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Title: Exposure to information and communication about HIV/AIDS and perceived credibility of information sources among young people in northern Tanzania.
Author: Bastien S; Leshabari MT; Klepp KI
Source: African Journal of AIDS Research. 2009;8(2):213-222.
Abstract: A structured face-to-face interview was completed by 993 young people out of school, between the ages of 13 and 18, in Kilimanjaro, Tanzania; additionally, the questionnaire was self-administered by 1,007 students attending either their last year of primary or first year of secondary school. Significant factors associated with the frequency of exposure to HIV/AIDS information and frequency of communication about HIV/AIDS included urban/rural location, sex, socio-economic status, and educational attainment. Both groups ranked the radio as the most frequent source of HIV/AIDS information. The in-school group reported significantly more frequent exposure to all sources of HIV/AIDS information, and they communicated more frequently about the topic than did the out-of-school group. The in-school group gave high credibility ratings to medical doctors, the radio, and parents as sources of information, whereas the out-of-school group attributed the most credibility to the mass media. Irrespective of school attendance, the young people ranked friends, parents, and doctors as preferred communicators of sexual and reproductive health information.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | SAMPLING STUDIES | COMPARATIVE STUDIES | OUT-OF-SCHOOL YOUTHS | STUDENTS | HIV INFECTIONS | INFORMATION SOURCES | INTERPERSONAL COMMUNICATION | INTERVIEWS | KNOWLEDGE | MASS MEDIA | SOCIOECONOMIC STATUS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Educational Status | Socioeconomic Factors | Economic Factors | Education | Viral Diseases | Diseases | Information | Communication | Data Collection | Sociocultural Factors
Document Number: 339889

Peer Reviewed

Title: Reflecting and shaping the discourse: the role of music in AIDS communication in Tanzania.
Author: Bastien S
Source: Social Science and Medicine. 2009 Apr;68(7):1357-60.
Abstract: Failure to recognize the importance of oral traditions in Africa and the potential of music and song for stimulating social and behavior change would represent a missed opportunity in HIV prevention strategies. Local narratives concerning AIDS are often utilized in popular songs and constitute rich sources of contextual information about the epidemic that have thus far been un- or underutilized in HIV prevention strategies. Endogenously conceived messages delivered via a channel such as music increase the likelihood of messages being contextually appropriate and culturally engaging. This form of media also presents the greatest opportunity for wide dissemination. Drawing on field work conducted in the Kilimanjaro region, this paper presents examples of how music and musicians in Tanzania reflect and potentially shape AIDS discourse. Three broad recurrent themes addressed in songs are discussed: AIDS metaphors, stigma and broader HIV prevention messages. By tapping into the wealth of information about AIDS discourse contained within popular songs, and by recognizing musicians as potential opinion leaders and agents of social change, the effectiveness of prevention strategies may be increased.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | BEHAVIOR CHANGE | MUSIC | HIV PREVENTION | HIV INFECTIONS | AIDS | COMMUNICATION STRATEGY | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Behavior | Culture | Sociocultural Factors | Viral Diseases | Diseases | Communication
Document Number: 341617

Title: Placing learning needs in context: distance learning for clinical officers in Tanzania.
Author: Brigley S; Hosein I; Myemba I
Source: Medical Teacher. 2009 Apr;31(4):e169-76.
Abstract: BACKGROUND: Poor public health indicators in Tanzania have led to the upgrading of nursing and clinical personnel who currently have just core training. Clinical officers (COs) have 3 years training in basic and applied medicine and are responsible for healthcare of large and dispersed rural populations. AIMS: UNESCO-Wales has funded colleagues in Wales (UK) to assist the upgrade of COs. An inquiry into their learning needs and the Tanzanian context has produced a framework for design of a module for COs on sexually transmissible infections and HIV & AIDS by distance learning. METHODS: Face-to-face discussions were held with the Ministry of Health, healthcare workers, educators and administrators in Tanzania; a review of training documents was carried out; and a follow-up questionnaire issued to COs. RESULTS: The discussions and review highlighted teacher-centred approaches, and management, infrastructure and resources obstacles to curriculum change. Principal learning needs of COs around STIs were: counselling, syndromic management, drugs management, laboratory diagnosis, health education, resources, staffing and service morale. CONCLUSIONS: Placing learning needs in context in dialogue with Tanzanian colleagues was an advance on simple transfer of educational technologies and expertise. The inquiry resulted in a draft study guide and resources pack that were positively reviewed by Tanzanian tutors. Management and resources issues raised problems of sustainability in the module implementation.
Language: English
Keywords:
TANZANIA | SUMMARY REPORT | HEALTH PERSONNEL | DISTANCE EDUCATION | TRAINING PROGRAMS | NEEDS | UNESCO | CURRICULUM | SEXUALLY TRANSMITTED DISEASES | HIV INFECTIONS | AIDS | TREATMENT | OBSTACLES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Delivery of Health Care | Health | Education | Economic Factors | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors | Reproductive Tract Infections | Infections | Diseases | Viral Diseases | Medical Procedures | Medicine | Health Services | Organization and Administration
Document Number: 341949

Peer Reviewed

Title: The "seeded" focus group: a strategy to recruit HIV+ community members into treatment research.
Author: Busza J; Zaba B; Urassa M
Source: Sexually Transmitted Infections. 2009 Jun;85(3):212-5.
Abstract: OBJECTIVE(S): We piloted an innovative community-based recruitment approach to contact known HIV+ individuals for referral to treatment without endangering their confidentiality. METHODS: Nested within an HIV cohort study, operations research to monitor and improve rural uptake of antiretroviral therapy (ART) was conducted alongside the introduction of Tanzania's national treatment programme. We confronted the challenge of recruiting participants without inadvertently disclosing their HIV status to family or other community members. During post-test counselling, nurses compiled a list of HIV+ persons who expressed interest in being contacted when ART became available. Study numbers, but not names, of 12 "seeds" were added to a randomly generated list of residents, matched by age group and sex, and all were invited to participate in focus-group discussions on community perceptions of treatment. After the discussion, the original counsellors met each participant in private, inviting the "seed" for ART referral and offering VCT to others. RESULTS: Ten "seeds" were successfully located and attended the local focus-group discussion; all subsequently volunteered to undergo clinical tests in advance of receiving antiretroviral therapy. They also agreed to participate in a study of barriers to ART access. The other focus-group members contributed useful information on levels of understanding and support for treatment, and several came forward for HIV testing. CONCLUSIONS: The "seeded" focus group is a very straightforward and easily arranged method of recruiting HIV+ people for research or service delivery within a wider context of engaging with local community perceptions.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | PILOT PROJECTS | COHORT ANALYSIS | OPERATIONS RESEARCH | PERSONS LIVING WITH HIV/AIDS | RECRUITMENT ACTIVITIES | ANTIRETROVIRAL THERAPY | PERCEPTION | COMMUNITY-BASED DISTRIBUTION | HIV TESTING | TREATMENT | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Program Evaluation | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | Program Activities | HIV | Psychological Factors | Behavior | Nonclinical Distribution | Distributional Activities | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342673

