Browsing by Author "Petrucka, Pammla"

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Assessment of sputum smear-positive but culture-negative results among newly diagnosed pulmonary tuberculosis patients in Tanzania
(Dove Press, 2017) Mnyambwa, Nicholaus Peter; Ngadaya, Esther S; Kimaro, Godfather; Kim, Dong-Jin; Kazwala, Rudovick; Petrucka, Pammla; Mfinanga, Sayoki G
Diagnosis of pulmonary tuberculosis (TB) in technology-limited countries is widely achieved by smear microscopy, which has limited sensitivity and specificity. The frequency and clinical implication of smear-positive but culture-negative among presumptive TB patients remains unclear. A cross-sectional substudy was conducted which aimed to identify the proportion of nontuberculous mycobacteria (NTM) infections among 94 “smear-positive culture-negative” patients diagnosed between January 2013 and June 2016 in selected health facilities in Tanzania. Out of 94 sputa, 25 (26.60%) were GeneXpert® mycobacteria TB positive and 11/94 (11.70%) repeat-culture positive; 5 were Capilia TB-Neo positive and confirmed by GenoType MTBC to be Mycobacterium tuberculosis/Mycobacterium canettii. The remaining 6 Capilia TB-Neo negative samples were genotyped by GenoType® CM/AS, identifying 3 (3.19%) NTM, 2 Gram positive bacteria, and 1 isolate testing negative, together, making a total of 6/94 (6.38%) confirmed false smear-positives. Twenty-eight (29.79%) were confirmed TB cases, while 60 (63.83%) remained unconfirmed cases. Out of 6 (6.38%) patients who were HIV positive, 2 patients were possibly coinfected with mycobacteria. The isolation of NTM and other bacteria among smear-positive culture-negative samples and the presence of over two third of unconfirmed TB cases emphasize the need of both advanced differential TB diagnostic techniques and good clinical laboratory practices to avoid unnecessary administration of anti-TB drugs.
Contribution of home and school environment in children’s food choice and overweight/obesity prevalence in African context: evidence for creating enabling healthful food environment
(DovePress, 2020) Pacific, Renatha; Martin, Haikael D.; Kulwa, Kissa; Petrucka, Pammla
Abstract: This review aimed primarily to investigate the current trends of overweight and obesity in school children in the African context, secondly to explore the contribution of home and school environments on the children’s food choices and lastly suggesting measures for creating a healthier food environment. Despite the increase in overweight and obesity among school children, empirical evidence on their determinants in the African context is scarce, thus calls for consideration of home and school environments. A literature search was conducted between October and December 2018 using Medline (PubMed), Directory of Open Access Journals, Google Scholar, manual search and “grey” literature. This review included articles published between the 1st January 2008 and 30th June 2018. Out of 343 articles, 49 were included for the full text reading after meeting the inclusion criteria. Five reports from grey literature were also included. Results show that the prevalence of over- weight and obesity among school children in Africa is increasing and ranges from <5% to >40% in the 10-year period in which the review was taken. High socio-economic status, urban residence and female gender predicted higher prevalence of overweight/obesity. Few reviewed articles on the contribution of home and school environments on children’s food choices showed a shred of evidence, thus calls for further research to address this gap. This review found an increasing prevalence of overweight and obesity in school children in Africa. Therefore, further investigation of home and school environment is imperative to curb the increase in the magnitude of overweight and obesity.
