Tanzania health research bulletin Journal Impact Factor & Information

Journal description

The Tanzanian Health Research Bulletin is published twice a year as an organ of the Health User's Trust Fund (HRUTF), whose mission is to promote in Tanzania the Essential National Health Research Initiative, and in particular demand driven health research. The Bulletin is targeted at all readers interested in health research issues in Tanzania, including priority health research, its planning, funding, implementation, and utilization of findings. It is also aimed at non-specialist scientists, policy and decision makers and the general public.

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Website Tanzanian Health Research Bulletin website
ISSN 0856-6496
OCLC 225531195
Material type Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publications in this journal

  • Tanzania health research bulletin 01/2013; 15(1). DOI:10.4314/thrb.v15i1.10
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    ABSTRACT: Almost 65% of the Tanzanian population is under the age of 24 and almost 20 % of the population is aged 15-24 years. Yet, this important group faces many significant health challenges, such as early sexual debut, early pregnancies, risky behaviours and sexually transmitted infections. The objective of this study was to assess knowledge, attitudes and practices on family planning services among adolescents in secondary schools in Hai District in northern Tanzania. A cross sectional study was conducted between April and June 2011 among 316 randomly selected students in 10 secondary schools using a self administered pre-tested questionnaire. Median age of participants was 17 years (15-19 years). Two-thirds (67.4%) of the respondents had adequate level of knowledge on family planning services (FPS) and the most popular source of information was the radio (65.8 %). Being in a lower class (χ² =8.6; P<0.02) and attending co education schools (χ² =12.9; P< 0.001) were predictors of inadequate level of knowledge on FPS. Most, 71.2% (225/316) respondents reported that FPS should not be used by adolescents and mentioned several reasons against its use. Less than 6 % (18/316) of all respondents had used FPS in their lifetime, with 44.4 % (8/18) in the past month, 33.3 %( 6/18) in the past year, and 22.3 % (4/18) in the past 5 years. In conclusion, most secondary school students in Hai District do not utilize family planning services despite of adequate level of knowledge on FPS. Interventions to improve utilization of FPS among secondary school students should address barriers to low utilization of FPS mentioned in this study.
    Tanzania health research bulletin 01/2013; 15(1). DOI:10.4314/thrb.v15i1.3
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    ABSTRACT: Misdiagnosis of malaria is a major problem in Africa leading not only to incorrect individual level treatment, but potentially the acceleration of the spread of drug resistance in low-transmission areas. In this paper we report on the outcomes of a simple intervention that utilized a social entrepreneurship approach (SEA) to reduce misdiagnosis associated with hospital-based microscopy of malaria in a low-transmission area of rural Tanzania. A pre-post assessment was conducted on patients presenting to the hospital outpatient department with malaria and non-malaria like symptoms in January 2009 (pre-intervention) and June 2009 (post-intervention). All participants were asked a health seeking behavior questionnaire and blood samples were taken for local and quality control microscopy. Multivariate logistic regression was conducted to determine magnitude of misdiagnosis with local microscopy pre- versus- post intervention. Local microscopy pre-intervention specificity was 29.5% (95% CI = 21.6% – 38.4%) whereas the post intervention specificity was 68.6% (95% CI = 60.2% - 76.2%). Both pre and post intervention sensitivity were difficult to determine due to an unexpected low number of true positive cases. The proportion of participants misdiagnosed pre-intervention was 70.2% (95%CI = 61.3%-78.0%) as compared to 30.6% (95%CI = 23.2%–38.8%) post-intervention. This resulted in a 39.6% reduction in misdiagnosis of malaria at the local hospital. The magnitude of misdiagnosis for the pre-intervention participants was 5.3 (95%CI = 3.1–9.3) that of the post-intervention participants. In conclusion, this study provides evidence that a simple intervention can meaningfully reduce the magnitude of microscopy-based misdiagnosis of malaria for those individuals seeking treatment for uncomplicated malaria. We anticipate that this intervention will facilitate a valuable and sustainable change in malaria diagnosis at the local hospital.
