Tanzania Journal of Health Research

Navigating Barriers: Challenges and Strategies for Adopting Artificial Intelligence in Qualitative Research in Low-Income African Contexts

Kahabi Ganka Isangula — 2025-04-17

Introduction: AI is transforming qualitative research. It enhances efficiency, accuracy, and depth in studies. Technologies like machine learning (ML), natural language processing (NLP), and large language models (LLMs) simplify tasks like transcription, coding, and thematic analysis. However, in low-income African settings, there are barriers to AI adoption. These include ethical concerns, infrastructure limitations, financial constraints, and technical skill gaps. Issues around data privacy and the dehumanization of research also add challenges.

Methods: This paper explores the challenges and opportunities of AI in qualitative research in low-income African contexts. It uses a descriptive approach, reviewing literature and personal experiences from rural African settings. The paper highlights how AI can democratize research, promote multilingual inclusivity, and improve analysis.

Results and Recommendations: To integrate AI effectively, capacity-building, ethical frameworks, infrastructure investments, community engagement, and partnerships are crucial. If these challenges are addressed, AI could empower researchers in low-resource settings. This would lead to more relevant, equitable qualitative studies and help tackle Africa's unique challenges. AI can drive informed decision-making in public health, education, and social cohesion.

STEPS Survey of non-communicable diseases, mental health, oral health and injuries in Tanzania: methodology and study population

Gibson Benard Kagaruki — 2025-04-17

Introduction: The burden of non-communicable diseases (NCDs) remains a public health concern in Tanzania, contributing to high morbidity and mortality. STEPS surveys conducted in 2011 and 2012 in Zanzibar and mainland Tanzania indicated a high prevalence of NCDs and related risk factors. This paper describes the methodology of the 2023 STEPS survey on NCD risk factors and presents the baseline characteristics of the survey respondents.

Objectives: The survey was conducted to provide nationally representative data on the NCD risk factors in Tanzania, Mainland, and Zanzibar

Methods: The survey was a household-based study that employed a three-stage cluster sampling design. The target population consisted of all individuals, both women and men, aged 18 to 69 years, who were usual residents of the selected households. The Tanzania Population and Housing Census 2022 was used as the sampling frame for the 2022/2023 STEPS survey. The overall estimated sample size was 4,320 respondents (Mainland = 3,780 and Zanzibar = 540). Data were collected on the levels of major NCD risk factors, including physical inactivity, unhealthy dietary practices, smoking, harmful alcohol consumption, depression, and overweight/obesity, using the standardized WHO STEPS methodology. Data were collected electronically using Open Data Kit (ODK)-based eSTEPS software. The survey was conducted from September 2022 to September 2023. Ethical approval to conduct the study was obtained from the National Health Research Ethics Committee for Tanzania Mainland, the Zanzibar Health Research Ethics Committee, and the Second Vice President's Office for Zanzibar.

Results: Estimates of NCD prevalence and associated risk factors and determinants will be reported.

Conclusion: This survey highlighted the prevalence estimates of hypertension, diabetes, mental health issues and depression, road traffic injuries, non-road traffic accidents, and the burden of cardiovascular risks in Tanzania. Risk factor analysis identified and quantified common behaviours and conditions that increase the likelihood of developing non-communicable diseases. Analysing these risk factors will help identify high-risk groups and inform targeted prevention strategies.

Mosquito larvae abundance and adult productivity in an area of intensive malaria control in northeast Tanzania

Eliningaya Kweka — 2025-04-17

Introduction: Targeting mosquito larval stages for malaria vector control is gaining more popularity in sub-Saharan Africa. Here we assessed mosquito species diversity and the effects of physicochemical parameters, distance to human habitation, and land use types on the productivity of larval habitats, with a focus on Anopheles gambiae (sensu lato).

Methods: A total of 21 habitats were surveyed for 15 weeks to evaluate species-specific oviposition preferences and species composition of An. gambiae (s.l.). Habitats were classified as drainage ditches, swamps, and man-made wells, whereas land types were classified as shrubs, farmland, and pasture. The distance to the nearest house and the habitat's physical characteristics and physicochemical parameters were recorded.

Results: A total of 4511 mosquito larvae were sampled during the survey period. Of these, 54.93% were An. gambiae (s.l.), 2.09% were An. funestus, and 42.98% were Culex quinquefasciatus. Among 2397 larvae of Anopheles mosquitoes sampled, 501 were identified to the species level using the TaqMan genotyping assay. A total of 251(50.10%) Anopheles specimens identified were An. arabiensis,173(34.53%) were An. gambiae (s.s.) and 17(3.39%) were An. coustani; DNA was not successfully amplified for 60 (11.98%) An. gambiae (s.l.).

Conclusion: The presence of An. gambiae larvae was positively correlated with habitats located nearest to houses.

A Rare Case of Iron Deficiency Anemia Manifesting with Xylophagia

Adam Michael Kilungu — 2025-04-17

Pica is an unusual condition in which patients develop cravings for non-nutritive substances. We present a 34-year-old female with severe iron deficiency anaemia and xylophagia (paper eating) who was treated with iron supplements and folic acid. Her anaemia symptoms and pica were resolved after three months, highlighting the importance of addressing nutritional deficiencies in managing pica.

