis endometritis is a pathological diagnosis and has been always over shadowed by pelvic tuberculosis. It is usually asymptomatic, but patients could complain of menstrual irregularity and per vaginal discharge. We report a case of a 37-year-old female who presented with per vaginal discharge for 2 years. Histopathology showed numerous caseating and non-caseating granulomas with plasma cells, Ziehl–Neelsen stain for acid fast bacillus is positive, and she was initiated on anti-tuberculosis treatment. On subsequent follow-up visits, patient was doing well with complete resolution of symptoms. Genital tuberculosis is usually caused by reactivation of organism from systemic distribution during primary infection. …

To Err Is Human; Acute Appendicitis A Mistaken Clinical Identity For Metastatic Follicular Thyroid Carcinoma, A Case Report, Ahmed Jusabani, Neelam Ismail, Zainab Fidaali, Ramadhani Mjejwa, Tausi Maftah, Ally Zain Ismail

Faculty of Health Sciences, East Africa

Introduction and importance: Thyroid cancer accounts for majority of endocrine cancers with follicular thyroid cancer the second most common. It tends to spread via hematogenous route with distant metastasis thus besides presenting as a neck mass it may also present with symptoms tallying to regions of metastasis which may misguide the diagnosis. We report a case of a 50-year-old man who presented with features of appendicitis only to discover metastatic right iliac bone follicular thyroid cancer. We describe our experience on diagnostic formulation, radiological work up, surgery, radioactive iodine therapy and follow up.

Case presentation: 50-year-old man presenting with acute …

Heterotopic Gestation In Polycystic Ovary Disease: Termination Of Tubal Pregnancy And Intrauterine Pregnancy Progressing To Term, Munawar Kaguta, Ahmed Jusabani, Ntiyakuze Gregory, Shweta Jaiswal, Zainab Fidaali, Pilly Ally, Davis Rubagumya, Miriam Mgonja, Farhat Seif

Faculty of Health Sciences, East Africa

Heterotopic pregnancy is rare. We report a 27-year-old lady with polycystic ovarian disease. She presented at our health facility with acute abdomen. Her evaluation revealed heterotopic pregnancy. High index of suspicion for heterotopic pregnancy in any woman with early pregnancy presenting with acute abdomen is crucial. Therefore, correct and early diagnosis allows appropriate management while it preserves the intrauterine pregnancy as in the index case.

Scaling Up Context-Tailored Clinical Guidelines And Training To Improve Childbirth Care In Urban, Low-Resource Maternity Units In Tanzania: A Protocol For A Stepped-Wedged Cluster Randomized Trial With Embedded Qualitative And Economic Analyses (The Partoma Scale-Up Study), Nanna Maaløe, Natasha Housseine, Jane Brandt Sørensen, Josephine Obel, Brenda Sequeira Dmello, Monica Lauridsen Kujabi, Haika Osaki, Thomas Wiswa John, Rashid Saleh Khamis, Zainab Suleiman Said Muniro, Daniel Joseph Nkungu, Britt Pinkowski Tersbøl, Flemming Konradsen, Sangeeta Mookherji, Columba Mbekenga, Tarek Meguid, Jos Van Roosmalen, Ib Christian Bygbjerg, Thomas Van Den Akker, Andreas Kryger Jensen, Morten Skovdal, Hussein Kidanto, Dan Wolf Meyrowitsch

Faculty of Health Sciences, East Africa

While facility births are increasing in many low-resource settings, quality of care often does not follow suit; maternal and perinatal mortality and morbidity remain unacceptably high. Therefore, realistic, context-tailored clinical support is crucially needed to assist birth attendants in resource-constrained realities to provide best possible evidence-based and respectful care. Our pilot study in Zanzibar suggested that co-created clinical practice guidelines (CPGs) and low-dose, high-frequency training (PartoMa intervention) were associated with improved childbirth care and survival. We now aim to modify, implement, and evaluate this multi-faceted intervention in five high-volume, urban maternity units in Dar es Salaam, Tanzania (approximately 60,000 births …

Tuberculous Meningitis Presenting With Stroke In An Immunocompetent Adolescent: A Case Report, Rukhsar S. Osman, Rahim Damji, Zainab Y. Fidaali, Nahida Walli, Mariam Noorani

Faculty of Health Sciences, East Africa

Background:

Tuberculous meningitis (TBM) is a severe infection of the central nervous system that has high mortality. The disease predominantly affects young children and those who are immuncompromised. Strokes have been reported in about one-third of children with tuberculous meningitis and are associated with poor clinical outcomes.

