Dodoma Region Research Articles

Effectiveness of virtual laboratory vs. paper-based experiences to the hands-on chemistry practical in Tanzanian secondary schools.

Science subjects at pre-tertiary and tertiary education levels are important for socio-economic and industrial development of any country; however, they are difficult for students to construct their concepts. In Tanzania, insufficient or lack of practical experiments are major challenges for science subjects due to insufficient or lack of laboratories, apparatus, expertise or reagents. Thus, this research assesses the effectiveness of paper-based against virtual laboratory experiences towards improvement of real (hands-on) chemistry practical in Tanzanian secondary schools focusing in Dodoma region. Chemistry virtual laboratory was developed and being deployed at Dodoma Secondary School for students who were never done practical sessions before to avoid biasness towards the study. The students were divided into three groups, namely paper-based and real laboratory as control groups (CG) and virtual laboratory as the experiment group (EG). Each group was further divided into two groups for the rest approaches forming six (6) groups. For EG, students were taught based on instructional approach which was enriched by computer animations in the computer laboratory. Results indicate that students who firstly attended virtual laboratory performed better in real laboratory than those who firstly attended real laboratory. Furthermore, the best progressive learning and performance for real experiments appears when the virtual laboratory preceded paper-based practical experiments. Thus, virtual laboratory is a very useful tool for learning chemistry practical not only to schools without laboratories but also to those with laboratories; and it should be considered by all the pre-tertiary schools in Tanzania and other schools in similar situations.

Enhancing Language of Instructions by Using the Language Supportive Teaching and Textbooks Materials in Secondary Schools in Temeke District

Various arguments and solutions are proposed in the current discourse on weak English language proficiency in Tanzania. Most authors agree that the standard of reading, writing, speaking of the language is low. Proposed solutions vary. One solution proposed has been to support student language proficiency in form 1 by running a language supportive program. Language Supportive Teaching and Textbooks [LSTT] is one among the recent programs designed and practiced in some schools in Dodoma, Morogoro and Lindi regions of Tanzania. The program with materials available for further experimentation since 2016. This study investigated the enhancement of the proficiency in the language of instructions by using tried LSTT materials to improve English language proficiency among Form 1 students in Temeke district in Dar es Salaam. The study employed action research design; using a quantitative approach to administer a vocabulary and comprehension pre and post –tests, and qualitative research approach aimed at understanding the views of teachers and students through interviews and observation of learning in classrooms. The study was guided by Constructivism Theory (Vygotsky, 1978) focusing on learning by seeing and scaffolding by following teachers and peers, and Bilingual theory of Common Underlying Proficiency model (Cummins, 1980’s). Two public secondary schools were involved in the study, which included a sample size of 160 participants among whom 154 were students, four English teachers and two Head teachers. The researcher selected students from two streams in two schools hence one stream termed as a “treated group” and other group used to compare the results of pre- and post-test. Purposive sampling used to select four teachers. After running eight lessons, the findings revealed that through LSTT materials both teachers and students benefited as classroom interaction improved. Teachers were able to present the lesson well through LSTT approaches and pedagogy, which promoted students participation through exercises and better understanding, as well as improved speaking and reading. Those who were oriented through LSTT material had a higher score in the posttest, which was significant. After the researcher had been teaching through the LSTT materials most of the students in the trial gained confidence and more interest to learn through English language. Their scores in vocabulary and comprehensive test also improved significantly.

Mineralogy and Geochemistry of the Asanje Iron Ore Deposit within the Mayamaya-Hombolo Belt, Dodoma Region, Central Tanzania

