JournalTOCs

Tanzania Journal of Health Research
Journal Prestige (SJR): 0.317

Citation Impact (citeScore): 1
Number of Followers: 2

This is an Open Access Journal

Open Access journal
ISSN (Print) 1821-6404 - ISSN (Online) 1821-9241
Published by African Journals Online

[261 journals]

Micro planning in the implementation of community-based health programmes:
lessons from vaccination services in Geita and Morogoro Tanzania
- Authors: Gasto Frumence, Nathanael Sirili , Linda Simon Paulo, Alex Mphuru , Catherine Joachim
  Pages: 1 - 16
  Abstract: Background: Micro planning is an important tool that health workers can use to ensure that immunization services reach every community. Through community participation, microplanning helped the health facility and communities to identify priority interventions, to address barriers, and to develop work plans with feasible solutions. Since 2017, Tanzania has implemented micro planning projects in poorly performing districts as a comprehensive approach to address Equity in immunization Objective: The study explored the benefits and challenges of the implementation of microplanning in community-based health programs in vaccination services in Tanzania Methods: This study employed a qualitative case study. In-depth interviews were used to obtain information from 22 key actors in the micro planning process at the district, health facility and Community levels. Results: the study identified benefits of micro planning including engagement of stakeholders from the district to the community level and creation of a sense of ownership of the Reach Every Child strategy at the community level. The study also revealed barriers of microplanning including delayed disbursement of funds to the health facilities and critical shortage of human resources for health. Conclusion: the implementation of microplanning at the health facility level has shown evidence of the theory of change indicating the paradigm shift from district dominated planning process to the involvement of local actors.
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)
Occurrence of staphylococcus spp associated with Urinary Tract Infections
among women attending Ibrahim Badamasi Babangida (IBB) specialist
hospital, Minna, Nigeria.
- Authors: Mabekoje Oladele Olatunbosun
  Pages: 17 - 30
  Abstract: Background: Urinary tract infection (UTI) refers to any part of urinary system infection caused by the presence and growth of microorganisms anywhere in the urinary tract. The infections are commonly found in women. Staphylococcus saprophyticus may infect the urinary tract. Methods: Each patient was administered a questionnaire to evaluate the likely socio-demographic/risk factors that could be associated with the presence of Staphylococcus species in the urine of the patients. The isolation, characterization and antibiotic susceptibility profile of Staphylococcus species was determined. Results: S.saprophyticus accounted for 27(55.1%) of the isolates, S.aureus accounted for 14 (28.6%) of the isolates, S.epidermidis accounted for 8 (10.2%) of the isolates. Most of the isolates were susceptible to Levofloxacin and Rifampin, while Erythromycin, Clarithromycin, Streptromycin, and Amoxicillin were resisted by the isolates of the Staphylococcus species. S.saprophyticus isolates were susceptible to levofloxacin (55.6%) and least susceptible to norfloxacin (11.1%). S. epidermidis were more susceptible to levofloxacin (75.0%), and resistant to Ampicillin (0.0%), while S. aureus was most susceptible to levofloxacin (78.6%) and least to ampicillin and erythromycin (14.3%). Age, occupation, marital status, and area of domicile of the patients were statistically significant to the occurrence of Staphylococcus species in the urine of patients (P˂0.5). Educational status was not statistically significant to the incidence of Staphylococcus species in the urine of patients (P˃0.5). Conclusion: Staphylococcus species which are likely the etiological agents for UTIs among women can be reduced through enlightenment on environmental and self-hygiene. Keywords: Staphylococcus species; Urinary tract infections; Women
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)
Electronic waste and the risks to human and environmental health: a
bibliographical review
- Authors: Valdenia Regis De Souza Cardoso, Agglaika Gomes Lucas, Juliana Teixeira Moreira, Anésio Mendes de Sousa, Wislayne Aires Moreira, Cristiely Maria de Sousa Alves de Oliveira, Fábia Souza da Silva, Dany Geraldo Kramer
  Pages: 31 - 36
  Abstract: Background: Electronic waste has a varied composition, and may contain metallic alloys, plastics, composites, ceramic material, glass and oxides. Among the elements with the most significant risk to human health are heavy metals. These elements can contaminate the soil and water resources, reaching the food chain, since they are bio-accumulative, hurting plants, animals and humans. The objective was to discuss the risks inherent to electronic waste for human and environmental health. Methods: This study was characterized as a descriptive bibliographic review, in which databases were consulted, through the use of descriptors: electronic waste; heavy metals and health. Bibliography sources in Portuguese, English and Spanish were selected, considering mainly the sources from 2015 to 2022. The present study was characterized as bibliographical research, through the literary consultation of previously published material and information in the public domain, dispensing with the need for prior authorization to take an ethics exam. Results: Regarding human health, heavy metals can lead to acute effects, depending on the dose and exposure time, as well as the long-term effect deadline. An example of heavy metals and human health issues are arsenic (pulmonary and neurological alterations); cadmium (renal and pulmonary alterations); chromium (lung disorders); lead, renal and hepatic alterations); nickel (pulmonary) and mercury (pulmonary and neurological). In the long term, these heavy metals can contribute to the development of cancers in these tissues. Conclusion: Therefore, policies must be implemented seeking to encourage regularization and training of recyclers, reinsertion of materials into the production chain, reverse logistics and bioremediation of contaminated areas, to reduce environmental impacts and human exposure to heavy metals.
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)
The prevalence, associated factors and clinical outcomes of acute kidney
injury among elderly patients admitted in medical wards of Princess Marina
Hospital, Gaborone, Botswana.
- Authors: Sandy Mpho Mosenye, Thato Moshomo, Dorothea Shailemo, Godfrey Mutashambara Rwegerera
  Pages: 37 - 56
  Abstract: Background Acute Kidney Injury (AKI) is a major problem worldwide as it is associated with high morbidity and mortality. The picture is likely to be worse in geriatric population of developing countries due to associated comorbid conditions. This study describes the prevalence, associated factors and clinical outcomes of Acute Kidney Injury among elderly patients admitted at Princess Marina Hospital (PMH), Gaborone, Botswana. Methods A retrospective cross-sectional study involved elderly patients admitted in medical wards of Princess Marina Hospital in Gaborone, Botswana from 1st March 2017 to 28th February 2018. Results Almost a third, 261/871 (29.96%) of admitted elderly patients had AKI. Final analysis involved 631 retrieved records (242 records of AKI and 371 records without AKI). Mean age (standard deviation) of participants was 66.98 (11.86) years. Male gender comprised 58.1% of participants. The factors independently associated with AKI were hypertension, heart failure, and liver failure, and sepsis, use of nephrotoxic drugs, polypharmacy and hypotension. About a fifth of patients, 50/242 (20.7%) with AKI, either recovered to normal or baseline serum creatinine before discharge. Over a third of participants did not recover to normal/ baseline serum creatinine at discharge; they comprised 96/242 (39.7%). Similarly, over a third of elderly patients with AKI, 96/242 (39.7%) died. Serum potassium was significantly associated with AKI non-recovery to normal or baseline serum creatinine whereas age over 80 years, chronic lung disease, and higher creatinine level at AKI diagnosis were independently associated with high all-cause mortality. Conclusions: The prevalence of AKI among elderly patients admitted in medical wards of a referral hospital in Botswana is high and AKI is associated with a high all-cause mortality. There is a need to conduct a prospective multicenter observational study in Botswana to obtain findings that will help generalizability while at the same time establish long-term outcomes of patients discharged with impaired renal functions
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)
Health Care Delivery System in Uganda: a review
- Authors: Medard Turyamureba, Bruno Yawe, John Bosco Oryema
  Pages: 57 - 64
  Abstract: This paper provides insights into Uganda’s health care delivery system and highlights its strengths, weaknesses, opportunities, and threats. Uganda’s health care system consists of both public and private health care providers. Uganda has around 6,940 health facilities, of which 45% are government-owned, 15% are private not-for-profit, and 40% are private for profit. In 2019, the health worker population ratio was 1.87 per 1,000 population, which is still lower than the WHO ratio of 2.5 per 1,000 population. The total health expenditure was UGX 5,309 billion, equivalent to US$ 1.8 billion. Public spending remains very low accounting for only 15% of total health expenditure. In the 2020/21 budget, the health sector was allocated UGX 2.7 trillion, equivalent to 6% of the total government budget. The total per capita health expenditure was estimated at US$ 51 for the financial year 2015/16, which is still low compared to the WHO recommended minimum level of US$84. The SWOT analysis shows that Uganda’s health delivery system boasts of having clear policies and plans, provision of free health care in public facilities and the existence of active international health agencies and Non-governmental organisations. However, the system is still fragmented with a very poor referral system, high out-of-pocket expenditure, low public spending, and inequitable distribution of health facilities across the country. Although considerable progress has been made in achieving health-related targets, several issues still require attention. There is need for a comprehensive redefinition of the health service delivery system, enhanced investment in health infrastructure with a focus on reducing inequalities; and establishment of a national health insurance scheme.
