Free radical scavenging activity of some fungi indigenous to Tanzania

The objective of this study was to evaluate free radical scavenging capacity of crude extracts from forest basidiomycetous fungi, domestic zygomycetous fungi and marine ascomycetous fungi. Lethal concentration values that kill 50% of the brine shrimps (LC50) were determined from 19 fungal extracts using brine shrimp test (BST). The LC50 values of fungal extract ranged between 0.28–40µg/ml. The basidiomycetous (Lactarius volemoides) was the most toxic fungi with LC50 of 0.28µg/ml while ascomycete Pichia guilliermondii showed the least toxicity with LC50 of 40µg/ml. The concentrations of eleven fungal extracts were further evaluated on their ability to scavenge free radical using 1-diphenyl-2-picrylhydrazyl (α,α-diphenyl-β-picrylhydrazyl) (DPPH) as a dye reagent for spectrophotometric assay at 517nm. The extract concentrations that decreased the initial DPPH radical by 50% (EC50) were determined. The EC50 values ranged from 19–60.4µg/ml ascorbic acid equivalents. Extracts from an edible but undomesticated basidiomycetous fungus isolated from Miombo forest and identified as Termitomyces microcarpus showed the highest scavenging effect with EC50 at 19µg/ml while that from ascomycete Candida tropicalis showed the least EC50 at 60.4µg/ml. These results draw attention to wild undomesticated Miombo fungi as potential source of nutritional supplements worth further investigation

Dermatological Malignancies at a University Teaching Hospital in north-western Tanzania: A Retrospective Review of 154 Cases

Dermatological malignancies are among the most common form of cancers and the global incidence has been increasing at an alarming rate. A retrospective study was conducted to determine the prevalence, histopathological pattern, anatomical distribution and treatment outcome of dermatological malignancies at Bugando Medical Centre in North-western Tanzania. Data were collected from patients’ files kept in the Medical record department; the surgical wards, operating theatre and histopathology laboratory and analyzed using Statistical package for social sciences system. A total of 154 patients with a histopathological diagnosis of dermatological malignancy were studied. Generally, males outnumbered females by a ratio of 1.4:1. The majority of patients were in the 5th and 6th decades of life. Malignant melanoma was the most common dermatological malignancy (67.5%) followed by Kaposi’s sarcoma (10.4%), Squamous cell carcinoma (8.4%) and Basal cell carcinoma(7.8%). The lower limbs were the most frequent site accounting for 55.8%. Wide local excision was the most common surgical procedure performed in 79.2% of cases. Post-operative wound infection was the most common complication in 58.3% of patients. Mortality rate was 3.8%. Dermatological malignancies are more prevalent in our setting. A high index of suspicion is needed to avoid labelling malignancies “chronic ulcers” and all suspected lesions should be biopse

Evaluation of Enzymatic Activity during Growth of Pleurotus HK 37 on Saba comorensis Exocarp

Mushrooms degrade lignocellulosic biomass by releasing lignolytic and hydrolytic enzymes which convert lignocellulosic material into soluble and low molecular weight compounds which are then absorbed as nutrients. In the present study, enzymatic activities of Pleurotus HK 37 during growth on Saba comorensis exocarps were evaluated. It was observed that, Pleurotus HK 37 has ability to produce lignolytic enzyme (Laccase) and hydrolytic enzymes (Carboxymethyl cellulase, xylanase and filterpaperase). Maximum laccase activity of 3.33 ± 0 UmL-1 was observed during colonization period and the activity dropped during fruitification phase. Similar to hydrolytic enzymes, the activity was observed during colonization period and decreased during fruitification. However, higher filterpaperase activity of 0.93 ± 0.13 UmL–1 was observed compared to other hydrolytic enzymes (CMCase 0.78 ± 0.13 UmL–1, and Xylanase 0.56 ± 0.07 UmL–1). Pleurotus HK 37 showed ability to degrade Saba comorensis exocarps and to release enzymes which can be used in biotechnological industries. Keywords:          Mushroom, Lignolytic, Hydrolytic, Enzyme, Saba comorensi

