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Kilusungu ZH, Kassam D, Kimera ZI, Mgaya FX, Nandolo W, Kunambi PP, Ulomi W, Matee MIN. Tetracycline and sulphonamide residues in farmed fish in Dar es Salaam, Tanzania and human health risk implications. Food Addit Contam Part B Surveill 2024:1-10. [PMID: 38516743 DOI: 10.1080/19393210.2024.2331106] [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: 01/04/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
In Africa, antibiotic residue investigations in animal food have primarily been focused on meat, neglecting farmed fish. This cross-sectional study conducted in Dar es Salaam, Tanzania, aimed to assess sulphonamide and tetracycline residues in farmed fish, comparing levels with Codex Alimentarius Commission's acceptable daily intake (ADI) and maximum residue limits (MRLs). A total of 84 farmed fish were sampled and analysed in the presence of tetracycline and sulphonamide residues. All samples were positive for sulphonamide residues (100%; n = 84), and 2.4% (n = 2) were positive for tetracycline and consequently also positive for both compounds. Tetracycline levels were below ADI and MRL, 28.5% (n = 24) surpassed the ADI, and 6% (n = 5) of the samples exceeded the MRL for sulphonamide. Regular monitoring of antibiotic residues in aquaculture products is crucial to mitigate health risks and expanding assessments to include other commonly used compounds is warranted.
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Affiliation(s)
- Zainabu H Kilusungu
- Department of Aquaculture and Fisheries Science, Africa Centre of Excellence in Aquaculture and Fisheries (AquaFish), Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Daud Kassam
- Department of Aquaculture and Fisheries Science, Africa Centre of Excellence in Aquaculture and Fisheries (AquaFish), Lilongwe University of Agriculture and Natural Resources, Lilongwe, Malawi
| | - Zuhura Idd Kimera
- Department of Environmental and Occupational Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Fauster X Mgaya
- Department of Microbiology and Immunology, School of Diagnostic Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Wilson Nandolo
- Department of Animal Science, Lilongwe University of Agriculture and Natural Resources(LUANAR), Lilongwe, Malawi
| | - Peter P Kunambi
- Department of Microbiology and Immunology, School of Diagnostic Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Winstone Ulomi
- Testing Department, Directorate of Testing and Calibration, Tanzania Bureau of Standards, Dar es Salaam, Tanzania
| | - Mecky I N Matee
- Department of Microbiology and Immunology, School of Diagnostic Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- SACIDS Foundation for One Health (SACIDS), Sokoine University of Agriculture (SUA), Morogoro, Tanzania
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Kiiti RW, Komba EV, Msoffe PL, Mshana SE, Rweyemamu M, Matee MIN. Antimicrobial Resistance Profiles of Escherichia coli Isolated from Broiler and Layer Chickens in Arusha and Mwanza, Tanzania. Int J Microbiol 2021; 2021:6759046. [PMID: 34721584 PMCID: PMC8556130 DOI: 10.1155/2021/6759046] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/22/2021] [Accepted: 09/27/2021] [Indexed: 12/02/2022] Open
Abstract
The rise in the spread of antibiotic-resistant pathogens such as Escherichia coli is one of the very important dynamics off-putting treatment and prophylaxis possibilities, hence posing a threat to the modern human medicine, veterinary medicine, and food safety. Therefore, the aim of this study was to determine antimicrobial resistance profiles in E. coli isolates obtained from broiler and layer chickens in Mwanza and Arusha regions in Tanzania. A cross-sectional study was carried out from February to March, 2021, in 402 poultry farms in Mwanza (201) and Arusha (201) regions in Tanzania. All samples that tested positive for E. coli were confirmed using MALDI-TOF MS, and two hundred and four (204) E. coli isolates were randomly chosen and subjected to antimicrobial susceptibility testing by disc diffusion method. Data were entered in Microsoft Excel® and analyzed using SPSS version 20. Isolates were tested against seven antimicrobial agents belonging to seven classes of antimicrobials. All the tested isolates (n = 204) were resistant to at least one antimicrobial agent. Overall, the highest resistance was observed in ampicillin (100%), whereas the lowest resistance was recorded for gentamicin (10.3%). Majority of the isolates (86.76%) were multidrug resistant. Antimicrobial resistance of E. coli to four classes of antimicrobial agents was the highest in this study (31.1%). Six of the 177 tested isolates (2.9%) were resistant to the seven classes of antimicrobial agents. 21 of the 204 (10.29%) isolates were ESBL producers where 21/21 (100%) isolates expressed bla TEM genes and only two isolates expressed (2/21) bla CTX-M gene. The isolates obtained in this study displayed high resistance to commonly used antimicrobial agents in veterinary and human medicine. This implies that there is existence of practices that accelerate antimicrobial resistance in the production of the sampled birds and therefore integration of appropriate use of antimicrobial agents and other measures that curb the spread of resistant genes is necessary.
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Affiliation(s)
- Ruth W. Kiiti
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
| | - Erick V. Komba
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
| | - Peter L. Msoffe
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro, Tanzania
| | - Stephen E. Mshana
- Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza 33109, Tanzania
| | - Mark Rweyemamu
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, Morogoro 67125, Tanzania
| | - Mecky I. N. Matee
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, Morogoro 67125, Tanzania
- Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam 11103, Tanzania
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Kimera ZI, Mgaya FX, Mshana SE, Karimuribo ED, Matee MIN. Occurrence of Extended Spectrum Beta Lactamase (ESBL) Producers, Quinolone and Carbapenem Resistant Enterobacteriaceae Isolated from Environmental Samples along Msimbazi River Basin Ecosystem in Tanzania. Int J Environ Res Public Health 2021; 18:ijerph18168264. [PMID: 34444027 PMCID: PMC8394723 DOI: 10.3390/ijerph18168264] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/24/2021] [Accepted: 07/28/2021] [Indexed: 12/18/2022]
Abstract
We conducted environmental surveillance of antimicrobial resistance (AMR) bacteria in the Msimbazi river basin in Tanzania to determine the occurrence of extended-spectrum β-lactamase (ESBL)-producing, carbapenem resistant Enterobacteriaceae (CRE) and quinolone resistant Escherichia coli and Klebsiella spp. A total of 213 Enterobacteriaceae isolates were recovered from 219 samples. Out of the recovered isolates, 45.5% (n = 97) were Klebsiella pneumoniae and 29.6% (n = 63) were Escherichia coli. K. pneumoniae isolates were more resistant in effluent (27.9%) compared to the E. coli (26.6%). The E. coli had a higher resistance in river water, sediment and crop soil than the K. pneumoniae (35 versus 25%), respectively. Higher resistance in K. pneumoniae was found in nalidixic acid (54.6%) and ciprofloxacin (33.3%) while the E. coli isolates were highly resistant to ciprofloxacin (39.7%) and trimethoprim/sulfamethoxazole (38%). Resistance increased from 28.3% in Kisarawe, where the river originates, to 59.9% in Jangwani (the middle section) and 66.7% in Upanga West, where the river enters the Indian Ocean. Out of 160 E. coli and K. pneumoniae isolates, 53.2% (n = 85) were resistant to more than three classes of the antibiotic tested, occurrence being higher among ESBL producers, quinolone resistant and carbapenem resistant strains. There is an urgent need to curb environmental contamination with antimicrobial agents in the Msimbazi Basin.
