Journals

Permanent URI for this collection

http://41.93.62.172:4000/handle/123456789/388

Browse

Now showing 1 - 20 of 23

Feasibility and acceptability of unconditional cash transfers intervention among unemployed young adults with first-episode psychosis in South Africa: a pilot randomized controlled trial
(International journal of mental health, 2026-04-25) Protas,Joyce.
There is a lack of high-quality evidence on cash transfers as an intervention to support young people with first-episode psychosis (FEP) in Africa. To address this gap, we conducted a pilot randomized controlled trial (RCT) with a 3-month follow-up period to assess the feasibility and acceptability of an unconditional cash transfer (UCT) intervention among FEP. We enrolled 60 unemployed young adults (18–29 years) with FEP from three public hospitals in KwaZulu-Natal, SA, and allocated participants into the intervention (n = 30) or the control arm (n = 30) using simple randomization. The intervention arm participants received a monthly transfer of R1,350 for three consecutive months. All 30 participants in the intervention arm completed the three-month follow-up, and 24 (80%) completed follow-up in the control arm. Although the effect of UCT on clinical and social outcomes is not the primary focus of this RCT, we observed significantly greater quality of life (p < 0.05) and medication adherence (p < 0.02) in the intervention group as compared to control group at the 3-month follow-up period. Although personal/social functioning challenge (p = 0.24) and cumulative relapses (p = 0.10) were greater in the control group, no statistically significant group differences were observed. Our study contributes the first evidence on UCT feasibility and acceptability for FEP.
Strategies for relapse prevention among people with schizophrenia in KwaZulu-Natal Province, South Africa: Healthcare providers' perspectives
(Plos One, 2025-03-10) Protas,Joyce.
Introduction Relapse is a significant challenge among people with schizophrenia and is broadly recog- nized by the aggravation of positive or negative symptoms, the need for re-hospitalization, more intensive case management, and/or changes in medication. The quality of inpatient care and proper transition to outpatient care are crucial in reducing the risk of relapse. Healthcare providers play vital roles in ensuring the continuity of care after patients are discharged from the hospital. Little is known about the roles of preventing relapse from the perspective of healthcare providers. This study explored the currently existing strategies for preventing relapse from the perspective of healthcare providers. Methods We captured the view of healthcare providers providing services to psychiatric patients using a qualitative methodological approach with descriptive phenomenology. We con- ducted audio-recorded, in-depth interviews with 15 consenting clinical providers from a public psychiatric hospital in Durban, South Africa. To facilitate analysis, we used Dedoose software (SocioCultural Research Consultants, LLC [www.dedoose.com]), and the themes were inducted from the data. Results Six major themes inducted from the analysis: Preparing patients and caregivers for discharge; Developing consistent and caring therapeutic relationships; Using an active approach to transition; Working with patients and caregivers concurrently; Creating and sustaining interagency connections; and Facilitating alternative forms of treatment. Conclusions Discharge planning and preparation are needed to ensure smooth transitions from hos- pital to outpatient care for relapse prevention. The healthcare system should ensure the availability of human resources for health at all levels of health facilities, and multidisci- plinary teamwork will help a successful transition.
Unmet needs of young adults following first-episode psychosis in KwaZulu-Natal, South Africa: Baseline findings from a pilot randomised controlled trial of basic income support
(South African Journal of Psychiatry, 2026-02-26) Protas,Joyce.
