In Tanzania like in many sub-Saharan countries the data about Intimate Partner Violence (IPV) are scarce and diverse. This study aims to determine the magnitude of IPV and associated factors among ...ever partnered women in urban mainland Tanzania.
Data for this report were extracted from a big quasi-experimental survey that was used to evaluate MAP (MAP - Men as Partners) project. Data were collected using standard questions as those in big surveys like Demographic and Health Surveys. Data analyses involved descriptive statistics to characterize IPV. Associations between IPV and selected variables were based on Chi-square test and we used binary logistic regression to assess factors associated with women's perpetration to physical IPV and Odds Ratio (OR) as outcome measures with their 95 % confidence intervals (CI).
The lifetime exposure to IPV was 65 % among ever-married or ever-partnered women with 34, 18 and 21 % reporting current emotional, physical and sexual violence respectively. Seven percent of women reported having ever physically abused partners. The prevalence of women perpetration to physical IPV was above 10 % regardless to their exposure to emotional, physical or sexual IPV.
IPV towards women in this study was high. Although rates are low, there is some evidence to suggest that women may also perpetrate IPV against their partners. Based on hypothesis of IPV and HIV co-existence, there should be strategies to address the problem of IPV especially among women.
Abstract
Background
There is evidence that pre-exposure prophylaxis (PrEP) is effective in preventing HIV transmission, and PrEP is recommended by the World Health organization (WHO) for use by ...individuals at high risk of HIV infection. However, low adherence has been reported to hamper its effectiveness. Some evidence indicates that mHealth interventions may be a promising way of promoting PrEP adherence. Nevertheless, evaluations of mHealth interventions in Africa, the region most affected by HIV, are scarce. This study aimed at identifying the extent of and predictors for use of a smartphone based mHealth application among female sex workers in Dar es Salaam, Tanzania.
Methods
As part of a quasi-experimental study in Tanzania, 470 female sex workers who were eligible for PrEP and who owned a smartphone were recruited using respondent driven sampling. All participants were provided with an mHealth application called
Jichunge
, a smartphone-based app designed to promote adherence to PrEP by offering users information, advise and support during start-up and use of PrEP. We collected data through structured interviews at baseline and extracted user data from the app for a period of 30 days. Modified Poisson regression model with robust standard errors was used to identify predictors for the optimal use of the
Jichunge
app.
Results
Overall, the optimal use of the
Jichunge
app was 46.4%. Optimal use was significantly higher among women who were older (aPR = 1.3, 95% CI: 1.10-1.65,
p
= 0.004 for age 25-34 years, and aPR = 1.6, 95% CI: 1.19-2.07,
p
= 0.001 for age at least 35 years), who had secondary education or higher (aPR = 1.8, 95% CI: 1.08-2.94,
p
= 0.023), who had suboptimal social support (aPR = 1.2, 95% CI: 1.02-1.48,
p
= 0.030), who had high awareness of PrEP (aPR = 1.3, 95% CI: 1.08-1.55,
p
= 0.005), and who had experience using common mainstream social media applications (aPR = 1.4, 95% CI: 1.08-1.71,
p
= 0.009).
Conclusion
Optimal use of the
Jichunge
app was substantially higher among women with higher age, higher education, higher PrEP awareness, less social support, and experience using common social media applications. Individual and interpersonal factors should be considered in planning mHealth interventions. Further studies to determine predictors of longer-term mHealth engagement are needed.
Trial registration
International Clinical Trials Registry Platform
PACTR202003823226570
; 04.03.2020.
There is a growing concern about child mortality especially in developing countries. The Government of Tanzania and non-governmental organizations are fighting against diseases like malaria, anaemia, ...diarrhoea and pneumonia that contribute extensively to child mortality. This was a hospital-based, retrospective cohort study involving 1130 under-fives (excluding neonates) being either discharged from or died in public hospitals of the Lake Zone in Tanzania. We extracted information on symptoms and signs at admission, major diagnoses and causes of death from the medical records. We applied binary logistic regression models to assess risk factors associated with in-patient under-five death.
The major leading morbidities include malaria (49%), anemia (37%), diarrhea (27%), pneumonia (22%) and severe acute malnutrition (21%). We found the case fatality of 74 deaths per 1000 under-five admissions. Major underlying causes of deaths were severe anaemia, severe malaria and severe pneumonia. Factors associated with in-patient death were female sex (AOR 1.7; 95% CI 1.0, 2.8) and the odds significantly decreased with increasing level of maternal education.
