The East African health research journal最新文献

Background: Corona Virus Disease of 2019 (COVID-19) spread across the globe, causing distress among various populations, including healthcare providers. This disease has had an unparalleled effect on the world's economic situation, livelihood, mental and physical well-being across the globe.The study aimed to determine the prevalence of depression and identify the occupational and psychological factors associated with depression among health care providers during the COVID-19 pandemic in a regional referral hospital in Kisumu County.

Methods: We conducted a hospital-based cross-sectional study at JOOTRH where a total of 202 respondents participated in the study. The survey questionnaire consisted of four components: demographic factors, occupational factors, and psychological factors. Depression was measured using the 9-item Patient Health Questionnaire (PHQ-9). Data was analysed using the statistical package for Social Science version 28. Pearson chi-square was used to determine the occupational and psychological factors associated with depression during the COVID-19 pandemic at p ≤.05.

Results: The overall prevalence of depression was at 57.4%. The occupational and psychological factors associated with depression among healthcare providers during the COVID-19 pandemic included being over 30 years old, married, having over 6 years of work experience, COVID-19 training, having an irregular work schedule, lacking psychological support services, and facing stigma.

Conclusion: The study findings revealed a considerable proportion of depressive symptoms among health providers during the COVID-19 pandemic at JOOTRH. Older age, being married, more years of work experience, previous exposure to pandemic, having COVID-19 training, and irregular work schedule, experience of stigma, and lack of psychological support were significantly associated with depression.

Background: Despite the existence of plans and strategies for providing family planning methods in Tanzania, the uptake rate of modern contraceptives among Adolescent Girls and Young Women (AGYW) in Tanzania remains low. The fertility rate is 112 per 1000; only 15.2% of adolescents are using Modern Contraceptives Methods (MCMs) in Tanzania. Modern contraceptive use is one of the important interventions to reduce the burden of adolescent pregnancy which is as high as 22% in the country. However, little is known regarding AGYW's perceptions and experiences with MCMs.

Objective: To explore the perceptions and experiences of AGYW with MCMs use in the Malinyi district of Morogoro, Tanzania.

Materials and methods: This was a qualitative phenomenology study. Purposive sampling was used to select 19 study participants. An in-depth interview guide was used to collect data. Data were transcribed verbatim. A thematic data analysis approach was used to analyze data.

Results: Two major themes that emerged from the findings were experiences and perceptions of AGYW on MCM use. On the experiences of MCMs, the study findings revealed that AGYW have limited knowledge and awareness about modern contraceptive methods; some of them acknowledged the benefits of modern contraceptive methods in preventing unintended pregnancies, providing a sense of empowerment, and enabling them to pursue their life goals. On perceptions of MCM use some of the study participants shared challenges encountered, including side effects, social influence, cultural and religious beliefs, myths and misconceptions that contribute to the perceptions and use of MCMs.

Conclusion and recommendation: Healthcare providers at the health facilities should continue educating AGYW on the importance of using MCMs.

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: 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.

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.

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: 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.

Background: Acute kidney injury (AKI) that occurs during pregnancy or in the post-partum period is a serious obstetric complication with a significant risk of feto-maternal morbidity and mortality. Although globally there has been an overall decrease in the burden of pregnancy-related (PRAKI) AKI, recent studies show the increasing occurrence of this disease in Low-middle income countries (LMICs).This study was conducted to determine the magnitude and predictors of maternal outcomes of pre-eclamptic and eclamptic-related acute kidney injury at Bugando Medical Centre (BMC) and Sengerema Designated District Hospital (SDDH) Mwanza, Tanzania.

Methods: A cohort study was conducted involving patients diagnosed with Preeclampsia-Eclampsia (PE-E) who were admitted at BMC and SDDH from November 2021 to June 2022. Data were collected through convenience sampling using a structured questionnaire. Statistical data analysis was performed using STATA version 15. A chi-square test was performed to test for significant associations between the predictor and outcome variables. A significant association was defined as a p-value of less than .05. Variables showing significant associations in the chi-square analysis were further analysed using multivariate logistic regression to evaluate the strength of the associations.

Results: The study enrolled a total of 258 women with PE-E. The magnitude of AKI was found to be 141(54.7%,) out of 258 participants, of which Kidney Disease Improving Outcomes (KDIGO) stage 1 accounted for 103 (73%) stage 2, 20 (14.2%) and stage 3, were 18 (12.8%). Of these, 141 participants with AKI, 101 (71.6%) resolved within 7 days of delivery, 12 (8.5%) persisted beyond 7 days after delivery, and 28 (19.8%) worsened. Serum creatinine stages 2 and 3 at admission, HIV positive status, and informal education status were highly associated with persistent/worsening AKI stage.

Conclusion: The magnitude of acute kidney injury was found to be high (54.7%) among pre-eclamptic and eclamptic patients in BMC and SDDH. AKI stages 2 and 3, HIV positive status and informal education level were associated with poor maternal outcomes mainly persistent AKI and worsening AKI.

Background: Health Care Workers (HCWs) have been playing crucial role in treating patient with COVID-19. They have a higher occupational risk of contracting the disease than the general population, and a greater chance of them transmitting the disease to vulnerable patients under their care. Given the scarcity of HCWs and low COVID-19 vaccine acceptance in Africa, it is essential that HCWs are seroprotected and their exposure to COVID-19 minimized Objective: To determine IgG antibody response to SARS-CoV-2 among HCWs of a tertiary hospital in North Eastern, Tanzania.

Methodology: This cross-sectional study was carried out among 273 HCWs at Kilimanjaro Christian Medical Centre (KCMC), a tertiary, zonal referral hospital in Tanzania's North Eastern region. Stratified sampling was used to select study participants. Data were obtained from each consenting participant using a validated questionnaire. Blood samples were collected for SARS-CoV-2 IgG antibody quantification using an indirect ELISA test. RedCap software was used to manage data. Statistical analysis was done using STATA statistical software version 15 and GraphPad Prism v 9.0. A p-value of <0.05 was considered the cut-off for statistical significance.

Results: Among 273 HCWS, 37.9 % reported receiving the COVID-19 vaccine. Except for one person, all of the participants (99.6%) had SARS-CoV-2 IgG antibody concentrations that were positive, with 64.5% of them having strong seropositivity. Cadre, sex, BMI, smoking status, adherence to recommended hand hygiene practices and COVID-19 patient interactions were significant predictors of variation of median SARS-CoV-2 antibody concentration. Age, usage of personal protective equipment, history of previously testing PCR positive for COVID-19, and total number of COVID-19 patients exposed were found to cause no statistically significant variation in median antibody concentration among participants.

Conclusion: This study identified a high seroprevalence of SARS-CoV-2 antibodies among healthcare workers in the study setting, indicating significant exposure to SARS-CoV-2 virus, despite only a minority of them being vaccinated. These findings underscore the need for robust communicable disease prevention strategies including; regular screening and pathogen surveillance to better prepare for potential future pandemics. Such measures are critical to mitigating the substantial impacts on health care workers and ensuring the resilience of the healthcare system.