Outwater, Anne; Mgaya, Edward; Campbell, Jacquelyn C.; Becker, Stan; Kinabo, Linna; Menick, Daniel Mbassa
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
Background Malaria is a major cause of paediatric morbidity and mortality. As no clinical features clearly differentiate malaria from other febrile illnesses, and malaria diagnosis is challenged by often lacking laboratory equipment and expertise, overdiagnosis and overtreatment is common. Methods Children admitted with fever at the general paediatric wards at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania from January to June 2009 were recruited consecutively and prospectively. Demographic and clinical features were registered. Routine thick blood smear microscopy at MNH was compared to results of subsequent thin blood smear microscopy, and rapid diagnostics tests (RDTs). Genus-specific PCR of Plasmodium mitochondrial DNA was performed on DNA extracted from whole blood and species-specific PCR was done on positive samples. Results Among 304 included children, 62.6% had received anti-malarials during the last four weeks prior to admission and 65.1% during the hospital stay. Routine thick blood smears, research blood smears, PCR and RDT detected malaria in 13.2%, 6.6%, 25.0% and 13.5%, respectively. Positive routine microscopy was confirmed in only 43% (17/40), 45% (18/40) and 53% (21/40), by research microscopy, RDTs and PCR, respectively. Eighteen percent (56/304) had positive PCR but negative research microscopy. Reported low parasitaemia on routine microscopy was associated with negative research blood slide and PCR. RDT-positive cases were associated with signs of severe malaria. Palmar pallor, low haemoglobin and low platelet count were significantly associated with positive PCR, research microscopy and RDT. Conclusions The true morbidity attributable to malaria in the study population remains uncertain due to the discrepancies in results among the diagnostic methods. The current routine microscopy appears to result in overdiagnosis of malaria and, consequently, overuse of anti-malarials. Conversely, children with a false positive malaria diagnosis
Dongus, Stefan; Nyika, Dickson; Kannady, Khadija; Mtasiwa, Deo; Mshinda, Hassan; Gosoniu, Laura; Drescher, Axel W; Fillinger, Ulrike; Tanner, Marcel; Killeen, Gerry F; Castro, Marcia C
A cross-sectional survey of agricultural areas, combined with routinely monitored mosquito larval information, was conducted in urban Dar es Salaam, Tanzania, to investigate how agricultural and geographical features may influence the presence of Anopheles larvae. Data were integrated into a geographical information systems framework, and predictors of the presence of Anopheles larvae in farming areas were assessed using multivariate logistic regression with independent random effects. It was found that more than 5% of the study area (total size 16.8 km2) was used for farming in backyard gardens and larger open spaces. The proportion of habitats containing Anopheles larvae was 1.7 times higher in agricultural areas compared to other areas (95% confidence interval = 1.56-1.92). Significant geographic predictors of the presence of Anopheles larvae in gardens included location in lowland areas, proximity to river, and relatively impermeable soils. Agriculture-related predictors comprised specific seedbed types, mid-sized gardens, irrigation by wells, as well as cultivation of sugar cane or leafy vegetables. Negative predictors included small garden size, irrigation by tap water, rainfed production and cultivation of leguminous crops or fruit trees. Although there was an increased chance of finding Anopheles larvae in agricultural sites, it was found that breeding sites originated by urban agriculture account for less than a fifth of all breeding sites of malaria vectors in Dar es Salaam. It is suggested that strategies comprising an integrated malaria control effort in malaria-endemic African cities include participatory involvement of farmers by planting shade trees near larval habitats.
Pfeiffer, Constanze; Kleeb, Matthis; Mbelwa, Alice; Ahorlu, Collins
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.
Outwater, Anne H; Campbell, Jacquelyn C; Mgaya, Edward; Abraham, Alison G; Kinabo, Linna; Kazaura, Method; Kub, Joan
Violence disproportionately affects low- and middle-income countries. Deeper understanding is needed in areas where little research has occurred. The objectives of the study were to: (a) ascertain rate of homicide death; (b) describe the victims and circumstances surrounding their deaths in Dar es Salaam, Tanzania in 2005. This study was developed by adapting the WHO/CDC Injury Surveillance Guidelines (Holder et al., 2001). Data on 12 variables were collected on all homicide deaths. Descriptive statistics and hypothesis tests were done when appropriate. Age standardised, age-specific and cause-specific mortality rates are presented. The overall homicide rate was 12.57 (males and females respectively: 22.26 and 2.64). Homicide deaths were 93.4% male, mostly unemployed, with a mean age of 28.2 years. Most deaths occurred in urban areas. Mob violence was the cause of 57% of deaths. The risk of homicide death for males was greater than the world average, but for females it was less. Most homicides were committed by community members policing against thieves.
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…
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
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
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
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.
Dixon, Pauline; Humble, Steve; Chan, David W.
This study was carried out with 1,857 poor children from 17 schools, living in low-income areas of Dar Es Salaam, Tanzania. All children took the "Student Multiple Intelligences Profile" (SMIP) questionnaire as part of a bigger project that gathered data around concepts and beliefs of talent. This paper sets out two aims, first to…
Chacha, Chacha Emmanuel; Kazaura, Method R.
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
Jamison, Amy J.
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…
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
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
Ndetto, Emmanuel L.; Matzarakis, Andreas
Dar es Salaam, Tanzania, is a typical African city along the Indian Ocean coast, and therefore an important urban area to examine human thermal perception in the hot-humid tropical climate. Earlier research on human bioclimate at Dar es Salaam indicated that heat stress prevails during the hot season from October to March, peaking between December and February, particularly the early afternoons. In order to assess the human thermal perception and adaptation, two popular places, one at an urban park and another at a beach environment, were selected and questionnaire surveys were conducted in August-September 2013 and January 2014, concurrently with local micro-meteorological measurements at survey locations. The thermal conditions were quantified in terms of the thermal index of the physiologically equivalent temperature (PET) using the micro-scale climate model RayMan. The thermal comfort range of human thermal comfort and the local thermal adaptive capacity were determined in respect to the thermal index by binning thermal sensation votes. The thermal comfort range was found to be well above that in temperate climates at about 23-31 °C of PET. The study could significantly contribute to urban planning in Dar es Salaam and other coastal cities in the tropics.
Maman, Suzanne; Yamanis, Thespina; Kouyoumdjian, Fiona; Watt, Melissa; Mbwambo, Jessie
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…
Ogoma, Sheila B; Kannady, Khadija; Sikulu, Maggy; Chaki, Prosper P; Govella, Nicodem J; Mukabana, Wolfgang R; Killeen, Gerry F
Background Malaria transmission in Africa occurs predominantly inside houses where the primary vectors prefer to feed. Human preference and investment in blocking of specific entry points for mosquitoes into houses was evaluated and compared with known entry point preferences of the mosquitoes themselves. Methods Cross-sectional household surveys were conducted in urban Dar es Salaam, Tanzania to estimate usage levels of available options for house proofing against mosquito entry, namely window screens, ceilings and blocking of eaves. These surveys also enabled evaluation of household expenditure on screens and ceilings and the motivation behind their installation. Results Over three quarters (82.8%) of the 579 houses surveyed in Dar es Salaam had window screens, while almost half (48.9%) had ceilings. Prevention of mosquito entry was cited as a reason for installation of window screens and ceilings by 91.4% (394/431) and 55.7% (127/228) of respondents, respectively, but prevention of malaria was rarely cited (4.3%, 22/508). The median cost of window screens was between US $ 21-30 while that of ceilings was between US $301-400. The market value of insecticide-treated nets, window screening and ceilings currently in use in the city was estimated as 2, 5 and 42 million US$. More than three quarters of the respondents that lacked them said it was too expensive to install ceilings (82.2%) or window screens (75.5%). Conclusion High coverage and spending on screens and ceilings implies that these techniques are highly acceptable and excellent uptake can be achieved in urban settings like Dar es Salaam. Effective models for promotion and subsidization should be developed and evaluated, particularly for installation of ceilings that prevent entry via the eaves, which are the most important entry point for mosquitoes that cause malaria, a variety of neglected tropical diseases and the nuisance which motivates uptake. PMID:19785779
Maheu-Giroux, Mathieu; Castro, Marcia C.
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
Pickering, A.; Boehm, A.; Davis, J.
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.
Kivaria, F M; Noordhuizen, J P T M
The prevalence of and case fatality rate due to East Coast fever (ECF) were estimated in 1402 dairy cattle in 87 small herds in the Dar es Salaam region of Tanzania, from January 2003 to January 2005 using a capture-recapture method. Information on clinical cases and deaths due to ECF were obtained from farm records and from a questionnaire-based cross-sectional survey conducted between July 2003 and March 2005 as part of longitudinal studies of bovine mastitis in these herds. The number of clinical cases identified was 567 (from farm records) and 496 (from the questionnaire), and the number of deaths recorded were 305 (from farm records) and 251 (from the questionnaire). In all, 450 clinical cases and 191 deaths due to ECF were identified from the two sources, giving an observed prevalence of 32% (CI(95%) 30-35%) and observed case fatality rate of 42% (CI(95%) 38-47%). Following application of the capture-recapture method, the estimated number of clinical cases and deaths was 625 (CI(95%) 617-633) and 401 (CI(95%) 384-418), respectively. The respective prevalence and case fatality rates were 45% (CI(95%) 41-48%) and 64% (CI(95%) 60-68%). The estimates obtained using the capture-recapture method are higher than those identified by traditional cross-sectional studies conducted in the same study area, and probably provide a more accurate epidemiological picture of ECF in this region of Tanzania.
Luciani, Giulia; Sappa, Giuseppe; Cella, Antonella
They are presented the results of a groundwater modeling study on the Coastal Aquifer of Dar es Salaam (Tanzania). Dar es Salaam is one of the fastest-growing coastal cities in Sub-Saharan Africa, with with more than 4 million of inhabitants and a population growth rate of about 8 per cent per year. The city faces periodic water shortages, due to the lack of an adequate water supply network. These two factors have determined, in the last ten years, an increasing demand of groundwater exploitation, carried on by quite a number of private wells, which have been drilled to satisfy human demand. A steady-state three dimensional groundwater model has been set up by the MODFLOW code, and calibrated with the UCODE code for inverse modeling. The aim of the model was to carry out a characterization of groundwater flow system in the Dar es Salaam Coastal Plain. The inputs applied to the model included net recharge rate, calculated from time series of precipitation data (1961-2012), estimations of average groundwater extraction, and estimations of groundwater recharge, coming from zones, outside the area under study. Parametrization of the hydraulic conductivities was realized referring to the main geological features of the study area, based on available literature data and information. Boundary conditions were assigned based on hydrogeological boundaries. The conceptual model was defined in subsequent steps, which added some hydrogeological features and excluded other ones. Calibration was performed with UCODE 2014, using 76 measures of hydraulic head, taken in 2012 referred to the same season. Data were weighted on the basis of the expected errors. Sensitivity analysis of data was performed during calibration, and permitted to identify which parameters were possible to be estimated, and which data could support parameters estimation. Calibration was evaluated based on statistical index, maps of error distribution and test of independence of residuals. Further model
Tellevik, Marit G.; Blomberg, Bjørn; Kommedal, Øyvind; Maselle, Samuel Y.; Langeland, Nina; Moyo, Sabrina J.
Background Faecal carriage of ESBL-producing bacteria is a potential risk for transmission and infection. Little is known about faecal carriage of antibiotic resistance in Tanzania. This study aimed to investigate the prevalence of faecal carriage of ESBL-producing Enterobacteriaceae and to identify risk factors for carriage among young children in Tanzania. Methodology/Principal Findings From August 2010 to July 2011, children below 2 years of age were recruited in Dar es Salaam, including healthy community children (n = 250) and children hospitalized due to diarrhoea (n = 250) or other diseases (n = 103). ChromID ESBL agar and ChromID CARBA SMART agar were used for screening. Antimicrobial susceptibility testing was performed by the disk diffusion method. ESBL genotypes were identified by Real-Time PCR and sequencing. The overall prevalence of ESBL carriage was 34.3% (207/ 603). The prevalence of ESBL carriage was significantly higher among hospitalized children (50.4%), compared to community children (11.6%; P < 0.001; OR = 7.75; 95% CI: 4.99–12.03). We found high prevalence of Multidrug-resistance (94%) among Escherichia coli and Klebsiella pneumoniae isolates. No resistance to carbapenems was detected. For the majority of isolates (94.7%) we detected a blaCTX-M-15-like gene. In addition, the plasmid mediated AmpC beta-lactamase CMY-2 was detected for the first time in Tanzania. ESBL prevalence was significantly higher among HIV positive (89.7%) than HIV negative (16.9%) children (P = 0.001; OR = 9.99; 95% CI: 2.52–39.57). Use of antibiotics during the past 14 days and age below 1 year was also associated with ESBL carriage. Conclusions/Significance We report a high rate of faecal carriage of ESBL-producing Enterobacteriaceae among children below 2 years of age in Tanzania, particularly those with HIV-infection. Resistance to a majority of the available antimicrobials commonly used for children in Tanzania leaves few treatment options for infections when
Lovgren, Kathleen; Soliman, Amr S; Ngoma, Twalib; Kahesa, Crispin; Meza, Jane
Cervical cancer is the leading incident cancer and the main cause of cancer-related mortality among women in sub-Saharan Africa. Furthermore, HIV-infected women are at a higher risk of developing cervical cancer than HIV-negative women. The purpose of this study was to distinguish differences in characteristics of HIV-positive and HIV-negative patients with cervical cancer in Dar es Salaam, Tanzania. The HIV status of cervical cancer patients diagnosed and/or treated at Ocean Road Cancer Institute in Dar es Salaam, Tanzania, during the period 2007-2011 was abstracted from the medical records. Additional abstracted information included patient's name, age, place of residence, occupation, education, marital status, age at marriage, gravidity, and screening clinic visit results. Ocean Road Cancer Institute patients came from two sources: the screening clinic followed by treatment clinic or the treatment clinic without prior screening. HIV-positive and HIV-negative patients were compared regarding the above-listed clinical and epidemiologic factors. Multivariable analysis was also performed to assess the risk factors associated with cervical cancer treatment without prior screening at Ocean Road Cancer Institute. HIV-positive cervical cancer patients tended to be younger, with higher education and lower parity. Patients screened for cervical cancer prior to treatment were more likely to be HIV-positive (OR: 2.09, 95% CI: 1.36, 3.21), less likely to have higher disease stages (OR: 0.64, 95% CI: 0.43, 0.94), and less likely to reside outside of Dar es Salaam (OR: 0.44, 95% CI: 0.30, 0.65). Screening for cervical cancer at Ocean Road Cancer Institute is utilised by more HIV-positive patients from Dar es Salaam. Future studies should focus on identifying the reasons for lower utilisation of screening by HIV-negative patients and patients from other distant rural regions in Tanzania.
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
Maganja, R K; Maman, S; Groves, A; Mbwambo, J K
Transactional sex has been associated with risk of HIV infection in a number of studies throughout sub-Saharan Africa. Urban young women are economically vulnerable and at heightened risk of HIV infection in Tanzania; yet there are few studies that have explored relationship dynamics, including transactional sex, in this setting. This paper sheds light on the broader context of sexual relationships among youth at risk for HIV, how transactional sex plays out in these relationships, and how the transactional nature of relationships affects women's risk for HIV. We conducted 60 in depth interviews and 14 focus group discussions with young men and women, 16-24 years old, in Dar es Salaam, Tanzania. These data guided the development of a community based HIV and violence prevention intervention for young men. Youth described the exchange of sex for money or other material goods in all types of sexual relationships. While the exchange was explicit in casual relationships, young women voiced material and monetary expectations from their committed partners as well. Young men described their pursuit of multiple partners as sexually motivated, while women sought multiple partners for economic reasons. Young men were aware of the expectations of material support from partners, and acknowledged that their ability to provide for a partner affected both the longevity and exclusivity of their relationships. Youth described a deep mistrust of the motivations and commitment of their sexual partners. Furthermore, young women's financial dependence on men impacted their ability to negotiate safe sexual behaviors in both casual and committed relationships. Programs designed to reduce HIV risk among Tanzanian youth need to take into account the transactional component of sexual relationships and how such exchanges differ according to partner type.
Sattler, Michael A; Mtasiwa, Deo; Kiama, Michael; Premji, Zul; Tanner, Marcel; Killeen, Gerry F; Lengeler, Christian
Introduction By 2030, more than 50% of the African population will live in urban areas. Controlling malaria reduces the disease burden and further improves economic development. As a complement to treated nets and prompt access to treatment, measures targeted against the larval stage of Anopheles sp. mosquitoes are a promising strategy for urban areas. However, a precise knowledge of the geographic location and potentially of ecological characteristics of breeding sites is of major importance for such interventions. Methods In total 151 km2 of central Dar es Salaam, the biggest city of Tanzania, were systematically searched for open mosquito breeding sites. Ecologic parameters, mosquito larvae density and geographic location were recorded for each site. Logistic regression analysis was used to determine the key ecological factors explaining the different densities of mosquito larvae. Results A total of 405 potential open breeding sites were examined. Large drains, swamps and puddles were associated with no or low Anopheles sp. larvae density. The probability of Anopheles sp. larvae to be present was reduced when water was identified as "turbid". Small breeding sites were more commonly colonized by Anopheles sp. larvae. Further, Anopheles gambiae s.l. larvae were found in highly organically polluted habitats. Conclusions Clear ecological characteristics of the breeding requirements of Anopheles sp. larvae could not be identified in this setting. Hence, every stagnant open water body, including very polluted ones, have to be considered as potential malaria vector breeding sites. PMID:15649333
Jenkins, Marion W.; Cumming, Oliver; Cairncross, Sandy
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
Haukenes, G; Shao, J F; Mbena, E; Rustad, S
A total of 542 serum samples from healthy adults (medical students and medical staff, blood donors and pregnant women) residing in or near the city of Dar es Salaam, Tanzania were examined for markers of hepatitis B virus (HBV) infection. Of these samples, 95 (17.5%) were not found to contain any HBV marker when examined by enzyme-linked immunoassay for hepatitis B surface antigen (HBsAg), antibody to hepatitis B surface antigen (anti-HBs) and antibody to hepatitis B core antigen (anti-HBc). HBsAg was demonstrated in 52 (9.6%) samples of which 7 (13.5%) were positive for hepatitis Be antigen (HBeAg) and 17 (32.7%) were positive for anti-HBc IgM. None of 9 HBsAg positive pregnant women were carriers of HBeAg. These results show that hepatitis B infection is very common in this country. The relatively low prevalence of HBeAg among HBsAg carriers may indicate that transmission of hepatitis B at birth is not of major importance.
Jenkins, Marion W; Cumming, Oliver; Cairncross, Sandy
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.
MCCORMICK, Nora M.; LI, Nan; SANDO, David; MUYA, Aisa; MANJI, Karim P.; KISENGE, Rodrick; DUGGAN, Christopher; CHALAMILLA, Guerino; FAWZI, Wafaie W.; SPIEGELMAN, Donna
Objective To identify risk factors for loss to follow up (LTFU) in an HIV-infected pediatric population in Dar es Salaam, Tanzania between 2004 and 2011. Design Longitudinal analysis of 6236 HIV-infected children. Methods We conducted a prospective cohort study of 6236 pediatric patients enrolled in care and treatment in Dar es Salaam from October 2004 to September 2011. LTFU was defined as missing a clinic visit for >90 days for patients on ART and for >180 days for patients in care and monitoring. The relationship of baseline and time-varying characteristics to risk of LTFU was examined using a Cox proportional hazards model. Results 2130 children (34%) were LTFU over a median follow up of 16.7 months (IQR, 3.4–36.9). Factors independently associated with a higher risk of LTFU were age 2 years (RR=1.59, 95% CI 1.40–1.80), diarrhea at enrollment (RR=1.20, 95% CI 1.03–1.41), a low mid-upper arm circumference for age (RR=1.20, CI 1.05–1.37), eating protein 3 times a week (RR=1.39, 95% CI 1.05–1.90), taking cotrimoxazole (RR=1.39, 95% CI 1.06–1.81), initiating onto antiretrovirals (RR=1.37, 95% CI 1.17–1.61), receiving treatment at a hospital instead of a local facility (RR=1.39, 95% CI 1.06–1.41), and starting treatment in 2006 or later (RR=1.10, 95% CI 1.04–1.16). Conclusions Health workers should be aware of pediatric patients who are at greatest risk of LTFU, such as younger and undernourished patients, so that they can proactively counsel families about the importance of visit adherence. Findings support decentralization of HIV care to local facilities as opposed to hospitals. PMID:26247894
Cavan, Gina; Lindley, Sarah; Kibassa, Deusdedit; Shemdoe, Riziki; Capuano, Paolo; De Paola, Francesco; Renner, Florian; Pauleit, Stephan
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
Dongus, Stefan; Nyika, Dickson; Kannady, Khadija; Mtasiwa, Deo; Mshinda, Hassan; Fillinger, Ulrike; Drescher, Axel W; Tanner, Marcel; Castro, Marcia C; Killeen, Gerry F
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
Merli, M. Giovanna; Verdery, Ashton; Mouw, Ted; Li, Jing
The streams of Chinese migration to Africa are growing in tandem with rising Chinese investments and trade flows in and to the African continent. In spite of the high profile of this phenomenon in the media, there are few rich and broad descriptions of Chinese communities in Africa. Reasons for this include the rarity of official statistics on foreign-born populations in African censuses, the absence of predefined sampling frames required to draw representative samples with conventional survey methods and difficulties to reach certain segments of this population. Here, we use a novel network-based approach, Network Sampling with Memory, which overcomes the challenges of sampling ‘hidden’ populations in the absence of a sampling frame, to recruit a sample of recent Chinese immigrants in Dar es Salaam, Tanzania and collect information on the demographic characteristics, migration histories and social ties of members of this sample. These data reveal a heterogeneous Chinese community composed of “state-led” migrants who come to Africa to work on projects undertaken by large Chinese state-owned enterprises and “independent” migrants who come on their own accord to engage in various types of business ventures. They offer a rich description of the demographic profile and social organization of this community, highlight key differences between the two categories of migrants and map the structure of the social ties linking them. We highlight needs for future research on inter-group differences in individual motivations for migration, economic activities, migration outcomes, expectations about future residence in Africa, social integration and relations with local communities. PMID:27746912
Merli, M Giovanna; Verdery, Ashton; Mouw, Ted; Li, Jing
The streams of Chinese migration to Africa are growing in tandem with rising Chinese investments and trade flows in and to the African continent. In spite of the high profile of this phenomenon in the media, there are few rich and broad descriptions of Chinese communities in Africa. Reasons for this include the rarity of official statistics on foreign-born populations in African censuses, the absence of predefined sampling frames required to draw representative samples with conventional survey methods and difficulties to reach certain segments of this population. Here, we use a novel network-based approach, Network Sampling with Memory, which overcomes the challenges of sampling 'hidden' populations in the absence of a sampling frame, to recruit a sample of recent Chinese immigrants in Dar es Salaam, Tanzania and collect information on the demographic characteristics, migration histories and social ties of members of this sample. These data reveal a heterogeneous Chinese community composed of "state-led" migrants who come to Africa to work on projects undertaken by large Chinese state-owned enterprises and "independent" migrants who come on their own accord to engage in various types of business ventures. They offer a rich description of the demographic profile and social organization of this community, highlight key differences between the two categories of migrants and map the structure of the social ties linking them. We highlight needs for future research on inter-group differences in individual motivations for migration, economic activities, migration outcomes, expectations about future residence in Africa, social integration and relations with local communities.
Lohri, Christian Riuji; Faraji, Adam; Ephata, Elia; Rajabu, Hassan Mtoro; Zurbrügg, Christian
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.
Wylie, Blair J.; Matechi, Emmanuel; Kishashu, Yahya; Fawzi, Wafaie; Premji, Zul; Coull, Brent A.; Hauser, Russ; Ezzati, Majid; Roberts, Drucilla J.
Background: Smoke from the burning of biomass fuels has been linked with adverse pregnancy outcomes such as low birth weight, stillbirth, and prematurity. Objective: To identify potential underlying mechanisms of adverse perinatal outcomes, we explored the association of placental pathology with household air pollution in pregnant women from urban/periurban Tanzania who cook predominantly with charcoal. Methods: Between 2011 and 2013, we measured personal exposures to fine particulate matter (PM2.5) and carbon monoxide (CO) over 72 hr among a cohort of Tanzanian pregnant women. Placentas were collected after delivery for examination. Placental pathologies of inflammatory, hypoxic, ischemic/hypertensive, infectious and thrombotic etiologies were diagnosed, blinded to exposure levels. Using multiple logistic regression, we explored the association of PM2.5 and CO exposure with placental pathology. Results: One hundred sixteen women had personal air exposure measurements and placental histopathology available for analysis. PM2.5 and CO exposures were moderate [geometric means (GSD) were 40.5 μg/m3 (17.3) and 2.21 ppm (1.47) respectively]; 88.6% of PM2.5 measurements exceeded World Health Organization air quality guidelines. We observed an increase in the odds (per 1-unit increase in exposure on the ln-scale) of fetal thrombotic vasculopathy (FTV) both with increasing PM2.5 [adjusted odds ratio (aOR) = 5.5; 95% CI: 1.1, 26.8] and CO measurements (aOR = 2.5; 95% CI: 1.0, 6.4) in adjusted models only. FTV also was more common among pregnancies complicated by stillbirth or low birth weight. Conclusions: Fetal thrombosis may contribute to the adverse outcomes associated with household air pollution from cook stoves during pregnancy. Larger studies are necessary for confirmation. Citation: Wylie BJ, Matechi E, Kishashu Y, Fawzi W, Premji Z, Coull BA, Hauser R, Ezzati M, Roberts D. 2017. Placental pathology associated with household air pollution in a cohort of pregnant
Abioye, Ajibola I; Isanaka, Sheila; Liu, Enju; Mwiru, Ramadhani S; Noor, Ramadhani A; Spiegelman, Donna; Mugusi, Ferdinand; Fawzi, Wafaie
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.
Vyas, Seema; Jansen, Henrica Afm; Heise, Lori; Mbwambo, Jessie
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.
Mtebe, Joel S.; Raphael, Christina
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…
Mlozi, Malongo R. S.
Urban agriculture in Dar es Salaam was found to use child labor of both children with parents of higher and lower socioeconomic status (SES). Discusses policy implications and calls for the education of parents of lower SES not to expect an economic contribution from their children's labor, and the education of children about their rights. (LZ)
Zamudio-Haas, Sophia; Mahenge, Bathsheba; Saleem, Haneefa; Mbwambo, Jessie; Lambdin, Barrot H.
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
Davis, J.; Pickering, A.; Horak, H.; Boehm, A.
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
Mahenge, Bathsheba; Stöckl, Heidi; Abubakari, Abdulai; Mbwambo, Jessie; Jahn, Albrecht
Background Intimate partner violence (IPV) during pregnancy and postpartum is a serious global health problem affecting millions of women worldwide. This study sought to determine the prevalence of different forms of IPV during pregnancy and postpartum and associated factors among women in Dar es Salaam, Tanzania. Methods We conducted a cross-sectional study among 500 women at one to nine months postpartum in three health facilities in the three districts of Dar es Salaam: Temeke, Kinondoni and Illala. Two trained research assistants administered the questionnaire, which aimed to examine sociodemographic characteristics and different forms of IPV. Results Of the 500 women who were interviewed, 18.8% experienced some physical and/or sexual violence during pregnancy. Forty-one women (9%) reported having experienced some physical and/or sexual violence at one to nine months postpartum. Physical and/or sexual IPV during pregnancy was associated with cohabiting (AOR 2.2, 95% CI 1.24–4.03) and having a partner who was 25 years old or younger (AOR 2.7, 95% CI 1.08–6.71). Postpartum, physical and/or sexual IPV was associated with having a partner who was 25 years old or younger (AOR 4.4, 95% CI 1.24–15.6). Conclusion We found that IPV is more prevalent during pregnancy than during the postpartum phase. There is also continuity and maintenance of IPV during and after pregnancy. These results call for policy and interventions to be tailored for pregnant and postpartum women. PMID:27755559
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
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.
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
Mwakagile, D; Mmari, E; Makwaya, C; Mbwana, J; Biberfeld, G; Mhalu, F; Sandstrom, E
Objectives: To investigate sex specific sexual behaviour in youths visiting a youth clinic for sexual and reproductive health in Dar es Saalam. Methods: A questionnaire was administered to a random sample of youths between 10 and 24 years of age attending the youth health clinic in Dar es Saalam. The clinical investigation included testing for syphilis and HIV-1 antibodies Results: 1423 youths attended the clinic between September 1997 and August 1998. The study population comprised 213 (53.5%) males and 185 (46.5%) females. 97 (24.4%) were below 20 years. The mean age at coitarche was 16.5 and 17.0 years of age for males and females, respectively. The coitarche was involuntary in 15 females (8.6%). 49.5% males reported more than five lifetime partners compared with 14.1% for females (p<0.0001). Males reported recent partners to be 2.5 years younger, while females reported them to be 5.0 years older. No contraceptive use was reported by 29.7% of the males and 40.3% of females. 52.7% females had been pregnant and 26 (14.1%) reported induced abortions. Genital discharge was found in 69.5% and 73.9% and GUD in 36.6% and 27.1% of males and females respectively. 12 males (5.9%) and 43 females (24.6%) were found to be HIV-1 infected. 13.8% of the females with only one lifetime partner were HIV-1 infected compared with 40.9% with more than five partners (p = 0.028). Conclusions: Many youths in Dar es Salaam engage in sexual behaviours that put them at risk of unwanted pregnancies and STIs including HIV infection. Female youths were more likely to contract HIV infection than males. In African urban areas youth oriented clinics can have a pivotal role in HIV/STI prevention and control Key Words: youth; sexual behaviour; HIV PMID:11463924
Pickering, Amy J.; Boehm, Alexandria B.; Mwanjali, Mathew; Davis, Jennifer
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
Adams, Lisa V; Kreiswirth, Barry N; Arbeit, Robert D; Soini, Hanna; Mtei, Lillian; Matee, Mecky; Bakari, Muhammad; Lahey, Timothy; Wieland-Alter, Wendy; Shashkina, Elena; Kurepina, Natalia; Driscoll, Jeffrey R; Pallangyo, Kisali; Horsburgh, C Robert; von Reyn, C Fordham
Molecular typing of Mycobacterium tuberculosis can be used to elucidate the epidemiology of tuberculosis, including the rates of clustering, the frequency of polyclonal disease, and the distribution of genotypic families. We performed IS6110 typing and spoligotyping on M. tuberculosis strains isolated from HIV-infected subjects at baseline or during follow-up in the DarDar Trial in Tanzania and on selected community isolates. Clustering occurred in 203 (74%) of 275 subjects: 124 (80%) of 155 HIV-infected subjects with baseline isolates, 56 (69%) of 81 HIV-infected subjects with endpoint isolates, and 23 (59%) of 39 community controls. Overall, 113 (41%) subjects had an isolate representing the East Indian "GD" family. The rate of clustering was similar among vaccine and placebo recipients and among subjects with or without cellular immune responses to mycobacterial antigens. Polyclonal disease was detected in 6 (43%) of 14 patients with multiple specimens typed. Most cases of HIV-associated tuberculosis among subjects from this study in Dar es Salaam resulted from recently acquired infection. Polyclonal infection was detected and isolates representing the East Indian GD strain family were the most common.
Bui, Thanh C.; Nyoni, Joyce E.; Ross, Michael W.; Mbwambo, Jessie; Markham, Christine M.; McCurdy, Sheryl A.
Understanding the associations between sexual motivation and sexual risk behaviors of men who have sex with men (MSM) is critical for developing effective HIV prevention interventions. To examine these associations, we employed data from a survey of 200 MSM in Dar es Salaam, Tanzania, recruited through respondent driven sampling. Results showed that 44.5% of surveyed participants most often looked for love/affection when having sex, and 36.5% most often looked for money. Money-motivated MSM were more likely to identify themselves as bisexual, more likely to have anal sex, and had significantly higher numbers of partners of both sexes. Those who most often looked for love/affection were less likely to ask for condom use, to actually use a condom, and to use lubrication in anal sex. MSM with different sexual motivations had dissimilar sexual risk behaviors. Tailored health interventions for each group to reduce these sexual risks for STIs/HIV prevention are needed. PMID:24890184
Jangu, Neema William; Tam, Ailie; Maticka-Tyndale, Eleanor
A poverty-HIV narrative has dominated many HIV prevention strategies in Africa despite epidemiological data showing higher prevalence of infection among educated and wealthier women in several African countries. This paper examines the perspectives of professional and entrepreneurial women on HIV risk and vulnerability based on their knowledge and lived experiences, comparing this to the HIV discourse evident in five strategic documents that shape intervention in Tanzania. The purpose is to uncover the confluence and dissonance between the discourses of government and those of professional women themselves. Qualitative research methods included critical discourse analysis of five strategic documents and thematic analysis of 37 in-depth interviews with women. The findings challenge fixed representations of women and notions of vulnerability embedded in the poverty-HIV discourse. Women described using their sexuality and sexual agency as a means to elevate their position in ways that made them vulnerable to sexual harassment and coercion. This is explored through two intersecting themes: non-marital sexual exchanges to gain an education or employment, and marriage. The intersecting social positions and constructions of female sexuality and agency expressed by the women in this study provide insights into other avenues and forms of HIV vulnerability.
Capuano, Paolo; Sellerino, Mariangela; Di Ruocco, Angela; Kombe, Wilbard; Yeshitela, Kumelachew
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
Background Skin diseases are underestimated and overlooked by most clinicians despite being common in clinical practice. Many patients are hospitalized with co-existing dermatological conditions which may not be detected and managed by the attending physicians. The objective of this study was to determine the burden of co-existing and overlooked dermatological disorders among patients admitted to medical wards of Muhimbili National hospital in Dar es Salaam. Study design and settings A hospital-based descriptive cross-sectional study conducted at Muhimbili National hospital in Dar es Salaam, Tanzania. Methods Patients were consecutively recruited from the medical wards. Detailed interview to obtain clinico-demographic characteristics was followed by a complete physical examination. Dermatological diagnoses were made mainly clinically. Appropriate confirmatory laboratory investigations were performed where necessary. Data was analyzed using the 'Statistical Package for Social Sciences' (SPSS) program version 10.0. A p-value of < 0.5 was statistically significant. Results Three hundred and ninety patients admitted to medical wards were enrolled into the study of whom, 221(56.7%) were females. The mean age was 36.7 ± 17.9 (range 7-84 years). Overall, 232/390 patients (59.5%) had co-existing dermatological disorders with 49% (191/390) having one, 9% (36/390) two and 5 patients (1%) three. A wide range of co-existing skin diseases was encountered, the most diverse being non-infectious conditions which together accounted for 36.4% (142/390) while infectious dermatoses accounted for 31.5% (123/390). The leading infectious skin diseases were superficial fungal infections accounting for 18%. Pruritic papular eruption of HIV/AIDS (PPE) and seborrheic eczema were the most common non-infectious conditions, each accounting for 4.3%. Of the 232/390 patients with dermatological disorders, 191/232 (82.3%) and 154/232 (66.3%) had been overlooked by their referring and admitting
Background Many blinding eye conditions of childhood are preventable or treatable, particularly in developing countries. However, primary eye care (PEC) for children is poorly developed, leading to unnecessary visual loss. Activities for control by health workers entail interventions for systemic conditions (measles, vitamin A deficiency), identification and referral of children with sight threatening conditions and health education for caregivers. This pilot study evaluated integrating a package of activities to promote child eye health into Reproductive and Child Health (RCH) services in Dar-es-Salaam, Tanzania. Methods Design: historical comparison study. Fifteen Clinical Officers and 15 nurses in 15 randomly selected RCH clinics were trained in PEC for children in July 2010. They were given educational materials (poster and manual) and their supervisors were orientated. Knowledge and practices were assessed before and 3 weeks after training. One year later their knowledge and practices were compared with a different group of 15 Clinical Officers and 15 nurses who had not been trained. Results Before training staff had insufficient knowledge to identify, treat and refer children with eye diseases, even conjunctivitis. Some recommended harmful practices or did not know that cataract requires urgent referral. Eye examination, vitamin A supplementation of mothers after delivery and cleaning the eyes at birth with instillation of antibiotics (Crede’s prophylaxis) were not routine, and there were no eye-specific educational materials. Three weeks after training several clinics delivering babies started Crede’s prophylaxis, vitamin A supplementation of women after delivery increased from 83.7% to 100%, and all staff included eye conditions in health education sessions. At one year, trained staff were more likely to correctly describe, diagnose and treat conjunctivitis (z=2.34, p=0.04)(30%-vs-60.7%). Mystery mothers observed health education sessions in 7/10 RCH
Mkupasi, Ernatus M; Ngowi, Helena A; Nonga, Hezron Emmanuel
A study was carried out to establish the prevalence of extra-intestinal porcine helminth infections and to assess the pig slaughter slab sanitary conditions in Dar es Salaam city, Tanzania. A total of 24 privately owned pig slaughter slabs were assessed. All slaughter slabs were sub-standard; wrongly located, poorly designed and constructed and lacked most basic requirements for a slaughter house. Because of inadequate slaughtering, disposal and cleaning facilities, the slaughter slabs were under unhygienic condition with questionable safety, soundness and wholesomeness of the pork produced. Routine meat inspection procedures were used to detect extra-intestinal porcine helminth infections. Of the 731 examined pigs; 8.1%, 5.9% and 0.4% were infected with ascariosis, porcine cysticercosis and hydatidosis, respectively. It was noted that almost all slaughter pigs in Dar es Salaam originated from different regions. Based on the region of origin, the status of porcine cysticercosis was 8.2% for Dodoma (n = 98), 8.2% for Manyara (n = 260) and 6.9% for Mbeya (n = 116). This study disclosed the unhygienic sanitary condition prevailing in Dar es Salaam pig slaughter slabs and recommends that strategies should be devised to improve the situation. Porcine ascariosis and cysticercosis were widely prevalent and caused economic losses due to condemnations. Because of their zoonotic nature, the observed extra-intestinal porcine helminth infections in pig pose a public health risk among consumers. Thus, there is a need to introduce appropriate control measures of parasitic infections in pigs.
