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Background: Chronic hepatitis B virus (HBV) infection is still a major public health problem. In response to the World Health Organization (WHO), Tanzania implemented immunization and treatment to achieve the eradication of HBV infection by 2030. To achieve this goal, frequent updates of demographic data, antiviral therapy eligibility, and uptake are essential. We therefore evaluated demographic data, antiviral therapy eligibility, and uptake among chronically HBV-infected patients attending at Bugando Medical Centre (BMC), Tanzania. Methods: A cross-sectional study enrolled 196 chronic HBV patients from April 23, 2023, to October 10, 2023, at BMC, where 100 and 96 patients were retrospectively and prospectively enrolled, respectively. Study's ethical clearance and permission were observed by the Catholic University of Health and Allied Sciences/Bugando Medical Centre research ethics and review committee and the Bugando Medical Centre management respectively. For all patients, socio-demographic data and whole blood samples were obtained. Full blood picture, alanine and aspartate amino transferases, and HBV viral load parameters were determined. Aspartate-Platelet Ratio Index (APRI) and Fibrosis Four (FIB-4) scores were calculated according to their respective formulas. Therapy eligibility and uptake were evaluated according to the 2015 WHO HBV prevention, treatment, and care guidelines. The data were summarized and analysed using STATA version 15. Results: The median age for all patients was 39 [IQR: 32–47.5] years. Nearly all study patients, 99% (194/196), were older than 20 years old, with significant male dominance (73.5% [144/196] versus 26.5% [52/196]; p<0.0001). Anti-HBV antiviral therapy eligibility was 22.4%, while uptake was 6.8% (3/4), which was significantly lower than the WHO expectation of 80% (p <0.0001). Conclusion: Almost all chronically HBV-infected patients attending at BMC were older than 20 years old and were significantly dominated by males. Antiviral therapy uptake was remarkably lower than expected by the WHO towards combating HBV infection by 2030. [ABSTRACT FROM AUTHOR]

Background: Glycaemic control is essential for improving the quality of life in patients with Diabetes Mellitus (DM). Untreated hyperglycaemia can result in numerous severe and life-threatening complications, such as damage to the eyes, kidneys, nerves, heart, and peripheral vascular system. Appropriate glycaemic control and management is fundamental to prevent and delay diabetes complications. Therefore, this study aims to assess the prevalence of poor glycaemic control, its associated factors, and the prevalence of diabetes-related complications among DM patients. Methods: A cross-sectional study was conducted among 340 DM patients treated at Bugando Medical Center from 4th - 30th April 2023 to determine the prevalence of poor glycaemic control and its predictors. Secondary data from 7952 DM patients treated between April 2022 and 30th May 2023 were used to determine DM-related complications. STATA 15 version ...was used for analysis. Results: Out of 340 patients, 66.4% had poor glycaemic control with HbA1c or Random Blood Glucose greater than 7% or 7mmol/L, respectively. Older age, duration of DM of more than 10 years, insulin therapy, and those unaware of glycaemic target goals were factors associated with poor glycaemic control. (AOR: 2.46, 95% CI: 1.28–6.01, P = 0.03), (AOR: 3.15, 95% CI: 2.22–6.55, P = 0.016), (AOR: 3.07, 95% CI: 2.10–6.12, P = 0.022) and (AOR: 3.42, 95% CI: 2.17–5.97, P = 0.001), respectively. Of the 7952 patient records reviewed indicated that 44.5% had complications, of which 25.8% had neurological complications and 55.3% had multiple complications. Conclusion: Two-third of DM patients failed to achieve good glycaemic control and about half of the patient's records reviewed indicated they developed diabetic complications. Thus appropriate interventions are necessary to improve glycaemic control and prevent or control complications among DM patients. [ABSTRACT FROM AUTHOR]

