Stella Emmanuel Mushy

Aim: This study examined the effects of a prenatal group education program in Tanzania which was focused on preeclampsia/eclampsia according to knowledge, behavioral intention, Pregnancy‐Related Empowerment Scale, satisfaction, and the incidence of preeclampsia. Methods: The study was conducted in two district hospitals in Tanzania and used a facility‐based pre‐post quasi‐experimental design with concurrent control. The prenatal group education program was developed to focus on preeclampsia/eclampsia and consisted of lectures, discussions, and review sessions directed at participatory group education. The intervention group participated in a midwife‐facilitated prenatal group education program, whereas the control group received routine care. Data were collected through questionnaires before the intervention and 1 month later. A descriptive analysis of the data was performed. Results: The study analyzed 95 pregnant women within an intervention group ( n = 48) and control group ( n = 47). At the 1‐month post‐test, statistically significant differences were observed between the intervention and control groups in the knowledge score ( mean = 3.8, SD = 3.6 vs. mean = −0.8, SD = 3.1, p < .001) and satisfaction score ( mean = 4.9 vs. mean = 4.6, p = .032). Between the two groups, there were no significant differences in the scores of behavioral intention, Pregnancy‐Related Empowerment Scale, and the incidence of preeclampsia. Conclusion: The prenatal group education program increased the knowledge level regarding preeclampsia and gave higher satisfaction among pregnant women. Knowledge was retained for at least 1 month. Continuity in implementation of this program is recommended.

Tanzania mandated reporting laws aim to identify and address child abuse, yet healthcare students' awareness and reporting are limited. This study assessed training's impact on their knowledge of reporting laws and handling confidential child abuse data. The study involved 412 medical and nursing students in a randomized controlled trial (RCT), with 206 participants receiving sexual health training and a waitlist control group of equal size receiving no intervention. Baseline and 3-month follow-up assessments evaluated knowledge of mandatory reporting laws and recording practices. At the 3-month follow-up, the control group showed minimal knowledge improvement (+7.5% for item 1, -6% for item 2), whereas the intervention group showed significant gains (23.7% for item 1, 0.7% for item 2). Additionally, notable disparity in total scores for reporting and recording between the groups emerged from baseline to follow-up (t = -3.682, p < .001, Cohen's d = 0.365). The intervention group (M = 0.527, SD = 1.630) had a larger mean difference score than the control group (M = -0.044, SD = 1.499). Therefore, the training significantly improved students' knowledge of mandatory reporting laws and the recording of clients' confidential information.

Background: The cancer burden in Africa is on the rise. A Cancer Training Course on screening, prevention, care, and community education is crucial for addressing a wide range of cancer health issues. When appropriately educated healthcare providers on cancer provide care, patient care improves, and healthcare costs decrease. However, in Tanzania, doctors and nurses receive little or no training in primary cancer care in their bachelor’s program. Aim: This study assessed the need and acceptability of a cancer training course for nursing and medical doctor students at the Muhimbili University of Health and Allied Sciences (MUHAS) in Dar es Salaam, Tanzania. Methods: This study was a cross-sectional parallel mixed method study during the 3-month follow-up within the larger study on sexual health training for health professionals. The study was a randomized controlled (RCT), single-blind, parallel trial of sexual health training versus a waitlist control among health students at MUHAS in Tanzania. Descriptive analysis was performed to analyze the participants’ demographic information, need, and acceptability of the cancer training courseto determine the frequencies and percentages of their distribution between disciplines. In addition, inductive thematic analysis was performed for the qualitative data. The RCT study was registered at Clinical Trial.gov (NCT03923582; 01/05/2021). Results: Data were collected from 408 students (272 medical doctors and 136 nursing students). The median age of the participants was 23 years. Most (86.0%) medical and 78.1% of nursing students reported receiving little to no cancer training. On the other hand, most (92.3%) medical and nursing (92.0%) students were interested in receiving cancer training. Furthermore, 94.1% of medical and 92.0% of nursing students needed a cancer training course in their undergraduate program. In addition, participants said a cancer training course would be important because it would help them improve the quality of cancer care and enhance the quality of life for patients by ensuring early diagnosis and treatment. Conclusion: A cancer training course is both highly needed and acceptable to medical and nursing students. Implementation of this cancer training course will improve students’ knowledge and skills and eventually improve the quality of cancer care and patients’ quality of life by ensuring early diagnosis and management.

