Background and Objective. The aim of this study was to determine factors associated with repeat b... more Background and Objective. The aim of this study was to determine factors associated with repeat blood donation. Methods. This was a cross-sectional study carried out among blood donors aged 18-65 years in northern Tanzania. The questionnaire was administered among 454 participants through the phone. Results. Of the 454 participants, the proportion of repeat donation was 63.9%. In the backward logistic regression analysis, the significant predictors were living in Arusha which had lower odds of repeat donation compared to those living in Kilimanjaro. Knowledge of time interval between donations increased odds of repeating donations. High intention increased odds of repeat donation compared to low intention. Altruistic score had minor effect on increasing odds of repeating donation. Conclusion. Repeat blood donation is affected by proximity of donating site, awareness of the blood donation interval, intention to donate, and experience on previous donation. We recommend continuous education concerning blood donors and donation among health workers and society as a whole; this will create awareness on motivational factors for repeat donations.
Background Of 270,000 new HIV infections in children, 90% are in Sub-Saharan Africa. High fertili... more Background Of 270,000 new HIV infections in children, 90% are in Sub-Saharan Africa. High fertility levels and high number of women infected with HIV results in high rates of Mother-to-Child-Transmission (MTCT) in SSA. To date, most efforts to prevent MTCT of HIV have focused on the third prong, a strategy that offers ARV drugs to HIV infected pregnant women and their exposed infants. However, the effective use of contraceptives to prevent unwanted pregnancies among HIV-positive women has the ability to reduce the rates of MTCT of HIV at a lower cost compared to the third prong. There is limited information on the levels of contraceptive use and associated factors among HIV positive women in Northern Tanzania. Methods This was a cross-sectional study conducted in February-May 2014 in three randomly selected districts of Kilimanjaro region. Univariate and multivariate logistic regression analysis were used to describe data and determine independent predictors of modern contraceptives use respectively. Results Of the 672 HIV-positive women participated in this study, 93% were aware of modern contraceptive methods, 54% were current modern contraceptives users and 21% were using dual contraceptive methods. Commonly modern contraceptives method used included male condom (41%), Depo-Provera (13%) and oral contraceptive pills (10%). Modern contraceptive use was significantly higher among HIV-positive women with; secondary education (aOR = 3.6, 95% CI 1.4-9.5), who do not plan to have more children (aOR = 2.2, 95% CI 1.5-3.2), counselled on contraceptives at CTC (aOR = 3.7, 95% CI 2.7-5.1), disclosed their HIV status to their partner (aOR = 2.5, 95% CI 1.8-3.4). Conclusions Prevalence of modern contraceptive use was higher than the national level. 46% of HIV-positive women are not using any method of contraception despite being sexually active. Strategies are required to increase use of long-term contraceptive methods to those who do not want more children and strengthening counselling to target non-users.
Background: Availability of emergency obstetric and newborn care (EmOC) is one of interventions t... more Background: Availability of emergency obstetric and newborn care (EmOC) is one of interventions to reduce maternal and newborn deaths. Maternal and newborn mortality is a public health problem in most developing countries including Tanzania. In these settings, coverage of EmOC is low especially in rural areas, with limited information on availability and use of EmOC services. Objectives: To assess the availability, utilization and quality of emergency obstetric care in Hai district, located at Kilimanjaro region, northern Tanzania. Methods: A cross-sectional survey of 12 health facilities (2 hospitals and 10 primary health care facilities) which provide delivery services in the district was conducted in May-June 2014. Modified AMDD data collection tool was used and it assessed availability of services, supplies and equipments, infrastructure and actual performance of EmOC within the past 3 months prior to the interview. Proportions were used to summarize the data. Results: The two comprehensive EmOC facilities (CEmOC) could provide all the nine required signal functions while none of the basic EmOC facilities (BEmOC) could provide the seven required signal functions. For a population of 214,454 in the district, the total number of health facilities designated to provide EmOC services exceeded the minimum required number which was 1 for CEmOC and 2 BEmOC. The proportion of births taking place in facilities was 65.3% and the met need for emergency obstetric complications was 94.5%. Population based caesarean section rate and the still birth rate were 7.4% and 1.3% respectively. Conclusion: BEmOC facilities, which are the first level of care for majority of women and newborns with complications, need to be strengthened to offer the required medical and surgical interventions to save lives. There is a need to scale-up training of health providers especially at the lower level (dispensaries and health centres) in EmOC as well as to strength supply chain system in order to contribute in attaining the national BEmOC coverage of 70% by December 2015.
To evaluate the effectiveness of the syndromic approach in management of vaginal infections among... more To evaluate the effectiveness of the syndromic approach in management of vaginal infections among pregnant women in Moshi urban, Tanzania. Between June 2002 and March 2004, 2654 pregnant women in their 3rd trimester were recruited from two community primary health care clinics. They were interviewed using a structured questionnaire, examined and genital samples collected. Vaginal secretions were evaluated for bacterial vaginosis (BV) by Amsel's criteria, for trichomoniasis (TV) and candidiasis (CA) by wet mount microscopy. Sensitivity, specificity, and positive and negative predictive values were used to assess the effectiveness of syndromic management for vaginal infections. The prevalence of TV, BV and CA were 5.0%, 20.9% and 11.4% respectively. Nearly 70% of the vaginal infections with trichomoniasis and/or bacterial vaginosis were asymptomatic. Self reported vaginal discharge or the presence of vaginal discharge during examination were poor predictors of vaginal infections w...
Objectives Estimates shows exclusive breastfeeding (EBF) has the potential to prevent 11.6 % of a... more Objectives Estimates shows exclusive breastfeeding (EBF) has the potential to prevent 11.6 % of all under-five deaths in developing countries. Prevalence of EBF is low globally (35 %), and in sub Saharan Africa ranges between 22 and 33 %. Like other developing countries the prevalence of EBF is 50 % in Tanzania. There is limited information in Tanzania on factors influencing EBF apart from information specific for HIV positive women. This study aimed at examining factors that affect EBF practice among women in Muheza district, Tanga region, northeastern Tanzania. Methods A community based cross-sectional study using both qualitative and quantitative methods was conducted from April to June 2014. To collect relevant information, a total of 316 women with infants aged 6-12 months were interviewed using a questionnaire and 12 key informants using in-depth interview guide. Qualitative data was analyzed using thematic analysis while bivariate and multivariate logistic regression analysis were used assess association between EBF and predictor variables. Results The prevalence of EBF was 24.1 %. The perception that mothers' breast milk is insufficient for child's growth, child being thirsty and the need to introduce herbal medicine for cultural purposes were among the important factors for early mixed feeding. In multivariate analysis advanced maternal age (OR 2.6; 95 % CI 1.18-5.59) and knowledge on EBF duration and advantages (OR 2.2; 95 % CI 1.2-3.8) remained significantly associated with EBF practice.
Background: Exclusive breastfeeding (EBF) practice is safe and simple intervention in improving c... more Background: Exclusive breastfeeding (EBF) practice is safe and simple intervention in improving child health and growth. However the practice of EBF is still low especially in developing countries. Objective: The objective of this paper is to assess the factors associated with EBF among women with infants' aged 0-5 months in Kilimanjaro region. Methods: This was a population based cross sectional study conducted between June 2010 and March 2011 in Kilimanjaro region to investigate local factors for adverse child development. A structured questionnaire was used to collect socio demographic data, breastfeeding history and reproductive information from mothers. Recall since birth was used to estimate EBF prevalence. Multivariable logistic regression was used to assess the factors associated with EBF among women with infants' aged 0-5 months in Kilimanjaro region. Results: Out of 462 women, 95% (n=437) were still breastfeeding their infants during the study period. About 29% of ...
BACKGROUND:Tanzania has extended prevention of mother-to-child HIV transmission (PMTCT) services ... more BACKGROUND:Tanzania has extended prevention of mother-to-child HIV transmission (PMTCT) services to primary health care clinics (PHC). Information on challenges and rates of MTCTC of HIV at this level is limited. The study aimed to describe theuptake of PMTCT interventions and MTCT rates at 18 months post-delivery. METHODS:Pregnant women,in their 3 rd trimester (N=2654),attending 2 primary health facilities in Moshi were recruited. They were interviewed, tested and women-infant pairs were followed-up for 18 months post-delivery, at which point the exposed children were tested for HIV. RESULTS:Of the 2654 women, 99% accepted testing, 93% returned for their HIV-test results and 7% (184) were HIV-positive. Of the 184 HIV-positive women, 93% (171/184) came for test-results, 71% (130/184) took anti-retroviral prophylaxis (sdNVP) in labor and 59% (103/175) infants received ARV (sdNVP) prophylaxis. HIV-testing at 18 months was conducted for 68% of the exposed infants. The rate of MTCT of H...
Background: Ensuring women have access to good quality Emergency Obstetric Care (EOC) is a key st... more Background: Ensuring women have access to good quality Emergency Obstetric Care (EOC) is a key strategy to reducing maternal and newborn deaths. Minimum coverage rates are expected to be 1 Comprehensive (CEOC) and 4 Basic EOC (BEOC) facilities per 500,000 population.
