1
|
Ngowi BN, Mremi A, Mbwambo OJ, Mitao MP, Nyindo M, Mteta KA, Mmbaga BT. Prostate cancer knowledge and barriers to screening among men at risk in northern Tanzania: A community-based study. Cancer Treat Res Commun 2024; 39:100811. [PMID: 38574439 DOI: 10.1016/j.ctarc.2024.100811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 03/27/2024] [Accepted: 03/29/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Although prostate cancer (Pca) screening plays important role in early diagnosis and reduction of mortality, Tanzanian men are relatively unscreened. We aimed to investigate Pca knowledge level and barriers to screening among at-risk men in northern Tanzania. METHODS This community-based survey was conducted in northern Tanzania from May to September 2022, involving men age ≥40 years. Participants were invited by announcing in local churches, mosques, brochures, and social media groups. Participants attended a nearby health facility where survey questionnaires were administered. Knowledge level was measured on the Likert scale and scored as poor (<50 %) or good (≥50 %). RESULTS A total of 6205 men with a mean age of 60.23 ± 10.98 years were enrolled in the study. Of these, 586 (9.5 %) had ever been screened for Pca. Overall, 1263 men (20.4 %) had good knowledge of Pca. Having health insurance, knowing at least 1 risk factor or symptoms of Pca, and hospital as the source of Pca information were significantly associated with ever being screened. The most common reasons for not being screened were a belief that they are healthy (n = 2983; 53.1 %), that Pca is not a serious disease (n = 3908; 69.6 %), and that digital rectal examination (DRE) as an embarrassing (n = 3634; 64.7 %) or harmful (n = 3047; 54.3 %) procedure. CONCLUSION Having Pca knowledge, health insurance and hospital source of information were correlated with increased screening. False beliefs about DRE and the seriousness of Pca had negative effects on screening. Increasing community knowledge and universal health coverage would improve uptake of Pca screening.
Collapse
Affiliation(s)
- Bartholomeo Nicholaus Ngowi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P. O. Box 2240, Moshi Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P. O. Box 3010 Moshi Tanzania.
| | - Alex Mremi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P. O. Box 2240, Moshi Tanzania; Department of Pathology, Kilimanjaro Christian Medical Centre, P. O. Box 3010 Moshi Tanzania
| | - Orgeness Jasper Mbwambo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P. O. Box 2240, Moshi Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P. O. Box 3010 Moshi Tanzania
| | | | - Mramba Nyindo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P. O. Box 2240, Moshi Tanzania
| | - Kien Alfred Mteta
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P. O. Box 2240, Moshi Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P. O. Box 3010 Moshi Tanzania
| | - Blandina Theophil Mmbaga
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P. O. Box 2240, Moshi Tanzania; Kilimanjaro Clinical Research Institute, P. O. Box 2236 Moshi Tanzania
| |
Collapse
|
2
|
Ngowi BN, Kimolo M, Mbwambo J, Bright F, Mremi A, Mbwambo OJ. Giant intravesical prostatic protrusion mimicking bladder carcinoma: Navigating diagnostic and management challenges. Int J Surg Case Rep 2024; 118:109590. [PMID: 38581945 PMCID: PMC11004631 DOI: 10.1016/j.ijscr.2024.109590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/08/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Benign prostate hyperplasia is common condition among elderly men, but giant intravesical prostatic protrusion is rare and may be confused with bladder carcinoma. CASE PRESENTATION We report an unusual case of giant intravesical prostatic protrusion mimicking bladder carcinoma. A diagnosis of giant intravesical prostatic protrusion was confirmed with the assistance of cystoscopy and patient was managed by transvesical simple open prostatectomy where he had uneventfully recovery. CLINICAL DISCUSSION Both bladder carcinoma and benign prostate hyperplasia are more prevalent in elderly men and they all present with lower urinary tract symptoms. Ultrasound and computer tomography may all suggest bladder carcinoma. The two conditions are treated differently, and therefore having correct diagnosis is mandatory. Cystoscopy is an important investigation that can act as a tiebreaker in differentiating giant intravesical prostatic protrusion from bladder carcinoma. Transvesical simple open prostatectomy is the preferred surgical approach with good postoperative outcome. CONCLUSION This case report reminds urology surgeons on the possibility of having giant intravesical prostate mimicking bladder carcinoma and the importance of cystoscopy in differentiating the two. Transvesical simple open prostatectomy has promising result.
