Tanzania Journal of Health Research https://www.ajol.info/index.php/thrb <p>Tanzania Journal of Health Research (TJHR) was established in 1997 as Tanzania Health Research Bulletin. It is a peer-reviewed journal, open to national and international community contributions. By adopting an Open Access policy, the Journal enables the unrestricted access and reuse of all peer-reviewed published research findings. It is published four times per year (January, April, July and October) by the Health Research Users Trust Fund under the National Institute for Medical Research (NIMR) in Tanzania.</p> <p>TJHR publishes original articles that cover issues related to epidemiology and public health aspects. These are but not limited to social determinants of health, the structural, biomedical, environmental, behavioural, and occupational correlates of health and diseases, and the impact of health policies, practices and interventions on the community.</p> <p>It accepts articles written in English; spelling should be based on British English. Manuscripts should be prepared by the fifth edition of the “Uniform Requirements for Manuscripts Submitted to Biomedical Journals” established by the Vancouver Group (International Committee of Medical Journal Editors, ICMJE). For additional details not covered in the ICMJE Recommendations, TJHR refers to the American Medical Association (AMA) Manual of Style (10th edition), published by the American Medical Association and Oxford University Press</p> <p>TJHR is committed to information sharing and transparency with a mission of promoting the Essential National Health Research Initiative in Tanzania and particular demand-driven health research. The journal targets readers interested in health research issues as well as non-specialist scientists, policy and decision-makers and the general public. TJHR receives articles on various areas among these are Global health and human rights, environmental health, public health informatics, chronic disease epidemiology, social determinants of health, dental public health, digital health, occupational health, mental health, epidemiology, maternal and child health, health policies, systems and management, biostatistics and methods, health economics and outcomes research, health behaviour, health promotion and communication.</p> <p>TJHR does not set explicit limits on the length of papers submitted but encourages authors to be concise to reach our audience effectively. In some cases, providing more detail in appendices may be appropriate. Formatting approaches such as subheadings, lists, tables, figures, and highlighting key concepts are highly encouraged. Summaries and single-sentence tag lines or headlines— abstracted sentences containing keywords that convey the essential messages—are also standard. The authors must sign and submit a declaration of the copyright agreement. Original scientific articles should follow the conventional structure: Introduction, Materials and Methods, Results and Discussion</p> <p><strong>Peer-reviewers Policy</strong></p> <p>Once manuscripts have been submitted to the TJHR, they undergo internal screening from the Journal Editorial Team. Manuscripts meeting submission criteria and/or standards are thereafter assigned to three peer reviewers who are given a maximum of three weeks to undertake the review and submit reviewers’ comments.</p> <p>Authors are henceforth allocated a maximum of fourteen days to respond to reviewers' comments. Such an allocated time may however may be extended upon substantive request from the authors. This turnaround time can be extended upon request from reviewers/authors. The Editor-in-Chief reviews the author's responses to ensure that the author has adequately responded to all comments raised by peer reviewers. Reviewers are then informed of the status of the manuscripts they have reviewed.</p> <p><strong>Special issues</strong></p> <p>All articles submitted are peer-reviewed in line with the journal’s standard peer-review policy and are subject to all of the journal’s standard editorial and publishing policies. This includes the journal’s policy on competing interests. The Editors declare no competing interests with the submissions which they have handled through the peer review process.</p> <p><strong>Editorial Policies: </strong>All manuscripts submitted to the <em>Tanzania Journal of Health Research</em> should adhere to the TJHR format and guidelines</p> <p><strong>Appeals and complaints: </strong>Authors who wish to appeal a rejection or make a complaint should contact the Editor-In-Chief by using the corresponding email address and not otherwise.</p> <p><strong>Conflict of Interest: </strong>All authors must complete the ICMJE Form for Disclosure of Potential Conflicts of Interest. You do not need to submit the forms to the Journal. Instead, the corresponding author should keep the forms on file if a question arises about competing interests related to your submission. The online submission system will ask you, however, to declare any competing interests for all authors, based on the ICMJE Uniform Disclosure Form. If there are no competing interests, please indicate, “None declared.”</p> <p><strong>Benefits of publishing with TJHR: </strong><em>TJHR's</em> open access policy allows maximum visibility of articles published in the journal as they are available to a wide community. </p> <p>For further information about publishing in the Tanzania Journal of Health Research please contact us via <a href="mailto:tjhr@nimr.or.tz">tjhr@nimr.or.tz</a>.