Ku Repository :: Browsing by Author "Fataki, Maulidi R."

Browsing by Author "Fataki, Maulidi R."

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Aetiology, antimicrobial susceptibility and predictors of urinary tract infection among febrile under-fives at Muhimbili National Hospital, Dar es Salaam-Tanzania
(African Journal of Microbiology Research, 2013) Fataki, Maulidi R.
Urinary tract infection (UTI) is a common cause of fever in children and contributes to morbidity and mortality. This study aimed at determining prevalence, aetiology and antimicrobial susceptibility pattern of the isolates at Muhimbili National Hospital (MNH), Dar es Salaam- Tanzania. Demographic data were collected using a pretested questionnaire. 382 febrile children below five years admitted in the general paediatric wards were recruited. Urine specimens were obtained for urinalysis, culture and antimicrobial sensitivity testing. UTI was detected in 16.8% (64/382). Children who presented prolonged duration of fever (7 days or longer) were more likely to have UTI (p< 0.01). Duration of fever, positive leukocyte and nitrite tests were independent predictors of UTI. Isolated bacteria included Escherichia coli (39.1%), Klebsiella spp (31.2%), Staphylococcus epidermidis (6.2%), Staphylococcus aureus (4.7%) and Pseudomonas aeruginosa (4.7%). We observed high resistance of the isolated uropathogens to ampicillin (79.9%), co-trimoxazole (89%) and clavulanate-amoxillin (70.3%). Amikacin had the least resistance (12.5%) from the isolated pathogens.
Asymptomatic hypoglycemia among pretermnewborns: A cross-sectional analysis
(Plos One, 2024-04-30) Kalabamu, Florence S.; Fataki, Maulidi R.
Background: Hypoglycemia is the commonest metabolic abnormality encountered in newborns. Besides, there is a growing body of evidence that links the causes of early neonatal mortality to neonatal hypoglycemia in Tanzania. However exact factors associated with asymptomatic hypoglycemia in preterm newborns are not known. Objective: Toassess factors associated with asymptomatic hypoglycemia among preterm newborns. Materials and methods Across sectional, analytical hospital- based study was carried out at Dar es salaam public regional referral hospitals. Preterm newborns with asymptomatic hypoglycemia were the target population. Data on demographic and clinical characteristics of preterm newborns andtheir mothers were collected and analyzed using Epi-Info™ software version 7.4. Main data analysis was done by applying a multivariable binary logistic regression model with neonatal random glycaemia coded in a binary fashion at a cut-off point of 2.6 mmol/L. An α level of 5% was used as a limit of type I error. Results: Werecruited and analysed 217 preterm newborns within 6–24 hours post-delivery. Male: Female =1.1:1 (females n = 105, 48.4%). Median glycemic level was 2.6 (IQR; 2.1–3.9) mmol/L. Median gestational age at delivery was 33 (IQR: 30–35) weeks. Breastfeeding within 1st hour post-delivery was a statistically significant factor against glycemic level associated with hypoglycemia (OR; 0.123, 95%-CI; 0.052–0.287) in a fitted multivariable logistic regression model. Conclusion: About half of all preterm newborns studied had glycemic values in a statistical range associated with hypoglycemia. Exclusive breast feeding within 1st hour post-delivery was associated with glycemic levels protective from risk of asymptomatic neonatal hypoglycemia. Recommendations: Exclusive breastfeeding practices within 1st hour post-delivery may need to be emphasized to all expectant mothers in order to avoid potential risk of asymptomatic hypoglycemia in preterm newborns.
Burden of disease and barriers to the diagnosis and treatment of group a beta-hemolytic streptococcal pharyngitis for the prevention of rheumatic heart disease in Dar Es Salaam, Tanzania.
(The Pediatric infectious disease journal, 2010) Fataki, Maulidi R.
To understand patient and clinician attitudes toward Streptococ- cus pharyngitis and rheumatic heart disease prevention in Tanzania, data from 3 sources were obtained: a survey of 119 clinicians, outpatient rapid test screening, and interviews with 17 rheumatic heart disease patients. Patients do not seek care for sore throat. Clinicians stated that identifying and treating Streptococcus pharyngitis is not prioritized
Challenges in diagnosing paediatric malaria in Dar es Salaam, Tanzania
(Malaria journal, 2013) Fataki, Maulidi R.
