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Mangowi I, Mirambo MM, Kilonzo SB, Mlewa M, Nyawale H, Majinge D, Hyera F, Jaka H, Mtemisika C, Michael F, Mshana SE. Hepatitis B virus infection, associated factors, knowledge and vaccination status among household contacts of hepatitis B index cases in Mwanza, Tanzania. IJID Reg 2024; 10:168-173. [PMID: 38317663 PMCID: PMC10840095 DOI: 10.1016/j.ijregi.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 12/27/2023] [Accepted: 12/29/2023] [Indexed: 02/07/2024]
Abstract
Objectives To determine the prevalence of hepatitis B virus (HBV) infection, knowledge regarding HBV, vaccination status, and associated factors among household contacts of HBV index cases in Mwanza, Tanzania. Methods Between July and August 2023, a cross-sectional study involving 97 index cases and 402 household contacts was conducted. Data were collected using pre-tested structured questionnaire and blood samples were collected from household contacts for HBV surface antigen (HBsAg) testing. Results The prevalence of HBV among household contacts was 5.4% (95% confidence interval, 2.9-9.0) with a significantly high proportion observed in > 45 years (16.6%) and in males (9.9%). A total of 40.0% of the household contacts had completed the full HBV vaccination series. On multivariate analysis, being male was significantly associated with HBsAg positivity (odds ratio: 7.16, 95% confidence interval: 1.81-28.2, P = 0.005). Conclusion About one-tenth of adults' male household contacts were HBsAg positive. In addition, the majority of household contacts had poor to fair knowledge regarding HBV infection with more than half being unvaccinated against HBV. There is a need to enhance awareness and education regarding HBV infection among household contacts in Tanzania and other low- and middle-income countries.
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Affiliation(s)
- Ivon Mangowi
- School of Public Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Semvua B. Kilonzo
- Department of Internal Medicine, Catholic University of Health and Allied Sciences- Bugando, Mwanza, Tanzania
| | - Mathias Mlewa
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | | | | | - Hyasinta Jaka
- Department of Internal Medicine, Catholic University of Health and Allied Sciences- Bugando, Mwanza, Tanzania
| | | | - Fausta Michael
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Michael F, Mirambo MM, Misinzo G, Minzi O, Beyanga M, Mujuni D, Kalabamu FS, Nyanda EN, Mwanyika-Sando M, Ndiyo D, Kasonogo R, Ismail A, Bahati A, Hassan F, Kaale E, Chai JJ, Kinyunyi P, Kyesi F, Tinuga F, Mongi D, Salehe A, Muhindi B, Mdachi J, Magodi R, Mwenesi M, Nyaki H, Katembo B, Tenga K, Kasya M, Mwengee W, Mshana SE. Trends of measles in Tanzania: A 5-year review of case-based surveillance data, 2018-2022. Int J Infect Dis 2024; 139:176-182. [PMID: 38122965 PMCID: PMC10784152 DOI: 10.1016/j.ijid.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/11/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES Tanzania observed a gradual increase in the number of measles cases since 2019 with a large outbreak recorded during 2022. This study describes the trend of measles in Tanzania over a 5-year period from 2018-2022. METHODS This was a descriptive study conducted using routine measles case-based surveillance system including 195 councils of the United Republic of Tanzania. RESULTS Between 2018 and 2022 there were 12,253 measles cases reported. Out of 10,691 (87.25%) samples tested by enzyme-linked immunosorbent assay, 903 (8.4%) were measles immunoglobulin M positive. The highest number of laboratory-confirmed measles cases was in 2022 (64.8%), followed by 2020 (13.8%), and 2019 (13.5%). Out of 1279 unvaccinated cases, 213 (16.7%) were laboratory-confirmed measles cases compared to 77/723 (10.6%) who were partially vaccinated and 71/1121 (6.3%) who were fully vaccinated (P < 0.001). Children aged between 1-4 years constituted the most confirmed measles cases after laboratory testing, followed by those aged 5-9 years. There was a notable increase in the number of laboratory-confirmed measles cases in children <1 year and 10-14 years during 2022 compared to previous years. The vaccination coverage of the first dose of measles-containing vaccine (MCV1) was maintained >90% since 2013 while MCV2 increased gradually reaching 88% in 2022. CONCLUSIONS Accumulation of susceptible children to measles due to suboptimal measles vaccination coverage over the years has resulted in an increase in the number of laboratory-confirmed measles cases in Tanzania with more cases recorded during the COVID-19 pandemic. Strengthening surveillance, routine immunization, and targeted strategies are key to achieving the immunity levels required to interrupt measles outbreaks.
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Affiliation(s)
- Fausta Michael
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Gerald Misinzo
- OR Tambo Africa Research Chair for Viral Epidemics, SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Omary Minzi
- Department of Clinical Pharmacy and Pharmacology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Medard Beyanga
- National Public Health Laboratory, Ministry of Health, Dar es Salaam, Tanzania
| | - Delphinus Mujuni
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Florence S Kalabamu
- Department of Pediatrics and Child Health, Hubert Kairuki Memorial University, Dar es Salaam, Tanzania
| | - Elias N Nyanda
- Mbeya Medical Research Centre, National Institute for Medical Research, Mbeya, Tanzania
| | | | - Daniel Ndiyo
- Directorate of Regulatory Services, Government Chemist Laboratory Authority, Dodoma, Tanzania
| | - Richard Kasonogo
- Tanzania Medicines and Medical Devices Authority, Ministry of Health, Dodoma, Tanzania
| | - Abbas Ismail
- Department of Mathematics and Statistics, University of Dodoma, Dodoma, Tanzania
| | - Andrew Bahati
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Farida Hassan
- Health System, Impact Evaluation and Policy, Ifakara Health Institute, Ifakara, Tanzania
| | - Eliangiringa Kaale
- Pharm R&D Lab and Department of Medicinal Chemistry, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - John J Chai
- District Court of Kwimba, Judiciary of Tanzania, Ngudu, Tanzania
| | - Pricillah Kinyunyi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Furaha Kyesi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Florian Tinuga
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Dhamira Mongi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Abdul Salehe
- Immunization and Vaccine Development Program, Ministry of Health, Mnazimmoja, Zanzibar
| | - Bonaventura Muhindi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Joseph Mdachi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Richard Magodi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Mwendwa Mwenesi
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Honest Nyaki
- Immunization and Vaccine Development Program, Ministry of Health, Dodoma, Tanzania
| | - Betina Katembo
- National Public Health Laboratory, Ministry of Health, Dar es Salaam, Tanzania
| | - Kelvin Tenga
- National Public Health Laboratory, Ministry of Health, Dar es Salaam, Tanzania
| | - Magdalena Kasya
- National Public Health Laboratory, Ministry of Health, Dar es Salaam, Tanzania
| | | | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
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Mirambo MM, Michael F, Nyawale H, Mbugano F, Walwa MB, Mahamba D, Msanga DR, Okamo B, Damiano P, Mshana SE. The High Seropositivity of Mumps Virus IgG Antibodies among School-Aged Children in Rural Areas of the Mbarali District in the Mbeya Region, Tanzania: It Is High Time for Consideration in the National Immunization Program. Children (Basel) 2024; 11:73. [PMID: 38255386 PMCID: PMC10814223 DOI: 10.3390/children11010073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/24/2024]
Abstract
Mumps is an acute contagious viral disease caused by paramyxovirus characterized by complications that include orchitis, oophoritis, aseptic meningitis, and spontaneous abortion among many others. This study reports high mumps IgG seropositivity among school-aged children in rural areas of the Mbeya region, information that might be useful in understanding the epidemiology of mumps and instituting appropriate control measures including vaccination. Between May and July 2023, a cross-sectional study involving 196 enrolled children aged 5-13 years was conducted. Sociodemographic information and other relevant information were collected using a structured data collection tool. Blood samples were collected and used to detect mumps immunoglobulin G antibodies using indirect enzyme-linked immunosorbent assay (ELISA). A descriptive analysis was performed using STATA version 15. The median age of the enrolled children was 13 (interquartile range (IQR): 8-13) years. The seropositivity of mumps IgG antibodies was 88.8% (174/196, 95% CI: 83.5-92.5). By multivariable logistic regression analysis, history of fever (OR: 5.36, 95% CI: 1.02-28.22, p = 0.047) and sharing utensils (OR: 8.05, 95% CI: 1.99-32.65, p = 0.003) independently predicted mumps IgG seropositivity. More than three-quarters of school-aged children in rural areas of the Mbeya region are mumps IgG-seropositive, which is significantly associated with the sharing of utensils and history of fever. This suggests that the virus is endemic in this region, which calls for further studies across the country so as to institute evidence-based, appropriate control measures including a vaccination program.
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Affiliation(s)
- Mariam M. Mirambo
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (F.M.); (M.B.W.); (P.D.); (S.E.M.)
| | - Fausta Michael
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania;
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (F.M.); (M.B.W.); (P.D.); (S.E.M.)
| | - Frank Mbugano
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (F.M.); (M.B.W.); (P.D.); (S.E.M.)
| | - Maneja B. Walwa
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (F.M.); (M.B.W.); (P.D.); (S.E.M.)
| | - Dina Mahamba
- Department of Pediatrics and Child Health, College of Health Sciences, University of Dodoma, Dodoma P.O. Box 395, Tanzania;
| | - Delfina R. Msanga
- Department of Pediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Bernard Okamo
- Department of Biochemistry and Molecular Biology, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Prisca Damiano
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (F.M.); (M.B.W.); (P.D.); (S.E.M.)
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (F.M.); (M.B.W.); (P.D.); (S.E.M.)
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Michael F, Mirambo MM, Lyimo D, Salehe A, Kyesi F, Msanga DR, Mahamba D, Nyawale H, Kwiyolecha E, Okamo B, Mwanyika PJ, Maghina V, Bendera E, Salehe M, Hokororo A, Mwipopo E, Khamis AC, Nyaki H, Magodi R, Mujuni D, Konje ET, Katembo B, Wilillo R, Mshana SE. Rotavirus genotype diversity in Tanzania during Rotavirus vaccine implementation between 2013 and 2018. Sci Rep 2023; 13:21795. [PMID: 38066194 PMCID: PMC10709589 DOI: 10.1038/s41598-023-49350-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 12/07/2023] [Indexed: 12/18/2023] Open
Abstract
The study aims to determine Rotavirus genotypes between 2013 and 2018 during implementation of ROTARIX vaccine in Tanzania. The analysis of surveillance data obtained between 2013 and 2018 was done to determine circulating genotypes after introduction of Rotarix vaccine. From 2013 to 2018, a total of 10,557 samples were collected and screened for Rotavirus using an enzyme immunoassay. A significant decrease in Rotavirus positivity (29.3% to 17.8%) from 2013 to 2018 (OR 0.830, 95% CI 0.803-0.857, P < 0.001) was observed. A total of 766 randomly selected Rotavirus positive samples were genotyped. Between 2013 and 2018, a total of 18 Rotavirus genotypes were detected with G1P [8] being the most prevalent. The G1P [8] strain was found to decrease from 72.3% in 2015 to 13.5% in 2018 while the G9P [4] strain increased from 1 to 67.7% in the same years. G2P [4] was found to decrease from 59.7% in 2013 to 6.8% in 2018 while G3P [6] decreased from 11.2% in 2014 to 4.1% in 2018. The data has clearly demonstrated that ROTARIX vaccine has provided protection to varieties of the wild-type Rotavirus strains. Continuous surveillance is needed to monitor the circulation of Rotavirus strains during this era of vaccine implementation.
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Affiliation(s)
- Fausta Michael
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
| | - Dafrossa Lyimo
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma, Tanzania
| | - Abdul Salehe
- Ministry of Health, Immunization and Vaccine Development Program, Zanzibar, Tanzania
| | - Furaha Kyesi
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma, Tanzania
| | - Delfina R Msanga
- Department of Paediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Dina Mahamba
- Department of Pediatrics and Child Health, College of Health Sciences, University of Dodoma, P.O. Box 395, Dodoma, Tanzania
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Elizabeth Kwiyolecha
- Department of Paediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Bernard Okamo
- Department of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Paul J Mwanyika
- Department of Pediatrics and Child Health, Mbeya Zonal Referral Hospital, P.O. Box 419, Mbeya, Tanzania
| | - Victoria Maghina
- Department of Pediatrics and Child Health, Mbeya Zonal Referral Hospital, P.O. Box 419, Mbeya, Tanzania
| | - Elice Bendera
- Department of Pediatrics and Child Health, Muheza Designated District Hospital, Tanga, Tanzania
| | - Mohammed Salehe
- Department of Pediatrics and Child Health, Bombo Regional Referral Hospital, Tanga, Tanzania
| | - Adolfine Hokororo
- Department of Paediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Ernestina Mwipopo
- Department of Pediatrics and Child Health, Mwananyamala Regional Referral Hospital, Dar es Salaam, Tanzania
| | - Asha C Khamis
- Department of Pediatrics and Child Health, Temeke Regional Referral Hospital, Dar es Salaam, Tanzania
| | - Honest Nyaki
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma, Tanzania
| | - Richard Magodi
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma, Tanzania
| | - Delphius Mujuni
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma, Tanzania
| | - Eveline T Konje
- Department of Epidemiology and Biostatistics, School of Public Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Betina Katembo
- National Public Health Laboratory, Dar es Salaam, Tanzania
| | - Ritha Wilillo
- World Health Organization, Country Office, Dar es Salaam, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Damiano P, Silago V, Nyawale HA, Mushi MF, Mirambo MM, Kimaro EE, Mshana SE. Efficacy of disinfectants on control and clinical bacteria strains at a zonal referral hospital in Mwanza, Tanzania: a cross sectional hospital-based study. Sci Rep 2023; 13:17998. [PMID: 37865710 PMCID: PMC10590406 DOI: 10.1038/s41598-023-45228-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/17/2023] [Indexed: 10/23/2023] Open
Abstract
Contaminated-hospital surfaces are an important source of pathogenic bacteria causing health-care associated infection (HCAIs). Monitoring the performance of disinfectants that are routinely used to clean hospital surfaces is critical for prevention and control of HCAIs. Nevertheless, the evaluation of the performance of disinfectants and their efficacy are not routinely practiced in most resource-limited countries. This study was designed to determine the efficacy of sodium dichloroisocyanurate (NaDCC) and chloroxylenol against American Type Culture Collection (ATCC) and their respective multidrug resistant (MDR) strains causing neonatal sepsis at a zonal referral hospital in Mwanza, Tanzania. Four ATCC (n = 4) and their respective MDR strains of Klebsiella pneumoniae, Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa were used. The suspension test was used with contact time of 1, 5 and 10 min with starting concentration of 105 bacterial colony forming unit per milliliters (CFU/mL). The log10 reduction value at specified bacteria-disinfectant contact time was used to assess the efficacy of 0.5%NaDCC and 4.8% chloroxylenol in-use and freshly prepared solutions. In-use 0.5%NaDCC demonstrated poor log reduction (˂ 5log) against MDR-clinical isolates. Freshly laboratory prepared 0.5% NaDCC had 100% microbial reduction at 1, 5 and 10 min of both ATCC and MDR strains up to 48 h after preparation when compared with freshly prepared 4.8% chloroxylenol (˂ 5log). Freshly, prepared 0.5% NaDCC should be used in health-care facilities for effective disinfection practices.
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Affiliation(s)
- Prisca Damiano
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania.