Insulin resistance among pregnant women in urban areas of Arusha region, Tanzania
(Mary Ann Liebert, Inc., 2019) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
Aim: To establish the prevalence of insulin resistance (IR) and its determinants among selected pregnant women in urban Arusha for taking preventive measures. Methods: A cross-sectional study was conducted between March and December 2018 at Ngarenaro and Kaloleni health facilities in Arusha District involving 230 randomly selected pregnant women who were not known to have diabetes before pregnancy. Blood glucose at fasting and 2 hr after consuming 75 grams of glucose dissolved in 300 mL of water was measured using Gluco-Plus , serum insulin concentrations using ELISA machine (Synergy/HTX ; BioTek), and IR was calculated using the Homeostasis Model of Assessment formula. Body fat was measured using a bioelectric impedance analyzer, mid-upper arm circumference using a regular tape, weight using SECA , blood pressure using GT-868UF Geratherm machine, and height by stadiometer. Maternal characteristics were collected through face to face interviews using a structured ques- tionnaire. Data were analyzed using the Statistical Package for Social Science Version 20. Results: The prevalence of IR was 21% (n = 49) and significantly associated with increased body fat percentage (adjusted odds ratio [AOR]: 1.68, 95% confidence interval [CI]: 1.01–2.5), family history of Type 2 diabetes mellitus (T2DM; AOR: 2.77, 95% CI: 1.21–6.33), hypertension (AOR: 2.5, 95% CI: 1.12–5.6), edema (AOR: 3.01, 95% CI: 1.31–6.96), and proteinuria (AOR: 3.44, 95% CI: 1.11–10.69). Conclusions: IR was higher among pregnant women with increased body fat percentage, family history of T2DM, hypertension, edema, and proteinuria. These findings call for large-scale screening to further explore risk factors to prevent gestational diabetes mellitus.
Nutritional status and dietary habits of urban and peri-urban primary school children (10-13 years) in Tanzania: A comparative study between public and private schools
(INNSPUB, 2021) Pacific, Renatha; Martin, Haikael D.; Kulwa, Kissa; Petrucka, Pammla
This study determined overweight and obesity prevalence and its association with dietary habits in primary school children in Ilala and Mkuranga Districts, Tanzania. A comparative cross-sectional survey was carried out among 406 school children (10- 13 years). Indices such as weight, height, mid-upper arm circumference, and body composition were measured. Body Mass Index-for-age-related Z-scores were computed using the World Health Organization's AnthroPlusTM software to classify children's nutrition status according to the defined cut-off values. A structured questionnaire collected dietary habits data. Descriptive, non-parametric methods and regression were used for analysis. A combined prevalence of overweight and obesity was 22.6%, significantly higher in private than in public schools (32.4% vs. 14.8%, p<0.001). Prevalence of thinness was 3.9% and stunting was 10.1%. It is clear that medians for body mass index for age (p=0.002), percentage body fat (p<0.001), and mid-upper arm circumference (p<0.001) were significantly higher in private schools than in public schools. Girls also had higher median BMI-for-age (p=0.021), percentage body fat (p<0.001), and mid-upper arm circumference (0.006) than boys. Consumption of fruits, vegetables, and milk was relatively low in all participants. Intake of cereal foods and sugary snacks among boys and low preference for fruit among girls was associated with high median BMI-for-age (p<0.05). The prevalence of overweight and obesity among school children is high. Median BMI-for-age was associated with selected dietary habits. Context-specific school-based interventions are fundamental in reducing the prevalence of overweight/obesity and modifying the dietary habits of school children after formulating policy options.
Physical activity and sedentary behaviors associated with overweight and obesity among primary school children in Tanzania: a case-control study
(Emerald, 2021) Pacific, Renatha; Kulwa, Kissa; Martin, Haikael D.; Petrucka, Pammla
Purpose – This study aims at determining the risk of physical inactivity and sedentary behaviors on overweight and obesity among primary school children aged 10–13 years in Tanzania. Design/methodology/approach – A case-control study was conducted from January to March 2020 involving 69 overweight/obese children as cases and 138 normal weight children as controls. Cases were identified as having body mass index-for-age þ1 standard deviation (SD) and controls as those having BMI-for-age range between 2 SD to <þ1 SD. A validated questionnaire was used for data collection on daily physical activities and sedentary behavior types, frequency duration and activity score. An independent sample t-test was used to compare means of activity score between cases and controls. Binary logistic regression was used to predict risk factors for overweight/obesity. Findings – Risk factors for overweight/obesity were listening to music and/or radio for >2 h/week (OR 2.7, 95% CI 1.2–6.1) and walking for exercise <2 h/week (OR 2.1, 95% confidence interval [CI] 1.1–4.1). On the other hand, rope skipping for >2 h/week (OR 0.14, 95% CI 0.03–0.7) was a protective factor against overweight/obesity. Controls had a significantly higher mean score of being active during lunch breaks compared to cases (p = 0.012). Cases had higher weight, height and percentage body fat than controls (p < 0.001). The home environment provided more avenues for physical activity than the school environment. Originality/value – To the best of the authors’ knowledge, this is original research work and the first case- control study to predict physical activity and sedentary behaviors as risk factors for overweight and obesity in Tanzanian school children.
