Antimicrobial Activity of Medicated Soaps Commonly Used By Dar es Salaam Residents in Tanzania.

An in vitro evaluation of the anti-microbial activity of medicated soaps was conducted using ditch-plate and hand washing techniques. Strains of reference microbes namely Candida albicans (ATCC90028), Staphylococcus aureus (ATCC25923), Pseudomonas aureginosa (ATCC27853) and Escherichia coli (ATCC25922) were tested at three different soaps' concentrations (1.0, 4.0 and 8.0 mg/ml). A total of 16 medicated soaps were assayed for their antimicrobial efficacy. Of these, 13 were medicated and 3 non-medicated soaps, which served as control. Ciprofloxacin and ketaconazole were employed as positive controls. Label disclosure for the soaps' ingredients and other relevant information were absorbed. The most common antimicrobial active ingredients were triclosan, trichloroxylenol and trichlorocarbanilide. ANOVA for means of zones of inhibition revealed variability of antimicrobial activity among the medicated soaps. Positive correlation (r=0.318; P<0.01) between zones of inhibition and soaps' concentrations was evidenced. Hand washing frequencies positively correlated with microbial counts. Roberts(®) soap exhibited the largest zone of inhibition (34 mm) on S. aureus. Candida albicans was the least susceptible microbe. Regency(®) and Dalan(®) exhibited the least zone of inhibition on the tested bacteria. Protex(®), Roberts(®), Family(®) and Protector(®) were equally effective (P<0.01) against S. aureus. In conclusion, majority of the assayed medicated soaps have satisfactory antibacterial activity; though lack antifungal effect with exception of Linda(®) liquid soap. The hand washing technique has proved to be inappropriate for evaluation of soaps' antimicrobial efficacy due to presence of the skin microflora.

Knowledge and perception of mothers and caregivers on childhood diarrhoea and its management in Temeke municipality, Tanzania.

Diarrhoea is an increase in volume of stool or frequency of defecation. It is one of the most common clinical signs of gastrointestinal diseases, but also can reflect primary disorders outside of the digestive system. This cross-sectional descriptive survey was conducted in Temeke Municipality, Dar es Salaam over a 4-month period to investigate on knowledge and perception of mothers/caregivers of underfives on childhood diarrhoea. Specifically, the study focused on frequency of diarrhoeal episodes and their risk factors as well as effectiveness of traditional remedies used for its management prior to seeking medical attention. A semi-structured questionnaire was used for data collection, through which a total of 161 mothers were interviewed. Of those, 74 (46%) had female and 87 (54%) had male underfives with median age of 2-years. Frequency of diarrhoeal episodes was high among the underfives and was comparable between females and males (87 vs 74; P<0.05). Medicinal plants were the most common traditional remedies employed by majority (71%) of the interviewees, which have been purported to be effective in management of childhood diarrhoea. Guava (leaves and fruits) was the most commonly used remedy in the treatment of diarrhoea. Mothers' knowledge on predisposing factors of childhood diarrhoea was poor, which was directly correlated with education level. Only about one-third of the respondents (31%) were aware of risk factors for childhood diarrhoea that cited poor sanitation and water as the main factors. Diarrhoeal episodes were perceived wrongly as normal growth stage and that were caused by several other "illnesses". It is important that further studies on traditional remedies should be carried out to validate their usefulness in the treatment of childhood diarrhoea.

Knowledge on management of fever among mothers of undertens in Dar es Salaam, Tanzania.

OBJECTIVES: To explore on mothers' knowledge on fever and its management as well as assess treatment received by under 10 year-old children (undertens) having fever prior to being presented in outpatient departments at two Municipal hospitals. METHODS: Data were collected using a semi-structured questionnaire interviews among mothers of undertens, who had problems of fever and presented at the two Municipal hospitals viz. Mwananyamala and Temeke Municipal hospitals, in Dar es Salaam. RESULTS: A total of 301 respondents were interviewed. Of those, 151 had male and 150 and female undertens, whose ages ranged from 1 month to 10 years-old with median of 2 years. Minority (32%) of the interviewees were unaware of possible causes of fever, while 52% attributed it to malaria. About 25% of the respondents regard fever as a minor health problem, thus they did not seek medical attention unless other severe symptoms were manifested. Majority (88.4%) of the respondents self-medicated, and out of those 24% used antimalarials and antipyretics, while 7.6% used both antipyretics and antibiotics for alleviation of fever. On arrival in OPDs, only 62.4% of the respondents were prescribed with antimalarial agents. Approximately 18% of the interviewees admitted to have had changed medications due to unresponsiveness to the previously prescribed drugs. Pharmacies were the main sources of the self-medicated drugs (n = 272; 90.4%). CONCLUSION: Fever is a public health concern among undertens, which contributed to high rate of self-medication and irrational use of medicines. However, respondents demonstrated adequate knowledge on fever and on its management though fever was associated with underlying causes.

The in vitro antimicrobial activity of fruit and leaf crude extracts of Momordica charantia: a Tanzania medicinal plant.

OBJECTIVE: To evaluate the antimicrobial activity of Momordica charantia extracts on reference strains and microorganisms isolated from clinical specimens. METHOD: Petroleum ether and methanolic crude extracts of fruits and leaves of the plant were evaluated for antimicrobial activity using the disk diffusion method on four reference microorganisms (Pseudomonas aeruginosa, Escherichia coli, Candida albicans and Staphylococcus aureus; and four clinical strains of Klebsiella pneumoniae, Proteus vulgaris, Salmonella typhi and Cryptococcus neoformans. RESULT: Antimicrobial activity was observed against all the tested microorganisms with exception to P. mirabilis and C. neoformans. Methanolic crude extracts exhibited relatively broader antimicrobial spectrum of activity than petroleum ether extracts with the as lower concentration as 0.075mg/µl. Methanolic fruit crude extract displayed the broadest antimicrobial spectrum by inhibiting majority (75%) of the tested microorganisms. Neither was there synergistic nor addition effect upon mixing leaf and fruit extracts of equal concentrations derived from the same solvent. CONCLUSION: Extracts of M.charantia demonstrated antimicrobial activity on tested microorganisms except on Proteus mirabilis and Cryptococcus neoformans. Fruit extracts showed higher antimicrobial activity than leaf extract. Further studies are recommended that will involve various parts of the plant, select different fractions of extracts and purify the active antimicrobial components.

