Health-Related Quality of Life and Needs of Care and Support of Adult Tanzanians with Cancer: A Mixed-Methods Study.

Cancer is among the three leading causes of death in low income countries and the highest increase with regard to incidence figures for cancer diseases are found in these countries. This is the first report of the health-related quality of life (HRQOL) and needs of care and support of adult Tanzanians with cancer. A mixed-methods design was used. The study was conducted at Ocean Road Cancer Institute (ORCI) in Dar es Salaam, Tanzania. One hundred and one patients with a variety of cancer diagnoses treated and cared for at ORCI answered the Kiswahili version of the EORTC QLQ-C30 investigating HRQOL. Thirty-two of the patients participated in focus group interviews discussing needs of care and support. Data from focus group interviews were analyzed with content analysis. The findings show that the patients, both women and men, report a low quality of life, especially with regard to physical, role, and social function and a high level of symptoms and problems especially with financial difficulties and pain. Financial difficulties are reported to a remarkably high extent by both women and men. The patients, both women and men report least problems with emotional function. A content analysis of the interview data revealed needs of food and water, hygienic needs, emotional needs, spiritual needs, financial needs, and needs of closeness to cancer care and treatment services. The high score for pain points out that ORCI is facing severe challenges regarding care and treatment. However, when considering this finding it should be noted that the pain subscale of the Kiswahili version of the EORTC QLQ-C30 did not reach acceptable internal consistency and showed less than satisfactory convergent validity. This also applies to the subscales cognitive function and global health/quality of life. Attention should be drawn to meet the identified needs of Tanzanian cancer patients while hospitalized but also when at home. Increased accessibility of mosquito nets, pads, and pain-killers would help to fulfil some needs

Nutritional quality of vegetable and seed from different accessions of Amaranthus in South Africa

Amaranthus vegetable and seed are highly nutritious, but in many parts of South Africa they are hardly utilised as food. Assessment of five accessions of Amaranthus available in South Africa was carried out to select the best accession for vegetable and seed. Seeds were planted in pots in a glass house and leaves and seed were harvested. Leaves were analysed for ascorbic acid, crude protein, nitrate and minerals. Seeds were analysed for protein, fat and minerals.Ascorbic acid content in the leaves varied between 630 and 496 mg/100g. V2 contained significantly higher amount of nitrates (1 474 mg/100g) while VOP and AMA17 had the lowest (729 mg/100g). AMA 17 leaves had the highest concentrations for all the minerals that were determined in leaves. The seeds of AMA17 contained significantly higher amounts of manganese, calcium and zinc than the seeds from all other accessions and it is therefore most recommended, especially in view of the more favourable health aspects thereof. VOP seed would probably be more acceptable to the local population as food because of the cream colour compared to the black colour of the other accessions.Keywords: Amaranthus accessions, nitrates, nutrient content, manganese, calcium, zin

A CRITICAL ANALYSIS OF THE INFLUENCE OF CURRICULUM DYNAMICS MISMATCH ON THE LABOR MARKET ALIGNMENT IN KENYA

The aim of the study was to conduct a critical analysis of the influence of curriculum dynamic mismatch on the labor market alignment. The study sought to analyze the type and quality of education reforms and innovations that have to be implemented in the education system. This looked forward to assess the strengths and weaknesses of the current curriculum and determine what could be done and assist the proposed new curriculum about to take place in a few months’ time. This would help to align the kind of education offered in our learning institutions and what is expected in the labor markets. The objectives of the 8-4-4 system were to prepare high school graduates for the world of work and provide a foundation for further training in relevant postsecondary institutions. The four dimensions of education in Kenya include; the personal dimension where learners acquire the desired knowledge and skills, the social dimension which involves interactions and socializing with others and the product dimension which is aimed at guiding the learning institutions in order to enable them produce graduates who have adequate skills and knowledge used as an input in the job markets. The Kenyan current 8-4-4 system needs to cater for and put emphasis on the product dimension. The study enabled the researchers to make appropriate recommendations that shall correct the situation. Researchers used qualitative research methodology with a content analysis design which involved intensive study of issues in the area of interest through the study of existing records. Relevant research findings as guidance for initial codes were applied. The critical method enabled the researchers to use a systematic analysis of the literature reviewed and discuss its validity and evaluate its worth. Through this research method, the researchers were able to come up with the recommendations on the ways alignment of subjects taught can be used in Kenyan school in a way to ease the ways to relevant job opportunities.  Article visualizations