Prevalence of hyperglycemia in pregnancy and influence of body fat on development of hyperglycemia in pregnancy among pregnant women in urban areas of Arusha region, Tanzania
(BMC Pregnancy and Childbirth, 2019) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
Background: Hyperglycemia in pregnancy is a medical condition resulting from either pre-existing diabetes or insulin resistance developed during pregnancy. This study aimed to determine the prevalence of hyperglycemia in pregnancy and influence of body fat percentage and other determinants on developing hyperglycemia in pregnancy among women in Arusha District, Tanzania. Methods: A cross–sectional study was conducted between March and December 2018 at selected health facilities in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Blood glucose was tested by Gluco-PlusTM using the World Health Organization criteria at fasting and 2 h after consuming 75 g of glucose dissolved in 300 ml of water. Body fat was measured using a bioelectric impedance analyzer, mid- upper arm circumference using a regulated tape, weight using SECATM, blood pressure using a GT-868UF GerathermTM machine, and height using a stadiometer. Demographic and maternal characteristics were collected through face to face interviews using a structured questionnaire. Results: The participants’ mean age was 28 years (SD ± 6), mid-upper arm circumference 27 cm (SD ± 3.7), body fat 33.72% (SD ± 7.2) and pre-pregnancy body mass index 25.6 kg/m 2 (SD ± 5.5). One-third of participants had mid- upper arm circumferences ≥28 cm with 25% being overweight and 22.7% obese before pregnancy. Prevalence of hyperglycemia in pregnancy was 16.2% (n = 76) of which 13% had gestational diabetes and 3.2% diabetes in pregnancy. Hyperglycemia in pregnancy was significantly associated with body fat percentage (AOR 1.33; 95% CI: 1.22–1.44), family history of Type 2 diabetes mellitus (AOR 6.95, 95% CI: 3.11–15.55), previous delivery of babies ≥4 kg (AOR 2.3, 95% CI: 1.00–5.28), mid-upper arm circumference ≥ 28 cm (AOR 1.2, 95% CI: 1.09–1.32), and Type 2 diabetes mellitus symptoms (AOR 2.83, 95% CI: 1.53–6.92). Conclusion: The prevalence of hyperglycemia in pregnancy was high, particularly among women with history of delivering ≥4-kg babies, increased body fat, mid-upper arm circumference, symptoms and/or family history of Type 2 diabetes mellitus. These findings identify opportunities to further explore the utility of body fat percentage and other determinants for rapid screening and management of hyperglycemia in pregnancy.
Simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania
(BMC Pregnancy and Childbirth, 2022) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
Background: Screening for gestational diabetes mellitus in Tanzania is challenged by limited resources. Therefore, this study aimed to develop a simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania. Methods: This study used data from a cross sectional study, that was conducted between March and December 2018 in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Urine glucose was tested using urine multistics and blood glucose levels by Gluco-Plus TM and diagnosed in accord- ance with the World Health Organization’s criteria. Anthropometrics were measured using standard procedures and maternal characteristics were collected through face-to-face interviews using a questionnaire with structured ques- tions. Univariate analysis assessed individual variables association with gestational diabetes mellitus where variables with p-value of < 0.05 were included in multivariable analysis and predictors with p-value < 0.1 remained in the final model. Each variable was scored based on its estimated coefficients and risk scores were calculated by multiplying the corresponding coefficients by ten to get integers. The model’s performance was assessed using c-statistic. Data were analyzed using Statistical Package for Social Science TM . Results: The risk score included body fat ≥ 38%, delivery to macrosomic babies, mid-upper arm circumfer- ence ≥ 28 cm, and family history of type 2 diabetes mellitus. The score correctly identified 98% of women with ges- tational diabetes with an area under the receiver operating characteristic curve of 0.97 (95% CI 0.96–0.99, p < 0.001), sensitivity of 0.98, and specificity of 0.46. Conclusion: The developed screening tool is highly sensitive and correctly differentiates women with and without gestational diabetes mellitus in a Tanzanian sub-population.