The role of pharmacists in diabetes management in Zanzibar and Dar es Salaam regions, Tanzania

A cross sectional descriptive study was conducted in public diabetes clinics, hospital and community pharmacies in vicinity of diabetes clinics in Dar es Salaam and Zanzibar to investigate the role of pharmacists in management of diabetes and diabetic patients’ care. Face to face interviews were conducted with patients, health workers and pharmacists. A total of 191 subjects were interviewed. Of those, 115 were patients, 18 health workers at the diabetes clinics and 58 pharmacists. Out of 18 health workers, none was pharmacist, and of those 13 (72.2%) were also involved in dispensing medicines. Majority (71%) of the interviewed patients were able to describe their medications, knew about the appropriate storage conditions and how to use them. Seventy-six percent (n=87) of the patients were aware of risks associated with non-adherence to medication regimen and symptoms of their disease conditions. Diabetesassociated complications and mitigation of the same were familiar to 64% and 72% of the patients, respectively. Pharmacists were not directly involved in diabetes patient care in clinics. Diabetic patients were managed by doctors and nurses. Procurement and storage of anti-diabetics were the main roles of hospital pharmacists. On the contrary, of 58 pharmacists, 51 (88%) community pharmacists were involved in counseling patients on storage and use of medicines. Based on these results, patients could not appreciate the roles of pharmacist in diabetes care. Therefore, pharmacists need to update their knowledge on diabetes through seminars and continuing education and professional development and thus be able to actively participate in the diabetes management and diabetes patient care.Keywords: Pharmacists, diabetes, patients, pharmacies, anti-diabetic drugsEast and Central African Journal of Pharmaceutical Sciences Vol.14 (2011) 64-7

Sources of Microbial Contamination of Local Herbal Medicines Sold on the Open Market in Dar es Salaam, Tanzania

Four hundred traditional herbalists operating in an open air market in Ilala, Dar es Salaam, Tanzania were interviewed using a questionnaire to establish the stage at which contamination takes place during the processesing of herbal medicine preparations. Among the interviewees, 82.0 % were true traditional medicine herbalists while the rest were vendors. Most of the practitioners had received primary school education while 17.0 % were illiterate. Seventy five percent of the herbalists displayed their medicines along the streets despite being aware of the potential hazards of microbial contamination at such locations. Of the true herbalists, 70 % personally processed the herbal medicines they sold. Most of these herbalists reported using boiled and cooled tap water in the preparation of liquid forms of the medicines. The containers in which the medicines were handled were washed using unboiled tap water and soap. Previous research has shown that the use of tap water in the processing of herbal medicines and exposure in the open market are possible sources of contamination. These results point to the need for educational intervention directed at traditional medicine practitioners to curb microbial contamination of herbal medicines.Keywords: Traditional herbalists, herbal medicine, microbial contaminationEast and Central African Journal of Pharmaceutical Sciences Vol. 12 (2009) 19-2

The Role of the Pharmacist in Animal Health Care: Case Study in Ilala District, Dar es Salaam Tanzania

In this cross-sectional study, the role of pharmacists in animal health care, particularly in the distribution of veterinary medicines in community pharmacies in Dar es Salaam was investigated. Using a semi-structured questionnaire a total of 260 pharmacists were interviewed. The study revealed that majority of the pharmacists play a very limited role in the dispensing of veterinary pharmaceutical products. Pharmacists and veterinary practitioners should compliment each other for the betterment of animal health care. The study highlighted the necessity for introducing veterinary pharmacy lectures in the pharmacy undergraduate curriculum in Tanzania. It further recommends that the Pharmacy Council and the Tanzanian Ministry of Health and Social Welfare enforce continuing professional development as a precondition for the renewal of practice licences for all practising pharmacists.Keywords: Pharmacist, veterinary medicines, veterinary surgeonEast and Central African Journal of Pharmaceutical Sciences Vol. 12 (2009) 34- 3

Prescribing Patterns and Cost of Antihypertensive Drugs in Private Hospitals in Dar es Salaam, Tanzania

