The East African health research journal最新文献

{"title":"Association Between COVID19 Vaccination Uptake and Socio-Demographic Characteristics Among Pregnant Women in Kenya.","authors":"Sylvia Ayieko, Sarah E Messiah, Kimberly Baker, Christine Markham","doi":"10.24248/eahrj.v9i1.819","DOIUrl":"10.24248/eahrj.v9i1.819","url":null,"abstract":"<p><strong>Background: </strong>Vaccination is considered more cost-effective in controlling the spread of COVID19 compared to other preventative measures. Pregnant women infected with COVID19 were likely to have severe COVID19 complications compared to uninfected women. This study examined the relationship between COVID19 vaccination uptake and socio-demographic characteristics among pregnant women in Kenya.</p><p><strong>Methods: </strong>We conducted a secondary analysis using data from a pilot study examining COVID19 vaccination uptake among pregnant women in Kenya. We used descriptive analysis to report the proportions and chi 2 to assess if there are any significant differences between groups. Our primary outcome was COVID19 vaccination uptake. We performed logistic regressions.</p><p><strong>Results: </strong>The predominant age groups of study participants were between 25-29 years (45.1%) and 30-39 years (45.1%). The majority of the pregnant had received COVID19 vaccination, with 87% having completed the full vaccine dosage. There was a higher uptake of adenovirus vector vaccines compared to mRNA COVID19 vaccines. Pregnant women between 30-39 years were 3.81 times more likely to have received COVID19 vaccination compared to those 25-29 years (aOR: 3.81; 95% CI: 1.28-11.39, <i>P</i> =.017). After adjustment, workplace requirements for COVID-19 vaccination were associated with increased odds of vaccination (aOR: 4.65; 95% CI 1.32-16.42). The study did not show any significant relationship between comorbid conditions during pregnancy and COVID19 vaccination.</p><p><strong>Discussion: </strong>The variations of uptake by age-group cohorts, education levels, and vaccine workplace requirements suggest a need for further and more robust research on COVID19 vaccination among pregnant women. While workplace vaccination requirements may have prompted COVID19 vaccination among pregnant women in this sample, the results cannot be generalized to the general population. However, our findings underscore the importance of effective public health policies at the institutional, local and national levels.</p>","PeriodicalId":74991,"journal":{"name":"The East African health research journal","volume":"9 1","pages":"24-32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Surgical Outcomes Between Open Herniotomy and Laparoscopic Hernia Repair Among Pediatric Patients with Inguinal Hernias: A Five-Year Retrospective Review at Tanzania's National Hospital.","authors":"Satrumin Shirima, Daniel Kitua, Ally Mwanga, Nashivai Kivuyo, Anab Issa, Innocent Kileo, Jeanine Justiniano, Meshack Brighton, Mohammed Salim","doi":"10.24248/eahrj.v9i1.832","DOIUrl":"10.24248/eahrj.v9i1.832","url":null,"abstract":"<p><strong>Background: </strong>Inguinal hernias (IH) are common congenital anomalies in children, requiring surgical repair to prevent complications. The primary methods for repairing pediatric IH are laparoscopic hernia repair (LHR) and open herniotomy (OH). However, there is limited evidence comparing postoperative outcomes between these approaches in Low- and Middle-Income Countries (LMICs).</p><p><strong>Objective: </strong>To compare postoperative outcomes between OH and LHR among pediatric patients treated at Muhimbili National Hospital (MNH) in Tanzania.</p><p><strong>Methodology: </strong>This 5-year retrospective comparative cohort study included 156 pediatric patients under 14 years who underwent OH or LHR at MNH from January 2019 to December 2023. Participants were selected using a hybrid random-consecutive sampling technique. LHR and OH patients were recruited at approximately a 1-to-4 ratio. Data was collected from patient records and via phone interviews. Inferential statistical tests were used to compare the outcomes of the two surgical methods.</p><p><strong>Results: </strong>Participants had a median age of 19.5 months (IQR 10-36) at presentation, with the majority being male (142, 91%). The median age was slightly higher in the LHR group [21.5 (IQR 12-46.5)] compared to 19 months (IQR 9-36) in the OH group. In the subgroup analysis of bilateral hernias (n=22), measures such as the duration of surgery, postoperative length of stay, total hospitalization time, parents` satisfaction, and cosmetic rating favored LHR (<i>p</i><.05). Satisfaction and cosmesis were also better with LHR for unilateral hernias (n=134) (<i>p</i><.05). However, the overall recurrence rate was higher with unilateral LHR at 22.7% (5/17) compared to 4.5% (5/107) with OH, <i>p</i><.05.