Collapse
Affiliation(s)
- Bartholomeo Nicholaus Ngowi
- Faculty of medicine, Kilimanjaro Christian medical university college, P. O. Box 2240, Moshi, Tanzania; Department of urology, Kilimanjaro Christian Medical Centre, P. O. Box 3010, Moshi, Tanzania.
| | - Mathias Kimolo
- Faculty of medicine, Kilimanjaro Christian medical university college, P. O. Box 2240, Moshi, Tanzania
| | - Jasper Mbwambo
- Faculty of medicine, Kilimanjaro Christian medical university college, P. O. Box 2240, Moshi, Tanzania
| | - Frank Bright
- Faculty of medicine, Kilimanjaro Christian medical university college, P. O. Box 2240, Moshi, Tanzania; Department of urology, Kilimanjaro Christian Medical Centre, P. O. Box 3010, Moshi, Tanzania
| | - Alex Mremi
- Faculty of medicine, Kilimanjaro Christian medical university college, P. O. Box 2240, Moshi, Tanzania; Department of pathology, Kilimanjaro Christian Medical Centre, P. O. Box 3010, Moshi, Tanzania
| | - Orgeness Jasper Mbwambo
- Faculty of medicine, Kilimanjaro Christian medical university college, P. O. Box 2240, Moshi, Tanzania; Department of urology, Kilimanjaro Christian Medical Centre, P. O. Box 3010, Moshi, Tanzania
| |
Collapse
|
3
|
Mremi A, Mpelumbe J, Kasyupa FE, Patrick E, Mbwambo OJ, Ngowi BN. A case report of two synchronous primary urologic malignancies in one patient. J Surg Case Rep 2024; 2024:rjae130. [PMID: 38476454 PMCID: PMC10930189 DOI: 10.1093/jscr/rjae130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/14/2024] Open
Abstract
It is quite unusual to have numerous primary malignant tumors at the same time in the same patient. These cancers are classified as metachronous or synchronous. The occurrence of synchronous urologic tumors poses diagnostic and treatment challenges and has always been a subject of controversy in the clinical decision-making process. Unfortunately, no clear standardized management protocols for these patients exist. Therefore, diagnosis and treatment may be difficult, especially with few resources. We present a 75-year-old man with simultaneous prostate and kidney cancers successfully treated at our center. This is one of the rare cases in the English literature with two primary urologic cancers.
Collapse
Affiliation(s)
- Alex Mremi
- Department of Pathology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Janeth Mpelumbe
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, Moshi, P.O. Box 3010, Tanzania
| | - Furaha Enos Kasyupa
- Department of Pathology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania
| | - Elizabeth Patrick
- Cancer Care Center, Kilimanjaro Christian Medical Centre, Moshi, P.O. Box 3010, Tanzania
| | - Orgeness Jasper Mbwambo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, Moshi, P.O. Box 3010, Tanzania
| | - Bartholomeo Nicholaus Ngowi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, Moshi, P.O. Box 3010, Tanzania
| |
Collapse
|
4
|
Mwasakyalo GS, Bright F, Mbwambo OJ, Ngowi BN, Mwakibibi D, Mbwambo JS, Majura MR, Sanga EA, Mremi A. Distal penile pyogenic granuloma: A case report. Clin Case Rep 2024; 12:e8659. [PMID: 38464565 PMCID: PMC10923701 DOI: 10.1002/ccr3.8659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 02/21/2024] [Accepted: 03/01/2024] [Indexed: 03/12/2024] Open
Abstract
Key Clinical Message The mainstays of treatment for granuloma pyogenicum include careful evaluation of any penile growth, thorough excision of the polypoid, histological examination, and close monitoring to check relapse and management. Abstract Pyogenic granuloma is an acquired noncancerous vascular proliferation that arises from the mucosa and skin, seldom subcutaneously or intravascularly. It is also referred to as telangiectasis granuloma or lobular capillary haemangioma. The risk factors include vascular abnormalities, medicines, hormones, and microtrauma. We discussed the case of a 24-year-old man who had a poorly managed ventral distal penile polypoid lesion at a peripheral hospital. Upon further histopathological examination, the diagnosis of pyogenic granuloma was made. Histopathologically speaking, the term "pyogenic granuloma" is misleading because the illness is not linked to the production of granulomas. Pyogenic granuloma's etiopathogenesis is still unknown; true hemangioma is thought to be a reactive hyperproliferative of the vasculature brought on by a variety of stimuli; pyogenic granuloma may be caused by uneven angiogenic factor production in response to minor local trauma or cutaneous disease. Histopathological analysis and surgical excision are the methods used for diagnosis and treatment. The mainstay of treatment for granuloma pyogenic granuloma includes careful evaluation of any penile growth, thorough excision of the polypoid, histological examination, close follow-up to check for relapse, and early management.
