Tanzania Journal of Health Research

Clinical patterns, surgical outcomes and prognostic factors among patients undergoing cleft palate surgery at Bugando Medical Centre, Tanzania

2023-08-28T09:51:15+00:00

Background: Cleft palate poses major therapeutic challenges among otorhinolaryngology, plastic/reconstructive, oral and maxillofacial surgeons practicing in resource limited countries. There is a paucity of prospective studies regarding this subject in Tanzania and Bugando Medical Centre (BMC) in particular. This study describes the clinical patterns, surgical outcomes and prognostic factors among patients undergoing cleft palate repair at BMC

Methods: This was a cross sectional study among patients undergoing cleft palate repair at BMC between January 2019 and June 2019.

Results: A total of 44 patients (M; F ratio = 1.4: 1) were studied. The majority of patients, 35(79.5%) were aged between 6 and 12 months at the time of presentation for treatment. Associated congenital anomaly was reported in one (2.3%) patient. Only 10 (22.7%) patients had isolated cleft palate and the remaining 34(77.3%) patients had associated cleft lip. No patient had associated atypical orofacial cleft. Most of patients, 22 (50.0%) had bilateral cleft palate. The right and left cleft palates were involved in 12 (27.3%) and 10 (22.7%) respectively. Majority of patients, 35(79.5%) had complete cleft palates. All patients underwent cleft palate repair. The median age at surgery was 9 months. A total of 21 (47.7%) postoperative complications were recorded, of which bleeding (10; 47.6%) and palatal fistula (9; 42.8%) were the most common postoperative complications. There was no death recorded in this study. Out of 44 patients, 34 were treated successfully giving an overall success rate of 77.3%. The success rate was significantly influenced by nutrition status (p= 0.020) and width of the cleft (p=0.033).

Conclusion: This study showed that the majority of patients with cleft palate presented to BMC within 1 year of life. More than three quarter of patients were treated successfully. Malnutrition and cleft width > 10 mm were the major prognostic factors affecting the treatment success. Appropriate measures focusing at these factors are vital in order to deliver optimal care for these patients in this region.

Motives for the first sexual experience and sexual behaviours practiced among out of school Youths in Mpimbwe District, Katavi Region Tanzania

2023-07-28T07:34:07+00:00

Background: Early sexual debut is a common practice among youth in Africa. However, little is known about motives for the first sexual experience and subsequent sexual behaviours practiced among out-of-school youths.

Objective: To determine motives for the first sexual experience and sexual behaviours practiced among out-of-school youths in Mpimbwe District, Katavi region Tanzania

Methods: A cross-sectional study was conducted among 320 out-of-school youths in Mpimbwe district. Data was collected through structured questions, analysed using SPSS version 22, results summarised and presented in textual and tabular formats.

Results: The age of the respondents ranged from 15 to 24 years. Age at first sexual experience varied from 14 to 19 years with a median age of 16 years. By the age of 14, about a quarter of the girls (26.8%) and relatively few boys (1.9%) had their first sexual experience. None of the respondents reported to use prevention against the consequences of unprotected sex during the first sexual experience. Pleasure was the main motive (79.1%) for the first sexual experience followed by gifts (18.6%) and these varied significantly by age and sex. Majority (98.4%) were aware of vaginal sex and had personal experience with it. Other common sexual behaviours reported were masturbation (81.9%) and anal sex (75.6%). None had practiced anal sex and a third of males (33.1%) and a few females (7.5%) had practiced masturbation. Other sexual behaviours reported were frotteurism, wet and dry sex.

Conclusion: Early sexual debut was common among out-of-school youths with less protection against the consequences of unprotected sex. Pleasure and gifts were the main motives for the first sexual experience. Different sexual behaviours are known and practiced by the study respondents. There is a need for effective educational interventions on safe sex for informed decisions on sexual behaviour among this population sub-group

Abdominal re-operations: indications, early surgical outcomes and prognostic factors at Bugando Medical Centre, Mwanza Tanzania

2023-08-21T06:18:52+00:00

Background: Abdominal re-operation is any repeated operation for an intra-abdominal procedure or wound complication on index admission or on a subsequent admission to the hospital within a post-operative period of sixty days. It is usually performed in case of post-operative complications either as a re-laparotomy, stoma or wound complications depending on the initial type of surgery. Incidence of abdominal re-operation differs according to the hospital’s settings, patient’s baseline clinical condition and type of primary abdominal surgery. Despite the increased number of surgical re-admissions, and post-operative complications, there is still a paucity of data describing burden, indications, outcomes and prognostic factors of abdominal re-operations at Bugando Medical Centre (BMC). This study was conducted to determine indications, early surgical outcomes and prognostic factors for abdominal re-operations at BMC.

