Journals
Permanent URI for this collection
Browse
Recent Submissions
Item Management of a prenatally diagnosed congenital anomaly and comparison of management in developed and developing countries: A case report(EC Paediatrics, 2024-08-12) Rutachunzibwa, Fredy F.Abstract Introduction: Congenital anomalies are structural or functional anomalies that occur during intrauterine life. These conditions may be identified before birth or after. Case Report: A 23-year-old female was referred to University of Miyazaki Hospital. Ultrasound showed polyhydramnios, intrauterine growth restriction, single umbilical artery and dilated fetal bowel loops. Numerical chromosomal anomalies were ruled out by amniotic fluid analysis. The baby was born at 35 weeks, abdominal X-ray showed features of small intestinal atresia. On day two of life the baby underwent surgery and had a good prognosis. Conclusion: Prenatal diagnosis is important to ensure timely management of anomalies.Item 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 clinicsItem 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.Item 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.Item 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.Item Insulin resistance in non-obese Africa hypertensive subjects with normal glucose tolerance(University of Dar es Salaam, 1992) Mgonda, Yassin M.Insulin resistance and the concomitant compensatory hyperinsulinaemia, independent of obesity or abnormal glucose tolerance have been demonstrated to be associated with essential hypertension in Caucasians. This study was conducted to establish if insulin resistance and the accompanying hyperinsulinaemia is also associated with essential hypertension in Africans. A sample of 15 newly detected, untreated hypertensive non-obese subjects, together with 15 normotensive controls matched for age, sex and body mass index were studied. The modified Harano's insulin sensitivity test was employed. All subjects as well as the controls had normal oral glucose tolerance by WHO criteria. The mean systolic blood pressure in hypertensive subjects was 176±6 mmHg while the mean diastolic blood pressure was 111±2 mmHg. The controls had a mean systolic blood pressure of 131±3 mmHg and a mean diastolic blood pressure of 83±1 mmHg. The mean ages of the hypertensive subjects and controls were 38.5±!. 7 years and 38.6±1.8 years respectively. The mean (±sem) body weight in hypertensive subjects was 67.0±11.5 kg while that in controls was 64.6±11.3 kg. The mean height was 1.6±0.1 m in both groups, and the respective body mass indices were 24. 6±0. 9 kg/m2 and 24.4±0.9 kg/m2 which were comparable (p = 0.92). Fasting blood glucose was significantly higher (p = 0.04) by about 7% in hypertensive subject's (mean = 4.4±0.1 mmol/l), than in controls (mean = 4.1±0.1 mmol/l). Steady state blood glucose concentration (SSBG) was significantly higher (p = 0.009) by about 26% in hypertensive subjects (mean = 5.0±0.3 mmol/I) than in controls (mean = 3.7±0.3 mmol/l). The mean metabolic clearance rate in hypertensive subjects (0.007± 0.001 -- -~ - - ~ - ----- ------- ---~-- - iii ml/kg/min) was stg nificarrtly lower (p = 0.014 by about 28.5% than that of controls (mean = 0.009±0.001 ml/kg/min.). There was no significant correlation between body mass index and systolic blood pressure in both groups (1' = 0.1, p > 0.7 and l' = 0.3, p > 0.2 respectively). A similar insignificant correlation was observed with diastolic blood pressure in the two groups. There was a positive and significant correlation between waist: hip ratio and systolic blood pressure in hypertensive subjects (r = 0.5, p < 0.05) but not in the controls (r = 0.2 p > 0.4). No significant correlation was observed between waist: hip ratio and diastolic blood pressure in both groups (r = 0.3, p> 0.2, and r = 0.2 p > 0.4, respectively). There was a negative correlation between metabolic clearance rate and systolic blood pressure in the control group which was statistically significant (r = -0.5, p<0.05), but not in the hypertensive subjects. No significant correlation was observed between steady state blood glucose concentration and both systolic and diastolic blood pressure in the hypertensives as well as controls. There was no significant difference in the mean fasting plasma insulin concentrations between the two groups. There was no correlation between fasting plasma insulin concentration and blood pressure in both g rou pa.). These data indicate that there is an abnormality of insulin -mediated glucose metabolism in African hypertensives, suggesting an association between insulin resistance and essential hypertension.Item Psoriatic – Arthritis among Psoriasis Patients Attending Skin Clinics n Dar es Salaam, Tanzania(Tanzania Medical Journal, 2007) Mgonda, Yassin M.Background: Psoriasis is an autoimmune inflammatory disease which primarily affects the skin but joints may also be targeted. Psoriatic arthritis is a destructive inflammatory arthropathy and ensethopathy which is considered to be