Application of Basic Pharmacology and Dispensing Practice of Antibiotics in Accredited Drug-Dispensing Outlets in Tanzania.

Provision of pharmaceutical services in accredited drug-dispensing outlets (ADDOs) in Tanzania has not been reported. This study compared the antibiotics dispensing practice between ADDOs and part II shops, or duka la dawa baridi (DLDBs), in Tanzania. This was a cross-sectional study that was conducted in ADDOs and DLDBs. A simulated client method for data collection was used, and a total of 85 ADDOs, located in Mvomero, Kilombero, and Morogoro rural districts, were compared with 60 DLDBs located in Kibaha district. The research assistants posed as simulated clients and requested to buy antibiotics from ADDOs and DLDBs after presenting a case scenario or disease condition. Among the diseases presented were those requiring antibiotics and those usually managed only by oral rehydration salt or analgesics. The simulated clients wanted to know the antibiotics that were available at the shop. The posed questions set a convincing ground to the dispenser either to dispense the antibiotic directly, request a prescription, or refer the patient to a health facility. Proportions were used to summarize categorical variables between ADDOs and DLDBs, and the chi-square test was used to test for statistical difference between the two drug-outlet types in terms of antibiotic-dispensing practice. As many as 40% of trained ADDO dispensers no longer worked at the ADDO shops, so some of the shops employed untrained staff. A larger proportion of ADDOs than DLDBs dispensed antibiotics without prescriptions (P = 0.004). The overall results indicate that there was no difference between the two types of shops in terms of adhering to regulations for dispensing antibiotics. However, in some circumstances, eg, antibiotic sale without prescription and no referral made, for complicated cases, ADDOs performed worse than DLDBs. As many as 30% of DLDBs and 35% of ADDOs dispensed incomplete doses of antibiotics. In both ADDOs and DLDBs, fortified procaine penicillin powder was dispensed as topical application for injuries. There was no statistical difference between ADDOs and DLDBs in the violation of dispensing practice and both ADDOs and DLDBs expressed poor knowledge of the basic pharmacology of antibiotics

Numerical modelling of the coastal ocean off Tanzania

Includes bibliographical references (pages 71-89).In this model study of the coastal ocean off Tanzania, the Regional Ocean Modelling System (ROMS) was employed to model the coastal ocean off Tanzania over the domain of 5°N-15°S and 38-55°E. It was integrated for ten years with monthly mean Comprehensive Ocean and Atmosphere Data Sets (COADS) winds and heat fluxes. Initial and lateral boundary conditions were derived from the World Ocean Atlas. The model was used to simulate the annual cycle, and the sea surface temperature (SST) output compared with the Tropical Rainfall Measuring Mission (TRMM) Microwave Imager (TMI) sea surface temperature (SST) measurements for the same region. Although broadly comparable, the model SST was generally warmer than that of TMI data. The high SSTs in the Tanzanian coastal waters (greater than 28°C) occur from December to May while SSTs of less than 28°C occur during the rest of the year. The East African Coastal Current (EACC) experiences its lowest spatial and temporal average speeds (about 0.4ms- 1) in February and its maximum speed (1.7 ms⁻¹) in July. Speeds of greater than 1 ms⁻¹ occur during both transition seasons north of 6°S. The meridional wind stresses appear to be positively correlated with the EACC(r>0.6) in all locations and they are statistically significant (p<0.05). The annual cycle of the model flow in the southern Tanzanian waters seems to be positively correlated with the flow to the north of Madagascar (r=0.57 and p=O.O5). The flow in these regions changes in phase with each other from October to April and June to July with minimum speeds in November. For the other months, the flow in these regions is out of phase with each other. The model currents off southern Tanzania attain their maximum speeds in August when the South West monsoon is fully developed while the flow north of Madagascar attains its maximum speed in September when the South West monsoon fades. However, the flow in the southern Tanzanian waters is more affected by the reversal of winds over the tropical western Indian Ocean (r=0.69, p=0.01) than that north of Madagascar (r=0.51, p=0.09). This difference results in a larger annual speed range in the flow off southern Tanzania (about 0.4 ms⁻¹ ) than that to the north of Madagascar (about 0.3ms⁻¹). The ROMS model realistically simulates the annual cycle of the sea surface temperature and heat flux, the East African Coastal Current and the annual cycle of the flow entering the coastal ocean off the southern part of Tanzania. However, studies which integrate the large scale domain and regional coupled ocean-atmosphere interactions are needed to better understand of the East African climate and ocean variability. Such model results combined with suitable remote sensing and in situ observations will help improve understanding of the circulation and properties of the coastal ocean off Tanzania

Pesticides, Anthropogenic Activities, History and the Health of Our Environment: Lessons from Africa

This chapter describes the historical events related to pesticide use. The description of events focuses on human activities that necessitated the use of chemical agents for pest control to protect crops, and animals including humans in African countries. The description covers the common pests in Africa and the need for pest control using pesticides. History of pesticide use in Africa and the ban of organochlorines are covered. Controversies under discussion in Africa and the current trend of pesticide use in Africa are part of the chapter as well as pesticide import and supply. Hazard and risk of exposure of biological organisms including humans to pesticides due to anthropogenic activities in Africa and pros and cons of pesticide use in Africa are covered

