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Asymtomatic parasitaemia and placental malaria infection among pregnant women in Kigoma urban District, Western Tanzania.
(East African Journal of Public Health, 2006) Kabalimu, Titus K.
Objective: To determine the magnitude of malaria infection and anaemia among pregnant women in Kigoma Municipality, western Tanzania. Setting: An urban maternal and child health clinic (MCH) located in the Kigoma Municipality in western Tanzania. Methods: A cross-sectional study was conducted in an urban MCH clinic in Kigoma Municipality. Informed consent to participate in the study was sought from each pregnant woman. Consenting Pregnant women were interviewed to solicit for socio-demographic characteristics and information relating to use of malaria preventive measures. The women were also examined for anaemia and malaria parasitaemia. At delivery, the women were also examined for malaria infection of the placenta. The research was cleared by the Ethical Clearance Committee of the Muhimbili University College of Health Sciences, Dar es Salaam. Data were managed and analysed using SPSS/PC+ for windows. Results: The mean age of the pregnant women was 26.7 years (SD = 5.4) with the youngest woman being 14 years and the oldest being 45 years. The response proportion to participate in the study was 96.7% (N= 705). It was found that 8.4% of the women examined had asymptomatic malaria parasitaemia while2.8% had malaria infection of the placenta. Women with placental malaria were more likely to deliver low birth weight babies than others (8.8% versus 2.1%. Pregnant women who reported using bednets were less likely to have placental malaria compared to those not using bednet (2.2% versus 3.3%). Similarly, pregnant women who reported using bednets were less likely to have asymptomatic malaria parasitaemia than others (5.9% versus 10.4%). Conclusions: We conclude that placental malaria occurs in Kigoma municipality and it appears that use of bednets might be an effective strategy in controlling malaria among pregnant women in Tanzania.
Determinants of utilisation of mosquito bednets for malaria prevention among pregnant women in Kigoma urban district
(East African Journal of Public Health, 2006) Kabalimu, Titus K.
Objectives: To determine factors influencing utilisation of mosquito bednets for malaria prevention among pregnant women in Kigoma urban district in western Tanzania. Setting: Kigoma urban MCH clinics Methodology: Pregnant women attending antenatal care clinic in Kigoma municility were interviewed using a structured questionnaire. The questionnaire originally developed in the English language was translated into Swahili language and pre-tested before use. A trained team administered the questionnaire as part of a larger baseline study involving several malaria chemoprophylaxis strategies among pregnant women. Informed consent was obtained from each pregnant woman before questionnaire administration. The project was reviewed and cleared by the ethical clearance committee of the Muhimbili University College of Health Sciences. Results: A total of 729 pregnant women participated in the interview. The age of the participating women ranged from 14-45 years with mean age of 26.7 years and standard deviation (SD) of 5.4. Of the 729 pregnant women interviewed, 61.0% (445) knew about malaria and of these 69.4% (309) stated that they knew how to protect themselves against malaria. About 47% (N=728) of the pregnant women interviewed reported being current users of bednets. Reported use of bednets appeared to increase with increasing age of the pregnant women. Single and divorced pregnant women were less likely to report being users of bednets as compared to married or cohabiting pregnant women (49.2% versus 18.6%, odds ratio (OR) = 0.24, 95% confidence interval (95%CI) = 0.12 – 0.46). Similarly, reported use of bednetssignificantly increased with increasing level of education. Employed and those engaged in business were significantly more likely to be bednet users than housewives or peasants. Conclusion: We conclude that factors influencing use of bednets among pregnant women in Kigoma urban district include marital status, educational level and occupational status.
Estimating and projecting HIV prevalence and AIDS deaths in Tanzania using antenatal surveillance data
(BMC public health, 2006) Kabalimu, Titus K.
