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Bacteriological Profile, Antimicrobial Susceptibility Patterns and Predictors of Bacteremia in Neonates with Clinical Sepsis at KCMC Hospital, Northern Tanzania

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Open Journal of Epidemiology 2024年第4期14卷 647-668页

作者： Nyemo P. Kwanga Aisa Shayo Rune Philemon Arnold Likiliwike mselle mathew Elise Kimambo Phillip Mrindoko Grace Kinabo Levina Msuya Hans Maro Raimos Olomi Department of Pediatrics and Child Health Kilimanjaro Christian Medical University College Moshi Tanzania Department of Pediatrics and Child Health Kilimanjaro Christian Medical Centre Moshi Tanzania UNICEF Tanzania Dar es Salaam Tanzania

Background: Despite a significant decline in neonatal deaths in the last 20 years (5 million in 1990 to 2.4 million in 2019), the risk of death is still high, especially in developing countries. In Tanzania, neonatal sepsis is the third leading cause of neonatal death, accounting for 25% of all deaths. The rising global threat of antimicrobial resistance and the rising burden of neonatal death due to neonatal sepsis have been of great concern and have delayed progress toward reaching SDG goal 3.2 by 2030. This study aims to determine the bacteriological profile, antibiotic susceptibility patterns, and predictors of bacteremia among neonates with clinical sepsis at KCMC Hospital in Northern Tanzania. Methodology: This study had a cross-sectional design conducted at KCMC Hospital, Northern Tanzania. The study population was neonates admitted to the neonatal unit at KCMC Hospital. Data were collected using questionnaires and blood cultures from neonates. Frequencies and proportions were used to summarize categorical variables, while continuous variables were summarized using mean and standard deviation. The frequencies and proportions of bacteria isolated and the antimicrobial susceptibility results were analyzed and compared using Pearson’s chi-square test and Fisher’s exact test where applicable. Modified Poisson regression model was used to determine factors associated with positive blood culture. Results: Out of 411 neonates with a clinical diagnosis of neonatal sepsis, 175 (42.9%) had positive blood cultures. Gram-positive bacteria were most frequently isolated at 52.3%, and gram-negative bacteria were 47.7%. Coagulase-negative Staphylococcus (30.7%) and Staphylococcus aureus (19.9%) were the predominant gram-positive isolates. Gram-negative isolates were Klebsiella spp 47 (26.7%), E. coli 10 (5.7%), and Citrobacter spp 10 (5.1%). The gram-positive isolates were sensitive to vancomycin, piperacillin/tazobactam, and ceftazidime, whereas the gram-negative were sensi

关键词： Bacteriological Profile Antimicrobial Susceptibility Patterns Clinical Sepsis Neonates

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HLA-G and single nucleotide polymorphism(SNP)associations with cancer in African populations:Implications in personal medicine

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Genes & Diseases 2022年第5期9卷 1220-1233页

作者： Ismael Chatita Adolf Amany Almars Nazima Dharsee Teddy mselle Gokce Akan Irene Jeremiah Nguma Abdolrahman S.Nateri Fatmahan Atalar Mbeya College of Health and Allied Sciences University of Dar es SalaamMbeyaP.O Box 608Tanzania Cancer Genetics&Stem Cell Group BioDiscovery InstituteDivision of Cancer and Stem CellsSchool of MedicineUniversity of NottinghamNottinghamNG72UHUK Ocean Road Cancer Institute Department of OncologyDar es SalaamP.O Box 3592Tanzania Muhimbili University of Health and Allied Sciences MUHAS Genetic LaboratoryDepartment of BiochemistryDar es SalaamP.O Box 65001Tanzania Clinical Oncology Department Mbeya Zonal Referral Hospital(MZRH)Mbeya P.O Box 419Tanzania Child Health Institute Department of Rare DiseasesIstanbul UniversityIstanbul 34093Turkey

