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Sample records for salaam tanzania methods

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-05-01

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

  3. Suicide in the Dar es Salaam region, Tanzania, 2005.

    PubMed

    Mgaya, Edward; Kazaura, Method R; Outwater, Anne; Kinabo, Lina

    2008-04-01

    Suicide surveillance was launched at the Muhimbili National Hospital mortuary in Dar es Salaam Region, Tanzania from 1st January to 31st December, 2005 to determine its magnitude and characteristics. Following the WHO guidelines with minor modifications, information on sex, dates of birth and death, places of residence and death, occupation, reasons and means of suicide were collected. There were 65 (2.3 per 100,000 population) suicides recorded in 2005. The suicide rate for males was 3.4/100,000 and for females was 1.2/100,000 which maybe some of the lowest rates ever reported in the world. The mean age at suicide was 32.9 (SD=13.1) years. Males were about three times more likely to commit suicide as females. The main motive behind suicide was recorded for 26 (40%) victims as family-related and for 11 (17%) as health related. Although there was a wide range of ages at which people committed suicide, the average age seems to be very low. Since reasons for suicide are coated with family problems, strategies to improve awareness of psychological and mental health services and to provide alternative economic and social support networks are advocated. PMID:18313013

  4. Factors Contributing to the Accumulation of Primary Teacher's Debts to the Government of Tanzania: A Case Study for Dar Es Salaam Region

    ERIC Educational Resources Information Center

    Kombo, Ibun

    2015-01-01

    This paper presents the findings of the study which was conducted to determine factors contributing to the accumulation of primary school teacher's debts to the Government of Tanzania, a case study of Dar es Salaam Region in its three municipalities namely, Ilala, Kinondoni and Temeke. Data was obtained through sampling method which also helped to…

  5. Clinical, Virologic, and Epidemiologic Characteristics of Dengue Outbreak, Dar es Salaam, Tanzania, 2014

    PubMed Central

    Mboera, Leonard E.G.; De Nardo, Pasquale; Oriyo, Ndekya M.; Meschi, Silvia; Rumisha, Susan F.; Colavita, Francesca; Mhina, Athanas; Carletti, Fabrizio; Mwakapeje, Elibariki; Capobianchi, Maria Rosaria; Castilletti, Concetta; Di Caro, Antonino; Nicastri, Emanuele; Malecela, Mwelecele N.; Ippolito, Giuseppe

    2016-01-01

    We investigated a dengue outbreak in Dar es Salaam, Tanzania, in 2014, that was caused by dengue virus (DENV) serotype 2. DENV infection was present in 101 (20.9%) of 483 patients. Patient age and location of residence were associated with infection. Seven (4.0%) of 176 patients were co-infected with malaria and DENV. PMID:27088845

  6. Clinical, Virologic, and Epidemiologic Characteristics of Dengue Outbreak, Dar es Salaam, Tanzania, 2014.

    PubMed

    Vairo, Francesco; Mboera, Leonard E G; De Nardo, Pasquale; Oriyo, Ndekya M; Meschi, Silvia; Rumisha, Susan F; Colavita, Francesca; Mhina, Athanas; Carletti, Fabrizio; Mwakapeje, Elibariki; Capobianchi, Maria Rosaria; Castilletti, Concetta; Di Caro, Antonino; Nicastri, Emanuele; Malecela, Mwelecele N; Ippolito, Giuseppe

    2016-05-01

    We investigated a dengue outbreak in Dar es Salaam, Tanzania, in 2014, that was caused by dengue virus (DENV) serotype 2. DENV infection was present in 101 (20.9%) of 483 patients. Patient age and location of residence were associated with infection. Seven (4.0%) of 176 patients were co-infected with malaria and DENV. PMID:27088845

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

    PubMed Central

    Chacha, Chacha Emmanuel; Kazaura, Method R.

    2015-01-01

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

  8. 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

  9. National and Global: A History of Scholars' Experiences with Research at the University of Dar Es Salaam, Tanzania (1961-Present)

    ERIC Educational Resources Information Center

    Jamison, Amy J.

    2010-01-01

    In this dissertation, I draw on research carried out at the University of Dar es Salaam (UDSM), Tanzania in 2008 to examine Tanzanian academics' experience with research throughout the history of this institution. This dissertation is designed as an historical case study and investigates how economic and political changes in Tanzania's…

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  11. Knowledge and attitudes towards obesity among primary school children in Dar es Salaam, Tanzania

    PubMed Central

    Njelekela, Marina A; Muhihi, Alfa; Mpembeni, Rose N. M.; Anaeli, Amani; Chillo, Omary; Kubhoja, Sulende; Lujani, Benjamin; Ngarashi, Davis; Maghembe, Mwanamkuu

    2015-01-01

    Background: Childhood obesity has increased over the past two decades. Child obesity is likely to persist through adulthood and increases the risk of non-communicable diseases (NCDs) later in life. This study assessed knowledge and attitudes towards obesity among primary school children in Dar es Salaam, Tanzania. Materials and Methods: A cross-sectional study was conducted in randomly selected primary schools in Dar es Salaam. A structured questionnaire was used to assess the knowledge and attitudes. Anthropometric and blood pressure measurements were taken using standard procedures. Results: A total of 446 children were included in the analysis. The mean age of the participants was 11.1 2.0 years. The mean body mass index (BMI), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 16.6 4.0 kg/m2, 103.9 10.3 mmHg and 65.6 8.2 mmHg, respectively. Prevalence of obesity (defined as BMI >95th percentile for age and sex) was 5.2%. Half of the children (51.1%) had heard about obesity from teachers at school (20%), radio (19.4%) and books/newspaper (17.3%). Less than half (45.4%) had knowledge about the risk factors for childhood obesity and correctly defined obesity (44.6%). However, a good number of the children (72.1%) were aware that they can be affected by obesity. Majority of them had negative attitude towards obesity and various factors leading to or resulting from childhood obesity. Conclusions: Knowledge about childhood obesity among primary school children is moderate and have negative attitude towards obesity. Integrating educational programs early in primary schools may be an effective strategy to impact knowledge about obesity and other non-communicable diseases early in childhood. PMID:25838624

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

    PubMed Central

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

    2015-01-01

    Introduction The purpose of this study was to determine prevalence of helmet use among motorcyclists as one of the preventive measures for road traffic injuries. Methods A cross sectional observational survey was conducted in the 3 Districts (Kinondoni, Ilala and Temeke) that make Dar es Salaam. Tanzania. A standardized line-listing form and checklist were used to record the drivers and passengers use of helmet as observed by study investigators. Data for helmet use was collected on one weekday and one weekend day. Time for observation was during the rush hour in the morning, noon and evening. Then data were entered into Epi Info 3.5.1 analysis Results A total of 7,678 motorcycle drivers and 4,328 passengers observed in this study. Drivers were almost male (98.8%) and 73.2% of all passengers were males. The prevalence use of helmet use among motorcyclist's riders was 82.1% and among passengers was 22.5%. Proportion of helmet use in drivers and passengers observed were relatively similar during weekday and weekend day and time of observation. Conclusion This study showed the relative high helmet use among motorcyclist riders though very low in passengers. This study recommends increased community awareness on helmet use among passengers and enforcement and revival of road safety laws of passengers and motorcyclists on helmet use. PMID:26309470

  13. Intimate Partner Violence and the Association with HIV Risk Behaviors among Young Men in Dar Es Salaam, Tanzania

    ERIC Educational Resources Information Center

    Maman, Suzanne; Yamanis, Thespina; Kouyoumdjian, Fiona; Watt, Melissa; Mbwambo, Jessie

    2010-01-01

    There is growing evidence of the association between gender-based violence and HIV from the perspective and experiences of women. The purpose of this study is to examine these associations from the perspective of young men living in Dar es Salaam, Tanzania. A community-based sample of 951 men were interviewed, of whom 360 had sex in the past 6…

  14. Abortions in a hospital setting: hidden realities in Dar es Salaam, Tanzania.

    PubMed

    Justesen, A; Kapiga, S H; van Asten, H A

    1992-01-01

    This study investigates the extent of unwanted pregnancy, the use of illegally induced abortion, and the attitudes toward and practice of contraception among women admitted to a hospital with the diagnosis of abortion in Dar es Salaam, Tanzania. (In Tanzania, induced abortion is permitted only to save the mother's life.) A random sample of 300 women with early pregnancy loss admitted to Muhimbili Medical Centre, the teaching hospital in Dar es Salaam, were interviewed between September and November 1987, using a structured questionnaire. Among the 300 respondents, 155 said that their pregnancy had been unwanted: 94 of them presented with an illegally induced abortion and 61 with a spontaneous abortion. The number of spontaneous abortions of unwanted pregnancies increased with age and stability in a relationship. Having a small child to look after and having completed the family were the most common reasons for the pregnancy to be unwanted in this group. Induced abortion was more a problem of the young, unmarried woman. The 61 women with spontaneous abortion but unwanted pregnancy suggest that a much larger group of pregnant women continue to term with what are, at least initially, unwanted pregnancies--precisely the group of women family planning programs want to reach. The low prevalence of contraceptive use in this group indicates the failure of family planning clinics to motivate their target group. Recommendations are made for improved functioning of family planning clinics. PMID:1475800

  15. 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

  16. Factors for change in maternal and perinatal audit systems in Dar es Salaam hospitals, Tanzania

    PubMed Central

    2010-01-01

    Background Effective maternal and perinatal audits are associated with improved quality of care and reduction of severe adverse outcome. Although audits at the level of care were formally introduced in Tanzania around 25 years ago, little information is available about their existence, performance, and practical barriers to their implementation. This study assessed the structure, process and impacts of maternal and perinatal death audit systems in clinical practice and presents a detailed account on how they could be improved. Methods A cross sectional descriptive study was conducted in eight major hospitals in Dar es Salaam in January 2009. An in-depth interview guide was used for 29 health managers and members of the audit committees to investigate the existence, structure, process and outcome of such audits in clinical practice. A semi-structured questionnaire was used to interview 30 health care providers in the maternity wards to assess their awareness, attitude and practice towards audit systems. The 2007 institutional pregnancy outcome records were reviewed. Results Overall hospital based maternal mortality ratio was 218/100,000 live births (range: 0 - 385) and perinatal mortality rate was 44/1000 births (range: 17 - 147). Maternal and perinatal audit systems existed only in 4 and 3 hospitals respectively, and key decision makers did not take part in audit committees. Sixty percent of care providers were not aware of even a single action which had ever been implemented in their hospitals because of audit recommendations. There were neither records of the key decision points, action plan, nor regular analysis of the audit reports in any of the facilities where such audit systems existed. Conclusions Maternal and perinatal audit systems in these institutions are poorly established in structure and process; and are less effective to improve the quality of care. Fundamental changes are urgently needed for successful audit systems in these institutions. PMID:20525282

  17. 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.

  18. A call for parental monitoring to improve condom use among secondary school students in Dar es Salaam, Tanzania

    PubMed Central

    2012-01-01

    Background The number of people newly infected with human immunodeficiency virus (HIV) has been decreasing in sub-Saharan Africa, but prevalence of the infection remains unacceptably high among young people. Despite the alarming pervasiveness of the virus, young people in this region continue to engage in risky sexual behaviors including unprotected sexual intercourse. In developed countries, parents can play important roles in protecting young people from such behaviors, but evidence regarding the impact of parental involvement is still limited in sub-Saharan Africa. Therefore, we conducted this study to examine the magnitude of risky sexual behaviors and the association of parental monitoring and parental communication with condom use at last sexual intercourse among secondary school students in Dar es Salaam, Tanzania. Methods We conducted this cross-sectional study among 2,217 male and female students aged 15 to 24 years from 12 secondary schools in Dar es Salaam. From October to November 2011, we collected data using a self-administered questionnaire. Multiple logistic regression analyses were conducted to examine the association of parental monitoring and parental communication with condom use at last sexual intercourse, adjusting for potential confounders. Results A total of 665 (30.3%) secondary school students reported being sexually active within the year prior to data collection. Among them, 41.7% had multiple sexual partners, 10.5% had concurrent sexual partners, and 41.1% did not use a condom at last sexual intercourse. A higher level of parental monitoring was associated with increased likelihood of condom use at last sexual intercourse among male students (AOR: 1.56, 95% CI: 1.05-2.32; p = 0.03) but not among female students (AOR: 1.54, 95% CI: 0.71-3.37; p = 0.28). The association between parental communication and condom use at last sexual intercourse among both male and female students was not statistically significant. Conclusions A high level of parental monitoring is associated with more consistent condom use among male students in Dar es Salaam, Tanzania -- many of whom have engaged in high-risk sexual behaviors such as multiple sexual partnerships, concurrent sexual partnerships, and unprotected sexual intercourse in the past one year. Interventions should thus be strengthened to reduce multiple sexual partnerships, concurrent sexual partnerships, and to improve parental monitoring among such students toward increasing condom use. PMID:23216949

  19. [Forensic medicine in Dar-es-Salaam, United Republic of Tanzania].

    PubMed

    Kibayashi, K; Tsunenari, S

    1998-02-01

    The authors had opportunities to visit and see the present state of forensic medicine in Dar-es-Salaam, a capital city of United Republic of Tanzania. In this city, Department of Histopathology and Morbid Anatomy in Muhimbili University College of Health Sciences is in charge of education and practice of forensic medicine. All bodies of unusual death, about 3,000 cases per year, are brought to the university mortuary and examined by pathologists. An order of forensic autopsy from the Tanzanian police is submitted to the department with details of the case, i.e. circumstances of death, witnesses, weapons, etc. In each case, a pathologist signs out a death certificate and issues an autopsy report which is standardized throughout the country. Embalming after autopsy is essential in a tropical country. Tanzania in particular, to prevent both putrefaction of the body and dispersion of pathogens during its transportation. Preventive measures against biohazards from human immunodeficiency virus-infected bodies are considered in the autopsy room and laboratory. Although Tanzania is one of the developing countries in the world, the forensic medicine in the capital city is rendering great services in the promotion of public health. PMID:9591404

  20. Serological evidence of Lyme borreliosis in Africa: results from studies in Dar es Salaam, Tanzania.

    PubMed

    Mhalu, F S; Matre, R

    1996-09-01

    Investigations were performed on sera from blood donors, pregnant women, patients with polyarthritis and from patients with clinical suspicion of syphilis in Dar es Salaam using Borrelia burgdorferi (Bb) flagellar antigen in a second generation ELISA test from DAKO A/S, Denmark, for specific IgM or IgG antibodies. An IgM and or IgG seropositivity rate of 30/100 (30%), 19/50 (7.2%), 10/20 (50%) and 11/20 (55%) was found in sera from the respective groups. These results compare with a Bb seroprevalence rate of 4/100 (4%), 1/52 (2%) and 363/5024 (7.2%) in blood donors, in pregnant women and in patients investigated serologically for Lyme borreliosis (Lb) respectively in Bergen, Norway, where cases of Lb are detected regularly. The high prevalence of antibodies to Bb flagellar antigen in Dar es Salaam, Tanzania where clinical conditions including erythema migrans, arthritis, mycocarditis and CNS diseases as well as tickbites are found call for further clinical, entomological and laboratory investigations. PMID:8991238

  1. Prevalence of obesity and associated risk factors among adults in Kinondoni municipal district, Dar es Salaam Tanzania

    PubMed Central

    2011-01-01

    Background Obesity is on the rise worldwide, not sparing developing countries. Both demographic and socio-economic factors play parts in obesity causation. Few surveys have been conducted in Tanzania to determine the magnitude of obesity and its association with these risk factors. This study aimed at determining the prevalence of obesity and its associated risk factors among adults aged 18 - 65 years in Kinondoni municipality, Dar es Salaam, Tanzania from April 2007 to April 2008. Methods Random sampling of households was performed. Interviews and anthropometric measurement were carried out to eligible and consenting members of the selected households. Obesity was defined using Body Mass Index (BMI). Results Out of 1249 subjects recruited, 814 (65.2%) were females. The overall prevalence of obesity was 19.2% (240/1249). However, obesity was significantly more prevalent in women (24.7%) than men (9%), p < 0.001, among respondents with high socio-economic status (29.2%) as compared to those with medium (14.3%) and low socio-economic status (11.3%), p value for trend < 0.001, and among respondents with light intensity activities (26.0%), p value for trend < 0.001. Conclusion This study revealed a higher prevalence of obesity among Kinondoni residents than previously reported in other parts of the country. Independent predictors of obesity in the population studied were increasing age, marriage and cohabitation, high SES, female sex and less vigorous physical activities. PMID:21605360

  2. 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

  3. 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

  4. Integrated urban malaria control: a case study in dar es salaam, Tanzania.

    PubMed

    Caldas de Castro, Marcia; Yamagata, Yoichi; Mtasiwa, Deo; Tanner, Marcel; Utzinger, Jurg; Keiser, Jennifer; Singer, Burton H

    2004-08-01

    The rapid growth of cities in sub-Saharan Africa, much of it driven by rural-urban migration, is associated with complex transformations of these ecosystems and an intricate set of challenges for malaria control. Urban malaria transmission is substantially less intense and much more focal than in rural and peri-urban settings. However, the danger of epidemics is higher and the presence of substantial non-immune populations places people of all ages at comparable levels of risk. The limited number of breeding sites in urban centers suggests that prevention strategies based on vector control, with emphasis on environmental management, should be a central feature of urban malaria control programs. We focus on malaria in the city of Dar es Salaam, Tanzania. Following a brief review of the 100-year history of malaria control in this urban center, we describe and evaluate a control program that operated from 1988 to 1996 as a consequence of a bilateral agreement between the governments of Tanzania and Japan. We present an innovative urban malaria risk mapping methodology based on high-resolution aerial photography with ground-based validation. This strategy clarifies that remote sensing technology at a level of resolution of one meter is essential if this kind of information is to play a role in guiding the detailed specification of intervention strategies for urban malaria control. The Tanzania-Japan multiple-intervention malaria control program, adaptively implemented over time, is described and evaluated with implications for urban malaria control in sub-Saharan Africa more generally. PMID:15331826

  5. A qualitative study of perceived risk for HIV transmission among police officers in Dar es Salaam, Tanzania

    PubMed Central

    2013-01-01

    Background Understanding people’s views about HIV transmission by investigating a specific population may help to design effective HIV prevention strategies. In addition, knowing the inherent sexual practices of such a population, as well as the risky circumstances that may facilitate HIV transmission, is crucial for the said strategies to become effective. In this article, we report how police officers in Dar es Salaam, Tanzania, perceived the problem of HIV and AIDS in their local context, particularly in relation to unsafe sexual practices. The study was done with the view to recommending ways by which HIV transmission could be minimised within the police force. Methods The study was conducted among members of the police force in Dar es Salaam, Tanzania. Eight focus group discussions (FGDs) were conducted, with a total of 66 participants who were mixed in terms of age, gender, and marital status. Some of these were caregivers to patients with AIDS. Data were analysed using the interpretive description approach. Results The participants believed that both individual sexual behaviour and work-related circumstances were sources of HIV infection. They also admitted that they were being tempted to engage in risky sexual practices because of the institutional rules that prohibit officers from getting married during their training and for three years after. Nevertheless, as members of the Police Force, they stressed the fact that the risky sexual behaviour that exposes them to HIV is not limited to the force; it is rather a common problem that is faced by the general population. However, they complained, the nature of their job exposes them to road accident victims, subjecting them further to possible infection, especially when they have to handle these road accident casualties without proper protective gear. Conclusion Individual sexual behaviour and job-related circumstances are worth investigating if proper advice is to be given to the police regarding HIV prevention strategies. In order to improve the lives of these police officers, there is a need to review the existing institutional rules and practices to accommodate individual sexual needs. In addition, improving their working environment may minimize the risk of HIV transmission from handling casualties in emergency situations. PMID:23984994

  6. Overweight, obesity and perceptions about body weight among primary schoolchildren in Dar es Salaam, Tanzania.

    PubMed

    Mpembeni, Rose N M; Muhihi, Alfa J; Maghembe, Mwanamkuu; Ngarashi, Davis; Lujani, Benjamin; Chillo, Omary; Kubhoja, Sulende; Anaeli, Amani; Njelekela, Marina A

    2014-10-01

    The increasing prevalence of overweight and obesity among children has become a public health concern both in developing and developed countries. Previous research studies have shown that favourable perception of one's body weight is an important factor in weight control. This study determined prevalence of overweight and obesity and assessed perception about body weight among primary schoolchildren in Dar es Salaam, Tanzania. In this cross sectional study, nine schools were selected randomly from a list of all primary schools in Dar es Salaam. A structured questionnaire was used to collect data on socio-demographic characteristics and lifestyle information including perception about body weight. Height and weight were measured following standard procedures. Chi- square tests and multiple logistic regressions were used to determine factors which influence perceptions about body weight. A total of 446 children were included into the study. The mean body mass index (BMI) was 16.6 ± 4.0 kg/m2 (16.1 ± 4.0 for males and 17.0 ± 4.0 for females). Prevalence of overweight and obesity was 9.8% and 5.2%, respectively. The prevalence of overweight and obesity was significantly higher among girls, 13.1% and 6.3% compared to boys with 6.3% and 3.8% overweight and obese respectively (P=0.0314). Overall, the prevalence of overweight and obesity was 15.0% (10.1% among boys and 19.4% among girls). One-third (33.3%) of the children perceived their body weight as overweight or obese. Among overweight and obese children, 35.4% had unfavourable perception of their body weights. There was a statistically significant difference between perceived body weight and actual body weight as indicated by BMI for both boys and girls (P < 0.05). Age of the child (AOR = 0.55 95% CI 0.36-0.85) and area of residence (COR = 0.64 95% CI 0.44-0.95) were found to be significant predictors of favourable perception of one's body weight. In conclusion, the prevalence of overweight and obesity is not very high in this population. However over a third of overweight and obese children, had unfavourable perception of their body weights. We recommend targeted educational programmes about overweight and obesity and the associated health effects in order to instil a behaviour of self consciousness on overweight and obesity among children in Tanzania. PMID:26891520

  7. Child burn injury in Dar es Salaam, Tanzania: results from a community survey.

    PubMed

    Roman, Iwona M; Lewis, Erin R; Kigwangalla, Hamisi A; Wilson, Michael L

    2012-01-01

    The objective of this study was to identify the incidence of burn injuries among children in a sub-Saharan urban area and describe contributing factors in the home environment. A cross-sectional household survey was conducted in Dar es Salaam, Tanzania between 8 and 22 July 2009. Demographic characteristics of participants were reported using descriptive statistics. Bivariate analyses using Pearson's chi-square tests for categorical variables were used to explore possible associations. Burns represented 16.3% of reported injuries. The one-month incidence was calculated to be 1.73%. The most common contributor to burn injury was open flame 36.9%, followed by hot liquids 33.8%. Most burns occurred in urban areas with 88% occurring in the home. A significant association with burn injury was found in the 0-4 age category. There exists a continued need for research examining the mechanisms of safety provision in the home in low resource settings, especially concerning burn injury. PMID:22054222

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

    PubMed Central

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

    2015-01-01

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

  9. Rational dispensing and use of artemether-lumefantrine during pregnancy in Dar es Salaam, Tanzania.

    PubMed

    Kamuhabwa, Appolinary R; Mnyusiwalla, Fatema

    2011-04-01

    Artemether-Lumefantrine (ALu) is widely used for uncomplicated malaria during the second and third trimester of pregnancy. Because of the suspected teratogenic effects of artemether during the first trimester, quinine is used in early pregnancy unless the risks outweigh the benefits. The aim of this study was to assess dispensing practice of ALu in private pharmacies and knowledge of pregnant women regarding the use of ALu. This was a prospective-descriptive study involving visits to 200 private retail pharmacies (using a mystery shopper) and interviewing pregnant women at the municipal public hospitals in Dar es Salaam, Tanzania. Among the drug dispensers, 60 (30%) were pharmacists, 71(35.5%) nurse assistants, 34 (17%) pharmaceutical technicians and 35 (17.5%) sales persons with no formal education on drug dispensing. Among the dispensers, 14.5% had high knowledge, 38.0% had medium knowledge and 47.5% had low knowledge on the use of ALu during pregnancy. About thirty three percent of the drug dispensers were willing to dispense ALu during the first trimester of pregnancy. Sixty two percent of the drug dispensers indicated that ALu is the drug of choice for uncomplicated malaria after the first trimester of pregnancy. However, 36% indicated that ALu could not be used during pregnancy. A total of 200 pregnant women were interviewed. Among them, 16.5% were aware that ALu should not be taken during the first trimester of pregnancy. Only 17% of pregnant women were given information on the importance of taking food when using ALu, but none of them was given information on the importance of fatty meals when using ALu. In conclusion, the results show that most drug dispensers have inadequate knowledge about good dispensing practice of ALu in pregnancy. There is therefore a need for continuing training of drug dispensers regarding antimalarial drugs use in pregnancy. PMID:25566607

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

    PubMed

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

    2014-01-01

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

  11. Urban morphological determinants of temperature regulating ecosystem services in African cities: the case of Dar es Salaam, Tanzania

    NASA Astrophysics Data System (ADS)

    Cavan, Gina; Lindley, Sarah; Kibassa, Deusdedit; Shemdoe, Riziki; Capuano, Paolo; De Paola, Francesco; Renner, Florian; Pauleit, Stephan

    2013-04-01

    Urban green structure provides important regulating ecosystem services, such as temperature and flood regulation, and thus, has the potential to increase the resilience of African cities to climate change. Green structures within urban areas are not only limited to discrete units associated with recreational parks, agricultural areas and open spaces: they also exist within zones which have other primary functions, such as church yards, along transport routes, and within residential areas. Differing characteristics of urban areas can be conceptualised and subsequently mapped through the idea of urban morphology types. Urban morphology types are classifications which combine facets of urban form and function. When mapped, UMT units provide biophysically relevant meso-scale geographical zones which can be used as the basis for understanding climate-related impacts and adaptations. For example, they support the assessment of urban temperature patterns and the temperature regulating services provided by urban green structures. There are some examples of the use of UMTs for assessing regulating ecosystem services in European cities but little similar knowledge is available in an African context. This paper outlines the concept of urban morphology types (UMTs) and how they were applied to African case study cities (Cavan et al., 2012). It then presents the methods used to understand temperature regulating ecosystem services across an example African case study city, including (i) a GIS-based assessment of urban green structures, and (ii) applying an energy balance model to estimate current and future surface temperatures under climate change projections. The assessment is carried out for Dar es Salaam, Tanzania. Existing evidence suggests increases in both mean and extreme temperatures in the city. Historical analysis of the number of hot days per year suggests a rise from a maximum of 47 days per year in the period 1961-87 to 72 days per year in 2003-2011 (Giugni et al., 2012). Mean temperatures in the climate zone are estimated to increase by at least 1°C between 1971-2000 and 2021-2050(CSIR, 2012). Dar es Salaam is represented using around 1700 UMT units mapped across 43 UMT categories for the year 2008. Modelled surface temperature profiles for the city are presented, including an assessment of the potential impact of changing green structure cover within selected UMT categories. Provisional recommendations are made concerning the potential contribution of green structures as a climate adaptation response to the increasing temperatures in Dar es Salaam, which could be relevant for other African cities in similar climate zones. References Cavan, G., Lindley, S., Yeshitela, K., Nebebe, A., Woldegerima, T., Shemdoe, R., Kibassa, D., Pauleit, S., Renner, R., Printz, A., Buchta, K., Coly, A., Sall, F., Ndour, N. M., Ouédraogo, Y., Samari, B. S., Sankara, B. T., Feumba, R. A., Ngapgue, J. N., Ngoumo, M. T., Tsalefac, M., Tonye, E. (2012) CLUVA deliverable D2.7 Green infrastructure maps for selected case studies and a report with an urban green infrastructure mapping methodology adapted to African cities. http://www.cluva.eu/deliverables/CLUVA_D2.7.pdf. Accessed 18/12/12. CSIR (2012) CLUVA deliverable D1.5 Regional climate change simulations available for the selected areas http://www.cluva.eu/deliverables/CLUVA_D1.5.pdf. Accessed 8/1/13. Giugni, M., Adamo, P., Capuano, P., De Paola, F., Di Ruocco, A., Giordano, S., Iavazzo, P., Sellerino, M., Terracciano, S., Topa, M. E. (2012) CLUVA deliverable D.1.2 Hazard scenarios for test cities using available data. http://www.cluva.eu/deliverables/CLUVA_D1.2.pdf. Accessed 8/1/13

  12. Participatory mapping of target areas to enable operational larval source management to suppress malaria vector mosquitoes in Dar es Salaam, Tanzania

    PubMed Central

    Dongus, Stefan; Nyika, Dickson; Kannady, Khadija; Mtasiwa, Deo; Mshinda, Hassan; Fillinger, Ulrike; Drescher, Axel W; Tanner, Marcel; Castro, Marcia C; Killeen, Gerry F

    2007-01-01

    Background Half of the population of Africa will soon live in towns and cities where it can be protected from malaria by controlling aquatic stages of mosquitoes. Rigorous but affordable and scaleable methods for mapping and managing mosquito habitats are required to enable effective larval control in urban Africa. Methods A simple community-based mapping procedure that requires no electronic devices in the field was developed to facilitate routine larval surveillance in Dar es Salaam, Tanzania. The mapping procedure included (1) community-based development of sketch maps and (2) verification of sketch maps through technical teams using laminated aerial photographs in the field which were later digitized and analysed using Geographical Information Systems (GIS). Results Three urban wards of Dar es Salaam were comprehensively mapped, covering an area of 16.8 km2. Over thirty percent of this area were not included in preliminary community-based sketch mapping, mostly because they were areas that do not appear on local government residential lists. The use of aerial photographs and basic GIS allowed rapid identification and inclusion of these key areas, as well as more equal distribution of the workload of malaria control field staff. Conclusion The procedure developed enables complete coverage of targeted areas with larval control through comprehensive spatial coverage with community-derived sketch maps. The procedure is practical, affordable, and requires minimal technical skills. This approach can be readily integrated into malaria vector control programmes, scaled up to towns and cities all over Tanzania and adapted to urban settings elsewhere in Africa. PMID:17784963

  13. 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

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

    PubMed

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

    2015-02-01

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

  15. Community Health Workers to Improve Antenatal Care and PMTCT Uptake in Dar es Salaam, Tanzania: A Quantitative Performance Evaluation

    PubMed Central

    Sando, David; Magesa, Lucy; Machumi, Lameck; Mungure, Esther; Mwanyika Sando, Mary; Geldsetzer, Pascal; Foster, Dawn; Kajoka, Deborah; Naburi, Helga; Ekström, Anna M.; Spiegelman, Donna; Li, Nan; Chalamilla, Guerino; Fawzi, Wafaie; Bärnighausen, Till

    2014-01-01

    Background: Home visits by community health workers (CHW) could be effective in identifying pregnant women in the community before they have presented to the health system. CHW could thus improve the uptake of antenatal care (ANC), HIV testing, and prevention of mother-to-child transmission (PMTCT) services. Methods: Over a 16-month period, we carried out a quantitative evaluation of the performance of CHW in reaching women early in pregnancy and before they have attended ANC in Dar es Salaam, Tanzania. Results: As part of the intervention, 213 CHW conducted more than 45,000 home visits to about 43,000 pregnant women. More than 75% of the pregnant women identified through home visits had not yet attended ANC at the time of the first contact with a CHW and about 40% of those who had not yet attended ANC were in the first trimester of pregnancy. Over time, the number of pregnant women the CHW identified each month increased, as did the proportion of women who had not yet attended ANC. The median gestational age of pregnant women contacted for the first time by a CHW decreased steadily and significantly over time (from 21/22 to 16 weeks, P-value for test of trend <0.0001). Conclusions: A large-scale CHW intervention was effective in identifying pregnant women in their homes early in pregnancy and before they had attended ANC. The intervention thus fulfills some of the conditions that are necessary for CHW to improve timely ANC uptake and early HIV testing and PMTCT enrollment in pregnancy. PMID:25436818

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

    PubMed Central

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

    2015-01-01

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

  17. High HIV seroprevalence, rectal STIs and risky sexual behaviour in men who have sex with men in Dar es Salaam and Tanga, Tanzania

    PubMed Central

    Ross, Michael W; Nyoni, Joyce; Ahaneku, Hycienth O; Mbwambo, Jessie; McClelland, R Scott; McCurdy, Sheryl A

    2014-01-01

    Objectives To assess HIV and sexually transmitted infection (STI) prevalence and associated risk factors in men who have sex with men (MSM) in two cities in mainland Tanzania. Methods We conducted respondent-driven sampling of 300 MSM in Dar es Salaam and Tanga. Results In Dar es Salaam, 172 (86%) men (median age 23, IQR 21–28) consented to HIV/STI testing, and 30.2% were HIV seropositive. Only five reported a previous positive HIV test: >90% were new HIV detections. 2.5% were syphilis-exposed and none hepatitis B positive, but 21.4% had a curable STI. Over 90% of the gonorrhoea and chlamydia was rectal. In Tanga, 11.1% of MSM were HIV seropositive, 8% hepatitis B positive and 0% were syphilis-exposed, with 4.4% having a curable STI. Predictors of HIV infection were number of MSM known, city, identifying as gay and having first sex with a man. Predictors for STIs were recent unprotected receptive anal intercourse, and number of MSM seen in the last month. 30% of the sample reported that they sold sex. There was no significant association between HIV and STI infection. Conclusions HIV and STI rates were substantially lower in MSM in a provincial city than in a large metropolis and rates appear to depend on larger numbers of MSM known. Most HIV detected were new cases, and there was a high burden of asymptomatic curable rectal STIs (>1 in 5 MSM). Owing to stigma, MSM may not report homosexuality and thus not have rectal STIs treated. High need for tailored HIV testing and STI screening and treatment of MSM in Tanzania is apparent. PMID:25168042

  18. Gender differences in diet and nutrition among adults initiating antiretroviral therapy in Dar es Salaam, Tanzania.

    PubMed

    Abioye, Ajibola I; Isanaka, Sheila; Liu, Enju; Mwiru, Ramadhani S; Noor, Ramadhani A; Spiegelman, Donna; Mugusi, Ferdinand; Fawzi, Wafaie

    2015-01-01

    Human immunodeficiency virus (HIV)-infected males have poor treatment outcomes after initiation of antiretroviral therapy (ART) compared to HIV-infected women. Dietary factors might mediate the association between sex and disease progression. However, the gender difference in diet among HIV-infected individuals in sub-Saharan Africa is largely unknown. The objective of this study was to examine differences in dietary intake among HIV-infected men and women. We conducted a cross-sectional analysis of dietary questionnaire data from 2038 adults initiating ART in Dar es Salaam, Tanzania to assess whether nutrient adequacy differed by sex. We dichotomized participants' nutrient intakes by whether recommended dietary allowances (RDAs) were met and estimated the relative risk (RR) of meeting RDAs in males using binomial regression models. We also estimated the mean difference in intake of foods and food groups by gender. We found poorer dietary practices among men compared to women. Males were less likely to meet the RDAs for micronutrients critical for slowing disease progression among HIV patients: niacin (RR = 0.39, 95% confidence interval [CI]: 0.27 to 0.55), riboflavin (RR = 0.81, 95% CI: 0.73 to 0.91), vitamin C (RR = 0.94, 95% CI: 0.89 to 1.00), and zinc (RR = 0.06, 95% CI: 0.01 to 0.24). Intake of thiamine, pantothenate, vitamins B6, B12, and E did not vary by gender. Males were less likely to eat cereals (mean difference [servings per day] = -0.21, 95% CI: -0.44 to 0.001) and vegetables (mean difference = -0.47, 95% CI: -0.86 to -0.07) in their diet, but more likely to have meat (mean difference = 0.14, 95% CI: 0.06 to 0.21). We conclude that male HIV patients have poorer dietary practices than females, and this may contribute to faster progression of the disease in males. PMID:25562355

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

    PubMed

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

    2015-12-01

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

  20. Urban lymphatic filariasis in the metropolis of Dar es Salaam, Tanzania

    PubMed Central

    2013-01-01

    Background The last decades have seen a considerable increase in urbanization in Sub-Saharan Africa, and it is estimated that over 50% of the population will live in urban areas by 2040. Rapid growth of cities combined with limited economic resources often result in informal settlements and slums with favorable conditions for proliferation of vectors of lymphatic filariasis (LF). In Dar es Salaam, which has grown more than 30 times in population during the past 55 years (4.4 million inhabitants in 2012), previous surveys have indicated high prevalences of LF. This study investigated epidemiological aspects of LF in Dar es Salaam, as a background for planning and implementation of control. Methods Six sites with varying distance from the city center (3–30 km) and covering different population densities, socioeconomic characteristics, and water, sewerage and sanitary facilities were selected for the study. Pupils from one public primary school at each site were screened for circulating filarial antigen (CFA; marker of adult worm infection) and antibodies to Bm14 (marker of exposure to transmission). Community members were examined for CFA, microfilariae and chronic manifestations. Structured questionnaires were administered to pupils and heads of community households, and vector surveys were carried out in selected households. Results The study indicated that a tremendous decrease in the burden of LF infection had occurred, despite haphazard urbanisation. Contributing factors may be urban malaria control targeting Anopheles vectors, short survival time of the numerous Culex quinquefasciatus vectors in the urban environment, widespread use of bed nets and other mosquito proofing measures, and mass drug administration (MDA) in 2006 and 2007. Although the level of ongoing transmission was low, the burden of chronic LF disease was still high. Conclusions The development has so far been promising, but continued efforts are necessary to ensure elimination of LF as a public health problem. These will include improving the awareness of people about the role of mosquitoes in transmission of LF, more thorough implementation of environmental sanitation to reduce Cx. quinquefasciatus breeding, continued MDA to high-risk areas, and set-up of programmes for management of chronic LF disease. PMID:24289718

  1. A Mismatch between High-Risk Behaviors and Screening of Infectious Diseases among People Who Inject Drugs in Dar es Salaam, Tanzania

    PubMed Central

    Mlunde, Linda Beatrice; Sunguya, Bruno Fokas; Mbwambo, Jessie Kazeni; Ubuguyu, Omary Said; Shibanuma, Akira; Yasuoka, Junko; Jimba, Masamine

    2016-01-01

    Background People who inject drugs are at risk of various infectious diseases. Despite such a risk, evidence is limited which studied the utilization of screening services for common infectious diseases among people who inject drugs in Tanzania. We aimed to examine their high-risk behaviors; utilization of screening services for HIV infection, hepatitis B/C, any other sexually transmitted infection, and tuberculosis; and their associated factors in Dar es Salaam, Tanzania. Methods We conducted a baseline cross-sectional study as part of a prospective cohort study of people who inject drugs. We included 578 participants comprising of new enrollees of the integrated methadone-assisted treatment program and those who were selected from the communities but not enrolled in the program. We interviewed new enrollees preceding their enrollment and receipt of services from the program. We measured participants’ high-risk behaviors and their utilization of screening services. We analyzed the data descriptively and used multiple logistic regressions to identify the factors associated with ever being screened for infectious diseases. Results Of 578 participants, 14.2% shared injection needles. Of 547 sexually active participants, 37.5% had multiple sexual partners and only 17.4% used a condom. Of all participants, however, only 36.0% had ever been screened for HIV infection, 18.5% for tuberculosis, 11.8% for any other sexually transmitted infection, and 11.6% for hepatitis B/C. They were more likely to have ever been screened for HIV infection if they had education levels above primary education (adjusted odds ratio [AOR]: 2.54, 95% CI: 1.54–4.20), had a history of transactional sex (OR: 2.63, 95% CI: 1.01–6.84), and were new enrollees of the program (AOR: 7.41, 95% CI: 4.41–12.86). Conclusions People who inject drugs practice high-risk behaviors but their utilization of screening services for infectious diseases is poor in Dar es Salaam, Tanzania. It is crucial to increase the coverage of screening services for them and strengthen the counseling of safer sexual practices. PMID:26849802

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

    ERIC Educational Resources Information Center

    Mtebe, Joel S.; Raphael, Christina

    2013-01-01

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

  3. Generating trust: Programmatic strategies to reach women who inject drugs with harm reduction services in Dar es Salaam, Tanzania

    PubMed Central

    Zamudio-Haas, Sophia; Mahenge, Bathsheba; Saleem, Haneefa; Mbwambo, Jessie; Lambdin, Barrot H.

