Bakari L Leguma, Rajabu Rocky Akarro, A. Msengwa, F. Sichona
Background: In Tanzania, like in many other poor African countries, cervical cancer is a major problem facing women especially for those aged 30 years and above. This study aimed at constructing a statistical model to enable the prediction of the outcome of treatment for cervical cancer patients in Tanzania. Methods: Data were collected retrospectively from patient’s files with histological proven cervical cancer who were treated at Ocean Road Cancer Institute (ORCI) from year 2009 and followed up to year 2011. The factors considered are screening status, HIV status, disease stage, age, treatment type and the intent of the treatment. The study employed the Chi-square (χ2) test and the logistic regression model for its analysis. Results: The Chi-square (χ2) test result showed that there was a significant relationship between outcome of treatment and the patient screening status, HIV status, disease stage and intent of treatment at 5% level of significance. On the other hand, the logistic regression results found patient disease stage and intent of the treatment to be statistically significant at 95 percent. Logistic regression results also showed that patients who attended ORCI when their disease at a late stage had an odds ratio of 0.128 less likely to have favorable outcomes compared to those patients who attended ORCI when their disease stage was at early stages. The odds ratio for cervical cancer patients who received both treatment, radiotherapy, and chemotherapy was 2.643 more likely to have favorable outcomes Conclusion: More emphasis and campaigns should be made in order to encourage women all over the country to attend cancer centers for screening and treatment at early stages or even before any symptoms for cervical cancer and other types of cancers.
{"title":"Some Traits on the Outcome of the Treatment of Cervical Cancer in Tanzania: A Case Study of Ocean Road Cancer Institute (ORCI)","authors":"Bakari L Leguma, Rajabu Rocky Akarro, A. Msengwa, F. Sichona","doi":"10.4314/THRB.V21I2.1","DOIUrl":"https://doi.org/10.4314/THRB.V21I2.1","url":null,"abstract":"Background: In Tanzania, like in many other poor African countries, cervical cancer is a major problem facing women especially for those aged 30 years and above. This study aimed at constructing a statistical model to enable the prediction of the outcome of treatment for cervical cancer patients in Tanzania. \u0000Methods: Data were collected retrospectively from patient’s files with histological proven cervical cancer who were treated at Ocean Road Cancer Institute (ORCI) from year 2009 and followed up to year 2011. The factors considered are screening status, HIV status, disease stage, age, treatment type and the intent of the treatment. The study employed the Chi-square (χ2) test and the logistic regression model for its analysis. \u0000Results: The Chi-square (χ2) test result showed that there was a significant relationship between outcome of treatment and the patient screening status, HIV status, disease stage and intent of treatment at 5% level of significance. On the other hand, the logistic regression results found patient disease stage and intent of the treatment to be statistically significant at 95 percent. Logistic regression results also showed that patients who attended ORCI when their disease at a late stage had an odds ratio of 0.128 less likely to have favorable outcomes compared to those patients who attended ORCI when their disease stage was at early stages. The odds ratio for cervical cancer patients who received both treatment, radiotherapy, and chemotherapy was 2.643 more likely to have favorable outcomes \u0000Conclusion: More emphasis and campaigns should be made in order to encourage women all over the country to attend cancer centers for screening and treatment at early stages or even before any symptoms for cervical cancer and other types of cancers.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48583815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Kimaro, C. Bottomley, A. Kahwa, L. Guinness, S. Kivuyo, V. Simms, B. Ngowi, D. Chanda, S. Jaffar, G. Mfinanga
Introduction: In 2018, there were appropriately 20.6 million [18.2 million–23.2 million] people living with HIV in Eastern and Southern Africa, and an estimated 67% of them were on antiretroviral therapy (ART). A major challenge in the scale-up of ART services in Sub-Saharan Africa is the severe shortage of clinical staff. Methods: We conducted a randomised trial in Tanzania and Zambia to test an innovative intervention that involved the use of lay health workers and screening for cryptococcal meningitis and tuberculosis. Here we describe the model of care with a particular focus on the trained lay worker component. Lay workers carried out home visits to patients in the intervention arm to deliver antiretroviral drugs, provide adherence counselling, and conduct simple monitoring for treatment side effects and other medical conditions. Lay workers were responsible for referring patients with conditions that might require further medical attention as well as discouraging self-referral. A total of 1999 participants were enrolled in the trial. Lay workers were recruited through public advertisements. Results: Six lay workers were recruited in each country and trained for two weeks. Each lay worker was paid a monthly salary of US$ 487.61 in Zambia and US$ 524.61in Tanzania. They were also paid communication and transport expenses for home visits. The median number of visits per patient was 3 for Tanzania and 4 for Zambia. On average a lay worker was responsible for 72.3 patients in Tanzania and 94.5 in Zambia for 1 year. Referrals were made in 9% of the home visits and self-referral was discouraged in 64% of visits. Conclusion: The use of paid lay workers to provide HIV/AIDS services in urban settings where there is a shortage of clinical staff may help to identify ART related side effects/adverse reactions and prevent unnecessary referrals.