The immune system plays an important role in protecting the body against *** cancer immunoediting,the immune system can recognize and keep checking the tumor cells by down-expression of some self-molecules or by increasing expression of some novel ***,the microenvironment created in the course of cancer development hampers the immune ability to recognize and destroy the transforming *** Leukocyte Antigen G(HLA-G)is emerging as immune checkpoint molecule produced more by cancer cells to weaken the immune response against ***-G is a non-classical HLA class I molecule which is normally expressed in immune privileged tissues as a soluble or membrane-bound ***-G locus is highly polymorphic in the non-coding 3′untranslated region(UTR)and in the 5′upstream regulatory region(5′URR).HLA-G expression is controlled by polymorphisms located in these regions,and several association studies between these polymorphic sites and disease predisposition,response to therapy,and/or HLA-G protein expression have been *** polymorphisms are demonstrated to modulate its expression and this is increasingly finding more significance in cancer *** review focuses on the relevance of the HLA-G gene and its polymorphisms in cancer *** highlight population genetics of HLA-G as evidence to espouse the need and importance of exploring potential utility of HLA-G in cancer diagnosis,prognosis and immunotherapy in the currently understudied African population.

关键词： African population Cancer HLA-G Immune system checkpoints MHC Single nucleotide polymorphism

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New Approach to the Delivery of Construction in Botswana

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Journal of Civil Engineering and Architecture 2011年第7期5卷 606-617页

作者： Aderemi Adeyemi Pasis mselle Dean Kashiwagi Jacob Kashiwagi Project Management Section Civil Engineering Department Faculty of Engineering and Technology （FET） University of Botswana Performance Based Studies Research Group （PBSRG） Arizona State University Tempe AZ USA

The construction industry in Botswana has been identified as an industry with many problems. Currently the Botswana government uses the design-bid-build process, using prequalification and awards to the lowest bidder for construction services. The government can also use the design-build delivery system. The current delivery system uses an engineering group that delivers designs and construction, uses a procurement group to award the contract and contract modifications. However, the analysis for all actions is done by the engineering group. The model is very similar to the Corps of Engineers traditional processes in the United States. Construction performance （on time and no contract deviations） has not been good. The authors propose that the delivery system and the paradigm of direction, control and decision making by the engineering group causes risk to the project and results in poor contractor performance. The authors suggest making modifications in the process and to use the design-build process. The authors also propose to change the paradigm using best value PIPS/IMT concepts.

关键词： Botswana procurement new PM model paradigm change.

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Risk Management： A New Project Management Perspective

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Journal of Civil Engineering and Architecture 2011年第6期5卷 505-512页

作者： Pasis mselle Jacob Kashiwagi Dean Kashiwagi Aderemi Adeyemi Project Management Section Civil Engineering Department University of Botswana Botswana Performance Based Studies Research Group （PBSRG） Arizona State University USA

Risk management in Botswana has been very ineffective at assisting projects to be on time, on budget, and meeting client＇s/buyer＇s expectations. Traditional risk management attempts to manage, control, and direct a project through various phases, from planning and design, through procurement, and to construction. However, the risk management in Botswana seems to be either not implemented or not successful. The project performance in Botswana has a poor performance record. The researchers are attempting to identify why the traditional project/risk management is not working. In analyzing the problem in Botswana, the researchers discovered that the traditional risk management model was theoretically unsound, and designed a new project and risk model, with an entirely different approach to risk. The new model is an outgrowth of the highly successful Performance Information Procurement System （PIPS） and the Information Measurement Theory （IMT）/Kashiwagi Solution Model （KSM） concepts. The approach has been presented to some Botswana clients and academics and has received a favorable response. The development of the new risk model will lead to a huge change in the paradigm for delivering projects in Botswana. The theoretical development of the new risk model is ongoing at the University of Botswana as a part of a doctoral dissertation.

关键词： Risk management Botswana projects new leadership based PM model.

