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Alexander Conor Hollis, Samuel Robert Ebbs
INTRODUCTION: There is a lack of published evidence examining the quality of patient notes in African healthcare settings. We aim to examine the completeness of the orthopaedic inpatient notes and begin development of a formal audit framework in a large Tanzanian Hospital. METHODS: A retrospective review of 155 orthopaedic inpatient notes at Kilimanjaro Christian Medical Centre (KCMC) was conducted spanning 3 months. Notes were reviewed using an agreed data collection pro forma considering 3 main outcomes; i) quantity of complete entries, ii) percentage completeness of individual sections, iii) documentation of follow-up...
2016: Pan African Medical Journal
Michael J Mahande, Joseph Obure
BACKGROUND: Both short and long interpregnancy intervals have been associated with an increased risk of adverse pregnancy outcomes. There is limited information about the impact of interpregnancy interval on pregnancy (IPI) outcomes in Tanzania. The objective of this study was to assess the effect of IPI on adverse pregnancy outcomes. METHODS: We performed a retrospective cohort study using maternally-linked data from Kilimanjaro Christian Medical Centre (KCMC) birth registry...
June 7, 2016: BMC Pregnancy and Childbirth
Alexander P Dahinten, Dorothy E Dow, Coleen K Cunningham, Levina J Msuya, Blandina T Mmbaga, Robert A Malkin
BACKGROUND: In developing countries, antiretroviral therapy provides life-saving treatment to HIV-positive women and their children before, during and after birth. However, supply chain challenges such as long distances, medication shortages and nonfacility deliveries often compromise consistent access to prophylactic treatment for at-risk infants. A proposed intervention to address these challenges, often referred to as the "Pratt Pouch," allows for liquid-formulation medications, such as nevirapine (NVP), to be repackaged into single-dose pouches...
September 2016: Pediatric Infectious Disease Journal
Aneth Mkunde Mahande, Michael Johnson Mahande
BACKGROUND: Parasitic infection(s) during pregnancy have been associated with increased risk of pregnancy complications and adverse outcomes in low resource settings. However, little is known about their influence on pregnancy outcomes. This study aimed to determine the prevalence of parasitic infections and their association with pregnancy complications and adverse outcomes. METHODS: A retrospective cross-sectional study was conducted using maternally-linked data from Kilimanjaro Christian Medical Center (KCMC) medical birth registry...
2016: BMC Infectious Diseases
Godwin S Macheku, Rune Nathaniel Philemon, Olola Oneko, Pendo S Mlay, Gileard Masenga, Joseph Obure, Michael Johnson Mahande
BACKGROUND: Abruptio placentae remains a major cause of maternal and perinatal morbidity and mortality in developing countries. Little is known about the burden of abruptio placentae in Tanzania. This study aimed to determine frequency, risk factors for abruptio placentae and subsequent feto-maternal outcomes in women with abruptio placentae. METHODS: We designed a retrospective cohort study using maternally-linked data from Kilimanjaro Christian Medical Centre (KCMC) medical birth registry...
2015: BMC Pregnancy and Childbirth
Alexander Blaauw Isaksen, Truls Østbye, Blandina Theophil Mmbaga, Anne Kjersti Daltveit
BACKGROUND: Alcohol can be harmful to the development of the foetus. In most developed countries, pregnant women are recommended to abstain from alcohol, however in developing countries, women are less likely to receive these recommendations. With respect to pregnant women in Northern Tanzania, this study aims to 1) describe time trends in level of alcohol consumption, 2) assess socio-demographic predictors of alcohol consumption, and 3) describe associations between alcohol consumption and health-related maternal and foetal outcomes...
2015: BMC Pregnancy and Childbirth
Ignatus Kissima Mosten, Bernadus Carolus Hamel, Grace Damas Kinabo
INTRODUCTION: Human Immunodeficiency Virus (HIV) infection is a significant cause of paediatric morbidity and mortality especially in Sub-Saharan Africa. It affects the kidney by injuring the glomerular and tubular epithelial cells causing leakage of albumin in urine. Microalbuminuria is known to be an early indicator of kidney injury including HIVAN. The purpose of this study was to identify the prevalence and factors associated with microalbuminuria among HIV infected children receiving care and treatment at Kilimanjaro Christian Medical Centre (KCMC)...
