Health care professional knowledge and attitude towards the use of digital technologies in provision of maternal health services at Tumbi regional referral hospital in Tanzania

Objectives: In recent years Tanzania introduced digital technologies in health industry where several initiatives such as Government of Tanzania, Hospital Management Information System (GoT-HoMIS) along other digital devices are taken to ensure quality services delivery. The purpose of this study was to assess Health Care Providers (HCPs) knowledge and attitude towards the use of Digital Health Technology (DHT) in provision of maternal health services at Tumbi Regional Referral Hospital (TRRH). Methods: Descriptive cross-sectional design involving 50 purposively selected HCPs from obstetrics and gynecology department was used. A self-administered questionnaire and direct field observation was used to collect data from respondents. Data were analyzed using SPSS V.20 and presented by using tables, percentages and frequencies. Results: We found that, DHT are highly used by HCPs 49(98%). Also, DHT devices are available and functioning properly thus used in providing maternal health services by enhancing effective patient management. 43(86%) of HCPs were aware on DHT practice and about 46(92%) understood the use of DHT in provision of maternal health services despite of varying knowledge level. On the side of attitude, we found that, 43(86%) of the HCP had a positive attitude on the use of DHT. Conclusion: Knowledge, attitudes and rate of use of DHT by HCP was found to be good, despite notable challenges such as dependent on the internet signals for their proper functioning. More initiatives should be undertaken by the Ministry of Health, Community and other stakeholders to promote DHT practices in the health facilities

The silent burden of anaemia in Tanzania children:a community-based study

Objective was to document the prevalence, age-distribution, and risk factors for anaemia in Tanzanian children less than 5 years old,thereby assisting in the development of effective strategies for controlling anaemia.\ud \ud Cluster sampling was used to identify 2417 households at random from four contiguous districts in south-eastern\ud United Republic of Tanzania in mid-1999. Data on various social and medical parameters were collected and analysed.\ud \ud Blood haemoglobin concentrations (Hb) were available for 1979 of the 2131 (93%) children identified and ranged from 1.7 to 18.6 g/dl. Overall, 87% (1722) of children had an Hb <11 g/dl, 39% (775) had an Hb <8 g/dl and 3% (65) had an Hb <5 g/dl. The highest prevalence of anaemia of all three levels was in children aged 6–11 months, of whom 10% (22/226) had an Hb <5 g/dl. However, the prevalence of anaemia was already high in children aged 1–5 months (85% had an Hb <11 g/dl, 42% had an Hb <8 g/dl, and 6% had an Hb <5 g/dl). Anaemia was usually asymptomatic and when symptoms arose they were nonspecific and rarely identified as a serious illness by the care provider. A recent history of treatment with antimalarials and iron\ud was rare. Compliance with vaccinations delivered through the Expanded Programme of Immunization (EPI) was 82% and was notassociated with risk of anaemia.\ud \ud Anaemia is extremely common in south-eastern United Republic of Tanzania, even in very young infants. Further implementation of the Integrated Management of Childhood Illness algorithm should improve the case management of anaemia. However, the asymptomatic nature of most episodes of anaemia highlights the need for preventive strategies. The EPI has good coverage of the target population and it may be an appropriate channel for delivering tools for controlling anaemia and malaria

Income and Value Chain Activities in Informal Solid Waste Collection in Tandale, Dar es Salaam, Tanzania

This study investigated on income and value chain activities in informal solid waste collection in Tandale, Dar es Salaam. The study involved the samples of 83 individuals using a non-probability purposive technique. Data was collected using a closed questionnaire and open ended interview guide.&nbsp; Data was analysed using descriptive statistics.&nbsp; The study established that the youth engaged in the informal solid waste collection without knowledge and skills on the use of personal protective equipment in executing the waste collection. Young people engaged in the informal solid waste collection regardless their gender age and education status. However, participation varied according to gender as males highly engaged compared to females.&nbsp; The decrease of number of waste collector was proportional to the increase of age. While primary education holders were leading in the informal solid waste collection, even university graduates participated. While the youth engaged in the informal solid collection were less respected by community members, they perceived source of income as a driving factor for engaging in solid waste collection. However, the amount generated was very minimal for sustainability especially in undertaking obligatory life requirements such as food, health care and personal servings.&nbsp; The study recommends that the government should set appropriate policies and strategies in running waste management so that it can attract all age groups as a source of employment

