Periodontal Diseases in Tanzania

Tutkimuksen tavoitteena oli kuvata hampaiden kiinnityskudossairauksien esiintyvyyttä ja suuhygieniatottumuksia Tansaniassa. Viiden eri tutkimuksen avulla kartoitettiin suuhygieniatottumuksia, kiinnityskudosten tilaa, kiinnityskudossairauksien riskitekijöitä ja hoidon tarvetta (CPITN) sekä ienvetäymiä. Tutkimukset toteutettiin eri paikkakunnilla vuosien 1987 ja 2003 välillä. Tutkittavat valittiin satunnaisesti tai harkitusti; tutkittavien määrä vaihteli 201:stä 1764:ään. Aineistot kerättiin kysymyslomakkeilla ja kliinisten tutkimusten avulla. Kliinisesti mitattiin plakin, hammaskiven ja ienten verenvuodon määrä, ientaskujen syvyys, ienvetäymien laajuus ja puuttuvien hampaiden lukumäärä. Tutkimusvälineinä käytettiin peiliä, Williamsin ja WHO:n ientaskumittareita. Muoviharjaksista hammasharjaa ilmoitti käyttävänsä 51,5-97,8% tutkituista. Ns. harjaustikun käyttö vaihteli paljon: 0,9-32,0 %. Plakkia löydettiin 65-100 %:lla tutkituista. Hammaskiveä oli suurimmalla osalla tutkituista. Myös ienverenvuotoa löytyi valtaosalta (79-100%). Ienverenvuotoa oli enemmän miehillä kuin naisilla sekä alhaisemman koulutustason omaavilla. Neljäkymmentä vuotta täyttäneiltä löydettiin 4–5 mm:n syvyisiä ientaskuja 82,1 %:lta ja ≥ 6 mm:n taskuja 43,8 %:lta. Suun terveystottumusten ohjaamiseen oli tarvetta yli 90 %:lla, hammaskiven poistoon ja juurten pinnan tasoitukseen yli 80%:lla. Yleisimmät riskitekijät kiinnityskudossairauksille olivat ikä (≥ 35 vuotta), miessukupuoli, alhainen koulutustaso, plakin, hammaskiven ja ientulehduksen määrä sekä asuminen maaseudulla. Ienvetäymiä (≥ 4 mm) löytyi noin 54%:lla tutkituista. Ienvetäymiä oli useammin miehillä kuin naisilla ja ne olivat yhteydessä ikään sekä hammaskiven ja ienverenvuodon esiintymiseen. Suuhygieniataso tutkituilla henkilöillä oli huono ja ienvetäymien esiintyvyys korkea. Syviä ientaskuja löytyi kuitenkin harvoilta tutkituilta. Riskitekijät kiinnityskudossairauksille olivat ikä, miessukupuoli, alhainen koulutustaso, plakin, hammaskiven ja ientulehduksen määrä sekä asuminen maaseudulla. Ienvetäymien riskit olivat ikä, miessukupuoli, hammaskivi ja ienverenvuotoThe aim of the study was to describe and analyse the periodontal condition and oral hygiene practices among Tanzanians. Five individual studies in different locations between 1987 and 2003 assessed oral hygiene practices, periodontal status, risk factors, community periodontal treatment needs (CPITN), and gingival recession. Sample sizes ranged from 201 to 1,764. Subjects were recruited from a wide age range (3–95 years) by random and cluster samplings. Data were collected using questionnaires and by clinical examinations. Plaque, calculus, gingival bleeding, periodontal pocket probing depth, gingival recession, and tooth loss were recorded using a mouth mirror, Williams- and WHO periodontal probes. Self-reported tooth-cleaning devices included plastic toothbrushes in 51.5-97.8%. The use of a chewing stick varied also: 0.9-32.0%. The prevalence of plaque was high; 65.0-100%. Most of the participants had supra- and sub-gingival calculus. Gingival bleeding (GB) on probing was found in 79-100% of the participants. GB was detected more often in males than in females, and in low educated participants. At the age ≥40 years, a periodontal pocket probing depth (PPD) of 4–5 mm was found in 82.1% and a PPD ≥6 mm in 43.8%. The CPITN indicated a very high need for oral health education (>90%), and for scaling and root planning (>80%). Tooth loss was higher among the chewing stick users than in the plastic toothbrush users. The most common risk factors for periodontal diseases were age (≥35 years), male sex, low education, plaque, calculus, gingival inflammation, and rural residency. Gingival recession (GR) ≥4 mm at the age ≥35 years was about 54%. Risk factors for gingival recession were age, calculus and gingival inflammation. Oral hygiene status in the studied populations was very poor and gingival recession common. However, the occurrence of severe periodontal disease was low. The risk factors for periodontal diseases were age, male sex, low education, rural residence, plaque and calculus. Risk factors for gingival recession were age, male sex, calculus and gingival inflammation.Siirretty Doriast

