Lindi Region Research Articles

Effectiveness of a Home-Based Counselling Strategy on Neonatal Care and Survival: A Cluster-Randomised Trial in Six Districts of Rural Southern Tanzania.

BackgroundWe report a cluster-randomised trial of a home-based counselling strategy, designed for large-scale implementation, in a population of 1.2 million people in rural southern Tanzania. We hypothesised that the strategy would improve neonatal survival by around 15%.Methods and FindingsIn 2010 we trained 824 female volunteers to make three home visits to women and their families during pregnancy and two visits to them in the first few days of the infant’s life in 65 wards, selected randomly from all 132 wards in six districts in Mtwara and Lindi regions, constituting typical rural areas in Southern Tanzania. The remaining wards were comparison areas. Participants were not blinded to the intervention. The primary analysis was an intention-to-treat analysis comparing the neonatal mortality (day 0–27) per 1,000 live births in intervention and comparison wards based on a representative survey in 185,000 households in 2013 with a response rate of 90%. We included 24,381 and 23,307 live births between July 2010 and June 2013 and 7,823 and 7,555 live births in the last year in intervention and comparison wards, respectively. We also compared changes in neonatal mortality and newborn care practices in intervention and comparison wards using baseline census data from 2007 including 225,000 households and 22,243 births in five of the six intervention districts. Amongst the 7,823 women with a live birth in the year prior to survey in intervention wards, 59% and 41% received at least one volunteer visit during pregnancy and postpartum, respectively. Neonatal mortality reduced from 35.0 to 30.5 deaths per 1,000 live births between 2007 and 2013 in the five districts, respectively. There was no evidence of an impact of the intervention on neonatal survival (odds ratio [OR] 1.1, 95% confidence interval [CI] 0.9–1.2, p = 0.339). Newborn care practices reported by mothers were better in intervention than in comparison wards, including immediate breastfeeding (42% of 7,287 versus 35% of 7,008, OR 1.4, CI 1.3–1.6, p < 0.001), feeding only breast milk for the first 3 d (90% of 7,557 versus 79% of 7,307, OR 2.2, 95% CI 1.8–2.7, p < 0.001), and clean hands for home delivery (92% of 1,351 versus 88% of 1,799, OR 1.5, 95% CI 1.0–2.3, p = 0.033). Facility delivery improved dramatically in both groups from 41% of 22,243 in 2007 and was 82% of 7,820 versus 75% of 7,553 (OR 1.5, 95% CI 1.2–2.0, p = 0.002) in intervention and comparison wards in 2013. Methodological limitations include our inability to rule out some degree of leakage of the intervention into the comparison areas and response bias for newborn care behaviours.ConclusionNeonatal mortality remained high despite better care practices and childbirth in facilities becoming common. Public health action to improve neonatal survival in this setting should include a focus on improving the quality of facility-based childbirth care.Trial RegistrationClinicalTrials.gov NCT01022788

An Archaeological Identity of the Majimaji: Toward an Historical Archaeology of Resistance to German Colonization in Southern Tanzania

This paper presents new insights on the Majimaji war, which is one of the least studied topics in Eastern Africa’s colonial history. The Majimaji (1905–1907) was a large scale war of resistance against German colonial rule in Tanzania. This war started in the Lindi Region and spread rapidly to other areas of southern Tanzania. It was primarily a reaction to the exploitative nature of German colonial rule. The archival records that exist are biased toward German sources and information supplied by their African agents who wished to please the colonists and spare their lives. Although local oral histories on the war existed, this has been poorly documented or the accounts have been lost. In this circumstance, archaeology provides an alternative source of evidence about the Majimaji war. This paper presents the intellectual arguments that underpin this research. It explains why archaeology is still important to study popular historical events. Using archaeology, the Majimaji battle sites can be identified and documented so as to enhance understandings of the war and to fill in gaps that arise from the limitations of documentary archival records and oral histories. In addition, this research has elicited public awareness and perception of the battle sites and obtained new insights into how the memories of the war resonate in people’s minds.

