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Intimate partner violence (IPV) perpetrators are often husbands. Understanding factors pertaining to women’s male partners is essential for programming interventions against IPV. The objective of the study was to describe husband-related... more
Intimate partner violence (IPV) perpetrators are often husbands. Understanding factors pertaining to women’s male partners is essential for programming interventions against IPV. The objective of the study was to describe husband-related social and behavioural risk factors and assess how they are associated with IPV during pregnancy. Cross-sectional data were collected among 1309 pregnant women with husbands in Dong Anh district, Vietnam. Information on sociodemographic characteristics of husbands, the husband’s behaviour and the husband’s involvement in pregnancy care was indirectly collected via women’s report at first antenatal care visit. Data on exposure to intimate partner violence during pregnancy were collected when the women returned for antenatal care in 30–34 gestational weeks. Logistic regression analyses were used to measure the relationships between IPV during pregnancy and risk factors from the husband. Pregnant women who had husbands who were younger or blue-collar worker/farmer/unemployed had more likelihood to be exposed to IPV. Women with husbands who drank alcohol before sexual intercourse and gambled were more likely to be exposed to IPV repeated times. Those with husbands who had intentions of having a child had over three times increased OR to be exposed to IPV once (AOR = 3.2, 95% CI 1.1–9.7). If the husband had a preference for sons, the woman had 1.5 times increased OR (AOR = 1.5; 95% CI 1.1–1.9) to be exposed to IPV repeated times during pregnancy. This study highlights significant associations between IPV and maternal perceptions of husbands’ behaviours and involvement in pregnancy. Findings may help to identify at-risk pregnant women to IPV and guide the development of targeted interventions to prevent IPV from husbands.
Cardio-metabolic diseases (CMDs) such as obesity, type 2 diabetes (T2D) and hypertension are now highly prevalent throughout low- and middle-income countries, even though half of the T2D cases cannot be explained by obesity. Non-obese T2D... more
Cardio-metabolic diseases (CMDs) such as obesity, type 2 diabetes (T2D) and hypertension are now highly prevalent throughout low- and middle-income countries, even though half of the T2D cases cannot be explained by obesity. Non-obese T2D individuals may have been exposed to foetal programming and/or be genetically susceptible to abdominal obesity. There is evidence for ethnic-specific risks for cardiometabolic disease. This calls for expanding research collaboration with so-called South partners in order to qualify decision making on diagnosis and prevention of CMDs at global level.
In Indonesia, the prevalence of smoking among 5 – 9 years old children has increased from 0.4% in 2001 to 2% in 2007. Among present adults smokers (>20 years), 17% started to smoke before the age of 13 years. This study identified... more
In Indonesia, the prevalence of smoking among 5 – 9 years old children has increased from 0.4% in 2001 to 2% in 2007. Among present adults smokers (>20 years), 17% started to smoke before the age of 13 years. This study identified factors related to smoking behaviour among 8 – 12 years old children in Jakarta, Indonesia using a questionnaire based cross sectional survey to obtain smoking status and possible predictors towards smoking habit. The total sample size was 1,097 students among 3rd - 7th grade students from schools in Jakarta. Self-reported smoking status was defined as whether the child had smoked tobacco within the past two months prior to the interview. The prevalence of smoking was 13.4%. Logistic regression analysis showed that high parental approval on tobacco use (OR=13.4; CI 95%: 5.1 – 35.1) was the strongest predictor on children smoking status, followed by low parental control (OR=12.1; CI 95%: 6.9 – 21.2), being a male compared to a female (OR=10.7; CI 95%: 5....