Stroke in Patients with Schistosomiasis: Review of Cases in Literature

Introduction. Cerebral vascular comorbidities may occur in patients with schistosomiasis, as described in case reports. Aim and Methods. We have summarized general clinical and neurological features in patients with stroke associated with schistosomiasis, through a review of case reports in the literature. Investigation Outcomes. A total of eight case reports were retrieved. The mean age of patients was 36.42 +/- 16.7 (19 to 56 years), four females, three males, and one anonymous sex. Eosinophilia was the most frequent feature at presentation, followed by cardiac abnormalities, confusion, fever, ataxia, hemiplegia, headache, urticaria, dysphasia, and memory impairment. Patients usually present with watershed infarction or intracranial vasculitis. In one case, extracranial carotid arteries presented with inflammation and stenosis. The patient's serology was positive on admission in five cases. Full neurological recovery was reported in three cases, and partial improvement in another three. In two cases, information on neurological outcomes was incomplete. Stroke in schistosomiasis can be caused by haemodynamic impairment, direct lesion to the arterial wall, vasa vasorum obliterative endarteritis, contiguity with a focus of inflamed tissue, or inflammatory intimal damage. Schistosomiasis needs to be included in the differential diagnosis of stroke in people living or coming back from endemic areas. Conclusions. Further studies addressing the noncommunicable comorbidity issues related to this condition are needed

Perceptions of tuberculosis and treatment seeking behaviour in Ilala and Kinondoni Municipalities in Tanzania

This study was carried out in Ilala and Kinondoni Municipalities in Tanzania to explore the perceptions of Tuberculosis (TB), and treatment seeking behaviour, among patients attending healthcare facilities. The study was conducted in four randomly selected health facilities providing directly observed treatment (DOT). Exit interviews were administered to 69 randomly selected TB patients. The mean age of the respondents was 33.2 years (range= 11-72 years). Forty-six (66.7%) of the patients had primary school education. Fifty-nine (84.1%) patients had good knowledge on the transmission of TB. Majority (75%) of the respondents were of the opinion that the incidence of TB was on the increase and this was mainly associated with HIV/AIDS epidemic. All respondents knew that TB was a curable disease if one complies with the treatment. Sixty-four (60%) respondents had good knowledge on the correct duration of tuberculosis treatment. The median duration before seeking treatment from a health facility was 1.5 months. The majority of the patients 47 (68%) visited public health facilities for treatment as their fi rst action. Overall, 83.8% (57/68) respondents said females comply better with treatment than male patients. The majority of the respondents lived within a walking distance to a healthcare facility. Only 18.8% (13/69) had to spend an average of US$ 0.2-0.3 as travel costs to the healthcare facility. Most of the respondents (57.8%) said they were well attended by service providers. Half (21/42) and 59.3% (16/27) of the males and females, respectively, mentioned good patient-service provider relationship as an important reason for satisfaction of the service (&#967;2 =0.57, df=1, P>0.005). Twenty-nine (42%) of respondents were of the opinion that female TB patients conformed better to treatment than males and a similar number thought that both of them equally conformed to treatment. Findings from this study indicate that a large population in urban settings are aware that health facilities play a major role in TB treatment. In conclusion, there is a need to further explore how this information could potentially be used to enhance early seeking of appropriate services among TB patients in the era of rapid urbanization. Strategies in the control of TB and other diseases should focus on advocacy in seeking appropriate care. Keywords: tuberculosis, perceptions, gender, treatment, behaviour, Tanzania Tanzania Journal of Health Research Vol. 10 (2) 2008: pp. 89-9

Seroprevalence of Toxoplasma gondii and Associated Risk factors Among Pregnant Women Attending Antenatal Care in Ilala Municipality, Dar es Salaam, Tanzania

