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Open Journal of Blood Diseases 2022年第2期12卷 11-28页

作者： Zivonishe Mwazyunga Emmanuela E. Ambrose Neema Kayange Respicious Bakalemwa Benson Kidenya Luke R. Smart adolfine hokororo Department of Paediatrics Catholic University of Health & Allied Sciences and Bugando Medical Centre Mwanza Tanzania Division of Haematology Cincinnati Children’s Hospital Cincinnati OH USA

Background: Sickle cell anaemia (SCA) is a serious, multisystem, genetic disorder affecting millions of children worldwide. The disease causes numerous complications that interfere with the health-related quality of life (HRQoL) of these children including an impact on educational, physical and psychosocial development. Few studies have described the clinical spectrum and quality of life of children with SCA living in a low-resource area. Objectives: This study aimed to determine the clinical spectrum and HRQoL among children living with sickle cell anaemia (SCA) in northwest Tanzania. Methods: This hospital-based cross-sectional study took place at Tertiary and teaching hospital, Bugando Medical Centre, Mwanza Tanzania. The study enrolled children ages 2 - 12 years old with SCA attending the Bugando Medical Centre sickle cell clinic. Health related quality of life was measured using the Pediatric Quality of Life, Brief Generic Core Scale after translating from English into a Swahili version. Important SCA complications were assessed using a structured questionnaire. Results: From October 2016 to March 2017, 204 children were enrolled. Participants presented at a median age of 6 years [IQR 4 - 9]. Among children with SCA the most common clinical signs at the time of enrolment were pale in 69.6% (142/204), jaundice in 65.9% (134/204), oxygen saturation 90% in 25% (51/204) and splenomegaly in 19% (39/204). Severe anaemia was observed in 30.9% (63/204). A majority reported vaso-occlusive crisis (166/204, 81.4%), and very few had experienced a prior stroke (5/204, 2.5%). Using a modified Likert scale, a total of 41/204 (20.1%) children had poor HRQoL indicated by low scores on PedsQLTM and 163/204 (79.9%) children had high scores, indicating good HRQoL. On multivariate analysis, age ≥ 5 years (p-value 3 hospitalizations per year (p-value = 0.008) were associated with poor HRQoL. Conclusion: SCA complicatio

关键词： Sickle Cell Anaemia Health Quality of Life Children Tanzania

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Candida Colonization among Neonates with Low Birth Weight: There Is Much More to Explore

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Open Journal of Pediatrics 2020年第4期10卷 626-634页

作者： Wilhelmina Mussa Benard Modest adolfine hokororo Florentina Mashuda Vitus Silago Stephen E. Mshana Martha F. Mushi Department of Pediatrics and Child Health Weill Bugando School of Medicine Catholic University of Health and Allied Sci-ences Mwanza Tanzania Department of Microbiology and Immunology Weill Bugando School of Medicine Catholic University of Health and Allied Sciences Mwanza Tanzania

Background and Objectives: Candida colonization in neonates with low birth weight is reported to be the first step for invasive candidiasis. This study was designed to describe the patterns of Candida spp. colonizing neonates with low birth weight in Mwanza, Tanzania to provide baseline information for future studies in this field. Methodology: The hospital based cross sectional study was conducted between January 2019 and April 2019 among neonates with low birth weight. Clinical and social demographic data were collected using interview guide questionnaire. Oral and umbilical rectal swabs were collected on the first and seventh day of life to assess Candida spp. colonization status. Data were analyzed using STATA version 13 following the study objectives. Results: A total of 320 neonates with median body weight of 1600 [IQR 1000 - 2000] grams were enrolled. Prevalence of Candida spp. colonization on either ora

关键词： Candida Colonization C. albicans C. glabrata Oral

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Prevalence and Factors Associated with Rotavirus Infection among Vaccinated Children Hospitalized for Acute Diarrhea in Mwanza City, Tanzania: A Cross Sectional Study

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Open Journal of Pediatrics 2020年第3期10卷 392-403页

作者： Dina Mahamba adolfine hokororo Florentina Mashuda Delfina R. Msanga Elice C. Bendera Elizabeth N. Kwiyolecha Benson R. Kidenya Stephen E. Mshana Mariam M. Mirambo Department of Pediatrics & Child Health College of Health Sciences University of Dodoma Dodoma Tanzania Department of Pediatrics and Child Health Weill Bugando School of Medicine Catholic University of Health and Allied Sciences Mwanza Tanzania Department of Biochemistry and Molecular Biology Weill Bugando School of Medicine Catholic University of Health and Allied Sciences Mwanza Tanzania Department of Microbiology and Immunology Weill Bugando School of Medicine Catholic University of Health and Allied Sciences Mwanza Tanzania

