Management of Medical Wastes: Public Awareness and Associated Health Risks

A study was carried out in 49 institutions involved in the provision of health care services in Morogoro Municipality, Tanzania. The aim was to assess the common practices with respect to the management of medical waste. Awareness of workers in the institutions on the public and environmental health risks associated with improper management of medical waste was also assessed. The results showed that the most common types of wastes include sharps, waste blood and fluids, and anatomical and pathological wastes. About 91.8% of the facilities separated medical wastes depending on their types although 77.6% of the facilities did not treat the wastes before disposal. The commonest method for disposal of solid wastes was land filling (57.1%) while for liquid wastes; most facilities drained them into the municipal sewage system (85.7%). Large proportions of interviewed workers were aware of the environmental (59.2%) and public (69.4%) health risks caused by improper management of medical wastes although some of them violated the regulations related to waste management. It can be concluded from this study that although the generation of medical wastes is increasing, there is still lack of health education on proper methods for waste management among workers in health care institutions. This calls for the need of awareness programmes and enforcement of legislation on proper medical waste management in order to prevent hazards and risks to the public and environment.Keywords: medical wastes, environment, public healt

Determinants of Consumption of Fluid Milk Products in Dar es Salaam, Tanzania

This paper investigated the determinants of consumer choices of fluid milk products in Dar es Salaam, Tanzania. The study was carried out in Dar es Salaam; the most populated city in the country (about 4 million residents). Specifically, the study sought to (i) explore locally and imported milks brands in the market; (ii) to examine fluid milk intake level amongst consumers (iii) examine characteristic features of locally processed milk products present in the market (iv) assess consumer choice responses to characteristic features of fluid milk products. A survey of 384 consumers was conducted, complemented by interviews of key stakeholders; importers of milk product, processors and wholesalers of local brands. It was found that the Dar es Salaam fluid market is dominated by imported milk brands and products mainly from Kenya and South Africa.  The dominant imported fluid milk was Ultra Heat Treated (UHT) with 6 to 12 months shelf-life. Local processors had limited access to UHT technology and thus produced short-lived milk which was dependent on refrigeration. A number of intrinsic and extrinsic consumption drivers which determined consumer responses were identified to include product form, price, packaging, taste/flavour and availability. Milk consumption was far lower than recommended by FAO/WHO mainly due to low level of consumer income and awareness/education. The study concludes that consumer responses to fluid milk products is determined driven mainly by intrinsic and extrinsic product characteristics and there is low consumption rate of milk in the market. A number of recommendations were put forward mainly directed towards enhanced product consumption promotion. Keywords: Fluid Milk Products Consumption, Dar es Salaam Milk Market, Milk Consumer Choice Responses, Milk Product Characteristic

Animal health management practices in zero grazing dairy units in Arusha City, Tanzania

This study aimed at investigating the animal health management practices in zero grazing dairy units. A questionnaire was used to assess the veterinary practices including the administration of antibiotics and other veterinary inputs to promote growth, prevent and treat diseases. Sixty-five (65) respondents were involved in the study. All the respondents (100%) reported that they did not use growth promoters while 98.5% reported the use of prophylactic vaccines. No withdrawal periods were observed for all the prophylactic vaccines given to animals as instructed by Ward Livestock Officers that the vaccines were not harmful to the health of consumers. Of the 65 respondents, 95.4% (62) reported the use of therapeutic antibiotics. The withdrawal period for therapeutic antibiotics ranged from 1 to 3 days as reported by 60% of the respondents while 24.6% (16) reported the withdrawal period of between 4 to 7 days, 4.6% did not observe withdrawal periods and 6.2% depended on the instructions from the veterinarians. Of the respondents, 53.8% attended animal health management training and 59.6% kept no records for any health interventions made to their animals. Based on the observational findings, majority (84.6%) of the cow’s enclosures were of poor hygiene. Warm water was used by 87.7% of the respondents to wash the udders prior to milking, 93.8% used towels to drain water from the udder(s) and100% of farmers lubricated the teats with udder salve prior to milking. Poor hygiene of the enclosures and washing the udders instead of teats only may predispose animals to infectious disease and this may lead to increased use of antibiotics, which may result into emergence of antibiotic resistance. It is, therefore, recommended that farmers should be trained on best animal health management practices such as teat washing, removal of manure from the animal pens as preventive measures for infectious diseases as well as improving the health and productivity of their animals.Keywords: Animal health, management practices, zero grazing, zoonotic infections, antibiotic resistanc

