Assessment of Doctors’ Perception on Clinical Leadership: A Case of Tertiary Hospitals in Dar es Salaam Tanzania.

This study sought to investigate the perception on Clinical leadership of doctors working in tertiary hospital in Dar es Salaam Tanzania. The study was guided by the following objectives; to find out whether clinical leadership and health care leadership mean the same thing for doctors, to determine the perceived difference between medical leadership and clinical leadership and to examine the perceived similarities of doctors’ leadership and clinical leadership all aiming eventually to lay a foundation of clinical leadership studies in Tanzania. Using a pre-tested structured questionnaire, doctors with a minimum of first degree working with Muhimbili (plus Mloganzila), JKCI, MOI, Aghakan, ORCI and CCBRT filled the questionnaire physically or submitting an electronic copy of the same. Descriptive statistics and correlation analysis were used to analyse data. The study found that healthcare leadership was significantly positively and moderately correlated with clinical leadership, Doctors’ leadership was positively correlated with clinical leadership and Medical leadership was also positively and significantly related to clinical leadership. Conclusively, the study recommends that policy makers and leaders in health care industry should give more leadership chance to clinical personnel than non-clinical personnel. A more well-structured research on clinical leadership targeting practices, attributes, barriers and enablers should be conducted as a follow up to this one. Keywords: Clinical leadership, health care leadership, medical leadership, doctors’ leadershi

Differences in clinical presentation of primary open-angle glaucoma between African and European populations

Purpose: Primary open-angle glaucoma (POAG) has been reported to occur more frequently in Africans, and to follow a more severe course compared to Europeans. We aimed to describe characteristics of POAG presentation and treatment across three ethnic groups from Africa and one from Europe. Methods: We ascertained 151 POAG patients from South African Coloured (SAC) and 94 South African Black (SAB) ethnicity from a university hospital in South Africa. In Tanzania, 310 patients were recruited from a university hospital and a referral hospital. In the Netherlands, 241 patients of European ancestry were included. All patients were over 35 years old and had undergone an extensive ophthalmic examination. Patients were diagnosed according to the ISGEO criteria. A biogeographic ancestry analysis was performed to estimate the proportion of genetic African ancestry (GAA). Results: The biogeographic ancestry analysis showed that the median proportion of GAA was 97.6% in Tanzanian, 100% in SAB, 34.2% in SAC and 1.5% in Dutch participants. Clinical characteristics at presentation for Tanzanians, SAB, SAC and Dutch participants, respectively: mean age: 63, 57, 66, 70 years (p < 0.001); visual acuity in the worse eye: 1.78, 1.78, 0.3, 0.3 LogMAR (p < 0.001); maximum intraocular pressure of both eyes: 36, 34, 29, 29 mmHg (panova < 0.001); maximum vertical cup to disc ratio (VCDR) of both eyes: 0.90, 0.90, 0.84, 0.83 (p < 0.001); mean central corneal thickness: 506, 487, 511, 528 μm (p < 0.001). Fourteen percent of Tanzanian patients presented with blindness (<3/60 Snellen) in the better eye in contrast to only 1% in the Dutch. Conclusion: In this multi-ethnic comparative study, Sub-Saharan Africans present at a younger age with lower visual acuity, higher IOP, larger VCDR, than SAC and Dutch participants. This indicates the more progressive and destructive course in Sub-Saharan Africans

Genome-wide meta-analysis identifies 127 open-angle glaucoma loci with consistent effect across ancestries

10.1038/s41467-020-20851-4Nature Communications121125