Digital Commons Network^™

What Motivates The Choice Of Specialty Among Medical Doctors In Tanzania, Thabit Ramadhani

Master of Surgery

Background: Studies have shown there is a low specialist workforce, coupled with wide range of disparity among different specialities in the country to cater for the needs of more than 54 million Tanzanians. The theories of motivation and development have shown many theories influencing choices made by people in life. Objectives: This study aims to assess the motivation for choice of specialty among medical doctors (including registrars, residents, and specialists) in Dar es Salaam, Tanzania. Methods: A descriptive cross-sectional study was conducted at Muhimbili University of Health and Allied Sciences, Muhimbili National hospital, and the Aga Khan University Hospital Dar …

Validation Of The Kiswahili Version Of The Migraine Disability Assessment Scale In Dar Es Salaam, Tanzania, Aliasger Nagri

Master of Internal Medicine

Background: Migraine is a chronic paroxysmal neurological disorder characterized by multiphase attacks of head pain and many neurological symptoms. The MIDAS is a five (5) question-based questionnaire used in clinical practices to identify the disability caused by migraine at work, school, household or social life; with a score indicating little or no disability (0-5), mild disability (6-10), moderate disability (11-20), and severe disability (21+). Translated versions of the MIDAS scale in a number of languages has been validated. Translating and validating the Kiswahili version of the MIDAS questionnaire is essential and needed to ensure its comparability to the original English …

Nurses’ Attitudes Towards Hospitalized Older Adults In A Tertiary Care Setting In Ghana, Yakubu H. Yakubu, Abdul-Ganiyu Fuseini, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

Introduction: The increasing population of older adults and rapid increases in co- morbidities globally has necessitated the need for a healthcare delivery system that meets the multifaceted needs of the growing population of older adults. Concurrent with these rising complex health needs is the importance of positive, non-judgmental attitudes of health services providers towards older adults. Moreover, this is particu-larly important in the nursing profession, given nurses' significant and crucial roles in healthcare settings.

Aim: The study aimed to evaluate nurses’ attitudes towards older adults in a tertiary hospital in Ghana.

Design: It employed a descriptive cross-sectional …

Early Neonatal Mortality Is Modulated By Gestational Age, Birthweight And Fetal Heart Rate Abnormalities In The Low Resource Setting In Tanzania – A Five Year Review 2015–2019, Aisa Shayo, Pendo Mlay, Emily Ahn, Hussein Kidanto, Michael Espiritu, Jeffrey Perlman

Obstetrics and Gynaecology, East Africa

Background: Early Neonatal mortality (ENM) (<7days) remains a signifcant problem in low resource settings. Birth asphyxia (BA), prematurity and presumed infection contribute signifcantly to ENM. The study objectives were to determine: frst, the overall ENM rate as well as yearly ENM rate (ENMR) from 2015 to 2019; second, the infuence of decreasing GA (<37weeks) and BW (<2500g) on ENM; third, the contribution of intrapartum and delivery room factors and in particular fetal heart rate abnormalities (FHRT) to ENM; and fourth, the Fresh Still Birth Rates (FSB) rates over the same time period.

Methods: Retrospective cohort study undertaken in a zonal referral teaching hospital located in Northern Tanzania. Labor and delivery room data were obtained from 2015 to 2019 and included BW, GA, fetal heart rate (FHRT) abnormalities, bag mask ventilation (BMV) during resuscitation, initial temperature, and antenatal steroids use. Abnormal outcome was ENM<7days. Analysis included t tests, odds ratios (OR), and multivariate regression analysis.

Results: The overall early neonatal mortality rate (ENMR) was 18/1000 livebirths over the 5 years and did not change signifcantly comparing 2015 to 2019. Comparing year 2018 to 2019, the overall ENMR decreased signifcantly (OR 0.62; 95% confdence interval (CI) …

Girls On The Map: Mapping For Program Planning And Social Change, Eva Roca

Adolescents and Young People

This guide explores ways in which maps can add depth to the learning process as practitioners design programs for girls. Mapping leads practitioners through a cycle of information collection and analysis. It supports decision-making about where, with whom, and when to work, and how programs can make a real difference in girls’ lives. Programs increasingly recognize the importance of household and community characteristics in shaping girls’ lives, yet it is relatively less common to measure or map community features as part of program planning. Mapping relevant populations of girls and the features of the communities they live in can inform …

