13 research outputs found
From Lands of the Night by T. Mollel
No full textMollel, Tololwa. From Lands of the Night. Illus. Darrell McCalla. Markham, Ontario: Red Deer Press, 2014. Print.In this work, a well-known author and storyteller, Tololwa Mollel, has drawn upon the folk customs of East Africa to illustrate how one family deals with critical illness. The tale is set in contemporary times and is told through the eyes of a child. Briefly, a feverish baby seems beyond the help of standard medical practice and, thus, his parents turn to a traditional healer for help. Under the healer’s guidance, they invite friends, neighbours and relatives to a “joyful celebration.” The healer summons guests from lands of the night: ancestors, angels, and even Mola, who is God. There follows a night of feasting, singing and dancing. Darrell McCalla’s watercolors brilliantly convey the otherworldliness of the occasion. The baby revives.Mollel’s text is well written for reading aloud or telling: in fact, anyone who has ever heard him perform will sense his voice engaging the listener throughout the story.In an author’s note, Mollel tells us of his intention to marry the traditional with the contemporary in writing of his native Tanzania. In doing so, he bridges the distance between the real and the imaginary world very subtly. No rabbit hole, no magic wardrobe, no melting railway station wall signals that we have entered a place where faith and magic are freely at work. It is left to the reader to suspend disbelief – or not -- respecting the baby’s recovery.Who then, will suspend disbelief? Young children who move effortlessly between the worlds of reality and magic will clearly accept and welcome the arrival of helpers from lands of the night. Many adults will be skeptical about the efficacy of the “joyful celebration;” nonetheless, they will be fascinated with the tradition that Mollel has here revealed.But the book may be troubling to some. We cannot ignore the current climate in which it has been published. In recent months, news of the incremental spread of the Ebola virus in West Africa has dominated the news. The World Health Organization declared this epidemic to be the most serious global health concern of our times. Those countries outside of Africa to which the virus has been carried entered “red alert” mode, and certain segments of their populations panicked. In the context of these realities, librarians might want to be prepared for the patron who storms in waving the book and demanding, “Why are you advocating miracle cures as a way of dealing with plague?” There are plenty of good responses: have them at the ready.Recommended: 3 out of 4 starsReviewer: Leslie AitkenLeslie Aitken’s long career in librarianship involved selection of children’s literature for school, public, special, and university collections. She is a former Curriculum Librarian at the University of Alberta
Predictors for Mortality among Multidrug-Resistant Tuberculosis Patients in Tanzania
No full textProblem. Factors related to MDRTB mortality in Tanzania have not been adequately explored and reported. Objectives. To determine demographic, clinical, radiographic, and laboratory factors associated with MDRTB mortality in a Tanzanian TB Referral Hospital. Methodology. This was a cross-sectional study with 193 participants. Demographic, clinical, laboratory, and radiological data were collected, and their associations with mortality among MDRTB patients were determined. Results and Conclusions. Cough was the commonest finding among these MDRTB patients, with 179 (92.75%) of them presenting with cough, followed by chest X-ray consolidation in 156 patients (80.83%) and history of previous TB treatment in 151 patients (78.24%). Cigarette smoking, HIV positivity, and low CD4 counts were significantly associated with MDRTB mortality, p values of 0.034, 0.044, and 0.048, respectively. Fever on the other hand was at the borderline with p value of 0.059. We conclude that cigarette smoking and HIV status are significant risk factors for mortality among MDRTB patients. HIV screening should continually be emphasized among patients and the general community for early ARTs initiation. Based on the results from our study, policy makers and public health personnel should consider addressing tobacco cessation as part of national TB control strategy
A comparative analysis of job design characteristics, organizational structure, and personal characteristics affecting job satisfaction of extension agents in two extension organizations in Tanzania
No full textThe present study was designed to compare two extension organizations in Tanzania: Commodity extension and General extension. Comparisons were made at three levels. First, to determine whether the two organizations differ in levels of job satisfaction; second, to determine whether the two organizations also differ in organizational structure, job design characteristics and personal characteristics of extension agents; and third, to determine whether the independent variables could explain the differences in levels of job satisfaction between the two extension organizations.Data were collected through a questionnaire distributed to extension agents during their monthly meetings. Data for the study came from 120 General extension agents and 64 Commodity extension agents. Additional information was obtained through personal and group interviews and analysis of documents.The major findings of the study are as follows: (1) Both at the individual and organizational level of analysis Commodity extension had significantly higher scores on satisfaction with supervision and satisfaction with promotion. (2) Differences in satisfaction with supervision could be explained by differences in formalization, autonomy and feedback. (3) Differences in satisfaction with promotion could be explained by differences in formalization and years of agricultural training.From these findings the following recommendations are suggested: (1) To enhance satisfaction with supervision extension organizations should develop effective communication channels to increase extension agents' awareness of rules and procedures governing their jobs. Further, tasks and activities performed by extension agents should be structured to provide autonomy and feedback. (2) Satisfaction with promotion can be increased by developing programs to increase extension agents knowledge of the rules, procedures and communications governing their work and the organization and by developing a promotion policy that takes into account individual levels of agricultural training.Made available in DSpace on 2011-05-07T13:00:13Z (GMT). No. of bitstreams: 2
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Transfusion-Transmitted Infections and associated risk factors at the Northern Zone Blood Transfusion Center in Tanzania: A study of blood donors between 2017 and 2019.