Key message: A rare case of iron deficiency anaemia with xylophagia was successfully managed through a multidisciplinary approach involving a haematologist, psychiatrist, and gynaecologist. This highlights the importance of collaborative care in addressing complex conditions and ensuring comprehensive treatment.

Influence of occupational cement exposure on inflammatory markers, hepatorenal function indices and oxidative stress markers among male cement handlers in Ilorin-Metropolis

Godwin Adunmo — 2025-04-17

Introduction: Cement dust is considered one of the most dangerous occupational hazards worldwide. Studies link cement dust exposure to respiratory disorders and cancer, but there is limited literature on its effect on inflammatory markers, hepato-renal function indices, and oxidative stress markers. This study examines how occupational exposure to cement dust affects different biochemical parameters in cement handlers in Ilorin Metropolis, an urban region in North-Central Nigeria.

Methodology: A total of one hundred and twenty (120) cement handlers and sixty (60) unexposed individuals aged 25 - 60 were recruited for the study after obtaining written consent. 10 ml of fasting blood was collected and dispensed into the appropriate sample bottle. Serum levels of creatinine, urea, aspartate aminotransferase (AST), alanine aminotransferase (ALT), total protein, albumin, alkaline Phosphatase (ALP) and Malondialdehyde (MDA) were measured spectrophotometrically, using commercially prepared reagents. C-reactive protein and cystatin-C levels were determined using ELISA methods. The modified diet in renal disease (MDRD) formula was utilized to calculate the estimated glomerular filtration rate (eGFR).

Results: When compared with controls, the cement handlers’ sera exhibited elevated levels of Creatinine, Urea, Cystatin C, MDA, AST, ALT and C-reactive protein. Conversely, levels of albumin, total protein, and eGFR were decreased in cement handlers compared to controls.

Conclusion: This study suggests that cement handlers are more susceptible to impaired kidney and liver function due to cement dust exposure. Although the exact mechanism remains unclear, increased oxidative damage and inflammation play significant roles in the observed physiological derangement.

Molecular characterization of urogenital schistosomiasis in Shinyanga and Misungwi districts, North-Western Tanzania

Yasinta Sylivester — 2025-04-17

Background: Schistosomiasis is a major parasitic disease, second only to malaria in its global socio-economic impact. In regions like Tanzania, praziquantel (PZQ) is the primary treatment. Recent studies in West Africa suggest the presence of Schistosoma hybrids, potentially influencing the disease's epidemiology. Understanding the prevalence of urogenital schistosomiasis and schistosome hybrids is essential for improving targeted interventions and disease management strategies. This study aimed to investigate the effect of praziquantel on urogenital schistosomiasis prevalence and assess the molecular epidemiology of both Schistosoma haematobium and its hybrid with Schistosoma bovis.

Methods: In a cross-sectional study, urine samples from 1,910 individuals in southern Lake Victoria villages were tested for S. haematobium eggs using urine filtration and microscopy. Genetic analysis of individual miracidia from egg-positive samples was conducted using Rapid Diagnostic Multiplex PCR.

Results: Pre-treatment, S. haematobium prevalence was 6.4%, with significant variation across villages. Post-treatment prevalence dropped to 0.3%, indicating a praziquantel cure rate above 90%. Hybrid infections of S. haematobium and S. bovis were detected in one village at a prevalence of 3.5%, all successfully treated with praziquantel. These results highlight praziquantel’s effectiveness against both S. haematobium and hybrid infections.

Conclusion: Praziquantel treatment resulted in a significant reduction in S. haematobium prevalence and the complete elimination of S. haematobium-S. bovis hybrids, indicating successful disease burden reduction. Further studies are needed to evaluate the long-term effectiveness and broader implications of this intervention.

Ebola Virus Disease Outbreak Prevention and Control Preparedness: A Qualitative Experience from High-Risk Regions in Tanzania

Hussein Mohamed — 2025-04-17

Introduction: Although rare, Ebola virus disease is one of the deadliest viral infections, with a case fatality rate of up to 50%. The virus was first identified in 1976 in the Democratic Republic of the Congo. Since then, outbreaks have been reported in various African countries, primarily in Central Africa, with the largest and most complex outbreak occurring between 2014 and 2016. The most recent outbreak was in Uganda in 2022, which posed a significant public health threat to both the Ugandan population and neighbouring countries, including Tanzania, due to the high risk of cross-border transmission caused by daily movement of people. However, there is limited information on how well-prepared communities in high-risk regions are in the event of an Ebola virus disease outbreak.

Method: This ethnographic study investigated community preparedness for an Ebola virus disease outbreak and the preventive measures in place in high-risk regions of Tanzania, including Kagera, Mwanza, Songwe, and Kigoma. Data were collected through observations, interviews, and focus group discussions.

Results: Community members showed awareness of Ebola prevention through risk communication and community engagement efforts. However, observations revealed a disconnect between this awareness and cultural practices. Many continued engaging in risky behaviours, such as large gatherings, physical contact (e.g., hugging and handshaking), and traditional funeral practices, which increased transmission risks. Healthcare workers at facilities and ports of entry were well-prepared, with preventive measures in place.

Conclusion: The study findings indicate that community members in high-risk regions for Ebola transmission possess some knowledge of the disease and its preventive measures. However, further efforts are needed to ensure that individuals are not only well-informed but also implementing these preventive measures in preparation for a potential outbreak.

