61 research outputs found
J Glob Health
No full textBackground94% of all birth defects (BD) and 95% of deaths due to the BD occur in low and middle income countries, many of which are preventable. In Tanzania, there is currently a paucity of BD data necessary to develop data informed prevention activities.MethodsA cross-sectional analysis was conducted of deliveries identified with BD in the labor ward registers at four Dar es Salaam hospitals between October, 2011 and February, 2012. The birth prevalence of structural BD, case fatality proportion, and the distribution of structural defects associated deaths within total deaths were calculated.ResultsA total of 28\ue2\u20ac\u2030217 resident births were encountered during the study period. Overall birth prevalence of selected defects was 28.3/10\ue2\u20ac\u2030000 live births. Neural tube defects and indeterminate sex were the most and least common defects at birth (9.9 and 1.1/10\ue2\u20ac\u2030000 live births, respectively). Among stillbirths (66.7%) and deaths that occurred within less than 5 days of an affected live birth (18.5%), neural tube defects were the most frequently associated structural defect.ConclusionStructural BD is common and contributes to perinatal mortality in Dar es Salaam. More than half of perinatal deaths encountered among the studied selected external structural BD are associated with neural tube defects, a birth defect with well\ue2\u20ac\u201cestablished evidence based prevention interventions. By establishing a population\ue2\u20ac\u201cbased BD surveillance program, Tanzania would have the information about neural tube defects and other major structural BD needed to develop and monitor prevention activities.26361541PMC456245
Factors associated with Partners Elicitation during HIV Index client’s testing in Dar es Salaam Region, Tanzania Catherine Gale Gitige, Gideon Paul Kwesigabo, Onna Duuma Panga, Florence George Samizi, Ahmed Mohamed Abade, Peter Masunga Mbelele, Rogath Saika Kishimba
No full textIntroduction: Identifying people exposed to HIV is critical towards achieving the UNAIDS 90-90-90 goals for HIV epidemic control. The first 90 in Tanzania is at 53% and yet factors for partner's elicitation to HIV care providers are poorly understood. The objective of this study was to determine predictors of partner's elicitation among index HIV positive clients.
Methods: We conducted a cross-sectional study from January to March 2019 among HIV positive clients diagnosed within the previous 12 months within HIV care and treatment centers in Dar-es Salaam. A structured questionnaire was used to collect the indexes' partner such as including name, type and status of relationship, and location. Participants were asked to choose the preferred approach to notify partners. Using modified Poisson regression estimate prevalence ratios predictors were determined for variables at p< to 0.05.
Results: A total of 438 HIV index clients, mean age 37yrs ±11 SD were identified. Of these, 243 (55.5%) provided partners information to HIV Testing and Care (HTC) provider. Predictors for partner elicitation were awareness of notification methods aPR 3.80, 95%CI 2.11-7.01; having privacy at initial HTC visit aPR 3.20 95%CI 1.30-7.40; awareness of partner's HIV status aPR 1.16, 95%CI 1.03-1.30 and having no fear of rejection by partner aPR1.52, 95%CI 1.23-1.88. However, being a female HIV index client was significantly associated with decreased likelihood of partner's elicitation aPR 0.87, 95% CI 0.80-0.95.
Conclusion: There is a low elicitation rate of exposed partners by index clients. Awareness of notification approaches, confidentiality, having no fear of rejection by partner, and privacy during HTC services contribute to high partner elicitation. Promotion of community awareness on partner's notification approaches and HIV transmission dynamics, and provision of additional support networks for women improve elicitation outcomes are recommended
Accuracy of clinical diagnosis and malaria rapid diagnostic test and its influence on the management of children with fever under reduced malaria burden in Misungwi district, Mwanza Tanzania
No full textIntroduction: malaria diagnosis is known to be non-specific because of the overlap of symptoms of malaria with other infectious diseases that is made worse with declining malaria burden. Though the use of malaria rapid diagnostic test (mRDT) for malaria confirmation has universally been adopted, malaria decline may alter performance of mRDT. This study examined accuracy of clinical diagnosis and mRDT and its influence on prescription for febrile underfives. Methods: a cross-sectional study of 600 underfives was carried out in 6 randomly selected health facilities in Misungwi district, Mwanza; from November - December 2014. Consecutive underfives with a fever consultation were recruited: for each fever and the clinical diagnosis entertained were recorded. Parasitological confirmation of malaria was done by mRDT and microscopic examination of finger prick blood samples. Treatment was based on mRDT results, drugs prescribed recorded. Accuracy of clinical diagnosis and mRDT in predicting malaria was assessed by performance indices against microscopy. Antimalarial and antibiotics prescriptions were assessed against parasitological findings. Results: clinically, 37.2% had malaria; 32.8% were mRDTpositive and 17.0% microscopically positive. Sensitivity of clinical diagnosis was very high (97.0% [95%CI: 91.0-99.2]); specificity 66.7% [95%CI: 62.3-70.8], and positive predictive value 37.4% (95%CI: 31.6-43.5). Sensitivity of mRDTwas very high (99.0% [95%CI: 93.9-99.9]), specificity (80.7% [95%CI: 76.9-84.0]), positive predictive value 51.3% [95% CI: 44.1-58.4]) and negative predictive 99.75% [95%CI: 99.4-100.0]. Those receiving antimalarial prescription, 75.0% were mRDT positive; 39.4% microscopically positive. Those receiving antibiotic, 78.8% were mRDT negative; 90.1% microscopically negative. Conclusion: decline in malaria lowered specificity of mRDT to < 95% against WHO recommendation. Though adherence to mRDT results was high, there was over prescription of antibiotics.The Pan African Medical Journal 2016;2