This paper presents the mineralogy and chemical composition including iron ore impurities to ascertain its suitability for industrial applications. The Asanje iron ore deposit is hosted in Precambrian volcano-sedimentary rocks in the Mayamaya-Hombolo Belt in Dodoma region, within the Lake Nyanza Superterrane. Iron ores are found in two parallel ridges trending NW-SE. Ridge I occurs as vein and banded hematite-type ore and Ridge II as massive-type ore. A total of 24 ore samples were analysed for major and trace elements by XRF and petrographic studies by optical microscopy and XRD. The XRD results revealed that hematite and goethite are the main components and quartz is the gangue mineral in the iron ores. The XRF data shows the Fe2O3t content ranges from 20.8 to 87.3 wt% with an average of 52.7 wt%. The average concentrations in wt% of impurities such as SiO2, Al2O3, P2O5 and S are 37.9, 0.9, 1.2, and 0.2, respectively. By comparison, Ridge II has greater iron content (30.5–87.3 = Avg. 64.66 wt% Fe2O3t) than Ridge I (20.8–78.22 = Avg. 48.68 wt% Fe2O3t). Based on the chemical composition, the quality of iron ore is categorised as low to medium grade, and can be used in metallurgical and cement industries.
 Keywords: Mineralogy, Geochemistry, Asanje Iron ore deposit, Mayamaya-Hombolo Belt, Tanzania

Contribution of wild edible plants to household livelihood in a semiarid Kondoa District, Tanzania

AbstractWild edible plants (WEPS) are an important source of nutrients and income particularly to poor households. However, information on how WEPS contribute to rural livelihoods varies due to heterogeneous methodologies and settings. This paper is based on a study that investigated the contribution of WEPs on rural livelihoods in semiarid Kondoa District, Dodoma Region, Tanzania. Mixed methods were used to collect data from 343 households (14.32%), comprising six focus group discussions and six key informant interviews with district officials. Findings show that whereas 97% of households use WEPs more on subsistence basis, 8.2% use it for income generation. Income generated from WEPs accounted for about 9.16% of household income, which is somewhat closely to other sources. More or less, prices are even higher than those of corn when compared with national figures. However, income generated from sale of WEPs, though substantial, is less accounted for in household capital assets, rather than satisfying the household's basic requirements. Thus, there is a need to recognize the role of WEPs to rural livelihoods in reducing vulnerability to food insecurity and developing interventions that can improve access to use and management of natural resources.

Community Participation in the Constituency Development Catalyst Fund: A case of Bahi District, Tanzania

This study examined the community participation in constituency development catalyst fund in Bahi District Council, Dodoma Region of Tanzania. The area was chosen because of low participation nature in community development programs among community members. The study used a descriptive design and employed the quantitative approach. A sample of 76 community stakeholders was selected out of the 94 study population through the simple random sampling technique. A structured questionnaire was used to collect information from respondents and the following mean scores interpretation scale was used: 3.50-4.00= very high participation, 2.50-3.49 = high participation, 1.50-2.49= low participation and 1.00-1.49 = very low participation. After analysis, the study concluded that the community highly participated in the Constituency Development Catalyst Fund (CDCF) programs. Due to such desirable results, it is recommended that the government should encourage community participation to continue for effective results to be maintained. Furthermore, the parliament should take all necessary steps to make sure that the Constituency Development Catalyst Fund’s (CDCF) Act of 2009 is amended by including provisions which show clearly how the community should participate in CDCF projects in various aspects as initiation, implementation and control. This will further enhance the community development.

Commercial motorcyclists and road safety measures compliance. A case study of Dodoma city, central Tanzania

ObjectiveRoad traffic accidents have been reported to contribute a greater proportion of deaths. Motorcyclists are among the high-risk group within road users to succumb to road traffic accidents. Road traffic accidents reflect the co-occurrence of multiple causes that involve road infrastructure, vehicle, and people. Understanding the level of compliance with road safety measures and their associated factors among commercial motorcyclists is important approach in the steps towards road traffic accident prevention. Study designA cross-sectional study of commercial motorcyclists from two districts in Dodoma region was conducted in 2020. MethodsMultistage sampling method was used to recruit motorcyclists from registered parking stations. At first stage, purposive sampling was used to select the two districts, while in the second stage simple random sampling by lottery method was employed in the selection of wards and parking stations. Descriptive and Chi-square test analyses determined the compliance level. Bivariate and multivariate logistic regression analyses were performed to determine the associated factors. ResultsA total of 378 male commercial motorcyclists participated in the study. Majority (87.8%) were within the age range of 18–29 years. A significant proportion of participants (61.9%) had adequate knowledge and 59.5% showed positive attitude towards road safety measures. Only 39.7% reported to have good level of compliance with road safety measures. Married motorcyclists and those with good road safety practice regarding road safety measures were more likely to comply with road safety measures than their counterpart. ConclusionGood road safety practices and marital status were predictors of good compliance with road safety measures. Coordinated approaches, including continuing provision of road safety education and enforcement of road safety measures are needed to control the way motorcyclist behave on the road.

