East Africa Science

Obituary for Professor Eliningaya John Kweka (1973-2025): A Fallen African Elephant

2026-04-22T18:27:03+00:00

Professor Eliningaya John Kweka was a Tanzanian medical entomologist and research professor, widely recognized for his work on malaria and vector biology. He was born on 18th February 1973 at Nshara village, north Machame ward of Hai district, along the slopes of Mount Kilimanjaro, Tanzania. He was born into a family of educators; his father and mother were teachers. His father Mwalimu John Kweka worked as a teacher at the Teachers training college and his mother as a primary school teacher.
He began his education at Mazoezi Primary School, Monduli district, Arusha region, Tanzania where he studied from 1981 to 1987. From 1988 to 1991, he pursued his ordinary level education at Moringe Sokoine Secondary School in Monduli District, Arusha Region. He then advanced to Old Moshi Secondary School in Kilimanjaro region, where he completed his advanced level studies between 1992 and 1994.

Inducible Clindamycin Resistance in Gram-positive Cocci Isolated from Clinical Specimens of Patients with Bacterial Infections at a Tertiary Hospital in Tanzania

2026-04-22T18:27:03+00:00

Background: Clindamycin is a reserved antibiotic used to treat infections caused by Gram-positive cocci; however, increasing bacterial resistance threatens its effectiveness. Routine antimicrobial susceptibility testing may fail to detect inducible macrolide-lincosamide-streptogramin B (iMLS B) resistance, which requires the double disc diffusion (D-test) for accurate identification. Therefore, this study aimed to use the D-test to determine the prevalence of inducible clindamycin resistance among Gram-positive cocci isolates from patients with bacterial infections at a tertiary hospital in Tanzania.
Methods: A cross-sectional study was conducted among patients presenting with bacterial infections at Muhimbili National Hospital (MNH) in Tanzania from April to August 2022. Convenience sampling was used to include all eligible clinical specimens yielding Gram-positive cocci during the study period. All Gram-positive cocci isolated from the participants’ clinical specimens were subjected to antimicrobial susceptibility testing (AST) using the Kirby-Bauer disc diffusion method, and the D-test was performed to phenotypically detect iMLS B resistance. Demographic variables (age and sex), clinical specimen types, bacterial species, and antimicrobial resistance profiles were collected from patients’ records and laboratory results. Data were analyzed using Stata® Statistical Software version 15.1 (StataCorp LLC, College Station, TX, USA). Descriptive statistics were used to summarize the data, while the Chi-square test was used for analysis of categorical variables. A p-value < 0.05 was considered statistically significant.
Results: A total of 246 Gram-positive cocci isolates from clinical specimens were analyzed. The majority were Coagulase-negative Staphylococci (CoNS) 64.6%, followed by Staphylococcus aureus 30.1%. The prevalence of inducible clindamycin resistance was 25.2% (95% Confidence Interval (CI) [20.2%-30.9%]). Among the Staphylococcus aureus and CoNS isolates, 39.2% (95% CI [28.9%-50.6%]) and 20.8%(95% CI [15.2%-27.7%]) exhibited the iMLS B resistance phenotype, respectively. In addition, 63.5% of Staphylococcus aureus isolates were phenotypically confirmed as methicillin-resistant Staphylococcus aureus (MRSA), and 44.7% of these isolates demonstrated the iMLS B resistance phenotype. Furthermore, 75.6% (95% CI [69.9%-80.6%]) of the Gram-positive bacterial isolates were multidrug-resistant (MDR).
Conclusions: The present study demonstrated that a substantial proportion of Gram-positive cocci isolates exhibited iMLS B resistance, and the prevalence of MDR was high. These findings highlight the importance of incorporating the D-test into routine antimicrobial susceptibility testing to guide appropriate antibiotic therapy for infections caused by Gram-positive cocci. Furthermore, the results provide baseline evidence for future surveillance studies and support the need for strengthened antimicrobial stewardship programs and continued research to monitor and control antibiotic resistance in resource-limited settings.

