Performance Characteristics of Malaria Rapid Diagnostic Test and Its Utilization in Management of Febrile Patients in Korogwe District (Tanga) Tanzania

Background: Malaria diagnosis continues to be the foremost among the challenge in malaria control strategies in Sub-Saharan countries including Tanzania. The World Health Organization changed malaria treatment Guidelines in 2010 to restrict the use of antimalarial drugs to parasitologically confirmed malaria cases in response to the overuse of antimalarial drugs. Malaria rapid diagnostic tests (mRDTs) are presented as a mean to implement the new guidelines for malaria parasitologically confirmed cases prior to initiating antimalarial drug therapy for mRDT positive patients. Methods: A hospital-based cross-sectional study among patients with fever and malaria-like symptoms was done between May and June, 2014 in Korogwe district hospital in a convenient manner. Data were cleaned and analysed in Epi-Info version 3.5.4 computer software, Chi-square test was used to compare proportions between two groups with P-value set at 0.05. Results: Results revealed that sensitivity, specificity, positive predictive value and negative predictive value of mRDT at 95% CI was 97.6%, 97.4%, 91.0% and 99.3% respectively. All patients with positive mRDT were treated with antimalarial drugs, while patients with negative mRDT results were treated with either antimalarial (P-value = 0.001) or antibiotics (P-value = 0.005) at 95% CI. The results of patients with negative mRDT results were less likely to be further investigated at 95% CI (P-value = 1.000). Conclusion: The mRDT had good sensitivity and specificity if compared with blood slide microscopy. Clinicians adhered to the 2010 World Health Organization guidelines adopted by the National Malaria Control Programme for patients with positive mRDT result; however, they did not adhere to malaria diagnosis and management guidelines in case of negative mRDT result

Morphologic and Genetic Identification of Taenia Tapeworms in Tanzania and DNA Genotyping of Taenia solium

Species identification of Taenia tapeworms was performed using morphologic observations and multiplex PCR and DNA sequencing of the mitochondrial cox1 gene. In 2008 and 2009, a total of 1,057 fecal samples were collected from residents of Kongwa district of Dodoma region, Tanzania, and examined microscopically for helminth eggs and proglottids. Of these, 4 Taenia egg positive cases were identified, and the eggs were subjected to DNA analysis. Several proglottids of Taenia solium were recovered from 1 of the 4 cases. This established that the species were T. solium (n=1) and T. saginata (n=3). One further T. solium specimen was found among 128 fecal samples collected from Mbulu district in Arusha, and this had an intact strobila with the scolex. Phylegenetic analysis of the mtDNA cox1 gene sequences of these 5 isolates showed that T. saginata was basal to the T. solium clade. The mitochondrial cox1 gene sequences of 3 of these Tanzanian isolates showed 99% similarity to T. saginata, and the other 2 isolates showed 100% similarity to T. solium. The present study has shown that Taenia tapeworms are endemic in Kongwa district of Tanzania, as well as in a previously identified Mbulu district. Both T. solium isolates were found to have an "African/Latin American" genotype (cox1)

Insecticide use pattern and phenotypic susceptibility of Anopheles gambiae sensu lato to commonly used insecticides in Lower Moshi, northern Tanzania

Abstract Background Evidence of insecticide resistance has been documented in different malaria endemic areas. Surveillance studies to allow prompt investigation of associated factors to enable effective insecticide resistance management are needed. The objective of this study was to assess insecticide use pattern and phenotypic susceptibility level of Anopheles gambiae sensu lato to insecticides commonly used in malaria control in Moshi, northern Tanzania. Methods A cross-sectional survey was conducted to assess insecticide usage pattern. Data was collected was through closed and open ended questionnaires The WHO diagnostic standard kit with doses of 0.1% bendiocarb, 0.05% deltamethrin, 0.75% permethrin and 4% DDT were used to detect knockdown time, mortality and resistance ratio of wild A. gambiae sensu lato. The questionnaire survey data was analyzed using descriptive statistics and one-way analysis of variance while susceptibility data was analysed by logistic regression with probit analysis using SPSS program. The WHO criteria was used to evaluate the resistance status of the tested mosquito populations. Results A large proportion of respondents (80.8%) reported to have used insecticide mainly for farming purposes (77.3%). Moreover, 93.3% of household reported usage of long lasting insecticidal nets. The frequently used class of insecticide was organophosphate with chloropyrifos as the main active ingredients and dursban was the brand constantly reported. Very few respondents (24.1%) applied integrated vector control approaches of and this significantly associated with level of knowledge of insecticide use (P < 0.001). Overall knockdown time for A. gambiae s.l was highest in DDT, followed by Pyrethroids (Permethrin and deltamethrin) and lowest in bendiocarb. Anopheles gambiae s.l showed susceptibility to bendiocarb, increased tolerance to permethrin and resistant to deltamethrin. The most effective insecticide against the population from tested was bendiocarb, with a resistance ratio ranging between 0.93–2.81. Conclusion Education on integrated vector management should be instituted and a policy change on insecticide of choice for malaria vector control from pyrethroids to carbamates (bendiocarb) is recommended. Furthermore, studies to detect cross resistance between pyrethroids and organophosphates should be carried out