    2016-01-01

    Background Strong evidence supports the effectiveness of methadone-assisted therapy (MAT) to treat opioid dependence, reduce the risk of HIV transmission, and improve HIV related health outcomes among people who inject drugs (PWID). HIV prevalence reaches 71% in women who inject drugs (WWID) in Dar es Salaam, Tanzania; creating an urgent need for access to MAT. Despite the availability and potential benefits of treatment, few women have enrolled in services. This formative research sought to identify programmatic strategies to increase women’s participation in outreach and their subsequent enrollment in MAT. Methods We conducted twenty-five, in-depth interviews with patients and their providers at a MAT clinic. Open-ended interviews explored enrollment experiences, with a focus on contextual barriers and facilitators unique to women. Ethnographic observations of harm reduction education at outreach sites and the MAT clinic enriched interview data. Trust/mistrust emerged as an overarching theme cross cutting patient and provider accounts of the connective process to enroll PWID in the methadone program. We explore trust and mistrust in relationship to the interrelated themes of family loss, social isolation, vehement discrimination and motivation for treatment. Results Narratives delineated both the generation of mistrust against PWID and the generation of mistrust in PWID against outsiders and medical institutions. In order to enroll PWID in treatment, community base organizations engaged outreach strategies to overcome mistrust and connect eligible patients to care, which varied in their success at recruiting women and men. Greater discrimination against WWID pushed them into hiding, away from outreach teams that focus on outdoor areas where men who inject drugs congregate. Building trust through multiple encounters and making a personal connection facilitated entry into care for women. Only PWID were eligible for MAT, due to resource constraints and the higher risk associated with injection drug use. Many women smoke heroin, yet still face high risk of HIV, resulting from low condom use during sex work to fund drug use. Conclusion Expanding outreach times and locations, by women peers, could increase women’s enrollment in treatment. Allowing women who smoke heroin to enter the program could prevent onward transmission via sex work and reduce the chance of progressing from the lower risk smoking or sniffing to injection drug use. PMID:26880500

  4. Awareness of HIV/AIDS and its oral manifestations among people living with HIV in Dar es Salaam, Tanzania.

    PubMed

    Kahabuka, Febronia; Fabian, Flora; Petersen, Poul Erick; Nguvumali, Hubert

    2007-04-01

    The aim of this study was to investigate the awareness of the oral manifestations of HIV/AIDS and general issues about HIV and AIDS among people living with HIV (PLHIV) in Dar es Salaam, Tanzania. A structured questionnaire was used to collect information from 187 participants chosen by convenience sampling from NGOs supporting PLHIV. A total of 13.4% of the participants were completely unaware of the oral manifestations of HIV/AIDS whereas all participants were fully aware of general symptoms of AIDS. There were no significant associations between awareness of oral manifestations and general awareness of HIV/AIDS, or level of education. Participants were relatively well aware of the different types of oral manifestations (e.g. oral ulcers 87%, oral candidiasis 84%) while their knowledge of the management of specific oral manifestations and the problems associated with oral manifestations was more limited. It is recommended that health authorities in Tanzania establish population-oriented health education for improving knowledge about oral disease in HIV/AIDS and that oral health professionals provide sound information to PLHIV in community-outreach oral healthcare programmes. PMID:25875349

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

    NASA Astrophysics Data System (ADS)

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

    2008-12-01

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

  6. 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

  7. The Risk of Dengue Virus Transmission in Dar es Salaam, Tanzania during an Epidemic Period of 2014

    PubMed Central

    Mboera, Leonard E. G.; Mweya, Clement N.; Rumisha, Susan F.; Tungu, Patrick K.; Stanley, Grades; Makange, Mariam R.; Misinzo, Gerald; De Nardo, Pasquale; Vairo, Francesco; Oriyo, Ndekya M.

    2016-01-01

    Background In 2010, 2012, 2013 and 2014 dengue outbreaks have been reported in Dar es Salaam, Tanzania. However, there is no comprehensive data on the risk of transmission of dengue in the country. The objective of this study was to assess the risk of transmission of dengue in Dar es Salaam during the 2014 epidemic. Methodology/Principal Findings This cross-sectional study was conducted in Dar es Salaam, Tanzania during the dengue outbreak of 2014. The study involved Ilala, Kinondoni and Temeke districts. Adult mosquitoes were collected using carbon dioxide-propane powered Mosquito Magnet Liberty Plus traps. In each household compound, water-holding containers were examined for mosquito larvae and pupae. Dengue virus infection of mosquitoes was determined using real-time reverse transcription polymerase chain reaction (qRT-PCR). Partial amplification and sequencing of dengue virus genome in infected mosquitoes was performed. A total of 1,000 adult mosquitoes were collected. Over half (59.9%) of the adult mosquitoes were collected in Kinondoni. Aedes aegypti accounted for 17.2% of the mosquitoes of which 90.6% were from Kinondoni. Of a total of 796 houses inspected, 38.3% had water-holding containers in their premises. Kinondoni had the largest proportion of water-holding containers (57.7%), followed by Temeke (31.4%) and Ilala (23.4%). The most common breeding containers for the Aedes mosquitoes were discarded plastic containers and tires. High Aedes infestation indices were observed for all districts and sites, with a house index of 18.1% in Ilala, 25.5% in Temeke and 35.3% in Kinondoni. The respective container indices were 77.4%, 65.2% and 80.2%. Of the reared larvae and pupae, 5,250 adult mosquitoes emerged, of which 61.9% were Ae. aegypti. Overall, 27 (8.18) of the 330 pools of Ae. aegypti were positive for dengue virus. On average, the overall maximum likelihood estimate (MLE) indicates pooled infection rate of 8.49 per 1,000 mosquitoes (95%CI = 5.72–12.16). There was no significant difference in pooled infection rates between the districts. Dengue viruses in the tested mosquitoes clustered into serotype 2 cosmopolitan genotype. Conclusions/Significance Ae. aegypti is the main vector of dengue in Dar es Salaam and breeds mainly in medium size plastic containers and tires. The Aedes house indices were high, indicating that the three districts were at high risk of dengue transmission. The 2014 dengue outbreak was caused by Dengue virus serotype 2. The high mosquito larval and pupal indices in the area require intensification of vector surveillance along with source reduction and health education. PMID:26812489

  8. Improved quality of management of eclampsia patients through criteria based audit at Muhimbili National Hospital, Dar es Salaam, Tanzania. Bridging the quality gap

    PubMed Central

    2012-01-01

    Background Criteria-based audits (CBA) have been used to improve clinical management in developed countries, but have only recently been introduced in the developing world. This study discusses the use of a CBA to improve quality of care among eclampsia patients admitted at a University teaching hospital in Dar es Salaam Tanzania. Objective The prevalence of eclampsia in MNH is high (?6%) with the majority of cases arriving after start of convulsions. In 20042005 the case-fatality rate in eclampsia was 5.1% of all pregnant women admitted for delivery (MNH obstetric data base). A criteria-based audit (CBA) was used to evaluate the quality of care for eclamptic mothers admitted at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania after implementation of recommendations of a previous audit. Methods A CBA of eclampsia cases was conducted at MNH. Management practices were evaluated using evidence-based criteria for appropriate care. The Ministry of Health (MOH) guidelines, local management guidelines, the WHO manual supplemented by the WHO Reproductive Health Library, standard textbooks, the Cochrane database and reviews in peer reviewed journals were adopted. At the initial audit in 2006, 389 case notes were assessed and compared with the standards, gaps were identified, recommendations made followed by implementation. A re-audit of 88 cases was conducted in 2009 and compared with the initial audit. Results There was significant improvement in quality of patient management and outcome between the initial and re-audit: Review of management plan by senior staff (76% vs. 99%; P=0.001), urine for albumin test (61% vs. 99%; P=0.001), proper use of partogram to monitor labour (75% vs. 95%; P=0.003), treatment with steroids for lung maturity (2.0% vs. 24%; P=0.001), Caesarean section within 2 hours of decision (33% vs. 61%; P=0.005), full blood count (28% vs. 93%; P=0.001), serum urea and creatinine (44% vs. 86%; P=0.001), liver enzymes (4.0% vs. 86%; P=0.001), and specialist review within 2 hours of admission (25% vs. 39%; P=0.018). However, there was no significant change in terms of delivery within 24 hours of admission (69% vs. 63%; P=0.33). There was significant reduction of maternal deaths (7.7% vs. 0%; P=0.001). Conclusion CBA is applicable in low resource setting and can help to improve quality of care in obstetrics including management of pre-eclampsia and eclampsia. PMID:23170817

  9. Reasons for Declining to Enroll in a Phase I and II HIV Vaccine Trial after Randomization among Eligible Volunteers in Dar es Salaam, Tanzania

    PubMed Central

    Tarimo, Edith A. M.; Thorson, Anna; Kohi, Thecla W.; Bakari, Muhammad; Mhalu, Fred; Kulane, Asli

    2011-01-01

    Background Recruitment, enrollment and retention of volunteers in an HIV vaccine trial is important in the efforts to ultimately develop a vaccine that can prevent new HIV infections. Following recruitment, some randomized individuals decline to be enrolled in an HIV vaccine trial. The reasons for such a decision are not well known. This article describes why individuals who were randomized in a phase I and II HIV vaccine trial in Dar es Salaam, Tanzania declined to be enrolled. Methods Face-to-face interviews were conducted with 14 individuals (7 men and 7 women). Repeated readings of the 14 interview transcripts to look for reasons for declining to enroll in the trial were performed. Data was analyzed using the content analysis approach. Results Informants expressed fear of the outcome of an experimental HIV vaccine in their lives. Unlike women, some men were concerned over the effect of the vaccine on their reproduction intentions. Women were concerned about the unknown effects of the vaccine in their bodies. Also, to a large extent, informants faced resistance from significant others such as fiancées, parents, relatives, and friends. Women were influenced by their potential intimate sexual partners; men were forbidden by their parents, and mothers had the most influential opinion. Conclusions Fear of the negative outcome of an experimental vaccine and resistance from significant others are the main reasons for declining to enroll in the HIV vaccine trial among eligible volunteers after randomization. The resistance from the significant others provides valuable guidance for designing future trials in Tanzania; for example, expanding the HIV vaccine trial education to the general population from the onset of the trial design. PMID:21358826

  10. Anemia in adults with tuberculosis is associated with HIV and anthropometric status in Dar es Salaam, Tanzania

    PubMed Central

    Saathoff, E.; Villamor, E.; Mugusi, F.; Bosch, R. J.; Urassa, W.; Fawzi, W. W.

    2013-01-01

    SUMMARY SETTING Tuberculosis (TB) infected adults attending out-patient TB clinics in Dar es Salaam, Tanzania. OBJECTIVE To examine the association of anemia with human immunodeficiency virus (HIV) co-infection, indicators of socio-economic status (SES) and anthropometric status in TB-infected adults. DESIGN Cross-sectional data collection during screening for a clinical trial. RESULTS Overall, 750 females and 1693 males participated in this study, of whom respectively 49% and 24% were co-infected with HIV-1. Hemoglobin levels were significantly lower in females than in males and in HIV-positive than in HIV-negative participants. HIV co-infection in this antiretroviral-nave population was also associated with severe anemia (hemoglobin < 85 g/l) in both women (prevalence ratio [PR] = 2.07, 95%CI 1.652.59) and men (PR 3.45, 95%CI 2.664.47). Although severe anemia was negatively associated with indicators of SES, especially in males, adjustment for SES indicators only marginally changed its association with HIV co-infection. In both sexes, anemia was inversely associated with anthropometric status, independently of HIV infection and SES. CONCLUSION Among TB-infected adults, anemia is strongly associated with HIV co-infection and anthropometric status, independently of SES indicators. As anemia is a risk factor for morbidity and mortality in both infections, the management of anemia in TB-HIV co-infected patients warrants special attention. PMID:21682966

  11. Modeling approaches and strategies for data-scarce aquifers: example of the Dar es Salaam aquifer in Tanzania

    NASA Astrophysics Data System (ADS)

    Van Camp, Marc; Mjemah, Ibrahimu Chikira; Al Farrah, Nawal; Walraevens, Kristine

    2013-03-01

    Management of groundwater resources can be improved by using groundwater models to perform risk analyses and to improve development strategies, but a lack of extensive basic data often limits the implementation of sophisticated models. Dar es Salaam in Tanzania is an example of a city where increasing groundwater use in a Pleistocene aquifer is causing groundwater-related problems such as saline intrusion along the coastline, lowering of water-table levels, and contamination of pumping wells. The lack of a water-level monitoring network introduces a problem for basic data collection and model calibration and validation. As a replacement, local water-supply wells were used for measuring groundwater depth, and well-top heights were estimated from a regional digital elevation model to recalculate water depths to hydraulic heads. These were used to draw a regional piezometric map. Hydraulic parameters were estimated from short-time pumping tests in the local wells, but variation in hydraulic conductivity was attributed to uncertainty in well characteristics (information often unavailable) and not to aquifer heterogeneity. A MODFLOW model was calibrated with a homogeneous hydraulic conductivity field and a sensitivity analysis between the conductivity and aquifer recharge showed that average annual recharge will likely be in the range 80-100 mm/year.

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

    PubMed Central

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

    2010-01-01

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

  13. Determinants of Anemia Among Human Immunodeficiency Virus-Positive Adults at Care and Treatment Clinics in Dar es Salaam, Tanzania.

    PubMed

    Petraro, Paul; Duggan, Christopher; Spiegelman, Donna; Hertzmark, Ellen; Makubi, Abel; Chalamilla, Guerino; Siril, Helen; Sando, David; Aboud, Said; Fawzi, Wafaie W

    2016-02-01

    Anemia is often a comorbidity of human immunodeficiency virus (HIV) infection. Many cross-sectional studies have been conducted on anemia and HIV, but few, if any, have addressed incidence of anemia prospectively. A longitudinal analysis was conducted in 48,068 nonpregnant HIV-infected adults in Dar es Salaam, Tanzania, seen at Management and Development for Health-U.S. President's Emergency Plan for AIDS Relief HIV care and treatment programs between 2004 and 2011. Almost 56% (N = 27,184) of study participants had anemia (hemoglobin < 11 g/dL) at the time of enrollment at the clinic. Female gender, low body mass index (BMI), low CD4 T-cell count, high levels of liver enzyme alanine aminotransferase, antiretroviral treatment (ART) regimens, and concurrent tuberculosis treatment were all independently significantly associated with an increased risk of anemia. Low BMI and low CD4 T-cell count were independently significantly associated with an increased risk for iron deficiency anemia (IDA). Higher BMI status and ART use were associated with recovery from anemia. Anemia, including IDA, is a comorbidity that is associated with other adverse consequences (e.g., low BMI and CD4 T-cell count) among individuals with HIV infection, including those on ART. Interventions to prevent anemia and its complications need to be examined in the context of future studies. PMID:26666698

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  15. 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

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

    PubMed Central

    2009-01-01

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

  17. “Can’t you initiate me here?”: Challenges to timely initiation on antiretroviral therapy among methadone clients in Dar es Salaam, Tanzania

    PubMed Central

    Saleem, Haneefa T.; Mushi, Dorothy; Hassan, Saria; Bruce, R. Douglas; Cooke, Alexis; Mbwambo, Jessie; Lambdin, Barrot H.

    2016-01-01

    Background Despite dramatic improvement in antiretroviral therapy (ART) access globally, people living with HIV who inject drugs continue to face barriers that limit their access to treatment. This paper explores barriers and facilitators to ART initiation among clients attending a methadone clinic in Dar es Salaam, Tanzania. Methods We interviewed 12 providers and 20 clients living with HIV at the Muhimbili National Hospital methadone clinic between January and February 2015. We purposively sampled clients based on sex and ART status and providers based on job function. To analyze interview transcripts, we adopted a content analysis approach. Results Participants identified several factors that hindered timely ART initiation for clients at the methadone clinic. These included delays in CD4 testing and receiving CD4 test results; off-site HIV clinics; stigma operating at the individual, social and institutional levels; insufficient knowledge of the benefits of early ART initiation among clients; treatment breakdown at the clinic level possibly due to limited staff; and initiating ART only once one feels physically ill. Participants perceived social support as a buffer against stigma and facilitator of HIV treatment. Some clients also reported that persistent monitoring and follow-up on their HIV care and treatment by methadone clinic providers led them to initiate ART. Conclusion Health system factors, stigma and limited social support pose challenges for methadone clients living with HIV to initiate ART. Our findings suggest that on-site point-of-care CD4 testing, a peer support system, and trained HIV treatment specialists who are able to counsel HIV-positive clients and initiate them on ART at the methadone clinic could help reduce barriers to timely ART initiation for methadone clients. PMID:26831364

  18. Microbial Larvicide Application by a Large-Scale, Community-Based Program Reduces Malaria Infection Prevalence in Urban Dar Es Salaam, Tanzania

    PubMed Central

    Geissbühler, Yvonne; Kannady, Khadija; Chaki, Prosper Pius; Emidi, Basiliana; Govella, Nicodem James; Mayagaya, Valeliana; Mtasiwa, Deo; Mshinda, Hassan; Lindsay, Steven William; Tanner, Marcel; Fillinger, Ulrike; de Castro, Marcia Caldas; Killeen, Gerry Francis

    2009-01-01

    Background Malaria control in Africa is most tractable in urban settlements yet most research has focused on rural settings. Elimination of malaria transmission from urban areas may require larval control strategies that complement adult mosquito control using insecticide-treated nets or houses, particularly where vectors feed outdoors. Methods and Findings Microbial larvicide (Bacillus thuringiensis var. israelensis (Bti)) was applied weekly through programmatic, non-randomized community-based, but vertically managed, delivery systems in urban Dar es Salaam, Tanzania. Continuous, randomized cluster sampling of malaria infection prevalence and non-random programmatic surveillance of entomological inoculation rate (EIR) respectively constituted the primary and secondary outcomes surveyed within a population of approximately 612,000 residents in 15 fully urban wards covering 55 km2. Bti application for one year in 3 of those wards (17 km2 with 128,000 residents) reduced crude annual transmission estimates (Relative EIR [95% Confidence Interval] = 0.683 [0.491–0.952], P = 0.024) but program effectiveness peaked between July and September (Relative EIR [CI] = 0.354 [0.193 to 0.650], P = 0.001) when 45% (9/20) of directly observed transmission events occurred. Larviciding reduced malaria infection risk among children ≤5 years of age (OR [CI] = 0.284 [0.101 to 0.801], P = 0.017) and provided protection at least as good as personal use of an insecticide treated net (OR [CI] = 0.764 [0.614–0.951], P = 0.016). Conclusions In this context, larviciding reduced malaria prevalence and complemented existing protection provided by insecticide-treated nets. Larviciding may represent a useful option for integrated vector management in Africa, particularly in its rapidly growing urban centres. PMID:19333402

  19. Balancing collective responsibility, individual opportunities and risks: a qualitative study on how police officers reason around volunteering in an HIV vaccine trial in Dar es Salaam, Tanzania

    PubMed Central

    2010-01-01

    Background Results from HIV vaccine trials on potential volunteers will contribute to global efforts to develop an HIV vaccine. The purpose of this study among police officers in Dar es Salaam, Tanzania, was to explore the underlying reasons that induce people to enrol in an HIV vaccine trial. Methods We conducted discussions with eight focus groups, containing a total of 66 police officers. The information collected was analyzed using interpretive description. Results The results showed that participants were motivated to participate in the trial by altruism, and that the participants experienced some concerns about their participation. They stated that altruism in the fight against HIV infection was the main reason for enrolling in the trial. However, young participants were seriously concerned about a possible loss of close relationships if they enrolled in the HIV vaccine trial. Both men and women feared the effect of the trial on their reproductive biology, and they feared interference with pregnancy norms. They were unsure about risks such as the risks of acquiring HIV infection and of suffering physical harm, and they were unsure of the intentions of the researchers conducting the trial. Further, enrolling in the trial required medical examination, and this led some participants to fear that unknown diseases would be revealed. Other participants, however, saw an opportunity to obtain free health services. Conclusions We have shown that specific fears are important concerns when recruiting volunteers to an HIV vaccine trial. More knowledge is needed to determine participants' views and to ensure that they understand the conduct of the trial and the reasons it is being carried out. PMID:20509908

  20. Elemental and ionic components of atmospheric aerosols and associated gaseous pollutants in and near Dar es Salaam, Tanzania

    NASA Astrophysics Data System (ADS)

    Mmari, Albert G.; Potgieter-Vermaak, Sanja S.; Bencs, László; McCrindle, Robert I.; Van Grieken, René

    2013-10-01

    Elemental and water-soluble ionic compounds (WSICs) of atmospheric aerosols (total suspended particulate - TSP) and some gaseous pollutants (SO2, NO2 and O3) from a coastal, semi-urban and rural site in and near Dar es Salaam, Tanzania were investigated during dry and wet seasons of January 2005-November 2007. Na+, Ca2+, SO42-, NO3- and Cl- made up the dominant fraction of WSICs during the dry season with average concentrations ranging from non-detectable (n.d.)-5.4, 0.26-2.6, 0.74-14.7, 0.4-1.5 and 1.1-3.4 μg m-3, respectively, while in the wet season, from n.d. up to 1.7, 1.2, 4.4, 2.1 and 3.0 μg m-3, respectively. The total air concentrations of the detected elements (Al, Si, S, Cl, K, Ca, Fe and Zn) showed seasonal and site-specific variation in the range of 7.5-26.6 with an average of 14.5 μg m-3. Most of the air concentrations of pollutants were observed to decrease with increasing distance from the coastal site, which is under urban and industrial pollutant emissions. Sulphur and nitrogen oxidation ratios during the dry season ranged from 0.08 to 0.91 and 0.013 to 0.049, respectively, while they were between 0.09-0.65 and 0.002-0.095, respectively, in the wet season. These values indicate the photochemical oxidation of SO2 and a high extent of NO3-formation in the atmosphere. Neutralization ratios revealed the presence of acidic SO42- and NO3- aerosols. Principal component analysis identified sea spray, local combustion, vehicular traffic, biomass burning and re-suspended road dust as dominant sources of aerosols at the studied coastal and semi-urban sites. However, at the rural site, besides sea spray, crustal sources, soil dust re-suspension and long-range transport are the possible origins of suspended particulates.

  1. Community-owned resource persons for malaria vector control: enabling factors and challenges in an operational programme in Dar es Salaam, United Republic of Tanzania

    PubMed Central

    2011-01-01

    Background Community participation in vector control and health services in general is of great interest to public health practitioners in developing countries, but remains complex and poorly understood. The Urban Malaria Control Program (UMCP) in Dar es Salaam, United Republic of Tanzania, implements larval control of malaria vector mosquitoes. The UMCP delegates responsibility for routine mosquito control and surveillance to community-owned resource persons (CORPs), recruited from within local communities via the elected local government. Methods A mixed method, cross-sectional survey assessed the ability of CORPs to detect mosquito breeding sites and larvae, and investigated demographic characteristics of the CORPs, their reasons for participating in the UMCP, and their work performance. Detection coverage was estimated as the proportion of wet habitats found by the investigator which had been reported by CORP. Detection sensitivity was estimated as the proportion of wet habitats found by the CORPS which the investigator found to contain Anopheles larvae that were also reported to be occupied by the CORP. Results The CORPs themselves perceived their role as professional rather than voluntary, with participation being a de facto form of employment. Habitat detection coverage was lower among CORPs that were recruited through the program administrative staff, compared to CORPs recruited by local government officials or health committees (Odds Ratio = 0.660, 95% confidence interval = [0.438, 0.995], P = 0.047). Staff living within their areas of responsibility had > 70% higher detection sensitivity for both Anopheline (P = 0.016) and Culicine (P = 0.012): positive habitats compared to those living outside those same areas. Discussion and conclusions Improved employment conditions as well as involving the local health committees in recruiting individual program staff, communication and community engagement skills are required to optimize achieving effective community participation, particularly to improve access to fenced compounds. A simpler, more direct, less extensive community-based surveillance system in the hands of a few, less burdened, better paid and maintained program personnel may improve performance and data quality. PMID:21955856

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

    ERIC Educational Resources Information Center

    Meli, Benjamin Mbeba

    2015-01-01

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

  3. Methadone Treatment for HIV Prevention—Feasibility, Retention, and Predictors of Attrition in Dar es Salaam, Tanzania: A Retrospective Cohort Study

    PubMed Central

    Lambdin, Barrot H.; Masao, Frank; Chang, Olivia; Kaduri, Pamela; Mbwambo, Jessie; Magimba, Ayoub; Sabuni, Norman; Bruce, R. Douglas

    2014-01-01

    Background. People who inject drugs (PWID) in Dar es Salaam, Tanzania, have an estimated human immunodeficiency virus (HIV) prevalence of 42%–50% compared with 6.9% among the general population. Extensive evidence supports methadone maintenance to lower morbidity, mortality, and transmission of HIV and other infectious diseases among PWID. In 2011, the Tanzanian government launched the first publicly funded methadone clinic on the mainland of sub-Saharan Africa at Muhimbili National Hospital. Methods. We conducted a retrospective cohort study of methadone-naive patients enrolling into methadone maintenance treatment. Kaplan-Meier survival curves were constructed to assess retention probability. Proportional hazards regression models were used to evaluate the association of characteristics with attrition from the methadone program. Results. Overall, 629 PWID enrolled into methadone treatment during the study. At 12 months, the proportion of clients retained in care was 57% (95% confidence interval [CI], 53%–62%). Compared with those receiving a low dose (<40 mg), clients receiving a medium (40–85 mg) (adjusted hazard ratio [aHR], 0.50 [95% CI, .37–.68]) and high (>85 mg) (aHR, 0.41 [95% CI, .29–.59]) dose of methadone had a lower likelihood of attrition, adjusting for other characteristics. Older clients (aHR, 0.53 per 10 years [95% CI, .42–.69]) and female clients (aHR, 0.50 [95% CI, .28–.90]) had a significantly lower likelihood of attrition, whereas clients who reported a history of sexual abuse (aHR, 2.84 [95% CI, 1.24–6.51]) had a significantly higher likelihood of attrition. Conclusions. Patient retention in methadone maintenance is comparable to estimates from programs in North America, Europe, and Asia. Future implementation strategies should focus on higher doses and flexible dosing strategies to optimize program retention and strengthened efforts for clients at higher risk of attrition. PMID:24855149

  4. The second African Federation of Neurological Surgeons course in the East, Central, and Southern Africa region held in Dar es Salaam, Tanzania, January 2011.

    PubMed

    Kahamba, Joseph F; Assey, Anthony B; Dempsey, Robert J; Qureshi, Mahmood M; Hrtl, Roger

    2013-01-01

    The second International African Federation of Neurological Surgeons course was organized on January 24 to 28, 2011, at the Seacliff Hotel and Muhimbili Orthopaedic Institute in Dar es Salaam, Tanzania. President Jakaya Mrisho Kikwete graced the official opening with high ranking government officials in attendance. The targeted participants were young neurosurgeons in the East, Central, and South African region. More than 80 surgeons, residents, and neurosurgical nurses came from Tanzania, Kenya, Uganda, Rwanda, Ethiopia, Zambia, and Zimbabwe. The objectives of the course were to teach and train young local surgeons in the essential-relevant for the region-and current techniques and management principles of brain and spinal diseases, acquire new skills through hands-on practical sessions, and share experiences. The course consisted of didactic sessions, practical aspects on spine internal fixation, cadaver dissections, and live microscopic and endoscopic surgery. Experienced faculty from different states of the United States, Spain, Turkey, India, Egypt, and Ethiopia facilitated the course. The objectives of the course were met with a favorable evaluation report. The collaboration and experience gained will be reinvested in organizing similar courses in the region. PMID:22120325

  5. Risky sexual practices among youth attending a sexually transmitted infection clinic in Dar es Salaam, Tanzania

    PubMed Central

    Urassa, W; Moshiro, C; Chalamilla, G; Mhalu, F; Sandstrom, E

    2008-01-01

    Background Youth have been reported to be at a higher risk of acquiring STIs with significant adverse health and social consequences. Knowledge on the prevailing risky practices is an essential tool to guide preventive strategies. Methods Youth aged between 18 and 25 years attending an STI clinic were recruited. Social, sexual and demographic characteristics were elicited using a structured standard questionnaire. Blood samples were tested for syphilis and HIV infections. Urethral, high vaginal and cervical swabs were screened for common STI agents. Results A total of 304 youth were studied with mean age of 21.5 and 20.3 years for males and females respectively. 63.5% of youth were seeking STI care. The mean age of coitache was 16.4 and 16.2 years for males and females respectively. The first sexual partner was significantly older in females compared to male youth (23.0 vs 16.8 years) (p < 0.01). 93.2% of male youth reported more than one sexual lifetime partner compared to 63.0% of the females. Only 50% of males compared to 43% of females had ever used a condom and fewer than 8.3% of female youth used other contraceptive methods. 27.1% of pregnancies were unplanned and 60% of abortions were induced. 42.0% of female youth had received gifts/money for sexual favours. The HIV prevalence was 15.3% and 7.5% for females and males respectively. The prevalence of other STIs was relatively low. Among male youth, use of alcohol or illicit drugs was associated with increased risk of HIV infection. However, the age of sexual initiation, number of sexual partners or the age of the first sexual partner were not associated with increased risk of being HIV infected. Conclusion Most female youth seen at the STI clinic had their first sexual intercourse with older males. Youth were engaging in high risk unprotected sexual practices which were predisposing them to STIs and unplanned pregnancies. There is a great need to establish more youth-friendly reproductive health clinics, encourage consistent and correct use of condoms, delay in sexual debut and avoid older sexual partners in females. PMID:19019224

  6. Infant feeding practices among HIV-positive women in Dar es Salaam, Tanzania, indicate a need for more intensive infant feeding counselling

    PubMed Central

    Young, Sera L; Israel-Ballard, Kiersten A; Dantzer, Emily A; Ngonyani, Monica M; Nyambo, Margaret T; Ash, Deborah M; Chantry, Caroline J

    2012-01-01

    Objective To assess feeding practices of infants born to HIV-positive women in Dar es Salaam, Tanzania. These data then served as a proxy to evaluate the adequacy of current infant feeding counselling. Design A cross-sectional survey of infant feeding behaviours. Setting Four clinics in greater Dar es Salaam in early 2008. Subjects A total of 196 HIV-positive mothers of children aged 6–10 months recruited from HIV clinics. Results Initiation of breastfeeding was reported by 95·4% of survey participants. In the entire sample, 80·1%, 34·2% and 13·3% of women reported exclusive breast-feeding (EBF) up to 2, 4 and 6 months, respectively. Median duration of EBF among women who ever breast-fed was 3 (interquartile range (IQR): 2·1, 4·0) months. Most non-breast-milk foods fed to infants were low in nutrient density. Complete cessation of breast-feeding occurred within 14 d of the introduction of non-breast-milk foods among 138 of the 187 children (73·8%) who had ever received any breast milk. Of the 187 infants in the study who ever received breast milk, 19·4% received neither human milk nor any replacement milks for 1 week or more (median duration of no milk was 14 (IQR: 7, 152) d). Conclusions Infant feeding practices among these HIV-positive mothers resulted in infants receiving far less breast milk and more mixed complementary feeds than recommended, thus placing them at greater risk of both malnutrition and HIV infection. An environment that better enables mothers to follow national guidelines is urgently needed. More intensive infant feeding counselling programmes would very likely increase rates of optimal infant feeding. PMID:20587116

  7. Organic liquids storage tanks volatile organic compounds (VOCS) emissions dispersion and risk assessment in developing countries: the case of Dar-es-Salaam City, Tanzania.

    PubMed

    Jackson, Msafiri M

    2006-05-01

    The emission estimation of nine volatile organic compounds (VOCs) from eight organic liquids storage tanks companies in Dar-es-Salaam City Tanzania has been done by using US EPA standard regulatory storage tanks emission model (TANKS 4.9b). Total VOCs atmospheric emission has been established to be 853.20 metric tones/yr. It has been established further that petrol storage tanks contribute about 87% of total VOCs emitted, while tanks for other refined products and crude oil were emitting 10% and 3% of VOCs respectively. Of the eight sources (companies), the highest emission value from a single source was 233,222.94 kg/yr and the lowest single source emission value was 6881.87 kg/yr. The total VOCs emissions estimated for each of the eight sources were found to be higher than the standard level of 40,000 kg/yr per source for minor source according to US EPA except for two sources, which were emitting VOCs below the standard level. The annual emissions per single source for each of the VOCs were found to be below the US EPA emissions standard which is 2,000 kg/yr in all companies except the emission of hexane from company F1 which was slightly higher than the standard. The type of tanks used seems to significantly influence the emission rate. Vertical fixed roof tanks (VFRT) emit a lot more than externally floating roof tanks (EFRT) and internally floating roof tanks (IFRT). The use of IFRT and EFRT should be encouraged especially for storage of petrol which had highest atmospheric emission contribution. Model predicted atmospheric emissions are less than annual losses measured by companies in all the eight sources. It is possible that there are other routes for losses beside atmospheric emissions. It is therefore important that waste reduction efforts in these companies are directed not only to reducing atmospheric emissions, but also prevention of the spillage and leakage of stored liquid and curbing of the frequently reported illegal siphoning of stored products. Emission rates for benzene, toluene, and xylene were used as input to CALPUFF air dispersion model for the calculation of spatial downwind concentrations from area sources. By using global positioning system (GPS) and geographical information system (GIS) the spatial benzene concentration contributed by organic liquid storage tanks has been mapped for Dar-es-Salaam City. Highest concentrations for all the three toxic pollutants were observed at Kigamboni area, possibly because the area is located at the wind prevailing direction from the locations of the storage tanks. The model predicted concentrations downwind from the sources were below tolerable concentrations by WHO and US-OSHA. The highest 24 hrs averaging time benzene concentration was used for risk assessment in order to determine maximum carcinogenic risk amongst the population exposed at downwind. Established risk for adult and children at 2.9x10(-3) and 1.9x10(-3) respectively, are higher than the acceptable US-EPA risk of 1x10(-6). It is very likely that the actual VOCs concentrations in some urban areas in Tanzania including Dar-es-Salaam City are much higher than the levels reported in this study when other sources such as petrol stations and motor vehicles on the roads are considered. Tanzania Government therefore need to put in place: an air quality policy and legislation, establish air quality guidelines and acquire facilities which will enable the implementation of air quality monitoring and management programmes. PMID:16779602

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2009-01-01

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

  10. 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.

  11. Assessment of physicochemical characteristics and hygienic practices along the value chain of raw fruit juice vended in Dar es Salaam City, Tanzania.

    PubMed

    Nonga, Hezron E; Simforian, Edeltruds A; Ndabikunze, Bernadette K

    2014-10-01

    Fresh fruit juice is an essential component of human diet and there is considerable evidence of health and nutritional benefits. However, nature of the fruits used in juicing and unhygienic processes in the value chain may cause poor quality of juice. This cross- sectional study was conducted to assess physicochemical characteristics and hygienic practices along the value chain of raw fruit juice vended in Dar es Salaam, Tanzania. A total of 90 juice vendors were interviewed. Ninety juice samples were collected and analysed for physicochemical quality. The pH of juices ranged between 2.7 and 6.4, acidity 0.01% and 1.3% and, total soluble solids ranged between -1.5 and 18.04 °Brix. Most juices (67.8%) had -Brix levels below Codex recommended values classified as weak and watery. Juices were made of mango, passion, tamarind, sugar cane and mixture of these fruits sourced from open markets in the city. Water for washing of fruits and dilution of juices was from deep wells (53.3%) and taps (46.7%). About one third (37.8%) of the juice vendors didn't wash the fruits before juicing and 44.4% didn't boil water for juice dilution. Juice extraction was done by kitchen blenders, boiling in water and squeezing by simple machines. Juice pasteurization was not done. The majority of vendors (78.9%) stored juices in plastic buckets and juice was sold in glass cups, reused plastic bottles and disposable cups. Vending sites were restaurants, bus stands and along roadsides. The majority of premises (78.9%) were in unhygienic condition that likely encouraged or introduced contaminants to the juices. It is concluded that, the overall handling, preparation practices and physicochemical quality of raw fruit juices vended in Dare es Salaam City are poor. The government should educate the vendors on food safety and hygiene as well as enforcing regular monitoring of the quality of street fruit juices. PMID:26891516

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

    PubMed Central

    2014-01-01

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

  13. 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

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

    NASA Astrophysics Data System (ADS)

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

    2015-05-01

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

  15. Prevalence and risk factors of cervical squamous intraepithelial lesions among HIV-infected women in Dar es Salaam, Tanzania.

    PubMed

    Liu, Enju; McCree, Renicha; Mtisi, Expeditho; Fawzi, Wafaie W; Aris, Eric; Lema, Irene A; Hertzmark, Ellen; Chalamilla, Guerino; Li, Nan; Vermund, Sten H; Spiegelman, Donna

    2016-03-01

    To determine the prevalence and predictors of cervical squamous intraepithelial lesions (SIL) among HIV-infected women in Tanzania, a cross-sectional study was conducted among HIV-infected women at HIV care and treatment clinics. A Papanicolaou (Pap) smear was used as a screening tool for detection of cervical SIL. From December 2006 to August 2009, 1365 HIV-infected women received cervical screening. The median age was 35 (interquartile range [IQR]: 30-42) years, and the median CD4 + cell count was 164 (IQR: 80-257) cells/mm(3). The prevalence of cervical SIL was 8.7% (119/1365). In multivariate analysis, older age (≥50 versus 30-<40 years: prevalence ratio [PR], 2.36; 95% confidence interval [CI], 1.45-3.84, p for trend = 0.001), lower CD4 + cell counts (<100 versus ≥200 cells/mm(3): PR, 1.55; 95% CI, 1.01-2.36, p for trend = 0.03) and cervical inflammation (PR, 1.73; 95% CI, 1.16-2.60, p = 0.008) were associated with an increased risk of cervical SIL. Women with advanced WHO HIV disease stage (IV versus I/II: PR, 3.45; 95% CI, 1.35-8.85, p for trend = 0.01) had an increased risk for high-grade SIL. In resource-limited settings where it is not feasible to provide cervical cancer prevention services to all HIV-infected women, greater efforts should focus on scaling-up services among those who are older than 50 years, with lower CD4 cell counts and advanced HIV disease stage. PMID:25957324

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

    PubMed Central

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

    2010-01-01

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

  17. 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

  18. Antibiotic use in urological surgeries: a six years review at Muhimbili National Hospital, Dar es salaam-Tanzania

    PubMed Central

    Nyongole, Obadia; Akoko, Larry; Mwanga, Ally; Mchembe, Mabula; Kamala, Benjamin; Mbembati, Naboth

    2015-01-01

    Introduction Antimicrobial prophylaxis for urologic procedures is a major issue, as potential advantages of antibiotic administration should be carefully weighed against potential side effects, microbial resistance, and health care costs. This study aimed to review a six years trend of antibiotic use in urological surgeries at Muhimbili National Hospital (MNH) being an experience in a typical third world environment. Methods This was a six years hospital based descriptive, retrospective study conducted of which all case notes of urological patients operated on in between January 2007 to December, 2012 were reviewed by using a structured data collecting tool. The data were analyzed using SPSS software. Results Male patients were the majority at 62% (450). The age range was 0 - 90 years, with a mean of 30 ± 22.09. Among the urological surgeries done at MNH 86.5% (628) received prophylactic antibiotics regardless of the type surgery done. Majority 63.7% (463) received antibiotics during induction. Ceftriaxone was the commonly given antibiotic regardless of the type of urological surgery done. Most of patients (86.4%) were given antibiotics for five days regardless whether it was for prophylactic or treatment intention. Conclusion Antibiotic use is still a challenge at our hospital with over use of prophylactic antibiotics without obvious indications. Prolonged use of prophylactic antibiotics beyond five days was the main finding. Ceftriaxone was the most given antibiotic regardless of the urological surgery done and its level of contamination. Antibiotic stewardship needs to be addressed urgently to avoid serious drug resistances leaving alone the cost implication.

  19. 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

  20. 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…

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

    PubMed Central

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

    2010-01-01

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

  2. Infant and young child feeding practices among children under 2 years of age and maternal exposure to infant and young child feeding messages and promotions in Dar es Salaam, Tanzania.