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Affiliation(s)
- Zuhura I. Kimera
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam 11103, Tanzania; (F.X.M.); (M.I.N.M.)
- Ministry of Livestock and Fisheries, Mtumba Area, P.O. Box 2182, Dodoma 40487, Tanzania
- Correspondence:
| | - Fauster X. Mgaya
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam 11103, Tanzania; (F.X.M.); (M.I.N.M.)
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza 33109, Tanzania;
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, Morogoro 67125, Tanzania;
| | - Esron D. Karimuribo
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, Morogoro 67125, Tanzania;
- Department of Veterinary Medicine and Public Health, Sokoine University of Agriculture, P.O. Box 3021, Morogoro 67125, Tanzania
| | - Mecky I. N. Matee
- Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam 11103, Tanzania; (F.X.M.); (M.I.N.M.)
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, Morogoro 67125, Tanzania;
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Frumence G, Mboera LEG, Sindato C, Katale BZ, Kimera S, Metta E, Durrance-Bagale A, Jung AS, Mshana SE, Clark TG, Rweyemamu M, Legido-Quigley H, Matee MIN. The Governance and Implementation of the National Action Plan on Antimicrobial Resistance in Tanzania: A Qualitative Study. Antibiotics (Basel) 2021; 10:273. [PMID: 33803077 PMCID: PMC7998560 DOI: 10.3390/antibiotics10030273] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 02/15/2021] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 12/17/2022] Open
Abstract
Tanzania launched its first National Action Plan (NAP) on antimicrobial resistance (AMR) in 2017 to reduce the burden of AMR in the country and contribute to the global response. We aimed to analyze the implementation of the NAP on AMR in Tanzania using the governance framework. In-depth interviews were conducted with human and animal health practitioners and national-level policy actors. We adapted Chua's AMR governance framework to analyze the development and implementation of the NAP in Tanzania. Implementation of the NAP has realized several achievements, including: (i) the establishment of a functioning Multi-Sectoral Coordinating Committee for coordinating the implementation of AMR activities; (ii) existence of governance structure; (iii) establishment of human and animal surveillance sites; (iv) creation of AMR awareness in the community and (v) availability of guidelines at the health facility level to ensure AMR stewardship. However, some dimensions of the governance areas, including reporting and feedback mechanisms, accountability, transparency and sustainability of AMR plans, are not effectively implemented. Addressing these challenges should involve strengthening the collaboration of the different sectors involved at different NAP implementation levels by careful planning and coordination, and provision of adequate resources to ensure sustainability.
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Affiliation(s)
- Gasto Frumence
- Muhimbili University of Health and Allied Sciences, Dar es Salaam 65001, Tanzania; (E.M.); (M.I.N.M.)
- Eastern and Southern Africa Centers of Excellence for Infectious Diseases of Humans and Animals (SACIDS-ACE), Morogoro 3019, Tanzania; (L.E.G.M.); (C.S.); (B.Z.K.); (S.K.); (S.E.M.); (M.R.)
| | - Leonard E. G. Mboera
- Eastern and Southern Africa Centers of Excellence for Infectious Diseases of Humans and Animals (SACIDS-ACE), Morogoro 3019, Tanzania; (L.E.G.M.); (C.S.); (B.Z.K.); (S.K.); (S.E.M.); (M.R.)
| | - Calvin Sindato
- Eastern and Southern Africa Centers of Excellence for Infectious Diseases of Humans and Animals (SACIDS-ACE), Morogoro 3019, Tanzania; (L.E.G.M.); (C.S.); (B.Z.K.); (S.K.); (S.E.M.); (M.R.)
- Tabora Research Centre, National Institute for Medical Research, Tabora 45026, Tanzania
| | - Bugwesa Z. Katale
- Eastern and Southern Africa Centers of Excellence for Infectious Diseases of Humans and Animals (SACIDS-ACE), Morogoro 3019, Tanzania; (L.E.G.M.); (C.S.); (B.Z.K.); (S.K.); (S.E.M.); (M.R.)
- Tanzania Commission for Science and Technology, Dar es Salaam 4302, Tanzania
| | - Sharadhuli Kimera
- Eastern and Southern Africa Centers of Excellence for Infectious Diseases of Humans and Animals (SACIDS-ACE), Morogoro 3019, Tanzania; (L.E.G.M.); (C.S.); (B.Z.K.); (S.K.); (S.E.M.); (M.R.)
- Sokoine University of Agriculture, Morogoro 3019, Tanzania
| | - Emmy Metta
- Muhimbili University of Health and Allied Sciences, Dar es Salaam 65001, Tanzania; (E.M.); (M.I.N.M.)
| | - Anna Durrance-Bagale
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (A.D.-B.); (A.-S.J.); (T.G.C.); (H.L.-Q.)
| | - Anne-Sophie Jung
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (A.D.-B.); (A.-S.J.); (T.G.C.); (H.L.-Q.)
| | - Stephen E. Mshana
- Eastern and Southern Africa Centers of Excellence for Infectious Diseases of Humans and Animals (SACIDS-ACE), Morogoro 3019, Tanzania; (L.E.G.M.); (C.S.); (B.Z.K.); (S.K.); (S.E.M.); (M.R.)
- Catholic University of Health and Allied Sciences, Mwanza 33109, Tanzania
| | - Taane G. Clark
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (A.D.-B.); (A.-S.J.); (T.G.C.); (H.L.-Q.)
| | - Mark Rweyemamu
- Eastern and Southern Africa Centers of Excellence for Infectious Diseases of Humans and Animals (SACIDS-ACE), Morogoro 3019, Tanzania; (L.E.G.M.); (C.S.); (B.Z.K.); (S.K.); (S.E.M.); (M.R.)