No full textBackgroundBlood transfusion saves many people every year that would otherwise have died. The present study aimed to provide an update and insightful information regarding prevalence of the common Transfusion-Transmitted Infections (TTIs) and associated factors among blood donors in Tanzania.MethodsThis was a cross-sectional study involving retrospectively collected data of blood donors from the Tanzania Northern Zone Blood Transfusion Center between 2017 and 2019. Descriptive statistics were performed to describe characteristics of the blood donors. Univariable and multivariable logistic regression analyses were performed to determine association between prevalence of TTIs and socio-demographic factors. P-value ResultsA total of 101, 616 blood donors were included in the present study of which 85,053(83.7%) were males while 16,563 (16.3%) were females. Of all participants, the majority 45,400 (44.7%) were aged between 18 and 25 years; 79,582 (78.3%) were voluntary non-remunerated donors while 22,034 (21.7%) were replacement donors. The vast majority of them 99,626 (98%) were first time blood donors while 1990 (2%) were multiple donors. The overall prevalence of TTIs was 10.1% (10,226 out of 101,616) of which the leading was HBV accounting for 5.1% (5,264 out of 101,616). Being a replacement donor was associated with all the four types of TTIs: HIV (AOR = 1.22, 95% CI = 1.10-1.35), HBV (AOR = 1.35, 95% CI = 1.27-1.44), HCV (AOR = 1.28, 95% CI = 1.12-1.46), and syphilis (AOR = 1.33, 95% CI = 1.20-1.48).ConclusionsOur study has demonstrated that Tanzania has relatively high prevalence of TTIs compared to some countries in Sub-Saharan Africa. HBV infection seems to be the most common infection among blood donors and replacement blood donors are at a higher risk of harboring the commonest TTIs among blood donors
Petrochemistry and geochronology of Ngorongoro Volcanic Highland Complex (NVHC) and its relationship to Laetoli and Olduvai Gorge, Tanzania
No full textThe Ngorongoro Volcanic Highland Complex (NVHC) of northern Tanzania is situated at the southern divergence of the Gregory Rift, part of the East African Rift System. The NVHC consists of at least nine major volcanic centers that erupted lavas, ash flows, and other pyroclastic materials from Pliocene to Present. These volcanoes are considered the source of lavas and other volcaniclastic material found interbedded in the adjacent anthropological sites of Olduvai Gorge and Laetoli.
This dissertation focuses on the petrochemistry and geochronology of six major NVHC centers: Satiman, Lemagurut, Oldeani, Ngorongoro caldera, Olmoti, and Embagai, as well as Laetoli Ogol lava flows, Olduvai Gorge Bed I lava and the isolated cone of Engelosin. The overall intent is to provide a geochemical and geochronological framework for the NVHC and refine correlations of the NVHC volcanoes with Olduvai and Laetoli.
Interpretation of petrographic and x-ray fluorescence data (major element) indicate that the studied volcanoes produced magmas that vary in composition from foidite to phonolite and basalt to rhyolite. Laser ablation data (trace element) from all lavas support an origination from a K-rich peridotite. The Sr-Nd-Pb isotopes (TIMs data) show wide variation in all centers that is considered to indicate crust-magma interaction, an interpretation supported by Ce/Pb ratios ([less than] 25 [plus/minus] 5) lower than expected for mantle derived melts. Lava samples with mantle values (Ce/Pb) have Sr-Nd-Pb isotope ratios that can be explained by mixing between high-µ and enriched mantle reservoirs.