Prevalence and Predictors of Antibiotic Prescriptions at Primary Healthcare Facilities in the Dodoma Region, Central Tanzania: A Retrospective, Cross-Sectional Study.

Background: Accelerated by the misuse or overuse of antibiotics, antibiotic resistance remains a global public health threat. We report the prevalence and predictors of antibiotic prescriptions in primary healthcare facilities in Dodoma, Tanzania. Methods: This retrospective cross-sectional study by medical records review was conducted in the Dodoma region, Central Tanzania. Results: In this study, children < 5 years accounted for over 45% (474/1021) of the patients consulted. The majority, 76.3% (779/1021), of consultations had an antibiotic prescribed; amoxicillin and cotrimoxazole were the most prescribed. Over 98% (766/779) of the antibiotics prescribed were on the National Essential Medicines List, but only 45% (429/779) of the antibiotic prescriptions adhered to the Standard Treatment Guidelines. The prescribing of antibiotics by clinical officers was almost 2.55 times higher than that among medical doctors (Odds Ratio (OR) = 2.546; 95% Confidence Interval (CI): 1.359, 4.769; p = 0.0035). Patients with pneumonia and upper respiratory tract infection were 15.9 (OR = 15.928; 95% CI: 2.151, 17.973; p = 0.0067) and 2 (OR = 2.064; 95% CI: 1.184, 3.600; p = 0.0106) times more likely to be prescribed antibiotics, respectively. Conclusions: We, therefore, report high rates of antibiotic prescriptions, poor adherence to standard treatment guidelines and high levels of antibiotic prescribing practices among prescribers with a diploma in clinical medicine.

Access to Water, Sanitation and Hygiene Services and Other Preventive Measures against COVID-19 among People with Disabilities, Dodoma, Tanzania.

ABSTRACT.Access to Water, Sanitation and Hygiene (WASH) among people with disabilities is a great concern in developing countries. During COVID-19 pandemic in 2020, in addition to other preventive measures the government of Tanzania invested heavily on handwashing facilities in public places. However, the interventions were mostly for the general population. A big question was the appropriateness of the preventive measures to address different kinds of disabilities. The study was conducted to assess access to WASH and other preventive measures against COVID-19 among people with disabilities. This was a qualitative study where a total of 16 key informant interviews and nine focus group discussions were conducted. The study was carried out in seven districts of Dodoma region, Tanzania. Findings show that there were inadequate WASH and other COVID-19 preventive measures designed specifically for people with disabilities against the pandemic. Many people with disabilities experienced challenges in accessing adequate water for handwashing and using handwashing facilities installed for general population. Also they received inadequate health education and timely communication on COVID-19 preventive measures in addition to challenges in keeping distance and accessing and use of face masks and sanitizers. People with mobility, hearing, and vision impairments were mostly affected. There was no representation of people with disability at the national COVID-19 task force. Specific programs for people with disabilities to address access to WASH and other preventive measures against COVID-19 would address most of the identified challenges.

Knowledge, attitudes and practices towards malaria diagnostics among healthcare providers and healthcare-seekers in Kondoa district, Tanzania: a multi-methodological situation analysis

