East Africa Science

Hemodynamically Stable Traumatic Diaphragmatic Rupture with Herniated Shattered Spleen: A Case Report

2025-07-03T15:07:00+00:00

Background: High-energy blunt abdominal trauma frequently involves multiple organ systems, often resulting in injuries to solid organs and, in some cases, visceral herniation due to diaphragmatic rupture. Hemodynamic stability in such cases is rare, particularly when the spleen is shattered. We present a unique case of a hemodynamically stable patient with these injuries.
Case: A 55-year-old male involved in a motor vehicle accident presented to our facility hemodynamically stable, seven days after initial management for a traumatic hemothorax, with a missed diagnosis of diaphragmatic rupture and herniated, shattered spleen. The diagnosis was confirmed following a thorough physical examination and cross-sectional imaging. Laparotomy was conducted to perform a splenectomy and repair a diaphragmatic rupture, and the patient had an uneventful postoperative recovery.
Conclusion: This case highlights the critical need for a high index of suspicion and comprehensive evaluation in cases of high-energy trauma, emphasizing the importance of detailed examination and cross-sectional imaging in detecting overlooked injuries. The patient’s hemodynamic stability, despite a shattered spleen, may have resulted from the compressive effect of the hernia defect on the splenic vessels, a factor that could play a role in similar trauma cases.

Applications of Artificial Intelligence in Malaria Vector Control in East Africa: A Scoping Review of Existing Evidence, Challenges, and Future Prospects

2025-07-03T15:07:00+00:00

Background: Malaria remains a leading cause of morbidity and mortality in East Africa despite decades of control efforts. Interventions such as long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), and larval source management have reduced transmission, yet progress is threatened by insecticide resistance, climate variability, and evolving mosquito behaviour.
Objective: This scoping review explores the application of artificial intelligence (AI) malaria vector control across East Africa. It aims to synthesize existing evidence, identify challenges, and inform future research and policy directions.
Methods: A comprehensive literature search was conducted using electronic databases and grey literature sources, following the PRISMA for Scoping Review guidelines. PubMed, Google Scholar, Science Direct and IEEE Xplore were databases used to search for scientific evidence. Studies were included if they addressed artificial intelligence applications in malaria surveillance, prediction, or intervention optimization within East African contexts. Data were charted synthesised across key thematic domains.
Results: Six scientific studies met the inclusion criteria for this scoping review. Evidence suggests growing interest in the use of artificial intelligence for vector habitat mapping, transmission risk forecasting, and malaria vector identification and surveillance. While these approaches show promise in enhancing malaria control, challenges persist, including limited data quality, algorithmic bias, and weak integration into national malaria programs.
Conclusion: Artificial intelligence offers significant potential to strengthen malaria vector control in East Africa by supporting data-driven, targeted interventions particularly through improved prediction, surveillance, and decision-making tools. However, their implementation remains limited, with notable regional gaps and operational challenges. Future work should focus on translating existing innovations into field-ready tools, expanding research across underrepresented countries, and fostering cross-sector collaboration to ensure AI contributes meaningfully to malaria vector control with elimination goals.

Genomic Disease Surveillance 2006 -2024: Current Trends as Revealed by a Bibliometric Analysis

2025-07-03T15:07:00+00:00

Background: Genomic disease surveillance has become an essential and transformative tool in public health. It enhances our ability to detect, monitor, and control infectious diseases by providing real-time genetic information about pathogens. This advanced approach allows for more accurate identification of disease outbreaks, tracking the spread of infections, and understanding the evolution of pathogens over time. Global genomic surveillance faces challenges with a lack of standardized data protocols and insufficient funding. Addressing privacy and ethical concerns about genetic data is crucial for building stakeholder trust and cooperation. Overcoming these obstacles is vital for maximizing the benefits of genomic surveillance in global public health protection.
Aim: This study aimed to identify key research trends and authors in genomic disease surveillance.
Methods: This study employed bibliometric analysis using data from the Scopus database, which was analyzed quantitatively with the biblioshiny software for bibliometric analysis. The R package offers functions for analyzing yearly outputs, country outputs, citations, collaboration networking, and publication trends.
Results: Two thousand and sixty-two (2062) articles were retrieved from the Scopus database. The United States leads with a total of four hundred and three (403) publications. Giovanetti M. was the lead author with twenty (20) publications. The field of Medicine had the highest number of articles (867 publications). Notably, there was a significant increase in research output between the years 2017 and 2023, with the highest number of publications (202) in the latter. The top-ranked article, written by Quick J, has garnered an impressive 998 citations.
Conclusion: This bibliometric analysis of scientific publications on genomic disease surveillance from 2006 to 2024 identified significant research trends, thematic hotspots, and patterns of international collaboration. The study observed a notable increase in research output from developed countries such as the United States United Kingdom, China, Australia, and Brazil, with less output from developing countries. These findings highlight the critical role of genomic surveillance in the detection, monitoring, and response to infectious diseases, particularly in the context of future pandemics.

