Introduction: Cotrimoxazole Prophylactic Therapy (CPT) compliance lowers the risk of opportunistic infections and other Acquired Immune Deficiency Syndrome (AIDS)-related diseases. The aim of this study was to examine...Introduction: Cotrimoxazole Prophylactic Therapy (CPT) compliance lowers the risk of opportunistic infections and other Acquired Immune Deficiency Syndrome (AIDS)-related diseases. The aim of this study was to examine factors that influence compliance with CPT among HIV patients in the Care and Treatment Clinic (CTC) at Bugando Medical Centre (BMC) in Mwanza, Tanzania. Methods: A descriptive cross-sectional study was conducted at the BMC between April 1, 2021, and June 30, 2021. Data were collected using face-to-face interviews and a semi-structured questionnaire. Data are presented in frequency, percentages, and cross-tabulation tables. A P-value of less than 0.05 was considered statistically significant. Results: The prevalence of compliance with CPT by self-reported measurement was 158 (63.7%). Most CPT-compliant participants were more likely to have a spouse who is familiar with CPT, have a family member who is aware of their HIV status, and be aware of the benefits of CPT. The majority of participants who complied with CPT were more likely to have experienced counseling during refill, felt that the length of time spent seeing doctors for treatment was reasonable, and received accurate information from them. Conclusion: Most adult HIV patients attending CTC at BMC were reported to be in compliance with CPT. These findings suggest that improving social support and patient-provider communication may be effective strategies for improving compliance with CPT among HIV patients.展开更多
Introduction: Obesity, excessive alcohol use, cigarette smoking, a lack of physical activity, stress, and an unhealthy diet are modifiable risk factors linked to hypertension. Non-modifiable risk factors for hypertens...Introduction: Obesity, excessive alcohol use, cigarette smoking, a lack of physical activity, stress, and an unhealthy diet are modifiable risk factors linked to hypertension. Non-modifiable risk factors for hypertension include older age and a family history of hypertension. The purpose of this study was to assess university students’ knowledge of hypertension risk factors. Methods: This was a cross-sectional study conducted at St. Augustine University of Tanzania. A pre-tested, semi-structured questionnaire was used to collect data. Out of a total score of eight, a score of four or more was considered good knowledge, and a score of less than four was considered poor. All sociodemographic characteristics were included in logistic regression to calculate the adjusted odds ratio. Results: A total of 390 undergraduate students participated in this study. Most of the participants 266 (68.2%) identified stress as a risk factor for hypertension. The median (IQR) knowledge score was 2 (2 - 3). Overall, only 43 (11.0%) of the participants had good knowledge of risk factors for hypertension. However, none of the sociodemographic factors were associated with a good level of knowledge of risk factors for hypertension. Conclusion: Our findings highlight poor knowledge of modifiable and non-modifiable risk factors for hypertension among university students in northwestern Tanzania. Only stress and older age were known by more than half of the students as risk factors for hypertension. To reduce the burden of hypertension, it is crucial for prevention and control programs to target improving university students’ knowledge of risk factors for hypertension.展开更多
Members of the Goliathus group in the order Coleoptera, family Scarabaeidae and the sub-family Cetoniidae is one among essential ecological insects worldwide with scanty documentation in Tanzania. The country was amon...Members of the Goliathus group in the order Coleoptera, family Scarabaeidae and the sub-family Cetoniidae is one among essential ecological insects worldwide with scanty documentation in Tanzania. The country was among the first point of collection of the specimen by Moser (1909) but subsequent attempts to locate and collect the specimen were unsuccessful possibly due to changed habitat and behaviour of Goliathus. Much of published work about the insect are based on the morphological characteristics of collected specimen which led to designation of six major species namely;Goliathus goliatus, G. cacicus, G. regius, G. albosignatus, G. orientalis and G. usambarensis, the last two being considered to exist in Tanzania. The current study reports on successful identification of habitats using biological cues and subsequently collected several Goliathus specimen that had been difficult to trace for more than a century. New insights into correct identity of the species by using a combination of morphological and molecular techniques have been set. The study has resolved that only one species, Goliathus orientalis with five sub-species exist in Tanzania.展开更多
Natural and human systems are exposed and vulnerable to climate extremes, which contributes to the repercussions of climate variability and the probability of disasters. The impacts of both natural and human-caused cl...Natural and human systems are exposed and vulnerable to climate extremes, which contributes to the repercussions of climate variability and the probability of disasters. The impacts of both natural and human-caused climate variability are reflected in the reported changes in climate extremes. Particularly at the local community levels in the majority of the regions, there is currently a dearth of information regarding the distribution, dynamics, and trends of excessive temperatures among the majority of Tanzanians. Over the years 1982-2022, this study examined trends in Tanzania’s extreme temperature over the June to August season. Based on the distinction between absolute and percentile extreme temperatures, a total of eight ETCCDI climate indices were chosen. Mann-Kendall test was used to assess the presence of trends in extreme climatic indices and the Sen’s Slope was applied to compute the extent of the trends in temperature extremes. The study showed that in most regions, there is significant increase of warm days and nights while the significant decrease of cold days and nights was evident to most areas. Moreover, nighttime warming surpasses daytime warming in the study area. The study suggests that anthropogenic influences may contribute to the warming trend observed in extreme daily minimum and maximum temperatures globally, with Tanzania potentially affected, as indicated in the current research. The overall results of this study reflect patterns observed in various regions worldwide, where warm days and nights are on the rise while cold days and nights are diminishing.展开更多
Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, d...Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, dietary and environmental factors. Histopathological patterns of surgically treated thyroid diseases play an important role in early diagnosis and management of these diseases. There is, however, limited published data regarding histopathological reports on thyroid disease in our local setting. This study aimed to determine the histopathological patterns and highlight early postoperative complications among patients with surgically treated thyroid diseases at Bugando Medical Centre (BMC). Methods: This was a longitudinal study involving all patients with surgically treated thyroid diseases seen at BMC over a period of 6 months from October 2019 to March 2020. Results: A total of 84 patients were studied. Females outnumbered males by a female to male ratio of 11:1. The median age of patients was 44 [IQR, 35 - 54] years old, the youngest was 14 years old and the oldest was 76 years old. Colloid goiter was the most common non-neoplastic lesion accounting for 34 (44.7%) patients. Among the neoplastic lesions, follicular adenoma was the most commonly encountered benign pathologies (n = 16;21.1%), while papillary carcinoma was the most commonly encountered malignancy (n = 4;50%). Following thyroidectomy, 12 (14.3%) patients developed early complications, of which hemorrhage sometimes requiring blood transfusion was the leading intra/postoperative complications accounting for 4 (33.3%) patients. Other complications include temporary recurrent laryngeal nerve palsy 2 (16.7%), surgical site infection 2 (16.7%) and tracheomalacia, bronchospasm, thyroid abscess and respiratory obstruction in 1 (8.3%) patient each, respectively. In this study, malignant thyroid lesion (p Conclusion: This study demonstrated that colloid goiter was the most common non-neoplastic lesion, and on the neoplastic category, follicular adenoma was the most common benign lesion, while papillary carcinoma was the most frequent malignant lesion.展开更多