    PubMed

    Vitta, Bineti S; Benjamin, Margaret; Pries, Alissa M; Champeny, Mary; Zehner, Elizabeth; Huffman, Sandra L

    2016-04-01

    There are limited data describing infant and young child feeding practices (IYCF) in urban Tanzania. This study assessed the types of foods consumed by children under 2 years of age and maternal exposure to promotions of these foods in Dar es Salaam, Tanzania. A cross-sectional survey was conducted among 305 mothers of children less than 24 months of age who attended child health services in October and November, 2014. Among infants less than 6 months of age, rates of exclusive breastfeeding were low (40.8%) and a high proportion (38.2%) received semi-solid foods. Continued breastfeeding among 20-23-month-olds was only 33.3%. Consumption of breastmilk substitutes was not prevalent, and only 3.9% of infants less than 6 months of age and 4.8% of 6-23 month-olds were fed formula. Among 6-23-month-olds, only 38.4% consumed a minimum acceptable diet (using a modified definition). The homemade complementary foods consumed by the majority of 6-23-month-olds (85.2%) were cereal-dominated and infrequently contained micronutrient-rich ingredients. Only 3.1% of 6-23-month-olds consumed commercially produced infant cereal on the day preceding the interview. In contrast, commercially produced snack foods were consumed by 23.1% of 6-23-month-olds. Maternal exposure to commercial promotions of breastmilk substitutes and commercially produced complementary foods was low (10.5% and 1.0%, respectively), while exposure to promotions of commercially produced snack foods was high (45.9%). Strategies are needed to improve IYCF practices, particularly with regard to exclusive and continued breastfeeding, increased dietary diversity and consumption of micronutrient-rich foods, and avoidance of feeding commercially produced snack foods. PMID:27061958

  3. 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

  4. Malaria control in Tanzania

    SciTech Connect

    Yhdego, M.; Majura, P. )

    1988-01-01

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

  5. 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

  6. Tanzania.

    PubMed

    1992-05-01

    Background notes on Tanzania present a profile of nationality, population count of 26 million, growth rate of 3.5%, ethnic groups (130), religions (33% Muslim, 33% animist, 33% Christian), languages, education (86% primary), literacy (79%), health (infant mortality of 106/1000), and work force (90% agriculture). Geographic data are given for the area, cities, terrain, and climate. The Tanzanian government is a republic with executive, legislative, and judicial branches of government. There is 1 political party and everyone 18 years is eligible to vote. 4% of the gross domestic product (GDP) ($5.9 billion) is devoted to defense. Economic growth is 4.3%/year and person income is $240/capita. Natural resources, agriculture, industry, and trade are identified. $400 million has been received between 1970-92 in US economic aid. The 1992 official exchange rate is 300 Tanzanian shillings to the US dollar. Descriptive text is given for the population, the history of Tanganyika and Zanzibar, the government, principal government officials (President, 1st Vice President [VP], 2nd VP and President of Zanzibar, Prime Minister, Foreign Affairs Minister, Ambassador to the US, Ambassador to the UN, and US embassy address and phone number), political conditions, the economy, the defense, foreign relations, and US-Tanzanian relations. Principal US officials are identified for the Ambassador, Deputy Chief of Mission, USAID Director, and Public Affairs Officer; the US embassy address is given also. The population is 80% rural with a density of 1/sq km in arid areas, 51/sq km on the mainland, and 134/sq km on Zanzibar. The new capital will be Dodoma in central Tanzania. Most residents are of Bantu stock; nomadic groups are the Masai and the Luo. 1% are non-Africans. Government has a strong central executive. The current President is Ali Hassan Mwinyi. The Revolutionary Party is in the primary policymaking body and provides all government leaders. The government seeks to foster the Kiswahili concept of "ujamaa" or a kind of communal cooperation. 47% of GDP comes from agriculture. There is little foreign investment. Diversification of export crops is needed. Foreign policy is nonaligned, and friendly to the US. PMID:12178040

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

    EPA Science Inventory

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

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

      EPA Science Inventory

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

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

        ERIC Educational Resources Information Center

        Mann, Gillian

        2010-01-01

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

      • Methicillin-resistant staphylococcus aureus (MRSA) colonization among Intensive Care Unit (ICU) patients and health care workers at Muhimbili national hospital, Dar Es Salaam, Tanzania, 2012

        PubMed Central

        Geofrey, Alfred; Abade, Ahmed; Aboud, Said

        2015-01-01

        Introduction Methicillin-resistant Staphylococcus aureus (MRSA) has been recognized as important nosocomial pathogens worldwide. S aureus may induce clinically manifested diseases, or the host may remain completely asymptomatic. Methods A cross-sectional hospital-based study was conducted from October 2012 to March 2013 in two ICUs at MNH. Admitted patients and health care workers were enrolled in the study. Interviewer administered questionnaires; patient history forms, observation charts and case report forms were used to collect data. Swabs (nostrils, axillary or wounds) were collected. MRSA were screened and confirmed using cefoxitin, oxacillin discs and oxacillin screen agar. Antibiotic susceptibility was performed using Kirby-Bauer disk diffusion method. The risk factors for MRSA were determined using the logistic regression analysis and a p - value of <0.05 was considered as statistically significant. Results Of the 169 patients and 47 health workers who were recruited, the mean age was 43.4 years ± SD 15.3 and 37.7 years ± (SD) 11.44 respectively. Among the patients male contributed 108 (63.9%) while in health worker majority 39(83%) were females. The prevalence of MRSA colonization among patients and health care workers was 11.83% and 2.1% respectively. All (21) MRSA isolates were highly resistant to penicillin and erythromycin, and 17 (85.7%) were highly sensitive to vancomycin. Being male (AOR 6.74, 95% CI 1.31-34.76), history of sickness in past year (AOR 4.89, 95% CI 1.82- 13.12), being sick for more 3 times (AOR 8.91, 95% CI 2.32-34.20), being diabetic (AOR 4.87, 95% CI 1.55-15.36) and illicit drug use (AOR 10.18, 95%CI 1.36-76.52) were found to be independently associated with MRSA colonization. Conclusion A study identified a high prevalence of MRSA colonization among patients admitted in the ICU. MRSA isolates were highly resistant to penicillin and erythromycin. History of illegal drug use was highly associated with MRSA colonization. PMID:26448806

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

        PubMed Central

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

        2015-01-01

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

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

        PubMed Central

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

        2011-01-01

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

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

        PubMed

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

        2014-01-01

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

      • Artisan Training and Employment Outcomes in Tanzania

        ERIC Educational Resources Information Center

        Bennell, Paul; Mukyanuzi, Faustin; Kasogela, Maurice; Mutashubirwa, Francis; Klim, Mikkel

        2006-01-01

        This article presents the main findings of a tracer survey of graduates from two artisan training centres in Tanzania, which was undertaken in early 2002. The two institutions are the Chang'ombe Regional Vocational Training and Service Centre (RVTSC) in Dar es Salaam and the Iringa RVTSC, which are owned and managed by the Vocational Education and…

      • Disposal frequencies of selected recyclable wastes in Dar es Salaam.

        PubMed

        Mgaya, Prosper; Nondek, Lubomir

        2004-01-01

        A statistical survey of households based upon questionnaires distributed via primary schools has been carried out in five wards of Dar es Salaam, Tanzania, to estimate disposal frequencies (number of items disposed per week) for newsprint, metal cans, glass and plastic containers and plastic shopping bags. Plastic shopping bags are disposed most frequently while glass containers are disposed least frequently. The statistical distribution of disposal frequencies, which seems to be influenced by household income, is well described by Poisson distribution. Disposal frequencies are mutually correlated at 95% level of probability despite the differences in disposal patterns of individual households. PMID:15504670

      • 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

      • Clinical and epidemiologic variations of esophageal cancer in Tanzania

        PubMed Central

        Gabel, Jaime V; Chamberlain, Robert M; Ngoma, Twalib; Mwaiselage, Julius; Schmid, Kendra K; Kahesa, Crispin; Soliman, Amr S

        2016-01-01

        AIM: To estimate the incidence of esophageal cancer (EC) in Kilimanjaro in comparison to other regions in Tanzania. METHODS: We also examined the clinical, epidemiologic, and geographic distribution of the 1332 EC patients diagnosed and/or treated at Ocean Road Cancer Institute (ORCI) during the period 2006-2013. Medical records were used to abstract patient information on age, sex, residence, smoking status, alcohol consumption, tumor site, histopathologic type of tumor, date and place of diagnosis, and type and date of treatment at ORCI. Regional variation of EC patients was investigated at the level of the 26 administrative regions of Tanzania. Total, age- and sex-specific incidence rates were calculated. RESULTS: Male patients 55 years and older had higher incidence of EC than female and younger patients. Of histopathologically-confirmed cases, squamous-cell carcinoma represented 90.9% of histopathologic types of tumors. The administrative regions in the central and eastern parts of Tanzania had higher incidence rates than western regions, specifically administrative regions of Kilimanjaro, Dar es Salaam, and Tanga had the highest rates. CONCLUSION: Further research should focus on investigating possible etiologic factors for EC in regions with high incidence in Tanzania. PMID:26989467

      • Walking in Unfamiliar Territory: Headteachers' Preparation and First-Year Experiences in Tanzania

        ERIC Educational Resources Information Center

        Onguko, Brown Bully; Abdalla, Mohamed; Webber, Charles F.

        2012-01-01

        Purpose: The purpose of this study is to describe the preappointment experiences of early-career headteachers in Tanzania and to discuss implications for postsecondary institutions and ministries of education in East Africa. Research Design: Seven novice headteachers in a suburb of Dar es Salaam, Tanzania, completed questionnaires and participated…

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

        PubMed Central

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

        2015-01-01

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

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

        PubMed

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

        2015-11-01

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

  1. 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.…

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

    PubMed Central

    2010-01-01

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

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

    SciTech Connect

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

    2014-06-01

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

  4. Key considerations in scaling up male circumcision in Tanzania: views of the urban residents in Tanzania.

    PubMed

    Francis, Joel M; Kakoko, Deodatus; Tarimo, Edith A M; Munseri, Patricia; Bakari, Muhammad; Sandstrom, Eric

    2012-01-01

    Male circumcision (MC) reduces the risk of sexually transmitted infections (STI) including HIV. The WHO and UNAIDS recommend male circumcision as an additional intervention to prevent HIV infection. Tanzania is embarking on activities to scale up safe male circumcision for HIV prevention and other related health benefits. In line with this, it is crucial to assess views of the population using specific groups. This paper describes perceptions on male circumcision and strategies of enhancing uptake of male circumcision in urban Tanzania using members of the police force. This cross sectional survey was conducted among members of the police force in Dar es Salaam Tanzania from January 2010 to July 2010. The police officer serves as a source of the clinical trial participants in on-going phase I/II HIV vaccine trials. Three hundred and thirteen (313) police officers responded to a self-administered questionnaire that comprised of socio-demographic characteristics, reasons for not circumcising, perceptions regarding circumcision, methods of enhancing male circumcision, communication means and barriers to promote circumcision. This was followed by a physical examination to determine male circumcision status. The prevalence of circumcision was 96%. Most (69%) reported to have been circumcised in the hospital. The reported barriers to male circumcision among adults and children were: anticipation of pain, cost, fear to lose body parts, and lack of advice for adult's circumcision. Sensitization of parents who take children to the reproductive and child health services was recommended by most respondents as the appropriate strategy to promote male circumcision. The least recommended strategy was for the women to sensitize men. Use of radio programs and including male circumcision issues in school curricula as means of enhancing community sensitization regarding male circumcision were also highly recommended. Other recommendations include use of public media, seminars at work and issuance of circumcision regulations by health authorities. In conclusion, the present study reveals male circumcision was common in a selected urban population. There are various barriers and channels of communication regarding male circumcision. In view of scaling male circumcision in Tanzania, use of radio messages, inclusion of male circumcision in the school curricula and sensitization at the reproductive and child health clinics are likely to promote early medical male circumcision. PMID:26591748

  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. 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

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

    PubMed Central

    KELLY, ANN H.; LEZAUN, JAVIER

    2014-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

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

    ERIC Educational Resources Information Center

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

    2010-01-01

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

  12. Maternal mortality and morbidity. Women's reproductive health in Tanzania.

    PubMed

    Alloo, F

    1994-01-01

    Sexuality is a taboo for women in a patriarchal society. Tanzania has inadequate reproductive health care. Aspects of reproductive health are dealt with in safe motherhood or maternal and child health programs. Tanzania's health policy is based on women as mothers; it does not refer to women's right. For women in Tanzania, reproductive health is the right to live. Thousands of Tanzanian women die every year due to maternal complications. In an effort to contribute to the improvement of the conditions in health institutions and the advancement of women's status in the country, the Tanzania Media Women's Association (TAMWA) and the Medical Women's Association of Tanzania (MEWATA) joined in the organization of a Reproductive Health Meeting in Dar es Salaam. At the conference, major factors causing maternal mortality and morbidity, such as complications of abortion, anaemia in pregnancy, hypertensive disorders in pregnancy and puerperal sepsis, were discussed. A World Health Organization (WHO) report indicated that maternal mortality in Tanzania was 200-400/100,000 live births, while a survey conducted by MEWATA showed that maternal deaths at the Muhimbili Medical Center in the capital were 754/100,000 live births in 1991. Many maternal deaths could be prevented if hospitals were be properly equipped. Tanzanian women's poor health results in large part from their low socioeconomic status, poor nutrition, lack of income and employment. TAMWA chairperson Fatma Alloo and Dr. Kimambo (Ministry of Health) endorsed a national women's health movement to demand a government commitment to a holistic reproductive health policy. PMID:12288398

  13. Using mixed methods to evaluate perceived quality of care in southern Tanzania

    PubMed Central

    Tancred, Tara; Schellenberg, Joanna; Marchant, Tanya

    2016-01-01

    Objective To compare perceived quality of maternal and newborn care using quantitative and qualitative methods. Design A continuous household survey (April 2011 to November 2013) and in-depth interviews and birth narratives. Setting Tandahimba district, Tanzania. Participants Women aged 13–49 years who had a birth in the previous 2 years were interviewed in a household survey. Recently delivered mothers and their partners participated in in-depth interviews and birth narratives. Intervention None. Main Outcome Measures Perceived quality of care. Results Quantitative: 1138 women were surveyed and 93% were confident in staff availability and 61% felt that required drugs and equipment would be available. Drinking water was easily accessed by only 60% of respondents using hospitals. Measures of interaction with staff were very positive, but only 51% reported being given time to ask questions. Unexpected out-of-pocket payments were higher in hospitals (49%) and health centres (53%) than in dispensaries (31%). Qualitative data echoed the lack of confidence in facility readiness, out-of-pocket payments and difficulty accessing water, but was divergent in responses about interactions with health staff. More than half described staff interactions that were disrespectful, not polite, or not helpful. Conclusion Both methods produced broadly aligned results on perceived readiness, but divergent results on perceptions about client–staff interactions. Benefits and limitations to both quantitative and qualitative approaches were observed. Using mixed methodologies may prove particularly valuable in capturing the user experience of maternal and newborn health services, where they appear to be little used together. PMID:26823050

  14. Rapid assessment of trachoma prevalence--Singida, Tanzania. A study to compare assessment methods.

    PubMed

    Paxton, A

    2001-07-01

    This article presents a methodology for the rapid assessment of trachoma that was validated against a prevalence survey, undertaken simultaneously in the same 12 villages in central Tanzania. The rapid assessment protocol suggests examinations for active trachoma in 50 children ages 1-10 in at least 20 households chosen from the high-risk neighborhoods in each village. Women over the age of 15 in the same households were examined for trichiasis. In the rapid assessment, 244 households were visited, with 691 children and 470 women examined. In the prevalence survey, 377 households were visited, with 1855 children and 1310 women examined. Rankings of the villages using population prevalence of active disease and rapid assessment prevalence of active disease are highly correlated (Spearman correlation = 0.59, p < 0.05). In fact, the three villages with the highest prevalence in the population data were identified as the villages with the highest prevalence by the rapid assessment. Although rankings of the villages using population prevalence of trichiasis and rapid assessment prevalence of trichiasis are positively correlated, this correlation is not significantly different from zero, the village with the highest trichiasis prevalence according to the random sample being ranked as 8th by the rapid assessment. The cost of the rapid assessment was roughly one-third the cost of the prevalence survey. Thus, it appears that the rapid assessment method can quickly and inexpensively determine which villages have the greatest amount of active disease in children, and roughly estimate the burden of trichiasis in the community. PMID:11471078

  15. Research Trends in Emerging Contaminants on the Aquatic Environments of Tanzania.

    PubMed

    Miraji, H; Othman, O C; Ngassapa, F N; Mureithi, E W

    2016-01-01

    The continuity for discovery and production of new chemicals, allied products, and uses has currently resulted into generation of recent form of contaminants known as Emerging Contaminants (ECs). Once in the aquatic environment ECs are carcinogenic and cause other threats to both human's and animals' health. Due to their effects this study was aimed at investigating research trends of ECs in Tanzania. Findings revealed that USA and EU countries were leading in ECs researches, little followed by Asia, South Africa, and then Zambia. Only few guidelines from USA-EPA, WHO, Canada, and Australia existed. Neither published guidelines nor regulations for ECs existed in Tanzania; rather only the occurrence of some disinfection by-products and antibiotics was, respectively, reported in Arusha and Dar es Salaam, Tanzania. As these reports had a limited coverage of ECs, henceforth, these findings constitute the first-line reference materials for ECs research in Tanzania which shall be useful for future monitoring and regulation planning. PMID:26998381

  16. Research Trends in Emerging Contaminants on the Aquatic Environments of Tanzania

    PubMed Central

    Miraji, H.; Othman, O. C.; Ngassapa, F. N.; Mureithi, E. W.

    2016-01-01

    The continuity for discovery and production of new chemicals, allied products, and uses has currently resulted into generation of recent form of contaminants known as Emerging Contaminants (ECs). Once in the aquatic environment ECs are carcinogenic and cause other threats to both human's and animals' health. Due to their effects this study was aimed at investigating research trends of ECs in Tanzania. Findings revealed that USA and EU countries were leading in ECs researches, little followed by Asia, South Africa, and then Zambia. Only few guidelines from USA-EPA, WHO, Canada, and Australia existed. Neither published guidelines nor regulations for ECs existed in Tanzania; rather only the occurrence of some disinfection by-products and antibiotics was, respectively, reported in Arusha and Dar es Salaam, Tanzania. As these reports had a limited coverage of ECs, henceforth, these findings constitute the first-line reference materials for ECs research in Tanzania which shall be useful for future monitoring and regulation planning. PMID:26998381

  17. Cutaneous squamous cell carcinoma in Tanzania.

    PubMed

    Amir, H; Mbonde, M P; Kitinya, J N

    1992-11-01

    The Tanzania Cancer Registry at Muhimbili Medical Centre, Dar es Salaam, Tanzania was reviewed for squamous cell carcinoma of the skin in non-albino African subjects. The data was analysed for age, sex, site and predisposing factors. Our results were then compared with studies previously carried out in Tanzania, elsewhere in Africa and also on Blacks in America. Squamous cell carcinoma of the skin was found to be a common malignancy, and the commonest skin cancer. Its peak was in the 40-49 years age group though it could occur in children under five years of age. The most affected site was the lower limb, followed by the head and the neck. The penis in the male and the vulva in the female were the third most affected sites. The scalp and the lip were more affected in females than males. Chronic trauma, chronic ulcers, and scars were the main predisposing risk factors to the lower limb and the scalp, while ultra violet radiation to the head and neck, and smegma of the uncircumcised penis were thought to be predisposing risk factors. PMID:1308840

  18. Is Development Assistance for Health fungible? Findings from a mixed methods case study in Tanzania.

    PubMed

    Martínez Álvarez, Melisa; Borghi, Josephine; Acharya, Arnab; Vassall, Anna

    2016-06-01

    The amount of Development Assistance for Health (DAH) available to low- and middle-income countries has increased exponentially over the past decade. However, there are concerns that DAH increases have not resulted in increased spending on health at the country level. This is because DAH may be fungible, resulting from the recipient government decreasing its contribution to the health sector as a result of external funding. The aim of this research is to assess whether DAH funds in Tanzania are fungible, by exploring government substitution of its own resources across sectors and within the health sector. A database containing 28140 projects of DAH expenditure between 2000 and 2010 was compiled from the Organisation for Economic Co-operation and Development's Creditor Reporting System (OECD-CRS) and AidData databases. Government health expenditure data for the same period were obtained from the Government of Tanzania, World Bank, public expenditure reviews and budget speeches and analysed to assess the degree of government substitution. 22 semi-structured interviews were conducted with Development Partners (DPs), government and non-government stakeholders between April and June 2012 to explore stakeholder perceptions of fungibility. We found some evidence of substitution of government funds at the health sector and sub-sector levels and two mechanisms through which it takes place: the resource allocation process and macro-economic factors. We found fungibility of external funds may not necessarily be detrimental to Tanzania's development (as evidence suggests the funds displaced may be reallocated to education) and the mechanisms used by DPs to prevent substitution were largely ineffective. We recommend DPs engage more effectively in the priority-setting process, not just with the Ministry of Health and Social Welfare (MoHSW), but also with the Ministry of Finance, to agree on priorities and mutual funding responsibilities at a macroeconomic level. We also call for more qualitative research on fungibility. PMID:27183131

  19. 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

  20. Coping with urban growth and development through environmental planning and management (EPM): the sustainable Dar es Salaam project.

    PubMed

    Majani, B B

    1996-03-01

    This article discusses the Urban Management Program (UMP) in Dar es Salaam, Tanzania. The UMP is a joint effort of UNCHS (Habitat), UNDP, and the World Bank. The UMP established the Sustainable Cities Program (SCP) in August 1990. The aim was to provide city officials and their partners in private, public, and popular sectors with improved environmental planning and management capacity. Dar es Salaam has 4 major land formations that constrain management options. About 70% of urban population live in unplanned areas with marginal access to piped water, sanitation, drainage, or basic social services. Improper waste disposal has contributed to water pollution. Under 3% of the city's solid waste is collected. Low lying areas along the coast become flooded, and poor drainage causes continually flooded road systems. SCP began a 4-stage process to identify issues, develop and implement strategy and action plans, and institutionalize the process. An environmental profile was established in 1992. Plans were developed for solid waste management, upgrading unplanned settlements, servicing planned land and city center renewal, and managing open spaces, wastes, and petty trading. These efforts were institutionalized. The efforts are noteworthy for their active participation in plan preparation by key urban managers, multisectoral coordination on environmental issues, involvement of the private sector, establishment of priorities, and detailed action plans. Political support at the highest levels combined with community participation were key to program success. The lessons learned are identified. PMID:12178488

  1. 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…

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

    PubMed Central

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

    2015-01-01

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

  3. Effect of prenatal and perinatal antibiotics on maternal health in Malawi, Tanzania, and Zambia

    PubMed Central

    Aboud, Said; Msamanga, Gernard; Read, Jennifer S.; Wang, Lei; Mfalila, Chelu; Sharma, Usha; Martinson, Francis; Taha, Taha E.; Goldenberg, Robert L.; Fawzi, Wafaie W.

    2009-01-01

    Objective We assessed the effect of prenatal and peripartum antibiotics on maternal morbidity and mortality among HIV-infected and uninfected women. Methods A multicenter trial was conducted at clinical sites in 4 Sub-Saharan African cities: Blantyre and Lilongwe, Malawi; Dar es Salaam, Tanzania; and Lusaka, Zambia. A total of 1558 HIV-infected and 271 uninfected pregnant women who were eligible to receive both the prenatal and peripartum antibiotic/placebo regimens were enrolled. Pregnant women were interviewed at 20–24 weeks of gestation and a physical examination was performed. Women were randomized to receive either antibiotics or placebo. At the 26–30 week visit, participants were given antibiotics or placebo to be taken every 4 hours beginning at the onset of labor and continuing after delivery 3 times a day until a 1-week course was completed. Logistic regression and Cox proportional hazards models were used. Results There were no significant differences between the antibiotic and placebo groups for medical conditions, obstetric complications, physical examination findings, puerperal sepsis, and death in either the HIV-infected or the uninfected cohort. Conclusion Administration of study antibiotics during pregnancy had no effect on maternal morbidity and mortality among HIV-infected and uninfected pregnant women. PMID:19716560

  4. 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

  5. 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.

  6. 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

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

    NASA Astrophysics Data System (ADS)

    Mwakalila, Shadrack

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

  8. Improved salt iodation methods for small-scale salt producers in low-resource settings in Tanzania

    PubMed Central

    Assey, Vincent D; Tylleskr, Thorkild; Momburi, Philip B; Maganga, Michael; Mlingi, Nicholaus V; Reilly, Marie; Greiner, Ted; Peterson, Stefan

    2009-01-01

    Background Universal salt iodation will prevent iodine deficiency disorders (IDD). Globally, salt-iodation technologies mostly target large and medium-scale salt-producers. Since most producers in low-income countries are small-scale, we examined and improved the performance of hand and knapsack-sprayers used locally in Tanzania. Methods We studied three salt facilities on the Bagamoyo coast, investigating procedures for preparing potassium-iodate solution, salt spraying and mixing. Different concentrations of solution were prepared and tested using different iodation methods, with the aim of attaining correct and homogeneous iodine levels under real-life conditions. Levels achieved by manual mixing were compared to those achieved by machine mixing. Results The overall median iodation level in samples of salt iodated using previously existing methods was 10.6 ppm (range 1.1 110.0 ppm), with much higher levels in the top than the bottom layers of the salt bags, p < 0.0001. Experimentation using knapsack-sprayers and manual mixing led to the reliable achievement of levels (60.9 ppm 7.4) that fell within the recommended range of 40 80 ppm. The improved methods yielded homogenous iodine concentrations in all layers of salt-bags (p = 0.58) with 96% of the samples (n = 45) falling within 40 80 ppm compared to only 9% (n = 45) before the experiment and training (p < 0.0001). For knapsack-spraying, a machine mixer improved the iodine levels and homogeneity slightly compared to manual mixing (p = 0.05). Conclusion Supervised, standardized salt iodation procedures adapted to local circumstances can yield homogeneous iodine levels within the required range, overcoming a major obstacle to universal salt iodation. PMID:19534763

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

    PubMed Central

    2013-01-01

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

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

    PubMed Central

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

    2003-01-01

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

  11. Providing anti-retroviral therapy in the context of self-perceived stigma: a mixed methods study from Tanzania.

    PubMed

    Tarimo, Edith A M; George, John

    2014-04-01

    Adherence to anti-retroviral treatment (ART) has been a significant step towards improving quality of life among people living with HIV. However, stigma has been described to influence adherence to ART. A cross-sectional mixed methods study was conducted to explore factors related to stigma and perceived influence of stigma on adherence to treatment amongst ART-prescribed patients and health care providers, respectively in Tanzania. Stigma was assessed through interviewer administered survey among 295 patients. The results from patients showed that 279/295 (95%) were satisfied with the services provided at the Care and Treatment Centres (CTCs). The set up of CTCs 107/295 (36%), and queuing at the CTCs 88/295 (30%) were associated with stigma (P < 0.001). The perceived influence of stigma on adherence to ART was assessed using focus group discussions (FGDs) of 33 health care providers (HCPs). Through FGDs, HCPs perceived the set up of CTCs as friendly yet violated confidentiality. The HCPs reported that ART-prescribed patients hide identifiable cards to avoid being recognised by other people. Some patients were reported to rush to avoid familiar faces, and due to the rush they picked wrong medicines. Also some patients were reported to throw away manufacturers' box with dosage instructions written on the box, resulting in use of doses contrary to the prescriptions. We conclude that despite the fact that most patients were satisfied with the services provided at the CTCs, it is important that HCPs provide dosage instructions on another piece of paper or use disposable bags. A common dispensing window for all patients regardless of the diagnosis may be useful to minimize stigma. Also HCPs may introduce appointment system to avoid long queue at the CTCs. PMID:26875301

  12. Claiming territory: medical mission, interreligious revivalism, and the spatialization of health interventions in urban Tanzania.

    PubMed

    Dilger, Hansjörg

    2014-01-01

    Over the past decades, new religious actors have become involved in the provision of medical care in urban Tanzania. Muslim revivalist organizations and neo-Pentecostal churches in particular have established a range of health interventions that are tied to revisionist claims about religion, spirituality, and politics in society. In this article I discuss medical mission in Dar es Salaam in the light of (post)colonial histories of health service provision as well as with regard to inter- and intradenominational contestations over health and well-being, a morally acceptable life, and political participation. I argue that the nature of the inscription of revivalist organizations in urban space through health interventions depends on their structural location and their respective members' social and economic capital. I also show that the ongoing transformations of urban space through medical mission have become reflective of, as well as are triggering, moral interpretations of history and social inequality in contemporary Tanzania. PMID:24383752

  13. 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

  14. Establishing an Anaesthesia and Intensive Care partnership and aiming for national impact in Tanzania.

    PubMed

    Ulisubisya, Mpoki; Jörnvall, Henrik; Irestedt, Lars; Baker, Tim

    2016-01-01

    Anaesthesia and Intensive Care is a neglected specialty in low-income countries. There is an acute shortage of health workers - several low-income countries have less than 1 anaesthesia provider per 100,000 population. Only 1.5 % of hospitals in Africa have the intensive care resources needed for managing patients with sepsis. Health partnerships between institutions in high and low-income countries have been proposed as an effective way to strengthen health systems. The aim of this article is to describe the origin and conduct of a health partnership in Anaesthesia and Intensive Care between institutions in Tanzania and Sweden and how the partnership has expanded to have an impact at regional and national levels.The Muhimbili-Karolinska Anaesthesia and Intensive Care Collaboration was initiated in 2008 on the request of the Executive Director of Muhimbili National Hospital in Dar es Salaam. The partnership has conducted training courses, exchanges, research projects and introduced new equipment, routines and guidelines. The partnership has expanded to include all hospitals in Dar es Salaam. Through the newly formed Life Support Foundation, the partnership has had a national impact assisting the reanimation of the Society of Anaesthesiologists of Tanzania and has seen a marked increase of the number of young doctors choosing a residency in Anaesthesia and Intensive Care. PMID:26993790

  15. Point-of-sale promotion of breastmilk substitutes and commercially produced complementary foods in Cambodia, Nepal, Senegal and Tanzania.

    PubMed

    Champeny, Mary; Pereira, Catherine; Sweet, Lara; Khin, Mengkheang; Ndiaye Coly, Aminata; Sy Gueye, Ndeye Yaga; Adhikary, Indu; Dhungel, Shrid; Makafu, Cecilia; Zehner, Elizabeth; Huffman, Sandra L

    2016-04-01

    In order to assess the prevalence of point-of-sale promotions of infant and young child feeding products in Phnom Penh, Cambodia; Kathmandu Valley, Nepal; Dakar Department, Senegal; and Dar es Salaam, Tanzania, approximately 30 retail stores per site, 121 in total, were visited. Promotional activity for breastmilk substitutes (BMS) and commercially produced complementary foods in each site were recorded. Point-of-sale promotion of BMS occurred in approximately one-third of sampled stores in Phnom Penh and Dakar Department but in 3.2% and 6.7% of stores in Kathmandu Valley and Dar es Salaam, respectively. Promotion of commercially produced complementary foods was highly prevalent in Dakar Department with half of stores having at least one promotion, while promotions for these products occurred in 10% or less of stores in the other three sites. While promotion of BMS in stores is legal in Senegal, it is prohibited in Cambodia without prior permission of the Ministry of Health/Ministry of Information and prohibited in both Nepal and Tanzania. Strengthening legislation in Senegal and enforcing regulations in Cambodia could help to prevent such promotion that can negatively affect breastfeeding practices. Key messages Even in countries such as Cambodia, Nepal and Tanzania where point-of-sale promotion is restricted, promotions of BMS were observed (in nearly one-third of stores in Phnom Penh and less than 10% in Dar es Salaam and Kathmandu). Limited promotion of commercially produced complementary foods was evident (less than 10% of stores had a promotion for such foods), except in Dakar Department, where promotions were found in half of stores. Efforts are needed to strengthen monitoring, regulation and enforcement of restrictions on the promotion of BMS. Manufacturers and distributors should take responsibility for compliance with national regulations and global policies pertaining to the promotion of breastmilk substitutes. PMID:27061961

  16. A novel technology to improve drinking water quality using natural treatment methods in rural Tanzania.

    PubMed

    Mbogo, Shaaban Aman

    2008-03-01

    It is estimated that one billion people worldwide do not have access to treated drinking water. This paper reports on an investigation into the potential of indigenous or natural water treatment methods as alternatives to conventional chemical water treatment methods. The seeds of five natural plant species--Vigna unguiculata, Phaseolus mungo, Glycine max, Pisum sativam, and Arachis hypogea--were evaluated for the removal of turbidity, and their efficiency was compared with that of alum. The use of a solar energy-saving method to disinfect drinking water--leaving it to heat under the sun to reduce bacteria colonies--also was evaluated, The study revealed that for raw water with turbidity of 482 nephelometric turbidity units, coagulation with seed extracts from natural plant species reduced natural turbidity by 96.7 to 100 percent when the seed extract was used as the primary coagulant and by 100 percent when it was used as a coagulant aid. The study showed further that natural coagulants were as effective as commercial alum [Al2(SO4)3] and even superior for clarification because the optimum dosage was low compared with that of alum. Leaving samples of water clarified by natural coagulants on a black-painted roof for 8 hours achieved up to 100 percent bacteria kill. PMID:18348392

  17. The Development of Snail Control Methods on an Irrigated Sugar-Cane Estate in Northern Tanzania*

    PubMed Central

    Fenwick, A.

    1970-01-01

    In an attempt to prevent the transmission of Schistosoma mansoni on an irrigated sugar-cane estate, molluscicide experiments were carried out to find the optimum methods for controlling the intermediate-host snails, Biomphalaria pfeifferi. The ease of application of N-tritylmorpholine led to its adoption as the molluscicide of choice for the two separate irrigation systems on the estate. Experiments on the frequency and duration of molluscicide treatments were carried out, and from these it was concluded that 5-day applications of N-tritylmorpholine at 0.025 ppm every 7 weeks might lead to a break in transmission by control of the snails. In another set of trials, drainage ditches were treated alternately with N-tritylmorpholine and niclosamide ethanolamine salt, and although the chemicals differed only slightly in their effect, the latter—being ovicidal—was chosen to be applied at approximately 4 ppm by knapsack sprayer every 8 weeks. Extra treatment of small pools with the same compound was carried out during the long rains when irrigation was unnecessary and most of the canals were dry. It is pointed out that the effect of the control methods on S. mansoni transmission will need to be evaluated by studying the incidence of the disease in the population. PMID:5310954

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

    PubMed Central

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

    2014-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2015-02-01

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

  20. Self Evaluation: A Case Study of a School in Dar Es Salaam, Tanzania

    ERIC Educational Resources Information Center

    Kokeyo, Carolyne Adhiambo; Oluoch, John

    2015-01-01

    External evaluation of schools purpose to monitor delivery of education with a view to ensuring adherence to stipulated curriculum and set standards as well as efficient and effective quality education. However, school improvement scholars in developed economies now argue that schools must take their own initiative to assess the extent to which

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

    NASA Astrophysics Data System (ADS)

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

    2012-10-01

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

  2. Huntington's disease in Tanzania.

    PubMed Central

    Scrimgeour, E M

    1981-01-01

    Huntington's disease was studied in a Bantu community in northern Tanzania. Although there is evidence to suggest that the disease has been present here for over one hundred years, this is the first report of the condition in Tanzania. A survey of published reports indicates that the disease is infrequently reported in persons of Negro ancestry. PMID:6453998

  3. Mixed Methods Survey of Zoonotic Disease Awareness and Practice among Animal and Human Healthcare Providers in Moshi, Tanzania

    PubMed Central

    Zhang, Helen L.; Mnzava, Kunda W.; Mitchell, Sarah T.; Melubo, Matayo L.; Kibona, Tito J.; Cleaveland, Sarah; Kazwala, Rudovick R.; Crump, John A.; Sharp, Joanne P.; Halliday, Jo E. B.

