Mtwara Region Research Articles

Respiratory symptoms and dust exposure among cement processing factory workers,Tanzania

Background: Cement manufacturing is among the growing industry in Tanzania. It involves processes from blending, kiln burning, clinker, grinding and cement final production. All of these cement manufacturing processes generates cement dust which contain silica and other toxic materials which can potentially affect respiratory system of exposed workers. Methods: This cross sectional comparative study design was conducted at cement processing factory and Ndanda mineral water processing factory as control, all of these factories are located in Mtwara region in Tanzania. A total of 398 workers were selected randomly from these two factories. Data were collected using structured questionnaires for respiratory health symptoms, Checklists was used for the observational parameters. Dust sampling was done using Side Kick Casella (SKC) pumps and PVC filter on IOM cassettes was used to determine dust exposures. The analysis was done by SPSS program vers 20. The significant association between the dependent variable and the factors was registered when Pvalue was less the 0.05. Results: Packing and cleaner were the sections with higher total cement dust concentrations above Occupational Exposure Limit which were 33.24 and 15.39 mg/m3 respectively. Workers in cement processing factory were exposed to higher levels of total dust with AM 14.1033 mg/m3 (SD 4.357) than in mineral water processing factory AM 0.0867 mg/m3 (SD 0.035). The Prevalence of respiratory symptoms was higher among workers in cement processing factory (45.7%) than in mineral water processing factory (25%), this was statistically significant. Conclusion: Exposure to cement dust in a working environment causes the increase in work related respiratory symptoms and reduced lung function. A control measure to decrease the dust exposure level among cement workers in line with periodic medical examination is highly needed.

Community perspectives on natural gas management in Tanzania

Several studies have discussed community participation in socio-economic projects. The studies have shown that many projects that have been initiated by either the government or private sectors have encountered resistance and reluctance from the local communities and other officials due to lack of prior and continuous involvements, poor dissemination of information on the significance of the projects, and differences in priority and interests. One of the key factors for the success and sustainability of any project is a clear understanding of the community's voluntary involvement, perspectives, and expectations of the given project. This study, therefore, aims to analyze the communities’ perspectives, expectations, and concerns related to the recent discovery and management of natural gas in Tanzania. The study adopted a questionnaire survey. Data was collected from the 115 respondents from local communities of Lindi and Mtwara regions in Tanzania. The study revealed that the communities are aware of the natural gas discoveries and policies and laws related to them. It shows that a small number of employment opportunities have been created and/or are expected to increase in the future. There should be transparency and accountability in the natural gas development, contracts, and agreements. The parliament should be the most trustworthy custodian of natural gas revenues. The study revealed that the natural gas sector would enhance the living conditions of Tanzanian households and support the attainment of the country's socio-economic development.

Early Warning Systems and Response Mechanisms for Countering Violent Extremism in Tanzania

This paper analyzed the early warning and response mechanisms developed and deployed at the local levels to respond to episodes and threats related to violent extremism. Qualitative methods – namely key informant interviews and documentary review were employed to gather findings from local community members and leaders, government official and police in Mwanza and Mtwara regions. The paper discovered that, first, growing incidents of violence in Tanzania ensued from the weakening of early warning and response mechanisms, and secondly, recent interventions to reinforce and deploy early warning and response mechanisms have helped to increase the capacity of communities to prevent incidents of violence. However, the paper found that, that even though the usefulness of early warning and response mechanisms to prevent VE - related security threats is acknowledged by all actors, success in the operationalization of these mechanisms is politically negotiated. Findings point to the need to invest in early warning mechanisms allowing communities to engage in developing context – specific solutions to address growing cases of violence.

How communication can help women who experience a maternal near-miss: a qualitative study from Tanzania

ObjectivesThis study aimed to explore experiences of communication as an element of quality of care, among women surviving a maternal near-miss event, thus women who nearly died but survived haemorrhage,...

