Tanzania health research bulletin

Publications in this journal

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  Article: Sex differences in prevalence rates and predictors of cigarette smoking among in-school adolescents in Kilimanjaro, Tanzania.

  S Siziya, P R T Ntata, E Rudatsikira, C M Makupe, E Umar, A S Muula
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  ABSTRACT: An analysis of the Global Youth Tobacco Survey for Kilimanjaro, Tanzania was carried out to assess sex differences in the prevalence rates and predictors of current cigarette smoking among in-school adolescents. A total of 2323 adolescents participated in the study of whom 53% were females and 47% males. The prevalence of current cigarette smoking was 3.0% and 1.4% among males and females, respectively. The common factors that were significantly positively associated with cigarette smoking between sexes were: having more pocket money, closest friend smoked cigarettes, seeing actors smoke on TV, videos or movies, and seeing advertisements for cigarettes at social gatherings. Seeing anti-smoking messages at social gatherings were negatively associated with smoking among both sexes. While having had something such as a t-shirt or pen with a cigarette brand logo on it was positively associated with cigarette smoking among males, it was negatively associated with cigarette smoking among females. Male adolescents older than 15 years, those in their 9th year of schooling, and those who had seen cigarette brand names on TV were more likely to smoke. Meanwhile, male respondents who were in their 8th year of schooling, had seen anti-smoking media messages, and advertisements for cigarettes in newspapers or magazines were less likely to smoke. Among female adolescents, those who had parents who smoked, and surprisingly those who perceived that cigarette smoking as harmful were more likely to smoke. Interestingly, seeing advertisement for cigarettes on billboards was negatively associated with smoking among female adolescents. Interventions aimed to reduce adolescent smoking need to be designed and implemented with due consideration of sex differences in these associated factors.
  Tanzania health research bulletin 10/2007; 9(3):190-5.
• Article: Antimicrobial susceptibility of Shigella flexneri and S. dysenteriae isolated from stool specimens of patients with bloody diarrhoea in Mwanza, Tanzania.

  M M Temu, G M Kaatano, N D Miyaye, S N Buhalata, M L Shushu, C Kishamawe, J M Changalucha
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  ABSTRACT: This study was conducted to determine frequency and pattern of antimicrobial susceptibility of Shigella species isolated from stool specimens collected from patients presenting with bloody diarrhoea in Mwanza City, Tanzania. The study was carried out from October 2004 to October 2005 and involved patients attending Sekou Toure Regional Hospital and Butimba Health Centre. Bacteriological cultures were done at the National Institute for Medical Research laboratory. A total of 489 patients (median age = 20 years) participated in the study and were able to provide stool specimens. Shigella species were isolated from 14% (69/489) of the stool specimens collected. Of the sixty nine strains of Shigella spp isolated, 62 (90%) were S. flexneri and 7 (10%) were S. dysenteriae. All Shigella strains isolated showed high resistance to ampicillin, tetracycline, trimethoprim-sulphamethoxazole and chloramphenicol, drugs commonly used for management of shigellosis in Tanzania. However all isolates were fully susceptible to ciprofloxacin, nalidixic acid, erythromycin, cefuroxime and gentamycin. S. flexneri showed resistance to amoxy-clavulanic_acid and azithromycin in 5% and 2% of isolates, respectively. None of the S. dysenteriae isolates were resistant to these two drugs. Entamoeba histolytica, Giardia lamblia and Schistosoma mansoni were microscopically detected in 16.5%, 4.4% and 5.3% of patients, respectively. These findings suggest that there is a need to carry out extensive susceptibility studies in different parts of the country with view of re-appraising the current guidelines for management of bloody diarrhoea in Tanzania.
  Tanzania health research bulletin 10/2007; 9(3):186-9.
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  Article: Knowledge and healthcare seeking behaviour of pulmonary tuberculosis patients attending Ilala District Hospital, Tanzania.

