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Mazigo HD, Chandika AB, Zinga M, Heukelbach J, Rambau P. Intestinal schistosomiasis associated with intussusception: a case report. ACTA ACUST UNITED AC 2015; 13:139-41. [PMID: 25566612 DOI: 10.4314/thrb.v13i2.64404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We report a case of intestinal schistosomiasis associated with iliocaecal intussusception resulting from obstructions of the terminal part of the ileum by schistosome egg-induced fibrosis. A 7-year-old boy presented with the history of abdominal pain and difficulties in passing stool for two months. Ultrasound examination revealed doughnut signs characterized with multiple concentric rings at the lateral abdomen, and the bowel loop appeared distended. Exploratory laparatomy confirmed intussusception of the terminal part of the ileum into the caecum, extending to the ascending colon. Hemicolectomy and end-to-end iliocolostomy was performed. Histological examination of the resected bowel revealed Schistosoma mansoni eggs within the mucosa, submucosa of the ileum, caecum and ascending colon, granulomatous inflammation with foreign body giant cells accompanied by fibrosis and eosinophilic infiltrate into the mucosa. Postoperatively, the patient recovered well. There may have been a synergistic effect of schistosomiasis with other underlying conditions, leading to intussusception. In conclusion, it is important to consider S. mansoni infection as a differential diagnosis for intestinal obstruction in endemic areas.
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Affiliation(s)
- Humphrey D Mazigo
- Weill-Bugando University College of Health Sciences, Mwanza, Tanzania.
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Mazigoi HD, Kidenya BR, Ambrose EE, Zinga M, Waihenya R. Association of intestinal helminths and P. falciparum infections in co-infected school children in northwest Tanzania. ACTA ACUST UNITED AC 2014; 12:299-301. [PMID: 24409638 DOI: 10.4314/thrb.v12i4.56152] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Plasmodium falciparum malaria and intestinal helminth infections are among the most common infections in the tropics and they share the same spatial distribution. The objective of this study was to explore the association between infections with intestinal helminths and P. falciparum infection as single helminth infections or co-infections among school children. A cross-sectional study was conducted among 400 school children in Nyamtongo, Sengerema District in Tanzania. The study involved examination of single stool and finger prick blood samples for intestinal helminths and malaria parasites. A Kato-Katz technique was employed to screen for intestinal helminths and Giemsa stained thin and thick blood smears were used to screen for malaria parasites. The results of logistic regression model adjusted for age and sex indicated no association between P. falciparum and S. mansoni (OR= 0.749, 95%CI 0.418-1.344), P. falciparum and hookworm (OR= 0.885, 95%CI 0.489-1.605) and P. falciparum and co-infection of S. mansoni and hookworm (OR=0.859, 95%CI 0.422-1.745). Using multinomial regression model adjusted for age and sex, no association was observed between P. falciparum with Schistosoma mansoni [Ratio of Relative Risk (RRR) = 0.651, 95% Confidence Interval (CI) 0.331-1.363] and hookworm (RRR=0712, CI 0.280-1.765). Similarly, no association was observed between co-infections of S. mansoni + hookworm (RRR=0.635, CI 0.268-1.504) with P. falciparum infection. Coinfections of S. mansoni, hookworm and P. falciparum among school children is common in the Nyamatongo ward, Sengerema District. We recommend prospective longitudinal studies to elucidate the interactions of malaria and helminths and its health impact in risk groups.
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Affiliation(s)
- Humphrey D Mazigoi
- Weill-Bugando University College of Health Sciences, PO. Box 1464, Mwanza, Tanzania.
| | - Benson R Kidenya
- Weill-Bugando University College of Health Sciences, PO. Box 1464, Mwanza, Tanzania
| | - Emmanuela E Ambrose
- Weill-Bugando University College of Health Sciences, PO. Box 1464, Mwanza, Tanzania
| | - Maria Zinga
- Weill-Bugando University College of Health Sciences, PO. Box 1464, Mwanza, Tanzania
| | - Rebecca Waihenya
- Department of Zoology, Jomo Kenyatta University ofAgriculture and Technology, Nairobi, Kenya
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Abstract
In Tanzania, Schistosoma mansoni is endemic and causes intestinal schistosomiasis which affects various internal organs. However, worldwide there have been very few reports of cases of peritonitis due to schistosomal appendicitis. Here we report a rare case of schistosomal appendicitis with peritonitis in a 33 year-old male patient who recovered quickly after surgery.
