Browsing by Author "Mwampagatwa, Ipyana"

Now showing 1 - 6 of 6
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    Emotional and relationship dynamics between HIV sero discordance and concordance couples: a narrative literature review and theoretical framework
    (ARC Publications Private Limited, 2017) Mwakalapuka, Amani; Mwampagatwa, Ipyana; Bali, Theodora; Mwashambwa, Masumbuko; Kibusi, Stephen
    Tanzania is among the countries with high prevalence of HIV prevalence in the World. Despite the fact that the epidemic has been, and still is a threat to persons of all ages, recent studies have suggested that most new infections occur among couples in stable relationships. Infected couples are categorised into two: the positive concordant, where both the partners are HIV positive; and sero-discordant couples, where one partner is HIV positive while the other is negative. Recently, researchers and many other stake-holders working on the HIV/AIDS epidemic have given a remarkable attention to this astonishing reality. For instance one study in East and Southern Africa indicates that there are great variations of discordancy varying from 36% to 85%, with an overall rate of 49%. HIV couple sero-discordancy is responsible for varied levels of psychological distress including heightened levels of anxiety, poor emotional adaptation and increased or excessive substance use, most often coupled with exclusion and social isolation within family and in the neighbourhood. However, to date the influence of sero-discordancy on family and couple relationship functioning and how it differs from that among concordant couples remains elusive. Discordancy have been associated with more difficulties as compared to the seroconverted couples, these include relationship and emotional disturbances, sexual contact distancing, marital separation and disruptions. The Lazarus and Folkmans (1984)s Transactional Model can be helpful in understanding individuals with HIV discordancy on their emotional response, coping strategies and the ultimate decisions towards their marital relationships fate. Couple sero-discordancy, HIV/AIDS, Theory, Emotional problems, psychosocial problems, Literature review.
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    Factors influencing nurses' knowledge and skills in the prevention and management of postpartum haemorrhage
    (Mark Allen Group, 2019) Joho, Angelina A; Kibusi, Stephen M; Mwampagatwa, Ipyana
    Background: Postpartum haemorrhage (PPH) is one of the main causes of maternal death. In Tanzania, 25% of maternal deaths are the result of PPH. Gaps in practitioner knowledge in the prevention and management of this issue may lead to severe maternal complications and death. Little has been documented about nurses' knowledge and skills regarding PPH prevention and management. Objective: To determine the factors influencing nurses' knowledge and skill in the prevention and management of PPH in the Dodoma Region, Central Tanzania. Method: A cross-sectional study was conducted involving 172 nurses working in Dodoma, Tanzania. Data on the sociodemographic characteristics of the nurses was collected using a structured questionnaire. Knowledge on PPH was assessed using a validated questionnaire and skills were assessed using an observational checklist. The chi-squared test was used to find associations between sociodemographic characteristics and knowledge and skills. Binary logistic regression (both reduced and full models) was used to identify significant predictors of knowledge and skills. Results: The findings indicated that being ≥40 years old (OR=2.87, P=0.004), being a registered nurse (OR=2.73, P=0.002), having >3 years of professional training (OR=2.38, P=0.01), and having ≥5 years of experience in a maternity unit (OR=3.06, P<0.00) were significant predictors for knowledge in the prevention and management of PPH in a reduced model of binary logistic regression. Being ≥40 years old (OR=11.5, P=0.00), having >3 years of professional training (OR=4.58, P<0.00), and having ≥5 years of experience in a maternity unit (OR=9.14, P<0.00) were significant predictors for skills in the reduced model. After adjusting to control for possible confounders, being a registered nurse was the only significant predictor of nurses' knowledge (AOR=3.35, P=0.001), while having ≥5 years experience in a maternity unit was the only significant predictor of nurses' skills (AOR=3.89, P=0.01). Conclusion: Professional qualification and experience in a maternity unit are significant factors influencing nurses' knowledge and skills, respectively, in the prevention and management of PPH.
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    Gestational trophoblastic disease and associated factors among women experiencing first trimester pregnancy loss at a regional referral hospital in central Tanzania: a cross-sectional study
    (Oxford Academic, 2022) Mdoea, Mwajuma B.; Mwakigonja, Amos R.; Mwampagatwa, Ipyana
    Gestational trophoblastic diseases (GTDs) may follow any form of pregnancy or a pregnancy loss. Early detection of GTDs is important, as some benign forms of the disease may progress into a chemoresistant and metastatic disease. This study aimed at determining the frequency of GTDs among women experiencing first trimester pregnancy loss and the associated patients’ characteristics. This was a cross-sectional study that included 200 conveniently sampled women who experienced first trimester pregnancy loss from January to December 2019 at a Regional Referral Hospital in central Tanzania. The specimen obtained from products of conception were collected, formalin-fixed and paraffin-embedded and submitted for histopathological evaluation, for which haematoxylin and eosin stain was used. Data were analysed using SPSS version 23.0. The χ2 test was used to determine the association between categorical variables. p-Values ˂0.05 were considered statistically significant. Among 200 study participants, the overall frequency of GTDs was 42 (21%). Among those with GTDs, the most common histopathological diagnosis was partial hydatidiform mole (18 [42.9%]), followed by complete hydatidiform mole (17 [40.5%]) and choriocarcinoma (7 [16.5%]). In the studied participants, only increased human chorionic gonadotropin hormone levels were found to be statistically significantly associated with GTDs (p=0.000). Results from this study suggest that routine histopathological evaluation of the products of conception is recommended in order to allow early detection of GTDs, including choriocarcinoma, which usually carries a poor prognosis. The histopathological reporting of choriocarcinoma among first trimester products of conception from Tanzania is novel.
