Prevalence and Correlates of Microalbuminuria among Type 2 Diabetes Patients at Muhimbili National Hospital, Dar es Salaam, Tanzania

Background Regular screening for microalbuminuria among type 2 diabetes patients is less common in most low-income countries while it is an early marker of diabetic nephropathy and cardiovascular complications. Objective This study aims to assess the need for regular screening for microalbuminuria among type 2 diabetes patients. Methodology  with cross-sectional approach, 124 diabetic patients were recruited at Muhimbili National Hospital, in Tanzania; their age, gender, body mass index, fasting blood sugar levels (by Accu Chek Active Glucometer), random urine albumin levels (by Microalbumin 2-1 Combo Test Strips), and the duration of diabetes were recorded. Results The study indicated that 62.1% of the participants were microalbuminuric while 2.4% were macroalbuminuric. The risk of microalbuminuria was 4.55 higher in patients aged 60-69 years (95% CI: 1.32-16.51), and 17.4 times higher in patients aged 70 and above (95% CI: 1.49-202.86) compared to individuals aged below 50 years. Patients with high blood sugar level had a risk of 8.09 times higher compared to those with normal blood sugar (CI: 2.53-25.86). Also, the odds were 7.89 higher in patients who lived with diabetes for 10-14 years compared to those lived with the disease less than 5 years (95% CI:1.33-45.59). Conclusion The odds of microalbuminuria increased significantly as the patient gets older, with high blood sugar, and the duration of diabetes. Health policies need to establish programs that enhance care at the diabetic clinic through regular screening for microalbuminuria to reduce the risk of developing kidney and cardiovascular complications. Rwanda J Med Health Sci 2021;4(1):84-9

Perceived Health System Causes of Obstetric Fistula from Accounts of Affected Women in Rural Tanzania: A qualitative study

Obstetric fistula is still a major problem in low income countries. While its main cause is untreated obstructed labour, misconceptions about it still persist. This study aimed at exploring and describing perceived health system causes of obstetric fistula from women affected by it in rural Tanzania. This exploratory qualitative study included twenty-eight women affected by obstetric fistula. Semi structured interviews and focus group discussions were held and thematic analysis used to analyse perceived health system causes of obstetric fistula from women’s account. Perceived health system causes of obstetric fistula fundamentally reflected the poor quality of obstetric care women received at health care facilities relating to staff unaccountability, late referral, and torture by nurses. The women's perception emphasizes the importance of improving the quality of obstetric care provided by health care providers in health care facilities. Keywords: Obstetric fistula, perceived causes, health system, birth experiences, Tanzani

Towards Human Activity-Based Interactive Communication Systems’ Design in Higher Learning Institutions: Study Conducted in Tanzania Higher Learning Institutions

The power of human computer interaction in interactive systems’ design processes is unimaginable as it determines their usability. However, these design processes encounter several challenges which make most of the designed interactive systems, notably in higher learning institutions fail to suitably satisfy targeted users’ needs despite the fact that they are normally designed based on their requirements. This study begins by exploring the challenges facing main communication and interaction means used in Tanzania higher learning institutions. The study then provides a review of challenges related to key research areas associated with interactive systems’ design. Based on the reviewed challenges, authors combined design science research with activity theory to come up with suited techniques through which user-involved interactive communication frameworks needed for suitable design of human activity-based interactive communication systems’ can be obtained. Based on that approach, authors came up with a suited four phase Design Science Research methodology to be used in designing of applicable frameworks. In its first phase and following a crucial user-centred design process, authors were able to come up with a Human-Activity Design Centred Framework for capturing most of the users’ needs in the design process through activities performed as well as a Human Factors’ Approach to interactive communication systems design in HLIs’

Patient Waiting Time: A Case Study of the Medical Outpatient Department of Kilimanjaro Christian Medical Center

Studies of patient waiting time are scarce in low-income countries. Significant consequences of long patient waiting times, such as reduced healthcare seeking behaviours, indicate that minimising patient waiting time should be prioritised in low-income settings. Several short and long-term intervention strategies to combat the effects of patient waiting time and improve overall efficiency are based on the analysis of patient waiting time at the Medical Outpatient Department of Kilimanjaro Christian Medical Center

Constraints Facing Incremental Housing Construction in Dar es Salaam, Tanzania

The owner-built incremental housing strategy has been used for many years across the developing world. This study examines the implication of construction constraints and challenges on annual construction cost expenditure across housing types. Using descriptive statistics and correlation analysis for 43 incrementally built housing units implemented in Dar es Salaam between year 1993 and 2013, the study has observed that single and two-storey incremental housing builders face the same set of human related construction challenges and external cost-push factors but different administrative, physical and interest related constraints. Of all the cost-push factors examined, interest rate intervention is the only observed strategy that has far reaching potentials to single-storey low cost incremental builders because such builders are less likely to resort to loans as a mechanism to fnance housing. These fndings suggest that any other external efforts targeting physical or human related incremental construction constraints are likely to end up either benefting the high quality builders or every incremental builder regardless of cost or property type or both. The study argues in favour of targeted interest rate support rather than physical or administrative housing assistance if owner-builders are to beneft specifcally in any housing policy support