The East African health research journal最新文献

Introduction: Nosocomial infections, also known as healthcare-associated infections (HCAIs), are infections that a patient acquires while receiving healthcare services within 48 hours of admission to hospital. In high income countries, an average of 7% of hospitalised patients acquire a nosocomial infection. In low and middle income countries, however, prevalence rates can be as high as 30%. This is due to limited resources and supplies for infection control, inadequate training and lack of compliance with infection prevention and control regulations.

Methods: A cross-sectional, hospital based study was conducted among patients admitted to a tertiary care facility in Tanzania. A semi-structured questionnaire was used to collect information from 134 patients in different wards. Correlation and multivariate regression analyses were performed to determine the association between the independent variables, i.e. chronic illness, invasive procedures, use of antibiotics and referral status, and the dependent variable, i.e. new symptom, and their level of significance. The significance level was set at P≤ .05.

Results: A total of 134 patients participated in the study. Of the total number, 61% (n=82) of the patients were male and 43% (n=57) were referrals from other institutions. Fifteen percent (n=21) of the surveyed patients reported a new symptom. There was a positive correlation between referral status and invasive procedure with the occurrence of a new symptom. Multivariate analysis identified 'referral status' as an independent significant factor positively associated with healthcare-associated infetions (P=.041).

Conclusions: The results indicate a prevalence of 15.7% of healthcare-associated infections, which is unacceptably high for a tertiary care facility. Referral status was independently and significantly associated with HCAI. Improving patient referral patterns and hospital infection control can significantly reduce the risk of healthcare-associated infections.

Background: Vaccines are administered to help the body develop immunity against a disease. A mother's understanding of the importance, safety, and benefits of vaccines can positively influence her decision to adhere to the recommended immunisation schedule. This study aimed to assess the knowledge, attitudes, and practices of mothers attending Magu District Hospital in Mwanza, Tanzania, towards child immunisation.

Methods: A cross-sectional study was conducted among 216 mothers between April and May 2021. A convenient sampling technique was used to recruit mothers who consented to participate in this study. An interviewer-administered semi-structured questionnaire was used. The coded data were analysed using STATA Version 15.

Results: About a quarter (27.3%) of respondents had good knowledge, while 64.8% showed positive attitudes towards child vaccination. Vaccine-preventable diseases that were commonly known by study participants were measles (90.7%) and poliomyelitis (81.9%). The majority of mothers (84.3%) would recommend others to vaccinate their children. About half of the children (50.9%) were fully immunized, while over a quarter (26.4%) of their children experienced side effects.

Conclusion: The knowledge of mothers about vaccination was found to be inadequate, while the majority showed positive attitudes towards child immunisation. Only half of their children were fully immunized. The practice and knowledge of mothers on child immunisation should be enhanced by health education, awareness campaigns, and health promotion interventions.

Background: Despite the existence of other public health interventions, vaccination remains a cornerstone in the fight against pandemics. COVID-19 has led to loss of many lives, global economic deteriorations, and unemployment, hence the call for urgent interventions which includes introduction of COVID-19 vaccines.

Aim: The study aimed to assess the level of knowledge and acceptance of COVID-19 vaccine among residents of Jinja District, Eastern Uganda.

Method: A population-based descriptive cross-sectional study was conducted among 210 participants from Jinja District between 8^th and 21^st October 2021. Data was collected using a structured questionnaire and analysed using IBM SPSS version 26.

Results: 45.2% of the participants had adequate level of knowledge with a 56.2% COVID-19 vaccine acceptability rate. Highly educated participants were most likely to have adequate knowledge of COVID-19 vaccine than the lowly educated ones (OR= 2.64; 95% CI; 1.32-5.26, P= .006). Having a high level of education (OR=2.7; 95% CI; 1.38-5.10, P= .004) was significantly associated with vaccine acceptability. Farmers and students were less likely to accept COVID-19 vaccine.

Conclusion: The general population of Jinja District demonstrated a low level of adequate knowledge and acceptance towards COVID-19 vaccine. There is need for more public awareness campaigns on the topic using radio and television as means of communication.

Background: Pleomorphic adenoma (PA) is the most common benign tumor representing about 80% of all salivary gland tumors. Despite this, there is limited documentation of the demographic information and pattern of PA in Tanzania. This study retrospectively determines the demographic information and the pattern of presentation of pleomorphic adenomas of the salivary gland among patients managed at a tertiary hospital in Tanzania.

Methods: This was a retrospective study of histological results of salivary gland pleomorphic adenoma diagnosed between 2016 and 2021. The information gathered included the age and sex of the patient and the anatomical location. Data analysis was done using Statistical Package for the Social Sciences version 27 computer program.