Prevalence and Microbial Distribution of Bacterial Vaginosis Among Women of Reproductive Age at Kilimanjaro Christian Medical Centre: A Three-Year Retrospective Laboratory Based Study

2026-04-22T18:27:03+00:00

Background: Bacterial vaginosis is a prevalent and often asymptomatic vaginal condition affecting women of reproductive age, posing significant reproductive health risks. Despite its importance, data on BV prevalence, microbial profiles, and associated factors at Kilimanjaro Christian Medical Centre, a major tertiary hospital in northern Tanzania, remain limited. Therefore, this study aimed to address these gaps.
Methods: This was a three-year retrospective laboratory based study of 891 high vaginal swab samples collected from women aged 15–49 years at KCMC between January 2021 and December 2023. Bacterial vaginosis was diagnosed using Amsel criteria and Nugent scoring. Demographic and clinical data were retrieved from the hospital electronic medical system. Data were analysed using descriptive and inferential statistics. P value of <.05 was considered statistically significant.
Results: Overall prevalence of bacterial vaginosis was 324 (36.4%). The majority of the studied vaginal samples belonged to women aged 25–34 years 359 (40.3%), and most samples were collected from the Outpatient Department 618 (69.4%). Microbiological analysis revealed that no bacterial growth was the most common finding 565 (63.4%), followed by Candida albicans 205 (23.0%) and Escherichia coli 58 (6.5%). In multivariable logistic regression, attendance at the Labour Ward was significantly protective against BV (AOR = 0.096; 95% CI: 0.012–0.787; P= .029), while the year of sample collection also predicted BV: samples from 2022 had reduced odds (AOR=0.63; 95% CI: 0.40–0.96; P=.035), and samples from 2023 had increased odds (AOR=2.24; 95% CI: 1.51–3.32; P<.01) compared to 2021. Age category and individual microorganisms were not independent predictors of BV.
Conclusion: This study showed a high prevalence of bacterial vaginosis (36.4%) with flactating trend among women of reproductive age at KCMC. The most affected were women of reproductive age attending labour ward. The high prevalence among pregnant women has important reproductive health implications, highlighting the need for routine screening to prevent adverse pregnancy outcomes.

Prevalence and Determinants of Carbapenem Resistance Among ESBL-Producing Enterobacteriaceae in Biological Specimens at Kilimanjaro Christian Medical Centre, Moshi, Tanzania

2026-04-22T18:27:03+00:00

Background: Carbapenem resistance represents a critical global health threat, as it undermines the efficacy of last resort antibiotics used to manage infections caused by multidrug-resistant, extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae. The burden is disproportionately higher in low- and middle-income countries, particularly in Africa, due to economic constraints and limited healthcare infrastructure. In sub-Saharan Africa, data on the prevalence and distribution of carbapenem resistance remain limited; however, existing studies highlight its growing emergence among the ESBL-producing Enterobacteriaceae in the region.
Objectives: The aim of this study was to determine the prevalence and determinants of carbapenem resistance among ESBL-producing Enterobacteriaceae isolated from biological specimens at Kilimanjaro Christian Medical Centre.
Methodology: A cross-sectional laboratory-based study was conducted from April to June 2023 at KCMC University, analysing 166 Enterobacteriaceae isolates from urine, pus, and blood. The production of ESBL was confirmed by phenotypic carbapenemase screening via the modified carbapenem inactivation method as per Clinical and Laboratory Standards Institute (CLSI) guidelines. Socio-demographic and clinical data were retrieved using data extraction sheets. Statistical analysis was performed using SPSS version 27, and a P value of <.05 was considered statistically significant.
Results: A total of 166 ESBL-producing Enterobacteriaceae were tested for carbapenemase production, 36 (21.7%) revealed to be resistant to carbapenem. The distribution of carbapenemase production E. coli were most prevalent at 23 (13.8%) followed by Citrobacter freundii at 7 (4.2%). Multivariable analysis revealed history of hospital admission within the past three months (AOR 6.28, 95% confidence interval [CI], 1.79 to 22.04; P=.004), the use of indwelling devices during the study period (P=.038), and the presence of comorbid conditions (P=.014) as independent predictors of carbapenem resistance.
Conclusion: The substantial prevalence observed underscores the urgent need to strengthen antimicrobial stewardship, enhance infection prevention strategies, and improve routine surveillance systems in resource-limited healthcare settings.

Bacterial Contamination of Inanimate Surfaces and Equipment, Distribution and Susceptibility Patterns in Paediatric Wards at a Northern Tanzania Zonal Referral Hospital

