Browsing by Author "Buza, Joram"

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    Dietary pattern as a predictor of colorectal cancer among general health population in Arusha Tanzania: A population based descriptive study
    (Academic Journals, 2017) Katalambula, Leonard Kamanga; Ntwenya, Julius Edward; Ngoma, Twalib; Buza, Joram; Mpolya, Emmanuel; Petrucka, Pammla; Paul, Edwin
    Proper diet is important in preventing many diseases, and colorectal cancer is no exception. The aim of this study was to identify major dietary patterns among the general population in Arusha Tanzania to determine whether diet is one of the predictors contributing to the observed pattern and distribution of colorectal cancer in Tanzania. A population based cross-sectional study recruited a sample of selfreported healthy individuals residing in four wards of the City of Arusha, Tanzania. A total of 549 participants were recruited on a voluntary basis. The Food Frequency Questionnaire and the World Health Organization (WHO) Step® survey tool were used to collect data. Factor analysis, Pearson correlation (Pearson’s r), and logistic regression were used to analyze the data.Two major dietary patterns, namely “healthy” and “western”, and one minor pattern existed among the study population. The "healthy" pattern was generally associated with females (56.2%, p=0.074), people with primary level of education (62.7%, p=0.667), age category of 25 to 44 (66.3%, p= 0.370), normal range body mass index (BMI) (42.4%, p=0.967), self-employed (78.5%), non-smokers (86.6%) and non-alcohol drinkers (51%), although the differences were not statistically significant. "Western" dietary pattern adherence was associated with area of residence (p=0.0001), gender (p=0.003) and BMI status (p=0.04) in univariate analysis. In multivariate analysis, higher odds were observed in individuals aged 25 to 34 (OR=1.104, 95%, CI (0.537-2.2267) and 45 to 54 OR=1.091, 95%, CI(0.521-2.283), alcohol drinkers (OR=1.2, 95%, CI(0.767-1.877), people with college or high levels of education (OR=0. 853, 95%, CI(0.260-2.803) and OR=0.550, 95%,CI(0. 159-1.897), smokers (OR=1.030, 95%, CI(0.519-2.044) and overweight or obese (OR=2.676, 95%, CI (0.981-7.298) and OR=2.045, 95%, CI (0.767-5.454). These data support our previous hypothesis that diet could be an important potential predictor of the previously observed pattern and distribution of colorectal cancer in Tanzania.
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    The efficacy of single-dose versus double-dose praziquantel treatments on schistosoma mansoni infections: its implication on undernutrition and anaemia among primary schoolchildren in two on-shore communities, Northwestern Tanzania
    (Hindawi Limited, 2017) Munisi, David Z.; Buza, Joram; Mpolya, Emmanuel A.; Angelo, Teckla; Kinung, Safari M.
    Administering more than one treatment may increase Praziquantel cure and egg reduction rates, there by hastening achievement of schistosomiasis transmission control. A total of 431S. Mansoni-infected schoolchildren were randomized to receive either a single or repeated 40 mg/kg Praziquantel dose. Heights, weights, and haemoglobin levels were determined using a stadiometer, weighing scale, and Hemo Cue, respectively. At 8 weeks, cure rate was higher on repeated dose (93.10%) compared to single dose (68.68%) (𝑝 <0.001). The egg reduction rate was higher on repeated dose (97.54%) compared to single dose (87.27%) (𝑝 = 0.0062). Geometric mean egg intensity was lower among those on repeated dose(1.30epg) compared to single dose (3.18epg)(𝑝 = 0.036)butnotat5 (𝑝 > 0.05)and8(𝑝 > 0.05) months with no difference in reinfection rate. No difference in the prevalence of stunting was observed between the two treatment regimens (𝑝 > 0.05) at 8 months, but there was an increase in the prevalence of wasting among those on repeated dose (𝑝 < 0.001). There was an increase in the mean haemoglobin level sat 8 months with no difference between the two arms (𝑝 > 0.05). To achieve reduction of transmission intensity and disease control in highly endemic areas, repeated treatments alone may not be sufficient. This trial was registered with PACTR 201601001416338.