Case report:

A previously healthy 14-year-old girl living in Dar es Salam, Tanzania presented with one month history of weight loss associated with weakness, loss of appetite, apathy; without respiratory symptoms. Anti-TB therapy was started, based on radiological findings of the chest which showed multiple patchy centrilobular nodules with linear branching pattern bilaterally, …

A Case Report Of Minimally Invasive Percutaneous Ultrasound Guided Tuberculous Iliopsoas Abscess Drainage In An Immunocompromised Patient, Allyzain Ismail, Neelam Ismail, Authar Ali, Shabbir Adamjee, Ahmed Jusabani, Zainab Fidaali

Faculty of Health Sciences, East Africa

Introduction and importance

Iliopsoas abscess is a collection of pus that presents with nonspecific features with often delays in diagnosis however cause significant morbidity and mortality with Mycobacterium tuberculosis to be considered as causative agent in at risk individuals in tuberculous endemic regions. Management involves drainage and initiation of adequate antibiotics with radiological guided percutaneous approach considered the appropriate initial approach.

Case presentation

50-year-old immunosuppressed presenting with left iliopsoas abscess who underwent ultrasound guided drainage and placement of pigtail catheter successfully without the need for open surgical drainage. Our experience of interventional radiology for diagnosis of causative agent and treatment …

Delivery Room St Segment Analysis To Predict Short Term Outcomes In Near-Term And Term Newborns, Jørgen Linde, Anne Lee Solevåg, Joar Eilevstjønn, Ladislaus Blacy, Hussein Kidanto, Hege Ersdal, Claus Klingenberg

Faculty of Health Sciences, East Africa

Background:

ST-segment changes to the fetal electrocardiogram (ECG) may indicate fetal acidosis. No large-scale characterization of ECG morphology immediately after birth has been performed, but ECG is used for heart rate (HR) assessment. We aimed to investigate ECG morphology immediately after birth in asphyxiated infants, using one-lead dry-electrode ECG developed for HR measurement.

Methods:

Observational study in Tanzania, between 2013–2018. Near-term and term infants that received bag-mask ventilation (BMV), and healthy controls, were monitored with one-lead dry-electrode ECG with a non-diagnostic bandwidth. ECGs were classified as normal, with ST-elevations or other ST-segment abnormalities including a biphasic ST-segment. We analyzed ECG …

Postoperative Subcutaneous Emphysema Following Percutaneous Nephrolithotomy: A Rare Complication, Hussam Uddin Soomro, Isaac Mawalla, Shabbir Adamjee, Nadeem Kassam, Authar Ali

Faculty of Health Sciences, East Africa

Percutaneous Nephrolithotomy (PCNL) is a common urological procedure performed for complicated upper urinary tract stones. The advantages of PCNL include lower morbidity and mortality rates and quicker recovery compared to traditional open surgery. A number of complications have been reported which can be life threatening. Here we present a case of 71 years old lady, who developed subcutaneous emphysema following PCNL.

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

Faculty of Health Sciences, East Africa

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

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

Seroprevalence Of Hepatitis B Virus Infection, Anti-Hcv Antibodies And Hiv And Knowledge Among People Who Use Drugs Attending Methadone Therapy Clinic In Tanzania; A Cross-Sectional Study, Semvua B. Kilonzo, Daniel L W Gunda, David C. Majinge, Hyasinta Jaka, Paulina M. Manyiri, Fredrick Kalokola, Grahame Mtui, Elichilia R. Shao, Fatma Bakshi, Alex Stephano

Faculty of Health Sciences, East Africa

Background

Methadone therapy clinics have been recently introduced in Tanzania, aiming at reducing risk behaviors and infection rates of viral hepatitis and HIV among people who use drugs. The objective of this study was to estimate the prevalence, associated factors and knowledge level of these conditions among people who use drugs attending a methadone clinic in Tanzania.

Methods

We enrolled 253 People who using drugs receiving Methadone therapy. Clinical data was retrospectively collected from the medical records and face-to face interviews were conducted to determine the behavioral risk factors and respondents’ knowledge on viral hepatitis and HIV.