Introduction: Rotavirus infection is a leading cause of severe diarrhea culminating to dehydration among children under five years of age. Understanding trends and factors that could assist towards devising effective preventive strategies of Rotavirus infection beyond vaccination is crucial. Objectives: This study was done in an attempt to determine the prevalence and associated factors of Rotavirus infection among vaccinated children aged between 6 weeks and 24 months admitted with acute diarrhea Mwanza, Tanzania. Material and Methods: Across sectional study involving vaccinated children aged 6 weeks to 24 months was conducted in three selected hospitals from July 2017 to January 2018. Socio-demographic and other relevant clinical information were collected using a standardized data collection tool adopted from WHO Rotavirus surveillance tool. Rotavirus infection from the stool was detected using an enzyme immunoassay. Data were analyzed using STATA version 13. Results: A total of 301 vaccinated children with acute diarrhea with a median age of 12 [IQR: 8 - 17] months were enrolled. Nine (3.0%) and 292 (97.0%) had received one dose and two doses of Rotavirus vaccine, respectively. The prevalence of Rotavirus infection was 74 (24.6%) [95% CI: 20.0 - 29.8]. Independent predictors of Rotavirus infection were: dry season (OR 6.9;95% CI: 2.9 -

关键词： Rotavirus Vaccination Diarrhea

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Health Facilities Readiness to Implement Standard Precautions for Infection Prevention and Control in Tanzania: Lesson Learnt from SARA Reports

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Advances in Infectious Diseases 2022年第3期12卷 392-404页

作者： Joseph Christopher hokororo Omary A. Nassoro Saumu Iddy Nungu Radenta Paul Bahegwa Ruth Raymond Ngowi Yohanes Silipamwambo Msigwa Laura Edward Marandu Mwendwa Mwenesi Chrisogone Justin German Akili Mawazo Michael M. Habtu Grace E. Saguti Tigest K. Mengestu Eliudi Saria Eliakimu Health Quality Assurance Unit Ministry of Health Dodoma Tanzania Health Emergency Preparedness and Response Unit Ministry of Health Dodoma Tanzania Immunization and Vaccine Development (IVD) Program Division of Preventive Services Ministry of Health Dodoma Tanzania School of Laboratory Sciences Muhimbili University Health and Allied Sciences Dar es Salaam Tanzania World Health Organization—Tanzania Country Office Dar es Salaam Tanzania

Introduction: Standard Precautions are a set of measures applied in the care of all individuals/patients regardless of their infectious status aiming at preventing healthcare workers and patients from infections, preventing environmental contamination and spread of infections to the community. Many health facilities have not implemented them to an acceptable level. The purpose of the study is to report progress of improvement in health facilities readiness to implement standard precautions for infection prevention and control based on SARA reports. Methods: We generated mean scores of all standard precautions each year and calculated their standard deviations, variances and confidence intervals. One-way ANOVA was used to determine if the mean scores were equal. Finally, the trend of improvement in health facilities readiness to implement the standard precautions was generated. Results: A total of nine standard precautions were reported in SARA reports for 2012, 2017 and 2020. The mean scores of the standard precautions were 52.22% in 2012, 64.55% in 2017 and 69.66% in 2020. The overall trend showed an increase in health facilities readiness to implement standard precautions, although the mean scores were not statistically different (p-value 0.3217). Conclusion: SARA surveys conducted in Tanzania in 2012, 2017 and 2020 have shown an overall increase in health facilities readiness to implement standard precautions. Safe final waste disposal was being done in fewest facilities while single-use or auto-disable syringes were in most facilities that were sampled in all years. SARA surveys may be a useful way to evaluate Infection Prevention and Control adherence in health facilities.