Malaria remains a leading cause of admissions in hospitals among under-fives. Although the case fatality among children aged between 2 and 59 months admitted in hospitals in Lake Zone is decreasing, efforts are needed to address major causes of deaths (severe anaemia, severe malaria and severe pneumonia).
Sexual activities are increasingly changing from the cultural point of view what they used to be. Knowledge of these practices among adolescents may be a basis to create awareness among adolescents ...on practices that involve risks. This study aims to assess sexual practices among unmarried adolescents in Tanzania.
A cross-sectional survey was conducted among in-school and out-of-school but unmarried adolescents aged 10 to 19 in five locations in Tanzania. A questionnaire was used to collect information and to characterize sexual practices among these adolescents.
About 32% of adolescents reported being sexually active; a higher proportion being males than females. The only inquired and reported sexual practices include vaginal sex, masturbation, oral and anal sex. About 15% of sexually active adolescents reported having multiple sexual partners. Significantly more males reported having multiple partners than females. Nearly 42% of sexually active adolescents reported having used a condom during most recent sexual act. Females reported older partners at first sexual act.
Adolescents experience several sexual practices that include penetrative and non-penetrative. More males reported being sexually active than females. Despite adolescents reporting having multiple sexual partners, reported condom use during the most recent sexual act was low. We advocate for a more enhanced approach of reproductive health education that includes safer sex to adolescents without forgetting those in-schools.
Almost 10 million of the global population was infected with tuberculosis (TB) in 2017. Tanzania is among countries with high incidence of TB. Although control measures of TB are multi factorial, it ...is important to understand the individual's knowledge, attitudes and practices (KAP) in order to control TB infection. We conducted a cross-sectional study in northeast Tanzania; recruited and interviewed 1519 adults from two districts, one rural and another urban. We scored each participant using several questions for each construct of KAP. A study participant scoring at least 60% of the possible maximum scores was considered as having a good knowledge, positive attitude or good practices. And herein, a participant having positive TB attitude would mean they acknowledge TB exist, recognizes its impact on health and would seek or advise TB-infected individuals to seek the correct remedies. We applied multiple linear regression analysis to assess independent individual-level factors related to TB on KAP scores in the rural and urban populations. Overall, less than half (44%) of the study participants had good overall knowledge about TB infection and significantly more urban than rural adult population had good overall knowledge (p<0.001). Almost one in ten, (11%) of all study participants had positive attitudes towards TB infection. More urban study participants, (16%) had positive attitudes than their rural counterparts, 6%). Almost nine in ten (89%) of all study participants had good practices towards TB prevention and control; significantly more adults in urban, (97%) than the rural populations (56%) (p<0.01). Predictors of KAP scores were individual's education and main source of income. Adults in rural and urban northeast Tanzania have poor knowledge, attitudes and practices for TB infection and prevention. Strategies focusing on health education are important for control of TB, especially among rural communities.
Abstract Background Ebola Virus Disease (EVD) is a rare but contagious disease caused by Ebola Virus (EBOV). The first Ebola outbreaks were reported in the Democratic Republic of Congo (DRC) before ...subsequent reported cases in Western and East African countries, including Uganda, which borders Tanzania. Proximity to EVD-infected countries raises the prospect of cross-border transmission, raising alarm in Tanzania. This study aimed to explore the cultural practices likely to prevent or escalate EVD transmission in the event of its outbreak in the country. Methods This rapid ethnographic assessment employed observation, interviews, and focus group discussions to collect data from people with diverse characteristics in five regions of Tanzania Mainland namely, Kagera, Kigoma, Mwanza and Songwe regions and Zanzibar Island. The qualitative data was then subjected to thematic analysis. Findings Cultural practices may escalate the transmission of EVD and hinder its prevention and control. These cultural practices include caring sick people at home, confirmation of death, mourning, and body preparation for burial. Communal life, ceremonies, and social gatherings were other aspects observed to have the potential for compounding EVD transmission and hindering its containment in case of an outbreak. Conclusion Cultural practices may escalate EVD transmission as identified in the study settings. As such, Risk Communication and Community Engagement (RCCE) activities should be interventionist in transforming cultural practices that may escalate the spread of EVD as part of preparedness, prevention, and control efforts in the event of an outbreak.
