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  1. Erika Smith, '08 Dar Es Salaam, Tanzania

    E-print Network

    volunteering in Dar es Salaam, Tanzania. Dar es Salaam is the largest city and until recently was the capital running about the room and hitting other children. This was paradoxical. As a punishment for hitting

  2. Homicide of children in Dar es Salaam, Tanzania, 2005

    PubMed Central

    Outwater, Anne; Mgaya, Edward; Campbell, Jacquelyn C.; Becker, Stan; Kinabo, Linna; Menick, Daniel Mbassa

    2014-01-01

    Background Although data are sparse, it has been estimated that the highest rates of homicide death amongst children are in Africa. Little information is available on ages 0 -< 15 years. No reliable quantitative surveillance analysis of neonaticide (killed at less than one week) has been done. Methods A Violent Death Survey following WHO/CDC Guidelines was completed in Dar es Salaam region, Tanzania (DSM) (population 2.845 million) in 2005. Qualitative and quantitative data were gathered and analyzed using mixed methods techniques. Results The overall age adjusted rate of discarded and killed children in DSM was 2.05. The rate of neonaticide was 27.7 per 100,000) while the rate of homicide incidence for children > one day was Discussion The overall estimated homicide rate for Africa of children under age 15 was 4.53 per 100,000, whereas. The estimated global rate is 1.7 per 100,000 closer to DSM‘s rate. The results in DSM show that broad age groupings such as ” <1 year” or “0–4 years” or “0 – <15 years” may mask a high incidence of neonaticide and an otherwise low incidence of murdered children. The print media provided good in-depth coverage for a few cases but it is not known if the reported cases are representative. Conclusion Eighty percent of homicides of children in DSM are neonaticides. Since it is believed that the forces behind neonaticide are fundamentally different than homicides of older children, it is suggested that data of future surveys be parsed to include neonates, until the phenomenon is more clearly understood and addressed. Further understanding of the mother and father of the deceased is needed. Continued surveillance data collection is important to expand the sample size. PMID:22066333

  3. The use of social media among adolescents in Dar es Salaam and Mtwara, Tanzania.

    PubMed

    Pfeiffer, Constanze; Kleeb, Matthis; Mbelwa, Alice; Ahorlu, Collins

    2014-05-01

    Social media form part of the rapid worldwide digital development that is re-shaping the life of many young people. While the use of social media by youths is increasingly researched in the North, studies about youth in the South are missing. It therefore remains unclear how social media can be included in interventions that aim at informing young people in many countries of the global South about sexual and reproductive health. This paper presents findings of a mixed-methods study of young people's user behaviour on the internet and specifically of social media as a platform for sexual health promotion in Tanzania. The study used questionnaires with 60 adolescents and in-depth interviews with eight students aged 15 to 19 years in Dar es Salaam, and in Mtwara, Southern Tanzania. Findings show that youth in Dar es Salaam and Mtwara access the internet mainly through mobile phones. Facebook is by far the most popular internet site. Adolescents highlighted their interest in reproductive and sexual health messages and updates being delivered through humorous posts, links and clips, as well as by youth role models like music stars and actors that are entertaining and reflect up-to-date trends of modern youth culture. PMID:24908469

  4. Body-Art Practices Among Undergraduate Medical University Students in Dar Es Salaam, Tanzania, 2014

    PubMed Central

    Chacha, Chacha Emmanuel; Kazaura, Method R.

    2015-01-01

    Background: Body-art practices are increasing among adolescents and young adults. Although substantial data are available in developed countries, little has been documented about body-art practices in developing countries. Objective: To determine the magnitude, types and reasons for practicing body-art practices among undergraduate medical University students in Dar es Salaam, Tanzania. Materials and Methods: A cross-sectional descriptive study was conducteed among undergraduate University students in Dar es Salaam involving 536 respondents from two Universities. We used a self-administered questionnaire to collect data. Analyses were based on summary measures and bivariate analyses. Results: While 7.5% of undergraduate students reported having tattoos, 20% reported having body puncturing or piercing. Body piercing is reported more among female university undergraduate students than their male counterparts. Reported main reasons for undergoing body-art include “a mark of beauty,” 24%, “just wanted one,” 18% and “a mark of femininity or masculinity,” 17%. The majority (98%) of students were aware that unsafe body-art practices may lead to contracting HIV and more than half (52%) reported awareness of the risk of Hepatitis B infection. Conclusions: Despite high awareness of the potential risks involved in unsafe body arts that include tattoo and piercing, these practices are increasing among adolescents and young adults. There is need to have educational and counseling efforts so as to minimize associated health risks. PMID:25814729

  5. Interdependence of domestic malaria prevention measures and mosquito-human interactions in urban Dar es Salaam, Tanzania

    PubMed Central

    Geissbühler, Yvonne; Chaki, Prosper; Emidi, Basiliana; Govella, Nicodemus J; Shirima, Rudolf; Mayagaya, Valeliana; Mtasiwa, Deo; Mshinda, Hassan; Fillinger, Ulrike; Lindsay, Steven W; Kannady, Khadija; de Castro, Marcia Caldas; Tanner, Marcel; Killeen, Gerry F

    2007-01-01

    Background Successful malaria vector control depends on understanding behavioural interactions between mosquitoes and humans, which are highly setting-specific and may have characteristic features in urban environments. Here mosquito biting patterns in Dar es Salaam, Tanzania are examined and the protection against exposure to malaria transmission that is afforded to residents by using an insecticide-treated net (ITN) is estimated. Methods Mosquito biting activity over the course of the night was estimated by human landing catch in 216 houses and 1,064 residents were interviewed to determine usage of protection measures and the proportion of each hour of the night spent sleeping indoors, awake indoors, and outdoors. Results Hourly variations in biting activity by members of the Anopheles gambiae complex were consistent with classical reports but the proportion of these vectors caught outdoors in Dar es Salaam was almost double that of rural Tanzania. Overall, ITNs confer less protection against exophagic vectors in Dar es Salaam than in rural southern Tanzania (59% versus 70%). More alarmingly, a biting activity maximum that precedes 10 pm and much lower levels of ITN protection against exposure (38%) were observed for Anopheles arabiensis, a vector of modest importance locally, but which predominates transmission in large parts of Africa. Conclusion In a situation of changing mosquito and human behaviour, ITNs may confer lower, but still useful, levels of personal protection which can be complemented by communal transmission suppression at high coverage. Mosquito-proofing houses appeared to be the intervention of choice amongst residents and further options for preventing outdoor transmission include larviciding and environmental management. PMID:17880679

  6. Climate change induced risk analysis of Dar es Salaam city (Tanzania)

    NASA Astrophysics Data System (ADS)

    Topa, Maria Elena; Herslund, Lise; Cavan, Gina; Printz, Andreas; Simonis, Ingo; Bucchignani, Edoardo; Jean-Baptiste, Nathalie; Hellevik, Siri; Johns, Regina; Kibassa, Deusdedit; Kweka, Clara; Magina, Fredrick; Mangula, Alpha; Mbuya, Elinorata; Uhinga, Guido; Kassenga, Gabriel; Kyessi, Alphonce; Shemdoe, Riziki; Kombe, Wilbard

    2013-04-01

    CLUVA (CLimate change and Urban Vulnerability in Africa; http://www.cluva.eu/) is a 3 years project, funded by the European Commission in 2010. The main objective of CLUVA is to develop context-centered methods and knowledge to be applied to African cities to assess vulnerabilities and increase knowledge on managing climate related risks. The project estimates the impacts of climate changes in the next 40 years at urban scale and downscales IPCC climate projections to evaluate specific threats to selected African test cities. These are mainly from floods, sea-level rise, droughts, heat waves, and desertification. The project evaluates and links: social vulnerability; urban green structures and ecosystem services; urban-rural interfaces; vulnerability of urban built environment and lifelines; and related institutional and governance dimensions of adaptation. The multi-scale and multi-disciplinary qualitative, quantitative and probabilistic approach of CLUVA is currently being applied to selected African test cities (Addis Ababa - Ethiopia; Dar es Salaam - Tanzania; Douala - Cameroun; Ouagadougou - Burkina Faso; St. Louis - Senegal). In particular, the poster will present preliminary findings for the Dar es Salaam case study. Dar es Salaam, which is Tanzania's largest coastal city, is exposed to floods, coastal erosion, droughts and heat waves, and highly vulnerable to impacts as a result of ineffective urban planning (about 70% unplanned settlements), poverty and lack of basic infrastructure (e.g. lack of or poor quality storm water drainage systems). Climate change could exacerbate the current situation increasing hazard-exposure alongside the impacts of development pressures which act to increase urban vulnerability for example because of informal (unregulated) urbanization. The CLUVA research team - composed of climate and environmental scientists, risk management experts, urban planners and social scientists from both European and African institutions - has started to produce research outputs suitable for use in evidence-based planning activities in the case study cities through interdisciplinary methods and analysis. Climate change projections at 8 km resolution are ready for regions containing each of the case study cities; a preliminary hazard assessment for floods, droughts and heat waves has been performed, based on historical data; urban morphology and related green structures have been characterized; preliminary findings in social vulnerability provide insights how communities and households can resist and cope with, as well as recover from climate induced hazards; vulnerability of informal settlements to floods has been assessed for a case study area (Suna sub ward) and a GIS based identification of urban residential hotspots to flooding is completed. Furthermore, a set of indicators has been identified and the most relevant for Dar es Salaam has been selected by local stakeholders to identify particular vulnerable high risk areas and communities. An investigation of the existing urban planning and governance system and its interface with climate risks and vulnerability has inter-alia suggested severe institutional deficits including over-centralized institutions for disaster risk management and climate change adaptation. A multi-risk framework considering climate-related hazards, and physical and social fragilities has been set up.

  7. Prevalence of helmet use among motorcycle users in Dar Es Salaam, Tanzania

    PubMed Central

    Kauky, Cosmas George; Kishimba, Rogath Saika; Urio, Loveness John; Abade, Ahmed Mohammed; Mghamba, Janneth Maridadi

    2015-01-01

    Introduction The purpose of this study was to determine prevalence of helmet use among motorcyclists as one of the preventive measures for road traffic injuries. Methods 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 Results 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. Conclusion 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. PMID:26309470

  8. Window screening, ceilings and closed eaves as sustainable ways to control malaria in Dar es Salaam, Tanzania

    PubMed Central

    Ogoma, Sheila B; Kannady, Khadija; Sikulu, Maggy; Chaki, Prosper P; Govella, Nicodem J; Mukabana, Wolfgang R; Killeen, Gerry F

    2009-01-01

    Background Malaria transmission in Africa occurs predominantly inside houses where the primary vectors prefer to feed. Human preference and investment in blocking of specific entry points for mosquitoes into houses was evaluated and compared with known entry point preferences of the mosquitoes themselves. Methods Cross-sectional household surveys were conducted in urban Dar es Salaam, Tanzania to estimate usage levels of available options for house proofing against mosquito entry, namely window screens, ceilings and blocking of eaves. These surveys also enabled evaluation of household expenditure on screens and ceilings and the motivation behind their installation. Results Over three quarters (82.8%) of the 579 houses surveyed in Dar es Salaam had window screens, while almost half (48.9%) had ceilings. Prevention of mosquito entry was cited as a reason for installation of window screens and ceilings by 91.4% (394/431) and 55.7% (127/228) of respondents, respectively, but prevention of malaria was rarely cited (4.3%, 22/508). The median cost of window screens was between US $ 21-30 while that of ceilings was between US $301-400. The market value of insecticide-treated nets, window screening and ceilings currently in use in the city was estimated as 2, 5 and 42 million US$. More than three quarters of the respondents that lacked them said it was too expensive to install ceilings (82.2%) or window screens (75.5%). Conclusion High coverage and spending on screens and ceilings implies that these techniques are highly acceptable and excellent uptake can be achieved in urban settings like Dar es Salaam. Effective models for promotion and subsidization should be developed and evaluated, particularly for installation of ceilings that prevent entry via the eaves, which are the most important entry point for mosquitoes that cause malaria, a variety of neglected tropical diseases and the nuisance which motivates uptake. PMID:19785779

  9. Microbial Efficacy of Waterless Hand Hygiene in Dar es Salaam, Tanzania

    NASA Astrophysics Data System (ADS)

    Pickering, A.; Boehm, A.; Davis, J.

    2008-12-01

    Millions of people die from diarrheal and respiratory diseases every year due to lack of proper sanitation, hygiene, and access to clean water. The act of handwashing with soap has been found to effectively reduce both diarrheal and respiratory illness, however, handwashing at critical times (i.e. after using the toilet, before preparing food) remains infrequent around the world. This research investigates the potential for alcohol- based hand sanitizer (ABHS) to be an effective and appropriate hand hygiene option in developing countries. A study was conducted to assess the microbiological effectiveness of ABHS, as compared to handwashing with soap and water, in field conditions in Dar es Salaam, Tanzania. A total of 205 participants, including mothers, nurses, students, and teachers, were introduced to ABHS, given a standardized amount (2ml) of product, and instructed on how to use the product correctly. Hand samples were obtained using the hand rinse method before and after the use of ABHS from 152 participants. The other 53 participants were hand sampled before and after handwashing with a non-antimicrobial liquid soap and clean water (prior to using ABHS). Visual inspections of the hands were performed before hand sampling to record the level of dirt on the hands. All hand samples were processed and analyzed by membrane filtration for concentrations of two microbial indicators, enterococci and E. coli. User perceptions of the product and willingness to pay are also documented. The results of this study provide valuable insight on the prospective of promoting ABHS in developing countries and water scarce areas.

  10. Knowledge of AIDS among secondary school pupils in Bagamoyo and Dar-Es-Salaam, Tanzania.

    PubMed

    Kapiga, S H; Nachtigal, G; Hunter, D J

    1991-03-01

    We assessed knowledge of AIDS among pupils in selected schools in Tanzania in August 1989. Four hundred and eight-one pupils from four randomly selected secondary schools, two from Dar-Es-Salaam (a city) and two from Bagamoyo (a semi-rural town), were interviewed using a structured questionnaire. Of these, 476 (99.0%) had heard of AIDS, and 447 (92.9%) were able to mention spontaneously at least one sexually transmitted disease (STD), of whom 374 (83.7%) mentioned AIDS. Knowledge was found to increase with age and tended to be higher among women in Dar-Es-Salaam than in Bagamoyo. These data suggest that communication channels directed at women in rural areas should be strengthened. While knowledge of sexual transmission of HIV was generally high, and prevalence of reported misconceptions about modes of transmission was very low, knowledge of non-sexual means of transmission (transfusions, injections, vertical) was lacking. Although 80% of pupils mentioned reduction of number of sexual partners as a means of AIDS prevention, only 22% mentioned condom use, and less than 5% reported that they had ever used a condom. Future research should concentrate on means of promoting sexual behavior change, the ultimate aim of any AIDS prevention strategy. PMID:2059373

  11. Basic analysis of climate and urban bioclimate of Dar es Salaam, Tanzania

    NASA Astrophysics Data System (ADS)

    Ndetto, Emmanuel L.; Matzarakis, Andreas

    2013-10-01

    Better understanding of urban microclimate and bioclimate of any city is imperative today when the world is constrained by both urbanisation and global climate change. Urbanisation generally triggers changes in land cover and hence influencing the urban local climate. Dar es Salaam city in Tanzania is one of the fast growing cities. Assessment of its urban climate and the human biometeorological conditions was done using the easily available synoptic meteorological data covering the period 2001-2011. In particular, the physiologically equivalent temperature (PET) was calculated using the RayMan software and results reveal that the afternoon period from December to February (DJF season) is relatively the most thermal stressful period to human beings in Dar es Salaam where PET values of above 35 °C were found. Additionally, the diurnal cycle of the individual meteorological elements that influence the PET index were analysed and found that air temperature of 30-35 °C dominate the afternoon period from 12:00 to 15:00 hours local standard time at about 60 % of occurrence. The current results, though considered as preliminary to the ongoing urban climate study in the city, provide an insight on how urban climate research is of significant importance in providing useful climatic information for ensuring quality of life and wellbeing of city dwellers.

  12. Undernutrition among HIV-positive children in Dar es Salaam, Tanzania: antiretroviral therapy alone is not enough

    PubMed Central

    2011-01-01

    Background The prevalence of HIV/AIDS has exacerbated the impact of childhood undernutrition in many developing countries, including Tanzania. Even with the provision of antiretroviral therapy, undernutrition among HIV-positive children remains a serious problem. Most studies to examine risk factors for undernutrition have been limited to the general population and ART-naive HIV-positive children, making it difficult to generalize findings to ART-treated HIV-positive children. The objectives of this study were thus to compare the proportions of undernutrition among ART-treated HIV-positive and HIV-negative children and to examine factors associated with undernutrition among ART-treated HIV-positive children in Dar es Salaam, Tanzania. Methods From September to October 2010, we conducted a cross-sectional survey among 213 ART-treated HIV-positive and 202 HIV-negative children in Dar es Salaam, Tanzania. We measured the children's anthropometrics, socio-demographic factors, food security, dietary habits, diarrhea episodes, economic status, and HIV clinical stage. Data were analyzed using both univariate and multivariate methods. Results ART-treated HIV-positive children had higher rates of undernutrition than their HIV-negative counterparts. Among the ART-treated HIV-positive children, 78 (36.6%) were stunted, 47 (22.1%) were underweight, and 29 (13.6%) were wasted. Households of ART-treated HIV-positive children exhibited lower economic status, lower levels of education, and higher percentages of unmarried caregivers with higher unemployment rates. Food insecurity was prevalent in over half of ART-treated HIV-positive children's households. Furthermore, ART-treated HIV-positive children were more likely to be orphaned, to be fed less frequently, and to have lower body weight at birth compared to HIV-negative children. In the multivariate analysis, child's HIV-positive status was associated with being underweight (AOR = 4.61, 95% CI 1.38-15.36 P = 0.013) and wasting (AOR = 9.62, 95% CI 1.72-54.02, P = 0.010) but not with stunting (AOR = 0.68, 95% CI 0.26-1.77, P = 0.428). Important factors associated with underweight status among ART-treated HIV-positive children included hunger (AOR = 9.90, P = 0.022), feeding frequency (AOR = 0.02, p < 0.001), and low birth weight (AOR = 5.13, P = 0.039). Factors associated with wasting among ART-treated HIV-positive children were diarrhea (AOR = 22.49, P = 0.001) and feeding frequency (AOR = 0.03, p < 0.001). Conclusion HIV/AIDS is associated with an increased burden of child underweight status and wasting, even among ART-treated children, in Dar es Salaam, Tanzania. In addition to increasing coverage of ART among HIV-positive children, interventions to ameliorate poor nutrition status may be necessary in this and similar settings. Such interventions should aim at promoting adequate feeding patterns, as well as preventing and treating diarrhea. PMID:22087543

  13. The health-related microbiological quality of bottled drinking water sold in Dar es Salaam, Tanzania.

    PubMed

    Kassenga, Gabriel R

    2007-03-01

    The consumption of bottled and plastic-bagged drinking water in Tanzania has increased largely because of the deteriorating quality of tap water. It is uncertain whether these water products are safe for drinking. In this study, the microbiological quality of bottled and plastic-bagged drinking water sold in Dar es Salaam, Tanzania, was investigated. One hundred and thirty samples representing 13 brands of bottled water collected from shops, supermarkets and street vendors were analysed for total coliform and faecal coliform organisms as well as heterotrophic bacteria. These were compared with 61 samples of tap water. Heterotrophic bacteria were detected in 92% of the bottled water samples analysed. Total and faecal coliform bacteria were present in 4.6% and 3.6%, respectively, of samples analysed with a tendency for higher contamination rates in plastic-bagged drinking water. Microbiological quality of tap water was found to be worse compared with bottled water, with 49.2% and 26.2% of sampling points showing the presence of total coliform and faecal coliform organisms, respectively. The results suggest caution and vigilance to avert outbreaks of waterborne diseases from these types of drinking water. PMID:17402289

  14. Attitudes, beliefs and norms relating to contraceptive use among young migrant and non-migrant adults in urban Dar es Salaam, Tanzania.

    PubMed

    Irani, Laili; Speizer, Ilene; Barrington, Clare

    2013-01-01

    The young urban population of Tanzania is growing rapidly, primarily due to rural-urban migration. More information is needed on the challenges facing young adult urban women and men in using family planning (FP). The purpose of this study is to identify perceptions, interpersonal and familial attitudes, and sociocultural norms regarding FP among young adults (18-25 years) in Dar es Salaam, Tanzania, comparing responses by sex, marital status and migration status. We conducted 12 focus groups with young adult men and women (n=74) in Dar es Salaam in December 2009. Participants knew of modern contraceptive methods, but had serious concerns about side effects. Single men and women preferred condoms. Female migrants stated that traditional methods were ineffective, yet commonly used in rural areas. Men's desires for more children frequently led female migrants not to use FP, while many married long-term residents used FP discreetly. Single women sometimes received the support of their parents/boyfriends to access and use contraception. Findings highlight differences in experiences among young adult men and women based on their migrant and marital status at the individual, interpersonal and normative levels. Future efforts to promote FP should engage existing social support systems and cultivate new ones in response to barriers. PMID:24156247

  15. Pit Latrine Emptying Behavior and Demand for Sanitation Services in Dar Es Salaam, Tanzania

    PubMed Central

    Jenkins, Marion W.; Cumming, Oliver; Cairncross, Sandy

    2015-01-01

    Pit latrines are the main form of sanitation in unplanned areas in many rapidly growing developing cities. Understanding demand for pit latrine fecal sludge management (FSM) services in these communities is important for designing demand-responsive sanitation services and policies to improve public health. We examine latrine emptying knowledge, attitudes, behavior, trends and rates of safe/unsafe emptying, and measure demand for a new hygienic latrine emptying service in unplanned communities in Dar Es Salaam (Dar), Tanzania, using data from a cross-sectional survey at 662 residential properties in 35 unplanned sub-wards across Dar, where 97% had pit latrines. A picture emerges of expensive and poor FSM service options for latrine owners, resulting in widespread fecal sludge exposure that is likely to increase unless addressed. Households delay emptying as long as possible, use full pits beyond what is safe, face high costs even for unhygienic emptying, and resort to unsafe practices like ‘flooding out’. We measured strong interest in and willingness to pay (WTP) for the new pit emptying service at 96% of residences; 57% were WTP ?U.S. $17 to remove ?200 L of sludge. Emerging policy recommendations for safe FSM in unplanned urban communities in Dar and elsewhere are discussed. PMID:25734790

  16. Patient satisfaction with HIV/AIDS care at private clinics in Dar es Salaam, Tanzania.

    PubMed

    Miller, James S; Mhalu, Aisa; Chalamilla, Guerino; Siril, Hellen; Kaaya, Silvia; Tito, Justina; Aris, Eric; Hirschhorn, Lisa R

    2014-01-01

    Health system responsiveness (HSR) measures quality of care from the patient's perspective, an important component of ensuring adherence to medication and care among HIV patients. We examined HSR in private clinics serving HIV patients in Dar es Salaam, Tanzania. We surveyed 640 patients, 18 or older receiving care at one of 10 participating clinics, examining socioeconomic factors, HIV regimen, and self-reported experience with access and care at the clinic. Ordered logistic regression, adjusted for clustering of the clinic sites, was used to measure the relationships between age, gender, education, site size, and overall quality of care rating, as well as between the different HSR domains and overall rating. Overall, patients reported high levels of satisfaction with care received. Confidentiality, communication, and respect were particularly highly rated, while timeliness received lower ratings despite relatively short wait times, perhaps indicating high expectations when receiving care at a private clinic. Respect, confidentiality, and promptness were significantly associated with overall rating of health care, while provider skills and communication were not significantly associated. Patients reported that quality of service and confidentiality, rather than convenience of location, were the most important factors in their choice of a clinic. Site size (patient volume) was also positively correlated with patient satisfaction. Our findings suggest that, in the setting of urban private-sector clinics, flexible clinics hours, prompt services, and efforts to improve respect, privacy and confidentiality may prove more helpful in increasing visit adherence than geographic accessibility. While a responsive health system is valuable in its own right, more work is needed to confirm that improvements in HSR in fact lead to improved adherence to care. PMID:24499337

  17. Urban biowaste for solid fuel production: waste suitability assessment and experimental carbonization in Dar es Salaam, Tanzania.

    PubMed

    Lohri, Christian Riuji; Faraji, Adam; Ephata, Elia; Rajabu, Hassan Mtoro; Zurbrügg, Christian

    2015-02-01

    The poor state of solid waste management in Dar es Salaam (DSM), Tanzania, the large fraction of organic waste generated and a high charcoal consumption by city residents has triggered this research on carbonization of municipal biowaste. Char produced by the thermochemical conversion method of slow pyrolysis can be briquetted and used as cooking fuel alternative to wood-based charcoal. To explore the potential of biowaste carbonization in DSM, the most suitable organic wastes were selected and pyrolyzed in a simple, externally heated carbonization system developed as part of this study. A Multi-Criteria Analysis framework allowed to assess prevailing biowaste types regarding availability and accessibility, and respective suitability in terms of physical-chemical properties. The assessment, using data from a survey and lab analysis, revealed the following biowaste types with highest overall potential for char production in DSM: packaging grass/leaves (PG) used for transportation of fruit and vegetables to the markets, wood waste (WW) from wood workshops, and cardboard (CB) waste. Best practice carbonization of these biowastes in the pyrolyzer showed satisfactory char yields (PG: 38.7%; WW: 36.2%; CB: 35.7% on dry basis). Proximate composition (including volatile, fixed carbon and ash content) and heating value (PG: 20.1 MJ kg(-1); WW: 29.4 MJ kg(-1); CB: 26.7 MJ kg(-1)) of the produced char also compare well with literature data. The energy and emission-related aspects of the system still require further research and optimizations to allow financially viable and safe operation. PMID:25649406

  18. Factors associated with major structural birth defects among newborns delivered at Muhimbili National Hospital and Municipal Hospitals in Dar Es Salaam, Tanzania 2011 – 2012

    PubMed Central

    Kishimba, Rogath Saika; Mpembeni, Rose; Mghamba, Janneth

    2015-01-01

    Introduction Ninety-four percent of all birth defects and 95% of deaths due to the birth defects occur in low and middle income countries, Tanzania among them. In Tanzania there are currently limited birth defects prevention strategies in place due to limited information on factors associated with the occurrence of birth defects. Methods We conducted a case control study that included newborns born from October, 2011 through February, 2012 at 4 participating hospitals. A case was defined as any newborn of a Dar es salaam resident with a neural tube defect, orofacial clefts, limb reduction defects or musculo-skeletal defects (SBD) born during the study period. A control was defined as the next three newborns (delivered after the case) without birth defects. Univariate, bivariate and multivariate analysis were done using Epi Info version 3.5.1. Results A total of 400 newborns participated in the study, 100 cases and 300 controls. Factors associated with higher odds of a SBD included maternal fever (adjusted odds ratio (AOR) = 1.99; 95% confidence interval (CI): 1.14-3.52), maternal hypertension (AOR = 3.99; 95% CI: 1.67-9.54), and low birth weight (AOR = 3.48; 95% CI: 1.77-6.85). Antimalarial use during pregnancy was protective (AOR = 0.48; 95% CI: 0.28-0.84). Folic acid supplementation was protective only in bivariate analysis (OR = 0.56; 95% CI: 0.32-0.96). Conclusion Maternal fever, hypertension, and low birth weight are associated with higher odds of SBD. Antimalarial use during pregnancy was associated with lower odds of SBD. Early screening of pregnant mothers for hypertension and other causes of low birth weight may reduce SBD in Dar Es Salaam. PMID:26525082

  19. Exploring the association between women's access to economic resources and intimate partner violence in Dar es Salaam and Mbeya, Tanzania.

    PubMed

    Vyas, Seema; Jansen, Henrica Afm; Heise, Lori; Mbwambo, Jessie

    2015-12-01

    The relationship between women's access to economic resources, e.g. employment or access to micro-credit, and experience of intimate partner violence is complex. Empirical evidence documents that in some settings women's employment is associated with higher risk of partner violence but in other settings with lower risk. Evidence also shows that these conflicting associations exist not only between countries but also within different country settings. Using two population-based data sets gathered in 2002 in contrasting Tanzania settings-Dar es Salaam and Mbeya-, we used multivariate logistic regression to examine the relationship between women's access to economic resources and partner violence. Two indicators of economic resources were examined: whether women earned money and whether women owned a business either with someone or exclusively. In Dar es Salaam we found evidence of a higher risk association among women who earned money and who owned a business exclusively by themselves and a lower risk association among women who owned a business with someone. We found no relationship between either indicator of economic resources and partner violence in Mbeya. Other factors were similarly associated with partner violence in both settings and the strongest associations found were related to the respondents' partners: refusal to give money; alcohol use and relationships with other women. The findings support the assertion that women's access to economic resources operate differently in different country settings, thus highlighting the need for targeted prevention efforts that are relevant for the context. PMID:26494417

  20. Students' Experiences and Challenges of Blended Learning at the University of Dar Es Salaam, Tanzania

    ERIC Educational Resources Information Center

    Mtebe, Joel S.; Raphael, Christina

    2013-01-01

    Recent developments in Information and Communication Technologies (ICTs), especially eLearning, have heightened the need for University of Dar es Salaam (UDSM) to supplement on-campus face-to-face delivery as well as meeting increased students' enrolments through blended distance learning. Since 2008, the University has been offering three…

  1. Child Labour in Urban Agriculture: The Case of Dar es Salaam, Tanzania.

    ERIC Educational Resources Information Center

    Mlozi, Malongo R. S.

    1995-01-01

    Urban agriculture in Dar es Salaam was found to use child labor of both children with parents of higher and lower socioeconomic status (SES). Discusses policy implications and calls for the education of parents of lower SES not to expect an economic contribution from their children's labor, and the education of children about their rights. (LZ)

  2. Does Personalized Water and Hand Quality Information Affect Attitudes, Behavior, and Health in Dar es Salaam, Tanzania?

    NASA Astrophysics Data System (ADS)

    Davis, J.; Pickering, A.; Horak, H.; Boehm, A.

    2008-12-01

    Tanzania (TZ) has one of the highest rates of child mortality due to enteric disease in the world. NGOs and local agencies have introduced numerous technologies (e.g., chlorine tablets, borewells) to increase the quantity and quality of water in Dar es Salaam, the capital of Tanzania, in hopes of reducing morbidity and mortality of waterborne disease. The objective of the present study is to determine if providing personalized information about water quality and hand surface quality, as determined by concentrations of enterococci and E. coli, results in improved health and water quality in households. A cohort study was completed in June-September 2008 in 3 communities ranging from urban to per-urban in Dar es Salaam, Tanzania to achieve our objective. The study consisted of 4 cohorts that were visited 4 times over the 3 month study. One cohort received no information about water and hand quality until the end of the summer, while the other groups received either just information on hand surface quality, just information on water quality, and information on both hand surface and water quality after the first (baseline) household visit. We report concentrations of enterococci and E. coli in water sources (surface waters and bore wells), water stored in households, and environmental waters were children and adults swim and bathe. In addition, we report concentrations of enterococci and E. coli on hands of caregivers and children in households. Preliminary results of surveys on health and perceptions of water quality and illness from the households are provided. Ongoing work will integrate the microbiological and sociological data sets to determine if personalized information interventions resulted in changes in health, water quality in the household, or perceptions of water quality, quantity and relation to human health. Future work will analyze DNA samples from hands and water for human-specific Bacteroides bacteria which are only present in human feces. Our study has the potential to provide empirical evidence to promote large scale monitoring and education campaigns in Africa to improve health and reduce the burden of waterborne disease.

  3. Sexual behaviour, contraceptive knowledge and use among female undergraduates’ students of Muhimbili and Dar es Salaam Universities, Tanzania: a cross-sectional study

    PubMed Central

    2014-01-01

    Background The rate of premarital sexual activity, unwanted pregnancies and illegal abortions remain higher among university students. This calls for understanding the knowledge on contraceptive use and sexual behaviours among this high risk group if the incidence of unintended pregnancy, illegal abortions and high sexual risky behaviour are to be minimized. This study aimed to assess ssexual behaviour, contraceptive knowledge and use among female undergraduates’ students of Muhimbili and Dar es Salaam Universities in Tanzania. Methods A cross-sectional analytic study was conducted among undergraduate female students in the two Universities located in Dar es Salaam region, Tanzania. The study period was from June 2013 to October 2013. A self-administered questionnaire was given to 281 students. Of these, 253 were retrieved, giving a response rate of 90%. Data was analyzed using Statistical Package for Social Science (SPSS) for Windows version 17.0. Descriptive statistics were summarized. The chi square test was used to examine relationship between various sociodemographic and sexual behaviours variables with contraceptive use. A P-value of less than 0.05 was considered statistically significant. Results Results showed that majority (70.4%) of the students have had sexual intercourse. All participants had knowledge of contraception. More than half, 148 (58.5%) of sexually active women reported ever used contraception before while 105 (41.5%) were current contraceptive users. Majority (74.7%) of the sexually active group started sexual activity at young age (19–24 years). Condom, 221(24.3%) and pills, 153 (16.8%) were the known contraceptive methods. The most popular method of contraception used were condoms, withdrawal and periodic abstinence. The main sources of information about contraception were from friends, radio and school (39.5%, 36% and 24%) respectively. Forty (15.8%) women had pregnancies. Of these, 11 (27%) have had unwanted pregnancies among which 54.6% have had induced abortion. Marital status, age at first sex, ever had sex, ever been pregnant and unwanted pregnancies were associated with use of contraception. Conclusions Most of the student’s had knowledge of contraception. However, rate of contraception use is still low. Majority of the respondent were sexually active, with the majority started sexual activity at young age. This needs advocacy for adolescence reproductive health education to promote the use of the available contraceptive services amongst university students. PMID:25099502

  4. Ready to Use Therapeutic Foods (RUTF) improves undernutrition among ART-treated, HIV-positive children in Dar es Salaam, Tanzania

    PubMed Central

    2012-01-01

    Background HIV/AIDS is associated with an increased burden of undernutrition among children even under antiretroviral therapy (ART). To treat undernutrition, WHO endorsed the use of Ready to Use Therapeutic Foods (RUTF) that can reduce case fatality and undernutrition among ART-naïve HIV-positive children. However, its effects are not studied among ART-treated, HIV-positive children. Therefore, we examined the association between RUTF use with underweight, wasting, and stunting statuses among ART-treated HIV-positive children in Dar es Salaam, Tanzania. Methods This cross-sectional study was conducted from September-October 2010. The target population was 219 ART-treated, HIV-positive children and the same number of their caregivers. We used questionnaires to measure socio-economic factors, food security, RUTF-use, and ART-duration. Our outcome variables were underweight, wasting, and stunting statuses. Results Of 219 ART-treated, HIV-positive children, 140 (63.9%) had received RUTF intervention prior to the interview. The percentages of underweight and wasting among non-RUTF-receivers were 12.4% and 16.5%; whereas those of RUTF-receivers were 3.0% (P?=?0.006) and 2.8% (P?=?0.001), respectively. RUTF-receivers were less likely to have underweight (Adjusted Odd Ratio (AOR) =0.19, CI: 0.04, 0.78), and wasting (AOR?=?0.24, CI: 0.07, 0.81), compared to non RUTF-receivers. Among RUTF receivers, children treated for at least four months (n?=?84) were less likely to have underweight (P?=?0.049), wasting (P?=?0.049) and stunting (P?Salaam, Tanzania. PMID:22931107

  5. Sexual motivation, sexual transactions and sexual risk behaviors in men who have sex with men in Dar es Salaam, Tanzania.

    PubMed

    Bui, Thanh C; Nyoni, Joyce E; Ross, Michael W; Mbwambo, Jessie; Markham, Christine M; McCurdy, Sheryl A

    2014-12-01

    Understanding the associations between sexual motivation and sexual risk behaviors of men who have sex with men (MSM) is critical for developing effective HIV prevention interventions. To examine these associations, we employed data from a survey of 200 MSM in Dar es Salaam, Tanzania, recruited through respondent driven sampling. Results showed that 44.5 % of surveyed participants most often looked for love/affection when having sex, and 36.5 % most often looked for money. Money-motivated MSM were more likely to identify themselves as bisexual, more likely to have anal sex, and had significantly higher numbers of partners of both sexes. Those who most often looked for love/affection were less likely to ask for condom use, to actually use a condom, and to use lubrication in anal sex. MSM with different sexual motivations had dissimilar sexual risk behaviors. Tailored health interventions for each group to reduce these sexual risks for STIs/HIV prevention are needed. PMID:24890184

  6. Efficacy of Waterless Hand Hygiene Compared with Handwashing with Soap: A Field Study in Dar es Salaam, Tanzania

    PubMed Central

    Pickering, Amy J.; Boehm, Alexandria B.; Mwanjali, Mathew; Davis, Jennifer

    2010-01-01

    Effective handwashing with soap requires reliable access to water supplies. However, more than three billion persons do not have household-level access to piped water. This research addresses the challenge of improving hand hygiene within water-constrained environments. The antimicrobial efficacy of alcohol-based hand sanitizer, a waterless hand hygiene product, was evaluated and compared with handwashing with soap and water in field conditions in Dar es Salaam, Tanzania. Hand sanitizer use by mothers resulted in 0.66 and 0.64 log reductions per hand of Escherichia coli and fecal streptococci, respectively. In comparison, handwashing with soap resulted in 0.50 and 0.25 log reductions per hand of E. coli and fecal streptococci, respectively. Hand sanitizer was significantly better than handwashing with respect to reduction in levels of fecal streptococci (P = 0.01). The feasibility and health impacts of promoting hand sanitizer as an alternative hand hygiene option for water-constrained environments should be assessed. PMID:20134005

  7. Climate change induced heat wave hazard in eastern Africa: Dar Es Salaam (Tanzania) and Addis Ababa (Ethiopia) case study

    NASA Astrophysics Data System (ADS)

    Capuano, Paolo; Sellerino, Mariangela; Di Ruocco, Angela; Kombe, Wilbard; Yeshitela, Kumelachew

    2013-04-01

    Last decades, new records were set in the world for tornadoes, drought, wind, floods, wildfires and hot temperatures, testifying unusual weather and climate patterns with increasing frequency and intensity of extreme weather events. Extreme heat events are natural hazards affecting many regions in the world, nevertheless limited work has been done on the analysis and effects of extreme heat events in Africa, that is considered a continent particularly vulnerable to the effects of climate change. In fact, the increase of temperature expected in the African continent during the 21st century is larger than the global mean warming, being about 3° to 4° C, about 1.5 times the global temperature increase (Christensen et al., 2007; Gualdi et al., 2012), with the subtropical regions projected to warm more than the tropical regions. Observations and downscaled model simulations (RCP4.5 and RCP8.5 IPCC scenarios) are analyzed to describe heat wave characteristics in Dar es Salaam (Tanzania) and Addis Ababa (Ethiopia), spanning the last five decades as well as that projected for the 21st century. Observed data are daily maximum and minimum temperature collected in the period 1961-2011; downscaled model simulations span up to 2050. Heat waves are defined following a peak over threshold approach by statistical comparison to historical meteorological baselines (site dependent), using a fixed absolute threshold. Projected future warming in the Dar es Salaam and Addis Ababa shows a further increase in the heat waves parameters. Heat wave duration and hot days number are strictly correlated showing that the temperature rise could generate not only an increase of heat waves number but mainly a longer average duration, that can strongly affect the resilience capacity of the population, particularly the elder people. In fact, the impacts of heat waves on the society are determined also by temporal duration (Stephenson, 2008), in addition to their frequency, in fact the capacity of adaptation can be reduced with prolonged exposure to high temperature and humidity. The expected persistence of long-lived heat waves lasting approximately 1.5-2 weeks is clearly longer with respect to the climatological period (1961-1990). During 100 years, short lived but more intense waves are more than doubled in duration. It is evident the needs for the national health services to develop strategies for the mitigation of the heat wave effects, to enhance the resilience of the population, particularly the elder people.

  8. A pilot study to evaluate incorporating eye care for children into reproductive and child health services in Dar-es-Salaam, Tanzania: a historical comparison study

    PubMed Central

    2014-01-01

    Background Many blinding eye conditions of childhood are preventable or treatable, particularly in developing countries. However, primary eye care (PEC) for children is poorly developed, leading to unnecessary visual loss. Activities for control by health workers entail interventions for systemic conditions (measles, vitamin A deficiency), identification and referral of children with sight threatening conditions and health education for caregivers. This pilot study evaluated integrating a package of activities to promote child eye health into Reproductive and Child Health (RCH) services in Dar-es-Salaam, Tanzania. Methods Design: historical comparison study. Fifteen Clinical Officers and 15 nurses in 15 randomly selected RCH clinics were trained in PEC for children in July 2010. They were given educational materials (poster and manual) and their supervisors were orientated. Knowledge and practices were assessed before and 3 weeks after training. One year later their knowledge and practices were compared with a different group of 15 Clinical Officers and 15 nurses who had not been trained. Results Before training staff had insufficient knowledge to identify, treat and refer children with eye diseases, even conjunctivitis. Some recommended harmful practices or did not know that cataract requires urgent referral. Eye examination, vitamin A supplementation of mothers after delivery and cleaning the eyes at birth with instillation of antibiotics (Crede’s prophylaxis) were not routine, and there were no eye-specific educational materials. Three weeks after training several clinics delivering babies started Crede’s prophylaxis, vitamin A supplementation of women after delivery increased from 83.7% to 100%, and all staff included eye conditions in health education sessions. At one year, trained staff were more likely to correctly describe, diagnose and treat conjunctivitis (z=2.34, p=0.04)(30%-vs-60.7%). Mystery mothers observed health education sessions in 7/10 RCH clinics with trained staff, five (71.4%) of which included eye conditions. Conclusions Primary eye care for children in Dar-es-Salaam is inadequate but training RCH staff can improve knowledge in the short term and change practices. Attendance by mothers and their children is high in RCH clinics, making them ideal for delivery of PEC. Ongoing supportive supervision is required to maintain knowledge and practices, as well as systems to track referrals. PMID:24932133

  9. Maternal and neonatal colonisation of group B streptococcus at Muhimbili National Hospital in Dar es Salaam, Tanzania: prevalence, risk factors and antimicrobial resistance

    PubMed Central

    2009-01-01

    Background Group B streptococcus (GBS), which asymptomatically colonises the vaginal and rectal areas of women, is the leading cause of septicemia, meningitis and pneumonia in neonates. In Tanzania no studies have been done on GBS colonisation of pregnant women and neonates. This study was conducted in Dar es Salaam, Tanzania to determine the prevalence of GBS colonisation among pregnant women, the neonatal colonisation rate and the antimicrobial susceptibility, thus providing essential information to formulate a policy for treatment and prevention regarding perinatal GBS diseases. Methods This cross sectional study involved 300 pregnant women attending antenatal clinic and their newborns delivered at Muhimbili National Hospital (MNH) between October 2008 and March 2009. High vaginal, rectal, nasal, ear and umbilical swabs were cultured on Todd Hewitt Broth and in 5% sheep blood agar followed by identification of isolates using conventional methods and testing for their susceptibility to antimicrobial agents using the Kirby-Bauer method. Results GBS colonisation was confirmed in 23% of pregnant women and 8.9% of neonates. A higher proportion of GBS were isolated from the vagina (12.3%) as compared to the rectum (5%). Prolonged duration of labour (>12 hrs) was significantly shown to influence GBS colonisation in neonates P < 0.05. Other risk factors such as prolonged rupture of membrane, intrapartum fever, low birth weight and HIV infection did not correlate with GBS colonisation. All isolates were sensitive to vancomycin and ampicillin. Resistance to clindamycin, erythromycin and penicillin G was found to 17.6%, 13% and 9.4%, respectively. Conclusion Our findings seem to suggest that a quarter of pregnant women attending ANC clinic at MNH and approximately 10% of their newborns are colonised with GBS. All isolates were found to be sensitive to vancomycin and ampicillin which seem to be the most effective antibiotics for the time being. However there is a need for continuous antibiotics surveillance of GBS to monitor trend of resistance. The high isolation frequency of GBS among pregnant women suggests routine antenatal screening at 35 to 37 weeks of gestation in order to provide antibiotic prophylaxis to GBS carrier. PMID:19948075

  10. Informal support to first-parents after childbirth: a qualitative study in low-income suburbs of Dar es Salaam, Tanzania

    PubMed Central

    2011-01-01

    Background In Tanzania, and many sub-Saharan African countries, postpartum health programs have received less attention compared to other maternity care programs and therefore new parents rely on informal support. Knowledge on how informal support is understood by its stakeholders to be able to improve the health in families after childbirth is required. This study aimed to explore discourses on health related informal support to first-time parents after childbirth in low-income suburbs of Dar es Salaam, Tanzania. Methods Thirteen focus group discussions with first-time parents and female and male informal supporters were analysed by discourse analysis. Results The dominant discourse was that after childbirth a first time mother needed and should be provided with support for care of the infant, herself and the household work by the maternal or paternal mother or other close and extended family members. In their absence, neighbours and friends were described as reconstructing informal support. Informal support was provided conditionally, where poor socio-economic status and non-adherence to social norms risked poor support. Support to new fathers was constructed as less prominent, provided mainly by older men and focused on economy and sexual matters. The discourse conveyed stereotypic gender roles with women described as family caretakers and men as final decision-makers and financial providers. The informal supporters regulated the first-time parents' contacts with other sources of support. Conclusions Strong and authoritative informal support networks appear to persist. However, poverty and non-adherence to social norms was understood as resulting in less support. Family health in this context would be improved by capitalising on existing informal support networks while discouraging norms promoting harmful practices and attending to the poorest. Upholding stereotypic notions of femininity and masculinity implies great burden of care for the women and delimited male involvement. Men's involvement in reproductive and child health programmes has the potential for improving family health after childbirth. The discourses conveyed contradicting messages that may be a source of worry and confusion for the new parents. Recognition, respect and raising awareness for different social actors' competencies and limitations can potentially create a health-promoting environment among families after childbirth. PMID:22126899

  11. The perceptions on male circumcision as a preventive measure against HIV infection and considerations in scaling up of the services: a qualitative study among police officers in Dar es Salaam, Tanzania

    PubMed Central

    2012-01-01

    Background In recent randomized controlled trials, male circumcision has been proven to complement the available biomedical interventions in decreasing HIV transmission from infected women to uninfected men. Consequently, Tanzania is striving to scale-up safe medical male circumcision to reduce HIV transmission. However, there is a need to investigate the perceptions of male circumcision in Tanzania using specific populations. The purpose of the present study was to assess the perceptions of male circumcision in a cohort of police officers that also served as a source of volunteers for a phase I/II HIV vaccine (HIVIS-03) trial in Dar es Salaam, Tanzania. Methods In-depth interviews with 24 men and 10 women were conducted. Content analysis informed by the socio-ecological model was used to analyze the data. Results Informants perceived male circumcision as a health-promoting practice that may prevent HIV transmission and other sexually transmitted infections. They reported male circumcision promotes sexual pleasure, confidence and hygiene or sexual cleanliness. They added that it is a religious ritual and a cultural practice that enhances the recognition of manhood in the community. However, informants were concerned about the cost involved in male circumcision and cleanliness of instruments used in medical and traditional male circumcision. They also expressed confusion about the shame of undergoing circumcision at an advanced age and pain that could emanate after circumcision. The participants advocated for health policies that promote medical male circumcision at childhood, specifically along with the vaccination program. Conclusions The perceived benefit of male circumcision as a preventive strategy to HIV and other sexually transmitted infections is important. However, there is a need to ensure that male circumcision is conducted under hygienic conditions. Integrating male circumcision service in the routine childhood vaccination program may increase its coverage at early childhood. The findings from this investigation provide contextual understanding that may assist in scaling-up male circumcision in Tanzania. PMID:22812484

  12. Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania

    PubMed Central

    2014-01-01

    Background Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. Case description The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. Discussion and evaluation The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. Conclusions The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam’s City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes. PMID:24964790

  13. Provision of Vocational Skills Education to Orphans: Lessons from Orphanage Centres in Dar es Salaam City, Tanzania

    ERIC Educational Resources Information Center

    Meli, Benjamin Mbeba

    2015-01-01

    This paper utilises data from a study that investigated the efficacy of vocational skills training provided to orphans from three orphanages in Temeke District, Dar es Salaam. The three orphanage centres that were studied are Kurasini National Children Home, Saudia and Don Bosco Vocational Centre. The sample comprised of 45 orphans, an official…

  14. Prevalence of Cryptosporidium parvum/hominis, Entamoeba histolytica and Giardia lamblia among Young Children with and without Diarrhea in Dar es Salaam, Tanzania

    PubMed Central

    Tellevik, Marit G.; Moyo, Sabrina J.; Blomberg, Bjørn; Hjøllo, Torunn; Maselle, Samuel Y.; Langeland, Nina; Hanevik, Kurt

    2015-01-01

    Background Although enteroparasites are common causes of diarrheal illness, few studies have been performed among children in Tanzania. This study aimed to investigate the prevalence of Cryptosporidium parvum/hominis, Entamoeba histolytica and Giardia lamblia among young children in Dar es Salaam, Tanzania, and identify risk factors for infection. Methodology/Principal Findings We performed an unmatched case-control study among children < 2 years of age in Dar es Salaam, recruited from August 2010 to July 2011. Detection and identification of protozoans were done by PCR techniques on DNA from stool specimens from 701 cases of children admitted due to diarrhea at the three study hospitals, and 558 controls of children with no history of diarrhea during the last month prior to enrollment. The prevalence of C. parvum/hominis was 10.4% (84.7% C. hominis), and that of G. lamblia 4.6%. E. histolytica was not detected. The prevalence of Cryptosporidium was significantly higher in cases (16.3%) than in controls (3.1%; P < 0.001; OR = 6.2; 95% CI: 3.7–10.4). G. lamblia was significantly more prevalent in controls (6.1%) than in cases (3.4%; P = 0.027; OR = 1.8; 95% CI: 1.1–3.1). Cryptosporidium infection was found more often in HIV-positive (24.2%) than in HIV-negative children (3.9%; P < 0.001; OR = 7.9; 95% CI: 3.1–20.5), and was also associated with rainfall (P < 0.001; OR = 2.41; 95% CI: 1.5–3.8). Among cases, stunted children had significantly higher risk of being infected with Cryptosporidium (P = 0.011; OR = 2.12; 95% CI: 1.2–3.8). G. lamblia infection was more prevalent in the cool season (P = 0.004; OR = 2.2; 95% CI: 1.3–3.8), and more frequent among cases aged > 12 months (P = 0.003; OR = 3.5; 95% CI: 1.5–7.8). Among children aged 7–12 months, those who were breastfed had lower prevalence of G. lamblia infection than those who had been weaned (P = 0.012). Conclusions Cryptosporidium infection is common among young Tanzanian children with diarrhea, particularly those living with HIV, and infection is more frequent during the rainy season. G. lamblia is frequently implicated in asymptomatic infections, but rarely causes overt diarrheal illness, and its prevalence increases with age. PMID:26452235

  15. Community-based environmental management for malaria control: evidence from a small-scale intervention in Dar es Salaam, Tanzania

    PubMed Central

    Castro, Marcia C; Tsuruta, Atsuko; Kanamori, Shogo; Kannady, Khadija; Mkude, Sixbert

    2009-01-01

    Background Historically, environmental management has brought important achievements in malaria control and overall improvements of health conditions. Currently, however, implementation is often considered not to be cost-effective. A community-based environmental management for malaria control was conducted in Dar es Salaam between 2005 and 2007. After community sensitization, two drains were cleaned followed by maintenance. This paper assessed the impact of the intervention on community awareness, prevalence of malaria infection, and Anopheles larval presence in drains. Methods A survey was conducted in neighbourhoods adjacent to cleaned drains; for comparison, neighbourhoods adjacent to two drains treated with larvicides and two drains under no intervention were also surveyed. Data routinely collected by the Urban Malaria Control Programme were also used. Diverse impacts were evaluated through comparison of means, odds ratios (OR), logistic regression, and time trends calculated by moving averages. Results Individual awareness of health risks and intervention goals were significantly higher among sensitized neighbourhoods. A reduction in the odds of malaria infection during the post-cleaning period in intervention neighbourhoods was observed when compared to the pre-cleaning period (OR = 0.12, 95% CI 0.05–0.3, p < 0.001). During the post-cleaning period, a higher risk of infection (OR = 1.7, 95% CI 1.1–2.4, p = 0.0069) was observed in neighbourhoods under no intervention compared to intervention ones. Eighteen months after the initial cleaning, one of the drains was still clean due to continued maintenance efforts (it contained no waste materials and the water was flowing at normal velocity). A three-month moving average of the percentage of water habitats in that drain containing pupae and/or Anopheles larvae indicated a decline in larval density. In the other drain, lack of proper resources and local commitment limited success. Conclusion Although environmental management was historically coordinated by authoritarian/colonial regimes or by industries/corporations, its successful implementation as part of an integrated vector management framework for malaria control under democratic governments can be possible if four conditions are observed: political will and commitment, community sensitization and participation, provision of financial resources for initial cleaning and structural repairs, and inter-sectoral collaboration. Such effort not only is expected to reduce malaria transmission, but has the potential to empower communities, improve health and environmental conditions, and ultimately contribute to poverty alleviation and sustainable development. PMID:19356246

  16. Implementation and Operational Research: Linkage to Care Among Methadone Clients Living With HIV in Dar es Salaam, Tanzania

    PubMed Central

    Bruce, Robert Douglas; Masao, Frank; Ubuguyu, Omary; Sabuni, Norman; Mbwambo, Jessie; Lambdin, Barrot H.

    2015-01-01

    Background: The first methadone maintenance treatment clinic in Tanzania was launched in February 2011 to address an emerging HIV epidemic among people who inject drugs. We conducted a retrospective cohort study to understand factors associated with linkage to HIV care and explore how a methadone maintenance treatment clinic can serve as a platform for integrated HIV care and treatment. Methods: This study used routine programmatic and clinical data on clients enrolled in methadone at Muhimbili National Hospital from February 2011 to January 2013. Multivariable proportional hazards regression model was used to examine time to initial CD4 count. Results: Final analyses included 148 HIV-positive clients, contributing 31.7 person-years. At 30, 60, and 90 days, the probability of CD4 screening was 40% [95% confidence interval (CI): 32% to 48%], 55% (95% CI: 47% to 63%), and 63% (95% CI: 55% to 71%), respectively. Clients receiving high methadone doses (?85 mg/d) [adjusted hazard ratio (aHR): 1.68, 95% CI: 1.03 to 2.74] had higher likelihood of CD4 screening than those receiving low doses (<85 mg/d). Clients with primary education or lower (aHR: 1.62, 95% CI: 1.05 to 2.51) and self-reported poor health (aHR: 1.96, 95% CI: 1.09 to 3.51) were also more likely to obtain CD4 counts. Clients with criminal arrest history (aHR: 0.56, 95% CI: 0.37 to 0.85]) were less likely to be linked to care. Among 17 antiretroviral therapy eligible clients (CD4 ? 200), 12 (71%) initiated treatment, of which 7 (41%) initiated within 90 days. Conclusions: Levels of CD4 screening and antiretroviral therapy initiation were similar to Sub-Saharan programs caring primarily for people who do not inject drugs. Adequate methadone dosing is important in retaining clients to maximize HIV treatment benefits and allow for successful linkage to services. PMID:26009835

  17. Active case finding for tuberculosis among people who inject drugs on methadone treatment in Dar es Salaam, Tanzania

    PubMed Central

    Gupta, A.; Mbwambo, J.; Mteza, I.; Shenoi, S.; Lambdin, B.; Nyandindi, C.; Doula, B. I.; Mfaume, S.; Bruce, R. D.

    2015-01-01

    SUMMARY SETTING Active case finding is a World Health Organization (WHO) endorsed strategy for improving tuberculosis (TB) case detection. Despite WHO recommendations for active case finding among people who inject drugs (PWID), few studies have been published. The historical focus of case finding has been in populations that are human immunodeficiency virus-positive, incarcerated or at higher occupational risk. OBJECTIVE We sought to examine the yield of active case finding among PWID newly started on methadone in Tanzania. DESIGN Of 222 methadone clients, 156 (70%) met with study administrators; 150 consented to participate, 139 (93%) of whom were male. The median age was 34 years. A symptom-based questionnaire was developed by the investigators and administered to every consenting patient by a native Swahili speaker. RESULTS Of the 150 patients surveyed, 16 (11%) had one or more TB symptoms and were referred for laboratory testing. Six new TB cases were identified in this active case finding program, with a prevalence of 4%. CONCLUSION This study presents the first data on TB prevalence in a population of PWID in Tanzania. This prevalence is 23 times that of the general Tanzanian TB prevalence of 0.2%. These results have significant implications for TB control. PMID:24902554

  18. Effects of seasonal change and seawater intrusion on water quality for drinking and irrigation purposes, in coastal aquifers of Dar es Salaam, Tanzania

    NASA Astrophysics Data System (ADS)

    Sappa, Giuseppe; Ergul, Sibel; Ferranti, Flavia; Sweya, Lukuba Ngalya; Luciani, Giulia

    2015-05-01

    Groundwater is the major source to meet domestic, industrial and agricultural needs in the city of Dar es Salaam, Tanzania. However, population growth, increasing urbanization, industrialization and tourism, and climatic changes have caused an intensive exploitation of groundwater resources leading the aquifers become more vulnerable to seawater intrusion. The aim of this study is to examine the variations of groundwater chemistry (as resulting from natural and anthropogenic inputs) depending on seasonal changes, in order to evaluate water quality for drinking and irrigation purposes. Physical and chemical data come from the analysis of groundwater samples, collected from 72 wells, used for the evaluation of water quality parameters, during a year of monitoring. Pattern diagrams, geochemical modeling techniques and Principal Component Analysis (PCA) have been used to identify the main factors influencing groundwater composition. Based on the hydrochemistry, the groundwater was classified into three types: (a) Na-Cl, (b) Ca-Cl, (c) mixed Ca-Na-HCO3-Cl (d) mixed Ca-Mg-Cl-SO4. The geochemical modeling results show that groundwater chemistry is mainly influenced by evaporation process, as it is suggested by the increase of Na and Cl ions concentrations. According to irrigation water quality assessment diagrams of USDA, most water samples from dry and rainy seasons, distributed in category C2-S1, C3-S1, C3-S2, C4-S2 highlighting medium to very high salinity hazard and low to medium sodium content class. PCA evidenced the role of seawater intrusion, evaporation process and anthropogenic pollution (i.e. high NO3 levels due to agricultural activities), as the major factors that influenced the water chemistry, and hence the water quality. Based on Pearson correlation matrix, the presence of high correlations (>0.8) among Na, Cl, Mg and SO4, in association with EC, were interpreted as the seawater intrusion effects. In this area groundwater quality is generally low, and often exceeds permissible limits of standard guideline values of WHO and FAO, referred to EC and chloride values. The high salinity and the groundwater level depletion create serious problems for current use of water supplies as well as future exploitation.

  19. Social venues that protect against and promote HIV risk for young men in Dar es Salaam, Tanzania

    PubMed Central

    Yamanis, Thespina Jeanne; Maman, Suzanne; Mbwambo, Jessie K.; Earp, JoAnne; Kajula, Lusajo

    2010-01-01

    Developing effective place-based health interventions requires understanding of the dynamic between place and health. The therapeutic landscape framework explains how place-based social processes and physical geography interact and influence health behavior. This study applied this framework to examine how venues, or social gathering places, influenced HIV risk behavior among young, urban men in Tanzania. Eighty-three public venues where men ages 15–19 met new sexual partners were identified by community informants in one city ward. The majority (86%) of the venues were called ‘camps’, social gathering places that had formal leaders and members. Observations were conducted at 23 camps and in-depth interviews were conducted with 36 camp members and 10 camp leaders in 15 purposively selected camps. Geographic and social features of camps were examined to understand their contributions to men’s behaviors. Camps were characterized by a geographic space claimed by members, a unique name and a democratic system of leadership and governance. Members were mostly men and socialized daily at their camp. They reported strong social bonds and engaging in health-promoting activities such as playing sports and generating income. Members also engaged in HIV risk behaviors, such as meeting new sexual partners and having sex in or around the camp at night. Some members promoted concurrent sexual partnerships with their friends and resisted camp leaders’ efforts to change their sexual risk behavior. We conclude that camps are strategic venues for HIV prevention programs for young Tanzanian men. They served as both protective and risk landscapes, illustrating three domains of the therapeutic landscape framework: the built environment; identities of landscape occupants; and sites for collective efficacy. The framework and data suggest HIV intervention components that might augment the protective features of the camps, while changing environmental features to reduce risk. PMID:20846768

  20. A tool box for operational mosquito larval control: preliminary results and early lessons from the Urban Malaria Control Programme in Dar es Salaam, Tanzania

    PubMed Central

    Fillinger, Ulrike; Kannady, Khadija; William, George; Vanek, Michael J; Dongus, Stefan; Nyika, Dickson; Geissbühler, Yvonne; Chaki, Prosper P; Govella, Nico J; Mathenge, Evan M; Singer, Burton H; Mshinda, Hassan; Lindsay, Steven W; Tanner, Marcel; Mtasiwa, Deo; de Castro, Marcia C; Killeen, Gerry F

    2008-01-01

    Background As the population of Africa rapidly urbanizes, large populations could be protected from malaria by controlling aquatic stages of mosquitoes if cost-effective and scalable implementation systems can be designed. Methods A recently initiated Urban Malaria Control Programme in Dar es Salaam delegates responsibility for routine mosquito control and surveillance to modestly-paid community members, known as Community-Owned Resource Persons (CORPs). New vector surveillance, larviciding and management systems were designed and evaluated in 15 city wards to allow timely collection, interpretation and reaction to entomologic monitoring data using practical procedures that rely on minimal technology. After one year of baseline data collection, operational larviciding with Bacillus thuringiensis var. israelensis commenced in March 2006 in three selected wards. Results The procedures and staff management systems described greatly improved standards of larval surveillance relative to that reported at the outset of this programme. In the first year of the programme, over 65,000 potential Anopheles habitats were surveyed by 90 CORPs on a weekly basis. Reaction times to vector surveillance at observations were one day, week and month at ward, municipal and city levels, respectively. One year of community-based larviciding reduced transmission by the primary malaria vector, Anopheles gambiae s.l., by 31% (95% C.I. = 21.6–37.6%; p = 0.04). Conclusion This novel management, monitoring and evaluation system for implementing routine larviciding of malaria vectors in African cities has shown considerable potential for sustained, rapidly responsive, data-driven and affordable application. Nevertheless, the true programmatic value of larviciding in urban Africa can only be established through longer-term programmes which are stably financed and allow the operational teams and management infrastructures to mature by learning from experience. PMID:18218148

  1. Current clinical efficacy of chloroquine for the treatment of Plasmodium falciparum infections in urban Dar es Salaam, United Republic of Tanzania.

    PubMed Central

    Premji, Z.; Makwaya, C.; Minjas, J. N.

    1999-01-01

    Reported is the use of a 14-day WHO protocol, which takes into account the clinical, parasitological and haematological responses to antimalarial drugs, to determine the efficacy of chloroquine in the treatment of uncomplicated malaria in young children (n = 200) in urban Dar es Salaam. Chloroquine failure was found in 43% of the children. Of these, 12.5% were considered to be early treatment failures and were given a single dose of sulfadoxine-pyrimethamine. Fever subsided in all children treated with sulfadoxine-pyrimethamine and there were no parasitological failures. In addition, children treated with sulfadoxine-pyrimethamine because of early treatment failure with chloroquine had better haematological recovery than the chloroquine-sensitive group. It is concluded that chloroquine can no longer be considered an effective therapy for P. falciparum malaria in young children in Dar es Salaam. PMID:10534897

  2. The Importance of Drains for the Larval Development of Lymphatic Filariasis and Malaria Vectors in Dar es Salaam, United Republic of Tanzania

    PubMed Central

    Castro, Marcia C.; Kanamori, Shogo; Kannady, Khadija; Mkude, Sigsbert; Killeen, Gerry F.; Fillinger, Ulrike

    2010-01-01

    Background Dar es Salaam has an extensive drain network, mostly with inadequate water flow, blocked by waste, causing flooding after rainfall. The presence of Anopheles and Culex larvae is common, which is likely to impact the transmission of lymphatic filariasis and malaria by the resulting adult mosquito populations. However, the importance of drains as larval habitats remains unknown. Methodology Data on mosquito larval habitats routinely collected by the Urban Malaria Control Program (UMCP) and a special drain survey conducted in 2006 were used to obtain a typology of habitats. Focusing on drains, logistic regression was used to evaluate potential factors impacting the presence of mosquito larvae. Spatial variation in the proportion of habitats that contained larvae was assessed through the local Moran's I indicator of spatial association. Principal Findings More than 70% of larval habitats in Dar es Salaam were human-made. Aquatic habitats associated with agriculture had the highest proportion of Anopheles larvae presence and the second highest of Culex larvae presence. However, the majority of aquatic habitats were drains (42%), and therefore, 43% (1,364/3,149) of all culicine and 33% (320/976) of all anopheline positive habitats were drains. Compared with drains where water was flowing at normal velocity, the odds of finding Anopheles and Culex larvae were 8.8 and 6.3 (p<0.001) times larger, respectively, in drains with stagnant water. There was a positive association between vegetation and the presence of mosquito larvae (p<0.001). The proportion of habitats with mosquito larvae was spatially correlated. Conclusion Restoring and maintaining drains in Dar es Salaam has the potential to eliminate more than 40% of all potential mosquito larval habitats that are currently treated with larvicides by the UMCP. The importance of human-made larval habitats for both lymphatic filariasis and malaria vectors underscores the need for a synergy between on-going control efforts of those diseases. PMID:20520797

  3. Malaria control in Tanzania

    SciTech Connect

    Yhdego, M.; Majura, P. )

    1988-01-01

    A review of the malaria control programs and the problem encountered in the United Republic of Tanzania since 1945 to the year 1986 is discussed. Buguruni, one of the squatter areas in the city of Dar es Salaam, is chosen as a case study in order to evaluate the economic advantage of engineering methods for the control of malaria infection. Although the initial capital cost of engineering methods may be high, the cost effectiveness requires a much lower financial burden of only about Tshs. 3 million compared with the conventional methods of larviciding and insecticiding which requires more than Tshs. 10 million. Finally, recommendations for the adoption of engineering methods are made concerning the upgrading of existing roads and footpaths in general with particular emphasis on drainage of large pools of water which serve as breeding sites for mosquitoes.

  4. USING AN INTEGRATED APPROACH OF RAPID MICROBIAL DETECTION TECHNOLOGY AND COMMUNITY EDUCATION TO REDUCE WATERBORNE ILLNESS IN DAR ES SALAAM TANZANIA

    EPA Science Inventory

    • Participated in the Uncommon Dialogue meeting, in which we were able to meet with local water authorities, tour various communities, and learn about the larger scale water challenges that unplanned communities face.
    • Piloted rapid method in n...

    • Morbidity and Mortality following Traditional Uvulectomy among Children Presenting to the Muhimbili National Hospital Emergency Department in Dar es Salaam, Tanzania

      PubMed Central

      Sawe, H. R.; Mfinanga, J. A.; Ringo, F. H.; Mwafongo, V.; Reynolds, T. A.; Runyon, M. S.

      2015-01-01

      Background. Traditional uvulectomy is performed as a cultural ritual or purported medical remedy. We describe the associated emergency department (ED) presentations and outcomes. Methods. This was a subgroup analysis of a retrospective review of all pediatric visits to our ED in 2012. Trained abstracters recorded demographics, clinical presentations, and outcomes. Results. Complete data were available for 5540/5774 (96%) visits and 56 (1.0%, 95% CI: 0.7–1.3%) were related to recent uvulectomy, median age 1.3 years (interquartile range: 7 months–2 years) and 30 (54%) were male. Presenting complaints included cough (82%), fever (46%), and hematemesis (38%). Clinical findings included fever (54%), tachypnea (30%), and tachycardia (25%). 35 patients (63%, 95% CI: 49–75%) received intravenous antibiotics, 11 (20%, 95% CI: 10–32%) required blood transfusion, and 3 (5%, 95% CI: 1–15%) had surgical intervention. All were admitted to the hospital and 12 (21%, 95% CI: 12–34%) died. By comparison, 498 (9.1%, 95% CI: 8–10%) of the 5484 children presenting for reasons unrelated to uvulectomy died (p = 0.003). Conclusion. In our cohort, traditional uvulectomy was associated with significant morbidity and mortality. Emergency care providers should advocate for legal and public health interventions to eliminate this dangerous practice. PMID:26161270

    • "Finding a Life" among Undocumented Congolese Refugee Children in Tanzania

      ERIC Educational Resources Information Center

      Mann, Gillian

      2010-01-01

      The majority of undocumented Congolese refugee children living in Dar es Salaam, Tanzania, experience extreme poverty and social exclusion, harassment and discrimination. Their fear of deportation, forcible removal to refugee camps and imprisonment is coupled with a strong feeling that they are unwelcome in Tanzania. These realities require that…

    • Understanding Household Behavioral Risk Factors for Diarrheal Disease in Dar es Salaam: A Photovoice Community Assessment

      PubMed Central

      Badowski, Natalie; Castro, Cynthia M.; Montgomery, Maggie; Pickering, Amy J.; Mamuya, Simon; Davis, Jennifer

      2011-01-01

      Whereas Tanzania has seen considerable improvements in water and sanitation infrastructure over the past 20 years, the country still faces high rates of childhood morbidity from diarrheal diseases. This study utilized a qualitative, cross-sectional, modified Photovoice method to capture daily activities of Dar es Salaam mothers. A total of 127 photographs from 13 households were examined, and 13 interviews were conducted with household mothers. The photographs and interviews revealed insufficient hand washing procedures, unsafe disposal of wastewater, uncovered household drinking water containers, a lack of water treatment prior to consumption, and inappropriate toilets for use by small children. The interviews revealed that mothers were aware and knowledgeable of the risks of certain household practices and understood safer alternatives, yet were restricted by the perceived impracticality and financial constraints to make changes. The results draw attention to the real economic and behavioral challenges faced in reducing the spread of disease. PMID:21969836

    • Gays, guys, and mchicha mwiba: same-sex relations and subjectivities in Dar es Salaam.

      PubMed

      Moen, Kåre; Aggleton, Peter; Leshabari, Melkizedeck T; Middelthon, Anne-Lise

      2014-01-01

      Drawing on 15 months of fieldwork, this article explores ways in which same-sex relations are perceived and performed in Dar es Salaam, Tanzania. While several different constructions of same-sex sexuality coexist in Dar es Salaam, it is common to conceive of same-sex practicing men as falling into two main categories. Men belonging to each of these differ with respect to the corporeal, gendered, and social positions that are open to them, and typically form dyads across the conceptual boundary of difference that runs between them. The article speaks to the importance of examining sexuality and gender in particular sociocultural settings. PMID:24313863

    • Science-based health innovation in Tanzania: bednets and a base for invention

      PubMed Central

      2010-01-01

      Background Tanzania is East Africa’s largest country. Although it is socially diverse, it has experienced general political stability since independence in 1964. Despite gradual economic development and Tanzania’s status as one of the biggest recipients of aid in Africa, health status remains poor. This paper explores Tanzania’s science-based health innovation system, and highlights areas which can be strengthened. Methods Qualitative case study research methodology was used. Data were collected through reviews of academic literature and policy documents, and through open-ended, face-to-face interviews with 52 people from across the science-based health innovation system over two visits to Tanzania from July to October 2007. Results and discussion Tanzania has a rich but complex S&T governance landscape, with the public sector driving the innovation agenda through a series of different bodies which are not well-coordinated. It has some of the leading health research on the continent at the University of Dar es Salaam, Muhimbili University of Health and Applied Sciences, the National Institute for Medical Research and the Ifakara Medical Institute, with strong donor support. Tanzania has found developing an entrepreneurial culture difficult; nevertheless projects such as the clusters initiative at the University of Dar es Salaam are encouraging low-tech innovation and overcoming knowledge-sharing barriers. In the private sector, one generics company has developed a South-South collaboration to enable technology transfer and hence the local production of anti-retrovirals. Local textile company A to Z Textiles is now manufacturing 30 million insecticide impregnated bednets a year. Conclusions To have a coherent vision for innovation, Tanzania may wish to address some key issues: coordination across stakeholders involved with health research, increasing graduates in health-related disciplines, and building capabilities in biological testing, preclinical testing, formulation and standardization, and related areas important to moving from basic research to applications. The private sector can be encouraged to innovate through improved access to financing, and incentives for R&D. The diaspora community represents an untapped source for partnerships and access to other developing world markets and technology. The government may wish to set up mechanisms to encourage south-south collaborations, and to bring the public and private sector together around specific projects to help realize the country’s innovation potential. PMID:21144075

    • Recurrence of konzo in southern Tanzania: Rehabilitation and prevention using the wetting method

      E-print Network

      Keywords: Konzo Cassava consumption Cyanogens Rehabilitation Tanzania a b s t r a c t There have been four of konzo resulted from large cyanogen intakes from bitter cassava during drought, which caused food shortages and led to people using short-cut methods of cassava processing. Rehabil- itation of the 214 konzo

    • The Determinants of Traditional Medicine Use in Northern Tanzania: A Mixed-Methods Study

      PubMed Central

      Stanifer, John W.; Patel, Uptal D.; Karia, Francis; Thielman, Nathan; Maro, Venance; Shimbi, Dionis; Kilaweh, Humphrey; Lazaro, Matayo; Matemu, Oliver; Omolo, Justin; Boyd, David

      2015-01-01

      Introduction Traditional medicines are an important part of healthcare in sub-Saharan Africa, and building successful disease treatment programs that are sensitive to traditional medicine practices will require an understanding of their current use and roles, including from a biomedical perspective. Therefore, we conducted a mixed-method study in Northern Tanzania in order to characterize the extent of and reasons for the use of traditional medicines among the general population so that we can better inform public health efforts in the region. Methods Between December 2013 and June 2014 in Kilimanjaro, Tanzania, we conducted 5 focus group discussions and 27 in-depth interviews of key informants. The data from these sessions were analyzed using an inductive framework method with cultural insider-outsider coding. From these results, we developed a structured survey designed to test different aspects of traditional medicine use and administered it to a random sample of 655 adults from the community. The results were triangulated to explore converging and diverging themes. Results Most structured survey participants (68%) reported knowing someone who frequently used traditional medicines, and the majority (56%) reported using them themselves in the previous year. The most common uses were for symptomatic ailments (42%), chronic diseases (15%), reproductive problems (11%), and malaria/febrile illnesses (11%). We identified five major determinants for traditional medicine use in Northern Tanzania: biomedical healthcare delivery, credibility of traditional practices, strong cultural identities, individual health status, and disease understanding. Conclusions In order to better formulate effective local disease management programs that are sensitive to TM practices, we described the determinants of TM use. Additionally, we found TM use to be high in Northern Tanzania and that its use is not limited to lower-income areas or rural settings. After symptomatic ailments, chronic diseases were reported as the most common reason for TM use which may be particularly important in Northern Tanzania where non-communicable diseases are a rapidly growing burden. PMID:25848762

    • Comparison of Methods for Xenomonitoring in Vectors of Lymphatic Filariasis in Northeastern Tanzania.

      PubMed

      Irish, Seth R; Stevens, William M B; Derua, Yahya A; Walker, Thomas; Cameron, Mary M

      2015-11-01

      Monitoring Wuchereria bancrofti infection in mosquitoes (xenomonitoring) can play an important role in determining when lymphatic filariasis has been eliminated, or in focusing control efforts. As mosquito infection rates can be low, a method for collecting large numbers of mosquitoes is necessary. Gravid traps collected large numbers of Culex quinquefasciatus in Tanzania, and a collection method that targets mosquitoes that have already fed could result in increased sensitivity in detecting W. bancrofti-infected mosquitoes. The aim of this experiment was to test this hypothesis by comparing U.S. Centers for Disease Control and Prevention (CDC) light traps with CDC gravid traps in northeastern Tanzania, where Cx. quinquefasciatus is a vector of lymphatic filariasis. After an initial study where small numbers of mosquitoes were collected, a second study collected 16,316 Cx. quinquefasciatus in 60 gravid trap-nights and 240 light trap-nights. Mosquitoes were pooled and tested for presence of W. bancrofti DNA. Light and gravid traps collected similar numbers of mosquitoes per trap-night, but the physiological status of the mosquitoes was different. The estimated infection rate in mosquitoes collected in light traps was considerably higher than in mosquitoes collected in gravid traps, so light traps can be a useful tool for xenomonitoring work in Tanzania. PMID:26350454

    • SU-E-E-03: Developing Solutions to Critical Radiation Oncology Challenges in Tanzania

      SciTech Connect

      Kenton, O; Dachi, J; Metz, J; Avery, S

      2014-06-01

      Purpose: Develop solutions to critical medical physics challenges in Tanzania. Methods: In September of 2013 we began working with Jumaa Bin Dachi, a Therapy Physicist at the Ocean Road Cancer Institute in Dar es Salaam, Tanzania. We developed a bi-lateral learning partnership over the course of eight qualitative Skype meetings with Jumaa. From these meetings we have ascertained that there is a gap between the installation of new equipment and treating patients. This gap has often been overlooked by international partners attempting to improve radiation therapy access. Relationships with academic institutions abroad can fill these gaps, and lead to sustained care of patients needing radiation. Results: Our efforts are best given in a supporting role to help develop solutions and new technology that can reduce the burden on the Medical Physicist. Solutions may include: training material, support for radiation therapy classes, development of appropriate local protocols, and peer-review on documents being produced. New technology needs to focus around simple and easy field shaping, improved patient imaging systems, and systems for patient set-up. We believe our work can help alleviate some of the burdens faced by this institute. Conclusion: While we are just in the beginning stage of this partnership, we believe there is great potential for success between both parties. We hope that the Ocean Road Cancer Institute will benefit from potential funding and resources by partnering with a High Income Country to develop affordable solutions to clinical problems in Tanzania.

    • Access to HIV prevention services among gender based violence survivors in Tanzania

      PubMed Central

      Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth

      2012-01-01

      Introduction Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. Methods In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. Results Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. Conclusion GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended. PMID:23467278

    • Prioritization of intervention methods for prevention of communicable diseases in Tanzania

      NASA Astrophysics Data System (ADS)

      Mayo, A. W.

      Water, sanitation, housing and hygienic behavior plays dominant role in the transmission and intensification of diseases. To effectively utilize limited financial resources, it is important to prioritize disease intervention methods in order to minimize mortality and morbidity cases. Realization of the environmental health components that respond to the practical effects of their contribution to transmission of diseases has greater chances of effectively enhancing health. Data of frequency of diseases and mortality rate were collected from four municipal hospitals from districts of Ilala, Kinondoni, Temeke and Kibaha in Dar es Salaam and Coast Regions. The populations at risk were sub-categorized in relation to age; below five years and above five years. The age parameter assists on envisaging the major causes to be either in-house or in public domain. Data were analyzed to assess the role of water quality, water quantity, excreta disposal, waste disposal and hygiene education on spreading the diseases in order to come up with scientifically evaluated information. Scores were given to each intervention method depending on its importance in controlling a particular disease. The results indicate that incidences of malaria, skin and eye infections, pneumonia and diarrhea are frequent in these districts. Children under 5 years are particularly affected by pneumonia and diarrhea more than adults. Malaria, tuberculosis and pneumonia are the major causes of mortality rates in these districts. Fatality cases are caused largely by malaria, pneumonia and diarrhea for children less than 5 years, but malaria, tuberculosis and pneumonia are responsible for mortality rates in adults and children over 5 years. Statistical analysis revealed that in all districts, hygiene education is the major factor responsible for transmission of diseases accounting for 32-39%. Other factors, which are the major contributors to the incidences of diseases, are inadequacy of water (15.6-22.5%) and poor housing environment (14.5-24.0%). Water quality played the least role in transmission of diseases accounting for only 3-8%. It was concluded that provision of hygiene education, and improvement of water quantity and housing, in that order can significantly contribute to reduction of communicable diseases in the area. Improvement of water quality has potentially the least effect on the number of morbidity and mortality cases.