</p><p><strong>Conclusion: </strong>While LHR demonstrated shorter operative time, faster recovery, and favourable cosmetic outcomes, the potential for hernia recurrence warrants careful consideration when selecting the surgical approach. Given the inherent methodological limitations, these findings should be interpreted with caution. Nevertheless, the findings provide valuable preliminary evidence that can inform future larger-scale, well-powered studies aimed at evaluating the long-term outcomes of LHR in LMIC settings.</p>","PeriodicalId":74991,"journal":{"name":"The East African health research journal","volume":"9 1","pages":"144-151"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Anaemia Perceptions Shape Dietary Diversity Practice in Pregnancy: A Health Belief Model Study in Tanzania.","authors":"Saada Ali Seif","doi":"10.24248/eahrj.v9i1.826","DOIUrl":"10.24248/eahrj.v9i1.826","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Maternal dietary diversity can significantly impact pregnancy outcomes for both the mother and the fetus. A varied and balanced diet during pregnancy provides crucial nutrients that support the baby's growth and development, as well as the mother's overall health, including being free from maternal anaemia. However, not much is known about the maternal dietary diversity practice in Tanzania. Identifying the magnitude and addressing the possible factors associated with maternal dietary diversity would have a significant contribution to enhancing the nutritional and health status of both the mother and her fetus. The use of the health belief model in this study helped to identify the belief factors influencing the behavioral practice, and this marked the aim of this study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a community-based analytical cross sectional study that was conducted in Ilala Municipality. It involved 367 pregnant women with gestational ages ranging from 13 to 40 weeks who were selected using a multistage sampling. The data were collected using an interviewer administered structured questionnaire. The data was described using descriptive statistics, and a Pearson correlation test and a linear regression model were used to determine the associations between the outcome variable and its explanatory variables. A standardized beta coefficient, a 95% confidence interval (CI), and a &lt;i&gt;P&lt;/i&gt; value were reported. A statistically significant variable in the final model was declared at the P value of &lt;.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nearly half of the participants were between the ages of 25 and 34 years (46.4%) and (45.2%) were primigravida. Only (35.1%) of women had good dietary diversity practice with a mean dietary diversity score of 3.97±1.4. The food groups that were mostly consumed were grains and tubers (100%), dark green leafy vegetables (61.3%) and other types of vegetables (53.7%). The majority of pregnant women (84.7%) believed they are at high risk of getting anaemia in any stage of pregnancy. Over 90% of pregnant women believed that anaemia in pregnancy can led to foetus complications, and maternal and foetus death. Substantial proportion of pregnant women reported barriers to access and afford iron rich food. Predicators of good dietary diversity practice for the studied pregnant women include perceived moderate risk of anaemia (Beta = 0.19; CI = 0.2-1.8), and perceived high severity (Beta = -0.09; CI = -0.7 - 0.01), having a higher education level (Beta = 0.8; CI = 0.1-0.8).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Pregnant women are not meeting adequate nutritional requirements. Accessibility and costs are barriers that contribute to low consumption of vitamin A-rich fruits, eggs, nuts, seeds, and dairy products. Higher education level, perceiving the risk, and severity of anaemia during pregnancy are the predictors of good dietary diversity practice. We recommend a tailored intervention, highli","PeriodicalId":74991,"journal":{"name":"The East African health research journal","volume":"9 1","pages":"86-95"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of Mumps among Patients Attending Selected Hospitals in Kenya.","authors":"Paul Muchai, Rosemary Nzunza, Joanne Hassan, Samoel Khamadi, Raphael Lihana, Vivienne Matiru, Peter Borus","doi":"10.24248/eahrj.v9i2.856","DOIUrl":"10.24248/eahrj.v9i2.856","url":null,"abstract":"<p><strong>Background: </strong>Mumps is a highly infectious viral disease that poses a significant public health concern despite presence of safe and effective vaccine. This study aimed to determine seroprevalence of mumps among patients attending selected hospitals in Coast and Central regions of Kenya, and to evaluate the demographic factors associated with mumps seropositivity.