The East African health research journal最新文献

Background: Vaccination is considered more cost-effective in controlling the spread of COVID19 compared to other preventative measures. Pregnant women infected with COVID19 were likely to have severe COVID19 complications compared to uninfected women. This study examined the relationship between COVID19 vaccination uptake and socio-demographic characteristics among pregnant women in Kenya.

Methods: We conducted a secondary analysis using data from a pilot study examining COVID19 vaccination uptake among pregnant women in Kenya. We used descriptive analysis to report the proportions and chi 2 to assess if there are any significant differences between groups. Our primary outcome was COVID19 vaccination uptake. We performed logistic regressions.

Results: The predominant age groups of study participants were between 25-29 years (45.1%) and 30-39 years (45.1%). The majority of the pregnant had received COVID19 vaccination, with 87% having completed the full vaccine dosage. There was a higher uptake of adenovirus vector vaccines compared to mRNA COVID19 vaccines. Pregnant women between 30-39 years were 3.81 times more likely to have received COVID19 vaccination compared to those 25-29 years (aOR: 3.81; 95% CI: 1.28-11.39, P =.017). After adjustment, workplace requirements for COVID-19 vaccination were associated with increased odds of vaccination (aOR: 4.65; 95% CI 1.32-16.42). The study did not show any significant relationship between comorbid conditions during pregnancy and COVID19 vaccination.

Discussion: The variations of uptake by age-group cohorts, education levels, and vaccine workplace requirements suggest a need for further and more robust research on COVID19 vaccination among pregnant women. While workplace vaccination requirements may have prompted COVID19 vaccination among pregnant women in this sample, the results cannot be generalized to the general population. However, our findings underscore the importance of effective public health policies at the institutional, local and national levels.

Background: Inguinal hernias (IH) are common congenital anomalies in children, requiring surgical repair to prevent complications. The primary methods for repairing pediatric IH are laparoscopic hernia repair (LHR) and open herniotomy (OH). However, there is limited evidence comparing postoperative outcomes between these approaches in Low- and Middle-Income Countries (LMICs).

Objective: To compare postoperative outcomes between OH and LHR among pediatric patients treated at Muhimbili National Hospital (MNH) in Tanzania.

Methodology: This 5-year retrospective comparative cohort study included 156 pediatric patients under 14 years who underwent OH or LHR at MNH from January 2019 to December 2023. Participants were selected using a hybrid random-consecutive sampling technique. LHR and OH patients were recruited at approximately a 1-to-4 ratio. Data was collected from patient records and via phone interviews. Inferential statistical tests were used to compare the outcomes of the two surgical methods.

Results: Participants had a median age of 19.5 months (IQR 10-36) at presentation, with the majority being male (142, 91%). The median age was slightly higher in the LHR group [21.5 (IQR 12-46.5)] compared to 19 months (IQR 9-36) in the OH group. In the subgroup analysis of bilateral hernias (n=22), measures such as the duration of surgery, postoperative length of stay, total hospitalization time, parents` satisfaction, and cosmetic rating favored LHR (p<.05). Satisfaction and cosmesis were also better with LHR for unilateral hernias (n=134) (p<.05). However, the overall recurrence rate was higher with unilateral LHR at 22.7% (5/17) compared to 4.5% (5/107) with OH, p<.05.

Conclusion: While LHR demonstrated shorter operative time, faster recovery, and favourable cosmetic outcomes, the potential for hernia recurrence warrants careful consideration when selecting the surgical approach. Given the inherent methodological limitations, these findings should be interpreted with caution. Nevertheless, the findings provide valuable preliminary evidence that can inform future larger-scale, well-powered studies aimed at evaluating the long-term outcomes of LHR in LMIC settings.

Background: Spinal anaesthesia is a common regional technique for caesarean sections, but is associated with hypotension in up to 80% of patients. Preventive measures include; intravenous fluid preloading, left uterine displacement, compression stockings, and vasopressors. This study aimed to determine the prevalence and risk factors of hypotension during spinal anaesthesia in pregnant patients undergoing caesarean section at Muhimbili National hospital.

Methods: A descriptive cross-sectional study was conducted at Muhimbili National Hospital's Obstetric theatre, involving patients who received spinal anaesthesia during caesarean section from August 2021 to January 2022. The study excluded patients with sedation, anti-hypertensive, pregnancy-induced hypertension, modified Bromage score, or combination anaesthesia. Data was collected, and analysed using SPSS version 20.

Results: A total of 300 patients were enrolled (calculated sample size 270 plus 10% margin). Of these, 33.3% underwent elective caesarean section and 66.7% emergency caesarean section. Most patients (92%) received 0.5% hyperbaric bupivacaine, while 8% received 5% heavy lidocaine. Hypotension occurred in 56.7% of patients (95% CI: 0.511-0.623). Risk factors included preload <10 mL/kg, higher sensory block levels, and absence of wedge positioning.

