Browsing by Author "Ntwenya, Julius Edward"
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Item Association between dietary diversity with overweight and obesity: a cross-sectional study conducted among pastoralists in Monduli district in Tanzania(Public library of science (PLoS), 2021) Khamis, Ahmed Gharib; Ntwenya, Julius Edward; Senkoro, Mbazi; Mfinanga, Sayoki Godfrey; Kreppe, Katharina; Mwanri, Akwilina Wendelin; Bonfoh, Bassirou; Kwesigabo, GideonThe prevalence of overweight and obesity is rising at a rapid pace and is associated with negative health consequences like cardiovascular diseases, type 2 diabetes and cancer. Obesity is a multifactorial problem that develops mainly from lifestyle factors including physical inactivity and poor dietary intake. Dietary diversity is a simplified method for assessing the adequacy and quality of diet and is associated with nutritional need and overall health status. Therefore, we conducted this study to synthesize the associations between consumption of a diversified diet and overweight/ obesity among adults living in pastoral communities in Monduli district in Tanzania. This was a cross-sectional study conducted among 510 adults aged ≥ 18 years old in the Monduli district, Arusha region in Tanzania. We conducted face-to-face interviews to collect information about socio-demographic characteristics, 24-hours dietary recall, and anthropometric measurements. The dietary diversity score (DDS) was constructed and used to determine the diversity of the diet consumed. We performed the multivariate Poisson regressions to determine the prevalence ratio (PR) with 95% confidence intervals (CI). The dependent variables were overweight and general obesity as measured by body mass index (BMI), abdominal obesity measured by waist-hip ratio (WHR) and waist circumference (WC). The prevalence of general obesity based on BMI was 20.2% (95%CI; 16.9–23.9), abdominal obesity based on WHR was 37.8% (95%CI; 33.7–42.1), and WC was 29.1% (95%CI; 25.2–33.1). More than half (54.3%) of the participants consumed an adequate dietary diversity (DDS ≥4). After adjustment for potential confounders, the prevalence of abdominal obesity by WHR decreased with higher DDS among male (APR = 0.42; 95% CI, 0.22–0.77) and female participants (APR = 0.63; 95% CI, 0.41–0.94). There were inconsistent positive associations between DDS and prevalence of overweight and general obesity among male and female. There was no association between DDS and abdominal obesity by WC. More than half of the pastoralists have consumed an adequate diversified diet. Given the inconsistent findings on associations between dietary diversity and obesity measures, this study suggests that targeting dietary diversity as an overweight/obesity prevention strategy requires careful consideration.Item Consumer awareness and production practices of farmers on antimicrobial residues in chicken eggs and Chinese cabbage in Dodoma, Central Tanzania(PLOS ONE, 2022) Mongi, Richard John; Meshi, Eugene Benjamin; Ntwenya, Julius EdwardAntimicrobial residues (ABs) in foods contribute to the development of antimicrobial resistance, which is becoming a major public health concern around the world. Understanding food production practices concerning antimicrobial use and consumer awareness on the possibility of ABs in foods is necessary for developing mitigation strategies. Therefore, this study was conducted to assess the production practices and awareness among eggs and Chinese cabbage consumers in Dodoma city. A cross-sectional study was conducted using a structured questionnaire and checklist to collect data on awareness and production practices from 420 consumers, 30 chicken egg farmers, and 30 Chinese cabbage farmers in eight city wards. About 42% of consumers of eggs and Chinese cabbages were not aware of the likelihood of antimicrobial residues in these foods. The awareness was significantly influenced by the consumer’s educational level (p = 0.001) and geographical location (p = 0.045), with educated and urban consumers being 7.7 and 1.6 times more informed than their uneducated and peri-urban counterparts. Furthermore, the majority of chicken farmers raised more layers than broilers, and they all used antimicrobial drugs, mainly tetracycline and its variants, to treat and prevent diseases. The findings also revealed that many vegetable producers utilized wastes from animals treated with antimicrobials as manure to amend the soil. In a view of the findings, a considerable number of egg and Chinese cabbage