rare in sub Saharan Africa. Left untreated the condition is permanently disabling. There are no studies in Dar es Salaam that have described psoriatic arthritis among psoriasis patients seen at dermatology clinics. Broad objective: To describe psoriatic arthritis among psoriasis patients attending specialized skin clinics in Dar es Salaam. Study design: Hospital – based – cross – sectional descriptive study Study setting: Muhimbili National Hospital and three private hospitals in the City of Dar es Salaam Study population: All patients attending skin clinics at Muhimbili National Hospital and three private hospitals in Dar es Salaam Measures of outcome: Psoriasis and psoriatic arthritis Intervention: Patients attending skin clinics at Muhimbili National Hospital and three private hospitals in Dar es Salaam were examined for the presence of psoriasis. Psoriasis was diagnosed clinically in most cases. Psoriatic arthritis was diagnosed according to the Moll and Wright criteria. Results: A total of 42 patients with psoriasis were recruited into the study. Males constituted 71%. The mean age at onset of psoriasis was 37 years and the psoriasis onset age – group with the highest number of patients (33%) was 31 – 40 years. Joint complaints of different types were encountered in 21% (9/42) and of these only 2 patients (5%) had psoriatic arthritis. Of the 2 patients with psoriatic arthritis, one was a known HIV sero positive. Conclusion and recommendations: Psoriatic arthritis occurs at a lower frequency among psoriasis patients in Dar es Salaam but the actual prevalence remains undetermined. More comprehensive studies are required to establish its magnitude.Item Diabetic Dyslipidemia Among Diabetic Patients Attending Specialized Clinics in Dar es Salaam.(Tanzania Medical Journal, 2008) Mgonda, Yassin M.Background: Diabetes mellitus is a major healthcare problem globally, and by 2030 there will be approximately 360 million patients world – over. Diabetes mellitus is associated with dyslipidemia involving quantitative and qualitative changes in lipoproteins. Correcting lipid abnormalities reduces the risks of coronary heart diseases (CHD) among diabetics. The prevalence of diabetic dyslipidemia and its association with glycemic control are all largely undetermined in Dar es Salaam. Objective: to determine the prevalence of diabetic dyslipidemia and its association with glycemic control among diabetes mellitus patients in Dar es Salaam. Methodology: A descriptive cross – sectional study was conducted between November 2006 and January 2007. Diabetic patients aged 18 years and above were recruited by simple random sampling technique from diabetic clinics in the city of Dar es Salaam. After enrolment each subject was interviewed using a structured questionnaire before undergoing a full physical examination. Fasting lipid profiles and glycosylated hemoglobin were measured using Konelab TM (© 2003 Thermo Electron Corporation) machine. Chi – squared test, Student\'s t – test and multiple logistic regression were used for data analysis. A p – value of < 0.05 was taken to represent a statistically significant difference between variables. Results: The prevalence of dyslipidemia was 95%. The commonest lipid derangement was hypertriglyceridemia with serum triglyceride level ranging from 1.00 – 3.26 mmol/L (mean 2.22 + 0.69). Dyslipidemia was mostly asymptomatic with only few presenting with angina, peripheral vascular disease and corneal arcus. In a multivariate analysis, poor glycemic control as determined by measurement of glycosylated hemoglobin was independently associated with dyslipidemia. Conclusion and Recommendation: The prevalence of dyslipidemia among diabetes mellitus patients attending diabetic clinics in government hospitals in Dar es Salaam is alarmingly high. Since risk factors for heart diseases among diabetics are known to be additive and even multiplicative, mild degrees of dyslipidemia may increase CHD risk. Controlling dyslipidemia should be given equal emphasis as controlling hyperglycemia in managing diabetes mellitus.Item Insulin Resistance and Hypertension in Non-obese Africans in Tanzania(Hypertension, 1998) Mgonda, Yassin M.Abstract—Insulin sensitivity was assessed using a glucose-insulin infusion test in 15 newly diagnosed non-obese hypertensive black Tanzanians with normal glucose tolerance and in 15 normotensive control subjects matched for age, sex, and body mass index. The steady-state blood glucose and metabolic clearance rate of glucose (MCR) were used as measures of insulin sensitivity. The mean MCR (glucose) was significantly reduced (7.12±0.57 versus 9.50±0.69 μmol/kg per minute; P<.05) and mean steady-state blood glucose was significantly elevated (5.0±0.3 versus 3.7±0.3 mmol/L; P<.01) in subjects with hypertension compared with the normotensive group. For all subjects there was a significant inverse correlation between MCR (glucose) and systolic (P=.003) and diastolic (P=.005) blood pressure; and a positive correlation was found between