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| 2. |
- Mongella, Stella, et al.
(author)
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High prevalence of Plasmodium falciparum pfcrt K76T mutation in children with sickle cell disease at a tertiary hospital in north-western Tanzania
- 2014
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In: Tanzania Journal of Health Research. - : African Journals Online (AJOL). - 1821-6404 .- 1821-9241. ; 16:4
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Journal article (peer-reviewed)abstract
- The high prevalence of sickle cell disease (SCD) and trait in Sub-Saharan Africa coincides with thedistribution of Plasmodium falciparum malaria. Due to prolonged heavy use of chloroquine (CQ) as anantimalarial, drug resistance has developed. Many countries including Tanzania abandoned the use of CQfor uncomplicated malaria, except its use as prophylaxis in patients with sickle cell disease. This studyinvestigated the prevalence of malaria in SCD patients and mutations associated with CQ resistance.Children diagnosed with sickle cell disease attending both outpatient clinic and those admitted at BugandoMedical Centre in north-western Tanzania were screened for malaria using thick blood smear. A driedblood spot on Whatman filter paper was also taken for polymerase chain reaction (PCR) and restrictionfragment length polymorphism. Among 123 known patients with sickle cell disease, the prevalence ofmalaria by blood smear microscopy was 3.2% and by PCR was 13.8%. The prevalence of K76T mutationamong the patients was 81.3%. The majority of the patients (72.4%) were using chloroquine prophylaxis. Inconclusion, the prevalence of malaria parasitaemia among children with sickle cell disease attending BMC islow (3.2%) by microscopy but several children maintain sub patent infection detectable by PCR. Theprevalence of chloroquine resistant P. falciparum in these children was higher than that previously seen innormal population in Tanzania. We recommend special attention to be paid to patients with sickle celldisease while studying the dynamics of drug resistant parasites.
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- Kamugisha, Erasmus, et al.
(author)
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Detecting adenosine triphosphatase 6 point mutations that may be associated with Plasmodium falciparum resistance to artemisinin : prevalence at baseline, before policy change in Uganda
- 2011
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In: Tanzania Journal of Health Research. - 1821-6404. ; 13:1, s. 50-60
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Journal article (peer-reviewed)abstract
- The artemisinin based combination therapy (ACT) of artemether and lumefantrine (Co-artem) has recently replaced chloroquine and fansidar as the first line treatment policy drug in Uganda. It is necessary to develop practical procedures to monitor the likely emergence and spread of artemisinin resistant P. falciparum strains. We have analyzed the genotypes of PfATP6 in parasites from 300 stored filter paper samples from malaria patients who were diagnosed and treated in the years 1999 to 2004 at three field sites in Uganda. This is a period just prior to introduction of Co-artem. In order to develop a simple molecular procedure for mutation detection, regions of PfATP6 encoding protein domains important in artemisinin binding was amplified by nested PCR. Three DNA products, which together contain most of the coding region of amino acids located within the putative active site of pfATP6 were readily amplified. The amplified DNA was digested by restriction enzymes and the fragments sized by agarose gel electrophoresis. For the important codons 260, 263 and 769, methods using engineered restriction sites were employed. We did not find mutations at codons for the key residues Lys 260, Leu263, Gln266, Ser769 and Asn1039. Nucleotide sequencing of pfATPase6 gene DNA from at least 15 clinical isolates confirmed the above findings and suggested that mutations at these amino acid residues have not emerged in our study sites.
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- Mbwilo, G. S. K., et al.
(author)
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Family perceptions in caring for children and adolescents with mental disabilities : a qualitative study from Tanzania
- 2010
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In: Tanzania Journal of Health Research. - 1821-6404. ; 12:2, s. 1-12
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Journal article (peer-reviewed)abstract
- Observations have shown that the provision of services to children and adolescents withmental disability (CAMDs) is not responding to the needs of this population. This community based study was carried out in Temeke Municipality in Tanzania and aimed to explore factors that influence family perspectives in the provision of care to CAMDs. This is a qualitative study of 52 respondents from 29 families involved in the daily care of CAMDs, chosen through convenient sampling. A semistructured questionnaire was used in the interviews. The text was analysed using thematic content analysis. The results of the study revealed family characteristics; deficient knowledge about mentaldisability (MD); and lack of health care facilities and resources for caring for CAMDs. The communityand families of CAMDs had poor knowledge on MD and appropriate care, and about availability of resources and quality care. Families were not supported in the care of their children. Some children inconsequence did not receive adequate health care. Some suffered from physical problems due to inadequate care; others were being locked in their room during periods when no‐one was able to look after them. These factors were related to socio‐economic characteristics of the families as well as t olacking service facilities. “Patient”‐oriented, community/family‐based health services to support management of chronic or life‐long conditions such as MD are needed. The support of caregivers to children with MDs has to be improved. A well worked‐out strategy would improve health care of CAMDs through provision of guidance and supervision to the families. Community and family/home‐based care in the study area would benefit families of CAMDs.
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| 5. |
- Sirili, Nathanael, et al.
(author)
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Addressing the human resource for health crisis in Tanzania : The lost in transition syndrome
- 2014
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In: Tanzania Journal of Health Research. - 1821-6404. ; 16:2
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Journal article (peer-reviewed)abstract
- Tanzania is experiencing a serious Human Resource for Health (HRH) crisis. Shortages are 87.5% and 67% in private and public hospitals, respectively. Mal-distribution and brain drain compound the shortage. The objective of this study was to improve knowledge on the HRH status in Tanzania by analyzing what happens to the number of medical doctors (MD) and doctor of dental surgery (DDS) degree graduates during the transition period from graduation, internship to appointment. We analyzed secondary data to get the number of MDs and DDS; who graduated from 2001 to 2010, the number registered for internship from 2005 to 2010 and the number allowed for recruitment by government permits from 2006 to 2010. Self administered questionnaires were provided to 91 MDs and DDS who were pursuing postgraduate studies at Muhimbili University of Health and Allied Sciences during this study who went through the graduation-internship-appointment (GIA) period to get the insight of the challenges surrounding the MDs and DDS during the GIA period. From 2001 to 2010 a total of 2,248 medical doctors and 198 dental surgeons graduated from five local training institutions and abroad. From 2005 to 2010 a total of 1691 (97.13%) and 186 (126.53%) of all graduates in MD and DDS, respectively, registered for internship. The 2007/2008 recruitment permit allowed only 37.7% (80/218) and 25.0% (7/27) of the MDs and DDS graduated in 2006, respectively. The 2009/2010 recruitment permit allowed 265 MDs (85.48%) out of 310 graduates of 2008. In 2010/2011 permission for MDs was 57.58% (190/ 330) of graduates of 2009 and in 2011/2012 permission for MDs was for 61.03% ((249/408) graduates of 2010. From this analysis the recruitment permits in 2007/2008, 2009/2010, 2010/2011 1nd 2011/2012 could not offer permission for employment of 482 (38.10%) of all MDs graduated in the subsequent years. Major challenges associated with the GIA period included place of accommodation, allowance (for internship) or salary delay (for first appointment), difficulty working environment, limited carrier opportunities and concern for job security. The failure to enforce mandatory registration for internship and failure to absorb all produced MDs and DDS results to loss of a substantial number of these graduates during the graduation-internshipappointment period. To solve this problem, it is recommended to establish better human resource for health management system.
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