Peer Reviewed

Title: Community-based environmental management for malaria control: evidence from a small-scale intervention in Dar es Salaam, Tanzania.
Author: Castro MC; Tsuruta A; Kanamori S; Kannady K; Mkude S
Source: Malaria Journal. 2009;8:57.
Abstract: BACKGROUND: Historically, environmental management has brought important achievements in malaria control and overall improvements of health conditions. Currently, however, implementation is often considered not to be cost-effective. A community-based environmental management for malaria control was conducted in Dar es Salaam between 2005 and 2007. After community sensitization, two drains were cleaned followed by maintenance. This paper assessed the impact of the intervention on community awareness, prevalence of malaria infection, and Anopheles larval presence in drains. METHODS: A survey was conducted in neighbourhoods adjacent to cleaned drains; for comparison, neighbourhoods adjacent to two drains treated with larvicides and two drains under no intervention were also surveyed. Data routinely collected by the Urban Malaria Control Programme were also used. Diverse impacts were evaluated through comparison of means, odds ratios (OR), logistic regression, and time trends calculated by moving averages. RESULTS: Individual awareness of health risks and intervention goals were significantly higher among sensitized neighbourhoods. A reduction in the odds of malaria infection during the post-cleaning period in intervention neighbourhoods was observed when compared to the pre-cleaning period (OR = 0.12, 95% CI 0.05-0.3, p < 0.001). During the post-cleaning period, a higher risk of infection (OR = 1.7, 95% CI 1.1-2.4, p = 0.0069) was observed in neighbourhoods under no intervention compared to intervention ones. Eighteen months after the initial cleaning, one of the drains was still clean due to continued maintenance efforts (it contained no waste materials and the water was flowing at normal velocity). A three-month moving average of the percentage of water habitats in that drain containing pupae and/or Anopheles larvae indicated a decline in larval density. In the other drain, lack of proper resources and local commitment limited success. CONCLUSION: Although environmental management was historically coordinated by authoritarian/colonial regimes or by industries/corporations, its successful implementation as part of an integrated vector management framework for malaria control under democratic governments can be possible if four conditions are observed: political will and commitment, community sensitization and participation, provision of financial resources for initial cleaning and structural repairs, and inter-sectoral collaboration. Such effort not only is expected to reduce malaria transmission, but has the potential to empower communities, improve health and environmental conditions, and ultimately contribute to poverty alleviation and sustainable development.
Language: English
Keywords:
TANZANIA | URBAN AREAS | RESEARCH REPORT | MALARIA PREVENTION | VECTOR CONTROL | INTERVENTIONS | SANITATION | MALARIA | PREVALENCE | COMMUNITY PARTICIPATION | POLITICAL FACTORS | FINANCIAL ACTIVITIES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Parasitic Diseases | Diseases | Disease Transmission Control | Prevention and Control | Programs | Organization and Administration | Public Health | Health | Measurement | Research Methodology | Sociocultural Factors | Economic Factors
Document Number: 341983

Title: Sustainable community management of urban water and sanitation schemes (a training manual).
Author: Castro V; Msuya N; Makoye C
Source: Nairobi, Kenya, World Bank, Water and Sanitation Program - Africa, 2009 Jan. 52 p.
Abstract: The aim of this capacity building programme is to improve the efficiency and positive impact of urban, community-managed water and sanitation schemes. The manual was originally developed in collaboration with the Dar es Salaam Water and Sewerage Authority's (DAWASA) Community Water Supply and Sanitation Program (CWSSP); but some of the material is applicable to other urban communities who may need to improve their management practices and increase the likelihood of a sustainable operation. The material included in this manual is intended to provide a trainer with the tools and information to build management capacity in the target communities. Although the manual is geared for trainers, it has also been designed to serve as a reference tool for communities who may wish to review the material on an on-going basis. (Excerpts)
Language: English
Keywords:
TANZANIA | MANUAL | WATER SUPPLY | SANITATION | COMMUNITY PARTICIPATION | PROGRAM SUSTAINABILITY | ORGANIZATION AND ADMINISTRATION | PROCEDURES | COMMUNICATION | FINANCIAL ACTIVITIES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Natural Resources | Environment | Public Health | Health | Programs | Economic Factors
Document Number: 331414

Peer Reviewed

Title: Evaluation of uptake and attitude to voluntary counseling and testing among health care professional students in Kilimanjaro region, Tanzania.
Author: Charles MP; Kweka EJ; Mahande AM; Barongo LR; Shekalaghe S; Nkya HM; Lowassa A; Mahande MJ
Source: BMC Public Health. 2009 May;9(128):1-9.
Abstract: A structured questionnaire was used among health care professional students aged 18-25 years who were enrolled in degree, diploma, and certificate courses at Kilimanjaro Christian Medical College and all other allied health schools. A total of 309 students were recruited; among these 197 (63.8%) were females. All respondents were aware of the benefits of voluntary counseling and testing (VCT). Only 107 (34.6%) of students had previously gone to VCT. Risk perception among the students was low (37.2%) even though they were found to have higher risk behaviors that predisposed them to becoming infected with HIV.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | SAMPLING STUDIES | STUDENTS | HEALTH PERSONNEL | VOLUNTARY COUNSELING AND TESTING | AWARENESS | PROGRAM ACCEPTABILITY | SEX BEHAVIOR | RISK BEHAVIOR | ATTITUDES | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Education | Delivery of Health Care | Health | HIV Testing | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Knowledge | Sociocultural Factors | Program Evaluation | Programs | Organization and Administration | Behavior | Psychological Factors
Document Number: 341407

Title: HIV stigma and missed medications in HIV-positive people in five African countries.
Author: Dlamini PS; Wantland D; Makoae LN; Chirwa M; Kohi TW; Greeff M; Naidoo J; Mullan J; Uys LR; Holzemer WL
Source: AIDS Patient Care and STDs. 2009 May;23(5):377-87.
Abstract: The availability of antiretroviral medications has transformed living with HIV infection into a manageable chronic illness, and high levels of adherence are necessary. Stigma has been identified as one reason for missing medication doses. The objective of this study was to explore the relationship between perceived HIV stigma and self-reported missed doses of antiretroviral medications in a 12-month, repeated measures cohort study conducted in Lesotho, Malawi, South Africa, Swaziland, and Tanzania. Data were collected from 1457 HIV-positive individuals at three times between January 2006 and March 2007. Participants completed a series of questionnaires. Of the 1457 participants, 698 were taking ARVs during the study and are included in this analysis. There was a significant relationship between perceived HIV stigma and self-report of missed medications over time (t = 6.04, p Language: English
Keywords:
LESOTHO | MALAWI | SOUTH AFRICA | SWAZILAND | TANZANIA | RESEARCH REPORT | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | STIGMA | PERCEPTION | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Africa, Eastern | Research Methodology | HIV Infections | Viral Diseases | Diseases | HIV | Behavior | Social Problems | Sociocultural Factors | Psychological Factors
Document Number: 342182

10.