Animal Waste Management Practices and Perceptions on Public and Environmental Health Risks

A study was conducted to assess the practices with respect to management of animal wastes and awareness of livestock keepers on the environmental and public health risks associated with improper management of animal wastes in 66 livestock-keeping households in Morogoro Municipality, Tanzania. A semi-structured questionnaire was used for data collection, complemented with review of secondary data and researchers’  observations. Majority of respondents (91.0%) heaped the wastes near the animal shed and none of them treated the waste before disposal. Main methods for waste disposal were spreading as manure on crop farms (62.1%) and burning (10.6%), and about 24% respondents disposed the wastes on any available open space. It was also observed that 40.9% of the respondents were aware of environmental risks caused by improper disposal of animal wastes while 59.1% were not aware of such risks, and the risk mentioned was air pollution. About 57.6% of the respondents were aware of the public health risks and they mentioned skin infections, helminthosis, diarrhea, allergy and respiratory infections. Majority of the respondents (87.9%) were not aware of the existence of legislation governing animal waste management. It can be concluded from the study that the limited knowledge on proper management of animal wastes in the study area as well as lack of enforcement of legislation predisposes the environment and public to health risks. It is recommended that responsible authorities should initiate programmes to educate livestock keepers and the general public on appropriate waste management technologies in order to minimize public and environmental health risks.Key words: animal wastes, environment, public healt

Occurrence of Escherichia coli in Brassica rapa L. chinensis irrigated with low quality water in urban areas of Morogoro, Tanzania

Academic Journal Vol. 15(49), pp. 2772-2777,Low quality water has become valuable resource with restricted or unrestricted use in food production depending on its quality. This study has quantified the occurrence of Escherichia coli in Brassica rapa L. chinensis (Chinese cabbage) vegetables and low quality irrigation water. A total of 106 samples including Chinese cabbage (69) and water (37) were collected. The E. coli were cultured in petri film selective E. coli plates at 44°C. The Chinese cabbage irrigated with river water at Fungafunga area indicated significantly (P<0.001) high prevalence 86% (n=21, 0.00-4.10 log cfu/g) of E. coli than those irrigated with treated wastewater at Mazimbu 10% (n=48, 0.00-1.36 log cfu/g). The mean counts of E. coli in untreated wastewater ranged from 4.59 to 5.56 log cfu/mL, while in treated wastewater was from 0.54 to 1.05 log cfu/mL and in river water it was 2.40 log cfu/mL. Treated wastewater of the quality found in this study could be used for food production

Removal of Escherichia coli in treated wastewater used for food production in Morogoro, Tanzania

