Sample records for salaam tanzania methods

  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 death in Dar es Salaam, Tanzania 2005.

    PubMed

    Outwater, Anne H; Campbell, Jacquelyn C; Mgaya, Edward; Abraham, Alison G; Kinabo, Linna; Kazaura, Method; Kub, Joan

    2008-12-01

    Violence disproportionately affects low- and middle-income countries. Deeper understanding is needed in areas where little research has occurred. The objectives of the study were to: (a) ascertain rate of homicide death; (b) describe the victims and circumstances surrounding their deaths in Dar es Salaam, Tanzania in 2005. This study was developed by adapting the WHO/CDC Injury Surveillance Guidelines (Holder et al., 2001). Data on 12 variables were collected on all homicide deaths. Descriptive statistics and hypothesis tests were done when appropriate. Age standardised, age-specific and cause-specific mortality rates are presented. The overall homicide rate was 12.57 (males and females respectively: 22.26 and 2.64). Homicide deaths were 93.4% male, mostly unemployed, with a mean age of 28.2 years. Most deaths occurred in urban areas. Mob violence was the cause of 57% of deaths. The risk of homicide death for males was greater than the world average, but for females it was less. Most homicides were committed by community members policing against thieves. PMID:19051087

  3. 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

  4. Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salaam, Tanzania

    Microsoft Academic Search

    Wafaie W. Fawzi; Roger Mbise; Donna Spiegelman; Maulidi Fataki; Ellen Hertzmark; Godwin Ndossi

    2000-01-01

    Objective: To determine the effect of vitamin A supplementation on the risk of diarrhea and of acute respiratory infection. Design: Double-blind, randomized, placebo-controlled trial. Setting: Dar-es-Salaam, Tanzania. Subjects: Six hundred eighty-seven children, 6 to 60 months old, hospitalized with pneumonia, who received vitamin A or placebo at baseline and at 4 and 8 months after discharge from hospital. Main outcome

  5. Prevalence and determinants of obesity among primary school children in Dar es Salaam, Tanzania

    PubMed Central

    2013-01-01

    Background Childhood obesity has increased dramatically and has become a public health concern worldwide. Childhood obesity is likely to persist through adulthood and may lead to early onset of NCDs. However, there is paucity of data on obesity among primary school children in Tanzania. This study assessed the prevalence and determinants of obesity among primary school children in Dar es Salaam. Methods A cross sectional study was conducted among school age children in randomly selected schools in Dar es Salaam. Anthropometric and blood pressure measurements were taken using standard procedures. Body Mass Index (BMI) was calculated as weight in kilograms divided by the square of height in meters (kg/m2). Child obesity was defined as BMI at or above 95th percentile for age and sex. Socio-demographic characteristics of children were determined using a structured questionnaire. Logistic regression was used to determine association between independent variables with obesity among primary school children in Dar es Salaam. Results A total of 446 children were included in the analysis. The mean age of the participants was 11.1±2.0 years and 53.1% were girls. The mean BMI, SBP and DBP were 16.6±4.0 kg/m2, 103.9±10.3mmHg and 65.6±8.2mmHg respectively. The overall prevalence of child obesity was 5.2% and was higher among girls (6.3%) compared to boys (3.8%). Obese children had significantly higher mean values for age (p=0.042), systolic and diastolic blood pressures (all p<0.001). Most obese children were from households with fewer children (p=0.019) and residing in urban areas (p=0.002). Controlling for other variables, age above 10 years (AOR=3.3, 95% CI=1.5-7.2), female sex (AOR=2.6, 95% CI=1.4-4.9), urban residence (AOR=2.5, 95% CI=1.2-5.3) and having money to spend at school (AOR=2.6, 95% CI=1.4-4.8) were significantly associated with child obesity. Conclusions The prevalence of childhood obesity in this population was found to be low. However, children from urban schools and girls were proportionately more obese compared to their counterparts. Primary preventive measures for childhood obesity should start early in childhood and address socioeconomic factors of parents contributing to childhood obesity. PMID:24094276

  6. Urban transmission of urinary schistosomiasis in Dar es Salaam, Tanzania.

    PubMed

    Sarda, R K; Simonsen, P E; Mahikwano, L F

    1985-03-01

    A cross sectional survey for Schistosoma haematobium infections was undertaken in 12 primary schools in the city of Dar es Salaam. The prevalence in the schools ranged from 5.3 to 55.1%, with an overall prevalence of 19.3%. More males (23.5%) than females (15.0%) were infected, and the highest prevalence was recorded in the 11-16 year age group. Intensity of infection was high, ranging from 12 to 96 eggs/10 ml urine in individual schools. 26% of the infected excreted more than 50 eggs/10 ml urine, and high rates of haematuria and proteinuria were observed in infected children. Interviews indicated that the majority of the children had acquired their infection in the city. Malacological surveys showed two potential vectors, Bulinus (Physopsis) globosus and B. (Ph.) nasutus, to be common in Dar es Salaam. Laboratory and field findings confirmed that these two species were vectors of S. haematobium. Factors responsible for continued transmission in this urban environment are discussed. PMID:2859753

  7. 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

  8. Impact of Community-Based Larviciding on the Prevalence of Malaria Infection in Dar es Salaam, Tanzania

    PubMed Central

    Maheu-Giroux, Mathieu; Castro, Marcia C.

    2013-01-01

    Background The use of larval source management is not prioritized by contemporary malaria control programs in sub-Saharan Africa despite historical success. Larviciding, in particular, could be effective in urban areas where transmission is focal and accessibility to Anopheles breeding habitats is generally easier than in rural settings. The objective of this study is to assess the effectiveness of a community-based microbial larviciding intervention to reduce the prevalence of malaria infection in Dar es Salaam, United Republic of Tanzania. Methods and Findings Larviciding was implemented in 3 out of 15 targeted wards of Dar es Salaam in 2006 after two years of baseline data collection. This intervention was subsequently scaled up to 9 wards a year later, and to all 15 targeted wards in 2008. Continuous randomized cluster sampling of malaria prevalence and socio-demographic characteristics was carried out during 6 survey rounds (2004–2008), which included both cross-sectional and longitudinal data (N?=?64,537). Bayesian random effects logistic regression models were used to quantify the effect of the intervention on malaria prevalence at the individual level. Effect size estimates suggest a significant protective effect of the larviciding intervention. After adjustment for confounders, the odds of individuals living in areas treated with larviciding being infected with malaria were 21% lower (Odds Ratio?=?0.79; 95% Credible Intervals: 0.66–0.93) than those who lived in areas not treated. The larviciding intervention was most effective during dry seasons and had synergistic effects with other protective measures such as use of insecticide-treated bed nets and house proofing (i.e., complete ceiling or window screens). Conclusion A large-scale community-based larviciding intervention significantly reduced the prevalence of malaria infection in urban Dar es Salaam. PMID:23977099

  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. 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

  11. Risk factors for HIV-1 seroprevalence among family planning clients in Dar es Salaam, Tanzania.

    PubMed

    Kapiga, S H; Lyamuya, E F; Vuylsteke, B; Spiegelman, D; Larsen, U; Hunter, D J

    2000-04-01

    Between March and September of 1995, women receiving family planning (FP) services in three large clinics in Dar es Salaam, Tanzania were invited to participate in a cross-sectional study. Consenting women were interviewed to obtain information about HIV risk factors, and blood for HIV testing was collected. The prevalence of HIV was 16.9% (95% CI: 14.4%-19.3%). The risk of HIV increased significantly with age. Compared with married women, the risk of HIV was significantly higher among cohabiting women (age-adjusted OR = 2.3; 95% CI = 1.5-3.5) and among women who were single, divorced or widowed (age-adjusted OR = 2.3; 95% CI = 1.2-4.4). The risk of HIV was also significantly higher among hotel workers (age-adjusted OR = 4.3; 95% CI = 1.4-12.9). Women with laboratory evidence of sexually transmitted diseases were at increased risk of HIV. This study shows that HIV is a major public health problem among FP clients in Tanzania. Innovative HIV interventions are needed to reduce further spread of HIV infection. PMID:11000712

  12. 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

  13. Habitat characterization and spatial distribution of Anopheles sp. mosquito larvae in Dar es Salaam (Tanzania) during an extended dry period

    PubMed Central

    Sattler, Michael A; Mtasiwa, Deo; Kiama, Michael; Premji, Zul; Tanner, Marcel; Killeen, Gerry F; Lengeler, Christian

    2005-01-01

    Introduction By 2030, more than 50% of the African population will live in urban areas. Controlling malaria reduces the disease burden and further improves economic development. As a complement to treated nets and prompt access to treatment, measures targeted against the larval stage of Anopheles sp. mosquitoes are a promising strategy for urban areas. However, a precise knowledge of the geographic location and potentially of ecological characteristics of breeding sites is of major importance for such interventions. Methods In total 151 km2 of central Dar es Salaam, the biggest city of Tanzania, were systematically searched for open mosquito breeding sites. Ecologic parameters, mosquito larvae density and geographic location were recorded for each site. Logistic regression analysis was used to determine the key ecological factors explaining the different densities of mosquito larvae. Results A total of 405 potential open breeding sites were examined. Large drains, swamps and puddles were associated with no or low Anopheles sp. larvae density. The probability of Anopheles sp. larvae to be present was reduced when water was identified as "turbid". Small breeding sites were more commonly colonized by Anopheles sp. larvae. Further, Anopheles gambiae s.l. larvae were found in highly organically polluted habitats. Conclusions Clear ecological characteristics of the breeding requirements of Anopheles sp. larvae could not be identified in this setting. Hence, every stagnant open water body, including very polluted ones, have to be considered as potential malaria vector breeding sites. PMID:15649333

  14. Pit latrine emptying behavior and demand for sanitation services in Dar Es Salaam, Tanzania.

    PubMed

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

    2015-03-01

    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

  15. Informal Urban Settlements and Cholera Risk in Dar es Salaam, Tanzania

    PubMed Central

    Penrose, Katherine; de Castro, Marcia Caldas; Werema, Japhet; Ryan, Edward T.

    2010-01-01

    Background As a result of poor economic opportunities and an increasing shortage of affordable housing, much of the spatial growth in many of the world's fastest-growing cities is a result of the expansion of informal settlements where residents live without security of tenure and with limited access to basic infrastructure. Although inadequate water and sanitation facilities, crowding and other poor living conditions can have a significant impact on the spread of infectious diseases, analyses relating these diseases to ongoing global urbanization, especially at the neighborhood and household level in informal settlements, have been infrequent. To begin to address this deficiency, we analyzed urban environmental data and the burden of cholera in Dar es Salaam, Tanzania. Methodology/Principal Findings Cholera incidence was examined in relation to the percentage of a ward's residents who were informal, the percentage of a ward's informal residents without an improved water source, the percentage of a ward's informal residents without improved sanitation, distance to the nearest cholera treatment facility, population density, median asset index score in informal areas, and presence or absence of major roads. We found that cholera incidence was most closely associated with informal housing, population density, and the income level of informal residents. Using data available in this study, our model would suggest nearly a one percent increase in cholera incidence for every percentage point increase in informal residents, approximately a two percent increase in cholera incidence for every increase in population density of 1000 people per km2 in Dar es Salaam in 2006, and close to a fifty percent decrease in cholera incidence in wards where informal residents had minimally improved income levels, as measured by ownership of a radio or CD player on average, in comparison to wards where informal residents did not own any items about which they were asked. In this study, the range of access to improved sanitation and improved water sources was quite narrow at the ward level, limiting our ability to discern relationships between these variables and cholera incidence. Analysis at the individual household level for these variables would be of interest. Conclusions/Significance Our results suggest that ongoing global urbanization coupled with urban poverty will be associated with increased risks for certain infectious diseases, such as cholera, underscoring the need for improved infrastructure and planning as the world's urban population continues to expand. PMID:20300569

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

    PubMed Central

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

    2015-01-01

    Health system responsiveness measures quality of care from the patient’s perspective, an important component of ensuring adherence to medication and care among HIV patients. We examined health system responsiveness 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 health system responsiveness in fact lead to improved adherence to care. PMID:24499337

  17. Roadside concentration of gaseous and particulate matter pollutants and risk assessment in Dar-es-Salaam, Tanzania.

    PubMed

    Jackson, Msafiri M

    2005-05-01

    This study used manual air sampling method to assess the contribution of road traffic to air pollution level in Dar-es-Salaam City, Tanzania. Samples were collected from 11 different sites. Parameters measured were: sulphur dioxide using pararosaniline method, nitrogen dioxide using saltzman method, particulate matter and particulate lead using filtration method and atomic absorption spectrometric method, respectively. Results showed that hourly average sulphur dioxide concentration range from 127 to 1385 microg/m3. The measured values of sulphur dioxide were above the recommended WHO guidelines with an hourly objective value of 350 microg/m3 at 87% of the sampling sites. The hourly average nitrogen dioxide concentration ranged from 18 to 53 microg/m3. The maximum hourly nitrogen dioxide concentration at 53 microg/m3 was below the WHO guideline value of 200 microg/m3. The hourly average suspended particulate matter (SPM) ranged from 98 to 1161 microg/m3, exceeding the recommended value of 230 microg/m3 by WHO at 87% of the sampling sites. The hourly average lead concentration was found to range from 0.60 to 25.6 microg/m3, exceeding again the WHO guideline value of 1.5 microg/m3 at 83% of the sampling sites. Results predicted by Gaussian model when compared with the measured values were found to have a correlation coefficient of 0.8, signifying a good correlation. The risk assessment was undertaken considering the people who spend a significant portion of their time near the roads, such as the Uhuru primary school pupils and the adult population who reside by the roadside. The unit risk realised was 18.2 x 10(-6) for adult population and 2.2 x 10(-6) for pupils, both scenarios showing risk higher than the United Sates of America Environmental Protection Agency (USEPA) acceptable limit of 1 x 10(-6). Considering the magnitude of the problem at hand, this study recommends an introduction of mandatory emission tests of SPM, lead and sulphur dioxide (SO2). The study further recommends the introduction of continuous and/or regular air quality monitoring and the use non-leaded petrol in Tanzania. PMID:15931998

  18. Identifying Programmatic Gaps: Inequities in Harm Reduction Service Utilization among Male and Female Drug Users in Dar es Salaam, Tanzania

    PubMed Central

    Lambdin, Barrot H.; Bruce, R. Douglas; Chang, Olivia; Nyandindi, Cassian; Sabuni, Norman; Zamudio-Haas, Sophia; McCurdy, Sheryl; Masao, Frank; Ivo, Yovin; Msami, Amani; Ubuguy, Omar; Mbwambo, Jessie

    2013-01-01

    Introduction Current estimates suggest an HIV prevalence of 42% among people who inject drugs (PWIDs) in Dar es Salaam, while HIV prevalence is estimated to be 8.8% among the general population in the city. To address the HIV epidemic in this population, the government of Tanzania began establishing HIV prevention, treatment and care services including outreach and medication assisted treatment (MAT) for PWIDs in 2010. We assessed gender inequities in utilization of outreach and MAT services and evaluated differences in HIV risk behaviors between female and male PWIDs. Materials and Methods Routine outreach data between December 2010 to mid-August 2012 and baseline data on clients enrolling in methadone from February 2011 to August 2012 were utilized. Binomial regression was used to estimate adjusted relative risk estimates comparing females to males. Results From December 2010 to August 2012, 8,578 contacts were made to drug users; among them 1,898 were injectors. A total of 453 injectors were eligible and referred to MAT, of which, 443 enrolled in treatment. However, regarding total outreach contacts, outreach to PWID, referral to MAT and enrollment in MAT, 8% or less of drug users accessing services were women. In contrast, weighted estimations from surveys suggest that 34% of PWIDs are female, and this approximation is similar to recent population size estimations. Overall, 43% of traditional outreach workers conducting outreach with drug users were female. Though reporting higher levels of condom usage, female PWID were more likely to report multiple sex partners, anal sex, commercial sex work and struggle under a higher burden of addiction, mental disorders and abuse. Conclusions Services have not been mobilized adequately to address the clear needs of females who inject drugs. A clear and urgent need exists for women-centered strategies that effectively engage female PWID into HIV prevention services. PMID:23825620

  19. 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

  20. 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

  1. Penicillin resistance and serotype distribution of Streptococcus pneumoniae in nasopharyngeal carrier children under 5 years of age in Dar es Salaam, Tanzania.

    PubMed

    Moyo, Sabrina J; Steinbakk, Martin; Aboud, Said; Mkopi, Namala; Kasubi, Mabula; Blomberg, Bjorn; Manji, Karim; Lyamuya, Eligius F; Maselle, Samuel Y; Langeland, Nina

    2012-07-01

    This study aimed to determine the magnitude of nasopharyngeal carriage, antimicrobial resistance and serotype distribution of Streptococcus pneumoniae in healthy children under 5 years of age in Tanzania. Nasopharyngeal swabs were obtained from 300 healthy children attending a child health clinic at Muhimbili National Hospital in Dar es Salaam, Tanzania. S. pneumoniae was isolated and identified using conventional methods. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disc diffusion method. Penicillin MICs and serotypes were determined by an agar gradient diffusion method and the Quellung reaction, respectively. A total of 105 samples (35?.0%) were positive for S. pneumoniae and 115 serotypes were detected (ten specimens yielded two serotypes each). Overall, 78 of 115 isolates (67.8?%) were penicillin-non-susceptible pneumococci (PNSP). The resistance levels of S. pneumoniae to trimethoprim-sulfamethoxazole, tetracycline, erythromycin, chloramphenicol and ceftriaxone were 82.6, 10.4, 6.0, 3.5 and 0.0?%, respectively. Multidrug resistance was detected in 19 isolates (16.5?%). The most prevalent serotypes were 19F (n?=?25, 21.7?%), 6B (n?=?15, 13.0?%), 9V (n?=?14, 12.2?%) and 13 (n?=?14, 12.2?%). Of the 64 pneumococcal isolates potentially covered by the seven-valent pneumococcal conjugate vaccine (PCV7), 44 (68.8?%) were PNSP. A high prevalence of PNSP, common pneumococcal serotypes circulating worldwide, was found, and many of the resistant pneumococci strains are covered by the PCV7. These findings indicate that the carriage rate of such resistant strains could be influenced by an appropriate vaccination programme in the study setting and by reinforcing regulations on the rational use of antimicrobial agents. PMID:22442292

  2. Efficacy of waterless hand hygiene compared with handwashing with soap: a field study in Dar es Salaam, Tanzania.

    PubMed

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

    2010-02-01

    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

  3. 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

  4. Skinning the goat and pulling the load: transactional sex among youth in Dar es Salaam, Tanzania

    Microsoft Academic Search

    R. K. Maganja; S. Maman; A. Groves; J. K. Mbwambo

    2007-01-01

    Transactional sex has been associated with risk of HIV infection in a number of studies throughout sub-Saharan Africa. Urban young women are economically vulnerable and at heightened risk of HIV infection in Tanzania; yet there are few studies that have explored relationship dynamics, including transactional sex, in this setting. This paper sheds light on the broader context of sexual relationships

  5. Genetic diversity of norovirus in hospitalised diarrhoeic children and asymptomatic controls in Dar es Salaam, Tanzania.

    PubMed

    Moyo, Sabrina; Hanevik, Kurt; Blomberg, Bjørn; Kommedal, Oyvind; Vainio, Kirsti; Maselle, Samuel; Langeland, Nina

    2014-08-01

    This study investigated and reports norovirus diarrhoea, genetic diversity and associated clinical symptoms, HIV status and seasonality in a paediatric population of Tanzania. Stool specimens and demographic/clinical information, were prospectively collected from 705 hospitalised children with diarrhoea (cases) and 561 children without diarrhoea (controls) between 2010 and 2011. Norovirus detection was done by real-time RT-PCR. Genotype was determined using Gel-based and real time RT-PCR methods and sequencing targeting the polymerase and the capsid region respectively. Norovirus was detected in 14.3%, 181/1266 children. The prevalence of norovirus was significantly higher in cases (18.3%, 129/705) than in controls, (9.2%, 52/561), P<0.05. Except for one child who had double infection with GI and GII all 129 cases had GII. Among controls, 23.1% had GI and 76.9% had GII. Norovirus GII.4 was significantly more prevalent in cases 87.9% than in controls 56.5%. Other genotypes detected in both cases and controls were GII.21, GII.16 and GII.g. The highest numbers of norovirus were detected in April 2011. The number of norovirus detected was significantly higher during the first than second year of life (109/540, 20.2% vs. 20/165, 12.1%). The prevalence of norovirus in HIV-positive and negative children was (21.2%, 7/33) and (10.3%, 40/390, P=0.05) respectively, regardless of diarrhoea symptoms. No significant difference in gender, parent's level of education or nutritional status with norovirus infection was observed within cases or controls. This study confirms the significant role of norovirus infection, especially GII.4 in diarrhoeic children who need hospitalisation and adds knowledge on norovirus epidemiology in the African region. PMID:24960396

  6. 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

  7. Urban schistosomiasis and soil transmitted helminthiases in young school children in Dar es Salaam and Tanga, Tanzania, after a decade of anthelminthic intervention.

    PubMed

    Mwakitalu, Mbutolwe E; Malecela, Mwele N; Mosha, Franklin W; Simonsen, Paul E

    2014-05-01

    Rapid urbanization in resource poor countries often results in expansion of unplanned settlements with overcrowding and inadequate sanitation. These conditions potentially support transmission of schistosomiasis and soil transmitted helminths (STH), but knowledge on the occurrence, transmission and control of these infections in urban settings is limited. The present study assessed the status of urinary schistosomiasis and STH across two different-sized cities in Tanzania - Dar es Salaam and Tanga - after a decade of anthelminthic intervention. Primary school children were examined for parasite eggs in urine and stool. Questionnaires were administered to the children, and observations were made on the urban environments. The burden of urinary schistosomiasis and STH was found to be low in both cities (overall 1.2% in Dar es Salaam and 0.3% in Tanga for urinary schistosomiasis; overall <1% in Dar es Salaam and 1-2% in Tanga for each STH infection), and the identified cases showed no clear pattern of spatial distribution. The findings indicated that a marked decrease in prevalence of these infections had occurred in the two cities during recent years. The observed promising developments appeared to have been accomplished by implementation of drug based intervention programs, in combination with environmental change (fewer snail habitats) and generally improved levels of hygiene. Continued efforts, including anthelminthic treatment and health education, are important to maintain these positive achievements. PMID:24495630

  8. Effect of Improved access to Antiretroviral Therapy on clinical characteristics of patients enrolled in the HIV care and treatment clinic, at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania

    Microsoft Academic Search

    Sabina F. Mugusi; Julius C. Mwita; Joel M. Francis; Said Aboud; Muhammad Bakari; Eric A. Aris; Andrew B. Swai; Ferdinand M. Mugusi; Kisali Pallangyo; Eric Sandstrom

    2010-01-01

    BACKGROUND: Sub-Saharan Africa has been severely affected by the HIV and AIDS pandemic. Global efforts at improving care and treatment has included scaling up use of antiretroviral therapy (ART). In Tanzania, HIV care and treatment program, including the provision of free ART started in 2004 with a pilot program at Muhimbili National Hospital in Dar es Salaam. This study describes

  9. Masculine attitudes of superiority deter men from accessing antiretroviral therapy in Dar es Salaam, Tanzania

    PubMed Central

    Nyamhanga, Tumaini M.; Muhondwa, Eustace P.Y.; Shayo, Rose

    2013-01-01

    Background This article presents part of the findings from a larger study that sought to assess the role that gender relations play in influencing equity regarding access and adherence to antiretroviral therapy (ART). Review of the literature has indicated that, in Southern and Eastern Africa, fewer men than women have been accessing ART, and the former start using ART late, after HIV has already been allowed to advance. The main causes for this gender gap have not yet been fully explained. Objective To explore how masculinity norms limit men's access to ART in Dar es Salaam. Design This article is based on a qualitative study that involved the use of focus group discussions (FGDs). The study employed a stratified purposive sampling technique to recruit respondents. The study also employed a thematic analysis approach. Results Overall, the study's findings revealed that men's hesitation to visit the care and treatment clinics signifies the superiority norm of masculinity that requires men to avoid displaying weakness. Since men are the heads of families and have higher social status, they reported feeling embarrassed at having to visit the care and treatment clinics. Specifically, male respondents indicated that going to a care and treatment clinic may raise suspicion about their status of living with HIV, which in turn may compromise their leadership position and cause family instability. Because of this tendency towards ‘hiding’, the few men who register at the public care and treatment clinics do so late, when HIV-related signs and symptoms are already far advanced. Conclusion This study suggests that the superiority norm of masculinity affects men's access to ART. Societal expectations of a ‘real man’ to be fearless, resilient, and emotionally stable are in direct conflict with expectations of the treatment programme that one has to demonstrate health-promoting behaviour, such as promptness in attending the care and treatment clinic, agreeing to take HIV tests, and disclosing one's status of living with HIV to at least one's spouse or partner. Hence, there is a need for HIV control agencies to design community-based programmes that will stimulate dialogue on the deconstruction of masculinity notions. PMID:24152373

  10. 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

  11. From Denis Burkitt to Dar es Salaam. What happened next in East Africa?--Tanzania's story.

    PubMed

    Scanlan, Trish; Kaijage, Jane

    2012-03-01

    East Africa was at the forefront of early achievements and discoveries in paediatric oncology thanks to Denis Burkitt's seminal work. Although these successes have been built upon and continued elsewhere, they were sadly not sustained in sub-Saharan Africa for a variety of reasons. In recent years however this situation is slowly changing in countries across the continent. Tanzania is one such African country. Until very recently, survival rates of 5-10% for all children's cancers were expected. However, change has been brought about thanks to the combined efforts and commitments of the Tanzanian Ministry of Health, non-governmental organizations--such as The International Network for Cancer Treatment and Research, and Children in Crossfire-- and the participation of the private sector. Services are rapidly developing and outcomes are continuing to improve with 1-year survival rates of approximately 60% achieved. Efforts to maintain this early progress are concentrated around providing high quality local subspecialty medical training and continued local ownership of the programme. PMID:22233461

  12. Risky behaviours among young people living with HIV attending care and treatment clinics in Dar Es Salaam, Tanzania: implications for prevention with a positive approach

    PubMed Central

    Mhalu, Aisa; Leyna, Germana H; Mmbaga, Elia J

    2013-01-01

    Introduction Prevention with a positive approach has been advocated as one of the main strategies to reduce new instances of HIV infection. Risky sexual behaviours among people living with HIV/AIDS are the cornerstone for this approach. Understanding the extent to which infected individuals practice risky behaviours is fundamental in designing appropriate population-specific interventions. With the HIV infection transmission rates remaining high among young people in sub-Saharan Africa, continued prevention among them remains a priority. This study therefore seeks to describe the magnitude and determinants of risky sexual behaviours among young people living with HIV. Methods A cross-sectional study was conducted between June and July 2010 in selected Care and Treatment Clinics (CTCs) in Dar Es Salaam, Tanzania. A total of 282 HIV-positive patients aged 15–24 were interviewed about their sexual behaviours using a questionnaire. Results Prevalence of unprotected sex was 40.0% among young males and 37.5% among young females (p<0.001). Multiple sexual partnerships were reported by 10.6% of males and 15.9% of females (p<0.005). More than 50% of the participants did not know about the HIV status of their sexual partners. A large proportion of participants had minimal knowledge of transmission (46.7% males vs. 60.4% females) and prevention (65.3% males vs. 73.4% females) of sexually transmitted infections (STIs). Independent predictors of condom use included non-use of alcohol [adjusted odds ratio (AOR), 0.40 95% confidence interval (CI); 0.17–0.84] and younger age (15–19 years) (AOR, 2.76, 95% CI: 1.05–7.27). Being on antiretroviral therapy (AOR, 0.38, 95% CI: 0.17–0.85) and not knowing partners’ HIV sero-status (AOR, 2.62, 95% CI: 1.14–5.10) predicted the practice of multiple sexual partnership. Conclusions Unprotected sex and multiple sexual partnerships were prevalent among young people living with HIV. Less knowledge on STI and lack of HIV disclosure increased the vulnerability and risk for HIV transmission among young people. Specific intervention measures addressing alcohol consumption, risky sexual behaviours, and STI transmission and prevention knowledge should be integrated in the routine HIV/AIDS care and treatment offered to this age group. PMID:24119708

  13. The diet of the edible cockle Anadara antiquata L. (Bivalvia, Arcidae) in Dar es Salaam, Tanzania, during the northeast monsoons

    Microsoft Academic Search

    P. F. Kasigwa; C. G. Mahika

    1991-01-01

    The diet of the cockle Anadara antiquata L. was studied along Dar es Salaam coast during the N-E Monsoon season. No zooplankton were found in the 80 cockle guts examined. 27 phytoplankton genera were identified, an indication of wide phytophagy. Members of classes Bacillariophyceae, Chlorophyceae, Pyrophyceae and Prasnophyceae were very prevalent in the diet. Scenedesmus, Chlamydomonas, Palmeria, Exuviella, and Coscinodiscus

  14. Introduction of a qualitative perinatal audit at Muhimbili National Hospital, Dar es Salaam, Tanzania

    PubMed Central

    Kidanto, Hussein L; Mogren, Ingrid; van Roosmalen, Jos; Thomas, Angela N; Massawe, Siriel N; Nystrom, Lennarth; Lindmark, Gunilla

    2009-01-01

    Background Perinatal death is a devastating experience for the mother and of concern in clinical practice. Regular perinatal audit may identify suboptimal care related to perinatal deaths and thus appropriate measures for its reduction. The aim of this study was to perform a qualitative perinatal audit of intrapartum and early neonatal deaths and propose means of reducing the perinatal mortality rate (PMR). Methods From 1st August, 2007 to 31st December, 2007 we conducted an audit of perinatal deaths (n = 133) with birth weight 1500 g or more at Muhimbili National Hospital (MNH). The audit was done by three obstetricians, two external and one internal auditors. Each auditor independently evaluated the cases narratives. Suboptimal factors were identified in the antepartum, intrapartum and early neonatal period and classified into three levels of delay (community, infrastructure and health care). The contribution of each suboptimal factor to adverse perinatal outcome was identified and the case graded according to possible avoidability. Degree of agreement between auditors was assessed by the kappa coefficient. Results The PMR was 92 per 1000 total births. Suboptimal factors were identified in 80% of audited cases and half of suboptimal factors were found to be the likely cause of adverse perinatal outcome and were preventable. Poor foetal heart monitoring during labour was indirectly associated with over 40% of perinatal death. There was a poor to fair agreement between external and internal auditors. Conclusion There are significant areas of care that need improvement. Poor monitoring during labour was a major cause of avoidable perinatal mortality. This type of audit was a good starting point for quality assurance at MNH. Regular perinatal audits to identify avoidable causes of perinatal deaths with feed back to the staff may be a useful strategy to reduce perinatal mortality. PMID:19765312

  15. Evaluation of self-care practices and emotional distress among people with Type 2 diabetes mellitus in Dar es Salaam, Tanzania.

    PubMed

    Mosha, Theobald C E; Rashidi, Heri

    2009-01-01

    This study was conducted to determine self-care practices and diabetes related emotional distress among people with Type 2 diabetes mellitus in Dar es Salaam, Tanzania. A cross sectional survey-involving 121 Types 2 diabetics was conducted in 4 diabetic clinics located in Dar es Salaam. Anthropometric and biomedical measurements namely weight, height, waist, hip, mid-upper arm circumference, blood pressure and fasting blood glucose were measured. Self-care practices and diabetic related emotion distress were evaluated by using validated instruments. Results revealed that, the average fasting plasma glucose was 11.2 ± 5.5 mmol/l, blood pressure was 134.7/86.1 mm/Hg and the mean BMI for males and females were 25.0 ± 4.3 and 27.0 ± 5.1 kg/m(2), respectively. Subject's self-care score for general diet, specific diet, physical exercise, foot-care and medication were 4.6 ± 2.4, 3.7 ± 1.5, 3.4 ± 1.8, 3.6 ± 2.8 and 5.5 ± 2.8 days per week, respectively. Self-monitoring of blood glucose was irregular and only 46.3% of the subjects tested their levels of blood glucose at least once in between the appointments (90 days). Low income was the major limitation for complying with the self-care practices related to diet, blood glucose testing and medication. It is recommended that, the Government of Tanzania should in the short run subsidize the prices of diabetes drugs, remove all taxes on the glucose test kits and establish a national diabetes program that would coordinate and oversee provision of the basic services such as screening, glucose testing, medication, counseling and management of the condition. In the long run, the government should establish a preventive public health program in order to curtail the escalation of diabetes. Further research should be conducted to determine how factors such as socio-cultural and demographic, self-care, and psychosocial distress interact to determine biomedical outcomes such as blood pressure, blood glucose and body mass index. PMID:21883073

  16. Seasonal variation of water-soluble inorganic species in the coarse and fine atmospheric aerosols at Dar es Salaam, Tanzania

    NASA Astrophysics Data System (ADS)

    Mkoma, Stelyus L.; Wang, Wan; Maenhaut, Willy

    2009-09-01

    The ionic composition of coarse, fine and total PM10 was investigated in aerosol samples collected from a kerbside in Dar es Salaam during the 2005 dry season and 2006 wet season. A "Gent" PM10 stacked filter unit sampler with sequential Nuclepore polycarbonate filters, providing coarse (8 ?m) and fine (0.4 ?m) size fractions, was deployed. The mean concentrations and associated standard deviation of fine, coarse and PM10 were, respectively, 17 ± 4, 52 ± 27, and 69 ± 29 ?g/m 3 during the 2005 dry season campaign and 13 ± 5, 34 ± 23 and 47 ± 25 ?g/m 3 for the 2006 wet season campaign. The higher PM mass concentrations during the dry season campaign are essentially due to soil dust dispersal, much biomass burning and temperature inversions. Chloride, Na + and Mg 2+ were the dominant ions in coarse fraction, indicating a significant influence of sea-salt aerosols. In the fine fraction, SO42- and NH4+ and K + were the most important ions. The mean equivalent PM2 NO3- concentration in the 2005 dry season campaign was two times higher than in the 2006 wet season campaign, probably due to reaction of NaCl (sea-salt) with HNO 3 as a result of higher levels of NO x during the dry season and/or reduced volatilization of NH 4NO 3 due to lower temperature in the dry season. The results from our water-soluble ions study strongly suggests that biomass burning and secondary aerosols make a significant contribution to fine particulate mass in Dar es Salaam atmosphere. Thus, burning of waste and biomass are thought to be the major causes for the atmospheric particulate pollution in Dar es Salaam during the dry season.

  17. Risk factors associated with the incidence rate of clinical mastitis in smallholder dairy cows in the Dar es Salaam region of Tanzania.

    PubMed

    Kivaria, F M; Noordhuizen, J P T M; Msami, H M

    2007-05-01

    Smallholder dairy herds around the Dar es Salaam region of Tanzania supply 86% of raw milk consumed by the city dwellers. Previous studies have indicated that clinical mastitis is an important disease affecting smallholder dairy cows and an 18-month questionnaire-based longitudinal field-study was conducted between July 2003 and March 2005 to elucidate risk factors associated with the incidence. A total of 6057 quarter-level observations from 317 lactating cows on 87 randomly selected smallholder dairy herds were analysed at the quarter and cow level using logistic and Poisson regression models, respectively. At the quarter level, the average incidence rate of clinical mastitis was 38.4 cases per 100 quarter-years at risk whereas at the cow level the incidence rate was 43.3 cases per 100 cow-years at risk. The incidence was significantly (P< or =0.001) associated with cow factors (body condition score, parity, stage of lactation, and udder consistency), housing (floor type) conditions and milking (cow and udder preparation) practices. It was concluded that the extrapolation of the classic ten-point mastitis control plan into smallholder dairy herds should be undertaken cautiously. An integrated approach to dairy extension should focus more on the creation of mastitis awareness among smallholder producers and on the improvement of animal nutrition and reproduction indices-factors that may also have a direct impact on milk yield. PMID:16516505

  18. Slow progression of HIV-1 infection in a cohort of antiretroviral naïve hotel workers in Dar es Salaam, Tanzania as defined by their CD4 cell slopes.

    PubMed

    Bakari, Muhammad; Urassa, Willy; Mhalu, Fred; Biberfeld, Gunnel; Pallangyo, Kisali; Sandström, Eric

    2008-01-01

    Data on slow progression following HIV-1 infection in Africa are sparse. From a study on the natural history of HIV-1 infection in Dar es Salaam, Tanzania, an analysis of immunological and clinical data from 237 HIV-1 seropositive individuals was performed. Annual CD4 cell determinations were carried out by flow cytometry. None was on antiretroviral treatment. CD4+ cell slopes were obtained by fitting a linear regression model. A study population of 50 individuals with >3 CD4 cell determinations and followed for >5 y had a mean follow-up of 72.7 months, and mean 5.7 CD4+ cell determinations. With a criterion of maintaining a CD4 cell count >or=500 cells/ml, 8 of the 50 (16.0%) were long-term non-progressors (LTNP). With a definition of maintaining a CD4+ cell slope

  19. Evaluation of HIV antigen /antibody combination ELISAs for diagnosis of HIV infection in Dar Es Salaam, Tanzania

    PubMed Central

    Urio, Loveness John; Mohamed, Mohamed Ally; Mghamba, Janneth; Abade, Ahmed; Aboud, Said

    2015-01-01

    Introduction The aim of this study was to evaluate the performance of Enzygnost HIV Integral II antigen/antibody combination ELISAs in order to formulate HIV ELISA testing algorithms for the Ministry of Health and Social Welfare, Tanzania. Methods This was a laboratory-based evaluation of Enzygnost HIV Integral II Antibody/ Antigen, Murex HIV antigen/antibody and Vironostika HIV Uniform II antigen/antibody conducted between October 2011 and May 2012. Results A total of 600 blood samples were included in the evaluation. A total of 209/596 (35.1%) serum samples were confirmed HIV positive. Of these, the prevalence of HIV infection was 2.3% (3/130), 2.3% (3/127), 2.2% (3/139) and 100% (200/200) for VCT clients, ANC attendees, blood donors and CTC patients, respectively. Three hundred and eighty seven (64.9%) were HIV negative samples. Sensitivity was 100% (95% CI; 98.3-100%) for all the three HIV ELISAs. The specificity for the Enzygnost HIV Integral II and Murex was 100% (95% CI; 99.1-100%). The final specificity at repeat testing was 99.5% (95% CI; 98.2-99.9%) for Vironostika. Enzygnost HIV Integral II detected HIV infection seven days since first bleed. Conclusion Initial testing using either Vironostika or Murex HIV antigen/antibody combination ELISA followed by testing of reactive samples on the Enzygnost HIV Integral II gave a sensitivity and specificity of 100% with reduced window period. Combination of two HIV antigen/antibody combination ELISAs can be used as an alternative confirmatory testing strategy for screening of donated blood at the National and Zonal blood transfusion centres and in lab diagnosis of HIV infection.

  20. 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

  1. Prevalence of genotypic resistance to antiretroviral drugs in treatment-naive youths infected with diverse HIV type 1 subtypes and recombinant forms in Dar es Salaam, Tanzania.

    PubMed

    Mosha, F; Urassa, W; Aboud, S; Lyamuya, E; Sandstrom, E; Bredell, H; Williamson, C

    2011-04-01

    As human immunodeficiency virus (HIV) diversity may have an impact on both vaccine efficacy and drug resistance, it is important to have knowledge of circulating genetic variants. With widespread use of antiretroviral (ARV) drugs in Africa, one of the major potential challenges is the risk of emergence of ARV drug-resistant HIV strains. This study aimed to determine the circulating HIV subtypes and recombinant forms, as well as the prevalence of ARV drug resistance mutations, among 75 treatment-naive HIV-infected youths in Dar es Salaam, Tanzania. Gag (n?=?48), partial pol (n?=?44), and partial env (n?=?35) sequencing was performed; all three regions were sequenced in 26 samples. Evidence of infection with recombinant viruses was found in 12 (46%) participants; AC recombinants were the most commonly detected and they were identified in six (23%) participants. Of individuals infected with nonrecombinant strains, subtype A was most commonly detected in seven (27%) participants, followed by subtype C detected in six (23%) participants and subtype D detected in one (4%) participant. Among the pol sequences from 44 individuals, three (7%) had resistance to nucleoside reverse transcriptase (RT) inhibitors and four (9%) had nonnucleoside RT inhibitor resistance mutations. Of these, three (7%) individuals were infected with viruses with cross-resistance mutations to both classes of RT inhibitors. These resistant mutations were all associated with drugs currently used in first-line therapy and in the prevention of vertical transmission. This high prevalence of resistance mutations is of considerable concern in apparently drug-naive populations as it may result in treatment failure and the spread of ARV-resistant strains. PMID:20954839

  2. Community-based surveillance of malaria vector larval habitats: a baseline study in urban Dar es Salaam, Tanzania

    Microsoft Academic Search

    Michael J Vanek; Bryson Shoo; Deo Mtasiwa; Michael Kiama; Steven W Lindsay; Ulrike Fillinger; Khadija Kannady; Marcel Tanner; Gerry F Killeen

    2006-01-01

    BACKGROUND: As the population of Africa rapidly urbanizes it may be possible to protect large populations from malaria by controlling aquatic stages of mosquitoes. Here we present a baseline evaluation of the ability of community members to detect mosquito larval habitats with minimal training and supervision in the first weeks of an operational urban malaria control program. METHODS: The Urban

  3. 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

  4. 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

  5. Conference on Resource Sharing in Southern and Central Africa (Dar-es-Salaam, Tanzania, December 16-19, 1985). Final Report.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific and Cultural Organization, Paris (France). General Information Programme.

    This document summarizes the activities of a conference held at the Institute of Finance Management in Tanzania on information resource sharing in Southern and Central Africa. Delegates and observers from Lesotho, Swaziland, Mozambique, Botswana, Zimbabwe, Malawi, Zambia, and Tanzania attended the conference. The 15 participants, 8 sponsored by…

  6. Sanitary inspection of wells using risk-of-contamination scoring indicates a high predictive ability for bacterial faecal pollution in the peri-urban tropical lowlands of Dar es Salaam, Tanzania.

    PubMed

    Mushi, Douglas; Byamukama, Denis; Kirschner, Alexander K T; Mach, Robert L; Brunner, K; Farnleitner, Andreas H

    2012-06-01

    Sanitary inspection of wells was performed according to World Health Organization (WHO) procedures using risk-of-contamination (ROC) scoring in the peri-urban tropical lowlands of Dar es Salaam, Tanzania. The ROC was assessed for its capacity to predict bacterial faecal pollution in the investigated well water. The analysis was based on a selection of wells representing environments with low to high presumptive faecal pollution risk and a multi-parametric data set of bacterial indicators, generating a comprehensive picture of the level and characteristics of faecal pollution (such as vegetative Escherichia coli cells, Clostridium perfringens spores and human-associated sorbitol fermenting Bifidobacteria). ROC scoring demonstrated a remarkable ability to predict bacterial faecal pollution levels in the investigated well water (e.g. 87% of E. coli concentration variations were predicted by ROC scoring). Physicochemical characteristics of the wells were not reflected by the ROC scores. Our results indicate that ROC scoring is a useful tool for supporting health-related well water management in urban and suburban areas of tropical, developing countries. The outcome of this study is discussed in the context of previously published results, and future directions are suggested. PMID:22717748

  7. Sanitary inspection of wells using risk-of-contamination scoring indicates a high predictive ability for bacterial faecal pollution in the peri-urban tropical lowlands of Dar es Salaam, Tanzania

    PubMed Central

    Mushi, Douglas; Byamukama, Denis; Kirschner, Alexander K.T.; Mach, Robert L.; Brunner, K.; Farnleitner, Andreas H.

    2012-01-01

    The sanitary inspection of wells was performed according to World Health Organization (WHO) procedures using risk-of-contamination (ROC) scoring to determine the capacity of ROC scoring to predict bacterial faecal pollution of well water in the peri-urban tropical lowlands of Dar es Salaam, Tanzania. The analysis was based on a selection of wells representing environments with low to high presumptive faecal pollution risk and a multi-parametric data set of bacterial indicators, generating a comprehensive picture of the level and characteristics of faecal pollution (such as vegetative Escherichia coli cells, Clostridium perfringens spores and human-associated sorbitol fermenting Bifidobacteria). ROC scoring demonstrated a remarkable ability to predict bacterial faecal pollution levels in the investigated well water (e.g. 87% of E. coli concentration variations were predicted by ROC scoring). Physicochemical characteristics of the wells were not reflected by the ROC scores. Our results indicate that ROC scoring is a useful tool for supporting health-related well water management in urban and suburban areas of tropical, developing countries. The outcome of this study is discussed in the context of previously published results, and future directions are suggested. PMID:22717748

  8. [Tanzania].

    PubMed

    The capital of Tanzania is Dodoma. As of 1995, Tanzania had a population of 29.7 million governed by a presidential regime. 1994 gross national product and per capita income were, respectively, $3 billion and $100. Per capita income grew at 4.8% per year over the period 1985-94. In 1994, Tanzania owed $7.4 billion, then being serviced at $548 million. For the same year, Tanzania exported $855 million in goods and services and imported $2.067 billion. As of 1995, the population was growing in size by 2.8% annually. In 1992-93, life expectancy at birth was 52.1 years, the infant mortality rate was 85 per 1000 births, 76% had access to health services, and 50% had access to drinkable water. Other data are presented on the country's topography, climate and vegetation, demographics, principal cities, population distribution, religions, political structure, economics and finances, foreign commerce, and transportation and communications. PMID:12347113

  9. Evaluation of the hygienic quality and associated public health hazards of raw milk marketed by smallholder dairy producers in the Dar es Salaam region, Tanzania.

    PubMed

    Kivaria, F M; Noordhuizen, J P T M; Kapaga, A M

    2006-04-01

    A cross-sectional study was conducted to determine three parameters of the quality of the raw milk marketed by milk selling points (MSPs) in Dar es Salaam region. Total bacterial count (TBC) was used as an indicator of the microbial quality of the milk; antimicrobial residues were determined; and the California mastitis test (CMT) was used to screen for milk somatic cells as an indication of the mastitis level in the cows that provided the milk. Moreover, a water sample at each MSP was taken for bacteriological culturing. Finally, a questionnaire survey was conducted with the milk sellers at the MSPs to identify risk factors for poor milk hygiene. A total of 128 milk samples and corresponding water samples were collected from randomly selected milk selling points in Dar es Salaam region. The mean TBC was (8.2 +/- 1.9) x 10(6) cfu/ml, and major bacterial isolates from the milk samples were Escherichia coli (6.3%), Bacillus cereus (6.3%), Staphylococcus aureus (6.3%) and Streptococcus agalactiae (6.3%), Enterobacter aerogenes (5.6%) and Enterococcus faecalis (4.7%). In most cases, the organisms identified in milk corresponded to those isolated from the corresponding water samples. Of milk samples, 79.0% were positive to the CMT and 7.0% were positive for antimicrobial residues. TBC was normalized by log-transformation, and the possible predictors of TBC were identified by fitting two linear regression models. In a random effect model, water microbial quality, frequency of cleaning the milk containers, frequency of milk supply, milk storage time and the type of containers, and mixing of fresh and previous milk were significantly (p < 0.05) associated with the mean log TBC. In a fixed effect model, in addition to these indicators, water shortage, water source and the refrigerator condition were significantly (p < or = 0.01) associated with log TBC. It was concluded that the milk sold in Dar es Salaam region is of poor quality and is of public health significance. PMID:16986766

  10. Malaria control in Tanzania

    SciTech Connect

    Yhdego, M.; Majura, P. (Ardhi Institute, Dar es Salaam (Tanzania))

    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.

  11. Gender differences in HIV disease progression and treatment outcomes among HIV patients one year after starting antiretroviral treatment (ART) in Dar es Salaam, Tanzania

    PubMed Central

    2013-01-01

    Background We investigated gender differences in treatment outcome during first line antiretroviral treatment (ART) in a hospital setting in Tanzania, assessing clinical, social demographic, virological and immunological factors. Methods We conducted a cohort study involving HIV infected patients scheduled to start ART and followed up to 1 year on ART. Structured questionnaires and patients file review were used to collect information and blood was collected for CD4 and viral load testing. Gender differences were assessed using Kruskal-Wallis test and chi-square test for continuous and categorical data respectively. Survival distributions for male and female patients were estimated using the Kaplan-Meier method and compared using Cox proportional hazards models. Results Of 234 patients recruited in this study, 70% were females. At baseline, women had significantly lower education level; lower monthly income, lower knowledge on ARV, less advanced HIV disease (33% women; 47% men started ART at WHO stage IV, p?=?0.04), higher CD4 cell count (median 149 for women, 102 for men, p?=?0.02) and higher BMI (p?=?0.002). After 1 year of standard ART, a higher proportion of females survived although this was not significant, a significantly higher proportion of females had undetectable plasma viral load (69% women, 45% men, p?=?0.003), however females ended at a comparable CD4 cell count (median CD4, 312 women; 321 men) signifying a worse CD4 cell increase (p?=?0.05), even though they still had a higher BMI (p?=?0.02). The unadjusted relative hazard for death for men compared to women was 1.94. After correcting for confounding factors, the Cox proportional hazards showed no significant difference in the survival rate (relative hazard 1.02). Conclusion We observed women were starting treatment at a less advanced disease stage, but they had a lower socioeconomical status. After one year, both men and women had similar clinical and immunological conditions. It is not clear why women lose their immunological advantage over men despite a better virological treatment response. We recommend continuous follow up of this and more cohorts of patients to better understand the underlying causes for these differences and whether this will translate also in longer term differences. PMID:23320567

  12. Role of traditional healers in psychosocial support in caring for the orphans: A case of Dar-es Salaam City, Tanzania

    PubMed Central

    Kayombo, Edmund J; Mbwambo, Zakaria H; Massila, Mariam

    2005-01-01

    Orphans are an increasing problem in developing countries particularly in Africa; due to the HIV/AIDS pandemic; and needs collective effort in intervention processes by including all stakeholders right from the grass roots level. This paper attempts to present the role of traditional healers in psychosocial support for orphan children in Dar-es-Salaam City with special focus on those whose parents have died because of HIV/AIDS. Six traditional healers who were involved in taking care of orphans were visited at their "vilinge" (traditional clinics). In total they had 72 orphans, 31 being boys and 41 being girls with age range from 3 years to 19. It was learned that traditional healers, besides providing remedies for illnesses/diseases of orphans, they also provided other basic needs. Further, they even provided psychosocial support allowing children to cope with orphan hood life with ease. Traditional healers are living within communities at the grass roots level; and appear unnoticed hidden forces, which are involved in taking care of orphans. This role of traditional healers in taking care of orphans needs to be recognised and even scaling it up by empowering them both in financial terms and training in basic skills of psychosocial techniques in how to handle orphans, in order to reduce discrimination and stigmatisation in the communities where they live. PMID:16270914

  13. Urban solid waste management in Tanzania Issues, concepts and challenges

    Microsoft Academic Search

    Michael Yhdego

    1995-01-01

    Urban solid waste in Tanzania in general and in Dar es Salaam city in particular, is a serious environmental problem. Concurrent with recent socioeconomic development, coupled with liberalization of the economy and rapid population growth, the quantum of solid waste generated has increased at a rapid rate. The manner in which urban solid waste is managed in Dar es Salaam

  14. HPLC analysis of anti-malaria agent, chloroquine in blood and tissue from forensic autopsy cases in Tanzania

    Microsoft Academic Search

    Kosei Yonemitsu; Ako Koreeda; Kazuhiko Kibayashi; Paul Ng'walali; Martin Mbonde; James Kitinya; Shigeyuki Tsunenari

    2005-01-01

    HPLC analysis of anti-malaria agent, chloroquine (CQ) in blood and tissues with a simple HCl back extraction method was applied to three forensic autopsy cases in Dar es Salaam, Tanzania. CQ concentrations in femoral vein blood were 8.5, 48.4 and 43.8?g\\/ml in three cases, respectively, which were high enough to attribute the cause of deaths to an acute CQ poisoning.