Background The Estimations and Projections Package (EPP 2005) for HIV/AIDS estimates and projects HIV prevalence, number of people living with HIV and new HIV infections and AIDS cases using antenatal clinic (ANC) surveillance data. The prevalence projection produced by EPP can be transferred to SPECTRUM, a demographic projectionmodel, to calculate the number of AIDS deaths. This paper presents estimates and projections of HIV prevalence, new cases of HIV infections and AIDS deaths in Tanzania between 2001 and 2010 using the EPP 2005 and SPECTRUM soft-wares on ANC data. Methods For this study we used; the 1985 – 2004 ANC data set, the 2005 UN population estimates for urban and rural adults, which is based on the 2002 population census, and results of the 2003 Tanzania HIV Indicator Survey. The ANC surveillance sites were categorized into urban and rural areas on the basis of the standard national definitions of urban and rural areas, which led to 40 urban and 35 rural clinic sites. The rural and urban epidemics were run independently by fitting the model to all data and on level fits. Results The national HIV prevalence increased from 0% in 1981 to a peak of 8.1% in 1995, and gradually decreased to 6.5% in 2004 which stabilized until 2010. The urban HIV epidemic increased from 0% in 1981 peaking at 12.6% in 1992 and leveled to between 10.9% and 11.8% from 2003 to 2010. The rural epidemic peaked in 1995 at 7.0% and gradually declined to 5.2% in 2004, and then stabilized at between 5.1% and 5.3% from 2005 to 2010. New infections are projected to rise steadily, resulting in 250,000 new cases in 2010. Deaths due to AIDS started in 1985 and rose steadily to reach 120,000 deaths in 2010, with more females dying than men. Conclusion The fact that the number of new infections is projected to increase steadily to reach 250,000 per year in 2010 calls for more concerted efforts to combat the spread of HIV infection particularly in the rural areas where the infrastructure needed for prevention programmes such as counseling and testing, condom accessibility and AIDS information is less developed.
Factors Influencing Outcomes of Diabetic Foot Management: Retrospective Study at Mwananyamala Regional Referral Hospital.
(www.easpublisher.com, 2024-10-21) Kabalimu, Titus K.
Background: Diabetic foot ulcers (DFUs) contribute to significant morbidity and mortality worldwide, with the global prevalence of diabetes expected to rise to 12.2% by 2045, an increasing number of people are at risk for complications like DFUs, which affect 19% to 34% of diabetic patients. People with DFUs carry a 20% lifetime risk of limb amputation and mortalityrate of 50% to 70%. In Tanzania DFUs account for 41.9% of major limb amputations and mortality rate of 54%. Methods: A retrospective observational study aimed to investigate the clinical factors, and treatment modalities that influence the management outcomes of diabetic foot among patients attending Mwananyamala Regional Referral Hospital (MRRH). The study reviewed existing patient records. Results: A total of 143 participants were enrolled in the study, of which 94 (65.73%) were female. The participants had a mean age of 57 ± 13.9 years. And approximately half (50.35%) were married. Nearly, all patients, 140 (97.90%), underwent surgical treatment, nearly half (41.96%) had DFU Wagner Class 3 while most of participants (69.93%) had hypertension. The mean hospital stay was 9.2 days. In binary logistic regression model output, marital status, level of education, working diagnosis, surgical management, patient progress and number of readmissions were identified as determinants of the outcome (P-value < 0.05). Conclusion: This study identified key factors influencing diabetic foot outcomes, including gender, marital status, co-morbidities and ulcer grade. These findings underscore the importance of early diagnosis, targeted interventions, and comprehensive management to improve patient outcomes.
Giant Bullae as a Great Mimicker of Pneumothorax in a symptomatic young adult Individual seen on CXR and CT chest
(EC Paediatrics, 2024-01-02) Rutachunzibwa, Fredy; Kajugusi, Julieth; Kabalimu, Titus K.
Giant pulmonary bulla (Vanishing Lung Syndrome) is a rare condition which is usually associated with male gender and smoking habits. Sometimes such patients may present with symptoms like chest pain while other patients may become asymptomatic. In this report we describe a patient with a giant pulmonary bulla occupying the whole right upper lobe inferiorly compressing the middle lobe and lower lobe with transmediastinal herniation at the level of the anterior junctional zone as per CT Chest, who had history of occasional attacks of lower right chest pain. Having diagnosed the patient in our facility, he was referred to another facility for possible bullectomy.
Knowledge and healthcare seeking behaviour of pulmonary tuberculosis patients attending Ilala district Hospital
(Tanzania Journal of Health Research, 2007) Kabalimu, Titus K.