Mwakitalu, Mbutolwe E; Malecela, Mwele N; Mosha, Franklin W; Simonsen, Paul E
Rapid urbanization in resource poor countries often results in expansion of unplanned settlements with overcrowding and inadequate sanitation. These conditions potentially support transmission of schistosomiasis and soil transmitted helminths (STH), but knowledge on the occurrence, transmission and control of these infections in urban settings is limited. The present study assessed the status of urinary schistosomiasis and STH across two different-sized cities in Tanzania - Dar es Salaam and Tanga - after a decade of anthelminthic intervention. Primary school children were examined for parasite eggs in urine and stool. Questionnaires were administered to the children, and observations were made on the urban environments. The burden of urinary schistosomiasis and STH was found to be low in both cities (overall 1.2% in Dar es Salaam and 0.3% in Tanga for urinary schistosomiasis; overall <1% in Dar es Salaam and 1-2% in Tanga for each STH infection), and the identified cases showed no clear pattern of spatial distribution. The findings indicated that a marked decrease in prevalence of these infections had occurred in the two cities during recent years. The observed promising developments appeared to have been accomplished by implementation of drug based intervention programs, in combination with environmental change (fewer snail habitats) and generally improved levels of hygiene. Continued efforts, including anthelminthic treatment and health education, are important to maintain these positive achievements.
Aveika, Akum; Spiegelman, Donna; Hawkins, Claudia; Armstrong, Catharina; Liu, Enju; Okuma, James; Chalamila, Guerino; Kaaya, Sylvia; Mugusi, Ferdinand; Fawzi, Wafaie
Background. Elevated blood pressure has been reported among treatment naïve HIV-infected patients. We investigated prevalence of hypertension and its associated risk factors in a HAART naïve HIV-infected population in Dar es Salaam, Tanzania. Methods. A cross-sectional analysis was conducted among HAART naïve HIV-infected patients. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg. Overweight and obesity were defined as body mass index (BMI) between 25.0–29.9 kg/m2 and ≥30 kg/m2, respectively. We used relative risks to examine factors associated with hypertension. Results. Prevalence of hypertension was found to be 12.5%. After adjusting for possible confounders, risk of hypertension was 10% more in male than female patients. Patients aged ≥50 years had more than 2-fold increased risk for hypertension compared to 30–39-years-old patients. Overweight and obesity were associated with 51% and 94% increased risk for hypertension compared to normal weight patients. Low CD4+ T-cell count, advanced WHO clinical disease stage, and history of TB were associated with 10%, 42%, and 14% decreased risk for hypertension. Conclusions. Older age, male gender, and overweight/obesity were associated with hypertension. Immune suppression and history of TB were associated with lower risk for hypertension. HIV treatment programs should screen and manage hypertension even in HAART naïve individuals. PMID:27872756
Saleem, Haneefa T.; Mushi, Dorothy; Hassan, Saria; Bruce, R. Douglas; Cooke, Alexis; Mbwambo, Jessie; Lambdin, Barrot H.
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
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
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
Kajula, Lusajo J; Darling, Nancy; Kaaya, Sylvia F; De Vries, Hein
Parenting styles and practices are suggested to be important predictors of adolescent sexual health, mostly in Europe and North America. Limited research has been conducted on these processes in Sub-Saharan Africa, which has different patterns of adolescent sexual behavior and family traditions. This study qualitatively explored parenting practices and styles associated with adolescent sexual health in Tanzania, with 12 adolescents and 12 parents of adolescents. The themes we identified from the data included parental monitoring, preventive, and punitive behaviors. Parents were reported to use mostly punitive behaviors to correct or prohibit sexual behavior; parents also set clear rules about appropriate sexual behavior (e.g., modesty and abstinence). Parents were also reported to closely monitor their adolescent children's friendships and sexual behavior to minimize sexual behavior. However, some parents also engaged in positive preventive practices aimed at protecting their adolescent children.
Poles, Gabriela; Li, Michelle; Siril, Hellen; Mhalu, Aisa; Hawkins, Claudia; Kaaya, Sylvia; Aris, Eric; Chalamilla, Guerino; Hirschhorn, Lisa R
Health system responsiveness (HSR), a measure of patient health care experience, may influence adherence to HIV/AIDS care and be an important predictor of outcomes. We studied the relationship between HSR, patient factors, and visit nonadherence in 16 President's Emergency Plan for AIDS Relief-supported HIV/AIDS clinics in Dar es Salaam. An HSR survey was administered in 2009, and all clinic visits 1 year following the interviews were analyzed for 720 patients on antiretrovirals (ARVs). Definitions of visit nonadherence were (1) low visit constancy ([VC], no visit in ≥1 quarter), (2) gaps in care (>60 days between visits), (3) no visit in last quarter (VLQ). The relationships between factors were analyzed using multivariate analysis with adjusted odds ratio (AOR) and 95% confidence intervals (CI) reported. Few patients were nonadherent using VLQ (14%) and VC (28%). Gaps in care were more common (49.6%) and associated with younger age (AOR: 3.86 [2.02-7.40]), no explanation of side effects (AOR: 2.21 [1.49-3.28]), and shorter antiretroviral therapy (ART) duration (0-3 months AOR: 1.49 [1.09-2.03]; 3-6 months AOR: 2.44 [1.40-4.25]). No VLQ was associated with younger age (AOR: 3.40 [1.63-7.07]), poor health care worker (HCW) communication (AOR: 4.83 [1.39-16.78]), and less time on ART (0-3 months AOR: 5.04 [2.47-10.30]; 3-6 months AOR: 3.09 [1.72-5.57]). Younger age, poor HCW communication, and shorter ART duration also predicted lower VC, as did higher patient-HCW ratios. The rates of visit nonadherence differed based on the definitions used. Younger age, shorter time on ART, and poor HCW communication predicted lower adherence regardless of the definition. More work is needed to understand the relationship between HSR, patient factors, and different patterns of visit nonadherence and their impact on ART outcomes.
Mujinja, Phares; Kilewo, Charles; Bärnighausen, Till; Orsini, Nicola; Manji, Karim; Biberfeld, Gunnel; Sando, David; Geldsetzer, Pascal; Ekström, Anna Mia
Background Mother-to-child transmission (MTCT) of HIV remains a major source of new HIV infections in children. Prevention of mother-to-child transmission of HIV (PMTCT) using lifelong antiretroviral treatment (ART) for all pregnant and breastfeeding women living with HIV (Option B+) is the major strategy for eliminating paediatric HIV. Ensuring that patients are satisfied with PMTCT services is important for optimizing uptake, adherence and retention in treatment. Methods We conducted a facility based quantitative cross-sectional survey in Dar-es-Salaam, Tanzania, between March and April 2014, when the country was transitioning to the implementation of PMTCT Option B+. We interviewed 595 pregnant and breastfeeding women living with HIV, who received PMTCT care in 36 public health facilities. Predictors of overall dissatisfaction with PMTCT services were identified using a multiple logistic regression. Results Overall 8% of the patients expressed dissatisfaction with PMTCT services. Patients who perceived health care workers (HCW) communication skills as poor, had a 5-fold (OR 4.9, 95% CI 1.8–13.4) increased risk of dissatisfaction and those who perceived HCW capacity to understand client concerns as poor, had a 6-fold (OR 5.7, 95% CI 2.3–14.0) increased risk. Having a total visit time longer than two hours was associated with a 2-fold increased risk of being dissatisfied (OR 2.3, 95% CI 1.1–4.7). Every 30-minute increment in total visit time was associated with a 10% higher (OR 1.1, 95% CI 1.0–1.2) risk of being dissatisfied. The probability of being dissatisfied ranged from 4% (95% CI 2% - 6%) in the presence of patient-perceived good communication, good understanding of patient concerns, and a total visit time below two hours, to 70% (95% CI 47% - 86%) if HCW failed in all of these aspects. Conclusion Patient dissatisfaction with PMTCT services was generally low; reflecting that quality of care was maintained during Tanzania’s transition to Option B
Scanlan, Trish; Kaijage, Jane
East Africa was at the forefront of early achievements and discoveries in paediatric oncology thanks to Denis Burkitt's seminal work. Although these successes have been built upon and continued elsewhere, they were sadly not sustained in sub-Saharan Africa for a variety of reasons. In recent years however this situation is slowly changing in countries across the continent. Tanzania is one such African country. Until very recently, survival rates of 5-10% for all children's cancers were expected. However, change has been brought about thanks to the combined efforts and commitments of the Tanzanian Ministry of Health, non-governmental organizations--such as The International Network for Cancer Treatment and Research, and Children in Crossfire-- and the participation of the private sector. Services are rapidly developing and outcomes are continuing to improve with 1-year survival rates of approximately 60% achieved. Efforts to maintain this early progress are concentrated around providing high quality local subspecialty medical training and continued local ownership of the programme.
Kaaya, S F; Mbwambo, J K; Fawzi, M C Smith; Van Den Borne, H; Schaalma, H; Leshabari, M T
Several studies show depression is common during pregnancy. However, there is limited information in Tanzania on the magnitude of perceived distress during pregnancy and meanings ascribed to such distress. A descriptive survey collected data using unstructured interviews from 12 traditional practitioners and 10 peri-urban women with previous pregnancy related mental health concerns identified using a depression vignette. The objectives were to describe the sources and characteristics of distress during pregnancy, and idioms of distress that could inform cultural adaptation of depression screening tools. Narrative analysis showed an emergent category of "problematic pregnancies" framed women's recollections of prolonged periods of sadness. This experience was qualified using various idioms of distress that were differentially emphasized depending on informant's perceived causes of health concern. The idiom kusononeka was consistently used to describe extreme sadness across causal categories and clustered with at least two typical features of major depression. This suggested existence of a construct with similarities to biomedical criteria for depression. "Thinking too much" emerged as a distinctive expression associated with prolonged sadness. Distinctive expressions of social functioning impairments were identified that can inform depression severity assessments. In conclusion, contextual inquiry into experiences of psychological distress showed distinct local idioms that clustered in patterns similar to symptoms of biomedical depressive episodes. Further studies to assess the utility of local idioms of distress and distress related functional impairment in depression assessment tools are warranted.
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
Meli, Benjamin Mbeba
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…
Background Preventing malaria by controlling mosquitoes in their larval stages requires regular sensitive monitoring of vector populations and intervention coverage. The study assessed the effectiveness of operational, community-based larval habitat surveillance systems within the Urban Malaria Control Programme (UMCP) in urban Dar es Salaam, Tanzania. Methods Cross-sectional surveys were carried out to assess the ability of community-owned resource persons (CORPs) to detect mosquito breeding sites and larvae in areas with and without larviciding. Potential environmental and programmatic determinants of habitat detection coverage and detection sensitivity of mosquito larvae were recorded during guided walks with 64 different CORPs to assess the accuracy of data each had collected the previous day. Results CORPs reported the presence of 66.2% of all aquatic habitats (1,963/2,965), but only detected Anopheles larvae in 12.6% (29/230) of habitats that contained them. Detection sensitivity was particularly low for late-stage Anopheles (2.7%, 3/111), the most direct programmatic indicator of malaria vector productivity. Whether a CORP found a wet habitat or not was associated with his/her unfamiliarity with the area (Odds Ratio (OR) [95% confidence interval (CI)] = 0.16 [0.130, 0.203], P < 0.001), the habitat type (P < 0.001) or a fence around the compound (OR [95%CI] = 0.50 [0.386, 0.646], P < 0.001). The majority of mosquito larvae (Anophelines 57.8% (133/230) and Culicines 55.9% (461/825) were not reported because their habitats were not found. The only factor affecting detection of Anopheline larvae in habitats that were reported by CORPs was larviciding, which reduced sensitivity (OR [95%CI] = 0.37 [0.142, 0.965], P = 0.042). Conclusions Accessibility of habitats in urban settings presents a major challenge because the majority of compounds are fenced for security reasons. Furthermore, CORPs under-reported larvae especially where larvicides were applied. This UMCP
Mbwambo, H A; Magwisha, H B; Mfinanga, J M
Evaluation trials of the efficacy of buparvaquone (BUTA-kel KELA Laboratoria, N.V. Belgium), as a treatment of field cases of Theileria parva infection (East Coast fever - ECF) were carried out on 63 cattle in the peri-urban of Dar Es Salaam city, Tanzania, during the period November 2004 to August 2005. Thirty-two cattle (56%) received single-dose treatment (2.5 mg buparvaquone per kg body weight), while two and three-dose treatment with interval(s) of 48 h was given to 33% and 11% of total treated cattle, respectively; 38 cattle (60.3%) were treated at an early stage of the disease, while 25 cattle (39.7%) were treated at an advanced stage of the disease. The rectal body temperature of 90.5% of buparvaquone-treated cattle dropped to normal values (37.5-39.5 degrees C) by day 7 of treatment, and by day 15 of treatment 96.8% of treated cattle showed normal values. Pulmonary signs were observed in 8/68 (11.8%) of total ECF diagnosed cattle and were successfully treated, albeit with parvaquone plus frusemide (Fruvexon); were not included in final evaluation of the efficacy of BUTA-kel. The present evaluation trials record a recovery rate of 95.2%. Buparvaquone (BUTA-kel KELA Laboratoria, N.V. Belgium), therefore, records another efficacious and valuable alternative treatment against East Coast fever in Tanzania.
Muganyizi, Projestine S; Kilewo, Charles; Moshiro, Candida
This cross-sectional household survey was conducted in Dar es Salaam between July and August 2000. The objectives were to establish the magnitude of rape against women, the perpetrators, disclosure of events and other related factors. Among the 1004 women who completed their interviews, 20% said they were ever raped. The known perpetrators were responsible for 92% of the most recent events. Whereas 34% of events were disclosed for non-legal purposes, only 10% were disclosed to the police. Repeated rape and patterns of disclosure were significantly associated with existing social relationships with the perpetrator. The results indicate that rape against women is a serious public health problem in Dar es Salaam commonly involving people who are close to the victims.
Jackson, Msafiri M
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
Tellevik, Marit G.; Moyo, Sabrina J.; Blomberg, Bjørn; Hjøllo, Torunn; Maselle, Samuel Y.; Langeland, Nina; Hanevik, Kurt
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
Castro, Marcia C; Tsuruta, Atsuko; Kanamori, Shogo; Kannady, Khadija; Mkude, Sixbert
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
Mbuligwe, Stephen E; Kaseva, Mengiseny E
Pollution and self-purification trends of an urban river namely, Msimbazi River, in Dar es Salaam City, Tanzania, were investigated. Site investigations and water quality analyses were done. The river is polluted in terms of high organic and nutrient concentrations, low dissolved oxygen, and high counts of indicator organisms. Biochemical oxygen demand (BOD5) concentrations were 27-340 mg/L. Dissolved oxygen was found to be as low as 0.9 mg O2/L. Bacteriological pollution increased with distance downstream of the river, a trend attributable to an increase in the catchment of pollution sources, which are on-site sanitation systems. Although the river has an appreciable self-purification capacity, the capacity is strained by persistent pollution overloads. The pollution plight of the river is attributable to its being flanked by expanding human habitats and vibrant industrial, institutional, and socio-economic activities. Provision for pretreatment of discharges into the river is put forward as a remedial measure for the observed pollution. Matching non-technical and techno-social remedial measures are also recommended. These include sensitization of polluters on merits of environmental protection practices such as cleaner production and strict enforcement of environmental protection laws.
Kivaria, F M; Noordhuizen, J P T M; Msami, H M
Smallholder dairy herds around the Dar es Salaam region of Tanzania supply 86% of raw milk consumed by the city dwellers. Previous studies have indicated that clinical mastitis is an important disease affecting smallholder dairy cows and an 18-month questionnaire-based longitudinal field-study was conducted between July 2003 and March 2005 to elucidate risk factors associated with the incidence. A total of 6057 quarter-level observations from 317 lactating cows on 87 randomly selected smallholder dairy herds were analysed at the quarter and cow level using logistic and Poisson regression models, respectively. At the quarter level, the average incidence rate of clinical mastitis was 38.4 cases per 100 quarter-years at risk whereas at the cow level the incidence rate was 43.3 cases per 100 cow-years at risk. The incidence was significantly (P< or =0.001) associated with cow factors (body condition score, parity, stage of lactation, and udder consistency), housing (floor type) conditions and milking (cow and udder preparation) practices. It was concluded that the extrapolation of the classic ten-point mastitis control plan into smallholder dairy herds should be undertaken cautiously. An integrated approach to dairy extension should focus more on the creation of mastitis awareness among smallholder producers and on the improvement of animal nutrition and reproduction indices-factors that may also have a direct impact on milk yield.
Kivaria, F M; Noordhuizen, J P T M
A 31-year record-based retrospective study was carried out to determine the aetiology and temporal distribution of bovine clinical mastitis in smallholder dairy herds in the Dar es Salaam region of Tanzania over the period November 1971-December 2002. Laboratory information on 1964 quarter samples from 1365 cows in 281 smallholder dairy herds were retrieved, compiled and studied. Eighty-eight percent of the quarter samples were culture-positive and the predominant mastitis pathogens isolated were Staphylococcus aureus (25.7%), Streptococcus agalactiae (15.4%), Klebsiella pneumoniae (14.3%) and Escherichia coli (14.1%). Other isolates included Pseudomonas aeruginosa (7.5%), Streptococcus dysgalactiae (5.2%) and Streptococcus uberis (4.2%). Contagious mastitis pathogens were isolated from 45.6% of the culture-positive samples, whereas environmental and miscellaneous pathogens were isolated from 48.2% and 5.7%, respectively. Thirty percent of the miscellaneous mastitis pathogens were Candida species. The results demonstrate a steady increase in clinical Candida albicans mastitis. The prevalence of Candida albicans has increased from 1% in 1971 to 17.0% in November 2002. Conversely, despite some fluctuations, the prevalence of Staphylococcus aureus, Streptococcus agalactiae, E. coli and K. pneumoniae remain above 10%. The possible risk factors for these observations are discussed.
Nonga, Hezron E; Simforian, Edeltruds A; Ndabikunze, Bernadette K
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.
Mtimavalye, L A; Runyoro, D E; Massawe, F N; Mhalu, F S; Kanyawana, J Z
This study was designed to determine the prevalence of significant bacteriuria in pregnancy in Dar es Salaam as well as attempt to find out whether bacteriuria has any effects on the mother and baby. Of 1007 pregnant women studied for asymptomatic bacteriuria, a significant bacteriuria rate of 6.3% was revealed. Escherichia coli was the predominant organism, making up 47.6% of the total organisms isolated. Schistosoma hematobium was present in 8.7%, T. vaginalis in 14%, yeast cells were found in the urine of 9.1% and the microfilariae of Wuchereria bancrofti were found in 1 specimen. 66.2% had no abnormality in their urine. It is recommended on the basis of this study that all women found to have significant bacteriuria in 1 cultured urine sample should be treated. There was a significant relationship noted between significant bacteriuria and the passing of S. hematobium in the urine. There was also a significant correlation between the presence of T. vaginalis and yeast cells in the urine. On the basis of laboratory sensitivity studies it was also found that the antimicrobial agents of choice for treating urinary tract infections in Dar es Salaam where E. coli and Klebsiella erogenes are the predominant organisms are nitrofurantoin, nalidixic acid and co-trimoxazole. The socioeconomic status of the bacteriuric and control group was divided into 4 groups according to take home pay; results show no significant increase of bacteriuria in any of the groups. It was not possible to follow up the effects of the presence of micro-organisms in urine during pregnancy because once a woman was found to have a positive culture she was treated.
Urio, Loveness John; Mohamed, Mohamed Ally; Mghamba, Janneth; Abade, Ahmed; Aboud, Said
Introduction The aim of this study was to evaluate the performance of Enzygnost HIV Integral II antigen/antibody combination ELISAs in order to formulate HIV ELISA testing algorithms for the Ministry of Health and Social Welfare, Tanzania. Methods This was a laboratory-based evaluation of Enzygnost HIV Integral II Antibody/ Antigen, Murex HIV antigen/antibody and Vironostika HIV Uniform II antigen/antibody conducted between October 2011 and May 2012. Results A total of 600 blood samples were included in the evaluation. A total of 209/596 (35.1%) serum samples were confirmed HIV positive. Of these, the prevalence of HIV infection was 2.3% (3/130), 2.3% (3/127), 2.2% (3/139) and 100% (200/200) for VCT clients, ANC attendees, blood donors and CTC patients, respectively. Three hundred and eighty seven (64.9%) were HIV negative samples. Sensitivity was 100% (95% CI; 98.3-100%) for all the three HIV ELISAs. The specificity for the Enzygnost HIV Integral II and Murex was 100% (95% CI; 99.1-100%). The final specificity at repeat testing was 99.5% (95% CI; 98.2-99.9%) for Vironostika. Enzygnost HIV Integral II detected HIV infection seven days since first bleed. Conclusion Initial testing using either Vironostika or Murex HIV antigen/antibody combination ELISA followed by testing of reactive samples on the Enzygnost HIV Integral II gave a sensitivity and specificity of 100% with reduced window period. Combination of two HIV antigen/antibody combination ELISAs can be used as an alternative confirmatory testing strategy for screening of donated blood at the National and Zonal blood transfusion centres and in lab diagnosis of HIV infection. PMID:26113927
Makubi, Abel N; Mugus, Ferdinand; Magesa, Pius M; Roberts, David; Quaresh, Amrana
There is paucity of data describing the risk factors for anaemia among HIV infected children in Tanzania. This cross sectional study aimed at determining the contributing factors for anaemia among HIV-infected children attending Muhimbili National Hospital in Dar es Salaam. Both univariate and multivariate logistic regression analyses were performed to identify possible factors associated with anaemia in HIV-infected children. In this study a total of 75 (44%) patients among 167 recruited HIV children aged 6 months to 59 months were found to be anaemic (Hg<11 g/dl). Multivariate logistic regression demonstrated that not being on HAART (OR 3.40, 95%CI (1.20-9.60), having CD4% <25% (OR 2.30, 95%CI (1.20-34.60), having a history of tuberculosis (TB) (OR 3.23, 95%CI (1.10-9.70) and having hookworm infestation (OR 5.97, 95%CI (1.92-18.4) were independent risk factors for anaemia among HIV infected children. The analyses also showed that being HIV positive for ≥ 2.5 years resulted into a low risk of severe anaemia compared to being HIV positive for < 2.5 years. Taking multivitamins (OR 0.07, 95%, CI (0.020-0.30) and antihelminthics (OR 0.27, 95%CI (0.10-0.74) were also protective against anaemia in children. Similar factors (with exception of using antihelmintics) were associated with severe anaemia. In conclusion the factors associated with anaemia in HIV infected children were multifactorial in nature. Efforts to correct anaemia in HIV infected children should include use of HAART and treatment of infections such as TB and hookworms.
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
Sappa, Giuseppe; Ergul, Sibel; Ferranti, Flavia; Sweya, Lukuba Ngalya; Luciani, Giulia
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
Muganyizi, Projestine S; Hogan, Nora; Emmelin, Maria; Lindmark, Gunilla; Massawe, Siriel; Nystrom, Lennarth; Axemo, Pia
Social reactions to rape are socioculturally determined and have a strong influence on the coping and recovery of the survivor. The existing knowledge on social reactions emanates from Western countries with limited research attention on non-Western populations, particularly sub-Saharan Africa. We aimed to establish the types and perceptions of social reactions that are expressed to rape survivors and people's intentions to express them to survivors of varied social backgrounds in Tanzania. Using triangulation of research methods, experiences of social reactions among rape survivors (n = 50) and nurses (n = 44) from a community in Tanzania were explored, and the intentions to express typical social reactions to rape survivors of different social backgrounds were established from a representative community sample (n = 1,505). Twelve typical social reactions were identified with the positive reactions more commonly mentioned than the negative reactions. Nondisclosure of rape events and distracting the survivor from the event were perceived as both positive and negative. A commercial sex worker was most vulnerable to negative reactions. The cultural influences of social reactions and implications for practical applicability of the results are discussed.
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
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
Premji, Z.; Makwaya, C.; Minjas, J. N.
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
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…
Castro, Marcia C.; Kanamori, Shogo; Kannady, Khadija; Mkude, Sigsbert; Killeen, Gerry F.; Fillinger, Ulrike
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
Vitta, Bineti S; Benjamin, Margaret; Pries, Alissa M; Champeny, Mary; Zehner, Elizabeth; Huffman, Sandra L
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.
Bakari, Muhammad; Urassa, Willy; Pallangyo, Kisali; Swai, Andrew; Mhalu, Fred; Biberfeld, Gunnel; Sandström, Eric
Current HIV management guidelines are based on natural history studies from the developed world. Data on the similarity of the natural course of HIV-1 infection conflict with studies in the developing world. A cohort of 1887 hotel workers with no access to antiretroviral therapy was followed between 1990 and 1998 in Dar es Salaam through annual clinical evaluations and CD4+ T-lymphocyte (CD4 cell) count determinations. 196 (10.4%) were HIV-1 sero-prevalents; 133 (7.9%) were HIV-1 sero-incidents; and 1558 (82.6%) remained HIV seronegative. Follow-up duration was 13,719 and 82,742 months for HIV-1 seropositives and HIV seronegatives respectively. Clinical events occurred at median CD4 cell counts similar to those previously reported from the developed world, but death occurred at higher counts. Off-duty last 6 months, chronic diarrhoea and a faster CD4 cell count decline were associated with faster disease progression and death. In Tanzania HIV natural history is similar to that from the developed world and similar management guidelines could be employed.
Mushi, Douglas; Byamukama, Denis; Kirschner, Alexander K T; Mach, Robert L; Brunner, K; Farnleitner, Andreas H
Sanitary inspection of wells was performed according to World Health Organization (WHO) procedures using risk-of-contamination (ROC) scoring in the peri-urban tropical lowlands of Dar es Salaam, Tanzania. The ROC was assessed for its capacity to predict bacterial faecal pollution in the investigated well water. The analysis was based on a selection of wells representing environments with low to high presumptive faecal pollution risk and a multi-parametric data set of bacterial indicators, generating a comprehensive picture of the level and characteristics of faecal pollution (such as vegetative Escherichia coli cells, Clostridium perfringens spores and human-associated sorbitol fermenting Bifidobacteria). ROC scoring demonstrated a remarkable ability to predict bacterial faecal pollution levels in the investigated well water (e.g. 87% of E. coli concentration variations were predicted by ROC scoring). Physicochemical characteristics of the wells were not reflected by the ROC scores. Our results indicate that ROC scoring is a useful tool for supporting health-related well water management in urban and suburban areas of tropical, developing countries. The outcome of this study is discussed in the context of previously published results, and future directions are suggested.
Kivaria, F M; Noordhuizen, J P T M; Kapaga, A M
A cross-sectional study was conducted to determine three parameters of the quality of the raw milk marketed by milk selling points (MSPs) in Dar es Salaam region. Total bacterial count (TBC) was used as an indicator of the microbial quality of the milk; antimicrobial residues were determined; and the California mastitis test (CMT) was used to screen for milk somatic cells as an indication of the mastitis level in the cows that provided the milk. Moreover, a water sample at each MSP was taken for bacteriological culturing. Finally, a questionnaire survey was conducted with the milk sellers at the MSPs to identify risk factors for poor milk hygiene. A total of 128 milk samples and corresponding water samples were collected from randomly selected milk selling points in Dar es Salaam region. The mean TBC was (8.2 +/- 1.9) x 10(6) cfu/ml, and major bacterial isolates from the milk samples were Escherichia coli (6.3%), Bacillus cereus (6.3%), Staphylococcus aureus (6.3%) and Streptococcus agalactiae (6.3%), Enterobacter aerogenes (5.6%) and Enterococcus faecalis (4.7%). In most cases, the organisms identified in milk corresponded to those isolated from the corresponding water samples. Of milk samples, 79.0% were positive to the CMT and 7.0% were positive for antimicrobial residues. TBC was normalized by log-transformation, and the possible predictors of TBC were identified by fitting two linear regression models. In a random effect model, water microbial quality, frequency of cleaning the milk containers, frequency of milk supply, milk storage time and the type of containers, and mixing of fresh and previous milk were significantly (p < 0.05) associated with the mean log TBC. In a fixed effect model, in addition to these indicators, water shortage, water source and the refrigerator condition were significantly (p < or = 0.01) associated with log TBC. It was concluded that the milk sold in Dar es Salaam region is of poor quality and is of public health significance.
Rumisha, Cyrus; Elskens, Marc; Leermakers, Martine; Kochzius, Marc
The influence of trace metal pollution on the community structure of soft bottom molluscs was investigated in intertidal areas of the Dar es Salaam coast. Significant enrichment of As, Mn, Mo, Sb, and Zn in sediments was recorded. Redundancy analysis indicated that trace metal pollution contributed 68% of the variation in community structure. Monte Carlo permutation test showed that As and Sb contributed significantly to variation in species composition. T-value biplots and van Dobben circles showed that the gastropods Acteon fortis, Assiminea ovata, and Littoraria aberrans, were negatively affected by As and Sb, while the bivalve Semele radiata and the gastropod Conus litteratus were only negatively affected by As. Bioaccumulation of As, Cd, Cu, Mo and Zn occurred in the bivalve Mactra ovalina and the gastropod Polinices mammilla. This calls for regular monitoring and management measures.
Gaspare, Lydia; Machiwa, John F; Mdachi, S J M; Streck, Georg; Brack, Werner
Surface sediment and oyster samples from the inter-tidal areas of Dar es Salaam were analyzed for 23 polycyclic aromatic hydrocarbons (PAHs) including the 16 compounds prioritized by US-EPA using GC/MS. The total concentration of PAHs in the sediment ranged from 78 to 25,000 ng/g dry weight, while oyster concentrations ranged from 170 to 650 ng/g dry weight. Hazards due to sediment contamination were assessed using Equilibrium Partitioning Sediment Benchmarks and Threshold Effect Levels. Diagnostic indices and principle component analysis were used to identify possible sources. Interestingly, no correlation between sediment and oyster concentrations at the same sites was found. This is supported by completely different contamination patterns, suggesting different sources for both matrices. Hazard assessment revealed possible effects at six out of eight sites on the benthic communities and oyster populations. The contribution of PAH intake via oyster consumption to carcinogenic risks in humans seems to be low.
Yhdego, M.; Majura, P. )
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.
The main thesis of this paper, which uses Tanzania's broadcasting system--Radio Tanzania Dar Es Salaam (RTD)--as a case study, is that media systems reflect the political and economic systems of the nation within which they operate subject to certain constraints. This discussion includes: (1) the history of the country's broadcasting policy before…
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…
Mtebe, Joel S.; Dachi, Hilary; Raphael, Christina
Since 1985, Tanzania has been undergoing significant political and economic changes from a centralized to a more market-oriented and globally connected economy. The University of Dar es Salaam (UDSM) has responded to these changes by reviewing its legal status, vision, and functions, particularly those related to research, teaching, and public…
The costs of providing antiretroviral therapy services to HIV-infected individuals presenting with advanced HIV disease at public health centres in Dar es Salaam, Tanzania: Findings from a randomised trial evaluating different health care strategies
Kimaro, Godfather Dickson; Mfinanga, Sayoki; Simms, Victoria; Kivuyo, Sokoine; Bottomley, Christian; Hawkins, Neil; Harrison, Thomas S.; Jaffar, Shabbar; Guinness, Lorna
Background Understanding the costs associated with health care delivery strategies is essential for planning. There are few data on health service resources used by patients and their associated costs within antiretroviral (ART) programmes in Africa. Material and methods The study was nested within a large trial, which evaluated screening for cryptococcal meningitis and tuberculosis and a short initial period of home-based adherence support for patients initiating ART with advanced HIV disease in Tanzania and Zambia. The economic evaluation was done in Tanzania alone. We estimated costs of providing routine ART services from the health service provider's perspective using a micro-costing approach. Incremental costs for the different novel components of service delivery were also estimated. All costs were converted into US dollars (US$) and based on 2012 prices. Results Of 870 individuals enrolled in Tanzania, 434 were enrolled in the intervention arm and 436 in the standard care/control arm. Overall, the median (IQR) age and CD4 cell count at enrolment were 38 [31, 44] years and 52 [20, 89] cells/mm3, respectively. The mean per patient costs over the first three months and over a one year period of follow up following ART initiation in the standard care arm were US$ 107 (95%CI 101–112) and US$ 265 (95%CI 254–275) respectively. ART drugs, clinic visits and hospital admission constituted 50%, 19%, and 19% of the total cost per patient year, while diagnostic tests and non-ART drugs (co-trimoxazole) accounted for 10% and 2% of total per patient year costs. The incremental costs of the intervention to the health service over the first three months was US$ 59 (p<0.001; 95%CI 52–67) and over a one year period was US$ 67(p<0.001; 95%CI 50–83). This is equivalent to an increase of 55% (95%CI 51%–59%) in the mean cost of care over the first three months, and 25% (95%CI 20%–30%) increase over one year of follow up. PMID:28234969
Raphael, Christina; Mtebe, Joel S.
The adoption of blended learning to widen access, reduce cost, and improve the quality of education is becoming prevalent in higher education in sub-Saharan Africa and Tanzania in particular. University of Dar es Salaam and the Open University of Tanzania offer various blended learning courses using Moodle system via regional centres scattered…
Onguko, Brown Bully; Abdalla, Mohamed; Webber, Charles F.
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…
Stanifer, John W.; Patel, Uptal D.; Karia, Francis; Thielman, Nathan; Maro, Venance; Shimbi, Dionis; Kilaweh, Humphrey; Lazaro, Matayo; Matemu, Oliver; Omolo, Justin; Boyd, David
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
Kilewo, Charles; Karlsson, Katarina; Swai, Andrew; Massawe, Augustine; Lyamuya, Eligius; Mhalu, Fred; Biberfeld, Gunnel
The objective of this study was to analyze the mortality during the first 24 months after delivery in relation to CD4 T-lymphocyte levels and viral load at enrollment (36 weeks of gestation) in a cohort of HIV-1-seropositive breast-feeding women at the Dar es Salaam site of the multicenter Petra trial (a mother-to-child HIV-1 transmission intervention trial using antiretroviral therapy). Antiretroviral treatment was not available in this setting apart from the short treatment given within the trial around delivery to prevent mother-to-child transmission of HIV. T-lymphocyte subsets were determined by flow cytometry. Plasma HIV-1 RNA was quantified by the Amplicor HIV-1 RNA Monitor v 1.5 assay. Mortality after delivery was analyzed using the life-table technique and Cox regression. The analysis included 266 mothers. The CD4 cell counts at enrollment were <200 cells/mm in 14.5% of the mothers. The viral load at enrollment was >100,000 RNA copies/mL in 33.6% of the mothers. The mortality 24 months after delivery was 6.7% (95% CI = 3.1-10.1%). The mortality 24 months after delivery was 29.9% (95% CI = 13.1-46.9%) for mothers with <200 CD4 cells/mm at enrollment, 3.3% (95% CI = 0-6.6%) for mothers with 200-499 CD4 cells/mm, 2.9% (95% CI = 0-7.1%) for mothers with >500 CD4 cells/mm (P = 0.0000), 15.0% (95% CI = 6.6-23.4%) for mothers with viral load >100,000 copies/mL at enrollment, and 2.8% (95% CI = 0-5.6%) for mothers with viral load <100,000 copies/mL (P = 0.0000). In the multivariate analysis CD4 cell counts and viral load were both independent risk factors for mortality (P < 0.001 and P = 0.004, respectively). In conclusion, the mortality was high among women with severe immunosuppression or high viral load at enrollment, but not in the rest of the women. CD4 lymphocyte count in late pregnancy was a better predictor of death within 2 years than was viral load. The results support the World Health Organization recommendation to initiate antiretroviral treatment in
Interpretation of California mastitis test scores using Staphylococcus aureus culture results for screening of subclinical mastitis in low yielding smallholder dairy cows in the Dar es Salaam region of Tanzania.
