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Mrema D, Ngocho JS, Mremi A, Amour M, Machange R, Shayo BC, Alloyce JP, Ndosi E, Shirima BT, Fande D, Shehoza R, Balandya E, Sunguya B, Mshana SE, Mteta AK, Lyamuya E, Bartlett J, Mmbaga BT. Cervical cancer in Northern Tanzania-What do women living with HIV know. Front Oncol 2023; 12:957325. [PMID: 36698389 PMCID: PMC9868899 DOI: 10.3389/fonc.2022.957325] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 12/09/2022] [Indexed: 01/12/2023] Open
Abstract
Background Cervical cancer (CC) is more prevalent in women living with human immunodeficiency virus (HIV) infection compared to the general population. The magnitude is high among all countries burdened with HIV-Tanzania is no exception. Despite the unprecedented risk, women living with HIV (WLHIV) may not be aware of the risk and might have unfounded beliefs thereof. This study aimed to determine the knowledge, awareness, and beliefs on CC screening among WLHIV attending a clinic at the Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania. Methods This hospital-based cross-sectional study was conducted among 327 WLHIV attending care and treatment clinic (CTC) at KCMC. A pre-tested questionnaire was used to collect quantitative data. Both descriptive and regression methods were used to determine CC knowledge, awareness, and beliefs as well as factors associated with knowledge of CC among WLHIV using SPSS version 23. Results Participants' mean age was 46 ± 10.4 years. Although just half (54.7%) of WLHIV had insufficient knowledge of CC, the majority of the participants (83.5%) were able to recognize at least three risk factors, but with limited understanding of symptoms and prevention. The majority held positive beliefs on CC and screening practices. Factors associated with good knowledge of CC included being married (AOR: 3.66, 95% CI: 1.84-7.28), having used ART for at least 2 years (AOR: 4.08, 95% CI: 1.36-12.21), and having previously screened for CC (AOR: 1.62, 95% CI: 1.01-2.59). Conclusion WLHIV attending care and treatment center had insufficient knowledge about CC screening. To further improve screening and treatment for CC, at both facility and community levels, targeted awareness and education campaigns are warranted.
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Affiliation(s)
- Dorah Mrema
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
- Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - James Samwel Ngocho
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro, Tanzania
| | - Alex Mremi
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
| | - Maryam Amour
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Rogathe Machange
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro, Tanzania
| | - Benjamin C. Shayo
- Department of Obstetrics and Gynaecology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Baylor College of Medicine, Houston, TX, United States
| | - Julius P. Alloyce
- Department of Oncology, Kilimanjaro Christian Medical Centre, Moshi, Kilimanjaro, Tanzania
| | - Evaline Ndosi
- Department of Oncology, Kilimanjaro Christian Medical Centre, Moshi, Kilimanjaro, Tanzania
| | - Beatus T. Shirima
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
| | - Device Fande
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
| | - Rahma Shehoza
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
| | - Emmanuel Balandya
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Bruno Sunguya
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Stephen E. Mshana
- Catholic University of Health and Allied Sciences, Bugando, Mwanza, Tanzania
| | - Alfred K. Mteta
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
| | - Eligius Lyamuya
- Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - John Bartlett
- Duke Global Health Institute, Duke University Medical Center, Durham, NC, United States
| | - Blandina T. Mmbaga
- Kilimanjaro Christian Medical University College, Moshi, Kilimanjaro, Tanzania
- Kilimanjaro Clinical Research Institute, Moshi, Kilimanjaro, Tanzania
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McLarty RP, Alloyce JP, Chitema GG, Msuya LJ. Glycemic control, associated factors, acute complications of Type 1 Diabetes Mellitus in children, adolescents and young adults in Tanzania. Endocrinol Diabetes Metab 2021; 4:e00200. [PMID: 33855206 PMCID: PMC8029575 DOI: 10.1002/edm2.200] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 10/14/2020] [Accepted: 10/18/2020] [Indexed: 12/22/2022] Open
Abstract
Objective To determine the factors associated with poor glycemic control in children (1-10 years), adolescents (11-18 years) and young adults (19-40 years) with Type 1 Diabetes Mellitus (T1DM) in Kilimanjaro Christian Medical Center (KCMC) in Moshi, Mount Meru Regional Referral Hospital (MMRRH) and Meru District Hospital (MDH) in Arusha, Tanzania. Methods Cross sectional study of 150 participants conducted from January to June 2019, data was collected by structured questionnaire and analyzed using SPSS version 23. Results The mean HbA1c was 12.3 ± 2.2%, 146 had poor glycemic control (HbA1c > 7.5%). BMI, insulin regime and caretaker education were associated with poor glycemic control. There were 16 participants diagnosed in DKA and the most frequently reported complications in the prior 3 months were hyperglycemia (n = 25), DKA (n = 18) and hypoglycemia (n = 4). Conclusions Glycemic control is still very poor particularly in adolescents. Significant associations with glycemic control were higher BMI, insulin regime and guardian education. The study revealed lower prevalence of DKA at diagnosis compared to previous studies.