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania
| | - Helmut A Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania
| | - Martha F Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania
| | - Emmanuel E Kimaro
- Department of Pharmaceutical Sciences, School of Pharmacy, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P. O. Box 1464, Mwanza, Tanzania
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Nyawale HA, Simchimba M, Mlekwa J, Mujuni F, Chibwe E, Shayo P, Mngumi EB, Majid KS, Majigo M, Mshana SE, Mirambo MM. High Seropositivity of Brucella melitensis Antibodies among Pregnant Women Attending Health Care Facilities in Mwanza, Tanzania: A Cross-Sectional Study. J Pregnancy 2023; 2023:2797441. [PMID: 37663922 PMCID: PMC10474955 DOI: 10.1155/2023/2797441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Background Brucellosis is one of the most prevalent zoonotic neglected tropical diseases across the globe. Brucella melitensis (B. melitensis), the most pathogenic species is responsible for several pregnancy adverse outcomes in both humans and animals. Here, we present the data on the magnitude of B. melitensis antibodies among pregnant women in Mwanza, Tanzania, the information that might be useful in understanding the epidemiology of the disease and devising appropriate control interventions in this region. Methodology. A hospital-based cross-sectional study involving pregnant women was conducted at two antenatal clinics in Mwanza between May and July 2019. The pretested structured questionnaire was used for data collection. Blood samples were collected aseptically from all consenting women followed by the detection of B. melitensis antibodies using slide agglutination test. Descriptive data analysis was done using STATA version 17. Results A total of 635 pregnant women were enrolled with the median age of 25 (interquartile range (IQR): 16-48) years and median gestation age of 21 (IQR: 3-39) weeks. Seropositivity of B. melitensis antibodies was 103 (16.2 (95% CI:13.3-19.1)). On the multivariate logistic regression analysis, as the gestation age increases, the odds of being seropositive decreases (aOR:0.972 (95% CI: 0.945-0.999), P = 0.045). Furthermore, being a housewife (aOR:3.902 (95% CI:1.589-9.577), P = 0.003), being employed (aOR:3.405 (95% CI:1.412-8.208), P = 0.006), and having history of miscarriage (aOR:1.940 (95% CI:1.043-3.606), P = 0.036) independently predicted B. melitensis seropositivity among pregnant women in Mwanza. Conclusion High seropositivity of B. melitensis was observed among employed and housewife pregnant women in Mwanza. This calls for the need of more studies in endemic areas that might lead to evidence-based control interventions.
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Affiliation(s)
- Helmut A. Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Michael Simchimba
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Joseph Mlekwa
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Fridolin Mujuni
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Elieza Chibwe
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Prosper Shayo
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Elifuraha B. Mngumi
- Department of Veterinary Pathology, Sokoine University of Agriculture, P.O. Box 3018, Morogoro, Tanzania
| | - Khadija S. Majid
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro P.O. Box 3021, Tanzania
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
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Mcdonald U, Nyawale H, Kajura A, Mujuni F, Chibwe E, Silago V, Msemwa B, Minja CA, Daffa Z, Karim M, Byasharila EC, Chongo AE, Mshana SE, Mirambo MM. High Seropositivity of Markers of Viral Infections among Women with Unfavorable Pregnancy Outcomes in Mwanza, Tanzania: The Urgent Need for Control Interventions. East Afr Health Res J 2023; 7:25-31. [PMID: 37529500 PMCID: PMC10388644 DOI: 10.24248/eahrj.v7i1.705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/12/2023] [Indexed: 08/03/2023] Open
Abstract
Background Viral infections such as Human cytomegalovirus (HCMV), Rubella virus (RV) and Herpes simplex virus-2(HSV-2) are implicated in causing adverse pregnancy outcomes with limited data from Africa. Here we report the magnitude of these viruses among women with unfavorable pregnancy outcomes (WUP) in Mwanza, Tanzania. Methods A cross sectional study involving 198 WUP was conducted between March and June 2019 in Mwanza. Enzyme linked immunosorbent assay was used to detect HCMV and RV IgM and IgG antibodies while immunochromatographic test was used to detect HSV-2 IgM and IgG antibodies. Data were analyzed by using STATA version13.0. Results The median age of enrolled women was 28(IQR, 24-34) years. Of these 194(98%) were HCMV IgG seropositive while only 2(2.1%) were IgM seropositive. Out of 180 women tested for RV, 175(96.7%) were IgG seropositive while only 1(1.2%) was RV IgM seropositive. Regarding HSV2; out of the 146 women tested, 21(14.4%) were seropositive for HSV2 IgG, and only 3(2.1%) were HSV-2 IgM seropositive. Having primary education (p=.046) and being married (p=.035) were significantly associated with HSV-2 IgG seropositivity. Conclusion A substantial proportion of WUP have markers of viral infections for potential pathogens that might be associated with unfavorable pregnancy outcomes necessitating further studies to establish causal effect relationship.
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Affiliation(s)
- Ulimbakisye Mcdonald
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, Mwanza, Tanzania
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Alphaxard Kajura
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, Mwanza, Tanzania
| | - Fridolin Mujuni
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Elieza Chibwe
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, Mwanza, Tanzania
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Betrand Msemwa
- Institute of Allied Health Sciences, Catholic University of Health and Allied sciences, Mwanza, Tanzania
| | - Caroline A Minja
- Department of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, Mwanza, Tanzania
| | - Zawadi Daffa
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mahmud Karim
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Evidence C. Byasharila
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Alda Ester Chongo
- Department of Biological Sciences, Eduardo Mondlane University, Maputo, Mozambique
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Msemwa B, Mushi MF, Kidenya B, Okamo B, Keenan K, Sabiiti W, Miyaye DN, Konje ET, Silago V, Mirambo MM, Mwanga JR, Gillespie S, Maldonado-Barragan A, Sandeman A, Holden M, Mshana SE. Urogenital pathogens in urine samples of clinically diagnosed urinary tract infected patients in Tanzania: A laboratory based cross-sectional study. IJID Reg 2023; 7:170-175. [PMID: 37069922 PMCID: PMC10105482 DOI: 10.1016/j.ijregi.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/19/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022]
Abstract
Background Urogenital pathogens such as Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Trichomonas vaginalis have been reported to cause pyuria, however they are not routinely cultured from urine samples of patients clinically diagnosed to have urinary tract infections (UTI). In this study, pathogen specific PCR was done to identify the urogenital pathogens in the urine samples among clinically diagnosed UTI patients with negative routine urine culture. Methods A cross-sectional study was conducted involving 227 archived urine samples from clinically diagnosed UTI patients with positive leucocyte esterase but negative urine culture results. The urogenital pathogens were detected using pathogen specific singleplex PCR. Data were cleaned and analyzed using STATA version 15. Results The median age of patients was 31[IQR 23 - 51] years and the majority (174, 76.7%) were females. Two thirds of patients had history of antibiotic use two weeks prior to recruitment (154, 67.8%). A total of 62(27.3%) urine samples were positive for at least one urogenital pathogen. Of 62 positive samples, 9 had two urogenital pathogens and 1 had three urogenital pathogens. The most predominant urogenital pathogen detected was Neisseria gonorrhoeae 25(34.2%) and Trichomonas vaginalis 24(32.9%). Being female (aOR 2.4; 95% CI: 1.04 - 5.49; p-value 0.039) and having history of using antibiotics in the past two weeks (aOR 1.9; 95%CI: 1.04 - 3.60; p-value 0.036) was independently associated with the presence of urogenital pathogens. Conclusion More than a quarter of female patients with clinical symptoms of UTI and routine urine culture negative results were infected with urogenital pathogens mainly Neisseria gonorrhoeae and Trichomonas vaginalis. Further research with a larger sample set in a range of settings is required to understand the implications of these finding generally.
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Affiliation(s)
- Betrand Msemwa
- Department of Medical Laboratory Sciences, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Martha F Mushi
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Benson Kidenya
- Department of Biochemistry and Molecular biology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Bernard Okamo
- Department of Biochemistry and Molecular biology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Katherine Keenan
- Geography and Sustainable Development, University of St Andrews, St Andrews, UK
| | - Wilber Sabiiti
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Donald N Miyaye
- National Institute for Medical Research, Mwanza Centre, P. O. Box 1462 Mwanza
| | - Eveline T Konje
- Department of Epidemiology and Biostatistics, and Behavioral Sciences, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Vitus Silago
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | - Joseph R Mwanga
- School of Public Health, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
| | | | | | - Alison Sandeman
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Mathew Holden
- School of Medicine, University of St Andrews, St Andrews, UK
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, P. O. Box 1464 Mwanza
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Blumenröder S, Wilson D, Ndaboine E, Mirambo MM, Mushi MF, Bader O, Zimmermann O, Mshana SE, Groß U. Neonatal infection in Sub-Saharan Africa: a cross-sectional pilot study on bacterial pathogens and maternal risk factors. Front Microbiol 2023; 14:1171651. [PMID: 37180246 PMCID: PMC10167281 DOI: 10.3389/fmicb.2023.1171651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 04/03/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction Although child morbidity and mortality could be reduced in Sub-Saharan Africa during the last years both remain high. Since neonatal infections play a major role, we conducted a cross-sectional pilot study in the lake region of Western Tanzania in order to analyze not only the prevalence of neonatal infection with its bacterial etiology including antimicrobial resistance pattern but also to detect potential maternal risk factors. Methods We screened 156 women for potential risk factors and examined their neonates for clinical signs of an infection including microbiological verification. All women were interviewed for medical history and their socio-economic background. High-vaginal swabs (HVS) of pregnant women and blood cultures of sick infants were investigated for bacterial pathogens using culture followed by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) or polymerase-chain-reaction (PCR)-based assays. Antimicrobial resistances were determined using a disk diffusion test and verified by VITEK 2. Maternal malaria, blood glucose, and hemoglobin levels were determined by rapid tests and helminth infections by stool microscopy. Results and discussion Our results showed a prevalence of 22% for neonatal infections. In total, 57% of them had culture-positive bloodstream infections with Gram-negative bacteria being the most prevalent. All these expressed resistance against ampicillin. The prevalence of maternal infection with helminths or Plasmodium was low, indicating that anti-worming strategies and intermittent preventive treatment of malaria for pregnant women (IPTp) are effective. The study identified maternal urinary tract infection (UTI) and an elevated blood glucose level as potential maternal risk factors for early neonatal infection, an elevated blood glucose level, and maternal anemia for a late-onset infection. Conclusion Our study, therefore, indicates that monitoring maternal UTI in the last trimester as well as levels of maternal hemoglobin and blood glucose might be important to predict and eventually manage neonatal infections. As Gram-negative bacteria with resistance to ampicillin were most prevalent in culture-proven neonatal sepsis, WHO recommendations for calculated antibiosis in the sick young infant should be discussed.
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Affiliation(s)
- Simone Blumenröder
- Institute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, Germany
| | - Damas Wilson
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Edgard Ndaboine
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Martha F. Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Oliver Bader
- Institute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, Germany
| | - Ortrud Zimmermann
- Institute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, Germany
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Uwe Groß
- Institute of Medical Microbiology and Virology, University Medical Centre Göttingen, Göttingen, Germany
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Shangali A, Kamori D, Massawe W, Masoud S, Kibwana U, Mwingwa AG, Manisha A, Mwandigha AM, Mirambo MM, Mshana SE, Manyahi J, Majigo M. Aetiology of ear infection and antimicrobial susceptibility pattern among patients attending otorhinolaryngology clinic at a tertiary hospital in Dar es Salaam, Tanzania: a hospital-based cross-sectional study. BMJ Open 2023; 13:e068359. [PMID: 37012005 PMCID: PMC10083798 DOI: 10.1136/bmjopen-2022-068359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
OBJECTIVES To determine the aetiological pathogens causing ear infections and their antimicrobial susceptibility patterns among patients with ear complaints at a tertiary hospital in Dar es Salaam. DESIGN Hospital-based cross-sectional study. SETTINGS Otorhinolaryngology clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania. PARTICIPANTS Patients presenting with signs and symptoms of ear infection. MAIN OUTCOME MEASURE Bacteria and fungi isolated from ear swab specimens of patients presenting with signs and symptoms of ear infection; and antimicrobial susceptibility patterns of isolated bacteria. RESULTS Two hundred and fifty-five participants were enrolled, with a median age of 31 years and an IQR of 15-49. Otitis externa was the predominant type of ear infection, accounting for 45.1%. We observed positive bacteria culture in 53.3% of study participants, in which 41% of isolates were obtained from patients with chronic suppurative otitis media. Moreover, Staphylococcus aureus (27.3%) and Pseudomonas aeruginosa (24.2%) were the most frequently isolated bacteria, while Candida spp, 12 (63.8%) and Aspergillus spp, 9 (36.2%) were the only isolated fungi. Furthermore, we report that 93% of isolated Enterobacterales were resistant to amoxicillin/clavulanic acid, and 73% were resistant to ceftazidime. In addition, we detected 34.4% extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-PE) and 44.4% methicillin-resistance S. aureus (MRSA). We also found that 22% of the bacteria isolates were resistant to ciprofloxacin, a primary topical antibiotic used in managing ear infections. CONCLUSIONS The findings from this study reveal that the leading aetiological agent of ear infection is bacteria. Furthermore, our findings show a significant proportion of ESBL-PE and MRSA-causing ear infections. Hence, detecting multidrug-resistant bacteria is crucial to improving ear infection management.
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Affiliation(s)
- Aminiel Shangali
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
- Department of Microbiology and Immunology, Mwanza University, Mwanza, Tanzania, United Republic of
| | - Doreen Kamori
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Willybroad Massawe
- Department of Otorhinolaryngology, Muhimbili National Hospital, Dar es Salaam, Tanzania, United Republic of
| | - Salim Masoud
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Upendo Kibwana
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Anthony G Mwingwa
- Department of Microbiology and Immunology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of
| | - Anselmo Manisha
- Department of Microbiology and Immunology, Mwanza University, Mwanza, Tanzania, United Republic of
| | - Ambele M Mwandigha
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania, United Republic of
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania, United Republic of
| | - Joel Manyahi
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
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Nyawale HA, Moremi N, Mohamed M, Njwalila J, Silago V, Krone M, Konje ET, Mirambo MM, Mshana SE. High Seroprevalence of SARS-CoV-2 in Mwanza, Northwestern Tanzania: A Population-Based Survey. Int J Environ Res Public Health 2022; 19:11664. [PMID: 36141938 PMCID: PMC9517516 DOI: 10.3390/ijerph191811664] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 09/03/2022] [Accepted: 09/07/2022] [Indexed: 06/16/2023]
Abstract
The transmission of the SARS-CoV-2 virus, which causes COVID-19, has been documented worldwide. However, the evidence of the extent to which transmission has occurred in different countries is still to be established. Understanding the magnitude and distribution of SARS-CoV-2 through seroprevalence studies is important in designing control and preventive strategies in communities. This study investigated the seropositivity of the SARS-CoV-2 virus antibodies in the communities of three different districts in the Mwanza region, Tanzania. A household cross-sectional survey was conducted in September 2021 using the modified African Centre for Disease and Prevention (ACDC) survey protocol. A blood sample was obtained from one member of each of the selected households who consented to take part in the survey. Immunochromatographic rapid test kits were used to detect IgM and IgG SARS-CoV-2 antibodies, followed by descriptive data analysis. Overall, 805 participants were enrolled in the study with a median age of 35 (interquartile range (IQR):27-47) years. The overall SARS-CoV-2 seropositivity was 50.4% (95%CI: 46.9-53.8%). The IgG and IgM seropositivity of the SARS-CoV-2 antibodies was 49.3% and 7.2%, respectively, with 6.1% being both IgG and IgM seropositive. A history of runny nose (aOR: 1.84, 95%CI: 1.03-3.5, p = 0.036), loss of taste (aOR: 1.84, 95%CI: 1.12-4.48, p = 0.023), and living in Ukerewe (aOR: 3.55, 95%CI: 1.68-7.47, p = 0.001) and Magu (aOR: 2.89, 95%CI: 1.34-6.25, p= 0.007) were all independently associated with SARS-CoV-2 IgM seropositivity. Out of the studied factors, living in the Ukerewe district was independently associated with IgG seropositivity (aOR 1.29, CI 1.08-1.54, p = 0.004). Twenty months after the first case of COVID-19 in Tanzania, about half of the studied population in Mwanza was seropositive for SARS-CoV-2.