Roles and responsibilities in newborn care in four African sites.

ObjectivesTo explore roles and responsibilities in newborn care in the intra‐ and postpartum period in Nigeria, Tanzania and Ethiopia.MethodsQualitative data were collected using in‐depth interviews with mothers, grandmothers, fathers, health workers and birth attendants and were analysed through content and framework analyses.ResultsWe found that birth attendants were the main decision‐makers and care takers in the intrapartum period. Birth attendants varied across sites and included female relatives (Ethiopia and Nigeria), traditional birth attendants (Tanzania and Nigeria), spiritual birth attendants (Nigeria) and health workers (Tanzania and Nigeria). In the early newborn period, when the mother is deemed to be resting, female family members assumed this role. The mothers themselves only took full responsibility for newborn care after a few days or weeks. The early newborn period was protracted for first‐time mothers, who were perceived as needing training on caring for the baby. Clear gender roles were described, with newborn care being considered a woman's domain. Fathers had little physical contact with the newborn, but played an important role in financing newborn care, and were considered the ultimate decision‐maker in the family.ConclusionInterventions should move beyond a focus on the mother–child dyad, to include other carers who perform and decide on newborn care practices. Given this power dynamic, interventions that involve men have the potential to result in behaviour change.

Forest and Forest Change Mapping with C- and L-band SAR in Liwale, Tanzania

Abstract. As part of a Tanzanian-Norwegian cooperation project on Monitoring Reporting and Verification (MRV) for REDD+, 2007-2011 Cand L-band synthetic aperture radar (SAR) backscatter data from Envisat ASAR and ALOS Palsar, respectively, have been processed, analysed and used for forest and forest change mapping over a study side in Liwale District in Lindi Region, Tanzania. Land cover observations from forest inventory plots of the National Forestry Resources Monitoring and Assessment (NAFORMA) project have been used for training Gaussian Mixture Models and k-means classifier that have been combined in order to map the study region into forest, woodland and non-forest areas. Maximum forest and woodland extension masks have been extracted by classifying maximum backscatter mosaics in HH and HV polarizations from the 2007-2011 ALOS Palsar coverage and could be used to map efficiently inter-annual forest change by filtering out changes in non-forest areas. Envisat ASAR APS (alternate polarization mode) have also been analysed with the aim to improve the forest/woodland/non-forest classification based on ALOS Palsar. Clearly, the combination of C-band SAR and L-band SAR provides useful information in order to smooth the classification and especially increase the woodland class, but an overall improvement for the wall-to-wall land type classification has yet to be confirmed. The quality assessment and validation of the results is done with very high resolution optical data from WorldView, Ikonos and RapidEye, and NAFORMA field observations.

COMMUNITY MEMBERS' PERCEPTIONS OF MASS DRUG ADMINISTRATION FOR CONTROL OF LYMPHATIC FILARIASIS IN RURAL AND URBAN TANZANIA.

Lymphatic filariasis is one of several neglected tropical diseases with severely disabling and stigmatizing manifestations that are referred to as 'neglected diseases of poverty'. It is a mosquito-borne disease found endemically and exclusively in low-income contexts where, concomitantly, general public health care is often deeply troubled and fails to meet the basic health needs of impoverished populations. This presents particular challenges for the implementation of mass drug administration (MDA), which currently is the principal means of control and eventual elimination. Several MDA programmes face the dilemma that they are unable to attain and maintain the required drug coverage across target groups. In recognition of this, a qualitative study was conducted in the Morogoro and Lindi regions of Tanzania to gain an understanding of community experiences with, and perceptions of, the MDA campaign implemented in 2011 by the National Lymphatic Filariasis Elimination Programme. The study revealed a wide variation of perceptions and experiences regarding the aim, rationale and justification of MDA. There were positive sentiments about the usefulness of the drugs, but many study participants were sceptical about the manner in which MDA is implemented. People were particularly disappointed with the limited attempts by implementers to share information and mobilize residents. In addition, negative sentiments towards MDA for lymphatic filariasis reflected a general feeling of desertion and marginalization by the health care system and political authorities. However, the results suggest that if the communities are brought on board with genuine respect for their integrity and informed self-determination, there is scope for major improvements in community support for MDA-based control activities.

