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Maya T, Komba E, Mensah G, Mnyambwa N, Doulla B, Mfinanga S, Addo K, Kazwala R. Non-tuberculous mycobacterial pulmonary disease: Awareness survey of front-desk healthcare workers in Northern Tanzania. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0000741. [PMID: 36963008 PMCID: PMC10021751 DOI: 10.1371/journal.pgph.0000741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 12/01/2022] [Indexed: 01/22/2023]
Abstract
Over the past decade, there have been increasing reports of non-tuberculous mycobacteria (NTM) species being implicated in tuberculosis (TB) treatment failure or misdiagnosed as TB. Inadequate awareness of NTM pulmonary disease among healthcare workers (HCWs) may contribute to a low index of suspicion for patients presenting to their hospitals. In this study, we assessed the awareness of NTM pulmonary disease (NTM-PD) among front desk HCWs in Northern Tanzania. A cross-sectional descriptive survey was carried out among front desk HCWs in four administrative regions of Northern Tanzania. A standardized questionnaire was administered to consented participants from four clusters; clinicians, laboratory scientists, nurses, and pharmacists serving TB patients from Regional and District Health Facilities. Each participant was asked a set of questions, scored and the total score for each participant was determined. An awareness score was used to measure the level of awareness. The average score for all participants was estimated including the 95% confidence interval (CI). The overall awareness score was 24.1%, 95% CI 22.0-26.2%. History of training, experience in TB care, level of health facilities, age group, and setting were found to be statistically associated with the level of awareness of study participants. More than two-thirds (67%) of participants believe that pulmonary NTM and TB are clinically similar and 60% are not aware that AFB Microscopy cannot distinguish between the two. Only 13% of participants could mention at least one risk factor for NTM pulmonary disease. The level of awareness of NTM pulmonary disease was poor among HCWs in the surveyed TB clinics. National TB Programs are advised to include a topic on NTM in various on-job TB training packages for HCWs.
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Affiliation(s)
- Togolani Maya
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
- Central Tuberculosis Reference Laboratory, National Tuberculosis and Leprosy Program, Dar es Salaam, Tanzania
| | - Erick Komba
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Gloria Mensah
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Nicholaus Mnyambwa
- National Institute for Medical Research, Muhimbili Research Centre, Dar es Salaam, Tanzania
| | - Basra Doulla
- Central Tuberculosis Reference Laboratory, National Tuberculosis and Leprosy Program, Dar es Salaam, Tanzania
| | - Sayoki Mfinanga
- National Institute for Medical Research, Muhimbili Research Centre, Dar es Salaam, Tanzania
| | - Kennedy Addo
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Rudovick Kazwala
- Department of Veterinary Medicine and Public Health, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, Morogoro, Tanzania
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HIV Prevalence among Injury Patients Compared to Other High-Risk Groups in Tanzania. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2030041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Sixty-eight percent of persons infected with HIV live in Africa, but as few as 67% of those know their infection status. The emergency department (ED) might be a critical access point to HIV testing. This study sought to measure and compare HIV prevalence in an ED injury population with other clinical and nonclinical populations across Tanzania. Adults (≥18 years) presenting to Kilimanjaro Christian Medical Center ED with acute injury of any severity were enrolled in a trauma registry. A systematic review and meta-analysis was conducted to compare HIV prevalence in the trauma registry with other population groups. Further, 759 injury patients were enrolled in the registry; 78.6% were men and 68.2% consented to HIV counseling and testing. The HIV prevalence was 5.02% (tested), 6.25% (self-report), and 5.31% (both). The systematic review identified 79 eligible studies reporting HIV prevalence (tested) in 33 clinical and 12 nonclinical population groups. Notable groups included ED injury patients (3.53%, 95% CI), multiple injury patients (10.67%, 95% CI), and people who inject drugs (17.43%, 95% CI). These findings suggest that ED injury patients might be at higher HIV risk compared to the general population, and the ED is a potential avenue to increasing HIV testing among young adults, particularly men.