Long Term Outcomes Of Anti-Retroviral Treatment Vs. Additional Nutritional Supplementation For Hiv Patients, Michael P. Gillispie

Physician Assistant Scholarly Project Papers

The purpose of this systematic literature review is not to determine the best treatment for human immunodeficiency virus HIV but to analyze additional supplementation that can prolong the progression of the disease process. Zinc, vitamin A, D, and E will be evaluated additionally with the antiretroviral treatment ART. The cost of an ART Regimen can be very expensive and challenging for patients to afford. The goal is to find an acceptable option to complement ART with a sensible cost to prolong disease progression and minimize additional costs of health care. With the advances of ART, more and more patients can …

Adequacy Of Pain Management Among Advanced Cancer Patients With Solid Tumors Attending Palliative Care Centers In Dar Es Salaam, Judith Mwijage

Master of Medicine in Family Medicine

Background: Cancer pain is a universal undesirable symptom among cancer patients that if not addressed causes suffering and impedes quality of life of both the patients and their family. Observational studies available have shown increase in palliative care programs in Tanzania but there is dearth of information regarding the adequacy of pain control among patients with cancer after the initiation of these programs and improvement of the available interventions. Objectives: This study aimed to determine adequacy of pain management among advanced cancer patients with solid tumors as well as factors affecting adequate Cancer Related Pain management. Methods: We conducted a …

Tuberculous Meningitis Presenting With Stroke In An Immunocompetent Adolescent: A Case Report, Rukhsar S. Osman, Rahim Damji, Zainab Fidaali, Nahida Z. Walli, Mariam Noorani

Paediatrics and Child Health, East Africa

Background: Tuberculous meningitis (TBM) is a severe infection of the central nervous system that has high mortality. The disease predominantly affects young children and those who are immuncompromised. Strokes have been reported in about one-third of children with tuberculous meningitis and are associated with poor clinical outcomes.
Case report: A previously healthy 14-year-old girl living in Dar es Salam, Tanzania presented with one month history of weight loss associated with weakness, loss of appetite, apathy; without respiratory symptoms. Anti-TB therapy was started, based on radiological findings of the chest which showed multiple patchy centrilobular nodules with linear branching …

Mapping The Tourism Value Chain For Fair-Trade And Tourism Handicraft Clusters In Tanzania, Peter M. Ezra

All Dissertations

The role of tourism industry as an agent to foster community development, and as a means for poverty reduction in lesser economically developed countries (LEDCs), has been widely addressed by the literature. However, critics have pointed out that tourism has failed to promote local development and improve the livelihoods of local communities in LEDCs due to unequal trading and neoliberal economic policies resulting to economic leakage. The introduction of fair-trade movements is a response to a call to redress these unequal trading and neoliberal economic policies between the Global North and Global South. Fair-trade is considered one of the ethical …

Historical Patterns Of Regional, Residential, And Socioeconomic Inequities In The Utilization Of Maternal Health Care In Tanzania, East Africa, Neema Langa

UNLV Theses, Dissertations, Professional Papers, and Capstones

The United Republic of Tanzania (URT) has been experiencing alarming maternal and neonatal mortality rates. While these deaths have decreased over time, they fall short of the World Health Organization's (WHO) standards. Due to their strong associations, understanding maternal healthcare utilization (MHC) is critical for improving our understanding of existing maternal and neonatal mortality patterns. Existing research, primarily focusing on antenatal care (ANC), indicates that utilization of maternal health care (MHC) has steadily increased since 1990. However, very little attention has been paid to period-based changes in other MHC measures (e.g., postnatal care) and how those changes vary across socioeconomic …

Healthcare Providers' Experiences With A Clinical Mentorship Intervention To Improve Reproductive, Maternal And Newborn Care In Mwanza, Tanzania, Kahabi Isangula, Columba Mbekenga, Tumbwene Mwansisya, Loveluck Mwasha, Lucy Kisaka, Edna Selestine, David Siso, Thomas Rutachunzibwa, Secilia Mrema, Eunice Pallangyo

School of Nursing & Midwifery, East Africa

Introduction: There is increasing evidence suggesting that clinical mentorship (CM) involving on-the-job training is one of the critical resources—friendly entry points for strengthening the knowledge and skills of healthcare providers (HCPs), which in turn facilitate the delivery of effective reproductive, maternal, and newborn health (RMNH) care. The article explores the experiences of HCPs following participation in the CM program for RMNH in eight districts of Mwanza Region in Tanzania.

