Children In Tanzania Research Articles

Widows, AIDs, Health and Human Rights in Africa: Case Study from Tanzania

Widows, AIDs, Health and Human Rights in Africa: Case Study from Tanzania

Why Children Aren't Attending School: The Case of Northwestern Tanzania

Policies designed to increase education in low-income settings require an understanding of why children do not attend school. Drawing on longitudinal data of primary-school age children in Tanzania, our analysis evaluates the role various dimensions in determining children’s attendance. Our results indicate that policies directed towards increasing a child’s attendance need to be focused on the demand for schooling within the context of the household. Policies that affect demand for child labour within the household, especially those that promote substitutes for child labour, should be considered. Furthermore, programmes aimed at secondary schools (including improving access) can have an indirect affect on hours of primary-school attendance, particularly for girls.

Why Children Aren't Attending School: The Case of Northwestern Tanzania

Policies designed to increase education in low-income settings require an understanding of why children do not attend school. Drawing on longitudinal data of primary-school age children in Tanzania, our analysis evaluates the role various dimensions in determining children’s attendance. Our results indicate that policies directed towards increasing a child’s attendance need to be focused on the demand for schooling within the context of the household. Policies that affect demand for child labour within the household, especially those that promote substitutes for child labour, should be considered. Furthermore, programmes aimed at secondary schools (including improving access) can have an indirect affect on hours of primary-school attendance, particularly for girls.

The effect of single dose ivermectin alone or in combination with albendazole on Wuchereria bancrofti infection in primary school children in Tanzania

Examination of 1829 children from 6 primary schools in coastal Tanzania revealed overall Wuchereria bancrofti microfilaria (mf) and circulating filarial antigen (CFA) prevalences of 17.3% and 43.7%, respectively. A randomized double-blind field trial with a single dose of ivermectin (150–200 μg/kg body weight) alone or in combination with albendazole (400 mg) was subsequently carried out among these children. Both treatment regimens resulted in a considerable decrease in mean mf intensities, with overall reductions being slightly but statistically significantly higher for the combination than for ivermectin alone. The difference in effect between the two treatment regimens was most pronounced at 6 months, whereas it was minor at 12 months after treatment. The relative effect of treatment on mean CFA units was less pronounced than on mf. For both treatment regimens, reductions in CFA intensity appeared to be higher in children who were both CFA and mf positive before treatment, which may suggest that treatment mainly affected the survival and/or production of mf, rather than the survival of adult worms. New cases of infection appeared after treatment with both regimens among the pre-treatment mf and CFA negative children. Adverse reactions were few and mild in both groups, and mainly reported from pre-treatment mf and CFA positive children. The alarmingly high prevalence of W. bancrofti infection in primary school children highlights the importance of also determining the reversibility of already acquired early lesions, and the development of new measures and strategies to specifically protect children from later developing clinical disease.

The effect of single dose ivermectin alone or in combination with albendazole on Wuchereria bancrofti infection in primary school children in Tanzania

Examination of 1829 children from 6 primary schools in coastal Tanzania revealed overall Wuchereria bancrofti microfilaria (mf) and circulating filarial antigen (CFA) prevalences of 17.3% and 43.7%, respectively. A randomized double-blind field trial with a single dose of ivermectin (150–200 μg/kg body weight) alone or in combination with albendazole (400 mg) was subsequently carried out among these children. Both treatment regimens resulted in a considerable decrease in mean mf intensities, with overall reductions being slightly but statistically significantly higher for the combination than for ivermectin alone. The difference in effect between the two treatment regimens was most pronounced at 6 months, whereas it was minor at 12 months after treatment. The relative effect of treatment on mean CFA units was less pronounced than on mf. For both treatment regimens, reductions in CFA intensity appeared to be higher in children who were both CFA and mf positive before treatment, which may suggest that treatment mainly affected the survival and/or production of mf, rather than the survival of adult worms. New cases of infection appeared after treatment with both regimens among the pre-treatment mf and CFA negative children. Adverse reactions were few and mild in both groups, and mainly reported from pre-treatment mf and CFA positive children. The alarmingly high prevalence of W. bancrofti infection in primary school children highlights the importance of also determining the reversibility of already acquired early lesions, and the development of new measures and strategies to specifically protect children from later developing clinical disease.