consumers in Dodoma city were unaware on the likelihood of antimicrobial residues in these foods from their production practices. All chicken farmers utilized antimicrobial drugs mainly tetracycline and its derivatives, for the treatment and prevention of diseases while vegetable producers used wastes from animals treated with antimicrobials as soil manure. Therefore, initiatives to inform farmers and consumers about the possibility of antimicrobial residues in these foods and their related public health risks upon long-term consumption are strongly advised.Item Design and validation of a food frequency questionnaire to assess the dietary intake for adults in pastoral settings in Northern Tanzania(BMC Research Notes, 2021) Khamis, Ahmed Gharib; Mwanri, Akwilina Wendelin; Ntwenya, Julius Edward; Senkoro, Mbazi; Kreppel, Katharina; Bonfoh, Bassirou; Mfinanga, Sayoki Godfrey; Kwesigabo, GideonObjective Food frequency questionnaires are widely used as a dietary assessment tool in nutritional epidemiology to determine the relationship between diet and diseases. In Tanzania, there are several cultural variations in food intake which makes it necessary to design and validate a culture-specific food frequency questionnaire (CFFQ). Therefore, we designed a 27-items CFFQ and examine its validity in pastoral communities. Validity of CFFQ was assessed by comparing nutrient intake estimated from the CFFQ against the average from two 24-h diet recall (2R24). Spearman’s correlation coefficients, cross classification and Bland–Altman’s methods were used to assess the validity of CFFQ. Results A total of 130 adults aged 18 years and above completed both CFFQ and 2R24. Correlation coefficients between CFFQ and 2R24 ranged from low (r = − 0.07) to moderate (r = 0.37). The correlation coefficients were moderately significant for kilocalories (r = 0.31, p < 0.001), carbohydrate (r = 0.33, p < 0.001), magnesium (r = 0.37, p < 0.001), and iron (r = 0.34, p < 0.001). On average, about 69% of participants were correctly classified into the same or adjacent quartile of energy and nutrient intake, while 9% were misclassified by the CFFQ. Bland–Altman’s plot demonstrated that the CFFQ had acceptable agreement with the 2R24.Item Dietary pattern as a predictor of colorectal cancer among general health population in Arusha Tanzania: A population based descriptive study(Academic Journals, 2017) Katalambula, Leonard Kamanga; Ntwenya, Julius Edward; Ngoma, Twalib; Buza, Joram; Mpolya, Emmanuel; Petrucka, Pammla; Paul, EdwinProper diet is important in preventing many diseases, and colorectal cancer is no exception. The aim of this study was to identify major dietary patterns among the general population in Arusha Tanzania to determine whether diet is one of the predictors contributing to the observed pattern and distribution of colorectal cancer in Tanzania. A population based cross-sectional study recruited a sample of selfreported healthy individuals residing in four wards of the City of Arusha, Tanzania. A total of 549 participants were recruited on a voluntary basis. The Food Frequency Questionnaire and the World Health Organization (WHO) Step® survey tool were used to collect data. Factor analysis, Pearson correlation (Pearson’s r), and logistic regression were used to analyze the data.Two major dietary patterns, namely “healthy” and “western”, and one minor pattern existed among the study population. The "healthy" pattern was generally associated with females (56.2%, p=0.074), people with primary level of education (62.7%, p=0.667), age category of 25 to 44 (66.3%, p= 0.370), normal range body mass index (BMI) (42.4%, p=0.967), self-employed (78.5%), non-smokers (86.6%) and non-alcohol drinkers (51%), although the differences were not statistically significant. "Western" dietary pattern adherence was associated with area of residence (p=0.0001), gender (p=0.003) and BMI status (p=0.04) in univariate analysis. In multivariate analysis, higher odds were observed in individuals aged 25 to 34 (OR=1.104, 95%, CI (0.537-2.2267) and 45 to 54 OR=1.091, 95%, CI(0.521-2.283), alcohol drinkers (OR=1.2, 95%, CI(0.767-1.877), people with college or high levels of education (OR=0. 853, 95%, CI(0.260-2.803) and OR=0.550, 95%,CI(0. 