Bibliometric Analysis of Congenital Toxoplasmosis: A Ten-Year (2013-2023) Review of Research Publications

2025-07-03T15:07:00+00:00

Background: Toxoplasma gondii, an obligate intracellular protozoan, infects more than one-third of the global population and causes toxoplasmosis, which can lead to severe fetal complications in pregnant women. The global prevalence of latent toxoplasmosis in pregnant women is 33.8%, with regional variations and risk factors, including the consumption of undercooked meat, exposure to cat feces, and consumption of contaminated water. Pregnant women lack sufficient awareness of these risk factors, necessitating enhanced education, regular screening, and counseling during antenatal care for early detection and management.
Aim: This study performed a comprehensive bibliometric analysis of research on congenital toxoplasmosis published between 2013 and 2023.
Methods: A bibliometric analysis was conducted using the Scopus database, focusing on original research publications related to congenital toxoplasmosis published between 2013 and 2023, spanning 10 years.
Results: A total of two thousand and one hundred (2100) publications on congenital toxoplasmosis and toxoplasmosis during pregnancy were indexed in Scopus between 2013 and 2023. Ferro E.A.V. (n=33), Villena I. (n=31), and Montoya J.G. (n=28) were the top three researchers with the most published scientific publications. A total of 134 countries contributed to congenital toxoplasmosis and pregnancy toxoplasmosis studies. The USA had the highest number of publications (n = 428) on congenital toxoplasmosis, followed by Brazil with 330 publications. Most publications were published between 2021 (n=235) and 2022 (n=245). Inserm (n=64), Fundacao Oswaldo Cruz (n=63), and Universidade de São Paulo (n=54) had the highest research output.
Conclusion: The number of publications on congenital toxoplasmosis has increased globally, with a slight decline during the COVID-19 period. However, the analysis revealed disparities in global research output between developed and developing countries, with underrepresentation in regions with the highest disease burden. These findings highlight the need for enhanced collaborative networks to improve research output, particularly in developing countries.

Spirulina Platensis in the Management of Type 2 Diabetes: A Systematic Review

2025-07-03T15:07:00+00:00

Background: Diabetes, characterized by insufficient insulin production or ineffective insulin utilisation, poses serious health risks if left unmanaged, including hypertension, hyperlipidemia, and organ damage. Spirulina platensis, a blue-green microalgae, has garnered attention for its potential in managing metabolic disorders like diabetes. However, its impact on blood sugar control remains inadequately understood. Consequently, this review aims to explore the efficacy of Spirulina platensis in managing type 2 diabetes mellitus.
Methods: A systematic search of PubMed, Embase, and Cochrane databases was done to identify original research articles that were published within the last 25 years.
Results: A total of 65 articles were retrieved. Upon screening, 56 articles were excluded for not meeting inclusion criteria. The remaining 9 articles revealed promising outcomes associated with Spirulina platensis supplementation, including reductions in fasting blood sugar (FBS), postprandial blood sugar (PPBS), glycated hemoglobin (HbA1C), total cholesterol, triglycerides, and malondialdehyde (MDA) levels.
Conclusion: Spirulina platensis demonstrates potential in improving key health indicators among type 2 diabetic patients. Health practitioners should consider recommending its adjunct use alongside glucose-regulating medication for enhanced diabetes management.

Transmissibility of COVID-19 in Rwanda: Epidemiological Modeling Study

2025-07-03T15:07:00+00:00

Background: The coronavirus disease 2019 (COVID-19) pandemic has become a public health threat in the 21st century. It contributed to more than 1.5 million deaths, per the report of the World Health Organization. Mathematical models have been used in epidemiology for decades to analyze the dynamism of infectious diseases and their impact on population health.
Objective: This study aimed to investigate the transmissibility of the coronavirus disease 2019 (COVID-19) pandemic in Rwanda from March 2020 to October 2021.
Methods: A mathematical model was proposed with five compartments, and a basic reproduction number (R0) was computed using the next-generation matrix. Four periods were selected, and each period had 5 months, from March 2020 to October 2021. Four R0 values showing the dynamism of the pandemic in each period were calculated using Python 3.8, and the disease spread among individuals living in Rwanda. The countrywide data extracted from the Rwanda Biomedical Center website were used to determine the coherence and relevance of diagnosis with case prevalence using STATA 13.1.
Results: There was a significant increase in R0 across the 4 periods from March 2020 to October 2021. The computed basic reproductive numbers are as follows: March to July 2020: R0=2.99; August to December 2020: R0=4.1; January to May 2021: R0=8.11; June to October 2021: R0=24.7 There was a statistically significant correlation with mass diagnosis and the number of infected individuals in the population (P=.01).
Conclusion: Since all and continued to increase with respect to the study periods, since the real data showed a positive contribution to mass diagnosis, the pandemic still persisted in the population, and mass diagnosis was key for explaining the rate of infection.