Peer Reviewed

Title: "When in the body, it makes you look fat and HIV negative": the constitution of antiretroviral therapy in local discourse among youth in Kahe, Tanzania.
Author: Ezekiel MJ; Talle A; Juma JM; Klepp K
Source: Social Science and Medicine. 2009 Mar;68(5):957-964.
Abstract: Antiretroviral therapy (ART) is becoming increasingly more accessible within the health care system in Tanzania. However, the impact of the increased availability of ART on local conceptions about medicines, health and physical wellbeing has not been fully explored. In this article we examine how ART is constituted within local discourses about treatment and healing. Based on 21 focus group discussions with young people aged 14-24 years in a rural area (Kahe), we examine how local terms and descriptions of antiretroviral therapy relate to wider definitions about the body, health, illness and drug efficacy. Findings illustrate how local understandings of ART draw on a wider discourse about the therapeutic functions of medicines and clinical dimensions of HIV/AIDS. Therapeutic efficacy of antiretroviral medication appeared to overlap and sometimes contradict locally shared understandings of the clinical functions of medicines in the body. Implications of ART on bodily appearance and HIV signs may influence conceptions about sick role, perpetuate stigma and affect local strategies for HIV prevention. Structural inequities in access, limited information on therapeutic efficacy of ART and perceived difficulties with status disclosure appear to inform local conceptions and possible implications of ART. Policy and programme interventions to foster public understanding and acceptability of ART should emphasize treatment education about the benefits and limitations of therapy and increased access to ART in rural areas, and should integrate voluntary status disclosure and HIV prevention. (author's)
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | FOCUS GROUPS | RURAL AREAS | YOUTH | ANTIRETROVIRAL THERAPY | HIV INFECTIONS | HIV | STIGMA | SELF-PERCEPTION | TREATMENT | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Geographic Factors | Population | Age Factors | Population Characteristics | Demographic Factors | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | Perception | Psychological Factors | Behavior | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 325348

11.

Peer Reviewed

Title: A comparison of HIV/AIDS-related stigma in four countries: negative attitudes and perceived acts of discrimination towards people living with HIV/AIDS.
Author: Genberg BL; Hlavka Z; Konda KA; Maman S; Chariyalertsak S; Chingono A; Mbwambo J; Modiba P; Van Rooyen H; Celentano DD
Source: Social Science and Medicine. 2009 Jun;68(12):2279-87.
Abstract: HIV/AIDS-related stigma and discrimination have a substantial impact on people living with HIV/AIDS (PLHA). The objectives of this study were: (1) to determine the associations of two constructs of HIV/AIDS-related stigma and discrimination (negative attitudes towards PLHA and perceived acts of discrimination towards PLHA) with previous history of HIV testing, knowledge of antiretroviral therapies (ARVs) and communication regarding HIV/AIDS and (2) to compare these two constructs across the five research sites with respect to differing levels of HIV prevalence and ARV coverage, using data presented from the baseline survey of U.S. National Institute of Mental Health (NIMH) Project Accept, a four-country HIV prevention trial in Sub-Saharan Africa (Tanzania, Zimbabwe and South Africa) and northern Thailand. A household probability sample of 14,203 participants completed a survey including a scale measuring HIV/AIDS-related stigma and discrimination. Logistic regression models determined the associations between negative attitudes and perceived discrimination with individual history of HIV testing, knowledge of ARVs and communication regarding HIV/AIDS. Spearman's correlation coefficients determined the relationships between negative attitudes and perceived discrimination and HIV prevalence and ARV coverage at the site-level. Negative attitudes were related to never having tested for HIV, lacking knowledge of ARVs, and never having discussed HIV/AIDS. More negative attitudes were found in sites with the lowest HIV prevalence (i.e., Tanzania and Thailand) and more perceived discrimination against PLHA was found in sites with the lowest ARV coverage (i.e., Tanzania and Zimbabwe). Programs that promote widespread HIV testing and discussion of HIV/AIDS, as well as education regarding and universal access to ARVs, may reduce HIV/AIDS-related stigma and discrimination.
Language: English
Keywords:
THAILAND | TANZANIA | ZIMBABWE | SOUTH AFRICA | RESEARCH REPORT | COMPARATIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | STIGMA | SOCIAL DISCRIMINATION | ANTIRETROVIRAL THERAPY | KNOWLEDGE | HIV TESTING | Developing Countries | Asia, Southeastern | Asia | Africa, Eastern | Africa, Sub Saharan | Africa | Africa, Southern | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Social Problems | Sociocultural Factors | HIV | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342737

12.

Peer Reviewed

Title: Alcohol abuse, sexual risk behaviors, and sexually transmitted infections in women in Moshi urban district, northern Tanzania.
Author: Ghebremichael M; Paintsil E; Larsen U
Source: Sexually Transmitted Diseases. 2009 Feb;36(2):102-7.
Abstract: BACKGROUND: To assess the covariates of alcohol abuse and the association between alcohol abuse, high-risk sexual behaviors and sexually transmitted infections (STIs). METHODS: Two thousand and nineteen women aged 20 to 44 were randomly selected in a 2-stage sampling from the Moshi urban district of northern Tanzania. Participant's demographic and socio-economic characteristics, alcohol use, sexual behaviors, and STIs were assessed. Blood and urine samples were drawn for testing of human immunodeficiency virus, herpes simplex virus, syphilis, chlamydia, gonorrhea, trichomonas, and mycoplasma genitalium infections. RESULTS: Adjusted analyses showed that a history of physical (OR = 2.05; 95% CI: 1.06-3.98) and sexual violence (OR = 1.63; 95% CI: 1.05-2.51) was associated with alcohol abuse. Moreover, alcohol abuse was associated with number of sexual partners (OR = 1.66; 95% CI: 1.01-2.73). Women who abused alcohol were more likely to report STIs symptoms (OR = 1.61; 95% CI: 1.08-2.40). Women who had multiple sexual partners were more likely to have an STI (OR = 2.41; 95% CI: 1.46-4.00) compared to women with 1 sexual partner. There was no direct association between alcohol abuse and prevalence of STIs (OR = 0.86; 95% CI: 0.55-1.34). However, alcohol abuse was indirectly associated with STIs through its association with multiple sexual partners. CONCLUSIONS: The findings of alcohol abuse among physically and sexually violated women as well as the association between alcohol abuse and a history of symptoms of STIs and testing positive for STIs have significant public health implications. In sub-Saharan Africa, where women are disproportionately affected by the HIV epidemic screening for alcohol use should be part of comprehensive STIs and HIV prevention programs.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | KAP SURVEYS | CLINICAL RESEARCH | EPIDEMIOLOGIC METHODS | WOMEN IN DEVELOPMENT | URBAN POPULATION | MULTIPLE PARTNERS | SEXUALLY TRANSMITTED DISEASES | SEX BEHAVIOR | RISK BEHAVIOR | ALCOHOL USE AND ABUSE | PREVALENCE | RAPE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Surveys | Sampling Studies | Studies | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Sexual Partners | Behavior | Reproductive Tract Infections | Infections | Diseases | Measurement | Crime | Social Problems | Sociocultural Factors
Document Number: 330387

13.