Collapse
Affiliation(s)
- Gideon Safiel Mwasakyalo
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Frank Bright
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Orgenes Jasper Mbwambo
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Bartholomeo Nicholaus Ngowi
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Daniel Mwakibibi
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Jasper Saidi Mbwambo
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | | | - Evans Azina Sanga
- Department of Anaesthesia and Critical careMinistry of Health Social Services (hMOHSS) District Hospital KeetmanshoopKharasNamibia
| | - Alex Mremi
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of PathologyKilimanjaro Christian Medical CentreMoshiTanzania
| |
Collapse
|
5
|
Ngowi BN, Bright F, Mremi A, Kimolo M, Mteta AK, Mbwambo OJ. Primary diffuse large B-cell lymphoma of the kidney: A rare case report and review of literature. Int J Surg Case Rep 2023; 108:108428. [PMID: 37364464 PMCID: PMC10382755 DOI: 10.1016/j.ijscr.2023.108428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Lymphoma can either be Hodgkin or non-Hodgkin (NHL) with diffuse large B cell lymphoma (DLBL) being a type of the latter with an aggressive behavior. Although it is common for NHL to involve the kidney in its advanced stages, disease that primarily originates from the kidney is rare and therefore poses a diagnostic challenge. CASE PRESENTATION We presented a case of NHL that was initially thought to be Renal Cell Carcinoma (RCC) but later confirmed histologically to be diffuse large B cell Lymphoma. The patient was kept on doxorubicin, cyclophosphamide and dexamethasone. However, on day five of the treatment he succumbed. CLINICAL DISCUSSION Lymphoma can be broadly grouped into Hodgkin and non-Hodgkin Lymphoma. Primary kidney lymphoma accounts for <1 % with non-specific symptoms hence can be challenging in the diagnosis. Biopsy yields in the diagnosis and management is primarily chemotherapy. CONCLUSION This case reminds health care professional on the possibility of having primary Lymphoma of the kidney in a patients with renal mass. Treatment of lymphoma is different from RCC, a common renal malignancy in adult. Therefore, tissue biopsy for definitive diagnosis is mandatory before initiation of treatment.
Collapse
Affiliation(s)
- Bartholomeo Nicholaus Ngowi
- Faculty of Medicine, Kilimanjaro Christian medical university college, P. O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P. O. Box 3010, Moshi, Tanzania.
| | - Frank Bright
- Faculty of Medicine, Kilimanjaro Christian medical university college, P. O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P. O. Box 3010, Moshi, Tanzania
| | - Alex Mremi
- Faculty of Medicine, Kilimanjaro Christian medical university college, P. O. Box 2240, Moshi, Tanzania; Department of Pathology, Kilimanjaro Christian Medical Centre, P. O. Box 3010, Moshi, Tanzania
| | - Mathias Kimolo
- Department of Urology, Kilimanjaro Christian Medical Centre, P. O. Box 3010, Moshi, Tanzania
| | - Alfred Kien Mteta
- Faculty of Medicine, Kilimanjaro Christian medical university college, P. O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P. O. Box 3010, Moshi, Tanzania
| | - Orgeness Jasper Mbwambo
- Faculty of Medicine, Kilimanjaro Christian medical university college, P. O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P. O. Box 3010, Moshi, Tanzania
| |
Collapse
|
6
|
Mbwambo OJ, Pallangyo A, Mbwambo JS, Bright F, Mteta AK, Bogdanowicz J, Ngowi BN. Primary scrotal lipoma posing a diagnostic quandary: Experience from northern Tanzania, a case report. Clin Case Rep 2023; 11:e7503. [PMID: 37323280 PMCID: PMC10264745 DOI: 10.1002/ccr3.7503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/06/2023] [Accepted: 05/25/2023] [Indexed: 06/17/2023] Open
Abstract
Primary scrotal lipoma is a rare urological diagnosis. It is usually diagnosed incidentally as most of time initial diagnosis may be confused with other common etiology of scrotal masses. A rare case of scrotal lipoma with initial misdiagnosis of hydrocele at primary health facility is presented in this article.