    Tanzania health research bulletin 01/2013; 15(1). DOI:10.4314/thrb.v15i1.4
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    ABSTRACT: Cutaneous leishmaniasis in Iran is usually caused by Leishmania major or L. tropica. However, the direct examination or the cultures of biopsies for diagnosis are not very sensitive. The objective of this study was to identify the responsible species obtained from patients suspected of cutaneous leishmaniasis referred to the reference laboratory at Yazd in Iran during 2010-2011 using parasitological and molecular assays. After completing a clinical/epidemiologic data questionnaire for 145 patients with suspected skin lesions, scraping samples were collected. Each specimen was examined using both direct microscopy and molecular assay using polymerase chain reaction-restriction length polymorphism (PCR-RFLP). Location of the lesions included 47.7% on hands, 30.7% on face, 15.4% on feet, and the remainder on other regions. Out of 145 samples, Leishman body was observed in 52 by direct smear and 73 by PCR assay. Molecular assay indicated 36 cases as L. major, 36 cases as L. tropica and one case as unknown. In conclusion, molecular characterization showed changing profile of Leishmania species in the study area which may have implications on treatment and/or control strategies.
    Tanzania health research bulletin 01/2013; 15(1). DOI:10.4314/thrb.v15i1.5
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    ABSTRACT: Prevalence of low back pain (LBP) among Africans is rising. Many adults in any given yearexperience low back pain at one time or the other, this should be of concern. It is then imperative to research into how to reduce the disability caused by LBP. The objective of this study was to assess the effect of Vertical Oscillatory Pressure (VOP) on the pain and disability of patients with mechanical low back pain. A total of 84 patients (34 males and 50 females) diagnosed with mechanical low back pain were purposely selected to participate in the study after obtaining their consent. The pain intensity of all the patients was assessed individually using Present Pain Intensity (PPI) on the first day of their appointment in addition to other examinations. Roland-Morris Disability Questionnaire (RMDQ) was also administered to all patients individually on the first day of report to the clinic. This is pre test record. VOP was then administered to each patient twice in a week for 6 weeks making 12 treatment sessions. Pain intensity and disability were assessed regularly every week of appointment for the 6-week period using PPI and RMDQ (post-test) by another physiotherapist in order to avoid bias. The difference between the first week score of RMDQ and the 6th week score was calculated and the percentage of improvement was determined. Dependent t–test was used to compare the pre and post test values and an alpha level of 0.05 was set as level of significance. An independent t-test was used to analyse the difference between male and female values. Result revealed that the maximum complaint of patients using RMDQ showed a significant disability for males but not for females, and the rate of improvement of male was higher than that of females. There were significant differences (P<.001) between the pre-test and post test measurements of PPI and RMDQ, respectively. The rate of improvement in males was significantly higher than that of females. The study concluded that VOP can be useful in ameliorating pain and disability of patients with low back pain.
    Tanzania health research bulletin 01/2013; 15(1). DOI:10.4314/thrb.v15i1.9
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    ABSTRACT: The thermotolerant species of Campylobacter have become very important in public health, particularly as agents of infectious diarrhoea in human beings. Though the mechanism by which they cause disease is yet to be fully explained, they have been recognized as the leading cause of bacterial enteritis in both developed and developing countries. The organisms colonize different animal species without causing any symptoms of disease; and humans acquire infections through contact with or consumption of contaminated meat especially raw/undercooked poultry meat. The growing trend of antibiotic resistant Campylobacter isolates continues to pose significant public health challenges. In this review we present the available information generated in Tanzania about Campylobacter infections in humans and animals. We conducted a structured literature search of PUBMED and ScienceDirect electronic databases and identified 15 articles. Studies on humans reported Campylobacter infections in both symptomatic and asymptomatic subjects; with higher prevalence in children under the age of five years. Studies on animals found colonization of both domestic and wild species. Among isolates, some demonstrated antimicrobial resistance. The available information for both human and animal Campylobacteriosis in the country is sparse. It however provides an insight of the bacteriological and epidemiological aspects of Campylobacter infections in the country and eventually creates more awareness on the need to develop control strategies. Since the organism is zoonotic its control strategies should adopt the “One Health” approach involving collaborative efforts from veterinary and human medicine.