Randomized efficacy trial of a micronutrient-fortified beverage in primary school children in Tanzania

Dietary supplements providing physiologic amounts of several micronutrients simultaneously have not been thoroughly tested for combating micronutrient deficiencies. We determined whether a beverage fortified with 10 micronutrients at physiologic doses influenced the iron and vitamin A status and growth of rural children (aged 6-11 y) attending primary schools. In this randomized, double-blind, placebo-controlled efficacy trial, children were assigned to receive the fortified beverage or an unfortified beverage at school for 6 mo. There were nonsignificant differences at baseline between children in the fortified and nonfortified groups in iron status, serum retinol, and anthropometry. At the 6-mo follow-up, among children with anemia (hemoglobin < 110 g/L), there was a significantly larger increase in hemoglobin concentration in the fortified group than in the nonfortified group (9.2 and 0.2 g/L, respectively). Of those who were anemic at baseline, 69.4% in the nonfortified group and 55.1% in the fortified group remained anemic at follow-up (RR: 0.79), a cure rate of 21%. The prevalence of children with low serum retinol concentrations (< 200 microg/L) dropped significantly from 21.4% to 11.3% in the fortified group compared with a nonsignificant change (20.6% to 19.7%) in the nonfortified group. At follow-up, mean incremental changes in weight (1.79 compared with 1.24 kg), height (3.2 compared with 2.6 cm), and BMI (0.88 compared with 0.53) were significantly higher in the fortified group than in the nonfortified group. The fortified beverage significantly improved hematologic and anthropometric measurements and significantly lowered the overall prevalence of anemia and vitamin A deficiency.

Is the exclusion of children under 24 months from anthelmintic treatment justifiable?

There are no reports documenting toxicity or adverse effects after treatment of children aged < 24 months with benzimidazole derivatives and there is an urgent need to clarify this point in light of the potential detrimental effect that soil-transmitted helminthiasis has on this age-group. A total of 653 treatments (317 mebendazole 500 mg; 336 placebo) were administered in 1996/97 to 212 children aged < 24 months as part of a 1-year anthelmintic drug study conducted among preschool-age children in Tanzania. Data on fever, cough, diarrhoea, dysentery and acute respiratory illness were collected 1 week following the treatment. No differences between the occurrence of adverse effects in the 2 groups were observed. In light of the potential nutritional benefit achieved by regular deworming in this young age-group, the policy that excludes children aged < 24 months from treatment should be re-considered.

Household Constraints on Schooling by Gender: Empirical Evidence from Ethiopia

Cet article cherche a identifier certaines caracteristiques individuelles et familiales importantes pouvant permettre de determiner la probabilite pour un enfant de suivre les cours et de terminer sa scolarite a l'ecole primaire en Ethiopie. Les differences de sexe a la lecture des resultats obtenus sont egalement soulignes. Les donnees ressortant d'une enquete menee dans deux regions du pays viennent etayer les reflexions et les conclusions sur l'ecart entre filles et garcons dans les effectifs scolaires.

Household Constraints on Schooling by Gender: Empirical Evidence from Ethiopia

Household Constraints on Schooling by Gender: Empirical Evidence from Ethiopia

Supplemental Vitamin A Improves Anemia and Growth in Anemic School Children in Tanzania

