Gastrointestinal endoscopy at Amana Municipal Referral Hospital in Tanzania: reasons for referral and findings

Upper gastrointestinal endoscopy is a medical procedure for visualizing and treating diseases in the upper gastrointestinal tract. It is useful in the surveillance, diagnosis and treatment of acute conditions such as gastrointestinal haemorrhages, benign, malignancies or inflammatory conditions. Because of unavailability of specialist doctors, open access endoscopy referral system is the main system practiced in Tanzania. This study was carried out to investigate the appropriateness of referrals for endoscopy and to determine the endoscopic findings at Amana Municipal Referral Hospital in Tanzania. This cross-sectional study was carried out from March 2010 to June 2011 involved patients referred for endoscopy. Demographic characteristics, reasons for referral and endoscopic findings were recorded for each patient. A total of 393 patients were involved in the study. The mean age of the study subjects was 47.3±17.4 years. The main reasons for referral were epigastric pain (57%), vomiting blood (23%) and difficult in swallowing (20%). The most common endoscopic findings were gastritis (57.2%), oesophagitis (10.2%) and gastric tumours (6.5%). The main reasons for endoscopy referrals at Amana Municipal Referral Hospital are epigastric pain, difficult in swallowing and vomiting blood. The normal endoscopy findings observed falls within normal range. These findings are important for further development of the endoscopy unit, for streamlining services, training of the required skills, and for planning

Asthma Prevalence, Knowledge, and Perceptions among Secondary School Pupils in Rural and Urban Costal Districts in Tanzania.

Asthma is a common chronic disease of childhood that is associated with significant morbidity and mortality. We aimed to estimate the prevalence of asthma among secondary school pupils in urban and rural areas of coast districts of Tanzania. The study also aimed to describe pupils' perception towards asthma, and to assess their knowledge on symptoms, triggers, and treatment of asthma. A total of 610 pupils from Ilala district and 619 pupils from Bagamoyo district formed the urban and rural groups, respectively. Using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, a history of "diagnosed" asthma or the presence of a wheeze in the previous 12 months was obtained from all the studied pupils, along with documentation of their perceptions regarding asthma. Pupils without asthma or wheeze in the prior 12 months were subsequently selected and underwent a free running exercise testing. A >= 20% decrease in the post-exercise Peak Expiratory Flow Rate (PEFR) values was the criterion for diagnosing exercise-induced asthma. The mean age of participants was 16.8 (+/-1.8) years. The prevalence of wheeze in the past 12 months was 12.1% in Bagamoyo district and 23.1% in Ilala district (p < 0.001). Self-reported asthma was found in 17.6% and 6.4% of pupils in Ilala and Bagamoyo districts, respectively (p < 0.001). The prevalence of exercise-induced asthma was 2.4% in Bagamoyo, and 26.3% in Ilala (P < 0.002). In both districts, most information on asthma came from parents, and there was variation in symptoms and triggers of asthma reported by the pupils. Non-asthmatic pupils feared sleeping, playing, and eating with their asthmatic peers. The prevalence rates of self-reported asthma, wheezing in the past 12 months, and exercise-induced asthma were significantly higher among urban than rural pupils. Although bronchial asthma is a common disease, pupils' perceptions about asthma were associated with fear of contact with their asthmatic peers in both rural and urban schools