Community knowledge and information communication gaps on HIV/AIDS in Iringa Municipality, Tanzania

This study was carried out to determine community knowledge and information communication gaps on HIV/AIDS in Iringa Municipality, Tanzania. In-depth interviews and focus group discussions were used to collect data from both the community and health workers. Results showed that eighty-one percent of the respondents were knowledgeable of at least one mode of HIV/AIDS transmission. Sexual intercourse, sharing of sharp instruments, blood transfusion and mother to child transmission were known to be the most common ways on how HIV is transmitted. The community knowledge on the symptoms of AIDS was poor. The main sources of information on HIV/AIDS were health facilities, radio, televisions, religious leaders and relatives. The information covered in most of the health education programmes included prevention, treatment and care for AIDS patients. The understanding of HIV/AIDS messages was found to vary significantly between respondents with different levels of education and marital status. It was higher among those with at least a primary school education than in those without education. Singles and individuals with primary or post-primary education sought more new information than those who had no education at all. Among the respondents, 59.7% reported to have difficulties in adopting and utilising HIV/AIDS educational messages. Singles had a better understanding of information provided than married respondents. However, the former had more difficulties in adopting and utilising health education information. Poor utilisation of the HIV/AIDS messages was attributed to culture, poverty, and illiteracy. The majority of the respondents, 370 (92.8%) reported to often carry out discussions with their family members (including children) on HIV/AIDS. It is concluded that health education should identify community needs and address economic and socio-cultural barriers to facilitate education utilisation and behavioural changes required in HIV/AIDS prevention and control in Tanzania. Keywords: HIV/AIDS, knowledge, information communication, Tanzania Tanzania Health Research Bulletin Vol. 8 (2) 2006: pp. 101-10

Patient's dissatisfaction with the public and private laboratory services in conducting HIV related testing in Tanzania

<p>Abstract</p> <p>Background</p> <p>Patient's satisfaction with both private and public laboratory services is important for the improvement of the health care delivery in any country.</p> <p>Methods</p> <p>A cross-sectional survey was conducted in 24 randomly selected health facilities with laboratories that are conducting HIV related testing, in Mainland Tanzania. The study assessed patient's satisfaction with the laboratory services where by a total of 295 patients were interviewed.</p> <p>Results</p> <p>Of data analyzed for a varying totals from 224 to 294 patients, the percentage of dissatisfaction with both public and private laboratory services, ranged from 4.3% to 34.8%, with most of variables being more than 15%. Patients who sought private laboratory services were less dissatisfied with the cleanness (3/72, 4.2%) and the privacy (10/72, 13.9%) than those sought public laboratory service for the same services of cleanness (41/222, 18.5%) and privacy (61/222, 27.5%), and proportional differences were statistically significant (X²= 8.7, p = 0.003 and X²= 5.5, p = 0.01, respectively). Patients with higher education were more likely to be dissatisfied with privacy (OR = 1.8, 95% CI: 1.1–3.1) and waiting time (OR = 2.5, 95% CI: 1.5 – 4.2) in both private and public facilities. Patients with secondary education were more likely to be dissatisfied with the waiting time (OR = 5.2; 95%CI: 2.2–12.2) and result notification (OR = 5.1 95%CI (2.2–12.2) than those with lower education.</p> <p>Conclusion</p> <p>About 15.0% to 34.8% of patients were not satisfied with waiting time, privacy, results notification cleanness and timely instructions. Patients visited private facilities were less dissatisfied with cleanness and privacy of laboratory services than those visited public facilities. Patients with higher education were more likely to be dissatisfied with privacy and waiting time in both private and public facilities.</p

Community knowledge and information communication gaps on HIV/AIDS in Iringa Municipality, Tanzania

This study was carried out to determine community knowledge and information communication gaps on HIV/AIDS in Iringa Municipality, Tanzania. In-depth interviews and focus group discussions were used to collect data from both the community and health workers. Results showed that eighty-one percent of the respondents were knowledgeable of at least one mode of HIV/AIDS transmission. Sexual intercourse, sharing of sharp instruments, blood transfusion and mother to child transmission were known to be the most common ways on how HIV is transmitted. The community knowledge on the symptoms of AIDS was poor. The main sources of information on HIV/AIDS were health facilities, radio, televisions, religious leaders and relatives. The information covered in most of the health education programmes included prevention, treatment and care for AIDS patients. The understanding of HIV/AIDS messages was found to vary significantly between respondents with different levels of education and marital status. It was higher among those with at least a primary school education than in those without education. Singles and individuals with primary or post-primary education sought more new information than those who had no education at all. Among the respondents, 59.7% reported to have difficulties in adopting and utilising HIV/AIDS educational messages. Singles had a better understanding of information provided than married respondents. However, the former had more difficulties in adopting and utilising health education information. Poor utilisation of the HIV/AIDS messages was attributed to culture, poverty, and illiteracy. The majority of the respondents, 370 (92.8%) reported to often carry out discussions with their family members (including children) on HIV/AIDS. It is concluded that health education should identify community needs and address economic and socio-cultural barriers to facilitate education utilisation and behavioural changes required in HIV/AIDS prevention and control in Tanzania

Capacity of healthcare facilities in the implementation of Direct Observed Treatment strategy for tuberculosis in Arumeru and Karatu districts, Tanzania

