20 research outputs found
The Regression Model of Risk Factors Associated with Maternal Mortality in Tanzania
Get PDFMaternal mortality is one of the statistics showing the largest degree of disparity between the developed and developing countries. According to literature up to 2016 Tanzania was among the countries with unacceptably maternal mortality ratio and claimed to be still very far from reaching the Millennium developing goals. This study aimed at modeling of risk factors for maternal mortality using pre collected data Based on Tanzania Demographic Health Survey (TDH 2015 -16. Therefore secondary data were used to build the model. Data were reanalyzed by descriptive statistics using statistical software package STATA version 13. Based on data the result indicates that mortality was about 345 per 100,000 live births. The contributing factor was identified as education [OR= 0.81), Age group between 20 to 24 (OR = 2.84), distance to the health center (OR = 0.89), Marital status (OR = 1.39). It is concluded that, the risk factor of maternal death is age groups 20 – 24 and 25 – 29 years especially in the mainland rural. Keywords : Martenal Motility, Regression model, Prevalence on maternal DOI: 10.7176/JHMN/67-06 Publication date:October 31st 201
Int J STD AIDS
Get PDFTo determine the prevalence and predictors of cervical squamous intraepithelial lesions (SIL) among HIV-infected women in Tanzania, a cross-sectional study was conducted among HIV-infected women at HIV care and treatment clinics. A Papanicolaou (Pap) smear was used as a screening tool for detection of cervical SIL. From December 2006 to August 2009, 1365 HIV-infected women received cervical screening. The median age was 35 (interquartile range [IQR]: 30-42) years, and the median CD4\u2009+\u2009cell count was 164 (IQR: 80-257) cells/mm(3). The prevalence of cervical SIL was 8.7% (119/1365). In multivariate analysis, older age ( 6550 versus 30-<40 years: prevalence ratio [PR], 2.36; 95% confidence interval [CI], 1.45-3.84, p for trend\u2009=\u20090.001), lower CD4\u2009+\u2009cell counts (<100 versus 65200\u2009cells/mm(3): PR, 1.55; 95% CI, 1.01-2.36, p for trend\u2009=\u20090.03) and cervical inflammation (PR, 1.73; 95% CI, 1.16-2.60, p\u2009=\u20090.008) were associated with an increased risk of cervical SIL. Women with advanced WHO HIV disease stage (IV versus I/II: PR, 3.45; 95% CI, 1.35-8.85, p for trend\u2009=\u20090.01) had an increased risk for high-grade SIL. In resource-limited settings where it is not feasible to provide cervical cancer prevention services to all HIV-infected women, greater efforts should focus on scaling-up services among those who are older than 50 years, with lower CD4 cell counts and advanced HIV disease stage.P30 MH062294/MH/NIMH NIH HHSUnited States/U2G PS001966/PS/NCHHSTP CDC HHSUnited States
AIDS
Get PDFObjective:The objective of this study was to assess the effectiveness of a routine multivitamin supplementation program for adults living with HIV in Tanzania.Design:We conducted a retrospective cohort study of 67,707 adults enrolled in the Dar es Salaam HIV care and treatment program during 2004\u20132012.Methods:The Dar es Salaam HIV care and treatment program intended to provide all adult patients with multivitamin supplements (vitamins B-complex, C, and E) free of charge; however, intermittent stockouts and other implementation issues did not afford universal coverage. We use Cox proportional hazard models to assess the time-varying association of multivitamin supplementation with mortality and clinical outcomes.Results:The study cohort contributed 41,540 and 129,315 person-years of follow-up time to the ART-na\uefve and ART-experienced analyses, respectively. Among 48,207 ART-na\uefve adults, provision of multivitamins reduced the risk of mortality (adjusted hazard ratio (aHR): 0.69; 95% CI: 0.59\u20130.81), incident tuberculosis (TB) (aHR: 0.83; 0.76\u20130.91), and meeting ART eligibility criteria (aHR: 0.78; 95% CI: 0.73\u20130.83) after adjustment for time-varying confounding. Among 46,977 ART-experienced patients, multivitamins reduced mortality (HR: 0.86; 95% CI: 0.80\u20130.92), incident TB (aHR: 0.78; 95% CI: 0.73\u20130.84), and immunologic failure (aHR: 0.70; 95% CI: 0.67\u20130.73). The survival benefits associated with provision multivitamins appeared to be greatest during the first year of ART and declined over time (p-value <0.001).Conclusion:Multivitamin supplementation appears to be a simple, effective, safe, and scalable program to improve survival, reduce incidence of TB, and improve treatment outcomes for adult HIV patients in Tanzania.20192020-01-27T00:00:00ZD43 TW009775/TW/FIC NIH HHS/United StatesU2G PS001966/PS/NCHHSTP CDC HHS/United StatesPEPFAR/PEPFAR/United States30289815PMC6599688712
RETRACTED ARTICLE: Determinants of viral load suppression failure among HIV adults on ARV attending health care facilities: a retrospective study in Tanga region, Tanzania