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Affiliation(s)
- Humphrey D Mazigo
- Department of Medical Parasitology and Entomology, Weill-Bugando University College of Health Sciences, Mwanza, Tanzania.
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Mazigo HD, Bahemana E, Dyegura O, Mnyone LL, Kweka EJ, Zinga M, Konje ET, Waihenya R, Heukelbach J. Severe tungiasis in Western Tanzania: case series. J Public Health Afr 2011; 2:e21. [PMID: 28299062 PMCID: PMC5345494 DOI: 10.4081/jphia.2011.e21] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [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: 10/31/2010] [Accepted: 05/14/2011] [Indexed: 11/23/2022] Open
Abstract
Tungiasis is caused by infestation with the sand flea (Tunga penetrans). This ectoparasitosis is endemic in economically depressed communities in South American and African countries. However, data on the epidemiology of tungiasis in Tanzania are very limited and the disease does not receive much attention from health care professionals. During a community cross sectional survey in northwest Tanzania, we identified five individuals extremely infested with high number of parasites. A total of 435 lesions were recorded with patients presenting with >75 lesions and showed signs of intense acute and chronic inflammation. Superinfection of the lesions characterized by pustule formation, suppuration and ulceration were common. Loss of nails and walking difficulty was also observed. In Tanzanian communities living under extreme poverty characterized by poor housing condition and inadequate health services, tungiasis may cause severe morbidities. Further studies on risk factors and disease-related behavior of affected populations are needed to design adequate control measures.
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Affiliation(s)
- Humphrey D Mazigo
- Department of Medical Parasitology and Entomology, Faculty of Medicine, Weill-Bugando University, College of Health Sciences, Mwanza, Tanzania
| | - Emmanuel Bahemana
- Weill-Bugando University, College of Health Sciences, Mwanza, Tanzania
| | - Ocimund Dyegura
- Weill-Bugando University, College of Health Sciences, Mwanza, Tanzania
| | - Ladslaus L Mnyone
- Pest Management Center, Sokoine University of Agriculture, Morogoro, Tanzania
| | - Eliningaya J Kweka
- Tropical Pesticides Research Institute, Division of Livestock and Human Disease Vector Control, Arusha, Tanzania
| | - Maria Zinga
- Department of Medical Parasitology and Entomology, Faculty of Medicine, Weill-Bugando University, College of Health Sciences, Mwanza, Tanzania
| | - Eveline T Konje
- Department of Community Medicine, Weill-Bugando University, College of Health Sciences, Mwanza, Tanzania
| | | | - Jorg Heukelbach
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Brazil;; Anton Breinl Centre for Tropical Medicine and Public Health, School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia
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Mazigo HD, Zinga M, Heukelbach J, Rambau P. Case Series of Adenocarcinoma of the Prostate Associated with Schistosoma haematobium Infection in Tanzania. J Glob Infect Dis 2011; 2:307-9. [PMID: 20927294 PMCID: PMC2946689 DOI: 10.4103/0974-777x.68540] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [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] [Indexed: 11/05/2022] Open
Abstract
In endemic areas, schistosomiasis has been associated with the pathogenesis of bladder, prostate, colorectal and renal carcinoma. However, the relationship between prostate cancer and schistosomiasis infection remains controversial. Here we present a series of three cases from Tanzania of prostatic adenocarcinoma associated with urinary schistosomiasis.