Kivaria, F M; Noordhuizen, J P T M; Nielen, M
Screening of subclinical mastitis under field conditions is done using the California mastitis test (CMT). CMT score of > or = 1 corresponding to > or = 500,000 somatic cells ml(-1) is commonly used as threshold of subclinical mastitis in temperate countries. However, given the innately high physiological level of somatic cells in low yielding dairy cows, this threshold may not apply to low yielding dairy cows. The current study was undertaken to investigate the clinical utility of CMT for screening of Staphylococcus aureus subclinical mastitis in low yielding smallholder dairy cows in Tanzania. A total of 1151 of quarter-milk samples were CMT tested, of these 914-originated from cows with a lactation period of 14-305 days. All samples were screened for subclinical mastitis by the CMT as well as microbiological culture of single, duplicate (two consecutive) and triplicate (three consecutive) samples as a gold standard. For the duplicate and triplicate quarter-samples, cows were considered positive for S. aureus subclinical mastitis if results of microbiologic culture for S. aureus were positive for two of two, and for at least two of the first three consecutive quarter-milk samples collected from that cow, respectively. Using a CMT score of > or = 1 would classify 78.6% of the 940 quarter-samples as positive. Eighty-two percent of the samples in which S. aureus was isolated had CMT scores > or = 2; this would classify 51.6% of the 940 quarter-samples as positive. For the single sample, this cut-off had sensitivity, specificity and likelihood ratio for S. aureus of 0.87, 0.83 and 4.24, respectively. For the duplicate quarter-milk samples this cut-off had sensitivity, specificity, and likelihood ratio of 0.94, 0.86, and 5.19. While, for the triplicate quarter-milk samples this cut-off had sensitivity, specificity and likelihood ratio of 0.97, 0.92 and 7.47, respectively. Based on these results and practical considerations, it is concluded that CMT score of > or = 2
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
Kenton, O; Dachi, J; Metz, J; Avery, S
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.
Francis, Joel M; Kakoko, Deodatus; Tarimo, Edith A M; Munseri, Patricia; Bakari, Muhammad; Sandstrom, Eric
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
Mboya, Beati; Temu, Florence; Awadhi, Bayoum; Ngware, Zubeda; Ndyetabura, Elly; Kiondo, Gloria; Maridadi, Janneth
Introduction Currently, Tanzania's HIV prevalence is 5.7%. Gender inequality and Gender Based Violence (GBV) are among factors fuelling the spread of HIV in Tanzania. This study was conducted to assess universal access to HIV prevention services among GBV survivors in Iringa and Dar-es-Salaam where HIV prevalence is as high as 14.7% and 9% respectively compared to a national average of 5.7%. Methods In 2010, a mixed methods study using triangulation model was conducted in Iringa and Dar-es-Salaam regions to represent rural and urban settings respectively. Questionnaires were administered to 283 randomly selected survivors and 37 health providers while 28 in-depth interviews and 16 focus group discussions were conducted among various stakeholders. Quantitative data was analyzed in SPSS by comparing descriptive statistics while qualitative data was analyzed using thematic framework approach. Results Counseling and testing was the most common type of HIV prevention services received by GBV survivors (29%). Obstacles for HIV prevention among GBV survivors included: stigma, male dominance culture and fear of marital separation. Bribery in service delivery points, lack of confidentiality, inadequate GBV knowledge among health providers, and fear of being involved in legal matters were mentioned to be additional obstacles to service accessibility by survivors. Reported consequences of GBV included: psychological problems, physical trauma, chronic illness, HIV infection. Conclusion GBV related stigma and cultural norms are obstacles to HIV services accessibility. Initiation of friendly health services, integration of GBV into HIV services and community based interventions addressing GBV related stigma and cultural norms are recommended. PMID:23467278
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
Sambo, Maganga; Johnson, Paul C. D.; Hotopp, Karen; Changalucha, Joel; Cleaveland, Sarah; Kazwala, Rudovick; Lembo, Tiziana; Lugelo, Ahmed; Lushasi, Kennedy; Maziku, Mathew; Mbunda, Eberhard; Mtema, Zacharia; Sikana, Lwitiko; Townsend, Sunny E.; Hampson, Katie
Rabies can be eliminated by achieving comprehensive coverage of 70% of domestic dogs during annual mass vaccination campaigns. Estimates of vaccination coverage are, therefore, required to evaluate and manage mass dog vaccination programs; however, there is no specific guidance for the most accurate and efficient methods for estimating coverage in different settings. Here, we compare post-vaccination transects, school-based surveys, and household surveys across 28 districts in southeast Tanzania and Pemba island covering rural, urban, coastal and inland settings, and a range of different livelihoods and religious backgrounds. These approaches were explored in detail in a single district in northwest Tanzania (Serengeti), where their performance was compared with a complete dog population census that also recorded dog vaccination status. Post-vaccination transects involved counting marked (vaccinated) and unmarked (unvaccinated) dogs immediately after campaigns in 2,155 villages (24,721 dogs counted). School-based surveys were administered to 8,587 primary school pupils each representing a unique household, in 119 randomly selected schools approximately 2 months after campaigns. Household surveys were conducted in 160 randomly selected villages (4,488 households) in July/August 2011. Costs to implement these coverage assessments were $12.01, $66.12, and $155.70 per village for post-vaccination transects, school-based, and household surveys, respectively. Simulations were performed to assess the effect of sampling on the precision of coverage estimation. The sampling effort required to obtain reasonably precise estimates of coverage from household surveys is generally very high and probably prohibitively expensive for routine monitoring across large areas, particularly in communities with high human to dog ratios. School-based surveys partially overcame sampling constraints, however, were also costly to obtain reasonably precise estimates of coverage. Post
Mweya, Clement N.; Kimera, Sharadhuli I.; Stanley, Grades; Misinzo, Gerald; Mboera, Leonard E. G.
Background Dengue is the second most important vector-borne disease of humans globally after malaria. Incidence of dengue infections has dramatically increased recently, potentially due to changing climate. Climate projections models predict increases in average annual temperature, precipitation and extreme events in the future. The objective of this study was to assess the effect of changing climate on distribution of dengue vectors in relation to epidemic risk areas in Tanzania. Methods/Findings We used ecological niche models that incorporated presence-only infected Aedes aegypti data co-occurrence with dengue virus to estimate potential distribution of epidemic risk areas. Model input data on infected Ae. aegypti was collected during the May to June 2014 epidemic in Dar es Salaam. Bioclimatic predictors for current and future projections were also used as model inputs. Model predictions indicated that habitat suitability for infected Ae. aegypti co-occurrence with dengue virus in current scenarios is highly localized in the coastal areas, including Dar es Salaam, Pwani, Morogoro, Tanga and Zanzibar. Models indicate that areas of Kigoma, Ruvuma, Lindi, and those around Lake Victoria are also at risk. Projecting to 2020, we show that risk emerges in Mara, Arusha, Kagera and Manyara regions, but disappears in parts of Morogoro, Ruvuma and near Lake Nyasa. In 2050 climate scenario, the predicted habitat suitability of infected Ae. aegypti co-occurrence with dengue shifted towards the central and north-eastern parts with intensification in areas around all major lakes. Generally, model findings indicated that the coastal regions would remain at high risk for dengue epidemic through 2050. Conclusion/Significance Models incorporating climate change scenarios to predict emerging risk areas for dengue epidemics in Tanzania show that the anticipated risk is immense and results help guiding public health policy decisions on surveillance and control of dengue epidemics. A
Justice, C. J.
80% of Tanzania's population is involved in the agriculture sector. Despite this national dependence, agricultural reporting is minimal and monitoring efforts are in their infancy. The cropland mask developed through this study provides the framework for agricultural monitoring through informing analysis of crop conditions, dispersion, and intensity at a national scale. Tanzania is dominated by smallholder agricultural systems with an average field size of less than one hectare (Sarris et al, 2006). At this field scale, previous classifications of agricultural land in Tanzania using MODIS course resolution data are insufficient to inform a working monitoring system. The nation-wide cropland mask in this study was developed using composited Landsat tiles from a 2010-2013 time series. Decision tree classifiers methods were used in the study with representative training areas collected for agriculture and no agriculture using appropriate indices to separate these classes (Hansen et al, 2013). Validation was done using random sample and high resolution satellite images to compare Agriculture and No agriculture samples from the study area. The techniques used in this study were successful and have the potential to be adapted for other countries, allowing targeted monitoring efforts to improve food security, market price, and inform agricultural policy.
Kisanga, Felix; Mbwambo, Jessie; Hogan, Norah; Nystrom, Lennarth; Emmelin, Maria; Lindmark, Gunilla
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…
Aaro, Leif E.; Breivik, Kyrre; Klepp, Knut-Inge; Kaaya, Sylvia; Onya, Hans E.; Wubs, Annegreet; Helleve, Arnfinn; Flisher, Alan J.
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…
KELLY, ANN H.; LEZAUN, JAVIER
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
Tancred, Tara; Schellenberg, Joanna; Marchant, Tanya
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
Katalambula, Leonard K.; Ntwenya, Julius Edward; Ngoma, Twalib; Buza, Joram; Mpolya, Emmanuel
Background. Colorectal cancer (CRC) is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (χ2) tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06%) and females (49.94%), although gender likelihood of diagnosis type (i.e., rectal or colon) was significantly different (P = 0.027). More than 60% of patients were between 40 and 69 years. Conclusions. Age (P = 0.0183) and time (P = 0.004) but not gender (P = 0.0864) were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P = 0.0405), age (P = 0.0015), and time (P = 0.0075) were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate. PMID:27965709
Miraji, H.; Othman, O. C.; Ngassapa, F. N.; Mureithi, E. W.
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
Miraji, H; Othman, O C; Ngassapa, F N; Mureithi, E W
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.
Clack, Zoanne A; Keim, Mark E; Macintyre, Anthony G; Yeskey, Kevin
In 1998, terrorists simultaneously bombed United States Embassies in Dar es Salaam, Tanzania and Nairobi, Kenya. The local response to these bombings was unorganized and ad hoc, indicating the need for basic disaster preparedness and improvement of emergency management capabilities in both countries. In this context, risk and risk management are defined and are related to the health hazards affecting Tanzanians and Kenyans. In addition, the growing number of injuries in Tanzania is addressed and the relationship between risk management and injury is explored. Also, an emergency medicine-based strategy for injury control and prevention is proposed. Implications of implementing such a protocol in developing nations also are discussed.
Buchta, Katja; Abo El Wafa, Hany; Printz, Andreas; Pauleit, Stephan
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
Wang, Alice; Hardy, Colleen; Rajasingham, Anangu; Martinsen, Andrea; Templin, Lindsay; Kamwaga, Stanislaus; Sebunya, Kiwe; Jhuthi, Brenda; Habtu, Michael; Kiberiti, Stephen; Massa, Khalid; Quick, Rob; Mulungu, Jane; Eidex, Rachel; Handzel, Thomas
Since August 2015, the Ministry of Health, Community Development, Gender, Elderly and Children (MoHCDGEC) of Tanzania has been leading the response to a widespread cholera outbreak. As of June 9, 2016, cholera had affected 23 of 25 regions in Tanzania, with 21,750 cumulative cases and 341 deaths reported (Ally Nyanga, MoHCDGEC Emergency Operations Center, personal communication, June 2016). Approximately one fourth of all cases occurred in the Dar es Salaam region on the east coast. Regions surrounding Lake Victoria, in the north, also reported high case counts, including Mwanza with 9% (Ally Nyanga, MoHCDGEC Emergency Operations Center, personal communication, June 2016). Since the start of the outbreak, MoHCDGEC and the Ministry of Water (MOW) have collaborated with the Tanzania Red Cross Society, United Nations Children's Fund (UNICEF), World Health Organization (WHO), and CDC to enhance the water, sanitation, and hygiene (WASH) response to prevent the further spread of cholera.
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…
Shubi, Farrid M; Hamza, Omar JM; Kalyanyama, Boniphace M; Simon, Elison NM
Background Human bites in the maxillofacial region compromise function and aesthetics, resulting in social and psychological effects. There is paucity of information regarding human bite injuries in Tanzania. The aim of the study was to assess the occurrence, treatment modalities and prognosis of human bite injuries in the oro-facial region at the Muhimbili National Hospital Dar es Salaam, Tanzania. Methods In a prospective study the details of patients with human bite injuries in the oro-facial region who attended at the Department of Oral and Maxillofacial Surgery of the Muhimbili National Hospital between January 2001 and December 2005 were recorded. Data included information on age, sex, site, duration of the injury at the time of reporting to hospital, reasons, details of treatment offered and outcome after treatment. Results A total of 33 patients, 13 males and 20 females aged between 12 and 49 years with human bite injuries in the oro-facial region were treated. Thirty patients presented with clean uninfected wounds while 3 had infected wounds. The most (45.5%) frequently affected site was the lower lip. Treatment offered included thorough surgical cleansing with adequate surgical debridement and primary suturing. Tetanus prophylaxis and a course of broad-spectrum antibiotics were given to all the patients. In 90% of the 30 patients who were treated by suturing, the healing was uneventful with only 10% experiencing wound infection or necrosis. Three patients who presented with wounds that had signs of infection were treated by surgical cleansing with debridement, antibiotics and daily dressing followed by delayed primary suturing. Conclusion Most of the human bite injuries in the oro-facial region were due to social conflicts. Although generally considered to be dirty or contaminated they could be successfully treated by surgical cleansing and primary suture with a favourable outcome. Management of such injuries often need multidisciplinary approach. PMID
Madulu, N F
Population strategies to relieve the density pressures on land and resources in Tanzania have not considered the basic causes of population growth. Resettlement results in the same environmental degradation as in the original settlement. There should be a reduction in the population growth and planning of proper land use and resource exploitation before resettlement. Rural development must include a decline in the dependency on subsistence agriculture. Population in Tanzania increased by 213% during 1948-88. An absolute increase in population size during 1978-88 is recorded despite a slight decline in the rate of growth. Death rates declined, but birth rates were relatively stable at around 50 per 1000 population. Regions with the highest growth rates were Dar es Salaam (4.8%), Rukwa (4.3%), Arusha (3.8%), Mbeya (3.1%), and Ruvuma (3.2%). The regions with the lowest rates were Tanga and Kilimanjaro (2.1%), Coast (2.1%), Lindi (2%), and Mtwara (1.4%). Low growth rates are attributed to low fertility and high infertility. Other factors affecting high growth rates are culture, rates of natural increase, intensity of internal and international migration, climatic conditions, and availability of resources. In 1988 46% of the population was under 15 years old. Per capita land availability declined from 11.8 hectares in 1948 to 3.8 hectares in 1988. The number of landless peasants increased. Productivity declined, and distances to farms increased. The total fertility rate was 6.5 children per woman in 1988 and 6.1 during 1991-92. Slight declines were apparent in the crude birth rate also. High fertility was a response to universal marriage, low contraceptive use (7% using modern methods during 1991-92), declining lactation periods, high mortality rates, and old traditions favoring large families. Children were used extensively in time-consuming and labor-intensive activities, such as fetching water. The mean number of children ever born was higher among women with 1
Kachur, S Patrick; Black, Carolyn; Abdulla, Salim; Goodman, Catherine
Background Recently global health advocates have called for the introduction of artemisinin-containing antimalarial combination therapies to help curb the impact of drug-resistant malaria in Africa. Retail trade in artemisinin monotherapies could undermine efforts to restrict this class of medicines to more theoretically sound combination treatments. Methods This paper describes a systematic search for artemisinin-containing products at a random sample of licensed pharmacies in Dar-es-Salaam, Tanzania in July 2005. Results Nineteen different artemisinin-containing oral pharmaceutical products, including one co-formulated product, one co-packaged product, and 17 monotherapies were identified. All but one of the products were legally registered and samples of each product were obtained without a prescription. Packaging and labeling of the products seldom included local language or illustrated instructions for low-literate clients. Packaging and inserts compared reasonably well with standards recommended by the national regulatory authority with some important exceptions. Dosing instructions were inconsistent, and most recommended inadequate doses based on international standards. None of the monotherapy products mentioned potential benefits of combining the treatment with another antimalarial drug. Conclusion The findings confirm the widespread availability of artemisinin monotherapies that led the World Health Organization to call for the voluntary withdrawal of these drugs in malaria-endemic countries. As the global public health community gathers resources to deploy artemisinin-containing combination therapies in Africa, planners should be mindful that these drugs will coexist with artemisinin monotherapies in an already well-established market place. In particular, regulatory authorities should be incorporated urgently into the process of planning for rational deployment of artemisinin-containing antimalarial combination therapies. PMID:16569252
Pearson, P. N.; Hudson, W.
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.
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
Boller, Christoph; Wyss, Kaspar; Mtasiwa, Deo; Tanner, Marcel
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
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
Dempewolf, J.; Becker-Reshef, I.; Nakalembe, C. L.; Tumbo, S.; Maurice, S.; Mbilinyi, B.; Ntikha, O.; Hansen, M.; Justice, C. J.; Adusei, B.; Kongo, V.
In-season monitoring of crop conditions provides critical information for agricultural policy and decision making and most importantly for food security planning and management. Nationwide agricultural monitoring in countries dominated by smallholder farming systems, generally relies on extensive networks of field data collectors. In Tanzania, extension agents make up this network and report on conditions across the country, approaching a "near-census". Data is collected on paper which is resource and time intensive, as well as prone to errors. Data quality is ambiguous and there is a general lack of clear and functional feedback loops between farmers, extension agents, analysts and decision makers. Moreover, the data are not spatially explicit, limiting the usefulness for analysis and quality of policy outcomes. Despite significant advances in remote sensing and information communication technologies (ICT) for monitoring agriculture, the full potential of these new tools is yet to be realized in Tanzania. Their use is constrained by the lack of resources, skills and infrastructure to access and process these data. The use of ICT technologies for data collection, processing and analysis is equally limited. The AgriSense-STARS project is developing and testing a system for national-scale in-season monitoring of smallholder agriculture using a combination of three main tools, 1) GLAM-East Africa, an automated MODIS satellite image processing system, 2) field data collection using GeoODK and unmanned aerial vehicles (UAVs), and 3) the Tanzania Crop Monitor, a collaborative online portal for data management and reporting. These tools are developed and applied in Tanzania through the National Food Security Division of the Ministry of Agriculture, Food Security and Cooperatives (MAFC) within a statistically representative sampling framework (area frame) that ensures data quality, representability and resource efficiency.
Ulisubisya, Mpoki; Jörnvall, Henrik; Irestedt, Lars; Baker, Tim
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.
Pereira, Catherine; Sweet, Lara; Khin, Mengkheang; Ndiaye Coly, Aminata; Sy Gueye, Ndeye Yaga; Adhikary, Indu; Dhungel, Shrid; Makafu, Cecilia; Zehner, Elizabeth; Huffman, Sandra L.
Abstract 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
Mbogo, Shaaban Aman
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.
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
Mwambete, K D; Lyombe, F
An in vitro evaluation of the anti-microbial activity of medicated soaps was conducted using ditch-plate and hand washing techniques. Strains of reference microbes namely Candida albicans (ATCC90028), Staphylococcus aureus (ATCC25923), Pseudomonas aureginosa (ATCC27853) and Escherichia coli (ATCC25922) were tested at three different soaps' concentrations (1.0, 4.0 and 8.0 mg/ml). A total of 16 medicated soaps were assayed for their antimicrobial efficacy. Of these, 13 were medicated and 3 non-medicated soaps, which served as control. Ciprofloxacin and ketaconazole were employed as positive controls. Label disclosure for the soaps' ingredients and other relevant information were absorbed. The most common antimicrobial active ingredients were triclosan, trichloroxylenol and trichlorocarbanilide. ANOVA for means of zones of inhibition revealed variability of antimicrobial activity among the medicated soaps. Positive correlation (r=0.318; P<0.01) between zones of inhibition and soaps' concentrations was evidenced. Hand washing frequencies positively correlated with microbial counts. Roberts(®) soap exhibited the largest zone of inhibition (34 mm) on S. aureus. Candida albicans was the least susceptible microbe. Regency(®) and Dalan(®) exhibited the least zone of inhibition on the tested bacteria. Protex(®), Roberts(®), Family(®) and Protector(®) were equally effective (P<0.01) against S. aureus. In conclusion, majority of the assayed medicated soaps have satisfactory antibacterial activity; though lack antifungal effect with exception of Linda(®) liquid soap. The hand washing technique has proved to be inappropriate for evaluation of soaps' antimicrobial efficacy due to presence of the skin microflora.
Walraevens, Kristine; Mjemah, Ibrahimu Chikira; Mtoni, Yohana; Van Camp, Marc
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.
Mwambete, K. D.; Lyombe, F.
An in vitro evaluation of the anti-microbial activity of medicated soaps was conducted using ditch-plate and hand washing techniques. Strains of reference microbes namely Candida albicans (ATCC90028), Staphylococcus aureus (ATCC25923), Pseudomonas aureginosa (ATCC27853) and Escherichia coli (ATCC25922) were tested at three different soaps’ concentrations (1.0, 4.0 and 8.0 mg/ml). A total of 16 medicated soaps were assayed for their antimicrobial efficacy. Of these, 13 were medicated and 3 non-medicated soaps, which served as control. Ciprofloxacin and ketaconazole were employed as positive controls. Label disclosure for the soaps’ ingredients and other relevant information were absorbed. The most common antimicrobial active ingredients were triclosan, trichloroxylenol and trichlorocarbanilide. ANOVA for means of zones of inhibition revealed variability of antimicrobial activity among the medicated soaps. Positive correlation (r=0.318; P<0.01) between zones of inhibition and soaps’ concentrations was evidenced. Hand washing frequencies positively correlated with microbial counts. Roberts® soap exhibited the largest zone of inhibition (34 mm) on S. aureus. Candida albicans was the least susceptible microbe. Regency® and Dalan® exhibited the least zone of inhibition on the tested bacteria. Protex®, Roberts®, Family® and Protector® were equally effective (P<0.01) against S. aureus. In conclusion, majority of the assayed medicated soaps have satisfactory antibacterial activity; though lack antifungal effect with exception of Linda® liquid soap. The hand washing technique has proved to be inappropriate for evaluation of soaps’ antimicrobial efficacy due to presence of the skin microflora. PMID:22131630
Kokeyo, Carolyne Adhiambo; Oluoch, John
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…
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.
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
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
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
Silberschmidt, M; Rasch, V
Adolescent girls' early sexual activity, early pregnancy, induced abortions and the increase in HIV infections have become major concerns in Sub-Saharan Africa. Efforts, though, to understand their sexual behaviour and to prevent reproductive health problems are almost non-existent. Adolescent girls are normally seen as victims and easy preys of (often older and married) men's sexual exploitation. This article, which is based on a qualitative study of 51 adolescent girls who had just had an illegal abortion in Dar es Salaam, Tanzania, reveals that these girls are not only victims but also willing preys and active social agents engaging in high-risk sexual behaviour. In order to get material benefits they expose themselves to serious health risks, including induced abortion - without realising their own vulnerability. In our study, one out of four girls had more than one partner at the time they became pregnant, and many counted on an illegally induced abortion if they got pregnant. Even if adolescents are now allowed free access to family planning information, education and services, our study shows that this remains in the realm of theory rather than practice. Moreover, most adolescent girls are not aware about their right to such services. The paper concludes that the vulnerability of adolescent girls increases without the recognition that sexuality education and contraceptive services do not constitute a licence to practice illicit sex - but rather a means to create more mature and responsible attitudes and to increase sexual and reproductive health.
Rao, T. Ramachandra; Trpis, M.; Gillett, J. D.; Teesdale, C.; Tonn, R. J.
The single-larva survey method was employed to study the breeding places and seasonal incidence of Aedes aegypti in Dar es Salaam, Tanzania. From May 1968 to May 1969, 28 462 containers of water—located in approximately equal numbers indoors and outdoors—were investigated. The highest frequency of breeding (8.0%) of A. aegypti was observed in tires and motor parts. Drums, barrels, water-pots, and other receptacles left outdoors showed a higher frequency (3.1%) than those kept indoors (0.6%). Metal containers were infested to a greater extent than those made of mud, wood, or other materials; 2.5% of coconut shells, snail shells, etc. and 1.3% of tree holes, plant axils, and cut bamboos were infested. The seasonal prevalence, expressed as a container index, closely followed and paralleled the fluctuations in rainfall. The value of this survey method for both ecological studies and practical control purposes is discussed. PMID:4544149
Geneau, Robert; Massae, Patrick; Courtright, Paul; Lewallen, Susan
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.
Romijnders, Kim Agj; Nyoni, Joyce E; Ross, Michael W; McCurdy, Sheryl A; Mbwambo, Jessie; Kok, Gerjo; Crutzen, Rik
The lack of data on condom and lubricant use among African men who have sex with men (MSM) hinders prevention efforts. We describe use, knowledge, and access to lubricants in Dar es Salaam and Tanga, Tanzania. Data were collected in 2012 and 2013 from a cross-sectional survey of 200 MSM in Dar es Salaam and 100 MSM in Tanga, Tanzania. The most common reason for not using condoms was dislike of condoms. Two-thirds of the men reported always using a lubricant for anal sex. Results showed that: fewer men who have sex with both men and women (MSMW) know about lubricants; more MSM look for, have difficulty finding, and find lubricants to be expensive; and MSM use lubricants to facilitate penetration. MSMW commonly receive their lubricants from their sexual partner, while MSM got them from friends and pharmacies. HIV-negative MSM used lubricants to facilitate penetration and reduce pain. HIV-positive MSM are likely to get their lubricants from pharmacies or friends. MSMW use Vaseline® significantly more than MSM as a lubricant. Results suggest that HIV prevention knowledge among MSM is greater, so HIV prevention efforts should emphasise carrying water-based lubricant among MSMW. Consequently, there is an opportunity to co-market condoms and water-based lubricants.
Kisanga, Felix; Mbwambo, Jessie; Hogan, Norah; Nystrom, Lennarth; Emmelin, Maria; Lindmark, Gunilla
Through in-depth interviews, this study explored perceptions and experiences of key players handling child sexual offense cases in Dar es Salaam, Tanzania. The informants included public police investigators, magistrates, legal workers, and social workers working with nongovernmental organizations. The interviews were recorded, transcribed verbatim, and analyzed using qualitative content analysis. Five themes emerged summarizing factors associated with sexual offenses, including community passivity, legal system weaknesses, legal framework inadequacy, and key players' vulnerabilities. Addressing the identified weaknesses may promote justice, while changes in attitudes and norms are needed for the prevention of sexual offenses to children.
Rasch, V; Silberschmidt, M; Mchumvu, Y; Mmary, V
This article reports on a study of induced abortion among adolescent girls in Dar es Salaam, Tanzania, who were admitted to a district hospital in Dar es Salaam because of an illegally induced abortion in 1997. In the quantitative part of the study, 197 teenage girls (aged 14-19) were asked for socio-economic details, contraceptive knowledge/use, age at first intercourse and number of sexual partners. In the qualitative part, 51 teenage girls were interviewed in-depth about their relationships with their partners, sexual behaviour, contraceptive use and reasons for non-use, and why they became pregnant. The girls were sexually active at an early age and having sex mainly with men older than themselves. Although most of the girls were in love with and enjoyed sex with their partners, they also entered these relationships to obtain money or gifts in exchange for sex. Most were not using contraception or condoms though they were also at risk of STDs and HIV. These girls were getting pregnant expecting their boyfriends to marry them, or because they did not think they could become pregnant or failed to use contraception correctly. Most adolescent girls are not aware of the 1994 Tanzanian policy that gave them the right to seek family planning services and in practice these services are not being provided. There is a need for youth-friendly family planning services and to make abortion safe and legal, in order to reduce unwanted pregnancies and abortion-related complications and deaths among adolescent girls.
Chen, Christine; Gerace, Jay; Mehner, Nicole; Mohamed, Sharif; Reiss, Kelly
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.
LIU, Enju; MAKUBI, Abel; DRAIN, Paul; SPIEGELMAN, Donna; SANDO, David; LI, Nan; CHALAMILLA, Guerino; SUDFELD, Christopher R.; HERTZMARK, Ellen; FAWZI, Wafaie W.
Objective To determine the incidence rate and risk factors of tuberculosis (TB) among HIV-infected adults accessing antiretroviral therapy (ART) in Tanzania. Design A prospective observational study among HIV-infected adults attending 47 HIV clinics in Dar es Salaam. Methods We estimated TB incidence rates among HIV-infected patients prior to and after ART initiation. We used Cox proportional hazard regressions to determine the predictors of incident TB among HIV-infected adults enrolled in the HIV care and treatment program. Results We assessed 67,686 patients for a median follow-up period of 24 (interquartile range: 8–49) months; 7,602 patients were diagnosed with active TB. The TB incidence rate was 7.9 (95% Confidence Interval (CI), 7.6–8.2)/100 person-years prior to ART initiation, and 4.4(95%CI, 4.2–4.4)/100 person-years for patients receiving ART. In multivariate analyses, patients on ART in the first 3 months had a 57% higher risk of TB (Hazard Ratio:1.57, 95%CI:1.47–1.68) compared to those not on ART, but the risk significantly decreased with increasing duration of ART. Risk factors for incident TB included being male, having low body mass index or middle upper arm circumference, lower CD4 cell count, and advanced WHO disease stage. There was seasonal variation for incident TB, with higher risk observed following the rainy seasons (May, June, and November). Conclusion In TB endemic regions, HIV-infected patients initiating ART, particularly males and those with poor nutritional status, should be closely monitored for active TB in the months following ART initiation. In addition to increasing the access to ART, interventions should be considered to improve nutritional status among HIV-infected patients. PMID:26091295
Banyikwa, W F
A general survey of population distribution in Tanzania is first presented using data from censuses taken between 1948 and 1979. Variations in distribution patterns are identified and discussed. The author then considers both spontaneous and planned internal migration trends and the factors affecting them. The effects of the official policy to resettle the rural population in larger villages are considered. (summary in ENG, RUS)
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)
Feinstein, Sheryl; Mwahombela, Lucas
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…
Rasch, V; Muhammad, H; Urassa, E; Bergström, S
Illegal abortion is known to be a major contributor to maternal mortality. The objective of the study was firstly to identify women with illegally induced abortion, (IA) and to compare them with women admitted with a spontaneous abortion (SA) or receiving antenatal care (AC), and secondly to describe the circumstances which characterized the abortion. The population of this cross-sectional questionnaire study comprised patients from Temeke District Hospital, Dar es Salaam, Tanzania. After an in-depth confidential interview, 603 women with incomplete abortion were divided into two groups: 362 women with IA and 241 with SA. They were compared with 307 AC women. IA women were significantly younger, more often better educated, unmarried, nulliparous and students than AC women. Regarding civil-status, educational level, proportion of nullipara and proportion of students, SA patients were similar to AC women. These results lend support to the assumption that the in-depth confidential interview made it possible to distinguish IA women from SA women.
Mul, M. L.; Savenije, H. H. G.; Uhlenbrook, S.
Understanding hydrological processes in poorly or ungauged catchments is of utmost importance for the management of water resources. This paper shows that a high resolution time series of hydrological data (rainfall, evaporation and runoff) collected over a limited period of time (i.e. 1.5 years), can give a good picture of the hydrological processes occurring in a 25 km2 catchment in Tanzania (Vudee catchment). In addition, several techniques, incl. tracer and mapping studies, have been applied to identify flow paths and contribution from different sources. All this information was used for the development of a conceptual hydrological model. The conceptual model is based on the Lumped Elementary Watershed (LEW) concept, restructured for hourly time steps. An additional flux, representing the drainage into the neighbouring catchment, identified using a multi-method approach, increased the model performance significantly, particularly related to a recession curve occurring at high flows. This corroborates the assumption that there is water draining towards the neighbouring catchment. The model runs show that surface runoff only occurs during heavy rains or directly thereafter, which is consistent with results from hydrograph separation. Overall, the major part of the runoff is generated by groundwater. Moreover, the model shows that the unsaturated zone has a relatively large storage capacity. At the meso-scale, hydrological processes are governed by a sub-daily timescale. As a result, only a high resolution conceptual model is able to mimic the hydrological processes accurately. By applying the LEW model, incorporating the hydrological processes as observed in the catchment, a better understanding has been obtained of the dominant hydrological processes at this scale. This is a prerequisite for sustainable management of the water resources in a water scarce region.
Kazungu, Yvette E M; Mwega, Elisa; Neselle, Moses Ole; Sallu, Raphael; Kimera, Sharadhuli I; Gwakisa, Paul
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.
Kalolo, Albino; Radermacher, Ralf; Stoermer, Manfred; Meshack, Menoris; De Allegri, Manuela
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.
Maro, Isaac I.; Moshi, Ndeserua; Clavier, Odile H.; MacKenzie, Todd A.; Kline-Schoder, Robert J.; Wilbur, Jed C.; Chambers, Robert D.; Fellows, Abigail M.; Jastrzembski, Benjamin G.; Mascari, John E.; Bakari, Muhammad; Matee, Mecky; Musiek, Frank E.; Waddell, Richard D.; von Reyn, C. Fordham; Buckey, Jay C.