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Affiliation(s)
- Helmut A Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
| | - Nyambura Moremi
- National Public Health Laboratory, Dar es Salaam P.O. Box 9083, Tanzania
| | - Mohamed Mohamed
- East Central and Southern Africa Health Community, Arusha P.O. Box 1009, Tanzania
| | - Johnson Njwalila
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
| | - Manuel Krone
- Infection Control and Antimicrobial Sterwardship Unit, University Hospital Wuerzburg, 97080 Wüerzburg, Germany
| | - Eveline T Konje
- Department of Epidemiology and Biostatistics, School of Public Health, Catholoic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania
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Malisa RA, Ndaboine E, Chibwe E, Mujuni F, Nyawale H, Mtebe M, Mshana SE, Mirambo MM. Treponema pallidum infection among women with macerated stillbirth in Mwanza Tanzania: an underestimated tragedy in Tanzania. Afr Health Sci 2022; 22:72-80. [PMID: 36910345 PMCID: PMC9993301 DOI: 10.4314/ahs.v22i3.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Treponema pallidum is one of the commonest cause of stillbirths world-wide. This study investigated the magnitude of T. pallidum among women with macerated stillbirth in Mwanza, Tanzania. Methods A cross-sectional study involving 301 women with macerated stillbirths attending selected health facilities in the region of Mwanza was conducted between October-2017 and March-2018. Detection of T. pallidum was done using venereal diseases research laboratory (VDRL) and T. pallidum hemagglutination test (TPHA). Data were analyzed by the STATA version 13. Results The median age of the enrolled women was 27 (IQR: 22 - 34) years. Eighteen (6.0%, 95% CI: 3.0-8.0) of women were T. pallidum seropositive. Seropositivity of T. pallidum was significantly higher among women residing in rural areas than urban areas (p=0.010), and among HIV seropositive than HIV seronegative women (p=0.036). By multivariable regression analysis, the odds of being T. pallidum seropositive were significantly high among women with positive HIV serostatus (OR: 3.9, 95% CI: 1.2-14.1, p=0.036) and those residing in rural areas (OR: 5.6, 95% CI: 1.5-20.3, p=0.010). Conclusion Seropositivity of T. pallidum is higher among women with macerated stillbirth than in normal pregnant women as previously reported which calls for the need to improve screening services in rural areas of Tanzania.
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Affiliation(s)
- Rose A Malisa
- Shinyanga Referral Regional hospital, P.O.Box 17, Shinyanga, Tanzania
| | - Edgard Ndaboine
- Department of obstetrics and gynecology, Catholic university of health and Allied Sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Elieza Chibwe
- Department of obstetrics and gynecology, Catholic university of health and Allied Sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Fridolin Mujuni
- Department of obstetrics and gynecology, Catholic university of health and Allied Sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Catholic university of health and Allied Sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Majigo Mtebe
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O.Box 65001, Dar es Salaam, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Catholic university of health and Allied Sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Catholic university of health and Allied Sciences, P.O.Box 1464, Mwanza, Tanzania
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Konje ET, Basinda N, Kapesa A, Mugassa S, Nyawale HA, Mirambo MM, Moremi N, Morona D, Mshana SE. The Coverage and Acceptance Spectrum of COVID-19 Vaccines among Healthcare Professionals in Western Tanzania: What Can We Learn from This Pandemic? Vaccines (Basel) 2022; 10:vaccines10091429. [PMID: 36146507 PMCID: PMC9503367 DOI: 10.3390/vaccines10091429] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 11/16/2022] Open
Abstract
The vaccination rate against COVID-19 remains low in developing countries due to vaccine hesitancy. Vaccine hesitancy is a public health threat in curbing COVID-19 pandemic globally. Healthcare professionals have been found to play a critical role in vaccine advocacy and promotion campaigns in the general population. A cross sectional study was conducted in the initial months of the COVID-19 vaccination roll out program in Tanzania to determine the acceptance rate, perceived barriers, and cues for actions. A total of 811 healthcare professionals participated from 26 health facilities in western Tanzania. The World Health Organization (WHO) vaccine acceptance questionnaire was adopted with minor modifications to capture the local contexts and used in data collection. Only (18.5%) healthcare professionals had received a COVID-19 vaccine and acceptance rate was 29%. The majority (62%) of participants were in the hesitancy stage due to issues related to lack of effective communication and reliable information regarding efficacy and safety. In this era of COVID-19 pandemic, there is a need to engage and involve public health figures and opinion leaders through transparent dialogue to clarify vaccine-related safety, quality, and efficacy. These strategies will reduce misconception, mistrust, and improve uptake among healthcare professionals and eventually in the general population.
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Affiliation(s)
- Eveline T. Konje
- Department of Biostatistics and Epidemiology, School of Public Health, Catholic University of Health and Allied Sciences–BUGANDO, Mwanza P.O. Box 1464, Tanzania
- Correspondence: or
| | - Namanya Basinda
- Department of Community Medicine, School of Public Health, Catholic University of Health and Allied Sciences–BUGANDO, Mwanza P.O. Box 1464, Tanzania
| | - Anthony Kapesa
- Department of Community Medicine, School of Public Health, Catholic University of Health and Allied Sciences–BUGANDO, Mwanza P.O. Box 1464, Tanzania
| | - Stella Mugassa
- Department of Biostatistics and Epidemiology, School of Public Health, Catholic University of Health and Allied Sciences–BUGANDO, Mwanza P.O. Box 1464, Tanzania
| | - Helmut A. Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences–BUGANDO, Mwanza P.O. Box 1464, Tanzania
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences–BUGANDO, Mwanza P.O. Box 1464, Tanzania
| | - Nyambura Moremi
- National Public Health Laboratory, Dar es Salaam P.O. Box 9083, Tanzania
| | - Domenica Morona
- Department of Parasitology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences–BUGANDO, Mwanza P.O. Box 1464, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences–BUGANDO, Mwanza P.O. Box 1464, Tanzania
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Mirambo MM, Silago V, Msemwa B, Nyawale H, Mgomi MG, Madeu JM, Nasson WS, Emmanuel G, Moses J, Basinda N, Mhamphi G, Mwakabumbe SS, Mngumi EB, Majid KS, Matemba L, Mgode G, Mshana SE. Seropositivity of Leptospira spp. Antibodies among Febrile Patients Attending Outpatient Clinics in Mwanza, Tanzania: Should It Be Included in Routine Diagnosis? Trop Med Infect Dis 2022; 7:tropicalmed7080173. [PMID: 36006265 PMCID: PMC9416181 DOI: 10.3390/tropicalmed7080173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 11/16/2022] Open
Abstract
Leptospirosis is a zoonotic neglected tropical disease with a worldwide distribution caused by the pathogenic spirochetes of the genus Leptospira. Despite being a widespread disease in tropical regions, it has never been considered in the routine diagnostic panel for febrile patients. This study determined seropositivity and factors associated with Leptospira antibodies among febrile adult patients in Mwanza, Tanzania. The cross-sectional study involving 296 febrile patients attending different outpatient clinics in Mwanza region was conducted between May and July 2019. Detection of Leptospira serovars antibodies was done using a microscopic agglutination test (MAT). Descriptive analysis was done using STATA version 13. The median age of the febrile patients was 32 (IQR: 24–45 years). Out of 296 patients, 36 (12.16%, 95%CI: 8–15) were seropositive for Leptospira antibodies. Common circulating serovars were Sokoine 28 (9.45%), followed by Lora 12 (4.05%) and Grippotyphosa 2 (0.67%). In the multivariable logistic regression analysis, the odds of being Leptospira seropositive were significantly higher with increased age (aOR: 1.03, 95%CI 1.00–1.07, p = 0.03). About one tenth of febrile patients in Mwanza were seropositive for Leptospira antibodies and this was significantly associated with age. With the decline of malaria fever in endemic areas, other causes of febrile illness like Leptospiral spp. should be considered in the routine diagnostic panel for febrile patients.
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Affiliation(s)
- Mariam M. Mirambo
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania
- Correspondence: ; Fax: +255-282502678
| | - Vitus Silago
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania
| | - Betrand Msemwa
- Department of Medical Laboratory Sciences, Institute of Allied Health Sciences, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania
| | - Mlekwa G. Mgomi
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania
| | - Julius M. Madeu
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania
| | - William S. Nasson
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania
| | - Gabriel Emmanuel
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania
| | - John Moses
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania
| | - Namanya Basinda
- Department of Community Medicine, School of Public Health, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania
| | - Ginethon Mhamphi
- SUA Pest Management Centre (SPMC), Sokoine University of Agriculture, Morogoro P.O. Box 3110, Tanzania
| | - Subira S. Mwakabumbe
- Veterinary Investigation Centre (VIC), Lake Zone, Ministry of Livestock and Fisheries, Mwanza P.O. Box 129, Tanzania
| | - Elifuraha B. Mngumi
- Department of Veterinary Anatomy and Pathology, School of Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3016, Tanzania
| | - Khadija S. Majid
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro P.O. Box 3021, Tanzania
| | - Lucas Matemba
- National Institute for Medical Research, Dodoma Research Centre, Benjamin Mkapa Hospital, Dodoma P.O. Box 805, Tanzania
| | - Georgies Mgode
- SUA Pest Management Centre (SPMC), Sokoine University of Agriculture, Morogoro P.O. Box 3110, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania
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Michael F, Mirambo MM, Lyimo D, Kyesi F, Msanga DR, Joachim G, Nyaki H, Magodi R, Mujuni D, Tinuga F, Bulula N, Nestory B, Mongi D, Makuwani A, Katembo B, Mwengee W, Mphuru A, Mohamed N, Kayabu D, Nyawale H, Konje ET, Mshana SE. Reduction in Rubella Virus Active Cases among Children and Adolescents after Rubella Vaccine Implementation in Tanzania: A Call for Sustained High Vaccination Coverage. Vaccines (Basel) 2022; 10:vaccines10081188. [PMID: 35893837 PMCID: PMC9332844 DOI: 10.3390/vaccines10081188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/15/2022] [Accepted: 07/22/2022] [Indexed: 02/04/2023] Open
Abstract
Rubella virus (RV) infection in susceptible women during the first trimester of pregnancy is associated with congenital Rubella syndrome (CRS). In countries where a vaccination program is implemented, active case surveillance is emphasized. This report documents the magnitude of active cases before and after vaccine implementation in Tanzania. A total of 8750 children and adolescents with signs and symptoms of RV infection were tested for Rubella IgM antibodies between 2013 and 2019 using enzyme immunoassay followed by descriptive analysis. The median age of participants was 3.8 (IQR: 2−6.4) years. About half (4867; 55.6%) of the participants were aged 1−5 years. The prevalence of RV active cases was 534 (32.6%, 95% CI: 30.2−34.9) and 219 (3.2%, 95% CI: 2.7−3.6) before and after vaccine implementation, respectively. Before vaccination, the highest prevalence was recorded in Pemba (78.6%) and the lowest was reported in Geita (15.6%), whereas, after vaccination, the prevalence ranged between 0.5% in Iringa and 6.5% in Pemba. Overall, >50% of the regions had a >90% reduction in active cases. The significant reduction in active cases after vaccine implementation in Tanzania underscores the need to sustain high vaccination coverage to prevent active infections and eventually eliminate CRS, which is the main goal of Rubella vaccine implementation.
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Affiliation(s)
- Fausta Michael
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (S.E.M.)
- Correspondence:
| | - Dafrossa Lyimo
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Furaha Kyesi
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Delfina R. Msanga
- Department of Pediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Georgina Joachim
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Honest Nyaki
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Richard Magodi
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Delphius Mujuni
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Florian Tinuga
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Ngwegwe Bulula
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Bonaventura Nestory
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Dhamira Mongi
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Ahmed Makuwani
- Ministry of Health, Immunization and Vaccine Development Program, Dodoma P.O. Box 743, Tanzania; (F.M.); (D.L.); (F.K.); (G.J.); (H.N.); (R.M.); (D.M.); (F.T.); (N.B.); (B.N.); (D.M.); (A.M.)
| | - Betina Katembo
- National Public Health Laboratory, Dar es Salaam P.O. Box 9083, Tanzania;
| | - William Mwengee
- World Health Organization, Country Office, Dar es Salaam P.O. Box 9292, Tanzania;
| | - Alex Mphuru
- United Nations Children’s Fund (UNICEF), Country Office, Dar es Salaam P.O. Box 4076, Tanzania;
| | - Nassor Mohamed
- Immunization Center, John Snow Inc. (JSI), 2733 Crystal Dr 4th Floor, Arlington, VA 22202, USA;
| | - David Kayabu
- Management and Development for Health (MDH), Dar es Salaam P.O Box 79810, Tanzania;
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (S.E.M.)
| | - Eveline T. Konje
- Department of Epidemiology and Biostatistics, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (S.E.M.)
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Masatu ES, Kajura A, Mujuni F, Chibwe E, Nyawale HA, Rambau P, Majigo M, Mshana SE, Mirambo MM. High prevalence of sexually transmitted infections among asymptomatic women opting for the intrauterine contraceptive device use in Mwanza, Tanzania: An urgent call for control interventions. SAGE Open Med 2022; 10:20503121221097536. [PMID: 35600700 PMCID: PMC9118402 DOI: 10.1177/20503121221097536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/12/2022] [Indexed: 11/15/2022] Open
Abstract
Objective: Placement of intrauterine contraceptive device (IUCD) in asymptomatic woman infected with sexually transmitted infection (STIs) can lead to pelvic inflammatory diseases (PID) and infertility if not well treated. The current study investigated the magnitude of sexually transmitted infections among women opting for IUCD use in the city of Mwanza, Tanzania. Methods: A cross-sectional study involving 150 asymptomatic women was conducted from August to December 2017. Detection of Chlamydia trachomatis antigen from endocervical swabs was done using immunochromatographic rapid tests while sera were used for detection of Treponema pallidum, human immunodeficiency virus (HIV) and herpes simplex virus Type 2 (HSV-2) antibodies. Results: The overall prevalence of STIs was 45/150 (30%, 95% CI: 22–37) while that of individual STIs were 27.3%, 5.3%, and 2.6% for C trachomatis, T pallidum, and HSV-2, respectively. History of dysuria (aOR 6.6; 95% CI 2.3–18.8; p < 0.001) and history of STIs (aOR 4.6; 95%CI 1.0–20.8; p = 0.049) independently predicted presence of STIs. Conclusions: Prevalence of STIs among women opted for IUCD use in the city of Mwanza, Tanzania is alarmingly high and is predicted by past history of dysuria and history of partner’s STIs, calling for the need of screening of the STIs among high-risk women in low- and middle-income countries (LMICs) opting for IUCD use.
