Reuben Mutagaywa | Muhimbili University of Health and Allied Sciences (MUHAS) (original) (raw)

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Research paper thumbnail of Aortic coarctation in the wake of COVID-19 resulting into brain aneurysm in a Tanzanian patient, diagnostic and management dilemma: a case report

Research paper thumbnail of Aortic coarctation in the wake of COVID-19 resulting into brain aneurysm in a Tanzanian patient, diagnostic and management dilemma: a case report

Research paper thumbnail of Statin Prescription Patterns and Associated Factors Among Patients with Type 2 Diabetes Mellitus Attending Diabetic Clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2022

Research paper thumbnail of Unmet needs in the management of arrhythmias among heart failure patients in Africa

European Heart Journal, 2022

Research paper thumbnail of attending diabetic clinic at Muhimbili National Hospital in Dar-es-Salaam, Tanzania

Introduction: There has been an increase in the prevalence of erectile dysfunction (ED) in the ge... more Introduction: There has been an increase in the prevalence of erectile dysfunction (ED) in the general population especially among Diabetic patients. This seems to be neglected problem in low-income countries. This study aims at establishing the prevalence of ED and associated risk factors in diabetic patients attended at Diabetic Clinic at Muhimbili National Hospital. Methods: A cross-sectional hospital based study was conducted among 312 diabetic patients attending diabetic clinic at Muhimbili National Hospital between May and December 2011. Results: More than half (55.1%) of the patients were found to have some form of ED (12.8 % had mild dysfunction, 11.5 % moderate and 27.9 % severe

Research paper thumbnail of Rationale, design and protocol of a cross-sectional study on pregnancy-related cardiovascular diseases in Tanzania (PRECARDT): burden, characterisation and prognostic significance at delivery

BMJ Open, 2021

IntroductionThe paucity of data describing cardiovascular disease (CVD) in pregnancy in many part... more IntroductionThe paucity of data describing cardiovascular disease (CVD) in pregnancy in many parts of Africa including Tanzania has given rise to challenges in proper management by the healthcare providers. This study is set out to (1) determine the prevalence of a range of CVDs during pregnancy in women attending antenatal clinics in Tanzania and (2) determine the impact of these CVDs on maternal and fetal outcomes at delivery.Methods and analysisThis is a cross-sectional study with a prospective component to be conducted in two referral hospitals in Tanzania. Pregnant women aged ≥18 years diagnosed with a CVD during the antenatal period are being identified and extensively characterised by performing clinical assessment, modified WHO staging, electrocardiography, echocardiography and laboratory tests. Patients identified with CVDs (exposed) and a subset without (unexposed) will be followed up to determine maternal and fetal outcomes at delivery. A minimum sample of 1560 will be su...

Research paper thumbnail of Intradialytic Arrhythmias Among Patients with End Stage Renal Disease on Maintenance Hemodialysis at Muhimbili National Hospital

BackgroundArrhythmias are responsible for almost 2 out of 3 cardiac deaths among patients on hemo... more BackgroundArrhythmias are responsible for almost 2 out of 3 cardiac deaths among patients on hemodialysis. We report the prevalence and risk factors for clinically significant arrhythmias among end stage renal disease (ESRD) patients on maintenance dialysis at a tertiary dialysis facility in Tanzania. MethodsCross-sectional study, involving consenting adults with ESRD was conducted September 2019 to February 2020. Arrhythmias were assessed using standard 5-leads Holter electrocardiography placed 15 minutes before dialysis and connected throughout dialysis. Clinically Significant Arrhythmias (CSA) was defined as ectopic beats in excess of 10 per hour or any of the ventricular tachycardia or Pause lasting for at least 2.5 seconds or paroxysmal supraventricular tachycardia or atrial flutter or atrial fibrillation. ResultsA total of 71 (44.4%) participants had CSA. Factors associated with increased risk for CSA were: age older than 60 years (OR 34; 95% CI: 5.15-236; P< 0.001), intrad...

