Medicines dispensers' knowledge on the implementation of an artemisinin-based combination therapy policy for the treatment of uncomplicated malaria in Tanzania

Objectives In 2005, Tanzania changed its policy for uncomplicated malaria treatment from sulphadoxine–pyrimethamine (SP) to artemisinin-based combination therapy (ACT), specifically artemether–lumefantrine (ALU). SP remains the medicine of choice for intermittent preventive treatment in pregnancy (IPTp). There is a need to assess dispensers' knowledge regarding the treatment of uncomplicated malaria and IPTp in Tanzania given appreciable self-purchasing to improve future care. Methods Descriptive cross-sectional design with structured questionnaires to capture quantitative data, with qualitative data captured using focus groups. The study was performed at 32 private pharmacies and 33 Accredited Drug Dispensing Outlets in the Nyamagana and Sengerema Districts in Tanzania, with 20 dispensers included in the qualitative discussions. Key findings The knowledge level of dispensers in the private medicine outlets was variable. Most dispensers knew ALU was first-line treatment in uncomplicated malaria, however variable knowledge about taking ALU with fatty meals. Generally, dispensers had poor knowledge about dosing intervals for SP in IPTp and variable knowledge regarding treatments in the first trimester. Overall, 49% had good knowledge and 48% had moderate knowledge of ACT in uncomplicated malaria. There was a significant relationship between dispenser type and knowledge of ACT but no statistical relationship between the level of knowledge on IPTp and the dispenser. Conclusions The majority of dispensers in private medicines outlets have good knowledge on ACT policy in the treatment of uncomplicated malaria; however, few dispensers had good knowledge on IPTp, which may contribute to irrational dispensing of SP. This needs addressing given the extent of self-purchasing in Tanzania

Self-medication among pregnant women attending antenatal clinic at Makongoro health centre in Mwanza, Tanzania: a challenge to health systems

Abstract Background Self-medication is a universal challenge that requires attention because of the potential threat not only to the pregnant women but also to unborn child. Data on self-medication practice and predictors among pregnant women is lacking in Tanzania. Information on the effects of this practice to the pregnant woman and the foetus globally is also scanty. Methods This was a cross sectional study which was conducted using face to face interview with 372 pregnant women at Makongoro health centre. Semi-structured questionnaires were used. Data were analysed using STATA 13 (Statistical Corporation, College Station, Texas, US). Results A total of 372 pregnant women participated in the study. The prevalence of self-medication among pregnant women was 172 (46.24%). There was a significant statistical association between self-medication and occupation (P value =0.01), gestation age (P < 0.01) and education (P < 0.01). Age, marital status and gravidity were not associated with self-medication (P = 0.809, P = 0.243 and P = 0.922) respectively. When bivariate logistic regression was performed, occupation and education were the only determining factors for self-medication. Pregnant women who were unemployed, doing business and house wife were most likely to practice self-medication than employed pregnant women (P = 0.03; OR = 2.33; 95% CI, 1.06–5.31, P = 0.01; OR = 2.31; CI 1.21–4.41, P = <0.01, OR = 2.73, 95% CI 0.52–2.43) respectively. Pregnant women with no formal education, incomplete primary education, primary education and secondary education were most likely to practice self-medication than pregnant women with college or university education (P < 0.01, OR = 6.37 95% CI 2.37–19.03, P < 0.01, OR = 6.58, 95% CI 2.36–18.25, P < 0.01, OR = 3.78, 95% CI 1.89–7.56, P < 0.01, OR = 2.59 95% CI = 1.30–5.17). The leading illness/symptoms which led to self-medication among pregnant women attending clinic were malaria 56 (32.56%, morning sickness 44 (25.55%) and headache 33(19.19%). Drugs commonly used in self-medication among pregnant women were ant malarial 42 (24.42%), antiemetics 59 (34.30%) and analgesics 33 (19.19%). Conclusion Prevalence of self-medication among pregnant women is high in Tanzania. This is a threat to the safety of the developing foetus and the pregnant woman. Therefore there is a need of interventions to minimize the practice among pregnant women

