Ku Repository :: Browsing by Author "Malasa, Leonard J."

Browsing by Author "Malasa, Leonard J."

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Acceptance of COVID-19 vaccination in children among adults attending selected health facilities in Kinondoni municipality; Dar es salaam, Tanzania: a cross sectional study
(Canadian Center of Science and Education, 2024-03-13) Malasa, Leonard J.; Fataki, Maulid R.; Rutachunzibwa, Felician; Kalabamu, Florence S.
Background: Safe and effective vaccines are crucial for controlling and containing COVID-19 pandemic. However, poor acceptance and hesitance to vaccinate limit effective utilization. In Tanzania, COVID-19 vaccines have been in use with adequate coverage in adults from 18-years old, however, the acceptability of their use in children is not well understood. This study was aimed at determining the acceptability of COVID-19 vaccination in children among adults in Dar es salaam, Tanzania. Methods: A cross section study was conducted among adults attending outpatient clinic in Dar es salaam and were having children below 18-years at home. A self-administered questionnaire was used to collect their demographic information and their opinions regarding COVID-19 vaccine use in their children. Data was analyzed using Statistical Package for Social Sciences (SPSS version 23). Level of acceptance and other categorical variables were calculated in frequency and percentages while factors associated with COVID-19 vaccination in children were determined using binary logistic regression analysis. A type II error of less or equal to 0.05 was considered statistically significant. Results: A total of 320 participants were recruited in the study. Among these, 289 (90.3%) were females. Out of all participants, 124 (38.57%) were willing for their children to receive COVID-19 vaccines upon availability and recommendation by respective authorities. Confidence in the safety of COVID-19 vaccines (Adjusted Odd Ratio= 0.03; 95% CI: 0.01-0.13; p=0.02, and perceived importance of COVID-19 vaccine use in children (AOR=0.29; 95% CI: 0.1-0.84; p=0.02) were independent factors associated with acceptance of COVID-19 vaccination in children. Conclusion: The level of acceptance of COVID-19 vaccination for children in this study was low (38.57%), with uncertainty around vaccine safety being the major concern. Therefore, to increase COVID-19 vaccines acceptance and uptake in children, effective public communication supported by data on safety and effectiveness of COVID19 vaccines should be emphasized. Keywords: Acceptance, COVID-19, children, Dar es Salaam, vaccines
Influence of gender norms in relation to child's quality of care: follow-up of families of children with SCD identified through NBS in Tanzania.
(Journal of Community Genetics, 2021) Malasa, Leonard J.
Introducing newborn screening (NBS) services for sickle cell disease (SCD) in Africa has been proven to be one of the most cost-effective approach to reducing morbidity and mortality associated with this condition. In view of this evidence, efforts have been made by countries in Africa where SCD prevalence is high to pilot NBS programmes and to strengthen comprehensive care services for SCD. While it is important to reap the benefits of NBS for SCD in Africa in terms of overall quantitative measures, it is also important to understand how certain social and cultural conditions may disproportionately influence the outcomes of screening for some groups. The aim of this study was to analyse the role of gender norms before and after NBS for SCD in Tanzania, and to assess how they influence the quality of care of diagnosed children. Using qualitative methods, we did in-depth interviews with families of children with SCD identified through the NBS services and focus group sessions with nurses working in neonatal and postnatal sections of regional referral hospitals in Dar es Salaam. By analysing the experiences of both the families and nurses, we were able to provide evidence on, firstly, the gendered relations that undergird childcare and, secondly, how those relations influence the quality of care the child may potentially receive. The results emphasize the importance of studying the social implications of SCD in Africa, especially with regard to improving the quality of care for patients with SCD in the region. We propose simple interventions, including gender-conscious health education and genetic counselling, which can help to improve the community understanding of genetic diseases while also reducing gender-related inequalities related to SCD care in Africa.
Iron deficiency and iron deficiency anemia among children 3 to 59 months of age in Kinondoni municipal, Dar es Salaam: a facility-based cross-sectional study
(East Africa Science, 2023-05-23) Malasa, Leonard J.; Rutachunzibwa, Felician; Fataki, Maulidi R.; Kalabamu, Florence S.