{"title":"Contributions of the lay workers in providing home-based treatment adherence support to patients with advanced HIV/AIDS disease in low-income settings: Lessons learned from the field in Tanzania and Zambia","authors":"G. Kimaro, C. Bottomley, A. Kahwa, L. Guinness, S. Kivuyo, V. Simms, B. Ngowi, D. Chanda, S. Jaffar, G. Mfinanga","doi":"10.4314/THRB.V21I2.5","DOIUrl":"https://doi.org/10.4314/THRB.V21I2.5","url":null,"abstract":"Introduction: In 2018, there were appropriately 20.6 million [18.2 million–23.2 million] people living with HIV in Eastern and Southern Africa, and an estimated 67% of them were on antiretroviral therapy (ART). A major challenge in the scale-up of ART services in Sub-Saharan Africa is the severe shortage of clinical staff. \u0000Methods: We conducted a randomised trial in Tanzania and Zambia to test an innovative intervention that involved the use of lay health workers and screening for cryptococcal meningitis and tuberculosis. Here we describe the model of care with a particular focus on the trained lay worker component. Lay workers carried out home visits to patients in the intervention arm to deliver antiretroviral drugs, provide adherence counselling, and conduct simple monitoring for treatment side effects and other medical conditions. Lay workers were responsible for referring patients with conditions that might require further medical attention as well as discouraging self-referral. A total of 1999 participants were enrolled in the trial. Lay workers were recruited through public advertisements. \u0000Results: Six lay workers were recruited in each country and trained for two weeks. Each lay worker was paid a monthly salary of US$ 487.61 in Zambia and US$ 524.61in Tanzania. They were also paid communication and transport expenses for home visits. The median number of visits per patient was 3 for Tanzania and 4 for Zambia. On average a lay worker was responsible for 72.3 patients in Tanzania and 94.5 in Zambia for 1 year. Referrals were made in 9% of the home visits and self-referral was discouraged in 64% of visits. \u0000Conclusion: The use of paid lay workers to provide HIV/AIDS services in urban settings where there is a shortage of clinical staff may help to identify ART related side effects/adverse reactions and prevent unnecessary referrals.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48256564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Comparison of mortality is very useful in assessing population health. Crude rates can easily be computed from the mortality but they are not good for comparison across groups of the population. The aim of this paper was to compare mortality in Tanzania by region and gender using the 2012 Tanzania Population and Housing Census. Methods: Age-specific death rates for regions, Tanzania Mainland, Tanzania Zanzibar and entire Tanzania were obtained from Mortality and Health monograph data downloadable from the National Bureau of Statistics website. The direct standardization method was used to compare the mortality for male and female populations across all regions of Tanzania Mainland and Zanzibar. Results: Findings show that the mortality is low in Arusha, Manyara, and Kilimanjaro compared to other regions in Tanzania mainland implying that health status for both male and female population in those regions is better than the other regions while it is the worst in Njombe, Iringa, and Kagera implying the poor health status for those regions as compared to the rest regions in Tanzania Mainland. In Tanzania Zanzibar, high mortality was observed in Kusini Unguja and the lowest in Kaskazini Unguja for both male and female populations. By national wise and for almost all regions, the mortality for the male population is higher than that for the female population. Conclusion: Direct standardization methods can save as the best way for comparing mortality because it takes into consideration both the population at risk and the age structure. However, in estimating mortality, crude death rates should be used to give the magnitude while direct standardized death rates should be used for comparison purposes.