The use of traditional medicine(TM)is essential for preventing and treating diseases and thus improving human health.Worldwide,TM has been used since time immemorial.In Tanzania,the use of TM was most common during pr...The use of traditional medicine(TM)is essential for preventing and treating diseases and thus improving human health.Worldwide,TM has been used since time immemorial.In Tanzania,the use of TM was most common during precolonial era before it was discriminated during the Germany colonial rule.However,it regained the attention during the private sector emergence era(1985-2004).Currently,there are ongoing efforts to integrate TM and modern medicine to improve healthcare systems in developing countries for sustainable healthcare management.This review aims to provide an overview of the historical and current status,challenges,and future direction for TM in Tanzania.The analysis revealed that the development of TM was somehow underdeveloped during the colonial rule but regained its popularity after independence.Currently,there are many opportunities such as the presence of legal and institutional frameworks,a varied medicinal biodiversity,with some of them being endemic to Tanzania,political will etc.Despite the available opportunities,there are numerous challenges to the development and use of TM.These include inadequate financial and human resources for research,poor conservation of medicinal biodiversity;modernization;intellectual property rights of TM knowledge;lack of safety,efficacy,and quality data of medicinal products.The development and utility of TM as a resource is crucial to protect practise.Thus,the study recommends more capacity building in terms of finances,technology development,human resources training,advocacy and integration of TM into healthcare system.展开更多
Tanzania is located in eastern Africa with a predominantly agricultural ecomomy,the potential for developing and utilizing cultivated land are promising,but scientific guidance is required.B,Zn and Se are essential mi...Tanzania is located in eastern Africa with a predominantly agricultural ecomomy,the potential for developing and utilizing cultivated land are promising,but scientific guidance is required.B,Zn and Se are essential micronutrients for plants and human body with crucial biological functions,in particular,Se is significant for human health and considered as“the king of anti-cancer”.As these elements required by human or plants are mainly absorbed from soil directly or indirectly,therefore,it is important to understand the contents and distributions of them in the soil of cultivated land for guiding agricultural production.In this work,low-density geochemical survey at the scale of 1∶1000000 was carried out in Tanzania,and the results show that the concentrations of B,Zn and Se in stream sediments are low and their distributions are heterogeneous.According to the distributions of geological units,the existing cultivated land resources can be divided into five regions in Tanzania.Compared with the national background values,the concentrations of B,Zn and Se are insufficient overall but enriched locally in these regions.In general,element concentrations in stream sediments and soil have a positive correlation because of their similar sources,which is essential in agriculture application.Based on the information provided by low-density geochemical data and maps,the Se-sufficient and Se-rich regions were delineated in Tanzania,where can be used to develop Se-rich industries.Finally,this paper believes that geochemical survey is a powerful tool for cultivated land evaluation,agriculture management and land development.展开更多
Understanding why individuals do or do not adopt optimal water, sanitation, and hygiene (WASH) practices is critical to designing successful behavior change interventions. However, policy makers and program implemente...Understanding why individuals do or do not adopt optimal water, sanitation, and hygiene (WASH) practices is critical to designing successful behavior change interventions. However, policy makers and program implementers often fail to obtain the context-specific information on behavioral determinants of WASH practices. This two-stage, randomized survey among 5000 female primary caregivers in the Lake Zone of Tanzania assessed associations between behavioral determinants and a range of hygiene and sanitation practices. Behavioral determinants of hygiene were almost always significantly associated with cleaning one’s own hands after cleaning the baby’s bottom and being able to show at least one place where family members wash their hands. In regression models, those who knew when to wash their own hands (OR = 1.8, 95% CI: 1.5, 2.1) and their child’s hands (OR = 1.5, 95% CI: 1.3, 1.7) and mothers who thought that their female friends washed their hands after cleaning the baby’s bottom (OR = 5.5, 95% CI: 4.5, 6.7) were significantly more likely to frequently clean their own hands after cleaning the baby’s bottom. This research suggests that in the Lake Zone of Tanzania, numerous determinants are associated with hygiene practices. Identifying context-specific determinants of WASH behaviors is the first step toward developing effective interventions.展开更多
Introduction: Transition of care strategies have shown to improve quality of lives of heart failure patients, but it has little implemented in clinical settings. Objective: To evaluate context-specific perceived barri...Introduction: Transition of care strategies have shown to improve quality of lives of heart failure patients, but it has little implemented in clinical settings. Objective: To evaluate context-specific perceived barriers and experiences of heart failure patients during their admission and after they were discharged from hospital. Methods: A cross-sectional qualitative study was conducted among 13 heart failure patients at two large referral hospitals in northwestern Tanzania. In-depth interviews among heart failure patients, in line with the Consolidated Criteria for Reporting Qualitative research checklist, were used to collect data. Interviews were audio recorded, transcribed, and translated into English. Results: Three key barriers were identified, as well as possible solutions that could improve the transition of care for heart failure patients. These include strengthening healthcare provider communications, organizing medication management, and assisting with follow-up appointments. Conclusion: The barriers identified are real and challenging in clinical resource- limited settings. Findings suggest they can be overcome when realistic and tailor-made interventions are in place.展开更多
Cultivated rice (Oryza sativa L. and Oryza. glaberrima) is one of the most important food crops in the world. World rice production has increased three times since the green revolution. However, climate change and glo...Cultivated rice (Oryza sativa L. and Oryza. glaberrima) is one of the most important food crops in the world. World rice production has increased three times since the green revolution. However, climate change and global warming effects as well as ever increasing world population will require the world to produce more rice without increasing area under rice production in order to meet those demands. The best option to overcome these challenges includes adoption of climate-smart technologies and sustainable solutions to rice production. Rice was probably introduced in Tanzania over 1000 years ago by Asian traders during trade contacts between Asia and East Africa Coast through Indian Ocean. Rice cultivation had been restricted to coastal area until 19th century when it started spreading to interior areas of Tanzania. During colonial period (1880s-1960s), the emphasis was to produce cash crops as raw materials for industrialized world. After independence production of rice increased significantly. Currently, rice is the second most important food crop in Tanzania after maize and Tanzania is the leading producer of rice in East African countries. It ranks 4th and 22nd in Africa and World respectively in terms of rice production. In this paper, the rice history, ecosystems, challenges and future perspective for sustaining rice production in Tanzania is reviewed.展开更多
Like other countries in East Africa, Tanzania has been affected by extreme precipitation incidences both socially and economically. Determining the trend and variability features of extreme precipitation in the countr...Like other countries in East Africa, Tanzania has been affected by extreme precipitation incidences both socially and economically. Determining the trend and variability features of extreme precipitation in the country is crucial. This study used data from 28 meteorological stations for 1981-2020 period to give an annual and seasonal analysis of the patterns of 10 ETCCDI’s extreme precipitation indices over the regions. At annual scale, the results showed that increasing trends had high frequency percentage than the decreasing ones, collecting about 76% in total. The decreasing trend was approximately 24%, and most of the stations with increasing percentage in trend are concentrated in Northern coast, Central, West, North-eastern highlands and Lake Victoria Basin. Most of the stations depicted negative trend are concentrated over Southern region. This highlights that extreme precipitation events have increased over the country for the period 1981-2020. At seasonal scale, during October to December (OND);the patterns of extreme precipitation climatic indices except R99p, showed positive significant increasing trend over Lake Victoria Basin and some Western parts of the country. In general, spatial patterns indicate decrease of precipitation over most parts of the country during OND. The seasonal average time series depicted non-significant positive trend during March to April (MAM) season, except for Consecutive Wet Days (CWD) which showed non-significant decreasing trend. Over the highest mountain in Africa, Kilimanjaro;the study has revealed significant decrease in Annual total-wet Precipitation (PRCPTOT), the number of heavy (very heavy) days of precipitation R10 mm (R20 mm) and Consecutive Wet Days (CWD) during MAM season. While the maximum one-day precipitation amount (RX1 day) was observed to decrease significantly over the Mountain during OND season. The result is very important in risk assessment and preparedness perspective in planning climate change mitigation and adaptations for different sectors like Tourism, Agriculture, Water and Energy.展开更多