Dynamics of Viral Rhinitis Incidences in the COVID-19 Pandemic Era Following Adopted Preventive and Control Measures to Coronavirus in Tanzania: A Lesson to Learn

2025-07-03T15:07:00+00:00

Background: Coronavirus disease 19 (COVID-19) is a highly contagious disease caused by a virus belonging to a large family of viruses called coronaviruses, namely severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in December 2019 in Wuhan, China. The disease has resulted in millions of human deaths worldwide to date. Different countries in the world have implemented various preventive measures against COVID-19, like social distancing, lockdown and mask wearing. These measures, apart from COVID-19, can cross prevent person-to-person transmission of other upper-respiratory conditions, including viral rhinitis (Common cold). This study aimed to assess the impact of COVID-19 preventive measures in the control of viral rhinitis and its potential consequences.
Methods: The study was conducted at Muhimbili University of Health and Allied Sciences in Dar es Salaam, involving 384 university students and healthcare workers purposively selected from two Higher Learning Institutions, the Muhimbili University of Health and Allied Sciences (MUHAS) and St. Joseph University in Tanzania (SJUIT). In addition, two referral hospitals, namely, Mwananyamala Regional Referral Hospital (MRRH) and Temeke Regional Referral Hospital (TRRH) to gather information from healthcare workers. The data was collected using closed and open-ended questionnaires, entered, cleaned and analysed using a IBM SPSS Statistics for Windows version 24.0 (IBM Corp, Armonk, NY, USA).
Results: The annual incidences of viral rhinitis during the COVID-19 pandemic were found to be lower than those before the pandemic during which a total of 163 (47.4%) respondents reported to have suffered more than two episodes of viral rhinitis. About 216 (56%) respondents reported having practised social distancing, while 43 (11%) reported not to have adhered to hand hygiene practice while less than one third, 103 (26%) of the respondents reported practising steaming, while 78 (20%) used traditional medicines. None of the preventive measures showed statistically significant relationship with viral rhinitis p<0.05.
Conclusion: While the use of preventive measures against COVID-19 might be unique, and considering their similarity with those of the common cold (viral rhinitis) prevention, the study has shown that if they are observed, particularly the face masks, they may reduce person-to-person transmission of airborne conditions. Therefore, we recommend instituting the use of masks and all hygienic measures in situations where upper respiratory infection of any source is suspected, to limit spread to others from acquiring the infection, particularly in large gatherings.

Effect of Antenatal Family Planning Counselling on Social Normative Beliefs Towards Early Postpartum Family Planning

2025-07-03T15:07:00+00:00

Introduction: Different countries and settings exhibit diverse trends in social normative beliefs towards early postpartum family planning (PPFP) with disparities based on cultural, socioeconomic, and age-related factors. There has been a paucity of studies addressing the influence of antenatal family planning (FP) counselling on these social normative beliefs, particularly in Kenya. This study analysed the impact of antenatal FP counselling on perceived social normative beliefs regarding early PPFP among postpartum women in Kisumu County.
Methods: This was an interventional study conducted in Kisumu County among 246 pregnant women in their second and third trimesters. Nurses’, community, and control study arms were established with a single 20-minute session of antenatal counselling on PPFP as the intervention. A postpartum assessment of social normative beliefs towards early PPFP uptake was done. Perceived normative beliefs on PPFP was measured using 7-point Likert scale questions and analysed through ordinal logistic regression and ANOVA at the P<.05 threshold.
Results: Perceived social normative beliefs towards early PPFP were highly positive (75.2%), mean 5.3. Employment (OR 1.5; P=.024) and positive intimate partner relationship (OR 2.1, P<.0001) increased positive perceived social normative beliefs towards early PPFP while being married (OR 0.7; P=.038) decreased it. The nurses’ arm (P=.047) exhibited more positive perceived social normative beliefs than the community and control arms.
Conclusions: There were high positive perceived normative beliefs on early PPFP, particularly in the nurses’ arm, thus recommending nurse-led antenatal counselling.