Methods: This was an analytical cross-sectional study that was conducted at BMC from May 2017 to May 2018. Data were entered into a Microsoft Excel sheet and statistical analysis was done using STATA version 15.

Results: A total of 104 patients were enrolled, of whom 41(39.4%) were males and 63(60.6%) were females, giving a male-to-female ratio of 1: 1.5. Their ages at diagnosis ranged from 1 day to 76 years with a median age of 29 [IQR 17 – 46] years. The most common indications for abdominal re-operation were peritonitis 45 (43.3%), burst abdomen 29 (28.0%) and anastomotic leak 18 (17.3%). Stoma complications 7 (6.7%), haemorrhage 4 (3.9%) and post-operative paralytic ileus 1 (1.0%) were also recorded indications but at a lesser frequency. The mortality rate following abdominal re-operation was 28.9% (n=30). Older age and increasing number of abdominal re-operations were the main independent predictors of mortality following abdominal re-operations (p < 0.001).

Conclusion: Abdominal re-operation is associated with high mortality. The most common indications for abdominal re-operation were peritonitis, burst abdomen and anastomotic leak. Predictors of mortality were older age and an increasing number of abdominal re-operations. Hence it is recommended that patients with peritonitis, burst abdomen or anastomotic leak be managed in a timely and well-planned manner to minimize the number of unnecessary re-operations which may increase the risk for mortality.

Predictors of Human Papilloma Virus Knowledge and Vaccine acceptability among College Students of a private University

2023-09-13T15:30:22+00:00

Objectives: In low to middle-income countries, 12% of all female cancers were attributed to Human papillomavirus (HPV) which is the leading infectious cause of malignancy globally. This study identified the predictors of HPV knowledge and vaccine acceptability among college students of a private university with a highlight of the influence of the Health Belief Model.

Methods: This was a cross-sectional study conducted among 388 students of a privately owned university using a stratified sampling technique. The questionnaire was designed to assess the predictors of HPV Knowledge and highlight how the Health Belief Model influenced vaccine acceptability.

Result: Respondents’ perception of HPV screening benefits correlates positively (r=0.45, p<0.001) with vaccine acceptance. There is a negative weak correlation between the perception of HPV susceptibility and vaccine acceptability (r= -0.06, p=0.215). Predictors of overall knowledge of HPV infection include course of study, mother’s employment status and good family health status. The predictors of HPV vaccine acceptability were moderate knowledge of HPV infection and course of study

Conclusion: Perceived benefits of HPV screening positively influence vaccine. The cues to action that influenced HPV knowledge include the choice of course of study, perception of good family health and mother’s employment status. Perception of susceptibility to contracting HPV can be increased with better education and improved ways of counselling on the need for HPV screening, testing and vaccination.

Orthodontic Treatment Compliance and Duration Among Adolescent and Young Patients at Smiles Dental Clinic

2023-08-17T09:43:34+00:00

Introduction: Patient compliance is a core issue as it can strongly affect the objectives and results of orthodontic treatment and the length of time a patient must wear orthodontic appliances.

Objective: This study aimed to explore factors affecting compliance and duration of orthodontic treatment among patients at Smiles Dental Clinic, Dar Es Salaam, Tanzania

Methods: Dental records for 2016 to 2023 of 176 adolescent and young orthodontic patients aged 10 to 24 years were extracted from a private dental clinic in the city of Dar Es Salaam. The collected secondary data included the age and sex of the patient, duration of treatment, missed appointments, oral hygiene, bracket and molar tube failure, insurance status and whether a patient was a day or boarding school student.

Results: The majority of the patients demonstrated inadequate compliance with orthodontic treatment. A significantly higher proportion of non-insured patients (15.9%) demonstrated good compliance to orthodontic treatment than insured (5.9%). A significantly high proportion of boarding school patients missed appointments and frequently experienced breakage of orthodontic appliances. Treatment duration was significantly longer in patients who missed appointments, with poor compliance and bracket and/or molar tube breakage. Variance in treatment duration was explained most significantly by bracket breakage.