We conducted a randomized controlled trial of the effects of dietary supplements on anemia, weight and height in 136 anemic school children from a low socioeconomic background in Bagamoyo District schools in Tanzania. The aim of the current study was to investigate the impact of dietary supplements on anemia and anthropometric indices of anemic school children. The supplements were vitamin A alone, iron and vitamin A, iron alone or placebo, administered in a double-blinded design for 3 mo. All supplements were provided with local corn meals. Hemoglobin concentration, body weight and height were measured at baseline and at follow-up after supplementation. Vitamin A supplementation increased the mean hemoglobin concentration by 13.5 g/L compared with 3.5 g/L for placebo [P < 0.0001, 95% confidence interval (CI) 6.19-13.57), the mean body weight by 0.6 kg compared with 0.2 kg for placebo (P < 0.0001, 95% CI 0.19-0.65) and the mean height by 0.4 cm compared with 0.1 cm for placebo (P = 0.0009, 95% CI 0.08-0.42). However, the group of children who received combined vitamin A and iron supplementation had the greatest improvements in all indicators compared with placebo (18.5 g/L, P < 0.0001, 95% CI 14.81-22.23; 0.7 kg, P < 0. 0001, 95% CI 0.43-0.88 and 0.4 cm, P < 0.0001, 95% CI 0.22-0.56 for hemoglobin, weight and height, respectively). It is likely that vitamin A supplementation may have a useful role in combating the problems of vitamin A deficiency and anemia, as well as in improving children's growth, in developing countries.

A Comparative Analysis of Some Aspects of Educating Young Children in Tanzania and in North America: Tanzanian Parents’ Perspectives*

Children moving from one country to another to continue their education at an early age, face serious adjustment challenges. Smooth transition from one education system to another depends on many factors, but parents play an important role. This paper is a comparative analysis of some aspects of educating young children in Tanzania on the one hand and in the United States and Canada on the other. Parents’ perspectives on their children's transition to the new education systems are examined and discussed. Data were collected through questionnaire and interviews. The data included demographic information, schooling and transfer information, presence or absence of educational aspirations ("dream") in both contexts, choice of school in the new education system, ratings on some school and home related factors, and parents’ specific observations and concerns about their children's educational development. Each set of data was analyzed separately using appropriate software and methods. Findings indicated that Tanzanian children who came to North America to continue their education were mostly from publicly owned schools or childcare centers, and most of them had high educational aspirations when they left the country. Parents indicated that learning English and speaking it at home and availability of learning materials were the major advantages of coming to Canada and the United States. Factors that prohibited smooth transition into the new education systems included inability to speak English fluently especially at school, lack of enough and directive teacher attention, lack of close and strong relationship with the teacher. Others were lack of focus on learning content, reduced enthusiasm about school, and feelings of inferiority among their peers. The findings are synthesized and discussed under three sup‐topics, namely, language and cognition, the Tanzanian child's perception of race, and confusion between racial label and socio‐economic background. Suggestions for parents and teachers are provided, as well as recommendations for further research. *Paper presented at the AERA Annual Meeting Montreal, Canada, April 19‐24, 1999.

The health and nutritional status of schoolchildren in Africa: evidence from school-based health programmes in Ghana and Tanzania

Surveys of the health of schoolchildren in Tanga Region, Tanzania and Volta Region, Ghana are reported. Two age groups of both sexes were studied: 8–9 and 12–13 years old. Children themselves tend to have a poor perception of their health status. This is confirmed by biomedical surveys. Evidence was common of chronic ill-health due to undernutrition, anaemia, parasitic infections and micronutrient deficiencies. The older age groups of both sexes were significantly more stunted (height-for-age z score <2 below National Center for Health Statistics reference values) than the younger groups, indicating that linear growth continues to falter throughout the school-age years. Anaemia was common: 38% of children in Ghana and 75% of children in Tanzania had a haemoglobin level <120 g/L. Younger children were more likely to be anaemic than older children, but no significant difference between the sexes was observed. Helminth infections which cause blood loss ( Schistosoma haematobium and hookworms) were common and only 37% of children in Ghana and 14% in Tanzania had no evidence of worm infection. In Ghana, 71% of children had a low urinary iodine concentration; in Tanzania 38%. The burden of ill-health suggests that school health programmes in these countries which deliver anthelmintics and micronutrient supplements have the potential to improve the health, growth and educational achievements of schoolchildren.

