Trauma admissions among street children at a tertiary care hospital in north-western Tanzania: a neglected public health problem

Background: Trauma among street children is an emerging but neglected public health problem in most low and middle income countries. This study was conducted to determine the incidence, etiological spectrum, injury characteristics and treatment outcome among street children and to identify the predictors of the outcome of these patients at Bugando Medical Centre in Mwanza, Tanzania.Methods: The study included street children aged <18 years. Routine investigations including haematological, biochemical and imaging were performed on admission. The severity of injury was determined using the Kampala Trauma Score II. Data on patient’s characteristics, circumstances of injury, injury characteristics, treatment offered, outcome variables, length of hospital stay and mortality were collected using a questionnaire.Results: A total of 342 street children (M: F = 6.8: 1) representing 11.5% of all paediatric injury patients were studied. The modal age group was 11-15 years (median = 12 years) accounting for 53.2% (n=182) of the patients. Assault was the most frequent (73.7%) cause of injury. More than three quarter of injuries occurred along the street. Most of patients (59.1%) presented late (>24 hours) after injury. Blunt injuries were the most common (76.0%) mechanism of injuries. Musculoskeletal (30.8%) and head (25.3%) were the most frequent body regions affected. Soft tissue injuries were the most common type of injuries affecting 322 (94.2%) cases. Majority of patients (96.5%) underwent surgical treatment of which wound debridement (97.6%) was the most common surgical procedure performed.  Complication rate was 39.5%. The median hospital stay was 6 days.  Mortality rate was 13.5% and it was significantly associated with injury-arrival time (OR =2.4, 95%CI (1.3-5.6), p = 0.002), severe injury (Kampala Trauma Score <6) (OR = 3.6, 95%CI (2.5-7.9), p = 0.001), severe head injuries (OR= 5.1, 95%CI (4.6 – 8.2), p =0.012) and surgical site infection.Conclusion: Trauma among street children is an emerging but neglected epidemic in Tanzania and contributes significantly to high morbidity and mortality. Assault was the most frequent cause of injury.  Urgent preventive measures targeting at reducing the occurrence of assault is necessary to reduce the incidence of trauma among street children in this region

The burden and management of self-inflicted injuries at a tertiary care hospital in Mwanza, Tanzania

Background: Self-inflicted injuries are a serious but neglected public health problem in developing countries and contribute significantly to the global injury burden. There is a paucity of published data regarding self-inflicted injuries in Tanzania.  This study describes the aetiology, patterns and treatment outcome of these injuries in Mwanza, Tanzania.Methods: This was a combined retrospective and prospective study of self-inflicted injury patients who were managed at Bugando Medical Centre in Mwanza between February 2007 and April 2014. Data were collected using a pretested and coded questionnaire and analysed using SPSS computer software version 17.0Results: A total of 136 patients (M: F = 3.3: 1) were enrolled into the study. The median age was 30 years. Psychiatric illness (30.9%) was the most common risk factor for self-inflicted injuries. Self-poisoning (35.3%) was the most frequent mechanism of self-inflicted injuries. This was followed by cutting/stabbing and jumping from heights in 23.5% and 20.6% of patients, respectively. The trunk was the most frequent (31.9%) body region affected. Open wounds were the most (4.2%) common type of injuries sustained. The majority (72.1%) of patients were treated surgically. The complication rate was 50.7% and it was significantly associated with delayed presentation (p= 0.012). The median hospital stay was 12 days. Patients with long bone fractures and those who had surgical site infection stayed longer in the hospital (p < 0.001). The mortality rate was 22.8%. Late presentation (>24 hour), severe injuries (KTS II ≤ 6) and presence of surgical site infections were the main predictors of mortality (p<0.001).Conclusion: Self-inflicted injuries are an emerging but neglected public health problem in Mwanza, Tanzania and contribute to unacceptably high morbidity and mortality. Addressing the root causes of self-inflicted injuries may reduce the incidence of these injuries in our environment

Modification of Nanozirconia with Sulfuric Acid and Calcium Oxide as Heterogeneous Catalysts for Biodiesel Production from Used Coconut Cooking Oil

The commercial zirconia nanopowder was modified using sulfuric acid and calcium oxide to synthesize SO4/ZrO2 and Zr/CaO catalysts. The wet impregnation technique was utilized to obtain SO4/ZrO2 acid catalyst, and the Zr/CaO base catalyst was produced as well using reflux method through the microwave heating process. The highest total acidity of SO4/ZrO2 catalyst was treated by 0.9 M H2SO4 and 500 °C of calcination temperature, and this catalyst was succeeded in reducing used coconut cooking oil FFA from 1.18% to 0.42% in the esterification process. The highest total alkalinity was reached using 1% w/w Zr/CaO and 900 °C of calcination temperature, and this catalyst was applied in the transesterification stage and successfully converted used coconut cooking oil into biodiesel by 62.25%. The formation of biodiesel was confirmed by the presence of methyl laurate (50.48%), methyl myristate (19.05%), methyl stearate (11.05%), methyl 11-octadecanoic (6.09%), methyl octanoate (5.25%), methyl decanoate (5.05%), and methyl octadecanoate (3.03%)