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Affiliation(s)
- Emmanuel S Masatu
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, Mwanza, Tanzania
| | - Alphaxard Kajura
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, Mwanza, Tanzania
| | - Fridolin Mujuni
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, Mwanza, Tanzania
| | - Elieza Chibwe
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, Mwanza, Tanzania
| | - Helmut A Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Peter Rambau
- Department of Pathology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Buchera FS, Silago V, Japhet G, Mtemisika CI, Damiano P, Nyawale HA, Mushi MF, Mirambo MM, Seni J, Mshana SE. Predominance of Other Pathogenic Bacteria among Presumptive Tuberculosis Cases Attending Tuberculosis Clinics in Mwanza, Tanzania: A Cross-Sectional Laboratory-Based Study. Microorganisms 2022; 10:microorganisms10040703. [PMID: 35456756 PMCID: PMC9025500 DOI: 10.3390/microorganisms10040703] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 02/10/2022] [Accepted: 02/12/2022] [Indexed: 12/04/2022] Open
Abstract
This study was designed to determine the prevalence and co-infection of Mycobacterium tuberculosis and other pathogenic bacteria among presumptive cases of tuberculosis (TB) at selected hospitals in Mwanza, Tanzania. GeneXpert and conventional bacteriological culture and sensitivity were used for the detection of TB and other pathogenic bacteria, respectively. STATA version 13.0 was used for data analysis. The median (IQR) age of participants was 33 (19−51) years with males forming more than half (i.e., 59% (158/264)) of the participants. Microscopically, 29.5% (78/264) of the patients had polymorphonuclear leucocytes in the sputum samples. Approximately 7.2% (19/264), 16.3% (43/264), and 1.1% (3/264) of participants had TB, other pathogenic bacteria, and co-infections, respectively. One sample had growth of two other bacteria, resulting in a total of 44 isolated bacteria with the predominance of Gram-negative bacteria at 75.0% (33/44). The predominant species isolated was the Klebsiella pneumoniae complex at 52.3% (23/44). Overall, 27.3% (9/33) of GNB were resistant to third-generation cephalosporins, while Gram-positive bacteria were more resistant to erythromycin at 63.6% (7/11). Good quality sputa had a significantly higher yield of pathogenic bacteria than poor quality sputa (37.2% vs. 7.5%, p < 0.001). Presumptive TB cases were predominantly infected with other pathogenic bacteria than M. tuberculosis. Therefore, other pathogenic bacteria should be considered when attending presumptive TB cases to ensure favorable treatment outcomes.
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Affiliation(s)
- Florencia S. Buchera
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (F.S.B.); (P.D.); (H.A.N.); (M.F.M.); (M.M.M.); (J.S.); (S.E.M.)
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (F.S.B.); (P.D.); (H.A.N.); (M.F.M.); (M.M.M.); (J.S.); (S.E.M.)
- Correspondence:
| | - Geofrey Japhet
- Tuberculosis Section, Central Pathology Laboratory, Bugando Medical Centre, Mwanza 1370, Tanzania;
| | - Conjester I. Mtemisika
- Central Pathology Laboratory, Department of Molecular Biology, Bugando Medical Centre, Mwanza 1370, Tanzania;
| | - Prisca Damiano
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (F.S.B.); (P.D.); (H.A.N.); (M.F.M.); (M.M.M.); (J.S.); (S.E.M.)
| | - Helmut A. Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (F.S.B.); (P.D.); (H.A.N.); (M.F.M.); (M.M.M.); (J.S.); (S.E.M.)
| | - Martha F. Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (F.S.B.); (P.D.); (H.A.N.); (M.F.M.); (M.M.M.); (J.S.); (S.E.M.)
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (F.S.B.); (P.D.); (H.A.N.); (M.F.M.); (M.M.M.); (J.S.); (S.E.M.)
| | - Jeremiah Seni
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (F.S.B.); (P.D.); (H.A.N.); (M.F.M.); (M.M.M.); (J.S.); (S.E.M.)
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (F.S.B.); (P.D.); (H.A.N.); (M.F.M.); (M.M.M.); (J.S.); (S.E.M.)
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Mtemisika CI, Nyawale H, Benju RJ, Genchwere JM, Silago V, Mushi MF, Mwanga J, Konje E, Mirambo MM, Mshana SE. Epidemiological Cut-Off Values and Multidrug Resistance of Escherichia coli Isolated from Domesticated Poultry and Pigs Reared in Mwanza, Tanzania: A Cross-Section Study. Animals (Basel) 2022; 12:835. [PMID: 35405825 PMCID: PMC8996986 DOI: 10.3390/ani12070835] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/12/2022] [Accepted: 03/18/2022] [Indexed: 12/21/2022] Open
Abstract
Increasing antimicrobial resistance (AMR) colonizing domesticated animals is a global concern threatening food safety. This study aimed at determining the prevalence of multidrug resistance (MDR) and epidemiological cut-off values (ECVs) of E. coli isolated from poultry and pigs in Mwanza, Tanzania. This cross-sectional study was conducted between June and August 2021, involving 297 pigs, 191 broilers, and 203 layers. Rectal and cloacal swabs were collected and processed following standard guidelines. ECVs were determined using normalized resistance interpretation (NRI), a computer software, and descriptive analysis was performed using STATA version 13.0. The overall prevalence of MDR E.coli was 63.2%, whereas poultry (87.5% layers and 86.3% broilers) were more colonized than pigs (31.8%) (p < 0.001). Based on ECVs of antibiotics tested, E. coli from broilers, layers, and pigs exhibited different resistance patterns hence different populations. Exotic breed (p < 0.001) and recent antimicrobial use (p < 0.001) significantly predicted colonization with MDR E. coli. Veterinary officers should implement regulations that prohibit the inappropriate use of antimicrobial agents in livestock keeping.
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Affiliation(s)
- Conjester I. Mtemisika
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (V.S.); (M.F.M.); (M.M.M.); (S.E.M.)
- Bugando Medical Centre, Molecular Biology Laboratory, Mwanza P.O. Box 1370, Tanzania
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (V.S.); (M.F.M.); (M.M.M.); (S.E.M.)
| | - Ronald J. Benju
- Tanzania Veterinary Laboratory Agency, Ministry of Livestock and Fisheries, Mwanza P.O. Box 129, Tanzania; (R.J.B.); (J.M.G.)
| | - Joseph M. Genchwere
- Tanzania Veterinary Laboratory Agency, Ministry of Livestock and Fisheries, Mwanza P.O. Box 129, Tanzania; (R.J.B.); (J.M.G.)
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (V.S.); (M.F.M.); (M.M.M.); (S.E.M.)
| | - Martha F. Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (V.S.); (M.F.M.); (M.M.M.); (S.E.M.)
| | - Joseph Mwanga
- Department of Epidemiology, Biostatistics and Behavioral Sciences, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (J.M.); (E.K.)
| | - Eveline Konje
- Department of Epidemiology, Biostatistics and Behavioral Sciences, School of Public Health, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (J.M.); (E.K.)
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (V.S.); (M.F.M.); (M.M.M.); (S.E.M.)
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (H.N.); (V.S.); (M.F.M.); (M.M.M.); (S.E.M.)
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Msanga DR, Silago V, Massoza T, Kidenya BR, Balandya E, Mirambo MM, Sunguya B, Mmbaga BT, Lyamuya E, Bartlet J, Mshana SE. High Fecal Carriage of Multidrug Resistant Bacteria in the Community among Children in Northwestern Tanzania. Pathogens 2022; 11:pathogens11030379. [PMID: 35335702 PMCID: PMC8955874 DOI: 10.3390/pathogens11030379] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/24/2022] [Accepted: 03/03/2022] [Indexed: 02/01/2023] Open
Abstract
Colonization of multidrug resistant (MDR) bacteria is associated with subsequent invasive infections in children with comorbidities. This study aimed to determine the resistance profile and factors associated with MDR pathogen colonization among HIV−and HIV+ children below five years of age in Mwanza, Tanzania. A total of 399 (HIV− 255 and HIV+ 144) children were enrolled and investigated for the presence of MDR bacteria. The median [IQR] age of children was 19 (10–36) months. Out of 27 Staphylococcus aureus colonizing the nasal cavity, 16 (59.5%) were methicillin resistant while 132/278 (47.2%) of Enterobacteriaceae from rectal swabs were resistant to third generation cephalosporins, with 69.7% (92/132) exhibiting extended spectrum beta lactamase (ESBL) phenotypes. The proportion of resistance to gentamicin, amoxicillin/clavulanic acid and meropenem were significantly higher among HIV+ than HIV− children. A history of antibiotic use in the last month OR 2.62 [1.1, 6.9] (p = 0.04) and history of a relative admitted from the same household in the past three months OR 3.73 [1.1, 13.2] (p = 0.03) independently predicted ESBL rectal colonization. HIV+ children had significantly more fecal carriage of isolates resistant to uncommonly used antibiotics. There is a need to strengthen antimicrobial stewardship and Infection Prevention and Control (IPC) programs to prevent the emergence and spread of MDR pathogens in children.
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Affiliation(s)
- Delfina R. Msanga
- Department of Pediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
- Correspondence:
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (V.S.); (M.M.M.); (S.E.M.)
| | - Tulla Massoza
- Department of Pediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Benson R. Kidenya
- Department of Biochemistry, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, Mwanza P.O. Box 1464, Tanzania;
| | - Emmanuel Balandya
- Department of Physiology, School of Medicine, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es Salaam P.O. Box 65001, Tanzania;
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (V.S.); (M.M.M.); (S.E.M.)
| | - Bruno Sunguya
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es Salaam P.O. Box 65001, Tanzania;
| | - Blandina Theophil Mmbaga
- Kilimanjaro Clinical Research Institute, Kilimanjaro Christian Medical University College, Moshi P.O. Box 2236, Tanzania;
| | - Eligius Lyamuya
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es Salaam P.O. Box 65001, Tanzania;
| | - John Bartlet
- Duke Global Health Institute, Duke University Medical Center Durham, P.O. Box 3238, Durham, NC 27710, USA;
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza P.O. Box 1464, Tanzania; (V.S.); (M.M.M.); (S.E.M.)
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Mirambo MM, Mshana SE. The Need to Emphasise on Confirmatory Test in the Diagnosis of Syphilis in Low and Middle Income Countries. J Clin Diagn Res 2022. [DOI: 10.7860/jcdr/2022/52108.15819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Awadh N, Nyawale H, Chibwe E, Mujuni F, Ollomi M, Hassan K, Mtebe M, Matemba L, Mshana SE, Mirambo MM. Serological Markers of Viral Infections (Rubella Virus, Human Cytomegalovirus and Arboviruses) among Symptomatic Pregnant Women in Rural and Urban Areas of Mwanza, Tanzania. Trop Med Infect Dis 2021; 6:tropicalmed6040186. [PMID: 34698317 PMCID: PMC8544715 DOI: 10.3390/tropicalmed6040186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022] Open
Abstract
Viral infections have been associated with poor pregnancy outcomes. We investigated the magnitude of rubella virus (RV), dengue virus (DENV), Zika virus (ZIKV) and human cytomegalovirus (HCMV) among symptomatic pregnant women in rural and urban areas of Mwanza. A cross-sectional study was conducted between July 2017 and April 2018 in Mwanza. A rapid immunochromatographic test was done to detect ZIKV IgM and IgG as well as DENV IgM and IgG antibodies. A multiplex_RT-PCR was also done to detect the viral RNA genome. Enzyme immunoassays were done to detect RV and HCMV. Out of 171 participants, 1 (0.6%) was found to be seropositive for ZIKV_IgM antibodies, while 5 (2.9%) were ZIKV_IgG seropositive. DENV seropositivity was 9 (5.3%) and 3 (1.8%) for IgM and IgG, respectively, with all being PCR negative. Two participants (1.2%) were RV_IgM seropositive. 100% were HCMV_IgG seropositive and none was HCMV_IgM seropositive. Among 70 women with high HCMV_IgG titters, 10 (14.3%) had a low avidity index, indicating recent infections. Residing in rural areas (p = 0.044) and advanced age (p = 0.024) independently predicted ZIKV/DENV seropositivity. A substantial proportion of pregnant women had markers for viral infections. There is a need for introducing routine screening and monitoring pregnancy outcomes of positive cases to establish the relationship of these viruses and adverse pregnancy outcomes in endemic areas.
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Affiliation(s)
- Najma Awadh
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (N.A.); (E.C.); (F.M.)
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (H.N.); (M.O.); (K.H.); (S.E.M.)
| | - Elieza Chibwe
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (N.A.); (E.C.); (F.M.)
| | - Fridolin Mujuni
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (N.A.); (E.C.); (F.M.)
| | - Margareth Ollomi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (H.N.); (M.O.); (K.H.); (S.E.M.)
| | - Karim Hassan
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (H.N.); (M.O.); (K.H.); (S.E.M.)
| | - Majigo Mtebe
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Mwanza 65001, Tanzania;
| | - Lucas Matemba
- National Institute for Medical Research Headquarters, Dar es Salaam 9653, Tanzania;
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (H.N.); (M.O.); (K.H.); (S.E.M.)
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza 1464, Tanzania; (H.N.); (M.O.); (K.H.); (S.E.M.)
- Correspondence:
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Msemwa B, Mirambo MM, Silago V, Samson JM, Majid KS, Mhamphi G, Genchwere J, Mwakabumbe SS, Mngumi EB, Mgode G, Mshana SE. Existence of Similar Leptospira Serovars among Dog Keepers and Their Respective Dogs in Mwanza, Tanzania, the Need for a One Health Approach to Control Measures. Pathogens 2021; 10:609. [PMID: 34065745 PMCID: PMC8156512 DOI: 10.3390/pathogens10050609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 02/18/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
This study investigated seroepidemiology of Leptospira serovars among the dog keepers and their dogs in the city of Mwanza, Tanzania. A total of 205 dog keepers and 414 dogs were tested for Leptospira antibodies using a microscopic agglutination test (MAT). The median age of the dog keepers was 26 (inter quartile range (IQR): 17-40) years and median duration of keeping dogs was 36 (IQR: 24-120) months. The seropositivity of Leptospira antibodies was (33/205 (16.1%, 95% CI: 11.0-21.1) among dog keepers and (66/414 (15.9%, 95% CI: 12.4-19.4) among dogs, p = 0.4745. Among the serovars tested (Sokoine, Grippotyphosa, Kenya, Pomona and Hebdomadis), the most prevalent serovar was Sokoine in both dog keepers and their dogs (93.9% (31/33) vs. and 65.1% (43/66), p = 0.009). Thirty-one out of thirty-three seropositive dog keepers (93.9%) had dogs positive for Leptospira antibodies with 28 (84.9%) having similar serovars with their respective seropositive dogs. Having tertiary education (AOR: 0.24, 95% CI: 0.07-0.84, p = 0.026) independently protected individuals from being Leptospira seropositive. More than three quarters of dog keepers had similar serovars as their dogs, necessitating one health approach to control measures in endemic areas.