Antimicrobial Activities of Endophytic Fungal Crude Extracts Isolated from Cashew Tree (Anacardium occidentale)

This study presents the antimicrobial activities of endophytic fungal crude extracts isolated from leaves, stems and roots of cashew trees (Anacardium occidentale) which showed disease symptoms and those resistant from Fusarium wilt in Mtwara region. Sections of the cashew trees were made and cultured to isolate endophytes. Eight endophytes were isolated and characterized by using morphological and molecular markers. Neopestalotiopsis, Penicillium, Lasidioplodia and Daldinia sp isolated from resistant tree and Auxarthron and Aspergillus sp from diseased tree. Antimicrobial activities of the isolated endophytic fungal crude extracts were done against pathogenic Fusarium oxysporum and three human pathogens namely, Staphylococcus aureus, Escherichia coli, and Candida tropicalis. Results showed that all endophytic fungal crude extracts isolated from resistant plants and one from diseased plants exhibited positive antimicrobial activities against bacteria and fungus Candida tropicalis but they had no antifungal activity against Fusarium oxysporum. This study could contribute to the discovery and innovation of therapeutics. This study also implied that the resistance against Fusarium wilt disease might be caused by other unknown factors. More research work is recommended for establishing other possible factors including endophytic bacteria, biotic and abiotic factors that could contribute to resistance of cashew plants to Fusarium oxysporum.
 Keywords: Antifungal; Phytopathology; Endophyte; Cashew nut disease

Human immunodeficiency virus transmission from a 24-year-old woman to her 78-year-old grandmother: a case report

IntroductionSince its debut recognition in 1981, human immunodeficiency virus/acquired immunodeficiency syndrome has affected over 77 million people and has resulted in premature cessation of 35.4 million lives worldwide. Commonly, human immunodeficiency virus is transmitted by sexual contact across mucosal surfaces, by sharing of injecting equipment, through contaminated blood transfusions, and by maternal–infant exposure. Nevertheless, accidental transmission incidences involving family members are rare but possible.Case presentationA 78-year-old woman of African descent from Mtwara Region south of Tanzania was referred to us for further evaluation and treatment. She is 30 years postmenopausal and has a 35-year history of hypertension. Her last attendance to our institute was 11 months prior the index visit and she tested negative for human immunodeficiency virus. She came with complaints of weight loss, recurrent fevers, and cough. Her hematological tests revealed leukopenia with lymphocytosis, together with a normocytic normochromic anemia. Enzyme-linked immunosorbent assay for human immunodeficiency virus was positive, and she had a CD4 count of 177 cells/µL. We went back to history taking to identify the potential source of infection. We were informed that for the past 6 months, the 78-year-old lady has been living with her unwell 24-year-old granddaughter who has been divorced. The granddaughter had a history of recurrent fevers, significant weight loss, and a suppurative skin condition. As a way to show love and care, the old lady was puncturing the suppurative lesions with bare hands; then she would suck them to clear away the discharge. We requested to see the young lady, and she tested positive for human immunodeficiency virus. Both were started on tenofovir/lamivudine/dolutegravir combination plus cotrimoxazole 960 mg. The family was in total disarray following these findings. The patient was discharged through infectious diseases department and died of Pneumocystis jirovecii pneumonia 12 weeks later.ConclusionsCertain sociocultural norms that are believed to express love, care, and togetherness in developing rural communities, particularly Sub-Saharan Africa, have a potential of spreading human immunodeficiency virus, thus warranting prompt transformation.

Mismatched ambition, execution and outcomes: implementing maternal death surveillance and response system in Mtwara region, Tanzania

BackgroundSince 2015, Tanzania has been implementing the Maternal Death Surveillance and Response (MDSR) system. The system employs interactions of health providers and managers to identify, notify and review maternal deaths...