Background: Voluntary HIV counseling and testing (VCT) is a key strategy towards HIV prevention y... more Background: Voluntary HIV counseling and testing (VCT) is a key strategy towards HIV prevention yet, the uptake of VCT services among young people remains low. This study determined the factors that influence the uptake of VCT among secondary school students in Arusha City, Tanzania.
Background: Exclusive breastfeeding (EBF) is recommended the first six months after birth as one ... more Background: Exclusive breastfeeding (EBF) is recommended the first six months after birth as one of cost effective interventions in saving children's lives. Objective: To determine the prevalence of exclusive breastfeeding and describe the common foods introduced to infants before 6months. Design: A prospective cohort study. Setting: Poor community of Moshi urban, Kilimanjaro region, Tanzania. Subjects: Women in their third trimester and were followed to 18 months after delivery. A questionnaire was used to collect information on maternal socio-demographics, delivery status and infant feeding practices at each visit. Maternal HIV status was checked at enrolment. Results: Out of 2231 women, with a live birth, 70% (1535) came back at least once after delivery and information on infant feeding were collected. 94% of the women were living below the poverty line. The prevalence of EBF at 1, 3 and up to 6 months was 48.8%, 22.0% and 0.2% respectively. Two percent of the infants were given semi-solids at 1 month, 35% at 3 months and 95% at 5 months. Water and cow's milk were the most common liquids introduced to infants by one month, while porridge, cow's milk and mtori were commonly introduced at 3 months. Conclusions: EBF up to 6 month is very rare in Kilimanjaro. There is an urgent need to strengthen community and health facility based EBF interventions so as to reach the 90% recommended coverage by the WHO. This will help in improving child survival and in attaining the Millennium Development Goal 4.
Women continue to be disproportionately affected by HIV in Tanzania, and factors contributing to ... more Women continue to be disproportionately affected by HIV in Tanzania, and factors contributing to this situation need to be identified. The objective of this study was to determine social, behavioral and biological risk factors of HIV infection among pregnant women in Moshi urban, Tanzania. In 2002-2004, consenting women (N = 2654), attending primary health clinics for routine antenatal care were interviewed, examined and biological samples collected for diagnosis of HIV and other sexually transmitted/reproductive tract infections. The prevalence of HIV was 6.9%. The risk for HIV was greater among women whose male partner; had other sexual partners (adjusted odds ratio [AOR], 15.11; 95% confidence interval [CI], 8.39-27.20), traveled frequently (AOR, 1.79; 95% CI, 1.22-2.65) or consumed alcohol daily (AOR, 1.68; 95% CI, 1.06-2.67). Other independent predictors of HIV were age, number of sex partners, recent migration, and presence of bacterial vaginosis, genital ulcer, active syphili...
Background: Exclusive breastfeeding (EBF) for the first six months of infants' lives is a cost ef... more Background: Exclusive breastfeeding (EBF) for the first six months of infants' lives is a cost effective intervention in saving children's lives and can avert 13 -15% of the 9 million deaths of children under 5 years old in resource poor settings. However, EBF rates have been shown to be low in resource poor settings, ranging between 20 and 40%. In Tanzania, the prevalence of EBF among infants under 6 months is 41%, with limited information on predictors of EBF. The aim of the study was to determine prevalence of EBF and its predictors in Kigoma Municipality, Western Tanzania. Methods: A cross-sectional study was conducted in March to May 2010 among 402 consenting women, with infants aged 6 to 12 months, from randomly selected households. A questionnaire was used to collect information on demographic characteristics, knowledge of EBF, infant feeding practices, and on HIV status. Results: The prevalence of EBF among women in Kigoma Municipality was 58%. Knowledge of EBF was relatively higher (86%) compared to the practice. In the multivariable analysis, women with adequate knowledge of EBF (AOR 5.4), women who delivered at health facilities (AOR 3.0) and women who had no problems related to breasts, like engorgement/cracked nipples (AOR 6.6) were more likely to exclusively breastfeed compared to others.
