scholarly journals Audit of clinical-laboratory practices in haematology and blood transfusion at Muhimbili National Hospital in Tanzania

2012 ◽  
Vol 14 (4) ◽  
Author(s):  
Abel N. Makubi ◽  
Collins Meda ◽  
Alex Magesa ◽  
Peter Minja ◽  
Juliana Mlalasi ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Health Care Services ◽  
Clinical Laboratory ◽  
Donor Selection ◽  
National Standard ◽  
Blood Component ◽  
Muhimbili National Hospital ◽  
National Guidelines ◽  
National Hospital ◽  
Cross Sectional

In Tanzania, there is paucity of data for monitoring laboratory medicine including haematology. This therefore calls for audits of practices in haematology and blood transfusion in order to provide appraise practice and devise strategies that would result in improved quality of health care services.  This descriptive cross-sectional study which audited laboratory practice in haematology and blood transfusion at Muhimbili National Hospital (MNH) aimed at assessing the  pre-analytical stage of laboratory investigations including laboratory request forms and handling specimen processing in the haematology laboratory and assessing the chain from donor selection, blood component processing  to administration of blood during transfusion. A national standard checklist was used to audit the laboratory request forms (LRF), phlebotomists’ practices on handling and assessing the from donor selection to administration of blood during transfusion. Both interview and observations were used. A total of 195 LRF were audited and 100% of had incomplete information such as patients’ identification numbers, time sample ordered, reason for request, summary of clinical assessment and differential diagnoses. The labelling of specimens was poorly done by phlebotomists/clinicians in 82% of the specimens. Also 65% (132/202) of the blood samples delivered in the haematology laboratory did not contain the recommended volume of blood. There was no laboratory request form specific for ordering blood and there were no guidelines for indication of blood transfusion in the wards/clinics. The blood transfusion laboratory section was not participating in external quality assessment and the hospital transfusion committee was not in operation. It is recommended that a referral hospital like MNH should have a transfusion committee to provide an active forum to facilitate communication between those involved with transfusion, monitor, coordinate and audit blood transfusion practices as per national guidelines.

scholarly journals The pattern of central corneal thickness in patients attending a Tertiary Hospital in Dar-Es-Salaam

2021 ◽  
Vol 9 (2) ◽  
pp. 127-133
Author(s):  
Annamary Stanislaus ◽  
Ntsilane Susan Mosenene ◽  
Celina Mhina ◽  
John Stanslaus Kisimbi ◽  
Frederick Robert Burgess ◽  
...  
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Dar Es Salaam ◽  
Applanation Tonometry ◽  
P Value ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean

Background: Central Corneal Thickness (CCT) is an indicator of corneal health status as well as being an essential tool in assessment and management of corneal diseases. It is an important factor in the diagnosis and management of glaucoma as it affects the measurement of intraocular pressure. However, the pattern of central corneal thickness in our population is not known. Our study aimed to describe the CCT measurements and their variation with age and sex among patients attending the eye clinic at Muhimbili National Hospital (MNH), in Dar es Salaam, Tanzania. Methodology: A hospital-based descriptive, cross-sectional study used convenient sampling to recruit adult patients aged 18 years and above, presenting to the MNH between August 2016 and January 2017.Visual acuity assessment, Goldman applanation tonometry and CCT assessment using an ultrasound pachymeter were performed. Patients with previous intraocular surgery were excluded. Results: A total of 398 patients (208 males and 190 females) were recruited. The mean CCT was 526.64±38.30 µm; being 523.99±38.20 µm for males and 529.7±38.3 µm for females. 226 (56.85%) had CCT of less than 520 µm.There was no statistically significant difference in CCT between gender. The proportion of patients with thinner CCT increased with increasing age from 25.8% in those < 30 years to 75% in those aged 71years and above. The mean CCT decreased with increasing age with P-value<0.001. Conclusion: The average CCT in patients attending Muhimbili National Hospital is 526.64 µm (SD 38.30) which is generally thin, inversely proportion to age and similar that of other Africans and African-Americans. This finding has implications for the management of glaucoma in this population.

scholarly journals Prevalence of Malnutrition Inflammation Complex Syndrome among Patients on Maintenance Haemodialysis at Muhimbili National Hospital in Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
Puneet Kishore Bramania ◽  
Paschal Ruggajo ◽  
Rimal Bramania ◽  
Muhiddin Mahmoud ◽  
Francis Fredrick Furia
Keyword(s):  
Total Cholesterol ◽  
Complete Blood Count ◽  
Early Recognition ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Reverse Epidemiology ◽  
Maintenance Haemodialysis