    • Urban mosquitoes, situational publics, and the pursuit of interspecies separation in Dar es Salaam

      PubMed Central

      KELLY, ANN H.; LEZAUN, JAVIER

      2014-01-01

      Recent work in anthropology points to the recognition of multispecies entanglements as the grounds for a more ethical politics. In this article, we examine efforts to control mosquitoes in Dar es Salaam, Tanzania, as an example of the laborious tasks of disentanglement that characterize public health interventions. The mosquito surveillance and larval elimination practices of an urban malaria control program offer an opportunity to observe how efforts to create distance between species relate to the physical and civic textures of the city. Seen in the particular context of the contemporary African metropolis, the work of public health appears less a matter of control than a commitment to constant urban maintenance and political mobilization. PMID:25429167

    • Perceptions of Child Sexual Abuse--A Qualitative Interview Study with Representatives of the Socio-Legal System in Urban Tanzania

      ERIC Educational Resources Information Center

      Kisanga, Felix; Mbwambo, Jessie; Hogan, Norah; Nystrom, Lennarth; Emmelin, Maria; Lindmark, Gunilla

      2010-01-01

      Through in-depth interviews, this study explored perceptions and experiences of key players handling child sexual offense cases in Dar es Salaam, Tanzania. The informants included public police investigators, magistrates, legal workers, and social workers working with nongovernmental organizations. The interviews were recorded, transcribed…

    • An HIV/AIDS Knowledge Scale for Adolescents: Item Response Theory Analyses Based on Data from a Study in South Africa and Tanzania

      ERIC Educational Resources Information Center

      Aaro, Leif E.; Breivik, Kyrre; Klepp, Knut-Inge; Kaaya, Sylvia; Onya, Hans E.; Wubs, Annegreet; Helleve, Arnfinn; Flisher, Alan J.

      2011-01-01

      A 14-item human immunodeficiency virus/acquired immunodeficiency syndrome knowledge scale was used among school students in 80 schools in 3 sites in Sub-Saharan Africa (Cape Town and Mankweng, South Africa, and Dar es Salaam, Tanzania). For each item, an incorrect or don't know response was coded as 0 and correct response as 1. Exploratory factor…

    • Modeling Urban Growth Spatial Dynamics: Case studies of Addis Ababa and Dar es Salaam

      NASA Astrophysics Data System (ADS)

      Buchta, Katja; Abo El Wafa, Hany; Printz, Andreas; Pauleit, Stephan

      2013-04-01

      Rapid urbanization, and consequently, the dramatic spatial expansion of mostly informal urban areas increases the vulnerability of African cities to the effects of climate change such as sea level rise, more frequent flooding, droughts and heat waves. The EU FP 7 funded project CLUVA (Climate Change and Urban Vulnerability in Africa, www.cluva.eu) aims to develop strategies for minimizing the risks of natural hazards caused by climate change and to improve the coping capacity of African cities. Green infrastructure may play a particular role in climate change adaptation by providing ecosystem services for flood protection, stormwater retention, heat island moderation and provision of food and fuel wood. In this context, a major challenge is to gain a better understanding of the spatial and temporal dynamics of the cities and how these impact on green infrastructure and hence their vulnerability. Urban growth scenarios for two African cities, namely Addis Ababa, Ethiopia and Dar es Salaam, Tanzania, were developed based on a characterization of their urban morphology. A population growth driven - GIS based - disaggregation modeling approach was applied. Major impact factors influencing the urban dynamics were identified both from literature and interviews with local experts. Location based factors including proximity to road infrastructure and accessibility, and environmental factors including slope, surface and flood risk areas showed a particular impact on urban growth patterns. In Addis Ababa and Dar es Salaam, population density scenarios were modeled comparing two housing development strategies. Results showed that a densification scenario significantly decreases the loss of agricultural and green areas such as forests, bushland and sports grounds. In Dar es Salaam, the scenario of planned new settlements with a population density of max. 350 persons per hectare would lead until 2025 to a loss of agricultural land (-10.1%) and green areas (-6.6%). On the other hand, 12.4% of agricultural land and 16.1% of green areas would be lost in the low density development scenario of unplanned settlements of max. 150 persons per hectare. Relocating the population living in flood prone areas in the case of Addis Ababa and keeping those areas free from further settlements in the case of Dar es Salaam would result in even lower losses (agricultural land: -10.0%, green areas: -5.6%) as some flood prone areas overlap with agricultural/ green areas. The scenario models introduced in this research can be used by planners as tools to understand and manage the different outcomes of distinctive urban development strategies on growth patterns and how they interact with different climate change drivers such as loss of green infrastructure and effects such as frequent flooding hazards. Due to the relative simplicity of their structure and the single modeling environment, the models can be transferred to similar cities with minor modifications accommodating the different conditions of each city. Already, in Addis Ababa the results of the model will be used in the current revision of the Master plan of the city. Keywords: GIS, modeling, Urban Dynamics, Dar es Salaam, Addis Ababa, urbanization

    • Child Sexual Abuse in Tanzania and Kenya

      ERIC Educational Resources Information Center

      Lalor, Kevin

      2004-01-01

      Objective: Most research on child abuse in Tanzania and Kenya is unpublished in the international literature. The purpose of this paper is to examine the various commentaries and reports extant, toward an overview of the nature and frequency of child sexual abuse in Tanzania and Kenya. Methods: Contacts were made with academics, government…

  1. Regional Differences in Intervention Coverage and Health System Strength in Tanzania

    PubMed Central

    Kumalija, Claud J.; Perera, Sriyanjit; Masanja, Honorati; Rubona, Josibert; Ipuge, Yahya; Mboera, Leonard; Hosseinpoor, Ahmad R.; Boerma, Ties

    2015-01-01

    Background Assessments of subnational progress and performance coverage within countries should be an integral part of health sector reviews, using recent data from multiple sources on health system strength and coverage. Method As part of the midterm review of the national health sector strategic plan of Tanzania mainland, summary measures of health system strength and coverage of interventions were developed for all 21 regions, focusing on the priority indicators of the national plan. Household surveys, health facility data and administrative databases were used to compute the regional scores. Findings Regional Millennium Development Goal (MDG) intervention coverage, based on 19 indicators, ranged from 47% in Shinyanga in the northwest to 71% in Dar es Salaam region. Regions in the eastern half of the country have higher coverage than in the western half of mainland. The MDG coverage score is strongly positively correlated with health systems strength (r = 0.84). Controlling for socioeconomic status in a multivariate analysis has no impact on the association between the MDG coverage score and health system strength. During 1991–2010 intervention coverage improved considerably in all regions, but the absolute gap between the regions did not change during the past two decades, with a gap of 22% between the top and bottom three regions. Interpretation The assessment of regional progress and performance in 21 regions of mainland Tanzania showed considerable inequalities in coverage and health system strength and allowed the identification of high and low-performing regions. Using summary measures derived from administrative, health facility and survey data, a subnational picture of progress and performance can be obtained for use in regular health sector reviews. PMID:26536351

  2. Early Cenozoic tropical climate: report from the Tanzania Onshore Paleogene Integrated Coring (TOPIC) workshop

    NASA Astrophysics Data System (ADS)

    Pearson, P. N.; Hudson, W.

    2014-12-01

    We are currently developing a proposal for a new International Continental Scientific Drilling Program (ICDP) project to recover a stratigraphic and paleoclimatic record from the full succession of Eocene hemipelagic sediments that are now exposed on land in southern Tanzania. Funding for a workshop was provided by ICDP, and the project was advertised in the normal way. A group of about 30 delegates assembled in Dar-es-Salaam for 3 intensive days of discussion, project development, and proposal writing. The event was hosted by the Tanzania Petroleum Development Corporation (TPDC) and was attended by several geologists, geochemists, geophysicists, and micropaleontologists from TPDC and the University of Dar-es-Salaam. International delegates were from Canada, Germany, India, Ireland, Italy, the Netherlands, United Kingdom, and United States (and we also have project partners from Australia, Belgium, and Sweden who were not able to attend). Some of the scientists are veterans of previous scientific drilling in the area, but over half are new on the scene, mostly having been attracted by Tanzania's reputation for world-class paleoclimate archives. Here we outline the broad aims of the proposed drilling and give a flavor of the discussions and the way our proposal developed during the workshop. A video of the workshop with an introduction to the scientific goals and interviews of many of the participants is available at http://vimeo.com/107911777.

  3. Residents’ perceptions of institutional performance in water supply in Dar es Salaam

    NASA Astrophysics Data System (ADS)

    Mwakalila, Shadrack

    This paper addresses the performance of institutions in water supply systems for improving social and economic benefits of people living in Dar es Salaam city. The methods employed in field data and information collection included interviews, questionnaire, focus group discussions and participatory observation. Kinondoni and Ilala Districts were used as case study. The study revealed that, the main water sources in the study areas are boreholes, shallow wells, rain water and water vendors. Other minor sources are piped water and natural water sources, such as rivers and streams. The supply of piped water by Dar es Salaam Water Sewerage and Sanitation Company (DAWASA/DAWASCO) meets only 45% of the total water demands. Individuals own and sell water from boreholes, shallow wells, piped water connected to their individual houses and natural wells located in their individual plots. The price of one 20 l bucket of water from a water vendor depends on the availability of water and the distance walked from the water source to the customer. Majority of the respondents (77.5%) indicated that individual water delivery systems provide sufficient water as compared to five years ago in the study areas. Few of the respondents (6.3%) said individual water delivery systems have no capacity to provide sufficient water while 16.3% indicate that individual water delivery systems provide moderate water supply but are important in supplementing other water providers in the study areas. The study reveals that a majority of the local population are satisfied with the capacity of individual water delivery systems in providing water for household uses. This paper recommends some improvements to be done to water supply systems in the Dar es Salaam city.

  4. Why give birth in health facility? Users’ and providers’ accounts of poor quality of birth care in Tanzania

    PubMed Central

    2013-01-01

    Background In Tanzania, half of all pregnant women access a health facility for delivery. The proportion receiving skilled care at birth is even lower. In order to reduce maternal mortality and morbidity, the government has set out to increase health facility deliveries by skilled care. The aim of this study was to describe the weaknesses in the provision of acceptable and adequate quality care through the accounts of women who have suffered obstetric fistula, nurse-midwives at both BEmOC and CEmOC health facilities and local community members. Methods Semi-structured interviews involving 16 women affected by obstetric fistula and five nurse-midwives at maternity wards at both BEmOC and CEmOC health facilities, and Focus Group Discussions with husbands and community members were conducted between October 2008 and February 2010 at Comprehensive Community Based Rehabilitation in Tanzania and Temeke hospitals in Dar es Salaam, and Mpwapwa district in Dodoma region. Results Health care users and health providers experienced poor quality caring and working environments in the health facilities. Women in labour lacked support, experienced neglect, as well as physical and verbal abuse. Nurse-midwives lacked supportive supervision, supplies and also seemed to lack motivation. Conclusions There was a consensus among women who have suffered serious birth injuries and nurse midwives staffing both BEmOC and CEmOC maternity wards that the quality of care offered to women in birth was inadequate. While the birth accounts of women pointed to failure of care, the nurses described a situation of disempowerment. The bad birth care experiences of women undermine the reputation of the health care system, lower community expectations of facility birth, and sustain high rates of home deliveries. The only way to increase the rate of skilled attendance at birth in the current Tanzanian context is to make facility birth a safer alternative than home birth. The findings from this study indicate that there is a long way to go. PMID:23663299

  5. Quality and comparison of antenatal care in public and private providers in the United Republic of Tanzania.

    PubMed Central

    Boller, Christoph; Wyss, Kaspar; Mtasiwa, Deo; Tanner, Marcel

    2003-01-01

    OBJECTIVE: To compare the quality of public and private first-tier antenatal care services in Dar es Salaam, United Republic of Tanzania, using defined criteria. METHODS: Structural attributes of quality were assessed through a checklist, and process attributes, including interpersonal and technical aspects, through observation and exit interviews. A total of 16 health care providers, and 166 women in the public and 188 in the private sector, were selected by systematic random sampling for inclusion in the study. Quality was measured against national standards, and an overall score calculated for the different aspects to permit comparison. FINDINGS: The results showed that both public and private providers were reasonably good with regard to the structural and interpersonal aspects of quality of care. However, both were poor when it came to technical aspects of quality. For example, guidelines for dispensing prophylactic drugs against anaemia or malaria were not respected, and diagnostic examinations for the assessment of gestation, anaemia, malaria or urine infection were frequently not performed. In all aspects, private providers were significantly better than public ones. CONCLUSION: Approaches to improving quality of care should emerge progressively as a result of regular quality assessments. Changes should be introduced using an incremental approach addressing few improvements at a time, while ensuring participation in, and ownership of, every aspect of the strategy by health personnel, health planners and managers and also the community. PMID:12751419

  6. Lessons from Tanzania on the integration of HIV and tuberculosis treatments into methadone assisted treatment.

    PubMed

    Bruce, R Douglas; Lambdin, Barrot; Chang, Olivia; Masao, Frank; Mbwambo, Jessie; Mteza, Ibrahim; Nyandindi, Cassian; Zamudio-Haas, Sophia; Buma, Deus; Dunbar, Megan S; Kilonzo, Gad

    2014-01-01

    To successfully address HIV and TB in the world, we must address the healthcare needs of key populations, such as drug users, and we must do this urgently. Currently in Tanzania, as in many countries, the care for these medical disorders is separated into disease specific clinical environments. Our consortium began working to integrate HIV and TB clinical services into the methadone program in Dar es Salaam, Tanzania. We present the key lessons learned in this process of integration and the importance of integrating HIV/TB into the methadone program, which serves as a critical anchor for adherence to clinical services. Integrated healthcare for people who use drugs is clearly a long-term goal and different health systems will progress upon this continuum at different rates. What is clear is that every health system that interacts with drug users must aspire to achieve some level of integrated healthcare if the incidence rates of HIV and TB are to decline. PMID:24210295

  7. Anti-mosquito plants as an alternative or incremental method for malaria vector control among rural communities of Bagamoyo District, Tanzania

    PubMed Central

    2014-01-01

    Background Plants represent one of the most accessible resources available for mosquito control by communities in Tanzania. However, no documented statistics exist for their contribution in the management of mosquitoes and other insects except through verbal and some publications. This study aimed at assessing communities’ knowledge, attitudes and practices of using plants as an alternative method for mosquito control among selected communities in a malaria-prone area in Tanzania. Methods Questionnaires were administered to 202 respondents from four villages of Bagamoyo District, Pwani Region, in Tanzania followed by participatory rural appraisal with village health workers. Secondary data collection for plants mentioned by the communities was undertaken using different search engines such as googlescholar, PubMED and NAPRALERT. Results Results showed about 40.3% of respondents used plants to manage insects, including mosquitoes. A broad profile of plants are used, including “mwarobaini” (Azadirachta indica) (22.5%), “mtopetope” (Annona spp) (20.8%), “mchungwa/mlimau” (Citrus spp) (8.3%), “mvumbashi/uvumbati” (Ocimum spp) (7.4%), “mkorosho” (Anacadium occidentale) (7.1%), “mwembe” (5.4%) (Mangifera indica), “mpera” (4.1%) (Psidium spp) and “maganda ya nazi” (4.1%) (Cocos nucifera). Majority of respondents collected these plants from the wild (54.2%), farms (28.9%) and/or home gardens (6%). The roles played by these plants in fighting mosquitoes is reflected by the majority that deploy them with or without bed-nets (p > 0.55) or insecticidal sprays (p >0.22). Most respondents were aware that mosquitoes transmit malaria (90.6%) while few respondents associated elephantiasis/hydrocele (46.5%) and yellow fever (24.3%) with mosquitoes. Most of the ethnobotanical uses mentioned by the communities were consistent with scientific information gathered from the literature, except for Psidium guajava, which is reported for the first time in insect control. Conclusion This survey has indicated some knowledge gap among community members in managing mosquito vectors using plant. The communities need a basic health education and sensitization for effective exploitation of this valuable tool for reducing mosquitoes and associated disease burdens. On the other hand, the government of Tanzania should strengthen advocacy of botanical pesticides development, registration and regulation for public health benefits because they are source of pest control tools people rely on them. PMID:25015092

  8. Waiting for attention and care: birthing accounts of women in rural Tanzania who developed obstetric fistula as an outcome of labour

    PubMed Central

    2011-01-01

    Background Obstetric fistula is a physically and socially disabling obstetric complication that affects about 3,000 women in Tanzania every year. The fistula, an opening that forms between the vagina and the bladder and/or the rectum, is most frequently caused by unattended prolonged labour, often associated with delays in seeking and receiving appropriate and adequate birth care. Using the availability, accessibility, acceptability and quality of care (AAAQ) concept and the three delays model, this article provides empirical knowledge on birth care experiences of women who developed fistula after prolonged labour. Methods We used a mixed methods approach to explore the birthing experiences of women affected by fistula and the barriers to access adequate care during labour and delivery. Sixteen women were interviewed for the qualitative study and 151 women were included in the quantitative survey. All women were interviewed at the Comprehensive Community Based Rehabilitation Tanzania in Dar es Salaam and Bugando Medical Centre in Mwanza. Results Women experienced delays both before and after arriving at a health facility. Decisions on where to seek care were most often taken by husbands and mothers-in-law (60%). Access to health facilities providing emergency obstetric care was inadequate and transport was a major obstacle. About 20% reported that they had walked or were carried to the health facility. More than 50% had reported to a health facility after two or more days of labour at home. After arrival at a health facility women experienced lack of supportive care, neglect, poor assessment of labour and lack of supervision. Their birth accounts suggest unskilled birth care and poor referral routines. Conclusions This study reveals major gaps in access to and provision of emergency obstetric care. It illustrates how poor quality of care at health facilities contributes to delays that lead to severe birth injuries, highlighting the need to ensure women's rights to accessible, acceptable and adequate quality services during labour and delivery. PMID:22013991

  9. Sources of salinity and urban pollution in the Quaternary sand aquifers of Dar es Salaam, Tanzania

    NASA Astrophysics Data System (ADS)

    Walraevens, Kristine; Mjemah, Ibrahimu Chikira; Mtoni, Yohana; Van Camp, Marc

    2015-02-01

    Groundwater is globally important for human consumption, and changes in quality can have serious consequences. The study area is within a coastal aquifer where groundwater quality is influenced by various potential sources of salinity that determine the composition of water extracted from wells. Groundwater chemistry data from the aquifer have been acquired to determine the geochemical conditions and processes that occur in this area and assess their implications for aquifer susceptibility. Analysis of groundwater samples shows that the dominant watertype is mostly NaCl with pH < 7 in both aquifers (i.e. upper and lower) except for the shallow wells where CaHCO3 prevails with pH ? 7, and boreholes located near the Indian Ocean, where coral reef limestone deposits are located and the watertype evolves towards CaHCO3. In the lower aquifer, Cl- is higher than in the upper aquifer. The origin of salinity in the area is strongly influenced by groundwater ascending from deep marine Miocene Spatangid Shales through faults, seawater incursion on the border of the Indian Ocean, and throughout, there is some salinity within the Quaternary aquifer, especially in intercalated deltaic clays in the fluviatile deposits, showing some marine influences. The seawater intrusion is linked to the strongly increasing groundwater exploitation since 1997. Another process that plays a major role to the concentration of major ions in the groundwater is calcite dissolution. Next to geogenic salinity and seawater intrusion, anthropogenic pollution as well is affecting groundwater quality in the aquifer. An important result of this study is the observation of high nitrate concentrations, that call for improved sanitation in the area, where domestic sewage with on-site sanitation (mainly pit latrines) also threatens the groundwater resource.

  10. Antimicrobial Activity of Medicated Soaps Commonly Used By Dar es Salaam Residents in Tanzania

    PubMed Central

    Mwambete, K. D.; Lyombe, F.

    2011-01-01

    An in vitro evaluation of the anti-microbial activity of medicated soaps was conducted using ditch-plate and hand washing techniques. Strains of reference microbes namely Candida albicans (ATCC90028), Staphylococcus aureus (ATCC25923), Pseudomonas aureginosa (ATCC27853) and Escherichia coli (ATCC25922) were tested at three different soaps’ concentrations (1.0, 4.0 and 8.0 mg/ml). A total of 16 medicated soaps were assayed for their antimicrobial efficacy. Of these, 13 were medicated and 3 non-medicated soaps, which served as control. Ciprofloxacin and ketaconazole were employed as positive controls. Label disclosure for the soaps’ ingredients and other relevant information were absorbed. The most common antimicrobial active ingredients were triclosan, trichloroxylenol and trichlorocarbanilide. ANOVA for means of zones of inhibition revealed variability of antimicrobial activity among the medicated soaps. Positive correlation (r=0.318; P<0.01) between zones of inhibition and soaps’ concentrations was evidenced. Hand washing frequencies positively correlated with microbial counts. Roberts® soap exhibited the largest zone of inhibition (34 mm) on S. aureus. Candida albicans was the least susceptible microbe. Regency® and Dalan® exhibited the least zone of inhibition on the tested bacteria. Protex®, Roberts®, Family® and Protector® were equally effective (P<0.01) against S. aureus. In conclusion, majority of the assayed medicated soaps have satisfactory antibacterial activity; though lack antifungal effect with exception of Linda® liquid soap. The hand washing technique has proved to be inappropriate for evaluation of soaps’ antimicrobial efficacy due to presence of the skin microflora. PMID:22131630

  11. Evaluation of detection methods for Campylobacter infections among under-fives in Mwanza City, Tanzania

    PubMed Central

    Mushi, Martha Fidelis; Paterno, Laurent; Tappe, Dennis; Deogratius, Anna Pendo; Seni, Jeremiah; Moremi, Nyambura; Mirambo, Mariam Mwijuma; Mshana, Stephen Eliatosha

    2014-01-01

    Introduction Campylobacter species are recognized as a major cause of acute gastroenteritis in humans throughout the world. The diagnosis is mainly based on stool culture. This study was done to evaluate the effectiveness of staining methods (Gram stain using 0.3% carbol fuchsin as counter stain and 1% carbol fuchsin direct stain) versus culture as the gold standard. Methods A total of 300 children attending Bugando Medical Centre (BMC) and the Sekou Toure regional hospital with acute watery diarrhea were enrolled. Two sets of slides were prepared stained with 1% carbol fuchsin for 30 seconds first set, and the second set stained with Gram's stain using 0.3% carbol fuchsin as counter stain for five minutes. Concurrently, stool samples were inoculated on Preston Agar selective. Results Of 300 stool specimens, 14(4.7%) showed positive culture after 48 hours of incubation and 28 (9.3%) shows typical morphology of Campylobacter species by both Gram stain and direct stain. The sensitivity of the Gram stain using 0.3% carbol fuchsin as counter stain and 1% carbol fuchsin simple stain versus culture as gold standard was 64.3%, with a specificity of 93.4%. The positive predictive value and negative predictive value were 32.1% and 98.2% respectively. Conclusion The detection of Campylobacter by 1% carbol fuchsin is simple, inexpensive, and fast, with both a high sensitivity and specificity. Laboratories in settings with high prevalence of campylobacteriosis and/or limited resources can employ 1% carbol fuchsin direct stain in detecting campylobacter infections. PMID:25995788

  12. Determining spatial variability of dry spells - a Markov based method, applied to the Makanya catchment, Tanzania

    NASA Astrophysics Data System (ADS)

    Fischer, B. M. C.; Mul, M. L.; Savenije, H. H. G.

    2012-10-01

    With a growing world population and a trend towards more resource intensive diets, pressure on land and water resources for food production will continue to increase in the coming decades. Large parts of the world rely on rainfed agriculture for their food security. In Africa, 90% of the food production is from rainfed agriculture, generally with low yields and a high risk of crop failure. One of the main reasons for crop failure is the occurrence of dry spells during the growing season. Key indicators are the critical dry spell duration and the probability of dry spell occurrence. In this paper a new Markov-based framework is presented to spatially map the probability of dry spell occurrence. The framework makes use of spatially varying Markov coefficients that are correlated to readily available spatial information such as elevation and distance to the sea. This map is then related to the critical dry spell duration, based on soil properties and crop water requirements, to assess the probability of crop failure. The results show that in the Makanya catchment the probability of dry spell occurrence is highly variable in space, even over relatively short distances. In certain areas the probability of crop failure reaches levels, which makes rainfed agricultural practices unsustainable, even close to areas where currently rainfed agriculture is successfully practiced. This method can be used to identify regions that are vulnerable to dry spells, and subsequently to develop strategies for supplementary irrigation or rainwater harvesting.

  13. Using qualitative methods to understand the determinants of patients' willingness to pay for cataract surgery: a study in Tanzania.

    PubMed

    Geneau, Robert; Massae, Patrick; Courtright, Paul; Lewallen, Susan

    2008-02-01

    Cataract is the leading cause of avoidable blindness in Africa. There are various documented barriers to the uptake of cataract surgery, cost being one of them. There is, however, little evidence regarding patients' willingness to pay (WTP) for cataract surgery in Africa and the best way to measure it. We conducted a grounded theory study in order to understand better cataract patients' WTP for surgery in Tanzania. A total of 47 cataract patients from three regions of Tanzania were interviewed. The interviews were tape-recorded and transcribed verbatim. The coding process involved identifying emerging themes and categories and their interconnection. Our study reveals that the main factors behind patients' WTP for cataract surgery are (1) the level of perceived need for sight and cataract surgery; (2) the decision-making processes at the family level and (3) the characteristics of local eye care programs. Our study shows that WTP concerns not only the patients but also their relatives. For most patients and families, the amount of $20-$30 is deemed reasonable for a sight-restoring procedure. It does not appear realistic for eye care program managers to charge the real cost of cataract surgery at present (about US $70-in Kilimanjaro). However, eye care programs can influence WTP for cataract surgery by providing quality services and by offering adequate counseling about the procedure. The qualitative findings enriched the interpretation of a previously reported quantitative survey and yield implications for both researchers and decision-makers using or relying on WTP methodologies in developing countries. PMID:18006201

  14. An Overview of HIV Prevention Interventions for People Who Inject Drugs in Tanzania

    PubMed Central

    Ratliff, Eric A.; McCurdy, Sheryl A.; Mbwambo, Jessie K. K.; Lambdin, Barrot H.; Voets, Ancella; Pont, Sandrine; Maruyama, Haruka; Kilonzo, Gad P.

    2013-01-01

    In the past decade, Tanzania has seen a rapid rise in the number of people who inject drugs (PWID), specifically heroin. While the overall HIV prevalence in Tanzania has declined recently to 5.6%, in 2009, the HIV prevalence among PWID remains alarmingly high at 35%. In this paper, we describe how the Tanzania AIDS Prevention Program (TAPP), Médecins du Monde France (MdM-F), and other organisations have been at the forefront of addressing this public health issue in Africa, implementing a wide array of harm reduction interventions including medication-assisted treatment (MAT), needle and syringe programs (NSP), and “sober houses” for residential treatment in the capital, Dar es Salaam, and in Zanzibar. Looking toward the future, we discuss the need to (1) extend existing services and programs to reach more PWID and others at risk for HIV, (2) develop additional programs to strengthen existing programs, and (3) expand activities to include structural interventions to address vulnerabilities that increase HIV risk for all Tanzanians. PMID:23346410

  15. Genetic basis of pyrethroid resistance in a population of Anopheles arabiensis, the primary malaria vector in Lower Moshi, north-eastern Tanzania

    PubMed Central

    2014-01-01

    Background Pyrethroid resistance has been slower to emerge in Anopheles arabiensis than in An. gambiae s.s and An. funestus and, consequently, studies are only just beginning to unravel the genes involved. Permethrin resistance in An. arabiensis in Lower Moshi, Tanzania has been linked to elevated levels of both P450 monooxygenases and ?-esterases. We have conducted a gene expression study to identify specific genes linked with metabolic resistance in the Lower Moshi An. arabiensis population. Methods Microarray experiments employing an An. gambiae whole genome expression chip were performed on An. arabiensis, using interwoven loop designs. Permethrin-exposed survivors were compared to three separate unexposed mosquitoes from the same or a nearby population. A subsection of detoxification genes were chosen for subsequent quantitative real-time PCR (qRT-PCR). Results Microarray analysis revealed significant over expression of 87 probes and under expression of 85 probes (in pairwise comparisons between permethrin survivors and unexposed sympatric and allopatric samples from Dar es Salaam (controls). For qRT-PCR we targeted over expressed ABC transporter genes (ABC ‘2060’), a glutathione-S-transferase, P450s and esterases. Design of efficient, specific primers was successful for ABC ‘2060’and two P450s (CYP6P3, CYP6M2). For the CYP4G16 gene, we used the primers that were previously used in a microarray study of An. arabiensis from Zanzibar islands. Over expression of CYP4G16 and ABC ‘2060’ was detected though with contrasting patterns in pairwise comparisons between survivors and controls. CYP4G16 was only up regulated in survivors, whereas ABC ‘2060’ was similar in survivors and controls but over expressed in Lower Moshi samples compared to the Dar es Salaam samples. Increased transcription of CYP4G16 and ABC ‘2060’ are linked directly and indirectly respectively, with permethrin resistance in Lower Moshi An. arabiensis. Conclusions Increased transcription of a P450 (CYP4G16) and an ABC transporter (ABC 2060) are linked directly and indirectly respectively, with permethrin resistance in Lower Moshi An. arabiensis. Our study provides replication of CYP4G16 as a candidate gene for pyrethroid resistance in An. arabiensis, although its role may not be in detoxification, and requires further investigation. PMID:24946780

  16. Social Cognition Variables and Victimization as Predictors of Sexual Debut Among Adolescents in South Africa and Tanzania: A Multi-group SEM Analysis.

    PubMed

    Wubs, Annegreet Gera; Aarø, Leif Edvard; Kaaya, Sylvia; Onya, Hans; Mathews, Catherine

    2015-12-01

    Early sexual debut is common in South Africa and Tanzania, with potentially negative reproductive health outcomes. The role of violence as a predictor of sexual debut was studied, in a context of predictors borrowed from social cognition models. Data were taken from cluster-randomized trials of school-based HIV prevention interventions in three sites in South Africa and Tanzania. Analyses consisted of descriptive statistics and multi-group structural equation modelling. The basic model functioned fairly well for Cape Town, but less well for Mankweng and Dar es Salaam (low R(2) values). Attitudes were the strongest predictor of intention. Adding socio-demographic variables to the model did not reduce the associations much and neither did subsequent inclusion of violence. Sexual debut was strongly associated with victimization; adding violence also substantially increased R(2) for sexual debut. Besides social cognition factors, intimate partner violence should be addressed in future research on reproductive health interventions for adolescents. PMID:25957857

  17. Tanzania: Country Status Report.

    ERIC Educational Resources Information Center

    Robson, Barbara

    A survey of the status of language usage in Tanzania begins with an overview of the three levels of language use: (1) Swahili, the national and official language, used in public life; (2) English, used in international affairs and in technical and intellectual matters; and (3) the over 120 vernacular languages used in family and religious life,…

  18. Identification of VIM-2-producing Pseudomonas aeruginosa from Tanzania is associated with sequence types 244 and 640 and the location of blaVIM-2 in a TniC integron.

    PubMed

    Moyo, Sabrina; Haldorsen, Bjørg; Aboud, Said; Blomberg, Bjørn; Maselle, Samuel Y; Sundsfjord, Arnfinn; Langeland, Nina; Samuelsen, Ørjan

    2015-01-01

    Epidemiological data on carbapenemase-producing Gram-negative bacteria on the African continent are limited. Here, we report the identification of VIM-2-producing Pseudomonas aeruginosa isolates in Tanzania. Eight out of 90 clinical isolates of P. aeruginosa from a tertiary care hospital in Dar es Salaam were shown to harbor bla(VIM-2). The bla(VIM-2)-positive isolates belonged to two different sequence types (ST), ST244 and ST640, with bla(VIM-2) located in an unusual integron structure lacking the 3' conserved region of qac?E1-sul1. PMID:25331700

  19. Multivitamin supplementation improves haematologic status in children born to HIV-positive women in Tanzania

    PubMed Central

    Liu, Enju; Duggan, Christopher; Manji, Karim P; Kupka, Roland; Aboud, Said; Bosch, Ronald J; Kisenge, Rodrick R; Okuma, James; Fawzi, Wafaie W

    2013-01-01

    Introduction Anaemia is prevalent among children born to HIV-positive women, and it is associated with adverse effects on cognitive and motor development, growth, and increased risks of morbidity and mortality. Objective To examine the effect of daily multivitamin supplementation on haematologic status and mother-to-child transmission (MTCT) of HIV through breastfeeding. Methods A total of 2387 infants born to HIV-positive women from Dar es Salaam, Tanzania were enrolled in a randomized, double-blind, placebo-controlled trial, and provided a daily oral supplement of multivitamins (vitamin B complex, C and E) or placebo at age 6 weeks for 24 months. Among them, 2008 infants provided blood samples and had haemoglobin concentrations measured at baseline and during a follow-up period. Anaemia was defined as haemoglobin concentrations<11 g/dL and severe anaemia<8.5 g/dL. Results Haemoglobin concentrations among children in the treatment group were significantly higher than those in the placebo group at 12 (9.77 vs. 9.64 g/dL, p=0.03), 18 (9.76 vs. 9.57 g/dL, p=0.004), and 24 months (9.93 vs. 9.75 g/dL, p=0.02) of follow-up. Compared to those in the placebo group, children in the treatment group had a 12% lower risk of anaemia (hazard ratio (HR): 0.88; 95% CI: 0.79–0.99; p=0.03). The treatment was associated with a 28% reduced risk of severe anaemia among children born to women without anaemia (HR: 0.72; 95% CI: 0.56–0.92; p=0.008), but not among those born to women with anaemia (HR: 1.10; 95% CI: 0.79–1.54; p=0.57; p for interaction=0.007). One thousand seven hundred fifty three infants who tested HIV-negative at baseline and had HIV testing during follow-up were included in the analysis for MTCT of HIV. No association was found between multivitamin supplements and MTCT of HIV. Conclusions Multivitamin supplements improve haematologic status among children born to HIV-positive women. Further trials focusing on anaemia among HIV-exposed children are warranted in the context of antiretroviral therapy. PMID:23948440

  20. "I am nothing": experiences of loss among women suffering from severe birth injuries in Tanzania

    PubMed Central

    2011-01-01

    Background Despite the increased attention on maternal mortality during recent decades, which has resulted in maternal health being defined as a Millennium Development Goal (MDG), the disability and suffering from obstetric fistula remains a neglected issue in global health. Continuous leaking of urine and the physical, emotional and social suffering associated with it, has a profound impact on women's quality of life. This study seeks to explore the physical, cultural and psychological dimensions of living with obstetric fistula, and demonstrate how these experiences shape the identities of women affected by the condition. Methods A cross-sectional study with qualitative and quantitative components was used to explore the experiences of Tanzanian women living with obstetric fistula and those of their husbands. The study was conducted at the Comprehensive Community Based Rehabilitation Tanzania hospital in Dar es Salaam, Bugando Medical Centre in Mwanza, and Mpwapwa district, in Dodoma region. Conveniently selected samples of 16 women were interviewed, and 151 additional women responded to a questionnaire. In addition, 12 women affected by obstetric fistula and six husbands of these affected women participated in a focus group discussions. Data were analysed using content data analysis framework and statistical package for the social sciences (SPSS) version 15 for Microsoft windows. Results The study revealed a deep sense of loss. Loss of body control, loss of the social roles as women and wives, loss of integration in social life, and loss of dignity and self-worth were located at the core of these experiences. Conclusion The women living with obstetric fistula experience a deep sense of loss that had negative impact on their identity and quality of life. Acknowledging affected women's real-life experiences is important in order to understand the occurrence and management of obstetric fistula, as well as prospects after treatment. This knowledge will help to improve women's sense of self-worth and maintain their identity as women, wives, friends and community members. Educational programmes to empower women socially and economically and counselling of families of women living with obstetric fistula may help these women receive medical and social support that is necessary. PMID:22082132

  1. Understanding key hydrological processes in a meso-scale semi-arid catchment in Tanzania by using a multi-method approach

    NASA Astrophysics Data System (ADS)

    Mul, M. L.; Savenije, H. H. G.; Uhlenbrook, S.

    2009-04-01

    Understanding hydrological processes in poorly or ungauged catchments is of utmost importance for the management of water resources. This paper shows that a high resolution time series of hydrological data (rainfall, evaporation and runoff) collected over a limited period of time (i.e. 1.5 years), can give a good picture of the hydrological processes occurring in a 25 km2 catchment in Tanzania (Vudee catchment). In addition, several techniques, incl. tracer and mapping studies, have been applied to identify flow paths and contribution from different sources. All this information was used for the development of a conceptual hydrological model. The conceptual model is based on the Lumped Elementary Watershed (LEW) concept, restructured for hourly time steps. An additional flux, representing the drainage into the neighbouring catchment, identified using a multi-method approach, increased the model performance significantly, particularly related to a recession curve occurring at high flows. This corroborates the assumption that there is water draining towards the neighbouring catchment. The model runs show that surface runoff only occurs during heavy rains or directly thereafter, which is consistent with results from hydrograph separation. Overall, the major part of the runoff is generated by groundwater. Moreover, the model shows that the unsaturated zone has a relatively large storage capacity. At the meso-scale, hydrological processes are governed by a sub-daily timescale. As a result, only a high resolution conceptual model is able to mimic the hydrological processes accurately. By applying the LEW model, incorporating the hydrological processes as observed in the catchment, a better understanding has been obtained of the dominant hydrological processes at this scale. This is a prerequisite for sustainable management of the water resources in a water scarce region.

  2. Factors affecting adoption, implementation fidelity, and sustainability of the Redesigned Community Health Fund in Tanzania: a mixed methods protocol for process evaluation in the Dodoma region

    PubMed Central

    Kalolo, Albino; Radermacher, Ralf; Stoermer, Manfred; Meshack, Menoris; De Allegri, Manuela

    2015-01-01

    Background Despite the implementation of various initiatives to address low enrollment in voluntary micro health insurance (MHI) schemes in sub-Saharan Africa, the problem of low enrollment remains unresolved. The lack of process evaluations of such interventions makes it difficult to ascertain whether their poor results are because of design failures or implementation weaknesses. Objective In this paper, we describe a process evaluation protocol aimed at opening the ‘black box’ to evaluate the implementation processes of the Redesigned Community Health Fund (CHF) program in the Dodoma region of Tanzania. Design The study employs a cross-sectional mixed methods design and is being carried out 3 years after the launch of the Redesigned CHF program. The study is grounded in a conceptual framework which rests on the Diffusion of Innovation Theory and the Implementation Fidelity Framework. The study utilizes a mixture of quantitative and qualitative data collection tools (questionnaires, focus group discussions, in-depth interviews, and document review), and aligns the evaluation to the Theory of Intervention developed by our team. Quantitative data will be used to measure program adoption, implementation fidelity, and their moderating factors. Qualitative data will be used to explore the responses of stakeholders to the intervention, contextual factors, and moderators of adoption, implementation fidelity, and sustainability. Discussion This protocol describes a systematic process evaluation in relation to the implementation of a reformed MHI. We trust that the theoretical approaches and methodologies described in our protocol may be useful to inform the design of future process evaluations focused on the assessment of complex interventions, such as MHI schemes. PMID:26679408

  3. Auditory impairments in HIV-infected individuals in Tanzania

    PubMed Central

    Maro, Isaac I.; Moshi, Ndeserua; Clavier, Odile H.; MacKenzie, Todd A.; Kline-Schoder, Robert J.; Wilbur, Jed C.; Chambers, Robert D.; Fellows, Abigail M.; Jastrzembski, Benjamin G.; Mascari, John E.; Bakari, Muhammad; Matee, Mecky; Musiek, Frank E.; Waddell, Richard D.; von Reyn, C. Fordham; Buckey, Jay C.

    2014-01-01

    Objectives Abnormal hearing tests have been noted in HIV-infected patients in several studies, but the nature of the hearing deficit has not been clearly defined. We performed a cross-sectional study of both HIV+ and HIV? individuals in Tanzania using an audiological test battery. We hypothesized that HIV+ adults would have a higher prevalence of abnormal central and peripheral hearing test results compared to HIV? controls. Additionally, we anticipated that the prevalence of abnormal hearing assessments would increase with anti-retroviral therapy (ART) use, and treatment for tuberculosis (TB). Design Pure-tone thresholds, distortion product otoacoustic emissions (DPOAEs), tympanometry, and a gap detection test were performed using a laptop-based hearing testing system on 751 subjects (100 HIV? in the U.S., plus 651 in Dar es Salaam Tanzania including 449 HIV+ [130 ART? and 319 ART+], and 202 HIV?, subjects. No U.S. subjects had a history of TB treatment. In Tanzania, 204 of the HIV+, and 23 of the HIV?, subjects had a history of TB treatment. Subjects completed a video and audio questionnaire about their hearing as well as a health history questionnaire. Results HIV+ subjects had reduced DPOAE levels compared to HIV? subjects, but their hearing thresholds, tympanometry results, and gap detection thresholds were similar. Within the HIV+ group, those on ART reported significantly greater difficulties understanding speech-in-noise, and were significantly more likely to report that they had difficulty understanding speech than the ART? group. The ART+ group had a significantly higher mean gap detection threshold compared to the ART? group. No effects of TB treatment were seen. Conclusions The fact that the ART+/ART? groups did not differ in measures of peripheral hearing ability (DPOAEs, thresholds), or middle ear measures (tympanometry), but that the ART+ group had significantly more trouble understanding speech and higher gap detection thresholds, indicates a central processing deficit. These data suggest that: (a) hearing deficits in HIV+ individuals could be a central nervous system (CNS) side effect of HIV infection, (b) certain ART regimens might produce CNS side effects that manifest themselves as hearing difficulties, and/or (c) some ART regimens may treat CNS HIV inadequately, perhaps due to insufficient CNS drug levels, which is reflected as a central hearing deficit. Monitoring of central hearing parameters could be used to track central effects of either HIV or ART. PMID:24441742

  4. Feasibility of Using Flash-heated Breastmilk as an Infant Feeding Option for HIV-exposed, Uninfected Infants after 6 Months of Age in Urban Tanzania

    PubMed Central

    Chantry, Caroline J.; Young, Sera L.; Rennie, Waverly; Ngonyani, Monica; Mashio, Clara; Israel-Ballard, Kiersten; Peerson, Janet; Nyambo, Margaret; Matee, Mecky; Ash, Deborah; Dewey, Kathryn; Koniz-Booher, Peggy

    2012-01-01

    Objective Heat-treating expressed breastmilk is recommended as an interim feeding strategy for HIV-exposed infants in resource-poor countries, but data on its feasibility are minimal. Flash-heating (FH) is a simple in-home technique for heating breastmilk that inactivates HIV while preserving its nutritional and anti-infective properties. Our primary objective was to determine, among HIV-infected mothers, the feasibility and protocol adherence of FH expressed breastmilk after 6 months of exclusive breastfeeding. Design Prospective longitudinal Participants 101 HIV-infected breastfeeding mothers Setting Dar es Salaam, Tanzania Intervention Peer counselors provided in-home counseling and support on infant feeding from 2 to 9 months postpartum. Mothers were encouraged to exclusively breastfeed for 6 months followed by FH expressed breastmilk if her infant was HIV-negative. Clinic-based staff measured infant growth and morbidity monthly and mothers kept daily logs of infant morbidity. FH behavior was tracked until 9 months postpartum using daily logs, in-home observations, and clinic-and home-based surveys. Bacterial cultures of unheated and heated milk samples were performed. Results Thirty-seven of 72 eligible mothers (51.4%) chose to Flash-heat. Median (range) frequency of milk expression was 3 (1–6) times daily and duration of method use on-study was 9.7 (0.1–15.6) weeks. Mean (SD) daily milk volume was 322 (201) mL (range 25–1120). No heated and 32 (30.5%) unheated samples contained bacterial pathogens. Conclusion FH is a simple technology that many HIV-positive women can successfully use after exclusive breastfeeding to continue to provide the benefits of breastmilk while avoiding maternal-to-child transmission associated with non-exclusive breastfeeding. Based on these feasibility data, a clinical trial of the effects of FH breastmilk on infant health outcomes is warranted. PMID:22362154

  5. Stock-outs of antiretroviral drugs and coping strategies used to prevent changes in treatment regimens in Kinondoni District, Tanzania: a cross-sectional study

    PubMed Central

    2014-01-01

    Objectives Since 2004, the government of Tanzania has been rolling out antiretroviral treatment programs all over the country. However, the capacity of the health system to cope with the rapid scale-up of these programs is a major concern, and problems may result in drug stock-outs that force changes in treatment regimens. This study aims to explore stock-outs of antiretroviral drugs and further determine the coping strategies employed to prevent changes in treatment regimens in HIV/AIDS care and treatment clinics in Kinondoni District, Dar es Salaam, Tanzania. Methods A cross-sectional study was conducted in 20 HIV/AIDS care and treatment clinics. Interviews were conducted with the person in charge and a member of the pharmacy staff from each clinic using a pre-tested semi-structured interview guide. Verbal responses were transcribed, coded and analysed by thematic approach. Quantitative data were analysed using Excel spreadsheet (Microsoft Excel®, Microsoft Corporation). Results The total number of clients enrolled in the visited clinics was 32,147, of whom 20,831 (64.8%) had already been initiated onto antiretroviral therapies (ART). Stock-out of antiretroviral drugs was reported in 16 out of the 20 clinics, causing 210 patients to change their ART regimens, during the 12 months preceding the survey. Inefficient supply systems, quantification problems and short expiry duration were cited as the main causes of stock-outs. The coping strategies utilised to prevent changes in ART regimens were: shortening of the refill period, borrowing and moving patients to other clinics. Conclusion Changes in ART regimens due to stock-outs of antiretroviral drugs occurred in a small but significant number of patients. This increases the risk of the emergence of drug-resistant HIV strains. Healthcare workers use various coping strategies to prevent changes in ART regimens but, unfortunately, some of these strategies are likely to increase patient-borne costs, which may discourage them from attending their routine clinics, hence leading to unplanned treatment interruptions. PMID:25848543

  6. Predictors of poor glycemic control in type 2 diabetic patients attending public hospitals in Dar es Salaam

    PubMed Central

    Kamuhabwa, Appolinary R; Charles, Emmanuel

    2014-01-01

    Background Tanzania has recently experienced a significant rise in the burden of diabetes, and it is estimated that more than 400,000 people are living with diabetes. A major concern in the management of diabetes is the occurrence of diabetic complications that occur as a result of poor glycemic control. Identification of the factors associated with poor glycemic control is important in order to institute appropriate interventions for the purpose of improving glycemic control and prevention of chronic complications. Aim The aim of this study was to determine the level of glycemic control and explore the factors associated with poor glycemic control among patients with type 2 diabetes mellitus (T2DM). Methodology A cross-sectional study was carried out at the diabetic clinics for T2DM patients at the national and municipal hospitals in Dar es Salaam. A total of 469 patients were enrolled over a period of 8 weeks from March 2013 to May 2013. Patients’ information such as sociodemographic characteristics, self-care management behaviors, and medication adherence were obtained through interviews. Blood pressure, weight, and height were measured during the day of the interview. All available last readings for fasting blood glucose (FBG) measurements, lipid profile, and other clinical characteristics were obtained from patients’ records. Results The mean age of patients was 54.93 years. The majority (63.5%) of patients were females and only eight patients had records of lipid profile measurements. Out of 469 patients, 69.7% had FBG of ?7.2 mmol/L, indicating poor glycemic control. Females aged between 40 years and 59 years had significantly higher poor glycemic control (76.1%) as compared with their male counterparts. Thirty-eight percent of patients had poor medication adherence, which was associated with poor glycemic control. The proportion of poor glycemic control increased with age. A significantly high proportion of poor glycemic control was observed in patients who had had the disease for more than 20 years since diagnosis. Factors associated with poor glycemic control included lack of health insurance, using more than one oral hypoglycemic agent, normal body mass index, obesity, and nonadherence to diabetic medications. Conclusion Patients in this study had generally poor glycemic control. From these findings it is recommended that diabetic patients should be routinely screened for lipid profile to determine levels of cholesterol, triglycerides, and low-density lipoproteins, which are risk factors for cardiovascular events. An education program should be developed to educate patients on the importance of medication adherence and weight management for better glycemic control. PMID:25368533

  7. Socio-economic comparison between traditional and improved cultivation methods in agroforestry systems, East Usambara Mountains, Tanzania.

    PubMed

    Reyes, Teija; Quiroz, Roberto; Msikula, Shija

    2005-11-01

    The East Usambara Mountains, recognized as one of the 25 most important biodiversity hot spots in the world, have a high degree of species diversity and endemism that is threatened by increasing human pressure on resources. Traditional slash and burn cultivation in the area is no longer sustainable. However, it is possible to maintain land productivity, decrease land degradation, and improve rural people's livelihood by ameliorating cultivation methods. Improved agroforestry seems to be a very convincing and suitable method for buffer zones of conservation areas. Farmers could receive a reasonable net income from their farm with little investment in terms of time, capital, and labor. By increasing the diversity and production of already existing cultivations, the pressure on natural forests can be diminished. The present study shows a significant gap between traditional cultivation methods and improved agroforestry systems in socio-economic terms. Improved agroforestry systems provide approximately double income per capita in comparison to traditional methods. More intensified cash crop cultivation in the highlands of the East Usambara also results in double income compared to that in the lowlands. However, people are sensitive to risks of changing farming practices. Encouraging farmers to apply better land management and practice sustainable cultivation of cash crops in combination with multipurpose trees would be relevant in improving their economic situation in the relatively short term. The markets of most cash crops are already available. Improved agroforestry methods could ameliorate the living conditions of the local population and protect the natural reserves from human disturbance. PMID:16261277

  8. Tri-Lateral Noor al Salaam High Concentration Solar Central Receiver Program

    SciTech Connect

    Blackmon, James B

    2008-03-31

    This report documents the efforts conducted primarily under the Noor al Salaam (“Light of Peace”) program under DOE GRANT NUMBER DE-FC36-02GO12030, together with relevant technical results from a closely related technology development effort, the U.S./Israel Science and Technology Foundation (USISTF) High Concentration Solar Central Receiver program. These efforts involved preliminary design, development, and test of selected prototype power production subsystems and documentation of an initial version of the system definition for a high concentration solar hybrid/gas electrical power plant to be built in Zaafarana, Egypt as a first step in planned commercialization. A major part of the planned work was halted in 2007 with an amendment in October 2007 requiring that we complete the technical effort by December 31, 2007 and provide a final report to DOE within the following 90 days. This document summarizes the work conducted. The USISTF program was a 50/50 cost-shared program supported by the Department of Commerce through the U.S./Israel Science and Technology Commission (USISTC). The USISTC was cooperatively developed by President Clinton and the late Prime Minister Rabin of Israel "to encourage technological collaboration" and "support peace in the Middle East through economic development". The program was conducted as a follow-on effort to Israel's Magnet/CONSOLAR Program, which was an advanced development effort to design, fabricate, and test a solar central receiver and secondary optics for a "beam down" central receiver concept. The status of these hardware development programs is reviewed, since they form the basis for the Noor al Salaam program. Descriptions are provided of the integrated system and the major subsystems, including the heliostat, the high temperature air receiver, the power conversion unit, tower and tower reflector, compound parabolic concentrator, and the master control system. One objective of the USISTF program was to conduct marketing research, identify opportunities for use of this technology, and to the extent possible, secure an agreement leading to a pre-commercialization demonstration or prototype plant. This was accomplished with the agreement to conduct the Noor al Salaam program as a tri-lateral project between Egypt, Israel, and the U.S. The tri-lateral project was led by the University of Alabama in Huntsville (UAH); this included the Egyptian New and Renewable Energy Authority and the Israeli USISTC participants. This project, known was Noor al Salaam, was funded by the U.S. Agency for International Development (USAID) through the Department of Energy (DOE). The Egyptian activity was under the auspices of the Egyptian Ministry of Energy and Electricity, New and Renewable Energy Authority (NREA) as part of Egypt's plans for renewable energy development. The objective of the Noor al Salaam project was to develop the conditions necessary to obtain funding and construct and operate an approximately 10 to 20 Megawatt hybrid solar/natural gas demonstration power plant in Zaafarana, Egypt that could serve both as a test bed for advanced solar technology evaluations, and as a forerunner to commercial plant designs. This plant, termed Noor Al Salaam, or “Light of Peace”, reached the initial phase of system definition before being curtailed, in part by changes in USAID objectives, coupled with various delays that were beyond the scope of the program to resolve. The background of the USISTF technology development and pre-commercialization effort is provided in this report, together with documentation of the technology developments conducted under the Noor al Salaam program. It should be noted that only a relatively small part of the Noor al Salaam funding was expended over the approximately five years for which UAH was prime contractor before the program was ordered closed (Reference 1) so that the remaining funds could be returned to USAID.

  9. Determining spatial variability of dry spells: a Markov-based method, applied to the Makanya catchment, Tanzania

    NASA Astrophysics Data System (ADS)

    Fischer, B. M. C.; Mul, M. L.; Savenije, H. H. G.

    2013-06-01

    With a growing world population and a trend towards more resource-intensive diets, pressure on land and water resources for food production will continue to increase in the coming decades. Large parts of the world rely on rainfed agriculture for their food security. In Africa, 90% of the food production is from rainfed agriculture, generally with low yields and a high risk of crop failure. One of the main reasons for crop failure is the occurrence of dry spells during the growing season. Key indicators are the critical dry spell duration and the probability of dry spell occurrence. In this paper a new Markov-based framework is presented to spatially map the length of dry spells for fixed probabilities of non-exceedance. The framework makes use of spatially varying Markov coefficients that are correlated to readily available spatial information such as elevation and distance to the sea. The dry spell map thus obtained is compared to the spatially variable critical dry spell duration, based on soil properties and crop water requirements, to assess the probability of crop failure in different locations. The results show that in the Makanya catchment the length of dry spell occurrence is highly variable in space, even over relatively short distances. In certain areas the probability of crop failure reaches levels that make rainfed agricultural unsustainable, even close to areas where currently rainfed agriculture is successfully being practised. This method can be used to identify regions that are vulnerable to dry spells and, subsequently, to develop strategies for supplementary irrigation or rainwater harvesting.

  10. Childhood Sexual Abuse among University Students in Tanzania

    ERIC Educational Resources Information Center

    McCrann, Denis; Lalor, Kevin; Katabaro, Joviter Kamugisha

    2006-01-01

    Objectives: There are no prevalence data for childhood sexual abuse among Tanzanian university students. This investigation addressed this paucity. The nature of sexual abuse was also investigated. Method: Participants (N=487) from a university in Tanzania completed a questionnaire which assessed abusive childhood sexual experiences, gathering…

  11. Insecticide resistance mechanisms associated with different environments in the malaria vector Anopheles gambiae: a case study in Tanzania

    PubMed Central

    2014-01-01

    Background Resistance of mosquitoes to insecticides is a growing concern in Africa. Since only a few insecticides are used for public health and limited development of new molecules is expected in the next decade, maintaining the efficacy of control programmes mostly relies on resistance management strategies. Developing such strategies requires a deep understanding of factors influencing resistance together with characterizing the mechanisms involved. Among factors likely to influence insecticide resistance in mosquitoes, agriculture and urbanization have been implicated but rarely studied in detail. The present study aimed at comparing insecticide resistance levels and associated mechanisms across multiple Anopheles gambiae sensu lato populations from different environments. Methods Nine populations were sampled in three areas of Tanzania showing contrasting agriculture activity, urbanization and usage of insecticides for vector control. Insecticide resistance levels were measured in larvae and adults through bioassays with deltamethrin, DDT and bendiocarb. The distribution of An. gambiae sub-species and pyrethroid target-site mutations (kdr) were investigated using molecular assays. A microarray approach was used for identifying transcription level variations associated to different environments and insecticide resistance. Results Elevated resistance levels to deltamethrin and DDT were identified in agriculture and urban areas as compared to the susceptible strain Kisumu. A significant correlation was found between adult deltamethrin resistance and agriculture activity. The subspecies Anopheles arabiensis was predominant with only few An. gambiae sensu stricto identified in the urban area of Dar es Salaam. The L1014S kdr mutation was detected at elevated frequency in An gambiae s.s. in the urban area but remains sporadic in An. arabiensis specimens. Microarrays identified 416 transcripts differentially expressed in any area versus the susceptible reference strain and supported the impact of agriculture on resistance mechanisms with multiple genes encoding pesticide targets, detoxification enzymes and proteins linked to neurotransmitter activity affected. In contrast, resistance mechanisms found in the urban area appeared more specific and more related to the use of insecticides for vector control. Conclusions Overall, this study confirmed the role of the environment in shaping insecticide resistance in mosquitoes with a major impact of agriculture activities. Results are discussed in relation to resistance mechanisms and the optimization of resistance management strategies. PMID:24460952

  12. Monitoring mosquitoes in urban Dar es Salaam: Evaluation of resting boxes, window exit traps, CDC light traps, Ifakara tent traps and human landing catches

    PubMed Central

    2011-01-01

    Background Ifakara tent traps (ITT) are currently the only sufficiently sensitive, safe, affordable and practical method for routine monitoring host-seeking mosquito densities in Dar es Salaam. However, it is not clear whether ITT catches represent indoors or outdoors biting densities. ITT do not yield samples of resting, fed mosquitoes for blood meal analysis. Methods Outdoors mosquito sampling methods, namely human landing catch (HLC), ITT (Design B) and resting boxes (RB) were conducted in parallel with indoors sampling using HLC, Centers for Disease Control and Prevention miniature light traps (LT) and RB as well as window exit traps (WET) in urban Dar es Salaam, rotating them thirteen times through a 3 × 3 Latin Square experimental design replicated in four blocks of three houses. This study was conducted between 6th May and 2rd July 2008, during the main rainy season when mosquito biting densities reach their annual peak. Results The mean sensitivities of indoor RB, outdoor RB, WET, LT, ITT (Design B) and HLC placed outdoor relative to HLC placed indoor were 0.01, 0.005, 0.036, 0.052, 0.374, and 1.294 for Anopheles gambiae sensu lato (96% An. gambiae s.s and 4% An. arabiensis), respectively, and 0.017, 0.053, 0.125, 0.423, 0.372 and 1.140 for Culex spp, respectively. The ITT (Design B) catches correlated slightly better to indoor HLC (r2 = 0.619, P < 0.001, r2 = 0.231, P = 0.001) than outdoor HLC (r2 = 0.423, P < 0.001, r2 = 0.228, P = 0.001) for An. gambiae s.l. and Culex spp respectively but the taxonomic composition of mosquitoes caught by ITT does not match those of the indoor HLC (?2 = 607.408, degrees of freedom = 18, P < 0.001). The proportion of An. gambiae caught indoors was unaffected by the use of an LLIN in that house. Conclusion The RB, WET and LT are poor methods for surveillance of malaria vector densities in urban Dar es Salaam compared to ITT and HLC but there is still uncertainty over whether the ITT best reflects indoor or outdoor biting densities. The particular LLIN evaluated here failed to significantly reduce house entry by An. gambiae s.l. suggesting a negligible repellence effect. PMID:21418622

  13. The Effects of Informational Interventions on Household Water Management, Hygiene Behaviors, Stored Drinking Water Quality, and Hand Contamination in Peri-Urban Tanzania

    PubMed Central

    Davis, Jennifer; Pickering, Amy J.; Rogers, Kirsten; Mamuya, Simon; Boehm, Alexandria B.

    2011-01-01

    Safe water storage and hand hygiene have been shown to reduce fecal contamination and improve health in experimental settings; however, triggering and sustaining such behaviors is challenging. This study investigates the extent to which personalized information about Escherichia coli contamination of stored water and hands influenced knowledge, reported behaviors, and subsequent contamination levels among 334 households with less than 5-year-old children in peri-urban Dar es Salaam, Tanzania. One-quarter of the study participants received information about strategies to reduce risk of water- and sanitation-related illness. Respondents in another three study cohorts received this same information, along with their household's water and/or hand-rinse test results. Findings from this study suggest that additional work is needed to elucidate the conditions under which such testing represents a cost-effective strategy to motivate improved household water management and hand hygiene. PMID:21292883

  14. Conventialization of Numerals in Tanzania

    ERIC Educational Resources Information Center

    Kajoro, Peter

    2012-01-01

    The supposed pre-eminence of an external examination can exert a disproportionate influence on a curriculum and the associated learning and teaching. Teaching can easily subordinate learning and understanding to curriculum coverage if the society develops a culture that appears to make such demands. This study focuses on Tanzania and provides the…

  15. Determinants of concurrent sexual partnerships within stable relationships: a qualitative study in Tanzania

    PubMed Central

    Cox, Carie Muntifering; Babalola, Stella; Kennedy, Caitlin E; Mbwambo, Jessie; Likindikoki, Samuel; Kerrigan, Deanna

    2014-01-01

    Objective Concurrent sexual partnerships (CP) have been identified as a potential driver in the HIV epidemic in southern Africa, making it essential to understand motivating factors for engagement in CP. We aimed to assess community attitudes and beliefs about relationship factors that influence men and women in stable relationships to engage in CP in Tanzania. Social exchange theory was used for interpreting the data. Design Qualitative study with focus group discussions (FGDs). Setting Semiurban/rural communities in four regions across Tanzania (Dar es Salaam, Shinyanga, Iringa and Mbeya). Participants 120 women aged 17–45?years and 111 men aged 18–49?years from four study areas participated in 32 FGDs. Outcome measures FGD participants were asked the following questions about CP: definitions and types, motivations and justifications for engaging or not engaging, cultural factors, gender and socialisation, and local resources and efforts available for addressing CP. Our analysis focused specifically on beliefs about how relationship factors influence engagement in CP. Results Dissatisfaction with a stable relationship was believed to be a contributing factor for engagement in CP for both men and women. Participants more commonly reported financial dissatisfaction as a contributing factor for women engaging in CP within stable relationships, whereas emotional and sexual dissatisfaction were reported as contributing factors for men and women. Furthermore, participants described how potential outside partners are often evaluated based on what they are able to offer compared with stable partners. Conclusions Efforts to reach men and women in stable relationships with HIV prevention messages must consider the various dimensions of motivation for engaging in CP, including relationship dynamics. PMID:24508848

  16. Crater Highlands, Tanzania

    NASA Technical Reports Server (NTRS)

    2006-01-01

    The Shuttle Radar Topography Mission (SRTM), flown aboard Space Shuttle Endeavour in February 2000, acquired elevation measurements for nearly all of Earth's landmass between 60oN and 56oS latitudes. For many areas of the world SRTM data provide the first detailed three-dimensional observation of landforms at regional scales. SRTM data were used to generate this view of the Crater Highlands along the East African Rift in Tanzania. Landforms are depicted with colored height and shaded relief, using a vertical exaggeration of 2X and a southwestwardly look direction.

    Lake Eyasi is depicted in blue at the top of the image, and a smaller lake occurs in Ngorongoro Crater. Near the image center, elevations peak at 3648 meters (11,968 feet) at Mount Loolmalasin, which is south of Ela Naibori Crater. Kitumbeine (left) and Gelai (right) are the two broad mountains rising from the rift lowlands. Mount Longido is seen in the lower left, and the Meto Hills are in the right foreground.

    Tectonics, volcanism, landslides, erosion and deposition -- and their interactions -- are all very evident in this view. The East African Rift is a zone of spreading between the African (on the west) and Somali (on the east) crustal plates. Two branches of the rift intersect here in Tanzania, resulting in distinctive and prominent landforms. One branch trends nearly parallel the view and includes Lake Eyasi and the very wide Ngorongoro Crater. The other branch is well defined by the lowlands that trend left-right across the image (below center, in green). Volcanoes are often associated with spreading zones where magma, rising to fill the gaps, reaches the surface and builds cones. Craters form if a volcano explodes or collapses. Later spreading can fracture the volcanoes, which is especially evident on Kitumbeine and Gelai Mountains (left and right, respectively, lower center).

    The Crater Highlands rise far above the adjacent savannas, capture moisture from passing air masses, and host rain forests. Over time, streams erode downward toward the level of the adjacent rift, deeply dissecting the volcanic slopes. This is especially evident on the eastern flanks of Mount Loolmalasin (left of center).

    Landsliding also occurs here. In particular, the small but steep volcanic cone nearest the image center has a landslide scar on its eastern (left) flank, and topographic evidence shows that the associated landslide deposits extend eastward 10 kilometers (6 miles) across the floor of the rift. Such a long run of landslide debris is unusual but is not unique on Earth.

    Elevation data used in this image were acquired by the Shuttle Radar Topography Mission (SRTM) aboard the Space Shuttle Endeavour, launched on February 11, 2000. SRTM used the same radar instrument that comprised the Spaceborne Imaging Radar-C/X-Band Synthetic Aperture Radar (SIR-C/X-SAR) that flew twice on the Space Shuttle Endeavour in 1994. SRTM was designed to collect three-dimensional measurements of the Earth's surface. To collect the 3-D data, engineers added a 60-meter-long (200-foot) mast, installed additional C-band and X-band antennas, and improved tracking and navigation devices. The mission is a cooperative project between the National Aeronautics and Space Administration (NASA), the National Geospatial-Intelligence Agency (NGA) of the U.S. Department of Defense (DoD), and the German and Italian space agencies. It is managed by NASA's Jet Propulsion Laboratory, Pasadena, Calif., for NASA's Science Mission Directorate, Washington, DC.

    View Size: 48 kilometers wide (30 miles) by 230 kilometers (140 miles) distance Location: 3 degrees South latitude, 36 degrees East longitude Orientation: View 35o south of west, 15o below horizontal SRTM Data Acquired: February 2000

  17. Exposure to wood dust and endotoxin in small-scale wood industries in Tanzania.

    PubMed

    Rongo, Larama Mb; Msamanga, Gernard I; Burstyn, Igor; Barten, Françoise; Dolmans, Wil Mv; Heederik, Dick

    2004-11-01

    Workers in small-scale wood industries (SSWI) have increased risks of developing asthma and other respiratory diseases. Wood dust and microbial agents have both been suggested to play a role, but few studies have measured endotoxin exposure in SSWI in Africa. We assessed inhalable dust levels in 281 samples from 115 workers and bacterial endotoxins levels in 157 samples from 136 workers from SSWI in Dar es Salaam, Tanzania. The overall geometric mean of personal exposure was 3.3 mg/m(3); geometric standard deviation (GSD) 2.5; range 0.45-67.0 mg/m(3)) and 91 EU/m(3) (GSD 3.7; range 9-4914.8 EU/m(3)) for wood dust and endotoxins, respectively. Dust and endotoxin levels were weakly correlated (r = 0.44, n = 157, P < 0.0001). Between- and within-worker variances and percentages explained by the differences among job titles and seasons were 0.31 (9%) and 0.35 (30%), respectively, for wood dust exposure, and 0.35 (0%) and 0.35 (38%) for endotoxin exposure. Higher dust and endotoxin exposure levels were observed in the dry compared to the wet season, after correcting for differences in exposure between jobs. Carving and manual cleaning were associated with the highest dust exposures. Sewing seat covers and manual cleaning were associated with the highest endotoxin exposures. Dust and endotoxin exposure levels in SSWI are high and appropriate control measures are necessary. PMID:15114366

  18. Effect of multivitamin supplements on weight gain during pregnancy among HIV-negative women in Tanzania.

    PubMed

    Changamire, Freeman T; Mwiru, Ramadhani S; Peterson, Karen E; Msamanga, Gernard I; Spiegelman, Donna; Petraro, Paul; Urassa, Willy; Fawzi, Wafaie W

    2015-07-01

    Multivitamin supplementation has been shown to reduce the risk of low birthweight. This effect could be mediated through gestational weight gain. However, the effect of multivitamin supplementation on weight gain during pregnancy has not been fully studied. The objective of this study was to examine the effects of multivitamins on pregnancy weight gain. We enrolled 8468 HIV-negative women from Dar es Salaam, Tanzania, in a randomised, placebo-controlled trial of multivitamins on birth outcomes. Women were randomly assigned to receive either a daily oral dose of multivitamin tablets or a placebo and were weighed every 4?weeks from enrolment until the last visit before delivery. Intent-to-treat analyses were carried out to examine the effects of multivitamins on pregnancy weight gain. Multivariate linear and binomial regression models with the log-link function were used to examine the association of weight gain during pregnancy to birthweight. The overall total weight gain was 253?g (SE: 69, P: 0.0003) more, while the overall 4?weekly weight gain was 59?g greater (SE: 18, P: 0.005) among women who received multivitamins compared to placebo. Women in the lowest quartile of gestational weight gain had babies with an average birthweight of 3030?g (SD: 524), while women in the highest quartile had babies weighing 3246?g (SD: 486), on average. Prenatal multivitamin supplements increased gestational weight gain, which was a significant predictor of birthweight. PMID:23253638

  19. Published in Habitat International 44 (2014) 358-366 ACCESSING WATER SERVICES IN DAR ES SALAAM: ARE WE COUNTING WHAT

    E-print Network

    2014-01-01

    ' access to reliable and safe water remains a challenge. Current trends show more pronounced deficiencies, the proportion of the population without sustainable access to safe drinking water and basic sanitationPublished in Habitat International 44 (2014) 358-366 1 ACCESSING WATER SERVICES IN DAR ES SALAAM

  20. "Hakuna Matata": Lakeside Literacy in Tanzania.

    ERIC Educational Resources Information Center

    Watson, Alan J.

    This paper begins by telling the story of Edward, a preacher/teacher in Tanzania who, although poor and uneducated himself, managed to teach his parishioners how to read. The paper describes the experience of one man and his wife who spent 4 years at Katoke Teachers College in northwest Tanzania during the early 1970s, after which they returned to…

  1. Geospatial Resource Access Analysis In Hedaru, Tanzania

    NASA Astrophysics Data System (ADS)

    Clark, Dylan G.; Premkumar, Deepak; Mazur, Robert; Kisimbo, Elibariki

    2013-12-01

    Populations around the world are facing increased impacts of anthropogenic-induced environmental changes and rapid population movements. These environmental and social shifts are having an elevated impact on the livelihoods of agriculturalists and pastoralists in developing countries. This appraisal integrates various tools—usually used independently— to gain a comprehensive understanding of the regional livelihood constraints in the rural Hedaru Valley of northeastern Tanzania. Conducted in three villages with different natural resources, using three primary methods: 1) participatory mapping of infrastructures; 2) administration of quantitative, spatially-tied surveys (n=80) and focus groups (n=14) that examined land use, household health, education, and demographics; 3) conducting quantitative time series analysis of Landsat- based Normalized Difference Vegetation Index images. Through various geospatial and multivariate linear regression analyses, significant geospatial trends emerged. This research added to the academic understanding of the region while establishing pathways for climate change adaptation strategies.

  2. Epidemiology and Management of Ocular Surface Squamous Neoplasia in Tanzania

    PubMed Central

    Furahini, Godfrey; Lewallen, Susan

    2013-01-01

    Purpose To estimate the incidence of suspected ocular surface squamous neoplasia (OSSN) by Region in Tanzania and learn where these lesions are treated. Methods We performed an analysis of existing theater records from three Tanzanian referral hospitals from 2006 to 2008 plus a prospective analysis of records from all other eye health workers who remove suspected OSSN outside the referral hospitals over 1 year. Results Approximately 40% of suspected OSSN are operated on outside of referral hospitals. The estimated annual incidence of ocular surface squamous neoplasia in Tanzania was 2.2 per 100,000 persons. Regional incidence rates were significantly correlated with Regional HIV (Human immunodeficiency virus) prevalence (Pearson’s r = 0.53, P = 0.03). Conclusion The incidence rate is high, in line with estimates from other East African countries. Management of these cases requires improvement as most patients are still not tested for HIV. PMID:20455848

  3. Use of coupled dynamic roughing filters and subsurface horizontal flow constructed wetland system as appropriate technology for upgrading waste stabilisation ponds effluents in Tanzania

    NASA Astrophysics Data System (ADS)

    Kimwaga, R. J.; Mashauri, D. A.; Mbwette, T. S. A.; Katima, J. H. Y.; Jørgensen, S. E.

    As a part of a comprehensive evaluation of post-treatment techniques for upgrading waste stabilization pond (WSP) effluents, coupled dynamic roughing filters (DyRF) and subsurface horizontal flow constructed wetland system (HSSFCW) system was evaluated in Tanzania. Coupled DyRF and HSSFCW were considered as cheaper and yet effective and appropriate alternative technology for upgrading WSP effluents in tropical environments like Tanzania. The main objective of the study was to determine the performance treatment of coupled DyRF and HSSFCW for upgrading WSP effluents with respect to organic compounds (TSS and BOD 5) and pathogen (FC). A pilot of coupled DyRF and HSSFCW was constructed at the outlet of the Maturation WSP at the University of Dar es Salaam, Tanzania. The study was carried out in a 2.2 m × 0.7 m × 0.7 m deep DyRF as a first stage, using three different fractions of gravel ranging from 8 mm to 32 mm, from the top to the bottom respectively. In the second stage, a HSSFCW planted with Phragmites Mauritianus with 0.6-m wide, 1.75-m long and 0.6-m deep was used. The DyRF-HSSFCW system achieved TSS load reduction by 89.35%, which is 15.97 g TSS/m 2/day, while BOD 5 load reduction by 84.47% which is 9.29 g BOD 5/m 2/day was achieved. The FC mean removal rate of 99.99% was also achieved. By achieving mean effluent TSS (12.63 ± 4.12 mg/l), BOD 5 (14.12 ± 3.84 mg/l), and mean effluent FC concentrations of 790 FC/100 ml it was concluded that application of coupled DyRF and HSSFCW in the tropics can be considered technically one of the most appropriate technology for upgrading WSP effluents.

  4. Tanzania post-colonial educational system and perspectives on secondary science education, pedagogy, and curriculum: A qualitative study

    NASA Astrophysics Data System (ADS)

    Wandela, Eugenia L.

    The development of technology and innovation in any country depends on a strong investment in science education from the lower to the upper levels of education. In most of the Sub-Saharan African nations, science education curriculum and teaching still faces many issues and problems that are inhibiting the growth of technology and innovation in these nations. In order to address these issues, an interpretive qualitative study that aims to examine how Tanzanian secondary science educators perceive secondary science education was conducted in the summer of 2013. The purpose of this study is to investigate problems and educational issues that might be limiting the growth of science, technology, and innovation in the Tanzanian society. Additionally, this research investigates the impacts of the colonial legacy that relates to language, politics, and economics, as they affect science education in Tanzania secondary schools. This study focuses on the governmental four-year ordinary level secondary science education; it took place in Dar-es-Salaam, Tanzania. The researcher interviewed nine secondary science educators: three secondary science teachers and six secondary science education administrators. The researcher also conducted classroom observations. The data results from both interview and classroom observations were contextualized with data from existing documentation on Tanzanian secondary science education and data from previous research. The emergent themes from the study indicate that most of the problems and issues that are currently facing secondary science education are historically connected to the impact of the colonization period in 19th and 20th centuries. This study suggests that in order to improve science education in Tanzanian society, the people, especially the elites, need to break away from an "Orientalist" mindset and start integrating the Tanzanian culture and science into the still existing Eurocentric science curriculum. In addition, the Tanzanian government needs to invest in industries and economic initiatives that will support strong science education at all levels of education, as well as the graduates produced through this system.

  5. Multi Drug and Other Forms of Drug Resistant Tuberculosis Are Uncommon among Treatment Naïve Tuberculosis Patients in Tanzania

    PubMed Central

    Nagu, Tumaini J.; Aboud, Said; Mwiru, Ramadhani; Matee, Mecky; Fawzi, Wafaie; Mugusi, Ferdinand

    2015-01-01

    Background Surveillance and effective management of drug resistance is important to sustaining tuberculosis (TB) control efforts. We aimed to determine resistance rates to first line anti tuberculosis drugs and to describe factors associated with the resistance to any of the first line anti tuberculosis drugs in Dar es Salaam Tanzania. Materials Newly diagnosed, TB patients with neither history of tuberculosis treatment nor isoniazid prophylaxis were included into the study. Sputum specimens were cultured on either mycobacteria growth indicator tube 960 (MGIT 960) or Lowenstein Jenstein (LJ) medium supplemented with either glycerol (GLJ) or pyruvate (PLJ). Drug susceptibility for isoniazid, rifampicin, streptomycin and ethambutol was determined by either Lowenstein–Jensen (LJ) medium or mycobacteria growth indicator tube 960 (MGIT 960). Results A total of 933 newly diagnosed TB patients, were included into the study. Multi drug resistance (MDR) tuberculosis was detected among 2 (0.2%) patients. Resistance to any of the four tested drugs was detected among 54 (5.8%) patients. Mono-resistance to isoniazid, rifampicin, streptomycin and ethambutol were 21(2.3%), 3 (0.3%), 13 (1.4%), 9 (1.0%) respectively. Conclusion Primary resistance to first line anti tuberculosis drugs is still low in this setting. Continued vigilance including periodic national surveillance of anti-tuberculosis resistance is recommended. PMID:25849784

  6. Pharmacoeconomics and its implication on priority-setting for essential medicines in Tanzania: a systematic review

    PubMed Central

    2012-01-01

    Background Due to escalating treatment costs, pharmacoeconomic analysis has been assigned a key role in the quest for increased efficiency in resource allocation for drug therapies in high-income countries. The extent to which pharmacoeconomic analysis is employed in the same role in low-income countries is less well established. This systematic review identifies and briefly describes pharmacoeconomic studies which have been conducted in Tanzania and further assesses their influence in the selection of essential medicines. Methods Pubmed, Embase, Cinahl and Cochrane databases were searched using “economic evaluation”, “cost-effectiveness analysis”, “cost-benefit analysis” AND “Tanzania” as search terms. We also scanned reference lists and searched in Google to identify other relevant articles. Only articles reporting full economic evaluations about drug therapies and vaccines conducted in Tanzania were included. The national essential medicine list and other relevant policy documents related to the identified articles were screened for information regarding the use of economic evaluation as a criterion for medicine selection. Results Twelve pharmacoeconomic studies which met our inclusion criteria were identified. Seven studies were on HIV/AIDS, malaria and diarrhoea, the three highest ranked diseases on the disease burden in Tanzania. Six studies were on preventive and treatment interventions targeting pregnant women and children under the age of five years. The national essential medicine list and the other identified policy documents do not state the use of economic evaluation as one of the criteria which has influenced the listing of the drugs. Conclusion Country specific pharmacoeconomic analyses are too scarce and inconsistently used to have had a significant influence on the selection of essential medicines in Tanzania. More studies are required to fill the existing gap and to explore whether decision-makers have the ability to interpret and utilise pharmacoeconomic evidence. Relevant health authorities in Tanzania should also consider how to apply pharmacoeconomic analyses more consistently in the future priority-setting decisions for selection of essential medicines. PMID:23016739

  7. Students' Attitudes towards School-Based Sex and Relationships Education in Tanzania

    ERIC Educational Resources Information Center

    Mkumbo, Kitila A. K.