Introduction: Limited access to treatment is a crucial factor contributing to the suboptimal control of hepatitis B virus (HBV) infection, especially in sub-Saharan African countries such as Tanzania. The eligibility ...Introduction: Limited access to treatment is a crucial factor contributing to the suboptimal control of hepatitis B virus (HBV) infection, especially in sub-Saharan African countries such as Tanzania. The eligibility for antiviral therapy is typically determined based on the extent of HBV replication and liver damage. However, there is insufficient data available regarding the actual treatment needs and the overall characteristics of HBV-infected individuals in Tanzania. Therefore, the aim of this study is to fill this knowledge gap and provide valuable insights to aid in the planning of treatment programs. Materials and Methods: We conducted a cross-sectional study at Bugando Medical Centre in northwest Tanzania, examining the data of 340 patients who were diagnosed with chronic HBV infection and attending the hepatitis clinic. Data on sociodemographic, clinical, and investigation details were collected through electronic files and subsequently analyzed. The eligibility for HBV antiviral treatment was assessed using the criteria established by the World Health Organization (WHO). Results: Out of the 340 patients included in the study, the majorities were males 252 (74.1%) and had a median age of 36 years. Most patients came from outside of Mwanza city. Twenty-percent had significantly elevated alanine transaminase, and over one-third had high DNA levels (>2000 IU/L). The prevalences of liver cirrhosis and significant liver fibrosis were 15% and 15.3%, respectively. None of the patients were on antiviral therapy for hepatitis B. A total of 64 (18.8%) patients met the criteria for treatment eligibility. Male sex, older age, residing outside Mwanza city, and anemia (all with p Conclusion and Recommendations: The significant number of HBV-infected patients is suitable for antiviral therapy but none of them have initiated the treatment. The significance of these findings is to emphasize the need for enhancing hepatitis B services in Tanzania.展开更多
Coffee (Coffea arabica L.) is a crop of major economic significance in Tanzania with annual revenue estimated at 100 Million USD. The current mean annual production of the crop is 68,000 MT of clean coffee of which 90...Coffee (Coffea arabica L.) is a crop of major economic significance in Tanzania with annual revenue estimated at 100 Million USD. The current mean annual production of the crop is 68,000 MT of clean coffee of which 90% is contributed by about 450,000 smallholder farmers and while large estate owners contribute the rest. Antestia bug (Antestiopsis orbitalis spp.), the pest known to attack all vegetative and fruiting parts of the coffee tree with substantial yield reduction of up to 45% has been reported to occur contemporary on Arabica coffee in Tanzania, particularly in Kilimanjaro Region. Despite the reported existence of Antestia bug and its damages that badly inflict on the productivity and quality of coffee, the pest status of the bug in Tanzania has never been established. The present study examined the incidence damage severity of Antestia bug in the Arabica coffee fields in major producing regions of Kilimanjaro, Ruvuma and Songwe. A stratified sampling of 360 coffee farms was done on which the Antestia bug incidence and severity were recorded. Results suggested that all regions were infested and the shade intensity influenced the pest incidences with the highest severity record in Kilimanjaro and the least affected was Songwe Region. Dense shade had the highest Antestia bug incidence than sparse shade canopy (p < 0.001). The current study sheds insights into understanding the pest status of Antestia bugs on Arabica coffee in Tanzania which could be used in designing effective management strategies. .展开更多
Background: Tuberculosis (TB) diagnostics, such as Xpert MTB/RIF, is still limited by cost. Testing of pooled samples from presumptive TB patients has been thought as a cost-saving strategy to diagnose TB. We assessed...Background: Tuberculosis (TB) diagnostics, such as Xpert MTB/RIF, is still limited by cost. Testing of pooled samples from presumptive TB patients has been thought as a cost-saving strategy to diagnose TB. We assessed the utility and cost-saving of pooled Xpert MTB/RIF testing strategy for the diagnosis of TB in Mwanza, Tanzania. Methods: Sputum samples from Presumptive TB patients were submitted to TB laboratory for routine diagnosis of TB using Xpert MTB/RIF. The TB results from the individual sputum samples were used as the reference standard and were concealed to the investigating laboratory technicians. The remainder of samples were collected serially and were pooled (5 samples per pool) for testing. The agreement of the results between individual sample testing against pooled sample testing and cost-savings was assessed. Results: A total of 250 sputum samples from presumptive TB patients were analyzed and 50 pools were made with each pool containing 5 samples. Of the 50 sputum pools made, Mycobacterium tuberculosis (MTB) was detected in 17 (34.0%) pools. Results from the individual sputum samples MTB/RIF testing were retrieved for all 250 samples and there were 28 (11.2%) samples in which MTB was detected whereas 222 (88.8%) samples had no MTB detected. Following re-analysis of positive pools, all 28 (100%) individual positive MTB samples were detected within the 17 positive pools, with 1 to 3 individual MTB positive samples per pool. The individual sputum samples were correctly identified by pooled sputum on Xpert MTB/RIF testing, with the sensitivity of 100% and specificity of 100%. Using pooling of sputum samples strategy, we saved 46.0% (115/250) of the cartridges. Conclusion: The pooled sputum testing strategy reduced cartridge costs by 46.0% and has the potential to increase the affordability of Xpert MTB/RIF testing in countries with limited resources, such as Tanzania.展开更多
Introduction: The burden of chronic kidney disease (CKD) is rapidly increasing in Tanzania. There is a rapid expansion of hemodialysis (HD) services to meet this demand. The quality of HD services, which is usually te...Introduction: The burden of chronic kidney disease (CKD) is rapidly increasing in Tanzania. There is a rapid expansion of hemodialysis (HD) services to meet this demand. The quality of HD services, which is usually termed HD inadequacy, is under-reported. Therefore, the objective of this study was to determine the prevalence of HD inadequacy using two equations, urea reduction ratio (URR) and Kt/V and its associated factors. The correlation between URR and Kt/V for the diagnosis of HD inadequacy is also determined. Materials and Methods: This was a prospective longitudinal study conducted from March to July 2021 in 98 patients with CKD who underwent maintenance HD at Bugando Medical Centre in Mwanza, Tanzania. Demographic, laboratory, and clinical information was collected and analyzed. The HD inadequacy was estimated by using both the URR and the Kt/V equations. The correlation between the two equations was analyzed by using Cohen’s kappa. Results: The majority (69.4%) of the study participants were male and the mean age was 59 (48 - 68) years. The median hemoglobin level was 10 (8.9 - 11.2) g/dl, and the pre-dialytic urea was 15 (10.6 - 21.3) mmol/L. The prevalence of HD inadequacy was 36 (36.7%). The predictors of HD inadequacy were older age (>50 years) (OR = 3.6, 95 % CI 1.0 - 12.6, p = 0.04), moderate or severe anemia (OR = 4.7, 95 % CI 1.5 - 14.4, p = 0.006) and short duration of HD (OR = 3.1, 95 % CI 1.0 - 9.1, p = 0.04). There was a strong agreement between URR and Kt/V in the diagnosis of HD inadequacy (Kappa = 0.887). Conclusion and Recommendations: HD inadequacy is common, and most predictors can be prevented. Clinicians should use a personalized approach in making sure that anemia is appropriately treated and HD prescription is adhered to for better clinical outcomes among patients with HD.展开更多