Anaemia during pregnancy is associated with negative maternal and neonatal outcomes. However, the... more Anaemia during pregnancy is associated with negative maternal and neonatal outcomes. However, there is limited data regarding prevalence and effects of anaemia during pregnancy in northern Tanzania. The objective of this study was to determine the prevalence and possible risk factors for anaemia and its effect on perinatal outcomes among pregnant women attending antenatal care in Moshi Municipality in northern Tanzania. A cohort of pregnant women aged 14-43 years and in their 3 rd trimester, was recruited from two primary health care clinics between June 2002 and March 2004. Interviews, anthropometric measurements and haematological examinations were conducted on 2654 consenting women. Perinatal outcomes were recorded during delivery and at 1 week after delivery. Of the 2654 participants, 47.4% had anaemia (haemoglobin [Hb] <11g/dl), 35.3% had mild anaemia (Hb= 9-10.9g/dl), 9.9% had moderate anaemia (Hb =7-8.9g/dl), and 2.1% had severe anaemia (Hb < 7 g/dl). Anaemia was significantly more prevalent in HIV-positive (56.4%) than in HIV-negative women (46.7%), (P = 0.01). In logistic regression anaemia was independently associated with maternal HIV (OR= 1.5), malaria (OR= 5.2), clinic of recruitment (OR= 1.5) and low income (OR= 1.9). Pregnant women with anaemia were more likely to have low birth weight (LBW) infants. Compared with nonanaemic women, the risk of LBW was 1.6 times and 4.8 times higher for children born to women with moderate and severe anaemia, respectively. In conclusion, anaemia in pregnancy is a severe public health problem in northern Tanzania. Control of maternal anaemia may be one important strategy to prevent LBW in this setting. Measures to prevent malaria and to control anaemia among all pregnant women irrespective of HIV status, should be strengthened. Outside of the health sector broader approaches for anaemia prevention targeting women of lower income, are required.
To identify risk factors for sexually transmitted infections (STI) and to evaluate the accuracy o... more To identify risk factors for sexually transmitted infections (STI) and to evaluate the accuracy of using risk assessment for identifying infected women in Moshi, Tanzania. A cross sectional study. Three primary health care clinics in Moshi. 382 consenting women attending the clinics for routine reproductive health care were interviewed followed by a pelvic examination between September and December 1999. Blood and genital specimens were collected for STI diagnosis. Prevalent STIs, risk factors and accuracy of using risk factors to identify infected women. Among 382 women, 118 (31%) had at least one STI diagnosed clinically or by a laboratory test; (T. vaginalis 21%, syphilis 4.2%, chlamydia and/or gonococcal cervicitis 3.2%, genital ulcer 4.5% and warts 2%). The risk of CT/GC cervicitis was greater among women aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 20 years (p = 0.04), with cervical friability (p = 0.01) and with &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 10 cervical leucocytes (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), while having more than one partner in the past three months (p = 0.008) predicted syphilis infection. Trichomoniasis was associated with the presence of vaginal discharge (p = 0.001) and pH &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 4.5 (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). However, using these risk factors as a screening tool for various STIs achieved a low sensitivity and a low positive predictive value, hence a low utility for case detection. STIs were prevalent in this setting. However, risk factors were not a good tool for identifying infected women. While there is an urgent need to develop low cost microbiological tests for case detection, efforts should be made to maximise the available control strategies, such as proper treatment of symptomatic patients and their partners.
To determine the prevalence of and risk factors for reproductive tract infections (RTI) among asy... more To determine the prevalence of and risk factors for reproductive tract infections (RTI) among asymptomatic women attending primary health care clinics in Harare, Zimbabwe. A cross sectional study. Prevalent RTI, HIV and socio-demographic data. Two primary health care clinics in Harare. 393 consecutive, consenting women aged 15 to 49 years, presenting at the clinics for antenatal care, family planning, or bringing their children to attend preventive care clinics. More than half of the women had at least one ongoing RTI. Voluntary reporting of symptoms was almost non-existent. Prevalence of HIV was 29.3% and that of classical STIs was 15.4% Trichomoniasis vaginalis, 3.9% syphilis, 3.9% Chlamydia trachomatis and 1.8% Neisseria gonorrhoea. Bacteria vaginosis was diagnosed in 30.3% of the women and candidiasis in 25.4%. Presence of any RTI was significantly associated with lower level of education, sexual debut &lt; 20 years, a non-monogamous partner, and use of a condom during the last sexual encounter. Independent factors associated with cervical infections were young age (&lt; 20 years), being unmarried, current dysuria, warts, clinical signs of purulent or yellowish discharge, lower abdominal pain and cervical friability. Vaginitis was associated with sexual debut or marriage &lt; 20 years, a partner who was a frequent traveller, history of STI, and presence of abnormal vaginal discharge. In view of the high prevalence of RTI and HIV and the low reporting of symptoms by infected women, it is recommended that strategies that improve women&#39;s awareness of urogenital symptoms be adopted, along with pro-active inquiry of genital symptoms by the health care workers, and treatment of RTIs, in order to reduce the unnecessary burden of RTIs.