    2014-01-01

    Objective: The objective of this paper was to assess students' attitudes towards school-based sex and relationships education (SRE). Design: This study featured a cross-sectional survey design. Method: A sample of 715 students from two districts in Tanzania completed a survey questionnaire assessing various aspects related to their attitudes…

  8. Teachers' Commitment To, and Experiences of, the Teaching Profession in Tanzania: Findings of Focus Group Research

    ERIC Educational Resources Information Center

    Mkumbo, Kitila A. K.

    2012-01-01

    This qualitative study examined teachers' commitment to, and experiences of, the teaching profession in six regions of Tanzania. The study used focus group discussions as research method and data collection tool. Twenty four groups were conducted, with group membership ranging from five to nine participants. The results show that the teachers'…

  9. HIV-1 drug mutations in children from northern Tanzania

    PubMed Central

    Shao, Elichilia R.; Kifaro, Emmanuel G.; Chilumba, Innocent B.; Nyombi, Balthazar M.; Moyo, Sikhulile; Gaseitsiwe, Simani; Musonda, Rosemary; Johannessen, Asgeir; Kibiki, Gibson; Essex, Max

    2014-01-01

    Objectives In resource-limited settings, it is a challenge to get quality clinical specimens due to poor infrastructure for their collection, transportation, processing and storage. Using dried blood spots (DBS) might be an alternative to plasma for HIV-1 drug resistance testing in this setting. The objectives of this study were to determine mutations associated with antiretroviral resistance among children <18 months old born to HIV-1-infected mothers enrolled in prevention of mother-to-child transmission services in northern Tanzania. Patients and methods Kilimanjaro Christian Medical Center (KCMC) Clinical Laboratory is the zonal centre for early infant diagnosis using DBS in northern Tanzania. DBS were collected from January 2011 to December 2012. Mothers were kept on triple therapy and single-dose nevirapine before pregnancy and during labour, respectively. Infants were given single-dose nevirapine and most of them were breastfed. Genotypic resistance was determined in those with a viral load of >400 copies/mL. Results Genotypic resistance mutations were detected in 13 of 46 children (28%). HIV-1 genotypes were A1 (n?=?27), C (n?=?10), A/D (n?=?4), D (n?=?3) and CRF10_CD (n?=?2). The median age was 12 weeks (IQR 6–28). The mean log10 viral load was 3.87 copies/mL (SD 0.995). All major mutations were detected in the reverse transcriptase gene and none in the protease gene region. The most frequent mutations were Y181C (n?=?8) and K103N (n?=?4), conferring resistance to non-nucleoside reverse transcriptase inhibitors. Conclusions One-third of infants newly diagnosed with HIV in northern Tanzania harboured major drug resistance mutations to currently used antiretroviral regimens. These mutations were detected from DBS collected from the field and stored at room temperature. Surveillance of drug resistance among this population in resource-limited settings is warranted. PMID:24729604

  10. Introduction of Information Science into Library Training in Eastern Africa. Expert Meeting (Dar es Salaam, Tanzania, February 26-29, 1980).

    ERIC Educational Resources Information Center

    Abidi, S. A. H.; Moeller, T.

    In 1978 a team of three people was formed to survey the existing library training facilities in East Africa and to suggest possibilities as to how the elements of information science could be introduced either into existing programs or into special courses organized for the purpose. The team submitted its report to a joint meeting of the…

  11. Fires in Tanzania and Mozambique

    NASA Technical Reports Server (NTRS)

    2002-01-01

    Like many countries, the southeastern African country of Malawi faces the challenge of balancing a growing population's need for food and energy with preservation of natural resources. This MODIS image from November 8, 2001, shows Malawi surrounded by (starting from top and moving clockwise) Tanzania, Mozambique, and northern Zambia. Lake Malawi runs north-south through the eastern part of the country, and is the southern-most of Africa's Great Rift Lakes, a series of deep lakes that run roughly north-south along the Great Rift Valley in eastern Africa, formed when the Earth buckled and then sank after the collision of Africa and Eurasia millions of years ago. Most of the land around the lake and throughout the country has been cleared of its natural vegetation and converted to agricultural land. This causes soil erosion problems and sedimentation in the lake, which affects the sustainability of fishing in the lake. In this image, greenish swirls in the water around the shores could indicate a mixture of sediment and phytoplankton or algae. Deforestation is also a major issue, especially since wood for fuel is the primary source of the country's energy. The difference between the lands protected by parks and preserves stand out dramatically. The largest protected area is halfway down the western border of the country-Kasungu National Park. Several smaller preserves also exist, and where they do, they stand out in green against the paler landscape. Image courtesy Jacques Descloitres, MODIS Land Rapid Response Team at NASA GSFC

  12. Does the use of modern family planning promote healthy timing and spacing of pregnancy in Dar es Salaam?

    PubMed Central

    2013-01-01

    Background Timing, spacing and limiting of pregnancy are key outcomes of family planning (FP) whose role in promoting health of mothers and babies is evidence based. Despite the evidence, recent studies in Tanzania have reported a trend towards child birth in older age, non-adherence to standard inter-pregnancy spacing, and preference of large families in the background of a rising national contraceptive prevalence rate. We explored if the use of modern FP promotes healthy timing and spacing of pregnancy among women seeking antenatal services. Design Analytical Cross-sectional study Methods Women seeking antenatal services at Muhimbili National Hospital, Tanzania (August-October, 2012) were enrolled. We used a semi-structured questionnaire to obtained information from the women. Data were analyzed using SPSS version 19. Outcomes of interest were adherence to timing of first pregnancy and to inter-pregnancy spacing after normal childbirth. Use of modern FP prior to index pregnancy was the independent variable of primary interest. Bivariate and multivariate logistic regression analyses were conducted to obtain odds ratios (OR) and 95% confidence intervals (CI) as estimates risk and clinical importance respectively. Ethical approval was obtained from the Research and Publications Committee at Muhimbili University of Health and Allied Sciences. Results In total 427 women were interviewed. Ages ranged 15–45 years, mean 29.2 (SD ± 5.1). Among all, 129 (30.2%) were primigravida, 298 (69. 8%) multigravida. Of these 298 women, 51 (17.1%) lost pregnancies preceding the index. Overall, 179 (41.9%) had ever used modern FP, 103 (24.1%) were on modern FP just prior to index pregnancy. Non-adherence to timing was increased for primigravida (AOR?=?4.5, 95%?CI: 2.1-9.6) and for women older than 29 years (AOR?=?7.6 95%?CI: 3.8-15.2). Non-adherence to spacing was increased with loss of the immediate past pregnancy (AOR?=?2.5; 95%?CI: 1.3-4.7). Use of modern FP was neither associated with adherence to timing (AOR?=?1.0; 95%?CI: 0.5-1.9) nor spacing (AOR?=?1.0; 95%?CI: 0.6-1.8). Conclusion Modern FP does not promote adherence to timing and spacing of pregnancy among women seeking antenatal services at MNH. Past obstetric experience was key to women’s decisions on spacing. There is need to promote educational messages on timing and spacing of pregnancy for healthy outcomes. PMID:24330466

  13. Practical Use of ICT in Science and Mathematics Teachers' Training at Dar es Salaam University College of Education: An Analysis of Prospective Teachers' Technological Pedagogical Content Knowledge

    ERIC Educational Resources Information Center

    Kafyulilo, Ayoub C.

    2010-01-01

    This study investigated the ways through which pre-service science and mathematics teachers at Dar es Salaam University College of Education (DUCE) can acquire competencies for integrating technology pedagogy and content in teaching. Specifically the study investigated the preservice teachers' ICT integration competencies; practices that can be…

  14. Curriculum Unit: Kenya and Tanzania, Tourist Economies.

    ERIC Educational Resources Information Center

    Lynn, Karen

    This curriculum guide is designed to enable teachers and ninth grade students to develop a clearer understanding of the countries of Kenya and Tanzania and the economic needs of their citizens. A pretest-posttest examination with 20 true or false questions, 2 essay questions, and a list of 50 vocabulary words is provided. Brief descriptions of the…

  15. Invasive Disease Caused by Nontuberculous Mycobacteria, Tanzania

    PubMed Central

    van Ingen, Jakko; Morrissey, Anne B.; Boeree, Martin J.; Mavura, Daudi R.; Swai, Britta; Thielman, Nathan M.; Bartlett, John A.; Grossman, Henning; Maro, Venance P.; van Soolingen, Dick

    2009-01-01

    Data on nontuberculous mycobacterial (NTM) disease in sub-Saharan Africa are limited. During 2006–2008, we identified 3 HIV-infected patients in northern Tanzania who had invasive NTM; 2 were infected with “Mycobacterium sherrisii” and 1 with M. avium complex sequevar MAC-D. Invasive NTM disease is present in HIV-infected patients in sub-Saharan Africa. PMID:19116050

  16. Evolution of Elections Management in Tanzania

    ERIC Educational Resources Information Center

    Norman, A. S.; Mdegella, O. M.; Lubawa, R. M.

    2011-01-01

    This paper provides a discussion on the evolution of elections management in Tanzania with a focus on technological advancement in administering registration of voters. The paper provides the merits that permanent voters register has brought over the thumb practice. It traces the management of elections during colonialism, after independence…

  17. High Malaria Prevalence among Schoolchildren on Kome Island, Tanzania.

    PubMed

    Kim, Min-Jae; Jung, Bong-Kwang; Chai, Jong-Yil; Eom, Keeseon S; Yong, Tai-Soon; Min, Duk-Young; Siza, Julius E; Kaatano, Godfrey M; Kuboza, Josephat; Mnyeshi, Peter; Changalucha, John M; Ko, Yunsuk; Chang, Su Young; Rim, Han-Jong

    2015-10-01

    In order to determine the status of malaria among schoolchildren on Kome Island (Lake Victoria), near Mwanza, Tanzania, a total of 244 schoolchildren in 10 primary schools were subjected to a blood survey using the fingerprick method. The subjected schoolchildren were 123 boys and 121 girls who were 6-8 years of age. Only 1 blood smear was prepared for each child. The overall prevalence of malaria was 38.1% (93 positives), and sex difference was not remarkable. However, the positive rate was the highest in Izindabo Primary School (51.4%) followed by Isenyi Primary School (48.3%) and Bugoro Primary School (46.7%). The lowest prevalence was found in Muungano Primary School (16.7%) and Nyamiswi Primary School (16.7%). These differences were highly correlated with the location of the school on the Island; those located in the peripheral area revealed higher prevalences while those located in the central area showed lower prevalences. Plasmodium falciparum was the predominant species (38.1%; 93/244), with a small proportion of them mixed-infected with Plasmodium vivax (1.6%; 4/244). The results revealed that malaria is highly prevalent among primary schoolchildren on Kome Island, Tanzania, and there is an urgent need to control malaria in this area. PMID:26537036

  18. High Malaria Prevalence among Schoolchildren on Kome Island, Tanzania

    PubMed Central

    Kim, Min-Jae; Jung, Bong-Kwang; Chai, Jong-Yil; Eom, Keeseon S.; Yong, Tai-Soon; Min, Duk-Young; Siza, Julius E.; Kaatano, Godfrey M.; Kuboza, Josephat; Mnyeshi, Peter; Changalucha, John M.; Ko, Yunsuk; Chang, Su Young; Rim, Han-Jong

    2015-01-01

    In order to determine the status of malaria among schoolchildren on Kome Island (Lake Victoria), near Mwanza, Tanzania, a total of 244 schoolchildren in 10 primary schools were subjected to a blood survey using the fingerprick method. The subjected schoolchildren were 123 boys and 121 girls who were 6-8 years of age. Only 1 blood smear was prepared for each child. The overall prevalence of malaria was 38.1% (93 positives), and sex difference was not remarkable. However, the positive rate was the highest in Izindabo Primary School (51.4%) followed by Isenyi Primary School (48.3%) and Bugoro Primary School (46.7%). The lowest prevalence was found in Muungano Primary School (16.7%) and Nyamiswi Primary School (16.7%). These differences were highly correlated with the location of the school on the Island; those located in the peripheral area revealed higher prevalences while those located in the central area showed lower prevalences. Plasmodium falciparum was the predominant species (38.1%; 93/244), with a small proportion of them mixed-infected with Plasmodium vivax (1.6%; 4/244). The results revealed that malaria is highly prevalent among primary schoolchildren on Kome Island, Tanzania, and there is an urgent need to control malaria in this area. PMID:26537036

  19. Hydrogeochemical features of Lake Ngozi (SW Tanzania)

    NASA Astrophysics Data System (ADS)

    Delalande-Le Mouëllic, Manuëlla; Gherardi, Fabrizio; Williamson, David; Kajula, Stephen; Kraml, Michael; Noret, Aurélie; Abdallah, Issah; Mwandapile, Ezekiel; Massault, Marc; Majule, Amos; Bergonzini, Laurent

    2015-03-01

    Located on the triple rift junction hosting the Karonga-Usungu depression in Tanzania, Lake Ngozi is the second largest crater lake of the East African Rift. The lake has a number of peculiar features: it has a near constant water level, no permanent surface inlets and outlets, it is vertically well-mixed, with homogeneous distribution of temperature and chemical composition, and it is characterised by near neutral to slightly acid Na-Cl waters of comparatively high salinity and high P-CO2. Based on the different chemical signature of surface and ground waters (low-Cl type) from lake waters, mass balance methods have been applied to investigate lake dynamics. Water enters the lake mainly by precipitation and groundwater inflow, and leaves by groundwater outflow and evaporation. A large groundwater outflow of 2.4 m yr-1 has been estimated. The high salinity, Na-Cl signature of Lake Ngozi waters, together with 3He/4He ratios measured on dissolved gases (between 7 and 8.3 Ra) and high-PCO2 values estimated all along the water vertical column indicate the inflow of deep-seated fluids, likely magmatic in origin, into the lake. The existence of a hydrothermal system possibly at 250 °C in the root of the volcanic edifice is also hypothesised on the basis of solute geothermometry. Despite the current lack of vertical stratification, the lake is suspected to act as condenser for CO2 and other gases of deep magmatic origin, and should be then further monitored for the risk of limnic eruptions as well as for environmental and climatic concerns.

  20. A SWOT Analysis of the Integration of E-Learning at a University in Uganda and a University in Tanzania

    ERIC Educational Resources Information Center

    Zhu, Chang; Justice Mugenyi, Kintu

    2015-01-01

    This research examines the strengths, weaknesses, opportunities and threats (SWOT) to integrating e-learning perceived by academic staff at a university in Uganda and a university in Tanzania. Mixed-methods research was used in which a main qualitative study was complemented by a quantitative method. The sample participants were academic staff…

  1. Angiogenic and inflammatory biomarkers in mid-pregnancy and small-for-gestational age outcomes in Tanzania

    PubMed Central

    DARLING, Anne Marie; MCDONALD, Chloe R.; CONROY, Andrea L.; HAYFORD, Kyla T.; RAJWANS, Nimerta; WANG, Molin; ABOUD, Said; URASSA, Willy S.; KAIN, Kevin C.; FAWZI, Wafaie W.

    2014-01-01

    OBJECTIVE To investigate the relationship between a panel of angiogenic and inflammatory biomarkers measured in mid-pregnancy and small-for-gestational age (SGA) outcomes in sub-Saharan Africa. STUDY DESIGN Concentrations of 18 angiogenic and inflammatory biomarkers were determined in 432 pregnant women in Dar es Salaam, Tanzania who participated in a trial examining the effect of multivitamins on pregnancy outcomes. Infants falling below the 10th percentile of birth weight for gestational age relative to the applied growth standards were considered SGA. Multivariate binomial regression models with the log link function were used to determine the relative risk of SGA associated with increasing quartiles of each biomarker. Stepwise cubic restricted splines were used to test for non-linearity of these associations. Receiver operating curves obtained from multivariate logistic regression models were used to assess the discriminatory capability of selected biomarkers. RESULTS A total of 60 participants (13.9%) gave birth to SGA infants. Compared to those in the first quartile, the risk of SGA was reduced among those in the fourth quartiles of VEGF-A (adjusted risk ratio (RR) 0.38, 95% Confidence Interval (CI), 0.19-0.74), PGF (adjusted RR 0.28, 95% CI, 0.12-0.61), sFlt-1 (adjusted RR 0.48, 95% CI, 0.23-1.01), MCP-1 (adjusted RR 0.48, 95% CI, 0.25-0.92), and Leptin (adjusted RR 0.46, 95% CI, 0.22-0.96) CONCLUSION Our findings provide evidence of altered angiogenic and inflammatory mediators, at mid-pregnancy, in women who went on to deliver small for gestational age infants. PMID:24881826

  2. A review of pig pathology in Tanzania.

    PubMed

    Wilson, Richard Trevor; Swai, Emmanuel

    2013-08-01

    The approximately 1.58 million pigs in Tanzania represent 3.7% of the national population of quadruped meat-producing animals. Pigs are kept mainly by small producers who own 99.5% of the national stock in units that average 3.04 animals (range 2-48). Government policy has had little practical application. African swine fever, foot-and-mouth disease and Cysticercosis are important diseases. The first two are notifiable diseases under Tanzania legislation; the last has widespread distribution and relevance as a major zoonosis. Ascariasis (Ascaris suum), hydatidosis (Echinococcus granulosus), leptospirosis (Leptospira interrogans) and thermophilic Campylobacter are other zoonoses associated with pigs. Gastrointestinal helminths and external parasites, especially Sarcoptes scabiei, are common. Risk factors associated with cysticercosis for humans working with pigs or eating their meat include the free-range or semi-confined management systems, the use of rivers or ponds as a source of water, lack of household sanitation, informal home slaughter, pork not being inspected at slaughter slabs and undercooked and barbecued meat. Pigs are a minor component of Tanzania's livestock sector but there is potential for increasing their contribution to human welfare. Prospects are enhanced by the shorter life cycle, greater number of young produced per year and the possibility of producing high-quality animal protein at a lower cost than meat produced by cattle and small ruminants. PMID:23733144

  3. Science Education in Tanzania: Challenges and Policy Responses

    ERIC Educational Resources Information Center

    Semali, Ladislaus M.; Mehta, Khanjan

    2012-01-01

    Students in rural and urban areas in Tanzania, and elsewhere in Africa, continue to have limited or lack access to culturally and employment-relevant science education. The current case study, a 2007-2009 examination of barriers to the reform movement of science education in Tanzania, uses data from interviews, classroom observations, document…

  4. District health managers’ perceptions of supervision in Malawi and Tanzania

    PubMed Central

    2013-01-01

    Background Mid-level cadres are being used to address human resource shortages in many African contexts, but insufficient and ineffective human resource management is compromising their performance. Supervision plays a key role in performance and motivation, but is frequently characterised by periodic inspection and control, rather than support and feedback to improve performance. This paper explores the perceptions of district health management teams in Tanzania and Malawi on their role as supervisors and on the challenges to effective supervision at the district level. Methods This qualitative study took place as part of a broader project, “Health Systems Strengthening for Equity: The Power and Potential of Mid-Level Providers”. Semi-structured interviews were conducted with 20 district health management team personnel in Malawi and 37 council health team members in Tanzania. The interviews covered a range of human resource management issues, including supervision and performance assessment, staff job descriptions and roles, motivation and working conditions. Results Participants displayed varying attitudes to the nature and purpose of the supervision process. Much of the discourse in Malawi centred on inspection and control, while interviewees in Tanzania were more likely to articulate a paradigm characterised by support and improvement. In both countries, facility level performance metrics dominated. The lack of competency-based indicators or clear standards to assess individual health worker performance were considered problematic. Shortages of staff, at both district and facility level, were described as a major impediment to carrying out regular supervisory visits. Other challenges included conflicting and multiple responsibilities of district health team staff and financial constraints. Conclusion Supervision is a central component of effective human resource management. Policy level attention is crucial to ensure a systematic, structured process that is based on common understandings of the role and purpose of supervision. This is particularly important in a context where the majority of staff are mid-level cadres for whom regulation and guidelines may not be as formalised or well-developed as for traditional cadres, such as registered nurses and medical doctors. Supervision needs to be adequately resourced and supported in order to improve performance and retention at the district level. PMID:24007354

  5. Scale reliability and construct validity: a pilot study among primary school children in Northern Tanzania.

    PubMed

    Seha, A M; Klepp, K I; Ndeki, S S

    1994-12-01

    Based on the World Health Organization's standardized survey inventories assessing AIDS-related knowledge, attitudes, beliefs, and practices (KABP) for adolescents, a written questionnaire was developed and pilot tested among primary school children in Northern Tanzania. Subjects included 472 fifth and sixth graders at four schools in Arusha and Kilimanjaro regions. Results indicated that the large majority of the students understood the questions and were able and willing to complete the survey. Non-response patterns did not seem to be related to the sensitivity of included questions. AIDS-related knowledge and attitudes toward engaging in sexual behavior had acceptable reliability and construct validity when compared with similar surveys in Western countries, while perceived social norms and self-efficacy need further development. KABP questionnaires may serve as a useful method in AIDS-related surveys and evaluation studies among school children in Tanzania if survey instruments are adapted to reflect the local social and cultural context. PMID:7702963

  6. Economic cost of primary prevention of cardiovascular diseases in Tanzania

    PubMed Central

    Ngalesoni, Frida; Ruhago, George; Norheim, Ole F; Robberstad, Bjarne

    2015-01-01

    Tanzania is facing a double burden of disease, with non-communicable diseases being an increasingly important contributor. Evidence-based preventive measures are important to limit the growing financial burden. This article aims to estimate the cost of providing medical primary prevention interventions for cardiovascular disease (CVD) among at-risk patients, reflecting actual resource use and if the World Health Organization (WHO)’s CVD medical preventive guidelines are implemented in Tanzania. In addition, we estimate and explore the cost to patients of receiving these services. Cost data were collected in four health facilities located in both urban and rural settings. Providers’ costs were identified and measured using ingredients approach to costing and resource valuation followed the opportunity cost method. Unit costs were estimated using activity-based and step-down costing methodologies. The patient costs were obtained through a structured questionnaire. The unit cost of providing CVD medical primary prevention services ranged from US$30–41 to US$52–71 per patient per year at the health centre and hospital levels, respectively. Employing the WHO’s absolute risk approach guidelines will substantially increase these costs. The annual patient cost of receiving these services as currently practised was estimated to be US$118 and US$127 for urban and rural patients, respectively. Providers’ costs were estimated from two main viewpoints: ‘what is’, that is the current practice, and ‘what if’, reflecting a WHO guidelines scenario. The higher cost of implementing the WHO guidelines suggests the need for further evaluation of whether these added costs are reasonable relative to the added benefits. We also found considerably higher patient costs, implying that distributive and equity implications of access to care require more consideration. Facility location surfaced as the main explanatory variable for both direct and indirect patient costs in the regression analysis; further research on the influence of other provider characteristics on these costs is important. PMID:25113027

  7. Economic cost of primary prevention of cardiovascular diseases in Tanzania.

    PubMed

    Ngalesoni, Frida; Ruhago, George; Norheim, Ole F; Robberstad, Bjarne

    2015-09-01

    Tanzania is facing a double burden of disease, with non-communicable diseases being an increasingly important contributor. Evidence-based preventive measures are important to limit the growing financial burden. This article aims to estimate the cost of providing medical primary prevention interventions for cardiovascular disease (CVD) among at-risk patients, reflecting actual resource use and if the World Health Organization (WHO)'s CVD medical preventive guidelines are implemented in Tanzania. In addition, we estimate and explore the cost to patients of receiving these services. Cost data were collected in four health facilities located in both urban and rural settings. Providers' costs were identified and measured using ingredients approach to costing and resource valuation followed the opportunity cost method. Unit costs were estimated using activity-based and step-down costing methodologies. The patient costs were obtained through a structured questionnaire. The unit cost of providing CVD medical primary prevention services ranged from US$30-41 to US$52-71 per patient per year at the health centre and hospital levels, respectively. Employing the WHO's absolute risk approach guidelines will substantially increase these costs. The annual patient cost of receiving these services as currently practised was estimated to be US$118 and US$127 for urban and rural patients, respectively. Providers' costs were estimated from two main viewpoints: 'what is', that is the current practice, and 'what if', reflecting a WHO guidelines scenario. The higher cost of implementing the WHO guidelines suggests the need for further evaluation of whether these added costs are reasonable relative to the added benefits. We also found considerably higher patient costs, implying that distributive and equity implications of access to care require more consideration. Facility location surfaced as the main explanatory variable for both direct and indirect patient costs in the regression analysis; further research on the influence of other provider characteristics on these costs is important. PMID:25113027

  8. Voluntary Medical Male Circumcision (VMMC) in Tanzania and Zimbabwe: Service Delivery Intensity and Modality and Their Influence on the Age of Clients

    PubMed Central

    Ashengo, Tigistu Adamu; Hatzold, Karin; Mahler, Hally; Rock, Amelia; Kanagat, Natasha; Magalona, Sophia; Curran, Kelly; Christensen, Alice; Castor, Delivette; Mugurungi, Owen; Dhlamini, Roy; Xaba, Sinokuthemba; Njeuhmeli, Emmanuel

    2014-01-01

    Background Scaling up voluntary medical male circumcision (VMMC) to 80% of men aged 15–49 within five years could avert 3.4 million new HIV infections in Eastern and Southern Africa by 2025. Since 2009, Tanzania and Zimbabwe have rapidly expanded VMMC services through different delivery (fixed, outreach or mobile) and intensity (routine services, campaign) models. This review describes the modality and intensity of VMMC services and its influence on the number and age of clients. Methods and Findings Program reviews were conducted using data from implementing partners in Tanzania (MCHIP) and Zimbabwe (PSI). Key informant interviews (N?=?13 Tanzania; N?=?8 Zimbabwe) were conducted; transcripts were analyzed using Nvivo. Routine VMMC service data for May 2009–December 2012 were analyzed and presented in frequency tables. A descriptive analysis and association was performed using the z-ratio for the significance of the difference. Key informants in both Tanzania and Zimbabwe believe VMMC scale-up can be achieved by using a mix of service delivery modality and intensity approaches. In Tanzania, the majority of clients served during campaigns (59%) were aged 10–14 years while the majority during routine service delivery (64%) were above 15 (p<0.0001). In Zimbabwe, significantly more VMMCs were done during campaigns (64%) than during routine service delivery (36%) (p<0.00001); the difference in the age of clients accessing services in campaign versus non-campaign settings was significant for age groups 10–24 (p<0.05), but not for older groups. Conclusions In Tanzania and Zimbabwe, service delivery modalities and intensities affect client profiles in conjunction with other contextual factors such as implementing campaigns during school holidays in Zimbabwe and cultural preference for circumcision at a young age in Tanzania. Formative research needs to be an integral part of VMMC programs to guide the design of service delivery modalities in the face of, or lack of, strong social norms. PMID:24801882

  9. Community perceptions of rape and child sexual abuse: a qualitative study in rural Tanzania

    PubMed Central

    2014-01-01

    Background Rape of women and children is recognized as a health and human rights issue in Tanzania and internationally. Exploration of the prevailing perceptions in rural areas is needed in order to expand the understanding of sexual violence in the diversity of Tanzania’s contexts. The aim of this study therefore was to explore and understand perceptions of rape of women and children at the community level in a rural district in Tanzania with the added objective of exploring those perceptions that may contribute to perpetuating and/or hindering the disclosure of rape incidences. Methods A qualitative design was employed using focus group discussions with male and female community members including religious leaders, professionals, and other community members. The discussions centered on causes of rape, survivors of rape, help-seeking and reporting, and gathered suggestions on measures for improvement. Six focus group discussions (four of single gender and two of mixed gender) were conducted. The focus group discussions were recorded, transcribed verbatim, and analyzed using manifest qualitative content analysis. Results The participants perceived rape of women and children to be a frequent and hidden phenomenon. A number of factors were singled out as contributing to rape, such as erosion of social norms, globalization, poverty, vulnerability of children, alcohol/drug abuse and poor parental care. Participants perceived the need for educating the community to raise their knowledge of sexual violence and its consequences, and their roles as preventive agents. Conclusions In this rural context, social norms reinforce sexual violence against women and children, and hinder them from seeking help from support services. Addressing the identified challenges may promote help-seeking behavior and improve care of survivors of sexual violence, while changes in social and cultural norms are needed for the prevention of sexual violence. PMID:25132543

  10. The make or buy debate: Considering the limitations of domestic production in Tanzania

    PubMed Central

    2012-01-01

    Background In order to ensure their population’s regular access to essential medicines, many least developed countries and developing countries are faced with the policy question of whether to import or manufacture drugs locally, in particular for life-saving antiretroviral medicines for HIV/AIDS patients. In order for domestic manufacturing to be viable and cost-effective, the local industry must be able to compete with international suppliers of medicines by producing sufficiently low cost ARVs. Methods This paper considers the ‘make-or-buy’ dilemma by using Tanzania as a case study. Key informant interviews, event-driven observation, and purposive sampling of documents were used to evaluate the case study. The case study focused on Tanzania’s imitation technology transfer agreement to locally manufacture a first-line ARV (3TC?+?d4T?+?NVP), reverse engineering the ARV. Results Tanzania is limited by weak political support for the use of TRIPS flexibilities, limited production capacity for ARVs and limited competitiveness in both domestic and regional markets. The Ministry of Health and Social Welfare encourages the use of flexibilities while others push for increased IP protection. Insufficient production capacity and lack of access to donor-financed tenders make it difficult to obtain economies of scale and provide competitive prices. Conclusions Within the “make-or-buy” context, it was determined that there are significant limitations in domestic manufacturing for developing countries. The case study highlights the difficulty of governments to make use of economies of scale and produce low-cost medicines, attract technology transfer, and utilize the flexibilities of the WTO Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). The results demonstrate the importance of evaluating barriers to the use of TRIPS flexibilities and long-term planning across sectors in future technology transfer and manufacturing initiatives. PMID:22747578

  11. Outcome of Different Nevirapine Administration Strategies in Preventing Mother-to-Child Transmission (PMTCT) Programs in Tanzania and Uganda

    PubMed Central

    Karcher, Heiko; Kunz, Andrea; Poggensee, Gabriele; Mbezi, Paulina; Mugenyi, Kizito; Harms, Gundel

    2006-01-01

    Objective Prevention-of-mother-to-child transmission (PMTCT) interventions based on single-dose nevirapine (NVP) are widely implemented in Africa, but strategies differ regarding how and when to administer the drug to women and infants. The aim of this study was to analyze the outcome of different strategies with regard to NVP intake in pregnant women and their infants in Tanzania and Uganda. Methods In an observational study carried out between March 2002 and December 2004, we compared a directly observed NVP administration strategy in Tanzania (supervised NVP intake for women and infants at a health unit) and a semi-observed administration strategy (self-administered NVP for women at home and supervised intake for infants at a health unit) in Uganda. Results The proportions of HIV-positive women accepting receipt of NVP from the health units were similar in the 2 countries (42.4% in Tanzania vs 45.6% in Uganda; P = .06). NVP intake in infants was significantly higher in Tanzania than in Uganda (43.7% vs 24.1%; P < .001). In a multivariate analysis, maternal age above 25 years, secondary education, Catholic faith, and having undergone PMTCT counseling at a hospital were independently associated with infant NVP intake. Conclusion In our settings, the directly observed administration strategy resulted in a higher NVP intake in infants. The semi-observed strategy, which implies that, after home delivery, the infant has to be presented to a health unit for NVP administration, was less successful. PMID:16926751

  12. Burden of serious fungal infections in Tanzania.

    PubMed

    Faini, Diana; Maokola, Werner; Furrer, Hansjakob; Hatz, Christoph; Battegay, Manuel; Tanner, Marcel; Denning, David W; Letang, Emilio

    2015-10-01

    The incidence and prevalence of fungal infections in Tanzania remains unknown. We assessed the annual burden in the general population and among populations at risk. Data were extracted from 2012 reports of the Tanzanian AIDS program, WHO, reports, Tanzanian census, and from a comprehensive PubMed search. We used modelling and HIV data to estimate the burdens of Pneumocystis jirovecii pneumonia (PCP), cryptococcal meningitis (CM) and candidiasis. Asthma, chronic obstructive pulmonary disease and tuberculosis data were used to estimate the burden of allergic bronchopulmonary aspergillosis (ABPA) and chronic pulmonary aspergillosis (CPA). Burdens of candidaemia and Candida peritonitis were derived from critical care and/or cancer patients' data. In 2012, Tanzania's population was 43.6 million (mainland) with 1 500 000 people reported to be HIV-infected. Estimated burden of fungal infections was: 4412 CM, 9600 PCP, 81 051 and 88 509 oral and oesophageal candidiasis cases respectively. There were 10 437 estimated posttuberculosis CPA cases, whereas candidaemia and Candida peritonitis cases were 2181 and 327 respectively. No reliable data exist on blastomycosis, mucormycosis or fungal keratitis. Over 3% of Tanzanians suffer from serious fungal infections annually, mostly related to HIV. Cryptococcosis and PCP are major causes of mycoses-related deaths. National surveillance of fungal infections is urgently needed. PMID:26449510

  13. ART IN TANZANIA INTERNHIP/WORK STUDY PROGRAMS

    E-print Network

    on working in the surrounding schools and areas. · Our focuses include and internships to empower our work in Tanzania. For questions on immigration as well as international documentaries. We offer various mentoring and learning

  14. Epilepsy following non-missile head injury among African people in Dar es Salaam: a retrospective clinical analysis study.

    PubMed

    Matuja, W B

    1990-06-01

    Over a period of 2 years, 26 subjects with epilepsy following non-missile head injury were referred to the neurology clinic at Muhimbili Medical Centre, Dar es Salaam. The mean age was 28.5 yr. Twenty of these subjects were males. Sixteen (62%) were victims of road traffic accidents, six (23%) had direct blows of the head and four (15%) had fallen from heights. The first late seizure occurred 2 weeks after injury in all subjects. Fifty-eight per cent had the first late seizure between the third and seventh month after injury. Only 8% had the first seizure after 1 year of injury. Posttraumatic amnesia of over 24 h was the commonest recorded complication and occurred in 58% of subjects. Other complications were: depressed fracture (31%), acute intracranial haematoma (27%) and early seizures (12%). Twenty per cent of subjects had no complications. The role of the head injury complications as a factor in increasing the risk of late epilepsy as well as individual susceptibility to seizures is discussed. PMID:2115733

  15. 78 FR 5555 - Culturally Significant Objects Imported for Exhibition Determinations: “SHANGAA, Art of Tanzania

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-25

    ...DEPARTMENT OF STATE [Public Notice 8162...Determinations: ``SHANGAA, Art of Tanzania'' SUMMARY...exhibition ``SHANGAA, Art of Tanzania,'' imported...exhibition within the United States, are of cultural significance...exhibit objects at QCC Art Gallery,...

  16. Spatial and Temporal Pattern of Rift Valley Fever Outbreaks in Tanzania; 1930 to 2007

    PubMed Central

    Sindato, Calvin; Karimuribo, Esron D.; Pfeiffer, Dirk U.; Mboera, Leonard E. G.; Kivaria, Fredrick; Dautu, George; Bernard, Bett; Paweska, Janusz T.

    2014-01-01

    Background Rift Valley fever (RVF)-like disease was first reported in Tanzania more than eight decades ago and the last large outbreak of the disease occurred in 2006–07. This study investigates the spatial and temporal pattern of RVF outbreaks in Tanzania over the past 80 years in order to guide prevention and control strategies. Materials and Methods A retrospective study was carried out based on disease reporting data from Tanzania at district or village level. The data were sourced from the Ministries responsible for livestock and human health, Tanzania Meteorological Agency and research institutions involved in RVF surveillance and diagnosis. The spatial distribution of outbreaks was mapped using ArcGIS 10. The space-time permutation model was applied to identify clusters of cases, and a multivariable logistic regression model was used to identify risk factors associated with the occurrence of outbreaks in the district. Principal Findings RVF outbreaks were reported between December and June in 1930, 1947, 1957, 1960, 1963, 1968, 1977–79, 1989, 1997–98 and 2006–07 in 39.2% of the districts in Tanzania. There was statistically significant spatio-temporal clustering of outbreaks. RVF occurrence was associated with the eastern Rift Valley ecosystem (OR?=?6.14, CI: 1.96, 19.28), total amount of rainfall of >405.4 mm (OR?=?12.36, CI: 3.06, 49.88), soil texture (clay [OR?=?8.76, CI: 2.52, 30.50], and loam [OR?=?8.79, CI: 2.04, 37.82]). Conclusion/Significance RVF outbreaks were found to be distributed heterogeneously and transmission dynamics appeared to vary between areas. The sequence of outbreak waves, continuously cover more parts of the country. Whenever infection has been introduced into an area, it is likely to be involved in future outbreaks. The cases were more likely to be reported from the eastern Rift Valley than from the western Rift Valley ecosystem and from areas with clay and loam rather than sandy soil texture. PMID:24586433

  17. Islands and Stepping-Stones: Comparative Population Structure of Anopheles gambiae sensu stricto and Anopheles arabiensis in Tanzania and Implications for the Spread of Insecticide Resistance

    PubMed Central

    Maliti, Deodatus; Ranson, Hilary; Magesa, Stephen; Kisinza, William; Mcha, Juma; Haji, Khamis; Killeen, Gerald; Weetman, David

    2014-01-01

    Population genetic structures of the two major malaria vectors Anopheles gambiae s.s. and An. arabiensis, differ markedly across Sub-Saharan Africa, which could reflect differences in historical demographies or in contemporary gene flow. Elucidation of the degree and cause of population structure is important for predicting the spread of genetic traits such as insecticide resistance genes or artificially engineered genes. Here the population genetics of An. gambiae s.s. and An. arabiensis in the central, eastern and island regions of Tanzania were compared. Microsatellite markers were screened in 33 collections of female An. gambiae s.l., originating from 22 geographical locations, four of which were sampled in two or three years between 2008 and 2010. An. gambiae were sampled from six sites, An. arabiensis from 14 sites, and both species from two sites, with an additional colonised insectary sample of each species. Frequencies of the knock-down resistance (kdr) alleles 1014S and 1014F were also determined. An. gambiae exhibited relatively high genetic differentiation (average pairwise FST?=?0.131), significant even between nearby samples, but without clear geographical patterning. In contrast, An. arabiensis exhibited limited differentiation (average FST?=?0.015), but strong isolation-by-distance (Mantel test r?=?0.46, p?=?0.0008). Most time-series samples of An. arabiensis were homogeneous, suggesting general temporal stability of the genetic structure. An. gambiae populations from Dar es Salaam and Bagamoyo were found to have high frequencies of kdr 1014S (around 70%), with almost 50% homozygote but was at much lower frequency on Unguja Island, with no. An. gambiae population genetic differentiation was consistent with an island model of genetic structuring with highly restricted gene flow, contrary to An. arabiensis which was consistent with a stepping-stone model of extensive, but geographically-restricted gene flow. PMID:25353688

  18. Spectroscopy of red dravite from northern Tanzania

    NASA Astrophysics Data System (ADS)

    Taran, Michail N.; Dyar, M. Darby; Naumenko, Ievgen V.; Vyshnevsky, Olexij A.

    2015-07-01

    Low-Fe dravite with a formula of Na0.66Ca0.16Mg2.62Fe0.33Mn0.02Ti0.02Al5.95B3Si6.04O27(OH)4 is described from Engusero Sambu, northern Tanzania (On maps, Engusero Sambu may be found to be marked as belonging to Kenya, but in reality, it is located near the border in northern Tanzania). The sample has an unusual red color that is distinctly different from the red dravite from the Osarara, Narok district, in Kenya that was formerly studied by Mattson and Rossman (Phys Chem Miner 14:225-234, 1984) and Taran and Rossman (Am Mineral 87:1148-1153, 2002). This unique sample has been characterized by optical and Mössbauer spectral measurements to investigate underlying cause of the intense bands in absorption spectra that give rise to the red color. These features are shown to be caused by exchange-coupled Fe3+-Fe3+ interactions. Thermal annealing of the samples causes an increase in Fe3+ contents due to oxidation of [Y]Fe2+. However, heat treatment does not change the high-energy absorption edge, which is probably caused by intense ligand-to-Fe3+ charge-transfer UV bands. In fact, Mössbauer results show that high-temperature annealing initiates breakdown of the tourmaline into an Fe oxide and causes accompanying redistribution of Fe3+ within the structure. Because of the popularity of tourmaline as a gemstone, this work has implications for understanding the causes of color in tourmaline, facilitating recognition of the distinctions between naturally occurring and treated tourmalines in the gem industry and enabling heat treatments for color enhancement.

  19. Barriers to Sustaining Antiretroviral Treatment in Kisesa, Tanzania

    PubMed Central

    Roura, Maria; Busza, Joanna; Wringe, Alison; Mbata, Doris; Urassa, Mark; Zaba, Basia

    2009-01-01

    Two years after the introduction of free antiretroviral therapy (ART) in Tanzania and in spite of the logistical support provided to facilitate clinic attendance, a considerable level of attrition from the program was identified among clients from a semi-rural ward. Qualitative research on ART patients’ health-seeking behavior identified factors affecting sustained attendance at treatment clinics. A mix of methods was used for data collection including semi-structured interviews with 42 clients and 11 service providers and 4 participatory group activities conducted with members of a post-test group between October and December 2006. A socio-ecological framework guided data analysis to categorize facilitators and barriers into individual, social, programmatic, and structural level influences, and subsequently explored their interaction and relative significance in shaping ART clients’ behavior. Our findings suggest that personal motivation and self-efficacy contribute to program retention, and are affected by other individual-level experiences such as perceived health benefits or disease severity. However, these determinants are influenced by others’ opinions and beliefs in the community, and constrained by programmatic and structural barriers. Individuals can develop the requisite willingness to sustain strict treatment requirements in a challenging context, but are more likely to do so within supportive family and community environments. Effectiveness and sustainability of ART roll-out could be strengthened by strategic intervention at different levels, with particular attention to community-level factors such as social networks’ influence and support. PMID:19866538

  20. Calf health and management in smallholder dairy farms in Tanzania.

    PubMed

    Chang'a, Jelly S; Mdegela, Robinson H; Ryoba, Ruth; Løken, Torleiv; Reksen, Olav

    2010-12-01

    Smallholder farmers' knowledge and practice of dairy calf management on 129 farms with calves less than 10 months of age in Southeastern and Southern Highland areas of Tanzania was assessed. The method of study included both a farm visit and completion of a questionnaire. Most of the farmers were female, with a primary level of education, and majority kept 1-3 milking cows that yielded 6-10 l milk/cow/day. Most of the calves were fed milk using a residual calf suckling system. Weaning age was 3-8 months. Overall, the body condition of the calves was poor, ranged from 1 to 2.5 with a mode of 2. The majority of the farmers believed that helminthosis was the most common disease condition affecting the calves; diarrhea was ranked as the second. Calf death was reported by 20% of the farmers to have occurred in their herd lasting the 2 years prior to the study. Calf body condition score was related to body weight for calves younger than 9 weeks, and older than 23 weeks of age, whereas no such relationship existed in the age group 9 to 23 weeks. The sex distribution was skewed with less male calves being older than 23 weeks. We hypothesize that male calves experience inferior management compared with female calves. This study demonstrates a low level of knowledge on, and poor practices of calf management among the surveyed farmers that suggest the need for educational intervention. PMID:20577807

  1. Antimicrobial Resistance and Genotypic Diversity of Campylobacter Isolated from Pigs, Dairy, and Beef Cattle in Tanzania

    PubMed Central

    Kashoma, Isaac P.; Kassem, Issmat I.; Kumar, Anand; Kessy, Beda M.; Gebreyes, Wondwossen; Kazwala, Rudovick R.; Rajashekara, Gireesh

    2015-01-01

    Foodborne Campylobacter infections pose a serious threat to public health worldwide. However, the occurrence and characteristics of Campylobacter in food animals and products remain largely unknown in Tanzania. The objective of this study was to determine the prevalence, antibiotic resistance, and genetic profiles (sequence types, STs) of Campylobacter isolated from feces of pigs and dairy and beef cattle in Tanzania. Overall, 259 (~30%) of 864 samples were positive for Campylobacter spp, which were detected in 32.5, 35.4, and 19.6% of the pig, dairy, and beef cattle samples, respectively. Multiplex PCR analysis identified 64.5 and 29.3% of the Campylobacter isolates as C. coli and C. jejuni, respectively. The majority (91.9%) of the isolates from pig samples were identified as C. coli, while C. jejuni accounted for 65.5% of the isolates from cattle. Antimicrobial susceptibility testing using the disk diffusion assay and the broth microdilution method revealed resistance to: ampicillin (Amp) (70.3% and 75.7%, respectively), gentamicin (Gen) (1.8% and 12.6%), streptomycin (Str) (65.8 and 74.8%), erythromycin (Ery) (41.4 and 48.7%), tetracycline (Tet) (18.9 and 23.4%), and ciprofloxacin (Cip) (14.4 and 7.2%). Resistance to nalidixic acid (Nal) (39.6%), azithromycin (Azm) (13.5%), and chloramphenicol (Chl) (4.5%) was determined using the disk diffusion assay only, while resistance to tylosin (Tyl) (38.7%) was quantified using the broth microdilution method. Multilocus sequence typing of 111 Campylobacter isolates resulted in the identification of 48 STs (26 C. jejuni and 22 C. coli) of which seven were novel (six C. jejuni and one C. coli). Taken together, this study revealed the high prevalence, genetic diversity and antimicrobial resistance of Campylobacter in important food animals in Tanzania, which highlights the urgent need for the surveillance and control of Campylobacter in this country. PMID:26617582

  2. Observation-centered approach to ASD assessment in Tanzania.

    PubMed

    Harrison, Ashley J; Zimak, Eric H; Sheinkopf, Stephen J; Manji, Karim P; Morrow, Eric M

    2014-10-01

    Abstract In many lower-income countries, there is a paucity of assessment services for autism spectrum disorders (ASD)., Guidelines will be provided for conducting cross-cultural assessments in the context of limited validated resources in Tanzania. By examining behavioral, social, and adaptive differences we were able to provide differential diagnostic evaluations aligning with best practice standards for 41 children in Tanzania age 2-21 years. We describe the utility of a flexible, behavioral observation instrument, the Childhood Autism Rating Scales, Second Edition (CARS2), to gather diagnostic information in a culturally sensitive manner. We observed that the ASD group was characterized by significantly higher scores on the CARS2, F ?=? 21.09, p < .001, ?(2) ?=? .37, than the general delay comparison group. Additional recommendations are provided for making cultural adaptations to current assessment instruments for use in a country without normed instruments, such as Tanzania. PMID:25247726

  3. Ending Open Defecation in Rural Tanzania: Which Factors Facilitate Latrine Adoption?

    PubMed Central

    Sara, Stephen; Graham, Jay

    2014-01-01

    Diarrheal diseases account for 7% of deaths in children under five years of age in Tanzania. Improving sanitation is an essential step towards reducing these deaths. This secondary analysis examined rural Tanzanian households’ sanitation behaviors and attitudes in order to identify barriers and drivers to latrine adoption. The analysis was conducted using results from a cross-sectional study of 1000 households in five rural districts of Tanzania. Motivating factors, perceptions, and constraints surrounding open defecation and latrine adoption were assessed using behavioral change theory. Results showed a significant association between use of improved sanitation and satisfaction with current sanitation facility (OR: 5.91; CI: 2.95–11.85; p = 0.008). Livestock-keeping was strongly associated with practicing open defecation (OR: 0.22; CI 0.063–0.75; p < 0.001). Of the 93 total households that practiced open defecation, 79 (85%) were dissatisfied with the practice, 62 (67%) had plans to build a latrine and 17 (18%) had started saving for a latrine. Among households that planned to build a latrine, health was the primary reason stated (60%). The inability to pay for upgrading sanitation infrastructure was commonly reported among the households. Future efforts should consider methods to reduce costs and ease payments for households to upgrade sanitation infrastructure. Messages to increase demand for latrine adoption in rural Tanzania should integrate themes of privacy, safety, prestige and health. Findings indicate a need for lower cost sanitation options and financing strategies to increase household ability to adopt sanitation facilities. PMID:25247427

  4. Access to institutional delivery care and reasons for home delivery in three districts of Tanzania

    PubMed Central

    2014-01-01

    Introduction Globally, health facility delivery is encouraged as a single most important strategy in preventing maternal and neonatal morbidity and mortality. However, access to facility-based delivery care remains low in many less developed countries. This study assesses facilitators and barriers to institutional delivery in three districts of Tanzania. Methods Data come from a cross-sectional survey of random households on health behaviours and service utilization patterns among women and children aged less than 5 years. The survey was conducted in 2011 in Rufiji, Kilombero, and Ulanga districts of Tanzania, using a closed-ended questionnaire. This analysis focuses on 915 women of reproductive age who had given birth in the two years prior to the survey. Chi-square test was used to test for associations in the bivariate analysis and multivariate logistic regression was used to examine factors that influence institutional delivery. Results Overall, 74.5% of the 915 women delivered at health facilities in the two years prior to the survey. Multivariate analysis showed that the better the quality of antenatal care (ANC) the higher the odds of institutional delivery. Similarly, better socioeconomic status was associated with an increase in the odds of institutional delivery. Women of Sukuma ethnic background were less likely to deliver at health facilities than others. Presence of couple discussion on family planning matters was associated with higher odds of institutional delivery. Conclusion Institutional delivery in Rufiji, Kilombero, and Ulanga district of Tanzania is relatively high and significantly dependent on the quality of ANC, better socioeconomic status as well as between-partner communication about family planning. Therefore, improving the quality of ANC, socioeconomic empowerment as well as promoting and supporting inter-spousal discussion on family planning matters is likely to enhance institutional delivery. Programs should also target women from the Sukuma ethnic group towards universal access to institutional delivery care in the study area. PMID:24934657

  5. Perceived unfairness in working conditions: The case of public health services in Tanzania

    PubMed Central

    2011-01-01

    Background The focus on the determinants of the quality of health services in low-income countries is increasing. Health workers' motivation has emerged as a topic of substantial interest in this context. The main objective of this article is to explore health workers' experience of working conditions, linked to motivation to work. Working conditions have been pointed out as a key factor in ensuring a motivated and well performing staff. The empirical focus is on rural public health services in Tanzania. The study aims to situate the results in a broader historical context in order to enhance our understanding of the health worker discourse on working conditions. Methods The study has a qualitative study design to elicit detailed information on health workers' experience of their working conditions. The data comprise focus group discussions (FGDs) and in-depth interviews (IDIs) with administrators, clinicians and nursing staff in the public health services in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in the same part of Tanzania. Results The article provides insights into health workers' understanding and assessment of their working conditions. An experience of unsatisfactory working conditions as well as a perceived lack of fundamental fairness dominated the FGDs and IDIs. Informants reported unfairness with reference to factors such as salary, promotion, recognition of work experience, allocation of allowances and access to training as well as to human resource management. The study also revealed that many health workers lack information or knowledge about factors that influence their working conditions. Conclusions The article calls for attention to the importance of locating the discourse of unfairness related to working conditions in a broader historical/political context. Tanzanian history has been characterised by an ambiguous and shifting landscape of state regulation, economic reforms, decentralisation and emerging democratic sentiments. Such a historic contextualisation enhances our understanding of the strong sentiments of unfairness revealed in this study and assists us in considering potential ways forward. PMID:21314985

  6. Incidence of Induced Abortion and Post-Abortion Care in Tanzania

    PubMed Central

    Keogh, Sarah C.; Kimaro, Godfather; Muganyizi, Projestine; Philbin, Jesse; Kahwa, Amos; Ngadaya, Esther; Bankole, Akinrinola

    2015-01-01

    Background Tanzania has one of the highest maternal mortality ratios in the world, and unsafe abortion is one of its leading causes. Yet little is known about its incidence. Objectives To provide the first ever estimates of the incidence of unsafe abortion in Tanzania, at the national level and for each of the 8 geopolitical zones (7 in Mainland plus Zanzibar). Methods A nationally representative survey of health facilities was conducted to determine the number of induced abortion complications treated in facilities. A survey of experts on abortion was conducted to estimate the likelihood of women experiencing complications and obtaining treatment. These surveys were complemented with population and fertility data to obtain abortion numbers, rates and ratios, using the Abortion Incidence Complications Methodology. Results In Tanzania, women obtained just over 405,000 induced abortions in 2013, for a national rate of 36 abortions per 1,000 women age 15–49 and a ratio of 21 abortions per 100 live births. For each woman treated in a facility for induced abortion complications, 6 times as many women had an abortion but did not receive care. Abortion rates vary widely by zone, from 10.7 in Zanzibar to 50.7 in the Lake zone. Conclusions The abortion rate is similar to that of other countries in the region. Variations by zone are explained mainly by differences in fertility and contraceptive prevalence. Measures to reduce the incidence of unsafe abortion and associated maternal mortality include expanding access to post-abortion care and contraceptive services to prevent unintended pregnancies. PMID:26361246

  7. Sources of community health worker motivation: a qualitative study in Morogoro Region, Tanzania

    PubMed Central

    2013-01-01

    Background There is a renewed interest in community health workers (CHWs) in Tanzania, but also a concern that low motivation of CHWs may decrease the benefits of investments in CHW programs. This study aimed to explore sources of CHW motivation to inform programs in Tanzania and similar contexts. Methods We conducted semi-structured interviews with 20 CHWs in Morogoro Region, Tanzania. Interviews were digitally recorded, transcribed, and coded prior to translation and thematic analysis. The authors then conducted a literature review on CHW motivation and a framework that aligned with our findings was modified to guide the presentation of results. Results Sources of CHW motivation were identified at the individual, family, community, and organizational levels. At the individual level, CHWs are predisposed to volunteer work and apply knowledge gained to their own problems and those of their families and communities. Families and communities supplement other sources of motivation by providing moral, financial, and material support, including service fees, supplies, money for transportation, and help with farm work and CHW tasks. Resistance to CHW work exhibited by families and community members is limited. The organizational level (the government and its development partners) provides motivation in the form of stipends, potential employment, materials, training, and supervision, but inadequate remuneration and supplies discourage CHWs. Supervision can also be dis-incentivizing if perceived as a sign of poor performance. Conclusions Tanzanian CHWs who work despite not receiving a salary have an intrinsic desire to volunteer, and their motivation often derives from support received from their families when other sources of motivation are insufficient. Policy-makers and program managers should consider the burden that a lack of remuneration imposes on the families of CHWs. In addition, CHWs’ intrinsic desire to volunteer does not preclude a desire for external rewards. Rather, adequate and formal financial incentives and in-kind alternatives would allow already-motivated CHWs to increase their commitment to their work. PMID:24112292

  8. Who Sinned? Parents' Knowledge of the Causes of Disability in Tanzania

    ERIC Educational Resources Information Center

    Tungaraza, Frida D.

    2012-01-01

    This study aimed at finding out from parents what they knew to be the causes of their children's disabilities. One hundred and twenty six parents from four regions, namely Dar es Salaam, Dodoma, Kilimanjaro and Morogoro were involved in this study. Data was collected through interview, narratives and observation. It was obvious from the findings…

  9. Rainfall and birthweight distribution in rural Tanzania.

    PubMed

    Bantje, H; Niemeyer, R

    1984-07-01

    This paper explores the possibility of using different techniques of time-series analysis lagged regression analysis for the study of the complicated interaction between ecological, socioeconomic and nutritional variables. The data discussed originate from a rural area in Tanzania, where life is subject to a marked seasonal variation, dependent on a bi-modal rainfall pattern. The unreliability of rainfall is characteristic: both drought and excessive rainfall are frequent occurrences. Seasonal variationns in birthweights over a 10-year period (1972-81) are here compared with the local rainfall pattern. Data on birthweight for this period show that birthweight was highest at the end of the dry season, fell rapidly during the 1st 1/2 of the rainy season, rose again during the later part of the rainy season, and fell to its lowest value just after the rans. It is argued that there are good reasons to attribute these variations to changes in labor output, food consumption, and health status, all of which are related to the seasonal cycle. Mean birthweight fell by about 60g. in the course of the rainy season. Lagged regression analysis reveals a negative impact of rainfall on birthweight after 3 months. Deviations from average rainfall show a positive correlation with birthweight after 4 months, but only in the months when rainfall is critical for food crop production. The interactions of these contrary effects are held responsible for the observed sudden fluctuations in mean birthweight. PMID:6470020

  10. Burned area, active fires and biomass burning - approaches to account for emissions from fires in Tanzania

    NASA Astrophysics Data System (ADS)

    Ruecker, Gernot; Hoffmann, Anja; Leimbach, David; Tiemann, Joachim; Ng'atigwa, Charles

    2013-04-01

    Eleven years of data from the globally available MODIS burned area and the MODS Active Fire Product have been analysed for Tanzania in conjunction with GIS data on land use and cover to provide a baseline for fire activity in this East African country. The total radiated energy (FRE) emitted by fires that were picked up by the burned area and active fire product is estimated based on a spatio-temporal clustering algorithm over the burned areas, and integration of the fire radiative power from the MODIS Active Fires product over the time of burning and the area of each burned area cluster. Resulting biomass combusted by unit area based on Wooste?s scaling factor for FRE to biomass combusted is compared to values found in the literature, and to values found in the Global Fire Emissions Database (GFED). Pyrogenic emissions are then estimated using emission factors. According to our analysis, an average of 11 million ha burn annually (ranging between 8.5 and 12.9 million ha) in Tanzania corresponding to between 10 and 14 % of Tanzaniás land area. Most burned area is recorded in the months from May to October. The land cover types most affected are woodland and shrubland cover types: they comprise almost 70 % of Tanzania's average annual burned area or 6.8 million ha. Most burning occurs in gazetted land, with an annual average of 3.7 million ha in forest reserves, 3.3 million ha in game reserves and 1.46 million ha in national parks, totalling close to 8.5 million ha or 77 % of the annual average burned area of Tanzania. Annual variability of burned area is moderate for most of the analysed classes, and in most cases there is no clear trend to be detected in burned area, except for the Lindi region were annual burned area appears to be increasing. Preliminary results regarding emissions from fires show that for larger fires that burn over a longer time, biomass burned derived through the FRP method compares well to literature values, while the integration over smaller fires with fewer observations yields unstable results due to undersampling issues and uncertainty in the start and end time of the fire events. Options for mitigating these issues using ancillary data such as fire weather information are discussed.

  11. A study of Rift Valley fever virus in Morogoro and Arusha regions of Tanzania – serology and farmers’ perceptions

    PubMed Central

    Wensman, Jonas J.; Lindahl, Johanna; Wachtmeister, Nica; Torsson, Emeli; Gwakisa, Paul; Kasanga, Christopher; Misinzo, Gerald

    2015-01-01

    Introduction Rift Valley fever (RVF) is a zoonosis primarily affecting ruminants, resulting in epidemic abortions, fever, nasal and ocular discharges, haemorrhagic diarrhoea, and a high mortality rate among young animals. Rift Valley fever virus (RVFV) is an arthropod-borne RNA virus occurring in epizootic periods associated with heavy rainfall. The last outbreak of RVF in Tanzania was in 2006–2007, resulting in severe economic losses and impaired food security due to greater number of deaths of livestock. The aim of this study was to investigate the presence of antibodies against RVFV in sheep and goats in two different regions of Tanzania during an inter-epidemic period (IEP). In addition, the perception of important diseases among livestock keepers was assessed. Material and methods A cross-sectional serological survey was conducted in three purposively selected districts in Arusha and Morogoro regions of Tanzania. Serum samples from 354 sheep and goats were analysed in a commercial RVFV competitive ELISA. At the sampling missions, a questionnaire was used to estimate the socio-economic impact of infectious diseases. Results and discussion In total, 8.2% of the analysed samples were seropositive to RVF, and most seropositive animals were younger than 7 years, indicating a continuous circulation of RVFV in the two regions. None of the livestock keepers mentioned RVF as an important livestock disease. Conclusions This study confirms that RVFV is circulating at low levels in small ruminants during IEPs. In spite of recurring RVF outbreaks in Tanzania, livestock keepers seem to have a low awareness of the disease, making them poorly prepared and thus more vulnerable to future RVF outbreaks. PMID:26584830

  12. Classroom Discourse and Discursive Practices in Higher Education in Tanzania

    ERIC Educational Resources Information Center

    Mohamed, Hashim Issa; Banda, Felix

    2008-01-01

    The paper problematises student writing as social practice from the perspective of lecturers' discursive practices. The paper uses data from a major study at a higher learning institution in Tanzania to explore lecturers' discursive practices and familiarity with the university orders of discourse including English medium of instruction, in…

  13. Etiologies of Autism in a Case-Series from Tanzania

    ERIC Educational Resources Information Center

    Mankoski, Raymond E.; Collins, Martha; Ndosi, Noah K.; Mgalla, Ella H.; Sarwatt, Veronica V.; Folstein, Susan E.

    2006-01-01

    Most autism has a genetic cause although post-encephalitis cases are reported. In a case-series (N = 20) from Tanzania, 14 met research criteria for autism. Three (M:F = 1:2) had normal development to age 22, 35, and 42 months, with onset of autism upon recovery from severe malaria, attended by prolonged high fever, convulsions, and in one case…

  14. The Past, Present and Future of Domestic Equines in Tanzania

    PubMed Central

    WILSON, R. Trevor

    2013-01-01

    Equines are minor species in Tanzania’s array of domestic livestock. Attempts to use them for transport by early explorers from the mid-nineteenth century usually failed. Donkeys were used extensively as pack animals to complement human porters by both British and German forces in the First World War, but their advantages were often outweighed by slow progress and competition with troops and porters for water, and they died in huge numbers. The British had regular cavalry troops in their campaign and mules found limited use as individual mounts for officers. In modern times, there are very few horses in Tanzania but they find several uses. Exotic safaris are made on horseback, they are used as stock horses on ranches, there is a polo club in northern Tanzania and there are leisure riding activities around the capital city. Official census records for donkeys estimate numbers at under 300,000 with concentrations in the northern pastoral and agropastoral areas where they are used as pack animals with water being the main commodity transported. Elsewhere donkeys are used to a limited extent in transport and traction work. There is little interest in equines by the central and local governments or the general public and the status quo can be expected to continue. PMID:24834000

  15. Schooling, Child Labor, and the Returns to Healthcare in Tanzania

    ERIC Educational Resources Information Center

    Adhvaryu, Achyuta R.; Nyshadham, Anant

    2012-01-01

    We study the effects of accessing better healthcare on the schooling and labor supply decisions of sick children in Tanzania. Using variation in the cost of formal-sector healthcare to predict treatment choice, we show that accessing better healthcare decreases length of illness and changes children's allocation of time to school and work.…

  16. Contextualized IT Education in Tanzania: Beyond Standard IT Curricula

    ERIC Educational Resources Information Center

    Tedre, Matti; Bangu, Nicholas; Nyagava, Seth I.

    2009-01-01

    Tumaini University at Iringa, Tanzania, started a new B.Sc. program in IT in 2007. In the course of planning and implementation of the program, we found out that standard ACM/IEEE IT curricula are not adequate for an IT program in a poor, developing country. The standard curricula describe, in detail, the competences that IT specialists in…

  17. Child Sexual Abuse: Community Concerns in Urban Tanzania

    ERIC Educational Resources Information Center

    Kisanga, Felix; Nystrom, Lennarth; Hogan, Nora; Emmelin, Maria

    2011-01-01

    The aim of this study was to explore community perceptions about child sexual abuse in Tanzania. Thirteen focus group discussions were conducted with adult community members. The core category, "children's rights challenged by lack of agency", was supported by eight categories. "Aware but distressed" portrayed feelings of hopelessness, "lack of…

  18. Mapping ntfp collection in Tanzania: A comparison of surveys

    E-print Network

    Bateman, Ian J.

    of the population live in extreme poverty, below the food poverty line, which means that their income is insufficient to afford their minimum daily calorific requirement. Poverty in Tanzania is mainly a rural an important source of income for poor households and a temporary safety net in times of food or income

  19. Resistance to Information Technology in Public Procurement in Tanzania

    ERIC Educational Resources Information Center

    Nditi, Christopher

    2010-01-01

    Organizations have become more dependent on information technology (IT) in the 21st century. But IT implementation and use is resisted in certain sectors of Tanzania, particularly in government-run enterprises. The purpose of this study was to investigate the causes and consequences of resistance to IT development and implementation in the…

  20. Successful Community Nutrition Programming: Lessons from Kenya, Tanzania, and Uganda.

    ERIC Educational Resources Information Center

    Iannotti, Lora; Gillespie, Stuart

    This report on the key findings from a series of assessments of successful community nutrition programming conducted in Kenya, Tanzania, and Uganda between 1999 and 2000. The aim of the assessments was to identify key lessons learned from the successful processes and outcomes in these programs. The report is divided into eight chapters: (1)…

  1. Investigating Motivations for Women's Skin Bleaching in Tanzania

    ERIC Educational Resources Information Center

    Lewis, Kelly M.; Robkin, Navit; Gaska, Karie; Njoki, Lillian Carol

    2011-01-01

    Why do many African women continue to use damaging skin-bleaching cosmetics that contain dangerous chemicals (e.g., mercury) that may increase their rates of infertility, skin cancer, and serious skin/brain/kidney disease? To address this question, our study investigated motivations driving the preservation of skin-bleaching practices in Tanzania.…

  2. Women's Access to Higher Education in Tanzania: A Qualitative Study

    ERIC Educational Resources Information Center

    Johnson, Megan Patricia

    2011-01-01

    The purpose of this study was to reveal the ways in which first-generation women in Tanzania explained their success in pursuing a university education despite cultural and social obstacles. Such obstacles include social policies, socio-cultural factors, and academic factors. A review of the literature revealed that issues such as patriarchy,…

  3. Greenhouse gases mitigation options and strategies for Tanzania

    SciTech Connect

    Mwandosya, M.J.; Meena, H.E.

    1996-12-31

    Tanzania became a party to the United Nations Framework on Climate Change (UN FCCC) when she ratified the Convention in March, 1996. Now that Tanzania and other developing countries are Parties to the UN FCCC, compliance with its provisions is mandatory. The legal requirements therefore provide a basis for their participation in climate change studies and policy formulation. All parties to the Convention are required by Article 4.1 of the United Nations Convention on Climate Change (UN FCCC) to develop, periodically update, publish, and make available national inventories of anthropogenic emissions and removal of greenhouse gases that are not controlled by the Montreal Protocol. This study on possible options for the mitigation of greenhouse gases in Tanzania is a preliminary effort towards the fulfilment of the obligation. In order to fulfil their obligations under the UN FCCC and have a meaningful mitigation assessment, identification and quantification of anthropogenic sources of atmospheric emissions of greenhouse gases in the country was undertaken. In this respect, the study of anthropogenic emissions by source and removals by sink of GHGs in Tanzania was done with the main objective of increasing the quantity and quality of base-line data available in order to further scientific understanding of the relationship of greenhouse gas emissions to climate change. Furthermore, the study facilitated identification of national policy and technological options that could reduce the level of emissions in the country.

  4. Wetland plant waxes from Olduvai Gorge, Tanzania

    NASA Astrophysics Data System (ADS)

    Tamalavage, A.; Magill, C. R.; Barboni, D.; Ashley, G. M.; Freeman, K. H.

    2013-12-01

    Olduvai Gorge, northern Tanzania, exposes a Plio-Pleistocene sedimentary record that includes lake and lake-margin sediments and fossil remains of ancient plants and early humans. There are rich paleontological and cultural records at Olduvai Gorge that include thousands of vertebrate fossils and stone tools. Previous studies of plant biomarkers in lake sediments from Olduvai Gorge reveal repeated, abrupt changes in landscape dominance by woodland or grassland vegetation during the early Pleistocene, about 1.8 million years ago. However, the reconstruction of wetland vegetation in the past is limited by a dearth of published lipid signatures for modern wetland species. Here, we present lipid and isotopic data for leaf tissues from eight modern plants (i.e., sedge and Typha species) living in wetlands near Olduvai Gorge. Trends in values for molecular and leaf ?13C and average chain length (ACL) of n-alkanes in plant tissues are similar to values for underlying soils. Compound-specific ?13C values for n-alkanes C25 to C33 range between -36.4 to -23.1‰ for C3 plants and -22.3 to -19.5‰ for C4 plants. Fractionation factors between leaf and lipids, ?29 and ?33, fall within the range reported in the literature, but they differ more widely within a single plant. For C3 plants, the average difference between ?29 and ?33 is 6.5 ‰, and the difference between ?29 and ?33 for C4 plants is less than 2‰. Both plant types show a parabolic relationship between chain length and ?13C values, in which C29 typically has the most depleted value, and typically shift by 3-5‰ between alkane homologs. This pattern has not been previously reported, and could be unique for sedge lipids. If so, these data help constrain the application of plant wax biomarkers from sedges for paleo-vegetation reconstruction in paleoclimate studies and at archaeological sites.

  5. Essential medicines in Tanzania: does the new delivery system improve supply and accountability?

    PubMed Central

    Mikkelsen-Lopez, Inez; Cowley, Peter; Kasale, Harun; Mbuya, Conrad; Reid, Graham; de Savigny, Don

    2014-01-01

    Objective: Assess whether reform in the Tanzanian medicines delivery system from a central ‘push' kit system to a decentralized ‘pull' Integrated Logistics System (ILS) has improved medicines accountability. Methods: Rufiji District in Tanzania was used as a case study. Data on medicines ordered and patients seen were compiled from routine information at six public health facilities in 1999 under the kit system and in 2009 under the ILS. Three medicines were included for comparison: an antimalarial, anthelmintic and oral rehydration salts (ORS). Results: The quality of the 2009 data was hampered by incorrect quantification calculations for orders, especially for antimalarials. Between the periods 1999 and 2009, the percent of unaccounted antimalarials fell from 60 to 18%, while the percent of unaccounted anthelmintic medicines went from 82 to 71%. Accounting for ORS, on the other hand, did not improve as the unaccounted amounts increased from 64 to 81% during the same period. Conclusions: The ILS has not adequately addressed accountability concerns seen under the kit system due to a combination of governance and system-design challenges. These quantification weaknesses are likely to have contributed to the frequent periods of antimalarial stock-out experienced in Tanzania since 2009. We propose regular reconciliation between the health information system and the medicines delivery system, thereby improving visibility and guiding interventions to increase the availability of essential medicines. PMID:25013720

  6. The Burden of Rabies in Tanzania and Its Impact on Local Communities

    PubMed Central

    Sambo, Maganga; Cleaveland, Sarah; Ferguson, Heather; Lembo, Tiziana; Simon, Cleophas; Urassa, Honorati; Hampson, Katie

    2013-01-01

    Background Rabies remains a major public health threat in many parts of the world and is responsible for an estimated 55,000 human deaths annually. The burden of rabies is estimated to be around US$20 million in Africa, with the highest financial expenditure being the cost of post-exposure prophylaxis (PEP). However, these calculations may be substantial underestimates because the costs to households of coping with endemic rabies have not been investigated. We therefore aimed to estimate the household costs, health-seeking behaviour, coping strategies, and outcomes of exposure to rabies in rural and urban communities in Tanzania. Methods and Findings Extensive investigative interviews were used to estimate the incidence of human deaths and bite exposures. Questionnaires with bite victims and their families were used to investigate health-seeking behaviour and costs (medical and non-medical costs) associated with exposure to rabies. We calculated that an average patient in rural Tanzania, where most people live on less than US$1 per day, would need to spend over US$100 to complete WHO recommended PEP schedules. High costs and frequent shortages of PEP led to poor compliance with PEP regimens, delays in presentation to health facilities, and increased risk of death. Conclusion The true costs of obtaining PEP were twice as high as those previously reported from Africa and should be considered in re-evaluations of the burden of rabies. PMID:24244767

  7. Risk distribution across multiple health insurance funds in rural Tanzania

    PubMed Central

    Chomi, Eunice Nahyuha; Mujinja, Phares Gamba; Enemark, Ulrika; Hansen, Kristian; Kiwara, Angwara Dennis

    2014-01-01

    Introduction Multiple insurance funds serving different population groups may compromise equity due to differential revenue raising capacity and an unequal distribution of high risk members among the funds. This occurs when the funds exist without mechanisms in place to promote income and risk cross-subsidisation across the funds. This paper analyses whether the risk distribution varies across the Community Health Fund (CHF) and National Health Insurance Fund (NHIF) in two districts in Tanzania. Specifically we aim to 1) identify risk factors associated with increased utilisation of health services and 2) compare the distribution of identified risk factors among the CHF, NHIF and non-member households. Methods Data was collected from a survey of 695 households. A multivariate logisitic regression model was used to identify risk factors for increased health care utilisation. Chi-square tests were performed to test whether the distribution of identified risk factors varied across the CHF, NHIF and non-member households. Results There was a higher concentration of identified risk factors among CHF households compared to those of the NHIF. Non-member households have a similar wealth status to CHF households, but a lower concentration of identified risk factors. Conclusion Mechanisms for broader risk spreading and cross-subsidisation across the funds are necessary for the promotion of equity. These include risk equalisation to adjust for differential risk distribution and revenue raising capacity of the funds. Expansion of CHF coverage is equally important, by addressing non-financial barriers to CHF enrolment to encourage wealthy non-members to join, as well as subsidised membership for the poorest. PMID:25574326

  8. Clinical and socio-behavioral correlates of tooth loss: a study of older adults in Tanzania

    PubMed Central

    Kida, Irene A; Åstrøm, Anne N; Strand, Gunhild V; Masalu, Joyce R

    2006-01-01

    Background Focusing 50 year olds and above, this study assessed the frequency, extent and correlates of tooth loss due to various reasons. Frequency and correlates of posterior occluding support was also investigated. Method A cross-sectional household survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. One thousand and thirty-one subjects, mean age 62.9 years participated in a clinical examination and completed interviews. Results The prevalence of tooth loss due to any reason was 83.5 %, due to caries 63.4% and due to other reasons than caries, 32.5%. A total of 74.9% had reduced number of posterior occluding units. Compared to subjects having less than 5 teeth lost due to caries, those with 5 or more lost teeth were more likely to be females, having decayed teeth, confirming dental attendance and to be among the least poor residents. Compared to subjects who had lost less than 5 teeth due to reasons other than caries, those who had lost 5 or more teeth were more likely to be of higher age, having mobile teeth, being males, being very poor and to disconfirm dental attendance when having problems. Predictors of prevalence of tooth loss (1 or more lost tooth) due to various reasons and reduced number of occluding units followed similar patterns of relationships. Conclusion The results are consistent with prevalence and extent of tooth loss due to caries and due to reasons other than caries being differently related to disease- and socio- behavioral risk indicators. Caries was the principle cause of tooth loss and molar teeth were the teeth most commonly lost. PMID:16536880

  9. The Political economy of the Film Industry in Tanzania: From Socialism to an Open Market economy, 1961-2010

    E-print Network

    Mwakalinga, Mona Ngusekela

    2010-12-15

    This study examines the film industry in Tanzania from the 1960s to 2010 and assesses how government policies, legislation, and cultural institutions have impacted filmmaking in Tanzania. By employing a critical political ...

  10. An analysis of pre-service family planning teaching in clinical and nursing education in Tanzania

    PubMed Central

    2014-01-01

    Background Promoting family planning (FP) is a key strategy for health, economic and population growth. Sub-Saharan Africa, with one of the lowest contraceptive prevalence and highest fertility rates globally, contributes half of the global maternal deaths. Improving the quality of FP services, including enhancing pre-service FP teaching, has the potential to improve contraceptive prevalence. In efforts to improve the quality of FP services in Tanzania, including provider skills, this study sought to identify gaps in pre-service FP teaching and suggest opportunities for strengthening the training. Methods Data were collected from all medical schools and a representative sample of pre-service nursing, Assistant Medical Officer (AMO), Clinical Officer (CO) and assistant CO schools in mainland Tanzania. Teachers responsible for FP teaching at the schools were interviewed using a semi-structured questionnaire. Observations on availability of teaching resources and other evidence of FP teaching and evaluation were documented. Relevant approved teaching documents were assessed for their suitability as competency-based FP teaching tools against predefined criteria. Quantitative data were analyzed using EPI Info 6 and qualitative data were manually analyzed using content analysis. Results A total of 35 pre-service schools were evaluated for FP teaching including 30 technical education and five degree offering schools. Of the assessed 11 pre-service curricula, only one met the criteria for suitability of FP teaching. FP teaching was typically theoretical with only 22.9% of all the schools having systems in place to produce graduates who could skillfully provide FP methods. Across schools, the target skills were the same level of competence and skewed toward short acting methods of contraception. Only 23.3% (n?=?7) of schools had skills laboratories, 76% (n?=?22) were either physically connected or linked to FP clinics. None of the degree providing schools practiced FP at its own teaching hospital. Teachers were concerned with poor practical exposure and lack of teaching material. Conclusions Pre-service FP teaching in Tanzania is theoretical, poorly guided, and skewed toward short acting methods; a majority of the schools are unable to produce competent FP service providers. Pre-service FP training should be strengthened with more focus on practical skills. PMID:25016391

  11. Workplace prevention programs promote behavior change in Tanzania.

    PubMed

    Henry, K

    1995-02-01

    An estimated 800,000 Tanzanians had been infected with HIV by the end of 1992. Since working-age people spend 75% of their time at work, the African Medical and Research Foundation (AMREF), the Tanzanian Council for Social Development, and the Organization of Tanzanian Trade Unions organize and implement workplace-based HIV/AIDS prevention programs. For example, anonymous HIV screening conducted by AMREF at Tanzania Breweries Limited in September 1993 found 11.4% of the brewery's truck drivers to be HIV-seropositive. The men subsequently participated in an informal AIDS education session conducted by peer educators with help from the brewery's STD/AIDS coordinator. These sessions are a regular part of workplace AIDS prevention programs supported by the US Agency of International Development's Tanzania AIDS Program implemented by the AIDS Control and Prevention Project (AIDSCAP). The author considers motivating managers, peer education, condoms, behavior change, and expansion and sustainability. PMID:12347575

  12. Epidemiology and control of human schistosomiasis in Tanzania

    PubMed Central

    2012-01-01

    In Tanzania, the first cases of schistosomiasis were reported in the early 19th century. Since then, various studies have reported prevalences of up to 100% in some areas. However, for many years, there have been no sustainable control programmes and systematic data from observational and control studies are very limited in the public domain. To cover that gap, the present article reviews the epidemiology, malacology, morbidity, and the milestones the country has made in efforts to control schistosomiasis and discusses future control approaches. The available evidence indicates that, both urinary and intestinal schistosomiasis are still highly endemic in Tanzania and cause significant morbidity.Mass drug administration using praziquantel, currently used as a key intervention measure, has not been successful in decreasing prevalence of infection. There is therefore an urgent need to revise the current approach for the successful control of the disease. Clearly, these need to be integrated control measures. PMID:23192005

  13. Nutritional Problems and Policy in Tanzania. Cornell International Nutrition Monograph Series, Number 7 (1980).

    ERIC Educational Resources Information Center

    Mgaza, Olyvia

    This monograph discusses policies designed to deal with food and nutrition problems in Tanzania. Available information on food supplies and nutritional conditions in Tanzania clearly shows that the country faces nutritional problems; protein energy malnutrition is the most serious and requires priority action. Iron deficiency anemia, goiter, and…

  14. Academia-Industry-Government Linkages in Tanzania: Trends, Challenges and Prospects

    ERIC Educational Resources Information Center

    Mpehongwa, Gasper

    2013-01-01

    This paper analyzed trends, challenges and prospects of academia-industry-government linkages in Tanzania. Using case study design, and documentary review to gather the required data, the study sought to answer three research questions: (1) what are the trends of academia-industry-government linkages in Tanzania?, (2) what are the challenges…

  15. Early Child Development and Care in Tanzania: Challenges for the Future

    ERIC Educational Resources Information Center

    Mtahabwa, Lyabwene

    2009-01-01

    Much remains unknown about the status of early child development and care in Tanzania. The little information available has never been put together to provide a holistic picture of the progress so far made in this important area. This paper intends to synchronise the information available in Tanzania for the purpose of depicting the country's…

  16. Tanzania at the Turn of the Century: Background Papers and Statistics. A World Bank Country Study.

    ERIC Educational Resources Information Center

    World Bank, Washington, DC.