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    Geographical and behavioral risks associated with Schistosoma haematobium infection in an area of complex transmission
    (BioMed Central, 2018) Angelo, Teckla; Buza, Joram; Kinung’hi, Safari Methusela; Kariuki, Henry Curtis; Mwanga, Joseph Rogathe; Munisi, David Zadock; Wilson, Shona
    Background: Schistosoma haematobium infection in endemic areas varies depending on the nature and complexity of the transmission networks present. Studies of micro-geographical transmission of S. Haematobium infection indicate that discrepancy in prevalence between households is associated with diverse water contact behaviours and transmission that is restricted to particular sites harbouring snail intermediate hosts. Detection of variations in the transmission sources with complex transmission networks of water bodies is required for the optimization of malacological control. Longitudinal parasitological and malacological surveys were conducted to investigate geographical variations in transmission of urogenital schistosomiasis in Ikingwamanoti village, Shinyanga District, Tanzania. Methods: Urine samples were collected at baseline and follow-up time points from 282 school-aged children and examined microscopically for the presence of S. Haematobium eggs. Malacological surveys involved the collection of Bulinus nasutus every month from 30 sites. Snails were examined for patent infections. Global positioning system was used to map household distances from S. Haematobium transmission sites, while water contact behaviour was assessed using a questionnaire. Results: Schistosoma haematobium infection was observed to be prevalent among older children (12–14 years) compared to younger groups prior to treatment, but no significant difference in infection prevalence was observed at one-year. Boys were highly infected than girls at both time points. No spatial influence was observed between children’s infection and the distance from child’s residence to the nearby snail habitats nor was any significant association observed between children’s reported water contact behaviour with S. haematobium infection. However, malacological surveys with cercarial shedding combined with GPS data detected significant variation among different water sources in the transmission of S. Haematobium with children living in households near to ponds with high B. nasutus populations having the highest prevalence of infection. Conclusions: Interaction between malacological surveys with cercarial shedding combined with GPS mapping in endemic settings can help detection of transmission sources even in areas with complex transmission networks. Subsequent studies are needed to determine whether the combination of GPS mapping and parasitology screens can aid the detection of transmission hotspots across varied transmission settings to enhance schistosomiasis control programmes.
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    Knowledge, attitude, and practices on intestinal schistosomiasis among primary schoolchildren in the Lake Victoria basin, Rorya district, north-western Tanzania
    (BioMed Central, 2017) Munisi, David Z.; Buza, Joram; Mpolya, Emmanuel A.; Angelo, Teckla; Kinung, Safari M.
    Globally school-age children, adolescents and young adults bear the highest burden of schistosomiasis. When developing a specific intervention to improve communitys knowledge, attitudes, and practices (KAPs), existing KAPs must be taken into account. Therefore, this study was designed to determine school childrens KAPs on schistosomiasis in the study area. A cross-sectional study was conducted in Busanga and Kibuyi villages involving 513 schoolchildren. A pre-tested questionnaire was used to collect socio-demographic data and to assess KAP on schistosomiasis among primary schoolchildren in the study area. Of the 488 interviewed children, 391 (80.12%) reported to have heard of schistosomiasis, with the majority 289 (73.91%) citing school as the source of this knowledge. Swimming in the lake, worms, witchcraft, and mosquitoes were mentioned to be the cause for intestinal schistosomiasis. Fishing in the lake, drinking unboiled lake water, walking bare footed, and shaking hands were reported to be practices that may lead to contracting schistosomiasis. Only 156 (39.90%) of the study respondents reported to know the signs of intestinal schistosomiasis. Avoiding swimming in the lake, drinking unboiled water and eating unwashed fruits were mentioned as preventive measures. Nearly 85% (412) reported understanding that there was a disease known as schistosomiasis; additionally, 419 (85.86%) considered schistosomiasis as a dangerous disease and 418 (85.66%) believed that schistosomiasis was treatable. Fishermen and schoolchildren were reported to be groups most at risk of schistosomiasis infection. Visiting the lake (for swimming and other gatherings) was a common practice among study participants 471 (96.52%). Nearly 93% (451) of participants mentioned using lake water for domestic chores and although 407 (84.61%) reported to own a toilet at home, only 229 (55.31%) reported to always use a toilet for sanitation purposes. Despite a high rate of awareness among school children regarding schistosomiasis, there was a persistent gap amongst the children regarding the causes, modes of transmission, symptoms, and preventive measures for the disease. Therefore, an appropriate health education intervention is needed in order to inculcate better knowledge, attitudes, and practices amongst school children regarding its transmission, control, and prevention as part of a successful schistosomiasis campaign.