Knowledge; attitude and acceptability of spermicidal contraception among university students in Dar Es Salaam

"Objectives: The aim of this study was to assess the knowledge; acceptability and attitude towards the use of spermicides among students of University of Dar es Salaam (UDSM). Methodology: This was a descriptive cross-sectional study conducted over four-month period among UDSM students. A random sample of students was recruited from all three university campus namely University College of Land and Architectural Studies (UCLAS); Muhimbili University College of Health Sciences (MUCHS) and Mlimani Campus (MC). Questionnaires with both closed and open end-questions were used for data collection in which knowledge; attitude; and acceptability of spermicides were determined. The collected data were analyzed using SPSS/PC+ version 10.0; 1999 computer package. Results: A total of 300 students participated in this study; out of which 154 (51.3) were females and 146 (48.7) males. Majority of the students 276 (92) had poor knowledge of spermicidal products; and out of these; 146 (53) were absolutely unable to describe the use of spermicides. Ninety-three percent of the students had never used spermicides. Of those who had never used spermicides; 84 (30) said because they used other contraceptive means; 50 (17.8) said they are expensive; 29 (10.3) attributed this to unavailability of the products; 3(1.1) to fear of ""contracting"" cancer and 13(4.6) to the unreliability. Furthermore; a few who had used them didn't trust the products as ideal means of contraception. Conclusion: The respondents had poor knowledge of spermicides. Spermicides were not accepted by the students because of the presumed side-effects; being very expensive and unreliable for contraception purpose. However; the respondents accepted spermicides usage as an ideal alternative to condom and effective means for a female-controlled method to prevent/reduce unwanted pregnancy and HIV risk. The study recommends that the Government/responsible authorities should encourage spermicides usage; particularly when coupled with microbicides; in reduction of unplanned pregnancies; sexually transmitted diseases (STDs) and HIV infection inclusive.). Only 185 (56.1) of all patients reported their willingness to disclose and a freedom to talk about the disease. Risk factors for cancer staging were sex; patient's education status; awareness and knowledge of disease symptoms. Conclusions: Interventions targeted to improve health care seeking behaviour among cancer patients need to include health education and sensitization specifically of cancer disease; establish a strong referral mechanisms at primary health level and to start a population cancer registry for monitoring and evaluation purposes."

Antimicrobial susceptibility patterns of Salmonella typhi and Candida Albicans isolates in Dar es Salaam, Tanzania

The aim of this study was to determine antimicrobial susceptibility testing patterns of Candida albicans and Salmonella typhi isolates. Fifteen isolates of each microorganism were collected from three hospitals located in Dar es Salaam region within a 3-month period in the year 2005. Candida albicans and Salmonella typhi isolates were purified by sub-culturing on appropriate culture media in order to obtain pure cultures of the assayed microorganisms. Candida albicans isolates were identified by Gram staining technique and germ tube test; while S. typhi isolates were also identified by Gram staining technique followed by sub-culturing in various selective and differential culture media; then confirmed by immunological (agglutination) test. In-vitro antimicrobial susceptibility patterns of the assayed microbial isolates were determined by the disk diffusion technique of Stokes. The disk strength and tentative sizes of zones of inhibition (ZI) were interpreted in accordance with American National Committee for Clinical Laboratory Standard (NCCLS). Antifungal susceptibility patterns for C. albicans isolates showed that azoles are more efficacious than other assayed antifungal agents. Results of antibacterial susceptibility revealed that all the assayed S. typhi isolates were resistant to chloramphenicol and co-trimoxazole; but were sensitive to ciprofloxacin; gentamicin; ampicillin; doxcycline and ceftriaxone. Therefore; this study finding calls for a need to review the current prescription and dispensing practices of antimicrobial agents in both hospitals and pharmacies respectively. Furthermore; it is recommended that a nationwide study on antimicrobial susceptibility pattern should be conducted in order to come up with national policy on rational use of antibiotics

Microbial Quality of Drinking Water in Dar Es Salaam and Use of Waterguard as Disinfectant

Water borne diseases are alarmingly high in urban areas like Dar es Salaam. Hence the importance of chlorine-based water disinfectant solutions such as Waterguard that consists of 0.75sodium hypochlorite. Waterguard has been in the market in Dar es Salaam for about 4 years. Despite this; prevalence of waterborne diseases like cholera; dysentery and typhoid are still high. The aim of this study was to investigate the effectiveness of Waterguard in disinfecting drinking water; and determine the level of fecal coliform contamination of water from four sources viz. taps; streams; shallow wells and deep wells located within Dar es Salaam city. The investigation on the efficacy of the agent was carried out in water samples collected in the city during a 4-month period.Sixty-four water samples were randomly collected and analyzed by the Most Probable Number (MPN) technique based on coliform counts for both untreated and treated water samples. Negative (distilled water) and positive (distilled water contaminated with feces)controls were also included. Results show that three out of the four water sources were heavily contaminated with the exception of deep wells. But appropriate use of Waterguard reduces the level of microbial contamination significantly. In this study the assayed Waterguard was found to be 100efficacious in treating the samples to a level within the WHO safety standards; hence is fit for disinfecting water for human use