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Affiliation(s)
- Betrand Msemwa
- Department of Medical Laboratory Sciences, Institute of Allied Health Sciences, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania;
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania; (V.S.); (J.M.S.); (S.E.M.)
| | - Vitus Silago
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania; (V.S.); (J.M.S.); (S.E.M.)
| | - Juma M. Samson
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania; (V.S.); (J.M.S.); (S.E.M.)
| | - Khadija S. Majid
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, Morogoro P.O. Box 3021, Tanzania;
| | - Ginethon Mhamphi
- SUA Pest Management Centre (SPMC), Sokoine University of Agriculture, Morogoro P.O. Box 3110, Tanzania; (G.M.); (G.M.)
| | - Joseph Genchwere
- Tanzania Veterinary Laboratory Agency (TVLA), Lake Zone, Ministry of Livestock and Fisheries, Mwanza P.O. Box 129, Tanzania;
| | - Subira S. Mwakabumbe
- Veterinary Investigation Centre (VIC), Lake Zone, Ministry of Livestock and Fisheries, Mwanza P.O. Box 129, Tanzania;
| | - Elifuraha B. Mngumi
- Department of Veterinary Anatomy and Pathology, School of Biomedical Sciences, Sokoine University of Agriculture, Morogoro P.O. Box 3016, Tanzania;
| | - Georgies Mgode
- SUA Pest Management Centre (SPMC), Sokoine University of Agriculture, Morogoro P.O. Box 3110, Tanzania; (G.M.); (G.M.)
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Bugando, Mwanza P.O. Box 1464, Tanzania; (V.S.); (J.M.S.); (S.E.M.)
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Moremi N, Silago V, Mselewa EG, Chifwaguzi AP, Mirambo MM, Mushi MF, Matemba L, Seni J, Mshana SE. Extended-spectrum β-lactamase bla CTX-M-1 group in gram-negative bacteria colonizing patients admitted at Mazimbu hospital and Morogoro Regional hospital in Morogoro, Tanzania. BMC Res Notes 2021; 14:77. [PMID: 33640022 PMCID: PMC7913416 DOI: 10.1186/s13104-021-05495-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/16/2021] [Indexed: 12/20/2022] Open
Abstract
Objective The objective of this study was to determine the proportion of extended spectrum β-lactamase producing gram-negative bacteria (ESBL-GNB) colonizing patients admitted at Mazimbu hospital and Morogoro Regional hospital, in Morogoro, Tanzania. Rectal colonization with ESBL-GNB increases the risks of developing bacterial infections by extra-intestinal pathogenic ESBL-GNB. Results Of the 285 patients investigated, 123 (43.2%) carried ESBL-GNB in their intestines. Five of the 123 ESBL positive patients were colonized with two different bacteria, making a total of 128 ESBL producing isolates. Escherichia coli (n = 95, 74.2%) formed the majority of ESBL isolates. The proportion of CTX-M-1 group genes among ESBL isolates tested was 94.9% (93/98). History of antibiotic use (OR: 1.83, 95% CI: 1.1–3.2, P = 0.03), being on antibiotic treatment (OR: 2.61, 95% CI: 1.5–4.53, P = 0.001), duration of hospital stay (OR: 1.2, 95% CI: 1.1–1.3, P < 0.001) and history of previous admission (OR: 2.24, 95% CI: 1.2–4.1, P = 0.009) independently predicted ESBL-GNB carriage.
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Affiliation(s)
- Nyambura Moremi
- Quality Assurance & Training Centre, National Health Laboratory, P. O. Box 9083, Dar Es Salaam, Tanzania
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences-Bugando, P. O. Box 1464, Mwanza, Tanzania.
| | - Erick G Mselewa
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences-Bugando, P. O. Box 1464, Mwanza, Tanzania
| | - Ashery P Chifwaguzi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences-Bugando, P. O. Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Quality Assurance & Training Centre, National Health Laboratory, P. O. Box 9083, Dar Es Salaam, Tanzania
| | - Martha F Mushi
- Quality Assurance & Training Centre, National Health Laboratory, P. O. Box 9083, Dar Es Salaam, Tanzania
| | - Lucas Matemba
- National Institute for Medical Research, P. O. Box 805, Dodoma, Tanzania
| | - Jeremiah Seni
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences-Bugando, P. O. Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences-Bugando, P. O. Box 1464, Mwanza, Tanzania
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Kwiyolecha E, Groendahl B, Okamo B, Kayange N, Manyama F, Kidenya BR, Mahamba DC, Msanga DR, Gehring S, Majigo M, Mshana SE, Mirambo MM. Patterns of viral pathogens causing upper respiratory tract infections among symptomatic children in Mwanza, Tanzania. Sci Rep 2020; 10:18490. [PMID: 33116166 PMCID: PMC7595034 DOI: 10.1038/s41598-020-74555-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/05/2020] [Indexed: 11/29/2022] Open
Abstract
Upper-respiratory tract infections (URTI) are the leading causes of childhood morbidities. This study investigated etiologies and patterns of URTI among children in Mwanza, Tanzania. A cross-sectional study involving 339 children was conducted between October-2017 and February-2018. Children with features suggestive of URTI such as nasal congestion, dry cough, painful swallowing and nasal discharge with/without fever were enrolled. Pathogens were detected from nasopharyngeal and ear-swabs by multiplex-PCR and culture respectively. Full blood count and C-reactive protein analysis were also done. The median age was 16 (IQR: 8-34) months. Majority (82.3%) had fever and nasal-congestion (65.5%). Rhinitis (55.9%) was the commonest diagnosis followed by pharyngitis (19.5%). Viruses were isolated in 46% of children, the commonest being Rhinoviruses (23.9%). Nineteen percent of children had more than 2 viruses; Rhinovirus and Enterovirus being the commonest combination. The commonest bacteria isolated from ears were Staphylococcus aureus and Pseudomonas aeruginosa. Children with viral pathogens had significantly right shift of lymphocytes (73%-sensitivity). Majority (257/339) of children were symptoms free on eighth day. Viruses are the commonest cause of URTI with Rhinitis being the common diagnosis. Rapid diagnostic assays for URTI pathogens are urgently needed in low-income countries to reduce unnecessary antibiotic prescriptions which is associated with antibiotic resistance.
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Affiliation(s)
- Elizabeth Kwiyolecha
- Department of Pediatrics & Child Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Britta Groendahl
- Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Bernard Okamo
- Department of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Neema Kayange
- Department of Pediatrics & Child Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Festo Manyama
- Department of Pediatrics & Child Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Benson R Kidenya
- Department of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Dina C Mahamba
- Department of Pediatrics & Child Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Delfina R Msanga
- Department of Pediatrics & Child Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Stephan Gehring
- Department of Pediatrics, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania.
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Ottaru S, Mirambo MM, Kabyemera R, Kidenya BR, Seugendo M, Msanga DR, Ngoya P, Morona D, Mshana SE. Predictors of Toxoplasma gondii IgG Seropositivity and Cranial Ultrasound Patterns among Children with Hydrocephalus. Int J Pediatr 2020; 2020:8326348. [PMID: 32963556 PMCID: PMC7492872 DOI: 10.1155/2020/8326348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/27/2020] [Accepted: 08/28/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Toxoplasma gondii infection during pregnancy is associated with serious neonatal complications, including hydrocephalus. In many high-income countries, T. gondii screening and treatment during the antenatal period are routinely carried out to prevent associated complications, whereas in most low-income countries, there is no routine screening of T. gondii during pregnancy. Despite the parasite being common in Tanzania, there is a paucity of information on the prevalence of T. gondii and cranial ultrasound patterns among children with hydrocephalus. METHODS An analytical cross-sectional hospital-based study involving 125 infants with hydrocephalus attending the Bugando Medical Centre (BMC) was conducted between May 2017 and February 2018. Sociodemographic and other relevant information was collected using a pretested data collection tool. Venous blood samples were collected, and sera were used for the detection of specific T. gondii antibodies by indirect enzyme-linked immunosorbent assay (ELISA) as per manufacturer's instructions. Data were analysed using STATA version 13 software. RESULTS The mean age of enrolled children was 4.8 ± 3.5 months. Out of 125 infants with hydrocephalus, 29 (23.2%, 95% CI: 21-36) were seropositive for T. gondii-specific IgG antibodies. By multiple generalized linear model analysis, being male (aRR = 1.1, 95% CI: 0.9-1.5, p = 0.049), higher birth order (aRR = 1.2, 95% CI: 1.0-1.5, p = 0.023), consumption of fish meat (aRR = 1.6, 95% CI: 1.2-2.3, p = 0.003), and using other methods of cooking meat than boiling (aRR = 1.7, 95% CI: 1.1-2.5, p = 0.015) were independent risk factors for T. gondii IgG seropositivity. Obstructive hydrocephalus was significantly more common among T. gondii-seronegative infants compared to IgG-seropositive infants (31.3% [30/96] vs. 13.8% [4/29]; p = 0.049). CONCLUSIONS A significant proportion of infants with nonobstructive hydrocephalus are T. gondii IgG seropositive, and this is predicted by male gender, increase of birth order, consuming fish, and using other methods of cooking meat than boiling. These facts highlight the importance of continuing health education for pregnant women regarding T. gondii transmission and the need to follow-up their infants so that appropriate counselling and management can be provided.
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Affiliation(s)
- Sofia Ottaru
- Department of Paediatrics & Child Health, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Rogatus Kabyemera
- Department of Paediatrics & Child Health, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Benson R. Kidenya
- Department of Biochemistry and Molecular Biology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Mwanaisha Seugendo
- Department of Paediatrics & Child Health, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Delfina R. Msanga
- Department of Paediatrics & Child Health, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Patrick Ngoya
- Department of Radiology, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Domenica Morona
- Department of Medical Parasitology and Entomology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
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Mirambo MM, Mkumbo E, Selega H, Msemwa B, Mushi MF, Silago V, Seni J, Mshana SE, Kasang C. Hepatitis B virus infections among health professional students in Mwanza city,Tanzania in 2016. ACTA ACUST UNITED AC 2020; 78:76. [PMID: 32832080 PMCID: PMC7436995 DOI: 10.1186/s13690-020-00459-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/12/2020] [Indexed: 11/24/2022]
Abstract
Background The World Health Organisation (WHO) recommends the vaccination against Hepatitis B virus in all infants and children up to the age of 18 years. In addition, adults in high-risk groups should also be vaccinated. This study investigated the prevalence and factors associated with Hepatitis B Virus (HBV) infections among health professional students in the city of Mwanza, Tanzania in order to provide data that can assist in devising prevention and control strategies in this special group. Methods A cross-sectional study involving health professional students of the Catholic University of health and Allied Sciences was conducted between April and July 2016. Hepatitis B surface antigen was detected using rapid antigen test while the anti-hepatitis B surface antibodies(anti-HBs) were quantified using Enzygnost Anti-HBs II assay and anti-HBV core antibodies tested using enzyme immunoassay. Results A total of 1211 health professional students with median age of 22 interquartile range (IQR):21–24 years were enrolled. The slighlty majority (57.5%) of these students were males and 475(39.2%) were in clinical practices. Out of 1211 students, 37 (3.1%) were Hepatitis B surface antigen positive. Of 1174 students tested for anti-HBs, 258 (22%) had titres > 10 IU/L indicating HBV immunity. The median anti-HBs titres was 47.7 IU/L(IQR:16–3-113). A total of 230(89.2%) students among those who were positive for anti-HBs were also positive for HBV core antibodies indicating HBV natural infections. Male sex (adjusted odd ratio(AOR):1.77, p < 0.000), being married (AOR:1.82, p = 0.002) and being in clinical practices (AOR:1.39, p = 0.028) independenlty predicted anti-HBs positivity. Conclusion A significant proportion of health professional students was naturally immune to Hepatitis B virus. There is a need to measure anti-HBs in order to reduce the cost of unnecessary vaccination especially in the countries with high endemicity of HBV.
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Affiliation(s)
- Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Emmanuel Mkumbo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Hadija Selega
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Betrand Msemwa
- Institute of Allied Health Sciences, Catholic University of Health and Allied sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Martha F Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Jeremiah Seni
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Christa Kasang
- Deutsche Lepra- und Tuberkulosehilfe e.V, Raiffeisenstr.3, 97080 Würzburg, Germany
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Makala R, Majigo MV, Bwire GM, Kibwana U, Mirambo MM, Joachim A. Seroprevalence of Brucella infection and associated factors among pregnant women receiving antenatal care around human, wildlife and livestock interface in Ngorongoro ecosystem, Northern Tanzania. A cross-sectional study. BMC Infect Dis 2020; 20:152. [PMID: 32070308 PMCID: PMC7029502 DOI: 10.1186/s12879-020-4873-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 02/11/2020] [Indexed: 11/15/2022] Open
Abstract
Background Brucellosis is a zoonotic disease transmitted to humans through contact with infected animals, animal products or consumption of infected dairy products. Brucella infection during pregnancy is of special interest due to association with adverse pregnancy outcomes. This study determined the seroprevalence and factors associated with Brucella infection among pregnant women around the human-wildlife-livestock interface area in Ngorongoro ecosystem, Northern Tanzania. Methods A facility-based cross-sectional study was conducted between May and June 2018 at six health facilities that provide antenatal services. Pregnant women receiving antenatal care were invited to participate. A structured questionnaire was used to collect socio-demographic and obstetric characteristics in addition to behavior and practices related to the occurrence of human brucellosis. The presence of serum immunoglobulin against Brucella was determined using Rose Bengal Plate Test (RBPT). The positive samples were further assayed for the presence of IgG and IgM using The enzyme-linkedimmunosorbent assay. Bivariate analysis was conducted to determine the variables associated with Brucella seropositivity. Multivariable logistic regression analysis was performed to examine the factors independently associations with Brucella seropositivity after adjustment for other explanatory variables. Results A total of 313 participants were enrolled in the study. The overall seroprevalence of Brucella infection was 10.9% (34/313) determined by Rose Bengal plate test. Of 34 positive individuals, 27(79.4%) and 8(23.5%) were positive in the ELISA specific for IgG and IgM Brucella antibodies respectively. Regular contact with manure (AOR 3.16, 95%CI 1.27–7.83) and preference for animal fresh milk (AOR 3.80, 95% CI 1.23–11.69), raw meat (AOR 2.58, 95% CI 1.14–5.81) and raw animal blood (AOR 2.71, 95% CI 1.15–6.35) increased the odds of being Brucella seropositive. Contact with the animal placenta were not associated with Brucella seropositivity after adjustment. Conclusion This study has found that brucellosis is an important public health problem among pregnant women in areas with interactions of humans; livestock and wildlife. The risk of infection increased with the regular contact with manure and preference of raw foodstuffs like animal blood, meat, and milk. We emphasize the need for interventional strategies to reduce the risk of exposure.
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Affiliation(s)
- Robert Makala
- Manyara Regional Referral Hospital, Babati, Tanzania
| | - Mtebe V Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
| | - George M Bwire
- Department of Pharmaceutical Microbiology, School of Pharmacy, Muhimbili University of Health and Allied, Dar es Salaam, Tanzania
| | - Upendo Kibwana
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Agricola Joachim
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Ng'wamkai G, Msigwa KV, Chengula D, Mgaya F, Chuma C, Msemwa B, Silago V, Majigo M, Mshana SE, Mirambo MM. Treponema pallidum infection predicts sexually transmitted viral infections (hepatitis B virus, herpes simplex virus-2, and human immunodeficiency virus) among pregnant women from rural areas of Mwanza region, Tanzania. BMC Pregnancy Childbirth 2019; 19:392. [PMID: 31664945 PMCID: PMC6820934 DOI: 10.1186/s12884-019-2567-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 10/22/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Sexually transmitted infections (STIs) is a global health problem with increased risk and morbidities during pregnancy. This study investigated the magnitude of viral STIs among pregnant women from three rural hospitals/clinics providing antenatal care in Mwanza region, Tanzania. METHODS Between February and May 2018, a total of 499 pregnant women were enrolled and tested for Human immunodeficiency virus (HIV), Herpes simplex virus-2 (HSV-2), Hepatitis B virus (HBV) and Hepatitis C virus (HCV) using rapid immunochromatographic tests and for syphilis using non-treponemal and treponemal antibody test. RESULTS The median age of enrolled women was 25 (IQR: 22-31) years. Seventy eight (15.6, 95% CI: 12-18) of women tested had at least one sexually transmitted viral infection. Specific prevalence of HIV, HBV, HCV, HSV-2 IgG and HSV-2 IgM were found to be 25(5.0%), 29(5.8%), 2(0.4%), 188(37.7%) and 24(4.8%), respectively. The odds of having viral infection was significantly high among women with positive T. pallidum serostatus (adjusted odd ratio (aOR): 3.24, 95%CI; 1.2-85). By multivariable logistic regression analysis, history of STIs predicted HSV-2 IgM seropositivity (aOR: 3.70, 95%CI: 1.43-9.62) while parity (aOR: 1.23, 95%CI: 1.04-1.46) predicted HBV infection and syphilis positive results (aOR: 8.63, 95%CI: 2.81-26.45) predicted HIV infection. CONCLUSION A significant proportion of pregnant women in rural areas of Mwanza region has at least one sexually transmitted viral infection which is independently predicted by positive T. pallidum serostatus. The strengthening and expansion of ANC screening package to include screening of STIs will ultimately reduce the viral STIs among pregnant women hence reduce associated morbidities and mortalities.
