14 research outputs found
Assessment of blood transfusion services in six remote regions in Tanzania
No full textMagister Public Health - MPHMost of the blood transfusion facilities had adequate space, but lacked some of the basic equipment. Blood collected in these facilities was not adequate to meet the blood needs of the regions. These facilities lacked specialised personnel and some of those practicing blood transfusion were not conversant with blood groups, transfusion reactions and the measures to be taken if a reaction occurs. The findings of this study will be used to strengthen blood transfusion services in these hard to reach regions.South Afric
Extended Spectrum β-Lactamases among Gram-negative bacteria of nosocomial origin from an Intensive Care Unit of a tertiary health facility in Tanzania
No full textAbstract Background Resistance to third generation cephalosporins due to acquisition and expression of extended spectrum β-lactamase (ESBL) enzymes among Gram-negative bacteria is on the increase. Presence of ESBL producing organisms has been reported to significantly affect the course and outcome of an infection. Therefore infections due to ESBL isolates continue to pose a challenge to infection management worldwide. The aim of this study was to determine the existence and to describe phenotypic and genotypic characteristics of ESBLs in an Intensive Care Unit (ICU) setting in Tanzania. Methods Between October 2002 and April 2003, clinical information and samples were collected from patients suspected to have nosocomial infections in an Intensive Care Unit of a tertiary hospital in Tanzania. The isolates were identified, tested for antimicrobial susceptibility and analysed for presence of ESBL genes. Results Thirty-nine Gram-negative bacteria were isolated from clinical samples of 39 patients. These isolates included 13 Escherichia coli, 12 Enterobacter spp, 5 Pseudomonas spp, 4 Proteus spp, 2 Klebsiella. pneumoniae, 2 Citrobacter freundii and 1 Chryseomonas luteola. Eleven (28.2%) of these isolates were ESBL producing. The ESBL genes characterised were SHV-12, SHV-28 and CTX-M-15. The ESBL producing isolates were more resistant to gentamicin and ciprofloxacin than non-ESBL producing isolates. Conclusion This study shows the presence of ESBL genes among Gram-negative bacteria in the ICU setting in Tanzania. There is a need to institute strict hospital infection control policy and a regular surveillance of resistance to antimicrobial agents.</p
Detection of CTX-M-15 beta-lactamases in Enterobacteriaceae causing hospital- and community-acquired urinary tract infections as early as 2004, in Dar es Salaam, Tanzania
No full textAbstract Background The spread of Extended Spectrum β-lactamases (ESBLs) among Enterobacteriaceae and other Gram-Negative pathogens in the community and hospitals represents a major challenge to combat infections. We conducted a study to assess the prevalence and genetic makeup of ESBL-type resistance in bacterial isolates causing community- and hospital-acquired urinary tract infections. Methods A total of 172 isolates of Enterobacteriaceae were collected in Dar es Salaam, Tanzania, from patients who met criteria of community and hospital-acquired urinary tract infections. We used E-test ESBL strips to test for ESBL-phenotype and PCR and sequencing for detection of ESBL genes. Results Overall 23.8% (41/172) of all isolates were ESBL-producers. ESBL-producers were more frequently isolated from hospital-acquired infections (32%, 27/84 than from community-acquired infections (16%, 14/88, p < 0.05). ESBL-producers showed high rate of resistance to ciprofloxacin (85.5%), doxycycline (90.2%), gentamicin (80.5%), nalidixic acid (84.5%), and trimethoprim-sulfamethoxazole (85.4%). Furthermore, 95% of ESBL-producers were multi-drug resistant compared to 69% of non-ESBL-producers (p < 0.05). The distribution of ESBL genes were as follows: 29/32 (90.6%) bla CTX-M-15, two bla SHV-12, and one had both bla CTX-M-15 and bla SHV-12. Of 29 isolates carrying bla CTX-M-15, 69% (20/29) and 31% (9/29) were hospital and community, respectively. Bla SHV-12 genotypes were only detected in hospital-acquired infections. Conclusion bla CTX-M-15 is a predominant gene conferring ESBL-production in Enterobacteriaceae causing both hospital- and community-acquired infections in Tanzania
Detection of CTX-M-15 beta-lactamases in Enterobacteriaceae causing hospital- and community-acquired urinary tract infections as early as 2004, in Dar es Salaam, Tanzania
No full textPan Afr Med J
