Management of medical waste in Tanzania hospitals

No Abstract

Analysis of the measured medical waste generation rate in Tanzanian district hospitals using statistical methods

In this study the medical waste generation rates at Amana and Ligula hospitals were measured and analyzed. The rate of medical waste generation is high; about 2,250 kg/day in Amana and 2,500 kg/day in Ligula hospital. The waste generation rate per patient per day is also high about 1.8 (Amana) and 2.0 (Ligula) kg/patient.day. The daily medical waste generation rate is not constant, and fluctuates randomly. About 6 to 10% of waste generated is left uncollected. Eight medical waste categories were measured and compared: general waste, pathological waste, radioactive waste, chemical waste, infectious waste, sharps waste, pharmaceutical waste, and pressurized containers. The results indicated general waste to have high generation rate while others waste types such as chemical and radioactive wastes have low generation rates. Due to differences in generation rates, the data was normalized in order to compare statistical parameters used to assess medical waste generation rates. The statistical parameters used include: range, skewness, kurtosis, probability density functions and histograms. The study revealed that management of medical waste is still facing critical problems and requires skilled health workers, appropriate technologies and suitable equipment for collection, storage and transportation. The study will enable hospitals to understand trends in variations of medical waste generation and accommodate fluctuations in their plans and budgets.Key words: Measured medical waste in selected Tanzania district hospitals, variations of waste generation, average waste generation, waste collection efficiency; range of waste generation, normalized waste generation

Quality assessment of drinking water in Temeke District (part II): Characterization of chemical parameters

This paper presents a study on drinking water quality in Temeke District (Dar es Salaam), which involved analyses of chemical parameters of drinking water samples from different drinking water sources. The drinking water sources examined included tap water, river water and well water (deep and shallow wells). Water quality studied includes pH, chloride, nitrate and total hardness levels. The concentrations of total hardness in mg CaCO3/L and chloride were obtained by titration method while the nitrate concentration levels were determined by spectrophotometer. Tap water was found to be of high quality than other sources in terms of chemical characteristics. The study revealed that the chemical parameters of water sources did not meet the permissible World Health Organization (WHO) and Tanzania Bureau of Standards (TBS) levels. Examining exceedence above the WHO standards, it was revealed that most of the samples contained chloride levels above allowable WHO limits. It was recommended that drinking water sources for domestic use should be protected from pollution sources.Key words: Drinking water quality, pH, chloride, nitrates, total hardness, exceedence

Factors affecting medical waste management in lowlevel health facilities in Tanzania S. V.

A study on evaluation of medical waste management systems was conducted in the low-level health facilities (LLHFs) in Dar es Salaam by comparing Ilala and Kinondoni municipalities. Questionnaires, interviews, visits and observation were used in data collection. The study has revealed that; most of the facilities have no specific disposal sites. In Ilala, 70% of the health facilities burn wastes in poorly designed incinerators, open pit burning or on the ground while in Kinondoni, 83% of the facilities bury wastes in the pits. More than 50% of the disposal sites surveyed are not fenced and were in close proximity to human settlements. About 60 and 70% of incinerators in the surveyed facilities in Ilala and Kinondoni municipalities, respectively, are not in good working conditions, 50% of them being of low capacity with some parts missing, e.g., chimneys, ash pits, covers for waste loading and ash removing doors. Also, 9 and 47% of the healthcare facilities in Ilala and Kinondoni, respectively, do not have the Standard Operating Procedures. Medical waste transportation is a serious problem, as 71% of the facilities in Kinondoni carry the wastes on hands to the disposal sites while in Ilala, 40% of LLHFs use wheelbarrows. Waste segregation and colour coding are poorly adhered to while most of the storage areas are too small. It was concluded that, the medical waste management in LLHFs is still poor. Awareness should be raised among LLHFs workers on proper management of the medical wastes

Self-Reported Occupational Exposure to HIV and Factors Influencing its Management Practice: A Study of Healthcare Workers in Tumbi and Dodoma Hospitals, Tanzania.

Blood borne infectious agents such as hepatitis B virus (HBV), hepatitis C virus (HCV) and human immune deficiency virus (HIV) constitute a major occupational hazard for healthcare workers (HCWs). To some degree it is inevitable that HCWs sustain injuries from sharp objects such as needles, scalpels and splintered bone during execution of their duties. However, in Tanzania, there is little or no information on factors that influence the practice of managing occupational exposure to HIV by HCWs. This study was conducted to determine the prevalence of self-reported occupational exposure to HIV among HCWs and explore factors that influence the practice of managing occupational exposure to HIV by HCWs in Tanzania. Self-administered questionnaire was designed to gather information of healthcare workers' occupational exposures in the past 12 months and circumstances in which these injuries occurred. Practice of managing occupational exposure was assessed by the following questions: Nearly half of the HCWs had experienced at least one occupational injury in the past 12 months. Though most of the occupational exposures to HIV were experienced by female nurses, non-medical hospital staff received PEP more frequently than nurses and doctors. Doctors and nurses frequently encountered occupational injuries in surgery room and labor room respectively. HCWs with knowledge on the possibility of HIV transmission and those who knew whom to contact in event of occupational exposure to HIV were less likely to have poor practice of managing occupational exposure. Needle stick injuries and splashes are common among HCWs at Tumbi and Dodoma hospitals. Knowledge of the risk of HIV transmission due to occupational exposure and knowing whom to contact in event of exposure predicted practice of managing the exposure. Thus provision of health education on occupational exposure may strengthen healthcare workers' practices to manage occupational exposure