</p> <p><strong> </strong></p> National Institute for Medical Research en-US Tanzania Journal of Health Research 1821-6404 Copyright for articles published in this journal is retained by the journal. Risk factors and outcomes of fetal macrosomia in Iringa municipality hospitals: A case-control study https://www.ajol.info/index.php/thrb/article/view/251514 <p><strong>Background:</strong> Factors associated with fetal macrosomia include genetics, duration of gestation, and diabetes mellitus. This condition may lead to complications for both the mother and the neonate. Thus this study aims to determine risk factors and outcomes of fetal macrosomia in comparison to those in normal-weight neonates.</p> <p><strong>Methods:</strong> A hospital-based case-control study involving 61 cases of neonates who weighed ≥ 4000g at birth and 122 controls who were neonates delivered on term with normal weight. A questionnaire was used to collect data. Data analysis was done using SPSS version 23. Bivariate and multivariate logistic regression analyses were done to identify risk factors associated with fetal macrosomia.</p> <p><strong>Results:</strong> The incidence of macrosomia was 3.26% in the Iringa municipality. Gestation age of ≥40 weeks (AOR 3.56, 95% CI= 1.65-7.69), and weight ≥80kgs post-delivery (AOR 10.22, 95% CI=2.74-38.12) were associated with delivery of macrosomia. Women with macrosomia had higher chances of prolonged labour, 2<sup>nd</sup>-degree perineal tear, and postpartum hemorrhage while their babies had hypoglycemia (AOR=8.65, 95%CI=3.23 – 23.17) compared to controls.</p> <p><strong>Conclusions:</strong> Risk factors for fetal macrosomia included a gestation age of ≥ 40 weeks, and a mother weighing ≥ 80kgs post-delivery Macrosomia is an important cause of maternal and neonatal complications.</p> Arvinder Singh Sohal Charles Kilewo Fredrick Mwakalemela Karpal Singh Sohal Copyright (c) 2024 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 500 510 Risk Factors and the Evolution of Tuberculosis Cases in the Laayoune and Tarfaya Provinces of Morocco https://www.ajol.info/index.php/thrb/article/view/257302 <p><strong>Background</strong>: Tuberculosis remains a major public health concern in Morocco. The main objective of this study was to evaluate its prevalence and analyze how risk factors influence the development of the disease and treatment failure rates in the Laayoune and Tarfaya provinces of Morocco.</p> <p><strong>Methods</strong>: This research took the form of a retrospective study of 1,333 tuberculosis cases, with all forms being combined, that were reported to the Center for the Diagnosis and Treatment of Respiratory Diseases in Laayoune between 2006 and 2012. We utilised the chi-square/Fisher's test for categorical analysis. Following this, a multivariate logistic analysis was undertaken to discern factors linked to Pulmonary/ extrapulmonary tuberculosis, presenting findings through odds ratios (OR) accompanied by 95% confidence intervals (CIs). Post-estimation analyses using the 'Lincom' command were executed to compute adjusted ORs and 95% CIs, amalgamating effects from preceding logistic models.</p> <p><strong>Results</strong>: This study found that 61.2% of patients were diagnosed with a form of pulmonary tuberculosis, while 38.8% presented extrapulmonary tuberculosis, including 12.2% lymph node cases and 15.9% pleural cases. In terms of treatment outcomes, 36.5% managed to complete their treatment, while 24.8% of pulmonary tuberculosis patients were cured. Nevertheless, 21.1% of patients needed to be transferred to other cities, 14.3% were lost to follow-up, and 3.2% died during treatment. 38.7% of patients had unfavourable outcomes, while 61.3% had favorable outcomes. A multivariate logistic analysis identified the risk factors associated with pulmonary and extrapulmonary tuberculosis and any adverse outcomes. Patients in some age groups had a significantly higher risk of pulmonary tuberculosis, when adjusted for diabetes (aOR=13.16, 95% CI[4.54-38.12]), more so once smoking was also taken into account (aOR=31.49, 95% CI [9.55-103.8]). Additionally, this study highlights how the high prevalence of pulmonary tuberculosis can be linked to smoking and a rural origin, with it underscoring a greater vulnerability among younger (aOR =7,16, 95% CI[2,34-21,83]) and elderly adults (aOR= 7,78 95% CI [2,24-27,00]), particularly those with diabetes.</p> <p>The study identifies challenges in terms of diagnostic delays and providing access to healthcare in rural areas. The study’s findings help improve our understanding of tuberculosis and will inform the development of more effective preventive strategies.</p> Nabil Ait ouaaziz Mohamed El bakkali Ouafae El yahyaoui Bahia Bouabid Mohamed Derdaki Amine Arfaoui Abd El Majid Soulaymani Ali Quyou Copyright (c) 2024 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 511 523 Advanced Maternal Age, Gestational Diabetes, and Parity: A Moderated Mediation Model for Preeclampsia https://www.ajol.info/index.php/thrb/article/view/256697 <p><strong>Background: </strong> As the trend of delaying pregnancy continues to grow globally, the prevalence of preeclampsia is expected to increase along with it, placing a significant burden on health systems. This study explores the mediating roles played by gestational diabetes and parity in the relationship between maternal age and preeclampsia.</p> <p><strong>Methods: </strong>This retrospective study considered 700 full-term pregnancies, with preeclampsia being the outcome of interest. Data were gathered from pregnant women at the El Idrissi provincial hospital in Kenitra, Morocco. We used Hayes' PROCESS macro model 7 (version 4.2) to analyze the direct effects and indirect effects in terms of moderated mediation while controlling for any family history of hypertension and hyperglycemia.