BackgroundDespite the large-scale rollout of malaria rapid diagnostic tests (RDTs) in Tanzania, many healthcare providers (HCPs) continue using blood film microscopy (BFM) and clinical examination to diagnose malaria, which can increase the risk of mal-diagnosis and over-prescribing of anti-malarials. Patients disregarding negative test results and self-treating exacerbate the problem. This study explored the knowledge, attitudes and practices of HCPs and healthcare-seekers regarding RDTs in comparison to BFM testing.MethodsA situational analysis was, therefore, conducted in Kondoa District, Dodoma Region, Tanzania. A multi-methodological approach was adopted including (i) a health facility inventory and screening of logbooks from May 2013 to April 2014 with 77,126 patient entries from 33 health facilities; (ii) a survey of 40 HCPs offering malaria services; and iii) a survey of 309 randomly selected household members from the facilities’ catchment area. Surveys took place in April and May 2014.ResultsHealth facility records revealed that out of 77,126 patient entries, 22% (n = 17,235) obtained a malaria diagnosis. Of those, 45% were made with BFM, 33% with RDT and 22% with clinical diagnosis. A higher rate of positive diagnoses was observed with BFM compared with RDT (71% vs 14%). In the HCP survey, 48% preferred using BFM for malaria testing, while 52% preferred RDT. Faced with a negative RDT result for a patient presenting with symptoms typical for malaria, 25% of HCPs stated they would confirm the result with a microscopy test, 70% would advise or perform a clinical diagnosis and 18% would prescribe anti-malarials. Interviews with household members revealed a preference for microscopy testing (58%) over RDT (23%), if presented with malaria symptoms. For participants familiar with both tests, a second opinion was desired in 45% after a negative microscopy result and in 90% after an RDT.ConclusionsNon-adherence to negative diagnostics by HCPs and patients continues to be a concern. Frequent training and supportive supervision for HCPs diagnosing and treating malaria and non-malaria febrile illnesses is essential to offer quality services that can instil confidence in HCPs and patients alike. The introduction of new diagnostic devices should be paired with context-specific behaviour change interventions targeting healthcare-seekers and healthcare providers.

The Moderation Effects of Demographic Variables on Trust of Mobile Phone Banking Services; a Case Study of Smallholder Farmers in Dodoma Region, Tanzania

This study analyzed the moderation effect of demographic variables on the trust in mobile phone banking services among smallholder farmers in the Dodoma Region. The study employed a quantitative research design with cross-sectional field surveys and structured questionnaires were employed as the research methods. The study employed a sample size of 355 smallholder farmers who were drawn by simple random sampling from grapes farmers. SPSS was used as an analytical tool for quantitative data analysis. Multiple linear regressions and Fisher’s Z-transformation were involved to test the moderating effect of demographic variables.&#x0D; Results show that demographic factors namely sex, age, experience, level of income, level of education, and marital status were significant moderating variables. However, the level of education did not show any moderating effect. Our results suggest that by integrating the accessibility and ease of use from the Technology Acceptance Model (TAM), age, sex, and experience from the Unified Theory of Acceptance and Use of Technology (UTAUT), and security and privacy from the Protection Motivation Theory (PMT), the research provides insights into the factors influencing consumers’ trust in mobile phone banking services. Besides, the results of moderating effect improve our understanding of the demographic differences, which influence the degree of mobile banking adoption. Besides, the results of moderating effect improve our understanding of the demographic differences, which influence the degree of mobile banking adoption. This study will help researchers and service providers to come up with improved mobile phone trust frameworks with a greater understanding of the influence of demographic variables.&#x0D; No similar study had been done in sub-Saharan African countries. Therefore, the study provides new knowledge and insight into the influence of demographic variables on the trust in mobile phone banking services.

Is Beekeeping Commercially and Environmentally viable? an assessment of the adoption of hanging frame beehives in semi-Arid Area of central Tanzania

In Tanzania, beekeeping contributes to the natural ecosystem growth and livelihood of rural poor people. This activity provides income and ensures food security as generated from bee products. This paper explores adoption of hanging frame beehives and its implications for livelihoods and forest conservation in the Chemba district, Dodoma region. Data was collected through interviews and Focus group discussions using structured and unstructured questionnaires. Quantitative and qualitative information were analysed through a statistical package SPSS version 16 and content analysis. The research revealed that 37.9% of the beekeepers obtain an average income of above 50,000 (21.57 USD) Tshs per year from using hanging frame beehives and 36% of other beekeepers obtain less than 50,000 (21.57 USD) Tshs per year from using log beehives. The average income from beekeeping indicates that the communities are not yet receiving reasonable income to emphasise the activity as a main source of income. Furthermore, traditional beekeeping has remained a preferred technique, thus jeopardising the forest ecosystems around the areas. Implying that adoption of hanging frame beehives is still to ensure forest conservation. The study recommends that the government, in collaboration with private stakeholders, should plan to improve beekeeping by introducing improved beehives that can be affordable to rural communities and ensure forest conservation.