ABSTRACT Background: Toxoplasma gondii (T. gondii) infection during pregnancy is associated with various complications for the mother and baby. In Tanzania, there is a paucity of data on exposure to T. gondii infection among pregnant women and the associated risk factors. Therefore, this study investigated the seroprevalence of T. gondii and associated factors among pregnant women attending antenatal care in Ilala Municipality, Dar es Salaam. Methods: A cross sectional study was carried out among 383 pregnant women attending antenatal health care. A five mL of blood sample was collected from each recruited pregnant woman, processed to obtain serum, and tested for the presence of IgG and IgM anti T. gondii specific antibodies. A structured questionnaire was used to gather information on the risk factors predisposing pregnant women to the infection. Data analysis was performed using descriptive statistics and logistic regression. Results: Of the 383 participants, 104 (27.2%) were positive for antibodies specific to T. gondii; 102 (26.63%) were positive only for IgG, and 2 (0.52%) were positive for both IgM and IgG antibodies. Significant risk factors for T. gondii infection were maternal age of 34-39 years (AOR:3.71;95% CI:1.52-9.06), eating unwashed fruits (AOR:7.39;95% CI:3.99-13.66), not washing hand with soap after meat preparation (AOR:7.53; 95% CI:3.40-16.64), consumption of undercooked meat (AOR:3.75; 95% CI:1.95-7.21), and consumption of raw vegetable (AOR: 1.99; 95% CI: 1.04-3.80). Cat ownership was not statistically significantly associated with toxoplasmosis (AOR:1.90; 95% CI: 0.89-4.08). Conclusions: The seroprevalence of T. gondii infection (27.2%) indicates ongoing transmission, hence the need for regular screening during antenatal care and establishment of a control programme

High rate of drinking water contamination due to poor storage in squatter settlements in Mwanza, Tanzania

Background: Drinking water of acceptable quality is supposed to be free from faecal coliform and chemical substances that may be hazardous to human health. Water treatment and safe storage at the household level has been advocated as effective means of ensuring safe drinking water. This study was undertaken to determine the microbiological quality of the drinking water at household level in the squatter settlements in the city of Mwanza, Tanzania.Methods: A cross-sectional study was conducted between June 2014 and September 2014.  A total of 15 randomly selected water sources (tap) and 207 households’ drinking water samples from these sources were studied to ascertain level of water contamination using Membrane Filtration Method. Pre-tested questionnaire was used to collect demographic and other data regarding water treatment and storage.  Data were entered, cleaned and analysed using STATA Version 11.Results:  All 15 samples from tap used as water sources were found to be free of indicator organism (Escherichia coli) while 109 (52.66%) of drinking water samples from 207 households were found to be contaminated with E. coli.  All contaminated drinking water samples were from containers with no cover and spigot. Conclusions: There is a significant level of deterioration of water quality from the source to the drinking cup. Efforts to ensure quality storage methods for drinking water should be addressed at household level

Long-term column-averaged greenhouse gas observations using a COCCON spectrometer at the high-surface-albedo site in Gobabeb, Namibia

