University of Dar es Salaam School of Health Sciences

Permanent URI for this community

http://192.168.13.253:4000/handle/123456789/5941

Back to the main page

Browse

Now showing 1 - 9 of 9

Acceptance of counseling HIV testing and prophylactic use of Nevirapine in labour and immediate puerperium at Muhimbili national hospital, Tanzania.
(University of Dar es Salaam, 2005) Ngarina, Matilda Michael
Background: Mother to child transmission contributes significantly to the incidence of HIV in our country. A PMTCT program exists in MNH and some surrounding public hospitals since 2000. In spite of this it has been observed that a substantial number of women delivering at MNH have not had VCT and therefore are not benefit from the PMTCT intervention. Objective: To determine the acceptance of counseling, voluntary HIV testing and prophylactic use of Nevirapine among pregnant women during labour / immediate postpartum at Muhimbili National Hospital. Methodology: Study setting: The labour ward of Muhimbili National Hospital. Study design: Descriptive Cross-sectional study. Study population: All pregnant women delivering at MNH during the study period of 3 months. (12thAugust-4thNovember 2004) Sample size: 885 women with unknown sero-status and 355 women who were sero-negative more than 3 months prior to delivery. Data collection: Trained counselors invited all women who met inclusion criteria as they were admitted. Women who accepted counseling were taken to private rooms for discussion and those who consented were screened for HIV using rapid tests. Direct observed therapy with Nevirapine was done. Data was filled in a structured questionnaire. Results: The overall acceptance of pre-test counseling in labour among women with unknown sero-status was 71.7%, and voluntary HIV testing 56%. Among women with unknown sero-status who accepted pre-test counseling in labour, 78.9% accepted HTV testing and 8.6% of these were diagnosed to be HIV infected. The overall acceptance of pre-test counseling in labour among those who were sero-negative more than 3 months prior to delivery was 70.5% while that of counseling and voluntary HIV testing was 64.1%. Ninety-one percent of women in this group accepted HIV testing in labour ward and 6% were diagnosed to be HIV infected. Eighty-three percent of women diagnosed to be HTV infected from the unknown sero-status group accepted NVP while all HTV infected women from the group of women who were initially sero-negative accepted prophylactic Nevirapine. Conclusion and recommendation: The results of this study show that HIV testing during labour and use of prophylactic ARV is acceptable in our setting. Acceptance of counseling, testing and use of NVP was higher among women who had HTV test during antenatal period compared to women who were admitted with unknown serostatus. Women with unknown serostatus in labour and those with a negative test more than three months prior to admission in the labour ward should be offered counseling and testing services in order to prevent MTCT of HIV.
Clinical characteristics of sputum smear negative pulmonary tuberculosis: the association with HIV infection.
(University of Dar es Salaam, 2002) Swai, Hedwiga Francis
Background: There have been a massive increase of Pulmonary Tuberculosis(PTB) that has threatened to undermine achievements that have been gained by National Tuberculosis Control programs(NTLP) in most Sub-Saharan Africa. This increase is due to widespread of infection with Human Immunodeficiency Virus (HIV). The diagnosis of PTB in HIV infection is made difficult in the increased presence of sputum smear negative tuberculosis. Objectives:To determine clinical and laboratory features of smear negative but culture positive PTB and the relationship of these features to HIV-1 sero-status. Methodology: Study site: The study was carried out at Muhimbili National Hospital and outpatient Tuberculosis clinics of IDC, Ilala and Mwananyamala, in Dar-es-salaam Tanzania. Study subjects: Male and female patients aged 18 to 75 years who presented with more than two weeks history of cough, but had three negative sputum smears for AFB were recruited in the study. Procedures: For patients with sputum smear negative, sputum was sent for culture. Counseling and HIV testing was done to all consenting recruited patients. A chest X-ray, mantoux test, and FBP were done to each patient. Those found to have features highly suggestive of PTB received treatment according to the NTLP guidelines. The remaining received a broad-spectrum antibiotic. Results: 467 fulfilled the inclusion criteria, 127(27.2%) had sputum culture positive for Mycobacterium tuberculosis. Of the 127sputum culture positive subjects, 66(51:9%) were correctly treated with anti-TB and 61(48.1%) were missed and did not get anti TB. Of the 286 subjects who had sputum culture negative, 107(37.4%) were wrongly treated with antiTB and 179(62.6%) received antibiotics. HIV perse is not a predictor of culture positive. The presence of a dry cough, a high respiratory rate, a low eosinophil count, a mixed type of anaemia and presence of a cavity were found to be predictive of smear negative but culture positive PTB. Conclusion: A third of patients who are investigated for PTB and found to have sputum smear negative results have active disease when sputum culture is done. The current practiced procedures of establishing PTB diagnosis are not sensitive enough to establish the correct diagnosis of TB. They under diagnose PTB and over treat people with no PTB.
