Rural Communities In Tanzania Research Articles

Examining the Role of Lower-Level Local Government Leaders in Mitigating Climate Change Impacts on Smallholder Farmers

The agricultural sector remains the main source of livelihoods for rural communities in Tanzania, but faces the challenge of changing climate. This study aimed at assessing the roles played with local government leaders towards smallholder farmers escaping from climate change effects. Specifically, the study examined the influence of Climate change information Adoptive strategies, Updated farming knowledge from local government leaders on smallholders’ ability to escape from climate change effects. The study employed a cross-sectional research design on 200 smallholder farmers. Data collection methods included survey, key informants’ interview (KIIs) and focus group discussions. The study collected and analysed both qualitative and quantitative data from primary and secondary sources. Quantitative data were analysed using a multiple regression model while the qualitative data were analysed using thematic analysis. findings revealed that local government leaders are not effectively supporting smallholders farmers escaping from climate change effects since the result under this study reveal that local government leaders are not providing supporting knowledge to smallholder farmers on climate change and strategies towards its adoptions, it can be concluded that local government leaders has a slight influence on supporting smallholders farmers to escape from climate change effects in the study area since observed that local leaders are not providing adequate climate and its adoption strategies. The study concludes that local government leaders have less knowledge on climate issues hence negatively influencing smallholder farmers to escape from climate change effects due to the absence of local government employees development program particularly to wards and village executive officers who are directly closely to local natives by increasing the ability of the smallholders’ farmers to have good wellbeing performance. The study recommends to the Moshi District Council particularly to local government leaders and ministry of agricultural to establish capacity building program to local government employees working at lower levels and local government leaders have to include climate change information agenda in their assembly to ensure farmers are updated with climate change issues.

Development and Profiling of Affordable and Nutritionally Optimal Pigeon Pea-Based Products for Improved Recipes Diversification in Rural Communities in Tanzania

Pigeon pea is an affordable source of protein, vitamins and minerals. Despite its nutritional importance, the legume has not been adequately utilized for human consumption in Tanzania due to limited recipes. Therefore, the study aimed to develop and profile quantitative attributes of value-added pigeon pea-based noodles (PPBN) and instant porridge (PPIP) flour for diversification of recipes in rural Tanzania communities. The computation on the amount of ingredients, the cost of the product mix and optimization was done using Linear programming, simplex method. PPBN and PPIP were developed and Quantitative Descriptive Analysis (QDA) was done by trained panelists. Data were analysed using R and XLSTAT software. Eight and four samples of PPBN and PPIP respectively were formulated and developed. Major ingredients for PPBN was pigeon pea, wheat and orange flesh sweet potatoes flour and for PPIP was pigeon pea, maize, orange flesh sweet potatoes flour (or pumpkin flour). The protein content for PPBN ranged from 41.0 to 58.2 g. The highest amount of iron content was observed in sample PPBN193 (26.4 mg), followed by PPBN1718 (21.0 mg), PPBN267 (19.3 mg) and PPBN136 (18.3mg). The highest value of zinc and pro-vitamin A was observed in sample PPBN136. For instant porridge the highest value of protein (17.1 g), iron (7.9 g), zinc (5.4 mg) and pro-vitamin A (308.5 µg) was observed in sample PPIPofspr. The highest mean intensity score for colour, aroma and mouthfeel was observed in samples PPBN718, PPBN193 and PPBN136. For sample PPIPofspr, colour (8.7) Aroma (7.7), mouthfeel (7.8), sweetness (7.1) and viscosity (7.9) had the highest mean intensity score. There was a significant increase in protein, iron, zinc and pro-vitamin A with an increase in the amount of pigeon pea and/or orange flesh sweet potato flour. Sample PPBN718, PPBN193, PPBN136 and PPIPofspr had better nutritional and sensory qualities that make

Quantitative risk assessment for human Taenia solium taeniasis/cysticercosis exposure through consumption of pork in Mpwapwa District of Dodoma Region, Tanzania.

