The development of reading tests for use in a regularly spelled language.

Data are presented on the development of tests of reading skill in rural Tanzanian primary school pupils. Instruction in these schools is in Kiswahili, a regularly spelt language. Using a translation of a standard reading test, children could read aloud all words once they had learnt sound-letter correspondences, regardless of comprehension. In addition, children can appear to pass traditional comprehension tasks by decoding only some of the words. Three graded tests were developed which allow testing of children who either have only some letter knowledge, can read single words, or are proficient readers. The tests require children to both decode and understand the reading material in order to achieve high scores. The tests correlated well with scores on other educational achievement tests, and showed age and school grade differences. It is suggested that these tests are useful measures of reading development in a regularly spelt language. Adaptation to English and validation against standardised instruments is planned

The quality of operation notes after trans-urethral resection of the prostate at Kilimanjaro Christian Medical University College Hospital Tanzania

Background: Operation notes are very vital in the practice of surgery. They are the only comprehensive account of what took place in theatre. Accurate and detailed documentation of surgical notes after Transurethral Resection of the Prostate (TURP) is vital. Yet it is usually forgotten in medical teaching. The Royal College of Surgeons of England (RCSE) safety standards are usually used as the benchmark for the assessment of operation notes.Patients and Methods: The study was descriptive retrospective conducted at Kilimanjaro Christian Medical Centre (KCMC). All patients who underwent TURP between January and December 2017 were enrolled. The Urology theatre register was used to trace patient identities. The Files were then extracted from the registry. Operation note sheets were analysed by the research team using a structured data collection tool. Two Independent assessors(residents) were used to assess legibility. If both agreed that the notes were decipherable, then they were deemed legible. The content of the notes was assessed for Presence or absence of recorded variables. Utmost confidentiality was kept about the surgeon and the patient.Results: A total of 251 files were assessed. Recording of date, Inpatient number, Post-Operative instructions and whether there were any intraoperative complications was at 100%. However, the time of surgery, Resection technique and Method of introduction of the resectoscope were not recorded at all. Other variables recorded were: Signature of surgeon -99.6%, Patient name-99.6%, Details of prostate chips-89%, Sheath used-81%, Circulating nurse-68%, Working element used-35%, Telescope used-12%, Type of diarthermy-7%, Loop Specifications-0.8% and type of Irrigant at 0.8%. Ninety-eight percent of the  operation notes were legible. Overall 56.6% of the operation notes had recorded variables after TURP.Conclusion: Some variables (Inpatient number, Date of operation, intraoperative complications and Postoperative instructions) were recorded at 100%. Others (Time of operation, Resection technique and method of introduction of resectoscope) were not recorded at all. Overall 56.6% of the variables were recorded and 98% of the notes were legible

Awareness concerning optimal pig production management and animal welfare among smallholder farmers in Tanzania

The aim of this study was to assess smallholder farmer awareness in terms of good pig management and to identify serious management issues that should be readily changeable despite resources being limited in a rural setting. Methodology was a combination of questionnaire and observational surveys performed at pig-keeping households practising either confinement or a free-range system. Households were identified using the snowball method. A total of 120 pig-keeping households were included, of which 32 practised free-range systems and 88 confined their pigs. The observational survey included management practices and welfare assessment based on one pig from each of the 120 households. The results indicated that farmers were not aware of the basic requirements of pigs regardless of the production system practised. Water was often neglected and provided less frequently among those practising free-range. Pigs kept free-range also received treatment less frequently compared to those kept confined. Pigs were generally kept in poor conditions with risk of injury and without shelter from wind, rain, cold, heat, and sun. Welfare issues exist within both production systems, but issues within the confinement system could be easily eliminated with proper management. More knowledge on basic pig husbandry is required in the region and is essential for improving production. Educating farmers on the basic requirements for water and feed, alone, could vastly improve smallholder pig production. Education on pig management should therefore be a cornerstone in any research activity involving smallholder farmers in rural areas.http://www.ufaw.org.ukam2017Veterinary Tropical Disease

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

A Cross-Sectional Study of People with Epilepsy and Neurocysticercosis in Tanzania: Clinical Characteristics and Diagnostic Approaches.

Neurocysticercosis (NCC) is a major cause of epilepsy in regions where pigs are free-ranging and hygiene is poor. Pork production is expected to increase in the next decade in sub-Saharan Africa, hence NCC will likely become more prevalent. In this study, people with epilepsy (PWE, n=212) were followed up 28.6 months after diagnosis of epilepsy. CT scans were performed, and serum and cerebrospinal fluid (CSF) of selected PWE were analysed. We compared the demographic data, clinical characteristics, and associated risk factors of PWE with and without NCC. PWE with NCC (n=35) were more likely to be older at first seizure (24.3 vs. 16.3 years, p=0.097), consumed more pork (97.1% vs. 73.6%, p=0.001), and were more often a member of the Iraqw tribe (94.3% vs. 67.8%, p=0.005) than PWE without NCC (n=177). PWE and NCC who were compliant with anti-epileptic medications had a significantly higher reduction of seizures (98.6% vs. 89.2%, p=0.046). Other characteristics such as gender, seizure frequency, compliance, past medical history, close contact with pigs, use of latrines and family history of seizures did not differ significantly between the two groups. The number of NCC lesions and active NCC lesions were significantly associated with a positive antibody result. The electroimmunotransfer blot, developed by the Centers for Disease Control and Prevention, was more sensitive than a commercial western blot, especially in PWE and cerebral calcifications. This is the first study to systematically compare the clinical characteristics of PWE due to NCC or other causes and to explore the utility of two different antibody tests for diagnosis of NCC in sub-Saharan Africa