Conclusion: Hypotension during spinal anaesthesia for caesarean section is common. Preventive measures, including adequate fluid preload, wedge positioning, and careful monitoring of sensory block height, are essential to improve maternal hemodynamic stability.

Backround: Tanzania has the fifth highest prevalence of Sickle Cell Disease (SCD) worldwide. Annually, 11,000 children are born with SCD, but only 10% survive to their fifth birthday. Limited screening has led to underestimation of the burden in regions such as the southern highlands. The epidemiology of SCD, just like other diseases, is affected by climate change through increasing migration in search of arable land hence the shifts in the geographical prevalence of SCD from high prevalent areas to low prevalence areas. Early identification of SCD across all regions is therefore essential to improve survival, quality of life, mental health, reduce stigma, and alleviate the financial burden.

Study objective: The objective of the study was to assess the prevalence of SCD and SCT in Chunya district, Mbeya Region, Tanzania and to identify demographical factors associated with the risk of SCT among community members.

Methods: A cross-sectional study on SCD was conducted in Chunya district, Mbeya Region, between 21^st and 22^nd February 2020. A total of 523 villagers were selected and screened for SCD and sickle cell trait (SCT) using rapid test (SICKLE SCAN(®).

Results: The study revealed a notably high prevalence of SCD in southern highlands of Tanzania which highlighted the need for early screening and community-based awareness programs. The prevalence of SCD in the tested population was 1.91% and the prevalence of SCT was 8.41% of which the majority of the SCD patient were five years and below P=.02. Having a mother from Southern Zone was a protective factor (OR 0.2) against acquiring SCT while having a father from Northern Zone was a risk factor (OR 10), P value <.005.

Conclusion: To reduce the burden of SCD, new strategies of screening should be developed to enable timely diagnosis and management of the disease.

Background: Hypertension is one of the major global public health problems that has been associated with an increasing prevalence of cardiovascular diseases (CVDs) such as stroke and ischemic heart disease. This study aimed to assess awareness and the practice of risk reduction of hypertension among adults in Ilala and Mkuranga districts, Tanzania.

Methods: A community based cross sectional study was conducted whereby a total of 295 participants were interviewed using a questionnaire adapted from the World Health Organization (WHO). Stepwise approach for chronic disease risk factor surveillance was used to obtain the socio-demographic information, knowledge, awareness, and attitudes regarding hypertension using a structured set of questions. Blood pressure was measured and recorded. Descriptive statistics were used to describe and summarize the study findings. Pearson Chi-square test was used to compare and determine the association between categorical variables and hypertension. Multiple logistic regression analysis was performed to determine predictors of hypertension.

Results: Statistical association for all comparisons was set at P<.05. Hypertension prevalence was high (36.9%) with high proportion of hypertensive individuals being aged between 30 to 44 years (48.6%), married or cohabiting (70.6%), self-employed (59.6%), attained primary education level (59.6%), earn

Conclusion: This study underscores the urgent need for enhanced hypertension prevention strategies in study population. Significant gaps remain in awareness, risk perception, and adoption of preventive practices.

Background: Since its outbreak, COVID-19 has brought several disastrous effects on the healthcare and economic systems of different countries globally. There is still no approved curative medicine for COVID-19; thus, the disease can only be controlled through preventive measures, especially vaccination through herd immunity. However, this is still far from being realized, as vaccination is still being affected by hesitancy and resistance from people, mainly due to the fears of side effects and other adverse events following vaccination. Therefore, understanding the incidence and associated factors, nature, and management of these adverse events is paramount for ensuring public confidence in vaccination programmes. The current study therefore aimed at documenting reported adverse events following COVID-19 vaccination among students and staff at the Islamic university in Uganda.

Methodology: This was a cross-sectional study design that was prospective in nature that recruited staff and students from Islamic University in Uganda that received COVID-19 vaccination between February and June 2022. Data was collected using Google Forms; participants were reached through the institutional ERP, emails, text messages and WhatsApp (social media). Data analysis was done using SPSS version 20.

Results: The study recruited 225 participants; 64.0% were female, and the median age range was between 26 and 30 years. Most of the respondents, 76.4%, reported receiving at least one side effect. More than 73% did not report any comorbidity (chronic conditions). 70.5% had received two doses of COVID-19 vaccines, and AstraZeneca was the most received brand at 51.8%. Most participants reported minor side effects, including pain at the injection site (44.4%). fever, chills, headache, and dizziness at 18.1%, and muscle pains and backpains at 14.6%. Only 1.2% reported vaccine sexual reproductive health.

Conclusions and recommendation: The study confirms that COVID-19 vaccines are safe, as most of the reported side effects were minor with no life-threatening events. More sensitization of the community about the safety of vaccines is encouraged. Ongoing pharmacovigilance surveys for COVID-19 vaccines are recommended to detect possible long-term side effects.