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Morogoro 3019, Tanzania
| | - Helena Legido-Quigley
- London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK; (A.D.-B.); (A.-S.J.); (T.G.C.); (H.L.-Q.)
| | - Mecky I. N. Matee
- Muhimbili University of Health and Allied Sciences, Dar es Salaam 65001, Tanzania; (E.M.); (M.I.N.M.)
- Eastern and Southern Africa Centers of Excellence for Infectious Diseases of Humans and Animals (SACIDS-ACE), Morogoro 3019, Tanzania; (L.E.G.M.); (C.S.); (B.Z.K.); (S.K.); (S.E.M.); (M.R.)
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Myemba DT, Bwire GM, Sambayi G, Maganda BA, Njiro BJ, Ndumwa HP, Majani F, Kunambi PP, Matee MIN. Clinical characteristics and treatment outcomes of patients with MDR tuberculosis in Dar Es Salaam region, Tanzania. JAC Antimicrob Resist 2020; 2:dlaa108. [PMID: 34223058 PMCID: PMC8210025 DOI: 10.1093/jacamr/dlaa108] [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] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 11/09/2020] [Indexed: 11/13/2022] Open
Abstract
Background In Tanzania more than 28% of all multi-drug resistant tuberculosis (MDR-TB) cases occur in Dar es Salaam. However, information about management and clinical outcomes of patients with MDR-TB in the region is scarce, and hence the need for this study. Methods A 5-year retrospective cohort study was conducted in six centres in Dar es Salaam. Descriptive statistics were used to summarize social demographics and clinical characteristics. Associations between occurrence of adverse events, regimen change and cure were determined using the Chi-square test whereas factors associated with mortality were determined using the Log-ranking test and Cox regression model. Results Three-hundred patient files were found and reviewed. The majority were male 199 (66.3%), aged 25-44 years [176 (58.7%)] and 89 (30.1%) were HIV co-infected. 186 (62%) completed their treatment, 68 (22.0%) were on treatment and 9 (3.3%) were lost to follow-up. The majority, 152 (51.0%) were managed using long MDR-TB regimens. The overall mortality rate was 5.7 per 1000 MDR-TB patients. A higher mortality rate was associated with being ≥45 years [adjusted hazard ratio (AHR): 10.82, 95% CI: 1.14-102.74, P = 0.038), female (AHR: 5.92, 95% CI: 1.75-20.08, P = 0.004), on a short anti-TB regimen (AHR: 4.34, 95% CI: 1.41-13.35, P = 0.010), HIV co-infected [crude hazard ratio (CHR): 2.56, 95% CI: 1.01-6.50, P = 0.048), on concomitant long-term medication use (CHR: 2.99, 95% CI: 1.17-7.64, P = 0.022) and having other co-morbidities (CHR: 3.45, 95% CI: 1.32-9.02, P = 0.011). Conclusions MDR-TB mortality was associated with short anti-TB regimens, sex, age, concomitant long-term medication use and HIV coinfection. In this population, use of long and individualized regimens is recommended.
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Affiliation(s)
- David T Myemba
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - George M Bwire
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Godfrey Sambayi
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Betty A Maganda
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Belinda J Njiro
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Harrieth P Ndumwa
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Frank Majani
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Peter P Kunambi
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
| | - Mecky I N Matee
- School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
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Kimera ZI, Frumence G, Mboera LEG, Rweyemamu M, Mshana SE, Matee MIN. Assessment of Drivers of Antimicrobial Use and Resistance in Poultry and Domestic Pig Farming in the Msimbazi River Basin in Tanzania. Antibiotics (Basel) 2020; 9:antibiotics9120838. [PMID: 33255152 PMCID: PMC7760815 DOI: 10.3390/antibiotics9120838] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [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: 09/06/2020] [Revised: 10/23/2020] [Accepted: 10/28/2020] [Indexed: 11/22/2022] Open
Abstract
Uncontrolled use of drugs both in humans and animals coupled with environmental contamination exacerbate the development and spread of antimicrobial resistance. This paper assessed the drivers of antimicrobial use and resistance in poultry and domestic pig farming and the environment. Questionnaires, in-depth interviews, and focus group discussions (FGDs) were used to collect information regarding demographic characteristics, knowledge, practices, attitudes, and perceptions of the drivers of antimicrobial use and resistance in animal farming and the environment. We found a higher proportion of usage of veterinary antimicrobials for prophylactic purposes (87.6%) in animal farming, than for therapeutic purposes (80.5%). The degree of farming experience was significantly (p < 0.05) related to the knowledge on the source of antimicrobial use, methods used in disease diagnosis, access to veterinary services, stocking of antimicrobials at home, and presence of agriculture activities that involve the use of manure. Uncontrolled disposal of wastes from households, disposal of human and veterinary drugs, and weak implementation of the legal framework was identified as the major contributors to the environment. The high usage of veterinary antimicrobials and the environmental contamination identified requires multisectoral interventions, as well as a review of government strategies, policies, and regulations on antimicrobial use.
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Affiliation(s)
- Zuhura I. Kimera
- Muhimbili University of Health and Allied Sciences, P.O. Box 65001, 11103 Dar es Salaam, Tanzania; (G.F.); (M.I.N.M.)
- Ministry of Livestock and Fisheries, Mtumba Area, P.O. Box 2182, 40487 Dodoma, Tanzania
- Correspondence:
| | - Gasto Frumence
- Muhimbili University of Health and Allied Sciences, P.O. Box 65001, 11103 Dar es Salaam, Tanzania; (G.F.); (M.I.N.M.)
| | - Leonard E. G. Mboera
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, 67125 Morogoro, Tanzania; (L.E.G.M.); (M.R.)
| | - Mark Rweyemamu
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, 67125 Morogoro, Tanzania; (L.E.G.M.); (M.R.)
| | - Stephen E. Mshana
- Catholic University of Health and Allied Sciences, P.O. Box 1464, 33109 Mwanza, Tanzania;
| | - Mecky I. N. Matee
- Muhimbili University of Health and Allied Sciences, P.O. Box 65001, 11103 Dar es Salaam, Tanzania; (G.F.); (M.I.N.M.)