English

Tanzania has over 12,000 plant species, some of which are endemic and have potential to yield useful medicines. This study seeks to document such plants used as traditional medicines for treatment of malaria in Kagera region of northwestern Tanzania and Lindi region in south eastern Tanzania. The study also reports on the antiplasmodial activity against chloroquine-resistant Plasmodium falciparum (Dd2) strain of some of the documented plants using the parasite lactate dehydrogenase method. A total of 108 plant species, among which the families Compositae (14; 12.96%), Fabaceae (12; 11.11%), Euphorbiaceae (8; 7.41%), Melastomataceae (6; 5.56%) and Myrtaceae (4; 3.70%) were documented. Sixteen (16; 44.4%) of 36 extracts from 31 plant species that were tested inhibited malaria parasites growth by more than 50%. Bersema abyssinica stem bark extract was the most active with 86.67% inhibition rate followed by Bridelia micrantha stem bark extract with 71.87% inhibition rate. These results confirm the potential for plants used in traditional medicine to yield active antimalarial compounds. Further in vitro and in vivo screening supported by bioassay-guided isolation of active compounds from plants showing good safety margin is suggested. Key words: Ethnobotanical survey, medicinal plants, malaria, treatment, in vitro antiplasmodial, Tanzania.

Rethinking ‘expert’ knowledge in community forest management in Tanzania

From the 1980s great hopes have been placed on community forest management to promote socio-economic development along with forest protection. Empirical research has shown, however, that while community forest management has often improved forest conditions, the goals of poverty alleviation and local empowerment have not been fully attained. The wide gap between theory and practice of community forest management has caused scholars to emphasise the role of power and politics in the design, practice and outcome of decentralisation. More recently, the roles of techno-bureaucratic values, practices and the authority given to ‘expert’ knowledge have been highlighted as important factors impeding its successful implementation. Building on these insights, this paper, conjoined with other contributions to this special issue, aims to examine the role of professionalisation and ‘expert’ knowledge in community-based forest management in Tanzania, particularly with regard to its economic development and local empowerment benefits. Drawing on long-term research in the Angai village land forest reserve in Liwale, Lindi Region, Tanzania, this paper illustrates how almost 20years after the inception of community-based forest management, villagers are still waiting for the promised political and economic benefits to materialise. We argue that professionalisation and the privileged role of ‘expert’ knowledge hampered forest decentralisation. Based on our findings, we join other authors of this special issue in calling for less technically and bureaucratically demanding ways of forest management and planning to allow local communities to fully take over ownership and control of forest resources and to relieve state and non-state actors of cumbersome and overburdening development requirements.

Evaluation of the cytotoxic activity of extracts from medicinal plants used for the treatment of malaria in Kagera and Lindi regions, Tanzania

Pharmacognostical standardization and toxicity profile of the methanolic leaf extract of Plectranthus amboinicus (Lour) SprengPreeja G. Pillai, P. Suresh, Gayatri Aggarwal, Gaurav Doshi, Vidhi Bhatia

Factors influencing drug uptake during mass drug administration for control of lymphatic filariasis in rural and urban Tanzania.