Peer Reviewed

Title: Association of age at first sex with HIV-1, HSV-2, and other sexual transmitted infections among women in northern Tanzania.
Author: Ghebremichael M; Larsen U; Paintsil E
Source: Sexually Transmitted Diseases. 2009 Sep;36(9):570-576.
Abstract: The authors examined the association between age at first sex and the prevalence of sexually transmitted infections (STIs), including HIV-1 and HSV-2, in women in Moshi urban district, northern Tanzania. A total of 2,019 women aged 20 to 44 were randomly selected in a two-stage sampling, and they provided information on demographics and sexual behaviors. Blood and urine samples were drawn for STI testing. Women who had their first sexual intercourse between ages 18 and 19 (OR = 0.66; 95% CI = 0.50-0.86) or 20+ (OR = 0.46; 95% CI = 0.36-0.60) were less likely to have STIs, including HIV-1 and HSV-2, than were women who had their first intercourse before their 18th birthday. Early age at first sex was associated with having a regular noncohabiting partner, female circumcision, and coercion at first intercourse.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | SAMPLING STUDIES | WOMEN | FIRST INTERCOURSE | HIV INFECTIONS | SEXUALLY TRANSMITTED DISEASES | INCIDENCE | SIGNS AND SYMPTOMS | LABORATORY EXAMINATIONS AND DIAGNOSES | RISK FACTORS | FEMALE GENITAL CUTTING | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Demographic Factors | Population | Sex Behavior | Behavior | Viral Diseases | Diseases | Reproductive Tract Infections | Infections | Measurement | Examinations and Diagnoses | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Harmful Traditional Practices | Traditional Health Practices | Culture | Sociocultural Factors
Document Number: 339905

14.

Peer Reviewed

Title: Adherence to anti retroviral therapy (ART) during Muslim Ramadan fasting.
Author: Habib AG; Shepherd JC; Eng MK; Babashani M; Jumare J; Yakubu U; Gebi UI; Saad M; Ibrahim H; Blattner WA
Source: AIDS and Behavior. 2009 Feb;13(1):42-45.
Abstract: Annual fasting during the month of Ramadan is observed in Muslim countries, some of which have widespread HIV infection. We studied treatment adherence and customary practices among 142 fasting 'FT' and 101 nonfasting 'NFT' patients on anti-retroviral therapy (ART) in Nigeria. Adherence on ART among FT and NFT patients was similar during Ramadan, 96% and 98%, and ever since commencement of ART, 80% and 88%, respectively. FT patients altered their typical daily behaviors by advancing morning and delaying evening doses thereby prolonging dosing intervals, eating heavier meals pre-dawn and on breakfast at sunset (78%), and changing or reducing their sleeping and waking times (40%). This preliminary study suggests that adherence and drug taking frequency appear uncompromised in FT HIV infected patients on ARVs.
Language: English
Keywords:
ETHIOPIA | KENYA | NIGERIA | SOMALIA | SOUTH AFRICA | TANZANIA | UGANDA | RESEARCH REPORT | PERSONS LIVING WITH HIV/AIDS | ISLAM | HIV | ANTIRETROVIRAL THERAPY | USER COMPLIANCE | RELIGION | CULTURE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Africa, Western | Africa, Southern | HIV Infections | Viral Diseases | Diseases | Sociocultural Factors | Behavior
Document Number: 330156

15.
Title: Household ownership and use of insecticide treated nets among target groups after implementation of a national voucher programme in the United Republic of Tanzania: plausibility study using three annual cross sectional household surveys.
Author: Hanson K; Marchant T; Nathan R; Mponda H; Jones C; Bruce J; Mshinda H; Schellenberg JA
Source: BMJ. 2009;339:b2434.
Abstract: OBJECTIVES: To evaluate the impact of the Tanzania National Voucher Scheme on the coverage and equitable distribution of insecticide treated nets, used to prevent malaria, to pregnant women and their infants. DESIGN: Plausibility study using three nationally representative cross sectional household and health facility surveys, timed to take place early, mid-way, and at the end of the roll out of the national programme. SETTING: The Tanzania National Voucher Scheme was implemented in antenatal services, and phased in on a district by district basis from October 2004 covering all of mainland Tanzania in May 2006. PARTICIPANTS: 6115, 6260, and 6198 households (in 2005, 2006, and 2007, respectively) in a representative sample of 21 districts (out of a total of 113). INTERVENTIONS: A voucher worth $2.45 ( pound1.47, euro1.74) to be used as part payment for the purchase of a net from a local shop was given to every pregnant woman attending antenatal services. MAIN OUTCOME MEASURES: Insecticide treated net coverage was measured as household ownership of at least one net and use of a net the night before the survey. Socioeconomic distribution of nets was examined using an asset based index. RESULTS: Steady increases in net coverage indicators were observed over the three year study period. Between 2005 and 2007, household ownership of at least one net (untreated or insecticide treated) increased from 44% (2686/6115) to 65% (4006/6198; P<0.001), and ownership of at least one insecticide treated net doubled from 18% (1062/5961) to 36% (2229/6198) in the same period (P<0.001). Among infants under 1 year of age, use of any net increased from 33% (388/1180) to 56% (707/1272; P<0.001) and use of an insecticide treated net increased from 16% (188/1180) to 34% (436/1272; P<0.001). After adjusting for potential confounders, household ownership was positively associated with time since programme launch, although this association did not reach statistical significance (P=0.09). Each extra year of programme operation was associated with a 9 percentage point increase in household insecticide treated net ownership (95% confidence interval -1.6 to 20). In 2005, only 7% (78/1115) of nets in households with a child under 1 year of age had been purchased with a voucher; this value increased to 50% (608/1211) in 2007 (P<0.001). In 2007, infants under 1 year in the least poor quintile were more than three times more likely to have used an insecticide treated net than infants in the poorest quintile (54% v 16%; P<0.001). CONCLUSIONS: The Tanzania National Voucher Scheme was associated with impressive increases in the coverage of insecticide treated nets over a two year period. Gaps in coverage remain, however, especially in the poorest groups. A voucher system that facilitates routine delivery of insecticide treated nets is a feasible option to "keep up" coverage.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | CROSS SECTIONAL ANALYSIS | HOUSEHOLDS | PREGNANT WOMEN | INFANT | MALARIA PREVENTION | BED NETS | COST EFFECTIVENESS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Family and Household | Sociocultural Factors | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Malaria | Parasitic Diseases | Diseases | Parasite Control | Public Health | Health | Evaluation Indexes | Quantitative Evaluation | Evaluation
Document Number: 342233

16.

Peer Reviewed

Title: Estimating the capacity for ART provision in Tanzania with the use of data on staff productivity and patient losses.
Author: Hanson S; Thorson A; Rosling H; Ortendahl C; Hanson C; Killewo J; Ekstrom AM
Source: PloS One. 2009;4(4):e5294.
Abstract: BACKGROUND: International targets for access to antiretroviral therapy (ART) have over-estimated the capacity of health systems in low-income countries in Sub-Saharan Africa. The WHO target for number on treatment by end 2005 for Tanzania was 10 times higher than actually achieved. The target of the national Care and Treatment Plan (CTP) was also not reached. We aimed at estimating the capacity for ART provision and created five scenarios for ART production given existing resource limitations. METHODS: A situation analysis including scrutiny of staff factors, such as available data on staff and patient factors including access to ART and patient losses, made us conclude that the lack of clinical staff is the main limiting factor for ART scale-up, assuming that sufficient drugs and supplies are provided by donors. We created a simple formula to estimate the number of patients on ART based on availability and productivity of clinical staff, time needed to initiate vs maintain a patient on ART and patient losses using five different scenarios with varying levels of these parameters. FINDINGS: Our scenario assuming medium productivity (40% higher than that observed in 2002) and medium loss of patients (20% in addition to 15% first-year mortality) coincides with the actual reported number of patients initiated on ART up to 2008, but is considerably below the national CTP target of 90% coverage for 2009, corresponding to 420,000 on ART and 710,000 life-years saved (LY's). Our analysis suggests that a coverage of 40% or 175,000 on treatment and 350,000 LY's saved is more achievable. CONCLUSION: A comparison of our scenario estimations and actual output 2006-2008 indicates that a simple user-friendly dynamic model can estimate the capacity for ART scale-up in resource-poor settings based on identification of a limiting staff factor and information on availability of this staff and patient losses. Thus, it is possible to set more achievable targets.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | CLIENTS | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | ANTIRETROVIRAL DRUGS | DEATH RATE | TREATMENT | TIME FACTORS | PROGRAM ACCESSIBILITY | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Program Activities | Programs | Organization and Administration | HIV Infections | Viral Diseases | Diseases | HIV | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Demographic Factors | Population | Program Evaluation
Document Number: 342074

17.

Title: Analyzing the cost-effectiveness of interventions to benefit orphans and vulnerable children: evidence from Kenya and Tanzania.
Author: Hutchinson P; Thurman TR
Source: Chapel Hill, North Carolina, University of North Carolina at Chapel Hill, Carolina Population Center [CPC], MEASURE Evaluation, 2009 Apr. 26 p. (SR-09-51USAID Cooperative Agreement No. GPO-A-00-03-00003-00)
Abstract: To provide insight on the success of programs providing services to orphans and vulnerable children (OVC), this paper analyzes cost-effectiveness of four programs in Kenya and Tanzania by comparing intervention costs to program outcomes. These results provide some evidence that investments in OVC programs-particularly (1) school-based HIV education and counseling for children and (2) savings and internal lending committees for guardians-can help improve the well-being of OVCs at a fairly low cost per beneficiary.
Language: English
Keywords:
KENYA | TANZANIA | RESEARCH REPORT | ORPHANS AND VULNERABLE CHILDREN | HIV INFECTIONS | PSYCHOSOCIAL FACTORS | ANTIRETROVIRAL THERAPY | EDUCATION | HEALTH SERVICES | TREATMENT | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Family and Household | Sociocultural Factors | Viral Diseases | Diseases | Behavior | HIV | Delivery of Health Care | Health | Medical Procedures | Medicine
Document Number: 339996

18.

Title: Total lymphocyte count and World Health Organization pediatric clinical stage as markers to assess need to initiate antiretroviral therapy among human immunodeficiency virus-infected children in Moshi, Northern Tanzania.
Author: Johnson OO; Benjamin DK; Benjamin DK Jr; Schimana W; Gayani Tillekeratne L; Crump JA; Landman KZ; Kinabo GD; Mmbaga B; Msuya LJ; Shao JF; Swai ME; Cunningham CK
Source: Pediatric Infectious Disease Journal. 2009 Jun;28(6):493-7.
Abstract: BACKGROUND: The World Health Organization (WHO) has recommended the use of clinical staging alone and with total lymphocyte count to identify HIV infected children in need of antiretroviral therapy (ART) in resource-limited settings, when CD4 cell count is not available.METHODS: We prospectively enrolled children obtaining care for HIV infection at the Kilimanjaro Christian Medical Centre Pediatric Infectious Diseases Clinic in Moshi, Tanzania between March 2004 and May 2006 for this cohort study.RESULTS: One hundred ninety two (89.7%) of 214 children met WHO ART initiation criteria based on clinical staging or CD4 cell count. Several low-cost measures identified individuals who met WHO ART initiation criteria to the following degree: WHO stages 3 or 4 had 87.5% (95% CI, 82.8-92.1) sensitivity and, by definition, 100% (CI, 100-100) specificity; WHO recommended advance disease TLC cutoffs: sensitivity = 23.9% (95% CI, 17.3-30.5) specificity = 78.2% (95% CI, 67.3-89.1). Low TLC was a common finding, (50 of 214; 23%); however, it did not improve the sensitivity or specificity of clinical staging in identifying the severely immunosuppressed stage 2 children. Growth failure or use of total lymphocyte counts in isolation were not reliable indicators of severe immunosuppression or need to initiate ART.CONCLUSION: The use of total lymphocyte count does not improve the ability to identify children in need of ART compared with clinical staging alone. Low absolute lymphocyte count did not correlate with severe immunosuppression based on CD4 cell count in this cohort.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | PROSPECTIVE STUDIES | PERSONS LIVING WITH HIV/AIDS | CHILDREN | ANTIRETROVIRAL THERAPY | NEEDS | IMMUNOLOGIC FACTORS | WHO | STANDARDS | IMMUNOLOGICAL EFFECTS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Research Methodology | HIV Infections | Viral Diseases | Diseases | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV | Economic Factors | Immunity | Immune System | Physiology | Biology | UN | International Agencies | Organizations | Political Factors | Sociocultural Factors
Document Number: 342640

19.
Peer Reviewed

Title: Geophagy (Soil-eating) in relation to Anemia and Helminth infection among HIV-infected pregnant women in Tanzania.
Author: Kawai K; Saathoff E; Antelman G; Msamanga G; Fawzi WW
Source: American Journal of Tropical Medicine and Hygiene. 2009 Jan;80(1):36-43.
Abstract: Geophagy, the regular and deliberate consumption of soil, is prevalent among pregnant women in sub-Saharan Africa. We examined the associations of geophagy with anemia and helminth infection among 971 human immunodeficiency virus (HIV)-positive pregnant women in Tanzania. About 29% of pregnant women regularly consumed soil. Occupation, marital status, and gestational age were associated with geophagy. Ascaris lumbricoides infection was associated with the prevalence of geophagy (adjusted-prevalence ratio 1.81; 95% confidence interval [CI] = 1.37-2.40); however, hookworm, Trichuris trichiura, and Strongyloides stercoralis showed no association. Anemia and red blood cell characteristics suggestive of iron deficiency were strongly correlated with geophagy at baseline. In longitudinal analyses, we found evidence suggesting that soil consumption may be associated with an increased risk of anemia (adjusted-relative risk 1.16; 95% CI = 0.98-1.36) and a lower hemoglobin concentration (adjusted-mean difference -3.8 g/L; 95% CI [-7.3, -0.4]). Pregnant women should be informed about the potential risks associated with soil consumption.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | EPIDEMIOLOGIC METHODS | CLINICAL RESEARCH | PERSONS LIVING WITH HIV/AIDS | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | PREVALENCE | PARASITIC DISEASES | ANEMIA | COMPLICATIONS | OCCUPATIONS | MARITAL STATUS | GESTATIONAL AGE | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | Persons Living With HIV/AIDS | HIV Infections | Viral Diseases | Diseases | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Measurement | Human Resources | Nuptiality | Fetus | Pregnancy | Reproduction
Document Number: 330314

20.
Peer Reviewed

Title: Risks for preterm delivery and low birth weight are independently increased by severity of maternal anaemia.
Author: Kidanto HL; Mogren I; Lindmark G; Massawe S; Nystrom L
Source: South African Medical Journal. 2009 Feb;99(2):98-102.
Abstract: OBJECTIVE: To estimate the effect of the severity of maternal anaemia on various perinatal outcomes. DESIGN: A cross-sectional study. SETTING: Labour Ward, Muhimbili National Hospital, Dar es Salaam, Tanzania. METHODS: The haemoglobin of eligible pregnant women admitted for delivery between 15 November 2002 and 15 February 2003 was measured. Data on socio-demographic characteristics, iron supplementation, malaria prophylaxis, blood transfusion during current pregnancy, and current and previous pregnancy outcomes were collected and analysed. Anaemia was classified according to the World Health Organization (WHO) standards: normal--Hb > or = 11.0 g/dl; mild--Hb 9.0-10.9 g/dl; moderate--Hb 7.0-8.9 g/dl; and severe--Hb < 7.0 g/dl. Logistic regression analysis was performed to estimate the severity of anaemia. The following outcome measures were used: preterm delivery (<37 weeks), Apgar score, stillbirth, early neonatal death, low birth weight (LBW) (<2500 g) and very low birth weight (VLBW) (<1500 g). RESULTS: A total of 1174 anaemic and 547 non-anaemic women were enrolled. Their median age was 24 years (range 14-46 years) and median parity was 2 (range 0-17). The prevalence of anaemia and severe anaemia was 68% and 5.8%, respectively. The risk of preterm delivery increased significantly with the severity of anaemia, with odds ratios of 1.4, 1.4 and 4.1 respectively for mild, moderate and severe anaemia. The corresponding risks for LBW and VLBW were 1.2 and 1.7, 3.8 and 1.5, and 1.9 and 4.2 respectively. CONCLUSION: The risks of preterm delivery and LBW increased in proportion to the severity of maternal anaemia.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | PREGNANT WOMEN | HEMOGLOBIN LEVEL | ANEMIA | PREMATURE BIRTH | LOW BIRTH WEIGHT | RISK FACTORS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Hemic System | Physiology | Biology | Diseases | Pregnancy Outcomes | Pregnancy | Reproduction | Birth Weight | Body Weight | Health
Document Number: 341326

21.

Peer Reviewed

Title: Bypassing primary care facilities for childbirth: a population-based study in rural Tanzania.
Author: Kruk ME; Mbaruku G; McCord CW; Moran M; Rockers PC; Galea S
Source: Health Policy and Planning. 2009 Jul;24(4):279-88.
Abstract: In an effort to reduce maternal mortality, developing countries have been investing in village-level primary care facilities to bring skilled delivery services closer to women. We explored the extent to which women in rural western Tanzania bypass their nearest primary care facilities to deliver at more distant health facilities, using a population-representative survey of households (N = 1204). Using a standardized instrument, we asked women who had a delivery within 5 years about the place of their most recent delivery. Information on all functioning health facilities in the area were obtained from the district health office. Women who delivered in a health facility that was not the nearest available facility were considered bypassers. Forty-four per cent (186/423) of women who delivered in a health facility bypassed their nearest facility. In adjusted analysis, women who bypassed were more likely than women who did not bypass to be 35 or older (OR 2.5, P Language: English
Keywords:
TANZANIA | RESEARCH REPORT | PRIMARY HEALTH CARE | HEALTH FACILITIES | MATERNAL HEALTH SERVICES | QUALITY OF HEALTH CARE | OBSTETRICS | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Health Services | Delivery of Health Care | Health | Maternal-Child Health Services | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Medicine
Document Number: 342992

22.

Peer Reviewed

Title: Women's Preferences for Place of Delivery in Rural Tanzania: A Population-Based Discrete Choice Experiment.
Author: Kruk ME; Paczkowski M; Mbaruku G; de Pinho H; Galea S
Source: American Journal of Public Health. 2009 Jul 16;
Abstract: Objectives. We fielded a population-based discrete choice experiment (DCE) in rural western Tanzania, where only one third of women deliver children in a health facility, to evaluate health-system factors that influence women's delivery decisions.Methods. Women were shown choice cards that described 2 hypothetical health centers by means of 6 attributes (distance, cost, type of provider, attitude of provider, drugs and equipment, free transport). The women were then asked to indicate which of the 2 facilities they would prefer to use for a future delivery. We used a hierarchical Bayes procedure to estimate individual and mean utility parameters.Results. A total of 1203 women completed the DCE. The model showed good predictive validity for actual facility choice. The most important facility attributes were a respectful provider attitude and availability of drugs and medical equipment. Policy simulations suggested that if these attributes were improved at existing facilities, the proportion of women preferring facility delivery would rise from 43% to 88%.Conclusions. In regions in which attended delivery rates are low despite availability of primary care facilities, policy experiments should test the effect of targeted quality improvements on facility use.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | RURAL POPULATION | PREGNANT WOMEN | CHILDBIRTH | HEALTH SERVICES | MATERNAL HEALTH | DELIVERY OF HEALTH CARE | QUALITY OF HEALTH CARE | SATISFACTION | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Pregnancy Outcomes | Pregnancy | Reproduction | Health | Health Services Evaluation | Program Evaluation | Programs | Organization and Administration | Psychological Factors | Behavior
Document Number: 342039

23.

Title: Predictors of stillbirth among HIV-infected Tanzanian women.
Author: Kupka R; Kassaye T; Saathoff E; Hertzmark E; Msamanga GI; Fawzi WW
Source: Acta Obstetricia Et Gynecologica Scandinavica. 2009;88(5):584-92.
Abstract: OBJECTIVE: To determine maternal risk factors for stillbirth among pregnant HIV-infected women in sub-Saharan Africa. DESIGN: Prospective cohort study nested within a micronutrient trial. At enrollment, maternal sociodemographic, obstetric, immunologic, clinical, and nutritional variables were measured. Women were followed through monthly clinic visits until delivery. Multivariate predictors of stillbirth were identified in Poisson regression models. SETTING: Antenatal clinic in a tertiary care hospital in urban Dar es Salaam, Tanzania. POPULATION: N=1,078 women enrolled between 12 and 27 weeks of gestation. MAIN OUTCOME MEASURES: Stillbirth (delivery of dead baby > or = 28 weeks' gestation), fresh stillbirth, and macerated stillbirth. RESULTS: Among 1,017 singleton pregnancies, there were 49 stillbirths, yielding a stillbirth risk of 50.0 per 1,000 deliveries (95% Confidence Interval(CI) = 37.2, 65.6). Of stillbirths with known type, 53.7% were fresh and 46.3% macerated. In multivariate analyses, baseline measures of late (> or = 21 weeks' gestation) study entry (Relative Risk (RR) = 2.13, 95% CI = 1.17, 3.87), CD3 count > or = 1,179 cells/ml (RR = 2.15, 95% CI = 1.16, 4.01), stillbirth history (RR = 3.53, 95% CI = 1.30, 9.59), primiparity (RR = 3.65, 95% CI = 1.83, 7.29), and syphilis infection (RR = 2.06, 95% CI = 1.09, 3.88) predicted increased stillbirth risk. Late study entry, illiteracy, stillbirth history, primiparity, CD3 count > or = 1,179 cells/ml, gonorrhea infection, and previous hospitalization predicted increased risk of fresh stillbirth, while living alone and syphilis infection predicted increased risk of macerated stillbirth. CONCLUSIONS: Applying antenatal screening and preventive tools for the socioeconomic, obstetric, immunologic, and clinical risk factors identified may assist in reducing the high incidence of stillbirth among HIV-infected women in urban sub-Saharan Africa.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | PREGNANT WOMEN | PERSONS LIVING WITH HIV/AIDS | PREGNANCY | HIV INFECTIONS | FETAL DEATH | ANTENATAL CARE | SCREENING | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Reproduction | Mortality | Population Dynamics | Maternal Health Services | Maternal-Child Health Services | Primary Health Care | Health Services | Delivery of Health Care | Health | Examinations and Diagnoses | Medical Procedures | Medicine
Document Number: 341226

24.

Title: Striving to make a difference: health care worker experiences with intimate partner violence clients in Tanzania.
Author: Laisser RM; Lugina HI; Lindmark G; Nystrom L; Emmelin M
Source: Health Care For Women International. 2009;30(1-2):64-78.
Abstract: In this article we describe health care workers' (HCWs') experiences and perceptions of meeting clients exposed to intimate partner violence (IPV). Qualitative content analysis of in-depth interviews from 16 informants resulted in four main themes. The first, "internalizing women's suffering and powerlessness," describes HCWs' perceptions of violence, relating it to gender relations. The second, "caught between encouraging disclosure and lack of support tools," refers to views on possibilities for transparency and openness. The third, "Why bother? A struggle to manage with limited resources," illustrates the consequences of a heavy workload. Last; "striving to make a difference," emphasizes a desire to improve abilities to support clients and advocate for prevention.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | QUALITATIVE RESEARCH | CLIENTS | SEXUAL PARTNERS | VIOLENCE | ADVOCACY | GENDER RELATIONS | PREVENTION AND CONTROL | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Program Activities | Programs | Organization and Administration | Sex Behavior | Behavior | Communication | Gender Issues | Sociocultural Factors | Diseases
Document Number: 341005

25.

Title: A case study of reproductive health supplies in Tanzania.
Author: Leahy E; Druce N; Akitobi E; Hardee K; Vogel CG
Source: Washington, D.C., Population Action International, 2009 Jun. 32 p.
Abstract: This paper, together with five additional case studies from other countries and information from other sources, provides an evidence base for national level advocacy. Each case study is written with generalist advocates in mind. These can include, but are not limited to, civic leaders, parliamentarians, faith-based leaders, and community leaders.This report provides overview of how RH supplies, specifically contraceptives and condoms, are programmed, managed and funded in Tanzania. It presents a distillation of information on policies, systems, budgets and key actors to help raise awareness of experienced advocates -- who may lack technical knowledge about contraceptives -- so that they strategically choose advocacy actions and targets. This information should also facilitate collaboration and coordination with advocacy efforts at the global and regional levels. Information and issues from one country may be useful to other countries facing similar challenges. (Excerpt)
Language: English
Keywords:
TANZANIA | SUMMARY REPORT | CASE STUDIES | RESEARCH METHODOLOGY | REPRODUCTIVE HEALTH | EQUIPMENT AND SUPPLIES | CONTRACEPTIVE DISTRIBUTION | HEALTH POLICY | PUBLIC SECTOR | LOGISTICS | MANAGEMENT | FINANCIAL ACTIVITIES | PROMOTION | KNOWLEDGE | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Studies | Health | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Distributional Activities | Program Activities | Programs | Organization and Administration | Policy | Political Factors | Sociocultural Factors | Macroeconomic Factors | Economic Factors | Marketing
Document Number: 331431

26.

27.

Peer Reviewed

Title: Sexual risk behaviour for women working in recreational venues in Mwanza, Tanzania: considerations for the acceptability and use of vaginal microbicide gels.
Author: Lees S; Desmond N; Allen C; Bugeke G; Vallely A; Ross D
Source: Culture, Health and Sexuality. 2009 May 14;:1.
Abstract: Qualitative research was conducted to explore the social context of sexual-risk behaviour among women working in recreational occupations, during a feasibility study in preparation for the Phase III clinical trial of vaginal microbicides in Mwanza, Tanzania. Participant observation was conducted in 68 recreational venues. Six focus group discussions were conducted with women working in recreational occupations and two with male customers at these venues. Findings revealed that these women are at risk of HIV due their dependence on sexual transactions to improve their economic circumstances, which take place in environments and relationships where condom use is difficult. However, the findings revealed that, in spite of constraints, women did take actions to prevent HIV by negotiating for condom use or avoiding perceived risky practices or partnerships, in particular moving to more casual partnerships where condom negotiation is more acceptable. This indicates that, given their perception of their own risk, women working in recreational occupations will welcome an effective microbicide. However, sustained use will depend on how formulations overcome the difficulties women currently experience with condom negotiation and the specific environments and relationships in which they engage in sex.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | FOCUS GROUPS | WOMEN IN DEVELOPMENT | WORKERS | PARKS AND RECREATIONAL FACILITIES | MICROBICIDES | VAGINAL GEL | CONDOM USE | HIV PREVENTION | SEX BEHAVIOR | RISK ASSESSMENT | PERCEPTION | PARTNER COMMUNICATION | SELF-PERCEPTION | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Data Collection | Research Methodology | Economic Development | Economic Factors | Labor Force | Human Resources | Natural Resources | Environment | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Vaginal Spermicides | Contraceptive Methods | Contraception | Family Planning | Risk Reduction Behavior | Behavior | HIV Infections | Viral Diseases | Diseases | Evaluation | Psychological Factors | Interpersonal Relations
Document Number: 341493

28.