Abstract Background: Malnutrition, inflammation, and the combination thereof are predictors of poor outcomes in haemodialysis patients. Malnutrition Inflammation Complex Syndrome (MICS) is an accelerator of atherosclerosis and portends high mortality. Early recognition and treatment of MICS may help to improve the clinical outlook of such patients. This study investigated the prevalence of MICS and its associated factors among patients on maintenance haemodialysis at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Methods: This was a prospective cross-sectional observational study done among 160 adult patients on maintenance haemodialysis at MNH in 2019. All participants provided written informed consent. Questionnaires were used to collect data and patients’ blood was tested for complete blood count (CBC), C-reactive protein (CRP), ferritin, transferrin, creatinine, urea, total cholesterol, and albumin. The Malnutrition Inflammation Score was used to assess MICS and its severity. Data analysis was done using the SPSS 20 software. Results: Of the 160 patients included in the study, 111 (69.4%) were male. The mean age (±SD) of patients and mean duration (±SD) on haemodialysis were 52.2(13.3) years and 22(18) months respectively. MICS was prevalent in 46.3% (mild in 24.4% and moderate to severe in 21.9%). Long-term haemodialysis (>4years) was an independent predictor of MICS [Adjusted Odds Ratio, AOR 5.04 (95% CI: 1.33–19.2), p<0.05]. Hypercholesterolaemia was a negative predictor of MICS [AOR 0.11 (95% CI: 0.01-0.97), p<0.05]. Patients with MICS had significantly lower mean body mass index, serum albumin, total cholesterol, transferrin, haemoglobin, and creatinine levels. The presence of MICS was higher in underweight patients and those who had inflammation. Haemodialysis adequacy did not correlate with MICS. Conclusion: Malnutrition Inflammation Complex Syndrome is relatively common among patients on haemodialysis in Dar es Salaam, Tanzania. Our study has shown a longer duration on haemodialysis to be associated with the occurrence of MICS; on the contrary, having hypercholesterolaemia seems to be protective against MICS consistent with the concept of reverse epidemiology. Patients on haemodialysis should be assessed regularly for malnutrition and inflammation and should receive appropriate and timely treatment to reduce the burden of associated morbidity, and mortality to these patients.

scholarly journals Prevalence of malnutrition inflammation complex syndrome among patients on maintenance haemodialysis at Muhimbili National Hospital in Tanzania: a cross-sectional study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Puneet K. Bramania ◽  
Paschal Ruggajo ◽  
Rimal Bramania ◽  
Muhiddin Mahmoud ◽  
Francis F. Furia
Keyword(s):  
Total Cholesterol ◽  
Complete Blood Count ◽  
Early Recognition ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Reverse Epidemiology ◽  
Maintenance Haemodialysis

Abstract Background Malnutrition, inflammation, and the combination thereof are predictors of poor outcomes in haemodialysis patients. Malnutrition Inflammation Complex Syndrome (MICS) is an accelerator of atherosclerosis and portends high mortality. Early recognition and treatment of MICS may help to improve the clinical outlook of such patients. This study investigated the prevalence of MICS and its associated factors among patients on maintenance haemodialysis at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Methods This was a prospective cross-sectional observational study done among 160 adult patients on maintenance haemodialysis at MNH in 2019. All participants provided written informed consent. Questionnaires were used to collect data and patients’ blood was tested for complete blood count (CBC), C-reactive protein (CRP), ferritin, transferrin, creatinine, urea, total cholesterol, and albumin. The Malnutrition Inflammation Score was used to assess MICS and its severity. Data analysis was done using the SPSS 20 software. Results Of the 160 patients included in the study, 111 (69.4%) were male. The mean age (±SD) of patients and mean duration (±SD) on haemodialysis were 52.2(13.3) years and 22(18) months respectively. MICS was prevalent in 46.3% (mild in 24.4% and moderate to severe in 21.9%). Long-term haemodialysis (> 4 years) was an independent predictor of MICS [Adjusted Odds Ratio, AOR 5.04 (95% CI: 1.33–19.2), p < 0.05]. Hypercholesterolaemia was a negative predictor of MICS [AOR 0.11 (95% CI: 0.01–0.97), p < 0.05]. Patients with MICS had significantly lower mean body mass index, serum albumin, total cholesterol, transferrin, haemoglobin, and creatinine levels. The presence of MICS was higher in underweight patients and those who had inflammation. Haemodialysis adequacy did not correlate with MICS. Conclusion Malnutrition Inflammation Complex Syndrome is relatively common among patients on haemodialysis in Dar es Salaam, Tanzania. Our study has shown a longer duration on haemodialysis to be associated with the occurrence of MICS; on the contrary, having hypercholesterolaemia seems to be protective against MICS consistent with the concept of reverse epidemiology. Patients on haemodialysis should be assessed regularly for malnutrition and inflammation and should receive appropriate and timely treatment to reduce the burden of associated morbidity, and mortality to these patients.