Background: Despite the decreased incidence of the human immunodeficiency virus (HIV) in Tanzania, the number of adolescents living with HIV is increasing. This study aimed to describe factors independently associated with viral load non-suppression among adolescents living with HIV (ALHIV) on ART in the Tanga region. Methods: We conducted a retrospective study of routinely collected data from ALHIV on ART from October 2018 to April 2022. We extracted data from the Care and Treatment Clinics form number 2 (CTC2) database that included age, sex, BMI, World Health Organization HIV clinical disease stage, marital status, ART duration, viral load suppression, facility level, and Dolutegravir (DTG)-based regimen. We did descriptive analysis using frequencies to describe the study participants’ socio-demographic and clinical characteristics. The Cox proportional hazard regression model was used to identify factors associated with viral load non-suppression (VLS). Viral load non-suppression was defined as viral load ≥ 1000 copies/ml. A total of 4735 ALHIV on ART were extracted from CTC2, then 2485 were excluded (2186 missed viral load results, 246 were lost to follow-up, and 53 deaths). Results: 2250 ALHIV on ART were tested for viral load, of whom 2216 (98.62%) adolescents were on first-line ART, and 2024 (89.96%) participants were virally suppressed, while 226 (10.04%) were virally non-suppressed. In addition, 2131 (94.71%) of participants were using a DTG-based regimen; of them, 1969 (92.40%) were virally suppressed. Not using a DTG-based regimen (HR: 9.36, 95% CI 3.41–15.31) and dispensary facility level (HR: 3.61, 95% CI 1.44–7.03) were independently associated with increased hazard for viral load non-suppression. In addition, adolescents aged between 15 and 19 years are less likely to be virally suppressed (HR: 0.55, 95% CI 0.30–0.99). Conclusions: The dispensary facility level and not using a DTG-based regimen were significantly associated with viral load non-suppression. HIV intervention strategies should ensure a DTG-based regimen utilization in all adolescents living with HIV, and techniques used by higher-level health facilities should be disseminated to lower-level facilities.

Background: Cancer remains a significant global health challenge, especially in low-resource settings where limited data obstructs effective control measures. Reliable cancer registries are essential tools for collecting, managing, and analyzing cancer-related data. In Tanzania, as in many other sub-Saharan African countries, the need for accurate and timely cancer data is critical for informed decision-making. This study assesses the data quality of a population-based cancer registry in Tanzania to improve cancer control efforts. Methodology: This study adopted a descriptive cross-sectional study design to analyze 9617 records of cancer patients in population-based cancer registry database (Canreg5) from 2018 to 2022. Data analysis is done using Stata 17.0 and IARC validity check software. The percentage of complete, valid, and timely records was computed and compared with the required target. Comparability analysis compared age-standardized rates (ASR) and percentages of morphologically verified (MV%) against the standards in sub-Saharan Africa. Results: In the defined period from 2018 to 2022, a total of 9,617 records were included in the final analysis. The study found high data quality indicators: completeness at 94% for mandatory variables, validity at 76%, timeliness at 93%, and a high comparability with cancer data in sub-Saharan Africa at 60%. However, variations were noticed in age-standardized rates (ASR) and morphologically verified cases (MV). For comparability findings, mouth and pharynx cancer had lower age-standardized rates (ASR) for males (5.7) and females (3.4) but high morphological verification rates. Esophageal cancer had significantly higher ASR for males (22.0) and females (6.1), with moderate morphological verification rates. Stomach cancer had lower ASR but higher verification rates. Colon, rectum, and anus cancer had comparable ASR and higher verification rates. Conclusion: The data quality in the population-based cancer registry at the study site was optimal, with a high proportion of completeness, timeliness, and comparability, but with suboptimal validity of data, particularly for date format, and unlike combinations that highlight continuous monitoring and quality checks. While data quality is vital, challenges like missing and invalid records persist, necessitating reinforced protocols and validation measures.