</p><p><strong>Methodology: </strong>This was a cross-sectional study where serum samples collected from patients attending Kiambu, Murang'a and Kilifi County hospitals were quantitatively tested for anti-mumps IgG antibodies using commercial enzyme linked immunosorbent assay (ELISA) kits. Sample size estimation was calculated using Cochran formula. A total of 451 volunteers were enrolled between October 2020 and November 2021. Ethical approval was obtained from Institutional Review Board of Kenya Medical Research Institute Scientific and Ethics Review Unit. Statistical analyses were conducted using Statistical Package for the Social Sciences (SPSS) version 23.0 software.</p><p><strong>Results: </strong>The overall mumps seropositivity rate was 90.5% and geometric mean of mumps IgG titers (GMT) was 401.3 U/ml. Both seroprevalence and GMT were not significantly influenced by the demographic factors of the population under study. Nonetheless, there were trends of higher prevalence related to certain demographic groups. Seroprevalence increased with increasing age from 85% for less than 10-year-olds to 100% among those aged between 60 and 69 years (<i>P</i>=.779). Similarly, females had a higher prevalence at 91.5% compared to 88.6% among males (<i>P</i>=.063). Also, the population from the central region of Kenya had a seroprevalence of 92% compared to 87.3% at the coast region (<i>P</i>=0.249) and rural residents reported 91.3% compared to 88.5% in urban residents (<i>P</i>=.607).</p><p><strong>Conclusions: </strong>The high mumps seroprevalence in this Kenyan population reflects widespread natural infection in the absence of vaccination. Age-related increases in antibody prevalence and geometric mean titres indicate cumulative exposure over time. These findings provide essential pre-vaccine baseline data and support the need for strengthened mumps surveillance and consideration of mumps vaccine inclusion in Kenya's national immunization program.</p>","PeriodicalId":74991,"journal":{"name":"The East African health research journal","volume":"9 2","pages":"350-356"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mobile Health Information and Decision Support System Architecture: Enhancing Maternal Healthcare Access in Uganda.","authors":"Martin Morgan Kusasira, Anthony Atwiine, Joseph Wamema","doi":"10.24248/eahrj.v9i2.848","DOIUrl":"10.24248/eahrj.v9i2.848","url":null,"abstract":"<p><strong>Background: </strong>Maternal Health Information (MHI) is vital for empowering Pregnant and Postpartum Mothers to make informed decisions. However, access to this information remains a significant challenge in low-resource countries (LRCs) like Uganda, contributing to unacceptably high maternal mortality rates.</p><p><strong>Methods: </strong>This study adopted a qualitative case study research design. Data was collected from 50 purposively selected respondents, including Pregnant and Postpartum Mothers, medical workers, and Village Health Team (VHT) members, using semi-structured interviews and questionnaires at two health facilities in Uganda.</p><p><strong>Results: </strong>The study identified key impediments to Maternal Health Information access, including financial instability, inadequate spouse support, long waiting times at health facilities, the negative attitude of health workers, and language barriers. While health facilities were the primary source of information, Maternal Health Information was often reported as untimely and irrelevant to mothers' specific needs.</p><p><strong>Conclusion: </strong>The proposed architecture is designed to bridge the gaps by extending relevant, reliable, and multilingual MHI directly to mothers, thus empowering their decision-making process and having the potential to reduce maternal mortality in Uganda and similar low resource countries.