17 research outputs found
The South African disability grant: influence on HIV treatment outcomes and household well-being in KwaZulu-Natal
No full textThis paper explores the implications of the disability grant for household members’ well-being and adults’ success on ART (antiretroviral therapy). It uses case studies based on data from an in-depth qualitative study of 10 households in KwaZulu-Natal. Receipt of the disability grant ensured that the basic needs of the HIV-infected adult could be met by other household members, especially when the grant was received when the person first met the qualifying criteria and in conjunction with ART. Where treatment was effective, HIV-infected adults were able to make substantial contributions to the well-being of other members in addition to the financial support provided by the grant itself. Thus, early access to financial support in conjunction with commencing ART may lead to improved health outcomes and reduce poverty and vulnerability associated with illness in poor households. This synergistic relationship between social welfare and treatment may in turn contribute to greater cost-efficiency
Population and antenatal-based HIV prevalence estimates in a high contracepting female population in rural South Africa.
No full textBACKGROUND: To present and compare population-based and antenatal-care (ANC) sentinel surveillance HIV prevalence estimates among women in a rural South African population where both provision of ANC services and family planning is prevalent and fertility is declining. With a need, in such settings, to understand how to appropriately adjust ANC sentinel surveillance estimates to represent HIV prevalence in general populations, and with evidence of possible biases inherent to both surveillance systems, we explore differences between the two systems. There is particular emphasis on unrepresentative selection of ANC clinics and unrepresentative testing in the population. METHODS: HIV sero-prevalence amongst blood samples collected from women consenting to test during the 2005 annual longitudinal population-based serological survey was compared to anonymous unlinked HIV sero-prevalence amongst women attending antenatal care (ANC) first visits in six clinics (January to May 2005). Both surveillance systems were conducted as part of the Africa Centre Demographic Information System. RESULTS: Population-based HIV prevalence estimates for all women (25.2%) and pregnant women (23.7%) were significantly lower than that for ANC attendees (37.7%). A large proportion of women attending urban or peri-urban clinics would be predicted to be resident within rural areas. Although overall estimates remained significantly different, presenting and standardising estimates by age and location (clinic for ANC-based estimates and individual-residence for population-based estimates) made some group-specific estimates from the two surveillance systems more predictive of one another. CONCLUSION: It is likely that where ANC coverage and contraceptive use is widespread and fertility is low, population-based surveillance under-estimates HIV prevalence due to unrepresentative testing by age, residence and also probably by HIV status, and that ANC sentinel surveillance over-estimates prevalence due to selection bias in terms of age of sexual debut and contraceptive use. The results presented highlight the importance of accounting for unrepresentative testing, particularly by individual residence and age, through system design and statistical analyses
THE PARADOX OF TRAINING IN THE SMALL BUSINESS SECTOR OF TANZANIA ECONOMY
No full text From the late 1970s onwards policy-makers, academics and analysts in Tanzania have increasingly focused attention upon the development of small- and medium-sized enterprises. The potential growth of this sector has progressively came to be seen as the solution to Tanzania‟s 'relative' economic decline. By the 1980s, however, it appeared that Tanzania labour force was relatively poorly educated and trained. In order to overcome the retarding effects of the 'Tanzania disease', priority has to be given to raising the level of vocational education and training, both quantitatively and qualitatively.    Skills needs and shortages specific to the small business sector are analyzed from a number of different perspectives, including those of owner/managers, employees and policy-makers. The data obtained from respondents are summarized in. Preliminary results and a discussion of owner/managers' attitudes to, and actual provision of, training are presented in the context of the traditional Tanzania 'training culture'. The author concludes that although owner/manager attitudes to vocational education and training are largely positive, its actual provision fails significantly to keep pace with the perceived needs of small firms. It is argued that Tanzania lacks a coherent training policy and the resulting failure to fund and provide transferable skills training can only deepen the competitive disadvantage faced by small businesses, in both the domestic and international markets. Â
Public Knowledge, Perceptions and Practices in Relation to Infectious and other Communicable Diseases in Tanzania: Lessons Learnt from Babati District
