Browsing by Author "Stephen, Ambroce M."

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    A cohort study to compare banana leaves dressing with convention dressing for children with burn wounds at Bugando Medical Centre, Mwanza, Tanzania 2021
    (Tanzania journal of health research, 2023-03-26) Sungwa, Edson.; Mwakanyamale, Adela A.; Stephen, Ambroce M.
    Background: Globally burns among children is a public health concern. Banana leaf dressings or Conventional dressing materials may be used to dress burn wounds to children. The study aimed to explore outcomes of burn wounds dressed using banana leaves and conventional dressing materials respectful. Methods: Hospital based cohort study design conducted at Bugando Medical Center Burn Unit. Non-probability convenient sampling method with a sample size of 35 pediatric patients with burn wounds for each group of convectional dressing methods and banana leaf dressings were reached. Stata program Version 13 was used to analyze data. Results: A total of 70 children; 1 to 18 years, median age of 4 and interquartile range [IQR: 1-17] years were enrolled in the study. Thirty-five were dressed with Banana leaf other 35 were dressed with convention materials. Results showed that Banana leaf dressing was associated with; less pain (aOR = 0.2, 95% CI: 0.1 – 0.5, p – value <0.001), less medication use (aOR = 3.0,95% CI: 1.1 – 8.7, p – value 0.02) and good satisfaction (aOR = 85.6, 95% CI: 3.3 – 219, p – value <0.001) respectful during dressing change compared to conventional dressing method. However, no different observed between length of hospital stay and dressing method chosen. Conclusions: Although there is no evidence of a dressing method that is best for burn wounds. This study shows that Banana leaf dressing is convenient in terms of having less pain experiences and that it can be locally obtained in areas where banana plant is easily available. We recommend the use of banana leaf dressings for burns moreover, enlightenment of the public on the intervention and prevention of burns among children. Keywords: Banana leaf dressing, Conventional dressing, Burns, wound
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    Immediate seven day outcomes and risk factors of low birth weight neonates at referral hospitals in Mwanza City, Tanzania in october 2020
    (African Journal of Health Sciences, 2020) Sungwa, Edson.; Stephen, Ambroce M.
    Background: Every year more than 20 million neonates worldwide are born with low birth weight (LBW) per year. Ninety-five percent of LBW births occur in developing countries. The aim of this study was to determine Immediate Seven Day Outcomes and Risk Factors of Low Birth Weight Neonates at Referral Hospitals in Mwanza City. Materials and Methods: This was a hospital based observational prospective cohort study of neonates with LBW whom were followed up for seven days in the neonatal wards at referral hospitals in Mwanza city. Maternal social-demographic, newborns clinical data and vitality outcomes were collected. Categorical and continuous variables were summarized and presented in tables or bar charts. Any p-value of < 0.05, at 95% confidence interval was regarded as statistically significant. Results: Total of 200 neonates with median age of 0.8 days at baseline were enrolled. Amongst 148 (74 %) had prolonged hospitalization; due to sickness 88 (59%), and 60 (40%) due to poor weight gain. Whereas, the remaining 42 (21%) were discharged and 10 (5%) died within seven days. Prolonged hospitalization was associated with family income (p-value= <0.001) and place of delivery (p-value = <0.001). Neonatal death was associated with family income (p-value =0.035) and birth weight (p-value = 0.019). Early discharge associated with gestational age at first antenatal visit, family income, mode of delivery, APGAR score at one minute, time interval between delivery and admission and timing of medication initiation. Conclusion: LBW neonates are at high risk of death and prolonged hospitalization due to sickness or due to poor weight gain. Associated factors of these outcomes were family income, place of delivery, birth weight, gestation age during first antenatal visit, mode of delivered and low APGAR score.
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    Nursing practice on post-operative wound care in surgical wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania
    (Open Journal of Nursing, 2019) Mwakanyamale, Adela A.; Mukaja, Anna-Mary; Ndomondo, Mathew D.; Zenas, Joan, P.; Stephen, Ambroce M.; Mika, Elizabeth Z.
    Background: Postoperative wound healing has been a problem which causes high mortality in the developing world; postoperative wound has been reported to cause devastating consequences and a measurable mortality. There is a limited number of published studies in Tanzania investigating Nursing practice on post-operative wound care in surgical wards at Muhimbili National Hospital, Dar-es-Salaam, Tanzania. This study assesses nursing practice on postoperative wound care by nurses in surgical wards at Muhimbili National Hospital. Methods: A cross-sectional study of surgical nurses was carried out through the use of randomly selected surgical wards at Muhimbili National Hospital in Tanzania from September 2011 to July 2013. A multistage cluster sampling technique was used to obtain a suitable number of study participants. Data collection was done using a checklist from a convenient sample of 71 nurses in selected surgical wards. Results: The result indicates that a big number of the participants were female (76.5%) and those of the age group 25 to 34 years were 40.8%. Participants exceeding a half of the selected sample reported to have poor post-operative wound care practice (57.7%). In comparison, male participants scored higher, and had better practice than their female counterparts, however, there was no considerable difference in the scores (P = 0.803). During set-up and preparation phase, the washing of hands before starting and after the completion of procedure was taken into consideration by less than half of the participants (49.3%). All participants did not ensure the environment is clean and take into account the patient’s privacy through the use of screen or even closing the room. The report shows that nurses take into consideration putting on clean gloves during the removal of the old dressing (99%), the use of sterile gloves during wound dressing was taken into consideration by most of the nurses (63%). Good practice was noted in applying dressing solution as recommended (85%), dry sterile dressing was applied by (90%), arrangement and setting up of dressing forceps and other items that may be needed in order of their application using forceps (20%), usage of forceps to dip gauze into antiseptic solution (35%) and cleaning of the wound cleaning from least contaminated to most contaminated area was only adhered to by (34%). Post-operative counseling and giving to the patient not to temper with the wound was done by a representation of only 15% of nurses. All the nurses did not do the documentation of the changes observed on the wound nor did they report on the patients comfort and the date and time after the procedure wound changes, reported patient comfort, and recorded date or time after the procedure. Conclusion: Majority of the nurses in surgical wards do not follow the postoperative wound care checklist provided by MNH although they know its importance. Assessment of the wound and documentation continues to be a problem in the nursing profession in Tanzania. Nurses are reasonably knowledgeable about the principal of wound dressing; however, lack of knowledge on some of the key principles of wound dressing is worth noting. Almost half of the nurses do not wash hands before and after the procedures, they don’t use single gauze in one direction only, not cleaning from least contaminated to most contaminated area, which can lead to wound contamination.