Worldwide obstetric hemorrhage remains the leading cause of maternal mortality, accounting for over one quarter of maternal deaths. Over half of these deaths occur in Sub-Saharan Africa with mortality rates of 500 - 1...Worldwide obstetric hemorrhage remains the leading cause of maternal mortality, accounting for over one quarter of maternal deaths. Over half of these deaths occur in Sub-Saharan Africa with mortality rates of 500 - 1000 per 100,000 births, compared to approximately 5 - 10 in developed countries. Over decades in Sub Saharan Africa preventive measures and treatment protocols have been made to reduce maternal mortality caused by PPH. While rates of postpartum hemorrhage have continued to rise, there is a need to evaluate if its etiology and patterns have changed over time. Broad Objective: This study aims at describing trends in incidence, causes and maternal outcomes of Postpartum Hemorrhage at Muhimbili National Hospital for a period of 7 years. Methodology: This is a retrospective descriptive hospital-based study that has included all cases of postpartum hemorrhage at Muhimbili National Hospital, a tertiary hospital in Tanzania from 2014 to 2020. The data was analyzed using SPSS Version 26 and presented using frequency tables, figures and percentages. The trends of postpartum hemorrhage over time were determined using chi-square test and P-value where less than 0.05 was considered statistically significant. Results: Overall, the incidence of postpartum hemorrhage has been fluctuating over the years with minimum of 1.78% and maximum of 2.87% with no statistical significance. Out of 1113 enrolled cases of PPH, 422 (37.9%) were attributed to genital tears followed by uterine atony 285 (25.6%). A statistically significant increase in linear trend was observed in the postpartum hemorrhage cases due to uterine atony, uterine rupture and sub analysis on genital tears (cervical tear). Overall, there was a statistically significant change in trend of maternal outcomes throughout the years, with a P-value < 0.001 and likelihood of complications increasing over time. Conclusion: The trend in the incidence of postpartum hemorrhage has been fluctuating over the years during the study period. The leading cause of postpartum hemorrhage was genital tears, followed by uterine atony with a significant increase in adverse maternal outcomes over the years. Continuous health education to medical personnel to improve timely and proper diagnosis of women in danger of PPH and timely referral, thus improve maternal morbidity and mortality.展开更多
We present new U-Pb and Hf zircon isotope data on a suite of granitoids from a hitherto unstudied area of the Palaeoproterozoic Lupa terrane of the Ubendian belt in SW Tanzania.The major part of the area comprises a s...We present new U-Pb and Hf zircon isotope data on a suite of granitoids from a hitherto unstudied area of the Palaeoproterozoic Lupa terrane of the Ubendian belt in SW Tanzania.The major part of the area comprises a sequence of upper amphibolite grade paragneisses and migmatites.Subsequently,the field relations show a complex history of granitoid emplacement from early pre-tectonic strongly foliated diorite-tonalite-granodiorite orthogneiss to late tectonic,weakly deformed ellipsoidal granitoid plutons.These were followed by emplacement of undeformed K-feldspar rich porphyritic alkali granite.U-Pb zircon data on the granitoids show their emplacement ages span the period^1925 Ma to 1890 Ma and constrain the culmination of the Ubendian orogeny in the Lupa terrane to about 1900 Ma.The undeformed K-feldspar rich Chimala granite,previously considered to be unconformably overlain by the Buanji Group volcano-sedimentary rocks(recently shown to be^1675 Ma,not Neoproterozoic as originally thought)was dated at^1407 Ma showing that it must intrude the sedimentary rocks,although the age relationships are not exposed in the mapping area.This is the first record of early Irumide/Kibaran-aged post-tectonic granites in this part of East Africa.Hf isotope data from the zircons show that the granitoids have a long crustal pre-history stretching back to as far as^3.9 Ga,and showing that the Lupa terrane may form part of the"metacratonic"margin of an originally much more extensive Tanzania Craton.展开更多
The analysis of available Nd isotope data from the Tanzania Craton places important constraints on the crest-mantle separation ages,and events marking juvenile crustal addition and crustal recycling.Nd model ages date...The analysis of available Nd isotope data from the Tanzania Craton places important constraints on the crest-mantle separation ages,and events marking juvenile crustal addition and crustal recycling.Nd model ages date the oldest crust extraction to 3.16 Ga in the Tanzania Craton,although a rock record of such antiquity is yet to be found there.The most significant period of juvenile crustal addition as well as crustal recycling is 2.7-2.6 Ga.The Nd isotopes of marie samples show that chemical heterogeneity existed in the mantle beneath the Tanzania Craton,with some samples originating from significantly depleted mantle, and most samples originating from the mixture of primitive mantle and depleted mantle.The Nd isotope section reveals significant differences in Nd isotopes between the north eraton and central craton;compared to the north craton,the central craton yields a Nd model age that is approximately 100 Ma older, and its εNd(t)values are more negative,indicating that the two parts of the craton have different mantle source regions.Different types of granitoids are distributed in the Tanzania Craton,such as high-K and low-Al granite,ealc-alkaline granite,peraluminous granite and transitional types of tonalite-trondhjemite- granodiorites (TTGs).Most of the granitoids formed later than the marie rocks in syn-collision and postcollision events.展开更多
Climate variability and change are among the biggest challenges of the 21st century. Like in many other areas globally, the coastal communities of Tanzania have always been facing climatic variability at various time ...Climate variability and change are among the biggest challenges of the 21st century. Like in many other areas globally, the coastal communities of Tanzania have always been facing climatic variability at various time scales. Using focus group discussion and a household survey, this study analyzes the perceptions of climate variability and change and the strategies for coping and adaptation by the selected coastal rural and peri-urban communities in Tanzania. The perception of climate variability and change is complemented with the time-series analysis of rainfall and temperature data from Julius Nyerere International Airport Met. station and Kisarawe using Instant Statistical Software. Results indicate that households are aware of climate variability and identify indicators of climate change and variability as being decreasing rainfall trends, increasing incidences of droughts, unpredictable rainfall patterns, disappearance of wetlands and failure to predict on-set of rainy season using traditional knowledge. Households primarily attribute reduced crop yields to changes in rainfall pattern and increasing incidences of drought leading to soil moisture stress. The implications are that the agriculture dependent households are now food insecure. As a way of coping to the observed changes, the coastal communities among others have shifted to production of high value horticultural crops and use of forest resources. Nevertheless, the increased use of forest resources is threatening the existence of coastal forests and contributes to the decline of forest resources and disappearance of wildlife in the forest reserves. It is concluded that the communities studied are aware of climate issues as revealed from perceived indicators of climate variability and changes. The results from statistical analysis of 30 years climatic data are consistent with community’s perception of climate variability and change. The study recommends examining the present coping strategies for the sustainability of the coastal forests and in designing of alternative adaptive strategies such as alternative energy options, crop diversification and environmental friendly activities such as beekeeping.展开更多