Rainwater Harvesting as a Strategic Planning Management of COVID-19 Pandemic among Public Secondary Schools in Tanzania

This study explored rainwater harvesting as strategic planning management of the Covid-19 Pandemic in Secondary Schools in Tanzania. The study was carried out in Dodoma Region, Tanzania. It adopted a mixed research method by employing both quantitative and qualitative approaches under the cross-sectional research design. The study involved a sample of 66 out of 191 heads of public secondary schools, selected through simple random sampling and 14 student leaders who were purposely selected. A questionnaire was used to collect quantitative data while a semi-structured interview was used to collect qualitative data. The study established that most public secondary schools had a strategic management plan. However, only a few had a specific goal on rainwater harvest strategies as a reliable source of water during rainy seasons. Heads of schools appreciated the convivial role of rainwater harvesting for their institutions. Lack of funds and poor innovation from school management teams (SMTs) were among the main challenges for the establishment of rainwater harvesting in some schools. The study recommends that there is a need to conduct regular reviews and revisits to maintain flexible institutional strategic plans to some contemporary issues like pandemics. Second, school management teams (SMTs) should promote rainwater harvesting, which is known for being a cheap, affordable technology and an environmentally friendly water supply system. Third, the Tanzanian Government authorities, development partners and other stakeholders should support the public secondary schools to adopt the affordable rainwater-harvesting technology. Finally, educational institutions should build the capacity of their managers on strategic planning management skills for better planning and execution of their goals and for organizational wellbeing improvement.

English

Maize (Zea mays) is the staple food for the majority of people in Tanzania which plays a key role in subsistence and a cash crop among actors of the maize value chain. Environmental factors such as soil contamination by fungi, water stress, warm and humid conditions are among several factors contributing to fungal growth and aflatoxins contamination in maize, leading to significant economic loss, reduced household income, health problems to humans and animals and interferes with food security to communities. Structured questionnaires were used to collect information on awareness associated with aflatoxin contamination in maize from 160 smallholder farmers, 160 consumers and 60 traders in Kondoa and Chemba districts in Dodoma Region. A total of 90 maize samples (40 from smallholder farmers, 30 from consumers and 20 from traders) were analyzed for AFB1 using immuno-affinity high-performance liquid chromatography (HPLC) type Agilent Technologies 1200 serial. Data were statistically analyzed to assess awareness levels among maize main stakeholder and to check the current levels of aflatoxins B1 contamination in the study community. AFB1 was detected in five samples. About 3.3% of the contaminated maize had AFB1 levels above TBS acceptable levels (5 &micro;g/kg). The highest mean concentration of AFB1 was in maize samples taken from traders with a mean of 9.88&plusmn;5.904 &micro;g/kg. The majority 56% of smallholder farmers and 52% of traders were aware of aflatoxins contamination and associated health effects on animals and humans. However, 74% of consumers were unaware of aflatoxins contamination in maize. The levels of contamination are low in the sample taken along maize value chain. An effective and broad awareness programme for community especially consumers on good management for prevention of aflatoxins contamination is necessary, as maize is the most consumed grain in the study area.&nbsp; &nbsp; Key words: Aflatoxins contamination, smallholder farmers, consumers.

Challenges in the Diagnosis of Taenia solium Cysticercosis and Taeniosis in Medical and Veterinary Settings in Selected Regions of Tanzania: A Cross-Sectional Study.