Factors Influencing Modern Contraceptive Use among Women of Reproductive Age in Rural Areas of Tanzania

Anicet Rwezaula — 2025-04-17

Introduction: The use of modern contraceptives among women of reproductive age in rural areas helps space pregnancies, reducing the risk of complications and enhancing maternal health. Identifying the factors influencing the use of modern contraceptives in rural settings is crucial for designing effective and appropriate interventions.

Objectives and Methods: This study aimed to identify factors associated with the use of modern contraception among women of reproductive age in rural Tanzania. Data was sourced from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2022 TDHS-MIS), available at https://www.dhsprogram.com. The data were analyzed using STATA Version 16, with a multilevel logistic regression model as the statistical approach.

Results: The findings revealed that more than two-thirds of rural women did not use modern contraceptives, while one-third did. The study identified several factors associated with contraceptive use, including the women's education level, their partner’s education, exposure to family planning information through radio or newspapers/magazines, decision-making regarding contraceptive use, and the number of living children.

Conclusions and recommendations: The study concludes that modern contraceptive use among rural women in Tanzania is low. To address this, the government, in collaboration with stakeholders, should implement sensitization and educational programs to change misconceptions about contraceptives. Additionally, enhancing the capacity of local health workers to provide accurate information and counseling is essential to increasing contraceptive use in rural areas.

Comparative study on genital yeasts diversity isolated from rural and urban women with vaginitis attending antenatal and gynecology clinics in Southern Highland regions of Tanzania

Lucy Namkinga — 2025-04-17

Background: Vaginal yeast infections are a common health concern for women worldwide. While Candida albicans remains the primary causative agent, the prevalence of non-albicans Candida species and other yeasts is increasing. This study aimed to compare the diversity of genital yeasts isolated from rural and urban women with vaginitis in the Southern Highlands regions of Tanzania and evaluate the impact of socio-economic and environmental factors on yeast diversity.

Methods: A cross-sectional study was conducted involving 800 women (400 urban, 400 rural) attending antenatal and gynecology clinics. Vaginal swabs were collected and analyzed using standard mycological techniques. Socio-demographic data and information on hygiene practices were collected through structured questionnaires. Chi-square tests and logistic regression were used for statistical analysis.

Results: Non-albicans Candida species were more prevalent in rural women (57%) compared to urban women (32%). Candida albicans was the predominant species in both urban (68%) and rural (40%) populations. Non-Candida yeasts, including Rhodotorula mucilaginosa (2%) and Pichia kudriavzevii (1%), were isolated only from rural women. The use of untreated water (OR: 2.3, 95% CI: 1.7-3.1, p<0.001) and drying clothes in bushes (OR: 3.1, 95% CI: 2.2-4.4, p<0.001) were significantly associated with the presence of non-albicans species.

Conclusion: This study revealed significant differences in genital yeast diversity between rural and urban women, likely influenced by environmental and socio-economic factors. These findings highlight the need for targeted interventions and further research to address the specific needs of different populations in managing vaginitis.

Ethnobotany and Antimicrobial Activity of the Selected Medicinal Plants Used for the Management of Microbial Infections in Pemba Island, Tanzania.

Hassan Mohamed Faqih — 2025-04-17

Introduction: Microbial infections are among the most life-threatening factors worldwide, killing millions of people annually. The high number of deaths is partly due to the antimicrobial resistance of some microbes to available antimicrobial agents on the market. On the other hand, local communities have used medicinal plants to manage microbial-related infections for a long time, but most of these plants are not well documented or even evaluated. This study aims to contribute to the documentation and evaluation of medicinal plants reported to be used for microbial infection management. The data recorded may be used for further research in the discovery of new antimicrobial agents, thereby saving the lives of people in the future.

Methodology: An ethnobotanical survey was conducted to collect data from 42 local informants through semi-structured interviews in Pemba Island. The plants with higher fidelity levels were selected for antimicrobial assays whereby disc diffusion and microdilution methods were used.

Results: A total of 117 plants belonging to 48 families were reported for use in the management of microbial infection conditions. Fever scored the highest Informant consensus factor (ICF) of 0.76 showing a high degree of agreement on the potential plants used for fever. Azadirachta indica scored the highest Fidelity Level (FL) of 100% for fever showing the potentiality of the particular plant species. This study evaluated plant species commonly used for the management of microbial infections in vitro for antimicrobial activity against bacteria and fungi strains. Results obtained show that the zones of inhibition for the active plant species ranged between 9.5mm and 18mm. The MICs of the active plant species ranged from 0.625mg/mL to 2.5mg/mL.

Conclusion: The findings show that most of the medicinal plant species used by the Pemba community have notable activity against S. aureus, E. coli, and K. Pneumoniae which are human pathogens.

Examining sociodemographic factors affecting male involvement in family planning services: a study of married men in Musanze district

Manifarasha Ndahiro Emmanuel — 2025-04-17

Background: Male involvement in family planning (FP) services utilization is crucial for promoting reproductive health, reducing unintended pregnancies, and fostering more equitable and healthy relationships between partners. This study aims to identify the Sociodemographic factors associated with male involvement in FP services utilization in Musanze district, Northern Rwanda.

Methods: A quantitative-method cross-sectional study was conducted with 397 married men in Musanze District. Participants were chosen through simple random sampling, and data were gathered using pre-tested, interview-administered questionnaires. Multivariable logistic regression analysis was utilized to identify sociodemographic factors associated with male involvement in FP services.

