Nodding syndrome in Tanzania may not be associated with circulating anti-NMDA-and anti-VGKC receptor antibodies or decreased pyridoxal phosphate serum levels-a pilot study.

Background: Nodding syndrome (NS) is a seemingly progressive epilepsy disorder of unknown underlying cause. We investigated association of pyridoxal-phosphate serum levels and occurrence of anti-neuronal antibodies against N-methyl-D-aspartate (NMDA) receptor and voltage gated potassium channel (VGKC) complex in NS patients.

Methods: Sera of a Tanzanian cohort of epilepsy and NS patients and community controls were tested for the presence of anti-NMDA-receptor and anti-VGKC complex antibodies by indirect immunofluorescence assay.

Histopathology of malignant tumours of childhood in Tanzania.

Objective: To determine the frequency distribution of malignant tumours of childhood aged 0-14 years.

Design: A retrospective histopathological review of 541 cases of malignant tumours of childhood.

Setting: Cancer Registry, Department of Histopathology, Muhimbili Medical Centre, Dar es Salaam, Tanzania.

Final stage surgical treatment of the conjoined twins of Masasi, Tanzania: case report.

A set of female pygopagus conjoined twins, Agnes and Helen, were born to Margaret Paulo, 22, primigravida, at Masasi in Southern Tanzania on 2/4/98. They were referred from Ndanda Mission Hospital to Muhimbili Medical Centre (MMC) on 28/5/98 and from MMC to the Children's Hospital, Cape Town, South Africa, where they were successfully separated by Prof. H.

Risk awareness, exposure to oral health information, oral health related beliefs and behaviours among students attending higher learning institutions in Dar es Salaam, Tanzania.

Objective: To assess the level of exposure to information about oral health from local sources, risk awareness, oral health beliefs and behaviours among male and female students attending higher learning institutions in Dar es Salaam.

Design: A cross sectional survey.

Setting: Government recognised higher education institutions in Dar es Salaam, Tanzania in 1999.

Dropouts in a long-term follow-up study involving voluntary counseling and HIV testing: experience from a cohort of police officers in Dar Es Salaam, Tanzania.

Background: Results of most population-based studies primarily are derived from people who responded positively and thereby continued to participate in such studies. It is, however, equally important to know the characteristics of study subjects who drop out to learn the reasons that kept them from continuing to participate in the study, especially because they had initially agreed to participate in such a study. In studies with long-term follow-up, reasons for nonresponse may provide invaluable information that may be gathered through continued contact with study subjects who have withdrawn from the study.

Clinical features of tuberculosis among adults in sub-Saharan Africa in the 21st century.

Although tuberculosis was unknown in sub-Saharan Africa before the 19th century, rapid spread of infections due to Mycobacterium tuberculosis occurred during the 20th century and could be found in up to 50% of the adult population by the 1950s. Owing to changes in age structure, rapid urbanization associated with overcrowding living conditions, increasing poverty and the HIV epidemic a 300-400% increase in tuberculosis cases and deaths has been reported from sub-Saharan Africa. Persons dually infected with HIV and tuberculosis may have active tuberculosis with typical or atypical clinical features and/or involving multiple organ systems.

Fungal keratitis as an indicator of HIV infection in Africa.

A 1-year hospital-based study was undertaken on 212 patients at Muhimbili Medical Centre (MMC) from October 1994 to October 1995. The objective was to determine the aetiology of corneal ulceration. A comparison of the prevalence of HIV infection between patients with fungal keratitis and those with non-fungal keratitis was included.

The complexity of pregnancy anemia in Dar-es-Salaam.

Objectives: To investigate the main causes of anemia in pregnancy in Dar-es-Salaam and identify appropriate investigations at all levels of care.

Materials: All pregnant women booking for antenatal care at 2 clinics (n = 2,235) were screened for anemia. Investigations for etiology of anemia were done in all anemic women (Hb <10.

Birthweight and neonatal outcome at the Muhimbili Medical Centre, Dar es Salaam, Tanzania.

A prospective study of neonatal morbidity and mortality was made over four months in 1990 at the neonatal unit in Muhimbili Medical Centre. The incidence of low birthweight (LBW) was 16%. Seven hundred and eighty four LBW infants and 612 heavier infants admitted for care in the unit were followed up for six weeks.

Visual impact of using traditional medicine on the injured eye in Africa.

A 1-year clinical study was performed on 257 consecutive patients with eye injury admitted in Muhimbili Medical Centre from January 1993 to January 1994. It describes the causes, presenting visual acuity and associated ocular complications, use of traditional eye medicine on the injured eye and lastly the visual outcome. Patients were classified into perforating and non-perforating injury patients.

Seroepidemiology of Rickettsia typhi, spotted fever group rickettsiae, and Coxiella burnetti infection in pregnant women from urban Tanzania.

Immunofluorescent antibody (IFA) testing was performed on sera drawn from 150 pregnant women in the port city of Dar es Salaam, Tanzania. Prevalence of antibodies to Rickettsia typhi was 28%, higher than in any of the 12 other African countries in which serosurveys using IFA testing have been performed. Seroprevalence of antibodies to spotted fever group rickettsiae antigens was 25.