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Gordillo-Marroquín C, Sánchez-Pérez HJ, Gómez-Velasco A, Martín M, Guillén-Navarro K, Vázquez-Marcelín J, Gómez-Bustamante A, Jonapá-Gómez L, Alocilja EC. Tween 80 Improves the Acid-Fast Bacilli Quantification in the Magnetic Nanoparticle-Based Colorimetric Biosensing Assay (NCBA). BIOSENSORS 2022; 12:29. [PMID: 35049656 PMCID: PMC8773761 DOI: 10.3390/bios12010029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/02/2022] [Accepted: 01/03/2022] [Indexed: 11/18/2022]
Abstract
Despite its reduced sensitivity, sputum smear microscopy (SSM) remains the main diagnostic test for detecting tuberculosis in many parts of the world. A new diagnostic technique, the magnetic nanoparticle-based colorimetric biosensing assay (NCBA) was optimized by evaluating different concentrations of glycan-functionalized magnetic nanoparticles (GMNP) and Tween 80 to improve the acid-fast bacilli (AFB) count. Comparative analysis was performed on 225 sputum smears: 30 with SSM, 107 with NCBA at different GMNP concentrations, and 88 with NCBA-Tween 80 at various concentrations and incubation times. AFB quantification was performed by adding the total number of AFB in all fields per smear and classified according to standard guidelines (scanty, 1+, 2+ and 3+). Smears by NCBA with low GMNP concentrations (≤1.5 mg/mL) showed higher AFB quantification compared to SSM. Cell enrichment of sputum samples by combining NCBA-GMNP, incubated with Tween 80 (5%) for three minutes, improved capture efficiency and increased AFB detection up to 445% over SSM. NCBA with Tween 80 offers the opportunity to improve TB diagnostics, mainly in paucibacillary cases. As this method provides biosafety with a simple and inexpensive methodology that obtains results in a short time, it might be considered as a point-of-care TB diagnostic method in regions where resources are limited.
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Affiliation(s)
- Cristina Gordillo-Marroquín
- Health Department, El Colegio de la Frontera Sur (ECOSUR), San Cristobal de Las Casas, Chiapas 29290, Mexico;
- The Network GRAAL (Grups de Recerca d’America i Africa Llatines), El Colegio de La Frontera Sur (ECOSUR), San Cristobal de Las Casas, Chiapas 29290, Mexico; (A.G.-V.); (M.M.)
- Global Alliance for Rapid Diagnostics, Nano-Biosensors Lab, College of Engineering, Michigan State University, East Lansing, MI 48824, USA
- Social Observatory of Tuberculosis Mexico, El Colegio de La Frontera Sur (ECOSUR), San Cristobal de Las Casas, Chiapas 29290, Mexico
| | - Héctor J. Sánchez-Pérez
- Health Department, El Colegio de la Frontera Sur (ECOSUR), San Cristobal de Las Casas, Chiapas 29290, Mexico;
- The Network GRAAL (Grups de Recerca d’America i Africa Llatines), El Colegio de La Frontera Sur (ECOSUR), San Cristobal de Las Casas, Chiapas 29290, Mexico; (A.G.-V.); (M.M.)
- Global Alliance for Rapid Diagnostics, Nano-Biosensors Lab, College of Engineering, Michigan State University, East Lansing, MI 48824, USA
- Social Observatory of Tuberculosis Mexico, El Colegio de La Frontera Sur (ECOSUR), San Cristobal de Las Casas, Chiapas 29290, Mexico
| | - Anaximandro Gómez-Velasco
- The Network GRAAL (Grups de Recerca d’America i Africa Llatines), El Colegio de La Frontera Sur (ECOSUR), San Cristobal de Las Casas, Chiapas 29290, Mexico; (A.G.-V.); (M.M.)
- Global Alliance for Rapid Diagnostics, Nano-Biosensors Lab, College of Engineering, Michigan State University, East Lansing, MI 48824, USA
- Department of Human Ecology, Center for Research and Advanced Studies of the National Polytechnic Institute (Cinvestav-IPN), Merida 97310, Mexico
| | - Miguel Martín
- The Network GRAAL (Grups de Recerca d’America i Africa Llatines), El Colegio de La Frontera Sur (ECOSUR), San Cristobal de Las Casas, Chiapas 29290, Mexico; (A.G.-V.); (M.M.)