Objectives Abnormal hearing tests have been noted in HIV-infected patients in several studies, but the nature of the hearing deficit has not been clearly defined. We performed a cross-sectional study of both HIV+ and HIV− individuals in Tanzania using an audiological test battery. We hypothesized that HIV+ adults would have a higher prevalence of abnormal central and peripheral hearing test results compared to HIV− controls. Additionally, we anticipated that the prevalence of abnormal hearing assessments would increase with anti-retroviral therapy (ART) use, and treatment for tuberculosis (TB). Design Pure-tone thresholds, distortion product otoacoustic emissions (DPOAEs), tympanometry, and a gap detection test were performed using a laptop-based hearing testing system on 751 subjects (100 HIV− in the U.S., plus 651 in Dar es Salaam Tanzania including 449 HIV+ [130 ART− and 319 ART+], and 202 HIV−, subjects. No U.S. subjects had a history of TB treatment. In Tanzania, 204 of the HIV+, and 23 of the HIV−, subjects had a history of TB treatment. Subjects completed a video and audio questionnaire about their hearing as well as a health history questionnaire. Results HIV+ subjects had reduced DPOAE levels compared to HIV− subjects, but their hearing thresholds, tympanometry results, and gap detection thresholds were similar. Within the HIV+ group, those on ART reported significantly greater difficulties understanding speech-in-noise, and were significantly more likely to report that they had difficulty understanding speech than the ART− group. The ART+ group had a significantly higher mean gap detection threshold compared to the ART− group. No effects of TB treatment were seen. Conclusions The fact that the ART+/ART− groups did not differ in measures of peripheral hearing ability (DPOAEs, thresholds), or middle ear measures (tympanometry), but that the ART+ group had significantly more trouble understanding speech and higher gap detection thresholds
Background High levels of rural to urban migration are a feature of most African countries. Our aim was to investigate changes, and their determinants, in cardiovascular risk factors on rural to urban migration in Tanzania. Methods Men and women (15 to 59 years) intending to migrate from Morogoro rural region to Dar es Salaam for at least 6 months were identified. Measurements were made at least one week but no more than one month prior to migration, and 1 to 3 monthly after migration. Outcome measures included body mass index, blood pressure, fasting lipids, and self reported physical activity and diet. Results One hundred and three men, 106 women, mean age 29 years, were recruited and 132 (63.2%) followed to 12 months. All the figures presented here refer to the difference between baseline and 12 months in these 132 individuals. Vigorous physical activity declined (79.4% to 26.5% in men, 37.8% to 15.6% in women, p < 0.001), and weight increased (2.30 kg men, 2.35 kg women, p < 0.001). Intake of red meat increased, but so did the intake of fresh fruit and vegetables. HDL cholesterol increased in men and women (0.24, 0.25 mmoll-1 respectively, p < 0.001); and in men, not women, total cholesterol increased (0.42 mmoll-1, p = 0.01), and triglycerides fell (0.31 mmoll-1, p = 0.034). Blood pressure appeared to fall in both men and women. For example, in men systolic blood pressure fell by 5.4 mmHg, p = 0.007, and in women by 8.6 mmHg, p = 0.001. Conclusion The lower level of physical activity and increasing weight will increase the risk of diabetes and cardiovascular disease. However, changes in diet were mixed, and may have contributed to mixed changes in lipid profiles and a lack of rise in blood pressure. A better understanding of the changes occurring on rural to urban migration is needed to guide preventive measures. PMID:20497567
The goal of this study is to determine the age at menarche of girls from Tanzania examined in 2005 considering their families' social and material status. For the purpose of the analysis of the age at menarche, N = 71 girls were qualified (N = 8 from Dares Salaam and N = 63 from Mafinga) out of N = 98 who took part in the anthropological study. The calendar age of the girls who qualified for the determination of the age at menarche ranged from 12.9 to 22.7 years of age (X = 15.9 +/- 1.9). The age at menarche revealed using the recall method was 14.3 +/- 1.1 years. The menarche of the girls included in the study with a parent (mother or father) residing in town was found to be earlier (14.1 and 14.0 respectively). When neither parent completed schooling or had only primary education, the age at the daughter's menarche was on average 15.0 years. The girls whose fathers completed secondary school had their first menstruation at 14.8 years, while the daughters of mothers who finished secondary school--at 14.5. The lowest age at menarche was found in the group of girls whose parents obtained higher education (13.4 years in the case of the father and 13.3 in the case of the mother). A higher age at menarche was typical of the group of girls from families in which the number of children in the household was > or = 6 (15.2). In the two-way ANOVA equation, the lowest age at menarche was found in the girls whose families lived in town and had higher education, while the highest--where the family lived in the countryside and did not finish school or had primary school only. In the two-way ANOVA equation (education*self-estimation of the family's material situation), the lowest age at menarche (13.2) was found in the group where the father had higher education and the material situation was assessed as very good or rather good. My own studies are representative for similar African environments. The results obtained allow for comparison with research findings for highly
Chantry, Caroline J.; Young, Sera L.; Rennie, Waverly; Ngonyani, Monica; Mashio, Clara; Israel-Ballard, Kiersten; Peerson, Janet; Nyambo, Margaret; Matee, Mecky; Ash, Deborah; Dewey, Kathryn; Koniz-Booher, Peggy
Objective Heat-treating expressed breastmilk is recommended as an interim feeding strategy for HIV-exposed infants in resource-poor countries, but data on its feasibility are minimal. Flash-heating (FH) is a simple in-home technique for heating breastmilk that inactivates HIV while preserving its nutritional and anti-infective properties. Our primary objective was to determine, among HIV-infected mothers, the feasibility and protocol adherence of FH expressed breastmilk after 6 months of exclusive breastfeeding. Design Prospective longitudinal Participants 101 HIV-infected breastfeeding mothers Setting Dar es Salaam, Tanzania Intervention Peer counselors provided in-home counseling and support on infant feeding from 2 to 9 months postpartum. Mothers were encouraged to exclusively breastfeed for 6 months followed by FH expressed breastmilk if her infant was HIV-negative. Clinic-based staff measured infant growth and morbidity monthly and mothers kept daily logs of infant morbidity. FH behavior was tracked until 9 months postpartum using daily logs, in-home observations, and clinic-and home-based surveys. Bacterial cultures of unheated and heated milk samples were performed. Results Thirty-seven of 72 eligible mothers (51.4%) chose to Flash-heat. Median (range) frequency of milk expression was 3 (1–6) times daily and duration of method use on-study was 9.7 (0.1–15.6) weeks. Mean (SD) daily milk volume was 322 (201) mL (range 25–1120). No heated and 32 (30.5%) unheated samples contained bacterial pathogens. Conclusion FH is a simple technology that many HIV-positive women can successfully use after exclusive breastfeeding to continue to provide the benefits of breastmilk while avoiding maternal-to-child transmission associated with non-exclusive breastfeeding. Based on these feasibility data, a clinical trial of the effects of FH breastmilk on infant health outcomes is warranted. PMID:22362154
Masanja, Honorati; Smith, Emily R; Muhihi, Alfa; Briegleb, Christina; Mshamu, Salum; Ruben, Julia; Noor, Ramadhani Abdallah; Khudyakov, Polyna; Yoshida, Sachiyo; Martines, Jose; Bahl, Rajiv; Fawzi, Wafaie W
Summary Background Supplementation of vitamin A in children aged 6–59 months improves child survival and is implemented as global policy. Studies of the efficacy of supplementation of infants in the neonatal period have inconsistent results. We aimed to assess the efficacy of oral supplementation with vitamin A given to infants in the first 3 days of life to reduce mortality between supplementation and 180 days (6 months). Methods We did an individually randomised, double-blind, placebo-controlled trial of infants born in the Morogoro and Dar es Salaam regions of Tanzania. Women were identified during antenatal clinic visits or in the labour wards of public health facilities in Dar es Salaam. In Kilombero, Ulanga, and Kilosa districts, women were seen at home as part of the health and demographic surveillance system. Newborn infants were eligible for randomisation if they were able to feed orally and if the family intended to stay in the study area for at least 6 months. We randomly assigned infants to receive one dose of 50 000 IU of vitamin A or placebo in the first 3 days after birth. Infants were randomly assigned in blocks of 20, and investigators, participants’ families, and data analysis teams were masked to treatment assignment. We assessed infants on day 1 and day 3 after dosing, as well as at 1, 3, 6, and 12 months after birth. The primary endpoint was mortality at 6 months, assessed by field interviews. The primary analysis included only children who were not lost to follow-up. This trial is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), number ACTRN12610000636055. Findings Between Aug 26, 2010, and March 3, 2013, 31 999 newborn babies were randomly assigned to receive vitamin A (n=15 995) or placebo (n=16 004; 15 428 and 15 464 included in analysis of mortality at 6 months, respectively). We did not find any evidence for a beneficial effect of vitamin A supplementation on mortality in infants at 6 months (26 deaths per
Reyes, Teija; Quiroz, Roberto; Msikula, Shija
The East Usambara Mountains, recognized as one of the 25 most important biodiversity hot spots in the world, have a high degree of species diversity and endemism that is threatened by increasing human pressure on resources. Traditional slash and burn cultivation in the area is no longer sustainable. However, it is possible to maintain land productivity, decrease land degradation, and improve rural people's livelihood by ameliorating cultivation methods. Improved agroforestry seems to be a very convincing and suitable method for buffer zones of conservation areas. Farmers could receive a reasonable net income from their farm with little investment in terms of time, capital, and labor. By increasing the diversity and production of already existing cultivations, the pressure on natural forests can be diminished. The present study shows a significant gap between traditional cultivation methods and improved agroforestry systems in socio-economic terms. Improved agroforestry systems provide approximately double income per capita in comparison to traditional methods. More intensified cash crop cultivation in the highlands of the East Usambara also results in double income compared to that in the lowlands. However, people are sensitive to risks of changing farming practices. Encouraging farmers to apply better land management and practice sustainable cultivation of cash crops in combination with multipurpose trees would be relevant in improving their economic situation in the relatively short term. The markets of most cash crops are already available. Improved agroforestry methods could ameliorate the living conditions of the local population and protect the natural reserves from human disturbance.
Pima, John Marco; Odetayo, Michael; Iqbal, Rahat; Sedoyeka, Eliamani
This paper is about the use of a Mixed Methods approach in an investigation that sought to assess the available Information and Communication Technologies (ICT) infrastructure capable of supporting Collaborative Web Technologies (CWTs) in a Blended Learning (BL) environment in Tanzanian Higher Education Institutions (HEIs). We first used…
Ziwa, Michael H; Matee, Mecky I; Hang'ombe, Bernard M; Lyamuya, Eligius F; Kilonzo, Bukheti S
Human plague remains a public health concern in Tanzania despite its quiescence in most foci for years, considering the recurrence nature of the disease. Despite the long-standing history of this problem, there have not been recent reviews of the current knowledge on plague in Tanzania. This work aimed at providing a current overview of plague in Tanzania in terms of its introduction, potential reservoirs, possible causes of plague persistence and repeated outbreaks in the country. Plague is believed to have been introduced to Tanzania from the Middle East through Uganda with the first authentication in 1886. Xenopsylla brasiliensis, X. cheopis, Dinopsyllus lypusus, and Pulex irritans are among potential vectors while Lophuromys spp, Praomys delectorum, Graphiurus murinus, Lemniscomys striatus, Mastomys natalensis, and Rattus rattus may be the potential reservoirs. Plague persistence and repeated outbreaks in Tanzania are likely to be attributable to a complexity of factors including cultural, socio-economical, environmental and biological. Minimizing or preventing people's proximity to rodents is probably the most effective means of preventing plague outbreaks in humans in the future. In conclusion, much has been done on plague diagnosis in Tanzania. However, in order to achieve new insights into the features of plague epidemiology in the country, and to reorganize an effective control strategy, we recommend broader studies that will include the ecology of the pathogen, vectors and potential hosts, identifying the reservoirs, dynamics of infection and landscape ecology.
Mwaiselage, Julius; Bråtveit, Magne; Moen, Bente; Yost, Michael
Dust exposure levels were studied in a cement factory in Dar es Salaam, Tanzania, as part of an epidemiological study assessing chronic respiratory health effects. One hundred and twenty personal 'total' dust samples were collected from 80 randomly selected workers from eight a priori occupational groups (OGs) based on work areas using a 37 mm Millipore sampler. The between-group, within-group and within-worker variances were determined to assess the contrast in exposure level between the OGs and to estimate the attenuation and standard error of the theoretical exposure-response slope. Using mixed-effect model estimates, the probability of overexposure relative to the occupational exposure limit (OEL) was assessed for each OG. The geometric means of total dust exposure were higher in the cranes (38.64 mg m(-3)), packing (21.30 mg m(-3)) and crusher (13.48 mg m(-3)) than in the cement mill (3.23 mg m(-3)), kiln (2.87 mg m(-3)), raw mill (1.85 mg m(-3)), maintenance (1.16 mg m(-3)) and administration (0.29 mg m(-3)). The a priori grouping scheme seems to be an efficient scheme because of the high contrast in exposure level between the OGs (0.78) and minimal attenuation of the theoretical exposure-response slope (1.0%). When using the reduced mixed-effect model, the probabilities of overexposure () relative to the OEL of 10 mg m(-3) for total cement dust were higher in the crane (96%), packing (88%) and crusher (73%) than in the cement mill (16%), kiln (14%), raw mill (5%), maintenance (2%) and administration (0.01%).
McCurdy, Sheryl A.; Ross, Michael W.; Williams, Mark L.; Kilonzo, G.P.; Leshabari, M.T.
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
Blackmon, James B
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
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
McCrann, Denis; Lalor, Kevin; Katabaro, Joviter Kamugisha
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…
Khamis, Farhat A.; Lugwisha, Esther H. J.
This study investigated the levels of pesticides and metabolites in vegetables from major markets in Dar es Salaam city, Tanzania. Samples of fresh cabbage, spinach, and onions from the markets were analysed for pesticide residues. Extraction was performed using acetone followed by dichloromethane : cyclohexane mixture and the extracts were cleaned up using Florisil. The compounds were determined by gas chromatography-mass spectrometry (GC-MS). Pesticides and metabolites were detected in 72.2% of the samples. The detected pesticide residues and their highest mean concentrations were p,p′-DDT 4.00 × 10−3 mg/kg, p,p′-DDD 6.40 × 10−1 mg/kg, o,p′-DDD 1.00 × 10−2 mg/kg, α-endosulfan 6.00 × 10−1 mg/kg, β-endosulfan 2.10 × 10−1 mg/kg, chlorpyrifos 3.00 mg/kg, and cypermethrin 4.00 × 10−2 mg/kg. The most frequently detected compounds were p,p′-DDD and chlorpyrifos. The order of contamination was spinach > cabbage > onions. Generally, there were no significant variations in concentrations of pesticide residues among samples and sampling sites, which indicated similarities in contamination patterns. The concentrations of contaminants were above the maximum residue limits (MRLs) in 33.3–50% of the samples. The findings indicated risks and concerns for public health. PMID:28280510
Ak'habuhaya, J.; Lodenius, M. )
The Misimbazi River in Dar es Salaam is polluted with industrial, urban and agricultural waste waters. A preliminary investigation on the extent of metal pollution (Hg, Cr, Cu, Zn, Fe, Ni, Cd, Mn, Al) was made from samples of sediments and biological indicators. The metal concentrations were in general low, but some of our results indicated industrial pollution.
A checklist of Ensifera and Acridomorpha of Kazimzumbwi Forest Reserve, Kisarawe near Dar es Salaam is given and eight new Tettigoniidae species described. These are the Agraeciini species Afroagraecia kisarawe n. sp., the Meconematinae species Phlugidia kisarawe n. sp., and the female of Aerotegmina megaloptera (Hexacentrinae). The Phaneropterinae species Dioncomena scutellata n. sp. is known at present only from two localities, the Pugu Hills near Dar es Salaam and Kwamgumi forest reseve on the foothills of the East Usambara Mountains. Two new Eurycorypha species, E. annexata n. sp. and E. ligata n. sp. are described from the area known at present only from the male sex. A second species is described in the genus Lunidia Hemp, L. acuticercata n. sp. Two new Phaneropterinae genera are erected on Pseudopreussia flavifolia n. gen. n. sp. and Materuana ericki n. gen. n. sp., species of wet lowland forest along coastal Tanzania and forest reserves in the East Usambara and on the foothills of the Uluguru Mountains.Kazimzumbwi Forest Reserve is severly threatened by encroachment and deforestation although it is recognized as belonging to the oldest surviving forests of the world.
Davis, Jennifer; Pickering, Amy J; Rogers, Kirsten; Mamuya, Simon; Boehm, Alexandria B
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.
movement of refugees. Societal violence against women and persons with albinism and women persisted. Female genital mutilation (FGM), especially of...Relief.6 Regional Role Tanzania is a member, with Kenya and Uganda, of the East African Community (EAC), established by a 1999 treaty, which
Hardman, Frank; Abd-Kadir, Jan; Tibuhinda, Audax
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…
The supposed pre-eminence of an external examination can exert a disproportionate influence on a curriculum and the associated learning and teaching. Teaching can easily subordinate learning and understanding to curriculum coverage if the society develops a culture that appears to make such demands. This study focuses on Tanzania and provides the…
Stephen, Hobokela; Roberts, Bayard
Tanzania is host to one of the highest refugee populations in the world, with over half a million refugees in 2006. The purpose of this case study was to explore the application of the UNHCR ART policy for the provision of therapeutic, long-term antiretroviral therapy (ART) to refugees in Tanzania. A case study method was used and 18 semistructured key-informants interviews were conducted in July 2007 with a cross-section of stakeholders involved in provision of ART to refugees in Tanzania. The results suggest positive implementation of the key principles of the UNHCR policy. Some differing opinions existed between respondents over the key principles of considering ART provision at earliest possible stage of displacement, and the criteria for repatriation of refugees. The right of refugees to access ART is increasingly accepted and Tanzania provides a positive example of how ART services can be scaled up for refugees.
Oberlin, Aisa S; Szántó, Gábor L
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.
Yamanis, Thespina J; Dervisevic, Ervin; Mulawa, Marta; Conserve, Donaldson F; Barrington, Clare; Kajula, Lusajo J; Maman, Suzanne
Men in sub-Saharan Africa have low HIV testing rates. Social networks exert an important influence on men's HIV-related behavior. We examined associations between network factors and HIV testing among men in Dar es Salaam, Tanzania. Data are from the baseline assessment of an HIV prevention trial with 48 primarily male networks. Among 923 sexually active men, 52 % had ever tested for HIV. In a random effects logistic regression model, men in the network core were 1.50 times more likely (p < .05) to test than those in the periphery. Percentage of women in the network was associated with men's increased HIV testing (AOR 4.24, p < .05). Perception of network HIV stigma was negatively associated with HIV testing (AOR 0.92, p < .01). Thinking at least one close friend tested for HIV was associated with increased testing (AOR 2.66, p < .001). Social network interventions are a promising approach for scaling up men's HIV testing.
Kivaria, F M; Noordhuizen, J P T M; Kapaga, A M
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.
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
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.
Feinstein, Sheryl; Mwahombela, Lucas
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.
Watson, Alan J.
This paper begins by telling the story of Edward, a preacher/teacher in Tanzania who, although poor and uneducated himself, managed to teach his parishioners how to read. The paper describes the experience of one man and his wife who spent 4 years at Katoke Teachers College in northwest Tanzania during the early 1970s, after which they returned to…
Clark, Dylan G.; Premkumar, Deepak; Mazur, Robert; Kisimbo, Elibariki
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.
Background In a study of prevention of mother-to-child transmission of HIV (PMTCT) by triple antiretroviral therapy (ART) in Dar es Salaam, Tanzania (the Mitra Plus study), retrospective viral load testing revealed a high and increasing frequency of detectable viral load during follow-up for two years postnatally in women given continuous ART for their own health suggesting poor adherence. This study explored women’s own perceived barriers to adherence to ART post-delivery so as to identify ways to facilitate better drug adherence among women in need of ART for their own health. Methods Semi-structured interviews were conducted with 23 of the 48 women who had detectable viral load at 24 months postnatally. Content analysis was used to analyze the data. Results Most women in the study did not acknowledge poor adherence until confronted with the viral load figures. Then, however, they revealed multiple reasons for failing to adhere. They said that their motivation to take ART decreased once they had protected their children from becoming infected and successfully weaned them. Feeling well for some, and a feeling of hopelessness for others, also decreased motivation to continue ART. The overwhelming demands of everyday life, poverty and lack of empowerment also posed significant barriers to long-term adherence. The need to keep their HIV status a secret and not let anyone see them taking the drugs was another steep barrier. Conclusion Reasons for postnatal failure to adhere by mothers put on ART for life during pregnancy included lack of motivation to continue ART after weaning the child, poverty and stigma. Projects that simultaneously address stigma, poverty and women’s lack of empowerment may be necessary for PMTCT and ART to reach their full potential. Our results indicate that the new WHO proposal to start all HIV-infected pregnant women on lifelong ART regardless of CD4 cell count needs to address the challenging realities of women in resource-poor contexts
Kamuhabwa, Appolinary AR; Gordian, Richard; Mutagonda, Ritah F
Background In 2011, Tanzania adopted a policy for provision of daily co-trimoxazole prophylaxis to HIV-infected pregnant women for prevention of malaria and other opportunistic infections. As per the policy, HIV-infected pregnant women should not be given sulfadoxine-pyrimethamine (SP) for intermittent preventive therapy. The challenges associated with this policy change and the extent to which the new policy for prevention of malaria in pregnant women coinfected with HIV was implemented need to be assessed. Aim To assess the implementation of malaria-preventive therapy policy among HIV-infected pregnant women in the public health facilities in Dar es Salaam, Tanzania. Methodology The study was conducted in Kinondoni Municipality, Dar es Salaam, Tanzania, from January 2015 to July 2015. Three hundred and fifty-three HIV-infected pregnant women who were attending antenatal clinics (ANCs) and using co-trimoxazole for prevention of malaria were interviewed. Twenty-six health care workers working at the ANCs were also interviewed regarding provision of co-trimoxazole prophylaxis to pregnant women. A knowledge scale was used to grade the level of knowledge of health care providers. Focus group discussions were also conducted with 18 health care workers to assess the level of implementation of the policy and the challenges encountered. Results Twenty-three (6.5%) pregnant women with known HIV serostatus were using co-trimoxazole for prevention of opportunistic infections even before they became pregnant. Out of the 353 HIV-infected pregnant women, eight (2.5%) were coadministered with both SP and co-trimoxazole. Sixty (16.7%) pregnant women had poor adherence to co-trimoxazole prophylaxis. Out of the 26 interviewed health care providers, 20 had high level of knowledge regarding malaria-preventive therapy in HIV-infected pregnant women. Lack of adequate supply of co-trimoxazole in health facilities and inadequate training of health care providers were among the factors
Dominicus, D A; Akamatsu, T
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)
van Roosmalen, J
Prolonged labour was the most frequent cause of perinatal death in a rural hospital in the south western highlands of Tanzania. After the introduction of an obstetric policy aiming to prevent prolonged labour by making use of the guidelines of the partogram, perinatal mortality was reduced from 71 to 39 per 1000 births. Baird's clinico-pathological classification is still considered a useful instrument for the discovery of avoidable factors in perinatal deaths. The concept of the partogram should be an integral part of the training of medical auxiliaries in the field of maternal and child health (MCH).
Boniface, Respicious; Museru, Lawrence; Kiloloma, Othman; Munthali, Victoria
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. PMID:27217872
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
Hutton, Mary Olivia; Leach, Allison M.; Leip, Adrian; Galloway, James N.; Bekunda, Mateete; Sullivan, Clare; Lesschen, Jan Peter
We present the first nitrogen footprint model for a developing country: Tanzania. Nitrogen (N) is a crucial element for agriculture and human nutrition, but in excess it can cause serious environmental damage. The Sub-Saharan African nation of Tanzania faces a two-sided nitrogen problem: while there is not enough soil nitrogen to produce adequate food, excess nitrogen that escapes into the environment causes a cascade of ecological and human health problems. To identify, quantify, and contribute to solving these problems, this paper presents a nitrogen footprint tool for Tanzania. This nitrogen footprint tool is a concept originally designed for the United States of America (USA) and other developed countries. It uses personal resource consumption data to calculate a per-capita nitrogen footprint. The Tanzania N footprint tool is a version adapted to reflect the low-input, integrated agricultural system of Tanzania. This is reflected by calculating two sets of virtual N factors to describe N losses during food production: one for fertilized farms and one for unfertilized farms. Soil mining factors are also calculated for the first time to address the amount of N removed from the soil to produce food. The average per-capita nitrogen footprint of Tanzania is 10 kg N yr‑1. 88% of this footprint is due to food consumption and production, while only 12% of the footprint is due to energy use. Although 91% of farms in Tanzania are unfertilized, the large contribution of fertilized farms to N losses causes unfertilized farms to make up just 83% of the food production N footprint. In a developing country like Tanzania, the main audiences for the N footprint tool are community leaders, planners, and developers who can impact decision-making and use the calculator to plan positive changes for nitrogen sustainability in the developing world.
Mwakyusa, Wilson Pholld; Mwalyagile, Neema Venance
It is experienced that most of the Higher Learning Institutions (HLIs) in developing countries including Tanzania fails to fully implement e-learning system as a an alternative method of delivering education to a large population in the universities. However, some of HLIs are practicing the blended method by which both elearning and traditional…
Hella, Jerry; Said, Khadija; Kamwela, Lujeko; Sasamalo, Mohamed; Maroa, Thomas; Chiryamkubi, Magreth; Mhalu, Grace; Schindler, Christian; Reither, Klaus; Knopp, Stefanie; Utzinger, Jürg; Gagneux, Sébastien; Fenner, Lukas
Background Helminth infections can negatively affect the immunologic host control, which may increase the risk of progression from latent Mycobacterium tuberculosis infection to tuberculosis (TB) disease and alter the clinical presentation of TB. We assessed the prevalence and determined the clinical relevance of helminth co-infection among TB patients and household contact controls in urban Tanzania. Methodology Between November 2013 and October 2015, we enrolled adult (≥18 years) sputum smear-positive TB patients and household contact controls without TB during an ongoing TB cohort study in Dar es Salaam, Tanzania. We used Baermann, FLOTAC, Kato-Katz, point-of-care circulating cathodic antigen, and urine filtration to diagnose helminth infections. Multivariable logistic regression models with and without random effects for households were used to assess for associations between helminth infection and TB. Principal findings A total of 597 TB patients and 375 household contact controls were included. The median age was 33 years and 60.2% (585/972) were men. The prevalence of any helminth infection among TB patients was 31.8% (190/597) and 25.9% (97/375) among controls. Strongyloides stercoralis was the predominant helminth species (16.6%, 161), followed by hookworm (9.0%, 87) and Schistosoma mansoni (5.7%, 55). An infection with any helminth was not associated with TB (adjusted odds ratio (aOR) 1.26, 95% confidence interval (CI): 0.88–1.80, p = 0.22), but S. mansoni infection was (aOR 2.15, 95% CI: 1.03–4.45, p = 0.040). Moreover, S. mansoni infection was associated with lower sputum bacterial load (aOR 2.63, 95% CI: 1.38–5.26, p = 0.004) and tended to have fewer lung cavitations (aOR 0.41, 95% CI: 0.12–1.16, p = 0.088). Conclusions/Significance S. mansoni infection was an independent risk factor for active TB and altered the clinical presentation in TB patients. These findings suggest a role for schistosomiasis in modulating the pathogenesis of human TB
Agarwal, Smisha; Lasway, Christine; L’Engle, Kelly; Homan, Rick; Layer, Erica; Ollis, Steve; Braun, Rebecca; Silas, Lucy; Mwakibete, Anna; Kudrati, Mustafa
Abstract To address low contraceptive use in Tanzania, a pilot intervention using a mobile job aid was developed to guide community health workers (CHWs) to deliver integrated counseling on family planning, HIV, and other sexually transmitted infections (STIs). In this article, we describe the process of developing the family planning algorithms and implementation of the mobile job aid, discuss how the job aid supported collection of real-time data for decision making, and present the cost of the overall system based on an evaluation of the pilot. The family planning algorithm was developed, beginning in June 2011, in partnership with the Tanzania Ministry of Health and Social Welfare based on a combination of evidence-based tools such as the Balanced Counseling Strategy Plus Toolkit. The pilot intervention and study was implemented with 25 CHWs in 3 wards in Ilala district in Dar es Salaam between January 2013 and July 2013. A total of 710 family planning users (455 continuing users and 255 new users) were registered and counseled using the mobile job aid over the 6-month intervention period. All users were screened for current pregnancy, questioned on partner support for contraceptive use, counseled on a range of contraceptives, and screened for HIV/STI risk. Most new and continuing family planning users chose pills and male condoms (59% and 73%, respectively). Pills and condoms were provided by the CHW at the community level. Referrals were made to the health facility for pregnancy confirmation, injectable contraceptives, long-acting reversible contraceptives and HIV/STI testing. Follow-up visits with clients were planned to confirm completion of the health facility referral. The financial cost of implementing this intervention with 25 CHWs and 3 supervisors are estimated to be US$26,000 for the first year. For subsequent years, the financial costs are estimated to be 73% lower at $7,100. Challenges such as limited client follow-up by CHWs and use of data by
Daneau, Géraldine; Aboud, Said; Prat, Irena; Urassa, Willy; Kestens, Luc
Background CD4 T-cell counts are widely used to assess treatment eligibility and to follow-up HIV-infected patients. The World Health Organization prequalification of in vitro diagnostics program conducted a performance evaluation of the FACSPresto (BD Biosciences), a new point-of-care instrument to measure absolute CD4-T cell (CD4) counts and percentages in venous and capillary blood samples from HIV-infected patients. Methods Patients were recruited in Belgium (200 patients) and in Tanzania (247 patients). Venous blood samples were analyzed in two nearby reference laboratories. In addition, nurses/technicians collected a capillary blood sample by finger prick directly into a FACSPresto CD4 cartridge. Assay precision was assessed on fresh blood and on external quality control samples. Trueness (bias) was assessed by comparing results from FACSPresto with the reference (single-platform FACSCalibur). Clinical misclassification was measured at 200, 350 and 500 cells/μL thresholds. Results Intra-assay precision was < 6%, and inter-assay < 8%. CD4 results from FACSPresto and reference method resulted in regression slopes of 0.99–1.11 using either venous or capillary blood. Correlation was better for venous than for capillary blood (minimum 0.97 vs 0.93 respectively). Capillary blood resulted in a larger bias than venous blood, with 24 and 83 cells/μL for absolute CD4 counts on capillary blood in Antwerp and Dar es Salaam respectively, vs 12 and 41 cells/μL on venous blood. Bias on CD4% was < 1% on both venous and capillary blood, and was proportionally better than for absolute CD4 counts. Clinical misclassification was in line with the average overestimation, showing a very good specificity, but sensitivity around 70–90%. The rejection rate was 11% on first reading, leading to 6% of all samples without final result after a second reading. Conclusions The FACSPresto performed very well on venous blood samples, and well on capillary blood samples. PMID:28129324
Muhogora, W E; Nyanda, A M; Ngoye, W M
The performance of four methods often used to calculate the secondary barrier requirements is evaluated for a typical 137Cs-therapy room as a case study. The first two methods are provided by the NCRP49 and IAEA and both consider the influence of the primary, leakage and scattered radiation at a point as corrected for the workload, use and occupancy factors. A different shielding model encompasses the third method, which determines the doses as corrected for build-up effects assuming the narrow beam geometry. The fourth method is based on the calculation of the dose rates from the source activity with a relevant gamma constant. In all four methods, an appropriate transmission factor for the protective barrier in question is applied. The results show that for controlled area, the similarity in the calculated thicknesses using all four methods was nearly within 50%. For uncontrolled areas, a significant difference of magnitude up to a factor of 2.4 was found, which is mainly attributed to the non-consideration of occupancy factors in the latter two methods. Nevertheless, the non-agreement is useful to validate the specific assumptions taken for the employed shielding method. Despite being slightly high, it is concluded that the current shielding methods based on NCRP fundamentals are satisfactorily optimal in planning new therapy facilities. However for existing facilities, such as those undesigned according to the standard requirements, the combination of the four different methods with the dose rate measurements tend to offer a better cost effective shielding option. Retrospectively, additional 41-cm thick concrete is recommended for the unshielded southern barrier of the 137Cs room. Interestingly, the recommended thickness agrees to within +/-5% with that estimated by using the recently recommended method by IAEA.
Knopp, Stefanie; Salim, Nahya; Schindler, Tobias; Karagiannis Voules, Dimitrios A; Rothen, Julian; Lweno, Omar; Mohammed, Alisa S; Singo, Raymond; Benninghoff, Myrna; Nsojo, Anthony A; Genton, Blaise; Daubenberger, Claudia
Sensitive diagnostic tools are crucial for an accurate assessment of helminth infections in low-endemicity areas. We examined stool samples from Tanzanian individuals and compared the diagnostic accuracy of a real-time polymerase chain reaction (PCR) with the FLOTAC technique and the Kato-Katz method for hookworm and the Baermann method for Strongyloides stercoralis detection. Only FLOTAC had a higher sensitivity than the Kato-Katz method for hookworm diagnosis; the sensitivities of PCR and the Kato-Katz method were equal. PCR had a very low sensitivity for S. stercoralis detection. The cycle threshold values of the PCR were negatively correlated with the logarithm of hookworm egg and S. stercoralis larvae counts. The median larvae count was significantly lower in PCR false negatives than true positives. All methods failed to detect very low-intensity infections. New diagnostic approaches are needed for monitoring of progressing helminth control programs, confirmation of elimination, or surveillance of disease recrudescence.
Knopp, Stefanie; Salim, Nahya; Schindler, Tobias; Karagiannis Voules, Dimitrios A.; Rothen, Julian; Lweno, Omar; Mohammed, Alisa S.; Singo, Raymond; Benninghoff, Myrna; Nsojo, Anthony A.; Genton, Blaise; Daubenberger, Claudia
Sensitive diagnostic tools are crucial for an accurate assessment of helminth infections in low-endemicity areas. We examined stool samples from Tanzanian individuals and compared the diagnostic accuracy of a real-time polymerase chain reaction (PCR) with the FLOTAC technique and the Kato–Katz method for hookworm and the Baermann method for Strongyloides stercoralis detection. Only FLOTAC had a higher sensitivity than the Kato–Katz method for hookworm diagnosis; the sensitivities of PCR and the Kato–Katz method were equal. PCR had a very low sensitivity for S. stercoralis detection. The cycle threshold values of the PCR were negatively correlated with the logarithm of hookworm egg and S. stercoralis larvae counts. The median larvae count was significantly lower in PCR false negatives than true positives. All methods failed to detect very low-intensity infections. New diagnostic approaches are needed for monitoring of progressing helminth control programs, confirmation of elimination, or surveillance of disease recrudescence. PMID:24445211
The Family Planning Association of Tanzania (UMATI)/JOICFP Integrated Project to promote the use of contraceptive methods was launched in 1984 to a target population of 20,000 spread over three villages. The project now covers 117 villages with a total population of 356,000. In initial project areas, the project has increased the contraceptive prevalence rate (CPR) to more than 50% compared to the national average of 11.3% in five years. In overwhelmingly Catholic areas in Mgeta, Morogoro Region, the CPR increased from 1.0% in 1990 at the project start to reach 50.4% in 1994. The community-based distribution (CBD) system is one of the most impressive aspects of the UMATI/JOICFP project. The flexibility and ready accessibility of CBD personnel have made them more effective in reaching community people than clinical services. CBD personnel also work closely with government health workers. To further improve the CBD system, UMATI is concentrating upon the development of an effective CBD supervision system.
Mkumbo, Kitila A. K.
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…
Frey, Laura M.; Kaff, Marilyn S.
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…
Ahmad, Athman Kyaruzi; Gjøtterud, Sigrid; Krogh, Erling
In this article we present and discuss experiences developed through a dialogue conference which we organised as part of a three-year participatory action research project related to primary education and agricultural education in Tanzania. We explore how dialogue conference as a research method can fill a gap between traditional ways of mutual…
Mkumbo, Kitila A. K.
This qualitative study examined teachers' commitment to, and experiences of, the teaching profession in six regions of Tanzania. The study used focus group discussions as research method and data collection tool. Twenty four groups were conducted, with group membership ranging from five to nine participants. The results show that the teachers'…
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
Abidi, S. A. H.; Moeller, T.
In 1978 a team of three people was formed to survey the existing library training facilities in East Africa and to suggest possibilities as to how the elements of information science could be introduced either into existing programs or into special courses organized for the purpose. The team submitted its report to a joint meeting of the…
Laisser, E L K; Chenyambuga, S W; Karimuribo, E D; Msalya, G; Kipanyula, M J; Mwilawa, A J; Mdegela, R H; Kusiluka, L J M
In Tanzania, control of East Coast fever (ECF) has predominantly relied on tick control using acaricides and chemotherapy, little on ECF vaccination, and very little on dissemination regarding animal immunization. In this paper, the prevalence, control measure, and tolerance of Tanzania Shorthorn Zebu (TSHZ) cattle to ECF are reviewed. In addition, the opportunities available for reducing the use of acaricides for the benefit of the farmers in terms of reduction of costs of purchasing acaricides and environmental pollution are described. The tick distribution and epidemiological factors for ECF such as the agro-ecological zones (AEZ), livestock production systems (LPS), strain, and age of the animals are also described. These factors influence the epidemiology of ECF and the distribution of TSHZ strains in different geographic locations of Tanzania. We have further showed that there is a tendency of farmers to select among the strains of TSHZ for animals which can tolerate ticks and ECF and crossbreed them with their local strains with the aim of benefiting from the inherent characteristics of the most tolerant strains. Generally, many strains of TSHZ cattle are tolerant to tick infestation and ECF infection and can be bred to respond to the needs of the people. In this review paper, we recommend that in future, ECF epidemiological studies should account for factors such as livestock production system, agro-climate, breed of animal, tick control strategy, and the dynamic interactions between them. In conclusion, we have demonstrated that an integrated control method involving use of acaricides, immunization, and ECF-tolerant/-resistant animals is required.
Trevisan, Chiara; Devleesschauwer, Brecht; Schmidt, Veronika; Winkler, Andrea Sylvia; Harrison, Wendy; Johansen, Maria Vang
Taenia solium is a zoonotic parasite prevalent in many low income countries throughout Latin America, Asia and sub-Saharan Africa, including Tanzania. The parasite is recognized as a public health threat; however the burden it poses on populations of Tanzania is unknown. The aim of this study was to estimate the societal cost of T. solium cysticercosis in Tanzania, by assessing both the health and economic burden. The societal cost of T. solium cysticercosis was assessed in humans and pigs based on data obtained by a systematic review. Experts' opinion was sought in cases where data were not retrievable. The health burden was assessed in terms of annual number of neurocysticercosis (NCC) associated epilepsy incident cases, deaths and disability-adjusted life years (DALYs), while the economic burden was assessed in terms of direct and indirect costs imposed by NCC-associated epilepsy and potential losses due to porcine cysticercosis. Based on data retrieved from the systematic review and burden assessments, T. solium cysticercosis contributed to a significant societal cost for the population. The annual number of NCC-associated epilepsy incident cases and deaths were 17,853 (95% Uncertainty Interval (UI), 5666-36,227) and 212 (95% UI, 37-612), respectively. More than 11% (95% UI, 6.3-17) of the pig population was infected with the parasite when using tongue examination as diagnostic method. For the year 2012 the number of DALYs per thousand person-years for NCC-associated epilepsy was 0.7 (95% UI, 0.2-1.6). Around 5 million USD (95% UI, 797,535-16,933,477) were spent due to NCC-associated epilepsy and nearly 3 million USD (95% UI, 1,095,960-5,366,038) were potentially lost due to porcine cysticercosis. Our results show that T. solium imposes a serious public health, agricultural and economic threat for Tanzania. We urge that a One Health approach, which involves the joint collaboration and effort of veterinarians, medical doctors, agricultural extension officers
This paper reviews research on the returns to education in Tanzania, both financial and non-financial, and considers whether these returns translate into poverty reduction. It looks at reasons why achievement of high primary enrolment rates in the past did not lead to the realisation of the associated developmental outcomes, considering factors…
Crump, John A; van Ingen, Jakko; Morrissey, Anne B; Boeree, Martin J; Mavura, Daudi R; Swai, Britta; Thielman, Nathan M; Bartlett, John A; Grossman, Henning; Maro, Venance P; van Soolingen, Dick
Data on nontuberculous mycobacterial (NTM) disease in sub-Saharan Africa are limited. During 2006-2008, we identified 3 HIV-infected patients in northern Tanzania who had invasive NTM; 2 were infected with "Mycobacterium sherrisii" and 1 with M. avium complex sequevar MAC-D. Invasive NTM disease is present in HIV-infected patients in sub-Saharan Africa.
Norman, A. S.; Mdegella, O. M.; Lubawa, R. M.
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…
Delalande-Le Mouëllic, Manuëlla; Gherardi, Fabrizio; Williamson, David; Kajula, Stephen; Kraml, Michael; Noret, Aurélie; Abdallah, Issah; Mwandapile, Ezekiel; Massault, Marc; Majule, Amos; Bergonzini, Laurent
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.