{"title":"Comparison of Mortality by Gender and Regions in Tanzania using Direct Standardized Death Rates (DSDR) Method","authors":"S. E. Kibona, Christopher H Mbotwa","doi":"10.4314/THRB.V21I1.1","DOIUrl":"https://doi.org/10.4314/THRB.V21I1.1","url":null,"abstract":"Background: Comparison of mortality is very useful in assessing population health. Crude rates can easily be computed from the mortality but they are not good for comparison across groups of the population. The aim of this paper was to compare mortality in Tanzania by region and gender using the 2012 Tanzania Population and Housing Census. \u0000Methods: Age-specific death rates for regions, Tanzania Mainland, Tanzania Zanzibar and entire Tanzania were obtained from Mortality and Health monograph data downloadable from the National Bureau of Statistics website. The direct standardization method was used to compare the mortality for male and female populations across all regions of Tanzania Mainland and Zanzibar. \u0000Results: Findings show that the mortality is low in Arusha, Manyara, and Kilimanjaro compared to other regions in Tanzania mainland implying that health status for both male and female population in those regions is better than the other regions while it is the worst in Njombe, Iringa, and Kagera implying the poor health status for those regions as compared to the rest regions in Tanzania Mainland. In Tanzania Zanzibar, high mortality was observed in Kusini Unguja and the lowest in Kaskazini Unguja for both male and female populations. By national wise and for almost all regions, the mortality for the male population is higher than that for the female population. \u0000Conclusion: Direct standardization methods can save as the best way for comparing mortality because it takes into consideration both the population at risk and the age structure. However, in estimating mortality, crude death rates should be used to give the magnitude while direct standardized death rates should be used for comparison purposes.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"21 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42564072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Tarimo, C. Moshiro, J. Ambikile, P. Munseri, M. Bakari, Ezekiel Matola, Hamisa Mangara, Theodora Mbunda, M. Ngatoluwa, K. Pallangyo
Background: Despite the successful conduct of three Phase I/II HIV vaccine trials in Dar es Salaam, Tanzania, misperception around the trials has been reported. In this study, misperception means incorrect understanding that in Phase I/II HIV vaccine trial, the researchers infected the volunteers with HIV. We describe the magnitude of misperception around HIV vaccine trials and associated factors among participating communities in Dar es Salaam, Tanzania. Methods: We conducted a cross-sectional study that included 605 respondents aged ³18 years from the communities that participated in Phase I/II HIV vaccine trials. These communities comprised of youths, Police and Prison officers. Respondents were interviewed using a pre-tested questionnaire on socio-demographic characteristics, HIV knowledge, and responses to HIV vaccine trial related questions. Results: Of the 605 respondents, 156 (26%) had misperception that the researchers infected the volunteers with HIV during the trials, while 58% weren’t sure whether the researchers infected the volunteers with the HIV or not. Awareness about progress in HIV vaccine development (adjusted risk ratio (RR)=1.50; 95% CI=1.11 – 2.04), participation in an HIV vaccine sensitization meeting (adjusted RR=1.50; 95% CI=1.14-1.97) and advanced secondary education (adjusted RR=1.92; 95% CI=1.19 – 3.09) were associated with an increased likelihood of having the misperception that researchers infected the volunteers. Nevertheless, the majority (94.5%) of respondents showed a willingness to know more about ongoing HIV vaccine studies while about 44.3% had reservations of taking part in HIV vaccine trials due to fear of getting HIV from the vaccine. Conclusions: The misperception that researchers infected volunteers with HIV in Phase I/II trial is significant and was associated with respondents’ awareness about HIV vaccine development, participation in sensitization meetings and advanced education. Partial knowledge about HIV vaccine trials was of note. Future HIV vaccine trials should strive to address the knowledge gap.
{"title":"Post-HIV vaccine trials’ misperception and associated factors among participating communities in Dar es Salaam, Tanzania","authors":"E. Tarimo, C. Moshiro, J. Ambikile, P. Munseri, M. Bakari, Ezekiel Matola, Hamisa Mangara, Theodora Mbunda, M. Ngatoluwa, K. Pallangyo","doi":"10.4314/THRB.V21I1.8","DOIUrl":"https://doi.org/10.4314/THRB.V21I1.8","url":null,"abstract":"Background: Despite the successful conduct of three Phase I/II HIV vaccine trials in Dar es Salaam, Tanzania, misperception around the trials has been reported. In this study, misperception means incorrect understanding that in Phase I/II HIV vaccine trial, the researchers infected the volunteers with HIV. We describe the magnitude of misperception around HIV vaccine trials and associated factors among participating communities in Dar es Salaam, Tanzania. \u0000Methods: We conducted a cross-sectional study that included 605 respondents aged ³18 years from the communities that participated in Phase I/II HIV vaccine trials. These communities comprised of youths, Police and Prison officers. Respondents were interviewed using a pre-tested questionnaire on socio-demographic characteristics, HIV knowledge, and responses to HIV vaccine trial related questions. \u0000Results: Of the 605 respondents, 156 (26%) had misperception that the researchers infected the volunteers with HIV during the trials, while 58% weren’t sure whether the researchers infected the volunteers with the HIV or not. Awareness about progress in HIV vaccine development (adjusted risk ratio (RR)=1.50; 95% CI=1.11 – 2.04), participation in an HIV vaccine sensitization meeting (adjusted RR=1.50; 95% CI=1.14-1.97) and advanced secondary education (adjusted RR=1.92; 95% CI=1.19 – 3.09) were associated with an increased likelihood of having the misperception that researchers infected the volunteers. Nevertheless, the majority (94.5%) of respondents showed a willingness to know more about ongoing HIV vaccine studies while about 44.3% had reservations of taking part in HIV vaccine trials due to fear of getting HIV from the vaccine. \u0000Conclusions: The misperception that researchers infected volunteers with HIV in Phase I/II trial is significant and was associated with respondents’ awareness about HIV vaccine development, participation in sensitization meetings and advanced education. Partial knowledge about HIV vaccine trials was of note. Future HIV vaccine trials should strive to address the knowledge gap.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48676048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Kalinga, R. Kavishe, D. Ishengoma, G. Kagaruki, C. Mweya, Saidi Mgata, L. Mahikwano, Charles E Mwanziva, E. Kamau, M. Hickman, N. Waters, Mara Kreishman-Deitrick, Lucky Temu, Sarah Chiduo, Christopher Mswanya, George Amoo, C. Ohrt, B. Vesely