ABSTRACT Aim of the study: The aim of this study was to describe and compare characteristics of subgroups of CAM users among people with MS in Denmark. Materials and methods: An Internet-based questionnaire was used for data collection... more
ABSTRACT Aim of the study: The aim of this study was to describe and compare characteristics of subgroups of CAM users among people with MS in Denmark. Materials and methods: An Internet-based questionnaire was used for data collection among 3361 patient members of the Danish MS society. The final response rate was 55.5%. The respondents were asked about their use of various treatments within the past year and were subsequently divided into subgroups of: (1) those who had combined CAM treatments and conventional pharmacological treatments (74.2%), (2) those who had combined CAM treatments and conventional non-pharmacological treatments (16.0%) and (3) those who had used CAM treatments exclusively (9.8%). Statistical associations were presented as odds ratios and their respective 95% confidence intervals. Results: When comparing with the other subgroups, those who had used CAM and conventional pharmacological treatments in combination were characterized by more often having other conditions than MS, more often using CAM for specific purposes and more often using herbal medicine. Exclusive CAM users were characterized by more often foregoing disease-modifying medicine for MS, more often using special diet and more often reporting a high self-assessed quality of life. The exclusive CAM users were also characterized by less often experiencing side effects and less often assessing the CAM treatments used positively. Conclusion: Some differences in background characteristics, as well as in characteristics related to the use of CAM, were found between subgroups
IntroductionExposure to intimate partner violence (IPV) has been found to be associated with a multitude of poor health and quality of life outcomes. Among the risks exacerbated by IPV is prenatal depression. Resilience is hypothesized to... more
IntroductionExposure to intimate partner violence (IPV) has been found to be associated with a multitude of poor health and quality of life outcomes. Among the risks exacerbated by IPV is prenatal depression. Resilience is hypothesized to protect against psychopathology after exposure to a traumatic influence. The present study aims to investigate resilience as a moderator of the effect of exposure to IPV on prenatal depression among pregnant women in Moshi, Tanzania.Material and methodsIn this cross‐sectional study, nested within a larger longitudinal study, pregnant women receiving antenatal care were interviewed about exposure to IPV, signs of depression using the Edinburgh Postpartum Depression Scale, and resilience using the abbreviated Connor‐Davidson Resilience Scale. Logistic regression was used to test the effect of the interaction term of resilience and exposure to IPV during pregnancy on the risk of high level of signs of depression.ResultsIn total, 1013 women completed a...
Little is known about young people’s behaviors and responses under outbreaks of infectious diseases such as the COVID-19 pandemic, especially in institutional settings. This research investigated the reactions of young adults residing at... more
Little is known about young people’s behaviors and responses under outbreaks of infectious diseases such as the COVID-19 pandemic, especially in institutional settings. This research investigated the reactions of young adults residing at Danish folk high schools (FHSs) towards COVID-19 guidelines and the communicative styles used to enforce COVID-19 guidelines. The qualitative data consists of focus group discussions (FGDs) with students, interviews with staff, and participant observations, as well as survey data from 1800 students. This study showed that young adults reacted negatively when first faced with the new reality of COVID-19 restrictions. They expressed distress over the loss of meaning (non-sense), loss of sense of community, as well as uncertainty. Hygiene guidelines, however, made immediate sense and were socially well accepted. Most FHSs actively involved students in risk communication and creative examples of community-building communication were identified. This stu...
Background Along with a nutritional transition in Sub-Saharan Africa, the prevalence of non-communicable diseases is increasing rapidly. We assess the association between food intake and cardiometabolic risk factors in a rural population... more
Background Along with a nutritional transition in Sub-Saharan Africa, the prevalence of non-communicable diseases is increasing rapidly. We assess the association between food intake and cardiometabolic risk factors in a rural population in Uganda. Methods The present study was based on data from a household-based case-control study of diabetic and non-diabetic households in Southwestern Uganda, 2012–2013. We analysed food intake in 359 individuals age ≥ 13 years from 87 households, using a household food frequency questionnaire, and measures of glycated haemoglobin (HbA1c), height and weight. We used multinomial logistic regression to model abnormal HbA1c (≥5.7%) and weight status (underweight, normal weight and overweight) as an outcome of total food intake and by nine food groups. Results were reported as odds ratios (OR) with 95% confidence intervals (CI). Models were adjusted for three nested sets of covariates. Results The diet primarily consisted of staple food (cassava and p...