Background: Iron deficiency with subsequent iron deficiency anemia is the most common micronutrient disorder in children below 5 years of age worldwide. The developing countries bear more weight on the problem as the result of multifactorial factors including but not limited to recurrent infections such as malaria, helminths infestation, and inadequate food security. However, its magnitude in children living in Kinondoni Municipal in Dar es salaam is not well understood. Therefore, the aim of this study was to determine the prevalence of anemia and how it is contributed by the presence of iron deficiency among children between 3-59months of age in the above-mentioned setting. Methods: A facility-based cross-section study was conducted among children 3-59months attending Reproductive and Child Health Services at Kairuki, Sinza Hospital, and Kambangwa dispensary. Children who met the criteria, their basic social demographic information, complete blood count and differentials as well as blood ferritin levels were collected to assess the level of anemia, erythrocytic indices, and iron deficiency. Data were analyzed using the Statistical Package of Social Sciences (SPSS version 22). The magnitude of anemia and iron deficiencies were presented in percentages, and the relationship between hemoglobin and blood ferritin was assessed using Spearman’s correlation test for two continuous variables. The p-value of less or equal to 0.05 was considered statistically significant. Results: A total of 350 children were recruited for the study, 255 Children (72.9%) were anemic. Children below 24 months of age were more anemic compared to the older age group (X2 = 50, p <0.001). Furthermore, anemia was significantly associated with low ferritin levels (X2 = 65, p <0.001). Iron deficiency was found in 156 (44.6%) participants while iron deficiency anemia (low MCV, low ferritin, and low hemoglobin) was found in 138 (39.4%) participants. However, among 255 participants with anemia, 147(65.3%) had iron deficiency. There was a significant positive correlation between hemoglobin and blood ferritin levels (Spearman’s correlation coefficient = 0.6; p<0.01. Conclusion: Prevalence of anemia was high among children and was highly associated with younger age and iron deficiency. To overcome this problem, appropriate interventions such as massive promotion of breastfeeding, appropriate complementary feeding, and ensuring food security are warranted.
Prevalence and factors associated with hypothermia among neonates in regional referral hospitals in Dar es Salaam, Tanzania
(Global Journal of Health Science, 2022-10-31) Malasa, Leonard J.; Kalabamu, Florence S.; Rutachunzibwa, Felician; Fataki, Maulidi R.; Mashalla, Yohana J.
Background: Neonatal hypothermia is a major cause of mortality. This study determined the prevalence and factors associated with neonatal hypothermia in two regional referral hospitals in Dar es Salaam, Tanzania. Methods: Cross-sectional study was carried out between March and May 2021 at the Mwananyamala and Temeke Regional Referral Hospitals. Simple random and stratified sampling procedures were used to select study sites and proportionate population samples from each hospital respectively. Body temperature was measured within 90 minutes post birth; knowledge of the WHO guidelines on thermal protection of new-borns was collected from the mothers and health care providers using questionnaires. Logistic regression was used to assess associations between variables. SPSS version 25 was used to analyse the data and p < 0.05 was considered significant. Results: Total of 296 mother-new-born pairs and 41 health care providers were enrolled in the study. 26 mothers did not consent for the study. 25.6% of the 270 studied neonates were hypothermic. Lack of skin-to-skin contact with the mother; early neonatal weighing and bathing increased likelihood of neonatal hypothermia. Knowledge of neonatal thermal protection among mothers and care-providers was inadequate. Conclusions: The prevalence of neonatal hypothermia among neonates in the referral hospitals is high. The findings suggest knowledge gaps of the WHO recommended guidelines on neonatal hypothermia are associated with neonatal hypothermia. Efforts to increase awareness of the WHO recommended thermal protection guidelines are needed.
Prevention of Congenital Disorders and Care of Affected Children A Consensus Statement.
(JAMA pediatrics, 2016) Malasa, Leonard J.
As the Sustainable Development Goals are adopted by United Nations member states, children with congenital disorders remain left behind in policies, programs, research, and funding. Although this finding was recognized by the creation and endorsement of the 63rd World Health Assembly Resolution in 2010 calling on United Nations member states to strengthen prevention of congenital disorders and the improvement of care of those affected, there has been little to no action since then. The Sustainable Development Goals call for the global health and development community to focus first and foremost on the most vulnerable and those left behind in the Millennium Development Goal era. To maximize the opportunity for every woman and couple to have a healthy child and to reduce the mortality and severe disability associated with potentially avoidable congenital disorders and their consequences for the children affected, their families and communities, and national health care systems, we propose priority measures that should be taken urgently to address this issue.
Self-care management practices, glycemic control, and associated challenges among adolescents with type 1 diabetes mellitus in Dar es salaam, Tanzania. Dissertation
(Kairuki University, 2025) Malasa, Leonard J.