BackgroundPeople with psychosis have multiple and complex needs. The first episode of psychosis (FEP), as a distinct health challenge that occurs frequently during adolescence or early adult years, is a serious threat because of high levels of poverty among the youth in South Africa. AimThis study quantifies the needs among unemployed FEP adults aged 18–29 years in South Africa for potential early intervention targeting. SettingThe study was conducted at government psychiatric facilities in Msunduzi Municipality, KwaZulu-Natal province, South Africa. MethodsAs part of a pilot randomised controlled trial of an unconditional cash transfer (UCT) intervention, also known as basic income support (BIS), 60 FEP participants were enrolled, and we assessed their needs using the Camberwell Assessment of Needs, the Household Food Insecurity Access Scale and the Water Insecurity Experience Scale. Descriptive cross-sectional analyses were summarised for various domains of needs. ResultsMost participants were black people (n = 58, 96.7%), male (n = 47, 78.3%), with a median age of 23 years (interquartile range [IQR] = 20.0–25.5), with half being diagnosed with schizophrenia (n = 30, 50%). The most significant severe unmet need was the inability to access government benefits to which one is entitled. Despite the limited availability of mental health services in South Africa, the majority reported that their need for managing psychotic symptoms was met or partially met. ConclusionThe needs of youth must go beyond the temporary management of psychotic symptoms. ContributionThis study highlights the unmet needs of young adults with FEP in resource-constrained environments and underscores the need for integrated interventions.
Experiences of an unconditional cash transfer intervention among young adults with first-episode psychosis in South Africa: qualitative inquiry of patients and their caregivers
(International Journal of Qualitative Studies on Health and Well-Being, 2025-11-25) Protas,Joyce .
Introduction Strengthening social protection through cash transfers has proven effective in reducing common mental disorders such as anxiety and depression. However, the acceptability of unconditional cash transfer (UCT) interventions, also known as Basic Income Support (BIS) in certain regions, for socially vulnerable young adults who have experienced first-episode psychosis (FEP) in sub-Saharan Africa, including South Africa, remains unknown. This qualitative inquiry explored the experience and acceptability of an unconditional cash transfer (UCT) intervention among patients with FEP and their caregivers. Methods The study was conducted at government hospitals in KwaZulu-Natal Province, South Africa. In this descriptive phenomenological qualitative study, we aimed to interview 15 recipients of a UCT intervention with their caregivers based on convenience sampling. An interview guide was designed to explore recipients’ experiences with money utilization and budget decisions, as well as their views on preferred recipients, the effects of UCT, and their recommendations on how much money is needed to cater to their needs. Information saturation was achieved after interviewing ten FEP recipients and their caregivers. NVIVO 14 was used to analyze the data using interpretive phenomenology. Results The UCT intervention was well accepted, with funds used for transportation to the hospital and purchasing groceries and food. Indirectly, UCT enhances family relationships and medication adherence and reduces patient and caregiver stress. Conclusion The UCT intervention was acceptable and positively experienced by patients with FEP. This study highlights the need to enhance social protection mechanisms to support engagement in mental health treatment for FEP.
Engagement, Disengagement and Re-Engagement in MentalHealth Services Among Young Patients With First-EpisodePsychosis: A Scoping Review
(Wiley, 2025-09-18) Protas,Joyce.
Introduction: Engagement in mental health services among young patients with first-episode psychosis (FEP) is crucial for pre- venting relapse. We conducted this scoping review to establish the proportion and determinants of engagement, disengagement and re-engagement in outpatient mental health care among young patients from 13 to 35 years with FEP. Methods: We used the guidelines for scoping review by the Joanna Briggs Institute (JBI) and the Arksey and O'Malley frame- work. We searched for published and unpublished studies guided by the inclusion criteria: studies published in English from 1990, the expansion of psychiatric outpatient, focused on engaged, disengaged and re- engaged in outpatient mental health care using quantitative, qualitative and mixed methods studies. We performed the numerical and thematic analysis and reporting using Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for scoping review (PRISMA-ScR). Results: About 25 articles published from 2002 to 2020 met the inclusion criteria for this review; the proportion of young peo- ple with FEP who remained engaged was 45.5% for 6 months of follow-up, and the proportion of re-engagement after initial disengagement was 78.8%. Disengagement ranged between 13% and 56.3% for 12–36 months. The socio-demographic factors associated with disengagement were older age, male, black, unmarried status, living alone, unemployment, social and material deprivation, poverty, substance use and involvement with criminal justice. Some clinical determinants included a history of mental illness in the family and a psychosis disorder diagnosis other than schizophrenia. Conclusion: Disengagement from mental health services is consistently high among people with FEP, indicating the need for intervention studies that address the associated individual and clinical factors to ensure their retention in treatment.