Materials and Methods: A qualitative descriptive design employing data from midterm project review meetings and Key Informant Interviews (KIIs) with purposefully selected HCPs (mentors and mentees) and District Medical Officers (DMOs) …

In Vitro Antibacterial And Antifungal Activities Of Sorindeia Madagascariensis And Albizia Harveyi Stem Barks, Paul Malaba Makoye, Sunday Mrutu, Innocent John Daniel, Mourice Nyangabo Mbunde, Joseph Sempombe, Veronica Mugoyela

Pharmaceutical Sciences and Research

The emerging multi-drug-resistant pathogens urge continuous searches for new antimicrobial agents. This study investigated the in vitro antibacterial and antifungal activities of the stem barks of two plants, Sorindeia madagascariensis and Albizia harveyi. Broth microdilution assay was used to determine the minimum inhibitory concentrations (MICs) of hydroethanolic extracts of the stem barks against selected bacteria and fungi. Both plant extracts exhibited activity against all tested microorganisms and their minimum inhibitory concentrations (MICs) against bacteria and fungi were from 1.67 to 5.00 mg/mL and from 1.67 to 10.00 mg/mL, respectively. This study reports the antibacterial and antifungal activities of the …

Librarians’ Perceptions, Information Technology Competencies And Use Of Cloud-Based Storage Systems In Academic Libraries In South-West Nigeria, Victoria Adeola Olukayode, Olayinka Babayemi Makinde Dr, Ibidapo Oketunji

Library Philosophy and Practice (e-journal)

The study investigated how perceptions and IT competencies of academic librarians influenced their use of Cloud-Based Storage (CBS) systems in libraries in South-West Nigeria. Primary data were collected from 127 academic librarians working in 11 university libraries across six Southwestern states of Nigeria. The answers from these valid copies of the questionnaire were descriptively (frequency count and percentage) and inferentially (regression statistics) analyzed using SPSS version 23. The findings revealed that the librarians had high perceptions for the use of CBS systems and also their IT competencies were on the high side. The perceptions and IT competencies of librarians significantly …

Heterotopic Gestation In Polycystic Ovary Disease: Termination Of Tubal Pregnancy And Intrauterine Pregnancy Progressing To Term, Munawar Kaguta, Ahmed Jusabani, Ntiyakuze Gregory, Shweta Jaiswal, Zainab Fidaali, Pilly Ally, Davis Rubagumya, Miriam Mgonja, Farhat Seif

Faculty of Health Sciences, East Africa

Heterotopic pregnancy is rare. We report a 27-year-old lady with polycystic ovarian disease. She presented at our health facility with acute abdomen. Her evaluation revealed heterotopic pregnancy. High index of suspicion for heterotopic pregnancy in any woman with early pregnancy presenting with acute abdomen is crucial. Therefore, correct and early diagnosis allows appropriate management while it preserves the intrauterine pregnancy as in the index case.

Applying Systems Thinking To Identify Enablers And Challenges To Scale-Up Interventions For Hypertension And Diabetes In Low-Income And Middle-Income Countries: Protocol For A Longitudinal Mixed-Methods Study, Anusha Ramani-Chander, Mark D Huffman, Et Al

Open Access Publications

INTRODUCTION: There is an urgent need to reduce the burden of non-communicable diseases (NCDs), particularly in low-and middle-income countries, where the greatest burden lies. Yet, there is little research concerning the specific issues involved in scaling up NCD interventions targeting low-resource settings. We propose to examine this gap in up to 27 collaborative projects, which were funded by the Global Alliance for Chronic Diseases (GACD) 2019 Scale Up Call, reflecting a total funding investment of approximately US$50 million. These projects represent diverse countries, contexts and adopt varied approaches and study designs to scale-up complex, evidence-based interventions to improve hypertension and …