Introduction: Type 1 diabetes mellitus is among the leading non communicable diseases of public health importance worldwide. According to the International Federation of Diabetes atlas report, there were 8.75 million people living with T1DM worldwide in the year 2022, and out of these individuals, 1.52 million were those under 20 years of age. In Tanzania, approximately 6,915 youth under the age of 20 have T1DM. Despite improvement in diabetes care, maintaining optimal glucose levels in adolescents with T1DM remains challenging, with many exhibiting poor glycemic controls. Therefore, this study aimed at assessing self care management practices, glycemic control, and associated challenges among adolescents with T1DM. Rationale: This study stems from the critical need to understand and address the challenges faced by adolescents with Type 1 diabetes mellitus in Dar es Salaam, Tanzania. Given the complexities of managing Type 1 diabetes mellitus during adolescence, especially in developing countries, this research is crucial to identify areas where support is most needed. Objective: The broad objective of this study was to assess self-care management practices, glycemic control, and associated challenges among adolescents with type 1 diabetes mellitus in Dar es Salaam, Tanzania. Methods: This was a cross-sectional study employing mixed-methods, sequential explanatory design comprising both quantitative and qualitative data collection methods. The standard questionnaire and Self Care Inventory-Revised Version of 2009 were used to gather quantitative data from 155 study participants. Qualitative data were gathered through focus group discussions to investigate challenges to self-care management. Data were analyzed using SPSS version 27, with continuous variables presented as mean ± standard deviation. Categorical responses were expressed in frequencies and percentages, with glycaemic control categorized as good (≤7.5% HbA1c) or poor (>7.5% HbA1c), and participants in each category reported proportionally. The thematic analysis method was used to analyze the qualitative data. Results: Among the 155 adolescents with Type 1 Diabetes recruited into the study, 51.6% were females. The majority of participants (62.6%) were aged 1519 years, and 37.4% were in the 11-14 years age group. Regarding self-care management practices, the overall weighted average was 3.6 out of 5 equivalent to 72%. High adherence was reported for insulin use and clinic attendance, with over 80%, while recording blood glucose results, keeping food records, carrying quick-acting sugar to treat low blood glucose, exercise, and adjusting insulin dosage were among the most challenging practices. The majority of participants, 122 (78.7%), had poor glycaemic control, while only 33 (21.3%) had good glycemic control. Conclusion: This study showed the self-care management practices among the 155 study participants with varying levels of adherence. The overall weighted average score for self-care management practices was 3.6 out of 5, indicating moderate adherence to recommended self-care behaviours. However, only a third of study participants had good glycaemic outcomes despite moderate overall adherence to self-care practices. The qualitative analysis revealed multiple interconnected challenges that adolescents with Type 1 Diabetes mellitus face in managing their condition. Seven areas stood out: Insulin management challenges; Blood glucose monitoring difficulties; Dietary management barriers; Exercise-related concerns; Healthcare system challenges and the perceptions of Type 1 Diabetes mellitus. These findings reveal a complex interplay between technical, psychosocial and systemic barriers that require comprehensive, multifaceted interventions addressing not only clinical education but also healthcare system improvements, social stigma reduction, and ageappropriate developmental support. Recommendations: To improve glycaemic control among adolescents with Type 1 Diabetes mellitus: i. There is an urgent need for targeted interventions designed specifically for this population. These interventions should address the multifactorial nature of poor glycaemic control by incorporating age-appropriate education, family-centered care approaches, peer support programs, and enhanced healthcare system capacity for adolescent diabetes management. ii. To conduct further studies, especially involving study participants in rural areas to ensure generalizability countrywide, as well as including family and healthcare providers to explore their perspectives.
Sickle Cell Disease Ontology Working Group, The Sickle Cell Disease Ontology: enabling universal sickle cell-based knowledge representation.
(Database, 2019) Malasa, Leonard J.
Sickle cell disease (SCD) is one of the most common monogenic diseases in humans with multiple phenotypic expressions that can manifest as both acute and chronic complications. Although described more than a century ago, challenges in comprehensive disease management and collaborative research on this disease are compounded by the complex molecular and clinical phenotypes of SCD, environmental and psychosocial factors, limited therapeutic options and ambiguous terminology. This ambiguous terminology has hampered the integration and interoperability of existing SCD knowledge, and SCD research translation. The SCD Ontology (SCDO), which is a community-driven integrative and universal knowledge representation system for SCD, overcomes this issue by providing a controlled vocabulary developed by a group of experts in both SCD and ontology design. SCDO is the first and most comprehensive standardized humanand machine-readable resource that unambiguously represents terminology and concepts about SCD for researchers, patients and clinicians. It is built around the central concept ‘hemoglobinopathy’, allowing inclusion of non-SCD haemoglobinopathies, such as thalassaemias, which may interfere with or influence SCD phenotypic manifestations. This collaboratively developed ontology constitutes a comprehensive knowledge management system and standardized terminology of various SCD-related factors. The SCDO will promote interoperability of different research datasets, facilitate seamless data sharing and collaborations, including meta-analyses within the SCD community,

Browsing by Author "Malasa, Leonard J."

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