High level of resistance of Plasmodium falciparum to sulfadoxine-pyrimethamine in children in Tanzania

In many areas of tropical Africa affected by chloroquine-resistant Plasmodium falciparum, a combination of sulfadoxine and pyrimethamine (S-P) is used for alternative medication, especially in young children. In Magoda village in Muheza District, north-eastern Tanzania, 38 children 1–10 years of age were enrolled in a therapeutic study of S-P in July 1994. All had monoinfections of P. falciparum and an asexual parasite count of 1000–80000/μL of blood. S-P was given as a single dose corresponding to 0·8–1·4 mg pyrimethamine/kg body weight. Of the 38 children followed up to day 7,10 showed an S/RI response, 26 an RII response, and 2 an RIII response. Older children had lower pre-treatment parasitaemia and a better therapeutic response than younger children. Among the various contributory factors responsible for the poor therapeutic result, drug pressure from a prophylactic intervention with weekly dapsonepyrimethamine between May 1993 and May 1994 seems to have been the most important.

Community-based sale, distribution and insecticide impregnation of mosquito nets in Bagamoyo District, Tanzania

Malaria is the leading cause of outpatient attendances hospital admissions and hospital deaths in Tanzania. Malaria also contributes significantly to the high rate of mortality in Africa among pregnant women and to the high levels of anemia among both women and children in Tanzania. Although malaria control in sub-Saharan Africa has focused upon the early treatment of clinical malaria with chloroquine the emergence and spread of chloroquine-resistant Plasmodium falciparum has sparked the search for alternative methods of malaria control. Bed nets impregnated every six months with pyrethroid insecticides seem to be a simple low-cost intervention ideally suited to village conditions. When used regularly the nets seem to have a positive impact upon both the frequency of episodes in children and upon the level of infection in the mosquito population. When insecticide-impregnated mosquito nets are used in malaria control programs however their distribution promotion of use and impregnation with insecticide are typically the responsibility of program personnel. In order to create a more sustainable system for implementing bed net interventions a bed net committee was formed in each of 13 villages in Bagamoyo District Tanzania. Once nominated and confirmed in a village meeting committee members attend a day-long seminar in which they discuss how distribution sales of nets and impregnation should take place. Committee members help on distribution days as well as promote the proper use of nets and help villagers set up the nets. A revolving fund is being established from which each village can pay committee members and purchase nets and insecticide after the project ends. Factors which may affect the sustainability of the system are discussed.

Lower Prevalence of Diarrhoea in Young Children Fed Lactic Acid-Fermented Cereal Gruels

In many developing countries, diarrhoea is one of the major precipitating factors of child morbidity and mortality. It also significantly contributes to the high prevalence of malnutrition in young children. Available information suggests that a major part of all diarrhoea episodes are associated with bacterial contamination of weaning foods. In vitro studies, however, have shown a strong inhibitory effect of lactic acid-fermented weaning gruels on the proliferation of diarrhoea-causing pathogens. To assess whether this inhibitory effect is reflected by a lower transmission of diarrhoea, a prospective epidemiological study was carried out to measure the prevalence of diarrhoea in a group of young children in Tanzania who were given a lactic acid-fermented cereal gruel on a daily basis. Two groups of about 100 children under five years of age were selected on the basis of the use or non-use of fermented gruels. The nutrition status of the children in each group, as measured by comparison of their weight for age with the standard, was not statistically different (p &gt; .05). The mean age of the children in the two groups was similar. An average feeding frequency of 3.5 times per day was reported for both groups. Biweekly recall for diarrhoea, defined as watery, loose stools two or more times per day, was conducted for nine months among selected children. The mean number of diarrhoea episodes over the study period was 2.1 for children eating fermented gruels, compared with 3.5 for those eating non-fermented gruels (p&lt;.001). The frequency of diarrhoea was also age dependent: it was significantly higher in children under three years of age than in older children in both diet groups (p&lt;.001). Fever episodes were reported in similar proportions in both groups, and were significantly related to diarrhoea (p &lt; .001). Other diseases and the children's nutrition status were not related to the frequency of diarrhoea.