Irrigation system is a scare resource in most of drought-stricken Africa.How to manage and maintain the existing irrigation facilities in Africa is a debatable issue to both policy makers and beneficiaries.Irrigation ...Irrigation system is a scare resource in most of drought-stricken Africa.How to manage and maintain the existing irrigation facilities in Africa is a debatable issue to both policy makers and beneficiaries.Irrigation facilities run by farmer cooperatives are considered ineffective,unsuccessful and dysfunctional in Tanzania by many researchers.A cooperative irrigation scheme is a mechanism that features the collective management of rural irrigation facilities by farmers'cooperative with some government intervention and external support.There is an increasing emphasis on the roles of cooperative irrigation scheme in the development of the agriculture sector and poverty reduction of smallholder farmers.In this study,the authors investigated the management and services of this scheme and analyzed its contribution to poverty reduction of smallholder rice farmers and community development in Tanzania through both quantitative and qualitative methods.The results showed that the scheme helped smallholder farmers increase the rice production and brought better market opportunities.The farmers'net income was also increased.Profit generated from rice farming not only improved the livelihoods of smallholder farmers but also created more employment opportunities in the rural communities.The research also revealed that the scheme was faced with a number of challenges due to resource and institutional constraints and low-level human capacity for both management and members.The research provides a feasible approach to effective management of small-scale agricultural infrastructure for poverty reduction in Africa.展开更多
文摘Introduction: Cotrimoxazole Prophylactic Therapy (CPT) compliance lowers the risk of opportunistic infections and other Acquired Immune Deficiency Syndrome (AIDS)-related diseases. The aim of this study was to examine factors that influence compliance with CPT among HIV patients in the Care and Treatment Clinic (CTC) at Bugando Medical Centre (BMC) in Mwanza, Tanzania. Methods: A descriptive cross-sectional study was conducted at the BMC between April 1, 2021, and June 30, 2021. Data were collected using face-to-face interviews and a semi-structured questionnaire. Data are presented in frequency, percentages, and cross-tabulation tables. A P-value of less than 0.05 was considered statistically significant. Results: The prevalence of compliance with CPT by self-reported measurement was 158 (63.7%). Most CPT-compliant participants were more likely to have a spouse who is familiar with CPT, have a family member who is aware of their HIV status, and be aware of the benefits of CPT. The majority of participants who complied with CPT were more likely to have experienced counseling during refill, felt that the length of time spent seeing doctors for treatment was reasonable, and received accurate information from them. Conclusion: Most adult HIV patients attending CTC at BMC were reported to be in compliance with CPT. These findings suggest that improving social support and patient-provider communication may be effective strategies for improving compliance with CPT among HIV patients.
文摘Introduction: Obesity, excessive alcohol use, cigarette smoking, a lack of physical activity, stress, and an unhealthy diet are modifiable risk factors linked to hypertension. Non-modifiable risk factors for hypertension include older age and a family history of hypertension. The purpose of this study was to assess university students’ knowledge of hypertension risk factors. Methods: This was a cross-sectional study conducted at St. Augustine University of Tanzania. A pre-tested, semi-structured questionnaire was used to collect data. Out of a total score of eight, a score of four or more was considered good knowledge, and a score of less than four was considered poor. All sociodemographic characteristics were included in logistic regression to calculate the adjusted odds ratio. Results: A total of 390 undergraduate students participated in this study. Most of the participants 266 (68.2%) identified stress as a risk factor for hypertension. The median (IQR) knowledge score was 2 (2 - 3). Overall, only 43 (11.0%) of the participants had good knowledge of risk factors for hypertension. However, none of the sociodemographic factors were associated with a good level of knowledge of risk factors for hypertension. Conclusion: Our findings highlight poor knowledge of modifiable and non-modifiable risk factors for hypertension among university students in northwestern Tanzania. Only stress and older age were known by more than half of the students as risk factors for hypertension. To reduce the burden of hypertension, it is crucial for prevention and control programs to target improving university students’ knowledge of risk factors for hypertension.
文摘Members of the Goliathus group in the order Coleoptera, family Scarabaeidae and the sub-family Cetoniidae is one among essential ecological insects worldwide with scanty documentation in Tanzania. The country was among the first point of collection of the specimen by Moser (1909) but subsequent attempts to locate and collect the specimen were unsuccessful possibly due to changed habitat and behaviour of Goliathus. Much of published work about the insect are based on the morphological characteristics of collected specimen which led to designation of six major species namely;Goliathus goliatus, G. cacicus, G. regius, G. albosignatus, G. orientalis and G. usambarensis, the last two being considered to exist in Tanzania. The current study reports on successful identification of habitats using biological cues and subsequently collected several Goliathus specimen that had been difficult to trace for more than a century. New insights into correct identity of the species by using a combination of morphological and molecular techniques have been set. The study has resolved that only one species, Goliathus orientalis with five sub-species exist in Tanzania.
文摘Natural and human systems are exposed and vulnerable to climate extremes, which contributes to the repercussions of climate variability and the probability of disasters. The impacts of both natural and human-caused climate variability are reflected in the reported changes in climate extremes. Particularly at the local community levels in the majority of the regions, there is currently a dearth of information regarding the distribution, dynamics, and trends of excessive temperatures among the majority of Tanzanians. Over the years 1982-2022, this study examined trends in Tanzania’s extreme temperature over the June to August season. Based on the distinction between absolute and percentile extreme temperatures, a total of eight ETCCDI climate indices were chosen. Mann-Kendall test was used to assess the presence of trends in extreme climatic indices and the Sen’s Slope was applied to compute the extent of the trends in temperature extremes. The study showed that in most regions, there is significant increase of warm days and nights while the significant decrease of cold days and nights was evident to most areas. Moreover, nighttime warming surpasses daytime warming in the study area. The study suggests that anthropogenic influences may contribute to the warming trend observed in extreme daily minimum and maximum temperatures globally, with Tanzania potentially affected, as indicated in the current research. The overall results of this study reflect patterns observed in various regions worldwide, where warm days and nights are on the rise while cold days and nights are diminishing.
文摘Background: Thyroid diseases are among the leading endocrine disorders affecting a large proportion of people worldwide and show geographical variation in incidence and histopathological pattern related to age, sex, dietary and environmental factors. Histopathological patterns of surgically treated thyroid diseases play an important role in early diagnosis and management of these diseases. There is, however, limited published data regarding histopathological reports on thyroid disease in our local setting. This study aimed to determine the histopathological patterns and highlight early postoperative complications among patients with surgically treated thyroid diseases at Bugando Medical Centre (BMC). Methods: This was a longitudinal study involving all patients with surgically treated thyroid diseases seen at BMC over a period of 6 months from October 2019 to March 2020. Results: A total of 84 patients were studied. Females outnumbered males by a female to male ratio of 11:1. The median age of patients was 44 [IQR, 35 - 54] years old, the youngest was 14 years old and the oldest was 76 years old. Colloid goiter was the most common non-neoplastic lesion accounting for 34 (44.7%) patients. Among the neoplastic lesions, follicular adenoma was the most commonly encountered benign pathologies (n = 16;21.1%), while papillary carcinoma was the most commonly encountered malignancy (n = 4;50%). Following thyroidectomy, 12 (14.3%) patients developed early complications, of which hemorrhage sometimes requiring blood transfusion was the leading intra/postoperative complications accounting for 4 (33.3%) patients. Other complications include temporary recurrent laryngeal nerve palsy 2 (16.7%), surgical site infection 2 (16.7%) and tracheomalacia, bronchospasm, thyroid abscess and respiratory obstruction in 1 (8.3%) patient each, respectively. In this study, malignant thyroid lesion (p Conclusion: This study demonstrated that colloid goiter was the most common non-neoplastic lesion, and on the neoplastic category, follicular adenoma was the most common benign lesion, while papillary carcinoma was the most frequent malignant lesion.