Background Malaria is a major cause of paediatric morbidity and mortality. As no clinical features clearly differentiate malaria from other febrile illnesses, and malaria diagnosis is challenged by often lacking laboratory equipment and expertise, overdiagnosis and overtreatment is common. Methods Children admitted with fever at the general paediatric wards at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania from January to June 2009 were recruited consecutively and prospectively. Demographic and clinical features were registered. Routine thick blood smear microscopy at MNH was compared to results of subsequent thin blood smear microscopy, and rapid diagnostics tests (RDTs). Genus-specific PCR of Plasmodium mitochondrial DNA was performed on DNA extracted from whole blood and species-specific PCR was done on positive samples. Results Among 304 included children, 62.6% had received anti-malarials during the last four weeks prior to admission and 65.1% during the hospital stay. Routine thick blood smears, research blood smears, PCR and RDT detected malaria in 13.2%, 6.6%, 25.0% and 13.5%, respectively. Positive routine microscopy was confirmed in only 43% (17/40), 45% (18/40) and 53% (21/40), by research microscopy, RDTs and PCR, respectively. Eighteen percent (56/304) had positive PCR but negative research microscopy. Reported low parasitaemia on routine microscopy was associated with negative research blood slide and PCR. RDT-positive cases were associated with signs of severe malaria. Palmar pallor, low haemoglobin and low platelet count were significantly associated with positive PCR, research microscopy and RDT. Conclusions The true morbidity attributable to malaria in the study population remains uncertain due to the discrepancies in results among the diagnostic methods. The current routine microscopy appears to result in overdiagnosis of malaria and, consequently, overuse of anti-malarials. Conversely, children with a false positive malaria diagnosis may die because they do not receive treatment for the true cause of their illness. RDTs appear to have the potential to improve routine diagnostics, but the clinical implication of the many RDT-negative, PCR-positive samples needs to be elucidated.
Child mortality in relation to HIV infection, nutritional status, and socio-economic background
(International journal of epidemiology, 2005) Fataki, Maulidi R.
Abstract Background The aims of this study were to examine the impact of child HIV infection on mortality and to identify nutritional and sociodemographic factors that increase the risk of child mortality independent of human immunodeficiency virus (HIV) infection. Methods We conducted a prospective study in Dar es Salaam, Tanzania, among 687 children 6–60 months of age who were admitted to hospital with pneumonia. After discharge, children were followed up every 2 weeks during the first year and every 4 months thereafter. Sociodemographic characteristics were determined at baseline, and HIV status, haemoglobin, and malaria infection were assessed from a blood sample. During the first year of follow-up, we measured height, weight, and mid-upper arm circumference (MUAC) monthly. We estimated the risk of mortality according to HIV status and socio-economic characteristics using Cox proportional hazards models. Nutritional status variables (wasting and stunting) were examined as time-varying risk factors. Results Mean age at enrolment was 18 months. A total of 90 children died during an average 24.7 months of follow-up. HIV infection was associated with an adjusted 4-fold higher risk of mortality [relative risk (RR) = 3.92, 95% confidence interval (CI) 2.34–6.55, P < 0.0001]. Other risk factors included child's age <24 months, stunting, low MUAC, anaemia, and lack of water supply in the household. In models with time-varying covariates, stunting and wasting during the previous month were both significant and independently related to increased risk of death. HIV infection appeared to be a stronger predictor of mortality among children who were wasted than among those who were not (P for interaction = 0.05). Conclusions HIV infection is a strong predictor of death among children who have been hospitalized with pneumonia. Preventable conditions including inadequate water supply, child undernutrition, and anaemia contribute significantly to infant and child mortality independent of HIV infection. Keyword:Child mortality, infant mortality, HIV, stunting, wasting, anaemia,
Effect of Zinc supplementation on duration of hospitalization in Tanzanian children presenting with acute pneumonia
(Journal of tropical pediatrics, 2014) Fataki, Maulidi R.