Research paper thumbnail of Health Literacy, Information Seeking Patterns and Perceived Outcomes among Pregnant Women in Two Districts of Tanzania

BackgroundPregnant women that engage in information seeking process are more likely to have a hig... more BackgroundPregnant women that engage in information seeking process are more likely to have a high level of knowledge about their health, be confident to discuss their health concerns with their health care providers and report better health promotion activities than individuals who do not seek health information. However, health literacy influence pregnant women’s information seeking behaviours and consequently their health knowledge and health outcomes. Limited studies have explored the effects of health literacy on the outcomes associated with the information seeking among pregnant women in Tanzania. This study investigates the relationship between health literacy and information seeking patterns and its associated outcomes among pregnant women in Tanzania. MethodsA cross- sectional survey was conducted among 260 pregnant women aged 18 and above attending selected antenatal clinics (ANC) in Tanzania. Health literacy was assessed using a REALM-SF instrument while information seeki...

Research paper thumbnail of A comparison of AAIR versus DDDR pacing for patients with sinus node dysfunction: a long-term follow-up study

OBJECTIVES The aim of the study was to compare the clinical outcomes [atrial fibrillation (AF), a... more OBJECTIVES The aim of the study was to compare the clinical outcomes [atrial fibrillation (AF), atrio-ventricular (AV) block, device sepsis and lead revision] of patients with sinus node dysfunction (SND) between atrial-pacing atrial-sensing inhibited-response rate-adaptive (AAIR) versus dual-chamber rate-adaptive (DDDR) pacing. The choice of AAIR pacing versus DDDR pacing was determined by AV nodal functional testing at implant. METHODS We conducted a retrospective review of consecutive patients who underwent AAIR and DDDR pacing over a 10-year period. RESULTS One hundred and sixteen patients required pacing for symptomatic SND. Fifty-four (46.6%) patients received AAIR pacemakers and 62 (53.4%) received DDDR pacemakers based on AV nodal functional testing at implant. Patients who had AV Wenkebach with atrial pacing at 120 beats per minute received DDDR pacing. Overall the mean age of patients with SND was 65 years and 66.4% were females, 30% were diabetics and 71% were hypertensiv...

Research paper thumbnail of Rheumatic heart disease anno 2020: Impacts of gender and migration on epidemiology and management

European Journal of Clinical Investigation, 2020

The epidemiology and management of diseases can be influenced by social demographic factors. Gend... more The epidemiology and management of diseases can be influenced by social demographic factors. Gender and migration are among these factors.

Research paper thumbnail of Risk factors and prevalence of dilated cardiomyopathy in Sub Sahara Africa: a systematic review article (Preprint)

BACKGROUND Cardiomyopathies, defined as diseases involving mainly the heart muscle, are linked to... more BACKGROUND Cardiomyopathies, defined as diseases involving mainly the heart muscle, are linked to 5.9 of 100,000 of estimated mortality of the global population although underdiagnosis is significant. In sub Saharan Africa, studies show that cardiomyopathy constitutes 21.4% of cases with heart failure and comes second only to hypertensive heart disease. However, there is paucity of data in the region regarding the different types of cardiomyopathies. It has been noted that presence of non-modifiable cardiovascular risk factors such as family history, age, ethnicity, gender as well as modifiable risk factors such as hypertension, diabetes, tobacco use, physical inactivity, poor nutrition, excessive alcohol consumption, high cholesterol and obesity increase the probability of developing cardiovascular disease. OBJECTIVE The review will focus on available literature in sub- Saharan Africa on prevalence of dilated cardiomyopathy (DCM) and associated risk factors in patients with DCM. It...

Research paper thumbnail of Pericardial cyst with right ventricular compression

The Pan African medical journal, 2012

Pericardial cysts are infrequent and benign mediastinal lesions. While most pericardial cysts are... more Pericardial cysts are infrequent and benign mediastinal lesions. While most pericardial cysts are asymptomatic, some patients may present with compression symptoms. We present the case of a 22-year-old man who presented with a right pericardial cyst that caused compression of the right ventricle.