  15. Challenges of caring for children with mental disorders: Experiences and views of caregivers attending the outpatient clinic at Muhimbili National Hospital, Dar es Salaam - Tanzania

    PubMed Central

    2012-01-01

    Background It is estimated that world-wide up to 20?% of children suffer from debilitating mental illness. Mental disorders that pose a significant concern include learning disorders, hyperkinetic disorders (ADHD), depression, psychosis, pervasive development disorders, attachment disorders, anxiety disorders, conduct disorder, substance abuse and eating disorders. Living with such children can be very stressful for caregivers in the family. Therefore, determination of challenges of living with these children is important in the process of finding ways to help or support caregivers to provide proper care for their children. The purpose of this study was to explore the psychological and emotional, social, and economic challenges that parents or guardians experience when caring for mentally ill children and what they do to address or deal with them. Methodology A qualitative study design using in-depth interviews and focus group discussions was applied. The study was conducted at the psychiatric unit of Muhimbili National Hospital in Tanzania. Two focus groups discussions (FGDs) and 8 in-depth interviews were conducted with caregivers who attended the psychiatric clinic with their children. Data analysis was done using content analysis. Results The study revealed psychological and emotional, social, and economic challenges caregivers endure while living with mentally ill children. Psychological and emotional challenges included being stressed by caring tasks and having worries about the present and future life of their children. They had feelings of sadness, and inner pain or bitterness due to the disturbing behaviour of the children. They also experienced some communication problems with their children due to their inability to talk. Social challenges were inadequate social services for their children, stigma, burden of caring task, lack of public awareness of mental illness, lack of social support, and problems with social life. The economic challenges were poverty, child care interfering with various income generating activities in the family, and extra expenses associated with the child’s illness. Conclusion Caregivers of mentally ill children experience various psychological and emotional, social, and economic challenges. Professional assistance, public awareness of mental illnesses in children, social support by the government, private sector, and non-governmental organizations (NGOs) are important in addressing these challenges. PMID:22559084

  16. Noise pollution associated with the operation of the Dar es Salaam International Airport

    Microsoft Academic Search

    Rubhera R. A. M Mato; T. S Mufuruki

    1999-01-01

    The operation of airports results in environmental impacts associated with high levels of noises and vibrations. These may have severe negative effects to both workers and surrounding residents and their properties. Here we look at the noise impacts associated with the operation of the Dar es Salaam International Airport (DIA) in Tanzania. Field measurements were carried out to determine noise

  17. 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.

  18. Prevalence of erectile dysfunction and associated factors among diabetic men attending diabetic clinic at Muhimbili National Hospital in Dar-es-Salaam, Tanzania

    PubMed Central

    Mutagaywa, Reuben Kato; Lutale, Janeth; Aboud, Muhsin; Kamala, Benjamin Anathory

    2014-01-01

    Introduction There has been an increase in the prevalence of erectile dysfunction (ED) in the general population especially among Diabetic patients. This seems to be neglected problem in low-income countries. This study aims at establishing the prevalence of ED and associated risk factors in diabetic patients attended at Diabetic Clinic at Muhimbili National Hospital. Methods A cross-sectional hospital based study was conducted among 312 diabetic patients attending diabetic clinic at Muhimbili National Hospital between May and December 2011. Results More than half (55.1%) of the patients were found to have some form of ED (12.8% had mild dysfunction, 11.5% moderate and 27.9% severe dysfunction). The severity of ED was correlated with increased age. Multivariate logistic regression revealed that ED was significantly predicted by old age (odds ratio (OR) = 7.1, 95% CI 1.2-40.7), evidence of peripheral neuropathy (OR) =5.9, 95% CI 1.6-21.3), and evidence of peripheral vascular disease (OR =2.5, 95% CI 1.2-5.3). Also longer duration of DM was marginally associated with ED (p=0.056). Patients with ED were also more likely to suffer other sexual domains (p<0.001). No lifestyle factor was associated with ED. Conclusion The prevalence of ED is high among DM patients. Interventions aimed at prevention, early diagnosis and detection of DM and its complications, and adherence to treatment to prevent complications should be implemented. Further studies should emphasize on temporal variation to show true causality of DM on erectile dysfunction. PMID:25170371

  19. Elemental Contents in Hair of Children from Two Regions in Dar Es Salaam

    PubMed Central

    Mohammed, Najat K.

    2012-01-01

    The work presented in this paper is part of the study which aims at determining the levels of elements in hair of children in Tanzania as a bioindicator of their nutrition and health. In this paper, the levels of trace elements in hair from children living in Dar es Salaam have been analysed. The analysis was carried out by long and short irradiation INAA at the reactor centre of the Institute of Nuclear Physics, Rez Czech Republic. 22 samples were collected from children living at Kiwalani about 12 km from Dar es Salaam city and 16 samples from children living at Mlimani, the main campus of University of Dar es Salaam. A total of 34 elements were found in the hair of the children. There were no big differences between the concentration levels of the essential elements in hair samples collected from the children which might indicate the same food consumption habits. PMID:22505919

  20. STUDIES ON THE STRUCTURE AND PROBLEMS OF FAMILY POULTRY PRODUCTION IN TANZANIA

    Microsoft Academic Search

    H. M. MSAMI

    STUDIES ON THE STRUCTURE AND PROBLEMS OF FAMILY POULTRY PRODUCTION IN TANZANIA. In order to identify the major disease conditions and factors limiting family chicken production in Coast and Dar-es-Salaam regions of Tanzania a survey was undertaken in six villages in two zones involving a total of 43 households. Field data were collected through identified farmer interviews in the wet

  1. Agricultural Marketing and Supply Chain Management in Tanzania: A Case Study

    Microsoft Academic Search

    Elina Eskola; East Africa Economies

    ABSTRACT This study describes the prevailing marketing arrangements in Tanzania at local, regional, national and export markets using Dar es Salaam, Ifakara, and Mtwara as case study examples. The major impediments for trade in Tanzania has been categorised into three groups: 1) Physical infrastructure, 2) know-how and capital, and 3) institutional framework. Insufficient physical infrastructure in terms of roads increases

  2. Excreta disposal in Dar-es-Salaam.

    PubMed

    Chaggu, Esnati; Mashauri, Damas; van Buuren, Joost; Sanders, Wendy; Lettinga, Gatze

    2002-11-01

    The sociocultural and socioeconomic situation of sanitation in Dar-es-Salaam (Dsm), Tanzania, was studied with explicit emphasis on pit-latrines. Without considering the sociocultural conditions, the so-called best solution might not be the right one. Therefore, in order to achieve the intended goal, a literature review, a questionnaire survey, and personal visits to the chosen study areas were done. In total, 207 household questionnaires were filled in 16 areas of the city. Interviewers did house-to-house visits and questionnaires were filled out on the spot. Results indicated that the city population is about 3.8 million at present, with over 80% of the dwellers using pit-latrines; some 3% use septic tanks with soakage pits, about 6% are connected to the sewerage system, and 1% have no excreta disposal facility. Difficulties faced include dismal budget allocations, fragmentation of sanitation activities among subsectors, lack of or poor sanitation record keeping, unsatisfactory machinery for septic tank and pit-latrine emptying, lack of a clear policy on pit-latrine handling and, in competition for resources, low priority is accorded to an excreta disposal system among the people. City residents will continue to use the pit-latrines for a long time to come. Reusing the fecal sludge is not known by most city dwellers and is influenced by sociocultural habits. To prevent groundwater pollution and to recover useful products in human excreta and urine, ecological sanitation toilets and anaerobic digesters offer a good option. PMID:12375082

  3. Marketing of Information in the Water Sector in Tanzania: A Strategy for MAJIDOC.

    ERIC Educational Resources Information Center

    Michael, Benedict P.

    1992-01-01

    Outlines a strategy for marketing the information products and services of the Water and Sanitation Information and Documentation Centre (MAJIDOC) of the Water Resources Institute in Dar es Salaam, Tanzania. Objectives of the marketing strategy are explained, ideas for internal and external promotion are described, and a budget plan is included.…

  4. The spectrum of dermatological disorders among primary school children in Dar es Salaam

    Microsoft Academic Search

    Ewaldo V Komba; Yassin M Mgonda

    2010-01-01

    BACKGROUND: Dermatologic disorders are common in many countries but the spectrum varies greatly. Many studies have reported a significant burden of skin diseases in school children. The objective of this study was to determine the current spectrum of dermatological disorders in primary school children in Dar es Salaam city. METHODS: Primary school children were recruited by multistage sampling. Detailed interview,

  5. 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.

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

    Microsoft Academic Search

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

    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 verbatim, and analyzed using qualitative content analysis. Five themes emerged summarizing factors associated with sexual offenses, including

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

    PubMed

    Kelly, Ann H; Lezaun, Javier

    2014-05-01

    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

  8. Participatory Mapping as a Component of Operational Malaria Vector Control in Tanzania

    Microsoft Academic Search

    Stefan Dongus; Victoria Mwakalinga; Khadija Kannady; Marcel Tanner; Gerry Killeen

    \\u000a Global efforts to tackle malaria have gained unprecedented momentum. However, in order to move towards the ambitious goal\\u000a of eliminating and eventually eradicating malaria, existing tools must be improved and new tools developed. The City of Dar\\u000a es Salaam, Tanzania, is home to the first operational community-based larviciding programme targeting malaria vectors in modern\\u000a Africa. In an attempt to optimize

  9. [AIDS in Tanzania].

    PubMed

    Barstad, S

    1993-04-20

    The World Health Organization has announced that within 3 years 10% of Tanzania's population of 26 million will be infected with the human immunodeficiency virus (HIV). But there is some faint hope in the research of Tanzanian traditional medicine. An almost 90-year-man, Waziri Mrisho, is credited with having treated AIDS patients successfully with herbs that strengthen the immune system. Margaret Nakamya was stricken by the symptoms of AIDs in March 1990. She was referred to Waziri and started using his herbs. 3 years later she weighs 49 kg compared to 40 kg before. The old man's son set up a little factory where he pulverizes herbs and sells them at the price he can command The 3 types of trees that the herbal medicine is taken from grow in the wild, but some have also been planted around the factory. Even if these herbs are effective, it will take years before the AIDS epidemic is over, when people have changed their lifestyles. The means of communication (TV, cinema, radio, telephone) are missing or inadequate. In the Kagera region, with 1.2 million inhabitants, 25% of pregnant women are HIV-infected and 65,000 children lost their parents to AIDS. There are 2000 children in Dar Es Salaam living in the streets. The Anglican St. Albans Church runs a center for street kids where they get meals 3 times a week. The nurse Ruth Nesje enlisted a Norwegian physician and homeopath in a research project involving 30 AIDS patients in Norway. The University in Bergen will do in vitro testing. One group of patients will receive both AZT and the herbs, another group will get only AZT, and the 3rd group will obtain only the herbs. The Norwegian Nursing Association, NORAD, and DANIDA also plan various projects in the Tanga region. PMID:8499187

  10. 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

  11. Population change in Tanzania 1978-88: a preliminary analysis.

    PubMed

    Barke, M; Sowden, C

    1992-04-01

    The preliminary results of Tanzania's 1988 census disclosed that the average annual rate of population growth decreased from 3.3% during 1967-78 to 2.8%. The growth of Dar es Salaam declined from 7.8% to 4.8% with a total of 1,723,000 people. Tanzania's total population numbered 23,174,336. The economic growth of 4.1% exceeded population growth. The population increased by 37% between 1978 and 1988. 10.1% of the population lived in the 20 largest towns in 1978; this increased to 12.7% in 1988. Population density increased from 20 people/sq km in 1978 to 26 in 1988. High density extended from Dar es Salaam northwest to around Lake Victoria. Many districts with agricultural advantages had a density of 100, and also exhibited signs of population pressure by the 1970s. In 1988 the male:female ratio stayed unchanged with 96 males for 100 females (with extremes of 84.5 and 108). In 16 of 20 towns the ratios were above average, and in 6 towns including Dar es Salaam, Tanga, Arusha, Moshi, Mtwara, and Bukoba, even the urban average of 110 was exceeded. In some towns, females surpassed males as a result of migration to cities to join husbands or make a living in trade or in the informal economic sector. Consequently, the sex ration decrease exceeded 10 points in Mwanza, Arusha, Dodoma, Shinyanga, and Bukoba. The average urban sex ratio decline was only 5 points. The fall of the population growth rate requires the examination of mortality and fertility rates to ascertain the causes. PMID:12286487

  12. 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…

  13. Reduction of anti-malarial consumption after rapid diagnostic tests implementation in Dar es Salaam: a before-after and cluster randomized controlled study

    PubMed Central

    2011-01-01

    Background Presumptive treatment of all febrile patients with anti-malarials leads to massive over-treatment. The aim was to assess the effect of implementing malaria rapid diagnostic tests (mRDTs) on prescription of anti-malarials in urban Tanzania. Methods The design was a prospective collection of routine statistics from ledger books and cross-sectional surveys before and after intervention in randomly selected health facilities (HF) in Dar es Salaam, Tanzania. The participants were all clinicians and their patients in the above health facilities. The intervention consisted of training and introduction of mRDTs in all three hospitals and in six HF. Three HF without mRDTs were selected as matched controls. The use of routine mRDT and treatment upon result was advised for all patients complaining of fever, including children under five years of age. The main outcome measures were: (1) anti-malarial consumption recorded from routine statistics in ledger books of all HF before and after intervention; (2) anti-malarial prescription recorded during observed consultations in cross-sectional surveys conducted in all HF before and 18 months after mRDT implementation. Results Based on routine statistics, the amount of artemether-lumefantrine blisters used post-intervention was reduced by 68% (95%CI 57-80) in intervention and 32% (9-54) in control HF. For quinine vials, the reduction was 63% (54-72) in intervention and an increase of 2.49 times (1.62-3.35) in control HF. Before-and-after cross-sectional surveys showed a similar decrease from 75% to 20% in the proportion of patients receiving anti-malarial treatment (Risk ratio 0.23, 95%CI 0.20-0.26). The cluster randomized analysis showed a considerable difference of anti-malarial prescription between intervention HF (22%) and control HF (60%) (Risk ratio 0.30, 95%CI 0.14-0.70). Adherence to test result was excellent since only 7% of negative patients received an anti-malarial. However, antibiotic prescription increased from 49% before to 72% after intervention (Risk ratio 1.47, 95%CI 1.37-1.59). Conclusions Programmatic implementation of mRDTs in a moderately endemic area reduced drastically over-treatment with anti-malarials. Properly trained clinicians with adequate support complied with the recommendation of not treating patients with negative results. Implementation of mRDT should be integrated hand-in-hand with training on the management of other causes of fever to prevent irrational use of antibiotics. PMID:21529365

  14. 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.

  15. Comparison of intervention methods for reducing human exposure to Mycobacterium bovis through milk in pastoralist households of Tanzania.

    PubMed

    Roug, Annette; Perez, Andres; Mazet, Jonna A K; Clifford, Deana L; VanWormer, Elizabeth; Paul, Goodluck; Kazwala, Rudovick R; Smith, Woutrina A

    2014-08-01

    Bovine tuberculosis (bTB), caused by Mycobacterium bovis, is a disease of zoonotic concern, especially in countries with no control programs in livestock and where routine pasteurization of milk is not practiced. In Tanzania, bTB is widespread in livestock and has been diagnosed in humans; however, herd bTB testing is primarily carried out for bTB-free certification in commercial dairy herds at the expense of the dairy cattle owner. For rural livestock holders, such an expense is prohibitive, and consequently there is no control of bTB in most areas. Although effective long-term solutions to control bTB in livestock are desirable, there is a need to assess the effect of preventive measures on reducing human exposure to bTB in such settings. We utilized locally relevant cattle herd characteristics and management data from the Health for Animals and Livelihood Improvement (HALI) project in south-central Tanzania to build a Reed-Frost model that compared the efficacy of alternative methods aimed at reducing the exposure of humans to infectious milk from a typical pastoralist cattle herd. During a 10-year simulation period, the model showed that boiling milk 80% of the time is necessary to obtain a reduction in liters of infectious milk approximately equivalent to what would be obtained with a standard 2-year testing and removal regimen, and that boiling milk was more effective than animal test and removal early in the time period. In addition, even with testing and removing infected cattle, a residual risk of exposure to infectious milk remained due to imperfect sensitivity of the skin test and a continuous risk of introduction of infectious animals from other herds. The model was sensitive to changes in initial bTB prevalence but not to changes in herd size. In conclusion, continuous complimentary treatment of milk may be an effective strategy to reduce human exposure to M. bovis-infected milk in settings where bTB is endemic and a comprehensive bTB control program is yet to be implemented. PMID:24853050

  16. 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

  17. Recent demographic change in Tanzania: causes, consequences and future prospects.

    PubMed

    Mturi, A J; Hinde, P R

    1995-01-01

    This description of the nature and consequences of demographic change in Tanzania is based on data from censuses in 1967, 1978, and 1988, and the 1991-92 Demographic and Health Survey (DHS). Intercensal decline in the two past decades was from 3.2% to 2.8%. The total fertility rate (TFR) computed with the Brass method from census data was 6.9 births per woman in 1967 and 6.5 in 1988. Reconstruction from retrospective data in the 1991-92 DHS yielded TFR 6.1 for 1988-92. The expectation of life at birth rose to 49 years in 1988, and the infant mortality rate (IMR) declined to 115 per 1000 live births. The 1991-92 DHS shows infant mortality of 92 infant deaths per 1000 live births, based on direct reports. Indirect estimation from DHS data yields an IMR of 100 infant deaths per 1000 live births. The mortality decline is attributed to the improvement in full immunization, which in 1991-92 covered 71% of children 12-23 months old. Regional differences in infant mortality are taken from estimation computed by Komba and Chuwa. These results indicate that low fertility (under 5.5 children per woman) is evident in Dar es Salaam, Morogoro, Pwani, Iringa, Kilimanjaro, Singida, and Mtwara. Regions with high fertility (over 6 children per woman) are Kagera, Mwanza, Shinyanga, and all regions in Zanzibar except Zanzibar town and west Zanzibar. Infant mortality under 100 deaths per 1000 live births is evident in Kilimanjaro, Arusha, and Singida regions. High IMR (over 130 deaths) regions are Lindi, Mtwara, Dodoma, Rukwa, Iringa, Kagera, and Zanzibar North. The National Population Policy Commission reports early marriage and low contraceptive use as determinants of high fertility. Other factors are identified as son preference, low educational levels, low status of women, large age differences between spouses, and desire for large families. An analysis of Tanzanian determinants (Mturi and Hinde) also points to long birth intervals, urban residence, and polygamous marriages in influencing fertility decline. Analysis of the increased risk of child death reveals determinants as region of residence, short birth intervals, teenaged pregnancy, and prior child deaths. Future sustained fertility is dependent on breast feeding trends, adolescent fertility, and increases in contraceptive prevalence. PMID:12319909

  18. Deficiencies of macronutrient intake among HIV-positive breastfeeding women in Dar es Salaam, Tanzania.

    PubMed

    Kim, Faith; Neke, Nyasule M; Hendricks, Kristy; Wamsele, Joyce; Lukmanji, Zohra; Waddell, Richard; Maro, Isaac; Connor, Ruth; Mackenzie, Todd; Matee, Mecky; Bakari, Muhammad; Pallangyo, Kisali; von Reyn, C Fordham

    2014-12-15

    We compared macronutrient intake, food insecurity, and anthropometrics in breastfeeding women: 40 HIV-positive women not yet on antiretroviral therapy and 40 HIV-negative women. Calculated deficits at 2 weeks were 517 kcal per day for HIV-positive women vs 87 kcal per day surplus for HIV-negative women (P = 0.01) and 29 g protein per day for HIV-positive women vs 16 g protein per day for HIV-negative women (P = 0.04). Food insecurity scores were 11.3 for HIV-positive women vs 7.8 for HIV-negative women (P < 0.01). Enhanced dietary education together with macronutrient supplementation may be required to improve health outcomes in HIV-positive women and their infants. PMID:25230293

  19. 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

  20. Microbiological quality of milk in Tanzania: from Maasai stable to African consumer table.

    PubMed

    Schoder, Dagmar; Maichin, Andreas; Lema, Benedict; Laffa, John

    2013-11-01

    In Tanzania, pastoralists such as the Maasai and small urban farmers are responsible for the country's milk production, and 95% of the national milk supply is sold without regulation. This study was conducted using hygiene checklists and milk sampling to investigate milk quality and safety at various steps throughout the milk production chain. In regions of Dar es Salaam and Lake Victoria, 196 milk samples were collected: 109 samples of raw milk, 41 samples of packed or open served heat-treated products, and 46 samples of fermented products. Samples were taken from (i) the production level (pastoralists and urban farmers), (ii) the collection level (middlemen and depots), (iii) processors (dairies), and (iv) retailers (kiosks). Samples were analyzed for hygiene criteria (total bacteria, total coliforms, Escherichia coli, and coagulase-positive staphylococci) and foodborne pathogens such as Salmonella, enterohemorrhagic E. coli O157:H7, and Listeria monocytogenes. Adequate heating of milk for drinking was determined via heat labile alkaline phosphatase and lactoperoxidase analysis. Total bacterial counts indicated that only 67% (73 of 109) of raw milk samples and 46% (19 of 41) of heat-treated samples met national Tanzanian standards. Bulk milk samples taken from the traditional milking vessels of Maasai pastoralists had the lowest total bacterial counts: ? 1 × 10(2) CFU/ml. Foodborne pathogens such as E. coli O157:H7 and Salmonella were isolated from 10.1% (11 of 109) of raw milk samples but were not detected in heat-treated or fermented products, and 83% of heat-treated milk samples were lactoperoxidase negative, indicating overpasteurization. Coliforms were detected in 41% (17 of 41) of processed milk samples, thus indicating a high rate of recontamination. A progressive decrease in microbial quality along the milk production chain was attributed to departures from traditional methods, inadequate milk containers, long transport distances, lack of cooling, and lack of a basic understanding of hygiene. PMID:24215695

  1. Delivering at home or in a health facility? health-seeking behaviour of women and the role of traditional birth attendants in Tanzania

    PubMed Central

    2013-01-01

    Background Traditional birth attendants retain an important role in reproductive and maternal health in Tanzania. The Tanzanian Government promotes TBAs in order to provide maternal and neonatal health counselling and initiating timely referral, however, their role officially does not include delivery attendance. Yet, experience illustrates that most TBAs still often handle complicated deliveries. Therefore, the objectives of this research were to describe (1) women’s health-seeking behaviour and experiences regarding their use of antenatal (ANC) and postnatal care (PNC); (2) their rationale behind the choice of place and delivery; and to learn (3) about the use of traditional practices and resources applied by traditional birth attendants (TBAs) and how they can be linked to the bio-medical health system. Methods Qualitative and quantitative interviews were conducted with over 270 individuals in Masasi District, Mtwara Region and Ilala Municipality, Dar es Salaam, Tanzania. Results The results from the urban site show that significant achievements have been made in terms of promoting pregnancy- and delivery-related services through skilled health workers. Pregnant women have a high level of awareness and clearly prefer to deliver at a health facility. The scenario is different in the rural site (Masasi District), where an adequately trained health workforce and well-equipped health facilities are not yet a reality, resulting in home deliveries with the assistance of either a TBA or a relative. Conclusions Instead of focusing on the traditional sector, it is argued that more attention should be paid towards (1) improving access to as well as strengthening the health system to guarantee delivery by skilled health personnel; and (2) bridging the gaps between communities and the formal health sector through community-based counselling and health education, which is provided by well-trained and supervised village health workers who inform villagers about promotive and preventive health services, including maternal and neonatal health. PMID:23448583

  2. Adolescent girls with illegally induced abortion in Dar es Salaam: the discrepancy between sexual behaviour and lack of access to contraception.

    PubMed

    Rasch, V; Silberschmidt, M; Mchumvu, Y; Mmary, V

    2000-05-01

    This article reports on a study of induced abortion among adolescent girls in Dar es Salaam, Tanzania, who were admitted to a district hospital in Dar es Salaam because of an illegally induced abortion in 1997. In the quantitative part of the study, 197 teenage girls (aged 14-19) were asked for socio-economic details, contraceptive knowledge/use, age at first intercourse and number of sexual partners. In the qualitative part, 51 teenage girls were interviewed in-depth about their relationships with their partners, sexual behaviour, contraceptive use and reasons for non-use, and why they became pregnant. The girls were sexually active at an early age and having sex mainly with men older than themselves. Although most of the girls were in love with and enjoyed sex with their partners, they also entered these relationships to obtain money or gifts in exchange for sex. Most were not using contraception or condoms though they were also at risk of STDs and HIV. These girls were getting pregnant expecting their boyfriends to marry them, or because they did not think they could become pregnant or failed to use contraception correctly. Most adolescent girls are not aware of the 1994 Tanzanian policy that gave them the right to seek family planning services and in practice these services are not being provided. There is a need for youth-friendly family planning services and to make abortion safe and legal, in order to reduce unwanted pregnancies and abortion-related complications and deaths among adolescent girls. PMID:11424268

  3. OA60?Public health and palliative care mix; a ccpmedicine approach to reverse the overgrowing burden of non-communicable diseases in tanzania.

    PubMed

    Frank, Manase; Bwemero, Joel; Kalunga, Deborah; Sangu, Willy; Semeni, Segella; Hamisi, Mwanahamisi; Julius, Mwaiselage

    2015-04-01

    : Outline of the Talk: The global prevalence of non-communicable diseases has increased persistently affecting developed and developing world. In 2008 alone 14 million premature deaths were reported globally and it is projected to reach 52 million by 2030. Diagnosis of NCDs in many of the developing countries [including Tanzania] is often made late while the disease progression advances leaving a very limited chance for interventions to yield good health outcomes. A recent study [2011] conducted in Dar es Salaam, Tanzania on NCDs revealed that, around 16% of people admitted in referral hospitals had diabetes, and 88% had hypertension. The CCPmedicine is a community based private organisation that focuses on promoting healthy behaviour practices through prevention of non-communicable diseases in Tanzania by helping communities to take a leading role to promote their own health through health education, early detection of diseases, and facilitates timely disease interventions CCPmedicine approach to Public Health and Palliative Care mix in addressing the burden of NCDs in low resource countries like Tanzania has recently attracted policy makers, and practices to engage and support Palliative Care Services. In this paper we seek to share our experience of working with the private and public sectors to promote palliative care services in Tanzania. PMID:25960482

  4. 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

  5. Geological Survey of Tanzania

    NSDL National Science Digital Library

    The United Republic of Tanzania was formed in 1964 by the merger of Tanganyika and Zanzibar and is located on the eastern coast of Africa between the Great Lakes of the Rift Valley. Tanzania has a diverse mineral resource base that includes gold and base metals, diamond-bearing kimberlites, nickel, cobalt, copper, coal resources, and a variety of industrial minerals and rocks such as kaolin, graphite, and dimension stone. This web site was created by the Mineral Resources Department (MRD), a subsidiary of the Ministry of Energy and Minerals, and contains basic information about the country's logistical environment, mineral sector policy, geological database, and more.

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

    Microsoft Academic Search

    Nicodem J Govella; Prosper P Chaki; John M Mpangile; Gerry F Killeen

    2011-01-01

    Background  Ifakara tent traps (ITT) are currently the only sufficiently sensitive, safe, affordable and practical method for routine\\u000a monitoring host-seeking mosquito densities in Dar es Salaam. However, it is not clear whether ITT catches represent indoors\\u000a or outdoors biting densities. ITT do not yield samples of resting, fed mosquitoes for blood meal analysis.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Outdoors mosquito sampling methods, namely human landing catch

  7. Quantitation of multiple mycotoxins and cyanogenic glucosides in cassava samples from Tanzania and Rwanda by an LC-MS/MS-based multi-toxin method.

    PubMed

    Sulyok, M; Beed, F; Boni, S; Abass, A; Mukunzi, A; Krska, R

    2015-01-01

    A multi-mycotoxin method based on liquid chromatography/tandem mass spectrometry (LC-MS/MS) was used for a mycotoxin survey in 627 samples of processed cassava collected from different districts across Tanzania and Rwanda after the method performance for this matrix had been determined. Matrix effects as well as extraction efficiencies were found to be similar to most other previously investigated matrices with the exception of distinct matrix effects in the negative ionisation mode for early eluting compounds. Limits of detection were far below the regulatory limits set in the European Union for other types of commodities. Relative standard deviations were generally lower than 10% as determined by replicates spiked on two concentration levels. The sample-to-sample variation of the apparent recoveries was determined for 15 individually spiked samples during three different analytical sequences. The related standard deviation was found to be lower than 15% for most of the investigated compounds, thus confirming the applicability of the method for quantitative analysis. The occurrence of regulated mycotoxins was lower than 10% (with the exception of zearalenone) and the related limits were exceeded only in few samples, which suggests that cassava is a comparatively safe commodity as regards mycotoxins. The most prevalent fungal metabolites were emodin, kojic acid, beauvericin, tryptophol, 3-nitropropionic acid, equisetin, alternariol methylether, monocerin, brevianamide F, tenuazonic acid, zearalenone, chrysophanol, monilifomin, enniatins, apicidin and macrosporin. The related concentrations exceeded 1 mg kg(-1) only in few cases. However, extremely high levels of cyanogenic plant toxins, which had been previously added to the method, were observed in few samples, pointing out the need for improved post-harvest management to decrease the levels of these compounds. PMID:25350522

  8. 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

  9. 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 Central

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

    2014-01-01

    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 blaVIM-2. The blaVIM-2-positive isolates belonged to two different sequence types (ST), ST244 and ST640, with blaVIM-2 located in an unusual integron structure lacking the 3? conserved region of qac?E1-sul1. PMID:25331700

  10. 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

  11. [Population census in Tanzania].

    PubMed

    Altvall, H E

    1981-01-01

    This article is based on the author's experience as a population census expert in Tanzania during the years preceding and following the August 1978 census. Information is included on the census objectives, time schedule, organizational structure, questionnaire work, pilot tests, preparatory geographical work, sample selection for the detailed version of the questionnaire, training of enumerators and supervisors, execution of the census, and analysis of the data. Summary results concerning population size and growth are also presented. (summary in ENG) PMID:12177841

  12. 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

  13. Adult Students go to Tanzania

    ERIC Educational Resources Information Center

    Harvey, Brian

    1976-01-01

    A preparatory course and a three-week study safari to Tanzania were conducted jointly by the University of Southampton and Nottingham University. The course sought to increase the participants' understanding of Tanzania's geography, economy, politics, education, and social systems. The actual visit is also described. (Author/EC)

  14. Corporal Punishment in Tanzania's Schools

    ERIC Educational Resources Information Center

    Feinstein, Sheryl; Mwahombela, Lucas

    2010-01-01

    The purpose of this survey was to acquire descriptive information regarding corporal punishment in Tanzania's O-level secondary schools. 448 individuals participated in the study: 254 teachers and 194 students, all from government or private secondary schools in the Iringa Region of Tanzania. In addition, 14 students and 14 teachers were…

  15. Incremental effect of natural tick challenge on the infection and treatment method-induced immunity against T. parva in cattle under agro-pastoral systems in Northern Tanzania.

    PubMed

    Kazungu, Yvette E M; Mwega, Elisa; Neselle, Moses Ole; Sallu, Raphael; Kimera, Sharadhuli I; Gwakisa, Paul

    2015-07-01

    This study was conducted to assess the incremental effect of natural tick challenge on the infection and treatment method-induced immunity against T. parva under agro-pastoral systems in Simanjiro district, Northern Tanzania. T. parva specific antibody percent positivity and prevalence of T. parva parasites were studied in relation to duration post vaccination and proximity to Tarangire National park. A total of 381 cattle were included in this study, of which 127 were unvaccinated and 254 had been vaccinated at different time points between 2008 and 2014. Antibody percent positivity (PP) determined by the PIM-based T. parva ELISA and the prevalence of T. parva parasites detected by a nested PCR based on the p104 gene were used to compare vaccinated and unvaccinated cattle. Results showed that seroprevalence was significantly higher in vaccinated than unvaccinated cattle (OR 10.89, p=0.0341). Only 1.6% (6/381) of all cattle were seronegative and 5/6 of these were unvaccinated. Prevalence of T. parva parasites was significantly higher in vaccinated (50.39%) than unvaccinated (19.69%) cattle (OR 2.03, p=0.0144). While there was a positive association between PP and duration post vaccination but the latter was inversely associated with T. parva parasite prevalence. This study also showed that cattle which were closer to the park had higher antibody PP and T. parva prevalence. It is concluded that duration post vaccination as well as proximity from the wildlife in Tarangire National park together may exert an incremental effect on the outcome of ECF vaccination by influencing stronger antibody immunity of cattle and ability to withhold high T. parva infection pressure under constant field tick challenge. Further, the high seroprevalence in vaccinated and unvaccinated cattle suggests a likely state of endemic stability to T. parva in the study area. PMID:26005108

  16. Soil test calibration studies for formulation of phosphorus fertilizer recommendations for maize in Morogoro district, Tanzania. I. evaluation of soil test methods

    Microsoft Academic Search

    D. A. Ussiri; P. N. S. Mnkeni; A. F. MacKenzie; J. M. R. Semoka

    1998-01-01

    Optimum crop production depends, among other things, on the maintenance of adequate plant nutrients in the root zone. The objective of this study was to find a reliable index for assessing needs for supplemental phosphorus (P) in soils of Morogoro District, Tanzania. Six indices of P availability, namely: Bray and Kurtz No. 1 (BK1), Bray and KurtzNo.2 (BK2), Mehlich 1,

  17. Investigations on the effect of traditional food processing, preservation and storage methods on vegetable nutrients: A case study in Tanzania

    Microsoft Academic Search

    M. H. Lyimo; S. Nyagwegwe; A. P. Mnkeni

    1991-01-01

    The effect of traditional food proceesing, preservation and storage methods on vegetable nutrients was studied using cassava, pumpkin and mwage leaves. Traditional cooking method for 90 min for cassava, 50 min for pumpkin and mwage leaves resulted in significant losses in protein, fats and vitamins. Sundrying using traditional mats caused losses of vitamin A of 36.3%, 38.0% and 50.3% for

  18. 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

  19. Habitat characterization and spatial distribution of Anopheles sp. mosquito larvae in Dar es Salaam (Tanzania) during an extended dry period

    Microsoft Academic Search

    Michael A Sattler; Deo Mtasiwa; Michael Kiama; Zul Premji; Marcel Tanner; Gerry F Killeen; Christian Lengeler

    2005-01-01

    INTRODUCTION: By 2030, more than 50% of the African population will live in urban areas. Controlling malaria reduces the disease burden and further improves economic development. As a complement to treated nets and prompt access to treatment, measures targeted against the larval stage of Anopheles sp. mosquitoes are a promising strategy for urban areas. However, a precise knowledge of the

  20. Solid waste collection by the private sector: Households’ perspective—Findings from a study in Dar es Salaam city, Tanzania

    Microsoft Academic Search

    Salha M. Kassim; Mansoor Ali

    2006-01-01

    The issue of poor solid waste management (SWM) is a challenge throughout the world, in both developed and developing countries. People always generate solid waste through their daily activities. This solid waste needs to be properly managed in a way that minimises risk to the environment and human health, which means storage, collection and proper disposal. At the same time

  1. A SWOT analysis of strategic urban development planning: The case of Dar es Salaam city in Tanzania

    Microsoft Academic Search

    Francos Halla

    2007-01-01

    Preparation and implementation of urban general and detailed planning schemes, according to respective legislation, preoccupies most practitioners of the profession of urban and regional development planning and management worldwide. For a century lasting from 1850s to 1940s the professional practice was guided by the urban design paradigm, which embodies architectural concepts and principles of municipal engineering. For the following half

  2. 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.

  3. 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…

  4. Under-5 Mortality in Tanzania: A Demographic Scenario

    PubMed Central

    Sathiya Susuman, A; Hamisi, Hamisi F

    2012-01-01

    Background: The government of the United Republic of Tanzania has initiated the Integrated Management of Childhood Illness program to improve the health and wellbeing of children. Methods: Tanzania’s under-five mortality rate is still 1.7 times higher than the world average and, in order to achieve its Millennium Development Goal 4 target, its annual reduction rate is quite low at 2.2. The main aim of the study is to examine under-five mortality combined with the Data from the Tanzania Demographic and Health Survey 2008 data was used. Odds ratios for infant and under-five mortality were estimated using logistic regression; crude and adjusting models were adopted. Results: Mortality cases (18.3%) have been reported to children born with an interval of <24 months. Mothers with no education reported 14.6%, primary education mothers reported 11.1% and higher education reported only 5.3% (P<0.001). Therefore, maternal education plays is a major role on fertility and infant and under-five mortality behavior. Conclusion: Maternal education also influences a mother’s behavior in her usage of available health services to improve the health of the children. Further in-depth analysis is immensely needed in this situation. PMID:23641385

  5. 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

  6. Reforming Teacher Education in Tanzania

    ERIC Educational Resources Information Center

    Hardman, Frank; Abd-Kadir, Jan; Tibuhinda, Audax

    2012-01-01

    It is widely acknowledged that in order to improve the quality of education in primary schools in developing countries there is a need to place pedagogy and its training implications at the centre of teacher education reform. Like many countries in Eastern and Southern Africa, Tanzania has introduced various initiatives and reforms to improve the…

  7. Commercial Banks Efficiency in Tanzania

    Microsoft Academic Search

    Jehovaness Aikaeli

    Abstract Efficient banking,system reflects a sound intermediation process and hence the banks’ due contribution to economic growth. If commercial banks are functioning efficiently, monetary policies are likely to be effective. This study is motivated by the fact that, though banking sector is the largest part of the financial system in Tanzania, little is known about its efficiency status. Secondary time

  8. 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

  9. Unsafe abortion in Tanzania and the need for involving men in postabortion contraceptive counseling.

    PubMed

    Rasch, Vibeke; Lyaruu, Mathias A

    2005-12-01

    Targeting male partners involved in unsafe abortions for contraceptive counseling could be an important strategy for decreasing the incidence of unwanted pregnancies, yet few postabortion-care programs have attempted to involve these men. To assess the need for and determine the content of postabortion contraceptive counseling for men, this study examined the contraceptive knowledge, attitudes, and practices of male partners of women who have had an unsafe abortion. A survey was administered to 213 men accompanying female partners receiving hospital care after having undergone an unsafe abortion in Dar es Salaam, Tanzania, and 20 of these men participated in in-depth interviews. Sixteen percent of the men surveyed accompanied an extramarital partner, and of those, only 44 percent reported having practiced contraception in the last six months, compared with 81 percent of the men accompanying their wives and 83 percent accompanying their girlfriends. In general, the men wished to support their partners in practicing contraception, and the majority were willing to participate in contraceptive counseling. These findings suggest that male partners should be included in postabortion contraceptive counseling, which should be sensitive to the nature of the partners' relationship, the risk of HIV transmission, and the importance of promoting gender PMID:16395947

  10. Species distribution and in vitro antifungal susceptibility of oral yeast isolates from Tanzanian HIV-infected patients with primary and recurrent oropharyngeal candidiasis

    Microsoft Academic Search

    Omar JM Hamza; Mainen J Moshi; Elison NM Simon; Ferdinand Mugusi; Frans HM Mikx; W. H. van Palenstein Helderman; Antonius JMM Rijs; André JAM van der Ven; Paul E Verweij

    2008-01-01

    BACKGROUND: In Tanzania, little is known on the species distribution and antifungal susceptibility profiles of yeast isolates from HIV-infected patients with primary and recurrent oropharyngeal candidiasis. METHODS: A total of 296 clinical oral yeasts were isolated from 292 HIV-infected patients with oropharyngeal candidiasis at the Muhimbili National Hospital, Dar es Salaam, Tanzania. Identification of the yeasts was performed using standard

  11. Corporal punishment in Tanzania's schools

    NASA Astrophysics Data System (ADS)

    Feinstein, Sheryl; Mwahombela, Lucas

    2010-10-01

    The purpose of this survey was to acquire descriptive information regarding corporal punishment in Tanzania's O-level secondary schools. 448 individuals participated in the study: 254 teachers and 194 students, all from government or private secondary schools in the Iringa Region of Tanzania. In addition, 14 students and 14 teachers were interviewed. It was found that corporal punishment was the most common form of punishment in secondary schools. The majority of teachers supported its continued use, but believed in moderation. The majority of students and teachers were unaware of national laws to restrict corporal punishment. There was agreement between students and teachers that corporal punishment was used for major and minor student offences such as misbehaviour and tardiness. Students reported disliking the practice and believed it was ineffective and resulted in emotional, as well as physical, distress.

  12. New approach to improve livelihoods for poor farmers and pastoralist in Tanzania through monitoring and control of African armyworm, Spodoptera exampta

    Microsoft Academic Search

    Wilfred L Mushobozi; David Grzywacz; Ken Wilson; Richard Musebe; Martin Kimani; Chatham Maritime

    A new strategy to control African armyworm in Tanzania is reviewed, with the utilization of the natural disease of the armyworm, Spodoptera exempta nucleopolyhedrovirus (SpexNPV) for control of armyworm outbreaks in Tanzania serving as case- study. Also the opportunity of linking novel control methods with Community Based Armyworm Forecasting (CBAF) is reviewed. Results from both ground and aerial application have

  13. Helium and carbon isotope systematics of Rungwe geothermal gases and fluids; southern Tanzania

    NASA Astrophysics Data System (ADS)

    Barry, P. H.

    2009-12-01

    P. H. BARRY1*, D. R. HILTON1, T. P. FISCHER2, J. M. DE MOOR2, F. MANGASINI3 C. RAMIREZ4 1 Geosciences Research Division, Scripps Institution of Oceanography, UCSD, La Jolla, California 92093-0244, USA (*Correspondence: pbarry@ucsd.edu) 2 Department of Earth and Planetary Sciences, MSC 03 2040, 1 University of New Mexico, Albuquerque, New Mexico 87131-0001, USA. 3 Department of Mining and Mineral Processing Engineering, University of Dar Es Salaam, PO Box 35131, Dar Es Salaam, Tanzania. 4 Centro de Investigaciones en Ciencias Geologicas, Escuela Centroamericana de Geologia, Universidad de Costa Rica. The East African Rift (EAR) is the largest modern example of continental rifting, extending from the Afar depression in the north to the Rungwe region in southern Tanzania. EAR volcanism is attributed to the presence of one or more mantle plumes [1]. Late Miocene to recent volcanism and geothermal activity mark the Rungwe region [2], with mafic eruptions as recently as 200 years ago. Our aim is to delineate the southern geographical extent of plume influence on the propagating EAR by investigating the He-CO2 characteristics of geothermal fluids in the Rungwe region. We report new helium (He) and carbon (C) isotopes (3He/4He, ?13C) and relative abundance (CO2/3He) characteristics for a suite of 20 geothermal gas and fluid samples from 11 different localities in the Rungwe region. He-isotopes are in good agreement with previous reports [3], and range from ~1 RA to ~7 RA (MORB-like values), indicating admixture between upper mantle He and variable proportions of radiogenic He. C-isotopes ranges from -2.8 to -6.5 ‰ (vs. PDB) with all falling in the MORB range (~4.5 ± 2‰). CO2/3He ratios vary over 5 orders of magnitude from ~3 x 10^9 (MORB-like) to higher values (up to ~3 x 10^13) normally associated with crustal lithologies. Taken together, the He-CO2 data can be explained by 2-component mixing of a deep-seated mantle source with crustal component(s). There are no observed latitudinal isotopic trends in He-CO2. However, the two localities with MORB-like 3He/4He ratios ~6 to 7 RA, ?13C ~ -4 to -5 ‰ and CO2/3He ~ 4 x10^9 are both cold temperature (~ 15°C) CO2 gas vents. The MORB-like characteristics of these cold vents are comparable to MORB-like values observed at Oldoinyo Lengai in northern Tanzania [4], suggesting that both Rungwe region and Oldoinyo Lengai may derive their volatile compositions from a homogeneous (MORB-like) mantle source common to the entire segment of the southern EAR. [1] Furman (2007) Journal of African Earth Sciences 48, 147-160. [2] Ebinger et al. (1989) Journal of Geophysical Research 94, 15,785-15,803. [3] Pik et al. (2006) Chemical Geology 226, 100-114. [4] Fisher et al. (2009) Nature 459, 77-80.

  14. "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…

  15. A study on problems of management of medical solid wastes in Dar es Salaam and their remedial measures

    Microsoft Academic Search

    R. R. A. M Mato; G. R Kassenga

    1997-01-01

    The collection, storage and disposal of medical solid wastes is a growing environmental problem in Tanzania which needs immediate attention before it goes out of hand. While the Government of Tanzania is making efforts to expand medical services by allowing private hospitals in the country, the management of medical wastes has received little attention despite their potential environmental hazards and

  16. Costing maternal health services in South Tanzania

    Microsoft Academic Search

    Claudia von Both; Albrecht Jahn; Steffen Fleßa

    2008-01-01

    The following paper presents the methodology and results of a costing exercise of maternal health services in Tanzania. The\\u000a main objective of this study was to determine the actual costs of antenatal and obstetric care in different health institutions\\u000a in a district in Tanzania as a basis of more efficient resource allocation. A costing tool was developed that allows the

  17. Results of Co-Teaching Instruction to Special Education Teacher Candidates in Tanzania

    ERIC Educational Resources Information Center

    Frey, Laura M.; Kaff, Marilyn S.

    2014-01-01

    This mixed-method descriptive pilot investigation addressed co-teaching as an inclusive school practice for special education teacher candidates at Sebastian Kolowa Memorial University (SEKOMU) in Tanzania. The investigation results, though preliminary, indicate that course content and instruction in co-teaching had a positive impact on the…

  18. 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…

  19. Geographical Aspects of Cancer in Tanzania

    PubMed Central

    Alexander, George A.

    1983-01-01

    Cancer is an important cause of morbidity and mortality in Tanzania. According to the Tanzanian Cancer Registry, which records all histologically confirmed malignant tumors, the number of reported cancer cases has increased significantly over the past three decades. The most commonly diagnosed tumors are cervix cancer, skin cancer, primary liver cancer, Kaposi's sarcoma, and Burkitt's lymphoma. Geographical and tribal variations exist in disease frequency. Environmental factors appear to have a major role in the distribution. Through elimination of these factors, cancer in Tanzania could be reduced if not totally prevented. ImagesFigure 3Figure 4Figure 5Figure 6Figure 7Figure 8 PMID:6631988

  20. Balancing abstraction and natural groundwater recharge as a mechanism of sustainable water use: a case study of the Kizinga catchment in Dar es Salaam region, Tanzania

    NASA Astrophysics Data System (ADS)

    Mkwizu, Yassin B.

    This paper focuses on balancing groundwater recharge and abstraction rates as a mechanism of ensuring sustainability of groundwater use. It uses a case study which was done in the Kizinga catchment area where its recharge rates were evaluated and then compared to that of abstraction. The study area is drained by river Kizinga having its upper reaches in Pugu and Kisarawe hills with a total surface area of 191 km 2. Determination of groundwater recharge rates gave a mean value of 52.8 mm/year which is equivalent to 10.1 × 10 6 m 3/year indicating that, 4.7% of the long term mean annual precipitation of 1124 mm ends up as groundwater recharge. Borehole yields was 3.4 × 10 6 m 3/year by the year 1997. Two years later the total yield tripled to 9.1 × 10 6 m 3/year which is an increase of about 179% of groundwater production. Based on the study findings, it is therefore suggested that proper management of groundwater utilization be established to balance recharge with discharge. This will ensure that groundwater abstraction is done sustainably and thus avoid negative consequences resulting from groundwater depletion.

  1. Who Gets Prompt Access to Artemisinin-Based Combination Therapy? A Prospective Community-Based Study in Children from Rural Kilosa, Tanzania

    Microsoft Academic Search

    Daudi O. Simba; Marian Warsame; Deodatus Kakoko; Zakayo Mrango; Goran Tomson; Zul Premji; Max Petzold; Abdisalan M. Noor

    2010-01-01

    BackgroundEffective and timely case management remains one of the fundamental pillars for control of malaria. Tanzania introduced artemisinin-combination therapy [ACT] for uncomplicated malaria; however, the policy change is challenged by limited availability of ACTs due to high cost. This study aimed to determine factors influencing prompt access to ACTs among febrile children in rural Kilosa, Tanzania.Methods and FindingsIn a community-based

  2. 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…

  3. Geologic map of Oldonyo Lengai (Oldoinyo Lengai) Volcano and surroundings, Arusha Region, United Republic of Tanzania

    USGS Publications Warehouse

    Sherrod, David R.; Magigita, Masota M.; Kwelwa, Shimba

    2013-01-01

    The geology of Oldonyo Lengai volcano and the southernmost Lake Natron basin, Tanzania, is presented on this geologic map at scale 1:50,000. The map sheet can be downloaded in pdf format for online viewing or ready to print (48 inches by 36 inches). A 65-page explanatory pamphlet describes the geologic history of the area. Its goal is to place the new findings into the framework of previous investigations while highlighting gaps in knowledge. In this way questions are raised and challenges proposed to future workers. The southernmost Lake Natron basin is located along the East African rift zone in northern Tanzania. Exposed strata provide a history of volcanism, sedimentation, and faulting that spans 2 million years. It is here where Oldonyo Lengai, Tanzania’s most active volcano of the past several thousand years, built its edifice. Six new radiometric ages, by the 40Ar/39Ar method, and 48 new geochemical analyses from Oldonyo Lengai and surrounding volcanic features deepen our understanding of the area. Those who prefer the convenience and access offered by Geographic Information Systems (GIS) may download an electronic database, suitable for most GIS software applications. The GIS database is in a Transverse Mercator projection, zone 36, New (1960) Arc datum. The database includes layers for hypsography (topography), hydrography, and infrastructure such as roads and trails.

  4. Kenya & Tanzania: a ClassiC safari

    E-print Network

    Connor, Ed

    Kenya & Tanzania: a ClassiC safari A Special Departure August 15 ­ 27, 2012 for Johns Hopkins volcano; Bilila Lodge Serengeti in the heart of the northern Serengeti; the Fairmont Mount Kenya SafariMartinCenter,2ndFloor 3400N.CharlesStreet Baltimore,Maryland21218 Johns Hopkins Reservation Form ­ Kenya

  5. 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…

  6. Human migration, protected areas, and conservation outreach in Tanzania.

    PubMed

    Salerno, Jonathan D; Borgerhoff Mulder, Monique; Kefauver, Shawn C

    2014-06-01

    A recent discussion debates the extent of human in-migration around protected areas (PAs) in the tropics. One proposed argument is that rural migrants move to bordering areas to access conservation outreach benefits. A counter proposal maintains that PAs have largely negative effects on local populations and that outreach initiatives even if successful present insufficient benefits to drive in-migration. Using data from Tanzania, we examined merits of statistical tests and spatial methods used previously to evaluate migration near PAs and applied hierarchical modeling with appropriate controls for demographic and geographic factors to advance the debate. Areas bordering national parks in Tanzania did not have elevated rates of in-migration. Low baseline population density and high vegetation productivity with low interannual variation rather than conservation outreach explained observed migration patterns. More generally we argue that to produce results of conservation policy significance, analyses must be conducted at appropriate scales, and we caution against use of demographic data without appropriate controls when drawing conclusions about migration dynamics. PMID:24476123

  7. 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.

  8. Appropriate deflouridation technology for use in flourotic areas in Tanzania

    NASA Astrophysics Data System (ADS)

    Mjengera, H.; Mkongo, G.

    High fluoride in drinking water is a problem found in both ground and surface water in various parts of Tanzania. Several defluoridation methods have been tested and detailed studies have been carried on bone-char method, alum/lime method and the combination of the two methods. In bone char method, the bones are charred in special kilns fuelled by wood charcoal. Different sizes of the kiln have been fabricated and tested. Crushing and sieving devices have been developed. The effectiveness of bone char particles sizes in fluoride removal has been studied and the results favoured small particle sizes. However, experimental conditions discouraged the use of very fine particles sizes of bone char due easy clogging. Household and institutional levels bone char defluoridation systems have been developed and tested. Filter columns packed with heat-activated bones are found to be more effective than fill and draw bucket type defluoridator. The bone char media used has the capability of producing water with a residual fluoride concentration of less than 0.1 mg/l from an initial fluoride of 12.0 mg/l. Use of alum and lime in fluoride removal from waters with excessive fluoride has been experimented upon. A plant with an automatic chemical dosing and mixing system for use at institutional levels has been developed and tested. The method was able to treat water with an initial fluoride concentration of 12 mg/l to a residual fluoride concentration ranging from 2 to 3 mg/l. During the study it was established, that the bone char method is appropriate for use in rural areas of Tanzania due its simplicity, local availability of materials and the possibility of processing the material locally.