Results

An overall …

Expired Carbon Dioxide During Newborn Resuscitation As Predictor Of Outcome, Kari Holte, Hege Ersdal, Claus Klingenberg, Joar Eilevstjønn, Hein Stigum, Samwel Jatosh, Hussein Kidanto, Ketil Størdal

Faculty of Health Sciences, East Africa

Aim:

To explore and compare expired CO2 (ECO2) and heart rate (HR), during newborn resuscitation with bag-mask ventilation, as predictors of 24-h outcome.

Methods:

Observational study from March 2013 to June 2017 in a rural Tanzanian hospital. Side-stream measures of ECO2, ventilation parameters, HR, clinical information, and 24-h outcome were recorded in live born bag-mask ventilated newborns with initial HR < 120 bpm. We analysed the data using logistic regression models and compared areas under the receiver operating curves (AUC) for ECO2 and HR within three selected time intervals after onset of ventilation (0-30 s, 30.1-60 s and 60.1-300 s).

Results:

Among 434 included newborns (median birth weight 3100 g), 378 were alive at 24 h, 56 had died. Both ECO2 and HR were independently significant predictors of 24-h outcome, with no differences in AUCs. In the first 60 s …

Spontaneous Fetal Reduction In Triplets And Prolongation Of Twin Pregnancy For 111 Days As An Outpatient: A Case Report, Davis Rubagumya,, Munawar Kaguta, Ernie Mdachi, Muzdalfat Abeid, Hussein Kidanto

Faculty of Health Sciences, East Africa

Background:

Multiple gestation has been on the rise because of advancement in assisted reproductive technology. Triplet pregnancy is associated with fetal loss and preterm birth as its major complications. Spontaneous triplet pregnancy is rare. In the case of fetal loss, delayed interval delivery has been used to achieve delivery of the retained fetuses. There is no common approach to delayed interval delivery. Case A 31-year-old East African lady with spontaneous triplet pregnancy presented to our institution at gestation age of 19 weeks with features of threatened miscarriage. One fetus was miscarried, and delayed interval delivery was done as an …

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

Faculty of Health Sciences, East Africa

Background:

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

Objectives:

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

Methods:

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

Testicular Torsion Induced By Epididymo-Orchitis: A Case Report, Ali Akbar Zehri, Allyzain Ismail, Philip Adebayo, Authar Ali

Faculty of Health Sciences, East Africa

Introduction and importance:

Acute scrotum is considered a urological emergency requiring early intervention depending on the cause. There are multiple causes of acute scrotum with testicular torsion being the most feared as delayed treatment leads to testicular loss. However, differentiating between epididymo-orchitis and torsion can be very difficult.

Case presentation: We present a case of an 18-year old male patient with 2 separate episodes of acute scrotum. He had epididymo-orchitis as the first presentation followed by testicular torsion 5 days later. To our knowledge this is the first case of testicular torsion secondary to epididymo-orchitis.

Clinical discussion: Differentiating between epididymo-orchitis …

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

Faculty of Health Sciences, East Africa

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

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

Faculty of Health Sciences, East Africa

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

F-Wave Parameters And Body Mass Index In Carpal Tunnel Syndrome, Philip Adebayo, Rose E. Mwakabatika

Faculty of Health Sciences, East Africa

Background

Severe carpal tunnel syndrome (CTS) readily lends itself to both clinical and electrophysiological recognition. The uncertainty sometimes is in identifying and quantifying motor involvement in mild and, perhaps, in moderate CTS. Our study aimed to evaluate F responses in mild and moderate CTS and determine the contribution of BMI to the F-wave parameters.

Methods A retrospective review of the clinical and electrophysiological data of patients with CTS seen at the clinical neurophysiology laboratory of Aga Khan Hospital, Dar es Salaam, between 1 August 2017 and 31 July 2019 was retrieved. Carpal tunnel syndrome was graded according to the electrophysiological …

Covid-19 And Teleneurology In Sub-Saharan Africa: Leveraging The Current Exigency, Philip Adebayo, Olusegun John Oluwole, Funmilola Tolulope Taiwo

Faculty of Health Sciences, East Africa

tion residing in rural areas that have poor access to medical experts. Despite having a ridiculously huge, underserved population, very few African countries currently have any form of sustained and organized telemedicine practice, and even fewer have dedicated tele-neurology services. The ongoing COVID-19 pandemic has proved to be one of the most significant disruptors of vital sectors of human endeavor in modern times. In the healthcare sector, there is an increasing advocacy to deliver non-urgent care via telemedicine. This paper examined the current state of tele-neurology practice and infrastructural preparedness in sub-Saharan Africa. Currently, there is over 70% mobile phone …