Pig farming is a livelihood activity undertaken by many rural communities in Tanzania. However, pigs in rural communities become infected with Taenia solium, a zoonotic parasite leading to porcine cysticercosis (PCC). Thus, routine meat inspection is fundamental in ensuring that the meat consumed is PCC-free. However, routine meat inspection is constrained by low sensitivity as a diagnostic test. Regardless of its low sensitivity, at the local level, no substitute tool would potentially lead to meat being risk-free for human infection. This study aimed at quantifying the risk of humans getting exposed to T. solium taeniasis through the consumption of pork approved safe for human consumption by employing a quantitative risk assessment (QRA) model. A cross-sectional study employing a quantitative risk assessment technique was conducted to quantify the risk of human infection in Mpwapwa District through exposure to T. solium infection through consumption of officially inspected pork. The input parameters in this study were simulated in @risk software to obtain the risk of exposure and the risk factors for exposure to T. solium taeniasis. The risk of one getting exposed to T. solium taeniasis/cysticercosis (TSTC) through consumption of pork approved for human consumption was found to be 0.018 (95% confidence interval [CI] = 0.00-0.0250). Likewise, the probability that a cyst is localized in a pork portion was found to be the most influencing input risk factor of getting exposed to TSTC. Furthermore, the probability of developing T. solium taeniasis was estimated to be 0.73605 (95% CI = 0-0.950) when infected undercooked pork portion is consumed and 0.99652 (95% CI = 0.98161-0.99908) from consuming raw pork portion. Likewise, about 47 (95% CI = 42-52) people who consumed undercooked pork and 26 (95% CI = 22-30) who consumed raw pork would get infected in Mpwapwa District per year. The results from this study are anticipated to create public awareness of the problem and promote the use of one-health approach in the control and prevention of the consumption of infected pork.

Seroprevalence of SARS-CoV-2 antibodies among children and adolescents recruited in a malariometric survey in north-eastern Tanzania July 2021

BackgroundAfrican countries stand out globally as the region seemingly least affected by the COVID-19 pandemic, caused by the virus SARS-CoV-2. Besides a younger population and potential pre-existing immunity to a SARS-CoV-2-like virus, it has been hypothesized that co-infection or recent history of Plasmodium falciparum malaria may be protective of COVID-19 severity and mortality. The number of COVID-19 cases and deaths, however, may be vastly undercounted. Very little is known about the extent to which the Tanzanian population has been exposed to SARS-CoV-2. Here, we investigated the seroprevalence of IgG to SARS-CoV-2 spike protein in two Tanzanian rural communities 1½ years into the pandemic and the association of coinciding malaria infection and exposure.MethodsDuring a malariometric survey in July 2021 in two villages in north-eastern Tanzania, blood samples were taken from 501 participants (0–19 years old). Malaria was detected by mRDT and microscopy. Levels of IgG against the spike protein of SARS-CoV-2 were measured by ELISA as well as IgG against five different antigens of P. falciparum; CIDRα1.1, CIDRα1.4 and CIDRα1.5 of PfEMP1 and GLURP and MSP3.ResultsThe seroprevalence of SARS-CoV-2 IgG was 39.7% (106/267) in Kwamasimba and 32.5% (76/234) in Mkokola. In both villages the odds of being seropositive increased significantly with age (AOR = 1.12, 95% CI 1.07–1.17, p < 0.001). P. falciparum malaria prevalence by blood smear microscopy was 7.9% in Kwamasimba and 2.1% in Mkokola. 81.3% and 70.5% in Kwamasimba and Mkokola, respectively, showed recognition of minimum one malaria antigen. Residing in Kwamasimba was associated with a broader recognition (AOR = 1.91, 95% CI 1.34–2.71, p < 0.001). The recognition of malaria antigens increased significantly with age in both villages (AOR = 1.12; 95% CI 1.08–1.16, p < 0.001). Being SARS-CoV-2 seropositive did not associate with the breadth of malaria antigen recognition when adjusting for age (AOR = 0.99; 95% CI 0.83–1.18; p = 0.91).ConclusionMore than a third of the children and adolescents in two rural communities in Tanzania had antibodies to SARS-CoV-2. In particular, the adolescents were seropositive but being seropositive did not associate with the status of coinciding malaria infections or previous exposure. In Tanzania, natural immunity may have developed fast, potentially protecting a substantial part of the population from later variants.

Anthropometrics, Hemoglobin Status and Dietary Micronutrient Intake among Tanzanian and Mozambican Pigeon Pea Farmers.