    Tanzania health research bulletin 01/2013; 15(1). DOI:10.4314/thrb.v15i1.6
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    ABSTRACT: Intentional injuries are an emerging silent epidemic in developing countries and contribute significantly to global injury burden. A descriptive prospective study was conducted to establish the prevalence, contributing factors, injury pattern and treatment outcome of intentional injuries at Bugando Medical Centre in North-western Tanzania. Data was collected using a pre-tested, coded questionnaire and analyzed using SPSS software version 17.0. A total of 1642 (23.7%) patients with intentional injuries were studied. Of these, 97.7% resulted from interpersonal violence (homicide) and 2.3% were self-inflicted (suicide). Males outnumbered females by a ratio of 2.2:1. Their median age was 24 years. The majority of injuries (53.5%) occurred at home. Criminal violence was the most common reason for intentional injuries accounting for 52.1% of cases. In women, domestic violence was responsible for 64.6% of the admissions. Poverty, lack of education, unemployment and alcohol abuse were the most common contributing factors to intentional injuries. Blunt and sharp objects (48.6%) were the most common weapons used. Gunshot injuries were recorded in 11.6% of cases. The head/neck was commonly affected in 49.2%. Soft tissue injuries (87.3%) were the most frequent type of injuries. The majority (90.1%) of patients were treated surgically. Complication rate was 15.0%.The median hospital stay was 26 days (range 1 day to 114 days). Patients with long bone fractures and those who had complications stayed longer in the hospital (P < 0.001). Mortality rate was 13.3%. The mortality rate was significantly high in patients with severe injuries (Injury Severity Score > 15), severe head injuries and those who needed intensive care unit admissions and ventilatory support (P< 0.001). Intentional injuries are an emerging but neglected epidemic in Mwanza City and contribute significantly to high morbidity and mortality. Urgent preventive measures targeting at the root causes of violence such as poverty, unemployment, and alcohol abuse will reduce the incidence of these injuries in our setting.
    Tanzania health research bulletin 10/2012; 14(3). DOI:10.4314/thrb.v14i3.7
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    ABSTRACT: In 2010, an estimated 216 million cases and 655,000 deaths due to malaria occurred worldwide. Of these, about 81% and 91% respectively were reported from the African Region, mostly affecting children under-the age of five. In Tanzania, malaria remains to be the leading cause of high morbidity and mortality. It is responsible for more than one-third of all deaths, 39.4% of all health care visits, and 33.4% of all hospital admissions among children under the age of 5 years. The objective of this article was to provide a systematic review of the literature to summarize the knowledge of the most important aspects of prevention and management of malaria in under-five children in Tanzania. The focus was on health care seeking decision-making and understanding the magnitude of the gap between ownership and use of insecticide treated mosquito nets (ITNs). The review considered published and unpublished literature covering a period from 2002 to the end of July 2012. The information used in this review was obtained through a Google search using specific keywords. Results show that across zones the difference between ownership and use of ITNs among under-fives was insignificant. This finding is consistent with a reduction in the proportion of children with suspected of malaria taking antimalarial drugs. Nevertheless, differences exist between zones in terms of both coverage of ownership and use of ITNs. Regarding health care seeking-decision making the literature reviewed indicated that caretakers generally, had a good biomedical understanding of febrile illnesses both in terms of types and symptoms. However, a frequent belief was that symptoms related to convulsions were not associated with malaria, hence cannot be cured in modern health care system. Moreover, some caretakers self-treated symptoms, which trigger others to seek medical care, thus end up delaying to seek medical care. In additional, most of the studies reviewed were designed within the health belief framework. There is a dearth of evidence documenting adherence to prescribed medications.
    Tanzania health research bulletin 10/2012; 14(3). DOI:10.4314/thrb.v14i3.10
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    ABSTRACT: In response to the growing recognition of quality of life measurement in health care, indicators that address the social and psychological consequences of oral disorders have been developed to complement conventional clinical assessment. The objective of this study was to determine socio-demographic and behavioural correlates of oral health related quality of life (OHRQoL) among Tanzanian adults. The national pathfinder survey methodology described in the WHO Oral Health Surveys – Basic Methods was used to obtain a total of 1,759 Tanzanian adults aged 18 years and above. In line with the pathfinder methodology clusters were purposively selected to represent cities, towns and rural areas. In each cluster individuals were stratified by age and sex. The outcome variable was the OHRQoL in terms of oral impacts on daily performances (OIDP). Frequency distribution, bivariate analyses, and generalized linear models using log binomial regression models were performed by SPSS version 15. About half (49.1%) of the respondents reported at least one oral impact during a period of three months before the survey. Difficulty in chewing was the most prevalent impact affecting 39.9% of participants. A higher proportion of those who reported poor conditions of teeth had difficulties in chewing and sleeping was often interrupted. Multivariate analysis indicated that those who perceived their teeth conditions to be good (PR=0.38; CI: 0.32-0.44), were of younger age (PR=0.84; CI: 0.77-0.90), and had visited a dentist during the past five years or more (PR=0.84; CI: 0.77-0.90) and were less likely to have an oral impact. On the other hand those who restricted their sugar consumption (PR=1.12; CI: 1.03-0.1.22) were more likely to have an impact on at least one daily performance. It is concluded that the prevalence of OIDP was high while perceived teeth conditions and age varied with OHRQoL in terms of OIDP in the expected direction. Those who visited the dental clinic in the recent past had more impacts than those who did not. The findings of this study confirm the usefulness of subjective indicators in explaining peoples’ suffering. In this regard it is recommended that in the next national pathfinder survey traditional clinical oral health indicators should be complemented with subjective indicators in order to obtain triangulated data for planning oral health services in Tanzania.