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)
Hypertension self- management and associated factors among patients
attending clinics in referral hospitals in Dar-Es-Salaam, Tanzania
- Authors: Ruchius Philbert, Pius Martin Temba, Ashabilan Ebrahim, Fredirick Mashili
  Pages: 64 - 75
  Abstract: Background: Hypertension is a growing risk for cardiovascular disease affecting more than 1.13 billion people worldwide. Rapid urbanization and associated lifestyle changes which are currently happening in low- middle-income countries are known to drive the growing prevalence of HT. With lifestyle factors playing a major role in its pathogenesis, lifestyle interventions are crucial for the management of the disease. To a large extent, lifestyle interventions are done by individual patients hence self-management practices are a key component. This study aims to elucidate and describe self-management practices for hypertension among adults attending a referral hospital in Dar es Salaam, Tanzania. Methods: A hospital-based cross-sectional study, involving 330 hypertensive patients was done in three regional referral hospitals in Dar es Salaam All eligible patients completed an interviewer-administered questionnaire consisting of a tool for the assessment of self-management practice, a modified and validated "hypertension evaluation of lifestyle and management scale" in Swahili and additional patient and healthcare-related data. Descriptive and logistic regression analyses were then conducted using SPSS version 20. Result: The overall prevalence of good self-management practice was found to be 19.7%. Education level, having a family member that suffered hypertensive complications, and self-management knowledge level was significantly associated with good self-management practices [p < 0.05]. The independent predictor for good practice was having good knowledge [OR = 0.209, 95% CI =0.060-0.727]. Conclusion: Despite being one of the key components in Hypertension management, self-management is inadequately practised among the studied patients. Awareness, knowledge and experience seem to influence self-management practices hence approaches to improve them should be incorporated into HT management regimes.
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)
Predictors of antenatal care visits among pregnant women in Kinondoni
district in Tanzania
- Authors: Amani Mkelenga, Amina Msengwa
  Pages: 76 - 86
  Abstract: Background: Antenatal care is one of the determinants of maternal mortality. Through antenatal care, a pregnant mother can be served with several treatments including danger signs of complications hence, serving her from death and other related complications. Objectives: This study assessed predictors of antenatal care visits among pregnant women. Methods: The study employed a cross-sectional design in which 424 pregnant women who had started antenatal care visits in the selected public dispensaries Kinondoni district were involved. A three-stage sampling technique was used to select wards, dispensaries, and women for this study. Data were collected using a questionnaire administered face-to-face by a researcher. a Chi Binary logistic regression model was used to determine significant predictors of antenatal care visits. Results: The results showed that the majority of pregnant women (69.5%) started the first antenatal care visit late. The predictors of antenatal care visits among pregnant women were; testing for HIV/AIDS would prevent ANC attendance during the first antenatal care visit (OR = 1.92, 95% CI: -1.09, -0.21), household size (OR = 2.46, 95% CI: -1.62, -0.18) and family planning method (OR = 1.52, 95% CI -0.87, 0.04). Conclusion: The government and stakeholders should provide programs and interventions concerned with ANC services to communities. Also, women and their partners should be encouraged to use family planning methods and testing for HIV/AIDS during the first ANC visits.
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)
Breastfeeding and breast cancer risk reduction in Sub-Saharan Africa: a
look at the evidence.