Background: Despite a decrease in malaria burden reported between 2000 and 2015, an increasing trend of malaria transmission has been recently reported in some endemic countries including Tanzania. Periodic monitoring to identify pocket areas for asymptomatic Plasmodium falciparum infection is vital for malaria elimination efforts. The objective of this study was to determine prevalence of asymptomatic malaria infections among military recruits in selected camps in Tanzania. Methods: A cross-sectional study was conducted in 2015 at four military camps (Bulombora, Mgambo, Ruvu, and Rwamkoma) of National Service located in regions with varying malaria endemicity in Tanzania. Finger prick blood samples collected from asymptomatic military recruits who had been at the camps for over two months were simultaneously tested using microscopy and malaria rapid diagnostic tests (mRDTs) to detect malaria parasite infections. Results: Malaria parasite prevalence among asymptomatic recruits was 20.3% and 19.4% by microscopy and mRDT respectively. There was moderate agreement (Kappa=0.724) between microscopy and mRDT test results. A significant difference (p<0.001) of malaria parasite prevalence among the four study camps was observed; ranging from 1.9% in Bulombora to 39.4% in Rwamkoma. The geometric mean parasite density was 11,053 asexual parasites/µl and most recruits (56.8%) had 200 to 1999 asexual parasites/µl. P. falciparum was the predominant (99.2%) malaria parasite species. Conclusion: Our study found high prevalence of asymptomatic malaria infections among military recruits in the selected camps, and this varied from one camp to another. The study has highlighted that public residence institutions such as military camps can be potential hotspots for malaria infection and therefore should not be skipped in routine national malaria surveillance system for monitoring trends of infections
{"title":"Prevalence of asymptomatic malaria infections in selected military camps in Tanzania","authors":"A. Kalinga, R. Kavishe, D. Ishengoma, G. Kagaruki, C. Mweya, Saidi Mgata, L. Mahikwano, Charles E Mwanziva, E. Kamau, M. Hickman, N. Waters, Mara Kreishman-Deitrick, Lucky Temu, Sarah Chiduo, Christopher Mswanya, George Amoo, C. Ohrt, B. Vesely","doi":"10.4314/THRB.V21I1.4","DOIUrl":"https://doi.org/10.4314/THRB.V21I1.4","url":null,"abstract":"Background: Despite a decrease in malaria burden reported between 2000 and 2015, an increasing trend of malaria transmission has been recently reported in some endemic countries including Tanzania. Periodic monitoring to identify pocket areas for asymptomatic Plasmodium falciparum infection is vital for malaria elimination efforts. The objective of this study was to determine prevalence of asymptomatic malaria infections among military recruits in selected camps in Tanzania. \u0000Methods: A cross-sectional study was conducted in 2015 at four military camps (Bulombora, Mgambo, Ruvu, and Rwamkoma) of National Service located in regions with varying malaria endemicity in Tanzania. Finger prick blood samples collected from asymptomatic military recruits who had been at the camps for over two months were simultaneously tested using microscopy and malaria rapid diagnostic tests (mRDTs) to detect malaria parasite infections. \u0000Results: Malaria parasite prevalence among asymptomatic recruits was 20.3% and 19.4% by microscopy and mRDT respectively. There was moderate agreement (Kappa=0.724) between microscopy and mRDT test results. A significant difference (p<0.001) of malaria parasite prevalence among the four study camps was observed; ranging from 1.9% in Bulombora to 39.4% in Rwamkoma. The geometric mean parasite density was 11,053 asexual parasites/µl and most recruits (56.8%) had 200 to 1999 asexual parasites/µl. P. falciparum was the predominant (99.2%) malaria parasite species. \u0000Conclusion: Our study found high prevalence of asymptomatic malaria infections among military recruits in the selected camps, and this varied from one camp to another. The study has highlighted that public residence institutions such as military camps can be potential hotspots for malaria infection and therefore should not be skipped in routine national malaria surveillance system for monitoring trends of infections","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42598824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Musenge, Sophia Tembo, Mutinta Hankwebe, Ndonia Kahinga, Ovy Mushibwe, Ivy Mulenga, S. Tembo
Background: Malnutrition is a severe and persisting cause of morbidity and mortality among under-five children in Zambia. We assessed malnutrition and its determinants among under-five children in Lusaka urban, Zambia. Methods: This cross-sectional study was conducted at Chawama, Kabwata, Chilenje and Mtendere urban clinics in Lusaka. A simple random sample of 384 under-five children were selected between February and March 2015. A structured interview schedule was used to collect data on demographic characteristics, determinants of malnutrition and anthropometric measurements. Multivariate binary logistic regression analysis was carried out using IBM® SPSS® Statistics for Windows Version 20.0 to identify determinants of malnutrition while adjusting for confounders. Results: Of the 384 under-five children, most (51.8%) of them were male and the mean (SD) age was 13.83±10.17 months. The zH/A; zW/H; and zW/A was 68.5% and 31.5%; 95.6% and 4.4%; and 86.2% and 13.8% for normal and stunted; normal and wasted; and normal and underweight respectively. Majority (77.1%) of the children had MUAC > 12.5 cm, 16.9% had 11.5 – 12.5 cm and 6.0% had 12.5 cm (OR 0.10, 95% CI: 0.01 – 0.94; OR 0.01, 0.00 – 0.10; and OR 0.4, 0.01 – 0.19) were statistically significantly associated with stunting, wasting and underweight respectively. Conclusion: We established varied levels of stunting, wasting and underweight and mother’s nutritional practices and MUAC predicted these levels. More information, education and communication messages to the mothers and caretakers with regard to nutritional practices are needed so that under-nutrition can be improved, to ensure healthy living for mothers, care takers and under-five children.