ABSTRACT While facility births are increasing in many low-resource settings, quality of care often does not follow suit; maternal and perinatal mortality and morbidity remain unacceptably high. Therefore, realistic, context-tailored... more
ABSTRACT While facility births are increasing in many low-resource settings, quality of care often does not follow suit; maternal and perinatal mortality and morbidity remain unacceptably high. Therefore, realistic, context-tailored clinical support is crucially needed to assist birth attendants in resource-constrained realities to provide best possible evidence-based and respectful care. Our pilot study in Zanzibar suggested that co-created clinical practice guidelines (CPGs) and low-dose, high-frequency training (PartoMa intervention) were associated with improved childbirth care and survival. We now aim to modify, implement, and evaluate this multi-faceted intervention in five high-volume, urban maternity units in Dar es Salaam, Tanzania (approximately 60,000 births annually). This PartoMa Scale-up Study will include four main steps: I. Mixed-methods situational analysis exploring factors affecting care; II. Co-created contextual modifications to the pilot CPGs and training, based on step I; III. Implementation and evaluation of the modified intervention; IV. Development of a framework for co-creation of context-specific CPGs and training, of relevance in comparable fields. The implementation and evaluation design is a theory-based, stepped-wedged cluster-randomised trial with embedded qualitative and economic assessments. Women in active labour and their offspring will be followed until discharge to assess provided and experienced care, intra-hospital perinatal deaths, Apgar scores, and caesarean sections that could potentially be avoided. Birth attendants’ perceptions, intervention use and possible associated learning will be analysed. Moreover, as further detailed in the accompanying article, a qualitative in-depth investigation will explore behavioural, biomedical, and structural elements that might interact with non-linear and multiplying effects to shape health providers’ clinical practices. Finally, the incremental cost-effectiveness of co-creating and implementing the PartoMa intervention is calculated. Such real-world scale-up of context-tailored CPGs and training within an existing health system may enable a comprehensive understanding of how impact is achieved or not, and how it may be translated between contexts and sustained. Trial registration number: NCT04685668
ABSTRACT Effective, low-cost clinical interventions to improve facility-based care during childbirth are critical to reduce maternal and perinatal mortality and morbidity in low-resource settings. While health interventions for low- and... more
ABSTRACT Effective, low-cost clinical interventions to improve facility-based care during childbirth are critical to reduce maternal and perinatal mortality and morbidity in low-resource settings. While health interventions for low- and lower-middle-income countries are often developed and implemented top-down, needs and circumstances vary greatly across locations. Our pilot study in Zanzibar improved care through locally co-created intrapartum clinical practice guidelines (CPGs) and associated training (the PartoMa intervention). This intervention was context-tailored with health-care providers in Zanzibar and now scaled up within five maternity units in Dar es Salaam, Tanzania. This PartoMa Scale-up Study thereby provides an opportunity to explore the co-creation process and modification of the intervention in another context and how scale-up might be successfully achieved. The overall protocol is presented in a separate paper. The aim of the present paper is to account for the Scale-up Study’s programme theory and qualitative methodology. We introduce social practice theory and argue for its value within the programme theory and towards qualitative explorations of shifts in clinical practice. The theory recognizes that the practice we aim to strengthen – safe and respectful clinical childbirth care – is not practiced in a vacuum but embedded within a socio-material context and intertwined with other practices. Methodologically, the project draws on ethnographic and participatory methodologies to explore current childbirth care practices. In line with our programme theory, explorations will focus on meanings of childbirth care, material tools and competencies that are being drawn upon, birth attendants’ motivations and relational contexts, as well as other everyday practices of childbirth care. Insights generated from this study will not only elucidate active ingredients that make the PartoMa intervention feasible (or not) but develop the knowledge foundation for scaling-up and replicability of future interventions based on the principles of co-creation and contextualisation.
