Master Dissertations

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The effectiveness of brief counseling in the treatment of clients with mild alcohol use disorder in Dodoma municipality, Dodoma, Tanzania
(The University of Dodoma, 2013) Kawamala, Paulo Michael
Background: Alcohol use is associated with risks, such as intoxication, physical and mental harm, alcohol dependence, distress and illness to the drinker, family and friends. This study, studied the use of brief counseling in treating persons with mild alcohol use disorder (AUD). in order to avoid its progression towards worse condition. Objective: The study objective was to assess the effectiveness of brief counseling in the treatment of persons with mild AUD. Methodology: The study area was Dodoma Municipality; used qua-experimental design, with quantitative approach. However, 80 study participants were recruited, 40 in the treatment group and another in control group. The data were in a quantitative form, Statistical Package for Social Science (SPSS) and Independent t test were used for data analysis. Results: There was no significant reduction in alcohol use in the treatment and control groups in the first follow-up. But was observed in the second follow-up in both treatment and control groups, but greater in the treatment group p- value <0.033 (95%CI: -3.24 to -0.14). Conclusion: This study supports that brief counseling significantly reduces alcohol use among individuals with mild AUD.
Proportion of blood pressure control, predictors of blood pressure control, and associated microvascular effects among patients with diabetes mellitus type 2 attending Dodoma regional referral hospital
(The University of Dodoma, 2016) Moirana, Ezekiel Noah
Diabetes and hypertension are among the most common diseases in developed countries and the frequency of both diseases tends to rise with age. According to JNC 8 criteria, the target Blood pressure control among diabetes patients is below 140/90 mmHg. A hospital-based cross-sectional study was carried out of 498 type 2 diabetic hypertensive patients who were attending hypertensive diabetic type 2 patients clinic at DRRH. The structured questionnaire was used to gather information on social-demographic variables, Anthropometric measurements were measured and bp was measured, retinopathy and proteinuria screening as well as symptoms for neuropathy were performed. The proportion of patients whose blood pressure was controlled with goal range is 30.9%; the predictor of good blood pressure control were: Residing in urban areas (OR= 5.85, 95% CI 3.88-6.98) and being unemployed (OR=2.01, 95% CI 1.27-3.64). The predictor of neuropathy was smoking (OR= 15.572, 95% CI 1.573- 154.191). The predictors of nephropathy were; Alcohol use (OR=2.294, 95% CI; 1.413-3.726) and the short period since being diagnosed with type 2 diabetes (OR= 3.66; 95% CI; .417-8.399). The predictors of retinopathy were; Low education (OR= 5.687, 95% CI 1.708-18.929) and cigarette smoking both current and past smokers (OR =5.062, 95% CI; 2.498-10.258 and OR 2.419, 95% CI; 1.379-4.244) respectively. The proportion of blood pressure control is very low, good predictors of blood pressure control are the area of residence and occupational status. This study has shown that there were some populations who had a higher risk of poor blood pressure control and microvascular complications.
Predictors of alcohol use disorders and their association with family functioning among adults residing in Dodoma municipal, Tanzania
(The University of Dodoma, 2016) Amos, Aeluya K
Background: Globally, alcohol use disorders (AUDs) cause 3.3 million deaths each year globally. They also add to the burden of diseases, violence, accidents and family dysfunction. This study aims to look at prevalence and predictors of AUDs and their association with family functioning among adults residing in Dodoma municipality. Methods: Cross-section study design was used with a sample size of 690 participants. Data collected using three assessment tools: social-demographic characteristics assessment tool, AUDIT for alcohol use and General family functioning of family assessment device (FAD). Face to face interviews were done to collect data from participants after considering ethical issues. Multivariate analysis was employed in this study. Results: Prevalence of AUDs among adults residing in Dodoma municipality was (21.4%). Predictors of alcohol use disorders were; those aged 40 years and above (OR:;15.04,CI:; 1.631-139.289), male gender (OR:;1.978,CI:;1.028-3.807 ), Not attending religious services in churches or mosques (OR:;14.687, CI:;5.423-39.779), cigarette smoking (OR:;31.434, CI:;1.949-162.203) and peer pressure (OR:;0.06;0.021- 0.169). Furthermore, it was found that alcohol use disorders have the significant association with family dysfunction, (OR:; 0.469, CI:;0.280-0.788). Conclusion and recommendation: AUDs are a problem among adults residing in Dodoma municipality. It predictors are male gender, age of 40 and above, peer pressure, cigarette smoking and not attending religious services. Also it is significantly associated with families' dysfunction. Therefore there is a need of the interventions which should deals with AUDs in Dodoma municipality.