Research paper thumbnail of Prevalence of erectile dysfunction and associated factors among men without concomitant diseases: a population study

International Journal of Impotence Research, 2003

We interviewed a population sample of 2412 men aged 40-70 y in Brazil, Italy, Japan and Malaysia ... more We interviewed a population sample of 2412 men aged 40-70 y in Brazil, Italy, Japan and Malaysia about medical history, lifestyle habits and sexual behavior. Men were classified as having moderate or complete erectile dysfunction (ED) if they reported to be sometimes or never able to achieve and maintain an erection satisfactory for sexual intercourse, respectively. There were 1335 men with no diagnosis of cardiovascular or prostate diseases, diabetes, ulcer or depression, nor taking hormones. The prevalence of ED was 16.1%. ED was associated with age (the risk increased 8% per y), moderate (odds ratio (OR) ¼ 2.2) or severe (OR ¼ 4.9) lower urinary tract symptoms and smoking (OR ¼ 2.3 for 430 cigarettes/day). It was inversely associated with physical activity (OR ¼ 0.5) and higher educational levels. Between the ages of 40 and 70 y, almost one in six 'healthy' men is affected by ED. Further research should look at preclinical disease stages and genetic factors.

Research paper thumbnail of Histopathological evaluation of chronic rheumatic mitral valve stenosis: the association with clinical presentation, pathogenesis, and management at a National Cardiac Institute, Tanzania

Research paper thumbnail of Total Proximal Left Anterior Descending Artery Occlusion Presenting as Right Sided Chest Pain with a Misdiagnosis of Costochondritis: A Case Report

Tanzania Medical Journal, 2021

Background Acute coronary syndrome refers to a group of clinical symptoms consistent with acute m... more Background Acute coronary syndrome refers to a group of clinical symptoms consistent with acute myocardial ischemia or infarction that are potentially life threating requiring immediate interventions. Certain proportion of patients can present with atypical symptoms leading to a missed diagnosis associated with devastating outcomes. Case presentation We present a 60 years’ female of African descent with a medical history of hypertension and type 2 Diabetes mellitus who presented with a 2 months’ history of right-sided anterior chest pain and was diagnosed with costochondritis. Further assessment revealed, normal cardiac markers and an electrocardiogram suggestive of anterior wall myocardial infarction. A coronary computed tomography and cardiac magnetic imaging scans revealed a total occlusion of the proximal left anterior descending artery and a viable myocardium respectively. She underwent successful percutaneous coronary interventions with stenting with complete alleviation of he...

Research paper thumbnail of Aortic coarctation in the wake of COVID-19 resulting into brain aneurysm in a Tanzanian patient, diagnostic and management dilemma: a case report

Research paper thumbnail of Aortic coarctation in the wake of COVID-19 resulting into brain aneurysm in a Tanzanian patient, diagnostic and management dilemma: a case report

Research paper thumbnail of Statin Prescription Patterns and Associated Factors Among Patients with Type 2 Diabetes Mellitus Attending Diabetic Clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania

Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2022

Research paper thumbnail of Unmet needs in the management of arrhythmias among heart failure patients in Africa

European Heart Journal, 2022

Research paper thumbnail of attending diabetic clinic at Muhimbili National Hospital in Dar-es-Salaam, Tanzania

Introduction: There has been an increase in the prevalence of erectile dysfunction (ED) in the ge... more Introduction: There has been an increase in the prevalence of erectile dysfunction (ED) in the general population especially among Diabetic patients. This seems to be neglected problem in low-income countries. This study aims at establishing the prevalence of ED and associated risk factors in diabetic patients attended at Diabetic Clinic at Muhimbili National Hospital. Methods: A cross-sectional hospital based study was conducted among 312 diabetic patients attending diabetic clinic at Muhimbili National Hospital between May and December 2011. Results: More than half (55.1%) of the patients were found to have some form of ED (12.8 % had mild dysfunction, 11.5 % moderate and 27.9 % severe

Research paper thumbnail of Rationale, design and protocol of a cross-sectional study on pregnancy-related cardiovascular diseases in Tanzania (PRECARDT): burden, characterisation and prognostic significance at delivery

BMJ Open, 2021

IntroductionThe paucity of data describing cardiovascular disease (CVD) in pregnancy in many part... more IntroductionThe paucity of data describing cardiovascular disease (CVD) in pregnancy in many parts of Africa including Tanzania has given rise to challenges in proper management by the healthcare providers. This study is set out to (1) determine the prevalence of a range of CVDs during pregnancy in women attending antenatal clinics in Tanzania and (2) determine the impact of these CVDs on maternal and fetal outcomes at delivery.Methods and analysisThis is a cross-sectional study with a prospective component to be conducted in two referral hospitals in Tanzania. Pregnant women aged ≥18 years diagnosed with a CVD during the antenatal period are being identified and extensively characterised by performing clinical assessment, modified WHO staging, electrocardiography, echocardiography and laboratory tests. Patients identified with CVDs (exposed) and a subset without (unexposed) will be followed up to determine maternal and fetal outcomes at delivery. A minimum sample of 1560 will be su...