Trauma admissions among victims of domestic violence at a tertiary care hospital in north-western Tanzania: an urgent call to action

Background: Despite the growing recognition of domestic violence as a public health and human rights concern, it remains rampant in developing countries and has a negative impact on the victim’s health. This study describes the injury characteristics and treatment outcome of trauma associated with domestic violence in north-western Tanzania.Methods: This was a descriptive prospective study of patients who were managed for domestic violence related trauma at Bugando Medical Centre in Mwanza, Tanzania from April 2009 to March 2014.Results: A total of 324 patients (M: F = 1: 10.6) were studied. Majority of the patients were in the second and third decades of life. The perpetrators were mainly husbands and ex-partners (55.5%). Suspecting sexual partner being unfaithful was the most common reason given by victims for domestic violence in 63.4% of cases. Blunt and sharp objects (56.8%) were the most common weapons used. Gunshot injuries were recorded in 0.6% of cases. The head/neck was commonly affected in 68.5%. Soft tissue injuries (77.8%) were the most frequent type of injuries. The majority of patients (65.4%) sustained mild injuries. Twenty-three (7.1%) patients were HIV positive. Surgical treatment was performed in only 34.6% of cases.  Complication rate was 26.8%. The median hospital stay was 12 days. Mortality rate was 6.5%. The main predictors of mortality were advanced age (> 60 years),  late presentation,  severity of injury, severe head injury, HIV seropositivity, low CD 4 count (<200 cells), surgical site infection (p<0.001). More than two-thirds of patients were lost to follow up.Conclusion: Domestic violence related trauma remains rampant in northwestern Tanzania and contributes significantly to high morbidity and mortality. Urgent preventive measures targeting at reducing the occurrence of domestic physical violence is necessary to reduce the morbidity and mortality resulting from these injuries.

Cut Throat Injuries at a University Teaching Hospital in Northwestern Tanzania: A Review of 98 cases.

Cut throat injuries though rarely reported in literature pose a great therapeutic challenge because multiple vital structures are vulnerable to injuries in the small, confined unprotected area. A sudden increase in the number of cut throat patients in our centre in recent years prompted the authors to analyze this problem. This study was conducted in our local setting to describe the etiology, patterns and treatment outcome of these injuries. This was a combined retrospective and prospective study of cut throat injury patients who were managed at Bugando Medical Centre between February 2009 and January 2013. Statistical data analysis was done using SPSS software version 17.0. A total of 98 patients with cut throat injuries were studied. Males outnumbered females by a ratio of 2.4: 1. The median age of patients was 26 years (range 8 to 78 years). Majority of patients (79.6%) had no employment and most of them (65.3%) came from rural community. Homicide was the commonest (55.1%) cause, followed by suicidal attempts (34.7%) and accidental (10.2%) injuries. Interpersonal conflict (24.4%) was the most common motivating factor for homicidal injury whereas psychiatric illness (16.2%) and road traffic accidents (9.2%) were the most frequent motivating factors of suicidal attempt and accidental injuries respectively. The majority of injuries were in Zone II accounting for 65.3% of cases and most of them had laryngeal (57.1%) injury. Surgical debridement, laryngeal/hypopharynx repair and tracheostomy were the most common surgical procedures performed in 93.9%, 73.5% and 70.4% of patients respectively. Postoperative complication rate was 57.1%, the commonest being surgical site infections in 28.1% of patients and it was significantly associated with late presentation and anatomical zones (P < 0.001). The overall median duration of hospitalization was 12 days. Patients who had postoperative complications stayed longer in the hospital and this was statistically significant (p = 0.011). Mortality rate was 11.2% and was significantly associated with co-morbidities, delayed presentation and presence of complications (p < 0.001). The follow up of patients was poor. Cut throat injuries are a major cause of morbidity and mortality among young adult males in our setting. Addressing the root causes of violence such as poverty, unemployment, and substance abuse will reduce the incidence of these injuries in our environment

Use of Sulfuric Acid-Impregnated Biochar Catalyst in Making of Biodiesel From Waste Cooking Oil Via Leaching Method

The biodiesel synthesis of waste cooking oil (WCO) over a impregnated biochar catalyst was systematically studied. This research aimed to prepare Biochar-based material that comes from coconut coir, activate it, and apply it as a catalyst to the esterification reaction of high-FFA waste cooking oil. Activation of the catalyst was done by impregnation H2SO4 solution in Biochar. The obtained catalyst was characterized by FTIR, XRF, XRD, surface area analyzer, and SEM-EDS. The esterification process was conducted by varying the catalyst weight (5, 7, and 10 wt%) and the reaction temperature (55 and 60 °C). The obtained liquid yields were characterized by GC-MS. The study found that the esterification process worked best with 10 wt% catalysts, a 1:76 mole ratio of oil to alcohol, and a reaction temperature of 60 °C. The waste cooking oil was successfully converted into biodiesel, reaching 84.50% of yield and 77.30% of purity (methyl ester content). Meanwhile, testing using national biodiesel standards with parameter limits of density, viscosity, iodine number, and acid number shows results that meet the requirements. Copyright © 2024 by Authors, Published by BCREC Publishing Group. This is an open access article under the CC BY-SA License (https://creativecommons.org/licenses/by-sa/4.0)