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Affiliation(s)
- Gilbert Ng'wamkai
- Department of Obstetrics and Gynecology, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Kalista V Msigwa
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Damas Chengula
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Frank Mgaya
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Clotilda Chuma
- Department of Obstetrics and Gynecology, Bugando Medical Centre, P.O. Box 370, Mwanza, Tanzania
| | - Betrand Msemwa
- Institute of Allied Health Sciences, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied sciences, P.O. Box 1464, Mwanza, Tanzania.
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Tebuka E, Fulgence RD, Msemwa B, Silago V, Mshana SE, Mirambo MM. Acute human cytomegalovirus infection among voluntary blood donors in the Lake Victoria zone blood transfusion centre: should it be considered in screening? Afr Health Sci 2019; 19:2351-2355. [PMID: 32127804 PMCID: PMC7040252 DOI: 10.4314/ahs.v19i3.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Despite blood transfusion being a lifesaving option, it may be associated with blood borne infections including human cytomegalovirus(HCMV). The World Health Organization recommends screening of blood products for HCMV before transfusion to pregnant women, neonates and immunocompromised patients. However, this is not routinely practised in many resource limited countries. OBJECTIVE This study aimed at determining seroprevalence of specific HCMV IgM antibodies among volunteered blood donors at the Lake Victoria zone blood transfusion centre. METHODS A total of 228 sera from volunteered blood donors were analyzed using HCMV IgM µ capture enzyme linked immunosorbent assay as per manufacturer's instructions. Data were analyzed by STATA version 13. RESULTS The median age of the study participants was 19 interquartile range (IQR): 18-23 years. The seroprevalence of specific HCMV IgM antibodies was found to be 23/228 (10.1%, 95% confidence interval (CI): 6-14. None of the factors was found to be associated with HCMV IgM seropositivity among blood donors. CONCLUSION One out 10 blood donors in the Lake Victoria zone blood transfusion centre is acutely infected with HCMV. There is a need to consider screening of HCMV before blood transfusion particularly in resource limited countries where HCMV is endemic.
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Affiliation(s)
- Erius Tebuka
- Department of Pathology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Ruharara D Fulgence
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Bertrand Msemwa
- Institute of Allied Health Sciences, Catholic University of health and allied sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Vitus Silago
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
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Mirambo MM, Mshana SE, Groß U. Rubella virus, Toxoplasma gondii and Treponema pallidum congenital infections among full term delivered women in an urban area of Tanzania: a call for improved antenatal care. Afr Health Sci 2019; 19:1858-1865. [PMID: 31656468 PMCID: PMC6794536 DOI: 10.4314/ahs.v19i2.8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND A significant proportion of newborns in the developing countries are born with congenital anomalies. OBJECTIVE This study investigated congenital infections due to Rubella virus, Toxoplasma gondii, Treponema pallidum among presumed normal neonates from full term pregnant women in Mwanza, Tanzania. METHODS Sera from mothers were tested for Treponema pallidum and Toxoplasma gondii infection while newborns from mothers with acute infections were tested for T. pallidum and T. gondii, and all newborns were tested for Rubella IgM antibodies. RESULTS A total of 13/300 (4.3 %) mothers had T. pallidum antibodies with 3 of them having acute infection. Two (0.7 %) of the newborns from mothers with acute infection were confirmed to have congenital syphilis. Regarding toxoplasmosis, 92/300 (30.7 %) mothers were IgG seropositive and 7 had borderline positivity, with only 1/99 (1%) being IgM seropositive who delivered IgM seronegative neonate. Only 1/300 (0.3 %) newborn had rubella IgM antibodies indicating congenital rubella infection. CONCLUSION Based on these results, it is estimated that in Mwanza city in every 100,000 live births about 300 and 600 newborns have congenital rubella and syphilis infections, respectively. Rubella virus and T. pallidum are likely to be among common causes of congenital infections in developing countries.
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Affiliation(s)
- Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Uwe Groß
- Institute of Medical Microbiology, Gottingen University Medical Centre, Germany
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Mushi MF, Jonathan E, Mirambo MM, Mshana SE. Prevalence and Predictors of Dermatophyte Infections Among Primary School Children in Ilemela, Mwanza, Tanzania. East Afr Health Res J 2019; 3:65-69. [PMID: 34308197 PMCID: PMC8279184 DOI: 10.24248/eahrj-d-18-00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 06/25/2019] [Indexed: 11/20/2022] Open
Abstract
Background: Dermatophytes are highly contagious organisms of public health importance, particularly among primary school children in the resource-limited settings with a prevalence of 10% to 20% in East Africa. Here, we report the prevalence and associated factors of dermatophyte infections among primary school children in Ilemela, Mwanza - Tanzania. Methods: A cross-sectional study was conducted involving 323 children aged between 4 and 10 years from 10 randomly selected primary schools. The study was conducted between July 2017 and September 2017. Pretested interviewer-administered semi-structured questionnaire was used to collect relevant social-demographic information followed by clinical examination to establish the diagnosis of dermatophyte infections. Data were analysed using Stata version 13. Results: The mean age of the study participants was 7.63±1.27 years, with the slightl majority (n=183, 56.7%) of participants being girls. The majority (n=277, 70.3%) of the study participants were from public schools. A total of 299 (92.6%) children reported using tap water at home. Using clinical diagnosis, 94 (29.1%) children had dermatophyte infections with 92 (97.9%) of them having tinea capitis. By multivariate logistic regression analysis: being a boy (odds ratio [OR] 1.98; 95% confidence interval [CI], 1.22 to 3.22; P=.01); using lake, river, or well water (OR 3.18; 95% CI, 1.36 to 7.38; P<.01); playing in a dusty environment (OR 2.65; 95% CI, 1.28 to 5.47; P<.01); playing with animals (OR 2.13; 95% CI, 1.28 to 3.56; P<.003); and having family members with dermatophyte infections (OR 10.56; 95% CI, 4.57 to 24.41; P<.001) predicted dermatophyte infections. Conclusion: The prevalence of dermatophyte infection is high in the study population and is associated with poor hygiene. Improved hygiene will reduce the prevalence of dermatophyte infections among primary school children in low-income countries. Further studies to identify the species and susceptibility patterns of these dermatophytes are recommended to establish empirical treatment guidelines.
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Affiliation(s)
- Martha F Mushi
- Microbiology and Immunology Department, Catholic University of Health and Allied Science, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Editha Jonathan
- School of Public Health, Catholic University of Health and Allied Science, Mwanza, Tanzania
| | - Mariam M Mirambo
- Microbiology and Immunology Department, Catholic University of Health and Allied Science, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Stephen E Mshana
- Microbiology and Immunology Department, Catholic University of Health and Allied Science, Weill Bugando School of Medicine, Mwanza, Tanzania
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Tizeba YA, Mirambo MM, Kayange N, Mhada T, Ambrose EE, Smart LR, Mshana SE. Parvovirus B19 Is Associated with a Significant Decrease in Hemoglobin Level among Children <5 Years of Age with Anemia in Northwestern Tanzania. J Trop Pediatr 2018; 64:479-487. [PMID: 29244176 DOI: 10.1093/tropej/fmx099] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Parvovirus B19 (B19) can cause transient aplastic crisis and lead to acute severe anemia. This study investigated the relationship between B19 and anemia among children <5 years old in the city of Mwanza, Tanzania. An enzyme immunoassay was used to detect B19 IgM- and IgG-specific antibodies among children with various categories of anemia according to the World Health Organization (WHO) guidelines. A total of 265 children with median age of 28.5 months (interquartile range 18-39.5) were investigated. Eighty-six children (32.5%) had severe anemia. B19-specific IgM and IgG antibodies were detected in 24 (9%) and 46 (17.4%) children, respectively. Low hemoglobin (Hb) level (p = 0.031), Plasmodium falciparum infection (p = 0.001) and residing in rural areas (p = 0.025) independently predicted B19 IgM seropositivity. Acute B19 infection decreased Hb level by 1.1 g/dl (p = 0.003). In malaria endemic areas, acute B19 infections should be considered among children with severe anemia from rural areas.
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Affiliation(s)
- Yustina A Tizeba
- Department of Pediatrics and Child health, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Neema Kayange
- Department of Pediatrics and Child health, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Tumaini Mhada
- Department of Pediatrics and Child health, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Emmanuela E Ambrose
- Department of Pediatrics and Child health, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Luke R Smart
- Department of Pediatrics and Child health, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania.,Department of Medicine, Center for Global Health, Weill Cornell Medical College, New York, NY, USA
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
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Mujuni F, Andrew V, Mngumi EB, Chibwe E, Mshana SE, Mirambo MM. Predominance of Brucella abortus antibodies among women with spontaneous abortion in the city of Mwanza: unrecognized link or coincidence? BMC Res Notes 2018; 11:792. [PMID: 30400996 PMCID: PMC6219096 DOI: 10.1186/s13104-018-3906-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 11/01/2018] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study investigated the association of Brucella seropositivity and spontaneous abortions in human population in the city of Mwanza, Tanzania. RESULTS A comparative cross sectional study which used 148 sera from women with spontaneous abortion and 250 sera from full-term delivered women was conducted in July 2017. Detection of Brucella abortus and Brucella melitensis antibodies was done using slide agglutination test. Data were analyzed using STATA version 13 software. The median age of the study participants was 25 (interquartile range 21-30) years. The overall seropositivity of Brucella antibodies was significantly higher among sera from women with spontaneous abortion than full term delivered women; (86/148, 58.1%: 95% CI 50-66 vs. 65/250, 26%: 95% CI 18-33, P < 0.001). Seropositivity of B. abortus was significantly higher among sera from women with spontaneous abortion than full-term delivered women (31.8% vs. 10.8%, P < 0.001). Women with abortion had 3.59 odds of being brucella seropositive compared to full term women (OR: 3.59, 95% CI; 2.25-5.74, P < 0.001). Seropositivity of Brucella antibodies is significantly higher among women with spontaneous abortion than full-term delivered women necessitating a need to investigate the relationship between Brucellosis and adverse pregnancy outcomes.
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Affiliation(s)
- Fridolin Mujuni
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Venance Andrew
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Elifuraha B. Mngumi
- Department of Veterinary Pathology, Sokoine University of Agriculture, P.O. Box 3018, Morogoro, Tanzania
| | - Elieza Chibwe
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
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Marando R, Seni J, Mirambo MM, Falgenhauer L, Moremi N, Mushi MF, Kayange N, Manyama F, Imirzalioglu C, Chakraborty T, Mshana SE. Predictors of the extended-spectrum-beta lactamases producing Enterobacteriaceae neonatal sepsis at a tertiary hospital, Tanzania. Int J Med Microbiol 2018; 308:803-811. [PMID: 29980372 PMCID: PMC6171784 DOI: 10.1016/j.ijmm.2018.06.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/25/2018] [Accepted: 06/28/2018] [Indexed: 11/27/2022] Open
Abstract
ESBL-PE sepsis was predicted by admission at ICU and ESBL-PE colonization. Neonates infected with ESBL-PE had significantly high mortality. ESBL-producing Klebsiella pneumoniae (ST45) carrying blaCTX-M-15 were predominant. Whole genome SNP analysis revealed clonal origin in 50% of ESBL-PE paired cases with similar sequence type.
The study was conducted to establish predictors of extended-spectrum beta-lactamase-producing Enterobacteriaceae (ESBL-PE) neonatal sepsis and mortality in a tertiary hospital, Tanzania. Between July and December 2016, blood culture was performed in neonates with clinical features of sepsis and neonates/mothers/guardians were screened for ESBL colonization. Selected isolates underwent whole genome sequencing to investigate relatedness. Logistic regression analysis was performed to determine predictors for ESBL-PE associated neonatal sepsis and mortality. Neonatal ESBL-PE sepsis was detected in 32(10.5%) of the 304 neonates investigated. Neonatal ESBL-PE sepsis was independently predicted by admission at the Intensive care Unit and positive mother and neonate ESBL-PE colonization. Deaths occurred in 55(18.1%) of neonates. Neonates infected with ESBL-PE, admitted at ICU, increased age and those transferred from other centres had significantly high mortality rates. Gram-negative bacteria formed the majority (76%) of the isolates, of which 77% were ESBL-PE. Virulent Klebsiella pneumoniae ST45 carrying blaCTX-M-15 were commonly isolated from neonates. Klebsiella pneumoniae (ST45) were the predominant cause of ESBL-PE neonatal sepsis and mortality. Improved infection control and antibiotic stewardship are crucial in controlling the spread of resistant strains. Rapid diagnostic tests to detect ESBL-PE in low-income countries are needed to guide treatment and reduce ESBL-PE-associated mortality.
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Affiliation(s)
- Rehema Marando
- Department of Pediatrics and Child Health, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Jeremiah Seni
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Linda Falgenhauer
- Institute of Medical Microbiology, Justus-Liebig University, Schubertstrasse 81, 35392, Giessen, Germany; German Center for Infection Research (DZIF), Partner site Giessen-Marburg-Langen, Campus Giessen, Schubertstrasse 81, 35392, Giessen, Germany
| | - Nyambura Moremi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Martha F Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Neema Kayange
- Department of Pediatrics and Child Health, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Festo Manyama
- Department of Pediatrics and Child Health, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Can Imirzalioglu
- Institute of Medical Microbiology, Justus-Liebig University, Schubertstrasse 81, 35392, Giessen, Germany; German Center for Infection Research (DZIF), Partner site Giessen-Marburg-Langen, Campus Giessen, Schubertstrasse 81, 35392, Giessen, Germany
| | - Trinad Chakraborty
- Institute of Medical Microbiology, Justus-Liebig University, Schubertstrasse 81, 35392, Giessen, Germany; German Center for Infection Research (DZIF), Partner site Giessen-Marburg-Langen, Campus Giessen, Schubertstrasse 81, 35392, Giessen, Germany
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania.