Perceived risk of HIV infection among injection drug users in Zanzibar: Cross sectional study
(The University of Dodoma, 2016) Vuai, Fahamni M
Background: There is a significant increase of drug abuse especially injection in Tanzania. Injection behaviors have been known to facilitate the transmission of HIV. Injecting drug users are among the population with an increased risk of contracting HIV. Understanding their perceived risk is a significant factor in determining the behaviors of this group Objective: This study wanted to assess the perceived risk of HIV infections among injecting drug users in Zanzibar. Methods: A cross-sectional study design was conducted among 1308 injecting drug users in Zanzibar by using quantitative approach. Multistage sampling was used and written questionnaires were employed for data collection Descriptive statistics were calculated using the demographic data and data on high risk injection behaviors. A chi-squared test was done to observe the relation between independent and dependent variable as well univariate analysis was done to identify the predictor variables. Finally a multiple logistic regression was employed to identify the independent effects, from the perceived risk of HIV infection among injecting drug users. Results: This study found about 49.5% perceived low risk of HIV infection The best five predictors includes the period of drug using of between 4-10 years which were more likely to perceive a low risk of HIV infection (AOR:1.532,95% CI 1.004-2.338), preference for amphetamine as the drug of choice were more likely to perceive low risk of HIV infection (AOR:2.526,95%CI 1.527-4.179),site of injection such as hands and foot were less likely to perceive low risk of HIV infection(AOR: 0.393 95% CI 0.198- 0.778),low frequency of using drug were more likely to perceive a low risk of HIV infection (AOR:2.330 95% CI 1.402-3.874) and injecting drug, own a room alone were less likely to perceive a low risk of HIV infection (AOR:0.496, 95% CI 0.335-0.734). Conclusion: We find that lower perceived risk of HIV infection are associated with a less period of using drug , preferred drug type, site of injection), frequency of using drug and place for injecting drug. This risk perception should be taken in to consideration when studying the risk of HIV infection among injection drug users. These findings could help to better target and focus interventions and understand the negative effects of fear arousing intervention as part of HIV prevention in Zanzibar.
Factors associated with high risk injection behavior among drug users in zanzibar: A cross section study
(The University of Dodoma, 2016) Mohammed, Khadija K
Background: Globally around 13million people are injecting drugs and 1.7million of them are living with HIV. Injecting drug users have created and remain a major international public health problem. Objective: This study aimed to determine factors associated with high risk of injection behaviors among injection drug user (IDU’s) in Zanzibar. Methods: A cross-sectional study design using a quantitative approach was conducted in Zanzibar islands. A total of 1308 injection drug users aged 15 to 64 years were interviewed on this study. A face to face interview through self-administered: questionnaires were and were selected from the four districts out of 11and 20shehia out of145.Mental hospital, methadone clinic, hot spot, lower spot, sober rehabilitation house. Results: A total of1308 respondents participated in this study on which 660 (50.5%) engaged on high risk injection behaviors. Low-risk behavior 648(49.5%). Where by the minority were females 293(22.4%) while the majority ware males about 1017(77.7%). Based on the multivariate logistic regression analysis, participants aged above 24 years were found to have a high risk of injection behaviors (AOR 2.287 95%CI 1.298 – 4.030 P < 0.05), compared to those aging between 18 to 19 years. Those who lived in lower spot areas had 1.728 odds of engaging on high risk behaviors compared to those living in hot spot areas (95% CI 1.188 – 2.513 P< 0.05), also females participants were found to have low risk of engaging on high risk injection behaviors (AOR 0.628 95%CI 0.431 – 0.915 P < 0.05) than males. Conclusion: This study,high-risk injection behaviours was very prevalent among (IDUs)including sharing insruments, needles, and swabs when injecting drugs. Majority were found to be engaged on high risk injection behaviours. Male were moreengaged on high-risk injections. For those whom had lived on hot spot areas were most engaged on high risk injection behaviors. long duration of drugs for long time 11 or more than 11 years