Research paper thumbnail of Intradialytic Arrhythmias Among Patients with End Stage Renal Disease on Maintenance Hemodialysis at Muhimbili National Hospital

BackgroundArrhythmias are responsible for almost 2 out of 3 cardiac deaths among patients on hemo... more BackgroundArrhythmias are responsible for almost 2 out of 3 cardiac deaths among patients on hemodialysis. We report the prevalence and risk factors for clinically significant arrhythmias among end stage renal disease (ESRD) patients on maintenance dialysis at a tertiary dialysis facility in Tanzania. MethodsCross-sectional study, involving consenting adults with ESRD was conducted September 2019 to February 2020. Arrhythmias were assessed using standard 5-leads Holter electrocardiography placed 15 minutes before dialysis and connected throughout dialysis. Clinically Significant Arrhythmias (CSA) was defined as ectopic beats in excess of 10 per hour or any of the ventricular tachycardia or Pause lasting for at least 2.5 seconds or paroxysmal supraventricular tachycardia or atrial flutter or atrial fibrillation. ResultsA total of 71 (44.4%) participants had CSA. Factors associated with increased risk for CSA were: age older than 60 years (OR 34; 95% CI: 5.15-236; P< 0.001), intrad...

Research paper thumbnail of Health Literacy, Information Seeking Patterns and Perceived Outcomes among Pregnant Women in Two Districts of Tanzania

BackgroundPregnant women that engage in information seeking process are more likely to have a hig... more BackgroundPregnant women that engage in information seeking process are more likely to have a high level of knowledge about their health, be confident to discuss their health concerns with their health care providers and report better health promotion activities than individuals who do not seek health information. However, health literacy influence pregnant women’s information seeking behaviours and consequently their health knowledge and health outcomes. Limited studies have explored the effects of health literacy on the outcomes associated with the information seeking among pregnant women in Tanzania. This study investigates the relationship between health literacy and information seeking patterns and its associated outcomes among pregnant women in Tanzania. MethodsA cross- sectional survey was conducted among 260 pregnant women aged 18 and above attending selected antenatal clinics (ANC) in Tanzania. Health literacy was assessed using a REALM-SF instrument while information seeki...

Research paper thumbnail of A comparison of AAIR versus DDDR pacing for patients with sinus node dysfunction: a long-term follow-up study

OBJECTIVES The aim of the study was to compare the clinical outcomes [atrial fibrillation (AF), a... more OBJECTIVES The aim of the study was to compare the clinical outcomes [atrial fibrillation (AF), atrio-ventricular (AV) block, device sepsis and lead revision] of patients with sinus node dysfunction (SND) between atrial-pacing atrial-sensing inhibited-response rate-adaptive (AAIR) versus dual-chamber rate-adaptive (DDDR) pacing. The choice of AAIR pacing versus DDDR pacing was determined by AV nodal functional testing at implant. METHODS We conducted a retrospective review of consecutive patients who underwent AAIR and DDDR pacing over a 10-year period. RESULTS One hundred and sixteen patients required pacing for symptomatic SND. Fifty-four (46.6%) patients received AAIR pacemakers and 62 (53.4%) received DDDR pacemakers based on AV nodal functional testing at implant. Patients who had AV Wenkebach with atrial pacing at 120 beats per minute received DDDR pacing. Overall the mean age of patients with SND was 65 years and 66.4% were females, 30% were diabetics and 71% were hypertensiv...

Research paper thumbnail of Rheumatic heart disease anno 2020: Impacts of gender and migration on epidemiology and management

European Journal of Clinical Investigation, 2020

The epidemiology and management of diseases can be influenced by social demographic factors. Gend... more The epidemiology and management of diseases can be influenced by social demographic factors. Gender and migration are among these factors.

