Tumwine, JK

English

Digital Library of the Tanzania Health Community

African Health Sciences Vol 13  Issue 4 December  2013 i
Infections and non-communicable diseases that just refuse to go away
What is new in HIV/AIDs and hepatitis?
Here we discuss the latest information on the above
subject. Tanzanian workers report a knowledge gap
among attendees on of antenatal care clinics.
(PMTCT), especially at primary health care facilities.1
This is disappointing because a lot of effort and
resources have been invested in PMTCT.  But they
are not alone. South African authors have found that
while traditional healers play a key role in the
diagnosis and management of sexually transmitted
infections including HI/AIDS, they have serious
shortcomings especially poor diagnosis.2
Testing for HIV remains a very important
strategy for HIV prevention in South Africa especially
for young people.  Over 50% of the youth reported
that they had had an HIV test with females more
likely to test than males.3 This is timely because work
in Lesotho has shown that health workers attribute
HIV/AIDS to changing lifestyles and demographic
profiles.4 In fact family dynamics in adherence to
HAART has been studied by Nigerian workers.5
Most of the respondents were adherent and
attributed this to care and support they received from
their families. In a related article, Ugandan authors
report on knowledge, attitude and barriers to
condom use among female sex workers and truck
drivers among whom the risk of HIV remains high.6
They conclude that condom use is still hampered by
socioeconomic and relationship factors.
Co-infection of HIV and hepatitis B among
children on HAART has hardly been reported from
Africa. Work from Nigeria shows a prevalence of
6%. Co-infected children were more likely to have
low CD4 counts.7 Outcome of patients on HAART
remains poor with a very high mortality of 21%
reported from Uganda is a cause for concern.8  The
main causes were opportunistic infections,
malignancy and AZT associated anemia.
Dyslipidaemia and dysglycaemia are serious problem
among patients on HAART. Ghanaian authors have
found that HAART was associated with
lipodystrophy and the risk of type 2 diabetes
mellitus.9 Hepatitis remains a big challenge in Africa.
The prevalence of hepatitis B antigemia (HBsAg)
among pregnant women was 6.6% consistent with
reports from elsewhere in Africa10.
Eating dog’s meat and rabies in Nigeria
Finally the story of the month: Stray dog meat and
the risk of rabies in Nigeria.11 While rabies is a
preventable zoonosis   with very high mortality, dog
meat remains a delicacy among some communities
in southern Nigeria. The authors report 10 cases of
rabies following consumption of dog meat. All the
10 patients died. The authors call for culling of stray
dogs, control of trade in dog meat, and provision
of post exposure prophylaxis (PEP).
Nodding syndrome (NS) still an enigma
This syndrome just refuses to go away from our
radar screens12,13. Although it is epidemiologically
linked to Onhocerca volvulus and the Simulium fly14,
this relationship has not been clearly elucidated raising
new lines of enquiry. For example Colebunders15
believes that the problem might be that of a virus
transmitted by the Simulium fly. Mutamba and
colleagues have written for us an article on stereotypes
of NS, looking specifically at the health workers
response in northern Uganda. The health workers
have very negative stereotypes which might negatively
impact their work.16
Exercise, cytokines, diabetes and other non communicable
diseases
Communicable diseases seem to have firmly
established themselves on the African continent.17,18.
Hitherto there has been limited information on effects
of exercise on biomarkers of inflammation especially
in type 2 diabetes mellitus. Saudi authors found that
moderate aerobic exercise modulates inflammatory
cytokines better than mild aerobic exercise in type 2
diabetes.19 Continuing the diabetes story, Chinese
authors sough to determine the association between
vitamin D intake and type 2 diabetes risk. In a meta
analysis of cohort studies, they found that there was
no association.20 In a related study Nigerian workers
concluded that mid upper arm circumference of
33 cm, and calf circumference of 39 might be
Of late there has been spate of new and emerging infections confounded by the non-communicable disease
epidemic in Africa.
Here we discuss the latest information on the above subject.African Health Sciences Vol 13  Issue 4 December  2013 ii
reliable cut off points for the diagnosis of obesity
during pregnancy.21 Although exercises are
recommended for the prevention of non
