Disparities in Risk Factors Associated with Obesity between Zanzibar and Tanzania Mainland among Women of Reproductive Age Based on the 2010 TDHS

The occurrence of overweight and obesity has serious health implications. The 2010 Tanzania Demographic and Health Survey data set was reanalysed to compare the prevalences of overweight and obesity between Mainland Tanzania and Zanzibar and to determine how demographic factors can predict overweight and obesity across the United Republic of Tanzania. About 7.92% of the Tanzanian women of reproductive age were obese, 15% were overweight, and 11.5% were underweight. Women from Mainland Tanzania (6.56%) were significantly less likely (AOR = 0.66, 95% CI: 0.53–0.82) to be affected by obesity as compared to women from Zanzibar (12.19%). The common predictors of obesity in Mainland Tanzania and Zanzibar were wealth index, marital status, and age. Whereas the place of residence and education level emerged as predictors of obesity in the Mainland Tanzania alone, the number of meals per day did so in Zanzibar. Most importantly, Zanzibar had a greater prevalence of obesity compared to Mainland Tanzania

Pattern and Distribution of Colorectal Cancer in Tanzania: A Retrospective Chart Audit at Two National Hospitals

Background. Colorectal cancer (CRC) is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square ( 2 ) tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06%) and females (49.94%), although gender likelihood of diagnosis type (i.e., rectal or colon) was significantly different ( = 0.027). More than 60% of patients were between 40 and 69 years. Conclusions. Age ( = 0.0183) and time ( = 0.004) but not gender ( = 0.0864) were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender ( = 0.0405), age ( = 0.0015), and time ( = 0.0075) were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate

Infant and young child feeding practices on Unguja Island in Zanzibar, Tanzania: a ProPAN based analysis

Background: Undernutrition in children has remained a challenge despite the success achieved in reduction of other childhood diseases in Zanzibar. Most empirical studies on infants and young child feeding (IYCF) have examined nutritional value of foods fed to the children in terms of energy and micronutrient content. Little is known on the role of culture, traditions and social norms in influencing IYCF practices. This study aimed at assessing the existing IYCF practices and socio-cultural factors influencing these practises using ProPAN tool to get an in-depth understanding of the mothers’ practices with respect to exclusive breastfeeding and infant and young child feeding.Methods: A cross sectional study involving mothers/caregivers was conducted using semi-structured interviews and opportunistic observations on Unguja Island, Zanzibar. A random selection of 36 Shehias and 213 households with children 0 – 23 months old was done proportional-to-size of Shehias and children. Quantitative and qualitative data were collected using the ProPAN tool and embedded software for analyses.Results: A total of 213 of mothers/caregivers were involved in the study. Almost all new-borns were fed colostrum (96%). Proportion of mothers who   initiated breastfeeding within one hour after giving birth was 63%. About 24% of the women practiced exclusive breastfeeding and 21% of the children were given pre-lacteal feeds 2-3 days after birth. The mean age of introduction of complementary foods was four months. Responsive feeding was not practiced by some mothers as 31% of the children 12-23 months of age were left to eat alone without any support from caregivers. The common reasons for non-adherence to the recommended feeding practices were related to income and socio-cultural norms which are strong in the community and supported by other family members.Conclusion: Infant and young child feeding in Unguja was suboptimal. Inadequate care practices, use of pre-lacteals, early introduction of complementary foods, low rate of exclusive breastfeeding and low meal frequency were among the common practices. The main causes of the observed feeding practice were related to socio-cultural norms and beliefs. There is a need to strengthen IYCF education into the antenatal clinic regime

Pesticide regulations and their malpractice implications on food and environment safety