</p> <p><strong>Result: </strong>The results show that gestational diabetes partially mediates the relationship between maternal age and preeclampsia with an indirect effect of 0.5275 (Boot SE = 0.2833, Boot CI%: 0.0151, 1.1258) for patients of advanced age and 0.8824 (Boot CI %: 0.0266, 1.7895) for those of very advanced age. In addition, parity moderates this relationship (advanced age x parity: β=0.2339, 95% CI: 0.1372, 0.3306; very advanced age x parity: β=0.2446, 95% CI: 0.0343, 0.4549). Finally, the mediating effect of gestational diabetes is also moderated by parity with a moderated mediation index of 0.4964 (Boot CI %: 0.0103, 1.1143) for patients of an advanced age and 0.5192 (Boot SE = 0.3677, Boot CI %: 0.0005, 1.4035) for those of a very advanced age.</p> <p><strong>Conclusion: </strong>A very advanced maternal age is an independent risk factor for preeclampsia. Multiparous women, especially older women, also have an increased risk of gestational diabetes, further increasing the risk of preeclampsia.</p> Mohamed EL Bakkali Mohamed Derdaki Ali Quyou Copyright (c) 2024 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 524 542 Knowledge, Attitudes, and Practice of Abortion among Adolescent female students in selected Secondary Schools in Moshi municipality, Kilimanjaro region. https://www.ajol.info/index.php/thrb/article/view/256479 <p><strong>Background: </strong>Induced abortion is an intentional termination of intrauterine pregnancy by medical or surgical means. Unsafe abortion is a serious public health problem most significant for adolescent females and one of the leading causes of maternal mortality globally. In Africa, unsafe abortion accounts for more than a quarter of causes of maternal mortality. Tanzania, where abortion is illegal, has the highest incidence of unsafe abortion. This study aimed to determine the knowledge, attitude, and practices towards induced abortion among adolescent female students in four selected secondary schools in Moshi municipality, Kilimanjaro region, Northern Tanzania.</p> <p><strong>Methods:</strong> A descriptive cross-sectional study was conducted among 342 secondary school girls aged 15-19 years from April to June 2019. A multistage sampling technique selected eligible participants. Semi-structured, self-administered questionnaires were used for data collection. Data were entered and analyzed using SPSS software. </p> <p><strong>Results:</strong> The mean age of respondents was 16.7(SD 3.7), and 50.6% (n= 173/342; mean knowledge score =38.9 ±1.4) had inadequate knowledge of induced abortion. More than half, 55.8% (n= 191/342; mean attitude score = 18.9 ± 1.9) had unfavourable attitudes towards induced abortion. Nineteen respondents had induced abortion from unplanned pregnancies. The two main reasons for induced abortion were to finish school (26.3%), and fear of parents’ reactions (26.3%).</p> <p><strong>Conclusion:</strong> There was no significant difference in the level of knowledge on induced abortion among study participants. However, the unfavourable attitude towards induced abortion observed is mostly influenced by cultural and religious factors. Two main reasons for induced abortion were fear of termination from school and fear of parents’ reactions. Comprehensive sexuality education, contraception counselling and provision, access to post-abortion care services, and parent-daughter communication interventions may be beneficial to prevent unplanned pregnancies may be beneficial to adolescent students attending secondary schools in this setting.</p> Frank Albert Kimbwereza Jesca Sael Nkya Andrew Lelo Mboya Bernard Njau Copyright (c) 2024 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 555 567 Obstetric factors associated with the uptake of Postnatal Care among mothers who gave birth in the last six months in Dodoma Region, Tanzania https://www.ajol.info/index.php/thrb/article/view/253590 <p><strong>Background: </strong>The World Health Organization defines postnatal care when it is given to the mother and her newborn baby immediately after the birth of the placenta and for the first six weeks of life. The majority of maternal and neonatal deaths occur during childbirth and the postpartum period which can be prevented through adequate utilization of antenatal and postnatal care services.</p> <p><strong>Objective</strong>: To assess obstetric factors associated with the uptake of postnatal care services among mothers who gave birth in the last six months in Dodoma region, Tanzania</p> <p><strong>Method: </strong>This community-based cross-sectional study was conducted among 420 study participants from January to March 2021. Logistic regression analysis was carried out to measure obstetric factors associated with the uptake of postnatal care. An adjusted odds ratio with a 95% confidence interval and p-value less than 0.05 was applied.</p> <p><strong>Results: </strong>The uptake of the recommended four postnatal care visits was 136 (32%). Mothers who received counselling during ANC were almost 4 times more likely to utilize adequate PNC services than their counterparts (AOR=3.737; 95%CI =1.176-31.882; P=0.025). Those who delivered by C/Section were almost 12 times more likely to utilize PNC services adequately (AOR=11.913; 95%CI =3.0901- 45.933; P=0.000). Awareness of the PNC schedule was 18 times more likely to use the PNC services adequately compared with their counterparts (AOR=18.092; 95%CI =8.239- 39.726; P=0.000). Awareness of maternal danger signs was almost 5 times more likely to utilize PNC service adequately than their counterparts (AOR=4.691; 95%CI =2.168- 10.153; P=0.000).</p> <p><strong>Conclusion: </strong>The overall uptake of adequate postnatal care in the study area was low. Obstetric factors were found as strong predictors of adequate PNC service uptake among study participants. There is a need to strengthen routine health education during the antenatal and postpartum periods to enhance adequate PNC services uptake among women.