  9. Attitudes of men towards family planning in Mbeya region, Tanzania: a rural-urban comparison of qualitative data.

    PubMed

    Mwageni, E A; Ankomah, A; Powell, R A

    1998-07-01

    Family planning programmes in Tanzania date back to the 1950s. By the early 1990s, however, only 5-10% of women of childbearing age used contraceptives in the country. Low contraceptive prevalence in Tanzania is reportedly attributable to men's opposition to family planning. This paper employs focus groups to explore the role of Tanzanian men in family planning. More specifically, it presents a rural-urban comparison of the attitudes of men in Mbeya region, Tanzania, to family size preference, sex composition, partners' communication on family planning matters and contraceptive behavior. Findings indicate that men express positive attitudes towards fertility-regulating methods. There is, moreover, little rural-urban variation in male attitudes towards family planning in the study area. Possible reasons for this normative convergence (including structural similarities and rural-urban migration between the two communities) are discussed. PMID:9746836

  10. Polycystic ovaries and associated clinical and biochemical features among women with infertility in a tertiary hospital in Tanzania.

    PubMed

    Pembe, A B; Abeid, M S

    2009-10-01

    The aim of this study was to determine prevalence of polycystic ovaries (PCO) and associated clinical and biochemical features among women with infertility attending gynaecological outpatient department (GOPD) at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. All women with infertility attending the GOPD from 11th September 2006 to 15th February 2007 were recruited to the study. Information on socio-demographic, obstetric and menstrual characteristics was collected. Anthropometric measurement, clinical examination of acne and hirsutism, vaginal ultrasonography for PCO and biochemical analysis of luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone were performed. All 102 women who attended the GOPD during the study period due to infertility were recruited. Two women were excluded after diagnosis of pregnancy made by hormonal assay and ultrasonography thus remaining with 100 women for analysis. Oligomenorrhoea and acne were significantly higher in a group of women with PCO than among women with normal ovaries. The mean hirsutism score though was not significant, was higher in women with PCO than in women with normal ovaries (5.1 +/- 2.7 vs. 4 +/- 2.4, P < 0.057). Using the Rotterdam criteria 32 (32%) women were diagnosed to have polycystic ovary syndrome (PCOS). Among these women 25 (78.1%) had PCO, 24 (75%) had signs of oligoanovulation, and 18 (56.3%) had hirsutism. Among 68 women with no PCOS, 7 (10.3%) had polycystic ovaries, 15 (22.1%) had signs of oligoanovulation and 6 (8.8%) had hirsutism. In conclusion, polycystic ovaries are common among women with infertility, however are not necessarily associated with polycystic ovary syndrome. Doctors should investigate their clients for PCOS and offer appropriate treatment. PMID:20734696

  11. Participatory wildlife surveys in communal lands: a case study from Simanjiro, Tanzania

    E-print Network

    Participatory wildlife surveys in communal lands: a case study from Simanjiro, Tanzania Fortunata U, Tanzania; 4 Tanzania Wildlife Research Institute, PO Box 661, Arusha, Tanzania; 5 Center for Collaborative that protected areas alone are not sufficient to conserve wildlife populations particularly for migratory or wide

  12. Role of cattle treated with deltamethrine in areas with a high population of Anopheles arabiensis in Moshi, Northern Tanzania

    Microsoft Academic Search

    Aneth M Mahande; Franklin W Mosha; Johnson M Mahande; Eliningaya J Kweka

    2007-01-01

    BACKGROUND: Malaria control measures were initiated from in October 2005 to August 2006 in the Lower Moshi irrigation schemes, Tanzania. This manuscript reports on the entomological evaluation of the impact of pyrethroid-treated cattle in reducing the population of the Anopheles arabiensis for selected houses in the Lower Moshi irrigation scheme. METHODS: Cattle were sprayed with the pyrethroid (deltamethrin) acaricide. Grazing

  13. Local management practices for dealing with change and uncertainty - a cross-scale comparison of cases in Sweden and Tanzania

    Microsoft Academic Search

    Maria Tengö; Kristina Belfrage

    2007-01-01

    ABSTRACT We investigated and compared management practices for dealing with uncertainty in agroecosystem dynamics in two cases of smallholder farming in different parts of the world: northeast Tanzania and east-central Sweden. Qualitative research methods were applied to map farmers' practices related to agroecosystem management. The practices are clustered according to a framework of ecosystem services relevant for agricultural production and

  14. Quality of paediatric blood transfusions in two district hospitals in Tanzania: a cross-sectional hospital based study

    Microsoft Academic Search

    Dominic Mosha; Anja Poulsen; Hugh Reyburn; Elimsaada Kituma; Frank Mtei; Ib C Bygbjerg

    2009-01-01

    BACKGROUND: Blood transfusion (BT) can be lifesaving for children; however, monitoring the quality of BT is important. The current study describes the quality of paediatric BT delivered in two district hospitals in north-east Tanzania in order to identify areas for quality assurance and improvement in the administration of BT. METHODS: All 166 children admitted in the paediatric wards and receiving

  15. The Book Industry in Tanzania. Occasional Paper No. 15.

    ERIC Educational Resources Information Center

    Kaungamno, E. E.

    This comprehensive treatment of the state of the publishing industry in Tanzania provides a general description of the book trade in Africa, including discussions of the types of publishers active in Africa and of the recording of African publishing output, and a review of publishing activities in Tanzania, which covers the history of Tanzanian…

  16. Crisis in the wetlands: Combined stresses in a changing climate – Experience from Tanzania

    Microsoft Academic Search

    Hamudu I. Hamisi; Madaka Tumbo; Elikana Kalumanga; Pius Yanda

    2012-01-01

    Climate variability and change has led to multifaceted stresses and compounded socio-environmental problems. Using the example of Simiyu wetlands in Tanzania, this article analyses the complexity and inter-connectedness of climate-related mal-adaptation and coping strategies and their implications. Various study methods were used, including consultative meetings, stakeholders workshops, a literature review, household questionnaires and land use cover and change analysis. Reactive

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

    Microsoft Academic Search

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

    2010-01-01

    AimsTo 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.MethodsWe 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

  18. 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

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

    PubMed

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

    2014-08-11

    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

  20. 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

  1. Structure and performance of infectious disease surveillance and response, United Republic of Tanzania, 1998.

    PubMed Central

    Nsubuga, Peter; Eseko, Nicholas; Tadesse, Wuhib; Ndayimirije, Nestor; Stella, Chungong; McNabb, Scott

    2002-01-01

    OBJECTIVE: To assess the structure and performance of and support for five infectious disease surveillance systems in the United Republic of Tanzania: Health Management Information System (HMIS); Infectious Disease Week Ending; Tuberculosis/Leprosy; Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome; and Acute Flaccid Paralysis/Poliomyelitis. METHODS: The systems were assessed by analysing the core activities of surveillance and response and support functions (provision of training, supervision, and resources). Data were collected using questionnaires that involved both interviews and observations at regional, district, and health facility levels in three of the 20 regions in the United Republic of Tanzania. FINDINGS: An HMIS was found at 26 of 32 health facilities (81%) surveyed and at all 14 regional and district medical offices. The four other surveillance systems were found at <20% of health facilities and <75% of medical offices. Standardized case definitions were used for only 3 of 21 infectious diseases. Nineteen (73%) health facilities with HMIS had adequate supplies of forms; 9 (35%) reported on time; and 11 (42%) received supervision or feedback. Four (29%) medical offices with HMIS had population denominators to use for data analyses; 12 (86%) were involved in outbreak investigations; and 11 (79%) had conducted community prevention activities. CONCLUSION: While HMIS could serve as the backbone for IDSR in the United Republic of Tanzania, this will require supervision, standardized case definitions, and improvements in the quality of reporting, analysis, and feedback. PMID:11984605

  2. Maritime and Underwater Cultural Heritage Initiatives in Tanzania and Mozambique

    NASA Astrophysics Data System (ADS)

    Jeffery, Bill; Parthesius, Robert

    2013-06-01

    The aim of this paper is provide an overview of the capacity building programmes in maritime and underwater cultural heritage (MUCH) conducted by the authors in Tanzania and Mozambique. Tanzania and Mozambique have long histories of indigenous cultures, foreign contacts and influences and African adaptations beginning in the late Greco-Roman period, when the coastal populations exploited the peoples and riches of the interior. Today the coastline contains numerous examples of indigenous tangible and intangible heritage and many sites and histories related to the Swahili culture. Some exploratory research and training has been conducted in Tanzania and Mozambique, but the implementation by local residents of their own MUCH programme is still at an early stage. Under a UNESCO agreement framework, Tanzania in particular has started to develop a MUCH programme, which can assist in highlighting their extensive histories, cultural landscapes and cultural identity.

  3. Trends in chloroquine resistance marker, Pfcrt-K76T mutation ten years after chloroquine withdrawal in Tanzania

    PubMed Central

    2013-01-01

    Background Plasmodium falciparum resistance to anti-malarial drugs remains a major obstacle to the control of malaria. In 2001 Tanzania replaced chloroquine (CQ) with sulphadoxine-pyrimethamine (SP) as first-line drug, which in turn was replaced by artemisinin combination therapy in 2006. SP has however, continued to be used in intermittent preventive treatment of malaria in pregnancy (IPTp) despite reports of high levels of resistance to SP due to the lack of alternatives to SP for IPTp. Recent reports have indicated recovery of CQ-susceptibility in Malawi, Kenya, Mozambique, and Tanzania based on the prevalence of wild types at codon 76 of the Pfcrt gene in indigenous P. falciparum populations. The current prevalence of this Pfcrt-76 CQ resistance marker from six regions of Tanzania mainland is hereby reported. Methods DNA extracted from filter-paper dried blood spots and rapid diagnostics kit strips collected from finger-prick blood were used to genotype the Pfcrt-76 resistance marker using PCR-RFLP. Data from previously published studies were used to generate CQ susceptibility recovery trends using logistic regression model. Results Seven hundred and forty one (741) samples were genotyped. The current frequency of the CQ-susceptible Pfcrt-K76 was above 92% and did not differ between regions in Tanzania (?2?=?2.37; p?=?0.795). The K76 allelic prevalence was between 85.7 and 93% in regions (?2?=?7.88, p?=?0.163). The CQ resistance recovery trends showed regional variability that may be caused by differences in malaria transmission intensity, but overall the trends converge as the susceptibility levels in all regions approach >90%. Conclusions CQ withdrawal in Tanzania has resulted into >90% recovery of susceptibility in ten years of withdrawal. These findings are in support of the search for CQ-based combination drugs as a possible future alternative to SP for IPTp in places where full recovery of CQ-susceptibility will be evident. PMID:24225406

  4. Productivity analysis and technology adoption for livestock in Tanzania 

    E-print Network

    Njukia, James Wambugu

    1977-01-01

    agricultural produc- tion increased at a slow rate in Kenya, showed considerable variability without an upward trend in Tanzania, and declined in Ethiopia and Uganda. Per capita food production declined throughout this period in Tanzania, Uganda... and Ethiopia, and in Kenya the maximum levels achieved in the seventies are still below the peak levels of the sixties (USDA Econ. Res. Service 1976). The decline in food production has resulted in a reallocation of scarce foreign exchange reserves...

  5. Human resources for emergency obstetric care in northern Tanzania: distribution of quantity or quality?

    PubMed Central

    Olsen, Øystein Evjen; Ndeki, Sidney; Norheim, Ole Frithjof

    2005-01-01

    Background Health care agencies report that the major limiting factor for implementing effective health policies and reforms worldwide is a lack of qualified human resources. Although many agencies have adopted policy development and clinical practice guidelines, the human resources necessary to carry out these policies towards actual reform are not yet in place. Objectives The goal of this article is to evaluate the current status of human resources quality, availability and distribution in Northern Tanzania in order to provide emergency obstetric care services to specific districts in this area. The article also discusses the usefulness of distribution indicators for describing equity in the decision-making process. Methods We conducted a quantitative facility survey in six districts of Northern Tanzania. We collected data from all 129 facilities that provide delivery services in the study area. The data includes information on the emergency obstetric care indicators, as described by the WHO/UNICEF/UFPA guidelines for monitoring the provision of obstetric care. The inventory also includes information on the numbers of qualified health personnel at the basic and comprehensive emergency obstetric care level. We analysed the distribution and workload of the available human resources in a wider policy context with a particular focus on equity, use and quality, by means of descriptive statistics and the Spearman's correlation test. Results We determined that there are adequate human resources allocated for health care provision in Tanzania, according to national standards. Compared to similar countries however, Tanzania has a very low availability of health care staff. Most qualified staff are concentrated in a few centralized locations, while those remaining are inequitably and inefficiently distributed in rural areas and lower-level services. Rural districts have restricted access to government-run health care, because these facilities are understaffed. In fact, voluntary agency facilities in these districts have more staff than the government facilities. There is a statistical correlation between availability of qualified human resources and use of services, but the availability of qualified human resources does not automatically translate into higher availability of qualified emergency obstetric care services. Conclusion National guidelines for human resources for health care in Tanzania require focused revisions in order to reflect the quality indicators more adequately when monitoring and setting criteria for HR distribution. Availability of qualified personnel as well as institutional management and capacity determine the quality of emergency obstetric care services and personnel. The current wide distribution of staff of inadequate quality should be reconsidered. The use of distribution indicators alone is not useful to properly monitor equity. This article suggests increasing access to high-quality health care instead of distributing low-quality services widely. PMID:16053519

  6. 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

  7. 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

  8. 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

    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

  9. Tribe or Nation?: Nation Building and Public Goods in Kenya versus Tanzania

    Microsoft Academic Search

    Edward Miguel

    2004-01-01

    This paper examines how government policies affect inter-ethnic relations by comparing outcomes across two nearby districts, one in Kenya and one in Tanzania. Despite similar geography and colonial legacies, post-independence governments in Kenya and Tanzania have followed radically different language, education, and local institutional policies, with Tanzania consistently pursuing more serious \\

  10. Tanzania's health system and workforce crisis.

    PubMed

    Kwesigabo, Gideon; Mwangu, Mughwira A; Kakoko, Deodatus C; Warriner, Ina; Mkony, Charles A; Killewo, Japhet; Macfarlane, Sarah B; Kaaya, Ephata E; Freeman, Phyllis

    2012-01-01

    This introduction to Tanzania's health system and acute workforce shortage familiarizes readers with the context in which health professions education takes place. The paper touches on poverty rates, population growth, and characteristics of the health system. The critical shortage of trained health staff is a major challenge facing the health sector, aggravated by low motivation of the few available staff. Other challenges facing the health sector include lack of effective staff supervision, poor transport and communication infrastructure and shortage of drugs and medical equipment. We recommend appropriate action be taken by the government and other stakeholders to provide more financial and human resources for the sector while ensuring their efficient and effective utilization to improve services delivery. PMID:23254848

  11. 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.

  12. Domestic pigs as potential reservoirs of human and animal trypanosomiasis in Northern Tanzania

    PubMed Central

    2013-01-01

    Background Pig keeping is becoming increasingly common across sub-Saharan Africa. Domestic pigs from the Arusha region of northern Tanzania were screened for trypanosomes using PCR-based methods to examine the role of pigs as a reservoir of human and animal trypanosomiasis. Methods A total of 168 blood samples were obtained from domestic pigs opportunistically sampled across four districts in Tanzania (Babati, Mbulu, Arumeru and Dodoma) during December 2004. A suite of PCR-based methods was used to identify the species and sub-species of trypanosomes including: Internally Transcribed Sequence to identify multiple species; species specific PCR to identify T. brucei s. l. and T. godfreyi and a multiplex PCR reaction to distinguish T. b. rhodesiense from T. brucei s. l. Results Of the 168 domestic pigs screened for animal and human infective trypanosome DNA, 28 (16.7%) were infected with one or more species of trypanosome; these included: six pigs infected with Trypanosoma vivax (3.6%); three with Trypanosoma simiae (1.8%); two with Trypanosoma congolense (Forest) (1%) and four with Trypanosoma godfreyi (2.4%). Nineteen pigs were infected with Trypanosoma brucei s. l. (10.1%) of which eight were identified as carrying the human infective sub-species Trypanosoma brucei rhodesiense (4.8%). Conclusion These results show that in Tanzania domestic pigs may act as a significant reservoir for animal trypanosomiasis including the cattle pathogens T. vivax and T. congolense, the pig pathogen T. simiae, and provide a significant reservoir for T. b. rhodesiense, the causative agent of acute Rhodesian sleeping sickness. PMID:24499540

  13. Dusty discos and dangerous desires: community perceptions of adolescent sexual and reproductive health risks and vulnerability and the potential role of parents in rural Mwanza, Tanzania

    Microsoft Academic Search

    Pieter Remes; Jenny Renju; Kija Nyalali; Lemmy Medard; Michael Kimaryo; John Changalucha; Angela Obasi; Daniel Wight

    2010-01-01

    This paper presents villagers' assessments of young people's sexual and reproductive health vulnerability and of community-based interventions that may reduce both vulnerability and risk in rural Mwanza, Tanzania. The primary methods used were 28 group discussions and 18 in-depth interviews with representatives of various social groups in four villages. The majority of participants attributed young people's sexual and reproductive health

  14. Effect of large-scale social marketing of insecticide-treated nets on child survival in rural Tanzania

    Microsoft Academic Search

    Joanna RM Armstrong Schellenberg; Salim Abdulla; Rose Nathan; Oscar Mukasa; Tanya J Marchant; Nassor Kikumbih; Adiel K Mushi; Haji Mponda; Happiness Minja; Hassan Mshinda; Marcel Tanner; Christian Lengeler

    2001-01-01

    Summary Background Insecticide-treated nets have proven efficacy as a malaria-control tool in Africa. However, the transition from efficacy to effectiveness cannot be taken for granted. We assessed coverage and the effect on child survival of a large- scale social marketing programme for insecticide-treated nets in two rural districts of southern Tanzania with high perennial malaria transmission. Methods Socially marketed insecticide-treated

  15. Antenatal care in practice: an exploratory study in antenatal care clinics in the Kilombero Valley, south-eastern Tanzania

    Microsoft Academic Search

    Karin Gross; Joanna Armstrong Schellenberg; Flora Kessy; Constanze Pfeiffer; Brigit Obrist

    2011-01-01

    Background  The potential of antenatal care for reducing maternal morbidity and improving newborn survival and health is widely acknowledged.\\u000a Yet there are worrying gaps in knowledge of the quality of antenatal care provided in Tanzania. In particular, determinants\\u000a of health workers' performance have not yet been fully understood. This paper uses ethnographic methods to document health\\u000a workers' antenatal care practices with

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

    Microsoft Academic Search

    Rose M Laisser; Lennarth Nyström; Helen I Lugina; Maria Emmelin

    2011-01-01

    Background  Intimate partner violence against women is a prevailing public health problem in Tanzania, where four of ten women have a\\u000a lifetime exposure to physical or sexual violence by their male partners. To be able to suggest relevant and feasible community\\u000a and health care based interventions, we explored community members' understanding and their responses to intimate partner\\u000a violence.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  A qualitative study

  17. Estimating Leptospirosis Incidence Using Hospital-Based Surveillance and a Population-Based Health Care Utilization Survey in Tanzania

    PubMed Central

    Biggs, Holly M.; Hertz, Julian T.; Munishi, O. Michael; Galloway, Renee L.; Marks, Florian; Saganda, Wilbrod; Maro, Venance P.; Crump, John A.

    2013-01-01

    Background The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions and disease control. In this study, we estimate the incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania. Methodology/Principal Findings We conducted a population-based household health care utilization survey in two districts in the Kilimanjaro Region of Tanzania and identified leptospirosis cases at two hospital-based fever sentinel surveillance sites in the Kilimanjaro Region. We used multipliers derived from the health care utilization survey and case numbers from hospital-based surveillance to calculate the incidence of leptospirosis. A total of 810 households were enrolled in the health care utilization survey and multipliers were derived based on responses to questions about health care seeking in the event of febrile illness. Of patients enrolled in fever surveillance over a 1 year period and residing in the 2 districts, 42 (7.14%) of 588 met the case definition for confirmed or probable leptospirosis. After applying multipliers to account for hospital selection, test sensitivity, and study enrollment, we estimated the overall incidence of leptospirosis ranges from 75–102 cases per 100,000 persons annually. Conclusions/Significance We calculated a high incidence of leptospirosis in two districts in the Kilimanjaro Region of Tanzania, where leptospirosis incidence was previously unknown. Multiplier methods, such as used in this study, may be a feasible method of improving availability of incidence estimates for neglected diseases, such as leptospirosis, in resource constrained settings. PMID:24340122

  18. Ending open defecation in rural Tanzania: which factors facilitate latrine adoption?

    PubMed

    Sara, Stephen; Graham, Jay

    2014-09-01

    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

  19. 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

  20. Emergency and critical care services in Tanzania: a survey of ten hospitals

    PubMed Central

    2013-01-01

    Background While there is a need for good quality care for patients with serious reversible disease in all countries in the world, Emergency and Critical Care tends to be one of the weakest parts of health systems in low-income countries. We assessed the structure and availability of resources for Emergency and Critical Care in Tanzania in order to identify the priorities for improving care in this neglected specialty. Methods Ten hospitals in four regions of Tanzania were assessed using a structured data collection tool. Quality was evaluated with standards developed from the literature and expert opinion. Results Important deficits were identified in infrastructure, routines and training. Only 30% of the hospitals had an emergency room for adult and paediatric patients. None of the seven district and regional hospitals had a triage area or intensive care unit for adults. Only 40% of the hospitals had formal systems for adult triage and in less than one third were critically ill patients seen by clinicians more than once daily. In 80% of the hospitals there were no staff trained in adult triage or critical care. In contrast, a majority of equipment and drugs necessary for emergency and critical care were available in the hospitals (median 90% and 100% respectively. The referral/private hospitals tended to have a greater overall availability of resources (median 89.7%) than district/regional hospitals (median 70.6). Conclusions Many of the structures necessary for Emergency and Critical Care are lacking in hospitals in Tanzania. Particular weaknesses are infrastructure, routines and training, whereas the availability of drugs and equipment is generally good. Policies to improve hospital systems for the care of emergency and critically ill patients should be prioritised. PMID:23590288

  1. 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…

  2. Factors affecting medical waste management in low- level health facilities in Tanzania

    Microsoft Academic Search

    S. V. Manyele; T. J. Lyasenga

    2010-01-01

    A study on evaluation of medical waste management systems was conducted in the low-level health facilities (LLHFs) in Dar es Salaam by comparing Ilala and Kinondoni municipalities. Questionnaires, interviews, visits and observation were used in data collection. The study has revealed that; most of the facilities have no specific disposal sites. In Ilala, 70% of the health facilities burn wastes

  3. Tanzania benefits from inter-organizational cooperation.

    PubMed

    1998-08-01

    This article describes observations of a monitoring mission by JOICFP, the IPPF Regional Africa Office, and JICA in Tanzania, during June 7-13, 1998. The team visited the Morogoro region to review and assess the current major Integrated Program (IP) activities. The community-based distribution agents have been successful in gaining the trust of the community and contributing to social change. Agents are motivated to work and receive additional training, even though they do not receive a salary. Communities recognize the agents as their representatives. Training agents at the grass roots level has been cost effective. The visiting doctor scheme has been successful in maximizing use of health personnel. In one example, 92 patients from 3 villages were treated by a visiting doctor, who had an adequate supply of basic drugs. Service fees paid by patients cover the cost of medicine. Women receive reproductive health and sexually transmitted disease check-ups. The Income Generation Activities (IGA) program strengthens income generation and women's organizations. IGA also provides tools for masonry and carpentry to encourage male participation in the program. The IP has cooperative support from UMATI, the Ministry of Health, UNFPA, and the Japanese government. Essential drugs and equipment are procured by JICA, and delivered through the UMATI-JOICFP distribution channels to government health centers and dispensaries and UMATI's clinics. The experience has confirmed the ability of nongovernmental organizations to supply a multi-bilateral project. Grassroots staff are most appreciative. PMID:12321789

  4. Why do health workers in rural Tanzania prefer public sector employment?

    PubMed Central

    2012-01-01

    Background Severe shortages of qualified health workers and geographical imbalances in the workforce in many low-income countries require the national health sector management to closely monitor and address issues related to the distribution of health workers across various types of health facilities. This article discusses health workers' preferences for workplace and their perceptions and experiences of the differences in working conditions in the public health sector versus the church-run health facilities in Tanzania. The broader aim is to generate knowledge that can add to debates on health sector management in low-income contexts. Methods The study has a qualitative study design to elicit in-depth information on health workers' preferences for workplace. The data comprise ten focus group discussions (FGDs) and 29 in-depth interviews (IDIs) with auxiliary staff, nursing staff, clinicians and administrators in the public health sector and in a large church-run hospital in a rural district in Tanzania. The study has an ethnographic backdrop based on earlier long-term fieldwork in Tanzania. Results The study found a clear preference for public sector employment. This was associated with health worker rights and access to various benefits offered to health workers in government service, particularly the favourable pension schemes providing economic security in old age. Health workers acknowledged that church-run hospitals generally were better equipped and provided better quality patient care, but these concerns tended to be outweighed by the financial assets of public sector employment. In addition to the sector specific differences, family concerns emerged as important in decisions on workplace. Conclusions The preference for public sector employment among health workers shown in this study seems to be associated primarily with the favourable pension scheme. The overall shortage of health workers and the distribution between health facilities is a challenge in a resource constrained health system where church-run health facilities are vital in the provision of health care in rural areas and where patients tend to prefer these services. In order to ensure equity in distribution of qualified health workers in Tanzania, a national regulation and legislation of the pension schemes is required. PMID:22480347

  5. Surveillance of artemether-lumefantrine associated Plasmodium falciparum multidrug resistance protein-1 gene polymorphisms in Tanzania

    PubMed Central

    2014-01-01

    Background Resistance to anti-malarials is a major public health problem worldwide. After deployment of artemisinin-based combination therapy (ACT) there have been reports of reduced sensitivity to ACT by malaria parasites in South-East Asia. In Tanzania, artemether-lumefantrine (ALu) is the recommended first-line drug in treatment of uncomplicated malaria. This study surveyed the distribution of the Plasmodium falciparum multidrug resistance protein-1 single nucleotide polymorphisms (SNPs) associated with increased parasite tolerance to ALu, in Tanzania. Methods A total of 687 Plasmodium falciparum positive dried blood spots on filter paper and rapid diagnostic test strips collected by finger pricks from patients attending health facilities in six regions of Tanzania mainland between June 2010 and August 2011 were used. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was used to detect Pfmdr1 SNPs N86Y, Y184F and D1246Y. Results There were variations in the distribution of Pfmdr1 polymorphisms among regions. Tanga region had exceptionally high prevalence of mutant alleles, while Mbeya had the highest prevalence of wild type alleles. The haplotype YFY was exclusively most prevalent in Tanga (29.6%) whereas the NYD haplotype was the most prevalent in all other regions. Excluding Tanga and Mbeya, four, most common Pfmdr1 haplotypes did not vary between the remaining four regions (?2 =?2.3, p =?0.512). The NFD haplotype was the second most prevalent haplotype in all regions, ranging from 17% - 26%. Conclusion This is the first country-wide survey on Pfmdr1 mutations associated with ACT resistance. Distribution of individual Pfmdr1 mutations at codons 86, 184 and 1246 varies throughout Tanzanian regions. There is a general homogeneity in distribution of common Pfmdr1 haplotypes reflecting strict implementation of ALu policy in Tanzania with overall prevalence of NFD haplotype ranging from 17 to 26% among other haplotypes. With continuation of ALu as first-line drug this haplotype is expected to keep rising, thus there is need for continued pharmacovigilance studies to monitor any delayed parasite clearance by the drug. PMID:25007802

  6. Costs of Inaction on Maternal Mortality: Qualitative Evidence of the Impacts of Maternal Deaths on Living Children in Tanzania

    PubMed Central

    Yamin, Alicia Ely; Boulanger, Vanessa M.; Falb, Kathryn L.; Shuma, Jane; Leaning, Jennifer

    2013-01-01

    Background Little is known about the interconnectedness of maternal deaths and impacts on children, beyond infants, or the mechanisms through which this interconnectedness is established. A study was conducted in rural Tanzania to provide qualitative insight regarding how maternal mortality affects index as well as other living children and to identify shared structural and social factors that foster high levels of maternal mortality and child vulnerabilities. Methods and Findings Adult family members of women who died due to maternal causes (N?=?45) and key stakeholders (N?=?35) participated in in-depth interviews. Twelve focus group discussions were also conducted (N?=?83) among community leaders in three rural regions of Tanzania. Findings highlight the widespread impact of a woman’s death on her children’s health, education, and economic status, and, by inference, the roles that women play within their families in rural Tanzanian communities. Conclusions The full costs of failing to address preventable maternal mortality include intergenerational impacts on the nutritional status, health, and education of children, as well as the economic capacity of families. When setting priorities in a resource-poor, high maternal mortality country, such as Tanzania, the far-reaching effects that reducing maternal deaths can have on families and communities, as well as women’s own lives, should be considered. PMID:23990971

  7. 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,…

  8. 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…

  9. Wealth, risk and activity choice: cattle in Western Tanzania

    Microsoft Academic Search

    Stefan Dercon

    1998-01-01

    Imperfect credit markets force households to use their savings for investment. Profitable activities often require lumpy investments, limiting entry by poorer households, resulting in increasing welfare differences. In Tanzania, cattle are a profitable but lumpy investment and a liquid asset for consumption smoothing. Richer households own substantial cattle herds, while poorer households specialize in low return, low risk activities. A

  10. 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

  11. Credit risk management system of a commercial bank in Tanzania

    Microsoft Academic Search

    Evelyn Richard; Marcellina Chijoriga; Erasmus Kaijage; Christer Peterson; Hakan Bohman

    2008-01-01

    Purpose – The purpose of this paper is to develop a conceptual model to be used further in understanding credit risk management (CRM) system of commercial banks (CBs) in an economy with less developed financial sector. Design\\/methodology\\/approach – The paper reviews existing literature that consists mostly evidence from developed countries. A study model is proposed with amendment to fit Tanzania's

  12. Funding, selected issues and trends in Tanzania higher education

    Microsoft Academic Search

    Justinian C. J. Galabawa

    1991-01-01

    The purpose of this article is to discuss the funding constraints as related to higher education in Tanzania. The article discusses also the trend of internal and external efficiency indicators. The funding constraints include: the low growth rate of GDP, balance of payment problems, inflation, devaluation of the shilling, absence of cost-sharing and resources mismanagement. Higher education is characterized by

  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. Literacy and Power--The Cases of Tanzania and Rwanda

    ERIC Educational Resources Information Center

    Wedin, Asa

    2008-01-01

    In this paper it is claimed that the relation between literacy and power is complex. What people do with literacy has effects on power relations but literacy is not democratic "per se". Drawing from two cases from Tanzania and Rwanda it is argued that plans for adult education and literacy education should consider the perspectives of target…

  15. 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…

  16. Teaching with IRA in the Mwanza Region of Tanzania

    ERIC Educational Resources Information Center

    McDermott, Peter

    2010-01-01

    This is a descriptive self-study of my experience participating in IRA's Diagnostic Teaching Project in Tanzania. The paper describes the teacher educators with whom I worked, their responses to IRA's curriculum, and what I learned about Tanzanian people, culture and education. Data are derived from a Likert survey, an open-item questionnaire, and…

  17. Demography of pastoralists: Preliminary data on the Datoga of Tanzania

    Microsoft Academic Search

    Monique Borgerhoff Mulder

    1992-01-01

    Preliminary demographic data are presented on the Datoga, a semi-nomadic pastoral population of northern Tanzania. In comparison with other pastoral populations Datoga fertility is high. There is a marked seasonal distribution of births that is only partly associated with rainfall patterns. Survivorship chances up to the age of 15 are poor, and are independently affected by both length of the

  18. 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

  19. AIDS education in Tanzania: promoting risk reduction among primary school children.

    PubMed Central

    Klepp, K I; Ndeki, S S; Leshabari, M T; Hannan, P J; Lyimo, B A

    1997-01-01

    OBJECTIVES: The purpose of this study was to test the effects of an education program in Tanzania designed to reduce children's risk of human immunodeficiency virus (HIV) infection and to improve their tolerance of and care for people with acquired immunodeficiency syndrome (AIDS). METHODS: A randomized controlled community trial including baseline and 12-month follow-up surveys was employed. Public primary schools in the Arusha and Kilimanjaro regions of Tanzania were stratified according to location and randomly assigned to intervention (n = 6) or comparison (n = 12) conditions. Of the 1063 sixth-grade students (average age: 13.6 years) who participated at baseline, 814 participated in the follow-up survey. RESULTS: At follow-up, statistically significant effects favoring the intervention group were observed for exposure to AIDS information and communication, AIDS knowledge, attitudes toward people with AIDS, and subjective norms and behavioral intentions toward having sexual intercourse. A consistent positive but nonsignificant trend was seen for attitudes toward having sexual intercourse and for initiation of sexual intercourse during the previous year (7% vs 17%). CONCLUSIONS: It is feasible and effective to train local teachers and health workers to provide HIV/AIDS education to Tanzanian primary school children. PMID:9431279

  20. Distribution and spread of pyrethroid and DDT resistance among the Anopheles gambiae complex in Tanzania.

    PubMed

    Kabula, B; Tungu, P; Malima, R; Rowland, M; Minja, J; Wililo, R; Ramsan, M; McElroy, P D; Kafuko, J; Kulkarni, M; Protopopoff, N; Magesa, S; Mosha, F; Kisinza, W

    2014-09-01

    The development of insecticide resistance is a threat to the control of malaria in Africa. We report the findings of a national survey carried out in Tanzania in 2011 to monitor the susceptibility of malaria vectors to pyrethroid, organophosphate, carbamate and DDT insecticides, and compare these findings with those identified in 2004 and 2010. Standard World Health Organization (WHO) methods were used to detect knock-down and mortality rates in wild female Anopheles gambiae s.l. (Diptera: Culicidae) collected from 14 sentinel districts. Diagnostic doses of the pyrethroids deltamethrin, lambdacyhalothrin and permethrin, the carbamate propoxur, the organophosphate fenitrothion and the organochlorine DDT were used. Anopheles gambiae s.l. was resistant to permethrin in Muleba, where a mortality rate of 11% [95% confidence interval (CI) 6-19%] was recorded, Muheza (mortality rate of 75%, 95% CI 66-83%), Moshi and Arumeru (mortality rates of 74% in both). Similarly, resistance was reported to lambdacyhalothrin in Muleba, Muheza, Moshi and Arumeru (mortality rates of 31-82%), and to deltamethrin in Muleba, Moshi and Muheza (mortality rates of 28-75%). Resistance to DDT was reported in Muleba. No resistance to the carbamate propoxur or the organophosphate fenitrothion was observed. Anopheles gambiae s.l. is becoming resistant to pyrethoids and DDT in several parts of Tanzania. This has coincided with the scaling up of vector control measures. Resistance may impair the effectiveness of these interventions and therefore demands close monitoring and the adoption of a resistance management strategy. PMID:24192019

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

    PubMed

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

    2014-02-01

    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

  2. Toxigenic Vibrio cholerae identified in estuaries of Tanzania using PCR techniques.

    PubMed

    Dalusi, Lucy; Lyimo, Thomas J; Lugomela, Charles; Hosea, Ken M M; Sjöling, Sara

    2015-03-01

    The current study assessed the occurrence of the Vibrio cholerae serogroups O1 and O139 in environmental samples along salinity gradients in three selected estuaries of Tanzania both through culture independent methods and by cultured bacteria. Occurrence of V. cholerae was determined by PCR targeting the V. cholerae outer membrane protein gene ompW. Furthermore, the presence of toxigenic strains and serogroups O1 and O139 was determined using multiplex PCR with specific primers targeting the cholera toxin gene subunit A, ctxA, and serotype specific primers, O1-rfb and O139-rfb, respectively. Results showed that V. cholerae occurred in approximately 10% (n = 185) of both the environmental samples and isolated bacteria. Eight of the bacteria isolates (n = 43) were confirmed as serogroup O1 while one belonged to serogroup O139, the first reported identification of this epidemic strain in East African coastal waters. All samples identified as serogroup O1 or O139 and a number of non-O1/O139 strains were ctxA positive. This study provides in situ evidence of the presence of pathogenic V. cholerae O1 and O139 and a number of V. cholerae non-O1/O139 that carry the cholera toxin gene in estuaries along the coast of Tanzania. PMID:25743072

  3. Comparing the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa

    PubMed Central

    Blaauw, Duane; Ditlopo, Prudence; Maseko, Fresier; Chirwa, Maureen; Mwisongo, Aziza; Bidwell, Posy; Thomas, Steve; Normand, Charles

    2013-01-01

    Background Job satisfaction is an important determinant of health worker motivation, retention, and performance, all of which are critical to improving the functioning of health systems in low- and middle-income countries. A number of small-scale surveys have measured the job satisfaction and intention to leave of individual health worker cadres in different settings, but there are few multi-country and multi-cadre comparative studies. Objective The objective of this study was to compare the job satisfaction and intention to leave of different categories of health workers in Tanzania, Malawi, and South Africa. Methods We undertook a cross-sectional survey of a stratified cluster sample of 2,220 health workers, 564 from Tanzania, 939 from Malawi, and 717 from South Africa. Participants completed a self-administered questionnaire, which included demographic information, a 10-item job satisfaction scale, and one question on intention to leave. Multiple regression was used to identify significant predictors of job satisfaction and intention to leave. Results There were statistically significant differences in job satisfaction and intention to leave between the three countries. Approximately 52.1% of health workers in South Africa were satisfied with their jobs compared to 71% from Malawi and 82.6% from Tanzania (?2=140.3, p<0.001). 18.8% of health workers in Tanzania and 26.5% in Malawi indicated that they were actively seeking employment elsewhere, compared to 41.4% in South Africa (?2=83.5, p<0.001). The country differences were confirmed by multiple regression. The study also confirmed that job satisfaction is statistically related to intention to leave. Conclusions We have shown differences in the levels of job satisfaction and intention to leave between different groups of health workers from Tanzania, Malawi, and South Africa. Our results caution against generalising about the effectiveness of interventions in different contexts and highlight the need for less standardised and more targeted HRH strategies than has been practised to date. PMID:23364090

  4. Dynamite fishing in northern Tanzania – pervasive, problematic and yet preventable

    Microsoft Academic Search

    Sue Wells

    2009-01-01

    Dynamite fishing, although illegal, has resurfaced in recent years as a major threat to the reefs of northern Tanzania. This is despite the fact that institutional arrangements for co-management of the inshore fisheries by local communities and the district governments have been put in place and, through a 12-year donor-funded programme, numerous activities undertaken to build capacity for effective fisheries

  5. Blister beetle periorbital dermatitis and keratoconjunctivitis in Tanzania.

    PubMed

    Poole, T R

    1998-01-01

    Two cases of periorbital dermatitis and one case of keratoconjunctivitis following contact with blister beetle are presented. In Tanzania and Kenya the commonest blister beetle is known as Nairobi Fly and is of the genus Paederus. Ocular symptoms are common, usually secondary to transfer by the fingers of the toxic chemical involved from elsewhere on the skin. Blister beetle keratoconjunctivitis has not previously been described in detail. PMID:10070529

  6. 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…

  7. Upper mantle Q and thermal structure beneath Tanzania, East Africa from teleseismic P wave spectra

    Microsoft Academic Search

    Anupama Venkataraman; Andrew A. Nyblade; Jeroen Ritsema

    2004-01-01

    We measure P wave spectral amplitude ratios from deep-focus earthquakes recorded at broadband seismic stations of the Tanzania network to estimate regional variation of sublithospheric mantle attenuation beneath the Tanzania craton and the eastern branch of the East African Rift. One-dimensional profiles of QP adequately explain the systematic variation of P wave attenuation in the sublithospheric upper mantle: QP ~

  8. Upper mantle Q and thermal structure beneath Tanzania, East Africa from teleseismic P wave spectra

    Microsoft Academic Search

    Anupama Venkataraman; Andrew A. Nyblade; Jeroen Ritsema

    2004-01-01

    We measure P wave spectral amplitude ratios from deep-focus earthquakes recorded at broadband seismic stations of the Tanzania network to estimate regional variation of sublithospheric mantle attenuation beneath the Tanzania craton and the eastern branch of the East African Rift. One-dimensional profiles of QP adequately explain the systematic variation of P wave attenuation in the sublithospheric upper mantle: QP ?

  9. Managing records as a strategic resource in the government ministries of Tanzania

    Microsoft Academic Search

    Esther Ndenje-Sichalwe; Patrick Ngulube; Christine Stilwell

    2011-01-01

    In Tanzania, the Records and Archives Management Act of 2002 established the Records and Archives Management Department (RAMD) to provide for the proper administration and better management of public records and archives throughout their life cycle. This article is based on findings from an ongoing study of the government ministries of Tanzania which examines the current state of records management

  10. Comparing the Role of Education in Serving Socioeconomic and Political Development in Tanzania and Cuba.

    ERIC Educational Resources Information Center

    Mtonga, Harry L.

    1993-01-01

    Compares Tanzania and Cuba to show how, in each case, the state has used education in political and socioeconomic development as a means of achieving socialism. In Cuba, the school system has contributed to creation of the new society, whereas Tanzania continues with piecemeal reconstruction of the educational system. (SLD)

  11. 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…

  12. Experience in Tanzania in Identifying and Satisfying Local Needs in Education. IIEP Seminar Paper: 14.

    ERIC Educational Resources Information Center

    Kinunda, M. J.

    Tanzania inherited a basically illiterate population that is largely rural. Hence, Tanzania is according top priority to rural development. Education is a vital input but its impact depends not only on the quality and relevance of the education given but also on its interaction with complementary inputs in agriculture, small-scale industry,…

  13. Provision of Pre-Primary Education as a Basic Right in Tanzania: Reflections from Policy Documents

    ERIC Educational Resources Information Center

    Mtahabwa, Lyabwene

    2010-01-01

    This study sought to assess provision of pre-primary education in Tanzania as a basic right through analyses of relevant policy documents. Documents which were published over the past decade were considered, including educational policies, action plans, national papers, the "Basic Education Statistics in Tanzania" documents, strategy documents,…

  14. Trends in HIV & syphilis prevalence and correlates of HIV infection: results from cross-sectional surveys among women attending ante-natal clinics in Northern Tanzania

    Microsoft Academic Search

    Yusufu Kumogola; Emma Slaymaker; Basia Zaba; Julius Mngara; Raphael Isingo; John Changalucha; Patrick Mwidunda; Daniel Kimaro; Mark Urassa

    2010-01-01

    BACKGROUND: Sentinel surveillance for HIV in ante-natal clinics (ANC) remains the primary method for collecting timely trend data on HIV prevalence in most of sub-Saharan Africa. We describe prevalence of HIV and syphilis infection and trends over time in HIV prevalence among women attending ante-natal clinics (ANC) in Magu district and Mwanza city, part of Mwanza region in Northern Tanzania.

  15. Prevalence of cardiovascular disease risk factors among young and middle-aged men in urban Mwanza, Tanzania

    Microsoft Academic Search

    Marina Njelekela; Alfa Muhihi; Rose Mpembeni; Zablon Masesa; Kazuya Kitamori; Mari Mori; Norihiro Kato; Jacob Mtabaji; Yukio Yamori

    Aim  We conducted a health survey to assess the prevalence of cardiovascular disease (CVD) risk factors and explore their socioeconomic\\u000a correlates in a population of young and middle-aged men in the fast-growing city of Mwanza, Tanzania.\\u000a \\u000a \\u000a \\u000a \\u000a Subjects and methods  A descriptive cross-sectional epidemiological study was conducted in Mwanza City among men aged 20–50 years. Anthropometric\\u000a and blood pressure measurements, dietary history, physical activity

  16. Using propensity score matching to estimate an "unbiased effect-size" between women's employment and partner violence in Tanzania.

    PubMed

    Vyas, Seema; Heise, Lori

    2014-11-01

    Estimates of the effect of employment on women's risk of partner violence in cross-sectional studies are subject to potential "self-selection bias." Women's personal choice of whether to pursue employment or not may create fundamental differences between the group of women who are employed and those who are not employed that standard regression methods cannot account for even after adjusting for confounding. The aim of this study is to demonstrate the utility of propensity score matching (PSM), a technique used widely in econometrics, to address this bias in cross-sectional studies. We use PSM to estimate an unbiased effect-size of women's employment on their risk of experiencing partner violence in urban and rural Tanzania using data from the 2010 Tanzania Demographic and Health Survey (DHS). Three different measures of women's employment were analyzed: whether they had engaged in any productive work outside of the home in the past year, whether they received payment in cash for this productive work, and whether their employment was stable. Women who worked outside of the home were significantly different from those who did not. In both urban and rural Tanzania, women's risk of violence appears higher among women who worked in the past year than among those who did not, even after using PSM to account for underlying differences in these two groups of women. Being paid in cash reversed this effect in rural areas whereas stability of employment reduced this risk in urban centers. The estimated size of effect varied by type of matching estimator, but the direction of the association remained largely consistent. This study's findings suggest substantial self-selection into employment. PSM methods, by compensating for this bias, appear to be a useful tool for estimating the relationship between women's employment and partner violence in cross-sectional studies. PMID:24729130

  17. 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

  18. The decentralisation-centralisation dilemma: recruitment and distribution of health workers in remote districts of Tanzania

    PubMed Central

    2009-01-01

    Background The implementation of decentralisation reforms in the health sector of Tanzania started in the 1980s. These reforms were intended to relinquish substantial powers and resources to districts to improve the development of the health sector. Little is known about the impact of decentralisation on recruitment and distribution of health workers at the district level. Reported difficulties in recruiting health workers to remote districts led the Government of Tanzania to partly re-instate central recruitment of health workers in 2006. The effects of this policy change are not yet documented. This study highlights the experiences and challenges associated with decentralisation and the partial re-centralisation in relation to the recruitment and distribution of health workers. Methods An exploratory qualitative study was conducted among informants recruited from five underserved, remote districts of mainland Tanzania. Additional informants were recruited from the central government, the NGO sector, international organisations and academia. A comparison of decentralised and the reinstated centralised systems was carried out in order to draw lessons necessary for improving recruitment, distribution and retention of health workers. Results The study has shown that recruitment of health workers under a decentralised arrangement has not only been characterised by complex bureaucratic procedures, but by severe delays and sometimes failure to get the required health workers. The study also revealed that recruitment of highly skilled health workers under decentralised arrangements may be both very difficult and expensive. Decentralised recruitment was perceived to be more effective in improving retention of the lower cadre health workers within the districts. In contrast, the centralised arrangement was perceived to be more effective both in recruiting qualified staff and balancing their distribution across districts, but poor in ensuring the retention of employees. Conclusion A combination of centralised and decentralised recruitment represents a promising hybrid form of health sector organisation in managing human resources by bringing the benefits of two worlds together. In order to ensure that the potential benefits of the two approaches are effectively integrated, careful balancing defining the local-central relationships in the management of human resources needs to be worked out. PMID:19405958

  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. Frequent Intra-Subtype Recombination among HIV-1 Circulating in Tanzania

    PubMed Central

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

    2013-01-01

    The study estimated the prevalence of HIV-1 intra-subtype recombinant variants among female bar and hotel workers in Tanzania. While intra-subtype recombination occurs in HIV-1, it is generally underestimated. HIV-1 env gp120 V1-C5 quasispecies from 45 subjects were generated by single-genome amplification and sequencing (median (IQR) of 38 (28–50) sequences per subject). Recombination analysis was performed using seven methods implemented within the recombination detection program version 3, RDP3. HIV-1 sequences were considered recombinant if recombination signals were detected by at least three methods with p-values of ?0.05 after Bonferroni correction for multiple comparisons. HIV-1 in 38 (84%) subjects showed evidence for intra-subtype recombination including 22 with HIV-1 subtype A1, 13 with HIV-1 subtype C, and 3 with HIV-1 subtype D. The distribution of intra-patient recombination breakpoints suggested ongoing recombination and showed selective enrichment of recombinant variants in 23 (60%) subjects. The number of subjects with evidence of intra-subtype recombination increased from 29 (69%) to 36 (82%) over one year of follow-up, although the increase did not reach statistical significance. Adjustment for intra-subtype recombination is important for the analysis of multiplicity of HIV infection. This is the first report of high prevalence of intra-subtype recombination in the HIV/AIDS epidemic in Tanzania, a region where multiple HIV-1 subtypes co-circulate. HIV-1 intra-subtype recombination increases viral diversity and presents additional challenges for HIV-1 vaccine design. PMID:23940702

  2. Correlates of out-of-pocket and catastrophic health expenditures in Tanzania: results from a national household survey

    PubMed Central

    2014-01-01

    Background Inequality in health services access and utilization are influenced by out-of-pocket health expenditures in many low and middle-income countries (LMICs). Various antecedents such as social factors, poor health and economic factors are proposed to direct the choice of health care service use and incurring out-of-pocket payments. We investigated the association of these factors with out-of-pocket health expenditures among the adult and older population in the United Republic of Tanzania. We also investigated the prevalence and associated determinants contributing to household catastrophic health expenditures. Methods We accessed the data of a multistage stratified random sample of 7279 adult participants, aged between 18 and 59 years, as well as 1018 participants aged above 60 years, from the first round of the Tanzania National Panel survey. We employed multiple generalized linear and logistic regression models to evaluate the correlates of out-of-pocket as well as catastrophic health expenditures, accounting for the complex sample design effects. Results Increasing age, female gender, obesity and functional disability increased the adults’ out-of-pocket health expenditures significantly, while functional disability and visits to traditional healers increased the out-of-pocket health expenditures in older participants. Adult participants, who lacked formal education or worked as manual laborers earned significantly less (p?Tanzania. PMID:24597486

  3. Biochemical basis of permethrin resistance in Anopheles arabiensis from Lower Moshi, north-eastern Tanzania

    PubMed Central

    2010-01-01

    Background Development of resistance to different classes of insecticides is a potential threat to malaria control. With the increasing coverage of long-lasting insecticide-treated nets in Tanzania, the continued monitoring of resistance in vector populations is crucial. It may facilitate the development of novel strategies to prevent or minimize the spread of resistance. In this study, metabolic-based mechanisms conferring permethrin (pyrethroid) resistance were investigated in Anopheles arabiensis of Lower Moshi, Kilimanjaro region of north-eastern Tanzania. Methods WHO susceptibility test kits were used to detect resistance to permethrin in An. arabiensis. The levels and mechanisms of permethrin resistance were determined using CDC bottle bioassays and microplate (biochemical) assays. In bottle bioassays, piperonyl butoxide (PBO) and s,s,s-tributyl phosphorotrithioate (DEF) were used as synergists to inhibit mixed function oxidases and non-specific esterases respectively. Biochemical assays were carried out in individual mosquitoes to detect any increase in the activity of enzymes typically involved in insecticide metabolism (mixed function oxidases, ?- and ?-esterases). Results Anopheles arabiensis from the study area was found to be partially resistant to permethrin, giving only 87% mortality in WHO test kits. Resistance ratios at KT50 and KT95 were 4.0 and 4.3 respectively. The permethrin resistance was partially synergized by DEF and by PBO when these were mixed with permethrin in bottle bioassays and was fully synergized when DEF and PBO were used together. The levels of oxidase and ?-esterase activity were significantly higher in An. arabiensis from Lower Moshi than in the laboratory susceptible strain. There was no difference in ?-esterase activity between the two strains. Conclusion Elevated levels of mixed function oxidases and ?-esterases play a role in detoxification of permethrin in the resistant An. arabiensis population of Lower Moshi. PMID:20609220

  4. Human resources for health care delivery in Tanzania: a multifaceted problem

    PubMed Central

    2012-01-01

    Background Recent years have seen an unprecedented increase in funds for procurement of health commodities in developing countries. A major challenge now is the efficient delivery of commodities and services to improve population health. With this in mind, we documented staffing levels and productivity in peripheral health facilities in southern Tanzania. Method A health facility survey was conducted to collect data on staff employed, their main tasks, availability on the day of the survey, reasons for absenteeism, and experience of supervisory visits from District Health Teams. In-depth interview with health workers was done to explore their perception of work load. A time and motion study of nurses in the Reproductive and Child Health (RCH) clinics documented their time use by task. Results We found that only 14% (122/854) of the recommended number of nurses and 20% (90/441) of the clinical staff had been employed at the facilities. Furthermore, 44% of clinical staff was not available on the day of the survey. Various reasons were given for this. Amongst the clinical staff, 38% were absent because of attendance to seminar sessions, 8% because of long-training, 25% were on official travel and 20% were on leave. RCH clinic nurses were present for 7 hours a day, but only worked productively for 57% of time present at facility. Almost two-third of facilities had received less than 3 visits from district health teams during the 6 months preceding the survey. Conclusion This study documented inadequate staffing of health facilities, a high degree of absenteeism, low productivity of the staff who were present and inadequate supervision in peripheral Tanzanian health facilities. The implications of these findings are discussed in the context of decentralized health care in Tanzania. PMID:22357353

  5. 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.