Although pesticides have a positive effect on plant health in terms of insect pests and diseases control, increased productivity and improved crop storage, their malpractice impacts on food safety negatively. Pesticide residues and corresponding metabolites are left as runoff to the environment affecting non-targeted organisms like fish, bees, butterflies, birds and other beneficial organisms in soil and water bodies. Moreover, the application of pesticides in non-agriculture activities goes unnoticed, such as spraying for anopheles mosquito to control malaria. Human health effects caused by pesticide residues in food include headache, vomiting, itching and skin irritation, restlessness, dizziness, breathing difficulties, neurotoxicity and chronic poisoning-related diseases such as cancer and death incidences. Maximum residue limits are the maximum pesticide residues limit in food considered safe to human as set by the Codex Alimentarius Commission and the joint Food and Agriculture Organization/World Health Organization meeting on pesticide residues. The residues of dichlorodiphenyltrichloroethane and chlorpyrifos are reported in various foods globally. Additionally, food safety is largely obstructed by illegal use of pesticides and the presence of counterfeit pesticides in the market. This review provides detail on pesticide control and regulations, residues in food, their health impacts and link approaches like good agricultural practices for ensuring sustainability on safe food production

In-vitro bioavailability of selected minerals in dry and green shelled beans

Academic Journals Afr. J. Agric. Res.Mineral deficiency especially that of iron and zinc has continuously emerged as a public health issue in developing countries, probably due to the over dependence on plant food sources, which contain more than enough minerals to meet the daily requirement but have a low bioavailability for physiological purposes. Experiments on in-vitro bioavailability were carried out on dry and green shelled beans. Invitro bioavailability of iron and zinc in bean samples was determined by HCl-pepsin (HCl-P) and pepsinpancreatin (P-P) method. The amount of the proxy bioavailable minerals were obtained by atomic absorption spectrophotometry. In both minerals there was a small but significant (P=0.009) and (P=0.0003) increase in in-vitro bioavailability after cooking. The average increase for all the varieties was 3.2 to 3.4% for iron and 1.3 to 1.6% for zinc. The two minerals were more available in cooked green shelled beans compared to dry ones. The highest difference for iron bioavailability was observed in Maharagi soja (12.9%) while lowest was in TY 3396-12 (1.4%). The highest observed for zinc was 3% in G59/1-2. Vulnerable groups who suffer from iron and zinc deficiency should be encouraged to consume green shelled beans more often in comparison to dry beans to improve their mineral uptake

In-vitro bioavailability of selected minerals in dry and green shelled beans

Academic Journals Afr. J. Agric. Res.Mineral deficiency especially that of iron and zinc has continuously emerged as a public health issue in developing countries, probably due to the over dependence on plant food sources, which contain more than enough minerals to meet the daily requirement but have a low bioavailability for physiological purposes. Experiments on in-vitro bioavailability were carried out on dry and green shelled beans. Invitro bioavailability of iron and zinc in bean samples was determined by HCl-pepsin (HCl-P) and pepsinpancreatin (P-P) method. The amount of the proxy bioavailable minerals were obtained by atomic absorption spectrophotometry. In both minerals there was a small but significant (P=0.009) and (P=0.0003) increase in in-vitro bioavailability after cooking. The average increase for all the varieties was 3.2 to 3.4% for iron and 1.3 to 1.6% for zinc. The two minerals were more available in cooked green shelled beans compared to dry ones. The highest difference for iron bioavailability was observed in Maharagi soja (12.9%) while lowest was in TY 3396-12 (1.4%). The highest observed for zinc was 3% in G59/1-2. Vulnerable groups who suffer from iron and zinc deficiency should be encouraged to consume green shelled beans more often in comparison to dry beans to improve their mineral uptake

Data from: Dietary patterns and household food insecurity in rural populations of Kilosa District, Tanzania

