University of Dar es Salaam School of Health Sciences

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Browsing University of Dar es Salaam School of Health Sciences by Subject "AIDS"

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    The association of intestinal parasites with chronic diarrhoea in adult AIDS patients in North-Eastern Tanzania.
    (University of Dar es Salaam, 1995) Tarimo, Donath S.
    A study on the association of intestinal parasites with chronic diarrhoea among adult AIDS patients was conducted in the North-Eastern zone of Tanzania. Diarrhoea was found to be a major problem among the patients. More than 70% of the patients had diarrhoea during their illness. Intestinal parasites were detected in 123 out of 352 (34.9%) patients. The proportion of patients with intestinal parasites and chronic diarrhoea was 62.6% (77 out of 123). The prevalence of chronic diarrhoea in patients who were in clinical stage III-IV of AIDS was highest among patients harbouring parasites that are known to cause diarrhoea. The association of diarrhoeagenic parasites (combined together) with chronic diarrhoea was found to be statistically significant. The adjusted associations were also found to be statistically significant. Cryptosporidiums Isospora belli and Strongylostercoralis were only isolated from patients with chronic diarrhoea. It was concluded that chronic diarrhoea was a major complaint of adult AIDS patients in North-Eastern Tanzania. Parasites known to cause diarrhoea considered together were the most likely cause of chronic diarrhoea in such patients. Cryptosporidium spp, Isospora bell, and Strongyloides stercoralis were the most likely cause of chronic diarrhoea among the patients. Development of clinical infection due to parasites known to cause diarrhoea was found to be related to the immunological status (clinical stage) of the AIDS patients. It is recommended to strengthen home based care for AIDS patients as well as laboratory facilities at all levels of health care delivery centres for diagnosing specific intestinal parasites in AIDS patients so as to institute specific therapies thereby improving the quality of life of such patients. A comprehensive case-control study, to establish cause and effect of the various agents isolated from AIDS patients with chronic diarrhoea is proposed. There is a need to determine the type of drugs which will be suitable for the treatment of opportunistic infections which may interact with AIDS in our set up.
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    Comparison of antimicrobial susceptibility patterns of some bacterial isolates and prevalence of antibodies to some common pathogens from HIV-1 infected patients and HIV-1 seronegative controls
    (University of Dar es Salaam, 1991) Dielly, Simon Andrew
    235 newly admitted patients into the medical wards of the Muhimbili Medical Centre in Dar es Salaam, Tanzania were investigated for antibiotic sensitivity patterns of bacterial isolates from the nostrils and urine samples obtained from HIV-1 infected/AIDS patients and HIV-1 seronegative referents. Immunoglobulin levels, serum antibodies against Treponema palladium, Salmonella spp, staphylolysin, and Group A Streptococcus streptolysin 0 were determined in the HIV-1 seropositive and HIV-1 seronegative referents. All staphylococcal isolates from the nostrils of HIV-1 infected/AIDS and HIV-1 seronegative referents were sensitive to vancomycin and oxacillin but there was significant difference (P=0.003) in the mean inhibition zones of vancomycin in the two groups. There was a significant (P<0.001) difference in resistance to chloramphenicol and doxycycline shown by staphylococcal isolates from the nostrils of HIV-1 infected/AIDS patients and HIV-1 seronegative referents. There was also a significant difference (P<0.001) in sensitivity pattern to cefuroxime in the two groups investigated. Resistance to antibiotics which are rarely or not used at all in Dar es salaam was not noted in the studied patients. Significant (P<0.001) difference in sensitivity to chloramphenicol and gentamicin was noted from the urine isolates from HIV1 seropositive and HIV-1 seronegative referents. Bacterial isolates from HIV-1 infected/AIDS patients were therefore significantly (P<0.005) more resistant to routinely used antibiotics than isolates from HIV-1 seronegative referents. There was a significant difference (P=0.003) in the prevalence of antibodies (IgM and IgG VDRL and TPHA respectively) against Treponema Palladium in HIV-1 infected patients compared to HIV-1 seronegative referents indicating that HIV-1 infected patients were more likely to have had infection with T. palladium than their HIV-1 seronegative referents. There was a difference in the levels of antistaphylolysin in the sera of HIV-1 infected AIDS patients and HIV-1 seronegative controls. The mean ASOT titres in the HIV-1 infected/AIDS and HIV-1 seronegative controls we re 288 and 343 Todd units respectively but there was no significant difference (P=0.497). There was also no significant difference (P=0.652) in the prevalence of salmonella antibodies in the HIV-1 infected/AIDS patients and the HIV-1 seronegative referents. There was a significant difference (P<0.001) in levels of IgG (mean =34g/L), IgA (mean=4.7g/L) and IgM (mean=4.03g/L) in HIV-1 serapositive patients compared to HIV-1 seronegative referents who had IgG levels (mean=25.3g/L), IgA {mean=3.9g/L) and IgM(mean=3.81g/L). Generally levels of Ig in the studied population were higher compared to a Tanzanian healthy adult population which are IgG, IgM, IgA as 18.55g/L, 2.5ig/L and 2.51g/L respectively [27). The present study suggests that HIV-1 infected/AIDS patients are more prone to bacterial infections with common pathogens, The results also suggest that HIV-1 infected/AIDS patients tend to harbour bacterial flora which are multiply resistant to antibiotics.
