Building community and public engagement in research – the experience of early career researchers in East Africa

Background: In this paper, we explain how three early career researchers actively engaged community members in health research in Kenya, Tanzania and Uganda in their research projects, and what was learnt from the experience. The research project in Kenya was on camel trypanosomiasis and the role of camel biting keds (or louse flies) in disease transmission. The project in Tanzania looked at the effect of human immunodeficiency virus (HIV) and antiretroviral therapy on fertility and ascertained the trends in the use of family planning services amongst women of reproductive age. The focus of the project in Uganda was the implementation of maternal death surveillance and the response policy to determine the cause of maternal deaths and how they might be prevented. Methods: In the three different settings, efforts to ensure local community engagement provided a focus for the researchers to hone their skills in explaining research concepts and working in partnership with community members to co-develop ideas, their research methods and outputs. Results: Involvement of communities in scientific research, which entailed a two-way mutual engagement process, led to (i) generation of new research ideas that shaped the work, (ii) strengthened mutual trust, and (iii) promoted uptake of research findings. Conclusions: Our key findings strongly support the need for considering community engagement as one of the key components in research studies.</ns4:p

Case studies from the experience of early career researchers in East Africa in building community engagement in research.

BACKGROUND: In this paper, we explain how three early career researchers actively engaged community members in their health research projects in Kenya, Tanzania and Uganda, and what was learnt from the experience. The research project in Kenya was on camel trypanosomiasis and the role of camel biting keds (or louse flies) in disease transmission. The project in Tanzania looked at the effect of human immunodeficiency virus and antiretroviral therapy on fertility and ascertained the trends in the use of family planning services amongst women of reproductive age. The focus of the project in Uganda was the implementation of maternal death surveillance and the response policy to determine the cause of maternal deaths and how they might be prevented. METHODS: In the three different settings, efforts to ensure local community engagement provided a focus for the researchers to hone their skills in explaining research concepts and working in partnership with community members to co-develop ideas, their research methods and outputs. RESULTS: Involvement of communities in scientific research, which entailed a two-way mutual engagement process, led to (i) generation of new research ideas that shaped the work, (ii) strengthened mutual trust, and (iii) promoted uptake of research findings. CONCLUSION: Our key findings strongly support the need for considering community engagement as one of the key components in research studies

Untersuchung zu Struktur und Umfang des Absatzes von Biomassefeuerungsanlagen in Deutschland Abschlussbericht

The increasing use of biogenic fuels provides machine and plant constructors with a variety of market opportunities and possibilities at home and abroad. Especially constructors of firing plants for solid fuels can currently boast high and still rising sales. However the available data do not permit a satsifactory assessment of the size of this new branch of industry, not least because of the difficulty in differentiating between sales of plants for coal and coke-based fuels and those of biomass firing plants. Data on sales distribution by plant capacity and by plant type are also lacking. The aim of the present project is therefore to establish, if possible by manufacturer, current sales of biomass firing plants in Germany and to analyse these data with regard to plant capacity, type, and design, and type of fuel. The study is intended as an update of an earlier market survey carried out by Landtechnik Weihenstephan. The study also considers European-built plants sold to Germany in order to infer from this the annual rate of new installations of biomass firing plants in Germany. (orig./SR)Mit zunehmender Bedeutung der biogenen Brennstoffe bieten sich auch fuer den Maschinen- und Anlagenbau einer Vielzahl von Marktchancen und Moeglichkeiten im In- und Ausland. Insbesondere die Branche der Feuerungsanlagenhersteller fuer feste Brennstoffe kann derzeit von nennenswerten und ansteigenden Verkaufszahlen berichten. Aktuelle Daten zur tatsaechlichen Bedeutung dieses Wirtschaftszweiges liegen jedoch nur in unbefriedigendem Umfang vor bzw. lassen sich nicht um den Anteil von Anlagen bereinigen, welche nur fuer Kohle- oder Koksbrennstoffe geeignet sind. Gleichermassen fehlen Angaben zur Leistungsstruktur und zum Gesamtbeitrag der einzelnen Bauarten. Ziel des Vorhabens ist es daher, die bundesweit abgesetzten Stueckzahlen von Feuerungsgeraeten moeglichst herstellerbezogen zu erfassen und eine Zuordnung zu den jeweiligen Leistungsklassen, Anlagentypen, Bauarten und vorgesehenen Brennstoffen vorzunehmen. Damit wird an eine fruehere Marktuebersicht der Landtechnik Weihenstephan angekuepft. Durch zusaetzliche Beruecksichtigung auch der europaeischen Anlagenverkaeufe nach Deutschland soll auf die derzeitige jaehrliche Neuinstallation von Biomassefeuerungsanlagen geschlossen werden. (orig./SR)SIGLEAvailable from TIB Hannover: F97B712 / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekCentrales Agrar-Rohstoff Marketing- und Entwicklungs-Netzwerk (CARMEN), Rimpar (Germany)DEGerman