A cross-sectional study was conducted, based on systematic sampling of consecutive patients with pulmonary tuberculosis (TB) symptoms and who attended the TB clinic for their medication at Ilala District Hospital, Tanzania. The study sample comprised of 153 people who were almost equally distributed among men and women. Three quarters (75%) of the subjects were vaccinated against TB with the majority being 40 years and younger. Half the study subjects were diagnosed to have TB between the 2nd and 4th month after their symptoms appeared. A chest X-ray was used to initiate anti-TB therapy in half the subjects. No consistency was followed in the diagnostic procedures done to confirm the diagnosis. Over half the patients (54.3%) admitted that they openly speak about their illness to others but that only one-third (33.3%) of their friends and family responded in a considerate and sympathetic manner. One-third (36.6%) of the friends and relatives became less friendly and the remaining one-third openly portrayed fear and tried to discriminate the patient even after the commencement of medications. The patients' compliance rate was 100%. The counselling received from the health personnel and the patients' own motivations to improve their health, was the main driving force in seeking treatment and taking daily medication. Discrimination against TB patients by relatives and friends is likely to hinder positive health seeking behaviour and thus impede control of this disease.
Malaria prophylaxis in pregnancy:result from a field trial conducted in Kigoma urban district in western Tanzania
(Tanzania Public Health Association, 2001) Kabalimu, Titus K.
A randomized study field study was conducted to assess the effectiveness of the chemoprophylactic regiments during pregnancy in Kigoma urban district. The study objective was to assess the effectiveness of alternative strategies of malaria chemoprophylaxis on the reduction of malaria episodes and the prevalence of parasitaemia among pregnant women attending maternal and childbirth (MCH) clinics. Study intervention measures were intermittent and continuous malaria chemoprophylaxis using chloroquine and proguanil. The study was conducted at two randomly selected antenatal care clinics as part of routine antenatal care services. Consecutive eligible pregnant women having their first and second pregnancies (designated as primigravidae) were randomized to chloroquine (continuous and intermittent prophylaxis)and proguanil (paludrine). Women having three or more pregnancies (multigravidae) were randomized to chloroquine(intermittent prophylaxis and chemotherapy when ill) and proguanil. Proguanil (paludrine). Women having three or pregnancies (multigravidae) were randomized to chloroquine (intermittent prophylaxis and chemotherapy when ill) and proguanil. Proguanil (continuous) was the golden standard for prophylaxis in both groups. Baseline laboratory investigations (hemoglobin, blood slide for malaria parasites and stool) and other routine clinic measurements were recorded, and women found with any infection were treated and some were referred to the regional hospital. There were follow-up studies consisting of a series of measurements and recording of all parameters as baselines; for each woman during subsequent visits to the clinic until delivery. A total of 705 eligible women registering at the clinic participated in the study and 701 had baseline results recorded. At baseline 17.8% (N=701) had helminithic infection; 9.3% (N=701) had malaria parasitaemia, while 71.1% (N=578) had anemia. Results: After 4 visits to the antenatal clinic, parasitaemia was reduced to 1.3% (N=578), and anemia drastically reduced from 71.1% to only 14.5 (N=578) during the intervention with chemoprophylaxis. However, there was no significant difference in the occurrence of a few malaria episodes/ parasitaemia and anemia among women receiving continuous prophylaxis with pronguanil as compared to those getting either continuous or intermitted chloroquine prophylaxis. The conclusions made from the study are clear usefulness of chemoprophylaxis as a practice in reducing anemia and malaria parasitaemia during pregnancy. Secondly, the chemoprophylactic regimens tested in this study had similar effects in reducing malaria parasitaemia episodes and pronguanil showed better either outcome results, though the difference was not statistically significant. These results pose a dilemma as well as challenges in malaria control programmes in Tanzania and, indeed suggest that results obtained in malaria holoendemic areas may not be easily generalizable to other parts of Tanzania.
Malnutrition and associated factors among adults starting on antiretroviral therapy at PASADA Hospital in Temeke District, Tanzania
(Tanzania Journal of Health Research, 2018) Kabalimu, Titus K.; Sungwa, Edson.; Lwabukuna, Warles C.