communicable diseases, Rwandan and South African
authors report factors associated with injuries among
female soccer players.
Up to half reported injury affecting mainly the ankle.
Factors associated with injury included age, excessive
ankle range and premenstrual symptoms, and use
of contraceptives.22  Injuries too are serious in South
Africa.23 A review of injuries at two hospitals in
Eastern Cape showed that interpersonal violence
(60%) and traffic accidents (19%) were the leading
causes of injury.
One would have thought that hearing loss might not
be such an important topic. Wrong! Two papers
highlight the problem. One: Nigerian workers
highlight the issue of hearing loss with increasing age
(presbycussis).24  They report that the commonest
symptoms were hearing loss, tinnitus, and vertigo.
Hearing impairment affected both speech and higher
frequencies. Zimbabwean authors on the other hand
found that the prevalence of noise induced hearing
loss was 37% - highlighting the need for prevention
and screening programmes.25
Another non communicable disease is liver
cirrhosis, even though t might arise from infections
such as hepatitis B and C. Uganda workers26  report
that liver cirrhosis contributes to almost 20% of
patients on the gastroenterology ward. Over 50%
had a history of alcohol consumption. While 27%
had hepatitis B, only 3.5% had hepatitis C. Most
patients presented with ascites and variceal bleeds.
They call for preventive measures such as educating
the population on the dangers of alcohol
consumption. Continuing with liver cirrhosis, Chinese
authors report on platelets in liver cirrhosis and
contend that CD62P might be a useful in the timely
monitoring and treatment of liver cirrhosis.27
Finally no treatise on non communicable disease is
complete without reference to cancer. In Ghana
cervical cancer patients did not have any more
knowledge than their counterparts without cancer!
The authors identified psychological barriers to
screening for cancer as well.9
Pregnancy, malaria and controversies in the origin of  NCDs
The use of iron-folic acid is an important
determinate of pregnancy outcome especially in low
income countries. Indian authors28 report a 65%
adherence to routine iron-folic acid tablets with
socioeconomic factors playing a role. On the other
hand work from Nigeria reports on the effect of
maternal hemoglobin on maternal measles
antibodies.29  Ugandan authors report on the
utilization of insecticide treated nets in pregnancy in
a post conflict district30 while Ibadan scientists muse
over the synergistic effects Telfaria occidentalis with
artesunate on Plasmodium berghei malaria in mice. Thank
you, Ghana: for highlighting the issue of urban
malaria. The prevalence seems to differ by location
and socioeconomic status of city dwellers31. As you
muse over how to spend your oil money this might
help, perhaps?
In an erratum due to confusion over order of
authorship, and title we are re running the work by
Yali Zhang.27
They report differential expressed genes in ECV304
endothelial like cells infected with cytomegalovirus.
They conclude that the gene products might play a
role in virus-induced pathogenesis. (REF2). Talking
of pathogenesis of viral diseases we bring you a
very interesting paper by Okonko and others on
enteroviruses as a possible cause of hypertension,
dilated cardiomyopathy and heart failure.32
Talking of infections, carbapenems are now in vogue
in most hospitals in Africa yet there are disturbing
reports of increasing resistance and cost. The paper
reports  Escherichia coli isolates with high molecular
weight plasmids harboring extended spectrum beta-
lactamase (ESBL) and carbapenemase resistant genes,
and co-acquired macrolide and other un-identified
resistant genes.33  In a related paper Sanya and others
report on the misuse of antibiotics by non medical
undergraduate students. They emphasize the need
for enlightening the students on rational use and
disposal of drugs especially antibiotics.34
Other manuscripts reviewed for this paper include
care of the terminally ill in the Middle East35,
management of perforated peptic ulcers36
dyspepsia,37 hypoglycemia,38 nano-technology39, sore
throat following surgery40 and research and ethics
committee function41. We also include infection
control42, infertility43 , drinking water44, and waiting
times in department of obstetrics.45
James K Tumwine
Editor in Chief
Cite as: Tumwine JK. Infections and non-
communicable diseases that just refuse to go away.
Afr Health Sci 2013;13(4): i-vAfrican Health Sciences Vol 13  Issue 4 December  2013 iii
References
1. Wangwe P, Nyasinde C. Effectiveness of counselling