159-1.897), smokers (OR=1.030, 95%, CI(0.519-2.044) and overweight or obese (OR=2.676, 95%, CI (0.981-7.298) and OR=2.045, 95%, CI (0.767-5.454). These data support our previous hypothesis that diet could be an important potential predictor of the previously observed pattern and distribution of colorectal cancer in Tanzania.Item Dietary patterns and household food in security in rural populations of Kilosa district, Tanzania(Public library of science (PLoS), 2015) Ntwenya, Julius Edward; Kinabo, Joyce; Msuya, John; Mamiro, Peter; Majili, Zahara SaidiFew studies have investigated the relationship between dietary pattern and household food insecurity. The objective of the present analysis was to describe the food consumption patterns and to relate these with the prevalence of food insecurity in the context of a rural community. Three hundred and seven (307) randomly selected households in Kilosa district participated in the study. Data were collected during the rainy season (February–May) and post harvest season (September–October) in the year 2011. Food consumption pattern was determined using a 24-h dietary recall method. Food insecurity data were based on the 30 day recall experience to food insecurity in the household. Factor analysis method using Principal Components extraction function was used to derive the dietary patterns and correlation analysis was used to establish the existing relationship between household food insecurity and dietary patterns factor score. Four food consumption patterns namely (I) Meat and milk; (II) Pulses, legumes, nuts and cooking oils; (III) fish (and other sea foods), roots and tubers; (IV) Cereals, vegetables and fruits consumption patterns were identified during harvest season. Dietary patterns identified during the rainy season were as follows: (I) Fruits, cooking oils, fats, roots and tubers (II) Eggs, meat, milk and milk products (III) Fish, other sea foods, vegetables, roots and tubers and (IV) Pulses, legumes, nuts, cereals and vegetables. Household food insecurity was 80% and 69% during rainy and harvest–seasons, respectively (P = 0.01). Household food insecurity access scale score was negatively correlated with the factor scores on household dietary diversity. Food consumption patterns and food insecurity varied by seasons with worst scenarios most prevalent during the rainy season. The risk for inadequate dietary diversity was higher among food insecure households compared to food secure households. Effort geared at alleviating household food insecurity could contribute to consumption of a wide range of food items at the household level.Item Disparities in risk factors associated with obesity between Zanzibar and Tanzania mainland among women of reproductive age based on the 2010 TDHS(Hindawi Publishing Corporation, 2016) Paul, Edwin; Mtumwa, Abdalla H.; Ntwenya, Julius Edward; Vuai, Said A. H.The occurrence of overweight and obesity has serious health implications. The 2010 Tanzania Demographic and Health Survey data set was reanalyzed to compare the prevalence of overweight and obesity between Mainland Tanzania and Zanzibar and to determine how demographic factors can predict overweight and obesity across the United Republic of Tanzania. About 7.92% of the Tanzanian women of reproductive age were obese, 15% were overweight, and 11.5% were underweight. Women from Mainland Tanzania (6.56%) were significantly less likely (AOR = 0.66, 95% CI: 0.53–0.82) to be affected by obesity as compared to women from Zanzibar (12.19%).The common predictors of obesity in Mainland Tanzania and Zanzibar were wealth index, marital status, and age. Whereas the place of residence and education level emerged as predictors of obesity in the Mainland Tanzania alone, the number of meals per day did so in Zanzibar. Most importantly, Zanzibar had a greater prevalence of obesity compared to Mainland Tanzania.Item Electronic medical record systems data use in decision-making and associated factors among health managers at public primary health facilities, Dodoma region: a cross-sectional analytical study(Frontiers Media SA, 2024-02-12) Kessy, Eusebi Cornelius; Kibusi, Stephen Mathew; Ntwenya, Julius EdwardBackground: Tanzania has shown some improvements in the adoption of electronic medical record (EMR) systems in public health facilities; however, the rate of utilization of data generated from EMRs among health managers is not well documented. This study aims to assess the use of electronic medical record systems data in decision-making among health managers at public primary health facilities in Dodoma Region, Central Tanzania. Methods: A facility-based quantitative cross-sectional analytical study was conducted among 308 randomly selected health managers. A self-administered questionnaire supplemented with documentary review was used. Descriptive summary