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Determinants of timely uptake of ITN and SP (IPT) and pregnancy time protected against malaria in Bukoba, Tanzania
(BMC research notes, 2016) Protas, Joyce
Objective: Insecticides treated nets (ITNs) and intermittent preventive therapy with two doses of sulfadoxine pyrimethamine (SP IPTp) are the cornerstone for malaria control in pregnancy. Despite the coverage of these interventions being high, it is not known whether they confer optimal protection time against malaria in pregnancy. This study investigated the timing and determinants of timely uptake of SP(IPTp) and ITNs and the pregnancy time protected. Methods: A health facility based cross-sectional study was carried out in Bukoba urban district from 16th April to 29 May 2013. Involving pregnant women and post natal mothers attending Reproductive and Child Health (RCH) clinics. Data on their socio-economic background, pregnancy history and attendance to RCH, receipt of a voucher and acquisition of an ITN as well as SP for IPTp were collected. Their responses were validated from the records of antenatal cards. Data was analysed using SPSS computer program version 20. Results: A total of 530 mothers were recruited. The overall uptake of SP IPTp was 96 % and the uptake of two SP (IPTp) doses was 86 %. Timely uptake of 1st dose was predicted by early antenatal booking, [AOR 2.59; 95 % CI 1.51–4.46; P = 0.001], and the availability of SP at the facility [AOR 4.63; 95 % CI 2.51–8.54; P < 0.0001]. Uptake of 2nd dose was independent of any predictor factors. A total of 486 (91.6 %) women received ITNs discount vouchers at different gestational age and of these, less than a quarter (21.4 %) received timely. Timely receipt of discount voucher was highly predicted by early antenatal booking [AOR 200; 95 % CI 80.38–498; P < 0.0001]. Conclusion: Although there is a high coverage of SP IPTp and discount vouchers for ITNs, timely uptake and therefore optimal protection time depended on early antenatal booking, the availability of (SP IPTp) and discount voucher at the health facility.
HIV retesting among pregnant women with gestational age of 36 weeks or higher attending antenatal clinic at Temeke regional referral hospital, Tanzania
(Tanzania Medical Journal, 2022-06-15) Protas, Joyce
Abstract Background Although Tanzania has set a target of 90% Human Immunodeficiency Virus (HIV), retesting among pregnant women, the rate of re-uptake is still low despite the service being free of charge. This study determined HIV retesting among pregnant women with the gestational age of 36 weeks or higher attending the antenatal clinic at Temeke Regional Referral Hospital. Methods The cross-sectional study design was used. The data was collected from 12th October 2020 to 9th November 2020 in Temeke regional referral Hospital. Two hundred pregnant mothers attending the Reproductive and child health clinic (RCH) clinic who had a gestational age of 36 weeks or above and tested HIV negative from the first test were included. The demographic and obstetrics information were collected by using a structured questionnaire. The descriptive and factors analysis was done by using SPSS version 20. The Chi-square test determined the relationship between variables, and the P-value of less or equal to 0.05 was considered statistically significant. Results The percentage for re-uptake of second HIV test was 30% (60/200). Out of 60 who repeated the test, 6.7% (4/60) were HIV seroconverted. Factors associated with re-test were being married (p-value 0.05, X2=7.8), being self-employed (p-value is 0.00 , X2=18.838 ) ,four and above antenatal clinic visit (p-value is 0.003, X2=11.737 ) ,having knowledge of repeating (p-value is 0.00 ,X2=59.294) , multiparty ( p-value is 0.015 ,X2=8.334 ,positive perception during the first test (p-value is 0.044, X2= 4.039) ,maternal age of 25-29 years old (p-value is 0.053, X2= 10.901) ,and having access to radio and television (p-value is 0.04, X2= 6.442). Conclusion The proportion of HIV retesting was 30%, and factors associated with retesting were being married, being self-employed, more than four ANC visits, multiparity, having knowledge about retesting, and positive perception during the first test.
The partten and management outcome of gastric and intestnal foreign bodies in children seen at Muhimbili National Hospital
(East and Central African Journal of Surgery, 2015) Protas, Joyce
Background: Finding an ingested sub-diaphragmatic foreign body in paediatrics is common and represents a considerable nervousness to parents. The vast majority is expelled uneventfully within one week of ingestion, however, sometimes can lead to complications and mortality. The purpose of this study was to explain the pattern of ingested gastric and intestinal foreign bodies, its management and outcomes in children at Muhimbili National Hospital. Methods: A prospective cross-sectional study was conducted in the paediatric surgery unit from April 2012 to October 2013 to children below 10 years of age using a structured questionnaire. Symptoms free children were discharged for observation at home and symptomatic children or with risky objects were planned to be cared in the hospital. Results: A total of 33 children were studied, Boys being 72.7% (24/33), M: F=2.7:1. The under 5-years were the majority (78.8%, 26/33). The commonest ingested foreign bodies were Coins (42.4%, 14/33), Nails (18.2%, 6/33) and screws (12.1%, 4/33). The mean length of ingested foreign bodies was 2.47 centimeters (±0.56 SD). The transient time was less than one week in the majority of children (90.9%, 30/33). The average transient time was 4.1±0.05 SD days. All children passed theirs foreign bodies under observation at home uneventfully. Conclusion: Foreign bodies risk of ingestion is high in under fives and conservative observational treatment is successful in the majority.
Prevalence and factors associated with late antenatal care visit among pregnant women in Lushoto, Tanzania
(Tanzania Journal of Health Research, 2017) Sariah, Adellah; Protas, Joyce
Background: Adequate utilization of antenatal health care services is associated with improved maternal and neonatal health outcomes. The World Health Organization recommends pregnant women to attend antenatal care services as early as in the first trimester. However, many women due to various reasons fail to meet the recommendations. The objective of this study was to determine the prevalence and factors associated with late antenatal booking among pregnant women in Lushoto district of north-eastern Tanzania. Methods: This hospital based cross sectional study involved pregnant women and was conducted in August-September 2015. A standardized questionnaire was used to obtain participants demographic characteristics and obstetrics history. Data analysis was done using (SPSS) and relationship between outcome variables and exposure variable was done using Chi-square test. Multivariate logistic regression was used to measure the association. Results: A total of 240 participants were involved in the study. Out of these, 169 (70.4%) participants booked late for antenatal care (ANC) services. Delayed booking was mainly associated with not being married (AOR=3.08; 95%CI 1.149-8.275; P value=0.025) and unemployment (AOR=4.28; 95% CI 2.11-8.679; p-value=0.000) Conclusion: Late first antenatal clinic visit was high in Lushoto, and was highly associated with unmarried and unemployment status. Therefore, provision of continuous health education and community sensitization on the importance of timely seeking ANC services should be strengthened.
Prevalence and factors associated with neonatal sepsis among neonates in Temeke and Mwananyamala Hospitals in Dar es Salaam, Tanzania
(Tanzania Journal of Health Research, 2016) Protas, Joyce; Semiono, Avelina; Sariah, Adellah
Background: Neonatal sepsis contributes significantly to neonatal mortality. This study was carried out to determine the prevalence and factors associated with neonatal sepsis in Dar es Salaam, Tanzania. Methods: A hospital based cross-sectional study was conducted at Mwananyamala and Temeke hospitals in Dar es Salaam, during August-September, 2015. A standardized questionnaire was used to obtain demographic, obstetrics and clinical information. Diagnosis of neonatal sepsis was done clinically. Relationship between outcome variable and exposure variable was done using Chi square test. Multivariate logistic regression was used to measure association after controlling for confounders. Results: A total of 220 neonates were recruited, 69 (31.4%) had sepsis. The risk factors associated with neonatal sepsis were maternal age of >35 years (AOR=6.7; 95%CI 2.1-20.1; p-value-0.001) and resuscitation at birth (AOR=1.25195%CI1. 22-3.88; p-value=0.025). Conclusion: Neonatal sepsis among neonates in Dar es Salaam is associated with maternal and health services related factors. The findings underscore the importance of routine assessment and close monitoring of neonates. It is therefore recommended to have more skilled health personnel and advanced equipment while providing maternal and new-born health care services.
Surgical Site Infection among Patients Undergone Orthopaedic Surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania.
(East and Central African Journal of Surgery, 2017) Protas, Joyce; Semiono, Avelina; Mika, Elizabeth Z.; Sariah, Adellah
Background: The aim of this study was to determine prevalence and factors associated with surgical site infection at Muhimbili Orthopedic Institute. Method: This was a cross-sectional study conducted at Muhimbili Orthopaedic Institute (MOI) in Dar es Salaam, from August, 2015 to October 2015. Convenience sampling technique was used to recruit postoperative patients for this study. Standardized questionnaires were used to obtain demographic, social, and clinical information from respondents. Determination of the relationship between outcome and exposure variables was done using chi square test. Multivariate logistic regression was used to measure the association after controlling for confounders. Odds ratio corresponding to 95% confidence interval with a p value of ≤ 0.05 was considered significant. Results: Out of 300 study participants 75(25.0%) had surgical site infection. This was highly determined by more than 2 hours length of surgical procedure (AOR= 1.4; 95%CI 1.14-6.69; P value=0.05), none prophylactic use of antibiotics (AOR= 3.4; 95%CI 1.6-7.78; P value=0.03), more than one week stay before surgery (AOR=3.3; 95%CI 2.24-3.34; P value =0.00). Conclusion: The overall prevalence of surgical site infection at Muhimbili Orthopedic Institute was high. This was associated with more than 2 hours length of surgery, lack of prophylaxis use, and pre-operative hospital stay.

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