BackgroundIn most countries of Sub-Saharan Africa, control of lymphatic filariasis (LF) is based on annual mass drug administration (MDA) with a combination of ivermectin and albendazole. Treatment coverages are however often suboptimal for programmes to reach the goal of transmission interruption within reasonable time. The present study aimed to identify predictors and barriers to individual drug uptake during MDA implementation by the National LF Elimination Programme in Tanzania.MethodsA questionnaire based cross sectional household survey was carried out in two rural and two urban districts in Lindi and Morogoro regions shortly after the 2011 MDA. 3279 adults (≥15 years) were interviewed about personal characteristics, socio-economic status, MDA drug uptake among themselves and their children, reasons for taking/not taking drugs, and participation in previous MDA activities for LF control.FindingsThe overall drug uptake rate was 55.1% (range of 44.5–75.6% between districts). There was no overall major difference between children (54.8%) and adults (55.2%) or between females (54.9%) and males (55.8%), but the role of these and other predictors varied to some extent between study sites. Major overall predictors of drug uptake among the interviewed adults were increasing age and history of previous drug uptake. Being absent from home during drug distribution was the main reason for not taking the drugs (50.2%) followed by clinical contraindications to treatment (10.8%), missing household visits of drug distributors (10.6%), and households not being informed about the distribution (9.0%).ConclusionDrug uptake relied more on easily modifiable provider-related factors than on individual perceptions and practices in the target population. Limited investments in appropriate timing, dissemination of accurate timing information to recipients and motivation of drug distributors to visit all households (repeatedly when residents are absent) are likely to have considerable potential for increasing drug uptake, in support of successful LF transmission elimination.

Sero-prevalence and associated risk factors of peste des petits ruminants and contagious caprine pleuro-pneumonia in goats and sheep in the Southern Zone of Tanzania

A retrospective Sero-prevalence analysis was conducted in 2012 in order to find out whether contagious caprine pleuro-pneumonia (CCPP) and peste des petits ruminants (PPR) had already been introduced in Mtwara and Lindi regions of Southern Tanzania by 2007 and 2009. A total of 477 randomly selected sera from a bank of 3500 small ruminant samples that were collected as part of Rift Valley Fever surveillance of 2007 in Mtwara and Lindi regions were used in this study. Seroconversion was also evaluated in the 504 sera that were collected in 2009 as part of disease outbreak investigations in Tandahimba and Newala districts of Mtwara region. Seroconversions to CCPP and PPR were tested using competitive ELISA. In addition, information on different variables available in the existing surveillance forms gathered during sampling was used in the analysis of risk factors associated with seropositivity to the two diseases. The overall seroprevalence of CCPP for the sera of 2007 and 2009 in goats was 52.1% (n=447) and 35.5% (n=434) respectively; while in sheep the seroprevalence was 36.7% (n=30) and 22.9% (n=70) respectively. Seroconversion to PPR in goats and sheep was 28.7% (n=434) and 35.7% (n=70) respectively based on the sera of 2009. However, no antibodies were detected in the 2007 sera. Mixed infections were detected in 7.4% (n=434) of the goat and 12.9% (n=70) of sheep samples. Significant risk factors associated with seropositivity to CCPP in 2007 included introduction of new animals in flocks (OR=3.94; 95% CI 1.86–8.36; p<0.001) and raising animals in government farms (OR=4.92; 95% CI 1.57–15.76; p=0.02); whereas, seropositivity to CCPP in 2009 increased with introduction of new animals in flocks (OR=18.82; 95% CI 8.06–43.96; p<0.001), raising animals in government farms (OR=4.04; 95% CI 2.69–6.42; p<0.001) and raising animals in Newala district (OR=2.35; 95% CI 1.53–3.62; p<0.001). On the other hand, predictors for seropositivity to PPR in 2009 were introduction of new animals in flocks (OR=2.83; 95% CI 1.73–4.62; p<0.001) and communal grazing of animals (OR=7.60; 95% CI 1.77–32.58; p=0.01). Therefore, these results show that CCPP was already circulating in goats in the southern zone by 2007 and that PPR was probably introduced thereafter. Their presence in this emerging animal keeping area in Tanzania calls for improved surveillance and control systems.