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

Faculty of Health Sciences, East Africa

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

Validation Of The Swahili Version Of The International Prostate Symptom Score At A Private, Nonprofit General Hospital In Dar Es Salaam, Tanzania, Miten Patel, Masawa Klint, Philip Adebayo, Authar Ali, Jasmit Shah, Ali Akbar Zehri

Faculty of Health Sciences, East Africa

Background:

Accuracy in translating the International Prostate Symptom Score (IPSS) into different languages is essential to ensure that it is comparable to the original version and acceptable to the target population. We aimed to develop and validate a Swahili version of the IPSS (sIPSS).

Methods:

We conducted a cross-sectional study involving 53 patients presenting with lower urinary tract symptoms to the Aga Khan Hospital in Dar es Salaam, Tanzania, from April through December 2018. We enrolled 53 patients with confirmed benign prostatic hypertrophy and 32 control patients with suspected or confirmed urolithiasis. We assessed the face validity and discriminative validity …

Learning From Changes Concurrent With Implementing A Complex And Dynamic Intervention To Improve Urban Maternal And Perinatal Health In Dar Es Salaam, Tanzania, 2011-2019, Brenda Sequeira Dmello, Ziada Sellah, Grace Magembe, Natasha Housseine, Nanna Maaløe, Thomas Van Den Akker, Dan W. Meyrowitsch, Timothy Mushi, Mangalu Masweko, Dorcas Jidayi, Jos Van Roosmalen, Hussein Kidanto

Faculty of Health Sciences, East Africa

Introduction Rapid urbanisation in Dar es Salaam, the main commercial hub in Tanzania, has resulted in congested health facilities, poor quality care, and unacceptably high facility-based maternal and perinatal mortality. Using a participatory approach, the Dar es Salaam regional government in partnership with a non-governmental organisation, Comprehensive Community Based Rehabilitation in Tanzania, implemented a complex, dynamic intervention to improve the quality of care and survival during pregnancy and childbirth. The intervention was rolled out in 22 public health facilities, accounting for 60% of the city’s facility births.

Methods Multiple intervention components addressed gaps across the maternal and perinatal continuum of …

Overview Of Antiretropulsion Devices For Prevention Of Inadvertent Stone Migration During Pneumatic Lithotripsy For Ureteric Stone, Ali Akbar Zehri, Miten Patel, Philip Adebayo, Authar Ali

Faculty of Health Sciences, East Africa

The purpose of the present chapter is to provide an update about the use of preventive devices used to stop retrograde stone migration during pneumatic lithotripsy for ureteric stone management. The aim to reduce the cost, ancillary procedure, reduce the operative time and improve the stone free rate. The hunt for ideal cadget to stop retrograde stone migration is still continue in 21 century.

Validation Of Kiswahili Version Of Hoqolhivbref Questionnaire Among People Living With Hiv/Aids In Tanzania: A Cross-Sectional Study, Nuru Kondo, Tumbwene Mwansisya, Eric Aghan, Riaz Ratansi

Faculty of Health Sciences, East Africa

Background: Quality of life is an important element of surveillance in people living with HIV/AIDS. WHO has developed an HIV specific quality of life tool (WHOQOLHIV-Bref) for assessing Quality of life of HIV individuals. This tool takes into account the different cultural variations that exist worldwide and hence enable assessment of the quality of life across different cultures. Despite its preliminary sound validity and reliability from several studies, the developers recommend it to be validated in different cultures to fully assess its psychometric properties before its adaptation.

Objectives: To evaluate the validity and reliability of WHOQOLHIV-Bref questionnaire in …

State Transition Modeling Of Complex Monitored Health Data, Jörn Schulz, Jan Terje Kvaløy, Kjersti Engan, Trygve Eftestol, Samwel Jatosh, Hussein Kidanto, Hege Ersdal

Faculty of Health Sciences, East Africa

This article considers the analysis of complex monitored health data, where often one or several signals are reflecting the current health status that can be represented by a finite number of states, in addition to a set of covariates. In particular, we consider a novel application of a non-parametric state intensity regression method in order to study time-dependent effects of covariates on the state transition intensities. The method can handle baseline, time varying as well as dynamic covariates. Because of the non-parametric nature, the method can handle different data types and challenges under minimal assumptions. If the signal that is …

Low Use Of Vacuum Extraction: Health Care Professionals’ Perspective In A University Hospital, Dar Es Salaam, Henrik Makokha-Sandell, Andrew Mgaya, Johanna Belachew, Helena Litorp, Hussein Kidanto, Birgitta Essén

Faculty of Health Sciences, East Africa

Background Use of vacuum extraction (VE) has been declining in low and middle income countries. At the highest referral hospital Tanzania, 54% of deliveries are performed by caesarean section (CS) and only 0.8% by VE. Use of VE has the potential to reduce CS rates and improve maternal and neonatal outcomes but causes for its low use is not fully explored.

Method During November and December of 2017 participatory observations, semi-structured in-depth interviews (n = 29) and focus group discussions (n = 2) were held with midwives, residents and specialists working at the highest referral hospital in Tanzania. Thematic analysis …

Negative Appendectomy Rate In Urban Referral Hospitals In Tanzania: A Cross-Sectional Analysis Of Associated Factors, Nyamuryekung’E Klint Masawa, Authar Ali, Miten Ramesh Patel, Aidan Njau, Omar Sherman, Ahmed Jusabani, Ali Akbar Zehri

Faculty of Health Sciences, East Africa

Background:

Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negative appendectomy rates (NAR). This study aimed to establish NAR and explore the associated factors and possible attainable solutions to reduce it in urban referral hospitals in Tanzania.

Methods:

This was a crosssectional study with 91 consecutive patients, aged 10 years and older undergoing appendectomy for suspected AA with histological evaluation of specimens. The study was powered to detect the NAR …

Magnitude Of Screening For Gestational Diabetes Mellitus In An Urban Setting In Tanzania; A Cross-Sectional Analytic Study, Akampa Mukuve, Mariam Noorani, Ibrahim Sendagire, Miriam Mgonja

Faculty of Health Sciences, East Africa

Background

Medical screening detects risk factors for disease or presence of disease in otherwise well persons in order to intervene early and reduce morbidity and mortality. During antenatal care (ANC) it is important to detect conditions that complicate pregnancy, like gestational diabetes mellitus (GDM). Despite international and local guidelines recommending screening for GDM during ANC, there is evidence to suggest that the practice was not being carried out adequately. A major challenge may be lack of consensus on uniform GDM screening and diagnostic guidelines internationally and locally.

The primary objective was to determine the magnitude of screening for GDM among …

Family Medicine In Tanzania: Seize The Moment, Riaz Ratansi, Bernhard M. Gaede

Faculty of Health Sciences, East Africa

In the context of addressing the pressing health needs for the global population, the World Health Organization has repeatedly called for universal health coverage (UHC) to be prioritised by its member countries. This is to be achieved through a high-quality primary health care (PHC) approach that provides comprehensive and integrated generalist care as close to where people live as well as links the clinical care to health promotion and disease prevention. In this paper, we argue for the introduction of family medicines as a critical player in the healthcare system of Tanzania to strengthen the strategies towards UHC. The paper …

Revisiting Caroli Syndrome In A Tanzanian Patient, Casmir Wambura, Sharma, Munishi, Salim Suran

Faculty of Health Sciences, East Africa

Caroli disease and Caroli syndrome are two rare congenital diseases of the intrahepatic bileducts. Caroli syndrome is characterized by the saccular dilatation of intrahepatic bile ductsassociated with congenital hepatic fibrosis. It is rarely diagnosed in childhood. We herebydescribe a case of Caroli syndrome in a young Tanzanian female who had abdominal pain anddistension since childhood. Her history suggested the presence of portal hypertension possiblyfrom congenital hepatic fibrosis. The diagnosis was reached based on ultrasound, computedtomography (CT) scan of the abdomen, and magnetic resonancecholangiopancreatography (MRCP)

Kawasaki Disease: Two Case Reports From The Aga Khan Hospital, Dar Es Salaam-Tanzania, Mariam Noorani, Nuruddin Lakhani

Faculty of Health Sciences, East Africa

Background

Kawasaki disease is a common childhood vasculitis which may result in cardiovascular morbidity if not adequately treated. Its epidemiology in the African region is not well described. Its features may mimic other childhood infections and hemoglobinopathies and it is rarely diagnosed in the East African region. These are the first reports of this disease from Tanzania. Case presentation We present two cases of complete Kawasaki disease seen over a 2 year period and diagnosed as per the criteria defined by the American Heart Association. One child was and infant and the other a 3 year old. Both of them …