Chemical Composition and Bioactive Potential of Extracts from Diospyros capricornuta F. White against Aspergillus flavus and Aspergillus parasiticus

Diospyros capricornuta is an endemic species widely distributed along the coast of Tanzania that is used as food condiments and traditional medicine. The chemical compositions of Diospyros capricornuta leaves, stem-bark, and root-bark extracts; and their bioactive potentials against Aspergillus flavus and Aspergillus parasiticus were investigated. The leaves, stem-bark, and root-bark samples of D. capricornuta were extracted using Soxhlet apparatus and the resultant extracts were analyzed using Gas Chromatography-Mass Spectrometry (GC-MS). A total of 14 compounds were identified from the extracts, whereby 2,4-di-tert-butylphenol was the most abundant compound in all extracts. The growth and aflatoxin production inhibitions against A. flavus and A. parasiticus were determined via antifungal and antiaflatoxigenic bioassays of the extracts at the concentrations of 0.0, 62.5, 125.0, and 250.0 µg/mL using a poisoned-food method. The High-Performance Liquid Chromatography (HPLC) technique was used to quantify the aflatoxins after bioassays to evaluate aflatoxin inhibitions. The stem-bark extracts at the highest dose of 250.0 µg/mL inhibited aflatoxin production by A. flavus for over 99% and A. parasiticus for over 94%. Overall, the results show that the leaves, stem-bark, and root-bark extracts of D. capricornuta are potential inhibitors against A. flavus and A. parasiticus-the producers of aflatoxins. Keywords: Diospyros capricornuta; Growth inhibitions; Aflatoxin inhibitions; Aspergillus flavus; and Aspergillus parasiticus

Sociocultural and Health System Factors Associated With Mortality Among Febrile Inpatients in Tanzania: A Prospective Social Biopsy Cohort Study

Introduction Communicable diseases are the leading causes of death in Tanzania despite the existence of effective treatment tools. We aimed to assess the sociocultural and health system factors associated with mortality from febrile illness in northern Tanzania. Methods We interviewed febrile inpatients to determine prevalence of barriers in seeking or receiving care and grouped these barriers using the Three Delays model (delays at home, in transport and at healthcare facilities). We assessed 6-week mortality and, after matching on age, gender and severity of illness, measured the association between delays and mortality using conditional logistic regression. Results We enrolled 475 children, of whom 18 (3.8%) died, and 260 adults, of whom 34 (13.0%) died. For children, home delays were not associated with mortality. Among adults, a delay in care-seeking due to not recognising severe symptoms was associated with mortality (OR: 3.01; 95% CI 1.24 to 7.32). For transport delays, taking \u3e1 hour to reach a facility increased odds of death in children (OR: 3.27; 95% CI 1.11 to 9.66) and adults (OR: 3.03; 95% CI 1.32 to 6.99). For health system delays, each additional facility visited was associated with mortality for children (OR: 1.59; 95% CI 1.06 to 2.38) and adults (OR: 2.00; 95% CI 1.17 to 3.41), as was spending \u3e4 days between the first facility visit and reaching tertiary care (OR: 4.39; 95% CI 1.49 to 12.93). Conclusion Our findings suggest that delays at home, in transport and in accessing tertiary care are risk factors for mortality from febrile illness in northern Tanzania. Interventions that may reduce mortality include community education regarding severe symptoms, expanding transportation infrastructure and streamlining referrals to tertiary care for the sickest patients

Enteric Pathogens Detected in Children under Five Years Old Admitted with Diarrhea in Moshi, Kilimanjaro, Tanzania

Despite the availability and wide coverage of rotavirus vaccinations in Tanzania, there is still a significant number of diarrhea cases being reported, with some patients requiring hospital admission. We investigated diarrhea-causing pathogens and determined the effect of co-infection on clinical symptoms. Total nucleic acid was extracted from archived stool samples (N = 146) collected from children (0–59 months) admitted with diarrhea in health facilities in Moshi, Kilimanjaro. Pathogen detection was performed using the quantitative polymerase chain reaction with custom TaqMan Array cards. The Poisson model was used to determine the effect of co-infection on clinical presentation during admission. Of all the participants, 56.85% were from rural Moshi with a median age of 11.74 months (IQR: 7.41–19.09). Vomiting (88.36%) and a fever (60.27%) were the most frequent clinical manifestations. At least one diarrhea-associated pathogen was detected in 80.14% (n = 117) of the study population. The most prevalent pathogens were rotavirus 38.36% (n = 56), adenovirus 40/41 19.86% (n = 29), Shigella/EIEC 12.33% (n = 18), norovirus GII 11.44% (n = 17) and Cryptosporidium 9.59% (n = 14). Co-infections were detected in 26.03% of the study population (n = 38). The presence of multiple pathogens in the stool samples of children with diarrhea indicates poor sanitation and may have significant implications for disease management and patient outcomes