at primary health  facilities and level of knowledge of
antenatal attendees and their attitude on Prevention
of Mother to Child Transmission of HIV in first
referral  health facilities in Dar es salaam, Tanzania. Afr
Health Sci 2013;13(4):914-19.
2. Semenya SS, Potgieter MJ. Sexually transmitted
infections and their diagnoses: Bapedi experience. Afr
Health Sci 2013;13(4):1047-53.
3. Peltzer K, Matseke G, Seutlwadi L. Determinants of
HIV testing among young people aged 18 – 24 years
in South Africa. Afr Health Sci 2013;13(4):1012-20.
4. Belle JA, Ferriera SB, Jordaan A. Attitude of Lesotho
health care workers towards HIV/AIDS and impact
of HIV/AIDS on the population structure. Afr
Health Sci 2013;13(4):1117-25.
5. Afolabi B, Afolabi M, Afolabi A, Olowookere S,
Odewale M. Roles of family dynamics on adherence
to highly active antiretroviral therapy among people
living with HIV/AIDS at a tertiary hospital in Osogbo,
south-west Nigeria   Afr Health Sci 2013;13(4):920-26.
6. Matovu JKB, Ssebadduka BN. Knowledge, Attitudes
& Barriers to Condom Use among Female Sex Workers
and Truck Drivers in Uganda: a Mixed-Methods Study
Afr Health Sci 2013;13(4):1027-33.
7. Ikpeme E, Etukudo O, Ekrikpo O. Seroprevalence of
hepatitis B virus (HBV) and human immunodeficiency
virus (HIV) co-infection in children, and outcomes
following highly active antiretroviral therapy (HAART)
in Uyo, south- south Nigeria.  Afr Health Sci
2013;13(4):948-954
8. Namutebi A, Kamya M, Byakika P. Causes and
Outcomes of Hospitalization among HIV - infected
Adults Receiving Antiretroviral Therapy in Mulago
Hospital, Uganda. Afr Health Sci 2013;13(4):977-85.
9. Williams MS, Ekuadzi E, Yeboah M, EL-Duah M,
Tuffour P. Assessment of Psychological Barriers to
Cervical Cancer Screening Among Women in Kumasi,
Ghana Using a Mixed Methods Approach. Afr Health
Sci 2013;13(4):1054-61.
10. Utoo BM. Hepatitis B Surface Antigenemia (HBsAg)
among Pregnant Women in Southern, Nigeria. Afr
Health Sci 2013;13(4):1139-43.
11. Ekanem EE, Eyong KI, Philip-Ephraim EE, Eyong
ME, Adams EB, Asindi AA. Stray dog trade fuelled
by dog meat consumption as a risk factor for rabies
infection in Calabar, southern Nigeria. Afr Health Sci
2013;13(4):1170-73.
12. Ndeezi G. Nodding Disease or syndrome: What is
the way forward? . Afr Health Sci 2012(3):240–41.
13. Spencer PS, Vandemaele K, Richer M, Palmer VS,
Chungong S, Anker M, et al. Nodding syndrome in
Mundri county, South Sudan: Environmental,
nutritional and infectious factors. Afr Health Sci
2013;13(2):183 - 204.
14. Tumwine JK. Nodding syndrome, infections and
sexuality. Afr Health Sci 2013;13(2):i-iv.
15. Hope A. Bob Colebunders to determine the causes
of the nodding disease. http://www.flanderstoday.eu/
current-affairs/week-brief-22-october 2013.
16. Mutamba B, Abbo C, Muron J, Idro R, Mwaka AD.
Stereotypes on Nodding Syndrome: Responses of
Health Workers in the affected region of Northern
Uganda. Afr Health Sci 2013;13(4):986-91.
17. Tumwine JK. Exercise and non-communicable
diseases in Africa- the challenge is here. Afr Health Sci
2013;13(1):i–ii.
18. Tumwine JK. Non-communicable diseases are reaching
epidemic proportions: evidence from low and middle
income countries. Afr Health Sci 2013;13(3): i-iv.
19. Abd El- Kader SM, Gari MA, Mohamed E, El-Den
Ashmawy S. Impact of Moderate versus Mild Aerobic
exercise training on inflammatory
20. Cytokines in Obese Type 2 Diabetic Patients - A
Randomized Clinical Trial. Afr Health Sci
2013;4(13):857-63.
21. Zhao Li-Min, Tian Xiao-Qin, Ge Jia-Pu, Xu Yan-
Cheng. Vitamin D intake and type 2 diabetes risk: A
meta-analysis of prospective cohort studies Afr Health
Sci 2013;13(4):1130-38.
22. Okereke CE, Anyaehie BU, Dim CC, Iyare EE, Nwagha
U. Evaluation of some Anthropometric Indices for
the Diagnosis of Obesity in Pregnancy in Nigeria: A
cross-sectional study  Afr Health Sci 2013;13(4):1034-
40.
23. Niyonsenga JD, Phillips JS. Factors associated with
injuries among first-division Rwandan female soccer
players. Afr Health Sci 2013;13(4):1021-26.
24. Dhaffala A, Longo-Mbenza B, Kingu JH, Peden M,
Kafuko-Bwoye A, Clarke M, et al. Demographic profile
and epidemiology of injury in Mthatha, South Africa.
Afr Health Sci 2013;13(4):1144-48.
25. Sogebi O, Olusoga-Peters O. Clinical and Audiometric
features of Presbycusis in Nigerians. Afr Health Sci,
2013:886-92.
26. Chadambuka A, Mususa F, Muteti S. Prevalence of
Noise Induced Hearing Loss among Employees at a
Mining Industry, Zimbabwe; 2011: A Descriptive
Cross-sectional Study.   Afr Health Sci 2013;13(4).
27. Apica BS, Ocama P, Seremba E, Opio CK, Kagimu M.
Decompensated cirrhosis-related admissions in a large