Conclusion: The studied patients had poor orthodontic compliance, which negatively impacted the treatment duration.

Awareness about first aid management of epistaxis among medical students at the State University of Zanzibar, Tanzania

2023-08-22T13:42:13+00:00

Background: Epistaxis is the most common otorhinolaryngology emergency and can be unilateral or bilateral due to a variety of pathologies of the nose, paranasal sinuses, and nasopharynx. It tends to be self-limiting on most occasions. It may be severe enough to necessitate medical attention and lead to life-threatening complications when left without prompt intervention. There is a scarcity of published data regarding awareness of first aid management of epistaxis among medical students in Zanzibar, Tanzania, thus the study aimed to address such an existing gap.

Methods: This was an analytical cross-sectional study that recruited 395 medical students. Data was collected using semi-structured questionnaires and analysis was done by Statistical Package for Social Sciences (SPSS) version 23 and a p-value <0.05 was considered to be statistically significant.

Results: About two-thirds (89.4%) of the medical students had good knowledge of first aid management of epistaxis and 85.3% of the participants had a good attitude toward first aid management of epistaxis. Almost half of the respondents of this study (52.7%) had good practice regarding first aid management of epistaxis. A significant association was found between academic year and overall knowledge, attitude and practices on first aid management of epistaxis among medical students.

Oral hygiene practice and the relationship between sugary food intake and dental caries among adults in Mbeya, Southwest Tanzania

2023-08-30T08:02:54+00:00

Background: Dental caries is a common dental health issue, but its prevalence varies across countries due to differences in oral healthcare programmes, lifestyles, and socio-economic status. Diet and fluoride exposure are major factors influencing the caries process. Sugars in the diet provide a substrate for bacteria in dental plaque, leading to tooth demineralisation. Our study assessed oral hygiene practice and the relationship between dental caries and sugary food intake among adults in Mbeya, Tanzania.

Methods: A community-based cross-sectional study was conducted among healthy adults in Mbeya selected through random sampling. The questionnaire was used to collect information on oral health practices and dental caries risk factors through interpersonal conversations. Oral cavity physical examinations were also conducted to assess oral cleanliness based on visible plaque presence and dentition status classified by the number of decayed, filled, and missing teeth due to caries. Data was analysed using SPSS version 23. χ2-test and logistic regression were used for studying associations.

Results: Our study included 168 participants. Nearly all 166 (98.8%) reported brushing their teeth. All participants reported sugary food intake, with 143 (85.1%) consuming sugary foods more than three times daily and 25 (14.9%) less than three times daily. Decayed teeth were present in 126 (75%) participants. Among those eating sugary foods over three times daily, 112 (66.7%) had dental caries versus 31 (18.5%) without caries (χ2=5.655, p=0.017). Reduced toothbrushing frequency is associated with increased decay (COR 2.839, 95% CI 1.172-6.873, p<0.05). The mean decayed, missing, and filled teeth score was 1.45 (± 0.45).

Conclusion: Findings indicate a positive oral hygiene practice overall. High sugar intake and inadequate brushing contributed to a high dental caries prevalence, indicating the need for improved oral health education, preventive efforts, and better access to dental services to address the substantial tooth decay burden.

Histomorphological and Biochemical Changes in the Liver Tissue Following Adjuvant Treatment with Hypoxis hemerocallidea and Antiretroviral Drugs in Diabetic Rats.

2023-08-14T12:31:20+00:00

Introduction: Highly Active Antiretroviral Therapy (HAART) has been used in management of people living with Human immunodeficiency virus (HIV). However, the long-term effects cause diabetes and result in liver damage. Similarly, Hypoxis hemerocellidae (H.h) has been used traditionally to treat disease including HIV annd Diabetes. The study aimed to investigate the effects of aqueous extract of H.h on the liver cytoarchitectonic in diabetic experimental animals under antiretroviral therapy.

Methods: Thirty-six (36) adult male Sprague-Dawley rats were used and divided into 6 groups namely: A ( control), B (diabetic) received distilled water, C (diabetic + 50mg/kg, H.h), D (diabetic + HAART), E ( diabetic + HAART+ 250 mg/kg VIt C), F (diabetic + HAART + 50mg/kg of H.h). Blood glucose levels, Body weight, oxidative stress markers and liver histomorphology of the experimental animals were measured and analyzed.