Antihypertensive agents are used to prevent morbidity and mortality related to hypertension. Prescribing patterns and the cost of some antihypertensive were studied for 600 patients attending medical clinics in four private hospitals in Dar es Salaam using the WHO drug use indicator forms. The average number of drugs per prescription ranged from 1.9 to 4.2 while that of antihypertensives varied from 1.3 to 2.1. About 50 % of the prescriptions contained 2 to 3 drugs. The most frequently prescribed antihypertensives were diuretics (41 %), β-blockers (28.5 %), calciumchannel blockers (19.8 %), hydralazine/losartan (18.5 %) and angiotensinconverting enzyme inhibitors (11.5 %). Antihypertensives prescribed asmonotherapy included atenolol (23.2 %), bendrofluazide (22 %), frusemide (19 %), hydralazine (11.2 %), nifedipine (9.8 %), amlodipine (9.5 %) and enalapril (9.3 %). Among the combination therapy drugs were angiotensin converting enzyme inhibitor+diuretic (7 %), β-blocker+diuretic (4 %), calcium channel blocker+losartan (2.3 %), β-blocker+angiotensin converting enzyme inhibitor (2.2 %), calcium channel blocker+angiotensin converting enzyme inhibitor (1.8 %) and diuretic+hydralazine (1.7 %). The cost of nifedipine, bendrofluazide and frusemide was about five to six times higher in the private hospitals than at the governmentowned medical stores department. This study reveals a need for continuingeducation and standard treatment guidelines for rational prescribing ofantihypertensive drugs

Assessment of Patient Satisfaction with Pharmaceutical Services in Hospital Pharmacies in Dar es Salaam, Tanzania

Exit survey was conducted at four hospitals in Dar es Salaam, Tanzania, where 401 outpatients (51% males and 49% females) were randomly recruited in the survey. A structured questionnaire was used to obtain the required information from the patients and the data was analyzed using Epi-Info version 6 software. The presence of a polite pharmacist at a particular pharmacy attracted many patients (85.8%). Availability of a reputable medical practitioner at the hospital was another reason for many patients (55.6%) going to the hospital pharmacy. A number of patients (46.3%) went to particular hospital pharmacies to obtain their medicines because of good services in those facilities. Dissatisfied respondents (23.7%) rated the waiting time to obtain the medicines as too long. This was followed by unavailability of prescribed medicines (18.2%) and poor facilities in the waiting room. Quality of services at the hospital pharmacies were rated at 46%. Patients felt that the waiting time and the availability of medicines could be improved.Key words: Pharmaceutical services, patient satisfaction, Dar es Salaa

Causes, magnitude and management of burns in under-fives in district hospitals in Dar es Salaam, Tanzania.

Objectives: To determine the causes, magnitude and management of burns in children under five years of age who were admitted in the district hospitals of Dar es Salaam City, Tanzania. Methods: In this study, a total of 204 under fives were enrolled. Questionnaires were used to elicit if the parent/caretaker had the knowledge of the cause of the burns, what was done immediately after burn injury, first aid given immediately after burn, source of the knowledge of first aid and when the child was taken to the hospital. Also the questionnaire was cited with data on the management of burns in the hospitals through observation and checking the treatment files. Results: Forty nine percent were males while 50.5% were females. Most of the children (54.9%) were aged between 1-2 years. 78.4% had scalds while 21.6% had flame burns. No children were found to have burns caused by chemicals or electricity. Most of the burns (97.5%) occurred accidentally, although some (2.5%) were intentional. 68.6% of these burn injuries occurred in the kitchen. Immediately after burn 87.3% of the children had first aid applied on their wounds while 12.7% didn\u27t apply anything. Of the agents used, honey was the most used (32.8%) followed by cold water (16.7%). The source of knowledge on these agents was from relatives and friends (72.5%), schools (7%), media (6%) and medical personnel (14%). The study further revealed that analgesics, intravenous fluids, antiseptics and antibiotics were the drugs used for treatment of burns in the hospital and that there was no specialized unit for burns in the hospitals. Conclusions: Causes of childhood burns are largely preventable requiring active social/medical education and public enlighten campaigns on the various methods of prevention. The government to see to it that hospitals have specialized units for managing burn cases and also the socio-economic status of its people be improved

Community Awareness of Adverse Effects of Nonsteroidal Anti-inflammatory Drugs in Ilala Municipality, Dar es Salaam

A cross sectional descriptive study was conducted within Ilala Municipality in Dar es Salaam, Tanzania. A structured questionnaire was used for data collection. A total of 196 community members were recruited into the study. The participants were asked to provide information on what drugs they took when they had pain and if they knew any adverse effects associated with the use of non-steroidal anti-inflammatory drugs. They were also asked if they had been given any education by health personnel on the adverse effects of non-steroidal anti-inflammatory drugs. Fifty two percent of the participants responded that when they had pain, they bought pain killers from pharmacies while 42% said they would go to hospital for treatment. About 4% drank a lot of water when they had a headache, while 1% performed massage at the site of pain. One percent visited traditional healers to seek treatment for the pain. Only 8% of the study participants knew some adverse effects caused by non-steroidal anti-inflammatory drugs. Hence, there is a need for health personnel to educate patients on the potential adverse effects of the non-steroidal anti-inflammatory drugs.Key words: Non-steroidal anti-inflammatory drugs, adverse drug reactions, community knowledge, Ilala Municipalit