Background: Zinc supplementation prevents incident pneumonia in children; however, the effect for pneumonia treatment remains unclear. Methods: A randomized, double-blind, placebo-controlled trial of zinc supplements (daily 25 mg) adjunct to antibiotic treatment of radiology-confirmed acute pneumonia was conducted among hospitalized children (6–36 months) in Dar es Salaam, Tanzania. Results: The trial was stopped early due to low enrollment, primarily owing to exclusion of children outside the age range and >3 days of prior illness. Among children enrolled (n = 94), zinc supplementation indicated no beneficial effect on the duration of hospitalization (IRR: 0.69; 95% CI 0.45–1.06; p = 0.09) or the proportion of children who were hospitalized for <3 days (RR: 0.85; 95% CI: 0.57–1.25; p = 0.40) or <5 days (RR: 1.01; 95% CI: 0.83–1.23; p = 0.92) (IRRs and RRs >1.0 favor zinc). Conclusions: Although underpowered, this randomized trial provided no evidence for a beneficial effect of zinc supplementation adjunct to antibiotics for hospitalized children.
Effects of maternal vitamin supplements on malaria in children born to HIV-infected women
(The American journal of tropical medicine and hygiene, 2007) Fataki, Maulidi R.
Vitamin deficiencies are frequent in children suffering from malaria. The effects of maternal multivitamin supplementation on the risk of malaria in children are unknown. We examined the impact of providing multivitamins or vitamin A/β-carotene supplements during pregnancy and lactation to HIV-infected women on their children’s risk of malaria up to 2 years of age, in a randomized, placebo-controlled trial. Tanzanian women (N = 829) received one of four daily oral regimens during pregnancy and after delivery: 1) vitamins B, C, and E (multivitamins); 2) vitamin A and β-carotene (VA/BC); 3) multivitamins including VA/BC; or 4) placebo. After 6 months of age, all children received 6-monthly oral vitamin A supplements irrespective of treatment arm. The incidence of childhood malaria was assessed through three-monthly blood smears and at monthly and interim clinic visits from birth to 24 months of age. Compared with placebo, multivitamins excluding VA/BC reduced the incidence of clinical malaria by 71% (95% CI = 11–91%; P = 0.02), whereas VA/BC alone resulted in a nonsignificant 63% reduction (95% CI = −4% to 87%; P = 0.06). Multivitamins including VA/BC significantly reduced the incidence of high parasitemia by 43% (95% CI = 2–67%; P = 0.04). The effects did not vary according to the children’s HIV status. Supplementation of pregnant and lactating HIV-infected women with vitamins B, C, and E might be a useful, inexpensive intervention to decrease the burden of malaria in children born to HIV-infected women in sub-Saharan Africa.
High rate of fatal cases of Pediatric Septicemia caused by Gram-Negative Bacteria with Extended-Spectrum Bjørn Blomberg, Beta-Lactamases in Dar es Salaam, Tanzania
(Journal of clinical microbiology, 2005) Fataki, Maulidi R.
Extended-spectrum beta-lactamases (ESBLs) were present in high proportions of Escherichia coli (25% [9 of 36]) and Klebsiella pneumoniae isolates (17% [9 of 52]) causing pediatric septicemia at a tertiary hospital in Tanzania. Patients with septicemia due to ESBL-producing organisms had a significantly higher fatality rate than those with non-ESBL isolates (71% versus 39%, P = 0.039). This is the first report of the CTX-M-15 genotype of ESBLs on the African continent and the first observation of SHV-12 genotype in an isolate of Salmonella enterica serotype Newport.
Human immunodeficiency virus infection, diarrheal disease and sociodemographic predictors of child growth
(Acta Paediatrica, 2004) Fataki, Maulidi R.