In this study, we present column-averaged dry-air mole fractions of CO2 (XCO2), CH4 (XCH4) and CO (XCO) from a recently established measurement site in Gobabeb, Namibia. Gobabeb is a hyperarid desert site at the sharp transition zone between the sand desert and the gravel plains, offering unique characteristics with respect to surface albedo properties. Measurements started in January 2015 and are performed utilizing a ground-based Fourier transform infrared (FTIR) EM27/SUN spectrometer of the COllaborative Carbon Column Observing Network (COCCON). Gobabeb is the first measurement site observing XCO2 and XCH4 on the African mainland and improves the global coverage of ground-based remote-sensing sites. In order to achieve the high level of precision and accuracy necessary for meaningful greenhouse gas observations, we performed calibration measurements for 8 d between November 2015 and March 2016 with the COCCON reference EM27/SUN spectrometer operated at the Karlsruhe Institute of Technology. We derived scaling factors for XCO2, XCH4 and XCO with respect to the reference instrument that are close to 1.0. We compare the results obtained in Gobabeb to measurements from the Total Carbon Column Observing Network (TCCON) sites at Réunion Island and Lauder. We choose these TCCON sites because, while 4000 km apart, the instruments at Gobabeb and Réunion Island operate at roughly the same latitude. The Lauder station is the southernmost TCCON station and functions as a background site without a pronounced XCO2 seasonal cycle. We find a good agreement for the absolute Xgas values, apart from an expected XCH4 offset between Gobabeb and Lauder due to significantly different tropopause height, as well as representative intraday variability between TCCON and COCCON. Together with the absence of long-term drifts, this highlights the quality of the COCCON measurements. In the southern hemispheric summer, we observe lower XCO2 values at Gobabeb compared to the TCCON stations, likely due to the influence of the African biosphere. We performed coincident measurements with the Greenhouse Gases Observing Satellite (GOSAT), where GOSAT observed three nearby specific observation points, over the sand desert south of the station, directly over Gobabeb and over the gravel plains to the north. GOSAT H-gain XCO2 and XCH4 agree with the EM27/SUN measurements within the 1σ uncertainty limit. The number of coincident soundings is limited, but we confirm a bias of 1.2–2.6 ppm between GOSAT M-gain and H-gain XCO2 retrievals depending on the target point. This is in agreement with results reported by a previous study and the GOSAT validation team. We also report a bias of 5.9–9.8 ppb between GOSAT M-gain and H-gain XCH4 measurements which is within the range given by the GOSAT validation team. Finally, we use the COCCON measurements to evaluate inversion-optimized CAMS model data. For XCO2, we find high biases of 0.9 ± 0.5 ppm for the Orbiting Carbon Observatory-2 (OCO-2) assimilated product and 1.1 ± 0.6 ppm for the in situ-driven product with R2 > 0.9 in both cases. These biases are comparable to reported offsets between the model and TCCON data. The OCO-2 assimilated model product is able to reproduce the drawdown of XCO2 observed by the COCCON instrument at the beginning of 2017, as opposed to the in situ-optimized product. Also, for XCH4, the observed biases are in line with prior model comparisons with TCCON

The acceptability of intermittent preventive treatment of malaria in infants (IPTi) delivered through the expanded programme of immunization in southern Tanzania

BACKGROUND\ud \ud Intermittent preventive treatment of malaria in infants (IPTi) reduces the incidence of clinical malaria. However, before making decisions about implementation, it is essential to ensure that IPTi is acceptable, that it does not adversely affect attitudes to immunization or existing health seeking behaviour. This paper reports on the reception of IPTi during the first implementation study of IPTi in southern Tanzania.\ud \ud METHODS\ud \ud Data were collected through in-depth interviews, focus group discussions and participant observation carried out by a central team of social scientists and a network of key informants/interviewers who resided permanently in the study sites.\ud \ud RESULTS\ud \ud IPTi was generally acceptable. This was related to routinization of immunization and resonance with traditional practices. Promoting "health" was considered more important than preventing specific diseases. Many women thought that immunization was obligatory and that health staff might be unwilling to assist in the future if they were non-adherent. Weighing and socialising were important reasons for clinic attendance. Non-adherence was due largely to practical, social and structural factors, many of which could be overcome. Reasons for non-adherence were sometimes interlinked. Health staff and "road to child health" cards were the main source of information on the intervention, rather than the specially designed posters. Women did not generally discuss child health matters outside the clinic, and information about the intervention percolated slowly through the community. Although there were some rumours about sulphadoxine pyrimethamine (SP), it was generally acceptable as a drug for IPTi, although mothers did not like the way tablets were administered. There is no evidence that IPTi had a negative effect on attitudes or adherence to the expanded programme on immunisation (EPI) or treatment seeking or existing malaria prevention.\ud \ud CONCLUSION\ud \ud In order to improve adherence to both EPI and IPTi local priorities should be taken into account. For example, local women are often more interested in weighing than in immunization, and they view vaccination and IPTi as vaguely "healthy" rather preventing specific diseases. There should be more emphasis on these factors and more critical consideration by policy makers of how much local knowledge and understanding is minimally necessary in order to make interventions successful