Hospital mortality statistics in Tanzania: availability, accessibility, and quality 2006–2015

Abstract Background Accurate and reliable hospital information on the pattern and causes of death is important to monitor and evaluate the effectiveness of health policies and programs. The objective of this study was to assess the availability, accessibility, and quality of hospital mortality data in Tanzania. Methods This cross-sectional study involved selected hospitals of Tanzania and was carried out from July to October 2016. Review of hospital death registers and forms was carried out to cover a period of 10 years (2006–2015). Interviews with hospital staff were conducted to seek information as regards to tools used to record mortality data, staff involved in recording and availability of data storage and archiving facilities. Results A total of 247,976 death records were reviewed. The death register was the most (92.3%) common source of mortality data. Other sources included the International Classification of Diseases (ICD) report forms, Inpatient registers, and hospital administrative reports. Death registers were available throughout the 10-year period while ICD-10 forms were available for the period of 2013–2015. In the years between 2006 and 2010 and 2011–2015, the use of death register increased from 82 to 94.9%. Three years after the introduction of ICD-10 procedure, the forms were available and used in 28% (11/39) hospitals. The level of acceptable data increased from 69% in 2006 to 97% in 2015. Inconsistency in the language used, use of non-standard nomenclature for causes of death, use of abbreviations, poorly and unreadable handwriting, and missing variables were common data quality challenges. About 6.3% (n = 15,719) of the records had no patient age, 3.5% (n = 8790) had no cause of death and ~ 1% had no sex indicated. The frequency of missing sex variable was most common among under-5 children. Data storage and archiving in most hospitals was generally poor. Registers and forms were stored in several different locations, making accessibility difficult. Conclusion Overall, this study demonstrates gaps in hospital mortality data availability, accessibility, and quality, and highlights the need for capacity strengthening in data management and periodic record reviews. Policy guidelines on the data management including archiving are necessary to improve data

Proportion of infants exclusively breastfed (EBF) and proportion with <i>Cryptosporidium</i> infection according to HIV-exposure.

<p>M1 = Month 1; M2 = Month 2; M3 = Month 3; M6 = Month 6; EBF-WHO = WHO definition of exclusive breastfeeding.</p

Anthropometric characteristics of infants at birth and baseline maternal characteristics.

<p>SD = standard deviation; Stunting was defined using WHO growth standards where length-for-age z-score (LAZ) <−2 (44.7 cm for infants at birth) is considered stunted. Likewise, small head was defined as a birth head circumference <31.5 cm, which corresponds to a head circumference-for-age z-score<−2; MUAC = mid-upper arm circumference, there are currently no MUAC cut-off values for infants at birth <a href="http://www.plosntds.org/article/info:doi/10.1371/journal.pntd.0003072#pntd.0003072-Mwangome1" target="_blank">[29]</a>; IQR = interquartile range; Treats water = maternal report that the household takes measures to make water safe for drinking, i.e. boiling, filtration.</p><p>Anthropometric characteristics of infants at birth and baseline maternal characteristics.</p

Prevalence of <i>Cryptosporidium</i> infection in mothers and infants according to HIV-status/exposure.