- Authors: Azubuike Samuel
  Pages: 87 - 96
  Abstract: Although the association between breast feeding and breast cancer has been investigated in high income countries, only a few studies have been conducted in sub-Saharan Africa (SSA). The aim of this study was to critically review the available evidence with an implicit aim of encouraging more studies in SSA. A literature search in Medline, Scopus, PubMed, Google Scholar, and reference list of published studies was conducted. Key studies published between 2000-2022 were selected for detailed review based on sample size, geographical distributions and relevance of the findings. The findings were summarized using tables and forest plots based on R statistical software version 3.4.0 (2017). Twenty-two (22) case-control studies and 6 cohort studies across five regions of the world- North America, Europe, Asia South America, and Africa were reviewed. A reduced risk of breast cancer (especially oestrogen receptor negative breast cancer) associated with having a breastfeeding experience or a longer lifetime duration of breastfeeding was observed in most studies. Nevertheless, studies in sub-Saharan Africa were few and most of them were limited in sample size and external validity.
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)
Determinants of enrollment in the Improved Community Health Fund among
household members in Manyara Region, Tanzania
- Authors: Agatha Fabian Ngowi, Shamira Nuru
  Pages: 97 - 106
  Abstract: Background: The improved community health fund (iCHF) concept was developed to increase access and utilization of health services while achieving financial protection against financial hardship. This study aimed to assess determinants of enrollment to the iCHF among household members in the Manyara region, Tanzania. Method: A cross-sectional study design was employed to collect quantitative data in the two selected districts of the Manyara region from January to March 2021. Data were collected using a structured questionnaire. The multivariable logistic regression model was employed to determine the predictors of enrollment to the iCHF. Results: Out of 403 participants sampled for this study, 157 (39%) were enrolled in the iCHF. After controlling for the potential confounder in the multivariate analysis results showed that, marital status (aOR=3.79; P=0.04), average income (aOR=3.01; P<0.001), chronic disease or disability (aOR=1.93; P=0.04), family size (aOR=4.55; P=0.009) and awareness of iCHF (aOR=5.89; P<0.0001) were predictors of enrollment in the scheme. Conclusion: Enrollment in the iCHF among community members is still low and the predictors for enrolment include marital status, average income, family size, chronic diseases or disabilities, and awareness of the scheme. The iCHF can be a pathway to universal health coverage through continuous health education on the importance of enrolment in the scheme
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)
Prevalence and predictors of adverse events among patients receiving
Multi-Drug Resistant Tuberculosis treatment at Kibong’oto Infectious
Disease Hospital, Tanzania: a retrospective study
- Authors: Abbas Said, Dennis Lyakurwa, Philip Sasi, Happiness Mvungi, Stella Mpagama, Sabina Mugusi
  Pages: 107 - 120
  Abstract: Background: Multidrug-resistant tuberculosis (MDR-TB) has been an emerging global public health threat and area of serious concern towards efforts of global TB control. The major challenge in MDR-TB management in Tanzania is the lack of up-to-date data on adverse events (AEs) associated with MDR-TB regimens. This study aimed to determine the prevalence and factors associated with AEs among patients treated for MDR-TB at Kibong’oto Infectious Diseases Hospital (KIiDH) Kilimanjaro, Tanzania. Methods: This was a hospital-based retrospective cross-sectional study whereby patient information was collected from patient files using a structured data extraction tool. Data from patients treated for MDR-TB at KIDH in Kilimanjaro, Tanzania from 2009 to 2019 were used for analysis. Patients with incomplete data were excluded from analysis. Adverse events were recorded either as documented by the physician or by comparing baseline laboratory results against ensuing results after initiating treatment. AE severity was graded according to the Common Terminology Criteria for Adverse Events. Results: A total of 260 patients were analyzed. Adverse events were recorded among 87.7% of the study population with a wide spectrum of these adverse events. Most common AEs included hepatotoxicity (40.4%), nephrotoxicity (37.7%), anaemia (24.2%) and death (10%). Patients previously treated for drug susceptible tuberculosis (DS-TB) had 2.75(95%CI: 1.20–6.29; p=0.017) times higher odds of developing AEs compared to those never treated for DS-TB. Predictors of death were: HIV co-infection (adjusted odds ratio (AOR) 3.3, 95%CI: 1.40-7.74, p=0.006); and patients with a low body mass index (BMI) <18.5kg/M2. A shorter MDR-TB regimen (AOR 2.4, 95%CI: 1.03-5.73; p=0.04) was a predictor of death as an AE. Conclusion: MDR-TB patients on treatment present with a high proportion of AEs. Patients with HIV co-infection, history of previous DS-TB treatment, those with a BMI <18.5kg/M2 and patients placed on shorter regimes are at an increased risk of developing AEs. Low BMI, HIV co-infection and use of the shorter MDR-TB regimen are associated with increased odds of dying among patients treated for MDR-TB. Therefore, it is pertinent to strengthen continuous follow-up among patients presenting with significant predictors of AEs.