statistics and bivariable and multivariable logistic regression analyses (crude and adjusted odds ratios) were used. A P-value of <0.05 was used to declare statistically significant associations. Results: Overall, more than a third (40.6%) of the health managers, that is 174 of the 308 included in the study, reported using data generated by EMR systems in decision-making. One-third (33.4%) of the health managers were adequately using data generated by EMR systems, of which 39.3% used data to support continuous quality improvement initiatives. Among the facilities visited, only nine (30%) had good documented EMR systems data use. Access to computers [adjusted odds ratio (AOR) = 4.72, 95% confidence interval (CI): 1.65, 13.48, p-value (p) = 0.004] and discussions on EMRs during meetings (AOR = 2.77, 95% CI: 1.01, 7.58, p = 0.047) were independent predictors of EMR system data use. Those who reported having EMR systems in all working areas were seven times more likely to use EMR system data (AOR = 7.23, 95% CI: 3.15, 16.59, p = 0.001). The respondents with good perceived EMR system information quality were more likely to use EMR system data (AOR = 2.84, 95% CI: 1.50, 5.39, p = 0.001) than those with poor perception. Furthermore, health managers who had excellent knowledge of computers and data use had higher odds of using EMR system data (AOR = 1.84, 95% CI: 3.38, 10.13, p = 0.001) compared with their counterparts. Conclusions: The findings of this study indicate that utilization of EMR system data in decision-making among health managers was optimal. It was found that training in itself is insufficient to improve use of EMR, which points to more organizational aspects of work routine as a challenge. Hence, a comprehensive approach that addresses these factors is essential for maximizing EMR system data use in decision-making.Item Electronic medical record systems data use in decision-making and associated factors among health managers at public primary health facilities, Dodoma region: a cross-sectional analytical study(Frontiers Media SA, 2024) Kessy, Eusebi Cornelius; Kibusi, Stephen Mathew; Ntwenya, Julius EdwardBackground: Tanzania has shown some improvements in the adoption of electronic medical record (EMR) systems in public health facilities; however, the rate of utilization of data generated from EMRs among health managers is not well documented. This study aims to assess the use of electronic medical record systems data in decision-making among health managers at public primary health facilities in Dodoma Region, Central Tanzania. Methods: A facility-based quantitative cross-sectional analytical study was conducted among 308 randomly selected health managers. A self-administered questionnaire supplemented with documentary review was used. Descriptive summary statistics and bivariable and multivariable logistic regression analyses (crude and adjusted odds ratios) were used. A P-value of <0.05 was used to declare statistically significant associations. Results: Overall, more than a third (40.6%) of the health managers, that is 174 of the 308 included in the study, reported using data generated by EMR systems in decision-making. One-third (33.4%) of the health managers were adequately using data generated by EMR systems, of which 39.3% used data to support continuous quality improvement initiatives. Among the facilities visited, only nine (30%) had good documented EMR systems data use. Access to computers [adjusted odds ratio (AOR) = 4.72, 95% confidence interval (CI): 1.65, 13.48, p-value (p) = 0.004] and discussions on EMRs during meetings (AOR = 2.77, 95% CI: 1.01, 7.58, p = 0.047) were independent predictors of EMR system data use. Those who reported having EMR systems in all working areas were seven times more likely to use EMR system data (AOR = 7.23, 95% CI: 3.15, 16.59, p = 0.001). The respondents with good perceived EMR system information quality were more likely to use EMR system data (AOR = 2.84, 95% CI: 1.50, 5.39, p = 0.001) than those with poor perception. Furthermore, health managers who had excellent knowledge of computers and data use had higher odds of using EMR system data (AOR = 1.84, 95% CI: 3.38, 10.13, p = 0.001) compared with their counterparts. Conclusions: The findings of this study indicate that utilization of EMR system data in decision-making among health managers was optimal. It was found that training in itself is insufficient to improve use of EMR, which points to more organizational aspects of work routine as a challenge. Hence, a comprehensive