East African Journal of Public Health

Prevalence of hoarseness of voice and associated symptoms among primary school teachers in Ilala Municipal, Tanzania

Enica Richard — 2024-06-28

Background: School teachers are at risk of developing hoarseness of voice due to excessive vocal use. The estimated global prevalence of hoarseness of voice is between 11% and 81% with an incidence rate of about 4 new cases per 1000 teachers per year. Most of the contributing lifestyle and work-related factors include years of teaching, grade being taught, and the number of teaching hours. The study aimed to determine the prevalence of hoarseness of voice and associated symptoms among primary school teachers in Ilala Municipal, Tanzania.

Methodology: A cross-sectional descriptive study that was conducted among primary school teachers in Ilala Municipal, Tanzania, using a quantitative approach. The study sample included 268 primary school teachers from 10 primary schools that were selected using two-stage cluster random sampling. Data were collected using self-administered questionnaire. The SPSS computer software version 20 was used for data entry and analysis.

Results: The prevalence of hoarseness of voice in the recruited participants was 42.9%. The risk of developing hoarseness of voice increased with increasing age of a teacher and with the duration of teaching (p < 0.01). The common symptoms associated with hoarseness of voice were vocal straining (85.8%), voice loss (58.9%), and vocal fatigue (55.3%) while the least associated symptoms were swallowing (17.4%) and breathing difficulties (21.6%).

Conclusion: The prevalence of hoarseness of voice among primary school teachers is high; implying the need for interventions to prevent and manage this occupational-related problem.

Occupational exposure to blood and body fluids and associated factors among healthcare workers in Zanzibar: A case of Mnazi Mmoja Referral Hospital

Maryam Khamis — 2024-06-28

Background: Occupational exposure to blood and body fluids is a risk healthcare workers face. The most common exposures include Hepatitis B and C Virus and Human Immunodeficiency Virus which may be present in patients' blood and body fluids.

Objective: This study aimed to assess occupational exposure to blood and body fluids and associated factors among healthcare workers at Mnazi Mmoja Referral Hospital, Zanzibar.

Method: A hospital-based cross-sectional study was conducted among healthcare workers at Mnazi Mmoja Referral Hospital, Zanzibar. Stratified random sampling was used in selecting study participants. A structured questionnaire and observation checklist were used to collect data. Descriptive statistics, univariate, bivariate, and multiple logistic regression analyses were done using a 95% confidence level and a P-value ≤ 0.05 was considered to be statistically significant for the association between dependent and independent variables.

Results: A total of 301 participants were recruited for the study, 235 (78%) and 213 (71%) respondents reported having been exposed to blood and body fluids in their lifetime and the past 12 months respectively. In addition to this, sharp object injuries were reported as the most occurring exposure at 110 (52%) followed by a splash at 103 (48%). The contributing factors for this type of exposure included inappropriate healthcare workers' practices concerning adhering to SOPs, inadequate use of PPE, lack of on-the-job training, inadequate supervision, and inadequate safety signs.

Conclusion: There is a high prevalence of occupational exposure to blood and body fluids at Mnazi Mmoja referral hospital, Zanzibar. Thus, hospital management should provide standard operating procedures, staff training, and adequate protective equipment to reduce the exposure and the Ministry of Health should develop strategies to ensure that occupational health and safety guidelines are available and implemented in all healthcare facilities.

Strategies for stakeholders’ engagement in the provision of health services: the case of immunization and vaccine development program in Tanzania

Anneth Massawe — 2024-06-28

Background: Stakeholders engagement has become an important component for making successful implementation of projects. In Tanzania, like any other country, projects in the health sector aim at improving the efficiency and cost effectiveness of the healthcare system. Immunization and Vaccine development (IVD) program engages stakeholders to support its implementation and to ensure its goals are achieved. However, limited empirical evidence exist regarding how stakeholders are involved in different stages of project. This paper aims at exploring strategies for engaging stakeholders in the development and provision of health services in Tanzania.

Method: This study adopted a qualitative approach and data were collected using in-depth interview and analyzed using thematic approach. A total of 16 participants were interviewed and included staff from IVD program, regional and council health management teams and IVD program stakeholders.

Results: The study identified strategies used by IVD program in engaging stakeholders in development and provision of vaccination services in Tanzania. These include mapping of stakeholders, communicating programs’ objectives to stakeholders and involving stakeholders in different program activities. Additionally, different means of communicating with stakeholders have been identified. Several barriers have been mentioned to affect stakeholder engagement in managing projects. They include lack of stakeholders’ engagement plan, lack of stakeholders’ communication plans and unavailability of formal stakeholders’ analysis matrix.

Conclusion: The IVD program uses several strategies to engage their stakeholders for the successful implementation of program activities; however, the unavailability of stakeholder engagement tools such as stakeholders’ analysis matrix, stakeholders’ communication plan and stakeholders’ engagement plan present weakness for engagement. This calls for an urgent need to address this challenge to have effective stakeholders’ engagement.

