Application of hydrolysis probe analysis to identify clade types of the malaria vector mosquito Anopheles funestus sensu stricto from Muheza, northeastern Tanzania.

A hydrolysis probe analysis (TaqMan assay) was used to study clade types in Anopheles funestus sensu stricto Giles, a major malaria vector in sub-Saharan Africa, with specimens collected from Muheza in Tanga, northeastern Tanzania. A total of 186 An. funestus specimens were analysed, revealing that 176 (94.6%) were of clade I and 10 (5.4%) of clade II. These findings extend the distribution of clade type II from southern Mozambique and northern Zambia to northeastern Tanzania. The technique used can also be of great value in assessing the role and contribution of these clade types in malaria transmission and insecticide resistance frequencies for An. funestus s.s.

Human African Trypanosomiasis and challenges to its control in Urambo; Kasulu and Kibondo Districts; western Tanzania

A study was carried out to determine the prevalence and management of Human African Trypanosomiasis (HAT) in Urambo; Kasulu and Kibondo districts of western Tanzania. Parasitological surveys for trypanosome and other blood parasites were conducted in selected villages. Interviews with health workers were conducted to explore facility capacity to diagnose and manage HAT. Community knowledge on tsetse and availability of trypanocidal drugs was explored. Results showed that; although health facility records showed HAT is an important public health problem in the three districts; typanosomes were found in 0.6of the examined individuals in Urambo district only. Malaria parasites with a prevalence of 12.1; 19.7and 9.7; in Urambo; Kibondo and Kasulu; respectively were detected in blood samples from the same individuals examined for trypanosomes. There was poor capacity for most of the health facilities in the diagnosis; treatment and control of HAT. In both districts; communities were knowledgeable of the tsetse identity (82.4) and had experienced tsetse bites (94). The majority (91.4) of the community members knew that they were at risk of acquiring HAT. However; only 29of the respondents knew that anti-trypanocidal drugs were readily available free of charge from health care facilities. Late treatment seeking behaviour was common in Kasulu and Urambo districts. In conclusion; health facilities in western Tanzania are faced with problems of poor capacity to diagnose and manage HAT and that treatment seeking behaviour among the communities at risk is poor. Efforts should be made to strengthen the capacity of the health facility to handle HAT cases and health education to the population at risk

Anaesthesia in rural Tanzania.

A survey of the anaesthetic services in rural Tanzania was carried out in an area of 67500 km2 and population of 4 million in order to assess the quality of anaesthesia and the major obstacles to good practice. Lack of draw-over vaporizers, Ayre's T-pieces, and a supply of oxygen were found to be the major obstacles to safe practice in this area of Africa.

Acute isovolaemic haemodilution: the best option for autologous blood transfusion in Africa?

The purpose of this study was to identify the best method of autologous blood transfusion to be applied in an East African hospital. One hundred and nine consecutive patients for whom major blood loss was anticipated were enrolled. Seventeen patients donated 1 unit of blood 3 days preoperatively and 92 underwent acute isovolaemic haemodilution prior to induction of anaesthesia. For the haemodiluted patients a 2:1 ratio of sterile pryogen-free saline to collected blood was used. One of the 16 patients from whom 2 units were withdrawn by haemodilution experienced hypovolaemia which was rapidly restored by additional transfusion of colloid. Of the patients who donated blood preoperatively only 23.5% were autotransfused compared to 98.9% of the haemodiluted patients. Of the latter 23.9% (22) had an intraoperative blood loss exceeding 15% of their total blood volume and 7.6% (7) lost more than 25%. Only one received homologous blood in addition. For hospitals with limited blood bank facilities and regular cancellation of surgery, the use of acute isovolaemic haemodilution is recommended. A 3:1 ratio of saline to blood is now advised when 1 unit is withdrawn and a part replacement with crystalloid when 2 units are collected.

Tick infestations on cattle vaccinated with extracts from the eggs and the gut of Boophilus microplus.

Extracts prepared from the membranes of eggs (EM) and guts (GM) of Boophilus microplus were used to immunise cattle which were then infested twice with 20,000 larval ticks 1 week apart. EM antigens did not protect cattle against challenge with ticks, despite high levels of anti-egg antibodies in the sera of the vaccinated cattle, detected by an indirect enzyme-linked immunosorbent assay (ELISA). Cattle vaccinated with GM, however, had high levels of antibodies against GM and were protected significantly against challenge with B. microplus. Anti-EM and anti-GM antibodies in the sera of cattle cross-reacted significantly with GM and EM respectively on ELISA and recognised both specific and common antigens in extracts of the eggs and guts of B. microplus on Western blots. Exposure of cattle to field infestation with ticks during vaccination with gut antigens did not adversely affect the levels of antibodies generated.