approach that addresses these factors is essential for maximizing EMR system data use in decision-making.Item The influence of dietary diversity on the nutritional status of children between 6 and 23 months of age in Tanzania(BioMed Central, 2019) Khamis, Ahmed Gharib; Mwanri, Akwilina Wendelin; Ntwenya, Julius Edward; Kreppel, KatharinaBackground: Undernutrition poses a serious health challenge in developing countries and Tanzania has the highest undernutrition burden of Eastern and Southern Africa. Poor infant and young child feeding practices have been identified as the main causes of undernutrition. As dietary diversity is a major requirement if children are to get all essential nutrients, it can thus be used as one of the core indicators when assessing feeding practices and nutrition of children. Therefore, adequate information on the association between dietary diversity and undernutrition to identify potential strategies for the prevention of undernutrition is critical. Here we examined to what extent dietary diversity is associated with undernutrition among children of 6 to 23 months in Tanzania. Methods: Using existing data from the Tanzania Demographic and Health Survey of 2015–2016, we carried out secondary data analysis. Stunting, Wasting and Underweight of the surveyed children were calculated from Z-scores of Height-for-age (HAZ), Weight-for-height (WHZ) and Weight-for-age (WAZ) based on 2006 WHO standards. A composite dietary diversity score was created by summing the number of food groups eaten the previous day as reported for each child by the mother ranging from 0 to 7. Then, minimum dietary diversity (MDD) of 4 food groups out of seven was used to assess the diversity of the diet given to children. Bivariate and multivariate logistic regression techniques were used to assess the crude and adjusted odds ratios of stunting, wasting and being underweight. Results: A total of 2960 children were enrolled in this study. The prevalence of stunting was 31%, wasting 6% and underweight 14%. Among all children, 51% were female and 49% male. The majority (74%) of children did not reach the MDD. The most commonly consumed types of foods were grains, roots and tubers (91%), and Vitamin A containing fruits and vegetables (65%). The remaining food groups were reported to be consumed by a much lower proportion of children, including eggs (7%), meat and fish (36%), milk and dairy products (22%), as well as legumes and nuts (35%), and other vegetables (21%). Consumption of a diverse diet was significantly associated with a reduction of stunting, wasting and being underweight in children. The likelihood of being stunted, wasted and underweight was found to decrease as the number of food groups consumed increased. Children who did not receive the MDD had a significantly higher likelihood of being stunted (AOR = 1.37, 95% CI; 1.13–1.65) and underweight (AOR = 1.49, 95% CI;1.15–1.92), but this was not the case for wasting. Consumption of animal-source foods has been found to be associated with reduced stunting among children.Item Pattern and distribution of colorectal cancer in Tanzania: a retrospective chart audit at two National hospitals(Hindawi, 2016) Katalambula, Leonard K.; Ntwenya, Julius Edward; Ngoma, Twalib; Buza, Joram; Mpolya, Emmanuel; Mtumwa, Abdallah H.; Petrucka, PammlaColorectal cancer (CRC) is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (x2) tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06%) and females (49.94%), although gender likelihood of diagnosis type (i.e., rectal or colon) was significantly different (P=0.027). More than 60% of patients were between 40 and 69 years. Conclusions. Age (P=0.0183) and time (P=0.004) but not gender (P=0.0864) were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P=0.0405), age (P=0.0015), and time (P=0.0075) were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate.Item Pesticide regulations and their malpractice implications on food and environment safety(Cogent OA, 2019) Zikankuba, Vumilia Lwoga; Mwanyika, Gaspary; Ntwenya, Julius Edward; James, ArmachiusAlthough pesticides have a positive effect on plant health in terms of insect pests and diseases control, increased productivity and improved crop storage, their malpractice impacts on food safety negatively. Pesticide residues and corresponding metabolites are left as runoff to the environment affecting non-targeted organisms like fish, bees, butterflies, birds and other beneficial organisms in soil and water bodies. Moreover, the application of