East African scientific research confronts an unprecedented funding crisis that has fundamentally transformed the region's research landscape. Traditional funding mechanisms, heavily dependent on international grants and donor aid, have proven increasingly unsustainable amid global economic volatility, shifting donor priorities, and persistent COVID-19 impacts. Between 2022 and 2024, research funding to sub-Saharan Africa declined by approximately 18%, with East Africa experiencing particularly severe reductions as university research budgets stagnated while inflation eroded purchasing power by 15-20% annually across Kenya, Uganda, Tanzania, Rwanda, Ethiopia, and Sudan. Even if the traditional funding reduction undermined scientific production in the EA region at the beginning, an impressive capacity of resiliency and innovation was thereafter quickly observed that catalyzed unprecedented innovation and collaboration among researchers. Rather than diminishing scientific capacity, this funding crisis has catalyzed unprecedented innovation and collaboration, spurring the development of resilient, self-sustaining research models that maintain scientific excellence despite severe resource constraints. This paper examines 6 transformative case studies that demonstrate how East African researchers have revolutionized scientific inquiry approaches, creating sustainable alternatives to traditional funding-dependent models through a comprehensive analysis spanning 2020-2025. The cases described in this paper reveal comprehensive strategic frameworks integrating diversified funding portfolios, resource-efficient methodologies, robust community engagement ensuring research relevance, and collaborative networks facilitating expertise and infrastructure sharing. Successful programs strategically leverage expanding digital connectivity, open science practices, and South-South partnerships while systematically building sustainable local capacity and maintaining rigorous scientific standards. Strategic policy engagement and research translation create additional sustainability pathways by aligning research priorities with pressing societal needs and generating diverse funding opportunities.

Background: During pregnancy and the puerperal period, women become more sensitive both physically and emotionally, making them particularly vulnerable to Intimate Partner Violence (IPV). Despite this heightened vulnerability, emotional violence in intimate relationships during pregnancy remains under-researched. This study aimed to address this gap by exploring the experiences of emotional violence among pregnant women in central Tanzania.

Method: This study employed a qualitative descriptive study design, utilizing purposive sampling to recruit twenty-nine (29) participants for both in-depth interviews (IDIs) and Focus Group Discussions (FGDs). The respondents were post-delivery mothers with infants aged 42 days to six months. Data analysis was conducted using an inductive thematic approach.

Results: The women who participated in the study were, on average, 27.76 years old, with ages ranging from 19 to 43 years. Most of the women had attained only a primary level of education and resided in rural areas. Thematic analysis of their experiences revealed five key themes related to emotional violence during pregnancy: frequent conflict and arguments, verbal abuse and insults, emotional trauma resulting from persistent mistreatment, neglect and abandonment by partners, and coercive control marked by degrading and manipulative behavior.

Conclusion: These findings highlight the multifaceted nature of emotional intimate partner violence and its profound impact on pregnant women's mental health. Addressing these issues requires comprehensive strategies that include raising awareness, enhancing support systems, and implementing targeted interventions to protect and empower women during this vulnerable period. Keywords: Emotional Violence, Intimate Partner, Experiences, Pregnancy, Tanzania.

Background: Tuberculosis (TB) remains a global health threat, necessitating continuous advancements in diagnostic techniques for effective management and control. This study aimed to evaluate the diagnostic utility of smear microscopy and the Xpert MTB/RIF Ultra test in TB diagnosis, focusing on the correlation between Cycle threshold (Ct) values and disease severity.

Methods: A prospective cross-sectional study was conducted in the Kilimanjaro region, enrolling 472 participants suspected of pulmonary TB. Sputum samples were subjected to smear microscopy, and Xpert MTB/RIF Ultra testing. Data were analysed using R software. The ROC curve was created to assess the performance of the Ct values, and Spearman's correlation and Mann-Whitney test to evaluate the association of Ct value and smear microscopy. Ethical approval was obtained from local and national ethical review boards.

Results: The study revealed discrepancies between smear microscopy and Xpert MTB/RIF Ultra, testing in identifying patients with high bacterial loads. The Ct value in predicting the smear grading yielded a sensitivity of 71% (95% CI 55.2 - 82.7) and specificity of 79.2% (95% CI 64.1 - 89.2), with an area under the curve (AUC) of 0.806. Analysis of Ct values revealed a negative correlation with smear grading, suggesting the potential utility of Ct values as predictive biomarkers for disease severity.

Conclusion: This study underscores the importance of advanced diagnostic techniques, such as the Xpert MTB/RIF Ultra test, in enhancing TB diagnosis and management. The correlation between Ct values and disease severity highlights the potential of Ct values as predictive indicators, offering promising prospects for personalized treatment strategies. Addressing discrepancies between diagnostic methods and further research into Ct value correlations are essential for refining TB diagnostic protocols and improving patient outcomes globally.