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

Small Estuarine and Non-Estuarine Mangrove Ecosystems of Tanzania: Overlooked Coastal Habitats?

This research article published by Springer Nature Switzerland AG., 2016Small estuaries and non-estuarine habitats harboring mangroves are very important ecosystems which provide important ecosystem goods and services; such as provision of ecological niches for juvenile fishes and invertebrates, enhances fisheries, and in biodiversity conservation. Similar to large estuaries, they are highly perturbed which threatens their existence. This chapter uses beach seine, underwater visual census, and stable isotope data to discuss the importance of and threats to small estuaries and non-estuarine mangroves found in Dar es Salaam, Bagamoyo and Zanzibar, Tanzania. For example, mangroves of Kunduchi (Dar es Salaam) and Mbegani (Bagamoyo) which harbour predominantly higher densities of juveniles (≤10 cm) of two economically important species—Lutjanus fulviflamma and Lethrinus harak—than adjacent coral reefs. Evidence suggests further that the Kunduchi mangroves replenish fish populations on adjacent coral reefs; where over 90% and 29% of adult L. fulviflamma and L. harak individuals, respectively, have been identified to have lived in the mangroves as juveniles. In terms of habitat utilization by different size classes of fish, five of the 13 species (Lethrinus lentjan, L. variegatus, Pelates quadrilineatus, Siganus sutor and Sphyraena barracuda) found in Chwaka Bay (Zanzibar) were found as small-sized individuals in shallow and turbid mangrove areas with large juveniles and sub-adults in adjacent seagrass beds. The non-estuarine mangroves of Kunduchi and those of Mtoni estuary (Dar es Salaam) are subjected to pollution from urban activities. For example, stable isotope data of fishes indicate elevated levels of nitrogen in these mangroves with highest levels (δ15N = 15.2 ± 0.2) recorded in Mtoni estuary. In view of their importance and threats they face, these ecosystems require attention similar to large estuaries. If the current degradation rate of these ‘overlooked’ but equally important ecosystems continues, they may be declared ‘functionally disappeared’ in a few decades

Environmental Changes in the Tanzanian Part of Lake Victoria

This research article published by Springer Nature Switzerland AG.,Lake Victoria is known for its explosive speciation and recent time hybridization, which is highly mediated by deterioration of water quality. This chapter summarizes the knowledge on change of water quality and environment of southern part of Lake Victoria, Tanzania. It analyses rainfall, air temperature and water quality data spanning 30 years (1985 to 2015). It also investigates changes in physical-chemical data sampled during and after the Lake Victoria Environmental Management Project I (LVEMP I). The chapter reviews some of the significant water quality changes that have occurred for the past 50 years. The results indicate no significant changes in annual rainfall variability. Nevertheless, trends of air temperature showed no clear patterns for Mwanza and Musoma, but trends of minimum and maximum air temperature in Bukoba increased significantly at annual rates of 0.19 °C and 0.14 °C, respectively. Water level in Lake Victoria has also declined significantly at an annual rate of about 5.5 cm from 1965 to 2004. These findings suggest that lake levels are determined by evapotranspiration rather than rainfall. It was also found that anthropogenic stressors are more important in explaining nutrients loading while thermal stratification explains hypoxia and reduction in water mixing. It is concluded that the current blooms of harmful algae and excess biomass in Lake Victoria will continue unabated unless nutrient loading, anoxia and high rates of denitrification are curbed. Appropriate measures to improve land use management should therefore be taken, while deliberate dumping of industrial, municipal and agricultural wastes into the lake should be controlled

Use and limitations of malaria rapid diagnostic testing by community health workers in war-torn Democratic Republic of Congo

<p>Abstract</p> <p>Background</p> <p>Accurate and practical malaria diagnostics, such as immunochromatographic rapid diagnostic tests (RDTs), have the potential to avert unnecessary treatments and save lives. Volunteer community health workers (CHWs) represent a potentially valuable human resource for expanding this technology to where it is most needed, remote rural communities in sub-Saharan Africa with limited health facilities and personnel. This study reports on a training programme for CHWs to incorporate RDTs into their management strategy for febrile children in the Democratic Republic of Congo, a tropical African setting ravaged by human conflict.</p> <p>Methods</p> <p>Prospective cohort study, satisfaction questionnaire and decision analysis.</p> <p>Results</p> <p>Twelve CHWs were trained to safely and accurately perform and interpret RDTs, then successfully implemented rapid diagnostic testing in their remote community in a cohort of 357 febrile children. CHWs were uniformly positive in evaluating RDTs for their utility and ease of use. However, high malaria prevalence in this cohort (93% by RDTs, 88% by light microscopy) limited the cost-effectiveness of RDTs compared to presumptive treatment of all febrile children, as evidenced by findings from a simplified decision analysis.</p> <p>Conclusions</p> <p>CHWs can safely and effectively use RDTs in their management of febrile children; however, cost-effectiveness of RDTs is limited in zones of high malaria prevalence.</p

Synaptonemal complex alterations in X-irradiated and in oestrogen-treated mice: a comparative study.