Results: The blood glucose levels of animals administered with H.h were significantly reduced compared with diabetic control. Group E had a significant reduced blood glucose levels compared with other treated groups D and F. There is a significant reduction of AST in group C and E compared to other groups D and F. Group F showed a significant reduction in MDA and an improvement in GSH compared to other treated groups except group E. Histologically, H& E and PAS staining revealed an improvement in groups C and F compared to the diabetic-treated groups.

Conclusion: This study demonstrated that H.hemerocallidae mitigated the metabolic effect of HAART in diabetic rats. Still, the antidiabetic and antioxidant effects, in combination with antiretroviral therapy need further investigation at different doses.

Eating habits and physical exercise patterns among undergraduate nursing students at Muhimbili University of Health and Allied Sciences, Tanzania: A cross-sectional study

2023-08-17T06:58:23+00:00

Background: Globally, overweight and obesity affect over one-third of the global population and it is projected that by 2030 obesity will affect more than half of the world population. The current burden of overweight and obesity is attributed to high rates of unhealthy eating and physical inactivity as it had also been revealed in Tanzania. The substantially increased prevalence of malnutrition at young ages is associated with a high incidence of non-communicable diseases in the young population and ultimately increased premature deaths.

Objectives: This study aimed to assess eating habits, physical exercise patterns, and the overweight/obesity status among undergraduate students at the Muhimbili University of Health and Allied Sciences (MUHAS).

Methods: A quantitative cross-sectional study was conducted between January and March 2022 by employing a stratified sampling technique to recruit 232 undergraduate nursing students. A self-administered questionnaire and anthropometric measurements were used to obtain data which were finally analyzed using SPSS version 25.

Results: The prevalence of overweight/obesity was 20.2%. Approximately 43% of the participants were physically inactive, with a higher proportion among females compared to males p=0.001. Male participants were more likely to perform physical exercises for a longer duration (≥ 30 minutes per day) compared to female participants, p=0.008. The consumption of more than three meals per day was associated with an increased odds of being overweight/obese than the consumption of three meals or less per day (OR: 3.11; 95%CI: 1.11-8.73). Similarly, the average long duration of sleeping per day (eight hours or more) was associated with an increased odds of being overweight/obese than sleeping less than eight hours per day (OR: 2.08; 95%CI: 1.06-4.11).

Conclusions: The findings revealed high rates of unhealthy eating habits, physical inactivity patterns and a significant prevalence of overweight/obesity. This indicates a need for developing actionable interventions and national health programs to promote healthy eating habits and physical activity, particularly among university students.

Technical Efficiency of Health Systems in African Least Developed Countries

2023-09-06T17:03:56+00:00

Background: Motivated by the fact that between 20-40% of health expenditure around the world is wasted due to inefficiencies the magnitude of these efficiencies/inefficiencies is unknown for African least developed countries (African LDCs). The objective of this study is to estimate the technical efficiency of the health systems in 29 African Least Developed Countries for the 2008-2018 period.

Method: Using the output-oriented Data Envelopment Analysis based on the Variable Returns to Scale assumption, panel data on the input variables including domestic general government health expenditure, domestic private health expenditure, external health expenditure and out-of-pocket expenditure, as well as the output variables including life expectancy at birth, maternal mortality ratio, under-five mortality rate, and infant mortality rate, were taken from the World Health Organization and World Bank.

Results: Findings of the study showed that between 2008 and 2018, 16 African LDCs were technically efficient, while 13 were not. The highest benchmarks for technically inefficient countries were Madagascar (12 peers), Senegal (7 peers), Eritrea and Ethiopia (7 peers), and Rwanda (1 peer).

Conclusion: The practices of nations with technically efficient health systems can serve as benchmarks for nations with technically inefficient health systems. African LDCs also needed to increase their domestic general government health expenditure, domestic private health expenditure, external health expenditure and out-of-pocket health expenditure to increase their infant survival rate.

Epistaxis: Prevalence and severity among Hypertensive patients attending District hospital in Tanzania

2023-09-08T11:50:30+00:00

Background: Epistaxis is one of the common ENT emergency conditions. Most of the time the bleeding is self-limited, but can be life-threatening. Serious spontaneous epistaxis may reveal underlying true hypertension in about 43% of patients with no previous history of hypertension. It can result from several causes and hypertension is among the aggravating factors.