Results: Out of 1824 reports of patients with oral and maxillofacial lesions retrieved from the archives of the department, 62 (3.4%) had the diagnosis of pleomorphic adenoma of the salivary glands. The patients' ages at diagnosis ranged from 7 to 72 years, with a mean age of 39.9 (SEM = 2.3) years. The male-to-female ratio of patients diagnosed with pleomorphic adenoma was 1:1. There were 31 (50%) cases of pleomorphic adenomas affecting major salivary glands. The palatal minor salivary glands were the most (n=31, 50%) affected followed by the parotid gland (n=16, 25.8%).

Conclusion: Pleomorphic adenomas have no sex predilection, most of these lesions occur during the 3^rd to 5^th decade of life. The majority of pleomorphic adenomas occur in the palatal minor salivary glands.

Introduction: Tobacco smoking increases the risk of death from many diseases, including ischemic heart disease, cancer, stroke, chronic obstructive pulmonary disease, diabetes, and other fatal and non-fatal diseases. Efforts have been invested towards cessation of tobacco smoking among youths aged 18-35 years. However, population-based data is limited on tobacco smoking in Wakiso district among youths. Therefore, this study aimed to determine the prevalence and factors associated with tobacco smoking among youths aged 18-35 years in Wakiso district Uganda.

Methods: Data from a Population-based survey in Wakiso district collected between October 2019 and September 2020 were used to determine the prevalence of tobacco smoking and associated factors. A cross-sectional design was employed. This study used multivariable logistic regression to estimate odds ratios and 95% confidence intervals (CI) for the association between tobacco smoking and various factors among youths aged (18-35) years in Wakiso district Uganda.

Results: A total of 1,092 participants were enrolled of whom 631(57.8%) were females. The mean age was 25.8 (SD=4.8) years. A total of 35 (3.2 %) reported current tobacco smoking while 64(5.9%) ever used tobacco. The mean age at smoking initiation was 20.6 (SD= 5.3) years. In the multivariable analysis, age groups 25-29 years (aOR= 3.66, [95% CI: 1.15, 11.65]) and 30-35 years (aOR= 4.26, [95% CI; 1.32, 13.72]) were more likely to smoke compared to those under 25 years). Other positively associated factors included alcohol users (aOR= 4.86, [95% CI: 2.01, 11.74]), HIV positive status (aOR= 5.43, [95% CI: 1.86, 15.86]), living with friends or relatives who smoke (aOR=9.93, [95% CI: 1.86, 15.86]), and being male (aOR=4.50 [95% CI; 1.82, 11.13]).

Conclusion: Overall tobacco smoking among youths aged 18-35 years is low compared to national prevalence of 9%. However, the focus should be on males, older youths, alcohol users, and HIV-positive youths including those living with friends or relatives who smoke.

Background: Postoperative complications are a leading cause of morbidity and mortality to surgical patients. Different complications are encountered in clinical practice, however surgical site infection (SSI) appears to be the most common. To date, limited published information is known pertaining to the patterns of postoperative complications and factors associated with SSI among patients operated on in other hospitals in Tanzania and referred to Muhimbili national hospital for further management. Therefore, the purpose of this study was to identify patterns of postoperative complications and factors associated with SSI among the study participants.

Methods: This was a hospital based cross-sectional study conducted at Muhimbili national hospital from August 2022 to January 2023, which included 181 patients. Obtained data was analysed using frequency tables, Pearson Chi-squared test and binary logistic regression model, at a level of significance of <0.05.

Results: One hundred eighty one (181) patients were included in this study, of whom 113(62.4%) were females; median age was 39 years. Cigarette smokers and alcohol consumers were 42(23.2%) and 90(49.7%) respectively. Diabetic patients were 8(4.4%), 35(19.3%) were HIV positive and 52(28.7%) had hypertension. Patients whose diagnosis was related to general surgery accounted for 50.2%, whereas 30.9% were obstetric cases. Patients who had undergone Caesarean section were 45(24.9%), whereas 20(11%) patients had undergone total abdominal hysterectomy. Bowel resection and primary anastomosis included 16(8.8%) patients and perforated peptic ulcer repair 8(4.4%) patients. Patients with infected peritoneal collection were 34(18.8%), postpartum haemorrhage 18(9.9%) and bowel perforation 10(5.5%). Patients who had undergone relaparotomy as part of treatment were 70(38.7%), whereas 30(16.6%) patients with SSIs were treated by serial wound dressing and 26(14.4%) patients were admitted and nursed in intensive care unit. None of the factors was found to have a statistically significant association with SSI.

Conclusions: There is a large proportion of patients suffering from postoperative complications after gastroenterology and obstetric surgeries; and of all complications encountered in this study; SSI was the most common contributing 52%, followed by gastrointestinal complications at 31%. Despite the fact that multiple factors were associated with SSI, none of them was found to be statistically significant.

Background: The survival, well-being, and development of young children depend on optimal infant and young child feeding (IYCF) practices. It is imperative to assess nutrition status and feeding behaviour practices in order to develop interventions. The objective of this study is to assess nutrition status, feeding behaviour, and its association with nutrition status among children aged 6 to 23 months old in Bahi district, Tanzania.