2026-04-22T18:27:03+00:00

Background: Hospital-acquired infections (HAIs) represent a significant global health concern, contributing to high rates of morbidity and mortality. Globally, bacterial contamination of hospital surfaces and equipment has been identified as a critical pathway for the transmission of nosocomial infections. Despite its significance, the extent of surface and equipment contamination in pediatric wards at Kilimanjaro Christian Medical Centre (KCMC) remains underexplored. This study aims to determine the proportion of bacterial contamination of inanimate surfaces and equipment, distribution and susceptibility patterns in pediatric wards at Northern Tanzania Zonal Referral Hospital.
Methodology: A descriptive cross-sectional hospital-based study was conducted in pediatric wards from May to August 2021. The study was conducted at Kilimanjaro Christian Medical Center, a Northern Tanzania Zonal Referral Hospital. Swabs were collected from inanimate surfaces and equipment and cultured on general-purpose media, differential media, and enriched media which were MacConkey agar, Blood agar and Chocolate agar to identify the bacteria isolated. Data was entered and analyzed using Statistical Package for the Social Sciences (SPSS).
Results: 206 (86.6%) were positive for bacterial growth. Gram-negative bacteria were the most predominant isolates, accounting for 304 (82.4%), with E. coli as the leading species 114 (30.9%), followed by Pseudomonas aeruginosa 93 (25.2%), Klebsiella oxytoca 44 (11.9%), Klebsiella pneumoniae 41 (11.1%), Acinetobacter species 10 (2.7%), Proteus vulgaris 1 (0.3%), and Citrobacter species 1 (0.3%). Gram-positive isolates accounted for 65 (17.6%), of which CoNS constituted 58 (15.7%) and S. aureus 7 (1.9%).
Conclusion: In pediatric wards, surfaces and equipment can harbor diverse pathogenic bacteria with the potential to cause hospital-acquired infections to patients especially immuno-compromised or critically ill patients. To mitigate this risk, it is crucial to assess infection prevention practices, implement regular disinfection programs and raise awareness among healthcare professionals about the potential for pathogen transmission from hospital surfaces and equipment.

Predominance of Gram-negative Bacteria in Orthopaedic Implant Infections: A Hospital-Based Cross-Sectional Study in Western Kenya

2026-04-22T18:27:04+00:00

Background: Orthopaedic implant infections remain a major clinical challenge, often complicated by biofilm formation that impairs antibiotic penetration and delays healing. Globally, the infection rate is about 13% in primary implantation and 40% in revision surgeries. In Kenya, the infection rate is about 13.8%. Gram-negative bacteria are increasingly recognised as key pathogens, yet data from Kenya remain limited.
Materials and Methods: This cross-sectional study was conducted at Kakamega County Teaching and Referral Hospital (KCTRH) between January 2023 and March 2024. A total of 191 patients with clinically suspected orthopaedic implant infections were enrolled in the study. Purposive sampling was used to recruit participants. Specimens (wound swabs) were inoculated on blood, MacConkey, and chocolate agar and incubated aerobically at 37°C for 24–48 hours. Bacterial identification and antimicrobial susceptibility testing were performed using standard biochemical tests and the VITEK 2 Compact system (bioMérieux, France). Sample size was estimated using Fisher’s formula, assuming an expected prevalence of 20%, a 5% margin of error, and a 95% confidence interval.
Results: Overall, the most prevalent Gram-negative species were Klebsiella pneumoniae (29.3%), Escherichia coli (17.9%), Pseudomonas aeruginosa (16.9%), and Citrobacter freundii (10.3%). Other Gram-negatives, including Proteus mirabilis, Providencia stuartii, Raoultella ornithinolytica, and Klebsiella oxytoca, were detected in <2.2% of cases. Staphylococcus aureus (14.9%) and Staphylococcus epidermidis (2.1%) were the only Gram-positive species. Infections occurred mainly in the early (47.67%) and delayed (50.78%) phases, with Klebsiella pneumoniae predominating in both phases. High resistance was observed to ampicillin, penicillin, vancomycin, and several cephalosporins, while amikacin and piperacillin-tazobactam showed the highest sensitivity.
Conclusion: Gram-negative bacteria, predominantly Klebsiella pneumoniae, were a major causative agent of orthopaedic implant infections, suggesting a shift from Staphylococcus aureus. The resistance patterns emphasise the need for routine, individualised AST to guide effective therapy.

Antimicrobial Susceptibility Patterns of Bacterial Isolates at Tertiary Hospital in Tanzania: A Retrospective Cross-Sectional Study