    Tanzania health research bulletin 10/2012; 14(3). DOI:10.4314/thrb.v14i3.8

  • Tanzania health research bulletin 10/2012; 14(3). DOI:10.4314/thrb.v14i3.1
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    ABSTRACT: Rupture of the gravid uterus is an obstetric catastrophe that is associated with complications that include massive blood loss, hysterectomy, and damage to the genitourinary tract. It is a serious complication that is associated with high maternal and perinatal morbidity and mortality. We conducted a retrospective review of case notes (from 2003 to 2009) to determine the incidence, causes, complications and foetal/maternal outcome among women with a diagnosis of ruptured uterus at Muhimbili National Hospital (MNH) in Dar es Salaam Tanzania. Case notes with diagnosis of ruptured uterus were retrieved from the records department and information on maternal demographic characteristics, surgical intervention, maternal and perinatal outcome were collected using a check list. Where information was inadequate it was sought from the obstetric database. Obtained data was cleaned and analyzed using PASW statistics 18 software. Out of 72,570 deliveries 163 cases of ruptured uterus were recorded in seven years, making an incidence of 2.25 per 1000 births. Most ruptures (38%) resulted from neglected obstructed labour and scared uterus (33.6%). Major obstetric haemorrhage (>1500 ml) was the most frequently encountered complication followed by sepsis. Subtotal hysterectomy was the most common (73.6%) surgical intervention. Maternal and perinatal case fatality rates were 12.9%, and 96.3% respectively. Ruptured uterus contributed to 6.6% of all maternal deaths. These findings underscores the need for proper monitoring of labour both in the referring facilities and at MNH and improvement of comprehensive emergence obstetric care at all levels of health care to avoid unnecessary delays in care.
    Tanzania health research bulletin 10/2012; 14(3). DOI:10.4314/thrb.v14i3.9
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    ABSTRACT: A substantial proportion of pregnant women reports experiencing oral health problems during pregnancy. However, most of them perceive that such problems are normal in pregnancy and hence do not seek dentist consultation. The objective of this study was to determine the prenatal oral health experience and the utilization of dental care services among pregnant women attending reproductive and child health clinics in Bariadi District in Tanzania. Data was collected using a questionnaire-guided interview. Key variables were socio-demographic characteristics of pregnant women, oral health experience, and dental visits during pregnancy with reasons and treatment received. A total of 305 pregnant women (mean age=25.7 years) were involved in the study. Women with 3 or more children reported oral health problems during pregnancy. The frequent oral health problems among the pregnant women were bleeding gums (22.6%, N=69), pain in gums (21.6%, N=66), swollen gums (21.3%, N=65), dental pain (30.5, N=93), and tooth decay (25.6%, n=78). However, only 31.8% (N=97) visited a dental clinic for consultation most whom, were those with three or more children (χ2=4.682; P=002). The pregnant women who had visited a dentist in the past 12 months were 11.1% (N=34), mostly those aged >24 years and those with informal employment (P<0.05). Curative and preventive treatments were received more significantly by the urban and with formal employment (P<0.01). In conclusion, pregnant women in Bariadi, Tanzania experiences substantial oral health problems for which they do not often utilize dentists for consultation and management during pregnancy. Dentists and other health workers should therefore, intensify dental screening, emphasizing active family and community participation as part of regular prenatal care.