urban Hospital in Uganda: Prevalence, clinical and
laboratory features and implications for planning
patient management Afr Health Sci 2013;13(4):927-
32.
28. .Xianghong G, Guanping C, Fenghua Y, Jiayin W.
Changes in platelet functional parameters and CD62 P
expression in hepatic cirrhosis. Afr Health Sci
2013;13(4):1079-83.
29. Mithra P, Bhaskaran U, Rekha T, Kumar N, Papanna
M, Kulkarni V, et al. Compliance with Iron -folic acidAfrican Health Sciences Vol 13  Issue 4 December  2013 iv
(IFA) therapy among pregnant women in an urban
area of South India. Afr Health Sci 2013;13(4):880-85.
30. Ahmadu BU, Mohammed A, Yakubu M, Gimba M,
Abubakar R, Ambe P. The effects of maternal
haemoglobin as an indicator of maternal
nutritional status on maternal measles antibodies
of mother-infant pairs at birth.   Afr Health Sci
2013;13(4):940-46.
31. Obol JH, Ononge S, Orach CG. Utilization of
insecticide treated nets among pregnanat women in
Gulu: a post conflict district in northern Uganda. Afr
Health Sci 2013;13(4):962-69.
32. Brenyah R, Osakunor D, Ephraim R. Factors
Influencing Urban Malaria: A Comparative Study of
Two Communities in the Accra Metropolis.   Afr
Health Sci 2013;13(4):992-98.
33. Okonko IO, Adebiyi AA, Ogah OS, Adu FD.
Enterovirusses as a possible cause of hypertension,
dilated cardiomyopathy and hyperstensive heart failure
in South western Nigeria. Afr Health Sci
2013;13(4):1098-106.
34. Motayo BO, Akinduti PA, Adeyakinu FA, Okerentugba
PO, Nwanze JC, Onoh CC, et al. Antibiogram and
plasmid profiling of carbapenemase and extended
spectrum â-lactamase (ESBL) producing Escherichia
coli and Klebsiella pneumoniae in Abeokuta,
Southwestern, Nigeria. Afr Health Sci 2013;13(4):1091-
97.
35. Sanya TE, Fakeye TO, Adisa R, Showande SJ. Use of
antibiotics among non-medical students in a Nigerian
university. Afr Health Sci 2013;13(4):1149-55.
36. Rahman M, Abuhasna S, Abu-Zidan FM. Care of
terminally-ill patients: an opinion survey among critical
care healthcare providers in the Middle East. Afr Health
Sci 2013;13(4):893-98.
37. Etonyeaku A, Agbakwuru E, Akinkuolie A, Talabi A,
Omotola C, C; O, et al. A review of the management
of perforated duodenal ulcers at a tertiary hospital in
south western Nigeria.   Afr Health Sci 2013;13(4):907-
13.
38. Olusoji AS, Ajayi AO. Risk factors for uninvestigated
dyspepsia among primary care patients in northern
Nigeria. Afr Health Sci 2013;13(4):1007-11.
39. Nkambo W, Anyama NG, Onegi B. In vivo
hypoglycaemic effect of methanolic fruit extract of
Momordica charantia. Afr Health Sci 2013;933-
939(13):4.
40. Phillips CL, Yah CS, Lyuke SE, Pillay V, Rumbold K ,
Chorona Y. The response effect of pheochromocytoma
(PC12) cell lines to oxidized multi-walled carbon
nanotubes (o-MWCMTs). Afr Health Sci
2013;13(4):947-54.
41. Thang’a V, Mung’ayi V, Kamya D. Effects of
intravenous diclofenac on postoperative sore throat
in patients undergoing laparoscopic surgery at Aga
Khan University Hospital, Nairobi: A prospective,
randomized, double blind controlled trial. Afr Health
Sci 2013;13(4):999-1006.
42. Ibingira CBR, Ochieng J. Knowledge about the
Research and Ethics Committee at Makerere University,
Kampala. Afr Health Sci 2013;13(4):1041-46.
43. Ojulong J, Mitonga KKH, Iipinge SN. Knowledge
and Attitudes of Infection Prevention and Control
among  Health Sciences Students at University of
Namibia  Afr Health Sci 2013;13(4):1071-78.
44. Adegbola O, Akindele OM. The pattern and challenges
of infertility management in Lagos, Nigeria. Afr Health
Sci 2013;13(4):1126-29.
45. Tsega N, Sahile S, Kibret M, Abera B. Bacteriological
and physico-chemical quality of drinking water sources
in a rural community of Ethiopia. Afr Health Sci
2013;13(4):1156-61.
46. Ocak T, Bekda S, Duran A, Göksügür SB, Küçükbayrak
B. The Obstetrics Gynecology and Children’s Hospital
Emergency Room Waiting Time before
Hospitalization. Afr Health Sci 2013;13(4):1162-69.
47. Varol E. Platelet volume evaluation in patients with
sepsis: associated factors should be considered. African
Health Sciences 2013; 13(4): 1174 - 1175 (L1)
48. Varol E. Mean platelet volume in supraventricular
tachyarrhythmia can be affected by many cardiovascular
risk factors. African Health Sciences 2013; 13(4): 1176 -
1177 (L2)
49. Ertugrul Guclu, Tuba Damar, Oguz Karabay. The
number of urine specimens for bacteriological
examination in women.  Afr Health Sci. 2013;13(4):
1178 - 1178 (L3)
49. Marie E. A. Bissong, Peter N. Fon, Fritz O. Tabe-Besong
and Theresa N. Akenji.  Bacteriuria in diabetes mellitus
patients in Cameroon: number of urine specimens in
women Afr Health Sci 2013; 13(4): 1178 - 1179 (L4)