Antibiotic Procurement Trends and ABC Analysis: Insights from a Three-Year Retrospective Descriptive Study at Benjamin Mkapa Zonal Referral Hospital

2025-07-03T15:07:01+00:00

Background: The lower middle income countries (LMICs) are experiencing exponential procurement expenditure and consumption of antibiotics yearly in primary to tertiary healthcare facilities. The menace of antimicrobial resistance (AMR) is a significant burden on the world economy, leading to financial losses due to reduced productivity from illness (in humans and animals) and increased treatment costs.
Objective: We analysed antibiotic procurement data at a Tanzanian hospital using an ABC analysis method. This could help fight Antimicrobial Resistance by providing insights into consumption patterns and expenditure.
Methodology: A retrospective descriptive study was employed to analyse quantities of antibiotics procured for three years (from 2020 to 2022). Antibiotic total purchasing costs were analysed using the ABC analysis at Benjamin Mkapa Hospital (BMH).
Results: A steady increase in antibiotic procurement was observed, with expenditures rising by 35.83% in 2021 and 59.35% in 2022 compared to 2020. ABC analysis revealed that Category A antibiotics—primarily ceftriaxone, amoxicillin/clavulanic acid, and flucloxacillin/amoxicillin—comprised 12.20% of all antibiotics purchased in 2020 but accounted for over 68% of the total antibiotic expenditure (TZS 116,197,700.00). In 2021, Category A antibiotics represented 15.2% of purchases and 64% of total expenditure (TZS 148,318,885.80), with ceftriaxone, meropenem, and azithromycin being the most frequently procured. By 2022, Category A antibiotics expanded to 23.26% of stocked items and contributed to more than 78% of the total antibiotic spending (TZS 213,033,376.50), with amoxicillin/clavulanic acid, ceftriaxone, and metronidazole being the leading agents.
Conclusion: A steady increase in antibiotic expenditures has been observed. However, the procurement, expenditure, and consumption of Access antibiotics are below the recommended threshold resulting in increased spending and consumption of Watch and Reserve antibiotics. Decreasing the consumption of Reserve antibiotics may help in avoidance or prevention of antimicrobial resistance.

Endoscopic Assessment of the Nasal Anatomical Variations among Adult Patients with Chronic Rhinosinusitis in Dar es Salaam, Tanzania

2025-07-03T15:07:01+00:00

Background: Chronic rhinosinusitis (CRS) tends to affect people of all ages. Diagnosis of CRS in resource-limited settings relies mainly on detailed clinical evaluation without nasal endoscopy and CT scans, which are mainly inevitable in the management of such patients. Data on endoscopic nasal anatomical variations among adult patients with CRS are scarce.
Methods: A prospective hospital-based study was conducted at a private hospital from January to December 2022 in Dar es Salaam. Cases were diagnosed to have CRS according to the Task Force criteria, while controls were individuals who attended outpatient clinics due to otological or laryngological complaints and had no symptoms of CRS. Cases and controls were matched in a 1:1 ratio. The rule of standard pass on each side was adhered to endoscopically. Data was analysed using the Statistical Package for Social Sciences version 23.
Results: A total of 120 patients with CRS and an equal number of controls were recruited. Patients and controls were equally aged between 18 and 70 years. Male patients predominated, 70 (58.3%), while female patients were 50 (41.7%), and the male-to-female ratio was 1.4:1. Among controls, males predominated, 68 (56.7%), while females were 52 (43.3%), and the male-to-female ratio was 1.3:1. Endoscopic nasal anatomical variations were found in 107 (89.2%) patients. Nasal septal deviation/nasal spur was the predominant anatomical variant in 51 (42.5%) patients, followed by concha bullosa in 27 (22.5%), a paradoxically curved middle turbinate in 22 (18.3%), and the least anatomical variant was a large bulla ethmoidalis, 7 (5.8%). Of the 120 controls, only 5 (4.2%) participants had endoscopic nasal anatomical variations, and 4 (3.3%) controls had septal deviation/spur, whereas 1 (0.8%) participant had a paradoxically curved middle turbinate. Regarding laterality of the observed endoscopic nasal anatomical variations, the majority of the variations had unilateral presentation, such as septal deviation (90.2% being unilateral), concha bullosa (81.5% being unilateral), and a paradoxically curved middle turbinate being unilateral in 77.3% of patients. Chronic rhinosinusitis was found to be significantly associated with septal deviation (P=.001), concha bullosa (P=.001) and a paradoxically curved middle turbinate (P=.001), while there was no significant association between CRS and large bulla ethmoidalis (P=.1).
Conclusion: Septal deviation/spur was the commonest nasal anatomical variant, 51(42.5%) and the least anatomical variant was a large bulla ethmoidalis 7(5.8%). Chronic rhinosinusitis was found to be significantly associated with septal deviation (P=.001), concha bullosa (P=.001) and a paradoxically curved middle turbinate (P=.001), and there was no significant association between CRS and large bulla ethmoidalis (P=.1).