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    Monitoring of efficacy and safety of artemisinin-based anti-malarials for treatment of uncomplicated malaria: a review of evidence of implementation of anti-malarial therapeutic efficacy trials in Tanzania
    (Springer, 2015) Shayo, Alex; Buza, Joram; Ishengoma, Deus S.
    Prompt diagnosis and effective treatment are considered the cornerstones of malaria control and artemisinin-based combination therapy (ACT) is currently the main anti-malarial drugs used for case management. After deployment of ACT due to widespread parasite resistance to the cheap and widely used anti-malarial drugs, chloroquine and sulphadoxine/pyrimethamine, the World Health Organization recommends regular surveillance to monitor the efficacy of the new drugs. The present paper assessed the implementation of anti-malarial efficacy testing for monitoring the therapeutic efficacy of ACT for treatment of uncomplicated malaria in Tanzania before and after policy changes in 2006. A literature search was performed for published clinical trials conducted in Tanzania from 2001 to 2014. It focused on studies which assessed at least one form of ACT for treatment of uncomplicated falciparum malaria in children less than 10 years and reported efficacy and safety of the tested anti-malarials. References were imported into the Endnote library and duplicates removed. An electronic matrix was developed in Microsoft Excel followed by full text review with predetermined criteria. Studies were independently assessed and information related to ACT efficacy and safety extracted. Nine papers were selected from 125 papers screened. The efficacy of both artemether lumefantrine (AL) and artesunate-amodiaquine (AS + AQ) against uncomplicated P. falciparum infections in Tanzania was high with PCR corrected cure rates on day 28 of 91-100% and 88-93.8%, respectively. The highest day-3 parasite positivity rate was 1.4%. Adverse events ranged from mild to serious but were not directly attributed to the drugs. ACT is efficacious and safe for treatment of uncomplicated malaria in Tanzania. However, few trials were conducted in Tanzania before and after policy changes in 2006 and thus more surveillance should be urgently undertaken to detect future changes in parasite sensitivity to ACT.
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    Pattern and distribution of colorectal cancer in Tanzania: a retrospective chart audit at two National hospitals
    (Hindawi, 2016) Katalambula, Leonard K.; Ntwenya, Julius Edward; Ngoma, Twalib; Buza, Joram; Mpolya, Emmanuel; Mtumwa, Abdallah H.; Petrucka, Pammla
    Colorectal cancer (CRC) is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (x2) tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06%) and females (49.94%), although gender likelihood of diagnosis type (i.e., rectal or colon) was significantly different (P=0.027). More than 60% of patients were between 40 and 69 years. Conclusions. Age (P=0.0183) and time (P=0.004) but not gender (P=0.0864) were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P=0.0405), age (P=0.0015), and time (P=0.0075) were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate.
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    The prevalence and determinants of Taenia multiceps infection (Cerebral Coenurosis) in small ruminants in Africa: A systematic review
    (MDPI, 2022) Kibona, Tito; Buza, Joram; Shirima, Gabriel; Lankester, Felix; Ngongolo, Kelvin; Hughes, Ellen; Cleaveland, Sarah; Allan, Kathryn J.
    Cerebral coenurosis is a fatal parasitic neurological disease affecting the brain and spinal cord of goats and sheep. Despite the large population of sheep and goats in Africa, there is very little awareness about the scale or effects of the disease. A systematic review was conducted to bridge the gap in the current understanding of the epidemiology of Taenia multiceps coenurosis in Africa. A detailed literature search was conducted in EBSCOhost, Google Scholar, Research4life (AGORA), and PubMed for studies in T. multiceps coenurosis in goats and sheep in Africa for the period spanning January 2000 to December 2019. The search identified 574 publications, of which only 11 studies were eligible, highlighting major gaps in reporting of this disease in Africa. Data were extracted and evidence synthesized in relation to prevalence and determinants for T. multiceps coenurosis. The descriptive summary statistics revealed a median (IQR) prevalence of coenurosis of 22.3% (range: 18.3–26.4 percent) for community based and 14.8% (range: 3.8–45.6) for abattoir-based studies. This high prevalence indicates that Taenia multiceps coenurosis is an important disease for small ruminant productivity in Africa. Knowledge of the determinants of prevalence could be used to inform preventive measures, including behaviour change among livestock keepers and those involved in livestock slaughter to break cycles of transmission between small ruminants and dogs