Breast cancer and self-examination knowledge among Tanzanian women: implications for breast cancer health education

The purpose of this study was to assess knowledge related to breast cancer and breast self-examination (BSE) among Tanzanian women. This hospital-based study was conducted at the Ocean Road Cancer Institute in Dar es Salaam, Tanzania. Face-to-face interviews were conducted with 130 women aged 20-69 years without a known history of breast cancer. Demographic data and subjects responses to a questionnaire addressing the knowledge of the women on breast anatomy and physiology; breast cancer causes; symptoms; breast self examination and treatment were recorded. Our results showed that correct scores ranged between 3% and 95.5% with a mean correct score of 36.1%. Since the average total correct scores fell below 50%, one might conclude that subjects possessed little knowledge related to breast cancer and BSE. However a closer look of the results showed that although correct and incorrect responses were dispersed throughout all content areas, the majority (80-90%) of subjects were more likely to correctly answer items assessing symptoms than any other subset of items but had knowledge deficits regarding when to get medical consultation. In this study, only 47% of subjects knew that they needed to see a doctor when they developed a breast lump. Few subjects correctly answered items assessing breast changes, breast cancer etiologic/risk factors, and BSE technique. The results highlight the need for breast cancer health education to Tanzanian women with an emphasis on breast changes, breast cancer and BSE technique. Tanzania Health Research Bulletin Vol.6(2) 2004: 64-6

Compliance With Infection Prevention Guidelines By Health Care Workers at Ronald Ross General Hospital Mufulira District

Objective: To determine the level of health-care workers’ compliance with Infection Prevention Guidelines and identify factors that influence compliance at Ronald Ross General Hospital, Mufulira District. Methods: A quantitative study was carried out in 2007. Convenient sampling method was used. Data was obtained using a self administered interview schedule and an observation checklist. A total of 77 health care workers who included Doctors, Registered Midwives and Nurses, Enrolled Midwives and Nurses, clinical Officers, Laboratory Technicians and physiotherapists took part in the study. Additionally, 40 out of the 77 interviewed health workers were observed carrying out at least one procedure requiring compliance with the Infection Prevention (IP) guidelines. Results: The study revealed that, high compliance was associated with inclusion of Guidelines in the Curricular, high knowledge of infection prevention/hospital acquired infections, positive attitude towards infection prevention and availability of materials for infection prevention. The study further reviewed revealed varied levels of compliance on different components of infection prevention. The highest level of compliance (100%) was with single use of needles and syringes while the lowest (35.1) was with decontamination of needles and syringes with 0.5% chlorine solution prior to disposal. Compliance with hand hygiene was moderate (61%). Conclusion: The study findings suggest a need for inclusion of Infection Prevention Guidelines in the health workers’ curricular, provision of in-service training in infection prevention protocols and improvements in the supply of materials for infection prevention

Effect of cowpea flour processing on the chemical properties and acceptability of a novel cowpea blended maize porridge

Childhood growth stunting is a pervasive problem in Malawi and is in large part due to low quality complementary foods and chronic gut inflammation. Introducing legumes such as cowpea (Vigna unguiculata) into the complementary diet has the potential to improve childhood growth by improving diet quality through improvements in macro- and micronutrients and also by reducing gut inflammation. However, cowpea is relatively underutilized in complementary feeding in Malawi due to its strong taste, long processing time, and high energy requirements for processing. Effective utilization of cowpea in complementary feeding requires processing which may affect chemical composition as well as sensory quality. The present study evaluated the effect of processing on the retention of zinc, crude fibre, and flavonoid in roasted, boiled, and dehulled cowpea flours, and assessed the acceptability of maize porridge (70%) enriched with one of the three cowpea flours (30%). Roasting, dehulling, and boiling did not have any effect on zinc content. Crude fibre content increased after processing by all methods. Processing had no effect on measurable flavonoids. Roasted, boiled, and dehulled cowpea blended maize porridges were acceptable to children with mean quantities of leftover food of less than 3g from the given 100g. Caregivers also rated the blended flours to be highly acceptable to them as well, with maize porridge blended with dehulled cowpea flour the most acceptable to both children and caregivers. These results demonstrate that cowpea flour, processed by any of these three different methods, could serve as a useful addition to maize porridge for complementary feeding of children in sub-Saharan Africa