Bacterial Contamination in Neonatal Intensive Care Unit: A Potential Threat of Nosocomial Infections to Neonates

2025-07-03T15:07:01+00:00

Background: Bacterial contamination in healthcare settings, especially neonatal intensive care units, plays a key role in the spread of nosocomial infections. However, there is limited data on the routine monitoring of contamination on surfaces and instruments in direct contact with neonates, as well as their antimicrobial susceptibility patterns in our setting.
Objective: The study determined the level of bacterial contamination on instruments and surfaces frequently touched or in contact with neonates, and their antimicrobial susceptibility patterns.
Methods: A cross-sectional study was conducted in the neonatal Intensive Care Unit (NICU) at St. Benedict Ndanda Referral Hospital (SBNRH) in Mtwara, Tanzania, over two days in November 2023. Swab samples were collected from surfaces and instruments that are frequently touched or in contact with neonates. Bacterial isolation, identification, and antimicrobial susceptibility testing were conducted according to the Clinical and Laboratory Standards Institute (CLSI) guideline. Multidrug resistance (MDR) was defined as resistance to at least one antibiotic from three or more different classes. Data analysis was conducted using STATA software version 15, with descriptive statistics presented as frequencies and percentages.
Results: Of 57 swab samples, 37 (64.9%) showed bacterial growth, yielding 43 isolates. The majority, 30(69.8%), were gram-negative bacteria. The predominant isolates were coagulasenegative Staphylococci species, accounting for 8 (18.6%), followed by Escherichia coli and Klebsiella pneumoniae, each at 7 (16.3%). The most contaminated areas were nurse stations 2(100.0%), wall sanitizer dispenser 2(100.0%), weighing scale 1(100.0%), neonatal beds 16(88.9%) and door handles 6(85.7%). Enterobacterales were highly resistant to cefotaxime 18(85.7%), ceftriaxone 17 (73.7%) and gentamicin 15(71.4%). Acinetobacter baumanii was resistant to piperacillin 5(100.0%), piperacillin-tazobactam 5(100.0%) and cefotaxime 5(100.0%). Pseudomonas aeruginosa were highly resistant to piperacillin 3(100.0%) and piperacillin-tazobactam 3(100.0%). Most of the gram-negative bacteria were susceptible to meropenem 25(83.3%). Staphylococcus aureus showed resistance to erythromycin 5(100.0%) and tetracycline 4(80.0%). Methicillin resistant Staphylococcus aureus (MRSA) was observed in 4(80.0%) isolated Staphylococcus aureus. Multi-drug resistance (MDR), extended-spectrum beta-lactamase (ESBL) production, and carbapenemase production were observed in 29 (82.9%), 3 (23.1%) and 5 (16.7%) respectively.
Conclusion: The instruments and surfaces in the NICU were contaminated with high-risk pathogens, many of which showed significant resistance to commonly used antibiotics. These findings highlight the urgent need to strengthen infection prevention and control measures and antibiotic stewardship to reduce bacterial colonization and transmission to neonates.

Histomorphological Comparison of Initial and Residual Prostate Cancer Chips at Muhimbili National Hospital, Tanzania

2025-07-03T15:07:01+00:00

Background: Residual prostate chips, after initial sampling provide an opportunity to examine potential differences in histomorphological features of prostate cancer. This study compared the histomorphological characteristics of prostate cancer in the partially sampled versus the residual prostate chips.
Methodology: This was a cross-sectional analytical laboratory-based study of archived slides of initial samples and residual tissue at the Muhimbili National Hospital’s Central Pathology Laboratory (MNH-CPL).
Results: A total of 162 cases of Transurethral resection of the prostate were included in the analysis. The mean age of the selected cases with transurethral resection of prostate was 69.19 (±9.14) years. In initial specimen, out of 162 selected cases, 42 (25.9%) were prostate cancer. The specific diagnoses included benign prostatic hyperplasia (BPH) (72.8%), adenocarcinoma (25.3%), Schistosomiasis (1.2%) and Squamous Cell Carcinoma (SCC) (0.6%). For residual specimen, 31.5% were prostate cancer. The specific diagnoses included BPH (66%), adenocarcinoma (30.9%), Schistosomiasis (1.2%) and SCC (0.6%). In both initial (43.9%) and residual (53.8%) specimens, Grade group 5 was prevalent. Most of the initial specimen showed tumor volume of 81 to 90% and most of the residual tumor volume was greater than 90%. Overall agreement in histological diagnoses between initial specimen and residual prostate chips was 93.2% with a kappa strength (κ) 0.79. For specific diagnosis the agreement was 97.6%, 91.5%, 100% and 100% for adenocarcinoma, BPH, schistosomiasis and SCC Grade 1 with Schistosomiasis respectively. With exception of Grade group 5, the rest of the Grade group had low Kappa value of 0.12. Agreement of tumor volumes was 83.3% with a kappa strength (κ) of 0.79.
Conclusions: This study showed that there are notable histomorphological differences between initial and residual prostate chips with regard to prostate cancer. Further research with a larger group of patients and follow-up is recommended to validate these initial findings and their implications for prostate cancer management.