Directly Observed Treatment Short course strategy (DOTS) has proved to have potential improvement in tuberculosis (TB) control in Tanzania. The objective of this cross sectional study was to assess the capacity of health facilities in implementing DOTS, in Arumeru and Karatu districts, Tanzania. Information sought included the capacity to offer TB service and availability of qualified staff and equipment for TB diagnosis. Information on availability and utilization of TB registers and treatment outcome for the year 2004 were also collected. A total of 111 health facilities were surveyed, 86 (77.5%) in Arumeru and 25 (22.5%) in Karatu. Only 23.4% (26/111) facilities were offering TB treatment services in the two districts. Majority 17/26 (65.38%) of them were government owned. Thirty eight (44.7%) facilities were offering TB laboratory services. All facilities with TB services (TB laboratory investigation and treatment) had TB registers. Seventy two (85.0%) of health facilities which do not provide any TB services had qualified clinical officers and at least a microscopy. Of the 339 cases notified in Arumeru in 2004, 187 (60.7%) had treatment outcome available, 124 (66.3%) were cured and 55 (29.4%) completed treatment. In Karatu 638 cases were notified in 2004, 305 (47.8%) had treatment outcome available, 68 (22.3%) cured and 165 (54.1%) completed treatment. In conclusion, the overall capacity for implementing DOTS among the facilities surveyed is found only in about 20% and 30% for clinical and laboratory components of DOTS, respectively. The capacity to provide TB diagnosis and treatment in Karatu district was relatively lower than Arumeru. It is important that capacity of the facilities is strengthened concurrently with the planned introduction of community-based DOTS in Tanzania

Prevalence of pulmonary tuberculosis in adult population of Tanzania: a national survey, 2012

Tanzania is classified as one of the 22 high tuberculosis (TB) burden countries; however, the true burden of TB disease in the country remains unknown. To assess the prevalence of bacteriologically confirmed pulmonary TB (PTB) in the adult population. This was a community-based cluster randomised survey with proportional-to-population-size selection of primary sampling units (districts). Participants were screened for TB using a symptom questionnaire and chest X-ray (CXR). Those with abnormal CXR and/or at least one symptom suggestive of TB were classified as individuals with presumptive TB, and asked to submit three sputum specimens for smear microscopy and culture. The weighted prevalence for sputum smear-positive TB cases was 249 per 100 000 adult population (95%CI 192-305) and that for bacteriologically confirmed TB cases was 293/100 000 (95%CI 228-358). Individuals aged ⩾45 years comprised 55% (71/129) of the identified smear-positive cases, but just 28% (6793/24 648) of the notified TB cases. CXR screening identified more TB cases than symptom screening. When weighted for human immunodeficiency virus prevalence among notified new smear-positive cases, the overall case detection of incident TB cases in 2012 was between 37% and 48%. The prevalence of sputum smear-positive PTB and bacteriologically confirmed PTB in the adult population was higher than previous World Health Organization estimates. There is a potential underestimation of the number of bacteriologically confirmed PTB cases in the adult population. The age distribution of prevalent cases suggests an epidemiological shift towards the older generations, which has been a sign of successful TB control activities in the past. However, the survey shows that many infectious TB cases are currently missed by the National Tuberculosis Programm

The quality of sputum smear microscopy diagnosis of pulmonary tuberculosis in Dar es Salaam, Tanzania

This study was carried out to determine the rate of agreement or disagreement of microscopy reading and culture positivity rate among smear positive and negative specimens between peripheral tuberculosis diagnostic centres (PDCs) and Central Reference Tuberculosis laboratory (CTRL). In this study 13 PDCs in Dar es Salaam, Tanzania were involved. Lot Quality Assurance Sampling (LQAS) method was used to collect 222 sputum smear slides. A total of 190 morning sputum specimens with corresponding slides were selected for culture. First readings were done by technicians at PDCs and thereafter selected slides and specimens were sent to CTRL for re-examination and culture. Culture results were used as a gold standard. Of 222 slides selected, 214 were suitable for re-examination. Percentage of agreement of smear reading between PDCs and CTRL was 42.9% and 100% for positive and negative slides, respectively. Measure of agreement (Kappa statistic) was 0.5, indicating moderate agreement. Of 190 samples cultured, percentage of agreement between smear reading from PDCs and CTRL was 37% and 88.9% for smear positive and negative slides, respectively. Kappa statistic was 0.3 indicating poor-fair agreements. Comparison of smear reading from PDCs with culture showed sensitivity of 36.9% and specificity of 88.9%. Comparison of smear readings from CTRL with culture results showed sensitivity of 95.6% and specificity of 98.6%. In conclusion there was inadequate performance in diagnosis of TB using smear microscopy among peripheral diagnostic centres in Dar es Salaam. This calls for immediate and rigorous measures to improve the quality of smear microscopy. It is therefore important to strengthen the capacity of laboratory personnel in smear microscopy techniques through supportive supervision and training

African pouched rats for the detection of pulmonary tuberculosis in sputum samples

The International Journal of Tuberculosis and Lung Disease, 2009; 13 (6):737–743SETTING: Resource-limited settings in sub-Saharan African countries. OBJECTIVE: To utilise African giant pouched rats (Cricetomys gambianus) for the diagnosis of tuberculosis (TB) in human sputum. DESIGN: A specially designed cage with 10 sniffi ng holes and cassette-carrier was used. The sputum samples were put in the sample cassette, containing 10 samples in line, placed under matching sniffi ng holes. Rats were trained to sniff each consecutive sample, and indicate TB positives by fi xing their nose for 5 seconds at the sniffi ng hole. This behaviour was maintained by food reinforcement upon correct indications. A total of 3416 samples were used. RESULTS: Of the 20 trained rats, 18 were able to discriminate positive from negative sputum samples, with average daily sensitivities ranging from 72% to 100%, and average daily false-positives ranging from 0.7% to 8.1%. The use of multiple rats signifi cantly increased sensitivity and negative predictive value. CONCLUSION: Utilising trained sniffer rats for TB detection is a potentially faster screening method and is at least as sensitive as smear microscopy. This method could therefore be suitable for active case fi nding, especially where large numbers of samples are to be analysed in resource-limited settings, to complement existing diagnostic techniques