    This report presents lessons from Tanzania's development experience of the past four decades, with emphasis on the period since the last report (1996), and assesses the imperatives for higher sustained growth and better livelihood for its citizens in the future. The background papers review and assess Tanzania's actual growth and poverty reduction…

  17. Aortic onchocercosis and elaeophorosis in traditional TSZ-cattle in Tabora (Tanzania): prevalence and pathology.

    PubMed

    Mtei, B J; Sanga, H J

    1990-05-01

    Onchocerca armillata was found in 3838 (95.4%) and Elaeophora poeli in 70 (1.7%) out of 4025 samples of aortas collected from cattle slaughtered at Tabora in Tanzania during the calendar year 1988. Gross lesions of the affected aortas varied from mild to severe, characterised by parasitic tunnels, nodules and corrugated calcified ridges on the aortic wall. Histological sections revealed changes as a result of tissue reaction against the parasites which were embedded into the intima of affected aortas. Calcification and hyaline degeneration were common features. The high prevalence of O. armillata and the extensive pathological lesions observed would seem to warrant assessment of the importance of onchocercosis in animal production in the tropics. Meanwhile, further studies are required to elucidate the epizootiology of aortic onchocercosis and elaeophorosis in order to devise practicable diagnosis, treatment and control methods. PMID:2143330

  18. Sociodemographic drivers of multiple sexual partnerships among women in three rural districts of Tanzania

    PubMed Central

    Exavery, Amon; Kanté, Almamy Malick; Tani, Kassimu; Hingora, Ahmed; Phillips, James F

    2015-01-01

    Background This study examines prevalence and correlates of multiple sexual partnerships (MSP) among women aged 15+ years in Rufiji, Kilombero, and Ulanga districts of Tanzania. Materials and methods Data were collected in a cross-sectional household survey in Rufiji, Kilombero, and Ulanga districts in Tanzania in 2011. From the survey, a total of 2,643 sexually active women ages 15+ years were selected for this analysis. While the chi-square test was used for testing association between MSP and each of the independent variables, logistic regression was used for multivariate analysis. Results Number of sexual partners reported ranged from 1 to 7, with 7.8% of the women reporting multiple sexual partners (2+) in the past year. MSP was more likely among both ever married women (adjusted odds ratio [AOR] =3.83, 95% confidence interval [CI] 1.40–10.49) and single women (AOR =6.13, 95% CI 2.45–15.34) than currently married women. There was an interaction between marital status and education, whereby MSP was 85% less likely among single women with secondary or higher education compared to married women with no education (AOR =0.15, 95% CI 0.03–0.61). Furthermore, women aged 40+ years were 56% less likely compared to the youngest women (<20 years) to report MSP (AOR =0.44, 95% CI 0.24–0.80). The odds of MSP among Muslim women was 1.56 times as high as that for Christians women (AOR =1.56, 95% CI 1.11–2.21). Ndengereko women were 67% less likely to report MSP compared to Pogoro women (AOR =0.33, 95% CI 0.18–0.59). Conclusion Eight percent of the women aged 15+ in Rufiji, Kilombero, and Ulanga districts of Tanzania are engaged in MSP. Encouraging achievement of formal education, especially at secondary level or beyond, may be a viable strategy toward partner reduction among unmarried women. Age, religion, and ethnicity are also important dimensions for partner reduction efforts. PMID:25914557

  19. Community perceptions of intimate partner violence - a qualitative study from urban Tanzania

    PubMed Central

    2011-01-01

    Background Intimate partner violence against women is a prevailing public health problem in Tanzania, where four of ten women have a lifetime exposure to physical or sexual violence by their male partners. To be able to suggest relevant and feasible community and health care based interventions, we explored community members' understanding and their responses to intimate partner violence. Methods A qualitative study using focus group discussions with 75 men and women was conducted in a community setting of urban Tanzania. We analysed data using a grounded theory approach and relate our findings to the ecological framework of intimate partner violence. Results The analysis resulted in one core category, "Moving from frustration to questioning traditional gender norms", that denoted a community in transition where the effects of intimate partner violence had started to fuel a wish for change. At the societal level, the category "Justified as part of male prestige" illustrates how masculinity prevails to justify violence. At the community level, the category "Viewed as discreditable and unfair" indicates community recognition of intimate partner violence as a human rights concern. At the relationship level, the category "Results in emotional entrapment" shows the shame and self-blame that is often the result of a violent relationship. At the individual level, the risk factors for intimate partner violence were primarily associated with male characteristics; the category "Fed up with passivity" emerged as an indication that community members also acknowledge their own responsibility for change in actions. Conclusions Prevailing gender norms in Tanzania accept women's subordination and justify male violence towards women. At the individual level, an increasing openness makes it possible for women to report, ask for help, and become proactive in suggesting preventive measures. At the community level, there is an increased willingness to intervene but further consciousness-raising of the human rights perspective of violence, as well as actively engaging men. At the macro level, preventive efforts must be prioritized through re-enforcement of legal rights, and provision of adequate medical and social welfare services for both survivors and perpetrators. PMID:21501506

  20. The influence of climate change on Tanzania's hydropower sustainability

    NASA Astrophysics Data System (ADS)

    Sperna Weiland, Frederiek; Boehlert, Brent; Meijer, Karen; Schellekens, Jaap; Magnell, Jan-Petter; Helbrink, Jakob; Kassana, Leonard; Liden, Rikard

    2015-04-01

    Economic costs induced by current climate variability are large for Tanzania and may further increase due to future climate change. The Tanzanian National Climate Change Strategy addressed the need for stabilization of hydropower generation and strengthening of water resources management. Increased hydropower generation can contribute to sustainable use of energy resources and stabilization of the national electricity grid. To support Tanzania the World Bank financed this study in which the impact of climate change on the water resources and related hydropower generation capacity of Tanzania is assessed. To this end an ensemble of 78 GCM projections from both the CMIP3 and CMIP5 datasets was bias-corrected and down-scaled to 0.5 degrees resolution following the BCSD technique using the Princeton Global Meteorological Forcing Dataset as a reference. To quantify the hydrological impacts of climate change by 2035 the global hydrological model PCR-GLOBWB was set-up for Tanzania at a resolution of 3 minutes and run with all 78 GCM datasets. From the full set of projections a probable (median) and worst case scenario (95th percentile) were selected based upon (1) the country average Climate Moisture Index and (2) discharge statistics of relevance to hydropower generation. Although precipitation from the Princeton dataset shows deviations from local station measurements and the global hydrological model does not perfectly reproduce local scale hydrographs, the main discharge characteristics and precipitation patterns are represented well. The modeled natural river flows were adjusted for water demand and irrigation within the water resources model RIBASIM (both historical values and future scenarios). Potential hydropower capacity was assessed with the power market simulation model PoMo-C that considers both reservoir inflows obtained from RIBASIM and overall electricity generation costs. Results of the study show that climate change is unlikely to negatively affect the average potential of future hydropower production; it will likely make hydropower more profitable. Yet, the uncertainty in climate change projections remains large and risks are significant, adaptation strategies should ideally consider a worst case scenario to ensure robust power generation. Overall a diversified power generation portfolio, anchored in hydropower and supported by other renewables and fossil fuel-based energy sources, is the best solution for Tanzania

  1. The Epidemiology of Alcohol Use and Alcohol Use Disorders among Young People in Northern Tanzania

    PubMed Central

    Francis, Joel M.; Weiss, Helen A.; Mshana, Gerry; Baisley, Kathy; Grosskurth, Heiner; Kapiga, Saidi H.

    2015-01-01

    Introduction Alcohol use is a global public health problem, including as a risk factor for HIV infection, but few data are available on the epidemiology of alcohol use and alcohol use disorders (AUD) among young people in sub-Saharan Africa. Methods We conducted a cross-sectional survey among 4 groups of young people aged 15–24 years old (secondary school students, college/university students, employees of local industries and casual labourers) in two regions (Kilimanjaro and Mwanza) of northern Tanzania. Using a multistage stratified random sampling strategy, we collected information on demographics, alcohol use, and behavioural factors. We screened severity of alcohol use using the Alcohol Use Disorder Identification Test (AUDIT) and estimated the quantity and frequency of alcohol consumption using the timeline-follow-back-calendar (TLFB) method. Results A total of 1954 young people were surveyed. The prevalence of reported alcohol use was higher among males (47–70% ever users and 20–45% current users) than females (24–54% ever users and 12–47% current users). Prevalence of use was substantially higher in Kilimanjaro than Mwanza region. In both regions, participants reported high exposure to alcohol advertisements, and wide alcohol availability. College students reported the highest prevalence of current alcohol use (45% among males; 26% among females) and of heavy episodic drinking (71% among males; 27% among females) followed by casual labourers. Males were more likely to have AUD (an AUDIT score ?8) than females, with 11–28% of males screening positive for AUD. Alcohol use was associated with male gender, being in a relationship, greater disposable income, non-Muslim religion and a higher number of sexual partners. Conclusions Alcohol use is a significant problem among young people in northern Tanzania. There is an urgent need to develop, pilot and deliver interventions to help young people delay initiation and reduce levels of harmful drinking, particularly among college students and casual labourers. PMID:26444441

  2. Children’s Medicines in Tanzania: A National Survey of Administration Practices and Preferences

    PubMed Central

    Adams, Lisa V.; Craig, Sienna R.; Mmbaga, Elia John; Naburi, Helga; Lahey, Timothy; Nutt, Cameron T.; Kisenge, Rodrick; Noel, Gary J.; Spielberg, Stephen P.

    2013-01-01

    Objective The dearth of age-appropriate formulations of many medicines for children poses a major challenge to pediatric therapeutic practice, adherence, and health care delivery worldwide. We provide information on current administration practices of pediatric medicines and describe key stakeholder preferences for new formulation characteristics. Patients and Methods We surveyed children aged 6–12 years, parents/caregivers over age 18 with children under age 12, and healthcare workers in 10 regions of Tanzania to determine current pediatric medicine prescription and administration practices as well as preferences for new formulations. Analyses were stratified by setting, pediatric age group, parent/caregiver education, and healthcare worker cadre. Results Complete data were available for 206 children, 202 parents/caregivers, and 202 healthcare workers. Swallowing oral solid dosage forms whole or crushing/dissolving them and mixing with water were the two most frequently reported methods of administration. Children frequently reported disliking medication taste, and many had vomited doses. Healthcare workers reported medicine availability most significantly influences prescribing practices. Most parents/caregivers and children prefer sweet-tasting medicine. Parents/caregivers and healthcare workers prefer oral liquid dosage forms for young children, and had similar thresholds for the maximum number of oral solid dosage forms children at different ages can take. Conclusions There are many impediments to acceptable and accurate administration of medicines to children. Current practices are associated with poor tolerability and the potential for under- or over-dosing. Children, parents/caregivers, and healthcare workers in Tanzania have clear preferences for tastes and formulations, which should inform the development, manufacturing, and marketing of pediatric medications for resource-limited settings. PMID:23484012

  3. The challenge to avoid anti-malarial medicine stock-outs in an era of funding partners: the case of Tanzania

    PubMed Central

    2014-01-01

    Background Between 2007 and 2013, the Tanzanian public sector received 93.1 million doses of first-line anti-malarial artemisinin-based combination therapy (ACT) in the form of artemether-lumefantrine entirely supplied by funding partners. The introduction of a health facility ACT stock monitoring system using SMS technology by the National Malaria Control Programme in mid 2011 revealed a high frequency of stock-outs of ACT in primary care public health facilities. The objective of this study was to determine the pattern of availability of ACT and possible causes of observed stock-outs across public health facilities in Tanzania since mid-2011. Methods Data were collected weekly by the mobile phone reporting tool SMS for Life on ACT availability from over 5,000 public health facilities in Tanzania starting from September 2011 to December 2012. Stock data for all four age-dose levels of ACT across health facilities were summarized and supply of ACT at the national level was also documented. Results Over the period of 15 months, on average 29% of health facilities in Tanzania were completely stocked out of all four-age dose levels of the first-line anti-malarial with a median duration of total stock-out of six weeks. Patterns of total stock-out by region ranged from a low of 9% to a high of 52%. The ACT stock-outs were most likely caused by: a) insufficient ACT supplies entering Tanzania (e.g. in 2012 Tanzania received 10.9 million ACT doses compared with a forecast demand of 14.4 million doses); and b) irregular pattern of ACT supply (several months with no ACT stock). Conclusion The reduced ACT availability and irregular pattern of supply were due to cumbersome bureaucratic processes and delays both within the country and from the main donor, the Global Fund to Fight AIDS, Tuberculosis and Malaria. Tanzania should invest in strengthening both the supply system and the health information system using mHealth solutions such as SMS for Life. This will continue to assist in tracking ACT availability across the country where all partners work towards more streamlined, demand driven and accountable procurement and supply chain systems. PMID:24885420

  4. Magnitude of HIV infection among older people in Mufindi and Babati districts of the Tanzania mainland

    PubMed Central

    Nyigo, Vitus; Kilale, Andrew; Kilima, Stella; Shayo, Elizabeth H; Senkoro, Kesheni P; Mshana, Jonathan; Mushi, Adiel K; Matemba, Lucas; Massaga, Julius

    2014-01-01

    Introduction According to the 2011–2012 HIV and Malaria Indicator Survey, the prevalence of HIV infection in Tanzania is 5.1%, with limited information on its magnitude among older people, as the community believes that the elderly are not at risk. Consequently, little attention is given to the fight against HIV and AIDS in this group. The present study investigated the magnitude of HIV and AIDS infection among older people in rural and urban areas of the Tanzania mainland. Subjects and methods The study was conducted in Mufindi and Babati districts of Iringa and Manyara regions, respectively, through multistage sampling procedures. Dried blood spot cards were used to collect blood samples for HIV testing among consenting participants. HIV testing was done and retested using different enzyme-linked immunosorbent assay kits. Results A total of 720 individuals, 340 (47.2%) males and 380 (52.8%) females, were randomly selected, of whom 714 (99.2%) consented to HIV testing while six (0.8%) refused to donate blood. The age ranged from 50 to 98 years, with a mean age of 64.2 years. Overall, a total of 56 (7.8%) participants were HIV-positive. Females had a higher prevalence (8.3%) than males (7.4%), with Mufindi district recording the higher rate (11.3%) compared to the 3.7% of Babati district. The prevalence was higher in the rural population (9.4%) compared to 6.4% of their urban counterparts. Conclusion Although HIV/AIDS is considered a disease of individuals aged 15–49 years, the overall prevalence among the older people aged 50 years and above for Mufindi and Babati districts was higher than the national prevalence in the general population. These findings point to the need to consider strengthening interventions targeting older populations against HIV/AIDS in these districts while establishing evidence countrywide to inform policy decisions. PMID:24926202

  5. Predictors of HIV serostatus disclosure to partners among HIV-positive pregnant women in Morogoro, Tanzania

    PubMed Central

    2013-01-01

    Background Prevention of mother to child transmission of HIV (PMTCT) has been scaled, to more than 90% of health facilities in Tanzania. Disclosure of HIV results to partners and their participation is encouraged in the program. This study aimed to determine the prevalence, patterns and predictors of HIV sero-status disclosure to partners among HIV positive pregnant women in Morogoro municipality, Tanzania. Methods A cross sectional study was conducted in March to May 2010 among HIV-positive pregnant women who were attending for routine antenatal care in primary health care facilities of the municipality and had been tested for HIV at least one month prior to the study. Questionnaires were used to collect information on possible predictors of HIV disclosure to partners. Results A total of 250 HIV-positive pregnant women were enrolled. Forty one percent (102) had disclosed their HIV sero-status to their partners. HIV-disclosure to partners was more likely among pregnant women who were?

  6. Adaptive livelihood strategies for coping with water scarcity in the drylands of central Tanzania

    NASA Astrophysics Data System (ADS)

    Liwenga, Emma T.

    In this paper, it is argued that local knowledge for adapting to water scarcity is important for integrated resource management by taking into consideration both the natural and social constraints in a particular setting based on accumulated experience. The paper examines the relevance of local knowledge in sustaining agricultural production in the semiarid areas of central Tanzania. The paper specifically focuses on how water scarcity, as the major limiting factor, is addressed in the study area using local knowledge to sustain livelihoods of its people. The study was conducted in four villages; Mzula, Ilolo, Chanhumba and Ngahelezi, situation in Mvumi Division in Dodoma Region. The study mainly employed qualitative data collection techniques. Participatory methods provided a means of exploring perceptions and gaining deeper insights regarding natural resource utilization in terms of problems and opportunities. The main data sources drawn upon in this study were documentation, group interviews and field observations. Group interviews involved discussions with a group of 6-12 people selected on the basis of gender, age and socio-economic groups. Data analysis entailed structural and content analysis within the adaptive livelihood framework in relation to management of water scarcity using local knowledge. The findings confirm that rainfall is the main limiting factor for agricultural activities in the drylands of Central Tanzania. As such, local communities have developed, through time, indigenous knowledge to cope with such environments utilizing seasonality and diversity of landscapes. Use of this local knowledge is therefore effective in managing water scarcity by ensuring a continuous production of crops throughout the year. This practice implies increased food availability and accessibility through sales of such agricultural products. Local innovations for water management, such as cultivation in sandy rivers, appear to be very important means of accessing water in these dryland areas. It can therefore be concluded that utilization of local knowledge has wide impact on integrated water resource management. These implications are important considerations for development of adaptive water system innovations at community level.

  7. Access, Use and Perceptions of Teachers and Students towards Mobile Phones as a Tool for Teaching and Learning in Tanzania

    ERIC Educational Resources Information Center

    Kafyulilo, Ayoub

    2014-01-01

    This study explored the access, use and perceptions of teachers and students towards mobile phones as a tool for facilitating teaching and learning beyond the classroom walls. A total of 29 pre-service teachers and four college instructors from Dar es salaam University College of Education (DUCE) as well as 12 in-service teachers and 40 students…

  8. Educational, scientific, tourist and outreach potential of the September 1, 2016 Annular Solar Eclipse in Tanzania

    NASA Astrophysics Data System (ADS)

    Tayabali Jiwaji, Noorali

    2015-08-01

    Tanzania will witness a major astronomical spectacle of an annular eclipse on September 1, 2016. The central part of the eclipse will pass through southern Tanzania, crossing national parks and game reserves such as Katavi and the world famous Selous. For the rest of Tanzania and neighbouring countries it will be a memorable event with large of the proportion of the Sun being covered up. The climate in Tanzania during September is cool and dry which will provide ideal viewing conditions. Solar eclipse events attract "eclipse chasers" from around the globe.Scientific interest in measuring the properties of the Sun and the effects of the eclipse on the atmosphere will allow local scientists to partner with leading scientists to gain valuable experience and knowledge.Local population's wonder and interest in eclipses can be exploited through public-private partnerships by encouraging students and local people to travel to the central path or to observe from their backyards. Large number of eclipse glasses can be manufactured cheaply using safe solar filters for supplying to students and general population in Tanzania and neigbouring countries. This will raise science awareness about the wonders of our Universe.When combined with the attraction of Tanzania's treasures in the north and the 16 tonne Mbozi meteorite in southern Tanzania, the touristic potential of this event can be exploited through tour packages and worldwide advertisements during the coming year.

  9. Red blood cell indices and prevalence of hemoglobinopathies and glucose 6 phosphate dehydrogenase deficiencies in male Tanzanian residents of Dar es Salaam

    PubMed Central

    Mwakasungula, Solomon; Schindler, Tobias; Jongo, Said; Moreno, Elena; Kamaka, Kasimu; Mohammed, Mgeni; Joseph, Selina; Rashid, Ramla; Athuman, Thabit; Tumbo, Anneth Mwasi; Hamad, Ali; Lweno, Omar; Tanner, Marcel; Shekalaghe, Seif; Daubenberger, Claudia A

    2014-01-01

    Hemoglobinopathies, disorders of hemoglobin structure and production, are one of the most common monogenic disorders in humans. Glucose 6 phosphate dehydrogenase deficiency (G6PD) is an inherited enzymopathy resulting in increased oxygen stress susceptibility of red blood cells. The distributions of these genetic traits in populations living in tropical and subtropical regions where malaria has been or is still present are thought to result from survival advantage against severe life threatening malaria disease. 384 male Tanzanian volunteers residing in Dar es Salaam were typed for G6PD, sickle cell disease and ?-thalassemia. The most prominent red blood cell polymorphism was heterozygous ?+-thalassemia (37.8%), followed by the G6PD(A) deficiency (16.4%), heterozygous sickle cell trait (15.9%), G6PD(A-) deficiency (13.5%) and homozygous ?+-thalassemia (5.2%). 35%, 45%, 17% and 3% of these volunteers were carriers of wild type gene loci, one, two or three of these hemoglobinopathies, respectively. We find that using a cut off value of 28.6 pg. for mean corpuscular hemoglobin (MCH), heterozygous ?+-thalassemia can be predicted with a sensitivity of 84% and specificity of 72% in this male population. All subjects carrying homozygous ?+-thalassemia were identified based on their MCH value < 28.6 pg. PMID:25755846

  10. Income and Health in Tanzania. An Instrumental Variable Approach

    PubMed Central

    Fichera, Eleonora; Savage, David

    2015-01-01

    Summary There is a substantial debate over the direction of the causal relation between income and health. This is important for our understanding of the health production process and for the policy debate over improving healthcare. We instrument income with rainfall measurements by matching satellite information on timing and positioning of 21 rainfall stations to longitudinal data (1991–94) of over 4,000 individuals in 51 villages in Tanzania. A 10% increase in income reduces the number of illnesses by 0.02. We also find that a 10% increase in income implies an increase of about 0.1 vaccinations of children under six. PMID:25648157

  11. Evaluation of potential impacts of climate change and water management on streamflow in the Rovuma River, Mozambique and Tanzania

    NASA Astrophysics Data System (ADS)

    Minihane, M.; Lettenmaier, D. P.

    2012-12-01

    Economic development and public health are tied to water resources development in many parts of the world. Effective use of water management infrastructure investments requires projections of future climatic and water use conditions. This is particularly true in developing countries. We explore in this work water resource availability in the Rovuma River, which lies in a sparsely-populated region of southeastern Africa, on the border of Mozambique and Tanzania. While there are only limited documented observations of flow of the Rovuma River and it's tributaries, particularly in recent years, there is widespread interest in development of the water resources of the region. The national governments are interested in hydropower potential while private companies, many of them large multinational organizations, have started irrigation programs to increase agricultural output. While the Mozambique and Tanzania governments have a joint agreement over the river development, there is a need to assess both current and potential future water resource conditions in the basin. The sustainability of these developments, however, may be affected by climate change. Here we quantify potential changes in streamflow in the Rovuma River under dry and wet climate projection scenarios using the delta method and the Variable Infiltration Capacity (VIC) macro-scale hydrology model. We then evaluate streamflow changes relative to water withdrawals required for a range of irrigated agriculture scenarios. Our analysis is intended to be a starting point for planners to consider potential impacts of both streamflow withdrawal permits (for irrigated agriculture) and future uncertain climate conditions.

  12. Postpartum Contraception in Northern Tanzania: Patterns of Use, Relationship to Antenatal Intentions, and Impact of Antenatal Counseling.

    PubMed

    Keogh, Sarah C; Urassa, Mark; Kumogola, Yusufu; Kalongoji, Samwel; Kimaro, Daniel; Zaba, Basia

    2015-12-01

    In Tanzania, unmet need for contraception is high, particularly in the postpartum period. Contraceptive counseling during routine antenatal HIV testing could reach 97 percent of pregnant women with much-needed information, but requires an understanding of postpartum contraceptive use and its relationship to antenatal intentions. We conducted a baseline survey of reproductive behavior among 5,284 antenatal clients in Northern Tanzania, followed by an intervention offering contraceptive counseling to half the respondents. A follow-up survey at 6-15 months postpartum examined patterns and determinants of postpartum contraceptive use, assessed their correspondence with antenatal intentions, and evaluated the impact of the intervention. Despite high loss to follow-up, our findings indicate that condoms and hormonal methods had particular and distinct roles in the postpartum period, based on understandings of postpartum fertility. Antenatal intentions were poor predictors of postpartum reproductive behavior. Antenatal counseling had an effect on postpartum contraceptive intentions, but not on use. Different antenatal/contraceptive service integration models should be tested to determine how and when antenatal counseling can be most effective. PMID:26643490

  13. Seroprevalence of Alphavirus Antibodies in a Cross-Sectional Study in Southwestern Tanzania Suggests Endemic Circulation of Chikungunya

    PubMed Central

    Dobler, Gerhard; Saathoff, Elmar; Kroidl, Inge; Ntinginya, Nyanda Elias; Maboko, Leonard; Löscher, Thomas; Hoelscher, Michael; Heinrich, Norbert

    2014-01-01

    Background To date, Alphavirus infections and their most prominent member, chikungunya fever, a viral disease which first became apparent in Tanzania in 1953, have been very little investigated in regions without epidemic occurrence. Few data exist on burden of disease and socio-economic and environmental covariates disposing to infection. Methods A cross-sectional seroprevalence study was undertaken in 1,215 persons from Mbeya region, South-Western Tanzania, to determine the seroprevalence of anti-Alphavirus IgG antibodies, and to investigate associated risk factors. Results 18% of 1,215 samples were positive for Alphavirus IgG. Seropositivity was associated with participant age, low to intermediate elevation, flat terrain and with IgG positivity for Rift Valley fever, Flaviviridae, and rickettsiae of the spotted fever group. When comparing the geographical distribution of Alphavirus seropositivity to that of Rift Valley fever, it was obvious that Alphaviruses had spread more widely throughout the study area, while Rift Valley fever was concentrated along the shore of Lake Malawi. Conclusion Alphavirus infections may contribute significantly to the febrile disease burden in the study area, and are associated with several arthropod-borne infections. Their spread seems only limited by factors affecting mosquitoes, and seems less restricted than that of Rift Valley fever. PMID:25079964

  14. Identifying implementation bottlenecks for maternal and newborn health interventions in rural districts of the United Republic of Tanzania

    PubMed Central

    Peterson, Stefan; Marchant, Tanya; Mbaruku, Godfrey; Temu, Silas; Manzi, Fatuma; Hanson, Claudia

    2015-01-01

    Abstract Objective To estimate effective coverage of maternal and newborn health interventions and to identify bottlenecks in their implementation in rural districts of the United Republic of Tanzania. Methods Cross-sectional data from households and health facilities in Tandahimba and Newala districts were used in the analysis. We adapted Tanahashi’s model to estimate intervention coverage in conditional stages and to identify implementation bottlenecks in access, health facility readiness and clinical practice. The interventions studied were syphilis and pre-eclampsia screening, partograph use, active management of the third stage of labour and postpartum care. Findings Effective coverage was low in both districts, ranging from only 3% for postpartum care in Tandahimba to 49% for active management of the third stage of labour in Newala. In Tandahimba, health facility readiness was the largest bottleneck for most interventions, whereas in Newala, it was access. Clinical practice was another large bottleneck for syphilis screening in both districts. Conclusion The poor effective coverage of maternal and newborn health interventions in rural districts of the United Republic of Tanzania reinforces the need to prioritize health service quality. Access to high-quality local data by decision-makers would assist planning and prioritization. The approach of estimating effective coverage and identifying bottlenecks described here could facilitate progress towards universal health coverage for any area of care and in any context. PMID:26240459

  15. Prevalence of Plasmodium falciparum Malaria among Pregnant Students in Dodoma Region, Tanzania: No Cases Have Been Detected

    PubMed Central

    Zablon, Karen N.; Kakilla, Charles; Lykina, Tatiana; Minakova, Victoria; Chibago, Alphaxad; Bochkaeva, Zanda

    2015-01-01

    Malaria in pregnancy, being often asymptomatic, is a major problem in endemic African countries. It is characterized by anemia and placental malaria leading to poor pregnancy outcomes. In 2001 Tanzania adopted an intermittent-preventive treatment of malaria in pregnancy (IPTp) policy, which recommends receiving doses of antimalarial drugs every planned visit to the antenatal care centre (ANC), starting from the second trimester. Currently the policy is valid across the whole country, regardless that there are regions with very low malaria endemicity in Tanzania, such as Dodoma region. The current study aimed to show the real prevalence of malaria among young pregnant women in Dodoma region, by measuring the prevalence of malaria among University of Dodoma (UDOM) students, and to describe the social health care features of student female community. Two methods of malaria diagnostic, microscopy, and rapid test, as well as retrospective inspection of ANC registry book, showed the very low prevalence of malaria disease among pregnant students, approximately 0.3%. Additionally, the sociodemographic data from the questionnaires showed that all students use different malaria preventive measures, and most of them have the regular sexual partner. This fact approves the correlation between illiteracy of woman and the risk of malaria infection transmission. PMID:26664761

  16. Abattoir surveillance demonstrates contagious bovine pleuropneumonia is widespread in Tanzania.

    PubMed

    Noah, Elly Yesse; Kimera, Sharazuli Iddi; Kusiluka, Lughano Jeremy Moses; Wambura, Philemon

    2015-12-01

    A study was conducted to investigate the presence of contagious bovine pleuropneumonia (CBPP) in the slaughter facilities in 10 regions of Tanzania that reported pathological lesions suggestive of CBPP during meat inspection. The aim was to ascertain if slaughter facilities can be used to monitor the occurrence and spread of CBPP in the country. The study involved a questionnaire survey, clinical examination of animals for CBPP symptoms prior to slaughter and postmortem examination of the respiratory system in slaughtered cattle. A total of 12 slaughterhouses and 31 animal markets were involved in the study. A total of 2736 cattle were slaughtered comprising 1978 and 758 in slaughterhouses and animal markets, respectively. Of the total slaughtered stock, 351 of 2736 (12.8 %) had lesions suggestive of CBPP and of these, 236 (8.6 %) were from slaughterhouses and 115 (4.2 %) from animal markets. Acute CBPP cases were observed in 192 of the 236 (81.4 %) and 71 of the 115 (61.7 %) of the animals inspected in the slaughterhouses and markets, respectively. Chronic cases were encountered in 24 (10.2 %) of the animals slaughtered in the slaughterhouses and 19 (16.5 %) at animal markets. This work has confirmed that targeted monitoring for CBPP lesions through meat inspection can be a useful tool for CBPP surveillance in endemic countries like Tanzania. PMID:26315150

  17. Experience on healthcare utilization in seven administrative regions of Tanzania

    PubMed Central

    2012-01-01

    Health care utilization in many developing countries, Tanzania included, is mainly through the use of traditional medicine (TRM) and its practitioners despite the presence of the conventional medicine. This article presents findings on the study that aimed to get an experience of health care utilization from both urban and rural areas of seven administrative regions in Tanzania. A total of 33 health facility managers were interviewed on health care provision and availability of supplies including drugs, in their respective areas. The findings revealed that the health facilities were overburden with higher population to serve than it was planned. Consequently essential drugs and other health supplies were available only in the first two weeks of the month. Conventional health practitioners considered traditional health practitioners to be more competent in mental health management, and overall, they were considered to handle more HIV/AIDS cases knowingly or unknowingly due to shear need of healthcare by this group. In general conventional health practitioners were positive towards traditional medicine utilization; and some of them admitted using traditional medicines. Traditional medicines like other medical health systems worldwide have side effects and some contentious ethical issues that need serious consideration and policy direction. Since many people will continue using traditional/alternative medicine, there is an urgent need to collaborate with traditional/alternative health practitioners through the institutionalization of basic training including hygiene in order to improved healthcare in the community and attain the Millennium Development Goals by 2015. PMID:22284539

  18. Cattle ticks of the genera Rhipicephalus and Amblyomma of economic importance in Tanzania: distribution assessed with GIS based on an extensive field survey.

    PubMed

    Lynen, Godelieve; Zeman, Petr; Bakuname, Christine; Di Giulio, Giuseppe; Mtui, Paul; Sanka, Paul; Jongejan, Frans

    2007-01-01

    In order to implement a robust integrated tick and tick-borne disease control programme in Tanzania, based on ecological and epidemiological knowledge of ticks and their associated diseases, a national tick and sero-surveillance study was carried out in all 21 regions of the mainland, as well as on Mafia Island, between 1998 and 2001. The current distributions of Rhipicephalus appendiculatus, R. pravus, Amblyomma variegatum, A. gemma, and A. lepidum are illustrated and discussed. Tick distribution maps were assessed using the Weights-of-Evidence method (WofE), and employing temperature, humidity, NDVI, rainfall, and land-cover predictive data. Ground-truthing was done to check correspondence both of the data employed in prediction with land-cover characteristics discerned in the field as well as of the surveyed and predicted tick distributions. Statistical methods were used to analyse associations of the tick species with their environment, cattle density, and other ticks. Except for R. appendiculatus, no appreciable changes were demonstrated in the predicted and observed tick distributions compared to the existing maps that originated in the 1950-1960s. Cattle density influenced the distribution of A. variegatum and, to a certain extent, of A. lepidum, but had no appreciable influence on the distribution of any of the other ticks discussed in this paper, neither did livestock movement. Distinct differences for environmental requirements where observed between different tick species within the same genus. The predictive maps of R. appendiculatus and R. pravus suggest their mutually exclusive distribution in Tanzania, and simultaneous statistical analysis showed R. pravus as a greater specialist. Of the three Amblyomma species, A. variegatum is the most catholic tick species in Tanzania, while both A. gemma and A. lepidum belong to the more specialized species. Despite dissimilar habitat preferences, all three Amblyomma spp. co-exist in central Tanzania, where very heterogeneous habitats may simultaneously satisfy the environmental requirements of all three species. The current study, conducted about 4 decades after the last major survey activities, has shown that changing livestock policies, unrestricted livestock movement and a continuous change in climatic/environmental conditions in Tanzania have brought about only limited changes in the distribution patterns of R. appendiculatus, R. pravus and the three Amblyomma species investigated. Whether this observation indicates a relative indifference of these ticks to environmental and/or climate changes allows room for speculation. PMID:18044004

  19. An analysis of the potential economic impact of natural gas production in Tanzania

    E-print Network

    Umeike, Ekenedilinna (Ekenedilinna Onyedikachi)

    2014-01-01

    Following substantial discoveries of natural gas in recent years, Tanzania has new options for economic development. The country's policy makers are faced with having to make decisions about how best to utilize the gas in ...

  20. Predicting Potential Risk Areas of Human Plague for the Western Usambara Mountains, Lushoto District, Tanzania

    E-print Network

    Neerinckx, Simon B.; Peterson, A. Townsend; Gulinck, Hubert; Deckers, Jozef; Kimaro, Didas; Leirs, Herwig

    2010-03-01

    A natural focus of plague exists in the Western Usambara Mountains of Tanzania. Despite intense research, questions remain as to why and how plague emerges repeatedly in the same suite of villages. We used human plague incidence data for 1986...

  1. Modelling and mapping the topsoil organic carbon content for Tanzania

    NASA Astrophysics Data System (ADS)

    Kempen, Bas; Kaaya, Abel; Ngonyani Mhaiki, Consolatha; Kiluvia, Shani; Ruiperez-Gonzalez, Maria; Batjes, Niels; Dalsgaard, Soren

    2014-05-01

    Soil organic carbon (SOC), held in soil organic matter, is a key indicator of soil health and plays an important role in the global carbon cycle. The soil can act as a net source or sink of carbon depending on land use and management. Deforestation and forest degradation lead to the release of vast amounts of carbon from the soil in the form of greenhouse gasses, especially in tropical countries. Tanzania has a high deforestation rate: it is estimated that the country loses 1.1% of its total forested area annually. During 2010-2013 Tanzania has been a pilot country under the UN-REDD programme. This programme has supported Tanzania in its initial efforts towards reducing greenhouse gas emission from forest degradation and deforestation and towards preserving soil carbon stocks. Formulation and implementation of the national REDD strategy requires detailed information on the five carbon pools among these the SOC pool. The spatial distribution of SOC contents and stocks was not available for Tanzania. The initial aim of this research, was therefore to develop high-resolution maps of the SOC content for the country. The mapping exercise was carried out in a collaborative effort with four Tanzanian institutes and data from the Africa Soil Information Service initiative (AfSIS). The mapping exercise was provided with over 3200 field observations on SOC from four sources; this is the most comprehensive soil dataset collected in Tanzania so far. The main source of soil samples was the National Forest Monitoring and Assessment (NAFORMA). The carbon maps were generated by means of digital soil mapping using regression-kriging. Maps at 250 m spatial resolution were developed for four depth layers: 0-10 cm, 10-20 cm, 20-30 cm, and 0-30 cm. A total of 37 environmental GIS data layers were prepared for use as covariates in the regression model. These included vegetation indices, terrain parameters, surface temperature, spectral reflectances, a land cover map and a small-scale Soil and Terrain (SOTER) map. Prediction uncertainty was quantified by the 90% prediction interval and the predictions were validated by cross-validation. The SOTER map proved to be the best predictor of SOC content, followed by the terrain parameters, mid-infrared reflectance, surface temperature, several vegetation indices, and the land cover map. The maps show that the SOC content decreases with depth, which is typically observed in soils. For the 0-10 cm layer the average predicted SOC content is 1.31%, for the 10-20 cm layer this is 0.93%, for the 20-30cm layer 0.72%, and for the 0-30cm layer 1.00%. The mean absolute error of the 0-10cm layer was 0.54%, that of the 10-20cm layer 0.38%, that of the 20-30cm layer 0.31%, and that of the 0-30cm layer 0.34%. The R2-value of the 0-10 cm layer was 0.47, that of the 10-20cm layer 0.49, that of the 20-30cm layer 0.44, and that of the 0-30cm layer 0.59. The next step will be the development of maps of SOC stock and key properties that are of interest for soil fertility management such as pH and the textural fractions.

  2. Challenges to the implementation of International Health Regulations (2005) on Preventing Infectious Diseases: experience from Julius Nyerere International Airport, Tanzania

    PubMed Central

    Bakari, Edith; Frumence, Gasto

    2013-01-01

    Background The International Health Regulations (IHR) (2005) is a legal instrument binding all World Health Organization (WHO) member States. It aims to prevent and control public health emergencies of international concern. Country points of entry (POEs) have been identified as potential areas for effective interventions to prevent the transmission of infectious diseases across borders. The agreement postulates that member states will strengthen core capacities detailed in the IHR (2005), including those specified for the POE. This study intended to assess the challenges faced in implementing the IHR (2005) requirements at Julius Nyerere International Airport (JNIA), Dar es Salaam. Design A cross-sectional, descriptive study, employing qualitative methods, was conducted at the Ministry of Health and Social Welfare (MoHSW), WHO, and JNIA. In-depth interviews, focus group discussions (FGDs) and documentary reviews were used to obtain relevant information. Respondents were purposively enrolled into the study. Thematic analysis was used to generate study findings. Results Several challenges that hamper implementation of the IHR (2005) were identified: (1) none of the 42 Tanzanian POEs have been specifically designated to implement IHR (2005). (2) Implementation of the IHR (2005) at the POE was complicated as it falls under various uncoordinated government departments. Although there were clear communication channels at JNIA that enhanced reliable risk communication, the airport lacked isolated rooms specific for emergence preparedness and response to public health events. Conclusions JNIA is yet to develop adequate core capacities required for implementation of the IHR (2005). There is a need for policy managers to designate JNIA to implement IHR (2005) and ensure that public health policies, legislations, guidelines, and practice at POE are harmonized to improve international travel and trade. Policy makers and implementers should also ensure that implementation of the IHR (2005) follow the policy implementation framework, particularly the contextual interaction theory which calls for the availability of adequate resources (inputs) and well-organized process for the successful implementation of the policy. PMID:23958240

  3. The impact of privatization on access in Tanzania.

    PubMed

    Benson, J S

    2001-06-01

    In the late 1980s, many developing countries were forced to adopt structural adjustment policies as a condition for securing loans from the International Monetary Fund (IMF) and the World Bank. One of the World Bank's recommended policies was to change the mix of private and public health facilities. This study, based on fieldwork done in Tanzania in 1993, examines the impact of this policy on health-care accessibility in two northern Tanzanian districts, one rural and one urban. Accessibility was measured in terms of equality and equity of coverage. The placement of the very few government clinics opened during the years 1985-1993 did much more to improve coverage than the haphazard location of many new private clinics. Equity was not improved as very few clinics were placed in demographically needy areas. PMID:11352415

  4. Factors influencing implementation of the Community Health Fund in Tanzania.

    PubMed

    Kamuzora, Peter; Gilson, Lucy

    2007-03-01

    Although prepayment schemes are being hailed internationally as part of a solution to health care financing problems in low-income countries, literature has raised problems with such schemes. This paper reports the findings of a study that examined the factors influencing low enrollment in Tanzania's health prepayment schemes (Community Health Fund). The paper argues that district managers had a direct influence over the factors explaining low enrollment and identified in other studies (inability to pay membership contributions, low quality of care, lack of trust in scheme managers and failure to see the rationale to insure). District managers' actions appeared, in turn, to be at least partly a response to the manner of this policy's implementation. In order better to achieve the objectives of prepayment schemes, it is important to focus attention on policy implementers, who are capable of re-shaping policy during its implementation, with consequences for policy outcomes. PMID:17299023

  5. East African and Kuunga Orogenies in Tanzania - South Kenya

    NASA Astrophysics Data System (ADS)

    Fritz, H.; Hauzenberger, C. A.; Tenczer, V.

    2012-04-01

    Tanzania and southern Kenya hold a key position for reconstructing Gondwana consolidation because here different orogen belts with different tectonic styles interfere. The older, ca. 650-620 Ma East African Orogeny resulted from the amalgamation of arc terranes in the northern Arabian-Nubian Shield (ANS) and continental collision between East African pieces and parts of the Azania terrane in the south (Collins and Pisarevsky, 2005). The change form arc suturing to continental collision settings is found in southern Kenya where southernmost arcs of the ANS conjoin with thickened continental margin suites of the Eastern Granulite Belt. The younger ca. 570-530 Ma Kuunga orogeny heads from the Damara - Zambesi - Irumide Belts (De Waele et al., 2006) over Tanzania - Mozambique to southern India and clashes with the East African orogen in southern-central Tanzania. Two transitional orogen settings may be defined, (1) that between island arcs and inverted passive continental margin within the East African Orogen and, (2) that between N-S trending East African and W-E trending Kuungan orogenies. The Neoproterozoic island arc suites of SE-Kenya are exposed as a narrow stripe between western Azania and the Eastern Granulite belt. This suture is a steep, NNW stretched belt that aligns roughly with the prominent southern ANS shear zones that converge at the southern tip of the ANS (Athi and Aswa shear zones). Oblique convergence resulted in low-vorticity sinstral shear during early phases of deformation. Syn-magmatic and syn-tectonic textures are compatible with deformation at granulite metamorphic conditions and rocks exhumed quickly during ongoing transcurrent motion. The belt is typified as wrench tectonic belt with horizontal northwards flow of rocks within deeper portions of an island arc. The adjacent Eastern Granulite Nappe experienced westward directed, subhorizontal, low-vorticity, high temperature flow at partly extreme metamorphic conditions (900°C, 1.2 to 1.4 GPa) (Fritz et al., 2009). Majority of data suggest an anticlockwise P-T loop and prolonged, slow cooling at deep crustal levels without significant exhumation. Isobaric cooling is explained by horizontal flow with rates faster than thermal equilibration of the lower crust. Those settings are found in domains of previously thinned lithosphere such as extended passive margins. Such rheolgically weak plate boundaries do not produce self-sustaining one-sided subduction but large areas of magmatic underplating that enable melt enhanced lateral flow of the lower crust. Western Granulites deformed by high-vorticity westwards thrusting at c. 550 Ma (Kuunga orogeny). Rocks exhibit clockwise P-T paths and experienced significant exhumation during isothermal decompression. Overprint between Kuungan structures and 620 Ma East African fabrics resulted in complex interference pattern within the Eastern Granulites. The three orogen portions that converge in Tanzania / Southern Kenya have different orogen styles. The southern ANS formed by transcurrent deformation of an island arc root; the Eastern Granulites by lower crustal channelized flow of a hot inverted passive margin; the Western Granulites by lower to mid crustal stacking of old and cold crustal fragments. Collins, A.S., Pisarevsky, S.A. (2005). Amalgamating eastern Gondwana: The evolution of the Circum-Indian Orogens. Earth-Science Reviews, 71, 229-270. De Waele, B., Kampunzu, A.B., Mapani, B.S.E., Tembo, F. (2006). The Mesoproterozoic Irumide belt of Zambia. Journal of African Earth Sciences, 46, 36-70 Fritz, H., Tenczer, V., Hauzenberger, C., Wallbrecher, E., Muhongo, S. (2009). Hot granulite nappes — Tectonic styles and thermal evolution of the Proterozoic granulite belts in East Africa. Tectonophysics, 477, 160-173.

  6. Aetiology of Acute Febrile Episodes in Children Attending Korogwe District Hospital in North-Eastern Tanzania

    PubMed Central

    Mahende, Coline; Ngasala, Billy; Lusingu, John; Butichi, Allvan; Lushino, Paminus; Lemnge, Martha; Premji, Zul

    2014-01-01

    Introduction Although the burden of malaria in many parts of Tanzania has declined, the proportion of children with fever has not changed. This situation underscores the need to explore the possible causes of febrile episodes in patients presenting with symptoms at the Korogwe District Hospital (KDH). Methods A hospital based cross-sectional study was conducted at KDH, north-eastern Tanzania. Patients aged 2 to 59 months presenting at the outpatient department with an acute medical condition and fever (measured axillary temperature ?37.5°C) were enrolled. Blood samples were examined for malaria parasites, human immunodeficiency virus (HIV) and bacterial infections. A urine culture was performed in selected cases to test for bacterial infection and a chest radiograph was requested if pneumonia was suspected. Diagnosis was based on both clinical and laboratory investigations. Results A total of 867 patients with a median age of 15.1 months (Interquartile range 8.6–29.9) were enrolled from January 2013 to October 2013. Respiratory tract infections were the leading clinical diagnosis with 406/867 (46.8%) of patients diagnosed with upper respiratory tract infection and 130/867 (15.0%) with pneumonia. Gastroenteritis was diagnosed in 184/867 (21.2%) of patients. Malaria infection was confirmed in 72/867 (8.3%) of patients. Bacterial infection in blood and urine accounted for 26/808 (3.2%) infections in the former, and 66/373 (17.7%) infections in the latter. HIV infection was confirmed in 10/824 (1.2%) of patients. Respiratory tract infections and gastroenteritis were frequent in patients under 36 months of age (87.3% and 91.3% respectively). Co-infections were seen in 221/867 (25.5%) of patients. The cause of fever was not identified in 65/867 (7.5%) of these patients. Conclusions The different proportions of infections found among febrile children reflect the causes of fever in the study area. These findings indicate the need to optimise patient management by developing malaria and non-malaria febrile illnesses management protocols. PMID:25090651

  7. Farmers' knowledge, practices and injuries associated with pesticide exposure in rural farming villages in Tanzania

    PubMed Central

    2014-01-01

    Background Pesticides in Tanzania are extensively used for pest control in agriculture. Their usage and unsafe handling practices may potentially result in high farmer exposures and adverse health effects. The aim of this study was to describe farmers’ pesticide exposure profile, knowledge about pesticide hazards, experience of previous poisoning, hazardous practices that may lead to Acute Pesticide Poisoning (APP) and the extent to which APP is reported. Methods The study involved 121 head- of-household respondents from Arumeru district in Arusha region. Data collection involved administration of a standardised questionnaire to farmers and documentation of storage practices. Unsafe pesticide handling practices were assessed through observation of pesticide storage, conditions of personal protective equipment (PPE) and through self-reports of pesticide disposal and equipment calibration. Results Past lifetime pesticide poisoning was reported by 93% of farmers. The agents reported as responsible for poisoning were Organophosphates (42%) and WHO Class II agents (77.6%). Storage of pesticides in the home was reported by 79% of farmers. Respondents with higher education levels were significantly less likely to store pesticides in their home (PRR High/Low = 0.3; 95% CI = 0.1-0.7) and more likely to practice calibration of spray equipment (PRR High/Low = 1.2; 95% CI = 1.03-1.4). However, knowledge of routes of exposure was not associated with safety practices particularly for disposal, equipment wash area, storage and use of PPE . The majority of farmers experiencing APP in the past (79%) did not attend hospital and of the 23 farmers who did so in the preceding year, records could be traced for only 22% of these cases. Conclusions The study found a high potential for pesticide exposure in the selected community in rural Tanzania, a high frequency of self-reported APP and poor recording in hospital records. Farmers’ knowledge levels appeared to be unrelated to their risk. Rather than simply focusing on knowledge-based strategies, comprehensive interventions are needed to reduce both exposure and health risks, including training, improvements in labeling, measures to reduce cost barriers to the adoption of safe behaviours, , promotion of control measures other than PPE and support for Integrated Pest Management (IPM). PMID:24754959

  8. A Spatial Analysis of Rift Valley Fever Virus Seropositivity in Domestic Ruminants in Tanzania

    PubMed Central

    Sindato, Calvin; Pfeiffer, Dirk U.; Karimuribo, Esron D.; Mboera, Leonard E. G.; Rweyemamu, Mark M.; Paweska, Janusz T.

    2015-01-01

    Rift Valley fever (RVF) is an acute arthropod-borne viral zoonotic disease primarily occurring in Africa. Since RVF-like disease was reported in Tanzania in 1930, outbreaks of the disease have been reported mainly from the eastern ecosystem of the Great Rift Valley. This cross-sectional study was carried out to describe the variation in RVF virus (RVFV) seropositivity in domestic ruminants between selected villages in the eastern and western Rift Valley ecosystems in Tanzania, and identify potential risk factors. Three study villages were purposively selected from each of the two Rift Valley ecosystems. Serum samples from randomly selected domestic ruminants (n = 1,435) were tested for the presence of specific immunoglobulin G (IgG) and M (IgM), using RVF enzyme-linked immunosorbent assay methods. Mixed effects logistic regression modelling was used to investigate the association between potential risk factors and RVFV seropositivity. The overall RVFV seroprevalence (n = 1,435) in domestic ruminants was 25.8% and speciesspecific seroprevalence was 29.7%, 27.7% and 22.0% in sheep (n = 148), cattle (n = 756) and goats (n = 531), respectively. The odds of seropositivity were significantly higher in animals sampled from the villages in the eastern than those in the western Rift Valley ecosystem (OR = 1.88, CI: 1.41, 2.51; p<0.001), in animals sampled from villages with soils of good than those with soils of poor water holding capacity (OR = 1.97; 95% CI: 1.58, 3.02; p< 0.001), and in animals which had been introduced than in animals born within the herd (OR = 5.08, CI: 2.74, 9.44; p< 0.001). Compared with animals aged 1–2 years, those aged 3 and 4–5 years had 3.40 (CI: 2.49, 4.64; p< 0.001) and 3.31 (CI: 2.27, 4.82, p< 0.001) times the odds of seropositivity. The findings confirm exposure to RVFV in all the study villages, but with a higher prevalence in the study villages from the eastern Rift Valley ecosystem. PMID:26162089

  9. Prevalence of Bacterial Febrile Illnesses in Children in Kilosa District, Tanzania

    PubMed Central

    Chipwaza, Beatrice; Mhamphi, Ginethon G.; Ngatunga, Steve D.; Selemani, Majige; Amuri, Mbaraka; Mugasa, Joseph P.; Gwakisa, Paul S.

    2015-01-01

    Introduction Bacterial etiologies of non-malaria febrile illnesses have significantly become important due to high mortality and morbidity, particularly in children. Despite their importance, there are few reports on the epidemiology of these diseases in Tanzania, and the true burden of such illnesses remains unknown. This study aimed to identify the prevalence of leptospirosis, brucellosis, typhoid fever and urinary tract infections and their rate of co-infections with malaria. Methods A cross-sectional study was conducted at Kilosa district hospital in Tanzania for 6 months. Febrile children aged from 2–13 years were recruited from the outpatient department. Patients were screened by serological tests such as IgM and IgG ELISA, and microscopic agglutination test. Results A total of 370 patients were enrolled; of these 85 (23.0%) had malaria parasites, 43 (11.6%) had presumptive acute leptospirosis and 26/200 (13%) had confirmed leptospirosis. Presumptive acute brucellosis due to B. abortus was identified among 26 (7.0%) of patients while B. melitensis was detected in 57 (15.4%) of the enrolled patients. Presumptive typhoid fever due to S. Typhi was identified in thirty eight (10.3%) of the participants and 69 (18.6%) had urinary tract infections. Patients presented with similar symptoms; therefore, the identification of these diseases could not be done based on clinical ground alone. Co-infections between malaria and bacterial febrile illnesses were observed in 146 patients (39.5%). Although antibacterials and/or anti-malarials were prescribed in most patients, some patients did not receive the appropriate treatment. Conclusion The study has underscored the importance of febrile bacterial diseases including zoonoses such as leptospirosis and brucellosis in febrile children, and thus such illnesses should be considered by clinicians in the differential diagnoses of febrile diseases. However, access to diagnostic tests for discrimination of febrile illnesses is needed. This would allow febrile patients to receive the correct diagnoses and facilitation of accurate and prompt treatment. PMID:25955522

  10. The Epidemiology of Chronic Kidney Disease in Northern Tanzania: A Population-Based Survey

    PubMed Central

    Stanifer, John W.; Maro, Venance; Egger, Joseph; Karia, Francis; Thielman, Nathan; Turner, Elizabeth L.; Shimbi, Dionis; Kilaweh, Humphrey; Matemu, Oliver; Patel, Uptal D.

    2015-01-01

    Background In sub-Saharan Africa, kidney failure has a high morbidity and mortality. Despite this, population-based estimates of prevalence, potential etiologies, and awareness are not available. Methods Between January and June 2014, we conducted a household survey of randomly-selected adults in Northern Tanzania. To estimate prevalence we screened for CKD, which was defined as an estimated glomerular filtration rate ? 60 ml/min/1.73m2 and/or persistent albuminuria. We also screened for human immunodeficiency virus (HIV), diabetes, hypertension, obesity, and lifestyle practices including alcohol, tobacco, and traditional medicine use. Awareness was defined as a self-reported disease history and subsequently testing positive. We used population-based age- and gender-weights in estimating prevalence, and we used generalized linear models to explore potential risk factors associated with CKD, including living in an urban environment. Results We enrolled 481 adults from 346 households with a median age of 45 years. The community-based prevalence of CKD was 7.0% (95% CI 3.8-12.3), and awareness was low at 10.5% (4.7-22.0). The urban prevalence of CKD was 15.2% (9.6-23.3) while the rural prevalence was 2.0% (0.5-6.9). Half of the cases of CKD (49.1%) were not associated with any of the measured risk factors of hypertension, diabetes, or HIV. Living in an urban environment had the strongest crude (5.40; 95% CI 2.05-14.2) and adjusted prevalence risk ratio (4.80; 1.70-13.6) for CKD, and the majority (79%) of this increased risk was not explained by demographics, traditional medicine use, socioeconomic status, or co-morbid non-communicable diseases (NCDs). Conclusions We observed a high burden of CKD in Northern Tanzania that was associated with low awareness. Although demographic, lifestyle practices including traditional medicine use, socioeconomic factors, and NCDs accounted for some of the excess CKD risk observed with urban residence, much of the increased urban prevalence remained unexplained and will further study as demographic shifts reshape sub-Saharan Africa. PMID:25886472

  11. Policy environment and male circumcision for HIV prevention: Findings from a situation analysis study in Tanzania

    PubMed Central

    2011-01-01

    Background Male circumcision (MC) has been shown to be effective against heterosexual acquisition of HIV infection and is being scaled up as an additional strategy against HIV in several countries of Africa. However, the policy environment (whether to formulate new specific policy on MC or adapts the existing ones); and the role of various stakeholders in the MC scale up process in Tanzania was unclear. We conducted this study as part of a situation analysis to understand the attitudes of policy makers and other key community and health authority decision makers towards MC, policy and regulatory environment, and the readiness of a health system to accommodate scaling up of MC services. Methods We conducted 36 key informants' interviews with a broad range of informants including civil servants, religious leaders, cultural and traditional gatekeepers and other potential informants. Study informants were selected at the national level, regional, district and community levels to represent both traditionally circumcising and non-circumcising communities. Results Study informants had positive attitudes and strong beliefs towards MC. Key informants in traditionally non-circumcising districts were willing to take their sons for medically performed MC. Religious leaders and traditional gatekeepers supported MC as it has been enshrined in their holy scripts and traditional customs respectively. Civil servants highlighted the need for existence of enabling policy and regulatory environment in the form of laws, regulations and guidelines that will ensure voluntary accessibility, acceptability, quality and safety for those in need of MC services. Majority of informants urged the government to make improvements in the health system at all levels to ensure availability of adequate trained personnel, infrastructure, equipment, and supplies for MC scale up, and insisted on the involvement of different MC stakeholders as key components in effective roll out of medically performed MC programme in the country. Conclusions Findings from the situation analysis in Tanzania have shown that despite the absence of a specific policy on MC, basic elements of enabling policy environment at national, regional, district and community levels are in place for the implementation of MC scale up programme. PMID:21708046

  12. High prevalence of trichomoniasis in rural men in Mwanza, Tanzania: results from a population based study

    PubMed Central

    Watson-Jones, D.; Mugeye, K.; Mayaud, P.; Ndeki, L.; Todd, J.; Mosha, F.; West, B.; Cleophas-Frisch, B.; Grosskurth, H.; Laga, M.; Hayes, R.; Mabey, D.; Buve, A.

    2000-01-01

    Objectives: To measure the prevalence of urethral infections including trichomoniasis in rural Tanzanian men, to assess the prevalence of symptoms and signs among men with Trichomonas vaginalis, and to analyse the risk factors for trichomoniasis. Design: A cross sectional study of 1004 men aged 15–54 years in a rural community in north west Tanzania. Methods: Participants were interviewed about sexual behaviour and symptoms of sexually transmitted diseases. First fraction urine samples and urethral swabs were collected and used to test for T vaginalis by wet preparation and culture, Neisseria gonorrhoeae by culture, Chlamydia trachomatis by ligase chain reaction and non-specific urethritis by Gram stain. Urine was also tested for the presence of leucocytes using a leucocyte esterase dipstick. Men were re-interviewed 2 weeks later to document new symptoms and signs of urethritis. Results: Complete laboratory results were available on 980 men. One in four men had laboratory evidence of urethritis. T vaginalis was found in 109 individuals (11%), gonorrhoea in eight (0.8%), and chlamydial infection in 15 (1.5%). Over 50% of men with urethritis were asymptomatic. The prevalence of signs and symptoms was similar among men with T vaginalis alone compared with men with other urethral infections. The sensitivity and specificity of the leucocyte esterase dipstick (LED) test for detecting T vaginalis were 80% and 48% respectively in symptomatic men and 60% and 68% in asymptomatic men. Factors associated with trichomoniasis included religion, type of employment, and marital status. Conclusions: A high prevalence of urethritis was found in men in this community based study. More than half of the urethral infections detected were asymptomatic. The most prevalent pathogen was T vaginalis. Studies are needed on the prevalence of trichomoniasis in men presenting to health services with complaints suggestive of urethritis since treatment for T vaginalis is not included in the syndromic management of urethritis in most countries. The performance of the LED test as a screening test for trichomoniasis was unsatisfactory in both symptomatic and asymptomatic men. Improved screening tests are urgently needed to identify urethral infections that are asymptomatic and which are not covered by current syndromic management algorithms. Key Words: urethritis; Tanzania; Trichomonas vaginalis PMID:11141851

  13. Men’s Knowledge of Obstetric Danger Signs, Birth Preparedness and Complication Readiness in Rural Tanzania

    PubMed Central

    August, Furaha; Pembe, Andrea B.; Mpembeni, Rose; Axemo, Pia; Darj, Elisabeth

    2015-01-01

    Background Men’s involvement in reproductive health is recommended. Their involvement in antenatal care service is identified as important in maternal health. Awareness of obstetric danger signs facilitates men in making a joint decision with their partners regarding accessing antenatal and delivery care. This study aims to assess the level of knowledge of obstetric complications among men in a rural community in Tanzania, and to determine their involvement in birth preparedness and complication readiness. Methods A cross-sectional survey was conducted where 756 recent fathers were invited through a two-stage cluster sampling procedure. A structured questionnaire was used to collect socio-demographic characteristics, knowledge of danger signs and steps taken on birth preparedness and complication readiness. Data were analyzed using bivariate and multivariable logistic regression to determine factors associated with being prepared, with statistically significant level at p<0.05. Results Among the invited men, 95.9% agreed to participate in the community survey. Fifty-three percent could mention at least one danger sign during pregnancy, 43.9% during delivery and 34.6% during the postpartum period. Regarding birth preparedness and complication readiness, 54.3% had bought birth kit, 47.2% saved money, 10.2% identified transport, 0.8% identified skilled attendant. In general, only 12% of men were prepared. Birth preparedness was associated with knowledge of danger signs during pregnancy (AOR = 1.4, 95% CI: 1.8-2.6). It was less likely for men living in the rural area to be prepared (AOR=0.6, 95% CI; 0.5-0.8). Conclusion There was a low level of knowledge of obstetric danger signs among men in a rural district in Tanzania. A very small proportion of men had prepared for childbirth and complication readiness. There was no effect of knowledge of danger signs during childbirth and postpartum period on being prepared. Innovative strategies that increase awareness of danger signs as well as birth preparedness and complication readiness among men are required. Strengthening counseling during antenatal care services that involve men together with partners is recommended. PMID:25950814

  14. Increasing Access to Subsidized Artemisinin-based Combination Therapy through Accredited Drug Dispensing Outlets in Tanzania

    PubMed Central

    2011-01-01

    Background In Tanzania, many people seek malaria treatment from retail drug sellers. The National Malaria Control Program identified the accredited drug dispensing outlet (ADDO) program as a private sector mechanism to supplement the distribution of subsidized artemisinin-based combination therapies (ACTs) from public facilities and increase access to the first-line antimalarial in rural and underserved areas. The ADDO program strengthens private sector pharmaceutical services by improving regulatory and supervisory support, dispenser training, and record keeping practices. Methods The government's pilot program made subsidized ACTs available through ADDOs in 10 districts in the Morogoro and Ruvuma regions, covering about 2.9 million people. The program established a supply of subsidized ACTs, created a price system with a cost recovery plan, developed a plan to distribute the subsidized products to the ADDOs, trained dispensers, and strengthened the adverse drug reactions reporting system. As part of the evaluation, 448 ADDO dispensers brought their records to central locations for analysis, representing nearly 70% of ADDOs operating in the two regions. ADDO drug register data were available from July 2007-June 2008 for Morogoro and from July 2007-September 2008 for Ruvuma. This intervention was implemented from 2007-2008. Results During the pilot, over 300,000 people received treatment for malaria at the 448 ADDOs. The percentage of ADDOs that dispensed at least one course of ACT rose from 26.2% during July-September 2007 to 72.6% during April-June 2008. The number of malaria patients treated with ACTs gradually increased after the start of the pilot, while the use of non-ACT antimalarials declined; ACTs went from 3% of all antimalarials sold in July 2007 to 26% in June 2008. District-specific data showed substantial variation among the districts in ACT uptake through ADDOs, ranging from ACTs representing 10% of all antimalarial sales in Kilombero to 47% in Morogoro Rural. Conclusions The intervention increased access to affordable ACTs for underserved populations. Indications are that antimalarial monotherapies are being "crowded out" of the market. Importantly, the transition to ACTs has been accomplished in an environment where the safety and efficacy of the drugs and the quality of services are being monitored and regulated. This paper presents a description of the pilot program implementation, results of the program evaluation, and a discussion of the challenges and recommendations that will be used to guide rollout of subsidized ACT in ADDOs in the rest of Tanzania and possibly in other countries. PMID:21658259

  15. Smallholder Information Sources and Communication Pathways for Cashew Production and Marketing in Tanzania: An Ex-Post Study in Tandahimba and Lindi Rural Districts, Southern Tanzania

    ERIC Educational Resources Information Center

    Nyambo, Brigitte; Ligate, Elly

    2013-01-01

    Purpose: To identify and review production and marketing information sources and flows for smallholder cashew (Anacardium occidentale L.) growers in Tanzania and recommend systems improvements for better technology uptake. Design/methodology/approach: Two-stage purposive samples were drawn. First, two districts in the main cashew producing areas,…

  16. The Tanzania Literacy Programme: A View from Below. Report of an IIEP Research Review Workshop (Morogoro, Tanzania, October 10-12, 1990).

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific, and Cultural Organization, Paris (France). International Inst. for Educational Planning.

    Research conducted in Tanzania had two purposes: to describe the literacy program and literacy learners and to determine the literacy skill levels of participants and to what use they are putting those skills. Researchers spent a month in each of four villages gaining information about the socioeconomic system, communication, development, the role…

  17. Cost-effectiveness of social marketing of insecticide-treated nets for malaria control in the United Republic of Tanzania.

    PubMed Central

    Hanson, Kara; Kikumbih, Nassor; Armstrong Schellenberg, Joanna; Mponda, Haji; Nathan, Rose; Lake, Sally; Mills, Anne; Tanner, Marcel; Lengeler, Christian

    2003-01-01

    OBJECTIVE: To assess the costs and consequences of a social marketing approach to malaria control in children by means of insecticide-treated nets in two rural districts of the United Republic of Tanzania, compared with no net use. METHODS: Project cost data were collected prospectively from accounting records. Community effectiveness was estimated on the basis of a nested case-control study and a cross-sectional cluster sample survey. FINDINGS: The social marketing approach to the distribution of insecticide-treated nets was estimated to cost 1560 US dollars per death averted and 57 US dollars per disability-adjusted life year averted. These figures fell to 1018 US dollars and 37 US dollars, respectively, when the costs and consequences of untreated nets were taken into account. CONCLUSION: The social marketing of insecticide-treated nets is an attractive intervention for preventing childhood deaths from malaria. PMID:12764493

  18. A Multi-Model Real Time Forecasting Prototype System in the Mara Basin (Kenya/Tanzania)

    NASA Astrophysics Data System (ADS)

    Serrat-Capdevila, A.; Valdes, J. B.; Valdes, R.; Demaria, E. M.; Durcik, M.; Maitaria, K.; Roy, T.

    2013-12-01

    Remote sensing data and hydrologic models can respond to monitoring and forecasting needs in Africa and other poorly gauged regions. We present here the progress to date in developing a multi-model platform to provide hydrologic monitoring and forecasting using real time remote sensing observations. Satellite precipitation products such as CMORPH, TMPA (at 0.25° resolution) and PERSIANN-CCS (at 4km resolution) are used to force two models of different structure. One model is physically based and distributed, and the other is conceptual and lumped at the sub-basin level. The performance of both models is evaluated using different metrics, and the uncertainty in their predictions based on the errors incurred during the historical simulations period is computed. The models were compared and the potential increase in performance from using both models versus a single one will be assessed. This work provides insights into the advantages of a multi-model platform over a single model, with respect to different management and decision-making purposes. The methods were applied to the Mara Basin (Kenya/Tanzania), where growing human demands on water and land use are likely to alter significantly the hydrologic balance of the basin and the ecosystems that depend on it. These efforts are part of the Applied Sciences Team of the NASA SERVIR Program in collaboration with its East Africa Hub at the Regional Center for Mapping of Resources for Development (Nairobi,Kenya).

  19. Neglect and perceived stigmatization impact psychological distress of orphans in Tanzania

    PubMed Central

    Hermenau, Katharin; Eggert, Ina; Landolt, Markus A.; Hecker, Tobias

    2015-01-01

    Background Research has shown that orphans in sub-Saharan Africa are at increased risk for mental health problems. Exposure to maltreatment and HIV/AIDS-related stigmatization are related to orphans’ psychological distress. Yet, researchers stress the need for more research in low-income countries to identify which factors of being an orphan may lead to psychological distress. Objectives The present study aims to systematically investigate orphans’ experiences of maltreatment and stigmatization to identify factors that relate to their psychological distress. Methods In total, 89 Tanzanian children who had lost at least one parent were compared to 89 matched non-orphans (mean age: 11 years; 51% boys). We measured exposure to maltreatment and perceived stigmatization as an orphan. Mental health was assessed using the Strengths and Difficulties Questionnaire, the Children's Depression Inventory, the UCLA PTSD Index for Children, and the Reactive–Proactive Questionnaire. Results Orphans reported significantly more experiences of neglect, but not of abuse. A group comparison revealed more depressive symptoms, posttraumatic stress symptoms, and aggressive behavior among orphans. Neglect, abuse, and stigmatization correlated with orphans’ internalizing and externalizing problems, yet only neglect and stigmatization were related to orphans’ depression severity. Perceived stigmatization moderated the relationship between neglect and depression. Conclusions Our findings suggest that orphans in Tanzania are at increased risk of experiencing neglect. Maltreatment and perceived stigmatization may play a role in orphans’ psychological distress. Culturally appropriate and evidence-based interventions may help to prevent maltreatment and stigmatization of orphans. PMID:26589257

  20. Qualitative Assessment of the Integration of HIV Services With Infant Routine Immunization Visits in Tanzania

    PubMed Central

    Wallace, Aaron; Kimambo, Sajida; Dafrossa, Lyimo; Rusibamayila, Neema; Rwebembera, Anath; Songoro, Juma; Arthur, Gilly; Luman, Elizabeth; Finkbeiner, Thomas; Goodson, James L.

    2015-01-01

    Background In 2009, a project was implemented in 8 primary health clinics throughout Tanzania to explore the feasibility of integrating pediatric HIV prevention services with routine infant immunization visits. Methods We conducted interviews with 64 conveniently sampled mothers of infants who had received integrated HIV and immunization services and 16 providers who delivered the integrated services to qualitatively identify benefits and challenges of the intervention midway through project implementation. Findings Mothers’ perceived benefits of the integrated services included time savings, opportunity to learn their child's HIV status and receive HIV treatment, if necessary. Providers’ perceived benefits included reaching mothers who usually would not come for only HIV testing. Mothers and providers reported similar challenges, including mothers’ fear of HIV testing, poor spousal support, perceived mandatory HIV testing, poor patient flow affecting confidentiality of service delivery, heavier provider workloads, and community stigma against HIV-infected persons; the latter a more frequent theme in rural compared with urban locations. Interpretation Future scale-up should ensure privacy of these integrated services received at clinics and community outreach to address stigma and perceived mandatory testing. Increasing human resources for health to address higher workloads and longer waiting times for proper patient flow is necessary in the long term. PMID:24326602

  1. Blood pressure and heart murmurs in a rural population in the United Republic of Tanzania*

    PubMed Central

    Vaughan, J. P.

    1979-01-01

    Hypertension, congestive heart failure, and valvular heart disease are frequently seen among hospital inpatients in the United Republic of Tanzania. A population survey was therefore carried out to determine the prevalence of hypertension and cardiac murmurs in a random sample of people aged 25-64 years living in an undeveloped rural area. Standard cardiovascular survey methods as recommended by WHO were used. Only mean systolic blood pressure in women increased with age; even so, the difference in mean levels between those aged 25-34 and 55-64 years was only about 1.6 kPa (12 mmHg). Hypertension was found to be uncommon, only 2% of subjects having blood pressures ? 21.3/ 12.7 kPa (? 160/95 mmHg). By means of multiple regression analysis, less than 10% of the variance in blood pressure levels could be explained by age and anthropometric measurements. Murmurs of grade 2 or more were detected in 17% of the men and 22% of the women, being most commonly heard at the apex (54%) and the left lower border of the sternum (31%). Mitral valve diastolic murmurs were heard in 4 of 275 women and these were asymptomatic. The cause of the high prevalence of systolic murmurs is unknown. PMID:311715

  2. Factors underlying diagnostic delay in tuberculosis patients in a rural area in Tanzania: a qualitative approach

    PubMed Central

    Kapinga, R.; van Rosmalen-Nooijens, K. A. W. L.

    2010-01-01

    Background Diagnostic delay in patients with tuberculosis (TB) leads to ongoing TB transmission, higher mortality rates and increased patient and government health expenditure. Qualitative research focussed on patients’ self-perceptions of disease and their care-seeking behaviour helps to guide health education programmes by providing us with the understanding of the knowledge, attitudes and practices that underlie diagnostic delay. Patients and methods Semi-structured interviews with 28 recently diagnosed TB patients and four traditional healers were conducted. The interviews were audio-recorded and content analysis was performed. Results The median total delay was 188 days. The health provider delay (31 days) was longer than the patient delay (21 days) and the health system delay (26 days). The health system delay was longest in patients not being diagnosed at their first hospital visit and subsequently visiting other health care providers, mostly traditional healers. Conclusions A poor knowledge of TB signs and symptoms and patients’ beliefs about curses as the origin of diseases lead to delayed care-seeking at the hospital level in an area of North-Western Tanzania. Failure to identify TB cases by formal and non-formal health providers indicates that the education of both communities as well as health workers is essential in order to reduce diagnostic delays. PMID:20878458

  3. Silica Exposures in Artisanal Small-Scale Gold Mining in Tanzania and Implications for Tuberculosis Prevention.

    PubMed

    Gottesfeld, Perry; Andrew, Damian; Dalhoff, Jeffrey

    2015-01-01

    Gold miners exposed to crystalline silica are at risk of silicosis, lung cancer, and experience higher incidence rates of pulmonary tuberculosis (TB). Although the hazards associated with mercury exposure in artisanal small-scale gold mining (ASGM) have been well documented, no published data was available on crystalline silica exposures in this population. Air sampling was conducted in the breathing zone of workers in five villages in Tanzania with battery-operated sampling pumps and bulk samples were collected to measure the type and concentration of crystalline silica in the ore. Samples were analyzed at an accredited laboratory with X-ray diffraction. Airborne crystalline silica exposures exceeded recommended limits for all tasks monitored with an average exposure of 16.85 mg/m(3) for underground drilling that was 337 fold greater than the recommended exposure limit (REL) published by the U.S. National Institute for Occupational Safety and Health (NIOSH) and 0.19 mg/m(3) for aboveground operations or 4-fold greater than the REL. The exposures measured raise concern for possible acute and chronic silicosis and are known to significantly contribute to TB incidence rates in mining communities. The use of wet methods could greatly reduce exposures and the risk of TB and silicosis in ASGM. Ongoing efforts to address mercury and other hazards in ASGM should incorporate crystalline silica dust controls. PMID:25897484

  4. Invasive Bacterial and Fungal Infections Among Hospitalized HIV-Infected and HIV-Uninfected Adults and Adolescents in Northern Tanzania

    PubMed Central

    Ramadhani, Habib O.; Morrissey, Anne B.; Saganda, Wilbrod; Mwako, Mtumwa S.; Yang, Lan-Yan; Chow, Shein-Chung; Morpeth, Susan C.; Reyburn, Hugh; Njau, Boniface N.; Shaw, Andrea V.; Diefenthal, Helmut C.; Shao, John F.; Bartlett, John A.; Maro, Venance P.

    2011-01-01

    (See the editorial commentary by Levine and Farag, on pages 349-351.) Background. Few studies describe patterns of human immunodeficiency virus (HIV) co-infections in African hospitals in the antiretroviral therapy (ART) era. Methods. We enrolled consecutive admitted patients aged ?13 years with oral temperature of ?38.0°C during 1 year in Moshi, Tanzania. A standardized clinical history and physical examination was done and hospital outcome recorded. HIV antibody testing, aerobic and mycobacterial blood cultures, and malaria film were performed. HIV-infected patients also received serum cryptococcal antigen testing and CD4+ T lymphocyte count (CD4 cell count). Results. Of 403 patients enrolled, the median age was 38 years (range, 14–96 years), 217 (53.8%) were female, and 157 (39.0%) were HIV-infected. Of HIV-infected patients, the median CD4 cell count was 98 cells/?L (range, 1–1,105 cells/ ?L), 20 (12.7%) were receiving ART, and 29 (18.5%) were receiving trimethoprim-sulfamethoxazole prophylaxis. There were 112 (27.7%) patients who had evidence of invasive disease, including 26 (23.2%) with Salmonella serotype Typhi infection, 24 (21.4%) with Streptococcus pneumoniae infection, 17 (15.2%) with Cryptococcus neoformans infection, 12 (10.7%) with Mycobacterium tuberculosis complex infection, 8 (7.1%) with Plasmodium falciparum infection, and 7 (6.3%) with Escherichia coli infection. HIV infection was associated with M. tuberculosis and C. neoformans bloodstream infection but not with E. coli, S. pneumoniae, or P. falciparum infection. HIV infection appeared to be protective against Salmonella. Typhi bloodstream infection (odds ratio, .12; P = .001). Conclusions. While Salmonella Typhi and S. pneumoniae were the most common causes of invasive infection overall, M. tuberculosis and C. neoformans were the leading causes of bloodstream infection among HIV-infected inpatients in Tanzania in the ART era. We demonstrate a protective effect of HIV against Salmonella. Typhi bloodstream infection in this setting. HIV co-infections continue to account for a large proportion of febrile admissions in Tanzania. PMID:21217181

  5. Feasibility of introducing compulsory community health fund in low resource countries: views from the communities in Liwale district of Tanzania

    PubMed Central

    2013-01-01

    Background In 1995, Tanzania introduced the voluntary Community Health Fund (CHF) with the aim of ensuring universal health coverage by increasing financial investment in the health sector. The uptake of the CHF is low, with an enrolment of only 6% compared to the national target of 75%. Mandatory models of community health financing have been suggested to increase enrolment and financial capacity. This study explores communities’ views on the introduction of a mandatory model, the Compulsory Community Health Fund (CCHF) in the Liwale district of Tanzania. Methods A cross-sectional study which involved 387 participants in a structured face to face survey and 33 in qualitative interviews (26 in focus group discussions (FGD) and 7 in in-depth interviews (IDI). Structured survey data were analyzed using SPSS version 16 to produce descriptive statistics. Qualitative data were analyzed using content analysis. Results 387 people completed a survey (58% males), mean age 38 years. Most participants (347, 89.7%) were poor subsistence farmers and 229 (59.2%) had never subscribed to any form of health insurance scheme. The idea of a CCHF was accepted by 221 (57%) survey participants. Reasons for accepting the CCHF included: reduced out of pocket expenditure, improved quality of health care and the removal of stigma for those who receive waivers at health care delivery points. The major reason for not accepting the CCHF was the poor quality of health care services currently offered. Participants suggested that enrolment to the CCHF be done after harvesting when the population were more likely to have disposable income, and that the quality care of care and benefits package be improved. Conclusions The CHF is acceptable to the most of study participants and feasible in rural Tanzania as an alternative mechanism to finance health care for the rural poor. Community members are willing to join the scheme provided they are well informed, involved in the design and implementation, and assured quality health care. Strong political will and a supportive environment are key ingredients for the success of the CCHF. PMID:23924271

  6. Analysing and recommending options for maintaining universal coverage with long-lasting insecticidal nets: the case of Tanzania in 2011

    PubMed Central

    2013-01-01

    Background Tanzania achieved universal coverage with long-lasting insecticidal nets (LLINs) in October 2011, after three years of free mass net distribution campaigns and is now faced with the challenge of maintaining high coverage as nets wear out and the population grows. A process of exploring options for a continuous or “Keep-Up” distribution system was initiated in early 2011. This paper presents for the first time a comprehensive national process to review the major considerations, findings and recommendations for the implementation of a new strategy. Methods Stakeholder meetings and site visits were conducted in five locations in Tanzania to garner stakeholder input on the proposed distribution systems. Coverage levels for LLINs and their decline over time were modelled using NetCALC software, taking realistic net decay rates, current demographic profiles and other relevant parameters into consideration. Costs of the different distribution systems were estimated using local data. Results LLIN delivery was considered via mass campaigns, Antenatal Care-Expanded Programme on Immunization (ANC/EPI), community-based distribution, schools, the commercial sector and different combinations of the above. Most approaches appeared unlikely to maintain universal coverage when used alone. Mass campaigns, even when combined with a continuation of the Tanzania National Voucher Scheme (TNVS), would produce large temporal fluctuations in coverage levels; over 10 years this strategy would require 63.3 million LLINs and a total cost of $444 million USD. Community mechanisms, while able to deliver the required numbers of LLINs, would require a massive scale-up in monitoring, evaluation and supervision systems to ensure accurate application of identification criteria at the community level. School-based approaches combined with the existing TNVS would reach most Tanzanian households and deliver 65.4 million LLINs over 10 years at a total cost of $449 million USD and ensure continuous coverage. The cost of each strategy was largely driven by the number of LLINs delivered. Conclusions The most cost-efficient strategy to maintain universal coverage is one that best optimizes the numbers of LLINs needed over time. A school-based approach using vouchers targeting all students in Standards 1, 3, 5, 7 and Forms 1 and 2 in combination with the TNVS appears to meet best the criteria of effectiveness, equity and efficiency. PMID:23641705

  7. Knowledge and attitude towards zoonoses among animal health workers and livestock keepers in Arusha and Tanga, Tanzania.