    2016-01-01

    Background Zoonoses are common causes of human and livestock illness in Tanzania. Previous studies have shown that brucellosis, leptospirosis, and Q fever account for a large proportion of human febrile illness in northern Tanzania, yet they are infrequently diagnosed. We conducted this study to assess awareness and knowledge regarding selected zoonoses among healthcare providers in Moshi, Tanzania; to determine what diagnostic and treatment protocols are utilized; and obtain insights into contextual factors contributing to the apparent under-diagnosis of zoonoses. Methodology/Results We conducted a questionnaire about zoonoses knowledge, case reporting, and testing with 52 human health practitioners and 10 livestock health providers. Immediately following questionnaire administration, we conducted semi-structured interviews with 60 of these respondents, using the findings of a previous fever etiology study to prompt conversation. Sixty respondents (97%) had heard of brucellosis, 26 (42%) leptospirosis, and 20 (32%) Q fever. Animal sector respondents reported seeing cases of animal brucellosis (4), rabies (4), and anthrax (3) in the previous 12 months. Human sector respondents reported cases of human brucellosis (15, 29%), rabies (9, 18%) and anthrax (6, 12%). None reported leptospirosis or Q fever cases. Nineteen respondents were aware of a local diagnostic test for human brucellosis. Reports of tests for human leptospirosis or Q fever, or for any of the study pathogens in animals, were rare. Many respondents expressed awareness of malaria over-diagnosis and zoonoses under-diagnosis, and many identified low knowledge and testing capacity as reasons for zoonoses under-diagnosis. Conclusions This study revealed differences in knowledge of different zoonoses and low case report frequencies of brucellosis, leptospirosis, and Q fever. There was a lack of known diagnostic services for leptospirosis and Q fever. These findings emphasize a need for improved diagnostic capacity alongside healthcare provider education and improved clinical guidelines for syndrome-based disease management to provoke diagnostic consideration of locally relevant zoonoses in the absence of laboratory confirmation. PMID:26943334

  4. 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

  5. Healthcare Cost of Smoking Induced Cardiovascular Disease in Tanzania

    PubMed Central

    Kidane, Asmerom; Hepelwa, Aloyce; Ngeh, Ernest Tingum; Hu, Teh-wei

    2016-01-01

    The study presented here estimates the total health care cost attributable to smoking induced cardiovascular disease in Tanzania. The study based on a survey conducted at a referral university hospital in Dar es Salaam in 2014. Assuming a 2% prevalence rate of cardiovascular disease and a population of 47.2 million, it was estimated that there are 943,800 cardiovascular patients in Tanzania. The proportion of ever smokers among the surveyed patients was found to be 25 percent yielding 240,400 patients who suffer from smoking induced cardiovascular diseases. Per capita annual expenditure per patient is estimated to be 566.6 US dollars and total annual expenditure for the country was estimated to be 136.1 million US dollars. On a per capita basis more direct and indirect cost is incurred on males compared to females; more is spent on the elderly (40 or more years) compared to the youth (less than 20 years). When compared with the mean annual household income of the surveyed population, the smoking induced per capita expenditure constitutes 35% of household income. PMID:27152318

  6. Mapping of Mycobacterium tuberculosis Complex Genetic Diversity Profiles in Tanzania and Other African Countries.

    PubMed

    Mbugi, Erasto V; Katale, Bugwesa Z; Streicher, Elizabeth M; Keyyu, Julius D; Kendall, Sharon L; Dockrell, Hazel M; Michel, Anita L; Rweyemamu, Mark M; Warren, Robin M; Matee, Mecky I; van Helden, Paul D; Couvin, David; Rastogi, Nalin

    2016-01-01

    The aim of this study was to assess and characterize Mycobacterium tuberculosis complex (MTBC) genotypic diversity in Tanzania, as well as in neighbouring East and other several African countries. We used spoligotyping to identify a total of 293 M. tuberculosis clinical isolates (one isolate per patient) collected in the Bunda, Dar es Salaam, Ngorongoro and Serengeti areas in Tanzania. The results were compared with results in the SITVIT2 international database of the Pasteur Institute of Guadeloupe. Genotyping and phylogeographical analyses highlighted the predominance of the CAS, T, EAI, and LAM MTBC lineages in Tanzania. The three most frequent Spoligotype International Types (SITs) were: SIT21/CAS1-Kili (n = 76; 25.94%), SIT59/LAM11-ZWE (n = 22; 7.51%), and SIT126/EAI5 tentatively reclassified as EAI3-TZA (n = 18; 6.14%). Furthermore, three SITs were newly created in this study (SIT4056/EAI5 n = 2, SIT4057/T1 n = 1, and SIT4058/EAI5 n = 1). We noted that the East-African-Indian (EAI) lineage was more predominant in Bunda, the Manu lineage was more common among strains isolated in Ngorongoro, and the Central-Asian (CAS) lineage was more predominant in Dar es Salaam (p-value<0.0001). No statistically significant differences were noted when comparing HIV status of patients vs. major lineages (p-value = 0.103). However, when grouping lineages as Principal Genetic Groups (PGG), we noticed that PGG2/3 group (Haarlem, LAM, S, T, and X) was more associated with HIV-positive patients as compared to PGG1 group (Beijing, CAS, EAI, and Manu) (p-value = 0.03). This study provided mapping of MTBC genetic diversity in Tanzania (containing information on isolates from different cities) and neighbouring East African and other several African countries highlighting differences as regards to MTBC genotypic distribution between Tanzania and other African countries. This work also allowed underlining of spoligotyping patterns tentatively grouped within the newly designated EAI3-TZA lineage (remarkable by absence of spacers 2 and 3, and represented by SIT126) which seems to be specific to Tanzania. However, further genotyping information would be needed to confirm this specificity. PMID:27149626

  7. Mapping of Mycobacterium tuberculosis Complex Genetic Diversity Profiles in Tanzania and Other African Countries

    PubMed Central

    Mbugi, Erasto V.; Katale, Bugwesa Z.; Streicher, Elizabeth M.; Keyyu, Julius D.; Kendall, Sharon L.; Dockrell, Hazel M.; Michel, Anita L.; Rweyemamu, Mark M.; Warren, Robin M.; Matee, Mecky I.; van Helden, Paul D.; Couvin, David; Rastogi, Nalin

    2016-01-01

    The aim of this study was to assess and characterize Mycobacterium tuberculosis complex (MTBC) genotypic diversity in Tanzania, as well as in neighbouring East and other several African countries. We used spoligotyping to identify a total of 293 M. tuberculosis clinical isolates (one isolate per patient) collected in the Bunda, Dar es Salaam, Ngorongoro and Serengeti areas in Tanzania. The results were compared with results in the SITVIT2 international database of the Pasteur Institute of Guadeloupe. Genotyping and phylogeographical analyses highlighted the predominance of the CAS, T, EAI, and LAM MTBC lineages in Tanzania. The three most frequent Spoligotype International Types (SITs) were: SIT21/CAS1-Kili (n = 76; 25.94%), SIT59/LAM11-ZWE (n = 22; 7.51%), and SIT126/EAI5 tentatively reclassified as EAI3-TZA (n = 18; 6.14%). Furthermore, three SITs were newly created in this study (SIT4056/EAI5 n = 2, SIT4057/T1 n = 1, and SIT4058/EAI5 n = 1). We noted that the East-African-Indian (EAI) lineage was more predominant in Bunda, the Manu lineage was more common among strains isolated in Ngorongoro, and the Central-Asian (CAS) lineage was more predominant in Dar es Salaam (p-value<0.0001). No statistically significant differences were noted when comparing HIV status of patients vs. major lineages (p-value = 0.103). However, when grouping lineages as Principal Genetic Groups (PGG), we noticed that PGG2/3 group (Haarlem, LAM, S, T, and X) was more associated with HIV-positive patients as compared to PGG1 group (Beijing, CAS, EAI, and Manu) (p-value = 0.03). This study provided mapping of MTBC genetic diversity in Tanzania (containing information on isolates from different cities) and neighbouring East African and other several African countries highlighting differences as regards to MTBC genotypic distribution between Tanzania and other African countries. This work also allowed underlining of spoligotyping patterns tentatively grouped within the newly designated EAI3-TZA lineage (remarkable by absence of spacers 2 and 3, and represented by SIT126) which seems to be specific to Tanzania. However, further genotyping information would be needed to confirm this specificity. PMID:27149626

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

    PubMed

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

    2008-02-01

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

  9. An overview of the global threat reduction initiative's physical protection work in Tanzania.

    SciTech Connect

    Banzi, Firmi Paul; Itamura, Michael Takeshi; Robinson, Phillip W.; Strosinski, Micheal Vernon

    2010-06-01

    The U.S. Department of Energy's (DOE) National Nuclear Security Administration (NNSA) established the Global Threat Reduction Initiative's (GTRI) mission to reduce and protect nuclear and radiological materials located at civilian sites worldwide. Internationally, over 80 countries are cooperating with GTRI to enhance security of facilities with these materials. In 2004, a GTRI delegation began working with the Tanzania Atomic Energy Commission, (TAEC). The team conducted site assessments for the physical protection of radiological materials in Tanzania. Today, GTRI and the Government of Tanzania continue cooperative efforts to enhance physical security at several radiological sites, including a central sealed-source storage facility, and sites in the cities of Arusha, Dar Es Salaam, and Tanga. This paper describes the scope of physical protection work, lessons learned, and plans for future cooperation between the GTRI program and the TAEC. Additionally the paper will review the cooperative efforts between TAEC and the International Atomic Energy Agency (IAEA) with regards to a remote monitoring system at a storage facility and to the repackaging of radioactive sources.

  10. 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

  11. 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 β-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

  12. Solar Power for Tanzania

    SciTech Connect

    Chen, Christine; Gerace, Jay; Mehner, Nicole; Mohamed, Sharif; Reiss, Kelly

    1999-12-06

    Condensed list of products and activities: 8 educational posters and 1 informational brochure (all original illustrations and text); a business plan with micro-agreements; corporation created called Tanzanian Power, LLC; business feasibility study developed with the University of Albany; Hampshire College collaborated in project development; research conducted seeking similar projects in underdeveloped countries; Citibank proposal submitted (but rejected); cleaned and sent PV panels to Tanzania; community center built in Tanzania; research and list provided to Robinson for educational TV videos and product catalogs; networked with Chase Manhattan Bank for new solar panels; maintained flow of information among many people (stateside and Tanzania); wrote and sent press releases and other outreach information. Several families purchased panels.

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

    PubMed

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

    2015-12-01

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

  14. Tanzania: Country Status Report.

    ERIC Educational Resources Information Center

    Robson, Barbara

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

  15. 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

  16. Vouchers for scaling up insecticide-treated nets in Tanzania: Methods for monitoring and evaluation of a national health system intervention

    PubMed Central

    Hanson, Kara; Nathan, Rose; Marchant, Tanya; Mponda, Hadji; Jones, Caroline; Bruce, Jane; Stephen, Godlove; Mulligan, Jo; Mshinda, Hassan; Schellenberg, Joanna Armstrong

    2008-01-01

    Background The Tanzania National Voucher Scheme (TNVS) uses the public health system and the commercial sector to deliver subsidised insecticide-treated nets (ITNs) to pregnant women. The system began operation in October 2004 and by May 2006 was operating in all districts in the country. Evaluating complex public health interventions which operate at national level requires a multidisciplinary approach, novel methods, and collaboration with implementers to support the timely translation of findings into programme changes. This paper describes this novel approach to delivering ITNs and the design of the monitoring and evaluation (M&E). Methods A comprehensive and multidisciplinary M&E design was developed collaboratively between researchers and the National Malaria Control Programme. Five main domains of investigation were identified: (1) ITN coverage among target groups, (2) provision and use of reproductive and child health services, (3) "leakage" of vouchers, (4) the commercial ITN market, and (5) cost and cost-effectiveness of the scheme. Results The evaluation plan combined quantitative (household and facility surveys, voucher tracking, retail census and cost analysis) and qualitative (focus groups and in-depth interviews) methods. This plan was defined in collaboration with implementing partners but undertaken independently. Findings were reported regularly to the national malaria control programme and partners, and used to modify the implementation strategy over time. Conclusion The M&E of the TNVS is a potential model for generating information to guide national and international programmers about options for delivering priority interventions. It is independent, comprehensive, provides timely results, includes information on intermediate processes to allow implementation to be modified, measures leakage as well as coverage, and measures progress over time. PMID:18544162

  17. Comparing patterns of sexual risk among adolescent and young women in a mixed-method study in Tanzania: implications for adolescent participation in HIV prevention trials

    PubMed Central

    Tolley, Elizabeth E; Kaaya, Sylvia; Kaale, Anna; Minja, Anna; Bangapi, Doreen; Kalungura, Happy; Headley, Jennifer; Baumgartner, Joy Noel

    2014-01-01

    Introduction Despite the disproportionate impact of HIV on women, and adolescents in particular, those below age 18 years are underrepresented in HIV prevention trials due to ethical, safety and logistical concerns. This study examined and compared the sexual risk contexts of adolescent women aged 1517 to young adult women aged 1821 to determine whether adolescents exhibited similar risk profiles and the implications for their inclusion in future trials. Methods We conducted a two-phase, mixed-method study to assess the opportunities and challenges of recruiting and retaining adolescents (aged 1517) versus young women (1821) in Tanzania. Phase I, community formative research (CFR), used serial in-depth interviews with 11 adolescent and 12 young adult women from a range of sexual risk contexts in preparation for a mock clinical trial (MCT). For Phase II, 135 HIV-negative, non-pregnant adolescents and young women were enrolled into a six-month MCT to assess and compare differences in sexual and reproductive health (SRH) outcomes, including risky sexual behaviour, incident pregnancy, sexually transmitted infections (STIs), reproductive tract infections (RTIs) and HIV. Results In both research phases, adolescents appeared to be at similar, if not higher, risk than their young adult counterparts. Adolescents reported earlier sexual debut, and similar numbers of lifetime partners, pregnancy and STI/RTI rates, yet had lower perceived risk. Married women in the CFR appeared at particular risk but were less represented in the MCT. In addition, adolescents were less likely than their older counterparts to have accessed HIV testing, obtained gynaecological exams or used protective technologies. Conclusions Adolescent women under 18 are at risk of multiple negative SRH outcomes and they underuse preventive services. Their access to new technologies such as vaginal microbicides or pre-exposure prophylaxis (PrEP) may similarly be compromised unless greater effort is made to include them in clinical trial research. PMID:25224611

  18. Identification of VIM-2-Producing Pseudomonas aeruginosa from Tanzania Is Associated with Sequence Types 244 and 640 and the Location of blaVIM-2 in a TniC Integron

    PubMed 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 qacΔE1-sul1. PMID:25331700

  19. 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

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

    2011-01-01

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

  2. 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)

  3. 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

  4. 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…

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

    NASA Astrophysics Data System (ADS)

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

    2013-06-01

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

  6. 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.

  7. Flashblood: Blood sharing among female injecting drug users in Tanzania

    PubMed Central

    McCurdy, Sheryl A.; Ross, Michael W.; Williams, Mark L.; Kilonzo, G.P.; Leshabari, M.T.

    2010-01-01

    Aims This study examined the association between the blood-sharing practice “flashblood” and demographic factors, HIV status, and variables associated with risky sex and drug behaviors among female injecting drug users. Flashblood is a syringe full of blood passed from someone who has just injected heroin to someone else who injects it in lieu of heroin. Design A cross-sectional study. Setting Dar es Salaam, Tanzania. Participants One hundred and sixty-nine female injecting drug users (IDUs) were recruited using purposive sampling for hard-to-reach populations. Measurements The association between flashblood use, demographic and personal characteristics and risky sex and drug use variables was analyzed by t-test and χ2 test. The association between flashblood use and residential neighborhood was mapped. Findings Flashblood users were more likely to: be married (p=.05), have lived in the current housing situation for a shorter time (p<.000), have been forced as a child to have sex by a family member(p=.007), inject heroin more in the last 30 days (p=.005), smoke marijuana at an earlier age (p=.04), use contaminated rinse-water (p<.03), pool money for drugs (p<.03), and share drugs (p=.00). Non-flashblood users were more likely to live with their parents (p=.003). Neighborhood flashblood use was highest near downtown and in the two next adjoining suburbs and lowest in the most distant suburbs. Conclusions These data indicate that more vulnerable women who are heavy users and living in shorter term housing are injecting flashblood. The practice of flashblood appears to be spreading from the inner city to the suburbs. PMID:20331567

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

    PubMed Central

    2014-01-01

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

  9. Condom use and sexuality communication with adults: a study among high school students in South Africa and Tanzania

    PubMed Central

    2013-01-01

    Background Fostering adolescents’ communication on sexuality issues with their parents and other significant adults is often assumed to be an important component of intervention programmes aimed at promoting healthy adolescent sexual practices. However, there are few studies describing the relationship between such communication and sexual practices, particularly in sub-Saharan Africa. This study examined the relationships between adolescents’ communication with significant adults and their condom use in three sites in this region. Methods Data stem from a multi-site randomized controlled trial of a school-based HIV prevention intervention implemented in Cape Town and Mankweng, South Africa and Dar es Salaam, Tanzania. Only data from comparison schools were used. The design is therefore a prospective panel study with three waves of data collections. Data were collected in 2004 from 6,251 participants in 40 schools. Associations between adolescents’ communication with adults about sexuality issues and their use of condoms were analysed cross-sectionally using analysis of variance, as well as prospectively using multiple ordinal logistic regression analysis. Results Cross-sectional analyses showed that consistent condom users had significantly higher mean scores on communication (across topics and communication partners) than both occasional users and never-users, who had the lowest scores. After controlling for condom use at the first data collection occasion in each model as well as for possible confounders, communication scores significantly predicted consistent condom use prospectively in all three ordinal logistic regression models (Model R2 = .23 to .31). Conclusion The findings are consistent with the assertion that communication on sexuality issues between adolescents and significant adults results in safer sexual practices, as reflected by condom use, among in-school adolescents. The associations between communication variables and condom use might have been stronger if we had measured additional aspects of communication such as whether or not it was initiated by the adolescents themselves, the quality of advice provided by adults, and if it took place in a context of positive adult-adolescent interaction. Studies with experimental designs are needed in order to provide stronger evidence of causality. PMID:24053420

  10. Childhood Sexual Abuse among University Students in Tanzania

    ERIC Educational Resources Information Center

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

    2006-01-01

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

  11. 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

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

    PubMed Central

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

    2011-01-01

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

  13. Rationale and design of the Tanzania Vitamin and HIV Infection Trial.

    PubMed

    Fawzi, W W; Msamanga, G I; Spiegelman, D; Urassa, E J; Hunter, D J

    1999-02-01

    We present the rationale and design of a randomized, double-blind, placebo-controlled trial of vitamin supplements among HIV-positive pregnant women in Dar es Salaam, Tanzania. Higher levels of intake of vitamins A, B, C, and E may decrease the risk of vertical transmission and progression of HIV infection by enhancing maternal and infant immune function; by reducing viral load in the blood, breast milk, or lower genital tract secretions; and/or by strengthening the placental barrier to infection. Eligible pregnant women were randomized to receive vitamin A, multivitamins excluding A, vitamin A and multivitamins, or placebo. The main endpoints include vertical transmission of HIV infection, as assessed by examination of infection in infants using polymerase chain reaction (PCR), and progression of HIV disease as measured by the WHO clinical staging system. Over a period of 2 years, 13,876 women were tested for HIV infection, with appropriate pre- and posttest counseling, to enroll 1085 consenting HIV-positive women. The trial assesses women and their children once a month for a minimum of 18 months after delivery or up to the end of this 5-year study. We examine recruitment strategies and means of enhancing cohort retention in long-term follow-up. We assess compliance with the use of supplements by direct questioning, by counting pills, and biochemically by using serum beta-carotene and urine riboflavin levels. Briefly, we discuss ethical issues related to the conduct of AIDS prevention trials in this setting. In sub-Saharan Africa, most HIV-infected persons lack access to the relevant antiretroviral and prophylactic drugs, and the region urgently needs low-cost treatments and preventive strategies. The Tanzania trial should provide valuable data to address the effect of vitamin supplements in the transmission and progression of HIV infection. PMID:10027501

  14. 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

  15. 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…

  16. Crater Highlands, Tanzania

    NASA Technical Reports Server (NTRS)

    2006-01-01

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

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

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

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

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

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

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

  17. Dispensing Practice of Prescribed Medicines in the Private Pharmacies in Urban Areas of Tanzania

    PubMed Central

    Kamuhabwa, A. R.; Ignace, A. M.

    2015-01-01

    A descriptive cross-sectional study was conducted to assess quality of dispensing and knowledge of dispensers in 206 private retail pharmacies. The study was conducted in Dar es Salaam, Tanzania between September 2011 and April 2012. Patient simulation (mystery shopper) approach was used to assess dispensing skills of drug dispensers for prescription only medicines. In assessing dispensing skills, a 7-days course of metronidazole tablets was bought from each pharmacy. The knowledge of drug dispenser's regarding dispensing of prescription only medicines was assessed through focus group discussions and interviews. Majority (70.4%) of drug dispensers were not trained pharmaceutical personnel. The level of dispensing skills ranged from low (25.7%) to medium (70.4%). Majority of drug dispensers had low (11.4%) to medium (83.2%) levels of knowledge about dispensing of ‘prescription only’ medicines. From these findings, it is recommended that the national Pharmacy Council should ensure that prescription only medicines are dispensed by trained pharmaceutical personnel. On job training and continuing professional development should also be emphasized to build capacity of drug dispensers. PMID:26798168

  18. Community level composting in a developing country: case study of KIWODET, Tanzania.

    PubMed

    Oberlin, Aisa S; Szántó, Gábor L

    2011-10-01

    Environmentally sustainable waste management practices have a limited relevance and viability in developing countries. Despite a technological potential, composting initiatives often share this fate. Little is known about the functioning of community level composting, which is reportedly the optimal level for viable compost production. This paper presents a multidisciplinary analysis of factors influencing the success and failure of the composting initiative of KIWODET, a community based organization in Dar es Salaam, Tanzania. The results show that despite the ready availability and good compostability of the waste stream, not all fractions of municipal organic wastes qualify as feedstock. Negative consumer attitude hindered the acceptance of compost produced from residential wastes. KIWODET did manage to successfully implement a composting operation for commercial organic wastes. Their additional waste collection and sorting activities also contributed to an increased feedstock control as well as the integration of informal waste collecting activities. When KIWODET was forced to suspend its composting activities because of land use issues, their diversified waste sector activities proved crucial in reducing the negative financial impact on their overall performance. This paper emphasizes that successful composting initiatives can arise from local capacity in developing countries. However, the lack of municipal integration and support leaves such technically viable initiatives strongly vulnerable to external factors. PMID:21558081

  19. Genital tract infections among HIV-infected pregnant women in Malawi, Tanzania and Zambia

    PubMed Central

    Aboud, S; Msamanga, G; Read, J S; Mwatha, A; Chen, Y Q; Potter, D; Valentine, M; Sharma, U; Hoffmann, I; Taha, T E; Goldenberg, R L; Fawzi, W W

    2009-01-01

    Summary The aim of this study was to compare the prevalence and factors associated with genital tract infections among HIV-infected pregnant women from African sites. Participants were recruited from Blantyre and Lilongwe, Malawi; Dar es Salaam, Tanzania; and Lusaka, Zambia. Genital tract infections were assessed at baseline. Of 2627 eligible women enrolled, 2292 were HIV-infected. Of these, 47.8% had bacterial vaginosis (BV), 22.4% had vaginal candidiasis, 18.8% had trichomoniasis, 8.5% had genital warts, 2.6% had chlamydia infection, 2.2% had genital ulcers and 1.7% had gonorrhoea. The main factors associated with genital tract infections included genital warts (adjusted odds ratio [AOR] 1.8, 95% CI 1.2–2.7), genital ulcers (AOR 2.4, 95% CI 1.2–5.1) and abnormal vaginal discharge (AOR 2.5, 95% CI 1.9–3.3) for trichomoniasis. BV was the most common genital tract infection followed by candidiasis and trichomoniasis. Differences in burdens and risk factors call for enhanced interventions for identification of genital tract infections among HIV-infected women. PMID:19050213

  20. Dispensing Practice of Prescribed Medicines in the Private Pharmacies in Urban Areas of Tanzania.

    PubMed

    Kamuhabwa, A R; Ignace, A M

    2015-01-01

    A descriptive cross-sectional study was conducted to assess quality of dispensing and knowledge of dispensers in 206 private retail pharmacies. The study was conducted in Dar es Salaam, Tanzania between September 2011 and April 2012. Patient simulation (mystery shopper) approach was used to assess dispensing skills of drug dispensers for prescription only medicines. In assessing dispensing skills, a 7-days course of metronidazole tablets was bought from each pharmacy. The knowledge of drug dispenser's regarding dispensing of prescription only medicines was assessed through focus group discussions and interviews. Majority (70.4%) of drug dispensers were not trained pharmaceutical personnel. The level of dispensing skills ranged from low (25.7%) to medium (70.4%). Majority of drug dispensers had low (11.4%) to medium (83.2%) levels of knowledge about dispensing of 'prescription only' medicines. From these findings, it is recommended that the national Pharmacy Council should ensure that prescription only medicines are dispensed by trained pharmaceutical personnel. On job training and continuing professional development should also be emphasized to build capacity of drug dispensers. PMID:26798168

  1. 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

  2. Risk indicators associated with subclinical mastitis in smallholder dairy cows in Tanzania.

    PubMed

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

    2004-08-01

    Smallholder dairy farmers in Tanzania appear to be unaware of the subclinical mastitis situation in their cows. A cross-sectional study was carried out between June and September 2002 on smallholder dairy herds in the Dar es Salaam region. The study objectives were to establish the prevalence of subclinical mastitis and related risk indicators, and to assess their contribution to the occurrence of subclinical mastitis. Three field procedures based on the principles of herd health and production management were followed: clinical, farm and data inspection. The California mastitis test (CMT) was carried out on quarter milk samples to determine the prevalence of subclinical mastitis. A total of 182 lactating cows from 62 herds were investigated. Clinical inspection indicated that 3.8% of the lactating cows had clinical mastitis. Subclinical mastitis was detected in 90.3% of lactating cows screened. Farm inspection revealed that water scarcity, barn size, residual suckling, single udder-towel and dairy labourers as the most substantial (p < 0.05) risk indicators. Although most of the risk indicators studied were not found to be statistically significantly associated with the occurrence of subclinical mastitis, possibly owing to sample size and the presence of confounders, the epidemiological need to address such risk indicators cannot be overemphasized. PMID:15560518

  3. Molecular Characterization of Foot-and-Mouth Disease Viruses Collected in Tanzania Between 1967 and 2009.

    PubMed

    Kasanga, C J; Wadsworth, J; Mpelumbe-Ngeleja, C A R; Sallu, R; Kivaria, F; Wambura, P N; Yongolo, M G S; Rweyemamu, M M; Knowles, N J; King, D P

    2015-10-01

    This paper describes the molecular characterization of foot-and-mouth disease viruses (FMDV) recovered from outbreaks in Tanzania that occurred between 1967 and 2009. A total of 44 FMDV isolates, containing representatives of serotypes O, A, SAT 1 and SAT 2 from 13 regions of Tanzania, were selected from the FAO World Reference Laboratory for FMD (WRLFMD) virus collection. VP1 nucleotide sequences were determined for RT-PCR amplicons, and phylogenetic reconstructions were determined by maximum likelihood and neighbour-joining methods. These analyses showed that Tanzanian type O viruses fell into the EAST AFRICA 2 (EA-2) topotype, type A viruses fell into the AFRICA topotype (genotype I), type SAT 1 viruses into topotype I and type SAT 2 viruses into topotype IV. Taken together, these findings reveal that serotypes O, A, SAT 1 and SAT 2 that caused FMD outbreaks in Tanzania were genetically related to lineages and topotypes occurring in the East African region. The close genetic relationship of viruses in Tanzania to those from other countries suggests that animal movements can contribute to virus dispersal in sub-Saharan Africa. This is the first molecular description of viruses circulating in Tanzania and highlights the need for further sampling of representative viruses from the region so as to elucidate the complex epidemiology of FMD in Tanzania and sub-Saharan Africa. PMID:24460931

  4. 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.

  5. Antimicrobial resistance among producers and non-producers of extended spectrum beta-lactamases in urinary isolates at a tertiary Hospital in Tanzania

    PubMed Central

    2010-01-01

    Background Published data on the existence and magnitude of extended spectrum beta-lactamase (ESBL) production in urinary pathogens in local setting is limited. The aim of the present study was to determine the prevalence of antimicrobial resistance and ESBL production among Escherichia coli and Klebsiella spp from urine samples in a tertiary hospital. This was a cross sectional study conducted at Muhimbili National Hospital in Dar es Salaam, Tanzania. Findings A total of 270 E.coli and Klebsiella spp urinary pathogens from children and adults isolated from January to March 2010 were included in the study. E. coli and Klebsiella spp isolates were tested for antimicrobial susceptibility by the Clinical and Laboratory Standard Institute's disc diffusion method. These isolates were further screened for ESBL phenotype using cefotaxime and ceftazidime discs. Isolates with reduced sensitivity were confirmed using ESBL E-test strips. Of 270 isolates, 138 (51.1%) were E. coli and 132 (48.9%) were Klebsiella spp. ESBL was detected in 122 (45.2%) of all the isolates. ESBL- producing E. coli strains were significantly more resistance to cotrimoxazole (90.7%), ciprofloxacin (46.3%) and nalidixic acid (61.6%) than strains that did not produce ESBL (p < 0.05). Similarly, ESBL- producing Klebsiella spp strains were significantly more resistance to cotrimoxazole (92.6%), ciprofloxacin (25.0%), nalidixic acid (66.2%), and gentamicin (38.2%) than strains that did not produce ESBL (P < 0.05). Multi-drug resistance was found to be significantly (P < 0.05) more in ESBL producing isolates (90.5%) than non ESBL producers (68.9%). The occurrence of ESBL was significantly higher among isolates from inpatients than outpatients [95 (50.5%) vs. 27(32.9%)] (p = 0.008). The occurrence of ESBL was significantly higher among isolates from children than in adults [84 (54.9%) vs. 38(32.5%)] (p < 0.001). Conclusions High prevalence of ESBL-producing E. coli and Klebsiella spp strains was found among inpatients and children. Most of the ESBL- producing isolates were multi-drug resistant making available therapeutic choices limited. We recommend continued antibiotic surveillance as well comprehensive multi-center studies to address the emerging problem of ESBL-associated infections in order to preserve the continued usefulness of most antimicrobial drugs. Further more conducting molecular studies will help to evaluate the various ESBL types. PMID:21184671

  6. Increasing caesarean section rates among low-risk groups: a panel study classifying deliveries according to Robson at a university hospital in Tanzania

    PubMed Central

    2013-01-01

    Background Rising caesarean section (CS) rates have been observed worldwide in recent decades. This study sought to analyse trends in CS rates and outcomes among a variety of obstetric groups at a university hospital in a low-income country. Methods We conducted a hospital-based panel study at Muhimbili National Hospital, Dar es Salaam, Tanzania. All deliveries between 2000 and 2011 with gestational age???28 weeks were included in the study. The 12 years were divided into four periods: 2000 to 2002, 2003 to 2005, 2006 to 2008, and 2009 to 2011. Main outcome measures included CS rate, relative size of obstetric groups, contribution to overall CS rate, perinatal mortality ratio, neonatal distress, and maternal mortality ratio. Time trends were analysed within the ten Robson groups, based on maternal and obstetric characteristics. We applied the ?2 test for trend to determine whether changes were statistically significant. Odds ratios of CS were evaluated using multivariate logistic regression, accounting for maternal age, referral status, and private healthcare insurance. Results We included 137,094 deliveries. The total CS rate rose from 19% to 49%, involving nine out of ten groups. Multipara without previous CS with single, cephalic pregnancies in spontaneous labour had a CS rate of 33% in 2009 to 2011. Adjusted analysis explained some of the increase. Perinatal mortality and neonatal distress decreased in multiple pregnancies (p?

  7. 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, δ13C) 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, δ13C ~ -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.

  8. Geospatial Resource Access Analysis In Hedaru, Tanzania

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  9. Prevalences of diabetes and cardiovascular disease risk factors in Hindu Indian subcommunities in Tanzania.

    PubMed Central

    Ramaiya, K L; Swai, A B; McLarty, D G; Bhopal, R S; Alberti, K G

    1991-01-01

    OBJECTIVES--To seek differences in the prevalence of diabetes mellitus and other coronary heart disease risk factors, and to identify factors associated with these differences within a Hindu Indian community. DESIGN--Population based cross sectional survey. SETTING--Dar-es-Salaam, Tanzania. SUBJECTS--Of 20 Hindu subcommunities categorised by caste in Dar-es-Salaam, seven were randomly selected. 1147 (76.7%) of 1495 subjects aged 15 or over participated. MAIN OUTCOME MEASURES--Blood glucose concentrations (fasting and two hours after oral glucose loading), serum total cholesterol and serum triglyceride concentrations, blood pressure, and height and weight. RESULTS--The subcommunities differed substantially in socioeconomic characteristics and lifestyle. Overall, 9.8% of subjects (109/1113) had diabetes, 17.0% (189/1113) impaired glucose tolerance, 14.5% (166/1143) hypertension, and 13.3% (151/1138) were obese. The mean fasting blood glucose concentration was 4.9 mmol/l, the blood glucose concentration two hours after oral loading (75 g) 6.0 mmol/l, the total cholesterol concentration 4.9 mmol/l, the serum triglyceride concentration 1.4 mmol/l, and body mass index (weight/height: kg/m2) 24.3. Systolic and diastolic blood pressures were 121 and 77 mm Hg respectively. There were important intercommunity differences even after standardisation for age, sex, and body mass index--for example, in mean fasting blood glucose concentration (range 4.5 (Jains) to 5.9 mmol/l (Patels)), serum total cholesterol concentration (range 4.5 (Jains) to 6.2 mmol/l (Suthars)), systolic blood pressure (range 110 (Limbachias) to 127 mm Hg (Bhatias)), and prevalences of diabetes (range 3.4% (3/87 Limbachias) to 18% (20/111 Navnats)) and hypertension (range 5.7% (5/87 Limbachias) to 19.4% (43/222 Bhatias). Variables which showed significant linear correlation with subcommunity variations were entered into a multiple regression model. Intercommunity variations persisted. The Limbachia and Jain communities had the lowest prevalence of and mean values for coronary heart disease risk factors and the Bhatia and Patel communities had the highest. CONCLUSIONS--In this series intercommunity variations in disease and risk factors might have been related to genetic, dietary, socioeconomic, and lifestyle differences but could not be explained by the characteristics studied. Studies of Indian subcommunities are warranted to confirm and extend these descriptive findings and explore the genetic basis of diabetes. Communities of Indian origin should not be perceived as homogeneous. PMID:1888926

  10. Factors associated with road traffic injuries in Tanzania

    PubMed Central

    Boniface, Respicious; Museru, Lawrence; Kiloloma, Othman; Munthali, Victoria

    2016-01-01

    Introduction Injuries represent a significant cause of morbidity and mortality worldwide and road traffic crashes accounts for a significant proportion of these injuries. Tanzania is among the countries with high rates of road traffic crashes. The aim of this study was to determine the pattern, associated factors and management of road traffic injury patients in Tanzania. Methods A cross-sectional study of patients involved in motor traffic crashes and attended in six public hospitals of Tanzania mainland between April 2014 and September 2014. Results A total of 4675 road traffic injury patients were seen in studied hospitals, 76.6% were males. Majority (70.2%) were between 18 - 45 years age group. Motorcycles were the leading cause of road traffic crashes (53.4%), and drivers (38.3%) accounted for majority of victims. Fractures accounted for 34.1%, and injuries were severe in 2.2% as determined by the Kampala trauma score II (KTS II). Majorities 57.4% were admitted and 2.2% died at the casualty. Factors associated with mortality were; using police vehicles to hospital (P = 0.000), receiving medical attention within 2 to 10 hours after injury (P = 0.000), 18 - 45 years age group (P = 0.019), not using helmet (P = 0.007), severe injuries (P = 0.000) and sustaining multiple injury (P = 0.000). Conclusion Road traffic Injuries in Tanzania are an important public health problem, predominantly in adult males, mostly due to motorcycle crashes. It is therefore important to reinforce preventive measures and pre-hospital emergency service is urgently needed.

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

    NASA Astrophysics Data System (ADS)

    Wandela, Eugenia L.

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

  12. Fighting FGM in Dodoma, Tanzania.

    PubMed

    1996-01-01

    This paper reports the aims of the Training and Information Program of Inter-Africa Committee (IAC) to eradicate the practice of female genital mutilation (FGM) in Dodoma, Tanzania. Dodoma is one of the 25 regions chosen for this pilot project because of the high prevalence of FGM, its proximity to Dar-es-Salam, and relative access to local transportation. The campaign was based on the active participation of concerned communities. Two coordinators were identified in 1993 who started to make a series of visits to the surrounding villages to discuss the situation of FGM with the local authorities and explain the objectives of IAC. Each village was requested to nominate one candidate as a Village Facilitator. 32 participants attended the first workshop that was organized by the IAC. Furthermore, the media collaborated with weekly radio programs and information that was provided to the Tanzania Midwifery School and to the primary school teachers. In 1995, the IAC in Dodoma had gained recognition among wider circles and had collaborated with the Ministry of Health in the training of traditional birth attendants and in creating awareness about FGM. The initiative sparked a very strong interest among other villagers in the area. The IAC-Dodoma team had plans to extending its services to other regions in 1997. PMID:12349589

  13. Factors that influence women's health in Tanzania.

    PubMed

    Lugina, H I

    1994-01-01

    A descriptive account of factors that influence women's health in Tanzania is given. The social and cultural processes that enhance or undermine women's health are emphasized. Recommendations for changes to improve women's health are made. PMID:8169170

  14. Health policy and implementations in Tanzania.

    PubMed

    Dominicus, D A; Akamatsu, T

    1989-06-01

    This paper describes the current health policy in Tanzania and its implementations. The present health policy in Tanzania originated from Arusha declaration of 1967, the country's most popular national policy after independence. Arusha declaration proclaims socialism and self-reliance, which has had important impact on the form and content of the present country's health policy in mainland Tanzania. Much of the wide-spread health care services infrastructure that is evident now in rural areas of Tanzania mainland is a result of the re-emphasis of the Arusha declaration in 1971. In Tanzania, the Ministry of Health has the responsibility for elaborating the health policy, ensuring that strategies and appropriate program are developed to give effect to the policy. In the present health policy discussed, the goal is seen to have shifted from having one dispensary in each village to one primary health unit in each village. One dispensary is intended to serve several villages together. In Tanzania, according to the present health policy, the village primary health care are mainly preventive oriented and only being managed by short term trained health staff. The candidate for training in each village is selected, among the village residents, by the villagers themselves. The primary health care system adopted by Tanzania is viewed as the only way through which it can achieve the social goal of health for everyone by the year 2000, provided the present political will which is evident continue, and enough availability of, human, financial and material resources.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2779061

  15. 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

  16. 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…

  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. The hypoxic ischaemic encephalopathy score in predicting neurodevelopmental outcomes among infants with birth asphyxia at the Muhimbili National Hospital, Dar-es-Salaam, Tanzania.

    PubMed

    Mwakyusa, Sekela D; Manji, Karim P; Massawe, Augustine W

    2009-02-01

    Hypoxic Ischemic Encephalopathy (HIE) score may be used to predict neurodevelopment outcome in infants with birth asphyxia. A total of 140 infants who had a 5 min Apgar score of <7 at birth had detailed motor and neurodevelopment assessment. Outcome measures were grouped as normal or abnormal with morbidity (convulsions, abnormal muscle tone and delayed development) or death. The positive predictive value (PPV) for mortality was 42.3% for moderate HIE and 93.8% for severe HIE. For severe HIE the PPV was 100%. Thirteen infants had delayed development, the score had PPV of 63.6% for moderate HIE and 100% for severe HIE. The best correlation with outcome was the peak score of 15 or higher had a PPV of 100%. Specificity was found to be 100% and sensitivity of 14%. The HIE scoring system is a useful predictor of neurodevelopment outcome at 6 months of age in a resource poor setting. PMID:18621775

  19. Young Men's Social Network Characteristics and Associations with Sexual Partnership Concurrency in Tanzania.

    PubMed

    Yamanis, Thespina J; Fisher, Jacob C; Moody, James W; Kajula, Lusajo J

    2016-06-01

    Social network influence on young people's sexual behavior is understudied in sub-Saharan Africa. Previous research identified networks of mostly young men in Dar es Salaam who socialize in "camps". This study describes network characteristics within camps and their relationship to young men's concurrent sexual partnerships. We conducted surveys with a nearly complete census of ten camp networks (490 men and 160 women). Surveys included name generators to identify camp-based networks. Fifty seven percent of sexually active men (n = 471) reported past year concurrency, measured using the UNAIDS method. In a multivariable model, men's individual concurrency was associated with being a member of a closer knit camp in which concurrency was the normative behavior. Younger men who had older members in their networks were more likely to engage in concurrency. Respondent concurrency was also associated with inequitable personal gender norms. Our findings suggest strategies for leveraging social networks for HIV prevention among young men. PMID:26271813

  20. Fires in Tanzania and Mozambique

    NASA Technical Reports Server (NTRS)

    2002-01-01

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

  1. Unexpected results from large-scale cryptosporidiosis screening study in calves in Tanzania

    PubMed Central

    ChangA, J S; Robertson, L J; Mtambo, M M A; Mdegela, R H; Lken, T; Reksen, O

    2011-01-01

    A study was undertaken to investigate Cryptosporidium infection in crossbreed dairy calves in two districts in Tanzania. A total of 943 fecal samples from 601 dairy calves were included in the study, with calves from both smallholder dairy farms and from large-scale and medium-scale dairy farms. The modified ZiehlNeelsen (mZN) technique was used to examine 710 samples, and 13 of these were considered to be positive for Cryptosporidium. These 13 samples considered positive by mZN, along with the remaining 233 samples, were analysed by immunofluorescent antibody test (IFAT). Of these 246 samples examined by IFAT, 15 samples, 10 of which were considered positive by mZN, were also examined by the auramine phenol technique, and 5 samples, all of which were considered positive by mZN, were analysed by PCR. The results from the IFAT, auramine phenol and PCR analyses demonstrated that none of the samples contained Cryptosporidium oocysts, indicating that, cryptosporidiosis is currently not a problem in dairy calves in these regions of Tanzania. These unexpected results are discussed with respect to other reports on cryptosporidiosis in calves that suggest that this parasite is a serious calf disease globally, and particularly in relation to studies from Tanzania. We suggest that results from studies of cattle in Tanzania, in which mZN has been used as the sole analytical method, should be treated with caution. PMID:22185946

  2. 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…

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

    PubMed Central

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

    2015-01-01

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

  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. 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.

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

    PubMed Central

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

    2015-01-01

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

  7. Grain size distribution along the Msasani Beach, north of Dar es Salaam Harbour

    NASA Astrophysics Data System (ADS)

    Muzuka, Alfred N. N.; Shaghude, Yohana W.

    2000-02-01

    Beach sediments collected from the tidal flat and beach slope at the Msasani Beach, about 15 km north of the Dar es Salaam Harbour, are used to (1) establish the grain size distribution pattern, (2) assess the effect of man-made and natural structures (rivers, creeks, sea wall and groynes) on the grain size distribution, and (3) assess whether sediments are preferentially transported northward by longshore currents. Generally, the Msasani Beach slope sediments have an average mean diameter of 1.55φ while those from the tidal flat average at 1.87φ. There is a general trend of decreasing grain size from south to north that is associated with improvement in sorting, particularly in the tidal flat. The northward fining of the sediment suggests that the sediment in the study area is transported from south to north. The trend of northward decrease in the mean grain size is locally distorted at the river mouths, creeks and man-made structures. The contribution of the man-made structures to the observed distortion can not be separated from that of natural structures owing to the fact that these man-made structures were placed next to the natural features. The data collected from the Msasani Beach were subjected to factor analysis. Four factors account for more than 95% of the observed variations in the grain size distribution in the study area. These factors are: medium energy environments (66.5% of total variance) common at the beach slope; low energy environments found in micro-bays (16%); high energy environment found at the tidal creeks and river entrance (7.8%); and intermediate (between medium and low) energy environments common in the tidal flat (5.6%). Most of the beach slope samples are unimodal (87%), while a significant number of the tidal flat samples (46%) are bimodal, with the most common mode being 2.25φ. The bimodality observed in this study can be attributed to the presence of shell fragments that were not removed during sieving, to sudden fluctuation in the energy strength at the beach, and to mixing of different grain populations.