A review of the management of perforated duodenal ulcers at a tertiary hospital in south western Nigeria. Afr Health Sci 2013;13(4):907-

Antibiogram and plasmid profiling of carbapenemase and extended spectrum â-lactamase (ESBL) producing Escherichia coli and Klebsiella pneumoniae in

Assessment of Psychological Barriers to Cervical Cancer Screening Among Women in Kumasi, Ghana Using a Mixed Methods Approach.

Attitude of Lesotho health care workers towards HIV/AIDS and impact of HIV/AIDS on the population structure.

Attitudes & Barriers to Condom Use among Female Sex Workers and Truck Drivers in Uganda: a Mixed-Methods Study Afr Health Sci

Bacteriological and physico-chemical quality of drinking water sources in a rural community of Ethiopia.

Bacteriuria in diabetes mellitus patients in Cameroon: number of urine specimens in women Afr Health Sci

Bob Colebunders to determine the causes of the nodding disease. http://www.flanderstoday.eu/ current-affairs/week-brief-22-october

Care of terminally-ill patients: an opinion survey among critical care healthcare providers in the Middle East. Afr Health Sci

Causes and Outcomes of Hospitalization among HIV - infected Adults Receiving Antiretroviral Therapy

Changes in platelet functional parameters and CD62 P expression in hepatic cirrhosis.

