Tetanus nearly eliminated after 40 years of vaccination in rural Sengerema district, Tanzania

Objective: To study the incidence of tetanus during the last 50 years in Sengerema, Tanzania.Design: Analysing the annual reports in the only district hospital, focusing on the number of admissions and mortality for tetanus and malaria.Setting: Sengerema Hospital, Sengerema district, Tanzania.Subject: Number of admissions and mortality in Sengerema Hospital due to tetanus. Interventions: In the seventies and eighties a vaccination campaign was started end organised in order to cover the whole district and to provide immunity for tetanus.Main outcome measures: From 1962 to 2012, we analysed the incidence and fatality rate of tetanus.Result: One hundred and fifteen admissions in the sixties, increasing to 183 in the seventies, dropping to 30 in the nineties. For the last ten years 18 patients with tetanus were seen in the only district hospital. Then last year no admissions for tetanus were registered. The number of deaths due to tetanus decreased simultaneously, during the last decade a single fatality case was reported.Conclusion: During the last decades, we have witnessed the disappearing of tetanus in Sengerema Hospital. The incidence of tetanus can be reduced significantly or eliminated by an effective immunisation programme, even in rural Tanzania

Relapsing fever, a disappearing cause of fever and maternal death in Sengerema, Tanzania, east Africa

Objective: To study the incidence of tick borne relapsing fever (TBRF) during the last 50 years, once like malaria an endemic disease in Sengerema, Tanzania.Design: By analyzing the annual reports, focusing on the number of admissions, maternal deaths, blood smears of patients with fever for Borrelia.Setting: Sengerema district, Tanzania.Subject: Admissions in Sengerema Hospital due to TBRF.Main Outcome Measures: From 1960 to 2010, we analyzed the incidence of TBRF.Result: Forty annual admissions in the sixties/seventies, 200 in the eighties (range from 37 in 1964 to 455 in 1988), dropping to 30 in the nineties. For the last nine years no Borrelia spirochetes were found in blood smears at the laboratory anymore and no admissions for TBRF were  registered. The number of maternal deaths due to relapsing fever  decreased simultaneously; the last one recorded was in 2002.Conclusion: During the last century, we have witnessed the disappearing of tick borne relapsing fever in Sengerema. Increase of gold mining,  improved local economy, housing and standards of living after the nineties resulted in an almost complete eradication of the incidence of TBRF

Experiences of family caregivers in caring for patients with heart failure admitted at Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania: A qualitative study.

BackgroundHeart failure (HF) continues to be a global health problem with its ramifications more pronounced in underdeveloped countries. Family members play a pivotal part in patient management which may influence the patient's overall quality of life. Prolonged delay in attendance to health care facilities among patients indicates ineffective support from family caregivers. In the Tanzanian context, there is limited information about the experiences of family caregivers in caring for patients with HF. This study explored family caregivers' experiences in caring for HF patients.MethodsA qualitative descriptive study design was conducted at Jakaya Kikwete Cardiac Institute in Dar es Salaam, Tanzania. A purposive sampling technique was used to select the potential participants. A sample size of 10 family caregivers of patients with HF was included in the study. Thematic analysis was used to derive the main theme and sub-themes.ResultsThree major themes were identified: demands for supportive care, new caring role and lifestyle, and professional support in caring for patients with HF. Caregivers needed social and financial support to facilitate the caring process. Learning to provide the required care at the right time was the new role acquired by caregivers while failing to participate in social events and caregiving in an unfavourable environment were reported as challenges in caregiving. However, compliance with instruction and effective interaction among the nurses and caregivers were considered to be positive professional support.ConclusionCaregivers need social and financial support to provide effective care to their patients. Caregiving is a learning process that needs continuous educational support to adapt to the new caring roles and challenges. Nurses should conduct regular assessments to explore caregivers' needs, challenges, and concerns and provide timely counselling that can facilitate coping

Themes and sub-themes.

BackgroundHeart failure (HF) continues to be a global health problem with its ramifications more pronounced in underdeveloped countries. Family members play a pivotal part in patient management which may influence the patient’s overall quality of life. Prolonged delay in attendance to health care facilities among patients indicates ineffective support from family caregivers. In the Tanzanian context, there is limited information about the experiences of family caregivers in caring for patients with HF. This study explored family caregivers’ experiences in caring for HF patients.MethodsA qualitative descriptive study design was conducted at Jakaya Kikwete Cardiac Institute in Dar es Salaam, Tanzania. A purposive sampling technique was used to select the potential participants. A sample size of 10 family caregivers of patients with HF was included in the study. Thematic analysis was used to derive the main theme and sub-themes.ResultsThree major themes were identified: demands for supportive care, new caring role and lifestyle, and professional support in caring for patients with HF. Caregivers needed social and financial support to facilitate the caring process. Learning to provide the required care at the right time was the new role acquired by caregivers while failing to participate in social events and caregiving in an unfavourable environment were reported as challenges in caregiving. However, compliance with instruction and effective interaction among the nurses and caregivers were considered to be positive professional support.ConclusionCaregivers need social and financial support to provide effective care to their patients. Caregiving is a learning process that needs continuous educational support to adapt to the new caring roles and challenges. Nurses should conduct regular assessments to explore caregivers’ needs, challenges, and concerns and provide timely counselling that can facilitate coping.</div

Association between fetal hemoglobin, lactate dehydrogenase, and disease severity in patients with sickle cell disease at Bugando Medical Centre, Mwanza, Tanzania.

