scholarly journals Cervical cytological changes in HIV-infected patients attending care and treatment clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania

2012 ◽  
Vol 7 (1) ◽  
Author(s):  
Amos R Mwakigonja ◽  
Liset Maria M Torres ◽  
Henry A Mwakyoma ◽  
Ephata E Kaaya
Keyword(s):  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Treatment Clinic ◽  
Cytological Changes ◽  
Care And Treatment

scholarly journals Peripheral neuropathy in HIV-infected children attending care and treatment clinic, at Muhimbili National Hospital, Dar es Salaam: a cross sectional study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Insiyah A Amiji ◽  
Helga E Naburi ◽  
Edward Kija ◽  
Livin P Mumburi
Keyword(s):  
Peripheral Neuropathy ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Antiretroviral Drugs ◽  
Muhimbili National Hospital ◽  
Sectional Study ◽  
National Hospital ◽  
Cross Sectional ◽  
Treatment Clinic ◽  
Care And Treatment

Abstract Background Peripheral neuropathy (PN) is a neurological complication of untreated Human Immunodeficiency Virus (HIV) infection or exposure to certain antiretroviral drugs. In Tanzania where HIV is a major public health problem, the burden of HIV associated peripheral neuropathy has not yet been well defined in children.Thisstudy investigated the prevalence and associated factors for peripheral neuropathy among children living with HIV, attending Care and Treatment Clinic (CTC) at Muhimbili National Hospital (MNH). Materials and methods A cross-sectional study was conducted among 383 HIV positive children aged 5 to 18 years at MNH, CTC in Dar es Salaam between October to December 2019. All participants provided written assent/consent. Structured questionnaires designed for this study was used to collect data and screening for peripheral neuropathy was done on each participant using the Pediatric modified Total Neuropathy Score (Ped m TNS) that includes subjective and objective assessment. A score of 5 or greater on the Ped m TNS was used to define peripheral neuropathy. Data analysis was done using SPSS Version 23. Results The prevalence of peripheral neuropathy among HIV infected children was 14.1 % (95 % CI (10.8 − 18 %). Common neuropathic symptoms were numbness, tingling sensation, reduced ankle reflexes and reduced sensation to light touch and pain that was limited to the toes. Low CD4 cell count (OR = 12.21; 95 % CI3.75–39.66; p = 0.0001), high viral load (OR = 10.54; 95 % CI 3.19–34.77; p = 0.0001), ART regime containing NRTI plus PI (OR = 3.93; 95 % CI 1.43– 10.74; p = 0.01) and the last exposure to isoniazid more than 6 months ago (OR = 3.71; 95 % CI 1.57–8.77; p = 0.003) were independent predictors for peripheral neuropathy. Conclusion Peripheral neuropathy is common among HIV infected children attending CTC at MNH and its frequency increases with advanced disease. The choice of ART regimen and other drugs for treating comorbid conditions should carefully be evaluated.

scholarly journals Peripheral Neuropathy in HIV-infected children attending Care and Treatment  Clinic, at Muhimbili National Hospital, Dar es Salaam: A Cross sectional study

2021 ◽  
Author(s):  
Insiyah Amiji ◽  
Helga Naburi ◽  
Edward Kija ◽  
Livin Mumburi
Keyword(s):  
Peripheral Neuropathy ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Hiv Positive ◽  
Muhimbili National Hospital ◽  
Sectional Study ◽  
National Hospital ◽  
Cross Sectional ◽  
Treatment Clinic ◽  
Care And Treatment