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
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
Salerno, Jonathan D; Borgerhoff Mulder, Monique; Kefauver, Shawn C
A recent discussion debates the extent of human in-migration around protected areas (PAs) in the tropics. One proposed argument is that rural migrants move to bordering areas to access conservation outreach benefits. A counter proposal maintains that PAs have largely negative effects on local populations and that outreach initiatives even if successful present insufficient benefits to drive in-migration. Using data from Tanzania, we examined merits of statistical tests and spatial methods used previously to evaluate migration near PAs and applied hierarchical modeling with appropriate controls for demographic and geographic factors to advance the debate. Areas bordering national parks in Tanzania did not have elevated rates of in-migration. Low baseline population density and high vegetation productivity with low interannual variation rather than conservation outreach explained observed migration patterns. More generally we argue that to produce results of conservation policy significance, analyses must be conducted at appropriate scales, and we caution against use of demographic data without appropriate controls when drawing conclusions about migration dynamics.
Social networks of men who have sex with men and their implications for HIV/STI interventions: results from a cross-sectional study using respondent-driven sampling in a large and a small city in Tanzania
Ross, Michael W; Larsson, Markus; Jacobson, Jerry; Nyoni, Joyce; Agardh, Anette
Objective Men who have sex with men (MSM) in sub-Saharan Africa remain hidden and hard to reach for involvement in HIV and sexually transmitted infection (STI) services. The aim of the current study was to describe MSM social networks in a large and a small Tanzanian city in order to explore their utility for peer-based healthcare interventions. Methods Data were collected through respondent-driven sampling (RDS) in Dar es Salaam (n=197) and in Tanga (n=99) in 2012 and 2013, using 5 and 4 seeds, respectively. All results were adjusted for RDS sampling design. Results Mean personal network size based on the number of MSM who were reported by the participants, as known to them was 12.0±15.5 in Dar es Salaam and 7.6±8.1 in Tanga. Mean actual RDS network size was 39.4±31.4 in Dar es Salaam and 25.3±9.7 in Tanga. A majority (97%) reported that the person from whom they received the recruitment coupon was a sexual partner, close friend or acquaintance. Homophile in recruitment patterns (selective affiliation) was present for age, gay openness, and HIV status in Dar es Salaam, and for sexual identification in Tanga. Conclusions The personal network sizes and existence of contacts between recruiter and referral indicate that it is possible to use peer-driven interventions to reach MSM for HIV/STI interventions in larger and smaller sub-Saharan African cities. The study was reviewed and approved by the University of Texas Health Science Center's Institutional Review Board (HSC-SPH-10-0033) and the Tanzanian National Institute for Medical Research (NIMR/HQ/R.8a/Vol. IX/1088). PMID:27864245
Mjengera, H.; Mkongo, G.
High fluoride in drinking water is a problem found in both ground and surface water in various parts of Tanzania. Several defluoridation methods have been tested and detailed studies have been carried on bone-char method, alum/lime method and the combination of the two methods. In bone char method, the bones are charred in special kilns fuelled by wood charcoal. Different sizes of the kiln have been fabricated and tested. Crushing and sieving devices have been developed. The effectiveness of bone char particles sizes in fluoride removal has been studied and the results favoured small particle sizes. However, experimental conditions discouraged the use of very fine particles sizes of bone char due easy clogging. Household and institutional levels bone char defluoridation systems have been developed and tested. Filter columns packed with heat-activated bones are found to be more effective than fill and draw bucket type defluoridator. The bone char media used has the capability of producing water with a residual fluoride concentration of less than 0.1 mg/l from an initial fluoride of 12.0 mg/l. Use of alum and lime in fluoride removal from waters with excessive fluoride has been experimented upon. A plant with an automatic chemical dosing and mixing system for use at institutional levels has been developed and tested. The method was able to treat water with an initial fluoride concentration of 12 mg/l to a residual fluoride concentration ranging from 2 to 3 mg/l. During the study it was established, that the bone char method is appropriate for use in rural areas of Tanzania due its simplicity, local availability of materials and the possibility of processing the material locally.
Zhu, Chang; Justice Mugenyi, Kintu
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…
Pembe, A B; Abeid, M S
The aim of this study was to determine prevalence of polycystic ovaries (PCO) and associated clinical and biochemical features among women with infertility attending gynaecological outpatient department (GOPD) at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. All women with infertility attending the GOPD from 11th September 2006 to 15th February 2007 were recruited to the study. Information on socio-demographic, obstetric and menstrual characteristics was collected. Anthropometric measurement, clinical examination of acne and hirsutism, vaginal ultrasonography for PCO and biochemical analysis of luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone were performed. All 102 women who attended the GOPD during the study period due to infertility were recruited. Two women were excluded after diagnosis of pregnancy made by hormonal assay and ultrasonography thus remaining with 100 women for analysis. Oligomenorrhoea and acne were significantly higher in a group of women with PCO than among women with normal ovaries. The mean hirsutism score though was not significant, was higher in women with PCO than in women with normal ovaries (5.1 +/- 2.7 vs. 4 +/- 2.4, P < 0.057). Using the Rotterdam criteria 32 (32%) women were diagnosed to have polycystic ovary syndrome (PCOS). Among these women 25 (78.1%) had PCO, 24 (75%) had signs of oligoanovulation, and 18 (56.3%) had hirsutism. Among 68 women with no PCOS, 7 (10.3%) had polycystic ovaries, 15 (22.1%) had signs of oligoanovulation and 6 (8.8%) had hirsutism. In conclusion, polycystic ovaries are common among women with infertility, however are not necessarily associated with polycystic ovary syndrome. Doctors should investigate their clients for PCOS and offer appropriate treatment.
Mazigo, Humphrey D.; Bahemana, Emmanuel; Dyegura, Ocimund; Mnyone, Ladslaus L.; Kweka, Eliningaya J.; Zinga, Maria; Konje, Eveline T.; Waihenya, Rebecca; Heukelbach, Jorg
Tungiasis is caused by infestation with the sand flea (Tunga penetrans). This ectoparasitosis is endemic in economically depressed communities in South American and African countries. However, data on the epidemiology of tungiasis in Tanzania are very limited and the disease does not receive much attention from health care professionals. During a community cross sectional survey in northwest Tanzania, we identified five individuals extremely infested with high number of parasites. A total of 435 lesions were recorded with patients presenting with >75 lesions and showed signs of intense acute and chronic inflammation. Superinfection of the lesions characterized by pustule formation, suppuration and ulceration were common. Loss of nails and walking difficulty was also observed. In Tanzanian communities living under extreme poverty characterized by poor housing condition and inadequate health services, tungiasis may cause severe morbidities. Further studies on risk factors and disease-related behavior of affected populations are needed to design adequate control measures. PMID:28299062
Caro, Tim; Davenport, Tim R B
Tanzania, arguably mainland Africa's most important nation for conservation, is losing habitat and natural resources rapidly. Moving away from a charcoal energy base and developing sustainable finance mechanisms for natural forests are critical to slowing persistent deforestation. Addressing governance and capacity deficits, including law enforcement, technical skills, and funding, across parts of the wildlife sector are key to effective wildlife protection. These changes could occur in tandem with bringing new models of natural resource management into play that include capacity building, corporate payment for ecosystem services, empowering nongovernmental organizations in law enforcement, greater private-sector involvement, and novel community conservation strategies. The future of Tanzania's wildlife looks uncertain-as epitomized by the current elephant crisis-unless the country confronts issues of governance, embraces innovation, and fosters greater collaboration with the international community.
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.
Kaungamno, E. E.
This comprehensive treatment of the state of the publishing industry in Tanzania provides a general description of the book trade in Africa, including discussions of the types of publishers active in Africa and of the recording of African publishing output, and a review of publishing activities in Tanzania, which covers the history of Tanzanian…
Semali, Ladislaus M.; Mehta, Khanjan
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…
Synolakis, C. E.; Okal, E. A.; Fritz, H. M.; Sladen, A.
We present a total of 59 new data points of run-up of the 2004 Sumatra tsunami in the Comoros and Tanzania, surveyed in 2006-2008 by International Tsunami Survey Teams. Run-up at the Northeastern tip of Grande Comore (6.8 m) is comparable to Socotra (6.1 m), and surpassed only in the Western Indian Ocean by the catastrophic values in Somalia (run-up 9 m; inundation 700 m). Run-up in Mayotte, and to a lesser extent Zanzibar, show considerable variations (from 1 to 5 m), attributed to the influence of the local structure of the reef surrounding these islands. By contrast, the unreefed islands of Anjouan and Moheli, and the mainland coast of Tanzania around Dar-es-Salaam, feature more consistent values in the 2 to 3 m range. The death toll in Tanzania is revised to at least 20. We then use the MOST code to simulate the propagation on the high seas of both the 2004 tsunami, and of potential future tsunamis under scenarios of mega earthquakes rupturing in the South Sumatra region; in particular, we consider the case of a probable event releasing the strain left over from the 1833 rupture after the 2007 Bengkulu earthquake. While these studies are not carried to the full extent of run-up calculations at individual sites, they give a general estimate of expectable hazard, relative to 2004, under the relevant scenarios, at 17 offshore virtual gauges strategically located from Oman to South Africa. We confirm more quantitatively the results of Okal and Synolakis (2008), namely that the change of directivity characteristics results in an increase of tsunami amplitude (with respect to 2004) at all sites South of Kenya (including Madagascar and the Mascarenes), while amplitudes at the Horn of Africa (Socotra, Somalia) remain large, due to focusing by individual bathymetric features. In short, potential earthquake sources along the Southern coast of Sumatra could result in higher wave heights than in 2004, along most of the Eastern shores of Africa, Madagascar and the
Safe, cost-effective interventions are being developed to reduce HIV transmission to children, suitable for lower income countries such as Tanzania. The interventions include Nevirapine treatment, replacement feeding, exclusive breast-feeding and heat-treating breast milk. This article reports on research to explore factors, which may influence the acceptability of these interventions. Data collection methods used were qualitative in-depth interviews with 12 health workers and focus group discussions with five community groups. Findings are presented with reference to the theory of diffusion of innovation, which seeks to explain how new ideas and products are disseminated through a community. Respondents describe the factors that may help and hinder this process. They propose ways to maximize this diffusion, such as integrating HIV and antenatal services, encouraging male participation, community-wide education, offering free HIV testing, and training health workers as change agents.
Hardre, Patricia L.; Garcia, Fe; Apamo, Peter; Mutheu, Lucy; Ndege, Monica
This study reports assessment of motivational and perceptual components of a youth and community AIDS awareness education program, focusing on effectiveness across program sites. The design of this investigation was quasi-experimental, with two intervention districts and one control each, in Kenya and Tanzania. Methods included questionnaires…
Seha, A M; Klepp, K I; Ndeki, S S
Based on the World Health Organization's standardized survey inventories assessing AIDS-related knowledge, attitudes, beliefs, and practices (KABP) for adolescents, a written questionnaire was developed and pilot tested among primary school children in Northern Tanzania. Subjects included 472 fifth and sixth graders at four schools in Arusha and Kilimanjaro regions. Results indicated that the large majority of the students understood the questions and were able and willing to complete the survey. Non-response patterns did not seem to be related to the sensitivity of included questions. AIDS-related knowledge and attitudes toward engaging in sexual behavior had acceptable reliability and construct validity when compared with similar surveys in Western countries, while perceived social norms and self-efficacy need further development. KABP questionnaires may serve as a useful method in AIDS-related surveys and evaluation studies among school children in Tanzania if survey instruments are adapted to reflect the local social and cultural context.
Kakoko, Deodatus C; Ketting, Evert; Kamazima, Switbert R; Ruben, Ruerd
Adherence to the policy guidelines and standards is necessary for family planning services. We compared public and private facilities in terms of provision of family planning services. We analyzed data from health facility questionnaire of the 2006 Tanzania Service Provision Assessment survey, based on 529 health facilities. Majority of public facilities (95.4%) offered family planning services, whereas more than half of private facilities (52.1%) did not offer those. Public facilities were more likely to offer modern contraceptives as compared to private facilities. However, private facilities were more likely to offer counseling on natural methods of family planning [AOR = 2.12 (1.15-3.92), P < or = 0.001]. Public facilities were more likely to report having guidelines or protocols for family planning services and various kinds of visual aids for family planning and STIs when compared to private facilities. This comparative analysis entails the need to enforce the standards of family planning services in Tanzania.
Ngalesoni, Frida; Ruhago, George; Norheim, Ole F; Robberstad, Bjarne
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
Ngalesoni, Frida; Ruhago, George; Norheim, Ole F; Robberstad, Bjarne
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
Mfinanga, G S; Mutayoba, B; Mbogo, G; Kahwa, A; Kimaro, G; Mhame, P P; Mwangi, C; Malecela, M N; Kitua, A Y
Tanzania is scaling up prevention, treatment, care and support of individuals affected with HIV. There is therefore a need for high quality and reliable HIV infection testing and AIDS staging. The objective of this study was to assess laboratories capacities of services in terms of HIV testing and quality control. A baseline survey was conducted from December 2004 to February 2005 in 12 laboratories which were conveniently selected to represent all the zones of Tanzania. The questionnaires comprised of questions on laboratory particulars, internal and external quality control for HIV testing and quality control of reagents. Source and level of customer satisfaction of HIV test kits supply was established. Of 12 laboratories, nine used rapid tests for screening and two used rapid tests for diagnosis. In the 12 laboratories, four used double ELISA and five used single ELISA and three did not use ELISA. Confirmatory tests observed were Western Blot in three laboratories, DNA PCR in two laboratories, CD4 counting in seven laboratories, and viral load in two laboratories. Although all laboratories conducted quality control (QC) of the HIV kits, only two laboratories had Standard Operating Procedures (SOPs). Internal and external quality control (EQC) was done at varied proportions with the highest frequency of 55.6% (5/9) for internal quality control (IQC) for rapid tests and EQC for ELISA, and the lowest frequency of 14.3% (1/ 7) for IQC for CD4 counting. None of the nine laboratories which conducted QC for reagents used for rapid tests and none of the five which performed IQC and EQC had SOPs. HIV kits were mainly procured by the Medical Store Department and most of laboratories were not satisfied with the delay in procurement procedures. Most of the laboratories used rapid tests only, while some used both rapid tests and ELISA method for HIV testing. In conclusion, the survey revealed inadequacy in Good Laboratory Practice and poor laboratory quality control process
Jiwaji, N. T.
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.
Mangesho, Peter Ernest; Neselle, Moses Ole; Karimuribo, Esron D.; Mlangwa, James E.; Queenan, Kevin; Mboera, Leonard E. G.; Rushton, Jonathan; Kock, Richard; Häsler, Barbara; Kiwara, Angwara; Rweyemamu, Mark
Background Zoonoses account for the most commonly reported emerging and re-emerging infectious diseases in Sub-Saharan Africa. However, there is limited knowledge on how pastoral communities perceive zoonoses in relation to their livelihoods, culture and their wider ecology. This study was carried out to explore local knowledge and perceptions on zoonoses among pastoralists in Tanzania. Methodology and principal findings This study involved pastoralists in Ngorongoro district in northern Tanzania and Kibaha and Bagamoyo districts in eastern Tanzania. Qualitative methods of focus group discussions, participatory epidemiology and interviews were used. A total of 223 people were involved in the study. Among the pastoralists, there was no specific term in their local language that describes zoonosis. Pastoralists from northern Tanzania possessed a higher understanding on the existence of a number of zoonoses than their eastern districts' counterparts. Understanding of zoonoses could be categorized into two broad groups: a local syndromic framework, whereby specific symptoms of a particular illness in humans concurred with symptoms in animals, and the biomedical framework, where a case definition is supported by diagnostic tests. Some pastoralists understand the possibility of some infections that could cross over to humans from animals but harm from these are generally tolerated and are not considered as threats. A number of social and cultural practices aimed at maintaining specific cultural functions including social cohesion and rites of passage involve animal products, which present zoonotic risk. Conclusions These findings show how zoonoses are locally understood, and how epidemiology and biomedicine are shaping pastoralists perceptions to zoonoses. Evidence is needed to understand better the true burden and impact of zoonoses in these communities. More studies are needed that seek to clarify the common understanding of zoonoses that could be used to guide
Nsubuga, Peter; Eseko, Nicholas; Tadesse, Wuhib; Ndayimirije, Nestor; Stella, Chungong; McNabb, Scott
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
Faini, Diana; Maokola, Werner; Furrer, Hansjakob; Hatz, Christoph; Battegay, Manuel; Tanner, Marcel; Denning, David W; Letang, Emilio
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.
Jeffery, Bill; Parthesius, Robert
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.
Nsojo, Anthony; Aboud, Said; Lyamuya, Eligius
Human immunodeficiency virus (HIV) DNA polymerase chain reaction (PCR) test using venous blood sample has been used for many years in low resource settings for early infant diagnosis of HIV infection in children less than 18 months. The aim of this study was to evaluate and compare the performance characteristics of Amplicor HIV-1 DNA assay version 1.5 following processing of venous blood and dried blood spot (DBS) samples by Roche manual DNA extraction and automated Roche MagNA Pure LC instrument (MP) for HIV-1 DNA PCR testing in Dar es Salaam, Tanzania, in order to scale up early infant diagnosis of HIV infection in routine practice. Venous blood samples from children under 18 months born to HIV-infected mothers between January and April 2008 were collected. Venous blood was used to prepare cell pellet and DBS samples. DNA extractions by manual procedure and MP were performed each on cell pellet, venous blood and DBS samples and tested by Amplicor HIV-1 DNA assay. Of 325 samples included, 60 (18.5%) were confirmed HIV-infected by manual extraction performed on cell pellets. Sensitivity of the assay following MP processing of venous blood was 95% (95% CI; 86.1-99.0%) and 98.3% (95% CI; 91.1 to 99.9%) for the manual extraction and processing by MP performed on DBS samples. Specificity of the assay with all DNA extraction methods was 99.6% (95% CI; 97.9 to 100%). Performance of the assay with Roche manual extraction and processing by MP on DBS samples compared well with Roche manual extraction performed on cell pellet samples. The choice of DNA extraction method needs to be individualized based on the level of laboratory facility, volume of testing and cost benefit analysis before it is adopted for use.
Sindato, Calvin; Stevens, Kim B.; Karimuribo, Esron D.; Mboera, Leonard E. G.; Paweska, Janusz T.; Pfeiffer, Dirk U.
Background Despite the long history of Rift Valley fever (RVF) in Tanzania, extent of its suitable habitat in the country remains unclear. In this study we investigated potential effects of temperature, precipitation, elevation, soil type, livestock density, rainfall pattern, proximity to wild animals, protected areas and forest on the habitat suitability for RVF occurrence in Tanzania. Materials and Methods Presence-only records of 193 RVF outbreak locations from 1930 to 2007 together with potential predictor variables were used to model and map the suitable habitats for RVF occurrence using ecological niche modelling. Ground-truthing of the model outputs was conducted by comparing the levels of RVF virus specific antibodies in cattle, sheep and goats sampled from locations in Tanzania that presented different predicted habitat suitability values. Principal Findings Habitat suitability values for RVF occurrence were higher in the northern and central-eastern regions of Tanzania than the rest of the regions in the country. Soil type and precipitation of the wettest quarter contributed equally to habitat suitability (32.4% each), followed by livestock density (25.9%) and rainfall pattern (9.3%). Ground-truthing of model outputs revealed that the odds of an animal being seropositive for RVFV when sampled from areas predicted to be most suitable for RVF occurrence were twice the odds of an animal sampled from areas least suitable for RVF occurrence (95% CI: 1.43, 2.76, p < 0.001). Conclusion/Significance The regions in the northern and central-eastern Tanzania were more suitable for RVF occurrence than the rest of the regions in the country. The modelled suitable habitat is characterised by impermeable soils, moderate precipitation in the wettest quarter, high livestock density and a bimodal rainfall pattern. The findings of this study should provide guidance for the design of appropriate RVF surveillance, prevention and control strategies which target areas with
It is a challenge to design and manage projects capable of reaching people over large geographical areas. The community-based Integrated Project (IP) in Tanzania, however, has creatively overcome obstacles to produce broadly successful interventions in family planning and maternal-child health care. Reaching out to people with effective IEC and distribution strategies, the IP was introduced to Tanzania in 1984 on a pilot basis to a population of 20,000 and has since expanded to cover more than 200,000 people. The project has developed from the bottom-up through community groups and leaders at different levels. for example, a 42-member women's club was established at the Masama Rural Health Center through which family planning, maternal and child health, and nutrition education activities are promoted. Further, women have formed a family planning association of 74 members of Sonu to talk about family planning and take part in collective activities such as gardening and animal raising; income generated by these women has been used to help further the goals of the IP. Other areas have gained the support of community leaders, politicians, and local groups. Churches, mosques, outpost clinics, MCH clinics, films, and home visits have all been used by the project. Together, these approaches and involved parties have positively affected the rate of contraceptive prevalence in the original IP areas such that they are in the range of 35-49%, compared to the national average of 0-7%. Rates of contraceptive prevalence range 16-34% in new project areas.
Taran, Michail N.; Dyar, M. Darby; Naumenko, Ievgen V.; Vyshnevsky, Olexij A.
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.
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
Sweet, Lara; Pereira, Catherine; Ford, Rosalyn; Feeley, Alison B; Mengkheang, Khin; Adhikary, Indu; Gueye, Ndèye Yaga Sy; Coly, Aminata Ndiaye; Makafu, Cecilia; Zehner, Elizabeth
Abstract 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
Fisher, Jacob C.; Moody, James W.; Kajula, Lusajo J.
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
Ngalawa, Athanas; Simmt, Elaine; Glanfield, Florence
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…
Dize, Laura; West, Sheila; Quinn, Thomas C.; Gaydos, Charlotte A.
Ocular swabs collected in Tanzania were evaluated by Amplicor CT and Aptima Combo2 assays for the detection of Chlamydia trachomatis (CT) to determine if pooling could be used to reduce the cost of detection. Pooling would be an accurate method and so far resulted in a cost-savings of 62.2%. PMID:24079951
Kashoma, Isaac P.; Kassem, Issmat I.; Kumar, Anand; Kessy, Beda M.; Gebreyes, Wondwossen; Kazwala, Rudovick R.; Rajashekara, Gireesh
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
Mhode, Maisara; Nyamhanga, Tumaini
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
Levira, Francis; Todd, Gemma
How are health inequalities articulated across urban and rural spaces in Tanzania? This research paper explores the variations, differences, and inequalities, in Tanzania's health outcomes-to question both the idea of an urban advantage in health and the extent of urban-rural inequalities in health. The three research objectives aim to understand: what are the health differences (morbidity and mortality) between Tanzania's urban and rural areas; how are health inequalities articulated within Tanzania's urban and rural areas; and how are health inequalities articulated across age groups for rural-urban Tanzania? By analyzing four national datasets of Tanzania (National Census, Household Budget Survey, Demographic Health Survey, and Health Demographic Surveillance System), this paper reflects on the outcomes of key health indicators across these spaces. The datasets include national surveys conducted from 2009 to 2012. The results presented showcase health outcomes in rural and urban areas vary, and are unequal. The risk of disease, life expectancy, and unhealthy behaviors are not the same for urban and rural areas, and across income groups. Urban areas show a disadvantage in life expectancy, HIV prevalence, maternal mortality, children's morbidity, and women's BMI. Although a greater level of access to health facilities and medicine is reported, we raise a general concern of quality and availability in health services; what data sources are being used to make decisions on urban-rural services, and the wider determinants of urban health outcomes. The results call for a better understanding of the sociopolitical and economic factors contributing to these inequalities. The urban, and rural, populations are diverse; therefore, we need to look at service quality, and use, in light of inequality: what services are being accessed; by whom; for what reasons?
Stephens, C.; Masamu, E. T.; Kiama, M. G.; Keto, A. J.; Kinenekejo, M.; Ichimori, K.; Lines, J.
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
Mohammed, Najat K.; Kazmili, Brenda
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.
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.
Minde, Elizabeth Maro
Land is the lifeline of people. In Tanzania, most people live in rural areas, where the industrial base is very poor, so issues relating to land are sensitive. This sensitivity is heightened when viewed through an HIV/AIDS lens. Denial of the right to land for people living with HIV/AIDS is tantamount to denying these people their lives. In this article, which is based on a presentation at a symposium session at the conference, Elizabeth Maro Minde examines the problems of land ownership in Tanzania, and describes the approaches used by Kilimanjaro Women's Information Exchange and Consultancy Organisation (KWIECO) to advance women's rights.
This article describes observations of a monitoring mission by JOICFP, the IPPF Regional Africa Office, and JICA in Tanzania, during June 7-13, 1998. The team visited the Morogoro region to review and assess the current major Integrated Program (IP) activities. The community-based distribution agents have been successful in gaining the trust of the community and contributing to social change. Agents are motivated to work and receive additional training, even though they do not receive a salary. Communities recognize the agents as their representatives. Training agents at the grass roots level has been cost effective. The visiting doctor scheme has been successful in maximizing use of health personnel. In one example, 92 patients from 3 villages were treated by a visiting doctor, who had an adequate supply of basic drugs. Service fees paid by patients cover the cost of medicine. Women receive reproductive health and sexually transmitted disease check-ups. The Income Generation Activities (IGA) program strengthens income generation and women's organizations. IGA also provides tools for masonry and carpentry to encourage male participation in the program. The IP has cooperative support from UMATI, the Ministry of Health, UNFPA, and the Japanese government. Essential drugs and equipment are procured by JICA, and delivered through the UMATI-JOICFP distribution channels to government health centers and dispensaries and UMATI's clinics. The experience has confirmed the ability of nongovernmental organizations to supply a multi-bilateral project. Grassroots staff are most appreciative.
Keogh, Sarah C.; Kimaro, Godfather; Muganyizi, Projestine; Philbin, Jesse; Kahwa, Amos; Ngadaya, Esther; Bankole, Akinrinola
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
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
Sara, Stephen; Graham, Jay
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
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
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
Background Several FIDELIS projects (Fund for Innovative DOTS Expansion through Local Initiatives to Stop TB) in Tanzania were conducted by the National Tuberculosis and Leprosy Programme (NTLP) during the years 2004-2008 to strengthen diagnostic and treatment services. These projects collected information on treatment delay and some of it was available for research purposes. With this database our objective was to assess the duration and determinants of treatment delay among new smear positive pulmonary tuberculosis (TB) patients in FIDELIS projects, and to compare delay according to provider visited prior to diagnosis. Methods Treatment delay among new smear positive TB patients was recorded for each patient at treatment initiation and this information was available and fairly complete in 6 out of 57 districts with FIDELIS projects enrolling patients between 2004 and 2007; other districts had discarded their forms at the time of analysis. It was analysed as a cross sectional study. Results We included 1161 cases, 10% of all patients recruited in the FIDELIS projects in Tanzania. Median delay was 12 weeks. The median duration of cough, weight loss and haemoptysis was 12, 8 and 3 weeks, respectively. Compared to Hai district Handeni had patients with longer delays and Mbozi had patients with shorter delays. Urban and rural patients reported similar delays. Patients aged 15-24 years and patients of 65 years or older had longer delays. Patients reporting contact with traditional healers before diagnosis had a median delay of 15 weeks compared to 12 weeks among those who did not. Patients with dyspnoea and with diarrhoea had longer delays. Conclusion In this patient sample in Tanzania half of the new smear positive pulmonary tuberculosis patients had a treatment delay longer than 12 weeks. Delay was similar in men and women and among urban and rural patients, but longer in the young and older age groups. Patients using traditional healers had a 25% longer median delay
Keding, Gudrun B; Msuya, John M; Maass, Brigitte L; Krawinkel, Michael B
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
Mwangome, Mary; Geubbels, Eveline; Klatser, Paul; Dieleman, Marjolein
Diabetes prevalence in Tanzania was estimated at 9.1% in 2012 among adults aged 24-65 years - higher than the HIV prevalence in the general population at that time. Health systems in lower- and middle-income countries are not designed for chronic health care, yet the rising burden of non-communicable diseases such as diabetes demands chronic care services. To inform policies on diabetes care, we conducted a study on the health services in place to diagnose, treat and care for diabetes patients in rural Tanzania. The study was an exploratory and descriptive study involving qualitative methods (in-depth interviews, observations and document reviews) and was conducted in a rural district in Tanzania. Fifteen health providers in four health facilities at different levels of the health care system were interviewed. The health care organization elements of the Innovative Care for Chronic Conditions (ICCC) framework were used to guide assessment of the diabetes services in the district. We found that diabetes care in this district was centralized at the referral and district facilities, with unreliable supply of necessary commodities for diabetes care and health providers who had some knowledge of what was expected of them but felt ill-prepared for diabetes care. Facility and district level guidance was lacking and the continuity of care was broken within and between facilities. The HMIS could not produce reliable data on diabetes. Support for self-management to patients and their families was weak at all levels. In conclusion, the rural district we studied did not provide diabetes care close to the patients. Guidance on diabetes service provision and human resource management need strengthening and policies related to task-shifting need adjustment to improve quality of service provision for diabetes patients in rural settings.
Tungaraza, Frida D.
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…
Ruecker, Gernot; Hoffmann, Anja; Leimbach, David; Tiemann, Joachim; Ng'atigwa, Charles
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
Wensman, Jonas J.; Lindahl, Johanna; Wachtmeister, Nica; Torsson, Emeli; Gwakisa, Paul; Kasanga, Christopher; Misinzo, Gerald
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
Reti, Jay S.
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
Reti, Jay S
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
Yamin, Alicia Ely; Boulanger, Vanessa M.; Falb, Kathryn L.; Shuma, Jane; Leaning, Jennifer
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
Samiji, M. E.
Seeing a need for more teachers in the sciences, including physics, the Tanzanian government upgraded two teachers' training colleges to become constituent colleges of the University of Dar es Salaam. The government has also been aware of the underrepresentation of women in a number of programs, notably science and engineering. The university created two programs—the Pre-Entry Program and the Female Undergraduate Scholarship Program (FUSP)—to facilitate female enrollment in science courses. In 2007 the physics department, in collaboration with the UNESCO Basic Science Program, conducted a workshop for physics teachers in secondary schools. Of 31 participants, six were female. As a result of these efforts, the number of female students who show interest in physics and other fields of science has increased by 5% since 2002.
Mohamed, Hashim Issa; Banda, Felix
The paper problematises student writing as social practice from the perspective of lecturers' discursive practices. The paper uses data from a major study at a higher learning institution in Tanzania to explore lecturers' discursive practices and familiarity with the university orders of discourse including English medium of instruction, in…
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)…
Tawete, Felix K.
The validity of resource sharing activities among libraries in Tanzania is examined, and the main types of libraries in the country are summarized with emphasis on cooperation between libraries. Some areas that need cooperative activity are identified as selection, ordering, processing, storage, conservation and protection of books, interlibrary…
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…
Mankoski, Raymond E.; Collins, Martha; Ndosi, Noah K.; Mgalla, Ella H.; Sarwatt, Veronica V.; Folstein, Susan E.
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…
Samoff, Joel; Sumra, Suleman
This paper assesses educational planning in Tanzania as moving from one of hope to despair as the country becomes more reliant upon foreign aid. As the country moved from colonialism, basic education was to be accessible to all children and adult illiteracy was to be eliminated. By the 1980s financial crisis and the conditions that accompanied…
Adhvaryu, Achyuta R.; Nyshadham, Anant
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.…
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…
Johnson, Megan Patricia
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,…
Kondylis, Florence; Manacorda, Marco
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…
Darling, Brianna; Thorp, Laurie; Chung, Kimberly
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 to community…
Development Goal "Achieve universal primary education", the challenges faced, along with the way forward towards achieving the fourth Sustainable Development Goal "Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all". Statistics show that Tanzania has made very promising steps…
Lewis, Kelly M.; Robkin, Navit; Gaska, Karie; Njoki, Lillian Carol
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.…
Lewallen, Susan; Massae, Patrick; Tharaney, Manisha; Somba, Margareth; Geneau, Robert; MacArthur, Chad; Courtright, Paul
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…
Mnubi, Godfrey M.
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…
Dill, Tatjana; Dobler, Gerhard; Saathoff, Elmar; Clowes, Petra; Kroidl, Inge; Ntinginya, Elias; Machibya, Harun; Maboko, Leonard; Löscher, Thomas; Hoelscher, Michael
Rickettsioses caused by typhus group rickettsiae have been reported in various African regions. We conducted a cross-sectional survey of 1,227 participants from 9 different sites in the Mbeya region, Tanzania; overall seroprevalence of typhus group rickettsiae was 9.3%. Risk factors identified in multivariable analysis included low vegetation density and highway proximity. PMID:23347529
Tedre, Matti; Bangu, Nicholas; Nyagava, Seth I.
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…
Kisanga, Felix; Nystrom, Lennarth; Hogan, Nora; Emmelin, Maria
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…
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…
Mwandosya, M.J.; Meena, H.E.
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.
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…
Mikkelsen-Lopez, Inez; Cowley, Peter; Kasale, Harun; Mbuya, Conrad; Reid, Graham; de Savigny, Don
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.
Dalusi, Lucy; Lyimo, Thomas J; Lugomela, Charles; Hosea, Ken M M; Sjöling, Sara
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.
Jaribu, Jennie; Penfold, Suzanne; Manzi, Fatuma; Schellenberg, Joanna; Pfeiffer, Constanze
Objective To describe health workers’ perceptions of a quality improvement (QI) intervention that focused on improving institutional childbirth services in primary health facilities in Southern Tanzania. Design A qualitative design was applied using in-depth interviews with health workers. Setting This study involved the Ruangwa District Reproductive and Child Health Department, 11 dispensaries and 2 health centres in rural Southern Tanzania. Participants 4 clinical officers, 5 nurses and 6 medical attendants from different health facilities were interviewed. Results The healthcare providers reported that the QI intervention improved their skills, capacity and confidence in providing counselling and use of a partograph during labour. The face-to-face QI workshops, used as a platform to refresh their knowledge on maternal and newborn health and QI methods, facilitated peer learning, networking and standardisation of care provision. The onsite follow-up visits were favoured by healthcare providers because they gave the opportunity to get immediate help, learn how to perform tasks in practice and be reminded of what they had learnt. Implementation of parallel interventions focusing on similar indicators was mentioned as a challenge that led to duplication of work in terms of data collection and reporting. District supervisors involved in the intervention showed interest in taking over the implementation; however, funding remained a major obstacle. Conclusions Healthcare workers highlighted the usefulness of applying a QI approach to improve maternal and newborn health in rural settings. QI programmes need careful coordination at district level in order to reduce duplication of work. PMID:27660313
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
Sherrod, David R.; Magigita, Masota M.; Kwelwa, Shimba
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.
Ngowi, Helena A.; Kassuku, Ayub A.; Carabin, Hélène; Mlangwa, James E. D.; Mlozi, Malongo R. S.; Mbilinyi, Boniface P.; Willingham, Arve L.
prevalence study did not reveal any significant clustering by this method. Spatial scan statistics found one significant cluster of porcine cysticercosis prevalence (P = 0.0036; n = 370). In addition, the analysis found one large cluster of porcine cysticercosis incidence based on Ag-ELISA (P = 0.0010; n = 236) and two relatively small clusters of incidence based on lingual examination (P = 0.0012 and P = 0.0026; n = 241). These clusters had similar spatial location and included six wards, four of which were identified as high risk areas of porcine cysticercosis. Conclusion/Significance This study has identified local clusters of porcine cysticercosis in Mbulu district, northern Tanzania, where limited resources for control of T. solium could be directed. Further studies are needed to establish causes of clustering to institute appropriate interventions. PMID:20386601
Kida, Irene A; Åstrøm, Anne N; Strand, Gunhild V; Masalu, Joyce R
Background Focusing 50 year olds and above, this study assessed the frequency, extent and correlates of tooth loss due to various reasons. Frequency and correlates of posterior occluding support was also investigated. Method A cross-sectional household survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. One thousand and thirty-one subjects, mean age 62.9 years participated in a clinical examination and completed interviews. Results The prevalence of tooth loss due to any reason was 83.5 %, due to caries 63.4% and due to other reasons than caries, 32.5%. A total of 74.9% had reduced number of posterior occluding units. Compared to subjects having less than 5 teeth lost due to caries, those with 5 or more lost teeth were more likely to be females, having decayed teeth, confirming dental attendance and to be among the least poor residents. Compared to subjects who had lost less than 5 teeth due to reasons other than caries, those who had lost 5 or more teeth were more likely to be of higher age, having mobile teeth, being males, being very poor and to disconfirm dental attendance when having problems. Predictors of prevalence of tooth loss (1 or more lost tooth) due to various reasons and reduced number of occluding units followed similar patterns of relationships. Conclusion The results are consistent with prevalence and extent of tooth loss due to caries and due to reasons other than caries being differently related to disease- and socio- behavioral risk indicators. Caries was the principle cause of tooth loss and molar teeth were the teeth most commonly lost. PMID:16536880
Tamalavage, A.; Magill, C. R.; Barboni, D.; Ashley, G. M.; Freeman, K. H.
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.