Background and Objective. The aim of this study was to determine factors associated with repeat b... more Background and Objective. The aim of this study was to determine factors associated with repeat blood donation. Methods. This was a cross-sectional study carried out among blood donors aged 18-65 years in northern Tanzania. The questionnaire was administered among 454 participants through the phone. Results. Of the 454 participants, the proportion of repeat donation was 63.9%. In the backward logistic regression analysis, the significant predictors were living in Arusha which had lower odds of repeat donation compared to those living in Kilimanjaro. Knowledge of time interval between donations increased odds of repeating donations. High intention increased odds of repeat donation compared to low intention. Altruistic score had minor effect on increasing odds of repeating donation. Conclusion. Repeat blood donation is affected by proximity of donating site, awareness of the blood donation interval, intention to donate, and experience on previous donation. We recommend continuous education concerning blood donors and donation among health workers and society as a whole; this will create awareness on motivational factors for repeat donations.
Background Of 270,000 new HIV infections in children, 90% are in Sub-Saharan Africa. High fertili... more Background Of 270,000 new HIV infections in children, 90% are in Sub-Saharan Africa. High fertility levels and high number of women infected with HIV results in high rates of Mother-to-Child-Transmission (MTCT) in SSA. To date, most efforts to prevent MTCT of HIV have focused on the third prong, a strategy that offers ARV drugs to HIV infected pregnant women and their exposed infants. However, the effective use of contraceptives to prevent unwanted pregnancies among HIV-positive women has the ability to reduce the rates of MTCT of HIV at a lower cost compared to the third prong. There is limited information on the levels of contraceptive use and associated factors among HIV positive women in Northern Tanzania. Methods This was a cross-sectional study conducted in February-May 2014 in three randomly selected districts of Kilimanjaro region. Univariate and multivariate logistic regression analysis were used to describe data and determine independent predictors of modern contraceptives use respectively. Results Of the 672 HIV-positive women participated in this study, 93% were aware of modern contraceptive methods, 54% were current modern contraceptives users and 21% were using dual contraceptive methods. Commonly modern contraceptives method used included male condom (41%), Depo-Provera (13%) and oral contraceptive pills (10%). Modern contraceptive use was significantly higher among HIV-positive women with; secondary education (aOR = 3.6, 95% CI 1.4-9.5), who do not plan to have more children (aOR = 2.2, 95% CI 1.5-3.2), counselled on contraceptives at CTC (aOR = 3.7, 95% CI 2.7-5.1), disclosed their HIV status to their partner (aOR = 2.5, 95% CI 1.8-3.4). Conclusions Prevalence of modern contraceptive use was higher than the national level. 46% of HIV-positive women are not using any method of contraception despite being sexually active. Strategies are required to increase use of long-term contraceptive methods to those who do not want more children and strengthening counselling to target non-users.
Background: Availability of emergency obstetric and newborn care (EmOC) is one of interventions t... more Background: Availability of emergency obstetric and newborn care (EmOC) is one of interventions to reduce maternal and newborn deaths. Maternal and newborn mortality is a public health problem in most developing countries including Tanzania. In these settings, coverage of EmOC is low especially in rural areas, with limited information on availability and use of EmOC services. Objectives: To assess the availability, utilization and quality of emergency obstetric care in Hai district, located at Kilimanjaro region, northern Tanzania. Methods: A cross-sectional survey of 12 health facilities (2 hospitals and 10 primary health care facilities) which provide delivery services in the district was conducted in May-June 2014. Modified AMDD data collection tool was used and it assessed availability of services, supplies and equipments, infrastructure and actual performance of EmOC within the past 3 months prior to the interview. Proportions were used to summarize the data. Results: The two comprehensive EmOC facilities (CEmOC) could provide all the nine required signal functions while none of the basic EmOC facilities (BEmOC) could provide the seven required signal functions. For a population of 214,454 in the district, the total number of health facilities designated to provide EmOC services exceeded the minimum required number which was 1 for CEmOC and 2 BEmOC. The proportion of births taking place in facilities was 65.3% and the met need for emergency obstetric complications was 94.5%. Population based caesarean section rate and the still birth rate were 7.4% and 1.3% respectively. Conclusion: BEmOC facilities, which are the first level of care for majority of women and newborns with complications, need to be strengthened to offer the required medical and surgical interventions to save lives. There is a need to scale-up training of health providers especially at the lower level (dispensaries and health centres) in EmOC as well as to strength supply chain system in order to contribute in attaining the national BEmOC coverage of 70% by December 2015.