背景：营养不良是赞比亚五岁以下儿童发病率和死亡率的一个严重而持久的原因。我们评估了赞比亚卢萨卡市区五岁以下儿童营养不良及其决定因素。方法：这项横断面研究在卢萨卡的Chawama、Kabwata、Chilenje和Mtendere城市诊所进行。2015年2月至3月期间，对384名五岁以下儿童进行了简单随机抽样。采用结构化访谈时间表收集人口统计学特征、营养不良的决定因素和人体测量数据。使用IBM®SPSS®Statistics for Windows 20.0版进行多变量二元逻辑回归分析，以确定营养不良的决定因素，同时调整混杂因素。结果：在384名5岁以下儿童中，大多数（51.8%）为男性，平均（SD）年龄为13.83±10.17个月。zH/A；zW/H；zW/A分别为68.5%和31.5%；95.6%和4.4%；正常和发育迟缓分别为86.2%和13.8%；正常和浪费；正常和体重不足。大多数（77.1%）儿童的MUAC>12.5 cm，16.9%的儿童为11.5–12.5 cm，6.0%为12.5 cm（OR 0.10，95%CI:0.01–0.94；OR 0.01，0.00–0.10；OR 0.4，0.01–0.19）分别与发育迟缓、消瘦和体重不足有统计学显著相关。结论：我们确定了发育迟缓、消瘦和体重不足的不同水平以及母亲的营养习惯，MUAC预测了这些水平。需要向母亲和看护人提供更多关于营养做法的信息、教育和沟通信息，以改善营养不足的情况，确保母亲、看护人和五岁以下儿童的健康生活。
{"title":"Prevalence and determinants of malnutrition among under-five children in Lusaka urban, Zambia","authors":"E. Musenge, Sophia Tembo, Mutinta Hankwebe, Ndonia Kahinga, Ovy Mushibwe, Ivy Mulenga, S. Tembo","doi":"10.4314/THRB.V21I1.5","DOIUrl":"https://doi.org/10.4314/THRB.V21I1.5","url":null,"abstract":"Background: Malnutrition is a severe and persisting cause of morbidity and mortality among under-five children in Zambia. We assessed malnutrition and its determinants among under-five children in Lusaka urban, Zambia. \u0000 Methods: This cross-sectional study was conducted at Chawama, Kabwata, Chilenje and Mtendere urban clinics in Lusaka. A simple random sample of 384 under-five children were selected between February and March 2015. A structured interview schedule was used to collect data on demographic characteristics, determinants of malnutrition and anthropometric measurements. Multivariate binary logistic regression analysis was carried out using IBM® SPSS® Statistics for Windows Version 20.0 to identify determinants of malnutrition while adjusting for confounders. \u0000 Results: Of the 384 under-five children, most (51.8%) of them were male and the mean (SD) age was 13.83±10.17 months. The zH/A; zW/H; and zW/A was 68.5% and 31.5%; 95.6% and 4.4%; and 86.2% and 13.8% for normal and stunted; normal and wasted; and normal and underweight respectively. Majority (77.1%) of the children had MUAC > 12.5 cm, 16.9% had 11.5 – 12.5 cm and 6.0% had 12.5 cm (OR 0.10, 95% CI: 0.01 – 0.94; OR 0.01, 0.00 – 0.10; and OR 0.4, 0.01 – 0.19) were statistically significantly associated with stunting, wasting and underweight respectively. \u0000 Conclusion: We established varied levels of stunting, wasting and underweight and mother’s nutritional practices and MUAC predicted these levels. More information, education and communication messages to the mothers and caretakers with regard to nutritional practices are needed so that under-nutrition can be improved, to ensure healthy living for mothers, care takers and under-five children.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":"1-13"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48420711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gislanne Stéphanne Estevam da Silva, Albenize de Azevedo Soares, Ana Beatriz Dantas do Nascimento, Graciane Pereira de Souza, Franklin Learcton Bezerra de Oliveira, D. G. Kramer
Introduction: Syphilis is an infection with increasing incidence in Brazilian regions, and the congenital form is liable to lead to cerebral palsy and musculoskeletal deformity. The objective of this study was to analyze the prevalence of congenital syphilis in the State of Rio Grande do Norte, Brazil. Methods: An exploratory and retrospective study was performed from 2015 to 2017. Public domain data and unrestricted access were used in the DATASUS computer department through the TABNET application. The following variables were collected: age range, clinical evolution (congenital syphilis late, late congenital syphilis, stillbirth / syphilis abortion, ignored / blank, discarded; live birth), mother's schooling, performed prenatal and residence zone. Results: In Brazil, there were 75,733 cases, whereas in the State of Rio Grande do Norte there were 1,436 cases of congenital syphilis, out of which a greater number of confirmed cases affected age group of 0-6 days (97.6%). The highest number of cases was observed in the city of Natal (75.8%), followed by Mossoro (7.8%) and Parnamirim (5.7%). Conclusion: The study shows that the incidence of congenital syphilis occurs predominantly in incomplete elementary schooling and in the urban area. It was also verified that the diagnosis of most cases of congenital syphilis occurred in the age group up to 6 days of life, which contributes to the rates of evolution with the living child. In addition, a greater number of confirmed cases of congenital syphilis were observed, and prenatal care was performed, indicating a serious failure in care.