40Ar/39Ar dating of matrix and anorthoclase from the sampled NVHC volcanoes indicates a range in activity from 4.65 Ma to ~ 0.60 Ma. Satiman is the oldest, followed by Engelosin 2.97 Ma, Lemagurut 2.40 Ma, Ngorongoro 2.28 Ma, Olmoti 2.01 Ma, Oldeani 1.61 Ma and Embagai ~1.20 Ma. Overlapping activity is recorded between Lemagurut, Ogol and Ngorongoro as well as between Ngorongoro and Olmoti. Correlation of ages and mineral assemblages from these volcanoes and that of the tephra from Olduvai and Laetoli, confirm a Satiman and Ngorongoro source for the Laetolil and Naibadad Beds in the Laetoli area respectively, whereas, that of Olmoti upper section correlates with Olduvai Bed I lava, confirming an Olmoti source.Ph.D.Includes bibliographical references (p. 219-232)
Naturally Acquired Antibody Responses to a Synthetic Malaria Antigen AS202.11
No full textBackground. A major challenge to malaria vaccine development is identification of protective epitopes and respective protective immune responses. Objective. To characterize naturally acquired Immunoglobulin G (IgG) responses to the synthetic peptide AS202.11, a malaria vaccine candidate. Methodology. This community based cross-sectional study enrolled 320 participants aged 1 year and above. Demographic information was recorded through interviews. Detection of P. falciparum infection was done by microscopy, malaria rapid diagnostic test, and polymerase chain reaction. ELISA was used to detect IgG antibody. Data was analyzed using STATA. Results. The overall AS202.11 IgG seropositivity was 78.8% (73.9–82.9). Seropositivity by age categories was ≤12 years [74.3% (67.4–80.2)], 13–40 years [85.3% (76.5–91.1)], and >40 years [82.6% (68.7–91.1)]. Compared to the ≤ 12-year-old group, aORs for the other groups were 2.22 (1.14–4.32), p=0.019, and 1.87 (0.81–4.35), p=0.143, for the 13–40-year-old and >40-year-old groups, respectively. The 13–40-year-old group had more seropositive individuals compared to the ≤ 12-year-old group. Conclusion. We report a high degree of recognition of AS202.11 by IgG elicited by field P. falciparum strains, suggesting its close similarity to native P. falciparum antigens and possible suitability of the peptide as a future malaria vaccine candidate
Evaluation of XpertMTB/Rif performance for diagnosis of tuberculosis among HIV positive patients in northern Tanzania
No full textBackground: Diagnosis of tuberculosis (TB) in patients co-infected with HIV poses an important challenge since they are usually smear negative for pulmonary TB. The reason for this is the low sensitivity and specificity of microscopy as the standard diagnostic method. This study aimed to evaluate the performance of the XpertMTB/Rif tool for TB diagnosis among TB-HIV co-infected patients in order to characterize TB features in HIV co-infections. The study assessed the sensitivity, specificity and positive and negative predictive values of XpertMTB/Rif for TB detection in symptomatic and asymptomatic patients.Methods: This was a cross-sectional analytical study involving 69 patients as study participants. Demographic, clinical, laboratory and radiological data were collected. The performance of the XpertMTB/RIF and microscopy using LJ culture as a gold standard were determined and compared.Results: XpertMTB/Rif had a higher sensitivity (100%), specificity (100%), PPV (79.2%) and NPV (98.9%) as compared to microscopy. There was a strong correlation between XpertMTB/Rif, LJ culture and Microscopy in terms of their sensitivity and specificity. Conclusion: While using TB symptoms screening tool alone in HIV infected individuals may result into overtreatment, relying on microscopy alone has the potential of TB under-diagnosing, miss-diagnosing and delayed treatment. Our results show XpertMTB/Rif to be highly sensitive and specific to detect all culture positive TB cases among HIV patients. We recommend the adoption of XpertMTB/Rif as an early TB diagnosis tool among HIV patients for early detection of TB among HIV patients
Incidence Rates for Tuberculosis Among HIV Infected Patients in Northern Tanzania.