Background Taenia solium (neuro) cysticercosis/taeniosis (TSCT) is a zoonotic disease complex. There is a perceived inefficient diagnosis of infections by either form, the adult pork tapeworm (taeniosis) and the larval stage of it (cysticercosis), in low-income settings, including Tanzania. This study aimed at identifying potential gaps around TSCT diagnosis and knowledge of primary healthcare providers (officers in charge (OICs) of primary healthcare facilities (PHFs)) and veterinarians (meat inspectors (MIs)) on various aspects of TSCT disease complex and addressing effective disease control in Tanzania. Methodology. A cross-sectional study was conducted between January and April 2020 in Manyara, Dodoma, Ruvuma, Iringa, and Arusha regions in Babati, Mbulu, Kongwa, Mbinga, and Nyasa districts. We interviewed 152 OICs of PHFs and 108 MIs using a structured questionnaire and 33 medical and veterinary officers from level I healthcare facilities and district livestock offices, respectively, from selected study districts to the respective ministerial level using key informant interviews. Results Quantitative data revealed inadequate microscopic diagnostic facilities (54.6%) and personnel (100%) for taeniosis diagnosis in PHFs (n = 152). Approximately 81.2% of MIs compared with only 42.1% of OICs of PHFs scored above average regarding T. solium cysticerci knowledge. Nevertheless, 61.2% of OICs of PHFs compared with only 42.6% of MIs scored above average regarding the adult T. solium tapeworm knowledge. Qualitative data revealed inadequate availability of advanced diagnostic facilities (neuroimaging) and trained personnel for specific diagnosis of TSCT with a focus on neurocysticercosis (NCC) in secondary and tertiary healthcare facilities. Inadequately number of qualified MIs, slaughter slabs, and resource facilitation challenged porcine cysticercosis diagnosis. Conclusion It is concluded that diagnostic capacity and knowledge of OICs of PHFs and MIs regarding TSCT are insufficient in both medical and veterinary sectors. A One Health approach should be adopted to improve TSCT diagnostic capacity and practitioners' knowledge in both medical and veterinary sectors.

Networks of Small Scale Agro Food Processing Enterprises in Dodoma, Morogoro and Singida Regions in Tanzania

For some time researchers in entrepreneurship have employed the concept of the network as a means of exploring how entrepreneurs do business. More recently, attempts have been made to show how networking contributes to small firm performance. The overall research on which this chapter is based aims to show how networking contributes to economic links in small agro-processing firms' activities. This paper assessed the influence of networking of small scale agro food processing enterprises in Dodoma, Morogoro and Singida Regions in Tanzania. Primary data were collected from 134 small agro processing firms. Secondary data were collected from Sokoine National Agricultural Library (SNAL), District councils, TRA, SIDO, Ministry of Industry and Trade, Ministry of agriculture, Tanzania Chamber of Commerce Industry and Agriculture (TCCIA), and National Bureau of Statistics and cluster officials. The paper focuses on a specific objective namely an understanding of the process of small firms' networking. The paper provides an in-depth analysis on the forms and structure of networks and how networks can facilitate linkage between local small-scale agro-processing firms and international firms. Data were collected using structured questionnaire. Data were analyzed using descriptive statistics. The analysis was grouped into how entrepreneurs value the contacts they make and their impact on business performance. The study also investigated the nature of organizational networks amongst agro-food processing firms and how network functions are translated into business performance. The findings indicate that agro-food processing firms value their sub-sectorial associations data were analysed using descriptive statistics. Results show that that small agro-food processing firms value their sub-sectorial associations. The findings also show that belonging to non-business-related associations is relevant in their business. This is however not the implication of getting direct assistance from these none related business associations. Therefore the study concludes that there is evidence of weak forward and backward linkage in the sub-sector because of poor linkages with rural farmers. The informal distribution channels are the most used in product and input marketing among the local and poor in Tanzania. It is recommended that dedicated public and private sector support on the development of small agro-food processing firms is called for the subsequent support of subsequent business and networking of the subsector. More importance should be given to local independent business organizations, local chambers of commerce and sub-sectoral associations in terms of the flexibility and efficiency of small agro-food processing enterprises.