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

    ERIC Educational Resources Information Center

    Zhu, Chang; Justice Mugenyi, Kintu

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Zhu, Chang; Justice Mugenyi, Kintu

    2015-01-01

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

  10. Challenges and coping strategies of orphaned children in Tanzania who are not adequately cared for by adults.

    PubMed

    Daniel, Marguerite; Mathias, Angela

    2012-10-01

    Orphaned children in poor rural communities sometimes have no adult who is able to care for them or else the adult caregiver is not able to provide adequate care. Tanzania remains one of the poorest countries in the world, and poverty frequently constrains foster care. Although HIV prevalence is declining, AIDS is still a major cause of orphaning. This article explores the challenges and coping strategies accompanying two possible life trajectories for orphaned children without adequate adult care: 1) that they remain in rural areas in child-headed households, or 2) that they are trafficked to an urban area. Antonovsky's salutogenic model is used as the theoretical framework. The data come from two separate phenomenological studies with vulnerable children. In the first study, in-depth interviews were held with 12 orphaned children in a poor rural area; data concerning three child heads of households are included here. In the second study, 15 girls who were trafficked from rural areas to Dar es Salaam gave extended life-history narrations; data are included for nine of the girls who were orphaned. Loss of parents, a lack of cash, and the need to balance school attendance with food production were chronic stressors for the children heading households, while resources included income-generation strategies and the ability to negotiate with teachers for time to cultivate. For the trafficked girls chronic stressors included exploitation, long working hours, little or no pay, isolation and rape. Resources for them, although limited, included faith networks and neighbours; escape from the exploitative situation frequently involved external help. We conclude that given physical and social assets the child-headed households were able to cope with the challenges of caring for themselves and a younger child, but isolation and dependency on employers made it difficult for the trafficked girls to cope with this exploitation. The salutogenic model proved a useful tool in analysing the coping strategies of children living without adequate adult care. PMID:25860095

  11. USAID and FINCA: helping women in Tanzania.

    PubMed

    Henderson, K

    2000-01-01

    In Tanzania, the international microfinance network FINCA set up shop and began training its first Village Banking Groups in June 1998, disbursing its first loans in July with a grant from the US Agency for International Development. Within 2 months, the program reached 757 low-income women and distributed loans worth US$57,183 using the group support system in which 30-50 neighbors come together to guarantee one another's loans. With the loans from FINCA, entrepreneurs quickly became involved in a range of business activities, from selling tomatoes to starting a hair salon. Located in Mwanza, in the Lake Zone, FINCA Tanzania's clients include many members of the Sukuma tribe. It is noted that in this region there are a few job opportunities in the formal economy. In 1999, FINCA Tanzania reached 3632 clients, exceeding its targets despite a difficult economic environment. In that same year, FINCA partnered with Freedom from Hunger in launching a program that offers some of its members health education and basic business training at Village Banking Group meetings. PMID:12296252

  12. A review of pig pathology in Tanzania.

    PubMed

    Wilson, Richard Trevor; Swai, Emmanuel

    2013-08-01

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

  13. Science Education in Tanzania: Challenges and Policy Responses

    ERIC Educational Resources Information Center

    Semali, Ladislaus M.; Mehta, Khanjan

    2012-01-01

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

  14. Educational Equity in Tanzania: The Imperiled Promise of Reform.

    ERIC Educational Resources Information Center

    Youngman, Deborah J.; Ishengoma, Johnson M.

    1999-01-01

    Profiles the recent history of Tanzania's efforts to educate its people. After describing Tanzania's history and educational policies, the paper discusses school reform in its historical context and focuses on sharing the costs and benefits of education. Examines ideological intent, theoretical merits, and practical limitations of applied…

  15. Noninvasive Tuberculosis Screening in Free-Living Primate Populations in Gombe National Park, Tanzania.

    PubMed

    Wolf, Tiffany M; Sreevatsan, Srinand; Singer, Randall S; Lipende, Iddi; Collins, Anthony; Gillespie, Thomas R; Lonsdorf, Elizabeth V; Travis, Dominic A

    2016-03-01

    Recent advances in noninvasive detection methods for mycobacterial infection in primates create new opportunities for exploring the epidemiology of tuberculosis in free-living species. Chimpanzees (Pan troglodytes schweinfurthii) and baboons (Papio anubis) in Gombe National Park, Tanzania, were screened for infection with pathogens of the Mycobacterium tuberculosis Complex using Fecal IS6110 PCR; none was positive. This study demonstrates the feasibility of large-scale mycobacterial screening in wild primates. PMID:26419483

  16. 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

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

    PubMed Central

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

    2015-01-01

    Tanzania is facing a double burden of disease, with non-communicable diseases being an increasingly important contributor. Evidence-based preventive measures are important to limit the growing financial burden. This article aims to estimate the cost of providing medical primary prevention interventions for cardiovascular disease (CVD) among at-risk patients, reflecting actual resource use and if the World Health Organization (WHO)s CVD medical preventive guidelines are implemented in Tanzania. In addition, we estimate and explore the cost to patients of receiving these services. Cost data were collected in four health facilities located in both urban and rural settings. Providers costs were identified and measured using ingredients approach to costing and resource valuation followed the opportunity cost method. Unit costs were estimated using activity-based and step-down costing methodologies. The patient costs were obtained through a structured questionnaire. The unit cost of providing CVD medical primary prevention services ranged from US$3041 to US$5271 per patient per year at the health centre and hospital levels, respectively. Employing the WHOs 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

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

    PubMed

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

    2015-09-01

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

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

    PubMed Central

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

    2014-01-01

    Background Scaling up voluntary medical male circumcision (VMMC) to 80% of men aged 1549 within five years could avert 3.4 million new HIV infections in Eastern and Southern Africa by 2025. Since 2009, Tanzania and Zimbabwe have rapidly expanded VMMC services through different delivery (fixed, outreach or mobile) and intensity (routine services, campaign) models. This review describes the modality and intensity of VMMC services and its influence on the number and age of clients. Methods and Findings Program reviews were conducted using data from implementing partners in Tanzania (MCHIP) and Zimbabwe (PSI). Key informant interviews (N?=?13 Tanzania; N?=?8 Zimbabwe) were conducted; transcripts were analyzed using Nvivo. Routine VMMC service data for May 2009December 2012 were analyzed and presented in frequency tables. A descriptive analysis and association was performed using the z-ratio for the significance of the difference. Key informants in both Tanzania and Zimbabwe believe VMMC scale-up can be achieved by using a mix of service delivery modality and intensity approaches. In Tanzania, the majority of clients served during campaigns (59%) were aged 1014 years while the majority during routine service delivery (64%) were above 15 (p<0.0001). In Zimbabwe, significantly more VMMCs were done during campaigns (64%) than during routine service delivery (36%) (p<0.00001); the difference in the age of clients accessing services in campaign versus non-campaign settings was significant for age groups 1024 (p<0.05), but not for older groups. Conclusions In Tanzania and Zimbabwe, service delivery modalities and intensities affect client profiles in conjunction with other contextual factors such as implementing campaigns during school holidays in Zimbabwe and cultural preference for circumcision at a young age in Tanzania. Formative research needs to be an integral part of VMMC programs to guide the design of service delivery modalities in the face of, or lack of, strong social norms. PMID:24801882

  20. Use of Modern Technologies in Improving Astronomy Education in Tanzania

    NASA Astrophysics Data System (ADS)

    Jiwaji, N. T.

    2006-08-01

    With only the most basic astronomy content officially included in the Physics syllabus of Secondary Schools in Tanzania and a one semester Astrophysics option course offered in the Physics Department of one University, the reasons for apathy towards astronomy education in Tanzania are discussed. Using the current focus on introducing ICT into Primary and Secondary schools in Tanzania, the potential for advancing astronomy education per se and natural sciences in general is presented. Limiting factors such as teachers in general and science and astronomy literate teachers in particular, infrastructure and running costs of providing ICT based education, cultural impediments need to be overcome.

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

    PubMed

    Kivaria, F M

    2006-05-01

    Tick-borne diseases, namely, anaplasmosis, babesiosis, cowdriosis and theileriosis, constrain cattle production and improvement in Tanzania, leading to considerable economic losses. A simple spreadsheet model was used to estimate the economic losses resulting from production losses, treatment and control costs associated with tick-borne diseases (TBD) in Tanzania. Model parameters included the national cattle population, reported TBD morbidity, fatality risk, and chemotherapy and control measures used. The total annual national loss due TBD was estimated to be 364 million USD, including an estimated mortality of 1.3 million cattle. Theileriosis accounted for 68% of the total loss, while anaplasmosis and babesiosis each accounted for 13% and cowdriosis accounted for 6% of the total loss. Costs associated with mortality, chemotherapy and acaricide application accounted for 49%, 21% and 14% of the total estimated annual TBD losses, respectively, infection and treatment method milk loss and weight loss accounted for 1%, 6% and 9% of the total annual loss, respectively. Despite the inadequacies of the data used, the results give evidence that tick-borne diseases inflict substantial economic losses on cattle production and resource use in Tanzania. PMID:17137131

  2. Promoters of and barriers to cervical cancer screening in a rural setting in Tanzania

    PubMed Central

    Perng, Powell; Perng, Wei; Ngoma, Twalib; Kahesa, Crispin; Mwaiselage, Julius; Merajver, Sofia D.; Soliman, Amr S.

    2014-01-01

    Objective To investigate promoters and barriers for cervical cancer screening in rural Tanzania. Methods We interviewed 300 women of reproductive age living in Kiwangwa village, Tanzania. The odds of attending a free, 2-day screening service were compared with sociodemographic variables, lifestyle factors, and knowledge and attitudes surrounding cervical cancer using multivariable logistic regression. Results Compared with women who did not attend the screening service (n = 195), women who attended (n = 105) were older (OR 4.29; 95% CI, 1.61–11.48, age 40–49 years versus 20–29 years), listened regularly to the radio (OR 24.76; 95% CI, 11.49–53.33, listened to radio 1–3 times per week versus not at all), had a poorer quality of life (OR 4.91; CI, 1.96–12.32, lowest versus highest score), had faced cost barriers to obtaining health care in the preceding year (OR 2.24; 95% CI, 1.11–4.53, yes versus no), and held a more positive attitude toward cervical cancer screening (OR 4.64; 95% CI, 1.39–15.55, least versus most averse). Conclusion Efforts aimed at improving screening rates in rural Tanzania need to address both structural and individual-level barriers, including knowledge and awareness of cervical cancer prevention, cost barriers to care, and access to health information. PMID:24095307

  3. 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

  4. Operational factors affecting maternal mortality in Tanzania.

    PubMed

    Urassa, E; Massawe, S; Lindmark, G; Nyström, L

    1997-03-01

    Identification of the main operational factors in cases of maternal death within and outside the health care system is necessary for safe motherhood programmes. In this study, a follow-up was done of all 117 cases of maternal deaths in Ilala district, Dar es Salaam, 1991-1993, at all levels of care. In all, 79% received some medical care whereas 11% arrived too late for treatment. For each case the major operational factors and all health care interventions were defined through interviews with family members and health care staff and from hospital records, and the avoidability of each case was determined. In the health institutions where the women had consulted, the available resources were assessed. It was found that in most cases the husband (29%) or the mother (31%) of the woman decided on her care in cases of complications, and together with the lack of transport, this often caused delay at home. Also, delay in transfer from the district hospital was common. Cases of abortion complications were often not managed on time because of the delay in reporting to hospital or misleading information. Suboptimal care was identified in 77% of the cases reaching health care. Inadequate treatment was identified by the district health staff in 61% and by the referral centres in 12% of their cases. Wrong decision at the district level and lack of equipment at the referral centre were the main reasons for inadequate care. It is concluded that although community education on danger signs in pregnancy and labour is important, provision of the core resources and supplies for emergency obstetric interventions, as well as clear protocols for management and referral, are absolutely necessary for improvement of maternal survival. PMID:10166102

  5. Burden of serious fungal infections in Tanzania.

    PubMed

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

    2015-10-01

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

  6. 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.

  7. Quantifying the Burden of Rhodesiense Sleeping Sickness in Urambo District, Tanzania

    PubMed Central

    Matemba, Lucas E.; Fèvre, Eric M.; Kibona, Stafford N.; Picozzi, Kim; Cleaveland, Sarah; Shaw, Alexandra P.; Welburn, Susan C.

    2010-01-01

    Background Human African trypanosomiasis is a severely neglected vector-borne disease that is always fatal if untreated. In Tanzania it is highly focalised and of major socio-economic and public health importance in affected communities. Objectives This study aimed to estimate the public health burden of rhodesiense HAT in terms of DALYs and financial costs in a highly disease endemic area of Tanzania using hospital records. Materials and Methods Data was obtained from 143 patients admitted in 2004 for treatment for HAT at Kaliua Health Centre, Urambo District. The direct medical and other indirect costs incurred by individual patients and by the health services were calculated. DALYs were estimated using methods recommended by the Global Burden of Disease Project as well as those used in previous rhodesiense HAT estimates assuming HAT under reporting of 45%, a figure specific for Tanzania. Results The DALY estimate for HAT in Urambo District with and without age-weighting were 215.7 (95% CI: 155.3–287.5) and 281.6 (95% CI: 209.1–362.6) respectively. When 45% under-reporting was included, the results were 622.5 (95% CI: 155.3–1098.9) and 978.9 (95% CI: 201.1–1870.8) respectively. The costs of treating 143 patients in terms of admission costs, diagnosis, hospitalization and sleeping sickness drugs were estimated at US$ 15,514, of which patients themselves paid US$ 3,673 and the health services US$ 11,841. The burden in terms of indirect non-medical costs for the 143 patients was estimated at US$ 9,781. Conclusions This study shows that HAT imposes a considerable burden on affected rural communities in Tanzania and stresses the urgent need for location- and disease-specific burden estimates tailored to particular rural settings in countries like Tanzania where a considerable number of infectious diseases are prevalent and, due to their focal nature, are often concentrated in certain locations where they impose an especially high burden. PMID:21072230

  8. The economic costs of malaria in children in three sub-Saharan countries: Ghana, Tanzania and Kenya

    PubMed Central

    2013-01-01

    Background Malaria causes significant mortality and morbidity in sub-Saharan Africa (SSA), especially among children less than five years of age (U5 children). Although the economic burden of malaria in this region has been assessed previously, the extent and variation of this burden remains unclear. This study aimed to estimate the economic costs of malaria in U5 children in three countries (Ghana, Tanzania and Kenya). Methods Health system and household costs previously estimated were integrated with costs associated with co-morbidities, complications and productivity losses due to death. Several models were developed to estimate the expected treatment cost per episode per child, across different age groups, by level of severity and with or without controlling for treatment-seeking behaviour. Total annual costs (2009) were calculated by multiplying the treatment cost per episode according to severity by the number of episodes. Annual health system prevention costs were added to this estimate. Results Household and health system costs per malaria episode ranged from approximately US$ 5 for non-complicated malaria in Tanzania to US$ 288 for cerebral malaria with neurological sequelae in Kenya. On average, up to 55% of these costs in Ghana and Tanzania and 70% in Kenya were assumed by the household, and of these costs 46% in Ghana and 85% in Tanzania and Kenya were indirect costs. Expected values of potential future earnings (in thousands) lost due to premature death of children aged 0–1 and 1–4 years were US$ 11.8 and US$ 13.8 in Ghana, US$ 6.9 and US$ 8.1 in Tanzania, and US$ 7.6 and US$ 8.9 in Kenya, respectively. The expected treatment costs per episode per child ranged from a minimum of US$ 1.29 for children aged 2–11 months in Tanzania to a maximum of US$ 22.9 for children aged 0–24 months in Kenya. The total annual costs (in millions) were estimated at US$ 37.8, US$ 131.9 and US$ 109.0 nationwide in Ghana, Tanzania and Kenya and included average treatment costs per case of US$ 11.99, US$ 6.79 and US$ 20.54, respectively. Conclusion This study provides important insight into the economic burden of malaria in SSA that may assist policy makers when designing future malaria control interventions. PMID:24004482

  9. 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 200607. 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, 197779, 1989, 199798 and 200607 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

  10. Maternal health in fifty years of Tanzania independence: Challenges and opportunities of reducing maternal mortality.

    PubMed

    Shija, Angela E; Msovela, Judith; Mboera, Leonard E G

    2011-12-01

    High rate of maternal death is one of the major public health concerns in Tanzania. Most of maternal deaths are caused by factors attributed to pregnancy, childbirth and poor quality of health services. More than 80% of maternal deaths can be prevented if pregnant women access essential maternity care and assured of skilled attendance at childbirth as well as emergency obstetric care. The objective of this review was to analyse maternal mortality situation in Tanzania during the past 50 years and to identify efforts, challenges and opportunities of reducing it. This paper was written through desk review of key policy documents, technical reports, publications and available internet-based literature. From 1961 to 1990 maternal mortality ratio in Tanzania had been on a downward trend from 453 to 200 per 100,000 live births. However, from 1990's there been an increasing trend to 578 per 100,000 live births. Current statistics indicate that maternal mortality ratio has dropped slightly in 2010 to 454 per 100,000 live births. Despite a high coverage (96%) in pregnant women who attend at least one antenatal clinic, only half of the women (51%) have access to skilled delivery. Coverage of emergence obstetric services is 64.5% and utilization of modern family planning method is 27%. Only about 13% of home deliveries access post natal check-up. Despite a number of efforts maternal mortality is still unacceptably high. Some of the efforts done to reduce maternal mortality in Tanzania included the following initiatives: reproductive and child survival; increased skilled delivery; maternal death audit; coordination and integration of different programs including maternal and child health services, family planning, malaria interventions, expanded program on immunization and adolescent health and nutrition programmes. These initiatives are however challenged by inadequate access to maternal health care services. In order to considerably reduce maternal deaths some of recommended strategies include: (i) strengthening the health system to provide skilled attendance during child birth; (ii) upgrading rural health centres to provide emergency obstetric services; (iii) providing adolescent and male friendly family planning services; (iv) strengthening public-private partnership to ensure continuum of care; (v) supporting operational research to answer the immediate concerns of the health system; and (vi) strengthening community participation and women empowerment to take role of their own health and the family at large. In conclusion, maternal mortality ratio in Tanzania is unacceptably high and still very far from reaching the millennium development goals. Maternal health care services should focus on ensuring there is continuum of care through strengthening the health system; provision of good quality of health care in a well organized referral health system and operation research to support programme implementation. PMID:26591990

  11. Assessment of corporate compliance with guidance and regulations on labels of commercially produced complementary foods sold in Cambodia, Nepal, Senegal and Tanzania.

    PubMed

    Sweet, Lara; Pereira, Catherine; Ford, Rosalyn; Feeley, Alison B; Badham, Jane; Mengkheang, Khin; Adhikary, Indu; Gueye, Ndèye Yaga Sy; Coly, Aminata Ndiaye; Makafu, Cecilia; Zehner, Elizabeth

    2016-04-01

    National legislation and global guidance address labelling of complementary foods to ensure that labels support optimal infant and young child feeding practices. This cross-sectional study assessed the labels of commercially produced complementary foods (CPCF) sold in Phnom Penh (n = 70), Cambodia; Kathmandu Valley (n = 22), Nepal; Dakar Department (n = 84), Senegal; and Dar es Salaam (n = 26), Tanzania. Between 3.6% and 30% of products did not provide any age recommendation and 8.6-20.2% of products, from all sites, recommended an age of introduction of <6 months. Few CPCF products provided a daily ration (0.0-8.6%) and 14.5-55.6% of those that did exceeded the daily energy recommendation for complementary foods for a breastfed child from 6 to 8.9 months of age. Only 3.6-27.3% of labels provided accurate and complete messages in the required language encouraging exclusive breastfeeding, and almost none (0.0-2.9%) provided accurate and complete messages regarding the appropriate introduction of complementary foods together with continued breastfeeding. Between 34.3% and 70.2% of CPCF manufacturers also produced breastmilk substitutes and 41.7-78.0% of relevant CPCF products cross-promoted their breastmilk substitutes products. Labelling practices of CPCF included in this study do not fully comply with international guidance on their promotion and selected aspects of national legislation, and there is a need for more detailed normative guidance on certain promotion practices in order to protect and promote optimal infant and young child feeding. PMID:27061960

  12. 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

  13. 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

  14. Agricultural Development, Land Change, and Livelihoods in Tanzania's Kilombero Valley

    NASA Astrophysics Data System (ADS)

    Connors, John Patrick

    The Kilombero Valley lies at the intersection of a network of protected areas that cross Tanzania. The wetlands and woodlands of the Valley, as well as the forest of surrounding mountains are abundant in biodiversity and are considered to be critical areas for conservation. This area, however, is also the home to more than a half million people, primarily poor smallholder farmers. In an effort to support the livelihoods and food security of these farmers and the larger Tanzanian population, the country has recently targeted a series of programs to increase agricultural production in the Kilombero Valley and elsewhere in the country. Bridging concepts and methods from land change science, political ecology, and sustainable livelihoods, I present an integrated assessment of the linkages between development and conservation efforts in the Kilombero Valley and the implications for food security. This dissertation uses three empirical studies to understand the process of development in the Kilombero Valley and to link the priorities and perceptions of conservation and development efforts to the material outcomes in food security and land change. The first paper of this dissertation examines the changes in land use in the Kilombero Valley between 1997 and 2014 following the privatization of agriculture and the expansion of Tanzania's Kilimo Kwanza program. Remote sensing analysis reveals a two-fold increase in agricultural area during this short time, largely at the expense of forest. Protected areas in some parts of the Valley appear to be deterring deforestation, but rapid agricultural growth, particularly surrounding a commercial rice plantation, has led to loss of extant forest and sustained habitat fragmentation. The second paper focuses examines livelihood strategies in the Valley and claims regarding the role of agrobiodiversity in food security. The results of household survey reveal no difference or lower food security among households that diversify their agricultural activities. Some evidence, however, emerges regarding the importance of home gardens and crop diversification for dietary diversity. The third paper considers the competing discourses surrounding conservation and development in the Kilombero Valley. Employing q-method, this paper discerns four key viewpoints among various stakeholders in the Valley. While there are some apparently intractable distinctions between among these discourses, consensus regarding the importance of wildlife corridors and the presence of boundary-crossing individuals provide the promise of collaboration and compromise.

  15. Plague and the Human Flea, Tanzania

    PubMed Central

    Leirs, Herwig; Makundi, Rhodes H.; Van Dongen, Stefan; Davis, Stephen; Neerinckx, Simon; Deckers, Jozef; Libois, Roland

    2007-01-01

    Domestic fleas were collected in 12 villages in the western Usambara Mountains in Tanzania. Of these, 7 are considered villages with high plague frequency, where human plague was recorded during at least 6 of the 17 plague seasons between 1986 and 2004. In the remaining 5 villages with low plague frequency, plague was either rare or unrecorded. Pulex irritans, known as the human flea, was the predominant flea species (72.4%) in houses. The density of P. irritans, but not of other domestic fleas, was significantly higher in villages with a higher plague frequency or incidence. Moreover, the P. irritans index was strongly positively correlated with plague frequency and with the logarithmically transformed plague incidence. These observations suggest that in Lushoto District human fleas may play a role in plague epidemiology. These findings are of immediate public health relevance because they provide an indicator that can be surveyed to assess the risk for plague. PMID:17553245

  16. Struggles over patriarchal structural adjustment in Tanzania.

    PubMed

    Mbilinyi, M

    1993-10-01

    Within the space of 7 years (1986-93), structural adjustment policies have contributed to a reversal of the gains in economic development achieved in Tanzania in the 1960s and 1970s. Structural adjustment policies have helped large-scale producers and ordinary citizens but have led to a decline in social services which is reflected in drops in primary school enrollment and increases in medical costs. Government revenues are absorbed by foreign debt servicing. The reduction of support for social services has increased women's work; bolstered gender division of labor; and reduced women's access to education, formal employment, and health services. On the other hand, increased participation in market-oriented activities has increased women's mobility and exposure to modern ideas. This has led to changing gender relations which on the positive side can lead to shared decision-making but on the negative side may cause men to abdicate their familial responsibilities. Women suffer, however, from a lack of investment in ways to lighten their household responsibilities and have lost their ability to control food production because of the shift to cash crop production for export. The combination of hard work, low income, and stress has taken a toll on women's health, and both the maternal mortality rate and incidence of HIV infections among teenage girls has increased. In response to this situation, Tanzanian women have formed the Tanzania Gender Networking Programme (TGNP) which seeks to empower women and transform society through such activities as education and training, research, and lobbying and networking. Workshops sponsored by the TGNP have resulted in recommendations for adoption of a people-centered development strategy. PMID:12320727

  17. 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.

  18. Care-seeking patterns for fatal malaria in Tanzania

    PubMed Central

    de Savigny, Don; Mayombana, Charles; Mwageni, Eleuther; Masanja, Honorati; Minhaj, Abdulatif; Mkilindi, Yahya; Mbuya, Conrad; Kasale, Harun; Reid, Graham

    2004-01-01

    Background Once malaria occurs, deaths can be prevented by prompt treatment with relatively affordable and efficacious drugs. Yet this goal is elusive in Africa. The paradox of a continuing but easily preventable cause of high mortality raises important questions for policy makers concerning care-seeking and access to health systems. Although patterns of care-seeking during uncomplicated malaria episodes are well known, studies in cases of fatal malaria are rare. Care-seeking behaviours may differ between these groups. Methods This study documents care-seeking events in 320 children less than five years of age with fatal malaria seen between 1999 and 2001 during over 240,000 person-years of follow-up in a stable perennial malaria transmission setting in southern Tanzania. Accounts of care-seeking recorded in verbal autopsy histories were analysed to determine providers attended and the sequence of choices made as the patients' condition deteriorated. Results As first resort to care, 78.7% of malaria-attributable deaths used modern biomedical care in the form of antimalarial pharmaceuticals from shops or government or non-governmental heath facilities, 9.4% used initial traditional care at home or from traditional practitioners and 11.9% sought no care of any kind. There were no differences in patterns of choice by sex of the child, sex of the head of the household, socioeconomic status of the household or presence or absence of convulsions. In malaria deaths of all ages who sought care more than once, modern care was included in the first or second resort to care in 90.0% and 99.4% with and without convulsions respectively. Conclusions In this study of fatal malaria in southern Tanzania, biomedical care is the preferred choice of an overwhelming majority of suspected malaria cases, even those complicated by convulsions. Traditional care is no longer a significant delaying factor. To reduce mortality further will require greater emphasis on recognizing danger signs at home, prompter care-seeking, improved quality of care at health facilities and better adherence to treatment. PMID:15282029

  19. Health and survival of young children in southern Tanzania

    PubMed Central

    Armstrong Schellenberg, Joanna RM; Mrisho, Mwifadhi; Manzi, Fatuma; Shirima, Kizito; Mbuya, Conrad; Mushi, Adiel K; Ketende, Sosthenes Charles; Alonso, Pedro L; Mshinda, Hassan; Tanner, Marcel; Schellenberg, David

    2008-01-01

    Background With a view to developing health systems strategies to improve reach to high-risk groups, we present information on health and survival from household and health facility perspectives in five districts of southern Tanzania. Methods We documented availability of health workers, vaccines, drugs, supplies and services essential for child health through a survey of all health facilities in the area. We did a representative cluster sample survey of 21,600 households using a modular questionnaire including household assets, birth histories, and antenatal care in currently pregnant women. In a subsample of households we asked about health of all children under two years, including breastfeeding, mosquito net use, vaccination, vitamin A, and care-seeking for recent illness, and measured haemoglobin and malaria parasitaemia. Results In the health facility survey, a prescriber or nurse was present on the day of the survey in about 40% of 114 dispensaries. Less than half of health facilities had all seven 'essential oral treatments', and water was available in only 22%. In the household survey, antenatal attendance (88%) and DPT-HepB3 vaccine coverage in children (81%) were high. Neonatal and infant mortality were 43.2 and 76.4 per 1000 live births respectively. Infant mortality was 40% higher for teenage mothers than older women (RR 1.4, 95% confidence interval (CI) 1.1 – 1.7), and 20% higher for mothers with no formal education than those who had been to school (RR 1.2, CI 1.0 – 1.4). The benefits of education on survival were apparently restricted to post-neonatal infants. There was no evidence of inequality in infant mortality by socio-economic status. Vaccine coverage, net use, anaemia and parasitaemia were inequitable: the least poor had a consistent advantage over children from the poorest families. Infant mortality was higher in families living over 5 km from their nearest health facility compared to those living closer (RR 1.25, CI 1.0 – 1.5): 75% of households live within this distance. Conclusion Relatively short distances to health facilities, high antenatal and vaccine coverage show that peripheral health facilities have huge potential to make a difference to health and survival at household level in rural Tanzania, even with current human resources. PMID:18522737

  20. [Early days of the Ocean Road Hospital in Dar es Salaam: from mission hospital to government hospital].

    PubMed

    Schneppen, H

    2000-01-01

    On 1 October 1997 Ocean Road Hospital in Daressalam commemorated one hundred years of its existence. As early as 1888 a provisional hospital had been set up in Zanzibar by the German Lutheran Church to serve the needs of the Germans living and working on the East African coast. But when the British established their protectorate over Zanzibar in 1890, the hospital was moved to Dar es Salaam. As cooperation between Mission hospital and Government authorities proved difficult, the German colonial administration was determined to build an hospital of its own. Lack of funds delayed the construction of the building which had to be built on a more modest scale than originally planned. But when the hospital was inaugurated in October 1897, people were impressed both by its functional usefulness and aesthetic attraction. The history of the German Government Hospital reflects the political context of the time as well as the progress of medicine in combatting endemic diseases. While patients were often segregated by race--the Government Hospital in Daressalam almost exclusively reserved for Europeans--all were benefitting from the results of medical science. For Robert Koch the hospital (and its laboratory) served as basis for his research in the field of malaria, black water fever, sleeping sickness, and relapsing fever. It was from Africa that the embarked on his journey to Stockholm to receive the Nobel Prize in December 1905. During the First World War Ocean Road Hospital, as it was called from now on, was taken over by the British. Since independence, the Tanzanians are in charge. It is presently the only tumor hospital of the country, closely cooperating with the German Cancer Research Center (DKFZ) in Heidelberg. Restoration of Ocean Road Hospital, completed at the beginning of this year, was made possible by a grant of the Federal Republic of Germany. PMID:11068515

  1. Knowledge of mosquitos in relation to public and domestic control activities in the cities of Dar es Salaam and Tanga.

    PubMed Central

    Stephens, C.; Masamu, E. T.; Kiama, M. G.; Keto, A. J.; Kinenekejo, M.; Ichimori, K.; Lines, J.

    1995-01-01

    A study of community awareness of mosquitos and related subjects in the residential areas of two Tanzanian cities (Dar es Salaam and Tanga) showed that residents were well aware of mosquitos. Almost all claimed to use some form of domestic mosquito control product for their personal protection, and many spend a significant portion of the household income on this. The problems of nuisance-biting and malaria transmission are usually not separated and are considered to be the result of poor environmental hygiene, for which both residents and local authorities are responsible. Although Culex mosquitos are not a primary target of the Urban Malaria Control Project (UMCP), the persistence of nuisance-biting has made residents sceptical and dissatisfied with insecticide spraying. The residents' priorities are evidently not the same as those of the health authorities, yet mutual cooperation is essential. In order to maintain community support, campaigns aimed at malaria vectors should consider the need for additional measures to control Culex mosquitos, such as those now being tried by the UMCP. Mosquito breeding sites are non-specifically associated with rubbish and standing water of all kinds, and so the actions that the community considers necessary for mosquito source reduction tend to be poorly targeted. Residents do not recognize that some sources produce malaria mosquitos while others produce nuisance mosquitos. The environmental anti-mosquito measures currently promoted by health education and other forms of propaganda are also poorly targeted. While some of them are directed at important Culex breeding sites, others are aimed at sites of little importance for mosquitos of any kind.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7704932

  2. 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

  3. Experiences and Impact of Stigma and Discrimination among People on Antiretroviral Therapy in Dar es Salaam: A Qualitative Perspective

    PubMed Central

    Mhode, Maisara; Nyamhanga, Tumaini

    2016-01-01

    Background. The impact of stigma on adherence to antiretroviral therapy (ART) has been less studied in Tanzania. Recent studies indicate that people on ART still experience stigma. Qualitative information on the subject matter is especially insufficient. Objective. This paper reports on the dimensions of stigma and discrimination and their impact on adherence to ART as experienced by people living with HIV (PLHIV). Design. A phenomenological approach was used to gather information on the lived experiences of stigma and discrimination. The sample size was determined according to the saturation principle. Results. Respondents experienced different forms of HIV-related stigma such as verbal, social, and perceived stigma. Various forms of discrimination were experienced, including relational discrimination, mistreatment by health care workers, blame and rejection by spouses, and workplace discrimination. HIV-related stigma and discrimination compromised ART adherence by reinforcing concealment of HIV status and undermining social suppport. Conclusion. After nearly a decade of increasing the provision of ART in Tanzania, PLHIV still experience stigma and discrimination; these experiences still appear to have a negative impact on treatment adherence. Efforts to reduce stigma and discrimination remain relevant in the ART period and should be given more impetus in order to maximize positive treatment outcomes. PMID:27110395

  4. Exploring the Emergence of Community Support for School and Encouragement of Innovation for Improving Rural School Performance: Lessons Learned at Kitamburo in Tanzania

    ERIC Educational Resources Information Center

    Ngalawa, Athanas; Simmt, Elaine; Glanfield, Florence

    2015-01-01

    This article describes a qualitative exploration of a primary school in a remote rural community of Tanzania, whose students showed promising performance in mathematics, as measured by the Primary School Leaving Examinations (PSLE). Case study methods were used to conduct research about the school and the community and included interviews, focus…

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed

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

    2015-01-01

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

  7. 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…

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

    PubMed Central

    Sara, Stephen; Graham, Jay

    2014-01-01

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

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

    PubMed Central

    2011-01-01

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

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

    PubMed Central

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  12. 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

  13. Where There Is No Toilet: Water and Sanitation Environments of Domestic and Facility Births in Tanzania

    PubMed Central

    Benova, Lenka; Cumming, Oliver; Gordon, Bruce A.; Magoma, Moke; Campbell, Oona M. R.

    2014-01-01

    Background Inadequate water and sanitation during childbirth are likely to lead to poor maternal and newborn outcomes. This paper uses existing data sources to assess the water and sanitation (WATSAN) environment surrounding births in Tanzania in order to interrogate whether such estimates could be useful for guiding research, policy and monitoring initiatives. Methods We used the most recent Tanzania Demographic and Health Survey (DHS) to characterise the delivery location of births occurring between 2005 and 2010. Births occurring in domestic environments were characterised as WATSAN-safe if the home fulfilled international definitions of improved water and improved sanitation access. We used the 2006 Service Provision Assessment survey to characterise the WATSAN environment of facilities that conduct deliveries. We combined estimates from both surveys to describe the proportion of all births occurring in WATSAN-safe environments and conducted an equity analysis based on DHS wealth quintiles and eight geographic zones. Results 42.9% (95% confidence interval: 41.6%–44.2%) of all births occurred in the woman's home. Among these, only 1.5% (95% confidence interval: 1.2%–2.0%) were estimated to have taken place in WATSAN-safe conditions. 74% of all health facilities conducted deliveries. Among these, only 44% of facilities overall and 24% of facility delivery rooms were WATSAN-safe. Combining the estimates, we showed that 30.5% of all births in Tanzania took place in a WATSAN-safe environment (range of uncertainty 25%–42%). Large wealth-based inequalities existed in the proportion of births occurring in domestic environments based on wealth quintile and geographical zone. Conclusion Existing data sources can be useful in national monitoring and prioritisation of interventions to improve poor WATSAN environments during childbirth. However, a better conceptual understanding of potentially harmful exposures and better data are needed in order to devise and apply more empirical definitions of WATSAN-safe environments, both at home and in facilities. PMID:25191753

  14. Obesity as a public health problem among adult women in rural Tanzania

    PubMed Central

    Keding, Gudrun B; Msuya, John M; Maass, Brigitte L; Krawinkel, Michael B

    2013-01-01

    ABSTRACT Background: For many developing countries, obesity and its sequelae have become a challenge of a magnitude similar to hunger and undernutrition. The main objective of this study was, therefore, to investigate the weight status of women in rural Tanzania with reference to season as well as the link between women's weight, food consumption, and attitudes toward obesity. Methods: Three cross-sectional surveys in 3 different seasons within 1 year interviewed the same 210 women, ages 17–45 years, from 3 rural districts of northeastern and central Tanzania. These surveys assessed body mass index (BMI), food intake, and dietary diversity through 24-hour recalls, women's attitudes toward obesity, vegetable production, and socioeconomic status. Results: Although 71% of the women had a normal BMI, 7% were underweight, 16% overweight, and 6% obese. The BMI was correlated with the Dietary Diversity Score (DDS), the Food Variety Score (FVS), with the consumption of foods from the food groups “bread/cakes,” “sugar,” and “tea,” and with the production of exotic vegetables. In a multiple regression model, FVS was directly associated with BMI. When asked to describe the typical characteristics of an obese person, women mentioned more negative than positive characteristics. Conclusion: The prevalence of overweight and obesity was 3 times higher than that of underweight. Apparently, even in rural areas of Tanzania, a nutrition transition is underway. No direct association was identified between vegetable consumption and BMI. Although this study did not assess behavioral factors, such behavioral factors as activity levels as well as attitudes need to be considered, even in rural settings, to address all facets of malnutrition. PMID:25276549

  15. The current status of women in physics in Tanzania

    NASA Astrophysics Data System (ADS)

    Mohammed, Najat K.; Kazmili, Brenda

    2015-12-01

    Women's representation in physics in Tanzania is generally low. Various studies have shown that Tanzanian girls face obstacles to realizing their educational and intellectual capabilities. The situation is even worse in the field of physics because of the perception that the subject is too difficult. The number of women in physics at the university level is highly associated with their number in secondary school level as well as their performance. This paper analyzes the current status of women engaged in physics in Tanzania in the academic and research institutions.