No full textBackground: HIV and tuberculosis (TB) are leading infectious diseases, with a high risk of co-infection. The risk of TB in people living with HIV (PLHIV) is high soon after sero-conversion and increases as the CD4 counts are depleted. Methodology: We used routinely collected data from Care and Treatment Clinics (CTCs) in three regions in northern Tanzania. All PLHIV attending CTCs between January 2012 to December 2017 were included in the analysis. TB incidence was defined as cases started on anti-TB medications divided by the person-years of follow-up. Poisson regression with frailty models were used to determine incidence rate ratios (IRR) and 95% confidence intervals (95% CI) for predictors of TB incidences among HIV positive patients. Results: Among 78,748 PLHIV, 405 patients developed TB over 195,296 person-years of follow-up, giving an overall TB incidence rate of 2.08 per 1,000 person-years. There was an increased risk of TB incidence, 3.35 per 1,000 person-years, in hospitals compared to lower level health facilities. Compared to CD4 counts of <350 cells/μl, a high CD4 count was associated with lower TB incidence, 81% lower for a CD4 count of 350-500 cells/μl (IRR 0.19, 95% CI 0.04-0.08) and 85% lower for those with a CD4 count above 500 cells/μl (IRR 0.15, 95% CI 0.04-0.64). Independently, those taking ART had 66% lower TB incidences (IRR 0.34, 95% CI 0.15-0.79) compared to those not taking ART. Poor nutritional status and CTC enrollment between 2008 and 2012 were associated with higher TB incidences IRR 9.27 (95% CI 2.15-39.95) and IRR 2.97 (95% CI 1.05-8.43), respectively. Discussion: There has been a decline in TB incidence since 2012, with exception of the year 2017 whereby there was higher TB incidence probably due to better diagnosis of TB following a national initiative. Among HIV positive patients attending CTCs, poor nutritional status, low CD4 counts and not taking ART treatment were associated with higher TB incidence, highlighting the need to get PLHIV on treatment early, and the need for close monitoring of CD4 counts. Data from routinely collected and available health services can be used to provide evidence of the epidemiological risk of TB
Effect of tuberculosis infection on mortality of HIV-infected patients in Northern Tanzania.
No full textBACKGROUND: TB and HIV are public health problems, which have a synergistic effect to each other. Despite the decreasing burden of these two diseases they still make a significant contribution to mortality. Tanzania is among the 30 high TB and HIV burden countries. METHODS: Routine data over 6 years from people living with HIV (PLHIV) attending health facilities in three regions of Northern Tanzania were analyzed, showing mortality trends from 2012 to 2017 for HIV and HIV/TB subpopulations. Poisson regression with frailty model adjusting for clustering at health facility level was used to analyze the data to determine mortality rate ratios (RR) and 95% confidence intervals (95%CI). RESULTS: Among all PLHIV the overall mortality rate was 28.4 (95% CI 27.6-29.2) deaths per 1000 person-years. For PLHIV with no evidence of TB the mortality rates was 26.2 (95% CI 25.4-27.0) per 1000 person-years, and for those with HIV/TB co-infection 57.8 (95% CI 55.6-62.3) per 1000 person-years. After adjusting for age, sex, residence, WHO stage, and bodyweight, PLHIV with TB co-infection had 40% higher mortality than those without TB (RR 1.4; 95% CI 1.24-1.67). CONCLUSIONS: Over the 6-year period mortality rates for HIV/TB patients were consistently higher than for PLHIV who have no TB. More efforts should be directed into improving nutritional status among HIV patients, as it has destructive interaction with TB for mortality. This will improve patients' body weight and CD4 counts which are protective against mortality. Among PLHIV attention should be given to those who are in WHO HIV stage 3 or 4 and having TB co-infection
Frequency and distribution of ABO and Rh blood group systems among blood donors at the Northern Zone Blood Transfusion Center in Kilimanjaro, Tanzania: a retrospective cross-sectional study
No full textObjectives ABO and Rh blood group systems are the major factors affecting the blood transfusion safety. The frequency and distribution of these blood group systems vary worldwide. We aimed to determine the frequency and distribution of ABO and Rh blood group systems among first-time blood donors at the Northern Zone Blood Transfusion Center in Kilimanjaro, Tanzania.Design Cross-sectional descriptive population-based study.Setting Data on ABO and Rh blood group systems were obtained and analysed from the Northern Zone Blood Transfusion Center among first-time blood donors.Participants There were 65 535 first-time blood donors aged 15–55 years who donated at the Northern Zone Blood Transfusion Center from January 2017 to December 2019.Outcome measures The percentage of ABO and Rh blood group systems among different categories of blood donors was calculated.Results Retrospective data from Blood Establishment Computer System of 65 535 first-time blood donors were analysed in the present study. The mean age of the blood donors was 30.6±11.2 years (range: 15–55 years). The vast majority of the blood donors 84.2% (n=55 210) were men. Also, the majority 69.6% (n=45 595) were aged ≥35 years. Blood group O was the most common blood group which was found in over half 52.4% (n=34 333) of the blood donors and majority 95.3% (n=62 461) of the donors were Rh positive. Moreover, the majority 78.3% (n=51 336) were voluntary donors and the remaining 21.7% (n=14 199) were replacement donors.Conclusion Majority of the donors had blood group O and also the vast majority of the donors were Rh positive. Considering the large size of our study population, this has provided a more comprehensive information regarding the frequency and patterns of ABO and Rh blood group systems in Tanzania. The observed association of blood group A with one of the regions from which donors were coming from, is intriguing and further studies may confirm possible related genetic evolution
