Tungiasis Infestation in Tanzania.

Tungiasis is caused by the jigger flea Tunga penetrans. We describe a case of severe infestation from Kigoma region, Western Tanzania. A 19-year-old male with epilepsy and mental disability presented with ulcerated and inflamed toes. Clinical examination revealed the presence of approximately 810 embedded jigger fleas on the feet, and another 60 lesions on the hands. The patient presented with fissures on the feet, hands and soles. He had difficulty walking and erythematous, oedematous, ulcerated and inflamed skin around the feet. Living conditions were precarious. The patient was assisted to extract the embedded fleas and his feet were washed with disinfectants. Oral antibiotics were given. The case shows that the disease may reach high parasite loads in Tanzanian individuals, with consequently severe pathology. There have been single reports of returning tourists from Tanzania with tungiasis, but the epidemiological situation and the geographic occurrence of the disease in this country are not known. Systematic studies are needed to increase knowledge on the epidemiological situation of tungasis in Tanzania and to identify endemic areas

The Community-First Land-Centred Theoretical Framework: Bringing a ‘Good Mind’ to Indigenous Education Research?

This article introduces an emergent research theoretical framework, the community-first Land-centred research framework.  Carefully examining the literature within Indigenous educational research, we noted the limited approaches for engaging in culturally aligned and relevant research within Indigenous communities.  The community-first Land-centred research framework was created by reflecting on how we engaged in research collaborations with Indigenous communities.  This process of reflection led us to realize that within our research we had been developing a research framework that was culturally-aligned, relevant, and based on respectful relations that differed in important ways from other community oriented research framework.  We articulate how we differentiate this framework from community-based approaches to research and discuss the community-first Land-centred research framework’s foundational principles. We draw upon lessons learned through our various collaborations over the past seven years.   Key words: Indigenous; Land-centred research; community engagemen

\ud Case Report: Unsuspected Uterine Choriocarcinoma with Lung Metastasis\ud

Choriocarcinoma is a rare form of cancer which commonly occurs in women of reproductive age, rarely in post-menopausal women and in women under 20 years of age. Methods & Results: We report an unsuspected case of uterine choriocarcinoma with lung metastasis in a 27 year-old woman who presented to a medical ward with a history of prominent respiratory, but also genital and gastrointestinal symptoms. Conclusions: The presented case report emphasizes the need for sophisticated diagnostic technology to enable early diagnosis and correct treatment. Furthermore the case highlights the need for healthcare workers to consider rare causes of respiratory signs and symptoms

Intestinal schistosomiasis associated with intussusception: a case report

We report a case of intestinal schistosomiasis associated with iliocaecal intussusception resulting from obstructions of the terminal part of the ileum by schistosome egg-induced fibrosis. A 7-year-old boy presented with the history of abdominal pain and difficulties in passing stool for two months. Ultrasound examination revealed doughnut signs characterized with multiple concentric rings at the lateral abdomen, and the bowel loop appeared distended. Exploratory laparatomy confirmed intussusception of the terminal part of the ileum into the caecum, extending to the ascending colon. Hemicolectomy and end-to-end iliocolostomy was performed. Histological examination of the resected bowel revealed Schistosoma mansoni eggs within the mucosa, submucosa of the ileum, caecum and ascending colon, granulomatous inflammation with foreign body giant cells accompanied by fibrosis and eosinophilic infiltrate into the mucosa. Postoperatively, the patient recovered well. There may have been a synergistic effect of schistosomiasis with other underlying conditions, leading to intussusception. In conclusion, it is important to consider S. mansoni infection as a differential diagnosis for intestinal obstruction in endemic areas

Home treatments with antipyretics and antimalarials given to underfives with fever in Mwanza, north-western Tanzania

Early diagnosis and prompt treatment is the recommended management for febrile illness among underfives. However, improper home management may be the cause of delay in seeking professional health care. This cross-sectional study was conducted at the outpatient department of Buzuruga Health Centre in Mwanza, Tanzania and involved 372 children 1 day (OR= 2.69; 95% CI: 1.95-3.70;

Co-infections with Plasmodium falciparum, Schistosoma mansoni and intestinal helminths among schoolchildren in endemic areas of northwestern Tanzania.