Kuchunguza Dhima ya Mtindo katika Tamthiliya za Kihistoria: Utafiti Linganishi wa Tamthiliya za Morani na Kinjeketile,

Lengo la utafiti huu kama lilivyobainishwa katika sura ya kwanza ilikuwa ni kuchunguza dhima ya vipengele vya kimtindo katika tamthiliya za kihistoria kwa kulinganisha tamthiliya ya Morani na Kinjeketile ili kubaini vipengele vinavyowafananisha na kuwatofautisha wasanii wa vitabu hivyo katika kuliwasilisha suala la kihistoria. Utafiti huu ulitumia mbinu tatu za ukusanyaji data ambazo ni; maktaba, usaili na dodoso. Sampuli iliteuliwa kwa kutumia mbinu ya madhumuni maalumu na uteuzi rahisi. Aidha data za utafiti huu zilichambuliwa kwa kutumia mbinu ya uchambuzi maudhui na uchambuzi linganishi. Utafiti huu uliongozwa na Nadharia ya Elimumitindo katika Uchambuzi wa Matini za Kifasihi. Utafiti umegundua kuwa, tamthiliya hizi zinatofautiana katika mbinu za kisanii na ubunifu. Tamthiliya ya Morani imetumia mbinu na lugha ya kitamathali wakati tamthiliya ya Kinjeketile imetumia lugha ya kawaida, rahisi na ya wazi zaidi. Aidha utafiti huu umebaini kuwa, tamthiliya hizi zinatofutiana katika kuwasilisha suala la kihistoria kwa sababu wasanii wanawasilisha historia ya jamii ya Tanzania katika vipindi viwili tofauti. Morani anawasilisha historia katika kipindi cha baada ya uhuru na hivyo kujadili juu ya historia ya harakati za kupambana na ukoloni mamboleo wakati Kinjeketile inajadili kwa uhalisia juu ya harakati za jamii za kusini katika kupambana na ukoloni mkongwe, yaani, ukoloni katika utawala wa Mjerumani. Kwa upande mwingine, ilibainika kuwa tamthiliya hizi kwa vile zimeandikwa na wasanii wa jamii moja ambao wameshuhudia na kupata masimulizi ya historia ya jamii yao. Wasanii hawa wanafanana katika kuwasilisha maudhui ya kazi zao ambapo wote kwa pamoja wanajadili juu ya mambo mbalimbali yaliyopo katika jamii kama vile; rushwa, harakati za ukombozi, usaliti, unyonyaji na ukandamizaji

Sociodemographics and School Environment Correlates of Clustered Oral and General Health Related Behaviours in Tanzanian Adolescents

Objectives: To identify underlying clusters of general and oral health behaviours and acertain possible factors influencing the existence of the behaviours. Materials and Methods: A cross sectional study was conducted among 4,847 school adolescents aged 11 to 17 years. Data were collected using a structured questionnaire in Kiswahili inquiring about general and oral health related behaviours, socio-demographics and adolescents’ school relationship. Principal component analysis was employed to identify clusters of health behaviour. Frequency distribution for proportions, cross tabulations with chi-square and a two stage binary logistic regression were done. Results: Principal component analysis identified four clusters from twelve health behaviours; hygiene practices, dietary behaviours, cigarette smoking & alcohol consumption and sedentary related behaviours. Girls, OR 0.8 (95% CI 0.7, 0.9); secondary school attendees, OR 0.5 (95% CI 0.4, 0.7) and adolescents with good school relationship OR 0.7 (95% CI 0.6, 0.8) were less likely to smoke or use alcohol. Urban residents were less likely OR 0.8, (95% CI 0.7, 0.9) to report acceptable dietary behaviours. Adolescents whose fathers had secondary education or higher, were in secondary schools and had good school relationship were most likely to have acceptable hygiene behaviours, OR 1.4 (95% CI 1.2, 1.6), 1.6 (95% CI 1.1, 2.2) and 1.4 (95% CI 1.3, 1.7), respectively. Conclusion: Oral and general health behaviours of Tanzanian adolescents factored into four clusters with hygiene behaviours being most practiced and physical exercise the least. The clustered behaviours were influenced by socio-demographics and school environment

