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Search Results: 1 - 10 of 87724 matches for " Mecky I Matee "
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Social Activity Patterns Drive High Rates of Latent Tuberculosis Infection among Adolescents in Urban Tanzania
—Latent TB Infection in Adolescents, Tanzania

Isaac I. Maro, Keiko Nakamura, Kaoruko Seino, Kisali Pallangyo, Patricia Munseri, Mecky Matee, Charles Fordham von Reyn
Journal of Tuberculosis Research (JTR) , 2018, DOI: 10.4236/jtr.2018.61008
Abstract: SETTING: Dar es Salaam, Tanzania. OBJECTIVE: To determine the prevalence of latent tuberculosis (TB) infection (LTBI) among adolescents in a country with a high TB burden, and examine risks of LTBI according to their social activity patterns. METHODS: A cross-sectional study nested within a phase 2b randomised, placebo controlled, double blind study and consisted of 824 adolescents, 13 - 15 years old who had received Bacillus Calmette-Guérin (BCG) vaccine, were attending public secondary schools and had no evidence of active tuberculosis (TB). Anthropometric measurements were obtained, a questionnaire administered, and phlebotomy performed for a T spot interferon-γ?release assay (IGRA) to detect LTBI. RESULTS: Among 824 subjects, 149 (18%) had a positive IGRA. After adjusting for the influence of household socioeconomic status, history of TB contact, living environment and nutritional status, LTBI risk was higher in subjects with than without regular informal encounters with traditional alcoholic beverage drinkers (AOR, 6.37 [1.84 - 22.00]). Other significant factors for LTBI risk included contact with TB patient at school (AOR, 3.34 [1.14 - 9.80]), and living close to a health facility, as was observed among those from houses within a 10 - 30-minute walking distance to the nearest health facility, who were less likely to be IGRA-positive than those who were living within a 10-minute walking distance (AOR, 0.30 [95%CI, 0.13 - 0.69]). CONCLUSION: This IGRA study revealed a high prevalence of LTBI among adolescents in Dar es Salaam, Tanzania with prior BCG immunization. Informal social encounters were identified as independent risk factors for LTBI, along with a history of contact with TB patients, living environment characteristics and household socioeconomic status. Efforts focusing on risk of MTB transmission in adolescents at informal social gatherings will improve interventions to reduce LTBI in this population and consequently the subsequent risk of developing active TB disease.
Seroprevalence of hepatitis B and C viral co-infections among children infected with human immunodeficiency virus attending the paediatric HIV care and treatment center at Muhimbili National Hospital in Dar-es-Salaam, Tanzania
Safila P Telatela, Mecky I Matee, Emmanuel K Munubhi
BMC Public Health , 2007, DOI: 10.1186/1471-2458-7-338
Abstract: Investigations included; interviews, physical examination and serology for HBsAg, IgG antibodies to HCV and alanine aminotransferase (ALT) levels. HIV serostatus and CD4 counts were obtained from patient records.167 HIV infected children, 88(52.7%) males and 79(47.3%) females were enrolled. The overall prevalence of hepatitis co-infection was 15%, with the seroprevalence of HBV and HCV being 1.2% and 13.8%, respectively. Hepatitis virus co-infection was not associated with any of the investigated risk factors and there was no association between HBV and HCV. Elevated ALT was associated with hepatitis viral co-infection but not with ART usage or immune status.The high seroprevalence (15%) of hepatitis co-infection in HIV infected children attending the Paediatrics HIV CTC at the MNH calls for routine screening of hepatitis viral co-infection and modification in the management of HIV infected children.With more than 1.4 million women estimated to give birth annually and 8.2% HIV prevalence rate at antenatal clinics (ANC), approximately 122,000 HIV-infected women deliver annually in Tanzania. Assuming a 40% transmission rate in the absence of any intervention, an estimated 48,000 children will become HIV-infected each year. In 2003, the number of children (0–15 years) living with HIV/AIDS in Tanzania was estimated to be between 85,000 and 230,000[1,2]. A large number of infected children have been associated with significant increase in morbidity, hospitalization and mortality [2].With increased access to antibiotics and antifungal agents hepatitis viruses, especially hepatitis B and C, are emerging as the leading causes of morbidity and mortality among children on ART [3].Relatively little is known regarding HCV or HBV co-infection in HIV infected children in Tanzania. Thus, not surprisingly the current national guidelines for management of HIV disease in children do not include screening and management of hepatitis viral co-infection.We conducted this study to determ