Introduction: Few studies have investigated the relationship between dietary pattern and household food insecurity. The objective of the present analysis was to describe the food consumption patterns and to relate these with the prevalence of food insecurity in the context of a rural community. Methodology: Three hundred and seven (307) randomly selected households in Kilosa district participated in the study. Data were collected during the rainy season (February–May) and post harvest season (September–October) in the year 2011. Food consumption pattern was determined using a 24-h dietary recall method. Food insecurity data were based on the 30 day recall experience to food insecurity in the household. Factor analysis method using Principal Components extraction function was used to derive the dietary patterns and correlation analysis was used to establish the existing relationship between household food insecurity and dietary patterns factor score. Results: (I) Meat and milk; (II) Pulses, legumes, nuts and cooking oils; (III) fish (and other sea foods), roots and tubers; (IV) Cereals, vegetables and fruits consumption patterns were identified during harvest season. Dietary patterns identified during the rainy season were as follows: (I) Fruits, cooking oils, fats, roots and tubers (II) Eggs, meat, milk and milk products (III) Fish, other sea foods, vegetables, roots and tubers and (IV) Pulses, legumes, nuts, cereals and vegetables. Household food insecurity was 80% and 69% during rainy and harvest–seasons, respectively (P=0.01). Household food insecurity access scale score was negatively correlated with the factor scores on household dietary diversity. Conclusion: Food consumption patterns and food insecurity varied by seasons with worst scenarios most prevalent during the rainy season. The risk for inadequate dietary diversity was higher among food insecure households compared to food secure households. Effort geared at alleviating household food insecurity could contribute to consumption of a wide range of food items at the household level

Uptake of Cervical Cancer Screening Services and Its Association with Cervical Cancer Awareness and Knowledge Among Women of Reproductive Age in Dodoma, Tanzania: A Cross-Sectional Study

Background: There is a close link between an individual’s knowledge about a given disease and uptake of screening and ultimately treatment. This study aimed to determine the link between knowledge levels and awareness and uptake of cervical cancer screening among women of reproductive age (15 to 49 years) in Dodoma, Tanzania.   Methods: A cross-sectional study of 1,587 women aged between 15 and 49 years was conducted in Dodoma City, Tanzania. A structured questionnaire, adapted from Montgomery and others, was pretested and used to collect data from March to April, 2016 via multistage sampling. Univariate and multiple regression analyses were used to determine factors associated with the level of knowledge about cervical cancer and the association between knowledge and uptake of cervical cancer screening.   Results: The mean age of the participants was 26.99±8.026 years. Only 165 (10.4%) of the 1,587 participants were knowledgeable about cervical cancer; 1,051 (66.2%) were aware of cervical cancer screening, and only 125 (7.9%) had undergone cervical cancer screening. Predictors of knowledge about cervical cancer were education level (secondary education adjusted odds ratio [AOR] 2.23; 95% confidence interval [CI], 1.030-4.811; P<.05; university level AOR 2.59; 95% CI, 1.179 to 5.669; P<.05); residence (rural AOR 1.85; 95% CI, 1.282 to 2.679; P=.001); parity (multipara AOR 1.88; 95% CI, 1.125 to 3.142; P<.05).   After adjusting for confounders, knowledge about cervical cancer significantly influenced both cervical cancer screening awareness (AOR 2.91; 95% CI, 1.821 to 4.640; P<.001) and uptake (AOR 2.065; 95% CI, 1.238 to 3.444; P=.005).   Conclusion: The level of knowledge about cervical cancer was extremely low. Women with less knowledge about cervical cancer were those with less education, those living in rural areas, and those without children. A low level of knowledge was associated with poor uptake of screening services, highlighting the need for integrating health education pertaining to cervical cancer and screening when providing reproductive health care in Tanzania

Adherence to standards of first-visit antenatal care among providers: A stratified analysis of Tanzanian facility-based survey for improving quality of antenatal care.