IntroductionThere is a wide range of clinical manifestations in sickle cell disease (SCD). Despite having the same condition, each person's response to disease complications differs greatly. Individuals can be categorized according to the severity of their diseases to determine which group they fall into and receive the appropriate care based on their needs. The relationship between fetal hemoglobin (HbF), lactate dehydrogenase (LDH), and disease severity in Tanzania is little understood. This investigation sought to ascertain the relationship between HbF, LDH, and disease severity in SCD patients at the Bugando Medical Center.MethodThis cross-sectional study was carried out on SCD patients aged 6 months and older at the Bugando Medical Center in Mwanza, Tanzania. A total of 130 SCD patients were enrolled. The clinical history and laboratory test results for SCD patients were recorded on a specially constructed patient report form.ResultsThe majority of participants (56.9%) were men. For the population under study, more than half (60.8%) of participants had a moderate clinical phenotype (MCP), followed by 31.5% of asymptomatic participants and 7.7% of people with severe clinical phenotypes (SCP). Participants with SCP had substantially higher levels of LDH, with a mean level of 810.97IU/L (95% CI: 559.31-1062.64) and a p-value of 0.005. The severe clinical phenotype exhibited a significantly higher mean HbF score value of 10.09% (95% CI: 7.44-13.74%) with a p-value of 0.024 when compared to the asymptomatic and moderate clinical phenotypes.ConclusionIn SCD patients with SCP compared to ACP and MCP, the HbF levels were higher, but did not show a protective effects, and LDH can be used to predict the severity of SCD

Example of the coding process.

BackgroundHeart failure (HF) continues to be a global health problem with its ramifications more pronounced in underdeveloped countries. Family members play a pivotal part in patient management which may influence the patient’s overall quality of life. Prolonged delay in attendance to health care facilities among patients indicates ineffective support from family caregivers. In the Tanzanian context, there is limited information about the experiences of family caregivers in caring for patients with HF. This study explored family caregivers’ experiences in caring for HF patients.MethodsA qualitative descriptive study design was conducted at Jakaya Kikwete Cardiac Institute in Dar es Salaam, Tanzania. A purposive sampling technique was used to select the potential participants. A sample size of 10 family caregivers of patients with HF was included in the study. Thematic analysis was used to derive the main theme and sub-themes.ResultsThree major themes were identified: demands for supportive care, new caring role and lifestyle, and professional support in caring for patients with HF. Caregivers needed social and financial support to facilitate the caring process. Learning to provide the required care at the right time was the new role acquired by caregivers while failing to participate in social events and caregiving in an unfavourable environment were reported as challenges in caregiving. However, compliance with instruction and effective interaction among the nurses and caregivers were considered to be positive professional support.ConclusionCaregivers need social and financial support to provide effective care to their patients. Caregiving is a learning process that needs continuous educational support to adapt to the new caring roles and challenges. Nurses should conduct regular assessments to explore caregivers’ needs, challenges, and concerns and provide timely counselling that can facilitate coping.</div

S1 Dataset -

BackgroundHeart failure (HF) continues to be a global health problem with its ramifications more pronounced in underdeveloped countries. Family members play a pivotal part in patient management which may influence the patient’s overall quality of life. Prolonged delay in attendance to health care facilities among patients indicates ineffective support from family caregivers. In the Tanzanian context, there is limited information about the experiences of family caregivers in caring for patients with HF. This study explored family caregivers’ experiences in caring for HF patients.MethodsA qualitative descriptive study design was conducted at Jakaya Kikwete Cardiac Institute in Dar es Salaam, Tanzania. A purposive sampling technique was used to select the potential participants. A sample size of 10 family caregivers of patients with HF was included in the study. Thematic analysis was used to derive the main theme and sub-themes.ResultsThree major themes were identified: demands for supportive care, new caring role and lifestyle, and professional support in caring for patients with HF. Caregivers needed social and financial support to facilitate the caring process. Learning to provide the required care at the right time was the new role acquired by caregivers while failing to participate in social events and caregiving in an unfavourable environment were reported as challenges in caregiving. However, compliance with instruction and effective interaction among the nurses and caregivers were considered to be positive professional support.ConclusionCaregivers need social and financial support to provide effective care to their patients. Caregiving is a learning process that needs continuous educational support to adapt to the new caring roles and challenges. Nurses should conduct regular assessments to explore caregivers’ needs, challenges, and concerns and provide timely counselling that can facilitate coping.</div

Social demographic characteristics of participants.

Social demographic characteristics of participants.</p