Emergency Peripartum Hysterectomy: Indications, Histopathological Patterns and Intraoperative Maternal Complications at Mwanza, Tanzania

2025-07-03T15:07:01+00:00

Background: This study explored the critical aspects of Emergency Peripartum Hysterectomy (EPH), a surgical procedure performed during childbirth to address life-threatening complications, such as excessive bleeding or severe uterine infections. Conducted in Mwanza, the research aimed to identify the indications for Emergency Peripartum Hysterectomy, examine histopathological patterns, and assess maternal complications during the procedure.
Methods: The study, conducted between May 2022 and May 2023, involved pregnant women beyond 28 weeks of gestation who required Emergency Peripartum Hysterectomy. Data collection included clinical and demographic information, intraoperative findings, and the preservation of samples in 10% Neutral Buffered Formalin (NBF) for morphological and pathological analysis. Analysis was carried out using STATA version 15.
Results: The findings were derived from 66 pregnant women who underwent Emergency Peripartum Hysterectomy, with 42 from Bugando Medical Centre (BMC) and 24 from Sekou Toure Regional Referral Hospital (SRRH). The participants had a median age of 30 years. Notably, 41(62.1%) of the women were referred from lower-level facilities due to labor complications, and 40(60.6%) had their hysterectomies performed within 24 hours post-delivery. The most common clinical indications for Emergency Peripartum Hysterectomy were septic uterus 24(36.4%), ruptured uterus 17(25.8%), and uterine atony 15(22.7%). Histopathological patterns revealed plasmatic endometritis 16(24.0%), placenta accreta spectrum 15(23.0%), and suppurative inflammation 12(18.0%) as the most frequent findings. Intraoperative complications included excessive hemorrhage requiring blood transfusion for 34(51.5%) participants, cardiac and respiratory arrest 5(7.6%), and ureteric injuries 2(3.0%) participants.
Conclusion: This study found that septic uterine infections and morbidly adherent placenta conditions were the most common clinical and histological findings, respectively. The research also highlighted that lower-level health facilities in the region experienced a higher incidence of labor complications, increasing the likelihood of patients undergoing EPH. These findings provide valuable insights

Malaria Burden in an Area With High Ownership and Usage of Insecticide-Treated Nets in North Eastern Tanzania

2025-07-03T15:07:01+00:00

Background: Insecticide-treated nets and artemisinin combination therapy are just two of the measures taken to control malaria in Tanzania. Nevertheless, several regions of the nation still have high malaria burden. We aimed to identify the key factors contributing to the persistent malaria burden in rural areas of North Eastern Tanzania, despite high ownership and usage of insecticide-treated nets.
Methods: Three cross-sectional surveys were conducted in June 2021, October 2021 and February 2022. A total of 362 participants were recruited. The study included children aged between 2 and 10 years and adolescents/adults aged 11 to 70 years. The study was conducted in Kwamgwe ward site, which comprises of three villages namely Bondo, Kwadoya, and Kwamgwe .
A face-to-face interview was conducted. Demographic data, bed net ownership, bed net use, and risk factors for malaria exposure were collected using a pre-tested questionnaire. The developed questionnaire was uploaded to the system, and data was collected electronically using the Open Data Kit (ODK) application. The blood sample from the finger-prick was used to test malaria parasites using a malaria rapid diagnostic test.
Results: Generally, malaria was higher in survey one, followed by survey two and three, with prevalence of 137 (37.8%), 90 (24.9%) and 86 (23.8%), respectively. Bondo had the highest malaria prevalence in all surveys. In Survey one, Kwamgwe had the highest rate of respondents using insecticide-treated nets, at 109(87.2%), P=.01. Insecticides treated nets usage was statistically higher in the age group between 18 to 45 years in all three surveys (P<.01). Participants were asked about using a insecticides treated net the night before. Surprisingly, the majority of individuals who tested positive for malaria slept under a bed net.
Conclusion: Despite extensive efforts to implement ITNs in Tanzania, malaria remains a significant challenge in areas like Kwamgwe, Handeni. High ITN ownership doesn’t guarantee protection from getting malaria, highlighting the need for understanding human sleeping and mosquito biting behaviours for more effective interventions.