Lithostratigraphy, biostratigraphy and chemostratigraphy of Upper Cretaceous and Paleogene sediments from southern Tanzania: Tanzania Drilling Project Sites 27–35

The 2008 Tanzania Drilling Project (TDP) expedition recovered common planktonic foraminifera (PF), calcareous nannofossils (CN) and calcareous dinoflagellates with extraordinary shell preservation at multiple Cenomanian–Campanian sites that will be used for paleoclimatic, paleoceanographic, and biostratigraphic studies. New cores confirm the existence of a more expanded and continuous Upper Cretaceous sequence than had previously been documented in the Lindi and Kilwa regions of southeastern coastal Tanzania. This TDP expedition cored 684.02m at eight Upper Cretaceous sites (TDP Sites 28–35) and a thin Paleocene section (TDP Site 27).TDP Sites 29, 30, 31 and 34 together span the lowermost Turonian to Coniacian (PF Whiteinella archaeocretacea to Dicarinella concavata Zones and CN Zones UC6a–9b), with TDP Site 31 being the most biostratigraphically complete Turonian section found during TDP drilling. A discontinuous section from the Santonian–upper Campanian (PF D. asymetrica to Radotruncana calcarata Zones and CN Zones UC12–16) was collectively recovered at TDP Sites 28, 32 and 35, while thin sequences of the lower Cenomanian (PF Thalmanninella globotruncanoides Zone and CN subzones UC3a–b) and middle Paleocene (Selandian; PF Zone P3a and CN Zone NP5) were cored in TDP Sites 33 and 27, respectively. Records of δ13Corg and δ13Ccarb from bulk sediments generated for all the Cretaceous sites show largely stable values through the sections. Only a few parallel δ13Corg and δ13Ccarb shifts have been found and they are interpreted to reflect local processes. The δ18Ocarb record, however, is consistent with Late Cretaceous cooling trends from the Turonian into the Campanian. Lithologies of these sites include thick intervals of claystones and siltstones with locally abundant, finely-laminated fabrics, irregular occurrences of thin sandstone layers, and sporadic bioclastic debris (e.g., inoceramids, ammonites). Minor lithologies represent much thinner units of up to medium-grained, massive sandstones. The %CaCO3 (∼5–40%) and %Corg (∼0.1–2%) are variable, with the highest %CaCO3 in the lower Campanian and the highest %Corg in the Turonian. Lithofacies analysis suggests that deposition of these sediments occurred in outer shelf-upper slope, a setting that agrees well with inferences from benthic foraminifera and calcareous dinoflagellates.

Can REDD+ Reconcile Local Priorities and Needs with Global Mitigation Benefits? Lessons from Angai Forest, Tanzania

Mustalahti, I., A. Bolin, E. Boyd, and J. Paavola. 2012. Can REDD+ reconcile local priorities and needs with global mitigation benefits? Lessons from Angai Forest, Tanzania. Ecology and Society 17(1): 16. https://doi.org/10.5751/ES-04498-170116

Lithostratigraphy, biostratigraphy and chemostratigraphy of Upper Cretaceous sediments from southern Tanzania: Tanzania drilling project sites 21–26

The 2007 drilling season by the Tanzania drilling project (TDP) reveals a much more expanded Upper Cretaceous sequence than was recognized previously in the Lindi region of southern Tanzania. This TDP expedition targeted recovery of excellently preserved microfossils (foraminifera and calcareous nannofossils) for Late Cretaceous paleoclimatic, paleoceanographic and biostratigraphic studies. A total of 501.17 m of core was drilled at six Upper Cretaceous sites (TDP Sites 21, 22, 23, 24, 24B and 26) and a thin Miocene–Pleistocene section (TDP Site 25). Microfossil preservation at all these sites is good to excellent, with foraminifera often showing glassy shells and consistently good preservation of small and delicate nannofossil taxa. In addition to adding to our knowledge of the subsurface geology, new surface exposures were mapped and the geological map of the region is revised herein. TDP Sites 24, 24B and 26 collectively span the upper Albian to lower-middle Turonian (planktonic foraminiferal Planomalina buxtorfi– Whiteinella archaeocretacea Zones and calcareous nannofossil zones UC0a–UC8a). The bottom of TDP Site 21 is barren, but the rest of the section represents the uppermost Cenomanian–Coniacian ( W. archaeocretacea– Dicarinella concavata Zones and nannofossil zones UC5c–UC10). Bulk organic δ 13C data suggest recovery of part of Ocean Anoxic Event 2 (OAE2) from these four sites. In the upper part of this interval, the lower Turonian nannofossil zones UC6a–7 are characterized by a low-diversity nannoflora that may be related to OAE2 surface-water conditions. TDP Site 22 presents a 122-m-thick, lower-middle Turonian ( W. archaeocretacea– Helvetoglobotruncana helvetica Zones) sequence that includes the nannofossil zones UC6a(-7?), but invariable isotopic curves. Further, a lower to upper Campanian ( Globotruncana ventricosa– Radotruncana calcarata Zones and nannofossil subzones UC15b TP–UC15d TP) succession was drilled at TDP Site 23. Lithologies of the new sites include thin units of gray, medium to coarse sandstones, separating much thicker intervals of dark claystones with organic-rich laminated parts, irregular silty to fine sandstone partings, and rare inoceramid and ammonite debris. These lithofacies are interpreted to have been deposited in outer shelf and upper slope settings and indicate relatively stable sedimentary conditions during most of the Late Cretaceous on the Tanzanian margin.