Risk factors and strategies for relapse prevention among individuals living with serious mental illness in South Africa: Qualitative inquiry from patients’ and caregivers’ perspectives
(Plos One, 2024-08-22) Protas,Joyce
Introduction Relapse among individuals with serious mental illnesses in resource-limited contexts, including South Africa, is a significant concern. To date, the risks for relapse among this population is well documented, but little is known about prevention strategies to reduce its occurrence in these resource-limited settings. Therefore, this qualitative study explores the risk factors and strategies for relapse prevention from the patients’ and caregivers’ perspectives. Methods We conducted audio-recorded face-to-face in-depth interviews to capture the lived experience of relapse of inpatient study participants with serious mental illness (N = 24) at a public specialized psychiatry hospital in South Africa and their caregivers (N = 6). We conducted an inductive thematic analysis with two pre-specified themes (risk factors for relapse and strategies for prevention), with the codes devised from the data. Results Six sub-themes were identified from the analysis within the two pre-specified themes(Risk factors and strategies for relapse prevention): personal-related, family-related, and health system-related risk factors and strategies for preventing relapse, respectively. To highlight some essential findings, the importance of motivation for drug adherence, family involvement, and availability of anti-psychotic drugs in public health care were noted. More importantly, this study identified important cultural complexities where traditional healers play a significant role in some cultural understanding and treatment of mental illness, affecting medication adherence. Conclusion This study calls for people-centered mental health care delivery in a public health system that listens to the voice of concern, including cultural challenges, and implements meaningful support that matters most to the patient and their family/caregivers.
Unmet needs of young adults following first-episode psychosis in KwaZulu-Natal, South Africa: Baseline findings from a pilot randomised controlled trial of basic income support
(South African Journal of Psychiatry,, 2026-02-16) Protas, Joyce
Background: People with psychosis have multiple and complex needs. The first episode of psychosis (FEP), as a distinct health challenge that occurs frequently during adolescence or early adult years, is a serious threat because of high levels of poverty among the youth in South Africa. Aim: This study quantifies the needs among unemployed FEP adults aged 18–29 years in South Africa for potential early intervention targeting. Setting: The study was conducted at government psychiatric facilities in Msunduzi Municipality, KwaZulu-Natal province, South Africa. Methods: As part of a pilot randomised controlled trial of an unconditional cash transfer (UCT) intervention, also known as basic income support (BIS), 60 FEP participants were enrolled, and we assessed their needs using the Camberwell Assessment of Needs, the Household Food Insecurity Access Scale and the Water Insecurity Experience Scale. Descriptive cross-sectional analyses were summarised for various domains of needs. Results: Most participants were black people (n = 58, 96.7%), male (n = 47, 78.3%), with a median age of 23 years (interquartile range [IQR] = 20.0–25.5), with half being diagnosed with schizophrenia (n = 30, 50%). The most significant severe unmet need was the inability to access government benefits to which one is entitled. Despite the limited availability of mental health services in South Africa, the majority reported that their need for managing psychotic symptoms was met or partially met. Conclusion: The needs of youth must go beyond the temporary management of psychotic symptoms.
Feasibility and acceptability of unconditional cashtransfers intervention among unemployed youngadults with first-episode psychosis in South Africa: apilot randomized controlled trial
(Routledge, 2026-04-25) Protas, Joyce
There is a lack of high-quality evidence on cash transfers as an intervention to support young people with first-episode psychosis (FEP) in Africa. To address this gap, we conducted a pilot randomized controlled trial (RCT) with a 3-month follow-up period to assess the feasibility and acceptability of an unconditional cash transfer (UCT) intervention among FEP. We enrolled 60 unemployed young adults (18–29 years) with FEP from three public hospitals in KwaZulu-Natal, SA, and allocated participants into the intervention (n = 30) or the control arm (n = 30) using simple randomization. The intervention arm participants received a monthly transfer of R1,350 for three consecutive months. All 30 participants in the intervention arm completed the three-month follow-up, and 24 (80%) completed follow-up in the control arm. Although the effect of UCT on clinical and social outcomes is not the primary focus of this RCT, we observed significantly greater quality of life (p < 0.05) and medication adherence (p < 0.02) in the intervention group as compared to control group at the 3-month follow-up period. Although personal/social functioning challenge (p = 0.24) and cumulative relapses (p = 0.10) were greater in the control group, no statistically significant group differences were observed. Our study contributes the first evidence on UCT feasibility and acceptability for FEP.