2015: Pan African Medical Journal
Jeremy A Gilmour-White, Peter Shah, Vinette Cross, William Makupa, Heiko Philippin
OBJECTIVE: To investigate the barriers to access to eye health services for patients with glaucoma in Tanzania with the aim of identifying key areas for improvement and further research. DESIGN: Qualitative investigation using face-to-face semi-structured interviews with patients recruited from the Kilimanjaro Christian Medical Centre (KCMC) outpatient eye clinic. This project is part of the international strategy of the Research into Glaucoma and Ethnicity (ReGAE) programme...
July 2015: Postgraduate Medical Journal
Michael Bartholomew Mwandri, Julius Chacha Mwita, Mgaywa Gilbert Mjungu Damas Magafu, Magafu Mgwaya, Kajiru Gad Kilonzo, Sarah Japhet Urasa, Sarah Urasa
INTRODUCTION: Risk factors and precipitants of gastro-oesophageal disease (GERD) differ widely in communities. We conducted an observational study to describe these risks, precipitants and clinical presentation of GERD patients at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania. METHODS: We consecutively recruited 92 GERD patients who were referred for endoscopy at KCMC from March to November 2008. Using structured questionnaire risk factors, precipitants and symptoms of GERD were enquired...
2014: Pan African Medical Journal
Livin Peter Mumburi, Bernardus Carolus Hamel, Rune Nathanael Philemon, Gibson Nsokolo Kapanda, Levina January Msuya
INTRODUCTION: With the introduction of antiretroviral drugs HIV-infected children live longer. Disclosure of HIV diagnosis is increasingly an important and inevitable issue. Both healthcare providers and caregivers face challenges of disclosure to children. The objective of the study was to explore factors associated with HIV-status disclosure to HIV-infected children receiving care at Kilimanjaro Christian Medical Centre (KCMC). METHODS: A cross-sectional hospital-based study was conducted from October 2011 to April 2012...
2014: Pan African Medical Journal
Cecilie Nilsen, Truls Østbye, Anne Kjersti Daltveit, Blandina Theophil Mmbaga, Ingvild Fossgard Sandøy
BACKGROUND: Caesarean section (CS) can prevent maternal or fetal complications. Sub-Saharan Africa has the lowest CS levels in the world but large variations are seen between and within countries. The tertiary hospital, Kilimanjaro Christian Medical Centre (KCMC) in Tanzania has had a high level of CS over years. The aim of this study was to examine trends in the socio-demographic background of babies born at KCMC from year 2000 to 2013, and trends in the CS percentage, and to identify socio-demographic factors associated with CS at KCMC during this period...
2014: International Journal for Equity in Health
Hendry R Sawe, Juma A Mfinanga, Salum J Lidenge, Boniventura C T Mpondo, Silas Msangi, Edwin Lugazia, Victor Mwafongo, Michael S Runyon, Teri A Reynolds
BACKGROUND: In sub-Saharan Africa the availability of intensive care unit (ICU) services is limited by a variety of factors, including lack of financial resources, lack of available technology and well-trained staff. Tanzania has four main referral hospitals, located in zones so as to serve as tertiary level referral centers. All the referral hospitals have some ICU services, operating at varying levels of equipment and qualified staff. We analyzed and describe the disease patterns and clinical outcomes of patients admitted in ICUs of the tertiary referral hospitals of Tanzania...
2014: BMC International Health and Human Rights
Amos Haki Nsheha, Dorothy Elizabeth Dow, Gabriel Erick Kapanda, Bernardus Carolus Hamel, Levina January Msuya
INTRODUCTION: Paediatric adherence to Highly Active Antiretroviral Therapy (HAART) is a dynamic process involving many factors. Adherence for the majority on therapy matters to prevent failure of 1(st) and 2(st) line therapy. The purpose of this study was to determine the rate of adherence to antiretroviral therapy in HIV infected children. METHODS: We conducted a cross-sectional hospital based analytical study, from October 2011 to April 2012. HIV-infected children aged 2 to 17 years who had been on treatment for at least six months were enrolled...
2014: Pan African Medical Journal
Elichilia R Shao, Emmanuel G Kifaro, Innocent B Chilumba, Balthazar M Nyombi, Sikhulile Moyo, Simani Gaseitsiwe, Rosemary Musonda, Asgeir Johannessen, Gibson Kibiki, Max Essex
OBJECTIVES: In resource-limited settings, it is a challenge to get quality clinical specimens due to poor infrastructure for their collection, transportation, processing and storage. Using dried blood spots (DBS) might be an alternative to plasma for HIV-1 drug resistance testing in this setting. The objectives of this study were to determine mutations associated with antiretroviral resistance among children <18 months old born to HIV-1-infected mothers enrolled in prevention of mother-to-child transmission services in northern Tanzania...