Inadequate consumption of micronutrient-dense and protein-rich foods such as vegetables, legumes and meat is an important contributing cause for anemia and deficiencies of vitamin A and iron in rural communities of Tanzania and Mozambique. A cross-sectional study was conducted to assess the nutritional status (anthropometrics and hemoglobin) and diets in particular micronutrient intake of female and male pigeon pea farmers from Lindi, Tanzania, and Gurué, the Zambézia province of Mozambique. A total of 1526 farmers (669 from Tanzania, 857 from Mozambique) were studied, of whom 16% were overweight and 35% were anemic. The highest prevalence of overweight and anemia, at 35% and 48%, was observed in Tanzanian and Mozambican women, respectively. Overall, only a small proportion of women and men reached the recommended daily dietary intake of vitamin A (10%), iron (51%) and zinc (44%). Multiple regression models revealed that dark green leafy vegetables (DGLVs) highly predicted vitamin A intake, whereas legumes in Tanzania and starchy plants in Mozambique were actually the dominant sources of vitamin A. Cereals covered over half of the iron and the zinc intake in both countries. An increased consumption of micronutrient-rich DGLVs and legumes, while reducing the high amounts of refined maize or polished rice, is suggested to counteract the high prevalence of anemia and overweight among smallholder farmers in East and South Eastern Africa.

P105 Prevalence and associated factors of musculoskeletal joint disease in the community setting in Hai district, northern Tanzania

Abstract Background/Aims There is little evidence on the prevalence of musculoskeletal (MSK) joint disorders, in particular around inflammatory and degenerative arthritis, in sub-Saharan Africa. In Tanzania specifically, the prevalence and distribution of these conditions in the population has never been studied and the nature of existing joint disorders and the associated factors are therefore unknown. The aim of this study is to establish the prevalence of MSK joint disease and associated factors among the rural population in Tanzania. Methods Households in the Hai district were randomly selected using a two-stage cluster sampling approach with villages selected with a probability proportional to size. Consenting individuals aged 5 years and above were screened for the presence of MSK joint problems using the Gait Arms Legs and Spine (GALS) examination. Individuals screened positive by the GALS exam, were further assessed using the Regional Examination of the Musculoskeletal System (REMS). Demographic and other information were gathered via questionnaire and subsequently checked for association with a positive REMS exam. Data were analysed in STATA using a mixed model logistic regression with village, household, and examiner as random effects. Results The overall prevalence of MSK joint disease (REMS positive) among the 2697 examined individuals (1969 Adults &amp; 728 children &amp;lt;18 years) was 5.9 % (CI: 5.1%-6.9%). Adult females have significantly higher odds of screening positive than adult males (Odds Ratio (OR): 2.2; CI: 1.5-3.2; p &amp;lt; 0.01). The prevalence of MSK joint problems varied significantly with age, with only 0.1 % (CI: 0%-0.75%) of children aged 5-18 years screening positive with REMS compared to 1.3% (CI: 0.7%-2.3%) of people aged 18-45 years, 9.1% (CI: 7.0%-11.6%) aged 46-65 years, 21.7% (CI: 17.1%-26.8%) aged 66-85 years, and 31.8% (CI: 20.6%-44.7%) of those aged over 85. We found that people living in mid-level altitudes had the highest odds of screening positive with REMS (OR midland vs lowland = 2.1; CI: 1.4-3.3, p = 0.01; OR highland vs lowland = 1.5; CI: 1-2.3, p = 0.081). Conclusion Our study provides new insight into the prevalence and distribution of MSK joint disease in rural communities in Tanzania and into the factors associated with higher odds of screening positive with the REMS examination. Results from this study will help build the evidence around the prevalence of MSK joint diseases and factors associated with them in Tanzania. This will enable researchers and practitioners to facilitate the diagnosis and management of Arthritis and other MSK conditions in the population and to improve the health of people living with these diseases in Tanzania. Disclosure S.J. Krauth: None. N. Yongolo: None. S. Biswaro: None. C. Kelly: None. R.W. Walker: None. S. Siebert: None. M. Deidda: None. S. Wyke: None. J. Halliday: None. B.T. Mmbaga: None. E. McIntosh: None.

