UDOM IR :: Browsing by Author "Mwampagatwa, Ipyana H."

Browsing by Author "Mwampagatwa, Ipyana H."

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Characteristics and outcomes of patients with eclampsia and severe pre-eclampsia in a rural hospital in Western Tanzania: a retrospective medical record study
(BMC, 2015) Mooij, Rob; Lugumila, Joseph; Mwashambwa, Masumbuko Y.; Mwampagatwa, Ipyana H.; Dillen, Jeroen van; Stekelenburg, Jelle
Eclampsia and pre-eclampsia are well-recognized causes of maternal and neonatal mortality in low income countries, but are never studied in a district hospital. In order to get reliable data to facilitate the hospitals obstetric audit a retrospective medical record study was performed in Ndala Hospital, Tanzania. All patients diagnosed with severe pre-eclampsia or eclampsia between July 2011 and December 2012 were included. Medical records were searched immediately following discharge or death. General patient characteristics, medical history, obstetrical history, possible risk factors, information about the current pregnancy, antenatal clinic attendance and prescribed therapy before admission were recorded. Symptoms and complications were noted. Statistical analysis was done with Epi Info®. Of the 3398 women who gave birth in the hospital 26 cases of severe pre-eclampsia and 55 cases of eclampsia were diagnosed (0.8 and 1.6 %). Six women with eclampsia died (case fatality rate 11 %). Convulsions in patients with eclampsia were classified as antepartum (44 %), intrapartum (42 %) and postpartum (15 %). Magnesium was given in 100 % of patients with eclampsia and was effective in controlling convulsions. Intravenous antihypertensive treatment was only started in 5 % of patients. Induction of labour was done in 29 patients (78 % of women who were not yet in labour). Delivery was spontaneous in 67 %, assisted vaginal (ventouse) in 14 % and by Caesarean section in 19 % of women. Perinatal deaths occurred in 30 % of women with eclampsia and 27 % of women with severe pre-eclampsia and were associated with low birth weight and prolonged time between admission and birth. 2.4 % of women were diagnosed with severe pre-eclampsia or eclampsia. The case fatality rate and overall perinatal mortality were comparable to other reports. Better outcomes could be achieved by better treatment of hypertension and starting induction of labour as soon as possible.
Effect of nutritional education intervention to reduce anaemia during pregnancy in Dodoma City, Tanzania: protocol for a cluster randomized controlled trial
(Oxford Academic, 2021) Munyogwa, Mariam J.; Gibore, Nyasiro S.; Ngowi, Agatha F.; Mwampagatwa, Ipyana H.
The objective of this study is to assess the effectiveness of community-based nutritional intervention in reducing the burden of anaemia during pregnancy. Study design will be a cluster-randomized controlled trial. Study setting will be peri-urban wards of Dodoma City. The study will have two arms (the interventional and the control arms). A total of 400 pregnant women at second trimester will be recruited. The study will consist of four phases in four months for both the interventional and the control arms namely: baseline, first and second follow-up and end-line surveys. During each phase, participants from both arms will be measured for haemoglobin concentration and assessed for gestational age, dietary practices and knowledge about anaemia. Furthermore, all participants will receive iron and folic acid supplements, sulphadoxinepyrimethamine and mebendazole tablets throughout the entire period of the study. Nutritional education will be provided to the interventional arm only during each phase. Main outcomes of the study will be changes in haemoglobin concentration, nutritional knowledge and dietary practices at each phase after the baseline survey in the interventional compared to the control arm. Descriptive statistics will be used to describe the participants. Independent and paired t-tests will be performed to make comparisons between and within groups. P-values less than 0.05 will be considered statistically significant.
The male circumcision: the oldest ancient procedure, its past, present and future roles
(Health Research User's Trust Fund, 2013) Mwashambwa, Masumbuko Y.; Mwampagatwa, Ipyana H.; Rastagaev, Alexender; Gesase, Ainory P.