A quick needs assessment of key stakeholder groups on the role of family medicine in Zambia

Background. Zambia is a nation of nine million people, and has too few physicians to meet the country’s health needs. Following the strategy of other sub- Saharan countries, Zambia has developed a training programme in family medicine to help improve the medical competencies of its physician workforce. A needs assessment was undertaken to better understand the landscape into which Zambian family medicine is being placed.Methods. In 2014, a nine-question survey in Likert-scale format was developed, validated, and then delivered to four stakeholder groups: (i) practicing clinical physicians, (ii) the general public, (iii) the University of Zambia’s School of Medicine’s academic faculty and (iv) medical students. The needs assessment was delivered through several different mechanisms: via web-based service, to respondents’ email addresses; in paper form, to population samples of convenience; and verbally, through face-to-face encounters.Results. The number of stakeholders from each group who responded to the needs assessment were: clinical physicians, 27; general public, 15; academic faculty, 14; and medical students, 31. Five of the nine survey statements achieved super-majority consensus, with >66% of stakeholders in each group agreeing. Two additional statements achieved a simple-majority consensus with >50% agreement within each stakeholder group.Conclusion. This survey suggests that there is a broad-based a priori understanding of family medicine in Zambia, and general agreement that its presence would be valuable to Zambia’s healthcare system

Tapping into the Power Lines of Project Success: The Strategic Role of Ethical Climate

Success has continued to elude many projects world over and hence raised the need to step up measures aimed at reversing this trend. Given the unique nature of particular projects, any efforts to cause project success ought to be targeted at a clearly defined set of projects. This study aimed at investigating the strategic role that the ethical climate components of Egoism, Principle and Benevolence play in enhancing the performance of Poverty Eradication Projects in LDCs, particularly Uganda. Cross sectional and quantitative survey designs were used with a study sample of 323 National Agricultural Advisory Services (NAADS) projects.  The results revealed that the ethical climate components of Egoism, Principle and Benevolence positively relate with and predict performance of poverty eradication projects. These findings generate implications and inform particular recommendations on the success of projects in LDCs as this article articulates. Keywords: Project, Ethical Climate, Poverty, Performance, Strateg

Extraction, chemical composition and nutrional characterization of vegetable oils: Case of Amaranthus hybridus (var 1 and 2) of Congo Brazzaville

Amaranthus hybridus is a vegetable which is eaten in Congo Brazzaville and in other countries. Two varieties of A. hybridus seeds (var 1 and 2) were selected for this study. Average oil content varies between 11 and 14%. A. hybridus seeds are also rich in proteins (17%) and minerals. Red oils obtained have a high saponification value (130-190) and the iodine value is between 100 and 113. The quantity of unsaponifiable matter (5 - 7%) in these oils is important. The fatty acids composition gives the following average profile: 18: 2n-6 > 18: 1 n-9 > 16: 0 > 22: 6n-3 > 18: 0. A. hybridus seeds oils also have long chain poly unsaturated fatty acids such as DHA (5.63-21.46%) and the results indicated that the n-6/n-3ratios were 1.48 to 5.63. The triacylglycerols analysis shows that oils extracted by Bligh and Dyer method contains 6 major TAGs in A. hybridus var1: LLnLn › OLL › POL. › OLL › PLL › LLL and Amaranthus hybridus var2: LLnLn › OLL › PLL › POL. › OLL › LLL. The A. hybridus seeds can be used ascattle food and baby complement food. These oils have nutritive and dietetic potentialitie

Determinants of Acceptance of Cervical Cancer Screening in Dar es Salaam, Tanzania.

To describe how demographic characteristics and knowledge of cervical cancer influence screening acceptance among women living in Dar es Salaam, Tanzania. Multistage cluster sampling was carried out in 45 randomly selected streets in Dar es Salaam. Women between the ages of 25-59 who lived in the sampled streets were invited to a cervical cancer screening; 804 women accepted and 313 rejected the invitation. Information on demographic characteristics and knowledge of cervical cancer were obtained through structured questionnaire interviews. Women aged 35-44 and women aged 45-59 had increased ORs of 3.52 and 7.09, respectively, for accepting screening. Increased accepting rates were also found among single women (OR 2.43) and among women who had attended primary or secondary school (ORs of 1.81 and 1.94). Women who had 0-2 children were also more prone to accept screening in comparison with women who had five or more children (OR 3.21). Finally, knowledge of cervical cancer and awareness of the existing screening program were also associated with increased acceptance rates (ORs of 5.90 and 4.20). There are identifiable subgroups where cervical cancer screening can be increased in Dar es Salaam. Special attention should be paid to women of low education and women of high parity. In addition, knowledge and awareness raising campaigns that goes hand in hand with culturally acceptable screening services will likely lead to an increased uptake of cervical cancer screening