Abstract Background: Peripheral neuropathy (PN) is a neurological complication of untreated Human Immunodeficiency Virus (HIV) infection or exposure to antiretroviral drugs. Objectives: To determine the prevalence and associated factors for peripheral neuropathy among children living with HIV, attending Care and Treatment Clinic (CTC) at Muhimbili National Hospital (MNH).Materials and Methods: A cross-sectional study was conducted at MNH-CTC in Dar es Salaam between October - December 2019, where 383 HIV positive children aged 5 to 18 years were enrolled . Baseline characteristics were obtained from participant’s medical records at enrollment. Screening for peripheral neuropathy was done on each participant using the Pediatric modified Total Neuropathy Score (Ped m TNS) screening tool . Continuous variables were summarized as mean (± standard deviation) or median (Interquartile range) and differences compared using student t -test or Mann-Whitney U test. Categorical variables were summarized as frequencies and differences compared using chi square or Fisher’s exact test. Logistic regression models were applied to determine the independent predictors of peripheral neuropathy on multivariate analysis, reported as odds ratios (ORs) and 95% confidence intervals (CI). ResultsThe prevalence of peripheral neuropathy among HIV infected children was 14.1% (95% CI (10.8% - 18%). Common neuropathic presentation was numbness and tingling sensation, reduced ankle reflexes, loss of vibration sense and reduced light touch and sensation to pain limited to fingers and toes. Severe immunosuppression reflected by CD4 count < 200 cell/mm3 (OR=5.21; 95% CI 2.0 – 13.57; p = 0.001), high viremia ≥ 1000 copies/ml (OR=26.31; 95% CI 7.91 – 86.51; p <0.001), use of a combination regimen containing NRTI plus PI (OR= 5.67; 95% CI 2.11– 15.22; p = 0.01) and time interval of at least ≥ 6 months since last use of isoniazid (OR=3.35; 95% CI 1.41 – 7.91; p = 0.006) were independent predictors for peripheral neuropathy. ConclusionPeripheral neuropathy is common among HIV infected children attending CTC at MNH and its frequency increases with advanced disease. The choice of antiretroviral regimen and other medications with potentially neurotoxic effect should be carefully done. Early screening for peripheral neuropathy among HIV positive children should be done routinely in CTCs.

Clinical epidemiology of individuals with Sickle cell anemia using Hydroxyurea at Muhimbili National Hospital, Dar Es Salaam, Tanzania

2020 ◽  
Vol 31 (1) ◽  
pp. 106-119
Author(s):  
Elisha Osati ◽  
Edward Kija ◽  
Florence Urio ◽  
Magdalena Lyimo ◽  
Siana Nkya ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Sickle Cell ◽  
Sickle Cell Anemia ◽  
Severe Pain ◽  
Clinical Epidemiology ◽  
Fetal Hemoglobin ◽  
Dar Es Salaam ◽  
Acute Chest Syndrome ◽  
Muhimbili National Hospital ◽  
National Hospital

Background: The pathophysiology of sickle cell disease (SCD) is complex and involves nitric oxide depletion, increased inflammation/adhesion molecules and vaso-occlusion in addition to the chronic hemolytic anemia. This pathophysiology results in systemic clinical complications including recurrent episodes of severe pain, stroke, acute chest syndrome (ACS) and an increased susceptibility to infection. SCD severity varies among individuals and fetal hemoglobin (HbF) is known as a major modulator of the disease. To date, hydroxyurea (HU) is a known intervention that acts by increasing HbF in individuals with SCD. The increase in HbF reduces the risk of ‘sickling’ events and improves clinical outcomes. This is the first study on the use of HU in individuals with SCA in Tanzania.Methods: A case-control study to determine the proportion, indications, clinical and laboratory outcomes of SCD patients with HU use was conducted at Muhimbili National Hospital in Dar Es Salaam, Tanzania.Results: Forty-two patients with Sickle cell anemia (SCA) on HU treatment and 32 patients with SCA not on HU treatment were enrolled. The proportion of HU use by individuals with SCA at Muhimbili National Hospital was 10 per 1000. The mean HbF % was 9.8 ± 2.4 vs 6.2 ±1.4 for controls (P <0.001). Thirty (71.4%) were enrolled for HU treatment due to central nervous system (CNS) events, frequent painful crises 11(26.2%) and recurrent anemia 1(2.4%). Thirty-two SCA patients (76.2%) reported improvements after being on HU for at least six months. Of these, 91% reported no history of severe pain that required hospitalizations since they started HU. Twenty patients (66.7%) out of those with CNS events reported not to have experienced convulsions after HU initiation.Conclusions: HbF was higher in patients who were on HU and had positive correlation with clinical outcomes. Further clinical trials are required to evaluate more effects of HU use among SCA individuals in Tanzania. Keywords: Sickle cell anemia, HU, Fetal hemoglobin, Tanzania.

Sign in / Sign up

Export Citation Format

Share Document