  16. Ideological framework and health development in Tanzania 1961-2000.

    PubMed

    Jonsson, U

    1986-01-01

    At independence in 1961, Tanzania inherited a classic economic structure from Britain. The most immediate aims of the new government included replacing the colonial administration with trained nationals, radical change of the development philosophy and strategies and development of self-reliance in all development sectors. The Arusha Declaration of 1967 was the turning point in Tanzania and achievements in all the sectors can be measured against targets established soon after. This paper examines development in the health sector within the wider national framework. PMID:3715514

  17. 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

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  19. 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

  20. Where there is no morphine: The challenge and hope of palliative care delivery in Tanzania

    PubMed Central

    Dean, Mervyn; Hartwig, Kari; Mmbando, Paul Z.; Sayed, Abduraoof; de Vries, Elma

    2014-01-01

    Abstract Background In Tanzania, a country of 42 million, access to oral morphine is rare. Aim To demonstrate the effectiveness of palliative care teams in reducing patients’ pain and in increasing other positive life qualities in the absence of morphine; and to document the psychological burden experienced by their clinical providers, trained in morphine delivery, as they observed their patients suffering and in extreme pain. Setting One hundred and forty-five cancer patients were included from 13 rural hospitals spread across Tanzania. Method A mixed method study beginning with a retrospective quantitative analysis of cancer patients who were administered the APCA African POS tool four times. Bivariate analyses of the scores at time one and four were compared across the domains. The qualitative arm included an analysis of interviews with six nurses, each with more than five years’ palliative care experience and no access to strong opioids. Results Patients and their family caregivers identified statistically significant (p < 0.001) improvements in all of the domains. Thematic analysis of nurse interviews described the patient and family benefits from palliative care but also their great distress when ‘bad cases’ arose who would likely benefit only from oral morphine. Conclusion People living with chronic cancer-related pain who receive palliative care experience profound physical, spiritual and emotional benefits even without oral morphine. These results demonstrate the need for continued advocacy to increase the availability of oral morphine in these settings in addition to palliative care services. PMID:26245417

  1. Nature, extent and implications of belief in Kikombe cha babu and other herbal HIV cures in Tanzania.

    PubMed

    Kaufman, Michelle R; Ioerger, Michael; Harman, Jennifer J; Modarres, Najmeh

    2014-01-01

    This study's objective was to describe awareness of, access to, belief in, and utilization of the healing tea Kikombe cha babu and other alternative treatments for HIV in Tanzania. Associations with HIV testing, treatment, and prevention behaviors are also explored. A survey with questions about alternative medicine was administered to a sample in Tanzania using a stratified, multistage random selection method. Adults were interviewed face-to-face. Items concerning alternative HIV treatments addressed awareness, access, beliefs, and treatment-seeking behaviors. Questions about HIV prevention and treatment were also asked. Results showed participants indicated a high awareness of alternative treatments available in Tanzania, with 95.3% of 2313 adults having heard of these treatments. Of those, 6.0% had actually sought the treatment, and 46.8% had an acquaintance seek it. However, 81.0% indicated these treatments were not easily accessible. There is a high level of belief in the ability of these alternative treatments to cure HIV, with 44.0% of people who had heard of these treatments indicating they believe such treatments can cure HIV. Additionally, many people indicated having these alternative treatments available would result in decreased condom use (15.6%), no need to use condoms (94.9%), and no need to take antiretroviral therapy (81.7%). However, 57.4% indicated they would be more likely to get tested for HIV if alternative treatments were available. Belief in the ability of alternative treatments to cure HIV in Tanzania is high and should be further explored due to its implications for potentially sidelining HIV prevention and treatment initiatives. PMID:25024091

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

    PubMed Central

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

    2015-01-01

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

  3. Health worker motivation in the context of HIV care and treatment challenges in Mbeya Region, Tanzania: A qualitative study

    PubMed Central

    2011-01-01

    Background Health worker motivation can potentially affect the provision of health services. The HIV pandemic has placed additional strain on health service provision through the extra burden of increased testing and counselling, treating opportunistic infections and providing antiretroviral treatment. The aim of this paper is to explore the challenges generated by HIV care and treatment and their impact on health worker motivation in Mbeya Region, Tanzania. Methods Thirty in-depth interviews were conducted with health workers across the range of health care professions in health facilities in two high HIV-prevalence districts of Mbeya Region, Tanzania. A qualitative framework analysis was adopted for data analysis. Results The negative impact of HIV-related challenges on health worker motivation was confirmed by this study. Training seminars and workshops related to HIV contributed to the shortage of health workers in the facilities. Lower status workers were frequently excluded from training and were more severely affected by the consequent increase in workload as seminars were usually attended by higher status professionals who controlled access. Constant and consistent complaints by clients have undermined health workers' expectations of trust and recognition. Health workers were forced to take responsibility for dealing with problems arising from organisational inefficiencies within the health system. Conclusion HIV-related challenges undermine motivation among health workers in Mbeya, Tanzania with the burden falling most heavily on lower status workers. Strained relations between health workers and the community they serve, further undermine motivation of health workers. PMID:21992700

  4. Reforms: a quest for efficiency or an opportunity for vested interests? a case study of pharmaceutical policy reforms in Tanzania

    PubMed Central

    2013-01-01

    Background Regulation of the pharmaceutical sector is a challenging task for most governments in the developing countries. In Tanzania, this task falls under the Food and Drugs Authority and the Pharmacy Council. In 2010, the Pharmacy Council spearheaded policy reforms in the pharmaceutical sector aimed at taking over the control of the regulation of the business of pharmacy from the Tanzania Food and Drugs Authority. This study provides a critical analysis of these reforms. Methods The study employed a qualitative case-study design. Data was collected through in-depth interviews, focus group discussions and document reviews. Data was analyzed thematically using a policy triangle framework. The analysis was done manually. Results The reforms adopted an incremental model of public policy-making and the process was characterized by lobbying for political support, negotiations and bargaining between the interest groups. These negotiations were largely centred on vested interests and not on the impact of the reforms on the efficiency of pharmaceutical regulations in the country. Stakeholders from the micro and meso levels were minimally involved in the policy reforms. Conclusion Recent pharmaceutical regulation reforms in Tanzania were overshadowed by vested interests, displacing a critical analysis of optimal policy options that have the potential to increase efficiency in the regulation of the business of pharmacy. Politics influenced decision-making at different levels of the reform process. PMID:23849334

  5. 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

  6. Quantifying Oldowan Stone Tool Production at Olduvai Gorge, Tanzania.

    PubMed

    Reti, Jay S

    2016-01-01

    Recent research suggests that variation exists among and between Oldowan stone tool assemblages. Oldowan variation might represent differential constraints on raw materials used to produce these stone implements. Alternatively, variation among Oldowan assemblages could represent different methods that Oldowan producing hominins utilized to produce these lithic implements. Identifying differential patterns of stone tool production within the Oldowan has implications for assessing how stone tool technology evolved, how traditions of lithic production might have been culturally transmitted, and for defining the timing and scope of these evolutionary events. At present there is no null model to predict what morphological variation in the Oldowan should look like. Without such a model, quantifying whether Oldowan assemblages vary due to raw material constraints or whether they vary due to differences in production technique is not possible. This research establishes a null model for Oldowan lithic artifact morphological variation. To establish these expectations this research 1) models the expected range of variation through large scale reduction experiments, 2) develops an algorithm to categorize archaeological flakes based on how they are produced, and 3) statistically assesses the methods of production behavior used by Oldowan producing hominins at the site of DK from Olduvai Gorge, Tanzania via the experimental model. Results indicate that a subset of quartzite flakes deviate from the null expectations in a manner that demonstrates efficiency in flake manufacture, while some basalt flakes deviate from null expectations in a manner that demonstrates inefficiency in flake manufacture. The simultaneous presence of efficiency in stone tool production for one raw material (quartzite) and inefficiency in stone tool production for another raw material (basalt) suggests that Oldowan producing hominins at DK were able to mediate the economic costs associated with stone tool procurement by utilizing high-cost materials more efficiently than is expected and low-cost materials in an inefficient manner. PMID:26808429

  7. Quantifying Oldowan Stone Tool Production at Olduvai Gorge, Tanzania

    PubMed Central

    Reti, Jay S.

    2016-01-01

    Recent research suggests that variation exists among and between Oldowan stone tool assemblages. Oldowan variation might represent differential constraints on raw materials used to produce these stone implements. Alternatively, variation among Oldowan assemblages could represent different methods that Oldowan producing hominins utilized to produce these lithic implements. Identifying differential patterns of stone tool production within the Oldowan has implications for assessing how stone tool technology evolved, how traditions of lithic production might have been culturally transmitted, and for defining the timing and scope of these evolutionary events. At present there is no null model to predict what morphological variation in the Oldowan should look like. Without such a model, quantifying whether Oldowan assemblages vary due to raw material constraints or whether they vary due to differences in production technique is not possible. This research establishes a null model for Oldowan lithic artifact morphological variation. To establish these expectations this research 1) models the expected range of variation through large scale reduction experiments, 2) develops an algorithm to categorize archaeological flakes based on how they are produced, and 3) statistically assesses the methods of production behavior used by Oldowan producing hominins at the site of DK from Olduvai Gorge, Tanzania via the experimental model. Results indicate that a subset of quartzite flakes deviate from the null expectations in a manner that demonstrates efficiency in flake manufacture, while some basalt flakes deviate from null expectations in a manner that demonstrates inefficiency in flake manufacture. The simultaneous presence of efficiency in stone tool production for one raw material (quartzite) and inefficiency in stone tool production for another raw material (basalt) suggests that Oldowan producing hominins at DK were able to mediate the economic costs associated with stone tool procurement by utilizing high-cost materials more efficiently than is expected and low-cost materials in an inefficient manner. PMID:26808429

  8. The Role of Vernacularization in Tanzania: Swahili as Political Tool.

    ERIC Educational Resources Information Center

    Russell, Joan

    A discussion of the role of Swahili in Tanzania looks at its elaboration as an indigenous language, involving both internal modification of the written language and the extension of its institutionalized domains of use. Because of its role as the lingua franca of the independence movement, Swahili became a vehicle for national political…

  9. Child Sexual Abuse: Community Concerns in Urban Tanzania

    ERIC Educational Resources Information Center

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

    2011-01-01

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

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  11. Evaluating a School-Based Trachoma Curriculum in Tanzania

    ERIC Educational Resources Information Center

    Lewallen, Susan; Massae, Patrick; Tharaney, Manisha; Somba, Margareth; Geneau, Robert; MacArthur, Chad; Courtright, Paul

    2008-01-01

    Trachoma remains a public health problem in a number of sub-Saharan Africa countries; behavioral change and environmental improvements are cornerstones of prevention efforts. Evidence of successful health education are few in Africa. Health education efforts through primary schools have recently been developed and adopted in Tanzania. We evaluated…

  12. 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…

  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. Engaged Learning and Peace Corps Service in Tanzania: An Autoethnography

    ERIC Educational Resources Information Center

    Darling, Brianna; Thorp, Laurie; Chung, Kimberly

    2014-01-01

    The Peace Corps Masters International program offers students the opportunity to combine their Peace Corps service with their master's education. This article demonstrates how classroom learning strengthened the author's Peace Corps service in Tanzania, which in turn strengthened her master's thesis. Peace Corps supports an approach…

  15. 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…

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

    ERIC Educational Resources Information Center

    Iannotti, Lora; Gillespie, Stuart

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

  17. 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…

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

    ERIC Educational Resources Information Center

    Adhvaryu, Achyuta R.; Nyshadham, Anant

    2012-01-01

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

  19. Resistance to Information Technology in Public Procurement in Tanzania

    ERIC Educational Resources Information Center

    Nditi, Christopher

    2010-01-01

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

  20. A Book Development Program for Tanzania; Report and Recommendations.

    ERIC Educational Resources Information Center

    Franklin Book Programs, Inc., New York, NY.

    In Tanzania there is a shortage of books and materials from other countries, local adaptations and translations of these books and materials, and locally written and produced books and materials. The Tengeru National Community Development Training Center and the Rungemba Adult Center at Iringa need books for students and library as well as the…

  1. Literacy for Working: Functional Literacy in Rural Tanzania.

    ERIC Educational Resources Information Center

    Viscusi, Margo

    This study, essentially a personal description is the first to deal with one of the pilot projects in functional literacy, part of the UNESCO experimental adult literacy program. The project discussed is a work-oriented literacy undertaking in Tanzania. Following a brief survey of the background of the project, the present situation is described.

  2. Special Education in Tanzania: Project Findings and Recommendations. Terminal Report.

    ERIC Educational Resources Information Center

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

    The report describes a UNESCO (United Nations Educational, Scientific, and Cultural Organization) project in Tanzania which has the following objectives: establishment of seven educational assessment and resource centers for handicapped children; establishment of four units for deaf children in ordinary schools; implementation of three training…

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

    ERIC Educational Resources Information Center

    Adhvaryu, Achyuta R.; Nyshadham, Anant

    2012-01-01

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

  4. School Proximity and Child Labor: Evidence from Rural Tanzania

    ERIC Educational Resources Information Center

    Kondylis, Florence; Manacorda, Marco

    2012-01-01

    Is improved school accessibility an effective policy tool for reducing child labor in developing countries? We address this question using microdata from rural Tanzania and a regression strategy that attempts to control for nonrandom location of households around schools as well as classical and nonclassical measurement error in self-reported…

  5. 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…

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

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  7. Higher Education System and Jobless Graduates in Tanzania

    ERIC Educational Resources Information Center

    Ndyali, Lyata

    2016-01-01

    The Tanzania's higher education institutions haven't raised much of expectations the graduates lack the skills required by the labor market and this trend results in mass graduate unemployment, otherwise this would have assisted them to be more self-reliant. The study explores the importance of higher-level business education human resources…

  8. 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,…

  9. 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,

  10. Child Sexual Abuse: Community Concerns in Urban Tanzania

    ERIC Educational Resources Information Center

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

    2011-01-01

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

  11. Tanzania Higher Education--Fifty Years after Independence

    ERIC Educational Resources Information Center

    Mnubi, Godfrey M.

    2013-01-01

    As Tanzania celebrates fifty years of independence at the crossroads of globalization, the country has experienced a changing landscape and a major transformation in higher learning education with spectacular expansion in student enrollment rates. This requires its higher education institutions, particularly universities, to function effectively…

  12. Greenhouse gases mitigation options and strategies for Tanzania

    SciTech Connect

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

    1996-12-31

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

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

    PubMed Central

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

    2013-01-01

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

  14. Estimating human rabies mortality in the United Republic of Tanzania from dog bite injuries.

    PubMed Central

    Cleaveland, Sarah; Fèvre, Eric M.; Kaare, Magai; Coleman, Paul G.

    2002-01-01

    OBJECTIVE: To make quantitative predictions about the magnitude of underreporting of human rabies deaths in the United Republic of Tanzania. METHODS: Human rabies deaths were estimated by using a series of probability steps to calculate the likelihood of rabies developing after the bite of a suspected rabid dog, incorporating field data on the incidence of animal bite injuries, the accuracy of rabies recognition, the distribution of bite wounds, and post-exposure treatment. FINDINGS: Predicted human rabies mortality was estimated to be (a) 1499 deaths per year (95% confidence interval 891-2238), equivalent to an annual incidence of 4.9 (2.9-7.2) deaths/100,000, when active surveillance data on bite incidence were used, and (b) 193 deaths per year (32-409), corresponding to an annual incidence of 0.62 (0.1-1.32) deaths/100,000, when national bite statistics were used. The annual mean number of rabies deaths officially recorded for the same period was 10.8 (7.7-14.0). CONCLUSION: In the United Republic of Tanzania, cases of rabies in humans have been greatly underreported. Dog bite injuries are an accessible source of epidemiological data that may be used to estimate the public health burden of rabies and to monitor epidemiological trends in developing countries. PMID:12075367

  15. Skills of general health workers in primary eye care in Kenya, Malawi and Tanzania

    PubMed Central

    2014-01-01

    Background Primary eye care (PEC) in sub-Saharan Africa usually means the diagnosis, treatment, and referral of eye conditions at the most basic level of the health system by primary health care workers (PHCWs), who receive minimal training in eye care as part of their curricula. We undertook this study with the aim to evaluate basic PEC knowledge and ophthalmologic skills of PHCWs, as well as the factors associated with these in selected districts in Kenya, Malawi, and Tanzania. Methods A standardized (26 items) questionnaire was administered to PHCWs in all primary health care (PHC) facilities of 2 districts in each country. Demographic information was collected and an examination aimed to measure competency in 5 key areas (recognition and management of advanced cataract, conjunctivitis, presbyopia, and severe trauma plus demonstrated ability to measure visual acuity) was administered. Results Three-hundred-forty-three PHCWs were enrolled (100, 107, and 136 in Tanzania, Kenya, and Malawi, respectively). The competency scores of PHCW varied by area, with 55.7%, 61.2%, 31.2%, and 66.1% scoring at the competency level in advanced cataract, conjunctivitis, presbyopia, and trauma, respectively. Only 8.2% could measure visual acuity. Combining all scores, only 9 (2.6%) demonstrated competence in all areas. Conclusion The current skills of health workers in PEC are low, with a large per cent below the basic competency level. There is an urgent need to reconsider the expectations of PEC and the content of training. PMID:25860909

  16. 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.

  17. 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

  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. 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

  20. 'We call it the shaking illness': perceptions and experiences of Parkinson's disease in rural northern Tanzania

    PubMed Central

    2011-01-01

    Background Parkinson disease (PD) causes physical disability that negatively affects the quality of life of the sufferer's and their families. There are no Parkinson's disease (PD) social science studies published from Africa. This paper presents findings from a qualitative research study on how PD is perceived and treated in a population of approximately 161,000 within a demographic surveillance site in rural Tanzania. Methods We conducted in-depth interviews with 28 PD sufferers, 28 carers, 4 health workers and 2 traditional healers. In addition, 6 focus group discussions were conducted in 3 villages to investigate wider community views of PD. Results PD sufferers expressed frustration with the physical, psychological, social and economic consequences of the illness. Feelings of a diminished quality of life characterised by dependency, stigma and social isolation were common. Additionally, a handful of male sufferers related their sexual incompetence to the illness. Carers complained of lost income opportunities and social isolation resulting from caring for sufferers. Misconceptions about the cause, symptoms and appropriated PD treatment were widespread. Only 2 PD sufferers had commenced western type treatment through outsourcing drugs from other parts of the country and outside of Tanzania. Conclusions This study highlights the urgent need for PD awareness and treatment interventions in such settings. Such interventions need to address the concerns and needs of sufferers, their carers and the wider community, including the health care system. PMID:21477284

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

    PubMed Central

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

    2014-01-01

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

  2. 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 (χ2=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 (χ2=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

  3. Wetland plant waxes from Olduvai Gorge, Tanzania

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

    Olduvai Gorge, northern Tanzania, exposes a Plio-Pleistocene sedimentary record that includes lake and lake-margin sediments and fossil remains of ancient plants and early humans. There are rich paleontological and cultural records at Olduvai Gorge that include thousands of vertebrate fossils and stone tools. Previous studies of plant biomarkers in lake sediments from Olduvai Gorge reveal repeated, abrupt changes in landscape dominance by woodland or grassland vegetation during the early Pleistocene, about 1.8 million years ago. However, the reconstruction of wetland vegetation in the past is limited by a dearth of published lipid signatures for modern wetland species. Here, we present lipid and isotopic data for leaf tissues from eight modern plants (i.e., sedge and Typha species) living in wetlands near Olduvai Gorge. Trends in values for molecular and leaf δ13C and average chain length (ACL) of n-alkanes in plant tissues are similar to values for underlying soils. Compound-specific δ13C values for n-alkanes C25 to C33 range between -36.4 to -23.1‰ for C3 plants and -22.3 to -19.5‰ for C4 plants. Fractionation factors between leaf and lipids, ɛ29 and ɛ33, fall within the range reported in the literature, but they differ more widely within a single plant. For C3 plants, the average difference between ɛ29 and ɛ33 is 6.5 ‰, and the difference between ɛ29 and ɛ33 for C4 plants is less than 2‰. Both plant types show a parabolic relationship between chain length and δ13C values, in which C29 typically has the most depleted value, and typically shift by 3-5‰ between alkane homologs. This pattern has not been previously reported, and could be unique for sedge lipids. If so, these data help constrain the application of plant wax biomarkers from sedges for paleo-vegetation reconstruction in paleoclimate studies and at archaeological sites.

  4. Effect of a control programme on transmission of Schistosoma mansoni on an irrigated estate in Tanzania

    PubMed Central

    Fenwick, A.

    1972-01-01

    Three methods were used to measure the level of transmission of infections of Schistosoma mansoni on an irrigated sugar estate in northern Tanzania. The studies were carried out over a period of 3 years, during a programme for the control of the host snail Biomphalaria pfeifferi. During the second and third years a mass diagnosis and treatment campaign against the infection was also carried out. Examinations for infection were made in newly employed subjects on arrival and after 6 and 12 months. Two studies were made in young children at an interval of 18 months, to determine age prevalence curves. In the third method, subjects were examined for infection 18 months after being found free from infection in a previous survey. Results are compared with data recorded in a previous study, made before snail control was commenced. The results suggest that the control programme has led to a great reduction in the incidence of S. mansoni on the estate. PMID:4539820

  5. HIV counselling and testing practices for children seen in an urban emergency department of a tertiary referral hospital in Dar es Salaam, Tanzania: a retrospective cross-sectional study

    PubMed Central

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

    2016-01-01

    Objectives To describe the HIV counselling and testing practices for children presenting to an emergency department (ED) in a low-income country. Setting The ED of a large east African national referral hospital. Participants This retrospective review of all paediatric (<18 years old) ED visits in 2012 enrolled patients who had an HIV test ordered and excluded those without testing. Files were available for 5540/5774 (96%) eligible patients and 1632 (30%) were tested for HIV, median age 1.3 years (IQR 9 months to 4 years), 58% <18 months old and 61% male. Primary and secondary outcome measures The primary outcome measure was documentation of pretest and post-test counselling, or deferral of counselling, for children tested for HIV in the ED. Secondary measures included the overall rate of HIV testing, rate of counselling documented in the inpatient record when deferred in the ED, rate of counselling documented when testing was initiated by the inpatient service, rate of counselling documented by test result (positive vs negative) and the rate of referral to follow-up HIV care among patients testing positive. Results Of 418 patients tested in the ED, counselling, or deferral of counselling, was documented for 70 (17%). When deferred to the ward, subsequent counselling was documented for 15/42 (36%). Counselling was documented in 33% of patients testing positive versus 1.1% patients testing negative (OR 43 (95% CI 23 to 83). Of 199 patients who tested positive and survived to hospital discharge, 76 (38%) were referred for follow-up at the HIV clinic on discharge. Conclusions Physicians documented the provision, or deferral, of counselling for <20% of children tested for HIV in the ED. Counselling was much more likely to be documented when the test result was positive. Less than 40% of those testing positive were referred for follow-up care. PMID:26880672

  6. Assessment of the experiences and coping strategies of people working in the informal sector in their quest to access health care services: the case of Dar es Salaam, Tanzania.

    PubMed

    Munga, Michael A; Gideon, Gilbert M

    2009-02-01

    Addressing inequities in health care provision and financing has been at the center stage of Health Sector Reform (HSR) discussions since the early 1980s. The poor, women, and informal health sector workers in most developing countries are rarely covered by formal health insurance mechanisms that are meant to ensure access to essential health services. They are also sidelined in formal banking and credit systems due to their being predominantly low income earners, with little resources to meet eligibility criteria for borrowing and also to be considered creditworthy. In light of this fact, the present paper analyzes both quantitative and qualitative data in an attempt to explore and discuss the experiences and coping strategies of women and men employed in the informal sector economy in their daily attempts to access health care services. The paper employs Malaria as a tracer disease and gender as a unit of analysis. Analysis indicated the significance, as perceived by interviewees, of both informal credit networks and formal insurance and banking systems as important shock-absorbers for vulnerable populations in their struggle to access basic health services in times of need. The paper further highlights and discusses diverse coping strategies that households employ in dealing with illness-related costs and a greater willingness to be integrated into both formal and informal financial mechanisms. The paper finally concludes that the government must take the following steps: 1) enhance existing formal and communitybased initiatives to make them sustainable, 2) devise ways to reduce the lack of flexibility in membership requirements for insurance schemes/financial institutions, and 3) reduce perverse incentives inherent in the health system that may prevent people from seeking membership in available insurance mechanisms. In addition, deliberate steps must be taken by the government to employ 'targeted measures' to ensure that health care access is improved and sustained particularly for vulnerable populations. PMID:20103939

  7. Willingness and ability to pay for artemisinin-based combination therapy in rural Tanzania

    PubMed Central

    Saulo, Eleonor C; Forsberg, Birger C; Premji, Zul; Montgomery, Scott M; Björkman, Anders

    2008-01-01

    Background The aim of this study was to analyse willingness to pay (WTP) and ability to pay (ATP) for ACT for children below five years of age in a rural setting in Tanzania before the introduction of artemisinin-based combination therapy (ACT) as first-line treatment for uncomplicated malaria. Socio-economic factors associated with WTP and expectations on anti-malaria drugs, including ACT, were also explored. Methods Structured interviews and focus group discussions were held with mothers, household heads, health-care workers and village leaders in Ishozi, Gera and Ishunju wards in north-west Tanzania in 2004. Contingent valuation method (CVM) was used with "take-it-or-leave-it" as the eliciting method, expressed as WTP for a full course of ACT for a child and households' opportunity cost of ACT was used to assess ATP. The study included descriptive analyses with multivariate adjustment for potential confounding factors. Results Among 265 mothers and household heads, 244 (92%, CI = 88%–95%) were willing to pay Tanzanian Shillings (TSh) 500 (US$ 0.46) for a child's dose of ACT, but only 55% (49%–61%) were willing to pay more than TSh 500. Mothers were more often willing to pay than male household heads (adjusted odds ratio = 2.1, CI = 1.2–3.6). Socio-economic status had no significant effect on WTP. The median annual non-subsidized ACT cost for clinical malaria episodes in an average household was calculated as US$ 6.0, which would represent 0.9% of the average total consumption expenditures as estimated from official data in 2001. The cost of non-subsidized ACT represented 7.0% of reported total annual expenditure on food and 33.0% of total annual expenditure on health care. "Rapid effect," "no adverse effect" and "inexpensive" were the most desired features of an anti-malarial drug. Conclusion WTP for ACT in this study was less than its real cost and a subsidy is, therefore, needed to enable its equitable affordability. The decision taken in Tanzania to subsidize Coartem® fully at governmental health care facilities and at a consumer price of TSh 300–500 (US$ 0.28–0.46) at special designated shops through the programme of Accredited Drug Dispensing Outlets (ADDOs) appears to be well founded. PMID:18976453

  8. Parents' experiences of reporting child sexual abuse in urban Tanzania.

    PubMed

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

    2013-01-01

    This article reports parental experiences of legally reporting child sexual abuse in Tanzania. Based on in-depth interviews, four types of sexual abuse incidents are portrayed. Each evokes different reactions from parents and the community. An incident characterized as the innocent child was associated with a determination to seek justice. The forced-sex youth elicited feelings of parental betrayal of their child. The consenting curious youth resulted in uncertainty of how to proceed, while the transactional-sex youth evoked a sense of parental powerlessness to control the child because of low economic status. Differentiating between types of sexual abuse incidents may increase awareness of the complexities of child sexual abuse reporting. Education on laws regulating sexual offenses and a functional national child protection system are needed to address child sexual abuse complexities and safeguard the rights of children in Tanzania. PMID:23829829

  9. Epidemiology and control of human schistosomiasis in Tanzania

    PubMed Central

    2012-01-01

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

  10. Pregnancy history and current use of contraception among women of reproductive age in Burundi, Kenya, Rwanda, Tanzania and Uganda: analysis of demographic and health survey data

    PubMed Central

    Bakibinga, Pauline; Matanda, Dennis J; Ayiko, Rogers; Rujumba, Joseph; Muiruri, Charles; Amendah, Djesika; Atela, Martin

    2016-01-01

    Objective To examine the relationship between pregnancy history and the use of contraception among women of reproductive age (15–49 years) in East Africa. Methods Demographic and Health Surveys data from Burundi (2010), Kenya (2008–2009), Rwanda (2010), Tanzania (2010) and Uganda (2011) were used in the analysis. Logistic regression was used to determine the effects of women's pregnancy history on their use of contraception. Setting Burundi, Kenya, Rwanda, Tanzania and Uganda. Participants 3226, 2377, 4396, 3250 and 2596 women of reproductive age (15–49 years) from Burundi, Kenya, Rwanda, Tanzania and Uganda, respectively, were included in the analysis. Results Women who had experienced a mistimed pregnancy were more likely to use a modern contraceptive method during their most recent sexual encounter in Kenya, Rwanda, Burundi and Uganda. Other significant correlates of women's contraceptive use were: desire for more children, parity, household wealth, maternal education and access information through radio. In-country regional differences on use of modern contraceptive methods were noted across five East African countries. Conclusions Women's birth histories were significantly associated with their decision to adopt a modern contraceptive method. This highlights the importance of considering women's birth histories, especially women with mistimed births, in the promotion of contraceptive use in East Africa. Variations as a result of place of residency, educational attainment, access to family planning information and products, and wealth ought to be addressed in efforts to increase use of modern contraceptive methods in the East African region. PMID:26966059

  11. The Status of Wind Energy Development in Tanzania

    NASA Astrophysics Data System (ADS)

    Kainkwa, R. R. M.

    Wind energy development in Tanzania started about 3 decades ago when some windmills were installed at several locations in the country to pump water for human and animal consumption and in a few cases for irrigation. There were some attempts to manufacture the windmills locally but these were never successful. In 1980 there were some attempts to generate electricity from wind but these also were unsuccessful.

  12. Regulating Tanzanias drug shops -- why do they break the rules, and does it matter?

    PubMed Central

    Goodman, CA; Kachur, SP; Abdulla, S; Bloland, P; Mills, A

    2009-01-01

    Regulatory infringements are extremely common in low income countries, especially with respect to retail pharmaceutical sales. There have been few practical suggestions on public policy responses other than stricter regulatory enforcement, which governments are often unable, or unwilling, to do. This paper explores the challenges of regulating retail drug sellers, and potential solutions, through a case study of malaria treatment in rural Tanzania where small drug shops are a common source of medicine. Infringement of health-related regulation was extremely common. Most stores lacked valid permits, and illegal stocking of prescription-only medicines and unpackaged tablets was the norm. Most stocked unregistered drugs, and no serving staff met the qualification requirements. Infringements are likely to have reflected infrequent regulatory inspections, a failure of regulatory authorities to implement sanctions, successful concealment of regulatory violations, and the tacit permission of local regulatory staff. Eliminating regulatory infringements is unlikely to be feasible, and could be undesirable if access to essential medicines is reduced. Alternatives include bringing official drug regulation closer into line with locally legitimate practices; greater use of positive incentives for providers; and consumer involvement. Such a change in approach has the potential to provide a firmer platform for public-private collaboration to improve shop-based treatment. PMID:17921151

  13. UPE in Tanzania: SWAP-ing Quality for Quantity--Again?

    ERIC Educational Resources Information Center

    Kuder, Jeanette

    2005-01-01

    In 2002, Tanzania renewed its 1974 commitment to universal primary education. This paper explores differences in the current policy-formulation context, examining how development discourse and aid practice have shifted the space and scale of public governance in Tanzania, legitimising international agendas and the participation of non-Tanzanians…

  14. 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…

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

    ERIC Educational Resources Information Center

    Mpehongwa, Gasper

    2013-01-01

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

  16. Implementing Educational Policies in Tanzania. World Bank Discussion Papers No. 86. Africa Technical Department Series.

    ERIC Educational Resources Information Center

    Galabawa, C. J.

    Of the three East African British colonies (Kenya, Uganda, and Tanzania), Tanzania was the least well off at the time of independence in 1961. At that time, only 16,691 students were enrolled in secondary schools, and all general education at higher levels was provided outside the country. Thus, the goals of post-independence educational policy…

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

    ERIC Educational Resources Information Center

    Mpehongwa, Gasper

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Mgaza, Olyvia

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

  19. 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

  20. 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,…

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

    ERIC Educational Resources Information Center

    Mgaza, Olyvia

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

  2. 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…

  3. Standards to Assure Quality in Tertiary Education: The Case of Tanzania

    ERIC Educational Resources Information Center

    Manyaga, Timothy

    2008-01-01

    Purpose: The purpose of this paper is to provide information on development of standards in Tanzania which may be of help to training providers in other countries as they seek to improve the quality and standards of their provision. Design/methodology/approach: The need to provide quality assured tertiary qualifications in Tanzania to win both…

  4. Angular leaf spot disease status and characterization of the causative pathgen (P. Griseola) in Tanzania

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Angular leaf spot caused by the fungus Pseudocercospora griseola is one of the most important disease of common bean in Tanzania. Breeding for resistance to this disease is complicated by the variable nature of the pathogen. In Tanzania no thorough attempt has been completed to evaluate the variabil...

  5. 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)

  6. 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,…

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

    PubMed

    Mtei, B J; Sanga, H J

    1990-05-01

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

  8. "Protect Your Loved Ones From Fataki": Discouraging Cross-Generational Sex in Tanzania.

    PubMed

    Kaufman, Michelle R; Tsang, Samantha W; Mooney, Alyssa; McCartney-Melstad, Anna; Mushi, Adiel K; Kamala, Benjamin

    2016-06-01

    The Fataki campaign aired in Tanzania via radio from 2008 to 2011 to address cross-generational sex, a major driver of HIV in the region. The campaign sought to incite social disapproval of men who engage in such relationships, generate dialogue around the issue, and encourage community interventions in these relationships through social learning. Using qualitative methods, we explored campaign reactions, use of the term Fataki to describe men in relationships with much younger women, and the nature of discussions spurred by the campaign. We conducted focus group discussions and individual interviews in Iringa and Pwani regions with young women, older men, and community leaders. Results showed that the Fataki term was widely used and had negative connotations reflecting social disapproval of men who participate in such relationships. Dialogue spurred by the campaign, primarily directed toward young women, focused on reasons for avoiding these relationships. We conclude with suggestions for relevant future interventions. PMID:25918112

  9. Use of health care services in two rural communities in Tanzania.

    PubMed

    Sarita, P T; Tuominen, R

    1993-06-01

    This study was undertaken to investigate the pattern of utilization of medical and dental health care services in rural Tanzania. Two hundred adults, 91 men and 109 women aged 20 or over, were interviewed. Nearly all subjects reported using modern dental and medical health care services. Home remedy was the only indigenous method of treatment used for dental problems while for medical problems a traditional healer was the most commonly used indigenous alternative. The use of both indigenous and modern health care services was significantly lower for dental than for medical problems (P < 0.05). It seems that the pattern of utilization of health care services differs for medical and dental problems. This should be taken into account when planning comprehensive health care services for rural African societies. PMID:8348785

  10. 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

  11. 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

  12. 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

  13. 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

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

    PubMed Central

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

    2013-01-01

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

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

    PubMed Central

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

    2015-01-01

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

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

    ERIC Educational Resources Information Center

    Kafyulilo, Ayoub

    2014-01-01

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

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

    ERIC Educational Resources Information Center

    Kafyulilo, Ayoub

    2014-01-01

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

  18. Sero-prevalence and factors associated with Toxoplasma gondii infection among pregnant women attending antenatal care in Mwanza, Tanzania

    PubMed Central

    2013-01-01

    Background Serological screening of pregnant women for Toxoplasma gondii-specific antibodies is not practiced as an antenatal care in Tanzania; and there is a limited data about sero-prevalence of T. gondii infection in developing countries. We therefore conducted this study to determine the sero-prevalence and factors associated with T. gondii infection among pregnant women attending antenatal care clinics in Mwanza, Tanzania. Methods Between 1st November 2012 and 31st May 2013 a total of 350 pregnant women attending antenatal care clinics in Mwanza were enrolled and screened for IgG and IgM antibodies against T. gondii using the ELISA technique. Results Of 350 pregnant women, 108 (30.9%) were sero-positive for T. gondii-specific antibodies. The risk of contracting T. gondii infection increases by 7% with each yearly increase in a woman’s age (OR=1.07, 95% CI: 1.02 - 1.11, p=0.002). The sero-positivity rate of T. gondii-specific antibodies was higher among pregnant women from the urban than those from rural communities (41.5% versus 22.0%); [OR=2.2, 95% CI; 1.4 - 3.7, p=0.001]. Likewise employed/business women were more likely to get T. gondii infection than peasants (40.0% versus 25.9%) [OR=1.9, 95% CI: 1.2 - 3.0, p=0.006]. Conclusions Sero-prevalence of T. gondii-specific antibodies is high among pregnant women in Mwanza with a significant proportion of women at risk of contracting primary T. gondii infections. Screening of T. gondii infections during antenatal care should be considered in Tanzania as the main strategy to minimize congenital toxoplasmosis. PMID:23915834

  19. Work Experience, Job-Fulfillment and Burnout among VMMC Providers in Kenya, South Africa, Tanzania and Zimbabwe

    PubMed Central

    Perry, Linnea; Rech, Dino; Mavhu, Webster; Frade, Sasha; Machaku, Michael D.; Onyango, Mathews; Aduda, Dickens S. Omondi.; Fimbo, Bennett; Cherutich, Peter; Castor, Delivette; Njeuhmeli, Emmanuel; Bertrand, Jane T.