- Biostatistics and Epidemiology Unit, Faculty of Medicine, Autonomous University of Barcelona, 08193 Bellaterra, Spain
- School of Medicine, Universidad Internacional del Ecuador, Quito 170113, Ecuador
| | - Karina Guillén-Navarro
- Sustainability Sciences Department, El Colegio de la Frontera Sur (ECOSUR), Tapachula, Chiapas 30700, Mexico;
| | - Janeth Vázquez-Marcelín
- Mycobacteriology Laboratory, TB Prevention and Control Program for the Highlands of Chiapas, Ministry of Health of Chiapas, San Cristobal de Las Casas, Chiapas 29290, Mexico;
| | - Adriana Gómez-Bustamante
- State Public Health Laboratory for Chiapas, Ministry of Health of Chiapas, Tuxtla Gutierrez, Chiapas 29040, Mexico; (A.G.-B.); (L.J.-G.)
| | - Letisia Jonapá-Gómez
- State Public Health Laboratory for Chiapas, Ministry of Health of Chiapas, Tuxtla Gutierrez, Chiapas 29040, Mexico; (A.G.-B.); (L.J.-G.)
| | - Evangelyn C. Alocilja
- The Network GRAAL (Grups de Recerca d’America i Africa Llatines), El Colegio de La Frontera Sur (ECOSUR), San Cristobal de Las Casas, Chiapas 29290, Mexico; (A.G.-V.); (M.M.)
- Global Alliance for Rapid Diagnostics, Nano-Biosensors Lab, College of Engineering, Michigan State University, East Lansing, MI 48824, USA
- Nano-Biosensors Laboratory, Department of Biosystems and Agricultural Engineering, Michigan State University, East Lansing, MI 48824, USA
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Mnyambwa NP, Kim DJ, Ngadaya E, Chun J, Ha SM, Petrucka P, Addo KK, Kazwala RR, Mfinanga SG. Genome sequence of Mycobacterium yongonense RT 955-2015 isolate from a patient misdiagnosed with multidrug-resistant tuberculosis: First clinical detection in Tanzania. Int J Infect Dis 2018; 71:82-88. [DOI: 10.1016/j.ijid.2018.04.796] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 04/18/2018] [Accepted: 04/18/2018] [Indexed: 01/29/2023] Open
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Mnyambwa NP, Ngadaya ES, Kimaro G, Kim DJ, Kazwala R, Petrucka P, Mfinanga SG. Assessment of sputum smear-positive but culture-negative results among newly diagnosed pulmonary tuberculosis patients in Tanzania. Int J Gen Med 2017; 10:199-205. [PMID: 28744153 PMCID: PMC5513826 DOI: 10.2147/ijgm.s137469] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Diagnosis of pulmonary tuberculosis (TB) in technology-limited countries is widely achieved by smear microscopy, which has limited sensitivity and specificity. The frequency and clinical implication of smear-positive but culture-negative among presumptive TB patients remains unclear. A cross-sectional substudy was conducted which aimed to identify the proportion of nontuberculous mycobacteria (NTM) infections among 94 "smear-positive culture-negative" patients diagnosed between January 2013 and June 2016 in selected health facilities in Tanzania. Out of 94 sputa, 25 (26.60%) were GeneXpert® mycobacteria TB positive and 11/94 (11.70%) repeat-culture positive; 5 were Capilia TB-Neo positive and confirmed by GenoType MTBC to be Mycobacterium tuberculosis/Mycobacterium canettii. The remaining 6 Capilia TB-Neo negative samples were genotyped by GenoType® CM/AS, identifying 3 (3.19%) NTM, 2 Gram positive bacteria, and 1 isolate testing negative, together, making a total of 6/94 (6.38%) confirmed false smear-positives. Twenty-eight (29.79%) were confirmed TB cases, while 60 (63.83%) remained unconfirmed cases. Out of 6 (6.38%) patients who were HIV positive, 2 patients were possibly coinfected with mycobacteria. The isolation of NTM and other bacteria among smear-positive culture-negative samples and the presence of over two third of unconfirmed TB cases emphasize the need of both advanced differential TB diagnostic techniques and good clinical laboratory practices to avoid unnecessary administration of anti-TB drugs.
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Affiliation(s)
- Nicholaus Peter Mnyambwa
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
- National Institute for Medical Research, Muhimbili Medical Research Center, Dar es Salaam, Tanzania
| | - Esther S Ngadaya
- National Institute for Medical Research, Muhimbili Medical Research Center, Dar es Salaam, Tanzania
| | - Godfather Kimaro
- National Institute for Medical Research, Muhimbili Medical Research Center, Dar es Salaam, Tanzania
| | - Dong-Jin Kim
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Rudovick Kazwala
- Department of Veterinary Medicine, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Pammla Petrucka
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
- College of Nursing, University of Saskatchewan, Saskatoon, Canada
| | - Sayoki G Mfinanga
- National Institute for Medical Research, Muhimbili Medical Research Center, Dar es Salaam, Tanzania
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