Results: The overall male involvement in FP services was low, at 36.7%. It was found that male involvement in FP services was significantly predicted by age (OR=6.199, 95% CI: 1.727-22.251), education level (OR=0.331, 95% CI: 0.147-0.745), and employment status (OR=2, 95% CI: 1.24-3.224).

Conclusion: In general, the level of male involvement in FP services utilization in the Musanze district was low. Based on these findings, the study suggests integrating men into existing FP services to enhance utilization and sustainability.

Effectiveness of knowledge sources in acquiring mental health knowledge among adults in Tanzania

Fransiska Mruma — 2025-04-17

Background: Mental health knowledge plays a crucial role in individuals' decision-making processes regarding their mental health. Therefore, it is important that the sources of this knowledge function effectively to ensure that this resource is readily available.

Objectives: This study aims to investigate the effectiveness of mental health knowledge sources, particularly those used by adults in two selected cities in Tanzania. Specifically, the study seeks to identify the sources from which adults acquire mental health knowledge and examine the effectiveness of these sources.

Methods: This study employed a cross-sectional descriptive research design. Data were collected using questionnaires, focus group discussions, and interviews. Thematic analysis was used to analyze qualitative data, while descriptive statistics were applied to the quantitative data using IBM SPSS version 25.

Results: Adults acquire mental health knowledge from various sources, with radio and informal sources such as family, friends, and relatives being the most commonly used. The findings further indicate that although radio is the most frequently used source, it is ineffective in providing mental health knowledge because it does not consistently deliver the information in appropriate quantities or regularly.

Conclusion: Relying on informal and largely ineffective sources, such as friends and family, presents a challenge. Formal knowledge sources are essential to enhance the delivery of accurate and relevant mental health information.

Exploring the drivers of unprescribed antibiotics dispensing in community drug outlets in Dodoma Region, Central Tanzania: a cross-sectional study

Richard Mabilika — 2025-04-17

Background: Community drug outlets have primarily been associated with the unregulated sale of antibiotics, accelerating the development and spread of antibiotic resistance.

Broad objective: This study aimed to determine the drivers and trends of unprescribed antibiotic dispensing in community drug outlets in Central Tanzania.

Methodology: This was a cross-sectional study in which 643 drug purchases were recorded in Chamba District Council (rural) and Dodoma City Council (urban) from March to June 2021. Data was collected using KoBo Collect software and analyzed by R statistical software using antibiotic dispensing as an outcome variable. Multivariate analyses were performed to determine the independent effect of variables on antibiotic dispensing.

Results: Of the 643 drug purchases recorded, 84.14 % (541/643) were in Dodoma City Council (urban), 50.3 % (324/643) were made by female clients, while only 24.88% (160/643) purchased antibiotics. Most antibiotics (75%; 120/160) were purchased and dispensed without prescriptions. Accredited Drug Dispensing Outlets (ADDO) and community pharmacies were the two types of drug stores visited in this study. Most antibiotics (86.3%; 138/160) were dispensed in ADDO beyond jurisdiction. Amoxicillin, ampicillin and cloxacillin fixed drug combination, azithromycin, Ciprofloxacin and doxycycline accounted for over 70% of the antibiotics dispensed. Compared to other diseases complaints, the odds of antibiotic dispensing for runny nose decreased by 11% (aOR=0.89;95%CI:0.81-0.98; p=0.024) and increased by 1.29 (aOR=1.29;95%CI:1.18-1.41; p<0.001), 1.31 (aOR=1.31;95%CI:1.11-1.54; p=0.001), 1.18 (aOR=1.18;95%CI:1.08-1.30; p<0.001) and 2 (aOR=2.01;95%CI: 1.75-2.31; p<0.001) times for cough, sore throat, fever and urinary tract complains respectively.

Conclusion: There are high levels of unprescribed antibiotic dispensing by accredited drug dispensers in ADDO. The majority of the antibiotics dispensed were well beyond those stipulated in the allowable ADDO medicines dispensing list. Upper respiratory and urinary tract infection symptoms accounted for most of the antibiotic dispensing in these settings.

Recommendations: Tailored community antibiotic stewardship campaigns among drug dispensers and the community at large, as well as more stringent law enforcement mechanisms, are inevitable in mitigating the overuse and/or misuse of antibiotics in community drug outlets.

Orofacial cleft patterns and risk factors among patients at Mbeya Zonal Referral Hospital, Tanzania: A retrospective descriptive study

Hery Mwakayoka — 2025-04-17

Background: Despite the global impact of orofacial clefts, there is limited information on their patterns and risk factors in Tanzania. This study aims to examine the patterns and risk factors of orofacial clefts among patients in the Southern Highlands of Tanzania treated at Mbeya Zonal Referral Hospital in collaboration with the Smile Train program.

Methods: A retrospective descriptive study was conducted at Mbeya Zonal Referral Hospital, analyzing data from November 2021 to June 2022 obtained from the Smile Train database. Descriptive and analytical methods were used with Stata 14.0, and a p-value of <0.05 was considered statistically significant.

