Browsing by Author "Rogers, Anastasia M."

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    Bacterial profile and antimicrobial susceptibility patterns of asymptomatic Urinary Tract Infection among pregnant women attending ante-natal care at Kairuki Hospital, Dar es Salaam, Tanzania
    (medrxiv.org, 2025-12-20) Gabriel, Deogratias R.; Mayanda, Ashura; Rogers, Anastasia M.; Kabuga, Hamis; Kungulilo, Selemani; Ngassala, Maureen; Msangi, Walter; Chiduo, Monica; Mtango, Manento E.; Pierre, Jeanne; Kapesa, Haji E.; Balilemwa, Lemmygius D.; Mafuru, Magesa; Isaac Makanda H.
    Introduction Urinary tract infections are common to pregnant and nonpregnant women estimated to 150 million new cases annually. The incidence increases with pregnancy due changes that take place. Causative microbes are E.coli, Klebsiella pneumoniae and Staphylococci species. The disease presents symptomatically or asymptomatically, early investigation, detection and treatment to pregnant mothers are crucial to avoid maternal and foetal complications. Several effective antimicrobials are contraindicated using ineffective agents jeopardizes treatment outcome leading to multidrug resistance. We assessed UTI causative microbes and susceptibility patterns to common antibiotics. Methods We conducted a hospital based cross sectional study at Kairuki hospital involving 262 pregnant mothers attending ante-natal clinics. Mid-stream urine was collected and inoculated on Cysteine-lactose-electrolyte-deficient agar, MacConkey and blood agar. Eleven microbes were isolated and tested for susceptibility against antibiotics using Kirby-Bauer disk diffusion technique on Mueller-Hinton agar. Data analysed using SPSS package version 23. Results The prevalence of UTI in pregnant mothers was 31.2% (82/262). The gram positive isolates were more prevalent than gram nmoste (59.3% versus 40.7%) Staphylococcus aureus 22/82 (26.2%) and S. saprophyticus 15/82 (17.9%) were the mostly isolated. Nitrofurantoin, Piperacillin/tazobactam have lowest resistant rate to both gram negative and gram positive isolates ranging from (0-26%) while Erythromycin and Ampicillin have the highest resistant rate ranging from (60-100%) therefore associated with multidrug resistant. Conclusion Asymptomatic UTI is prevalent to pregnant women at this hospital. We recommend culture and sensitivity results to guide treatment and usage of nitrofurantoin, piperacillin/tazobactam as first line treatment of UTI in pregnancy.
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    A narrative review of recent antibiotic prescribing practices in ambulatory care in Tanzania: findings and implications
    (Medicina, 2023-12-18) Massele, Amos Y.; Rogers, Anastasia M.; Gabriel, Deogratius R.; Mayanda, Ashura.
    Background and objectives: There are concerns with the current prescribing practices of antibiotics in ambulatory care in Tanzania, including both the public and private sectors. These concerns need to be addressed as part of the national action plan (NAP) of Tanzania to reduce rising antimicrobial resistance (AMR) rates. Issues and concerns include high rates of prescribing of antibiotics for essentially self-limiting conditions. Consequently, there is a need to address this. As a result, the aims of this narrative review were to comprehensively summarize antibiotic utilization patterns particularly in ambulatory care and their rationale in Tanzania and to suggest ways forward to improve future prescribing practices. Materials and Methods: We undertook a narrative review of recently published studies and subsequently documented potential activities to improve future prescribing practices. Potential activities included instigating quality indicators and antimicrobial stewardship programs (ASPs). Results: Published studies have shown that antibiotics are being excessively prescribed in ambulatory care in Tanzania, in up to 95% to 96.3% of presenting cases depending on the sector. This is despite concerns with their appropriateness. High rates of antibiotic prescribing are not helped by variable adherence to current treatment guidelines. There have also been concerns with extensive prescribing of ‘Watch’ antibiotics in the private sector. Overall, the majority of antibiotics prescribed across the sectors, albeit inappropriately, were typically from the ‘Access’ group of antibiotics in the AWaRe (Access/Watch/Reserve) classification rather than ‘Watch’ antibiotics to limit AMR. The inappropriate prescribing of antibiotics in ambulatory care is linked to current knowledge regarding antibiotics, AMR, and ASPs among both prescribers and patients. Recommended activities for the future include improved education for all groups, the instigation of updated quality indicators, and the regular monitoring of prescribing practices against agreed-upon guidelines and indicators. Education for healthcare professionals on ASPs should start at undergraduate level and continue post qualification. Community advocacy on the rational use of antibiotics should also include social media activities to dispel misinformation. Conclusion: The quality of current prescribing practices of antibiotics in ambulatory care is sub-optimal in Tanzania. This needs to be urgently addressed.