Blaauw, Duane; Ditlopo, Prudence; Maseko, Fresier; Chirwa, Maureen; Mwisongo, Aziza; Bidwell, Posy; Thomas, Steve; Normand, Charles
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
Bond, Monica L; Strauss, Megan K L; Lee, Derek E
Giraffe skin disease (GSD) is a disorder of undetermined etiology that causes lesions on the forelimbs of Masai giraffe ( Giraffa camelopardalis tippelskirchi) in Tanzania, East Africa. We examined soil correlates of prevalence of GSD from 951 giraffe in 14 sites in Tanzania, and estimated mortality using 3 yr of longitudinal mark-recapture data from 382 giraffe with and without GSD lesions, in Tarangire National Park (TNP). Spatial variation in GSD prevalence was best explained by soil fertility, measured as cation exchange capacity. We found no mortality effect of GSD on adult giraffe in TNP. Based on our findings, GSD is unlikely to warrant immediate veterinary intervention, but continued monitoring is recommended to ensure early detection if GSD-afflicted animals begin to show signs of increased mortality or other adverse effects.
Patil, Crystal L
Women all over the globe report physical and appetite sensations in early pregnancy, and this study contributes to this growing literature by reporting on the appetite sensations experienced by pregnant women from rural Tanzania. Appetite changes associated with 545 pregnancies were compiled from surveys conducted to report on the prevalence of appetite loss, nausea, vomiting, dizziness, joint pain, cravings, aversions, and pica experienced by agropastoral women from rural north-central Tanzania. In addition to these symptoms, specific craved and aversive food groups are described. Statistical associations among appetite sensations, NVP, and birthweight are tested. The only symptom associated with a lower average birth weight for newborns was vomiting. In addition to investigating micronutrient content and chemical properties of specific food and non-food items, future research should include assessing relationships among various appetite sensations and short- and long-term health outcomes for both the mother and child.
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
Societal ideas and explanations of albinism at the local level in Tanzania are conceived in terms of family history, social relations, economic status, moral-religious positions, global-local flows of information and humanitarian actions on behalf of people with the congenital condition. This paper aims to show how the subjectivities of people with albinism in Tanzania are shaped and re-shaped through local moral conceptions as well as globalizing (bio)medical explanations of albinism. An exemplary case study of a 28-year-old woman, plus episodes from the lives of seven other informants with the condition, are analyzed in order to understand, on the one hand, local social relationships between people with albinism and other individuals in family and community settings, and on the other hand, the interconnections between persons with albinism and global humanitarian actors and the broadcast media. When stigma and marginalizing behaviors are perceived by individuals with albinism in Tanzania as impeding their social lives, they employ different coping strategies and discourses to enhance social acceptance.
ABSTRACT Societal ideas and explanations of albinism at the local level in Tanzania are conceived in terms of family history, social relations, economic status, moral-religious positions, global-local flows of information and humanitarian actions on behalf of people with the congenital condition. This paper aims to show how the subjectivities of people with albinism in Tanzania are shaped and re-shaped through local moral conceptions as well as globalizing (bio)medical explanations of albinism. An exemplary case study of a 28-year-old woman, plus episodes from the lives of seven other informants with the condition, are analyzed in order to understand, on the one hand, local social relationships between people with albinism and other individuals in family and community settings, and on the other hand, the interconnections between persons with albinism and global humanitarian actors and the broadcast media. When stigma and marginalizing behaviors are perceived by individuals with albinism in Tanzania as impeding their social lives, they employ different coping strategies and discourses to enhance social acceptance. PMID:27354179
Munga, Michael A; Gideon, Gilbert M
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.
Mtonga, Harry L.
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)
Chediel, Richard W.; Sekwao, Nesta; Kirumba, Pinnecy L.
Case studies were undertaken to investigate nongovernmental education in Tanzania, both Mainland and Zanzibar. This report focuses on Mainland Tanzania. In the 1960s and 1970s, during the government campaign for free universal public education, all private schools, whether missionary or NGO-run, were nationalized by the government and became…
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...
Low soil fertility is a limiting factor for bean production in East Africa. In Tanzania low available N and P soils are widespread. Average bean yields in Tanzania are around 500 kg/ha although the potential yield under reliable rain-fed conditions is 1500–3000kg/ha, using improved varieties and pro...
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…
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…
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…
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…
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…
Sperna Weiland, Frederiek; Boehlert, Brent; Meijer, Karen; Schellekens, Jaap; Magnell, Jan-Petter; Helbrink, Jakob; Kassana, Leonard; Liden, Rikard
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
Sarita, P T; Tuominen, R
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.
Lewis, Ashley L.; Baird, Timothy D.; Sorice, Michael G.
Throughout the developing world, mobile phones are spreading rapidly into rural areas where subsistence livelihoods, biodiversity conservation, and human-wildlife conflict (HWC) are each common. Despite this trend, little is known about the relationship between mobile phones and HWC in conservation landscapes. This paper examines this relationship within ethnically Maasai communities in northern Tanzania on the border of Tarangire National Park. Mixed qualitative and quantitative methods of data collection and analysis are used to (1) describe how Maasai agro-pastoralists use phones to manage human-wildlife interactions; and (2) assess the relationship between phone use and measures of HWC, controlling for other factors. The findings indicate that households use phones to reduce the number and severity of HWC events and that the relationship between phones and HWC varies according to the type of HWC.
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
Vyas, Seema; Heise, Lori
Estimates of the effect of employment on women's risk of partner violence in cross-sectional studies are subject to potential "self-selection bias." Women's personal choice of whether to pursue employment or not may create fundamental differences between the group of women who are employed and those who are not employed that standard regression methods cannot account for even after adjusting for confounding. The aim of this study is to demonstrate the utility of propensity score matching (PSM), a technique used widely in econometrics, to address this bias in cross-sectional studies. We use PSM to estimate an unbiased effect-size of women's employment on their risk of experiencing partner violence in urban and rural Tanzania using data from the 2010 Tanzania Demographic and Health Survey (DHS). Three different measures of women's employment were analyzed: whether they had engaged in any productive work outside of the home in the past year, whether they received payment in cash for this productive work, and whether their employment was stable. Women who worked outside of the home were significantly different from those who did not. In both urban and rural Tanzania, women's risk of violence appears higher among women who worked in the past year than among those who did not, even after using PSM to account for underlying differences in these two groups of women. Being paid in cash reversed this effect in rural areas whereas stability of employment reduced this risk in urban centers. The estimated size of effect varied by type of matching estimator, but the direction of the association remained largely consistent. This study's findings suggest substantial self-selection into employment. PSM methods, by compensating for this bias, appear to be a useful tool for estimating the relationship between women's employment and partner violence in cross-sectional studies.
Kashoma, Isaac P; Kassem, Issmat I; John, Julius; Kessy, Beda M; Gebreyes, Wondwossen; Kazwala, Rudovick R; Rajashekara, Gireesh
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.
Francis, Joel M.; Weiss, Helen A.; Mshana, Gerry; Baisley, Kathy; Grosskurth, Heiner; Kapiga, Saidi H.
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
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.
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
Watson-Jones, Deborah; Lees, Shelley; Mwanga, Joseph; Neke, Nyasule; Changalucha, John; Broutet, Nathalie; Maduhu, Ibrahim; Kapiga, Saidi; Chandra-Mouli, Venkatraman; Bloem, Paul; Ross, David A
Background: Human papillomavirus (HPV) vaccination offers an opportunity to strengthen provision of adolescent health interventions (AHI). We explored the feasibility of integrating other AHI with HPV vaccination in Tanzania. Methods: A desk review of 39 policy documents was preceded by a stakeholder meeting with 38 policy makers and partners. Eighteen key informant interviews (KIIs) with health and education policy makers and district officials were conducted to further explore perceptions of current programs, priorities and AHI that might be suitable for integration with HPV vaccination. Results: Fourteen school health interventions (SHI) or AHI are currently being implemented by the Government of Tanzania. Most are delivered as vertical programmes. Coverage of current programs is not universal, and is limited by financial, human resource and logistic constraints. Limited community engagement, rumours, and lack of strategic advocacy has affected uptake of some interventions, e.g. tetanus toxoid (TT) immunization. Stakeholder and KI perceptions and opinions were limited by a lack of experience with integrated delivery and AHI that were outside an individual’s area of expertise and experience. Deworming and educational sessions including reproductive health education were the most frequently mentioned interventions that respondents considered suitable for integrated delivery with HPV vaccine. Conclusions: Given programme constraints, limited experience with integrated delivery and concern about real or perceived side-effects being attributed to the vaccine, it will be very important to pilot-test integration of AHI/SHI with HPV vaccination. Selected interventions will need to be simple and quick to deliver since health workers are likely to face significant logistic and time constraints during vaccination visits. PMID:26768827
Mswia, Robert; Lewanga, Mary; Moshiro, Candida; Whiting, David; Wolfson, Lara; Hemed, Yusuf; Alberti, K. G. M. M.; Kitange, Henry; Mtasiwa, Deo; Setel, Philip
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
Mushi, Hildegalda P; Mullei, Kethi; Macha, Janet; Wafula, Frank; Borghi, Josephine; Goodman, Catherine; Gilson, Lucy
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
Larsen, Anna; Exavery, Amon; Phillips, James F; Tani, Kassimu; Kanté, Almamy M
Objectives Four antenatal visits, delivery in a health facility, and three postnatal visits are the World Health Organization recommendations for women to optimize maternal health outcomes. This study examines maternal compliance with the full recommended maternal health visits in rural Tanzania with the goal of illuminating interventions to reduce inequalities in maternal health. Methods Analysis included 907 women who had given birth within two years preceding a survey of women of reproductive age. Multinomial logistic regression was used to assess the influence of maternal, household, and community-level characteristics on four alternative classes defining relative compliance with optimal configuration of maternal health care seeking behavior. Results Parity, wealth index, timeliness of ANC initiation, nearest health facility type, religion, and district of residence were significant predictors of maternal health care seeking when adjusted for other factors. Multiparous women compared to primiparous were less likely to seek care at the high level [RRR 0.16, 95 % confidence interval (CI) 0.06-0.46], at the mid-level (RRR 0.22, 95 % CI 0.09-0.58), and the mid-low level (RRR 0.27, 95 % CI 0.09-0.80). Women in the highest wealth index compared to those in the poorest group were almost three times more likely to seek the highest two levels of care versus the lowest level (high RRR 2.92, 95 % CI 1.27-6.71, mid-level RRR 2.71, 95 % 1.31-5.62). Conclusion Results suggest that efforts to improve the overall impact of services on the continuum of care in rural Tanzania would derive particular benefit from strategies that improve maternal health coverage among multiparous and low socioeconomic status women.
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
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
Mtaya, Matilda; Åstrøm, Anne N; Tsakos, Georgios
Background There is a need for studies evaluating oral health related quality of life (OHRQoL) of children in developing countries. Aim to assess the psychometric properties, prevalence and perceived causes of the child version of oral impact on daily performance inventory (Child-OIDP) among school children in two socio-demographically different districts of Tanzania. Socio-behavioral and clinical correlates of children's OHRQoL were also investigated. Method One thousand six hundred and one children (mean age 13 yr, 60.5% girls) attending 16 (urban and rural) primary schools in Kinondoni and Temeke districts completed a survey instrument in face to face interviews and participated in a full mouth clinical examination. The survey instrument was designed to measure a Kiswahili translated and culturally adapted Child-OIDP frequency score, global oral health indicators and socio-demographic factors. Results The Kiswahili version of the Child-OIDP inventory preserved the overall concept of the original English version and revealed good reliability in terms of Cronbach's alpha coefficient of 0.77 (Kinondoni: 0.62, Temeke: 0.76). Weighted Kappa scores from a test-retest were 1.0 and 0.8 in Kinondoni and Temeke, respectively. Validity was supported in that the OIDP scores varied systematically and in the expected direction with self-reported oral health measures and socio-behavioral indicators. Confirmatory factor analyses, CFA, confirmed three dimensions identified initially by Principle Component Analysis within the OIDP item pool. A total of 28.6% of the participants had at least one oral impact. The area specific rates for Kinondoni and Temeke were 18.5% and 45.5%. The most frequently reported impacts were problems eating and cleaning teeth, and the most frequently reported cause of impacts were toothache, ulcer in mouth and position of teeth. Conclusion This study showed that the Kiswahili version of the Child-OIDP was applicable for use among schoolchildren in
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
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
Kamazima, Switbert R; Ezekiel, Mangi J; Kazaura, Method R; Fimbo, Benett
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.
Mbwele, B; Slot, A; De Mast, Q; Kweka, P; Msuya, M; Hulscher, M
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. PMID:27213093
Tayabali Jiwaji, Noorali
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.
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
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.
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…
Fichera, Eleonora; Savage, David
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
Adhvaryu, Achyuta R; Nyshadham, Anant
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.
Adhvaryu, Achyuta R.; Nyshadham, Anant
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
Ishengoma, Johnson M.
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.
Schmidt, P; Avery, D H
Western scientists and students of history have long explaind th iron bloomery process by evidence available from European archeology. Ethnographic, technological, and archeological research into the technological life of the Haya of northwestern Tanzania show that these people and their forebears 1500 to 2000 years ago practiced a highly advanced iron smelting technology based on preheating principles and, as a result, produced carbon steel. This sophisticated technology may have evolved as an adaptation to overexploited forest resources. These discoveries are significant for the history of Africa and the history of metallurgy.
Makani, Julie; Cox, Sharon E.; Soka, Deogratius; Komba, Albert N.; Oruo, Julie; Mwamtemi, Hadija; Magesa, Pius; Rwezaula, Stella; Meda, Elineema; Mgaya, Josephine; Lowe, Brett; Muturi, David; Roberts, David J.; Williams, Thomas N.; Pallangyo, Kisali; Kitundu, Jesse; Fegan, Gregory; Kirkham, Fenella J.; Marsh, Kevin; Newton, Charles R.
Background The World Health Organization has declared Sickle Cell Anemia (SCA) a public health priority. There are 300,000 births/year, over 75% in Africa, with estimates suggesting that 6 million Africans will be living with SCA if average survival reaches half the African norm. Countries such as United States of America and United Kingdom have reduced SCA mortality from 3 to 0.13 per 100 person years of observation (PYO), with interventions such as newborn screening, prevention of infections and comprehensive care, but implementation of interventions in African countries has been hindered by lack of locally appropriate information. The objective of this study was to determine the incidence and factors associated with death from SCA in Dar-es-Salaam. Methods and Findings A hospital-based cohort study was conducted, with prospective surveillance of 1,725 SCA patients recruited from 2004 to 2009, with 209 (12%) lost to follow up, while 86 died. The mortality rate was 1.9 (95%CI 1.5, 2.9) per 100 PYO, highest under 5-years old [7.3 (4.8–11.0)], adjusting for dates of birth and study enrollment. Independent risk factors, at enrollment to the cohort, predicting death were low hemoglobin (<5 g/dL) [3.8 (1.8–8.2); p = 0.001] and high total bilirubin (≥102 µmol/L) [1.7 (1.0–2.9); p = 0.044] as determined by logistic regression. Conclusions Mortality in SCA in Africa is high, with the most vulnerable period being under 5-years old. This is most likely an underestimate, as this was a hospital cohort and may not have captured SCA individuals with severe disease who died in early childhood, those with mild disease who are undiagnosed or do not utilize services at health facilities. Prompt and effective treatment for anemia in SCA is recommended as it is likely to improve survival. Further research is required to determine the etiology, pathophysiology and the most appropriate strategies for management of anemia in SCA. PMID:21358818
Maman, Suzanne; Kajula, Lusajo; Balvanz, Peter; Kilonzo, Mrema; Mulawa, Marta; Yamanis, Thespina
Gender inequality is at the core of the HIV patterns that are evident in sub-Saharan Africa. Gender-based violence (GBV) and lack of economic opportunity are important structural determinants of HIV risk. We piloted a microfinance and health promotion intervention among social networks of primarily young men in Dar es Salaam. Twenty-two individuals participated in the microfinance component and 30 peer leaders were recruited and trained in the peer health leadership component. We collected and analysed observational data from trainings, monitoring data on loan repayment, and reports of peer conversations to assess the feasibility and acceptability of the intervention. Eighteen of the loan recipients (82%) paid back their loans, and of these 15 (83%) received a second, larger loan. Among the loan defaulters, one died, one had chronic health problems, and two disappeared, one of whom was imprisoned for theft. The majority of conversations reported by peer health leaders focused on condoms, sexual partner selection, and HIV testing. Few peer leaders reported conversations about GBV. We demonstrated the feasibility and acceptability of this innovative HIV and GBV prevention intervention. The lessons learned from this pilot have informed the implementation of a cluster-randomised trial of the microfinance and peer health leadership intervention.
Maman, Suzanne; Kajula, Lusajo; Balvanz, Peter; Kilonzo, Mrema Noel; Mulawa, Marta; Yamanis, Thespina
Gender inequality is at the core of the HIV patterns that are evident in sub-Saharan Africa. Gender-based violence (GBV) and lack of economic opportunity are important structural determinants of HIV risk. We piloted a microfinance and health promotion intervention among social networks of primarily young men in Dar es Salaam. Twenty-two individuals participated in the microfinance component and 30 peer leaders were recruited and trained in the peer health leadership component. We collected and analyzed observational data from trainings, monitoring data on loan repayment, and reports of peer conversations to assess the feasibility and acceptability of the intervention. Eighteen of the loan recipients (82%) paid back their loans, and of these 15 (83%) received a second, larger loan. Among the loan defaulters, one died, one had chronic health problems, and two disappeared, one of whom was imprisoned for theft. The majority of conversations reported by peer health leaders focused on condoms, sexual partner selection and HIV testing. Few peer leaders reported conversations about GBV. We demonstrated the feasibility and acceptability of this innovative HIV and GBV prevention intervention. The lessons learned from this pilot have informed the implementation of a cluster-randomized trial of the microfinance and peer health leadership intervention. PMID:26588115
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
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.
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.
Seth, Misago; Saguti, Fredy
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.
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.
Mushi, Philemon A. K.
A number of adult education innovations were introduced in Tanzania in the late 1960s and early 1970s. This article analyzes the context of three innovations, namely functional literacy, workers' education and the programme of the Folk Development Colleges. The analysis reveals that these innovations had firm roots within the socio-economic conditions prevailing in the country in the 1960s and 1970s, Nyerere's influence as President and Party leader, Tanzania's ideology of development, the policy of popular participation, the roots of educational policy in a humanistic philosophy of education, and indigenous education. Some of the factors which affected their implementation included lack of trained educators, inadequate financial resources, ineffective evaluation mechanisms, and a mis-match between participants' needs and actual programmes. It is suggested that there is a need to introduce economic innovations alongside educational innovations, to involve participants in determining their training needs, and to train and retain adult educators with a view to improving adult education initiatives in the country.
Durnez, Lies; Katakweba, Abdul; Sadiki, Harrison; Katholi, Charles R.; Kazwala, Rudovick R.; Machang'u, Robert R.; Portaels, Françoise; Leirs, Herwig
The control of bovine tuberculosis and atypical mycobacterioses in cattle in developing countries is important but difficult because of the existence of wildlife reservoirs. In cattle farms in Tanzania, mycobacteria were detected in 7.3% of 645 small mammals and in cow's milk. The cattle farms were divided into “reacting” and “nonreacting” farms, based on tuberculin tests, and more mycobacteria were present in insectivores collected in reacting farms as compared to nonreacting farms. More mycobacteria were also present in insectivores as compared to rodents. All mycobacteria detected by culture and PCR in the small mammals were atypical mycobacteria. Analysis of the presence of mycobacteria in relation to the reactor status of the cattle farms does not exclude transmission between small mammals and cattle but indicates that transmission to cattle from another source of infection is more likely. However, because of the high prevalence of mycobacteria in some small mammal species, these infected animals can pose a risk to humans, especially in areas with a high HIV-prevalence as is the case in Tanzania. PMID:21785686
Babalola, O E; Maegga, B; Katenga, S; Ogbuagu, F K; Umeh, R E; Seketeli, E; Braide, E
The goal of the African Programme for Onchocerciasis Control (APOC) is to eliminate Onchocerciasis as a disease of public Health significance and an important constraint to socio-economic development in the 19 none OCP (Onchocerciasis Control Project) countries covered through Community-Directed Treatment with Ivermectin, CDTI. In 1998, impact assessment studies were carried out in Morogoro, Tanzania during which baseline ophthalmological parameters were established. The hypothesis being tested is that CDTI will prevent or delay progression of onchocercal eye lesions and blindness. A total of 425 subjects aged 10 years or more from 14 villages within Bwakira district ofMorogoro region in Tanzania were examined for Snellen visual acuity, ocular microfilaria, lens opacities, uveitis and posterior segment disease especially chorioretinitis and optic nerve disease. Motion Sensitivity Screening Test (MSST) was carried out as well. Microfilaria was present in the anterior chamber of nearly half (49.2%) of all subjects examined. Prevalence of blindness was extremely high at 15.2%. Onchocercal lesions were responsible for blindness in 41.5% of these, followed by cataracts (27.7%), glaucoma (10.8%) and trachoma (6.2%). The main pathway to onchocercal blindness in this population was anterior uveitis with or without secondary cataracts. There is an urgent need to get CDTI underway and institute other horizontal primary eye care measures, especially cataract backlog reduction, in order to reduce the excessive burden of avoidable blindness in this community.
WILSON, R. Trevor
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
Kempen, Bas; Kaaya, Abel; Ngonyani Mhaiki, Consolatha; Kiluvia, Shani; Ruiperez-Gonzalez, Maria; Batjes, Niels; Dalsgaard, Soren
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
Mtenga, S; Shamba, D; Wamoyi, J; Kakoko, D; Haafkens, J; Mongi, A; Kapiga, S; Geubbels, E
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
Peterson, Stefan; Marchant, Tanya; Mbaruku, Godfrey; Temu, Silas; Manzi, Fatuma; Hanson, Claudia
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
Larson, Elysia; Rabkin, Miriam; Mbaruku, Godfrey M; Mbatia, Redempta; Kruk, Margaret E
Objectives To assess the prevalence of high blood pressure amongst postpartum women in rural Tanzania, and to explore factors associated with hypertension prevalence, awareness, treatment, and control. Methods 1849 women in Tanzania's Pwani Region who delivered a child in the prior year participated in the study. We measured blood pressure, administered a structured questionnaire and assessed factors associated with the prevalence, awareness, treatment, and control of hypertension (HTN) using bivariable and multivariable logistic regressions. Findings 26.7% of women had high blood pressure and/or were taking antihypertensive medication. Women were on average 27.5 years old (range 15-54). Nearly all women (99.5%) reported contact with the health system during their pregnancy and delivery, with an average of 5.2 visits for their own care in the past year. Only 23.5% of those with HTN were aware of their diagnosis, 17.4% were taking medication, and only 10.5% had controlled blood pressure. In multivariable analysis, facility delivery, health insurance, and increased distance from a hospital were associated with increased likelihood of HTN awareness; facility delivery and hospital distance were associated with current hypertensive treatment; younger age and increased hospital distance were associated with control of HTN. Conclusion The prevalence of high blood pressure in this postpartum population was high, and despite frequent recent contacts with the health system, awareness, treatment and control of HTN were low. These findings highlight an important missed opportunity to improve women's health during antenatal and postnatal care.
Dobler, Gerhard; Saathoff, Elmar; Kroidl, Inge; Ntinginya, Nyanda Elias; Maboko, Leonard; Löscher, Thomas; Hoelscher, Michael; Heinrich, Norbert
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
Minihane, M.; Lettenmaier, D. P.
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.
Sommer, Marni; Likindikoki, Samuel; Kaaya, Sylvia
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
Stewart, Fiona A; Piel, Alex K
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.
Lyatuu, Margaret Benjamin; Mkumbwa, Temina; Stevenson, Raz; Isidro, Marissa; Modaha, Francis; Katcher, Heather; Dhillon, Christina Nyhus
Background: Micronutrient deficiency in Tanzania is a significant public health problem, with vitamin A deficiency (VAD) affecting 34% of children aged 6 to 59 months. Since 2007, development partners have worked closely to advocate for the inclusion of twice-yearly vitamin A supplementation and deworming (VASD) activities with budgets at the subnational level, where funding and implementation occur. As part of the advocacy work, a VASD planning and budgeting tool (PBT) was developed and is used by district officials to justify allocation of funds. Helen Keller International (HKI) and the Tanzania Food and Nutrition Centre (TFNC) conduct reviews of VASD funds and health budgets annually in all districts to monitor the impact of advocacy efforts. This paper presents the findings of the fiscal year (FY) 2010 district budget annual review. The review was intended to answer the following questions regarding district-level funding: (1) how many funds were allocated to nutrition-specific activities in FY 2010? (2) how many funds were allocated specifically to twice-yearly VASD activities in FY 2010? and (3) how have VASD funding allocations changed over time? Methods: Budgets from all 133 districts in Tanzania were accessed, reviewed and documented to identify line item funds allocated for VASD and other nutrition activities in FY 2010. Retrospective data from prior annual reviews for VASD were used to track trends in funding. The data were collected using specific data forms and then transcribed into an excel spreadsheet for analysis. Results: The total funds allocated in Tanzania’s districts in FY 2010 amounted to US$1.4 million of which 92% were for VASD. Allocations for VASD increased from US$0.387 million to US$1.3 million between FY 2005 and FY 2010. Twelve different nutrition activities were identified in budgets across the 133 districts. Despite the increased trend, the percentage of districts allocating sufficient funds to implement VAS (as defined by cost per
Pozio, E; De Meneghi, D; Roelke-Parker, M E; La Rosa, G
A survey of trichinellosis among sylvatic carnivore mammals from the Serengeti ecosystem (Tanzania) demonstrated the presence of Trichinella nelsoni in 5 of 9 species examined. Muscle samples were collected from carcasses of 56 carnivores from 1993 to 1995 and frozen before transport and examination. Following artificial digestion of the samples, collected larvae were analyzed by the random amplified polymorphic DNA technique. Trichinella nelsoni was identified in 1 bat-eared fox (Otocyon megalotis), 1 cheetah (Acinonyx jubatus), 1 leopard (Panthera pardus), 3 lions (Panthera leo), and 3 spotted hyenas (Crocuta crocuta). The numbers of bat-eared foxes (6), cheetahs (5), and leopards (3) examined were too small to reveal the roles of these carnivore species in the ecology of T. nelsoni. The numbers of lions and spotted hyenas examined, with a prevalence of 12% and 23%, respectively, suggest that these species may be reservoirs of T. nelsoni in the area under study.
Packer, Craig; Ikanda, Dennis; Kissui, Bernard; Kushnir, Hadas
Large carnivores inspire opposition to conservation efforts owing to their impact on livestock and human safety. Here we analyse the pattern of lion attacks over the past 15 years on humans in Tanzania, which has the largest population of lions in Africa, and find that they have killed more than 563 Tanzanians since 1990 and injured at least 308. Attacks have increased dramatically during this time: they peak at harvest time each year and are most frequent in areas with few prey apart from bush pigs (Potamochoerus larvatus), the most common nocturnal crop pest. Our findings provide an important starting point for devising strategies to reduce the risk to rural Tanzanians of lion attacks.
Benson, J S
In the late 1980s, many developing countries were forced to adopt structural adjustment policies as a condition for securing loans from the International Monetary Fund (IMF) and the World Bank. One of the World Bank's recommended policies was to change the mix of private and public health facilities. This study, based on fieldwork done in Tanzania in 1993, examines the impact of this policy on health-care accessibility in two northern Tanzanian districts, one rural and one urban. Accessibility was measured in terms of equality and equity of coverage. The placement of the very few government clinics opened during the years 1985-1993 did much more to improve coverage than the haphazard location of many new private clinics. Equity was not improved as very few clinics were placed in demographically needy areas.
Fritz, H.; Hauzenberger, C. A.; Tenczer, V.
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
Mwidunda, Patrick E; Eliakimu, Eliudi
Although quality improvement has been a priority for Tanzania's health sector since the 1970s, few effective quality improvement initiatives were implemented, due to limited expertise, political commitment and resources. More recently, as the HIV epidemic gained momentum within the country, an influx of funding and of international organizations with quality improvement expertise accelerated the implementation of quality improvement projects, as well as efforts to institutionalize quality improvement at the national level. The support of US President's Emergency Plan for AIDS Relief (PEPFAR) and other donors, and the increasing numbers of HIV-implementing partners focused on quality management, and quality improvement strategies catalysed the development of HIV-specific quality improvement initiatives first, and then of national quality improvement frameworks. The diversity of quality improvement approaches championed by various donors and partners also presented important challenges to harmonization and institutionalization of quality improvement programmes.
Chavasse, D C; Lines, J D; Ichimori, K; Majala, A R; Minjas, J N; Marijani, J
In two contrasting areas of Dar es Salaam (Ilala and Mikocheni) all enclosed breeding sites of Culex quinquefasciatus, such as latrines and septic tanks, were treated with a floating layer of expanded polystyrene beads. 7 months later checks in both study areas revealed only one site (from which the polystyrene had been removed during emptying) containing immature stages of Cx quinquefasciatus. Open breeding sites such as areas of flooded land and blocked drains were treated with pyriproxyfen (an insect growth regulator) at a concentration of 0.1 ppm. Emergence of Cx quinquefasciatus adults from these sites was inhibited for 4 weeks during the rainy season and for up to 11 weeks during the dry season. The problem of mosquito breeding sites caused by bathroom sullage water was addressed through a combination of health education and indirect pressure from the Urban Malaria Control Project (UMCP) via local community leaders. Households responsible for these sites were encouraged to eliminate them by diverting the water into an enclosed drainage structure, usually a pit latrine. After two weekly visits 64.7% of households had complied and 93.4% had complied after five visits. 5 months later, only 15.7% had reverted to allowing sullage water to collect into puddles. Densities of Cx quinquefasciatus adults dropped by 76.7% in Mikocheni and by 46.2% in Ilala following intervention, but increased by 84.9% and 25.6% in two untreated comparison areas. The reasons for differential success of the combined interventions in the two treated areas are discussed.
Billings, Erik; Sanders-Buell, Eric; Bose, Meera; Kijak, Gustavo H; Bradfield, Andrea; Crossler, Jacqueline; Arroyo, Miguel A; Maboko, Leonard; Hoffmann, Oliver; Geis, Steffen; Birx, Deborah L; Kim, Jerome H; Michael, Nelson L; Robb, Merlin L; Hoelscher, Michael; Tovanabutra, Sodsai
In preparation for vaccine trials, HIV-1 genetic diversity was surveyed between 2002 and 2006 through the Cohort Development study in the form of a retrospective and prospective observational study in and around the town of Mbeya in Tanzania's Southwest Highlands. This study describes the molecular epidemiology of HIV-1 strains obtained from 97 out of 106 incident HIV-1 infections identified in three subpopulations of participants (one rural, two urban) from the Mbeya area. Near full-genome or half-genome sequencing showed a subtype distribution of 40% C, 17% A1, 1% D, and 42% inter-subtype recombinants. Compared to viral subtyping results previously obtained from the retrospective phase of this study, the overall proportion of incident viral strains did not change greatly during the study course, suggesting maturity of the epidemic. A comparison to a current Phase I-II vaccine being tested in Africa shows ∼17% amino acid sequence difference between the gp120 of the vaccine and subtype C incident strains. Phylogenetic and recombinant breakpoint analysis of the incident strains revealed the emergence of CRF41_CD and many unique recombinants, as well as the presence of six local transmission networks most of which were confined to the rural subpopulation. In the context of vaccine cohort selection, these results suggest distinct infection transmission dynamics within these three geographically close subpopulations. The diversity and genetic sequences of the HIV-1 strains obtained during this study will greatly contribute to the planning, immunogen selection, and analysis of vaccine-induced immune responses observed during HIV-1 vaccine trials in Tanzania and neighboring countries.
Kifaro, Emmanuel G; Nkangaga, Japhet; Joshua, Gradson; Sallu, Raphael; Yongolo, Mmeta; Dautu, George; Kasanga, Christopher J
Rift Valley fever virus (RVFV) is an acute, zoonotic viral disease caused by a Phlebovirus, which belongs to the Bunyaviridae family. Among livestock, outbreaks of the disease are economically devastating. They are often characterised by large, sweeping abortion storms and have significant mortality in adult livestock. The aim of the current study was to investigate RVFV infection in the Kigoma region, which is nestled under the hills of the western arm of the Great Rift Valley on the edge of Lake Tanganyika, Tanzania. A region-wide serosurvey was conducted on non-vaccinated small ruminants (sheep and goats, n = 411). Sera samples were tested for the presence of anti-RVFV antibodies and viral antigen, using commercial enzyme-linked immunosorbent assay and reverse transcriptase polymerase chain reaction, respectively. The overall past infections were detected in 22 of the 411 animals, 5.4% (Confidence Interval (CI) 95% = 3.5% - 8.1%). The Kigoma rural area recorded the higher seroprevalence of 12.0% (CI 95% = 7.3% - 18.3%; p < 0.0001), followed by Kibondo at 2.3% (CI 95% = 0.5% - 6.5%; p > 0.05) and the Kasulu district at 0.8% (CI 95% = 0.0% - 4.2%; p > 0.05). The prevalence was 12.5% and 4.7% for sheep and goats, respectively. Reverse transcriptase polymerase chain reaction results indicated that only eight samples were found to be positive (n = 63). This study has confirmed, for the first time, the presence of the RVFV in the Kigoma region four years after the 2007 epizootic in Tanzania. The study further suggests that the virus activity exists during the inter-epizootic period, even in regions with no history of RVFV.
Kashoma, Isaac P.; Kassem, Issmat I.; John, Julius; Kessy, Beda M.; Gebreyes, Wondwossen; Kazwala, Rudovick R.
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
Background More than 90% of children living with HIV have been infected through mother to child transmission. The aims of our present study were to: (1) assess the utilization of the prevention of mother to child transmission (PMTCT) services in five reproductive and child health clinics in Moshi, northern Tanzania, after the implementation of routine counselling and testing; (2) explore the level of knowledge the postnatal mothers had about PMTCT; and (3) assess the quality of the counselling given. Methods This study was conducted in 2007 and 2008 in rural and urban areas of Moshi in the Kilimanjaro region of Tanzania. Mixed methods were used. We interviewed 446 mothers when they brought their four-week-old infants to five reproductive and child health clinics for immunization. On average, the urban clinics included in the study had implemented the programme two years earlier than the rural clinics. We also conducted 13 in-depth interviews with mothers and nurses, four focus group discussions with mothers, and four observations of mothers receiving counselling. Results Nearly all mothers (98%) were offered HIV testing, and all who were offered accepted. However, the counselling was hasty with little time for clarifications. Mothers attending urban antenatal clinics tended to be more knowledgeable about PMTCT than the rural attendees. Compared with previous studies in the area, our study found that PMTCT knowledge had increased and the counsellors had greater confidence in their counselling. Conclusions Routine counselling and testing for HIV at the antenatal clinics was greatly accepted and included practically every mother in this time period. However, the counselling was suboptimal due to time and resource constraints. We interpret the higher level of PMTCT knowledge among the urban as opposed to the rural attendees as a result of differences in the start up of the PMTCT programme and, thus, programme maturation. After comparison with earlier studies conducted
Manyanga, Vicky; Chambuso, Mhina; Liana, Jafary; Rutta, Edmund; Embrey, Martha; Layloff, Thomas; Johnson, Keith
Introduction The purpose of this study was to investigate the quality of a select group of medicines sold in accredited drug dispensing outlets (ADDOs) and pharmacies in different regions of Tanzania as part of an in-depth cross-sectional assessment of community access to medicines and community use of medicines. Methods We collected 242 samples of amoxicillin trihydrate, artemether-lumefantrine (ALu), co-trimoxazole, ergometrine maleate, paracetamol, and quinine from selected ADDOs and pharmacies in Mbeya, Morogoro, Singida, and Tanga regions. The analysis included physical examination and testing with validated analytical techniques. Assays for eight of nine products were conducted using high-performance thin-layer chromatography (HPTLC). For ALu tablets, we used a two-tiered approach, where tier 1 was a semi-quantitative Global Pharma Health Fund-Minilab® method and tier 2 was high-performance liquid chromatography (HPLC) as described in The International Pharmacopoeia’s monograph for artemether-lumefantrine. Results and Discussion The physical examination of samples revealed no defects in the solid and oral liquid dosage forms, but unusual discoloration in an injectable solution, ergometrine maleate. For ALu, the results showed that of 38 samples, 31 (81.6%) passed tier 1 testing and 7 (18.4%) gave inconclusive drug content results. The inconclusive ALu samples were submitted for tier 2 testing and all met the quality standards. The pass rate using the HPTLC and TLC/HPLC assays was 93.8%; the failures were the ergometrine maleate samples purchased from both ADDOs and pharmacies. The disintegration testing of the solid dosage forms was conducted in accordance with US Pharmacopeia monographs. Only two samples of paracetamol, 1.2% of the solid dosage forms, failed to comply to standards. The study revealed a high overall rate of 92.6% of samples that met the quality standards. Although the overall failure rate was 7.4%, it is important to note that this was
Fenton, Carol; Hatfield, Jennifer; McIntyre, Lynn
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
Harris, Angela R; Davis, Jennifer; Boehm, Alexandria B
Access to household water connections remains low in sub-Saharan Africa, representing a public health concern. Previous studies have shown water stored in the home to be more contaminated than water at the source; however, the mechanisms of post-supply contamination remain unclear. Using water quality measurements and structured observations of households in Bagamoyo, Tanzania, this study elucidates the causal mechanisms of the microbial contamination of drinking water after collection from a communal water source. The study identifies statistically significant loadings of fecal indicator bacteria (FIB) occurring immediately after filling the storage container at the source and after extraction of the water from the container in the home. Statistically significant loadings of FIB also occur with various water extraction methods, including decanting from the container and use of a cup or ladle. Additionally, pathogenic genes of Escherichia coli were detected in stored drinking water but not in the source from which it was collected, highlighting the potential health risks of post-supply contamination. The results of the study confirm that storage containers and extraction utensils introduce microbial contamination into stored drinking water, and suggest that further research is needed to identify methods of water extraction that prevent microbial contamination of drinking water.