Dog ownership practices and responsibilities for children's health in terms of rabies control and prevention in rural communities in Tanzania.

Interventions tackling zoonoses require an understanding of healthcare patterns related to both human and animal hosts. The control of dog-mediated rabies is a good example. Despite the availability of effective control measures, 59,000 people die of rabies every year worldwide. In Tanzania, children are most at risk, contributing ~40% of deaths. Mass dog vaccination can break the transmission cycle, but reaching the recommended 70% coverage is challenging where vaccination depends on willingness to vaccinate dogs. Awareness campaigns in communities often target children, but do not consider other key individuals in the prevention chain. Understanding factors related to dog ownership and household-level responsibility for dog vaccination and child health is critical to the design of vaccination strategies. We investigated who makes household decisions about dogs and on health care for children in rural Tanzania. In the Kilosa district, in-depth interviews with 10 key informants were conducted to inform analysis of data from a household survey of 799 households and a survey on Knowledge Attitudes and Practices of 417 households. The in-depth interviews were analysed using framework analysis. Descriptive analysis showed responsibilities for household decisions on dogs’ and children’s health. Multivariate analysis determined factors associated with the probability of dogs being owned and the number of dogs owned, as well as factors associated with the responsibility for child health. Dog ownership varied considerably between villages and even households. The number of dogs per household was associated with the size of a household and the presence of livestock. Children are not directly involved in the decision to vaccinate a dog, which is largely made by the father, while responsibility for seeking health care if a child is bitten lies with the mother. These novel results are relevant for the design and implementation of rabies interventions. Specifically, awareness campaigns should focus on decision-makers in households to improve rabies prevention practices and on the understanding of processes critical to the control of zoonoses more broadly.

Mobile phone use is associated with higher smallholder agricultural productivity in Tanzania, East Africa.

Mobile phone use is increasing in Sub-Saharan Africa, spurring a growing focus on mobile phones as tools to increase agricultural yields and incomes on smallholder farms. However, the research to date on this topic is mixed, with studies finding both positive and neutral associations between phones and yields. In this paper we examine perceptions about the impacts of mobile phones on agricultural productivity, and the relationships between mobile phone use and agricultural yield. We do so by fitting multilevel statistical models to data from farmer-phone owners (n = 179) in 4 rural communities in Tanzania, controlling for site and demographic factors. Results show a positive association between mobile phone use for agricultural activities and reported maize yields. Further, many farmers report that mobile phone use increases agricultural profits (67% of respondents) and decreases the costs (50%) and time investments (47%) of farming. Our findings suggest that there are opportunities to target policy interventions at increasing phone use for agricultural activities in ways that facilitate access to timely, actionable information to support farmer decision making.

Rural Water Collection Patterns: Combining Smart Meter Data with User Experiences in Tanzania

Water collection from piped water distribution systems (PWSs) in rural communities in sub-Saharan Africa is not understood in much detail. Here, distances travelled to distribution points (DPs), volumes collected, times of day of collection, and the relationship between location of DP and volume dispensed are investigated in a rural community in Tanzania using a combination of novel smart pre-payment meters and results from surveys and interviews. Continuous availability of water through pre-payment smart meters is shown to eliminate queue time, freeing time for farming or schooling, and enhance revenue collection for service provision. 97% of users use DPs as a main source of drinking water as opposed to unimproved alternative sources, and 42% live further than 400 m from a DP. Collection occurs across daylight with greater volumes dispensed in the afternoon–evening due to free time from economic activities and children returning from school. A low mean daily collection of 47 L per household from DPs is approximated. Volume dispensed across different DPs over time shows no clear pattern. However, the volume dispensed is indicated by the number of households that use each DP. Increasing PWS capacity can accommodate for variable collection patterns, and help improve sustainability of rural water supply.

