Tackling the grassroots: appraisal of career choice and prospects of the students at a medical school in Tanzania

Tanzania has one of the world’s worst doctor-to-population ratio. Ironically, the number of medical graduates who do not practice medicine remains very high. Lack of interest and commitment of the young doctors may greatly contribute to the huge number of non-practicing doctors. We assessed medical students’ career views from interest and choice during childhood, their current learning motivations, future career expectations and interest to work in the academia. One hundred and ninetyfive students halfway their first year of medical school complete a self-administered questionnaire with a verbal consent sought from each respondent. Four in every ten students had made their decision to become a doctor before or during primary school. Over 5 out of 10 students made their choice during secondary school. Majority chose medicine due to altruistic and humanity reasons and would prefer work in clinical practice in the hospital. Very few would prefer a faculty job. Knowing about the human body, controlling and managing diseases are the main motivating factors. ‘Too much to learn’ and ‘tight schedules’ were the most aspect and deterrent factors during the medical school and the medical profession in general. Attaining a higher academic honour such as a professorship would not inspire students into the academia. Majority of students make their medical career choice early in life driven by altruistic reasons. Poor learning environments disenchant them from the passion for the career. More studies are needed to assess and improve the training in medicine.Keywords: Medical students, motivation, career prospects, Tanzani

Inspiring Tanzanian medical students into the profession: appraisal of cadaveric dissection stress and coping strategies

Learning experiences and environments greatly influence mastery of competencies during training and in future career. From its nature, cadaveric dissection early in the medical training has the potential to daunt the student’s interest in the medical profession during training and in the future clinical practice. This study aimed at appraising the Tanzanian first year medical students at Muhimbili University of Health and Allied Sciences on emotional and physical stress during practice in cadaver dissection room, coping strategies and attitude on dissection. 169 students completed a self administered questionnaire that assessed emotional and physical symptoms encountered during cadaver dissection. The questionnaire also asked for the coping strategies. The frequency distributions were used to summarize demographic variables, reaction and coping strategies. The commonest symptoms were disgust, fear and nausea. Curiosity, prior mental preparedness, pressure and help from the staff were the major coping strategies. About four in five students were fearful and anxious at the beginning, but the figure dropped towards the end of the dissection course. Females reported significantly higher rates of symptoms than males. Prior exposure to a dead body significantly lowered the levels of stress. Close to 95% positively favored dissection over other methods. About 90% would go through the dissection course given another chance. Almost all students would recommend the medical profession to their younger relatives. Anatomy staff and mentors should devise appropriate coping strategies including gradual introduction to dissection room, proper cadaver preparations, proper counselling and complementing dissection with videos and radiographic pictures

A variant branching pattern of the Aortic Arch: a case report

Variant aortic arch branching pattern may occur with different embryological mechanisms. We report on a variant aortic arch branching in a 41-year old Tanzanian male cadaver during dissection practice. The left common carotid artery was seen originating from the root of the brachiocephalic trunk and the left vertebral artery from the arch of the aorta proximal to the origin of the left subclavian artery. We discuss the relative literature, its potential embryologic development and clinical significance

Gender-Related Differences in the Prevalence of Cardiovascular Disease Risk Factors and their Correlates in Urban Tanzania.