Most women diagnosed with cervical cancer by a visual screening program in Tanzania completed treatment: evidence from a retrospective cohort study

Abstract Background Visual inspection with acetic acid (VIA) to identify and treat pre-cancerous lesions is effective for cervical cancer prevention. Screening programs also facilitate screening and diagnosis of invasive cancers that must be referred for radiation therapy or chemotherapy. This study compared characteristics of women diagnosed with invasive cervical cancer by a VIA screening program who did and did not follow up for treatment and who did and did not complete treatment at the Ocean Road Cancer Institute (ORCI), Dar es Salaam, Tanzania. Methods We conducted a retrospective cohort study of ORCI screening referrals from the period November 2002 to June 2011. Women referred for treatment of invasive disease (n = 980) were identified from an existing database of all women attending the screening clinic during this period (n = 20,131) and matched to a dataset of all cervical cancer patients attending ORCI in this period (n = 8,240). Treatment information was abstracted from patient records of women who followed up. Records of a random sample (n = 333) of unscreened patients were reviewed for disease stage. Results Of the 980 women referred women, 829 (84.6%) sought treatment. Most of those women (82.8%) completed their prescribed radiation. Lower disease stage, having a skilled occupation, residence in Dar es Salaam, and younger age were independently associated with loss to follow-up. Higher disease stage, residence in Dar es Salaam, older age, and later year of first treatment appointment were independently associated with incomplete treatment among those who followed up. Significantly more screened women had stage 1 disease (14.0%) than unscreened women (7.8%). Conclusions Most women referred from the screening clinic completed treatment for their cancer at ORCI. Some of those lost to follow-up may have sought treatment elsewhere. In most cases, the screening clinic appears to facilitate diagnosis and treatment, rather than screening, for women with invasive cervical cancer.http://deepblue.lib.umich.edu/bitstream/2027.42/109468/1/12889_2013_Article_7027.pd

Using Open Public Meetings and Elections to Promote Inward Transparency and Accountability: Lessons from Zambia

BackgroundCommunity-led governance can ensure that leaders are accountable to the populations they serve and strengthen health systems for maternal care. A key aspect of democratic accountability is electing respective governance bodies, in this case community boards, and holding public meetings to inform community members about actions taken on their behalf. After helping build and open 10 maternity waiting homes (MWHs) in rural Zambia as part of a randomized controlled trial, we assisted community governance committees to plan and execute annual meetings to present performance results and, where needed, to elect new board members. MethodsWe applied a principally qualitative design using observation and analysis of written documentation of public meetings to answer our research question: how do governance committees enact inward transparency and demonstrate accountability to their communities. The analysis measured participation and stakeholder representation at public meetings, the types and purposes of accountability sought by community members as evidenced by questions asked of the governance committee, and responsiveness of the governance committee to issues raised at public meetings. ResultsPublic meetings were attended by 6 out of 7 possible stakeholder groups, and reports were generally transparent. Stakeholders asked probing questions focused mainly on financial performance. Governance committee members were responsive to questions raised by participants, with 59% of answers rated as fully or mostly responsive (showing understanding of and answering the question). Six of the 10 sites held elections to re-elect or replace governance committee members. Only 2 sites reached the target set by local stakeholder committees of 50% female membership, down from 3 at formation. To further improve transparency and accountability, community governance committees need to engage in advance preparation of reports, and should consult with stakeholders on broader measures for performance assessment. Despite receiving training, community-level governance committees lacked understanding of the strategic purpose of open public meetings and elections, and how these relate to democratic accountability. They were therefore not motivated to engage in tactics to manage stakeholders effectively. ConclusionWhile open meetings and elections have potential to enhance good governance at the community level, continuous training and mentoring are needed to build capacity and enhance sustainability