No full textWe report public knowledge, perceptions and practices on selected infectious diseases in Tanzania using a study done in Babati district, and identify policy related messages in light of health promotion strategies instituted for communicable disease control. Data were gathered through semi-structured interviews with individual household members and focus group discussions with other residents in several villages; in-depth interviews with health workers, local government leaders, and district health managers. Many villagers associated malaria transmission with people’s exposure to intense sunrays; TB and brucellosis with people drinking raw-milk, animal blood and meat; sharing a bed or utensils with TB/brucellosis patients; TB with smoking or inhaling cigarette smoke; leprosy with witchcraft; and lymphatic filariasis and schistosomiasis with people contacting dirty-water or through sexual intercourse. Occasional shortage of drugs and laboratory services, lack of reliable transport facilities, low public use of latrines, unaffordable bednet prices, and common sale of counterfeit drugs by unregulated retailers were perceived to perpetuate the existence and widespread communicable diseases. Use of traditional medicines to treat these diseases was reported to be a common practice. Culturally rooted knowledge and beliefs about diseases influence people’s health care seeking practices and may perpetuate prevalence and transmission of diseases. There should be educational policy program considerations among the strategies aimed at effective disease control.\u
Community knowledge, perceptions and practices on malaria in Mpwapwa District, central Tanzania
No full textA study on community knowledge, attitudes and perception on malaria and its management was conducted in Mpwapwa district of central Tanzania in January-February 2001. Six villages, three with health facilities (Kibakwe, Makose and Mwanawota) and three without health facilities (Chogola, Kidenge and Wangi) lying between 975 and 1859 m above sea level were selected for the study. According to most respondents, the general health problems for adults in the district included malaria, diarrhoea, typhoid fever and pneumonia. Malaria, pneumonia and diarrhoea were the major health problems among children. Among pregnant women, malaria, abortions and diarrhoea were identified as the major public health problems in the district. In the view of most of villagers, malaria was the cause of most fevers and convulsions at low and intermediate altitudes. Cold weather was considered as the main predisposing factor to most of the fevers experienced in the highland villages. The common antimalarial drugs used in Mpwapwa district were chloroquine and quinine. The cost of antimalarial drugs ranged between TShs. 10/- and 20/- for one tablet of chloroquine, 600/- for chloroquine syrup, and 320/- for a single dose of chloroquine injection. However, shortage of drugs was frequently encountered in most of the health facilities. Traditional medicine practitioners were most frequently consulted for cases of convulsions in the district. Our findings showed that only 2.1% of the children in the district were sleeping under mosquito nets. The use of mosquito net was common among individuals living in the villages with health facilities than in those without health facilities. Generally, most respondents considered long distances to health facilities and inability to pay for health services as the main constraints in obtaining proper health care. Tanzania Health Research Bulletin Vol.6(2) 2004: 37-4
Using machine learning for detecting liquidity risk in banks
No full textThe accurate classification of banks’ Liquidity Risk (LR) for regulatory supervision is hindered by limitations in the measures, such as Minimum Liquid Assets (MLA), Net-Stable Funding Ratio (NSFR), and Liquidity Coverage Ratio (LCR). This study addressed two limitations on data integrity vulnerabilities and the narrow composition of LR factors excluding practical LR determinants such as credit portfolio quality, market conditions, strategies of assets and funding. Theoretical gaps included the eight new LR factors in this study, benchmarking study results with measures to interpret the studies’ contributions and the selection of suitable prediction methods for non-linear, imbalanced, scaling, and near real-time data. We used data from 38 Tanzanian banks (2010-2021) from the Bank of Tanzania (BOT). Extensive factors experimentation using Random Forest (RF) and Multi-Layer Perceptron (MLP) models identified ten features for Machine Learning (ML) analysis and LR rating as output. A hybrid RF-MLP model with a 199-tree RF and 10-512-250-120-80-60-6 MLP was developed. It increased LR sensitivity and reduced RF and MLP model limitations through generalisation, and demonstrated statistical and practical performance. It minimised classification errors with Type I and II errors, and Negative Likelihood of 0.8%, 9.1%, and 1%; Discriminant Power of 2.61; and 90% to 96% Accuracy, Balanced Accuracy, Precision, Recall, F1 Score, G-mean, Cohen’s Kappa, Youden Index, and Area Under the Curve. Past LR scenarios confirmed RF-MLP performance improvement over MLA. The unavailability of LCR and NSFR data hindered a comprehensive evaluation. This study extended LR factors and proposed a model to complement LR classification