Market participation among smallholder farmers in Tanzania: determining the dimensionality and influence of psychological contracts

PurposeSmallholder farmers in Tanzania were investigated in this paper to determine the dimensions and influence of psychological contracts on smallholder farmers' decisions to participate in the market.Design/methodology/approachData were collected through structured questionnaires, of which a cross-sectional design was conducted in central Tanzania, the Dodoma region in which 467 smallholder farmers were surveyed. First, a preliminary Exploratory Factor Analysis (EFA) was conducted by involving psychological contracts and market participation items derived from previous studies. This was followed by the Confirmatory Factor Analysis (CFA) to verify the items obtained in the EFA. The regression analysis was then performed to test the causal effects of psychological contracts on market participation among smallholder farmers.FindingsThe path analysis revealed that transactional, relational, and ideological contracts have a positive and statistically significant impact on the participation of smallholder farmers in the market. Therefore, smallholder farmers have own set of expectations for participating in the marketplace. As a result, smallholder farmers' relationships with market participation decisions can be strengthened.Research limitations/implicationsThis study covered only smallholder farmers. However, future studies can include large-scale farmers, because psychological contracts and market participation difficulties also apply to them. This may increase the generalizability of the findings.Originality/valuePast studies have not extensively covered the psychological contracts in smallholder farming, especially in market participation. Based on prior empirical and theoretical research from other disciplines, the findings of this study contribute to a better understanding of the psychological contract framework and the significance of multiple psychological obligations between smallholder farmers and market management.

Prevalence and predictors of self-medication with antibiotics in selected urban and rural districts of the Dodoma region, Central Tanzania: a cross-sectional study

BackgroundAntibiotic resistance is a global health threat driven partly by self-medication with antibiotics (SMA). This study aims to assess the prevalence and predictors of SMA in selected rural and urban communities of the Dodoma region, Central Tanzania.MethodsThis cross-sectional study was conducted in Chemba District Council (rural) and Dodoma City Council (urban) from August to November 2019 using multistage stratified random sampling. Data were collected through face-to-face interviews using structured questionnaires.ResultsA total of 430 respondents were interviewed in Chemba District Council (rural) (161/430) and Dodoma City Council (urban) (269/430). The prevalence of SMA was 23.6% (38/161) among rural respondents and 23.4% (63/269) among urban respondents. The median amount of SMA in both settings was 2, while the maximum amounts were 4 and 5, respectively. SMA among rural and urban participants was associated mostly with perceived cough (76.3%/82%), body pain (71.1%/41.5%) and fever (63.2%/39.7%), and amoxicillin was the most commonly used antibiotic in both settings (47.3%/41%). Rural participants who reported a shorter perceived distance to a health care facility than to a drug outlet were 58.9% less likely to practise SMA (adjusted OR: 0.421; 95% CI: 0.388, 0.458; p < 0.001), whereas SMA decreased by 16.3% among urban participants who reported a shorter perceived distance to a health care facility than to a drug outlet (adjusted OR: 0.837; 95% CI: 0.755, 0.929; p < 0.001). SMA was 17.3% lower among farmers than among nonfarmers in the urban area (adjusted OR: 0.827; 95% CI: 0.716, 0.955; p = 0.01), while farming had no effect in the rural area.ConclusionsThe prevalence of SMA is similar among participants in rural and urban districts. In both localities, a shorter perceived distance to a drug outlet is an independent risk factor for SMA, while having health insurance reduces the risk. Equally weighted interventions to reduce SMA are required in rural and urban communities.

Enhancing Tuberculosis Case-Finding: A Case of Quality Improvement Initiative in Tanzania.

Background: Tanzania is 1 of the 30 high TB burden countries and 1 of the 13 countries in which 75% of people with TB are unaccounted for and that is prioritized for the Global Fund Catalytic investment and Strategic Initiative support. Tanzania decided to strengthen its National TB Programme to find these people with TB who are unaccounted for by identifying evidence-driven innovations to deliver high-quality services and to improve the efficiency of TB case-finding. A quality improvement (QI) initiative was implemented by the National Tuberculosis and Leprosy Programme to enhance TB case-finding. The initiative involved identifying gaps in the quality of services, introducing new tools, improving the work capacity of health care workers through training and mentorship sessions, strengthening laboratory and referral services, and implementing mandatory TB screening of all patients attending health facilities. We aimed to assess the effectiveness of QI initiative to enhance TB case-findings at the health facility level. Method: A cross-sectional design, and intervention and control facilities randomly selected for an evaluation of the QI initiative were used. Twenty facilities from the Dodoma region across all health care system levels (dispensaries, health centres, and hospitals) were involved in this evaluation. The facilities were randomly divided into either the intervention or control groups at a 1:1 ratio (10 intervention and 10 control facilities). Data routinely collected from program registers from January 2016 to June 2017 were used. Result: The evaluation registered a 52% increase in TB case notification in Q1 of 2017 compared with in Q1 of 2016 and, similarly, a 52% increase in Q2 of 2017 compared with in Q2 of 2016, with 9 out of 10 intervention sites reporting increases in their quarterly TB case notifications. There were no positive changes in the ‘control facilities’ where routine services were provided, with half of the facilities showing a decrease in TB case notification from baseline. Conclusion: This QI initiative has the potential to support a long-term comprehensive approach to ending TB and to improve the quality of the foundations of the health care system. This initiative sets a reliable pace for health facilities to efficiently respond to and manage TB case-finding interventions put into action. Tanzania’s experience with implementing QI interventions could serve as a model for improving TB case notifications in other settings.

