PATHOGENIC ISOLATES IN MENINGITIS PATIENTS IN DAR ES SALAAM, TANZANIA

Objectives: To determine, from laboratory records, the spectrum of bacterial and fungalpathogens isolated fromcerebrospinal fluids (CSF) of in-patients with meningitis at MuhimbiliMedical Centre (MMC) in Dares Salaam and to ascertain the laboratory results (based onmicroscopy and culture) using the latex agglutination technique.Design: A retrospective study based on laboratory records of CSF samples investigatedbetween November 1999 and June 2000 and a cross-sectional study involving investigationof 60 freshly collected CSF samples by conventional (microscopy and culture) and antigendetection by latex agglutination technique (LAT).Setting: Muhimbili Medical Centre in Dares Salaam, Tanzania.Investigations: Information from laboratory records, bacteriological examination of CSFby microscopy, culture and agglutination techniques.Result: According to records, a total of 1144 CSF samples were investigated betweenNovember 1999and June 2000, of which two hundred and twenty twospecimens (19.4%) hada positive bacterial or fungal culture. Fifty five of the isolates were from children (aged lessthan 15 years) and were; 20 (36.4%) were Streptococcus pneumoniae, 12(21.8%) wereCryptococcus neoformans, and nine (16.4%) were Haemophilus infIuenzae type b. Theremaining 14 (25%) isolates included three group B streptococci, three Klebsiella spp, twoE.coli, two Staphylococcus aureus, two Pseudomonas spp, one Moraxella and one Salmonellagroup B. For adults a total of 167 positive cultures were reported and 163 (97.6%) of theisolates were Cryptocaccus neoformans, two (1.2%) were Pseudomonas spp. and two were S.aureus. There was good agreement between conventional microscopy and culture with thelatex agglutination technique in the identification of CSF pathogens.Conclusion: In children, S. pneumonia, and bacteria in general constituted the majority ofisolates. Adult cases of meningitis were almost exclusively due to C. neoformans. Overall, C.neoformans appears to be the most common isolate among meningitis cases. Based on LATresults, our routine diagnostic methods seem to be adequate in the identification of thecommon CSF pathogens

The influence of dietary sugars and starch on the establishment of Streptococcus mutans and Actinomyces viscosus in dental plaque of specific pathogen free rats

Contains fulltext : 21323.PDF (publisher's version ) (Open Access

Cariogenicity depends more on diet than the prevailing mutans streptococcal species

Contains fulltext : 23469.PDF (publisher's version ) (Open Access

Decayed/missing/filled teeth and shortened dental arches in Tanzanian adults.

Contains fulltext : 57645.pdf (publisher's version ) (Closed access)PURPOSE: This study assessed decayed/missing/filled teeth (DMFT), presence of occlusal units, and prevalence of shortened dental arches in a Tanzanian adult population. MATERIALS AND METHODS: The dental state of samples of the Tanzanian population was studied. Oral examinations were conducted on 5,532 adults from rural and urban cluster samples. DMFT was related to age, gender, and residence. The pattern of tooth loss within dental arches was mapped, and the prevalence of shortened dental arches was estimated. RESULTS: Mean DMFT scores increased gradually from 1.8 (20- to 29-year-olds) to 3.8 (50- to 59-year-olds). A steep increase was observed in the > or = 60-year-olds (DMFT 8.1). "Missing" was the dominant component of DMFT. The mean number of present teeth ranged from 27 in the youngest to 20 in the oldest age group. Under 60 years of age, DMFT was significantly higher for women than for men. No differences were found between residence categories. Molars were more frequently decayed, missing, and mobile than premolars. Of all subjects, 41% had complete dental arches, 44% had interruptions (of these, 73% were in posterior regions only), and 15% had shortened dental arches; 0.5% were edentulous. Of the subjects with shortened dental arches, about 65% had at minimum three pairs of occluding premolars. CONCLUSION: An initial low DMFT rate increased after the age of 60 years. Molars had the highest risk of dental decay and were most frequently absent. Shortened dental arches develop as a consequence of the pattern of tooth decay and tooth loss, although interruptions were frequently seen in the posterior regions

Antifungal activity of some Tanzanian plants used traditionally for the treatment of fungal infections.

Contains fulltext : 50678.pdf (publisher's version ) (Closed access)Using the ethnobotanical approach, some Tanzanian plants reported to be used by traditional healers for the treatment of oral candidiasis and fungal infections of the skin were collected and screened for their antifungal activity against Candida albicans, Candida glabrata, Candida tropicalis, Candida parapsilosis, Candida krusei and Cryptococcus neoformans. A total of 65 crude methanol extracts belonging to 56 plant species and 38 families were screened using the broth microdilution method, according to the guidelines of the Clinical and Laboratory Standard Institute (CLSI) (formerly, National Committee for Clinical and Laboratory Standards) [National Committee for Clinical Laboratory Standards, 2002. Reference Method for Broth Dilution Antifungal Susceptibility Testing of Yeasts. Approved Standard-2nd Edition M27-A2, National Committee for Clinical Laboratory Standards, Wayne, PA, USA]. Among the tested plant species, 45% (25 species) showed antifungal activity against one or more of the test fungi. The most susceptible yeasts were Cryptococcus neoformans, followed by Candida krusei, Candida tropicalis, and Candida parapsilosis. The least susceptible were Candida albicans and Candida glabrata. Strong antifungal activity was exhibited by extracts of Clausena anisata Oliv., Sclerocariya birrea Sond, Turraea holstii Gurk, Sterculia africana (Lour) Fiori, Acacia robusta subsp. Usambarensis (Taub) Brenan, Cyphosterma hildebrandti (Gilg), Desc, Elaeodendron buchannanii (Lows), Acacia nilotica (L.) Wild ex Del, Jatropha multifida L., and Pteridium aquilinum (L.) Kuhn

Evaluation of cytotoxic, genotoxic and CYP450 enzymatic competition effects of Tanzanian plant extracts traditionally used for treatment of fungal infections.

HIV-infected patients in sub-Saharan countries highly depend on traditional medicines for the treatment of opportunistic oral infections as candidiasis. Previous investigations on antifungal activity of medicinal plant extracts utilized by traditional healers in Tanzania have revealed 12 extracts with potent antifungal activity. Although the plants may be good candidates for new treatment opportunities, they can be toxic or genotoxic and could cause pharmacokinetic interactions when used concomitantly with antiretroviral agents. Therefore, we investigated the cytotoxicity, genotoxicity and cytochrome P450 interaction potential of these medicinal plants. Cytotoxicity was tested by Hoechst 33342, Alamar Blue, calcein-AM, glutathione depletion and O(2)-consumption assays and genotoxicity by a Vitotox assay. Competition of the 12 extracts on substrate metabolism by CYP3A4, 2C9, 2C19 and 2D6 was tested with high-throughput CYP inhibition screening. Pregnane X receptor (PXR) activation was tested using Chinese hamster ovary cell lines expressing human PXR. Herbal extracts inducing high human PXR activation were tested for enhanced CYP3A4 mRNA levels with quantitative polymerase chain reaction. Genotoxicity was found for Jatropha multifida, Sterculia africana and Spirostachys africana. All plant extracts showed high cytotoxic effects in almost all tests. Potent competition with CYP3A4, 2D6, 2C9 and 2C19 was found for 75% of the herbal extracts. Spirostachys africana did not affect CYP2D6 and for S. africana and Turraea holstii no effect on CYP2D6 and CYP3A4 (DBF) was found. Nine plant extracts showed significant activation of human PXR, but only Agaura salicifolia, Turraea holstii and S. africana significantly induced CYP3A4 mRNA levels. These results indicate the possibility of potential medicinal plant-antiretroviral interactions