Browsing by Author "Makanda, Isaac H."

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    Challenges in Diagnosis and Management of Second Trimester Omental Pregnancy in Limited Resource Settings: Case Report
    (East African Health Research Journal, 2022-07) Mushema, Beata; Makanda, Isaac H.; Chiduo, Monica
    Background: Abdominal pregnancies are a rare occurrence and are associated with high maternal and perinatal mortality rates compared to intra-uterine and other ectopic pregnancies. Localization of sites of abdominal pregnancies and determining the gestational age at the time of diagnosis play a fundamental role in guiding the treatment approach and minimizing potential complications. However, the vague presentation coupled with low accuracy of ultrasound detection often leads to misdiagnosis of abdominal pregnancy, and hence delaying initiation of appropriate management. We present a case of a second trimester abdominal pregnancy detected following failure of induction for an initial diagnosis of missed abortion, and the ensuing outcome, rarely reported in limited-resource settings. Case presentation: A 19 year old unbooked woman, gravida 2 para 1 at 17thweek gestation age by ultrasound presented with loss of foetal movement for one week. Based on clinical assessment and referral ultrasound findings, she was initially diagnosed with missed abortion and planned for induction. Failure of induction prompted a repeat ultrasound which revealed a non-viable abdominal pregnancy. Laparotomy was done, localisation of the pregnancy at the omentum was observed and a dead foetus was extracted with the placenta left in-situ. A complication of surgical wound dehiscence with infection developed post-operatively and was managed with secondary sutures. The patient recovered and was discharged in a stable condition. Conclusion: This case demonstrates that the diagnosis of abdominal pregnancy remains a challenge especially in settings where skilled human resources for health are few and equipment and supplies for effective and timely treatment are limited. The case sheds some light on the broader challenges in maternal and perinatal health in developing countries. Accurate pre-operative diagnosis requires a high index of suspicion, especially due to the variability of its presentation. This case emphasises the important of quality antenatal care and the need for clinicians to conduct comprehensive assessments of patients and receive training on obstetric ultrasound skills.
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    Prevalence and risk factors of Anaemia in pregnancy at Mwananyamala and Sinza Antenatal Clinics
    (Hubert Kairuki Memorial University, 2018) Makanda, Isaac H.
    Abstract: Introduction: Worldwide, anaemia among pregnant women has been a big burden both in the developing and developed countries whose maternal and foetal effects are enormous and gravious. Objective: To determine the prevalence and risk factors of anaemia in pregnancy Methods: A hospital based cross sectional comparative study on 437 participants attending antenatal care clinics was conducted at two Municipal hospitals in Dar es Salaam,Tanzania from November 2017 to April 2018.Sociodemographic informations together with some risk factors for anaemia and utilization of some preventive interventions were collected through a well-structured questionaire.Two millilitres of venous blood, four millilitres of urine and a stool samples were collected from each study participant.Hametological parameters were determined using automated Full Blood Picture machine .Blood slide was stained with Giemsa’s stain and viewed under 100x objective for malaria parasites. Stool samples were checked for hookworm ova under direct mount and urine was analysed using dipstick to determine the presence of urinary tract infection. Data were analysed using Epi info 7.2 Results: The overall prevalence of anaemia in this study was 49.89%, of which the majority (53%) had mild anaemia. History of postpartum haemorrhage (PPH) in the previous pregnancy OR 5.02 (95% CI 3.16-7.94), p-value 0.00 and urinary tract infection (UTI) in the current pregnancy OR 1.81 (95% CI 1.81-5.28),p-value 0.00 were found to be statistically significant. Other factors like the use of sulfadoxine-pyrimethamine as an Intermittent Preventive Treatment of malaria in pregnancy (IPTp),Insecticide treated Nets (ITNs),were all protective but not statistically significant. Conclusion: The prevalence of anaemia was found to be a public health problem.Those factors identified to be risk for anaemia should be considered in prevention and control of anaemia among pregnant women.Adherence to both WHO and National guidelines on the preventive measures is very important Key words: Anaemia , Prevalence,