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Browsing Journals by Author "Lwabukuna, Warles C."

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    Clinical predictors of imminent diabetic foot ulcer among diabetes mellitus patients in Dar es salaam and Zanzibar
    (IOSR Journal of Dental and Medical Sciences, 2024-05) Lwabukuna, Warles C.; Mgonda, Yassin M.
    Background: Diabetic foot ulcer (DFU) is a lesion that involves breakage in the skin with loss of epithelium that extends to the dermis and deeper layers involving muscle and bone which tend to develop due to factors associated with diabetes; hyperglycemia, presence of calluses, foot deformities, peripheral neuropathy, and vasculopathy. The management of diabetic foot ulcers requires a multidisciplinary approach; and is burdensome on the health care systems due to its chronic nature and potential complications. Diabetic foot ulcer has caused financial distress to the government in treating diabetic foot ulcer and its consequences; such as lower limb amputation which is irreversible, costly, and devastating to the quality of life of the patients, since diabetic foot ulcer patients have a low work productivity which in turn causes them to remain unemployed. DFU leads to increased morbidity and mortality due to complications like sepsis. Identification of the clinical predictors of imminent diabetic foot ulcer among diabetes mellitus patients is pivotal for the prevention and prompt identification of diabetic foot ulcer. This study aimed to identify and outline the clinical predictors of imminent diabetic foot ulcer among diabetes mellitus patients in Dar es Salaam and Zanzibar. Hence, identifying the clinical predictors of imminent diabetic foot ulcer such as; peripheral neuropathy for example which usually goes unnoticed because of its oblivious nature will therefore have no room for excuse and further prevent the development of diabetic foot ulcer. Correspondingly it allows health care systems to distribute access to health care rather than focusing on treating DFU significantly. It will also enable the government’s economic burden placed on managing DFU to temper down. The quality of life of patients will improve in terms of physical, mental, and social health hence, reducing morbidity and mortality. Methods: a descriptive cross-sectional study was conducted among diabetes mellitus patients attending diabetic clinics in Dar es Salaam and Zanzibar. Questionnaires were used to collect demographic data and clinical characteristics of study participants. Random blood glucose and skin scrape tests were done using standard methods. Results: A total of 202 participants (72 males and 130 females) were studied. The overall mean age of the study participants was 55.3± 16.7 years with a range of (13-83 years). The majority of the participants resided in Dar es Salaam, with 164 (81.2%) individuals, while 38 (18.8%) were from Zanzibar. Out of the 202 study participants, the proportion of diabetic foot ulcer was 40.6%, with the clinical predictors of imminent diabetic foot ulcer; peripheral neuropathy (47%), calluses (43.1%), hyperglycemia (34.2%) foot deformities (20.8%) and peripheral vasculopathy (10.4%). Conclusion: findings from this study provide evidence for the existence of clinical predictors of imminent diabetic foot ulcer among diabetes mellitus patients in which peripheral neuropathy, calluses, hyperglycemia, foot deformities, and peripheral vasculopathy predominate.
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    Early clinical markers of metabolic syndrome among secondary school adolescents in Dar es Salaam, Tanzania.
    (Tanzania Journal of Health Research, 2021) Lwabukuna, Warles C.; Mgonda, Yassin M.
    Background:Metabolic syndrome is defined by the presence of three of four disorders; hypertension, obesity, dyslipidemia and diabetes mellitus type 2. The presence of any one or two of these constitutes early markers of the syndrome. It occurs in children and adolescents but its magnitude has not been determined consistently in many countries including Tanzania. Detection of early clinical markers is effective preventive strategy. The aim of this study was to determine the prevalence of early clinical markers of metabolic syndrome among secondary school adolescents in Dar es Salaam. Methods:A descriptive cross-sectional study was conducted among secondary schools in Dar es Salaam. Structured questionnaires were used to record demographic data. Blood pressure and anthropometric measurements were taken using standard methods. Fasting blood samples were collected for blood glucose, total cholesterol, low density lipoprotein, high density lipoprotein and triglyceride. The International Diabetes Federation (IDF) criteria were utilized. Results:A total of 217 adolescents were enrolled; of these males and females were 32% (69) and 68% (148) respectively. Of these; 75% (162) were young adolescents (14-17years). Participants from public and private schools were 48% (104) and 52% (113) respectively.Early clinical markers of metabolic syndrome were detected in 43% (94) with at least oneclinical marker and 9% (19) with two markers. The prevalence of full-blown metabolic syndrome was 1.4% (3). Overall, the clinical markers included; dyslipidemia 30% (64), central obesity 22% (48), hyperglycemia 13% (29) and hypertension 2% (4). Prevalence of central obesity was 26% (42) among young adolescents and 11% (6) among elderly adolescents and the differencewas significant (p value= 0.02). Conclusion:Early clinical markers of metabolic syndrome exist among Dar es Salaam secondary school adolescents with dyslipidemia being the commonest marker while central obesity wasmuch common among young adolescents. School programs for screening students for detection of early markers of metabolic syndrome are needed.