    PubMed

    Swai, Emanuel S; Schoonman, Luuk; Daborn, Chris J

    2010-10-01

    Zoonoses are infections naturally transmitted between vertebrate animals and humans. An exploratory questionnaire-based survey of animal health workers(n=36) and livestock keepers(n=43) was carried out from April 2001 to March 2002 in Tanga and Arusha regions, northern Tanzania, to assess local knowledge, attitudes and public awareness for animal zoonoses. A combination of closed and open-ended questions, focus group discussions and ranking techniques were employed to gather information on perceptions concerning the type of zoonotic diseases prevalent in the study area, level of risk, mode of transmission and methods of preventing disease transmission from animals to humans. The results demonstrated that rabies, tuberculosis and anthrax were considered the three most common zoonotic diseases. Sharing living accommodation with animals, consumption of un-treated livestock products (i.e. milk, meat or eggs) and attending to parturition were perceived as routes of transmission. Knowledge about zoonosis was higher in smallholder dairy (92%; 33/36) than traditional livestock keepers (P<0.05). On the contrary, the perceived risk of contracting a zoonosis was significantly higher in traditional livestock (86%; 6/7) than smallholder dairy keepers (P<0.05). Stratification of the risk of zoonosis by farm location revealed that rural farms (85%; 7/8) were considered significantly at a higher risk when compared to peri or urban located farms (P<0.05). Most of the respondents stated cooking of meat or boiling of milk as a way to prevent transmission. However, there was a significant difference in the perception of the risk posed by contact with potentially infected animals /or animal products with animal health workers having a much higher level of perception compared to livestock keepers. These results suggest that in the Tanga and Arusha, Tanzania, patchy awareness and knowledge of zoonoses, combined with food consumption habits and poor animal husbandry are likely to expose respondents to an increased risk of contracting zoonoses. Public health promotion on education and inter-disciplinary one-health collaboration between vets, public health practitioners and policy makers should result in a more efficient and effective joint approach to the diagnosis and control of zoonoses in Tanzania. PMID:24409636

  8. Contraception prevalence under rural poverty: the case of the rural areas of Kondoa District, Tanzania.

    PubMed

    Madulu, N F

    1995-01-01

    This case study illustrates that low contraceptive prevalence in the rural areas of Kondoa District in Tanzania is related to socioeconomic conditions that foster high fertility. These socioeconomic conditions include a subsistence level of production, the high value on children, early marriage, low educational levels, discrimination in the distribution of contraception, and the persistence of traditional norms and values. High contraceptive awareness is not sufficient to overcome the influence of the high demand for children. It is argued that contraceptive prevalence can be increased through changes in socioeconomic conditions that will reduce poverty and increase literacy. Analysis is based on survey data from 849 women aged 15 years and older in October 1992 among 9 randomly selected villages. Family planning services in the district study area are available only in the 1 district hospital, 4 health centers, and 42 public dispensaries that are not accessible to large segments of the population of 340,232. Distance to a facility may be 10 km or more. In 1991 contraceptive use was 16% of women of reproductive age. 6.8% of current users relied on modern methods, and contraceptive prevalence among respondents was 13.7%. 67.4% were aware of at least one method of contraception. The pill was the most widely used modern method and the most widely known method. Women with 9 or more years of education were the most knowledgeable about contraception. Reasons for nonuse included disapproval by their husbands (13.3%), fear of side effects (5.8%), and a high demand for children (12.8%). Many women with no education or a primary education indicated husband's objection and lack of demand as reasons for nonuse. Only 2.6% of women had an education higher than the primary school level. The mean desired number of children was 6 children. The mean number of children ever born was 5 children. The total fertility rate was 7.1 children. PMID:12291260

  9. Experienced and Perceived Risks of Mycobacterial Diseases: A Cross Sectional Study among Agropastoral Communities in Northern Tanzania

    PubMed Central

    Kilale, Andrew Martin; Ngadaya, Esther; Kagaruki, Gibson Benard; Lema, Yakobo Leonard; Muhumuza, Julius; Ngowi, Bernard James; Mfinanga, Sayoki Godfrey; Hinderaker, Sven Gudmund

    2015-01-01

    Objective The current study was conducted to assess experienced risk factors and perceptions of mycobacterial diseases in communities in northern Tanzania. Methods We conducted a cross-sectional study in Arusha and Manyara regions in Northern Tanzania. We enrolled tuberculosis (TB) patients attending Mount Meru Hospital, Enduleni Hospital and Haydom Lutheran Hospitals in Arusha municipality, Ngorongoro and Mbulu districts, respectively. Patient addresses were recorded during their first visit to the hospitals. Patients with confirmed diagnosis of TB by sputum smear microscopy and/or culture at central laboratory were followed up and interviewed using pre-tested questionnaires, and selected relatives and neighbors were also interviewed. The study was conducted between June 2011 and May 2013. Results The study involved 164 respondents: 41(25%) were TB patients, 68(41.5%) were their relatives and 55(33.5%) their neighbors. Sixty four (39%) knew a risk factor for mycobacterial disease. Overall, 64(39%) perceived to be at risk of mycobacterial diseases. Exposure to potential risks of mycobacterial diseases were: keeping livestock, not boiling drinking water, large family, smoking and sharing dwelling with TB patients. Rural dwellers were more often livestock keepers (p<0.01), more often shared dwelling with livestock (p<0.01) than urban dwellers. More primary school leavers reported sharing dwelling with TB patients than participants with secondary and higher education (p = 0.01). Conclusion Livestock keeping, sharing dwelling with livestock, sharing household with a TB patient were perceived risk factors for mycobacterial diseases and the participants were exposed to some of these risk factors. Improving knowledge about the risk factors may protect them from these serious diseases. PMID:26107266

  10. Community Knowledge and Attitudes and Health Workers' Practices regarding Non-malaria Febrile Illnesses in Eastern Tanzania

    PubMed Central

    Chipwaza, Beatrice; Mugasa, Joseph P.; Mayumana, Iddy; Amuri, Mbaraka; Makungu, Christina; Gwakisa, Paul S.

    2014-01-01

    Introduction Although malaria has been the leading cause of fever for many years, with improved control regimes malaria transmission, morbidity and mortality have decreased. Recent studies have increasingly demonstrated the importance of non-malaria fevers, which have significantly improved our understanding of etiologies of febrile illnesses. A number of non-malaria febrile illnesses including Rift Valley Fever, dengue fever, Chikungunya virus infection, leptospirosis, tick-borne relapsing fever and Q-fever have been reported in Tanzania. This study aimed at assessing the awareness of communities and practices of health workers on non-malaria febrile illnesses. Methods Twelve focus group discussions with members of communities and 14 in-depth interviews with health workers were conducted in Kilosa district, Tanzania. Transcripts were coded into different groups using MaxQDA software and analyzed through thematic content analysis. Results The study revealed that the awareness of the study participants on non-malaria febrile illnesses was low and many community members believed that most instances of fever are due to malaria. In addition, the majority had inappropriate beliefs about the possible causes of fever. In most cases, non-malaria febrile illnesses were considered following a negative Malaria Rapid Diagnostic Test (mRDT) result or persistent fevers after completion of anti-malaria dosage. Therefore, in the absence of mRDTs, there is over diagnosis of malaria and under diagnosis of non-malaria illnesses. Shortages of diagnostic facilities for febrile illnesses including mRDTs were repeatedly reported as a major barrier to proper diagnosis and treatment of febrile patients. Conclusion Our results emphasize the need for creating community awareness on other causes of fever apart from malaria. Based on our study, appropriate treatment of febrile patients will require inputs geared towards strengthening of diagnostic facilities, drugs availability and optimal staffing of health facilities. PMID:24852787

  11. Predictors of mistimed, and unwanted pregnancies among women of childbearing age in Rufiji, Kilombero, and Ulanga districts of Tanzania

    PubMed Central

    2014-01-01

    Background While unintended pregnancies pose a serious threat to the health and well-being of families globally, characteristics of Tanzanian women who conceive unintentionally are rarely documented. This analysis identifies factors associated with unintended pregnancies—both mistimed and unwanted—in three rural districts of Tanzania. Methods A cross-sectional survey of 2,183 random households was conducted in three Tanzanian districts of Rufiji, Kilombero, and Ulanga in 2011 to assess women’s health behavior and service utilization patterns. These households produced 3,127 women age 15+?years from which 2,199 gravid women aged 15–49 were selected for the current analysis. Unintended pregnancies were identified as either mistimed (wanted later) or unwanted (not wanted at all). Correlates of mistimed, and unwanted pregnancies were identified through Chi-squared tests to assess associations and multinomial logistic regression for multivariate analysis. Results Mean age of the participants was 32.1 years. While 54.1% of the participants reported that their most recent pregnancy was intended, 32.5% indicated their most recent pregnancy as mistimed and 13.4% as unwanted. Multivariate analysis revealed that young age (<20 years), and single marital status were significant predictors of both mistimed and unwanted pregnancies. Lack of inter-partner communication about family planning increased the risk of mistimed pregnancy significantly, and multi-gravidity was shown to significantly increase the risk of unwanted pregnancy. Conclusions About one half of women in Rufiji, Kilombero, and Ulanga districts of Tanzania conceive unintentionally. Women, especially the most vulnerable should be empowered to avoid pregnancy at their own will and discretion. PMID:25102924

  12. Inter-epidemic abundance and distribution of potential mosquito vectors for Rift Valley fever virus in Ngorongoro district, Tanzania

    PubMed Central

    Mweya, Clement N.; Kimera, Sharadhuli I.; Mellau, Lesakit S. B.; Mboera, Leonard E. G.

    2015-01-01

    Background Rift Valley fever (RVF) is a mosquito-borne viral zoonosis that primarily affects ruminants but also has the capacity to infect humans. Objective To determine the abundance and distribution of mosquito vectors in relation to their potential role in the virus transmission and maintenance in disease epidemic areas of Ngorongoro district in northern Tanzania. Methods A cross-sectional entomological investigation was carried out before the suspected RVF outbreak in October 2012. Mosquitoes were sampled both outdoors and indoors using the Centre for Disease Control (CDC) light traps and Mosquito Magnets baited with attractants. Outdoor traps were placed in proximity with breeding sites and under canopy in banana plantations close to the sleeping places of animals. Results A total of 1,823 mosquitoes were collected, of which 87% (N=1,588) were Culex pipiens complex, 12% (N=226) Aedes aegypti, and 0.5% (N=9) Anopheles species. About two-thirds (67%; N=1,095) of C. pipiens complex and nearly 100% (N=225) of A. aegypti were trapped outdoors using Mosquito Magnets. All Anopheles species were trapped indoors using CDC light traps. There were variations in abundance of C. pipiens complex and A. aegypti among different ecological and vegetation habitats. Over three quarters (78%) of C. pipiens complex and most (85%) of the A. aegypti were trapped in banana and maize farms. Both C. pipiens complex and A. aegypti were more abundant in proximity with cattle and in semi-arid thorn bushes and lower Afro-montane. The highest number of mosquitoes was recorded in villages that were most affected during the RVF epidemic of 2007. Of the tested 150 pools of C. pipiens complex and 45 pools of A. aegypti, none was infected with RVF virus. Conclusions These results provide insights into unique habitat characterisation relating to mosquito abundances and distribution in RVF epidemic-prone areas of Ngorongoro district in northern Tanzania. PMID:25613346

  13. Historical Perspective and Risk of Multiple Neglected Tropical Diseases in Coastal Tanzania: Compositional and Contextual Determinants of Disease Risk

    PubMed Central

    Armah, Frederick Ato; Quansah, Reginald; Luginaah, Isaac; Chuenpagdee, Ratana; Hambati, Herbert; Campbell, Gwyn

    2015-01-01

    Background In the past decade, research on neglected tropical diseases (NTDs) has intensified in response to the need to enhance community participation in health delivery, establish monitoring and surveillance systems, and integrate existing disease-specific treatment programs to control overlapping NTD burdens and detrimental effects. In this paper, we evaluated the geographical distribution of NTDs in coastal Tanzania. Methods and Findings We also assessed the collective (compositional and contextual) factors that currently determine risks to multiple NTDs using a cross sectional survey of 1253 individuals in coastal Tanzania. The results show that the effect size in decreasing order of magnitude for non-binary predictors of NTD risks is as follows: NTD comorbidities > poverty > educational attainment > self-reported household quality of life > ethnicity. The multivariate analysis explained 95% of the variance in the relationship between NTD risks and the theoretically-relevant covariates. Compositional (biosocial and sociocultural) factors explained more variance at the neighbourhood level than at the regional level, whereas contextual factors, such as access to health services and household quality, in districts explained a large proportion of variance at the regional level but individually had modest statistical significance, demonstrating the complex interactions between compositional and contextual factors in generating NTD risks. Conclusions NTD risks were inequitably distributed over geographic space, which has several important policy implications. First, it suggests that localities of high burden of NTDs are likely to diminish within statistical averages at higher (regional or national) levels. Second, it indicates that curative or preventive interventions will become more efficient provided they can be focused on the localities, particularly as populations in these localities are likely to be burdened by several NTDs simultaneously, further increasing the imperative of multi-disease interventions. PMID:26241050

  14. How Can Childbirth Care for the Rural Poor Be Improved? A Contribution from Spatial Modelling in Rural Tanzania

    PubMed Central

    Fogliati, Piera; Straneo, Manuela; Brogi, Cosimo; Fantozzi, Pier Lorenzo; Salim, Robert Mahimbo; Msengi, Hamis Mwendo; Azzimonti, Gaetano; Putoto, Giovanni

    2015-01-01

    Introduction Maternal and perinatal mortality remain a challenge in resource-limited countries, particularly among the rural poor. To save lives at birth health facility delivery is recommended. However, increasing coverage of institutional deliveries may not translate into mortality reduction if shortage of qualified staff and lack of enabling working conditions affect quality of services. In Tanzania childbirth care is available in all facilities; yet maternal and newborn mortality are high. The study aimed to assess in a high facility density rural context whether a health system organization with fewer delivery sites is feasible in terms of population access. Methods Data on health facilities’ location, staffing and delivery caseload were examined in Ludewa and Iringa Districts, Southern Tanzania. Geospatial raster and network analysis were performed to estimate access to obstetric services in walking time. The present geographical accessibility was compared to a theoretical scenario with a 40% reduction of delivery sites. Results About half of first-line health facilities had insufficient staff to offer full-time obstetric services (45.7% in Iringa and 78.8% in Ludewa District). Yearly delivery caseload at first-line health facilities was low, with less than 100 deliveries in 48/70 and 43/52 facilities in Iringa and Ludewa District respectively. Wide geographical overlaps of facility catchment areas were observed. In Iringa 54% of the population was within 1-hour walking distance from the nearest facility and 87.8% within 2 hours, in Ludewa, the percentages were 39.9% and 82.3%. With a 40% reduction of delivery sites, approximately 80% of population will still be within 2 hours’ walking time. Conclusions Our findings from spatial modelling in a high facility density context indicate that reducing delivery sites by 40% will decrease population access within 2 hours by 7%. Focused efforts on fewer delivery sites might assist strengthening delivery services in resource-limited settings. PMID:26422687

  15. Post exposure prophylaxis following occupational exposure to HIV: a survey of health care workers in Mbeya, Tanzania, 2009-2010

    PubMed Central

    Mponela, Marcelina John; Oleribe, Obinna Ositadimma; Abade, Ahmed; Kwesigabo, Gideon

    2015-01-01

    Introduction Approximately, 1,000 HIV infections are transmitted annually to health care workers (HCWs) worldwide from occupational exposures. Tanzania HCWs experience one to nine needle stick injuries (NSIs) per year, yet the use of post-exposure prophylaxis (PEP) is largely undocumented. We assessed factors influencing use of PEP among HCWs following occupational exposure to HIV. Methods A cross-sectional study was conducted in Mbeya Referral Hospital, Mbozi and Mbarali District Hospitals from December 2009 to January 2010 with a sample size of 360 HCWs. Participants were randomly selected from a list of eligible HCWs in Mbeya hospital and all eligible HCWs were enrolled in the two District Hospitals. Information regarding risk of exposure to body fluids and NSIs were collected using a questionnaire. Logistic regression was done to identify predictors for PEP use using Epi Info 3.5.1 at 95% confidence interval. Results Of 291 HCWs who participated in the study, 35.1% (102/291) were exposed to NSIs and body fluids, with NSIs accounting for 62.9% (64/102). Exposure was highest among medical attendants 38.8% (33/85). Out of exposed HCWs, (22.5% (23/102) used HIV PEP with females more likely to use PEP than males. Reporting of exposures (OR=21.1, CI: 3.85-115.62) and having PEP knowledge (OR =6.5, CI: 1.78-23.99) were significantly associated with using PEP. Conclusion Despite the observed rate of occupational exposure to HCWs in Tanzania, use of PEP is still low. Effective prevention from HIV infection at work places is required through proper training of HCWs on PEP with emphasis on timely reporting of exposures. PMID:26405468

  16. Prosecuting child abusers, respecting victims: a contrast of approaches in the UK, Tajikistan and Tanzania.

    PubMed

    Owen, David M

    2013-11-01

    This article summarises child abuse as a global problem of increasing breadth and complexity. It reviews the development of procedures for prosecuting alleged abusers and treating complainants appropriately in the course of investigations, medical examinations and court hearings. It contrasts the diverse environments of the UK, Tajikistan and Tanzania. The author draws on his experience of practising criminal law since 1984 in England and Wales and working as a consultant in 2011 with the Girls Support Service in Tajikistan, a European-and UN-funded NGO, and with UNICEF in Tanzania in 2012. PMID:24069954

  17. Heterogeneous HIV Testing Preferences in an Urban Setting in Tanzania: Results from a Discrete Choice Experiment

    PubMed Central

    Ostermann, Jan; Njau, Bernard; Brown, Derek S.; Mühlbacher, Axel; Thielman, Nathan

    2014-01-01

    Background Efforts to reduce Human Immunodeficiency Virus (HIV) transmission through treatment rely on HIV testing programs that are acceptable to broad populations. Yet, testing preferences among diverse at-risk populations in Sub-Saharan Africa are poorly understood. We fielded a population-based discrete choice experiment (DCE) to evaluate factors that influence HIV-testing preferences in a low-resource setting. Methods Using formative work, a pilot study, and pretesting, we developed a DCE survey with five attributes: distance to testing, confidentiality, testing days (weekday vs. weekend), method for obtaining the sample for testing (blood from finger or arm, oral swab), and availability of HIV medications at the testing site. Cluster-randomization and Expanded Programme on Immunization (EPI) sampling methodology were used to enroll 486 community members, ages 18–49, in an urban setting in Northern Tanzania. Interviewer-assisted DCEs, presented to participants on iPads, were administered between September 2012 and February 2013. Results Nearly three of five males (58%) and 85% of females had previously tested for HIV; 20% of males and 37% of females had tested within the past year. In gender-specific mixed logit analyses, distance to testing was the most important attribute to respondents, followed by confidentiality and the method for obtaining the sample for the HIV test. Both unconditional assessments of preferences for each attribute and mixed logit analyses of DCE choice patterns suggest significant preference heterogeneity among participants. Preferences differed between males and females, between those who had previously tested for HIV and those who had never tested, and between those who tested in the past year and those who tested more than a year ago. Conclusion The findings suggest potentially significant benefits from tailoring HIV testing interventions to match the preferences of specific populations, including males and females and those who have never tested for HIV. PMID:24643047

  18. Language promotion for educational purposes: The example of Tanzania

    NASA Astrophysics Data System (ADS)

    Rubagumya, Casmir M.

    1991-03-01

    Kiswahili is one of the most widely used languages in East and Central Africa. In Tanzania, where it is the national language, attempts have been made to develop it so that it can be used as an efficient tool of communication in all sectors of the society, including education. This paper shows that although Kiswahili has successfully been promoted as the medium of primary and adult education, at secondary and tertiary levels of education, its position is still precarious. The notion that English and Kiswahili are in complementary distribution is rejected. It is argued that the two languages are in conflict, and that those who are in a better socio-political/economic position have more control of, and better access to, English. In such a situation the right question to ask is not in which domains English is used, but why it is used in such domains and who uses it. The paper further argues that the present sociolinguistic environment makes the use of English as a viable medium unsustainable. For this reason, insistence on the use of English adversely affects the learning process. It is suggested that if Kiswahili became the medium of education at secondary school level and English was taught well as a foreign language, this would help to promote both languages without jeopardising the learning process.

  19. Fossil sedges, macroplants, and roots from Olduvai Gorge, Tanzania.

    PubMed

    Bamford, Marion K

    2012-08-01

    A variety of macroplants has been recorded and collected from the eastern paleolake margin of Olduvai Gorge, Tanzania, from Upper Bed I and Lower Bed II, dated at ~1.7-1.85 Ma. The plant groups represented are sedges, grasses, and woody and herbaceous dicotyledons. Most of these plants are fragmented, but the roots are in situ. The modes and quality of preservation, however, are very variable. Silicification is the dominant type of preservation; it ranges from high quality faithful replacement of cells resulting in silicified wood and sedge culms that are identifiable on the basis of their internal anatomy, to poor quality biotubes lacking internal anatomy or external features that prevent assignment to a specific plant or invertebrate origin. In between this range are silicified roots and grass culms identified by their external anatomy, and leaf and stem impressions. Interpretation of the paleoecology is limited by the quality of preservation. The in situ root horizons are useful for recognizing paleo-surfaces. The best quality preservation where internal anatomy is preserved occurs at HWK E and MCK, localities that are in the middle of the fault compartments so the vegetation can be reconstructed for these sites. Some sedge culms are described, illustrated, and identified as possible species of Cyperus, Fuirena, and Schoenoplectus. PMID:21930291

  20. Monitoring prevention or emergence of HIV drug resistance: results of a population-based foundational survey of early warning indicators in mainland Tanzania

    PubMed Central

    2014-01-01

    Background In Tanzania, routine individual-level testing for HIV drug resistance (HIVDR) using laboratory genotyping and phenotyping is not feasible due to resource constraints. To monitor the prevention or emergence of HIVDR at a population level, WHO developed generic strategies to be adapted by countries, which include a set of early warning indicators (EWIs). Methods To establish a baseline of EWIs, we conducted a retrospective longitudinal survey of 35 purposively sampled care and treatment clinics in 17 regions of mainland Tanzania. We extracted data relevant for four EWIs (ART prescribing practices, patients lost to follow-up 12 months after ART initiation, retention on first-line ART at 12 months, and ART clinic appointment keeping in the first 12 months) from the patient monitoring system on patients who initiated ART at each respective facility in 2010. We uploaded patient information into WHO HIVResNet excel-based tool to compute national and facility averages of the EWIs and tested for associations between various programmatic factors and EWI performance using Fisher’s Exact Test. Results All sampled facilities met the WHO EWI target (100%) for ART prescribing practices. However, the national averages for patients lost to follow-up 12 months after ART initiation, retention on first-line ART at 12 months, and ART clinic appointment keeping in the first 12 months fell short, at 26%, 54% and 38%, respectively, compared to the WHO targets ??20%, ??70%, and ??80%. Clinics with fewer patients lost to follow-up 12 months after ART initiation and more patients retained on first-line-ART at 12 months were more likely to have their patients spend the longest time in the facility (including wait-time and time with providers), (p?=?0.011 and 0.007, respectively). Conclusion Tanzania performed very well in EWI 1a, ART prescribing practices. However, its performance in other three EWIs was far below the WHO targets. This study provides a baseline for future monitoring of EWIs in Tanzania and highlights areas for improvement in the management of ART patients in order not only to prevent emergence of HIVDR due to programmatic factors, but also to improve the quality of life for ART patients. PMID:24725750

  1. A cross-sectional survey on knowledge and perceptions of health risks associated with arsenic and mercury contamination from artisanal gold mining in Tanzania

    PubMed Central

    2013-01-01

    Background An estimated 0.5 to 1.5 million informal miners, of whom 30-50% are women, rely on artisanal mining for their livelihood in Tanzania. Mercury, used in the processing gold ore, and arsenic, which is a constituent of some ores, are common occupational exposures that frequently result in widespread environmental contamination. Frequently, the mining activities are conducted haphazardly without regard for environmental, occupational, or community exposure. The primary objective of this study was to assess community risk knowledge and perception of potential mercury and arsenic toxicity and/or exposure from artisanal gold mining in Rwamagasa in northwestern Tanzania. Methods A cross-sectional survey of respondents in five sub-villages in the Rwamagasa Village located in Geita District in northwestern Tanzania near Lake Victoria was conducted. This area has a history of artisanal gold mining and many of the population continue to work as miners. Using a clustered random selection approach for recruitment, a total of 160 individuals over 18 years of age completed a structured interview. Results The interviews revealed wide variations in knowledge and risk perceptions concerning mercury and arsenic exposure, with 40.6% (n=65) and 89.4% (n=143) not aware of the health effects of mercury and arsenic exposure respectively. Males were significantly more knowledgeable (n=59, 36.9%) than females (n=36, 22.5%) with regard to mercury (x2=3.99, p<0.05). An individual’s occupation category was associated with level of knowledge (x2=22.82, p=<0.001). Individuals involved in mining (n=63, 73.2%) were more knowledgeable about the negative health effects of mercury than individuals in other occupations. Of the few individuals (n=17, 10.6%) who knew about arsenic toxicity, the majority (n=10, 58.8%) were miners. Conclusions The knowledge of individuals living in Rwamagasa, Tanzania, an area with a history of artisanal gold mining, varied widely with regard to the health hazards of mercury and arsenic. In these communities there was limited awareness of the threats to health associated with exposure to mercury and arsenic. This lack of knowledge, combined with minimal environmental monitoring and controlled waste management practices, highlights the need for health education, surveillance, and policy changes. PMID:23351708

  2. Promoting Life Skills and Preventing Tobacco Use among Low-Income Mumbai Youth: Effects of Salaam Bombay Foundation Intervention

    PubMed Central

    Sorensen, Glorian; Gupta, Prakash C.; Nagler, Eve; Viswanath, Kasisomayajula

    2012-01-01

    Background In response to India's growing tobacco epidemic, strategies are needed to decrease tobacco use among Indian youth, particularly among those who are economically disadvantaged. The objective of this study was to assess the effectiveness of a school-based life-skills tobacco control program for youth of low socio-economic status in Mumbai and the surrounding state of Maharashtra. We hypothesized that compared to youth in control schools, youth exposed to the program would have greater knowledge of effects of tobacco use; be more likely to take action to prevent others from using tobacco; demonstrate more positive life skills and attitudes; and be less likely to report tobacco use. Methods/Findings Using a quasi-experimental design, we assessed program effectiveness by comparing 8th and 9th grade students in intervention schools to 8th grade students in comparable schools that did not receive the program. Across all schools, 1851 students completed a survey that assessed core program components in early 2010. The program consisted of activities focused on building awareness about the hazards of tobacco, developing life skills, and advocacy development. The primary outcome measure was self-reported tobacco use in the last 30 days. Findings indicate that 4.1% of 8th grade intervention students (OR?=?0.51) and 3.6% of 9th grade intervention students (OR?=?0.33) reported using tobacco at least once in the last 30 days, compared to 8.7% of students in the control schools. Intervention group students were also significantly more knowledgeable about tobacco and related legislation, reported more efforts to prevent tobacco use among others, and reported stronger life skills and self-efficacy than students in control schools. Limitations to the study include schools not being randomly assigned to condition and tobacco use being measured by self-report. Conclusions This program represents an effective model of school-based tobacco use prevention that low-income schools in India and other low- and middle-income countries can replicate. PMID:22523567

  3. Implementation of antiretroviral therapy guidelines for under-five children in Tanzania: translating recommendations into practice

    PubMed Central

    Nuwagaba-Biribonwoha, Harriet; Wang, Chunhui; Kilama, Bonita; Jowhar, Farhat K; Antelman, Gretchen; Panya, Milembe F; Abrams, Elaine J

    2015-01-01

    Introduction Paediatric antiretroviral therapy (ART) guidelines have been updated several times in recent years. We assessed implementation of ART guidelines among under-five children to inform the transition to universal paediatric ART in Tanzania. Methods We conducted a retrospective cohort analysis of infants (0 to 11 months) and children (12 to 59 months) enrolled between 2010 and 2012 using routinely collected data. Infants and children were initiated on ART according to the 2008 World Health Organization (WHO) recommendations/2009 Tanzania guidelines (universal ART for infants). Cumulative ART initiation incidence and correlates of ART initiation were examined using competing risk methods accounting for attrition (death or loss to follow-up). Kaplan-Meier methods and Cox regression models were used to examine attrition on ART and its correlates. Results A total of 1679 children were enrolled at 69 clinics: 469 (28%) infants and 1210 (74%) children. Infant cumulative ART initiation incidence was 59.6, 71.3 and 78.0% at one, three and six months of follow-up. Infants were more likely to start ART if enrolled in 2012 [adjusted sub-hazard ratio (AsHR)=2.2, 95% confidence interval (CI): 1.7 to 2.8] or 2011 (AsHR=1.8, 95% CI: 1.4 to 2.3) compared to 2010; they were more likely to start ART from prevention of mother-to-child HIV transmission (AsHR=1.6, 95% CI: 1.3 to 2.1) and inpatient wards (AsHR=1.5, 95% CI: 1.2 to 2.0) versus being enrolled from voluntary counselling and testing centres. Attrition at 12 months on ART was 33.9% and was more likely among infants with WHO Stage 4 [adjusted hazard ratio (AHR)=3.1. 95% CI: 1.8 to 5.2] and severe malnutrition (AHR=1.4, 95% CI: 1.0 to 1.9). Among 599 children eligible for ART at enrolment, cumulative ART initiation incidence was 51.8, 68.6 and 76.1% at one, three, and six months. Children were more likely to start ART if enrolled in 2012 (AsHR=1.8, 95% CI: 1.4 to 2.3) or 2011 (AsHR=1.5, 95% CI: 1.2 to 1.8) compared to 2010; they were more likely to start ART at primary health facilities (AsHR=1.5, 95% CI: 1.1 to 2.0) and less likely at urban facilities (AsHR=0.6, 95% CI: 0.5 to 0.9) and facilities without CD4 testing on site (AsHR=0.7, 95% CI: 0.5 to 0.9). Attrition at 12 months on ART was 23.1% and was more likely with severe malnutrition (AHR=1.8, 95% CI: 1.1 to 3.0), WHO Stage 4 (AHR=3.0, 95% CI: 1.0 to 8.5) and outpatient enrolees (AHR=1.7, 95% CI: 1.1 to 2.7). Conclusions Our findings suggest the gradual adoption of guidelines over calendar time. Interventions to expedite ART initiation and support retention on ART are needed. PMID:26690303

  4. Language of Instruction and Student Performance: New Insights from Research in Tanzania and South Africa

    ERIC Educational Resources Information Center

    Brock-Utne, Birgit

    2007-01-01

    This article, drawing on a set of studies conducted in the framework of the Language of Instruction in Tanzania and South Africa (LOITASA) research project, shows how well African students express themselves if they are allowed to use a familiar African language, and conversely the difficulties they have when forced to use a foreign language, a…

  5. Language Policies and Practices in Tanzania and South Africa: Problems and Challenges

    ERIC Educational Resources Information Center

    Brock-Utne, Birgit; Holmarsdottir, Halla B.

    2004-01-01

    The authors of the present article are engaged in a research project funded by the Norwegian Research Council. In this project the language policies of Tanzania and South Africa, as well as the practices of these policies in the classroom are analyzed. The article gives some preliminary results from the project. While the language policies of…

  6. Democratising Higher Education in Ghana and Tanzania: Opportunity Structures and Social Inequalities

    ERIC Educational Resources Information Center

    Morley, Louise; Leach, Fiona; Lugg, Rosemary

    2009-01-01

    This article is based on an ESRC/DFID funded research project on Widening Participation in Higher Education in Ghana and Tanzania: Developing an Equity Scorecard (http://www.sussex.ac.uk/education/wideningparticipation). There are questions about whether widening participation in higher education is a force for democratisation or differentiation.…

  7. Prevalence of and Factors Associated with Work Stress in Academia in Tanzania

    ERIC Educational Resources Information Center

    Mkumbo, Kitila

    2014-01-01

    Work stress has been identified as a common phenomenon in the teaching profession. However, little research has been done to examine the prevalence of and factors associated with work stress among employees in university context in Tanzania and sub-Saharan African countries in general. Using survey design within the quantitative approach, this…

  8. Trachoma and Health Education in Primary Schools in Tanzania: A Pointer to Community Action

    ERIC Educational Resources Information Center

    Lansdow, Richard; Issae, Wahab; Katala, Sidney; Mwaisumo, Rose

    2005-01-01

    Purpose: The primary aim of the work reported here is to determine whether a low cost teaching approach which had been successfully used in one region of Tanzania (Tanga) could be introduced to other teachers in a different region by teachers, rather than outside experts. A second aim is to determine whether changes occurred in children's…

  9. Towards the Social and Economic Promotion of Rural Women in Tanzania

    ERIC Educational Resources Information Center

    Kokuhirwa, Hilda

    1975-01-01

    The report describes the changing image of women in rural Tanzania and the various agencies responsible for their social, economic, cultural, and political promotion in rural areas, including the Tanganyika African National Union (TANU), and the Union of Women in Tanganyika (UWT). (LH)

  10. Precambrian Research xxx (2006) xxxxxx Anorthosites in the Eastern Granulites of Tanzania--New SIMS

    E-print Network

    Fritz, Harald

    2006-01-01

    Precambrian Research xxx (2006) xxx­xxx Anorthosites in the Eastern Granulites of Tanzania March 2006 Abstract Several occurrences of anorthosites are known in the Neoproterozoic Mozambique Belt of the Eastern Granulites. Two larger anorthosite bodies and associated rocks from the Pare Mountains

  11. Antecedents of Continued Usage Intentions of Web-Based Learning Management System in Tanzania

    ERIC Educational Resources Information Center

    Lwoga, Edda Tandi; Komba, Mercy

    2015-01-01

    Purpose: The purpose of this paper is to examine factors that predict students' continued usage intention of web-based learning management systems (LMS) in Tanzania, with a specific focus on the School of Business of Mzumbe University. Specifically, the study investigated major predictors of actual usage and continued usage intentions of…

  12. Agriculture and Trade Opportunities for Tanzania: Past Volatility and Future Climate Changerode_672 429..447

    E-print Network

    price insulation. Indeed,the food price crisis of 2007­2008 saw several countries erect export- tially increase its maize exports to other countries. If global maize production is lower than usual owing to supply shocks in major exporting regions, Tanzania may be able to export more maize at higher

  13. Girls' Education in Pastoral Communities: An Ethnographic Study of Monduli District, Tanzania. Research Report

    ERIC Educational Resources Information Center

    Raymond, Adella

    2014-01-01

    This research report notes that despite the focus on girls' education in the Millennium Development Goals, there remains a huge number of girls out of education, a situation which, although improving, is still a significant concern in Tanzania, Africa. Women and girls in pastoral communities are subject to a particularly challenging…

  14. The Success of Students' Loans in Financing Higher Education in Tanzania

    ERIC Educational Resources Information Center

    Nyahende, Veronica R.

    2013-01-01

    Students' loans in financing higher education in Tanzania have been subjected to many researches. However, less information is available on how the success of students' loans in financing higher education can be revealed. Therefore the purpose of this study is to examine the factors indicating the success of students' loans in financing higher…

  15. Sibling Negotiations and the Construction of Literacy Events in an Urban Area of Tanzania

    ERIC Educational Resources Information Center

    Frankenberg, Sofia Johnson; Holmqvist, Rolf; Rubenson, Birgitta; Rindstedt, Camilla

    2012-01-01

    This study presents findings from analyses of naturally occurring literacy events, where children jointly focus on reading and writing letters of the alphabet, illustrating social constructions of learning created through language and embodied action. Video recorded data from two different families living in an urban low-income area in Tanzania is…

  16. Learning to Negotiate Sexual Relationships: A Girls' School in Tanzania as a Restrictive and Agentic Site

    ERIC Educational Resources Information Center

    Willemsen, Laura Wangsness; DeJaeghere, Joan

    2015-01-01

    Literature on schooling in Africa often frames sexual relationships as threatening girls' educational participation, health, and general well-being. Schooling practices aimed at sheltering girls reflect the prevalence of discourses emphasising danger and abstinence. This article presents the case of one all-girls school in Tanzania which provides…

  17. Uranium-series dating of bone from the Isimila prehistoric site, Tanzania

    USGS Publications Warehouse

    Howell, F.C.; Cole, G.H.; Kleindienst, M.R.; Szabo, B. J.; Oakley, K.P.

    1972-01-01

    EXCAVATIONS in 1957 and 1958 at the Isimila prehistoric site, in Tanzania1, sampled Acheulian occurrences in horizons at various levels in the Isimila Beds which are approximately 18 m thick. No significant breaks were observed in the sedimentary sequence, although there are numerous local hiatuses. ?? 1972 Nature Publishing Group.

  18. Predicting Participation in Environmental Education by Teachers in Coastal Regions of Tanzania

    ERIC Educational Resources Information Center

    Bruyere, Brett; Nash, Peter E.; Mbogella, Felix

    2011-01-01

    Theories of responsible environmental behavior (REB) have most often been applied in developed countries and to direct forms of REB such as recycling and conserving water. This study applied a model of REB to a developing country setting in Tanzania based in part on variables from a Hungerford and Volk (1990) model and targeting an indirect form…

  19. Students' Perceived Level of English Proficiency in Secondary Schools in Dodoma, Tanzania

    ERIC Educational Resources Information Center

    Makewa, Lazarus Ndiku; Role, Elizabeth; Tuguta, Ellen

    2013-01-01

    This paper looked at students' perceived level of English proficiency among Dodoma secondary schools in Tanzania. Factors like attitude, anxiety, classroom activities, motivation, and learning resources were considered as influencing English learning. The study was guided by three theories: Input Hypothesis, Inter-language and Vygotsky's theory of…

  20. Building an Agricultural Extension Services System Supported by ICTs in Tanzania: Progress Made, Challenges Remain

    ERIC Educational Resources Information Center

    Sanga, C.; Kalungwizi, V. J.; Msuya, C. P.

    2013-01-01

    The conventional agricultural extension service in Tanzania is mainly provided by extension officers visiting farmers to provide agricultural advisory service. This system of extension service provision faces a number of challenges including the few number of extension officers and limited resources. This article assesses the effectiveness of an…

  1. "Drugs, Religion and Chemistry in Tanzania": An Interactive Seminar for Chemistry Students

    ERIC Educational Resources Information Center

    Buchanan, Malcolm S.

    2015-01-01

    Most Tanzanian Higher Education Institutes do not have the materials and technology to give students a significant practical experience in the sciences. In 2013 Tanzania was rated 159th out of 187 countries for "human development" (United Nations Development Program 2014 Report). In order to supplement their current, limited practical…

  2. Critical Success Factors for Adoption of Web-Based Learning Management Systems in Tanzania

    ERIC Educational Resources Information Center

    Lwoga, Edda Tandi

    2014-01-01

    This paper examines factors that predict students' continual usage intention of web-based learning content management systems in Tanzania, with a specific focus at Muhimbili University of Health and Allied Science (MUHAS). This study sent a questionnaire surveys to 408 first year undergraduate students, with a rate of return of 66.7. This study…

  3. Preparing Tanzania's Young Children for the Economic World: Possibilities for Collaboration with Other Countries.

    ERIC Educational Resources Information Center

    Mushi, Selina L. P.

    This paper is a critical analysis of the role of the Tanzanian education system in enhancing young children's awareness of economic aspects around them. The major factors the paper considers are: the poverty of the country; the prominence of the education system as a socializing agent for children; the aim of early education in Tanzania; and young…

  4. Quaternary ostracodes and molluscs from the Rukwa Basin (Tanzania) and their evolutionary and paleobiogeographic implications

    E-print Network

    Quaternary ostracodes and molluscs from the Rukwa Basin (Tanzania) and their evolutionary September 2013 Keywords: Lake Rukwa Lake Tanganyika Paleolimnology Freshwater biogeography Ostracode Mollusc in the last 5 ky. Some of the molluscs and ostracodes studied here are closely related to taxa (or part

  5. Equity and Equality in Access to Higher Education: The Experiences of Students with Disabilities in Tanzania

    ERIC Educational Resources Information Center

    Mwaipopo, Rosemarie Nyigulila; Lihamba, Amandina; Njewele, Delphine Cosmas

    2011-01-01

    Social development policies in Tanzania are exemplary in terms of their recognition of the rights of access to higher education institutions by specific demographic groups. Policy documents such as the 2005 "National Strategy for Growth and Reduction of Poverty" (known as the MKUKUTA) and the 2004 "National Policy on Disability" emphasise this…

  6. Peasants and Educators: A Study of the Literacy Environment in Rural Tanzania.

    ERIC Educational Resources Information Center

    Kadege, Nyasugara P.; And Others

    A study mapped out the current provision of and needs for post-literacy facilities in Tanzania, in particular in the rural regions. Study activities included the following: literature review on post-literacy provision and participation; review of the Ministry of Education and Culture's (MEC's) official statistics on post-literacy provision and…

  7. Pupils' Perceptions of Sex and Reproductive Health Education in Primary Schools in Tanzania: A Phenomenological Study

    ERIC Educational Resources Information Center

    Kapinga, Orestes Silverius; Hyera, Daniel Frans

    2015-01-01

    This study explored pupils' perceptions of sex and reproductive health education in primary schools in Tanzania. Specifically, the study aimed at (i) exploring pupils' views on sex and reproductive health education in primary schools; (ii) determining opinions on the appropriateness of sex and reproductive health education for pupils in primary…

  8. Using Images to Promote Reflection: An Action Research Study in Zambia and Tanzania

    ERIC Educational Resources Information Center

    Miles, Susie; Kaplan, Ian

    2005-01-01

    This paper focuses on the use of images to promote reflection and analysis of inclusive practices. The image-based work was set in the context of a two-year action research study, which took place in Tanzania and Zambia, 2001-2003, in collaboration with researchers from the Enabling Education Network (EENET), based at the University of…

  9. Exploring Understandings of Inclusion in Schools in Zambia and Tanzania Using Reflective Writing and Photography

    ERIC Educational Resources Information Center

    Miles, Susie

    2011-01-01

    In this article I explore insights gained from participating in an exploratory, small-scale study led by the Enabling Education Network (EENET) in 17 schools in northern Zambia and five schools in Tanzania. Facilitating South-based research, while based in a Northern university, raises complex ethical issues about voice and control which are…

  10. Wetland Diagenesis and Traces of Early Hominids, Olduvai Gorge, Tanzania

    NASA Astrophysics Data System (ADS)

    Deocampo, Daniel M.; Blumenschine, Robert J.; Ashley, Gail M.

    2002-03-01

    Lateral variations in whole-rock and clay geochemistry of basal Bed II claystones in Olduvai Gorge, Tanzania, reflect water quality differences across the Eastern Lacustrine Plain ?1.75 myr ago. Bulk Ba/Sr and (Na2O+K2O+MgO)/Al2O3 range from 1.4 to 4.2 and from 0.7 to 1.4, respectively, and indicate leaching of lacustrine claystones beneath freshwater wetlands at times following lake retreat. Bulk MgO/Al2O3 (0.3-1.0) and molar Mg/Al (0.5-3.9) ratios of <0.2-?m clays reflect alteration of Mg-rich lacustrine clays. These indicators point to freshest conditions near Locality 43 of Hay (1976; HWK-East; Leakey, 1971), moderate conditions to the east (Locality 40-MCK), and high salinity and alkalinity to the west (Localities 85-VEK, 45-FLK). Clay geochemistry and artifact abundances are well correlated (r=-0.67, p<0.005), suggesting a relationship between paleo-water quality and hominid paleoecology. This pattern is consistent with predictions of greatest artifact discard/loss around freshwater sources where scavanging opportunities were greatest for hominids. This quantifies a relationship between artifact density distribution and a paleoecological proxy over landscape scales for the first time in Early Stone Age archaeology. In contrast, fossil bone abundance is uncorrelated (r=0.14, p=0.6), reflecting more complex taphonomic processes. Quantitative tests of landscape-scale land-use models are important for understanding early hominid behavior and its evolution.

  11. Rangeland management and fluvial geomorphology in northern Tanzania.

    PubMed

    Miller, Brian W; Doyle, Martin W

    2014-06-01

    Researchers have independently documented the effects of land use on rivers and threats to river management institutions, but the relationship between changes in institutional context and river condition is not well described. This study assesses the connections between resource management institutions, land use, and rivers by integrating social science, geospatial analysis, and geomorphology. In particular, we measured hydraulic geometry, sediment size distributions, and estimated sediment yield for four rivers in northern Tanzania and conducted semistructured interviews that assessed corresponding resource management institutions. Communities managed rivers through both customary (traditional, nonstate) and government institutions, but the differences in the resource management policies and practices of the study rivers themselves were fairly subtle. Clearer differences were found at broader scales; the four watersheds exhibited substantial differences in land cover change and sediment yield associated with the location of settlements, roadways, and cultivation. Unexpectedly, these recent land use changes did not initiate a geomorphic response in rivers. The long history of grazing by domestic and wild ungulates may have influenced water and sediment supplies such that river channel dimensions are more resistant to changes in land use than other systems or have already adjusted to predominant changes in boundary conditions. This would suggest that not all rivers will have the anticipated responses to contemporary land use changes because of antecedent land use patterns; over long time scales (centuries to millennia), the presence of grazers may actually increase the ability of rivers to withstand changes in land use. Our findings point to a need for further interdisciplinary study of dryland rivers and their shifts between system states, especially in areas with a long history of grazing, relatively recent changes in land use, and a dynamic social and institutional context. PMID:24932057

  12. Rangeland management and fluvial geomorphology in northern Tanzania

    PubMed Central

    Miller, Brian W.; Doyle, Martin W.

    2014-01-01

    Researchers have independently documented the effects of land use on rivers and threats to river management institutions, but the relationship between changes in institutional context and river condition is not well described. This study assesses the connections between resource management institutions, land use, and rivers by integrating social science, geospatial analysis, and geomorphology. In particular, we measured hydraulic geometry, sediment size distributions, and estimated sediment yield for four rivers in northern Tanzania and conducted semistructured interviews that assessed corresponding resource management institutions. Communities managed rivers through both customary (traditional, nonstate) and government institutions, but the differences in the resource management policies and practices of the study rivers themselves were fairly subtle. Clearer differences were found at broader scales; the four watersheds exhibited substantial differences in land cover change and sediment yield associated with the location of settlements, roadways, and cultivation. Unexpectedly, these recent land use changes did not initiate a geomorphic response in rivers. The long history of grazing by domestic and wild ungulates may have influenced water and sediment supplies such that river channel dimensions are more resistant to changes in land use than other systems or have already adjusted to predominant changes in boundary conditions. This would suggest that not all rivers will have the anticipated responses to contemporary land use changes because of antecedent land use patterns; over long time scales (centuries to millennia), the presence of grazers may actually increase the ability of rivers to withstand changes in land use. Our findings point to a need for further interdisciplinary study of dryland rivers and their shifts between system states, especially in areas with a long history of grazing, relatively recent changes in land use, and a dynamic social and institutional context. PMID:24932057

  13. Fossil struthionid eggshells from Laetoli, Tanzania: Taxonomic and biostratigraphic significance

    NASA Astrophysics Data System (ADS)

    Harrison, Terry; Msuya, Charles P.

    2005-04-01

    Recent paleontological investigations at Laetoli and neighboring localities in northern Tanzania have produced a large collection of fossil ostrich eggshells from the Pliocene-aged Laetolil Beds (˜3.5-4.5 Ma) and Ndolanya Beds (˜2.6-2.7 Ma). A detailed analysis of the morphology of the eggshells and their taxonomic affinities indicates that two different species of Struthio are represented. In the Lower Laetolil Beds and in the Upper Laetolil Beds below Tuff 3 a new species is recognized— Struthio kakesiensis. This is replaced in the Upper Laetolil Beds by Struthio camelus, the modern species of ostrich. Since radiometric age determinations are available for the stratigraphic sequence at Laetoli, it is possible to precisely date the first appearance of S. camelus at ˜3.6-3.8 Ma. Comparisons of the Laetoli material with specimens from the well-dated sequences at Lothagam and Kanapoi in northern Kenya, allow the taxonomic and biochronological analysis to be extended back in time to the late Miocene. At about 6.5 Ma, Diamantornis and elephant birds were replaced in East Africa by ostriches belonging to the genus Struthio. Three time-successive species of ostriches are identified in the fossil record of East Africa, beginning with Struthio. cf. karingarabensis (˜6.5-4.2 Ma), followed by S. kakesiensis (˜4.5-3.6 Ma) and then S. camelus (˜3.8 Ma onwards). A similar sequence of taxa has previously been recorded from localities in Namibia, but at these sites there is no possibility to precisely calibrate the ages of the different species using radiometric dating. Nevertheless, the broadly similar evolutionary sequence and the close correspondence in inferred ages for the succession of species in East Africa and Namibia suggest that ostrich eggshells are a very useful tool for biochronological correlation of paleontological sites in sub-Saharan Africa.

  14. Voluntary Medical Male Circumcision: Matching Demand and Supply with Quality and Efficiency in a High-Volume Campaign in Iringa Region, Tanzania

    PubMed Central

    Hellar, Augustino; Koshuma, Sifuni; Nyabenda, Simeon; Machaku, Michael; Lukobo-Durrell, Mainza; Castor, Delivette; Njeuhmeli, Emmanuel; Fimbo, Bennett

    2011-01-01

    The government of Tanzania has adopted voluntary medical male circumcision (VMMC) as an important component of its national HIV prevention strategy and is scaling up VMMC in eight regions nationwide, with the goal of reaching 2.8 million uncircumcised men by 2015. In a 2010 campaign lasting six weeks, five health facilities in Tanzania's Iringa Region performed 10,352 VMMCs, which exceeded the campaign's target by 72%, with an adverse event (AE) rate of 1%. HIV testing was almost universal during the campaign. Through the adoption of approaches designed to improve clinical efficiency—including the use of the forceps-guided surgical method, the use of multiple beds in an assembly line by surgical teams, and task shifting and task sharing—the campaign matched the supply of VMMC services with demand. Community mobilization and bringing client preparation tasks (such as counseling, testing, and client scheduling) out of the facility and into the community helped to generate demand. This case study suggests that a campaign approach can be used to provide high-volume quality VMMC services without compromising client safety, and provides a model for matching supply and demand for VMMC services in other settings. PMID:22140366

  15. A feasibility study to determine if minimally trained medical students can identify markers of chronic parasitic infection using bedside ultrasound in rural Tanzania

    PubMed Central

    Barsky, Maria; Kushner, Lauren; Ansbro, Megan; Bowman, Kate; Sassounian, Michael; Gustafson, Kevin; Lahham, Shadi; Joseph, Linda; Fox, John C

    2015-01-01

    BACKGROUND: Parasitic infections pose a significant health risk in developing nations and are a major cause of morbidity and mortality worldwide. In the Republic of Tanzania, the CDC estimates that 51.5% of the population is infected with one or more intestinal parasites. If diagnosed early, the consequences of chronic parasitic infection can potentially be avoided. METHODS: Six first-year medical students were recruited to enroll patients in the study. They underwent ten hours of formal, hands-on, ultrasound which included basic cardiac, hepatobiliary, renal, pulmonary and FAST scan ultrasound. A World Health Organization protocol with published grading scales was adapted and used to assess for pathology in each patient’s liver, bladder, kidneys, and spleen. RESULTS: A total of 59 patients were enrolled in the study. Students reported a sensitivity of 96% and specificity of 100% for the presence of a dome shaped bladder, a sensitivity and specificity of 100% for bladder thickening, a sensitivity and specificity of 100% for portal hypertension and ascites. The sensitivity was 81% with a specificity of 100% for presence of portal vein distention. The sensitivity was 100% with a specificity of 90% for dilated bowel. CONCLUSIONS: Ultrasound has shown a promise at helping to identify pathology in rural communities with limited resources such as Tanzania. Our data suggest that minimally trained first year medical students are able to perform basic ultrasound scans that can identify ultrasonographic markers of parasitic infections. PMID:26693265

  16. Soil Properties Assessment using Apparent Electric Conductivity (ECa) in semi-arid Environments of Northern Tanzania

    NASA Astrophysics Data System (ADS)

    Märker, M.; Quénéhervé, G.

    2012-04-01

    Semi-arid environments such as in Northern Tanzania are characterized by a variety of degradation processes due to long dry periods and short but intensive rainfall events. High potential evaporation, high run-off rates, and low water holding capacities are typical for the present soils. The area is mainly covered by semi-arid savannah, the dominating crop is maize and extensive grazing is conducted. Soil properties and their spatial distribution play a critical role for hydrologic processes. To assess the spatial distribution of these soil properties we utilized a Electromagnetic Induction (EMI) device that induce an electromagnetic field into the soil, creating an electric current. The strength of a resulting secondary electromagnetic field is recorded as the apparent electric conductivity (ECa), measured in mS/m. ECa can provide an indirect indicator of important soil properties. Factors that influence ECa include soil salinity, clay content and cation exchange capacity (CEC), clay mineralogy, soil pore size and distribution, soil moisture content, and temperature. However, in non-saline soils, conductivity variations are primarily a function of soil texture, moisture content, and CEC. There are few studies, related to EMI measurements, conducted in semi-arid environments. In this study we conducted field measurements with the GSSI Profiler EMP-400. Soil physical characteristics were also measured in field on typical soil profiles to get the respective calibration data, validation was done by lab analysis. We analyzed the spatial pattern of the soil ECa maps to determine relationships with soil properties, with a focus on soil texture. The regionalization was carried out using stochastic models. In this study we tested classification and regression trees as well as advanced stochastic gradient boosting methods.

  17. Does size matter? An investigation of habitat use across a carnivore assemblage in the Serengeti, Tanzania

    PubMed Central

    Durant, Sarah M.; Craft, Meggan E.; Foley, Charles; Hampson, Katie; Lobora, Alex L.; Msuha, Maurus; Eblate, Ernest; Bukombe, John; Mchetto, John; Pettorelli, Nathalie

    2012-01-01

    Summary This study utilizes a unique data set covering over 19 000 georeferenced records of species presence collected between 1993 and 2008, to explore the distribution and habitat selectivity of an assemblage of 26 carnivore species in the Serengeti–Ngorongoro landscape in northern Tanzania. Two species, the large-spotted genet and the bushy-tailed mongoose, were documented for the first time within this landscape. Ecological Niche Factor Analysis (ENFA) was used to examine habitat selectivity for 18 of the 26 carnivore species for which there is sufficient data. Eleven ecogeographical variables (EGVs), such as altitude and habitat type, were used for these analyses. The ENFA demonstrated that species differed in their habitat selectivity, and supported the limited ecological information already available for these species, such as the golden jackals’ preference for grassland and the leopards’ preference for river valleys. Two aggregate scores, marginality and tolerance, are generated by the ENFA, and describe each species’ habitat selectivity in relation to the suite of EGVs. These scores were used to test the hypothesis that smaller species are expected to be more selective than larger species [Science, 1989, 243, 1145]. Two predictions were tested: Marginality should decrease with body mass; and tolerance should increase with body mass. Our study provided no evidence for either prediction. Our results not only support previous analyses of carnivore diet breadth, but also represent a novel approach to the investigation of habitat selection across species assemblages. Our method provides a powerful tool to explore similar questions in other systems and for other taxa. PMID:20646121

  18. Religion and HIV in Tanzania: influence of religious beliefs on HIV stigma, disclosure, and treatment attitudes

    PubMed Central

    Zou, James; Yamanaka, Yvonne; John, Muze; Watt, Melissa; Ostermann, Jan; Thielman, Nathan

    2009-01-01

    Background Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV) treatment. Methods A self-administered survey was distributed to a convenience sample of parishioners (n = 438) attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and people living with HIV/AIDS. Results Results indicate that shame-related HIV stigma is strongly associated with religious beliefs such as the belief that HIV is a punishment from God (p < 0.01) or that people living with HIV/AIDS (PLWHA) have not followed the Word of God (p < 0.001). Most participants (84.2%) said that they would disclose their HIV status to their pastor or congregation if they became infected. Although the majority of respondents (80.8%) believed that prayer could cure HIV, almost all (93.7%) said that they would begin ARV treatment if they became HIV-infected. The multivariate analysis found that respondents' hypothetical willingness to begin ARV treatme was not significantly associated with the belief that prayer could cure HIV or with other religious factors. Refusal of ARV treatment was instead correlated with lack of secondary schooling and lack of knowledge about ARVs. Conclusion The decision to start ARVs hinged primarily on education-level and knowledge about ARVs rather than on religious factors. Research results highlight the influence of religious beliefs on HIV-related stigma and willingness to disclose, and should help to inform HIV-education outreach for religious groups. PMID:19261186

  19. Exposure to an Indoor Cooking Fire and Risk of Trachoma in Children of Kongwa, Tanzania

    PubMed Central

    Zambrano, Andrea I.; Muñoz, Beatriz E.; Mkocha, Harran; West, Sheila K.

    2015-01-01

    Background Elimination of blinding trachoma by 2020 can only be achieved if affected areas have effective control programs in place before the target date. Identifying risk factors for active disease that are amenable to intervention is important to successfully design such programs. Previous studies have linked sleeping by a cooking fire to trachoma in children, but not fully explored the mechanism and risks. We propose to determine the risk for active trachoma in children with exposure to cooking fires by severity of trachoma, adjusting for other known risk factors. Methods Complete census of 52 communities in Kongwa, Tanzania, was conducted to collect basic household characteristics and demographic information on each family member. Information on exposure to indoor cooking fires while the mother was cooking and while sleeping for each child was collected. 6656 randomly selected children ages 1-9yrs were invited to a survey where both eyelids were graded for follicular (TF) and intense trachoma (TI) using the WHO simplified grading scheme. Ocular swab were taken to assess the presence of Chlamydia trachomatis. Findings 5240 (79%) of the invited children participated in the study. Overall prevalence for trachoma was 6·1%. Odds for trachoma and increased severity were higher in children sleeping without ventilation and a cooking fire in their room (TF OR = 1·81, 1·00–3·27 and TI OR 4·06, 1·96–8·42). Children with TF or TI who were exposed were more likely to have infection than children with TF or TI who were not exposed. There was no increased risk with exposure to a cooking fire while the mother was cooking. Conclusions In addition to known risk factors for trachoma, sleeping by an indoor cooking fire in a room without ventilation was associated with active trachoma and appears to substantially increase the risk of intense inflammation. PMID:26046359

  20. Perceived acceptability of home-based couples voluntary HIV counseling and testing in Northern Tanzania.

    PubMed

    Njau, B; Watt, M H; Ostermann, J; Manongi, R; Sikkema, K J

    2012-01-01

    It is estimated that 5.6% of the Tanzanian population ages 15-49 are infected with HIV, but only 30% of adults have ever had an HIV test. Couples' testing has proven to increase testing coverage and introduce HIV prevention, but barriers include access to testing services and unequal gender dynamics in relationships. Innovative approaches are needed to address barriers to couple's testing and increase uptake of HIV testing. Using qualitative data collection methods, a formative study was conducted to assess the acceptability of a home-based couples counseling and testing (HBCCT) approach. Eligible study participants included married men and women, HIV-infected individuals, health care and home-based care providers, voluntary counseling and testing counselors, and community leaders. A total of 91 individuals participated in focus group discussions (FGDs) and in-depth interviews conducted between September 2009 and January 2010 in rural settings in Northern Tanzania. An HBCCT intervention appears to be broadly acceptable among participants. Benefits of HBCCT were identified in terms of access, confidentiality, and strengthening the relationship. Fears of negative consequences from knowing one's HIV status, including stigma, blame, physical abuse, or divorce, remain a concern and a potential barrier to the successful provision of the intervention. Lessons for implementation highlighted the importance of appointments for home visits, building relationships of confidence and trust between counselors and clients, and assessing and responding to a couple's readiness to undergo HIV testing. HBCCT should addresses HIV stigma, emphasize confidentiality, and improve communication skills for disclosure and decision-making among couples. PMID:21939369

  1. Change in function and spectacle-use 2 months after providing presbyopic spectacles in rural Tanzania

    PubMed Central

    Patel, Ilesh; Munoz, Beatriz; Mkocha, Harran; Schwarzwalder, Alison W; Mchiwa, Wilson; West, Sheila K

    2013-01-01

    Aims To examine near vision spectacle retention and use, and changes in self-reported and performance-based near vision, 2 months after the provision of near vision spectacles. Methods We conducted a 2-month follow-up of a population-based cohort of persons in rural Tanzania with near vision impairment who had received spectacles. Previously, residents age ?40 years were examined for distance and near vision acuity. Those with presbyopia and hyperopia (‘functional presbyopia’) were given near vision spectacles. At baseline, subjects were asked to thread a needle; they were also asked questions on the perception of their near vision, ability to be independent and general health. At 2 months, subjects were again queried. Questions on the perceived affordability of replacement spectacles were also asked. Results Of the 866 people provided with spectacles, 89% were seen at 2 months. Ninety-two per cent were still using the spectacles. Users were more likely to have any education (51.8%) than non-users (28.3%) (p<0.001). Only 31% had successfully threaded a needle at baseline, increasing to 91% at follow-up (p<0.001). Spectacle-users showed a significant improvement in satisfaction with near vision and ability to be independent, but no change in perception of general health, from baseline to follow-up. Men were more likely than women to be able to afford spectacles and to know where to get them. Conclusions Our cohort maintained their spectacles and reported tangible improvements associated with their use. The value of simple reading spectacles for those with near vision impairment suggests that a greater emphasis on near vision is needed in the Vision 2020 agenda. PMID:20508042

  2. Evaluation of Olyset™ insecticide-treated nets distributed seven years previously in Tanzania

    PubMed Central

    Tami, Adriana; Mubyazi, Godfrey; Talbert, Alison; Mshinda, Hassan; Duchon, Stéphane; Lengeler, Christian

    2004-01-01

    Background 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™ 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. PMID:15225349

  3. Quality of antenatal care in rural Tanzania: counselling on pregnancy danger signs

    PubMed Central

    2010-01-01

    Background The high rate of antenatal care attendance in sub-Saharan Africa, should facilitate provision of information on signs of potential pregnancy complications. The aim of this study was to assess quality of antenatal care with respect to providers' counselling of pregnancy danger signs in Rufiji district, Tanzania. Methods A cross-sectional study was conducted in 18 primary health facilities. Thirty two providers were observed providing antenatal care to 438 pregnant women. Information on counselling on pregnancy danger signs was collected by an observer. Exit interviews were conducted to 435 women. Results One hundred and eighty five (42%) clients were not informed of any pregnancy danger signs. The most common pregnancy danger sign informed on was vaginal bleeding 50% followed by severe headache/blurred vision 45%. Nurse auxiliaries were three times more likely to inform a client of a danger sign than registered/enrolled nurses (OR = 3.7; 95% CI: 2.1-6.5) and Maternal Child Health Aides (OR = 2.3: 95% CI: 1.3-4.3) and public health nurses (OR = 2.5; CI: 1.4-4.2) were two times more likely to provide information on danger signs than registered/enrolled nurses. The clients recalled less than half of the pregnancy danger signs they had been informed during the interaction. Conclusion Two out of five clients were not counselled on pregnancy danger signs. The higher trained cadre, registered/enrolled nurses were not informing majority of clients pregnancy danger signs compared to the lower cadres. Supportive supervision should be made to enhance counselling of pregnancy danger signs. Nurse auxiliaries should be encouraged and given chance for further training and upgrading to improve their performance and increase human resource for health. PMID:20594341

  4. Guidelines and mindlines: why do clinical staff over-diagnose malaria in Tanzania? A qualitative study

    PubMed Central

    Chandler, Clare IR; Jones, Caroline; Boniface, Gloria; Juma, Kaseem; Reyburn, Hugh; Whitty, Christopher JM

    2008-01-01

    Background Malaria over-diagnosis in Africa is widespread and costly both financially and in terms of morbidity and mortality from missed diagnoses. An understanding of the reasons behind malaria over-diagnosis is urgently needed to inform strategies for better targeting of antimalarials. Methods In an ethnographic study of clinical practice in two hospitals in Tanzania, 2,082 patient consultations with 34 clinicians were observed over a period of three months at each hospital. All clinicians were also interviewed individually as well as being observed during routine working activities with colleagues. Interviews with five tutors and 10 clinical officer students at a nearby clinical officer training college were subsequently conducted. Results Four, primarily social, spheres of influence on malaria over-diagnosis were identified. Firstly, the influence of initial training within a context where the importance of malaria is strongly promoted. Secondly, the influence of peers, conforming to perceived expectations from colleagues. Thirdly, pressure to conform with perceived patient preferences. Lastly, quality of diagnostic support, involving resource management, motivation and supervision. Rather than following national guidelines for the diagnosis of febrile illness, clinician behaviour appeared to follow 'mindlines': shared rationales constructed from these different spheres of influence. Three mindlines were identified in this setting: malaria is easier to diagnose than alternative diseases; malaria is a more acceptable diagnosis; and missing malaria is indefensible. These mindlines were apparent during the training stages as well as throughout clinical careers. Conclusion Clinicians were found to follow mindlines as well as or rather than guidelines, which incorporated multiple social influences operating in the immediate and the wider context of decision making. Interventions to move mindlines closer to guidelines need to take the variety of social influences into account. PMID:18384669

  5. Does size matter? An investigation of habitat use across a carnivore assemblage in the Serengeti, Tanzania.

    PubMed

    Durant, Sarah M; Craft, Meggan E; Foley, Charles; Hampson, Katie; Lobora, Alex L; Msuha, Maurus; Eblate, Ernest; Bukombe, John; McHetto, John; Pettorelli, Nathalie

    2010-09-01

    1. This study utilizes a unique data set covering over 19 000 georeferenced records of species presence collected between 1993 and 2008, to explore the distribution and habitat selectivity of an assemblage of 26 carnivore species in the Serengeti-Ngorongoro landscape in northern Tanzania. 2. Two species, the large-spotted genet and the bushy-tailed mongoose, were documented for the first time within this landscape. Ecological Niche Factor Analysis (ENFA) was used to examine habitat selectivity for 18 of the 26 carnivore species for which there is sufficient data. Eleven ecogeographical variables (EGVs), such as altitude and habitat type, were used for these analyses. 3. The ENFA demonstrated that species differed in their habitat selectivity, and supported the limited ecological information already available for these species, such as the golden jackals' preference for grassland and the leopards' preference for river valleys. 4. Two aggregate scores, marginality and tolerance, are generated by the ENFA, and describe each species' habitat selectivity in relation to the suite of EGVs. These scores were used to test the hypothesis that smaller species are expected to be more selective than larger species [Science, 1989, 243, 1145]. Two predictions were tested: Marginality should decrease with body mass; and tolerance should increase with body mass. Our study provided no evidence for either prediction. 5. Our results not only support previous analyses of carnivore diet breadth, but also represent a novel approach to the investigation of habitat selection across species assemblages. Our method provides a powerful tool to explore similar questions in other systems and for other taxa. PMID:20646121

  6. Greenhouse gas exchange in tropical mountain ecosystems in Tanzania

    NASA Astrophysics Data System (ADS)

    Gerschlauer, Friederike; Kikoti, Imani; Kiese, Ralf

    2014-05-01

    Tropical mountain ecosystems with their mostly immense biodiversity are important regions for natural resources but also for agricultural production. Their supportive ecosystem processes are particularly vulnerable to the combined impacts of global warming and the conversion of natural to human-modified landscapes. Data of impacts of climate and land use change on soil-atmosphere interactions due to GHG (CO2, CH4, and N2O) exchange from these ecosystems are still scarce, in particular for Africa. Tropical forest soils are underestimated as sinks for atmospheric CH4 with regard to worldwide GHG budgets (Werner et al. 2007, J GEOPHYS RES Vol. 112). Even though these soils are an important source for the atmospheric N2O budget, N2O emissions from tropical forest ecosystems are still poorly characterized (Castaldi et al. 2013, Biogeosciences 10). To obtain an insight of GHG balances of selected ecosystems soil-atmosphere exchange of N2O, CH4 and CO2 was investigated along the southern slope of Mt. Kilimanjaro, Tanzania. We will present results for tropical forests in three different altitudes (lower montane, Ocotea, and Podocarpus forest), home garden (extensive agro-forestry), and coffee plantation (intensive agro-forestry). Therefore we used a combined approach consisting of a laboratory parameterization experiment (3 temperature and 2 moisture levels) and in situ static chamber measurements for GHG exchange. Field measurements were conducted during different hygric seasons throughout two years. Seasonal variation of temperature and especially of soil moisture across the different ecosystems resulted in distinct differences in GHG exchange. In addition environmental parameters like soil bulk density and substrate availability varying in space strongly influenced the GHG fluxes within sites. The results from parameterization experiments and in situ measurements show that natural forest ecosystems and extensive land use had higher uptakes of CH4. For the investigated forest ecosystems we found considerable differences in soil sink strength for CH4. N2O emissions were highest in natural forest ecosystems even though N input in the intensively managed system was considerably higher. Highest N2O efflux rates were identified in the region of highest mean annual precipitation. CO2 emissions reduced from managed to natural ecosystems. In general an increase in temperature as well as in soil moisture caused higher GHG fluxes throughout all investigated natural and managed ecosystems. With increasing altitude of the investigated forests GHG emissions reduced overall.

  7. “My children and I will no longer suffer from malaria”: a qualitative study of the acceptance and rejection of indoor residual spraying to prevent malaria in Tanzania

    PubMed Central

    2012-01-01

    Background The objective of this study was to identify attitudes and misconceptions related to acceptance or refusal of indoor residual spraying (IRS) in Tanzania for both the general population and among certain groups (e.g., farmers, fishermen, community leaders, and women). Methods This study was a series of qualitative, semi-structured, in-depth interviews and focus group discussions conducted from October 2010 to March 2011 on Mainland Tanzania and Zanzibar. Three groups of participants were targeted: acceptors of IRS (those who have already had their homes sprayed), refusers (those whose communities have been sprayed, but refused to have their individual home sprayed), and those whose houses were about to be sprayed as part of IRS scale-up. Interviews were also conducted with farmers, fishermen, women, community leaders and members of non-government organizations responsible for community mobilization around IRS. Results Results showed refusers are a very small percentage of the population. They tend to be more knowledgeable people such as teachers, drivers, extension workers, and other civil servants who do not simply follow the orders of the local government or the sprayers, but are skeptical about the process until they see true results. Refusal took three forms: 1) refusing partially until thorough explanation is provided; 2) accepting spray to be done in a few rooms only; and 3) refusing outright. In most of the refusal interviews, refusers justified why their houses were not sprayed, often without admitting that they had refused. Reasons for refusal included initial ignorance about the reasons for IRS, uncertainty about its effectiveness, increased prevalence of other insects, potential physical side effects, odour, rumours about the chemical affecting fertility, embarrassment about moving poor quality possessions out of the house, and belief that the spray was politically motivated. Conclusions To increase IRS acceptance, participants recommended more emphasis on providing thorough public education, ensuring the sprayers themselves are more knowledgeable about IRS, and asking that community leaders encourage participation by their constituents rather than threatening punishment for noncompliance. While there are several rumours and misconceptions concerning IRS in Tanzania, acceptance is very high and continues to increase as positive results become apparent. Swahili Abstract Usuli Malengo mahususi ya utafiti huu ni kutambua tabia na imani potofu zinazopelekea kukubali au kutakaa upuliaziaji wa dawa ya kuua mbu majumbani (IRS) katika Tanzania kwa watu wote kwa ujumla na kwa makundi maalumu ya watu (kama wakulima, wavuvi, viongozi wa jamii na wanawake). Njia Utafiti huu ni mfululizo wa tafiti stahilifu zenye sehemu ya muundo, tafiti za kina na majadilianao ya vikundi vya walengwa yaliyofanyika Tanzania bara na Zanzibar kuanzia mwezi Oktoba, 2010 hadi mwezi Machi, 2011. Yalikuwepo makundi matatu ya walengwa: wanaokubali IRS (wale ambao nyumba zao zilikwisha kupulizwa dawa ya kuua mbu) wasiokubali (hii ni jamii iliyokwisha kupulizwa dawa na wale watu waliokataa dawa isipulizwe kwenye nyumba zao) na wale ambao nyumba zao zilikuwa zinakaribia kupulizwa dawa ikiwa ni kama sehemu ya kusambaza IRS. Usaili ulifanyika pia kwa wakulima, wavuvi, wanawake na viongozi wa jamii vile vile na kwa wanachama wa asasi zisizo za kiserikali waliokuwa wakiwajibika kwa IRS. Matokeo Matokeo yalionyesha kuwa waliokataa walikuwa ni asilimia ndogo sana ya watu wote. Walikuwa ni watu waelewa kama vile walimu, madereva, wafanyakazi katika miradi na watumishi wengine wa serikali ambao wanafuata amri kutoka kwa serikali yao au kwa wapuliza dawa lakini walikuwa na wasiwasi kuhusu mchakato huo mpaka waone matokeo yake. Waliokataa walikuwa katika maainisho matatu: 1) waliokataa kidogo mpaka wapewe maelezo; 2) waliokubali dawa ipulizwe kwenye vyumba vichache tu; 3) waliokataa katu katu. Mara kwa mara wengi wa wasailiwa waliokataa, walitoa sababu zao za kukataa nyumba zao zisipuliziwe, bila kukubali kuwa wamekataa kupuliziwa. Sababu za kukataa

  8. Health and social support services to HIV/AIDS infected individuals in Tanzania: employees and employers perceptions

    PubMed Central

    2014-01-01

    Background HIV is a major public health problem in the world, especially in sub-Saharan Africa. It often leads to loss of productive labour and disruption of existing social support system which results in deterioration of population health. This poses a great challenge to infected people in meeting their essential goods and services. This paper examines health and social support services provided by employers to HIV/AIDS infected employees in Tanzania. Methods This was a cross-sectional study, which employed qualitative and quantitative methods in data collection and analysis. Structured questionnaires and in-depth interviews were used to assess the health and social support services provision at employers and employees perspectives. The study participants were employees and employers from public and private organizations. Results A total of 181 employees and 23 employers from 23 workplaces aged between 18–68 years were involved. The results show that 23.8% (i.e., 20.4% males and 27.3% females) of the employees had at least one member of the family or close relatives living with HIV at the time of the study. Fifty six percent of the infected employees reported to have been receiving health or social support from their employers. Employees’ responses were consistent with those reported by their employers. A total of 12(52.2%) and 11(47.8%) employers reported to have been providing health and social supports respectively. Female employees (58.3%) from the private sector (60.0%) were more likely to receive supports than male employees (52.6%) and than those from the public sector (46.2%). The most common health and social support received by the employees were treatment, and nutritional support and reduction of workload, respectively. Conclusions HIV/AIDS infected employees named treatment and nutritional support, and soft loans and reduced workload respectively, as the most important health and social supports they needed from their employers. This study provides baseline information for further studies on provision of health and social support services by employers to HIV/AIDS infected employees in the context of a developing economy like Tanzania. PMID:24950701

  9. Prolonged sexual abstinence after childbirth: gendered norms and perceived family health risks. Focus group discussions in a Tanzanian suburb

    PubMed Central

    2013-01-01

    Background Prolonged sexual abstinence after childbirth is a socio-cultural practice with health implications, and is described in several African countries, including Tanzania. This study explored discourses on prolonged postpartum sexual abstinence in relation to family health after childbirth in low-income suburbs of Dar es Salaam, Tanzania. Methods Data for the discourse analysis were collected through focus group discussions with first-time mothers and fathers and their support people in Ilala, Dar es Salaam, Tanzania. Results In this setting, prolonged sexual abstinence intended at promoting child health was the dominant discourse in the period after childbirth. Sexual relations after childbirth involved the control of sexuality for ensuring family health and avoiding the social implications of non-adherence to sexual abstinence norms. Both abstinence and control were emphasised more with regard to women than to men. Although the traditional discourse on prolonged sexual abstinence for protecting child health was reproduced in Ilala, some modern aspects such as the use of condoms and other contraceptives prevailed in the discussion. Conclusion Discourses on sexuality after childbirth are instrumental in reproducing gender-power inequalities, with women being subjected to more restrictions and control than men are. Thus, interventions that create openness in discussing sexual relations and health-related matters after childbirth and mitigate gendered norms suppressing women and perpetuating harmful behaviours are needed. The involvement of males in the interventions would benefit men, women, and children through improving the gender relations that promote family health. PMID:23316932

  10. Globalisation, Language and Education: A Comparative Study of the United States and Tanzania

    NASA Astrophysics Data System (ADS)

    Roy-Campbell, Zaline M.

    2001-07-01

    Educational language choice has been one of the most provocative issues of the 20th century and continues to be a dominant issue at the turn of the new millennium. Efforts to naturalize English as the only suitable language for post primary school education persist in many African countries, including Tanzania. In the United States the campaign for "English only" in the schools is gaining momentum, despite the increasing multilingual population in the schools. Focusing on Tanzania and the United States, this article examines the fallacy of a monolingual, English only, policy in education. It examines the ethos surrounding the debate about the language of instruction, and considers some of the detrimental effects upon students of attempting to impose a monolingual policy. Finally, the paper suggests possible roles of educators and researchers in fostering international understanding of educational language issues as one aspect of the quest for global peace and social justice in the 21st century.