No full textAs of 2010 sub-Saharan Africa had approximately 865 million inhabitants living with numerous public health challenges. Several public health initiatives [e.g., the United States (US) President's Emergency Plan for AIDS Relief and the US President's Malaria Initiative] have been very successful at reducing mortality from priority diseases. A competently trained public health workforce that can operate multi-disease surveillance and response systems is necessary to build upon and sustain these successes and to address other public health problems. Sub-Saharan Africa appears to have weathered the recent global economic downturn remarkably well and its increasing middle class may soon demand stronger public health systems to protect communities. The Epidemic Intelligence Service (EIS) program of the US Centers for Disease Control and Prevention (CDC) has been the backbone of public health surveillance and response in the US during its 60 years of existence. EIS has been adapted internationally to create the Field Epidemiology Training Program (FETP) in several countries. In the 1990s CDC and the Rockefeller Foundation collaborated with the Uganda and Zimbabwe ministries of health and local universities to create 2-year Public Health Schools Without Walls (PHSWOWs) which were based on the FETP model. In 2004 the FETP model was further adapted to create the Field Epidemiology and Laboratory Training Program (FELTP) in Kenya to conduct joint competency-based training for field epidemiologists and public health laboratory scientists providing a master's degree to participants upon completion. The FELTP model has been implemented in several additional countries in sub-Saharan Africa. By the end of 2010 these 10 FELTPs and two PHSWOWs covered 613 million of the 865 million people in sub-Saharan Africa and had enrolled 743 public health professionals. We describe the process that we used to develop 10 FELTPs covering 15 countries in sub-Saharan Africa from 2004 to 2010 as a strategy to develop a locally trained public health workforce that can operate multi-disease surveillance and response systems.22187606PMC322407
Target product profile for a diagnostic assay to differentiate between bacterial and non-bacterial infections and reduce antimicrobial overuse in resource-limited settings: an expert consensus
No full textAcute fever is one of the most common presenting symptoms globally. In order to reduce the empiric use of antimicrobial drugs and improve outcomes, it is essential to improve diagnostic capabilities. In the absence of microbiology facilities in low-income settings, an assay to distinguish bacterial from non-bacterial causes would be a critical first step. To ensure that patient and market needs are met, the requirements of such a test should be specified in a target product profile (TPP). To identify minimal/optimal characteristics for a bacterial vs. non-bacterial fever test, experts from academia and international organizations with expertise in infectious diseases, diagnostic test development, laboratory medicine, global health, and health economics were convened. Proposed TPPs were reviewed by this working group, and consensus characteristics were defined. The working group defined non-severely ill, non-malaria infected children as the target population for the desired assay. To provide access to the most patients, the test should be deployable to community health centers and informal health settings, and staff should require 90% and >80% for sensitivity and specificity, respectively. Other key characteristics, to account for the challenging environment at which the test is targeted, included: i) time-to-result <10 min (but maximally <2 hrs); ii) storage conditions at 0-40°C, ≤90% non-condensing humidity with a minimal shelf life of 12 months; iii) operational conditions of 5-40°C, ≤90% non-condensing humidity; and iv) minimal sample collection needs (50-100μL, capillary blood). This expert approach to define assay requirements for a bacterial vs. non-bacterial assay should guide product development, and enable targeted and timely efforts by industry partners and academic institutions
Structure-based optimization and binding assays for discovery of tau PET radiotracers: Synthesis and in vivo evaluation of [11C]Z-3272
No full textHuman tau protein has six isoforms, differing in the number of microtubule-binding repeats. Progressive supranuclear palsy (PSP) and corticobasal degeneration (CBD) are primarily 4-repeat (4R)-tauopathies, and Alzheimer’s disease (AD) and chronic traumatic encephalopathy (CTE) are mixed 3R/4R-tau. Here, a promising lead compound for positron emission tomography (PET) imaging of non-AD tauopathies (Z5873993272; (methyl-1-(5-(7-hydroxynaphthalen-2-yl)pyridin-2-yl)piperidine-4-carboxylate; Z-3272), was identified as a potential 4R-tau binding ligand through computational structure-based optimization from the 2D structure of known 4R-tau ligands, followed by iterative competition binding assays. Homologous binding assays in post-mortem AD, PSP, and CBD brain with [3H]Z-3272 provided Kd (nM) values (n = 3) of AD = 1.2 ± 0.1, PSP = 2.7 ± 0.9, and CBD = 1.7 ± 0.1. [11C]Z-3272 was synthesized by 11C-methylation, by reaction of [11C]CH3I with 1-(5-(7-hydroxynaphthalen-2-yl)pyridin-2-yl)piperidine-4-carboxylic acid with NaHCO3 in DMF at 70 ºC for 3 min. The crude product was purified by semi-preparative HPLC and formulated in saline, with an overall synthesis time of 35 min from end of bombardment. [11C]Z-3272 was isolated with a non-decay corrected radiochemical yield of 4 ± 1% (n = 4), high radiochemical purity (>95%), and high molar activity (149 ± 55.5 GBq/μmol). PET imaging following bolus injection of [11C]Z-3272 in rats showed high initial brain radioactivity (>2.3 standardized uptake values (SUV)) with moderate washout (~0.7 SUV at 60 min), however, ex vivo studies revealed the rapid formation of troublesome brain penetrant radiometabolites. Medicinal chemistry optimization is underway to improve binding affinity, selectivity, and metabolic stability.The presentation of the authors' names and (or) special characters in the title of the pdf file of the accepted manuscript may differ slightly from what is displayed on the item page. The information in the pdf file of the accepted manuscript reflects the original submission by the author