Research paper thumbnail of Risk factors and prevalence of dilated cardiomyopathy in Sub Sahara Africa: a systematic review article (Preprint)

BACKGROUND Cardiomyopathies, defined as diseases involving mainly the heart muscle, are linked to... more BACKGROUND Cardiomyopathies, defined as diseases involving mainly the heart muscle, are linked to 5.9 of 100,000 of estimated mortality of the global population although underdiagnosis is significant. In sub Saharan Africa, studies show that cardiomyopathy constitutes 21.4% of cases with heart failure and comes second only to hypertensive heart disease. However, there is paucity of data in the region regarding the different types of cardiomyopathies. It has been noted that presence of non-modifiable cardiovascular risk factors such as family history, age, ethnicity, gender as well as modifiable risk factors such as hypertension, diabetes, tobacco use, physical inactivity, poor nutrition, excessive alcohol consumption, high cholesterol and obesity increase the probability of developing cardiovascular disease. OBJECTIVE The review will focus on available literature in sub- Saharan Africa on prevalence of dilated cardiomyopathy (DCM) and associated risk factors in patients with DCM. It...

Research paper thumbnail of Pericardial cyst with right ventricular compression

The Pan African medical journal, 2012

Pericardial cysts are infrequent and benign mediastinal lesions. While most pericardial cysts are... more Pericardial cysts are infrequent and benign mediastinal lesions. While most pericardial cysts are asymptomatic, some patients may present with compression symptoms. We present the case of a 22-year-old man who presented with a right pericardial cyst that caused compression of the right ventricle.

Research paper thumbnail of Prevalence of erectile dysfunction and associated factors among men without concomitant diseases: a population study

International Journal of Impotence Research, 2003

We interviewed a population sample of 2412 men aged 40-70 y in Brazil, Italy, Japan and Malaysia ... more We interviewed a population sample of 2412 men aged 40-70 y in Brazil, Italy, Japan and Malaysia about medical history, lifestyle habits and sexual behavior. Men were classified as having moderate or complete erectile dysfunction (ED) if they reported to be sometimes or never able to achieve and maintain an erection satisfactory for sexual intercourse, respectively. There were 1335 men with no diagnosis of cardiovascular or prostate diseases, diabetes, ulcer or depression, nor taking hormones. The prevalence of ED was 16.1%. ED was associated with age (the risk increased 8% per y), moderate (odds ratio (OR) ¼ 2.2) or severe (OR ¼ 4.9) lower urinary tract symptoms and smoking (OR ¼ 2.3 for 430 cigarettes/day). It was inversely associated with physical activity (OR ¼ 0.5) and higher educational levels. Between the ages of 40 and 70 y, almost one in six 'healthy' men is affected by ED. Further research should look at preclinical disease stages and genetic factors.

Research paper thumbnail of Histopathological evaluation of chronic rheumatic mitral valve stenosis: the association with clinical presentation, pathogenesis, and management at a National Cardiac Institute, Tanzania

Research paper thumbnail of Total Proximal Left Anterior Descending Artery Occlusion Presenting as Right Sided Chest Pain with a Misdiagnosis of Costochondritis: A Case Report

Tanzania Medical Journal, 2021

Background Acute coronary syndrome refers to a group of clinical symptoms consistent with acute m... more Background Acute coronary syndrome refers to a group of clinical symptoms consistent with acute myocardial ischemia or infarction that are potentially life threating requiring immediate interventions. Certain proportion of patients can present with atypical symptoms leading to a missed diagnosis associated with devastating outcomes. Case presentation We present a 60 years’ female of African descent with a medical history of hypertension and type 2 Diabetes mellitus who presented with a 2 months’ history of right-sided anterior chest pain and was diagnosed with costochondritis. Further assessment revealed, normal cardiac markers and an electrocardiogram suggestive of anterior wall myocardial infarction. A coronary computed tomography and cardiac magnetic imaging scans revealed a total occlusion of the proximal left anterior descending artery and a viable myocardium respectively. She underwent successful percutaneous coronary interventions with stenting with complete alleviation of he...