fasting serum insulin levels and systolic (P=.005) and diastolic (P=.004) blood pressure. These observations were independent of body mass index and serum lipid levels. These data indicate a strong association between insulin mediated glucose uptake and blood pressure in this population of normal weight untreated urban Africans.Item The burden of co-existing dermatological disorders and their tendency of being overlooked among patients admitted to muhimbili national hospital in Dar es Salaam, Tanzania(BMC dermatology, 2011) Mgonda, Yassin M.; Chale, Pauline NF.Background: Skin diseases are underestimated and overlooked by most clinicians despite being common in clinical practice. Many patients are hospitalized with co-existing dermatological conditions which may not be detected and managed by the attending physicians. The objective of this study was to determine the burden of co-existing and overlooked dermatological disorders among patients admitted to medical wards of Muhimbili National hospital in Dar es Salaam. Study design and settings: A hospital-based descriptive cross-sectional study conducted at Muhimbili National hospital in Dar es Salaam, Tanzania. Methods: Patients were consecutively recruited from the medical wards. Detailed interview to obtain clinicodemographic characteristics was followed by a complete physical examination. Dermatological diagnoses were made mainly clinically. Appropriate confirmatory laboratory investigations were performed where necessary. Data was analyzed using the ‘Statistical Package for Social Sciences’ (SPSS) program version 10.0. A p-value of < 0.5 was statistically significant. Results: Three hundred and ninety patients admitted to medical wards were enrolled into the study of whom, 221(56.7%) were females. The mean age was 36.7 ± 17.9 (range 7-84 years). Overall, 232/390 patients (59.5%) had co-existing dermatological disorders with 49% (191/390) having one, 9% (36/390) two and 5 patients (1%) three. A wide range of co-existing skin diseases was encountered, the most diverse being non-infectious conditions which together accounted for 36.4% (142/390) while infectious dermatoses accounted for 31.5% (123/390). The leading infectious skin diseases were superficial fungal infections accounting for 18%. Pruritic papular eruption of HIV/AIDS (PPE) and seborrheic eczema were the most common non-infectious conditions, each accounting for 4.3%. Of the 232/390 patients with dermatological disorders, 191/232 (82.3%) and 154/232 (66.3%) had been overlooked by their referring and admitting doctors respectively. Conclusion: Dermatological disorders are common among patients admitted to medical wards and many are not detected by their referring or admitting physicians. Basic dermatological education should be emphasized to improve knowledge and awareness among clinicians.Item The pattern of mucocutaneous disorders in HIV – infected children attending care and treatment centres in Dar es Salaam, Tanzania(BMC Public Health, 2009) Mgonda, Yassin M.; Panya, Millembe F.; Massawe, Augustine W.Background: HIV/AIDS is associated with a wide range of mucocutaneous disorders some ofwhich are useful in the clinical staging and prognosis of the syndrome. There is paucity of information regarding the prevalence and pattern of mucocutaneous disorders among HIV infected children attending paediatric Care and Treatment Centres (CTC) in Dar es Salaam. Objective To determine the prevalence and pattern of mucocutaneous disorders among HIV infected children attending public paediatric 'Care and Treatment Centres' in Dar es Salaam. Methods: This was a cross sectional descriptive study involving public paediatric 'Care and Treatment Centres' in Dar es Salaam. Clinical information was obtained using a questionnaire.Dermatological examination was carried out in daylight. Investigations were taken as appropriate.Data was analysed using the Statistical Package for Social Sciences (SPSS) program version 10.0.Chi-squared and Fisher's exact tests were utilized. A p-value of less than 0.05 was consideredstatistically significant. Results: Three hundred and forty seven HIV infected children (52% males) attending CTCs were recruited into the study. Mucocutaneous disorders were encountered in 85% of them. There wasno gender difference in the prevalence of the infective mucocutaneous disorders but males had ahigher prevalence of non-infective/inflammatory dermatoses (58%) than females (42%) (p = 0.02).Overall, mucocutaneous disorders (infective + non infective) were more prevalent in advancedstages of HIV disease. Children with advanced HIV disease had a significantly increased frequencyof fungal and viral infections (43% and 25% respectively than those with less advanced disease; 24%and 13% respectively (p = 0.01). Seventy four percent of the HIV-infected children withmucocutaneous disorders were already on ART. Conclusion: Mucocutaneous disorders among HIV infected children attending Care and Treatment Centres are common and highly variable. Comprehensive