Malaria, schistosomiasis and intestinal helminth infections are causes of high morbidity in most tropical parts of the world. Even though these infections often co-exist, most studies focus on individual diseases. In the present study, we investigated the prevalence of Plasmodium falciparum-malaria, intestinal schistosomiasis, soil-transmitted helminth infections, and the respective co-infections, among schoolchildren in northwest Tanzania. A cross sectional study was conducted among schoolchildren living in villages located close to the shores of Lake Victoria. The Kato Katz technique was employed to screen faecal samples for S. mansoni and soil-transmitted helminth eggs. Giemsa stained thick and thin blood smears were analysed for the presence of malaria parasites. Of the 400 children included in the study, 218 (54.5%) were infected with a single parasite species, 116 (29%) with two or more species, and 66 (16.5%) had no infection. The prevalences of P. falciparum and S. mansoni were 13.5% (95% CI, 10.2-16.8), and 64.3% (95% CI, 59.6-68.9) respectively. Prevalence of hookworm infection was 38% (95% CI, 33.2-42.8). A. lumbricoides and T. trichiura were not detected. Of the children 26.5% (95% CI, 21.9-30.6) that harbored two parasite species, combination of S. mansoni and hookworm co-infections was the most common (69%). Prevalence of S. mansoni - P. falciparum co-infections was 22.6% (95%CI, 15.3-31.3) and that of hookworm - P. falciparum co-infections 5.7% (95%CI, 2.6-12.8). Prevalence of co-infection of P. falciparum, S. mansoni and hookworm was 2.8% (95%CI, 1.15-4.4). Multiple parasitic infections are common among schoolchildren in rural northwest Tanzania. These findings can be used for the design and implementation of sound intervention strategies to mitigate morbidity and co-morbidity

Knowledge, Attitudes, and Practices about Malaria and Its Control in Rural Northwest Tanzania

Background. We assessed community knowledge, attitudes, and practices on malaria as well as acceptability to indoor residual spraying. Material and Methods. A cross-sectional survey was done in a community in Geita district (northwest Tanzania). Household heads (n = 366) were interviewed Results. Knowledge on malaria transmission, prevention, and treatment was reasonable; 56% of respondents associated the disease with mosquito bites, with a significant difference between education level and knowledge on transmission (P < .001). Knowledge of mosquito breeding areas was also associated with education (illiterate: 22%; literate: 59% (P < .001). Bed nets were used by 236 (64.5%), and usage was significantly associated with education level (P < .01). The level of bed net ownership was 77.3%. Most respondents (86.3%) agreed with indoor residual spraying of insecticides. Health facilities were the first option for malaria treatment by 47.3%. Artemether-lumefantrine was the most common antimalarial therapy used. Conclusions. Despite reasonable knowledge on malaria and its preventive measures, there is a need to improve availability of information through proper community channels. Special attention should be given to illiterate community members. High acceptance of indoor residual spraying and high level of bed net ownership should be taken as an advantage to improve malaria control

MuProp: Unbiased Backpropagation for Stochastic Neural Networks

This is the final version of the article. It first appeared from International Conference on Learning Representations via http://arxiv.org/abs/1511.05176v3Deep neural networks are powerful parametric models that can be trained efficiently using the backpropagation algorithm. Stochastic neural networks combine the power of large parametric functions with that of graphical models, which makes it possible to learn very complex distributions. However, as backpropagation is not directly applicable to stochastic networks that include discrete sampling operations within their computational graph, training such networks remains difficult. We present MuProp, an unbiased gradient estimator for stochastic networks, designed to make this task easier. MuProp improves on the likelihood-ratio estimator by reducing its variance using a control variate based on the first-order Taylor expansion of a mean-field network. Crucially, unlike prior attempts at using backpropagation for training stochastic networks, the resulting estimator is unbiased and well behaved. Our experiments on structured output prediction and discrete latent variable modeling demonstrate that MuProp yields consistently good performance across a range of difficult tasks.ALTA; Jesus College Cambridge; Cambridge-Tubingen PhD Fellowshi