Synaptonemal complexes (SCs) were analysed in male NMRI mice either X-irradiated or treated with oestradiol benzoate (E2B). Animals 30 days old underwent a single X-ray exposure of either 5, 7.5 or 10 Gy and were killed at different times after exposure, i.e., 24 h, 1, 4, 12 and 16 weeks. E2B was injected daily to adult mice from day 30 to day 60 or up to day 90 of age. Oestradiol was also administered during the neonatal period and animals were examined on days 28, 60 and 90 of age. Different SC alterations were found in X-irradiated and in E2B-treated mice. SC lesions were rare in oestrogen-treated adult mice. Among SC anomalies, asynapsis and fragmentation of SC were common lesions. However, the former was more frequent in E2B-treated mice, whereas the latter was more frequent in X-irradiated mice. Quadri- or multi-valents, bridges between bivalents, rings and loops were exclusively encountered in the latter, whereas heterotelomeric associations seemed to be specific in E2B-treated animals. The mechanisms of the different SC lesions are discussed

Synaptonemal complex studies in male mice treated with cyproterone acetate or with testosterone.

Male mice were injected either with cyproterone acetate (CyAc) or with testosterone enanthate (TE) separately or in combination with estradiol benzoate (E2B) from the neonatal period on or during adulthood. Neonatally treated animals were killed on d28 or d60, whereas all treated adults were killed on d60. Synaptonemal complexes (SCs) were analyzed under the electron microscope. Various SC anomalies were recorded. The frequency of SC alterations was higher in neonatally treated mice injected with E2B alone or in combination with CyAc (range 9.6-23.7%) than in those injected separately with TE or CyAc (range 2-3.9%). In treated neonates, combination of CyAc and E2B treatment increased the prevalence of synaptic impairments (range 11-23.5%). However, whenever TE was added to E2B treatment a significant reduction of these impairments was observed (range 11-2.4 and 23.7-9.7% respectively). In treated adult mice the prevalence of SC anomalies was low (range 2.4-3.1%) whatever hormone was injected. Furthermore, the combination of estradiol with CyAc had no increasing effect on the induction of synaptic alterations. In E2B-treated animals, those injected during the neonatal period were more susceptible than those treated in adulthood. In mice injected separately with TE or CyAc such a difference of sensitivity between neonates and adults was not noticeable. This work demonstrates that testosterone deficiency is partly responsible for E2B-induced SC alterations. However, inhibition of testosterone action at the level of testicular target cells, such as that resulting from administration of cyproterone acetate, is less harmful to the synaptic process of meiosis

Coastal upwelling and seasonal variation in phytoplankton biomass in the Pemba Channel

This research article published by African Journals Online, 2021This study was conducted in the Pemba Channel off Tanga Region in northern Tanzania to investigate physical and chemical factors that drive changes in phytoplankton biomass. Three transects off Mwaboza, Vyeru and Sahare were selected. For each transect, ten stations were sampled. Phytoplankton biomass was determined as chlorophyll-a (Chl-a) concentration. Similarly, physico-chemical variables (temperature, salinity, dissolved oxygen, pH and nutrients) were determined. It was observed that the Chl-a concentration was significantly higher during the northeast monsoon (median 1.44 mg m-3) as compared to the southeast monsoon (median 1.19 mg m-3; W = 2216, p = 0.029). The higher productivity during the northeast monsoon is attributed to the presence of high-nutrient water caused by coastal upwelling. It is concluded that indication of upwelling, observed through relatively low temperatures during the northeast monsoon season, could be responsible for bringing nutrient-rich waters to the surface, which in turn stimulated the increase in Chl-a concentration

Age and living in an urban environment are major determinants of diabetes among South Kivu Congolese adults

OBJECTIVES: This study aimed to determine the risk factors for diabetes mellitus (DM) in the eastern part of the Democratic Republic of Congo. METHODOLOGY: Multilevel sampling identified 200 households (444 adults aged ≥ 20 years) from 20 neighbourhoods in the city of Bukavu, and 90 households (255 adults aged ≥ 20 years) from 10 villages in the Kaziba (South Kivu) chiefdom (the South Kivu VITARAA study). DM was defined as a personal history of the disorder or a casual glycaemia greater or equal to 200 mg/dL. Standardization according to age and sample readjustment based on the urban-rural distribution of the population was applied accordance with the typical Congolese population. The probability of DM was assessed by multiple logistic regressions. RESULTS: Total prevalence of DM was 3.5%. DM was significantly more prevalent in urban areas (age-standardized prevalence: 4.0%) than in rural areas (1.7%). City-dwelling DM patients were characterized by higher rates of indices of abdominal obesity (P < 0.05) whereas, in rural areas, no patients were obese. In the study group as a whole, only 25.0% of diabetic patients were obese. On multivariate analyses, only age [adjusted OR (95% CI): 4.79 (1.60-14.25); P = 0.004] was independently associated with the prevalence of DM, while the effect of obesity was not significant [2.64 (0.99-7.02); P = 0.051]. CONCLUSION: Age and living in an urban environment appeared to be major determinants of DM in South Kivu. Also, obesity prevalence was relatively low in these diabetic patients, confirming the peculiar, relatively lean, phenotype of type 2 DM in indigenous sub-Saharan African