</p> Agatha F Ngowi Neema Msemwa Nyasiro Gibore Selestine Ngoma Copyright (c) 2023 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 568 581 Barriers to early postnatal care attendance among women in Ubungo Municipality in Tanzania: A qualitative study https://www.ajol.info/index.php/thrb/article/view/247839 <p style="margin: 0cm; text-align: justify;"><strong><span lang="EN-US" style="font-size: 11.0pt; color: #0e101a;">Introduction: </span></strong><span lang="EN-US" style="font-size: 11.0pt; font-family: 'Candara',sans-serif; color: #0e101a;">Adequate utilization of postnatal care services is associated with improved maternal and neonatal health outcomes. The World Health Organization recommends postnatal women attend postnatal care as early as seven days after delivery because most maternal deaths occur within 7 days of the postnatal period. However, many postnatal women attend postnatal care very late during the 42 days and mainly for child immunization purposes. Little information is known on barriers to postnatal women who delay initiating postnatal care clinics for seven days post-delivery. This study explored barriers to attending early postnatal care among women attending early postnatal care services in Ubungo municipality, Dar es Salaam. </span></p> <p style="margin: 0cm; text-align: justify;"><strong><span lang="EN-US" style="font-size: 11.0pt; font-family: 'Candara',sans-serif; color: #0e101a;">Methods:</span></strong> <span lang="EN-US" style="font-size: 11.0pt; font-family: 'Candara',sans-serif; color: #0e101a;">A cross-sectional study design using a qualitative approach was used to explore factors associated with early postnatal care attendance among postnatal women in Ubungo Municipal, Dar es Salaam, Tanzania. Study participants were purposively selected. In-depth interviews were used to collect data. Audio-recorded interviews were transcribed verbatim and translated into English. Thematic analysis approach was used to excerpt barriers to delaying seeking early postnatal care services in Ubungo Municipality.</span></p> <p style="margin: 0cm; text-align: justify;"><strong><span lang="EN-US" style="font-size: 11.0pt; font-family: 'Candara',sans-serif; color: #0e101a;">Findings:</span> </strong><span lang="EN-US" style="font-size: 11.0pt; font-family: 'Candara',sans-serif; color: #0e101a;">The finding revealed a lack of awareness of the appropriate time to start early postnatal care visits and the recommended number of postnatal visits, the perception of postnatal women that the postnatal period is a normal condition that does not require health personnel’s attention, thus the perception that no need to initiate early postnatal care clinics if they were not sick. Similarly, long waiting times, transport costs, and healthcare providers’ attitudes were<strong><span style="font-family: 'Candara',sans-serif;"> </span></strong>major reasons reported by postnatal women to contribute to late postnatal care attendance. Thus, healthcare providers should continue providing education to pregnant women on when and the importance of attending early postnatal care.</span></p> <p> </p> <p><strong> </strong></p> Idda Hubert Mosha Rehema Timotheo Panga Copyright (c) 2023 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 582 595 Coping with Challenges and Aftermath of COVID-19 among Street Food Catering Operators in Dodoma City: Lessons and Policy Implications https://www.ajol.info/index.php/thrb/article/view/241093 <p><strong>Introduction: </strong>Street food catering forms an important part of the food system in urban areas of Tanzania, and other parts of Africa, particularly by providing nutrition for poor consumers and means of livelihood for those who operate them. However, governments have for a long time excluded them from the traditional safety-net measures enjoyed by other traders whenever there is a major economic crisis in the society such as the effects of COVID-19 pandemic. With the devastating effect of COVID-19, it is important to evaluate how the sector reacted and coped during and after the pandemic crisis. This understanding is important if we need to formulate effective recovery policies and strategies. This paper examined the street food catering in Dodoma city in Tanzania. Specifically, the paper sought to determine the characteristics of people who operate such businesses to identify challenges imposed by COVID-19 analyze the adopted coping strategies and attempt to recommend appropriate recovery policies and strategies.</p> <p><strong>Methods: </strong>The study was conducted in Dodoma City. The study area was purposively selected because of its nature of being fast-growing and of its recent status as the national capital of the United Republic of Tanzania. A cross-sectional research design was used to collect data from 113 operators or owners of street food catering places, who were randomly selected. A questionnaire was used to collect data. Descriptive statistics was used to analyze data.</p> <p><strong>Results: </strong>Results indicated that the majority of the operators were in age between 25 and 44 years. The most common short-term and long-term challenges of COVID-19 on street food catering included a reduction in the number of customers and deterioration of trade, respectively. The most common coping strategies included shortening the supply chain, use of cash on delivery and digitalized marketing systems.</p> <p><strong>Conclusion: </strong>Contactless mobile payments have proved to have a clear advantage during the pandemic. more importantly, lowering the money transfer charges. Both the challenges and the resulting coping strategies tend to comply with what has been happening globally for the impact of the COVID-19 pandemic, and therefore much of what has been recommended elsewhere internationally may likely apply to the case of street food catering in Dodoma city and Tanzania.