| 1. |
- Msuya, Sia E, et al.
(författare)
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COVID-19 Vaccine Uptake and Associated Factors in Sub-Saharan Africa : Evidence from a Community-Based Survey in Tanzania
- 2023
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Ingår i: Vaccines. - : MDPI AG. - 2076-393X. ; 11:2, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- COVID-19 is a major public health threat associated with the increased global burden of infectious diseases, mortality, and enormous economic loss to countries and communities. Safe and efficacious COVID-19 vaccines are crucial in halting the pandemic. We assessed the COVID-19 vaccine uptake and associated factors among community members from eight regions in Tanzania. The interviewer-administered questionnaire collected data. Multiple logistic regression models determined the factors associated with vaccine uptake. The median age of 3470 respondents was 37 years (interquartile range of 29-50 years) and 66% of them were females. Only 18% of them had received the COVID-19 vaccine, ranging from 8% in Dar es Salaam to 37% in Simiyu regions. A third (34%) of those vaccinated people did not know which vaccine they were given. Significantly higher rates of COVID-19 vaccine uptake were among the respondents aged 30+ years, males, and with a history of COVID-19 infection. Unfavorable perceptions about vaccine safety and efficacy lowered the rates of vaccine uptake. Setting-specific interventions and innovations are critical to improving vaccine uptake, given the observed differences between regions. Efforts are needed to increase vaccine uptake among women and younger people aged less than 30 years. Knowledge-based interventions should enhance the understanding of the available vaccines, benefits, target groups, and availability.
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| 2. |
- Mgongo, Melina Bernard, et al.
(författare)
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A Qualitative Study on Barriers to COVID-19 Vaccine Uptake among Community Members in Tanzania
- 2023
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Ingår i: Vaccines. - 2076-393X. ; 11:8, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- The use of vaccines is one of the key tools in reversing the COVID-19 pandemic; however, various reports reported the low uptake of the vaccines. This study explored the barriers to the COVID-19 vaccine uptake among community members in Tanzania. A qualitative explorative study was conducted in December 2021 and April 2022 in eight regions of Tanzania. Focus group discussions (FGDs) and in-depth interviews (IDIs) were the methods of data collection. A total of 48 FGDs and 32 IDIs were conducted. Participants were aware of the COVID-19 disease and vaccines. The barriers to the COVID-19 vaccine non-uptake included receiving contradicting statements from top government leaders, vaccine preceded the education, myths towards vaccines, the presence of different types of vaccines, the process of getting the vaccine, the influence of social media and random people from the community, and vaccine conflicting religious beliefs. Despite being aware of the vaccine, the uptake of the COVID-19 vaccine is still low. Interventions that focus on increasing community knowledge about COVID-19 vaccines and addressing myths about the vaccines are needed.
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| 3. |
- Mgongo, Melina, et al.
(författare)
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Early Infant Feeding Practices among Women Engaged in Paid Work in Africa : A Systematic Scoping Review
- 2024
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Ingår i: Advances in Nutrition. - 2161-8313. ; 15:3
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Forskningsöversikt (refereegranskat)abstract
- Around the world, paid work without appropriate structural support is a key barrier to optimal breastfeeding practices. To better protect, promote, and support optimal breastfeeding practices among working women in Africa, this scoping review sought to understand how paid work influences infant feeding practices in the first 6 mo of life and what support women need to manage work and optimal infant feeding practices. We systematically searched PubMed, Scopus, Global Health, and CINAHL Plus, screened 2436 abstracts, and reviewed 322 full-text articles using Covidence for review and charting. We identified 203 articles that met the inclusion criteria. We identified 32 quantitative, 10 qualitative, 3 mixed-methods, and 2 review articles that focused on examining the relationship between work and breastfeeding, and 109 quantitative, 22 qualitative, 21 mixed-methods, and 4 review articles that included work as part of broader breastfeeding research but did not focus on work. Most studies reported a significant negative association between work and exclusive breastfeeding. Three major domains were reported in the qualitative studies: challenges to managing work and infant feeding, receiving support from employers and family members/caregivers, and strategies for feeding infants when the mother is working. Reviewed studies proposed recommendations to increase support for breastfeeding through changes to policies and support within worksites, the health system, and childcare; however, evidence of previously implemented policies or programs is limited. We recommend more consistent definitions and measurement of women's work. Future research is needed on the impact of implementing various strategies and benefits for breastfeeding at workplaces, as well as efforts to support breastfeeding among informal workers.
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| 4. |
- Mtei, Monica, et al.