July 2014: Journal of Antimicrobial Chemotherapy
Leah L Zullig, Sky B Vanderburg, Charles Muiruri, Amy Abernethy, Bryan J Weiner, John Bartlett
The projected cancer burden in Africa demands a comprehensive surveillance strategy. Kilimanjaro Christian Medical Centre (KCMC) is developing a population-based cancer registry, and understanding stakeholders' perceptions of factors impacting cancer registration sustainability is critical to its long-term success. We conducted 11 semi-structured qualitative interviews with clinicians and administrators. Interviews were double-coded and evaluated for predetermined and emerging themes. Nearly half (45%) of participants discussed change commitment, stating that the cancer registry would benefit KCMC and that they were committed to it...
2014: World Health & Population
Mwanahawa Suba, Segni Mekonnen Ayana, Charles M Mtabho, Gibson S Kibiki
Upper gastro-intestinal (GI) bleeding is a life-threatening emergency that results in high morbidity and mortality and therefore requires admission to hospital for urgent diagnosis and management. The aim of this study was to determine the causes of upper GI bleeding and clinical outcome of patients admitted to medical department with the diagnosis of upper GI bleeding. A retrospective study of records of all upper GI bleeding patients who were admitted to medical department, Kilimanjaro Christian Medical Centre (KCMC) from January 2007 to December 2008 was conducted...
October 2010: Tanzania Journal of Health Research
Holly M Biggs, Rebecca Lester, Behzad Nadjm, George Mtove, Jim E Todd, Grace D Kinabo, Rune Philemon, Ben Amos, Anne B Morrissey, Hugh Reyburn, John A Crump
BACKGROUND:  The epidemiology of Salmonella Typhi and invasive nontyphoidal Salmonella (NTS) differs, and prevalence of these pathogens among children in sub-Saharan Africa may vary in relation to malaria transmission intensity. METHODS:  We compared the prevalence of bacteremia among febrile pediatric inpatients aged 2 months to 13 years recruited at sites of high and low malaria endemicity in Tanzania. Enrollment at Teule Hospital, the high malaria transmission site, was from June 2006 through May 2007, and at Kilimanjaro Christian Medical Centre (KCMC), the low malaria transmission site, from September 2007 through August 2008...
March 2014: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Y Ringo, K Chilonga
BACKGROUND: About 90% of the global burden of burns occurs in the low and middle income countries. In Africa it is estimated that between 17,000 and 30,000 children under five die each year due to burns. In Tanzania there are no specialized burn centers. Burn patients are often managed in the general surgical wards in most hospitals. Kilimanjaro Christian Medical Centre is one of the four tertiary referral hospitals in Tanzania. RATIONALE: This study aimed to review the epidemiology presentation management and outcome of burn patients in this challenging environment...
August 2014: Burns: Journal of the International Society for Burn Injuries
Michael J Mahande, Anne K Daltveit, Blandina T Mmbaga, Joseph Obure, Gileard Masenga, Rachel Manongi, Rolv T Lie
BACKGROUND: Perinatal mortality is known to be high in Sub-Saharan Africa. Some women may carry a particularly high risk which would be reflected in a high recurrence risk. We aim to estimate the recurrence risk of perinatal death using data from a hospital in Northern Tanzania. METHODS: We constructed a cohort study using data from the hospital based KCMC Medical Birth Registry. Women who delivered a singleton for the first time at the hospital between 2000 and 2008 were followed in the registry for subsequent deliveries up to 2010 and 3,909 women were identified with at least one more delivery within the follow-up period...
2013: BMC Pregnancy and Childbirth
Leah L Zullig, Charles Muiruri, Amy Abernethy, Bryan J Weiner, John Bartlett, Olola Oneko, S Yousuf Zafar
Cancer burden is increasing in Africa more than in any other continent, but population-based tracking of cancer incidence is incomplete. Cancer registries can improve understanding of cancer incidence. To assess organizational readiness to sustain registry development, we conducted a survey assessing change efficacy, resource availability and change commitment at the Kilimanjaro Christian Medical Centre (KCMC), an academic hospital in Moshi, Tanzania. Fifty-two surveys were returned (80% response rate). There was strong reliability among change efficacy and commitment survey items, with Cronbach's alphas of 0...
2013: World Health & Population
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