Simulation of variability in the tropical Western Indian Ocean

Includes bibliographical references.The oceanic circulation and properties in the Tanzanian shelf region in the tropical western Indian Ocean have been studied in this thesis using a regional ocean model. The study investigated the influences of the Northeast Madagascar Current (NEMC) in the Tanzanian shelf waters at the annual cycle. Furthermore, the thesis examined the interannual variability of the sea surface temperature (SST) in the Tanzanian shelf region, and compares it with that offshore or with subsurface temperature. At the annual cycle, the westward-flowing NEMC advects relatively warm and fresh waters from the north of Madagascar towards the Tanzanian shelf region by interrupting the upwelled water from the Seychelles-Chagos ridge. At interannual timescales, the weakest interannual SST variations, which lie over the weak subsurface waters variations, occur in the coastal waters off Tanzania, where its variance is shared with waters to the north of Madagascar. Such SST variations are dominated by variability at about five year periods. The strongest interannual SST variations, which lie over the strongest subsurface temperature variations, occur offshore, being dominated by two periods, one at about 2.7 and the other near five years. The interannual variability of the region seems to be linked to El Niño- Southern Oscillation (ENSO) and Indian Ocean Dipole (IOD) events, which induce changes in the thermocline and surface forcing in the region. Local surface heat flux exchanges driven by the anomalous shortwave radiation dominate the weakest interannual SST variability in the Tanzanian shelf region, with some contribution by the advection of heat anomalies from the NEMC. Further offshore, the strongest interannual variability of the SST is dominated by the thermocline variations induced by local Ekman pumping from local wind stress curl and by remote forcing from large-scale climate modes.

Design of Land Administration and Title Registration Model Based on Blockchain Technology

Land administration and title registration system is the system for storing land title information and managing transactions involving land titles. Due to the sensitivity of land issues, land administration and title registration system should be strong to avoid any document forgery, available all the time, and take a short time to complete tasks. Thus, this study aims at designing a model for such system based on blockchain technology. The proposed model is designed using UML diagrams and then tested for verification using statistical usage models (Markov chains). The proposed model integrates the Integrated Land Management Information System (ILMIS) with factom and bitcoin blockchains which enables encryption of information from ILMIS to get the fingerprint information of each land title and store it to the blockchains. The model further encrypts the land information from ILMIS when needed and then compare it with fingerprints from blockchains for verification. Such implementation of the proposed model will help ILMIS to have the capability of providing tamper proof for stored data, providing the self-notarization mechanism, and availability of evidence for the land title from distributed databases. Furthermore, the society is expected to benefit from this study as the time and cost for registering land title will decrease and the possibilities of a piece of land having more than one owner will not be there. Keywords: Blockchain, Bitcoin Blockchain, Factom Blockchain, Land Management System, Model Design.

The small pelagic fishery of the Pemba Channel, Tanzania: what we know and what we need to know for management under climate change

Small pelagic fish, including anchovies, sardines and sardinellas, mackerels, capelin, hilsa, sprats and herrings, are distributed widely, from the tropics to the far north Atlantic Ocean and to the southern oceans off Chile and South Africa. They are most abundant in the highly productive major eastern boundary upwelling systems and are characterised by significant natural variations in biomass. Overall, small pelagic fisheries represent about one third of global fish landings although a large proportion of the catch is processed into animal feeds. Nonetheless, in some developing countries in addition to their economic value, small pelagic fisheries also make an important contribution to human diets and the food security of many low-income households. Such is the case for many communities in the Zanzibar Archipelago and on mainland Tanzania in the Western Indian Ocean. Of great concern in this region, as elsewhere, is the potential impact of climate change on marine and coastal ecosystems in general, and on small pelagic fisheries in particular. This paper describes data and information available on Tanzania's small pelagic fisheries, including catch and effort, management protocols and socio-economic significance

Clients' perceptions on Sulfadoxine-Pyrimethamine (SP) use as the first line drug and alternative drugs for the treatment of uncomplicated malaria in Kibaha District, Tanzania

No Abstract. East African Journal of Public Health Vol. 3 (1) April 2006: 12-1

Application of basic pharmacology and dispensing practice of antibiotics in accredited drug-dispensing outlets in Tanzania