</p> Emiliana Assenga John M. Msuya Copyright (c) 2023 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 596 604 Oral Hygiene Status and Experience of Orthodontic Appliance Breakage Among Adolescents and Young People Treated at Smiles Dental Clinic, Dar es Salaam, Tanzania https://www.ajol.info/index.php/thrb/article/view/255374 <p><strong>Introduction:</strong> Treatment of malocclusion with fixed orthodontic appliances can create some stagnations that harbour plaque with concomitant obstruction to conventional oral hygiene procedures.</p> <p><strong>Objectives: </strong>The purpose of the present study was to assess oral hygiene status, and determine its effect on treatment duration and orthodontic appliance failure among adolescent and young orthodontic clients treated at Smile Dental Clinic.</p> <p><strong>Methods: </strong>A retrospective study covering the period between 2019 and 2022 was conducted at Smile Dental Clinic. A total of 176 dental records of adolescent and young orthodontic clients aged 10 to 24 years were accessed to collect information on oral hygiene status, number of dental visits, missed scheduled appointments, socio-demographics and status of brackets and molar tube breakages.</p> <p><strong>Results:</strong> A high proportion of female (71.4%) and young orthodontic clients aged 20 – 24 years (50.6%) had good oral hygiene. A significantly high proportion of clients in boarding schools (67.8%) and those who frequently missed scheduled appointments (91.9%) had poor oral hygiene status. Treatment duration was longer for clients with poor oral hygiene (30.5 months versus 26.8 months) but those with good oral hygiene made significantly fewer numbers of dental visits (8 versus 10). Clients with poor oral hygiene were 9 and 14 times more likely to experience broken molar tubes and broken brackets respectively. </p> <p><strong>Conclusion: </strong>Oral hygiene of adolescent and young orthodontic clients treated is sub-optimal and affects the rate of orthodontic appliance failure and duration of fixed orthodontic treatment duration. Increased exposure to oral hygiene messages through frequent dental visits may help to motivate clients to maintain good oral hygiene.</p> Kijakazi Mashoto Ambege Jack Mwakatobe Copyright (c) 2024 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 605 611 Complementary Feeding Practices and Psychosocial Care Level of Nursing Mothers of Under-five Children in Ogun State. https://www.ajol.info/index.php/thrb/article/view/255414 <p><strong>Introduction: </strong>Psychosocial care is the process by which caregivers (mothers, siblings, fathers and childcare providers) are meeting the needs of infants in terms of adequate nutrition, emotional, social, mental and healthcare for promoting healthy growth and development. This study therefore was aimed to assess the influence of psychosocial care during complementary feeding among mothers</p> <p><strong>Methodology:</strong> It was a cross-sectional designed, and the sample size was statistically calculated to arrive at 385 mothers. A structured and self-administered questionnaire was used to collect information on socio-economic status; psychosocial care during complementary feeding practices and WHO feeding indicators was used to assess feeding practices of the mothers. Data were analysed using both descriptive statistics and inferential statistics.</p> <p><strong>Results</strong>: The study showed that 52.1% of respondents were between aged 20 to 29 years, 88.1% were married, while others were either single or divorced mothers. The feeding indicator showed that 21.5% of respondents met the Minimum Adequate Diet. Half of the respondents (50%) monitored amount of food consumed by the children, while 12.4% encouraged the children to finish the served food. The study established that low proportion of mothers exhibited good (30.9%) psychosocial care during complementary feeding, while others exhibited fair (68%) and bad (1.1%), respectively. However, there was insignificant relationship between maternal psychosocial care and complementary feeding practices (<em>χ</em><sup>2</sup>; <em>p</em>&gt;0.05); whereas, there were significant differences between maternal psychosocial care and maternal age (<em>χ</em><em><sup>2</sup></em>; <em>p</em>=0.043) as well as religion (<em>χ</em><em><sup>2</sup></em>; <em>p</em>=0.031).</p> <p><strong>Conclusion:</strong> The study concluded that low proportion of mothers had good maternal psychosocial care during complementary feeding. Therefore, maternal nutrition education should be encouraged during antenatal and post-natal clinics.</p> Remilekun Akinrinmade Beatrice Olubukola Ogunba Opeyemi Racheal Dagunduro Esther Mercy Amanam Copyright (c) 2024 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 612 623 Antimicrobial Susceptibility Pattern of Bacterial Isolates and Associated Factors for Bacteriuria among Cancer Patients Attending Ocean Road Cancer Institute, Tanzania https://www.ajol.info/index.php/thrb/article/view/251038 <p><strong>Background:</strong> Cancer patients are among people at high risk of infection with antibiotic-resistant bacteria causing bacteriuria as a consequence of cancer-induced immunosuppression and complex cancer treatments.</p> <p><strong>Methodology:</strong> A hospital-based cross-sectional study involving the quantitative method of data collection was carried out to determine the prevalence of bacteriuria, antibacterial susceptibility pattern of the causative isolates and associated risk factors among cancer patients attending Ocean Road Cancer Institute. A convenient sampling technique was used to obtain 422 cancer patients. A urine sample was collected to establish the prevalence of bacteriuria and the antibacterial susceptibility pattern of the isolates. Interviews were carried out with study participants using a questionnaire to collect social-demographic data. A clinical record collection form was used to collect clinical data of each participant. Data analysis was performed using descriptive statistics (mean, frequencies and proportions) and binary logistic regression by using SPSS software version 20.