Objective: The study aimed to determine the prevalence and severity of epistaxis among hypertensive patients.

Material and method: This study was a prospective cross-sectional study conducted from October 2021 to April 2022 involving a total of 196 adult patients with hypertension at a district hospital in Tanzania. A consecutive sampling technique was employed and structured questionnaires were used to collect data. Data entry was performed using SPSS version 25 and a P value of <0.05 was considered statistically significant.

Result:196 patients aged above 30 years were recruited, the majority of the patients were females (63%) and males were only (37%). The Prevalence of epistaxis was found to be lower among patients with hypertension aged below 40 years which accounted for 4.2%.However, patients aged 51-60 had a high prevalence of epistaxis (41.7%). The overall prevalence of epistaxis among hypertensive patients was found to be (12.2%) of which (62.5%) were females and (37.5%) were males. Furthermore, in this study, it was found that the severity of epistaxis among hypertensive patients was mild to moderate with (2%) of patients who required nasal packing. In this study (1%) of patients had mild epistaxis and (2%) had moderate epistaxis but no patients were found to have severe epistaxis as per epistaxis severity score (ESS) by Jeffrey B. Hoag (Score tool).

Conclusion and recommendation: Epistaxis can result from several local and systemic conditions. Hypertension is one of the systemic causes of epistaxis among our patients which is still prevalent in our settings, however slightly low as compared to the previous studies. Females have a higher occurrence of epistaxis compared to males and the most common age group involved are patients at the fifth and sixth decades. Likewise, in terms of severity, most of the time is mild to moderate. The health care providers managing these groups of patients should also evaluate the co-existence of the two disorders for the better outcome of treatment.

Spatial relationship between urban expansion and distribution of healthcare facilities in Morogoro municipality, Tanzania

2023-09-01T15:55:46+00:00

Background: The majority of the world's uninsured population, 1.3 billion individuals, reside in developing countries. Location disparity is a characteristic of the distribution of healthcare facilities in metropolitan regions of developing countries like Tanzania. Spatial variation in urban expansion and population growth are critical factors influencing the establishment and distribution of healthcare facilities in urban areas.

Methods: Statistical regression techniques can be used to describe the relationship between the variables. To achieve the study's goal, a variety of techniques were used to evaluate the spatial relationship between urban growth and the distribution of healthcare services. Remote sensing data provides massive amounts of spatial data on urban expansion. Population projection and population density indexes were used to determine population growth. Using Morogoro Municipality as a case study, Geographically Weighted Regression was applied to facilitate efficient spatial assessment of the relationship between urban expansion and distribution of healthcare facilities.

Results: The result shows that from 1990 to 2020 built-up increased from 3.9% to 18.9% of the total urban area of Morogoro Municipality while non-build class decreased from 96.1% to 81.9% of the total urban area of Morogoro Municipality. The overall coefficient determination R²was 0.599, 0.34 and 0.07 for the study period 2010-2020, 2000-2010 and 1990-2000 respectively showing that the explanatory power of variables urban expansion and population density was increasing with time.

Conclusion: The spatial relationship link of urban expansion and distribution of healthcare facilities in Morogoro Municipality within 30 years’ study period implies that there has been a progressive relationship between urban expansion and distribution of healthcare facilities during 1990-2000 there was a weak relationship same for 2000-2010 while 2010 -2020 exhibited a moderate relationship

Prevalence and risk factors associated with Schistosoma haematobium infection among school pupils in an area receiving annual mass drug administration with praziquantel: a case study of Morogoro municipality, Tanzania

2023-09-07T18:05:34+00:00

Background: There is a scarcity of accurate data on Schistosoma haematobium infection on country-specific prevalence despite mass drug administration over the years. Prevalence estimates for the number of people infected and the number at risk of infection must still be made based on calculations of limited prevalence survey data at the country level. This study aimed to fill in the gap of data on prevalence in an urban setting that has been receiving mass drug administration with praziquantel and determine the risk factors associated with S. haematobium infection among school pupils.

Method: A cross-sectional, stage-wise random sampling survey of S. haematobium infection, factors influencing its transmission and mass drug administration with praziquantel were studied among primary school pupils in Morogoro Municipality. A semi-structured questionnaire was used to collect data on risk factors, and urine samples were collected from pupils and examined for S. haematobium eggs and macro and microhematuria. Results were analyzed using SPSS version 12.0.