Enhanced REC collaborative review through video-conferencing

As international collaborative health research activities increase, building research ethics committees (REC) infrastructure and capacity in lowand middle-income countries for efficient and thorough review of research protocols becomes more critical, especially in sub-Saharan Africa. International investigators may face multiple challenges when conducting research in these settings, an important one being the length of time involved in securing REC review and approval. We discuss an approach to the problem that involved organisation of ‘rapid review’ REC sub-committees who met via video-conference for collaborative review of research protocols

Prevalence and predictors of anaemia among patients presenting with kidney diseases at the University of Dodoma Hospital in central Tanzania

Background: Anaemia is a common complication that contributes to the burden of kidney diseases. Anaemia confers significant risk of cardiovascular disease and contributes to decreased quality of life. While the primary cause of anaemia is the inadequate production of erythropoietin by the kidneys to support erythropoiesis, other factors may contribute to anaemia. The aim of this study was to determine the prevalence and predictors of anaemia among patients presenting with kidney diseases at the haemodialysis unit of the University of Dodoma (UDOM) hospital in central Tanzania.Methodology: In this retrospective study we reviewed data of patients who presented at UDOM haemodialysis unit in Tanzania with kidney diseases as from January 2013 to June 2015. Data were descriptively and inferentially analysed using Stata version 11 software.Results: A total of 1,395 patients were involved in this study. Of these, 792 (56.8%) presented with kidney diseases, 249 (31.4%) were found to have anaemia.  The leading cause of anaemia was chronic kidney disease (CKD) 136 (54.6%), blood loss 74(29.7), haemolysis 15 (6.0%), Nutrition 13(5.2%) and others 11 (4.4%). Glomerular filtration rate of < 60 mL/min/1.73 m2 accounted for 59.1% of CKD. Median [IQR] serum creatinine level: 246 [177 – 317] μmol/L, Urea level 16[8 -24] mmol/L and haemoglobin of 9.8 [6.2 - 13.4] g/dL. Prevalence of anaemia was strongly associated with declining glomerular filtration rate (P= 0.01).Conclusion: Anaemia is very common among patients presenting with kidney diseases. These patients require a thorough evaluation to identify and correct causes of anaemia other than erythropoietin deficiency

HIV Serostatus and Tumor Differentiation Among Patients with Cervical Cancer at Bugando Medical Centre.

Evidence for the association between Human immunodeficiency virus infection and cervical cancer has been contrasting, with some studies reporting increased risk of cervical cancer among HIV positive women while others report no association. Similar evidence from Tanzania is scarce as HIV seroprevalence among cervical cancer patients has not been rigorously evaluated. The purpose of this study was to determine the association between HIV and tumor differentiation among patients with cervical cancer at Bugando Medical Centre and Teaching Hospital in Mwanza, North-Western Tanzania. This was a descriptive analytical study involving suspected cervical cancer patients seen at the gynaecology outpatient clinic and in the gynaecological ward from November 2010 to March 2011. A total of 91 suspected cervical cancer patients were seen during the study period and 74 patients were histologically confirmed with cervical cancer. The mean age of those confirmed of cervical cancer was 50.5 ± 12.5 years. Most patients (39 of the total 74-52.7%) were in early disease stages (stages IA-IIA). HIV infection was diagnosed in 22 (29.7%) patients. On average, HIV positive women with early cervical cancer disease had significantly more CD4+ cells than those with advanced disease (385.8 ± 170.4 95% CI 354.8-516.7 and 266.2 ± 87.5, 95% CI 213.3-319.0 respectively p = 0.042). In a binary logistic regression model, factors associated with HIV seropositivity were ever use of hormonal contraception (OR 5.79 95% CI 1.99-16.83 p = 0.001), aged over 50 years (OR 0.09 95% CI 0.02-0.36 p = 0.001), previous history of STI (OR 3.43 95% CI 1.10-10.80 p = 0.035) and multiple sexual partners OR 5.56 95% CI 1.18-26.25 p = 0.030). Of these factors, only ever use of hormonal contraception was associated with tumor cell differentiation (OR 0.16 95% CI 0.06-0.49 p = 0.001). HIV seropositivity was weakly associated with tumor cell differentiation in an unadjusted analysis (OR 0.21 95% CI 0.04-1.02 p = 0.053), but strong evidence for the association was found after adjusting for ever use of hormonal contraception with approximately six times more likelihood of HIV infection among women with poorly differentiated tumor cells compared to those with moderately and well differentiated cells (OR 5.62 95% CI 1.76-17.94 p = 0.004).\ud Results from this study setting suggest that HIV is common among cervical cancer patients and that HIV seropositivity may be associated with poor tumour differentiation. Larger studies in this and similar settings with high HIV prevalence and high burden of cervical cancer are required to document this relationship