- SACIDS Africa Centre of Excellence for Infectious Diseases, Sokoine University of Agriculture, P.O. Box 3297, 67125 Morogoro, Tanzania; (L.E.G.M.); (M.R.)
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Kimera ZI, Mshana SE, Rweyemamu MM, Mboera LEG, Matee MIN. Antimicrobial use and resistance in food-producing animals and the environment: an African perspective. Antimicrob Resist Infect Control 2020; 9:37. [PMID: 32122406 PMCID: PMC7053060 DOI: 10.1186/s13756-020-0697-x] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [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: 07/09/2019] [Accepted: 02/07/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND The overuse of antimicrobials in food animals and the subsequent contamination of the environment have been associated with development and spread of antimicrobial resistance. This review presents information on antimicrobial use, resistance and status of surveillance systems in food animals and the environment in Africa. METHODS Information was searched through PubMed, Google Scholar, Web of Science, and African Journal Online databases. Full-length original research and review articles on antimicrobial use, prevalence of AMR from Africa covering a period from 2005 to 2018 were examined. The articles were scrutinized to extract information on the antimicrobial use, resistance and surveillance systems. RESULTS A total of 200 articles were recovered. Of these, 176 studies were included in the review while 24 articles were excluded because they were not relevant to antimicrobial use and/or resistance in food animals and the environment. The percentage of farms using antimicrobials in animal production ranged from 77.6% in Nigeria to 100% in Tanzania, Cameroon, Zambia, Ghana and Egypt. The most antibiotics used were tetracycline, aminoglycoside and penicillin groups. The percentage of multi drug resistant isolates ranged from 20% in Nigeria to 100% in South Africa, Zimbabwe and Tunisia. In the environment, percentage of multi drug resistant isolates ranged from 33.3% in South Africa to 100% in Algeria. None of the countries documented national antimicrobial use and resistance surveillance system in animals. CONCLUSION There is high level of antimicrobial use, especially tetracycline, aminoglycoside and penicillin in animal production systems in Africa. This is likely to escalate the already high prevalence of antimicrobial resistance and multi drug resistance in the continent. This, coupled with weak antimicrobial resistance surveillance systems in the region is a great concern to the animals, environment and humans as well.
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Affiliation(s)
- Zuhura I Kimera
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
- Ministry of Livestock and Fisheries, Dodoma, Tanzania.
| | - Stephen E Mshana
- Department of Microbiology and Immunology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Mark M Rweyemamu
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Chuo Kikuu Morogoro, Tanzania
| | - Leonard E G Mboera
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Chuo Kikuu Morogoro, Tanzania
| | - Mecky I N Matee
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- SACIDS Foundation for One Health, Sokoine University of Agriculture, Chuo Kikuu Morogoro, Tanzania
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Mawazo A, Bwire GM, Matee MIN. Performance of Widal test and stool culture in the diagnosis of typhoid fever among suspected patients in Dar es Salaam, Tanzania. BMC Res Notes 2019; 12:316. [PMID: 31167646 PMCID: PMC6551910 DOI: 10.1186/s13104-019-4340-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 12/15/2018] [Accepted: 05/23/2019] [Indexed: 11/16/2022] Open
Abstract
Objective We set an experiment to determine the diagnostic performance of the Widal test and stool culture in typhoid-suspected cases attending tertiary hospitals in Dar es Salaam, Tanzania using blood culture as a golden standard. We also evaluated the agreement between Widal, stool and blood culture. Results This was a cross-sectional study conducted between June and September 2018, in three Regional Referral Hospitals in Dar es Salaam, Tanzania. A total of 158 typhoid-suspected cases were enrolled, after obtaining an informed consent. Of the 158 patients participated in the study, 128 (81%) tested positive for the Widal test and 17 (11%) patients were stool culture positive. Widal test recorded 81.5% sensitivity, 18.3% specificity, 10.1% positive predictive value and 89.7% negative predictive value. Stool culture showed 31.3% sensitivity, 91.5% specificity, 29% positive predictive value and 91.5% negative predictive value. In conclusion, Widal test is not reliable for diagnosis of typhoid fever since false positive and negative results are common. In addition, Widal test recorded poor agreement with the blood culture (kappa = 0.014, p < 0.05) while stool culture had strong agreement with the blood culture (kappa = 0.22, p < 0.05).
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Affiliation(s)
- Akili Mawazo
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.
| | - George M Bwire
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania.,Department of Pharmaceutical Microbiology, School of Pharmacy, Muhimbili University of Health and Allied Sciences, P.O. Box 65013, Dar es Salaam, Tanzania
| | - Mecky I N Matee
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania
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Somi G, Majigo M, Manyahi J, Nondi J, Agricola J, Sambu V, Todd J, Rwebembera A, Makyao N, Ramadhani A, Matee MIN. Pediatric HIV care and treatment services in Tanzania: implications for survival. BMC Health Serv Res 2017; 17:540. [PMID: 28784131 PMCID: PMC5547461 DOI: 10.1186/s12913-017-2492-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Accepted: 08/01/2017] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Improving child survival for HIV-infected children remains an important health agenda. We present progress regarding care and treatment services to HIV infected children in Tanzania. METHODS The National AIDS Control Programme Care and Treatment (CTC 2) database was used to obtain information of all children aged 0-14yearsenrolled in the HIV Care and Treatment Program between January 2011 and December 2014. We assessed eligibility for ART, time from enrolment to ART initiation, nutritional status, and mortality using Kaplan-Meier methods. RESULTS A total of 29,531 (14,304 boys and 15,227 girls) ART-naive children aged 0-14 years were enrolled during the period, approximately 6700 to 8000 children per year. The male to female ratio was 48:50. At enrolment 72% were eligible for ART, 2-3% of children were positive for TB, and 2-4% were severely malnourished. Between 2011 and 2014, 2368 (8%) died, 9243 (31%) were Lost to Follow-up and 17,920 (61%) were on care or ART. The probability of death was 31% (95% CI 26-35), 43% (40-47), 52% (49-55) and 61% (58-64) by 1,2, 5 and 10 years of age, respectively. The hazard of death was greatest at very young ages (<2 years old), and decreased sharply by 4 years old. Children who were on ART had around 10-15% higher survival over time. CONCLUSIONS Significant progress has been made regarding provision of paediatric HIV care and treatment in Tanzania. On average 7000 children are enrolled annually, and that approximately two thirds of children diagnosed under the age of 2 years were initiated on ART within a month. Provision of ART as soon as the child is diagnosed is the biggest factor in improving survival. However we noted that i) most children had advanced disease at the time of enrolment ii) approximately two-thirds of children were missing a baseline CD4 measurement and only 35% of children had either a CD4 count or percentage recorded, indicating limited access to CD4 testing services, and iii) 31% were lost to follow-up (LTFU). These challenges need to be addressed to improve early detection, enrolment and retention of HIV-infected children into care and improve documentation of services offered.