Characterization of carcass and preference of consumers for meat from four strains of the Tanzania small East African goats

Goats are an integral part of farming systems in rural communities of Tanzania and are second in importance after cattle in the provision of meat, milk, and income. It was estimated that there were 18 million goats in Tanzania in 2018 and the majority (about 98%) belonged to the Small East African (SEA) breed. The SEA goats are characterized by low productivity due to their inherently low genetic potential for meat and milk leading to low profitability. It is important to design sustainable programmes for increasing productivity of indigenous goats and the first step is to compile status with regard to productivity and to assess market-oriented characteristics for these animals. The aims of this study were: to evaluate carcass characteristics of meat from four strains of the SEA goats namely Gogo, Pare, Sonjo as well as Sukuma, and to assess the preference of consumers for goat meat and meat cuts. Forty eight goats (12 per strain) were involved in this study. The meat was dissected into lean, bone, subcutaneous fat as well as standard joints, and these parts were weighed or measured to obtain the lengths. Longissimus dorsi was sampled from the carcass to determine quality using proximate analysis. Also, a survey was conducted to determine the prices of meat cuts and preferences of consumers using a questionnaire. Averages were compared using the General Linear Model (GLM) procedure of the statistical analysis system. Survey data were coded and analyzed using Statistical Package for Social Sciences (SPSS). Test of significance was based on 5%. The composition of meat was 65.2 to 67% lean, 23.5 to 25.7% bone and 8.4 to 10.7% fat. Gogo strain had heaviest carcasses (10.3±0.45kg). Dressing Percentage (DP) ranged from 42.1 to 43.5% and was not significant among strains. Carcass Length (CL), Chest Depth (CD), length of Hind Legs (HLL) and leg circumference were significant among strains and CD was associated with the weight of the carcass. Fore and hind parts as well as ribs comprised 60% lean. Crude protein and ash were significant among strains whereas dry matter and fat were not significant. The hind leg was most preferred (52.5% respondents) because of more meat although was the most priced part (9798±385 Tanzanian shillings about 4.3US$). In conclusion, the SEA strains evaluated in this study contained more meat and less bone and fat; there are variations in characteristics and quality of meat among the strains, and consumers prefer the more meaty parts.

Consumption of Dark Green Leafy Vegetables Predicts Vitamin A and Iron Intake and Status among Female Small-Scale Farmers in Tanzania.

Inadequate consumption of micronutrient-dense foods such as vegetables and meat are an important contributing cause for anemia and deficiencies of iron and vitamin A in rural communities of Tanzania. A cross-sectional study was conducted in 2016 to examine nutritional and micronutrient status and their associations to the diet of female small-scale farmers in the sub-humid Kilosa (n = 333) and the semi-arid Chamwino (n = 333) districts, in the Morogoro and Dodoma region. An overall higher prevalence of overweight (19.7%) and obesity (7.1%) than of underweight (5.9%) was detected. Significantly more women in the two villages of Kilosa (27–40%) than in the two villages of Chamwino district (19–21%) were overweight/obese, but also more frequently had anemia (34–41% vs. 11–17%), iron deficiency (24–32% vs. 15–17%), and low serum retinol (21–24% vs. 8–9%). Overall, only a small proportion of women reached recommended daily micronutrient intakes: 27% for vitamin A, 17% for iron, 7% for zinc, and 12–38% for B-vitamins. The amount of dark green leafy vegetables (DGLV) consumed was the main determinant of vitamin A and iron intake by women in Chamwino and corresponded to higher hemoglobin, serum retinol and iron status than in the villages of the Kilosa district; in agreement, DGLV consumption also predicted iron and vitamin A intake in Kilosa district. DGLV consumed with wholemeal millet was advantageous in terms of women’s vitamin A and iron intake and status over the predominantly maize-rice-based diet lacking vegetables.

Provitamin A Carotenoids, Tocopherols, Ascorbic Acid and Minerals in Indigenous Leafy Vegetables from Tanzania

The essential micronutrients in indigenous leafy vegetables (ILVs) could substantially contribute to the micronutrient supply in rural communities in Tanzania, but concentrations differ between species. Provitamin A carotenoids, tocopherols, ascorbic acid, minerals, and phytate were analysed in 13 different species using HPLC-, ICP-OES, and photometric techniques. Eight of the 13 ILVs, including Amaranthus ssp. and Sesamum angustifolium, had high β-carotene concentrations (2.91–4.84 mg/100 g fresh weight), which could provide ≥50% of vitamin A’s recommended nutrient intake (RNI). Six ILVs including Cleome hirta and Sonchus luxurians had high iron contents (34.5–60.4 mg/100 g, >50% RNI); Amaranthus ssp. represented the ILV with high calcium, magnesium and zinc contents (85%, 207% and 21% of RNI per 100 g); Cleome hirta and Cleome gynandra had high ascorbic acid contents (>15 mg/100 g, 34–35% of RNI), while Sesamum angustifolium was the only ILV with a high tocopherol content (7.34 mg α-TE/100 g). The highest phytate concentration was found in Amaranthus ssp., which could negatively affect its role as a very good source of minerals. Results indicate that the analysed ILVs could make a substantial contribution to the vitamin A and iron supply in the diets of rural Tanzanian populations.