Determinants of adherence to heart treatment among HIV patients in Mbeya region, Tanzania.
(University of Dar es Salaam, 2006) Rwehumbiza, Patrick Rweikiza
Background: High level of Highly Active Antiretroviral Therapy (HAART) adherence (>95%) is required for a patient to have a significant decrease in viral load. HAART non-adherence has been associated with higher risk of developing resistant strains of HTV that may necessitate changing the regimen to a second line, which is costly. Objective: The aim of the study was to determine the level of adherence to HAART and its determinants among HTV patients attending treatment in Mbeya Region. Specifically, the study determined how adherence is influenced by the patient’s knowledge on HIV, use of alcohol, serostatus disclosure, perception on severity to the disease, the discrimination by the family members and side effect of the drugs. Methods: Cross-sectional study was conducted involving a total of 268 HIV patients who were attending three HAART clinics in three rural hospitals of Tukuyu, Igogwe and Kyela in Mbeya Region, Tanzania, for at least three months prior to interview. An assessment of adherence among HAART users who 15 years were or older was done using a two weeks recall and one month pill count. Data were collected through a structured questionnaire; with open and closed questions. Data were entered into Epi info version 6 software and analyzed using the same software. Results: Of the 268 respondents, 125(46.6%) were males and 143(53.4%) were females. Their mean age was 36.2 years, range from 15 to 62 years, standard deviation of 8.2 years, and 74% of the patients above 30 years. Of all the respondents, 42.2% were married with proportion of males (62.4%) greater than females (24.5%) Thirty five percent of the patients (34.7%) interviewed were not adhering to treatment. Among those who had high perception on severity of HIV/AIDS, 13.9% of them missed the dose as compared with 31.1% of those whose perception was low. Among those who developed side effects 30.9% reported they had missed their dose compared to 10.7% who had no side effect and did not miss the dose Conclusion: The reasons given for non-adherence to treatment were perceptions of severity about HTV/AIDS, long waiting time at the clinic, discrimination at the family and community level and fear of side effects of the drugs. Therefore it is recommended that, patients should be educated on the possible side effects that can occur during treatment and that they should not stop taking the drugs against medical advice; this should be done at all levels from the Doctors, Nurses and dispensers. Continuous sensitization and education in the community to reduce stigma and misconception is required. Time motion studies should be done to assess why there are long waiting times at the hospitals. Patients should be encouraged to take their drugs when they go for their daily activities. Counseling has been shown to improve adherence and therefore this should be emphasized and maintained in all clinics.
Factors predisposing primary school teachers to risk of sexually related HIV/AIDS infection in Singida rural district
(University of Dar es Salaam, 2004) Mremi, Amos E
The risk of sexually transmitted HIV/AIDS among primary school teachers has been expressed by researchers in various parts of sub Saharan Africa. Mortality among teachers due to AIDS and AIDS related conditions has been reported to be high including here in Tanzania. A few studies have been conducted in Tanzania regarding HIV/AIDS among primary school teachers. Similarly minimal publications concerning factors predisposing the teachers to sexually related HIV/AIDS are available. This study therefore, focused on the important factors which if worked upon will reduce HIV/AIDS among the teachers, other professionals and the general population. The broad objective was: - To determine the behavioural and Economic factors predisposing primary school teachers to risk of sexually related HIV/AIDS infection in Singida rural district. The specific objectives of the study aimed at determining whether level of knowledge, attitude and behaviour, as well as economic status predispose the primary school teachers to sexually related HIV/AIDS. A cross sectional descriptive study was conducted during the period May - August 2004 where the study population comprised of primary school teachers from 42 selected primary schools as the main elements, and the education administrators and community members for provision of supporting information . Multistage cluster sampling was used to select the wards and the primary schools. All primary school teachers found in respective selected schools during data collection were involved in the research. A total of 377 teachers were researched. Forty five education administrators and 39 community members were also researched. Data collection tools included close and open ended questionnaires and an interview guide. Ethical clearance was ascertained before starting data collection. Data analysis was through EPI6 computer program where appropriate statistical tests were carried out. It was found that 90.2% of all teachers interviewed were highly knowledgeable about AIDS infection, transmission and prevention. 