Results: A total of 65 patients were treated during the study period, with 64.6% being male. The median age at the procedure was six months (IQR 3-10 months). The majority (33.8%) of patients were from Chunya district. The most common type of cleft was cleft lip (83.1%), followed by clefts of the hard and soft palate. Nine patients had clefts involving the lip, hard palate, and soft palate. Age at the procedure was associated with the severity of the cleft (OR 5.45, CI: 1.09-27.28, p-value: 0.039). No significant associations were found between cleft severity and gender, family history, antenatal clinic attendance, or other malformations.

Conclusions: Understanding the patterns and types of orofacial clefts through routine clinical data is crucial for assessing the disease burden and allocating resources effectively. This study underscores the importance of routine data collection in identifying trends and potential areas for further research. Additional comprehensive studies are needed to investigate the causal factors and broader implications of these findings.

Prevalence of hypertension and associated factors in Dar es Salaam semi-urban, Tanzania: A community-based cross-sectional study

Lilian Fweja — 2025-04-17

Background: Hypertension is a major cause of disability and death globally. While several studies have assessed the prevalence of hypertension in Tanzania, most of these studies have focused on urban and rural areas.

Objective: This study aimed to assess the prevalence of hypertension and its associated risk factors in semi-urban areas of Dar es Salaam, Tanzania.

Methods: A community-based cross-sectional study was conducted in semi-urban areas of Dar es Salaam between May and July 2023. A total of 408 adults aged 18 years and above were selected through multistage cluster sampling. Data were gathered using interviewer-administered questionnaires that included questions on socio-demographics, dietary intake, physical activity, smoking, and alcohol consumption. Anthropometric measurements such as height, weight, waist and hip circumferences, and blood pressure were also taken using standard procedures. Descriptive and inferential statistics were performed using IBM SPSS version 23. Logistic regression analysis was used to identify factors associated with hypertension.

Results: The average age of participants was 40.4±13.9 years, with women making up 49% of the sample. The prevalence of hypertension was 24% (n=98). Factors associated with hypertension included; Age (AOR=1.103, 95% CI: 1.08–1.13), Male gender (AOR=2.21, 95% CI: 1.18–4.11), Obesity (AOR=5.266, 95% CI: 2.38–11.63), High vegetable consumption (AOR=3.237, 95% CI: 1.276–6.315), High consumption of sweet soft drinks (AOR=3.214, 95% CI: 1.720–6.004) and Consumption of sugary snacks (AOR=2.656, 95% CI: 1.154–6.112)

Conclusion: Hypertension was highly prevalent among residents of semi-urban areas in Dar es Salaam. Regular screening for early detection and management is essential. Additionally, public health interventions should focus on promoting healthier lifestyles to reduce the risk of hypertension and other non-communicable diseases.

Factors for Prime Vendor System Performance in Complementing Health Commodities in Public Health Facilities: A Case Study of Tanzania Mainland

Mathew Mganga — 2025-04-17

Introduction: The World Health Organization (WHO) estimates that one-third of the global population lacks access to essential medicines, highlighting the importance of the Prime Vendor System (PVS) in improving supply chain efficiency. In Tanzania, the PVS was introduced in 2018 to complement the Medical Stores Department (MSD), which could meet only 60% of the demand. However, inefficiencies in the system have led to regional disparities in the availability of health commodities.

Aim: This study explored the factors affecting the performance of regional prime vendors in addressing the health commodities supply chain gap. Data was collected from 149 health facilities across different regions from June to September 2023. The findings revealed that while 83% of facilities had prime vendor tools, significant gaps in tool availability and regional variation in fulfillment rates and lead times were observed.

Results: Prime Vendor Tools: 83% of health facilities had these tools available, with price schedules being the most common. Fulfillment Rate and Lead Time: Fulfillment rates ranged from 74.9% to 91.5% across regions, with lead times of 17 to 27 days, which is longer than the recommended 14 working days. Fulfillment Rate for Multiple Installments: Orders were often delivered in multiple installments, with fulfillment rates varying from 65% to 92%.Prime Vendor Performance: Regional performance scores showed significant differences, with Mwanza scoring the highest at 91% and Morogoro the lowest at 79.22%.

Conclusion: The study concludes that while the PVS has improved commodity availability, issues like delayed lead times, inconsistent availability of management tools, and a lack of effective electronic platforms need to be addressed for better system performance.

Cumulative effect of consanguinity on prenatal mortalities among offspring in Northen Morocco

Mohamed Hajjaji — 2025-04-17

Introduction: Consanguinity is defined as a union between two individuals related as first cousins, second cousins or even more distant unions. This behaviour will contribute to the impoverishment of genetic variability and will offer a possibility of prenatal mortality.

Objective: In this context, we suggest modelling the cumulative effect of consanguinity of maternal and paternal grandparents across that of parents among socio-demographic differences on prenatal mortality indicators in Tetouan (Morocco).

Methods: Data were collected on 882 couples in 2017. We conducted multivariable logistic regression analysis for factors associated with prenatal mortalities and then generated the average adjusted predictions and marginal effects.