{"title":"Incidence of congenital syphilis in the State of Rio Grande do Norte and Brazil: a retrospective study","authors":"Gislanne Stéphanne Estevam da Silva, Albenize de Azevedo Soares, Ana Beatriz Dantas do Nascimento, Graciane Pereira de Souza, Franklin Learcton Bezerra de Oliveira, D. G. Kramer","doi":"10.4314/THRB.V21I1.2","DOIUrl":"https://doi.org/10.4314/THRB.V21I1.2","url":null,"abstract":"Introduction: Syphilis is an infection with increasing incidence in Brazilian regions, and the congenital form is liable to lead to cerebral palsy and musculoskeletal deformity. The objective of this study was to analyze the prevalence of congenital syphilis in the State of Rio Grande do Norte, Brazil. \u0000Methods: An exploratory and retrospective study was performed from 2015 to 2017. Public domain data and unrestricted access were used in the DATASUS computer department through the TABNET application. The following variables were collected: age range, clinical evolution (congenital syphilis late, late congenital syphilis, stillbirth / syphilis abortion, ignored / blank, discarded; live birth), mother's schooling, performed prenatal and residence zone. \u0000Results: In Brazil, there were 75,733 cases, whereas in the State of Rio Grande do Norte there were 1,436 cases of congenital syphilis, out of which a greater number of confirmed cases affected age group of 0-6 days (97.6%). The highest number of cases was observed in the city of Natal (75.8%), followed by Mossoro (7.8%) and Parnamirim (5.7%). \u0000Conclusion: The study shows that the incidence of congenital syphilis occurs predominantly in incomplete elementary schooling and in the urban area. It was also verified that the diagnosis of most cases of congenital syphilis occurred in the age group up to 6 days of life, which contributes to the rates of evolution with the living child. In addition, a greater number of confirmed cases of congenital syphilis were observed, and prenatal care was performed, indicating a serious failure in care.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42564956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Chalya, Shija B Mabenda, Gustave Bunabe, J. Gilyoma, W. Mahalu
Background: Cerumen impaction is a worldwide problem constituting a significant proportion of health problems in many settings and its prevalence varies. There is a paucity of published data regarding this condition in Tanzania with none from Mwanza region. The aim of this study was to determine the prevalence of cerumen impaction and associated factors among primary school children in Mwanza City and to assess the effect of cerumen impaction and its removal on hearing ability Methods and Patients: This was a cross-sectional, community-based study of primary school children with cerumen impaction that was carried out in randomly selected primary schools in Mwanza City between December 2016 and May 2017. Multistage cluster sampling technique was employed to obtain a required number of the study population. Results: Out of the 406 participants, ninety-five (23.4%) had cerumen impacted in their ears. Of these, 56 (58.9%) were males and 39(41.1%) were females. The mean age at presentation was 11.24±8.86 years. Ear bud abuse (83.7%) was the most common predisposing factor for cerumen impaction. Cerumen impaction was found in the right ear of 9 (9.5%) patients and in the left ear in 31 (32.6%) patients and bilateral in 55 (57.9%) of patients. The major presenting symptoms were ear itching, otalgia, hearing loss and tinnitus. Ear syringing was used to remove cerumen impaction and caused significant improvement in hearing thresholds. There were no recorded complications. Conclusion: Cerumen impaction is a common otologic presentation in our sub-region. Ignorance with the profound abuse of cotton buds is the major predisposing factor. Health education is of the essence as treatment is simple and effective.