(författare)
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Confidence in COVID-19 vaccine effectiveness and safety and its effect on vaccine uptake in Tanzania : A community-based cross-sectional study
- 2023
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Ingår i: Human Vaccines & Immunotherapeutics. - 2164-5515. ; 19:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- COVID-19 is a major public health threat associated with increased disease burden, mortality, and economic loss to countries and communities. Safe and efficacious COVID-19 vaccines are key in halting and reversing the pandemic. Low confidence in vaccines has been one of the factors leading to hesitancy. We aimed to assess the COVID-19 vaccine confidence (safety and effectiveness), associated factors, and its effects on vaccine uptake among general community members in Tanzania. This was a community-based cross-sectional survey conducted from December 2021 to April 2022 in six regions of Tanzania mainland and two regions in Zanzibar. Participants were interviewed using an electronic questionnaire. Multiple logistic regression models estimated odds ratios (ORs) and 95% confidence interval (CI) for factors associated with vaccine confidence. All analyses were performed using SPSS version 25.0. The study enrolled 3470 general Tanzanian community members; their mean age was 40.3 (standard deviation ±14.9) years, and 34% were males. The proportion of COVID-19 vaccine confidence was 54.6%. Geographical region, residence area, COVID-19 disease risk perception, and good knowledge of COVID-19 vaccines were significantly associated with COVID-19 vaccine confidence. Confidence in COVID-19 vaccines was associated with over three times higher odds of vaccine uptake. Confidence in COVID-19 vaccines was low in Tanzania. Innovative community engagement strategies and region-specific interventions are needed to improve comprehensive knowledge and address community perceptions and attitudes toward COVID-19 vaccines.
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| 5. |
- Amour, Maryam A., et al.
(författare)
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Determinants of COVID-19 Vaccine Uptake and Hesitancy among Healthcare Workers in Tanzania : A Mixed-Methods Study
- 2023
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Ingår i: COVID. - : MDPI. - 2673-8112. ; 3:5, s. 777-791
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Tidskriftsartikel (refereegranskat)abstract
- The novel Coronavirus disease 2019 (COVID-19) presents a major threat to public health but can be prevented by safe and effective COVID-19 vaccines. Vaccine acceptance among healthcare workers (HCWs) is essential to promote uptake. This study, aimed to determine the COVID-19 vaccination uptake and hesitancy and its associated factors among HCWs in Tanzania. We employed a convergent-parallel mixed-methods design among 1368 HCWs across health facilities in seven geographical zones in Tanzania in 2021. We collected quantitative data by using an interviewer-administered questionnaire and qualitative data, using in-depth interviews and focus group discussions. Participants in the quantitative aspect were conveniently selected whereas those in the qualitative aspect were purposively selected based on their role in patient care, management, and vaccine provision. Stata software version 16.1 was used in the analysis of quantitative data and thematic analysis for the qualitative data. Multiple logistic regression was used to assess the determinants of COVID-19 vaccine uptake. The median age of 1368 HCWs was 33, and the interquartile range was 28-43 years; 65.6% were aged 30+ years, and 60.1% were females. Over half (53.4%) of all HCWs received the COVID-19 vaccine, 33.6% completely refused, and 13% chose to wait. HCWs aged 40+ years, from lower-level facilities (district hospitals and health centers), who worked 6+ years, and with perceived high/very high risk of COVID-19 infection had significantly higher odds of vaccine uptake. The qualitative data revealed misinformation and inadequate knowledge about COVID-19 vaccine safety and efficacy as the key barriers to uptake. Nearly half of all HCWs in Tanzania are still unvaccinated against COVID-19. The predominance of contextual influence on COVID-19 vaccine uptake calls for interventions to focus on addressing contextual determinants, focusing on younger HCWs' population, short working duration, those working at different facility levels, and providing adequate vaccine knowledge.
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| 6. |
- Masika, Lyidia V., et al.