关键词： Infection Prevention and Control Standard Precautions Health Facilities Readiness Safe Waste Disposal Implementation of Standard Precautions

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Training of Infection Prevention and Control to Healthcare Workers of Mining Health Facilities: A Shared Responsibility for Improving Safety of Mining Communities

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Occupational Diseases and Environmental Medicine 2024年第4期12卷 243-264页

作者： Joseph C. hokororo Laura E. Marandu Ruth R. Ngowi Radenta P. Bahegwa Yohannes S. Msigwa Chrisogone J. German Omary A. Nasoro Erick S. Kinyenje Syabo M. Mwaisengela Mbwana M. Degeh Robert S. Mazengo Irene F. Ndauzi Eliudi S. Eliakimu Health Quality Assurance Unit Ministry of Health Dodoma Tanzania North Mara Medical Centre North Mara Gold Mine Limited Tarime Tanzania

Introduction: Without appropriately trained healthcare workers (HCWs), infection prevention and control (IPC) cannot be implemented according to set standards. Although training is crucial, authorities rarely consider those working in health facilities owned by the mining. We describe the training which was conducted in North Mara in Mara region mining health facilities. Methods: This was descriptive study on the training of IPC to HCWs of mining health facilities. The training was conducted to North Mara Gold Mine Limited on April 2024. We targeted the HCWs and supporting staff working in the health facilities of the mining communities. The duration of the training was five days. The sessions started with pre-training test to evaluate what participants understood before training and followed with training itself. The training was carried out using mixed adult learning methods like: illustrated lectures, demonstrations, brainstorming, small group activities, group discussions, role plays, case studies and simulations. The training was finalized with posttest. Results: A total of ten HCWs were trained out of 13 of the facility. In that training six were males and four were females. Also, out of the ten trained three were clinicians, four nurses, one lab technician, one pharmaceutical technician, one support staff. The average score of the results of the pretest was 70.7% with a range of 16% (minimum 64% and maximum 80%) and that of the posttest was 79.8% with a range of 12% (min 74% and max 88%). Conclusions: If HCWs are well trained to comply with IPC standards and transmission-based precautions, they have the ability to deliver safe health services and protect themselves, patients, environment and the community. Training of HCWs working at the mining, therefore, can be adapted in all mines to improve the quality of mining healthcare and respond to the need to improve the safety of mining communities.

关键词： Healthcare Associated Infection Infection Prevention and Control Safety of Mining Community

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Patient Safety Efforts in Tanzania: A Rapid Review of Two-Decades Efforts (2002-2022) to Inform Interventions towards Attainment of 2030 Targets

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Advances in Infectious Diseases 2022年第3期12卷 466-495页

作者： Joseph C. hokororo Michael Habtu Radenta P. Bahegwa Ruth R. Ngowi Yohanes S. Msigwa Mbwana M. Degeh Erick S. Kinyenje Omary A. Nassoro Laura E. Marandu Chrisogone J. German Edwin Mkwama Bushi Lugoba Grace E. Saguti Zabulon Yoti Eliudi S. Eliakimu Health Quality Assurance Unit Ministry of Health Dodoma Tanzania World Health Organization Dar es Salaam Tanzania Centre for Distance Education Morogoro Tanzania Benjamin Mkapa Hospital Dodoma Tanzania

Introduction: The need to address the problem of patient safety has been a focus of World Health Assembly (WHA) meetings of 2002, 2019 and 2021. The 2019 WHA Resolution urged the Member States to take action on patient safety. We aimed to review patient safety efforts in Tanzania from 2002 to 2022 to inform improvement efforts towards the 2030 target. Methods: A rapid literature review was conducted between January 2002 and April 2022. We searched Google, PubMed and PubMed Central in April and May 2022 using the following search terms: PubMed—“patient safety Tanzania”, “blood safety in Tanzania”, “safe surgery Tanzania”, and “healthcare-associated infections Tanzania”;Google—“blood safety in Tanzania”, injection safety in Tanzania”, “infection prevention and control”, “radiation safety in health facilities in Tanzania”;and PubMed Central—“injection safety in Tanzania. Results: The search identified 4160 articles, of which 4053 were removed in initial screening;21 were duplicates, giving 86 relevant articles for full screening. Of the 86 articles, 04 were removed after the full screening, hence remaining with 82 articles. Among the 82 eligible articles, 27 are on IPC, 26 on safe surgery, 12 on blood safety, 07 on radiation safety, 06 on injection safety, and 02 on medication safety. One article was relevant to—blood safety, IPC and injection safety;and one article was relevant to—IPC and injection safety. Conclusion: Most of the eligible literature was on IPC and safe surgery, followed by blood safety, radiation safety, injection safety and medication safety. The literature on IPC has highlighted the need to strengthen efforts to address AMR. Findings from the implementation of the safe surgery 2020 intervention warrants for its scale-up to other zones. There is a need to strengthen hemovigilance and pharmacovigilance functions;and strengthen quality management and assurance systems and regulatory functions to ensure radiation safety.

关键词： Patient Safety Safe Surgery Infection Prevention and Control Medication Safety Radiation Safety

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