Acadmic Journal Vol. 10(33), pp. 1344-1350The aim of this study was to assess the removal efficiency of Escherichia coli at Mafisa and Mzumbe domestic wastewater treatment ponds in Morogoro, Tanzania. The study was done from October, 2013 to April, 2014. A total of 125 water samples from inlets and subsequent anaerobic, facultative and maturation ponds as well as treated wastewater were collected and analysed for E. coli. The estimated retention times of the wastewater treatment units were 19 and 22 days in Mafisa and Mzumbe ponds, respectively. The concentration of E. coli ranged from 4.70 to 5.60 log cfu/mL in untreated wastewater and was reduced to <1.00 to 2.00 log cfu/mL in the treated wastewater. During rainy and cold seasons, the effluent discharged out at Mafisa during August 2013; and March and April, 2014 was about 2 log cfu/mL while at Mzumbe E. coli concentration in effluent discharged out was up to 1.23 log cfu/mL. The concentration of E. coli in untreated and treated wastewater from the two wastewater treatment ponds study sites were comparable (P<0.05). Reduction of E. coli concentration in wastewater treatment ponds study sites was significant with less reduction seen at Mafisa, during rainy and cold seasons in March, April and August. To conclude, the simple wastewater treatment ponds in the study sites were effective and demonstrated potential for reduction of public health risks associated with use of treated wastewater in agricultural irrigation and aquaculture

Detection of Contagious Caprine Pleuropneumonia and Concurrent Diseases in Outbreaks Presenting with Respiratory Signs in Small Ruminants in Tanzania

This research article published by the International Journal of TROPICAL DISEASE & Health, 2020Aims: To establish the prevalence and concurrent diseases in outbreaks presenting with respiratory signs, major associated clinical signs and postmortem lesions and proportions of those diseases in clinically and autopsied small ruminants for a proper diagnosis and control strategies. Study Design: Purposive outbreaks investigation. Place and Duration of Study: Department of Global Health, School of Life Science and Bio-Engineering (LiSBE), Nelson Mandela Institution of Science and Technology (NM-AIST) between September 2016 and December 2018. Methodology: We included investigations of outbreaks of diseases presenting with respiratory signs in small ruminants reported from five agro-ecological zones in Tanzania. Small ruminats with clinical signs or postmortem lesions suggestive of respiratory involvement were subjected to clinical or postmortem examination. Samples from all examined animals were tested in the laboratory using conventional polymerase chain reaction (PCR) to confirm the tentative diagnosis. Results: A total of 205 small ruminats were examined and tested, of these 72.2% and 20.8% were goats and sheep respectively. In goats, 79.1% (117/148) and sheep, 28.1% (16/57) were confirmed to have concurrent infections, and pneumonic pasteurellosis and peste des petits ruminants (PPR) for goats, and PPR for sheep being mostly involved diseases. Contagious caprine pleuropneumonia (CCPP) was detected in 16.1% (n=205) of the animals, and was significantly high in goats (p=0.003, OR=7.3) than sheep. Pneumonic mannheimiosis (prevalence = 9.3%) was less likely to affect goats than sheep (p=0.047, OR=0.38). In goats (n=148), detection of all diseases was significantly (p<0.05) low in clinically examined animals except pneumonic pasteurellosis and PPR, (p =0.056, OR=2.1) and (p=0.096, OR=2.15) respectively, though the difference was not significant. In sheep (n=57), CCPP was significantly (p=0.005, OR=0.17) more likely to be detected in clinically examined animals. Conclusion: In investigations of outbreaks presenting with respiratory signs in small ruminants, it is important to consider concurrent infections in the interventions and control strategies to be deployed, which may include development and use of multivalent vaccines

Diagnosis Challenges and Control Strategies of Transboundary Diseases Presenting with Respiratory Signs in Small Ruminants in Developing Countries: Emphasis on Contagious Caprine Pleuropneumonia and Peste Des Petits Ruminants