Solar powered nanofiltration for drinking water production from fluoride-containing groundwater – A pilot study towards developing a sustainable and low-cost treatment plant

The following paper summarizes the findings of a pilot study to develop a simple, low-cost, holistic water concept on fluoride removal from groundwater in rural communities of Tanzania; an ideal representative community for other areas in the world with similar problems. A small photovoltaic powered nanofiltration (NF) pilot plant was installed at a vocational training center in Boma Ng´ombe in northern Tanzania. The groundwater in this region is contaminated with fluoride at very high concentrations of up to 60 mg/L. The pilot plant was equipped with a single membrane module containing a spiral wound 4040 membrane NF90 of Dow Water & Process Solutions and was successfully operated over a nine-month period.The membrane removed more than 98% of fluoride. In fact, the fluoride concentration in the permeate was always less than 1 mg/L, which is in agreement with the WHO recommended standard (1.5 mg/L). Permeate was also used as weekly flush medium, so no chemical cleaning was required. Aside from permeate (drinking water) concentrate was also used for washing and flushing the toilets. In conclusion, the use of solar PV power (2.25 KWP) for approximately 2.5 h per day allowed producing about 240 L/h of permeate on average. Therefore, the sustainability of the process and suitability for the Tanzanian communities was proved.

Integration of eye health into primary care services in Tanzania: a qualitative investigation of experiences in two districts

BackgroundVisual impairment is a public health problem in sub-Saharan Africa, affecting nearly 5% of the population. Efforts to combat avoidable causes have been hampered by weak health systems and little evidence exists to suggest what interventions may be effective to improve the situation. Despite this, there are calls to promote some specific interventions, one of which being the closer integration of eye health services into health systems, often focusing on training primary health workers to deliver basic eye health services. This study seeks to understand how eye health services are delivered by primary health workers who have received training and what constraints remain to effective service provision.MethodsThis was a qualitative investigation into the experiences of 20 primary health workers trained in primary eye care and eight key informants working within specialist eye health services or regional and district health management positions in two districts in Tanzania.ResultsDespite feeling confident in their own eye care skills, most primary health workers felt constrained in the services they could provide to their communities by insufficient resources needed for diagnosis and treatment, and by lack of systematic supportive supervision to their work. Specialist ophthalmic staff were aware of this issue, although for the most part they felt it was not within their capacity to remedy and that it fell within the remit of general health managers. Many participants discussed the low support to eye health from the national government, evidenced through the lack of dedicated funding to the area and traditional reliance on outside funds including international charities.ConclusionsAlthough training of primary health workers is useful, it is recognised that is not sufficient to address the burden of eye health disease present in rural communities in Tanzania. It is likely that broader engagement with the general health system, and most likely with the private sector, will be necessary to improve the coverage of eye health care to remote and poor communities such as those in Morogoro. Further investment is needed to develop innovative approaches to delivering eye health services, including preventative, curative and rehabilitative services.

English

Information access in rural communities of Tanzania is very important as it keeps its members aware of what happened and what happening in the world. This importance can not be undermined since it helps farmers and other members of the rural community to make the right decision about their activities. Rural community areas are surrounded by many factors which in one way or another influence or hinder accessibility of information. Several works have been done on analysis of these factors; however most of them were conducted a number of years back. This study focused on providing the current survey on analysis of these factors. Specifically, the study analysed the following factors: source of power, penetration of mobile phones, subscription to networks, languages used and level of education, policy, government support, government administration and farming system. Mwanga District was used as a study area where descriptive research design was applied. Primary data were collected from farmers by using questionnaires while secondary data were collected from village reports and other research reports. The collected data were analysed by using Statistical Package for Social Science (SPSS). Findings show that in rural areas, there are unreliable source of power, higher penetrations of feature phones, high subscription to Vodacom network and high uses of Swahili language for communication, good government support and policy which favour farmer’s development. Generally, we recommend that the existing sources of information like information systems and other applications should be integrated to form one stop centre where all information can be accessed. Key words: Farmers, rural area, rural community, information access.

