Sickle cell anemia with acute splenic sequestration

A three and half years old girl, a known sickler presented with abdominal pain of four days, vomiting, cough and fever of three days. She had history of chest infections and fever which were treated as pneumonia. On examination she was febrile, had a tinge of jaundice, severe palmor pallor, hepatomegally with span of 11 cm, enlarged spleen 5 cm below costal margin. Respiratory rate was 40/min and crackles were heard on the lower right lung. Pulse rate was 130 beats/min, regular and gallop rhythm was present. Diagnosis of acute splenic sequestration syndrome and non-severe pneumonia was made. Packed cell volume blood transfusion was done twice and antibiotics were given. She was discharged after five days stay in the hospital

Multiple Sexual Partners and Condom use among 10 - 19 Year-olds in four Districts in Tanzania: What do we Learn?

Although some studies in Tanzania have addressed the question of sexuality and STIs among adolescents, mostly those aged 15 - 19 years, evidence on how multiple sexual partners influence condom use among 10 - 19 year-olds is limited. This study attempts to bridge this gap by testing a hypothesis that sexual relationships with multiple partners in the age group 10 - 19 years spurs condom use during sex in four districts in Tanzania. Secondary analysis was performed using data from the Adolescents Module of the cross-sectional household survey on Maternal, Newborn and Child Health (MNCH) that was done in Kigoma, Kilombero, Rufiji and Ulanga districts, Tanzania in 2008. A total of 612 adolescents resulting from a random sample of 1200 households participated in this study. Pearson Chi-Square was used as a test of association between multiple sexual partners and condom use. Multivariate logistic regression model was fitted to the data to assess the effect of multiple sexual partners on condom use, having adjusted for potential confounding variables. STATA (10) statistical software was used to carry out this process at 5% two-sided significance level. Of the 612 adolescents interviewed, 23.4% reported being sexually active and 42.0% of these reported having had multiple (> 1) sexual partners in the last 12 months. The overall prevalence of condom use among them was 39.2%. The proportion using a condom at the last sexual intercourse was higher among those who knew that they can get a condom if they want than those who did not. No evidence of association was found between multiple sexual partners and condom use (OR = 0.77, 95% CI = 0.35 - 1.67, P = 0.504). With younger adolescents (10 - 14 years) being a reference, condom use was associated with age group (15 - 19: OR = 3.69, 95% CI = 1.21 - 11.25, P = 0.022) and district of residence (Kigoma: OR = 7.45, 95% CI = 1.79 - 31.06, P = 0.006; Kilombero: OR = 8.89, 95% CI = 2.91 - 27.21, P < 0.001; Ulanga: OR = 5.88, 95% CI = 2.00 - 17.31, P = 0.001), Rufiji being a reference category. No evidence of association was found between multiple sexual partners and condom use among adolescents in the study area. The large proportion of adolescents who engage in sexual activity without using condoms, even those with multiple partners, perpetuates the risk of transmission of HIV infections in the community. Strategies such as sex education and easing access to and making a friendly environment for condom availability are important to address the risky sexual behaviour among adolescents

Snowledge, attitude and practices on HIV/AIDS, its transmission and prevention among primary school pupils in rural Kisarawe

Objective: To determine level of knowledge of HIV/AIDS and its transmissions, demographic factors influencing level of knowledge, rate of condom use and attitude toward condoms use and sexual activities among primary school pupils Design: Descriptive cross-sectional study Setting: the study was conducted in rural areas of Kisarawe district in Coast region. Six primary schools were involved Subjects: grade six and seven pupils were involved in the study Results: The study involved 334 pupils from five primary schools. 48.8% were males and 51.2% females. Most students were of 15-16 age group. Majority of pupils had high knowledge on HIV/AIDS and its transmission (76%). Males were more knowledgeable than females on prevention (69.9% vs. 61.4%) and results were significant. Forty two percent (42%) of pupils have had sexual intercourse and in most cases with their fellow pupils (57.1%). Age group in which most pupils started to engage in sexual activities was 11 to 14 years (65.7%). 32.9% of pupils were forced into sexual intercourse and females were more coerced than males (58% vs. 15.7%) and results were statistically significant. Only about 28.6% of pupils reported condom use in their last sexual intercourse. Furthermore 61.1% of pupils considered condoms ineffective in preventing HIV transmission. Among interviewed pupils 25 (7.5%) reported to have suffered from STI