Antibiotics prescription practices for provisional malaria cases in three hospitals in Moshi, northern Tanzania

Background: Irrational antibiotic use is an important factor for development and spread of resistance to currently used antibiotics. This study was carried out to assess antibiotic prescribing practices among cases diagnosed as malaria at three hospitals in Moshi Municipality in northern Tanzania.Methods: This was a cross sectional, retrospective study that included patients files from Kilimanjaro Christian Medical Centre (KCMC), Mawenzi Regional Hospital and St Joseph Hospital. Patient files whose primary provisional diagnosis was malaria were analysed using a convenient sampling method. Variables of interest were the types of medications prescribed, whether or not a laboratory test was requested and treatment was initiated before laboratory reports.Results: A total of 250 patients’ files were included in the analysis (KCMC=62.8%; Mawenzi=23.2%; St. Joseph=14.0%). In 232 (92.8%) prescriptions made in the three hospitals, laboratory tests were requested to confirm diagnoses. Among laboratory tests requested, 89.2% were blood slides for microscopic detection of malaria parasites, 3.01% malaria rapid diagnostic tests and 3.01% other tests. The majority of prescriptions across all three hospitals (KCMC=86.4%; Mawenzi=91.4%; St. Joseph= 72.4%; X2=7.787). Clinicians at Mawenzi were more likely to start treatment before laboratory findings than their counterparts at KCMC and St Joseph hospitals (X2=7.787, p≤0.05). A significantly higher number of prescriptions made before laboratory findings were observed at KCMC than Mawenzi and St. Joseph hospitals (X2=7.787, p<0.05). Prescriptions from KCMC were more likely to include at least one type of antibiotic than in the other two facilities. Over one third (KCMC=34.0%; St. Joseph=42.1%; Mawenzi=38.1%) of the prescriptions made contained at least one type of an antibiotic. There was a strong association between health facilities and antibiotics prescription in which KCMC prescribed antibiotics at the highest rate while Mawenzi Regional Hospital prescribed antibiotics at the lowest rates (X2=29.234, p<0.001).Conclusion: Antibiotics are prescribed at a high rate among provisionally diagnosed malaria cases before availability of laboratory results. Efforts should be made to improve laboratory services in terms of trained personnel and equipment to reduce irrational use of antibiotics in provisionally diagnosed malaria cases

The gap between knowledge and practice of risky sexual behaviors for HIV among University students and staff in Moshi Town in Tanzania

Knowledge on HIV spread is important in combating HIV/AIDS, however its impact can only be realized if put into practice. This study was carried out in a Higher Learning Institution in Moshi Township in Kilimanjaro Region to assess the level of awareness of university communities about HIV/AIDs and its link with practice of risky sexual behaviors (RSB). We have found an adequate level of knowledge on the spread, risk behaviors and methods for protection leading to attendance to voluntary testing and counseling by 61% of respondents. Conversely, we have observed great extent of practice of RSBs including early sexual debut (16.7 years), having multiple and extramarital partners, involvement in practices that lead to unprotected sexual intercourse. We report an obvious gap between knowledge and behavior. This study therefore recommends that serious operational interventions must be put in place targeting the most sexually active groups, the youth in preliminary schools to sensitize on RSBs and ways to avoid them before they are engaged in sexual activities

Participation of rural communities in the national poverty reduction strategies: a case of Gairo division in Kilosa District

This study was carried out in four villages of Gairo division, Kilosa district, Morogoro Region to assess participation of rural communities in the national poverty reduction strategies. Focus group discussion and structured questionnaire were used to collect data. Descriptive statistics were used to obtain general characteristics of the study population. Bivariate and partial correlations of variables were used to describe the relationship between variables. Chi- square statistic testing was used to compare populations from more and less accessible villages. Results indicated that majority of rural community members participated in poverty reduction activities/programs through agriculture. However, the income of respondents increased with an increase of the number of income generating activities. Thus, the hypothesis that the annual income at household level has an association with the number of income generating activities undertaken was accepted. Poverty reduction opportunities listed in the document of the National Poverty Eradication strategy (1998) were relatively more known to rural communities in villages which were more accessible than in less accessible villages. Therefore, the hypothesis that accessibility of an area affects recognition of poverty reduction opportunities by the residents was accepted. Chisquare statistic test showed that there were statistical differences in awareness at P < 0.01. At household level, at least 80% of respondents reported to involve family members in household poverty reduction activities. Also, participation of the rural community members in poverty reduction activities was being affected by factors such as age of household head and household size. Hence, the hypothesis that participation of rural communities in poverty reduction strategies is influenced by some of household demographic factors was true. Recommendations: rural communities should diversify their economic activities; availability of working capital and involvement of rural community members in community development activities should be improved. Also, community awareness on poverty reduction opportunities should be raised.Evangelischer Entwicklungsdienst e. V. (EED)- (Ecomenical Scholarships Programme