Collapse
Affiliation(s)
- Orgeness Jasper Mbwambo
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Angela Pallangyo
- Department of PathologyKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of PathologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Jasper Saidi Mbwambo
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Frank Bright
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Alfred K. Mteta
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | | | - Bartholomeo Nicholaus Ngowi
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| |
Collapse
|
7
|
Thomas JA, Ngowi BN, Mpelumbe J, Mwasakialo G, Mbwambo JS, Bogdanowicz J, Bright F, Kien Mteta A, Mbwambo OJ. Intravesical textiloma mistook for bladder stone: A case report. Clin Case Rep 2023; 11:e7434. [PMID: 37305858 PMCID: PMC10248209 DOI: 10.1002/ccr3.7434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/07/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023] Open
Abstract
Key Clinical Message Intravesical textiloma is a rare surgical complication, that may cause nonspecific lower urinary tract symptoms. Clinicians should consider it in patients with a history of bladder surgery and persistent or new-onset urinary symptoms. Abstract Intravesical textiloma is a rare condition usually presents asymptomatic or with non specific symptoms. A 72 years old man with prior open prostatectomy presented lower urinary tract symptoms and diagnosed with bladder stones, explorative laparotomy revealed semi calcified gauze. Similar history should prompt suspicion of this condition.
Collapse
Affiliation(s)
- Jonaviva Anthony Thomas
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
| | - Bartholomeo Nicholaus Ngowi
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Janeth Mpelumbe
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Gideon Mwasakialo
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Jasper Saidi Mbwambo
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Jack Bogdanowicz
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Frank Bright
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Alfred Kien Mteta
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Orgeness Jasper Mbwambo
- Department of Urology, Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| |
Collapse
|
8
|
Lodhia J, Mremi A, Robert B, Sadiq A, Bright F, Mbwambo OJ, Ngowi BN. An unusual presentation of penetrating bladder injury with vesicocutaneous fistula: a case report. BMC Urol 2023; 23:80. [PMID: 37138272 PMCID: PMC10158159 DOI: 10.1186/s12894-023-01254-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/19/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND Blunt trauma to the urinary bladder is common with penetrating injury being a rare occasion. Most common entry pint for penetrating injuries includes buttock, abdomen and perineum with thigh being rare. There are a number of complications that may develop as a result of penetrating injury with vesicocutanous fistula being a rare occurrence that usually presents with typical sign and symptoms. CASE PRESENTATION We present a rare case of penetrating bladder injury through medial upper thigh as an entry point that had complicated into vesicocutaneous fistula with atypical presentation of long-standing pus discharge that had been managed by incision and drainage several times with no success. MRI demonstrated a presence of fistula tract and a foreign body (piece of wood) in-situ confirmed the diagnosis. CONCLUSION Fistulas are a rare complication of bladder injuries and can cause negative impact on the quality of life of patients. Delayed urinary tract fistulations and secondary thigh abscesses are uncommon therefore a high index of suspicion is needed for early diagnosis. This case emphasizes the importance of radiological tests in aiding the diagnosis and ultimately proper management.
Collapse
Affiliation(s)
- Jay Lodhia
- Department of General Surgery, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania.
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240, Moshi, Tanzania.
| | - Alex Mremi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240, Moshi, Tanzania
- Department of Pathology, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania
| | - Bahati Robert
- Department of General Surgery, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania
| | - Adnan Sadiq
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240, Moshi, Tanzania
- Department of Radiology, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania
| | - Frank Bright
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240, Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania
| | - Orgeness Jasper Mbwambo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240, Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania
| | - Bartholomeo Nicholaus Ngowi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240, Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010, Moshi, Tanzania
| |
Collapse
|
9
|
Kimolo M, Mbwambo OJ, Seif M, Mbwambo JS, Mremi A, Mteta AK, Bright F, Ngowi BN. Giant perineal epidermoid cyst in adult man: a rare case report and review of literature. J Surg Case Rep 2023; 2023:rjad243. [PMID: 37255952 PMCID: PMC10226807 DOI: 10.1093/jscr/rjad243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 04/10/2023] [Indexed: 06/01/2023] Open
Abstract
An epidermoid cyst is a common benign cutaneous mass that mostly occurs on the neck, face and trunk. The majority of epidermoid cysts are small and asymptomatic with the giant perineal epidermal cyst being rare and more liable to develop complications such as malignant transformation. The treatment of an epidermal cyst involves total excision of the cyst along with its wall to prevent recurrence. We present an unusual case of a giant perineal epidermal cyst in a 52-year-old male.