The importance of supportive environments for oral health promotion in school-aged children in Tanzania

Children in Tanzanian primary schools are being provided with education for oral health. A supportive environment is needed to enable and reinforce them to sustain behaviour conducive to oral health. Some aspects of the home and school that might support or conflict with such behaviour were studied. In 10 urban and rural primary schools from one district, 200 children were interviewed, and the surroundings of the schools observed. The children were being advised by their parents to brush their teeth and to avoid sugary snacks, but the economic realities and school environments were less supportive of these behaviour. Tooth brushes and toothpastes were available but appeared to be costly. Rural children, in particular, went to school without breakfast. At school there were no organized meals but sugary snacks were being sold by vendors and shopkeepers. The ability of children to sustain behaviours conducive to oral health taught at the schools can be questioned. The need is evident for intersectoral action to improve the availability and affordability of healthy foods and proper toothcleaning materials to school-aged children in Tanzania.

The effects of house spraying with DDT or lambda-cyhalothrin against Anopheles arabiensis on measures of malarial morbidity in children in Tanzania

The effects of house spraying of DDT and lambda-cyhalothrin against populations of Anopheles arabiensis were assessed in children aged between 1 and 10 years with regard to fever episodes and parasite prevalences. DDT and lambda-cyhalothrin treatment did not reduce the prevalence of malaria episodes as defined by fever (temperatures ≥37.4°C and/or fever reported) combined with high parasitaemia (≥ 100 parasites/200 leucocytes). However, the prevalence of malaria parasitaemia, of the episodes of fever with any level of malaria parasitaemia and of high parasitaemia alone were significantly reduced. Furthermore, the reduction in mean parasite densities was greater in children of the 1–2 years age group for both insecticides and also for children of 3–5 years age group with lambda-cyhalothrin. Measured and/or reported fever and high parasitaemia were correlated and the data indicated that most of the fevers in these children could be attributed to malaria. Using this criterion it is concluded that the population of An. arabiensis responded to both DDT and lambda-cyhalothrin house spraying which in turn also reduced malaria-related morbidity.

The Law and Practice Relating to the Adoption of Children in Tanzania

The law relating to the adoption of children in Tanzania has, since its inception, remained obscure. It has neither received judicial interpretation comparable to other branches of family law nor has it been a subject of academic discourse. This is so despite the fact that the first adoption legislation was introduced in colonial Tanganyika as early as 1942, was repealed and re-enacted in 1953 and has remained in force ever since.Some statistical information regarding how this legislation has been utilised by the population would assist in further elaboration of the above contention. During the first 18 years of the operation of the Ordinance, i.e. from 1944 to the end of the British colonial era in 1961, the High Court of Tanganyika, which under the Ordinance had exclusive jurisdiction to hear adoption applications, made a total of 130 adoption orders. This works out to an average of seven adoption orders per year. With regard to the cultural background of the applicants, so far as this could be ascertained, Europeans formed the majority accounting for about two thirds while members of the Asiatic communities accounted for about one third of the total number of adoption orders granted by the High Court. The number of African applicants was comparatively insignificant.After independence, the picture changed considerably, both in terms of volume of adoption applications and the cultural background of the leading applicants.

Ring-like perilimbic pigment deposits in dark-skinned children An oculo-aural syndrome?

A description is given of a perilimbic ring-like pigment deposit which the author found in East Africa. It appears that the rings were more frequently present among deaf than among non-deaf children in Tanzania and Kenya, and in both more frequently in these countries than in Ethiopia, Florida, India, Malawi and South Africa. In the absence of a satisfactory explanation being found in the previous literature, it is hypothesized, on the basis of data gathered in 1748 children, that the occurrence of the rings is negatively correlated with the level of the regions' general health conditions as well as with an unfavourable individual case history, and positively with a genetically determined pigment proneness and the individual's age.

An eye-ear syndrome? A hypothesis.

A ring-like pigment deposit in the perilimbic conjunctiva of dark-skinned subjects was found more frequently among deaf than among non-deaf children in Tanzania and Kenya, and in both more frequently in these countries than in South Africa, Florida, Malawi, India and Ethiopia. It is hypothesized that this is due to differences in the regions' general health conditions, in the individual's case history, in genetically determined pigmentation, and in the individual's age.