Inadequate Clearance of Circulating Cathodic Antigen Following Single-Dose Praziquantel Treatment Among Pre- and School-Aged Children in Schistosoma mansoni Hyper-Endemic Areas of North-Western Tanzania

2025-07-03T15:07:01+00:00

Background: Praziquantel (PZQ) remains the primary drug for treating schistosomiasis, with its efficacy traditionally measured using the Kato-Katz technique. However, these methods have limitations, prompting interest in point-of-care circulating cathodic antigen (POC-CCA) tests as an alternative diagnostic tool. This study aimed to assess the efficacy of praziquantel in clearing circulating cathodic antigen (CCA) among pre- and school-aged children in a S. mansoni hyper-endemic area of North-Western Tanzania.
Methods: A longitudinal study was conducted among 161 children aged 2–17 years. Participants were screened for S. mansoni infection using Kato-Katz and POC-CCA tests at baseline and 21 days post-treatment with a single dose of PZQ (40 mg/kg). Cure rates (CR) and egg reduction rates (ERR) were calculated.
Results: The overall prevalence of S. mansoni was 98 (70.0%) (Kato-Katz) and 114 (70.8%) (POC-CCA). The parasitological cure rate (PCR) was 61 (66.3%) (Kato-Katz) and 27 (27.6%) (POC-CCA), with an ERR of 73.6%. Significant differences were observed between the two diagnostic methods.
Conclusion: While PZQ demonstrated adequate efficacy based on Kato-Katz results, poor CCA clearance highlights the need for improved diagnostics and monitoring strategies in schistosomiasis control programs.

Molecular Pathotyping of Escherichia Coli Colonising Urinary Tract and Their Drug Susceptibility Patterns Among Patients at Outpatient Department of Zonal Referral Hospital in Southern Highlands, Tanzania

2025-07-03T15:07:01+00:00

Background: Uropathogenic E. coli (UPEC) is the most common causative agent of both community-acquired and hospital-acquired urinary tract infections (UTIs). However, E. coli encompasses several other pathotypes that cause a wide range of intestinal and extraintestinal infections. For intestinal infections, the main pathotypes include Enteropathogenic E. coli (EPEC), Shiga toxin-producing E. coli (STEC), Enteroaggregative E. coli (EAEC), Enterotoxigenic E. coli (ETEC), Entero-invasive E. coli (EIEC), and Diffusely Adherent E. coli (DAEC).
Methods: This was a cross-sectional hospital-based study conducted in the Mbeya Zonal Referral Hospital (MZRH) from December 2022 to March 2023. A total of 315 participants from whom the urine samples were collected conveniently by using a standard formula (N = (Z²X P (1-P)/e². Whereby N = minimum required sample size, Z = corresponding level of confidence (95%), P = proportion of the characteristics of interest (23%) and e = margin of error (5%). This enabled the calculation of the minimum sample size of 292 plus 10% of non-respondents.
Results: A total of 315 participants were recruited in the study; the median age (IQR) was 37 (25-53), whereby 46.7% were aged between 18 and 34 years, 30.1% were aged between 35 and 54 years, and 23.2% were older than 54 years. Male participants were 44.4%, urban participation made up 52.7% of the participants, and 60.6% of them were unemployed
Conclusions: The findings of this study showed that the predominant pathotype associated with urinary tract infections was UPEC, followed by EAEC and EPEC, with ETEC being the least frequently identified. The study also indicated that all isolated pathotypes were resistant to ampicillin and amoxicillin/clavulanic acid.

Comparative Performance of Different Glucometers for Random Glucose Measurements in Diabetic Patients at Emergency Medicine Department of the Muhimbili National Hospital, Dar es Salaam, Tanzania

2025-07-03T15:07:01+00:00

Background: Proper management of diabetic patients is dependent on accurate patients’ self-monitoring of blood glucose levels at home and during healthcare visits. Several glucometers are currently available in the market with variability in technical and clinical accuracy. The study aimed at assessing the performance of various glucometers and their reliability as tools worth depending on for patient blood sugar management.
Methods: This cross-sectional study involved 125 diabetic patients aged 39-59 years old comprised of 56 (47%) males and 69 (55.2%) females recruited from November 2022 to January 2023 at Muhimbili National Hospital Emergency Medicine Department. Patients’ demographic and other relevant information were recorded using a questionnaire along with glucometer readings and the laboratory values of glucose. Bland Altman graphs, ISO 15197:2013, Consensus Grid Reference, were used to assess the technical and clinical accuracies.
Results: A total of 78 (62.4%) of participants did not have glucometers at home. The results showed five glucometers, namely; Accu Chek, GlucoPlus, GlucoNavii, OneTouch Ultra Plus Flex and CareSens, to have relatively stable mean glucose levels between glucometers and known laboratory glucose readings. There was a likelihood for CareSens not meeting the ISO 15179:2013 criteria while both Accu Chek and CareSens glucometers had higher coefficient of variation (CV) values of 77% and 56.5%, respectively.
Conclusions: This study highlights the variability in readings among glucometers with GlucoPlus, GlucoNavii and OneTouch Plus, showing a degree of reliability for patients’ self-monitoring of random blood glucose levels. Thus, regular evaluation of glucometers remains key for their accuracy and patient management.