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
Prytherch, Helen; Massawe, Siriel; Kuelker, Rainer; Hunger, Claudia; Mtatifikolo, Ferdinand; Jahn, Albrecht
Background Improving maternal health by reducing maternal mortality constitutes the fifth Millennium Development Goal and represents a key public health challenge in the United Republic of Tanzania. In response to the need to evaluate and monitor safe motherhood interventions, this study aims at assessing the coverage of obstetric care according to the Unmet Obstetric Need (UON) concept by obtaining information on indications for, and outcomes of, major obstetric interventions. Furthermore, we explore whether this concept can be operationalised at district level. Methods A two year study using the Unmet Obstetric Need concept was carried out in three districts in Tanga Region, Tanzania. Data was collected prospectively at all four hospitals in the region for every woman undergoing a major obstetric intervention, including indication and outcome. The concept was adapted to address differentials in access to emergency obstetric care between districts and between rural and urban areas. Based upon literature and expert consensus, a threshold of 2% of all deliveries was used to define the expected minimum requirement of major obstetric interventions performed for absolute maternal indications. Results Protocols covering 1,260 complicated deliveries were analysed. The percentage of major obstetric interventions carried out in response to an absolute maternal indication was only 71%; most major obstetric interventions (97%) were caesarean sections. The most frequent indication was cephalo-pelvic-disproportion (51%). The proportion of major obstetric interventions for absolute maternal indications performed amongst women living in urban areas was 1.8% of all deliveries, while in rural areas it was only 0.7%. The high proportion (8.3%) of negative maternal outcomes in terms of morbidity and mortality, as well as the high perinatal mortality of 9.1% (still birth 6.9%, dying within 24 hours 1.7%, dying after 24 hours 0.5%) raise concern about the quality of care being
Background Early antenatal care (ANC) initiation is a doorway to early detection and management of potential complications associated with pregnancy. Although the literature reports various factors associated with ANC initiation such as parity and age, pregnancy intentions is yet to be recognized as a possible predictor of timing of ANC initiation. Methods Data originate from a cross-sectional household survey on health behaviour and service utilization patterns. The survey was conducted in 2011 in Rufiji, Kilombero and Ulanga districts in Tanzania on 3,127 women from whom 910 of reproductive age who had given birth in the past two years and sought ANC at least once during pregnancy were selected for the current analysis. ANC initiation was considered to be early only if it occurred in the first trimester of pregnancy gestation. A recently completed pregnancy was defined as mistimed if a woman wanted it later, and if she did not want it at all the pregnancy was termed as unwanted. Chi-square was used to test for associations and multinomial logistic regression was conducted to examine how mistimed and unwanted pregnancies relate with timing of ANC initiation. Results Although 49.3% of the women intended to become pregnant, 50.7% (34.9% mistimed and 15.8% unwanted) became pregnant unintentionally. While ANC initiation in the 1st trimester was 18.5%, so was 71.7% and 9.9% in the 2nd and 3rd trimesters respectively. Multivariate analysis revealed that ANC initiation in the 2nd trimester was 1.68 (95% CI 1.10–2.58) and 2.00 (95% CI 1.05–3.82) times more likely for mistimed and unwanted pregnancies respectively compared to intended pregnancies. These estimates rose to 2.81 (95% CI 1.41–5.59) and 4.10 (95% CI 1.68–10.00) respectively in the 3rd trimester. We controlled for gravidity, age, education, household wealth, marital status, religion, district of residence and travel time to a health facility. Conclusion Late ANC initiation is a significant maternal and
Sindato, Calvin; Pfeiffer, Dirk U; Karimuribo, Esron D; Mboera, Leonard E G; Rweyemamu, Mark M; Paweska, Janusz T
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 species specific 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.
Mwanjali, Gloria; Kihamia, Charles; Kakoko, Deodatus Vitalis Conatus; Lekule, Faustin; Ngowi, Helena; Johansen, Maria Vang; Thamsborg, Stig Milan; Willingham, Arve Lee
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
Chipwaza, Beatrice; Mhamphi, Ginethon G.; Ngatunga, Steve D.; Selemani, Majige; Amuri, Mbaraka; Mugasa, Joseph P.; Gwakisa, Paul S.
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
Sindato, Calvin; Pfeiffer, Dirk U.; Karimuribo, Esron D.; Mboera, Leonard E. G.; Rweyemamu, Mark M.; Paweska, Janusz T.
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
Angular leaf spot (ALS) caused by the fungus Pseudocercospora griseola is one of the most important diseases of common bean in Tanzania. Breeding for resistance to this disease is complicated by the variable nature of the pathogen. In Tanzania no thorough analysis of the variability of this pathogen...
Memba, Albert Zephaniah; Feng, Zhao Jun
Financing of higher education in Tanzania is considered a crucial factor in realizing the country's development vision. It is for these reasons that Tanzania has been financing its higher education since its inception. Diminishing resource capacity and competing interests for government finance plunged the higher education into financial doldrums.…
Harrison, Ashley Johnson; Long, Kristin A.; Manji, Karim P.; Blane, Karyn K.
Despite the global presence of autism spectrum disorder (ASD), a paucity of treatment services exists in Tanzania and other low- and middle-income countries. The effect of delayed or low-quality treatments is enduring and contributes to lifelong variability in ASD-related functional impairments. Service disparities in Tanzania derive in part from…
Lukindo, Jesse John
This study aimed at getting an insight on the implementation of Competence Based Education in Tanzania (CBE) in Tanzania. A study was conducted in Changchun, Jilin in China due to limited time the researcher had. The study was guided by the following research objective; specifically this study did the following; to assess the knowledge that rural…
Since independence in 1961, Tanzania's political ideology (known as Ujamaa-familyhood) has gone hand in hand with the country's education philosophy. The most important feature of this combination is that people should be educated to fit in Tanzania's environment and culture. Education should emancipate man from mental slavery inherited from…
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…
Nyambo, Brigitte; Ligate, Elly
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,…
Kapinga, R.; van Rosmalen-Nooijens, K. A. W. L.
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
Frick, Kevin D.; Lynch, Matthew; West, Sheila; Munoz, Beatriz; Mkocha, Harran A.
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
Wilson, Sarah M.; Sikkema, Kathleen J.; Watt, Melissa H.; Masenga, Gileard G.
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
Mrisho, Mwifadhi; Schellenberg, David; Manzi, Fatuma; Tanner, Marcel; Mshinda, Hassan; Shirima, Kizito; Msambichaka, Beverly; Abdulla, Salim; Schellenberg, Joanna Armstrong
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.
Beckham, Sarah W; Shembilu, Catherine R; Winch, Peter J; Beyrer, Chris; Kerrigan, Deanna L
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.
Goodman, Catherine; Kachur, S Patrick; Abdulla, Salim; Bloland, Peter; Mills, Anne
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.
Mauka, Wilhellmuss I; Mahande, Michael J; Msuya, Sia E; Philemon, Rune N
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.
Gower, Shelley; van den Akker, Jose; Jones, Mark; Dantas, Jaya A R; Duggan, Ravani
Since 2011, Western Australian nursing and midwifery educators have been providing evidence-based continuing education to Tanzanian health professionals. Despite thorough preparation before departure, differences in local resource levels and available facilities have necessitated impromptu adaptation of curriculum content and delivery methods to ensure an effective program was delivered. This study explored the personal, cultural and teaching strategies utilised by Western Australian nursing and midwifery educators in Tanzania and examined if the transferability of education packages was influenced by the educators' cultural competence. Using a qualitative exploratory approach, data was collected from 15 Western Australian nursing and midwifery educators using a demographic survey and in-depth individual semi-structured interviews. The core themes identified from the analysis were Determination to learn, Assessing needs, Communication skills and Greater understanding. These findings are described using the conceptual framework of Campinha-Bacote's The Process of Cultural Competence in the Delivery of Healthcare Services. With appropriate levels of cultural competence, international health professionals can be effective at providing ongoing professional development to colleagues in developing country contexts, which may help address difficulties with retention and motivation of staff. It is essential that prior to departure cultural competence training is provided to educators to enhance their teaching capacity and effectiveness in international settings.
Serrat-Capdevila, A.; Valdes, J. B.; Valdes, R.; Demaria, E. M.; Durcik, M.; Maitaria, K.; Roy, T.
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).
Hermenau, Katharin; Eggert, Ina; Landolt, Markus A.; Hecker, Tobias
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
Kangalawe, Richard Y. M.
The Irangi Hills in the semiarid central Tanzania are known for their severe land degradation, particularly through soil erosion. This study aims at investigating the dynamics in the local resource management and adaptive farming strategies. A combination of conventional survey methods, participatory analysis, soil description and aerial photo interpretations were used in the analysis of spatial and temporal land-use patterns. Results from the study showed that farmers utilised all possible niches in the landscape with the agricultural practices varying considerably, depending on spatial variations in soil conditions, water availability and retention capacity of the soil. The hard clayey soils were often ploughed at the end of the rainy season, before the soil dried out, to facilitate timeliness of planting in the following growing season, and to enhance water infiltration at the onset of the rainy season. Seasonally waterlogged soils were intensively cultivated and planted late during the growing season, with crops maturing only from groundwater resource. To make effective use of available groundwater resources during the dry season, the droughty and often infertile sands in ephemeral watercourses are used for growing vegetables or sugarcane in sunken holes without additional fertilisers/manure. This suggests that the crops grown obtain sufficient nutrients only from groundwater resources. However, the sustainability of cultivation in these ephemeral waterways is still questionable.
Winkler, Andrea Sylvia; Trendafilova, Anna; Meindl, Michael; Kaaya, John; Schmutzhard, Erich; Kassubek, Jan
Restless legs syndrome (RLS) is a highly prevalent movement disorder. However, prevalences seem to vary amongst different ethnicities. To date, no community-based prevalence studies on RLS have been reported from the African continent. We have conducted a community-based, door-to-door study in northern Tanzania. Over a period of 16 months, 7,654 people aged 14 years and older were screened for the RLS Essential Diagnostic Criteria. Sampling was performed according to the method of "multistage cluster sampling." People who screened positive where reinterviewed and physically examined by a specialist neurologist. During the screening phase, 10 people answered "yes" to at least one of the screening questions. After reinterviewing those people, the result was confirmed in five people only. After careful re-evaluation of the results, only one person was diagnosed with RLS. Because of methodological limitations a definite prevalence may only be calculated from larger population-based studies of different African ethnicities with screening questions adapted to the cultural context.
Schuler, Sidney R.; Rottach, Elisabeth; Mukiri, Peninah
Experience suggests that the incorporation of gender approaches into family planning (FP) and reproductive health (RH) programs may increase their impact and sustainability, but further work is needed to examine the interactions between gender norms and family planning and to incorporate this understanding into behavior change communication (BCC) in specific social contexts. We conducted open-ended, in-depth interviews with 30 young currently married men, 30 young married women and 12 older people who influenced FP decisions. Six focus group interviews were also conducted. The interviews focused on the role of gender norms in reproductive decision-making and contraceptive use among young married men and women in Tanzania. The findings suggest that gender factors, such as men's dominance in decision-making do function as barriers to the use of modern contraceptives, but that fear of side effects, by both men and women, may be even more important deterrents. Results from this research will inform the development of BCC interventions to be tested in a subsequent intervention study in which gender factors and poor information about contraceptive methods will be addressed. PMID:28299066
Mattioli, Mia Catharine; Pickering, Amy J; Gilsdorf, Rebecca J; Davis, Jennifer; Boehm, Alexandria B
Diarrheal disease is a leading cause of under-five childhood mortality worldwide, with at least half of these deaths occurring in sub-Saharan Africa. Transmission of diarrheal pathogens occurs through several exposure routes including drinking water and hands, but the relative importance of each route is not well understood. Using molecular methods, this study examines the relative importance of different exposure routes by measuring enteric bacteria (pathogenic Escherichia coli) and viruses (rotavirus, enterovirus, adenovirus) in hand rinses, stored water, and source waters in Bagamoyo, Tanzania. Viruses were most frequently found on hands, suggesting that hands are important vectors for viral illness. The occurrence of E. coli virulence genes (ECVG) was equivalent across all sample types, indicating that both water and hands are important for bacterial pathogen transmission. Fecal indicator bacteria and turbidity were good predictors of ECVG, whereas turbidity and human-specific Bacteroidales were good predictors of viruses. ECVG were more likely found in unimproved water sources, but both ECVG and viral genes were detected in improved water sources. ECVG were more likely found in stored water of households with unimproved sanitation facilities. The results provide insights into the distribution of pathogens in Tanzanian households and offer evidence that hand-washing and improved water management practices could alleviate viral and bacterial diarrhea.
Machumu, Milali Ernest; Yakupitiyage, Amararatne
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.
Hanson, Kara; Kikumbih, Nassor; Armstrong Schellenberg, Joanna; Mponda, Haji; Nathan, Rose; Lake, Sally; Mills, Anne; Tanner, Marcel; Lengeler, Christian
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
Background Tanzania is a wild orchid biodiversity hotspot and has a high prevalence of HIV/AIDS. The wild orchids in the study are endemic and protected by the Convention on International Trade in Endangered Species. Every year, however, between 2.2 and 4.1 million orchid plants consumed in Zambia are estimated as originating from Tanzania. This research examines the differences between HIV/AIDS wild edible orchid gatherers and non-HIV/AIDS gatherers with regards to the frequency of gathering, salience in naming the various orchids, gathering knowledge acquisition and perceptions regarding the current state of abundance of the edible species. Methods Data was collected through interviews with 224 individuals in the Makete District of Tanzania close to the boarder of Zambia. Free-listings were conducted and Sutrup's Cultural Significance Index (CSI) constructed. The independent t-test was used to compare the differences in gathering frequencies between affected and non-affected gatherers. A multiple comparison of the 4 subgroups (affected adults and children, and non-affected adults and children) in gathering frequencies was done with a one way ANOVA test and its post hoc test. To examine the difference between affected and non-affected gatherers difference in source of gathering knowledge, a chi square test was run. Results Forty two vernacular names of gathered orchid species were mentioned corresponding to 7 botanical species belongs to genera Disa, Satyrium, Habenaria, Eulophia and Roeperocharis. Ninety-seven percent of HIV/AIDS affected households state that orchid gathering is their primary economic activity compared to non-HIV/AIDS affected households at 9.7 percent. The HIV/AIDS affected gathered significantly more often than the non-affected. AIDS orphans, however, gathered most frequently. Gatherers perceive a decreasing trend of abundance of 6 of the 7 species. Gathering activities were mainly performed in age based peer groups. The results revealed a
Background In 2006, researchers and decision-makers launched a five-year project - Response to Accountable Priority Setting for Trust in Health Systems (REACT) - to improve planning and priority-setting through implementing the Accountability for Reasonableness framework in Mbarali District, Tanzania. The objective of this paper is to explore the acceptability of Accountability for Reasonableness from the perspectives of the Council Health Management Team, local government officials, health workforce and members of user boards and committees. Methods Individual interviews were carried out with different categories of actors and stakeholders in the district. The interview guide consisted of a series of questions, asking respondents to describe their perceptions regarding each condition of the Accountability for Reasonableness framework in terms of priority setting. Interviews were analysed using thematic framework analysis. Documentary data were used to support, verify and highlight the key issues that emerged. Results Almost all stakeholders viewed Accountability for Reasonableness as an important and feasible approach for improving priority-setting and health service delivery in their context. However, a few aspects of Accountability for Reasonableness were seen as too difficult to implement given the socio-political conditions and traditions in Tanzania. Respondents mentioned: budget ceilings and guidelines, low level of public awareness, unreliable and untimely funding, as well as the limited capacity of the district to generate local resources as the major contextual factors that hampered the full implementation of the framework in their context. Conclusion This study was one of the first assessments of the applicability of Accountability for Reasonableness in health care priority-setting in Tanzania. The analysis, overall, suggests that the Accountability for Reasonableness framework could be an important tool for improving priority-setting processes in the
Njau, Joseph D; Goodman, Catherine A; Kachur, S Patrick; Mulligan, Jo; Munkondya, John S; Mchomvu, Naiman; Abdulla, Salim; Bloland, Peter; Mills, Anne
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
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
Swai, Emanuel S; Schoonman, Luuk; Daborn, Chris J
Zoonoses are infections naturally transmitted between vertebrate animals and humans. An exploratory questionnaire-based survey of animal health workers(n=36) and livestock keepers(n=43) was carried out from April 2001 to March 2002 in Tanga and Arusha regions, northern Tanzania, to assess local knowledge, attitudes and public awareness for animal zoonoses. A combination of closed and open-ended questions, focus group discussions and ranking techniques were employed to gather information on perceptions concerning the type of zoonotic diseases prevalent in the study area, level of risk, mode of transmission and methods of preventing disease transmission from animals to humans. The results demonstrated that rabies, tuberculosis and anthrax were considered the three most common zoonotic diseases. Sharing living accommodation with animals, consumption of un-treated livestock products (i.e. milk, meat or eggs) and attending to parturition were perceived as routes of transmission. Knowledge about zoonosis was higher in smallholder dairy (92%; 33/36) than traditional livestock keepers (P<0.05). On the contrary, the perceived risk of contracting a zoonosis was significantly higher in traditional livestock (86%; 6/7) than smallholder dairy keepers (P<0.05). Stratification of the risk of zoonosis by farm location revealed that rural farms (85%; 7/8) were considered significantly at a higher risk when compared to peri or urban located farms (P<0.05). Most of the respondents stated cooking of meat or boiling of milk as a way to prevent transmission. However, there was a significant difference in the perception of the risk posed by contact with potentially infected animals /or animal products with animal health workers having a much higher level of perception compared to livestock keepers. These results suggest that in the Tanga and Arusha, Tanzania, patchy awareness and knowledge of zoonoses, combined with food consumption habits and poor animal husbandry are likely to expose
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
Vagi, Kevin J; Brookmeyer, Kathryn A; Gladden, R Matthew; Chiang, Laura F; Brooks, Andrew; Nyunt, Myo-Zin; Kwesigabo, Gideon; Mercy, James A; Dahlberg, Linda L
During a household survey in Tanzania, a nationally representative sample of females and males aged 13-24 years reported any experiences of sexual violence that occurred before the age of 18 years. The authors explore the prevalence, circumstances, and health outcomes associated with childhood sexual violence. The results suggest that violence against children in Tanzania is pervasive, with roughly three in 10 females and one in eight males experiencing some form of childhood sexual violence, and its health consequences are severe. Results are being used by the Tanzanian government to implement a National Plan of Action.
Sommer, Marni; Likindikoki, Samuel; Kaaya, Sylvia
The challenge of violence for youth in low-income countries includes a range of experiences from witnessing, to experiencing, to participating in violence. Although boys and young men are often the perpetrators of such violence, they may also be its victims. Yet little evidence exists from the voiced experiences of boys themselves on perceptions and interpretations of the violence around them. Given the numerous negative health implications of violence for boys, for the girls and other boys with whom they interact, and for the health of their future partners and families, we conducted an in-depth study in rural and urban Tanzania with adolescent boys on the masculinity norms shaping their transitions through puberty that might be contributing to high-risk behaviours, including engagement in violence. The findings identified underlying societal gendered norms influencing the enactment of violence, and recommendations from the boys on how to diminish the violence around them. Additional research is needed with boys on the social norms and structural factors influencing their engagement in violence.
Rubagumya, Casmir M.
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.
Haji, Isihaka J; Malele, Imna; Namangala, Boniface
Haemoparasite infections are among the most economically important cattle diseases in sub-Saharan Africa. The present study investigated the occurrence of haemoparasites in 295 indigenous cattle from five villages (Mswakini, Lake Manyara, Naitolia, Makuyuni and Nanja) of the Monduli district, a wildlife-domestic animal-human interface area in northern Tanzania. The data showed that the overall occurrence of haemoparasites in the sampled cattle was 12.5% (95% CI: 8.7% - 16.3%), involving single and mixed infections with Theileria parva, Anaplasma marginale, Babesia bovis, Trypanosoma vivax and Trypanosoma brucei. The highest haemoparasite occurrence was recorded in Lake Manyara (18.3%; 95% CI: 8.5% - 28.1%), and the lowest was recorded in Nanja (6.5%; 95% CI: 0.4% - 12.6%). This preliminary study, furthermore, provided evidence of the possible arthropod vectors (ticks and tsetse flies) that may be involved in the transmission of haemoparasites to cattle in the Monduli district. It is envisaged that this survey will stimulate more studies to determine the prevalence of haemoparasites in livestock by using more sensitive molecular techniques.
McCleary-Sills, Jennifer; Douglas, Zayid; Rwehumbiza, Annagrace; Hamisi, Aziza; Mabala, Richard
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.
Kooriyama, Takanori; Hasegawa, Hideo; Shimozuru, Michito; Tsubota, Toshio; Nishida, Toshisada; Iwaki, Takashi
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.
Zuckerman, Richard; Manji, Karim; Matee, Mecky; Naburi, Helga; Bisimba, Jema; Martinez, Raquel; Wieland-Alter, Wendy; Kim, Faith; von Reyn, C Fordham; Palumbo, Paul
Herpes simplex virus (HSV) oral shedding has not been studied among HIV-positive children in Africa. We sought to evaluate longitudinal oral HSV reactivation in HIV-positive and -negative children. Twenty HIV-positive antiretroviral-naive and 10 HIV-negative children aged 3-12 years in Tanzania were followed prospectively for 14 days. Oral swabs were collected daily and submitted for HSV DNA PCR analysis. Clinical data were collected via chart review and daily diaries. HSV DNA was detected in 10 (50%) of HIV-positive and 4 (40%) of HIV-negative children. Children who shed HSV had virus detected in a median of 21.4% of samples; shedding was intermittent. Median CD4 count among HIV-infected children was 667 cells/µL in those with positive HSV DNA and 886 cells/µL in those who were negative (p = 0.6). Of the HIV-positive children reporting prior sores, five (83%) had positive HSV swabs, whereas the one HIV-negative child with prior sores did not have a PCR-positive swab. HSV is detected frequently in children with and without HIV. HIV-infected children reporting oral sores have a high rate of HSV detection. Given the proven strong interactions between HIV and HSV, further study of co-infection with these viruses is warranted in children.
Kavana, Nicholas; Sonaimuthu, Parthasarathy; Kasanga, Christopher; Kassuku, Ayub; Al-Mekhlafi, Hesham M.; Fong, Mun Yik; Khan, Mohammad Behram; Mahmud, Rohela; Lau, Yee Ling
In this study, the seroprevalence of sparganosis and its relationship with sociodemographic factors in northern Tanzania have been assessed. A total of 216 serum samples from two rural districts, Monduli and Babati, were tested for sparganosis using an enzyme-linked immunosorbent assay. The seroprevalence of anti-sparganum IgG antibodies was 62.5% (95% confidence interval [CI] = 56.1–68.9) in all age groups. There were significant associations between district (relative risk [RR] = 1.95, 95% CI = 1.42–2.69), education (RR = 1.40, 95% CI = 1.15–1.70), and pet ownership with seropositivity (RR = 1.48, 95% CI = 1.02–2.16) based on univariate analysis. However, only the district was significantly associated with seropositivity (odds ratio = 4.20, 95% CI = 1.89–9.32) in binary logistic regression analysis. Providing health education to people residing in sparganosis-endemic areas is likely to improve the efficacy of preventative measures and reduce human disease burden. PMID:27481059
Downs, Jennifer A; de Dood, Claudia J; Dee, Hannah E; McGeehan, Megan; Khan, Hijab; Marenga, Abena; Adel, Patrick E; Faustine, Edward; Issarow, Benson; Kisanga, Emmanuel F; Kisigo, Godfrey Alfred; Ngahyolerwa, Salvius; Zahoro, Frank; Miyaye, Donald; Magawa, Ruth Gideon; Mngara, Julius; Lee, Myung Hee; Corstjens, Paul L A M; van Dam, Govert J; Fitzgerald, Daniel W
Schistosomiasis is a parasitic worm infection that affects over 260 million individuals worldwide. Women with schistosome infections have been demonstrated to have a 4-fold increase in the odds of human immunodeficiency virus (HIV) infection compared with women without schistosome infections. A relationship between schistosome and HIV infections has not been clearly defined in men. Among 674 men aged 18-50 years living in rural Tanzania, we identified 429 (63.6%) who had a schistosome infection as defined by serum positivity for schistosome circulating anodic antigen, visualization of parasite eggs in urine or stool, or both. HIV infection was identified in 38 (5.6%). The odds of HIV infection was 1.3 [95% confidence interval = 0.6-2.5] (P = 0.53) among men with any schistosome infection (Schistosoma haematobium or Schistosoma mansoni), and it was 1.4 [0.6-3.3] (P = 0.43) among men with S. haematobium infection. Men with S. haematobium infection were significantly more likely to report the symptom of hemospermia than men without S. haematobium infection. We conclude that schistosome infections appear to have little to no association with HIV infection in men.
Background Since its launch in 2010, the Tanzania National Voluntary Medical Male Circumcision (VMMC) Program has focused efforts on males ages 10–34 in 11 priority regions. Implementers have noted that over 70% of VMMC clients are between the ages of 10 and 19, raising questions about whether additional efforts would be required to recruit men age 20 and above. This analysis uses mathematical modeling to examine the economic and epidemiological consequences of scaling up VMMC among specific age groups and priority regions in Tanzania. Methods and Findings Analyses were conducted using the Decision Makers’ Program Planning Tool Version 2.0 (DMPPT 2.0), a compartmental model implemented in Microsoft Excel 2010. The model was populated with population, mortality, and HIV incidence and prevalence projections from external sources, including outputs from Spectrum/AIDS Impact Module (AIM). A separate DMPPT 2.0 model was created for each of the 11 priority regions. Tanzania can achieve the most immediate impact on HIV incidence by circumcising males ages 20–34. This strategy would also require the fewest VMMCs for each HIV infection averted. Circumcising men ages 10–24 will have the greatest impact on HIV incidence over a 15-year period. The most cost-effective approach (lowest cost per HIV infection averted) targets men ages 15–34. The model shows the VMMC program is cost saving in all 11 priority regions. VMMC program cost-effectiveness varies across regions due to differences in projected HIV incidence, with the most cost-effective programs in Njombe and Iringa. Conclusions The DMPPT 2.0 results reinforce Tanzania’s current VMMC strategy, providing newfound confidence in investing in circumcising adolescents. Tanzanian policy makers and program implementers will continue to focus scale-up of VMMC on men ages 10–34 years, seeking to maximize program impact and cost-effectiveness while acknowledging trends in demand among the younger and older age groups
Mponela, Marcelina John; Oleribe, Obinna Ositadimma; Abade, Ahmed; Kwesigabo, Gideon
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
Chipwaza, Beatrice; Mugasa, Joseph P.; Mayumana, Iddy; Amuri, Mbaraka; Makungu, Christina; Gwakisa, Paul S.
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
Clelland, Samuel John; Chauhan, Priyesh; Mandari, Faiton Ndesanjo
Introduction Tibia/fibula fractures are one of the commonest admissions to the orthopaedic department at a resource-limited Northern Tanzanian hospital. These fractures are associated with poor prognosis and pose a huge socioeconomic burden on developing countries. However, to date there is a paucity of epidemiological data on lower-limb fractures in Tanzania. Methods A retrospective review of admissions to the orthopaedic department at Kilimanjaro Christian Medical Centre (KCMC) was completed between February 2015 and 2016. Inpatient record books were used to source epidemiological data which was subsequently analysed. Results 199 of the 1016 patients admitted sustained tibia/fibula fractures. 78% (n=156) of admissions were male and the most frequently affected age group was 21-30 years. Motor traffic accidents (MTAs) were the most common cause and accounted for 78% of fractures, with nearly half of these involving motorbikes (42%). Falls were identified as the second most common cause (13%). It was determined that 72% (n=143) of fractures were open, 19% (n=38) were comminuted and the most common site of injury was the distal-third of tibia/fibula. The most frequently recorded treatments were surgical toilet/debridement (66% of patients) and the application of a backslab (34% of patients). Conclusion Males in the 21-30 age group, who were involved in MTAs, were most commonly affected by tibia/fibula fractures. Given that MTA incidence is increasing in Tanzania, there is a growing public health concern that this will be reflected by a step-increase in the number of people who sustain lower-limb fractures.
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
Fogliati, Piera; Straneo, Manuela; Brogi, Cosimo; Fantozzi, Pier Lorenzo; Salim, Robert Mahimbo; Msengi, Hamis Mwendo; Azzimonti, Gaetano; Putoto, Giovanni
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
Armah, Frederick Ato; Quansah, Reginald; Luginaah, Isaac; Chuenpagdee, Ratana; Hambati, Herbert; Campbell, Gwyn
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
Mehta, Saurabh; Mugusi, Ferdinand M; Spiegelman, Donna; Villamor, Eduardo; Finkelstein, Julia L; Hertzmark, Ellen; Giovannucci, Edward L; Msamanga, Gernard I; Fawzi, Wafaie W
Vitamin D has a potential role in preventing HIV-related complications, based on its extensive involvement in immune and metabolic function, including preventing osteoporosis and premature cardiovascular disease. However, this association has not been examined in large studies or in resource-limited settings. Vitamin D levels were assessed in 884 HIV-infected pregnant women at enrollment in a trial of multivitamin supplementation (excluding vitamin D) in Tanzania. Information on HIV related complications was recorded during follow-up (median, 70 months). Proportional hazards models and generalized estimating equations were used to assess the relationship of vitamin D status with these outcomes. Women with low vitamin D status (serum 25-hydroxyvitamin D<32 ng/mL) had 43% higher risk of reaching a body mass index (BMI) less than 18 kg/m(2) during the first 2 years of follow-up, compared to women with adequate vitamin D levels (hazard ratio [HR]: 1.43; 95% confidence intervals: [1.03-1.99]). The relationship between continuous vitamin D levels and risk of BMI less than 18 kg/m(2) during follow-up was inverse and linear (p=0.03). Women with low vitamin D levels had significantly higher incidence of acute upper respiratory infections (HR: 1.27 [1.04-1.54]) and thrush (HR: 2.74 [1.29-5.83]) diagnosed during the first 2 years of follow-up. Low vitamin D status was a significant risk factor for wasting and HIV-related complications such as thrush during follow-up in this prospective cohort in Tanzania. If these protective associations are confirmed in randomized trials, vitamin D supplementation could represent a simple and inexpensive method to improve health and quality of life of HIV-infected patients, particularly in resource-limited settings.
Mbunde, Mourice Victor Nyangabo; Innocent, Ester; Mabiki, Faith; Andersson, Pher G.
Background/Aim: Some of the antifungal drugs used in the current treatments regime are responding to antimicrobial resistance. In rural areas of Southern Tanzania, indigenous people use antifungal drugs alone or together with medicinal plants to curb the effects of antibiotic resistance. This study documented ethnobotanical information of medicinal plants used for managing fungal infections in the Southern Highlands of Tanzania and further assess their safety. Materials and Methods: Ethnobotanical survey was conducted in Makete and Mufindi districts between July 2014 and December 2015 using semi-structured questionnaires followed by two focus group discussions to verify respondents’ information. Cytotoxicity study was conducted on extracts of collected plants using brine shrimp lethality test and analyzed by MS Excel 2013 program. Results: During this survey about 46 plant species belonging to 28 families of angiosperms were reported to be traditionally useful in managing fungal and other health conditions. Among these, Terminalia sericea, Aloe nutii, Aloe lateritia, Zanthoxylum chalybeum, Zanthoxylum deremense, and Kigelia africana were frequently mentioned to be used for managing fungal infections. The preparation of these herbals was mostly by boiling plant parts especially the leaves and roots. Cytotoxicity study revealed that most of the plants tested were nontoxic with LC50 > 100 which implies that most compounds from these plants are safe for therapeutic use. The dichloromethane extract of Croton macrostachyus recorded the highest with LC50 value 12.94 µg/ml. The ethnobotanical survey correlated well with documented literature from elsewhere about the bioactivity of most plants. Conclusions: The ethnobotanical survey has revealed that traditional healers are rich of knowledge to build on for therapeutic studies. Most of the plants are safe for use; and thus can be considered for further studies on drug discovery. PMID:28163965
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.
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
Background Intermittent preventive treatment during pregnancy (IPTp) with optimal doses (two+) of sulphadoxine-pyrimethamine (SP) protects pregnant women from malaria-related adverse outcomes. This study assesses the extent and predictors of uptake of optimal doses of IPTp-SP in six districts of Tanzania. Methods The data come from a cross-sectional survey of random households conducted in six districts in Tanzania in 2012. A total of 1,267 women, with children aged less than two years and who had sought antenatal care (ANC) at least once during pregnancy, were selected for the current analysis. Data analysis involved the use of Chi-Square (χ2) for associations and multivariate analysis was performed using multinomial logistic regression. Results Overall, 43.6% and 28.5% of the women received optimal (two+) and partial (one) doses of IPTp-SP respectively during pregnancy. Having had been counseled on the dangers of malaria during pregnancy was the most pervasive determinant of both optimal (RRR = 6.47, 95% CI 4.66-8.97) and partial (RRR = 4.24, 95% CI 3.00-6.00) uptake of IPTp-SP doses. Early ANC initiation was associated with a higher likelihood of uptake of optimal doses of IPTp-SP (RRR = 2.05, 95% CI 1.18-3.57). Also, women with secondary or higher education were almost twice as likely as those who had never been to school to have received optimal SP doses during pregnancy (RRR = 1.93, 95% CI 1.04-3.56). Being married was associated with a 60% decline in the partial uptake of IPTp-SP (RRR = 0.40, 95% CI 0.17-0.96). Inter-district variations in the uptake of both optimal and partial IPTp-SP doses existed (P < 0.05). Conclusion Counseling to pregnant women on the dangers of malaria in pregnancy and formal education beyond primary school is important to enhance uptake of optimal doses of SP for malaria control in pregnancy in Tanzania. ANC initiation in the first trimester should be promoted to enhance coverage of optimal doses of IPTp
Background In Tanzania, routine individual-level testing for HIV drug resistance (HIVDR) using laboratory genotyping and phenotyping is not feasible due to resource constraints. To monitor the prevention or emergence of HIVDR at a population level, WHO developed generic strategies to be adapted by countries, which include a set of early warning indicators (EWIs). Methods To establish a baseline of EWIs, we conducted a retrospective longitudinal survey of 35 purposively sampled care and treatment clinics in 17 regions of mainland Tanzania. We extracted data relevant for four EWIs (ART prescribing practices, patients lost to follow-up 12 months after ART initiation, retention on first-line ART at 12 months, and ART clinic appointment keeping in the first 12 months) from the patient monitoring system on patients who initiated ART at each respective facility in 2010. We uploaded patient information into WHO HIVResNet excel-based tool to compute national and facility averages of the EWIs and tested for associations between various programmatic factors and EWI performance using Fisher’s Exact Test. Results All sampled facilities met the WHO EWI target (100%) for ART prescribing practices. However, the national averages for patients lost to follow-up 12 months after ART initiation, retention on first-line ART at 12 months, and ART clinic appointment keeping in the first 12 months fell short, at 26%, 54% and 38%, respectively, compared to the WHO targets ≤ 20%, ≥ 70%, and ≥ 80%. Clinics with fewer patients lost to follow-up 12 months after ART initiation and more patients retained on first-line-ART at 12 months were more likely to have their patients spend the longest time in the facility (including wait-time and time with providers), (p = 0.011 and 0.007, respectively). Conclusion Tanzania performed very well in EWI 1a, ART prescribing practices. However, its performance in other three EWIs was far below the WHO targets. This study provides a
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
Frankenberg, Sofia Johnson; Holmqvist, Rolf; Rubenson, Birgitta; Rindstedt, Camilla
This study presents findings from analyses of naturally occurring literacy events, where children jointly focus on reading and writing letters of the alphabet, illustrating social constructions of learning created through language and embodied action. Video recorded data from two different families living in an urban low-income area in Tanzania is…
Ilomo, C. S.
Beginning with an overview of the Tanzanian education system, this essay examines the problems associated with school library programs in Tanzania and reviews the steps being taken to improve those programs and enhance the effectiveness of school libraries within the Tanzanian educational system. The actions of the Tanzanian government affecting…
Sabates, Ricardo; Westbrook, Jo; Hernandez-Fernandez, Jimena
This study focuses on the importance of increasing women's education as a result of Universal Primary Education (UPE) and its further impact on improving children's educational access in Tanzania. The study uses data from the 2007 Demographic Health Survey (DHS) for empirical analysis and it is informed by the historical accounts of the UPE reform…
Msoka, Vidate C.; Mtebe, Joel S.; Kissaka, Mussa M.; Kalinga, Ellen C.