Factors Associated with HIV Viral Load suppression AmongAdults at HIV Care and Treatment Centers in Dodoma, Mtwaraand Lindi Region, July 2018-June 2019

Despite the increase number of people living with HIV still there are limited information about the factors associated with viral load suppression among HIV+ individual enrolled into HIV care and treatment centers in Tanzania. Data reports that 87% of those who are living with HIV have attained viral suppression. However this is still low compare to the UNAIDS global targets that by 2020 of 90% on treatment must achieve viral suppression. Viral load remains a gold standard for assessing treatment outcome for those who are on treatment. In 2014 UNAIDS introduced 90- 90-90 goal so as to combat HIV epidemic by 2020. First 90% know there status, second 90 accessing treatment and Third 90% viral suppression. The aim of this study was therefore to identify factors affecting viral load suppression among HIV+ adults attending care and treatment services in the regions. Crossectional analytical study conducted at Dodoma, Mtwara and Lindi regions in randomly selected health facilities. 459 participants who are on ART for atleast 12 months and 18+ years were recruited for the study. Structured questionnaire was used. Data was entered, cleaned and analyzed using EPI info 7.2.2.16. Odds ratio was used to establish association, 95% CI, and P value of 0.05 were used for statistically significance. A total of 459 study participants were enrolled. The prevalence of viral load suppression was 79%. Viral load suppression was found to be association with Satisfaction to care OR, 11.6 (95% CI: 1.2, 113.6) and Stigma level OR, 2.5 (95% CI: 1.03, 6.1) and found to be statistically significant. Majority of participants were female 165 (68.6%), married 185 (40.3%), with primary education 309 (67.3%) and 280 (61%) had small business or self-employed. Those younger than 35 years had a 70% reduced chance of having viral load suppression OR 0.7 (95% CI: 0.41 OR 1.18), gender OR 0.85 (95% CI: 0.5,1.35), marital status OR, 0.93 ( 95% CI: 0.59, 1.47), those with primary education level OR, 0.47, (95% CI: 0.22 OR 0.99), duration on ART OR, 0.46 (95%:0.15,1.42) disclosure status OR, 0.39 (95% CI: 0.15, 1.01)there were found to be associated with viral suppression but not statistically significant. Satisfaction with care and low level of stigma were associated with viral load suppression.

Parental concerns and uptake of childhood vaccines in rural Tanzania \u2013 a mixed methods study

BackgroundVaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. In Tanzania, 1 in 4 children is not fully vaccinated. The objective of this mixed methods study was to describe and contextualize parental concerns towards vaccines in Tanzania.MethodsBetween 2016 and 2017, we conducted a cross-sectional survey (n = 134) and four focus group discussions (FGDs, n = 38) with mothers of children under 2 years of age residing in Mtwara region in Southern Tanzania. The survey and FGDs assessed vaccination knowledge and concerns and barriers to timely vaccinations. Vaccination information was obtained from government-issued vaccination cards.ResultsIn the cross-sectional survey, 72% of mothers reported missed or delayed receipt of vaccines for their child. Although vaccine coverage was high, timeliness of vaccinations was lower and varied by vaccine. Rural mothers reported more vaccine-related concerns compared to urban mothers; literacy and access to information were identified as key drivers of the difference. Mothers participating in FGDs indicated high perceived risk of vaccine-preventable illnesses, but expressed concerns related to poor geographic accessibility, unreliability of services, and missed opportunities for vaccinations resulting from provider efforts to minimize vaccine wastage.ConclusionsFindings from our cross-sectional survey indicate the presence of vaccination delays and maternal concerns related to childhood vaccines in Tanzania. In FGDs, mothers raised issues related to convenience more often than issues related to vaccine confidence or complacency. Further research is necessary to understand how these issues may contribute to the emergence and persistence of vaccine hesitancy and to identify effective mitigation strategies.

Characterization and chemical management of Cashew Fusarium Wilt Disease caused by Fusarium oxysporum in Tanzania