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Affiliation(s)
- G Somi
- National AIDS Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Mwanza, Tanzania
| | - M Majigo
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Mwanza, Tanzania
| | - J Manyahi
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Mwanza, Tanzania
| | - J Nondi
- National AIDS Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Mwanza, Tanzania
| | - J Agricola
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Mwanza, Tanzania
| | - V Sambu
- National AIDS Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Mwanza, Tanzania
| | - J Todd
- London School of Hygiene and Tropical Medicine and National Institute for Medical Research (NIMR), Mwanza, Tanzania
| | - A Rwebembera
- National AIDS Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Mwanza, Tanzania
| | - N Makyao
- National AIDS Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Mwanza, Tanzania
| | - A Ramadhani
- National AIDS Control Programme, Ministry of Health, Community Development, Gender, Elderly and Children, Mwanza, Tanzania
| | - MIN Matee
- Department of Microbiology and Immunology, School of Medicine, Muhimbili University of Health and Allied Sciences, Mwanza, Tanzania
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Runyoro DKB, Joseph CC, Ngassapa OD, Darokar MP, Srivastava SK, Matee MIN, Wright CW. Anticandida Agents from a Tanzanian Plant Albizia anthelmintica. J CHIN CHEM SOC-TAIP 2015. [DOI: 10.1002/jccs.201500161] [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: 11/11/2022]
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Hamza OJM, Matee MIN, Moshi MJ, Simon ENM, Mugusi F, Mikx FHM, Helderman WHVP, Rijs AJMM, van der Ven AJAM, Verweij PE. Species distribution and in vitro antifungal susceptibility of oral yeast isolates from Tanzanian HIV-infected patients with primary and recurrent oropharyngeal candidiasis. BMC Microbiol 2008; 8:135. [PMID: 18694525 PMCID: PMC2518160 DOI: 10.1186/1471-2180-8-135] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [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: 04/28/2008] [Accepted: 08/12/2008] [Indexed: 12/04/2022] Open
Abstract
Background In Tanzania, little is known on the species distribution and antifungal susceptibility profiles of yeast isolates from HIV-infected patients with primary and recurrent oropharyngeal candidiasis. Methods A total of 296 clinical oral yeasts were isolated from 292 HIV-infected patients with oropharyngeal candidiasis at the Muhimbili National Hospital, Dar es Salaam, Tanzania. Identification of the yeasts was performed using standard phenotypic methods. Antifungal susceptibility to fluconazole, itraconazole, miconazole, clotrimazole, amphotericin B and nystatin was assessed using a broth microdilution format according to the guidelines of the Clinical and Laboratory Standard Institute (CLSI; M27-A2). Results Candida albicans was the most frequently isolated species from 250 (84.5%) patients followed by C. glabrata from 20 (6.8%) patients, and C. krusei from 10 (3.4%) patients. There was no observed significant difference in species distribution between patients with primary and recurrent oropharyngeal candidiasis, but isolates cultured from patients previously treated were significantly less susceptible to the azole compounds compared to those cultured from antifungal naïve patients. Conclusion C. albicans was the most frequently isolated species from patients with oropharyngeal candidiasis. Oral yeast isolates from Tanzania had high level susceptibility to the antifungal agents tested. Recurrent oropharyngeal candidiasis and previous antifungal therapy significantly correlated with reduced susceptibility to azoles antifungal agents.
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Affiliation(s)
- Omar J M Hamza
- Department of Oral Surgery and Oral Pathology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
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van den Bout-van den Beukel CJP, Hamza OJM, Moshi MJ, Matee MIN, Mikx F, Burger DM, Koopmans PP, Verweij PE, Schoonen WGEJ, van der Ven AJAM. Evaluation of cytotoxic, genotoxic and CYP450 enzymatic competition effects of Tanzanian plant extracts traditionally used for treatment of fungal infections. Basic Clin Pharmacol Toxicol 2008; 102:515-26. [PMID: 18331392 DOI: 10.1111/j.1742-7843.2008.00225.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
HIV-infected patients in sub-Saharan countries highly depend on traditional medicines for the treatment of opportunistic oral infections as candidiasis. Previous investigations on antifungal activity of medicinal plant extracts utilized by traditional healers in Tanzania have revealed 12 extracts with potent antifungal activity. Although the plants may be good candidates for new treatment opportunities, they can be toxic or genotoxic and could cause pharmacokinetic interactions when used concomitantly with antiretroviral agents. Therefore, we investigated the cytotoxicity, genotoxicity and cytochrome P450 interaction potential of these medicinal plants. Cytotoxicity was tested by Hoechst 33342, Alamar Blue, calcein-AM, glutathione depletion and O(2)-consumption assays and genotoxicity by a Vitotox assay. Competition of the 12 extracts on substrate metabolism by CYP3A4, 2C9, 2C19 and 2D6 was tested with high-throughput CYP inhibition screening. Pregnane X receptor (PXR) activation was tested using Chinese hamster ovary cell lines expressing human PXR. Herbal extracts inducing high human PXR activation were tested for enhanced CYP3A4 mRNA levels with quantitative polymerase chain reaction. Genotoxicity was found for Jatropha multifida, Sterculia africana and Spirostachys africana. All plant extracts showed high cytotoxic effects in almost all tests. Potent competition with CYP3A4, 2D6, 2C9 and 2C19 was found for 75% of the herbal extracts. Spirostachys africana did not affect CYP2D6 and for S. africana and Turraea holstii no effect on CYP2D6 and CYP3A4 (DBF) was found. Nine plant extracts showed significant activation of human PXR, but only Agaura salicifolia, Turraea holstii and S. africana significantly induced CYP3A4 mRNA levels. These results indicate the possibility of potential medicinal plant-antiretroviral interactions.