(författare)
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Forgetting to Take Medication, Treatment Adherence and Their Relationship with Viral Load Suppression Among People Living with HIV in the Kilimanjaro Region, Tanzania
- 2024
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Ingår i: HIV/AIDS - Research and Palliative Care. - 1179-1373. ; 16, s. 245-257
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Tidskriftsartikel (refereegranskat)abstract
- Background: Antiretroviral therapy (ART) adherence is crucial for virological suppression and positive treatment outcomes among people living with HIV (PLHIV), but remains a challenge in ensuring patients achieve and sustain viral load suppression. Despite the recommended use of digital tools medications uptake reminders, the contribution of forgetting to take medication is unknown. This study investigated the contribution of forgetting to take medication on the total missed medication and its effects on detectable viral load (VL). Methods: This mixed-method research was conducted among children, adolescents, pregnant, and breastfeeding women living with HIV on ART in northern Tanzania. Forgetting to take medication constituted reporting to have missed medication due to forgetfulness. A multivariable logistic regression model was used to estimate the adjusted odds ratio (AOR) with a 95% confidence interval (CI) to determine the contribution of forgetting medication intakes on total missed medication and other factors associated with having a detectable VL. Results: Of 427 respondents, 33.3% were children, 33.4% adolescents, and 33.3% pregnant and breastfeeding women, whose median age (interquartile range) was 9 (7–12), 18 (16–18), and 31 (27–36) years, respectively. Ninety-two (22.3%) reported missing medication over the past month, of which 72 (17.9%) was due to forgetting. Forgetting to take medication (AOR: 1.75 95% CI: 1.01–3.06) and being on second-line regimen (AOR: 2.89 95% CI: 1.50–5.55) increased the chances of a detectable VL, while females had lower chances of detectable VL (AOR: 0.62 95% CI: 0.41–0.98). The themes on the reasons for forgetting to take medication from qualitative results included being busy with work and the importance of reminders. Conclusion: Forgetting to take medication is common among PLHIV and an important predictor of a detectable VL. This calls for the use of automated short message services (SMS) reminders or Digital Adherence Tools with reminders to improve and promote good ART adherence among PLHIV.
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| 7. |
- Metta, Emmy, et al.
(författare)
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The role of trust in the implementation and uptake of COVID-19 response measures : a qualitative study of health professionals' experiences in Tanzania
- 2023
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Ingår i: BMC Health Services Research. - 1472-6963. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Even though trust is placed at the central point in ensuring proper functioning of the health systems, studies remain scant on how it affects both the implementation and uptake of COVID-19 response measures in low- and middle-income countries such as Tanzania. This study, therefore, explored the role of trust in the implementation and uptake of recommended COVID-19 response measures including vaccines from the perspective of health professionals in Tanzania.METHODS: This cross-sectional qualitative study was implemented in four of Tanzania's thirty-one regions. Qualitative data was collected through 26 in-depth interviews held with regional and district disease outbreak response teams, district cold chain co-ordinators and health facility in-charges. In addition, five focus group discussions and seven group interviews were conducted with healthcare workers from the lower-level health facilities. Thematic analysis was conducted and applied the trust constructs.RESULTS: Interpersonal trust and health system trust emerged as two major themes in the study. Interpersonal trust was reported to stem from lack of transparency that instigated fear, worries, and confusion regarding the implementation and uptake of the recommended response measures. The distrust was mainly between health professionals in health facilities and those assigned to isolation centres as well as between patients and community members. On the other hand, the health system trust was shaped by mixed feelings regarding COVID-19 vaccine national decisions, and conflicting messages from national officials, politicians and religious leaders on COVID-19 responses, safety, and effectiveness of the vaccines. Questions surrounding the short duration of clinical trials, indeterminate post-vaccination protection duration, impotence-linked beliefs, freemasonry notion and unclear vaccinated cards information are other reported contributory factors to mistrust in the health system. However, after a comprehensive health education and experience in COVID-19 vaccination administration most professionals affirmed the effectiveness of the vaccines in limiting infections and its severe consequences.CONCLUSION: Participants indicated limited trust at both interpersonal and health system levels aggravated by lack of transparency, unclear and conflicting messages on COVID-19 infections and response measures. Enforced transparency on pandemics alongside standardised messages from the reliable sources is crucial in enhancing trust in implementation and uptake of the recommended response measures.
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| 8. |
- Mitao, Modesta, et al.