  6. Partial genetic characterization of peste des petits ruminants virus from goats in northern and eastern Tanzania.

    PubMed

    Kgotlele, T; Macha, E S; Kasanga, C J; Kusiluka, L J M; Karimuribo, E D; Van Doorsselaere, J; Wensman, J J; Munir, M; Misinzo, G

    2014-08-01

    Peste des petits ruminants (PPR) is an acute viral disease of small ruminants. The disease was first reported in Tanzania in 2008 when it was confined to the Northern Zone districts bordering Kenya. The present study was carried out to confirm the presence of PPR virus (PPRV) in Tanzania and to establish their phylogenetic relationships. Samples (oculonasal swabs, tissues and whole blood) were obtained from live goats with clinical presentation suggestive of PPR and goats that died naturally in Ngorongoro (Northern Tanzania) and Mvomero (Eastern Tanzania) districts. The clinical signs observed in goats suspected with PPR included fever, dullness, diarrhea, lacrimation, matting of eye lids, purulent oculonasal discharges, cutaneous nodules, erosions on the soft palate and gums and labored breathing. Post mortem findings included pneumonia, congestion of the intestines, and hemorrhages in lymph nodes associated with the respiratory and gastrointestinal systems. PPRV was detected in 21 out of 71 tested animals using primers targeting the nucleoprotein (N) gene. Phylogenetic analysis, based on the N gene, indicated that PPRV obtained from Northern and Eastern Tanzania clustered with PPRV strains of Lineage III, together with PPRV from Sudan and Ethiopia. The findings of this study indicate that there are active PPRV infections in Northern and Eastern Tanzania, suggesting risks for potential spread of PPR in the rest of Tanzania. PMID:25135464

  7. Partial Genetic Characterization of Peste Des Petits Ruminants Virus from Goats in Northern and Eastern Tanzania

    PubMed Central

    Kgotlele, T; Macha, E S; Kasanga, C J; Kusiluka, L J M; Karimuribo, E D; Van Doorsselaere, J; Wensman, J J; Munir, M; Misinzo, G

    2014-01-01

    Peste des petits ruminants (PPR) is an acute viral disease of small ruminants. The disease was first reported in Tanzania in 2008 when it was confined to the Northern Zone districts bordering Kenya. The present study was carried out to confirm the presence of PPR virus (PPRV) in Tanzania and to establish their phylogenetic relationships. Samples (oculonasal swabs, tissues and whole blood) were obtained from live goats with clinical presentation suggestive of PPR and goats that died naturally in Ngorongoro (Northern Tanzania) and Mvomero (Eastern Tanzania) districts. The clinical signs observed in goats suspected with PPR included fever, dullness, diarrhea, lacrimation, matting of eye lids, purulent oculonasal discharges, cutaneous nodules, erosions on the soft palate and gums and labored breathing. Post mortem findings included pneumonia, congestion of the intestines, and hemorrhages in lymph nodes associated with the respiratory and gastrointestinal systems. PPRV was detected in 21 out of 71 tested animals using primers targeting the nucleoprotein (N) gene. Phylogenetic analysis, based on the N gene, indicated that PPRV obtained from Northern and Eastern Tanzania clustered with PPRV strains of Lineage III, together with PPRV from Sudan and Ethiopia. The findings of this study indicate that there are active PPRV infections in Northern and Eastern Tanzania, suggesting risks for potential spread of PPR in the rest of Tanzania. PMID:25135464

  8. Prevalence of wheeze and self-reported asthma and asthma care in an urban and rural area of Tanzania and Cameroon.

    PubMed

    Mugusi, Ferdinand; Edwards, Richard; Hayes, Louise; Unwin, Nigel; Mbanya, Jean-Claude; Whiting, David; Sobngwi, Eugene; Rashid, Seif

    2004-10-01

    We investigated the prevalence of wheeze, self-reported asthma, and asthma care via four cross-sectional surveys among adults and children (5-15 years) in urban and rural populations from Tanzania and Cameroon. Age-standardized prevalence of current wheeze (in the previous year) was 2.2% to 5.0% in adults and 1.9% to 5.2% in children in Tanzania, and 1.3% to 2.5% (adults) and 0.8% to 5.4% (children) in Cameroon. There were no consistent patterns of urban:rural prevalence. Peak flow rates varied with age, peaking at 25-34 years, and were higher in urban areas (age adjusted difference 22-70 L/min) and in the Tanzania populations. Awareness (83%-86% versus 52%-58%) and treatment (43%-71% versus 30%-44%) of asthma was higher among those with current wheeze in rural areas. Use of inhaled drugs, particularly steroids, was rare. Diagnosis by traditional healers (15%) and use of traditional remedies (62% of those recalling any treatment) were common only among self-reported asthmatic patients in rural Cameroon. Asthma is an importantclinical condition in sub-Saharan Africa. There were major gaps in clinical care, particularly in urban areas. Sustainable methods for delivering accessible and effective asthma care in sub-Saharan Africa are required. PMID:15510944

  9. 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

  10. 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.

  11. 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

  12. Focal mechanisms and the stress regime in NE and SW Tanzania, East Africa

    NASA Astrophysics Data System (ADS)

    Brazier, Richard A.; Nyblade, Andrew A.; Florentin, Juliette

    2005-07-01

    We report 12 new focal mechanisms from earthquakes in NE and SW Tanzania where the stress regime within the East African rift system is not well constrained. Focal mechanisms for events at the intersection of the Lake Tanganyika and Rukwa rifts in SW Tanzania indicate a complicated stress pattern with possible dextral strike-slip motion on some faults but oblique motion on others (either sinistral on NW striking faults or dextral on NE striking faults). Within the Rukwa rift, focal mechanisms indicate normal dip-slip motion with NE-SW opening. In NE Tanzania where the Eastern rift impinges on the margin of the Tanzania Craton, fault motions are consistent with a zone of distributed block faults and sub E-W extension. All twelve earthquakes likely nucleated within the crust.

  13. 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

  14. Magnesium-Rich Clays of the Meerschaum Mines in the Amboseli Basin, Tanzania and Kenya

    Microsoft Academic Search

    R. L. Hay; R. E. HUGHES; T. K. KYSER; H. D. GLASS; J. Lxu

    1995-01-01

    The Sinya Beds of the Amboseli Basin in Tanzania and Kenya consist largely of carbonate rocks and Mg-rich clays that are intensely deformed where exposed in and near former meerschaum mines. The carbonate rocks consist of limestone and dolomite in Tanzania, but only dolomite has been identified in Kenya. Sepiolite and mixed-layered kerolite\\/stevensite (Ke\\/St) are subordinate constituents of the carbonate

  15. Morphological Diversity of Bambara Groundnut [ Vigna subterranea (L.) Verdc.] Landraces in Tanzania

    Microsoft Academic Search

    W. H. Ntundu; S. A. Shillah; W. Y. F. Marandu; J. L. Christiansen

    2006-01-01

    A field experiment was conducted in Tanzania for two seasons to assess the genetic diversity of bambara groundnut landraces\\u000a based on morphological characters. One hundred accessions collected from a wide range of agricultural zones in the country\\u000a were evaluated in a 10 10 triple lattice block design at Maruku station in Bukoba, Tanzania. For the qualitative characters\\u000a evaluated, considerable morphological

  16. Estimated direct economic costs associated with tick-borne diseases on cattle in Tanzania

    Microsoft Academic Search

    F. M. Kivaria

    2006-01-01

    Tick-borne diseases, namely, anaplasmosis, babesiosis, cowdriosis and theileriosis, constrain cattle production and improvement\\u000a in Tanzania, leading to considerable economic losses. A simple spreadsheet model was used to estimate the economic losses\\u000a resulting from production losses, treatment and control costs associated with tick-borne diseases (TBD) in Tanzania. Model\\u000a parameters included the national cattle population, reported TBD morbidity, fatality risk, and chemotherapy

  17. Essays on Dynamics of Cattle Prices in Three Developing Countries of Mali, Kenya, and Tanzania

    E-print Network

    Bizimana, Jean-Claude

    2012-07-16

    fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY May 2012 Major Subject: Agricultural Economics Essays on Dynamics of Cattle Prices in Three Developing Countries of Mali, Kenya..., and Tanzania Copyright 2012 Jean-Claude Bizimana ESSAYS ON DYNAMICS OF CATTLE PRICES IN THREE DEVELOPING COUNTRIES OF MALI, KENYA, AND TANZANIA A Dissertation By JEAN-CLAUDE BIZIMANA Submitted to the Office of Graduate Studies of Texas...

  18. High level of resistance in the mosquito Anopheles gambiae to pyrethroid insecticides and reduced susceptibility to bendiocarb in north-western Tanzania

    PubMed Central

    2013-01-01

    Background To control malaria in Tanzania, two primary vector control interventions are being scaled up: long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS). The main threat to effective malaria control is the selection of insecticide resistance. While resistance to pyrethroids, the primary insecticide used for LLINs and IRS, has been reported among mosquito vectors in only a few sites in Tanzania, neighbouring East African countries are recording increasing levels of resistance. To monitor the rapidly evolving situation, the resistance status of the malaria vector Anopheles gambiae s.l to different insecticides and the prevalence of the kdr resistance allele involved in pyrethroid resistance were investigated in north-western Tanzania, an area that has been subject to several rounds of pyrethroid IRS since 2006. Methods Household collections of anopheline mosquitoes were exposed to diagnostic dosages of pyrethroid, DDT, and bendiocarb using WHO resistance test kits. The relative proportions of An. gambiae s.s and Anopheles arabiensis were also investigated among mosquitoes sampled using indoor CDC light traps. Anophelines were identified to species and the kdr mutation was detected using real time PCR TaqMan assays. Results From the light trap collections 80% of An. gambiae s.l were identified as An. gambiae s.s and 20% as An. arabiensis. There was cross-resistance between pyrethroids and DDT with mortality no higher than 40% reported in any of the resistance tests. The kdr-eastern variant was present in homozygous form in 97% of An. gambiae s.s but was absent in An. arabiensis. Anopheles gambiae s.s showed reduced susceptibility to the carbamate insecticide, bendiocarb, the proportion surviving WHO tests ranging from 0% to 30% depending on season and location. Conclusion Anopheles gambiae s.s has developed phenotypic resistance to pyrethroids and DDT and kdr frequency has almost reached fixation. Unlike in coastal Tanzania, where the ratio of An. gambiae s.s to An. arabiensis has decreased in response to vector control, An. gambiae s.s persists at high frequency in north-western Tanzania, probably due to selection of pyrethroid resistance, and this trend is likely to arise in other areas as resistance spreads or is subject to local selection from IRS or LLINs. PMID:23638757

  19. Trends in availability and prices of subsidized ACT over the first year of the AMFm: evidence from remote regions of Tanzania

    PubMed Central

    2012-01-01

    Background The Affordable Medicines Facility for malaria (AMFm) is a pilot supra-national subsidy program that aims to increase access and affordability of artemisinin combination therapy (ACT) in public sector clinics and private retail shops. It is unclear to what extent the AMFm model will translate into wide scale availability and price reductions in ACT, particularly for rural, remote areas where disparities in access to medicines often exist. This study is the first to rigorously examine the availability and price of subsidized ACT during the first year of the AMFm, measured through retail audits in remote regions of Tanzania. Methods Periodic retail audits of Accredited Drug Dispensing Outlets (ADDOs) were conducted in two remote regions of Tanzania (Mtwara and Rukwa). Temporal and spatial variation in ACT availability and pricing were explored. A composite measure of ADDO remoteness, using variables, such as distance to suppliers and towns, altitude and population density, was used to explore whether ACT availability and price vary systematically with remoteness. Results Between February 2011 and January 2012, the fraction of ADDOs stocking AMFm-ACT increased from 25% to 88% in Mtwara and from 3% to 62% in Rukwa. Availability was widespread, though diffusion throughout the region was achieved more quickly in Mtwara. No significant relationship was found between ACT availability and remoteness. Adult doses of AMFm-ACT were much more widely available than any other age/weight band. Average prices fell from 1529 TZS (1.03 USD) to 1272 TZS (0.81 USD) over the study period, with prices in Rukwa higher than Mtwara. The government recommended retail price for AMFm- ACT is 1,000 TZS ($0.64 USD). The median retail ACT price in the final round of data collection was 1,000 TZS. Conclusions The AMFm led to large increases in availability of low priced ACT in Tanzania, with no significant variation in availability based on remoteness. Availability did remain lower and prices remained higher in Rukwa, which is a more remote region overall. Low availability of child and adolescent ACT doses could be due in part to lower quantities of non-adult packs imported into Tanzania. Future research will explore whether increased availability and affordability persists and whether it translates into higher ACT use in Tanzania. PMID:22929587

  20. Mosquito control in Dar es Salaam. II. Impact of expanded polystyrene beads and pyriproxyfen treatment of breeding sites on Culex quinquefasciatus densities.

    PubMed

    Chavasse, D C; Lines, J D; Ichimori, K; Majala, A R; Minjas, J N; Marijani, J

    1995-04-01

    In two contrasting areas of Dar es Salaam (Ilala and Mikocheni) all enclosed breeding sites of Culex quinquefasciatus, such as latrines and septic tanks, were treated with a floating layer of expanded polystyrene beads. 7 months later checks in both study areas revealed only one site (from which the polystyrene had been removed during emptying) containing immature stages of Cx quinquefasciatus. Open breeding sites such as areas of flooded land and blocked drains were treated with pyriproxyfen (an insect growth regulator) at a concentration of 0.1 ppm. Emergence of Cx quinquefasciatus adults from these sites was inhibited for 4 weeks during the rainy season and for up to 11 weeks during the dry season. The problem of mosquito breeding sites caused by bathroom sullage water was addressed through a combination of health education and indirect pressure from the Urban Malaria Control Project (UMCP) via local community leaders. Households responsible for these sites were encouraged to eliminate them by diverting the water into an enclosed drainage structure, usually a pit latrine. After two weekly visits 64.7% of households had complied and 93.4% had complied after five visits. 5 months later, only 15.7% had reverted to allowing sullage water to collect into puddles. Densities of Cx quinquefasciatus adults dropped by 76.7% in Mikocheni and by 46.2% in Ilala following intervention, but increased by 84.9% and 25.6% in two untreated comparison areas. The reasons for differential success of the combined interventions in the two treated areas are discussed. PMID:7787222

  1. Spatial variation and socio-economic determinants of Plasmodium falciparum infection in northeastern Tanzania

    PubMed Central

    2011-01-01

    Background Malaria due to Plasmodium falciparum is the leading cause of morbidity and mortality in Tanzania. According to health statistics, malaria accounts for about 30% and 15% of hospital admissions and deaths, respectively. The risk of P. falciparum infection varies across the country. This study describes the spatial variation and socio-economic determinants of P. falciparum infection in northeastern Tanzania. Methods The study was conducted in 14 villages located in highland, lowland and urban areas of Korogwe district. Four cross-sectional malaria surveys involving individuals aged 0-19 years were conducted during short (Nov-Dec) and long (May-Jun) rainy seasons from November 2005 to June 2007. Household socio-economic status (SES) data were collected between Jan-April 2006 and household's geographical positions were collected using hand-held geographical positioning system (GPS) unit. The effects of risk factors were determined using generalized estimating equation and spatial risk of P. falciparum infection was modelled using a kernel (non-parametric) method. Results There was a significant spatial variation of P. falciparum infection, and urban areas were at lower risk. Adjusting for covariates, high risk of P. falciparum infection was identified in rural areas of lowland and highland. Bed net coverage levels were independently associated with reduced risk of P. falciparum by 19.1% (95%CI: 8.9-28.2, p < 0.001) and by 39.3% (95%CI: 28.9-48.2, p < 0.001) in households with low and high coverage, respectively, compared to those without bed nets. Households with moderate and lower SES had risk of infection higher than 60% compared to those with higher SES; while inhabitants of houses built of mud walls were at 15.5% (95%CI: 0.1 - 33.3, p < 0.048) higher risk compared to those living in houses built by bricks. Individuals in houses with thatched roof had an excess risk of 17.3% (95%CI: 4.1 - 32.2, p < 0.009) compared to those living in houses roofed with iron sheet. Conclusions There was high spatial variation of risk of P. falciparum infection and urban area was at the lowest risk. High bed net coverage, better SES and good housing were among the important risk factors associated with low risk of P. falciparum infection. PMID:21612637

  2. Creating a national culture of quality: the Tanzania experience.

    PubMed

    Mwidunda, Patrick E; Eliakimu, Eliudi

    2015-07-01

    Although quality improvement has been a priority for Tanzania's health sector since the 1970s, few effective quality improvement initiatives were implemented, due to limited expertise, political commitment and resources. More recently, as the HIV epidemic gained momentum within the country, an influx of funding and of international organizations with quality improvement expertise accelerated the implementation of quality improvement projects, as well as efforts to institutionalize quality improvement at the national level. The support of US President's Emergency Plan for AIDS Relief (PEPFAR) and other donors, and the increasing numbers of HIV-implementing partners focused on quality management, and quality improvement strategies catalysed the development of HIV-specific quality improvement initiatives first, and then of national quality improvement frameworks. The diversity of quality improvement approaches championed by various donors and partners also presented important challenges to harmonization and institutionalization of quality improvement programmes. PMID:26102628

  3. A qualitative pilot study of food insecurity among Maasai women in Tanzania

    PubMed Central

    Fenton, Carol; Hatfield, Jennifer; McIntyre, Lynn

    2012-01-01

    Background Food insecurity is an ongoing threat in rural sub-Saharan Africa and is complicated by cultural practices, the rise of chronic conditions such as HIV and land use availability. In order to develop a successful food security intervention program, it is important to be informed of the realities and needs of the target population. The purpose of this study was to pilot a qualitative method to understand food insecurity based on the lived experience of women of the Maasai population in the Ngorongoro Conservation Area of Tanzania. Methods Short semi-structured qualitative interviews with 4 Maasai women. Results Food insecurity was present in the Maasai community: the participants revealed that they did not always have access to safe and nutritious food that met the needs of themselves and their families. Themes that emerged from the data fell into three categories: Current practices (food sources, planning for enough, food preparation, and food preservation), food Insecurity (lack of food, emotions, coping strategies, and possible solutions), and division (co-wives, food distribution, and community relationships). Conclusion This pilot study suggested the presence of food insecurity in the Maasai community. Larger sample studies are needed to clarify the extent and severity of food insecurity among this population. Having a detailed understanding of the various aspects of the food insecurity lived experience could inform a targeted intervention program. PMID:23077702

  4. Epidemiological study of Rift Valley fever virus in Kigoma, Tanzania.

    PubMed

    Kifaro, Emmanuel G; Nkangaga, Japhet; Joshua, Gradson; Sallu, Raphael; Yongolo, Mmeta; Dautu, George; Kasanga, Christopher J

    2014-01-01

    Rift Valley fever virus (RVFV) is an acute, zoonotic viral disease caused by a Phlebovirus, which belongs to the Bunyaviridae family. Among livestock, outbreaks of the disease are economically devastating. They are often characterised by large, sweeping abortion storms and have significant mortality in adult livestock. The aim of the current study was to investigate RVFV infection in the Kigoma region, which is nestled under the hills of the western arm of the Great Rift Valley on the edge of Lake Tanganyika, Tanzania. A region-wide serosurvey was conducted on non-vaccinated small ruminants (sheep and goats, n = 411). Sera samples were tested for the presence of anti-RVFV antibodies and viral antigen, using commercial enzyme-linked immunosorbent assay and reverse transcriptase polymerase chain reaction, respectively. The overall past infections were detected in 22 of the 411 animals, 5.4% (Confidence Interval (CI) 95% = 3.5% - 8.1%). The Kigoma rural area recorded the higher seroprevalence of 12.0% (CI 95% = 7.3% - 18.3%; p < 0.0001), followed by Kibondo at 2.3% (CI 95% = 0.5% - 6.5%; p > 0.05) and the Kasulu district at 0.8% (CI 95% = 0.0% - 4.2%; p > 0.05). The prevalence was 12.5% and 4.7% for sheep and goats, respectively. Reverse transcriptase polymerase chain reaction results indicated that only eight samples were found to be positive (n = 63). This study has confirmed, for the first time, the presence of the RVFV in the Kigoma region four years after the 2007 epizootic in Tanzania. The study further suggests that the virus activity exists during the inter-epizootic period, even in regions with no history of RVFV. PMID:25005550

  5. Acceptability of medical male circumcision in the traditionally circumcising communities in Northern Tanzania

    PubMed Central

    2011-01-01

    Background Data from traditionally circumcising communities show that non-circumcised males and those circumcised in the medical settings are stigmatised. This is because traditional circumcision embodies local notions of bravery as anaesthetics are not used. This study was conducted to assess the acceptability of safe medical circumcision before the onset of sexual activity for HIV infection risk reduction in a traditionally circumcising community in Tanzania. Methods A cross-sectional study was conducted among males and females aged 18-44 years in traditionally circumcising communities of Tarime District in Mara Region, North-eastern Tanzania. A face-to-face questionnaire was administered to females to collect information on the attitudes of women towards circumcision and the preferred age for circumcision. A similar questionnaire was administered to males to collect information on socio-demographic, preferred age for circumcision, factors influencing circumcision, client satisfaction, complications and beliefs surrounding the practice. Results Results were available for 170 males and 189 females. Of the males, 168 (98.8%) were circumcised and 61 (36.3%) of those circumcised had the procedure done in the medical setting. Of those interviewed, 165 (97.1%) males and 179 (94.7%) females supported medical male circumcision for their sons. Of these, 107 (64.8%) males and 130 (72.6%) females preferred prepubertal medical male circumcision (12 years or less). Preference for prepubertal circumcision was significantly associated with non-Kurya ethnic group, circumcision in the medical setting and residence in urban areas for males in the adjusted analysis. For females, preference for prepubertal circumcision was significantly associated non-Kurya ethnic group and being born in urban areas in the adjusted analysis. Conclusions There is a shift of preference from traditional male circumcision to medical male circumcision in this traditionally circumcising population. However, this preference has not changed the circumcision practices in the communities because of the community social pressure. Male circumcision national program should take advantage of this preference of medical male circumcision by introducing safe and affordable circumcision services and mobilising communities in a culturally sensitive manner to take up circumcision services. PMID:21605433

  6. 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

  7. Costs of delivering human papillomavirus vaccination to schoolgirls in Mwanza Region, Tanzania

    PubMed Central

    2012-01-01

    Background Cervical cancer is the leading cause of female cancer-related deaths in Tanzania. Vaccination against human papillomavirus (HPV) offers a new opportunity to control this disease. This study aimed to estimate the costs of a school-based HPV vaccination project in three districts in Mwanza Region (NCT ID: NCT01173900), Tanzania and to model incremental scaled-up costs of a regional vaccination program. Methods We first conducted a top-down cost analysis of the vaccination project, comparing observed costs of age-based (girls born in 1998) and class-based (class 6) vaccine delivery in a total of 134 primary schools. Based on the observed project costs, we then modeled incremental costs of a scaled-up vaccination program for Mwanza Region from the perspective of the Tanzanian government, assuming that HPV vaccines would be delivered through the Expanded Programme on Immunization (EPI). Results Total economic project costs for delivering 3 doses of HPV vaccine to 4,211 girls were estimated at about US$349,400 (including a vaccine price of US$5 per dose). Costs per fully-immunized girl were lower for class-based delivery than for age-based delivery. Incremental economic scaled-up costs for class-based vaccination of 50,290 girls in Mwanza Region were estimated at US$1.3 million. Economic scaled-up costs per fully-immunized girl were US$26.41, including HPV vaccine at US$5 per dose. Excluding vaccine costs, vaccine could be delivered at an incremental economic cost of US$3.09 per dose and US$9.76 per fully-immunized girl. Financial scaled-up costs, excluding costs of the vaccine and salaries of existing staff were estimated at US$1.73 per dose. Conclusions Project costs of class-based vaccination were found to be below those of age-based vaccination because of more eligible girls being identified and higher vaccine uptake. We estimate that vaccine can be delivered at costs that would make HPV vaccination a very cost-effective intervention. Potentially, integrating HPV vaccine delivery with cost-effective school-based health interventions and a reduction of vaccine price below US$5 per dose would further reduce the costs per fully HPV-immunized girl. PMID:23148516

  8. Prevalence and Risk Factors Associated with Human Taenia Solium Infections in Mbozi District, Mbeya Region, Tanzania

    PubMed Central

    Mwanjali, Gloria; Kihamia, Charles; Kakoko, Deodatus Vitalis Conatus; Lekule, Faustin; Ngowi, Helena; Johansen, Maria Vang; Thamsborg, Stig Milan; Willingham, Arve Lee

    2013-01-01

    Background Taenia solium cysticercosis/taeniosis is emerging as a serious public health and economic problem in many developing countries. This study was conducted to determine prevalence and risk factors of human T. solium infections in Mbeya Region, Tanzania. Methods and Findings A cross-sectional survey was conducted in 13 villages of Mbozi district in 2009. Sera of 830 people (mean 37.9±11.3 years (SD); 43% females) were tested for circulating cysticerci antigen (Ag-ELISA) and antibody (Ab-ELISA). A subset of persons found seropositive by Ag-ELISA underwent computed tomography (CT) scan of the brain for evidence of neurocysticercosis. Stool samples from 820 of the same participants were tested for taeniosis by copro-antigens (copro-Ag-ELISA) and formol-ether concentration technique. Cases of T. solium taeniosis were confirmed serologically by EITB assay (rES38). A questionnaire was used for identification of risk factors. Active cysticercosis by positive Ag-ELISA was found in 139 (16.7%) persons while anti-cysticercal antibodies were detected in 376 (45.3%) persons by Ab-ELISA. Among 55 persons positive for Ag-ELISA undergoing CT scan, 30 (54.6%) were found to have structures in the brain suggestive of neurocysticercosis. Using faecal analysis, 43 (5.2%) stool samples tested positive for taeniosis by copro-Ag-ELISA while Taenia eggs were detected in 9 (1.1%) stool samples by routine coprology. Antibodies specifically against adult T. solium were detected in 34 copro-Ag-ELISA positive participants by EITB (rES38) indicating T. solium taeniosis prevalence of 4.1%. Increasing age and hand washing by dipping in contrast to using running water, were found associated with Ag-ELISA seropositivity by logistic regression. Gender (higher risk in females) and water source were risk factors associated with Ab-ELISA seropositivity. Reported symptoms of chronic severe headaches and history of epileptic seizures were found associated with positive Ag-ELISA (p?0.05). Conclusion The present study indicates T. solium infection in humans is highly endemic in the southern highlands of Tanzania. PMID:23516650

  9. 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

  10. Citywide trauma experience in Mwanza, Tanzania: a need for urgent intervention

    PubMed Central

    2013-01-01

    Background Trauma remains a leading cause of morbidity and mortality in resource limited countries. There is paucity of published reports on trauma care in Tanzania, particularly the study area. This study was carried out to describe our experiences in trauma management outlining the etiological spectrum, injury characteristics and treatment outcome of trauma patients at our local setting and compare our results with those from other centers in the world. Methods A descriptive prospective study of trauma patients was conducted at Bugando Medical Centre from April 2010 to March 2012. Statistical data analysis was done using SPSS software version 17.0. Results A total of 5672 trauma patients were enrolled in the study. The male to female ratio was 2.3: 1. The majority of patients were in the 2nd decade of life. Road traffic accident was the most common cause of trauma accounting for 60.7% of cases. The majority of patients (76.6%) sustained blunt injuries. Musculoskeletal (68.5%) and head/neck (52.6%) were the most frequent body region injured. Soft tissue injuries (open wounds) and fractures were the most common injuries accounting for 82.8% and 76.8% respectively. Majority of patients (74.4%) were treated surgically with wound debridement (94.0%) being the most frequently performed procedure. Postoperative complications were recorded in 31.5% of cases. The overall median duration of hospitalization was 26 days (range 1 day to 144 days). Mortality rate was 16.7%. Patients who had polytrauma, burn injuries and those who had tetanus and long bone fractures stayed longer in the hospital and this was statistically significant (P??65 years, severe trauma, admission Systolic Blood Pressure?Tanzania. Urgent preventive measures targeting at reducing the occurrence of road traffic accidents is necessary to reduce the incidence of trauma in this region. PMID:24499566

  11. 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

  12. 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

  13. The sexual health of pupils in years 4 to 6 of primary schools in rural Tanzania

    PubMed Central

    Todd, J; Changalucha, J; Ross, D; Mosha, F; Obasi, A; Plummer, M; Balira, R; Grosskurth, H; Mabey, D; Hayes, R

    2004-01-01

    Background/objectives: There is an urgent need for effective interventions to improve the sexual and reproductive health of adolescents. Reliable data on the sexual health of adolescents are needed to guide the development of such interventions. The aim was to describe the sexual health of pupils in years 4 to 6 of 121 rural primary schools in north western Tanzania, before the implementation of an innovative sexual health intervention in 58 of the schools. Methods: A cross sectional survey of primary school pupils in rural Tanzania was carried out. The study population comprised pupils registered in years 4 to 6 of 121 primary schools in 20 rural communities in 1998. Basic demographic information was collected from all pupils seen. Those born before 1 January 1985 (aged approximately 14 years and over) were invited to participate in the survey, and asked about their knowledge and attitudes towards sexual health issues, and their sexual experience. A urine specimen was requested and tested for HIV, Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and, for females, pregnancy. Results: 9283 pupils born before 1 January 1985 were enrolled and provided demographic information and a urine sample. Male pupils were significantly older than females (mean age 15.5 years v 14.8 years, p<0.001), but all other demographic characteristics were similar between the sexes. 14 (0.2%) of the enrolled pupils (four male and 10 female) were HIV positive, 83 (0.9%) were positive for CT, and 12 (0.1%) for NG. 32 female pupils (0.8%) were positive by pregnancy test. Sexual experience was reported by one fifth of primary school girls, and by almost half of boys. Only 45/114 (39%) girls with biological markers of sexual activity reported having had sex. Conclusions: HIV, CT, NG, and pregnancy were present though at relatively low levels among pupils in years 4 to 6 of primary school. A high proportion of pupils with a biological marker of sexual activity denied ever having had sex. Alternative ways of collecting sensitive data about the sexual behaviour of school pupils should be explored. PMID:14755033

  14. A Ghanaian Response to the Study on "Widening Participation in Higher Education in Ghana and Tanzania: Developing an Equity Scorecard"

    ERIC Educational Resources Information Center

    Effah, Paul

    2011-01-01

    The study on "Widening Participation in Higher Education in Ghana and Tanzania: developing an Equity Scorecard" is a contribution to making higher education more socially inclusive in sub-Saharan Africa. The findings reinforce some of the policy initiatives taken in Ghana and Tanzania, and underscore the importance of widening participation in…

  15. "For Poor Nations a Library Service Is Vital": Establishing a National Public Library Service in Tanzania in the 1960s

    ERIC Educational Resources Information Center

    Olden, Anthony

    2005-01-01

    The Tanganyika Library Service (TLS) was the national public library service set up in Tanzania, East Africa, in the 1960s. By the end of the decade, it was generally regarded as a model of Western-style public library development in Africa. This is an account of its establishment and early years based on accessible documentary sources in Tanzania

  16. Local Government Reform Programs and Human Resource Capacity Building in Africa: Evidence from Local Government Authorities (LGAs) in Tanzania

    Microsoft Academic Search

    William Pallangyo; Christopher J. Rees

    2010-01-01

    The Local Government Reform Program (LGRP) in Tanzania was introduced to improve the access and quality of services provided by Local Government Authorities (LGAs). The main aim of the study is to clarify the practice and impact of Human Resource Capacity Building with reference to the LGRP in Tanzania. The study adopted a three-dimensional framework involving Human Resource Development (HRD),

  17. Pn Tomography in Tanzania: Implications for Precambrian lithospheric controls on the development of the East African Rift System

    Microsoft Academic Search

    A. A. Nyblade; R. A. Brazier

    2001-01-01

    A new map of uppermost mantle P wave velocities beneath Tanzania, combined with seismic images of the upper mantle in East Africa from previous studies, show that the lithospheric mantle under the Archean Tanzania Craton has not been modified to any great extent by the Cenozoic exentsional tectonism in East Africa. Therefore, the craton appears to have behaved tectonically as

  18. 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

  19. Effectiveness of marine protected areas in managing the drivers of ecosystem change: a case of Mnazi Bay Marine Park, Tanzania.

    PubMed

    Machumu, Milali Ernest; Yakupitiyage, Amararatne

    2013-04-01

    Marine protected areas (MPAs) are being promoted in Tanzania to mitigate the drivers of ecosystem change such as overfishing and other anthropogenic impacts on marine resources. The effectiveness of MPAs in managing those drivers was assessed in three ecological zones, seafront, mangrove, and riverine of Mnazi Bay Marine Park, using Participatory Community Analysis techniques, questionnaire survey, checklist and fishery resource assessment methods. Eleven major drivers of ecosystem change were identified. Resource dependence had a major effect in all ecological zones of the park. The results indicated that the park's legislations/regulations, management procedures, and conservation efforts are reasonably effective in managing its resources. The positive signs accrued from conservation efforts have been realized by the communities in terms of increased catch/income, awareness and compliance. However, some natural and anthropogenic drivers continued to threaten the park's sustainability. Furthermore, implementation of resource use and benefit sharing mechanisms still remained a considerable challenge to be addressed. PMID:23307198

  20. Genome Wide Association Study of Fetal Hemoglobin in Sickle Cell Anemia in Tanzania

    PubMed Central

    Rooks, Helen; Mgaya, Josephine; Mariki, Harvest; Soka, Deogratius; Mmbando, Bruno; Msaki, Evarist; Kolder, Iris; Thein, Swee Lay; Menzel, Stephan; Cox, Sharon E.; Makani, Julie; Barrett, Jeffrey C.

    2014-01-01

    Background Fetal hemoglobin (HbF) is an important modulator of sickle cell disease (SCD). HbF has previously been shown to be affected by variants at three loci on chromosomes 2, 6 and 11, but it is likely that additional loci remain to be discovered. Methods and Findings We conducted a genome-wide association study (GWAS) in 1,213 SCA (HbSS/HbS?0) patients in Tanzania. Genotyping was done with Illumina Omni2.5 array and imputation using 1000 Genomes Phase I release data. Association with HbF was analysed using a linear mixed model to control for complex population structure within our study. We successfully replicated known associations for HbF near BCL11A and the HBS1L-MYB intergenic polymorphisms (HMIP), including multiple independent effects near BCL11A, consistent with previous reports. We observed eight additional associations with P<10?6. These associations could not be replicated in a SCA population in the UK. Conclusions This is the largest GWAS study in SCA in Africa. We have confirmed known associations and identified new genetic associations with HbF that require further replication in SCA populations in Africa. PMID:25372704

  1. Sustaining water resource use in the degraded environment of the Irangi Hills, central Tanzania

    NASA Astrophysics Data System (ADS)

    Kangalawe, Richard Y. M.

    The Irangi Hills in the semiarid central Tanzania are known for their severe land degradation, particularly through soil erosion. This study aims at investigating the dynamics in the local resource management and adaptive farming strategies. A combination of conventional survey methods, participatory analysis, soil description and aerial photo interpretations were used in the analysis of spatial and temporal land-use patterns. Results from the study showed that farmers utilised all possible niches in the landscape with the agricultural practices varying considerably, depending on spatial variations in soil conditions, water availability and retention capacity of the soil. The hard clayey soils were often ploughed at the end of the rainy season, before the soil dried out, to facilitate timeliness of planting in the following growing season, and to enhance water infiltration at the onset of the rainy season. Seasonally waterlogged soils were intensively cultivated and planted late during the growing season, with crops maturing only from groundwater resource. To make effective use of available groundwater resources during the dry season, the droughty and often infertile sands in ephemeral watercourses are used for growing vegetables or sugarcane in sunken holes without additional fertilisers/manure. This suggests that the crops grown obtain sufficient nutrients only from groundwater resources. However, the sustainability of cultivation in these ephemeral waterways is still questionable.

  2. 'If you have children, you have responsibilities': motherhood, sex work and HIV in southern Tanzania.

    PubMed

    Beckham, Sarah W; Shembilu, Catherine R; Winch, Peter J; Beyrer, Chris; Kerrigan, Deanna L

    2015-01-01

    Many female sex workers begin sex work as mothers, or because they are mothers, and others seek childbearing. Motherhood may influence women's livelihoods as sex workers and their subsequent HIV risks. We used qualitative research methods (30 in-depth interviews and three focus group discussions) and employed Connell's theory of Gender and Power to explore the intersections between motherhood, sex work, and HIV-related risk. Participants were adult women who self-reported exchanging sex for money within the past month and worked in entertainment venues in southern Tanzania. Participants had two children on average, and two-thirds had children at home. Women situated their socially stigmatised work within their respectable identities as mothers caring for their children. Being mothers affected sex workers' negotiating power in complex manners, which led to both reported increases in HIV-related risk behaviours (accepting more clients, accepting more money for no condom, anal sex), and decreases in risk behaviours (using condoms, demanding condom use, testing for HIV). Sex workers/mothers were aware of risks at work, but with children to support, their choices were constrained. Future policies and programming should consider sex workers' financial and practical needs as mothers, including those related to their children such as school fees and childcare. PMID:25270410

  3. Neonatal Deaths in Rural Southern Tanzania: Care-Seeking and Causes of Death

    PubMed Central

    Mrisho, Mwifadhi; Schellenberg, David; Manzi, Fatuma; Tanner, Marcel; Mshinda, Hassan; Shirima, Kizito; Msambichaka, Beverly; Abdulla, Salim; Schellenberg, Joanna Armstrong

    2012-01-01

    Introduction. We report cause of death and care-seeking prior to death in neonates based on interviews with relatives using a Verbal Autopsy questionnaire. Materials and Methods. We identified neonatal deaths between 2004 and 2007 through a large household survey in 2007 in five rural districts of southern Tanzania. Results. Of the 300 reported deaths that were sampled, the Verbal Autopsy (VA) interview suggested that 11 were 28 days or older at death and 65 were stillbirths. Data was missing for 5 of the reported deaths. Of the remaining 219 confirmed neonatal deaths, the most common causes were prematurity (33%), birth asphyxia (22%) and infections (10%). Amongst the deaths, 41% (90/219) were on the first day and a further 20% (43/219) on day 2 and 3. The quantitative results matched the qualitative findings. The majority of births were at home and attended by unskilled assistants. Conclusion. Caregivers of neonates born in health facility were more likely to seek care for problems than caregivers of neonates born at home. Efforts to increase awareness of the importance of early care-seeking for a premature or sick neonate are likely to be important for improving neonatal health. PMID:22518328

  4. Women's Preferences for Place of Delivery in Rural Tanzania: A Population-Based Discrete Choice Experiment

    PubMed Central

    Paczkowski, Magdalena; Mbaruku, Godfrey; de Pinho, Helen; Galea, Sandro

    2009-01-01

    Objectives. We fielded a population-based discrete choice experiment (DCE) in rural western Tanzania, where only one third of women deliver children in a health facility, to evaluate health-system factors that influence women's delivery decisions. Methods. Women were shown choice cards that described 2 hypothetical health centers by means of 6 attributes (distance, cost, type of provider, attitude of provider, drugs and equipment, free transport). The women were then asked to indicate which of the 2 facilities they would prefer to use for a future delivery. We used a hierarchical Bayes procedure to estimate individual and mean utility parameters. Results. A total of 1203 women completed the DCE. The model showed good predictive validity for actual facility choice. The most important facility attributes were a respectful provider attitude and availability of drugs and medical equipment. Policy simulations suggested that if these attributes were improved at existing facilities, the proportion of women preferring facility delivery would rise from 43% to 88%. Conclusions. In regions in which attended delivery rates are low despite availability of primary care facilities, policy experiments should test the effect of targeted quality improvements on facility use. PMID:19608959

  5. 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

  6. Association of geophagia with Ascaris, Trichuris and hookworm transmission in Zanzibar, Tanzania

    PubMed Central

    Young, Sera L.; Goodman, Dave; Farag, Tamer H.; Ali, Said M.; Khatib, Mzee R.; Khalfan, Sabra S.; Tielsch, James M.; Stoltzfus, Rebecca J.

    2007-01-01

    Summary Geophagia may be harmful as a method for the transmission of geohelminths. In this study, we pose two questions in a representative sample of 970 pregnant women from Pemba Island, Zanzibar, Tanzania. Can consumed earth be a vector for geohelminth infection? And do geophagists have differential parasitic infection? The parasitological content of 59 non-food substance samples was analysed. Cross-sectional data regarding pica behaviour were collected through interviews conducted by local researchers. Ascaris, Trichuris and hookworm status was ascertained through Kato–Katz smears. The prevalence of geophagia at baseline was 5.6% and the overall prevalence of Ascaris, Trichuris and hookworm infection was 5.6%, 33.2% and 32.9%, respectively. No consumed soil samples contained infectious parasitic stages, and only one of the consumed pica substances (charcoal) contained parasites of potential risk to human health. Neither the prevalence nor the intensity of infection with Ascaris, Trichuris or hookworm differed significantly by geophagia status. Furthermore, in multivariate models, geophagia was not a significant predictor of helminth infection status. We conclude that geophagia is not a source of Trichuris or hookworm infection among pregnant women in Pemba (insufficient power to evaluate the effect of Ascaris), which is in contrast to existing findings of helminth infection and geophagia. PMID:17568644

  7. Foot-and-mouth disease in Tanzania from 2001 to 2006.

    PubMed

    Picado, A; Speybroeck, N; Kivaria, F; Mosha, R M; Sumaye, R D; Casal, J; Berkvens, D

    2011-02-01

    Foot-and-mouth disease (FMD) is endemic in Tanzania, with outbreaks occurring almost each year in different parts of the country. There is now a strong political desire to control animal diseases as part of national poverty alleviation strategies. However, FMD control requires improving the current knowledge on the disease dynamics and factors related to FMD occurrence so control measures can be implemented more efficiently. The objectives of this study were to describe the FMD dynamics in Tanzania from 2001 to 2006 and investigate the spatiotemporal patterns of transmission. Extraction maps, the space-time K-function and space-time permutation models based on scan statistics were calculated for each year to evaluate the spatial distribution, the spatiotemporal interaction and the spatiotemporal clustering of FMD-affected villages. From 2001 to 2006, 878 FMD outbreaks were reported in 605 different villages of 5815 populated places included in the database. The spatial distribution of FMD outbreaks was concentrated along the Tanzania-Kenya, Tanzania-Zambia borders, and the Kagera basin bordering Uganda, Rwanda and Tanzania. The spatiotemporal interaction among FMD-affected villages was statistically significant (P?0.01) and 12 local spatiotemporal clusters were detected; however, the extent and intensity varied across the study period. Dividing the country in zones according to their epidemiological status will allow improving the control of FMD and delimiting potential FMD-free areas. PMID:21078082

  8. Mosquito abundance, bed net coverage and other factors associated with variations in sporozoite infectivity rates in four villages of rural Tanzania

    PubMed Central

    Kweka, Eliningaya J; Nkya, Watoky MM; Mahande, Aneth M; Assenga, Charles; Mosha, Franklin W; Lyatuu, Ester E; Massenga, Charles P; Nyale, Edwin M; Mwakalinga, Stephen B; Lowassa, Asanterabi

    2008-01-01

    Background Entomological surveys are of great importance in decision-making processes regarding malaria control strategies because they help to identify associations between vector abundance both species-specific ecology and disease intervention factors associated with malaria transmission. Sporozoite infectivity rates, mosquito host blood meal source, bed net coverage and mosquito abundance were assessed in this study. Methodology A longitudinal survey was conducted in four villages in two regions of Tanzania. Malaria vectors were sampled using the CDC light trap and pyrethrum spray catch methods. In each village, ten paired houses were selected for mosquitoes sampling. Sampling was done in fortnight case and study was undertaken for six months in both Kilimanjaro (Northern Tanzania) and Dodoma (Central Tanzania) regions. Results A total of 6,883 mosquitoes were collected including: 5,628 (81.8%) Anopheles arabiensis, 1,100 (15.9%) Culex quinquefasciatus, 89 (1.4%) Anopheles funestus, and 66 (0.9%) Anopheles gambiae s.s. Of the total mosquitoes collected 3,861 were captured by CDC light trap and 3,022 by the pyrethrum spray catch method. The overall light trap: spray catch ratio was 1.3:1. Mosquito densities per room were 96.5 and 75.5 for light trap and pyrethrum spray catch respectively. Mosquito infectivity rates between villages that have high proportion of bed net owners and those without bed nets was significant (P < 0.001) and there was a significant difference in sporozoite rates between households with and without bed nets in these four villages (P < 0.001). Conclusion Malaria remains a major problem in the study areas characterized as low transmission sites. Further studies are required to establish the annual entomological inoculation rates and to observe the annual parasitaemia dynamics in these communities. Outdoor mosquitoes collection should also be considered. PMID:18423018

  9. Temporal trends of molecular markers associated with artemether-lumefantrine tolerance/resistance in Bagamoyo district, Tanzania

    PubMed Central

    2013-01-01

    Background Development and spread of Plasmodium falciparum resistance to artemisinin-based combination therapy (ACT) constitutes a major threat to recent global malaria control achievements. Surveillance of molecular markers could act as an early warning system of ACT-resistance before clinical treatment failures are apparent. The aim of this study was to analyse temporal trends of established genotypes associated with artemether-lumefantrine tolerance/resistance before and after its deployment as first-line treatment for uncomplicated malaria in Tanzania 2006. Methods Single nucleotide polymorphisms in the P. falciparum multidrug resistance gene 1 (pfmdr1) N86Y, Y184F, D1246Y and P. falciparum chloroquine transporter gene (pfcrt) K76T were analysed from dried blood spots collected during six consecutive studies from children with uncomplicated P. falciparum malaria in Fukayosi village, Bagamoyo District, Tanzania, between 2004–2011. Results There was a statistically significant yearly increase of pfmdr1 N86, 184F, D1246 and pfcrt K76 between 2006–2011 from 14% to 61% (yearly OR = 1.38 [95% CI 1.25-1.52] p < 0.0001), 14% to 35% (OR = 1.17 [95% CI 1.07-1.30] p = 0.001), 54% to 85% (OR = 1.21 [95% CI 1.03-1.42] p = 0.016) and 49% to 85% (OR = 1.33 [95% CI 1.17-1.51] p < 0.0001), respectively. Unlike for the pfmdr1 SNP, a significant increase of pfcrt K76 was observed already between 2004–2006, from 26% to 49% (OR = 1.68 [95% CI 1.17-2.40] p = 0.005). From 2006 to 2011 the pfmdr1 NFD haplotype increased from 10% to 37% (OR = 1.25 [95% CI 1.12-1.39] p < 0.0001), whereas the YYY haplotype decreased from 31% to 6% (OR = 0.73 [95% CI 0.56-0.98] p = 0.018). All 390 successfully analysed samples had one copy of the pfmdr1 gene. Conclusion The temporal selection of molecular markers associated with artemether-lumefantrine tolerance/resistance may represent an early warning sign of impaired future drug efficacy. This calls for stringent surveillance of artemether-lumefantrine efficacy in Tanzania and emphasizes the importance of molecular surveillance as a complement to standard in vivo trials. PMID:23506218

  10. Endangered edible orchids and vulnerable gatherers in the context of HIV/AIDS in the Southern Highlands of Tanzania

    PubMed Central

    2009-01-01

    Background Tanzania is a wild orchid biodiversity hotspot and has a high prevalence of HIV/AIDS. The wild orchids in the study are endemic and protected by the Convention on International Trade in Endangered Species. Every year, however, between 2.2 and 4.1 million orchid plants consumed in Zambia are estimated as originating from Tanzania. This research examines the differences between HIV/AIDS wild edible orchid gatherers and non-HIV/AIDS gatherers with regards to the frequency of gathering, salience in naming the various orchids, gathering knowledge acquisition and perceptions regarding the current state of abundance of the edible species. Methods Data was collected through interviews with 224 individuals in the Makete District of Tanzania close to the boarder of Zambia. Free-listings were conducted and Sutrup's Cultural Significance Index (CSI) constructed. The independent t-test was used to compare the differences in gathering frequencies between affected and non-affected gatherers. A multiple comparison of the 4 subgroups (affected adults and children, and non-affected adults and children) in gathering frequencies was done with a one way ANOVA test and its post hoc test. To examine the difference between affected and non-affected gatherers difference in source of gathering knowledge, a chi square test was run. Results Forty two vernacular names of gathered orchid species were mentioned corresponding to 7 botanical species belongs to genera Disa, Satyrium, Habenaria, Eulophia and Roeperocharis. Ninety-seven percent of HIV/AIDS affected households state that orchid gathering is their primary economic activity compared to non-HIV/AIDS affected households at 9.7 percent. The HIV/AIDS affected gathered significantly more often than the non-affected. AIDS orphans, however, gathered most frequently. Gatherers perceive a decreasing trend of abundance of 6 of the 7 species. Gathering activities were mainly performed in age based peer groups. The results revealed a significant difference between affected and non-affected individuals in terms of their source of gathering knowledge. Conclusions HIV/AIDS is related to increased reliance on the natural environment. This appears even more so for the most vulnerable, the AIDS orphaned children followed by HIV/AIDS widows. PMID:20021656

  11. The costs of introducing artemisinin-based combination therapy: evidence from district-wide implementation in rural Tanzania

    PubMed Central

    Njau, Joseph D; Goodman, Catherine A; Kachur, S Patrick; Mulligan, Jo; Munkondya, John S; Mchomvu, Naiman; Abdulla, Salim; Bloland, Peter; Mills, Anne

    2008-01-01

    Background The development of antimalarial drug resistance has led to increasing calls for the introduction of artemisinin-based combination therapy (ACT). However, little evidence is available on the full costs associated with changing national malaria treatment policy. This paper presents findings on the actual drug and non-drug costs associated with deploying ACT in one district in Tanzania, and uses these data to estimate the nationwide costs of implementation in a setting where identification of malaria cases is primarily dependant on clinical diagnosis. Methods Detailed data were collected over a three year period on the financial costs of providing ACT in Rufiji District as part of a large scale effectiveness evaluation, including costs of drugs, distribution, training, treatment guidelines and other information, education and communication (IEC) materials and publicity. The district-level costs were scaled up to estimate the costs of nationwide implementation, using four scenarios to extrapolate variable costs. Results The total district costs of implementing ACT over the three year period were slightly over one million USD, with drug purchases accounting for 72.8% of this total. The composite (best) estimate of nationwide costs for the first three years of ACT implementation was 48.3 million USD (1.29 USD per capita), which varied between 21 and 67.1 million USD in the sensitivity analysis (2003 USD). In all estimates drug costs constituted the majority of total costs. However, non-drug costs such as IEC materials, drug distribution, communication, and health worker training were also substantial, accounting for 31.4% of overall ACT implementation costs in the best estimate scenario. Annual implementation costs are equivalent to 9.5% of Tanzania's recurrent health sector budget, and 28.7% of annual expenditure on medical supplies, implying a 6-fold increase in the national budget for malaria treatment. Conclusion The costs of implementing ACT are substantial. Although drug purchases constituted a majority of total costs, non-drug costs were also considerable. It is clear that substantial external resources will be required to facilitate and sustain effective ACT delivery across Tanzania and other malaria-endemic countries. PMID:18179716

  12. 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

  13. 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

  14. The dependency on central government funding of decentralised health systems: experiences of the challenges and coping strategies in the Kongwa District, Tanzania

    PubMed Central

    2014-01-01

    Background Decentralised health systems in Tanzania depend largely on funding from the central government to run health services. Experience has shown that central funding in a decentralised system is not an appropriate approach to ensure the effective and efficient performance of local authorities due to several limitations. One of the limitations is that funds from the central government are not disbursed on a timely basis, which in turn, leads to the serious problem of shortage of financial resources for Council Health Management Teams (CHMT). This paper examines how dependency on central government funding in Tanzania affects health activities in Kongwa district council and the strategies used by the CHMT cope with the situation. Methods The study adopted a qualitative approach and data were collected using semi-structured interviews and focus group discussions. One district in the central region of Tanzania was strategically selected. Ten key informants involved in the management of health service delivery at the district level were interviewed and one focus group discussion was held, which consisted of members of the council health management team. The data generated were analysed for themes and patterns. Results The results showed that late disbursement of funds interrupts the implementation of health activities in the district health system. This situation delays the implementation of some activities, while a few activities may not be implemented at all. However, based on their prior knowledge of the anticipated delays in financial disbursements, the council health management team has adopted three main strategies to cope with this situation. These include obtaining supplies and other services on credit, borrowing money from other projects in the council, and using money generated from cost sharing. Conclusion Local government authorities (LGAs) face delays in the disbursement of funds from the central government. This has necessitated introduction of informal coping strategies to deal with the situation. National-level policy and decision makers should minimise the bureaucracy involved in allocating funds to the district health systems to reduce delays. PMID:24460781

  15. What elements of the work environment are most responsible for health worker dissatisfaction in rural primary care clinics in Tanzania?