Emergency pulpotomy in relieving acute dental pain among Tanzanian patients
Joachim W Nyerere, Mecky I Matee, Elison NM Simon
BMC Oral Health , 2006, DOI: 10.1186/1472-6831-6-1
Abstract: Setting: School of Dentistry, Muhimbili National Hospital, Dar es Salaam, Tanzania.Study design: Longitudinal study.Participants: 180 patients who presented with dental pain due to acute irreversible pulpitis during the study period between July and August 2001.Treatment and evaluation: Patients were treated by emergency pulpotomy on permanent posterior teeth and were evaluated for pain after one, three and six week's post-treatment. Pain, if present, was categorised as either mild or acute.Of the patients with treated premolars, 25 (13.9%) patients did not experience pain at all while 19 (10.6%) experienced mild pain. None of the patients with treated premolars experienced acute pain. Among 136 patients with treated molars 56 (31%) did not experience any pain, 76 (42.2%) experienced mild pain and the other 4 (2.2%) suffered acute pain.The short term treatment success of emergency pulpotomy was high being 100% for premolars and 97.1% for molars, suggesting that it can be recommended as a measure to alleviate acute dental pain while other conservative treatment options are being considered.In Tanzania, it is estimated that over 85% of dental patients seek dental care due to painful tooth conditions, and that over 90% of the treatment rendered is tooth extraction [1]. A total of 159,660 extractions were conducted in 1993 and 99,636 extractions in 1995 in the 20 regions of Tanzania, the majority of them due to dental caries [2]. These extractions are unjustifiably too many and therefore the situation needs to be rectified. Thus, any strategy aiming at improving emergency oral health services in Tanzania should at least strive at minimising the number of undue extractions performed.Previous studies [3-6] have shown that emergency pulpotomy is very effective in relieving acute dental pain caused by acute pulpitis. The emergency pulpotomy procedure includes the removal of the coronal pulp exposed by caries, cleaning the cavity, dressing the access cavity and filling with
High potential of escalating HIV transmission in a low prevalence setting in rural Tanzania
Khadija I Yahya-Malima, Mecky I Matee, Bj?rg Evjen-Olsen, Knut Fylkesnes
BMC Public Health , 2007, DOI: 10.1186/1471-2458-7-103
Abstract: Using a two-stage cluster sampling approach, we enrolled and then interviewed and collected saliva samples from 1,698 adults aged 15–49 years between December 2003 and May 2004. We anonymously tested saliva samples for IgG antibodies against HIV using Bionor HIV-1&2 assays ?. Risk factors for HIV infection were analysed by multivariate logistic regression using the rural population of the two regions as a standard.The prevalence of HIV in the general population was 1.8% (95%CI: 1.1–2.4), closely matching the ANC-based estimate (2.0%, 95% CI: 1.3–3.0). The female to male prevalence ratio was 0.8 (95%CI 0.4–1.7). HIV was associated with being a resident in a fishing community, and having recently moved into the area. Multiple sexual partners increased likelihood of HIV infection by 4.2 times (95% CI; 1.2–15.4) for men. In women, use of contraceptives other than condoms was associated with HIV infection (OR 6.5, 95% CI; 1.7–25.5), while most of the population (78%) have never used condoms.The HIV prevalence from the general population was comparable to that of pregnant women attending antenatal clinics. The revealed patterns of sexual risk behaviours, for example, close to 50% of men having multiple partners and 78% of the population have never used a condom; it is likely that HIV infection will rapidly escalate. Immediate and effective preventive efforts that consider the socio-cultural contexts are necessary to reduce the spread of the infection.Few countries have presented evidence of declining trends in HIV incidence [1-8]. However, there are signs of escalating rural epidemics even within countries reporting a decline of HIV prevalence [4,6,8]. Unfortunately relatively little information is available in rural settings, especially in remote areas with difficult terrain where the dynamics and epidemiology of HIV infection is likely to be different.To estimate HIV prevalence in remote rural Manyara and Singida regions in Tanzania, we set up a local HIV surveillance s