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Affiliation(s)
- Humphrey D Mazigo
- Departments of Medical Parasitology and Entomology, Weill-Bugando University College of Health Sciences, P.O. Box 1464, Mwanza, Tanzania
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Mazigo HD, Bushahu HM, Kidenya BR, Ambrose EE, Zinga M, Heukelbach J. Home treatments with antipyretics and antimalarials given to underfives with fever in Mwanza, north-western Tanzania. Tanzan J Health Res 2011; 13:114-118. [PMID: 25566608 DOI: 10.4314/thrb.v13i2.62989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Early diagnosis and prompt treatment is the recommended management for febrile illness among underfives. However, improper home management may be the cause of delay in seeking professional health care. This cross-sectional study was conducted at the outpatient department of Buzuruga Health Centre in Mwanza, Tanzania and involved 372 children < 5 years of age. Socio-demographic data of caregivers and children, type and source of treatment, and duration of fever were recorded. A total of 283 (76.1%) febrile underfives had received different types of treatment at home, before presenting at the hospital. The majority received antipyretics (204; 72.1%), and only a few (31; 10.9%) received antimalarials. The major sources of drugs were local drug stores (270; 94.7%). Duration of fever > 1 day (OR = 2.69; 95% CI: 1.95-3.70; P < 0.001), low grade fever (OR = 4.37, 95% CI: 2.60-7.35; P < 0.001) and fever accompanied with other major complaints (OR = 1.14, 95% CI: 1.05 - 1.23; P = 0.002) were significantly associated with prompt home medication before presenting to the health centre. In logistic regression analysis, duration of fever, low-grade fever and the presence of other symptoms remained significant predictors to receive antimalarial and or antipyretic drugs. In conclusion, home treatments with antipyretics and antimalarials in preschool children are common in Mwanza. Management of fevers may be improved by educating caregivers on community standard case definition of malaria while emphasizing the importance of early seeking of health facility services.
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Affiliation(s)
- Humphrey D Mazigo
- Weill-Bugando University College of Health Sciences, Mwanza, Tanzania.
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Mazigo HD, Obasy E, Mauka W, Manyiri P, Zinga M, Kweka EJ, Mnyone LL, Heukelbach J. Knowledge, Attitudes, and Practices about Malaria and Its Control in Rural Northwest Tanzania. Malar Res Treat 2010; 2010:794261. [PMID: 22332023 PMCID: PMC3275933 DOI: 10.4061/2010/794261] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [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: 01/15/2010] [Accepted: 04/05/2010] [Indexed: 11/26/2022] Open
Abstract
Background. We assessed community knowledge, attitudes, and practices on malaria as well as acceptability to indoor residual spraying. Material and Methods. A cross-sectional survey was done in a community in Geita district (northwest Tanzania). Household heads (n = 366) were interviewed Results.
Knowledge on malaria transmission, prevention, and treatment was reasonable; 56% of
respondents associated the disease with mosquito bites, with a significant difference between education level and knowledge on transmission (P < .001). Knowledge of mosquito breeding areas was also associated with education (illiterate: 22%; literate: 59%
(P < .001). Bed nets were used by 236 (64.5%), and usage was significantly associated with education level (P < .01). The level of bed net ownership was 77.3%. Most respondents (86.3%) agreed with indoor residual spraying of insecticides. Health facilities were the first option for malaria treatment by 47.3%. Artemether-lumefantrine was the most common antimalarial therapy used. Conclusions. Despite reasonable knowledge on malaria and its preventive measures, there is a need to improve availability of information through proper community channels. Special attention should be given to illiterate community members. High acceptance of indoor residual spraying and high level of bed net ownership should be taken as an advantage to improve malaria control.