Scaling Up Context-Tailored Clinical Guidelines And Training To Improve Childbirth Care In Urban, Low-Resource Maternity Units In Tanzania: A Protocol For A Stepped-Wedged Cluster Randomized Trial With Embedded Qualitative And Economic Analyses (The Partoma Scale-Up Study), Nanna Maaløe, Natasha Housseine, Jane Brandt Sørensen, Josephine Obel, Brenda Sequeira Dmello, Monica Lauridsen Kujabi, Haika Osaki, Thomas Wiswa John, Rashid Saleh Khamis, Zainab Suleiman Said Muniro, Daniel Joseph Nkungu, Britt Pinkowski Tersbøl, Flemming Konradsen, Sangeeta Mookherji, Columba Mbekenga, Tarek Meguid, Jos Van Roosmalen, Ib Christian Bygbjerg, Thomas Van Den Akker, Andreas Kryger Jensen, Morten Skovdal, Hussein Kidanto, Dan Wolf Meyrowitsch

Faculty of Health Sciences, East Africa

While facility births are increasing in many low-resource settings, quality of care often does not follow suit; maternal and perinatal mortality and morbidity remain unacceptably high. Therefore, realistic, context-tailored clinical support is crucially needed to assist birth attendants in resource-constrained realities to provide best possible evidence-based and respectful care. Our pilot study in Zanzibar suggested that co-created clinical practice guidelines (CPGs) and low-dose, high-frequency training (PartoMa intervention) were associated with improved childbirth care and survival. We now aim to modify, implement, and evaluate this multi-faceted intervention in five high-volume, urban maternity units in Dar es Salaam, Tanzania (approximately 60,000 births …

Chapter 6. The Cry Of The Vulnerable: Twenty-Five Years In Permanent State Of Transition, Paul Flamm C.S.Sp.

Spiritan Horizons

No abstract provided.

Perceptions Of The Efficacy And Trustworthiness Of Faith-Based Organizations And Secular Ngos In Mgwashi, Bumbuli District, Tanzania, Naomi Tomlin

Independent Study Project (ISP) Collection

This study investigated perceptions of faith-based organizations (FBOs) compared to secular non-governmental organizations (NGOs) in Mgwashi, Bumbuli District, Tanzania. Perceptions were sorted into two categories: efficacy of services and trustworthiness. This study also examined gender and religion to determine potential influences on perceptions of trustworthiness and efficacy.

This study conducted 72 interviews of Mgwashi residents (18 Muslim men, 18 Muslim women, 18 Christian men, and 18 Christian women). Participants were asked for their opinions on the trustworthiness and efficacy of secular NGOs and FBOs with which they had experience. Then, those who had experience with both types (n=41) were asked …

The Dangers Of Being Old In Rural Tanzania: A Call For Interventions For Strengthening Palliative Care In Low-Income Communities, Kahabi Isangula

School of Nursing & Midwifery, East Africa

Tanzania is currently implementing political reforms that, with time, are expected to improve quality of life among individuals regardless of their age. This improvement in quality of life, consequently prolonged life expectancy implies that the aging population will significantly increase in a few years to come. Research projects that the number of people aged 60 years and above will increase from the current 4- percent to 10-percent of the total population by 2050 (United Republic of Tanzania, 2003; Kivelia and Kirway, 2011; Morrissette andWane, 2012). The projected increase suggests that the older population will be at a disadvantage because majority …

Transboundary Aquifers, Raya Marina Stephan, Alice Aureli, Aurélien Dumont, Annukka Lipponen, Sarah Tiefenauer-Linardon, Christina Fraser, Alfonso Rivera, Shammy Puri, Stefano Burchi, Gabriel Eckstein, Christian Brethaut, Ziad Khayat, Karen Villholth, Lesha Witmer, Renee Martin-Nagle, Anita Milman, Francesco Sindico, James Dalton

Faculty Scholarship

This chapter gives an overview of the status of transboundary aquifers and the cooperation related to shared groundwater resources, highlighting the complexity of the assessment, analysis and management of these systems. It summarizes the main challenges regarding transboundary aquifers and the need for more comprehensive and integrated management, which would include technical, legal and organizational aspects as well as training and cooperation.