Knowledge of Sexually Transmitted Diseases Management Among Pharmacists in Dar es Salaam Tanzania: A Case Study

This study was conducted to find out if pharmacists are conversant with the management of sexually transmitted diseases (STDs) and whether they use their knowledge appropriately in managing their clients with STDs syndromes. A comparison was made between community pharmacists who graduated before and after the introduction of STDs/HIV management program in the Faculty of Pharmacy, University of Dar es Salaam, Tanzania in 1992. The aim was also to find out if these pharmacists have attended any training on STDs management after their formal training, and whether they are able to make correct diagnosis and give the right drug(s) to their clients suffering from STDs. Self-administered questionnaires were distributed to eighty-seven pharmacists operating in Dar es Salaam. The response was 74.7% (n=65), with female to male ratio of 1:1.8. Of the responding pharmacists, 73.8% reported to have had formal training on STDs management during their undergraduate course. All pharmacists reported that they normally see clients at their pharmacies with complaints suggestive of STDs. All pharmacists were able to list three or more STDs. About 65% of post-curricula pharmacists were able to list one or more STDs causative agents. Ninety four and hundred percent of pre- and post-curricular pharmacists, respectively were found to give the right drug(s) for various STDs. Twenty seven percent post- and 64.7% pre-curricula pharmacists had attended training on STDs management since they graduated. (E & C Afr Jnl Pharm Sci: 2002 5(1): 3-7

Availability and Usage of Drugs at Household Level i Tanzania: Case Study in Kinondoni District, Dar es Salaam

A survey was conducted in 400 households in Kinondoni District, Tanzania, to determine the availability, source, storage condition, and usage of medicinal drugs. Majority of the households (73.3 %) stored drugs at home. Seven hundred and sixty one (761) different types of drug preparations were encountered. Only 64.7 % of these drugs were in use at the time of study. About 45 % of the antibacterials found in the households were being kept for future use in self-medication. Large proportions of these drugs were obtained from authorised private health facilities. Only a minority (10 %) were obtained from unauthorised sources. Sixty seven percent of all the drugs kept at the households were not stored properly. Majority of the respondents (83 %) admitted practising self-medication. Sharing of drugs within and across households was also practised. Key Words: Household, storage condition, drug use status, self-medication. East and Central African Journal of Pharmaceutical Sciences Vol.5(3) 2002: 49-5

Anti-diabetic drugs in the private and public sector in Dar es Salaam, Tanzania

Objectives: To compare availability, cost, affordability and sources of anti-diabetic drugs between private and public health facilities in Dar es Salaam, Tanzania. Design: Cross sectional descriptive study.Setting: Diabetic clinics in private and public health facilities in Dar es Salaam, Tanzania. Subjects: Eighty patients randomly selected and 45 health facility personnel staff working in the diabetic clinics. Semi-structured questionnaires and a checklist were used to collect the information. Results: Oral hypoglycaemic agents were available in all seven private and three public facilities that were studied. Private facilities stocked more types of oral hypoglycaemic agents than public facilities, which stocked only chlorpropamide and tolbutamide, based on the National Essential Drugs List. The cost of chlorpropamide was five times higher in private facilities compared to public facilities. Insulin was also available in all the facilities. The price of animal insulin in private health facilities was ten times that in public health facilities. Human insulin, which is generally more expensive than animal insulin, was only available in private facilities. Although prices were much lower in public facilities, affordability emerged as a common issue in both private and public facilities. Conclusions: Urban private health facilities offer a wider choice for the needs of diabetic patients but this advantage is compromised by higher prices as compared to public facilities as well as inconsistent supply across facilities. Public health facilities offer only a limited selection of essential oral hypoglycaemics and insulin but at a lower price and across all facilities. Twenty six per cent and 10% of patients in public and private facilities respectively are unable to afford anti-diabetic drugs. The need for intervention to increase affordability of anti-diabetic drugs is evident. Financing and cost of drugs needs to be addressed, either by means of health insurance or other mechanisms, in this era of increasing prevalence of diabetes mellitus among developing countries