The Seismicity of the Nyanza Rift: Implication for its Propagation from the Main Central Kenya Rift Valley
No full textA new seismicity map of the Nyanza Rift is presented, using a compiled and unified earthquake catalog of 290 earthquakes spanning 107 years from 1913 to June 2020 and magnitude ML≤5.2. A magnitude of completeness Mc 4.0 and a b-value of 0.74 confirm that the Nyanza Rift Valley is an active extensional rift. The seismicity patterns confirm that the Nyanza Rift propagates in a WSW direction off the main Central Kenya Rift. The Nyanza Rift lacks, to a large extent, bounding structural controls eastwards of Lake Victoria, implying that Lake Victoria sits in half-graben, except at the Winam Gulf, where the active Kisumu faults, Nyando faults, and Kendu faults bound imply a graben. The seismicity predominantly diffuses and straddles the entire length of the Nyanza Rift, about 250 km, with a breadth of 50 km. Six active faults are identified: The Nandi fault, Kisumu fault, Nyando fault, Kendu fault, Lambwe-Samanga fault, and the Siria-Vitumbara fault. Earthquake depths increase southwestwards, where lower crustal earthquakes 30-38 km confirm crustal thickness increases within the Tanzanian Craton and underneath Lake Victoria. Four seismogenic source zones are delineated as the Tinderet-Timboroa Zone (Zone-1), the Winam Gulf and Homabay-Rangwe Zone (Zone-2), the Southeast Lake Victoria Zone (Zone-3), the Siria-Vitumbara Fault Zone (Zone-4). Within seismogenic source zones, Zone-1 to Zone-3 a north-northeast seismicity trend is observed, implying possible re-activation of buried faults. Keywords: Seismicity, Seismicity patterns, Seismogenic source zones, West-southwest propagation of the Nyanza Rift Valley DOI: 10.7176/JEES/14-6-05 Publication date: December 30th 202
Malaria and Mosquito net Utilisation among Schoolchildren in Villages with or without Healthcare Facilities at Different Altitudes in Iringa District, Tanzania.
No full textThe endemicity of malaria in Tanzania is heterogenous, mainly associated with physical factors such as topography, climate and socio-economic status. The contributions of these factors in many regions of Tanzania have not been studied in detail. This study was carried out to determine the prevalence and transmission of malaria and mosquito nets coverage among schoolchildren in relation to altitude in villages with or without healthcare facilities in Iringa District,Tanzania. A cross-sectional survey of schoolchildren was carried out in six villages in three altitude transects (965-2075 m). In each transect a village with and without a healthcare facility were selected. The villages included Idodi (965m), Makifu (985m), Tosamaganga (1561m) Mangalali (1520m) Lulanzi (1917) and Kilolo (2075m). For the purpose of this study, the villages were categorised as lowlands (Idodi and Makifu), intermediate (Tosamaganga and Mangalali) and highlands (Lulanzi and Kilolo. Healthcare facilities were available at Idodi,Tosamaganga and Kilolo. Each child was asked whether or not slept under a mosquito net during the previous night. Mosquitoes were collected using pyrethrum spray catch technique in ten houses in each study village.\ud
Blood smears from a total of 1643 schoolchildren (mean age = 5.9-12.3 years) were examined for malaria infection. Plasmodium falciparum accounted for 93.1% of the malaria parasites. The prevalence of P. falciparum among children in Idodi, Makifu, Mangalali,Tosamaganga, was 51.51%, 73.66%, 22.79%, and 14.83%, respectively. Malaria parasites were not found among children in the highland villages of Lulanzi and Kilolo). The prevalence of malaria parasitaemia, packed cell volume, geometric mean parasite density and spleen rates were higher in children living in villages without healthcare facilities (P<0.001). Of the children, 16.1% (264/1643) slept under a mosquito net during the previous night. About three quarters (253/344) of the schoolchildren who had malaria parasites were not using mosquito nets. Mosquito net coverage was higher in lowland villages, accounting for 61.7% (163/264) of the total net use in the district. The majority (75.5%) of the mosquito net users were from village with health facilities (P<0.001). A total of 228 mosquitoes were collected, with Anopheles gambiae s.l. accounting for the majority (53.5%). Overall, 8.7% of the An. gambiae s.l. were infected with malaria sporozoites. Higher sporozoite rates were observed in mosquitoes collected in the lowlands. Communities living in areas without health facilities form the largest proportion of malaria-infected populations in Iringa district. Availability of healthcare service has an influence on mosquito net coverage. The results provide more evidence of the existence of a relationship between altitude variability or accessibility to healthcare services, and the burden of malaria in rural communities of Tanzania
What are the effects of having an illness or injury whilst deployed on post deployment mental health? A population based record linkage study of UK army personnel who have served in Iraq or Afghanistan.