Aim: To compare growth patterns between human immunodeficiency virus (HIV)-infected and -uninfected preschool children. To examine the associations between diarrheal and respiratory infections, sociodemographic factors and growth. Methods: A longitudinal study was conducted among 524 children who were 6-60 mo of age at recruitment. Information on sociodemographic characteristics was collected at baseline from the caregiver. Hemoglobin, malaria infection and HIV status of the children were assessed from a blood sample. Monthly height (length if >24 mo) and weight measurements were obtained, and clinical assessments carried out, during an average 12 mo follow-up period. Yearly increments in height and weight were compared by HIV status, incidence of diarrhea and respiratory infections, and levels of sociodemographic variables. Results: After adjusting for maternal education, anemia and vitamin A supplementation, HIV infection was related to 2.8 cm [95% confidence interval (95% CI) 0.6, 5.0] and 1.3 kg (95% CI 0.0, 2.5) lower yearly length and weight gains, respectively, in children who were between 6 and 11 mo old at baseline. Among children who were 12-23 mo old at recruitment, HIV infection was associated with 0.6 kg (95% CI 0.1, 1.0) less yearly weight gain. HIV infection was not related to linear or ponderal growth in children ≤24 mo old. Maternal illiteracy, severe child anemia and episodes of acute diarrhea were additional risk factors for growth delay in length. Conclusion: HIV infection is associated with linear and ponderal growth retardation in children aged >24 mo. Additional predictors of linear growth retardation include preventable conditions such as poor maternal education, child anemia and diarrheal disease.
Iron deficiency and iron deficiency anemia among children 3 to 59 months of age in Kinondoni municipal, Dar es Salaam: a facility-based cross-sectional study
(East Africa Science, 2023-05-23) Malasa, Leonard J.; Rutachunzibwa, Felician; Fataki, Maulidi R.; Kalabamu, Florence S.
Background: Iron deficiency with subsequent iron deficiency anemia is the most common micronutrient disorder in children below 5 years of age worldwide. The developing countries bear more weight on the problem as the result of multifactorial factors including but not limited to recurrent infections such as malaria, helminths infestation, and inadequate food security. However, its magnitude in children living in Kinondoni Municipal in Dar es salaam is not well understood. Therefore, the aim of this study was to determine the prevalence of anemia and how it is contributed by the presence of iron deficiency among children between 3-59months of age in the above-mentioned setting. Methods: A facility-based cross-section study was conducted among children 3-59months attending Reproductive and Child Health Services at Kairuki, Sinza Hospital, and Kambangwa dispensary. Children who met the criteria, their basic social demographic information, complete blood count and differentials as well as blood ferritin levels were collected to assess the level of anemia, erythrocytic indices, and iron deficiency. Data were analyzed using the Statistical Package of Social Sciences (SPSS version 22). The magnitude of anemia and iron deficiencies were presented in percentages, and the relationship between hemoglobin and blood ferritin was assessed using Spearman’s correlation test for two continuous variables. The p-value of less or equal to 0.05 was considered statistically significant. Results: A total of 350 children were recruited for the study, 255 Children (72.9%) were anemic. Children below 24 months of age were more anemic compared to the older age group (X2 = 50, p <0.001). Furthermore, anemia was significantly associated with low ferritin levels (X2 = 65, p <0.001). Iron deficiency was found in 156 (44.6%) participants while iron deficiency anemia (low MCV, low ferritin, and low hemoglobin) was found in 138 (39.4%) participants. However, among 255 participants with anemia, 147(65.3%) had iron deficiency. There was a significant positive correlation between hemoglobin and blood ferritin levels (Spearman’s correlation coefficient = 0.6; p<0.01. Conclusion: Prevalence of anemia was high among children and was highly associated with younger age and iron deficiency. To overcome this problem, appropriate interventions such as massive promotion of breastfeeding, appropriate complementary feeding, and ensuring food security are warranted.
Malaria parasitaemia in relation to HIV status and vitamin A supplementation among pre-school children
(Tropical Medicine & International Health, 2003) Fataki, Maulidi R.