Result: The overall prevalence rate of S. haematobium infection was found to be 32.5% (95% CI, -3.1- 5.6%) in the ten schools that were sampled. It was observed that 228/884 (25.8%) of the pupils had low infection intensity and 82/884 (9.3%) had high infection intensity. The total number of pupils that had S. haematobium infection was 287, where 116 (40.42%) of them had micro-hematuria. The proportion of students that did receive praziquantel in the last general distribution was found to be 14.3% while 25.8% of the students had low infection intensity and 9.3% had high infection intensity across all age groups. Whereby 3.96% of pupils that received praziquantel in the last general administration also had S. haematobium infection (OR 0.77, 95% CI 0.5-1.2) The risk factors associated with S. haematobium infection were playing, bathing, fishing in rivers and helping parents work in rice fields (p –value<0.001).

Conclusion: The prevalence and intensity are high enough to cause re-infection. Still, more effort is needed to enforce mass praziquantel administration among primary school pupils, alternative water sources for recreational activities, provision of proper latrines and further studies needed to explore the risk factors.

Assessment of Bacterial contamination and associated risk factors in pork slaughtered and marketed in urban Tanzania

2023-08-15T07:11:00+00:00

Introduction: In Tanzania, pork consumption is increasing and become popular in urban areas creating a good market for pigs raised in rural areas. However, little is known regarding the microbial safety of the marketed pork in the country. This study assessed the level of bacterial contamination and contributing factors in pork slaughtered and sold in Arusha, Dar es Salaam and Dodoma Tanzania through Total Viable count, Coliform count, Escherichia coli and Staphylococcus aureus count.

Methods: A cross-section study was conducted and a total of 90 pork samples were collected from pig slaughter facilities, pork centres and butcheries. Standard methods for microbial analysis in food products (ISO 7218:2007(E)) were used.

Results: It was revealed that all (100%) pork samples had bacteria contamination with an overall mean for total viable count of 5.93±1.50 log CFU/g, and coliform forming unit of 4.30±1.14 log CFU/g. Over 92.2% of the pork samples were contaminated by E.coli with a mean count of 3.12±1.33 and S. aureus was isolated in more than 84.4% with a mean count of 2.71±1.34 log CFU/g. The mean values were higher than the limit set by Tanzania Standard (TBS/AFDC 22 (5266) P3). In addition, 79.4% of the pork slaughter facilities and selling points surveyed had poor hygiene and lacked safety and quality control measures.

Conclusion: Thus, it may be deduced that the pork carcasses assessed were of poor microbiological quality posing a health risk to pork consumers. To minimize public health risks, food control authorities should ensure effective enforcement of policies and regulations in controlling pig slaughtering and pork marketing in the country. Also, education on hygienic practices for all stakeholders along the pork value chain should be provided.

Assessment of knowledge on the danger signs of pregnancy among pregnant women at Sinza Palestina Hospital in Ubungo Municipality, Tanzania

2023-09-08T12:28:25+00:00

Background: The rate of maternal mortality has dropped globally however in some developing countries the rate of decline has been slow. Several efforts have been made to improve maternal health and reduce maternal mortality. Lack of information on danger signs during pregnancy is one of the factors that contribute to maternal mortality. The study aimed to assess knowledge of pregnancy danger signs among pregnant women at Sinza Palestina Hospital in Ubungo Municipality, Tanzania.

Methods: This was a cross-sectional study involving all pregnant women who attended RHC services at Sinza Palestina Hospital in Ubungo Municipality. Socio-demographic characteristics and obstetrics experiences in the last pregnancy, knowledge on danger signs of pregnancy were collected. Data were analysed using the SPSS statistical package. Categorical and continuous variables were summarized and presented in tables and bar charts. Any p-value of < 0.05, at a 95% confidence interval was regarded as statistically significant.

Results: A total of 410 pregnant women aged 18 – 46 years, mean age of 27 years were enrolled in this study. Amongst, 66 (16.1%) had low knowledge on obstetric danger signs and associated with age less than 20 years (aOR = 15.3, 95% CI: 4.8 – 48.3, p–value, < 0.001), education level (aOR = 27.7, 95% CI: 5.0 – 152, p–value, < 0.001), being single (aOR = 3.5, 95% CI: 1.1 – 12.9, p–value, < 0.04), parity (aOR = 1.9, 95% CI: 1.1 – 3.4, p–value, < 0.02 and less ANC visits (aOR = 2.6, 95% CI: 1.2 – 7.0, p–value, < 0.04). Moreover, occupation which was thought to have an association with knowledge of obstetrics danger signs, the association did not reach a statistically significant with p = 0.44.