Background: Malnutrition is known to play a significant role in HIV/AIDS progression. Severe malnutrition has been previously found to be associated with early mortality among people living with HIV/AIDS (PLHIV) undergoing anti-retroviral therapy (ART) in Sub-Saharan Africa. The objective of this study was to determine the prevalence and factors associated with malnutrition among adult PLHIV attending care and treatment centre (CTC) in Temeke District, Tanzania. Methods: The cross-sectional descriptive study involved consecutive eligible patients attending the CTC for initiating in ART, between January and April, 2014. All participants who agreed to sign a consent form were enrolled. The participants had undergone baseline workup for ART initiation (by CTC), which included blood tests for liver and renal function tests, and CD4+ cell count, using calibrated instruments and standard techniques. In all patients the weight and height were measured to calculate the body mass index (BMI), denoting the nutritional status. This parameter was recorded in the study instrument together with the CD4+ count for each patient. A structured questionnaire was used to obtain more information, namely demographic and lifestyle data. Results: A total of 125 patients were included in this study. The prevalence of malnutrition among participants was 19.4%. Those with severe malnutrition comprised of 9%. Significant association was noted between malnutrition and irregular income (OR= 3.8, CI: 1.2-11.5) and also inability to get at least two meals a day (OR= 3.4, CI: 1.2-9.2). Severe malnutrition was significantly associated with the CD4+ counts of <200 cells/mm (OR =7.6; CI: 1.7-34.6). Conclusion: About 19% of participants were malnourished at the time of initiation of ART and among them 9% were severely malnourished. The most important risks for malnutrition were found to be irregular income and inability to get adequate feeding. This calls for routine nutritional assessment at CTCs prior to initiation of ART so as to identify those who need immediate intervention, including those with severe malnutrition.
Opportunistic Infections and Associated Factors among HIV Infected Patients on anti-retroviral treatment at Bombo Hospital in Tanga Region, Tanzania
(African Journal of Health Sciences, 2022) Kabalimu, Titus K.; Sungwa, Edson.; ;
BACKGROUND A substantive number of People Living with HIV (PLHIV) develop Opportunistic Infections (OIs). The introduction of Anti-Retroviral Therapy (ART) in Tanzania led to a significant decline in opportunistic infections and a slower progression to AIDS, but OIs are still prevalent. This study was set to determine the magnitude of OIs and associated factors among HIV/AIDS patients on Anti-Retroviral Therapy (ART) attending care and treatment clinic at Bombo Regional Referral hospital, Tanga region. MATERIALS AND METHODS A cross‐sectional descriptive study was conducted on HIV/AIDS patients on ART attending Bombo Hospital in Tanga from July to October 2019. A non-probability, consecutive sampling technique was employed to obtain study participants. Data were collected using available data obtained from the patients’ files, hospital record books and interviews of study participants by using semi-structured questionnaires. Data were entered into the computer using Excel 2013, cleaned and analysed using Epi Info version 7.2.2.6. Any p-value of < 0.05, at a 95% confidence interval was regarded as statistically significant. RESULTS The study showed that out of the 360 participants, 126 cases (35.0%) of OIs were reported. Pulmonary Tuberculosis had the highest prevalence of 18.0% among PLHIV while other opportunistic Infections altogether contributed 17.0%. Late ART initiation (OR=10.9, 95% CI: 6.5 – 18.3, p-value <0.001), Poor drug adherence (OR=19, 95% CI: 9.0 – 39.7, p-value <0.001), female gender (69% vs. 31%), which was however, not statistically significant (p-value – 0.904), Informal and Primary School education (OR = 1.6, 95% CI: 1.1 – 1.6, p-value 0.04) being married (OR=2.1, 95% CI: 1.3 – 3.4, p – value 0.004) and widowed/widower (OR=7.7, 95% CI: 1.7 – 33.7, p – value 0.007) respectively were found to be associated with OIs to PLHIV. CONCLUSION The rate of OIs still high among PLHIV, Pulmonary Tuberculosis is the leading disease with 18.0% of all OIs symptomatic patients. Delay in ART initiation after positive test results, poor drug adherence and moderate malnutrition have been identified as major risk factors affecting 66.0%, 70.0%, 71%of PLWHA with OIs. We recommend early initiation of ART, Education on ART adherence and refilling of large quantities of ARV drugs to individuals working far from their homes.
Perception and utilisation of malaria prophylaxis among pregnant women in Dar es Salaam, Tanzania
(East African medical journal, 1995) Kabalimu, Titus K.