文摘The use of traditional medicine(TM)is essential for preventing and treating diseases and thus improving human health.Worldwide,TM has been used since time immemorial.In Tanzania,the use of TM was most common during precolonial era before it was discriminated during the Germany colonial rule.However,it regained the attention during the private sector emergence era(1985-2004).Currently,there are ongoing efforts to integrate TM and modern medicine to improve healthcare systems in developing countries for sustainable healthcare management.This review aims to provide an overview of the historical and current status,challenges,and future direction for TM in Tanzania.The analysis revealed that the development of TM was somehow underdeveloped during the colonial rule but regained its popularity after independence.Currently,there are many opportunities such as the presence of legal and institutional frameworks,a varied medicinal biodiversity,with some of them being endemic to Tanzania,political will etc.Despite the available opportunities,there are numerous challenges to the development and use of TM.These include inadequate financial and human resources for research,poor conservation of medicinal biodiversity;modernization;intellectual property rights of TM knowledge;lack of safety,efficacy,and quality data of medicinal products.The development and utility of TM as a resource is crucial to protect practise.Thus,the study recommends more capacity building in terms of finances,technology development,human resources training,advocacy and integration of TM into healthcare system.
基金the cooperation projects between China Geological Survey and geological survey institutions of Africa(DD20190439,DD20160108,DD20221801)。
文摘Tanzania is located in eastern Africa with a predominantly agricultural ecomomy,the potential for developing and utilizing cultivated land are promising,but scientific guidance is required.B,Zn and Se are essential micronutrients for plants and human body with crucial biological functions,in particular,Se is significant for human health and considered as“the king of anti-cancer”.As these elements required by human or plants are mainly absorbed from soil directly or indirectly,therefore,it is important to understand the contents and distributions of them in the soil of cultivated land for guiding agricultural production.In this work,low-density geochemical survey at the scale of 1∶1000000 was carried out in Tanzania,and the results show that the concentrations of B,Zn and Se in stream sediments are low and their distributions are heterogeneous.According to the distributions of geological units,the existing cultivated land resources can be divided into five regions in Tanzania.Compared with the national background values,the concentrations of B,Zn and Se are insufficient overall but enriched locally in these regions.In general,element concentrations in stream sediments and soil have a positive correlation because of their similar sources,which is essential in agriculture application.Based on the information provided by low-density geochemical data and maps,the Se-sufficient and Se-rich regions were delineated in Tanzania,where can be used to develop Se-rich industries.Finally,this paper believes that geochemical survey is a powerful tool for cultivated land evaluation,agriculture management and land development.
文摘Understanding why individuals do or do not adopt optimal water, sanitation, and hygiene (WASH) practices is critical to designing successful behavior change interventions. However, policy makers and program implementers often fail to obtain the context-specific information on behavioral determinants of WASH practices. This two-stage, randomized survey among 5000 female primary caregivers in the Lake Zone of Tanzania assessed associations between behavioral determinants and a range of hygiene and sanitation practices. Behavioral determinants of hygiene were almost always significantly associated with cleaning one’s own hands after cleaning the baby’s bottom and being able to show at least one place where family members wash their hands. In regression models, those who knew when to wash their own hands (OR = 1.8, 95% CI: 1.5, 2.1) and their child’s hands (OR = 1.5, 95% CI: 1.3, 1.7) and mothers who thought that their female friends washed their hands after cleaning the baby’s bottom (OR = 5.5, 95% CI: 4.5, 6.7) were significantly more likely to frequently clean their own hands after cleaning the baby’s bottom. This research suggests that in the Lake Zone of Tanzania, numerous determinants are associated with hygiene practices. Identifying context-specific determinants of WASH behaviors is the first step toward developing effective interventions.
文摘Introduction: Transition of care strategies have shown to improve quality of lives of heart failure patients, but it has little implemented in clinical settings. Objective: To evaluate context-specific perceived barriers and experiences of heart failure patients during their admission and after they were discharged from hospital. Methods: A cross-sectional qualitative study was conducted among 13 heart failure patients at two large referral hospitals in northwestern Tanzania. In-depth interviews among heart failure patients, in line with the Consolidated Criteria for Reporting Qualitative research checklist, were used to collect data. Interviews were audio recorded, transcribed, and translated into English. Results: Three key barriers were identified, as well as possible solutions that could improve the transition of care for heart failure patients. These include strengthening healthcare provider communications, organizing medication management, and assisting with follow-up appointments. Conclusion: The barriers identified are real and challenging in clinical resource- limited settings. Findings suggest they can be overcome when realistic and tailor-made interventions are in place.
文摘Cultivated rice (Oryza sativa L. and Oryza. glaberrima) is one of the most important food crops in the world. World rice production has increased three times since the green revolution. However, climate change and global warming effects as well as ever increasing world population will require the world to produce more rice without increasing area under rice production in order to meet those demands. The best option to overcome these challenges includes adoption of climate-smart technologies and sustainable solutions to rice production. Rice was probably introduced in Tanzania over 1000 years ago by Asian traders during trade contacts between Asia and East Africa Coast through Indian Ocean. Rice cultivation had been restricted to coastal area until 19th century when it started spreading to interior areas of Tanzania. During colonial period (1880s-1960s), the emphasis was to produce cash crops as raw materials for industrialized world. After independence production of rice increased significantly. Currently, rice is the second most important food crop in Tanzania after maize and Tanzania is the leading producer of rice in East African countries. It ranks 4th and 22nd in Africa and World respectively in terms of rice production. In this paper, the rice history, ecosystems, challenges and future perspective for sustaining rice production in Tanzania is reviewed.
文摘Like other countries in East Africa, Tanzania has been affected by extreme precipitation incidences both socially and economically. Determining the trend and variability features of extreme precipitation in the country is crucial. This study used data from 28 meteorological stations for 1981-2020 period to give an annual and seasonal analysis of the patterns of 10 ETCCDI’s extreme precipitation indices over the regions. At annual scale, the results showed that increasing trends had high frequency percentage than the decreasing ones, collecting about 76% in total. The decreasing trend was approximately 24%, and most of the stations with increasing percentage in trend are concentrated in Northern coast, Central, West, North-eastern highlands and Lake Victoria Basin. Most of the stations depicted negative trend are concentrated over Southern region. This highlights that extreme precipitation events have increased over the country for the period 1981-2020. At seasonal scale, during October to December (OND);the patterns of extreme precipitation climatic indices except R99p, showed positive significant increasing trend over Lake Victoria Basin and some Western parts of the country. In general, spatial patterns indicate decrease of precipitation over most parts of the country during OND. The seasonal average time series depicted non-significant positive trend during March to April (MAM) season, except for Consecutive Wet Days (CWD) which showed non-significant decreasing trend. Over the highest mountain in Africa, Kilimanjaro;the study has revealed significant decrease in Annual total-wet Precipitation (PRCPTOT), the number of heavy (very heavy) days of precipitation R10 mm (R20 mm) and Consecutive Wet Days (CWD) during MAM season. While the maximum one-day precipitation amount (RX1 day) was observed to decrease significantly over the Mountain during OND season. The result is very important in risk assessment and preparedness perspective in planning climate change mitigation and adaptations for different sectors like Tourism, Agriculture, Water and Energy.