  11. Language of instruction in Tanzania: Why are research findings not heeded?

    NASA Astrophysics Data System (ADS)

    Qorro, Martha A. S.

    2013-06-01

    The issue of language of instruction (LOI) and its effects on education in Tanzanian secondary education has been widely researched since the early 1980s. In 2009, the Ministry of Education and Vocational Training proposed a new education and training policy that allows English to be used as LOI from nursery school to tertiary education. The proposed policy goes against what researchers in this area have recommended over the years. In the light of the proposed policy, the author of this article felt the need to review studies done on LOI in Tanzania from 1974 to date, aiming to eliminate or greatly reduce the negative effects of the policy on education in Tanzania. Quoting examples, the paper demonstrates students' levels of proficiency in English; suggests reasons why governmental policy has over time ignored research findings; and recommends as well as proposes the way forward.

  12. Ixodid tick infestation in cattle and wild animals in Maswa and Iringa, Tanzania.

    PubMed

    Kwak, You Shine; Kim, Tae Yun; Nam, Sung-Hyun; Lee, In-Yong; Kim, Hyung-Pyo; Mduma, Simon; Keyyu, Julius; Fyumagwa, Robert; Yong, Tai-Soon

    2014-10-01

    Ticks and tick-borne diseases are important in human and livestock health worldwide. In November 2012, ixodid ticks were collected and identified morphologically from cattle and wild animals in the Maswa district and Iringa urban, Tanzania. Amblyomma gemma, A. lepidum, and A. variegatum were identified from Maswa cattle, and A. variegatum was the predominant species. A. marmoreum, Hyalomma impeltatum, and Rhipicephalus pulchellus were identified from Iringa cattle in addition to the above 3 Amblyomma species, and A. gemma was the most abundant species. Total 4 Amblyomma and 6 Rhipicephalus species were identified from wild animals of the 2 areas. A. lepidum was predominant in Maswa buffaloes, whereas A. gemma was predominant in Iringa buffaloes. Overall, A. variegatum in cattle was predominant in the Maswa district and A. gemma was predominant in Iringa, Tanzania. PMID:25352709

  13. The Quaternary stratigraphy and its associated fossil fauna and flora of the Holili area, NE Tanzania

    NASA Astrophysics Data System (ADS)

    Kafumu, Peter D.; Paepe, Roland

    2003-04-01

    The basement for the Holili area (NE Tanzania) comprises gneisses of the Mozambique Belt. These rocks are overlain by a Middle Pleistocene (0.35 Ma) olivine basalt which is part of the Kilimanjaro volcanic massif. A red paleosol was formed from this basalt. This paleosol is covered successively by mudstone and calcareous tuffaceous gritty breccia. Some faunal fossil remains (bone fragments, a tooth and horns) and floral fossil remains ( angiosperm dicotyledon plant leaf impressions, twigs and wood) were discovered on the paleosol-mudstone-gritty breccia lithological boundary. The animal fossil remains were recovered from the paleosol surface while the plant fossil remains were recovered from within the mudstone that overlies the paleosol. A primitive hominid stone tool associated with chopped bones and a tooth were also discovered on the paleosol surface. The geological environment of Holili area and its associated fossil fauna and flora resembles other paleontological sites in Tanzania.

  14. Ixodid Tick Infestation in Cattle and Wild Animals in Maswa and Iringa, Tanzania

    PubMed Central

    Kwak, You Shine; Kim, Tae Yun; Nam, Sung-Hyun; Lee, In-Yong; Kim, Hyung-Pyo; Mduma, Simon; Keyyu, Julius; Fyumagwa, Robert

    2014-01-01

    Ticks and tick-borne diseases are important in human and livestock health worldwide. In November 2012, ixodid ticks were collected and identified morphologically from cattle and wild animals in the Maswa district and Iringa urban, Tanzania. Amblyomma gemma, A. lepidum, and A. variegatum were identified from Maswa cattle, and A. variegatum was the predominant species. A. marmoreum, Hyalomma impeltatum, and Rhipicephalus pulchellus were identified from Iringa cattle in addition to the above 3 Amblyomma species, and A. gemma was the most abundant species. Total 4 Amblyomma and 6 Rhipicephalus species were identified from wild animals of the 2 areas. A. lepidum was predominant in Maswa buffaloes, whereas A. gemma was predominant in Iringa buffaloes. Overall, A. variegatum in cattle was predominant in the Maswa district and A. gemma was predominant in Iringa, Tanzania. PMID:25352709

  15. Diffusion of subsidized ACTs in accredited drug shops in Tanzania: determinants of stocking and characteristics of early and late adopters

    PubMed Central

    2013-01-01

    Background Many households in sub-Saharan Africa utilize the private sector as a primary source of treatment for malaria episodes. Expanding access to effective treatment in private drug shops may help reduce incidence of severe disease and mortality. This research leveraged a longitudinal survey of stocking of subsidized artemisinin combination therapies (ACTs), an effective anti-malarial, in Accredited Drug Dispensing Outlets (ADDOs) in two regions of Tanzania. This provided a unique opportunity to explore shop and market level determinants of product diffusion in a developing country retail market. Methods 356 ADDOs in the Rukwa and Mtwara regions of Tanzania were surveyed at seven points between Feb 2011 and May 2012. Shop level audits were used to measure the availability of subsidized ACTs at each shop. Data on market and shop level factors were collected during the survey and also extracted from GIS layers. Regression and network based methodologies were used. Shops classified as early and late adopters, following Rogers’ model of product diffusion, were compared. The Bass model of product diffusion was applied to determine whether shops stocked ACTs out of a need to imitate market competitors or a desire to satisfy customer needs. Results Following the introduction of a subsidy for ACTs, stocking increased from 12% to nearly 80% over the seven survey rounds. Stocking was influenced by higher numbers of proximal shops and clinics, larger customer traffic and the presence of a licensed pharmacist. Early adopters were characterized by a larger percentage of customers seeking care for malaria, a larger catchment and sourcing from specific wholesalers/suppliers. The Bass model of product diffusion indicated that shops were adopting products in response to competitor behavior, rather than customer demand. Conclusions Decisions to stock new pharmaceutical products in Tanzanian ADDOs are influenced by a combination of factors related to both market competition and customer demand, but are particularly influenced by the behavior of competing shops. Efforts to expand access to new pharmaceutical products in developing country markets could benefit from initial targeting of high profile shops in competitive markets and wholesale suppliers to encourage faster product diffusion across all drug retailers. PMID:24350611

  16. A Prospective Study of Growth and Biomarkers of Exposure to Aflatoxin and Fumonisin during Early Childhood in Tanzania

    PubMed Central

    Shirima, Candida P.; Kimanya, Martin E.; Routledge, Michael N.; Srey, Chou; Kinabo, Joyce L.; Humpf, Hans-Ulrich; Wild, Christopher P.; Tu, Yu-Kang

    2014-01-01

    Background: Aflatoxin and fumonisin are toxic food contaminants. Knowledge about effects of their exposure and coexposure on child growth is inadequate. Objective: We investigated the association between child growth and aflatoxin and fumonisin exposure in Tanzania. Methods: A total of 166 children were recruited at 6–14 months of age and studied at recruitment, and at the 6th and 12th month following recruitment. Blood and urine samples were collected and analyzed for plasma aflatoxin–albumin adducts (AF-alb) using ELISA, and urinary fumonisin B1 (UFB1) using liquid chromatography–mass spectrometry, respectively. Anthropometric measurements were taken, and growth index z-scores were computed. Results: AF-alb geometric mean concentrations (95% CIs) were 4.7 (3.9, 5.6), 12.9 (9.9, 16.7), and 23.5 (19.9, 27.7) pg/mg albumin at recruitment, 6 months, and 12 months from recruitment, respectively. At these respective sampling times, geometric mean UFB1 concentrations (95% CI) were 313.9 (257.4, 382.9), 167.3 (135.4, 206.7), and 569.5 (464.5, 698.2) pg/mL urine, and the prevalence of stunted children was 44%, 55%, and 56%, respectively. UFB1 concentrations at recruitment were negatively associated with length-for-age z-scores (LAZ) at 6 months (p = 0.016) and at 12 months from recruitment (p = 0.014). The mean UFB1 of the three sampling times (at recruitment and at 6 and 12 months from recruitment) in each child was negatively associated with LAZ (p < 0.001) and length velocity (p = 0.004) at 12 months from recruitment. The negative association between AF-alb and child growth did not reach statistical significance. Conclusions: Exposure to fumonisin alone or coexposure with aflatoxins may contribute to child growth impairment. Citation: Shirima CP, Kimanya ME, Routledge MN, Srey C, Kinabo JL, Humpf HU, Wild CP, Tu YK, Gong YY. 2015. A prospective study of growth and biomarkers of exposure to aflatoxin and fumonisin during early childhood in Tanzania. Environ Health Perspect 123:173–178;?http://dx.doi.org/10.1289/ehp.1408097 PMID:25325363

  17. Social Capital as a Determinant of Pregnant Mother’s Place of Delivery: Experience from Kongwa District in Central Tanzania

    PubMed Central

    2015-01-01

    Introduction Maternal ill health contributes highly to the global burden of diseases in countries South of Sahara including Tanzania. Ensuring that all deliveries take place in health facilities and hence attended by skilled health personnel is one of the strategies advocated by global and national policies, including the Millennium Development Goals (MDGs). However, the number of women delivered by skilled health personnel has remained low in sub Saharan Africa despite of a number of interventions. We sought to determine the role of social capital in facilitating health facility delivery. Methods We randomly selected 744 households with children aged less than five years from two randomly selected wards in a rural area in Tanzania. Mothers were enquired about place of delivery of the last child. Social capital was assessed using a modified questionnaire with both structural and cognitive aspects of social capital, administered in face-to-face interviews. Principal Component Analysis (PCA) was used to develop asocial capital index measure. Uni-variate and multivariable regression models were run using STATA 12. Results Majority (85.9%) of the mothers reported to have delivered in a health facility during their last birth. Compared to the lowest social capital quintile, delivering in a health facility increased significantly with increase in social capital level: low (Adjusted Odds Ratio (AOR) = 2.9; Confidence Interval (CI): 1.4–6.1, p = 0.004); moderate (AOR = 5.5, CI: 2.3–13.3, p-value<0.001); high (AOR = 4.7; CI: 1.9–11.6, p-value<0.001) and highest (AOR = 5.6, CI: 2.4–13.4, p-value<0.001) and ?2-test for the trend was significant (?2 = 17.21, p<0.001). Conclusion Overall, social capital seems to play an important role in enhancing health facility delivery that may lead to improved maternal and child health. Concerted efforts should focus on promoting and supporting effective social capital and in particular cognitive social capital. PMID:26426538

  18. Integrating interannual climate variability forecasts into weather-indexed crop insurance. The case of Malawi, Kenya and Tanzania

    NASA Astrophysics Data System (ADS)

    Vicarelli, M.; Giannini, A.; Osgood, D.

    2009-12-01

    In this study we explore the potential for re-insurance schemes built on regional climatic forecasts. We focus on micro-insurance contracts indexed on precipitation in 9 villages in Kenya, Tanzania (Eastern Africa) and Malawi (Southern Africa), and analyze the precipitation patterns and payouts resulting from El Niño Southern Oscillation (ENSO). The inability to manage future climate risk represents a “poverty trap” for several African regions. Weather shocks can potentially destabilize not only household, but also entire countries. Governments in drought-prone countries, donors and relief agencies are becoming aware of the importance to develop an ex-ante risk management framework for weather risk. Joint efforts to develop innovative mechanisms to spread and pool risk such as microinsurance and microcredit are currently being designed in several developing countries. While ENSO is an important component in modulating the rainfall regime in tropical Africa, the micro-insurance experiments currently under development to address drought risk among smallholder farmers in this region do not take into account ENSO monitoring or forecasting yet. ENSO forecasts could be integrated in the contracts and reinsurance schemes could be designed at the continental scale taking advantage of the different impact of ENSO on different regions. ENSO is associated to a bipolar precipitation pattern in Southern and Eastern Africa. La Niña years (i.e. Cold ENSO Episodes) are characterized by dry climate in Eastern Africa and wet climate in Southern Africa. During El Niño (or Warm Episode) the precipitation dipole is inverted, and Eastern Africa experiences increased probability for above normal rainfall (Halpert and Ropelewski, 1992, Journal of Climate). Our study represents the first exercise in trying to include ENSO forecasts in micro weather index insurance contract design. We analyzed the contracts payouts with respect to climate variability. In particular (i) we simulated possible payouts using historical precipitation data and analyzed the differences between years with different ENSO states from 1961 to 2005; (ii) we applied Monte Carlo methods to simulate precipitation distributions in each location and calculated the mean and variance of payouts associated to different ENSO states. The results obtained from historical precipitation data indicate that more abundant rainfall reduces payouts and the risk of loan default during La Niña in southern Kenya and Malawi, during El Niño in Tanzania. The results of the Monte Carlo simulations confirm our findings. Our results suggest that re-insurance schemes could be successfully designed to exploit the anti-correlation patterns related to interannual climate variability for different regions in Africa. Moreover, the exploratory framework presented can potentially be refined applied to other regions (e.g. Central and Latin America).

  19. DENTAL PRACTITIONERS' ATTITUDES, SUBJECTIVE NORMS AND INTENTIONS TO PRACTICE ATRAUMATIC RESTORATIVE TREATMENT (ART) IN TANZANIA

    PubMed Central

    Kikwilu, Emil N.; Frencken, Jo E.; Mulder, Jan; Masalu, Joyce R.

    2009-01-01

    The aim of this study was to describe the attitude and subjective norm of dental practitioners towards practicing the atraumatic restorative treatment (ART) in Tanzania. A pre-tested questionnaire on attitudes and subjective norms to practice ART was mailed to all 147 dental practitioners working in the regional and district government clinics. The independent variables were: gender, working experience, qualification and ever heard of ART. The dependent variables were: attitude, subjective norm and intention to practice ART. Chi-square tests and multiple regression analysis were used to test for effects between independent and dependent variables. Significance level was set at 5%. A total of 138 practitioners returned completed questionnaires. More experienced dental practitioners encountered moderate social pressure than less experienced dental practitioners, who met strong social pressure (p=0.045). A total of 73.2% of dental practitioners felt that ART was worth introducing in Tanzania, 92.8% recommended ART training for all dental practitioners and 97.8% recommended inclusion of ART in dental curricula. Positive attitude, strong subjective norm and high intention to practice ART were recorded in 76.3%, 28.1% and 90.6% of the practitioners, respectively. Only subjective norm had a statistically significant influence on the intention to practice ART (p<0.0001). The results indicated that dental practitioners were willing to have ART introduced in Tanzania and had positive attitudes towards practicing this technique. Nevertheless, their intention to perform ART was strongly influenced by social pressures. Therefore, in order to have a successful introduction of ART in Tanzania, people who matter in the daily practice of dental practitioners need to accept and appraise the ART approach positively. PMID:19274393

  20. Costs and Impacts of Scaling up Voluntary Medical Male Circumcision in Tanzania

    PubMed Central

    Menon, Veena; Gold, Elizabeth; Godbole, Ramona; Castor, Delivette; Mahler, Hally; Forsythe, Steven; Ally, Mariam; Njeuhmeli, Emmanuel

    2014-01-01

    Background Given the proven effectiveness of voluntary medical male circumcision (VMMC) in preventing the spread of HIV, Tanzania is scaling up VMMC as an HIV prevention strategy. This study will inform policymakers about the potential costs and benefits of scaling up VMMC services in Tanzania. Methodology The analysis first assessed the unit costs of delivering VMMC at the facility level in three regions—Iringa, Kagera, and Mbeya—via three currently used VMMC service delivery models (routine, campaign, and mobile/island outreach). Subsequently, using these unit cost data estimates, the study used the Decision Makers' Program Planning Tool (DMPPT) to estimate the costs and impact of a scaled-up VMMC program. Results Increasing VMMC could substantially reduce HIV infection. Scaling up adult VMMC to reach 87.9% coverage by 2015 would avert nearly 23,000 new adult HIV infections through 2015 and an additional 167,500 from 2016 through 2025—at an additional cost of US$253.7 million through 2015 and US$302.3 million from 2016 through 2025. Average cost per HIV infection averted would be US$11,300 during 2010–2015 and US$3,200 during 2010–2025. Scaling up VMMC in Tanzania will yield significant net benefits (benefits of treatment costs averted minus the cost of performing circumcisions) in the long run—around US$4,200 in net benefits for each infection averted. Conclusion VMMC could have an immediate impact on HIV transmission, but the full impact on prevalence and deaths will only be apparent in the longer term because VMMC averts infections some years into the future among people who have been circumcised. Given the health and economic benefits of investing in VMMC, the scale-up of services should continue to be a central component of the national HIV prevention strategy in Tanzania. PMID:24802022

  1. Adolescents' Communication with Parents, Other Adult Family Members and Teachers on Sexuality: Effects of School-Based Interventions in South Africa and Tanzania.

    PubMed

    Namisi, Francis; Aarø, Leif Edvard; Kaaya, Sylvia; Kajula, Lusajo J; Kilonzo, Gad P; Onya, Hans; Wubs, Annegreet; Mathews, Catherine

    2015-12-01

    Cluster-randomized controlled trials were carried out to examine effects on sexual practices of school-based interventions among adolescents in three sites in sub-Saharan Africa. In this publication, effects on communication about sexuality with significant adults (including parents) and such communication as a mediator of other outcomes were examined. Belonging to the intervention group was significantly associated with fewer reported sexual debuts in Dar es Salaam only (OR 0.648). Effects on communication with adults about sexuality issues were stronger for Dar es Salaam than for the other sites. In Dar, increase in communication with adults proved to partially mediate associations between intervention and a number of social cognition outcomes. The hypothesized mediational effect of communication on sexual debut was not confirmed. Promoting intergenerational communication on sexuality issues is associated with several positive outcomes and therefore important. Future research should search for mediating factors influencing behavior beyond those examined in the present study. PMID:25724974

  2. Water quality management and sustainability: the experience of Lake Victoria Environmental Management Project (LVEMP)??Tanzania

    NASA Astrophysics Data System (ADS)

    Machiwa, Praxeda K.

    Human health and development are threatened in many parts of the world either from lack of water or poor water quality. Human development has partially contributed to water quality deterioration. In Tanzania, for instance, rapid population growth that caused expansion of agricultural activities, livestock keeping, deforestation, biomass burning and human settlement have exerted pressures within the Lake Victoria Basin. These developments have led to land degradation and increased levels of pollution mainly from non-point sources. The Governments of Kenya, Tanzania and Uganda initiated the program of Lake Victoria Environmental Management Project, (LVEMP), in 1994 to rehabilitate the Lake Ecosystem through restoration and conservation of biodiversity in the lake as well as within the catchment. This paper presents the five years (1997-2002) experience of LVEMP in Tanzania on the issues of water quality; focusing on water pollution, water quality monitoring and LVEMP strategies to accomplish water quality management in the Lake Zone (Kagera, Mara and Mwanza regions). The findings show that non-point source pollution from agricultural practices; as well as unplanned urban settlements contribute more to siltation and eutrophication of the of Lake Victoria than that from point source pollution. Recommendations for water quality management and sustainability are presented.

  3. Potential hominin plant foods in northern Tanzania: semi-arid savannas versus savanna chimpanzee sites.

    PubMed

    Copeland, Sandi R

    2009-10-01

    Savanna chimpanzees are useful as referential models for early hominins, and here potential differences between chimpanzee and early hominin ecology is the focus. Whereas chimpanzees inhabit only a handful of modern African savannas, there is evidence that early hominins occupied relatively more open and arid savannas than those in which chimpanzees live. In order to help expand potential models of early hominin palaeoecology beyond savanna chimpanzee-like scenarios, and to provide a basis for future modeling and testing of actual hominin diets, this study compares the types of plant foods available in modern semi-arid savannas of northern Tanzania to plant foods at savanna chimpanzee sites. The semi-arid savannas are not occupied by modern chimpanzees, but are potentially similar to environments occupied by some early hominins. Compared to savanna chimpanzee habitats, the northern Tanzania semi-arid savanna has a lower density and fewer species of trees that produce fleshy fruits. Additionally, the most abundant potential hominin plant foods are seasonally available Acacia seeds/pods and flowers, grass seeds, and the underground parts of marsh plants, as evidenced by vegetation surveys and by studies of the diets of baboons that forage in similar areas. The information from this study should be useful for framing hypotheses about hominin diets for sites with palaeoenvironmental contexts similar to those of the northern Tanzania semi-arid savannas and for contextualising tests of actual hominin diets (e.g., those based on dental microwear or isotopes). PMID:19733386

  4. Priority setting on malaria interventions in Tanzania: strategies and challenges to mitigate against the intolerable burden.

    PubMed

    Makundi, Emmanuel A; Mboera, Leonard E G; Malebo, Hamisi M; Kitua, Andrew Y

    2007-12-01

    In Tanzania, malaria remains one of the major causes of illness and death. The disease causes major obstacles to social and economic development. The extent of the problem is greatest among children less than five years of age and pregnant women. Malaria has been estimated to cost Tanzania more than US$ 240 million every year in lost gross domestic product, although it can be controlled for a fraction of that sum. Tanzania has actively participated in malaria research and in developing most control tools. However, the use of such tools and scaling up of effective interventions has been a major challenge. Major system constraints include inadequate human, financial, material resources, as well as an inefficient health care system. With an increasing burden with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), there has been a shift in the use of resources whereby more prioritization is given to interventions for HIV/AIDS than for malaria. The country is faced with several challenges including diagnosis, treatment, and control measures. Districts are faced with the inability to generate reliable information needed to make decisions to inform policy and lack skills for priority setting and planning. Budget allocation is not done according to evidence-based priorities, thus leading to stagnation over time. In this report, we present some success stories and discuss the challenges facing scaling up of interventions and propose priority areas to solving the problems. PMID:18165481

  5. Determination of essential and toxic elements in clay soil commonly consumed by pregnant women in Tanzania

    NASA Astrophysics Data System (ADS)

    Mwalongo, D.; Mohammed, N. K.

    2013-10-01

    A habit of eating clay soil especially among pregnant women is a common practice in Tanzania. This practice known as geophagy might introduce toxic elements in the consumer's body to endanger the health of the mother and her child. Therefore it is very important to have information on the elemental composition of the eaten soil so as to assess the safety nature of the habit. In this study 100 samples of clay soil, which were reported to be originating from five regions in Tanzania and are consumed by pregnant women were analyzed to determine their levels of essential and toxic elements. The analysis was carried out using energy dispersive X-ray fluorescent technique (EDXRF) of Tanzania Atomic Energy Commission, Arusha. Essential elements Fe, Zn, Cu, Se and Mn and toxic elements As, Pb, Co, Ni, U and Th were detected in concentrations above WHO permissible limits in some of the samples. The results from this study show that the habit of eating soil is exposing the pregnant mothers and their children to metal toxicity which is detrimental to their health. Hence, further actions should be taken to discourage the habit of eating soil at all levels.

  6. Same-sex practicing men in Tanzania from 1860 to 2010.

    PubMed

    Moen, Kåre; Aggleton, Peter; Leshabari, Melkizedeck T; Middelthon, Anne-Lise

    2014-08-01

    This article offers a review of published texts describing sexual relations between men in Tanzania in the period 1860-2010. It explores ways in which men who have sex with men have been named and understood; describes the sexual and social roles associated with differing same-sex identities and subjectivities; tracks politics, policies, and sociocultural expressions relating to sex between men; and explores the ways in which men's same-sex sexual practices have been responded to in the context of health and HIV. Among the impressions emerging from the historical record is that sex between men is not (and has not been) uncommon in Tanzania; that a significant conceptual distinction exists between men who are anally receptive and men who penetrate anally; and that there has been a range of views on, and opinions about, same-sex relations within the wider society. There is evidence that same-sex practicing men in Tanzania have been affected by HIV at least since 1982, with one seroprevalence study indicating that the burden of HIV among men who have sex with men was quite disproportionate as far back as 2007. However, while men who have sex with men have been defined as a "vulnerable population" with respect to HIV in national frameworks since 2003, this had not led to any significant amount of targeted HIV prevention work being reported by either local or international actors by 2010. PMID:24752788

  7. Independent Origin of Plasmodium falciparum Antifolate Super-Resistance, Uganda, Tanzania, and Ethiopia

    PubMed Central

    Alifrangis, Michael; Schousboe, Mette L.; Ishengoma, Deus; Lusingu, John; Pota, Hirva; Kavishe, Reginald A.; Pearce, Richard; Ord, Rosalynn; Lynch, Caroline; Dejene, Seyoum; Cox, Jonathan; Rwakimari, John; Minja, Daniel T.R.; Lemnge, Martha M.; Roper, Cally

    2014-01-01

    Super-resistant Plasmodium falciparum threatens the effectiveness of sulfadoxine–pyrimethamine in intermittent preventive treatment for malaria during pregnancy. It is characterized by the A581G Pfdhps mutation on a background of the double-mutant Pfdhps and the triple-mutant Pfdhfr. Using samples collected during 2004–2008, we investigated the evolutionary origin of the A581G mutation by characterizing microsatellite diversity flanking Pfdhps triple-mutant (437G+540E+581G) alleles from 3 locations in eastern Africa and comparing it with double-mutant (437G+540E) alleles from the same area. In Ethiopia, both alleles derived from 1 lineage that was distinct from those in Uganda and Tanzania. Uganda and Tanzania triple mutants derived from the previously characterized southeastern Africa double-mutant lineage. The A581G mutation has occurred multiple times on local Pfdhps double-mutant backgrounds; however, a novel microsatellite allele incorporated into the Tanzania lineage since 2004 illustrates the local expansion of emergent triple-mutant lineages. PMID:25061906

  8. Educating a Nation towards Self-Reliance: Tanzania's Journey in Search for an Education That Is Meaningful to Its People

    ERIC Educational Resources Information Center

    Wabike, Paul

    2015-01-01

    Since independence in 1961, Tanzania's political ideology (known as Ujamaa-familyhood) has gone hand in hand with the country's education philosophy. The most important feature of this combination is that people should be educated to fit in Tanzania's environment and culture. Education should emancipate man from mental slavery…

  9. Past and present vegetation ecology of Laetoli, Tanzania.

    PubMed

    Andrews, Peter; Bamford, Marion

    2008-01-01

    We are attempting to set up a new protocol for palaeoecological reconstruction in relation to the fossil hominin site Laetoli, Tanzania. This is based on the premise that habitat variability in the past was at least as great as at present; that this variability at the landscape level is a function of variations in geology, soils, and topography rather than climate; and that vegetation type at the landscape level can be reconstructed from these environmental variables. Measurable variation in climate in tropical Africa today occurs over distances of at least 100 km, so that ranges of habitat variation within the limited area of Laetoli today can be reconstructed in relation to soils and topography, and the effects of climate changes are then estimated in relation to these other factors. In order to document the modern vegetation, we have made voucher collections of plants in the Laetoli region, recorded distributions of plants by habitat, climate, soil, and topography, and mapped the vegetation distributions. Results show that areas of low relief have soils with impeded drainage and dense Acacia drepanolobium woodland, having low canopies when disturbed by human action, higher when not; shallow brown soils on volcanic lavas have four woodland associations, two dominated by Acacia species, two by Combretum-Albizia species; shallow volcanic soils to the east have a woodland association with Croton-Dombeya-Albizia species; elevated land to the east on volcanic soils has two associations of montane-edge species, one with Croton-Celtis-Lepidotrichilia, and the other with Acacia lahai; the eastern highlands above 2,750 m have montane forest; seasonal water channels flowing from east to west have three Acacia riverine woodland associations; three deep valleys to the north of the area have dense riverine woodland with Celtis, Albizia, Euclea, Combretum, Acacia spp.; emergence of springs at Endulen feed a perennial stream with closed gallery forest with Ficus-Croton-Lepidotrichilia; and, finally, recent ash falls have produced immature alkaline soils with calcrete formation and short grass vegetation. All of these vegetation associations have been modified by human disturbance to greater or lesser degrees, and we have attempted to allow for this both by basing the associations on the least modified areas and by predicting how the associations, or parts of associations, have been altered by human action. Past land forms at Laetoli have been based on the geology and geomorphology of the area. Past vegetation patterns were estimated by superimposing present distributions of plant associations on equivalent landforms in the past, assuming similar climate to the present. This indicates the overall pattern of vegetation at Laetoli to have been a mosaic of low and tall deciduous woodlands and with riverine woodland and forest associations along water courses. Low woodlands would have been dominated by Acacia species, and tall woodlands by Combretum-Albizia species, with increasing increments of montane species, such as Croton species, to the east of the area. Riverine woodlands would have been dominated by Acacia-Euclea species, with wetter associations (downriver or linked with spring activity) supporting gallery forest with Ficus, Celtis, and Croton species. These are all species associations common in the area today, and with landforms little changed in the past, and assuming similar climate, there is every reason to predict that they would have been present in the past. Moreover, Pliocene environments lack the human disturbance that has destroyed much of the present day vegetation. Presence of woodlands is supported by fossil wood attributed to several of the tree species present in the area today and by similarities in the mammalian community structure between past and present. Having established the pattern for Pliocene vegetation based on climatic variables existing today, we then predict the effects of past variations in climate. PMID:17765945

  10. Ruminant methane reduction through livestock development in Tanzania. Final report for US Department of Energy and US Initiative on Joint Implementation--Activities Implemented Jointly

    SciTech Connect

    Livingston, Roderick

    1999-07-01

    This project was designed to help develop the US Initiative on Joint Implementation activities in Eastern Africa. It has been communicated in meetings with representatives from the Ministry of Environment of Tanzania and the consultant group that developed Tanzania's National Climate Change Action Plan, the Centre for Energy, Environment, Science and Technology, that this project fits very well with the developmental and environmental goals of the Government of Tanzania. The goal of the Activities Implemented Jointly ruminant livestock project is to reduce ruminant methane emissions in Eastern Africa. The project plans a sustainable cattle multiplication unit (CMU) at Mabuki Ranch in the Mwanza Region of Tanzania. This CMU will focus on raising genetically improved animals to be purchased by farmers, developmental organizations, and other CMUs in Tanzania. Through the purchase of these animals farmers will raise their income generation potential and reduce ruminant methane emissions.

  11. Risks, precipitants and clinical presentation of gastro-oesophageal reflux disease at the Kilimanjaro Christian Medical Centre in Tanzania

    PubMed Central

    Mwandri, Michael Bartholomew; Mwita, Julius Chacha; Magafu, Mgaywa Gilbert Mjungu Damas; Kilonzo, Kajiru Gad; Urasa, Sarah Japhet

    2014-01-01

    Introduction Risk factors and precipitants of gastro-oesophageal disease (GERD) differ widely in communities. We conducted an observational study to describe these risks, precipitants and clinical presentation of GERD patients at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania. Methods We consecutively recruited 92 GERD patients who were referred for endoscopy at KCMC from March to November 2008. By using structured questionnaire we enquired: risk factors, precipitants and symptoms of GERD and upper gastrointestinal endoscopic findings. Their upper gastrointestinal endoscopic findings were as well documented. Results The mean (± SD) age of the study population was 47.32 (±17) years. Reported symptoms included water brash (37%), dyspepsia (6%), chronic cough (11%) and hemoptysis (5%). More than half (56%) of the patients surveyed identified food precipitants for their GERD symptoms. Triggers of GERD symptoms were boiled beans 19%, spicy food 11%, sour/fermented meals 10%, roasted tomato 9%, silver cyprinid fish (dagaa) 5%, beans with cooked green banana (matoke) 2% and fermented milk 1%. Most of the studied patients had normal body mass index (52%), and 25% admitted to be consuming alcohol though they didn't associate it with their GERD symptoms. The most common endoscopy finding was “loose lower oesophageal sphincter” (85%). Conclusion Most GERD patients referred for endoscopy at KCMC were found to have water brash and “loose lower oesophageal sphincters” as described by endoscopists to denote mechanical abnormality of the lower oesophageal sphincter. GERD symptoms were precipitated by common locally available food and spices. PMID:25745527

  12. Chronic Diseases in North-West Tanzania and Southern Uganda. Public Perceptions of Terminologies, Aetiologies, Symptoms and Preferred Management

    PubMed Central

    Nnko, Soori; Bukenya, Dominic; Kavishe, Bazil Balthazar; Biraro, Samuel; Peck, Robert; Kapiga, Saidi; Grosskurth, Heiner; Seeley, Janet

    2015-01-01

    Background Research has shown that health system utilization is low for chronic diseases (CDs) other than HIV. We describe the knowledge and perceptions of CDs identified from rural and urban communities in north-west Tanzania and southern Uganda. Methods Data were collected through a quantitative population survey, a quantitative health facility survey and focus group discussions (FGDs) and in-depth interviews (IDIs) in subgroups of population survey participants. The main focus of this paper is the findings from the FGDs and IDIs. Results We conducted 24 FGDs, involving approximately 180 adult participants and IDIs with 116 participants (?18 years). CDs studied included: asthma/chronic obstructive lung disease (COPD), diabetes, epilepsy, hypertension, cardiac failure and HIV- related disease. The understanding of most chronic conditions involved a combination of biomedical information, gleaned from health facility visits, local people who had suffered from a complaint or knew others who had and beliefs drawn from information shared in the community. The biomedical contribution shows some understanding of the aetiology of a condition and the management of that condition. However, local beliefs for certain conditions (such as epilepsy) suggest that biomedical treatment may be futile and therefore work counter to biomedical prescriptions for management. Conclusion Current perceptions of selected CDs may represent a barrier that prevents people from adopting efficacious health and treatment seeking behaviours. Interventions to improve this situation must include efforts to improve the quality of existing health services, so that people can access relevant, reliable and trustworthy services. PMID:26555896

  13. Staff experiences of providing maternity services in rural southern Tanzania – a focus on equipment, drug and supply issues

    PubMed Central

    2013-01-01

    Background The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse patient outcomes through delaying care provision. We aim to describe staff experiences of providing maternal and neonatal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies. Methods Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items. Results The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures with potential health risks to themselves as a result. Conclusions Inadequately stocked and equipped facilities compromise the health system’s ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions. PMID:23410228

  14. Factors that hinder community participation in developing and implementing comprehensive council health plans in Manyoni District, Tanzania

    PubMed Central

    Kilewo, Emmanuel G.; Frumence, Gasto

    2015-01-01

    Background Decentralization of public health planning is proposed to facilitate public participation in health issues. Health Sector Reform in Tanzania places emphasis on the participation of lower level health facilities and community in health planning process. Despite availability of policies, guidelines, and community representative organs, actual implementation of decentralization strategies is poorly achieved. This study intended to find out factors that hinder community participation in developing and implementing Comprehensive Council Health Plan (CCHP). Materials and methods A qualitative approach was conducted in this study with key informants from Health Facility Governing Committees (HFGC), Council Health Service Board (CHSB), and Council Health Management Team (CHMT). Data were collected using in-depth interviews. Data generated were analyzed for themes and patterns. Results Factors that hindered community participation included lack of awareness on the CCHP among HFGC members, poor communication and information sharing between CHMT and HFGC, unstipulated roles and responsibilities of HFGC, lack of management capacity among HFGC members, and lack of financial resources for implementing HFGC activities. Conclusions The identified challenges call for policy makers to revisit the decentralization by devolution policy by ensuring that local governance structures have adequate resources as well as autonomy to participate in planning and managing CCHP in general and health facility plans in particular. PMID:26037041

  15. Design, implementation and evaluation of a national campaign to deliver 18 million free long-lasting insecticidal nets to uncovered sleeping spaces in Tanzania

    PubMed Central

    2013-01-01

    Background Since 2004, the Tanzanian National Voucher Scheme has increased availability and accessibility of insecticide-treated nets (ITNs) to pregnant women and infants by subsidizing the cost of nets purchased. From 2008 to 2010, a mass distribution campaign delivered nine million long-lasting insecticidal nets (LLINs) free-of-charge to children under-five years of age in Tanzania mainland. In 2010 and 2011, a Universal Coverage Campaign (UCC) led by the Ministry of Health and Social Welfare (MoHSW) was implemented to cover all sleeping spaces not yet reached through previous initiatives. Methods The UCC was coordinated through a unit within the National Malaria Control Programme. Partners were contracted by the MoHSW to implement different activities in collaboration with local government authorities. Volunteers registered the number of uncovered sleeping spaces in every household in the country. On this basis, LLINs were ordered and delivered to village level, where they were issued over a three-day period in each zone (three regions). Household surveys were conducted in seven districts immediately after the campaign to assess net ownership and use. Results The UCC was chiefly financed by the Global Fund to Fight AIDS, Tuberculosis and Malaria with important contributions from the US President’s Malaria Initiative. A total of 18.2 million LLINs were delivered at an average cost of USD 5.30 per LLIN. Overall, 83% of the expenses were used for LLIN procurement and delivery and 17% for campaign associated activities. Preliminary results of the latest Tanzania HIV Malaria Indicator Survey (2011–12) show that household ownership of at least one ITN increased to 91.5%. ITN use, among children under-five years of age, improved to 72.7% after the campaign. ITN ownership and use data post-campaign indicated high equity across wealth quintiles. Conclusion Close collaboration among the MoHSW, donors, contracted partners, local government authorities and volunteers made it possible to carry out one of the largest LLIN distribution campaigns conducted in Africa to date. Through the strong increase of ITN use, the recent activities of the national ITN programme will likely result in further decline in child mortality rates in Tanzania, helping to achieve Millennium Development Goals 4 and 6. PMID:23496881

  16. Factors Associated with Testing and Prompt Use of Recommended Antimalarials following Malaria Diagnosis: A Secondary Analysis of 2011-12 Tanzania HIV and Malaria Indicator Survey Data

    PubMed Central

    Adinan, Juma; Damian, Damian J.; Msuya, Sia E.

    2015-01-01

    Introduction Malaria is still a public health problem in Sub-Saharan Africa. Malaria causes mortality mostly in children under-five years. Early detection and prompt treatment using recommended antimalarials is key to malaria control. However, in Tanzania, contrary to the national goals, a large proportion of children with fever taken to health facilities are not tested for malaria and those tested positive are not promptly treated using recommended antimalarials. The aim of this study was to determine factors associated with malaria testing and prompt use of recommended antimalarials among under-five children with fever in Tanzania. Methods This was a secondary analysis of Tanzania HIV and Malaria Indicator Survey (THMIS) data 2011-12 obtained from a national cross sectional survey. The analysis involved children aged 6-59 months whose mothers reported they had fever two weeks preceding the survey. Factors associated with testing and uses of recommended antimalarials were obtained using logistic regression. Results Of the 1675 under-five children with fever, 951 (56.8%) were taken to the health facilities. Of the 951 children, only 394 (41.48%) febrile children were tested for malaria. Of those tested, 291 (78.91%) were diagnosed with malaria. Of those diagnosed with malaria, only 124 (42.68%) children used recommended antimalarials within 1st 24 hours of diagnosis. In multivariate analysis, children taken to health centers (OR 1.79; 95%CI: 1.07 - 3.00) and to the hospitals (OR 3.4; 95%CI: 1.75 - 6.77) had higher odds of being tested compared to those taken to dispensary and other lower level health facilities. Children were more likely to use recommended antimalarial promptly if they had a caretaker with secondary or higher education (OR: 4.07; 95%CI: 0.61 - 2.68) or living in the rural area (OR: 3.21; 95%CI: 1.09 - 9.44) compared to those with an uneducated caretaker or from an urban area. Conclusion Training on malaria testing and treatment guidelines should be provided, and preventing stock outs of malaria testing kits and medications at dispensary level should be made available as it is the first point of health care for most Tanzanians. Reasons on why urban people are less likely to use recommended antimalarials need to be investigated and addressed for proper malaria management. PMID:26186547

  17. Expanded Quality Management Using Information Power (EQUIP): protocol for a quasi-experimental study to improve maternal and newborn health in Tanzania and Uganda

    PubMed Central

    2014-01-01

    Background Maternal and newborn mortality remain unacceptably high in sub-Saharan Africa. Tanzania and Uganda are committed to reduce maternal and newborn mortality, but progress has been limited and many essential interventions are unavailable in primary and referral facilities. Quality management has the potential to overcome low implementation levels by assisting teams of health workers and others finding local solutions to problems in delivering quality care and the underutilization of health services by the community. Existing evidence of the effect of quality management on health worker performance in these contexts has important limitations, and the feasibility of expanding quality management to the community level is unknown. We aim to assess quality management at the district, facility, and community levels, supported by information from high-quality, continuous surveys, and report effects of the quality management intervention on the utilization and quality of services in Tanzania and Uganda. Methods In Uganda and Tanzania, the Expanded Quality Management Using Information Power (EQUIP) intervention is implemented in one intervention district and evaluated using a plausibility design with one non-randomly selected comparison district. The quality management approach is based on the collaborative model for improvement, in which groups of quality improvement teams test new implementation strategies (change ideas) and periodically meet to share results and identify the best strategies. The teams use locally-generated community and health facility data to monitor improvements. In addition, data from continuous health facility and household surveys are used to guide prioritization and decision making by quality improvement teams as well as for evaluation of the intervention. These data include input, process, output, coverage, implementation practice, and client satisfaction indicators in both intervention and comparison districts. Thus, intervention districts receive quality management and continuous surveys, and comparison districts-only continuous surveys. Discussion EQUIP is a district-scale, proof-of-concept study that evaluates a quality management approach for maternal and newborn health including communities, health facilities, and district health managers, supported by high-quality data from independent continuous household and health facility surveys. The study will generate robust evidence about the effectiveness of quality management and will inform future nationwide implementation approaches for health system strengthening in low-resource settings. Trial registration PACTR201311000681314 PMID:24690284

  18. Implementation of an insecticide-treated net subsidy scheme under a public-private partnership for malaria control in Tanzania – challenges in implementation

    PubMed Central

    2009-01-01

    Background In the past decade there has been increasing visibility of malaria control efforts at the national and international levels. The factors that have enhanced this scenario are the availability of proven interventions such as artemisinin-based combination therapy, the wide scale use of insecticide-treated nets (ITNs) and a renewed emphasis in indoor residual house-spraying. Concurrently, there has been a window of opportunity of financial commitments from organizations such as the Global Fund for HIV/AIDS, Tuberculosis and Malaria (GFATM), the President's Malaria Initiative and the World Bank Booster programme. Methods The case study uses the health policy analysis framework to analyse the implementation of a public-private partnership approach embarked upon by the government of Tanzania in malaria control – 'The Tanzania National Voucher Scheme'- and in this synthesis, emphasis is on the challenges faced by the scheme during the pre-implementation (2001 – 2004) and implementation phases (2004 – 2005). Qualitative research tools used include: document review, interview with key informants, stakeholder's analysis, force-field analysis, time line of events, policy characteristic analysis and focus group discussions. The study is also complemented by a cross-sectional survey, which was conducted at the Rufiji Health Demographic Surveillance Site, where a cohort of women of child-bearing age were followed up regarding access and use of ITNs. Results The major challenges observed include: the re-introduction of taxes on mosquito nets and related products, procurement and tendering procedures in the implementation of the GFATM, and organizational arrangements and free delivery of mosquito nets through a Presidential initiative. Conclusion The lessons gleaned from this synthesis include: (a) the consistency of the stakeholders with a common vision, was an important strength in overcoming obstacles, (b) senior politicians often steered the policy agenda when the policy in question was a 'crisis event', the stakes and the visibility were high, (c) national stakeholders in policy making have an advantage in strengthening alliances with international organizations, where the latter can become extremely influential in solving bottlenecks as the need arises, and (d) conflict can be turned into an opportunity, for example the Presidential initiative has inadvertently provided Tanzania with important lessons in the organization of 'catch-up' campaigns. PMID:19698109

  19. Nutritional composition and micronutrient status of home made and commercial weaning foods consumed in Tanzania.

    PubMed

    Mosha TCE; Laswai, H S; Tetens, I

    2000-01-01

    About 50% of young children in Tanzania suffer from protein-energy undernutrition (PEU) while more than 45% of children under the age of five suffer from various micronutrient deficiency disorders. The immediate cause of these conditions is inadequate intake and poor utilization of nutrients, which begins in the weaning period and amplifies in the subsequent years. This study was conducted to assess the potential of some home made and commercial weaning foods commonly consumed in Tanzania to supply adequate amounts of both macro- and micronutrients as recommended in the Tanzania and FAO/WHO Codex Alimentarius Standards for cereal/milk-based weaning foods. Six types of home made weaning foods, maize, cassava, millet, sorghum and millet-sardine-peanut composite gruels and plantain pap, and four types of commercial weaning foods, Cerelac- 1, Cerelac-2, Lactogen-1 and Lactogen-2, popularly consumed in Tanzania, were chemically assayed for proximate composition, energy and mineral density. Results of the study indicated that, both the home made and commercial weaning foods were good sources of macro- and micronutrients. When compared with the Codex Alimentarius and Tanzania Bureau of Standards specifications for weaning foods, both home made and commercial weaning foods had some shortcomings in terms of nutrient composition and energy balance. Many of the foods were low in fat. Fe, Ca, Zn and P but high in crude fiber, carbohydrate and magnesium. Ca, Fe and Zn were the most common deficient macro/micronutrients in the home made weaning foods. In spite of these shortcomings, most of the home made and commercial weaning foods were nutritionally sound since they could provide reasonable percentages of the recommended daily allowances for macro/micronutrients and energy. It is suggested that, more efforts must be directed towards increasing the concentration of Ca, Fe and Zn in the home made weaning foods through supplementation of the starchy staples with mineral rich foods. Meanwhile, the parents, caretakers and health workers should be educated on the selection and preparation of nutritious, balanced weaning foods and good weaning practices. PMID:11030474

  20. HIV-1 pol diversity among female bar and hotel workers in Northern Tanzania.

    PubMed

    Kiwelu, Ireen E; Novitsky, Vladimir; Kituma, Elimsaada; Margolin, Lauren; Baca, Jeannie; Manongi, Rachel; Sam, Noel; Shao, John; McLane, Mary F; Kapiga, Saidi H; Essex, M

    2014-01-01

    A national ART program was launched in Tanzania in October 2004. Due to the existence of multiple HIV-1 subtypes and recombinant viruses co-circulating in Tanzania, it is important to monitor rates of drug resistance. The present study determined the prevalence of HIV-1 drug resistance mutations among ART-naive female bar and hotel workers, a high-risk population for HIV-1 infection in Moshi, Tanzania. A partial HIV-1 pol gene was analyzed by single-genome amplification and sequencing in 45 subjects (622 pol sequences total; median number of sequences per subject, 13; IQR 5-20) in samples collected in 2005. The prevalence of HIV-1 subtypes A1, C, and D, and inter-subtype recombinant viruses, was 36%, 29%, 9% and 27%, respectively. Thirteen different recombination patterns included D/A1/D, C/A1, A1/C/A1, A1/U/A1, C/U/A1, C/A1, U/D/U, D/A1/D, A1/C, A1/C, A2/C/A2, CRF10_CD/C/CRF10_CD and CRF35_AD/A1/CRF35_AD. CRF35_AD was identified in Tanzania for the first time. All recombinant viruses in this study were unique, suggesting ongoing recombination processes among circulating HIV-1 variants. The prevalence of multiple infections in this population was 16% (n?=?7). Primary HIV-1 drug resistance mutations to RT inhibitors were identified in three (7%) subjects (K65R plus Y181C; N60D; and V106M). In some subjects, polymorphisms were observed at the RT positions 41, 69, 75, 98, 101, 179, 190, and 215. Secondary mutations associated with NNRTIs were observed at the RT positions 90 (7%) and 138 (6%). In the protease gene, three subjects (7%) had M46I/L mutations. All subjects in this study had HIV-1 subtype-specific natural polymorphisms at positions 36, 69, 89 and 93 that are associated with drug resistance in HIV-1 subtype B. These results suggested that HIV-1 drug resistance mutations and natural polymorphisms existed in this population before the initiation of the national ART program. With increasing use of ARV, these results highlight the importance of drug resistance monitoring in Tanzania. PMID:25003939

  1. Measuring client satisfaction and the quality of family planning services: A comparative analysis of public and private health facilities in Tanzania, Kenya and Ghana

    PubMed Central

    2011-01-01

    Background Public and private family planning providers face different incentive structures, which may affect overall quality and ultimately the acceptability of family planning for their intended clients. This analysis seeks to quantify differences in the quality of family planning (FP) services at public and private providers in three representative sub-Saharan African countries (Tanzania, Kenya and Ghana), to assess how these quality differentials impact upon FP clients' satisfaction, and to suggest how quality improvements can improve contraceptive continuation rates. Methods Indices of technical, structural and process measures of quality are constructed from Service Provision Assessments (SPAs) conducted in Tanzania (2006), Kenya (2004) and Ghana (2002) using direct observation of facility attributes and client-provider interactions. Marginal effects from multivariate regressions controlling for client characteristics and the multi-stage cluster sample design assess the relative importance of different measures of structural and process quality at public and private facilities on client satisfaction. Results Private health facilities appear to be of higher (interpersonal) process quality than public facilities but not necessarily higher technical quality in the three countries, though these differentials are considerably larger at lower level facilities (clinics, health centers, dispensaries) than at hospitals. Family planning client satisfaction, however, appears considerably higher at private facilities - both hospitals and clinics - most likely attributable to both process and structural factors such as shorter waiting times and fewer stockouts of methods and supplies. Conclusions Because the public sector represents the major source of family planning services in developing countries, governments and Ministries of Health should continue to implement and to encourage incentives, perhaps performance-based, to improve quality at public sector health facilities, as well as to strengthen regulatory and monitoring structures to ensure quality at both public and private facilities. In the meantime, private providers appear to be fulfilling an important gap in the provision of FP services in these countries. PMID:21864335

  2. Using electronic technology to improve clinical care – results from a before-after cluster trial to evaluate assessment and classification of sick children according to Integrated Management of Childhood Illness (IMCI) protocol in Tanzania

    PubMed Central

    2013-01-01

    Background Poor adherence to the Integrated Management of Childhood Illness (IMCI) protocol reduces the potential impact on under-five morbidity and mortality. Electronic technology could improve adherence; however there are few studies demonstrating the benefits of such technology in a resource-poor settings. This study estimates the impact of electronic technology on adherence to the IMCI protocols as compared to the current paper-based protocols in Tanzania. Methods In four districts in Tanzania, 18 clinics were randomly selected for inclusion. At each site, observers documented critical parts of the clinical assessment of children aged 2 months to 5 years. The first set of observations occurred during examination of children using paper-based IMCI (pIMCI) and the next set of observations occurred during examination using the electronic IMCI (eIMCI). Children were re-examined by an IMCI expert and the diagnoses were compared. A total of 1221 children (671 paper, 550 electronic) were observed. Results For all ten critical IMCI items included in both systems, adherence to the protocol was greater for eIMCI than for pIMCI. The proportion assessed under pIMCI ranged from 61% to 98% compared to 92% to 100% under eIMCI (p?Tanzania. With the before-after nature of the design, potential for temporal confounding is the primary limitation. However, the data collection for both phases occurred over a short period (one month) and so temporal confounding was expected to be minimal. The results suggest that the use of electronic IMCI protocols can improve the completeness and consistency of clinical assessments and future studies will examine the long-term health and health systems impact of eIMCI. PMID:23981292

  3. Self-medication with anti-malarials is a common practice in rural communities of Kilosa district in Tanzania despite the reported decline of malaria

    PubMed Central

    2014-01-01

    Background Self-medication has been widely practiced worldwide particularly in developing countries including Tanzania. In sub-Saharan Africa high incidences of malaria have contributed to self-medication with anti-malarial drugs. In recent years, there has been a gain in malaria control, which has led to decreased malaria transmission, morbidity and mortality. Therefore, understanding the patterns of self-medication during this period when most instances of fever are presumed to be due to non-malaria febrile illnesses is important. In this study, self-medication practice was assessed among community members and information on the habit of self-medication was gathered from health workers. Methods Twelve focus group discussions (FGD) with members of communities and 14 in-depth interviews (IDI) with health workers were conducted in Kilosa district, Tanzania. The transcripts were coded into different categories by MaxQDA software and then analysed through thematic content analysis. Results The study revealed that self-medication was a common practice among FGD participants. Anti-malarial drugs including sulphadoxine-pyrimethamine and quinine were frequently used by the participants for treatment of fever. Study participants reported that they visited health facilities following failure of self-medication or if there was no significant improvement after self-medication. The common reported reasons for self-medication were shortages of drugs at health facilities, long waiting time at health facilities, long distance to health facilities, inability to pay for health care charges and the freedom to choose the preferred drugs. Conclusion This study demonstrated that self-medication practice is common among rural communities in the study area. The need for community awareness is emphasized for correct and comprehensive information about drawbacks associated with self-medication practices. Deliberate efforts by the government and other stakeholders to improve health care services, particularly at primary health care facilities will help to reduce self-medication practices. PMID:24992941

  4. “Man, what took you so long?” Social and individual factors affecting adult attendance at voluntary medical male circumcision services in Tanzania

    PubMed Central

    Plotkin, Marya; Castor, Delivette; Mziray, Hawa; Küver, Jan; Mpuya, Ezekiel; Luvanda, Paul James; Hellar, Augustino; Curran, Kelly; Lukobo-Durell, Mainza; Ashengo, Tigistu Adamu; Mahler, Hally

    2013-01-01

    ABSTRACT Background: In 2009, the Government of Tanzania embarked on scaling up voluntary medical male circumcision (VMMC) services for HIV prevention in 8 priority regions, with the aim of serving 2.8 million boys and men ages 10–34 years by 2013. By mid-2012, more than 110,000 boys and men in Iringa and Njombe regions had received VMMC. The majority (85%) of these VMMC clients were under 19 years old (average age, 16 years). This study aimed to identify potential barriers and facilitators to VMMC among older men. Methods: We conducted 16 focus group discussions, stratified by sex and age, with 142 purposefully selected participants in 3 districts of Iringa and Njombe regions. Results: Both men and women generally had positive attitudes toward VMMC. Social and personal barriers to obtaining VMMC among adult men included shame associated with seeking services co-located with younger boys and perceived inappropriateness of VMMC after puberty, particularly after marriage and after having children. Additional barriers included concerns about partner infidelity during the post-surgical abstinence period, loss of income, and fear of pain associated with post-surgical erections. Facilitators included awareness of the HIV-prevention benefit and perceptions of cleanliness and enhanced attractiveness to women. Conclusions: While men and women in Iringa and Njombe regions in Tanzania generally view VMMC as a desirable procedure, program implementers need to address barriers to VMMC services among adult men. Selected service delivery sites in the Iringa and Njombe regions will be segregated by age to provide services that are “friendly” to adult men. Services will be complemented with behavior change communication initiatives to address concerns of older men, encourage women’s support for circumcision and adherence to the post-surgical abstinence period, and change social norms that inhibit older men from seeking circumcision. PMID:25276521

  5. Beyond antimalarial stock-outs: implications of health provider compliance on out-of-pocket expenditure during care-seeking for fever in South East Tanzania

    PubMed Central

    2013-01-01

    Background To better understand how stock-outs of the first line antimalarial, Artemisinin-based Combination Therapy (ACT) and other non-compliant health worker behaviour, influence household expenditures during care-seeking for fever in the Ulanga District in Tanzania. Methods We combined weekly ACT stock data for the period 2009-2011 from six health facilities in the Ulanga District in Tanzania, together with household data from 333 respondents on the cost of fever care-seeking in Ulanga during the same time period to establish how health seeking behaviour and expenditure might vary depending on ACT availability in their nearest health facility. Results Irrespective of ACT stock-outs, more than half (58%) of respondents sought initial care in the public sector, the remainder seeking care in the private sector where expenditure was higher by 19%. Over half (54%) of respondents who went to the public sector reported incidences of non-compliant behaviour by the attending health worker (e.g. charging those who were eligible for free service or referring patients to the private sector despite ACT stock), which increased household expenditure per fever episode from USD0.14 to USD1.76. ACT stock-outs were considered to be the result of non-compliant behaviour of others in the health system and increased household expenditure by 21%; however we lacked sufficient statistical power to confirm this finding. Conclusion System design and governance challenges in the Tanzanian health system have resulted in numerous ACT stock-outs and frequent non-compliant public sector health worker behaviour, both of which increase out-of-pocket health expenditure. Interventions are urgently needed to ensure a stable supply of ACT in the public sector and increase health worker accountability. PMID:24161029

  6. Are health interventions implemented where they are most needed? District uptake of the integrated management of childhood illness strategy in Brazil, Peru and the United Republic of Tanzania.

    PubMed Central

    Victora, C. G.; Huicho, L.; Amaral, J. J.; Armstrong-Schellenberg, J.; Manzi, F.; Mason, E.; Scherpbier, R.

    2006-01-01

    OBJECTIVE: To describe geographical patterns of implementation of the Integrated Management of Childhood Illness (IMCI) strategy in three countries and to assess whether the strategy was implemented in areas with the most pressing child health needs. METHODS: We conducted interviews with key informants at the national and district levels in Brazil, Peru and the United Republic of Tanzania, and an ecological study of factors associated with health worker training in IMCI. Explanatory factors included district population, distance from the capital, human development index, other socioeconomic indicators and baseline mortality rates in children younger than five years. FINDINGS: In line with recommendations by WHO, early implementation districts were characterized by proximity to the capital and suitable training sites, presence of motivated health managers and a functioning health system. In the expansion phase, IMCI tended to be adopted by other districts with similar characteristics. In Brazil, uptake by poor and small municipalities and those further away from the state capital was significantly lower. In Peru, there was no association with distance from Lima, and a non-significant trend for IMCI adoption by small and poor departments. In the United Republic of Tanzania, the only statistically significant finding was a lower uptake by remote districts. Implementation was not associated with baseline mortality levels in any country studied. CONCLUSION: Whereas clear and reasonable guidelines are provided for selection of early use districts, no criteria for promoting IMCI expansion had been issued, and areas of greatest need were not prioritized. Equity analyses based on the geographical deployment of new programmes and strategies can contribute to assessing whether they are reaching those who need them most. PMID:17128359

  7. The Role of Evidence in the Decision-Making Process of Selecting Essential Medicines in Developing Countries: The Case of Tanzania

    PubMed Central

    Mori, Amani Thomas; Kaale, Eliangiringa Amos; Ngalesoni, Frida; Norheim, Ole Frithjof; Robberstad, Bjarne

    2014-01-01

    Background Insufficient access to essential medicines is a major health challenge in developing countries. Despite the importance of Standard Treatment Guidelines and National Essential Medicine Lists in facilitating access to medicines, little is known about how they are updated. This study aims to describe the process of updating the Standard Treatment Guidelines and National Essential Medicine List in Tanzania and further examines the criteria and the underlying evidence used in decision-making. Methods This is a qualitative study in which data were collected by in-depth interviews and document reviews. Interviews were conducted with 18 key informants who were involved in updating the Standard Treatment Guidelines and National Essential Medicine List. We used a thematic content approach to analyse the data. Findings The Standard Treatment Guidelines and National Essential Medicine List was updated by committees of experts who were recruited mostly from referral hospitals and the Ministry of Health and Social Welfare. Efficacy, safety, availability and affordability were the most frequently utilised criteria in decision-making, although these were largely based on experience rather than evidence. In addition, recommendations from international guidelines and medicine promotions also influenced decision-making. Cost-effectiveness, despite being an important criterion for formulary decisions, was not utilised. Conclusions Recent decisions about the selection of essential medicines in Tanzania were made by committees of experts who largely used experience and discretionary judgement, leaving evidence with only a limited role in decision-making process. There may be several reasons for the current limited use of evidence in decision-making, but one hypothesis that remains to be explored is whether training experts in evidence-based decision-making would lead to a better and more explicit use of evidence. PMID:24416293

  8. Prevalence, Antimicrobial Resistance and Risk Factors for Thermophilic Campylobacter Infections in Symptomatic and Asymptomatic Humans in Tanzania.

    PubMed

    Komba, E V G; Mdegela, R H; Msoffe, P L M; Nielsen, L N; Ingmer, H

    2015-11-01

    The genus Campylobacter comprises members known to be a leading cause of foodborne gastrointestinal illness worldwide. A study was conducted to determine the epidemiology and antimicrobial resistance of Campylobacter in humans in Morogoro, Eastern Tanzania. Isolation of Campylobacter from stool specimens adopted the Cape Town protocol. Campylobacter isolates were preliminarily identified by conventional phenotypic tests and subsequently confirmed by matrix-assisted laser desorption/ionization-time-of-flight (MALDI-TOF) mass spectrometry and polymerase chain reaction. Antimicrobial resistance testing employed the disc diffusion method. A small proportion of the test isolates was also subjected to agar dilution method. Risk factors for human illness were determined in an unmatched case-control study. Thermophilic Campylobacter were isolated from 11.4% of the screened individuals (n = 1195). The agreement between PCR and MALDI-TOF was perfect (? = 1.0). Symptomatics and young individuals were infected with higher numbers than asymptomatic and adults, respectively. The majority (84.6%) of the isolates were C. jejuni and the remaining were C. coli. Isolates had highest resistance (95.6%) for colistin sulphate and lowest for ciprofloxacin (22.1%). The rates of resistance for other antibiotics (azithromycin, erythromycin, tetracycline, cephalothin, gentamycin, nalidixic acid, ampicillin, amoxycillin, norfloxacin, chloramphenicol) ranged from 44.1% to 89%. Comparison between disc diffusion and agar dilution methods indicated a good correlation, and the tests were in agreement to each other (? ? 0.75). Human illness was found to be associated with young age and consumption of chicken meat and pre-prepared salad. Our data indicate the presence of antibiotic-resistant thermophilic Campylobacter in humans in the study area. There is a need for routine investigation of the presence of the organisms in gastroenteritis aetiology, including determination of their antibiotic susceptibilities. PMID:25753615

  9. Community perception on biomedical research: A case study of malariometric survey in Korogwe District, Tanga Region, Tanzania

    PubMed Central

    2014-01-01

    Background Community perception in biomedical research remains critical in Africa with many participants being driven by different motives. The objective of this study was to explore the perceived motives for women or females guardians to volunteer for their children to participate in biomedical research and to explore experiences and challenges faced by Community Owned Resource Persons (CORPs) when mobilizing community members to participate in biomedical research. Methods This cross sectional study was conducted in Korogwe district, in north-eastern Tanzania. Qualitative methods combining random and purposive sampling techniques were used for data collection. A randomly selected sample using random table method from the existing list of households in the ward office was used to select participants for Focus Group Discussions (FGDs). A purposive sampling technique was used for In-Depth Interviews (IDIs) with CORPs. Thematic framework analysis was used to analyze the data. Results Need for better health services, availability of qualified clinicians, and better access to services provided at the research points were reported as main motives for community members to participate in biomedical research. With regard to experience and challenges faced by CORPs, the main reasons for mothers and guardians not participating in biomedical research were linked to misconception of the malariometric surveys, negative perception of the validity and sensitivity of rapid diagnostic tests, fear of knowing Human Immunodeficiency Virus Infection (HIV)/Acquired Immune Deficiency Syndrome (HIV/AIDS) sero status, and lack of trust for the medical information provided by the CORPs. Challenges reported by CORPs included lack ofawareness of malariometric surveys among participants, time consumption in mobilization of the community, difficulties in identifying individual results, and family responsibilities. Conclusion This study has shown that majority of community members had positive perceptions of the about malariometric surveys services provided. The availability of free health services was the major determining factor for community members’ participation in malariometric surveys. CORPs are instrumental in mobilizing community members participation during malariometric surveys, despite their experiences and the challenges they face. PMID:24755404

  10. Intermittent preventive treatment of malaria during pregnancy: a qualitative study of knowledge, attitudes and practices of district health managers, antenatal care staff and pregnant women in Korogwe District, North-Eastern Tanzania

    PubMed Central

    Mubyazi, Godfrey; Bloch, Paul; Kamugisha, Mathias; Kitua, Andrew; Ijumba, Jasper

    2005-01-01

    Background Intermittent preventive treatment of malaria during pregnancy (IPTp) is a key intervention in the national strategy for malaria control in Tanzania. SP, the current drug of choice, is recommended to be administered in the second and third trimesters of pregnancy during antenatal care (ANC) visits. To allow for a proper design of planned scaling up of IPT services in Tanzania it is useful to understand the IPTp strategy's acceptability to health managers, ANC service providers and pregnant women. This study assesses the knowledge, attitudes and practices of these groups in relation to malaria control with emphasis on IPTp services. Methods The study was conducted in February 2004, in Korogwe District, Tanzania. It involved in-depth interviews with the district medical officer (DMO), district hospital medical officer in charge and relevant health service staff at two peripheral dispensaries, and separate focus group discussions (FGDs) with district Council Health Management Team members at district level and pregnant women at dispensary and community levels. Results Knowledge of malaria risks during pregnancy was high among pregnant women although some women did not associate coma and convulsions with malaria. Contacting traditional healers and self-medication with local herbs for malaria management was reported to be common. Pregnant women and ANC staff were generally aware of SP as the drug recommended for IPTp, albeit some nurses and the majority of pregnant women expressed concern about the use of SP during pregnancy. Some pregnant women testified that sometimes ANC staff allow the women to swallow SP tablets at home which gives a room for some women to throw away SP tablets after leaving the clinic. The DMO was sceptical about health workers' compliance with the direct observed therapy in administering SP for IPTp due to a shortage of clean water and cups at ANC clinics. Intensified sensitization of pregnant women about the benefits of IPTp was suggested by the study participants as an important approach for improving IPTp compliance. Conclusion The successful implementation of the IPTp strategy in Tanzania depends on the proper planning of, and support to, the training of health staff and sustained sensitization of pregnant women at health facility and community levels about the benefits of IPTp for the women and their unborn babies. PMID:16033639

  11. Assessing performance enhancing tools: experiences with the open performance review and appraisal system (OPRAS) and expectations towards payment for performance (P4P) in the public health sector in Tanzania

    PubMed Central

    2012-01-01

    Background Health workers’ motivation is a key determinant of the quality of health services, and poor motivation has been found to be an obstacle to service delivery in many low-income countries. In order to increase the quality of service delivery in the public sector in Tanzania, the Open Performance Review and Appraisal System (OPRAS) has been implemented, and a new results-based payment system, Payment for performance (P4P) is introduced in the health sector. This article addresses health workers’ experiences with OPRAS, expectations towards P4P and how lessons learned from OPRAS can assist in the implementation of P4P. The broader aim is to generate knowledge on health workers’ motivation in low-income contexts. Methods A qualitative study design has been employed to elicit data on health worker motivation at a general level and in relation to OPRAS and P4P in particular. Focus group discussions (FGDs) and in-depth interviews (IDIs) have been conducted with nursing staff, clinicians and administrators in the public health sector in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in Tanzania. Results Health workers evaluated OPRAS and P4P in terms of the benefits experienced or expected from complying with the tools. The study found a general reluctance towards OPRAS as health workers did not see OPRAS as leading to financial gains nor did it provide feedback on performance. Great expectations were expressed towards P4P due to its prospects of topping up salaries, but the links between the two performance enhancing tools were unclear. Conclusions Health workers respond to performance enhancing tools based on whether the tools are found appropriate or yield any tangible benefits. The importance placed on salary and allowances forms the setting in which OPRAS operates. The expected addition to the salary through P4P has created a vigorous discourse among health workers attesting to the importance of the salary for motivation. Lessons learned from OPRAS can be utilized in the implementation of P4P and can enhance our knowledge on motivation and performance in the health services in low-income contexts such as Tanzania. PMID:22963317

  12. Ethnicity and child health in northern Tanzania: Maasai pastoralists are disadvantaged compared to neighbouring ethnic groups.

    PubMed

    Lawson, David W; Borgerhoff Mulder, Monique; Ghiselli, Margherita E; Ngadaya, Esther; Ngowi, Bernard; Mfinanga, Sayoki G M; Hartwig, Kari; James, Susan

    2014-01-01

    The Maasai of northern Tanzania, a semi-nomadic ethnic group predominantly reliant on pastoralism, face a number of challenges anticipated to have negative impacts on child health, including marginalisation, vulnerabilities to drought, substandard service provision and on-going land grabbing conflicts. Yet, stemming from a lack of appropriate national survey data, no large-scale comparative study of Maasai child health has been conducted. Savannas Forever Tanzania surveyed the health of over 3500 children from 56 villages in northern Tanzania between 2009 and 2011. The major ethnic groups sampled were the Maasai, Sukuma, Rangi, and the Meru. Using multilevel regression we compare each ethnic group on the basis of (i) measurements of child health, including anthropometric indicators of nutritional status and self-reported incidence of disease; and (ii) important proximate determinants of child health, including food insecurity, diet, breastfeeding behaviour and vaccination coverage. We then (iii) contrast households among the Maasai by the extent to which subsistence is reliant on livestock herding. Measures of both child nutritional status and disease confirm that the Maasai are substantially disadvantaged compared to neighbouring ethnic groups, Meru are relatively advantaged, and Rangi and Sukuma intermediate in most comparisons. However, Maasai children were less likely to report malaria and worm infections. Food insecurity was high throughout the study site, but particularly severe for the Maasai, and reflected in lower dietary intake of carbohydrate-rich staple foods, and fruits and vegetables. Breastfeeding was extended in the Maasai, despite higher reported consumption of cow's milk, a potential weaning food. Vaccination coverage was lowest in Maasai and Sukuma. Maasai who rely primarily on livestock herding showed signs of further disadvantage compared to Maasai relying primarily on agriculture. We discuss the potential ecological, socioeconomic, demographic and cultural factors responsible for these differences and the implications for population health research and policy. PMID:25353164

  13. HIV serostatus disclosure in the treatment cascade: evidence from Northern Tanzania.

    PubMed

    Ostermann, Jan; Pence, Brian; Whetten, Kathryn; Yao, Jia; Itemba, Dafrosa; Maro, Venance; Reddy, Elizabeth; Thielman, Nathan

    2015-12-01

    HIV serostatus disclosure plays an important role in HIV transmission risk reduction and is positively associated with HIV medication adherence and treatment outcomes. However, to date, no study has quantified the role of disclosure across the HIV treatment cascade, particularly in Sub-Saharan Africa. We used data from a cohort of HIV-infected adults in Northern Tanzania to describe associations between disclosure and engagement and retention in the HIV treatment cascade. Between 2008 and 2009, the Coping with HIV/AIDS in Tanzania (CHAT) study enrolled 260 clients newly diagnosed with HIV and 492 HIV-infected patients in established HIV care in two large HIV care and treatment centers in Northern Tanzania. Participants aged 18 and older completed annual clinical assessments and twice-annual in-person interviews for 3.5 years. Using logistic regression models, we assessed sociodemographic correlates of HIV serostatus disclosure to at least one household member, and associations between this disclosure measure and linkage to care, evaluation for antiretroviral therapy (ART) eligibility, ART coverage, and rates of undetectable HIV RNA levels during the follow-up period. Married individuals and those diagnosed earlier were more likely to have disclosed their HIV infection to at least one household member. During follow-up, HIV serostatus disclosure was associated with higher rates of linkage to care, evaluation for ART eligibility, and ART coverage. No significant association was observed with rates of undetectable viral loads. Marginal effects estimates suggest that a 10 percentage-point lower probability of linkage to care for those who did not disclose their HIV serostatus (86% vs. 96%; p?=?0.035) was compounded by an 18 percentage-point lower probability of ever receiving a CD4 count (62% vs. 80%; p?=?.039), and a 20 percentage-point lower probability of ever receiving ART (55% vs. 75%; p?=?.029). If causal, these findings suggest an important role for disclosure assistance efforts across the HIV treatment cascade. PMID:26616126

  14. HIV serostatus disclosure in the treatment cascade: evidence from Northern Tanzania

    PubMed Central

    Ostermann, Jan; Pence, Brian; Whetten, Kathryn; Yao, Jia; Itemba, Dafrosa; Maro, Venance; Reddy, Elizabeth; Thielman, Nathan

    2015-01-01

    ABSTRACT HIV serostatus disclosure plays an important role in HIV transmission risk reduction and is positively associated with HIV medication adherence and treatment outcomes. However, to date, no study has quantified the role of disclosure across the HIV treatment cascade, particularly in Sub-Saharan Africa. We used data from a cohort of HIV-infected adults in Northern Tanzania to describe associations between disclosure and engagement and retention in the HIV treatment cascade. Between 2008 and 2009, the Coping with HIV/AIDS in Tanzania (CHAT) study enrolled 260 clients newly diagnosed with HIV and 492 HIV-infected patients in established HIV care in two large HIV care and treatment centers in Northern Tanzania. Participants aged 18 and older completed annual clinical assessments and twice-annual in-person interviews for 3.5 years. Using logistic regression models, we assessed sociodemographic correlates of HIV serostatus disclosure to at least one household member, and associations between this disclosure measure and linkage to care, evaluation for antiretroviral therapy (ART) eligibility, ART coverage, and rates of undetectable HIV RNA levels during the follow-up period. Married individuals and those diagnosed earlier were more likely to have disclosed their HIV infection to at least one household member. During follow-up, HIV serostatus disclosure was associated with higher rates of linkage to care, evaluation for ART eligibility, and ART coverage. No significant association was observed with rates of undetectable viral loads. Marginal effects estimates suggest that a 10 percentage-point lower probability of linkage to care for those who did not disclose their HIV serostatus (86% vs. 96%; p?=?0.035) was compounded by an 18 percentage-point lower probability of ever receiving a CD4 count (62% vs. 80%; p?=?.039), and a 20 percentage-point lower probability of ever receiving ART (55% vs. 75%; p?=?.029). If causal, these findings suggest an important role for disclosure assistance efforts across the HIV treatment cascade. PMID:26616126

  15. Ethnicity and Child Health in Northern Tanzania: Maasai Pastoralists Are Disadvantaged Compared to Neighbouring Ethnic Groups

    PubMed Central

    Lawson, David W.; Borgerhoff Mulder, Monique; Ghiselli, Margherita E.; Ngadaya, Esther; Ngowi, Bernard; Mfinanga, Sayoki G. M.; Hartwig, Kari; James, Susan

    2014-01-01

    The Maasai of northern Tanzania, a semi-nomadic ethnic group predominantly reliant on pastoralism, face a number of challenges anticipated to have negative impacts on child health, including marginalisation, vulnerabilities to drought, substandard service provision and on-going land grabbing conflicts. Yet, stemming from a lack of appropriate national survey data, no large-scale comparative study of Maasai child health has been conducted. Savannas Forever Tanzania surveyed the health of over 3500 children from 56 villages in northern Tanzania between 2009 and 2011. The major ethnic groups sampled were the Maasai, Sukuma, Rangi, and the Meru. Using multilevel regression we compare each ethnic group on the basis of (i) measurements of child health, including anthropometric indicators of nutritional status and self-reported incidence of disease; and (ii) important proximate determinants of child health, including food insecurity, diet, breastfeeding behaviour and vaccination coverage. We then (iii) contrast households among the Maasai by the extent to which subsistence is reliant on livestock herding. Measures of both child nutritional status and disease confirm that the Maasai are substantially disadvantaged compared to neighbouring ethnic groups, Meru are relatively advantaged, and Rangi and Sukuma intermediate in most comparisons. However, Maasai children were less likely to report malaria and worm infections. Food insecurity was high throughout the study site, but particularly severe for the Maasai, and reflected in lower dietary intake of carbohydrate-rich staple foods, and fruits and vegetables. Breastfeeding was extended in the Maasai, despite higher reported consumption of cow's milk, a potential weaning food. Vaccination coverage was lowest in Maasai and Sukuma. Maasai who rely primarily on livestock herding showed signs of further disadvantage compared to Maasai relying primarily on agriculture. We discuss the potential ecological, socioeconomic, demographic and cultural factors responsible for these differences and the implications for population health research and policy. PMID:25353164

  16. Feeding frequency and nutrient content of foods commonly consumed in the Iringa and Morogoro regions in Tanzania.

    PubMed

    Kinabo, J; Mnkeni, A P; Nyaruhucha, C N M; Msuya, J; Haug, Anna; Ishengoma, J

    2006-01-01

    Information on the nutrient content of foods commonly consumed (especially indigenous ones) in rural communities of Tanzania is limited. A study was conducted to determine the nutrient content of foods commonly consumed in the Iringa and Morogoro regions. A survey was carried out in six representative villages to identify the types of foods and to determine the frequency of their consumption. Representative samples of the raw foods were collected from local markets and brought to the laboratory for analyses. Determination of protein was done by the micro-Kjeldahl method, fat by Soxhlet extraction and moisture by an oven-drying method. The mineral content was determined by atomic absorption spectrophotometer. The results showed that there is a wide range of foods commonly consumed in the two regions, especially legumes and vegetables. The frequency of consumption depended mainly on the season, whereby during the dry season the frequency of consumption was two to three meals per day and in the rainy season was one to two meals per day. Foods rich in fats were nuts and oil seeds, while good sources of protein included legumes, nuts and oil seeds especially pumpkin seeds, which contained 34.36 g/100 g edible portion. Indigenous vegetables such as mnavu (Solunum nigrum), twangabilidiga, mlenda (Corchorusolitarus) and mkochwe were rich in iron and calcium, with values as high as 24.78 mg iron in twangalibidiga and 812.41 mg calcium/100 g edible portion in mkunungu. Magnesium was highest in mtosi (288.58 mg) and copper was highest in mkunungu (0.49 mg). Mkochwe contained the highest amount of manganese. This study shows that foods locally produced in these regions are rich in nutrients, especially micronutrients, and therefore if consumed in adequate amounts may help to prevent dietary-related disorders. PMID:16849110

  17. Barriers to sexual reproductive health services and rights among young people in Mtwara district, Tanzania: a qualitative study

    PubMed Central

    Mbeba, Rita Moses; Mkuye, Martin Sem; Magembe, Grace Elias; Yotham, William Lubazi; Mellah, Alfred obeidy; Mkuwa, Serafina Baptist

    2012-01-01

    Background In Tanzania over 1/3 of the population is under 24 years. Nationwide 23% of teenagers have started childbearing. However, Mtwara Region has the highest percentage (25.5%) of teenagers who begin childbearing early. Mtwara District has a teenage pregnancy rate of 11% with young people utilizing sexual reproductive health services (SRHS) less frequently than adults.This study aimed at gaining insights on barriers to the utilization of SRHS in Mtwara district. Methods A qualitative study was carried out using focus group discussions, facility assessment interviews and case studies. A total of nine focus group discussions (comprising 8 to10 persons per group) were conducted among girls (10-18 years), community leaders and adults. Data was transcribed using pattern matching methods then merged into relevant themes for analysis and interpretation. Results The study revealed that a good number of health facilities do not have skilled service providers (SPs) on sexual reproductive health rights. Girls start sexual intercourse between 9 and12 years. Services sought included; education, family planning and voluntary counseling and testing. However, the services were inaccessible due to lack of privacy, confidentiality, equipments and negative attitudes from SPs. Initiation ceremonies, early marriages and gender disparities were mentioned as social-cultural barriers to SRH rights. Conclusion This study has demonstrated that factors such as lack of youth friendly services, gender disparity and unfavorable socio-cultural practices may create barriers to accessing adolescent SRHS and rights. Therefore, there is a need to integrate youth friendly services in health facilities and advocate for behavior change. PMID:23467684

  18. Outcomes of Swedish nursing students' field experiences in a hospital in Tanzania.

    PubMed

    Sandin, Ingrid; Grahn, Kristina; Kronvall, Ewa

    2004-07-01

    This study describes the experiences of a group of nursing students from Sweden in a hospital in Tanzania. Students were interviewed on their return after the trip. Although students experienced considerable upheaval and frustration working in a different context, they learned valuable lessons as to how nursing can be conducted in conditions entirely different from those familiar to them. They attempted to understand the value and behavioral divergences they encountered, yet values of their home culture remained their frame of reference. This project reflected the importance of working through students' experience if knowledge and understanding of self and others are to be enhanced or developed. PMID:15189644

  19. Livelihood Diversification through Migration among a Pastoral People: Contrasting Case Studies of Maasai in Northern Tanzania

    PubMed Central

    McCabe, J. Terrence; Smith, Nicole M.; Leslie, Paul W.; Telligman, Amy L.