Results: Multiple logistic regression analyses show that, for first cousin once removed and first cousin paternal grandparents, the odds in favour of prenatal mortalities among the student’s mother were 9.60 (aOR=9.60) and 3.90 (aOR=3.90) times greater than non-consanguineous, respectively, controlling for all other variables. Similarly, the odds in favour of prenatal mortalities among the offspring of these mothers was 3.62 (aOR=4.89) times greater when maternal grandparents were first cousins versus non-consanguineous. However, average adjusted predictions showed that when paternal grandparents were first cousins compared to non-consanguineous, and when paternal grandparents were first cousins once removed compared to non-consanguineous or second cousins, whatever the degree of parents’ consanguinity, the predicted probability of prenatal mortalities was higher than 20% and 30% (p≤0.05), respectively. Furthermore, for first cousin maternal grandparents compared to other degrees of consanguinity, concerning all degrees of parents’ consanguinity, the predicted probability of prenatal mortalities was between 20% and 48% (p≤0.05).

Conclusion: Accumulation of close biological relationships in several generations increases the probability of prenatal mortalities among offspring. A better understanding of the cumulative effect of consanguinity by socio-demographic factors can inform more-targeted interventions to reduce pregnancy wastage.

Determinants of the desire for more children among women of reproductive age using TDHS data 2022

Nsajigwa Mwalupani — 2025-04-17

Background: The desire for more children impacts a couple’s fertility behaviors. It may serve as an early indication of real fertility performance. Globally, there are many places with lower fertility rates. In developing countries, the total fertility rate (TFR) is decreasing.

Objective: We aimed to evaluate the determinants of the desire for more children among women of reproductive age in Tanzania.

Methods: This study used TDHS data, the study analyzed descriptive statistics of the respondents’ characteristics, followed by bivariate analysis to test the association between the dependent variable and each independent variable, and those variables that were statistically associated were included in the Binary Logistic Model to test their significance as determinants for the desire to have more children among women aged 15-49.

Results: The results of the multivariate logistic model, women aged 15-24 (OR=5.7, 95% CI:5.07-6.42, p<0.00) and 25-3 4 (OR=4.7, 95% CI:4.45-5.00, p<0.00) had higher odds to desire for more children, compared to women aged 35–49, those with secondary education (OR=1.8, 95% CI:1.62 -2.01, p<0.00) and higher education (OR=1.4, 95% CI:1.00 -2.03, p<0.04) had higher odds to desire for more children, compared to women with no education. Those whose partner/husband with primary education (OR=0.7, 95% CI: 0.73-0.84, p<0.00) and higher education (OR=0.69, 95% CI: 0.0.56-0.86, p<0.001) had lower odds to desire for more children compared to women whose partner had no education. Women using contraceptives (OR=0.87, 95% CI: 0.82-0.92, p<0.00) had lower odds of desiring more children compared to those who were not using contraceptives. Women who consider 4-5 (OR=2.52, 95% CI: 2.25-2.83, p<0.00) and 6+ (OR=6.17, 95% CI: 0.5.49-6.93, p<0.00) children as the ideal number had higher odds to desire more children compared to those who consider 0-3 as an ideal number.

Conclusion: The findings underscore the significance of age, education, partner's education, contraceptive use, ideal family size, number of living children, media influence, decision-making power, and wealth index in shaping the desire for additional children among women. The study recommends that the government implement comprehensive family planning education programs considering the complex interplay between education and fertility desires.

The role of commodification of health care in Reproducing Health Care inequality in the Context of Neoliberalism in Amana Regional Referral Hospital

Nassoro Kitunda — 2025-04-17

Background: This article examines how the commodification of healthcare contributes to the perpetuation of healthcare inequality. It focuses on how this process operates through money, the distinction between exchange value and use value, marketization, and the continuation of user fees.

Method: A critical ethnography approach was used. which included in-depth interviews, focus group discussions, and observations.

Theories: The study draws on two key theoretical frameworks: Marxian Political Economy (MPE), as explained by Harvey (2014), to explore the contradiction between use-value and exchange-value, and Farmer’s concept of Structural Violence (SV) (2003) to analyze the role of commodification in healthcare inequality. This perspective looks beyond the visible factors of inequality, such as education, poverty, and geography.

Results: The findings indicate that the commodification of healthcare plays a central role in driving healthcare inequality within hospitals.

Conclusion: The study concludes that the commodification of healthcare should not be overlooked in discussions about healthcare inequality, as it leads to significant harm, including death and poor health outcomes for many people

Factors associated with postpartum depression among adolescent mothers in Kigamboni municipality, Dar es Salaam: A cross-sectional study

Peter Wangwe — 2025-04-17

Background: Postpartum depression(PPD)has been described as “a thief that steals motherhood”. Maternal depression is a major public health concern as it affects both mothers and their children. PPD is often underdiagnosed and has been associated with child abundance, malnutrition and suicidal or suicidal ideation. It is associated with mother-infant bonding impairment, child abuse, child neglect, maternal abuse and self-harm. This study aimed to determine the prevalence of PPD and its associated factors among Adolescent mothers attending postnatal and under-five clinics in a Peri-urban area (Kigamboni) Dar-es-salaam.

Methods: A cross-sectional analytical study was conducted in two Health Centers located at Kigamboni, Dar es Salaam. A consecutive sampling technique was used to select 380 adolescent mothers accessing postnatal and under-five clinics. A structured questionnaire and review of the ANC card were used to collect information on social demographics and bio-psychosocial factors contributing to PPD. Edinburg Postpartum Depression Scoring scale with a score of ≥13 was used to assess the level of depression. Data were analyzed using SPSS software version 23 where Bivariate and multivariate logistic regression were used to identify the associated factors with PPD. A p-value of <0.05 was considered to be statistically significant.