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Mirambo MM, Mgode GF, Malima ZO, John M, Mngumi EB, Mhamphi GG, Mshana SE. Seropositivity of Brucella spp. and Leptospira spp. antibodies among abattoir workers and meat vendors in the city of Mwanza, Tanzania: A call for one health approach control strategies. PLoS Negl Trop Dis 2018; 12:e0006600. [PMID: 29939991 PMCID: PMC6034905 DOI: 10.1371/journal.pntd.0006600] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 07/06/2018] [Accepted: 06/10/2018] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Brucellosis and leptospirosis are among neglected tropical zoonotic diseases particularly in the resource limited countries. Despite being endemic in these countries, there is paucity of information on its magnitude. This study investigated seropositivity of Brucella spp. and Leptospira spp., and associated factors among abattoir workers and meat vendors in the city of Mwanza, Tanzania. METHODOLOGY A community based cross-sectional study was conducted in Mwanza city from May to July 2017. Socio-demographic and other relevant information were collected. Detection of Brucella spp. and Leptospira spp. antibodies were done using slide agglutination test and microscopic agglutination test, respectively. Data were analyzed using STATA version 13 Software. FINDINGS A total of 250 participants (146 abattoir workers and 104 meat vendors) were enrolled with median age of 31 (IQR: 25-38) years. The overall, seropositivity of Brucella spp. antibodies was 48.4% (95% Cl: 42-54). Seropositivity of B. abortus was significantly higher than that of B. melitensis (46.0%, 95%Cl: 39-52 vs. 23.6%, 95% Cl: 18-28, P<0.001) while seropositivity of both species was 21.2% (95%Cl: 16-26). The seropositivity of Leptospira spp. was 10.0% (95% CI: 6-13) with predominance of Leptospira kirschneri serovar Sokoine which was detected in 7.2% of the participants. Being abattoir worker (OR: 2.19, 95% CI 1.06-4.54, p = 0.035) and long work duration (OR: 1.06, 95%CI: 1.01-1.11, p = 0.014) predicted presence of both B.abortus and B. melitensis antibodies. Only being married (p = 0.041) was significantly associated with seropositivity of Leptospira spp. Primary education was the only factor independently predicted presence of Brucella spp. antibodies among abattoir workers on sub-analysis of occupational exposure. None of factors were found to be associated with presence of Brucella spp. antibodies among meat vendors on sub-analysis. CONCLUSION Seropositivity of B.abortus antibodies among abattoir workers and meat vendors is high and seem to be a function of being abattoir worker, having worked for long duration in the abattoir and having primary education. In addition, a significant proportion of abattoir workers and meat vendors in the city was seropositive for Leptospira kirschneri serovar Sokoine. There is a need to consider 'one health approach' in devising appropriate strategies to control these diseases in the developing countries.
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Affiliation(s)
- Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Georgies F. Mgode
- Pest Management Centre (SPMC), Sokoine University of Agriculture, Morogoro, Tanzania
| | - Zakaria O. Malima
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Matata John
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Elifuraha B. Mngumi
- Department of Veterinary Pathology, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Ginethon G. Mhamphi
- Pest Management Centre (SPMC), Sokoine University of Agriculture, Morogoro, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Mushi MF, Ngeta N, Mirambo MM, Mshana SE. Predictors of oesophageal candidiasis in persons with or without HIV infection. Afr Health Sci 2018; 18:470-471. [PMID: 30602975 PMCID: PMC6306978 DOI: 10.4314/ahs.v18i2.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Martha F Mushi
- Microbiology and Immunology Department; Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Nathaniel Ngeta
- Department of Internal Medicine Weill Bugando School of Medicine, P.O. Box 1464 Mwanza, Tanzania
| | - Mariam M Mirambo
- Microbiology and Immunology Department; Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Microbiology and Immunology Department; Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
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Manyiri P, Kabangila R, Kasang C, Mushi MF, Mirambo MM, Mshana SE. Prevalence and factors associated with Mycobacteremia and mortality among febrile HIV infected patients in Mwanza, Tanzania. Int J Infect Dis 2018; 70:69-71. [PMID: 29550450 DOI: 10.1016/j.ijid.2018.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/02/2018] [Accepted: 03/09/2018] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVES This study investigated the prevalence and factors associated with mycobacteremia and mortality among febrile HIV infected patients in developing countries. METHODS A hospital based cross-sectional study was conducted among febrile HIV patients admitted at Bugando Medical centre and Sekou Toure hospital between November 2016 and March 2017. Blood culture was done on BACTEC Myco/F Lytic bottles. Clinical and demographic data were collected using a pre-tested data collection tool. RESULTS A total of 154 patients with the mean age of 41.5±12.2 were enrolled. Females formed the majority, 93 (60%) of the study participants. The prevalence of Mycobacteremia was 3.3% while that of other bacteria was 8.4%. Age (p=0.03), recent HIV diagnosis (p=0.005), not taking HAART (p=0.031) and low CD4+ count (p=0.002) were significantly associated with Mycobacteremia. Factors significantly associated with 14-day in-hospital mortality were advanced HIV infection (p<0.001), poor ART adherence (p<0.001), low CD4+ (p=0.0002) and Mycobacteremia (p=0.007). CONCLUSION The prevalence of Mycobacteremia was low; however, it was significantly associated with mortality. Mycobacteremia should be suspected in high risk febrile HIV infected individuals followed by early appropriate treatment in order to reduce associated morbidity and mortality.
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Affiliation(s)
- Paulina Manyiri
- Department of Internal Medicine, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Tanzania
| | - Rodrick Kabangila
- Department of Internal Medicine, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Tanzania
| | - Christa Kasang
- Medical Mission Institute Wuerzburg, Herrmann-Schell-Str. 7, 97074 Wuerzburg, Germany
| | - Martha F Mushi
- Department of Microbiology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Tanzania
| | - Stephen E Mshana
- Department of Microbiology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Tanzania
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Mushi MF, Ngeta N, Mirambo MM, Mshana SE. Predictors of esophageal candidiasis among patients attending endoscopy unit in a tertiary hospital, Tanzania: a retrospective cross-sectional study. Afr Health Sci 2018; 18:66-71. [PMID: 29977259 PMCID: PMC6016994 DOI: 10.4314/ahs.v18i1.10] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Esophageal candidiasis is a common disease among patients with impaired cell mediated immunity. In the current study, we report esophageal candidiasis among patients with various co-morbidities attending the endoscopic unit at the Bugando Medical Centre. Methods This retrospective study was conducted from June to September 2015. All data of the patients who attended the endoscopic unit between 2009 and 2014 were retrieved and analyzed. Results A total of 622 patients who underwent oesophagogastroduodenoscopy were analyzed. A slight majority 334/622(53.7%) of patients were female. Out of 622 patients; 35(5.6%) had esophageal candidiasis. Decrease in age (OR 1.1, 95%CI; 1.0–1.1), female sex (OR 3.8, 95%CI; 1.1–13.1), drinking alcohol (OR 17.1, 95%CI; 4.9–58.9), smoking (OR 8.3, 95%CI; 1.7–41.0), antibiotic use (OR 5.7, 95%CI; 2.0–16.4), positive HIV status (OR 10.3, 95%CI; 4.6–6.0) and presence of peptic ulcer disease (OR 13.2, 95%CI; 3.5–49.0) independently predicted esophageal candidiasis. Conclusion Patients with a history of drinking alcohol, smoking, use of antibiotics and those with chronic diseases such as peptic ulcers were at high risk of developing esophageal candidiasis. Further studies are needed to identify Candida spp. and their anti-fungal susceptibility for proper management of esophageal candidiasis in HIV and non-HIV individuals.
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Affiliation(s)
- Martha F Mushi
- Microbiology and Immunology Department; Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Nathaniel Ngeta
- Department of Internal Medicine Weill Bugando School of Medicine. P.O. Box 1464 Mwanza, Tanzania
| | - Mariam M Mirambo
- Microbiology and Immunology Department; Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Microbiology and Immunology Department; Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
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Mirambo MM, Majigo M, Scana SD, Mushi MF, Aboud S, Groß U, Kidenya BR, Mshana SE. Rubella natural immunity among adolescent girls in Tanzania: the need to vaccinate child bearing aged women. BMC Womens Health 2018; 18:3. [PMID: 29298693 PMCID: PMC5751833 DOI: 10.1186/s12905-017-0505-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 12/21/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rubella primary infection during early stages of pregnancy is associated with high risk of congenital Rubella syndrome (CRS). Prevention of CRS in the resource-limited countries requires multiple strategies. Here, we document the data on the magnitude of Rubella natural immunity among adolescent girls which is a crucial group in devising effective control strategies to prevent CRS. METHODS A cross sectional study involving 397 adolescent girls was conducted in the city of Mwanza involving five secondary schools. Socio-demographic and other relevant information were collected using pre-tested data collection tool. Rubella IgG antibodies were determined using enzyme immunoassay. The presence of Rubella IgG titers of >10 IU/ml indicated natural immunity. RESULTS The mean age of the study participants was 15.18 ± 1.48 years. Of 397 girls, 340 (85.6%) and 57 (14.4%) were from secondary schools representing peri-urban and rural areas, respectively. Out of 397 girls, 90.4% (95% CI: 87-93) were found to be naturally immune with median Rubella IgG antibodies titers of 56.7 IU/ml interquartile range (IQR): 40.8-137. The median Rubella IgG antibodies titers were significantly high in adolescent girls from families with high socio-economic status (63.96 vs. 47.13 IU/ml, P < 0.001) and in adolescent girls from peri-urban areas of the city (63.33 vs. 39.9 IU/ml, P < 0.001). CONCLUSION The majority of adolescent girls in the city of Mwanza are naturally immune to Rubella virus. There is a need to compare the effectiveness of screening and vaccinating susceptible adolescent girls with the effectiveness of vaccinating all women of childbearing in controlling CRS in low-income countries.
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Affiliation(s)
- Mariam M. Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili university of Health and allied sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Seth D. Scana
- Department of Microbiology and Immunology, Weill Bugando School of medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Martha F. Mushi
- Department of Microbiology and Immunology, Weill Bugando School of medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Said Aboud
- Department of Microbiology and Immunology, Muhimbili university of Health and allied sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Uwe Groß
- Institute of Medical Microbiology, University Medical Centre Göttingen, Kreuzbergring 57, 37075 Göttingen, Germany
| | - Benson R. Kidenya
- Department of Epidemiology and Biostatics, School of Public Health, Catholic University of Health and Allied sciences, P.O.Box 1464, Mwanza, Tanzania
| | - Stephen E. Mshana
- Institute of Medical Microbiology, University Medical Centre Göttingen, Kreuzbergring 57, 37075 Göttingen, Germany
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Chibwe E, Mirambo MM, Kihunrwa A, Mshana SE. Magnitude of the Cytomegalovirus infection among pregnant women attending antenatal clinics in the city of Mwanza, Tanzania. BMC Res Notes 2017; 10:489. [PMID: 28931421 PMCID: PMC5607485 DOI: 10.1186/s13104-017-2813-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 09/14/2017] [Indexed: 11/13/2022] Open
Abstract
Background Despite, Cytomegalovirus (CMV) infection being associated with a potential risk to the fetus, there is limited data from Tanzania and many other developing countries regarding the epidemiology and the impact of CMV infections. This cross-sectional study was conducted between December 2014 and June 2015 among pregnant women attending antenatal clinics in the city of Mwanza, Tanzania to investigate the magnitude and associated factors of CMV infection. Methods The specific CMV IgM and IgG antibodies were detected using indirect enzyme linked immunosorbent assay (ELISA). Demographic and clinical data were collected using pre-tested data collection tool. Data were analysed using STATA version 13. Results A total of 261 pregnant women with median age of 20 (IQR 19–25) years and mean gestation age of 17 ± 7.8 weeks were enrolled. The seroprevalence of CMV IgG antibodies was 193(73.9%; 95% CI 67.2–79.6) while that of CMV IgM antibodies was 0.4%. As the age increased by one unit the IgG seroprevalence was found to increase by 0.3% (95% CI 0.13–0.47, p = 0.001) whereas the risk of being IgG positive increased by 24%. On multivariable logistic regression analysis only urban residence (OR 6.329, 95% CI 2.885–13.887, p < 0.001) was found to independently predict CMV IgG seropositivity. Regarding the outcomes of previous pregnancies the history of miscarriage independently predicted IgG seropositivity (OR 5.6, 95% CI 1.29–24.178, p = 0.021). The IgM seropositive woman had fatal outcome of the term delivery of the baby with microcephaly and spinal-bifida. Conclusion Cytomegalovirus seroprevalence among pregnant women residing in urban areas of Mwanza city, Tanzania is high and is associated with poor pregnancy outcomes. There is a need to emphasize routine screening of CMV in order to establish the impact of CMV during pregnancy.
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Affiliation(s)
- Elieza Chibwe
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania.
| | - Albert Kihunrwa
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O. Box 1464, Mwanza, Tanzania
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Mirambo MM, Maliki F, Majigo M, Mushi MF, Moremi N, Seni J, Matovelo D, Mshana SE. The magnitude and correlates of Parvovirus B19 infection among pregnant women attending antenatal clinics in Mwanza, Tanzania. BMC Pregnancy Childbirth 2017; 17:176. [PMID: 28592274 PMCID: PMC5463315 DOI: 10.1186/s12884-017-1364-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 05/31/2017] [Indexed: 11/17/2022] Open
Abstract
Background Human parvovirus B19 (B19) infection has been associated with congenital infection which may result into a number of the adverse pregnancy outcomes. The epidemiology and the magnitude of B19 infections among pregnant women have been poorly studied in developing countries. This study was done to establish preliminary information about the magnitude of B19 among pregnant women attending antenatal clinics in the city of Mwanza, Tanzania. Methods A cross-sectional study was conducted between December 2014 and June 2015 among 258 pregnant women attending two antenatal clinics representing rural and urban areas in the city of Mwanza. Socio-demographic data were collected using structured data collection tool. Specific B19 IgM and IgG antibodies were determined using indirect enzyme linked immunosorbent assay kits (DRG Instruments GmbH, Germany). Data were analyzed using STATA version 11 software. Results The median age of study participants was 21 IQR (19–25) years. Of 253 pregnant women; 116(44.96%), 109(42.25%) and 33(12.79%) were in the first, second and third trimester respectively. The majority 168(66.4%) of women were from urban areas. Of 253 pregnant women, the overall prevalence of IgM was 83(32.8%) while that of IgG was 142(55.0%) among 258 women tested. A total of 50(19.4%) women were positive for both IgG and IgM indicating true IgM positive. History of baby with low birth weight (OR: 10, 95% CI: 1.82–58.05, P = 0.01) was independent predictor of B19 IgG seropositivity and being at the third trimester was protective (OR: 0.38, 95% CI: 0.16–0.92, P = 0.03). The IgG titers were found to decrease significantly as gestational age increases (Spearman’s rho = −0.2939, p = 0.0004) Conclusion More than a half of pregnant women in Mwanza city are B19 IgG sero-positive with about one third of these being B19 IgM seropositive. Further studies to determine the impact of B19 infections among pregnant women and their newborns are recommended in developing countries.