Methods: A community-based, cross-sectional study was employed. A multistage sampling technique was used. Bahi district council, wards, and village were randomly selected, and then a systematic random sampling method was used to select participants. Anthropometric measurements were used to determine the nutrition status of children. Process for the Promotion of Child Feeding (ProPAN) manual guided assessment of feeding behaviours associated with nutrition status. Z-score was used to determine the level of malnutrition; the chi-square test and logistic regression were used as descriptive and inferential statistical tests, respectively, to determine the association between nutrition status and feeding behaviour.

Results: Out of 395 children aged between 6 and 23 months, 62.8% were stunted, 25.3% were underweight, and 6.6% were wasted. In the multivariable analysis, the results reveal that stunting was significantly associated with perception of exclusive breastfeeding (number of months) (AOR 4.24, 95%CI: 2.012-8.284) and number of feeds per day (AOR 2.02, 95%CI: 1.00-6.314). With regard to perception of exclusive breastfeeding (number of months), the children whose mothers perceived that children supposed to be breastfed for more than six months were four times more likely to be not stunted compared to those who were perceived to be breastfed less than three months, and the children whose mothers' fed them twice to three times were two times more likely to be not stunted compared to the children who were fed only two times.

Conclusion: Bahi district council has a higher prevalence rate of stunting, underweight, and wasting among children aged 6 to 23 months. Feeding on the first colostrum, exclusive breastfeeding, and breastfeeding for more than six months are the main determinants of nutrition status.

Introduction: The effect of COVID-19 on KMC practices in limited resource settings and on healthcare delivery globally remains unclear.

Methods: In this cross-sectional descriptive study, we aimed to assess the perceptions and practice of Kangaroo mother care (KMC) during the COVID-19 pandemic by postnatal mothers of preterm babies in the New Born Unit (NBU) at Kenyatta National Hospital.

Results: A total of 82 postnatal mothers of preterm babies participated in this study. Majority of respondents practiced KMC during the pandemic period, with intermittent KMC being the most common form of practice. The reasons for practicing KMC were to promote mother-baby bonding and facilitate infant breastfeeding, while the main reason for fear of practicing KMC was concerns that the baby could contract COVID-19. We found no significant associations between KMC practice and education level, religion, pre-existing illness, and knowledge about COVID-19. It was noted that older mothers and those with more children were less likely to engage in KMC. There was a trend for married women to be more likely to engage in KMC, even though this did not reach statistical significance.

Conclusion: There is a need to reinforce continued KMC practice during the pandemics and allay any concerns that mothers have over practicing KMC. We emphasise the need to prioritise KMC practices in the context of possible future pandemics, as it has been shown to have numerous benefits for preterm babies and their mothers.

Background: Human Papilloma Virus (HPV) vaccination is a key primary prevention method against cervical cancer which is given to young girls before onset of sexual activity. In Tanzania, cervical cancer is the most frequent occurring cancer among women and is the leading cause of cancer mortality. The HPV Vaccination programme was rolled-out in Tanzania in 2018 for adolescent girls aged 9-14 years to receive two doses at a six-months interval, with an annual vaccine uptake of 46.1%. In 2019, the uptake of the HPV vaccine was only 64%, whereas the national coverage target is 75%. This study aimed at assessing the determinants of HPV vaccination among adolescent girls in Hai district, Kilimanjaro region, northern Tanzania.

Methodology: A cross-sectional study was conducted from July 2020 to August 2020 among 14-year-old adolescent girls in four selected secondary schools, including two government-owned and two private-owned, within Hai district. Close-ended questionnaire interviews were conducted with the adolescent girls in the study and data analysis was done using IBM SPSS Statistics for Windows version 20.0 (IBM Corp, Armonk, NY, USA). Odds ratio was used to assess the association between several factors and HPV vaccination.

Results: A total of 301 adolescent girls aged 14 years consented to the study. HPV vaccination uptake was 65%. More than three-fifths (n=119, 60.7%) reported having received the two required doses. Knowledge of HPV (OR 5.68; 95% CI, 0.72 to 44.96; P=.01) and HPV vaccine (OR 20.11; 95% CI, 10.88 to 37.99); P =.01) contributed significantly to HPV vaccine uptake among the adolescent girls in the study. More than one-third (n=105, 34.9%,) of the participants, were not vaccinated, the main reasons adduced for not being vaccinated include lack of proper information about the HPV vaccine (60.0%), fear of side effects (14%) and parental refusal (11%).

Conclusion: HPV vaccination uptake was 65%. Lack of proper information to both the children and parents about the safety of the vaccine hinders its uptake. More effort should be made for clear and comprehensible dissemination of information especially to the community stakeholders mainly parents, community and religious leaders, about cervical cancer and HPV vaccine in order to considerably increase vaccination coverage among adolescent girls. Likewise, involvement of healthcare workers and policymakers in educating people about cervical cancer prevention measures can ensure successful implementation of HPV vaccination. There is need to conduct an indepth qualitative study to explore further people's perceptions and attitudes towards HPV.