To evaluate the effectiveness of the syndromic approach in management of vaginal infections among... more To evaluate the effectiveness of the syndromic approach in management of vaginal infections among pregnant women in Moshi urban, Tanzania. Between June 2002 and March 2004, 2654 pregnant women in their 3rd trimester were recruited from two community primary health care clinics. They were interviewed using a structured questionnaire, examined and genital samples collected. Vaginal secretions were evaluated for bacterial vaginosis (BV) by Amsel's criteria, for trichomoniasis (TV) and candidiasis (CA) by wet mount microscopy. Sensitivity, specificity, and positive and negative predictive values were used to assess the effectiveness of syndromic management for vaginal infections. The prevalence of TV, BV and CA were 5.0%, 20.9% and 11.4% respectively. Nearly 70% of the vaginal infections with trichomoniasis and/or bacterial vaginosis were asymptomatic. Self reported vaginal discharge or the presence of vaginal discharge during examination were poor predictors of vaginal infections w...
Objectives Estimates shows exclusive breastfeeding (EBF) has the potential to prevent 11.6 % of a... more Objectives Estimates shows exclusive breastfeeding (EBF) has the potential to prevent 11.6 % of all under-five deaths in developing countries. Prevalence of EBF is low globally (35 %), and in sub Saharan Africa ranges between 22 and 33 %. Like other developing countries the prevalence of EBF is 50 % in Tanzania. There is limited information in Tanzania on factors influencing EBF apart from information specific for HIV positive women. This study aimed at examining factors that affect EBF practice among women in Muheza district, Tanga region, northeastern Tanzania. Methods A community based cross-sectional study using both qualitative and quantitative methods was conducted from April to June 2014. To collect relevant information, a total of 316 women with infants aged 6-12 months were interviewed using a questionnaire and 12 key informants using in-depth interview guide. Qualitative data was analyzed using thematic analysis while bivariate and multivariate logistic regression analysis were used assess association between EBF and predictor variables. Results The prevalence of EBF was 24.1 %. The perception that mothers' breast milk is insufficient for child's growth, child being thirsty and the need to introduce herbal medicine for cultural purposes were among the important factors for early mixed feeding. In multivariate analysis advanced maternal age (OR 2.6; 95 % CI 1.18-5.59) and knowledge on EBF duration and advantages (OR 2.2; 95 % CI 1.2-3.8) remained significantly associated with EBF practice.
Background: Exclusive breastfeeding (EBF) practice is safe and simple intervention in improving c... more Background: Exclusive breastfeeding (EBF) practice is safe and simple intervention in improving child health and growth. However the practice of EBF is still low especially in developing countries. Objective: The objective of this paper is to assess the factors associated with EBF among women with infants' aged 0-5 months in Kilimanjaro region. Methods: This was a population based cross sectional study conducted between June 2010 and March 2011 in Kilimanjaro region to investigate local factors for adverse child development. A structured questionnaire was used to collect socio demographic data, breastfeeding history and reproductive information from mothers. Recall since birth was used to estimate EBF prevalence. Multivariable logistic regression was used to assess the factors associated with EBF among women with infants' aged 0-5 months in Kilimanjaro region. Results: Out of 462 women, 95% (n=437) were still breastfeeding their infants during the study period. About 29% of ...
BACKGROUND:Tanzania has extended prevention of mother-to-child HIV transmission (PMTCT) services ... more BACKGROUND:Tanzania has extended prevention of mother-to-child HIV transmission (PMTCT) services to primary health care clinics (PHC). Information on challenges and rates of MTCTC of HIV at this level is limited. The study aimed to describe theuptake of PMTCT interventions and MTCT rates at 18 months post-delivery. METHODS:Pregnant women,in their 3 rd trimester (N=2654),attending 2 primary health facilities in Moshi were recruited. They were interviewed, tested and women-infant pairs were followed-up for 18 months post-delivery, at which point the exposed children were tested for HIV. RESULTS:Of the 2654 women, 99% accepted testing, 93% returned for their HIV-test results and 7% (184) were HIV-positive. Of the 184 HIV-positive women, 93% (171/184) came for test-results, 71% (130/184) took anti-retroviral prophylaxis (sdNVP) in labor and 59% (103/175) infants received ARV (sdNVP) prophylaxis. HIV-testing at 18 months was conducted for 68% of the exposed infants. The rate of MTCT of H...
Background: Ensuring women have access to good quality Emergency Obstetric Care (EOC) is a key st... more Background: Ensuring women have access to good quality Emergency Obstetric Care (EOC) is a key strategy to reducing maternal and newborn deaths. Minimum coverage rates are expected to be 1 Comprehensive (CEOC) and 4 Basic EOC (BEOC) facilities per 500,000 population.
Background: Voluntary HIV counseling and testing (VCT) is a key strategy towards HIV prevention y... more Background: Voluntary HIV counseling and testing (VCT) is a key strategy towards HIV prevention yet, the uptake of VCT services among young people remains low. This study determined the factors that influence the uptake of VCT among secondary school students in Arusha City, Tanzania.