Qualitative Exploration of Ethical and Regulatory Review of Herbal Remedy Trials in Tanzania: A Case Study of the Maytenus Senegalensis Clinical Trial

Kamaka Kassimu — 2024-06-28

Background: Herbal remedies are vital worldwide and 80% of Africans rely on them. However, the limited number of well-designed clinical trials in Tanzania emphasizes the necessity for specific ethical and regulatory guidance. This research article examines the M. senegalensis clinical trial as case study to highlight ethical and regulatory review process in Tanzania.

Methods: A single intrinsic case study design was employed to gain insight into the ethical and regulatory review process of the M. senegalensis trial in Tanzania. A qualitative desk review was utilized, and searches were conducted using PubMed, ScienceDirect, Google Scholar databases, and gray literature. Thematic analysis was used for the data analysis.

Results: The document screening identified valuable sources, including three regulatory authority guidelines, five peer-reviewed journal articles, one organizational report and guideline, and five submission packages for the M. senegalensis trial protocol. It also included responses from ethics committees and regulatory authorities. The study found that the essential information for the ethical and regulatory review of herbal remedy trials in Tanzania encompasses nonclinical and clinical studies, anecdotal and ethnomedical evidence, study design, population, endpoints, scientific name, plant extraction details, product type (e.g., raw (fresh or dry), extract), extraction solvent, moisture content, identification of raw material, chemical profile, dose determination, and adverse event monitoring.

Conclusions: The majority of essential information identified focuses on the standardization and quality assurance of the tested herbal product to ensure its verifiability and reproducibility. The findings can guide the review process and create specific herbal trial guidelines in Tanzania and beyond.

“His biological mother told him; you do not have children”. The lived experience and coping strategies of married women living with infertility in Tanzania

Dinnar Lucas — 2024-06-28

Background: Women seeking infertility treatment are facing various psychological and social challenges worldwide. The projected time for pregnancy following marriage, gender and existential factors all have role in how cultures describe infertility. In majority of Tanzanian ethnic groups, bearing children is considered to be one of a female’s duty and task, prescribed by gender norms in ethnicity and customs. Women who are unable to achieve this expectation owing to infertility issues encounter a range of psychological implications. The present study aimed to assess social cultural issues that face infertile women seeking treatment at the Gynecology Outpatient Department at Muhimbili National Hospital.

Objective: To assess the experience, social-cultural issues, and coping strategies among infertile married women seeking treatment at Gynecology Outpatient Department at Muhimbili National Hospital in Dar es Salaam.

Methodology: This was a qualitative study design using phenomenological approach with women aged 15 to 49. A total of 12 childless married women were purposively chosen for in-depth interviews. Data were analyzed using thematic analysis.

Results: In this study four themes were identified namely effects of infertility on relationship with their husbands, family and in-laws. The emotional problems related to infertility treatment and childlessness that explained how childless married women regretted some of their own actions, were stressed and frustrated. Another theme was Socio-cultural and economic issues faced when seeking treatment which revealed the social pressure by society members, stigma; financial constraints, polygamy practices of husbands, and cultural belief in traditional medicines. Lastly was the coping mechanism towards addressing these challenges which were religious practices, escapism, sharing the burden, and family support in addressing social cultural issues that faced infertile married women when seeking treatment.

Conclusion: Married women shared challenges that were conveyed by their communities, culture and traditions of a particular person and healthcare systems. Therefore, community involvement is important in changing people’s attitudes towards infertility through education to raise awareness.

Uptake of Hepatitis B Vaccine and Associated Factors Among Healthcare Workers in District Hospitals in Pemba, Zanzibar, Tanzania

Bakar Khamis — 2024-06-28

Background: Hepatitis B virus vaccine remains as a strategic intervention to combat spread of Hepatitis B infection. However, status of uptake is not well documented among healthcare workers in various levels of Health facility in Zanzibar. The study was conducted to assess the uptake of Hepatitis B vaccine and associated factors among healthcare workers in district hospitals in Pemba, Zanzibar by using the health belief model.

Methods: A Hospital-based cross-sectional analytic study design was conducted in district hospitals in Pemba, Zanzibar. An interviewer-administered questionnaire was used to collect data. The descriptive analysis was performed where bivariable and multivariable analyses were conducted via Modified Poisson regression in STATA version 17.

Results: Among 210 healthcare workers enrolled, 58 % had ever received the hepatitis B vaccine. Gender and perceived susceptibility were associated with the uptake of the vaccine. Being a woman healthcare worker had a 57 % higher prevalence of receiving hepatitis B vaccine compared to men in District Hospital (APR =1.57, 95% CI =1.21-2.024). Healthcare workers with high perceived susceptibility had a higher prevalence of HBV vaccine uptake (APR =1.56, 95% CI= 1.10 -2.32)

Conclusion: The uptake of the Hepatitis B vaccine among healthcare workers in the district hospitals in Pemba, Zanzibar is below WHO target of 90% coverage. Therefore, health education should be provided to increase perceived susceptibility among HCWs. Health facility management should prepare special campaign to influence male healthcare workers to uptake HBV vaccine. Further study should be conducted to address factors associated with full vaccination among Health care workers in district hospitals in Pemba Zanzibar