Knowledge, perception and utilisation of malaria prophylaxis were assessed among pregnant women attending antenatal care clinic in Dar es Salaam, Tanzania. Of the 301 women interviewed, 71.1% reported having used chloroquine prophylaxis while 28.9% did not. Women with high knowledge of malaria were more likely to use malaria prophylaxis than those with low knowledge. However, there was no significant association between knowledge of malaria and perceived effectiveness of the various methods of malaria control. Chloroquine side effects and perceived lack of protective effect against malaria were mentioned as causes of failure to use chloroquine prophylaxis. Fear of chloroquine-induced pruritus accounted for the largest proportion (49.4%) of women who reported having failed to use chloroquine prophylaxis. Occurrence of malaria episodes was reported to be similar among users and non-users of malaria prophylaxis probably due to inconsistent use of malaria prophylaxis and reduced chloroquine sensitivity of malaria parasites. It is suggested that, in addition to chemoprophylaxis, pregnant women should be encouraged to use bednets in combination with mosquito repellents throughout the course of pregnancy.
Prevalence and factors associated with hazardous alcohol consumption among motorcycle taxi riders in Kinondoni district, Dar-es-Salaam, Tanzania: A Cross-Sectional Study
(EA Health Research Journal, 2019) Kabalimu, Titus K.; Muindi, Robert
Background: Hazardous alcohol consumption is a significant public health problem contributing to road traffic accidents in nearly all countries. Despite the fact that motorcycles are involved in more than half of all road traffic accidents in Tanzania, little has been reported about hazardous alcohol consumption among motorcyclists. This study investigated the prevalence and factors associated with hazardous alcohol consumption among motorcycle taxi riders in Kinondoni District, Dar es Salaam. Methods: A cross-sectional survey was conducted in Kinondoni District in August 2018 among motorcycle taxi riders. Multistage sampling was applied to select the study participants. Data were collected using structured self-administered questionnaires incorporating the Alcohol Use Disorders Identification Test. Analysis was done using IBM SPSS version 20. Results: A total of 210 individuals participated in the study. Within the study sample, the prevalence of hazardous alcohol consumption was 61.5% (n=128). Hazardous alcohol consumption was positively associated with a positive family history of alcohol consumption (odds ratio [OR] 11.74; 95% confidence interval [CI], 5.14 to 26.79; P<.001). Protective factors were younger age (OR 0.09; 95% CI, 0.02 to 0.40; P<.001), having a secondary level of education (OR 0.21; 95% CI, 0.04 to 0.99; P=.034), having a primary level of education (OR 0.06; 95% CI, 0.01 to 0.26; P<.001), and being employed (OR 11.74; 95% CI, 5.14 to 26.79; P<.001). Conclusion: A high prevalence of hazardous alcohol consumption among motorcycle taxi riders was reported along with several associated factors. Interventions to mitigate hazardous alcohol consumption among commercial motor vehicle drivers must be developed and implemented.
A radiological approach to ischemic stroke in a young adult non hypertensive patient
(EC Paediatrics, 2024-02-16) Kabalimu, Titus K.; Rutachunzibwa, Fred F.
Stroke is the second leading cause of death above the age of 60 years, and the fifth leading cause in people aged 15 to 59 years old as reported by the World Health Organization global burden of diseases [1]. Hypertension is the leading risk factor for stroke in Tanzania, and its early detection, treatment and management cannot be overemphasized. Previous studies in SSA have demonstrated that 45% of all strokes could be prevented by simply measuring and controlling blood pressure. It is notable that in Tanzania, stroke occurs at a much younger age with later presentation associated with devastating outcomes. Hospital-based studies have reported early mortality ranging from 30 - 60% [2]. Other related known modifiable risk factors for stroke, of which smoking, and hypercholesterolaemia have been mentioned [3]. HIV infection is a notable finding, and associated with an increase of five times in risk of stroke [3]. Stroke in the young is particularly tragic because of the potential to create long-term disability, burden on the victims, their families, and the community at large. Despite this, there is limited data on stroke in young adults, and its risk factors in Tanzania. Therefore, in this case study we determined important radiological investigation that can possibly establish the diagnosis to this young adult patient who presented with weakness on the left side at Kairuki Hospital.
Randomised trial of alternative malaria chemoprophylaxis strategies among pregnant women in Kigoma, Tanzania: II results from baseline studies
(East Africa Medical Journal, 2000) Kabalimu, Titus K.