Anticancer Activity of Extracts from some Endemic Tanzanian Plants

Plants have shown to be good sources of a variety of drugs for human ailments including cancer. Tanzania is rich in plant species most of which have not been investigated for any biological activity. In the continuing effort to screen Tanzanian plants for anticancer activity, plants were collected from Lindi region and extracts tested for the activity using two cell lines namely RT112 (Human bladder transitional cell carcinoma) and HeLa (Human cervical carcinoma). Of the 52 extracts from 26 plants of different families tested, 5 demonstrated potential activity on the cells. Extract X13 had an exceptionally high activity on both cell lines while extract X29 was highly active on HeLa cells. Fractionation and isolation of constituents from the extracts that have shown anticancer activity in these cell lines is recommended. Keywords: Medicinal plants, extracts, anticancer activity, screeningEast and Central African Journal of Pharmaceutical Sciences Vol. 10 (3) 2007: pp. 63-67

Assessing the validity of health facility‐based data on insecticide‐treated bednet possession and use: comparison of data collected via health facility and household surveys – Lindi region and Rufiji district, Tanzania, 2005

Objective To assess the validity of health facility (HF)-based data on bednet and insecticide-treated bednet possession and use by children <5 years old. Methods We compared estimates based on data collected via HF surveys of under-5s attending well-child visits (e.g. immunizations) and sick-child visits vs. representative household surveys (a 'gold standard' method for measuring insecticide-treated net coverage). In Lindi region, Tanzania, we collected contemporaneous data on 637 under-5s via a HF survey (444 well-child visits and 193 sick-child visits), and on 305 households with an under-5 (including 354 children) via a household survey. In Rufiji district, Tanzania, we collected contemporaneous data on 1433 under-5s via a HF survey (911 well-child visits and 522 sick-child visits), and on 328 households with an under-5 (including 455 children) via a household survey. Results Possession of bednets by households with an under-5 was similar using HF data and household data in both Lindi region and Rufiji district. However, reported use of bednets was significantly higher in HF data than household data in both Lindi and Rufiji, as was reported use of insecticide-treated bednets. HF-based data accurately estimated community-level bednet possession in households with an under-5, but overestimated community-level bednet use by 9-35% and insecticide-treated bednet use by 15-21%. Conclusions Information bias rather than selection bias appears to be a key cause for the overestimation of bednet and insecticide-treated bednet use (e.g. social desirability bias: caretakers of under-5s attending health facilities might be more likely to report using bednets and insecticide-treated bednets). Additional studies of the validity, cost and utility of HF-based data to monitor insecticide-treated bednet use are needed before recommending this monitoring strategy for widespread use. Overestimating insecticide-treated bednet use could lead to inappropriate public health actions and missed opportunities for achieving local and global public health goals.