Performance of Hb HemoCue Machine Compared to Automated Hematology Analyzer for Hemoglobin Measurements Among Adult Patients at Kilimanjaro Christian Medical Centre

2025-07-03T15:07:02+00:00

Background: Automated haematology analysers offer precise haemoglobin measurements, but are expensive and impractical for field, point of care, primary care and remote settings use. The portable and cost-effective Hemocue device provides an alternative. Comparing their accuracies is crucial to prevent diagnostic discrepancies and misdiagnoses. This study aimed to determine the accuracy of Hb HemoCue machine by comparing its performance to automated analyser at Kilimanjaro Christian Medical Centre (KCMC) clinical laboratory where both equipment are used.
Methodology: A cross-sectional study was conducted at KCMC Clinical Laboratory among adult patients whose haemoglobin concentrations were measured from May to June 2024. Haemoglobin levels were estimated using two distinct methods: Hb HemoCue machine and automated haematology analyser.
Results: Haemoglobin (Hb) concentration values obtained from the HemoCue machine and the automated analyser, had a mean difference of 0.001 g/dL (95% Cl: -0.036 to 0.038), t value of 0.062, and a p-value of .95, indicating a non-statistically significant differences between the two measurement methods. The Bland-Altman plot analysis indicated that the mean difference (bias) between the two methods was 0.0012 g/dL, and the limits of agreement ranged from -0.481 to 0.482 g/dL, suggesting that the HemoCue machine tends to slightly overestimate Hb values compared to the automated haematology analyser. The Pearson correlation coefficient for the Hb concentrations measured using HemoCue and automated analyser was 0.995, indicating a very strong positive correlation. The HemoCue demonstrated a sensitivity of 98.3%, specifity of 90.4%, positive predictive value of 95.9% and a negative predictive value of 95.9%, indicating high performance accuracy of HemoCue in diagnosing anaemia.
Conclusion: The study revealed strong agreement between HemoCue and automated haematology analyser for measuring haemoglobin concentrations. Both methods demonstrated high diagnostic accuracy suitable for clinical use. Although HemoCue slightly overestimated haemoglobin, this difference was deemed insignificant. The study endorses HemoCue as a reliable tool for haemoglobin concentration measurement alongside and in lack of automated analysers.

Antimycobacterial Activity, Phytochemical Profile, and Molecular Docking of Compounds of Albizia Zygia (Dc.) J.F. Macrb

2025-07-03T15:07:02+00:00

Background: Tuberculosis (TB) remains a significant global health burden, exacerbated by increasing multidrug resistance. Medicinal plants, such as Albizia zygia (DC.) J.F. Macbr, is being used in Kenya to manage TB symptoms; however, antimycobacterial potential remains scientifically underexplored.
Methods: The root bark of A. zygia was sequentially extracted using hexane, dichloromethane, ethyl acetate, methanol, and water. Antimycobacterial activity against Mycobacterium smegmatis was assessed using the Microplate Alamar Blue Assay (MABA). Cytotoxicity was evaluated via the MTT assay on Vero cells, and synergistic interactions with rifampicin (RIF) were determined using a checkerboard assay. GC-MS was employed for phytochemical profiling, followed by molecular docking against Mycobacterium tuberculosis targets (pks13 and EthR) using Schrödinger 2023. ADME/T properties were also predicted using in silico studies.
Results: Methanol and aqueous extracts showed antimycobacterial activity with MIC₉₉ values of 625 μg/mL and 2500 μg/mL, respectively, and were non-cytotoxic (CC₅₀ >1000 μg/mL), except for the moderately cytotoxic dichloromethane extract. Synergistic and additive interactions with RIF were observed with FICI of 0.5 and 0.63, respectively. GC-MS identified 42 compounds; among which 7-ethyl-quinoline, diphenyl sulfone, hexa-decanoic acid, and 2,4-di-tert-butylphenol have been reported to exhibit antimycobacterial activity, also showed strong binding affinities (d-score ≥ -7.0 kcal/mol) to the multidrug resistance TB protein targets, Pks13 and EthR, suggesting their potential contribution to the observed antimycobacterial effects. ADME/T predictions indicated good oral bioavailability but raised concerns about CYP interactions and short terminal half-lives.
Conclusion: A. zygia root bark contains bioactive phytochemicals with promising antimycobacterial activity and synergism with rifampicin. These findings validate the ethnomedicinal use of A. zygia in TB management in Kenya; therefore, further in vivo evaluation and pharmacokinetic optimization of lead compounds are needed.