Scaling Up Context-Tailored Clinical Guidelines And Training To Improve Childbirth Care In Urban, Low-Resource Maternity Units In Tanzania: A Protocol For A Stepped-Wedged Cluster Randomized Trial With Embedded Qualitative And Economic Analyses (The Partoma Scale-Up Study), Nanna Maaløe, Natasha Housseine, Jane Brandt Sørensen, Josephine Obel, Brenda Sequeira D'Mello, Monica Lauridsen Kujabi, Haika Osaki, Thomas Wiswa John, Rashid Saleh Khamis, Hussein Kidanto

Obstetrics and Gynaecology, East Africa

While facility births are increasing in many low-resource settings, quality of care often does not follow suit; maternal and perinatal mortality and morbidity remain unacceptably high. Therefore, realistic, context-tailored clinical support is crucially needed to assist birth attendants in resource-constrained realities to provide best possible evidence-based and respectful care. Our pilot study in Zanzibar suggested that co-created clinical practice guidelines (CPGs) and low-dose, high-frequency training (PartoMa intervention) were associated with improved childbirth care and survival. We now aim to modify, implement, and evaluate this multi-faceted intervention in five high-volume, urban maternity units in Dar es Salaam, Tanzania (approximately 60,000 births …

In-Kitchen Aerosol Exposure In Twelve Cities Across The Globe, Ahemd El-Gendy, Prashant Kumar, Sarkawt Hama, Rana Alaa Abbass

Faculty Journal Articles

Poor ventilation and polluting cooking fuels in low-income homes cause high exposure, yet relevant global studies are limited. We assessed exposure to in-kitchen particulate matter (PM2.5 and PM10) employing similar instrumentation in 60 low-income homes across 12 cities: Dhaka (Bangladesh); Chennai (India); Nanjing (China); Medellín (Colombia); São Paulo (Brazil); Cairo (Egypt); Sulaymaniyah (Iraq); Addis Ababa (Ethiopia); Akure (Nigeria); Blantyre (Malawi); Dar-es-Salaam (Tanzania) and Nairobi (Kenya). Exposure profiles of kitchen occupants showed that fuel, kitchen volume, cooking type and ventilation were the most prominent factors affecting in-kitchen exposure. Different cuisines resulted in varying cooking durations and disproportional exposures. Occupants in Dhaka, …

Heterotopic Gestation In Polycystic Ovary Disease: Termination Of Tubal Pregnancy And Intrauterine Pregnancy Progressing To Term, Munawar Kaguta, Ahmed Jusabani, Ntiyakuze Gregory, Shweta Jaiswal, Zainab Fidaali, Pilly Ally, Davis Rubagumya, Miriam Mgonja, Farhat Seif

Obstetrics and Gynaecology, East Africa

Heterotopic pregnancy is rare. We report a 27-year-old lady with polycystic ovarian disease. She presented at our health facility with acute abdomen. Her evaluation revealed heterotopic pregnancy. High index of suspicion for heterotopic pregnancy in any woman with early pregnancy presenting with acute abdomen is crucial. Therefore, correct and early diagnosis allows appropriate management while it preserves the intrauterine pregnancy as in the index case.

Tuberculous Meningitis Presenting With Stroke In An Immunocompetent Adolescent: A Case Report, Rukhsar S. Osman, Rahim Damji, Zainab Y. Fidaali, Nahida Walli, Mariam Noorani

Faculty of Health Sciences, East Africa

Background:

Tuberculous meningitis (TBM) is a severe infection of the central nervous system that has high mortality. The disease predominantly affects young children and those who are immuncompromised. Strokes have been reported in about one-third of children with tuberculous meningitis and are associated with poor clinical outcomes.

Case report:

A previously healthy 14-year-old girl living in Dar es Salam, Tanzania presented with one month history of weight loss associated with weakness, loss of appetite, apathy; without respiratory symptoms. Anti-TB therapy was started, based on radiological findings of the chest which showed multiple patchy centrilobular nodules with linear branching pattern bilaterally, …

Using Constructed Wetlands To Remove Pathogenic Parasites And Fecal Coliforms From Wastewater In Tanzania, Abdallah Zacharia, Wajihu Ahmada, Anne H. Outwater, Billy Ngasala, Rob Van Deun

