Diarrhoea is an increase in volume of stool or frequency of defecation. It is one of the most common clinical signs of gastrointestinal diseases, but also can reflect primary disorders outside of the digestive system. This cross-sectional descriptive survey was conducted in Temeke Municipality, Dar es Salaam over a 4-month period to investigate on knowledge and perception of mothers/caregivers of underfives on childhood diarrhoea. Specifically, the study focused on frequency of diarrhoeal episodes and their risk factors as well as effectiveness of traditional remedies used for its management prior to seeking medical attention. A semi-structured questionnaire was used for data collection, through which a total of 161 mothers were interviewed. Of those, 74 (46%) had female and 87 (54%) had male underfives with median age of 2-years. Frequency of diarrhoeal episodes was high among the underfives and was comparable between females and males (87 vs 74; P<0.05). Medicinal plants were the most common traditional remedies employed by majority (71%) of the interviewees, which have been purported to be effective in management of childhood diarrhoea. Guava (leaves and fruits) was the most commonly used remedy in the treatment of diarrhoea. Mothers' knowledge on predisposing factors of childhood diarrhoea was poor, which was directly correlated with education level. Only about one-third of the respondents (31%) were aware of risk factors for childhood diarrhoea that cited poor sanitation and water as the main factors. Diarrhoeal episodes were perceived wrongly as normal growth stage and that were caused by several other ''illnesses''. It is important that further studies on traditional remedies should be carried out to validate their usefulness in the treatment of childhood diarrhoea.___________________________________________________________________________________

PurposeContamination of pharmaceuticals with microorganisms irrespective whether they are harmful or nonpathogenic can bring about changes in physicochemical characteristics of the medicines. Although sterility is not a requirement in official compendia for nonsterile pharmaceuticals, bioburdens need to be within acceptable limits. Therefore, this study investigated microbial contamination of 10 nonsterile pharmaceuticals frequently delivered to outpatients by identifying and quantifying microbial contaminants and susceptibility pattern testing on the microbes isolated.MethodsThe study was carried out at Amana Municipal Hospital in Dar es Salaam, Tanzania. The protocol for the study involved structured selection of representative tablets, syrups, and capsules from the hospital’s outpatient pharmacy. Constitutive microorganisms were elaborated and enumerated using standard microbiologic procedures.ResultsResults showed that 50% of all tested products were heavily contaminated, and the predominant contaminants comprised Klebsiella, Bacillus, and Candida species. Furthermore, the results showed that the isolated Bacillus and Klebsiella species were resistant to Augmentin ® and cloxacillin. The differences in means for cfu/mL and zones of inhibition among the microorganisms isolated were considered significant at P < 0.05.ConclusionThe nonsterile pharmaceuticals were presumably microbiologically contaminated due to poor handling during dispensing, repackaging, and/or nonadherence to good manufacturing practice. Therefore, training and educating the dispensers, as well as patients, on the proper handling and use of medicines cannot be overemphasized, because these are key aspects in controlling cross-contamination of medicines.

Tanzania requires more health professionals equipped to tackle its serious health challenges. When it became an independent university in 2007, Muhimbili University of Health and Allied Sciences (MUHAS) decided to transform its educational offerings to ensure its students practice competently and contribute to improving population health. In 2008, in collaboration with the University of California San Francisco (UCSF), all MUHAS's schools (dentistry, medicine, nursing, pharmacy, and public health and social sciences) and institutes (traditional medicine and allied health sciences) began a university-wide process to revise curricula. Adopting university-wide committee structures, procedures, and a common schedule, MUHAS faculty set out to: (i) identify specific competencies for students to achieve by graduation (in eight domains, six that are inter-professional, hence consistent across schools); (ii) engage stakeholders to understand adequacies and inadequacies of current curricula; and (iii) restructure and revise curricula introducing competencies. The Tanzania Commission for Universities accredited the curricula in September 2011, and faculty started implementation with first-year students in October 2011. We learned that curricular revision of this magnitude requires: a compelling directive for change, designated leadership, resource mobilization inclusion of all stakeholders, clear guiding principles, an iterative plan linking flexible timetables to phases for curriculum development, engagement in skills training for the cultivation of future leaders, and extensive communication.

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Trimethoprim-sulfamethoxazole (CTX) has been recommended by the World Health Organization as a prophylactic drug for HIV/AIDS-patients against opportunistic infections. However, daily use of CTX may reduce its efficacy to enteric Escherichia coli, thus increasing the burden of CTX-resistant pathogens. Resistance of enteric pathogens to CTX may affect empiric treatment approaches especially in HIV/AIDS patients. We prospectively investigated incidences of fecal E. coli resistance to CTX in 188 HIV-infected patients of 15-72 years of age, and determined changes in susceptibility patterns. The study was conducted in Dar es Salaam, Tanzania involving collection of stool specimens from HIV-patients prior and after initiation of CTX prophylaxis. Specimens were collected on 1 st , 4 th , and 24 th weeks upon commencing CTX prophylaxis. Susceptibility profiling of E. coli and other enteric bacteria to CTX and other widely used antibiotics were done using Kirby-Bauer disk diffusion method. On the first visit, 143(76.1%) enteric bacteria were isolated. Of those, 123(86%) were E. coli. About 98.6% were resistant to CTX. On the second visit, 103(54.2%) bacteria were isolated; of those, 100(98.4%) of them exhibited resistance to CTX. On the third visit, 64(34%) out of 188 patients had significant enteric bacteria, and of those 63 (98.4%) were resistant to CTX. About 53.2% of bacterial isolates were resistant to ciprofloxacin and ampicillin. Majority (95.2%) of the patients had initiated CTX prophylaxis prior to testing at the care and treatment clinics. About 32% of the patients reported to have skipped some doses of CTX prophylaxis. Non-adherence to CTX prophylaxis and self-medication among patients may have attributed to the observed high prevalence rate of E. coli resistance to CTX and other commonly used antibiotics. For better understanding of the observed pattern of bacterial resistance to CTX, phenotypic and/or genotypic characterization of the isolated bacteria needs to be conducted. the need to use antibiotics more cautiously. Unless we act now, we face a future of untreatable bacterial infections. Immune-compromised patients such as people living with HIV/AIDS (PLHA) are the most likely to be affected by resistant bacterial and fungal infections. As in many other developing countries, conditions that may foster antibiotic resistance in Tanzania differ from developed countries, and so resistance prevalence. Faecal pollution and other traits of overcrowded cities with poor sanitary conditions might create ideal settings for selecting, exchanging and maintaining resistance traits. In addition, medical abuse of antibiotics, along with low-quality drugs are also prevalent [13]. Self-medication, a common yet unmeasured practice among Tanzanian population, may also contribute to increased resistance rates [15]. Therefore, knowledge of antimicrobial resistance trends among bacterial isolates is essential in order to provide clinically appropriate and cost effective therapy. Microbial infections such as NTS and Salmonella fo...