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Moshi MJ, van den Beukel CJP, Hamza OJM, Mbwambo ZH, Nondo ROS, Masimba PJ, Matee MIN, Kapingu MC, Mikx F, Verweij PE, van der Ven AJAM. Brine shrimp toxicity evaluation of some Tanzanian plants used traditionally for the treatment of fungal infections. Afr J Tradit Complement Altern Med 2006; 4:219-25. [PMID: 20162095 DOI: 10.4314/ajtcam.v4i2.31211] [Citation(s) in RCA: 14] [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] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Plants which are used by traditional healers in Tanzania have been evaluated to obtain preliminary data of their toxicity using the brine shrimps test. The results indicate that 9 out of 44 plant species whose extracts were tested exhibited high toxicity with LC(50) values below 20 microg/ml. These include Aloe lateritia Engl. (Aloaceae) [19.1 microg/ml], Cassia abbreviata Oliv. (Caesalpiniaceae) [12.7 microg/ml], Croton scheffleri Pax (Euphorbiaceae) [13.7 microg/ml], Hymenodactyon parvifolium Brig (Rubiaceae) [13.4 microg/ml], Kigelia Africana L. (Bignoniaceae) [7.2 microg/ml], and Ocimum suave Oliv. (Labiatae) [16.7 microg/ml]. Twelve plants gave LC(50) values between 21 and 50 microg/ml, 11 plants gave LC(50) values between 50 and 100 microg/ml, and 18 plants gave LC(50) values greater than 100 microg/ml.
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Affiliation(s)
- Mainen J Moshi
- Institute of Traditional Medicine, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
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Hamza OJM, van den Bout-van den Beukel CJP, Matee MIN, Moshi MJ, Mikx FHM, Selemani HO, Mbwambo ZH, Van der Ven AJAM, Verweij PE. Antifungal activity of some Tanzanian plants used traditionally for the treatment of fungal infections. J Ethnopharmacol 2006; 108:124-32. [PMID: 16829001 DOI: 10.1016/j.jep.2006.04.026] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2005] [Revised: 04/05/2006] [Accepted: 04/26/2006] [Indexed: 05/10/2023]
Abstract
Using the ethnobotanical approach, some Tanzanian plants reported to be used by traditional healers for the treatment of oral candidiasis and fungal infections of the skin were collected and screened for their antifungal activity against Candida albicans, Candida glabrata, Candida tropicalis, Candida parapsilosis, Candida krusei and Cryptococcus neoformans. A total of 65 crude methanol extracts belonging to 56 plant species and 38 families were screened using the broth microdilution method, according to the guidelines of the Clinical and Laboratory Standard Institute (CLSI) (formerly, National Committee for Clinical and Laboratory Standards) [National Committee for Clinical Laboratory Standards, 2002. Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts. Approved Standard-2nd Edition M27-A2, National Committee for Clinical Laboratory Standards, Wayne, PA, USA]. Among the tested plant species, 45% (25 species) showed antifungal activity against one or more of the test fungi. The most susceptible yeasts were Cryptococcus neoformans, followed by Candida krusei, Candida tropicalis, and Candida parapsilosis. The least susceptible were Candida albicans and Candida glabrata. Strong antifungal activity was exhibited by extracts of Clausena anisata Oliv., Sclerocariya birrea Sond, Turraea holstii Gurk, Sterculia africana (Lour) Fiori, Acacia robusta subsp. Usambarensis (Taub) Brenan, Cyphosterma hildebrandti (Gilg), Desc, Elaeodendron buchannanii (Lows), Acacia nilotica (L.) Wild ex Del, Jatropha multifida L., and Pteridium aquilinum (L.) Kuhn.
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Affiliation(s)
- Omar J M Hamza
- Department of Oral Surgery and Oral Pathology, Muhimbili University College of Health Sciences, P.O. Box 65014, Dar es Salaam, Tanzania.
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Basra D, Matee MIN, McNerney R. Quality assessment of sputum smear microscopy for detection of acid fast bacilli in peripheral health care facilities in Dar es Salaam, Tanzania. ACTA ACUST UNITED AC 2006; 83:306-10. [PMID: 16989375 DOI: 10.4314/eamj.v83i6.9437] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND There is no published information regarding the quality of sputum smear microscopy in Tanzania. OBJECTIVE To evaluate technical quality and results of smear microscopy for acid-fast bacilli (AFB) in peripheral health care facilities in Kinondoni and Ilala Districts in Dar es Salaam, Tanzania. DESIGN Cross-sectional study. SETTING All tuberculosis diagnostic centres in Dar es Salaam, Tanzania. RESULTS The proportion of well prepared smears was 86.2% and that of well stained smears was 81.2%. The overall average agreement in reading was (89.2%). The overall sensitivity was 88.5% and specificity was 100%. High false negatives (HFN) were the major errors found in this study and Low false negative (LFN) and quantification errors (QE) were the minor errors found. There were no false positive errors. Minor errors occurred more frequently in hospitals than dispensaries, while major errors occurred more frequently in dispensaries than in hospitals. CONCLUSIONS The types of errors found in this survey, HFN, LFN and QE, suggest a systematic under-reading of smears in all the surveyed health facilities, probably due to a number of technical factors (quality of smears, poor stains, bad microscopes, or inadequate training) and other factors such as overwork and lack of motivation which need to be addressed. RECOMMENDATIONS Regular supervision using the new WHO quality assurance guidelines should be conducted countrywide. We do recommend that blind re-checking as the most efficient means of making the first broad assessment of sputum smear microscopy in Tanzania.
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Affiliation(s)
- D Basra
- National Tuberculosis and Leprosy Programme, Ministry of Health, P.O. Box 9083, Dar es Salaam, Tanzania
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Matee MIN, Scheutz F, Simon ENM, Lembariti BS. Patients' satisfaction with dental care provided by public dental clinics in Dar es Salaam, Tanzania. East Afr Med J 2006; 83:98-104. [PMID: 16863005 DOI: 10.4314/eamj.v83i4.9423] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In Tanzania, patient satisfaction with dental services has received only minor attention. OBJECTIVE To assess patients' satisfaction with public dental health services in Dar es Salaam. DESIGN A cross-sectional study. SETTING Five public dental clinics randomly selected from a list of all the nine public dental clinics in Dar es Salaam. SUBJECTS Five hundred and sixteen consecutive patients, 193 males and 323 females aged between 12 and 77 years who, during the study period between July and November, 2002 were attending five dental clinics were randomly selected. RESULTS No significant differences in patients' satisfaction level (overall or for the specific studied items) were found in all the five public dental clinics. The answers to the specific sub-items, apart from time spent with doctor, were around the average with very few responses with a high ranking. CONCLUSIONS Findings indicate a moderate level of patient satisfaction with dental care offered in public dental clinics in Dar es Salaam. Areas identified as needing improvement included; technical quality of care, interpersonal aspects and communication.