Tanzania Journal of Science

Wastewater treatment is a widely used health protection measure that can be applied to control the transmission of wastewater-related infectious diseases to communities exposed to wastewater. This study determined the efficiency of three full-scale constructed wetlands (CWs) in removing pathogenic parasites and fecal coliforms (FC) bacteria from wastewater. Wastewater samples were collected from three CW systems located in the Dar es Salaam and Iringa regions of Tanzania. The modified Bailenger and modified Ziehl-Neelsen stain techniques were used to detect and quantity parasites. The membrane filtration method was used to detect and quantify FC. Data were analysed using IBM SPSS version …

Distribution And Pattern Of An Insurance Health Claim System: A Time Series Approach, Maxwell Mashasha, Praise Mutize, Felix Mazunga

Tanzania Journal of Science

There is a continuous increase in health costs, thereby increasing pressure on individuals and consequently making the amounts claimed by the insured to be on the increase. In this study, data was collected from a large local insurance company in Zimbabwe for the period from January 2012 to December 2016. The aim of this study was to analyse the distribution and future pattern of insurance health claim system using time series approach. Akaike information criterion and Schwarz Bayesian criterion were used to select the adequate model through maximum likelihood estimation methods.  ARIMA (0, 0, 0) (1, 0, 1) [12] is …

Reproductive Potential Of The Mackerel Scad, Decapterus Macarellus (Cuvier, 1833) In The Coastal Waters Of Tanzania, Joseph S Sululu, Blandina R Lugendo, Benaiah L Benno

Tanzania Journal of Science

This study investigated the reproductive biology of Decapterus macarellus locally known as ''Msumari", one of the most economically important scad fish along the coastline of Tanzania. Fish samples were collected from ring net artisanal fishers operating in Tanga and Bagamoyo coastal waters, monthly between April 2019 and September 2020. Findings indicated that D. macarellus spawns throughout the year with peaks in August at Tanga and September at Bagamoyo. Overall sex ratios (M: F) were 1:1.03 (Tanga) and 1:1.2 (Bagamoyo) in favour of females. The males and females of D. macarellus at Tanga attained the first maturity at 145.5 mm and …

The Role Of Agricultural Social Enterprise To Smallholder Farmers’ Adaptive Capacity To Climatic Stresses In Tanzania, Stanley G Kulanga, Noah M Pauline

Tanzania Journal of Science

This paper intended to ascertain the implications of agricultural social enterprise on the adaptive capacity of smallholder farmers to climatic stresses in the Kilolo District, Tanzania. The study used a sample of 90 households. Household questionnaires, focus group discussions (FGD), and key informant interviews were used to collect primary data for this study. Secondary data were collected through a review of literature relevant to this study. The content analysis was used to analyse qualitative data, whereas quantitative data were subjected to Statistical Product and Service Solution (SPSS) version 20 for analysis. Microsoft Excel 2007 was used to analyse rainfall and …

Solar Cells: Types, Modules, And Applications–A Review, Amira Abd-Elfattah Darwish, Rana S. Abdelmohsen, Mohamed Ahmed, M. Megeed

Tanzania Journal of Science

The basic operating principle of photovoltaic (PV) devices is the conversion of solar irradiation into electricity. There are various applications of this principle in many countries such as Egypt, Nigeria and Denmark. Most of the solar PV projects are designed for street lighting, water pumping and water desalination. However, we hope about wide range of using the appropriate components and best technical procedures, standard PV projects with maximum performance output. The present systems now provide 20% to 40% only of the community's heat or lightness on annual basic needs. These include innovative and alternative ways to reduce material uses and …

Investigation Of The Vertical Profile Radio Refractivity Gradient And Effective Earth Radius Factor (K-Factor) In Transmission Link Over Oyo, Oyo State, South Western Nigeria, Akeem L. Sheu, Kamaldeen O Suleman, Qasim A Adeniji

Tanzania Journal of Science

Surface radio refractive gradient and k-factor are very imperative in observing propagation conditions, designing and planning of microwave communication links in the lower part of the atmospheric boundary layer. The measurement of weather variables (air temperature, atmospheric pressure, relative humidity and wind speed) were conducted in this study at the School of Science, Emmanuel Alayande College of Education, Oyo (7.83°N, 3.95°E), Oyo State, Nigeria. The research was carried out for a period of one year (January to December, 2020) using self-designed cost effective portable weather monitoring systems. The systems were sited from the ground to a height of 200 m …