Peer Reviewed

Title: Evaluation of simple rapid HIV assays and development of national rapid HIV test algorithms in Dar es Salaam, Tanzania.
Author: Lyamuya EF; Aboud S; Urassa WK; Sufi J; Mbwana J; Ndugulile F; Massambu C
Source: BMC Infectious Diseases. 2009;9:19.
Abstract: BACKGROUND: Suitable algorithms based on a combination of two or more simple rapid HIV assays have been shown to have a diagnostic accuracy comparable to double enzyme-linked immunosorbent assay (ELISA) or double ELISA with Western Blot strategies. The aims of this study were to evaluate the performance of five simple rapid HIV assays using whole blood samples from HIV-infected patients, pregnant women, voluntary counseling and testing attendees and blood donors, and to formulate an alternative confirmatory strategy based on rapid HIV testing algorithms suitable for use in Tanzania. METHODS: Five rapid HIV assays: Determine HIV-1/2 (Inverness Medical), SD Bioline HIV 1/2 3.0 (Standard Diagnostics Inc.), First Response HIV Card 1-2.0 (PMC Medical India Pvt Ltd), HIV1/2 Stat-Pak Dipstick (Chembio Diagnostic System, Inc) and Uni-Gold HIV-1/2 (Trinity Biotech) were evaluated between June and September 2006 using 1433 whole blood samples from hospital patients, pregnant women, voluntary counseling and testing attendees and blood donors. All samples that were reactive on all or any of the five rapid assays and 10% of non-reactive samples were tested on a confirmatory Inno-Lia HIV I/II immunoblot assay (Immunogenetics). RESULTS: Three hundred and ninety samples were confirmed HIV-1 antibody positive, while 1043 were HIV negative. The sensitivity at initial testing of Determine, SD Bioline and Uni-Gold was 100% (95% CI; 99.1-100) while First Response and Stat-Pak had sensitivity of 99.5% (95% CI; 98.2-99.9) and 97.7% (95% CI; 95.7-98.9), respectively, which increased to 100% (95% CI; 99.1-100) on repeat testing. The initial specificity of the Uni-Gold assay was 100% (95% CI; 99.6-100) while specificities were 99.6% (95% CI; 99-99.9), 99.4% (95% CI; 98.8-99.7), 99.6% (95% CI; 99-99.9) and 99.8% (95% CI; 99.3-99.9) for Determine, SD Bioline, First Response and Stat-Pak assays, respectively. There was no any sample which was concordantly false positive in Uni-Gold, Determine and SD Bioline assays. CONCLUSION: An alternative confirmatory HIV testing strategy based on initial testing on either SD Bioline or Determine assays followed by testing of reactive samples on the Determine or SD Bioline gave 100% sensitivity (95% CI; 99.1-100) and 100% specificity (95% CI; 96-99.1) with Uni-Gold as tiebreaker for discordant results.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | URBAN POPULATION | PREGNANT WOMEN | WOMEN IN DEVELOPMENT | BLOOD DONORS | HIV TESTING | TIME FACTORS | GOVERNMENT PROGRAMS | HEALTH SERVICES EVALUATION | VOLUNTARY COUNSELING AND TESTING | RELIABILITY | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Research Methodology | Studies | Population Characteristics | Demographic Factors | Population | Economic Development | Economic Factors | Blood Supply | Equipment and Supplies | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Laboratory Examinations and Diagnoses | Examinations and Diagnoses | Population Dynamics | Programs | Organization and Administration | Program Evaluation | Measurement
Document Number: 330705

29.

Title: Usefulness of highly active antiretroviral therapy on health-related quality of life of adult recipients in Tanzania.
Author: Magafu MG; Moji K; Igumbor EU; Hashizume M; Mizota T; Komazawa O; Cai G; Yamamoto T
Source: AIDS Patient Care and STDs. 2009 Jul;23(7):563-70.
Abstract: This study assessed health-related quality of life (HRQOL) of highly active antiretroviral therapy (HAART) recipients aged 18 or older and associated factors, 2 years after HAART administration had started in Kagera, Tanzania. Using the 36-Item Short Form Health Survey (SF-36), 329 HAART recipients were interviewed in May 2007. Questions on sociodemographic characteristics, chronic diseases (besides HIV/AIDS), HAART side effects and adherence to antiretroviral drugs were added. Treatment data, the first and latest available CD4 counts were retrieved from patients' records. Gender and age-adjusted mean scale scores of the sample were compared to those of the general Tanzanian population of the late 1990 s using t test. Logistic regression was used to explore the effect of sex, age, education level, income, chronic diseases, CD4 count, HAART side effects and adherence to antiretroviral drugs on recipients' physical functioning and mental health scale scores. The mean scale scores of HAART recipients were generally lower than those of the general population except for general health perceptions (p = 0.191) and mental health (p = 0.161). HAART recipients with chronic disease comorbidity were more likely to score below the general population's mean score for mental health (p = 0.007). While the effect of chronic disease comorbidity on physical functioning among those who recorded a CD4 count increase was negative (odds ratio [OR] = 13.6, 95% confidence interval [CI] = 3.7, 49.9), there was no effect on those who did not have such an increase. The control of chronic diseases among recipients should be given priority to improve their HRQOL.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | HEALTH SURVEYS | CLIENTS | SOCIOECONOMIC FACTORS | DISEASES | HIV INFECTIONS | AIDS | HIV | ANTIRETROVIRAL THERAPY | TREATMENT | QUALITY OF LIFE | PERCEPTION | MENTAL HEALTH | TESTING | Developing Countries | Africa, Eastern | Africa, Sub Saharan | Africa | Health | Program Activities | Programs | Organization and Administration | Economic Factors | Viral Diseases | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Social Welfare | Psychological Factors | Behavior | Measurement | Research Methodology
Document Number: 342980

30.

Peer Reviewed

Title: Predictors of risky sexual behavior among adolescents in Tanzania.
Author: Masatu MC; Kazaura MR; Ndeki S; Mwampambe R
Source: AIDS and Behavior. 2009 Feb;13(1):94-99.
Abstract: Studies on sexual behavior among adolescents are fundamental in understanding and fighting against outcomes of unprotected sex that include unplanned/ unwanted pregnancies and sexually transmitted diseases. This survey conducted among in- and out-of-schools adolescents measured prevalence of sexual behavior variables, including risky sexual behavior and associated factors. Risky sexual behavior was defined as having first sex before 16 years, inconsistent condom use and having multiple sexual partners. About 30% of adolescents reported being sexually active; a higher proportion being among males than females and 24.5% of sexually active adolescents reported having multiple sexual partners. More males (37%) reported having multiple sexual partners than females (26%). Nearly 48% of unmarried sexually active adolescents reported having used a condom during the most recent sexual intercourse. Predictors of risky sexual behavior were being male, young age (10-14 years) and being inschool. Preventive information and education should take into consideration these factors.
Language: English
Keywords:
TANZANIA | RESEARCH REPORT | ADOLESCENTS | SEX BEHAVIOR | RISK BEHAVIOR | HIV INFECTIONS | TRANSMISSION | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Behavior | Viral Diseases | Diseases | Infections
Document Number: 330155


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