COVID‐19 vaccine became available in Tanzania during the first wave of the Omicron variant. During that time community seroprevalence of SARS‐CoV‐2 was already at 50%–80%. To date, it remains largely unknown whether ongoing vaccination with the primary series vaccines has any meaningful immune‐boosting effects against newer Omicron subvariants. Therefore, we tested cross‐neutralizing capacity of antibodies elicited by infection, vaccination, or both against SARS‐CoV‐2 Omicron subvariants BA.1, and the newer subvariants BQ.1.1 and XBB.1.5. that were unexperienced by this population. Participants who were either SARS‐CoV‐2 infected‐only (n = 28), infected vaccinated (n = 22), or vaccinated‐only (n = 73) were recruited from Dar‐es‐Salaam, Tanzania, between April and December 2022. Plasma 50% neutralization titers (NT50) against SARS‐CoV‐2 wild‐type strain and Omicron subvariants were quantified by a lentiviral‐based pseudo‐virus assay. Percentage of participants with neutralizing activity against WT and BA.1 was high (>85%) but was reduced against BQ.1.1 (64%–77%) and XBB.1.5 (35%–68%) subvariants. The low median cross‐neutralization titer was slightly higher in the infected vaccinated group compared to vaccine‐only group against BQ.1.1 (NT50 148 vs. 85, p = 0.032) and XBB.1.5 (NT50 85 vs. 37 p = 0.022) subvariants. In contrast, vaccine‐boost among the infected vaccinated did not result to increased cross‐neutralization compared to infected‐only participants (BQ.1.1 [NT50 of 148 vs. 100, p = 0.501] and XBB.1.5 [NT50 86 vs. 45, p = 0.474]). We report severely attenuated neutralization titers against BQ.1.1 and XBB.1.5 subvariants among vaccinated participants, which marginally improved in the infected vaccinated participants. Our findings call for further studies to evaluate effectiveness of the primary series vaccines in preventing severe infection and mortality against the newer variants. [ABSTRACT FROM AUTHOR]

Background: Cleft palate poses major therapeutic challenges among otorhinolaryngology, plastic/reconstructive, oral and maxillofacial surgeons practicing in resource-limited countries. There is a paucity of prospective studies regarding this subject in Tanzania and Bugando Medical Centre (BMC) in particular. This study aims to determine the clinical patterns, surgical outcomes and prognostic factors among patients undergoing cleft palate repair at BMC Methods: This was a cross-sectional study among patients undergoing cleft palate repair at BMC between January 2019 and June 2019. Results: A total of 44 patients (M; F ratio = 1.4: 1) were studied. The majority, 35(79.5%) were within 1 year of age at presentation. One (2.3%) patient had two associated congenital anomalies. Only 10 (22.7%) patients had isolated cleft palate and the remaining 34(77.3%) patients had associated cleft lip. Half of the patients, 22 (50.0%) had a bilateral cleft palate. The majority of patients, 35(79.5%) had complete cleft palates. All patients underwent cleft palate repair, the majority at the age of 9 months. A total of 21 (47.7%) developed postoperative complications, mainly bleeding (10; 47.6%) and palatal fistula (9; 42.8%). No death was recorded in this study. Out of 44 patients, 34 were treated successfully giving an overall success rate of 77.3%. The success rate was significantly influenced by nutrition status (p= 0.020) and the width of the cleft (p=0.033). Conclusion: This study showed that the majority of patients with cleft palate presented to BMC within 1 year of life. More than three-quarters of patients were treated successfully. Malnutrition and cleft width > 10 mm were the major prognostic factors affecting the treatment success. Appropriate measures focusing on these factors are vital in order to deliver optimal care for these patients in this region. [ABSTRACT FROM AUTHOR]