Background: Exclusive breastfeeding (EBF) is recommended the first six months after birth as one ... more Background: Exclusive breastfeeding (EBF) is recommended the first six months after birth as one of cost effective interventions in saving children's lives. Objective: To determine the prevalence of exclusive breastfeeding and describe the common foods introduced to infants before 6months. Design: A prospective cohort study. Setting: Poor community of Moshi urban, Kilimanjaro region, Tanzania. Subjects: Women in their third trimester and were followed to 18 months after delivery. A questionnaire was used to collect information on maternal socio-demographics, delivery status and infant feeding practices at each visit. Maternal HIV status was checked at enrolment. Results: Out of 2231 women, with a live birth, 70% (1535) came back at least once after delivery and information on infant feeding were collected. 94% of the women were living below the poverty line. The prevalence of EBF at 1, 3 and up to 6 months was 48.8%, 22.0% and 0.2% respectively. Two percent of the infants were given semi-solids at 1 month, 35% at 3 months and 95% at 5 months. Water and cow's milk were the most common liquids introduced to infants by one month, while porridge, cow's milk and mtori were commonly introduced at 3 months. Conclusions: EBF up to 6 month is very rare in Kilimanjaro. There is an urgent need to strengthen community and health facility based EBF interventions so as to reach the 90% recommended coverage by the WHO. This will help in improving child survival and in attaining the Millennium Development Goal 4.
Women continue to be disproportionately affected by HIV in Tanzania, and factors contributing to ... more Women continue to be disproportionately affected by HIV in Tanzania, and factors contributing to this situation need to be identified. The objective of this study was to determine social, behavioral and biological risk factors of HIV infection among pregnant women in Moshi urban, Tanzania. In 2002-2004, consenting women (N = 2654), attending primary health clinics for routine antenatal care were interviewed, examined and biological samples collected for diagnosis of HIV and other sexually transmitted/reproductive tract infections. The prevalence of HIV was 6.9%. The risk for HIV was greater among women whose male partner; had other sexual partners (adjusted odds ratio [AOR], 15.11; 95% confidence interval [CI], 8.39-27.20), traveled frequently (AOR, 1.79; 95% CI, 1.22-2.65) or consumed alcohol daily (AOR, 1.68; 95% CI, 1.06-2.67). Other independent predictors of HIV were age, number of sex partners, recent migration, and presence of bacterial vaginosis, genital ulcer, active syphili...
Background: Exclusive breastfeeding (EBF) for the first six months of infants' lives is a cost ef... more Background: Exclusive breastfeeding (EBF) for the first six months of infants' lives is a cost effective intervention in saving children's lives and can avert 13 -15% of the 9 million deaths of children under 5 years old in resource poor settings. However, EBF rates have been shown to be low in resource poor settings, ranging between 20 and 40%. In Tanzania, the prevalence of EBF among infants under 6 months is 41%, with limited information on predictors of EBF. The aim of the study was to determine prevalence of EBF and its predictors in Kigoma Municipality, Western Tanzania. Methods: A cross-sectional study was conducted in March to May 2010 among 402 consenting women, with infants aged 6 to 12 months, from randomly selected households. A questionnaire was used to collect information on demographic characteristics, knowledge of EBF, infant feeding practices, and on HIV status. Results: The prevalence of EBF among women in Kigoma Municipality was 58%. Knowledge of EBF was relatively higher (86%) compared to the practice. In the multivariable analysis, women with adequate knowledge of EBF (AOR 5.4), women who delivered at health facilities (AOR 3.0) and women who had no problems related to breasts, like engorgement/cracked nipples (AOR 6.6) were more likely to exclusively breastfeed compared to others.
Anaemia during pregnancy is associated with negative maternal and neonatal outcomes. However, the... more Anaemia during pregnancy is associated with negative maternal and neonatal outcomes. However, there is limited data regarding prevalence and effects of anaemia during pregnancy in northern Tanzania. The objective of this study was to determine the prevalence and possible risk factors for anaemia and its effect on perinatal outcomes among pregnant women attending antenatal care in Moshi Municipality in northern Tanzania. A cohort of pregnant women aged 14-43 years and in their 3 rd trimester, was recruited from two primary health care clinics between June 2002 and March 2004. Interviews, anthropometric measurements and haematological examinations were conducted on 2654 consenting women. Perinatal outcomes were recorded during delivery and at 1 week after delivery. Of the 2654 participants, 47.4% had anaemia (haemoglobin [Hb] <11g/dl), 35.3% had mild anaemia (Hb= 9-10.9g/dl), 9.9% had moderate anaemia (Hb =7-8.9g/dl), and 2.1% had severe anaemia (Hb < 7 g/dl). Anaemia was significantly more prevalent in HIV-positive (56.4%) than in HIV-negative women (46.7%), (P = 0.01). In logistic regression anaemia was independently associated with maternal HIV (OR= 1.5), malaria (OR= 5.2), clinic of recruitment (OR= 1.5) and low income (OR= 1.9). Pregnant women with anaemia were more likely to have low birth weight (LBW) infants. Compared with nonanaemic women, the risk of LBW was 1.6 times and 4.8 times higher for children born to women with moderate and severe anaemia, respectively. In conclusion, anaemia in pregnancy is a severe public health problem in northern Tanzania. Control of maternal anaemia may be one important strategy to prevent LBW in this setting. Measures to prevent malaria and to control anaemia among all pregnant women irrespective of HIV status, should be strengthened. Outside of the health sector broader approaches for anaemia prevention targeting women of lower income, are required.