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Affiliation(s)
- Humphrey D Mazigo
- Department of Medical Parasitology and Entomology, Weill Bugando University College of Health Sciences, P.O. Box 1464, Mwanza, Tanzania
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Mazigo HD, Waihenya R, Lwambo NJ, Mnyone LL, Mahande AM, Seni J, Zinga M, Kapesa A, Kweka EJ, Mshana SE, Heukelbach J, Mkoji GM. Co-infections with Plasmodium falciparum, Schistosoma mansoni and intestinal helminths among schoolchildren in endemic areas of northwestern Tanzania. Parasit Vectors 2010; 3:44. [PMID: 20482866 PMCID: PMC2881914 DOI: 10.1186/1756-3305-3-44] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Accepted: 05/19/2010] [Indexed: 11/17/2022] Open
Abstract
Background Malaria, schistosomiasis and intestinal helminth infections are causes of high morbidity in most tropical parts of the world. Even though these infections often co-exist, most studies focus on individual diseases. In the present study, we investigated the prevalence of Plasmodium falciparum-malaria, intestinal schistosomiasis, soil-transmitted helminth infections, and the respective co-infections, among schoolchildren in northwest Tanzania. Methods A cross sectional study was conducted among schoolchildren living in villages located close to the shores of Lake Victoria. The Kato Katz technique was employed to screen faecal samples for S. mansoni and soil-transmitted helminth eggs. Giemsa stained thick and thin blood smears were analysed for the presence of malaria parasites. Results Of the 400 children included in the study, 218 (54.5%) were infected with a single parasite species, 116 (29%) with two or more species, and 66 (16.5%) had no infection. The prevalences of P. falciparum and S. mansoni were 13.5% (95% CI, 10.2-16.8), and 64.3% (95% CI, 59.6-68.9) respectively. Prevalence of hookworm infection was 38% (95% CI, 33.2-42.8). A. lumbricoides and T. trichiura were not detected. Of the children 26.5% (95% CI, 21.9-30.6) that harbored two parasite species, combination of S. mansoni and hookworm co-infections was the most common (69%). Prevalence of S. mansoni - P. falciparum co-infections was 22.6% (95%CI, 15.3-31.3) and that of hookworm - P. falciparum co-infections 5.7% (95%CI, 2.6-12.8). Prevalence of co-infection of P. falciparum, S. mansoni and hookworm was 2.8% (95%CI, 1.15-4.4). Conclusion Multiple parasitic infections are common among schoolchildren in rural northwest Tanzania. These findings can be used for the design and implementation of sound intervention strategies to mitigate morbidity and co-morbidity.
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Affiliation(s)
- Humphrey D Mazigo
- Weill-Bugando University College of Health Sciences, P,O, Box 1464, Mwanza, Tanzania.
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Mazigo HD, Behamana E, Zinga M, Heukelbach J. Tungiasis infestation in Tanzania. J Infect Dev Ctries 2010; 4:187-9. [PMID: 20351463 DOI: 10.3855/jidc.680] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 01/18/2010] [Accepted: 01/20/2010] [Indexed: 10/31/2022] Open
Abstract
Tungiasis is caused by the jigger flea Tunga penetrans. We describe a case of severe infestation from Kigoma region, Western Tanzania. A 19-year-old male with epilepsy and mental disability presented with ulcerated and inflamed toes. Clinical examination revealed the presence of approximately 810 embedded jigger fleas on the feet, and another 60 lesions on the hands. The patient presented with fissures on the feet, hands and soles. He had difficulty walking and erythematous, oedematous, ulcerated and inflamed skin around the feet. Living conditions were precarious. The patient was assisted to extract the embedded fleas and his feet were washed with disinfectants. Oral antibiotics were given. The case shows that the disease may reach high parasite loads in Tanzanian individuals, with consequently severe pathology. There have been single reports of returning tourists from Tanzania with tungiasis, but the epidemiological situation and the geographic occurrence of the disease in this country are not known. Systematic studies are needed to increase knowledge on the epidemiological situation of tungasis in Tanzania and to identify endemic areas.
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Affiliation(s)
- Humphrey D Mazigo
- Department of Medical Parasitology and Entomology, Weill-Bugando University College of Health Sciences, Mwanza, Tanzania.
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