No full textAbstract Background Availability and accessibility of Antiretroviral drugs (ARV’s) improve the lives of People living with HIV (PLHIV) by improving client’s immune system to overcome infections and prevent the development of AIDS and other HIV complications. Combination therapy, early initiation of ART, newer ART drugs, single dosage and drug affordability significantly contribute in the reduction of viral multiplication and suppression of HIV to undetectable plasma levels. Methods A retrospective longitudinal study design study was conducted from 1st October, 2018 to 30th June 2022 in all supported HIV care and treatment health facilities in Tanga region which were supported by Amref Health Africa, Tanzania. The participants were HIV adult patients aged 15 years and above on ART and attended the clinic at least once after ART initiation. Viral load suppression levels are defined with viral load 15 years whom were on ART were included in the analysis to determine the level of plasma Viral Load suppression after being on ART. Female 41,304 (69.4%) and male 18,199 (30.6%). Only four percent (2,290) were found to be unsuppressed i.e having plasma Viral Load >1,000cp/ml while 96% (57,213) were virally suppressed. Several factors were independently associated with virologic failure that included; age between 15 - <25 years (HR: 2.82, 95% CI 1.96 – 4.04), BMI <18.5 (HR: 1.69, 95% CI 1.23 – 2.30), advanced WHO stage IV (HR: 1.60, 95% CI 1.12 – 2.24), CD4 cell count <350 (HR: 2.61, 95% CI 2.12 – 3.23), poor adherence (HR: 1.98, 95% CI 1.80 – 2.18) and not using DTG based drug (HR: 11.8, 95% CI 9.74 – 14.3). Conclusion Virologic failure was observed in this study among clients with young age, advanced WHO stage IV, not using DTG based regimen, poor drug adherence and second line regime. To improve Viral Load Suppression among these clients; the existing HIV intervention strategies should be taken care by targeting the identified risk factors
Retraction Note: Determinants of viral load suppression failure among HIV adults on ARV attending health care facilities: a retrospective study in Tanga region, Tanzania
No full textHigh magnitude of under nutrition among HIV infected adults who have not started ART in Tanzania--a call to include nutrition care and treatment in the test and treat model.
No full textBarriers to viral load suppression among adolescents living with HIV on anti-retroviral therapy: a retrospective study in Tanga, Tanzania
No full textAbstract Background Despite the decreased incidence of the human immunodeficiency virus (HIV) in Tanzania, the number of adolescents living with HIV is increasing. This study aimed to describe factors independently associated with viral load non-suppression among adolescents living with HIV (ALHIV) on ART in the Tanga region. Methods We conducted a retrospective study of routinely collected data from ALHIV on ART from October 2018 to April 2022. We extracted data from the Care and Treatment Clinics form number 2 (CTC2) database that included age, sex, BMI, World Health Organization HIV clinical disease stage, marital status, ART duration, viral load suppression, facility level, and Dolutegravir (DTG)-based regimen. We did descriptive analysis using frequencies to describe the study participants’ socio-demographic and clinical characteristics. The Cox proportional hazard regression model was used to identify factors associated with viral load non-suppression (VLS). Viral load non-suppression was defined as viral load ≥ 1000 copies/ml. A total of 4735 ALHIV on ART were extracted from CTC2, then 2485 were excluded (2186 missed viral load results, 246 were lost to follow-up, and 53 deaths). Results 2250 ALHIV on ART were tested for viral load, of whom 2216 (98.62%) adolescents were on first-line ART, and 2024 (89.96%) participants were virally suppressed, while 226 (10.04%) were virally non-suppressed. In addition, 2131 (94.71%) of participants were using a DTG-based regimen; of them, 1969 (92.40%) were virally suppressed. Not using a DTG-based regimen (HR: 9.36, 95% CI 3.41–15.31) and dispensary facility level (HR: 3.61, 95% CI 1.44–7.03) were independently associated with increased hazard for viral load non-suppression. In addition, adolescents aged between 15 and 19 years are less likely to be virally suppressed (HR: 0.55, 95% CI 0.30–0.99). Conclusions The dispensary facility level and not using a DTG-based regimen were significantly associated with viral load non-suppression. HIV intervention strategies should ensure a DTG-based regimen utilization in all adolescents living with HIV, and techniques used by higher-level health facilities should be disseminated to lower-level facilities
Patients’ and providers’ perceptions of the Swahili words of msongo (stress) and sonona (depression): implications for treating mood disorders among people living with HIV/AIDS, Dar Es Salaam, Tanzania