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Is the Culture or Unstable Procurement System Causing Nonperforming Projects？

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Journal of Civil Engineering and Architecture 2011年第5期5卷 389-401页

作者： Dean Kashiwagi Jacob Kashiwagi Pasis mselle Aderemi Adeyemi Performance Based Studies Research Group （PBSRG） Arizona State University USA Project Management Section Department of Civil Engineering University of Botswana

A research group at the University of Botswana has been investigating how culture and construction delivery system stability affect the Botswana construction industry performance. The government of Botswana is attempting to increase the construction performance and sustainability of the Botswana construction industry in an environment of local contractors who do not seem to have the expertise and experience. Currently, the Botswana industry is heavily dependent on foreign contractors. The researchers are trying to identify if the problem is the underdeveloped industry and Botswana culture, or potentially the combination of culture and unstable delivery system, and can a stable delivery system raise the performance of Botswana contractors. The two potential areas of interest are the country culture, and the project delivery/management model. The authors are using deductive logic, logical and simplistic models, and dominant or extreme information to minimizing the need to get into a long drawn out study of details which may be difficult to obtain and not necessarily solve the issue. The objective of the paper is to identify the best method to increase the performance of the construction industry, addressing both the cultural and delivery system problems. The preliminary measurement of the success of the solution is the acceptance of the concepts by major users in Botswana. This paper will propose the potential solution, which will be tested starting January 2011. If this solution is valid, it has a tremendous potential in underdeveloped countries.

关键词： Culture project management Botswana.

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Caretaker’s Perceptions on Caretaker-Adolescent Communication on Sexual and Reproductive Health in Unguja-Zanzibar: Implication for Intervention

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Health 2016年第6期8卷 518-530页

作者： Saada A. Seif Thecla W. Kohi Lilian T. mselle Department of Nursing Management School of Nursing Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania Department of Clinical Nursing School of Nursing Muhimbili University of Health and Allied Sciences Dar es Salaam Tanzania

Caretaker-adolescent communication is an appealing source for influencing adolescents’ knowledge, attitudes and behavior, because caretakers are an accessible and often willing source of information for their children. With the realization of the importance of caretakers in influencing adolescent behaviours, it becomes interesting to explore their perceptions about caretaker-adolescent communication on Sexual and Reproductive Health (SRH). An exploratory qualitative research design was conducted in all six districts of Unguja-Zanzibar. Twelve focus group discussions (FGDs) with caretakers who were purposively selected were conducted. Thematic analysis guided the interpretation of the data. The main themes that were identified are perceived the risk of adolescents;style, time and content of communication;barriers to parent-child communication on SRH;and helping our children pass through adolescence safely. The findings show that participants have acknowledged the apparent risky sexual behaviors of their adolescents, and that information on SRH should be offered to children before they reach puberty. Participants had the opinion that communication on SRH should be in the form of warning, threat and unidirectional. Topics such as teenage pregnancy, STIs and HIV, and drug and alcohol were proposed to be openly discussed. However, topics on condom and contraceptives use faced strong opposition. Lack of favorable time, caretakers’ limited knowledge and skills, myth on SRH communication, and being uncomfortable were among the caretaker-adolescent communication barriers identified by caretakers. The findings suggest that participants are keen to help their adolescents to avoid SRH problems, most importantly they emphasised on the need to empower caretakers by equipping them with knowledge of SRH, good communication skills and religious knowledge. Communal parenting on the other hand has been identified as the major weapon in shaping adolescents’ behaviour. This information

关键词： Caretaker Adolescent Reproductive Health Sexuality IMB-Model Qualitative Study

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Nutritional Status, Feeding Practices and Factors Associated to Undernutrition among 6 to 59 Months of Age Orphans in the Arusha Region

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Open Journal of Pediatrics 2024年第6期14卷 1012-1037页