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    Knowledge on prevention and management of preeclampsia and eclampsia among nurses in primary health settings: baseline findings from an interventional study in Dodoma Region, Tanzania
    (East African Health Research Commission, 2020) Mwampagatwa, Ipyana; Ernest, Alex; Angelina, Joho A.; Kibusi, Stephen M.
    Preeclampsia and eclampsia are conditions which increase maternal and foetal morbidity and mortality worldwide. These conditions are ranked as the second leading cause of maternal deaths. Nurses have a critical role in preventing and managing preeclampsia. However, their knowledge has not been evaluated particularly among those working in primary health facilities, where opportunities for continue education is limited. To assess knowledge on prevention and management of preeclampsia and eclampsia among nurses working in the primary health care settings. Analysis of baseline data from an intervention study which test the effectiveness of simulation-based training on obstetric and neonatal emergencies among nurses in managing maternal and newborn emergencies in primary health care settings. A total of 39 primary health centres within 7 districts in Dodoma Region were selected to take part in the interventional study. Individual participants were nurses working in maternity units were involved. 172 nurses were selected using a simple random method. Nurses’ knowledge on prevention and management of PEE and its predictors were assessed using a self-administered questionnaire. Descriptive statistics analysis was done to determine the distribution of the background characteristics of nurses and logistic regression analysis was performed to explore predictors of nurses’ knowledge Overall knowledge on preeclampsia and eclampsia was 88 (51.2%). Professional qualification was a predictor associated with a nurse’s knowledge about preeclampsia and eclampsia. Registered nurses were more knowledgeable compared to enrolled nurses (AOR3.311; CI, 1.62 to 6.768; P value =.001), years of working experience showed no association with knowledge on preeclampsia and eclampsia (AOR 0.98; CI: 0.39-2.47; P values = 0.970). This study showed there is a critical knowledge deficiency in the prevention and management of preeclampsia and eclampsia among nurses working in maternal units of primary health care setting. Effective regular training on prevention and man agement of preeclampsia and eclampsia for frontline nurses is required in order to improve maternal and neonatal survival.
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    Predictors of helping babies breathe knowledge and skills among nurses in primary health settings in Dodoma region, Tanzania
    (BMC, 2020) Joho, Angelina A.; Kibusi, Stephen M.; Mwampagatwa, Ipyana
    Globally, birth asphyxia is one of the leading causes of neonatal death. In Tanzania, neonatal deaths are estimated to be 25 deaths per 1000 live births and birth asphyxia accounts for 31% of those deaths. A cross-sectional study was conducted in 40 health centers within 7 districts in Dodoma Region among nurses working in maternity units. Simple random sampling was used to select participants. A knowledge questionnaire and performance skills checklist were used to assess nurses’ knowledge and skills respectively. Chi-square and binary logistic regression were employed to test association and identify significant predictors of HBB knowledge and skills. A total of 172 participants completed the study out of 176 recruited. This represents a respondent rate of98%. Findings indicate that age, duration of professional training, and experience in maternity were significant predictors for knowledge and skills. However, after control of the confounders, experience in the maternity unit was found to be the only significant predictor of knowledge and skills in resuscitation of the neonates (AOR = 2.94; CI: 0.96–8.98; P= 0.05) and (AOR = 4.14; CI: 1.12–15.31; P= 0.03) respectively. Nurses with longer maternity nursing care experience of 5 years and above were better able to answer questions that demonstrated adequate knowledge(53.9%) and perform skills correctly (53.2%) related to HBB. Those with less than 5 years’ experience had limited knowledge (20%) and skills (10.5%). In this setting, direct work experience in the maternity unit was the main factor influencing knowledge and skills in neonatal resuscitation with HBB.
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    Uterine rupture: a retrospective analysis of causes, complications and management outcomes at Muhimbili National Hospital in Dar es Salaam, Tanzania
    (Health Research User's Trust Fund, 2012) Kidanto, Hussein L.; Mwampagatwa, Ipyana; Roosemalen, Jos Van
    Rupture of the gravid uterus is an obstetric catastrophe that is associated with complications that include massive blood loss, hysterectomy, and damage to the genitourinary tract. It is a serious complication that is associated with high maternal and perinatal morbidity and mortality. We conducted a retrospective review of case notes (from 2003 to 2009) to determine the incidence, causes, complications and foetal/maternal outcome among women with a diagnosis of ruptured uterus at Muhimbili National Hospital (MNH) in Dar es Salaam Tanzania. Case notes with diagnosis of ruptured uterus were retrieved from the records department and information on maternal demographic characteristics, surgical intervention, maternal and perinatal outcome were collected using a check list. Where information was inadequate it was sought from the obstetric database. Obtained data was cleaned and analyzed using PASW statistics 18 software. Out of 72,570 deliveries 163 cases of ruptured uterus were recorded in seven years, making an incidence of 2.25 per 1000 births. Most ruptures (38%) resulted from neglected obstructed labour and scared uterus (33.6%). Major obstetric haemorrhage (>1500 ml) was the most frequently encountered complication followed by sepsis. Subtotal hysterectomy was the most common (73.6%) surgical intervention. Maternal and perinatal case fatality rates were 12.9%, and 96.3% respectively. Ruptured uterus contributed to 6.6% of all maternal deaths. These findings underscores the need for proper monitoring of labour both in the referring facilities and at MNH and improvement of comprehensive emergence obstetric care at all levels of health care to avoid unnecessary delays in care.