scholarly journals Prevalence and clinical characteristics of otitis externa among patients attending Otorhinolaryngology Department at Muhimbili National Hospital, Tanzania

2019 ◽  
Vol 5 (4) ◽  
pp. 826
Author(s):  
Zephania Saitabau Abraham ◽  
Onesmo Tarimo ◽  
Aveline Aloyce Kahinga ◽  
Daudi Ntunaguzi ◽  
Kassim Babu Mapondella ◽  
...  
Keyword(s):  
Risk Factor ◽  
Otitis Externa ◽  
Clinical Characteristics ◽  
Public Awareness ◽  
Tertiary Hospital ◽  
Age Group ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Male Predominance

<p class="abstract"><strong>Background:</strong> Otitis externa is among the otological diseases with significant impact on the quality of life of sufferers. Little is known in Sub Saharan countries despite being the focus of such disease. The study aimed to determine the prevalence and clinical characteristics of otitis externa at Muhimbili National Hospital, Tanzania’s largest tertiary hospital.</p><p class="abstract"><strong>Methods:</strong> This was a hospital based descriptive cross sectional study where 1200 participants were recruited from June 2016 to January 2017. Data was analyzed using SPSS program version 20.  </p><p class="abstract"><strong>Results:</strong> A total of 1200 patients were recruited in this study and majority 601(50.1%) were females. Majority 672(56%) were in age group 0–10 years. Among 1200 patients, 138 (11.5%) were diagnosed to have otitis externa and male predominance (55.1%) was found. Majority 120 (87%) had diffuse otitis externa and with 0-10 years (25.83%) being the commonly affected age group by variant. The commonest risk factor was self-ear cleansing 87(53.7%) and only 2.9% were found to have complications of otitis externa.</p><p class="abstract"><strong>Conclusions:</strong> Otitis externa was found to be prevalent and with male predominance. Self-ear cleansing was the commonest risk factor. Complications of otitis externa were found to be rare. Public awareness on otitis externa should be advocated in our country.</p>

scholarly journals Metabolic Bone Disease in Chronic Kidney Disease Patients (CKD-MBD) and its Associated Factors at Muhimbili National Hospital in Dar es salaam, Tanzania: A Cross-Sectional Study

2020 ◽  
Author(s):  
Felix Faustin Mungulluh ◽  
Paschal Ruggajo ◽  
Francis Fredrick Furia
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Cross Sectional Study ◽  
Dar Es Salaam ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Metabolic Bone

Abstract Background: Metabolic bone disease in chronic kidney disease patients is associated with high morbidity and mortality, and it has been reported to start early in the course of the disease and worsen as the kidney damage progresses. However, the prevalence and factors associated with metabolic bone disease in chronic kidney disease patients in our setting has not been established, so we aimed to determine the prevalence and factors associated with metabolic bone disease among patients with chronic kidney disease at a tertiary Muhimbili National Hospital in Dar es salaam, Tanzania so as to help physicians recognize the patients at risk, diagnose the problem and prevent complications sooner.Methods: This was a hospital based cross-sectional study involving adult patients with chronic kidney disease attending renal unit Muhimbili National Hospital, a tertiary referral center in Dar es Salaam, Tanzania. Systematic sampling technique was employed to get study participants after being given informed consent. In this study, CKD-MBD was defined basing on the abnormality of serum calcium, phosphate or parathyroid hormone level. Data analysis was done using the SPSS version 23.0 software. Results: A total of 300 participants with chronic kidney disease stage 3 and above were included in this study. Majority were male, 198 (66.0%), with a mean age of 53 years. The prevalence of metabolic bone disease was found to be 75.0%. The most common form of metabolic bone disease was hyperparathyroidism 196 (87.1%), followed by hypocalcemia 174 (77.3%) and hyperphosphatemia 82 (36.4%), which was the least common. Factors which were found to be significantly associated with CKD-MBD were the use of calcium supplements, use of phosphate binders, being on dialysis, a calcium rich diet and a low phosphate diet.Conclusion: Metabolic bone diseases are common in patients with CKD at Muhimbili National Hospital. Patients with CKD should undergo serial assessment of phosphate, calcium and parathyroid hormone level, considered together, so as to diagnose metabolic bone disease early and treat those patients who will be found to have persistently or prolonged abnormalities in these bone mineral biomarkers.