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)
A theory-based behaviour change intervention to increase HIV self-testing
uptake and linkage to HIV prevention, care and treatment for hard to reach
populations in Northern Tanzania
- Authors: Bernard Njau
  Pages: 121 - 137
  Abstract: Background: HIV Self-Testing (HIVST) has the potential to circumvent barriers associated with conventional, facility-based HIV testing services. To increase the uptake of HIVST among hard to reach populations, we need effective HIVST implementation strategies based on theory and evidence. In this article, we describe the development of a behaviour change intervention (BCI) using the PRECEDE -PROCEED model; Capability, Opportunity, Motivation, and Behaviour (COM_B) model and the Behavior Change Wheel (BCW). We also describe the acceptability and feasibility of the BCI and fidelity of its implementation. Methods: Content and delivery were informed by systematic review, qualitative syntheses and formative exploration of barriers and facilitators for uptake of HIVST among hard to reach populations in northern Tanzania. Additional inputs were received from members of a local community advisory board (CAB). An uncontrolled before-after study design was conducted between March 2018 (pre-intervention phase) and July 2018 (post-intervention phase). Acceptability and feasibility of the BCI was assessed qualitatively among ten conveniently selected participants. Fidelity of implementation was assessed using direct observation of ten-trained PEs using a pre-defined index checklist. Results: The resulting intervention was two individual sessions delivered by ten-trained peer –educators. Participants perceived the BCI acceptable and feasible to increase HIVST uptake among hard to reach populations. Ratings for the overall intervention sessions ranged from 4.3 to 4.8(max= 5). Overall ratings on materials ranged from 4.7 to 4.8(max =5). The overall mean adherence score was 33.5(SD 3.2) ranging from 20 to 38. The overall mean performance score was 15.5 (SD 1.9) ranging from 12 to 18. Conclusions: The present findings suggest the BCI was well acceptable among hard to reach populations and feasible in an urban setting in northern Tanzania. The BCI was implemented with moderate to high levels of fidelity by trained PEs.
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)
A cohort study to compare banana leaves dressing with convention dressing
for children with burn wounds at Bugando Medical Centre, Mwanza, Tanzania
2021
- Authors: Edson Elias Sungwa
  Pages: 138 - 148
  Abstract: ABSTRACT Background: Globally burns among children is a public health concern. Banana leaf dressings or Conventional dressing materials may be used to dress burn wounds to children. The study aimed to explore outcomes of burn wounds dressed using banana leaves and conventional dressing materials respectful. Methods: Hospital based cohort study design conducted at Bugando Medical Center Burn Unit. Non-probability convenient sampling method with a sample size of 35 pediatric patients with burn wounds for each group of convectional dressing methods and banana leaf dressings were reached. Stata program Version 13 was used to analyze data. Results: A total of 70 children; 1 to 18 years, median age of 4 and interquartile range [IQR: 1-17] years were enrolled in the study. Thirty-five were dressed with Banana leaf other 35 were dressed with convention materials. Results showed that Banana leaf dressing was associated with; less pain (aOR = 0.2, 95% CI: 0.1 – 0.5, p – value <0.001), less medication use (aOR = 3.0,95% CI: 1.1 – 8.7, p – value 0.02) and good satisfaction (aOR = 85.6, 95% CI: 3.3 – 219, p – value <0.001) respectful during dressing change compared to conventional dressing method. However, no different observed between length of hospital stay and dressing method chosen. Conclusions: Although there is no evidence of a dressing method that is best for burn wounds. This study shows that Banana leaf dressing is convenient in terms of having less pain experiences and that it can be locally obtained in areas where banana plant is easily available. We recommend the use of banana leaf dressings for burns moreover, enlightenment of the public on the intervention and prevention of burns among children.
  PubDate: 2023-03-26
  DOI: 10.4314/thrb.v24i2.
  Issue No: Vol. 24, No. 2 (2023)