</p> <p><strong>Results:</strong> The prevalence of bacteriuria among asymptomatic and symptomatic cancer patients was 3.6% and 14.0%, respectively. <em>Escherichia coli</em> accounted for a large proportion of all Gram-negative bacteria isolates (53%). The other Gram-negative bacteria were <em>Pseudomonas species</em> (16%), <em>Acinetobacter species</em> (15%), <em>Klebsiella species</em> (10%), <em>Enterobacter species</em> (3%), <em>Proteus mirabilis</em> (1.5%), and <em>Aeromonas species</em> (1.5%). <em>Enterococcus species</em> contributed roughly two-thirds of all Gram-positive bacteria isolates (67%). Multidrug resistance (MDR) was found in 27 (75%) of <em>Escherichia coli </em>isolates. The factors associated with bacteriuria in cancer patients were sex, patients’ settings, history of antibiotic use and occupation.</p> <p><strong>Conclusion:</strong> Bacteriuria, particularly that caused by MDR <em>Escherichia coli</em>, is common among cancer patients at Ocean Road Cancer Institute and is associated with sex, patients’ settings and occupation.</p> Mwanaisha Abdallah Ibrahim Mauki Eligius Lyamuya Copyright (c) 2023 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 624 641 Prevalence and Risk factors associated with Sexually Transmitted Infections among Women of reproductive age attending reproductive and child health clinics in Dodoma and Dar es Salaam Tanzania https://www.ajol.info/index.php/thrb/article/view/256148 <p><strong>Introduction: </strong>Sexually transmitted infections (STIs) continue to cause reproductive morbidity worldwide. Socio-demographics and behaviour influence the likelihood of contracting reproductive tract infections and significantly predict STI acquisition. Determining prevalence and analysing the population’s socio-demographic and sexual behaviour can assist in determining its risk profile and prevention strategies. This study aimed to determine the prevalence and risk factors of curable STIs, bacterial vaginosis and vaginal candidiasis among women of reproductive age attending reproductive and maternal health clinics in Dar es Salaam and Dodoma.</p> <p><strong>Method:</strong> This was a cross-sectional study where high vaginal and endocervical swabs from 400 women were collected and tested for the presence of reproductive tract infections using culture, wet mount preparation, and Gram stain. Women were interviewed on sociodemographic factors, sexual behaviours and clinical symptoms using a pretested questionnaire. A chi-square test was conducted to determine the factors associated with curable STIs. Logistic regression was done to determine independent predictors for STIs using SPSS version 23.</p> <p><strong>Results:</strong> Prevalence of <em>Neisseria gonorrhoea</em>, <em>Trichomonas vaginalis</em>, vaginal candidiasis and bacterial vaginosis was 2.5%,9.8%,13.5%, and 23.3% respectively. High education level was associated with a reduction in the likelihood of having STIs (AOR=0.41, 95%CI: 0.17-0.97). Likewise, consistent condom use was associated with a reduction in the likelihood of having STIs (AOR=0.16, 95% CI: (0.073-0.34). Participants with the recent history of STI were more likely to have STIs (AOR=2.4, 95%CI:1.05-5.27).</p> <p><strong>Conclusion:</strong> High prevalence of <em>Trichomonas vaginalis,</em> bacterial vaginosis and vaginal candidiasis in studied women calls for an intervention to prevent infection complications. We recommend health education and screening interventions to all reproductive-age women to reduce transmission of curable STIs and bacterial vaginosis.</p> Rehesina Hassan Senkoro Juma Hussein Lucy Namkinga Copyright (c) 2024 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 642 655 Acute Toxicity, Immunomodulation Activities, and Phytochemical Profiles of Sapium ellipticum Stem Bark Aqueous Extract https://www.ajol.info/index.php/thrb/article/view/248330 <p><strong>Background: </strong>The stem bark of <em>Sapium ellipticum</em> is a medicinal plant frequently utilized in traditional medicine for treating a range of ailments. Despite its widespread use, there is limited data regarding the safety and immunomodulatory potential of its extract.</p> <p><strong>Objective:</strong> This investigation was conducted to assess the phytochemical profile, acute toxicity, and immunomodulatory activity of the aqueous extract of <em>S. ellipticum</em> stem bark.</p> <p><strong>Methods: </strong>Acute toxicity was assessed using the Organization for Economic Cooperation and Development (OECD) guidelines at doses of 123, 300, and 2000 mg/kg. Immunomodulatory activity was evaluated using real-time quantitative polymerase chain reaction (RT-qPCR) to measure the expression levels of IL-10, IL-6, IL-1Ra, and IL-1β. Phytochemical profiling was carried out using liquid chromatography-tandem mass spectrometry (LC-MS/MS).</p> <p><strong>Results: </strong>The aqueous extract of <em>S. ellipticum</em> stem bark did not produce any hematological or biochemical signs of toxicity, indicating that the lethal dose was greater than 2000 mg/kg. The extract showed potential as an immunomodulator, with downregulation of IL-6 and IL-10 and upregulation of IL-1Ra and IL-1β. Phytochemical analysis revealed the presence of anti-inflammatory compounds, such as Fraxetin and L-carnitine. However, the extract also showed upregulation of the pro-inflammatory cytokine IL-1β, with no inflammatory compounds identified.