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    Pattern of kidney disease among adult Hypertensive patients attending cardiac clinics in Dar es Salaam, Tanzania
    (IOSR Journal of Dental and Medical Sciences, 2024-07-11) Lwabukuna, Warles C.; Mgonda, Yassin M.
    Background: Hypertension is a worldwide public health challenge. Over the years it has become one of the leading cause of kidney disease. This is due to closely interlinked pathophysiological states such that sustained hypertension impairs kidney function. Progressive decline in kidney function conversely leads to worsening hypertension. Early detection of indicators of kidney disease among hypertensive individuals and timely preventive intervention are the key strategies to prevent development of kidney disease among hypertensive patients. Objective: The aim of this study was to determine the pattern of kidney disease among adult hypertensive patients in Dar es Salaam. Method: A descriptive cross-sectional study was conducted. Questionnaires were applied for social-demographic data. Blood pressure, body weight and height were measured using standardized methods. Blood sample was collected to measure serum creatinine and estimated GFR using CKD EPI2021, while urine was collected for biochemical analysis, dipstick method and albumin creatinine ratio. Results: A total of 400 hypertensive patients were enrolled in this study, 287 (72%) were females; 249(62%) had primary education, 232(58%) were unemployed, 240 (60%) had history of hypertension less than 10 years, 346(86.5%) had no history of alcohol consumption and 380(95%) had no history of cigarette smoking. Furthermore 240(60%) and 211(52.8%) had a blood pressure of ≥140 mmHg for systolic and ≥90 mmHg for diastolic respectively. BMI of ≥25kg/m2 was found among 236(59%). Reduced eGFR (<60Ml/Min/1.73M 2) and micro albuminuria were observed among 119 (30%) and 179(61.5%) respectively. Conclusion: Acute Kidney Injury, Nephrotic Syndrome and End Stage Renal Disease were found to be the main kidney diseases among hypertensive patients, while higher systolic blood pressure, advanced age, long standing hypertension and unemployment being significant risk factors for decreased eGFR. Keywords: Kidney disease, Hypertensive patients, Cardiac clinics
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    Profile of fasting blood glucose among secondary school students in Dar Es Salaam Region: A cross- sectional study
    (IOSR Journal of Dental and Medical Sciences, 2024-05-04) Lwabukuna, Warles C.; Ngemera, J.
    Introduction: Of recent eras, there has been a dramatic increase in type 2 diabetes mellitus among children and adolescents. Female gender, childhood hypertension, overweight and obesity have been reported as the main risk factors for pre-diabetes and diabetes among children and adolescents. Screening children and adolescents for type 2 diabetes mellitus helps earlier detection and interventions for the disease. Objective: The aim of this study was to determine the profile of fasting blood glucose among secondary school students in Dar es Salaam. Methods: This was a descriptive cross-sectional study among secondary schools in Dar es Salaam. Structured questionnaires were used to obtain demographic information. Anthropometric measurements were taken using standard methods. Fasting blood samples were collected for blood glucose. The American Diabetic Association and International Diabetic Federation criteria were utilized. Results: A total of 217 participants were enrolled; 32% (69) were males and 68% (148) were females, 75% (162) were in 14-17years age group. Students from private and public schools were 52% (113) and 48% (104) respectively. Fasting blood glucose levels were distributed as follows; normal level 87 %( 189), impaired/pre- diabetes 11.5 %( 25) and diabetes 1.4% (3). Impaired fasting blood glucose was significantly higher among students aged 18-19; 16.4% (9) with p-value 0.044. Similarly, diabetes was significantly higher among students within age group of 18-19 years 3.6% (2) than 14-17 age group counterparts. Prevalence of central obesity was 22% (48) which was higher among pre-diabetes 46% (22) and diabetes 6.1%(3) groups, and the difference was statistically significant (p value <0.001). Conclusion: Normal fasting blood glucose among secondary school students in Dar es Salaam is 6.7 fold of the abnormal with pre-diabetes being the commonest abnormality which is significantly prevalent among private schools and elder students with central obesity.