management should also emphasize on the management of mucocutaneous disordersItem The spectrum of dermatological disorders among primary school children in Dar es Salaam(BMC public health, 2010) Mgonda, Yassin M.; Komba, Ewaldo V.Background: Dermatologic disorders are common in many countries but the spectrum varies greatly. Many studies have reported a significant burden of skin diseases in school children. The objective of this study was to determine the current spectrum of dermatological disorders in primary school children in Dar es Salaam city. Methods: Primary school children were recruited by multistage sampling. Detailed interview, dermatological examination and appropriate laboratory investigations were performed. Data was analyzed using the ‘Statistical Package for Social Sciences’ (SPSS) program version 10.0 and EPI6. A p-value of < 0.5 was significant. Results: A total of 420 children were recruited (51% males; mean age 11.4 ± 2.8 years; range 6-19 years). The overall point prevalence of any skin disorder was 57.3% and it was 61.9% and 52.6% in males and females respectively (p = 0.05). Infectious dermatoses accounted for 30.4% with superficial fungal infections (dermatophytoses and pityriasis versicolor) being the commonest (20%). Dermatophytoses were diagnosed in 11.4% (48/420); the prevalence in males and females being 12.6% and 10.1% respectively (p = 0.41) and higher (21.8%) in the age-group 6-10 years (p = 0.045). Fungal cultures were positive in 42/48 children (88%). All three dermatophyte genera were isolated. Tinea capitis was the commonest disease among culture-positive dermatophytoses (30/42; 71.4%) with an overall prevalence of 7.1% (30/420) followed by tinea pedis (11/42; 26.1%) whose overall prevalence was 2.6%. Microsporum canis was common in tinea capitis (14/30; 46.7%) followed by Trichophyton violaceum (6/30; 20%). Trichophyton rubrum was common in tinea pedis (5/11; 45.5%). Thirty six children (8.6%) had pityriasis versicolor which was more prevalent (6/27; 22.l2%) in the age group 16-19 years (p = 0.0004). The other common infectious dermatoses were pyodermas (4%) and pediculosis capitis (3.6%). Common non-infectious dermatoses were: acne vulgaris (36.4%), non-specific dermatoses (10.7%), non-specific ulcers (5%) and atopic eczema (2.6%). Rare conditions (prevalence < 1%) included: vitiligo, alopecia areata and intertrigo. The majority of the affected children (67.2%) did not seek any medical assistance. Conclusions:Skin disorders are common in primary school children; infectious dermatoses are still rampant andmany children do not seek medical assistance.Item Experience of initiating collaboration of traditional healers in managing HIV and AIDS in Tanzania(Journal of Ethnobiology Ethnomedicine, 2007) Mgonda, Yassin M.Collaboration between traditional healers and biomedical practitioners is now being accepted by many African countries south of the Sahara because of the increasing problem of HIV/AIDS. The key problem, however, is how to initiate collaboration between two health systems which differ in theory of disease causation and management. This paper presents findings on experience learned by initiation of collaboration between traditional healers and the Institute of Traditional Medicine in Arusha and Dar-es-Salaam Municipalities, Tanzania where 132 and 60 traditional healers respectively were interviewed. Of these 110 traditional healers claimed to be treating HIV/AIDS. The objective of the study was to initiate sustainable collaboration with traditional healers in managing HIV/AIDS. Consultative meetings with leaders of traditional healers' associations and government officials were held, followed by surveys at respective traditional healers' "vilinge" (traditional clinics). The findings were analysed using both qualitative and quantitative methods. The findings showed that influential people and leaders of traditional healers' association appeared to be gatekeepers to access potential good healers in the two study areas. After consultative meetings these leaders showed to be willing to collaborate; and opened doors to other traditional healers, who too were willing to collaborate with the Institute of Traditional Medicine in managing HIV/ AIDS patients. Seventy five percent of traditional healers who claimed to be treating HIV/AIDS knew some HIV/AIDS symptoms; and some traditional healers attempted to manage these symptoms. Even though, they were willing to collaborate with the Institute of Traditional Medicine there were nevertheless some reservations based on questions surrounding sharing from collaboration. The reality of past experiences of mistreatment of traditional healers in the colonial period informed these reservations. General findings suggest that initiating collaboration is not as easy as it appears to be from the literature, if it is to be meaningful; and thus we are calling for appropriate strategies to access potential healers targeted for any study designed with sustainability in mind.