Results: Forty -four per cent of adolescent mothers were found to have signs of depression. PPD was significantly associated with an unplanned pregnancy (AOR=7.40, 95% CI=3.16 -17.38). On the other hand, being married (AOR=O.92, 95% CI=0.12-0.69); having family support (AOR=0.42, 95% CI=0.22-0.81) and partner support (AOR=0.13, CI=0.28-0.60) had less likelihood of being associated with postpartum depression.

Conclusion: Adolescent mothers attending postnatal services and under-five clinics are at risk of developing PPD. Unplanned pregnancy, unmarried, poor family and partner support are among the identified common risk factors for PPD. Prevention of adolescent pregnancy by advocating sexual education and family planning in youth-friendly service clinics at every health facility is highly recommended.

Factors contributing to errors during radiotherapy in a resource-constrained setting: Experience from Ocean Road Cancer Institute in Tanzania

Polikalipo Kagina — 2025-04-17

Background: Various factors have been identified as contributing to errors during radiotherapy. However, there is limited data on these factors in Tanzania's radiotherapy settings. Understanding these factors is essential for developing strategies to reduce errors in radiotherapy.

Objective: To investigate staff experiences with factors that contribute to errors during radiotherapy at the Ocean Road Cancer Institute.

Methods: In-depth interviews were conducted with 10 staff members involved in radiotherapy planning and delivery at the Ocean Road Cancer Institute from June to July 2023. The data was analyzed using qualitative content analysis.

Results: Five key categories emerged from the data, highlighting staff experiences with factors leading to errors in radiotherapy. These categories were: the use of outdated and malfunctioning equipment, negligence, a stressful working environment, the absence of an error monitoring system, and communication breakdowns.

Conclusion: This study identifies several factors contributing to errors during radiotherapy. The findings emphasize the need for accurate and reliable equipment, improved staff practices, better working conditions, and the establishment of a robust error-monitoring system.

Community Perceptions on Mass Drug Treatments for Schistosomiasis and Strategies to Increase Treatment Coverage in Mwanza Region, Tanzania

Roza Ndaro — 2025-04-17

Background: Schistosomiasis is a public health problem in Tanzania, with a high prevalence of up to 100% in some areas. Praziquantel is currently the drug of choice for the preventive treatment of schistosomiasis because it is effective against all Schistosome species (World Health Organization, 2002). Despite the proceeding efforts against schistosomiasis in villages within Mwanza region, the disease remained endemic. Little is known about the community’s perceptions of mass drug treatment and how it influences coverage of treatments and control of schistosomiasis.

Aim: The study was conducted to describe the community perceptions of mass drug treatments for schistosomiasis and strategies to increase treatment coverage in the selected villages.

Methods: A cross-sectional descriptive study characterized by a mixed research approach was conducted in Lutale and Fogofogo villages in Mwanza region, Tanzania. A total of 387 participants were recruited and consented to information through quantitative data using a structured questionnaire and qualitative data using a semi-structured interview guide. In qualitative, 6 Focus group discussions (FGD) and 12 In-depth Interviews (IDIs) were conducted. Data were analysed using STATA version 12 and Qualitative manual thematic content analysis.

Result: The study found that Community knowledge of schistosomiasis disease was very low at 19.63% (75/382), but people were well-informed on mass drug treatment for schistosomiasis (74.16%). Traditional medicine contributed 4.42% of all treatments for schistosomiasis in the study population. There was a significant association between knowledge of schistosomiasis and drug uptake (P<0.001).

Conclusion: The studied community had insufficient knowledge about the disease, and most of them perceived mass drug treatment and the administered approach as being good. Treatment coverage can be improved when community members are educated on the importance of mass treatments, and the drug should be given and available at all times. All health stakeholders in the community, the government, health policy planners, researchers, and health providers should take part in controlling and eliminating Schistosomiasis in Tanzania and improving health services for the betterment of human life.

Oral Prosthesis Hygiene, Cleaning Habits and Oral Tissue Conditions among Removable Oral Prosthesis Wearers, attending at Kilimanjaro Christian Medical Centre, Moshi, Tanzania

Ruchius Philbert — 2025-04-17

Background: Maintaining good oral health and extending the lifespan of the prosthesis require effective and routine cleaning procedures for complete and partial removable appliances. Cleaning removable oral prostheses should be done every day to remove bacteria plaque that has built up and prevent infections like Candida albicans stomatitis. Patients with affected prostheses must practice good oral hygiene for the rest of their lives. This study aims to assess prosthesis hygiene, cleaning habits and oral tissue conditions among removable oral prosthesis wearers attending at Kilimanjaro Christian Medical Centre, Moshi, Tanzania.

Methods: A hospital based descriptive cross-sectional study, involving 200 patients attending dental clinic at Kilimanjaro Christian Medical Centre, Moshi, Tanzania. All eligible patients completed self-administered questionnaire consisting of a tool for the assessment of oral prosthesis hygiene, cleaning habits and oral tissue condition. Descriptive and logistic regression analyses were then conducted using STATA software version 15.0. A p-value <5% was used to determine statistical significance.