(författare)
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Recurrence of post-term pregnancy and associated factors among women who delivered at Kilimanjaro Christian Medical Centre in northern Tanzania : A retrospective cohort study
- 2023
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Ingår i: PLoS ONE. - 1932-6203. ; 18:4, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Post-term pregnancy is a health problem of clinical importance and; tends to recur in subsequent pregnancies. Maternal age, height, and male fetal sex are risk factors associated with Post-term pregnancy. The study aimed to determine the recurrence risk of post-term pregnancy and associated factors among women delivered at KCMC referral hospital.METHODOLOGY: This retrospective cohort study used KCMC zonal referral hospital medical birth registry cohort data for 43472 women delivered between 2000 and 2018. Data were analyzed using STATA version 15 software. Log-binomial regression with robust variance estimator determined the factors associated recurrence of post-term pregnancy adjusted for other factors.RESULTS: A total of 43472 women were analyzed. The proportion of post-term pregnancy was 11.4%, and the recurrence was 14.8%. The recurrence risk of post-term pregnancy was increased when a woman had a history of previous post-term pregnancy (aRR: 1.75; 95%CI: 1.44, 2.11). Advanced maternal age, i.e., ≥35years (aRR: 0.80; 95%CI: 0.65, 0.99), having secondary and higher education (aRR: 0.8; 95%CI: 0.66, 0.97), and being employed (aRR: 0.68; 95%CI: 0.55, 0.84) decreased the recurrence risk of post-term pregnancy. Women with recurrence of post-term pregnancy had a higher risk of delivering newborns weighed ≥4000gm (aRR: 5.05; 95% CI: 2.80, 9.09).CONCLUSION: Post-term pregnancy is associated with recurrence risk in subsequent pregnancies. A history of previous post-term pregnancy is associated risk factor and these women are at increased risk of delivering newborns weighed ≥4000gm. Clinical counselling of women at risk of post-term pregnancy and timely management is recommended to prevent adverse neonatal and maternal outcomes.
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| 9. |
- Mwimo, Julius, et al.
(författare)
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Prevalence of hypertension and associated factors among diabetic patients in Kilimanjaro region, northern Tanzania : A hospital-based cross-sectional study
- 2023
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Ingår i: Clinical Epidemiology and Global Health. - 2213-3984. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Hypertension is among the most common non-communicable diseases, being the major cause of premature deaths worldwide. The co-existence of hypertension and diabetes mellitus increases the risk of cardiovascular events and death. Objective: To determine the prevalence of hypertension and associated factors among individuals with type II diabetes mellitus in the Kilimanjaro region, northern Tanzania. Research design and methods: We conducted a cross-sectional study from June to September 2020 among 315 individuals with type II diabetes mellitus aged 18 years and above receiving care from two diabetic clinics in the Kilimanjaro region, northern Tanzania. Participants were selected using a systematic random sampling technique. The WHO Steps Survey for non-communicable diseases was used to collect data and analyzed using SPSS version 20. A multiple logistic regression model was used to estimate the odds ratios (OR) and 95% confidence intervals (CIs) for factors associated with hypertension adjusted for demographic, behavioral, and clinical characteristics. Results: The mean (±SD) age of 315 respondents was 58.62 ± 10.8 years and 58.4% were females. The prevalence of hypertension was 55.2% and was independently associated with older age; 60–69 years (OR = 2.75, 95%CI 1.14–6.64, p-value = 0.02) and ≥70 years (OR = 5.61; 95% CI: 1.65, 19.04), with history of cigarette smoking (OR = 3.98; 95% CI: 1.25, 12.72), and history of ischemic heart disease (OR = 16.86; 95% CI: 2.03, 140.3). Conclusion: More than half of individuals with diabetes in this study had co-existing hypertension, calling for routine and regular checkups of blood pressure at diabetic clinics. Special attention should be given to older individuals (≥60 years), smokers, and those with a history of ischemic heart disease for early prevention and management of adverse complications of diabetes and hypertension.
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| 10. |
- Shirima, Jackline, et al.
(författare)
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Suicidal Attempts among Secondary School-Going Adolescents in Kilimanjaro Region, Northern Tanzania
- 2023
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Ingår i: Behavioral Sciences. - : MDPI AG. - 2076-328X. ; 13:4, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Suicide attempts among adolescents are common and can lead to death. The study aimed to determine the prevalence and factors associated with suicide attempts among secondary school-going adolescents in the Kilimanjaro region, northern Tanzania. The study used data from two repeated regional school-based student health surveys (RSHS), conducted in 2019 (Survey 1) and 2022 (Survey 2). Data were analyzed for secondary school students aged 13 to 17 years from four districts of the Kilimanjaro region. The study included 4188 secondary school-going adolescents: 3182 in Survey 1 and 1006 in Survey 2. The mean age in Survey 1 was 14 years and the median age in Survey 2 was 17 years ( p < 0.001). The overall prevalence of suicide attempts was 3.3% (3.0% in Survey 1 and 4.2% in Survey 2). Female adolescents had higher odds of suicide attempts (aOR = 3.0, 95% CI 1.2-5.5), as did those who felt lonely (aOR = 2.0, 95% CI 1.0-3.6), had ever been worried (aOR = 1.9, 95% CI 1.0-3.5), or had ever been bullied (aOR = 2.2, 95% CI 1.2-4.1). Suicidal attempts are prevalent among secondary school-going adolescents in the Kilimanjaro region, northern Tanzania. In-school programs should be established to prevent such attempts.
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