\ud Urban areas in Africa suffer a serious problem with dual burden of infectious diseases and emerging chronic diseases such as cardiovascular diseases (CVD) and diabetes which pose a serious threat to population health and health care resources. However in East Africa, there is limited literature in this research area. The objective of this study was to examine the prevalence of cardiovascular disease risk factors and their correlates among adults in Temeke, Dar es Salaam, Tanzania. Results of this study will help inform future research and potential preventive and therapeutic interventions against such chronic diseases. The study design was a cross sectional epidemiological study. A total of 209 participants aged between 44 and 66 years were included in the study. A structured questionnaire was used to evaluate socioeconomic and lifestyle characteristics. Blood samples were collected and analyzed to measure lipid profile and fasting glucose levels. Cardiovascular risk factors were defined using World Health Organization criteria. The age-adjusted prevalence of obesity (BMI > or = 30) was 13% and 35%, among men and women (p = 0.0003), respectively. The prevalence of abdominal obesity was 11% and 58% (p < 0.0001), and high WHR (men: >0.9, women: >0.85) was 51% and 73% (p = 0.002) for men and women respectively. Women had 4.3 times greater odds of obesity (95% CI: 1.9-10.1), 14.2-fold increased odds for abdominal adiposity (95% CI: 5.8-34.6), and 2.8 times greater odds of high waist-hip-ratio (95% CI: 1.4-5.7), compared to men. Women had more than three-fold greater odds of having metabolic syndrome (p = 0.001) compared to male counterparts, including abdominal obesity, low HDL-cholesterol, and high fasting blood glucose components. In contrast, female participants had 50% lower odds of having hypertension, compared to men (95%CI: 0.3-1.0). Among men, BMI and waist circumference were significantly correlated with blood pressure, triglycerides, total, LDL-, and HDL-cholesterol (BMI only), and fasting glucose; in contrast, only blood pressure was positively associated with BMI and waist circumference in women. The prevalence of CVD risk factors was high in this population, particularly among women. Health promotion, primary prevention, and health screening strategies are needed to reduce the burden of cardiovascular disease in Tanzania.\u

カイメン カッセイザイ ショリ デ キテイマク オ ノコシタ コッカクキン ソシキヘン ノ イショク ニ ヨル シンケイ サイセイ

京都大学0048新制・課程博士博士(医学)甲第9457号医博第2470号新制||医||795(附属図書館)UT51-2002-G215京都大学大学院医学研究科生理系専攻(主査)教授 中村 孝志, 教授 中辻 憲夫, 教授 井出 千束学位規則第4条第1項該当Doctor of Medical ScienceKyoto UniversityDA

Relationship between diet and cardiovascular disease risk factors among middle- aged men and women in Dar es Salaam, Tanzania

Background:The prevalence of cardiovascular diseases is increasing in most developing countries, especially in urban settings. Despite this increasing trend, there is limited data on the association between diet and cardiovascular disease risk factors in Tanzania. Objective: To assess the frequency of intake of various foods and explore their relationship with cardiovascular disease risk factors Design: Cross-sectional epidemiological study Study setting: Five randomly selected wards in Temeke district, Dar es Salaam Subjects: Two hundred and nine men and women aged 44-66 years Outcome measures: Blood pressure measured using a standardized digital blood pressure measuring machine, anthropometric measurements, lipid profile and a dietary history which was obtained using a seven-day recall food frequency questionnaire Results: Overall; ugali, tea, green vegetables, white rice, fish and fruits were the most frequently consumed foods in this population. No gender differences were noted in the consumption of the various foods. Overweight and obese participants had significantly higher intakes of beverages, white rice and fruits compared to normal subjects (all p &lt;0.05). Higher monthly income was significantly associated with higher consumption of white rice, meat and fruits (all p&lt;0.05). Frequency of intake of beverages correlated positively and significantly with BMI, total cholesterol and LDL-cholesterol (all p&lt;0.05). Consumption of rice correlated positively with BMI and HDL-cholesterol (all p&lt;0.05) while meat correlated with only BMI (p=0.006). Logistic regression analysis revealed that white rice was the most important dietary determinant of BMI (&#946;=1.91, p=0.038, 95% CI=0.1-3.7) in this population.Conclusion: Consumption of beverages, white rice and meat is associated with obesity in this population. Advocacy on the importance of healthy dietary habits and obesity control as primary and cost-effective intervention is of utmost importance in Tanzania.Key words: Cardiovascular disease risk factors, diet, Middle-aged, Dar es Salaam, Tanzani