作者： Philip Mrindoko Matei mselle Lucy Frisch Ali Iman Magreth Swai Zaituni Hatibu Ikupa Minga Arnold Likiliwike Elise Kimambo Nyemo Peter Baraka Moshi Aisa Shayo Department of Pediatrics and Child Health Kilimanjaro Christian Medical Centre Moshi Tanzania Department of Pediatrics and Child Health Kilimanjaro Christian Medical University College Moshi Tanzania Institute of Public Health Kilimanjaro Christian Medical University College Moshi Tanzania

Background: Orphans are potentially at greater risk of malnutrition because they are more likely to be extremely poor and receive less medical and social care. Children living in orphanages tend to be neglected and may be malnourished and they’re at risk of losing their full potential, with consequences to the child, nation and worldwide. Despite the nutritional concerns raised globally and in neighboring countries among these children, there exists an inadequate body of information about orphans’ nutritional status and feeding practices in Tanzania. This study aimed to assess the nutritional status, feeding practices and factors contributing to malnutrition among children aged 6 - 59 months in Arusha region orphanages, Tanzania. Study Objective: To assess the nutritional status, feeding practices and factors contributing to undernutrition among children aged 6 - 59 months in Arusha region orphanages, Tanzania. Methodology: This was an institution-based cross-sectional study conducted in selected orphanage Centre in the Arusha region. A representative sample size of 216 children aged 6 - 59 months in Arusha orphanages was selected to participate in the study. Multistaging sampling was used to select the study participants. Interviewer-administered questionnaires and anthropometric measurements were used during data collection. The data collected were entered, processed, and analyzed;continuous variables were summarized by use of mean and Standard deviation, while categorical variables were summarized by use of frequency, percentages and figures. Multivariable logistic regression was used to estimate the Odds Ratio with 95% CI and measure the strength of association between the outcomes with respect to selected independent variables. Variables with a p-value of less than 0.05 were considered statistically significant. Results: A total of 216 children from the orphanage Centre were involved in this study. Prevalence of Stunting, underweight and wasting among orphan ch

关键词： Undernutrition Eating Habits Under Five Children Home Based Care

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Rare Case of Surviving Infant with Strawberry Yoghurt like Blood Diagnosed to Be Infantile Hypertriglyceridemia at 1 Month Old: A Case Report

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Open Journal of Pediatrics 2021年第4期11卷 777-785页

作者： Matei mselle Aisa Shayo Ronald Mbwasi Faith Mosha Jeremia Pyuza Philip Mrindoko Nyemo Peter Elton Meleki Elise Kimambo Arnold Likiliwike Lucy Frisch Magreth Swai Zaituni Hatibu Ally Iman Beatrice Maringo Linda Kissila Ikupa Minga Deborah Mchaile Department of Paediatrics and Child Health Kilimanjaro Christian Medical University College Moshi Tanzania Department of Paediatrics and Child Health Kilimanjaro Christian Medical Centre Moshi Tanzania Department of Clinical Laboratory Kilimanjaro Christian Medical Centre Moshi Tanzania

Background: Hypertriglyceridemia in children means increased plasma fasting Triglyceride levels above the 95th percentile for age and sex. For children aged 0 to 9 years, a triglyceride level greater than or equal to 100 mg/dl is considered above the 95th percentile. Hypertriglyceridemia can be mild to borderline high, moderate to high, very high, severe and very severe (>2000 mg/dl). We present the case of a 1 month and 3 weeks old baby who presented with difficulty in breathing. It was accidentally found to have strawberry yoghurt like blood during phlebotomy, of which upon investigation had very high triglyceride levels of >2000 mg/dl. Case Presentation: 1 month and 3 weeks old female baby, admitted as referral from nearby health centre presenting with difficulty in breath, her blood sample was incidentally found to appear as strawberry yoghurt like. Clinically the infant had features suggestive of respiratory distress, with no other systemic abnormalities noted. Chest X-ray that was don

关键词： Strawberry Yoghurt Like Blood Hypertriglyceridemia Tanzania

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