  L Irani, T K Kabalimu, S Kasesela
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  ABSTRACT: A cross-sectional study was conducted, based on systematic sampling of consecutive patients with pulmonary tuberculosis (TB) symptoms and who attended the TB clinic for their medication at Ilala District Hospital, Tanzania. The study sample comprised of 153 people who were almost equally distributed among men and women. Three quarters (75%) of the subjects were vaccinated against TB with the majority being 40 years and younger. Half the study subjects were diagnosed to have TB between the 2nd and 4th month after their symptoms appeared. A chest X-ray was used to initiate anti-TB therapy in half the subjects. No consistency was followed in the diagnostic procedures done to confirm the diagnosis. Over half the patients (54.3%) admitted that they openly speak about their illness to others but that only one-third (33.3%) of their friends and family responded in a considerate and sympathetic manner. One-third (36.6%) of the friends and relatives became less friendly and the remaining one-third openly portrayed fear and tried to discriminate the patient even after the commencement of medications. The patients' compliance rate was 100%. The counselling received from the health personnel and the patients' own motivations to improve their health, was the main driving force in seeking treatment and taking daily medication. Discrimination against TB patients by relatives and friends is likely to hinder positive health seeking behaviour and thus impede control of this disease.
  Tanzania health research bulletin 10/2007; 9(3):169-73.
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  Article: Knowledge on malaria transmission and its prevention among schoolchildren in Kyela District, south-western Tanzania.

  F Edson, E J Kayombo
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  ABSTRACT: A school-based study was carried out to assess the knowledge on malaria and its prevention among children in Kyela District, south-western, Tanzania in August-September 2004. A total of 400 schoolchildren (age = 10-20 years) from four schools were selected. A structured questionnaire was used to collect data on knowledge on malaria transmission, methods of prevention, source of information and use of mosquito nets. More than 85% of the respondents were knowledgeable on malaria and preventive measures. Sources of information about malaria and its control were mainly from their teachers (47.4%), print materials (21.9%), family members (20.4%), television and radio (7.3%) and medical personnel (2.2.%). The perceived best control measures were untreated nets (32.1%), treated nets (21.4%), environmental management (25.7%) and burning mosquito coils and insect repellents (20.8%). Availability of mosquito nets was relatively high (70%), but only 38% of the pupils were using insecticide treated nets (ITNs). Low ITN use was due to its unavailability (57.5%), cost (35%) and foul smell and fear of side effects (7.5%). These findings suggest schoolchildren are aware about malaria and its prevention methods, but are not well-informed of the benefits of using ITNs. More education and advocacies on use of ITNs to parents and children is needed.
  Tanzania health research bulletin 10/2007; 9(3):207-10.
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  Article: Health research agenda for East Africa in the new millennium: looking ahead.

  A Y Kitua
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  ABSTRACT: The Regional East African Health Research agenda was presented as a keynote speech during the first East African Health and Scientific Conference, held in Kampala, Uganda from 28th to 30th March 2007. The agenda was developed through a critical analysis of the global, African and Regional East African health challenges and mitigating strategies, taking into account the Millennium Development Goals (MDG), the Abuja declaration and the New Partnership for African Development as background environment, within which the agenda will operate. It is proposed to establish a joint mechanism for research coordination, promotion and regulation; establish stronger collaborative mechanisms for research and training; create a joint Regional East African Community health research and development fund; create joint intellectual property rights protection mechanism; enhance patenting and link research to industry; create a mechanism to enhance translation of research to policy and practice; strengthen clinical research capacities; and strengthen innovation and discovery research capacities. Effective implementation of this agenda will greatly raise the profile and quality of research in the region and improve the health status of the East African populations.
  Tanzania health research bulletin 10/2007; 9(3):147-53.
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  Article: Prevalence of sexual intercourse among school-going adolescents in Coast Province, Kenya.