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Affiliation(s)
- Ronald P. McLarty
- Kilimanjaro Christian Medical University CollegeMoshiTanzania
- Kilimanjaro Christian Medical CentreMoshiTanzania
| | | | | | - Levina J. Msuya
- Kilimanjaro Christian Medical University CollegeMoshiTanzania
- Kilimanjaro Christian Medical CentreMoshiTanzania
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Lema G, Mremi A, Amsi P, Pyuza JJ, Alloyce JP, Mchome B, Mlay P. Placental pathology and maternal factors associated with stillbirth: An institutional based case-control study in Northern Tanzania. PLoS One 2020; 15:e0243455. [PMID: 33382728 PMCID: PMC7775101 DOI: 10.1371/journal.pone.0243455] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/22/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To determine the placental pathologies and maternal factors associated with stillbirth at Kilimanjaro Christian Medical Centre, a tertiary referral hospital in Northern Tanzania. METHODS A 1:2 unmatched case-control study was carried out among deliveries over an 8-month period. Stillbirths were a case group and live births were the control group. Respective placentas of the newborns from both groups were histopathologically analyzed. Maternal information was collected via chart review. Mean and standard deviation were used to summarize the numerical variables while frequency and percentage were used to summarize categorical variables. Crude and adjusted logistic regressions were done to test the association between each variable and the risk of stillbirth. RESULTS A total of 2305 women delivered during the study period. Their mean age was 30 ± 5.9 years. Of all deliveries, 2207 (95.8%) were live births while 98 (4.2%) were stillbirths. Of these, 96 stillbirths (cases) and 192 live births (controls) were enrolled. The average gestational age for the enrolled cases was 33.8 ±3.2 weeks while that of the controls was 36.3±3.6 weeks, (p-value 0.244). Of all stillbirths, nearly two thirds 61(63.5%) were males while the females were 35(36.5%). Of the stillbirth, 41were fresh stillbirths while 55 were macerated. The risk of stillbirth was significantly associated with lower maternal education [aOR (95% CI): 5.22(2.01-13.58)], history of stillbirth [aOR (95%CI): 3.17(1.20-8.36)], lower number of antenatal visits [aOR (95%CI): 6.68(2.71-16.48), pre/eclampsia [aOR (95%CI): 4.06(2.03-8.13)], and ante partum haemorrhage [OR (95%CI): 2.39(1.04-5.53)]. Placental pathology associated with stillbirth included utero-placental vascular pathology and acute chorioamnionitis. CONCLUSIONS Educating the mothers on the importance of regular antenatal clinic attendance, monitoring and managing maternal conditions during antenatal periods should be emphasized. Placentas from stillbirths should be histo-pathologically evaluated to better understand the possible aetiology of stillbirths.
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Affiliation(s)
- Godwin Lema
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Alex Mremi
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Pathology, Kilimanjaro Christian Medical Center, Moshi, Tanzania
| | - Patrick Amsi
- Department of Pathology, Kilimanjaro Christian Medical Center, Moshi, Tanzania
| | - Jeremia J. Pyuza
- Department of Pathology, Kilimanjaro Christian Medical Center, Moshi, Tanzania
| | - Julius P. Alloyce
- Cancer Registry Unit, Cancer Care Centre, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Bariki Mchome
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - Pendo Mlay
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Obstetrics and Gynecology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
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