Environmental factors associated with diarrhoea among under-five children attending at Muhimbili National Hospital, Tanzania
(Tanzania J Clin Nur Rep, 2024-06-30) Mathias, Victor A.
Generally, diarrhoea is still a second major reason of death and illness in children below the age of five years. It holds breathes of around half a million under five children every year and causes million more to be admitted. Every year diarrhoea kills around 525000 children under five years. Globally there are nearly 1.7 billion cases of child- hood diarrhoea disease every year. Unfortunately, environmental factors associated with diarrhoea among under five children in Tanzania have not yet well addressed. Therefore, this study aimed to determine environmental factors associated with diarrhoea among under-five children attending at Muhimbili National Hospital (MNH), in Tanzania. A quantitative cross-sectional study design of 100 simple randomly selected participants was applied. Questionnaires were used to collect data from mothers/ carers with a child of under-five children suffering from diarrhoea admitted at MNH. Data were analysed using SPSS. Environmental risk factors associated with diarrhoea were determined with a p value of ≤ 0.05. Unsuitable infrastructure for grey water disposal, improper hand washing before feeding the baby and hand washing without using clean water and soap had strongly association with diarrhoea in under-five children attending at MNH with P-value of 0.001, 0.001, and 0.01 respectively. Identified risk factors for diarrhoea among under-five children call for the importance of providing health education to the caregivers on the causes, prevention, and treatment on the problem.
Tanzanian mothers’ cultural beliefs and misinformation regarding the reasons for their cesarean sections
(International Journal of Childbirth, 2019) Mathias, Victor A.
BACKGROUND: In Tanzania, cesarean section (CS) rates have been steadily increasing, yet little is known about mothers’ understanding of the medical rationale for their CSs. ID:p0060 AIM: To identify mothers’ cultural understandings of the rationale for their CSs. ID:p0065 METHODS: Design: A qualitative descriptive design was employed. ID:p0070 Setting: A government hospital in the western region in Tanzania. ID:p0075 Participants: A total of 117 mothers were interviewed using convenience sampling post CS. ID:p0080 FINDINGS: Forty percent of the mothers were younger than 18 years, with more than 50% having had five or more live babies. Among multigravida women, 40.2% had had one or more previous CSs. ID:p0085 The emergent themes were lack of dietary knowledge, use of local herbs, delays in coming to hospital, avoiding stressful labor pains and no ability to exercise, and no personal preferences of “push or go for an operation.” ID:p0090 CONCLUSION: Pregnant women in Tanzania need improved health education to make informed choices about childbirth and be involved all processes of antepartum care decision making to achieve optimal birth outcomes.
Knowledge and practice on early breastfeeding initiation among postpartal mothers at Amana Hospital, Tanzania.
(International Journal of Childbirth, 2021-12) Mathias, Victor A.
BACKGROUND: Early breastfeeding initiation refers to putting the newborn to the breast within 1 hour of birth. However, rates of exclusive breastfeeding are low both globally (42%) and in Tanzania (51%). AIM: To assess knowledge about, attitudes toward, and practice of early breastfeeding initiation among postpartal mothers in Tanzania. METHODS: This study used a cross-sectional design. Simple random sampling was used to recruit 100 postpartal mothers who had delivered within the previous 48 hours at Amana Regional Referral Hospital, which is in the Eastern zone of Tanzania. FINDINGS: Of the participating postpartal mothers, 65% were knowledgeable about early breastfeeding initiation and the remaining 35% were not knowledgeable. Most mothers (62%) had positive attitudes toward early breastfeeding initiation, and 38% had negative attitudes. Furthermore, 45% of participating mothers had initiated early breastfeeding (within 1 hour), whereas 55% had delayed initiation of early breastfeeding (after 1 hour). Mothers' age was positively associated with knowledge about breastfeeding (p =.048), but the association between knowledge about early breastfeeding and education was non-significant (p =.514). Associations between attitude toward early breastfeeding and age and education were also nonsignificant (p = 1.000 and p =.132, respectively). Furthermore, associations between the practice of early breastfeeding and age and education were nonsignificant (p = 1.000 andp =.204, respectively). CONCLUSION: Postpartal mothers may benefit from being informed about the health benefits of early initiation of breastfeeding after delivery for both mother and baby. Improving their knowledge and attitudes toward this practice may help to avoid unnecessary morbidity and mortality among newborns.