Objective: To determine baseline data among pregnant women consenting to participate in a randomized trial of alternative strategies of malaria chemoprophylaxis in Kigoma urban district, western Tanzania. Design: Cross-sectional study. Setting: The study was conducted in an urban MCH clinic in Kigoma town in western Tanzania. Subjects: All consenting pregnant women who fulfilled entry criteria were recruited into the study. Baseline studies: Baseline data were collected prior to randomisation of women to antimalarial prophylactic regimens. Baseline measurements included examination for blood depleting parasitic infections (stool and urine examinations), haemoglobin levels, haematocrit, sickling test, and blood slide for malaria parasites. Results: A total of 728 pregnant women consented to participate in the interview and of these 705 participated in baseline studies constituting a participation rate of 96.8%. The age of participating women ranged from 14 to 45 years with a mean age of 23.7 years (standard deviation [SD] = 5.4) while the mean number of pregnancies ranged from 1 to 13 with a mean of 3.2 (SD = 2.2). The prevalence of malaria parasitaemia among the pregnant women examined was 9.4% (N = 705) while the revalence of anaemia (defined as Hb < 8.5 gdl 12.4% (N = 579). No significant difference was observed in prevalence proportions of malaria parasitaemia in relation to age, parity, marital status and use of mosquito bednets. However the prevalence of anaemia among women in the age group 31-45 years was significantly lower than that observed among women in the age group 14-20 years (2.9% versus 18.9%; crude odds ratio [OR] = 0.13; 95% confidence interval [CI], 0.02-0.55). Sickle cell disease (HbAS) was found in 2.3% (N = 564) of the pregnant women examined. Conclusion: It is concluded that the prevalence of malaria parasitaemia and anaemia was very high in this population suggesting the need for interventions directed at controlling these major causes of maternal morbidity and mortality in Tanzania.
Randomised trials of alternative malaria chemoprophylaxis strategies among pregnant women in Kigoma, Tazania: I. Rationale and design.
(East African medical journal, 2000) Kabalimu, Titus K.
Objective: The objective of the study was to assess the effectiveness of alternative strategies of malaria chemoprophylaxis on the reduction of malaria episodes and prevalence of parasitaemia among pregnant women in Kigoma urban district in western Tanzania. Design: Randomised antimalarial prophylactic trial. Setting: The study was conducted in an urban maternal and child health (MCH) clinic in Kigoma town. Subjects: All pregnant women attending antenatal care services at Kigoma urban MCH clinic were eligible. Informed consent was sought from each pregnant woman for participation in the study. Intervention measures: The intervention measures were intermittent and continuous malaria chemoprophylaxis using chloroquine and proguanil. Main outcome measures: Reduction of malaria episodes and parasitaemia and haemoglobin levels among participating pregnant women in Kigoma urban district. Results: Baseline data indicates that the overall mean haemoglobin concentrations among the primigravidae and multigravidae women were similar within the intervention and comparison groups (F-test (df= 5, N = 701) = 1.27, P = 0.27). Similarly, no significant difference was observed in the prevalence of malaria parasitaemia within the primigravidae intervention and comparison groups (c2 test (df=5, N = 701) = 5.4, P = 0.4). Hence, the process of randomisation produced comparable intervention and comparison groups with balanced characteristics. Specific results of the baseline studies are presented in the companion paper. Conclusion: We conclude that the process of randomisation resulted in comparable intervention and comparison groups. As malaria is a common cause of considerable morbidity and mortality among pregnant women in Tanzania, the present study provided useful data for improving reproductive health in Kigoma region, western Tanzania.
Self-medication with antimalarial drugs in Dar es Salaam, Tanzania
(Tropical and geographical medicine, 1995) Kabalimu, Titus K.
A hospital-based cross-sectional study was conducted in Dar es Salaam, Tanzania, using a questionnaire to assess the extent of self-medication with antimalarial drugs and malaria treatment-seeking behaviour among patients attending out-patient treatment at Mnazi mmoja dispensary. It was found that 15.3% of respondents admitted to having ever used malaria chemoprophylaxis while 8.0% reported to be current users of chemoprophylaxis. Among the current users of malaria chemoprophylaxis, some reported having used quinine and Fansidar. While 71.7% reported having treated themselves with home-kept antimalarial drugs for a suspected malaria fever, 14.7% consulted traditional healers. The data suggest the need for increasing public awareness on malaria and appropriate use of antimalarial drugs.