3.7% had negative attitude against preventive measures more of them being males than females. 54.6% of respondents expressed high risk sexual behaviour with respect to spreading of HIV/AIDS. On economic status 80.1% of the teachers expressed inadequate income and 36.3% of them depended upon their sex partners for income support, majority of them being females. In conclusion, the main factors predisposing primary school teachers to sexually related HIV/AIDS are behavioural, that is attitude and behaviour, and economic constraints. It is recommended that the school HIV/AIDS programme be reviewed to target both the pupils and their teachers with focus on both raising awareness and behavioural change communication, and on economic issues. All teachers should be persuaded to enroll in the Savings and Credit Society so that they can get loans to relieve their deficits.
Knowledge and practice on utilization of HIV care and treatment data at health facility by healthcare workers in kahama district
(2016) Omary, Siwajibu
In Tanzania, HIV/AIDS remains a major public health problem with enormous impact on human health and socio-economic development. Information system is increasingly important for measuring and improving the quality and the coverage of health services. Timely and reliable health information is important for both operation and informed decision making. Despite of the existing guidelines, trainings and resource allocated to monitoring of HIV care; still there are little promising utilization of HIV care related data at health facility level. The general objective of the study was to assess documentation and utilization of HIV care and treatment data at the health facility by health care workers in Kahama district. Cross-sectional research design was used in this study. The sample size included 37 respondents. Data collected were processed and analysed by Statistical Package for Social Science (SPSS) computer software. The findings indicated that data were taken in routine as well as non-routine basis. Yet, there is a problem on knowledge and practice on utilization of HIV care and treatment data by healthcare workers. Further, 31 of respondents reported that there has been an interrupted network system that goes hand in hand with lack of reliable infrastructures. Furthermore, 26 of respondents reported that there has been a lack of proper data analysis tools in some facilities that undermines the provision of services. The district councils should facilitate the availability of fulltime healthcare workers at the CTC and need enough time to support healthcare workers on coaching and mentoring on data use and data management and provide regular feedback to healthcare workers.
Knowledge, perception, attitudes and practices of safer sex among youth in Moshi rural district, Kilimanjaro region
(University of Dar es Salaam, 2003) Moshi, Sisty Joseph
Safer sex is considered to be the best way to fight against the growing pandemic of HIV/AIDS among youth in Africa. Good knowledge, appropriate perceptions and attitudes towards safer sex methods are the cornerstone for the practice of safer sex among youth. To assess the knowledge, perceptions, attitudes and practices of safer sex among youths in Moshi rural district Kilimanjaro region Tanzania, 264 unmarried youths in Moshi rural district were interviewed in June 2003. In this study it was found that 99.6% of the respondents were aware that HIV is transmitted through sexual contact. Practice of various methods of safer sex was significantly low. Only 62.1% of the respondents had ever used a condom among which only 16.7% were using condoms consistently. Also 52.3% had had two or more sexual partners. However although the majority of the youth agreed strongly that methods of safer sex can help to reduce HIV transmission, the majority also admitted that they are difficult to practice The proportion of the respondents who had correct knowledge, attitudes, perceptions and practices with regard to safer sex was much higher among those with secondary education compared to those with primary education and those with no formal education. Also was much better in those above 20 years of age. Sex and religion of the respondents had no significant effect on the measured issues. It seems AIDS activists still have work to do to bridge the gap between knowledge and practice of safer sex.
The prevalence and characteristics of cardiovascular disorders in children infected with Human immunodeficiency virus type 1 (HIV-1) at Muhimbili National Hospital.
(University of Dar es Salaam, 2002) Kubhoja, Sulende D.M.
Introduction and review of Literature The prevalence and characteristics of HIV cardiac disorders vary from one area to another and these have seldom been elucidated in African children. The cardiac disorders include disturbances of rhythm, pericardial effusions, cardiomyopathies, endocarditis, arteriopathies and other cardiac disease. Study objective To determine the prevalence and characteristics of cardiovascular disorders infected with Human Immunodeficiency Virus type 1 (HIV-1). Study design A cross-sectional comparative hospital based study. Setting The study was conducted in the General Paediatric wards and General paediatric outpatient elinics of Muhimbili National Hospital (MNH) in Dar es Salaam, from April 2001 to January 2002. Subjects A total of 280 children aged between 18 months to 7 years who were admitted in the wards