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Affiliation(s)
- M I N Matee
- Muhimbili University College of Health Sciences, Department of Microbiology/Immunology, School of Medicine, P.O. Box 65347, Dar es Salaam, Tanzania
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Runyoro DKB, Ngassapa OD, Matee MIN, Joseph CC, Moshi MJ. Medicinal plants used by Tanzanian traditional healers in the management of Candida infections. J Ethnopharmacol 2006; 106:158-65. [PMID: 16458463 DOI: 10.1016/j.jep.2005.12.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2004] [Revised: 09/02/2005] [Accepted: 12/12/2005] [Indexed: 05/06/2023]
Abstract
An ethnomedical survey in Coast, Dar es Salaam, Morogoro and Tanga regions of Tanzania has resulted in the identification of 36 plant species belonging to 21 plant families that are used traditionally for the treatment of Candida infections. Twenty-one plants constituting 58.3% of all collected plants are used to treat of oral candidiasis (Utando) one of the important signs of HIV/AIDS. The knowledge of traditional healers for the treatment of Candida infections has been highly supported by the literature in that 13 (36.1%) out of the 36 plants identified have been proven to be active against Candida albicans and/or other species of Candida. Also, some of the plants were reported to be active against other species of fungi including Cryptococcus neoformans, one of the important pathogenic fungi in HIV/AIDS. It can be seen that ethnomedical information from traditional healers provides a solid lead towards development of new drugs than random screening. The task that remains is to screen extracts prepared from these plants and perform a bioassay-guided fractionation of the active extracts so as to isolate the active compounds from these plants.
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Affiliation(s)
- D K B Runyoro
- Department of Pharmacognosy, School of Pharmacy, Muhimbili University College of Health Sciences, P.O. Box 65013, Dar es Salaam, Tanzania
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Abstract
OBJECTIVES Atraumatic Restorative Treatment (ART), which involves the use of hand instruments, is a relatively inexpensive, non-sophisticated, tooth conservative technique that offers the opportunity for restorative work in remote areas without electricity. The objectives of this survey were to evaluate the experience of dental practitioners with ART and the impact of the technique on oral health care in Tanzania, where ART was pioneered. METHODS Dental officers (DOs), assistant dental officers (ADOs) and dental therapists (DTs) from different parts of the Tanzania mainland participated in a cross-sectional study that gathered information using a self-administered structured questionnaire. RESULTS Only 41 (35%) of the 117 respondents were practising ART with only 6.5% of them doing so either "most of the time" or "always". Practising ART was significantly associated with the cadre of the dental practitioner, being higher among ADOs (50%) than DOs (37%) and DTs (20%), and with ART training, but was not related to either working experience or material availability. CONCLUSIONS To date, ART has made little impact on oral health care delivery in Tanzania, where dental extractions still account for over 90% of all forms of dental treatment, and restorative work for less than 5%. Several problems in providing ART were noted, such as limited practical training and practice in ART, scarce resources, and lack of advocacy. RECOMMENDATIONS An increased involvement and support for ART from the Ministry of Health and professional organisations, and public education of ART is called for.
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Affiliation(s)
- G J Mandari
- Department of Restortive Dentistry, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
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Namkinga LA, Matee MIN, Kivaisi AK, Moshiro C. Prevalence and risk factors for vaginal candidiasis among women seeking primary care for genital infections in Dar es Salaam, Tanzania. ACTA ACUST UNITED AC 2005; 82:138-43. [PMID: 16122076 DOI: 10.4314/eamj.v82i3.9270] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the prevalence and risk factors for vaginal candidiasis (VC) among women seeking primary care for genital infections. DESIGN Cross-sectional study. SETTING Ilala Municipal Hospital in Dar es Salaam, Tanzania. SUBJECTS Four hundred and sixty four women presenting with complaints of genital infections. RESULTS Of the 464 women examined, 177 (38.1%) had abnormal vaginal discharge, 68(14.7%) had genital ulcers, 272 (58.6%) had genital pruritus, 18 (3.9%) had genital warts and 58 (12.5%) had chancre. The prevalencies of VC, bacterial vaginosis, HIV, T vaginalis, N. gonorrhoeae and syphilis were 45%, 48.4%, 22%, 93%, 1.5% and 4.3%, respectively. The occurrence of VC was positively associated with HIV, (OR = 1.81, 95% CI (1.0-2.67), bacterial vaginosis; (OR = 2.6, 95% CI (1.7-3.9), genital pruritus; (OR = 1.8 1, 95% CI (1.2-2.7) genital discharge; (OR = 1.867, 95% (1.28-2.73) and negatively with T. vaginalis (OR = 0.27, 95% CI (0.12 - 0.6), occupation (OR = 0.65, 95% CI (0.35-0.86)) and with education (OR = 0.43, 95% CI (0.11-0.73). There were increased but non-significant odds for VC in patients with syphilis (OR = 1.6 95% CI (0.6-4.3) and venereal warts (OR = 2.5 95% CI (0.92-6.8) VC was not associated with N. gonorrhoeae, genital ulcers, age at first intercourse, number of sexual partners, marital status or antibiotic usage. CONCLUSION The high prevalence of vaginal candidiasis among women with genital infections should be taken into account when updating policies concerning syndromic management of sexually transmitted diseases. More gender specific approach to syndromic management of sexually transmitted infections in females should be considered.