Introduction People who inject drugs (PWID) in Sub-Saharan Africa have limited access to comprehensive HIV services. While it is important to inform programming, knowledge about factors influencing access to comprehensive HIV services is... more
Introduction People who inject drugs (PWID) in Sub-Saharan Africa have limited access to comprehensive HIV services. While it is important to inform programming, knowledge about factors influencing access to comprehensive HIV services is scarce. We assessed the proportions of PWID with access to HIV prevention services and associated socio-cognitive factors in Tanzania. Methods A cross-sectional survey was conducted among PWID between October and December 2017 in Dar es Salaam, Tanzania. Data on access to HIV prevention services, demographics and selected socio-cognitive factors were collected through structured face-to-face interviews. Weighted descriptive and forward selection multivariable logistics regression analyses were done to assess independent associations between HIV prevention services and predictors of interest. The results were two tailed and a p-value of less than 0.05 was considered statistically significant. Results The study included 611 PWID (males: 94.4%) with a ...
Use of HIV testing services among FSW in sub-Saharan Africa (SSA) is below the desired UNAIDS target of 90%. We estimated the prevalence and factors associated with HIV testing among FSW in Dar es Salaam, Tanzania. A respondent-driven... more
Use of HIV testing services among FSW in sub-Saharan Africa (SSA) is below the desired UNAIDS target of 90%. We estimated the prevalence and factors associated with HIV testing among FSW in Dar es Salaam, Tanzania. A respondent-driven sampling method was used to recruit FSW aged 18. Modified Poisson regression models were used to determine factors associated with recent HIV testing. Of 958 surveyed FSW (median age 26 years), 85.4% (95% CI: 82.3, 88.1) reported to have ever been tested for HIV and 65.3% (95% CI: 61.2, 69.3) tested in the past 12 months. Condom use on the last day worked (prevalence ratio (PR) = 1.17; 95% CI: 0.99, 1.38), no or low self-perceived risk of HIV acquisition (PR = 1.16; 95% CI: 1.02, 1.32), having never felt stigmatized as a sex worker (PR = 1.18; 95% CI: 1.04, 1.33), and having been in contact with a peer educator (PR = 1.33; 95% CI: 1.18, 1.49) during the past year preceding the survey were associated with recent HIV testing. Interventions aiming to mitigate stigma due to sex work, improve health education to address risk perception as a barrier to HIV testing, and scaling up peer educator's engagement should be given priority.
Introduction Achieving high Mass Drug Administration (MDA) coverage and drug uptake are pivotal in the efforts to eradicate onchocerciasis. The present study investigated the extent and predictors of ivermectin MDA coverage and uptake... more
Introduction Achieving high Mass Drug Administration (MDA) coverage and drug uptake are pivotal in the efforts to eradicate onchocerciasis. The present study investigated the extent and predictors of ivermectin MDA coverage and uptake from the individual and healthcare providers' perspectives. The extent of ivermectin distribution and uptake, and the predictors of distribution and uptake were investigated in endemic communities in the Ashanti Region of Ghana. Methods A cross-sectional survey was conducted from August to October 2019 in communities within the Atwima Nwabiagya North District. A total of 2008 respondents were interviewed. Data was collected with REDCap mobile App which had an electronic version of the structured questionnaire. Descriptive data was presented in frequency tables, and bivariate and multivariate logistics regression analysis were performed to measure the associations between exposure variables and outcome variables which were received and uptake of MDA drugs. Results A total of 1284 (63.9%) respondents did not receive ivermectin during the 2019 MDA programme and more than half of them were not aware of the drug distribution (53.3%). The most common reasons for not ingesting the drug were fear of side effects (47.7%) and not trusting the drug distributors (20.0%). Respondents in the age group 48–57 years (AOR = 1.37; 95%CI: 1.01–2.67), Persons in the high wealth index (AOR = 1.40; 95%CI: 1.11–1.77), Being aware of the MDA programme (AOR = 6.67: 95%CI: 4.76–9.35), MDA being beneficial (AOR = 2.12; 95%CI: 1.54–2.92) participating in previous MDA (AOR = 5.44; 95%CI: 4.25–6.98) and having stayed in the communities for 10 years and above significantly increased the odds of receiving MDA drugs. Previous uptake of MDA drugs (AOR = 10.58; 95%CI: 5.78–19.38) and perception of the MDA drug as beneficial (AOR = 5.25; 95%CI: 2.55–10.82) increased the likelihood of ingesting drugs when received. Conclusion The main health system challenge was limited awareness creation regarding MDA. This seems to affect the optimal utilization of the ivermectin MDA intervention. MDA programmes against onchocerciasis eradication should be designed taking into account specific contextual factors to improve implementation outcomes.