Purpose. This exploratory qualitative study aimed to analyze the experiences of healthcare providers (HCPs) in pharmacovigilance (PV) and ADR reporting in the southern highland zone of Tanzania. Methods. In 2022, an exploratory qualitative case study using in-depth interviews (IDIs) was conducted to explore the experiences of PV and ADR reporting among HCPs (doctors, nurses, and pharmacists). The study was carried out in a zonal referral hospital and a regional referral hospital of the Tanzanian southern highlands zone. Inductive-deductive thematic analysis was adopted for data analysis. Results. Participants demonstrated adequate knowledge of PV and its related activities including ADR reporting. Knowing the interactions and wrong medication dosage as sources of ADR, signs, and symptoms, stopping the drug, and treating the symptoms following ADR emerged as subthemes linked with adequate knowledge in identifying and managing ADR. Participants perceived reporting ADR as laborious, posing a subjective burden and that not all ADRs needed to be reported. The latter contributed to limited participation in ADR reporting despite that participants were conversant with both physical and online ADR reporting platforms. Conclusion. Although HCPs are well informed about PV and ADR reporting including the benefits to public health, their involvement in ADR reporting is low. In addition to the ongoing on-the-job training and regular supportive supervision for HCPs to improve the ADR practice, there is still a need to explore other strategies to be used as motives for HCPs to report ADR regularly.

Purpose. This study assessed the awareness, actions, and predictors of actions on adverse drug reaction reporting among patients attending a referral hospital in southern highland Tanzania. Methods. A hospital-based cross-sectional study was conducted from January to August 2022 at Mbeya Zonal Referral Hospital (MZRH) in Mbeya, Tanzania. A total of 792 adult patients with chronic conditions attending outpatient clinics at MZRH were recruited consecutively. A semistructured questionnaire was used to collect demographic characteristics, ADR awareness, and actions when encountering ADR. Data were analyzed using the statistical package for social sciences (SPSS) version 23 and results are summarized using frequency and percentages. Binary logistic regression was used to assess the predictors associated with reporting ADR among patients. P value ≤0.05 was considered statistically significant. Results. Out of 792, 397 (50.1%) were males and 383 (48.6%) had a primary education level. Only 171 (21.6%) participants previously experienced ADR, and 111 (14.1%) were aware that ADR is an unexpected harm that occurs after medication use. The majority 597 (70.3%) of the participants said will report ADR to healthcare providers, 706 (88.9%) prefer reporting ADR to healthcare providers, and 558 (69.1%) said patients are not aware of the importance of reporting ADR. Patients aged below 65 years of age, unemployed ((AOR (95% CI) = 0.4 (0.18–0.87), self-employed ((AOR (95% CI) = 0.5 (0.32–0.83)), and those who ever encountered ADR ((AOR (95% CI) = 0.1 (0.05–0.11)) were more likely to report the ADR to HCPs compared to the rest. Conclusions. The majority of patients are not aware of what is ADR and the importance of ADR reporting. Most of the patients prefer to report ADR to healthcare providers. We recommend an awareness campaign to raise awareness of the patients on ADR and other methods of ADR reporting.

Background: The role of health literacy based interventions have not been well documented in improving self-care practices among patients with type-2-diabetes. This study aimed at exploring the effectiveness of a low budget educational intervention on improving self-care knowledge, attitude,...

Background: Despite interventions improving maternal and newborn morbidity and mortality, progress has been sluggish, especially in hard-to-reach indigenous communities. Sociocultural beliefs in these communities more often influence the adoption of particular behaviors throughout pregnancy, childbirth, and postpartum. Therefore, this study identified sociocultural beliefs and practices during pregnancy, childbirth, and postpartum among indigenous pastoralist women of reproductive age in the Manyara region, Tanzania. Methods: The study was a descriptive qualitative design. We used purposive sampling to select twelve participants among community members who were indigenous women of Manyara who had ever experienced pregnancy. In-depth interviews were audio-recorded and transcribed verbatim, and organized manually. We used manual coding and inductive-deductive thematic analysis. Results: The study’s findings showed that sociocultural beliefs and practices are widespread, covering antenatal through childbirth to the postnatal period. Both harmful and harmless practices were identified. For example, the use of herbal preparations to augment labor was reported. Previously, most women preferred home delivery; however, the practice is changing because of increased knowledge of home delivery complications and the accessibility of the facilities. Nevertheless, women still practice hazardous behaviors like applying strange things in the birth canal after delivery, increasing the risk of puerperal infection. Conclusions: Sociocultural practices are predominant and widely applied throughout the peripartum period. These beliefs encourage adopting specific behaviors, most harmful to both mother and fetus. These sociocultural practices tend to affect the utilization of some essential maternal and child health practices. Eliminating unsafe peripartum practices will increase the use of medical services and ultimately improve outcomes for both mothers and their newborns. Public health interventions must recognize the cultural context informing these cultural practices in marginalized indigenous communities. Healthcare providers should routinely take the history of commonly traditional practices during the peripartum period to guide them in providing quality care to women by correcting all harmful practices.