Estimating and projecting HIV prevalence and AIDS deaths in Tanzania using antenatal surveillance data

BACKGROUND: The Estimations and Projections Package (EPP 2005) for HIV/AIDS estimates and projects HIV prevalence, number of people living with HIV and new HIV infections and AIDS cases using antenatal clinic (ANC) surveillance data. The prevalence projection produced by EPP can be transferred to SPECTRUM, a demographic projectionmodel, to calculate the number of AIDS deaths. This paper presents estimates and projections of HIV prevalence, new cases of HIV infections and AIDS deaths in Tanzania between 2001 and 2010 using the EPP 2005 and SPECTRUM soft-wares on ANC data. METHODS: For this study we used; the 1985 – 2004 ANC data set, the 2005 UN population estimates for urban and rural adults, which is based on the 2002 population census, and results of the 2003 Tanzania HIV Indicator Survey. The ANC surveillance sites were categorized into urban and rural areas on the basis of the standard national definitions of urban and rural areas, which led to 40 urban and 35 rural clinic sites. The rural and urban epidemics were run independently by fitting the model to all data and on level fits. RESULTS: The national HIV prevalence increased from 0% in 1981 to a peak of 8.1% in 1995, and gradually decreased to 6.5% in 2004 which stabilized until 2010. The urban HIV epidemic increased from 0% in 1981 peaking at 12.6% in 1992 and leveled to between 10.9% and 11.8% from 2003 to 2010. The rural epidemic peaked in 1995 at 7.0% and gradually declined to 5.2% in 2004, and then stabilized at between 5.1% and 5.3% from 2005 to 2010. New infections are projected to rise steadily, resulting in 250,000 new cases in 2010. Deaths due to AIDS started in 1985 and rose steadily to reach 120,000 deaths in 2010, with more females dying than men. CONCLUSION: The fact that the number of new infections is projected to increase steadily to reach 250,000 per year in 2010 calls for more concerted efforts to combat the spread of HIV infection particularly in the rural areas where the infrastructure needed for prevention programmes such as counseling and testing, condom accessibility and AIDS information is less developed

The Role of Mobile Phones in Tanzania’s Informal Construction Sector:The Case of Dar es Salaam

The Pierre Auger Observatory is currently the largest detector for measurements of cosmic rays with energies beyond 10^18 eV. It uses a hybrid detection method with fluorescence telescopes and surface detector stations. Cosmic rays with energies above 10^15 eV cannot be studied directly but they interact with the atmosphere and produce secondary particle cascades, called extensive air shower. These air showers carry information about the energy, the arrival direction and the chemical composition of the primary cosmic ray particle. The fluorescence telescopes measure the longitudinal air shower profile, whereas the surface detector stations study the lateral profile on the ground. The combination of both detectors provides measurements of cosmic rays with high accuracy.This thesis is focused on the study of the chemical composition of cosmic rays with the virtual fluorescence telescope HECO, which is the combination of the low energy enhancement HEAT (High Elevation Auger Telescopes) and the Coihueco telescope station. HEAT consists of 3 additional fluorescence telescopes, extending the energy range down to below 10^17.0 eV. The cosmic rays with energies between 10^17 eV to 10^18.4 eV are studied, which is the expected transition region from galactic to extra galactic cosmic rays.For the analysis of the chemical composition the atmospheric depth of the air shower maximum Xmax is used. The distribution of Xmax is depending on the atomic mass of the primary cosmic ray particle.An improved profile reconstruction using air shower universality is introduced in the reconstruction and several cross checks on the acquired data and simulations are performed. A complete Monte Carlo based composition analysis is performed to validate the analysis method. The systematic uncertainties of the analysis are studied in detail. The resulting first moments, the mean and the variance of the measured Xmax-distribution per energy bin are compared to theoretical predictions from current cosmic ray interaction models. Additionally, a new fit method is introduced to fit chemical composition fractions based on prediction from interaction models. A parametrization based on Gumbel statistics and air shower simulation is used to describe the Xmax-distribution as a function of energy and primary atomic mass. A superposition model of these parametrization is fitted on a simulated scenario to find the optimal fit routine. The method is applied on the measured Xmax data including all know systematic uncertainties. The findings of this thesis are compared to published results of other experiments. The results of all interaction models suggest a heavy composition at 10^17.0 eV that becomes lighter up to 10^18.4 eV, where it is composed of a mixture of nuclei with light atomic masses

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

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. 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. 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. The article calls for attention to the importance of locating the discourse of unfairness related to working conditions in a broader historical/political context. Tanzanian history has been characterised by an ambiguous and shifting landscape of state regulation, economic reforms, decentralisation and emerging democratic sentiments. Such a historic contextualisation enhances our understanding of the strong sentiments of unfairness revealed in this study and assists us in considering potential ways forward

H - サイシキ モンダイ ニ オケル コア カイソウ コウゾウ ト ケイサン フクザツサ ニ カンスル ケンキュウ

京都大学0048新制・課程博士博士(情報学)甲第11716号情博第145号新制||情||33(附属図書館)23359UT51-2005-D465京都大学大学院情報学研究科通信情報ｼｽﾃﾑ専攻(主査)教授 岩間 一雄, 教授 永持 仁, 助教授 伊藤 大雄学位規則第4条第1項該当Doctor of InformaticsKyoto UniversityDA