</p>","PeriodicalId":74991,"journal":{"name":"The East African health research journal","volume":"9 2","pages":"287-306"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Malaria Knowledge and Associated Factors Towards Mosquito Net Use among School Children in Muheza District, Tanzania.","authors":"Raphael Hillary Sebukoto, Loveness Urio, Billy Ngasala","doi":"10.24248/eahrj.v9i2.855","DOIUrl":"10.24248/eahrj.v9i2.855","url":null,"abstract":"<p><strong>Background: </strong>Schoolchildren face a high risk of malaria, yet remain a neglected demographic in control programmes compared to pregnant women and children under five. In Tanzania, in recent years, mosquito nets have been provided to primary schoolchildren, but usage remains low. Studies on malaria knowledge and mosquito net use among schoolchildren is limited. This study aimed to assess malaria knowledge and identify factors associated with mosquito net use among schoolchildren in Muheza District, Tanzania.</p><p><strong>Methods: </strong>A school-based cross-sectional study was conducted from December 2022 to February 2023. Schoolchildren and household heads were interviewed using an interviewer-administered questionnaire. Malaria knowledge was assessed, with scores above 50% classified as good knowledge. Modified Poisson regression analysis was used to identify factors associated with mosquito net use, with statistical significance set at <i>p</i> ≤ .05.</p><p><strong>Results: </strong>A total of 530 schoolchildren were enrolled. Of these, 87.2% owned at least one mosquito net, and among them, 69.8% reported using a net the previous night. Overall, 90.6% of children demonstrated good malaria knowledge. Factors significantly associated with mosquito net use included urban residence (aPR 1.40; 95% CI, 1.19 to 1.62), living with parents (aPR 1.35; 95% CI, 1.14-1.58), and ownership of a television or radio (aPR 1.39; 95% CI, 1.05 to 1.83). Household-level determinants included access to electricity (aPR 2.17; 95% CI, 1.12 to 4.20), a household size-to-bed-net ratio of ≤ 2 (aPR 2.30; 95% CI, 1.36 to 3.88), and possession of a mosquito net that had been in use for ≤ 3 years (aPR 1.69; 95% CI, 1.19 to 2.41).</p><p><strong>Conclusion: </strong>Although most schoolchildren in Muheza District have good malaria knowledge, 30% did not use a mosquito net the night before the interview, and 3% still believed in local herbal remedies. Higher mosquito net use was associated with living in urban areas, parental care, ownership of mass-media devices, household access to electricity, a favourable household size-to-bed-net ratio, and having a relatively new mosquito net. Strengthened malaria education and targeted interventions, particularly in rural areas are urgently needed to promote consistent net use and correct misconceptions regarding malaria treatment.</p>","PeriodicalId":74991,"journal":{"name":"The East African health research journal","volume":"9 2","pages":"341-349"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Factors of Hypotension in Patients Undergoing Caesarean Section with Spinal Anaesthesia at Muhimbili National Hospital.","authors":"Willbroad Kyejo, Sunil Samji, Allyzain Ismal, Edwin Lugazia","doi":"10.24248/eahrj.v9i1.837","DOIUrl":"10.24248/eahrj.v9i1.837","url":null,"abstract":"<p><strong>Background: </strong>Spinal anaesthesia is a common regional technique for caesarean sections, but is associated with hypotension in up to 80% of patients. Preventive measures include; intravenous fluid preloading, left uterine displacement, compression stockings, and vasopressors. This study aimed to determine the prevalence and risk factors of hypotension during spinal anaesthesia in pregnant patients undergoing caesarean section at Muhimbili National hospital.</p><p><strong>Methods: </strong>A descriptive cross-sectional study was conducted at Muhimbili National Hospital's Obstetric theatre, involving patients who received spinal anaesthesia during caesarean section from August 2021 to January 2022. The study excluded patients with sedation, anti-hypertensive, pregnancy-induced hypertension, modified Bromage score, or combination anaesthesia. Data was collected, and analysed using SPSS version 20.</p><p><strong>Results: </strong>A total of 300 patients were enrolled (calculated sample size 270 plus 10% margin). Of these, 33.3% underwent elective caesarean section and 66.7% emergency caesarean section. Most patients (92%) received 0.5% hyperbaric bupivacaine, while 8% received 5% heavy lidocaine. Hypotension occurred in 56.7% of patients (95% CI: 0.511-0.623). Risk factors included preload <10 mL/kg, higher sensory block levels, and absence of wedge positioning.