Conclusions and recommendations: In general, the findings of this study, show that the vast majority (83.9%) of pregnant mothers have sufficient knowledge of obstetric danger signs. Vaginal bleeding was the most commonly mentioned obstetric danger while Convulsion and fever were mentioned less. Age and education level of pregnant women, parity and ANC visits were identified as the significant factors for knowledge of obstetric danger signs among pregnant women. We recommend that health education and behavioural change programs to continue be implemented in all health facilities to continue imparting knowledge to all pregnant mothers. Efforts should be directed towards empowering nurse midwives.

Factors associated with delays in seeking Paediatric Dental Care in Tanzania

2023-04-19T09:30:50+00:00

Background: Seeking dental care services among Tanzanian children is usually done responding to pain or potentially painful outcomes of advanced oral lesions. The situation implies untimely dental consultation inhibiting quality dental care for these children. This study aims to assess the duration taken to seek dental care, determine the proportion of delay to seek care and identify the dental setting and socio-demographic characteristics that could explain the delays.

Methods: Cross-sectional study involving 312 child dental patient-escort pairs at the university paediatric dental clinic in Tanzania. Structured questionnaires and clinical examination forms were used as means for collecting data. Frequency distributions, cross-tabulations and binary logistic regression were conducted. These provided proportions, tested for the presence and magnitude of associations between delay in seeking care and socio-demographics plus oral health-related behaviours.

Results: Over two-thirds (68.6%) of the participants were delayed to seek dental care with 45.2% being brought more than a month since the parents were informed or noted the child’s oro-dental complaint. A higher proportion of children who were delayed attended school and had mothers who were employed. The nature of the dental visit and requiring the use of physical stabilization retain the statistical significance with the odds of delay being higher among children who have had a previous dental visit (OR =1.8 95% CI 1.1,3.0) and those who were not physically stabilized during the procedure (OR=0.5 95% CI 0.3,1.0).

Conclusion: Delay in seeking care was common with the majority of children being presented to the dental clinic more than a month after being aware of the child’s complaint. Socio-demographics had minimal influence on observed delay for care as it were for the role of dental setting factors.

Preconception prevalence of iron, Vitamin B 12 and Folate deficiencies among women of reproductive age in a Nigerian population

2023-08-19T08:00:30+00:00

Background: Maternal healthcare is an index of national healthcare coverage. Gestational anaemia is reportedly prevalent in Nigeria mainly due to nutritional deficiency and malaria infection. Considerable effort has been directed towards addressing these challenges among pregnant women. However, preconception care is yet to be routinely practised in our locality. It is possible that lack of preconception care, especially with regards to assessment of nutritional status, could be contributing to a gestational health crisis, thus necessitating due investigation.

Methods: This study enrolled 360 women of reproductive age at the University of Calabar Teaching Hospital in southern Nigeria between November 2021 and April 2022. Simple random sampling was used to recruit consenting subjects to be part of the survey where structured questionnaires were administered. Guided by their responses, subjects who were neither on supplements at the time of the study nor in the practice of taking supplements prior to pregnancy were purposively enrolled. Blood samples were collected from each participant for assays of iron, Vitamin B12 and folate by enzyme-linked immunosorbent assay method and measurement of haemoglobin concentration by automation. Data analysis to derive frequencies and Student’s t-test comparison of means was carried out using SPSS 22.0.

Results: Folate deficiency was the least at 8.9%, followed by Vitamin B12 deficiency at 14.2% and Iron deficiency at 42.5%. Anaemia was observed to be 31.1% within the studied population. Iron deficiency alone dominated in the observed distribution pattern of the assessed deficiencies Co-deficiency of all three measured parameters stood at 4.4%.

Conclusion: Deficiencies of iron, vitamin B12 and folate are prevalent at the preconception stage in the study area. So, also, is anaemia even though the severity may be considered mild. Women in the study area are at risk of pre-existing anaemia and nutritional deficiency prior to pregnancy. Routine preconception care including assessment of nutritional status is therefore recommended in the study locality.