Knowledge, attitudes and practices of parents on child sexual abuse and its prevention in Shinyanga district, Tanzania

Background: The role of parents in preventing child sexual abuse in the community in low-and-middle income countries has not been adequately emphasized. The objective of this study was to assess parents’ knowledge, attitudes and practices on child sexual abuse and its prevention in Shinyanga district, Tanzania in order to strengthen child protection. Methods: This was a cross-sectional study conducted during July 2015. Multistage cluster sampling technique was employed to obtain study participants from a list of sampling frame. Parents with children below 18 years old were randomly selected to form a study population. A quantitative technique using structured questions was used to assess parents’ knowledge, attitude and practices about preventing child sexual abuse.Results: A total of 384 respondents were included in the study. The majority (95.6%) of respondents had high knowledge regarding prevention of child sexual abuse. Majority (98.7%) of the respondents had positive attitudes on preventing child sexual abuse. However, only about a quarter (27.3%) of respondents had good practices on protection and prevention of child sexual abuse.Conclusion: Knowledge and attitudes of parents on child sexual abuse prevention was high in the study area. However, the practices of parents on child sexual abuse prevention were poor. Therefore, a public education programme is needed for parents, with the ultimate aim of protecting children from the preventable harm and trauma of sexual abuse in rural communities of Tanzania.

Effect of National Schistosomiasis Control Programme on Taenia solium taeniosis and porcine cysticercosis in rural communities of Tanzania

Taenia solium is found throughout sub-Saharan Africa and co-endemic with schistosomiasis in many regions. Taenia solium leads to taeniosis and neurocysticercosis - the leading cause of preventable epilepsy globally. This study aimed to assess the effects of the National Schistosomiasis Control Programme on prevalence of taeniosis and porcine cysticercosis over a four year period in Tanzania. School-based mass drug administration (MDA) of praziquantel was carried out based on schistosomiasis endemicity. Four human and five porcine cross-sectional surveys were carried out from 2012 to 2015 in Mbozi and Mbeya district in Tanzania. Three rounds of school-based MDA of praziquantel were delivered in Mbozi and two in Mbeya. The prevalence of taeniosis and porcine cysticercosis was estimated annually. Stool samples were collected from humans and prevalence of taeniosis estimated by copro-Ag-ELISA. Blood samples from pigs were collected to estimate cysticercosis prevalence by Ag-ELISA. “Track-and-treat” of taeniosis cases was carried out after each survey. In total 12082 stool samples and 4579 porcine serum samples were collected. Significantly fewer children (≤15) from Mbozi were infected throughout the study than children from Mbeya who showed a significant decrease in copro-Ag prevalence after the first treatment only. During the final survey in Mbozi the prevalence of taeniosis in adults (1.8%) was significantly lower (p=0.031, OR 0.40, CI: 0.17–0.89), compared to baseline (4.1%). The prevalence of porcine cysticercosis (8%) had also dropped significantly (p=0.002, OR 0.49, CI: 0.32–0.76) in this district compared to baseline (13%), whereas no significant difference was seen in Mbeya compared to baseline. The study suggests that three rounds of MDA targeting schistosomiasis in school-aged children combined with ‘track-and-treat’ contributed to a reduction in prevalence of T. solium in this population, and also had a spillover effect on adults in treated areas as well as reducing the prevalence of T. solium in the intermediate pig host population. Elimination of T. solium in this area would require a One Health approach.