文摘Introduction: Limited access to treatment is a crucial factor contributing to the suboptimal control of hepatitis B virus (HBV) infection, especially in sub-Saharan African countries such as Tanzania. The eligibility for antiviral therapy is typically determined based on the extent of HBV replication and liver damage. However, there is insufficient data available regarding the actual treatment needs and the overall characteristics of HBV-infected individuals in Tanzania. Therefore, the aim of this study is to fill this knowledge gap and provide valuable insights to aid in the planning of treatment programs. Materials and Methods: We conducted a cross-sectional study at Bugando Medical Centre in northwest Tanzania, examining the data of 340 patients who were diagnosed with chronic HBV infection and attending the hepatitis clinic. Data on sociodemographic, clinical, and investigation details were collected through electronic files and subsequently analyzed. The eligibility for HBV antiviral treatment was assessed using the criteria established by the World Health Organization (WHO). Results: Out of the 340 patients included in the study, the majorities were males 252 (74.1%) and had a median age of 36 years. Most patients came from outside of Mwanza city. Twenty-percent had significantly elevated alanine transaminase, and over one-third had high DNA levels (>2000 IU/L). The prevalences of liver cirrhosis and significant liver fibrosis were 15% and 15.3%, respectively. None of the patients were on antiviral therapy for hepatitis B. A total of 64 (18.8%) patients met the criteria for treatment eligibility. Male sex, older age, residing outside Mwanza city, and anemia (all with p Conclusion and Recommendations: The significant number of HBV-infected patients is suitable for antiviral therapy but none of them have initiated the treatment. The significance of these findings is to emphasize the need for enhancing hepatitis B services in Tanzania.
文摘Coffee (Coffea arabica L.) is a crop of major economic significance in Tanzania with annual revenue estimated at 100 Million USD. The current mean annual production of the crop is 68,000 MT of clean coffee of which 90% is contributed by about 450,000 smallholder farmers and while large estate owners contribute the rest. Antestia bug (Antestiopsis orbitalis spp.), the pest known to attack all vegetative and fruiting parts of the coffee tree with substantial yield reduction of up to 45% has been reported to occur contemporary on Arabica coffee in Tanzania, particularly in Kilimanjaro Region. Despite the reported existence of Antestia bug and its damages that badly inflict on the productivity and quality of coffee, the pest status of the bug in Tanzania has never been established. The present study examined the incidence damage severity of Antestia bug in the Arabica coffee fields in major producing regions of Kilimanjaro, Ruvuma and Songwe. A stratified sampling of 360 coffee farms was done on which the Antestia bug incidence and severity were recorded. Results suggested that all regions were infested and the shade intensity influenced the pest incidences with the highest severity record in Kilimanjaro and the least affected was Songwe Region. Dense shade had the highest Antestia bug incidence than sparse shade canopy (p < 0.001). The current study sheds insights into understanding the pest status of Antestia bugs on Arabica coffee in Tanzania which could be used in designing effective management strategies. .
文摘Background: Tuberculosis (TB) diagnostics, such as Xpert MTB/RIF, is still limited by cost. Testing of pooled samples from presumptive TB patients has been thought as a cost-saving strategy to diagnose TB. We assessed the utility and cost-saving of pooled Xpert MTB/RIF testing strategy for the diagnosis of TB in Mwanza, Tanzania. Methods: Sputum samples from Presumptive TB patients were submitted to TB laboratory for routine diagnosis of TB using Xpert MTB/RIF. The TB results from the individual sputum samples were used as the reference standard and were concealed to the investigating laboratory technicians. The remainder of samples were collected serially and were pooled (5 samples per pool) for testing. The agreement of the results between individual sample testing against pooled sample testing and cost-savings was assessed. Results: A total of 250 sputum samples from presumptive TB patients were analyzed and 50 pools were made with each pool containing 5 samples. Of the 50 sputum pools made, Mycobacterium tuberculosis (MTB) was detected in 17 (34.0%) pools. Results from the individual sputum samples MTB/RIF testing were retrieved for all 250 samples and there were 28 (11.2%) samples in which MTB was detected whereas 222 (88.8%) samples had no MTB detected. Following re-analysis of positive pools, all 28 (100%) individual positive MTB samples were detected within the 17 positive pools, with 1 to 3 individual MTB positive samples per pool. The individual sputum samples were correctly identified by pooled sputum on Xpert MTB/RIF testing, with the sensitivity of 100% and specificity of 100%. Using pooling of sputum samples strategy, we saved 46.0% (115/250) of the cartridges. Conclusion: The pooled sputum testing strategy reduced cartridge costs by 46.0% and has the potential to increase the affordability of Xpert MTB/RIF testing in countries with limited resources, such as Tanzania.
文摘Introduction: The burden of chronic kidney disease (CKD) is rapidly increasing in Tanzania. There is a rapid expansion of hemodialysis (HD) services to meet this demand. The quality of HD services, which is usually termed HD inadequacy, is under-reported. Therefore, the objective of this study was to determine the prevalence of HD inadequacy using two equations, urea reduction ratio (URR) and Kt/V and its associated factors. The correlation between URR and Kt/V for the diagnosis of HD inadequacy is also determined. Materials and Methods: This was a prospective longitudinal study conducted from March to July 2021 in 98 patients with CKD who underwent maintenance HD at Bugando Medical Centre in Mwanza, Tanzania. Demographic, laboratory, and clinical information was collected and analyzed. The HD inadequacy was estimated by using both the URR and the Kt/V equations. The correlation between the two equations was analyzed by using Cohen’s kappa. Results: The majority (69.4%) of the study participants were male and the mean age was 59 (48 - 68) years. The median hemoglobin level was 10 (8.9 - 11.2) g/dl, and the pre-dialytic urea was 15 (10.6 - 21.3) mmol/L. The prevalence of HD inadequacy was 36 (36.7%). The predictors of HD inadequacy were older age (>50 years) (OR = 3.6, 95 % CI 1.0 - 12.6, p = 0.04), moderate or severe anemia (OR = 4.7, 95 % CI 1.5 - 14.4, p = 0.006) and short duration of HD (OR = 3.1, 95 % CI 1.0 - 9.1, p = 0.04). There was a strong agreement between URR and Kt/V in the diagnosis of HD inadequacy (Kappa = 0.887). Conclusion and Recommendations: HD inadequacy is common, and most predictors can be prevented. Clinicians should use a personalized approach in making sure that anemia is appropriately treated and HD prescription is adhered to for better clinical outcomes among patients with HD.