Situation analysis of healthcare standards and criteria that contribute to the care of residents in homes for older people in Tanzania
(Sage publication, 2022-12) Mathias, Victor A.
Problems experienced in homes for older people in Tanzania highlighted the need for a situation analysis of healthcare standards to identify the baseline of care provided to residents in these homes. This study conducted a situation analysis of structure healthcare standards and associated criteria with the aim of contributing to improved quality of care for residents in homes for older people in Tanzania. Thirty-two homes for older people in Tanzania were audited using an audit instrument that included seven fields, 26 structure standards, and 262 associated criteria. The analysis showed that overall, the homes were non-compliant with healthcare structure standards and associated criteria. The Tanzanian Government should urgently introduce measures to address the missing standards and associated criteria.
Structure healthcare standards and criteria that contribute to the care of residents in homes for the elderly: a narrative review
(Journal of Aging and Environment, 2023-01-16) Mathias, Victor A.
Meaningful life for the residents is mostly influenced by the context of the homes for the elderly. Context in terms of structure healthcare standards should recognize protection needs of residents as their rights to safety. The review aimed to identify structure healthcare standards and criteria that contribute to the care of residents in homes for the elderly. The literature reviewed included theoretical and empirical literature. Peer-reviewed scientific journals based on the structure standards in healthcare that contribute to the care of residents in homes for the elderly were obtained from three databases (Google scholar, PubMed, HINARI). Key words search of these databases were used. One hundred twenty-eight studies (n = 128) on healthcare standards were identified. Latter analysis was followed to analyze the studies whereby researchers merged findings of single and independent studies. Seven main themes emerged from the analysis namely infrastructure, clinical management, meals and water, residents’ rights, guiding documents for the care of residents, human resources required, and safety and security. Homes for the elderly should involve the elderly in their care to promote ownership of their services. In addition, the homes must improve the physical set-up to balance residents’ needs and protecting them from physical and psychological maltreatment.
HIV retesting among pregnant women with gestational age of 36 weeks or higher attending antenatal clinic at Temeke regional referral hospital, Tanzania
(Tanzania Medical Journal, 2022-06-15) Protas, Joyce
Abstract Background Although Tanzania has set a target of 90% Human Immunodeficiency Virus (HIV), retesting among pregnant women, the rate of re-uptake is still low despite the service being free of charge. This study determined HIV retesting among pregnant women with the gestational age of 36 weeks or higher attending the antenatal clinic at Temeke Regional Referral Hospital. Methods The cross-sectional study design was used. The data was collected from 12th October 2020 to 9th November 2020 in Temeke regional referral Hospital. Two hundred pregnant mothers attending the Reproductive and child health clinic (RCH) clinic who had a gestational age of 36 weeks or above and tested HIV negative from the first test were included. The demographic and obstetrics information were collected by using a structured questionnaire. The descriptive and factors analysis was done by using SPSS version 20. The Chi-square test determined the relationship between variables, and the P-value of less or equal to 0.05 was considered statistically significant. Results The percentage for re-uptake of second HIV test was 30% (60/200). Out of 60 who repeated the test, 6.7% (4/60) were HIV seroconverted. Factors associated with re-test were being married (p-value 0.05, X2=7.8), being self-employed (p-value is 0.00 , X2=18.838 ) ,four and above antenatal clinic visit (p-value is 0.003, X2=11.737 ) ,having knowledge of repeating (p-value is 0.00 ,X2=59.294) , multiparty ( p-value is 0.015 ,X2=8.334 ,positive perception during the first test (p-value is 0.044, X2= 4.039) ,maternal age of 25-29 years old (p-value is 0.053, X2= 10.901) ,and having access to radio and television (p-value is 0.04, X2= 6.442). Conclusion The proportion of HIV retesting was 30%, and factors associated with retesting were being married, being self-employed, more than four ANC visits, multiparity, having knowledge about retesting, and positive perception during the first test.