IntroductionDespite the benefits of early antenatal care visits for early prevention, detection, and treatment of potential complications in pregnancy, a high level of provider adherence to first-visit antenatal care standards is needed. However, little information is available regarding provider adherence to antenatal care in Tanzania. This study was performed to assess provider adherence to first-visit antenatal care standards and to apply stratified analysis to identify associated factors in Tanzania.MethodsData from the 2014-2015 Tanzania Service Provision Assessment Survey were used in this study. Provider adherence to first-visit antenatal care standards was measured using 10 domains: client history; aspects of prior pregnancies; danger signs of the current pregnancy; physical examination; routine tests; HIV testing and counseling; maintaining a healthy pregnancy; iron/folate supplements; tetanus toxoid vaccination, and preparation for delivery. A composite score was then created in which the highest quantile (corresponding to ≥60.5%) considered to provider adhering to first-visit antenatal care standards. Initially, a series of unadjusted logistic regression analyses according to the type of facility and managing authority were performed separately at each level (i.e., facility, provider, and client). Thereafter, all variables with P ResultsA total of 1756 first-visit antenatal care consultations performed by 822 providers in 648 health facilities were analyzed. The overall median [Interquartile range, IQR] adherence to first-visit antenatal care was relatively low at 47.1% [35.7%-60.5%]. After adjusting for selected variables from each level in specific strata, at dispensary; female providers [AOR = 5.5; 95% CI, 1.8-16.4], at health centre; performance of quality assurance [AOR = 2.2; 95% CI, 1.3-3.9], at hospital; availability of routine tests [AOR = 2.5; 95% CI, 1.3-4.8] and basic medicine [AOR = 2.8; 95% CI, 1.4-5.7], at public facilities; availability of medicine [AOR = 1.8; 95% CI, 1.1-3.2] and receiving refresher training [AOR = 1.8; 95% CI, 1.1-3.1], and at private facility; receiving external fund from government [AOR = 3.0; 95% CI, 1.1-8.4] were significantly associated with better adherence to first-visit antenatal care standards.ConclusionsThe study highlighted the important factors, including the provision of refresher training, regular distribution of basic medicines, and diagnostics equipment which may influence provider adherence to first-visit ANC standards

Dietary pattern as a predictor of colorectal cancer among general health population in Arusha Tanzania: A population based descriptive study

Research Article published by International Journal of Nutrition and Metabolism Vol. 9 (3)Proper diet is important in preventing many diseases, and colorectal cancer is no exception. The aim of this study was to identify major dietary patterns among the general population in Arusha Tanzania to determine whether diet is one of the predictors contributing to the observed pattern and distribution of colorectal cancer in Tanzania. A population based cross-sectional study recruited a sample of selfreported healthy individuals residing in four wards of the City of Arusha, Tanzania. A total of 549 participants were recruited on a voluntary basis. The Food Frequency Questionnaire and the World Health Organization (WHO) Step® survey tool were used to collect data. Factor analysis, Pearson correlation (Pearson’s r), and logistic regression were used to analyze the data.Two major dietary patterns, namely “healthy” and “western”, and one minor pattern existed among the study population. The "healthy" pattern was generally associated with females (56.2%, p=0.074), people with primary level of education (62.7%, p=0.667), age category of 25 to 44 (66.3%, p= 0.370), normal range body mass index (BMI) (42.4%, p=0.967), self-employed (78.5%), non-smokers (86.6%) and non-alcohol drinkers (51%), although the differences were not statistically significant. "Western" dietary pattern adherence was associated with area of residence (p=0.0001), gender (p=0.003) and BMI status (p=0.04) in univariate analysis. In multivariate analysis, higher odds were observed in individuals aged 25 to 34 (OR=1.104, 95%, CI(0.537-2.2267) and 45 to 54 OR=1.091, 95%, CI(0.521-2.283), alcohol drinkers (OR=1.2, 95%, CI(0.767-1.877), people with college or high levels of education (OR=0. 853, 95%, CI(0.260-2.803) and OR=0.550, 95%,CI(0. 159-1.897), smokers (OR=1.030, 95%, CI(0.519-2.044) and overweight or obese (OR=2.676, 95%, CI(0.981-7.298) and OR=2.045, 95%, CI(0.767-5.454). These data support our previous hypothesis that diet could be an important potential predictor of the previously observed pattern and distribution of colorectal cancer in Tanzania