Background: Same-sex attracted men in Tanzania are disproportionately affected by HIV. Drawing on qualitative research, the present study explores healthcare providers’ perspectives on access to HIV-related healthcare services among... more
Background: Same-sex attracted men in Tanzania are disproportionately affected by HIV. Drawing on qualitative research, the present study explores healthcare providers’ perspectives on access to HIV-related healthcare services among same-sex attracted men. Methods: A qualitative study was carried out among healthcare workers in in the cities of Dar es Salaam and Tanga in Tanzania between August 2018 and October 2019. Fieldwork entailed qualitative interviewing, focus group discussions and participant observation. A purposive sampling strategy was used to select study participants who varied with respect to age, education level, work experience, and the type and location of the facilities they worked in. Twenty-four interviews and six focus group discussions were conducted.Results: This paper describes four different discourses that were identified among healthcare workers with respect to their perception of access to healthcare services for SSAM. One held that access to healthcare w...
BackgroundPoor community awareness and social mobilization serve as a major barrier by increasing absenteeism and downplaying the relevance of the ivermectin mass distribution by community members. Inadequate awareness also creates... more
BackgroundPoor community awareness and social mobilization serve as a major barrier by increasing absenteeism and downplaying the relevance of the ivermectin mass distribution by community members. Inadequate awareness also creates confusion among community members especially when one intervention is mistaken for the other. MethodsWe designed a targeted Social and Behaviour Change Communication (SBCC) intervention with clearly defined and tailored messages of ivermectin MDA program targeting onchocerciasis in endemic communities in Ghana. Quasi experiment was conducted with a total sample size of 2008 at baseline and 2113 at endline. ResultsAt baseline, 63.9% respondents did not receive Ivermectin during the previous year (2019) MDA programme and more than half of them (53.3%) were not aware of the drug distribution. The communities that received the intervention at endline revealed a significantly higher increase in coverage (SATT=0.123, 95% CI=0. 0.073, 0.173, p<0.001). At base...
IntroductionRapid urbanisation in Dar es Salaam, the main commercial hub in Tanzania, has resulted in congested health facilities, poor quality care, and unacceptably high facility-based maternal and perinatal mortality. Using a... more
IntroductionRapid urbanisation in Dar es Salaam, the main commercial hub in Tanzania, has resulted in congested health facilities, poor quality care, and unacceptably high facility-based maternal and perinatal mortality. Using a participatory approach, the Dar es Salaam regional government in partnership with a non-governmental organisation, Comprehensive Community Based Rehabilitation in Tanzania, implemented a complex, dynamic intervention to improve the quality of care and survival during pregnancy and childbirth. The intervention was rolled out in 22 public health facilities, accounting for 60% of the city’s facility births.MethodsMultiple intervention components addressed gaps across the maternal and perinatal continuum of care (training, infrastructure, routine data quality strengthening and utilisation). Quality of care was measured with the Standards-Based Management and Recognition tool. Temporal trends from 2011 to 2019 in routinely collected, high-quality data on facility...
Background Diabetes-related distress (DRD) refers to negative emotional and affective experiences from daily demands of living with diabetes. People who received social support seem less likely to experience DRD. The prevalence of T2D in... more
Background Diabetes-related distress (DRD) refers to negative emotional and affective experiences from daily demands of living with diabetes. People who received social support seem less likely to experience DRD. The prevalence of T2D in Vietnam is rapidly increasing. Yet, DRD and its association with social support have not been investigated. This study investigates DRD and how it is associated with unmet needs for social support in people with T2D in Thai Binh Province, Vietnam. Methods A total of 806 people, age ≥ 40 years, treated for T2D at primary hospitals in Thai Binh Province, Vietnam, completed a questionnaire-based cross-sectional survey. DRD was self-reported, based on the Problem Areas In Diabetes scale 5 (PAID5). We assessed 6 types of unmet needs for social support from family/friends/community including: (i) Transport and company when visiting health facilities; (ii) Reminders to take medication; (iii) Purchase and preparation of food; (iv) Reminders to engage in phy...