The effects of sex and age of responders on the reliability of self-diagnosed infection: a study of self-reported urinary schistosomiasis in Tanzanian school children

Self-reported schistosomiasis has been proven to be a reliable estimation of the prevalence of infection in school children. For the first time, this paper presents an investigation into the use of self-reported schistosomiasis to estimate the prevalence of urinary schistosomiasis, due to Schistosoma haematobium, in school children with particular emphasis on whether the age and sex of respondents influences the reliability of diagnosis. It is shown first, that the prevalence and intensity of infection vary with sex; infection in boys is always more prevalent and more intense than in girls of the same age and second, that age and sex influence the reliability of self-reported schistosomiasis as a diagnostic method. Age and sex are factors that should be considered when implementing control measures in endemic areas.Schistosoma haematobium Diagnosis Sensitivity Specificity Age Tanzania Sex

Evaluation of efficacy of school-based anthelmintic treatments against anaemia in children in the United Republic of Tanzania

OBJECTIVE: To determine the impact of deworming on anaemia as part of a large-scale school-based anthelmintic treatment programme in the Tanga Region of the United Republic of Tanzania. METHODS: Both the reduction in the prevalence of anaemia and the cost per case prevented were taken into consideration. Cross-sectional studies involved parasitological examination and anaemia evaluation before and at 10 months and 15 months after schoolchildren were dewormed. FINDINGS: Baseline studies indicated that the prevalence of anaemia (haemoglobin < 110 g/l) was high (54%) among schoolchildren, particularly those with high intensities of hookworm and schistosomiasis. Attributable fraction analysis suggested that hookworm and schistosomiasis were responsible for 6% and 15% of anaemia cases, respectively. Fifteen months after deworming with albendazole and praziquantel the prevalence of anaemia was reduced by a quarter and that of moderate-to- severe anaemia (haemoglobin <90 g/l) was reduced by nearly a half. The delivery of these anthelmintics through the school system was achieved at the relatively low cost of US$1 per treated child. The cost per anaemia case prevented by deworming schoolchildren was in the range US$ 6-8, depending on the haemoglobin threshold used. CONCLUSION: The results suggested that deworming programmes should be included in public health strategies for the control of anaemia in schoolchildren where there are high prevalences of hookworm and schistosomiasis

Prevalence and Risk Factors Associated with Human <em>Taenia Solium</em> Infections in Mbozi District, Mbeya Region, Tanzania

<div><p>Background</p><p><i>Taenia solium</i> cysticercosis/taeniosis is emerging as a serious public health and economic problem in many developing countries. This study was conducted to determine prevalence and risk factors of human <i>T. solium</i> infections in Mbeya Region, Tanzania.</p> <p>Methods and Findings</p><p>A cross-sectional survey was conducted in 13 villages of Mbozi district in 2009. Sera of 830 people (mean 37.9±11.3 years (SD); 43% females) were tested for circulating cysticerci antigen (Ag-ELISA) and antibody (Ab-ELISA). A subset of persons found seropositive by Ag-ELISA underwent computed tomography (CT) scan of the brain for evidence of neurocysticercosis. Stool samples from 820 of the same participants were tested for taeniosis by copro-antigens (copro-Ag-ELISA) and formol-ether concentration technique. Cases of <i>T. solium</i> taeniosis were confirmed serologically by EITB assay (rES38). A questionnaire was used for identification of risk factors. Active cysticercosis by positive Ag-ELISA was found in 139 (16.7%) persons while anti-cysticercal antibodies were detected in 376 (45.3%) persons by Ab-ELISA. Among 55 persons positive for Ag-ELISA undergoing CT scan, 30 (54.6%) were found to have structures in the brain suggestive of neurocysticercosis. Using faecal analysis, 43 (5.2%) stool samples tested positive for taeniosis by copro-Ag-ELISA while <i>Taenia</i> eggs were detected in 9 (1.1%) stool samples by routine coprology. Antibodies specifically against adult <i>T. solium</i> were detected in 34 copro-Ag-ELISA positive participants by EITB (rES38) indicating <i>T. solium</i> taeniosis prevalence of 4.1%. Increasing age and hand washing by dipping in contrast to using running water, were found associated with Ag-ELISA seropositivity by logistic regression. Gender (higher risk in females) and water source were risk factors associated with Ab-ELISA seropositivity. Reported symptoms of chronic severe headaches and history of epileptic seizures were found associated with positive Ag-ELISA (p≤0.05).</p> <p>Conclusion</p><p>The present study indicates <i>T. solium</i> infection in humans is highly endemic in the southern highlands of Tanzania.</p> </div

Associations between reported neurological symptoms and <i>T. solium</i> positivity (Ag- and Ab-ELISA), Mbozi district, Tanzania.

<p>Pos = positive.</p

Prevalence of <i>Taenia solium</i> and other helminth infections in Mbozi district, Mbeya Region, Tanzania.

<p>Pos = Positive; Neg = Negative; 95%CI = 95% Confidence Interval.</p

Multivariate analysis on risk factors for human cysticercosis considered in the logistic regression analysis.

<p>OR = odds ratio; 95%CI = 95% confidence interval; Ref = reference; pos = positive; neg = negative.</p>*<p>Significant factor at 95%CI.</p