scholarly journals The magnitude of prescribing medicines by brand names at Muhimbili National Hospital, Tanzania

2020 ◽  
Vol 4 ◽  
pp. 239920261990014
Author(s):  
Ombeni Kisamo ◽  
Manase Kilonzi ◽  
Wigilya P Mikomangwa ◽  
George M Bwire ◽  
Hamu J Mlyuka ◽  
...  
Keyword(s):  
Treatment Guidelines ◽  
Cross Sectional Study ◽  
Brand Names ◽  
World Health ◽  
P Value ◽  
Muhimbili National Hospital ◽  
Prescribing Practices ◽  
National Hospital ◽  
Chi Square ◽  
Cross Sectional

Background: Tanzania National Treatment Guidelines and National Therapeutic Committee circular of 2012 requires prescribers to prescribe medicines using their generic names as recommended by the World Health Organization. The implementation of the aforementioned recommendations by prescribers is not well documented in our settings. Therefore, this study aimed to explore the compliance on the use of generic names by prescribers at Muhimbili National Hospital. Methods: A descriptive cross-sectional study was conducted at Muhimbili National Hospital from January to May 2019 in both inpatient and outpatient pharmacy units. Data were analyzed using SPSS, version 23. Chi-square test was used to analyze proportions between the different variables of the study. A p-value for significance was <0.05. Results: Of 1001 prescriptions analyzed, 71.6% contained medicines prescribed using brand names. The mean (±standard deviation (SD)) number of medicines per prescription was 2.98 (±1.5). The most frequently prescribed medicines by brand names were a combination of vitamin and mineral supplements (34.4%) followed by antibiotics (26.7%). Medical doctors (25.6%) and medical specialists (21.6%) prescribed ⩾2 medicines using brand names per prescription compared to interns (15.0%) and residents (6.9%) ( p < 0.001). Conclusion: Prescribing medicines using brand names was highly observed in this study. Supplements and antibiotics were among the products that were highly prescribed using their brand names. Qualitative studies to explore reasons for brand name prescribing practices are recommended.

scholarly journals Level of medication self-management capacity among patients on ambulatory care exiting hospital pharmacy at Muhimbili National hospital, Tanzania: a descriptive cross-sectional study

2019 ◽  
Author(s):  
Hamu Joseph Mlyuka ◽  
Hija Salehe ◽  
Wigilya P Mikomangwa ◽  
Manase E Kilonzi ◽  
Alphonce I Marealle ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Medication Management ◽  
Cross Sectional Study ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Management Capacity ◽  
Dosing Frequency ◽  
Medication Management Capacity ◽  
Study Participants

Abstract Objectives: Medication management capacity of a patient on ambulatory care is direct related to adherence. To our knowledge data on medication management capacity for ambulatory care patients exiting outpatient pharmacy outlets in Tanzania are scarce. This study aimed to determine the level of medication management capacity among patients on ambulatory care exiting Muhimbili National Hospital outpatient pharmacy outlet. Results: A total of 424 patients on ambulatory care participated in the study. Three hundred eighty seven (91.3%) out of 424 interview questionnaires had complete data and qualified for data analysis. Majority (62.3%) out of 387 study participants had poor medication management capacity; 65.3% out of 387 patients were unable to correctly read the prescription and match the drugs they are carrying. More than half (57.4%) out of 387 participants were unable to correctly take the dose, 73.9% out of 387 were unable to correctly tell the dosing frequency and duration. Only 10.6% out 155 patients with prescription containing drugs with warning or precaution or contraindication or potential side effects were aware.

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