High seroprevalence of specific Toxoplasma gondii IgG antibodies among HIV/AIDS patients with immunological failure attending a tertiary hospital in northwestern Tanzania

 Toxoplasmosis is a major cause of morbidity and mortality among patients with advanced HIV disease. However, there is limited data on the magnitude of toxoplasmosis among HIV patients with immunological treatment failure. Therefore, this study was designed to determine the seroprevalence of specific Toxoplasma gondii IgG antibodies among HIV/AIDS patients attending Bugando Medical Centre in Mwanza, Tanzania. Immunological treatment failure was defined using the World Health Organization (WHO) criteria and specific T.gondii IgG antibodies were determined using indirect enzyme linked immunosorbent (ELISA). A total of 178 non-repetitive sera from HIV/AIDS patients were analyzed. The mean age of study participants was 38.5±11.3 years. Majority of study participants were males 120 (67.42%). Out of 178 patients, 38 (21.34%) were diagnosed to have immunological failure. T.gondii specific IgG antibodies were found in 26 (68.4%) of the patients with immunological failure compared to 46 (32.86%) of those without immunological failure (OR: 4.42, CI: 2.05-9.55; p<0.001). The seroprevalence of T.gondii infection is high among patients with immunological treatment failure and place them at a high risk of T. gondii encephalitis necessitating sustained trimethoprim-sulfamethaxazole prophylaxis to prevent reactivation.  

Treatment delays in children and young adults with lymphoma: report from an East Africa Lymphoma Cohort Study

Background: Affordable treatments for lymphoma from the WHO's essential medicine list are available in low-income settings. However, precise diagnosis is often lacking and prolonged time to diagnosis and treatment results in poor treatment outcomes. So far, a detailed analysis of the root causes of the treatment delay is lacking. Methods: This prospective cohort study was conducted at three tertiary cancer hospitals in Tanzania and one cancer centre, St. Mary's Hospital-Lacor Hospital, in Northern Uganda. The study included patients with a confirmed diagnosis of lymphoma. The primary outcome was the median total treatment delay and its components. Total treatment delay was defined as the time taken from the onset of symptoms to receiving definitive cancer treatment. Results: The median age of patients was 12 years (IQR 9-18), and 100 (68%) were males. The median Total Treatment Delay for the entire cohort was 124 days (95% CI 107 - 136). Not started treatment probability for the entire cohort was 64% (95% CI 56-72) at 90 days and 30% (24 - 39) at 180 days. The median Total Treatment Delay for Burkitt lymphoma was 91 days (95% CI 80 - 115), while for DLBCL and Hodgkin lymphoma, it was 114 days (95% CI 84 - 148) and 232 days (95% CI 179 - 305), respectively. Conclusion: Significant treatment delay for lymphoma patients emanates from healthcare system-related factors. Due to delays in referrals from primary care and lack of capacity of pathology in secondary care, initial treatment decisions are still often based on clinical suspicion and urgency

Analysis of traumatic injuries presenting to a referral hospital emergency department in Moshi,

Abstract Background: Injuries represent a significant and growing public health concern in the developing world, yet their impact on patients and the emergency health-care system in the countries of East Africa has received limited attention. This study evaluates the magnitude and scope of injury related disorders in the population presenting to a referral hospital emergency department in northern Tanzania

Maternal oral health status and preterm low birth weight at Muhimbili National Hospital, Tanzania: a case-control study