DISTRIBUTION OF FREE UNTREATED BEDNETS BUNDLED WITH INSECTICIDE VIA AN INTEGRATED CHILD HEALTH CAMPAIGN IN LINDI REGION, TANZANIA: LESSONS FOR FUTURE CAMPAIGNS

Use of insecticide-treated bednets (ITNs) to prevent malaria remains low, and effective distribution strategies are needed. An integrated child health campaign with free distribution of 162,254 untreated bednets bundled with insecticide, measles vaccination, vitamin A, and mebendazole for children < 5 years old ("under-5s") was conducted in Lindi Region, Tanzania. We conducted a representative household survey 3 months after the campaign. Altogether, 574 households with 354 under-5s were visited. In households with an under-5, possession of bednets and ITNs increased from 60.9% to 90.7% (P < 0.001) and from 16.5% to 37.3% (P < 0.001), respectively. Increases occurred in all wealth quintiles and equity improved. Reported bednet and ITN use the previous night among under-5s was 46.3% and 21.5%, respectively. Integrated campaigns rapidly and equitably increase bednet possession and use meriting continued large-scale implementation. However, our study found that bednets were rarely treated; thus, future campaigns should provide factory-treated long-lasting ITNs. Low ITN use underscores the need for further efforts to increase use after campaigns.

Crop losses due to outbreaks of Mastomys natalensis (Smith, 1834) Muridae, Rodentia, in the Lindi Region of Tanzania

In 1989, a widespread outbreak of the multimammate rat— Mastomys natalensis (Smith, 1834) occurred in the Lindi Region in southern Tanzania. Population densities of the rodent were estimated in some areas to be over 1400 rats ha −1 . Crop loss due to the outbreak was evaluated in the region. A total yield loss of 48% of maize, sorghum, paddy, and pulses that were in production during the 1989/90 crop season was attributed to seed depredation by the rats. The Tanzanian government spent about US$16,000 on a rodent-control campaign in this region. Food losses due to rodents required the government to supply relief food to residents threatened by famine.

Evaluating traditional midwife training programs: lessons learned from Tanzania

This study evaluated a training program for traditional midwives (TM) in Lindi Region Tanzania by assessing knowledge and practices among the trained and untrained TMs. A semi-structured questionnaire was given to 87 women who gave birth with a TM and were interviewed while attending Mother and Child Health clinics for vaccination. The indicators used to assess the quality of care provided by the trained TMs were: 1) knowledge and danger signs during pregnancy; 2) inappropriate obstetric interventions during home deliveries; and 3) management of the umbilical cord. Overall findings showed that the training had improved the knowledge of trained TMs on the risk factors and danger signs in pregnancy and childbirth. However there was not much improvement in the actual quality of care provided by trained TMs. The study noted that there was no difference between trained and untrained TMs in the management of the umbilical cord in terms of cutting and cleanliness. In conclusion the role of the TMs in the community and the learning objectives of the program should be re-examined with focus on the conditions and priorities on community level.

Two new trypanosome species from East African cordylid lizards

Two species ofTrypanosoma are described from East African cordylid lizards.Trypanosoma zonuri n. sp. was found in a disjunct population ofCordylus cordylus on the western slope of Ngorongoro Crater in Arusha Region, northern Tanzania. It has the appearance of a delicate and fragile trypanosome, slightly over half the size of the robust, leaf-likeT. cordyli n. sp. that parasitisesCordylus t. tropidosternum in the Rondo Forest, Lindi Region, southern Tanzania. These are the first trypanosome species recorded from the saurian family Cordylidae in East Africa.

A New Species and a New Record of Dichapetalum from Tanzania

The southeastern part of Tanzania, together with the adjacent part of Mozambique, harbours a relatively large number of endemic Dichapetalum species, namely D. braunii Engl. & Krause, D. edule Engl., and D. macrocarpum Engl. ex Krause (Breteler 1988). Recent collections made in the Lindi Region have revealed a fourth endemic species in this area, which is described here for the first time. It had been collected before, but the relevant material was then inadequate to decide whether or not a new species was involved (Breteler 1986: 43). The recent collection also revealed the presence of D. deflexum (Kl.) Engl., which was hitherto known only from Mozambique, but was likely to be found within the F.T.E.A. area (Breteler 1988: 2).