    2014-01-01

    Background Human resource capacity is vital to the scale-up of voluntary medical male circumcision (VMMC) services. VMMC providers are at risk of “burnout” from performing a single task repeatedly in a high volume work environment that produces long work hours and intense work effort. Methods and findings The Systematic Monitoring of the Voluntary Medical Male Circumcision Scale-up (SYMMACS) surveyed VMMC providers in Kenya, South Africa, Tanzania, and Zimbabwe in 2011 (n = 357) and 2012 (n = 591). Providers self-reported on their training, work experience, levels of job-fulfillment and work fatigue/burnout. Data analysis included a descriptive analysis of VMMC provider characteristics, and both bivariate and multivariate analyses of factors associated with provider work fatigue/burnout. In 2012, Kenyan providers had worked in VMMC for a median of 31 months compared to South Africa (10 months), Tanzania (15 months), and Zimbabwe (11 months). More than three-quarters (78 – 99%) of providers in all countries in 2012 reported that VMMC is a personally fulfilling job. However, 67% of Kenyan providers reported starting to experience work fatigue/burnout compared to South Africa (33%), Zimbabwe (17%), and Tanzania (15%). Despite the high level of work fatigue/burnout in Kenya, none of the measured factors (i.e., gender, age, full-time versus part-time status, length of service, number of operations performed, or cadre) were significantly associated with work fatigue/burnout in 2011. In 2012, logistic regression found increases in age (p<.05) and number of months working in VMMC (p<.01) were associated with an increased likelihood of experiencing work fatigue/burnout, while higher career total VMMCs decreased the likelihood of experiencing burnout. Conclusion Given cross-country differences, further elucidation of cultural and other contextual factors that may influence provider burnout is required. Continuing to emphasize the contribution that providers make in the fight against HIV/AIDS is important. PMID:24802260

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

    PubMed Central

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

    2014-01-01

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

  1. Q Fever, Spotted Fever Group, and Typhus Group Rickettsioses Among Hospitalized Febrile Patients in Northern Tanzania

    PubMed Central

    Prabhu, Malavika; Nicholson, William L.; Roche, Aubree J.; Kersh, Gilbert J.; Fitzpatrick, Kelly A.; Oliver, Lindsay D.; Massung, Robert F.; Morrissey, Anne B.; Bartlett, John A.; Onyango, Jecinta J.; Maro, Venance P.; Kinabo, Grace D.; Saganda, Wilbrod

    2011-01-01

    Background. The importance of Q fever, spotted fever group rickettsiosis (SFGR), and typhus group rickettsiosis (TGR) as causes of febrile illness in sub-Saharan Africa is unknown; the putative role of Q fever as a human immunodeficiency virus (HIV) coinfection is unclear. Methods. We identified febrile inpatients in Moshi, Tanzania, from September 2007 through August 2008 and collected acute- and convalescent-phase serum samples. A ≥4-fold increase in immunoglobulin (Ig) G immunfluorescence assay (IFA) titer to Coxiella burnetii phase II antigen defined acute Q fever. A ≥4-fold increase in IgG IFA titer to Rickettsia conorii or Rickettsia typhi antigen defined SFGR and TGR, respectively. Results. Among 870 patients, 483 (55.5%) were tested for acute Q fever, and 450 (51.7%) were tested for acute SFGR and TGR. Results suggested acute Q fever in 24 (5.0%) patients and SFGR and TGR in 36 (8.0%) and 2 (0.5%) patients, respectively. Acute Q fever was associated with hepato- or splenomegaly (odds ratio [OR], 3.1; P = .028), anemia (OR, 3.0; P = .009), leukopenia (OR, 3.9; P = .013), jaundice (OR, 7.1; P = .007), and onset during the dry season (OR, 2.7; P = .021). HIV infection was not associated with acute Q fever (OR, 1.7; P = .231). Acute SFGR was associated with leukopenia (OR, 4.1; P = .003) and with evidence of other zoonoses (OR, 2.2; P = .045). Conclusions. Despite being common causes of febrile illness in northern Tanzania, Q fever and SFGR are not diagnosed or managed with targeted antimicrobials. C. burnetii does not appear to be an HIV-associated co-infection. PMID:21810740

  2. The challenges of achieving high training coverage for IMCI: case studies from Kenya and Tanzania

    PubMed Central

    Mushi, Hildegalda P; Mullei, Kethi; Macha, Janet; Wafula, Frank; Borghi, Josephine; Goodman, Catherine; Gilson, Lucy

    2011-01-01

    Health worker training is a key component of the integrated management of childhood illness (IMCI). However, training coverage remains low in many countries. We conducted in-depth case studies in two East African countries to examine the factors underlying low training coverage 10 years after IMCI had been adopted as policy. A document review and in-depth semi-structured interviews with stakeholders at facility, district, regional/provincial and national levels in two districts in Kenya (Homa Bay and Malindi) and Tanzania (Bunda and Tarime) were carried out in 2007–08. Bunda and Malindi achieved higher levels of training coverage (44% and 25%) compared with Tarime and Homa Bay (5% and 13%). Key factors allowing the first two districts to perform better were: strong district leadership and personal commitment to IMCI, which facilitated access to external funding and encouraged local-level policy adaptation; sensitization and training of district health managers; and lower staff turnover. However, IMCI training coverage remained well below target levels across all sites. The main barrier to expanding coverage was the cost of training due to its duration, the number of facilitators and its residential nature. Mechanisms for financing IMCI also restricted district capacity to raise funds. In Tanzania, districts could not spend more than 10% of their budgets on training. In Kenya, limited financial decentralization meant that district managers had to rely on donors for financial support. Critically, the low priority given to IMCI at national and international levels also limited the expansion of training. Levels of domestic and donor support for IMCI have diminished over time in favour of vertical programmes, partly due to the difficulty in monitoring and measuring the impact of an integrated intervention like IMCI. Alternative, lower cost methods of IMCI training need to be promoted, and greater advocacy for IMCI is needed both nationally and internationally. PMID:21047808

  3. 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

  4. Depression and HIV risk among men who have sex with men in Tanzania

    PubMed Central

    Ahaneku, Hycienth; Ross, Michael W.; Nyoni, Joyce E.; Selwyn, Beatrice; Troisi, Catherine; Mbwambo, Jessie; Adeboye, Adeniyi; McCurdy, Sheryl

    2016-01-01

    ABSTRACT Studies have shown high rates of depression among men who have sex with men (MSM) in developed countries. Studies have also shown association between depression and HIV risk among MSM. However, very little research has been done on depression among African MSM. We assessed depression and HIV risk among a sample of MSM in Tanzania. We reviewed data on 205 MSM who were recruited from two Tanzanian cities using the respondent driven sampling method. Demographic and behavioral data were collected using a structured questionnaire. HIV and sexually transmitted infections data were determined from biological tests. Depression scores were assessed using the Patient Health Questionnaire (PHQ-9). For the analysis, depression scores were dichotomized as depressed (PHQ > 4) and not depressed (PHQ ≤ 4). Bivariate and multivariable Poisson regression analyses were conducted to assess factors associated with depression. The prevalence of depression in the sample was 46.3%. The mean (±SD) age of the sample was 25 (±5) years. In bivariate analysis, depression was associated with self-identifying as gay (p = .001), being HIV positive (p < .001: <8% of MSM knew they were HIV infected) and having a high number of sexual partners in the last 6 months (p = .001). Depression was also associated with sexual (p = .007), physical (p = .003) and verbal (p < .001) abuse. In the Poisson regression analysis, depression was associated with verbal abuse (APR = 1.91, CI = 1.30–2.81). Depression rates were high among MSM in Tanzania. It is also associated with abuse, HIV and HIV risk behaviors. Thus, reducing the risk of depression may be helpful in reducing the risk of HIV among MSM in Africa. We recommend the colocation of mental health and HIV preventive services as a cost-effective means of addressing both depression and HIV risk among MSM in Africa. PMID:27002772

  5. 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, α- and β-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 β-esterase activity were significantly higher in An. arabiensis from Lower Moshi than in the laboratory susceptible strain. There was no difference in α-esterase activity between the two strains. Conclusion Elevated levels of mixed function oxidases and β-esterases play a role in detoxification of permethrin in the resistant An. arabiensis population of Lower Moshi. PMID:20609220

  6. Community-based monitoring of safe motherhood in the United Republic of Tanzania.

    PubMed Central

    Mswia, Robert; Lewanga, Mary; Moshiro, Candida; Whiting, David; Wolfson, Lara; Hemed, Yusuf; Alberti, K. G. M. M.; Kitange, Henry; Mtasiwa, Deo; Setel, Philip

    2003-01-01

    OBJECTIVE: To examine the progress made towards the Safe Motherhood Initiative goals in three areas of the United Republic of Tanzania during the 1990s. METHODS: Maternal mortality in the United Republic of Tanzania was monitored by sentinel demographic surveillance of more than 77,000 women of reproductive age, and by prospective monitoring of mortality in the following locations; an urban site; a wealthier rural district; and a poor rural district. The observation period for the rural districts was 1992-99 and 1993-99 for the urban site. FINDINGS: During the period of observation, the proportion of deaths of women of reproductive age (15-49 years) due to maternal causes (PMDF) compared with all causes was between 0.063 and 0.095. Maternal mortality ratios (MMRatios) were 591-1099 and maternal mortality rates (MMRates; maternal deaths per 100,000 women aged 15-49 years) were 43.1-123.0. MMRatios in surveillance areas were substantially higher than estimates from official, facility-based statistics. In all areas, the MMRates in 1999 were substantially lower than at the start of surveillance (1992 for rural districts, 1993 for the urban area), although trends during the period were statistically significant at the 90% level only in the urban site. At the community level, an additional year of education for household heads was associated with a 62% lower maternal death rate, after controlling for community-level variables such as the proportion of home births and occupational class. CONCLUSION: Educational level was a major predictor of declining MMRates. Even though rates may be decreasing, they remained high in the study areas. The use of sentinel registration areas may be a cost-effective and accurate way for developing countries to monitor mortality indicators and causes, including for maternal mortality. PMID:12751416

  7. 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

  8. Understanding the link between trafficking in persons and HIV and AIDS risk in Tanzania.

    PubMed

    Kamazima, Switbert R; Ezekiel, Mangi J; Kazaura, Method R; Fimbo, Benett

    2012-01-01

    The magnitude of trafficking in persons in Tanzania is unknown. Consequently, available information on health risks of persons trafficked for different forms of exploitation is extremely scanty. We conducted a baseline study in eight administrative regions of Tanzania using both qualitative and quantitative methods to generate data on the health conditions of trafficked persons to inform trafficking in persons control measures through HIV and AIDS interventions. Study participants included the national, regional and district community development officers, district medical officers, local government leaders, managers or representatives of non-governmental organizations involved in anti-trafficking in persons activities, members of the community and victims. Findings indicated that common forms of labour into which persons are trafficked include domestic services, agriculture (farming), construction, mining/quarrying, fishing, lumbering and manufacturing. Trafficked persons are reported to be exposed to risks like overcrowding, long working hours, psychological problems, physical injuries, impotence, breathing problems and sexually transmitted infections including HIV. It is concluded that the reported occupational hazards in industries where trafficked persons are forced into are not specific to trafficked persons as they affect all labourers. However, the underground nature of the trafficking in persons process increases health problems and risks, including the vulnerability to HIV infection. More tailored research is needed, especially to find means of how to reach out and provide services to this particular vulnerable population, validate labour forms of exploitation into which persons are trafficked to enable the integration or mainstreaming of HIV and AIDS and trafficking in persons at the policy and programmatic levels. In addition, findings would facilitate the understanding of the link between increased risk of IRV and trafficking in persons. PMID:26591750

  9. The Use of Guidelines for Lower Respiratory Tract Infections in Tanzania: A Lesson from Kilimanjaro Clinicians

    PubMed Central

    Mbwele, B; Slot, A; De Mast, Q; Kweka, P; Msuya, M; Hulscher, M

    2016-01-01

    Background: Evaluations of the guidelines for the management of Lower Respiratory Tract Infections (LRTI) Sub-Saharan Africa, particularly in Tanzania is scant. Aim: The aim of the study was to assess the usefulness of the current Tanzanian treatment guideline for the management lower respiratory tract infection. Subjects and Methods: A descriptive cross sectional study in 11 hospitals of different levels in the Kilimanjaro region Data were collected from May 2012 to July 2012 by semi-structured interview for clinicians using 2 dummy cases for practical assessment. Data were analyzed by STATA v11 (StataCorp, TX, USA). Qualitative narratives from the interviews were translated, transcribed then coded by colors into meaningful themes. Results: A variety of principles for diagnosing and managing LRTI were demonstrated by 53 clinicians of Kilimanjaro. For the awareness, 67.9% (36/53) clinicians knew their responsibility to use Standard Treatment Guideline for managing LRTI. The content derived from Standard Treatment Guideline could be cited by 11.3% of clinicians (6/53) however they all showed concern of gaps in the guideline. Previous training in the management of patients with LRTI was reported by 25.9% (14/53), majority were pulmonary TB related. Correct microorganisms causing different forms of LRTI were mentioned by 11.3% (6/53). Exact cause of Atypical pneumonia and Q fever as an example was stated by 13.0% (7/53) from whom the need of developing the guideline for LRTI was explicitly elaborated. Conclusion: The current guidelines have not been used effectively for the management of LRTI in Tanzania. There is a need to review its content for the current practical use.

  10. Depression and HIV risk among men who have sex with men in Tanzania.

    PubMed

    Ahaneku, Hycienth; Ross, Michael W; Nyoni, Joyce E; Selwyn, Beatrice; Troisi, Catherine; Mbwambo, Jessie; Adeboye, Adeniyi; McCurdy, Sheryl

    2016-03-01

    Studies have shown high rates of depression among men who have sex with men (MSM) in developed countries. Studies have also shown association between depression and HIV risk among MSM. However, very little research has been done on depression among African MSM. We assessed depression and HIV risk among a sample of MSM in Tanzania. We reviewed data on 205 MSM who were recruited from two Tanzanian cities using the respondent driven sampling method. Demographic and behavioral data were collected using a structured questionnaire. HIV and sexually transmitted infections data were determined from biological tests. Depression scores were assessed using the Patient Health Questionnaire (PHQ-9). For the analysis, depression scores were dichotomized as depressed (PHQ > 4) and not depressed (PHQ ≤ 4). Bivariate and multivariable Poisson regression analyses were conducted to assess factors associated with depression. The prevalence of depression in the sample was 46.3%. The mean (±SD) age of the sample was 25 (±5) years. In bivariate analysis, depression was associated with self-identifying as gay (p = .001), being HIV positive (p < .001: <8% of MSM knew they were HIV infected) and having a high number of sexual partners in the last 6 months (p = .001). Depression was also associated with sexual (p = .007), physical (p = .003) and verbal (p < .001) abuse. In the Poisson regression analysis, depression was associated with verbal abuse (APR = 1.91, CI = 1.30-2.81). Depression rates were high among MSM in Tanzania. It is also associated with abuse, HIV and HIV risk behaviors. Thus, reducing the risk of depression may be helpful in reducing the risk of HIV among MSM in Africa. We recommend the colocation of mental health and HIV preventive services as a cost-effective means of addressing both depression and HIV risk among MSM in Africa. PMID:27002772

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

    PubMed Central

    2014-01-01

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

  12. Increased utilisation of PEPFAR-supported laboratory services by non-HIV patents in Tanzania

    PubMed Central

    McNairy, Margaret L.; Gwynn, Charon; Rabkin, Miriam; Antelman, Gretchen; Wu, Yingfeng; Alemayehu, Bereket; Lim, Travis; Imtiaz, Rubina; Mosha, Fausta; Mwasekaga, Michael; Othman, Asha A.; Justman, Jessica

    2016-01-01

    Background It is unknown to what extent the non-HIV population utilises laboratories supported by the President's Emergency Plan for AIDS Relief (PEPFAR). Objectives We aimed to describe the number and proportion of laboratory tests performed in 2009 and 2011 for patients referred from HIV and non-HIV services (NHSs) in a convenience sample collected from 127 laboratories supported by PEPFAR in Tanzania. We then compared changes in the proportions of tests performed for patients referred from NHSs in 2009 vs 2011. Methods Haematology, chemistry, tuberculosis and syphilis test data were collected from available laboratory registers. Referral sources, including HIV services, NHSs, or lack of a documented referral source, were recorded. A generalised linear mixed model reported the odds that a test was from a NHS. Results A total of 94 132 tests from 94 laboratories in 2009 and 157 343 tests from 101 laboratories in 2011 were recorded. Half of all tests lacked a documented referral source. Tests from NHSs constituted 42% (66 084) of all tests in 2011, compared with 31% (29 181) in 2009. A test in 2011 was twice as likely to have been referred from a NHS as in 2009 (adjusted odds ratio: 2.0 [95% confidence interval: 2.0–2.1]). Conclusion Between 2009 and 2011, the number and proportion of tests from NHSs increased across all types of test. This finding may reflect increased documentation of NHS referrals or that the laboratory scale-up originally intended to service the HIV-positive population in Tanzania may be associated with a ‘spillover effect’ amongst the general population. PMID:26962475

  13. 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.

  14. The challenges of achieving high training coverage for IMCI: case studies from Kenya and Tanzania.

    PubMed

    Mushi, Hildegalda P; Mullei, Kethi; Macha, Janet; Wafula, Frank; Borghi, Josephine; Goodman, Catherine; Gilson, Lucy

    2011-09-01

    Health worker training is a key component of the integrated management of childhood illness (IMCI). However, training coverage remains low in many countries. We conducted in-depth case studies in two East African countries to examine the factors underlying low training coverage 10 years after IMCI had been adopted as policy. A document review and in-depth semi-structured interviews with stakeholders at facility, district, regional/provincial and national levels in two districts in Kenya (Homa Bay and Malindi) and Tanzania (Bunda and Tarime) were carried out in 2007-08. Bunda and Malindi achieved higher levels of training coverage (44% and 25%) compared with Tarime and Homa Bay (5% and 13%). Key factors allowing the first two districts to perform better were: strong district leadership and personal commitment to IMCI, which facilitated access to external funding and encouraged local-level policy adaptation; sensitization and training of district health managers; and lower staff turnover. However, IMCI training coverage remained well below target levels across all sites. The main barrier to expanding coverage was the cost of training due to its duration, the number of facilitators and its residential nature. Mechanisms for financing IMCI also restricted district capacity to raise funds. In Tanzania, districts could not spend more than 10% of their budgets on training. In Kenya, limited financial decentralization meant that district managers had to rely on donors for financial support. Critically, the low priority given to IMCI at national and international levels also limited the expansion of training. Levels of domestic and donor support for IMCI have diminished over time in favour of vertical programmes, partly due to the difficulty in monitoring and measuring the impact of an integrated intervention like IMCI. Alternative, lower cost methods of IMCI training need to be promoted, and greater advocacy for IMCI is needed both nationally and internationally. PMID:21047808

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

    NASA Astrophysics Data System (ADS)

    Tayabali Jiwaji, Noorali

    2015-08-01

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

  16. 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

  17. Response to Rift Valley Fever in Tanzania: Challenges and Opportunities.

    PubMed

    Fyumagwa, Robert D; Ezekiel, Mangi J; Nyaki, Athanas; Mdaki, Maulid L; Katale, Zablon B; Moshiro, Candida; Keyyu, Julius D

    2011-12-01

    Rift Valley Fever (RVF) is an arthropod borne viral disease affecting livestock (cattle, sheep, goats and camels), wildlife and humans caused by Phlebovirus. The disease occurs in periodic cycles of 4-15 years associated with flooding from unusually high precipitations in many flood-prone habitats. Aedes and Culex spp and other mosquito species are important epidemic vectors. Because of poor living conditions and lack of knowledge on the pathogenesis of RVF, nomadic pastoralists and agro-pastoralists are at high risk of contracting the disease during epidemics. RVF is a professional hazard for health and livestock workers because of poor biosafety measures in routine activities including lack of proper Personal Protective Equipment (PPE). Direct exposure to infected animals can occur during handling and slaughter or through veterinary and obstetric procedures or handling of specimens in laboratory. The episodic nature of the disease creates special challenges for its mitigation and control and many of the epidemics happen when the governments are not prepared and have limited resource to contain the disease at source. Since its first description in 1930s Tanzania has recorded six epidemics, three of which were after independence in 1961. However, the 2007 epidemic was the most notable and wide spread with fatal human cases among pastoralists and agro-pastoralists concurrent with high livestock mortality. Given all the knowledge that exist on the epidemiology of the disease, still the 2006/2007 epidemic occurred when the government of Tanzania was not prepared to contain the disease at source. This paper reviews the epidemiology, reporting and outbreak-investigation, public awareness, preparedness plans and policy as well as challenges for its control in Tanzania. PMID:26591988

  18. African Oral Traditions: Riddles Among The Haya of Northwestern Tanzania

    NASA Astrophysics Data System (ADS)

    Ishengoma, Johnson M.

    2005-05-01

    This study argues for the integration of African oral traditions and other elements of traditional learning into the modern school curriculum. It thus contributes to supporting the increased relevance of education to local communities. In particular, using the example of riddles collected from one of the main ethnic groups in Northwestern Tanzania, the Haya people, the present study challenges the views of those social and cultural anthropologists who hold that African riddles have no substantially meaningful educational value. Instead, it is maintained that riddles make an important contribution to children's full participation in the social, cultural, political, and economic life of African communities, especially by fostering critical thinking and transmitting indigenous knowledge.

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

    PubMed Central

    Adhvaryu, Achyuta R.; Nyshadham, Anant

    2013-01-01

    We study the effects of accessing better healthcare on the schooling and labor supply decisions of sick children in Tanzania. Using variation in the cost of formal-sector healthcare to predict treatment choice, we show that accessing better healthcare decreases length of illness and changes children’s allocation of time to school and work. Children attend school for more days per week—but not for more hours per day—as a result of accessing better healthcare. There are no significant effects on child labor, but the results suggest that time spent in physically strenuous activities such as farming and herding increases. PMID:24353348

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

    PubMed

    Adhvaryu, Achyuta R; Nyshadham, Anant

    2012-01-01

    We study the effects of accessing better healthcare on the schooling and labor supply decisions of sick children in Tanzania. Using variation in the cost of formal-sector healthcare to predict treatment choice, we show that accessing better healthcare decreases length of illness and changes children's allocation of time to school and work. Children attend school for more days per week-but not for more hours per day-as a result of accessing better healthcare. There are no significant effects on child labor, but the results suggest that time spent in physically strenuous activities such as farming and herding increases. PMID:24353348

  1. 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

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

    PubMed Central

    2012-01-01

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

  3. 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

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

    PubMed

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

    2015-12-01

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

  5. AIDS prevention for refugees. The case of Rwandans in Tanzania.

    PubMed

    Benjamin, J A

    1996-07-01

    Rwanda erupted in civil war in the spring of 1994, leading to the flight from the country of hundreds of thousands of refugees into neighboring Tanzania and Zaire. Within days, the population of the Benaco refugee camp grew to more than 250,000, making it the second largest city in Tanzania. HIV infection rates in some sectors of the Rwandan population had been among the highest observed in Africa. High levels of HIV infection thus remain among the refugees from Rwanda. Four months after the beginning of the exodus from Rwanda, the AIDS Control and Prevention (AIDSCAP) Project contracted with CARE International to manage a broad-based HIV prevention pilot project for Rwandan refugees at the Benaco refugee camp. Conditions in the camp and the project are described, followed by consideration of the prevailing culture and behavior change. The author believes that the pioneering work at Benaco and three other Ngara District camps offers valuable lessons on working with displaced populations under crisis conditions. PMID:12347593

  6. Navigating the AIDS industry: being poor and positive in Tanzania.

    PubMed

    Boesten, Jelke

    2011-01-01

    This article shows how poor people living with HIV/AIDS in Tanzania navigate a myriad of actors, agencies and organizations to obtain the aid they need to survive. It focuses on community-based organizations which establish networks of care through which people obtain care, treatment and financial support. A case study of a roadside town in Tanzania illustrates that these community-based networks of care — essential to the survival of many — are partly the product of the AIDS industry, which encourages the establishment of community-based organizations and voluntary service delivery rather than more formalized systems of care. Community-based organizations, however, are so poorly supported that they often deploy self-destructive strategies. The need to strategically navigate the AIDS industry creates tension and even conflict among HIV-positive activists, the people they represent and the wider community, which undermines rather than strengthens community-based interventions. Whilst the AIDS industry promises inclusion of HIV-positive people in the response to HIV/AIDS, it succeeds only partially, with the result that it may potentially do more harm than good. PMID:22069802

  7. Animal research ethics in Africa: is Tanzania making progress?

    PubMed

    Seth, Misago; Saguti, Fredy

    2013-12-01

    The significance of animals in research cannot be over-emphasized. The use of animals for research and training in research centres, hospitals and schools is progressively increasing. Advances in biotechnology to improve animal productivity require animal research. Drugs being developed and new interventions or therapies being invented for cure and palliation of all sorts of animal diseases and conditions need to be tested in animals for their safety and efficacy at some stages of their development. Drugs and interventions for human use pass through a similar development process and must be tested pre-clinically in laboratory animals before clinical trials in humans can be conducted. Therefore, animals are important players in research processes which directly and indirectly benefit animals and humans. However, questions remain as to whether these uses of animals consider the best interests of animals themselves. Various research and training institutions in Tanzania have established some guidelines on animal use, including establishing animal ethics committees. However, most institutions have not established oversight committees. In institutions where there may be guidelines and policies, there are no responsible committees or units to directly oversee if and how these guidelines and policies are enforced; thus, implementation becomes difficult or impossible. This paper endeavours to raise some issues associated with the responsible use of animals in research and training in Tanzania and highlights suggestions for improvement of deficiencies that exist in order to bridge the gap between what ought to be practised and what is practised. PMID:23006770

  8. Towards a food and nutrition policy in Tanzania.

    PubMed

    Jonsson, U

    1980-05-01

    Fragments of a nutrition policy are seen throughout the different phases of Tanzania's modern history. Efforts of the pre-Independence period culminated in formation of a committee on nutrition which advocated improving food storage, food legislation and standardization, and nutrition education. After independence, an initial period of concentration on cash crops was followed by increased cooperation with the Ministry of Agriculture, and some nutritional surveys were undertaken. After the Arusha Declaration in 1967 a basic needs strategy giving greater stress to food production and adequate nutrition received emphasis, and a Food and Nutrition Centre was established with 4 departments: food science and technology; manpower development; medical nutrition; and planning and coordination. Emphasis on production is reflected in a target of reducing malnutrition by 30 to 50% in every region by 1981, and an interdisciplinary approach is being used to achieve this goal. The basic similarity in proposed activities during the various phases of Tanzania's history indicates that political will is necessary for carrying out the policies. PMID:12336494

  9. “Bend a fish when the fish is not yet dry”: Adolescent Boys’ Perceptions of Sexual Risk in Tanzania

    PubMed Central

    Sommer, Marni; Likindikoki, Samuel; Kaaya, Sylvia

    2015-01-01

    Despite decades of effort, the spread of HIV/AIDS continues among many African young people. A key contributor is unsafe sexual behavior that is desired, persuaded or coerced. We explored the masculinity norms shaping pubescent boys’ perceptions of and engagement in (unsafe) sexual behaviors in Tanzania. Through a comparative case study in rural and urban Tanzania, qualitative and participatory methods were used with 160 adolescent boys in and out of school to better understand the social and contextual factors promoting unsafe sexual behaviors. Adolescent boys in both the rural and urban sites reported struggling with intense sexual desires, strong peer pressures to have sex, and social norms dissuading condom use. A growing “normalization” of AIDS suggests messages promoting the dangers of HIV infection may be less effective. Findings reinforce the need for interventions with very young adolescents. Research is needed to identify more effective approaches for promoting safer sexual practices among boys in sub-Saharan Africa. Harm reduction approaches and gender transformative approaches might prove more effective than current HIV prevention efforts focused on youth. PMID:25583374

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

    PubMed

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

    Minihane, M.; Lettenmaier, D. P.

    2012-12-01

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

  12. How long-distance truck drivers and villagers in rural southeastern Tanzania think about heterosexual anal sex: a qualitative study

    PubMed Central

    Mtenga, S; Shamba, D; Wamoyi, J; Kakoko, D; Haafkens, J; Mongi, A; Kapiga, S; Geubbels, E

    2015-01-01

    Objective To explore ideas of truck drivers and villagers from rural Tanzania about heterosexual anal sex (HAS) and the associated health risks. Methods Qualitative study using 8 in-depth interviews (IDIs) and 2 focus group discussions (FGDs) with truck drivers and 16 IDIs and 4 FGDs with villagers from the Morogoro region. Study participants included 24 women and 46 men. Data analysis was performed thematically employing standard qualitative techniques. Results Reasons why men would practice HAS included sexual pleasure, the belief that anal sex is safer than vaginal sex, alternative sexual practice, exploration and proof of masculinity. Reasons why women would practice HAS included financial need, retaining a partner, alternative for sex during menses, pregnancy prevention and beauty enhancement because HAS is believed to ‘fatten the female buttocks’. Most participants believed that condoms are not needed during HAS. This was linked to the ideas that infections only ‘reside in wet places’ (vagina) and that the anus is not ‘conducive’ for condom use; condoms reduce ‘dryness’ and ‘friction’ (pleasure) and may ‘get stuck inside’. Conclusions The study participants reported practices and ideas about HAS that put them at risk for HIV and sexually transmitted infections. Greater attention to education about HAS is urgently needed in Tanzania, where this sexual practice is still regarded as a taboo. This study offers useful information that could be included in sex education programmes. PMID:26113730

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

    PubMed Central

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

    2015-01-01

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

  14. 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

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

    PubMed Central

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

    2015-01-01

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

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

    NASA Astrophysics Data System (ADS)

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

    2014-05-01

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

  17. 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

  18. Termite fishing by wild chimpanzees: new data from Ugalla, western Tanzania.

    PubMed

    Stewart, Fiona A; Piel, Alex K

    2014-01-01

    Chimpanzees manufacture flexible fishing probes to fish for termites in Issa, Ugalla, western Tanzania. These termite-fishing tools are similar in size and material to those used by long-studied communities of chimpanzees in western Tanzania (Pan troglodytes schweinfurthii) and in West Africa (P. t. verus), but not central African populations (P. t. troglodytes). This report adds to the patchwork of evidence of termite-fishing tool use behaviour by chimpanzees across Africa. PMID:23720026

  19. Factors associated with inappropriate complementary feeding practices among children aged 6-23 months in Tanzania.

    PubMed

    Victor, Rose; Baines, Surinder K; Agho, Kingsley E; Dibley, Michael J

    2014-10-01

    Inappropriate complementary feeding is one of the major causes of undernutrition among young children in Tanzania. Prevalence of newly developed World Health Organization complementary feeding indicators and their associated factors were determined among 2402 children aged 6-23 months in Tanzania using data from the 2010 Tanzania Demographic and Health Survey. The survey used a multistage cluster sample of 10 300 households from the eight geographical zones in the country. The prevalence of the introduction of soft, semi-solid or solid foods among infants aged 6-8 months was 92.3%. Of all the children aged 6-23 months, the prevalence of minimum dietary diversity, meal frequency and acceptable diet were 38.2%, 38.6% and 15.9%, respectively. Results from multivariate analyses indicated that the main risk factors for inappropriate complementary feeding practices in Tanzania include young child's age (6-11 months), lower level of paternal/maternal education, limited access to mass media, lack of post-natal check-ups, and poor economic status. Overall, complementary feeding practices in Tanzania, as measured by dietary diversity, meal frequency and acceptable diet, are not adequately met, and there is a need for interventions to improve the nutritional status of young children in Tanzania. PMID:22925557

  20. Carotenoids retention and in vitro iron bioavailability of traditional cowpea leaf dishes of rural Tanzania.

    PubMed

    Mduma, I; Msuya, J; Mwanri, A W; Yang, R Y

    2012-05-01

    Food preparation methods play a role in micronutrient retention and ultimately intake. Analyses for carotenoids retention and in vitro iron bioavailability of five cowpea leaf dishes prepared according to the traditional methods of rural Tanzania were carried out. All the five dishes are commonly eaten as relishes for staple meals of maize or rice. Laboratory analyses were carried out at the Nutrition Laboratory of the World Vegetable Centre in Taiwan. Carotenoids were analysed by high-performance liquid chromatography while iron bioavailability was analysed by an in vitro method. Results showed that traditional cowpea leaf dish consisting of sunflower oil, onion, tomatoes and coconut milk cooked for 30 min had the highest retention of β-carotene (40.83 ± 7.00%) and lutein (34.60 ± 3.30%) compared to other traditional recipes (p < 0.05). The highest iron bioavailability (10.04 ± 0.49%) was observed in the traditional recipe which involved boiling fresh cowpea leaves for 15 min. Although recipe variation can affect carotenoids retention and iron bioavailability, simple practices such as reduced cooking time and avoiding direct sun drying also need to be promoted. PMID:21942714

  1. Energy-balance model validation on the top of Kilimanjaro, Tanzania, using eddy covariance data

    NASA Astrophysics Data System (ADS)

    Cullen, Nicolas J.; Mölg, Thomas; Kaser, Georg; Steffen, Konrad; Hardy, Douglas R.

    2007-10-01

    Eddy covariance data collected over a horizontal surface on the largest ice body on Kilimanjaro, Tanzania, over 26-29 July 2005 were used to assess the uncertainty of calculating sublimation with a surface energy balance (SEB) model. Data required for input to the SEB model were obtained from an existing automatic weather station. Surface temperatures that were solved iteratively by the SEB model were used to compute emitted longwave radiation, turbulent heat fluxes using the aerodynamic bulk method and the subsurface heat flux. Roughness lengths for momentum and temperature, which were found to be the most important input parameters controlling the magnitude of modelled (bulk method) turbulent heat fluxes, were obtained using eddy covariance data. The roughness length for momentum was estimated to be 1.7 × 10-3 m, while the length for temperature was one order of magnitude smaller. Modelled sensible and latent heat fluxes (bulk method) compared well to eddy covariance data, with root-mean-square differences between 3.1 and 4.8 W m-2 for both turbulent heat fluxes. Modelled sublimation accounted for about 90% of observed ablation, confirming that mass loss by melting is much less important than sublimation on the horizontal surfaces of the remaining plateau glaciers on Kilimanjaro.

  2. Predominance of Klebsiella pneumoniae ST14 carrying CTX-M-15 causing neonatal sepsis in Tanzania

    PubMed Central

    2013-01-01

    Background Klebsiella pneumoniae strains expressing ESBLs are a predominant cause of hospital acquired infections. Here we describe the molecular epidemiology of these isolates in a tertiary hospital in Tanzania, as potential pathogens for neonatal infections. Methods Between April 2009 and March 2010 all Klebsiella pneumoniae isolates with phenotypic expression Extended Spectrum Beta Lactamase (ESBL) were collected and characterized. Identification was done using in house biochemical tests in case of ambiguous results confirmation was done using API 20E. Susceptibility testing was determined using the disc diffusion method followed by specific PCR and sequencing to determine ESBL genes. Phylogenetic analysis, Pulse field gel electrophoresis (PFGE) and Multi-Locus sequence typing (MLST) to PFGE clusters representative isolates were performed to determine clones of the isolates. Conjugation and hybridization were performed to determine the location of blaCTX-M-15 gene. Results A total of 92 non- repetitive ESBL producing K. pneumoniae representing 50.3% of Klebsiella pneumoniae isolates were characterized. These isolates were from blood 61 (66%), wound swab 13 (14%), urine 12 (13%) and pus 6 (7%) were analyzed. Most blood culture strains originated from neonatal unit 39/61(64%) and 22 (36%) of the blood culture isolates were from neonatal ICU. All isolates were resistant to gentamicin and 54% were resistant to ciprofloxacin. Using a similarity index of 80%, the isolates were assigned to thirteen clusters based on PFGE patterns and contained sub-clusters with identical strains indicating clonal outbreaks. Cluster X5, X7 and X8, and X9 were grouped into ST48, ST14 and ST348 respectively. Based on gyrA PCR- RFLP phylogenetic analysis all isolates were grouped as KpI. The predominant ESBL allele detected was blaCTX-M-15 which was found in 76% of isolates, followed by blaTEM-104 (19%), blaSHV-11 (3.2%) and blaTEM-176 (2%). The blaCTX-M-15 gene was located in multiple conjugative IncF plasmids ranging from 25 kb-485 kb in size. Conclusion The high prevalence of blaCTX-M-15 observed among ESBL producing K. pneumoniae in Tanzania, is possibly due to the spread of a common IncFII 145 kb plasmid and of certain clones such as ST14 and ST48. Furthermore the 485 kb plasmid detected is the largest plasmid reported to carry blaCTX-M-15 todate. PMID:24099282

  3. Prevalence and Antimicrobial Resistance of Campylobacter Isolated from Dressed Beef Carcasses and Raw Milk in Tanzania.

    PubMed

    Kashoma, Isaac P; Kassem, Issmat I; John, Julius; Kessy, Beda M; Gebreyes, Wondwossen; Kazwala, Rudovick R; Rajashekara, Gireesh

    2016-01-01

    Campylobacter species are commonly transmitted to humans through consumption of contaminated foods such as milk and meat. The aim of this study was to investigate the prevalence, antimicrobial resistance, and genetic determinants of resistance of Campylobacter isolated from raw milk and beef carcasses in Tanzania. The antimicrobial resistance genes tested included blaOXA-61 (ampicillin), aph-3-1 (aminoglycoside), tet(O) (tetracycline), and cmeB (multi-drug efflux pump). The prevalence of Campylobacter was 9.5% in beef carcasses and 13.4% in raw milk, respectively. Using multiplex-polymerase chain reaction (PCR), we identified 58.1% of the isolates as Campylobacter jejuni, 30.7% as Campylobacter coli, and 9.7% as other Campylobacter spp. One isolate (1.6%) was positive for both C. jejuni and C. coli specific PCR. Antimicrobial susceptibility testing using the disk diffusion assay and the broth microdilution method showed resistance to: ampicillin (63% and 94.1%), ciprofloxacin (9.3% and 11.8%), erythromycin (53.7% and 70.6%), gentamicin (0% and 15.7%), streptomycin (35.2% and 84.3%), and tetracycline (18.5% and 17.7%), respectively. Resistance to azithromycin (42.6%), nalidixic acid (64.8%), and chloramphenicol (13%) was determined using the disk diffusion assay only, while resistance to tylosin (90.2%) was quantified using the broth microdilution method. The blaOXA-61 (52.6% and 28.1%), cmeB (26.3% and 31.3%), tet(O) (26.3% and 31.3%), and aph-3-1 (5.3% and 3.0%) were detected in C. coli and C. jejuni. These findings highlight the extent of antimicrobial resistance in Campylobacter occurring in important foods in Tanzania. The potential risks to consumers emphasize the need for adequate control approaches, including the prudent use of antimicrobials to minimize the spread of antimicrobial-resistant Campylobacter. PMID:26153978

  4. The evolutionary ecology of early weaning in Kilimanjaro, Tanzania.

    PubMed

    Wander, Katherine; Mattison, Siobhán M

    2013-10-01

    Public health recommendations promote prolonged breastfeeding of all children; however, parental investment (PI) theory predicts that breastfeeding will be allocated among a mothers' offspring to maximize her reproductive success. We evaluated PI in terms of risk for weaning before age two among 283 children in Kilimanjaro, Tanzania. Results demonstrate: (i) a Trivers-Willard effect--high socioeconomic status (SES) females and low SES males were more likely to be weaned early; (ii) later-born children were less likely to be weaned early; (iii) higher birthweight children were less likely to be weaned early, and (iv) no effect of cattle (a source of supplementary milk) ownership. These associations were largely independent and remained significant in models controlling for potential confounders; however, the inverse association between early weaning and birth order lost significance in the model containing birthweight. These patterns were observed despite public health recommendations encouraging breastfeeding for at least two years. PMID:23926151

  5. Hydrograph separation using hydrochemical tracers in the Makanya catchment, Tanzania

    NASA Astrophysics Data System (ADS)

    Mul, Marloes L.; Mutiibwa, Robert K.; Uhlenbrook, Stefan; Savenije, Hubert H. G.

    Hydrochemical tracers were used to separate and quantify different runoff components in the semi-arid Makanya catchment in the South Pare Mountains of Tanzania. One flood event was investigated during the rainy season of October-December 2005 and analysed for electrical conductivity, dissolved silica and major anions and cations. The event on 9 November 2005 showed two peaks, each originating from one of two sub-catchments, upper-Vudee and Ndolwa, each with a distinct water quality signature. Hydrograph separation indicated that the two peaks in the hydrograph originated from a delay in response between the two catchments. The hydrograph separation indicated that, for this event, over 95% of the discharge could be attributed to sub-surface runoff, while the remainder was due to faster surface runoff processes. The dominance of sub-surface processes was also indicated by the lack of suspended sediments in the samples, which is a clear indication that no surface runoff took place.

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

    NASA Astrophysics Data System (ADS)

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

    2012-04-01

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

  7. 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

  8. 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

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

    PubMed Central

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

    2014-01-01

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

  10. 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

  11. Malaria treatment in the retail sector: Knowledge and practices of drug sellers in rural Tanzania

    PubMed Central

    Hetzel, Manuel W; Dillip, Angel; Lengeler, Christian; Obrist, Brigit; Msechu, June J; Makemba, Ahmed M; Mshana, Christopher; Schulze, Alexander; Mshinda, Hassan

    2008-01-01

    Background Throughout Africa, the private retail sector has been recognised as an important source of antimalarial treatment, complementing formal health services. However, the quality of advice and treatment at private outlets is a widespread concern, especially with the introduction of artemisinin-based combination therapies (ACTs). As a result, ACTs are often deployed exclusively through public health facilities, potentially leading to poorer access among parts of the population. This research aimed at assessing the performance of the retail sector in rural Tanzania. Such information is urgently required to improve and broaden delivery channels for life-saving drugs. Methods During a comprehensive shop census in the districts of Kilombero and Ulanga, Tanzania, we interviewed 489 shopkeepers about their knowledge of malaria and malaria treatment. A complementary mystery shoppers study was conducted in 118 retail outlets in order to assess the vendors' drug selling practices. Both studies included drug stores as well as general shops. Results Shopkeepers in drug stores were able to name more malaria symptoms and were more knowledgeable about malaria treatment than their peers in general shops. In drug stores, 52% mentioned the correct child-dosage of sulphadoxine-pyrimethamine (SP) compared to only 3% in general shops. In drug stores, mystery shoppers were more likely to receive an appropriate treatment (OR = 9.6), but at an approximately seven times higher price. Overall, adults were more often sold an antimalarial than children (OR = 11.3). On the other hand, general shopkeepers were often ready to refer especially children to a higher level if they felt unable to manage the case. Conclusion The quality of malaria case-management in the retail sector is not satisfactory. Drug stores should be supported and empowered to provide correct malaria-treatment with drugs they are allowed to dispense. At the same time, the role of general shops as first contact points for malaria patients needs to be re-considered. Interventions to improve availability of ACTs in the retail sector are urgently required within the given legal framework. PMID:18471299

  12. 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

  13. 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

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

    PubMed Central

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

    2015-01-01

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

  15. HIV serostatus disclosure among people living with HIV/AIDS in Mwanza, Tanzania

    PubMed Central

    2014-01-01

    Background Disclosing HIV serostatus is important for HIV prevention and maintenance of health for people living with HIV their spouses and the community, it plays a role in the social relation which is critical in reducing HIV transmission. The process may have positive and negative effects to the HIV infected people who disclose their status. The present study was undertaken to describe HIV serostatus disclosure among HIV infected people attending care and treatment clinic at Sekou-Toure hospital in Mwanza, Tanzania. Methods A cross-sectional study was carried out on 270 HIV infected adults attending Care and Treatment Clinic (CTC) at Sekou-Toure hospital between September and October, 2010. A Swahili questionnaire was used to obtain demographic and HIV disclosure information. Results Hundred and ninety five (72.5%) of all recruited participants were females, 88.1% (238/270) were aged above 30 years and 44.1% (119/270) were married. The prevalence of serostatus disclosure was 93.3% (252/270) with participants aged above 30 years having significantly higher proportion of serostatus disclosure compared to those aged below 30 years (94.5% vs. 84.4%, p < 0.05). Among the participants who disclosed their status, 69.3% reported closeness to the disclosed person as the reason for disclosure while 25.8% (65/252) disclosed because they needed help. Two hundred (79.4%) reported to have received emotional support following disclosure while 25.8% and 29.7% received financial support and freedom to use their anti-retroviral drugs around the person they disclosed their status respectively. Thirty four participants reported to have been discriminated following disclosure and 12 participants reported to have been divorced. Conclusions Rate of disclosure of HIV serostatus was noted to be high in this study. Delayed disclosure was also noted in small proportion of participants. Negative outcomes following disclosure of serostatus were reported by participants. Efforts need to be increased to promote disclosure of HIV serostatus in Tanzania through health education and awareness for both HIV infected individuals and the community. PMID:24450933

  16. Pattern of childhood burn injuries and their management outcome at Bugando Medical Centre in Northwestern Tanzania

    PubMed Central

    2011-01-01

    Background Burn injuries constitute a major public health problem and are the leading cause of childhood morbidity and mortality worldwide. There is paucity of published data on childhood burn injuries in Tanzania, particularly the study area. This study was conducted to describe the pattern of childhood burn injuries in our local setting and to evaluate their management outcome. Methods A cross sectional study was conducted at Bugando Medical Centre (in Northwestern Tanzania) over a 3-year period from January 2008 to December 2010. Data was collected using a pre-tested coded questionnaire and statistical analyses performed using SPSS software version 15.0. Results A total of 342 burned children were studied. Males were mainly affected. Children aged = 2 were the majority accounting for 45.9% of cases. Intentional burn injuries due to child abuse were reported in 2.9% of cases. Scald was the most common type of burns (56.1%). The trunk was the most commonly involved body region (57.3%). Majority of patients (48.0%) sustained superficial burns. Eight (2.3%) patients were HIV positive. Most patients (89.8%) presented to the hospital later than 24 h. The rate of burn wound infection on admission and on 10th day were 32.4% and 39.8% respectively.Staphylococcus aureus were more common on admission wound swabs, with Pseudomonas aeruginosa becoming more evident after 10th day. MRSA was detected in 19.2% of Staphylococcus aureus. Conservative treatment was performed in 87.1% of cases. Surgical treatment mainly skin grafting (65.9%) was performed in 44 (12.9%) of patients. The overall average of the length of hospital stay (LOS) was 22.12 ± 16.62 days. Mortality rate was 11.7%. Using multivariate logistic regression analysis; age of the patient, type of burn, delayed presentation, clothing ignition, %TBSA and severity of burn were found to be significantly associated with LOS (P < 0.001), whereas mortality rate was found to be independently and significantly related to the age of the patient, type of burn, HIV positive with stigmata of AIDS, CD4 count, inhalation injury, %TBSA and severity of burn (P < 0.001). Conclusion Childhood burn injuries still remain a menace in our environment with virtually unacceptable high morbidity and mortality. There is need for critical appraisal of the preventive measures and management principles currently being practiced. PMID:22070934

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

    PubMed Central

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

    2015-01-01

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

  18. 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…

  19. "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

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

    ERIC Educational Resources Information Center

    Nyambo, Brigitte; Ligate, Elly

    2013-01-01

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

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

    ERIC Educational Resources Information Center

    Nyambo, Brigitte; Ligate, Elly

    2013-01-01

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

  2. 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

  3. 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

  4. 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

  5. '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

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

    PubMed

    Gottesfeld, Perry; Andrew, Damian; Dalhoff, Jeffrey

    2015-01-01

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

  7. Household willingness to pay for azithromycin treatment for trachoma control in the United Republic of Tanzania.

    PubMed Central

    Frick, Kevin D.; Lynch, Matthew; West, Sheila; Munoz, Beatriz; Mkocha, Harran A.