Background: Globally burns among children are a public health concern. Banana leaf dressings or Conventional dressing materials may be used to dress burn wounds children. The study aimed to explore the outcomes of burn wounds dressed using banana leaves and conventional dressing materials respectful. Methods: Hospital-based cohort study design conducted at Bugando Medical Center Burn Unit. Nonprobability convenient sampling method with a sample size of 35 pediatric patients with burn wounds for each group of convectional dressing methods and banana leaf dressings was reached. Stata program Version 13 was used to analyze data. Results: A total of 70 children; 1 to 18 years, with a median age of 4 and interquartile range [IQR: 1-17] years were enrolled in the study. Thirty-five were dressed with Banana leaf the other 35 were dressed with conventional materials. Results showed that Banana leaf dressing was associated with; less pain (aOR = 0.2, 95% CI: 0.1 - 0.5, p-value <0.001), less medication use (aOR = 3.0,95% CI: 1.1 - 8.7, p -- value 0.02) and good satisfaction (aOR = 85.6, 95% CI: 3.3 - 219, p -- value <0.001) respectful during dressing change compared to conventional dressing method. However, no difference was observed between the length of hospital stay and the dressing method chosen. Conclusions: Although there is no evidence of a dressing method that is best for burn wounds. This study shows that Banana leaf dressing is convenient in terms of having fewer pain experiences and that it can be locally obtained in areas where the banana plant is easily available. We recommend the use of banana leaf dressings for burns moreover, enlightenment of the public on the intervention and prevention of burns among children. [ABSTRACT FROM AUTHOR]

Background: Emergency caesarean section (C-section) for women with two or more uterine scars is documented to be associated with poor fetomaternal outcomes. The World Health Organization recommends elective C-section for women with two or more previous scars. However, in Tanzania there is a paucity of data for women with two or more prior C-sections and how it contributes to increased maternal and perinatal morbidity and mortality when they come in active labour without a planned delivery. The purpose of the study was to determine factors associated with pregnant women with multiple C-section deliveries presenting in labour and their fetomaternal outcomes. Methods: This was a cross-sectional, hospital-based study, involving 275 pregnant women who underwent C-section due to multiple uterine scars in the Mwanza region. Socio-demographic and clinical characteristics were collected serially until the sample size was reached using a structured questionnaire and patients' files. Data were analyzed using STATA version 13.0 software. Results: All pregnant women with two or more previous uterine scars attended antenatal care (ANC) and the majority, 62.2%, had four or more visits. However, 61.9% were not told of the need for elective C-section. In addition, 26% were not counselled about the obstetric danger signs. Among the study participants, 66.6% presented with labour pain requiring emergency C-section, 13.1% had postpartum hemorrhage and 3.3% had ruptured uterus. There were 3.3% of peri-natal deaths and 10.9% required newborn resuscitation. The associated factors for women with two or more C-section scars presenting in active labour were: having the last ANC visit at primary healthcare (PHC) facility, unemployment, visiting ANC <4 visits or being attended by a non-physician health provider in her last ANC visit. Conclusion: Parturient women with uterine scars, when attending primary health care facilities for their ANC visits, ought to be counselled and referred to high facilities with clinicians who can plan an elective c-section delivery. [ABSTRACT FROM AUTHOR]

Background: Admission hyperglycemia has been reported to be associated with poor outcomes among patients with major trauma. However, most of the available literature on this subject has been conducted in the developed world. This study aimed to determine the association between admission hyperglycemia and the outcome of major trauma patients admitted to Bugando Medical Centre. Methods: This was a prospective cohort study, involving major trauma patients admitted to Bugando Medical Centre (BMC) within 6 months from Sept 2017 to February 2018. The exposure was admission hyperglycemia (>11.1mmol/l) and non-exposure was normoglycemia (=11.1mmol/l). Results: A total of 217 patients (M: F ratio = 4.1: 1) were recruited. Their ages ranged from 4 - to 97 years with a median age of 31 years. Out of 217 patients, 106 (48.8%) were hyperglycemic and the remaining 111(51.2%) were normoglycemic. The overall median days of the length of hospital stay (LOS) was 15 days. There was no statistically significant association between admission hyperglycemia and LOS (p =.0.875). In this study, 73 patients died giving a mortality of 33.6%. Patients with admission hyperglycemia (>11.1mmol/l) had significantly higher mortality as compared to normoglycemic patients (=11.1mmol/l) (p < 0.001). Conclusion: From this study, it was found that admission hyperglycemia was statistically significantly associated with increased mortality among major trauma patients at BMC. Therefore, there is a need to institute regular monitoring of blood sugar levels among these patients and give appropriate treatment to those found with elevated blood sugar levels. [ABSTRACT FROM AUTHOR]