Earth blocks stabilized by cow-dung

WOS:000379589500010International audienceIn developing countries, most of the population cannot afford conventional building blocks made with the sand-cement mixture. In addition, these blocks do not provide thermal comfort and have a high embodied energy compared to vernacular materials. The main objective of this work was to produce low cost, resistant and durable (good resistance to water) blocks with a thermal behaviour enabling quality comfort indoor. For that purpose, the effects of cow-dung on microstructural changes in earth blocks (adobes) are investigated by means of X-ray diffraction, thermal gravimetric analyses, scanning electronic microscopy coupled with energy dispersive spectrometry, and video microscopy. The effects of these changes on the physical properties (water absorption and linear shrinkage) and mechanical properties (flexural and compressive strengths) of adobe blocks are evaluated. It is shown that cow-dung reacts with kaolinite and fine quartz to produce insoluble silicate amine, which glues the isolated soil particles together. Moreover, the significant presence of fibres in cow-dung prevents the propagation of cracks in the adobes and thus reinforces the material. The above phenomena make the adobe microstructure homogeneous with an apparent reduction of the porosity. The major effect of cow-dung additions is a significant improvement in the water resistance of adobe, which leads to the conclusion that adobes stabilized by cow-dung are suitable as building materials in wet climates

Expanding access to rehabilitation using mobile health to address musculoskeletal pain and disability

Introduction Musculoskeletal (MSK) disorders such as low back pain and osteoarthritis are a leading cause of disability and the leading contributor to the need for rehabilitation services globally. This need has surpassed the availability of trained clinicians; even in urban areas where services and providers are thought to be more abundant, access can be challenged by transportation options and financial costs associated with travel, care and lost time from work. However, continuing standard of fully in-person rehabilitation care for MSK-associated pain and disability may no longer be necessary. With increased ownership or access to even a basic mobile phone device, and evidence for remote management by trained clinicians, some individuals with MSK disorders may be able to continue their rehabilitation regimen predominantly from home after initial evaluation in primary care or an outpatient clinic. Methods This manuscript describes application of a framework we used to culturally and contextually adapt an evidence-based approach for leveraging digital health technology using a mobile phone (mHealth) to expand access to rehabilitation services for MSK-associated pain and disability. We then conducted a multi-level analysis of policies related to the adapted approach for rehabilitation service delivery to identify opportunities to support sustainability. Results Our study was conducted in Tanzania, a lower-middle income country with their first National Rehabilitation Strategic Plan released in 2021. Lessons learned can be applied even to countries with greater infrastructure or fewer barriers. The seven-step adaptation framework used can be applied in other regions to improve the likelihood of local mHealth adoption and implementation. Our practice and policy assessment for Tanzania can be applied in other regions and used collaboratively with government officials in support of building or implementing a national rehabilitation strategic plan. Conclusion The work described, lessons learned and components of the plan are generalizable globally and can improve access to rehabilitation services using mHealth to address the significant and increasing burden of disability

Advances in crop insect modelling methods—Towards a whole system approach

A wide range of insects affect crop production and cause considerable yield losses. Difficulties reside on the development and adaptation of adequate strategies to predict insect pests for their timely management to ensure enhanced agricultural production. Several conceptual modelling frameworks have been proposed, and the choice of an approach depends largely on the objective of the model and the availability of data. This paper presents a summary of decades of advances in insect population dynamics, phenology models, distribution and risk mapping. Existing challenges on the modelling of insects are listed; followed by innovations in the field. New approaches include artificial neural networks, cellular automata (CA) coupled with fuzzy logic (FL), fractal, multi-fractal, percolation, synchronization and individual/agent based approaches. A concept for assessing climate change impacts and providing adaptation options for agricultural pest management independently of the United Nations Intergovernmental Panel on Climate Change (IPCC) emission scenarios is suggested. A framework for estimating losses and optimizing yields within crop production system is proposed and a summary on modelling the economic impact of pests control is presented. The assessment shows that the majority of known insect modelling approaches are not holistic; they only concentrate on a single component of the system, i.e. the pest, rather than the whole crop production system. We suggest system thinking as a possible approach for linking crop, pest, and environmental conditions to provide a more comprehensive assessment of agricultural crop production.Peer reviewe