    PubMed Central

    2014-01-01

    Background In countries with high maternal and newborn morbidity and mortality, reliable access to quality healthcare in rural areas is essential to save lives. Health workers who are satisfied with their jobs are more likely to remain in rural posts. Understanding what factors influence health workers’ satisfaction can help determine where resources should be focused. Although there is a growing body of research assessing health worker satisfaction in hospitals, less is known about health worker satisfaction in rural, primary health clinics. This study explores the workplace satisfaction of health workers in primary health clinics in rural Tanzania. Methods Overall, 70 health workers in rural Tanzania participated in a self-administered job satisfaction survey. We calculated mean ratings for 17 aspects of the work environment. We used principal components analysis (PCA) to identify groupings of these variables. We then examined the bivariate associations between health workers demographics and clinic characteristics and each of the satisfaction scales. Results Results showed that 73.9% of health workers strongly agreed that they were satisfied with their job; however, only 11.6% strongly agreed that they were satisfied with their level of pay and 2.9% with the availability of equipment and supplies. Two categories of factors emerged from the PCA: the tools and infrastructure to provide care, and supportive interpersonal environment. Nurses and medical attendants (compared to clinical officers) and older health workers had higher satisfaction scale ratings. Conclusions Two dimensions of health workers’ work environment, namely infrastructure and supportive interpersonal work environment, explained much of the variation in satisfaction among rural Tanzanian health workers in primary health clinics. Health workers were generally more satisfied with supportive interpersonal relationships than with the infrastructure. Human resource policies should consider how to improve these two aspects of work as a means for improving health worker morale and potentially rural attrition. Trial registration (ISRCTN 17107760) PMID:25086596

  16. 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

  17. 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

  18. Impact of Atraumatic Restorative Treatment (ART) on the treatment profile in pilot government dental clinics in Tanzania

    PubMed Central

    Kikwilu, Emil Namakuka; Frencken, Jo; Mulder, Jan

    2009-01-01

    Background The predominant mode of treatment in government dental clinics in Tanzania has been tooth extraction because the economy could not support the conventional restorative care which depends on expensive equipment, electricity and piped water systems. Atraumatic Restorative Treatment (ART) was perceived as a suitable alternative. A 3.5-year study was designed to document the changes in the treatment profiles ascribed to the systematic introduction of ART in pilot government dental clinics. Methods Dental practitioners who were working in 13 government dental clinics underwent a 7-day ART training. Treatment record data on teeth extracted and teeth restored by the conventional and ART approaches were collected from these clinics for the three study periods. The mean percentage of ART restorations to total treatment, ART restorations to total restorations, and total restorations to total treatments rendered were computed. Differences between variables were determined by ANOVA, t-test and Chi-square. Results The mean percentage of ART restorations to total treatment rendered was 0.4 (SE = 0.5) and 11.9 (SE = 1.1) during the baseline and second follow-up period respectively (ANOVA mixed model; P < 0.0001). The mean percentage of ART restorations to total restorations rendered at baseline and 2nd follow-up period was 8.4% and 88.9% respectively (ANOVA mixed model; P < 0.0001). The mean percentage of restorations to total treatment rendered at baseline and 2nd follow-up was 3.9% and 13.0%, respectively (ANOVA mixed model; P < 0.0001). Ninety-nine percent of patients were satisfied with ART restorations, 96.6% willing to receive ART restoration again in future, and 94.9% willing to recommend ART treatment to their close relatives. Conclusion ART introduction in pilot government dental clinics raised the number of teeth saved by restorative care. Countrywide introduction of the ART approach in Tanzania is recommended. PMID:19505294

  19. Spatially Explicit Burden Estimates of Malaria in Tanzania: Bayesian Geostatistical Modeling of the Malaria Indicator Survey Data

    PubMed Central

    Gosoniu, Laura; Msengwa, Amina; Lengeler, Christian; Vounatsou, Penelope

    2012-01-01

    A national HIV/AIDS and malaria parasitological survey was carried out in Tanzania in 2007–2008. In this study the parasitological data were analyzed: i) to identify climatic/environmental, socio-economic and interventions factors associated with child malaria risk and ii) to produce a contemporary, high spatial resolution parasitaemia risk map of the country. Bayesian geostatistical models were fitted to assess the association between parasitaemia risk and its determinants. Bayesian kriging was employed to predict malaria risk at unsampled locations across Tanzania and to obtain the uncertainty associated with the predictions. Markov chain Monte Carlo (MCMC) simulation methods were employed for model fit and prediction. Parasitaemia risk estimates were linked to population data and the number of infected children at province level was calculated. Model validation indicated a high predictive ability of the geostatistical model, with 60.00% of the test locations within the 95% credible interval. The results indicate that older children are significantly more likely to test positive for malaria compared with younger children and living in urban areas and better-off households reduces the risk of infection. However, none of the environmental and climatic proxies or the intervention measures were significantly associated with the risk of parasitaemia. Low levels of malaria prevalence were estimated for Zanzibar island. The population-adjusted prevalence ranges from in Kaskazini province (Zanzibar island) to in Mtwara region. The pattern of predicted malaria risk is similar with the previous maps based on historical data, although the estimates are lower. The predicted maps could be used by decision-makers to allocate resources and target interventions in the regions with highest burden of malaria in order to reduce the disease transmission in the country. PMID:22649486

  20. Spatially explicit burden estimates of malaria in Tanzania: bayesian geostatistical modeling of the malaria indicator survey data.

    PubMed

    Gosoniu, Laura; Msengwa, Amina; Lengeler, Christian; Vounatsou, Penelope

    2012-01-01

    A national HIV/AIDS and malaria parasitological survey was carried out in Tanzania in 2007-2008. In this study the parasitological data were analyzed: i) to identify climatic/environmental, socio-economic and interventions factors associated with child malaria risk and ii) to produce a contemporary, high spatial resolution parasitaemia risk map of the country. Bayesian geostatistical models were fitted to assess the association between parasitaemia risk and its determinants. bayesian kriging was employed to predict malaria risk at unsampled locations across Tanzania and to obtain the uncertainty associated with the predictions. Markov chain Monte Carlo (MCMC) simulation methods were employed for model fit and prediction. Parasitaemia risk estimates were linked to population data and the number of infected children at province level was calculated. Model validation indicated a high predictive ability of the geostatistical model, with 60.00% of the test locations within the 95% credible interval. The results indicate that older children are significantly more likely to test positive for malaria compared with younger children and living in urban areas and better-off households reduces the risk of infection. However, none of the environmental and climatic proxies or the intervention measures were significantly associated with the risk of parasitaemia. Low levels of malaria prevalence were estimated for Zanzibar island. The population-adjusted prevalence ranges from 0.29% in Kaskazini province (Zanzibar island) to 18.65% in Mtwara region. The pattern of predicted malaria risk is similar with the previous maps based on historical data, although the estimates are lower. The predicted maps could be used by decision-makers to allocate resources and target interventions in the regions with highest burden of malaria in order to reduce the disease transmission in the country. PMID:22649486

  1. Mass distribution of free insecticide-treated nets do not interfere with continuous net distribution in Tanzania

    PubMed Central

    2014-01-01

    Background To protect the most vulnerable groups from malaria (pregnant women and infants) the Tanzanian Government introduced a subsidy (voucher) scheme in 2004, on the basis of a public-private partnership. These vouchers are provided to pregnant women at their first antenatal care visit and mothers of infants at first vaccination. The vouchers are redeemed at registered retailers for a long-lasting insecticidal net against the payment of a modest top-up price. The present work analysed a large body of data from the Tanzanian National Voucher Scheme, focusing on interactions with concurrent mass distribution campaigns of free nets. Methods In an ecologic study involving all regions of Tanzania, voucher redemption data for the period 2007 2011, as well as data on potential determinants of voucher redemption were analysed. The four outcome variables were: pregnant woman and infant voucher redemption rates, use of treated bed nets by all household members and by under- five children. Each of the outcomes was regressed with selected determinants, using a generalized estimating equation model and accounting for regional data clustering. Results There was a consistent improvement in voucher redemption rates over the selected time period, with rates >80% in 2011. The major determinants of redemption rates were the top-up price paid by the voucher beneficiary, the retailer- clinic ratio, and socio-economic status. Improved redemption rates after 2009 were most likely due to reduced top-up prices (following a change in policy). Redemption rates were not affected by two major free net distribution campaigns. During this period, there was a consistent improvement in net use across all the regions, with rates of up to 75% in 2011. Conclusion The key components of the National Treated Nets Programme (NATNETS) seem to work harmoniously, leading to a high level of net use in the entire population. This calls for the continuation of this effort in Tanzania and for emulation by other countries with endemic malaria. PMID:24884786

  2. 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

  3. 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

  4. Prevalence of multiresistant gram-negative organisms in a tertiary hospital in Mwanza, Tanzania

    PubMed Central

    Mshana, Stephen E; Kamugisha, Erasmus; Mirambo, Mariam; Chakraborty, Trinad; Lyamuya, Eligius F

    2009-01-01

    Background Antimicrobial resistance is fast becoming a global concern with rapid increases in multidrug-resistant Gram negative organisms. The prevalence of extended spectrum beta-lactamase (ESBL)-producing clinical isolates increases the burden on implementing infectious disease management in low socio-economic regions. As incidence can vary widely between regions, this study was done to determine resistance patterns of Gram-negative organisms at Bugando Medical Center, a tertiary hospital in Mwanza, Tanzania. Methods A total of 800 clinical samples (urine, wound swab, pus, blood, aspirate, sputum etc) were processed over a period of 6 months. Gram-negative bacteria were identified using conventional in-house biochemical tests and susceptibility to common antibiotics done using disc diffusion methods. The disc approximation method was used to identify ESBL producers. Results A total of 377 Gram-negative bacteria (GNB) recovered from 377 clinical specimens were analyzed of which 76.9% were Enterobacteriaceae. Among all GNB, 110/377 (29.2%) were found to be ESBL producers. Species specific ESBLs rate among Klebsiella pneumoniae, Escherichia coli, Acinetobacter spp, Proteus spp and other enterobacteria were 63.7%, 24.4%, 17.7%, 6.4% and 27.9% respectively. A statistically significant higher number of inpatients 100/283 (35.3%) compared to 10/94 (10.6%) of outpatients had ESBL-producing organisms (p = 0.000023). Rates of resistances to gentamicin, tetracycline, sulphamethaxazole/trimethoprim and ciprofloxacin were significantly higher among ESBLs isolates than non-ESBL isolates (p = 0.000001). Conclusion ESBL producing organisms are common at BMC (Bugando Medical Center) and pose a challenge to antibiotic therapy. Successful implementation of a routine detection of ESBL production is essential in designing appropriate antibiotic prescribing policies and infection control intervention programmes. PMID:19323805

  5. Antiretroviral treatment failure predicts mortality in rural Tanzania.

    PubMed

    Pettersen, Pernille S; Brox, Ida K; Naman, Ezra; Bruun, Johan N; Dyrhol-Riise, Anne M; Trøseid, Marius; Johannessen, Asgeir

    2015-08-01

    Virological monitoring of HIV-infected patients on antiretroviral treatment (ART) is rarely available in resource-limited settings and many patients experience unrecognized virological failure. We studied the long-term consequences of virological failure in rural Tanzania. Previously, virological efficacy was measured in a cohort treated with ART. In the present study, patients with virological failure (VF; HIV-RNA >400 copies/ml) were followed up and compared to those with virological response (VR; HIV-RNA <400 copies/ml) with regard to mortality, CD4 change and subsequent virological outcome. Fifty-six patients with VF had a median CD4 count of 358 cells/µl (interquartile range [IQR] 223-635) and a median HIV-RNA of 13,573 copies/ml (IQR 2326-129,736). Median CD4 count for those with VR was 499 cells/µl (IQR 290-636). During a median follow-up time of 39 months (IQR 18-42), 8 of 56 patients (14.3%) with VF died, compared to 1 of 63 patients (1.6%) with VR (p?=?0.009). All registered deaths were HIV-related. Of 55 patients with subsequent HIV-RNA measurements, only 12 of 30 (40%) patients with VF achieved virological suppression, compared to 20 of 25 (80%) patients with VR (p?=?0.003). Virological failure predicted death and subsequent virological failure in patients on ART in a resource-limited setting. PMID:25122578

  6. Late Quaternary vegetation reconstruction from the Eastern Arc Mountains, Tanzania

    NASA Astrophysics Data System (ADS)

    Mumbi, C. T.; Marchant, R.; Hooghiemstra, H.; Wooller, M. J.

    2008-03-01

    Pollen, spore, macrofossil and stable isotope (C and N) analyses from a 266-cm sediment core collected from a swamp on the Eastern Arc Mountains, Tanzania, are used to reconstruct vegetation and environmental history. An estimated time scale based on five 14C ages records approximately 38,000 yr. This palaeorecord is the first from this biodiversity hotspot and importantly extends through the last glacial maximum (LGM). The altitudinal transition from montane to upper montane forest shifted from 1700-1800 m (38,000 14C yr BP) to 1800-1900 m (35,000-29,000 14C yr BP). From 29,000 to 10,000 14C yr BP, it shifted from 1850-1950 m across the LGM to 1750-1800 m (during 10,000-3500 14C yr BP), and to present-day elevations at 2000 m during the last 3500 14C yr BP. The relative ecosystem stability across the LGM may be explained by the Indian Ocean's influence in maintaining continuous moist forest cover during a period of East African regional climate aridity. During the late Holocene, presence of abundant coprophilous fungi and algal blooms demonstrates increasing human impact. Neurospora spores indicate frequent fires, coinciding with clear signals of decline in Podocarpus and Psychotria trees that possibly represent selective logging.

  7. The Rungwe Volcanic Province, Tanzania - A volcanological review

    NASA Astrophysics Data System (ADS)

    Fontijn, Karen; Williamson, David; Mbede, Evelyne; Ernst, Gerald G. J.

    2012-02-01

    The Rungwe Volcanic Province in SW Tanzania is a densely populated area that is considered volcanically active. As part of the East African Rift System, a significant control of tectonic activity seems to exist on the location and also potential destabilization of volcanic edifices. Three large volcanoes, Ngozi, Rungwe, and Kyejo, dominate the landscape and all show contrasting eruptive behaviour in the recent geological past. Kyejo volcano is a flow-dominated volcano that had a historic lava flow eruption. Lake sediment cores, drilled in Lakes Malawi, Masoko, Rukwa, and Tanganyika, provide a record of frequent explosive eruptions in the last few tens of thousands of years. In combination with on-land stratigraphic observations, they constrain the minimum eruptive frequency of especially Rungwe and Ngozi volcanoes. Both volcanoes had Plinian-style eruptions in the Holocene. The most striking documented Rungwe eruption, the ca. 4 ka Rungwe Pumice, is a rare case of a Plinian eruption in near-wind-free conditions. Furthermore, the Rungwe Pumice, just like any other Rungwe tephra deposit, does not show any evidence of pyroclastic density current deposits. Apart from explosive eruptions at a range of scales happening every few hundred years at Rungwe, the volcano also experienced at least two sector collapse events generating debris avalanches. All existing evidence shows that the Rungwe Volcanic Province is prone to future significant explosive eruptions. To further assess, quantify and mitigate volcanic hazard risks, extensive and systematic multidisciplinary geological research, and both volcanic and tectonic monitoring are needed.

  8. Health assessment of artisanal gold miners in Tanzania.

    PubMed

    Bose-O'Reilly, Stephan; Drasch, Gustav; Beinhoff, Christian; Tesha, Aloyce; Drasch, Katalin; Roider, Gabriele; Taylor, Helen; Appleton, Don; Siebert, Uwe

    2010-01-15

    In 2003 UNIDO (United Nations Industrial Development Organization) conducted an environmental and health assessment in a small-scale mining area in Tanzania. BGS (British Geological Survey) performed the environmental assessment. The Institute of Forensic Medicine - University of Munich performed the health assessment. The results of the medical, neurological and neuro-psychological examination of 180 participants from the affected area of Rwamagasa and 31 controls were analyzed. Urine, blood and hair samples were analyzed to detect the level of mercury body burden. Mercury concentrations in the bio-monitors urine, blood and hair were statistically significantly higher in the exposed population from Rwamagasa compared to the control group from Katoro. Only amalgam burners showed mercury levels above the toxicological threshold limits. A speciation of mercury in hair indicated that mainly elemental mercury vapor contributed to the high body burden of the artisanal miners. 104 amalgam-burners, the most exposed population group, were examined. 25 of these workers were found to be intoxicated. Small-scale mining is a serious health hazard for amalgam burners. Reduction of the exposure is essential to prevent further damage. PMID:19945738

  9. Occurrence of haemoparasites in cattle in Monduli district, northern Tanzania.

    PubMed

    Haji, Isihaka J; Malele, Imna; Namangala, Boniface

    2014-01-01

    Haemoparasite infections are among the most economically important cattle diseases in sub-Saharan Africa. The present study investigated the occurrence of haemoparasites in 295 indigenous cattle from five villages (Mswakini, Lake Manyara, Naitolia, Makuyuni and Nanja) of the Monduli district, a wildlife-domestic animal-human interface area in northern Tanzania. The data showed that the overall occurrence of haemoparasites in the sampled cattle was 12.5% (95% CI: 8.7% - 16.3%), involving single and mixed infections with Theileria parva, Anaplasma marginale, Babesia bovis, Trypanosoma vivax and Trypanosoma brucei. The highest haemoparasite occurrence was recorded in Lake Manyara (18.3%; 95% CI: 8.5% - 28.1%), and the lowest was recorded in Nanja (6.5%; 95% CI: 0.4% - 12.6%). This preliminary study, furthermore, provided evidence of the possible arthropod vectors (ticks and tsetse flies) that may be involved in the transmission of haemoparasites to cattle in the Monduli district. It is envisaged that this survey will stimulate more studies to determine the prevalence of haemoparasites in livestock by using more sensitive molecular techniques. PMID:25685864

  10. Factors affecting uptake of optimal doses of sulphadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy in six districts of Tanzania

    PubMed Central

    2014-01-01

    Background Intermittent preventive treatment during pregnancy (IPTp) with optimal doses (two+) of sulphadoxine-pyrimethamine (SP) protects pregnant women from malaria-related adverse outcomes. This study assesses the extent and predictors of uptake of optimal doses of IPTp-SP in six districts of Tanzania. Methods The data come from a cross-sectional survey of random households conducted in six districts in Tanzania in 2012. A total of 1,267 women, with children aged less than two years and who had sought antenatal care (ANC) at least once during pregnancy, were selected for the current analysis. Data analysis involved the use of Chi-Square (?2) for associations and multivariate analysis was performed using multinomial logistic regression. Results Overall, 43.6% and 28.5% of the women received optimal (two+) and partial (one) doses of IPTp-SP respectively during pregnancy. Having had been counseled on the dangers of malaria during pregnancy was the most pervasive determinant of both optimal (RRR?=?6.47, 95% CI 4.66-8.97) and partial (RRR?=?4.24, 95% CI 3.00-6.00) uptake of IPTp-SP doses. Early ANC initiation was associated with a higher likelihood of uptake of optimal doses of IPTp-SP (RRR?=?2.05, 95% CI 1.18-3.57). Also, women with secondary or higher education were almost twice as likely as those who had never been to school to have received optimal SP doses during pregnancy (RRR?=?1.93, 95% CI 1.04-3.56). Being married was associated with a 60% decline in the partial uptake of IPTp-SP (RRR?=?0.40, 95% CI 0.17-0.96). Inter-district variations in the uptake of both optimal and partial IPTp-SP doses existed (P?Tanzania. ANC initiation in the first trimester should be promoted to enhance coverage of optimal doses of IPTp-SP. Programmes should aim to curb geographical barriers due to place of residence to enhance optimal coverage of IPTp-SP in Tanzania. PMID:24423279

  11. High levels of sulphadoxine-pyrimethamine resistance Pfdhfr-Pfdhps quintuple mutations: a cross sectional survey of six regions in Tanzania

    PubMed Central

    2014-01-01

    Background In 2006, the first-line anti-malarial drug treatment in Tanzania was changed from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (ALu), an artemisinin-based combination (ACT), since when the use of SP has been restricted for intermittent preventive treatment in pregnancy (IPTp). A number of Plasmodium falciparum mutations are known to be associated with resistance to SP, but it is not known if the prevalence of these mutations is increasing or decreasing under the conditions of reduced levels of SP use. This study reports on the current SP resistant quintuple Pfdhfr-Pfdhps mutations in six regions of Tanzania. Methods Finger-prick blood on filter paper and rapid diagnostic test strips from P. falciparum-positive individuals of all age groups attending health facilities in six regions of Tanzania between June 2010 and August 2011 were obtained. Using chelex-100 extracted DNA, genotyping was done for mutations on codons 51, 59 and 108 of Pfdhfr and 437 and 540 of Pfdhps genes using PCR-RFLP technique. Results A total of 802 malaria-positive samples were screened and genotyped. The prevalence of Pfdhfr 51I, Pfdhps 437G and 540E varied between the regions (p?Tanzania with evidence of quintuple mutations that are likely to become fixed in the population. This threatens the future of SP not only in IPTp programmes, but as a combination drug for ACT. Continuous monitoring of SP-IPTp efficacy should be encouraged subsequent to searching for alternative drugs for IPTp in East Africa. PMID:24751352

  12. Improvements in access to malaria treatment in Tanzania after switch to artemisinin combination therapy and the introduction of accredited drug dispensing outlets - a provider perspective

    PubMed Central

    2010-01-01

    Background To improve access to treatment in the private retail sector a new class of outlets known as accredited drug dispensing outlets (ADDO) was created in Tanzania. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (ALu) in 2007. Subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on access to malaria treatment was studied in rural Tanzania. Methods The study was carried out in the villages of Kilombero and Ulanga Demographic Surveillance System (DSS) and in Ifakara town. Data collection consisted of: 1) yearly censuses of shops selling drugs; 2) collection of monthly data on availability of anti-malarials in public health facilities; and 3) retail audits to measure anti-malarial sales volumes in all public, mission and private outlets. The data were complemented with DSS population data. Results Between 2004 and 2008 access to malaria treatment greatly improved and the number of anti-malarial treatment doses dispensed increased by 78%. Particular improvements were observed in the availability (from 0.24 shops per 1,000 people in 2004 to 0.39 in 2008) and accessibility (from 71% of households within 5 km of a shop in 2004 to 87% in 2008) of drug shops. Despite no improvements in affordability this resulted in an increase of the market share from 49% of anti-malarial sales 2005 to 59% in 2008. The change of treatment policy from SP to ALu led to severe stock-outs of SP in health facilities in the months leading up to the introduction of ALu (only 40% months in stock), but these were compensated by the wide availability of SP in shops. After the introduction of ALu stock levels of the drug were relatively high in public health facilities (over 80% months in stock), but the drug could only be found in 30% of drug shops and in no general shops. This resulted in a low overall utilization of the drug (19% of all anti-malarial sales) Conclusions The public health and private retail sector are important complementary sources of treatment in rural Tanzania. Ensuring the availability of ALu in the private retail sector is important for its successful uptake. PMID:20550654

  13. "Workhood"-a useful concept for the analysis of health workers' resources? an evaluation from Tanzania

    PubMed Central

    2012-01-01

    Background International debates on improving health system performance and quality of care are strongly coined by systems thinking. There is a surprising lack of attention to the human (worker) elements. Although the central role of health workers within the health system has increasingly been acknowledged, there are hardly studies that analyze performance and quality of care from an individual perspective. Drawing on livelihood studies in health and sociological theory of capitals, this study develops and evaluates the new concept of workhood. As an analytical device the concept aims at understanding health workers' capacities to access resources (human, financial, physical, social, cultural and symbolic capital) and transfer them to the community from an individual perspective. Methods Case studies were conducted in four Reproductive-and-Child-Health (RCH) clinics in the Kilombero Valley, south-eastern Tanzania, using different qualitative methods such as participant observation, informal discussions and in-depth interviews to explore the relevance of the different types of workhood resources for effective health service delivery. Health workers' ability to access these resources were investigated and factors facilitating or constraining access identified. Results The study showed that lack of physical, human, cultural and financial capital constrained health workers' capacity to act. In particular, weak health infrastructure and health system failures led to the lack of sufficient drug and supply stocks and chronic staff shortages at the health facilities. However, health workers' capacity to mobilize social, cultural and symbolic capital played a significant role in their ability to overcome work related problems. Professional and non-professional social relationships were activated in order to access drug stocks and other supplies, transport and knowledge. Conclusions By evaluating the workhood concept this study highlights the importance of understanding health worker performance by looking at their resources and capacities. Rather than blaming health workers for health system failures, applying a strength-based approach offers new insights into health workers' capacities and identifies entry points for target actions. PMID:22401037

  14. Trematode infections in cattle in Arumeru District, Tanzania are associated with irrigation

    PubMed Central

    2014-01-01

    Background The relationship between the environment and infection of cattle with trematodes was studied at Arumeru District, Arusha Region, northern Tanzania. Randomly selected villages were grouped into three cattle management strata, (i) zero-grazing (ZZ) (ii) communal grazing without irrigation (ZC) and (iii) communal grazing with irrigation (ZCI). Methods Faecal samples were collected from 241 cattle, and processed using the Flukefinder® method. Snail intermediate hosts were collected with a snail scoop from the water bodies in the study villages and identified morphologically. Results The overall prevalence of F. gigantica, paramphistomes and S. bovis were 33%, 37% and 2% respectively. Prevalence for F. gigantica, paramphistomes, and S. bovis for each stratum were, zero-grazing (ZZ) (29.7%, 36.0% and 0%), communal grazing without irrigation (ZC) (6.3%, 15.0% and 3.8%) and communal grazing with irrigation (ZCI) (57.7%, 56.7% and 1.0%) respectively. The differences between strata were significant for F. gigantica (p < 0.001) and paramphistomes (p < 0.05) but not for S. bovis. Irrigation could account for the high prevalence of F. gigantica and paramphistomes in the ZCI stratum as compared to the ZZ and ZC strata. The higher prevalences of F. gigantica and paramphistomes in the ZZ stratum compared with the ZC stratum were unexpected and attributed to the practice of farmers in some ZZ stratum villages buying fodder for their cattle obtained from pastures in ZCI villages. Conclusion Trematode infections in cattle are prevalent in Arumeru District. Fasciola gigantica and paramphistomes are associated with grazing in areas with irrigation of crops. Zero-grazing of cattle does not necessarily prevent the risk of infection. PMID:24650420

  15. Emergency care capacity in Africa: A clinical and educational initiative in Tanzania

    PubMed Central

    Reynolds, Teri A; Mfinanga, Juma A; Sawe, Hendry R; Runyon, Michael S; Mwafongo, Victor

    2012-01-01

    Even though sub-Saharan Africa faces a disproportionate burden of acute injury and illness, few clinical facilities are configured to take an integrated approach to resuscitation and stabilization. Emergency care is a high-impact and cost-effective form of secondary prevention; disease surveillance at facilities delivering acute and emergency care is essential to guide primary prevention. Barriers to emergency care implementation in the region include limited documentation of the acute disease burden, a lack of consensus on regionally appropriate metrics to facilitate impact evaluation, and the lack of coordinated advocacy for acute disease prevention and emergency care. Despite these challenges, interest in creating dedicated acute care facilities and emergency training programs is rapidly expanding in Africa. We describe one such initiative at Muhimbili National Hospital in Dar es Salaam, with a focus on the development of the emergency medicine residency program. PMID:23254838

  16. Impacts of Wildlife on Household Food Security and Income in Northeastern Tanzania

    Microsoft Academic Search

    Abiud Kaswamila; Shaun Russell; Mike McGibbon

    2007-01-01

    We evaluated the impacts of wildlife on household food security and income in three semi-arid villages adjacent to Lake Manyara National Park (LMNP) and Mkomazi Game Reserve (MGR) in Northeastern Tanzania. Survey data were collected using both household interviews and human–wildlife conflict related archive information from the village government offices. Crop destruction by wildlife influenced both household food security and

  17. Dividing the Labor of Development: Education and Participation in Rural Tanzania

    ERIC Educational Resources Information Center

    Phillips, Kristin D.

    2013-01-01

    Since the 1940s, the concept of community participation has framed, mobilized, and legitimated national development agendas in the Singida Region of rural central Tanzania. Based on 19 months of ethnographic and archival research, this study examines the forms of community participation elicited through state and international development…

  18. 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…

  19. The Cultural Politics of Constructivist Pedagogies: Teacher Education Reform in the United Republic of Tanzania

    ERIC Educational Resources Information Center

    Vavrus, Frances

    2009-01-01

    This article examines recent educational reforms in Tanzania by looking at the cultural politics of pedagogical change in secondary and teacher education. It presents an ethnography of a teachers college founded on the principles of social constructivism in a country where formalistic, teacher-centered pedagogy is the norm. Using data collected…

  20. A Household Survey of Source, Availability, and Use of Antimalarials in a Rural Area of Tanzania

    Microsoft Academic Search

    Stephen E. D. Nsimba; Marian Warsame; Göran Tomson; Amos Y. Massele; Zebwe A. Mbatiya

    1999-01-01

    The source, availability, and use of antimalarial drugs in a rural community in the Kibaha district of Tanzania were assessed. Using questionnaires, the heads of households and mothers\\/guardians of children under five years of age in 1000 randomly selected households were interviewed, and an inventory of antimalarials at all drug stores and shops in the area was carried out. The

  1. Scaling up priority health interventions in Tanzania: the human resources challenge

    Microsoft Academic Search

    Christoph Kurowski; Kaspar Wyss; Salim Abdulla; Anne Mills

    2007-01-01

    The international community has set ambitious goals (Millennium Development Goals) to improve health in developing countries by 2015. Effective and often cheap interventions exist to achieve these goals. In the mainland of Tanzania, one of the poorest countries of the world, we explored the human resources challenges of expanding the coverage of such priority interventions. We projected human resources for

  2. Empathy-Based Stories Capturing the Voice of Female Secondary School Students in Tanzania

    ERIC Educational Resources Information Center

    Posti-Ahokas, Hanna

    2013-01-01

    Tanzania, like many other African countries, has experienced a rapid expansion of its secondary education sector. This has resulted in large numbers of secondary school graduates struggling to build a future through continuing education or finding employment.1 Students are faced with the difficult task of assessing their opportunities in the face…

  3. The decentralisation-centralisation dilemma: recruitment and distribution of health workers in remote districts of Tanzania

    Microsoft Academic Search

    Michael A Munga; Nils Gunnar Songstad; Astrid Blystad; Ottar Mæstad

    2009-01-01

    BACKGROUND: The implementation of decentralisation reforms in the health sector of Tanzania started in the 1980s. These reforms were intended to relinquish substantial powers and resources to districts to improve the development of the health sector. Little is known about the impact of decentralisation on recruitment and distribution of health workers at the district level. Reported difficulties in recruiting health

  4. A Bibliography on Rural Development in Tanzania. MSU Rural Development Paper No. 3.

    ERIC Educational Resources Information Center

    Kocher, James E.; Fleisher, Beverly

    Rural development is understood to mean both the increased productivity of agriculture and other rural economic activities and the enhancement of the material well-being of the rural people (who comprise about 90% of Tanzania's 16 million population) through education, improved health, and better nutrition. Seven hundred and sixty-one books,…

  5. The market shaping of charges, trust and abuse: health care transactions in Tanzania

    Microsoft Academic Search

    Paula Tibandebage; Maureen Mackintosh

    2005-01-01

    Effective health care is a relational activity, that is, it requires social relationships of trust and mutual understanding between providers and those needing and seeking care. The breakdown of these relationships is therefore impoverishing, cutting people off from a basic human capability, that of accessing of decent health care in time of need. In Tanzania as in much of Africa,

  6. 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…

  7. Curriculum Diversification, Cognitive Achievement and Economic Performance: Evidence from Colombia and Tanzania.

    ERIC Educational Resources Information Center

    Psacharopoulos, George

    A study evaluated diversified secondary school systems in Colombia and Tanzania. It compared advantages that might have accrued to diversified school students and graduates relative to more conventional types of formal training. A random sample of approximately 14,000 school students following diversified and conventional secondary curricula was…

  8. 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…

  9. Pre-Primary Education in Tanzania: Observations from Urban and Rural Classrooms

    ERIC Educational Resources Information Center

    Mtahabwa, Lyabwene; Rao, Nirmala

    2010-01-01

    This study examined the relationship between pre-primary educational policy and actual practice in Tanzania. Policy relevant to pre-primary education was analyzed and 15 pre-primary lessons from two urban and two rural schools were videotaped. Although the national educational policy specifies the same standards for pre-primary education…

  10. Truck Drivers' Opinion On Road Safety In Tanzania—A Questionnaire Study

    Microsoft Academic Search

    Katja Kircher; Jan Andersson

    2012-01-01

    Objective: Even though the traffic fatality risk (fatalities per 100 000 inhabitants) in Tanzania is quite low, the fatality rate (fatalities per 10 000 vehicles) is one of the highest in the world. With increasing vehicle density this means that the number of people dying in traffic will increase dramatically in the near future. Therefore it is important to implement

  11. Adult Literacy in Africa--Nigeria, Rhodesia, South Africa, Sudan, Tanzania. Literacy Bibliographies 23.

    ERIC Educational Resources Information Center

    International Inst. for Adult Literacy Methods, Teheran (Iran).

    Approximately 200 items are listed in this bibliography of materials pertaining to adult literacy in Nigeria, Rhodesia, South Africa, the Sudan, and Tanzania. The listed materials are categorized according to country and deal with a variety of topics, including the following: (1) adult education and adaptation to change in Nigeria; (2) adult…

  12. Roots of Traditional Personality Development Among the Zaramo in Coastal Tanzania.

    ERIC Educational Resources Information Center

    Forssen, Anja

    The manner in which the traditional way of life and the traditional rituals of the Zaramo of Tanzania affect the personality development of Zaramo children and individuals in general was the focus of this preliminary study for an envisioned longitudinal program of research. Data was gathered during 1970 and 1974 in a typical traditional rural…

  13. Seronera: Excavations at a Stone Bowl Site in the Serengeti National Park, Tanzania

    Microsoft Academic Search

    John R. F. Bower

    1973-01-01

    Excavations at six localities at Seronera in the Serengeti National Park of northern Tanzania have revealed traces of prehistoric occupation from the “Middle Stone Age” to within the present millennium. A stratigraphical sequence of pottery styles was established; the earliest ware being of Gumban A type, here dated to around the first century B.C. Subsequent and perhaps partly contemporary with

  14. Weed populations and agronomic practices at wheat farms on the Hanang plains in Tanzania

    Microsoft Academic Search

    J. R. Moyer; Z. J. Owenya; S. P. Kibuwa

    1989-01-01

    Weed species and densities of weeds present on the wheat farms at the Hanang plains in northern Tanzania were surveyed just before wheat harvest in May, 1986. The dominant weed was Setaria spp. mainly, Setaria verticillata (L.) Beauv., which occurred at an average density of 58 shoots\\/m. Additional weed species which occurred at average densities of greater than 1 plant\\/m

  15. Nation-Building: Tanzania and the World. Through African Eyes: Cultures in Change, Unit VI.

    ERIC Educational Resources Information Center

    Clark, Leon E., Ed.

    The process of nation building in Tanzania is the topic of this book, the sixth in a series dealing with African culture and intended for secondary level students. Almost all of the selections in the book were written by Africans, and they come from a variety of sources including speeches, government documents, newspaper and magazine articles,…

  16. Small Scale Fisheries Management: Lessons from Cockle Harvesters in Nicaragua and Tanzania

    Microsoft Academic Search

    Brian Crawford; Maria D. Herrera; Nelvia Hernandez; Carlos Rivas Leclair; Narriman Jiddawi; Semba Masumbuko; Maria Haws

    2010-01-01

    The role of women in gleaning fisheries tends to be underestimated and poorly documented although they play an important role in coastal food security and income generation. This article describes two initiatives for co-management of women dominated cockle (Anadara spp.) fisheries implemented in Zanzibar Island of Tanzania and in Nicaragua that were based on a Fiji model. In each case,

  17. Influence of satellite-derived rainfall patterns on plague occurrence in northeast Tanzania

    Microsoft Academic Search

    Annekatrien Debien; Simon Neerinckx; Didas Kimaro; Hubert Gulinck

    2010-01-01

    BACKGROUND: In the tropics, rainfall data are seldom accurately recorded, and are often discontinuous in time. In the scope of plague-research in northeast Tanzania, we adapted previous research to reconstruct rainfall patterns at a suitable resolution (1 km), based on time series of NDVI: more accurate satellite imagery was used, in the form of MODIS NDVI, and rainfall data were

  18. 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.…

  19. Patterns of concurrent hookworm infection and schistosomiasis in schoolchildren in Tanzania

    Microsoft Academic Search

    N. J. S. Lwambo; J. E. Siza; S. Brooker; D. A. P. Bundy; H. Guyatt

    1999-01-01

    A cross-sectional study of 6897 schoolchildren in 59 out of the 155 primary schools in Magu District on the shores of Lake Victoria, Tanzania, was undertaken in 1997 to determine the prevalence of single- and multiple-species helminth infection. Schistosoma haematobium, hookworm (primarily Necator americanus) and S. mansoni were the most common helminth species infecting schoolchildren in the district. The prevalences

  20. Smallholder vegetable farmers in Northern Tanzania: Pesticides use practices, perceptions, cost and health effects

    Microsoft Academic Search

    A. V. F. Ngowi; T. J. Mbise; A. S. M. Ijani; O. C. Ajayi

    2007-01-01

    Smallholder farmers in Northern Tanzania grow vegetables that include tomatoes, cabbages and onions and use many types of pesticides to control pests and diseases that attack these crops. Based on the use of questionnaires and interviews that were conducted in Arumeru, Monduli, Karatu and Moshi rural districts, this study investigates farmers’ practices, perceptions and related cost and health effects on

  1. The geology and mineralisation at the Golden Pride gold deposit, Nzega Greenstone Belt, Tanzania

    Microsoft Academic Search

    I. M. A. Vos; F. P. Bierlein; J. S. Standing; G. Davidson

    2009-01-01

    The Golden Pride gold deposit (˜3 Moz) is located in the central part of the Nzega Greenstone Belt at the southern margin of the Lake Victoria Goldfields in Tanzania. It represents an inferred Late Archaean, orogenic gold deposit and is hosted in intensely deformed meta-sedimentary rocks in the hanging wall of the approximately E-W striking Golden Pride Shear Zone. The

  2. Antifungal and anti-bacterial activity of some herbal remedies from Tanzania

    Microsoft Academic Search

    Hugo J. de Boer; Anneleen Kool; Anders Broberg; William R. Mziray; Inga Hedberg; Jolanta J. Levenfors

    2005-01-01

    Plants are not only important to the millions of people to whom traditional medicine serves as the only opportunity for health care and to those who use plants for various purposes in their daily lives, but also as a source of new pharmaceuticals. During interviews with the Pare people from Northeastern Tanzania, 29 plants that are used for medicinal purposes

  3. Consumption patterns and nutritional contribution of Crotalaria Brevidens (Mitoo) in Tarime District, Tanzania

    Microsoft Academic Search

    Febronia C. Uiso; Timothy Johns

    1996-01-01

    We assessed the nutritional benefit of consumption of Crotalaria brevidens (mitoo), a leafy vegetable indigenous to the Lake Victoria basin of East Africa. Food frequency questionnaires and 24?hour recalls with 74 women in Tarime District, Tanzania, documented the consumption of 24 cultivated and wild species of leafy vegetables and 38 species of fruits during June?July, 1990. Leaves of cultivated or

  4. 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…

  5. Occurrences and management of lameness in goats: A case study of Magadu farm, Morogoro, Tanzania

    Microsoft Academic Search

    H. E. Nonga; M. Makungu; S. B. P. Bittegeko; D. G. Mpanduji

    2009-01-01

    A survey of lameness in goats was carried out at Magadu farm, Morogoro, Tanzania during the rainy and dry season of 1996, 1997 and 1998 involving 383, 449 and 438 animals, respectively. Digital lesions as cause of lameness were diagnosed through clinical and radiological evaluations. For the 3 years of study, a significantly (P<0.001) higher prevalence of lameness was recorded

  6. Sex ratio of leopards taken in trophy hunting: genetic data from Tanzania

    Microsoft Academic Search

    Goran Spong; Linda Hellborg; Scott Creel

    2000-01-01

    The sex ratio of leopards, Panthera pardus, taken by trophyhunters in Tanzania is examined. We used sex specific molecularmarkers to analyze 77 samples collected from animals shot betweenthe years 1995–1998 and found that 28.6% were females, despitethe fact that only males are allowed on licenses and all skinswere tagged as males. The model used for quota setting assumesthat only males

  7. Sex ratio of leopards taken in trophy hunting: genetic data from Tanzania

    Microsoft Academic Search

    Goran Spong; Linda Hellborg; Scott Creel

    2000-01-01

    The sex ratio of leopards, Panthera pardus, taken by trophy hunters in Tanzania is examined. We used sex specific molecular markers to analyze 77 samples collected from animals shot between the years 1995-1998 and found that 28.6% were females, despite the fact that only males are allowed on licenses and all skins were tagged as males. The model used for

  8. Effects of trophy hunting on lion and leopard populations in Tanzania.

    PubMed

    Packer, C; Brink, H; Kissui, B M; Maliti, H; Kushnir, H; Caro, T

    2011-02-01

    Tanzania holds most of the remaining large populations of African lions (Panthera leo) and has extensive areas of leopard habitat (Panthera pardus), and both species are subjected to sizable harvests by sport hunters. As a first step toward establishing sustainable management strategies, we analyzed harvest trends for lions and leopards across Tanzania's 300,000 km(2) of hunting blocks. We summarize lion population trends in protected areas where lion abundance has been directly measured and data on the frequency of lion attacks on humans in high-conflict agricultural areas. We place these findings in context of the rapidly growing human population in rural Tanzania and the concomitant effects of habitat loss, human-wildlife conflict, and cultural practices. Lion harvests declined by 50% across Tanzania between 1996 and 2008, and hunting areas with the highest initial harvests suffered the steepest declines. Although each part of the country is subject to some form of anthropogenic impact from local people, the intensity of trophy hunting was the only significant factor in a statistical analysis of lion harvest trends. Although leopard harvests were more stable, regions outside the Selous Game Reserve with the highest initial leopard harvests again showed the steepest declines. Our quantitative analyses suggest that annual hunting quotas be limited to 0.5 lions and 1.0 leopard/1000 km(2) of hunting area, except hunting blocks in the Selous Game Reserve, where harvests should be limited to 1.0 lion and 3.0 leopards/1000 km(2) . PMID:20825444

  9. A sustainable information security framework for e-Government – case of Tanzania

    Microsoft Academic Search

    Carina Kabajunga Wangwe; Maria Margaretha Eloff; Lucas Venter

    2012-01-01

    The government of Tanzania adopted an e-Government strategy in 2009 that is aimed at improving efficiency in government and providing better services to citizens. Information security is identified as one of the requirements for the successful e-Government implementation although the government has not adopted any standards or issued guidelines to government agencies with regards to information security. Comprehensive addressing of

  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. A New Horned Crocodile from the Plio-Pleistocene Hominid Sites at Olduvai Gorge, Tanzania

    Microsoft Academic Search

    Christopher A. Brochu; Jackson Njau; Robert J. Blumenschine; Llewellyn D. Densmore; Carles Lalueza-Fox

    2010-01-01

    BackgroundThe 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”

  12. Identification, characterisation and composition of scavengeable feed resources for rural poultry production in Central Tanzania

    Microsoft Academic Search

    E. H. Goromela; R. P. Kwakkel; M. W. A. Verstegen; A. M. Katule

    2007-01-01

    A participatory study was carried out in four villages of central Tanzania to appraise existing and potential scavengeable feed resources available for rural poultry. In addition, proximate analysis of selected scavengeable feed resources including chicken crop and gizzards contents was carried out to quantify their feeding value. Results indicate that the most important scavengeable feed resources in the dry season

  13. Increasing health worker capacity through distance learning: a comprehensive review of programmes in Tanzania

    Microsoft Academic Search

    Anya J Nartker; Liz Stevens; Alyson Shumays; Martin Kalowela; Daniel Kisimbo; Katy Potter

    2010-01-01

    BACKGROUND: Tanzania, like many developing countries, faces a crisis in human resources for health. The government has looked for ways to increase the number and skills of health workers, including using distance learning in their training. In 2008, the authors reviewed and assessed the country's current distance learning programmes for health care workers, as well as those in countries with

  14. Peste des petits ruminants infection among cattle and wildlife in northern Tanzania.

    PubMed

    Lembo, Tiziana; Oura, Christopher; Parida, Satya; Hoare, Richard; Frost, Lorraine; Fyumagwa, Robert; Kivaria, Fredrick; Chubwa, Chobi; Kock, Richard; Cleaveland, Sarah; Batten, Carrie

    2013-12-01

    We investigated peste des petits ruminants (PPR) infection in cattle and wildlife in northern Tanzania. No wildlife from protected ecosystems were seropositive. However, cattle from villages where an outbreak had occurred among small ruminants showed high PPR seropositivity, indicating that spillover infection affects cattle. Thus, cattle could be of value for PPR serosurveillance. PMID:24274684

  15. 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…

  16. The Forgotten ‘Coastal Forests’ of Mtwara, Tanzania: A Biologically Impoverished and Yet Important Ecosystem

    Microsoft Academic Search

    Giulia Wegner; Kim M. Howell; Tim R. B. Davenport; Neil D. Burgess

    2009-01-01

    Biodiversity surveys and the compilation of indigenous knowledge were conducted in eight previously unstudied proposed and already gazetted Forest Reserves of Mtwara Region, south-eastern Tanzania, from April to August of 2005. The results indicate relatively low biodiversity and endemism values in these forests, and high levels of forest disturbance. In most areas the original vegetation has been converted by clearance

  17. 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…

  18. Transaction costs of community-based forest management: empirical evidence from Tanzania

    Microsoft Academic Search

    Charles K. Meshack; Bhim Ahdikari; Nike Doggart; Jon C. Lovett

    2006-01-01

    Levels of transaction costs in community-based forest management (CBFM) in four communities adjacent to the Ambangulu mountain forests of the north-east of Tanzania were assessed through questionnaire responses from 120 households. Costs and benefits of CBFM to the rich, med- ium and poor groups of forest users were estimated. Costs of CBFM were participation in forest monitoring and time spent

  19. Do country images affect private development finance? Explaining differences between Tanzania & the Central African Republic

    Microsoft Academic Search

    DIRK-JAN KOCH; DIK VAN DE KOOLWIJK

    Recent research has mapped the uneven coverage of international development NGOs in Africa, but failed to explain the drivers of this inequality. This paper shows that management literature can provide novel insight into this area and applies the concept of country images to the Central African Republic (CAR) and Tanzania. Contrasting an innovative survey of international NGOs with the results

  20. Soil fertility evaluation and management by smallholder farmer communities in northern Tanzania

    Microsoft Academic Search

    Jeremias G. Mowo; Bert H. Janssen; Oene Oenema; Laura A. German; Jerome P. Mrema; Riziki S. Shemdoe

    2006-01-01

    The objective of this paper is to compare soil fertility evaluation based on experience and knowledge of smallholder farmer communities with the evaluation by scientists based on soil analysis and model calculations. The role of the smallholder farmer community in soil fertility evaluation and management was examined from two ‘research for development’ projects in northern Tanzania. These are the African

  1. Malaria risk and access to prevention and treatment in the paddies of the Kilombero Valley, Tanzania

    Microsoft Academic Search

    Manuel W Hetzel; Sandra Alba; Mariette Fankhauser; Iddy Mayumana; Christian Lengeler; Brigit Obrist; Rose Nathan; Ahmed M Makemba; Christopher Mshana; Alexander Schulze; Hassan Mshinda

    2008-01-01

    BACKGROUND: The Kilombero Valley is a highly malaria-endemic agricultural area in south-eastern Tanzania. Seasonal flooding of the valley is favourable to malaria transmission. During the farming season, many households move to distant field sites (shamba in Swahili) in the fertile river floodplain for the cultivation of rice. In the shamba, people live for several months in temporary shelters, far from

  2. 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…

  3. Sex, Grades and Power in Higher Education in Ghana and Tanzania

    ERIC Educational Resources Information Center

    Morley, Louise

    2011-01-01

    Quantitative increases tell a partial story about the quality of women's participation in higher education. Women students' reporting of sexual harassment has been noteworthy in a recent study that I directed on widening participation in higher education in Ghana and Tanzania. The hierarchical and gendered power relations within universities have…

  4. "Nipe Nikupe": Dependency, Reciprocity, and Paradoxes of Food Aid in Lugufu Refugee Camp Kigoma, Tanzania

    ERIC Educational Resources Information Center

    Hoyer, Brian

    2005-01-01

    This paper is based on primary fieldwork conducted in Lugufu refugee camp in the rural Kigoma Region of western Tanzania. It is an anthropological inquiry into the paradox of refugee food aid based on the prevailing dynamic of domination and submission currently advanced by the international aid community. This inquiry asks fundamental questions…

  5. Monitoring and evaluation of Integrated Disease Surveillance and Response in selected districts in Tanzania

    Microsoft Academic Search

    S. F. RUMISHA; L. E. G. MBOERA; K. P. SENKORO; D. GUEYE; P. K. MMBUJI

    Integrated Disease Surveillance and Response (IDSR) is a strategy developed by the World Health Organization Regional Office for Africa in 1998. The Ministry of Health, Tanzania has adopted this strategy for strengthening communicable diseases surveillance in the country. In order to improve the effectiveness of the implementation of IDSR monitoring and evaluating the performance of the surveillance system, identifying areas

  6. The potential of agro-industrial residues for production of biogas and electricity in Tanzania

    Microsoft Academic Search

    Amelia K. Kivaisi; M. S. T. Rubindamayugi

    1996-01-01

    This paper gives an overview of the energy demands in Tanzania, and highlights the current serious shortage of electricity. Government strategy to alleviate the problem include exploitation of the country's big natural gas reserves for power generation, and utilization of the renewable energies such as solar, wind and biogas. Important agro-industrial residues with a large potential for anaerobic conversion into

  7. Initiation of a Teacher Education Project in Tanzania (TEPT). Publication No. 1.

    ERIC Educational Resources Information Center

    Malmberg, Lars-Erik, Ed.

    This volume describes and analyzes the initiation of a Bachelors in Education course carried out as part-time (distance) and full-time (seminar) studies at Teacher's College in Morogoro, Tanzania. The volume contains six chapters, including: (1) "Framework for English Content Instruction at the Department of Teacher Education at Abo Akademi…

  8. 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

  9. Rangeland management and fluvial geomorphology in northern Tanzania

    NASA Astrophysics Data System (ADS)

    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.