  E Rudatsikira, A E O Ogwell, S Siziya, A S Muula
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  ABSTRACT: A study was carried out to estimate the prevalence and associated factors of sexual intercourse among school adolescents in Coast Province, Kenya. Data were obtained through the Kenya Global School-Based Health Survey. Overall the prevalence of sexual intercourse within the last 12 months was 14.9% (22.2% in males and 5.0% in females). Among males, the protective factors against having sex were being of age < 15 years (OR = 0.60, 95% CI 0.58, 0.62) and ever been drunk (OR = 0.63, 95% CI 0.59, 0.67). The risk factors for having sex among males were ever smoked (OR = 2.05, 95% CI 1.92, 2.19), having close friends (OR = 1.68, 95% CI 1.56, 1.81), currently drinking alcohol (OR = 1.13, 95% CI 1.06, 1.20), ever used drugs (OR = 2.36, 95% CI 2.24, 2.49) and parental supervision (OR = 1.30, 95% CI 1.25, 1.34). Meanwhile among female respondents, parental supervision was protective (OR = 0.88, 95% CI 0.81, 0.94) and the only risk factor was ever used drugs (OR = 2.85, 95% CI 2.57, 3.15). It is suggested that public health interventions aimed to promote adolescent sexual health should be designed with the appreciation of the factors associated with sexual activity in due consideration.
  Tanzania health research bulletin 09/2007; 9(3):159-63.
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  Article: Suicidal ideation and associated factors among in-school adolescents in Zambia.

  A S Muula, L N Kazembe, E Rudatsikira, S Siziya
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  ABSTRACT: A cross sectional study was conducted to estimate the prevalence and correlates of suicidal ideation among in-school adolescents in Zambia. Backward logistic regression analysis was conducted to assess the association between relevant predictor variables and suicidal ideation within the last 12 months. A total of 1970 in-school adolescents who participated in the Zambia Global School-Based Health Survey in 2004 responded to the question on suicidal ideation. Overall, 54.0% were males, 40.8% were current drinkers, and 35.9% ever smoked marijuana (cannabis). Altogether 31.3% reported suicidal ideation in the past 12 months (males = 31.1%; females = 31.4%). Being male (OR = 1.05; 95%CI 1.03, 1.05): being <14 years old (OR = 1.21; 95%CI 1.19, 1.23), having been drunk (OR = 1.28; 95%CI 1.27, 1.29). worried (OR= 1.05; 95%CI 1.04, 1.06), sad or hopeless in the past 12 months (OR = 1.02; 95%CI 1.01, 1.03) and ever used marijuana (OR = 1.18; 95%CI 1.17, 1.19) were positively associated with suicidal ideation. Loneliness appeared to be protective (OR = 0.92; 95%CI 0.91, 0.92). All the results, except for ever smoked marijuana and ever been drunk, may have been biased due to non-response to the question on suicidal ideation. A series of cross sectional studies should be conducted to monitor changes in behavioural factors among others ever smoked marijuana and ever been drunk in order to broaden our understanding of factors that may be causing adolescents to seriously consider committing suicide.
  Tanzania health research bulletin 09/2007; 9(3):202-6.
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  Article: Placental malaria in Owerri, Imo State, south-eastern Nigeria.

  C N Ukaga, B E B Nwoke, O S Udujih, O G Udujih, A A Ohaeri, J C Anosike, B U Udujih, M I Nwachukwu
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  ABSTRACT: Malaria in pregnancy jeopardizes the outcome of pregnancy, affecting both the mother and the foetus. The prevalence of placental malaria in women, who routinely attended ante-natal clinics in Owerri, south-eastern Nigeria, was assessed using three hospitals between March 2004 and August 2005. Placental blood was collected in EDTA bottles from incisions made on cleaned basal plate of the placenta, within an hour of delivery. Blood collected was used to assess ABO blood group, haemoglobin level as well as malaria parasitaemia. Malaria parasitaemia was determined from thick and thin smears stained with Giemsa, while the haemoglobin level was measured using the cyanomethaemoglobin method. A total of 586 pregnant women were involved in this study with written consents. Malaria parasites were observed in 175 (29.9%) of the women on delivery. Of these women, 64 (36.6%) were anaemic. A significant relationship at P<0.05 variation, was observed between the prevalence of malaria parasites in the placenta and gravidity, age and blood group. The rate of occurrence of malaria parasitaemia, in the placenta of women who were on a weekly prophylaxis against malaria is alarming and calls for more serious efforts in the prevention of malaria especially in this vulnerable group.
  Tanzania health research bulletin 09/2007; 9(3):180-5.
• Article: Low intensity laser therapy is comparable to bromocriptine-evening primrose oil for the treatment of cyclical mastalgia in Egyptian females.