</p><p><strong>Conclusion: </strong>Hypotension during spinal anaesthesia for caesarean section is common. Preventive measures, including adequate fluid preload, wedge positioning, and careful monitoring of sensory block height, are essential to improve maternal hemodynamic stability.</p>","PeriodicalId":74991,"journal":{"name":"The East African health research journal","volume":"9 1","pages":"183-189"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12590992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High Prevalence of Sickle Cell Disease in Low-Endemic Areas: A Pilot Study in Chunya Tanzania.","authors":"Amani Twaha, Deocles Donatus, Khanafi Said, Moshi Moshi Shabani, Marygladness Ngeme, Maryjesca Mafie, Stamily Ally Ramadhani, Abdulrahman Hussein, Nazareth M Mbilinyi, Kasia Maksym","doi":"10.24248/eahrj.v9i1.835","DOIUrl":"10.24248/eahrj.v9i1.835","url":null,"abstract":"<p><strong>Backround: </strong>Tanzania has the fifth highest prevalence of Sickle Cell Disease (SCD) worldwide. Annually, 11,000 children are born with SCD, but only 10% survive to their fifth birthday. Limited screening has led to underestimation of the burden in regions such as the southern highlands. The epidemiology of SCD, just like other diseases, is affected by climate change through increasing migration in search of arable land hence the shifts in the geographical prevalence of SCD from high prevalent areas to low prevalence areas. Early identification of SCD across all regions is therefore essential to improve survival, quality of life, mental health, reduce stigma, and alleviate the financial burden.</p><p><strong>Study objective: </strong>The objective of the study was to assess the prevalence of SCD and SCT in Chunya district, Mbeya Region, Tanzania and to identify demographical factors associated with the risk of SCT among community members.</p><p><strong>Methods: </strong>A cross-sectional study on SCD was conducted in Chunya district, Mbeya Region, between 21^st and 22^nd February 2020. A total of 523 villagers were selected and screened for SCD and sickle cell trait (SCT) using rapid test (SICKLE SCAN(®).</p><p><strong>Results: </strong>The study revealed a notably high prevalence of SCD in southern highlands of Tanzania which highlighted the need for early screening and community-based awareness programs. The prevalence of SCD in the tested population was 1.91% and the prevalence of SCT was 8.41% of which the majority of the SCD patient were five years and below <i>P</i>=.02. Having a mother from Southern Zone was a protective factor (OR 0.2) against acquiring SCT while having a father from Northern Zone was a risk factor (OR 10), <i>P</i> value <.005.</p><p><strong>Conclusion: </strong>To reduce the burden of SCD, new strategies of screening should be developed to enable timely diagnosis and management of the disease.</p>","PeriodicalId":74991,"journal":{"name":"The East African health research journal","volume":"9 1","pages":"165-173"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12591030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ceftriaxone Resistance in the Surgical Adult Intensive Care Unit at Muhimbili National Hospital, Dar es Salaam, Tanzania.","authors":"Gibonce Mwakisambwe, Edwin Lugazia","doi":"10.24248/eahrj.v9i2.860","DOIUrl":"10.24248/eahrj.v9i2.860","url":null,"abstract":"<p><strong>Background: </strong>The resistance to first line agents, namely third generation cephalosporins, specifically ceftriaxone, has been clinically observed in a number of patients at Muhimbili National Hospital (MNH) medical wards. However, there has been no any study from the intensive care units with regards to resistance to ceftriaxone per se.</p><p><strong>Objective: </strong>The objective of our study was to audit the use of ceftriaxone with STG adherence as the first line antibacterial agent on the prophylaxis and treatment of bacterial infections among patients admitted in the surgical Adult Intensive Care Unit (AICU) at MNH, Dar es Salaam, Tanzania.</p><p><strong>Methods: </strong>This was a prospective descriptive cross-sectional clinical audit study, done from January, 2021 to December, 2021. Results were analyzed using SPSS 23.