Cashew (Anacardium occidentale L.) is the present leading currency earning crop in Tanzania, generating income to over 2.5 million farmers. Despite of its importance, cashew is threatened by a new serious destructive disease called Cashew Fusarium Wilt (CFWD), which is caused by Fusarium oxysporum. The impact of the disease has reduced income at both household and national levels. The current study was conducted to characterize CFWD and investigate chemical management options for the disease. The study was conducted during the rainy and off-rainy season(s) at Tuungane-Liwale and Kitangari-Newala in Lindi and Mtwara regions respectively. Disease characterization involved field observation of the infected cashew trees, laboratory isolation and characterization of the causative agent. Chemical management involved application of azoxystrobin, carbendazim and thiophanate methyl each at a concentration of 5, 10 and 15 g of formulated product/L. Laboratory findings revealed that the causative agent of the cashew wilting symptoms is Fusarium oxysporum characterized by whitish mycelia growth, chlamydospores, macroconidia and microconidia. The tested chemical fungicides revealed significant effects on the suppression of Fusarium wilt disease and thus enhancing cashew recovery after 120 days of application. Azoxystrobin and carbendazim reduced severity and enhanced recovery. Application of azoxystrobin (15 g/L) promoted 65.2 percent recovery of cashew from 50.0 percent of disease severity and 10 g/L of carbendazim enhanced 49.4 percent of cashew recovery from 50.0 percent severity. Thiophanate methyl exhibited significant effect (P ≤ 0.05) on reducing the severity of the disease and enhancing cashew recovery whereby 15 g/L of thiophanate methyl enhanced 21.6 percent recovery from 45.0 percent severity. These findings advocate the administration of these chemicals, especially carbendazim and azoxystrobin in proper concentration for timely disease management in the affected areas. Studies to establish the effect of the applied chemicals to other biota for betterment and continued applications to combat the disease are underway.

Maternal Death Surveillance and Response: Factors Affecting its Implementation in Mtwara Region, Tanzania

Maternal Death Surveillance and Response: Factors Affecting its Implementation in Mtwara Region, Tanzania

Local ecological knowledge demonstrates shifting baselines and the large-scale decline of sawfishes (Pristidae) in Tanzania

Sawfishes are coastally distributed rays that grow to very large sizes. All five species are assessed as Endangered or Critically Endangered as a result of population declines caused mainly by entanglements in fishing gear and by habitat degradation. Three species occur in the western Indian Ocean, but their populations are believed to have declined drastically in many areas and little is known about their presence in Tanzania. Fisher interviews were conducted to provide an overview of the status of sawfishes in Tanzania and to highlight where conservation actions should be focused to conserve sawfishes nationally. In total, 386 interviews were conducted: 296 at 31 villages in four regions on Tanzania’s mainland, and 90 interviews at 12 villages in four regions of Pemba Island. Less than half (46%) of the fishers were familiar with sawfishes and could identify one from a photograph. A precipitous decline in sawfish abundance in Tanzania could be inferred from the age-related decline in local knowledge of their existence; all fishers aged between 70 and 80 years were familiar with sawfishes, whereas only 10% of fishers younger than age 20 had ever heard of them. A total of 29 sawfish records were compiled, comprising 16 rostra and 14 catches that occurred between 2002 and 2014 (one record included both a catch and a rostrum). All rostra examined were from the largetooth sawfish Pristis pristis. Since 2002, the sawfish catches occurred in three locations, all on the mainland coast: in the southern Mtwara region, in the vicinity of the Rufiji Delta, and at Bagamoyo on the Zanzibar Channel. Interview data and rostra evidence suggest that the Rufiji Delta may be a largetooth sawfish nursery area, and confirmation of this should be a priority.

Supervision and support in surgical practice using mobile platform: a case of mass hydrocele surgeries in remote regions.

Globally, nearly 19 million people with Lymphatic filariasis (LF) who require surgery have not been attended. To reach them needs the scaling up and expansion of surgical services. In Tanzania, hydrocele is more prevalent in the coastal belt, where surgical workforce is also scarce. Thus, scaling up hydrocele surgery services would require the use of non-physician clinicians (NPCs) that are currently based there by offering procedure specific training. With new technique of partial sac excision, constant support and mentorship would be required. We therefore sought to test if use of mobile platform would be an adjunct to supervision and support to practicing non surgeon clinicians in Tanzania. This was a prospective cohort study done in Mtwara and Lindi regions during the period of 2014-2015. Training model followed the West African Morbidity Management protocol for hydrocele followed by practical sessions in the operating room in each locality. Subsequently, patients were screened and discussed by sharing pictures on WhatsApp created to link the hydrocele teams and the two consultant surgeons. Patients with simple hydrocele not to require scrotoplasty and with non-coexistent of hernia were recruited. Data collected included: number of cases performed, time spent per procedure, hematoma formation and adherence to local anesthesia. Descriptive statistics was used to summarize the findings. Fifteen NPCs were successfully trained and mentored throughout the study period and were subsequently able to perform 1,337 hydrocelectomies in 1,250 patients with 387 having bilateral hydrocele. The use of local anesthesia was successful in nearly all the patients and case selection was appropriate as can be seen with only 7/1,250 requiring additional procedures other than hydrocelectomy. The mean procedure duration was 50.2±0.24 minutes and complications rates were low at 2.16%. Mobile platform with instant photo and video sharing capacity can be a reliable tool in offering support and supervision in surgical service provision.