2026-04-22T18:27:04+00:00

Background: Antimicrobial resistance (AMR) has escalated significantly within healthcare facilities and community settings, presenting substantial challenges in the management of bacterial infections. Our research aimed to analyze three-year trends in antimicrobial susceptibility through the evaluation of AMR patterns in blood, urine, and wound swabs.
Methods: A retrospective cross sectional study was carried out at The Benjamin Mkapa Tertiary Hospital (BMH) in Dodoma, Tanzania. Researchers reviewed electronic medical records and laboratory results of patients from January 2020 to December 2022.
Results: The number of positive blood samples tested for antimicrobial susceptibility testing (AST) was 166 (2020). Escherichia coli showed resistance trends to ceftriaxone 100 (60%), meropenem 19 (12%), amikacin 21 (12%), and piperacillin-tazobactam 17 (10%). Staphylococcus aureus exhibited resistance trends of 89 (46%) for ciprofloxacin and 75 (45%) for levofloxacin, while those for gentamicin, vancomycin, and azithromycin were 30 (18%), 18 (11%), and 58 (35%), respectively. ASTs were performed on 65 positive wound/pus swabs in 2020. Pseudomonas aeruginosa showed fluctuating resistance patterns to ciprofloxacin, meropenem, and piperacillin-tazobactam over the years: 7 (11%), 17 (26%), and 19 (29%) in 2020. In 2020, 107 urine samples were tested for AST. Escherichia coli showed resistance to nine antimicrobials, including ceftazidime 20 (19%), meropenem 7 (7%), piperacillin-tazobactam 7 (32%), cefuroxime 9 (8%), amoxicillin-clavulanic acid 29 (27%), nitrofurantoin 7 (7%), and amikacin 8 (8%).
Conclusion: The findings underscore an increase in antimicrobial resistance (AMR) among priority pathogens, emphasising the importance of evidence-based antibiotic selection for direct treatment, empiric therapy, and surgical prophylaxis. We recommend future prospective, ward-specific, and outpatient-inpatient comparative AMR surveillance to address existing limitations and improve infection management strategies.

Antimalarial Activity and Safety of Conyza pyrrhopappa Sch. Bip. ex A. Rich

2026-04-22T18:27:04+00:00

Background
Malaria continues to pose a significant global health challenge, particularly in developing countries including Tanzania. The rising resistance to existing antimalarial drugs has intensified the need for alternative therapeutic options.
Objective: This study aimed to evaluate the in-vivo antimalarial activity and safety profile of Conyza pyrrhopappa.
Methodology: Plant materials were collected from Mbulu District in Manyara Region, Tanzania. Extraction was performed using 80% ethanol-water. Fractionation was carried out via liquid-liquid partitioning with solvents of varying polarity, starting with petroleum ether, dichloromethane, and ethyl acetate. The in-vivo antimalarial activity was evaluated using a 4-day suppressive assay. Mice were infected with 2×107 erythrocytes infected with Plasmodium berghei ANKA. Chloroquine was used as a positive control, and extracts were administered orally. The crude extract’s effects on peripheral blood mononuclear cells (PBMCs) and brine shrimps were assessed. The oral acute toxicity was tested in mice.
Results: Conyza pyrrhopappa extracts demonstrated significant in-vivo antimalarial activity compared with the negative control group. The highest average percentage suppression of parasitaemia (65.7%) was observed with the leaf extract at a dose of 800 mg/kg body weight. The ethyl acetate leaf fraction exhibited the highest parasitaemia suppression compared with the negative control (P≤.001). In PBMCs, growth inhibition was found to be concentration-dependent, with an IC₅₀ (95% CI) of 94.56 (45.82-196.8) μg/ml. In the brine shrimp lethality assay, the leaf extract exhibited an LC₅₀ of 144.2 μg/ml (95% CI, 110.9 to 187.5). The oral acute toxicity test indicated that the leaf crude extract is safe, with an LD₅₀>2000 mg/kg body weight in mice.
Conclusion: Conyza pyrrhopappa leaf and root extracts demonstrated safety and in-vivo antimalarial activity. These findings support the traditional use of the plant in malaria treatment. Further research focusing on the ethyl acetate leaf fraction could lead to the identification of potent antimalarial compounds.

MEF2C Mutation Analysis in Patients with Congenital Heart Diseases Among the Tanzanian Population

2026-04-22T18:27:04+00:00

Background: Congenital heart disease (CHD) is the most common congenital anomaly worldwide and a leading cause of infant morbidity and mortality, particularly in low- and middle-income countries. Genetic factors, including mutations in cardiac transcription factor genes such as MEF2C, play a critical role in cardiac development. However, data on MEF2C gene mutations in Sub-Saharan Africa remain limited. This study aimed to determine the presence of MEF2C gene mutations among infants with CHD attending Jakaya Kikwete Cardiac Institute (JKCI), Tanzania.
Methods: A case-control study was conducted involving 62 infants with echocardiographically confirmed CHD and 101 healthy controls aged 0 to 12 months. Genomic DNA was extracted from dry blood spot samples, and polymerase chain reaction (PCR) was used to amplify exon 1 and exon 11 of the MEF2C gene. Due to resource constraints, 10 samples from cases and 10 from controls with adequate DNA quality were selected for sequencing. Sequence analysis was performed using BLAST and MEGA11 software, and the pathogenicity of identified variants was assessed using MutationTaster and Swiss-modeling tools.
Results: Among the sequenced samples, two non-synonymous MEF2C mutations were identified exclusively in CHD cases. A missense mutation (c.185T>A; p.M62K) was detected in an 8-month-old male with patent ductus arteriosus, while an insertion mutation (c.64_65insA; p.T22N) causing a frameshift and truncated protein was identified in an 8-month-old female with tetralogy of Fallot. These mutations were absent in all control samples and were predicted to be disease-causing.
Conclusion: This study identified potentially pathogenic MEF2C gene mutations among infants with CHD, suggesting a role of this gene in the disease pathogenesis. The findings highlight the importance of genetic studies in understanding CHD in low-resource settings and underscore the need for larger-scale genomic and functional studies to validate these associations.

