Master Dissertations

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Browsing Master Dissertations by Subject "ACS"

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    Iron profiles and associated factors among children with sickle cell disease at St. Gema hospital and Dodoma regional referral hospital in Dodoma city
    (The University of Dodoma, 2021) Bossy, Asha Omary
    Patients with sickle cell disease (SCD) are prone to iron profile derangements. This study aimed to determine the prevalence of iron deficiency and iron overload and their predictors among children aged between 6 months and 18 years at both St. Gemma Hospital (SGH) and Dodoma Regional Referral Hospital (DRRH) in Dodoma city. This was a cross-sectional analytical hospital-based study which included 174 patients with SCD attending SCD clinics at SGH and DRRH in Dodoma city from October 2020 to March 2021.Statistical analysis was done using SPSS version 20.0. Binary logistic regression was used to determine the predictors of both iron deficiency and iron overload. P-value less than 5% was considered significant. The prevalence of iron deficiency and iron overload in this study was 28 (16.1%) and9 (5.2%), respectively. Family income of less than 70, 000/= Tshs/month (AOR=2.2, 95% CI=1.073-2.490, p=0.023), transfused with bloodless than 3 times (AOR = 5.45, 95% CI = 1.029-8.905, p = 0.046), and eating red meat per month (AOR = 3.60, 95% CI = 1.366-9.462, p = 0.010) were the predictors of iron deficiency. Moreover, being transfused with blood 3 times and above 3 months prior to enrollment into the study (AOR = 7.917, 95% CI = 1.256-9.888, p = 0.028) was the predicting factor of iron overload. The prevalence of iron deficiency and that of overload both indicate that, patients with SCD were at a high risk of getting deficiency of iron and at the same time a number of them might be affected with iron overload due to repeated episodes of blood transfusion. Although blood transfusion is a lifesaving process, measures should always be taken to prevent patients with SCD from ending with iron overload.
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    Prevalence and factors associated with impaired lung function in children with sickle cell disease-acomparative cross-sectional study in Dodoma city, Tanzania
    (The University of Dodoma, 2022) Mbotoni, Tatu Seif
    Children with Sickle Cell Disease (SCD) are susceptible to several recurrent lung injuries that might lead to progressive impaired lung function. The magnitude and factors associated with this complication in Tanzania which is the fourth highest SCD prevalence globally is unknown. Lung function evaluation among children with SCD is not routinely performed. This study was conducted to determine the prevalence and factors associated with impaired lung functions in children with SCD compared to non-SCD. This was a comparative cross-sectional study conducted from December 2021 to May 2022 enrolling 115 children, 59 with SCD and 56 non SCD aged 6 -18 years. A semi structured questionnaire was used to collect demographic and clinical details of children with SCD and their comparative group. Lung function test was `performed using spirometry ndd Easy OneTM spirometer (Medizintechnich Switzerland). Lung function impairment was defined as any value below the predicted lower limit of normal (FEV1/FVC below 85% of predicted value for obstructive and FVC below 80% for restrictive). Hemoglobin level was measured and hemoglobin electrophoresis for the SCD group. Frequency, proportion, t-test and binary logistic regression was used for analysis. SPSS version 26 was used to analyze data and p< 0.05 was considered statistically significant. Out of 115 participants 61(53.04%) were females and the mean age of all participant was 9.67 ± 3.07. In SCD group females were 35(53.38%) with the mean age of 9.39 ±3.04. In children with no SCD majority were males 30(55.56%) with mean age of 9.95±3.09. Prevalence of impaired lung function among children with SCD was 52.5% and for non SCD group was 10.72%. Factors significantly associated with impaired lung function were low fetal hemoglobin (AOR=0.878, 95%CL [0.779, 0.989], p=0.0326), low blood pressure (AOR=0.196, 95%CL [0.069, 0.960], p=0.0311) older age at starting SCD clinic (AOR=2.220, 95%CL [1.780, 4.332], p=0.0169) and older age of the child 2. 908[1.220, 16.554], p=0.0367. Lung function impairment is prevalent in Tanzanian children with SCD as compared to their counterparts with predominance of restrictive pattern. Early screening of lung function is of significance especially to those with risk factors in order to diagnose them early and plan interventions for management and prevention
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    Prevalence and factors associated with renal dysfunction among children with sickle cell disease in Dodoma urban, Tanzania
    (The University of Dodoma, 2021) Nywage, Elita Erasto
    Sickle Cell Disease (SCD) is an established cause of progressive renal dysfunction which is increasingly associated with the development of end-stage renal disease. Identifying and preventing factors related to renal dysfunction in this population constitute a crucial strategy to halt the occurrence of this life-limiting complication. This study was conducted to determine factors associated with renal dysfunction among children with SCD. The referred were attended at two outpatient clinics in Dodoma, central Tanzania. This study aimed to determine the prevalence and factors associated with renal dysfunction among children with SCD aged one year to 18 years. This was a cross-sectional analytical study which was conducted from August 2020 to February 2021and involved 240 children with SCD aged 1 to 18 years. Demographic and clinical parameters were recorded using a structured questionnaire. Laboratory tests to evaluate renal dysfunction urine albumin and serum creatinine were conducted. Estimated glomerular filtration rate (eGFR) was calculated using the Schwartz formula. Renal dysfunction was defined as albuminuria of 30mg/g or eGFR of <60 ml/min/1.73m2. Statistical relationships were ascertained using chi-square test and multivariate analysis was conducted to determined predictors of renal dysfunction. Data analysis was performed using SPSS version 26 and statistical significance was assumed for factors with P < 0.05. Out of 240 children enrolled, 81 (33.8%) had renal dysfunction. Malnutrition (AOR=5.1, 95% CI [2.4 – 10.5], p <0.001), jaundice (AOR= 4.9, 95% CI [2 – 11.8], p <0.001) and leukocytosis (AOR=5.7, 95% CI [2 – 16.4], <0.001) were independently associated with renal dysfunction. High prevalence of renal dysfunction among children with SCD was observed in this study and factors which were associated with renal dysfunction included jaundice, malnutrition and leukocytosis on full blood picture. Urinary microalbuminuria is cheap, simple and quick test that can pick up the patients who may need further interventions during routine clinic visits, it can be done every after twelve month starting at age of one year.