文摘Worldwide obstetric hemorrhage remains the leading cause of maternal mortality, accounting for over one quarter of maternal deaths. Over half of these deaths occur in Sub-Saharan Africa with mortality rates of 500 - 1000 per 100,000 births, compared to approximately 5 - 10 in developed countries. Over decades in Sub Saharan Africa preventive measures and treatment protocols have been made to reduce maternal mortality caused by PPH. While rates of postpartum hemorrhage have continued to rise, there is a need to evaluate if its etiology and patterns have changed over time. Broad Objective: This study aims at describing trends in incidence, causes and maternal outcomes of Postpartum Hemorrhage at Muhimbili National Hospital for a period of 7 years. Methodology: This is a retrospective descriptive hospital-based study that has included all cases of postpartum hemorrhage at Muhimbili National Hospital, a tertiary hospital in Tanzania from 2014 to 2020. The data was analyzed using SPSS Version 26 and presented using frequency tables, figures and percentages. The trends of postpartum hemorrhage over time were determined using chi-square test and P-value where less than 0.05 was considered statistically significant. Results: Overall, the incidence of postpartum hemorrhage has been fluctuating over the years with minimum of 1.78% and maximum of 2.87% with no statistical significance. Out of 1113 enrolled cases of PPH, 422 (37.9%) were attributed to genital tears followed by uterine atony 285 (25.6%). A statistically significant increase in linear trend was observed in the postpartum hemorrhage cases due to uterine atony, uterine rupture and sub analysis on genital tears (cervical tear). Overall, there was a statistically significant change in trend of maternal outcomes throughout the years, with a P-value < 0.001 and likelihood of complications increasing over time. Conclusion: The trend in the incidence of postpartum hemorrhage has been fluctuating over the years during the study period. The leading cause of postpartum hemorrhage was genital tears, followed by uterine atony with a significant increase in adverse maternal outcomes over the years. Continuous health education to medical personnel to improve timely and proper diagnosis of women in danger of PPH and timely referral, thus improve maternal morbidity and mortality.
基金supported by the research funding agencies of Denmark,Iceland,Norway and Sweden,and the Swedish Museum of Natural Historyfunded by an NRF-NEP grant(No.93208)
文摘We present new U-Pb and Hf zircon isotope data on a suite of granitoids from a hitherto unstudied area of the Palaeoproterozoic Lupa terrane of the Ubendian belt in SW Tanzania.The major part of the area comprises a sequence of upper amphibolite grade paragneisses and migmatites.Subsequently,the field relations show a complex history of granitoid emplacement from early pre-tectonic strongly foliated diorite-tonalite-granodiorite orthogneiss to late tectonic,weakly deformed ellipsoidal granitoid plutons.These were followed by emplacement of undeformed K-feldspar rich porphyritic alkali granite.U-Pb zircon data on the granitoids show their emplacement ages span the period^1925 Ma to 1890 Ma and constrain the culmination of the Ubendian orogeny in the Lupa terrane to about 1900 Ma.The undeformed K-feldspar rich Chimala granite,previously considered to be unconformably overlain by the Buanji Group volcano-sedimentary rocks(recently shown to be^1675 Ma,not Neoproterozoic as originally thought)was dated at^1407 Ma showing that it must intrude the sedimentary rocks,although the age relationships are not exposed in the mapping area.This is the first record of early Irumide/Kibaran-aged post-tectonic granites in this part of East Africa.Hf isotope data from the zircons show that the granitoids have a long crustal pre-history stretching back to as far as^3.9 Ga,and showing that the Lupa terrane may form part of the"metacratonic"margin of an originally much more extensive Tanzania Craton.
文摘The analysis of available Nd isotope data from the Tanzania Craton places important constraints on the crest-mantle separation ages,and events marking juvenile crustal addition and crustal recycling.Nd model ages date the oldest crust extraction to 3.16 Ga in the Tanzania Craton,although a rock record of such antiquity is yet to be found there.The most significant period of juvenile crustal addition as well as crustal recycling is 2.7-2.6 Ga.The Nd isotopes of marie samples show that chemical heterogeneity existed in the mantle beneath the Tanzania Craton,with some samples originating from significantly depleted mantle, and most samples originating from the mixture of primitive mantle and depleted mantle.The Nd isotope section reveals significant differences in Nd isotopes between the north eraton and central craton;compared to the north craton,the central craton yields a Nd model age that is approximately 100 Ma older, and its εNd(t)values are more negative,indicating that the two parts of the craton have different mantle source regions.Different types of granitoids are distributed in the Tanzania Craton,such as high-K and low-Al granite,ealc-alkaline granite,peraluminous granite and transitional types of tonalite-trondhjemite- granodiorites (TTGs).Most of the granitoids formed later than the marie rocks in syn-collision and postcollision events.
文摘Climate variability and change are among the biggest challenges of the 21st century. Like in many other areas globally, the coastal communities of Tanzania have always been facing climatic variability at various time scales. Using focus group discussion and a household survey, this study analyzes the perceptions of climate variability and change and the strategies for coping and adaptation by the selected coastal rural and peri-urban communities in Tanzania. The perception of climate variability and change is complemented with the time-series analysis of rainfall and temperature data from Julius Nyerere International Airport Met. station and Kisarawe using Instant Statistical Software. Results indicate that households are aware of climate variability and identify indicators of climate change and variability as being decreasing rainfall trends, increasing incidences of droughts, unpredictable rainfall patterns, disappearance of wetlands and failure to predict on-set of rainy season using traditional knowledge. Households primarily attribute reduced crop yields to changes in rainfall pattern and increasing incidences of drought leading to soil moisture stress. The implications are that the agriculture dependent households are now food insecure. As a way of coping to the observed changes, the coastal communities among others have shifted to production of high value horticultural crops and use of forest resources. Nevertheless, the increased use of forest resources is threatening the existence of coastal forests and contributes to the decline of forest resources and disappearance of wildlife in the forest reserves. It is concluded that the communities studied are aware of climate issues as revealed from perceived indicators of climate variability and changes. The results from statistical analysis of 30 years climatic data are consistent with community’s perception of climate variability and change. The study recommends examining the present coping strategies for the sustainability of the coastal forests and in designing of alternative adaptive strategies such as alternative energy options, crop diversification and environmental friendly activities such as beekeeping.
基金funded by the former UK Department for International Development(DFID)through China International Development Research Network(CIDRN)Research Grants(20200105)。
文摘Irrigation system is a scare resource in most of drought-stricken Africa.How to manage and maintain the existing irrigation facilities in Africa is a debatable issue to both policy makers and beneficiaries.Irrigation facilities run by farmer cooperatives are considered ineffective,unsuccessful and dysfunctional in Tanzania by many researchers.A cooperative irrigation scheme is a mechanism that features the collective management of rural irrigation facilities by farmers'cooperative with some government intervention and external support.There is an increasing emphasis on the roles of cooperative irrigation scheme in the development of the agriculture sector and poverty reduction of smallholder farmers.In this study,the authors investigated the management and services of this scheme and analyzed its contribution to poverty reduction of smallholder rice farmers and community development in Tanzania through both quantitative and qualitative methods.The results showed that the scheme helped smallholder farmers increase the rice production and brought better market opportunities.The farmers'net income was also increased.Profit generated from rice farming not only improved the livelihoods of smallholder farmers but also created more employment opportunities in the rural communities.The research also revealed that the scheme was faced with a number of challenges due to resource and institutional constraints and low-level human capacity for both management and members.The research provides a feasible approach to effective management of small-scale agricultural infrastructure for poverty reduction in Africa.