Do mobile phone-based reminders and conditional financial transfers improve the timeliness of childhood vaccinations in Tanzania? Study protocol for a quasi-randomized controlled trial

BackgroundVaccination is a cost-effective strategy for reducing morbidity and mortality among children under 5 years old. To be fully protected from diseases such as tuberculosis, diphtheria, pertussis, and polio, children must receive all recommended vaccinations in a timely manner. In many countries, including Tanzania, high overall vaccination rates mask substantial regional variation in vaccination coverage and low rates of vaccination timeliness. This study evaluates the efficacy of mobile phone-based (mHealth) reminders and incentives for improving vaccination timeliness in the first year of life.MethodsThe study, conducted in Mtwara Region in Tanzania, includes 400 late-stage pregnant women enrolled from rural and urban health facilities and surrounding communities. The primary outcome is timeliness of vaccinations among their children at 6, 10, and 14 weeks after birth. Timeliness is defined as vaccination receipt within 28 days after the vaccination due date. The quasi-randomized controlled trial includes three arms: (1) standard of care (no reminders or incentives), (2) mobile phone-based reminders, and (3) mobile phone-based reminders and incentives in the form of conditional financial transfers. Assignment into study arms is based on scheduled vaccination dates. Reminder messages are sent to arms 2 and 3 participants via mobile phones 1 week and 1 day prior to each scheduled vaccination. For arm 3 participants, reminder messages offer an incentive that is provided in the form of a mobile phone airtime recharge voucher code for each timely vaccination. Vaccination dates are recorded via participant contact with an mHealth system, phone calls with mothers, and a review of government-issued vaccination cards during an end-line survey. Random effects logistic regression models will be used to estimate the effects of reminders and incentives on the timeliness of vaccinations.DiscussionThe results will inform implementation science research on the effectiveness of reminders and incentives as a means of improving vaccination timeliness.Trial registrationClinicalTrials.gov, NCT03252288. Registered on 17 August 2017 (retrospectively registered).

The Linkage between Institutional Changes and Food Security in Mtwara Region, Tanzania

This study focuses on the linkage between institutional changes and food security in Mtwara region. Institutional changes in terms of increase numbers of financial, commercial, hospitalizes, education, infrastructures and improved moral and altitudes of farmers have a direct relation with food availability and accessibility. Both formal and informal institutions have potentials to help improvement of food availability and accessibility. However, despite institutions dealing with food security having changed in Mtwara, food security is low. The fundamental question is which one among these institutions, has high impact on food security.This study sought to determine the linkage between institutional changes and food security in Mtwara region. The specific objectives of the study were to identify institutions existing and their functions at household level, analyze various sources of food grains and states of food security at the household level in Mtwara region, and assess the linkages between institutional changes and food security. Structured questionnaire, Focus Group Discussion and Oral interview had been useful for collecting primary information in which the best recorded interviewees were analyzed supplemented by documentaries (text and photography). Findings revealed that financial institutions and education have high impact on food security in the study area. Generally, this study concluded that banks, SACCOS, traditions (moral, attitudes, beliefs), and roadshave slightly difference effect on food security. Since 2010these institutions had been increased and improved and have a direct relation with food security.It is recommended that the, government and other stakeholders should create true transformation in rural people to provide them decent jobs, good living conditions, and different opportunities in order to maintain youth to stay in rural area for maximizing the food production. Further studies should be done on the factors influencing people to stay in rural areas in which agricultural activities are being done.