</p><p><strong>Results: </strong>During one year of the study period, a total of 735 patients were admitted in the surgical MNH-AICU with different clinical diagnosis. A total of 731 (99.50%) were included in the final analysis, with only 75 (10.26%) having culture and sensitivity performed on them. Among all isolates, <i>Klebsiella pneumoniae</i> 34 (45%) was the most predominant bacteria. <i>Klebsiella pneumonia</i>, <i>Acinetobacter spp</i> and <i>Escherichia coli</i> were 100% resistant to ceftriaxone (CRO) while five isolates of <i>K. pneumoniae</i> were resistant to all tested antibiotics including Meropenem. The STG adherence was only in 26 (4.30%) patients out of 731 patients studied with regards to ceftriaxone prescription.</p><p><strong>Conclusion: </strong>In this study, the majority of pathogens were due to multi-drug resistant (MDR) bacteria. The STG adherence was very low with regard to the use of ceftriaxone (4.30%). The resistance to Ceftriaxone was 100%; thus, Ceftriaxone should no longer be used as the first line for prophylaxis and treatment of bacterial infections in the surgical MNH-AICU and similar settings. Crucially, the establishment of dedicated Antimicrobial Stewardship Program (ASP) teams, along with rigorous education and strict adherence to defined guidelines, is of paramount importance to counteract and effectively reduce the observed antimicrobial resistance (AMR) burden.</p>","PeriodicalId":74991,"journal":{"name":"The East African health research journal","volume":"9 2","pages":"386-391"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial Activity of Zinc Oxide Nanoparticles and <i>Allium Sativum</i> Extract Against Pathogenic <i>Escherichia Coli</i> and <i>Staphylococcus Aureus</i> Isolates.","authors":"Fromence Nyambu Mwachofi, Anthony Mwangi, Catherine Macharia, Anthony Kebira Nyamache","doi":"10.24248/eahrj.v9i2.862","DOIUrl":"10.24248/eahrj.v9i2.862","url":null,"abstract":"<p><strong>Background: </strong>The increasing trends in antimicrobial resistance (AMR) have continued to pose a global public health concern. This rapid emergence and spread of antimicrobial resistance have necessitated the exploration of innovative approaches to combat microbial infections. This study investigated the potential of enhancing antimicrobial properties through the synergistic effect of zinc oxide nanoparticles (ZnO NPs) and <i>Allium Sativum</i> (garlic) extracts against <i>Escherichia Coli</i> and <i>Staphylococcus aureus</i>.</p><p><strong>Methods: </strong>Zinc oxide nanoparticles (ZnO NPs), were synthesised using the sol-gel method and later synergised with extracts of Allium sativum. Formation of ZnO NPs was confirmed using X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FTIR) and UV-visible spectrophotometry methods. Similarly, these methods were also used in formed <i>Allium Sativum</i> extracts as well as in ZnO NPs and garlic acid combined product. The antimicrobial activity of the nanoparticles against <i>Staphylococcus aureus</i> and <i>Escherichia coli</i> isolates were determined using Kirby Bauer disc and well diffusion methods.</p><p><strong>Results: </strong>The average size of ZnO NPs in the present study is 40.96nm with a percentage crystallinity of 58.30%. The minimum inhibitory concentrations (MIC) of ZnO NPs ranged from 5 to 0.312 mg/ml. The antimicrobial assay of both ZnO NPs and crude <i>Allium Sativum</i> extracts showed a concentration-dependent effect. The zones of inhibition for ZnO NPs ranged from 18mm to 20mm±2.5, crude <i>Allium Sativum</i> extracts 8mm to 14.2mm±2, while the synergistic effect of ZnO NPs and crude <i>Allium Sativum</i> extracts was more effective with zones of inhibition ranging from 40mm±2 and 42mm±3.5 against Enteropathogenic <i>Escherichia coli</i> and <i>Staphylococcus aureus</i>, respectively. Antimicrobial assays revealed that the drug combination exhibited a significantly enhanced inhibitory effect against tested isolates by 35% with reduced minimum inhibitory concentrations (MICs) by 50% compared with individual treatments.</p><p><strong>Conclusion: </strong>Our findings confirm the promising use of zinc oxide nanoparticles (ZnO NPs) in treating pathogenic <i>Staphylococcus aureus</i> and Enteropathogenic <i>Escherichia coli</i> (EPEC) bacteria that zinc oxide nanoparticles (ZnO NPs) could be a possible alternative antibiotic. These results highlight the powerful potential of combining nanotechnology with natural products as alternative antimicrobial agents.</p>","PeriodicalId":74991,"journal":{"name":"The East African health research journal","volume":"9 2","pages":"401-409"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13126607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}