Markers of perceived managerial success within the Tanzanian nursing profession
(International Journal of Africa Nursing Sciences, 2015) Mella, Pauline P.
This study explores the views of nurse managers in Tanzania regarding desirable attributes for effective management of their health services. The mixed method study utilised an initial questionnaire (n = 78) and subsequent responses from two semi-structured focus group interviews (n = 14) with purposive samples of consenting nurse managers who had completed the original questionnaire. Overall, ‘Skills’ were considered the most important dimension, followed by ‘Knowledge and Learning’. Specific skills, such as decision making, were considered essential. Culture was perceived to be a key influence on management potential, with education providing a pathway to overcome early and subsequent barriers. A lack of delegation was highlighted. An overall transactional style perpetuates as a means of maximising scant resources which impedes trust and sharing of power through delegation. The provision of culturally appropriate management education, relevant to the local context, is essential for the development of nursing in Tanzania.
Major factors that impact on women’s health in Tanzania: the way forward
(Health Care for Women International, 2003) Mella, Pauline P.
Tanzania’s health policy is to improve the health of all Tanzanians with a focus on those most at risk. One of the major objectives is to reduce infant and maternal morbidity and mortality and increase life expectancy. The life expectancy in Tanzania is 49 years for males and 53 years for females. Maternal mortality is recorded at 300–400 deaths per 100,000 women. The main causes are haemorrhage, sepsis, rupture of the uterus, anaemia, and others. The risk factors associated with the above causes include maternal height, age, child spacing, and number of births per woman; malaria and anaemia; imbalance of energy and food intake; HIV/AIDS; women’s workload; and female genital mutilation (FGM). To address issues of women’s health, the government has put in place many strategies, for example, a ministry to look after women’s issues, the safe motherhood initiatives, improvement of the knowledge and skill of health care providers, as well as collaboration with nongovernmental organizations (NGOs) and private agencies. The health sector reform is important because it has negatively affected women’s access to health care. To improve the health of women in Tanzania, health and health-related sectors should cooperate and collaborate in order to empower women in the areas of education, social status, and technology. Policies must also address poverty, nutrition, adolescent health, and violence and sexual abuse.
Effects of educated professionals on the health and care of women in Tanzania
(Health care for women international, 1987) Mella, Pauline P.
Education of women in Tanzania, one of the 31 least developed countries of the world, is a farily recent event. Education of Tanzanian women has afforded better health for whole families through better knowledge of self‐care, employment opportunities, birth planning, and status in the community. A negative effect of education and employment is an erosion of traditional cultural patterns. Children often do not learn the values thought important in their tribes. The value of education, however, seems to outweigh the disadvantages, as the health of the country as measured by the infant mortality rates improves. A study of Tanzanian women indicated that professional nurses were identified as the source of the most useful and reliable health advice.
Prevalence and factors associated with neonatal sepsis among neonates in Temeke and Mwananyamala Hospitals in Dar es Salaam, Tanzania
(Tanzania Journal of Health Research, 2016) Protas, Joyce; Semiono, Avelina; Sariah, Adellah
Background: Neonatal sepsis contributes significantly to neonatal mortality. This study was carried out to determine the prevalence and factors associated with neonatal sepsis in Dar es Salaam, Tanzania. Methods: A hospital based cross-sectional study was conducted at Mwananyamala and Temeke hospitals in Dar es Salaam, during August-September, 2015. A standardized questionnaire was used to obtain demographic, obstetrics and clinical information. Diagnosis of neonatal sepsis was done clinically. Relationship between outcome variable and exposure variable was done using Chi square test. Multivariate logistic regression was used to measure association after controlling for confounders. Results: A total of 220 neonates were recruited, 69 (31.4%) had sepsis. The risk factors associated with neonatal sepsis were maternal age of >35 years (AOR=6.7; 95%CI 2.1-20.1; p-value-0.001) and resuscitation at birth (AOR=1.25195%CI1. 22-3.88; p-value=0.025). Conclusion: Neonatal sepsis among neonates in Dar es Salaam is associated with maternal and health services related factors. The findings underscore the importance of routine assessment and close monitoring of neonates. It is therefore recommended to have more skilled health personnel and advanced equipment while providing maternal and new-born health care services.