    Tanzania health research bulletin 05/2012; 14(2). DOI:10.4314/thrb.v14i2.8
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    ABSTRACT: Postpartum haemorrhage is the leading cause of maternal death in the developing country and yet is poorly diagnosed due to inaccurate measurement of blood loss following delivery. A study was carried out at Muhimbili National Hospital (MNH) Tanzania between 14th October 2005 and 31st January 2006 to determine the accuracy of visual estimation of blood loss (VEBL) in comparison to laboratory measurement of blood loss in diagnosis of primary postpartum haemorrhage (PPH). Four hundred twenty six pregnant women who were in active phase of labour were recruited and their venous blood was drawn for estimation of haematocrit before delivery and twelve hours thereafter. Active management of third stage of labour was conducted by giving 10 IU of oxytocin (intramuscularly or intravenously) and this was followed by visual estimation of blood loss. Proportion of patients who developed PPH was then determined by both methods. The mean duration of third stage of labour was 8.3 minutes and mean blood loss was164.9 mls. The prevalence of PPH was 8.9% and 16.2% by VEBL and changes in haematocrit respectively. Change in haematocrit in diagnosis of PPH was found to be more accurate, specific with high positive predictive values compared to VEBL.The need for additional uterotonics was 5.8% and the commonest labour complications associated with PPH were second degree tear, retained placenta and EUA for continued bleeding. In a busy labour ward like that in MNH service providers and medical students working in labour ward need to be taught regularly on how to estimate blood loss using simulated methods so as to increase their long term memory and accuracy in diagnosis of PPH hence provision of immediate intervention in case primary PPH occurs.
    Tanzania health research bulletin 05/2012; 14(2). DOI:10.4314/thrb.v14i2.9
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    ABSTRACT: The World Health Organization aims at universal access to effective antimalarial treatment by the year 2015. Consequently, an enormous financial resource has been invested on Artemisinin Combination Therapy (ACT))) subsidy. In Tanzania, strategies to increase access of artemether-lumufantrine (ALu) rural areas, where the burden is highest, includes subsidy to the Faith-based Organisations (FBO) facilities and accredited drug dispensing outlets (ADDOs). This study was done to assess the extent to which children suffering from malaria access ALu from the private sector in rural areas. A total of 1,235 under fives randomly selected from 12 rural villages were followed up at home on weekly basis for six months in Kilosa district in 2008. Using a structured questionnaire, caretakers were interviewed about the child’s history of fever in the past 7 days; type of treatment given and the source. Baseline data were obtained on demographic characteristics, caretakers’ knowledge about malaria and social economic indicators of the household. Of the 1,235 children followed-up, 740 care-seeking visits were recorded, of which, 264 (35.7%) were made at government health facilities and nearly a quarter (24.1%; 178/740) at ordinary shops that sell general merchandize including rice and sugar. Only 22% of the caretakers sought care from FBO and ADDOs. While 686 (86.6%) of the episodes were treated with antimalarials, only 319 (43%) received ALu, the recommended antimalarial. Majority (83%) of the visits made at government facilities were prescribed with ALu compared to less than half who went to FBO facilities (40.0%) and ADDOs (25.0%). In conclusion, this study has shown that less than a quarter of fever episodes suspected to be malaria in rural areas were made at FBO facilities and ADDOs, of which, less than half were treated with ALu. This shows that ALu subsidy to formal private sector does not adequately reach children in rural areas, where the malaria burden is highest. This cast some doubts if the target of universal access to effective antimalarial, by 2015, will be reached. There is need to consider enlisting the services of community health workers in the efforts to improve access to ALu in rural areas. Further research is needed to explore providers’ / dispensers’ preference for non-recommended antimalarials in the private sector and caretakers’ preference for ordinary shops.
    Tanzania health research bulletin 05/2012; 14(2). DOI:10.4314/thrb.v14i2.1
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    ABSTRACT: This paper reviews preparedness for containing and controlling emerging and re-emerging diseases drawing lessons from disease events that occurred in animal and human populations in the last five decades (1961-2011). A comprehensive analysis based on retrieval and analysis of grey and published literature as well as reported cases was carried out to document type and trend of occurrence of emerging and re-emerging infectious diseases in different parts of Tanzania. Overall, the majority of diseases reported in the country were viral in nature followed by bacterial diseases. The trend for the occurrence shows a number of new emerging diseases as well as re-occurrence of old diseases in both animal (domestic and wild) and human populations. In humans, the major disease epidemics reported in the last five decades include cholera, influenza A H1N1, plague and rubella. In animals, the major epidemic diseases reported were Contagious Bovine Pleuropneumonia, Contagious Caprine Pleuropneumonia, Peste des petits ruminants and Giraffe Ear and Skin Diseases. Some epidemics have been reported in both human and animal populations including Rift Valley fever and anthrax. The emergence of the ‘fit-for purpose’ approaches and technologies such as the discipline of One Health, use of participatory epidemiology and disease surveillance and mobile technologies offers opportunity for optimal use of limited resources to improve early detection, diagnosis and response to disease events and consequently reduced impact of such diseases in animal and human populations.
    Tanzania health research bulletin 03/2012; 13(5). DOI:10.4314/thrb.v13i5.8