Development, Implementation, and Scale Up of the National Campaign to Promote HIV Test and Treat Services Uptake Among Men in Tanzania
No full textEvidence has demonstrated that immediate HIV treatment initiation upon a positive HIV test, referred to as Test and Treat, can help people living with HIV live longer, healthier lives and prevent HIV transmission. Although Tanzania adopted the evidence-based Test and Treat strategy since 2016, men were not being adequately reached for HIV services. A national campaign was launched to promote the new HIV services with a focus on men. To inform the development and implementation of the campaign, we conducted formative audience insights-gathering (AIG) sessions to assess facilitators and barriers to accessing HIV Test and Treat services and inform the concepts and materials for the campaign. Qualitative AIG interviews and focus group discussions were conducted with 54 people who were unaware or aware of their HIV status and currently or not currently on treatment, as well as health workers. Facilitators and barriers included a of testing positive, the desire to , their narratives, and themselves to achieve their dreams and live a happy life. The campaign played off a creative concept to position antiretroviral therapy (ART) as a solution to fears around what life would be like after a positive HIV diagnosis. The development and implementation of the campaign were informed by the AIG sessions and national stakeholders, leading to strong partners\u27 buy-in that supported the scale-up of the ongoing campaign from 12 to 26 regions via the collaborative efforts of government, donors, and implementing partners
School-based prevention of teacher and parental violence against children: Study protocol of a cluster-randomized controlled trial in Tanzania
No full textMattonet K, Kabelege E, Mkinga G, et al. School-based prevention of teacher and parental violence against children: Study protocol of a cluster-randomized controlled trial in Tanzania. BMC public health. 2024;24(1): 2367 (2024).BACKGROUND: Violence against children at home and at school is particularly prevalent in Africa and is associated with adverse and persistent health effects on children. The violence prevention intervention Interaction Competencies with Children-for Teachers (ICC-T) is an effective tool to reduce violence against children by fostering teachers' non-violent communication and interaction skills. To enhance these effects, in the present study, ICC-T will be extended to parents (ICC-P) aiming to increase children's experience of consistent behavior and application of non-violent discipline strategies between teachers and parents.; METHODS: To investigate the effectiveness of the school-based combined implementation of ICC-T and ICC-P, a cluster-randomized controlled trial with 16 primary schools in the urban district of Morogoro in Eastern Tanzania will be conducted. Both quantitative (structured interviews) and qualitative (focus group discussions, in-depth interviews, evaluation forms) methods will be used to investigate the effects on teachers' and parents' violence against children in home and school settings. The intervention implementation will be accompanied by a comprehensive process evaluation to assess the implementation quality of and participants' engagement with ICC-T and ICC-P. Potential downstream effects of violence reduction will be investigated by assessing the children's mental health and well-being.; DISCUSSION: The present study aims to provide evidence for the feasibility, acceptability, and effectiveness of the school-based combined implementation of ICC-T and ICC-P to reduce teacher and parental violence against children and contribute to children's well-being in home and school settings.; TRAIL REGISTRATION: The clinical trial was registered at ClinicalTrials.gov (ClinicalTrials.gov, 2024) under the identifier NCT06369025 (Hecker, Preventing Physical and Emotional Violence by Parents and Teachers in Public Schools in Tanzania (ICC-T/ICC-P_Tanz) (PreVio), 2024) on April 17, 2024. © 2024. The Author(s)
Field Epidemiology and Laboratory Training Programs in sub-Saharan Africa from 2004 to 2010: need, the process and prospects
No full texthealth workforce that can operate multi-disease surveillance and response systems