Circumcision, a surgical removal of male prepuce has existed throughout human history, and it appears it shall exist until humanity ends. During its entire existence, there have been changing reasons or indications from cultural, traditional, religious and currently medical, and it has vehemently been criticized by some individuals for different reasons and in different countries. Emergency of new diseases particularly Human Immunodeficient virus (HIV) has brought the ancient procedure back on spot light, this has come as a result of recent studies which have demonstrated that it does not only reduces significantly the rate of HIV infection, as well as penile cancer and cervical cancer. This has lead to massive male circumcision campaigns in areas with low prevalence of circumcision. On the other hand the socio-cultural and sexual aspects of male circumcision have been studied but often ignored. This article will therefore increase awareness of male circumcision and the increasing roles with time, recommend up scaling of medical male circumcision and possible safe circumcision training to tradition circumcisers.
Morpho-physiological features associated with menopause: recent knowledge and areas for future work
(Health Research User's Trust Fund, 2013) Mwampagatwa, Ipyana H.; Mwashambwa, Masumbuko Y.; Gesase, Ainory P.
Menopause is the permanent cessation of menstruation resulting from loss of ovarian follicular activity which happens as a result of depletion of primary follicles which is basically an aging effect. Depletion of ovarian follicles is reflected as declined production of oestradiol which is currently known to be central to the morphologic and physiological changes that happen during the climacteric, menopause and post menopause periods. The cessation of oestradiol production is much more pronounced in tissues with oestrogen receptors such as bones, brain, blood vessels, central nervous system and the skin. But generally little is known on the subject and in particular the bioactive substances involved in the process such that there are some symptoms that menopause women experience which not only defy clinicians but also challenge the management of the condition. This article is presented to shade light to what is currently known, what is not known and stimulate future research which may reveal more understanding and advance our knowledge on management of women throughout the climacteric and menopausal periods.
Rationale of indications for caesarean delivery and associated factors among primigravidae in Tanzania
(Elsevier Ltd, 2021) Mpotora, Juliana C.; Yahaya, James J.; Ngw'eshemi, Secilia K.; Mwampagatwa, Ipyana H.
This study aimed to determine the prevalence of modes of delivery and associated maternal and newborn outcomes among singleton primigravidae in the Iringa region of Tanzania. A cross-sectional, analytical hospital-based study was conducted in the Iringa region among 356 singleton primigravidae between April and August 2018. Convenience sampling and consecutive collection of data using a face-to-face interviewer-administered questionnaire was done. A total of 356 singleton primigravid women with a mean age of 22.0 years (range: 15–49) participated in the study. The majority of the participants (73.0%, n = 250) were in the 20–35 age group. Caesarean and vaginal delivery were performed in 41.3% (n = 147) and 58.7% (n = 209) of the cases, respectively. The maternal height and weight of the newborn were significantly associated with caesarean delivery; (p = 0.001) and (p = 0.029), respectively. After adjusting for all variables, birth asphyxia (AOR = 3.25, 95% CI: 1.867–5.646, p = 0.000) and low birth weight (AOR = 0.03, 95% CI: 0.003–0.211, p = 0.001) were associated with caesarean delivery. The findings of our study indicated the prevalence of caesarean section to be three times more than that recommended by the World Health Organization. Pregnant women with a height of less than 150 cm should be considered for caesarean section. Therefore, it is necessary for stakeholders in the health sector to formulate guidelines for absolute indications for caesarean section.
Role of male partners in the long-term well-being of women who have experienced severe pre-eclampsia and eclampsia in rural Tanzania: a qualitative study
(Informa UK Limited, 2021) Mooij, Rob; Kapanga, Ruth R.; Mwampagatwa, Ipyana H.; Mgalega, George C.; Dillen, Jeroen van; Stekelenburg, Jelle; de Kok, Bregje C
Men can be essential sources of support in maternal health, even more so in case of severe acute maternal morbidity (SAMM), affecting 1–2% of childbearing women in low-resource settings. In a qualitative study using semi-structured interviews, we explored the perspectives of nine male partners of women who suffered from (pre-)eclampsia six to seven years earlier in rural Tanzania. Male partners considered their role to be pivotal regarding finances, decision-making in healthcare-seeking and family planning and provided physical and emotional support. After SAMM, households may be affected in the long run. Some men took over their female partner’s household duties until up to two years after birth. Providing men with more information on complication readiness and birth preparedness would enable them to extend their role in maternal morbidity prevention.

Browsing by Author "Mwampagatwa, Ipyana H."

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