KNOWLEDGE, ATTITUDES AND PRACTICE OF VENOUS THROMBOEMBOLISM RISK ASSESSMENT AMONG SURGICAL DOCTORS IN TANZANIA

Introduction Surgical patients are at increased risk of venous thromboembolism due to the nature of their conditions and treatments. The incidence ranges from 61.3% to 64.9% in developed countries, compared to 43% in Africa. Although venous thromboembolism is fatal, it is potentially preventable. Physician-implemented risk assessment models reduce events by 70%. No country in sub-Sahara Africa has implemented a national venous thromboembolism risk assessment guideline. The subsequent burden is probably a reflection of low awareness and knowledge, negative attitudes, and substandard practice among physicians towards risk assessment. Justification In the current study, we assessed Tanzanian surgical doctors\u27 knowledge, attitudes, and practices of venous thromboembolism risk assessment and further determined whether surgical physicians\u27 age, gender, years of practice since graduation of bachelor of medicine (experience), and academic level were associated with their knowledge, attitudes, and practice on venous thromboembolism assessment. Findings of this study would allow conception of evidence-based recommendations and possible interventions targeted at reducing the incidence of hospital-acquired venous thromboembolism and its associated morbidity and mortality in Tanzania. Methods A prospective survey among surgical doctors was conducted at two, public national refferal level hospitals in Dar es salaam, Tanzania. A researcher-administered questionnaire was used. The questions on knowledge were adopted from PROMOTE study, and the questions on attitudes and practice domains were developed by the investigators. The knowledge and practice domains were assessed according to the 10th ACCP guidelines. Results: The overall mean venous thromboembolism knowledge score among surgical doctors was 55.2%. Although 66% of respondents felt hospitalization increased venous thromboembolism risk, 58% felt some surgical patients do not require venous thromboembolism risk assessment. About 45% felt venous thromboembolism prophylaxis increased treatment costs, 33% felt it increased hospital mortality and 47.7% felt some thromboprophylaxis interventions were ineffective. thromboembolism risk, only --- felt surgical patient required risk assessment. More than 8 out of 10 have had an experience of patient developing venous thromboembolism, a similar proportion doctors reported that they would prescribe thrombo-phylaxis in a patient with significant risk, however some setbacks like inadequate knowledge (53.8%) was reported to limit practice. Conclusion and Recommendations: The venous thromboembolism knowledge is not ideal among surgical doctors in Tanzanian refferal level hospitals, this adversely impacts attitudes and practice and is a patient safety risk. There is a need to develop and adopt a comprehensive hospital-wide policy on VTE and ensure implementation of its guidelines and protocols in all clinical settings. Knowledge gaps need to be addressed, and sustainable program for regular and frequent regular re-training of surgical doctors in Tanzania tertiary level hospitals on VTE, its risk assessment, prevention and management needs to be set up

Effectiveness of Savings on Loan Delivery to Members at Workplaces: A case of Selected SACCOS in Shinyanga

The study focuses on the effectiveness of savings on loan delivery to SACCOS members at workplaces using four selected SACCOS in Shinyanga region. Various methods were used for data collection such as questionnaires, interviews and documentary review. The study has revealed that generally there is a positive relationship between savings and loans issued to members. Nevertheless, all the four studied SACCOS are faced by a challenge of none adherence to rules and policies set out for the best running of cooperative societies’ activities including that of loan delivery to members. Study recommends training members on the Cooperative Societies Rules and other SACCOS operating policies to enable them know their responsibilities and rights in SACCOS. The Cooperative Societies Rules should be reviewed to accommodate issues addressed as challenges in loan delivery to SACCOS members at workplaces

Parents’ income and primary school students performance in Tabora region.