OM Minzi,1 VS Manyilizu21Unit of Pharmacology and Therapeutics, School of Pharmacy, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, 2Logistics System Strengthening Unit, John Snow Inc, Dar es Salaam, TanzaniaBackground: Provision of pharmaceutical services in accredited drug-dispensing outlets (ADDOs) in Tanzania has not been reported. This study compared the antibiotics dispensing practice between ADDOs and part II shops, or duka la dawa baridi (DLDBs), in Tanzania.Methodology: This was a cross-sectional study that was conducted in ADDOs and DLDBs. A simulated client method for data collection was used, and a total of 85 ADDOs, located in Mvomero, Kilombero, and Morogoro rural districts, were compared with 60 DLDBs located in Kibaha district. The research assistants posed as simulated clients and requested to buy antibiotics from ADDOs and DLDBs after presenting a case scenario or disease condition. Among the diseases presented were those requiring antibiotics and those usually managed only by oral rehydration salt or analgesics. The simulated clients wanted to know the antibiotics that were available at the shop. The posed questions set a convincing ground to the dispenser either to dispense the antibiotic directly, request a prescription, or refer the patient to a health facility. Proportions were used to summarize categorical variables between ADDOs and DLDBs, and the chi-square test was used to test for statistical difference between the two drug-outlet types in terms of antibiotic-dispensing practice.Results: As many as 40% of trained ADDO dispensers no longer worked at the ADDO shops, so some of the shops employed untrained staff. A larger proportion of ADDOs than DLDBs dispensed antibiotics without prescriptions (P = 0.004). The overall results indicate that there was no difference between the two types of shops in terms of adhering to regulations for dispensing antibiotics. However, in some circumstances, eg, antibiotic sale without prescription and no referral made, for complicated cases, ADDOs performed worse than DLDBs. As many as 30% of DLDBs and 35% of ADDOs dispensed incomplete doses of antibiotics. In both ADDOs and DLDBs, fortified procaine penicillin powder was dispensed as topical application for injuries.Conclusion: There was no statistical difference between ADDOs and DLDBs in the violation of dispensing practice and both ADDOs and DLDBs expressed poor knowledge of the basic pharmacology of antibiotics.Keywords: antibiotic-dispensing practice, duka la dawa baridi, accredited drug-dispensing outlet

CLIENTS' PERCEPTIONS ON SULFADOXINE - PYRIMETHAMINE (SP) USE AS THE 1ST LINE DRUG AND ALTERNATIVE DRUGS FOR THE TREATMENT OF UNCOMPLICATED MALARIA IN KIBAHA DISTRICT, TANZANIA

Objective: To assess clients' perceptions on Sulfadoxine / Sulfalene - Pyrimethamine (SP) use as the 1st line drug and perceived alternative drugs for the treatment of uncomplicated malaria. Methods: Health facilities cross-sectional survey of 365 caregivers of underfives with fever was conducted in a malaria holoendemic area. Using semi-structured questionnaires, caregivers were interviewed to explore their perceptions on efficacy & safety of SP for the management of childhood malaria and the perceived alternative drugs to SP. Results: Clients held the notion that childhood febrile episodes had gone down after the policy change; however, SP could fail to treat febrile episodes because of wrong diagnosis (not malaria) or ineffectiveness. There was the misconception that "SP" in the different names such as Fansidar (Sulfadoxie-Pyrimethamine) and Metakelfin (Sulfalene-Pyrimethamine) are different drugs inducing half of clients to perceive that Fansidar or Metakelfin should be used in case of "SP" failure. Fansidar was considered to have more side effects, mainly cutaneous reactions; raising concerns as clients associated the side effects with HIV / AIDS. Adherence to SP was inconsistent, as some clients preferred Quinine. Conclusions: The notion that "Fansidar" and "Metakelfin" are different from SP and could be used in case of "SP" failure indicates the need for using chemical rather than trade names in prescribing antimalarial drugs. The success of a new antimalarial policy requires a countrywide monitoring and reporting side effects and a mechanism for allaying fears is put in place. Continuing education to health workers and clients is necessary for consistent adherence to a new policy

Self-reported health effects among short and long-term pesticide sprayers in Arusha, Northern Tanzania: A cross sectional Study

Occupational Medicine & Health Affairs Occupational, 2015; 3(6)Background: The aim of the present study was to assess whether long-term exposure to pesticides is associated with adverse health effects in professional pesticide sprayers. Methods: The study was conducted in Lake Eyasi Basin and Ngarenanyuki in Arusha region, during the dry season in September-October 2013. In a cross-sectional study, 97 short-term exposed men with at most three months as professional sprayers were compared with 60 long-term exposed men with experience of at least five years as professional sprayers. The study participants were aged 18-30 years, drawn from the same source population and interviewed using semi structured questionnaire. The questions focused on spraying procedures and on present and recurrent medical history including presence of selected six known pesticide induced health conditions. Results: Organophosphates, carbamates, dithiocarbamates and pyrethroids were the most applied insecticides but also organochlorine fungicides and endosulfan were frequently applied. The majority of the sprayers reported unsafe pesticide use. Mean pesticide uses in litres, spray frequency per crop and per week were 637, and 1.3 respectively for about 270 days a year. Respiratory disease symptoms were the most frequently reported (46/157; 29.3%) followed by skin (27/157; 17.2%), and sight (24/157; 15.3%). When adjusted for age and other predictors, long-term exposed sprayers had significantly higher self-reported occurrences of peripheral neuropathy (OR=7.7, CI95%: 1.045-56.728, p=0.045) and respiratory disorders (OR=0.2, CI95%: 0.067-0.501, p=0.001) compared with short-term exposed. Furthermore, 10 sprayers, all long-term exposed reported poor libido and erection problems. Conclusions: These findings document lack of safety knowledge, safe pesticide management and the implementation of protective measures as well as suggesting that long-term exposure to pesticides increase the risk of experience disease conditions compared to short-term exposure