  G M Saied, R M Kamel, N Dessouki
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  ABSTRACT: One of the successful treatments for cyclical mastalgia is bromocriptine evening primrose combination. A double blind study was applied on 80 patients with cyclical mastalgia. They were randomly divided into two groups (A and B). In group A, patients were treated by bromocriptine/evening primrose. To group B, LILT with specified dosimetry was applied, using a device that delivers He-Ne laser combined with 4 infra-red diode laser. Evaluation of treatment was both subjective (using VAS) and objective (studying the degree of drop in plasma cortisol level). The drop of plasma cortisol with treatment was studied using the student -t distribution. A good response was observed in the laser group in 82.5%, compared to 63.9% in the bromocriptine/evening primrose group. There was a significant deference before and after treatment in both groups (P<0.05). This difference was more for the drug treated group than for the laser treated group, but in the latter, it acted on a wider sector of patients. In conclusion, LILT is recommended as a new treatment modality for cyclical mastalgia.
  Tanzania health research bulletin 09/2007; 9(3):196-201.
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  Article: Nutritional status and intelligence quotient of primary schoolchildren in Akure community of Ondo State, Nigeria.

  O S Ijarotimi, K T Ijadunola
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  ABSTRACT: A cross-sectional survey was conducted among 402 children (10-15 years) randomly selected from twelve public and private primary schools in Akure community of Ondo State, Nigeria. Self-administered questionnaire was used to collect information on children's demographic features and parent's socio-economic characteristics. The subject's weight, height, height-for-age and weight-for-height z-score were measured and determined respectively. Raven Standard Progressive Matrices consisted of 60 questions was administered in a quiet classroom within 60 minutes to assess intelligence quotient (IQ) of the children. The means of measured parameters were: age, 11.5 +/- 0.08 years; weight, 33.3 +/- 0.35 kg; height, 1.4 +/- 0.0 m; height-for-age z-score, -0.003 +/- 0.04; weight-for-height z-score -7.2E-7 +/- 0.1 and IQ, 20.9 +/- 0.56 (34.8%). The occupations of the children's parents were civil service (43.3%), petty business (21.9%), farming (15.8%), vocational jobs (16.0%) and none (3.2%). The majority of the parents (31.8%) had secondary school education. Parents with no formal education, primary education, tertiary education and higher degrees accounted for 7.2%, 30.6%, 22.9% and 7.4%, respectively. Monthly incomes ranged between $38.5 and 230.8. Weight-for-height z-score of the children showed that 49.8% were normal, 40% mildly wasted, 9.7% moderately wasted and 0.5% severely wasted. Height-for-age z-score was 50% normal, 35.1% mildly stunted, 13.4% moderately stunted and 1.5% severely stunted. IQ scores were 5% superior 11.2% above average, 11.4% average, 8.2% below average and 64.2% intellectual deficit. The interrelationship between height-for-age, IQ and socio-demographic characteristics showed that there were insignificant differences between the age groups, gender and socio-economic status of the pupils. Conclusively, this study showed that the proportion of malnourished and intellectual deficit among the studied population were high. However, it is not clear whether the findings are specific to the studied population alone or applicable to other parts of Nigeria. Further studies are therefore needed to confirm these findings.
  Tanzania health research bulletin 06/2007; 9(2):69-76.
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  Article: The vulnerability of orphans in Thyolo District, southern Malawi.