Hypertension and obesity among HIV patients in a care programme in Nairobi

Objective: To determine the prevalence of hypertension and obesity among HIV patients enrolled in the Sex Worker Outreach Programme (SWOP), Nairobi, Kenya.Design: A retrospective astudy.Setting: SWOP managed by the University of Manitoba, Nairobi team.Subjects: We selected clinic visit records from HIV patients seen between 2011 and 2014, which had valid blood pressure and age entries.Interventions: We analysed data to determine prevalence and correlates of hypertension and obesity in the study population. Associations were tested using chi-square for categorical variables and t-test for continuous variables.Main outcome measures: Hypertension and obesity.Results: Three thousand one hundred ninty seven subjects were included in the study. All were HIV-positive and most (97.8%) were on ART. The mean age was 39.7 years (standard deviation = 8.8) and 72.4% of the subjects were female. The prevalence of hypertension was 7.7% (246/3197) and 31% of the study cases (798/2590) were either overweight or obese. Males were more likely to have hypertension (p < 0.001) while females were more predisposed to obesity (p < 0.001).Conclusion: Hypertension and obesity are important co-morbidities among HIV patients. Preventive and management strategies should be adopted as part of the comprehensive packages on offer at all existing HIV care and ART centres targeting those enrolled for services as well as their relatives and the community at large

Hypertension and obesity among HIV patients in a care programme in Nairobi

Objective: To determine the prevalence of hypertension and obesity among HIV patients enrolled in the Sex Worker Outreach Programme (SWOP), Nairobi, Kenya.Design: A retrospective a study.Setting: SWOP managed by the University of Manitoba, Nairobi team.Subjects: We selected clinic visit records from HIV patients seen between 2011 and 2014, which had valid blood pressure and age entries.Interventions: We analysed data to determine prevalence and correlates of hypertension and obesity in the study population. Associations were tested using chi-square for categorical variables and t-test for continuous variables.Main outcome measures: Hypertension and obesity.Results: Three thousand one hundred ninety seven subjects were included in the study. All were HIV-positive and most (97.8%) were on ART. The mean age was 39.7 years (standard deviation = 8.8) and 72.4% of the subjects were female. The prevalence of hypertension was 7.7% (246/3197) and 31% of the study cases (798/2590) were either overweight or obese. Males were more likely to have hypertension (p < 0.001) while females were more predisposed to obesity (p < 0.001).Conclusion: Hypertension and obesity are important co-morbidities among HIV patients. Preventive and management strategies should be adopted as part of the comprehensive packages on offer at all existing HIV care and ART centres targeting those enrolled for services as well as their relatives and the community at large

Over-diagnosis of malaria is not a lost cause.

BACKGROUND: Recent studies have highlighted the over-diagnosis of malaria in clinical settings in Africa. This study assessed the impact of a training programme implemented as part of an intervention trial on diagnostic behaviour of clinicians in a rural district hospital in a low-moderate malaria transmission setting. METHODS: From the beginning of 2005, a randomized controlled trial (RCT) of intermittent preventive treatment for malaria in infants (IPTi) has been conducted at the study hospital. As part of the RCT, the study team offered laboratory quality assurance, and supervision and training of paediatric ward staff using information on malaria epidemiology in the community. Data on clinical and blood slide confirmed cases of malaria from 2001 to 2005 were extracted from the hospital records. RESULTS: The proportion of blood slides positive for malaria parasites had decreased from 21% in 2001 to 7% in 2005 (p < .01). The proportion of outpatient and inpatient cases diagnosed as malaria ranged between 34% and 28% from 2001 to 2004 and this decreased substantially to 17% after the introduction of the package of training and support in 2005 (p < .01). There was no clear trend in the ratio of blood slide examined versus total diagnosis of malaria. CONCLUSION: It may be possible to change the diagnostic behaviour of clinicians by rigorous training using local malaria epidemiology data and supportive supervision