Collapse
Affiliation(s)
- Mathias Kimolo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
| | - Orgeness Jasper Mbwambo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010 Moshi, Tanzania
| | - Mshangama Seif
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
| | - Jasper Said Mbwambo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010 Moshi, Tanzania
| | - Alex Mremi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
- Department of Pathology, Kilimanjaro Christian Medical Centre, PO Box 3010 Moshi, Tanzania
| | - Alfred Kien Mteta
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010 Moshi, Tanzania
| | - Frank Bright
- Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania
- Department of Urology, Kilimanjaro Christian Medical Centre, PO Box 3010 Moshi, Tanzania
| | - Bartholomeo Nicholaus Ngowi
- Correspondence address. Faculty of Medicine, Kilimanjaro Christian Medical University College, PO Box 2240 Moshi, Tanzania. E-mail:
| |
Collapse
|
10
|
Ngowi BN, Bright F, Lazaro E, Lodhia J, Kimolo M, Mbwambo OJ. Triple penile fracture: A rare case report and review of literature. Int J Surg Case Rep 2023; 106:108245. [PMID: 37126924 PMCID: PMC10172890 DOI: 10.1016/j.ijscr.2023.108245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 04/15/2023] [Accepted: 04/19/2023] [Indexed: 05/03/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Penile fracture is uncommon entity that rarely involves all the three erectile bodies (the two corpora carvenosa and corpus spongiosum). The diagnosis is clinical as most cases presents with typical signs and symptoms. CASE PRESENTATION We present a case of young man who sustained penile fracture involving the two corpora cavernosum and corpus spongiosum with associated urethral injury that was successfully repaired primarily. CLINICAL DISCUSSION In this case apart from MRI confirming the diagnosis it showed the injury to involve all the three corpora bodies as well as the urethral. Although MRI is reserved for controversial cases, when available, apart from just confirming the diagnosis, it can help in showing the extent of the injury and assist surgeon in management. Primary repair of the erectile bodies as well as the urethral gives excellent outcome. CONCLUSION This case reminds surgeons the possibility of having such extensive injury with promising outcome if properly managed.
Collapse
Affiliation(s)
- Bartholomeo Nicholaus Ngowi
- Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania.
| | - Frank Bright
- Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Ester Lazaro
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Jay Lodhia
- Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania
| | - Mathias Kimolo
- Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Orgeness Jasper Mbwambo
- Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| |
Collapse
|
11
|
Mbwambo OJ, Mremi A, Mugusi S, Mbwambo JS, Bright F, Mteta AK, Ngowi BN. Concomitant squamous cell carcinoma of the bladder and renal tuberculosis: A case report from northern Tanzania. Clin Case Rep 2023; 11:e7127. [PMID: 36992675 PMCID: PMC10041367 DOI: 10.1002/ccr3.7127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 02/24/2023] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
Concomitant squamous cell carcinoma (SCC) and renal tuberculosis (TB) are a rare presentation. It is associated with poor prognosis and poses a challenge in the management. To the best of our knowledge, we present a challenging first document case of locally advanced SCC of the bladder with coactive renal tuberculosis.
Collapse
Affiliation(s)
- Orgeness Jasper Mbwambo
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Alex Mremi
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of PathologyKilimanjaro Christian Medical centreMoshiTanzania
| | - Sabina Mugusi
- Department of Clinical Pharmacology, Campus College of MedicineMuhimbili University of Health and Allied SciencesDar es SalaamTanzania
| | - Jasper Said Mbwambo
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Frank Bright
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Alfred Kien Mteta
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| | - Bartholomeo Nicholaus Ngowi
- Faculty of MedicineKilimanjaro Christian Medical University CollegeMoshiTanzania
- Department of UrologyKilimanjaro Christian Medical CentreMoshiTanzania
| |
Collapse
|
12
|
Venn SN, Mabedi C, Ngowi BN, Mbwambo OJ, Mteta KA, Payne SR. Disseminating surgical experience for sustainable benefits - the Urolink experience. BJU Int 2022; 129:661-667. [PMID: 35349222 DOI: 10.1111/bju.15733] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 11/29/2022]
Abstract
The dissemination of urological knowledge, and consequent surgical expertise, is entirely dependent on the availability of individuals to provide education and the mechanism by which that knowledge is spread. In low, or low-middle, income countries the numbers of specialist surgeons, especially urologists, is extremely limited and the time they have to train aspiring urologists is, therefore, restricted as a consequence of the demand for clinical help. Urologists from high-income countries, being more prevalent, can assist with the education, but are limited by the needs of their own careers and the time they have available to educate in a resource poor setting. Bringing surgeons from a low to a high income environment for training is one option to overcome this trainer/trainee imbalance, but is relatively expensive, bureaucratic, and has inherent risks of the individual being lost from their domestic workforce. Short-term medical trips to educate larger numbers of individuals in their home setting is one of a number of different options that has been used to bridge this gap. It has, however, been suggested that such a model is not the most efficient way of perpetuating knowledge and skills in a low-income environment. Urolink has found, however, that when short term trips are used to support a longitudinal commitment to a centre they can be remarkable effective. By helping the expansion of personnel to a critical mass in designated regional hubs, linked to credible local or regional academic institutions, it has been possible to develop sustainable centres that can disseminate training across a wide geographical area. Such a co-operative approach has been used between Urolink and the Kilimanjaro Christian Medical Centre in Moshi, Tanzania, a model that has initiated the evolution of other regional training hubs across east Africa over the last three decades.