High Burden of Biochemical Liver Function Test Abnormalities and Clinical Implications in Chronic Heart Failure Patients: A Cross Sectional Study at a Tertiary Hospital in Rwanda

2026-04-22T18:27:04+00:00

Background: Chronic heart failure (CHF), a significant global health burden, precipitates multi-organ dysfunction, including liver impairment. However, data on biochemical liver function test (LFT) profiles in Africa settings remain limited. This study aimed to determine the prevalence and severity of biochemical LFT abnormalities among Rwandan CHF patients and examine their association with the cardiac function category (New York Heart Association [NYHA] class).
Methods: A hospital-based cross-sectional study was conducted among 65 adults with confirmed CHF at the University Teaching Hospital of Butare (CHUB) from March to May 2025. Consecutive adult patients (≥18 years) with CHF were recruited from both outpatient and inpatient wards. Participants provided written informed consent before commencing study procedures. Sociodemographic and clinical data were collected using a structured questionnaire. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gammaglutamyl transferase (GGT), total bilirubin (TBil) and albumin were analysed using the Architect ci4100 chemistry autoanalyser. Biochemical LFT abnormalities were defined according to manufacturer‑specified reference intervals. Associations between LFTs and NYHA class were analysed using the chi-square test.
Results: Liver function test abnormalities were observed in most study participants. The most frequent derangements were elevated ALP (n=54, 83.08%), TBil (n=51, 78.46%), hypoalbuminaemia (n=48, 73.85%), and elevated GGT (n=46, 70.77%). Aminotransferase elevations were less common with ALT abnormal (n=32, 49.23%) and AST (n=24, 36.92%). Significant associations were identified between NYHA class and hypoalbuminaemia (P=.012) as well as elevated GGT (P=.034), with abnormalities becoming more frequent in patients with more severe functional classes.
Conclusion: Biochemical liver dysfunction, predominantly cholestatic abnormalities and hypoalbuminaemia, is common among Rwandan CHF patients and increases with advancing symptom severity. Routine monitoring of liver function tests can aid early detection of decompensation, guide timely nutritional and decongestive interventions, and support individualized management strategies to improve outcomes.

Effectiveness of Canalith Repositioning Manoeuvres in the Management of Benign Paroxysmal Positional Vertigo: A Longitudinal Study Among Patients With Vestibular Disorders at a Tertiary Hospital in Tanzania

2026-04-22T18:27:04+00:00

Background: Previous studies have shown that canalith repositioning manoeuvres (CRM), such as Epley’s manoeuvre, offer adequate treatment for Benign Paroxysmal Positional Vertigo (BPPV) with a success rate of over 90% after a single treatment session. Benign Paroxysmal Positional Vertigo (BPPV) is one of the otological disorders encountered during routine otorhinolaryngology practice in the study area. Data on the effectiveness of CRM in the management of BPPV in Tanzania remain extremely scarce. This study aimed to determine the proportion of BPPV and the effectiveness of CRM among patients with vestibular disorders at Muhimbili National Hospital in Tanzania.
Methods: A hospital-based longitudinal study was conducted from October 2022 to March 2023 at a vestibular clinic of Muhimbili National Hospital, Tanzania. The study included 133 male and female patients with vestibular disorders such as dizziness, vertigo, and/or imbalance. Patients underwent initial Dix-Hallpike and Supine head roll tests, with results recorded, including the site and side of the semicircular canal (SCC) involved for BPPV, followed by the performance of CRM. A one-week follow-up assessed the conversion from a positive to a negative BPPV test. For those whose tests remained positive, weekly re-evaluations and additional CRM sessions were conducted until a negative conversion was achieved. The data collected was analysed using the Statistical Package for the Social Sciences Version 25.0.
Results: A total of 133 patients were recruited and 29 (21.8%) were diagnosed with BPPV. The most affected age group was 67-86 years, 11 (36.7%), with a mean age of 55.14±17.7 years. The proportion of BPPV was higher in females, 23 (27.1%), than in males, 6 (12.5%), (M: F ratio of 1:3.8). Majority of patients, 27 (93.2%) had Posterior SCC BPPV (16 had Right Posterior SCC BPPV and 11 had Left Posterior SCC BPPV), followed by 2 (6.8%) having Horizontal SCC BPPV (One patient with Right and one with Left Horizontal SCC BPPV) However, no one was found to have Anterior SCC BPPV. The majority of BPPV-positive patients, 24 (82.8%), converted to a negative BPPV test after the first CRM, and a few required up to a fourth CRM.
Conclusion: Benign Paroxysmal Positional Vertigo is one of the most common diagnoses among patients with vestibular disorders in our setting. It is characterised by vertigo and nystagmus caused by inertia of the otoconia in the semicircular canals and diagnosed by Dix-Hallpike and supine head roll tests. In this study, CRM has shown significant effectiveness in BPPV treatment. Therefore, healthcare providers should be aware that most patients require only one manoeuvre; however, follow-up remains essential as some may need up to four manoeuvres to achieve full recovery.
Keywords: Vertigo, Benign paroxysmal positional vertigo, Canalith repositioning manoeuvre, Vestibular Disorder, Dix-Hallpike test, Tanzania

