4TH ANNUAL NETWORK MEETINGnetSPEAR

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4TH ANNUAL NETWORK MEETING-netSPEAR

• TANZANIA SUMMARY REPORT
• Dr H. Mwamtemi
• Dr Ben Amos
• Dr D. Mwakagile

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SITES

• 1. Muhimbili National Hospital (MNH)
• 2. Muheza Hospital.

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Site Characteristics

• 1. Paediatric admissions per month 320 for MNH
  and 440 for Muheza
• 2. No. of monthly LPs (2006) 32 for MNH and 22
  for Muheza

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ISOLATES FROM CSFNov 2005 Oct 2006
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MNH Bacterial species isolated from 352 blood
cultures on children with pneumonia

• Pathogen Number of
  isolates ()
• Gram positive
• Streptococcus species
  2 (0.6)
• Staphylococcus aureus
  3 (0.8)
• Other
  65 (18.5)
• Total
  70 (19.9)
• Gram negative
• Salmonella species
  3 (0.8)
• Escherichia coli
  3 (0.8)
• Acinetobacter species
  4 (1.1)
• Klebsiella species
  5 (1.4)
• Pseudomonas aeroginosa
  3 (0.8)
• Pasteurella pneumotropica
  2 (0.6)
• Pantoea species
  2 (0.6)
• Other
  8 (2.3)
• Total
  100 (28.4)

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Muheza Blood culture isolates from all children
with febrile illness June-Sep 2006 (1500 children)
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Challenges

• Poor Hib isolation and poor general perfomance
  due to limited technical and financial support
• Very limited communication among the key players
  for PBMS(the Lab, EPI, WHO)
• Lack of central coordination (EPI) for the 2
  sites to share reports and experiences.

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cont.

• No internal programme monitoring/evaluation
  meetings to share performance indicators
• Disagreement EPI/WHO about where data should go.
• No feedback/comments on data sent to EPI
• Resignation of MNH data manager after being
  demoralised due to poor support from EPI

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Contd

• Late submission of data after resignation of MNH
  data manager
• Problems in storage and sending of isolates to
  Kilifi for further testing
• Reluctance to undertake LP on suspected cases
• Use of human blood

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WAY FOWARD

• Strive for improvement of communication between
  sites and EPI/WHO Tanzania
• Study reasons for poor isolation of HIB at MNH.
• Find source of sheep blood for all sentinal
  sites.
• Latex agglutination check of any WBC positive
  CSF.
• Haydom due to start shortly

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ACKNOWLEDGEMENT

• netSPEAR
• WHO/AFRO
• Hib initiative group
• MoH/EPI Tanzania
• PAT (important agenda during Annual Meeting/Paed.
  Evidence week)
• MNH MUCHS Staff
• Muheza Hospital Staff

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