    2015-01-01

    This paper brings together over two decades of research concerning the patterns and processes of livelihood diversification through migration among Maasai pastoralists and agro-pastoralists of northern Tanzania. Two case studies, one from the Ngorongoro Conservation Area and the other from the Simanjiro plains, jointly demonstrate the complexity of migration within a single ethnic group. We analyze the relationship between wealth and migration and examine some of the consequences of migration for building herds, expanding cultivation, and influencing political leadership. We further argue that migration in Maasai communities is becoming a cultural norm and not only a response to economic conditions. PMID:25745192

  20. Pre-service teachers' experiences teaching secondary mathematics in English-medium schools in Tanzania

    NASA Astrophysics Data System (ADS)

    Kasmer, Lisa

    2013-09-01

    In order to promote mathematical understanding among English Language Learners (ELLs), it is necessary to modify instructional strategies to effectively communicate mathematical content. This paper discusses the instructional strategies used by four pre-service teachers to teach mathematics to secondary students in English-medium schools in Arusha, Tanzania as a result of the tensions they faced and reflections on their teaching. Strategies such as code switching, attending to sentence structure, non-linguistic representations, and placing the content within a familiar context proved to be beneficial strategies for conveying mathematical ideas.

  1. Evaluation of a eucalyptus-based repellent against Anopheles spp. in Tanzania.

    PubMed

    Trigg, J K

    1996-06-01

    A eucalyptus-based insect repellent (PMD) with the principal active ingredient p-menthane-3,8-diol was evaluated in the field in comparison with deet. In human landing catches in Tanzania, 3 formulations of PMD were tested against Anopheles gambiae and An. funestus. Repellents, applied to the legs and feet at doses chosen as used in practice, gave complete protection from biting for between 6 and 7.75 h, depending upon the formulation type, with no significant difference between PMD and deet in terms of efficacy and duration of protection. PMID:8827599

  2. Towards transferable functions for extraction of Non-timber Forest Products: A case study on charcoal production in Tanzania

    E-print Network

    Vermont, University of

    on charcoal production in Tanzania M. Schaafsma a, , S. Morse-Jones a , P. Posen a , R.D. Swetnam b , A-surveyed areas. We illustrate the empirical application of this approach in an analysis of charcoal production. The total flow of charcoal benefits is estimated at USD 14 million per year, providing an important source

  3. Science Teacher Learning of MBL-Supported Student-Centered Science Education in the Context of Secondary Education in Tanzania

    ERIC Educational Resources Information Center

    Voogt, Joke; Tilya, Frank; van den Akker, Jan

    2009-01-01

    Science teachers from secondary schools in Tanzania were offered an in-service arrangement to prepare them for the integration of technology in a student-centered approach to science teaching. The in-service arrangement consisted of workshops in which educative curriculum materials were used to prepare teachers for student-centered education and…

  4. The Books-in-a-Bag Project: Developing a Literacy Initiative for Children with Disabilities in Tanzania

    ERIC Educational Resources Information Center

    Kaff, Marilyn S.; Fees, Bronwyn; Wiseman, Nicole; Evans, Valerie

    2015-01-01

    This column describes a long-term service-learning project by faculty from an American university who travelled to Tanzania to consult with educators who work with and care for children with a wide range of disabilities. The project is focused on literacy education and has resulted in several books being developed and distributed in the Kiswahili…

  5. A Qualitative Assessment of the Risk of Introducing Peste des Petits Ruminants into Northern Zambia from Tanzania

    PubMed Central

    Chazya, R.; Muma, J. B.; Mwacalimba, K. K.; Karimuribo, E.; Mkandawire, E.; Simuunza, M.

    2014-01-01

    A qualitative risk assessment was performed to evaluate the risk of introducing Peste des petits ruminants virus into northern Zambia from Tanzania via live goat trade. Data was collected during a mission to Tanzania and northern Zambia and also from literature and interviews with experts. The risk of PPRV introduction was evaluated as a function of the probability of hazard (PPRV) release, exposure of susceptible hosts, and the consequences of spread using the following parameters: prevalence of infection, volume of trade, C-ELISA and quarantine screening missing an infected animal, PPRV viability (remaining infective) in transit, and the virus potential for infection. The magnitude of the consequences was derived from the probability of transmission and spread and the impact of PPRV introduction and establishment. Accordingly, the probability of occurrence of PPRV in northern Zambia from Tanzania was rated as “high” and the economic consequences were also rated as “high.” Finally, the overall risk of introducing PPRV into northern Zambia from Tanzania at the time of the assessment was rated “high.” It was concluded that import of goats and sheep be prohibited until efficient and adequate measures to reduce the risk have been put in place. PMID:24558632

  6. The Social and Political Context of Literacy Education for Pastoral Societies: The Case of the Maasai of Tanzania.

    ERIC Educational Resources Information Center

    Semali, Ladislaus

    Part of a large study in Tanzania, a study provides a broad context of obstacles to literacy, particularly those affecting migratory subpopulation groups. Subjects, 480 adults who participated in national literacy programs and belonged to one of two communities of the Maasai, were interviewed. The first group--the Maasai of Longido--represent a…

  7. Spillover of Peste des Petits Ruminants Virus from Domestic to Wild Ruminants in the Serengeti Ecosystem, Tanzania.

    PubMed

    Mahapatra, Mana; Sayalel, Kuya; Muniraju, Murali; Eblate, Ernest; Fyumagwa, Robert; Shilinde, Ligge; Mdaki, Maulid; Keyyu, Julius; Parida, Satya; Kock, Richard

    2015-12-01

    We tested wildlife inhabiting areas near domestic livestock, pastures, and water sources in the Ngorongoro district in the Serengeti ecosystem of northern Tanzania and found 63% seropositivity for peste des petits ruminants virus. Sequencing of the viral genome from sick sheep in the area confirmed lineage II virus circulation. PMID:26583961

  8. Spillover of Peste des Petits Ruminants Virus from Domestic to Wild Ruminants in the Serengeti Ecosystem, Tanzania

    PubMed Central

    Mahapatra, Mana; Sayalel, K.; Muniraju, Murali; Eblate, Ernest; Fyumagwa, R.; Shilinde, S.; MaulidMdaki, M.; Keyyu, J.

    2015-01-01

    We tested wildlife inhabiting areas near domestic livestock, pastures, and water sources in the Ngorongoro district in the Serengeti ecosystem of northern Tanzania and found 63% seropositivity for peste des petits ruminants virus. Sequencing of the viral genome from sick sheep in the area confirmed lineage II virus circulation. PMID:26583961

  9. Management of Information Services. Reports and Papers of a Training Course (Arusha, Tanzania, April 11-22, 1988).

    ERIC Educational Resources Information Center

    Musana, A., Ed.; And Others

    These reports and papers from a training course which brought together information services professionals from Uganda, Tanzania, Kenya, the Sudan, Ethiopia, Malawi, Zambia, Zimbabwe, Lesotho, Botswana, and Swaziland address the following topics: (1) information systems analysis; (2) the state of the art in bibliographic control in Eastern and…

  10. Post-Project Assessment of Community-Supported Emergency Transport Systems for Health Care Services in Tanzania

    ERIC Educational Resources Information Center

    Ahluwalia, Indu B.; Robinson, Dorcas; Vallely, Lisa; Myeya, Juliana; Ngitoria, Lukumay; Kitambi, Victor; Kabakama, Alfreda

    2012-01-01

    We examined the continuation of community-organized and financed emergency transport systems implemented by the Community-Based Reproductive Health Project (CBRHP) from 1998 to 2000 in two rural districts in Tanzania. The CBRHP was a multipronged program, one component of which focused on affordable transport to health facilities from the…

  11. Impact of non-livelihood-based land management on land resources: the case of upland watersheds in Uporoto Mountains, South West Tanzania.

    PubMed

    Mwanukuzi, Phillip K

    2011-01-01

    Various land management strategies are used to prevent land degradation and keep land productive. Often land management strategies applied in certain areas focus on the context of the physical environment but are incompatible with the social environment where they are applied. As a result, such strategies are ignored by land users and land degradation becomes difficult to control. This study observes the impacts of land management in the upland watersheds of the Uporoto Mountains in South West Tanzania. In spite of various land management practices used in the area, 38% of the studied area experienced soil fertility loss, 30% gully erosion, 23% soil loss, 6% biodiversity loss and drying up of river sources. Land management methods that were accepted and adopted were those contributing to immediate livelihood needs. These methods did not control land resource degradation, but increased crop output per unit of land and required little labour. Effective methods of controlling land degradation were abandoned or ignored because they did not satisfy immediate livelihood needs. This paper concludes that Integrating poor people's needs would transform non-livelihood-based land management methods to livelihood-based ones. Different ways of transforming these land management methods are presented and discussed. PMID:21560271

  12. Genetic characterization of Giardia duodenalis by sequence analysis in humans and animals in Pemba Island, Tanzania.

    PubMed

    Di Cristanziano, V; Santoro, M; Parisi, F; Albonico, M; Shaali, M A; Di Cave, D; Berrilli, F

    2014-04-01

    Giardia duodenalis represents one of the most widespread human enteric parasites: about 200million people in Asia, Africa and Latin America are infected. Giardia exerts a deep impact on public health because of high prevalence and possible effects on growth and cognitive functions in infected children. The major aim of this study was to detect and genetically characterize G. duodenalis in both human and animal fecal samples collected in Pemba Island, in the archipelago of Zanzibar (Tanzania), in order to deepen the knowledge of genotypes of Giardia in this area. Between October 2009 and October 2010, we collected 45 human fecal samples from children from 2 primary schools and 60 animal fecal samples: 19 from zebus (Bos primigenius indicus) and 41 from goats (Capra hircus). Detection and genetic identification were performed by multilocus analysis of ssu-rDNA and gdh genes. In humans we found a higher prevalence of assemblage B (sub-assemblage BIV), in goats of assemblage E and in zebus of assemblage A. Our study represents an important contribution to the epidemiological knowledge of G. duodenalis in this area of Tanzania. PMID:24269210

  13. Schistosoma mansoni-Related Hepatosplenic Morbidity in Adult Population on Kome Island, Sengerema District, Tanzania

    PubMed Central

    Kaatano, Godfrey M.; Min, Duk-Young; Siza, Julius E.; Yong, Tai-Soon; Chai, Jong-Yil; Ko, Yunsuk; Chang, Su-Young; Changalucha, John M.; Eom, Keeseon S.; Rim, Han-Jong

    2015-01-01

    Schistosomiasis is one of the important neglected tropical diseases (NTDs) in Tanzania, particularly in Lake Victoria zone. This baseline survey was a part of the main study of integrated control of schistosomiasis and soil-transmitted helminths (STHs) aimed at describing morbidity patterns due to intestinal schistosomiasis among adults living on Kome Island, Sengerema District, Tanzania. Total 388 adults from Kome Islands (about 50 people from each village) aged between 12 and 85 years, were examined by abdominal ultrasound according to the Niamey protocol. Liver image patterns (LIPs) A and B were considered normal, and C-F as distinct periportal fibrosis (PPF). The overall prevalence of PPF was 42.2%; much higher in males than in females (47.0% in male vs 34.4% in females, P=0.007). Abnormal increase of segmental branch wall thickness (SBWT) and dilated portal vein diameter (PVD) were also more common in males than in females. Hepatosplenomegaly was frequently encountered; 68.1% had left liver lobe hepatomegaly and 55.2% had splenomegaly. Schistosoma mansoni-related morbidity is quite high among adults in this community justifying the implementation of integrated control strategies through mass drug administration, improved water supply (pumped wells), and health education that had already started in the study area. PMID:26537033

  14. Patterns of partnership and condom use in two communities of female sex workers in Tanzania.

    PubMed

    Outwater, A; Nkya, L; Lwihula, G; O'Connor, P; Leshabari, M; Nguma, J; Mwizarubi, B; Laukamm-Josten, U; Green, E C; Hassig, S E

    2000-01-01

    Two rapid ethnographic studies have found that commercial sex workers (CSWs) and other high-risk women in Tanzania have different categories of partners, ranging from single-time contacts to long and enduring relationships. Since the advent of HIV/AIDS prevention programs in Tanzania in the late 1980s, CSWs and their clients have been aware of the multiple benefits of condom use for the prevention of pregnancy and STDs including HIV. These women often use condoms for the single-time contact. However, since the HIV/AIDS epidemic, casual partners have decreased in number. These days, most of their sexual contacts occur within long-term partnerships, and within these relationships, condom use is rare. Although the message that condoms should be used during high-risk behavior has been largely accepted, the definition of a high-risk relationship needs to be extended from casual partnerships to include multiple long-term partnerships. In addition, men and women's empowerment through education, business, and equal rights needs to be addressed at all levels of society. PMID:10911593

  15. A gendered users' perspective on decentralized primary health services in rural Tanzania.

    PubMed

    Masanyiwa, Zacharia S; Niehof, Anke; Termeer, Catrien J A M

    2015-01-01

    Since the 1990s, Tanzania has been implementing health sector reforms including decentralization of primary healthcare services to districts and users. The impact of the reforms on the access, quality and appropriateness of primary healthcare services from the viewpoint of users is, however, not clearly documented. This article draws on a gendered users' perspective to address the question of whether the delivery of gender-sensitive primary health services has improved after the reforms. The article is based on empirical data collected through a household survey, interviews, focus group discussions, case studies and analysis of secondary data in two rural districts in Tanzania. The analysis shows that the reforms have generated mixed effects: they have contributed to improving the availability of health facilities in some villages but have also reinforced inter-village inequalities. Men and women hold similar views on the perceived changes and appropriateness to women on a number of services. Gender inequalities are, however, reflected in the significantly low membership of female-headed households in the community health fund and their inability to pay the user fees and in the fact that women's reproductive and maternal health needs are as yet insufficiently addressed. Although over half of users are satisfied with the services, more women than men are dissatisfied. The reforms appear to have put much emphasis on building health infrastructure and less on quality issues as perceived by users. PMID:24285278

  16. Schistosoma mansoni-Related Hepatosplenic Morbidity in Adult Population on Kome Island, Sengerema District, Tanzania.

    PubMed

    Kaatano, Godfrey M; Min, Duk-Young; Siza, Julius E; Yong, Tai-Soon; Chai, Jong-Yil; Ko, Yunsuk; Chang, Su-Young; Changalucha, John M; Eom, Keeseon S; Rim, Han-Jong

    2015-10-01

    Schistosomiasis is one of the important neglected tropical diseases (NTDs) in Tanzania, particularly in Lake Victoria zone. This baseline survey was a part of the main study of integrated control of schistosomiasis and soil-transmitted helminths (STHs) aimed at describing morbidity patterns due to intestinal schistosomiasis among adults living on Kome Island, Sengerema District, Tanzania. Total 388 adults from Kome Islands (about 50 people from each village) aged between 12 and 85 years, were examined by abdominal ultrasound according to the Niamey protocol. Liver image patterns (LIPs) A and B were considered normal, and C-F as distinct periportal fibrosis (PPF). The overall prevalence of PPF was 42.2%; much higher in males than in females (47.0% in male vs 34.4% in females, P=0.007). Abnormal increase of segmental branch wall thickness (SBWT) and dilated portal vein diameter (PVD) were also more common in males than in females. Hepatosplenomegaly was frequently encountered; 68.1% had left liver lobe hepatomegaly and 55.2% had splenomegaly. Schistosoma mansoni-related morbidity is quite high among adults in this community justifying the implementation of integrated control strategies through mass drug administration, improved water supply (pumped wells), and health education that had already started in the study area. PMID:26537033

  17. Spatial and temporal distribution of rabies in northern Tanzania in the period of 1993-2002.

    PubMed

    Swai, E S; Moshy, W E; Kaaya, J E; Mtui, P F

    2010-01-01

    A retrospective study was carried out to investigate the occurrence and distribution patterns of rabies cases in northern Tanzania. Data on laboratory confirmed brain samples and associated case reports submitted to the Arusha Veterinary Investigation Centre, for a period of ten years (1993-2002) was retrieved and reviewed. A total of 98 suspected rabies brain specimens from different animal species and geographical areas were submitted and processed during the period under review. Rabies was confirmed using Fluorescent Antibody Technique test. Of the 98 brain specimens processed, 65 (66.3%) were confirmed to be rabies cases. Canine rabies accounted for 73.8% of the cases and was diagnosed in dogs (43), jackals (4) and hyenas (1). Rabies in wildlife accounted for 5 out of 48 canine confirmed cases. Most of the cases were from Arusha Municipality (20) followed by Arumeru (19), Ngorongoro (9) and Moshi (8) districts. Rabies positive cases in other animal species were in the following order of frequencies: bovine (9 out of 11); feline (5 out of 10); equine (1 out of 2); caprine (2 out of 2). One porcine brain specimen was rabies negative. The high proportion of rabies positive cases confirmed suggests the level of their endemicity in the northern regions of Tanzania. Moreover, the findings highlights the need for sustained surveillance and institution of control measures among dog population and awareness creation particularly among general public and children whom are at high risk of contracting rabies because of their close contact with dogs. PMID:20737833

  18. Applying a random encounter model to estimate lion density from camera traps in Serengeti National Park, Tanzania

    PubMed Central

    Cusack, Jeremy J; Swanson, Alexandra; Coulson, Tim; Packer, Craig; Carbone, Chris; Dickman, Amy J; Kosmala, Margaret; Lintott, Chris; Rowcliffe, J Marcus

    2015-01-01

    The random encounter model (REM) is a novel method for estimating animal density from camera trap data without the need for individual recognition. It has never been used to estimate the density of large carnivore species, despite these being the focus of most camera trap studies worldwide. In this context, we applied the REM to estimate the density of female lions (Panthera leo) from camera traps implemented in Serengeti National Park, Tanzania, comparing estimates to reference values derived from pride census data. More specifically, we attempted to account for bias resulting from non-random camera placement at lion resting sites under isolated trees by comparing estimates derived from night versus day photographs, between dry and wet seasons, and between habitats that differ in their amount of tree cover. Overall, we recorded 169 and 163 independent photographic events of female lions from 7,608 and 12,137 camera trap days carried out in the dry season of 2010 and the wet season of 2011, respectively. Although all REM models considered over-estimated female lion density, models that considered only night-time events resulted in estimates that were much less biased relative to those based on all photographic events. We conclude that restricting REM estimation to periods and habitats in which animal movement is more likely to be random with respect to cameras can help reduce bias in estimates of density for female Serengeti lions. We highlight that accurate REM estimates will nonetheless be dependent on reliable measures of average speed of animal movement and camera detection zone dimensions. © 2015 The Authors. Journal of Wildlife Management published by Wiley Periodicals, Inc. on behalf of The Wildlife Society. PMID:26640297

  19. Multi-level factors affecting entry into and engagement in the HIV continuum of care in Iringa, Tanzania.

    PubMed

    Layer, Erica H; Kennedy, Caitlin E; Beckham, Sarah W; Mbwambo, Jessie K; Likindikoki, Samuel; Davis, Wendy W; Kerrigan, Deanna L; Brahmbhatt, Heena

    2014-01-01

    Progression through the HIV continuum of care, from HIV testing to lifelong retention in antiretroviral therapy (ART) care and treatment programs, is critical to the success of HIV treatment and prevention efforts. However, significant losses occur at each stage of the continuum and little is known about contextual factors contributing to disengagement at these stages. This study sought to explore multi-level barriers and facilitators influencing entry into and engagement in the continuum of care in Iringa, Tanzania. We used a mixed-methods study design including facility-based assessments and interviews with providers and clients of HIV testing and treatment services; interviews, focus group discussions and observations with community-based providers and clients of HIV care and support services; and longitudinal interviews with men and women living with HIV to understand their trajectories in care. Data were analyzed using narrative analysis to identify key themes across levels and stages in the continuum of care. Participants identified multiple compounding barriers to progression through the continuum of care at the individual, facility, community and structural levels. Key barriers included the reluctance to engage in HIV services while healthy, rigid clinic policies, disrespectful treatment from service providers, stock-outs of supplies, stigma and discrimination, alternate healing systems, distance to health facilities and poverty. Social support from family, friends or support groups, home-based care providers, income generating opportunities and community mobilization activities facilitated engagement throughout the HIV continuum. Findings highlight the complex, multi-dimensional dynamics that individuals experience throughout the continuum of care and underscore the importance of a holistic and multi-level perspective to understand this process. Addressing barriers at each level is important to promoting increased engagement throughout the continuum. PMID:25119665

  20. High Seroprevalence for Spotted Fever Group Rickettsiae, Is Associated with Higher Temperatures and Rural Environment in Mbeya Region, Southwestern Tanzania

    PubMed Central

    Dobler, Gerhard; Clowes, Petra; Kroidl, Inge; Starke, Mandy; Ntinginya, Nyanda Elias; Maboko, Leonard; Löscher, Thomas; Hoelscher, Michael; Saathoff, Elmar

    2015-01-01

    Background Rickettsioses are endemic in sub-Sahara Africa. Burden of disease, risk factors and transmission are hitherto sparsely described. Methods From the EMINI (Evaluating and Monitoring the Impact of New Interventions) population cohort, we randomly selected 1,228 persons above the age of 5 years from the nine participating communities in Mbeya region, Southwestern Tanzania, stratified by age, altitude of residence and ownership of domestic mammals, to conduct a cross-sectional seroprevalence study in. The aim was to estimate the seroprevalence of IgG antibodies against Spotted Fever Group (SFG) rickettsiae and to assess socioeconomic and environmental risk factors. Serology (indirect immunofluorescence) was performed at a dilution of 1:64. Results SFG-seropositivity in the cohort was found to be 67.9% (range among nine sites: 42.8–91.4%). Multivariable analysis revealed an association with age (prevalence ratio, PR per 10 years: 1.08; 95% CI 1.06–1.10), warmer temperatures (PR per °C: 1.38; 1.11–1.71), male gender (PR 1.08; 1.00–1.16), and low population density (PR per 1.000 persons/km²increase 0.96; 0.94–0.99). At higher elevations, higher cattle density was associated with higher seroprevalence. Conclusion SFG rickettsial infection seems to be common in the more rural population of Mbeya Region. Spread seems to be further limited by temperature and higher elevation. Examination of the contribution of SFG to febrile illnesses seems warranted in a prospective study to estimate the disease burden in the population. This will also allow determination of the causative pathogens. PMID:25849718

  1. Factors Influencing Drug Uptake during Mass Drug Administration for Control of Lymphatic Filariasis in Rural and Urban Tanzania

    PubMed Central

    Kisoka, William J.; Simonsen, Paul E.; Malecela, Mwelecele N.; Tersbøl, Britt P.; Mushi, Declare L.; Meyrowitsch, Dan W.

    2014-01-01

    Background In most countries of Sub-Saharan Africa, control of lymphatic filariasis (LF) is based on annual mass drug administration (MDA) with a combination of ivermectin and albendazole. Treatment coverages are however often suboptimal for programmes to reach the goal of transmission interruption within reasonable time. The present study aimed to identify predictors and barriers to individual drug uptake during MDA implementation by the National LF Elimination Programme in Tanzania. Methods A questionnaire based cross sectional household survey was carried out in two rural and two urban districts in Lindi and Morogoro regions shortly after the 2011 MDA. 3279 adults (?15 years) were interviewed about personal characteristics, socio-economic status, MDA drug uptake among themselves and their children, reasons for taking/not taking drugs, and participation in previous MDA activities for LF control. Findings The overall drug uptake rate was 55.1% (range of 44.5–75.6% between districts). There was no overall major difference between children (54.8%) and adults (55.2%) or between females (54.9%) and males (55.8%), but the role of these and other predictors varied to some extent between study sites. Major overall predictors of drug uptake among the interviewed adults were increasing age and history of previous drug uptake. Being absent from home during drug distribution was the main reason for not taking the drugs (50.2%) followed by clinical contraindications to treatment (10.8%), missing household visits of drug distributors (10.6%), and households not being informed about the distribution (9.0%). Conclusion Drug uptake relied more on easily modifiable provider-related factors than on individual perceptions and practices in the target population. Limited investments in appropriate timing, dissemination of accurate timing information to recipients and motivation of drug distributors to visit all households (repeatedly when residents are absent) are likely to have considerable potential for increasing drug uptake, in support of successful LF transmission elimination. PMID:25296034

  2. Cost and results of information systems for health and poverty indicators in the United Republic of Tanzania.

    PubMed Central

    Rommelmann, Vanessa; Setel, Philip W.; Hemed, Yusuf; Angeles, Gustavo; Mponezya, Hamisi; Whiting, David; Boerma, Ties

    2005-01-01

    OBJECTIVE: To examine the costs of complementary information generation activities in a resource-constrained setting and compare the costs and outputs of information subsystems that generate the statistics on poverty, health and survival required for monitoring, evaluation and reporting on health programmes in the United Republic of Tanzania. METHODS: Nine systems used by four government agencies or ministries were assessed. Costs were calculated from budgets and expenditure data made available by information system managers. System coverage, quality assurance and information production were reviewed using questionnaires and interviews. Information production was characterized in terms of 38 key sociodemographic indicators required for national programme monitoring. FINDINGS: In 2002-03 approximately US$ 0.53 was spent per Tanzanian citizen on the nine information subsystems that generated information on 37 of the 38 selected indicators. The census and reporting system for routine health service statistics had the largest participating populations and highest total costs. Nationally representative household surveys and demographic surveillance systems (which are not based on nationally representative samples) produced more than half the indicators and used the most rigorous quality assurance. Five systems produced fewer than 13 indicators and had comparatively high costs per participant. CONCLUSION: Policy-makers and programme planners should be aware of the many trade-offs with respect to system costs, coverage, production, representativeness and quality control when making investment choices for monitoring and evaluation. In future, formal cost-effectiveness studies of complementary information systems would help guide investments in the monitoring, evaluation and planning needed to demonstrate the impact of poverty-reduction and health programmes. PMID:16184275

  3. Alcohol Abuse, Sexual Risk Behaviors and Sexually Transmitted Infections in Women in Moshi Urban District, Northern Tanzania

    PubMed Central

    Ghebremichael, Musie; Paintsil, Elijah; Larsen, Ulla

    2012-01-01

    Background To assess the covariates of alcohol abuse and the association between alcohol abuse, high-risk sexual behaviors and sexually transmitted infections (STIs). Methods 2,019 women aged 20–44 were randomly selected in a two-stage sampling from the Moshi urban district of northern Tanzania. Participant’s demographic and socio-economic characteristics, alcohol use, sexual behaviors and STIs were assessed. Blood and urine samples were drawn for testing of human immunodeficiency virus, herpes simplex virus, syphilis, chlamydia, gonorrhea, trichomonas and mycoplasma genitalium infections. Results Adjusted analyses showed that a history of physical (OR=2.05; 95% CI: 1.06–3.98) and sexual violence (OR=1.63; 95% CI: 1.05–2.51) was associated with alcohol abuse. Moreover, alcohol abuse was associated with number of sexual partners (OR=1.66; 95% CI: 1.01–2.73). Women who abused alcohol were more likely to report STIs symptoms (OR=1.61; 95% CI: 1.08–2.40). Women who had multiple sexual partners were more likely to have an STI (OR=2.41; 95% CI: 1.46–4.00) compared to women with one sexual partner. There was no direct association between alcohol abuse and prevalence of STIs (OR=0.86; 95% CI: 0.55–1.34). However, alcohol abuse was indirectly associated with STIs through its association with multiple sexual partners. Conclusions The findings of alcohol abuse among physically and sexually violated women as well as the association between alcohol abuse and a history of symptoms of STIs and testing positive for STIs have significant public health implications. In sub-Saharan Africa, where women are disproportionately affected by the HIV epidemic screening for alcohol use should be part of comprehensive STIs and HIV prevention programs. PMID:19060779

  4. A ‘Mystery Client’ Evaluation of Adolescent Sexual and Reproductive Health services in Health Facilities from Two Regions in Tanzania

    PubMed Central

    Mchome, Zaina; Richards, Esther; Nnko, Soori; Dusabe, John; Mapella, Elizabeth; Obasi, Angela

    2015-01-01

    Unwelcoming behaviours and judgemental attitudes have long been recognised as a barrier to young people’s access to reproductive health services. Over the last decade youth friendly reproductive health services have been promoted and implemented world-wide. However, long term evidence of the impact of these programmes is lacking. We report the results of a large mystery client evaluation of adolescent sexual and reproductive health services in Tanzania, a country that has had a long established youth friendly policy. Forty-eight visits made to thirty-three health facilities were conducted by twelve young people (six in each region) trained to perform three different scripted scenarios (i.e., condom request, information on sexually transmitted infections and family planning). The study revealed barriers in relation to poor signage and reception for services. In addition health workers demonstrated paternalistic attitudes as well as lack of knowledge about adolescent sexual and reproductive health services. In some cases, health workers discouraged young people from using services such as condoms and family planning methods. Lack of confidentiality and privacy were also noted to be common challenges for the young people involved. Intervention strategies that focus on changing health workers’ mind-set in relation to adolescent sexual and reproductive health are crucial for ensuring quality provision of sexual and reproductive health services to young people. The study identified the importance of reception or signs at the health units, as this can facilitate young people’s efforts in seeking sexual and reproductive health services. Likewise, improvement of health workers knowledge of existing policy and practice on sexual and reproductive health services and youth friendly services is much needed. PMID:25803689

  5. Differences in HIV-related behaviors at Lugufu refugee camp and surrounding host villages, Tanzania

    PubMed Central

    Rowley, Elizabeth A; Spiegel, Paul B; Tunze, Zawadi; Mbaruku, Godfrey; Schilperoord, Marian; Njogu, Patterson

    2008-01-01

    Background An HIV behavioral surveillance survey was undertaken in November 2005 at Lugufu refugee camp and surrounding host villages, located near western Tanzania's border with the Democratic Republic of Congo (DRC). Methods The sample size was 1,743 persons based on cluster survey methodology. All members of selected households between 15–49 years old were eligible respondents. Questions included HIV-related behaviors, population displacement, mobility, networking and forced sex. Data was analyzed using Stata to measure differences in proportions (chi-square) and differences in means (t-test) between gender, age groups, and settlement location for variables of interest. Results Study results reflect the complexity of factors that may promote or inhibit HIV transmission in conflict-affected and displaced populations. Within this setting, factors that may increase the risk of HIV infections among refugees compared to the population in surrounding villages include young age of sexual initiation among males (15.9 years vs. 19.8 years, p = .000), high-risk sex partners in the 15–24 year age group (40% vs. 21%, ?2 33.83, p = .000), limited access to income (16% vs. 51% ?2 222.94, p = .000), and the vulnerability of refugee women, especially widowed, divorced and never-married women, to transactional sex (married vs. never married, divorced, widowed: for 15–24 age group, 4% and 18% respectively, ?2 8.07, p = .004; for 25–49 age group, 4% and 23% respectively, ?2 21.46, p = .000). A majority of both refugee and host village respondents who experienced forced sex in the past 12 months identified their partner as perpetrator (64% camp and 87% in villages). Although restrictions on movements in and out of the camp exist, there was regular interaction between communities. Condom use was found to be below 50%, and expanded population networks may also increase opportunities for HIV transmission. Availability of refugee health services may be a protective factor. Most respondents knew where to go for HIV testing (84% of refugee respondents and 78% of respondents in surrounding villages), while more refugees than respondents from villages had ever been tested (42% vs. 22%, ?2 63.69, p = .000). Conclusion This research has important programmatic implications. Regardless of differences between camp and village populations, study results point to the need for targeted activities within each population. Services should include youth education and life skills programs emphasizing the benefits of delayed sexual initiation and the risks involved in transactional sex, especially in the camp where greater proportions of youth are affected by these issues relative to the surrounding host villages. As well, programs should stress the importance of correct and consistent condom use to increase usage in both populations. Further investigation into forced sex within regular partnerships, and programs that encourage male involvement in addressing this issue are needed. Program managers should verify that current commodity distribution systems ensure vulnerable women's access to resources, and consider additional program responses. PMID:18928546

  6. Geochronology of granitic rocks from the Ruangwa region, southern Tanzania - Links with NE Mozambique and beyond

    NASA Astrophysics Data System (ADS)

    Thomas, Robert J.; Bushi, Alphonce M.; Roberts, Nick M. W.; Jacobs, Joachim

    2014-12-01

    New U-Pb zircon LA-ICP-MS data are presented for 4 granitoid bodies which intrude high grade gneisses of the previously unmapped Ruangwa region in southern Tanzania. The study area forms part of the late Neoproterozoic East African Orogen (EAO). The oldest unit, a coarse-grained migmatitic granitic orthogneiss gave an early Neoproterozoic (Tonian) crystallization age of 899 ± 9/16 Ma, which is similar to, but significantly younger than, Stenian-Tonian basement ages in areas relatively nearby. Crust of this age may extend as far north as the major Phanerozoic Selous Basin, north of which Archaean protolith ages predominate (the "Western Granulites"), except for the juvenile Neoproterozoic "Eastern Granulites", which are not represented in the study area. To the south, the Tonian crust of the study area provides a tentative link with the Marrupa Complex in NE Mozambique. A granite pluton, dated at 650 ± 5/11 Ma is broadly coeval with the main Pan-African tectono-thermal event in the East African Orogen that is recorded across Tanzania north of the Selous Basin. Zircons in this granite contain inherited cores at ca. 770 Ma. This age is within the range of dates obtained from south and west of the study area from juvenile granitoid orthogneisses which might be related to a widespread, but poorly understood, early phase of Gondwana assembly along an Andean-type margin. South of the study area, in NE Mozambique, the latest orogenic events occurred at ca. 550 Ma, and are sometimes attributed to the Ediacaran-aged "Kuunga Orogeny". While metamorphic dates of this age have been recorded from the EAO north of the Selous Basin, magmatic rocks of this event have not been recognized in Tanzania. The two youngest granitoids of the present study are thus the first 500-600 Ma igneous rocks reported from the region. A weakly deformed very coarse-grained granite pluton was dated at 591 ± 4/10 Ma, while a very late, cross-cutting, undeformed granite dyke gave an intrusive age of 549 ± 4/9 Ma. The granitoids ages presented in this study contain elements that are characteristic of the northern, Tanzania-Kenya, segment of the East African Orogen and of the southern, Mozambique, segment. The Tonian orthogneiss sample is typical of (but somewhat younger than) the Marrupa Complex of NE Mozambique. No zircon inheritance was recorded in the sample, typical of the juvenile Marrupa Complex. On the other hand, the ca. 650 Ma granite pluton has an age that is typical of the northern segment of the orogen; this is the first recorded granite of that age intruded into the Tonian-dominated crust of southern Tanzania or NE Mozambique. The two younger granites have provided dates that are typical of the southern segment of the orogen, and that of the Kuunga Orogen. The study area thus appears to represent an area of transitional crust straddling two complex and contrasting segments of the East African Orogen, with elements of both segments present and evidence for a ca. 770 Ma event which appears to be quite widespread and may relate to the early phases of Gondwana amalgamation in southern East Africa.

  7. Prevalence of intestinal protozoa infection among school-aged children on Pemba Island, Tanzania, and effect of single-dose albendazole, nitazoxanide and albendazole-nitazoxanide

    PubMed Central

    2013-01-01

    Background Pathogenic intestinal protozoa infections are common in school-aged children in the developing world and they are frequently associated with malabsorption syndromes and gastrointestinal morbidity. Since diagnosis of these parasites is difficult, prevalence data on intestinal protozoa is scarce. Methods We collected two stool samples from school-aged children on Pemba Island, Tanzania, as part of a randomized controlled trial before and 3 weeks after treatment with (i) single-dose albendazole (400 mg); (ii) single-dose nitazoxanide (1,000 mg); (iii) nitazoxanide-albendazole combination (1,000 mg–400 mg), with each drug given separately on two consecutive days; and (iv) placebo. Formalin-fixed stool samples were examined for the presence of intestinal protozoa using an ether-concentration method to determine the prevalence and estimate cure rates (CRs). Results Almost half (48.7%) of the children were diagnosed with at least one of the (potentially) pathogenic protozoa Giardia intestinalis, Entamoeba histolytica/E. dispar and Blastocystis hominis. Observed CRs were high for all treatment arms, including placebo. Nitazoxanide showed a significant effect compared to placebo against the non-pathogenic protozoon Entamoeba coli. Conclusions Intestinal protozoa infections might be of substantial health relevance even in settings where they are not considered as a health problem. Examination of a single stool sample with the ether-concentration method lacks sensitivity for the diagnosis of intestinal protozoa, and hence, care is indicated when interpreting prevalence estimates and treatment effects. PMID:23289920

  8. Impact of climate change on human health and health systems in Tanzania: a review.

    PubMed

    Mboera, Leonard E G; Mayala, Benjamin K; Kweka, Eliningaya J; Mazigo, Humphrey D

    2011-12-01

    Climate change (CC) has a number of immediate and long-term impacts on the fundamental determinants of human health. A number of potential human health effects have been associated either directly or indirectly with global climate change. Vulnerability to the risks associated with CC may exacerbate ongoing socio-economic challenges. The objective of this review was to analyse the potential risk and vulnerability in the context of climate-sensitive human diseases and health system in Tanzania. Climate sensitive vector- and waterborne diseases and other health related problems and the policies on climate adaptation in Tanzania during the past 50 years are reviewed. The review has shown that a number of climate-associated infectious disease epidemics have been reported in various areas of the country; mostly being associated with increase in precipitation and temperature. Although, there is no single policy document that specifically addresses issues of CC in the country, the National Environmental Management Act of 1997 recognizes the importance of CC and calls for the government to put up measures to address the phenomenon. A number of strategies and action plans related to CC are also in place. These include the National Biodiversity Strategy and Action Plan, the National Action Programme, and the National Bio-safety Framework. The government has put in place a National Climate Change Steering Committee and the National Climate Change Technical Committee to oversee and guide the implementation of CC activities in the country. Recognizing the adverse impacts of natural disasters and calamities, the government established a Disaster Management Division under the Prime Minister's Office. Epidemic Preparedness and Response Unit of the Ministry of Health and Social Welfare is responsible for emergency preparedness, mostly disease outbreaks. However, specific climate changes associated with human health issues are poorly addressed in the MoHSW strategies and the national health research priorities. In conclusion, CC threatens to slow, halt or reverses the progress the country has made or is making to achieve its national and millennium development goals. It is therefore important that Tanzania prepares itself to appropriately address CC impact on human health. It is equally important that policy makers and other stakeholders are engaged in a process to update and adapt priorities, mobilize resources and build interdisciplinary research and implementation capacity on climate change and its mitigation. PMID:26591995

  9. Evaluating landscape and wildlife changes over time in Tanzania's protected areas

    NASA Astrophysics Data System (ADS)

    Mtui, Devolent Tomas

    Declines in wildlife and their habitats associated with land cover changes are documented worldwide. Wildlife protected areas are established as a strategy to maintain and protect viable wildlife populations. International and national policies and regulations are set-forth in countries across the globe to emphasize wildlife species protection. Tanzania has allocated 26.5% (250,425 km2) of its total land area for wildlife protection, and its government established in 1998 a National Wildlife Policy to ensure the maintenance of viable protected areas and survival of important species, habitat and ecosystems. After more than a decade of its implementation, the level and rate of anthropogenic activities experienced in and around protected areas, and the consequent declines of wildlife species, was expected to be reduced to a minimum. Yet, recent studies show that degradation and isolation of wildlife habitats and declines in species populations continue to occur in Tanzanian protected areas. I evaluated changes in landscape and wildlife in three protected areas in Tanzania from the 1980s to the 2010s. Specifically, we investigated changes in land cover and species abundance over time, inside and outside the protected areas, and determined the effects of changes in the types of land cover on wildlife abundance. First, I used Maximum Likelihood classification procedure to derive land cover classes from Landsat TM and ETM+ satellite images of the 1980s, 1990s and 2010s, and to detect changes using post-classification comparison technique and landscape metrics approach. Second, I analysed animal density data for six species or groups of large herbivores, from 1991 to 2012. Thirdly, I evaluated the effect of land cover change on three species of large herbivores. The results show evidence of loss and degradation of types of land covers utilized by large herbivores. Habitats for large herbivores species have shrunken, inside and outside protected areas, resulting in declines of large herbivore populations. Wildlife protected areas in Tanzania appear not effective in protecting and maintaining wildlife populations and their habitats. As a result, revision of the existing wildlife policy is needed in order to come up with techniques that could assist protected areas achieve their intended goal.

  10. On two pterosaur humeri from the Tendaguru beds (Upper Jurassic, Tanzania).

    PubMed

    Costa, Fabiana R; Kellner, Alexander W A

    2009-12-01

    Jurassic African pterosaur remains are exceptionally rare and only known from the Tendaguru deposits, Upper Jurassic, Tanzania. Here we describe two right humeri of Tendaguru pterosaurs from the Humboldt University of Berlin: specimens MB.R. 2828 (cast MN 6661-V) and MB.R. 2833 (cast MN 6666-V). MB.R. 2828 consists of a three-dimensionally preserved proximal portion. The combination of the morphological features of the deltopectoral crest not observed in other pterosaurs suggests that this specimen belongs to a new dsungaripteroid taxon. MB.R. 2833 is nearly complete, and because of a long and round proximally placed deltopectoral crest it could be referred to the Archaeopterodactyloidea. It is the smallest pterosaur from Africa and one of the smallest flying reptiles ever recorded. These specimens confirm the importance of the Tendaguru deposits for the Jurassic pterosaur record. This potential, however, has to be fully explored with more field work. PMID:19893904

  11. Malaria in the United Republic of Tanzania: cultural considerations and health-seeking behaviour.

    PubMed Central

    Oberländer, L.; Elverdan, B.

    2000-01-01

    Malaria is one of the biggest health problems in sub-Saharan Africa. Large amounts of resources have been invested to control and treat it. Few studies have recognized that local explanations for the symptoms of malaria may lead to the attribution of different causes for the disease and thus to the seeking of different treatments. This article illustrates the local nosology of Bondei society in the north-eastern part of the United Republic of Tanzania and shows how sociocultural context affects health-seeking behaviour. It shows how in this context therapy is best viewed as a process in which beliefs and actions are continuously debated and evaluated throughout the course of treatment. PMID:11143196

  12. Ascertaining in vivo virulence of Mycobacterium tuberculosis lineages in patients in Mbeya, Tanzania.

    PubMed

    Olaru, I D; Rachow, A; Lange, C; Ntinginya, N E; Reither, K; Hoelscher, M; Vollrath, O; Niemann, S

    2015-01-01

    We evaluated the relationship between the degree of immunodeficiency indicated by the number of circulating CD4+ T-cells and Mycobacterium tuberculosis lineages identified by spoligotyping and mycobacterial interspersed repetitive units-variable number of tandem repeats genotyping in human immunodeficiency virus (HIV) infected individuals with pulmonary tuberculosis from Mbeya, Tanzania. Of M. tuberculosis strains from 129 patients, respectively 55 (42.6%) and 37 (28.7%) belonged to Latin American Mediterranean and Delhi/Central-Asian lineages, while 37 (28.7%) patients were infected with other strains. There was no difference in the distribution of M. tuberculosis lineages among patients with early or advanced stages of HIV infection (P = 0.785), indicating that the virulence of strains from these lineages may not be substantially different in vivo. PMID:25519793

  13. Epidemiological Assessment of the Rift Valley Fever Outbreak in Kenya and Tanzania in 2006 and 2007

    PubMed Central

    Jost, Christine C.; Nzietchueng, Serge; Kihu, Simon; Bett, Bernard; Njogu, George; Swai, Emmanuel S.; Mariner, Jeffrey C.

    2010-01-01

    To capture lessons from the 2007 Rift Valley fever (RVF) outbreak, epidemiological studies were carried out in Kenya and Tanzania. Somali pastoralists proved to be adept at recognizing symptoms of RVF and risk factors such as heavy rainfall and mosquito swarms. Sandik, which means “bloody nose,” was used by Somalis to denote disease consistent with RVF. Somalis reported that sandik was previously seen in 1997/98, the period of the last RVF epidemic. Pastoralists communicated valuable epidemiological information for surveillance and early warning systems that was observed before international warnings. The results indicate that an all or none approach to decision making contributed to the delay in response. In the future, a phased approach balancing actions against increasing risk of an outbreak would be more effective. Given the time required to mobilize large vaccine stocks, emergency vaccination did not contribute to the mitigation of explosive outbreaks of RVF. PMID:20682908

  14. Integrating the Management of Ruaha Landscape of Tanzania with Local Needs and Preferences

    NASA Astrophysics Data System (ADS)

    Masozera, Michel; Erickson, Jon D.; Clifford, Deana; Coppolillo, Peter; Sadiki, Harrison G.; Mazet, Jonna K.

    2013-12-01

    Sustainable management of landscapes with multiple competing demands such as the Ruaha Landscape is complex due to the diverse preferences and needs of stakeholder groups involved. This study uses conjoint analysis to assess the preferences of representatives from three stakeholder groups—local communities, district government officials, and non-governmental organizations—toward potential solutions of conservation and development tradeoffs facing local communities in the Ruaha Landscape of Tanzania. Results demonstrate that there is little consensus among stakeholders about the best development strategies for the Ruaha region. This analysis suggests a need for incorporating issues deemed important by these various groups into a development strategy that aims to promote conservation of the Ruaha Landscape and improve the livelihood of local communities.

  15. Intergenerational differences in perceptions of heritage tourism among the Maasai of Tanzania.

    PubMed

    Kalavar, Jyotsna M; Buzinde, Christine N; Melubo, Kokel; Simon, Josephine

    2014-03-01

    Besides wildlife tourism in the African savannah, cultural heritage tourism (sometimes known only as heritage tourism) is a big draw in Tanzania. In order to attract cultural tourism dollars, Maasai communities have established cultural bomas, typically pseudo Maasai villages where they display cultural performances and crafts before tourists. Such cultural contact has resulted in the growing influence of globalization that challenges traditional ways. The economic, social and environmental impact of heritage tourism on intergenerational relationships and community well-being has not been examined among the Maasai people. In this study, focus groups were conducted with different age-groups of Maasai people residing in Esilalei and Oltukai villages. Results suggest that for the Maasai, heritage tourism appears to be a double-edged sword. While tourism results in some trickled down economic benefits for the Maasai community, economic change appears to have created a social distance between generations. PMID:24390314

  16. Language of instruction and student performance: new insights from research in Tanzania and South Africa

    NASA Astrophysics Data System (ADS)

    Brock-Utne, Birgit

    2007-11-01

    This article, drawing on a set of studies conducted in the framework of the Language of Instruction in Tanzania and South Africa (LOITASA) research project, shows how well African students express themselves if they are allowed to use a familiar African language, and conversely the difficulties they have when forced to use a foreign language, a language they hardly hear and never use outside of school, as a language of instruction. A key finding of the research is that when the foreign language, English in this case, is used, there is a much larger spread in test performance between students. This means that a small group of students succeed while the vast majority sinks. The author therefore argues for working towards a goal whereby African children like children in industrialized countries may study in their own language. Pursuing this goal should be a centrepiece in poverty reduction strategies.

  17. Satellite monitoring of vegetation and geology in semi-arid environments. [Tanzania

    NASA Technical Reports Server (NTRS)

    Kihlblom, U.; Johansson, D. (principal investigators)

    1980-01-01

    The possibility of mapping various characteristics of the natural environment of Tanzania by various LANDSAT techniques was assessed. Interpretation and mapping were carried out using black and white as well as color infrared images on the scale of 1:250,000. The advantages of several computer techniques were also assessed, including contrast-stretched rationing, differential edge enhancement; supervised classification; multitemporal classification; and change detection. Results Show the most useful image for interpretation comes from band 5, with additional information being obtained from either band 6 or band 7. The advantages of using color infrared images for interpreting vegetation and geology are so great that black and white should be used only to supplement the colored images.

  18. Symbolic mediation and commoditization: a critical examination of alcohol use among the Haya of Bukoba, Tanzania.

    PubMed

    Carlson, R G

    1992-11-01

    Low-alcohol-content fermented beverages are thoroughly enmeshed in the social, economic, commensal, and cosmological spheres of life among most peoples of sub-Saharan Africa. This paper describes and analyzes the role of alcoholic beverages as symbolic mediators and commodities among the Haya of northwest Tanzania. Data gathered during field research in 1985-86 are employed to describe the ways in which the Haya portray excessive drinking and the indigenous strategies they use to address frequent drunkenness when it is perceived as a health problem. A central feature of the paper contrasts the role of a cultural schema of four levels of intoxication in processes of symbolic mediation and commoditization, thereby contributing to critical medical anthropological analysis. PMID:1300410

  19. Women's perceptions of antenatal, delivery, and postpartum services in rural Tanzania

    PubMed Central

    Mahiti, Gladys Reuben; Mkoka, Dickson Ally; Kiwara, Angwara Dennis; Mbekenga, Columba Kokusiima; Hurtig, Anna-Karin; Goicolea, Isabel

    2015-01-01

    Background Maternal health care provision remains a major challenge in developing countries. There is agreement that the provision of quality clinical services is essential if high rates of maternal death are to be reduced. However, despite efforts to improve access to these services, a high number of women in Tanzania do not access them. The aim of this study is to explore women's views about the maternal health services (pregnancy, delivery, and postpartum period) that they received at health facilities in order to identify gaps in service provision that may lead to low-quality maternal care and increased risks associated with maternal morbidity and mortality in rural Tanzania. Design We gathered qualitative data from 15 focus group discussions with women attending a health facility after child birth and transcribed it verbatim. Qualitative content analysis was used for analysis. Results ‘Three categories emerged that reflected women's perceptions of maternal health care services: “mothers perceive that maternal health services are beneficial,” “barriers to accessing maternal health services” such as availability and use of traditional birth attendants (TBAs) and the long distances between some villages, and “ambivalence regarding the quality of maternal health services” reflecting that women had both positive and negative perceptions in relation to quality of health care services offered’. Conclusions Mothers perceived that maternal health care services are beneficial during pregnancy and delivery, but their awareness of postpartum complications and the role of medical services during that stage were poor. The study revealed an ambivalence regarding the perceived quality of health care services offered, partly due to shortages of material resources. Barriers to accessing maternal health care services, such as the cost of transport and the use of TBAs, were also shown. These findings call for improvement on the services provided. Improvements should address, accessibility of services, professionals' attitudes and stronger promotion of the importance of postpartum check-ups, both among health care professionals and women. PMID:26498576

  20. Genetic diversity of Mycobacterium tuberculosis isolated from tuberculosis patients in the Serengeti ecosystem in Tanzania.

    PubMed

    Mbugi, Erasto V; Katale, Bugwesa Z; Siame, Keith K; Keyyu, Julius D; Kendall, Sharon L; Dockrell, Hazel M; Streicher, Elizabeth M; Michel, Anita L; Rweyemamu, Mark M; Warren, Robin M; Matee, Mecky I; van Helden, Paul D

    2015-03-01

    This study was part of a larger cross-sectional survey that was evaluating tuberculosis (TB) infection in humans, livestock and wildlife in the Serengeti ecosystem in Tanzania. The study aimed at evaluating the genetic diversity of Mycobacterium tuberculosis isolates from TB patients attending health facilities in the Serengeti ecosystem. DNA was extracted from 214 sputum cultures obtained from consecutively enrolled newly diagnosed untreated TB patients aged ?18 years. Spacer oligonucleotide typing (spoligotyping) and Mycobacterium Interspersed Repetitive Units and Variable Number Tandem Repeat (MIRU-VNTR) were used to genotype M. tuberculosis to establish the circulating lineages. Of the214 M. tuberculosis isolates genotyped, 55 (25.7%) belonged to the Central Asian (CAS) family, 52 (24.3%) were T family (an ill-defined family), 38 (17.8%) belonged to the Latin American Mediterranean (LAM) family, 25 (11.7%) to the East-African Indian (EAI) family, 25 (11.7%) comprised of different unassigned ('Serengeti') strain families, while 8 (3.7%) belonged to the Beijing family. A minority group that included Haarlem, X, U and S altogether accounted for 11 (5.2%) of all genotypes. MIRU-VNTR typing produced diverse patterns within and between families indicative of unlinked transmission chains. We conclude that, in the Serengeti ecosystem only a few successful families predominate namely CAS, T, LAM and EAI families. Other types found in lower prevalence are Beijing, Haarlem, X, S and MANU. The Haarlem, EAI_Somalia, LAM3 and S/convergent and X2 subfamilies found in this study were not reported in previous studies in Tanzania. PMID:25522841

  1. Genetic diversity of Mycobacterium tuberculosis isolated from tuberculosis patients in the Serengeti ecosystem in Tanzania

    PubMed Central

    Mbugi, Erasto V.; Katale, Bugwesa Z.; Siame, Keith K.; Keyyu, Julius D.; Kendall, Sharon L.; Dockrell, Hazel M.; Streicher, Elizabeth M.; Michel, Anita L.; Rweyemamu, Mark M.; Warren, Robin M.; Matee, Mecky I.; van Helden, Paul D.

    2015-01-01

    Summary This study was part of a larger cross-sectional survey that was evaluating tuberculosis (TB) infection in humans, livestock and wildlife in the Serengeti ecosystem in Tanzania. The study aimed at evaluating the genetic diversity of Mycobacterium tuberculosis isolates from TB patients attending health facilities in the Serengeti ecosystem. DNA was extracted from 214 sputum cultures obtained from consecutively enrolled newly diagnosed untreated TB patients aged ?18 years. Spacer oligonucleotide typing (spoligotyping) and Mycobacterium Interspersed Repetitive Units and Variable Number Tandem Repeat (MIRU-VNTR) were used to genotype M. tuberculosis to establish the circulating lineages. Of the214 M. tuberculosis isolates genotyped, 55 (25.7%) belonged to the Central Asian (CAS) family, 52 (24.3%) were T family (an ill-defined family), 38 (17.8%) belonged to the Latin American Mediterranean (LAM) family, 25 (11.7%) to the East-African Indian (EAI) family, 25 (11.7%) comprised of different unassigned (‘Serengeti’) strain families, while 8 (3.7%) belonged to the Beijing family. A minority group that included Haarlem, X, U and S altogether accounted for 11 (5.2%) of all genotypes. MIRU-VNTR typing produced diverse patterns within and between families indicative of unlinked transmission chains. We conclude that, in the Serengeti ecosystem only a few successful families predominate namely CAS, T, LAM and EAI families. Other types found in lower prevalence are Beijing, Haarlem, X, S and MANU. The Haarlem, EAI_Somalia, LAM3 and S/convergent and X2 subfamilies found in this study were not reported in previous studies in Tanzania. PMID:25522841

  2. Molecular survey for foot-and-mouth disease virus in livestock in Tanzania, 2008-2013.

    PubMed

    Sallu, Raphael S; Kasanga, Christopher J; Mathias, Mkama; Yongolo, Mmeta; Mpelumbe-Ngeleja, Chanasa; Mulumba, Misheck; Ranga, Ezekia; Wambura, Philemon; Rweyemamu, Mark; Knowles, Nick; King, Donald

    2014-01-01

    Phylogeography data are of paramount importance in studying the molecular epidemiology dynamics of foot-and-mouth disease virus (FMDV). In this study, epithelial samples and oesophageal-pharyngeal fluids were collected from 361 convalescent animals (cattle and buffaloes) in the field throughout Tanzania between 2009 and 2013. The single plex real-time RT-PCR (qRT-PCR) assay for rapid and accurate diagnosis of FMDV employing the Callahan 3DF-2, 3DF-R primers and Callahan 3DP-1 probe were used. Preparation of the samples was performed according to the OIE manual, with a Kenya O serotype obtained from the attenuated vaccine serving as a positive control and samples collected from healthy animals serving as true negatives. The results indicated that 53.49% of samples (n = 176) were positive for FMDV genome by qRT-PCR, with Ct values ranging from 14 to 32. In addition, molecular typing of the FMDV genome positive samples using serotype specific primers revealed the existence of several serotypes: serotype South Africa Territory 1 (SAT1) (34.25%, n = 60), serotype A (68.92%, n = 98), serotype O (59.20%, n = 98) and SAT2 (54.54%, n = 96). The virus protein 1 sequences analysis for 35 samples was performed and the collective results indicated: 54.28% serotype O, 25.71% serotype A, 14.28% serotype SAT1 and 2.85% serotype SAT2. Therefore in this study, both the phylogenetic trees and spatial distribution of serotypes elucidated the phylodynamics of multiple FMDV field strains in Tanzania and neighbouring countries. PMID:25005022

  3. Carbonatite tuffs in the Laetolil Beds of Tanzania and the Kaiserstuhl in Germany

    USGS Publications Warehouse

    Hay, R.L.; O'Neil, J.R.

    1983-01-01

    Carbonatite lava and tephra are now well known. The only modern eruptive carbonatites, from Oldoinyo Lengai, Tanzania, are of alkali carbonatite, whereas all of the pre-modern examples are of calcite or dolomite. Chemical and stable isotope analyses were made of separate phases of Pliocene carbonatite tuffs of the Laetolil Beds in Tanzania and of Miocene carbonatite tuffs of the Kaiserstuhl in Germany in order to understand the reasons for this major difference. The Laetolil Beds contain numerous carbonatite and melilitite-carbonatite tuffs. It is proposed that the carbonatite ash was originally of alkali carbonate composition and that the alkali component was dissolved, leaving a residuum of calcium carbonate. The least recrystallized melilitite-carbonatite tuff contains early-deposited calcite cement and calcite pseudomorphs after nyerereite (?) that have contents of strontium and barium and ??18O and ??13C values suggestive of incomplete chemical and isotopic exchange during alteration and replacement of alkali carbonatite ash. Carbonatite tuffs of the Kaiserstuhl contain globules composed of calcite phenocrysts and microphenocrysts in a groundmass of calcite with a small amount of clay, apatite, and magnetite. The SrO contents of phenocrysts, microphenocrysts, and groundmass calcite average 0.90, 1.42, and 0.59 percent, respectively. The average ??18O and ??13C values of globules (+14.3 and -9.0, respectively) fall between those of coarse-grained intrusive Kaiserstuhl carbonatite (avg. +6.6, -5.8) and those of low-temperature calcite cement in the carbonatite tuffs (+21.8, -14.9). The phenocrysts and microphenocrysts are primary magmatic calcite, but several features indicate that the groundmass has been recrystallized and altered in contact with meteoric water, resulting in weathering of silicate to clay, leaching of strontium, and isotopic exchange. The weight of evidence favors an original high content of alkali carbonatite in the groundmass, with recrystallization following leaching of the alkalies. ?? 1983 Springer-Verlag.

  4. Knowledge, Attitudes and Practices (KAP) about Rabies Prevention and Control: A Community Survey in Tanzania

    PubMed Central

    Sambo, Maganga; Lembo, Tiziana; Cleaveland, Sarah; Ferguson, Heather M.; Sikana, Lwitiko; Simon, Cleophas; Urassa, Honorati; Hampson, Katie

    2014-01-01

    Background Despite being entirely preventable, canine rabies still kills 55,000 people/year in developing countries. Information about local beliefs and practices can identify knowledge gaps that may affect prevention practices and lead to unnecessary deaths. Methodology/Principal Findings We investigated knowledge, attitudes and practices related to rabies and its prevention and control amongst a cross-section of households (n?=?5,141) in urban and rural areas of central, southern and northern Tanzania. Over 17% of respondents owned domestic dogs (average of 2.3 dogs/household),>95% had heard about rabies, and>80% knew that rabies is transmitted through dog bites. People who (1) had greater education, (2) originated from areas with a history of rabies interventions, (3) had experienced exposure by a suspect rabid animal, (4) were male and (5) owned dogs were more likely to have greater knowledge about the disease. Around 80% of respondents would seek hospital treatment after a suspect bite, but only 5% were aware of the need for prompt wound cleansing after a bite. Although>65% of respondents knew of dog vaccination as a means to control rabies, only 51% vaccinated their dogs. Determinants of dog vaccination included (1) being a male-headed household, (2) presence of children, (3) low economic status, (4) residing in urban areas, (5) owning livestock, (6) originating from areas with rabies interventions and (7) having purchased a dog. The majority of dog-owning respondents were willing to contribute no more than US$0.31 towards veterinary services. Conclusions/Significance We identified important knowledge gaps related to, and factors influencing the prevention and control of rabies in Tanzania. Increasing knowledge regarding wound washing, seeking post-exposure prophylaxis and the need to vaccinate dogs are likely to result in more effective prevention of rabies; however, greater engagement of the veterinary and medical sectors is also needed to ensure the availability of preventative services. PMID:25473834

  5. Constraints and potential for efficient inter-sectoral water allocations in Tanzania

    NASA Astrophysics Data System (ADS)

    Kashaigili, Japhet J.; Kadigi, Reuben M. J.; Sokile, Charles S.; Mahoo, Henry F.

    In many sub-Saharan African countries, there are conflicts over water uses in most river basins. In Tanzania, conflicts are becoming alarming and are exacerbated by increasing water demands due to rapid population growth and expanding economic activities. This paper reviews the major constraints and potential for achieving efficient systems of allocating water resources to different uses and users in Tanzania. The following constraints are identified: (a) the lack of active community involvement in management of water resources, (b) conflicting institutions and weak institutional capacities both in terms of regulations and protection of interests of the poor, (c) the lack of data and information to inform policy and strategies for balanced water allocation, and (d) inadequate funds for operation, maintenance and expansion of water supply systems. Despite these constraints, there are also opportunities for improving water allocation and management systems in the country. These include: the available reserve of both surface and groundwater resources, which remain unexploited; high demand for water services; a high potential for investing in the water sector; and availability of basic infrastructure and elements of institutional framework that can be improved. The paper recommends the use of combined variants of water allocation devices which (a) meet different water requirements and ensure desirable multiple-use outcomes, (b) facilitate the classification of water resources in terms of desired environmental protection levels, (c) allow reforms in water utilization to achieve equity and meet changing social and economic priorities, (d) facilitate the development of effective local institutions, (e) put in place the legal system that assigns rights to water resources and describes how those rights may be transferred, (f) enforce the rights and punish infringements on those rights, and (g) use cost-effective pricing systems to ensure that payment for water uses cover development, operational and management costs.

  6. Socio-economic impacts of irrigated agriculture in Mbarali District of south west Tanzania

    NASA Astrophysics Data System (ADS)

    Mwakalila, Shadrack

    Irrigation has been found to be central in curbing food scarcity not only in Tanzania but also in many other developing countries. It has been proved that continued reliability on rainfall in agriculture cannot sustain the increase in population. This study examines the impacts of smallholder irrigated agriculture in improving social and economic benefits in Igurusi Ward of Mbarali District which is located in the southern-western part of Tanzania. The study applies the Participatory Rural Appraisal Framework for data collection. The study was confined to five villages in Igurusi ward which are Majenje, Igurusi, Chamoto, Uhambule and Mahango. The study examined critically paddy production for smallholder farmers that practice irrigation and those who cultivates rain-fed paddy. The study examined both existing traditional and modern irrigation systems. It was found that, most of the respondents (79%) practice irrigated agriculture in paddy production while the remaining 21% practice rain-fed agriculture. Forty percent of households that practice irrigated agriculture harvest paddy two seasons per year. The return to labour in paddy production for smallholder farmers who irrigate their paddy fields is about US 2.5/manday which is above the poverty line of US 1.0/day. The smallest return to labour (US $ 0.85/manday) is obtained by an average smallholder farmer who cultivates rain-fed paddy using hand hoe and family labour. The potential implication of the current irrigation systems is that if irrigation is managed properly it may lead to sustainable increases in small farmer’s productivity and income, thus alleviating rural poverty.

  7. HIV-1 subtypes and recombinants in Northern Tanzania: distribution of viral quasispecies.

    PubMed

    Kiwelu, Ireen E; Novitsky, Vladimir; Margolin, Lauren; Baca, Jeannie; Manongi, Rachel; Sam, Noel; Shao, John; McLane, Mary F; Kapiga, Saidi H; Essex, M

    2012-01-01

    This study analyzed the distribution and prevalence of HIV-1 subtypes, multiplicity of HIV-1 infection, and frequency of inter-subtype recombination among HIV-1-infected female bar and hotel workers in Moshi, Kilimanjaro Region, Tanzania, from 2004 to 2007. The HIV-1 viral sequences spanning the V1-C5 region of HIV-1 env gp120 were analyzed from 50 subjects by single genome amplification and sequencing (SGA/S) technique. A total of 1740 sequences were amplified and sequenced from the HIV-1 proviral DNA template. The median env sequences analyzed per subject per two time points was 38 (IQR 28-50) over one year of HIV infection. In a subset of 14 subjects, a total of 239 sequences were obtained from HIV-1 RNA template at the baseline visit. The most prevalent HIV-1 subtypes were A1 (56%) and C (30%), while HIV-1 subtype D and inter-subtype recombinant viruses were found in 6% and 8% of subjects respectively. Transmission of multiple HIV-1 variants was evident in 27% of the subjects infected with pure HIV-1 subtypes A1, C, or D. The HIV-1 inter-subtype recombinants were found in 8% including HIV-1 C/A, D/A, and complex mosaic recombinants. Multiple viral variants were found in two subjects infected with inter-subtype recombinants. One subject harbored quasispecies of both pure HIV-1 A1 and C/A recombinant. The other subject was infected with two complex mosaic inter-subtype recombinant variants belonging to subtype D. HIV-1 multiple infections and ongoing recombination contribute significantly to the genetic diversity of circulating HIV-1 in Tanzania and have important implications for vaccine design and the development of therapeutic strategies. PMID:23118882

  8. Health policy for sickle cell disease in Africa: experience from Tanzania on interventions to reduce under-five mortality.

    PubMed

    Makani, Julie; Soka, Deogratias; Rwezaula, Stella; Krag, Marlene; Mghamba, Janneth; Ramaiya, Kaushik; Cox, Sharon E; Grosse, Scott D

    2015-02-01

    Tanzania has made considerable progress towards reducing childhood mortality, achieving a 57% decrease between 1980 and 2011. This epidemiological transition will cause a reduction in the contribution of infectious diseases to childhood mortality and increase in contribution from non-communicable diseases (NCDs). Haemoglobinopathies are amongst the most common childhood NCDs, with sickle cell disease (SCD) being the commonest haemoglobinopathy in Africa. In Tanzania, 10,313 children with SCD under 5 years of age (U5) are estimated to die every year, contributing an estimated 7% of overall deaths in U5 children. Key policies that governments in Africa are able to implement would reduce mortality in SCD, focusing on newborn screening and comprehensive SCD care programmes. Such programmes would ensure that interventions such as prevention of infections using penicillin plus prompt diagnosis and treatment of complications are provided to all individuals with SCD. PMID:25365928

  9. Assessing healthcare providers' knowledge and practices relating to insecticide-treated nets and the prevention of malaria in Ghana, Laos, Senegal and Tanzania

    PubMed Central

    2011-01-01

    Background Research evidence is not always being disseminated to healthcare providers who need it to inform their clinical practice. This can result in the provision of ineffective services and an inefficient use of resources, the implications of which might be felt particularly acutely in low- and middle-income countries. Malaria prevention is a particularly compelling domain to study evidence/practice gaps given the proven efficacy, cost-effectiveness and disappointing utilization of insecticide-treated nets (ITNs). Methods This study compares what is known about ITNs to the related knowledge and practices of healthcare providers in four low- and middle-income countries. A new questionnaire was developed, pilot tested, translated and administered to 497 healthcare providers in Ghana (140), Laos (136), Senegal (100) and Tanzania (121). Ten questions tested participants' knowledge and clinical practice related to malaria prevention. Additional questions addressed their individual characteristics, working context and research-related activities. Ordinal logistic regressions with knowledge and practices as the dependent variable were conducted in addition to descriptive statistics. Results The survey achieved a 75% response rate (372/497) across Ghana (107/140), Laos (136/136), Senegal (51/100) and Tanzania (78/121). Few participating healthcare providers correctly answered all five knowledge questions about ITNs (13%) or self-reported performing all five clinical practices according to established evidence (2%). Statistically significant factors associated with higher knowledge within each country included: 1) training in acquiring systematic reviews through the Cochrane Library (OR 2.48, 95% CI 1.30-4.73); and 2) ability to read and write English well or very well (OR 1.69, 95% CI 1.05-2.70). Statistically significant factors associated with better clinical practices within each country include: 1) reading scientific journals from their own country (OR 1.67, 95% CI 1.10-2.54); 2) working with researchers to improve their clinical practice or quality of working life (OR 1.44, 95% CI 1.04-1.98); 3) training on malaria prevention since their last degree (OR 1.68, 95% CI 1.17-2.39); and 4) easy access to the internet (OR 1.52, 95% CI 1.08-2.14). Conclusions Improving healthcare providers' knowledge and practices is an untapped opportunity for expanding ITN utilization and preventing malaria. This study points to several strategies that may help bridge the gap between what is known from research evidence and the knowledge and practices of healthcare providers. Training on acquiring systematic reviews and facilitating internet access may be particularly helpful. PMID:22165841

  10. Effect of home-based counselling on newborn care practices in southern Tanzania one year after implementation: a cluster-randomised controlled trial

    PubMed Central

    2014-01-01

    Background In Sub-Saharan Africa over one million newborns die annually. We developed a sustainable and scalable home-based counselling intervention for delivery by community volunteers in rural southern Tanzania to improve newborn care practices and survival. Here we report the effect on newborn care practices one year after full implementation. Methods All 132 wards in the 6-district study area were randomised to intervention or comparison groups. Starting in 2010, in intervention areas trained volunteers made home visits during pregnancy and after childbirth to promote recommended newborn care practices including hygiene, breastfeeding and identification and extra care for low birth weight babies. In 2011, in a representative sample of 5,240 households, we asked women who had given birth in the previous year both about counselling visits and their childbirth and newborn care practices. Results Four of 14 newborn care practices were more commonly reported in intervention than comparison areas: delaying the baby’s first bath by at least six hours (81% versus 68%, OR 2.0 (95% CI 1.2-3.4)), exclusive breastfeeding in the three days after birth (83% versus 71%, OR 1.9 (95% CI 1.3-2.9)), putting nothing on the cord (87% versus 70%, OR 2.8 (95% CI 1.7-4.6)), and, for home births, tying the cord with a clean thread (69% versus 39%, OR 3.4 (95% CI 1.5-7.5)). For other behaviours there was little evidence of differences in reported practices between intervention and comparison areas including childbirth in a health facility or with a skilled attendant, thermal care practices, breastfeeding within an hour of birth and, for home births, the birth attendant having clean hands, cutting the cord with a clean blade and birth preparedness activities. Conclusions A home-based counselling strategy using volunteers and designed for scale-up can improve newborn care behaviours in rural communities of southern Tanzania. Further research is needed to evaluate if, and at what cost, these gains will lead to improved newborn survival. Trial registration Trial Registration Number NCT01022788 (http://www.clinicaltrials.gov, 2009) PMID:25052850

  11. Out-of-Pocket Costs and Other Determinants of Access to Healthcare for Children with Febrile Illnesses: A Case-Control Study in Rural Tanzania

    PubMed Central

    Castellani, Joëlle; Mihaylova, Borislava; Evers, Silvia M. A. A.; Paulus, Aggie T. G.; Mrango, Zakayo E.; Kimbute, Omari; Shishira, Joseph P.; Mulokozi, Francis; Petzold, Max; Singlovic, Jan; Gomes, Melba

    2015-01-01

    Objectives To study private costs and other determinants of access to healthcare for childhood fevers in rural Tanzania. Methods A case-control study was conducted in Tanzania to establish factors that determine access to a health facility in acute febrile illnesses in children less than 5 years of age. Carers of eligible children were interviewed in the community; cases were represented by patients who went to a facility and controls by those who did not. A Household Wealth Index was estimated using principal components analysis. A multivariable logistic regression analysis was performed to understand the factors which influenced attendance of healthcare facility including severity of the illness and household wealth/socio-demographic indicators. To complement the data on costs from community interviews, a hospital-based study obtained details of private expenditures for hospitalised children under the age of 5. Results Severe febrile illness is strongly associated with health facility attendance (OR: 35.76, 95%CI: 3.68-347.43, p = 0.002 compared with less severe febrile illness). Overall, the private costs of an illness for patients who went to a hospital were six times larger than private costs of controls ($5.68 vs. $0.90, p<0.0001). Household wealth was not significantly correlated with total costs incurred. The separate hospital based cost study indicated that private costs were three times greater for admissions at the mission versus public hospital: $13.68 mission vs. $4.47 public hospital (difference $ 9.21 (95% CI: 7.89 -10.52), p<0.0001). In both locations, approximately 50% of the cost was determined by the duration of admission, with each day in hospital increasing private costs by about 12% (95% CI: 5% - 21%). Conclusion The more severely ill a child, the higher the probability of attending hospital. We did not find association between household wealth and attending a health facility; nor was there an association between household wealth and private cost. PMID:25861012

  12. Factors influencing the implementation of integrated management of childhood illness (IMCI) by healthcare workers at public health centers & dispensaries in Mwanza, Tanzania

    PubMed Central

    2014-01-01

    Background Integrated Management of Childhood Illness (IMCI) was developed by the World Health Organization (WHO) and the United Nations International Children’s Fund (UNICEF) and aims at reducing childhood morbidity and mortality in resource-limited settings including Tanzania. It was introduced in 1996 and has been scaled up in all districts in the country. The purpose of this study was to identify factors influencing the implementation of IMCI in the health facilities in Mwanza, Tanzania since reports indicates that the guidelines are not full adhered to by the healthcare workers. Methods A cross-sectional study design was used and a sample size of 95 healthcare workers drawn from health centers and dispensaries within Mwanza city were interviewed using self-administered questionnaires. Structured interview was also used to get views from the city IMCI focal person and the 2 facilitators. Data were analyzed using SPSS and presented using figures and tables. Results Only 51% of healthcare workers interviewed had been trained. 69% of trained Healthcare workers expressed understanding of the IMCI approach. Most of the respondents (77%) had a positive attitude that IMCI approach was a better approach in managing common childhood illnesses especially with the reality of resource constraint in the health facilities. The main challenges identified in the implementation of IMCI are low initial training coverage among health care workers, lack of essential drugs and supplies, lack of onsite mentoring and lack of refresher courses and regular supportive supervision. Supporting the healthcare workers through training, onsite mentoring, supportive supervision and strengthening the healthcare system through increasing access to essential medicines, vaccines, strengthening supply chain management, increasing healthcare financing, improving leadership & management were the major interventions that could assist in IMCI implementation. Conclusions The healthcare workers can implement better IMCI through the collaboration of supervisors, IMCI focal person, Council Health Management Teams (CHMT) and other stakeholders interested in child health. However, significant barriers impede a sustainable IMCI implementation. Recommendations have been made related to supportive supervision and HealthCare system strengthening among others. PMID:24666561

  13. Involving traditional birth attendants in emergency obstetric care in Tanzania: policy implications of a study of their knowledge and practices in Kigoma Rural District

    PubMed Central

    2013-01-01

    Introduction Access to quality maternal health services mainly depends on existing policies, regulations, skills, knowledge, perceptions, and economic power and motivation of service givers and target users. Critics question policy recommending involvement of traditional birth attendants (TBAs) in emergency obstetric care (EmoC) services in developing countries. Objectives This paper reports about knowledge and practices of TBAs on EmoC in Kigoma Rural District, Tanzania and discusses policy implications on involving TBAs in maternal health services. Methods 157 TBAs were identified from several villages in 2005, interviewed and observed on their knowledge and practice in relation to EmoC. Quantitative and qualitative techniques were used for data collection and analysis depending on the nature of the information required. Findings Among all 157 TBAs approached, 57.3% were aged 50+ years while 50% had no formal education. Assisting mothers to deliver without taking their full pregnancy history was confessed by 11% of all respondents. Having been attending pregnant women with complications was experienced by 71.2% of all respondents. Only 58% expressed adequate knowledge on symptoms and signs of pregnancy complications. Lack of knowledge on possible risk of HIV infections while assisting childbirth without taking protective gears was claimed by 5.7% of the respondents. Sharing the same pair of gloves between successful deliveries was reported to be a common practice by 21.1% of the respondents. Use of unsafe delivery materials including local herbs and pieces of cloth for protecting themselves against HIV infections was reported as being commonly practiced among 27.6% of the respondents. Vaginal examination before and during delivery was done by only a few respondents. Conclusion TBAs in Tanzania are still consulted by people living in underserved areas. Unfortunately, TBAs’ inadequate knowledge on EmOC issues seems to have contributed to the rising concerns about their competence to deliver the recommended maternal services. Thus, the authorities seeming to recognize and promote TBAs should provide support to TBAs in relation to necessary training and giving them essential working facilities, routine supportive supervision and rewarding those seeming to comply with the standard guidelines for delivering EmoC services. PMID:24124663

  14. A randomised controlled trial to investigate effects of enhanced supervision on primary eye care services at health centres in Kenya, Malawi and Tanzania

    PubMed Central

    2014-01-01

    Background Knowledge and skills of primary health care workers (PHCWs) in primary eye care have been demonstrated to be inadequate in several districts of Kenya, Malawi, and Tanzania. We tested whether enhanced supervision, focused on improving practical skills over two years, would raise the scores of these workers on a test of basic knowledge and skills. Methods This was a randomised controlled trial. All primary health care (PHC) facilities within two districts of each country were enrolled and randomly assigned by district (Kenya, Malawi) or by health care facility (Tanzania) to receive quarterly skills-based supervision by a district eye coordinator or to continue existing routine supervision. At baseline, a test of basic knowledge and skills in five key areas was administered to PHCWs, and visual acuity (VA) charts and working torches were provided. After two years the test was administered again. Changes in test scores were compared between the intervention (enhanced supervision) and the non-intervention (routine supervision) facilities. Results All 137 facilities in the six districts were enrolled including 343 PHCWs. At baseline, no facility had a visual acuity chart and 18 (13%) had a working torch; the average total skills scores were 6.04 and 6.38 (maximum of 12) in the non-intervention and the intervention facilities, respectively. After two years, 16 intervention facilities (23.2%) had a visual acuity chart correctly placed and 19 (27.5%) had a working torch, compared to 4 (5.9%) and 6 (8.8%), respectively, in the routine supervision facilities. At the facility level, the change in overall test scores was +1.84 points in the intervention sites compared to +0.42 points in the non-intervention sites (p<0.001). Staff turnover included about 75% of the staff by the end of the study. Conclusion The improvements in the enhanced supervision facilities were very modest and of questionable clinical significance. The low impact of the intervention may be due to the high turnover of PHCWs or high absenteeism. A better understanding of the quality of eye care at PHC facilities and influencing factors are urgently needed before continuing to invest resources in the scale up of this model of task shifting in Africa. PMID:25079942

  15. A cross-sectional pilot study assessing needs and attitudes to implementation of Information and Communication Technology for rational use of medicines among healthcare staff in rural Tanzania

    PubMed Central

    2014-01-01

    Background In resource-poor countries access to essential medicines, suboptimal prescribing and use of medicines are major problems. Health workers lack updated medical information and treatment support. Information and Communication Technology (ICT) could help tackle this. The impact of ICT on health systems in resource-poor countries is likely to be significant and transform the practice of medicine just as in high-income countries. However, research for finding the best way of doing this is needed. We aimed to assess current approaches to and use of ICT among health workers in two rural districts of Tanzania in relation to the current drug distribution practices, drug stock and continuing medical information (CME), as well as assessing the feasibility of using ICT to improve ordering and use of medicines. Methods This pilot study was conducted in 2010–2011, mapping the drug distribution chain in Tanzania, including problems and barriers. The study was conducted in Bunda and Serengeti districts, both part of the ICT4RD (ICT for rural development) project. Health workers involved in drug procurement and use at 13 health facilities were interviewed on use and knowledge of ICT, and their attitudes to its use in their daily work. They were also shown and interviewed about their thoughts on an android tablet application prototype for drug stock inventory and drug ordering, based on the Tanzanian Medical Stores Department (MSD) current paper forms. Results The main challenge was a stable supply of essential medicines. Drug supplies were often delayed and incomplete, resulting in stock-outs. All 20 interviewed health workers used mobile phones, 8 of them Smartphones with Internet connection. The Health workers were very positive to the tablet application and saw its potential in reducing drug stock-outs. They also expressed a great need and wish for CME by distance. Conclusion The tablet application was easily used and appreciated by health workers, and thus has the potential to save time and effort, reduce transportation costs and minimise drug stock-outs. Furthermore, the android tablet could be used to reach out with CME programs to health care workers at remote health facilities, as well as those in towns. PMID:25158806

  16. Motivation and incentives of rural maternal and neonatal health care providers: a comparison of qualitative findings from Burkina Faso, Ghana and Tanzania

    PubMed Central

    2013-01-01

    Background In Burkina Faso, Ghana and Tanzania strong efforts are being made to improve the quality of maternal and neonatal health (MNH) care. However, progress is impeded by challenges, especially in the area of human resources. All three countries are striving not only to scale up the number of available health staff, but also to improve performance by raising skill levels and enhancing provider motivation. Methods In-depth interviews were used to explore MNH provider views about motivation and incentives at primary care level in rural Burkina Faso, Ghana and Tanzania. Interviews were held with 25 MNH providers, 8 facility and district managers, and 2 policy-makers in each country. Results Across the three countries some differences were found in the reasons why people became health workers. Commitment to remaining a health worker was generally high. The readiness to remain at a rural facility was far less, although in all settings there were some providers that were willing to stay. In Burkina Faso it appeared to be particularly difficult to recruit female MNH providers to rural areas. There were indications that MNH providers in all the settings sometimes failed to treat their patients well. This was shown to be interlinked with differences in how the term ‘motivation’ was understood, and in the views held about remuneration and the status of rural health work. Job satisfaction was shown to be quite high, and was particularly linked to community appreciation. With some important exceptions, there was a strong level of agreement regarding the financial and non-financial incentives that were suggested by these providers, but there were clear country preferences as to whether incentives should be for individuals or teams. Conclusions Understandings of the terms and concepts pertaining to motivation differed between the three countries. The findings from Burkina Faso underline the importance of gender-sensitive health workforce planning. The training that all levels of MNH providers receive in professional ethics, and the way this is reinforced in practice require closer attention. The differences in the findings across the three settings underscore the importance of in-depth country-level research to tailor the development of incentives schemes. PMID:23617375

  17. The effect of mother’s age and other related factors on neonatal survival associated with first and second birth in rural, Tanzania: evidence from Ifakara health and demographic surveillance system in rural Tanzania

    PubMed Central

    2014-01-01

    Background With a view to improve neonatal survival, data on birth outcomes are critical for planning maternal and child health care services. We present information on neonatal survival from Ifakara Health and Demographic Surveillance System (HDSS) in Tanzania, regarding the influence of mother’s age and other related factors on neonatal survival of first and second births. Methods The study conducted analysis using longitudinal health and demographic data collected from Ifakara HDSS in parts of Kilombero and Ulanga districts in Morogoro region. The analysis included first and second live births that occurred within six years (2004–2009) and the unit of observation was a live birth. A logistic regression model was used to assess the influence of socio-demographic factors on neonates’ survival. Results A total of 18,139 first and second live births were analyzed. We found neonatal mortality rate of 32 per 1000 live births (95% CI: 29/1000-34/1000). Results from logistic regression model indicated increase in risk of neonatal mortality among neonates those born to young mothers aged 13–19 years compared with those whose mother‘s aged 20–34 years (aOR?=?1.64, 95% CI?=?1.34-2.02). We also found that neonates in second birth order were more likely to die than those in first birth order (aOR?=?1.85: 95% CI?=?1.52-2.26). The risk of neonatal mortality among offspring of women who had a partner co-resident was 18% times lower as compared with offspring of mothers without a partner co-resident in the household (aOR?=?0.82: 95% CI?=?0.66-0.98). Short birth interval (<33 months) was associated with increased risk of neonatal mortality (aOR?=?1.50, 95% CI =1.16-1.96) compared with long birth interval (>?=?33 months). Male born neonates were found to have an increased risk (aOR?=?1.34, 95% CI =1.13- 1.58) of neonatal mortality as compared to their female counterparts. Conclusions Delaying the age at first birth may be a valuable strategy to promote and improve neonatal health and survival. Moreover, birth order, birth interval, mother’s partner co-residence and sex of the neonate appeared as important markers for neonatal survival. PMID:25048353

  18. Association between anaemia during pregnancy and blood loss at and after delivery among women with vaginal births in Pemba Island, Zanzibar, Tanzania.