Pattern of Skin Diseases and their Impact on Quality of Life Among Adults Attending the Dermatology Clinic at Muhimbili National Hospital, Tanzania

2026-04-22T18:27:04+00:00

Background: Skin diseases contribute substantially to morbidity worldwide and are associated with impaired health-related quality of life (HRQoL). In sub-Saharan Africa, clinico-epidemiological data remain scarce despite the high burden of dermatological conditions.
Objective: To determine the pattern of skin diseases, associated sociodemographic and clinical factors, and their impact on HRQoL among adults attending the dermatology clinic at Muhimbili National Hospital, Tanzania.
Methods: A hospital-based cross-sectional study was conducted at Muhimbili National Hospital, Dar es Salaam, from September 2021 to January 2022. Adults (≥18 years) attending the dermatology clinic were consecutively recruited. Diagnoses were made clinically and supported by laboratory examination (e.g., fungal microscopy, bacterial culture, biopsies) where necessary. Conditions were classified using ICD-10 groupings. Health-related quality of life was assessed using the validated Swahili version of the Dermatology Life Quality Index (DLQI). Data were analysed using SPSS v23. Associations were tested using the chi-square test and odds ratios (95% CI); p<.05 was considered statistically significant.
Results: A total of 378 participants were enrolled; 158 (41.8%) were male, with an overall median age of 34 years (IQR 26–49). The most common disease categories were eczemas and urticaria 146 (38.6%), disorders of skin appendages 43 (11.4%), autoimmune diseases 38 (10.1%), fungal infections 30 (7.9%), benign neoplasms 23 (6.1%), bacterial infections 22 (5.8%), and viral infections 18 (4.8%). Skin diseases were significantly associated with sex, age, education level, depression, family history, endocrine disorders, and seasonal variation. The mean DLQI score was 9.7 ± 6.5, indicating moderate impairment. Notably, 43.7% of patients reported a very large or extremely large impact, particularly in domains related to work performance, symptoms, and clothing choices.
Conclusion: Eczema and urticaria were the most prevalent conditions and had a substantial negative impact on patients’ health-related quality of life (HRQoL). Integrating routine HRQoL assessments, psychosocial support, and comorbidity screening into dermatology care is therefore recommended. Policymakers should prioritise the prevention and management of skin diseases, and future community-based studies, supported by laboratory confirmation, are needed to improve generalisability and diagnostic accuracy.

Clinical Patterns of Allergic Rhinitis Among Paediatric Patients Attending A Tertiary Hospital in Dodoma, Tanzania