The silent HIV epidemic among pregnant women within rural Northern Tanzania
Khadija I Yahya-Malima, Bj?rg E Olsen, Mecky I Matee, Knut Fylkesnes
BMC Public Health , 2006, DOI: 10.1186/1471-2458-6-109
Abstract: We consecutively enrolled 1377 counselled and consenting pregnant women attending ANC clinics for the first time during the current pregnancy. The study was conducted in six antenatal clinics, within three divisions of rural Manyara and Singida regions in 2003/2004. Interviews were conducted and blood samples for routine purposes were collected and tested for anti-HIV IgG antibody anonymously, using Bionor HIV-1 & 2 assay ?.Among enrolees, 94% (1296/1377) participated fully. The overall prevalence of HIV was 2.0% (95%CI: 1.34–2.97). The highest HIV prevalence was among women aged between 15–19 years in both rural and remote rural populations. The odds of HIV infection was 4.3 (95%CI: 1.42–12.77) times among women reporting more than one lifetime sexual partners compared with those with one partner. HIV infection was associated with history of genital sores or foul smelling discharge, OR 6.8 (95%CI: 2.78–16.66) and age at first pregnancy (2.5 times higher likelihood of infection if before the age of 18 years versus at a later age).Including rural remote sites, as part of the national ANC routine surveillance, is crucial in order to discover imminent silent epidemics such as the one described in this paper. Scaling up HIV prevention efforts is mandatory to prevent the imminent escalation of the HIV epidemic highly associated with a history of sexually transmitted infections (STIs), multiple sexual partners and pregnancies at a younger age. Ignorance of relevant knowledge and low utilisation of condoms underscores the urgency for large-scale preventive efforts. Research to capture a wider representation of the risk factors in the general population should be a priority to enable further customised HIV prevention efforts.Surveillance of human immunodeficiency virus (HIV) infection among pregnant women attending antenatal care clinics (ANC) has been the mainstay system of monitoring of HIV epidemic in most countries of sub-Saharan Africa [1-5]. Several studies from the 1
Maternal and neonatal colonisation of group B streptococcus at Muhimbili National Hospital in Dar es Salaam, Tanzania: prevalence, risk factors and antimicrobial resistance
Agricola Joachim, Mecky I Matee, Furaha A Massawe, Eligius F Lyamuya
BMC Public Health , 2009, DOI: 10.1186/1471-2458-9-437
Abstract: This cross sectional study involved 300 pregnant women attending antenatal clinic and their newborns delivered at Muhimbili National Hospital (MNH) between October 2008 and March 2009. High vaginal, rectal, nasal, ear and umbilical swabs were cultured on Todd Hewitt Broth and in 5% sheep blood agar followed by identification of isolates using conventional methods and testing for their susceptibility to antimicrobial agents using the Kirby-Bauer method.GBS colonisation was confirmed in 23% of pregnant women and 8.9% of neonates. A higher proportion of GBS were isolated from the vagina (12.3%) as compared to the rectum (5%). Prolonged duration of labour (>12 hrs) was significantly shown to influence GBS colonisation in neonates P < 0.05. Other risk factors such as prolonged rupture of membrane, intrapartum fever, low birth weight and HIV infection did not correlate with GBS colonisation. All isolates were sensitive to vancomycin and ampicillin. Resistance to clindamycin, erythromycin and penicillin G was found to 17.6%, 13% and 9.4%, respectively.Our findings seem to suggest that a quarter of pregnant women attending ANC clinic at MNH and approximately 10% of their newborns are colonised with GBS. All isolates were found to be sensitive to vancomycin and ampicillin which seem to be the most effective antibiotics for the time being. However there is a need for continuous antibiotics surveillance of GBS to monitor trend of resistance. The high isolation frequency of GBS among pregnant women suggests routine antenatal screening at 35 to 37 weeks of gestation in order to provide antibiotic prophylaxis to GBS carrier.Group B Streptococcus (GBS) is now recognized to be an important cause of maternal and neonatal morbidity and mortality in many parts of the world [1,2]. GBS infections tend to occur more commonly among adults than in neonates, but the overall mortality is higher in neonates [3]. Risk of disease is greater in pregnant women than in men and non-pregnant women.
