Prevalence and Correlates of Common Mental Disorders among Mothers of Young Children in Kilimanjaro Region of Tanzania.

Although poor maternal mental health is a major public health problem, with detrimental effects on the individual, her children and society, information on its correlates in low-income countries is sparse. This study investigates the prevalence of common mental disorders (CMD) among at-risk mothers, and explores its associations with sociodemographic factors. This population-based survey of mothers of children aged 0-36 months used the 14-item Shona Symptom Questionnaire (SSQ). Mothers whose response was "yes" to 8 or more items on the scale were defined as "at risk of CMD." Of the 1,922 mothers (15-48 years), 28.8% were at risk of CMD. Risk of CMD was associated with verbal abuse, physical abuse, a partner who did not help with the care of the child, being in a polygamous relationship, a partner with low levels of education, and a partner who smoked cigarettes. Cohabiting appeared to be protective. Taken together, our results indicate the significance of the quality of relations with one's partner in shaping maternal mental health. The high proportion of mothers who are at risk of CMD emphasizes the importance of developing evidence-based mental health programmes as part of the care package aimed at improving maternal well-being in Tanzania and other similar settings

Prevalence and Predictors of Exclusive Breastfeeding among Women in Kilimanjaro Region, Northern Tanzania: A Population Based Cross-Sectional Study.

Exclusive breastfeeding (EBF) is a simple and cost-effective intervention to improve child health and survival. Effective EBF has been estimated to avert 13% - 15% of under-five mortality and contribute to reduce mother to child transmission of HIV. The prevalence of EBF for infant less than six months is low in most developing countries, including Tanzania (50%). While the Tanzania Demographic Health Survey collects information on overall EBF prevalence, it does not evaluate factors influencing EBF. The aim of this paper was to determine the prevalence and predictors of exclusive breastfeeding in urban and rural areas in Kilimanjaro region. A population-based cross-sectional study was conducted between June 2010 to March 2011 among women with infants aged 6-12 months in Kilimanjaro. Multi-stage proportionate to size sampling was used to select participants from all the seven districts of the region. A standardized questionnaire was used to collect socio-demographic, reproductive, alcohol intake, breastfeeding patterns and nutritional data during the interviews. Estimation on EBF was based on recall since birth. Multivariable logistic regression was used to obtain independent predictors of EBF. A total of 624 women participated, 77% (483) from rural areas. The prevalence of EBF up to six months in Kilimanjaro region was 20.7%, without significant differences in the prevalence of EBF up to six months between urban (22.7%) and rural areas (20.1%); (OR = 0.7, 95% CI 0.5,1.4).In multivariable analysis, advice on breastfeeding after delivery (Adjusted odds ratio, AOR = 2.6, 95% CI 1.5, 4.6) was positively associated with EBF up to six months. Compared to married/cohabiting and those who do not take alcohol, single mothers (AOR = 0.4, 95% CI 0.2, 0.9) and mothers who drank alcohol (AOR = 0.4, 95% CI 0.3, 0.7) had less odds to practice EBF up to six months. Prevalence of EBF up to six months is still low in Kilimanjaro, lower than the national coverage of 50%. Strengthening of EBF counseling in all reproductive and child health clinics especially during antenatal and postnatal periods may help to improve EBF rates

Awareness and Factors Associated with Health Care Worker’s Knowledge on Rubella Infection: A Study after the Introduction of Rubella Vaccine in Tanzania

Background Congenital rubella syndrome is a global health problem. The incidence is much higher in Africa and Southeast Asia than the rest of the world, especially in countries where universal rubella vaccination has not been implemented. Healthcare worker’s knowledge on rubella infection and the rubella vaccine is of utmost importance in achieving and maintaining vaccination coverage targets. This study aimed to assess health care workers knowledge on rubella infection in Kilimanjaro Tanzania, after the introduction of a rubella vaccination. Methods This was a health facility-based cross sectional study. It was conducted in three districts of the Kilimanjaro region between August and October 2016. The study involved eligible health care workers in selected health facilities. An interview guide was used for collecting information by face-to-face interviews. Multivariate analysis was used to assess factors associated with rubella knowledge among healthcare workers. Results A total of 126 health care workers were interviewed. An acceptable level of knowledge was considered if all five questions about rubella were correctly answered. Only 26.4% (n = 31) answered all questions correctly. In multivariate analysis education level and working department were predictors of rubella knowledge; health care workers with an advanced diploma had an adjusted odds ratio (AOR) of 7.7 (95% Confidence interval; CI: 1.4, 41.0), those with a university degree (AOR: 10; 95% CI: 2.4; 42.5) and health care workers in the outpatient department (AOR: 0.06; 95% CI: 0.04; 0.29). Conclusions Our study confirmed that health care worker’s knowledge on rubella infection was low in the areas where rubella vaccination had been introduced. We recommend continuous education and supportive supervision post vaccine introduction in order to increase healthcare worker’s knowledge on rubella infection, congenital rubella syndrome and prevention through sustained high vaccination coverage

Prevalence and factors associated with HIV and syphilis infection among children aged 0–36 months in Kilimanjaro, Tanzania: a community-based cross-sectional study