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Affiliation(s)
- L A Namkinga
- Applied Microbiology Unit, University of Dar es Salaam, Tanzania
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Namkinga LA, Matee MIN, Kivaisi AK, Kullaya A, Mneney EE. Identification of Candida strains isolated from Tanzanian pregnant women with vaginal candidiasis. ACTA ACUST UNITED AC 2005; 82:226-34. [PMID: 16119751 DOI: 10.4314/eamj.v82i5.9311] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify Candida strains isolated from Tanzanian women (13 to 45 years) with vaginal candidiasis. DESIGN A cross-sectional study. SETTING Antenatal clinic in Ilala district hospital in Dar es Salaam, Tanzania from March 1998 to December 2000. RESULTS The identities of the 272 isolates tested with API Candida were: Candida albicans 180(66.2%), Candida tropicalis 13(4.7%), Candida glabrata 20(7.35%), Candida famata 6(2.2%), Candida parapsilosis 6 (2.2%) and Candida lusitaniae one (0.37%). API Candida could not speciate 43 (15.8%) isolates of these; two (0.7%) fell between C. albicans and C. tropicalis, 17(6.25%) C. lusitaniael, C. guilliermondii/C. famata, 14(5.15%) C. krusei, C. inconspicua, and C. norvegensis and nine (3.3%) either C. parapsilosis, C. krusei, C. incospicua or Geotrichum spp. Four (1.5%) isolates had an assimilation pattern of Trichosporo spp, but were all germ tube positive and had morphological features on cornemeal agar that were consistent with C. albicans. API 20C AUX was used for testing 29 isolates and results showed: 11/29 (37.9%) C. albicans, 1/29 (3.4%) C. tropicalis, 4/29 (13.8%) C. glabrata, 1/29 (3.4%) C. parapsilosis, 1/29 (3.4%) C. famata, 1/29 (3.4%) C. lusitaniae, 1/29 (3.4%) C. colliculosa/C. magnoliae, 5/29(17.2%) C. albicans/ C. tropicals 2/29 (6.8%) C. norvegensis/C. parapsilosis, and 2/29(6.8%) C. kruseil/C. inconspicua. Results of 20 isolates identified by Randomly Amplified Polymorphic DNA (RAPID) technique showed a 95% agreement with API Candida and a 100% agreement with API 20C AUX. CONCLUSION Although most (66.3%) of the species isolated from Dar es Salaam women with vaginal candidiasis were C. albicans, a considerable percentage (33.7%) were non-albicans, mainly C. glabrata, C. krusei and C. tropicalis. The high prevalence of non-albicans Candida spp observed in this population may have therapeutic implications.
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Affiliation(s)
- L A Namkinga
- Applied Microbiology Unit, Department of Botany, Faculty of Medicine, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania
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Mumghamba EGS, Pitiphat W, Matee MIN, Simon E, Merchant AT. The usefulness of using Ramfjord teeth in predicting periodontal status of a Tanzanian adult population. J Clin Periodontol 2004; 31:16-8. [PMID: 15058369 DOI: 10.1111/j.0303-6979.2004.00430.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The only partial mouth index that has been validated against full-mouth examinations in the East African population is the CPITN (Community Periodontal Index of Treatment Needs). Since the Ramfjord index can potentially shorten the examination time by almost half, we evaluated Ramfjord teeth in predicting full-mouth periodontal status of an adult population in Tanzania. MATERIAL AND METHODS Pocket depth was measured for 192 consecutive patients aged from 15 to 77 years (36 years old on average); 86 (45%) females referred to the Department of Restorative Dentistry, Muhimbili National Hospital, Tanzania between January 1997 and December 1999, and the mean pocket depth for full-mouth and Ramfjord teeth was calculated. RESULTS The correlation between the mean pocket depth calculated from the full-mouth and Ramfjord teeth was 0.96. The beta coefficient for the mean pocket depth measured by Ramfjord teeth to predict the full-mouth mean was 0.94, and was not affected by adjustment for age, missing teeth or sex. CONCLUSION This overall high agreement between Ramjford teeth and full-mouth periodontal pocket situation confirms the epidemiological validity of Ramfjord's dental sample in our setting.
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Affiliation(s)
- E G S Mumghamba
- Department of Restorative Dentistry, Faculty of Dentistry, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania.
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Scheutz F, Frydenberg M, Matee MIN, Poulsen S. The effect of choosing different units of analysis when estimating risk of presence of dental caries in the primary dentition. Community Dent Health 2003; 20:27-33. [PMID: 12688601] [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] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
BACKGROUND Data on caries are usually collected with the tooth surface or the tooth as the unit, but subsequently analysed by aggregating the data at the level of the individual. AIMS To evaluate how different units of analysis may affect the result of the statistical analyses in a study of the association between deciduous dental caries and a set of risk factors. METHOD 293 children (mean age: 7.5 yrs) from two primary schools in Dar es Salaam, Tanzania were examined. Thus the study design was cross-sectional. Logistic regression analysis was used to determine the association between caries experience and nutritional status, socioeconomic background, and microbiological and salivary characteristics using the subject, the tooth, and the tooth surface as unit of analysis, allowing for the fact that teeth and surfaces within the same individual must be considered non-independent. RESULTS When aggregated data were used, point estimates were larger in some instances. The precision of the estimates increased considerably when the tooth as compared to the individual was used as the unit of analysis. No or limited gain in precision was obtained when the tooth surface as compared to the tooth was used as unit of analysis. CONCLUSIONS The choice of unit of analysis may strongly influence the result of the statistical analyses and thus the conclusion of an investigation.
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Affiliation(s)
- F Scheutz
- Department of Community Oral Health and Pediatric Dentistry, Dental School, Faculty of Health Sciences, University of Aarhus, Aarhus, Denmark
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Abstract
AIM To provide information on the types and distribution of oral tumours and tumour-like lesions occurring in a Tanzanian child population aged 0-16 years. DESIGN Retrospective study of biopsy results from hospital records from 1982-1997. SETTING Department of Histopathology, the Muhimbili Medical Centre (MMC) in Dar es Salaam. INTERVENTION/ METHODS: A total of 158 biopsy results, from 75 girls and 83 boys, were retrieved and studied. RESULTS Malignant tumours were the most frequent (43.0%) followed by benign tumours (30.4%) and tumour-like lesions (26.6%). Burkitt's lymphoma was the most frequent malignant tumour accounting for 88.2% of all malignancies followed by squamous cell carcinoma (4.4%) and oral Kaposi's sarcoma (2.9%). Fibroma, papilloma and haemangioma were the most frequent benign tumours constituting 27.1%, 14.6% and 12.5%, respectively. Odontogenic cysts were the most frequent tumour-like lesions (28.6%) followed by fibrous dysplasia (19%) and giant cell granuloma (16.7%). CONCLUSION The six most common oral lesions were Burkitt's lymphoma, fibroma, odontogenic cysts, fibrous dysplasia, papilloma and giant cell granuloma.
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Affiliation(s)
- B M Kalyanyama
- Department of Oral Surgery & Oral Pathology, Faculty of Dentistry, Muhimbili University College of Health Sciences, Dar es Salaam, Tanzania
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