Collapse
Affiliation(s)
- Suzie N Venn
- University Hospitals Sussex NHS Foundation Trust, Worthing, UK.,Urolink, British Association of Urological Surgeons
| | | | | | - Orgeness J Mbwambo
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College
| | - Kien Alfred Mteta
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania.,Kilimanjaro Christian Medical University College
| | | |
Collapse
|
13
|
Ngowi BN, Bright F, Mbwambo JS, Mmbaga BT, Lekei E, Kimolo M, Mteta KA, Mbwambo OJ. Perineal ectopic testis in adult: Experience from tertiary hospital, northern Tanzania. Int J Surg Case Rep 2022; 92:106817. [PMID: 35183004 PMCID: PMC8857501 DOI: 10.1016/j.ijscr.2022.106817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/02/2022] [Accepted: 02/03/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction and importance Perineal ectopic testis is a rare congenital abnormality mostly diagnosed during childhood period. The diagnosis can be easily reached by physical examination. The treatment of choice is either orchidopexy or orchiectomy through scrotal or inguinal approach. Case presentation We report a case of 30 year old male with painful perineal mass and empty right hemiscrotum. Ultrasound of the mass was done prior to operative procedure and the ectopic testis was the working diagnosis ever since. At exploration there was no abnormality found on the testis; thus, orchidopexy was done with uneventful postoperative period. Clinical discussion Ectopic testis is rare congenital anomaly with perineal ectopic testis accounting for only 1% of all cases. Most cases of ectopic testis are diagnosed during childhood period. Our case presented at the age of 30 years, the reason could be either late diagnosis by physician or lack of insight of parents/care takers or both. The late presentation might pose a diagnostic challenge but also the testis may be atrophic or undergo malignant changes. In this case the testis was normal and therefore it was successfully relocated surgically through trans-inguinal approach. Conclusion It is suggested to make perineal ectopic testis one of the differential diagnoses on painful perineal swelling without ipsilateral testis on any man. Perineal ectopic testis is a very rare anomaly that represents a true ectopic location of the tests. It is more rare in adults and young boys. Diagnosis depends on level of suspicious index as it is mostly clinical. Any man presenting with painful perineal swelling in the setting of absent testis should be regarded as having perineal ectopic testis until proved other wise. Trans-inguinal orchidopex offers a safe way of managing perineal ectopic testis as the testis is usually of normal size and the spermatic cord is of adequate length even in adults.
Collapse
Affiliation(s)
- Bartholomeo Nicholaus Ngowi
- Urology Department, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Urology department, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania.
| | - Frank Bright
- Urology Department, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Urology department, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Jasper Said Mbwambo
- Urology Department, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Urology department, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | | | - Esther Lekei
- Urology Department, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania
| | - Mathias Kimolo
- Urology Department, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania
| | - Kien Alfred Mteta
- Urology Department, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Urology department, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Orgeness Jasper Mbwambo
- Urology Department, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, Tanzania; Urology department, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| |
Collapse
|
14
|
Lodhia J, Mremi A, Mbwambo OJ, Mshangama S, Bright F, Ngowi BN. An uncommon presentation of a large vulval wart in a child. Int J Surg Case Rep 2022; 91:106758. [PMID: 35030402 PMCID: PMC8760350 DOI: 10.1016/j.ijscr.2022.106758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction and importance Ano-genital warts are rare presentation in children. The main route of transmission is by sexual intercourse however horizontal transmission, self-inoculation and vertical transmission are also documented. Establishing the route of transmission when there is no evidence of sexual abuse may be difficult in pediatric and female virgins such as in our case report. Surgical excision remains one of the best options for treatment of large warts in pediatrics. To the best of our knowledge, this is the first report of novel case of large genital warts in pediatrics in Tanzania. Case presentation We present a case of female child of one year and 10 months old with large ano-genital cauli-flower masses admitted at Kilimanjaro Christian Medical Centre. The child's hymen was intact and with no evidence of sexual abuse identified. The masses were excised under general anesthesia and histology confirmed Condyloma acuminata. Clinical discussion Ano-genital warts are rare presentation in pediatrics and female virgins. Sexual abuse should be ruled out in pediatrics patients. Self-inoculation is described as a possible route of transmission in pediatrics and in female virgins. Horizontal and vertical transmissions are also possible route of transmission of HPV. It might be difficult to establish the route of transmission as in our case report. The warts were successful treated by surgical excision and cauterization. Conclusion Condyloma acuminata are rare in pediatrics and establishing the route of transmission may be difficult. Sexual abuse should be ruled out in pediatrics. Large genital warts are uncommon to the pediatric population. If encountered in children, sexual assault/abuse should be ruled out. The exact route of transmission in pediatrics without sexual abuse and female virgins may be difficult to establish. HPV can be transmitted through horizontal and self-inoculation. Surgical excision and electro-cauterization are effective treatment for pediatric genital warts
Collapse
Affiliation(s)
- Jay Lodhia
- Department of General Surgery, Kilimanjaro Christian Medical Center, P.O Box 3010, Moshi, Tanzania; Kilimanjaro Christian Medical University College, P. O Box 2240, Moshi, Tanzania.
| | - Alex Mremi
- Kilimanjaro Christian Medical University College, P. O Box 2240, Moshi, Tanzania; Department of Pathology, Kilimanjaro Christian Medical Center, P.O Box 3010, Moshi, Tanzania
| | - Orgeness Jasper Mbwambo
- Kilimanjaro Christian Medical University College, P. O Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Center, P.O Box 3010, Moshi, Tanzania
| | - Seif Mshangama
- Department of Urology, Kilimanjaro Christian Medical Center, P.O Box 3010, Moshi, Tanzania
| | - Frank Bright
- Kilimanjaro Christian Medical University College, P. O Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Center, P.O Box 3010, Moshi, Tanzania
| | - Bartholomeo Nicholaus Ngowi
- Kilimanjaro Christian Medical University College, P. O Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Center, P.O Box 3010, Moshi, Tanzania
| |
Collapse
|
15
|
Mbwambo OJ, Kiattu E, Mbwambo J, Bright F, Mteta AK, Ngowi BN. Penile strangulation by a metallic nut in an 8-year-old male: A rare case report of urological emergency. Int J Surg Case Rep 2021; 89:106581. [PMID: 34823162 PMCID: PMC8627972 DOI: 10.1016/j.ijscr.2021.106581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 11/02/2021] [Accepted: 11/04/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION AND IMPORTANCE Penile strangulation due to metallic objects in pediatric age groups is a rare urological emergency that warrant emergency management. Removal of metallic ring from strangulated penis poses a great challenge to urologist as it may require industrial gadgets. Multidisciplinary management involving psychiatrist is required. To the best of our knowledge, this is the first reported novel case of penile strangulation by a metallic nut in children in Tanzania. Furthermore, this case report shows that Industrial Manual Scissor metal (IMSMC) cutter offers a safe way of removing metallic nut from strangulated penis with few complications. CASE PRESENTATION We report a case report of penile strangulation in an 8 year-old boy by a metallic nut which stayed for 11 h prior to arriving at a tertiary hospital in Northern Tanzania. The reason for insertion of nut by a child was not clear. CLINICAL DISCUSSION On arrival to the hospital the child was clinically stable but in pain. Local examination revealed a metallic nut at proximal penis with grossly edematous penis. A diagnosis of penile strangulation by metallic nut was reached and the child was planned for emergency surgery to remove the metallic nut. The metallic nut was successful removed by IMSMC. This technique has been used in adult with success with few complications and therefore opted in our setting. The child was also diagnosed with oppositional defiant disorder. CONCLUSION Industrial Manual Scissor Metal cutter is a safe way of managing penile strangulation by a metallic nut in children.
Collapse
Affiliation(s)
- Orgeness Jasper Mbwambo
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, United Republic of Tanzania.