Background Childhood mortality is high in sub-Saharan Africa. Mother-to-child transmission (MTCT) of HIV and congenital syphilis are among significant causes. Dual elimination of these two infections is one of the international goals. Community-based studies on the burden of HIV and syphilis among children will contribute to fine-tuning the interventions to achieve the elimination goal. This study aims to describe the prevalence of HIV and syphilis among children aged 0–36 months and associated factors in northern Tanzania. Methods This was a community-based cross-sectional study, which was conducted in all the seven districts of Kilimanjaro region. Multistage sampling was used, and a total of 2452 children aged 0 to 36 months and their primary caretakers were enrolled. Interviews were conducted with the mother/caretaker, and dried blood samples were collected from the children and processed for laboratory diagnosis of HIV and syphilis. HIV ELISA was first performed on all the samples. Positive samples of children < 18 months were confirmed using PCR. Results The prevalence of HIV among 2452 children aged 0–36 months was 1.7% (n = 42). There was a significant difference in the distribution of HIV by age of the child, maternal antenatal attendance, and breastfeeding history. The prevalence of syphilis was 0.4% (n = 10). Five of the children were more than 1 year old. All children with a positive test for syphilis were from Moshi rural district, and their mothers consumed alcohol. No child was co-infected with HIV and syphilis. Conclusions Though the prevalence of the two infections was low, detecting syphilis in children suggests a missed opportunity in screening women during pregnancy. The region may be on track with the goal to achieve dual elimination of mother-to-child transmitted HIV and syphilis. However, efforts are needed to reduce missed opportunities for screening women for syphilis and HIV early in pregnancy and retesting at 3rd trimester/delivery. Strategies to improve testing for HIV-exposed children are needed

Predictors of appropriate breastfeeding knowledge among pregnant women in Moshi Urban, Tanzania: a cross-sectional study

Background Knowledge on infant feeding among pregnant women is essential when promoting optimal breastfeeding practices. This study aimed to assess the knowledge of women on optimal breastfeeding during pregnancy and associated factors as well as performance of the health system in reaching women with information on breastfeeding and infant feeding issues. Methods A cross-sectional study was conducted from October 2013 to April 2014 among pregnant women, in their third trimester, attending for routine care at two primary health care facilities in Moshi urban, northern Tanzania. Results A total of 536 women were enrolled, with mean age of 25.9 (SD 5.7) years. Only 51% (n = 274) reported to have received counselling on breastfeeding from their healthcare providers during the current pregnancy. More than seven out of ten pregnant women were knowledgeable about key issues regarding appropriate breastfeeding practices: importance of colostrum (95%), time of breastfeeding initiation (71%), exclusive breastfeeding (EBF) (81%), and time of introducing complementary feeding (83%). Receiving counselling on breastfeeding during the current pregnancy (Adjusted Odds Ratio [AOR] 3.7; 95% Confidence Interval [CI]: 2.4, 5.7), having two children (AOR 2.6; 95% CI: 1.5, 4.4), having three or more children (AOR 3.5; 95% CI: 1.8, 6.9) and intention to breastfeed the child exclusively (AOR 3.6; 95% CI: 2.0, 6.5) were significantly associated with appropriate breastfeeding knowledge. Conclusions The health system failed to reach the 49% of women who did not receive counselling on infant feeding. Pregnant women who had received counselling on optimal breastfeeding and women with more than one child were more likely to have knowledge of optimal breastfeeding practices

Exclusive Breastfeeding Rates and Factors Associated with Exclusive Breastfeeding Practices in Northern Tanzania: Measurement using Two Different Methodologies—24 Hours Recall and Recall Since Birth

Background: Exclusive breastfeeding (EBF) has many benefits to the child from mental to physical growth and development; however, methods of measuring EBF have raised a number of policy and programmatic questions. This study assesses EBF rates and factors associated with EBF practices in Northern Tanzania using two different methodologies, namely, the 24-hours recall and recall-since-birth. Methods:  A cohort study was conducted from October 2013 to December 2015 among mother-infants’ pairs. Mothers with child delivery information (N=430) were followed and included in the analyses. We enrolled pregnant women who were in their third trimesters and interviewed them with the help of questionnaires at enrollment, delivery, 7 days and thereafter monthly up to nine months after delivery. At each visit after delivery, information on breastfeeding using the two methods (24 hours recall and recall-since-birth) was collected. Results: The prevalence of EBF dropped from one month to six months when using both the 24 hours recall and the recall since birth methods, but at different rates.At six months, 24.2% of the mothers practiced EBF when measured with the recall since birth method, compared to 38.8% when measured with the 24 hour recall. Predictors of EBF were also different.When using the recall since birth method, women who had received counseling on infant feeding had increased odds of practicing EBF compared to those who did not receive counseling, [AOR=2.3; 95% CI (1.2, 3.7)]. When using 24 hours recall, women who were unemployed had increased odds of practicing EBF compared to those who were employed [AOR=1.5;95% CI(1.1,2.5)], and women aged 35 - 49 years had decreased odds of practicing EBF compared to younger women [AOR=0.28; 95% CI(0.1,0.7)]. Conclusions and Global Health Implications: The two methods for EBF give substantially different results, both in the prevalence of EBF and factors associated with EBF. The higher EBF obtained with 24 hours recall represents an overestimation and thereby an overly positive picture of the situation. Key words: • Breastfeeding • Exclusive Breastfeeding • Factors • Rates • 24 Hours • Recall Since Birth • Tanzania   Copyright © 2019 Hussein et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited