In the elderly population, the predicted increased burden of NCDs on health services in Africa appears to have occurred. Greater awareness and some reallocation of resources toward NCDs may be required if the burden of such diseases is to be reduced.

Objective: To review iatrogenic ureteric and urinary bladder injuries from obstetric and gynaecological surgeries treated in the urology department analysing; ureteric anatomy, aetiologic factors, diagnosis, treatment and outcomes. Design: A retrospective study.

Background Sustainability of research culture in Sub-Saharan Africa is threatened in part by the lack of a critical mass of young researchers with the requisite skills and interest to undertake research careers. This paper describes an intensive mentorship programme combining hierarchical (vertical) and peer-to-peer (horizontal) mentoring strategies among young researchers in a resource limited setting in Sub-Saharan Africa. Methods A consortium of three partnering large Tanzanian health training institutions (MUHAS, CUHAS and KCMUCo) and two collaborating US institutions (UCSF and Duke University) was formed as part of the five-year Transforming Health Professions Education in Tanzania (THET) project, funded by the NIH through Health Professional Education Partnership Initiative (HEPI). Within THET, the Community of Young Research Peers (CYRP) was formed, comprising of inter-professional and cross-institutional team of 12 Master-level Young Research Peers and 10 co-opted fellows from the former MEPI-Junior Faculty (MEPI-JF) project. The Young Peers received mentorship from senior researchers from the consortium through mentored research awards and research training, and in turn provided reciprocal peer-to-peer mentorship as well as mentorship to undergraduate students. Results At the end of the first 2 years of the project, all 12 Young Peers were proceeding well with mentored research awards, and some were at more advanced stages. For example, three articles were already published in peer reviewed journals and two other manuscripts were in final stages of preparation. All 12 Young Peers participated in CYRP-wide thematic training workshops on mentoring and secondary data analysis; 11 had undertaken at least three research training short courses in identified areas of need; 9 joined at least one other ongoing research project; 5 made at least one scientific presentation, and 5 participated in at least one submitted grant application. Half of the Young Peers have enrolled in PhD programmes. A collective total of 41 undergraduate students were actively mentored by the Young Peers in research. Conclusion The CYRP has demonstrated to be an effective model for dual vertical and horizontal mentorship in research to young investigators in resource-limited settings. This model is recommended to educators working on developing research competence of early career researchers, particularly in Sub-Saharan Africa.

Although the CBE programs have similar goals, their strategies for achieving these goals vary. To identify approaches that successfully address the challenges, particularly with increasing enrollment, medical schools need to develop structured models and tools for evaluating the processes, outcomes, and impacts of CBE programs. Such efforts should be accompanied by training faculty and embracing technology, improving curricula, and using global/regional networking opportunities.

Introduction Little is known about outcomes after hospitalization for HIV-infected adults in sub-Saharan Africa. We determined 12-month, post-hospital mortality rates in HIV-infected vs. uninfected adults and predictors of mortality. Methods In this prospective cohort study, we enrolled adults admitted to the medical wards of a public hospital in northwestern Tanzania. We conducted standardized questionnaires, physical examinations, and basic laboratory analyses including HIV testing. Participants or proxies were called at one, three, six, and 12 months to determine outcomes. Predictors of in-hospital and post-hospital mortality were determined using logistic regression. Cox regression models were used to analyze mortality incidence and associated factors. To confirm our findings, we studied adults admitted to another government hospital. Results We enrolled 637 consecutive adult medical inpatients: 38/143 (26.6%) of the HIV-infected adults died in-hospital vs. 104/494 (21.1%) of the HIV-uninfected. Twelve-month outcomes were determined for 98/105 (93.3%) vs. 352/390 (90.3%) discharged adults, respectively. Post-hospital mortality was 53/105 (50.5%) for HIV-infected adults vs. 126/390 (32.3%) for HIV-uninfected (adjusted p=0.006). The 66/105 (62.9%) of HIV-infected who attended clinic within one month after discharge had significantly lower mortality than other HIV-infected adults (adjusted hazards ratio = 0.17 [0.07–0.39], p<0.001). Adults admitted to a nearby government hospital had similarly high rates of post-hospital mortality. Conclusions Post-hospital mortality is disturbingly high among HIV-infected adult inpatients in Tanzania. The post-hospital period may offer a window of opportunity to improve survival in this population. Interventions are urgently needed and should focus on increasing post-hospital linkage to primary HIV care.

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Learning Management Systems (LMS) are powerful tools for the organization and presentation of curricular learning materials, for monitoring of student and faculty members performance, and for overall quality control. However, there is limited evidence regarding the acceptance and performance of LMS in Africa. This manuscript describes the implementation, the outcomes, and the challenges of the first five years of a LMS at the Kilimanjaro Christian Medical University College (KCMUCo). The LMS has been fully adopted into KCMUCo curriculum and deployed to 1356 students. It has been demonstrated to enhance learning with strength of consensus measure of 84% for basic sciences and 78% for clinical classes. 80% of faculty members have been satisfied with the use of LMS. Electronic assessment has become an obligatory platform for theory examinations. LMS adoption may improve education outcomes at other medical schools in Tanzania and sub-Saharan Africa.

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