{"title":"Prevalence of cerumen impaction and associated factors among primary school children in Mwanza city, Tanzania","authors":"P. Chalya, Shija B Mabenda, Gustave Bunabe, J. Gilyoma, W. Mahalu","doi":"10.4314/THRB.V21I1.6","DOIUrl":"https://doi.org/10.4314/THRB.V21I1.6","url":null,"abstract":"Background: Cerumen impaction is a worldwide problem constituting a significant proportion of health problems in many settings and its prevalence varies. There is a paucity of published data regarding this condition in Tanzania with none from Mwanza region. The aim of this study was to determine the prevalence of cerumen impaction and associated factors among primary school children in Mwanza City and to assess the effect of cerumen impaction and its removal on hearing ability \u0000Methods and Patients: This was a cross-sectional, community-based study of primary school children with cerumen impaction that was carried out in randomly selected primary schools in Mwanza City between December 2016 and May 2017. Multistage cluster sampling technique was employed to obtain a required number of the study population. \u0000Results: Out of the 406 participants, ninety-five (23.4%) had cerumen impacted in their ears. Of these, 56 (58.9%) were males and 39(41.1%) were females. The mean age at presentation was 11.24±8.86 years. Ear bud abuse (83.7%) was the most common predisposing factor for cerumen impaction. Cerumen impaction was found in the right ear of 9 (9.5%) patients and in the left ear in 31 (32.6%) patients and bilateral in 55 (57.9%) of patients. The major presenting symptoms were ear itching, otalgia, hearing loss and tinnitus. Ear syringing was used to remove cerumen impaction and caused significant improvement in hearing thresholds. There were no recorded complications. \u0000Conclusion: Cerumen impaction is a common otologic presentation in our sub-region. Ignorance with the profound abuse of cotton buds is the major predisposing factor. Health education is of the essence as treatment is simple and effective.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"21 1","pages":"1-9"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42697742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Asakura, G. Makingi, Kunda John, R. Kazwala, K. Makita
Background: Brucellosis is an endemic zoonosis in Tanzania. This study was conducted to investigate the seroprevalence of human brucellosis and its risk factors in agro-pastoral areas in Morogoro Region, Tanzania. Methods: Questionnaire survey and blood sampling were conducted from January to February 2018 at four villages. Anyone living in the villages and wished to participate were involved. Competitive ELISA was used for diagnosis. Risk factor analysis for sero-positivity in human and analysis for the association of sero-positivity between cattle and human within each farm were conducted, using the data of farm-level bovine brucellosis status from our bovine brucellosis research performed in 2016. Results: The seroprevalence was 33.3% (44/132). In univariable analysis, the Maasai were significantly more sero-positive (56.5%) than other tribes (28.4%) (OR = 3.23, 95% CI: 1.28–8.41). Drinking raw milk was a risk factor in both univariable and multivariable analyses (OR = 3.97, 95% CI: 1.61–10.20). A negative association between sero-positivity in cattle and human within each farm was found (p<0.01). The Maasai performed more risk-taking behaviours for human infection than other tribes: drinking raw milk (p<0.01) or blood (p<0.01) and helping delivery of cattle with bare hands (p=0.03). Conclusions: The Maasai were at high risk of human brucellosis. More detailed survey and educational interventions are urgently needed.