</p> <p><strong>Conclusion: </strong>Findings from the present study suggest aqueous extract of <em>S. ellipticum</em> stem bark is safe up to a dose of 2000 mg/kg, and shows immunomodulatory potential through the presence of anti-inflammatory compounds. Furthermore, provides a foundation for future research on the potential medicinal uses of this extract.</p> Rose Justus Masalu Cyprian Beda Mpinda Copyright (c) 2023 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 656 671 Statistical analysis and modelling of the prevalence of malaria in Nyasa district; Tanzania https://www.ajol.info/index.php/thrb/article/view/254980 <p><strong>Background:</strong> Demographic, social economic factors influencing the prevalence of Malaria in Nyasa District and the level of knowledge attitude and prevention on malaria disease incurred by the domicile of Nyasa district.</p> <p><strong>Objective:</strong> The demographic conditions affecting the spread of malaria and precautions they take to prevent the disease. Determine the factors affecting the malaria gender-wise.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted using questionnaire on 350 householders selected randomly from two distinguishable wards of Nyasa municipal, Tanzania. Prevalence, incidence, factor analysis to identify knowledge and attitude, binary logistic model on general and gender-wise identifying the significant factors were traced out. Using SPSS 14.5 software model and its adequacy, factors and its validity are verified.</p> <p><strong>Results:</strong> The prevalence rate of malaria in Nyaza is 24.9%, while it is 16.7% in the hills and 36% in sea shores. The ratio of affecting malaria among males and female is 41: 47 and among poor: middle class: Upper class =9.3 :1:.001. The government provide bed nets for 64.1% but 94% are not getting free hospital facilities. About 90% know that malaria is a transmitting killer disease and its symptoms, preventive measures and mosquito breeding timings. Using bed nets (95%), removing stagnant water (71.7%) and cleaning the environment (62%) are the general measures preferred by people. 17% prefer burning coils or repellents and 28% keep meshes to doors and windows. Child malaria was diagnosed by 61.4% families, If the number of family members is more than 3, the chance for affecting malaria is 0.62, There is a need for hospital stay in many malaria patients (Male 38.8% and Female 47.7%). 95% pregnant woman take hospital advice of which 50% go only in the third month and about 60% are going to know the condition of fetus and mother as well as prevent CDs. 75% of malaria-affected people belong to informal or primary education groups, 89% are poor and 10% are middle-class people. Knowledge of prevention and control of malaria depends on 3 factors use, official service, and self-awareness. Similarly, attitude towards prevention and control also depends on 3 factors- seriousness, lack of awareness, and practicability. Binary logistic model on affecting malaria depends on 5 significant variables – altitude of land, sex, age, income, education</p> <p><strong>Conclusion:</strong> The prevalence of malaria is moderately high in Nyasa compared to the national prevalence rate. Women and children are mostly affected by the disease. Most dwellers were aware of the seriousness of the disease and using bed nets as a preventive measure. People are also keen to destroy stagnant water sources and clean the premises to keep away grass and bushes. The important dependent demographic factors for the incidence of malaria were sex, age, depriving conditions of family, lack of sufficient education and the location of areas like seashores or hills.</p> Ramkumar Balan Thandiakkal Copyright (c) 2023 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 672 685 Persistent Mullerian Duct Syndrome: A case report https://www.ajol.info/index.php/thrb/article/view/238223 <p>The Müllerian duct is the structure that later develops into the female reproductive tract during embryology. It usually obliterates in males. Persistent Müllerian duct syndrome is a disorder characterized by the presence of female reproductive organs in a male individual. The common presentations in males are undescended testes or inguinal hernias. The uterus and fallopian tubes are noted during surgery. This syndrome is due to deficiency of fetal anti-Müllerian hormone which is caused by mutations of the gene for anti-Müllerian hormone or anti-Müllerian hormone receptor. The testosterone levels are normal that’s why the development of external genitalia is normal. Imaging investigations are the key to establishing the diagnosis. The treatment modality is surgical for replacing the gonads into their normal position and probably a hysterectomy. We reported a case of a 30-year-old male presented with painful, tender, firm and mobile supra pubic swelling. On urogenital examination he had a well-developed penis with no urethral meatus, the scrotum divides into two parts forming labia majora-like structure with an opening in between. The testicles were not palpable. Imaging investigations reveal the cystic pelvic mass and bilateral testes were not visualized. On laparotomy, a distended uterus with bilateral fallopian tubes was found. The uterus consisted foul smelling pus and the testicles were found. Drainage of pus and then a hysterectomy was done. The patient did well and was discharged home. Globally a few cases of Persistent Müllerian duct syndrome were reported but with a variation of manifestation. Persistent Müllerian duct syndrome is a rare condition.