Clinical and Audiometric features of Presbycusis in Nigerians. Afr Health Sci,

Cytokines in Obese Type 2 Diabetic Patients - A Randomized Clinical Trial.

Decompensated cirrhosis-related admissions in a large urban Hospital in Uganda: Prevalence, clinical and laboratory features and implications for planning patient management Afr Health Sci 2013;13(4):927-

Demographic profile and epidemiology of injury in

Determinants of HIV testing among young people aged

Effectiveness of counselling at primary health facilities and level of knowledge of antenatal attendees and their attitude on Prevention of Mother to Child Transmission of HIV in first referral health facilities in Dar es salaam,

Effects of intravenous diclofenac on postoperative sore throat in patients undergoing laparoscopic surgery at Aga Khan University Hospital, Nairobi: A prospective, randomized, double blind controlled trial.

Enterovirusses as a possible cause of hypertension, dilated cardiomyopathy and hyperstensive heart failure

Evaluation of some Anthropometric Indices for the Diagnosis of Obesity in Pregnancy in Nigeria: A cross-sectional study Afr Health Sci 2013;13(4):1034-

Exercise and non-communicable diseases in Africa- the challenge is here.

Factors associated with injuries among first-division Rwandan female soccer players.

Factors Influencing Urban Malaria: A Comparative Study of Two Communities in the Accra Metropolis. Afr Health Sci

Hepatitis B Surface Antigenemia (HBsAg) among Pregnant Women

Impact of Moderate versus Mild Aerobic exercise training on inflammatory

In vivo hypoglycaemic effect of methanolic fruit extract of Momordica charantia.

iv (IFA) therapy among pregnant women in an urban area of South India.

Knowledge about the Research and Ethics Committee at

Mean platelet volume in supraventricular tachyarrhythmia can be affected by many cardiovascular risk factors. African Health Sciences

Nodding Disease or syndrome: What is the way forward?

Nodding syndrome in Mundri county, South Sudan: Environmental, nutritional and infectious factors.

Nodding syndrome, infections and sexuality.

Non-communicable diseases are reaching epidemic proportions: evidence from low and middle income countries.

Platelet volume evaluation in patients with sepsis: associated factors should be considered. African Health Sciences

Prevalence of Noise Induced Hearing Loss among Employees at a Mining Industry,

Risk factors for uninvestigated dyspepsia among primary care patients in northern Nigeria.

Roles of family dynamics on adherence to highly active antiretroviral therapy among people living with HIV/AIDS at a tertiary hospital in Osogbo, south-west Nigeria Afr Health Sci

Seroprevalence of hepatitis B virus (HBV) and human immunodeficiency virus (HIV) co-infection in children, and outcomes following highly active antiretroviral therapy (HAART) in Uyo, south- south Nigeria.

Sexually transmitted infections and their diagnoses: Bapedi experience.

Stereotypes on Nodding Syndrome: Responses of Health Workers in the affected region of Northern Uganda.

Stray dog trade fuelled by dog meat consumption as a risk factor for rabies infection in Calabar, southern Nigeria. Afr Health Sci

The effects of maternal haemoglobin as an indicator of maternal nutritional status on maternal measles antibodies of mother-infant pairs at birth.

The Obstetrics Gynecology and Children’s Hospital Emergency Room Waiting Time before Hospitalization. Afr Health Sci

The pattern and challenges of infertility management

The response effect of pheochromocytoma (PC12) cell lines to oxidized multi-walled carbon nanotubes (o-MWCMTs).

Tian Xiao-Qin, Ge Jia-Pu, Xu YanCheng. Vitamin D intake and type 2 diabetes risk: A meta-analysis of prospective cohort studies Afr Health Sci

Tuba Damar, Oguz Karabay. The number of urine specimens for bacteriological examination in women.

Use of antibiotics among non-medical students in a Nigerian university.

Utilization of insecticide treated nets among pregnanat women in Gulu: a post conflict district in northern Uganda.

Infections and Non-Communicable Diseases that Just Refuse to Go Away

Infections and Non-Communicable Diseases that Just Refuse to Go Away

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Digital Library of the Tanzania Health Community