  10. The Palaeoproterozoic Ubendian shear belt in Tanzania: geochronology and structure

    NASA Astrophysics Data System (ADS)

    Lenoir, J. L.; Liégeois, J.-P.; Theunissen, K.; Klerkx, J.

    1994-10-01

    The Ubendian belt is a linear, NW-SE trending orogenic belt in western Tanzania. It is part of a larger Palaeoproterozoic orogen, developed around the west and south-western margin of the Archaean Tanzanian craton. The Ubendian Belt has experienced several periods of reactivation since the Palaeoproterozoic, acting as a zone of displacement during successive orogenic and rift-forming events. The Ubendian Belt is characterized by an early deformation and granulite-facies metamorphism, isotopically dated at 2100-2025 Ma, and marked by an E-W to ESE-WNW trending foliation. This phase also affected the adjacent Usagaran (and Bangweulu?) Belt and is interpreted as a product of collisional orogeny along the SW margin of the Tanzanian, and possibly Congo, cratons. A second phase of deformation, apparently restricted to the Ubendian Belt, is characterized by large, NW-SE trending, dextral shear zones. This phase is responsible for the creation of the eight crustal blocks developed throughout the belt and overprints much of the earlier deformation fabric. This second deformation phase is terminated by late- to post-kinematic calc-alkaline granitic batholiths ( ca 1860 Ma). A phase of tectonic reactivation occurred locally at ca 1725 Ma. Notable by its absence, is any evidence of Kibaran isotopic ages in the Ubendian Belt. Major Kibaran orogenic belts occur to the north (Burundi) and south (Zambia) of the Ubendian Belt, although they are apparently not isotopically recorded within it. A third phase of deformation is characterized by Neoproterozoic ( ca 750 Ma) reactivations of the Ubendian shear zones. This deformation is marked by the development of sinistral, brittle-ductile shear zones, displaying retrograde metamorphic mineral assemblages, and intruded by alkaline plutons. These late shear zones were the preferential locus for the brittle rift faults of the western branch of the East African Rift.

  11. The control of rinderpest in Tanzania between 1997 and 1998.

    PubMed

    Taylor, W P; Roeder, P L; Rweyemamu, M M; Melewas, J N; Majuva, P; Kimaro, R T; Mollel, J N; Mtei, B J; Wambura, P; Anderson, J; Rossiter, P B; Kock, R; Melengeya, T; Van den Ende, R

    2002-11-01

    In January 1997, Tanzania requested international assistance against rinderpest on the grounds that the virus had probably entered the country from southern Kenya. Over the next few months, a variety of attempts were made to determine the extent of the incursion by searching for serological and clinical evidence of the whereabouts of the virus. At the clinical level, these attempts were hampered by the low virulence of the strain, and at the serological level by the lack of a baseline against which contemporary interpretations could be made. Once it became apparent that neither surveillance tool was likely to produce a rapid result, an infected area was declared on common-sense grounds and emergency vaccination was initiated. The vaccination programme had two objectives, firstly to prevent any further entry across the international border, and secondly to contain and if possible eliminate rinderpest from those districts into which it had already entered. On the few occasions that clinical rinderpest was subsequently found, it was always within this provisional infected area. Emergency vaccination campaigns within the infected area ran from January to the end of March 1997 but were halted by the onset of the long rains. At this time, seromonitoring in two districts showed that viral persistence was still theoretically possible and therefore a second round of emergency vaccination was immediately organized. Further seromonitoring then indicated a large number of villages with population antibody prevalences of over 85%. These populations were considered to have been 'immunosterilized'. Although no clinical disease had been observed in them, it was decided to undertake additional vaccination in a group of districts to the south of the infected area. Serosurveillance indicated that rinderpest could have been present in a number of these districts prior to vaccination. Serosurveillance in 1998 suggested that numerous vaccinated animals had probably moved into districts outside the infected and additional vaccination areas, but did not rule out the continued presence of field infection. PMID:12537386

  12. Molecular identification of the causative agent of human strongyloidiasis acquired in Tanzania: dispersal and diversity of Strongyloides spp. and their hosts.

    PubMed

    Hasegawa, Hideo; Sato, Hiroshi; Fujita, Shiho; Nguema, Pierre Philippe Mbehang; Nobusue, Kenichi; Miyagi, Kei; Kooriyama, Takanori; Takenoshita, Yuji; Noda, Shohei; Sato, Akiko; Morimoto, Azusa; Ikeda, Yatsukaho; Nishida, Toshisada

    2010-09-01

    In order to identify the causative agent of imported strongyloidiasis found in a Japanese mammalogist, who participated in a field survey in Tanzania, the hyper-variable region IV (HVR-IV) of 18S ribosomal DNA and partial mitochondrial cytochrome c-oxidase subunit 1 gene (cox1) were analyzed and compared with Strongyloides fuelleborni collected from apes and monkeys of Africa and Japan, and S. stercoralis from humans, apes and dogs. The HVR-IV and cox1 of the patient's worms were identical to or only slightly differed from those of worms parasitic in Tanzanian chimpanzees and yellow baboons, demonstrating that the patient acquired the infection during her field survey in Tanzania. Phylogenetic analysis with the maximum-likelihood method largely divided isolates of S. fuelleborni into three groups, which corresponded to geographical localities but not to host species. Meanwhile, isolates of S. stercoralis were grouped by the phylogenetic analysis into dog-parasitic and primate-parasitic clades, and not to geographical regions. It is surmised that subspeciation has occurred in S. fuelleborni during the dispersal of primates in Africa and Asia, while worldwide dispersal of S. stercoralis seems to have occurred more recently by migration and the activities of modern humans. PMID:20621633

  13. Invasive Salmonella Infections in Areas of High and Low Malaria Transmission Intensity in Tanzania

    PubMed Central

    Biggs, Holly M.; Lester, Rebecca; Nadjm, Behzad; Mtove, George; Todd, Jim E.; Kinabo, Grace D.; Philemon, Rune; Amos, Ben; Morrissey, Anne B.; Reyburn, Hugh; Crump, John A.

    2014-01-01

    Background.?The epidemiology of Salmonella Typhi and invasive nontyphoidal Salmonella (NTS) differs, and prevalence of these pathogens among children in sub-Saharan Africa may vary in relation to malaria transmission intensity. Methods.?We compared the prevalence of bacteremia among febrile pediatric inpatients aged 2 months to 13 years recruited at sites of high and low malaria endemicity in Tanzania. Enrollment at Teule Hospital, the high malaria transmission site, was from June 2006 through May 2007, and at Kilimanjaro Christian Medical Centre (KCMC), the low malaria transmission site, from September 2007 through August 2008. Automated blood culture, malaria microscopy with Giemsa-stained blood films, and human immunodeficiency virus testing were performed. Results.?At Teule, 3639 children were enrolled compared to 467 at KCMC. Smear-positive malaria was detected in 2195 of 3639 (60.3%) children at Teule and 11 of 460 (2.4%) at KCMC (P < .001). Bacteremia was present in 336 of 3639 (9.2%) children at Teule and 20 of 463 (4.3%) at KCMC (P < .001). NTS was isolated in 162 of 3639 (4.5%) children at Teule and 1 of 463 (0.2%) at KCMC (P < .001). Salmonella Typhi was isolated from 11 (0.3%) children at Teule and 6 (1.3%) at KCMC (P = .008). With NTS excluded, the prevalence of bacteremia at Teule was 5.0% and at KCMC 4.1% (P = .391). Conclusions.?Where malaria transmission was intense, invasive NTS was common and Salmonella Typhi was uncommon, whereas the inverse was observed at a low malaria transmission site. The relationship between these pathogens, the environment, and the host is a compelling area for further research. PMID:24336909

  14. Etiology of Severe Non-malaria Febrile Illness in Northern Tanzania: A Prospective Cohort Study

    PubMed Central

    Crump, John A.; Morrissey, Anne B.; Nicholson, William L.; Massung, Robert F.; Stoddard, Robyn A.; Galloway, Renee L.; Ooi, Eng Eong; Maro, Venance P.; Saganda, Wilbrod; Kinabo, Grace D.; Muiruri, Charles; Bartlett, John A.

    2013-01-01

    Introduction The syndrome of fever is a commonly presenting complaint among persons seeking healthcare in low-resource areas, yet the public health community has not approached fever in a comprehensive manner. In many areas, malaria is over-diagnosed, and patients without malaria have poor outcomes. Methods and Findings We prospectively studied a cohort of 870 pediatric and adult febrile admissions to two hospitals in northern Tanzania over the period of one year using conventional standard diagnostic tests to establish fever etiology. Malaria was the clinical diagnosis for 528 (60.7%), but was the actual cause of fever in only 14 (1.6%). By contrast, bacterial, mycobacterial, and fungal bloodstream infections accounted for 85 (9.8%), 14 (1.6%), and 25 (2.9%) febrile admissions, respectively. Acute bacterial zoonoses were identified among 118 (26.2%) of febrile admissions; 16 (13.6%) had brucellosis, 40 (33.9%) leptospirosis, 24 (20.3%) had Q fever, 36 (30.5%) had spotted fever group rickettsioses, and 2 (1.8%) had typhus group rickettsioses. In addition, 55 (7.9%) participants had a confirmed acute arbovirus infection, all due to chikungunya. No patient had a bacterial zoonosis or an arbovirus infection included in the admission differential diagnosis. Conclusions Malaria was uncommon and over-diagnosed, whereas invasive infections were underappreciated. Bacterial zoonoses and arbovirus infections were highly prevalent yet overlooked. An integrated approach to the syndrome of fever in resource-limited areas is needed to improve patient outcomes and to rationally target disease control efforts. PMID:23875053

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

    PubMed Central

    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

  16. 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

  17. Effect of Herpes Simplex Suppression on Incidence of HIV among Women in Tanzania

    PubMed Central

    Watson-Jones, Deborah; Weiss, Helen A.; Rusizoka, Mary; Changalucha, John; Baisley, Kathy; Mugeye, Kokugonza; Tanton, Clare; Ross, David; Everett, Dean; Clayton, Tim; Balira, Rebecca; Knight, Louise; Hambleton, Ian; Le Goff, Jerome; Belec, Laurent; Hayes, Richard

    2009-01-01

    BACKGROUND Infection with herpes simplex virus type 2 (HSV-2) is associated with an increased risk of acquiring infection with the human immunodeficiency virus (HIV). This study tested the hypothesis that HSV-2 suppressive therapy reduces the risk of HIV acquisition. METHODS Female workers at recreational facilities in northwestern Tanzania who were 16 to 35 years of age were interviewed and underwent serologic testing for HIV and HSV-2. We enrolled female workers who were HIV-seronegative and HSV-2–seropositive in a randomized, double-blind, placebo-controlled trial of suppressive treatment with acyclovir (400 mg twice daily). Participants attended mobile clinics every 3 months for a follow-up period of 12 to 30 months, depending on enrollment date. The primary outcome was the incidence of infection with HIV. We used a modified intention-to-treat analysis; data for participants who became pregnant were censored. Adherence to treatment was estimated by a tablet count at each visit. RESULTS A total of 821 participants were randomly assigned to receive acyclovir (400 participants) or placebo (421 participants); 659 (80%) completed follow-up. Mean follow-up for the acyclovir and placebo groups was 1.52 and 1.62 years, respectively. The incidence of HIV infection was 4.27 per 100 person-years (27 participants in the acyclovir group and 28 in the placebo group), and there was no overall effect of acyclovir on the incidence of HIV (rate ratio for the acyclovir group, 1.08; 95% confidence interval, 0.64 to 1.83). The estimated median adherence was 90%. Genital HSV was detected in a similar proportion of participants in the two study groups at 6, 12, and 24 months. No serious adverse events were attributable to treatment with acyclovir. CONCLUSIONS These data show no evidence that acyclovir (400 mg twice daily) as HSV suppressive therapy decreases the incidence of infection with HIV. (Current Controlled Trials number, ISRCTN35385041.) PMID:18337596

  18. 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

  19. Timing of antenatal care for adolescent and adult pregnant women in south-eastern Tanzania

    PubMed Central

    2012-01-01

    Background Early and frequent antenatal care attendance during pregnancy is important to identify and mitigate risk factors in pregnancy and to encourage women to have a skilled attendant at childbirth. However, many pregnant women in sub-Saharan Africa start antenatal care attendance late, particularly adolescent pregnant women. Therefore they do not fully benefit from its preventive and curative services. This study assesses the timing of adult and adolescent pregnant women's first antenatal care visit and identifies factors influencing early and late attendance. Methods The study was conducted in the Ulanga and Kilombero rural Demographic Surveillance area in south-eastern Tanzania in 2008. Qualitative exploratory studies informed the design of a structured questionnaire. A total of 440 women who attended antenatal care participated in exit interviews. Socio-demographic, social, perception- and service related factors were analysed for associations with timing of antenatal care initiation using regression analysis. Results The majority of pregnant women initiated antenatal care attendance with an average of 5 gestational months. Belonging to the Sukuma ethnic group compared to other ethnic groups such as the Pogoro, Mhehe, Mgindo and others, perceived poor quality of care, late recognition of pregnancy and not being supported by the husband or partner were identified as factors associated with a later antenatal care enrolment (p < 0.05). Primiparity and previous experience of a miscarriage or stillbirth were associated with an earlier antenatal care attendance (p < 0.05). Adolescent pregnant women started antenatal care no later than adult pregnant women despite being more likely to be single. Conclusions Factors including poor quality of care, lack of awareness about the health benefit of antenatal care, late recognition of pregnancy, and social and economic factors may influence timing of antenatal care. Community-based interventions are needed that involve men, and need to be combined with interventions that target improving the quality, content and outreach of antenatal care services to enhance early antenatal care enrolment among pregnant women. PMID:22436344

  20. A political ecology of community-based forest and wildlife management in Tanzania: politics, power and governance

    E-print Network

    Humphries, Kathryn

    2013-06-11

    My research is focused on investigating the socio-political processes taking place within Community Based Natural Resource Management (CBNRM) in Tanzania. I draw on a political ecology approach in an investigation of the politics of struggles over...

  1. 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

    Play Act of 1976, the Cultural Policy, the Cultural Trust Fund, the Copyright Law of 1999, the Copyright Society of Tanzania (COSOTA), and the Zanzibar International Film Festival (ZIFF) were established as mechanisms to control local cultural products...

  2. Determining and addressing obstacles to the effective use of long-lasting insecticide-impregnated nets in rural Tanzania

    Microsoft Academic Search

    Maria Widmar; Courtney J Nagel; Deborah Y Ho; Peter W Benziger; Nils Hennig

    2009-01-01

    BACKGROUND: The objective of this project was to achieve high, sustainable levels of net coverage in a village in rural Tanzania by combining free distribution of long-lasting insecticide-impregnated nets (LLINs) with community-tailored education. In Tanzania, malaria is the leading cause of morbidity and mortality. Although malaria bed nets have a well-established role in reducing disease burden, few rural households have

  3. Efficacy of in-service nutrition training for mid-level providers to improve feeding practices among HIV-positive children in Tanga, Tanzania: study protocol for a cluster randomized controlled trial

    PubMed Central

    2013-01-01

    Background Feeding practices and child undernutrition can be improved when trained health workers provide proper nutrition counseling to caregivers. However, this important management component is difficult to achieve in countries where trained health workers are limited; Tanzania is no exception. In rural and semi-urban areas, mid-level providers (MLPs) are left to manage diseases such as HIV/AIDS. Training health workers in nutrition has been shown to be an effective intervention among HIV-negative children elsewhere, but no studies have been conducted among HIV-positive children. Furthermore, in Tanzania and other countries with MLPs, no evidence currently exists demonstrating an improvement in nutrition among children who receive health services given by MLPs. This study thus aims to examine the efficacy of nutrition training of MLPs on feeding practices and the nutrition status of HIV-positive children in Tanga, Tanzania. Methods/Design We will conduct a cluster randomized controlled trial in care and treatment centers (CTCs) in Tanga, Tanzania. The CTCs will be the unit of randomization. We will select 16 CTCs out of 32 for this study, of which we will randomly assign 8 to the intervention arm and 8 to the control arm by coin flipping. From the selected CTCs we will attempt to recruit a total of 800 HIV-positive children aged 6 months to 14 years, half of whom will be receiving care and/or treatment in the CTCs of the intervention arm, and the other half of whom will be receiving care and/or treatment in the CTCs of the control arm (400 children in each condition). We will provide nutrition training to MLPs of the CTCs selected for the intervention arm. In this intervention, we will use the World Health Organization guidelines on nutrition training of health workers for HIV-positive children aged 6 months to 14 years. The trained MLPs will then provide tailored nutrition counseling to caregivers of children being treated at the 8 CTCs of the intervention arm. We will measure nutrition status and child feeding practices monthly for a total of six months. Conclusions Results of this trial will help expanding undernutrition interventions among HIV-positive children in Tanzania and other countries. Trial registration Current Controlled Trials: ISRCTN65346364. PMID:24156500

  4. Factors influencing pregnancy outcomes in Morogoro Municipality, Tanzania.

    PubMed

    Mosha, Theobald C E; Philemon, Napendaeli

    2010-10-01

    Neonatal, perinatal and infant mortality rates are still high in developing countries despite national and international efforts to redress this problem. This study was conducted to investigate maternal knowledge and attitudes regarding the risk factors that adversely affect pregnancy outcomes in Morogoro municipality, Tanzania. A longitudinal study was conducted among 157 pregnant women attending antenatal clinics from their second trimesters to term. Socio-economic, demographic, anthropometric, biomedical and obstetric information was collected. Results showed that, majority of the pregnant women (> 70%, n = 157) were aware of the risk factors that could adversely affect the pregnancy outcomes, however, they did not know the exact mechanisms by which the risk factors acted to cause the adverse effects. Occurrence of risk factors among pregnant women was severe anaemia - 1.4%, smoking (0.6%), passive smoking (22.9%), alcohol consumption (2.5%), unmarried status (11.5%), under-age (< 20 years) (17.8%), over-age (> 35 years) (4.5%), history of stillbirth (7.0%), history of caesarean section (3.2%) and history of miscarriage (2.5%). Maternal total weight gain in the last two trimesters was 7.76 kg. The average birth weight was 3.05 kg, with male infants being heavier (3.14 kg) than their female counterparts (2.95 kg). The incidence of low birth weight was 11.6%, lower than the national average of 18%. It was concluded from this study that, although most women were aware of the pregnancy risk factors, they lacked the knowledge on how the factors affected the pregnancy outcomes. Occurrence of the pregnancy risk factors was generally low and the pregnancy outcomes were good. It is recommended that, women should be educated more about the pregnancy risk factors and encouraged to begin their antenatal clinic early in pregnancy. A larger study should also be conducted to ascertain the association of the other risk factors with pregnancy outcomes, starting with pregnant women in their first trimester. PMID:24409632

  5. “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

  6. The current epidemiology and control of trypanosomiasis and other zoonoses in Tanzania.

    PubMed

    Kilonzo, B S; Komba, E K

    1993-01-01

    The epidemiology and control strategies of African trypanosomiasis, plague, rabies, brucellosis, anthrax and hydatidosis, the most important and well documented zoonotic diseases in Tanzania, have been described. Bovine tuberculosis, tetanus, taeniosis, trichinosis and tungosis are also endemic in some parts of the country but records of their incidences are not available. Initial outbreaks of trypanosomiasis in Tanzania were caused by Trypanosoma gambiense which originated from West Africa and reached Tanzania via Zaire around 1902. T. rhodesiense which is currently responsible for human trypanosomiasis in Tanzania was introduced from Mozambique around 1910 and quickly spread to many parts of the country. The disease is currently prevalent in the western, north and northwestern parts, the southern highlands and southern regions. Over 6000 cases have reported since 1979. Control strategies against sleeping sickness in Tanzania include chemical control of vectors, treatment of patients with trypanocides and avoidance of humantsetse contact. Plague is mostly endemic in central, northern and north-eastern Tanzania. A total of 8161 cases with 1885 deaths have been recorded since 1890. The disease is currently prevalent in Lushoto district where outbreaks have been experienced since 1980, and in Singida district where it has been endemic since 1918. Integrated control measures are currently applied and were possibly responsible for the 1989 decline of outbreaks in the area. Financial constraints which led to deterioration of control activities from July 1989 probably accounted for the severe outbreaks in 1990/91 which spread to other parts of the country. Rabies is endemic country-wide except in Mtwara, Lindi and Zanzibar. Domestic dogs are the principal transmitters and prompt vaccination and destruction of unvaccinated stray dogs are the main control measures. Brucellosis is widely endemic in livestock and potentially so in humans. Destruction of infected animals, immunisation of susceptible ones, proper boiling of milk and its products and chemotherapy are the currently applied control measures against the disease. Anthrax and hydatidosis are sparsely endemic in the country, and they are mostly controlled by appropriate meat inspection and consequent condemnation and proper disposal of the affected meat. Vaccination and treatment of animals are also effective against anthrax. PMID:8261496

  7. 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

  8. 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

  9. Epidemiologic and clinical aspects of a Rift Valley fever outbreak in humans in Tanzania, 2007.

    PubMed

    Mohamed, Mohamed; Mosha, Fausta; Mghamba, Janeth; Zaki, Sherif R; Shieh, Wun-Ju; Paweska, Janusz; Omulo, Sylvia; Gikundi, Solomon; Mmbuji, Peter; Bloland, Peter; Zeidner, Nordin; Kalinga, Raphael; Breiman, Robert F; Njenga, M Kariuki

    2010-08-01

    In January 2007, an outbreak of Rift Valley fever (RVF) was detected among humans in northern Tanzania districts. By the end of the outbreak in June, 2007, 511 suspect RVF cases had been recorded from 10 of the 21 regions of Tanzania, with laboratory confirmation of 186 cases and another 123 probable cases. All confirmed RVF cases were located in the north-central and southern regions of the country, with an eventual fatality rate of 28.2% (N = 144). All suspected cases had fever; 89% had encephalopathy, 10% hemorrhage, and 3% retinopathy. A total of 169 (55%) of the 309 confirmed or probable cases were also positive for malaria as detected by peripheral blood smear. In a cohort of 20 RVF cases with known outcome that were also positive for human immunodeficiency virus, 15 (75%) died. Contact with sick animals and animal products, including blood, meat, and milk, were identified as major risk factors of acquiring RVF. PMID:20682902

  10. 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.

  11. 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

  12. Water supply development and tariffs in Tanzania: From free water policy towards cost recovery

    NASA Astrophysics Data System (ADS)

    Mashauri, Damas A.; Katko, Tapio S.

    1993-01-01

    The article describes the historical development of water tariff policy in Tanzania from the colonial times to present. After gaining independence, the country introduced “free” water policy in its rural areas. Criticism against this policy was expressed already in the 1970s, but it was not until the late 1980s that change became unavoidable. All the while urban water tariffs continued to decline in real terms. In rural and periurban areas of Tanzania consumers often have to pay substantial amounts of money for water to resellers and vendors since the public utilities are unable to provide operative service. Besides, only a part of the water bills are actually collected. Now that the free water supply policy has been officially abandoned, the development of water tariffs and the institutions in general are a great challenge for the country.

  13. Epidemiologic and Clinical Aspects of a Rift Valley Fever Outbreak in Humans in Tanzania, 2007

    PubMed Central

    Mohamed, Mohamed; Mosha, Fausta; Mghamba, Janeth; Zaki, Sherif R.; Shieh, Wun-Ju; Paweska, Janusz; Omulo, Sylvia; Gikundi, Solomon; Mmbuji, Peter; Bloland, Peter; Zeidner, Nordin; Kalinga, Raphael; Breiman, Robert F.; Njenga, M. Kariuki

    2010-01-01

    In January 2007, an outbreak of Rift Valley fever (RVF) was detected among humans in northern Tanzania districts. By the end of the outbreak in June, 2007, 511 suspect RVF cases had been recorded from 10 of the 21 regions of Tanzania, with laboratory confirmation of 186 cases and another 123 probable cases. All confirmed RVF cases were located in the north-central and southern regions of the country, with an eventual fatality rate of 28.2% (N = 144). All suspected cases had fever; 89% had encephalopathy, 10% hemorrhage, and 3% retinopathy. A total of 169 (55%) of the 309 confirmed or probable cases were also positive for malaria as detected by peripheral blood smear. In a cohort of 20 RVF cases with known outcome that were also positive for human immunodeficiency virus, 15 (75%) died. Contact with sick animals and animal products, including blood, meat, and milk, were identified as major risk factors of acquiring RVF. PMID:20682902

  14. Implementing accountability for reasonableness framework at district level in Tanzania: a realist evaluation

    PubMed Central

    2011-01-01

    Background Despite the growing importance of the Accountability for Reasonableness (A4R) framework in priority setting worldwide, there is still an inadequate understanding of the processes and mechanisms underlying its influence on legitimacy and fairness, as conceived and reflected in service management processes and outcomes. As a result, the ability to draw scientifically sound lessons for the application of the framework to services and interventions is limited. This paper evaluates the experiences of implementing the A4R approach in Mbarali District, Tanzania, in order to find out how the innovation was shaped, enabled, and constrained by the interaction between contexts, mechanisms and outcomes. Methods This study draws on the principles of realist evaluation -- a largely qualitative approach, chiefly concerned with testing and refining programme theories by exploring the complex interactions of contexts, mechanisms, and outcomes. Mixed methods were used in data collection, including individual interviews, non-participant observation, and document reviews. A thematic framework approach was adopted for the data analysis. Results The study found that while the A4R approach to priority setting was helpful in strengthening transparency, accountability, stakeholder engagement, and fairness, the efforts at integrating it into the current district health system were challenging. Participatory structures under the decentralisation framework, central government's call for partnership in district-level planning and priority setting, perceived needs of stakeholders, as well as active engagement between researchers and decision makers all facilitated the adoption and implementation of the innovation. In contrast, however, limited local autonomy, low level of public awareness, unreliable and untimely funding, inadequate accountability mechanisms, and limited local resources were the major contextual factors that hampered the full implementation. Conclusion This study documents an important first step in the effort to introduce the ethical framework A4R into district planning processes. This study supports the idea that a greater involvement and accountability among local actors through the A4R process may increase the legitimacy and fairness of priority-setting decisions. Support from researchers in providing a broader and more detailed analysis of health system elements, and the socio-cultural context, could lead to better prediction of the effects of the innovation and pinpoint stakeholders' concerns, thereby illuminating areas that require special attention to promote sustainability. PMID:21310021

  15. Facial morphometrics of children with NON-syndromic orofacial clefts in Tanzania

    PubMed Central

    2014-01-01

    Background Orofacial clefts (cleft lip/palate; CL/P) are among the most common congenital anomalies, with prevalence that varies among different ethnic groups. Craniofacial shape differences between individuals with CL/P and healthy controls have been widely reported in non-African populations. Knowledge of craniofacial shape among individuals with non-syndromic CL/P in African populations will provide further understanding of the ethnic and phenotypic variation present in non-syndromic orofacial clefts. Methods A descriptive cross-sectional study was carried out at Bugando Medical Centre, Tanzania, comparing individuals with unrepaired non-syndromic CL/P and normal individuals without orofacial clefts. Three-dimensional (3D) facial surfaces were captured using a non-invasive 3D camera. The corresponding 3D coordinates for 26 soft tissue landmarks were used to characterize facial shape. Facial shape variation within and between groups, based on Procrustes superimposed data, was studied using geometric morphometric methods. Results Facial shape of children with cleft lip differed significantly from the control group, beyond the cleft itself. The CL/P group exhibited increased nasal and mouth width, increased interorbital distance, and more prognathic premaxillary region. Within the CL/P group, PCA showed that facial shape variation is associated with facial height, nasal cavity width, interorbital distance and midfacial prognathism. The isolated cleft lip (CL) and combined cleft lip and palate (CLP) groups did not differ significantly from one another (Procrustes distance?=?0.0416, p?=?0.50). Procrustes distance permutation tests within the CL/P group showed a significant shape difference between unilateral clefts and bilateral clefts (Procrustes distance?=?0.0728, p?=?0.0001). Our findings indicate the morphological variation is similar to those of studies of CL/P patients and their unaffected close relatives in non-African populations. Conclusion The mean facial shape in African children with non-syndromic CL/P differs significantly from children without orofacial clefts. The main differences involve interorbital width, facial width and midface prognathism. The axes of facial shape differences we observed are similar to the patterns seen in Caucasian populations, despite apparent differences in cleft prevalence and cleft type distribution. Similar facial morphology in individuals with CL/P in African and Caucasian populations suggests a similar aetiology. PMID:25070002

  16. Clinical performance of an automated reader in interpreting malaria rapid diagnostic tests in Tanzania

    PubMed Central

    2013-01-01

    Background Parasitological confirmation of malaria is now recommended in all febrile patients by the World Health Organization (WHO) to reduce inappropriate use of anti-malarial drugs. Widespread implementation of rapid diagnostic tests (RDTs) is regarded as an effective strategy to achieve this goal. However, the quality of diagnosis provided by RDTs in remote rural dispensaries and health centres is not ideal. Feasible RDT quality control programmes in these settings are challenging. Collection of information regarding diagnostic events is also very deficient in low-resource countries. Methods A prospective cohort of consecutive patients aged more than one year from both genders, seeking routine care for febrile episodes at dispensaries located in the Bagamoyo district of Tanzania, were enrolled into the study after signing an informed consent form. Blood samples were taken for thick blood smear (TBS) microscopic examination and malaria RDT (SD Bioline Malaria Antigen Pf/Pan™ (SD RDT)). RDT results were interpreted by both visual interpretation and Deki Reader™ device. Results of visual interpretation were used for case management purposes. Microscopy was considered the “gold standard test” to assess the sensitivity and specificity of the Deki Reader interpretation and to compare it to visual interpretation. Results In total, 1,346 febrile subjects were included in the final analysis. The SD RDT, when used in conjunction with the Deki Reader and upon visual interpretation, had sensitivities of 95.3% (95% CI, 90.6-97.7) and 94.7% (95% CI, 89.8–97.3) respectively, and specificities of 94.6% (95% CI, 93.5–96.1) and 95.6% (95% CI, 94.2–96.6), respectively to gold standard. There was a high percentage of overall agreement between the two methods of interpretation. Conclusion The sensitivity and specificity of the Deki Reader in interpretation of SD RDTs were comparable to previous reports and showed high agreement to visual interpretation (>98%). The results of the study reflect the situation in real practice and show good performance characteristics of Deki Reader on interpreting malaria RDTs in the hands of local laboratory technicians. They also suggest that a system like this could provide great benefits to the health care system. Further studies to look at ease of use by community health workers, and cost benefit of the system are warranted. PMID:23617722

  17. 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).

  18. Prevalence and predictors of exclusive breastfeeding among women in Kilimanjaro region, Northern Tanzania: a population based cross-sectional study

    PubMed Central

    2013-01-01

    Background Exclusive breastfeeding (EBF) is a simple and cost-effective intervention to improve child health and survival. Effective EBF has been estimated to avert 13% - 15% of under-five mortality and contribute to reduce mother to child transmission of HIV. The prevalence of EBF for infant less than six months is low in most developing countries, including Tanzania (50%). While the Tanzania Demographic Health Survey collects information on overall EBF prevalence, it does not evaluate factors influencing EBF. The aim of this paper was to determine the prevalence and predictors of exclusive breastfeeding in urban and rural areas in Kilimanjaro region. Methods A population-based cross-sectional study was conducted between June 2010 to March 2011 among women with infants aged 6–12 months in Kilimanjaro. Multi-stage proportionate to size sampling was used to select participants from all the seven districts of the region. A standardized questionnaire was used to collect socio-demographic, reproductive, alcohol intake, breastfeeding patterns and nutritional data during the interviews. Estimation on EBF was based on recall since birth. Multivariable logistic regression was used to obtain independent predictors of EBF. Results A total of 624 women participated, 77% (483) from rural areas. The prevalence of EBF up to six months in Kilimanjaro region was 20.7%, without significant differences in the prevalence of EBF up to six months between urban (22.7%) and rural areas (20.1%); (OR?=?0.7, 95% CI 0.5,1.4). In multivariable analysis, advice on breastfeeding after delivery (Adjusted odds ratio, AOR?=?2.6, 95% CI 1.5, 4.6) was positively associated with EBF up to six months. Compared to married/cohabiting and those who do not take alcohol, single mothers (AOR?=?0.4, 95% CI 0.2, 0.9) and mothers who drank alcohol (AOR?=?0.4, 95% CI 0.3, 0.7) had less odds to practice EBF up to six months. Conclusion Prevalence of EBF up to six months is still low in Kilimanjaro, lower than the national coverage of 50%. Strengthening of EBF counseling in all reproductive and child health clinics especially during antenatal and postnatal periods may help to improve EBF rates. PMID:24107593

  19. Residual Antimalarials in Malaria Patients from Tanzania – Implications on Drug Efficacy Assessment and Spread of Parasite Resistance

    PubMed Central

    Hodel, Eva Maria; Kabanywanyi, Abdunoor Mulokozi; Malila, Aggrey; Zanolari, Boris; Mercier, Thomas; Beck, Hans-Peter; Buclin, Thierry; Olliaro, Piero; Decosterd, Laurent Arthur; Genton, Blaise

    2009-01-01

    Background Repeated antimalarial treatment for febrile episodes and self-treatment are common in malaria-endemic areas. The intake of antimalarials prior to participating in an in vivo study may alter treatment outcome and affect the interpretation of both efficacy and safety outcomes. We report the findings from baseline plasma sampling of malaria patients prior to inclusion into an in vivo study in Tanzania and discuss the implications of residual concentrations of antimalarials in this setting. Methods and Findings In an in vivo study conducted in a rural area of Tanzania in 2008, baseline plasma samples from patients reporting no antimalarial intake within the last 28 days were screened for the presence of 14 antimalarials (parent drugs or metabolites) using liquid chromatography-tandem mass spectrometry. Among the 148 patients enrolled, 110 (74.3%) had at least one antimalarial in their plasma: 80 (54.1%) had lumefantrine above the lower limit of calibration (LLC?=?4 ng/mL), 7 (4.7%) desbutyl-lumefantrine (4 ng/mL), 77 (52.0%) sulfadoxine (0.5 ng/mL), 15 (10.1%) pyrimethamine (0.5 ng/mL), 16 (10.8%) quinine (2.5 ng/mL) and none chloroquine (2.5 ng/mL). Conclusions The proportion of patients with detectable antimalarial drug levels prior to enrollment into the study is worrying. Indeed artemether–lumefantrine was supposed to be available only at government health facilities. Although sulfadoxine–pyrimethamine is only recommended for intermittent preventive treatment in pregnancy (IPTp), it was still widely used in public and private health facilities and sold in drug shops. Self-reporting of previous drug intake is unreliable and thus screening for the presence of antimalarial drug levels should be considered in future in vivo studies to allow for accurate assessment of treatment outcome. Furthermore, persisting sub-therapeutic drug levels of antimalarials in a population could promote the spread of drug resistance. The knowledge on drug pressure in a given population is important to monitor standard treatment policy implementation. PMID:20011529

  20. 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

  1. Caesarean section among referred and self-referred birthing women: a cohort study from a tertiary hospital, northeastern Tanzania

    PubMed Central

    2011-01-01

    Background The inequity in emergency obstetric care access in Tanzania is unsatisfactory. Despite an existing national obstetric referral system, many birthing women bypass referring facilities and go directly to higher-level care centres. We wanted to compare Caesarean section (CS) rates among women formally referred to a tertiary care centre versus self-referred women, and to assess the effect of referral status on adverse outcomes after CS. Methods We used data from 21,011 deliveries, drawn from the birth registry of a tertiary hospital in northeastern Tanzania, during 2000-07. Referral status was categorized as self-referred if the woman had bypassed or not accessed referral, or formally-referred if referred by a health worker. Because CS indications were insufficiently registered, we applied the Ten-Group Classification System to determine the CS rate by obstetric group and referral status. Associations between referral status and adverse outcomes after CS delivery were analysed using multiple regression models. Outcome measures were CS, maternal death, obstetric haemorrhage ? 750 mL, postpartum stay > 9 days, neonatal death, Apgar score < 7 at 5 min and neonatal ward transfer. Results Referral status contributed substantially to the CS rate, which was 55.0% in formally-referred and 26.9% in self-referred birthing women. In both groups, term nulliparous singleton cephalic pregnancies and women with previous scar(s) constituted two thirds of CS deliveries. Low Apgar score (adjusted OR 1.42, 95% CI 1.09-1.86) and neonatal ward transfer (adjusted OR 1.18, 95% CI 1.04-1.35) were significantly associated with formal referral. Early neonatal death rates after CS were 1.6% in babies of formally-referred versus 1.2% in babies of self-referred birthing women, a non-significant difference after adjusting for confounding factors (adjusted OR 1.37, 95% CI 0.87-2.16). Absolute neonatal death rates were > 2% after CS in breech, multiple gestation and preterm deliveries in both referral groups. Conclusions Women referred for delivery had higher CS rates and poorer neonatal outcomes, suggesting that the formal referral system successfully identifies high-risk birth, although low volume suggests underutilization. High absolute rates of post-CS adverse outcomes among breech, multiple gestation and preterm deliveries suggest the need to target self-referred birthing women for earlier professional intrapartum care. PMID:21798016

  2. Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania

    PubMed Central

    2012-01-01

    Background Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people’s needs. In Tanzania, the policy of decentralization and the health sector reform place an emphasis on community participation in making decisions in health care. However, aspects that can influence an individual’s opportunity to be listened to and to contribute to discussion have been researched to a very limited extent in low-income settings. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory. Methods The study was carried out in the Mbarali District of Tanzania. A qualitative study design was used. In-depth interviews and focus group discussion were conducted among members of the district health team, local government officials, health care providers and community members. Informal discussion on the topics was also of substantial value. Results The study findings indicate a substantial influence of gender, wealth, ethnicity and education on health care decision-making processes. Men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate. Conclusions Existing challenges related to individuals’ influence of decision making processes in health care need to be addressed if greater participation is desired. There is a need for increased advocacy and a strengthening of responsive practices with an emphasis on the right of all individuals to participate in decision-making processes. This simultaneously implies an emphasis on assuring the distribution of information, training and education so that individuals can participate fully in informed decision making. PMID:22676204

  3. Tuberculous bowel obstruction at a university teaching hospital in Northwestern Tanzania: a surgical experience with 118 cases

    PubMed Central

    2013-01-01

    Background Bowel obstruction resulting from intestinal tuberculosis has been reported to be more prevalent in developing countries including Tanzania. This study was undertaken to describe the clinicopathological profile, surgical management and outcome of tuberculous intestinal obstruction in our local setting and to identify factors responsible for poor outcome among these patients. Methods This was a prospective descriptive study of patients operated for tuberculous intestinal obstruction at Bugando Medical Centre (BMC) in northwestern Tanzania from April 2008 to March 2012. Ethical approval to conduct the study was obtained from relevant authorities. Statistical data analysis was performed using SPSS version 17.0. Results A total of 118 patients with tuberculous intestinal obstruction were studied. The male to female ratio was 1.8: 1. The median age was 26 years (range 11-67 years). The modal age group was 21-30 years. Thirty-one (26.3%) patients had associated pulmonary tuberculosis and 25 (21.2%) patients were HIV positive with a median CD4+ count of 225 cells /?l. Small bowel strictures were the most common operative findings accounting for 72.9% of cases. The ileo-caecal region was the commonest area of involvement in 68 (57.6%) patients. The right hemicolectomy with ileo-transverse anastomosis was the most frequent surgical procedure performed in 66 (55.9%) patients. Postoperatively all the patients received antituberculous drugs for a period of one year. Postoperative complication rate was 37.3% and surgical site infection (SSI) was the most frequent complication in 42.8% of cases. HIV positivity and low CD4+ count were the main predictors of SSI (p?

  4. The Tanzania Field Epidemiology and Laboratory Training Program: building and transforming the public health workforce.

    PubMed

    Mmbuji, Peter; Mukanga, David; Mghamba, Janeth; Ahly, Mohamed; Mosha, Fausta; Azima, Simba; Senga, Sembuche; Moshiro, Candida; Semali, Innocent; Rolle, Italia; Wiktor, Stefan; McQueen, Suzzane; McElroy, Peter; Nsubuga, Peter

    2011-01-01

    The Tanzania Field Epidemiology and Laboratory Training Program (TFELTP) was established in 2008 as a partnership among the Ministry of Health and Social Welfare (MOHSW), Muhimbili University of Health and Allied Sciences, National Institute for Medical Research, and local and international partners. TFELTP was established to strengthen the capacity of MOHSW to conduct public health surveillance and response, manage national disease control and prevention programs, and to enhance public health laboratory support for surveillance, diagnosis, treatment and disease monitoring. TFELTP is a 2-year full-time training program with approximately 25% time spent in class, and 75% in the field. TFELTP offers two tracks leading to an MSc degree in either Applied Epidemiology or, Epidemiology and Laboratory Management. Since 2008, the program has enrolled a total of 33 trainees (23 males, 10 females). Of these, 11 were enrolled in 2008 and 100% graduated in 2010. All 11 graduates of cohort 1 are currently employed in public health positions within the country. Demand for the program as measured by the number of applicants has grown from 28 in 2008 to 56 in 2011. While training the public health leaders of the country, TFELTP has also provided essential service to the country in responding to high-profile disease outbreaks, and evaluating and improving its public health surveillance systems and diseases control programs. TFELTP was involved in the country assessment of the revised International Health Regulations (IHR) core capabilities, development of the Tanzania IHR plan, and incorporation of IHR into the revised Tanzania Integrated Disease Surveillance and Response (IDSR) guidelines. TFELTP is training a competent core group of public health leaders for Tanzania, as well as providing much needed service to the MOHSW in the areas of routine surveillance, outbreak detection and response, and disease program management. However, the immediate challenges that the program must address include development of a full range of in-country teaching capacity for the program, as well as a career path for graduates. PMID:22359697

  5. The impact of probiotic yogurt on HIV positive women in Tanzania

    Microsoft Academic Search

    J. A. M. Dols; M. E. Boon; M. Monachese; J. Changalucha; N. Butamanya; S. Varriano; O. Vihant; Y. Hullegie; A. van Tienen; R. Hummelen; G. Reid

    2011-01-01

    In a randomized, double blind study, 145 HIV+ women receiving anti-retroviral therapy at Sekou-Toure Regional Hospital in Mwanza, Tanzania were enrolled. Participants were randomly allocated to receive 125 mL daily regular yogurt or 125 mL probiotic supplemented yogurt for 29 days. Subject interviews at day 0 and 29 revealed fewer vaginal symptoms and signs, better appetite, less stomach gas and more energy

  6. The effects of marine parks and fishing on coral reefs of northern Tanzania

    Microsoft Academic Search

    T. R. McClanahan; N. A. Muthiga; A. T. Kamukuru; H. Machano; R. W. Kiambo

    1999-01-01

    The macrobenthic (coral, algae, and sea urchins) and fish communities in 15 back-reef sites on the patch and rock-island reefs of southern Kenya and northern Tanzania (?250 km of coastline) were studied in order to (1) test an overfishing model developed in Kenya’s fringing reef (McClanahan, 1995a, A coral reef ecosystem-fisheries model: impacts of fishing intensity and catch selection on

  7. Biodiversity Values, Threats and Conservation Strategies of the Selous - Niassa Wildlife Corridor, Tanzania

    Microsoft Academic Search

    Urs Bloesch

    The Selous-Niassa miombo woodlands of southern Tanzania and northern Mozambique are one of the largest and for the global biodiversity most significant, trans-boundary natural ecosystem in Africa, covering over 154,000 km2. The Selous-Niassa Wildlife Corridor serves as migratory route between the Selous and the Niassa Game Reserves hosting the world's largest elephant, buffalo and sable populations. The Corridor will be

  8. Fundamental changes in the activity of the natrocarbonatite volcano Oldoinyo Lengai, Tanzania

    Microsoft Academic Search

    Matthieu Kervyn; Gerald G. J. Ernst; Jörg Keller; R. Greg Vaughan; Jurgis Klaudius; Evelyne Pradal; Frederic Belton; Hannes B. Mattsson; Evelyne Mbede; Patric Jacobs

    2010-01-01

    On September 4, 2007, after 25 years of effusive natrocarbonatite eruptions, the eruptive activity of Oldoinyo Lengai (OL),\\u000a N Tanzania, changed abruptly to episodic explosive eruptions. This transition was preceded by a voluminous lava eruption in\\u000a March 2006, a year of quiescence, resumption of natrocarbonatite eruptions in June 2007, and a volcano-tectonic earthquake\\u000a swarm in July 2007. Despite the lack of

  9. A hydrogeochemical survey of Kilimanjaro (Tanzania): implications for water sources and ages

    Microsoft Academic Search

    Jeffrey M. Mckenzie; Bryan G. Mark; Lonnie G. Thompson; Ulrich Schotterer; Ping-Nan Lin

    2010-01-01

    Kilimanjaro, Tanzania, the highest mountain in Africa, has undergone extensive hydrologic changes over the past century in\\u000a an area where water resources are critical. A hydrochemical and isotopic synoptic sampling program in January 2006 is used\\u000a to characterize hydrogeology, hydrology, and water quality of the area. Samples were collected from the summit and southern\\u000a side of Kilimanjaro and the Moshi

  10. Hunting and Foraging in the Eyasi Basin, Northern Tanzania: Past, Present and Future Prospects

    Microsoft Academic Search

    Audax Z. P. Mabulla

    2007-01-01

    In this paper I document the history of hunting and foraging in the Eyasi Basin, northern Tanzania, from about 130,000 bp\\u000a to contemporary times, by reviewing the available archaeological, palaeontological, historical and ethnographic data. The\\u000a review reveals a complex co-existence and interactions between hunter-foragers and herders and farmers from about 3,000 bp\\u000a until the present. In addition, the review exposes intricate opportunities

  11. [Tropical medicine/tropical dermatology training in Tanzania and Ghana : Personal experience and selected case reports].

    PubMed

    Völker, K

    2015-05-01

    As a consultant for dermatology with special interested in tropical diseases, I accepted my employers offer (German Armed Forces) to start my training in tropical medicine and tropical dermatology in Africa. The dermatological part of the training was completed at the Regional Dermatology Training Centre (RDTC) in Moshi, Tanzania. This was followed by tropical medicine training at the Presbyterian Hospital in Agogo, Ghana. In this article, I report on my experiences in Africa and present selected case reports. PMID:25911202

  12. A taxonomic and ecological analysis of two forest Chlorophytum taxa (Anthericaceae) on Mount Kilimanjaro, Tanzania

    Microsoft Academic Search

    Charlotte S. Bjorå; Andreas Hemp; Gry Hoell; Inger Nordal

    2008-01-01

    On Kilimanjaro, Tanzania two rather different forms of Chlorophytum comosum were observed. One form occurred on higher altitudes, the other on lower altitudes. Morphological, molecular and ecological\\u000a studies conclude that the two forms both are entitled to species recognition. The high altitude form must still be referred\\u000a to C. comosum s.l., while the low altitude form is a new species

  13. SEROSURVEY FOR SELECTED VIRAL DISEASES AND DEMOGRAPHY OF AFRICAN WILD DOGS IN TANZANIA

    Microsoft Academic Search

    Scott Creel; Nancy Marusha Creel; Linda Munson; Dane Sanderlin; Max J. G. AppeI

    1997-01-01

    African wild dogs (Lycaon pictus) are endangered, with only 3,000-5,000 remaining in the wild. It is believed that wild dogs are unusually vulnerable to viral diseases, particularly rabies and canine distemper (CDV). However, canine distemper has been confirmed by laboratory diagnosis in only one free-living wild dog. The 43,000 km2 Selous Game Reserve (SGR; Tanzania) holds approximately 900 adult wild

  14. The geology and mineralisation at the Golden Pride gold deposit, Nzega Greenstone Belt, Tanzania

    Microsoft Academic Search

    I. M. A. Vos; F. P. Bierlein; J. S. Standing; G. Davidson

    2009-01-01

    The Golden Pride gold deposit (?3 Moz) is located in the central part of the Nzega Greenstone Belt at the southern margin\\u000a of the Lake Victoria Goldfields in Tanzania. It represents an inferred Late Archaean, orogenic gold deposit and is hosted\\u000a in intensely deformed meta-sedimentary rocks in the hanging wall of the approximately E–W striking Golden Pride Shear Zone.\\u000a The hanging-wall

  15. Food transfer between mother and infant chimpanzees of the Mahale Mountains National Park, Tanzania

    Microsoft Academic Search

    Toshisada Nishida; Linda A. Turner

    1996-01-01

    We studied food transfer between chimpanzee mothers and infants in the Mahale Mountains National Park, Tanzania. The rate\\u000a of infant solicitation for food dramatically increased in the second year of life, then gradually decreased and, in the seventh\\u000a year, virtually disappeared. The pattern of the ontogeny of food sharing precisely followed that of solicitation because mothers\\u000a shared food only when

  16. Applicability of an abbreviated version of the Child-OIDP inventory among primary schoolchildren in Tanzania

    Microsoft Academic Search

    Matilda Mtaya; Anne N Åstrøm; Georgios Tsakos

    2007-01-01

    BACKGROUND: There is a need for studies evaluating oral health related quality of life (OHRQoL) of children in developing countries. AIM: to assess the psychometric properties, prevalence and perceived causes of the child version of oral impact on daily performance inventory (Child-OIDP) among school children in two socio-demographically different districts of Tanzania. Socio-behavioral and clinical correlates of children's OHRQoL were

  17. Revegetation of natural and human-caused disturbances in the Serengeti National Park, Tanzania

    Microsoft Academic Search

    A. Joy Belsky

    1987-01-01

    Patterns of revegetation on natural and human-caused disturbances in grasslands and savannas of the Serengeti National Park, Tanzania, were investigated by recording species compositions on all disturbances, in the undisturbed vegetation, and in unique microhabitats in 51 sites along a north-to-south transect through the park. The 487 resulting samples were ordinated by detrended correspondence analysis (DCA) and classified by two-way

  18. Environmental assessment of mercury contamination from the Rwamagasa artisanal gold mining centre, Geita District, Tanzania

    Microsoft Academic Search

    H. Taylor; J. d. Appletonsupasu; R. Lister; B. Smith; D. Chitamweba; O. Mkumbo; J. F. Machiwa; A. L. Tesha; C. Beinhoff

    2005-01-01

    This study presents the results of an environmental assessment of mercury (Hg) contamination in the Rwamagasa artisanal gold mining area, northwest Tanzania, and the potential downstream dispersion along the River Malagarasi to Lake Tanganyika. At the time of sampling, generally low concentrations of Hg (<0.05 mg\\/kg) occurred in most cultivated soils although higher Hg (0.05–9.2 mg\\/kg) was recorded in urban

  19. Apiculture potential in protected areas: the case of Udzungwa Mountains National Park, Tanzania

    Microsoft Academic Search

    Marcelian A. Njau; Pauline M. Mpuya; Fatina A. Mturi

    2009-01-01

    Information on nesting behaviour, productivity in natural tree cavities and man-made hives and natural enemies of resident stinging honeybee sub-species was gathered for a period of 1 year in Udzungwa Mountains National Park, Tanzania. Three sub-species of the honeybee Apis mellifera occur in this area. Six types of hive were sited in appropriate locations and colony dynamics studied. The bees

  20. Helminthosis in goats in southern Tanzania: investigations on epidemiology and control.

    PubMed

    Connor, R J; Munyuku, A P; Mackyao, E; Halliwell, R W

    1990-02-01

    Investigations were conducted in naturally infected goats to determine the main epidemiological factors related to gastro-intestinal nematode infections in southern Tanzania with a view to making appropriate recommendations for control. Faecal worm egg counts rose during the single rainy season and then fell to remain low during the dry season. The beneficial effect of an anthelmintic treatment after the rains was demonstrated in weaner goats under traditional management and this should form the basis of rational control. PMID:2321258

  1. Comparison of Cape Town and Skirrow's Campylobacter isolation protocols in humans and broilers in Morogoro, Tanzania

    Microsoft Academic Search

    Petro Jacob; Robinson H. Mdegela; Hezron Emmanuel Nonga

    2011-01-01

    Comparison of Cape Town and Skirrow's protocols used in isolation of Campylobacter in humans and broilers was carried out in a cross-sectional study in Morogoro, Tanzania. A total of 176 and 158 human stool\\u000a and broiler intestinal samples were collected, respectively. While human stool samples were collected from selected health\\u000a centers, broiler intestinal samples were obtained from selected farms and

  2. A slaughterhouse survey of lung lesions in slaughtered stocks at Arusha, Tanzania

    Microsoft Academic Search

    L. S. B. Mellau; H. E. Nonga; E. D. Karimuribo

    2010-01-01

    An abattoir survey was conducted on clinically healthy 115,186 cattle, 61,551 sheep and 37,850 goats slaughtered in Arusha municipality, Tanzania, between 2005 and 2007. The objective was to determine the prevalence of disease conditions affecting the lungs. Routine meat inspection procedures were used to detect the presence of the pathological lesions. A total of 15,245 (13.2%), 4668 (7.8%) and 3192

  3. The Tanzania Field Epidemiology and Laboratory Training Program: building and transforming the public health workforce

    PubMed Central

    Mmbuji, Peter; Mukanga, David; Mghamba, Janeth; Ahly, Mohamed; Mosha, Fausta; Azima, Simba; Senga, Sembuche; Moshiro, Candida; Semali, Innocent; Rolle, Italia; Wiktor, Stefan; McQueen, Suzzane; McElroy, Peter; Nsubuga, Peter

    2011-01-01

    The Tanzania Field Epidemiology and Laboratory Training Program (TFELTP) was established in 2008 as a partnership among the Ministry of Health and Social Welfare (MOHSW), Muhimbili University of Health and Allied Sciences, National Institute for Medical Research, and local and international partners. TFELTP was established to strengthen the capacity of MOHSW to conduct public health surveillance and response, manage national disease control and prevention programs, and to enhance public health laboratory support for surveillance, diagnosis, treatment and disease monitoring. TFELTP is a 2-year full-time training program with approximately 25% time spent in class, and 75% in the field. TFELTP offers two tracks leading to an MSc degree in either Applied Epidemiology or, Epidemiology and Laboratory Management. Since 2008, the program has enrolled a total of 33 trainees (23 males, 10 females). Of these, 11 were enrolled in 2008 and 100% graduated in 2010. All 11 graduates of cohort 1 are currently employed in public health positions within the country. Demand for the program as measured by the number of applicants has grown from 28 in 2008 to 56 in 2011. While training the public health leaders of the country, TFELTP has also provided essential service to the country in responding to high-profile disease outbreaks, and evaluating and improving its public health surveillance systems and diseases control programs. TFELTP was involved in the country assessment of the revised International Health Regulations (IHR) core capabilities, development of the Tanzania IHR plan, and incorporation of IHR into the revised Tanzania Integrated Disease Surveillance and Response (IDSR) guidelines. TFELTP is training a competent core group of public health leaders for Tanzania, as well as providing much needed service to the MOHSW in the areas of routine surveillance, outbreak detection and response, and disease program management. However, the immediate challenges that the program must address include development of a full range of in-country teaching capacity for the program, as well as a career path for graduates. PMID:22359697

  4. Contradictory sexual norms and expectations for young people in rural Northern Tanzania

    Microsoft Academic Search

    Daniel Wight; Mary L. Plummer; Gerry Mshana; Joyce Wamoyi; Zachayo S. Shigongo; David A. Ross

    2006-01-01

    There has been a long-running debate as to whether sexual cultures in sub-Saharan Africa are permissive or characterised by restrictive rules, rituals and self-restraint. This paper, based on participant observation data, outlines the main features of sexual culture in rural northern Tanzania and highlights both permissive and restrictive norms and expectations for young people. It also illustrates how sexual beliefs

  5. "Ormilo disease" a disorder of zebu cattle in Tanzania: bovine cerebral theileriosis or new protozoan disease?