    2003-01-01

    OBJECTIVE: Household willingness to pay for treatment provides important information for programme planning. We tested for relationships between socioeconomic status, risk of trachoma, perceptions of the effects of azithromycin, and the household willingness to pay for future mass treatment with azithromycin. METHODS: We surveyed 394 households in 6 villages located in central United Republic of Tanzania regarding their willingness to pay for future azithromycin treatment. A random sample of households with children under 8 years of age was selected and interviewed following an initial treatment programme in each village. Data were gathered on risk factors for trachoma, socioeconomic status, and the perceived effect of the initial azithromycin treatment. Ordered probit regression analysis was used to test for statistically significant relationships. FINDINGS: 38% of responding households stated that they would not be willing to pay anything for future azithromycin treatment, although they would be willing to participate in the treatment. A proxy for cash availability was positively associated with household willingness to pay for future antibiotic treatment. Cattle ownership (a risk factor) and being a household headed by a female not in a polygamous marriage (lower socioeconomic status) were associated with a lower willingness to pay for future treatment. A perceived benefit from the initial treatment was marginally associated with a willingness to pay a higher amount. CONCLUSIONS: As those at greatest risk of active trachoma indicated the lowest willingness to pay, imposing a cost recovery fee for azithromycin treatment would likely reduce coverage and could prevent control of the disease at the community level. PMID:12751418

  8. 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/HbSβ0) 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

  9. 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

  10. Psychological Symptoms Among Obstetric Fistula Patients Compared to Gynecology Outpatients in Tanzania

    PubMed Central

    Wilson, Sarah M.; Sikkema, Kathleen J.; Watt, Melissa H.; Masenga, Gileard G.

    2016-01-01

    Background Obstetric fistula is a childbirth injury prevalent in sub-Saharan Africa that causes uncontrollable leaking of urine and/or feces. Research has documented the social and psychological sequelae of obstetric fistula, including mental health dysfunction and social isolation. Purpose This cross-sectional study sought to quantify the psychological symptoms and social support in obstetric fistula patients, compared with a patient population of women without obstetric fistula. Methods Participants were gynecology patients (N = 144) at the Kilimanjaro Christian Medical Center in Moshi, Tanzania, recruited from the Fistula Ward (n = 54) as well as gynecology outpatient clinics (n = 90). Measures included previously validated psychometric questionnaires, administered orally by Tanzanian nurses. Outcome variables were compared between obstetric fistula patients and gynecology outpatients, controlling for background demographic variables and multiple comparisons. Results Compared to gynecology outpatients, obstetric fistula patients reported significantly higher symptoms of depression, posttraumatic stress disorder, somatic complaints, and maladaptive coping. They also reported significantly lower social support. Conclusions Obstetric fistula patients present for repair surgery with more severe psychological distress than gynecology outpatients. In order to address these mental health concerns, clinicians should engage obstetric fistula patients with targeted mental health interventions. PMID:25670025

  11. Factors Associated with Repeat Blood Donation at the Northern Zone Blood Transfusion Centre in Tanzania

    PubMed Central

    Mauka, Wilhellmuss I.; Mahande, Michael J.; Msuya, Sia E.; Philemon, Rune N.

    2015-01-01

    Background and Objective. The aim of this study was to determine factors associated with repeat blood donation. Methods. This was a cross-sectional study carried out among blood donors aged 18–65 years in northern Tanzania. The questionnaire was administered among 454 participants through the phone. Results. Of the 454 participants, the proportion of repeat donation was 63.9%. In the backward logistic regression analysis, the significant predictors were living in Arusha which had lower odds of repeat donation compared to those living in Kilimanjaro. Knowledge of time interval between donations increased odds of repeating donations. High intention increased odds of repeat donation compared to low intention. Altruistic score had minor effect on increasing odds of repeating donation. Conclusion. Repeat blood donation is affected by proximity of donating site, awareness of the blood donation interval, intention to donate, and experience on previous donation. We recommend continuous education concerning blood donors and donation among health workers and society as a whole; this will create awareness on motivational factors for repeat donations. PMID:26783496

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

    PubMed Central

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

    2015-01-01

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

  13. CONCENTRATION AND DRUG PRICES IN THE RETAIL MARKET FOR MALARIA TREATMENT IN RURAL TANZANIA

    PubMed Central

    GOODMAN, CATHERINE; KACHUR, S. PATRICK; ABDULLA, SALIM; BLOLAND, PETER; MILLS, ANNE

    2009-01-01

    SUMMARY The impact of market concentration has been little studied in markets for ambulatory care in the developing world, where the retail sector often accounts for a high proportion of treatments. This study begins to address this gap through an analysis of the consumer market for malaria treatment in rural areas of three districts in Tanzania. We developed methods for investigating market definition, sales volumes and concentration, and used these to explore the relationship between antimalarial retail prices and competition. The market was strongly geographically segmented and highly concentrated in terms of antimalarial sales. Antimalarial prices were positively associated with market concentration. High antimalarial prices were likely to be an important factor in the low proportion of care seekers obtaining appropriate treatment. Retail sector distribution of subsidised antimalarials has been proposed to increase the coverage of effective treatment, but this analysis indicates that local market power may prevent such subsidies from being passed on to rural customers. Policymakers should consider the potential to maintain lower retail prices by decreasing concentration among antimalarial providers and recommending retail price levels. PMID:19301420

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

    NASA Astrophysics Data System (ADS)

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

    2013-12-01

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

  15. 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

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

    PubMed

    Tibandebage, Paula; Mackintosh, Maureen

    2005-10-01

    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, health care relationships are generally also market transactions requiring out-of-pocket payment. This paper analyses the active constitution and destruction of trust within Tanzanian health care transactions, demonstrating systematic patterns both of exclusion and abuse and also of inclusion and merited trust. We triangulate evidence on charges paid and payment methods with perceptions of the trustworthiness of providers and with the socio-economic status of patients and household interviewees, distinguishing calculative, value based and personalised forms of trust. We draw on this interpretative analysis to argue that policy can support the construction of decent inclusive health care by constraining perverse market incentives that users understand to be a source of merited distrust; by assisting reputation-building and enlarging professional, managerial and public scrutiny; and by reinforcing value-based sources of trust. PMID:16005774

  17. 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

  18. Improvements in access to malaria treatment in Tanzania following community, retail sector and health facility interventions -- a user perspective

    PubMed Central

    2010-01-01

    Background The ACCESS programme aims at understanding and improving access to prompt and effective malaria treatment. Between 2004 and 2008 the programme implemented a social marketing campaign for improved treatment-seeking. 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 in 2006. Tanzania changed its first-line treatment for malaria from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (ALu) in 2007 and subsidized ALu was made available in both health facilities and ADDOs. The effect of these interventions on understanding and treatment of malaria was studied in rural Tanzania. The data also enabled an investigation of the determinants of access to treatment. Methods Three treatment-seeking surveys were conducted in 2004, 2006 and 2008 in the rural areas of the Ifakara demographic surveillance system (DSS) and in Ifakara town. Each survey included approximately 150 people who had suffered a fever case in the previous 14 days. Results Treatment-seeking and awareness of malaria was already high at baseline, but various improvements were seen between 2004 and 2008, namely: better understanding causes of malaria (from 62% to 84%); an increase in health facility attendance as first treatment option for patients older than five years (27% to 52%); higher treatment coverage with anti-malarials (86% to 96%) and more timely use of anti-malarials (80% to 93-97% treatments taken within 24 hrs). Unfortunately, the change of treatment policy led to a low availability of ALu in the private sector and, therefore, to a drop in the proportion of patients taking a recommended malaria treatment (85% to 53%). The availability of outlets (health facilities or drug shops) is the most important determinant of whether patients receive prompt and effective treatment, whereas affordability and accessibility contribute to a lesser extent. Conclusions An integrated approach aimed at improving understanding and treatment of malaria has led to tangible improvements in terms of people's actions for the treatment of malaria. However, progress was hindered by the low availability of the first-line treatment after the switch to ACT. PMID:20550653

  19. 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

  20. 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

  1. The "politics of the queue": the politicization of people living with HIV/AIDS in Tanzania.

    PubMed

    Beckmann, Nadine; Bujra, Janet

    2010-01-01

    Starting from a body of literature on movements around "biological citizenship," this article analyses the political significance of HIV-positive people's collective action in Tanzania. We explore reasons for the limited impact of Tanzanian AIDS activism on the wider political scene, concluding that the formation of a "movement" is still in its infancy and faces many constraints, though some breakthroughs have been made. Participation in PLHA groups in Tanzania encourages politicizing struggles over representation, democratic forms and gender that can lead to a process of political socialization in which members learn to recognize and confront abuses of power. It is in such low-level, less visible social transformations that the greatest potential of participation in collective action around HIV/AIDS in Tanzania lies. PMID:21125767

  2. 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

  3. Women's experiences and views about costs of seeking malaria chemoprevention and other antenatal services: a qualitative study from two districts in rural Tanzania

    PubMed Central

    2010-01-01

    Background The Tanzanian government recommends women who attend antenatal care (ANC) clinics to accept receiving intermittent preventive treatment against malaria during pregnancy (IPTp) and vouchers for insecticide-treated nets (ITNs) at subsidized prices. Little emphasis has been paid to investigate the ability of pregnant women to access and effectively utilize these services. Objectives To describe the experience and perceptions of pregnant women about costs and cost barriers for accessing ANC services with emphasis on IPTp in rural Tanzania. Methods Qualitative data were collected in the districts of Mufindi in Iringa Region and Mkuranga in Coast Region through 1) focus group discussions (FGDs) with pregnant women and mothers to infants and 2) exit-interviews with pregnant women identified at ANC clinics. Data were analyzed manually using qualitative content analysis methodology. Findings FGD participants and interview respondents identified the following key limiting factors for women's use of ANC services: 1) costs in terms of money and time associated with accessing ANC clinics, 2) the presence of more or less official user-fees for some services within the ANC package, and 3) service providers' application of fines, penalties and blame when failing to adhere to service schedules. Interestingly, the time associated with travelling long distances to ANC clinics and ITN retailers and with waiting for services at clinic-level was a major factor of discouragement in the health seeking behaviour of pregnant women because it seriously affected their domestic responsibilities. Conclusion A variety of resource-related factors were shown to affect the health seeking behaviour of pregnant women in rural Tanzania. Thus, accessibility to ANC services was hampered by direct and indirect costs, travel distances and waiting time. Strengthening of user-fee exemption practices and bringing services closer to the users, for example by promoting community-directed control of selected public health services, including IPTp, are urgently needed measures for increasing equity in health services in Tanzania. PMID:20163707

  4. HIV-1 drug resistance in recently HIV-infected pregnant mother’s naïve to antiretroviral therapy in Dodoma urban, Tanzania

    PubMed Central

    2013-01-01

    Background HIV resistance affects virological response to therapy and efficacy of prophylaxis in mother-to-child-transmission. The study aims to assess the prevalence of HIV primary resistance in pregnant women naïve to antiretrovirals. Methods Cross sectional baseline analysis of a cohort of HIV + pregnant women (HPW) enrolled in the study entitled Antiretroviral Management of Antenatal and Natal HIV Infection (AMANI, peace in Kiswahili language). The AMANI study began in May 2010 in Dodoma, Tanzania. In this observational cohort, antiretroviral treatment was provided to all women from the 28th week of gestation until the end of the breastfeeding period. Baseline CD4 cell count, viral load and HIV drug-resistance genotype were collected. Results Drug-resistance analysis was performed on 97 naïve infected-mothers. The prevalence of all primary drug resistance and primary non-nucleoside reverse-transcriptase inhibitors resistance was 11.9% and 7.5%, respectively. K103S was found in two women with no M184V detection. HIV-1 subtype A was the most commonly identified, with a high prevalence of subtype A1, followed by C, D, C/D recombinant, A/C recombinant and A/D recombinant. HIV drug- resistance mutations were detected in A1 and C subtypes. Conclusion Our study reports an 11.9% prevalence rate of primary drug resistance in naïve HIV-infected pregnant women from a remote area of Tanzania. Considering that the non-nucleoside reverse-transcriptase inhibitors are part of the first-line antiretroviral regimen in Tanzania and all of Africa, resistance surveys should be prioritized in settings where antiretroviral therapy programs are scaled up. PMID:24053581

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

    PubMed Central

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

    2015-01-01

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

  6. 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

  7. 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

  8. Prospective study on severe malaria among in-patients at Bombo regional hospital, Tanga, north-eastern Tanzania

    PubMed Central

    2011-01-01

    Background In Tanzania, malaria is the major cause of morbidity and mortality, accounting for about 30% of all hospital admissions and around 15% of all hospital deaths. Severe anaemia and cerebral malaria are the two main causes of death due to malaria in Tanga, Tanzania. Methods This was a prospective observational hospital-based study conducted from October 2004 to September 2005. Consent was sought from study participants or guardians in the wards. Finger prick blood was collected from each individual for thick and thin smears, blood sugar levels and haemoglobin estimations by Haemocue machine after admission. Results A total of 494 patients were clinically diagnosed and admitted as cases of severe malaria. Majority of them (55.3%) were children below the age of 5 years. Only 285 out of the total 494 (57.7%) patients had positive blood smears for malaria parasites. Adults aged 20 years and above had the highest rate of cases with fever and blood smear negative for malaria parasites. Commonest clinical manifestations of severe malaria were cerebral malaria (47.3%) and severe anaemia (14.6%), particularly in the under-fives. Case fatality was 3.2% and majority of the deaths occurred in the under-fives and adults aged 20 years and above with negative blood smears. Conclusion Proper laboratory diagnosis is crucial for case management and reliable data collection. The non-specific nature of malaria symptomatologies limits the use of clinical diagnosis and the IMCI strategy. Strengthening of laboratory investigations to guide case management is recommended. PMID:21958391

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

    PubMed Central

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  11. 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

  12. Deciphering the Complex Distribution of Human Immunodeficiency Virus Type 1 Subtypes among Different Cohorts in Northern Tanzania

    PubMed Central

    Njai, Harr F.; Ewings, Fiona M.; Lyimo, Eric; Foulongne, Vincent; Ngerageza, Dhamira; Mongi, Aika; Ssemwanga, Deogratius; Andreasen, Aura; Nyombi, Balthazar; Ao, Tony; Michael, Denna; Urassa, Mark; Todd, Jim; Zaba, Basia; Changalucha, John; Hayes, Richard; Kapiga, Saidi H.

    2013-01-01

    Background Increased understanding of the genetic diversity of HIV-1 is challenging but important in the development of an effective vaccine. We aimed to describe the distribution of HIV-1 subtypes in northern Tanzania among women enrolled in studies preparing for HIV-1 prevention trials (hospitality facility-worker cohorts), and among men and women in an open cohort demographic surveillance system (Kisesa cohort). Methods The polymerase encompassing partial reverse transcriptase was sequenced and phylogenetic analysis performed and subtype determined. Questionnaires documented demographic data. We examined factors associated with subtype using multinomial logistic regression, adjusted for study, age, and sex. Results Among 140 individuals (125 women and 15 men), subtype A1 predominated (54, 39%), followed by C (46, 33%), D (25, 18%) and unique recombinant forms (URFs) (15, 11%). There was weak evidence to suggest different subtype frequencies by study (for example, 18% URFs in the Kisesa cohort versus 5–9% in the hospitality facility-worker cohorts; adjusted relative-risk ratio (aRR) = 2.35 [95% CI 0.59,9.32]; global p = 0.09). Compared to men, women were less likely to have subtype D versus A (aRR = 0.12 [95% CI 0.02,0.76]; global p = 0.05). There was a trend to suggest lower relative risk of subtype D compared to A with older age (aRR = 0.44 [95% CI 0.23,0.85] per 10 years; global p = 0.05). Conclusions We observed multiple subtypes, confirming the complex genetic diversity of HIV-1 strains circulating in northern Tanzania, and found some differences between cohorts and by age and sex. This has important implications for vaccine design and development, providing opportunity to determine vaccine efficacy in diverse HIV-1 strains. PMID:24349139

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

    PubMed Central

    2014-01-01

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

  14. 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

  15. Lithostratigraphy, biostratigraphy and chemostratigraphy of Upper Cretaceous and Paleogene sediments from southern Tanzania: Tanzania Drilling Project Sites 27-35

    NASA Astrophysics Data System (ADS)

    Jimènez Berrocoso, Àlvaro; Huber, Brian T.; MacLeod, Kenneth G.; Petrizzo, Maria Rose; Lees, Jacqueline A.; Wendler, Ines; Coxall, Helen; Mweneinda, Amina K.; Falzoni, Francesca; Birch, Heather; Singano, Joyce M.; Haynes, Shannon; Cotton, Laura; Wendler, Jens; Bown, Paul R.; Robinson, Stuart A.; Gould, Jeremy

    2012-07-01

    The 2008 Tanzania Drilling Project (TDP) expedition recovered common planktonic foraminifera (PF), calcareous nannofossils (CN) and calcareous dinoflagellates with extraordinary shell preservation at multiple Cenomanian-Campanian sites that will be used for paleoclimatic, paleoceanographic, and biostratigraphic studies. New cores confirm the existence of a more expanded and continuous Upper Cretaceous sequence than had previously been documented in the Lindi and Kilwa regions of southeastern coastal Tanzania. This TDP expedition cored 684.02 m at eight Upper Cretaceous sites (TDP Sites 28-35) and a thin Paleocene section (TDP Site 27). TDP Sites 29, 30, 31 and 34 together span the lowermost Turonian to Coniacian (PF Whiteinella archaeocretacea to Dicarinella concavata Zones and CN Zones UC6a-9b), with TDP Site 31 being the most biostratigraphically complete Turonian section found during TDP drilling. A discontinuous section from the Santonian-upper Campanian (PF D. asymetrica to Radotruncana calcarata Zones and CN Zones UC12-16) was collectively recovered at TDP Sites 28, 32 and 35, while thin sequences of the lower Cenomanian (PF Thalmanninella globotruncanoides Zone and CN subzones UC3a-b) and middle Paleocene (Selandian; PF Zone P3a and CN Zone NP5) were cored in TDP Sites 33 and 27, respectively. Records of δ13Corg and δ13Ccarb from bulk sediments generated for all the Cretaceous sites show largely stable values through the sections. Only a few parallel δ13Corg and δ13Ccarb shifts have been found and they are interpreted to reflect local processes. The δ18Ocarb record, however, is consistent with Late Cretaceous cooling trends from the Turonian into the Campanian. Lithologies of these sites include thick intervals of claystones and siltstones with locally abundant, finely-laminated fabrics, irregular occurrences of thin sandstone layers, and sporadic bioclastic debris (e.g., inoceramids, ammonites). Minor lithologies represent much thinner units of up to medium-grained, massive sandstones. The %CaCO3 (∼5-40%) and %Corg (∼0.1-2%) are variable, with the highest %CaCO3 in the lower Campanian and the highest %Corg in the Turonian. Lithofacies analysis suggests that deposition of these sediments occurred in outer shelf-upper slope, a setting that agrees well with inferences from benthic foraminifera and calcareous dinoflagellates.

  16. Parasitology of five primates in Mahale Mountains National Park, Tanzania.

    PubMed

    Kooriyama, Takanori; Hasegawa, Hideo; Shimozuru, Michito; Tsubota, Toshio; Nishida, Toshisada; Iwaki, Takashi

    2012-10-01

    Parasitological surveillance in primates has been performed using coprological observation and identification of specimens from chimpanzees (Pan troglodytes schweinfurthii) in Mahale Mountains National Park, Tanzania (Mahale). In this study, we conducted coprological surveillance to identify the fauna of parasite infection in five primate species in Mahale: red colobus (Procolobus badius tephrosceles), red-tailed monkeys (Cercopithecus ascanius schmidti), vervet monkeys (Cercopithecus aethiops pygerythrus), yellow baboons (Papio cynocephalus), and chimpanzees. Fecal samples were examined microscopically, and parasite identification was based on the morphology of cysts, eggs, larvae, and adult worms. Three nematodes (Oesophagostomum spp., Strongyloides sp., and Trichuris sp.), Entamoeba coli, and Entamoeba spp. were found in all five primate species. The following infections were identified: Bertiella studeri was found in chimpanzees and yellow baboons; Balantidium coli was found in yellow baboons; three nematodes (Streptopharagus, Primasubulura, an undetermined genus of Spirurina) and Dicrocoeliidae gen. sp. were found in red-tailed monkeys, vervet monkeys, and yellow baboons; Chitwoodspirura sp. was newly identified in red colobus and red-tailed monkeys; Probstmayria gombensis and Troglocorys cava were newly identified in chimpanzees, together with Troglodytella abrassarti; and Enterobius sp. was newly identified in red colobus. The parasitological data reported for red colobus, vervet monkeys, and yellow baboons in Mahale are the first reports for these species. PMID:22661394

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

    NASA Astrophysics Data System (ADS)

    Rubagumya, Casmir M.

    1991-03-01

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

  18. Water resource use in the Great Ruaha Basin of Tanzania

    NASA Astrophysics Data System (ADS)

    Mwakalila, Shadrack

    This paper assesses water availability in the Great Ruaha basin of Tanzania and reviews current water uses and demands in the basin. The paper is a complement to an on-going research project on development of water resources management guidelines that will help optimize agricultural production in the Usangu plains and energy production of the whole power system, inclusive of Mtera and Kidatu hydropower plants. The historic and new data on water availability, use and demands were collected and subjected to rigorous analysis. The key finding indicates that water abstracted from rivers for irrigation is 56% of wet season flow, 93% of dry season flow, and 64% overall. However, there are significant differences between irrigation water requirements and current abstraction rates; some, but not all, of these differences are accounted for by return flows. The indications are that more water is being abstracted than required for crop production. There is little evidence of significant changes in rainfall or in river flows into Usangu plain. However, there is clear evidence that water entering Usangu plain is being diverted in large amounts into irrigation schemes. The effect of irrigation is, however, complicated and varies both seasonally and annually.

  19. Human and animal Campylobacteriosis in Tanzania: A review.

    PubMed

    Komba, Erick V G; Mdegela, Robinson H; Msoffe, Peter L M; Ingmer, Hanne

    2013-01-01

    The thermotolerant species of Campylobacter have become very important in public health, particularly as agents of infectious diarrhoea in human beings. Though the mechanism by which they cause disease is yet to be fully explained, they have been recognized as the leading cause of bacterial enteritis in both developed and developing countries. The organisms colonize different animal species without causing any symptoms of disease; and humans acquire infections through contact with or consumption of contaminated meat especially raw/undercooked poultry meat. The growing trend of antibiotic resistant Campylobacter isolates continues to pose significant public health challenges. In this review we present the available information generated in Tanzania about Campylobacter infections in humans and animals. We conducted a structured literature search of PUBMED and ScienceDirect electronic databases and identified 15 articles. Studies on humans reported Campylobacter infections in both symptomatic and asymptomatic subjects; with higher prevalence in children under the age of five years. Studies on animals found colonization of both domestic and wild species. Among isolates, some demonstrated antimicrobial resistance. The available information for both human and animal Campylobacteriosis in the country is sparse. It however provides an insight of the bacteriological and epidemiological aspects of Campylobacter infections in the country and eventually creates more awareness on the need to develop control strategies. Since the organism is zoonotic its control strategies should adopt the "One Health" approach involving collaborative efforts from veterinary and human medicine. PMID:26591672

  20. Gendered norms, sexual exploitation and adolescent pregnancy in rural Tanzania.

    PubMed

    McCleary-Sills, Jennifer; Douglas, Zayid; Rwehumbiza, Annagrace; Hamisi, Aziza; Mabala, Richard

    2013-05-01

    Adolescent pregnancy places girls at increased risk for poor health and educational outcomes that limit livelihood options, economic independence, and empowerment in adulthood. In Tanzania, adolescent pregnancy remains a significant concern, with over half of all first births occurring before women reach the age of 20. A participatory research and action project (Vitu Newala) conducted formative research in a rural district on the dynamics of sexual risk and agency among 82 girls aged 12-17. Four major risk factors undermined girls' ability to protect their own health and well-being: poverty that pushed them into having sex to meet basic needs, sexual expectations on the part of older men and boys their age, rape and coercive sex (including sexual abuse from an early age), and unintended pregnancy. Transactional sex with older men was one of the few available sources of income that allowed adolescent girls to meet their basic needs, making this a common choice for many girls, even though it increased the risk of unintended (early) pregnancy. Yet parents and adult community members blamed the girls alone for putting themselves at risk. These findings were used to inform a pilot project aimed to engage and empower adolescent girls and boys as agents of change to influence powerful gender norms that perpetuate girls' risk. PMID:23684192

  1. Interpreting characteristic drainage timescale variability across Kilombero Valley, Tanzania

    NASA Astrophysics Data System (ADS)

    Lyon, S. W.; Koutsouris, A.

    2013-12-01

    We derived the characteristic drainage timescale (K) from river discharge records across the Kilombero Valley in central Tanzania to explore seasonal variability and spatiotemporal patterns in dominant hydrologic processes. This was done using streamflow recession analysis to isolate storage-discharge relationships drawing from hydraulic groundwater theory. Such an approach may be advantageous in this and other data limited environments as it allows utilization of streamflow records with large time gaps and limited consistency. The observed K values during the wet season and for the relatively smaller catchments draining upland positions are consistent with those expected from hydraulic groundwater theory (e.g., K = 45 15 days). In the dry season, however, the timescales estimated for these catchments are larger than expected from hydraulic groundwater theory. Further, larger catchments draining part of the valley bottom, which is dominated by wetlands, never exhibited K values consistent with those expected from hydraulic groundwater theory. These hydrometric results are consistent with initial hydrologic tracer investigations with implications for the transit times of water moving through this upland-wetland seasonally-connected region and resultant regional groundwater recharge. Identifying these spatiotemporal shifts (i.e., isolating when general hydraulic groundwater theory may not be valid) facilitates process representation relevant for improved hydrologic modeling and water resources management in regions like Kilombero Valley.

  2. Tanzania's policy on biodiversity prospecting and drug discovery programs.

    PubMed

    Mahunnah, R L; Mshigeni, K E

    1996-04-01

    Tanzania is endowed with a rich natural resource. The biodiversity comprises over 10,000 plant species, a rich fauna and marine resources. The collection of biological resources is guided by a set of formalities, namely: (i) entry visas, (ii) research permits, (iii) designation of a relevant collaborating host institution or organization, and (iv) eventual joint field work with the collaborating host institution. A facility exists whereby an institution within the country can collaborate with a technologically developed institution or country through mutual research agreement in short and long-term programs. In such a case, Tanzanian scientists collect and export biological materials for drug testing by the collaborating partner. The research agreement is based on the understanding that benefits of the discovery are shared among all parties, namely, the host country's collaborating institution(s), government and indigenous cultures. Rules and regulations governing biodiversity prospecting fall under the categories of (a) floristic resources, (b) fauna or animal substances and (c) marine biological resources. The collection and export of CITES-listed organisms is governed by a separate policy package. Various national institutions are directly involved in overseeing the implementation of these policies. In this paper, these are reviewed to accommodate new conventions concerning research management policies on biological diversity and the sustainable utilization and conservation of these resources. PMID:9213620

  3. Family planning decisions, perceptions and gender dynamics among couples in Mwanza, Tanzania: a qualitative study

    PubMed Central

    2013-01-01

    Background Contraceptive use is low in developing countries which are still largely driven by male dominated culture and patriarchal values. This study explored family planning (FP) decisions, perceptions and gender dynamics among couples in Mwanza region of Tanzania. Methods Twelve focus group discussions and six in-depth interviews were used to collect information from married or cohabiting males and females aged 18–49. The participants were purposively selected. Qualitative methods were used to explore family planning decisions, perceptions and gender dynamics among couples. A guide with questions related to family planning perceptions, decisions and gender dynamics was used. The discussions and interviews were tape-recorded, transcribed verbatim and analyzed manually and subjected to content analysis. Results Four themes emerged during the study. First, “risks and costs” which refer to the side effects of FP methods and the treatment of side -effects as well as the costs inherit in being labeled as an unfaithful spouse. Second, “male involvement” as men showed little interest in participating in family planning issues. However, the same men were mentioned as key decision-makers even on the number of children a couple should have and the child spacing of these children. Third, “gender relations and communication” as participants indicated that few women participated in decision-making on family planning and the number of children to have. Fourth, “urban–rural differences”, life in rural favoring having more children than urban areas therefore, the value of children depended on the place of residence. Conclusion Family Planning programs should adapt the promotion of communication as well as joint decision-making on FP among couples as a strategy aimed at enhancing FP use. PMID:23721196

  4. 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

  5. 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

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

    PubMed Central

    2013-01-01

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

  7. Acceptability of condom promotion and distribution among 10–19 year-old adolescents in Mpwapwa and Mbeya rural districts, Tanzania

    PubMed Central

    2012-01-01

    Background The HIV/AIDS pandemic remains a leading challenge for global health. Although condoms are acknowledged for their key role on preventing HIV transmission, low and inappropriate use of condoms persists in Tanzania and elsewhere in Africa. This study assesses factors affecting acceptability of condom promotion and distribution among adolescents in Mpwapwa and Mbeya rural districts of Tanzania. Methods Data were collected in 2011 as part of a larger cross-sectional survey on condom use among 10–19 year-olds in Mpwapwa and Mbeya rural districts of Tanzania using a structured questionnaire. Associations between acceptability of condom promotion and distribution and each of the explanatory variables were tested using Chi Square. Multivariate logistic regression model was used to examine independent predictors of the acceptability of condom promotion and distribution using STATA (11) statistical software at 5% significance level. Results Mean age of the 1,327 adolescent participants (50.5% being males) was 13.5 years (SD = 1.4). Acceptance of condom promotion and distribution was found among 37% (35% in Mpwapwa and 39% in Mbeya rural) of the adolescents. Being sexually active and aged 15–19 was the strongest predictor of the acceptability of condom promotion and distribution (OR = 7.78, 95% CI 4.65-12.99). Others were; not agreeing that a condom is effective in preventing transmissions of STIs including HIV (OR = 0.34, 95% CI 0.20-0.56), being a resident of Mbeya rural district (OR = 1.67, 95% CI 1.28-2.19), feeling comfortable being seen by parents/guardians holding/buying condoms (OR = 2.20, 95% CI 1.40-3.46) and living with a guardian (OR = 1.48, 95% CI 1.08-2.04). Conclusion Acceptability of condom promotion and distribution among adolescents in Mpwapwa and Mbeya rural is low. Effect of sexual activity on the acceptability of condom promotion and distribution is age-dependent and was the strongest. Feeling comfortable being seen by parents/guardians buying or holding condoms, perceived ability of condoms to offer protection against HIV/AIDS infections, district of residence and living arrangements also offered significant predictive effect. Knowledge of these factors is vital in designing successful and sustainable condom promotion and distribution programs in Tanzania. PMID:22892205

  8. Stakeholders’ participation in planning and priority setting in the context of a decentralised health care system: the case of prevention of mother to child transmission of HIV programme in Tanzania

    PubMed Central

    2013-01-01

    Background In Tanzania, decentralisation processes and reforms in the health sector aimed at improving planning and accountability in the sector. As a result, districts were given authority to undertake local planning and set priorities as well as allocate resources fairly to promote the health of a population with varied needs. Nevertheless, priority setting in the health care service has remained a challenge. The study assessed the priority setting processes in the planning of the prevention of mother to child transmission of HIV (PMTCT) programme at the district level in Tanzania. Methods This qualitative study was conducted in Mbarali district, south-western Tanzania. The study applied in-depth interviews and focus group discussions in the data collection. Informants included members of the Council Health Management Team, regional PMTCT managers and health facility providers. Results Two plans were reported where PMTCT activities could be accommodated; the Comprehensive Council Health Plan and the Regional PMTCT Plan that was donor funded. As donors had their own globally defined priorities, it proved difficult for district and regional managers to accommodate locally defined PMTCT priorities in these plans. As a result few of these were funded. Guidelines and main priority areas of the Ministry of Health and Social Welfare (MoHSW) also impacted on the ability of the districts and regions to act, undermining the effectiveness of the decentralisation policy in the health sector. Conclusion The challenges in the priority setting processes revealed within the PMTCT initiative indicate substantial weaknesses in implementing the Tanzania decentralisation policy. There is an urgent need to revive the strategies and aims of the decentralisation policy at all levels of the health care system with a view to improving health service delivery. PMID:23849730

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

    PubMed Central

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

    2012-01-01

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

  10. Bacterial vaginosis in female facility workers in north-western Tanzania: prevalence and risk factors

    PubMed Central

    Baisley, K; Changalucha, J; Weiss, H A; Mugeye, K; Everett, D; Hambleton, I; Hay, P; Ross, D; Tanton, C; Chirwa, T; Hayes, R; Watson-Jones, D

    2009-01-01

    Objectives: To determine prevalence of, and risk factors for, bacterial vaginosis (BV) among herpes simplex virus (HSV) 2 seropositive Tanzanian women at enrolment into a randomised, placebo-controlled trial of HSV suppressive treatment. Methods: 1305 HSV-2 seropositive women aged 16–35 years working in bars, guesthouses and similar facilities were interviewed, examined and tested for HIV, syphilis, Neisseria gonorrhoeae, Chlamydia trachomatis, BV, candidiasis and trichomoniasis. Factors associated with BV were analysed using logistic regression to estimate odds ratios and 95% confidence intervals. Results: BV prevalence was 62.9%; prevalence of Nugent score 9–10 was 16.1%. Independent risk factors for BV were work facility type, fewer dependents, increasing alcohol consumption, sex in the last week (adjusted OR 2.03; 95% CI 1.57 to 2.62), using cloths or cotton wool for menstrual hygiene, HIV (adjusted OR 1.41; 95% CI 1.09 to 1.83) and Trichomonas vaginalis infection. There was no association between BV and the frequency or method of vaginal cleansing. However, BV was less prevalent among women who reported inserting substances to dry the vagina for sex (adjusted OR 0.44; 95% CI 0.25 to 0.75). Conclusion: BV was extremely prevalent among our study population of HSV-2 positive female facility workers in North-western Tanzania. Although recent sex was associated with increased BV prevalence, vaginal drying was associated with lower BV prevalence. Further studies of the effects of specific practices on vaginal flora are warranted. PMID:19473997

  11. Soft targets or partners in health? Retail pharmacies and their role in Tanzania's malaria control program.

    PubMed

    Kamat, Vinay R; Nyato, Daniel J

    2010-08-01

    The retail sector has been at the center of recent policy debates concerning its role in malaria control programs in Africa. This article closely examines the perspectives of owners and managers of retail pharmacies and drug shops in Dar es Salaam, toward the dominant public health discourse and practices surrounding the deployment of artemisinin-based combination therapy (ACT) as a way forward in malaria control. Drawing on fieldwork conducted between May-August 2007, and July-August 2009, involving in-depth interviews and participant observation in pharmacies and drug shops in Dar es Salaam, the article describes the social realities facing people who manage retail pharmacies, the nature of their interactions with customers, the kinds of antimalarials they sell, and their perspective on how the new malaria treatment guidelines have affected their business. Findings suggest that for most pharmacy owners and managers, it is 'business as usual' concerning the sale of conventional antimalarials, with a majority reporting that the introduction of ACT in public health facilities had not negatively affected their business. Implications of the research findings are examined in the context of proposed interventions to make pharmacy owners and managers more socially responsible and adhere to government health regulations. The article makes a case for actively involving pharmacy owners and managers in decision making processes surrounding the implementation of new treatment guidelines, and training programs that have an impact on their business, social responsibility, and community health. In considering regulatory interventions, health planners must explicitly address the concern that retail pharmacies fill an important role in the country's health care system, and that the complex nexus that drives the global pharmaceutical market often governs their operations at the local level. PMID:20621751

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

    PubMed Central

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

    2015-01-01

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

  13. 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…

  14. Adolescent Hopefulness in Tanzania: Street Youth, Former Street Youth, and School Youth

    ERIC Educational Resources Information Center

    Nalkur, Priya G.

    2009-01-01

    This study compares hope in street youth, former street youth, and school youth (aged 12-18) in Tanzania. Responding to Snyder's hope theory, the author argues that not only personal agency but also the stability of living context (street, shelter, home) shapes hopefulness. Employing qualitative and quantitative analyses, the author presents a

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

    ERIC Educational Resources Information Center

    Miles, Susie

    2011-01-01

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

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

    ERIC Educational Resources Information Center

    Miles, Susie; Kaplan, Ian

    2005-01-01

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

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

    ERIC Educational Resources Information Center

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

    2005-01-01

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

  18. Language Ideologies and Schooled Education in Rural Tanzania: The Case of Karagwe

    ERIC Educational Resources Information Center

    Wedin, Asa

    2005-01-01

    In this paper I argue that language policies for education have effects on pupils' educational possibilities. With the case of the Karagwe district in Tanzania the research suggests that the policy of "Swahili only" in primary school education favours the small minority of the children that live in a context where Swahili is used. This appears to…

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