This research article was published in the International Journal of TROPICAL DISEASE & Health Volume 41 [Issue 22], 2020Aims: To review the diagnosis challenges and control strategies of the diseases presenting with respiratory signs. The emphasis being more on two transboundary animal diseases of small ruminants; contagious caprine pleuropneumonia (CCPP) and peste des petits ruminants (PPR). Clinical signs and postmortem lesions associated with the two diseases were also explicated. Study Design: Review. Place and Duration of Study: Department of Global Health, School of Life Science and Bio-Engineering (LiSBE), Nelson Mandela African Institution of Science and Technology (NM-AIST) from December 2017 to June 2020. Methodology: A comprehensive review was carried out following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 506 articles, handbooks, Master’s and PhD thesis and conference proceedings were collected and after removal of the duplicates 80.6% (424/526) passed the first stage. Of the remaining search materials, (n=291) were removed including handbooks, master’s and PhD thesis which did not originate from the developing countries, 31.4% (133/424) passed the second. Of the articles that passed the second stage, (n=85) were removed from the study, these included all articles that did not involve field diagnosis such as review papers and those not originating from the developing countries, 36.1% (48/133) passed the third stage. In the fourth stage, (n=5) articles which reported on retrospective cases and archived samples were removed and 43 articles were reviewed. Results: Out of the 526 documents retrieved, 43 were eligible for review as they met all criteria for inclusion. Control strategies were recommended in 44.2% (19/43) of the articles of which most of them 63.2%, 12/19) recommended vaccination as a control strategy. Most of the articles reported definitive diagnosis reached following laboratory involvement as majority of them involved outbreak investigation or research works which is not the case in routine diagnosis. The major clinical signs mentioned in the review articles including fever 60.9% (14/23), oculonasal discharge 87.0% (20/23), respiratory distress 82.6% (19/23), erosive stomatitis 43.5% (10/23), diarrhea 56.5% (13/23) and coughing 30.4% (7/23) have been discussed relating to the definitive diagnosis reached in reporting articles. On the other hand, postmortem lesions including lung consolidation 38.1% (8/21), intestinal hemorrhage 38.1% (8/21), lung congestion 28.6% (6/21), serofibrinous pleurisy 28.6% (6/21), pneumonic lungs 23.8% (5/21) and unilateral lung inflammation 14.3% (3/21), have been discussed in relation to the definitive diagnosis reached. Conclusion: Despite the similarities in clinical signs and postmortem lesions associated with diseases presenting with respiratory signs, definitive diagnosis of CCPP was reached in cases that involved clinical signs and postmortem lesions confined in the respiratory system whereas, PPR was more diagnosed in cases that presented with clinical signs and postmortem lesions associating the digestive system. However, presence of respiratory signs in the cases the diagnosed PPR may implicate presence of unidentified secondary bacterial infections. Vaccinations being the most advocated approach of control, require a broader look to make sure that polyvalent vaccines are available against the four common diseases. Also, use of treatment to reduce the effect of secondary infecting bacteria may be of help. Furthermore, for effective outcomes of the control strategies, collaborative efforts among countries at risk should be advocated

Low topotype diversity of recent foot-and-mouth disease virus serotypes O and A from districts located along the Uganda and Tanzania border

Foot-and-mouth disease (FMD) is one of the most important livestock diseases in East Africa with outbreaks reported annually that cause severe economic losses. It is possible to control disease using vaccination, but antigenic matching of the vaccine to circulating strains is critical. To determine the relationship between foot-and-mouth disease viruses circulating in districts along the Uganda and Tanzanian border between 2016 and 2017 and currently used vaccines, phylogenetic analysis of the full VP1 virus sequences was carried out on samples collected from both sides of the border. A total of 43 clinical samples were collected from animals exhibiting signs of FMD and VP1 sequences generated from 11 of them. Eight out of the 11 sequences obtained belonged to serotype O and three belonged to serotype A. The serotype O sequences obtained showed limited nucleotide divergence (average of 4.9%) and belonged to topotype East Africa-2, whereas the most common O-type vaccine strain used in the region (O/KEN/77/78) belonged to East Africa-1. The serotype A viruses belonged to topotype Africa-G1 (average nucleotide divergence 7.4%), as did vaccine strain K5/1980. However, vaccine strain K35/1980 belonged to Africa G VII with an average sequence divergence of 20.5% from the study sequences. The genetic distances between current vaccine strains and circulating field strains underscores the crucial need for regular vaccine matching and the importance of collaborative efforts for better control of FMD along this border area