Validity and reliability of the Oral Impacts on Daily Performance (OIDP) frequency scale: a cross-sectional study of adolescents in Uganda

BACKGROUND: Assessing oral health related quality of life impact of mouth in adolescents is a relatively ignored area in dental research. This study aimed to examine reliability and validity of an abbreviated version of the oral impact of daily performance (OIDP) questionnaire and to analyse the interrelationship among OIDP scores, socio-demographic characteristics and oral health status in Uganda. METHOD: 1146 adolescents (mean age 15.8, response rate 87%) attending secondary schools in Kampala (urban) and Lira (rural) completed a survey instrument designed to measure subjective oral health indicators including the eight-item OIDP frequency scores. A clinical examination was conducted among 372 students (mean age 16.3, response rate 72%) and caries was assessed following the World Health Organisation criteria (1997). RESULTS: 62% of the students experienced at least one oral impact during the 6 months preceding the survey. Cronbach's alpha for the OIDP frequency items was 0.91 and the corrected item-total correlation ranged from 0.62 to 0.75. Discriminant and construct validity were demonstrated in that the OIDP scores varied systematically in the expected direction with missing teeth and self-report indicators of oral health status, respectively. Socio-demographics and dental attendance did not predict OIDP through interaction with clinical indicators but varied systematically and independently with OIDP frequency scores in the multivariate analysis. CONCLUSION: the OIDP frequency score have acceptable psychometric properties in the context of an oral health survey among Ugandan adolescents. Some evidence of the importance of social and personal characteristics in shaping adolescents' responses to oral disorders was provided

Skin Cancers Among Albinos at a University Teaching Hospital in Northwestern Tanzania: A Retrospective Review of 64 Cases.

Skin cancers are a major risk associated with albinism and are thought to be a major cause of death in African albinos. The challenges associated with the care of these patients are numerous and need to be addressed. The aim of this study was to outline the pattern and treatment outcome of skin cancers among albinos treated at our centre and to highlight challenges associated with the care of these patients and proffer solutions for improved outcome. This was a retrospective study of all albinos with a histopathological diagnosis of skin cancer seen at Bugando Medical Centre from March 2001 to February 2010. Data collected were analyzed using descriptive statistics. A total of 64 patients were studied. The male to female ratio was 1.5:1. The median age of patients was 30 years. The median duration of illness at presentation was 24 months. The commonest reason for late presentation was financial problem. Head and the neck was the most frequent site afflicted in 46(71.8%) patients. Squamous cell carcinoma was the most common histopathological type in 75% of cases. Surgical operation was the commonest modality of treatment in 60 (93.8%) patients. Radiotherapy was given in 24(37.5%) patients. Twenty-seven (42.2%) of the patients did not complete their treatment due to lack of funds. Local recurrence following surgical treatment was recorded in 6 (30.0%) patients. Only thirty-seven (61.7%) patients were available for follow-up at 6-12 months and the remaining patients were lost to follow-up. Skin cancers are the most common cancers among albinos in our environment. Albinism and exposure to ultraviolet light appears to be the most important risk factor in the development of these cancers. Late presentation and failure to complete treatment due to financial difficulties and lack of radiotherapy services at our centre are major challenges in the care of these patients. Early institution of preventive measures, early presentation and treatment, and follow-up should be encouraged in this population for better outcome

Relationship Between Non-Hodgkin's Lymphoma and Blood Levels of Epstein-Barr Virus in Children in North-Western Tanzania: A Case Control Study.

Non-Hodgkin's Lymphomas (NHL) are common in African children, with endemic Burkitt's lymphoma (BL) being the most common subtype. While the role of Epstein-Barr Virus (EBV) in endemic BL is known, no data are available about clinical presentations of NHL subtypes and their relationship to Human Immunodeficiency Virus (HIV) infection and Epstein Barr Virus (EBV) load in peripheral blood of children in north-western, Tanzania. A matched case control study of NHL subtypes was performed in children under 15 years of age and their respective controls admitted to Bugando Medical Centre, Sengerema and Shirati district designated hospitals in north-western, Tanzania, between September 2010 and April 2011. Peripheral blood samples were collected on Whatman 903 filter papers and EBV DNA levels were estimated by multiplex real-time PCR. Clinical and laboratory data were collected using a structured data collection tool and analysed using chi-square, Fisher and Wilcoxon rank sum tests where appropriate. The association between NHL and detection of EBV in peripheral blood was assessed using conditional logistic regression model and presented as odds ratios (OR) and 95% confidence intervals (CI). A total of 35 NHL cases and 70 controls matched for age and sex were enrolled. Of NHLs, 32 had BL with equal distribution between jaw and abdominal tumour, 2 had large B cell lymphoma (DLBCL) and 1 had NHL-not otherwise specified (NHL-NOS). Central nervous system (CNS) presentation occurred only in 1 BL patient; 19 NHLs had stage I and II of disease. Only 1 NHL was found to be HIV-seropositive. Twenty-one of 35 (60%) NHL and 21 of 70 (30%) controls had detectable EBV in peripheral blood (OR = 4.77, 95% CI 1.71 - 13.33, p = 0.003). In addition, levels of EBV in blood were significantly higher in NHL cases than in controls (p = 0.024). BL is the most common childhood NHL subtype in north-western Tanzania. NHLs are not associated with HIV infection, but are strongly associated with EBV load in peripheral blood. The findings suggest that high levels of EBV in blood might have diagnostic and prognostic relevance in African children

Oral health behavior patterns among Tanzanian university students: a repeat cross-sectional survey

PURPOSE: This study examines oral health behavioral trends and the development of sociodemographic differences in oral health behaviors among Tanzanian students between 1999 and 2000. METHODS: The population targeted was students attending the Muhimbili University College of Health Sciences (MUCHS) at the University of Dar es Salaam (UDSM), Dar es Salaam, Tanzania. Cross-sectional surveys were conducted and a total of 635 and 981 students, respectively, completed questionnaires in 1999 and 2001. RESULTS: Cross-tabulation analyses revealed that in 1999, the rates of abstinence from tobacco use, and of soft drink consumption, regular dental checkups, and intake of chocolate/candy were 84%, 51%, 48%, and 12%, respectively, among students of urban origin and 83%, 29%, 37%, and 5% among their rural counterparts. The corresponding rates in 2001 were 87%, 56%, 50%, and 9% among urban students and 84%, 44%, 38%, and 4% among rural ones. Multiple logistic regression analyses controlling for sex, age, place of origin, educational level, year of survey, and their interaction terms revealed a significant increase in the rate of soft drink consumption, implementation of oral hygiene measures, and abstinence from tobacco use between 1999 and 2001. Social inequalities observed in 1999, with urban students being more likely than their rural counterparts to take soft drinks and go for regular dental checkups, had leveled off by 2001. CONCLUSION: This study provides initial evidence of oral health behavioral trends, that may be utilized in the planning of preventive programs among university students in Tanzania