objectives: To ascertain whether malaria parasitaemia in children is associated with HIV status. To examine the effect of vitamin A supplementation on malaria parasitaemia in children. methods We studied the cross-sectional associations between HIV status and malaria parasitaemia among 546 children 6–60 months of age who participated in a double-blind, randomized clinical trial of vitamin A supplementation. Prevalence ratios and 95% confidence intervals (CI) were estimated for the presence of malaria parasites at baseline by HIV status in uni- and multivariate models that adjusted for sociodemographic and environmental variables. Among children with malaria, correlates of high parasite loads were identified. Next, we examined the effect of vitamin A supplementation on the risk of malaria parasitaemia and high parasite density at 4–8 months of the first dose in a subset of children. Results: The prevalence of malaria parasitaemia was 11.4% among HIV-infected children, compared with 27.6% among uninfected. After adjusting for season, anaemia, use of bednets, maternal education and indicators of socioeconomic status, we found some evidence for lower prevalence of parasitaemia among HIV positive compared with HIV-negative children (prevalence ratio ¼ 0.56; 95% CI ¼ 0.29, 1.09; P ¼ 0.09). Other important correlates of malaria parasitaemia at baseline included low level of maternal education, poor quality of water supply, and the presence of animals at home. Vitamin A supplementation did not have a significant effect on malaria parasitaemia at 4–8 months of follow-up, overall or within levels of potential effect modifiers. conclusion: HIV infection appears to be negatively correlated with malaria parasitaemia in this group of children. Investing in women’s education is likely to decrease the prevalence of malaria parasitaemia in children. Vitamin A supplementation does not seem to have an effect on malaria parasitaemia in this population; possible benefits against clinical episodes and severe malaria deserve further examination.
Maternal disease stage and child undernutrition in relation to mortality among children born to HIV-infected women in Tanzania
(JAIDS Journal of Acquired Immune Deficiency Syndromes, 2007) Fataki, Maulidi R.
Objective: To examine whether maternal HIV disease stage during pregnancy and child malnutrition are associated with child mortality. Design: Prospective cohort study in Tanzania. Methods: Indicators of disease stage were assessed for 939 HIV-infected women during pregnancy and at delivery, and children's anthropometric status was obtained at scheduled monthly clinic visits after delivery. Children were followed up for survival status until 24 months after birth. Results: Advanced maternal HIV disease during pregnancy (CD4 count <350 vs. ≥350 cells/mm3) was associated with increased risk of child mortality through 24 months of age (hazard ratio [HR] = 1.74, 95% confidence interval [CI]: 1.32 to 2.30). CD4 count <350 cells/mm3 was also associated with an increased risk of death among children who remained HIV-negative during follow-up (HR = 2.00, 95% CI: 1.36 to 2.94). Low maternal hemoglobin concentration and child undernutrition were related to an increased risk of mortality in this cohort of children. Conclusions: Low maternal CD4 cell count during pregnancy is related to increased risk of mortality in children born to HIV-infected women. Care and treatment for HIV disease, including highly active antiretroviral therapy to pregnant women, could improve child survival. Prevention and treatment of undernutrition in children remain critical interventions in settings with high HIV prevalence.
No asymptomatic malaria parasitaemia found among 108 young children at one health facility in Dar es Salaam, Tanzania
(Malaria journal, 2013) Fataki, Maulidi R.
Background: Asymptomatic malaria parasitaemia has been reported in areas with high malaria transmission. It may serve as a reservoir for continued transmission, and furthermore complicates diagnostics, as not all individuals with a positive malaria test are necessarily ill due to malaria, although they may present with malaria-like symptoms. Asymptomatic malaria increases with age as immunity to malaria gradually develops. As mortality and morbidity of malaria is higher among younger children it is important to know the prevalence of asymptomatic malaria parasitaemia in this population in order to interpret laboratory results for malaria correctly. Methods: A total of 108 children that had neither been treated for malaria nor had a fever the previous four weeks were recruited consecutively at a maternal and child health clinic (MCHC) in Dar es Salaam, Tanzania. A rapid diagnostic test (RDT) for malaria and dried blood spot (DBS) on filter paper were taken from each child. Social and clinical data were recorded. DNA was extracted from the DBS of study participants by a method using InstaGene™ matrix. PCR targeting the Plasmodium mitochondrial genome was performed on all samples. Results: Median age was 4.6 months (range 0.5-38). All the RDTs were negative. PCR was negative for all study subjects. Conclusion: The study suggests that asymptomatic malaria may not be present in apparently healthy children up to the age of three years in Dar es Salaam, Tanzania. However, because of the small sample size and low median age of the study population, the findings cannot be generalized. Larger studies, including higher age groups, need to be done to clarify whether asymptomatic malaria parasitaemia is present in the general population in the Dar es Salaam area.
PCR targeting Plasmodium mitochondrial genome of DNA extracted from dried blood on filter paper compared to whole blood
(Malaria journal, 2014) Fataki, Maulidi R.