Social and cultural factors affecting treatment seeking behavior of patients with cancer of the cervix, at Ocean Road Cancer Institute Dar es salaam, Tanzania
(Journal of the Open University of Tanzania, 2018) Kabalimu, Titus K.; Muindi, Robert
Some social and cultural factors influence the treatment seeking behavior among women with cervical cancer in that they hinder seeking early treatment. This study was set to investigate social and cultural factors associated with the unfavourable pattern of seeking treatment. A hospital based cross-sectional descriptive study was carried out at Ocean Road Cancer Institute (ORCI) from 1st to 30th of October 2015, involving women who were diagnosed with cervical cancer and were undertaking treatment or were coming for follow up. A standardized questionnaire with both closed and open ended questions was used to get the information. Data were collected, managed and analyzed using SPSS version 20 computer programme. A total of 160 respondents participated and were interviewed. Early treatment seekers (cancer stages I and II) were only 10.6% while 89.4 % came very late when the disease was more advanced to higher stages. The overall knowledge on cervical cancer was poor, only 15.1% had adequate knowledge on the disease (p < 0.03). Symptoms awareness was only 14.4% while 85.6% of respondents being unaware (p < 0.09). Social cultural factors associated with the problem included: attending to traditional healers 88.1%, being delayed by traditional healers on different pretexts, 81.9% (p < 0.541), stigma from society 13.1%, and poverty 78.8%i.e. being unable to cater for hospital investigations and treatments. Perception that radiotherapy leads to early death was noted among 96.3% of respondents. Generally those with poor health education on cervical cancer comprised 89.5%. The study showed that the majority of women had suboptimal knowledge about cervical cancer and also symptoms specific to the disease. Beliefs that this kind of problem could not be treated in hospitals and the fact that radiotherapy kills were cemented by information obtained from traditional healers leading to delay in seeking appropriate treatment.
Surveillance of HIV and syphilis infections among antenatal clinic attendees in Tanzania-2003/2004
(BMC Public Health, 2006) Kabalimu, Titus K.
Background: This paper presents the prevalence of human immunodeficiency virus (HIV) and syphilis infections among women attending antenatal clinics (ANC) in Tanzania obtained during the 2003/2004 ANC surveillance. Methods: Ten geographical regions; six of them were involved in a previous survey, while the remaining four were freshly selected on the basis of having the largest population among the remaining 20 regions. For each region, six ANC were selected, two from each of three strata (urban, peri-urban and rural). Three of the sites did not participate, resulting into 57 surveyed clinics. 17,813 women who were attending the chosen clinics for the first time for any pregnancy between October 2003 and January 2004. Patient particulars were obtained by interview and blood specimens were drawn for HIV and syphilis testing. HIV testing was done anonymously and the results were unlinked. Results: Of the 17,813 women screened for HIV, 1,545 (8.7% (95% CI = 8.3–9.1)) tested positive with the highest prevalence in women aged 25–34 years (11%), being higher among single women (9.7%) than married women (8.6%) (p < 0.07), and increased with level of education from 5.2% among women with no education to 9.3% among those at least primary education (p < 0.001). Prevalence ranged from 4.8% (95% CI = 3.8% – 9.8%) in Kagera to 15.3% (95% CI = 13.9% – 16.8%) in Mbeya and was; 3.7%, 4.7%, 9.1%, 11.2% and 15.3% for rural, semiurban, road side, urban and 15.3% border clinics, respectively (p < 0.001). Of the 17,323 women screened for syphilis, 1265 (7.3% (95%CI = 6.9–7.7)) were positive, with highest prevalence in the age group 35–49 yrs (10.4%) (p < 0.001), and being higher among women with no education than those with some education (9.8% versus 6.8%) (p < 0.0001), but marital status had no influence. Prevalence ranged from 2.1% (95% CI = 1.4% – 3.0%) in Kigoma to 14.9% (95% CI = 13.3%-16.6%) in Kagera and was 16.0% (95% CI = 13.3–18.9), 10.5% (95% CI = 9.5–11.5) and 5.8% (95% CI = 5.4–6.3) for roadside, rural and urban clinics, respectively. Syphilis and HIV co-infection was seen in 130/17813 (0.7%). Conclusion: The high HIV prevalence observed among the ANC clinic attendees in Tanzania call for expansion of current voluntary counselling and testing (VCT) services and access to antiretroviral drugs (ARV) in the clinics. There is also a need for modification of obstetric practices and infant feeding options in HIV infection in order to prevent mother to child transmission of HIV. To increase uptake to HIV testing the opt-out strategy in which all clients are offered HIV testing is recommended in order to meet the needs of as many pregnant women as possible.

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