  A Funkquist, Bodil Eriksson, A S Muula
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  ABSTRACT: It is estimated that Malawi has about 900,000 orphans, the majority of whom are orphaned as a result of AIDS. Orphans in rural areas are mostly neglected by economic and social empowerment initiatives. This study was conducted to explore the living situation of orphans in rural Thyolo District, southern Malawi. Qualitative methodology was used in data collection and analysis to explore orphan children's living situation and specifically with regard to access to health care, education, food and basic needs. In addition, issues of love and companionship, discrimination and the future. Twenty-three orphan children and four adults were interviewed. The children reported experience with lack of food, school drop out and truancy, lack of social support to obtain present needs and prepare for the future. Public health programs aimed to prevent and mitigate the effects of AIDS in Malawi should be tailored to provide support to orphan children.
  Tanzania health research bulletin 06/2007; 9(2):102-9.
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  Article: From research to policy: the role of health research institution in social development in Africa.

  David H Mwakyusa
  Tanzania health research bulletin 06/2007; 9(2):140-3.
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  Article: Assessment of quality assurance in HIV testing in health facilities in Lake Victoria zone, Tanzania.

  F M Mashauri, J E Siza, M M Temu, J T Mngara, C Kishamawe, J M Changalucha
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  ABSTRACT: Tanzania is currently implementing the antiretroviral treatment programme, and has a target of putting about 400,000 eligible HIV infected individuals on treatment by 2008. This will involve screening a large number of people, which will require non-laboratory personnel to be involved in doing HIV testing. In order to guarantee reliable and quality HIV test results, there is a need to ensure that quality assurance (QA) procedures are followed from specimen collection, testing and reporting of results. In light of the above a survey was conducted to assess QA in HIV testing in health facilities in Lake Victoria zone, Tanzania. A total of 89 health facilities (29 hospitals, 34 health centres, 9 dispensaries and 17 voluntary and counselling testing centres) were surveyed. Only three (10.3%) health facilities reported performing Uniform II ELISA for HIV diagnosis. All other health facilities reported to be using HIV rapid tests Capillus and Determine. Five (5.6%) of health facility laboratories performed CD4 counts. Internal quality control (IQC) were performed in 21 (63.6%) of the hospitals. Kits for HIV testing were reported to be readily available by 54 (60.7%) of the facilities. Only 16 (18%) of the health facilities had standard operating procedures in place. Systems of equipment calibration were reported by 13 (14.6%) of the health facilities. Counselling services were available in all health facilities and all counsellors had received the 6-week mandatory training course. These findings show that most of health facilities in the Lake Victoria zone do not adhere to QA procedures in HIV testing. There is therefore, a need to establish a monitoring system to laboratories performing HIV testing for the purpose of ensuring QA procedures are done. Personnel doing HIV testing should be re-trained at a regular basis to cope with new techniques and ensure QA procedures are followed.
  Tanzania health research bulletin 06/2007; 9(2):110-4.
• Article: Seasonal variation in human African trypanosomiasis in Tarangire National Park in Babati district, Tanzania.

  C Sindato, I I Malele, C Mwalimu, H S Nyingilili, S Kaboya, E Kombe, C Msumary, A Manoza
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  ABSTRACT: A survey was carried out to determine seasonal epidemiological variation of human African trypanosomiasis (HAT) in Tarangire National Park and villages around it in Babati District, Tanzania. Concentration and Field's stain techniques were employed to examine the presence of trypanosomes in human blood samples. Tsetse flies were collected using traps and dissected under light microscope to examine for presence of trypanosomes. Retrospective data on HAT were sought from health facilities. Blood samples were collected from a total 509 individuals (306 during the dry and 203 during wet seasons). None of the individuals was infected with trypanosomes in the area. A total of 766 tsetse flies were collected. Of these, Glossina swynnertoni accounted for 94.6% and G. pallidipes for 5.4% of the total collection. The largest proportion (63.8%) of the tsetse flies was collected during the wet season. Glossina swynnertoni was most abundant tsetse species during both wet and dry seasons. Salivary gland examination revealed the presence of Trypanosoma brucei type of infection in 3.2% of tsetse flies collected. All infective trypanosomes were found during the dry season. This study concludes that the transmission and prevalence of HAT among human population in Tarangire National Pars and its surrounding villages is low despite the recent reports on tourists acquiring the infection during their visits to the Park. However, disease surveillance needs to be strengthened to monitor any impending epidemic.
  Tanzania health research bulletin 06/2007; 9(2):136-9.
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  Article: Traditional health practitioner and the scientist: bridging the gap in contemporary health research in Tanzania.