Soil nutrient adequacy for optimal cassava growth, implications on cyanogenic glucoside production: A case of konzo-affected Mtwara region, Tanzania.

Soils in areas affected by konzo (a cassava cyanide intoxication paralytic disorder) are predominantly infertile and probably unable to supply cultivated cassava with the nutrients it needs to achieve optimal growth. Soil nutrient supply in these areas could also be influencing cyanogenic glucoside production in cassava, however there is hardly any knowledge on this. An assessment of soil nutrient levels on crop fields in konzo-affected areas was therefore carried out to determine their adequacy for optimal cassava growth. Konzo-affected Mtwara region of Tanzania, was used as a case study. Whether soil nutrient supply influences cyanogenic glucoside production in cassava cultivated in konzo-affected areas and how it could be doing this, was additionally investigated. To investigate this, correlations between total hydrogen cyanide (HCN) levels (a measure of cyanogenic glucoside content) in cassava roots and various soil nutrient levels on crops fields were carried out. This was followed by an investigation of relationships between cases of cassava cyanide intoxication and soil nutrient levels on crop fields from which the consumed toxic cassava roots had been harvested. Cases of cassava cyanide intoxication were used as a proxy for high cyanogenic glucoside levels in cassava roots. Logistic regression analysis was used in the latter investigation. Other important non-nutrient soil chemical characteristics, like pH and soil organic carbon, were also included in all analysis performed. The results revealed that most soil nutrients known to have reducing effects on cassava cyanogenic glucosides, like potassium (mean = 0.09 cmol/kg, SD = 0.05 cmol/kg), magnesium (mean = 0.26 cmol/kg, SD = 0.14 cmol/kg) and zinc (mean = 1.34 mg/kg, SD = 0.26 mg/kg) were deficient on several crop fields. The results also showed that cyanogenic glucosides in cassava roots could be increased with the increased supply of sulphur in soils in bitter cassava varieties (rs = 0.593, p = 0.032), and with the increased supply of P in soils in all cassava varieties (rs = 0.486, p = 0.026). The risk of cassava cyanide intoxication occurring (and thus high cyanogenic glucoside levels in cassava) was found to be likely increased by cultivating cassava on soils with high pH (X2 = 8.124, p = 0.004) and high iron (X2 = 5.740, p = 0.017). The study managed to establish that cassava grows under conditions of severe nutrient stress and that soil nutrient supply influences cyanogenic glucoside production in cassava cultivated in konzo-affected areas of Mtwara region. Despite the multiple soil nutrient deficiencies on crop fields, low soil fertility was however not the only probable cause of increased cyanogenic glucosides in cassava, as high soil nutrient levels were also found to be potential contributors.

Farmers' perceptions on the causes of cassava root bitterness: A case of konzo-affected Mtwara region, Tanzania.

In areas where konzo (a cassava cyanide related paralytic disorder) persists, the agronomic factors causing increased cyanogenic glucoside levels in cassava, during periods without water stress, are hardly known. However, through their assessment of cassava root toxicity, using its bitter taste, farmers may have noticed factors unrelated to water stress that additionally influence the cyanogenic glucoside content of cassava cultivated in these areas. Increased cassava root bitterness is often associated with an increase in cyanogenic glucoside levels, making it a good indicator of changes in root cyanogenic glucoside content. Bitter cassava varieties that are preferentially planted by people living in most konzo-affected areas, are an additional known contributor to high cyanogenic glucosides. It is water stress that further increases the inherent toxicity of the planted bitter cassava varieties. Using konzo-affected Mtwara region in Tanzania as a case study, a household survey was carried out to identify the overlooked agronomic factors that additionally influence cyanogenic glucoside levels in cassava cultivated in konzo-affected areas. A total of 120 farmers were interviewed and they mentioned a number of factors unrelated to water stress, as agronomic factors that influenced cassava root bitterness and hence cyanogenic glucoside production in cassava. The mentioned factors included; certain soil characteristics (14.2%), plant age at harvest (7.5%), poor weeding (0.8%), piecemeal harvesting (0.8%), and branch pruning (0.8%). The revealed factors constitute permanent environmental characteristics and crop management practices commonly used by farmers living in konzo-affected Mtwara region in Tanzania. The revealed factors could be contributing to increased cyanogenic glucoside levels in cassava, during periods without water stress in areas where konzo persists.