Schistosoma mansoni among pre-school children in Musozi village, Ukerewe Island, North-Western-Tanzania: prevalence and associated risk factors

Abstract Background Recent evidence indicates that pre-school children (PSC) living in S. mansoni highly endemic areas are at similar risk of schistosomiasis infection and morbidity as their school aged siblings. Recognizing this fact, the World Health Organization (WHO) is considering including this age group in highly endemic areas in control programmes using mass drug administration (MDA). However, detailed epidemiological information on S. mansoni infection among PSC is lacking for many endemic areas, specifically in Tanzania. This study was conducted to determine the prevalence of S. mansoni infection and its associated risk factors among PSC in Ukerewe Island, North-Western Tanzania. Methods This was a cross-sectional study, which studied 400 PSC aged 1–6 years. The Kato-Katz (K-K) technique and the point of care circulating cathodic antigen (CCA) immunodiagnostic test were used to diagnose S. mansoni infection in stool and urine samples respectively. A pre-tested questionnaire was used to collect demographic data and water contact behaviour of the children from their parents/guardians. Results Based on the K-K technique, 44.4 % (95 % CI: 39.4–49.4) pre-school children were infected with S. mansoni and the overall geometric mean eggs per gram of faeces (GM-epg) was 110.6 epg with 38.2 and 14.7 % having moderate and heavy intensity infections respectively. Based on the CCA, 80.1 %, (95 % CI: 76.0–84.0) were infected if a trace was considered positive, and 45.9 %, (95 % CI: 40.9–50.9), were infected if a trace was considered negative. Reported history of lake visits (AOR = 2.31, 95 % CI: 1.06–5.01, P < 0.03) and the proximity to the lake shore (<500 m) (AOR = 2.09, 95 % CI: 1.05–4.14, P < 0.03) were significantly associated with S. mansoni infection. Reported lake visit frequency (4–7 days/week) was associated with heavy intensities of S. mansoni infection (P < 0.00). Conclusion The prevalence of S. mansoni infection in the study population using K-K and CCA-trace-negative was moderate. The frequency of lake visits and the proximity to the lake shore were associated with the infection of S. mansoni and its intensity. These findings call for the need to include the PSC in MDA programmes, public health education and provision of safe water for bathing

Disposal practices of expired and unused medications among households in Mwanza, Tanzania.

BackgroundThe community practice towards disposal of expired and unused medications in spite of its adverse impact have been widely neglected in many developing countries. The available guidelines in Tanzania focus on the disposal of expired medications and cosmetics in hospitals and community pharmacies only.AimThe aim of this study was to assess the disposal practice of expired and unused medications at household level in Mwanza city, north-western Tanzania.MethodologyThe household based cross-sectional study was conducted among 359 randomly selected household members. Semi-structured questionnaires were used for interview during data collection and while STATA® version 13 was used for analysis.ResultsOut 359 households visited, 252 (70.19%) had medications kept in their houses at the time of data collection. Among them, 10 (4.0%) households had kept medications at their houses because they were still continuing with treatment while 242 (96.0%) kept unused medications which were supposed to be discarded. The main reason for keeping unused or expired medications at home was uncompleted course of treatment (199 (82.20%) after feeling that they had recovered from illness. The main reason for discarding medications were recovering from illness (141(48.7%) and expiry (136 (46.9%). The major discarding practices for medications were disposing into domestic trashes (219 (75.5%) and pit latrines (45 (15.5%). Majority of respondents (273 (76%) were aware that improper disposal of expired medications are detrimental to human health and environment in general.ConclusionImproper disposal of unused and expired medications at household level was a common practice in the study area. Tailor-made interventions by the Food and Drugs Authority (FDA) and other national as well as local stake holders are urgently needed to address the situation

Additional file 1: of Self-medication among pregnant women attending antenatal clinic at Makongoro health centre in Mwanza, Tanzania: a challenge to health systems

Self-medication Questionnaire Responses. The data comprises the results of the questionnaires administered to 372 pregnant women attending antenatal clinic in Tanzania to assess their self-medication practice and predictors. (DOCX 18 kb