  Z H Mbwambo, R L A Mahunnah, E J Kayombo
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  ABSTRACT: Traditional health practitioners (THPs) and their role in traditional medicine health care system are worldwide acknowledged. Trend in the use of Traditional medicine (TRM) and Alternative or Complementary medicine (CAM) is increasing due to epidemics like HIV/AIDS, malaria, tuberculosis and other diseases like cancer. Despite the wide use of TRM, genuine concern from the public and scientists/biomedical heath practitioners (BHP) on efficacy, safety and quality of TRM has been raised. While appreciating and promoting the use of TRM, the World Health Organization (WHO), and WHO/Afro, in response to the registered challenges has worked modalities to be adopted by Member States as a way to addressing these concerns. Gradually, through the WHO strategy, TRM policy and legal framework has been adopted in most of the Member States in order to accommodate sustainable collaboration between THPs and the scientist/BHP. Research protocols on how to evaluate traditional medicines for safety and efficacy for priority diseases in Africa have been formulated. Creation of close working relationship between practitioners of both health care systems is strongly recommended so as to revamp trust among each other and help to access information and knowledge from both sides through appropriate modalities. In Tanzania, gaps that exist between THPs and scientists/BHP in health research have been addressed through recognition of THPs among stakeholders in the country's health sector as stipulated in the National Health Policy, the Policy and Act of TRM and CAM. Parallel to that, several research institutions in TRM collaborating with THPs are operating. Various programmed research projects in TRM that has involved THPs and other stakeholders are ongoing, aiming at complementing the two health care systems. This paper discusses global, regional and national perspectives of TRM development and efforts that have so far been directed towards bridging the gap between THPs and scientist/BHP in contemporary health research in Tanzania.
  Tanzania health research bulletin 06/2007; 9(2):115-20.
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  Article: Prevalence of blindness and visual impairment in Atakunmosa West Local Government area of southwestern Nigeria.

  O H Onakpoya, A O Adeoye, F B Akinsola, B O Adegbehingbe
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  ABSTRACT: Blindness survey remains a useful tool for eye care needs assessment. A cross sectional survey of Atakunmosa West Local Government Area, a rural community of southwest Nigeria with no form of eye care facility was carried out. The objective of this study was to define areas of eye care need and develop programme for elimination of avoidable blindness in the region. Multistage cluster sampling technique selected 1248 respondents across all the eleven health districts. Respondents had visual acuity and ocular examination. Blindness was defined as presenting visual acuity (pva) of < 3/60 in the better eye and visual impairment as pva of < 6/18 in the better eye. Out of the 1,248 respondents screened, 14 (1.1%) were blind and 78 (6.3%) were visually impaired. There was an increasing risk of blindness and visual impairment with age; occurring more commonly after 60 years of age. The prevalence of blindness and visual impairment were higher in females although not statistically significant (P = 0.70; 0.46 respectively). Blindness was caused mainly by cataract (57.2%), glaucoma (14.3%) and congenital childhood blindness (14.3%). Cataract (57.7%), glaucoma (16.7%) and uncorrected refractive error (15.4%) were the leading causes of visual impairment. Blindness was avoidable in 85.7% of cases. Qualitative and subsidised cataract surgical and refractive services are needed urgently in this region and therefore, the incorporation of eye health care into the existing primary health care system may ensure programme sustainability.
  Tanzania health research bulletin 05/2007; 9(2):126-31.