Use of the GenoType? MTBDRplus assay to assess drug resistance of Mycobacterium tuberculosis isolates from patients in rural Uganda
Joel Bazira, Benon B Asiimwe, Moses L Joloba, Fred Bwanga, Mecky I Matee
BMC Clinical Pathology , 2010, DOI: 10.1186/1472-6890-10-5
Abstract: We enrolled, consecutively, all newly diagnosed and previously treated smear-positive TB patients aged ≥ 18 years. Isolates were tested for drug resistance against rifampicin (RIF) and isoniazid (INH) using the Genotype? MDRTBplus assay and results were compared with those obtained by the indirect proportion method on Lowenstein-Jensen media. HIV testing was performed using two rapid HIV tests.A total of 125 isolates from 167 TB suspects with a mean age 33.7 years and HIV prevalence of 67.9% (55/81) were analysed. A majority (92.8%) of the participants were newly presenting while only 7.2% were retreatment cases. Resistance mutations to either RIF or INH were detected in 6.4% of the total isolates. Multidrug resistance, INH and RIF resistance was 1.6%, 3.2% and 4.8%, respectively. The rpoβ gene mutations seen in the sample were D516V, S531L, H526Y H526 D and D516V, while one strain had a Δ1 mutation in the wild type probes. There were three strains with katG (codon 315) gene mutations while only one strain showed the inhA promoter region gene mutation.The TB resistance rate in Mbarara is relatively low. The GenoType? MTBDRplus assay can be used for rapid screening of MDR-TB in this setting.Despite the availability of drugs to treat tuberculosis (TB), it remains the world's leading cause of death from a single infectious disease. The World Health Organization (WHO) estimates current rates of multidrug resistant TB (resistance to at least isoniazid and rifampicin) in new and previously treated cases globally at 2.9% and 15.3% respectively, with 57% of multidrug resistant tuberculosis (MDR-TB) cases coming from three high burden countries (China, India, and the Russian Federation) [1].Uganda is currently ranked 16th among the highest TB burdened countries in the world [2]. The prevalence of MDR-TB in new cases in this setting has previously been reported to be low at less than 2% [3]. However, there are recent reports that 12.7% of re-treatment cases attending the Nati
Identification of diarrheagenic Escherichia coli isolated from infants and children in Dar es Salaam, Tanzania
Sabrina J Moyo, Samwel Y Maselle, Mecky I Matee, Nina Langeland, Haima Mylvaganam
BMC Infectious Diseases , 2007, DOI: 10.1186/1471-2334-7-92
Abstract: DEC were isolated from stool samples collected from two hundred and eighty children with acute/persistent diarrhea at Muhimbili National Hospital and Ilala and Mwananyamala Municipal Hospitals in Dar es Salaam. A multiplex PCR system method was used to detect a species specific gene for E.coli and ten different virulence genes for detection of five pathogroups of DEC namely enteroaggregative- (EAEC), enteropathogenic- (EPEC), enterotoxigenic- (ETEC), enteroinvasive- (EIEC) and enterohemorghagic- Escherichia coli (EHEC).Sixty-four patients (22.9%) harbored DEC. Forty-one of them (14.6%) were categorized as EAEC. Most of the EAEC (82.9%) were classified as typical EAEC possessing the aggR gene, and 92.6% carried the aat gene. Isolates from thirteen patients were EPEC (4.6%) and most of these (92.3%) were typical EPEC with both eae and bfpA genes. Ten isolates were identified as ETEC (3.6%) with only the heat stable toxin; either st1a or st1b but not both. Age wise, EAEC and EPEC were significantly more prevalent among the age group 0–6 months (p < 0.05). Genes for EHEC (stx1 and stx2) and EIEC (ial) were not detected in this study group.The results show a high proportion of DEC among Tanzanian children with diarrhea, with typical EAEC and typical EPEC predominating. The use of primers for both variants of ST1 (st1a and st1b) increased the sensitivity for detection of ETEC strains.Diarrhea is one of the leading causes of morbidity and mortality among children under five years in the developing world [1]. During the period from 1950 to 1970s it was estimated that 4.6 million children died annually from diarrhea in developing world [2,3]. Mortality due to diarrhea declined to approximately 3.3 million annually in the 1980s [1,3]. Currently diarrhea has been reported to account for 1.6–2.5 million deaths annually [3,4]. Despite the decline in mortality, diarrhea still remains one of the principal causes of morbidity in the developing world, with each child experiencing an