    PubMed

    Catalano, Deborah; Biasibetti, Elena; Lynen, Godelieve; Di Giulio, Giuseppe; De Meneghi, Daniele; Tomassone, Laura; Valenza, Federico; Capucchio, Maria Teresa

    2015-06-01

    "Ormilo" disease is a neurological disorder of cattle described by Maasai herders in Tanzania. It is attributed to infection by Theileria species, although no detailed data are available in the literature. The authors describe the macroscopical and histological changes observed in 30 brains of indigenous short-horn zebu cattle from Northern Tanzania, aged 2-9 years, with the characteristic neurological signs of "Ormilo". Moreover, the ultrastructural details observed in 14 selected brain samples were reported. Areas of congestion and hemorrhages, associated with the obstruction of the cerebral vessels with large numbers of parasitized lymphoid cells, were observed. Electron microscopy showed the presence of intralymphocytic parasites morphologically comparable to flagellated protozoa, not previously described in the lymphoid cells of cattle, but only reported during the sexual stages within the vector. Theileria taurotragi was detected by polymerase chain reaction (PCR) and reverse line blot (RLB) in nine samples. The authors hypothesize that the parasite detected by electron microscopy could be a strain of a Theileria endemic to this region till now not investigated, having an intralymphocytic phase and being associated with other Theileria spp. infestation. Further studies are needed to better understand the etiology of "Ormilo" disease and to characterize the morphology of the observed parasite, clarifying its role in the disease in Tanzania. PMID:25851929

  6. 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.

  7. The Costs of Climate Change: A Study of Cholera in Tanzania

    PubMed Central

    Trærup, Sara L. M.; Ortiz, Ramon A.; Markandya, Anil

    2011-01-01

    Increased temperatures and changes in rainfall patterns as a result of climate change are widely recognized to entail potentially serious consequences for human health, including an increased risk of diarrheal diseases. This study integrates historical data on temperature and rainfall with the burden of disease from cholera in Tanzania and uses socioeconomic data to control for the impacts of general development on the risk of cholera. The results show a significant relationship between temperature and the incidence of cholera. For a 1 degree Celsius temperature increase the initial relative risk of cholera increases by 15 to 29 percent. Based on the modeling results, we project the number and costs of additional cases of cholera that can be attributed to climate change by 2030 in Tanzania for a 1 and 2 degree increase in temperatures, respectively. The total costs of cholera attributable to climate change are shown to be in the range of 0.32 to 1.4 percent of GDP in Tanzania 2030. The results provide useful insights into national-level estimates of the implications of climate change on the health sector and offer information which can feed into both national and international debates on financing and planning adaptation. PMID:22408580

  8. 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.

  9. 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…

  10. 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

  11. "After my husband's circumcision, I know that I am safe from diseases": women's attitudes and risk perceptions towards male circumcision in Iringa, Tanzania.

    PubMed

    Layer, Erica H; Beckham, Sarah W; Mgeni, Lilian; Shembilu, Catherine; Momburi, Romani B; Kennedy, Caitlin E

    2013-01-01

    While male circumcision reduces the risk of female-to-male HIV transmission and certain sexually transmitted infections (STIs), there is little evidence that circumcision provides women with direct protection against HIV. This study used qualitative methods to assess women's perceptions of male circumcision in Iringa, Tanzania. Women in this study had strong preferences for circumcised men because of the low risk perception of HIV with circumcised men, social norms favoring circumcised men, and perceived increased sexual desirability of circumcised men. The health benefits of male circumcision were generally overstated; many respondents falsely believed that women are also directly protected against HIV and that the risk of all STIs is greatly reduced or eliminated in circumcised men. Efforts to engage women about the risks and limitations of male circumcision, in addition to the benefits, should be expanded so that women can accurately assess their risk of HIV or STIs during sexual intercourse with circumcised men. PMID:24009771

  12. 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.

  13. Prevalence and Correlates of Common Mental Disorders among Mothers of Young Children in Kilimanjaro Region of Tanzania

    PubMed Central

    Uriyo, Jacqueline G.; Abubakar, Amina; Swai, Mark; Msuya, Sia E.; Stray-Pedersen, Babill

    2013-01-01

    Background Although poor maternal mental health is a major public health problem, with detrimental effects on the individual, her children and society, information on its correlates in low-income countries is sparse. Aims This study investigates the prevalence of common mental disorders (CMD) among at-risk mothers, and explores its associations with sociodemographic factors. Methods This population-based survey of mothers of children aged 0–36 months used the 14-item Shona Symptom Questionnaire (SSQ). Mothers whose response was “yes” to 8 or more items on the scale were defined as “at risk of CMD.” Results Of the 1,922 mothers (15–48 years), 28.8% were at risk of CMD. Risk of CMD was associated with verbal abuse, physical abuse, a partner who did not help with the care of the child, being in a polygamous relationship, a partner with low levels of education, and a partner who smoked cigarettes. Cohabiting appeared to be protective. Conclusions Taken together, our results indicate the significance of the quality of relations with one’s partner in shaping maternal mental health. The high proportion of mothers who are at risk of CMD emphasizes the importance of developing evidence-based mental health programmes as part of the care package aimed at improving maternal well-being in Tanzania and other similar settings. PMID:23844249

  14. 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

  15. 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

  16. Evaluation of efficacy of school-based anthelmintic treatments against anaemia in children in the United Republic of Tanzania.

    PubMed Central

    Guyatt, H. L.; Brooker, S.; Kihamia, C. M.; Hall, A.; Bundy, D. A.

    2001-01-01

    OBJECTIVE: To determine the impact of deworming on anaemia as part of a large-scale school-based anthelmintic treatment programme in the Tanga Region of the United Republic of Tanzania. METHODS: Both the reduction in the prevalence of anaemia and the cost per case prevented were taken into consideration. Cross-sectional studies involved parasitological examination and anaemia evaluation before and at 10 months and 15 months after schoolchildren were dewormed. FINDINGS: Baseline studies indicated that the prevalence of anaemia (haemoglobin < 110 g/l) was high (54%) among schoolchildren, particularly those with high intensities of hookworm and schistosomiasis. Attributable fraction analysis suggested that hookworm and schistosomiasis were responsible for 6% and 15% of anaemia cases, respectively. Fifteen months after deworming with albendazole and praziquantel the prevalence of anaemia was reduced by a quarter and that of moderate-to-severe anaemia (haemoglobin <90 g/l) was reduced by nearly a half. The delivery of these anthelmintics through the school system was achieved at the relatively low cost of US$ 1 per treated child. The cost per anaemia case prevented by deworming schoolchildren was in the range US$ 6-8, depending on the haemoglobin threshold used. CONCLUSIONS: The results suggested that deworming programmes should be included in public health strategies for the control of anaemia in schoolchildren where there are high prevalences of hookworm and schistosomiasis. PMID:11545325

  17. 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

  18. 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

  19. 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

  20. Geophagy practices and the content of chemical elements in the soil eaten by pregnant women in artisanal and small scale gold mining communities in Tanzania

    PubMed Central

    2014-01-01

    Background Geophagy, a form of pica, is the deliberate consumption of soil and is relatively common across Sub-Saharan Africa. In Tanzania, pregnant women commonly eat soil sticks sold in the market (pemba), soil from walls of houses, termite mounds, and ground soil (kichuguu). The present study examined geophagy practices of pregnant women in a gold mining area of Geita District in northwestern Tanzania, and also examined the potential for exposure to chemical elements by testing soil samples. Method We conducted a cross sectional study using a convenience sample of 340 pregnant women, ranging in age from 15–49 years, who attended six government antenatal clinics in the Geita District, Tanzania. Structured interviews were conducted in June-August, 2012, to understand geophagy practices. In addition, soil samples taken from sources identified by pregnant women practicing geophagy were analysed for mineral element content. Results Geophagy was reported by 155 (45.6%) pregnant women with 85 (54.8%) initiating the practice in the first trimester. A total of 101 (65%) pregnant women reported eating soil 2 to 3 times per day while 20 (13%) ate soil more than 3 times per day. Of 155 pregnant women 107 (69%) bought pemba from local shops, while 48 (31%) consumed ground soil kichuguu. The estimated mean quantity of soil consumed from pemba was 62.5 grams/day. Arsenic, chromium, copper, iron, manganese, nickel and zinc levels were found in both pemba and kichuguu samples. Cadmium and mercury were found only in the kichuguu samples. Based on daily intake estimates, arsenic, copper and manganese for kichuguu and copper and manganese for pemba samples exceed the oral Minimum Risk Levels designated by the U.S. Agency for Toxic Substance and Disease Registry. Conclusion Almost 50% of participants practiced geophagy in Geita District consistent with other reports from Africa. Both pemba and kichuguu contained chemical elements at varying concentration, mostly above MRLs. As such, pregnant women who eat soil in Geita District are exposed to potentially high levels of chemical elements, depending upon frequency of consumption, daily amount consumed and the source location of soil eaten. PMID:24731450

  1. Fertility desire and intention of people living with HIV/AIDS in Tanzania: a call for restructuring care and treatment services

    PubMed Central

    2013-01-01

    Background Scaling up of antiretroviral therapy (ART) is currently underway in sub-Saharan Africa including, Tanzania, increasing survival of people living with HIV/AIDS (PLWHA). Programmes pay little attention to PLWHA’s reproductive health needs. Information on fertility desire and intention would assist in the integration of sexual and reproductive health in routine care and treatment clinics. Methods A cross-sectional study of all PLWHA aged 15–49 residing in Kahe ward in rural Kilimanjaro Tanzania was conducted. Participants were recruited from the community and a local counselling centre located in the ward. Data on socio-demographic, medical and reproductive characteristics were collected through face-to-face interviews. Data were entered and analysed using STATA statistical software. Results A total of 410 PLWHA with a mean age of 34.2 and constituting 264 (64.4%) females participated. Fifty-one per cent reported to be married/cohabiting, 73.9% lived with their partners and 60.5% were sexually active. The rate of unprotected sex was 69.0% with 12.5% of women reporting to be pregnant at the time of the survey. Further biological children were desired by 37.1% of the participants and lifetime fertility intention was 2.4 children. Increased fertility desire was associated with living and having sex with a partner, HIV disclosure, good perceived health status and CD4 count ?200 cells for both sexes. Reduced desire was associated with havingmore than 2 children among females, divorce or separation, and having a child with the current partner among both males and females. Conclusion Fertility desire and intention of PLWHA was substantially high though lower than that of the general population in Tanzania. Practice of unprotected sexual intercourse with higher pregnancy rate was observed. Fertility desire was determined by individual perceived health and socio-family related factors. With increasing ART coverage and subsequent improved quality of life of PLWHA, these findings underscore the importance of integrating reproductive health services in the routine care and treatment of HIV/AIDS worldwide. The results also highlight a group of PLWHA with potentially high desire for children who need to be targeted during care. PMID:23360397

  2. Clinicopathological profile and surgical treatment of abdominal tuberculosis: a single centre experience in northwestern Tanzania

    PubMed Central

    2013-01-01

    Background Abdominal tuberculosis continues to be a major public health problem worldwide and poses diagnostic and therapeutic challenges to general surgeons practicing in resource-limited countries. This study was conducted to describe the clinicopathological profile and outcome of surgical treatment of abdominal tuberculosis in our setting and compare with what is described in literature. Methods A prospective descriptive study of patients who presented with abdominal tuberculosis was conducted at Bugando Medical Centre (BMC) in northwestern Tanzania from January 2006 to February 2012. Ethical approval to conduct the study was obtained from relevant authorities. Statistical data analysis was performed using SPSS version 17.0. Results Out of 256 patients enrolled in the study, males outnumbered females. The median age was 28 years (range = 16–68 years). The majority of patients (77.3%) had primary abdominal tuberculosis. A total of 127 (49.6%) patients presented with intestinal obstruction, 106 (41.4%) with peritonitis, 17 (6.6%) with abdominal masses and 6 (2.3%) patients with multiple fistulae in ano. Forty-eight (18.8%) patients were HIV positive. A total of 212 (82.8%) patients underwent surgical treatment for abdominal tuberculosis. Bands /adhesions (58.5%) were the most common operative findings. Ileo-caecal region was the most common bowel involved in 122 (57.5%) patients. Release of adhesions and bands was the most frequent surgical procedure performed in 58.5% of cases. Complication and mortality rates were 29.7% and 18.8% respectively. The overall median length of hospital stay was 32 days and was significantly longer in patients with complications (p < 0.001). Advanced age (age ? 65 years), co-morbid illness, late presentation, HIV positivity and CD4+ count < 200 cells/?l were statistically significantly associated with mortality (p < 0.0001). The follow up of patients were generally poor as only 37.5% of patients were available for follow up at twelve months after discharge. Conclusion Abdominal tuberculosis constitutes a major public health problem in our environment and presents a diagnostic challenge requiring a high index of clinical suspicion. Early diagnosis, early anti-tuberculous therapy and surgical treatment of the associated complications are essential for survival. PMID:23758837

  3. Trends in weekly reported net use by children during and after rainy season in central Tanzania

    PubMed Central

    2012-01-01

    Background The use of long-lasting insecticidal nets (LLINs) is one of the principal interventions to prevent malaria in young children, reducing episodes of malaria by 50% and child deaths by one fifth. Prioritizing young children for net use is important to achieve mortality reductions, particularly during transmission seasons. Methods Households were followed up weekly from January through June 2009 to track net use among children under seven under as well as caretakers. Net use rates for children and caretakers in net-owning households were calculated by dividing the number of person-weeks of net use by the number of person-weeks of follow-up. Use was stratified by age of the child or caretaker status. Determinants of ownership and of use were assessed using multivariate models. Results Overall, 60.1% of the households reported owning a bed net at least once during the study period. Among net owners, use rates remained high during and after the rainy season. Rates of use per person-week decreased as the age of the child rose from 0 to six years old; at ages 0–23?months and 24–35?months use rates per person-week were 0.93 and 0.92 respectively during the study period, while for children ages 3 and 4 use rates per person-week were 0.86 and 0.80. For children ages 5–6 person-week ratios dropped to 0.55. This represents an incidence rate ratio of 1.67 for children ages 0–23?months compared to children aged 5–6. Caretakers had use rates similar to those of children age 0–35?months. Having fewer children under age seven in the household also appeared to positively impact net use rates for individual children. Conclusions In this area of Tanzania, net use is very high among net-owning households, with no variability either at the beginning or end of the rainy season high transmission period. The youngest children are prioritized for sleeping under the net and caretakers also have high rates of use. Given the high use rates, increasing the number of nets available in the household is likely to boost use rates by older children. PMID:22747524

  4. Paediatric injuries at Bugando Medical Centre in Northwestern Tanzania: a prospective review of 150 cases

    PubMed Central

    2013-01-01

    Background Injuries continue to be the leading cause of death and disability for children. The is a paucity of published data on paediatric injuries in our local environment. This study describes the etiological spectrum, injury characteristics and treatment outcome of paediatric injuries in our local setting and provides baseline data for establishment of prevention strategies as well as treatment guidelines. Methods This was a descriptive cross-sectional study involving paediatric injury patients admitted to Bugando Medical Centre from August 2011 to April 2012. Statistical data analysis was done using SPSS version 17.0 and STATA version 12.0. Results A total of 150 patients were studied. The age of patients ranged from 1 month to 10 years with a median age of 5 years. The male to female ratio was 2.3:1. Road traffic accident was the most common cause of injury (39.3%) and motorcycle (71.2%) was responsible for the majority of road traffic accidents. Only 11 (7.3%) patients received pre-hospital care. The head /neck (32.7%) and musculoskeletal (28.0%) were the most frequent body region injured. Open wounds (51.4%), foreign bodies (31.3%) and fractures (17.3%) were the most common type of injuries sustained. The majority of patients 84 (56.0%) were treated surgically. Complication rate was 3.9%. The mean duration of hospitalization was 9.7?±?13.1 days. Mortality rate was 12.7%. Age of the patient (< 5 years), late presentation and presence of complications were the main predictors of length of hospital stay (P Tanzania. Urgent preventive measures targeting at reducing the occurrence of RTAs is necessary to reduce the incidence of paediatric injuries in this region. PMID:24499558

  5. Factors Associated with Problem Drinking among Women Employed in Food and Recreational Facilities in Northern Tanzania

    PubMed Central

    Mongi, Aika S.; Baisley, Kathy; Ao, Trong Thanh-Hoang; Chilongani, Joseph; Aguirre-Andreasen, Aura; Francis, Suzanna C.; Shao, John; Hayes, Richard; Kapiga, Saidi

    2013-01-01

    Background There is growing evidence that alcohol consumption is associated with increased risk of HIV infection. To determine factors associated with problem drinking, we analyzed data collected in two prospective cohorts of at-risk female food and recreational facility workers in northern Tanzania. Methods We enrolled HIV seronegative women aged 18–44 years and employed in the towns of Geita, Kahama, Moshi, and Shinyanga. At enrolment, women were interviewed to obtain information about alcohol use, using CAGE and AUDIT screening scales, and risk factors for HIV infection. Blood and genital samples were collected for detection of HIV and sexually transmitted infections (STIs). We characterized alcohol use, concordance, and agreement of the scales, and examined the associations between characteristics of participants and problem drinking as defined by both scales using logistic regression. Lastly, we assessed problem drinking as a risk factor for recent sexual behavior and prevalent STIs. Results Among enrollees, 68% women reported ever drinking alcohol; of these 76% reported drinking alcohol in the past 12 months. The prevalence of problem drinking was 20% using CAGE and 13% using AUDIT. Overall concordance between the scales was 75.0% with a Kappa statistic of 0.58. After adjusting for age, independent factors associated with problem drinking, on both scales, were marital status, occupation, facility type, increasing number of lifetime sexual partners, and transactional sex in the past 12 months. In addition, women who were problem drinkers on either scale were more likely to report having ?1 sexual partner (CAGE: aOR?=?1.56, 95% confidence interval, CI: 1.10–2.23; AUDIT: aOR?=?2.00, 95% CI: 1.34–3.00) and transactional sex (CAGE: aOR?=?1.79, 95% CI: 1.26–2.56; AUDIT: aOR?=?1.51, 95% CI: 1.04–2.18), in the past 3 months. Conclusion These findings suggest that interventions to reduce problem drinking in this population may reduce high-risk sexual behaviors and contribute in lowering the risk of HIV infection. PMID:24391956

  6. The silent HIV epidemic among pregnant women within rural Northern Tanzania

    PubMed Central

    Yahya-Malima, Khadija I; Olsen, Bjørg E; Matee, Mecky I; Fylkesnes, Knut

    2006-01-01

    Background Many national antenatal clinics (ANC) based HIV surveillance systems in sub-Saharan Africa have limited coverage of remote rural sites, a weakness that compromises adequate estimation, monitoring and development of effective preventive and care programmes. To address this void in rural Manyara and Singida within Northern Tanzania, we conducted antenatal clinic-based sentinel surveillance. Methods We consecutively enrolled 1377 counselled and consenting pregnant women attending ANC clinics for the first time during the current pregnancy. The study was conducted in six antenatal clinics, within three divisions of rural Manyara and Singida regions in 2003/2004. Interviews were conducted and blood samples for routine purposes were collected and tested for anti-HIV IgG antibody anonymously, using Bionor HIV-1 & 2 assay ®. Results Among enrolees, 94% (1296/1377) participated fully. The overall prevalence of HIV was 2.0% (95%CI: 1.34–2.97). The highest HIV prevalence was among women aged between 15–19 years in both rural and remote rural populations. The odds of HIV infection was 4.3 (95%CI: 1.42–12.77) times among women reporting more than one lifetime sexual partners compared with those with one partner. HIV infection was associated with history of genital sores or foul smelling discharge, OR 6.8 (95%CI: 2.78–16.66) and age at first pregnancy (2.5 times higher likelihood of infection if before the age of 18 years versus at a later age). Conclusion Including rural remote sites, as part of the national ANC routine surveillance, is crucial in order to discover imminent silent epidemics such as the one described in this paper. Scaling up HIV prevention efforts is mandatory to prevent the imminent escalation of the HIV epidemic highly associated with a history of sexually transmitted infections (STIs), multiple sexual partners and pregnancies at a younger age. Ignorance of relevant knowledge and low utilisation of condoms underscores the urgency for large-scale preventive efforts. Research to capture a wider representation of the risk factors in the general population should be a priority to enable further customised HIV prevention efforts. PMID:16643653

  7. Endoscopic and clinicopathological patterns of esophageal cancer in Tanzania: experiences from two tertiary health institutions

    PubMed Central

    2013-01-01

    Background Esophageal cancer is one of the most serious gastrointestinal cancer worldwide, owing to its rapid development and fatal prognoses in most cases. There is a paucity of published data regarding esophageal cancer in Tanzania and the study area in particular. This study was conducted to describe the endoscopic and clinicopathological patterns of esophageal cancer in this part of the world. The study provides baseline local data for future comparison. Methods This was a retrospective study of histologically confirmed cases of esophageal cancer seen at Bugando Medical Center and Muhimbili National Hospital between March 2008 and February 2013. Data were retrieved from medical record computer database and analyzed using SPSS computer software version 17.0. Results A total of 328 esophageal cancer patients were enrolled in the study, representing 25.3% of all malignant gastrointestinal tract tumors. The male to female ratio was 2.2:1. The median age of patients at presentation was 47 years. The majority of patients (86.6%) were peasants coming from the rural areas. Smoking and alcohol consumption were documented in 74.7% and 61.6% of patients respectively. Family history of esophageal cancer was reported in 4.6% of cases. The majority of patients (81.7%) presented late with advanced stage of cancer. Progressive dysphagia and weight loss were the most common presenting symptoms occurring in all patients. The middle third esophagus (58.5%) was the most frequent anatomical site for esophageal cancer followed by lower third (27.4%) and upper third esophagus (10.4%). Squamous cell carcinoma (96.0%) was the most common histopathological type. Adenocarcinoma occurred in 13 (4.0%) patients. TNM staging was documented in only 104 (31.7%) patients. Of these, 102(98.1%) patients were diagnosed with advanced esophageal cancer (Stages III and IV). According to tumor grading, most of tumors were moderately differentiated accounting for 56.1% of cases. Distant metastasis was documented in 43.3% of patients. Conclusion Esophageal cancer is not uncommon in this region and shows a trend towards a relative young age at presentation and the majority of patients present late with advanced stage. There is a need for screening of high-risk populations and detecting esophageal cancer at an early stage in order to improve chances for successful treatment and survival. PMID:24094270

  8. The interrelation of HIV, cervical human papillomavirus, and neoplasia among antenatal clinic attenders in Tanzania

    PubMed Central

    Mayaud, P.; Gill, D.; Weiss, H.; Uledi, E.; Kopwe, L.; Todd, J.; ka-Gina, G.; Grosskurth, H.; Hayes, R.; Mabey, D. C.; Lacey, C.

    2001-01-01

    * Died April 2000 Objectives: To determine the prevalence and interrelation of cervical human papillomavirus (HPV) genotypes, squamous intraepithelial lesions (SIL), HIV, and other reproductive tract infections (RTIs) among urban antenatal clinic attenders in Mwanza, Tanzania. Methods: Genital swabs were collected from 660 pregnant women and tested for a range of RTIs and for cervical cytology. Cervical HPV-DNA was detected by PCR and genotyped. HIV and syphilis serologies were performed. Results: HPV prevalence was 34% (209/612 women). Of the 144 typeable samples, 83% were high risk (HR-HPV) oncogenic strains (56% HPV 16 related types). SIL was detected in 43 women (7%), with high grade SIL in 3%. There was a high prevalence of HIV (15%), and of any RTI (83%). Genital warts were detected in 20 women (3%). HPV infection was associated with some behavioural factors (short duration of relationship, single status, not using condoms) and gonorrhoea. There was no overall association between HPV and HIV (OR=1.02, 95% CI 0.6–1.6), but a non-significant trend towards a stronger association with HR-HPV in women aged 15–19 (OR=2.79, 95% CI 0.8–9.5) and women aged ?30 (OR=3.20, 95% CI 0.7–15). SIL was associated with HPV (OR=3.66, 95% CI 1.9–7.0), but not significantly with HIV (OR=1.54, 95% CI 0.7–3.4). Prevalence of SIL was higher among women dually positive for HPV/HIV compared to HPV infection only (21% v 12%), although this difference was not statistically significant (p=0.17). Conclusions: HPV infection was highly prevalent in this young antenatal population. The association of HIV with HR-HPV types in older women may suggest that the principal HIV/HPV interaction in this population is for HIV to upregulate HPV persistence, leading to subsequent development of SIL. Key Words: human papillomavirus; squamous intraepithelial lesion; HIV/AIDS; Africa PMID:11463923

  9. Inpatient child mortality by travel time to hospital in a rural area of Tanzania

    PubMed Central

    Manongi, Rachel; Mtei, Frank; Mtove, George; Nadjm, Behzad; Muro, Florida; Alegana, Victor; Noor, Abdisalan M.; Todd, Jim; Reyburn, Hugh

    2014-01-01

    OBJECTIVE To investigate the association, if any, between child mortality and distance to the nearest hospital. METHODS The study was based on data from a 1-year study of the cause of illness in febrile paediatric admissions to a district hospital in north-east Tanzania. All villages in the catchment population were geolocated, and travel times were estimated from availability of local transport. Using bands of travel time to hospital, we compared admission rates, inpatient case fatality rates and child mortality rates in the catchment population using inpatient deaths as the numerator. RESULTS Three thousand hundred and eleven children under the age of 5 years were included of whom 4.6% died; 2307 were admitted from <3 h away of whom 3.4% died and 804 were admitted from ?3 h away of whom 8.0% died. The admission rate declined from 125/1000 catchment population at <3 h away to 25/1000 at ?3 h away, and the corresponding hospital deaths/catchment population were 4.3/1000 and 2.0/1000, respectively. Children admitted from more than 3 h away were more likely to be male, had a longer pre-admission duration of illness and a shorter time between admission and death. Assuming uniform mortality in the catchment population, the predicted number of deaths not benefiting from hospital admission prior to death increased by 21.4% per hour of travel time to hospital. If the same admission and death rates that were found at <3 h from the hospital applied to the whole catchment population and if hospital care conferred a 30% survival benefit compared to home care, then 10.3% of childhood deaths due to febrile illness in the catchment population would have been averted. CONCLUSIONS The mortality impact of poor access to hospital care in areas of high paediatric mortality is likely to be substantial although uncertainty over the mortality benefit of inpatient care is the largest constraint in making an accurate estimate. PMID:24661618

  10. Folk taxonomy and use of mushrooms in communities around Ngorongoro and Serengeti National Park, Tanzania

    PubMed Central

    2012-01-01

    Background Maasai and Kurya form two main communities around the Serengeti National Park in Tanzania which are mainly pastoralists. Changing climate to excessive drought, have recently forced them to start practicing subsistence farming which is severely affected by wild animals. This study explored status of the folk taxonomy and uses of mushrooms in the two communities as a pave way for possibilities of introducing mushroom cultivation, an alternative crop which is hardly affected by wild animals. Methods Folk taxonomy and use mushrooms by the Kurya and Maasai communities were investigated. Information was collected by face to face interviews with 150 individuals in 6 selected villages. Using descriptive statistics by Statistic Package for the Social Science (SPSS) version 17.0, the demographic characteristics of informants were evaluated and cross relationships with the recorded data were analysed. Results Kurya are mycophilic with 94% of the informants recognizing utilization of the wild mushroom either as foodstuff or as tonics while the Maasai are mycophobic with 99% being unaware of the edibility of mushroom although 28% recognized mushrooms as tonic. For both communities, the knowledge of mushroom utilization and folk taxonomy increased with age of the informants, while it decreases with formal education level of the informants which imply that the basis of knowledge is mainly traditional. Comparing the two communities, the Maasai use mushrooms only for medicinal purposes and never sought them for food while the Kurya were well knowledgeable on the edibility and folk classification especially the Termitomyces species. Characters used in folkal taxonomy included color and size of the basidiomata, shape and size of the pseudorrhiza, habitats and edibility information. A new use of ascospores whereby they anaesthaesia bees during honey harvesting was discovered, and mushroom cultivation was widely welcomed (94.7%) as an alternative crop which is rarely affected by wild animals. Conclusion In order to salvage a noted tremendous decrease of knowledge in mushroom utilization and folk taxonomy from vanishing, there is a need to document it throughout, and incorporate it in lower levels of our education system. Mushroom cultivation may possibly be the best alternative crop for the two communities thus should be advocated for improving livelihood and reduce human wildlife conflicts. The new recorded use of ascospores to anaesthaesia the bees during honey harvesting should be exploited and scaled up for sustainable integrated bee keeping and mushroom farming. PMID:22999253

  11. Local production of pharmaceuticals in Africa and access to essential medicines: 'urban bias’ in access to imported medicines in Tanzania and its policy implications

    PubMed Central

    2014-01-01

    Background International policy towards access to essential medicines in Africa has focused until recently on international procurement of large volumes of medicines, mainly from Indian manufacturers, and their import and distribution. This emphasis is now being challenged by renewed policy interest in the potential benefits of local pharmaceutical production and supply. However, there is a shortage of evidence on the role of locally produced medicines in African markets, and on potential benefits of local production for access to medicines. This article contributes to filling that gap. Methods This article uses WHO/HAI data from Tanzania for 2006 and 2009 on prices and sources of a set of tracer essential medicines. It employs innovative graphical methods of analysis alongside conventional statistical testing. Results Medicines produced in Tanzania were equally likely to be found in rural and in urban areas. Imported medicines, especially those imported from countries other than Kenya (mainly from India) displayed 'urban bias’: that is, they were significantly more likely to be available in urban than in rural areas. This finding holds across the range of sample medicines studied, and cannot be explained by price differences alone. While different private distribution networks for essential medicines may provide part of the explanation, this cannot explain why the urban bias in availability of imported medicines is also found in the public sector. Conclusions The findings suggest that enhanced local production may improve rural access to medicines. The potential benefits of local production and scope for their improvement are an important field for further research, and indicate a key policy area in which economic development and health care objectives may reinforce each other. PMID:24612518

  12. 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

  13. Helping Tanzanian teenage girls avoid pregnancy

    E-print Network

    Richner, Heinz

    ' resources Many studies on teen pregnancy look at the risks that young people face: the risk of getting and deal with sex.This edition of evidence for policy examines this issue, based on research in Tanzania in Tanzania Groups of young people in Dar es Salaam and Mtwara identified key aspects related to teen

  14. 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

  15. “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

  16. Has Tanzania Embraced the Green Leaf? Results from Outlet and Household Surveys before and after Implementation of the Affordable Medicines Facility -Malaria

    PubMed Central

    Thomson, Rebecca; Festo, Charles; Johanes, Boniface; Kalolella, Admirabilis; Bruxvoort, Katia; Nchimbi, Happy; Tougher, Sarah; Cairns, Matthew; Taylor, Mark; Kleinschmidt, Immo; Ye, Yazoume; Mann, Andrea; Ren, Ruilin; Willey, Barbara; Arnold, Fred; Hanson, Kara; Kachur, S. Patrick; Goodman, Catherine

    2014-01-01

    Background The Affordable Medicines Facility - malaria (AMFm) is primarily an artemisinin combination therapy (ACT) subsidy, aimed at increasing availability, affordability, market share and use of quality-assured ACTs (QAACTs). Mainland Tanzania was one of eight national scale programmes where AMFm was introduced in 2010. Here we present findings from outlet and household surveys before and after AMFm implementation to evaluate its impact from both the supply and demand side. Methods Outlet surveys were conducted in 49 randomly selected wards throughout mainland Tanzania in 2010 and 2011, and data on outlet characteristics and stocking patterns were collected from outlets stocking antimalarials. Household surveys were conducted in 240 randomly selected enumeration areas in three regions in 2010 and 2012. Questions about treatment seeking for fever and drugs obtained were asked of individuals reporting fever in the previous two weeks. Results The availability of QAACTs increased from 25.5% to 69.5% among all outlet types, with the greatest increase among pharmacies and drug stores, together termed specialised drug sellers (SDSs), where the median QAACT price fell from $5.63 to $0.94. The market share of QAACTs increased from 26.2% to 42.2%, again with the greatest increase in SDSs. Household survey results showed a shift in treatment seeking away from the public sector towards SDSs. Overall, there was no change in the proportion of people with fever obtaining an antimalarial or ACT from baseline to endline. However, when broken down by treatment source, ACT use increased significantly among clients visiting SDSs. Discussion Unchanged ACT use overall, despite increases in QAACT availability, affordability and market share in the private sector, reflected a shift in treatment seeking towards private providers. The reasons for this shift are unclear, but likely reflect both persistent stockouts in public facilities, and the increased availability of subsidised ACTs in the private sector. PMID:24816649

  17. Getting antimalarials on target: impact of national roll-out of malaria rapid diagnostic tests on health facility treatment in three regions of Tanzania

    PubMed Central

    Bruxvoort, Katia; Kalolella, Admirabilis; Nchimbi, Happy; Festo, Charles; Taylor, Mark; Thomson, Rebecca; Cairns, Matthew; Thwing, Julie; Kleinschmidt, Immo; Goodman, Catherine; Kachur, S Patrick

    2013-01-01

    Objectives Parasitological confirmation of malaria prior to treatment is recommended for patients of all ages, with malaria rapid diagnostic tests (mRDTs) an important tool to target artemisinin-based combination therapies (ACTs) to patients with malaria. To evaluate the impact on case management practices of routine government implementation of mRDTs, we conducted large-scale health facility surveys in three regions of Tanzania before and after mRDT roll-out. Methods Febrile patients at randomly selected health facilities were interviewed about care received at the facility, and blood samples were collected for reference blood smears. Health facility staff were interviewed about their qualifications and availability of malaria diagnostics and drugs. Results The percentage of febrile patients tested for malaria at the facility increased from 15.8% in 2010 to 54.9% in 2012. ACTs were obtained by 65.8% of patients positive by reference blood smear in 2010 and by 50.2% in 2012 (P = 0.0675); no antimalarial was obtained by 57.8% of malaria-negative patients in 2010 and by 82.3% in 2012 (P < 0.0001). Overall, ACT use decreased (39.9–21.3%, P < 0.0001) and antibiotic use increased (31.2–48.5%, P < 0.0001). Conclusion Roll-out of mRDTs in Tanzania dramatically improved diagnostic testing for malaria and reduced overuse of ACTs for patients without parasitemia. However, post–roll-out almost 50% of febrile patients did not receive a diagnostic test, and almost 50% of patients testing positive did not receive ACTs. Stock-outs of ACTs and mRDTs were important problems. Further investigation is needed to determine reasons for not providing ACTs to patients with malaria and potential for inappropriate antibiotic use. PMID:23937722

  18. Communication, knowledge, social network and family planning utilization among couples in Mwanza, Tanzania.

    PubMed

    Mosha, Idda H; Ruben, Ruerd

    2013-09-01

    Family planning utilization in Tanzania is low. This study was cross sectional. It examined family planning use and socio demographic variables, social networks, knowledge and communication among the couples, whereby a stratified sample of 440 women of reproductive age (18-49), married or cohabiting was studied in Mwanza, Tanzania. A structured questionnaire with questions on knowledge, communication among the couples and practice of family planning was used. Descriptive statistics and Logistic regression were used to identify factors associated with family planning (FP) use at four levels. The findings showed that majority (73.2%) of respondents have not used family planning. Wealth was positive related to FP use (p=.000, OR = 3.696, and 95% C.I = 1.936 lower and upper 7.055). Religion was associated with FP use (p=.002, OR =2.802, 95% C.I = 1.476 lower and 5.321 upper), communication and FP use were significantly associated, (p=.000, OR = 0.323 and 95% C.I = 0.215) lower and upper = 0.483), social network and FP use (p=.000, OR = 2.162 and 95% C.I = 1.495 lower and upper =3.125) and knowledge and FP use(p=.000, OR = 2.224 and 95% C.I = 1.509 lower and upper =3.278). Wealth showed a significant association with FP use (p=.001, OR = 1.897, 95% C.I = 0.817 lower and 4.404).Urban area was positively associated with FP use (p= .000, OR = 0.008 and 95% C.I = 0.001 lower and upper =0.09), semi urban was significant at (p= .004, OR = 3.733 and C.I = 1.513 lower and upper =9.211). Information, education and communication materials and to promote family planning in Tanzania should designed and promoted. PMID:24069768

  19. Ultra-high temperature granulite-facies metamorphic rocks from the Mozambique belt of SW Tanzania

    NASA Astrophysics Data System (ADS)

    Sommer, H.; Kröner, A.

    2013-06-01

    The metamorphic rocks in the Neoproterozoic (Pan-African) Mozambique belt of southwestern Tanzania, around the town of Songea, can be subdivided into one- and two pyroxene bearing charnockitic gneisses, migmatitic granitoid gneisses and amphibolite-facies metapelites. Lower-grade amphibolite-facies rocks are rare and can be classified as sillimanite- and/or garnet-bearing metapelites. Most of the studied charnockitic gneisses show excellent corona textures with large orthopyroxene grains rimmed by clinopyroxene, followed by quartz and well developed garnet rims due to the reaction Opx + Pl = Grt + Cpx + Qtz that formed during isobaric cooling. These and other charnockitic gneisses show symplectites of orthopyroxene and An-rich plagioclase that resulted from the breakdown of garnet during isothermal decompression due to the reaction Grt + Cpx + Qtz = Opx + Pl. Geothermobarometric calculations yield up to ~ 1050 °C and up to ~ 12 kbar for peak metamorphic conditions. These are higher temperature and slightly lower pressure conditions than reported for other granulite-facies terrains in the Mozambique belt of Tanzania. Single zircon Pb-Pb evaporation and U-Pb SHRIMP ages for magmatic zircons extracted from two charnockitic and two granitic gneisses cluster in two groups, one at ~ 750 Ma and one at ~ 1150 Ma with the older reflecting the time of emplacement of the igneous precursors, and the younger approximating the time of charnockitization. These protolith ages are similar to those farther east in the Masasi area of southern Tanzania, as well as in northern Mozambique and in southern Malawi, and suggest that the Mozambique belt consists of chronologically heterogeneous assemblages whose pre-metamorphic tectonic setting remains obscure.

  20. Costing maternal health services in South Tanzania: a case study from Mtwara Urban District.

    PubMed

    von Both, Claudia; Jahn, Albrecht; Fleba, Steffen

    2008-05-01

    The following paper presents the methodology and results of a costing exercise of maternal health services in Tanzania. The main objective of this study was to determine the actual costs of antenatal and obstetric care in different health institutions in a district in Tanzania as a basis of more efficient resource allocation. A costing tool was developed that allows the calculation of costs of service units, such as deliveries and antenatal care, and separates these costs from the costs of other services. Time consumed by each activity was used as an allocation key. For that purpose, we recorded the personnel consumption with different time-study methodologies. This approach was tested and implemented in Mtwara Urban District, South Tanzania. The results were analyzed by a spreadsheet program. The paper presents average costs for different costing units of maternal care. Among other findings, we found that the cost of a normal vaginal delivery is US $12.30 in a dispensary and US $6.30 in the hospital--a result that needs explanation, as usually one would expect that hospitals are more cost-intensive than first-line facilities. However, dispensaries are grossly underutilized so that the costs per service unit are rather high. The cost for surgical delivery (only in hospitals) was found to be US $69.26 and the average cost per antenatal care consultation (only at dispensaries) was US $2.50. We conclude that improved planning of elective services is a prerequisite for more effective and efficient use of personnel resources. In addition, the definition of medically and economically sound standards, in particular staffing standards, is critical to make cost analysis an effective management tool to guide rational resource allocation. PMID:17453262

  1. A Large Cross-Sectional Community-Based Study of Newborn Care Practices in Southern Tanzania

    PubMed Central

    Penfold, Suzanne; Hill, Zelee; Mrisho, Mwifadhi; Manzi, Fatuma; Tanner, Marcel; Mshinda, Hassan; Schellenberg, David; Armstrong Schellenberg, Joanna R. M.

    2010-01-01

    Despite recent improvements in child survival in sub-Saharan Africa, neonatal mortality rates remain largely unchanged. This study aimed to determine the frequency of delivery and newborn-care practices in southern Tanzania, where neonatal mortality is higher than the national average. All households in five districts of Southern Tanzania were approached to participate. Of 213,220 female residents aged 13–49 years, 92% participated. Cross-sectional, retrospective data on childbirth and newborn care practices were collected from 22,243 female respondents who had delivered a live baby in the preceding year. Health facility deliveries accounted for 41% of births, with nearly all non-facility deliveries occurring at home (57% of deliveries). Skilled attendants assisted 40% of births. Over half of women reported drying the baby and over a third reported wrapping the baby within 5 minutes of delivery. The majority of mothers delivering at home reported that they had made preparations for delivery, including buying soap (84%) and preparing a cloth for drying the child (85%). Although 95% of these women reported that the cord was cut with a clean razor blade, only half reported that it was tied with a clean thread. Furthermore, out of all respondents 10% reported that their baby was dipped in cold water immediately after delivery, around two-thirds reported bathing their babies within 6 hours of delivery, and 28% reported putting something on the cord to help it dry. Skin-to-skin contact between mother and baby after delivery was rarely practiced. Although 83% of women breastfed within 24 hours of delivery, only 18% did so within an hour. Fewer than half of women exclusively breastfed in the three days after delivery. The findings suggest a need to promote and facilitate health facility deliveries, hygienic delivery practices for home births, delayed bathing and immediate and exclusive breastfeeding in Southern Tanzania to improve newborn health. PMID:21203574

  2. The costs of hospital services: a case study of Evangelical Lutheran Church hospitals in Tanzania.

    PubMed

    Flessa, S

    1998-12-01

    The health care systems of many developing countries are facing a severe crisis. Problems of financing services leads to high patient fees which make institutions of Western health care unaffordable for the majority of the rural poor. The conflict between sustainability and affordability of the official health care system challenges both local decision-makers and health management consultants. Decisions must be made soon so that the existing health care systems can survive. However, these decisions must be based on sound data, especially on the costs of health care services. The existing accounting systems of most hospitals in developing countries do not provide decision-makers with these data. Costs are generally underestimated. The leadership of the 16 hospitals of the Evangelical Lutheran Church in Tanzania is currently analyzing how the existing health care services should be restructured. Therefore, reliable estimates of the costs of hospitals services are required. A survey on 'Costing of health services of the Evang. Luth. Church in Tanzania' was prepared, which summarizes the results of seven months of field investigations in Lutheran hospitals. The major findings are that the costs of providing adequate services are much higher than expected. The most important factors determining these costs are the administrative efficiency of the hospital and the scope of services offered. The paper closes with some recommendations on how to improve the services in order to make them both affordable for the rural poor and financially sustainable for the Church. It is concluded that even the best improvement of technical efficiency will not safeguard the survival of the hospital-based health care services of the Lutheran Church in Tanzania. These findings call for a reallocation of health care resources to lower levels of the health care pyramid. PMID:10346031

  3. 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

  4. 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.

  5. 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

  6. 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

  7. Comparison of isotope dilution with bioelectrical impedance analysis among HIV-infected and HIV-uninfected pregnant women in Tanzania

    PubMed Central

    Kupka, R.; Manji, K.P.; Wroe, E.; Aboud, S.; Bosch, R.J.; Fawzi, W.W.; Kurpad, A.V.; Duggan, C.

    2013-01-01

    Background Bioelectrical impedance analysis (BIA) is a simple tool to assess total body water (TBW), from which body composition can be estimated using statistical equations. However, standard BIA equations have not been sufficiently validated during pregnancy, in HIV infection, or in sub-Saharan Africa. We therefore compared TBW estimates from multifrequency BIA with those from the reference method deuterium isotope dilution (Deut) in a cohort of 30 HIV-uninfected and 30 HIV-infected pregnant women from Tanzania. Methods We enrolled pregnant women presenting for routine antenatal care and collected data on pregnancy outcomes. At each trimester of gestation and once at 10-wk post-partum, we measured maternal anthropometry, TBWBIA, and TBWDeut. Results TBWBIA was highly correlated at each time point with TBWDeut among HIV-infected (all P ?0.001) and HIV-uninfected women (all P <0.0001). During pregnancy, mean TBWBIA progressively underestimated TBWDeut in the overall cohort; trimester-specific differences (mean ±SD) were ?1.02 ±2.36 kg, ?1.47 ±2.43 kg, and ?2.42 ±2.63 kg, respectively. The difference at 10-wk postpartum was small (?0.24 ±2.07 kg). In Bland-Altman and regression models, TBWBIA was subject to a systematic predictive bias at each antenatal and postnatal time point (all P ?0.038). Among HIV-positive women, TBWDeut measured during the first (P =0.02) and second trimester (P =0.03) was positively related to birthweight. Conclusions The validity of current BIA equations to assess TBW during pregnancy and in the postpartum period among women from sub-Saharan Africa remains uncertain. Deuterium dilution may assess aspects of maternal body composition relevant for pregnancy outcomes among HIV-infected women. PMID:24244104

  8. Reflections on informed choice in resource-poor settings: the case of infant feeding counselling in PMTCT programmes in Tanzania.

    PubMed

    Våga, Bodil Bø; Moland, Karen Marie; Evjen-Olsen, Bjørg; Blystad, Astrid

    2014-03-01

    A growing emphasis on patient involvement in health care has brought 'informed choice' to the core of the debate on provider-patient interaction in global health-care programmes. How the principles of patient involvement and informed choice are implemented and experienced in diverging health systems and cultural contexts are issues of increasing interest. Infant feeding and infant feeding counselling of HIV-positive women have posed particular challenges related to choice. Based on ethnographic research conducted from 5 November 2008 to 5 August 2009 within prevention of mother-to-child transmission of HIV (PMTCT) programmes in two hospitals in rural and semi-urban Tanzania, this study explores nurse counsellors' and HIV-positive women's experiences of infant feeding counselling and patient choice. One of the hospitals (hospital A) promoted exclusive breastfeeding as the only infant feeding option, while the other hospital (hospital B) aimed to follow the Tanzanian PMTCT infant feeding guidelines of 2007 promoting patient choice in infant feeding methods. Women in hospital A expressed trust in the advice given and confidence in their own ability to practice exclusive breastfeeding, while women in hospital B expressed great uncertainty and confusion about how best to feed their infants. This paper reflects on the feasibility of a counselling procedure that promotes choice of infant feeding methods in PMTCT programmes in severely resource-poor settings where HIV-positive women have limited access to resources and to up-to-date knowledge on HIV and infant feeding outside the counselling room. We suggest that a universalistic procedure presenting the same unambiguous message on infant feeding to all women enrolled in the PMTCT programme in this and similar settings is likely to produce more confidence, less confusion and, hence, better results in terms of HIV-free survival of the baby. PMID:24508717

  9. 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

  10. One size does not fit all: HIV testing preferences differ among high-risk groups in Northern Tanzania.

    PubMed

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

    2015-01-01

    In order to maximize the effectiveness of "Seek, Test, and Treat" strategies for curbing the HIV epidemic, new approaches are needed to increase the uptake of HIV testing services, particularly among high-risk groups. Low HIV testing rates among such groups suggest that current testing services may not align well with the testing preferences of these populations. Female bar workers and male mountain porters have been identified as two important high-risk groups in the Kilimanjaro Region of Tanzania. We used conventional survey methods and a discrete choice experiment (DCE), a preference elicitation method increasingly applied by economists and policy-makers to inform health policy and services, to analyze trade-offs made by individuals and quantify preferences for HIV testing services. Bivariate descriptive statistics were used to analyze differences in survey responses across groups. Compared to 486 randomly selected community members, 162 female bar workers and 194 male Kilimanjaro porters reported 2-3 times as many lifetime sexual partners (p < 0.001), but similar numbers of lifetime HIV tests (median 1-2 across all groups). For the DCE, participants' stated choices across 12,978 hypothetical HIV testing scenarios (422 female and 299 male participants × 9 choice tasks × 2 alternatives) were analyzed using gender-specific mixed logit models. Direct assessments and the DCE data demonstrated that barworkers were less likely to prefer home testing and were more concerned about disclosure issues compared with their community counterparts. Male porters preferred testing in venues where antiretroviral therapy was readily available. Both high-risk groups were less averse to traveling longer distances to test compared to their community counterparts. These results expose systematic differences in HIV testing preferences across high-risk populations compared to their community peers. Tailoring testing options to the preferences of high-risk populations should be evaluated as a means of improving uptake of testing in these populations. PMID:25616562

  11. 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…

  12. Occurrence of Pasteurella multocida and related species in village free ranging chickens and their animal contacts in Tanzania

    Microsoft Academic Search

    A. P Muhairwa; M. M. A Mtambo; J. P Christensen; M Bisgaard

    2001-01-01

    Investigation was done to determine the presence of Pasteurellamultocida and related species in free ranging chickens and ducks, dogs, cats and pigs in three climatic zones (cool, warm and hot) of rural Morogoro, Tanzania. A total of 153 isolates of P.multocida ssp. multocida and related species were obtained by direct culture on blood agar, selective medium and mouse inoculation. P.multocida

  13. Content Analysis of the Status and Place of Sexuality Education in the National School Policy and Curriculum in Tanzania

    ERIC Educational Resources Information Center

    Mkumbo, Kitila A.

