Objective: To determine the prevalence and risk factors for vaginal candidiasis (VC) among women seeking primary care for genital infections. Design: Cross-sectional study. Setting: Ilala Municipal Hospital in Dar es Salaam, Tanzania. Subjects: Four hundred and sixty four women presenting with complaints of genital infections. Results: Of the 464 women examined, 177 (38.1%) had abnormal vaginal discharge, 68(14.7%) had genital ulcers, 272 (58.6%) had genital pruritis, 18 (3.9%) had genital warts and 58 (12.5%) had chancre. The prevalencies of VC, bacterial vaginosis, HIV, T vaginalis, N. gonorrhoeae and syphilis were 45%, 48.4%, 22%, 93%, 1.5% and 4.3%, respectively. The occurrence of VC was positively associated with HIV, (OR=1.81, 95% CI (1.0-2.67), bacterial vaginosis; (OR=2.6, 95%CI (1.7-3.9), genital pruritis; (OR=1.8 1, 95%CI (1.2-2.7) genital discharge; (OR=1.867, 95% (1.28-2.73) and negatively with T. vaginalis (OR=0.27, 95% CI (0.12-0.6), occupation (OR=0.65, 95%CI (0.35-0.86)) and with education (OR=0.43, 95% CI (0.11-0.73). There were increased but non-significant odds for VC in patients with syphilis (OR=1.6 95%CI (0.6-4.3) and venereal warts (OR=2.5 95% CI (0.92-6.8) VC was not associated with N. gonorrhoeae, genital ulcers, age at first intercourse, number of sexual partners, marital status or antibiotic usage. Conculsion: The high prevalence of vaginal candidiasis among women with genital infections should be taken into account when updating policies concerning syndromic management of sexually transmitted diseases. More gender specific approach to syndromic management of sexually transmitted infections in females should be considered.
Background Recent epidemiological studies suggest that reproductive factors are associated with breast cancer (BC) molecular subtypes. However, these associations have not been thoroughly studied in the African populations. The present study aimed to investigate the prevalence of BC molecular subtypes and assess their association with reproductive factors in Tanzanian BC patients. Methods This hospital-based case-only cross-sectional study consisted of 263 histologically confirmed BC patients in Tanzania. Clinico-pathological data, socio-demographic characteristics, anthropometric measurements, and reproductive risk factors were examined using the Chi-square test and one-way ANOVA. The association among reproductive factors and BC molecular subtypes was analyzed using multinomial logistic regression. The heterogeneity of the associations was assessed using the Wald test. Results We found evident subtype heterogeneity for reproductive factors. We observed that post-menopausal status was more prevalent in luminal-A subtype, while compared to luminal-A subtype, luminal-B and HER-2 enriched subtypes were less likely to be found in post-menopausal women (OR: 0.21, 95%CI 0.10–0.41, p = 0.001; OR: 0.39, 95%CI 0.17–0.89, p = 0.026, respectively). Also, the luminal-B subtype was more likely to be diagnosed in patients aged ≤ 40 years than the luminal-A subtype (OR: 2.80, 95%CI 1.46–5.32, p = 0.002). Women who had their first full-term pregnancy at < 30 years were more likely to be of luminal-B (OR: 2.71, 95%CI 1.18–4.17, p = 0.018), and triple-negative (OR: 2.28, 95%CI 1.02–4.07, p = 0.044) subtypes relative to luminal-A subtype. Furthermore, we observed that breastfeeding might have reduced odds of developing luminal-A, luminal-B and triple-negative subtypes. Women who never breastfed were more likely to be diagnosed with luminal-B and triple-negative subtypes when compared to luminal-A subtype (OR: 0.46, 95%CI 0.22–0.95, p = 0.035; OR: 0.41, 95%CI 0.20–0.85, p = 0.017, respectively). . Conclusion Our results are the first data reporting reproductive factors heterogeneity among BC molecular subtypes in Tanzania. Our findings suggest that breast-feeding may reduce the likelihood of developing luminal-A, luminal-B, and triple-negative subtypes. Meanwhile, the first full-term pregnancy after 30 years of age could increase the chance of developing luminal-A subtype, a highly prevalent subtype in Tanzania. More interventions to promote modifiable risk factors across multiple levels may most successfully reduce BC incidence in Africa.