{"title":"Seroprevalence and risk factors for human brucellosis in agro-pastoral areas in Tanzania","authors":"S. Asakura, G. Makingi, Kunda John, R. Kazwala, K. Makita","doi":"10.4314/THRB.V21I1.7","DOIUrl":"https://doi.org/10.4314/THRB.V21I1.7","url":null,"abstract":"Background: Brucellosis is an endemic zoonosis in Tanzania. This study was conducted to investigate the seroprevalence of human brucellosis and its risk factors in agro-pastoral areas in Morogoro Region, Tanzania. \u0000Methods: Questionnaire survey and blood sampling were conducted from January to February 2018 at four villages. Anyone living in the villages and wished to participate were involved. Competitive ELISA was used for diagnosis. Risk factor analysis for sero-positivity in human and analysis for the association of sero-positivity between cattle and human within each farm were conducted, using the data of farm-level bovine brucellosis status from our bovine brucellosis research performed in 2016. \u0000Results: The seroprevalence was 33.3% (44/132). In univariable analysis, the Maasai were significantly more sero-positive (56.5%) than other tribes (28.4%) (OR = 3.23, 95% CI: 1.28–8.41). Drinking raw milk was a risk factor in both univariable and multivariable analyses (OR = 3.97, 95% CI: 1.61–10.20). A negative association between sero-positivity in cattle and human within each farm was found (p<0.01). The Maasai performed more risk-taking behaviours for human infection than other tribes: drinking raw milk (p<0.01) or blood (p<0.01) and helping delivery of cattle with bare hands (p=0.03). \u0000Conclusions: The Maasai were at high risk of human brucellosis. More detailed survey and educational interventions are urgently needed.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45349181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Akan, P. Kisenge, Tulizo Shemu Sanga, E. Mbugi, Mehmet Kerem Turkcan, M. Janabi, F. Atalar
Introduction: Sub-Saharan Africa (SSA) is facing a rising epidemic of non-communicable diseases including the coronary artery disease (CAD) ranking at the top of the list. Chromosome locus 9p21.3 containing CDKN2B antisense RNA 1 (CDKN2B-AS1), identified in many genome-wide association studies for coronary artery disease (CAD), encompasses multiple single nucleotide polymorphisms (SNPs). This study aimed to conduct the first genetic study evaluating the common polymorphisms in 9p21.3 locus in Tanzanian CAD patients from different regions of Tanzania and their associations with CAD risk factors. Material and Methods: A total of 90 patients from Northern region (N-CAD) of Tanzania and 65 patients from other regions (South, East, West and Central) (R-CAD) were included in the study. Further the biochemical analysis the genotyping of common variants was performed with the LightSNiP typing assay using qRT-PCR method. Results: Our analyses revealed that both genotype and allele frequencies of rs10757274, rs10757278 and rs10811656 were significantly different between the groups (p<0.05, respectively). We identified that one previously undescribed three-marker haplotype (rs1333049, rs10757274 and rs10757278) encompassing CDKN2B-AS1 was overrepresented (G-G-G, the risk haplotype, p<0.05) in N-CAD group compared to R-CAD group. The AUC of a risk model based on non-genetic factors was 0.730 (0.654-0.797) and the combination with genetic risk factors improved the AUC to 0.784 (95%CI=0.713-0.844, p<0.0001). Conclusion: Our results identified the presence of a novel three-marker haplotype having a significant association with CAD in Northern Tanzania. Moreover, combination of the nongenetic and genetic risk models were demonstrated to indicate good diagnostic accuracy for CAD in Northern Tanzania.
{"title":"Intronic variants in the long non-coding RNA CDKN2B-AS1 are strongly associated with the risk of coronary artery disease in the Northern Tribes of Tanzania","authors":"G. Akan, P. Kisenge, Tulizo Shemu Sanga, E. Mbugi, Mehmet Kerem Turkcan, M. Janabi, F. Atalar","doi":"10.4314/THRB.V21I1.3","DOIUrl":"https://doi.org/10.4314/THRB.V21I1.3","url":null,"abstract":"Introduction: Sub-Saharan Africa (SSA) is facing a rising epidemic of non-communicable diseases including the coronary artery disease (CAD) ranking at the top of the list. Chromosome locus 9p21.3 containing CDKN2B antisense RNA 1 (CDKN2B-AS1), identified in many genome-wide association studies for coronary artery disease (CAD), encompasses multiple single nucleotide polymorphisms (SNPs). This study aimed to conduct the first genetic study evaluating the common polymorphisms in 9p21.3 locus in Tanzanian CAD patients from different regions of Tanzania and their associations with CAD risk factors. Material and Methods: A total of 90 patients from Northern region (N-CAD) of Tanzania and 65 patients from other regions (South, East, West and Central) (R-CAD) were included in the study. Further the biochemical analysis the genotyping of common variants was performed with the LightSNiP typing assay using qRT-PCR method. Results: Our analyses revealed that both genotype and allele frequencies of rs10757274, rs10757278 and rs10811656 were significantly different between the groups (p<0.05, respectively). We identified that one previously undescribed three-marker haplotype (rs1333049, rs10757274 and rs10757278) encompassing CDKN2B-AS1 was overrepresented (G-G-G, the risk haplotype, p<0.05) in N-CAD group compared to R-CAD group. The AUC of a risk model based on non-genetic factors was 0.730 (0.654-0.797) and the combination with genetic risk factors improved the AUC to 0.784 (95%CI=0.713-0.844, p<0.0001). Conclusion: Our results identified the presence of a novel three-marker haplotype having a significant association with CAD in Northern Tanzania. Moreover, combination of the nongenetic and genetic risk models were demonstrated to indicate good diagnostic accuracy for CAD in Northern Tanzania.","PeriodicalId":39815,"journal":{"name":"Tanzania Journal of Health Research","volume":"21 1","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70663699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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