Participation of rural communities in the national poverty reduction strategies: a case of Gairo division in Kilosa District

This study was carried out in four villages of Gairo division, Kilosa district, Morogoro Region to assess participation of rural communities in the national poverty reduction strategies. Focus group discussion and structured questionnaire were used to collect data. Descriptive statistics were used to obtain general characteristics of the study population. Bivariate and partial correlations of variables were used to describe the relationship between variables. Chi- square statistic testing was used to compare populations from more and less accessible villages. Results indicated that majority of rural community members participated in poverty reduction activities/programs through agriculture. However, the income of respondents increased with an increase of the number of income generating activities. Thus, the hypothesis that the annual income at household level has an association with the number of income generating activities undertaken was accepted. Poverty reduction opportunities listed in the document of the National Poverty Eradication strategy (1998) were relatively more known to rural communities in villages which were more accessible than in less accessible villages. Therefore, the hypothesis that accessibility of an area affects recognition of poverty reduction opportunities by the residents was accepted. Chisquare statistic test showed that there were statistical differences in awareness at P < 0.01. At household level, at least 80% of respondents reported to involve family members in household poverty reduction activities. Also, participation of the rural community members in poverty reduction activities was being affected by factors such as age of household head and household size. Hence, the hypothesis that participation of rural communities in poverty reduction strategies is influenced by some of household demographic factors was true. Recommendations: rural communities should diversify their economic activities; availability of working capital and involvement of rural community members in community development activities should be improved. Also, community awareness on poverty reduction opportunities should be raised.Evangelischer Entwicklungsdienst e. V. (EED)- (Ecomenical Scholarships Programme

COVID-19 Knowledge, Attitudes, Practices and Vaccination Hesitancy in Moshi, Kilimanjaro Region, Northern Tanzania: COVID-19 Vaccination Hesitancy in Tanzania

Background: The COVID-19 vaccinations have reignited optimism in many cultures devastated by the pandemic's tremendous loss of lives and livelihoods. Vaccination hesitancy is a critical and growing international problem in the global effort to manage the COVID-19 pandemic. To successfully handle vaccination hesitancy concerns, it is necessary to understand the levels of knowledge, attitudes, and behaviors on COVID-19. The purpose of this study was to understand people’s knowledge, behaviors, and attitudes about COVID 19 and its related vaccines. Methods: In October 2021, a cross-sectional study with 232 participants was conducted. A standardized interviewer-administered questionnaire was used to collect data. Results: Most respondents in the present survey heard about COVID-19 between January and March 2020. Social media and newspapers are the most effective sources of information on COVID-19, reaching 34.48 % of the population. Basic COVID-19 knowledge was reported to be moderate. Nearly half of the respondents (48.3 %) thought SARSCOV-2 was man-made, while 36.21 % were unsure. Good preventive behaviors were indicated by 49.14 % of subjects. Overall, we find that around 65 % of people are reluctant to get vaccinated against COVID-19. Male gender, low education, and occupation were shown to be more hesitant about vaccination. In this study, healthcare workers were averse to getting the COVID-19 vaccine. The reasons for vaccination hesitation were "unknown safety" of the vaccines (17.4 %) and "unknown long-term consequences" of the vaccines (18.97 %). Almost a third (27.59 %) of those interviewed said they had no intention of being vaccinated. Conclusion: We report moderate knowledge on COVID-19, as well as effective preventive practices, but negative attitudes regarding COVID-19 vaccination, resulting in low vaccination rates of 6.9%. Misinformation regarding COVID-19 appears to play a key role in vaccination reluctance

The gap between knowledge and practice of risky sexual behaviors for HIV among University students and staff in Moshi Town in Tanzania

Knowledge on HIV spread is important in combating HIV/AIDS, however its impact can only be realized if put into practice. This study was carried out in a Higher Learning Institution in Moshi Township in Kilimanjaro Region to assess the level of awareness of university communities about HIV/AIDs and its link with practice of risky sexual behaviors (RSB). We have found an adequate level of knowledge on the spread, risk behaviors and methods for protection leading to attendance to voluntary testing and counseling by 61% of respondents. Conversely, we have observed great extent of practice of RSBs including early sexual debut (16.7 years), having multiple and extramarital partners, involvement in practices that lead to unprotected sexual intercourse. We report an obvious gap between knowledge and behavior. This study therefore recommends that serious operational interventions must be put in place targeting the most sexually active groups, the youth in preliminary schools to sensitize on RSBs and ways to avoid them before they are engaged in sexual activities