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Affiliation(s)
- Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania.
| | - Fatma Maliki
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Martha F Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
| | - Nyambura Moremi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
| | - Jeremiah Seni
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
| | - Dismas Matovelo
- Department of Obstetrics and gynecology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
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Machumi I, M Mirambo M, Ruganuza D, Rambau P, N Massinde A, Kihunrwa A, E Mshana S, Morona D. Factors Associated With Toxoplasma gondii IgG and IgM Antibodies, and Placental Histopathological Changes Among Women With Spontaneous Abortion in Mwanza City, Tanzania. East Afr Health Res J 2017. [DOI: 10.24248/eahrj.v1i2.554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ramadhani MY, Mirambo MM, Mbena H, Kihunrwa A, Mshana SE. High prevalence of Chlamydia trachomatis infection among infertile women in Mwanza city, Tanzania: a need to introduce screening and treatment programme. Sex Transm Infect 2017; 93:111. [PMID: 28213576 DOI: 10.1136/sextrans-2016-052795] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 10/11/2016] [Accepted: 10/15/2016] [Indexed: 11/03/2022] Open
Affiliation(s)
- Mansour Y Ramadhani
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Happiness Mbena
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Albert Kihunrwa
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania
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Lulandala L, Mirambo MM, Matovelo D, Gumodoka B, Mshana SE. Acute Rubella Virus Infection among Women with Spontaneous Abortion in Mwanza City, Tanzania. J Clin Diagn Res 2017; 11:QC25-QC27. [PMID: 28511456 PMCID: PMC5427382 DOI: 10.7860/jcdr/2017/22634.9544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/20/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Acute rubella virus infection in early pregnancy has been associated with poor pregnancy outcome ranging from spontaneous abortion, stillbirth and multiple birth defects known as Congenital Rubella Syndrome (CRS). Despite its importance the prevalence of acute rubella virus infections is not known among women with spontaneous abortion in most centres in developing countries. AIM The present study was aimed to determine the seroprevalence of acute rubella infection among women with spontaneous abortion in Mwanza city. MATERIALS AND METHODS A total of 268 women with spontaneous abortion were enrolled from four different hospitals in Mwanza city between November 2015 and April 2016. Blood samples were collected; sera were extracted and stored at -80°C until processing. Acute rubella virus infection was diagnosed by the detection of rubella specific IgM antibodies using indirect Enzyme Linked Immunosorbent Assay (ELISA) as per manufacturer's instructions. Data were analysed by using STATA version 11. RESULTS The mean age of enrolled women was 26.3±5.6 years. The prevalence of acute rubella virus infection was found to be 9/268 (3.7%, 95% CI: 1-5). Only women residing in urban areas (AOR: 5.65, 95% CI: 1.15-27.77, p=0.035) were found to predict acute rubella virus infection among cases with spontaneous abortion in Mwanza city. CONCLUSION About four out of hundred women residing in urban areas with spontaneous abortion in Mwanza are acutely infected with rubella virus highlighting the potential of this virus in contributing to poor pregnancy outcome in this setting.
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Affiliation(s)
- Lukombodzo Lulandala
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Dismas Matovelo
- Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Balthazar Gumodoka
- Professor, Department of Obstetrics and Gynecology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Stephen E Mshana
- Professor, Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania
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Mirambo MM, Aboud S, Groß U, Majigo M, Mushi MF, Mshana SE. Rubella Seromarkers and Determinants of Infection among Tanzanian Children and Adolescents in Prevaccination Era: Are We in the Right Track? Int J Prev Med 2017; 8:3. [PMID: 28217265 PMCID: PMC5288956 DOI: 10.4103/2008-7802.198914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 08/12/2016] [Indexed: 11/12/2022] Open
Abstract
Background: The World health organization advocates assessment of the burden of rubella and congenital rubella syndrome (CRS) by seroepidemiological surveys and surveillance programs in all countries without vaccination programs. Due to scarcity of data in developing countries, this study was conducted to assess the seromakers for natural rubella infection in Tanzania during prevaccination era so as to ascertain the gaps for future research and prevention strategies. Methods: A cross-sectional study was conducted between September and October 2014. Indirect enzyme-linked immunosorbent assay was used to detect rubella IgG and IgM antibodies. STATA version 11 was used to perform data analysis. Results: Of 723 enrolled participants, 368 (50.8%) and 94 (13%) were positive for specific IgG and IgM rubella antibodies, respectively. On multivariable logistic regression analysis, significant determinants of rubella IgG seropositivity were increase in age (odds ratios [OR]: 1.24, 95% confidence interval [CI]: 1.18–1.29, P < 0.001), low socioeconomic status (SES) (OR: 2.38, 95% CI: 1.1.23–4.50, P = 0.010), and absence of rash (OR: 4.34, 95% CI: 1.1.17–15.3, P = 0.027), while only the presence of rashes was significant determinant of rubella IgM seropositivity (OR: 2.5, 95%; 1.07–5.98, P = 0.034). Significantly higher mean IgG titers were observed in population ≥10 years (P < 0.001), those residing in urban and peri-urban areas (P < 0.001), those from employed mothers (P = 0.018), and those with no current history of fever (P = 0.018). Conclusions: The prevalence of specific rubella IgG antibodies in Tanzania is high and is associated with increase in age, absence of rash, and low SES. Results suggest a need to reconsider upper age limit for vaccination campaigns in developing countries. Screening and vaccinating women may be cost-effective campaign to prevent CRS in developing countries.
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Affiliation(s)
- Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Said Aboud
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Uwe Groß
- Institute of Medical Microbiology, University Medical Centre Gottingen, Gottingen, Germany
| | - Mtebe Majigo
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Martha F Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania
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Ahmed M, Mirambo MM, Mushi MF, Hokororo A, Mshana SE. Bacteremia caused by multidrug-resistant bacteria among hospitalized malnourished children in Mwanza, Tanzania: a cross sectional study. BMC Res Notes 2017; 10:62. [PMID: 28122629 PMCID: PMC5267369 DOI: 10.1186/s13104-017-2389-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 01/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Severe malnutrition has been known to increase susceptibility and severity of infections. Bacteremia in malnourished children has been found to increase morbidity and mortality especially if is due to multidrug resistant bacteria. Here, we report the prevalence of bacteremia among children under 5 years of age and the antibiotic susceptibility pattern of the isolates; the information that can be used by clinicians to guide on the empirical antibiotic treatment. FINDINGS A total of 402 malnourished children were investigated for bacteremia. The median age of enrolled children were 17 (IQR 12-31) months. Severe malnutrition was observed in 19.1% of malnourished underfives. The point prevalence of bacteremia among malnourished children was 56/402 (13.9%; 95% CI 10.3-17.3). The prevalence of bacteremia was significantly higher among severely malnourished children than in children with moderate/mild malnutrition (18.0 vs. 10.7%, P = 0.03). Mortality was significantly associated with bacteremia among severely malnourished children (OR 2.77, 95% CI 1.02-6.98, P = 0.02). Pseudomonas spp. 20/56 (35.7%) were the most frequent isolates while Staphylococcus aureus and Streptococcus pneumoniae were isolated in 8/56 (14.2%) and 5/56 (8.9%) respectively. Rates of resistance for gram negative bacteria were; ampicillin (100%), amoxicillin/clavulanic acid (85.7%), gentamicin (23.8%), ceftriaxone (23.8%), ceftazidime (23.8%) meropenem (4.7%) and ciprofloxacin (2.4%). methicillin resistant S. aureus strains were confirmed in 4/8 (50%) of S. aureus isolates and 60% of S. pneumoniae isolates were resistant to 1 µg oxacillin. CONCLUSION Bacteremia due to multi drug resistant isolates is common among severely malnourished children under 5 years of age. There is a need to review empirical antibiotic treatment coupled with antibiotic stewardship to prevent mortality and morbidity of severely malnourished children under 5 years of age.
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Affiliation(s)
- Maimuna Ahmed
- Department of Paediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
| | - Martha F Mushi
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Adolfine Hokororo
- Department of Paediatrics and Child Health, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
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Machumi I, Mirambo MM, Ruganuza D, Rambau P, Massinde AN, Kihunrwa A, Mshana SE, Morona D. Factors Associated With Toxoplasma gondii IgG and IgM Antibodies, and Placental Histopathological Changes Among Women With Spontaneous Abortion in Mwanza City, Tanzania. East Afr Health Res J 2017; 1:86-94. [PMID: 34308163 PMCID: PMC8279292 DOI: 10.24248/eahrj-d-16-00408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 07/25/2017] [Indexed: 11/20/2022] Open
Abstract
Background: Toxoplasma gondii infection in early pregnancy has been associated with significant adverse pregnancy outcomes. Despite being common in the city of Mwanza, its association with spontaneous abortion has never been studied. Here, we report the IgG and IgM seropositivity and histopathological changes of toxoplasmosis among women with spontaneous abortion. Methods: A total of 260 women with spontaneous abortion were enrolled between November 2015 and April 2016 from 4 hospitals in Mwanza city. Specific T. gondii IgG and IgM antibodies were detected from sera by indirect enzyme-linked immunosorbent assay (ELISA) while the conceptus tissues were stained with haematoxylin and eosin to demonstrate histo-pathological changes. Data were analysed by using Stata version 13. Results: The mean age of the enrolled women was 2665.9 years. The seropositivity of IgG and IgM antibodies were 144/260 (55.4%; 95% confidence interval [CI], 49–61) and 6/260 (2.3%; 95% CI, 3–8), respectively. IgG seropositivity was significantly high among women in the first trimester (59.1% vs.43.5%; P=.03). Only low gestation age (odds ratio [OR] 1.11; 95% CI, 1.02–1.20; P=.02) and keeping a cat (OR 11.80; 95% CI, 1.32–10.5; P=.03) independently predicted IgG and IgM seropositivity, respectively. Presence of inflammation (OR 1.95; 95% CI, 1.05–3.64; P=.03), calcification (OR 3.28; 95% CI, 1.01–10.63; P=.04), necrosis (OR 2.86; 95% CI, 1.39–5.89; P=.04), and lymphocyte infiltrations (OR 2.24; 95% CI, 1.17–4.24; P=.01) were significantly associated with T. gondii IgG seropositivity. Conclusion: Almost half of women with spontaneous abortion in the city of Mwanza have specific T. gondii IgG antibodies. Placental histopathological changes suggestive of toxoplasmosis were significantly found among IgG seropositive women. This calls for the need to screen these women during antenatal visits in order to institute appropriate measures, such as treatment and counselling, to prevent complications associated T. gondii infection.
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Affiliation(s)
- Illuminata Machumi
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Deodatus Ruganuza
- Department of Medical Parasitology and Entomology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Peter Rambau
- Department of Pathology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Anthony N Massinde
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Albert Kihunrwa
- Department of Obstetrics and Gynaecology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Domenica Morona
- Department of Medical Parasitology and Entomology, Weill Bugando School of Medicine, Mwanza, Tanzania
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Mirambo MM, Majigo M, Aboud S, Groß U, Mshana SE. Erratum to: Serological makers of rubella infection in Africa in the pre vaccination era: a systematic review. BMC Res Notes 2016; 9:333. [PMID: 27381216 PMCID: PMC4932662 DOI: 10.1186/s13104-016-2129-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 06/16/2016] [Indexed: 11/10/2022] Open
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Mngumi EB, Mirambo MM, Wilson S, Mshana SE. Predictors of specific anti- Brucella antibodies among humans in agro-pastoral communities in Sengerema district, Mwanza, Tanzania: the need for public awareness. Trop Med Health 2016; 44:34. [PMID: 27857610 PMCID: PMC5067884 DOI: 10.1186/s41182-016-0034-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Accepted: 09/14/2016] [Indexed: 11/10/2022] Open
Abstract
Background Human brucellosis remains to be a neglected zoonotic disease among agro-pastoral communities where livestock rearing is one of the main economic activities. This study was conducted in different agro-pastoral communities in Sengerema district, Mwanza, Tanzania, to determine seroprevalence and predictors of anti-Brucella antibodies, information that may influence public awareness on the risk factors and strategies to improve the diagnosis of brucellosis in developing countries. Methods A cross-sectional community-based study was conducted between July and September 2008 in ten villages of Sengerema district. Sociodemographic and other related information were collected using a standardized data collection tool. Detection of Brucella abortus and Brucella melitensis antibodies were done using rapid Brucella serum agglutination test. Data were analysed by using STATA version 11.0. Adjusted odds ratios (AOR) were calculated using multivariate logistic regression analysis. Results A total of 382 adults were enrolled with the median age of 30 (interquartile range 15–40) years. Males formed the majority of the participants 234 (61.5 %). Overall, seroprevalence of anti-Brucella antibodies was found to be 14.1 % (54/382, 95 % CI 10.6–17.5). Seroprevalence of B. melitensis was 11 % (42/382) while that of B. abortus was found to be 7 % (26/282), P = 0.0267. Co-infection of B. melitensis and B. abortus was observed in 3.6 % (14/382, 95 % CI 1.7–5.4) of participants. On a multivariate logistic regression analysis, male sex (AOR 3.2, 95 % CI 1.3–7.5, P = 0.007), touching goat placenta (AOR 2.54, 95 % CI 1.05–6.14, P = 0.012) and agro-pastoralist occupation (AOR 2.07, 95 % CI 1.01–4.24, P = 0.04) were found to predict B. melitensis infection. Males (AOR 3.07, 95 % CI 1.45–6.51, P = 0.003) and agro-pastoralists (AOR 2.98, 95 % CI 1.38–6.43, P = 0.005) were found to be predictors for specific anti-Brucella antibodies. Conclusions A significant proportion of the agro-pastoralist male population in agro-pastoral communities in Sengerema district is positive for anti-Brucella antibodies. With the decrease incidence of malaria fever, other causes of fever such as Brucella spp. should be considered of public health concern in Tanzania especially in agro-pastoral communities.
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Affiliation(s)
- Elifuraha B Mngumi
- Department of Veterinary Pathology, Sokoine University of Agriculture, P.O. Box 3018, Morogoro, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Sospeter Wilson
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania
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Jaka H, Mushi MF, Mirambo MM, Wilson L, Seni J, Mtebe M, Mshana SE. Sero-prevalence and associated factors of Helicobacter pylori infection among adult patients with dyspepsia attending the gastroenterology unit in a tertiary hospital in Mwanza, Tanzania. Afr Health Sci 2016; 16:684-689. [PMID: 27917200 DOI: 10.4314/ahs.v16i3.7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Prevalence of H.pylori infection varies greatly between populations in different countries. This study was conducted to determine the magnitude of H.pylori among adult patients with dyspepsia attending the gastroenterology unit at Bugando medical centre. METHODS A cross sectional study involving 202 dyspeptic patients was conducted between June and July 2014. A Standardized data collection tool was used to collect socio-demographic characteristics. H.pylori antibodies were detected using rapid immunochromatographic tests according to manufacturer's instructions. RESULTS The median age of study population was 42 (IQR: 33-54). Females 105 (51.9%) formed majority of the population studied. Of 202 participants; 119 (58.9%) were from rural areas. Seroprevalence of H.pylori infection was found to be 79/202 (39.1%, 95% CI: 32.3-45.7). As the age increased the risk of having H.pylori infection also increased (OR: 1.02 95% CI: 1-1.04, P=0.02). On multivariate logistic regression analysis untreated drinking water was found to predict H.pylori seropositivity (OR: 2.33, CI: 1.09-4.96, p=0.028). CONCLUSION The seroprevalence of H.pylori among dyspeptic patients is high in this setting. Therefore the community in Mwanza should be educated on the use of safe drinking water in order to minimize H. pylori infections.
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Affiliation(s)
- Hyasinta Jaka
- Department of Internal medicine, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
| | - Martha F Mushi
- Department of Microbiology/Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
| | - Mariam M Mirambo
- Department of Microbiology/Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
| | - Leonard Wilson
- Department of Microbiology/Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
| | - Jeremiah Seni
- Department of Microbiology/Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
| | - Majigo Mtebe
- Department of Microbiology and Immunology, Muhimbili university of Health and allied sciences P.O.Box 65001, Dar es Salaam
| | - Stephen E Mshana
- Department of Microbiology/Immunology, Weill Bugando School of Medicine, P.O.Box 1464, Mwanza, Tanzania
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