Recent trends on bacterial resistance to antibiotics.

Antimicrobial resistance has become a major medical and public health problem. The main factor responsible for development and spread of bacterial resistance is injudicious use of antimicrobial agents which has resulted in most gram positive and gram negative bacteria continuously developing resistance to the antimicrobials in regular use at different time periods. In East Africa, among E.

Operational factors affecting maternal mortality in Tanzania.

Identification of the main operational factors in cases of maternal death within and outside the health care system is necessary for safe motherhood programmes. In this study, a follow-up was done of all 117 cases of maternal deaths in Ilala district, Dar es Salaam, 1991-1993, at all levels of care. In all, 79% received some medical care whereas 11% arrived too late for treatment.

Community based studies on childhood mortality in a malaria holoendemic area on the Tanzanian coast.

Demographic surveillance of children under 5 years of age was undertaken over a 2 year period in a rural area of coastal Tanzania where holoendemic malaria conditions exist. The mean annual entomological innoculation rate (EIR) during the period under study was 234 infective bites per person. There were 192 deaths in children and 1130 live births during the 2 years.

Assessment of mouth-to-mask ventilation in resuscitation of asphyxic newborn babies. A pilot study.

The aim of the study was to compare the effectiveness of mouth-to-mask ventilation (MM) in neonatal asphyxia with bag-and-mask ventilation (BM). A new mouth-to-mask infant resuscitation system was constructed. The study was performed in two university clinics with different resources.

Anaemia in pregnancy: a major health problem with implications for maternal health care.

Women (n=2235) registering for antenatal care in two maternal and child health clinics in the Dar es Salaam area between June, 1991 and June 1992 had their haemoglobin (Hb) measured by use of a HaemoCuer haemoglobinometer. The prevalence of anaemia Hb<10.5 g/dl) was 60% while severe anaemia (Hb<7.

Diabetes mellitus as a cause of death in sub-Saharan Africa: results of a community-based study in Tanzania. The Adult Morbidity and Mortality Project.

The aim of this study was to determine the contribution of diabetes mellitus to all-cause mortality and diabetes mortality rates in adults 15 years and above living in one urban and two rural areas of Tanzania (Dar es Salaam, Hai and Morogoro Rural Districts). The three surveillance populations comprised 307,912 persons. Prospective monitoring of all deaths between 1 June 1992 and 31 May 1995 was carried out.

PCR detection of mycobacteraemia in tanzanian patients with extrapulmonary tuberculosis.

In 191 Tanzanian patients admitted to hospital with suspected extrapulmonary tuberculosis (TB), TB was diagnosed in 158 patients; the remaining 33 patients had neither microbiological nor clinical evidence of TB. Mycobacterium tuberculosis was detected in the blood of 25 patients, in 92% by a polymerase chain reaction (PCR) technique and in 52% by culture of buffy coat cells. The presence of mycobacterial DNA or Mycobacterium tuberculosis bacteria in peripheral blood (positive culture) was significantly associated with HIV infection; it was detected in 22 (21.

Elevated levels of methaemoglobin in Tanzanian children with severe and uncomplicated malaria.

Elevated levels of methaemoglobin, the ferric form of haemoglobin incapable of oxygen transport, have been previously found during Plasmodium vivax infections and in acidotic infants. We measured methaemoglobin in the following 5 groups of children with P. falciparum malaria admitted to Muhimbili Medical Centre, Dar es Salaam, Tanzania.

Appendicitis in Dar es Salaam, histological pattern.

Histology of 378 appendicectomy specimens submitted to the Histopathology Department of Muhimbili Medical Centre from its surgical wards over a 10 year period (1985 to 1994) were reviewed. There were 185 cases (48.9 pc) of acute appendicitis, 101 cases (26.

Predictive markers of survival in HIV-seropositive and HIV-seronegative Tanzanian patients with extrapulmonary tuberculosis.

Setting: Prediction of survival in Tanzanian patients with extrapulmonary tuberculosis (TB).

Objective: To evaluate the prognostic value of clinical and laboratory parameters on survival in human immunodeficiency virus (HIV) seropositive and HIV seronegative patients with extrapulmonary TB.

Design: Over an 8-month period 192 consecutive patients with extrapulmonary TB, admitted to a major referral centre in Tanzania, were enrolled in the study.

Cholelithiasis in Dar es Salaam, Tanzania.

In a five year review, there were 30 cases of cholelithiasis treated at the Muhimbili Medical Centre, Dar es Salaam, Tanzania. The male to female ratio was 1:3, and the peak age for cholelithiasis was in the 30 to 49 years age group. Right upper quadrant abdominal pain was the commonest presenting symptom (100 pc), and cholecystectomy was performed in all patients.

Clinical features of HIV seropositive and HIV seronegative patients with tuberculous lymphadenitis in Dar es Salaam.

Setting: The medical wards of a referral hospital in Dar es Salaam, Tanzania.

Objective: To investigate the impact of HIV infection on clinical features in tuberculous lymphadenitis.

Design: A prospective clinical study of HIV seropositive and HIV seronegative patients with lymphadenopathy.