To identify risk factors for sexually transmitted infections (STI) and to evaluate the accuracy o... more To identify risk factors for sexually transmitted infections (STI) and to evaluate the accuracy of using risk assessment for identifying infected women in Moshi, Tanzania. A cross sectional study. Three primary health care clinics in Moshi. 382 consenting women attending the clinics for routine reproductive health care were interviewed followed by a pelvic examination between September and December 1999. Blood and genital specimens were collected for STI diagnosis. Prevalent STIs, risk factors and accuracy of using risk factors to identify infected women. Among 382 women, 118 (31%) had at least one STI diagnosed clinically or by a laboratory test; (T. vaginalis 21%, syphilis 4.2%, chlamydia and/or gonococcal cervicitis 3.2%, genital ulcer 4.5% and warts 2%). The risk of CT/GC cervicitis was greater among women aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 20 years (p = 0.04), with cervical friability (p = 0.01) and with &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 10 cervical leucocytes (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), while having more than one partner in the past three months (p = 0.008) predicted syphilis infection. Trichomoniasis was associated with the presence of vaginal discharge (p = 0.001) and pH &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 4.5 (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). However, using these risk factors as a screening tool for various STIs achieved a low sensitivity and a low positive predictive value, hence a low utility for case detection. STIs were prevalent in this setting. However, risk factors were not a good tool for identifying infected women. While there is an urgent need to develop low cost microbiological tests for case detection, efforts should be made to maximise the available control strategies, such as proper treatment of symptomatic patients and their partners.
To determine the prevalence of and risk factors for reproductive tract infections (RTI) among asy... more To determine the prevalence of and risk factors for reproductive tract infections (RTI) among asymptomatic women attending primary health care clinics in Harare, Zimbabwe. A cross sectional study. Prevalent RTI, HIV and socio-demographic data. Two primary health care clinics in Harare. 393 consecutive, consenting women aged 15 to 49 years, presenting at the clinics for antenatal care, family planning, or bringing their children to attend preventive care clinics. More than half of the women had at least one ongoing RTI. Voluntary reporting of symptoms was almost non-existent. Prevalence of HIV was 29.3% and that of classical STIs was 15.4% Trichomoniasis vaginalis, 3.9% syphilis, 3.9% Chlamydia trachomatis and 1.8% Neisseria gonorrhoea. Bacteria vaginosis was diagnosed in 30.3% of the women and candidiasis in 25.4%. Presence of any RTI was significantly associated with lower level of education, sexual debut &lt; 20 years, a non-monogamous partner, and use of a condom during the last sexual encounter. Independent factors associated with cervical infections were young age (&lt; 20 years), being unmarried, current dysuria, warts, clinical signs of purulent or yellowish discharge, lower abdominal pain and cervical friability. Vaginitis was associated with sexual debut or marriage &lt; 20 years, a partner who was a frequent traveller, history of STI, and presence of abnormal vaginal discharge. In view of the high prevalence of RTI and HIV and the low reporting of symptoms by infected women, it is recommended that strategies that improve women&#39;s awareness of urogenital symptoms be adopted, along with pro-active inquiry of genital symptoms by the health care workers, and treatment of RTIs, in order to reduce the unnecessary burden of RTIs.
Introduction: Tanzania is among of the African countries with high maternal and child mortality r... more Introduction: Tanzania is among of the African countries with high maternal and child mortality rates and fast growing population. It also has high fertility rate and a huge unmet need for family planning. Contraceptive use reported to avert more than 1 million maternal deaths in Sub-Saharan Africa due to decline in fertility rate and thus help to achieve MDG 4 and 5. Therefore, this study aimed to determine factors influencing modern contraceptive use among women aged 15 - 49 years in Tanzania. Methods: This was a secondary analysis of Tanzania Demographic Health Survey (TDHS), 2010. A total of 475 clusters (urban and rural) composed of 9663 households were selected.
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