pesticides in non-agriculture activities goes unnoticed, such as spraying for Anopheles mosquito to control malaria. Human health effects caused by pesticide residues in food include headache, vomiting, itching and skin irritation, restlessness, dizziness, breathing difficulties, neurotoxicity and chronic poisoning-related diseases such as cancer and death incidences. Maximum residue limits are the maximum pesticide residues limit in food considered safe to human as set by the Codex Alimentarius Commission and the joint Food and Agriculture Organization/World Health Organization meeting on pesticide residues. The residues of dichlorodiphenyltrichloroethane and chlorpyrifos are reported in various foods globally. Additionally, food safety is largely obstructed by the illegal use of pesticides and the presence of counterfeit pesticides in the market. This review provides detail on pesticide control and regulations, residues in food, their health impacts and link approaches like good agricultural practices for ensuring sustainability on safe food production.Item Prevalence and factors influencing Alcohol use in pregnancy among women attending Antenatal care in Dodoma region, Tanzania: a cross-sectional study(Hindawi, 2018) Mpelo, Matunga; Kibusi, Stephen Matthew; Moshi, Fabiola; Nyundo, Azan; Ntwenya, Julius Edward; Mpondo, Bonaventura C. T.Alcohol use during pregnancy is high despite the well-established evidence on its adverse pregnancy outcomes and poor child development. Early identification and behavioural modification are of great significance. This study aimed to determine the prevalence and associated factors of alcohol use during pregnancy among women in Dodoma region. Methods. 365 randomly selected pregnant women attending antenatal care services in Dodoma region were included. Structured questionnaires were used to assess sociodemographic characteristic and alcohol use. Both descriptive and inferential analyses were used to estimate the prevalence and independent relationships of factors associated with alcohol use in pregnancy, respectively. Results showed a prevalence of 15.1% out of the 365 women attending antenatal services in Dodoma region. Prepregnancy alcohol use and having relatives who use alcohol were associated with alcohol use (AOR= 5.19; 95% CI: 4.791-34.867 and AOR=1.57; 95% CI: 1.393-6.248), respectively. Moreover, other associated factors included low education status (AOR=10.636; 95% CI: 1.89-19.844), making local brews as a source of income (AOR=11.44; 95% CI: 1.008-19.86), and not having had complications in previous pregnancies (AOR=4.93; 95% CI: 1.031-23.59). There is a significantly high prevalence of alcohol use during pregnancy in Dodoma. Social networks and low social, economic status were associated with alcohol use in pregnancy. There is a need for public health interventions to address alcohol use particularly targeting women of reproductive age with low socioeconomic status.Item Socio-economic and spatial correlates of subclinical iodine deficiency among pregnant women age 15–49 years in Tanzania(BMC, 2017) Mtumwa, Abdalla H.; Ntwenya, Julius Edward; Paul, Edwin; Huang, Megan; Vuai, SaidBackground: Iodine deficiency is a widespread global health problem that affects about 2 billion people each year. Pregnant women are particularly vulnerable to iodine deficiency due to increased iodine requirement leading to death, miscarriage, and stillbirth. Iodine deficiency also has significant negative effects on newborns including impaired cognitive development, impaired learning capabilities, and stunting. This study looks at the association between subclinical iodine deficiency and demographic factors including age, wealth index, education, family size, geographical zone, number of children, fish consumption, pregnancy trimester and household salt in pregnant women aged 15–49 years in Tanzania. Methods: The 2010 Tanzania Demographic and Health Survey (TDHS) data was re analyzed. Subclinical iodine deficiency is classified as a urinary iodine concentration (UIC) of <150 μg/L. Results: Results showed that the prevalence of iodine deficiency (54%) was unacceptably high among pregnant women. The results of multiple logistic regression model found that number of children, wealth index, household salt, and geographical zone were significantly associated with iodine deficiency in these women. Conclusion: These results indicate a need to implement interventions to increase iodine intake that targets pregnant women with the specific demographic characteristics.