No full textObjectives: People living with HIV/AIDS (PLH) in resource-limited settings have high and often unrecognized prevalence of mood disorders, with adverse implications for medication adherence and engagement in transmission risk reduction behaviors. Working in HIV treatment and care provision, we observed lack of common understandings between PLH and health care workers (HW) of the words msongo and sonona (Swahili) intended to mean stress and depression, respectively. This gap in psychosocial health communication may result in missed opportunities for depression management, which can contribute to altered immune functioning, poor self-care practices, accelerated HIV disease progression, and poor clinical outcomes among PLH. We explored perceptions and experiences in use of the terms msongo and sonona among PLH, to better inform the management of mood disorders among PLHMethods: A two-phased study which included exploratory mixed methods study including focus group discussions (FGDs), indepth interviews (IDIs) with PLH and HW, and a cross-sectional pilot survey with PLH in Dar es Salaam, Tanzania was conducted from 2012 to 2013. Only the data for phase I was included in this manuscript. Thematic analysis of qualitative data from 86 participants explored PLH and HW experiences with the use of terms msongo and sonona. From these findings, we developed scale items based on PLH’s descriptive idioms for a structured survey questionnaire administered to 318 PLH. Through Principal Component Analysis (PCA) we identified meaningful dimensions for the msongo and sonona scalesResults: Predominant meanings for PLH with mood disorder of the terms included troubling thoughts, emotional and physical symptoms. There were gender and age differences in meanings given to both words. For older PLH, msongo and sonona had similar meanings; the former representing higher severity of sonona. In contrast, younger women perceived sonona as a worse form of msongo, while for some young men sonona was understood as kisonono (gonorrhea). Among PLH with mood disorder, 60% and 80% requested help from a health worker for managing sonona and msongo, respectively. PLH without a mood disorder articulated msongo as normal thoughts not requiring hospital treatment; while sonona was a new word, the meaning of which they did not know. This group reported they did not seek care from a health worker for these concerns. The HW interchanged meanings and symptoms of msongo and sonona, while some thought sonona was a type of psychosis. PCA of the data from PLH revealed five dimensions for the combined sonona and msongo scale, with Cronbach’s alpha estimates of 0.92, a unidimensional msongo scale with Cronbach’s alpha estimates of 0.77 and four dimensions for the sonona scale with Cronbach’s alpha estimates of 0.90Conclusions: Though PLH overall had a limited understanding of the psychological health implications of msongo and sonona, those with mood disorders understood these words as meaning stress and depression, respectively. HW should raise their awareness and be alerted to possibilities of depressive disorders when PLH express concerns about msongo or sonona or have symptoms in order to facilitate the identification and management of depression in such settingsKeywords: HIV, PLH, msongo, sonona, depression, stress scale, Swahili, Tanzani
Recommended from our members
Effectiveness of a multivitamin supplementation program among HIV-infected adults in Tanzania
No full textAbstract
Objective: The objective of this study was to assess the effectiveness of a routine multivitamin supplementation program for adults living with HIV in Tanzania.
Design: We conducted a retrospective cohort study of 67,707 adults enrolled in the Dar es Salaam HIV care and treatment program during 2004-2012.
Methods: The Dar es Salaam HIV care and treatment program intended to provide all adult patients with multivitamin supplements (vitamins B-complex, C, and E) free of charge; however, intermittent stockouts and other implementation issues did not afford universal coverage. We use Cox proportional hazard models to assess the time-varying association of multivitamin supplementation with mortality and clinical outcomes.
Results: The study cohort contributed 41,540 and 129,315 person-years of follow-up time to the ART-naïve and ART-experienced analyses, respectively. Among 48,207 ART-naïve adults, provision of multivitamins reduced the risk of mortality (adjusted hazard ratio (aHR): 0.69; 95% CI: 0.59-0.81), incident tuberculosis (TB) (aHR: 0.83; 0.76-0.91), and meeting ART eligibility criteria (aHR: 0.78; 95% CI: 0.73-0.83) after adjustment for time-varying confounding. Among 46,977 ART-experienced patients, multivitamins reduced mortality (HR: 0.86; 95% CI: 0.80-0.92), incident TB (aHR: 0.78; 95% CI: 0.73-0.84), and immunologic failure (aHR: 0.70; 95% CI: 0.67-0.73). The survival benefits associated with provision multivitamins appeared to be greatest during the first year of ART and declined over time (p-value <0.001).
Conclusion: Multivitamin supplementation appears to be a simple, effective, safe, and scalable program to improve survival, reduce incidence of TB, and improve treatment outcomes for adult HIV patients in Tanzania.Accepted Manuscrip
Recommended from our members
Who are they? Identifying risk factors of loss to follow up among HIV+ patients on care and treatment in Dar es Salaam
No full textLoss to follow up (LTFU) is a challenge in care and treatment programs in Sub Saharan Africa, Tanzania included. We analyzed risk factors LTFU among HIV+ patients receiving care and treatment in Dar es Salaam, Tanzania in order to inform strategies to retain patients in care and treatment services.Version of Recor