</p> Oscar Kivike Mario Nyamba Jerry Valerian Mishael Phares Copyright (c) 2024 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 686 691 Efficacy of central-shielding external beam radiotherapy for FIGO stage IB2 carcinoma of the cervix: A case report https://www.ajol.info/index.php/thrb/article/view/239661 <p><strong>Introduction: </strong>Cervical cancer is now the leading cause of malignancy-related morbidity and mortality in sub-Saharan Africa. Concurrent chemo-radiation using cisplatin alone, or in combination with 5-fluorouracil is considered the main treatment for FIGO stage 1B2 disease or higher for patients who cannot or choose not to have surgery.</p> <p><strong>Objective: </strong>To report the efficacy of central-shielding external beam radiotherapy in the treatment of grade 1, FIGO stage 1B2 carcinoma of the uterine cervix.</p> <p><strong>Case description:</strong> A 55-year-old female reported a history of backache and post-coital pain associated with vaginal bleeding for three months. She was diagnosed with cervical cancer FIGO stage 1B2 and chose not to have surgery. </p> <p><strong>Method: </strong>A computed tomography scan simulation and three-dimensional treatment planning were done, and a total dose of 45Gy of EBRT was administered in fractions for five weeks. Control ultrasonography was then performed to assess the efficacy of CS-EBRT before initiating intracavitary brachytherapy.</p> <p><strong>Results:</strong> Five weeks of CS-EBRT showed significant tumor regression and improvements in health status.</p> <p><strong>Conclusion:</strong> A well-planned central-shielding radiotherapy alone may be curative in selected patients with cervical cancer FIGO stage IB2. Large-scale studies are warranted to compare the efficacy of concurrent chemoradiation with that of radiotherapy in this patient population.</p> Agapiti Chuwa Copyright (c) 2024 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 692 696 Annular pancreas as a rare cause of gastric outlet obstruction in a 16-year-old male patient: A case report https://www.ajol.info/index.php/thrb/article/view/248504 <p>Annular pancreas (AP) is a rare cause of congenital gastric outlet obstruction that is usually discovered during the neonatal period, but clinical severities can vary over a wide range and definite diagnosis could be delayed until late childhood or adulthood. We report here a case of AP detected in a 16-year-old malnourished male patient who was admitted because of non-bilious vomiting and epigastric fullness after intake of food which was relieved after vomiting. A contrast-enhanced CT scan of the abdomen confirmed the diagnosis of AP. At operation, a complete obstruction of the second part of the duodenum was found, caused by an annular pancreas. No other congenital anomaly of the intra-abdominal organs was noted. He successfully underwent retro-colic gastro-jejunostomy with uneventful postoperative recovery. Though a rare finding, AP should be considered as a differential diagnosis in patients presenting with gastric outlet obstruction after excluding common causes. Both the rarity of this congenital abnormality and its successful correction by surgical means have prompted us to make the following presentation.</p> Bonephace Tresphory Agness Mlawa Geofrey Giiti Andrea Mombo Giacomo Antonini Phillipo Chalya Copyright (c) 2024 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 Pregnancy Complications in Women with Uterine Fibroids and the Role of Stem Cells https://www.ajol.info/index.php/thrb/article/view/255844 <p><strong>Introduction: </strong>Uterine fibroids are a prevalent and benign tumor in the uterine wall that commonly affects women of reproductive age. These growths can lead to adverse pregnancy outcomes. This study aims to investigate the crucial role of myometrial stem cells in the development of fibroids and their impact on pregnancy complications.</p> <p><strong>Methods: </strong>The following terms were used in the PubMed, Embase, Scopus, ScienceDirect and MEDLINE databases to search for articles in English: Uterine Fibroids, Myometrial stem cells, Pregnancy complications, and Hormones. The articles selected were systematic reviews, meta-analyses, randomized controlled trials, and reviews. These data were searched from 2016 to May 2023.</p> <p><strong>Results: </strong>The study found that myometrial stem cells differentiated into smooth muscle cells, contributing to fibroid development. These fibroid stem cells had distinct hormone receptor characteristics. Hormonal imbalances and genetic predisposition led to the uncontrolled growth of myocytes, which played a central role in the formation of fibroids. Estrogen and progesterone, which support</p> <p> uterine tissue growth, were identified as key factors in this process. In addition, ECM remodeling, angiogenesis, inflammation, and dysregulated signaling pathways were shown to be implicated in fibroid development.</p> <p><strong>Conclusion: </strong>Uterine fibroids have a significant impact on pregnancy outcomes, leading to various complications such as preterm birth, cesarean delivery, placental abnormalities, and heavy bleeding. The severity of these complications depends on factors like fibroid size, location, and individual factors. Therefore, understanding the complex interplay of factors, including the involvement of myometrial stem cells, hormonal influence, inflammation, and ECM changes, is crucial for improving patient care. The knowledge gained from this study has the potential to inform targeted therapies and interventions for women with fibroids during pregnancy, ultimately improving the health of both mother and baby. However, further research is needed to elucidate precise mechanisms and develop more effective treatments for managing pregnancies complicated by fibroids.</p> <p> </p> Ramakrishnan Veerabathiran Jethendra Kumar Muruganantham Copyright (c) 2023 Tanzania Journal of Health Research 2023-12-30 2023-12-30 25 1 543 554 10.4314/%u.v25i1.%c