Background Monitoring mortality and morbidity attributable to malaria is paramount to achieve elimination of 1,2 malaria. Diagnosis of malaria is challenging and PCR is a reliable method for identifying malaria with high sensitivity. However, blood specimen collection and transport can be challenging and obtaining dried blood spots (DBS) on filter paper by finger-prick may have advantages over collecting whole blood by venepuncture. Methods: DBS and whole blood were collected from febrile children admitted at the general paediatric wards at a referral hospital in Dar es Salaam, Tanzania. DNA extracted from whole blood and from DBS was tested with a genus-specific PCR targeting the mitochondrial Plasmodium genome. Positive samples by PCR of DNA from whole blood were tested with species-specific PCR targeting the 18S rRNA locus, or sequencing if species-specific PCR was negative. Rapid diagnostic test (RDT) and thin blood smear microscopy was carried out on all patients where remnant whole blood and a blood slide, respectively, were available. Results: Positivity of PCR was 24.5 (78/319) and 11.2% (52/442) by whole blood and DBS, respectively. All samples positive on DBS were also positive on Plasmodium falciparum species-specific PCR. All RDT positive cases were also positive by DBS PCR. All but three cases with positive blood slides were also positive by DBS. Conclusions: In this study, PCR for malaria mitochondrial DNA extracted from whole blood was more sensitive than from DBS. However, DBS are a practical alternative to whole blood and detected approximately the same number of cases as RDTs and, therefore, remain relevant for research purposes.
Post-transfusion hepatitis C seroprevalence in Tanzanian children.
(Annals of tropical paediatrics, 2001) Fataki, Maulidi R.
In Tanzania, children with malaria-associated anaemia are frequently given blood transfusions, and donor blood is not screened for hepatitis C virus (HCV) infection. To determine the seroprevalence of HCV infection in Tanzanian children previously transfused with blood, 184 children (92 transfused, 92 not transfused) aged between 15 and 59 months matched for age and sex were screened for HCV antibodies by the particle agglutination test using Serodia® anti-HCV (Fujirebio Inc., Japan). The overall prevalence of HCV infection was 7.1% (13/184). HCV seropositivity was 5.4% (5/92) among children with a history of blood transfusion and 8.6% (8 /92) among the non-transfused. There was no significant difference in the prevalence of HCV infection between transfused and non-transfused children. None of the factors investigated, such as gender, the nutrition and HIV serostatus of the children and the marital and education status of their mothers, was associated with HCV seropositivity. Further studies are recommended to identify the factors associated with HCV infection in Tanzanian children
Prevalence and factors associated with asymptomatic hypoglycemia among preterm newborns in dar es salaam regional referral hospitals, tanzania: a cross sectional analytical study protocol
(MedRxiv, 2022-10-30) Kalabamu, Florence S.; Fataki, Maulidi R.
Background: Hypoglycemia is the most common metabolic abnormality in newborns. It is still unclear whether the condition is truly pathological, especially if it occurs transiently during the 1st 24 hours of birth in an asymptomatic phase. Besides, there is hardly any data on the burden of asymptomatic neonatal hypoglycemia and its associated factors among preterm newborns in Africa. Aim: To assess the prevalence and associated factors of asymptomatic neonatal hypoglycemia among preterm newborns in a typical African settings. Design and Methods: We plan to conduct a quick, cross-sectional analytical hospital-based survey at all public regional referral hospitals in Dar es Salaam, Tanzania. We will consider all preterm newborns delivered in the specified settings between June 2022 and December 2022. Our study population will be all preterm newborns delivered at Dar es Salaam public regional referral hospitals. Our target population will be all preterm newborns with asymptomatic hypoglycemia. All newborns with clinically detected congenital anomalies and those who will be delivered at home but brought to the facilities for care will thus be excluded from the study. Our primary outcome measure will be neonatal RBG < 2.6 mmol/L without any symptoms associated with hypoglycemia. Maternal, fetal and early neonatal (> 6 hours but within 24 hours post-delivery) factors will be logistically regressed against the outcome variable after appropriate model validation. Unless otherwise stated, an α-level of 5% will be used as a limit of type I error in findings. Written informed consent will be obtained from mothers of each newborn prior to inclusion into the study. Main Outcome measure: Prevalence of asymptomatic hypoglycemia among preterm newborns in Dar es Salaam hospitals. Relevance of the findings to science, policy & practice: Current clinical practice does not provide evidence for routine glycaemic screening among preterm newborns asymptomatic for hypoglycemia. The study will have a potential to assess stata of preterm newborn with asymptomatic hypoglycemia
Prevalence and factors associated with hypothermia among neonates in regional referral hospitals in Dar es Salaam, Tanzania
(Global Journal of Health Science, 2022-10-31) Malasa, Leonard J.; Kalabamu, Florence S.; Rutachunzibwa, Felician; Fataki, Maulidi R.; Mashalla, Yohana J.