No full textBACKGROUND: The negative impact of sustaining an injury on a military deployment on subsequent mental health is well-documented, however, the relationship between having an illness on a military operation and subsequent mental health is unknown. METHODS: Population based study, linking routinely collected data of attendances at emergency departments in military hospitals in Iraq and Afghanistan [Operational Emergency Department Attendance Register (OpEDAR)], with data on 3896 UK Army personnel who participated in a military health study between 2007 and 2009 and deployed to Iraq or Afghanistan between 2003 to 2009. RESULTS: In total, 13.8% (531/3896) of participants had an event recorded on OpEDAR during deployment; 2.3% (89/3884) were medically evacuated. As expected, those medically evacuated for an injury were at increased risk of post deployment probable PTSD (odds ratio 4.27, 95% confidence interval 1.80-10.12). Less expected was that being medically evacuated for an illness was also associated with a similarly increased risk of probable PTSD (4.39, 1.60-12.07) and common mental disorders (2.79, 1.41-5.51). There was no association between having an OpEDAR event and alcohol misuse. Having an injury caused by hostile action was associated with increased risk of probable PTSD compared to those with a non-hostile injury (3.88, 1.15 to 13.06). CONCLUSIONS: Personnel sustaining illnesses on deployment are just as, if not more, at risk of having subsequent mental health problems as personnel who have sustained an injury. Monitoring of mental health problems should consider those with illnesses as well as physical injuries
Evaluation of Olyset insecticide-treated nets distributed seven years previously in Tanzania.
No full textBACKGROUND: Insecticide-treated nets represent currently a key malaria control strategy, but low insecticide re-treatment rates remain problematic. Olyset nets are currently one of two long-lasting insecticidal nets recommended by WHO. An assessment was carried out of the effect of Olyset nets after seven years of use in rural Tanzania. METHODS: A survey of Olyset nets was conducted in two Tanzanian villages to examine their insecticide dosage, bioassay efficacy and desirability compared with ordinary polyester nets. RESULTS: Of 103 randomly selected nets distributed in 1994 to 1995, 100 could be traced. Most nets were in a condition likely to offer protection against mosquito biting. Villagers appreciated mainly the durability of Olyset trade mark nets and insecticide persistence. People disliked the small size of these nets and the light blue colour and preferred a smaller mesh size, features that can easily be modified. At equal price, 51% said they would prefer to buy an Olyset net and 49% opted for an ordinary polyester net. The average permethrin content was 33%-41% of the initial insecticide dose of 20,000 mg/Kg. Bioassay results indicated high knock-down rates at 60 minutes, but the mosquito mortality after 24 hours was rather low (mean: 34%). No significant correlation was found between bioassay results and insecticide concentration in and on the net. CONCLUSIONS: Olyset nets are popular, durable and with a much longer insecticide persistence than ordinary polyester nets. Hence, Olyset nets are one of the best choices for ITN programmes in rural malaria-endemic areas