    2009-01-01

    In Tanzania, sexuality education in schools is not provided as a standalone subject; rather it is mainstreamed in other subjects, namely Social Studies, Science, Civics and Biology. However, it is not clear how much sexuality education is covered in these subjects. The purpose of this study was to examine the status of sexuality education in the…

  14. Ngoro: an indigenous, sustainable and profitable soil, water and nutrient conservation system in Tanzania for sloping land

    Microsoft Academic Search

    Z. J. U. Malley; B. Kayombo; T. J. Willcocks; P. W. Mtakwa

    2004-01-01

    The Matengo people, in SW Tanzania, developed the ngoro conservation system several hundred years ago and it is a very effective indigenous manual cultivation practice for steep slopes. It deserves wider recognition and investigation to gain a quantitative understanding of the conservation system processes and its management to see whether it can be adapted to be more cost effective with

  15. BRIEF REPORT Incident of Intense Aggression by Chimpanzees Against an Infant From Another Group in Mahale Mountains National Park, Tanzania

    Microsoft Academic Search

    NOBUYUKI KUTSUKAKE; TAKAHISA MATSUSAKA

    2002-01-01

    We document here an unusual case of intense aggression against an infant male from another group by chimpanzees (Pan troglodytes schweinfurthii) of the Mahale Mountains National Park, in Tanzania. Adult males of the study group collectively attacked an unknown male infant. Although an unknown female, probably the mother, tried to retrieve him, the infant was seriously injured and most likely

  16. On the formation of an inverted weathering profile on Mount Kilimanjaro, Tanzania: Buried paleosol or groundwater weathering?

    Microsoft Academic Search

    Mark Gabriel Little; Cin-Ty Aeolus Lee

    2006-01-01

    This paper presents an investigation into the degree and nature of chemical weathering during soil formation on a volcanic (phonolite) substrate on the southern slopes of Mt. Kilimanjaro in northern Tanzania. The high field strength elements Nb and Ta were used to estimate enrichments and depletions relative to the bedrock. The degree of weathering was found to increase with depth

  17. Tourist satisfaction in relation to attractions and implications for conservation in the protected areas of the Northern Circuit, Tanzania

    Microsoft Academic Search

    Moses Makonjio Okello; Sarah Yerian

    2009-01-01

    This study assessed tourist satisfaction and its links with tourist attractions and infrastructure at the following six protected areas on the Northern Tourist Circuit of Tanzania: Tarangire National Park, Lake Manyara National Park, Ngorongoro Conservation Area, Serengeti National Park, Arusha National Park, and Mt. Kilimanjaro National Park. Semi-structured interviews were conducted with 185 tourists visiting the protected areas. Satisfaction ratings

  18. Situation Report--Australia, The Gambia, Papua and New Guinea, Rhodesia, Sri Lanka, Taiwan, Tanzania, Tonga, and Western Samoa.

    ERIC Educational Resources Information Center

    International Planned Parenthood Federation, London (England).

    Data relating to population and family planning in nine foreign countries are presented in these situation reports. Countries included are Australia, The Gambia, Papua and New Guinea, Rhodesia, Sri Lanka, Taiwan, Tanzania, Tonga, and Western Somoa. Information is provided under three topics, statistical information, general background information,…

  19. A qualitative assessment of the risk of introducing peste des petits ruminants into northern zambia from Tanzania.

    PubMed

    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

  20. The impact of school mapping in the development of education in Tanzania: an assessment of the experiences of six districts

    Microsoft Academic Search

    Justinian C. J. Galabawa; Augustine Obeleagu Agu; Ichiro Miyazawa

    2002-01-01

    In this study the authors have looked at the impact of school mapping in the development of education in Tanzania. The study examined the experiences of six districts where school mapping exercises were carried out. The key question that guided the study is what happened after school mapping. Through a combination of instruments and\\/or techniques—interviews, questionnaires, focus group discussion, and

  1. The Impact of School Mapping in the Development of Education in Tanzania: An Assessment of the Experiences of Six Districts.

    ERIC Educational Resources Information Center

    Galabawa, Justinian C. J.; Agu, Augustine Obeleagu; Miyazawa, Ichiro

    2002-01-01

    Studied the impact of school mapping in the development of education in Tanzania. Data from a variety of sources (interviews, questionnaires, focus group discussion, and document analysis) show that school mapping had various positive impacts on the development of education in terms of increased enrollment and attendance, decreased dropping out,…

  2. The Impact of Time Use Differentials on Poverty levels in the Eastern and Northern Zones of Tanzania

    Microsoft Academic Search

    Rocky Akarro

    Abstract Development,is positively correlated with poverty. People who are poor are generally less developed,compared ,with the rich. Analysis of poverty ,levels in Northern and Eastern Zones of Tanzania ,is hereby ,presented. These zones ,were selected because they are a representative of coastal and upcountry culturesrespectively. Principal component analysis was used in constructing ,poverty index. The households ,possessions that were used

  3. Priorities and allocation of health care resources in developing countries: A case-study from the Mtwara region, Tanzania

    Microsoft Academic Search

    Steffen Flessa

    2003-01-01

    Models of health economics usually maximise the sum of individual health. However, as the term health reflects very different aspects of well being, quite different objectives can be derived for the allocation of health care resources. This paper analyses the optimum allocation of health care resources in the Mtwara region, Tanzania, for five different objectives: minimisation of death cases, minimisation

  4. Girls Getting to Secondary School Safely: Combating Gender-Based Violence in the Transportation Sector in Tanzania

    ERIC Educational Resources Information Center

    Mack, Laura

    2009-01-01

    While increasing girls' access to education is a global priority, there are numerous barriers that impede significant progress in achieving gender parity in schools. While enrollment of girl students is up in Tanzania, especially at the primary and secondary levels, AED has become concerned about the barriers girls face, including gender-based…

  5. Predictors of positive blood culture and deaths among neonates with suspected neonatal sepsis in a tertiary hospital, Mwanza- Tanzania

    Microsoft Academic Search

    Neema Kayange; Erasmus Kamugisha; Damas L Mwizamholya; Seni Jeremiah; Stephen E Mshana

    2010-01-01

    BACKGROUND: Neonatal sepsis is a significant cause of morbidity and mortality in neonates. Appropriate clinical diagnosis and empirical treatment in a given setting is crucial as pathogens of bacterial sepsis and antibiotic sensitivity pattern can considerably vary in different settings. This study was conducted at Bugando Medical Centre (BMC), Tanzania to determine the prevalence of neonatal sepsis, predictors of positive

  6. 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

  7. Larvicidal, antimicrobial and brine shrimp activities of extracts from Cissampelos mucronata and Tephrosia villosa from coast region, Tanzania

    Microsoft Academic Search

    Ramadhani S O Nondo; Zakaria H Mbwambo; Abdul W Kidukuli; Ester M Innocent; Matobola J Mihale; Paul Erasto; Mainen J Moshi

    2011-01-01

    Background The leaves and roots of Cissampelos mucronata A. Rich (Menispermaceae) are widely used in the tropics and subtropics to manage various ailments such as gastro-intestinal complaints, menstrual problems, venereal diseases and malaria. In the Coast region, Tanzania, roots are used to treat wounds due to extraction of jigger. Leaves of Tephrosia villosa (L) Pers (Leguminosae) are reported to be

  8. A matter of approach: the retort's potential to reduce mercury consumption within small-scale gold mining settlements in Tanzania

    Microsoft Academic Search

    Jesper Bosse Jønsson; Peter W. U. Appel; Raphael Tihelwa Chibunda

    2009-01-01

    The mercury-based gold extraction processes prevalent within small-scale mining are both efficient and harmful. While ensuring relatively high levels of gold recovery, they cause environmental and health problems for people living within mining settlements. This mercury consumption can be minimized by using a simple mercury recycling device known as a retort. While mining legislation in Tanzania dictates the use of

  9. 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…

  10. The distribution and behaviour of rhenium and osmium amongst mantle minerals and the age of the lithospheric mantle beneath Tanzania

    Microsoft Academic Search

    K. W. Burton; P. Schiano; J.-L. Birck; C. J. Allègre; M. Rehkämper; A. N. Halliday; J. B. Dawson

    2000-01-01

    Rhenium–osmium (Re–Os) isotope and elemental abundances have been obtained for primary mantle minerals, metasomatic phases, and a range of mantle rock types from xenoliths in recent volcanics in northern Tanzania. Re and Os abundances for sulphide and coexisting silicates in garnet lherzolites from Lashaine confirm that sulphide dominates the Os budget, but also show that Re is almost exclusively sited

  11. Prevalence of congenital malaria among neonates at Morogoro Regional Hospital, Morogoro, Tanzania.

    PubMed

    Mosha, Theobald C E; Ntarukimana, Devote; John, Matilda

    2010-10-01

    Congenital malaria is increasingly reported among babies born to mothers living in malaria endemic areas. The aim of this study was to determine the prevalence of congenital malaria among newborn babies delivered at Morogoro Regional Hospital, Tanzania. A cross-sectional study was conducted among 200 pregnant women attending delivery services at the hospital. Socio-demographic and obstetric information of the mothers was also collected. Samples of the placental, cord and peripheral blood smears of mothers and babies were stained with Giemsa and examined for malaria parasites. Plasmodiun falciparum was the dominant malaria parasite species. The prevalence of congenital malaria among newly born babies was 4.0% (95% CI, 1.2-6.8%). Prevalence of placental parasitaemia was 7.0% (95% CI, 3.3-10.7%), while prevalence of cord parasitaemia was 0.5% (95% CI, 0.0-1.5%). The prevalence of malaria among the mothers at delivery was 11.5% (95% CI, 6.9-16.1%). There was a strong association between placental, cord, maternal and congenital parasitaemia. All babies with congenital malaria had infected mothers and placentas (P<0.01). In conclusion, congenital malaria is still common in Tanzania especially in malaria endemic areas. It is important that blood smear from neonates are taken and examined for malaria parasite soon after birth. Malaria prevention measures such as intermittent preventive treatment, prompt management of all malaria cases and use of insecticide treated bed nets should be emphasized for all pregnant women. PMID:24409631

  12. Can mothers afford maternal health care costs? User costs of maternity services in rural Tanzania.

    PubMed

    Kowalewski, Marga; Mujinja, Phare; Jahn, Albrecht

    2002-04-01

    Following the difficult economic situation various countries introduced health sector reforms, including user charges to finance the system. The assessment of user costs for maternity services in Tanzania was part of a larger study, which covered inputs, outputs and efficiency of services. The study was carried out from October 1997 to January 1998 in Mtwara urban and rural district in South Tanzania. One hundred and seven women attending a quarter of government health facilities were randomly selected and interviewed. Twenty one key informants were also interviewed and service procedures observed. Users of maternity services pay mainly for admission, drugs, other supplies and travel costs. Travel costs represent about half of these financial costs. The average total costs vary between US$11.60 for antenatal consultation and US$135.40 for caesarean section at the hospital. Unofficial payments are not included in the calculation. The amounts vary and payment is irregular. We therefore conclude that time costs are constantly higher than financial costs. High direct payments and the fear of unofficial costs are acute barriers to the use of maternity services. User costs can substantially be reduced by the re-organisation of service delivery especially at antenatal consultation. PMID:12476730

  13. Isolation of Mycobacterium species from raw milk of pastoral cattle of the Southern Highlands of Tanzania.

    PubMed

    Kazwala, R R; Daborn, C J; Kusiluka, L J; Jiwa, S F; Sharp, J M; Kambarage, D M

    1998-08-01

    A study to determine the secretion of Mycobacterium spp. in milk from indigenous cattle was carried out in pastoral cattle reared in the Southern Highlands to Tanzania. The study was aimed at elucidating the dangers associated with milk-borne zoonoses in a society where milk is normally consumed raw. Out of 805 milk samples, 31 (3.9%) were positive for mycobacteria. There was a preponderance of atypical mycobacteria (87%) whereas only two isolates (6.5%) were confirmed as M. bovis. Atypical mycobacteria included: M. terrae (n = 7), M. fortuitum (n = 2), M. flavescens (n = 13), M. gordonae (n = 1) and M. smegmatis (n = 4). Although the number of M. bovis positive samples was low, the habit of pooling milk may still pose great public health dangers to milk consumers in this part of the world. Moreover, isolation of atypical mycobacteria should also be considered to be a danger to human health in countries such as Tanzania, where the number of people with lowered immunity due to HIV infection is on the increase. PMID:9760715

  14. Morphologic and Genetic Identification of Taenia Tapeworms in Tanzania and DNA Genotyping of Taenia solium

    PubMed Central

    Eom, Keeseon S.; Chai, Jong-Yil; Yong, Tai-Soon; Min, Duk-Young; Rim, Han-Jong; Kihamia, Charles

    2011-01-01

    Species identification of Taenia tapeworms was performed using morphologic observations and multiplex PCR and DNA sequencing of the mitochondrial cox1 gene. In 2008 and 2009, a total of 1,057 fecal samples were collected from residents of Kongwa district of Dodoma region, Tanzania, and examined microscopically for helminth eggs and proglottids. Of these, 4 Taenia egg positive cases were identified, and the eggs were subjected to DNA analysis. Several proglottids of Taenia solium were recovered from 1 of the 4 cases. This established that the species were T. solium (n=1) and T. saginata (n=3). One further T. solium specimen was found among 128 fecal samples collected from Mbulu district in Arusha, and this had an intact strobila with the scolex. Phylegenetic analysis of the mtDNA cox1 gene sequences of these 5 isolates showed that T. saginata was basal to the T. solium clade. The mitochondrial cox1 gene sequences of 3 of these Tanzanian isolates showed 99% similarity to T. saginata, and the other 2 isolates showed 100% similarity to T. solium. The present study has shown that Taenia tapeworms are endemic in Kongwa district of Tanzania, as well as in a previously identified Mbulu district. Both T. solium isolates were found to have an "African/Latin American" genotype (cox1). PMID:22355207

  15. Assessment of pollution in sewage ponds using biomarker responses in wild African sharptooth catfish (Clarias gariepinus) in Tanzania.

    PubMed

    Mdegela, Robinson H; Braathen, Marte; Mosha, Resto D; Skaare, Janneche U; Sandvik, Morten

    2010-04-01

    The interactive effects of mixed pollutants in sewage wastewater on biomarker responses were investigated using wild male African sharptooth catfish (Clarias gariepinus) in Morogoro, Tanzania. A total of 58 fish were used, of which 21 were from Mindu dam (reference site) and 22, 9 and 10 from Mafisa, Mazimbu and Mzumbe sewage ponds, respectively. Liver somatic index (LSI) and gonadosomatic index (GSI) were significantly greater (two- to threefold) and (five- to sixfold), respectively, in fish from all sewage ponds. Haemoglobin concentration and gill filament 7-ethoxyresurufin O-deethylase (EROD) activities were significantly higher (1.2-fold and twofold, respectively) in fish from Mzumbe sewage ponds than in fish from Mindu dam, whereas liver EROD activity was significantly higher in fish from Mzumbe and Mafisa sewage ponds (5-fold). A HPLC method for determination of enzymatically formed p-nitrophenyl-glucuronide (PNPG) was developed and applied to measure UDP-glucuronosyl transferase (UGT) activities that was significantly higher in fish from all sewage ponds (2-2.5-fold) than in fish from Mindu dam. Kinetic characteristics and assay dependence of UGT were studied with microsomal preparations. Metallothionein (MT) content was significantly lower (three- to fourfold) in fish from sewage ponds than in fish from Mindu dam, and corresponded with cumulative levels of cadmium, lead and mercury. Condition factor, vitellogenin (Vtg), acetylcholinesterase (AChE) activities in plasma, eyes and brain, haematocrit, plasma protein and cytosolic glutathione S-transferase (GST) activities were comparable in fish from sewage ponds and Mindu dam. Although specific pollutants other than the metals were not identified by chemical analysis, application of a suite of biomarkers in C. gariepinus demonstrated that all sewage ponds were contaminated by pollutants of public health concern. PMID:20012187

  16. 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

  17. Evolving Strategies, Opportunistic Implementation: HIV Risk Reduction in Tanzania in the Context of an Incentive-Based HIV Prevention Intervention

    PubMed Central

    Packel, Laura; Keller, Ann; Dow, William H.; de Walque, Damien; Nathan, Rose; Mtenga, Sally

    2012-01-01

    Background Behavior change communication (BCC) interventions, while still a necessary component of HIV prevention, have not on their own been shown to be sufficient to stem the tide of the epidemic. The shortcomings of BCC interventions are partly due to barriers arising from structural or economic constraints. Arguments are being made for combination prevention packages that include behavior change, biomedical, and structural interventions to address the complex set of risk factors that may lead to HIV infection. Methods In 2009/2010 we conducted 216 in-depth interviews with a subset of study participants enrolled in the RESPECT study - an HIV prevention trial in Tanzania that used cash awards to incentivize safer sexual behaviors. We analyzed community diaries to understand how the study was perceived in the community. We drew on these data to enhance our understanding of how the intervention influenced strategies for risk reduction. Results We found that certain situations provide increased leverage for sexual negotiation, and these situations facilitated opportunistic implementation of risk reduction strategies. Opportunities enabled by the RESPECT intervention included leveraging conditional cash awards, but participants also emphasized the importance of exploiting new health status knowledge from regular STI testing. Risk reduction strategies included condom use within partnerships and/or with other partners, and an unexpected emphasis on temporary abstinence. Conclusions Our results highlight the importance of increasing opportunities for implementing risk reduction strategies. We found that an incentive-based intervention could be effective in part by creating such opportunities, particularly among groups such as women with limited sexual agency. The results provide new evidence that expanding regular testing of STIs is another important mechanism for providing opportunities for negotiating behavior change, beyond the direct benefits of testing. Exploiting the latent demand for STI testing should receive renewed attention as part of innovative new combination interventions for HIV prevention. PMID:22952872

  18. Transactional sex amongst young people in rural northern Tanzania: an ethnography of young women's motivations and negotiation

    PubMed Central

    2010-01-01

    Background Material exchange for sex (transactional sex) may be important to sexual relationships and health in certain cultures, yet the motivations for transactional sex, its scale and consequences are still little understood. The aim of this paper is to examine young women's motivations to exchange sex for gifts or money, the way in which they negotiate transactional sex throughout their relationships, and the implications of these negotiations for the HIV epidemic. Method An ethnographic research design was used, with information collected primarily using participant observation and in-depth interviews in a rural community in North Western Tanzania. The qualitative approach was complemented by an innovative assisted self-completion questionnaire. Findings Transactional sex underlay most non-marital relationships and was not, per se, perceived as immoral. However, women's motivations varied, for instance: escaping intense poverty, seeking beauty products or accumulating business capital. There was also strong pressure from peers to engage in transactional sex, in particular to consume like others and avoid ridicule for inadequate remuneration. Macro-level factors shaping transactional sex (e.g. economic, kinship and normative factors) overwhelmingly benefited men, but at a micro-level there were different dimensions of power, stemming from individual attributes and immediate circumstances, some of which benefited women. Young women actively used their sexuality as an economic resource, often entering into relationships primarily for economic gain. Conclusion Transactional sex is likely to increase the risk of HIV by providing a dynamic for partner change, making more affluent, higher risk men more desirable, and creating further barriers to condom use. Behavioural interventions should directly address how embedded transactional sex is in sexual culture. PMID:20429913

  19. 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

  20. Bypassing primary care clinics for childbirth: a cross-sectional study in the Pwani region, United Republic of Tanzania

    PubMed Central

    Hermosilla, Sabrina; Larson, Elysia; Mbaruku, Godfrey M

    2014-01-01

    Abstract Objective To measure the extent, determinants and results of bypassing local primary care clinics for childbirth among women in rural parts of the United Republic of Tanzania. Methods Women were selected in 2012 to complete a structured interview from a full census of all 30?076 households in clinic catchment areas in Pwani region. Eligibility was limited to those who had delivered between 6 weeks and 1 year before the interview, were at least 15 years old and lived within the catchment areas. Demographic and delivery care information and opinions on the quality of obstetric care were collected through interviews. Clinic characteristics were collected from staff via questionnaires. Determinants of bypassing (i.e. delivery of the youngest child at a health centre or hospital without provider referral) were analysed using multivariate logistic regression. Bypasser and non-bypasser birth experiences were compared in bivariate analyses. Findings Of 3019 eligible women interviewed (93% response rate), 71.0% (2144) delivered in a health facility; 41.8% (794) were bypassers. Bypassing likelihood increased with primiparity (odds ratio, OR: 2.5; 95% confidence interval, CI: 1.9–3.3) and perceived poor quality at clinics (OR: 1.3; 95% CI: 1.0–1.7) and decreased if clinics recently underwent renovations (OR: 0.39; 95% CI: 0.18–0.84) and/or performed ??4 obstetric signal functions (OR: 0.19; 95% CI: 0.08–0.41). Bypassers reported better quality of care on six of seven quality of care measures. Conclusion Many pregnant women, especially first-time mothers, choose to bypass local primary care clinics for childbirth. Perceived poor quality of care at clinics was an important reason for bypassing. Primary care is failing to meet the obstetric needs of many women in this rural, low-income setting. PMID:24700992

  1. A 'mystery client' evaluation of adolescent sexual and reproductive health services in health facilities from two regions in Tanzania.

    PubMed

    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

  2. Studies on the ecology of Bulinus globosus, the intermediate host of Schistosoma haematobium in the Ifakara area, Tanzania.

    PubMed

    Marti, H P; Tanner, M; Degrémont, A A; Freyvogel, T A

    1985-06-01

    During a period of 2 years, the ecology of Bulinus globosus was studied in 8 habitats in two streams near Ifakara, SE-Tanzania. The relative Bulinus densities were followed monthly. Two different methods for estimating snail densities (man/time vs. palmleaf traps) gave comparable results. Bulinus densities were constantly low throughout the year in the stream, but they showed distinct seasonal fluctuations in adjacent pools, with a density-peak at the end of the small rainy season. B. globosus, identified by starch gel electrophoresis, was found to be the only intermediate host for urinary schistosomiasis in the investigated streams. A correlation of the Bulinus densities with several abiotic and biotic factors revealed that pH, temperature and conductivity had little effect on the Bulinus population, as they oscillated within the tolerated limits. No correlation of the distribution of B. globosus and other snail species was found. Rainfall patterns have a distinct influence on snail densities. They determine the duration of desiccation and affect the snails by fluctuations of the water level and by the fast increase of water velocity after heavy rains. B. globosus shows a clear predilection for the sedge Cyperus exaltatus as support for oviposition. It is also preferred as food and/or food-support. During the dry season, oviposition of B. globosus is concentrated in clearly defined sites ("breeding pockets"), which, due to the lowering of the water level, become isolated from the stream or retain only a small connection to it. These sites form important reservoirs of B. globosus, from where the snails are spread when the sites are flooded during the subsequent rainy season. The significance of these observations for control measures is discussed. PMID:2862780

  3. Multi-Level Factors Affecting Entry into and Engagement in the HIV Continuum of Care in Iringa, Tanzania

    PubMed Central

    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

  4. Attitudes towards African traditional medicine and Christian spiritual healing regarding treatment of epilepsy in a rural community of northern Tanzania.

    PubMed

    Winkler, Andrea Sylvia; Mayer, Michael; Ombay, Michael; Mathias, Bartholomayo; Schmutzhard, Erich; Jilek-Aall, Louise

    2010-01-01

    Most people with epilepsy (PWE) live in developing countries with limited access to health care facilities. In sub-Saharan Africa with approximately 12 million PWE, 90% do not receive adequate medical treatment. In this context, traditional medicine, being easily accessible, plays an important role. However, in sub- Saharan Africa, studies on the attitude of people (both affected and not affected by epilepsy) towards traditional medicine for treatment of epilepsy are scarce. In this study, 167 people (59 PWE, 62 relatives, 46 villagers) were interviewed at the hospital and in the community with a semi-structured validated questionnaire regarding the prevailing attitude towards traditional medicine for treatment of epilepsy in a rural area of northern Tanzania. Various traditional healing methods (THM) could be ascertained, i.e. traditional herbal medicine, spiritual healing, scarifications and spitting. 44.3% (n=74/167) of the interviewed people were convinced that epilepsy could be treated successfully with THM. Interestingly, 34.1% (n=57/167) thought that Christian prayers could cure the cause and/or treat symptoms of epilepsy. Significantly more PWE and their relatives were in favour of THM compared to villagers not knowing about epilepsy or not being immediately affected by epilepsy (?(2)-test, p=0.004). Further factors influencing people's attitudes towards THM were gender, tribe, religion and urbanity of people's dwellings. Our study demonstrates that not only THM but also prayers in the Christian sense seem to play an important role in people's beliefs regarding successful treatment of epilepsy. Factors influencing this belief system have been identified and are discussed. PMID:21304629

  5. Molecular characterization of African swine fever virus from domestic pigs in northern Tanzania during an outbreak in 2013.

    PubMed

    Misinzo, Gerald; Kwavi, David E; Sikombe, Christopher D; Makange, Mariam; Peter, Emma; Muhairwa, Amandus P; Madege, Michael J

    2014-10-01

    African swine fever (ASF) is an acute, highly contagious and deadly viral hemorrhagic fever of domestic pigs caused by African swine fever virus (ASFV), a double-stranded DNA virus of the family Asfarviridae. In this study, molecular diagnosis and characterization of outbreak ASFV in northern Tanzania, was performed on spleen, lymph node, kidney, and heart samples collected in June and July 2013 from domestic pigs that died during a hemorrhagic disease outbreak. Confirmatory diagnosis of ASF was performed using polymerase chain reaction (PCR) by partial amplification of B646L gene of ASFV encoding the major capsid protein p72 using PPA1/PPA2 primers. PCR using PPA1/PPA2 primers produced an expected PCR product size, confirming ASF outbreak in northern Tanzania. In addition, nucleotide amplification and sequencing, and phylogenetic reconstruction of the variable 3'-end of the B646L gene and complete E183L gene encoding the inner envelope transmembrane protein p54 showed that the 2013 outbreak ASFV from northern Tanzania were 100 % identical and clustered into ASFV B646L (p72) and E183L (p54) genotype X. Furthermore, the tetrameric amino acid repeats within the central variable region (CVR) of the B602L gene coding for the J9L protein had the signature BNBA(BN)5NA with a single novel tetramer NVDI (repeat code N). The results of the present study confirm an ASF outbreak in northern Tanzania in the year 2013 and show that the present outbreak ASFV is closely related to other ASFV from ticks, warthogs, and domestic pigs previously reported from Tanzania. PMID:24996815

  6. Effectiveness of community based safe motherhood promoters in improving the utilization of obstetric care. The case of Mtwara Rural District in Tanzania

    Microsoft Academic Search

    Declare Mushi; Rose Mpembeni; Albrecht Jahn

    2010-01-01

    BACKGROUND: In Tanzania, maternal mortality ratio remains unacceptably high at 578\\/100,000 live births. Despite a high coverage of antenatal care (96%), only 44% of deliveries take place within the formal health services. Still, \\

  7. Operational performance of an STD control programme in Mwanza Region, Tanzania

    PubMed Central

    Grosskurth, H.; Mwijarubi, E.; Todd, J.; Rwakatare, M.; Orroth, K.; Mayaud, P.; Cleophas, B.; Buve, A.; Mkanje, R.; Ndeki, L.; Gavyole, A.; Hayes, R.; Mabey, D.

    2000-01-01

    Objectives: To describe important details of the design and operational features of the Mwanza sexually transmitted diseases (STD) control programme. To assess the feasibility of the intervention, the distribution of STD syndromes observed, the clinical effectiveness of syndromic STD case management, the utilisation of STD services by the population, and the quality of syndromic STD services delivered at rural health units. Methods: The intervention was integrated into rural primary healthcare (PHC) units. It comprised improved STD case management using the syndromic approach, facilitated by a regional programme office which ensured the training of health workers, a reliable supply of effective drugs, and regular support supervision. Five studies were performed to evaluate operational performance: (i) a survey of register books to collect data on patients presenting with STDs and reproductive tract infections (RTIs) to rural health units with improved STD services, (ii) a survey of register books from health units in communities without improved services, (iii) a survey of register books from referral clinics, (iv) a home based cross sectional study of STD patients who did not return to the intervention health units for follow up, (v) a cross sectional survey of reported STD treatment seeking behaviour in a random cohort of 8845 adults served by rural health units. Results: During the 2 years of the Mwanza trial, 12 895 STD syndromes were treated at the 25 intervention health units. The most common syndromes were urethral discharge (67%) and genital ulcers (26%) in men and vaginal discharge (50%), lower abdominal tenderness (33%), and genital ulcers (13%) in women. Clinical treatment effectiveness was high in patients from whom complete follow up data were available, reaching between 81% and 98% after first line treatment and 97%–99% after first, second, and third line treatment. Only 26% of patients referred to higher levels of health care had presented to their referral institutions. During the trial period, data from the cohort showed that 12.8% of men and 8.6% of women in the intervention communities experienced at least one STD syndrome. Based on various approaches, utilisation of the improved health units by symptomatic STD patients in these communities was estimated at between 50% and 75%. During the first 6 months of intervention attendance at intervention units increased by 53%. Thereafter, the average attendance rate was about 25% higher than in comparison communities. Home visits to 367 non-returners revealed that 89% had been free of symptoms after treatment, but 28% became symptomatic again within 3 months of treatment. 100% of these patients reported that they had received treatment, but only 74% had been examined, only 57% had been given health education, and only 30% were offered condoms. Patients did not fully recall which treatment they had been given, but possibly only 63% had been treated exactly according to guidelines. Conclusions: This study demonstrated that it is feasible to integrate effective STD services into the existing PHC structure of a developing country. Improved services attract more patients, but additional educational efforts are needed to further improve treatment seeking behaviour. Furthermore, clear treatment guidelines, a reliable drug supply system, and regular supervision are critical. All efforts should be made to treat patients on the spot, without delay, as referral to higher levels of care led to a high number of dropouts. The syndromic approach to STD control should be supported by at least one reference clinic and laboratory per country to ensure monitoring of prevalent aetiologies, of the development of bacterial resistance, and of the effectiveness of the syndromic algorithms in use. Key Words: sexually transmitted infections; syndromic treatment; programme performance; Tanzania PMID:11221123

  8. 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.

  9. A cluster-randomized trial of mass drug administration with a gametocytocidal drug combination to interrupt malaria transmission in a low endemic area in Tanzania

    PubMed Central

    2011-01-01

    Background Effective mass drug administration (MDA) with anti-malarial drugs can clear the human infectious reservoir for malaria and thereby interrupt malaria transmission. The likelihood of success of MDA depends on the intensity and seasonality of malaria transmission, the efficacy of the intervention in rapidly clearing all malaria parasite stages and the degree to which symptomatic and asymptomatic parasite carriers participate in the intervention. The impact of MDA with the gametocytocidal drug combination sulphadoxine-pyrimethamine (SP) plus artesunate (AS) plus primaquine (PQ, single dose 0.75 mg/kg) on malaria transmission was determined in an area of very low and seasonal malaria transmission in northern Tanzania. Methods In a cluster-randomized trial in four villages in Lower Moshi, Tanzania, eight clusters (1,110 individuals; cluster size 47- 209) were randomized to observed treatment with SP+AS+PQ and eight clusters (2,347 individuals, cluster size 55- 737) to treatment with placebo over three days. Intervention and control clusters were 1km apart; households that were located between clusters were treated as buffer zones where all individuals received SP+AS+PQ but were not selected for the evaluation. Passive case detection was done for the entire cohort and active case detection in 149 children aged 1-10 year from the intervention arm and 143 from the control arm. Four cross-sectional surveys assessed parasite carriage by microscopy and molecular methods during a five-month follow-up period. Results The coverage rate in the intervention arm was 93.0% (1,117/1,201). Parasite prevalence by molecular detection methods was 2.2-2.7% prior to the intervention and undetectable during follow-up in both the control and intervention clusters. None of the slides collected during cross-sectional surveys had microscopically detectable parasite densities. Three clinical malaria episodes occurred in the intervention (n = 1) and control clusters (n = 2). Conclusions This study illustrates the possibility to achieve high coverage with a three-day intervention but also the difficulty in defining suitable outcome measures to evaluate interventions in areas of very low malaria transmission intensity. The decline in transmission intensity prior to the intervention made it impossible to assess the impact of MDA in the chosen study setting. Trial Registration ClinicalTrials.gov: NCT00509015 PMID:21864343

  10. Burns in Tanzania: morbidity and mortality, causes and risk factors: a review.

    PubMed

    Outwater, Anne H; Ismail, Hawa; Mgalilwa, Lwidiko; Justin Temu, Mary; Mbembati, Naboth A

    2013-01-01

    Burn injuries in low and middle income countries still remain a significant health problem, even though numbers of burn injuries in high income countries have decreased showing that such events are not "accidents" but are usually preventable. WHO states that the vast majority (over 95%) of fire-related burns occur in low and middle income countries. Burn injuries are a major cause of prolonged hospital stays, disfigurement, disability, and death in Africa Region. Evidence shows that prevention strategies can work. However prevention strategies need to be tailored to the specific environment taking into account local risk factors and available resources. An examination of the patterns and causes of burns should allow site specific recommendations for interventions. This literature review, specific to the United Republic of Tanzania, was conducted by researching PubMed, SafetyLit, and African Journals on Line data bases for primary sources using key words <Tanzania> plus . Two sets of student data collected as part of Bachelor's degree final dissertations at Muhimbili University of Health and Allied Sciences were used. In all, twenty two primary sources were found. Risk factors for burn morbidity in Tanzania are: 1/ a young age, especially years 1-3, 2/ home environment, especially around cooking fires, 3/ epilepsy, during seizures, and 4/ perceived inevitability of the incident. It was expected that ground level cooking fires would be found to be a risk factor, but several studies have shown non-significant results about raised cooking fires, types of fuel used, and cooking appliances. Risk factors for burn mortality are: being male, between 20-30 years of age, and being punished for alleged thieving by community mobs. An important factor in reducing burn morbidity, especially in children, is to educate people that burns are preventable in most cases and that most burns occur in the home around cooking fires. Children need to be kept away from fires. Epileptics should be monitored for medication and kept away from cooking fires as well. Community members need to be encouraged to bring wrong doers to the police. PMID:23386982

  11. An in-depth, exploratory assessment of the implementation of the National Health Information System at a district level hospital in Tanzania

    PubMed Central

    2014-01-01

    Background A well functioning Health Information System (HIS) is crucial for effective and efficient health service delivery. In Tanzania there is a national HIS called Mfumo wa Taarifa za Uendeshaji Huduma za Afya (MTUHA). It comprises a guideline/manual, a series of registers for primary data collection and secondary data books where information from the registers is totalled or used for calculations. Methods A mix of qualitative methods were used. These included key informant interviews; staff interviews; participant observations; and a retrospective analysis of the hospital’s 2010 MTUHA reporting documents and the hospital’s development plan. Results All staff members acknowledged data collection as part of their job responsibilities. However, all had concerns about the accuracy of MTUHA data. Access to training was limited, mathematical capabilities often low, dissemination of MTUHA knowledge within the hospital poor, and a broad understanding of the HIS’s full capabilities lacking. Whilst data collection for routine services functioned reasonably well, filling of the secondary data tools was unsatisfactory. Internal inconsistencies between the different types of data tools were found. These included duplications, and the collection of data that was not further used. Sixteen of the total 72 forms (22.2%) that make up one of the key secondary data books (Hospital data/MTUHA book 2) could not be completed with the information collected in the primary data books. Moreover, the hospital made no use of any of the secondary data. The hospital’s main planning document was its development plan. Only 3 of the 22 indicators in this plan were the same as indicators in MTUHA, the information for 9 more was collected by the MTUHA system but figures had to be extracted and recalculated to fit, while for the remaining 10 indicators no use could be made of MTUHA at all. Conclusion The HIS in Tanzania is very extensive and it could be advisable to simplify it to the core business of data collection for routine services. Alternatively, the more comprehensive, managerial aspects could be sharpened for each type of facility, with a focus upon the hospital level. In particular, hospital planning documents need to be more closely aligned with MTUHA indicators. PMID:24572013

  12. Poor Nutrition Status and Associated Feeding Practices among HIV-Positive Children in a Food Secure Region in Tanzania: A Call for Tailored Nutrition Training

    PubMed Central

    Sunguya, Bruno F.; Poudel, Krishna C.; Mlunde, Linda B.; Urassa, David P.; Yasuoka, Junko; Jimba, Masamine

    2014-01-01

    Undernutrition among HIV-positive children can be ameliorated if they are given adequate foods in the right frequency and diversity. Food insecurity is known to undermine such efforts, but even in food rich areas, people have undernutrition. As yet no study has examined feeding practices and their associations with nutrition status among as HIV-positive children in regions with high food production. We therefore examined the magnitude of undernutrition and its association with feeding practices among HIV-positive children in a high food production region in Tanzania. Methods We conducted this mixed-method study among 748 children aged 6 months-14 years attending 9 of a total of 32 care and treatment centers in Tanga region, Tanzania. We collected quantitative data using a standard questionnaire and qualitative data through seven focus group discussions (FGDs). Results HIV-positive children had high magnitudes of undernutrition. Stunting, underweight, wasting, and thinness were prevalent among 61.9%, 38.7%, 26.0%, and 21.1% of HIV-positive children, respectively. They also had poor feeding practices: 88.1% were fed at a frequency below the recommendations, and 62.3% had a low level of dietary diversity. Lower feeding frequency was associated with stunting (??=?0.11, p?=?0.016); underweight (??=?0.12, p?=?0.029); and thinness (??=?0.11, p?=?0.026). Lower feeding frequency was associated with low wealth index (??=?0.06, p<0.001), food insecurity (??=??0.05, p<0.001), and caregiver's education. In the FGDs, participants discussed the causal relationships among the key associations; undernutrition was mainly due to low feeding frequency and dietary diversity. Such poor feeding practices resulted from poor nutrition knowledge, food insecurity, low income, and poverty. Conclusion Feeding practices and nutrition status were poor among HIV-positive children even in food rich areas. Improving feeding frequency may help to ameliorate undernutrition. To improve it, tailored interventions should target children of poor households, the food insecure, and caregivers who have received only a low level of education. PMID:24846016

  13. Malaria and Helminth Co-Infections in School and Preschool Children: A Cross-Sectional Study in Magu District, North-Western Tanzania

    PubMed Central

    Kinung'hi, Safari M.; Magnussen, Pascal; Kaatano, Godfrey M.; Kishamawe, Coleman; Vennervald, Birgitte J.

    2014-01-01

    Background Malaria, schistosomiasis and soil transmitted helminth infections (STH) are important parasitic infections in Sub-Saharan Africa where a significant proportion of people are exposed to co-infections of more than one parasite. In Tanzania, these infections are a major public health problem particularly in school and pre-school children. The current study investigated malaria and helminth co-infections and anaemia in school and pre-school children in Magu district, Tanzania. Methodology School and pre-school children were enrolled in a cross-sectional study. Stool samples were examined for Schistosoma mansoni and STH infections using Kato Katz technique. Urine samples were examined for Schistosoma haematobium using the urine filtration method. Blood samples were examined for malaria parasites and haemoglobin concentrations using the Giemsa stain and Haemoque methods, respectively. Principal Findings Out of 1,546 children examined, 1,079 (69.8%) were infected with one or more parasites. Malaria-helminth co-infections were observed in 276 children (60% of all children with P. falciparum infection). Malaria parasites were significantly more prevalent in hookworm infected children than in hookworm free children (p?=?0.046). However, this association was non-significant on multivariate logistic regression analysis (OR?=?1.320, p?=?0.064). Malaria parasite density decreased with increasing infection intensity of S. mansoni and with increasing number of co-infecting helminth species. Anaemia prevalence was 34.4% and was significantly associated with malaria infection, S. haematobium infection and with multiple parasite infections. Whereas S. mansoni infection was a significant predictor of malaria parasite density, P. falciparum and S. haematobium infections were significant predictors of anaemia. Conclusions/Significance These findings suggest that multiple parasite infections are common in school and pre-school children in Magu district. Concurrent P. falciparum, S. mansoni and S. haematobium infections increase the risk of lower Hb levels and anaemia, which in turn calls for integrated disease control interventions. The associations between malaria and helminth infections detected in this study need further investigation. PMID:24489732

  14. Integrating the management of Ruaha landscape of Tanzania with local needs and preferences.

    PubMed

    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. PMID:24126572

  15. 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

  16. 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

  17. Indigenous and Invasive Fruit Fly Diversity along an Altitudinal Transect in Eastern Central Tanzania

    PubMed Central

    Geurts, Katrien; Mwatawala, Maulid; De Meyer, Marc

    2012-01-01

    The relative abundance of indigenous and invasive frugivorous fruit flies (Diptera: Tephritidae) was evaluated spatially and temporally along an altitudinal transect between 581–1650 m in the Uluguru Mountains near Morogoro, Tanzania. The polyphagous invasive fruit fly Bactrocera invadens Drew, Tsuruta, and White and the indigenous fruit fly Ceratitis rosa Karsch show a similar temporal pattern, but are largely separated spatially, with B. invadens being abundant at lower elevation and C. rosa predominant at higher elevation. The polyphagous indigenous C. cosyra (Walker) coincides with B. invadens but shows an inverse temporal pattern. The cucurbit feeders B. cucurbitae (Coquillett) and Dacus bivittatus (Bigot) show a similar temporal pattern, but the former is restricted to lower elevations. Host availability and climatic differences seem to be the determining factors to explain the differences in occurrence and abundance in time and space. PMID:22935017

  18. Will mass drug administration eliminate lymphatic filariasis? Evidence from northern coastal Tanzania.

    PubMed

    Parker, Melissa; Allen, Tim

    2013-07-01

    This article documents understandings and responses to mass drug administration (MDA) for the treatment and prevention of lymphatic filariasis among adults and children in northern coastal Tanzania from 2004 to 2011. Assessment of village-level distribution registers, combined with self-reported drug uptake surveys of adults, participant observation and interviews, revealed that at study sites in Pangani and Muheza districts the uptake of drugs was persistently low. The majority of people living at these highly endemic locations either did not receive or actively rejected free treatment. A combination of social, economic and political reasons explain the low uptake of drugs. These include a fear of treatment (attributable, in part, to a lack of trust in international aid and a questioning of the motives behind the distribution); divergence between biomedical and local understandings of lymphatic filariasis; and limited and ineffective communication about the rationale for mass treatment. Other contributory factors are the reliance upon volunteers for distribution within villages and, in some locations, strained relationships between different groups of people within villages as well as between local leaders and government officials. The article also highlights a disjuncture between self-reported uptake of drugs by adults at a village level and the higher uptake of drugs recorded in official reports. The latter informs claims that elimination will be a possibility by 2020. This gives voice to a broader problem: there is considerable pressure for those implementing MDA to report positive results. The very real challenges of making MDA work are pushed to one side - adding to a rhetoric of success at the expense of engaging with local realities. It is vital to address the kind of issues raised in this article if current attempts to eliminate lymphatic filariasis in mainland coastal Tanzania are to achieve their goal. PMID:23014581

  19. Decentralized health care priority-setting in Tanzania: evaluating against the accountability for reasonableness framework.

    PubMed

    Maluka, Stephen; Kamuzora, Peter; San Sebastiån, Miguel; Byskov, Jens; Olsen, Øystein E; Shayo, Elizabeth; Ndawi, Benedict; Hurtig, Anna-Karin

    2010-08-01

    Priority-setting has become one of the biggest challenges faced by health decision-makers worldwide. Fairness is a key goal of priority-setting and Accountability for Reasonableness has emerged as a guiding framework for fair priority-setting. This paper describes the processes of setting health care priorities in Mbarali district, Tanzania, and evaluates the descriptions against Accountability for Reasonableness. Key informant interviews were conducted with district health managers, local government officials and other stakeholders using a semi-structured interview guide. Relevant documents were also gathered and group priority-setting in the district was observed. The results indicate that, while Tanzania has a decentralized public health care system, the reality of the district level priority-setting process was that it was not nearly as participatory as the official guidelines suggest it should have been. Priority-setting usually occurred in the context of budget cycles and the process was driven by historical allocation. Stakeholders' involvement in the process was minimal. Decisions (but not the reasoning behind them) were publicized through circulars and notice boards, but there were no formal mechanisms in place to ensure that this information reached the public. There were neither formal mechanisms for challenging decisions nor an adequate enforcement mechanism to ensure that decisions were made in a fair and equitable manner. Therefore, priority-setting in Mbarali district did not satisfy all four conditions of Accountability for Reasonableness; namely relevance, publicity, appeals and revision, and enforcement. This paper aims to make two important contributions to this problematic situation. First, it provides empirical analysis of priority-setting at the district level in the contexts of low-income countries. Second, it provides guidance to decision-makers on how to improve fairness, legitimacy, and sustainability of the priority-setting process. PMID:20554365

  20. HIV-1 Subtypes and Recombinants in Northern Tanzania: Distribution of Viral Quasispecies

    PubMed Central

    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

  1. Seroprevalence of Rift Valley fever virus infection in camels (dromedaries) in northern Tanzania.

    PubMed

    Swai, Emmanuel Senyael; Sindato, Calvin

    2015-02-01

    Rift Valley fever (RVF) is an arthropod-borne viral zoonotic disease that affects a wide range of animals including sheep, goats, cattle, camels and humans. Camels have only recently been introduced into Tanzania and, as a result, there is no credible diseases status information concerning this population, estimated to be in the low hundreds. As part of a broader study on camel diseases in different localities of northern Tanzania, serum samples (n?=?109) were collected from apparently healthy, non-vaccinated camels during the period June to August 2010 and tested for antibodies specific to RVF virus (RVFV) using the inhibition enzyme-linked immunosorbent assay (ELISA). Overall, herd and individual camel IgG seroprevalence was 78.5 % (11/14) and 27.5 % (30/109), respectively. IgG was found to be most prevalent in camels from Kilindi and Hai districts (45 %, each) and in introduced camels from other areas (37.1 %). The relationship between age and seropositivity showed that the seroprevalence was the highest (84.6 %) in age group of ?10 years and lowest (11.9 %) in age group of ?5 years.The results of this study reveal that evidence of camels being exposed to RVFV and that the risk of seropositivity varied according to district, being higher in Kilindi and Hai compared with other districts sampled. The risk of seropositivity increased with increasing animal age and the introduction of camels into the herd. Based on these study findings, continuous disease surveillance of camels for RVFV is indicated. PMID:25432300

  2. 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

  3. Influence of satellite-derived rainfall patterns on plague occurrence in northeast Tanzania

    PubMed Central

    2010-01-01

    Background In the tropics, rainfall data are seldom accurately recorded, and are often discontinuous in time. In the scope of plague-research in northeast Tanzania, we adapted previous research to reconstruct rainfall patterns at a suitable resolution (1 km), based on time series of NDVI: more accurate satellite imagery was used, in the form of MODIS NDVI, and rainfall data were collected from the TRMM sensors instead of in situ data. First, we established a significant relationship between monthly rainfall and monthly composited MODIS NDVI. The established linear relationship was then used to reconstruct historic precipitation patterns over a mountainous area in northeastern Tanzania. Results We validated the resulting precipitation estimates with in situ rainfall time series of three meteorological stations located in the study area. Taking the region's topography into account, a correlation coefficient of 0.66 was obtained for two of the three meteorological stations. Our results suggest that the adapted strategy can be applied fruitfully to estimate rainfall variability and seasonality, despite the underestimation of overall rainfall rates. Based on this model, rainfall in previous years (1986) is modelled to obtain a dataset with which we can compare plague occurrence in the area. A positive correlation of 82% is obtained between high rainfall rates and plague incidence with a two month lag between rainfall and plague cases. Conclusions We conclude that the obtained results are satisfactory in support of the human plague research in which this study is embedded, and that this approach can be applied in other studies with similar goals. PMID:21144014

  4. Newborn care practices in Pemba Island (Tanzania) and their implications for newborn health and survival.

    PubMed

    Thairu, Lucy; Pelto, Gretel

    2008-07-01

    Newborn mortality accounts for about one-third of deaths in children under five. Neglecting this problem may undermine the fourth Millennium Development Goal of reducing child mortality by two-thirds by 2015. This study was conducted in Tanzania, where an estimated 32/1000 infants die within the first 28 days. Our objective was to describe newborn care practices and their potential impact on newborn health. We interviewed two purposive samples of mothers from Pemba Island, a predominantly Muslim community of Arab-African ethnicity, and one of Tanzania's poorest. The first sample of mothers (n = 12) provided descriptive data; the second (n = 26) reported actual practice. We identified cultural beliefs and practices that promote early initiation of breastfeeding and bonding, including 'post-partum seclusion'. We also identified practices which are potentially harmful for newborn health, such as bathing newborns immediately after delivery, a practice motivated by concerns about 'ritual pollution', which may lead to newborn hypothermia and premature breast milk supplementation (e.g. with water and other fluids) which may expose newborns to pathogens. Some traditional practices to treat illness, such as exposing sick newborns to medicinal smoke from burning herbs, are also of concern. It is unclear whether the practice of massaging newborns with coconut oil is harmful or beneficial. Interventions to reduce neonatal mortality need to identify and address the cultural rationales that underlie negative practices, as well as reinforce and protect the beliefs that support positive practices. The results suggest the need to improve use of health services through improving health worker communication skills and social management of patients, as well as by lowering healthcare costs. PMID:18582353

  5. Mapping socio-economic scenarios of land cover change: A GIS method to enable ecosystem service modelling

    E-print Network

    Vermont, University of

    Mapping socio-economic scenarios of land cover change: A GIS method to enable ecosystem service, Chuo Kikuu, Morogoro, Tanzania e School of Geography, University of Leeds, Leeds LS2 9JT, United of York, Heslington, York YO10 5DD, United Kingdom i Flamingo Land Ltd., Kirby Misperton, Malton, North

  6. Divinity and distress: the impact of religion and spirituality on the mental health of HIV-positive adults in Tanzania.

    PubMed

    Steglitz, Jeremy; Ng, Reuben; Mosha, John S; Kershaw, Trace

    2012-11-01

    This study examined the relationship between religiosity, spirituality and mental health in the context of a stress-coping framework. Participants were 135 rural, low-income HIV-positive adults in Iringa, Tanzania. The relationships between religiosity, spirituality, coping responses, social support, and psychological distress (depression, anxiety, and stress) were examined using structural equation modeling. Religiosity was related to decreased avoidant coping and increased social support, which in turn were related to psychological distress. Spirituality was positively related to active coping and social support. Results suggest that coping strategies and social support may mediate the relationship between religiosity and spirituality and psychological distress. Interventions to reduce psychological distress among HIV-positive individuals in Tanzania might incorporate strategies to reduce avoidant coping and increase social support. According to the present findings, this may be accomplished through faith-based approaches that incorporate religious and spiritual activities into HIV prevention programs. PMID:22797930

  7. Condom availability in high risk places and condom use: a study at district level in Kenya, Tanzania and Zambia

    PubMed Central

    2012-01-01

    Background A number of studies from countries with severe HIV epidemics have found gaps in condom availability, even in places where there is a substantial potential for HIV transmission. Although reported condom use has increased in many African countries, there are often big differences by socioeconomic background. The aim of this study was to assess equity aspects of condom availability and uptake in three African districts to evaluate whether condom programmes are given sufficient priority. Methods Data on condom availability and use was examined in one district in Kenya, one in Tanzania and one in Zambia. The study was based on a triangulation of data collection methods in the three study districts: surveys in venues where people meet new sexual partners, population-based surveys and focus group discussions. The data was collected within an overall study on priority setting in health systems. Results At the time of the survey, condoms were observed in less than half of the high risk venues in two of the three districts and in 60% in the third district. Rural respondents in the population-based surveys perceived condoms to be less available and tended to be less likely to report condom use than urban respondents. Although focus group participants reported that condoms were largely available in their district, they expressed concerns related to the accessibility of free condoms. Conclusion As late as thirty years into the HIV epidemic there are still important gaps in the availability of condoms in places where people meet new sexual partners in t