Results: The average age on participant profile was (SD) 57±17.4 with 56% of the patients being female. This study has revealed that majority had good denture hygiene accounting 44%. The findings also revealed that 49.5 %of patients over the age of 60 had poor hygiene habits, and 64.0% of study participants did not sleep with their dentures while 27.0%% cleaned them more than twice a day. Only 9.5% received annual examinations for their dentures, 25.95% exhibit a mild irritation on the denture's fit surface. The independent predictors for good oral hygiene were age, denture check-up habit, and frequency of denture cleaning including palatal erythema.

Conclusions: According to this study, removable denture hygiene was not favorable. Most patients sleep with their dentures in place, and the preferred cleaning technique is water and toothpaste (mechanical method). Therefore, dentists should instruct their patients how to care for their dentures in order to stop oral cavity infections.

Keywords: Prosthesis hygiene, denture cleaning frequency, oral mucosa lesion.

Availability and quality of vaccine cold chain equipment at healthcare facilities in Mtwara region, Tanzania: evidence from routine assessment of vaccine cold chain equipment

Serveus Kamala — 2025-04-17

Background: The quality of vaccines relies heavily on maintaining proper cold chain equipment (CCE) throughout the supply chain. However, Tanzania faces gaps in CCE, as indicated by the Effective Vaccine Management Assessment (EVMA) 2021, where the country scored 73%, falling short of the 80% benchmark. The ongoing measles outbreak in several districts, including Mtwara, may lead to the delivery of low-quality vaccines due to sub-optimal storage conditions. This study aimed to evaluate the availability and quality of CCE at healthcare facilities in Mtwara region and identify areas for improvement.

Methods: A descriptive cross-sectional study was conducted using an updated vaccine CCE inventory from 263 healthcare facilities (HFs) across nine councils in Mtwara region. The updated inventories were compiled into a single Microsoft Excel dataset, which was analyzed to determine the frequency and functionality of CCE. The results were presented in tables for comparison.

Results: Routine immunization services were available at 263 out of 301 (87.4%) healthcare facilities, with 234 (89%) of them being public. Among these, 218 (82.9%) were dispensaries, and 209 (79.5%) were located in rural areas. A total of 252 (95.8%) healthcare facilities had functional refrigerators, 115 (43.7%) of which were RCW 50EG models. Although all refrigerators met the World Health Organization's pre-qualification standards, 192 (76%) had functional deficiencies. Additionally, 115 (43.7%) had been in use for over ten years, and 48 (19%) lacked temperature monitoring devices. Vaccine carriers, although available, showed deficiencies that rendered them unsuitable for effective vaccine storage.

Conclusion: Most cold chain equipment (CCE) in Mtwara region exhibited sub-optimal conditions, potentially compromising vaccine quality and impeding immunization services. This could lead to cancelling immunization sessions, resulting in low vaccination coverage and failure to protect recipients. Urgent action is needed to repair or replace non-functional, outdated, and inefficient CCE. Moreover, regular refresher training for healthcare providers on assessing and maintaining vaccine CCE is recommended, along with the procurement of refrigerator models suitable for local conditions, in line with manufacturer guidelines.

Voluntary Choice of Lifestyle Modification in Secondary Prevention of NCDs

Soumik Gangopadhyay — 2025-04-17

Background: A cheap and simple intervention strategy that is effective in the fight against non-communicable illnesses is lifestyle change. Furthermore, if the victims are interested in it, it is considerably more effective as primary, secondary, and tertiary prevention than it is as primordial prevention.

Objective: The main goal was to learn how NCD patients and/ attendants seek information about lifestyle modifications, health and healthcare.

Method: This is an opinion-based study where opinions were collected from 500 NCD patients and their attendants or relatives who visited the OPD at 10 specialty tertiary care hospitals in Kolkata, India.

Results: The study showed that specific lifestyle modification-related advice from hospitals is needed to prevent NCDs.

Conclusion: In conclusion, private hospitals are changing their focus from product promotion to health promotion. Both the formation of strategic policy and the generation of commercial value may benefit from this study. This can support the use of health promotion as a hospital's strategic communication tool.

Knowledge, Attitudes, Perceptions and Health-Seeking Practices Towards Rabies and Dog-Bite Injuries among Residents in Ibadan, South-Western Nigeria

Blessing Agbajelola — 2025-04-17

Background: Rabies is a fatal viral infection causing encephalomyelitis in carnivores and other vertebrates, including humans, primarily transmitted through bites or scratches from infected animals. Understanding knowledge and health-seeking behaviors related to rabies is critical for designing effective public health interventions. This study evaluated knowledge, attitudes, perceptions, and health-seeking practices regarding dog-bite injuries and rabies infection.

Methods: A community-based, cross-sectional study was conducted among 418 adults, selected using a multi-stage sampling technique. Data were collected via a pre-tested, interviewer-administered questionnaire and analyzed with descriptive and inferential statistics at a 5% significance level.

Results: The mean age of respondents was 35.6±12.7 years, with 35.4% aged 21–30 years. Nearly half of the respondents (45.2%) demonstrated poor knowledge of rabies and dog-bite injuries, while 60% showed a positive attitude toward prevention and management. A moderate negative correlation was found between knowledge and perceived susceptibility (r = -0.314, p < 0.001) and perceived severity (r = -0.638, p < 0.001).

Conclusion: The study identified low perceived susceptibility and severity of rabies, highlighting the need for One Health interventions and targeted advocacy campaigns to improve awareness and preventive practices.