<p>+  = number of participants with evidence of <i>Cryptosporidium</i> infection; n = number of fecal samples analyzed. Note: the denominator increases across the study period for some groups due to missing data resulting from a missed appointment or failure to bring a fecal sample to the follow-up appointment.</p

Risk factors for infant <i>Cryptosporidium</i> infection between birth and six months.

<p>*Adjusted for maternal HIV status (0 = negative; 1 = positive), PBF at Month 6 (0 = no breastfeeding or partial breastfeeding; 1 = predominant breastfeeding or exclusive breastfeeding), Maternal <i>Cryptosporidium</i> infection at Month 1 (0 = uninfected; 1 = infected), animal ownership (0 = no animals; 1 = owns animals), hand washing (0 = mother doesn't wash hands prior to infant feeding; 1 = mother washes hands prior to infant feeding), wealth (0 = lower 2 tertiles; 1 = top tertile), and maternal literacy (0 = mother cannot read; 1 = mother can read).</p><p>OR = odds ratio; CI = confidence interval; EBF-WHO = WHO definition of exclusive breastfeeding; PBF = exclusive or predominant breastfeeding; Washes hands = mother's self report of washing hands prior to feeding infant; Wealth = index (0–10) calculated by summing a categorical list of household possessions and then stratified into wealth (top tertile) vs. not wealthy (lower 2 tertiles); maternal literacy = mother's self-report that she can read.</p><p>Risk factors for infant <i>Cryptosporidium</i> infection between birth and six months.</p

Cause-specific mortality patterns among hospital deaths in Tanzania, 2006-2015.

BACKGROUND:Understanding the causes of inpatient mortality in hospitals is important for monitoring the population health and evidence-based planning for curative and public health care. Dearth of information on causes and trends of hospital mortality in most countries of Sub-Saharan Africa has resulted to wide use of model-based estimation methods which are characterized by estimation errors. This retrospective analysis used primary data to determine the cause-specific mortality patterns among inpatient hospital deaths in Tanzania from 2006-2015. MATERIALS AND METHODS:The analysis was carried out from July to December 2016 and involved 39 hospitals in Tanzania. A review of hospital in-patient death registers and report forms was done to cover a period of 10 years. Information collected included demographic characteristics of the deceased and immediate underlying cause of death. Causes of death were coded using international classification of diseases (ICD)-10. Data were analysed to provide information on cause-specific, trends and distribution of death by demographic and geographical characteristics. PRINCIPAL FINDINGS:A total of 247,976 deaths were captured over a 10-year period. The median age at death was 30 years, interquartile range (IQR) 1, 50. The five leading causes of death were malaria (12.75%), respiratory diseases (10.08%), HIV/AIDS (8.04%), anaemia (7.78%) and cardio-circulatory diseases (6.31%). From 2006 to 2015, there was a noted decline in the number of deaths due to malaria (by 47%), HIV/AIDS (28%) and tuberculosis (26%). However, there was an increase in number of deaths due to neonatal disorders by 128%. Malaria and anaemia killed more infants and children under 5 years while HIV/AIDS and Tuberculosis accounted for most of the deaths among adults. CONCLUSION:The leading causes of inpatient hospital death were malaria, respiratory diseases, HIV/AIDS, anaemia and cardio-circulatory diseases. Death among children under 5 years has shown an increasing trend. The observed trends in mortality indicates that the country is lagging behind towards attaining the global and national goals for sustainable development. The increasing pattern of respiratory diseases, cancers and septicaemia requires immediate attention of the health system

Proportion of infants infected with <i>Cryptosporidium</i> between 0 and 6 months according to status of breastfeeding practice.

<p>Cryptosporidium negative = <i>Cryptosporidium</i> was not detected in the feces of the infant during the study period; Cryptosporidium positive = <i>Cryptosporidium</i> was detected at least once during the study period; No BF (breastfeeding) = infant was not receiving any breast milk; Mixed BF = infant was receiving breast milk and other liquids and foods; Pred. BF = infant was receiving breast milk and locally prepared gripe water; EBF-WHO = WHO definition of exclusive breastfeeding.</p