Delayed illness recognition and multiple referrals: a qualitative study exploring care-seeking trajectories contributing to maternal and newborn illnesses and death in southern Tanzania

BackgroundMaternal and neonatal mortality remain high in southern Tanzania despite an increasing number of births occurring in health facilities. In search for reasons for the persistently high mortality rates, we explored illness recognition, decision-making and care-seeking for cases of maternal and neonatal illness and death.MethodsWe conducted 48 in-depth interviews (16 participants who experienced maternal illnesses, 16 mothers whose newborns experienced illness, eight mothers whose newborns died, and eight family members of a household with a maternal death), and five focus group discussions with community leaders in two districts of Mtwara region. Thematic analysis was used for interpretation of findings.ResultsOur data indicated relatively timely illness recognition and decision-making for maternal complications. In contrast, families reported difficulties interpreting newborn illnesses. Decisions on care-seeking involved both the mother and her partner or other family members. Delays in care-seeking were therefore also reported in absence of the husband, or at night. Primary-level facilities were first consulted. Most respondents had to consult more than one facility and described difficulties accessing and receiving appropriate care. Definitive treatment for maternal and newborn complications was largely only available in hospitals.ConclusionsDelays in reaching a facility that can provide appropriate care is influenced by multiple referrals from one facility to another. Referral and care-seeking advice should include direct care-seeking at hospitals in case of severe complications and primary facilities should facilitate prompt referral.

Communicating Cultural Heritage Resources to the Public: Experiences from the Makonde of Mtwara Region, Tanzania.

Communicating cultural heritage to the public has gained popularity in many African countries and the world at large. However,little efforts have been done to promote the practice of public archaeology in Tanzania. The main reason is the dominance of conventional archaeology which is mainly meant for academic consumption. In this kind of practice, the participation of local communities has been passive. This paper explores local communities’ understanding of cultural heritage resources focusing on local communities in the Mtwara Region of Tanzania. The results of this study reveal that little effort has been made by archaeologists and cultural heritage professionals to create awareness among local communities on matters related to archaeology and cultural heritage resources. Apart from discussing the state of local communities’ awareness on archaeology and cultural heritage resources, the paper also discusses the importance of communicating cultural heritage resources to the general public and the need to engage local communities in the conservation and preservation of cultural heritage resources.

Antinutritional Factors Reduction from Cassava (Manihot esculenta Crantz) Roots by Grating or Chipping Processing Technique in Mtwara Tanzania

Regular intake of diets high in cyanogenic amount in iodine deficiency areas with limited sulfur supply diets have been associated with the development of hypothyroidism, goiter and cretinism in young and adult populations. This study aimed at the investigation of the suitable processing technique for the production of high-quality cassava flour (HQCF) with acceptable consumption level of cyanide residues from different cassava varieties available at Mmongo village in Mtwara region. Grating technique was used to produce wet and dried cassava grits, whereas chipping technique produced wet and dried cassava chips. The wet and dried cassava products were all produced in a single day and under the same environmental conditions. The results showed that the hydrogen cyanide (HCN) in fresh cassava roots was 62.18–139.28 mg HCN/kg. Upon processing, the cyanide was lower (P<0.05) in wet cassava grits 24.27–76.74 mg HCN/Kg but higher in wet cassava chips 44.81–92.57 mg HCN/kg. After sun drying, the HCN retention was higher in dried cassava chips (10.7–14.2%) and lower in dried cassava grits (7.3–9.1%). Grating, efficiently reduced HCN from bitter cassava roots to the level within the WHO/FAO recommended safe limit (10 mg HCN/kg) as chipping only suite for sweet cassava roots. Therefore, HQCF can be nutritionally strategic cassava product consumed regularly and during food shortage without causing potential health problems even in iodine deficiency areas.