Diarrhea is a daily public health song in developing countries like Tanzania. The causative agents are theoretically known almost to everybody. However, the eradication of this killer disease for the under-fives is an enigma. This study aimed to provide update advantages of molecular diagnostic versus conventional methods as regards to acute diarrhea, and to determine bacterial causes of diarrhea among children aging five years and below in Dar Es Salaam, Tanzania, using multiplex PCR technique.Samples were collected from the under-fives from district hospitals in Dar Es Salaam city between June 2010 and February 2014. This included children admitted due to acute and/ or Journal of Biology and Life Science ISSN 2157-6076 2016 www.macrothink.org/jbls 72 chronic diarrhea. A total of 3600 stool samples were analyzed, of which 1800 samples were from diarrhea cases and 1800 samples from normal control cases. About 1080 (60%) of the patients recruited were aged less than 3 years and 983 (54.6%) were males. Diarrheagenic bacteria were isolated and identified using conventional stool cultures then were characterized by mPCR.Pathogenic bacteria were detected in 67.7% of the cases and in 20% of the controls. The pathogenic bacteria most strongly associated with diarrhea disease were diarrheagenic Escherichia coli (21.6% of cases, 6% of controls), Shigella spp. (16.1% of cases, 5% of controls) and Salmonellae, (10.6% of cases, 3% of controls. The pathogenic bacteria were mostly from children aging from 24 months and above.Diarrheagenic bacteria play an important role in relation to childhood diarrhea aging from two years and above. Proper diagnostic methods, prevention and control through fostering good hygiene and sanitation to water and food should be emphasized especially to oral-faecal age.
Background: During cancer growth, immunosuppressive microenvironment is created that enables tumour cells to evade an eliminative immune response and hence manage to grow into malignancy. HLA-G, existing as either membrane-bound (mHLA-G) or soluble (sHLA-G) molecule is thought to be immunosuppressive and produced more by tumor cells. The +3142G/C polymorphism in HLA-G gene affects its expression, and G allele is considered to be a protective mutant allele associated with less expression of HLA-G. The implication of HLA-G in cancer development has been reported in different cancers and populations. But, its implication in most African populations has not yet been investigated. The aim of this study was to determine the possible associations of soluble HLA-G and HLA-G +3142G/C SNP with breast cancer. Materials and Methods: 75 breast cancer patients and 84 normal controls were recruited in this study. The genotyping of HLA-G +3142G/C polymorphism was determined by LightSNiP typing assay using quantitative Real-Time PCR and sHLA-G levels were determined by ELISA. Results: The sHLA-G levels were significantly lower in breast cancer patients than in controls (p<0.001). Also, they were significantly lower in mastectomized patients compared to non-mastectomized patients (p=0.018). The ROC analysis revealed a significant ability of sHLA-G to differentiate breast cancer patients versus normal controls (AUC=0.697, 95% CI= 0.619-0.767, p<0.001) and identify mastectomized patients (AUC=0.667, 95% CI= 0.549 to 0.772, p=0.041). The assessment of +3142G/C polymorphism revealed a relatively similar distribution of frequencies of genotypes and alleles between breast cancer patients and normal controls (p>0.05) and was neither associated with sHLA-G levels. Conclusion: While the +3142G/C SNP was found not to be relevant to breast cancer, the changes of sHLA-G levels in response to medical interventions such as mastectomy may be translated into its potential prognostic utility for breast cancer. More studies are needed to provide clear evidence of sHLA-G as a diagnostic and prognostic marker of breast cancer in Tanzania.
In this paper, we derive and analyse rigorously a mathematical model of control strategies (screening, education, health care and immunization) of HCV in a community with inflow of infected immigrants. Both qualitative and quantitative analysis of the model is performed with respect to stability of the disease free and endemic equilibria. The results show that the disease free equilibrium is locally stable at threshold parameter less than unity and unstable at threshold parameter greater than unity. Using Lyapunov method, endemic equilibrium is globally stable under certain conditions. Numerical simulation of the model is implemented to investigate the sensitivity of certain key parameters on the HCV model in a community with inflow of infected immigrants. However, analysis shows that screening, education, health care and immunization have the effect of reducing the transmission of the disease in the community.
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