Background: Neonatal hypothermia is a major cause of mortality. This study determined the prevalence and factors associated with neonatal hypothermia in two regional referral hospitals in Dar es Salaam, Tanzania. Methods: Cross-sectional study was carried out between March and May 2021 at the Mwananyamala and Temeke Regional Referral Hospitals. Simple random and stratified sampling procedures were used to select study sites and proportionate population samples from each hospital respectively. Body temperature was measured within 90 minutes post birth; knowledge of the WHO guidelines on thermal protection of new-borns was collected from the mothers and health care providers using questionnaires. Logistic regression was used to assess associations between variables. SPSS version 25 was used to analyse the data and p < 0.05 was considered significant. Results: Total of 296 mother-new-born pairs and 41 health care providers were enrolled in the study. 26 mothers did not consent for the study. 25.6% of the 270 studied neonates were hypothermic. Lack of skin-to-skin contact with the mother; early neonatal weighing and bathing increased likelihood of neonatal hypothermia. Knowledge of neonatal thermal protection among mothers and care-providers was inadequate. Conclusions: The prevalence of neonatal hypothermia among neonates in the referral hospitals is high. The findings suggest knowledge gaps of the WHO recommended guidelines on neonatal hypothermia are associated with neonatal hypothermia. Efforts to increase awareness of the WHO recommended thermal protection guidelines are needed.
Prevalence of HIV type 1 infection, associated clinical features and mortality among hospitalized children in Dar es Salaam, Tanzania.
(Scandinavian Journal of Infectious Diseases, 2000) Fataki, Maulidi R.
The aim of this study was to determine the prevalence of HIV-1 infection, the clinical spectrum of HIV-1-associated conditions and HIV-1-associated mortality among children hospitalized in the medical paediatric wards at Muhimbili Medical Centre (MMC), Dar es Salaam, Tanzania. All children admitted to the medical paediatric wards of MMC between August 1995 and January 1996 were eligible for the study. Testing for HIV antibodies was done using 2 consecutive enzyme linked immunosorbent assays (ELISAs). ELISA-reactive samples from children aged 18 months and below were further tested by a recently developed heat-denatured p24 antigen assay. The prevalence of HIV-1 infection among the 2015 children studied was 19.2%. When present for 14 days or more, fever, cough, diarrhoea, ear discharge, oral ulcers and skin rash were all significantly more common in HIV-1-infected than in HIV-uninfected children (p < 0.001). In the multivariate analysis cough, ear discharge, oropharyngeal ulcers and skin rash were found to be the most important symptoms. Clinical signs found to be significantly associated with HIV-1 infection in the univariate analysis were wasting, stunting, hair changes, oral thrush, oropharyngeal ulcers, lymphadenopathy, lung consolidation and lung crepitations (p < 0.001). In the multivariate analysis, oral thrush, lung crepitations, cervical lymphadenopathy, wasting and inguinal lymphadenopathy were found to be the most important signs. The 3 most common diagnoses in HIV-1-infected children were acute respiratory infection (ARI) (39.4%), malnutrition (38.1%) and tuberculosis (19.3%), while in HIV-uninfected children they were malaria (47.0%), ARI (25.0%) and malnutrition (16.1%). The mortality rate was 21.4% in HIV-1-infected children and 8.4% in HIV-uninfected children (p < 0.001). In conclusion, the prevalence of HIV-1 infection among hospitalized children at the main hospital in Dar es Salaam was high and associated with high mortality. Many symptoms and signs are indicative of HIV-1 infection, but appropriate laboratory testing is required for diagnosis.