Students in secondary schools in Tanzania have been facing difficulties in conducting laboratory experiments. This has been due to the acute shortage of laboratory facilities and poor teaching methodologies. Consequently, students perceive science subjects as unattractive, difficult and irrelevant to understanding the world around them. An…
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…
Okkolin, Mari-Anne; Lehtomaki, Elina; Bhalalusesa, Eustella
In this paper we discuss to what extent the international and national equality goals regarding gender balance and inclusive education have been reached in the education sector development in Tanzania. According to recent reports, the development trend has been generally positive, and the country is close to achieving its primary education…
Dar es Salaam Univ. (Tanzania). Inst. of Adult Education.
The adult education directory was prepared for three purposes: as a guide for counselors and adult students who wish to know what courses are available in Tanzania to meet their special interests and needs; to inform adult educators of the present provisions and fields of study covered by existing organizations; and to offer information on the…
Lwoga, Edda Tandi; Komba, Mercy
Purpose: The purpose of this paper is to examine factors that predict students' continued usage intention of web-based learning management systems (LMS) in Tanzania, with a specific focus on the School of Business of Mzumbe University. Specifically, the study investigated major predictors of actual usage and continued usage intentions of…
Sanga, C.; Kalungwizi, V. J.; Msuya, C. P.
The conventional agricultural extension service in Tanzania is mainly provided by extension officers visiting farmers to provide agricultural advisory service. This system of extension service provision faces a number of challenges including the few number of extension officers and limited resources. This article assesses the effectiveness of an…
Nonformal adult education in Tanzania includes literacy classes, rural extension, community development, training within industry (TWI), civil service inservice training courses, correspondence and evening courses, residential adult education (Kivukoni College,) and women's groups other than literacy classes. Provisions for nonformal education…
Miles, Susie; Kaplan, Ian
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…
Examines the impact of structural adjustment policies on young women's educational opportunities and reproductive health in Kimimanjaro (Tanzania). Begins with a discussion of the economic, education, and reproductive health conditions. Describes the questionnaire and essay task used in the study. Reports findings from analysis of the quantitative…
Manyerere, David J.
There has been an alarming increase in the rate of unemployment among active urban population in Tanzania whereby the youth are severely affected. In this regard Youth Economic Groups (YEGs) program was formed as one among the best alternative strategies to address this perennial problem. Membership in YEGs act as a means to complement youth…
Mwaipopo, Rosemarie Nyigulila; Lihamba, Amandina; Njewele, Delphine Cosmas
Social development policies in Tanzania are exemplary in terms of their recognition of the rights of access to higher education institutions by specific demographic groups. Policy documents such as the 2005 "National Strategy for Growth and Reduction of Poverty" (known as the MKUKUTA) and the 2004 "National Policy on…
Work stress has been identified as a common phenomenon in the teaching profession. However, little research has been done to examine the prevalence of and factors associated with work stress among employees in university context in Tanzania and sub-Saharan African countries in general. Using survey design within the quantitative approach, this…
In developing countries, higher education is a powerful instrument for social mobility and economic prosperity. An in-depth study of the relationship between higher education and certain equity issues has revealed that in Ghana and Tanzania there is inadequate effort to widen higher education participation to include traditionally disadvantaged…
This paper is based on primary fieldwork conducted in Lugufu refugee camp in the rural Kigoma Region of western Tanzania. It is an anthropological inquiry into the paradox of refugee food aid based on the prevailing dynamic of domination and submission currently advanced by the international aid community. This inquiry asks fundamental questions…
Massamba, David P. B.
Although the development of Kiswahili in Tanzania has had a number of stumbling blocks, it is slowly developing into a language of modern technology. Individual institutions have contributed greatly to its spread and promotion. More books are now published in Kiswahili than ever before, and scientific and technical terminology has been developed.…
Nyahende, Veronica R.
Students' loans in financing higher education in Tanzania have been subjected to many researches. However, less information is available on how the success of students' loans in financing higher education can be revealed. Therefore the purpose of this study is to examine the factors indicating the success of students' loans in financing higher…
Independent School, 2016
In 2012, Louisville Collegiate School (Kentucky) formed a partnership with The School of St. Jude in Arusha, Tanzania. As part of their professional development, six Collegiate faculty members travel each summer to spend two weeks coteaching and interacting with Tanzanian faculty and students. This professional development experience forces…
Mtebe, Joel Samson; Raisamo, Roope
Higher education in Tanzania like in many other Sub-Saharan countries suffers from unavailability of quality teaching and learning resources due to lack of tradition, competence, and experience to develop such resources. Nevertheless, there are thousands of open educational resources (OER) freely available in the public domain that can potentially…
This study examined parental demand for early childhood education (ECE) in relation to choice and access to early childhood programmes in Tanzania. Extensive analyses of both Government and privately written documents over the past decade were used to determine parental demand, choice and access to ECE. The literature revealed that although…
Shavega, Theresia J.; Brugman, Daniel; van Tuijl, Cathy
Research Findings: The present study concerns children's behavioral adjustment in the context of pre-primary schools in Tanzania. Twenty teachers and 320 children from 20 pre-primary schools participated in the study. Teacher-child relationships, children's behavioral adjustment, and teachers' cultural beliefs were reported by teachers; classroom…
Buchanan, Malcolm S.
Most Tanzanian Higher Education Institutes do not have the materials and technology to give students a significant practical experience in the sciences. In 2013 Tanzania was rated 159th out of 187 countries for "human development" (United Nations Development Program 2014 Report). In order to supplement their current, limited practical…
Lwoga, Edda Tandi
This paper examines factors that predict students' continual usage intention of web-based learning content management systems in Tanzania, with a specific focus at Muhimbili University of Health and Allied Science (MUHAS). This study sent a questionnaire surveys to 408 first year undergraduate students, with a rate of return of 66.7. This study…
Mtebe, Joel S.; Mbwilo, Betty; Kissaka, Mussa M.
Tanzania is faced with a severe shortage of qualified in-service school science and mathematics teachers. While science and mathematics account for 46% of the curriculum, only 28% of teachers are qualified to teach these subjects. In order to overcome this challenge, the Ministry of Education and Vocational Training (MoEVT) implemented a project…
This research report notes that despite the focus on girls' education in the Millennium Development Goals, there remains a huge number of girls out of education, a situation which, although improving, is still a significant concern in Tanzania, Africa. Women and girls in pastoral communities are subject to a particularly challenging situation:…
This article examines recent educational reforms in Tanzania by looking at the cultural politics of pedagogical change in secondary and teacher education. It presents an ethnography of a teachers college founded on the principles of social constructivism in a country where formalistic, teacher-centered pedagogy is the norm. Using data collected…
Torsson, Emeli; Kgotlele, Tebogo; Berg, Mikael; Mtui-Malamsha, Niwael; Swai, Emanuel S.; Wensman, Jonas Johansson; Misinzo, Gerald
Peste des petits ruminants virus (PPRV) causes the acute, highly contagious disease peste des petits ruminants (PPR) that affects small domestic and wild ruminants. PPR is of importance in the small livestock-keeping industry in Tanzania, especially in rural areas as it is an important source of livelihood. Morbidity and case fatality rate can be as high as 80–100% in naïve herds; however, in endemic areas, morbidity and case fatality range between 10 and 100% where previous immunity, age, and species of infected animal determine severity of outcome. PPR was officially confirmed in domestic animals in the Ngorongoro district of Tanzania in 2008. It is now considered to be endemic in the domestic sheep and goat populations throughout Tanzania, but restricted to one or more areas in the small ruminant wildlife population. In this article, we review the history and the current status of PPR in Tanzania and neighboring countries. To control and eradicate PPR in the region, a joint effort between these countries needs to be undertaken. The effort must also secure genuine engagement from the animal holders to succeed. PMID:27770516
Willemsen, Laura Wangsness; DeJaeghere, Joan
Literature on schooling in Africa often frames sexual relationships as threatening girls' educational participation, health, and general well-being. Schooling practices aimed at sheltering girls reflect the prevalence of discourses emphasising danger and abstinence. This article presents the case of one all-girls school in Tanzania which provides…
Heijnen, Johannes Daniel
The objectives and functions of the primary school in Tanzania, Africa, are evaluated and analyzed in terms of the agricultural needs and employment of the residents. The document includes discussions on the people, the land, Mwanza Township (the area under study), migration (causes and consequences), influences of primary education on migration,…
Phillips, Kristin D.
Since the 1940s, the concept of community participation has framed, mobilized, and legitimated national development agendas in the Singida Region of rural central Tanzania. Based on 19 months of ethnographic and archival research, this study examines the forms of community participation elicited through state and international development…
Common bean (Phaseolus vulgaris L.) is the most important grain legume in human diets in East Africa. For example, it is estimated that over 75 % of rural households in Tanzania depend on it for daily dietary requirements. Despite its importance, bean yield in the East African region is among the lo...
Packer, C; Brink, H; Kissui, B M; Maliti, H; Kushnir, H; Caro, T
Tanzania holds most of the remaining large populations of African lions (Panthera leo) and has extensive areas of leopard habitat (Panthera pardus), and both species are subjected to sizable harvests by sport hunters. As a first step toward establishing sustainable management strategies, we analyzed harvest trends for lions and leopards across Tanzania's 300,000 km(2) of hunting blocks. We summarize lion population trends in protected areas where lion abundance has been directly measured and data on the frequency of lion attacks on humans in high-conflict agricultural areas. We place these findings in context of the rapidly growing human population in rural Tanzania and the concomitant effects of habitat loss, human-wildlife conflict, and cultural practices. Lion harvests declined by 50% across Tanzania between 1996 and 2008, and hunting areas with the highest initial harvests suffered the steepest declines. Although each part of the country is subject to some form of anthropogenic impact from local people, the intensity of trophy hunting was the only significant factor in a statistical analysis of lion harvest trends. Although leopard harvests were more stable, regions outside the Selous Game Reserve with the highest initial leopard harvests again showed the steepest declines. Our quantitative analyses suggest that annual hunting quotas be limited to 0.5 lions and 1.0 leopard/1000 km(2) of hunting area, except hunting blocks in the Selous Game Reserve, where harvests should be limited to 1.0 lion and 3.0 leopards/1000 km(2) .
Lee, Derek E; Bond, Monica L
Giraffe skin disease (GSD) is a disorder of undetermined etiology that causes lesions on the forelimbs of Masai giraffe ( Giraffa camelopardalis tippelskirchi). We estimated occurrence and prevalence of GSD in six wildlife conservation areas of Tanzania. The disjunct spatial pattern of occurrence implies that environmental factors may influence GSD.
Kalimasi, Perpetua Joseph; Herman, Chaya
This qualitative case study explores the integration of entrepreneurship education (EE) across the curricula in two public universities in Tanzania. Based on Shapero's model of the entrepreneurial event, the feasibility and desirability of EE in the selected universities are analysed. In-depth interviews and document analysis were used for data…
Morley, Louise; Leach, Fiona; Lugg, Rosemary
This article is based on an ESRC/DFID funded research project on Widening Participation in Higher Education in Ghana and Tanzania: Developing an Equity Scorecard (http://www.sussex.ac.uk/education/wideningparticipation). There are questions about whether widening participation in higher education is a force for democratisation or differentiation.…
Kapinga, Orestes Silverius; Hyera, Daniel Frans
This study explored pupils' perceptions of sex and reproductive health education in primary schools in Tanzania. Specifically, the study aimed at (i) exploring pupils' views on sex and reproductive health education in primary schools; (ii) determining opinions on the appropriateness of sex and reproductive health education for pupils in primary…
Msuya, Ombeni William
A case study on the role of extrinsic factors (hygiene factors) and socio-demographic factors in determining job satisfaction among teachers in public secondary schools in Tanzania was undertaken. Biographical variables pertaining to teachers' age, sex, marital status and work experience were investigated to determine whether they had any…
Two new species of Phlugidia (Orthoptera: Tettigoniidae: Meconematinae) are described from the Eastern Arc Mountains of Tanzania. P. planicercus Hemp n. sp. occurs in lowland forest at the foothills of the Uluguru Mountains, while P. ob- tusicercus Hemp n. sp. was collected in the Nguru Mountains. A key to Phlugidia species is provided.
Makewa, Lazarus Ndiku; Role, Elizabeth; Tuguta, Ellen
This paper looked at students' perceived level of English proficiency among Dodoma secondary schools in Tanzania. Factors like attitude, anxiety, classroom activities, motivation, and learning resources were considered as influencing English learning. The study was guided by three theories: Input Hypothesis, Interlanguage and Vygotsky's theory of…
Makewa, Lazarus Ndiku; Role, Elizabeth; Tuguta, Ellen
This paper looked at students' perceived level of English proficiency among Dodoma secondary schools in Tanzania. Factors like attitude, anxiety, classroom activities, motivation, and learning resources were considered as influencing English learning. The study was guided by three theories: Input Hypothesis, Inter-language and Vygotsky's theory of…
Mtahabwa, Lyabwene; Rao, Nirmala
This study examined the relationship between pre-primary educational policy and actual practice in Tanzania. Policy relevant to pre-primary education was analyzed and 15 pre-primary lessons from two urban and two rural schools were videotaped. Although the national educational policy specifies the same standards for pre-primary education…
Malmberg, Lars-Erik, Ed.
This volume describes and analyzes the initiation of a Bachelors in Education course carried out as part-time (distance) and full-time (seminar) studies at Teacher's College in Morogoro, Tanzania. The volume contains six chapters, including: (1) "Framework for English Content Instruction at the Department of Teacher Education at Abo Akademi…
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…
Bruyere, Brett; Nash, Peter E.; Mbogella, Felix
Theories of responsible environmental behavior (REB) have most often been applied in developed countries and to direct forms of REB such as recycling and conserving water. This study applied a model of REB to a developing country setting in Tanzania based in part on variables from a Hungerford and Volk (1990) model and targeting an indirect form…
Lansdow, Richard; Issae, Wahab; Katala, Sidney; Mwaisumo, Rose
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…
Kocher, James E.; Fleisher, Beverly
Rural development is understood to mean both the increased productivity of agriculture and other rural economic activities and the enhancement of the material well-being of the rural people (who comprise about 90% of Tanzania's 16 million population) through education, improved health, and better nutrition. Seven hundred and sixty-one books,…
Nalkur, Priya G.
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…
Crittenden, Alyssa N; Sorrentino, John; Moonie, Sheniz A; Peterson, Mika; Mabulla, Audax; Ungar, Peter S
Conventional wisdom holds that a decline in oral health accompanies the transition from hunting and gathering to agriculture, given increased consumption of carbohydrates. This widely touted example of the mismatch between our biology and modern lifestyle has been intuited largely from the bioarchaeological record of the Neolithic Revolution in the New World. Recent studies of other populations have, however, challenged the universality of this assertion. Here, we present the first comprehensive study of oral health among a living population in transition from the bush to village life, the Hadza hunter-gatherers of Tanzania, to test the hypothesis that the shift from foraging to farming, or agricultural intensification, inevitably leads to increased periodontal disease, caries, and orthodontic disorders. Our results showed that women living in villages consuming a mostly agricultural diet exhibited more caries and periodontal disease than those living in the bush consuming a mostly wild-food diet. Furthermore, men living in the bush consuming mostly a wild-food diet had more than those living in the village consuming a mostly agricultural diet. These findings are explained by the high incidence of maize consumption in village settings, along with previously recognized variation in rate of caries between men and women. The unexpected discovery of high caries incidences for men in the bush is likely explained by heavy reliance on honey, and perhaps differential access to tobacco and marijuana. These data support the notions that mechanisms of cariogenesis are multifactorial and that the relationships between oral health and the shift from a predominantly wild-food diet to one dominated by cultigens are nuanced.
Deocampo, Daniel M.; Blumenschine, Robert J.; Ashley, Gail M.
Lateral variations in whole-rock and clay geochemistry of basal Bed II claystones in Olduvai Gorge, Tanzania, reflect water quality differences across the Eastern Lacustrine Plain ∼1.75 myr ago. Bulk Ba/Sr and (Na2O+K2O+MgO)/Al2O3 range from 1.4 to 4.2 and from 0.7 to 1.4, respectively, and indicate leaching of lacustrine claystones beneath freshwater wetlands at times following lake retreat. Bulk MgO/Al2O3 (0.3-1.0) and molar Mg/Al (0.5-3.9) ratios of <0.2-μm clays reflect alteration of Mg-rich lacustrine clays. These indicators point to freshest conditions near Locality 43 of Hay (1976; HWK-East; Leakey, 1971), moderate conditions to the east (Locality 40-MCK), and high salinity and alkalinity to the west (Localities 85-VEK, 45-FLK). Clay geochemistry and artifact abundances are well correlated (r=-0.67, p<0.005), suggesting a relationship between paleo-water quality and hominid paleoecology. This pattern is consistent with predictions of greatest artifact discard/loss around freshwater sources where scavanging opportunities were greatest for hominids. This quantifies a relationship between artifact density distribution and a paleoecological proxy over landscape scales for the first time in Early Stone Age archaeology. In contrast, fossil bone abundance is uncorrelated (r=0.14, p=0.6), reflecting more complex taphonomic processes. Quantitative tests of landscape-scale land-use models are important for understanding early hominid behavior and its evolution.
Miller, Brian W.; Doyle, Martin W.
Researchers have independently documented the effects of land use on rivers and threats to river management institutions, but the relationship between changes in institutional context and river condition is not well described. This study assesses the connections between resource management institutions, land use, and rivers by integrating social science, geospatial analysis, and geomorphology. In particular, we measured hydraulic geometry, sediment size distributions, and estimated sediment yield for four rivers in northern Tanzania and conducted semistructured interviews that assessed corresponding resource management institutions. Communities managed rivers through both customary (traditional, nonstate) and government institutions, but the differences in the resource management policies and practices of the study rivers themselves were fairly subtle. Clearer differences were found at broader scales; the four watersheds exhibited substantial differences in land cover change and sediment yield associated with the location of settlements, roadways, and cultivation. Unexpectedly, these recent land use changes did not initiate a geomorphic response in rivers. The long history of grazing by domestic and wild ungulates may have influenced water and sediment supplies such that river channel dimensions are more resistant to changes in land use than other systems or have already adjusted to predominant changes in boundary conditions. This would suggest that not all rivers will have the anticipated responses to contemporary land use changes because of antecedent land use patterns; over long time scales (centuries to millennia), the presence of grazers may actually increase the ability of rivers to withstand changes in land use. Our findings point to a need for further interdisciplinary study of dryland rivers and their shifts between system states, especially in areas with a long history of grazing, relatively recent changes in land use, and a dynamic social and
Miller, Brian W; Doyle, Martin W
Researchers have independently documented the effects of land use on rivers and threats to river management institutions, but the relationship between changes in institutional context and river condition is not well described. This study assesses the connections between resource management institutions, land use, and rivers by integrating social science, geospatial analysis, and geomorphology. In particular, we measured hydraulic geometry, sediment size distributions, and estimated sediment yield for four rivers in northern Tanzania and conducted semistructured interviews that assessed corresponding resource management institutions. Communities managed rivers through both customary (traditional, nonstate) and government institutions, but the differences in the resource management policies and practices of the study rivers themselves were fairly subtle. Clearer differences were found at broader scales; the four watersheds exhibited substantial differences in land cover change and sediment yield associated with the location of settlements, roadways, and cultivation. Unexpectedly, these recent land use changes did not initiate a geomorphic response in rivers. The long history of grazing by domestic and wild ungulates may have influenced water and sediment supplies such that river channel dimensions are more resistant to changes in land use than other systems or have already adjusted to predominant changes in boundary conditions. This would suggest that not all rivers will have the anticipated responses to contemporary land use changes because of antecedent land use patterns; over long time scales (centuries to millennia), the presence of grazers may actually increase the ability of rivers to withstand changes in land use. Our findings point to a need for further interdisciplinary study of dryland rivers and their shifts between system states, especially in areas with a long history of grazing, relatively recent changes in land use, and a dynamic social and
Harrison, Terry; Msuya, Charles P.
Recent paleontological investigations at Laetoli and neighboring localities in northern Tanzania have produced a large collection of fossil ostrich eggshells from the Pliocene-aged Laetolil Beds (˜3.5-4.5 Ma) and Ndolanya Beds (˜2.6-2.7 Ma). A detailed analysis of the morphology of the eggshells and their taxonomic affinities indicates that two different species of Struthio are represented. In the Lower Laetolil Beds and in the Upper Laetolil Beds below Tuff 3 a new species is recognized— Struthio kakesiensis. This is replaced in the Upper Laetolil Beds by Struthio camelus, the modern species of ostrich. Since radiometric age determinations are available for the stratigraphic sequence at Laetoli, it is possible to precisely date the first appearance of S. camelus at ˜3.6-3.8 Ma. Comparisons of the Laetoli material with specimens from the well-dated sequences at Lothagam and Kanapoi in northern Kenya, allow the taxonomic and biochronological analysis to be extended back in time to the late Miocene. At about 6.5 Ma, Diamantornis and elephant birds were replaced in East Africa by ostriches belonging to the genus Struthio. Three time-successive species of ostriches are identified in the fossil record of East Africa, beginning with Struthio. cf. karingarabensis (˜6.5-4.2 Ma), followed by S. kakesiensis (˜4.5-3.6 Ma) and then S. camelus (˜3.8 Ma onwards). A similar sequence of taxa has previously been recorded from localities in Namibia, but at these sites there is no possibility to precisely calibrate the ages of the different species using radiometric dating. Nevertheless, the broadly similar evolutionary sequence and the close correspondence in inferred ages for the succession of species in East Africa and Namibia suggest that ostrich eggshells are a very useful tool for biochronological correlation of paleontological sites in sub-Saharan Africa.
Crittenden, Alyssa N.; Sorrentino, John; Moonie, Sheniz A.; Peterson, Mika; Mabulla, Audax
Conventional wisdom holds that a decline in oral health accompanies the transition from hunting and gathering to agriculture, given increased consumption of carbohydrates. This widely touted example of the mismatch between our biology and modern lifestyle has been intuited largely from the bioarchaeological record of the Neolithic Revolution in the New World. Recent studies of other populations have, however, challenged the universality of this assertion. Here, we present the first comprehensive study of oral health among a living population in transition from the bush to village life, the Hadza hunter-gatherers of Tanzania, to test the hypothesis that the shift from foraging to farming, or agricultural intensification, inevitably leads to increased periodontal disease, caries, and orthodontic disorders. Our results showed that women living in villages consuming a mostly agricultural diet exhibited more caries and periodontal disease than those living in the bush consuming a mostly wild-food diet. Furthermore, men living in the bush consuming mostly a wild-food diet had more than those living in the village consuming a mostly agricultural diet. These findings are explained by the high incidence of maize consumption in village settings, along with previously recognized variation in rate of caries between men and women. The unexpected discovery of high caries incidences for men in the bush is likely explained by heavy reliance on honey, and perhaps differential access to tobacco and marijuana. These data support the notions that mechanisms of cariogenesis are multifactorial and that the relationships between oral health and the shift from a predominantly wild-food diet to one dominated by cultigens are nuanced. PMID:28296885
Maliyamkono, T. L.
In newly independent countries where traditional theories of educational policy have continued to be followed, education has persisted as little more than a sophisticated mechanism for the recruitment of elites, and there has been an increased dependence on the advanced industrial nations for aid, experts and educational models. Tanzania, however, has attempted to break away from traditional strategies, and the author here describes and analyses the impact of two of the most far-reaching reforms — Education for Self-Reliance, and Decentralization — on national goals and policies. President Nyerere enunciated the objectives for Education for Self-Reliance in 1967 as relating education to rural life, correcting the elitist bias of education, and changing negative attitudes among students towards agriculture and rural life. Five major programmes of reform covering primary and secondary education, teacher and higher education, and examinations were to be pursued, ensuring a closer integration of schools with local communities, e.g., through school farms and co-operative shops, and making curricula directly relevant to local needs. A policy of Decentralization is being implemented, allowing, theoretically at least, a much greater participation at community level in decision-making. In primary and adult education this has already been effected to some extent, though there is evidence to suggest that decentralization in some regions and districts has resulted in the creation of local bureaucratic machinery for control, defeating the intention of the reform. Decentralization of secondary and teacher education is likely to follow, leaving only higher education centrally controlled for manpower training and allocation purposes. Finally the author discusses the question of the transferability of the Tanzanian reforms.
Doijad, Swapnil; Imirzalioglu, Can; Yao, Yancheng; Pati, Niladri Bhusan; Falgenhauer, Linda; Hain, Torsten; Foesel, Bärbel U; Abt, Birte; Overmann, Jorg; Mirambo, Mariam M; Mshana, Stephen E; Chakraborty, Trinad
A total of 17 'Enterobacter-like' isolates obtained from a septicemic outbreak from a neonatal unit, Tanzania, that could not be assigned based on phenotypic tests to any existing Enterobacter species. Eight representative outbreak isolates were investigated in detail. Fermentation characteristics, biochemical assays and fatty acid profiles for taxonomic analysis were determined and supplemented with information derived from whole genome sequences. Phenotypic and morphological tests revealed that these isolates are Gram-negative, rod-shaped, highly motile and facultatively anaerobic. The fatty acid profile was similar to all other Enterobacter type strains, with quantitative differences in C17:0, C18:1 ω7c and C17:0 cyclo fatty acids. We performed whole genome sequencing and examined it for taxonomically relevant characteristics i.e. 16S rDNA, multi-locus sequence analysis (MLSA), in silico DNA-DNA hybridisation (isDDH) and average nucleotide identity (ANI). Draft genomes were approximately 4.9 Mb in size with a G+C content of 56.0%. The 16S rDNA sequence of these eight isolates showed > 97% similarity to all the Enterobacter species, while MLSA clustered them closely with type strains of E. xiangfangensis and E. hormaechei, respectively. These eight strains showed less than 70% isDDH identity with type strains of the Enterobacter species. In addition, less than 95% ANI to type strains of Enterobacter species was observed. From these results, we conclude that these isolates possess sufficient characteristics that different them from all known Enterobacter species, and should therefore be considered as a novel species. The name Enterobacter bugandensis sp. nov. is proposed with EB-247T as the type strain (=DSM 29888T=NCCB 100573T).
Rosenstock, Todd S.; Mpanda, Mathew; Pelster, David E.; Butterbach-Bahl, Klaus; Rufino, Mariana C.; Thiong'o, Margaret; Mutuo, Paul; Abwanda, Sheila; Rioux, Janie; Kimaro, Anthony A.; Neufeldt, Henry
Knowledge of greenhouse gas (GHG) fluxes in soils is a prerequisite to constrain national, continental, and global GHG budgets. However, data characterizing fluxes from agricultural soils of Africa are markedly limited. We measured carbon dioxide (CO2), nitrous oxide (N2O), and methane (CH4) fluxes at 10 farmer-managed sites of six crop types for 1 year in Kenya and Tanzania using static chambers and gas chromatography. Cumulative emissions ranged between 3.5-15.9 Mg CO2-C ha-1 yr-1, 0.4-3.9 kg N2O-N ha-1 yr-1, and -1.2-10.1 kg CH4-C ha-1 yr-1, depending on crop type, environmental conditions, and management. Manure inputs increased CO2 (p = 0.03), but not N2O or CH4, emissions. Soil cultivation had no discernable effect on emissions of any of the three gases. Fluxes of CO2 and N2O were 54-208% greater (p < 0.05) during the wet versus the dry seasons for some, but not all, crop types. The heterogeneity and seasonality of fluxes suggest that the available data describing soil fluxes in Africa, based on measurements of limited duration of only a few crop types and agroecological zones, are inadequate to use as a basis for estimating the impact of agricultural soils on GHG budgets. A targeted effort to understand the magnitude and mechanisms underlying African agricultural soil fluxes is necessary to accurately estimate the influence of this source on the global climate system and for determining mitigation strategies.
Borghi, Josephine; Mtei, Gemini; Ally, Mariam
A model was developed to assess the impact of possible moves towards universal coverage in Tanzania over a 15-year time frame. Three scenarios were considered: maintaining the current situation ('the status quo'); expanded health insurance coverage (the estimated maximum achievable coverage in the absence of premium subsidies, coverage restricted to those who can pay); universal coverage to all (government revenues used to pay the premiums for the poor). The model estimated the costs of delivering public health services and all health services to the population as a proportion of Gross Domestic Product (GDP), and forecast revenue from user fees and insurance premiums. Under the status quo, financial protection is provided to 10% of the population through health insurance schemes, with the remaining population benefiting from subsidized user charges in public facilities. Seventy-six per cent of the population would benefit from financial protection through health insurance under the expanded coverage scenario, and 100% of the population would receive such protection through a mix of insurance cover and government funding under the universal coverage scenario. The expanded and universal coverage scenarios have a significant effect on utilization levels, especially for public outpatient care. Universal coverage would require an initial doubling in the proportion of GDP going to the public health system. Government health expenditure would increase to 18% of total government expenditure. The results are sensitive to the cost of health system strengthening, the level of real GDP growth, provider reimbursement rates and administrative costs. Promoting greater cross-subsidization between insurance schemes would provide sufficient resources to finance universal coverage. Alternately, greater tax funding for health could be generated through an increase in the rate of Value-Added Tax (VAT) or expanding the income tax base. The feasibility and sustainability of efforts to
Hampson, Katie; Lembo, Tiziana; Bessell, Paul; Auty, Harriet; Packer, Craig; Halliday, Jo; Beesley, Cari A.; Fyumagwa, Robert; Hoare, Richard; Ernest, Eblate; Mentzel, Christine; Metzger, Kristine L.; Mlengeya, Titus; Stamey, Karen; Roberts, Keith; Wilkins, Patricia P.; Cleaveland, Sarah
Summary Anthrax is endemic throughout Africa, causing considerable livestock and wildlife losses and severe, sometimes fatal, infection in humans. Predicting the risk of infection is therefore important for public health, wildlife conservation and livestock economies. However, because of the intermittent and variable nature of anthrax outbreaks, associated environmental and climatic conditions, and diversity of species affected, the ecology of this multihost pathogen is poorly understood. We explored records of anthrax from the Serengeti ecosystem in north-west Tanzania where the disease has been documented in humans, domestic animals and a range of wildlife. Using spatial and temporal case-detection and seroprevalence data from wild and domestic animals, we investigated spatial, environmental, climatic and species-specific associations in exposure and disease. Anthrax was detected annually in numerous species, but large outbreaks were spatially localized, mostly affecting a few focal herbivores. Soil alkalinity and cumulative weather extremes were identified as useful spatial and temporal predictors of exposure and infection risk, and for triggering the onset of large outbreaks. Interacting ecological and behavioural factors, specifically functional groups and spatiotemporal overlap, helped to explain the variable patterns of infection and exposure among species. Synthesis and applications. Our results shed light on ecological drivers of anthrax infection and suggest that soil alkalinity and prolonged droughts or rains are useful predictors of disease occurrence that could guide risk-based surveillance. These insights should inform strategies for managing anthrax including prophylactic livestock vaccination, timing of public health warnings and antibiotic provision in high-risk areas. However, this research highlights the need for greater surveillance (environmental, serological and case-detection-orientated) to determine the mechanisms underlying anthrax dynamics
Miller, Brian W.; Doyle, Martin W.
Researchers have independently documented the effects of land use on rivers and threats to river management institutions, but the relationship between changes in institutional context and river condition is not well described. This study assesses the connections between resource management institutions, land use, and rivers by integrating social science, geospatial analysis, and geomorphology. In particular, we measured hydraulic geometry, sediment size distributions, and estimated sediment yield for four rivers in northern Tanzania and conducted semistructured interviews that assessed corresponding resource management institutions. Communities managed rivers through both customary (traditional, nonstate) and government institutions, but the differences in the resource management policies and practices of the study rivers themselves were fairly subtle. Clearer differences were found at broader scales; the four watersheds exhibited substantial differences in land-cover change and sediment yield associated with the location of settlements, roadways, and cultivation. Unexpectedly, these recent land-use changes did not initiate a geomorphic response in rivers. The long history of grazing by domestic and wild ungulates may have influenced water and sediment supplies such that river channel dimensions are more resistant to changes in land use than other systems or have already adjusted to predominant changes in boundary conditions. This would suggest that not all rivers will have the anticipated responses to contemporary land-use changes because of antecedent land-use patterns; over long time scales (centuries to millennia), the presence of grazers may actually increase the ability of rivers to withstand changes in land use. Our findings point to a need for further interdisciplinary study of dryland rivers and their shifts between system states, especially in areas with a long history of grazing, relatively recent changes in land use, and a dynamic social and
Kamat, Vinay R; Nyato, Daniel J
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.
Msuya, Sia E; Uriyo, Jacqueline; Hussain, Akhtar; Mbizvo, Elizabeth M; Jeansson, Stig; Sam, Noel E; Stray-Pedersen, Babill
Objectives To determine the prevalence of sexually transmitted infections (STIs) and other reproductive tract infections (RTIs) among pregnant women in Moshi, Tanzania and to compare the occurrence of STIs/RTIs among human immunodeficiency virus (HIV)-infected and uninfected women. Methods Pregnant women in their 3rd trimester (N = 2654) were recruited from two primary health care clinics between June 2002 and March 2004. They were interviewed, examined and genital and blood samples were collected for diagnosis of STIs/RTIs and HIV. Results The prevalence of HIV, active syphilis and herpes simplex virus – type 2 (HSV-2) were 6.9%, 0.9% and 33.6%, respectively, while 0.5% were positive for N gonorrhoeae, 5.0% for T vaginalis and 20.9% for bacterial vaginosis. Genital tract infections were more prevalent in HIV-seropositive than seronegative women, statistically significant for syphilis (3.3% vs 0.7%), HSV-2 (43.2% vs 32.0%), genital ulcers (4.4% vs 1.4%) and bacterial vaginosis (37.2% vs 19.6%). In comparison with published data, a declining trend for curable STIs/RTIs (syphilis, trichomoniasis and bacterial vaginosis) was noted. Conclusion Rates of STIs and RTIs are still high among pregnant women in Moshi. Where resources allow, routine screening and treatment of STIs/RTIs in the antenatal care setting should be offered. Higher STIs/RTIs in HIV-seropositive women supports the expansion of HIV-counseling and testing services to all centers offering antenatal care. After identification, STIs/RTIs need to be aggressively addressed in HIV-seropositive women, both at antenatal and antiretroviral therapy care clinics. PMID:19243592
Houlihan, Catherine F; Baisley, Kathy; Bravo, Ignacio G; Kapiga, Saidi; de Sanjosé, Silvia; Changalucha, John; Ross, David A; Hayes, Richard J; Watson-Jones, Deborah
Background: No reports exist on genotype-specific human papillomavirus (HPV) acquisition in girls after first sex in sub-Saharan Africa, despite high HPV prevalence and cervical cancer incidence. Methods: We followed 503 HP-unvaccinated girls aged 15-16 years in Mwanza, Tanzania, 3-monthly for 18 months with interviews and self-administered vaginal swabs. Swabs were tested for 13 higHRisk and 24 low-risk HPV genotypes. Incidence, clearance and duration of overall HPV and genotype-specific infections were calculated and associated factors evaluated. Results: A total of 106 participants reported first sex prior to enrolment (N = 29) or during follow-up (N = 77). One was HIV-positive at the final visit. The remaining 105 girls contributed 323 adequate specimens. Incidence of any new HPV genotype was 225/100 person-years (pys), and incidence of vaccine types HPV-6, -11, -16 and -18 were 12, 2, 2 and 7/100 pys, respectively. Reporting sex in the past 3 months and knowing the most recent sexual partner for a longer period before sex were associated with HPV acquisition. Median time from reported sexual debut to first HPVinfection was 5 months, and infection duration was 6 months. Conclusion: This is the first description of HPV acquisition after first sex in sub-Saharan Africa where the incidence of cervical cancer is amongst the highest in the world. HPV incidence was very high after first sex, including some vaccine genotypes, and infection duration was short. This very high HPV incidence may help explain high cervical cancer rates, and supports recommendations that the HPV vaccine should be given to girls before first sex. PMID:26944311
Shamba, Donat D; Schellenberg, Joanna; Penfold, Suzanne C; Mashasi, Irene; Mrisho, Mwifadhi; Manzi, Fatuma; Marchant, Tanya; Tanner, Marcel; Mshinda, Hassan; Schellenberg, David; Hill, Zelee
The study explored the childbirth-related hygiene and newborn care practices in home-deliveries in Southern Tanzania and barriers to and facilitators of behaviour change. Eleven home-birth narratives and six focus group discussions were conducted with recently-delivering women; two focus group discussions were conducted with birth attendants. The use of clean cloth for delivery was reported as common in the birth narratives; however, respondents did not link its use to newborn's health. Handwashing and wearing of gloves by birth attendants varied and were not discussed in terms of being important for newborn's health, with few women giving reasons for this behaviour. The lack of handwashing and wearing of gloves was most commonly linked to the lack of water, gloves, and awareness. A common practice was the insertion of any family member's hands into the vagina of delivering woman to check labour progress before calling the birth attendant. The use of a new razor blade to cut the cord was near-universal; however, the cord was usually tied with a used thread due to the lack of knowledge and the low availability of clean thread. Applying something to the cord was near-universal and was considered essential for newborn's health. Three hygiene practices were identified as needing improvement: family members inserting a hand into the vagina of deliv