2026-04-22T18:27:05+00:00

Background: Allergic rhinitis is a chronic and recurrent nasal condition, but it has often been given little attention in children with late presentations. Globally allergic rhinitis affects more than 400 million people with prevalence rates being between 10% and 30% among adults and 40% among children. In Tanzania, the overall prevalence of allergic rhinitis is 10.3%, and commonly affected groups are children and adolescents. This study aimed to determine the clinical patterns of allergic rhinitis among paediatric patients attending Benjamin Mkapa Hospital in Dodoma region as there are scare studies on allergic rhinitis in Tanzania especially in central Tanzania.
Methods: A hospital based prospective cross-sectional study at Benjamin Mkapa Hospital recruited 348 children with a clinical diagnosis of allergic rhinitis using convenience sampling technique. Data was collected using a semi-structured questionnaire and analyzed using Statistical Package for Social Sciences version 25. A P-value less than 0.05 was considered statistically significant.
Results: In this study, 86.2% children had a seasonal type of allergy and according to ARIA classification, 50% children had mild-intermittent allergic rhinitis followed by 34.5% children, with moderate to severe allergic rhinitis. The commonest form of allergy was an inhalant, 97.5%. The commonest triggers of allergic rhinitis were dust exposure, 90.8% and smoke, 74.4% and the commonest symptoms were recurrent sneezing, 87.1%, runny nose, 66.4%, blocked nose, 58% and nasal itching, 52.3%. Recurrent tonsillitis, 26.1%, sinusitis, 21.8% and allergic conjunctivitis, 20.7% were the common comorbidities reported.
Conclusion: In this study, seasonal allergic rhinitis predominated and mild-intermittent allergic rhinitis was common as per ARIA classification of allergic rhinitis. The commonest allergen was an inhalant and both dust exposure and smoke were the commonest triggers. The predominant symptoms were recurrent sneezing, runny nose and blocked nose but recurrent tonsillitis, sinusitis and allergic conjunctivitis were the commonest comorbidities. These findings lay emphasis on the importance of early identification of environmental triggers and implementation of appropriate preventive and therapeutic measures, including allergen avoidance and optimized pharmacological management. Future studies should further explore specific allergen sensitization patterns, long-term outcomes, and the effectiveness of targeted interventions to improve the management of allergic rhinitis and its possible associated comorbidities.

Preoperative Malnutrition Among Patients Scheduled for Elective Gastrointestinal Surgery at a National Hospital in Tanzania

2026-04-23T11:17:16+00:00

Background: Malnutrition is a critical but under recognized factor contributing to poor surgical outcomes, particularly in low resource settings. In sub-Saharan Africa, data on preoperative malnutrition among patients undergoing gastrointestinal (GI) surgeries are scarce. Therefore, this study aimed to determine the proportion of preoperative malnutrition and its associated factors among adults scheduled for major GI surgeries at the national hospital in Tanzania
Methods: We conducted a cross sectional study involving 143 adult patients who were scheduled to undergo major GI surgeries at Muhimbili National Hospital between August 2023 and January 2024. Nutritional status was assessed using body mass index (BMI) and serum albumin levels. We used the nutritional risk index (NRI) as a proxy estimate of postoperative complications. Sociodemographic and clinical data were analyzed using SPSS version 26. Associations with malnutrition were examined using the chi-square and Fisher’s exact tests.
Results: Thirty six percent (n=52) of patients were malnourished based on at least one indicator. Overall, 22.4% (n=32) of patients were undernourished, whereas 14.0% (n=20) were classified as overnourished. Overweight and obesity (BMI > 24.9 kg/m²) were present in 14% (n=20) of the patients, while 2.1% (n=3) were underweight (BMI < 18.5 kg/m²). Low serum albumin levels (<35 g/L) were noted in 22.4% (n=32) of the cases. Using the NRI as a proxy measure for postoperative complications, 44.1% (n = 63) of patients were classified as having moderate-to-severe risk. Malnutrition was significantly associated with American Society of Anesthesiology Physiological Status class III (p=.007), illness duration of ≥28 days (P=.042), hypertension (P=.004), and severe anemia (P=.002).
Conclusion: Preoperative malnutrition is common among patients undergoing elective GI surgery, with undernutrition being the most prevalent. Nutritional screening and prehabilitation should be integrated into routine perioperative care to improve surgical outcomes.

Prevalence and Predictors of Vitamin D Deficiency Among Children Attending Makongoro Reproductive and Child Health Clinic in Mwanza, Tanzania

2026-04-22T18:27:05+00:00

Background: Vitamin D deficiency (VDD) is a global public health problem which affects all age groups and it is prevalent even in countries with adequate sunlight due to inadequate sunlight exposure and consumption of diet poor in vitamin D. The effects of VDD peak between 3 to 18 months due to increased requirement of vitamin D. This study was done in order to determine the prevalence and predictors of VDD among children attending Makongoro reproductive and child health (RCH) in Mwanza, Tanzania
Methods: This was a cross sectional study involving children aged 1 month and 2 weeks to 24 months attending Makongoro RCH clinic in Mwanza Tanzania. The sample size for prevalence was estimated using Kish Leslie formula while double proportion formula was used for calculations of predictors of low serum vitamin D levels. Convenient sampling was therefore used to recruit 305 children who met the inclusion criteria. Social demographic and clinical data were obtained using data collection tool. Rapid vitamin D (25-hydroxy-vitamin-D [25(OH)D]) test was done followed by serum 25(OH)D and calcium levels in all children with positive rapid 25(OH)D test results. Vitamin D deficiency was defined as serum levels <20ng/ml and Vitamin D insufficiency (VDI) when levels were between 20 and 30ng/ml. Hypocalcaemia was defined as serum ionized calcium <1.17mmol/l. Data was analyzed using STATA version 13.
Results: A total of 305 children were enrolled in this study. While normal serum vitamin D levels were observed in 80% of the studied children, 9% had VDI and 11% had VDD. Low serum vitamin D levels were independently associated with prematurity (OR 6.9, 95% CI; 2.28-20.69,P=.001), delayed milestones (OR 3.3, 95% CI; 1.38-28.57, P =.03), inadequate sun exposure (OR 12, 95% CI; 4.14-35.49, P<.001) and malnutrition (OR= 7.9, 95% CI; 1.91-32.96, P=.004). Hypocalcaemia was observed in 24% of children with low serum vitamin D levels.
Conclusion: Substantial proportion of children attending Makongoro RCH clinic have VDD. Prematurity, inadequate sun exposure, malnutrition and delayed milestones significantly predicted low serum vitamin D levels hence screening should be prioritized in children with these conditions.

