Maternal weight gain in second and third trimesters and their relationship with birth weights in Morogoro Municipality, Tanzania

A prospective study was carried out to determine the relationship between weight gain in the second and third trimesters with the corresponding birth weights in Morogoro, Tanzania. A total of 270 pregnant women who gave birth to singleton deliveries and their consecutive newborns were randomly selected from among women who were attending one antenatal clinic. Average weight gains in second and third trimesters were 2.45 ± 0.68 and 2.14 ± 0.43 kg, respectively (a total of 4.59 ± 1.11 kg) for the two trimesters. Weight gains per week were 0.47 ± 0.16 and 0.33 ± 0.13 kg for the second and third trimesters, respectively. Weight gain in the two trimesters was lower than the expected value for the same period. Results from Pearson correlation analysis found a positive correlation (

Nutritional status and feeding practices of under-five children in Simanjiro District, Tanzania

No Abstract

Anthropometric characteristics and nutritional status of older adults in the Lake Victoria Basin of East Africa: Region, sex, and age differences

Background: Malnutrition, either as undernutrition or overnutrition, leads to detrimental alterations in body composition. The objective of this study was to investigate selected anthropometric measurements, and the nutritional status of older men and women living in the Lake Victoria Basin. This was a cross-sectional study.Setting: The setting was selected rural and urban areas of Kisumu, Jinja, and Mwanza, in Kenya, Uganda and Tanzania, respectively.Subjects: The subjects were older adults (227 men and 310 women) aged ≥ 60 years.Outcome measures: The outcome measures were weight, height, arm span, mid-upper-arm circumference (MUAC) and triceps skin-fold thickness (TSF). Body mass index (BMI) and arm muscle area (AMA) were computed using standard equations.Results: The results show that older adults in the three regions were significantly different (p-value < 0.05) in all anthropometric measurements, except MUAC. The women had significantly higher (p-value < 0.05) BMI, TSF, and MUAC, than the men. Negative slopes indicated a decline in all anthropometric measurements with age. Overall underweight (BMI < 18.5 kg/m2) was 26.4%, 58.3% were normal (BMI 18.5-24.9 kg/m2), 10.8% were overweight (BMI 25-29.9 kg/m2), and 4.5% were obese (BMI ≥ 30 kg/m2). Older men (29.5%) were significantly more underweight (p-value < 0.05) than older women (24.2%), with overweight (12.5%) and obesity (6.8%) being significantly higher (p-value < 0.05) in older women.Conclusion: The findings suggest energy depletion and loss of muscle mass, with significant differences in the three regions, and in the sex and age groups. A small proportion was overweight and obese. The decline in anthropometric measurements with age indicates poor nutritional status with aging. Thus, nutrition and health interventions should be specific to regions

Male partner attendance of skilled antenatal care in peri-urban Gulu district, Northern Uganda

<p>Abstract</p> <p>Background</p> <p>Male partner attendance of skilled Antenatal Care (ANC) is beneficial to improving maternal outcomes. This study investigated the level, perceived benefits and factors associated with male partner attendance of skilled ANC in a peri-urban community recovering from two decades of civil conflict.</p> <p>Methods</p> <p>This cross-sectional survey used multi-stage sampling in 12 villages of Omoro county to select 331 married male respondents aged 18 years or more, whose female spouses had childbirth within 24 months prior to the survey. A structured questionnaire elicited responses about male partner attendance of ANC during pregnancy at a public health facility as the main outcome variable. Analysis used Generalized Linear Model (GLM) in Stata version 10.0 to obtain Prevalence Risk Ratios (PRR) for association between the binary outcome and independent factors. All factors significant at p < 0.15 and potential confounders were included in the multivariable model.</p> <p>Results</p> <p>Overall, 65.4% (95%CI; 60.3, 70.5) male partners attended at least one skilled ANC visit. Mean age was 31.9 years [SD 8.2]. Perceived benefits of attending ANC were: HIV screening (74.5%), monitoring foetal growth (34%) and identifying complications during pregnancy (18.9%). Factors independently associated with higher ANC attendance were: knowledge of 3 or more ANC services (adj.PRR 2.77; 95%CI 2.24, 3.42), obtaining health information from facility health workers (adj.PRR 1.14; 95%CI 1.01, 1.29) and if spouse had skilled attendance at last childbirth (adj.PRR 1.31; 95%CI 1.04-1.64). However, factors for low attendance were: male partners intending their spouse to carry another pregnancy (adj.PRR 0.83; 95%CI 0.71, 0.97) and living more than 5 Km from a health facility (adj.PRR 0.83, 95%CI 0.70, 0.98).</p> <p>Conclusions</p> <p>Men who were knowledgeable of ANC services, obtained health information from a health worker and whose spouses utilised skilled delivery at last pregnancy were more likely to accompany their spouses at ANC, unlike those who wanted to have more children and lived more than 5 km from the health facility. These findings suggest that empowering male partners with knowledge about ANC services may increase their ANC participation and in turn increase skilled delivery. This strategy may improve maternal health care in post conflict and resource-limited settings.</p

Cervical cytological changes in HIV-infected patients attending care and treatment clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania

\ud Tanzania is among Sub-Saharan countries mostly affected by the HIV and AIDS pandemic, females being more vulnerable than males. HIV infected women appear to have a higher rate of persistent infection by high risk types of human papillomavirus (HPV) strongly associated with high-grade squamous intraepithelial lesions (HSIL) and invasive cervical carcinoma. Furthermore, although HIV infection and cervical cancer are major public health problems, the frequency and HIV/HPV association of cervical cancer and HSIL is not well documented in Tanzania, thus limiting the development of preventive and therapeutic strategies. A prospective unmatched, case-control study of HIV-seropositive, ≥ 18 years of age and consenting non-pregnant patients attending the care and treatment center (CTC) at Muhimbili National Hoospital (MNH) as cases was done between 2005 and 2006. HIV seronegative, non-pregnant and consenting women recruited from the Cervical Cancer Screening unit (CCSU) at ORCI were used as controls while those who did not consent to study participation and/or individuals under < 18 years were excluded. Pap smears were collected for routine cytodiagnosis and P53 immunohistochemistry (IHC). Cervical lesions were classified according to the Modified Bethesda System. A total of 170 participants from the two centers were recruited including 50 HIV-seronegative controls were from the CCSU. Ages ranged from 20-66 years (mean 40.5 years) for cases and 20-69 years (mean 41.6 years) for controls. The age group 36-45 years was the most affected by HIV (39.2%, n = 47). Cervicitis, squamous intraepithelial lesions (SIL) and carcinoma constituted 28.3% (n = 34), 38.3% (n = 46) and 5.8% (n = 7) respectively among cases, and 28% (n = 14), 34% (n = 17) and 2% (n = 1) for controls, although this was not statistically significant (P-value = 0.61). IHC showed that p53 was not detectable in HPV + Pap smears and cell blocks indicating possible degradation. The frequency of SIL and carcinoma appeared to be higher among HIV-infected women on HAART compared to seronegative controls and as expected increased with age. HIV seropositive patients appeared to present earlier with SIL compared to those HIV seronegative suggesting a role of HIV in altering the natural history of HPV infection and cervical lesions. The absence of p53 immunoreactivity in HPV + lesions is indicative of the ability of HPV E6 proteins to interact with the tumor suppressor gene and pave way for viral-induced oncogenesis in the studied Tanzanian women.\u

Low HIV incidence in pregnant and postpartum women receiving a community-based combination HIV prevention intervention in a high HIV incidence setting in South Africa

BACKGROUND: Young Southern African women have the highest HIV incidence globally. Pregnancy doubles the risk of HIV acquisition further, and maternal HIV acquisition contributes significantly to the paediatric HIV burden. Little data on combination HIV prevention interventions during pregnancy and lactation are available. We measured HIV incidence amongst pregnant and postpartum women receiving a community-based combination HIV prevention intervention in a high HIV incidence setting in South Africa. METHODS: A cohort study that included HIV-uninfected pregnant women was performed. Lay community- based workers provided individualized HIV prevention counselling and performed three-monthly home and clinic-based individual and couples HIV testing. Male partners were referred for circumcision, sexually transmitted infections or HIV treatment as appropriate. Kaplan-Meier analyses and Cox's regression were used to estimate HIV incidence and factors associated with HIV acquisition. RESULTS The 1356 women included (median age 22.5 years) received 5289 HIV tests. Eleven new HIV infections were detected over 828.3 person-years (PY) of follow-up, with an HIV incidence rate of 1.33 infections/100 PY (95% CI: 0.74±2.40). Antenatally, the HIV incidence rate was 1.49 infections/100 PY (95% CI: 0.64±2.93) and postnatally the HIV incidence rate was 1.03 infections/100 PY (95% CI: 0.33±3.19). 53% of male partners received HIV testing and 66% of eligible partners received referral for circumcision. Women within known serodiscordant couples, and women with newly diagnosed HIV-infected partners, adjusted hazard ratio (aHR) = 32.7 (95% CI: 3.8±282.2) and aHR = 126.4 (95% CI: 33.8±472.2) had substantially increased HIV acquisition, respectively. Women with circumcised partners had a reduced risk of incident HIV infection, aHR = 0.22 (95% CI: 0.03±1.86). CONCLUSIONS: Maternal HIV incidence was substantially lower than previous regional studies. Community-based combination HIV prevention interventions may reduce high maternal HIV incidence in resource-poor settings. Expanded roll-out of home-based couples HIV testing and initiating pre-exposure prophylaxis for pregnant women within serodiscordant couples is needed in Southern Africa

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Assessment of over time changes of moisture, cyanide and selected nutrients of stored dry leaves from cassava (Manihot esculenta Crantz)

Most fresh agricultural products are quickly perishable and various methods of preservation are necessary. Cassava leaves from different types of cassava (bitter, sweet and wild) were (1) dried un-pounded and (2) dried pounded in a tunnel solar dryer, filled in high density polyethylene material, sealed and placed into opaque cartons. The packing materials were purposively chosen to limit water, oxygen and light access. The complete drying was when samples were completely brittle. The storage was done at room temperature at Sokoine University of Agriculture, Morogoro, Tanzania. The main purpose of the study was to estimate shelf life by evaluating satisfactory quality in terms of nutritional values, dryness and organoleptic parameters. Water, cyanide, ascorbic acid, β-carotene, protein, iron, phosphorus, potassium and zinc were chemically analyzed at zero, three, six, nine and twelve months of storage. Dryness and organoleptic parameters were also evaluated at these different storage lengths. Processing procedure had significant effect only on water (p=0.0358), cyanide (p=0.0189) and β-carotene (p=0.0214) contents. Storage time affected water, cyanide, ascorbic acid, β-carotene, protein, iron, phosphorus, potassium and zinc significantly (p&lt;.0001). Water content increased by 6.8% and ascorbic acid decreased to zero while β-carotene, protein, minerals and cyanide showed slight decline during the storage period. The optimum storage time under the conditions was judged to be six months for nutrients and organoleptic parameters stability.Keywords: Cassava leaves, solar drying, storage time, Rwanda.African Journal of Biotechnology, Vol 13(42) 4112-411