    PubMed

    Kavle, Justine A; Stoltzfus, Rebecca J; Witter, Frank; Tielsch, James M; Khalfan, Sabra S; Caulfield, Laura E

    2008-06-01

    The study sought to identify determinants of blood loss at childbirth and 24 hours postpartum. The study was nested in a community-based randomized trial of treatments for anaemia during pregnancy in Wete Town, Pemba Island, Zanzibar, United Republic of Tanzania. Status of anaemia during pregnancy, nutritional information, obstetric history, and socioeconomic status were assessed at enrollment during routine antenatal care. Pregnant women presented for spontaneous vaginal delivery, and nurse-midwives collected information on labour and delivery via partograph. Blood-stained sanitary napkins and pads from childbirth and 24 hours postpartum were quantified using the alkaline hematin method. Moderate-to-severe anaemia (Hb <90 g/L) at enrollment was strongly associated with blood loss at delivery and the immediate postpartum period, after adjusting for maternal covariates and variables of biological relevance to blood loss. Greater blood loss was associated (p<0.10) with duration of the first stage of labour, placental weight, receipt of oxytocin, preterm birth, and grand multiparity. The findings provide unique evidence of a previously-suspected link between maternal anaemia and greater blood loss at childbirth and postpartum. Further research is needed to confirm these findings on a larger sample of women to determine whether women with moderate-to-severe anaemia are more likely to experience postpartum haemorrhage and whether appropriate antenatal or peripartum care can affect the relationships described here. PMID:18686556

  19. Factors associated with health facility childbirth in districts of Kenya, Tanzania and Zambia: a population based survey

    PubMed Central

    2014-01-01

    Background Maternal mortality continues to be a heavy burden in low and middle income countries where half of all deliveries take place in homes without skilled attendance. The study aimed to investigate the underlying and proximate determinants of health facility childbirth in rural and urban areas of three districts in Kenya, Tanzania and Zambia. Methods A population-based survey was conducted in 2007 as part of the ‘REsponse to ACcountable priority setting for Trust in health systems’ (REACT) project. Stratified random cluster sampling was used and the data included information on place of delivery and factors that might influence health care seeking behaviour. A total of 1800 women who had childbirth in the previous five years were analysed. The distal and proximate conceptual framework for analysing determinants of maternal mortality was modified for studying factors associated with place of delivery. Socioeconomic position was measured by employing a construct of educational attainment and wealth index. All analyses were stratified by district and urban–rural residence. Results There were substantial inter-district differences in proportion of health facility childbirth. Facility childbirth was 15, 70 and 37% in the rural areas of Malindi, Mbarali and Kapiri Mposhi respectively, and 57, 75 and 77% in the urban areas of the districts respectively. However, striking socio-economic inequities were revealed regardless of district. Furthermore, there were indications that repeated exposure to ANC services and HIV related counselling and testing were positively associated with health facility deliveries. Perceived distance was negatively associated with facility childbirth in rural areas of Malindi and urban areas of Kapiri Mposhi. Conclusion Strong socio-economic inequities in the likelihood of facility childbirths were revealed in all the districts added to geographic inequities in two of the three districts. This strongly suggests an urgent need to strengthen services targeting disadvantaged and remote populations. The finding of a positive association between HIV counselling/testing and odds in favor of giving birth at a health facility suggests potential positive effects can be achieved by strengthening integrated approaches in maternal health service delivery. PMID:24996456

  20. SMS for Life: a pilot project to improve anti-malarial drug supply management in rural Tanzania using standard technology

    PubMed Central

    2010-01-01

    Background Maintaining adequate supplies of anti-malarial medicines at the health facility level in rural sub-Saharan Africa is a major barrier to effective management of the disease. Lack of visibility of anti-malarial stock levels at the health facility level is an important contributor to this problem. Methods A 21-week pilot study, 'SMS for Life', was undertaken during 2009-2010 in three districts of rural Tanzania, involving 129 health facilities. Undertaken through a collaborative partnership of public and private institutions, SMS for Life used mobile telephones, SMS messages and electronic mapping technology to facilitate provision of comprehensive and accurate stock counts from all health facilities to each district management team on a weekly basis. The system covered stocks of the four different dosage packs of artemether-lumefantrine (AL) and quinine injectable. Results Stock count data was provided in 95% of cases, on average. A high response rate (? 93%) was maintained throughout the pilot. The error rate for composition of SMS responses averaged 7.5% throughout the study; almost all errors were corrected and messages re-sent. Data accuracy, based on surveillance visits to health facilities, was 94%. District stock reports were accessed on average once a day. The proportion of health facilities with no stock of one or more anti-malarial medicine (i.e. any of the four dosages of AL or quinine injectable) fell from 78% at week 1 to 26% at week 21. In Lindi Rural district, stock-outs were eliminated by week 8 with virtually no stock-outs thereafter. During the study, AL stocks increased by 64% and quinine stock increased 36% across the three districts. Conclusions The SMS for Life pilot provided visibility of anti-malarial stock levels to support more efficient stock management using simple and widely available SMS technology, via a public-private partnership model that worked highly effectively. The SMS for Life system has the potential to alleviate restricted availability of anti-malarial drugs or other medicines in rural or under-resourced areas. PMID:20979633

  1. Microbicides Development Programme: Engaging the community in the standard of care debate in a vaginal microbicide trial in Mwanza, Tanzania

    PubMed Central

    Vallely, Andrew; Shagi, Charles; Lees, Shelley; Shapiro, Katherine; Masanja, Joseph; Nikolau, Lawi; Kazimoto, Johari; Soteli, Selephina; Moffat, Claire; Changalucha, John; McCormack, Sheena; Hayes, Richard J

    2009-01-01

    Background HIV prevention research in resource-limited countries is associated with a variety of ethical dilemmas. Key amongst these is the question of what constitutes an appropriate standard of health care (SoC) for participants in HIV prevention trials. This paper describes a community-focused approach to develop a locally-appropriate SoC in the context of a phase III vaginal microbicide trial in Mwanza City, northwest Tanzania. Methods A mobile community-based sexual and reproductive health service for women working as informal food vendors or in traditional and modern bars, restaurants, hotels and guesthouses has been established in 10 city wards. Wards were divided into geographical clusters and community representatives elected at cluster and ward level. A city-level Community Advisory Committee (CAC) with representatives from each ward has been established. Workshops and community meetings at ward and city-level have explored project-related concerns using tools adapted from participatory learning and action techniques e.g. chapati diagrams, pair-wise ranking. Secondary stakeholders representing local public-sector and non-governmental health and social care providers have formed a trial Stakeholders' Advisory Group (SAG), which includes two CAC representatives. Results Key recommendations from participatory community workshops, CAC and SAG meetings conducted in the first year of the trial relate to the quality and range of clinic services provided at study clinics as well as broader standard of care issues. Recommendations have included streamlining clinic services to reduce waiting times, expanding services to include the children and spouses of participants and providing care for common local conditions such as malaria. Participants, community representatives and stakeholders felt there was an ethical obligation to ensure effective access to antiretroviral drugs and to provide supportive community-based care for women identified as HIV positive during the trial. This obligation includes ensuring sustainable, post-trial access to these services. Post-trial access to an effective vaginal microbicide was also felt to be a moral imperative. Conclusion Participatory methodologies enabled effective partnerships between researchers, participant representatives and community stakeholders to be developed and facilitated local dialogue and consensus on what constitutes a locally-appropriate standard of care in the context of a vaginal microbicide trial in this setting. Trial registration Current Controlled Trials ISRCTN64716212 PMID:19814830

  2. Ethnomedicine of the Kagera Region, north western Tanzania. Part 3: plants used in traditional medicine in Kikuku village, Muleba District

    PubMed Central

    2012-01-01

    Background The Kagera region of north western Tanzania has a rich culture of traditional medicine use and practice. Traditional medicines are the mainstay of healthcare in this region and are known to support the management of many illnesses such as malaria, bacterial infections, epilepsy, gynecological problems and others. However, most of the plants being used have either not been documented or evaluated for safety and efficacy or both. This study, the sixth of an ongoing series, reports on the medicinal plants that are used at Kikuku village, Muleba District. Methodology A semi-structured questionnaire was used to collect information on the common/local names of the plants, parts of the plants used, diseases treated, methods of preparing the herbal remedies, dosage of the remedies administered, frequency and duration of treatment and toxicity of the medicines. A literature review was carried out for information on the ethnomedical uses of the reported plants. Results A total of 49 plant species belonging to 47 genera and 24 plant families were documented. The family Euphorbiaceae and Asteraceae had the highest representation. The plants are used for the treatment of skin conditions (10 plants; 20%), bacterial infections and wounds (14 plants; 28.6%), malaria (14 plants; 28.6%), gastrointestinal disorders (11 plants; 22.4%), gynecological problems including infertility (8 plants; 16.3%), hypertension (5 plants; 10.2%), viral infections (7 plants; 14.3%), chest problems (5 plants; 10.2%), diabetes (3 plants; 6.1%), cancer (2 plants; 4.1%), inflammatory conditions (arthritis, rheumatism), HIV and AIDS, and hernia each treated by 1 plant (3 plants in total; 6.1%). Information obtained from the literature indicate that 25 (51.0%) of the therapeutic claims are supported by laboratory results or have similar claims of ethnomedical use from other countries. Conclusion Herbal remedies comprise an important and effective component of the healthcare system in Kikuku village with plants in the families Euphorbiaceae and Asteraceae comprising an important part of plants used in the indigenous healthcare management in the village. Malaria and bacterial infections dominate the list of diseases that are managed using traditional medicines. PMID:22472473

  3. Evaluation of Cervical Cancer Screening Programs in Côte d’Ivoire, Guyana, and Tanzania: Effect of HIV Status

    PubMed Central

    Estep, Deb; Besana, Giulia; Kibwana, Sharon; Varallo, John; Sun, Kai; Lu, Enriquito

    2015-01-01

    Background HIV infection increases a woman’s risk for cervical cancer, and cervical cancer incidence and mortality rates are higher in countries with high HIV prevalence and limited resources for screening. Visual inspection with acetic acid (VIA) allows screening and treatment of cervical lesions in a single-visit approach (SVA), but data on its performance in HIV-infected women are limited. This study’s objective was to examine cervical cancer screening using VIA/SVA in programs serving HIV-infected women. Methods A VIA/SVA program with cryotherapy for VIA-positive lesions was implemented in Côte d’Ivoire, Guyana, and Tanzania from 2009 to 2012. The effect of HIV status on VIA positivity and on presence of cryotherapy-eligible lesions was examined using a cross-sectional study design, with Chi-square tests for comparisons and constructed multivariate logistic regression models. A P-value of < 0.05 was significant. Findings VIA was performed on 34,921 women, 10% (3,580) were VIA positive; 2,508 (85%) eligible women received cryotherapy during the same visit; only 234 (52%) of those who postponed returned for treatment; 622 (17%) VIA-positive women had lesions too large to be treated with cryotherapy and were referred for excisional treatment. In multivariate analysis—controlling for HIV status, location of the screening clinic, facility location, facility type, and country—compared to HIV-uninfected/unknown women, HIV-infected women had higher odds of being VIA positive (OR 1.95, 95% CI 1.76, 2.16, P<0.0001) and of having large lesions requiring referral (OR 1.93, 95% CI 1.49, 2.51, P< 0.0001). Minor treatment complications occurred in 19 of 3,032 (0.63%) women; none required further intervention. Conclusions This study found that compared to HIV-uninfected/unknown women, HIV-infected women had nearly twice the odds of being VIA-positive and to require referral for large lesions. SVA was safe and resulted in significant reductions in loss to follow-up. There is increased need for excisional treatment in countries with high HIV prevalence. PMID:26405784

  4. Predominant Leptospiral Serogroups Circulating among Humans, Livestock and Wildlife in Katavi-Rukwa Ecosystem, Tanzania

    PubMed Central

    Assenga, Justine A.; Matemba, Lucas E.; Muller, Shabani K.; Mhamphi, Ginethon G.; Kazwala, Rudovick R.

    2015-01-01

    Background Leptospirosis is a worldwide zoonotic disease and a serious, under-reported public health problem, particularly in rural areas of Tanzania. In the Katavi-Rukwa ecosystem, humans, livestock and wildlife live in close proximity, which exposes them to the risk of a number of zoonotic infectious diseases, including leptospirosis. Methodology/Principal Findings A cross-sectional epidemiological study was carried out in the Katavi region, South-west Tanzania, to determine the seroprevalence of Leptospira spp in humans, domestic ruminants and wildlife. Blood samples were collected from humans (n = 267), cattle (n = 1,103), goats (n = 248), buffaloes (n = 38), zebra (n = 2), lions (n = 2), rodents (n = 207) and shrews (n = 11). Decanted sera were tested using the Microscopic Agglutination Test (MAT) for antibodies against six live serogroups belonging to the Leptospira spp, with a cutoff point of ? 1:160. The prevalence of leptospiral antibodies was 29.96% in humans, 30.37% in cattle, 8.47% in goats, 28.95% in buffaloes, 20.29% in rodents and 9.09% in shrews. Additionally, one of the two samples in lions was seropositive. A significant difference in the prevalence P<0.05 was observed between cattle and goats. No significant difference in prevalence was observed with respect to age and sex in humans or any of the sampled animal species. The most prevalent serogroups with antibodies of Leptospira spp were Sejroe, Hebdomadis, Grippotyphosa, Icterohaemorrhagie and Australis, which were detected in humans, cattle, goats and buffaloes; Sejroe and Grippotyphosa, which were detected in a lion; Australis, Icterohaemorrhagie and Grippotyphosa, which were detected in rodents; and Australis, which was detected in shrews. Antibodies to serogroup Ballum were detected only in humans. Conclusions The results of this study demonstrate that leptospiral antibodies are widely prevalent in humans, livestock and wildlife from the Katavi-Rukwa ecosystem. The disease poses a serious economic and public health threat in the study area. This epidemiological study provides information on circulating serogroups, which will be essential in designing intervention measures to reduce the risk of disease transmission. PMID:25806825

  5. Cervical cancer screening and HPV vaccine acceptability among rural and urban women in Kilimanjaro Region, Tanzania

    PubMed Central

    Cunningham, Melissa S; Skrastins, Emily; Fitzpatrick, Ryan; Jindal, Priya; Oneko, Olola; Yeates, Karen; Booth, Christopher M; Carpenter, Jennifer; Aronson, Kristan J

    2015-01-01

    Objective To determine cervical cancer screening coverage and the knowledge, attitudes and barriers toward screening tests among women in rural and urban areas of Tanzania, as well as explore how they view the acceptability of the HPV vaccine and potential barriers to vaccination. Setting A cross-sectional study using interview-administered questionnaires was conducted using multistage random sampling within urban and rural areas in Kilimanjaro Region, Tanzania. Participants Women aged 18–55 were asked to participate in the survey. The overall response rate was 97.5%, with a final sample of 303 rural and 272 urban dwelling women. Primary and secondary outcome measures Descriptive and simple test statistics were used to compare across rural and urban strata. Multivariate logistic regression models were used to estimate ORs and 95% CIs. Results Most women (82%) reported they had heard of cervical cancer, while self-reported cervical cancer screening among women was very low (6%). In urban areas, factors associated with screening were: older age (OR=4.14, 95% CI 1.86 to 9.24 for ages 40–49, and OR=8.38, 95% CI 2.10 to 33.4 for >50?years), having health insurance (OR=4.15, 95% CI 1.52 to 11.4), and having knowledge about cervical cancer (OR=5.81, 95% CI 1.58 to 21.4). In contrast, among women residing in rural areas, only condom use (OR=6.44, 95% CI 1.12 to 37.1) was associated with screening. Women from both rural and urban areas had low vaccine-related knowledge; however, most indicated they would be highly accepting if it were readily available (93%). Conclusions The current proportion of women screened for cervical cancer is very low in Kilimanjaro Region, and our study has identified several modifiable factors that could be addressed to increase screening rates. Although best implemented concurrently, the availability of prophylactic vaccination for girls may provide an effective means of prevention if they are unable to access screening in the future. PMID:25757944

  6. Prevalence of sexually transmitted infections among women attending antenatal clinics in Tanga, north eastern Tanzania.

    PubMed

    Chiduo, M; Theilgaard, Z P; Bakari, V; Mtatifikolo, F; Bygbjerg, I; Flanholc, L; Gerstoft, J; Christiansen, C B; Lemnge, M; Katzenstein, T L

    2012-05-01

    This study aimed to determine the prevalence of sexually transmitted infections (STIs) among HIV-infected and uninfected pregnant women in Tanga, Tanzania. Retrospective data on syphilis and HIV status during 2008-2010 were collected from antenatal clinic (ANC) records. Prospective data were collected from HIV-infected (n = 105) and HIV-uninfected pregnant women (n = 100) attending ANCs between April 2009 and August 2010. Syphilis prevalence showed a declining trend (3.1%, 1.4% and 1.3%), while HIV prevalence was stable (6.1%, 6.4% and 5.4%) during 2008-2010. HIV-infected women had significantly higher prevalence of trichomoniasis (18.8% versus 5.0%; P < 0.003) and candidiasis (16.5% versus 2.0%; P < 0.001) while the higher rate of gonorrhoea (3.5% versus 0%; P = 0.095) was not statistically significant when compared with HIV-uninfected women. There were no statistically significant differences in prevalence of chlamydial infection (0% versus 3.0%; P = 0.156) or syphilis (2.4% versus 3.0%; P = 1) between HIV-infected and uninfected women. Other STIs were common in both HIV-infected and uninfected pregnant women. PMID:22648885

  7. Preliminary small mammal taphonomy of FLK NW level 20 (Olduvai Gorge, Tanzania)

    NASA Astrophysics Data System (ADS)

    Arcos, Saleta; Sevilla, Paloma; Fernández-Jalvo, Yolanda

    2010-11-01

    The Bed-I series of Olduvai Gorge (Tanzania) is a reference site in human evolution, having yielded the holotypes of Paranthropus boisei and Homo habilis, together with manufactured artefacts and abundant large and micro-fauna. Excavations in Olduvai Gorge have been recently resumed, with new aims and new results. This paper presents the results of the taphonomic analysis carried out on a fossil small-mammal assemblage recovered from FLK NW level 20, a layer overlying Tuff C, dated from 1.84 Ma. The analysis provides good evidence of a category 1 predator, most likely a barn owl, as the predator of the bone assemblage. Trampling and sediment compression might influence postdepositional breakage of the bones. This study is especially relevant since previous taphonomic analyses carried out at levels above and below this sample led to inconclusive results due to a low number of fossils ( Fernández-Jalvo et al., 1998). The new sample provides new information to reconstruct the paleoenvironmental context in which early hominins inhabited.

  8. Soil erosion history in central Tanzania based on OSL dating of colluvial and alluvial hillslope deposits

    NASA Astrophysics Data System (ADS)

    Eriksson, M. G.; Olley, J. M.; Payton, R. W.

    2000-12-01

    The Irangi Hills in Kondoa District, central Tanzania, are severely degraded by sheet, rill and gully erosion. Using recently developed optically stimulated luminescence (OSL) dating techniques, and a detailed study of the hillslope stratigraphy and soils, we have determined the sequence of events that gave rise to this highly degraded landscape. Two major colluvial deposits have been identified on the slopes. The oldest colluvium gave OSL deposition dates of 14,700±1600, 14,200±1500 and 11,400±1300 years ago. These dates coincide with the climatic change from dry to wet conditions, which took place during the Late Pleistocene. It is possible that the erosion and deposition of the old colluvium occurred as a response to this change. This phase of erosion and deposition was followed by a long phase of stability and pedogenetic alteration of the old colluvium. A phase of accelerated soil erosion began not later than 900 years ago, as indicated by a dated alluvial fan, the presence of which indicates that some deeper gullies already existed on upper pediment slopes at that time. The second, more recent colluvial deposit gave OSL dates of 460±40, 590±70 and 660±50 years. A major period of gully formation and incision, with subsequent fan development, occurred sometime between 600 and 300 years ago. The recent phase of erosion (<1000 years), which is still continuing, is probably a result of the introduction and/or intensification of agriculture, livestock husbandry and iron smelting practices in the Irangi Hills.

  9. Factors determining the choice of hunting and trading bushmeat in the Kilombero Valley, Tanzania.

    PubMed

    Nielsen, Martin Reinhardt; Jacobsen, Jette Bredahl; Thorsen, Bo Jellesmark

    2014-04-01

    Regulation of illegal bushmeat trade is a major conservation challenge in Africa. We investigated what factors are most likely to induce actors in the bushmeat trade to shift to an alternative occupation by conducting a choice experiment with 325 actors in the bushmeat trade in the Kilombero Valley, Tanzania. Specifically, we asked respondents to choose between hunting or trading bushmeat and alternative salary-paying work, in a set of hypothetical scenarios where the attributes of these alternatives were varied and included measures of command and control, price of substitute meat, daily salary in the work option, and whether or not cows were donated to the respondent. We modeled the choice contingent on socioeconomic characteristics. The magnitude of fines and patrolling frequency had a significant but very low negative effect on the probability of choosing to engage in hunting or trading bushmeat compared with the salary of an alternative occupation. Donation of livestock and the price of substitute meats in the local market both affected the choice significantly in a negative and a positive direction, respectively. The wealthier a household was the more likely the respondent was to choose to continue hunting or trading bushmeat. On the margin, our results suggest that given current conditions in the Kilombero Valley on any given day 90% of the respondents would choose salary work at US$3.37/day over their activities in the bushmeat trade, all else equal. PMID:24372874

  10. Results from intercropping fast-growing trees and food crops at Morogoro, Tanzania

    SciTech Connect

    Redhead, J.F.

    1992-12-31

    In Morogoro, Tanzania, agroforestry trials were set up to investigate intercropping with primarily eucalypt species. The climate in the region is very similar to Kolar, Karnataka State, India. Three crops-sorghum, bean and maize-were grown annually under Eucalyptus tereticornis at 2.5 m x 2.5 m for three years with a range of weeding practices. Plots that were intercropped with beans showed best results. Shading by the eucalypts after three years resulted in negligible crop yields in all treatments. Three tree spacings of E. camaldulensis (3 m x 3 m, 4 m x 4 m, and 5 m x 5 m) were combined with the intercropping of beans and maize. Beans gave satisfactory yields at all spacings, but the maize showed significantly depressed yields at 3 m x 3 m at 4 m x 4 m, but was similar to pure maize crop at 5 m x 5 m spacing. Overall the extra revenue from a food crop in the first and second year of tree growth increases the return from the land. The short rotation of fast growing trees depleted the soil of nutrients and, as with other crops, the fertility would have to be maintained by applying fertilizer.

  11. Ecological and social outcomes of a new protected area in Tanzania.

    PubMed

    Hall, Jaclyn M; Burgess, Neil D; Rantala, Salla; Vihemäki, Heini; Jambiya, George; Gereau, Roy E; Makonda, Fortunatus; Njilima, Fadhili; Sumbi, Peter; Kizaji, Adam

    2014-12-01

    Balancing ecological and social outcomes of conservation actions is recognized in global conservation policy but is challenging in practice. Compensation to land owners or users for foregone assets has been proposed by economists as an efficient way to mitigate negative social impacts of human displacement from protected areas. Joint empirical assessments of the conservation and social impacts of protected area establishment involving compensation payments are scarce. We synthesized social and biological studies related to the establishment of the Derema forest corridor in Tanzania's biodiverse East Usambara Mountains. This lengthy conservation process involved the appropriation of approximately 960 ha of native canopy agroforest and steep slopes for the corridor and monetary compensation to more than 1100 claimants in the surrounding villages. The overarching goals from the outset were to conserve ecological processes while doing no harm to the local communities. We evaluated whether these goals were achieved by analyzing 3 indicators of success: enhancement of forest connectivity, improvement of forest condition, and mitigation of negative impacts on local people's livelihoods. Indicators of forest connectivity and conditions were enhanced through reductions of forest loss and exotic species and increases in native species and canopy closure. Despite great efforts by national and international organizations, the intervention failed to mitigate livelihood losses especially among the poorest people. The Derema case illustrates the challenges of designing and implementing compensation schemes for conservation-related displacement of people. PMID:25046979

  12. The impact of structural adjustment policies on women's and children's health in Tanzania.

    PubMed

    Lugalla, J L

    1995-03-01

    Since 1981, the government of Tanzania has adopted a variety of policy measures including the National Economic Survival Plan (NESP), Structural Adjustment Program (SAP), Economic Recovery Program (ERP) I, ERP II, Economic and Social Action Plan (ESAP), and Priority Social Action Plan (PSAP) to deal with the country's present social and economic crisis dating back to the late 1970s. The main objective of the these adjustment measures has been to attain macroeconomic balance by bringing national expenditure into line with national income to reduce inflation and to increase exports. Other objectives have been to maintain egalitarian income distribution and the provision of basic social services to the majority of the population. To realize these objectives, the government has been controlling credit and removed subsidies on certain food items and agricultural inputs, introduced a system of progressive devaluation, liberalized trade, and has been trying to reduce government expenditure by introducing cost sharing measures in the education and health sector. The author concludes that the erosion of real incomes and increased poverty have had a devastating effect upon women and children. Rural women have heavier workloads as males migrate to urban areas in search of work, there is increased maternal mortality, and chronic malnutrition and poverty make it difficult to implement HIV/AIDS intervention strategies. PMID:12290679

  13. Community environments shaping transactional sex among sexually active men in Malawi, Nigeria, and Tanzania.

    PubMed

    Stephenson, Rob; Winter, Amy; Elfstrom, Miriam

    2013-01-01

    Transactional sex, or the exchange of sex for material goods or money, is a risky sexual behavior that has been linked to HIV/AIDS and gender-based violence. Throughout sub-Saharan Africa, transactional sex remains a common practice, putting men and women at risk of HIV. However, little is known of how community environments shape men's participation in risky transactional sex. This analysis examines community-level influences on participation in risky transactional sex among sexually active men in three African countries (Malawi, Tanzania, and Nigeria). The analysis uses Demographic and Health Survey (DHS) data to examine the association between men's report of risky transactional sex and community characteristics including economic, gender norms, HIV behavior and knowledge, and demographic factors. The results show that men residing in communities with more female education and later age of first birth are less likely to report risky transactional sex, while men who live in communities where men report higher number of sexual partners are more likely to report risky transactional sex. While programmatic interventions should continue to improve women's status individually and relative to men, such efforts should be extended to recognize that many community and cultural influences also affect men's sexual behavior. Programs that understand, discuss, and challenge community factors that influence men's sexual behavior may be able to provide a more effective intervention resulting in opportunities for communities to initiate behavioral change. PMID:23215551

  14. Grips and hand movements of chimpanzees during feeding in Mahale Mountains National Park, Tanzania.

    PubMed

    Marzke, Mary W; Marchant, Linda F; McGrew, William C; Reece, Sandra P

    2015-03-01

    It has long been assumed that stone tool making was a major factor in the evolution of derived hominin hand morphology. However, stresses on the hand associated with food retrieval and processing also have been recognized as relevant early hominin behaviors that should be investigated. To this end, chimpanzee food manipulation was videotaped in the Mahale Mountains National Park, Tanzania. Grips and hand movements by 39 chimpanzees were analyzed for arboreal and terrestrial feeding involving 10 food-types and associated vegetation. It was predicted that (1) new grips would be found that had not been observed in captivity, (2) forceful precision grips would be absent from the repertoire, as in captivity, and (3) precision handling would be observed. New grips involving the full thumb and buttressed index finger, and a new integrated pattern of grips and forceful hand movements were discovered, associated with feeding on large fruits and meat. Participation of the full thumb in these grips, rather than the distal thumb and fingers, throws light on feeding behaviors that may have become increasingly significant factors in the evolution of derived hominin thumb morphology. The proximal thumb stabilizes food with the flexed index finger against the pull of the teeth and provides leverage in breaking food into portions. Isolated qualitative observations of possibly forceful pinch by the thumb and side of the index finger highlight the need for comparative quantitative data to test whether humans are unique in forceful precision gripping capability. Precision handling was not seen. PMID:25363236

  15. Breeding biology of an afrotropical forest understory bird community in northeastern Tanzania

    USGS Publications Warehouse

    Mkongewa, Victor J.; Newmark, William D.; Stanley, Thomas R.

    2013-01-01

    Many aspects of the breeding biology of Afrotropical forest birds are poorly known. Here we provide a description based on the monitoring of 1461 active nests over eight breeding seasons about one or more aspects of the breeding biology for 28 coexisting understory bird species on the Amani Plateau in the East Usambara Mountains, Tanzania. Mean nest height and mean distance of nest from forest edge varied widely among species with most species constructing nests across a broad vertical and forest edge to interior gradient. However, there were important exceptions with all sunbird species and several dove and waxbill species constructing nests in close proximity to the forest edge. For 17 common species for which we recorded two or more active nests, mean clutch size across species was 1.9 eggs per clutch, the lowest site-specific mean clutch size yet reported for a tropical forest bird community. For nine bird species, a subset of the 17 common species, length of breeding season, defined as the difference between the earliest and latest recorded incubation onset date, ranged from 88–139 days. Most of these nine species displayed a unimodal distribution in incubation onset dates across a breeding season which extended from the end of August through middle January. In summary, a wide variation exists in most aspects of the breeding biology within an understory forest bird community in the East Usambara Mountains.

  16. Diversity and host specificity of Blastocystis in syntopic primates on Rubondo Island, Tanzania.

    PubMed

    Petrášová, J; Uzlíková, M; Kostka, M; Petrželková, K J; Huffman, M A; Modrý, D

    2011-09-01

    The isolated ecosystem of Rubondo Island National Park, Tanzania is an interesting model site, inhabited by an assembly of primate species with various histories: two introduced primate species, Pantroglodytes (chimpanzee) and Colobus guereza (colobus), and a single indigenous species Chlorocebus aethiops pygerythrus (vervet monkey). Apart from important lessons for future introduction/re-introduction projects, Rubondo National Park offers a unique place to study the patterns of transmission of primate parasites and their host specificity. Blastocystis was detected using standard microscopy, together with PCR-based determination and the prevalence and subtype identification of Blastocystis was determined in each primate species. Subtype (ST) 1 was detected in all three Rubondo primate populations; ST2, ST3 and ST5 were found in colobus and vervet monkeys. All chimpanzee isolates of Blastocystis belonged exclusively to ST1, which formed a discrete group, suggesting that Rubondo chimpanzees are colonized by a single, host-specific Blastocystis strain that circulates among the members of the group. Phylogenetic analysis indicated that transmission of Blastocystis did not occur between Rubondo primate populations. Observed host specificity of Blastocystis provides a new understanding of the transmission and distribution of Blastocystis among sympatric hosts under natural conditions. PMID:21854778

  17. Abundance and Spatial Dispersion of Rice Stem Borer Species in Kahama, Tanzania.

    PubMed

    Leonard, Alfonce; Rwegasira, Gration M

    2015-01-01

    Species diversity, abundance, and dispersion of rice stem borers in framer's fields were studied in four major rice growing areas of Kahama District. Stem borer larvae were extracted from the damaged tillers in 16 quadrants established in each field. Adult Moths were trapped by light traps and collected in vials for identification. Results indicated the presence of Chilo partellus, Maliarpha separatella, and Sesamia calamistis in all study areas. The most abundant species was C. partellus (48.6%) followed by M. separatella (35.4%) and S. calamistis was least abundant (16.1%). Stem borers dispersion was aggregated along the edges of rice fields in three locations (wards) namely: Bulige, Chela, and Ngaya. The dispersion in the fourth ward, Kashishi was uniform as established from two of the three dispersion indices tested. Further studies would be required to establish the available alternative hosts, the extent of economic losses and the distribution of rice stem borers in the rest of the Lake zone of Tanzania. PMID:26411785

  18. Fossil legumes from the Middle Eocene (46.0 Ma) Mahenge Flora of Singida, Tanzania.

    PubMed

    Herendeen, P S; Jacobs, B F

    2000-09-01

    Middle Eocene age caesalpinioid and mimosoid legume leaves are reported from the Mahenge site in north-central Tanzania. The Mahenge flora complements a sparse Paleogene tropical African fossil plant record, which until now consisted of a single macrobotanical assemblage, limited palynological studies in West Africa and Egypt, and fossil wood studies primarily from poorly dated deposits. Mahenge leaf macrofossils have the potential to add significantly to what is known of the evolutionary history of extant African plant groups and to expand our currently limited knowledge of African Paleogene environments. The site is associated with a kimberlite eruption and demonstrates the potential value of kimberlite-associated lake deposits as much-needed resources for African Paleogene floras. In this report we document a relatively diverse component of the flora consisting of the leaves of at least five species of Leguminosae. A new species of the extant genus Acacia (Mimosoideae), described herein, is represented by a bipinnate leaf. Another taxon is described as a new species of the extant genus Aphanocalyx (Caesalpinioideae), and a third leaf type may be related to the extant genus Cynometra (Caesalpinioideae). Two additional leaf types are less well understood: one appears to be referable to the Caesalpinioideae and subfamily affinities of the other taxon are unknown. PMID:10991905

  19. A Hepatozoon species genetically distinct from H. canis infecting spotted hyenas in the Serengeti ecosystem, Tanzania.

    PubMed

    East, Marion L; Wibbelt, Gudrun; Lieckfeldt, Dietmar; Ludwig, Arne; Goller, Katja; Wilhelm, Kerstin; Schares, Gereon; Thierer, Dagmar; Hofer, Heribert

    2008-01-01

    Health monitoring of spotted hyenas (Crocuta crocuta) in the Serengeti ecosystem, Tanzania, revealed Hepatozoon infection in all of 11 immature individuals examined following death from natural causes. Hepatozoon infection was probably an important factor contributing to mortality in two cases that exhibited clinical signs of ataxia, lethargy, ocular discharge, retching, and labored breathing before death. Whether Hepatozoon infection contributed to six deaths from fire, probable lion predation and unknown causes could not be determined. Four deaths from infanticide and starvation were unlikely to be associated with Hepatozoon infection. Histologic examination revealed lung tissue infected with cyst-like structures containing protozoan stages in all eight cases examined and interstitial pneumonia in most cases. Systemic spread of infection to several organs was found in three cases. Alignment of a 426 bp sequence from the parasite's 18s rRNA gene revealed a Hepatozoon species identical to that recently described from two domestic cats in Spain and only 7 bp substitutions when a 853 bp sequence was aligned to this cat Hepatozoon species. Previous reports of infection of wild carnivores in eastern and southern Africa with an unspecified Hepatozoon species similar in appearance to H. canis may have involved the species described in this study. PMID:18263820

  20. Acceptability of azithromycin for the control of trachoma in Northern Tanzania.

    PubMed

    Desmond, Nicola; Solomon, Anthony W; Massae, Patrick A; Lema, Ndeeshi; Anemona, Alessandra; Foster, Allen; Mabey, David C W

    2005-09-01

    Trachoma causes blindness; the prevention strategy includes mass antibiotic treatment. In a community in Northern Tanzania offered mass treatment with azithromycin for the control of trachoma, we used focus group discussions, individual interviews, questionnaires and direct observation to quantify, explore and contextualize reasons for acceptance or refusal of the drug. In the village studied, 76% of the population eligible to receive azithromycin were treated. Uptake was significantly higher among women (79% treated) than men (72%). Factors affecting acceptability included: local prevention norms (such as the belief that injections, rather than oral medicine, should be used for prevention); perceptions of drugs in general and azithromycin in particular; perceptions of the distribution team's expertise; witnessing adverse effects in others; and the timing, quality and quantity of information about azithromycin and its availability. Familiarity with trachoma as a blinding disease was significantly associated with uptake. Individuals who refused treatment seemed to be less altruistic than other respondents. Neither socio-economic status nor use of traditional healers was related to uptake. Pre-distribution community assessment and community education, advance notice of the distribution, standardized distribution guidelines and improved distributor training are recommended to maximize acceptance of azithromycin in future campaigns. PMID:15979657

  1. Abundance and Spatial Dispersion of Rice Stem Borer Species in Kahama, Tanzania

    PubMed Central

    Leonard, Alfonce; Rwegasira, Gration M.

    2015-01-01

    Species diversity, abundance, and dispersion of rice stem borers in framer’s fields were studied in four major rice growing areas of Kahama District. Stem borer larvae were extracted from the damaged tillers in 16 quadrants established in each field. Adult Moths were trapped by light traps and collected in vials for identification. Results indicated the presence of Chilo partellus, Maliarpha separatella, and Sesamia calamistis in all study areas. The most abundant species was C. partellus (48.6%) followed by M. separatella (35.4%) and S. calamistis was least abundant (16.1%). Stem borers dispersion was aggregated along the edges of rice fields in three locations (wards) namely: Bulige, Chela, and Ngaya. The dispersion in the fourth ward, Kashishi was uniform as established from two of the three dispersion indices tested. Further studies would be required to establish the available alternative hosts, the extent of economic losses and the distribution of rice stem borers in the rest of the Lake zone of Tanzania. PMID:26411785

  2. Can mobile phones help control neglected tropical diseases? Experiences from Tanzania.

    PubMed

    Madon, Shirin; Amaguru, Jackline Olanya; Malecela, Mwele Ntuli; Michael, Edwin

    2014-02-01

    The increasing proliferation of mobiles offers possibilities for improving health systems in developing countries. A case in point is Tanzania which has piloted a mobile phone-based Management Information System (MIS) for the control of neglected tropical diseases (NTDs) where village health workers (VHWs) were given mobile phones with web-based software to test the feasibility of using frontline health workers to capture data at point of source. Based on qualitative case study research carried out in 2011, we found that providing mobile phones to VHWs has helped to increase the efficiency of routine work boosting the motivation and self-esteem of VHWs. However, despite these advantages, the information generated from the mobile phone-based NTD MIS has yet to be used to support decentralised decision-making. Even with improved technology and political will, the biggest hindrance to local usage of information for health planning is the lack of synthesised and analysed health information from the district and national levels to the villages. Without inculcating a culture of providing health information feedback to frontline workers and community organisations, the benefits of the intervention will be limited. If not addressed, this will mean that mobiles have maintained the one-way upward flow of information for NTD control and simply made reporting more hi-tech. PMID:24565147

  3. Structure and kinematics of the Livingstone Mountains border fault zone, Nyasa (Malawi) Rift, southwestern Tanzania

    NASA Astrophysics Data System (ADS)

    Wheeler, Walter H.; Karson, Jeffrey A.

    Reconnaissance mapping of the Livingstone Mountains border fault zone (LMBFZ) at the northern end of the Nyasa (Malawi) Rift in SW Tanzania constrains the geometry and movement history of this typical rift border fault. The fault is a narrow zone of complex brittle deformation, striking 320°, that overprints and reactivates an older ductile shear zone. Long, straight, NW-trending border fault segments are offset by minor NE-trending faults. These two orthogonal fault sets integrate along strike to produce an overall curved fault trace that is concave towards a major depositional basin in the rift. A typical section through the fault zone shows an E to W progression from gneissic country rock through ductilely deformed country rock, into a zone overprinted by closely spaced fractures and grading into an intensely fractured, massive, flinty, aphanitic mylonite band at the lakeshore. Pseudotachylite veins, probably generated during seismic movement on the border fault, are common within and near the aphanitic mylonite. Slickensides indicate dextral oblique-slip, whereas shear belts and rolled porphyroclasts with complex tails in the older ductile shear zone indicate sub-horizontal sinistral motion. The adjacent rift basin is typical of other East African Rift Basins, and contains at least 4 km of Recent to perhaps Mesozoic sediment. Whereas the minimum net slip on the LMBFZ, in the dominant slickenside direction, is on the order of 10 km, regional geologic considerations suggest that dominantly strike-slip motion preceded the oblique-slip phase that produced the LMBFZ and the adjacent rift basin.

  4. The Malagarasi River Does Not Form an Absolute Barrier to Chimpanzee Movement in Western Tanzania

    PubMed Central

    Piel, Alex K.; Stewart, Fiona A.; Pintea, Lilian; Li, Yingying; Ramirez, Miguel A.; Loy, Dorothy E.; Crystal, Patricia A.; Learn, Gerald H.; Knapp, Leslie A.; Sharp, Paul M.; Hahn, Beatrice H.

    2013-01-01

    The Malagarasi River has long been thought to be a barrier to chimpanzee movements in western Tanzania. This potential geographic boundary could affect chimpanzee ranging behavior, population connectivity and pathogen transmission, and thus has implications for conservation strategies and government policy. Indeed, based on mitochondrial DNA sequence comparisons it was recently argued that chimpanzees from communities to the north and to the south of the Malagarasi are surprisingly distantly related, suggesting that the river prevents gene flow. To investigate this, we conducted a survey along the Malagarasi River. We found a ford comprised of rocks that researchers could cross on foot. On a trail leading to this ford, we collected 13 fresh fecal samples containing chimpanzee DNA, two of which tested positive for SIVcpz. We also found chimpanzee feces within the riverbed. Taken together, this evidence suggests that the Malagarasi River is not an absolute barrier to chimpanzee movements and communities from the areas to the north and south should be considered a single population. These results have important consequences for our understanding of gene flow, disease dynamics and conservation management. PMID:23536841

  5. Taenia hydatigena cysticercosis in slaughtered pigs, goats, and sheep in Tanzania.

    PubMed

    Braae, Uffe Christian; Kabululu, Mwemezi; Nørmark, Michelle Elisabeth; Nejsum, Peter; Ngowi, Helena Aminel; Johansen, Maria Vang

    2015-12-01

    Few studies have been carried out in Africa to estimate the prevalence of Taenia hydatigena. With the aim to determine the prevalence of T. hydatigena in slaughtered pigs and small ruminants (goats and sheep) in Mbeya, Tanzania, two cross-sectional surveys were carried out investigating pigs in April to May 2014 and small ruminants in September 2012. In total, 243 pigs were examined post-mortem for T. hydatigena cysts which were found in 16 (6.6 %) pigs. The majority (80 %) of cysts were found on the omentum and the rest on the liver (20 %), all on the visceral surface. Two pigs were also found infected with Taenia solium but showed no signs of other infections. A total of 392 goats and 27 sheep were examined post-mortem, and the prevalence of T. hydatigena was similar in goats and sheep with 45.7 and 51.9 %, respectively. DNA sequencing of the mitochondrial cytochrome c oxidase subunit 1 gene (cox1) from a subsample of metacestodes from goats and sheep confirmed the T. hydatigena infection. The prevalence found in small ruminants was comparable to other studies conducted in Africa, but for pigs, it is one of the highest recorded to date. The present study also confirms the occurrence of T. hydatigena and T. solium in pigs from Mbeya. Further studies are needed to determine the impact of T. hydatigena on production under sub-Saharan conditions and the financial consequences for smallholder farmers. PMID:26210397

  6. A New Horned Crocodile from the Plio-Pleistocene Hominid Sites at Olduvai Gorge, Tanzania

    PubMed Central

    Brochu, Christopher A.; Njau, Jackson; Blumenschine, Robert J.; Densmore, Llewellyn D.

    2010-01-01

    Background The fossil record reveals surprising crocodile diversity in the Neogene of Africa, but relationships with their living relatives and the biogeographic origins of the modern African crocodylian fauna are poorly understood. A Plio-Pleistocene crocodile from Olduvai Gorge, Tanzania, represents a new extinct species and shows that high crocodylian diversity in Africa persisted after the Miocene. It had prominent triangular “horns” over the ears and a relatively deep snout, these resemble those of the recently extinct Malagasy crocodile Voay robustus, but the new species lacks features found among osteolaemines and shares derived similarities with living species of Crocodylus. Methodology/Principal Findings The holotype consists of a partial skull and skeleton and was collected on the surface between two tuffs dated to approximately 1.84 million years (Ma), in the same interval near the type localities for the hominids Homo habilis and Australopithecus boisei. It was compared with previously-collected material from Olduvai Gorge referable to the same species. Phylogenetic analysis places the new form within or adjacent to crown Crocodylus. Conclusions/Significance The new crocodile species was the largest predator encountered by our ancestors at Olduvai Gorge, as indicated by hominid specimens preserving crocodile bite marks from these sites. The new species also reinforces the emerging view of high crocodylian diversity throughout the Neogene, and it represents one of the few extinct species referable to crown genus Crocodylus. PMID:20195356

  7. Whale sharks target dense prey patches of sergestid shrimp off Tanzania

    PubMed Central

    Rohner, Christoph A.; Armstrong, Amelia J.; Pierce, Simon J.; Prebble, Clare E. M.; Cagua, E. Fernando; Cochran, Jesse E. M.; Berumen, Michael L.; Richardson, Anthony J.

    2015-01-01

    Large planktivores require high-density prey patches to make feeding energetically viable. This is a major challenge for species living in tropical and subtropical seas, such as whale sharks Rhincodon typus. Here, we characterize zooplankton biomass, size structure and taxonomic composition from whale shark feeding events and background samples at Mafia Island, Tanzania. The majority of whale sharks were feeding (73%, 380 of 524 observations), with the most common behaviour being active surface feeding (87%). We used 20 samples collected from immediately adjacent to feeding sharks and an additional 202 background samples for comparison to show that plankton biomass was ?10 times higher in patches where whale sharks were feeding (25 vs. 2.6 mg m?3). Taxonomic analyses of samples showed that the large sergestid Lucifer hanseni (?10 mm) dominated while sharks were feeding, accounting for ?50% of identified items, while copepods (<2 mm) dominated background samples. The size structure was skewed towards larger animals representative of L.hanseni in feeding samples. Thus, whale sharks at Mafia Island target patches of dense, large, zooplankton dominated by sergestids. Large planktivores, such as whale sharks, which generally inhabit warm oligotrophic waters, aggregate in areas where they can feed on dense prey to obtain sufficient energy. PMID:25814777

  8. Laboratory studies on Yersinia pestis during the 1991 outbreak of plague in Lushoto, Tanzania.

    PubMed

    Lyamuya, E F; Nyanda, P; Mohammedali, H; Mhalu, F S

    1992-10-01

    Thirty-one specimens from patients involved in an outbreak of plague were cultured. Suspicious isolates were presumptively identified by colonial characteristics, simple strains and by API 20E, and confirmed by inoculation into white mice. Antimicrobial susceptibility testing was also done. The isolation rate of Y. pestis was 22.6%. All isolates were uniformly sensitive to tetracycline, streptomycin, sulphadimidine and chloramphenicol; moderately sensitive to erythromycin, and resistant to trimethoprim. Y. pestis was confirmed as a cause of the epidemic and sensitivity of Y. pestis to the four antimicrobial agents used was demonstrated. It is recommended that laboratories in zonal hospitals serving areas with plague foci should be provided with facilities for isolation and preliminary identification of Y. pestis in order to speed up diagnosis of plague outbreaks. Confirmation of the identity, biotyping and antibiotic susceptibility testing should be undertaken in a well established national reference laboratory. This appears to be the first publication on bacteriological investigations of human plague in Tanzania. PMID:1404556

  9. Effects of land use on plague (Yersinia pestis) activity in rodents in Tanzania.

    PubMed

    McCauley, Douglas J; Salkeld, Daniel J; Young, Hillary S; Makundi, Rhodes; Dirzo, Rodolfo; Eckerlin, Ralph P; Lambin, Eric F; Gaffikin, Lynne; Barry, Michele; Helgen, Kristofer M

    2015-04-01

    Understanding the effects of land-use change on zoonotic disease risk is a pressing global health concern. Here, we compare prevalence of Yersinia pestis, the etiologic agent of plague, in rodents across two land-use types-agricultural and conserved-in northern Tanzania. Estimated abundance of seropositive rodents nearly doubled in agricultural sites compared with conserved sites. This relationship between land-use type and abundance of seropositive rodents is likely mediated by changes in rodent and flea community composition, particularly via an increase in the abundance of the commensal species, Mastomys natalensis, in agricultural habitats. There was mixed support for rodent species diversity negatively impacting Y. pestis seroprevalence. Together, these results suggest that land-use change could affect the risk of local transmission of plague, and raise critical questions about transmission dynamics at the interface of conserved and agricultural habitats. These findings emphasize the importance of understanding disease ecology in the context of rapidly proceeding landscape change. PMID:25711606

  10. Challenges to the implementation of health sector decentralization in Tanzania: experiences from Kongwa district council

    PubMed Central

    Frumence, Gasto; Nyamhanga, Tumaini; Mwangu, Mughwira; Hurtig, Anna-Karin

    2013-01-01

    Background During the 1990s, the government of Tanzania introduced the decentralization by devolution (D by D) approach involving the transfer of functions, power and authority from the centre to the local government authorities (LGAs) to improve the delivery of public goods and services, including health services. Objective This article examines and documents the experiences facing the implementation of decentralization of health services from the perspective of national and district officials. Design The study adopted a qualitative approach, and data were collected using semi-structured interviews and were analysed for themes and patterns. Results The results showed several benefits of decentralization, including increased autonomy in local resource mobilization and utilization, an enhanced bottom-up planning approach, increased health workers’ accountability and reduction of bureaucratic procedures in decision making. The findings also revealed several challenges which hinder the effective functioning of decentralization. These include inadequate funding, untimely disbursement of funds from the central government, insufficient and unqualified personnel, lack of community participation in planning and political interference. Conclusion The article concludes that the central government needs to adhere to the principles that established the local authorities and grant more autonomy to them, offer special incentives to staff working in the rural areas and create the capacity for local key actors to participate effectively in the planning process. PMID:23993021

  11. Capturing and Explaining Preference Heterogeneity for Wetland Management Options in the Kilombero Valley, Tanzania

    NASA Astrophysics Data System (ADS)

    Speelman, Stijn; Mombo, Felister; Vandermeulen, Valerie; Phillip, Damas; Van Huylenbroeck, Guido

    2015-01-01

    Wetland degradation has recently received considerable research attention. Although wetlands are valuable ecosystems, their actual value is difficult to measure because the services they provide often do not have market values. The current study seeks to investigate the preferences for wetland management options in the Kilombero Valley, central Tanzania using choice modeling. The results show that both respondents from the Kilombero Valley and Morogoro Municipality desire improvements in the condition of the wetlands. This indicates that the ongoing degradation is not socially optimal. A second finding is that the preferences for wetland conservation are heterogeneous and can be linked to livelihood characteristics. Communities living in the area, for example, are highly dependent on the wetland for their livelihood and would be impacted by conservation measures. Therefore, in order to reduce the pressure on wetlands, it is necessary and imperative to explore the options for alternative income-generating activities or to focus, for example, on technologies to improve efficiency and effectiveness in crop production.

  12. The "Rhampholeon uluguruensis complex" (Squamata: Chamaeleonidae) and the taxonomic status of the pygmy chameleons in Tanzania.

    PubMed

    Fisseha, Makda; Mariaux, Jean; Menegon, Michele

    2013-01-01

    The specific status of several pygmy chameleons endemic to mountain massifs in the Eastern Arc Mountains, Tanzania has long been controversial due to their lack of distinctive morphological characters. In this work we extend our previous sampling of Rieppeleon and Rhampholeon species, especially from the Rhampoleon moyeri/Rhampholeon uluguruensis complex, and add data from a new mitochondrial marker to address this problem. Our results show that there is geographical structure between populations of pygmy chameleons from different mountains. This structure is especially well defined for Rhampholeon (Rhinodigitum). Phylogenetic analyses confirm that both Rh. uluguruensis Tilbury and Emmrich, 1995 and Rh. moyeri Menegon, Salvidio and Tilbury, 2002 are distinct lineages, the former from the Uluguru Mountains and the latter from the Udzungwa Mountains. However, the paratype material used to erect Rh. moyeri belongs to a separate lineage from the holotype. Similarly, a number of additional lineages within the Rh. moyeri/Rh. uluguruensis complex recovered in the analysis may deserve specific status. At present, there is a lack of morphological characters that can be used to distinguish these lineages, suggesting that there are multiple cryptic taxa in this complex.  PMID:25113487

  13. Reflecting and shaping the discourse: the role of music in AIDS communication in Tanzania.

    PubMed

    Bastien, Sheri

    2009-04-01

    Failure to recognize the importance of oral traditions in Africa and the potential of music and song for stimulating social and behavior change would represent a missed opportunity in HIV prevention strategies. Local narratives concerning AIDS are often utilized in popular songs and constitute rich sources of contextual information about the epidemic that have thus far been un- or underutilized in HIV prevention strategies. Endogenously conceived messages delivered via a channel such as music increase the likelihood of messages being contextually appropriate and culturally engaging. This form of media also presents the greatest opportunity for wide dissemination. Drawing on field work conducted in the Kilimanjaro region, this paper presents examples of how music and musicians in Tanzania reflect and potentially shape AIDS discourse. Three broad recurrent themes addressed in songs are discussed: AIDS metaphors, stigma and broader HIV prevention messages. By tapping into the wealth of information about AIDS discourse contained within popular songs, and by recognizing musicians as potential opinion leaders and agents of social change, the effectiveness of prevention strategies may be increased. PMID:19232806

  14. Maltreatment and mental health in institutional care--comparing early and late institutionalized children in Tanzania.

    PubMed

    Hermenau, Katharin; Hecker, Tobias; Elbert, Thomas; Ruf-Leuschner, Martina

    2014-01-01

    Research has shown the harmful potential of institutional care on young children; however, little is known about the consequences of institutional care on infants in Sub-Saharan Africa. We compared 35 Tanzanian children who were institutionalized at birth to 4 years of age with a matched group of 35 children who were institutionalized at 5 to 14 years of age. We examined adverse childhood experiences over the course of their entire lives, in their family of origin and in institutional care, and mental health problems at primary school age, such as depressive symptoms, aggressive behavior, and internalizing and externalizing problems. Results showed that early institutionalized children reported more adverse experiences during their time in institutional care and a greater variety of mental health problems than did late institutionalized children. Moreover, maltreatment in institutional care was positively related to mental health problems only in early institutionalized children. We conclude that adverse experiences in institutional care play an important role for early institutionalized children who need special care from adequately educated caregivers. Therefore, training concepts focusing on the needs of the youngest children have to be developed, tested, and established. Countries such as Tanzania need policies that apply to all orphanages to ensure an adequate standard of quality in childcare. PMID:25798516

  15. Air quality and acute respiratory illness in biomass fuel using homes in Bagamoyo, Tanzania.

    PubMed

    Kilabuko, James H; Matsuki, Hidieki; Nakai, Satoshi

    2007-03-01

    Respiratory Diseases are public health concern worldwide. The diseases have been associated with air pollution especially indoor air pollution from biomass fuel burning in developing countries. However, researches on pollution levels and on association of respiratory diseases with biomass fuel pollution are limited. A study was therefore undertaken to characterize the levels of pollutants in biomass fuel using homes and examine the association between biomass fuel smoke exposure and Acute Respiratory Infection (ARI) disease in Nianjema village in Bagamoyo, Tanzania. Pollution was assessed by measuring PM10, NO2, and CO concentrations in kitchen, living room and outdoors. ARI prevalence was assessed by use of questionnaire which gathered health information for all family members under the study. Results showed that PM10, NO2, and CO concentrations were highest in the kitchen and lowest outdoors. Kitchen concentrations were highest in the kitchen located in the living room for all pollutants except CO. Family size didn't have effect on the levels measured in kitchens. Overall ARI prevalence for cooks and children under age 5 making up the exposed group was 54.67% with odds ratio (OR) of 5.5; 95% CI 3.6 to 8.5 when compared with unexposed men and non-regular women cooks. Results of this study suggest an association between respiratory diseases and exposure to domestic biomass fuel smoke, but further studies with improved design are needed to confirm the association. PMID:17431314

  16. Association of maternal depression and infant nutritional status among women living with HIV in Tanzania.

    PubMed

    Kaaya, Sylvia; Garcia, Maria E; Li, Nan; Lienert, Jeffrey; Twayigize, William; Spiegelman, Donna; Smith Fawzi, Mary C

    2014-11-01

    Antenatal and post-natal depression has demonstrated a significant burden in sub-Saharan Africa, with rates ranging from 10% to 35%. However, perinatal women living with HIV in Tanzania have reported an even greater prevalence of depression (43-45%). The primary goal of this study was to examine the relationship between maternal depression and infant malnutrition among women living with HIV. The design was a retrospective cohort study within the context of a randomised controlled trial among women living with HIV and their infants. Within this trial, 699 mother-child pairs were analysed for the present study. Although antenatal depression was not associated with infant malnutrition and post-natal depression was negatively associated [relative risk (RR?=?0.80, P?=?0.04], cumulative depression demonstrated a positive association with infant wasting (RR?=?1.08, P?

  17. Constraints on smallholder market oriented dairy systems in the north eastern coastal region of Tanzania.

    PubMed

    Nkya, R; Kessy, B M; Lyimo, Z C; Msangi, B S J; Turuka, F; Mtenga, K

    2007-12-01

    Twenty five smallholder dairy farmers and other stakeholders, through a Participatory Rural Appraisal in three wards of the Tanga township of north east coastal Tanzania, ranked their perceived constraints in descending order of importance: Low milk price and marketing, feed shortage in the dry season, poor management, low animal productivity, poor reproductive performance and diseases. Tick borne diseases were reported on a majority of farms. An Economic Opportunity Survey revealed wide ranges in management indices and improvement in annual milk production, age at first calving and lactation length to represent the best potential for gain. Performance generally was below locally set targets. Farmers spent on average in the three wards between 39% and 77% of income from milk on feed costs yearly. Interventions were instituted emphasising those that farmers could afford immediately. They included farmer training, dry season feed supplementation, tick control, improvement of animal shed/ house cleanliness and the formation of a cooperative for milk marketing. Partial budgeting is being used to monitor success. Follow-up meetings and regular visits to farms by field officers are disseminating information on outcomes to encourage farmers to continue with interventions and spread useful knowledge to friends and neighbours. PMID:18265872

  18. Boys’ and Young Men’s Perspectives on Violence in Northern Tanzania

    PubMed Central

    Likindikoki, Samuel; Kaaya, Sylvia

    2013-01-01

    The challenge of violence for youth in low-income countries includes a range of experiences from witnessing to experiencing to participating in violence. Although boys and young men are often the perpetrators of such violence, they may also be its victims. Yet little evidence exists from the voiced experiences of boys themselves on perceptions and interpretations of the violence around them. Given the numerous negative health implications of violence for boys, for the girls and other boys with whom they interact, and for the health of their future partners and families, we conducted an in-depth study in rural and urban Tanzania with adolescent boys on the masculinity norms shaping their transitions through puberty that might be contributing to high-risk behaviours, including engagement in violence. The findings identified underlying societal gendered norms influencing the enactment of violence, and recommendations from the boys on how to diminish the violence around them. Additional research is needed with boys on the social norms and structural factors influencing their engagement in violence. PMID:23586440

  19. Y-chromosomal evidence of a pastoralist migration through Tanzania to southern Africa

    PubMed Central

    Henn, Brenna M.; Gignoux, Christopher; Lin, Alice A.; Oefner, Peter J.; Shen, Peidong; Scozzari, Rosaria; Cruciani, Fulvio; Tishkoff, Sarah A.; Mountain, Joanna L.; Underhill, Peter A.

    2008-01-01

    Although geneticists have extensively debated the mode by which agriculture diffused from the Near East to Europe, they have not directly examined similar agropastoral diffusions in Africa. It is unclear, for example, whether early instances of sheep, cows, pottery, and other traits of the pastoralist package were transmitted to southern Africa by demic or cultural diffusion. Here, we report a newly discovered Y-chromosome-specific polymorphism that defines haplogroup E3b1f-M293. This polymorphism reveals the monophyletic relationship of the majority of haplotypes of a previously paraphyletic clade, E3b1-M35*, that is widespread in Africa and southern Europe. To elucidate the history of the E3b1f haplogroup, we analyzed this haplogroup in 13 populations from southern and eastern Africa. The geographic distribution of the E3b1f haplogroup, in association with the microsatellite diversity estimates for populations, is consistent with an expansion through Tanzania to southern-central Africa. The data suggest this dispersal was independent of the migration of Bantu-speaking peoples along a similar route. Instead, the phylogeography and microsatellite diversity of the E3b1f lineage correlate with the arrival of the pastoralist economy in southern Africa. Our Y-chromosomal evidence supports a demic diffusion model of pastoralism from eastern to southern Africa ?2,000 years ago. PMID:18678889

  20. Development of an intervention to improve mental health for obstetric fistula patients in Tanzania.

    PubMed

    Watt, Melissa H; Wilson, Sarah M; Sikkema, Kathleen J; Velloza, Jennifer; Mosha, Mary V; Masenga, Gileard G; Bangser, Margaret; Browning, Andrew; Nyindo, Pilli M

    2015-06-01

    Obstetric fistula is a debilitating childbirth injury that has been associated with high rates of psychological distress. Global efforts have helped to link women to surgical repair, but thus far no evidence-based interventions exist to address the psychological needs of these women during the hospital stay. In this paper, we describe the development of a psychological intervention for women in Tanzania who are receiving surgical care for an obstetric fistula. The intervention was developed based on theories of cognitive behavioral therapy and coping models. Content and delivery were informed by qualitative data collection with a range of stakeholders including women with fistula, and input from a study advisory board. The resulting intervention was six individual sessions, delivered by a trained community health nurse. The session topics were (1) recounting the fistula story; (2) creating a new story about the fistula; (3) loss, grief and shame; (4) specific strategies for coping; (5) social relationships; and (6) planning for the future. A trial run of the intervention revealed that the intervention could be delivered with fidelity and was acceptable to patients. A future randomized control trial will evaluate the efficacy of this intervention to address the mental health symptoms of this population. PMID:25710896

  1. Gold deposits in the late Archaean Nzega-Igunga greenstone belt, central plateau of tanzania

    SciTech Connect

    Feiss, P.G.; Siyomana, S.

    1985-01-01

    2.2 m oz of gold have been produced, since 1935, from late Archaean (2480-2740 Ma) greenstone belts of the Central Plateau, Tanzania. North and east of Nzega (4/sup 0/12'S, 3/sup 0/11'E), 18% of the exposed basement, mainly Dodoman schists and granites, consists of metavolcanics and metasediments of the Nyanzian and Kavirondian Series. Four styles of mineralization are observed. 1. Stratabound quartz-gold veins with minor sulfides. Host rocks are quartz porphyry, banded iron formation (BIF), magnetite quartzite, and dense, cherty jasperite at the Sekenke and Canuck mines. The Canuck veins are on strike from BIF's in quartz-eye porphyry of the Igusule Hills. 2. Stratabound, disseminated gold in coarse-grained, crowded feldspar porphyry with lithic fragments and minor pyrite. At Bulangamilwa, the porphyry is conformable with Nyanzian-aged submarine (.) greenstone, volcanic sediment, felsic volcanics, and sericite phyllite. The deposits are on strike with BIF of the Wella Hills, which contains massive sulfide with up to 15% Pb+Zn. 3. Disseminated gold in quartz-albite metasomes in Nyanzian greenstones. At Kirondatal, alteration is associated with alaskites and feldspar porphyry dikes traceable several hundred meters into post-Dodoman diorite porphyry. Gold is with pyrite, arsenopyrite, pyrrhotite, minor chalcopyrite, and sphalerite as well as tourmalinite and silica-cemented breccias. 4. Basal Kavirondian placers in metaconglomerates containing cobbles and boulders of Dodoman and Nyanzian rocks several hundred meters up-section from the stratabound, disseminated mineralization at Bulangamilwa.

  2. Prevalence of coenurosis in sheep and goats at three slaughter slabs in Ngorongoro District, Tanzania.

    PubMed

    Miran, Miran Busheleji; Nzalawahe, Jahashi; Kassuku, Ayubu Ahmed; Swai, Emmanuel Senyael

    2015-12-01

    Prevalence of Coenurus cerebralis prevalence was assessed in sheep and goats at three slaughter slabs in Ngorongoro district, Tanzania. Predisposing factors were also determined by using a structured questionnaire. Between January 2013 and April 2013, a total of 180 heads (90 sheep and 90 goats) were collected and examined for the presences of C. cerebralis cysts. Out of 180 heads examined, 80 were found to be infected with C. cerebralis. Lack of knowledge in the community on how coenurosis occurs, free access of dogs to the carcasses/offal of small ruminants and inadequate animal health services for dogs especially worm control were major factors which contribute to persistence of coenurosis. This study, in Ngorongoro district, reports for the first time the occurrence and prevalence of coenurosis in slaughtered sheep and goats due to Taenia multiceps metacestode (C. cerebralis). It is recommended that more studies are undertaken in order to pave the way for developing preliminary coenurosis control guidelines and for sign posting the direction for future research. PMID:26306799

  3. Treatment retention and care transitions during and after the scale-up of HIV care and treatment in Northern Tanzania.

    PubMed

    Ostermann, Jan; Whetten, Kathryn; Reddy, Elizabeth; Pence, Brian; Weinhold, Andrew; Itemba, Dafrosa; Maro, Venance; Mosille, Eligy; Thielman, Nathan

    2014-01-01

    Decentralization of HIV care is promoted to improve access to antiretroviral therapy in sub-Saharan Africa. This study describes care transitions among HIV-infected persons in Northern Tanzania during a period of rapid decentralization of HIV care and treatment centers (CTCs) from hospitals to local health centers. Between November 2008 and June 2009, 492 HIV-infected patients in established care at two referral hospitals in Moshi, Tanzania, and 262 persons newly diagnosed with HIV were selected for participation in a prospective cohort study entitled Coping with HIV/AIDS in Tanzania. Clinical records and participant self-reports, collected between June and November 2012, were used to describe retention in care and transitions between CTCs during the study period. After a mean follow-up period of 3.5 years, 10% of participants had died, 9% were lost to follow-up, and 11% had moved. Of the remaining participants enrolled from CTCs, more than 90% reported at least one CTC visit during the previous six months, with 98% still in care at the CTC at which they were enrolled. Nearly three out of four newly diagnosed clients listed a referral hospital as their primary CTC. Fewer than 10% of participants ever sought care at another CTC in the study area; nearly 90% of those in care bypassed their closest CTC. Administrative data from all facilities in the study area indicate that new clients, even after the scale-up from 8 CTCs in 2006 to 21 CTCs in 2008, disproportionately selected established CTCs, and client volume at newly approved facilities was highly variable. Despite the decentralization of HIV care and treatment in this setting, many patients continue to bypass their closest CTC to seek care at established facilities. Patient preferences for decentralized HIV care, which may inform optimal resource utilization, are largely unknown and warrant further investigation. PMID:24517083

  4. Distribution and Risk Factors for Plasmodium and Helminth Co-infections: A Cross-Sectional Survey among Children in Bagamoyo District, Coastal Region of Tanzania

    PubMed Central

    Salim, Nahya; Knopp, Stefanie; Lweno, Omar; Abdul, Ummi; Mohamed, Ali; Schindler, Tobias; Rothen, Julian; Masimba, John; Kwaba, Denis; Mohammed, Alisa S.; Althaus, Fabrice; Abdulla, Salim; Tanner, Marcel; Daubenberger, Claudia; Genton, Blaise

    2015-01-01

    Background Plasmodium and soil transmitted helminth infections (STH) are a major public health problem, particularly among children. There are conflicting findings on potential association between these two parasites. This study investigated the Plasmodium and helminth co-infections among children aged 2 months to 9 years living in Bagamoyo district, coastal region of Tanzania. Methods A community-based cross-sectional survey was conducted among 1033 children. Stool, urine and blood samples were examined using a broad set of quality controlled diagnostic methods for common STH (Ascaris lumbricoides, hookworm, Strongyloides stercoralis, Enterobius vermicularis, Trichuris trichura), schistosoma species and Wuchereria bancrofti. Blood slides and malaria rapid diagnostic tests (mRDTs) were utilized for Plasmodium diagnosis. Results Out of 992 children analyzed, the prevalence of Plasmodium infection was 13% (130/992), helminth 28.5% (283/992); 5% (50/992) had co-infection with Plasmodium and helminth. The prevalence rate of Plasmodium, specific STH and co-infections increased significantly with age (p < 0.001), with older children mostly affected except for S. stercoralis monoinfection and co-infections. Spatial variations of co-infection prevalence were observed between and within villages. There was a trend for STH infections to be associated with Plasmodium infection [OR adjusted for age group 1.4, 95% CI (1.0–2.1)], which was more marked for S. stercoralis (OR = 2.2, 95% CI (1.1–4.3). Age and not schooling were risk factors for Plasmodium and STH co-infection. Conclusion The findings suggest that STH and Plasmodium infections tend to occur in the same children, with increasing prevalence of co-infection with age. This calls for an integrated approach such as using mass chemotherapy with dual effect (e.g., ivermectin) coupled with improved housing, sanitation and hygiene for the control of both parasitic infections. PMID:25837022

  5. "Just like fever": a qualitative study on the impact of antiretroviral provision on the normalisation of HIV in rural Tanzania and its implications for prevention

    PubMed Central

    2009-01-01

    Background Once effective therapy for a previously untreatable condition is made available, a normalisation of the disease often occurs. As part of a broader initiative to monitor the implementation of the national antiretroviral therapy (ART) programme, this qualitative study investigated the impact of ART availability on perceptions of HIV in a rural ward of North Tanzania and its implications for prevention. Methods A mix of qualitative methods was used including semi-structured interviews with 53 ART clinic clients and service providers. Four group activities were conducted with persons living with HIV. Data were analyzed using the qualitative software package NVIVO-7. Results People on ART often reported feeling increasingly comfortable with their status reflecting a certain "normalization" of the disease. This was attributed to seeing other people affected by HIV, regaining physical health, returning to productive activities and receiving emotional support from health service providers. Overcoming internalized feelings of shame facilitated disclosure of HIV status, helped to sustain treatment, and stimulated VCT uptake. However "blaming" stigma - where people living with HIV were considered responsible for acquiring a "moral disease" - persisted in the community and anticipating it was a key barrier to disclosure and VCT uptake. Attributing HIV symptoms to witchcraft seemed an effective mechanism to transfer "blame" from the family unit to an external force but could lead to treatment interruption. Conclusion As long as an HIV diagnosis continues to have moral connotations, a de-stigmatisation of HIV paralleling that occurring with diseases like cancer is unlikely to occur. Maximizing synergies between HIV treatment and prevention requires an enabling environment for HIV status disclosure, treatment continuation, and safer sexual behaviours. Local leaders should be informed and sensitised and communities mobilised to address the blame-dimension of HIV stigma. PMID:19740437

  6. Racemization of amino acids in fossil bones and teeth from the Olduvai Gorge region, Tanzania, East Africa

    NASA Astrophysics Data System (ADS)

    Bada, Jeffrey L.

    1981-10-01

    Investigation of amino acid racemization in fossil bones and teeth from the Olduvai Gorge region, Tanzania, indicates that aspartic acid racemization can be used to date samples which are less than ˜80,000-100,000 years old in this area. In older samples, significant secondary aspartic acid is apparently present and thus these samples have lower than expectedD/L aspartic acid ratios. Isoleucine in older samples, however, is apparently syngenetic with the samples, so the epimerization of isoleucine to alloisoleucine can be used with certain limitations to date fossil bones and teeth from the older stratigraphic sections in the Olduvai region.

  7. Exploring the Use of ICTs in Learning and Disseminating Livestock Husbandry Knowledge to Urban and Peri-Urban Communities in Tanzania

    ERIC Educational Resources Information Center

    Angello, Consolata

    2015-01-01

    This paper discusses the importance of various Information and Communication Technologies (ICTs) in learning and disseminating relevant information on livestock husbandry in Tanzania. The paper is part of a study that investigated the extent of use of ICTs by urban and peri-urban livestock keepers and how access and dissemination of livestock…

  8. Managing in the Contemporary World: Rape Victims' and Supporters' Experiences of Barriers within the Police and the Health Care System in Tanzania

    ERIC Educational Resources Information Center

    Muganyizi, Projestine S.; Nystrom, Lennarth; Axemo, Pia; Emmelin, Maria

    2011-01-01

    Grounded theory guided the analysis of 30 in-depth interviews with raped women and community members who had supported raped women in their contact with the police and health care services in Tanzania. The aim of this study was to understand and conceptualize the experiences of the informants by creating a theoretical model focusing on barriers,…

  9. The Health and Education Benefits of Universal Primary Education for the Next Generation: Evidence from Tanzania. CREATE Pathways to Access. Research Monograph No. 62

    ERIC Educational Resources Information Center

    Sabates, Ricardo; Westbrook, Jo; Hernandez-Fernandez, Jimena

    2011-01-01

    This research focuses on the importance of increasing women's education as a result of Universal Primary Education and its further impact on improving children's health and educational access in Tanzania. The study uses data from the 2007 Demographic Health Survey for empirical analysis and it is informed by the historical accounts of the…

  10. Situation Reports--Austria, Belgium, Bolivia, Botswana, Finland, German Federal Republic, Italy, Luxembourg, Mauritania, Netherlands, Norway, Portugal, Puerto Rico, Sweden, Tanzania, Yugoslavia, and Zambia.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Data pertaining to population and family planning in seventeen foreign countries are presented in these situation reports. Countries included are Austria, Belgium, Bolivia, Botswana, Finland, German Federal Republic, Italy, Luxembourg, Mauritania, Netherlands, Norway, Portugal, Puerto Rico, Sweden, Tanzania, Yugoslavia, and Zambia. Information is…

  11. Major shifts in calcareous phytoplankton assemblages through the Eocene-Oligocene transition of Tanzania and their implications for low-latitude primary production 

    E-print Network

    Jones, Tom Dunkley; Bown, Paul R.; Pearson, Paul N.; Wade, Bridget S.; Coxall, Helen K.; Lear, Caroline H.

    2008-01-01

    phytoplankton assemblages through the Eocene-Oligocene transition of Tanzania and their implications for low-latitude primary production Tom Dunkley Jones, 1 Paul R. Bown, 2 Paul N. Pearson, 3 Bridget S. Wade, 4 Helen K. Coxall, 3 and Caroline H. Lea