or seen at outpatient clinic, were recruited for the study. Methodology All children aged between 18 months to 7 years attending paediatric outpatient clinics or admitted to MNII medical Paediatric wards whose parents/ guardians consented the study and for HIV testing were enrolled for study. A thorough history and physical examination was done on recruitment. All children who tested negative for HIV infection formed the comparable group. Both groups were further subjected to cardiovascular assessment including chest X-Ray, Electrocardiogram and echocardiogram. Main outcome measures The main outcome measures were the magnitude and characteristics of cardiovascular disorders among the two studied groups. Results The overall prevalence of cardiovascular disorders was 83/280 (29.6%). The prevalence of cardiovascular disorders in HIV infected children was higher at 36/78 (46.2%) compared to 47/202 (23.3%) in HIV uninfected children. The difference was statistically significant in the two studied groups, p=0.00017. The common cardiac disorders strongly associated with HIV- infected children were; pericardial effusion 26.9%, Left ventricular dysfunction 24.7%, cardiomyopathy 24.4% and tachycardia 20.5%. Conclusions and Recommendations 1. Cardiovascular disorders are common among HIV-I infected children at MNH. 2. Echocardiogram was the most important tool in diagnosing cardiac disorders. 3. Cardiac disorders in HIV-I positive children were similar to those reported in other centres. 4. It is recommended that a thorough cardiovascular evaluation including Echocardiogram should be done in HIV infected children so as to diagnose cardiac disorders easily and ofer better management.
Utilization of HIV VCT services and associated factors, among soldiers in Tanzania people's defense forces in Dar es Salaam, Tanzania
(University of Dar es Salaam, 2006) Mekere, Josiah Mwita
Voluntary counseling and testing (VCT) has been shown by researchers to reduce high risk behavior, prevent HIV transmission and make HIV prevention more cost effective by providing clients with appropriate linkages to care, treatment and support services. However, the VCT services have not been met with encouraging uptake, both in the general population and in the militaries. Very little is known about the level of utilization of VCT services among soldiers in TPDF. Objective: the study aimed at exploring the rate of utilization of VCT Services and associated factors among soldiers in the Tanzania Peoples’ Defense Forces in Dar-es- Salaam area. Methods: An analytical cross-sectional study using quantitative methods was conducted in the TPDF camps in Dar-es Salaam area in June - July 2006 to explore factors associated with VCT services utilization among soldiers in TPDF. A total of 390 soldiers of different ranks, randomly sampled (from Infantry, Navy and Air defense) were interviewed.
Voluntary HIV/AIDS counseling and testing (VCT) services among university students the Case of University of Dodoma and University of Dar es Salaam
(University of Dar es Salaam,, 2017) Msangazi, Vitus David
The study investigated factors associated with low utilization of Voluntary HIV/AIDS Counseling and Testing services provided to students at the University of Dodoma and the University of Dar Es salaam. It was conducted among undergraduate students. A survey design was deployed in undertaking the investigation. The study adopted a mixed research paradigm where qualitative and quantitative approaches were deployed. A simple random sampling method was used to select the participants for the survey and a total of 768 students were involved of which 384 were selected from each university and respondents were selected for the qualitative interviews using a purposive sampling approach. The study results indicate low awareness among students on the availability of VCT services within the campus area. It was revealed that there was low utilization of on campus VCT services associated with poor motivation and inadequate time that students have due to studies’ schedule. However, more than half of participants indicated positive perception toward VCT services. Furthermore, the study revealed that there was low awareness of the available voluntary HIV counseling and testing services since only45.5% of participants declared to be aware of the availability of on campus services despite the fact that service providers declared to have been providing information to students for the purpose of increasing awareness. Based on the findings the study recommends the Ministry of Health, Community Development, Gender, Elderly and Children to create friendly environment to young people to feel free to use services that are available but also it should provide guideline to service providers on how to reach students (outreach programs).University administrations should integrate VCT services and other health and HIV programs into day to day activities at the campuses. Further studies should be conducted to explore services and innovative techniques to attract VCT services utilization to students. Furthermore other sources of information that are appropriate to the environment should be innovated for the purpose of increasing awareness of students on the available VCT services at their campuses.

Browse

Browsing University of Dar es Salaam School of Health Sciences by Subject "Aids (Disease)"

Results Per Page

Sort Options