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    HIV/AIDS related knowledge, attitude and practice of health workers towards pregnant women in the labour wards in Magu district.
    (University of Dar es Salaam, 2000) Kasindi, Stella
    HTV/AIDS continues to be one of the prominent killer disease despite the feet that attempts are still going on to find a definitive cure for the condition. Sub Saharan Africa has the highest numbers of patients, including Tanzania (UNAIDS, 1998). Care of these patients, lies on the health workers, as well as family members, when providing symptomatic treatment and support. Health workers also take care of people infected with the disease, but who may not have attained the full-blown disease, such patients are only detected by blood tests. The lack of cure, combined with the fact that the disease can be transmitted in workplace situations, is a major fact that results in changing the way of handling patients in this era of AIDS pandemic, directly affecting patient care. HTV/AIDS related knowledge, attitude and practice of health workers towards pregnant women in the labour wards in Magu district was done in the context of such situation. The studied population was health workers in the labour wards, delivering patients, chosen because in the labour wards, these workers encounter more blood and body fluids, which are a potential source of the virus if, infected. In-depth interviews to the in-charges were administered as well as observations and patients’ interviews. The results show that health workers are knowledgeable (92.3%) on the modes of HIV transmission, but this is not associated to the resultant attitude. However, most workers (60.2%) had positive attitude to the pregnant women in the labour wards. The workers had high risk-perception (91.2%) as well as fear (73.6%) especially when they did not have protective equipment. Availability and use of protective gear was also found to be inadequate in the labour wards, when delivering pregnant women. It can be seen that training of health workers on the workplace precautions still needs increased efforts.
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    Prevalence and risk factors for HIV-infection and other sexually transmitted diseases among youth in Moshi rural district, Kilimanjaro region, 1995.
    (University of Dar es Salaam, 1996) Kessy, Anna Tengia
    A population-based study was undertaken in the Moshi rural district, Kilimanjaro region during March through June 1995, to determine the prevalence and risk factors for infection with the Human Immunodeficiency Virus (HIV) and other sexually transmitted diseases (STDs) among youth aged 15-24 years. Subjects were obtained through multistage cluster sampling. Information on sociodemographic characteristics and reproductive health behaviour was obtained using an interview questionnaire. Subjects were examined for signs of STDs and urogenital specimens were screened for Neisseria gonorrhoea and Trichomonas vaginalis organisms. Antibodies to HIV and syphilis infections were determined by ELISA and VDRL/TPHA tests respectively. Out of 1104 youth interviewed, 86 % participated in both genital examination and blood specimen taking. Results showed high prevalence of STDs in general, being 14.2 % for trichomoniasis, 11.6 % for syphilis, 7.5 % for HIV infection, 5.2 % for gonorrhoea and 1.3 % for genital ulcer disease. Past or current histories of STDs were significantly associated with HIV infection. Females, youth aged 20-24 years, married or cohabiting subjects had higher risk of having any of the STDs compared to males, youth aged 15-19 years and single subjects respectively. Results also showed high prevalence of high risk behaviours associated with STDs. Subjects who had had sexual intercourse at least once in their lifetime were 70%, majority (67.3 % ) having had their first coital exposure between 15-19 years of age; 40.5 % had multiple sexual partners; 61 % consumed alcohol and among females who had experienced at least one sexual act, 50 % had received a gift for the first sexual encounter. Majority of the youth had heard of AIDS/STDs and could mention spontaneously the routes of transmission. However, their level of knowledge on preventive measures was generally low. Findings show that high risk behaviours among youth in a rural setting were associated with HIV/STDs, females being more at risk than males. There is therefore, an urgent need to target interventions towards behavioural change among the youth so as to reduce the rate of transmission of these diseases. In order to institute culturally appropriate interventions it is recommended that similar surveys be carried out in other cultural settings.