Surgical Site Infection among Patients Undergone Orthopaedic Surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania.
(East and Central African Journal of Surgery, 2017) Protas, Joyce; Semiono, Avelina; Mika, Elizabeth Z.; Sariah, Adellah
Background: The aim of this study was to determine prevalence and factors associated with surgical site infection at Muhimbili Orthopedic Institute. Method: This was a cross-sectional study conducted at Muhimbili Orthopaedic Institute (MOI) in Dar es Salaam, from August, 2015 to October 2015. Convenience sampling technique was used to recruit postoperative patients for this study. Standardized questionnaires were used to obtain demographic, social, and clinical information from respondents. Determination of the relationship between outcome and exposure variables was done using chi square test. Multivariate logistic regression was used to measure the association after controlling for confounders. Odds ratio corresponding to 95% confidence interval with a p value of ≤ 0.05 was considered significant. Results: Out of 300 study participants 75(25.0%) had surgical site infection. This was highly determined by more than 2 hours length of surgical procedure (AOR= 1.4; 95%CI 1.14-6.69; P value=0.05), none prophylactic use of antibiotics (AOR= 3.4; 95%CI 1.6-7.78; P value=0.03), more than one week stay before surgery (AOR=3.3; 95%CI 2.24-3.34; P value =0.00). Conclusion: The overall prevalence of surgical site infection at Muhimbili Orthopedic Institute was high. This was associated with more than 2 hours length of surgery, lack of prophylaxis use, and pre-operative hospital stay.
Risk factors associated with pre-term birth in Dar es Salaam, Tanzania: a case-control study
(Tanzania Journal of Health Research, 2016) Kumpuni,Kitindi ,Protas, Joyce
Background: Preterm birth remains one of the most serious problems in obstetrics care. Its aetiology is complex and multifactorial. This study was carried out to determine risk factors for preterm birth in Dar es Salaam City in Tanzania.Methods: This case-control study was conducted in three municipal hospitals namely, Amani, Mwananyamala and Temeke in Dar es Salaam. It involved 377 pairs of women with preterm birth (cases) and term birth (controls). Eligible women who agreed to participate and who signed the consent form completed a short interview regarding demographic and lifestyle factors, had their baby examined for maturity, and had their medical records abstracted. All cases and controls were interviewed face-to-face using a specially designed questionnaire. Multivariate logistic regression after controlling for potential confounders was used to measure the strength of associations between preterm birth and related factors.Results: Several significant risk factors associations with pre-term birth were multiple pregnancies (AOR = 8.6; 95%CI 4.5-16.5; p-value <0.001), untreated vaginal discharge (AOR = 5.2; 95%CI 1.1-24.4; p-value 0.034), public prenatal care (AOR = 2.1; 95%CI 1.1-4.1; p-value 0.017), untreated urinary tract infection (AOR = 2.7; 95%CI 1.2-6.1; p-value 0.016), complication during pregnancy (AOR = 2.7; 95%CI 1.3-5.3; p-value 0.004), cervical incompetence (AOR = 11.6; 95%CI 1.1-121.5; p-value 0.04), polyhydramnios (AOR = 8.3; 95%CI 1.7-40.2; p-value 0.008), and lack of antenatal visits (AOR = 5.1; 95%CI 1.4-17.8; p-value 0.042).Conclusion: This study has identified several risk factors for preterm birth in the city of Dar es Salaam. It is important that planners design community-based interventions to address complications from preterm birth.

Browse

Recent Submissions