Prevalence and determinants of caesarean sections among women in selected health facilities in Njombe region, Tanzania
No full textAbstract When medically required, Caesarean sections (CS) can help to reduce maternal and newborn mortality significantly. However, excessive or non-indicated CS causes serious health hazards. Tanzania’s national CS rate is 13%, with the Njombe area reporting a significantly higher rate of 29% in 2022 nearly double the WHO-recommended maximum of 15%. This study investigated the prevalence and risk factors for CS among postpartum mothers in Njombe health facilities. A facility-based cross-sectional investigation was carried out utilizing a multistage cluster sampling method. A total of 567 post-delivery women aged 15–44 years from six health facilities were surveyed using Kobo Collect structured questionnaires. Demographic data were analyzed using descriptive statistics. Modified Poisson regression was used to investigate the relationships between independent variables and CS delivery. The multivariable model included variables with p-values 4.1 kg (aPR = 1.67; 95% CI: 1.07–2.27), gestational age ≥ 43 weeks (aPR = 1.49; 95% CI: 1.05–2.20), and referral from health centers (aPR = 2.10; 95% CI: 1.50-3). Delivering in private facilities also increased the likelihood of CS, albeit not significantly (aPR = 1.13; 95% CI: 0.75–1.67). The CS rate in Njombe substantially exceeds national and worldwide averages. Targeted initiatives are urgently required to encourage evidence-based decision-making, improve ANC scheduling, and strengthen monitoring of health insurance and private sector influences on CS delivery. Policy changes should focus on enforcing clinical criteria and increasing accountability in maternity healthcare
Birth prevalence of selected external structural birth defects at four hospitals in Dar es Salaam, Tanzania, 2011–2012
Get PDF94% of all birth defects (BD) and 95% of deaths due to the BD occur in low and middle income countries, many of which are preventable. In Tanzania, there is currently a paucity of BD data necessary to develop data informed prevention activities.
Methods A cross-sectional analysis was conducted of deliveries identified with BD in the labor ward registers at four Dar es Salaam hospitals between October, 2011 and February, 2012. The birth prevalence of structural BD, case fatality proportion, and the distribution of structural defects associated deaths within total deaths were calculated.
A total of 28 217 resident births were encountered during the study period. Overall birth prevalence of selected defects was 28.3/10 000 live births. Neural tube defects and indeterminate sex were the most and least common defects at birth (9.9 and 1.1/10 000 live births respectively). Among stillbirths (66.7%) and deaths that occurred within less than 5 days of an affected live birth (18.5%), neural tube defects were the most frequently associated structural defect.
Structural BD is common and contributes to perinatal mortality in Dar es Salaam. More than half of perinatal deaths encountered among the studied selected external structural BD are associated with neural tube defects, a birth defect with well–established evidence based prevention interventions. By establishing a population–based BD surveillance program, Tanzania would have the information about neural tube defects and other major structural BD needed to develop and monitor prevention activities
Characteristics of adolescents on ART (N = 25,484).
No full textCharacteristics of adolescents on ART (N = 25,484).</p
Rate of loss to follow up among adolescents on ART.
No full textRate of loss to follow up among adolescents on ART.</p
Bivariate and multivariate analysis of loss to follow up among adolescent on ART.
No full textBivariate and multivariate analysis of loss to follow up among adolescent on ART.</p
Flow chart for the selection procedure of the study subjects.
No full textFlow chart for the selection procedure of the study subjects.</p
Prevalence of Helmet Use among Motorcycle Users in Dar Es Salaam, Tanzania.
Get PDFThe purpose of this study was to determine prevalence of helmet use among motorcyclists as one of the preventive measures for road traffic injuries. A cross sectional observational survey was conducted in the 3 Districts (Kinondoni, Ilala and Temeke) that make Dar es Salaam. Tanzania. A standardized line-listing form and checklist were used to record the drivers and passengers use of helmet as observed by study investigators. Data for helmet use was collected on one weekday and one weekend day. Time for observation was during the rush hour in the morning, noon and evening. Then data were entered into Epi Info 3.5.1 analysis. A total of 7,678 motorcycle drivers and 4,328 passengers observed in this study. Drivers were almost male (98.8%) and 73.2% of all passengers were males. The prevalence use of helmet use among motorcyclist's riders was 82.1% and among passengers was 22.5%. Proportion of helmet use in drivers and passengers observed were relatively similar during weekday and weekend day and time of observation. This study showed the relative high helmet use among motorcyclist riders though very low in passengers. This study recommends increased community awareness on helmet use among passengers and enforcement and revival of road safety laws of passengers and motorcyclists on helmet use
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