HIV-1 drug resistance in recently HIV-infected pregnant mother's naïve to antiretroviral therapy in Dodoma urban, Tanzania

HIV resistance affects virological response to therapy and efficacy of prophylaxis in mother-to-child-transmission. The study aims to assess the prevalence of HIV primary resistance in pregnant women naïve to antiretrovirals

Westbrook Junior College Waitress with Six Students, June 1954

A Westbrook Junior College work-study waitress waits on table in the Dining Hall connector between Hersey Hall and Goddard Hall in this 1954 black and white photograph by William M. Rittase, Philadelphia, PA. The waitress serves a fruit crumble topped with ice cream to each of the six students seated at the square, wooden dining table. In addition to the desserts in front of each student, there are glasses of water and milk and arrays of silverware. In the center of the table is a cloth napkin arranged with a sugar container, creamer, and salt and pepper shakers. The Campus Green can be glimpsed through two curtained windows behind the waitress.https://dune.une.edu/wchc_photos_students1950s/1059/thumbnail.jp

Assessing completeness of patient medical records of surgical and obstetric patients in Northern Tanzania

Background Strengthening surgical services in resource-constrained settings is contingent on using high-quality data to inform decision making at clinical, facility, and policy levels. However, the evidence is sparse on gaps in paper-based medical record quality for surgical and obstetric patients in low-resource settings. Objective We aim to examine surgical and obstetric patient medical record data quality in health facilities as part of a surgical system strengthening initiative in northern Tanzania. Methods To measure the incidence of Surgical Site Infections (SSIs), sepsis and maternal sepsis surgical and obstetric inpatients were followed prospectively, over three months in ten primary, district, and regional health facilities in northern Tanzania. Between April 22nd to May 1st, 2018, we retrospectively reviewed paper-based medical records of surgical and obstetric patients diagnosed with SSIs, post-operative sepsis, and maternal sepsis in the three-month follow-up period. A data quality assessment tool with18 data elements related to documentation of SSIs and sepsis diagnosis, their respective symptoms and vital signs, inpatient daily monitoring indicators, and demographic information was developed and used to assess the completeness of patient medical records. Results Among the 157 patients diagnosed with SSI and sepsis, we found and reviewed 68% of all medical records. Among records reviewed, approximately one third (34%) and one quarter (23%) included documentation of SSI and sepsis diagnoses, respectively. 6% of reviewed records included documentation of all SSI and sepsis diagnoses, symptoms and vital signs, inpatient daily monitoring indicators, and demographic data. Conclusions Strengthening data quality and record-keeping is essential for surgical team communication, continuity of care, and patient safety, especially in low resource settings where paper-based records are the primary means of data collection. High-quality primary health information provides facilities with actionable data for improving surgical and obstetric care quality at the facility level

Predictors associated with completion of PEP among the total number of people with suspected rabid animal bites from 2008 to 2014 in Dodoma Region (10,771).

<p>Predictors associated with completion of PEP among the total number of people with suspected rabid animal bites from 2008 to 2014 in Dodoma Region (10,771).</p

Total number of suspected rabid animal bites in Dodoma region.

<p>(a) Total number of suspected rabid animal bites from 2008 to 2014 distributed per district. (b) Diagram of number of suspected rabid animal bites per district and year.</p

Patients’ characteristics, delay, PEP administration and follow up of suspected rabid animal bites.

<p>Patients’ characteristics, delay, PEP administration and follow up of suspected rabid animal bites.</p

Reliability and validity of using telephone calls for post-discharge surveillance of surgical site infection following caesarean section at a tertiary hospital in Tanzania

Abstract Background Surgical site infection (SSI) is a common post-operative complication causing significant morbidity and mortality. Many SSI occur after discharge from hospital. Post-discharge SSI surveillance in low and middle income countries needs to be improved. Methodology We conducted an observational cohort study in Dodoma, Tanzania to examine the sensitivity and specificity of telephone calls to detect SSI after discharge from hospital in comparison to a gold standard of clinician review. Women undergoing caesarean section were enrolled and followed up for 30 days. Women providing a telephone number were interviewed using a structured questionnaire at approximately days 5, 12 and 28 post-surgery. Women were then invited for out-patient review by a clinician blinded to the findings of telephone interview. Results A total of 374 women were enrolled and an overall SSI rate of 12% (n = 45) was observed. Three hundred and sixteen (84%) women provided a telephone number, of which 202 had at least one telephone interview followed by a clinical review within 48 h, generating a total of 484 paired observations. From the clinical reviews, 25 SSI were diagnosed, of which telephone interview had correctly identified 18 infections; telephone calls did not incorrectly identify SSI in any patients. The overall sensitivity and specificity of telephone interviews as compared to clinician evaluation was 72 and 100%, respectively. Conclusion The use of telephone interview as a diagnostic tool for post-discharge surveillance of SSI had moderate sensitivity and high specificity in Tanzania. Telephone-based detection may be a useful method for SSI surveillance in low-income settings with high penetration of mobile telephones

Predictors associated with delay to health care access among people with suspected rabid animal bites in Dodoma, Tanzania (10,771).

<p>Predictors associated with delay to health care access among people with suspected rabid animal bites in Dodoma, Tanzania (10,771).</p

Characteristics of reported suspected rabid animal bites and post-exposure prophylaxis.

<p>(a) Proportion of suspected rabid animal bites over total number of bites per year. (b) Animal species responsible for bites. (c) Post-exposure prophylaxis administered between 2008 and 2014.</p

The Situation of Safe Surgery and Anaesthesia in Tanzania : A Systematic Review

Background: Improvement in the surgical system requires intersectoral coordination. To achieve this, the development of National Surgical, Obstetric, and Anaesthesia Plans (NSOAPS) has been recommended. One of the first steps of NSOAP development is situational analysis. On the ground situational analyses can be resource intensive and often duplicative. In 2016, the Ministry of Health of Tanzania issued a directive for the creation of an NSOAP. This systematic review aimed to assess if a comprehensive situational analysis could be achieved with existing data. These data would be used for evidence-based priority setting for NSOAP development and streamline any additional data collection needed. Methods: A systematic literature review of scientific literature, grey literature, and policy documents was performed as per PRISMA. Extraction was performed for all articles relating to the five NSOAPS domains: infrastructure, service delivery, workforce, information management, and financing. Results: 1819 unique articles were generated. Full-text screening produced 135 eligible articles; 46 were relevant to surgical infrastructure, 53 to workforce, 81 to service delivery, 11 to finance, and 15 to information management. Rich qualitative and quantitative data were available for each domain. Conclusions: Despite little systematic data collection around SOA, a thorough literature review provides significant evidence which often have a broader scope, longer timeline and better coverage than can be achieved through snapshot-stratified samples of directed on the ground assessments. Evidence from the review was used during stakeholder discussion to directly inform the NSOAP priorities in Tanzania