Knowledge, attitudes and practices of parents on child sexual abuse and its prevention in Shinyanga district, Tanzania

Background: The role of parents in preventing child sexual abuse in the community in low-and-middle income countries has not been adequately emphasized. The objective of this study was to assess parents’ knowledge, attitudes and practices on child sexual abuse and its prevention in Shinyanga district, Tanzania in order to strengthen child protection. Methods: This was a cross-sectional study conducted during July 2015. Multistage cluster sampling technique was employed to obtain study participants from a list of sampling frame. Parents with children below 18 years old were randomly selected to form a study population. A quantitative technique using structured questions was used to assess parents’ knowledge, attitude and practices about preventing child sexual abuse. Results : A total of 384 respondents were included in the study. The majority (95.6%) of respondents had high knowledge regarding prevention of child sexual abuse. Majority (98.7%) of the respondents had positive attitudes on preventing child sexual abuse. However, only about a quarter (27.3%) of respondents had good practices on protection and prevention of child sexual abuse. Conclusion : Knowledge and attitudes of parents on child sexual abuse prevention was high in the study area. However, the practices of parents on child sexual abuse prevention were poor. Therefore, a public education programme is needed for parents, with the ultimate aim of protecting children from the preventable harm and trauma of sexual abuse in rural communities of Tanzania.

Birth preparedness and complication readiness – a qualitative study among community members in rural Tanzania

BackgroundBirth preparedness and complication readiness (BP/CR) strategies are aimed at reducing delays in seeking, reaching, and receiving care. Counselling on birth preparedness is provided during antenatal care visits. However, it is not clear why birth preparedness messages do not translate to utilisation of facility delivery. This study explores the perceptions, experiences, and challenges the community faces on BP/CR.DesignA qualitative study design using Focused Group Discussions was conducted. Twelve focus group discussions were held with four separate groups: young men and women and older men and women in a rural community in Tanzania. Qualitative content analysis was used to analyse the data.ResultsThe community members expressed a perceived need to prepare for childbirth. They were aware of the importance to attend the antenatal clinics, relied on family support for practical and financial preparations such as saving money for costs related to delivery, moving closer to the nearest hospital, and also to use traditional herbs, in favour of a positive outcome. Community recognised that pregnancy and childbirth complications are preferably treated at hospital. Facility delivery was preferred; however, certain factors including stigma on unmarried women and transportation were identified as hindering birth preparedness and hence utilisation of skilled care. Challenges were related to the consequences of poverty, though the maternal health care should be free, they perceived difficulties due to informal user fees.ConclusionsThis study revealed community perceptions that were in favour of using skilled care in BP/CR. However, issues related to inability to prepare in advance hinder the realisation of the intention to use skilled care. It is important to innovate how the community reinforces BP/CR, such as using insurance schemes, using community health funds, and providing information on other birth preparedness messages via community health workers.

Men's Knowledge of Obstetric Danger Signs, Birth Preparedness and Complication Readiness in Rural Tanzania.

BackgroundMen’s involvement in reproductive health is recommended. Their involvement in antenatal care service is identified as important in maternal health. Awareness of obstetric danger signs facilitates men in making a joint decision with their partners regarding accessing antenatal and delivery care. This study aims to assess the level of knowledge of obstetric complications among men in a rural community in Tanzania, and to determine their involvement in birth preparedness and complication readiness.MethodsA cross-sectional survey was conducted where 756 recent fathers were invited through a two-stage cluster sampling procedure. A structured questionnaire was used to collect socio-demographic characteristics, knowledge of danger signs and steps taken on birth preparedness and complication readiness. Data were analyzed using bivariate and multivariable logistic regression to determine factors associated with being prepared, with statistically significant level at p<0.05.ResultsAmong the invited men, 95.9% agreed to participate in the community survey. Fifty-three percent could mention at least one danger sign during pregnancy, 43.9% during delivery and 34.6% during the postpartum period. Regarding birth preparedness and complication readiness, 54.3% had bought birth kit, 47.2% saved money, 10.2% identified transport, 0.8% identified skilled attendant. In general, only 12% of men were prepared. Birth preparedness was associated with knowledge of danger signs during pregnancy (AOR = 1.4, 95% CI: 1.8-2.6). It was less likely for men living in the rural area to be prepared (AOR=0.6, 95% CI; 0.5-0.8).ConclusionThere was a low level of knowledge of obstetric danger signs among men in a rural district in Tanzania. A very small proportion of men had prepared for childbirth and complication readiness. There was no effect of knowledge of danger signs during childbirth and postpartum period on being prepared. Innovative strategies that increase awareness of danger signs as well as birth preparedness and complication readiness among men are required. Strengthening counseling during antenatal care services that involve men together with partners is recommended.