The aim of the study was to investigate the influence of parent’s income on the student’s performance in primary schools in Tabora region. The specific objectives of the study were;(i) to examine the relationship between parent’s education level and students’ performance;(ii) to investigate the extent of fulfillments of basic study materials needed in class and during private time studies; (iii) to investigate parental influence on managing students’ time and other necessary resources investing in education; and (iv) to analyze the influences of parent’s income and students’ performance. The study used cross-sectional survey design in data collection. The aim was to allow collection of data on different groups of respondents at one point at a time. Data were collected using an interview and questionnaires. Moreover, Focus Group Discussion (FGD) was employed during data collection. Cross tabulation and logistic regression models were used to analyze data on the factors that influence student’s school performance. The study was purposely carried in only one primary school selected out of 72 primary schools in Tabora Municipality (due to its students’ family income heterogeneity). The study involved 120 respondents (63 pupils; 19 teachers and 38 parents). Study findings revealed that the availability of teaching- learning materials to students and long distance from home to school affected student’s performance in Tabora region. Other factors like student’s attitude towards education; tuition and student’s self time study affect student’s performance in Tabora region. Thus, the study recommends on the availability of teaching-learning materials to students. Further more, the study recommends on introduction of various programmes that could improve student’s attitude towards education. More over, many schools should be built to reduce distance from home to school a factor that tends to affect student’s performance in Tabora

Knowledge, attitudes and practice of venous thromboembolism risk assessment among surgical doctors in Tanzania

Introduction: Surgical patients are at increased risk of venous thromboembolism due to the nature of their conditions and treatments. The incidence ranges from 61.3% to 64.9% in developed countries, compared to 43% in Africa. Although venous thromboembolism is fatal, it is potentially preventable. Physician-implemented risk assessment models reduce events by 70%. No country in sub-Sahara Africa has implemented a national venous thromboembolism risk assessment guideline. The subsequent burden is probably a reflection of low awareness and knowledge, negative attitudes, and substandard practice among physicians towards risk assessment. Justification: In the current study, we assessed Tanzanian surgical doctors\u27 knowledge, attitudes, and practices of venous thromboembolism risk assessment and further determined whether surgical physicians\u27 age, gender, years of practice since graduation of bachelor of medicine (experience), and academic level were associated with their knowledge, attitudes, and practice on venous thromboembolism assessment. Findings of this study would allow conception of evidence-based recommendations and possible interventions targeted at reducing the incidence of hospital-acquired venous thromboembolism and its associated morbidity and mortality in Tanzania. Methods: A prospective survey among surgical doctors was conducted at two, public national refferal level hospitals in Dar es salaam, Tanzania. A researcher-administered questionnaire was used. The questions on knowledge were adopted from PROMOTE study, and the questions on attitudes and practice domains were developed by the investigators. The knowledge and practice domains were assessed according to the 10th ACCP guidelines. Results: The overall mean venous thromboembolism knowledge score among surgical doctors was 55.2%. Although 66% of respondents felt hospitalization increased venous thromboembolism risk, 58% felt some surgical patients do not require venous thromboembolism risk assessment. About 45% felt venous thromboembolism prophylaxis increased treatment costs, 33% felt it increased hospital mortality and 47.7% felt some thromboprophylaxis interventions were ineffective. thromboembolism risk, only --- felt surgical patient required risk assessment. More than 8 out of 10 have had an experience of patient developing venous thromboembolism, a similar proportion doctors reported that they would prescribe thrombo-phylaxis in a patient with significant risk, however some setbacks like inadequate knowledge (53.8%) was reported to limit practice. Conclusion and Recommendations: The venous thromboembolism knowledge is not ideal among surgical doctors in Tanzanian refferal level hospitals, this adversely impacts attitudes and practice and is a patient safety risk. There is a need to develop and adopt a comprehensive hospital-wide policy on VTE and ensure implementation of its guidelines and protocols in all clinical settings. Knowledge gaps need to be addressed, and sustainable program for regular and frequent regular re-training of surgical doctors in Tanzania tertiary level hospitals on VTE, its risk assessment, prevention and management needs to be set up