BACKGROUND From a diabetes management perspective, informal care has proven at least as important as care from health professionals when targeting poorly controlled diabetes. The objective of this study was to identify determinants... more
BACKGROUND From a diabetes management perspective, informal care has proven at least as important as care from health professionals when targeting poorly controlled diabetes. The objective of this study was to identify determinants associated with unmet needs for informal support among people with type-2 diabetes in rural communities of Vietnam. METHODS A cross-sectional survey was conducted from December 2018 to February 2019 in a rural area of northern Vietnam. From 2 districts in Thai Binh Province, Vietnam, 806 people with type-2 diabetes participated in a survey designed to assess who were their most important informal caregivers (ICGs) and to measure the association between demographic and socio-economic predictors and unmet needs of informal support of relevance for diabetes self-care using bivariate and multivariate analyses. RESULTS The spouse was reported as the most important ICG (62.9%) followed by a daughter or son (28.4%). 32.0% of the people with type-2 diabetes repor...
Background: Diabetes-related distress (DRD) in people with type 2 diabetes (T2D) is associated with reduced quality of life. Lower levels of DRD were found in people who received informal support. The prevalence of T2D in Vietnam is... more
Background: Diabetes-related distress (DRD) in people with type 2 diabetes (T2D) is associated with reduced quality of life. Lower levels of DRD were found in people who received informal support. The prevalence of T2D in Vietnam is rapidly increasing. Yet, the prevalence of DRD and its association with informal social support have not been investigated. The present investigate the prevalence of DRD and its association with unmet needs for informal support in people with T2D in Vietnam. Methods: A total of 806 people, age ³40 years, diagnosed with T2D in Thai Binh, Vietnam, completed a questionnaire-based cross-sectional survey. DRD was self-reported, based on the Problem Areas In Diabetes scale 5 (PAID 5). We assessed 6 types of unmet needs for informal support from family/friends/community including: (i) Transport and company when visiting health facilities; (ii) Reminders to take medication; (iii) Purchase and preparation of food; (iv) Reminders to engage in physical exercise; (v...
Background While there are indications of declining HIV infection rates in the general population globally, Tanzania included, men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWID), now called Key... more
Background While there are indications of declining HIV infection rates in the general population globally, Tanzania included, men who have sex with men (MSM), female sex workers (FSW) and people who inject drugs (PWID), now called Key Populations (KP) for HIV epidemic have 2–20 times higher infections rates and contributes up to 30% of new HIV infection. Tanzania have developed a Comprehensive Guideline for HIV prevention among key population (CHIP) to address the epidemic among KPs. However, these populations are stigmatized and discriminated calling for innovative approaches to improve access to CHIP. This project seeks to test the effectiveness of healthcare workers and peer-to-peer engagement in promoting access to CHIP among HIV at risk populations in Tanzania. Methods A quasi-experimental design involving Dar es Salaam City as an intervention region and Tanga as a control region will be done. Using respondent driven sampling, 1800 at risk population (900 from Intervention sit...
ObjectiveTo examine the association between postpartum depression and child growth in a Tanzanian birth cohort.DesignProspective cohort study.SettingMoshi, Tanzania.PopulationPregnant women over the age of 18 who sought antenatal care at... more
ObjectiveTo examine the association between postpartum depression and child growth in a Tanzanian birth cohort.DesignProspective cohort study.SettingMoshi, Tanzania.PopulationPregnant women over the age of 18 who sought antenatal care at two health clinics in Moshi, and the children they were pregnant with, were assessed for inclusion in this study.MethodsThe women were interviewed twice during pregnancy and three times after birth, the final follow up taking place 2–3 years postpartum. Signs of postpartum depression were assessed approximately 40 days postpartum with the Edinburgh Postnatal Depression Scale.Main outcome measuresChild growth was assessed with anthropometric measurements at 2–3 years of age and expressed as mean z‐scores.ResultsIn all, 1128 mother–child pairs were followed throughout the duration of the study. In total, 12.2% of the mothers showed signs of postpartum depression. Adjusted mean height‐for‐age z‐score (HAZ) was significantly lower at 2–3 years follow up...