Background: Dengue fever (DF) is currently widespread in tropical and sub-tropical countries. Among the triggers of ep- idemic include urbanization and internal migrations. Within the past few years, ...there have been DF outbreaks in Tanzania. Although Pwani region is among the predicted risk areas for the DF, there is insufficient data about people’s knowledge, attitude and practices towards prevention of DF in their settings. Therefore, the aim of this study was to assess knowledge, attitude and practices about DF among adults in Pwani region in Tanzania.
Methods: The cross-sectional study conducted in Mkuranga District, Pwani region in Tanzania. We used face-to-face inter- views to collect data. The main analytical procedure was descriptive using frequencies.
Results: The majority, 97.7%, were aware of DF. Nevertheless, almost 80% had a low knowledge on symptoms, transmis- sion and vector control measures. Furthermore, less than 20% had positive attitude towards dengue fever prevention, sever- ity of the illness and health seeking behavior.
Conclusion: Lack of enough knowledge and positive attitude about disease transmission, symptoms and preventive meas- ures put the population at high risk of contracting the disease. There is need to create and improve friendly, correct and simple information, education and education messages for the rural populations.
Keywords: Attitude; Dengue; knowledge; practice; rural.
Abstract
Background
Increasing access to smartphones in sub-Saharan Africa offers an opportunity to leverage mobile health (mHealth) technology to improve access to health care in underserved ...populations. In the domain of HIV prevention, mHealth interventions can potentially contribute to solving the challenges of suboptimal adherence to pre-exposure prophylaxis (PrEP) and low retention in PrEP services among populations most vulnerable to HIV acquisition. However, there is a gap in the knowledge about the use of such interventions in sub-Saharan Africa.
Objective
This study aims to evaluate the extent and predictors of retention in an mHealth app (
Jichunge
) that aims to promote adherence to PrEP and retention in PrEP care among female sex workers in Dar es Salaam, Tanzania.
Methods
A prospective cohort of female sex workers residing in Dar es Salaam were recruited, using respondent-driven sampling. All participants were provided with the
Jichunge
app as they started PrEP. A questionnaire was used to collect data on sociodemographics and other structural factors, while app use data for the 60-day period following the first 150 days of being in the intervention arm were extracted from the app’s back end. A multivariable log-binomial model was used to determine predictors of 6-month retention in the
Jichunge
app.
Results
A total of 470 female sex workers were recruited. Nearly three-quarters of participants (206/284, 72.5%) who came to the 6-month follow-up interview no longer had the
Jichunge
app on their phones. The majority of these participants (193/206, 93.7%) no longer had access to the app because of issues related to their phones. Data extracted from the back end of the app showed that the use of the app declined over time, and only 13.4% (63/470) of the participants were retained (continued to use the app) after 6 months of intervention. At 6 months, women aged ≥35 years were >2 times more likely to use the app than women aged 18 to 24 years (adjusted risk ratio aRR 2.2, 95% CI 1.2-4.1;
P
=.01). Furthermore, retention in the app was higher among participants who demonstrated high PrEP awareness at baseline (aRR 1.8, 95% CI 1.1-3;
P
=.01) and among those who had experienced financial difficulties due to health care spending (aRR 1.9, 95% CI 1.2-3.2;
P
=.01).
Conclusions
Most female sex workers (206/284, 72.5%) who were enrolled in PrEP care in Tanzania no longer used the
Jichunge
app after 6 months. Retention in the app at 6 months was predicted by older age, high PrEP awareness, and financial difficulties due to health care spending. Strategies for the long-term retention of participants in mHealth apps, such as systems for reinstallations of apps, should be considered during the design phase.
Safe water supply, sanitation, and hygiene (WaSH) are among key components to prevent and control waterborne diseases such as cholera, schistosomiasis, and other gastrointestinal morbidities in the ...community. In 2018, there was cholera outbreak in Ngorongoro district that was fueled by inadequate and unsafe water as well as poor sanitation and hygiene. We used an analytical cross-sectional study first to determine the proportion of households with access to WaSH and second to assess factors associated with coverage of household's access to WaSH. Methods included interviewing heads of the household to assess the availability of safe drinking water, use of unshared toilet/latrine by household members only, and the availability of functional handwashing facility. Eight percent of households had access to WaSH. Access to household's WaSH was positively associated with household's monthly income, education of heads of the household, and water use per person per week. To control water-related morbidities, there is a need to improve access to reliable safe drinking water, expand alternatives of households to earn more incomes, and enhance proper sanitation and hygiene services to rural areas and marginalized groups like the Maasai of Ngorongoro in Tanzania.
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