Practices and constraints of tomato production among smallholder farmers in Uganda

Tomato (Solanum esculentum) is one of the most promising vegetables whose production is being intensified in Uganda. However, tomato yields remain low due to several constraints. The study aimed at identifying production and marketing practices, and constraints affecting tomato productivity in major tomato growing areas of Uganda. A survey was conducted in eight major tomato producing districts using a questionnaire to guide interviews for 240 farmers and 16 key informants. The data were analyzed using SPSS software. Results revealed that tomato production in Uganda is dominated by males who grow them on 0.68 acres of land on average. Most tomato farmers (78.4%) use mono cropping system with varieties Asilla F1 (35.3%), Tengeru97 (21.1%), Rambo (18.1%), Novela F1 (17.7%) and Riogrande (10.3%) dominating. The choice of tomato varieties used by farmers mainly depend on yield potential, pest and disease tolerance and market preference attributes such as long shelf life. In the study area, tomato is mainly fertilized using foliar fertilizers, followed by Diammonium phosphate and cattle manure. The key pests affecting tomato include caterpillars, thrips, worms and whitefly, while bacterial wilt, blight, leaf spots and viral infections are the major diseases. Majority (95.7%) of farmers use chemical sprays (pesticides and fungicides) and 4.3% of farmers used other control methods. The other methods of pest and disease control included rogueing, hand picking, ash, organic extracts, urine and frequent weeding. Average tomato yield was 4,846.3 kg/acre lower than the potential yield of 6000kg/acre. Thirty five percent of farmers market their tomato individually on-farm, 32.8% sell in rural markets, while 32.2% send to the nearest urban markets. The study revealed intensive chemical use accounting for 20% of the production costs, high seed costs (11%) and drought (10%) as the major production constraints impeding tomato production; and price fluctuations, low prices, high transport costs, post-harvest loss on farm, and poor market access as the major marketing constraints. The research findings will aid in the development of new market-oriented, highly productive tomato varieties with improved access to seed and designing initiatives to address production and marketing constraints, which will eventually enhance tomato production

Completion of Baseline Trachoma Mapping in Malawi: Results of Eight Population-Based Prevalence Surveys Conducted with the Global Trachoma Mapping Project.

PURPOSE: Following a first phase of trachoma mapping in Malawi with the Global Trachoma Mapping Project, we identified and mapped trachoma districts previously suspected to be non-endemic, although adjacent to districts with estimated trachoma prevalences indicating a public health problem. METHODS: We conducted population-based surveys in eight evaluation units (EUs) comprising eight districts in Malawi (total population 3,230,272). A 2-stage cluster random sampling design allowed us to select 30 households from each of 30 clusters per EU; all residents aged 1 year and older in selected households were examined for evidence of trachomatous inflammation-follicular (TF) and trachomatous trichiasis (TT). RESULTS: None of the eight EUs had a TF prevalence in 1-9-year-olds ≥10%, one district (Dedza) had a TF prevalence between 5.0% and 9.9%, and only one district (Karonga) had a trichiasis prevalence in adults ≥0.2%. CONCLUSION: The prevalence of TF and TT in six of eight EUs surveyed was consistent with an original categorization of trachoma being unlikely to be a public health problem. In the absence of formal surveys, health management information system data and other locally available information about trachoma is likely to be useful in predicting areas where public health interventions against trachoma are required