Benefits of P16/Ki- 67 Cytology as a Co-Test for High-Risk HPV Positive Women in a “See and Treat Strategy”

2026-04-22T18:27:05+00:00

Background: While the high-risk human papilloma virus DNA (hr-HPV-DNA) test is the primary tool for cervical cancer screening, with visual inspection with acetic acid (VIA) serving as a triage test where Pap cytology is not available, the low inter-observer agreement associated with VIA means that its reliability is limited and a more efficient test is still required. The aim of this study was to compare the performance of p16/Ki-67 cytology with that of VIA in the detection of cervical precancer and its feasibility as an alternative triage method in the “see and treat strategy”.
Methods: In this hospital-based cross-sectional study, we utilised stored, provider-collected specimens from a previous study involving women referred with cervical abnormalities to a tertiary hospital in Kisumu County, Kenya. The samples were analysed using both Xpert testing and p16/Ki-67 dual staining. All high-risk HPV–positive women with cervical lesions were triaged using VIA and p16/Ki-67 cytology. Cervical intraepithelial neoplasia grade 2 or worse (≥CIN2) was defined as the clinical endpoint.
Results: Compared with VIA, p16/Ki-67 immunostaining had a significantly greater sensitivity (84.6% vs. 59.0%), specificity (44.0% vs. 62.0%), positive predictive value (28.2% vs. 28.8%) and negative predictive value (91.7% vs. 85.3%).
Conclusion: p16/Ki-67 immunostaining for the detection of ≥CIN2 demonstrated high sensitivity and a high negative predictive value in our study, consistent with findings from several previous studies. These results suggest that the assay is superior to VIA for identifying ≥CIN2 and could serve as an alternative tool for triaging women who test positive for primary HPV within the current “see-and-treat” strategy.

Hepatitis E Virus Exposure at the Human–Pig Interface: Seroprevalence Among Pregnant Women and Slaughter Pigs in Tanzania

2026-04-22T18:27:05+00:00

Background: Hepatitis E virus (HEV) is a major cause of acute viral hepatitis worldwide and can lead to severe complications, particularly among pregnant women. In sub-Saharan Africa, outbreaks occur periodically, yet routine surveillance remain limited. Domestic pigs are known reservoirs of zoonotic HEV genotypes, raising concern about transmission at the human–animal interface. However, evidence on HEV exposure in both humans and pigs in Tanzania is scarce. This study assessed the seroprevalence of HEV among pregnant women and slaughter pigs in resource-limited communities in Tanzania.
Methods: Cross-sectional study was conducted between September 2023 and July 2024 in Dodoma and Morogoro regions. Pregnant women attending antenatal care clinics and pigs presented for slaughter at municipal abattoirs were systematically sampled. Serum samples were tested for anti-HEV IgG antibodies using a commercial enzyme-linked immunosorbent assay (ELISA). Sociodemographic data from women and pig husbandry practices were collected using structured questionnaires. Descriptive statistics were used to estimate seroprevalence with 95% confidence intervals (CIs). Associations between HEV seropositivity and risk factors were assessed using Chi-square or Fisher’s exact tests, followed by logistic regression analysis.
Results: A total of 372 pregnant women and 280 pigs were included in the study. HEV seroprevalence was 15.1% (95% CI: 11.8 – 19.0) among women and 32.9% (95% CI: 27.6–38.6) among pigs. Higher seropositivity among women was observed in the 25 to 34-year age group. In pigs, housing systems, water sources, and farm biosecurity practices were associated with HEV infection.
Conclusion: These findings demonstrate concurrent HEV exposure in humans and pigs in central Tanzania. The higher prevalence in pigs supports their role as potential reservoirs, while detection in pregnant women suggests ongoing community transmission. Strengthening surveillance and adopting a One Health approach integrating maternal health services, veterinary monitoring, and improved farm biosecurity are essential to reduce zoonotic transmission risks.