Mycobacterium tuberculosis spoligotypes and drug susceptibility pattern of isolates from tuberculosis patients in South-Western Uganda
Joel Bazira, Benon B Asiimwe, Moses L Joloba, Freddie Bwanga, Mecky I Matee
BMC Infectious Diseases , 2011, DOI: 10.1186/1471-2334-11-81
Abstract: We enrolled, consecutively; all newly diagnosed and previously treated smear-positive TB patients aged ≥ 18 years. The isolates were characterized using regions of difference (RD) analysis and spoligotyping. Drug resistance against rifampicin and isoniazid were tested using the Genotype? MDRTBplus assay and the indirect proportion method on Lowenstein-Jensen media. HIV-1 testing was performed using two rapid HIV tests.A total of 125 isolates from 167 TB suspects (60% males) with a mean age 33.7 years and HIV prevalence of 67.9% (55/81) were analyzed. Majority (92.8%) were new cases while only 7.2% were retreatment cases. All the 125 isolates were identified as M. tuberculosis strict sense with the majority (92.8%) of the isolates being modern strains while seven (7.2%) isolates were ancestral strains. Spoligotyping revealed 79 spoligotype patterns, with an overall diversity of 63.2%. Sixty two (49.6%) of the isolates formed 16 clusters consisting of 2-15 isolates each. A majority (59.2%) of the isolates belong to the Uganda genotype group of strains. The major shared spoligotypes in our sample were SIT 135 (T2-Uganda) with 15 isolates and SIT 128 (T2) with 3 isolates. Sixty nine (87%) of the 79 patterns had not yet been defined in the SpolDB4.0.database. Resistance mutations to either RIF or INH were detected in 6.4% of the isolates. Multidrug resistance, INH and RIF resistance was 1.6%, 3.2% and 4.8%, respectively. The rpoβ gene mutations seen in the sample were D516V, S531L, H526Y H526D and D516V, while one strain had a Δ1 mutation in the wild type probes. There were three strains with katG (codon 315) gene mutations only while one strain showed the inhA promoter gene mutation.The present study shows that the TB epidemic in Mbarara is caused by modern M. tuberculosis strains mainly belonging to the Uganda genotype and anti-TB drug resistance rate in the region is low.Uganda ranks 16th among the world's 22 countries with the highest tuberculosis burden in the world
HIV-1, HSV-2 and syphilis among pregnant women in a rural area of Tanzania: Prevalence and risk factors
Khadija I Yahya-Malima, Bj?rg Evjen-Olsen, Mecky I Matee, Knut Fylkesnes, Lars Haarr
BMC Infectious Diseases , 2008, DOI: 10.1186/1471-2334-8-75
Abstract: We analysed 1296 sera and responses to a standard structured questionnaire collected from pregnant women aged between 15–49 years, attending six different antenatal clinics within rural Manyara and Singida regions in Tanzania. Linked anonymous testing (with informed consent) of the serum for specific antibodies against HSV-2 was done using a non-commercial peptide- 55 ELISA. Antibodies against syphilis were screened by using rapid plasma reagin (RPR) and reactive samples confirmed by Treponema pallidum haemagglutination assay (TPHA).Previous analysis of the collected sera had shown the prevalence of HIV antibodies to be 2%. In the present study the prevalence of genital herpes and syphilis was 20.7% (95% CI: 18.53–23.00) and 1.6% (95% CI: 1.03–2.51), respectively. The presence of HSV-2 antibodies was associated with polygamy (OR 2.2, 95% CI: 1.62 – 3.01) and the use of contraceptives other than condoms (OR 1.7, 95% CI: 1.21 – 2.41). Syphilis was associated with reporting more than one lifetime sexual partner (OR 5.4, 95% CI: 1.88 – 15.76) and previous spontaneous abortion (OR 4.3, 95% CI: 1.52–12.02).The low prevalence of HIV infection offers a unique opportunity for strengthening HIV prevention in a cost-effective manner. The identification and control of other prevalent curable STIs other than syphilis and specific intervention of HSV-2 in specific populations like pregnant women would be one among approaches towards preventing incident HIV infections.There is strong evidence that a substantial proportion of new HIV infections in African countries are associated with herpes simplex virus type 2 (HSV-2) [1-6]. Infection with HSV-2 has a significant impact on the risk of HIV acquisition and the impact increases as the HIV epidemic progresses [7,8]. One reason for this association could be the relative importance of HSV-2 in genital ulcer disease (GUD) in Africa has increased markedly. Infection with HSV-2 disrupts the genital mucosa and provides a portal of entry fo
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