Lymphatic filariasis (LF), malaria and soil transmitted helminthiasis (STH) cause major health problems in Nepal, but in spite of this very few stud- ies have been carried out on these parasitic infections in Nepal. A cross sectional... more
Lymphatic filariasis (LF), malaria and soil transmitted helminthiasis (STH) cause major health problems in Nepal, but in spite of this very few stud- ies have been carried out on these parasitic infections in Nepal. A cross sectional survey of all three categories of parasitic infections was carried out in Deuda- kala Village of Bardiya District, western Nepal. A total of 510 individuals aged 5 years and above were examined from finger prick blood for circulating filarial antigen (CFA), malaria antigen using a rapid diagnostic test (RDT), and malaria DNA using a PCR-based assay. In addition, 317 individuals were examined for soil-transmitted helminth (STH) eggs by the Kato-Katz technique. Prevalence of LF, malaria (antigen) and STH infection was 25.1%, 0.6% and 18.3%, respectively. PCR analysis did not detect any additional malaria cases. The prevalence of LF and STH infections differ significantly among different age groups and ethnic communities. The high prevalence of LF in the c...
The effect of temperature (19–36 °C) and snail host density (0.014–10 snails/1) on the snail-finding capacity of Echinostoma caproni cercariae is described. The initial swimming speed increased whereas the length of the infective period... more
The effect of temperature (19–36 °C) and snail host density (0.014–10 snails/1) on the snail-finding capacity of Echinostoma caproni cercariae is described. The initial swimming speed increased whereas the length of the infective period decreased with increasing temperature. The combined effect resulted in the E. caproni cercarial snail-finding capacity being temperature independent in the range 19 to 36 °C at a snail density of 0·014 snails/1. A moderate temperature dependency was, however, seen at a lower snail density. The cercarial snail-finding capacity was snail-host density dependent in the density range 0.014 to 1 snail/1. The findings from this study show that a relatively low and biologically realistic snail host density must be used in experimental studies if realistic estimates of the dynamics of cercarial transmission are to be obtained.
Is the current decline in malaria burden in sub-Saharan Africa due to a decrease in vector population?
Violence against pregnant women is a prevalent issue with severe health implications, especially during pregnancy. This study seeks to determine the prevalence of intimate partner violence against women during pregnancy and its associated... more
Violence against pregnant women is a prevalent issue with severe health implications, especially during pregnancy. This study seeks to determine the prevalence of intimate partner violence against women during pregnancy and its associated mental health symptoms. Cross-sectional survey conducted from December 2011 to April 2012. Muhimbili National Hospital antenatal clinic in Dar es Salaam, Tanzania. 1180 pregnant antenatal care patients. Trained interviewers conducted face-to-face standardised interviews with the women in a private room prior to their antenatal care appointment. (PTSD), anxiety and depressive symptoms were assessed through the Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. The Conflict Tactics Scale, the John Hopkins Symptom Checklist (25) and the Posttraumatic Diagnostic Scale. Of the 1180 women who were interviewed, 27% reported experiencing both physical and sexual intimate partner violence in the index pregnancy, with 18% reporting physical violence and 20% reporting sexual violence. After adjusting for the sociodemographic characteristics of women, women who experienced physical and/or sexual intimate partner violence during pregnancy were significantly more likely to have moderate PTSD (AOR 2.94, 95% CI 1.71-5.06), anxiety (AOR 3.98, 95% CI 2.85-5.57) and depressive (AOR 3.31, 95% CI 2.39-4.593) symptoms than women who did not report physical and/or sexual intimate partner violence during pregnancy. About three out of ten women experienced physical or sexual intimate partner violence during pregnancy by an intimate partner, which was significantly associated with poor mental health symptoms. These rates are alarming, and justify training and education of antenatal care providers to raise awareness.

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