A randomized trial of multivitamin supplementation in children with tuberculosis in Tanzania
(Nutrition journal, 2011) Fataki, Maulidi R.
Background:Children with tuberculosis often have underlying nutritional deficiencies. Multivitaminsupplementation has been proposed as a means to enhance the health of these children; however, the efficacy ofsuch an intervention has not been examined adequately. Methods:255 children, aged six weeks to five years, with tuberculosis were randomized to receive either a dailymultivitamin supplement or a placebo in the first eight weeks of anti-tuberculous therapy in Tanzania. This wasonly 64% of the proposed sample size as the trial had to be terminated prematurely due to funding constraints.They were followed up for the duration of supplementation through clinic and home visits to assessanthropometric indices and laboratory parameters, including hemoglobin and albumin. Results:There was no significant effect of multivitamin supplementation on the primary endpoint of the trial:weight gain after eight weeks. However, significant differences in weight gain were observed among children agedsix weeks to six months in subgroup analyses (n = 22; 1.08 kg, compared to 0.46 kg in the placebo group; 95% CI= 0.12, 1.10; p = 0.01). Supplementation resulted in significant improvement in hemoglobin levels at the end offollow-up in children of all age groups; the median increase in children receiving multivitamins was 1.0 g/dL,compared to 0.4 g/dL in children receiving placebo (p < 0.01). HIV-infected children between six months and threeyears of age had a significantly higher gain in height if they received multivitamins (n = 48; 2 cm, compared to 1cm in the placebo group; 95% CI = 0.20, 1.70; p = 0.01; p for interaction by age group = 0.01). Conclusions:Multivitamin supplementation for a short duration of eight weeks improved the hematologicalprofile of children with tuberculosis, though it didn’t have any effect on weight gain, the primary outcome of thetrial. Larger studies with a longer period of supplementation are needed to confirm these findings and assess theeffect of multivitamins on clinical outcomes including treatment success and growth failure.
A randomized trial of vitamin A supplements in relation to mortality among human immunodeficiency virus-infected and uninfected children in Tanzania
(The Pediatric infectious disease journal, 1999) Fataki, Maulidi R.; Ndossi, Godwin D.
Objectives. To determine whether vitamin A supplements result in reduced mortality among HIV-infected and uninfected children. Design. Randomized, double blind, placebo-controlled trial. Methods. Starting in April, 1993, we randomized 687 children age 6 months to 5 years who were admitted to the hospital with pneumonia. Children who were severely malnourished or had clinical signs of vitamin A deficiency were excluded. At baseline children received placebo or 400 000 IU (or half that for infants) of vitamin A, in addition to standard treatment for pneumonia. They received further doses of the same regimen 4 and 8 months after hospital discharge. Sera from children were tested for HIV antibodies by enzyme-linked immunosorbent assay and Western blot tests. For positive children <15 months of age, HIV infection was confirmed by amplified heat-denatured HIV-p24 antigen assays with confirmatory neutralization assays. HIV status was ascertained for 648 of 687 enrolled children. The mean duration of follow-up was 24.4 months (SD = 12.1). Results. Of 648 children 58 (9%) were HIV-infected. Compared with uninfected children, all-cause mortality was higher among HIV-infected children, as was mortality caused by pneumonia or diarrhea (P < 0.001 for each). Overall vitamin A supplements resulted in a 49% reduction in mortality [relative risk (RR), 0.51; 95% confidence interval (CI), 0.29 to 0.90, P = 0.02]. Vitamin A supplements reduced all-cause mortality by 63% among HIV-infected children (RR 0.37; CI 0.14 to 0.95, P = 0.04) and by 42% among uninfected children (RR 0.58, CI 0.28 to 1.19, P = 0.14). Vitamin A supplements were also associated with a 68% reduction in AIDS-related deaths (P = 0.05) and a 92% reduction in diarrhea-related deaths (P = 0.01). Conclusion. Vitamin A deficiency, which is common among children in many developing countries, is particularly severe among HIV-infected children. Our findings indicate that vitamin A supplements, a low cost intervention, reduce mortality of HIV-infected children.

Browsing by Author "Fataki, Maulidi R."

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