| | - Edward Kiattu
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania
| | - Jasper Mbwambo
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, United Republic of Tanzania
| | - Frank Bright
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, United Republic of Tanzania
| | - Alfred K Mteta
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, United Republic of Tanzania
| | - Bartholomeo Nicholaus Ngowi
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, P.O. Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, P.O. Box 3010, Moshi, United Republic of Tanzania
| |
Collapse
|
16
|
Ngowi BN, Sunguya B, Herman A, Chacha A, Maro E, Rugarabamu LF, Bartlett J, Balandya E, Mteta KA, Mmbaga BT. Prevalence of Multidrug Resistant UTI Among People Living with HIV in Northern Tanzania. Infect Drug Resist 2021; 14:1623-1633. [PMID: 33911886 PMCID: PMC8075732 DOI: 10.2147/idr.s299776] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/11/2021] [Indexed: 12/27/2022] Open
Abstract
Background Bacterial urinary tract infection (BUTI) is the commonest urinary tract infection among people living with human immunodeficiency virus (PLHIV). It causes significant morbidity in this vulnerable group. Immunosuppression due to HIV can mask the signs and symptoms of infection leading to asymptomatic disease. There is limited evidence in Tanzania regarding BUTI and PLHIV. This study aimed to determine the prevalence, etiology, risk factors and susceptibility pattern of isolates causing asymptomatic UTI in PLHIV at Kilimanjaro Christian Medical Centre (KCMC). Patients and Methods This cross-sectional study was conducted from July to September 2020 at Kilimanjaro Christian Medical Centre (KCMC) hospital. A questionnaire was used to collect social demographic data from patients' files together with necessary information required by this study. Urine samples were obtained from participants for urinalysis and urine culture and sensitivity. Data from 300 adults aged ≥18 years were analyzed using Statistical Package for Social Science (SPSS) version 22. Mean or median with their measure of dispersion were calculated for continuous variables. Logistic regression was used to determine associations between variables, where P-value <0.05 was considered to be significant. Results Bacteriuria was prevalent in 37 (12.3%) of PLHIV. Positive nitrite in urine was associated with bacteriuria (P = 0.01). Gram-positive bacteria were the most common 25 (67.6%) isolates with high sensitivity to nitrofurantoin (88.2%) followed by gentamycin (69.2%). However, resistance was high against ciprofloxacin (77.8%). Multidrug resistance (MDR) was noted in 17 (45.9%). Conclusion One in eight of PLHIV attending CTC at KCMC referral hospital in Northern zone of Tanzania have BUTI. Presence of nitrites in urine is an important biomarker associated with BUTI. About two third of the isolates were Gram-positive bacteria, and nearly half of all isolates showed MDR to commonly used antibiotics.
Collapse
Affiliation(s)
| | - Bruno Sunguya
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es salaam, Tanzania
| | - Ayesiga Herman
- General Surgery Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Alfred Chacha
- Clinical Laboratory Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Eusebious Maro
- Obstetric and Gynecology Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | | | | | - Emmanuel Balandya
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Upanga West, Dar es salaam, Tanzania
| | - Kien Alfred Mteta
- Urology Department, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | | |
Collapse
|
17
|
Mohammed M, Bright F, Mteta A, Mbwambo J, Ngowi BN, Mbwambo O, Yongolo S, Mganga A. Long-Term Complications of Hypospadias Repair: A Ten-Year Experience from Northern Zone of Tanzania. Res Rep Urol 2020; 12:463-469. [PMID: 33117746 PMCID: PMC7567991 DOI: 10.2147/rru.s270248] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/17/2020] [Indexed: 11/23/2022] Open
Abstract
Background Hypospadias is one of the commonest congenital penile abnormalities in newborn males. The external urethral opening can be located anywhere from the glans penis along the ventral aspect of the shaft of the penis up to the scrotum or the perineum in extreme cases. The condition has a huge impact on the patient’s psychological, emotional and sexual well-being. Aim To determine the proportion of patients who develop long-term complications after hypospadias repair and its associated risk factors. Methods This was a hospital-based analytical cross-sectional study, conducted at KCMC Urology Institute from January 2009 to December 2018 and all children were followed up for 1-year post-operatively. A structural data sheet was used to collect information from patients’ files. Study parameters include age, location of hypospadias, surgical technique, surgeon experience, chordee, suture size, materials to assess the association with long-term complications. Results A total of 254 patients were included in the study, the majority were aged more than 2 years (71.83%) with mean age at operation (SD) of 4.74 ± 2.99 years. Distal types were the most common type of hypospadias (125 patients; 50%), and 51 patients (20%) had severe chordee. Tubularized incised plate (TIP) repair was the most common technique (130 patients; 51.59%). The number of patients with long-term complications following hypospadias repair was 156 (61.60%) and urethrocutaneous fistula
(UCF) accounted for 40.5%. The surgeon’s experience, location of hypospadias, surgical technique and associated chordee were significant predictors of long-term complications of hypospadias repair. Conclusion Tubularized incised plate urethroplasty is a safe and reliable method of hypospadias repair. Proximal hypospadias with severe chordee still remain a challenge.
Collapse
Affiliation(s)
- Mbarouk Mohammed
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Frank Bright
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Alfred Mteta
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Jasper Mbwambo
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Bartholomeo Nicholaus Ngowi
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Orgeness Mbwambo
- Department of Urology, Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Sidney Yongolo
- Department of Urology, Faculty of Medicine, Muhimbili University of Health and Allied Science, Dar es Salaam, Tanzania
| | - Andrew Mganga
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| |
Collapse
|