Neurocognitive decline as a major predictor of nonadherence to antiretroviral therapy among adults living with HIV in Dodoma region, central Tanzania.

BackgroundThe survival of people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome largely depends on good adherence to antiretroviral medications. Neuropsychiatric conditions such as major depressive disorders (MDDs) and neurocognitive disorders, in particular, are common in the HIV population and attributed to suboptimal adherence to antiretroviral treatment and overall poor clinical outcomes. This study aimed to determine the association between neurocognitive disorders and nonadherence to antiretroviral therapy (ART) in the Dodoma region's adult population living with HIV.MethodsThe study was conducted in Dodoma Regional Referral Hospital using a cross‐sectional design to assess 397 participants through a systematic sampling approach. Montreal Cognitive Assessment was used to determine neurocognitive function, while the Simplified Medical Adherence Questionnaire was used to assess nonadherence to ART. Logistic regression analysis was computed to determine the association between cognitive decline and nonadherence to ART while controlling for sociodemographic and clinical confounders.ResultsOut of the 397 recruited participants, 266 (67.00%) and 41 (10.33%) met the criteria for neurocognitive decline and nonadherence to ART. Participants with cognitive impairment had a significantly poorer adherence rate than those without, even after controlling for confounders adjusted odds ratio (aOR): 2.183 (95% confidence interval [CI]: 1.031, 4.630, p = 0.0413). MDD was the only additional factor that remained significantly associated with ART nonadherence (aOR: 4.332, 95% CI: 1.634, 11.485, p = 0.0032).ConclusionNeurocognitive disorders are strong predictor of suboptimal adherence to ART; a comorbid neuropsychiatric condition such as MDD may further compromise the ART adherence rate leading to poor HIV care and poor clinical outcome. Further research with systematic and more robust studies in the field will provide a baseline to design and integrate appropriate care models to maximize ART adherence in HIV care. Integration of psychiatric services in HIV care can benefit the overall patient outcome.

Community Participation and Non-Governmental Organizations-Funded Rural Water Projects’ Sustainability: A Case of Chamwino District, Dodoma Region, Tanzania

Introduction: Every year, two million people die because of unsafe water, sanitation, and hygiene. Children and young women living in rural communities are the most affected groups. To address this problem, NGOs have implemented various water projects across the country but their sustainability is questionable. Objective: To assess community participation and rural water projects’ sustainability in Chamwino District, Dodoma, Tanzania. Materials and Methods: The study was exploratory in nature, employing a qualitative approach. In-depth interviewing and focus group discussions methods were used to collect data from the participants. A purposive sampling technique was used to select participants to get their insights on community participation and the sustainability of rural water projects in Chamwino District, Dodoma Region, Tanzania. Thematic analysis was used for data analysis, to embrace community participation in the rural water projects, which can affect their sustainability. Results: Findings show that lack of community participation, lack of community support, and involvement at various stages of project implementation from the designing, implementation, operation, and monitoring and evaluation through various village water committees are key factors negatively impacting sustainability of rural water projects implemented in Chamwino District. Conclusions: Effective community participation, community support, and participation from the designing, implementation, operation, and monitoring and evaluation through water committees are key factors to be adhered to for the sustainability of rural water projects in Chamwino District and other areas in Tanzania.