The study examined the relationship between oral health status (periodontal disease and carious pulpal exposure (CPE)) and preterm low-birth-weight (PTLBW) infant deliveries among Tanzanian-African mothers at Muhimbili National Hospital (MNH), Tanzania. A retrospective case-control study was conducted, involving 373 postpartum mothers aged 14-44 years (PTLBW--150 cases) and at term normal-birth-weight (TNBW)--223 controls), using structured questionnaire and full-mouth examination for periodontal and dentition status. The mean number of sites with gingival bleeding was higher in PTLBW than in TNBW (P = 0.026). No significant differences were observed for sites with plaque, calculus, teeth with decay, missing, filling (DMFT) between PTLBW and TNBW. Controlling for known risk factors in all post-partum (n = 373), and primiparaous (n = 206) mothers, no significant differences were found regarding periodontal disease diagnosis threshold (PDT) (four sites or more that had probing periodontal pocket depth 4+mm and gingival bleeding > or = 30% sites), and CPE between cases and controls. Significant risk factors for PTLBW among primi- and multiparous mothers together were age < or = 19 years (adjusted Odds Ratio (aOR) = 2.09, 95% Confidence interval (95% CI): 1.18-3.67, P = 0.011), hypertension (aOR = 2.44, (95% CI): 1.20-4.93, P = 0.013) and being un-married (aOR = 1.59, (95% CI): 1.00-2.53, P = 0.049). For primiparous mothers significant risk factors for PTLBW were age < or = 19 years (aOR = 2.07, 95% CI: 1.13 - 3.81, P = 0.019), and being un-married (aOR = 2.58, 95% CI: 1.42-4.67, P = 0.002). These clinical findings show no evidence for periodontal disease or carious pulpal exposure being significant risk factors in PTLBW infant delivery among Tanzanian-Africans mothers at MNH, except for young age, hypertension, and being unmarried. Further research incorporating periodontal pathogens is recommended

Climate seasonality limits leaf carbon assimilation and wood productivity in tropical forests

The seasonal climate drivers of the carbon cycle in tropical forests remain poorly known, although these forests account for more carbon assimilation and storage than any other terrestrial ecosystem. Based on a unique combination of seasonal pan-tropical data sets from 89 experimental sites (68 include aboveground wood productivity measurements and 35 litter productivity measurements), their associate canopy photosynthetic capacity (enhanced vegetation index, EVI) and climate, we ask how carbon assimilation and aboveground allocation are related to climate seasonality in tropical forests and how they interact in the seasonal carbon cycle. We found that canopy photosynthetic capacity seasonality responds positively to precipitation when rainfall is < 2000 mm.yr−1 (water-limited forests) and to radiation otherwise (light-limited forests); on the other hand, independent of climate limitations, wood productivity and litterfall are driven by seasonal variation in precipitation and evapotranspiration respectively. Consequently, light-limited forests present an asynchronism between canopy photosynthetic capacity and wood productivity. Precipitation first-order control indicates an overall decrease in tropical forest productivity in a drier climate.Peer reviewe

Climate seasonality limits leaf carbon assimilation and wood productivity in tropical forests

The seasonal climate drivers of the carbon cycle in tropical forests remain poorly known, although these forests account for more carbon assimilation and storage than any other terrestrial ecosystem. Based on a unique combination of seasonal pan-tropical data sets from 89 experimental sites (68 include aboveground wood productivity measurements and 35 litter productivity measurements), their associated canopy photosynthetic capacity (enhanced vegetation index, EVI) and climate, we ask how carbon assimilation and aboveground allocation are related to climate seasonality in tropical forests and how they interact in the seasonal carbon cycle. We found that canopy photosynthetic capacity seasonality responds positively to precipitation when rainfall is  < 2000 mm yr⁻¹ (water-limited forests) and to radiation otherwise (light-limited forests). On the other hand, independent of climate limitations, wood productivity and litterfall are driven by seasonal variation in precipitation and evapotranspiration, respectively. Consequently, light-limited forests present an asynchronism between canopy photosynthetic capacity and wood productivity. First-order control by precipitation likely indicates a decrease in tropical forest productivity in a drier climate in water-limited forest, and in current light-limited forest with future rainfall  < 2000 mm yr⁻¹