Patterns and early treatment outcomes of peritonitis among patients admitted at Dodoma regional referral hospital, Dodoma region,Tanzania
(The University of Dodoma, 2016) Kivike, Oscar Lucas
Background: Peritonitis is a common surgical condition which can occur either primarily or secondarily to other underlying pathologies including post operation. Studies show that the major causes of peritonitis are bowels perforations, perforated appendix, volvulus and strangulated bowel. Objective: This study aimed at describing the patterns, and early treatment outcomes of patients with peritonitis at Dodoma Regional Referral Hospital. Methods: This was prospective cross sectional hospital based study which included all patients admitted with the clinical features of peritonitis for seven months from 1/10/2015 to 30/4/2016. The study was conducted in surgical wards of Dodoma Regional Referral Hospital which is located in Dodoma Region, central part of Tanzania. Results: A total number of 66 patients with generalized peritonitis were involved in the study. Of these, 23 (34.85%) were females and 43 (65.15%) were males. Perforation was found to be the commonest cause accounting for 51 (77.3%) and was slightly higher in males than female patients. Typhoid fever was the leading cause of perforations leading to peritonitis in 12 patients (18.18% ) followed by abdominal trauma 9 patients (13.64%) while the least causes were inflammatory bowel disease and idiopathic 2 patients each (6.06% ). Conclusion: Generalized peritonitis was found to be a common problem at Dodoma Referral Regional Hospital and in the developing countries as a whole. It seems to affects individuals mostly from low social economic class of which males were affected more than females. Mortality and morbidity found to be high
Socio cultural determinants and post-traumatic stress disorders of intimate partner violence among women: A case of Dodoma Municipality
(The University of Dodoma, 2016) Nzigo, Edna G
Background: This study was conducted in Dodoma Municipality with the aim of determining socio-cultural determinants for intimate partner violence and its impacts to the post-traumatic stress disorder among women in Dodoma municipality. Methods: Across sectional study was conducted amongst 440 women aged 18-60 years from March to April 2016. Data were collected through interviewing women by using structured questionnaires. Multiple logistic regression models were used to assess Socio cultural determinants and post-traumatic stress disorder of IPV. Results: The lifetime prevalence for physical intimate partner violence was 53.2% and psychological violence was 67.7% while sexual violence was 36.8%. Alcohol use was significantly associated with characteristics of men who were violent to their wives compared to those who were not using alcohol. Marriage involving dowry was found to associate with intimate partner violence (AOR 95 % CI 0.309- 0.988). PTSD was associated with intimate partner violence, participants who had experienced physical violence found to be more like experience PTSD compared to those who did not (AOR 0.153 95%CI 0.093-0.252) , also participants who had experienced psychological violence were more likely to experience PTDS compared to those who did not (AOR 0.255 95%CI 0.143-0.457) while victims of sexual violence were more likely to experience PTSD compared to those who did not experience (AOR 0. 95% 0.889-0.023) . Conclusion: Study findings indicated that prevalence of intimate partner violence in Dodoma Municipal has been decreased. Majority of women who experienced intimate partner violence did not take any action. However, findings from this study showed that majority who had IPV also had PTSD.
The effect of HIV status on childhood deprivation, depressive symptoms and quality of life among HIV-infected and uninfected children: A case control study, Mbeya Tanzania.
(2016) Mgalilwa, Lwidiko A.
Background: HIV/AIDS pose a direct threat to child health and well-being, which gives a burden of poverty to the household family and increase the risk of mental health problems among HIV infected children. Objective: The aim of this study was to determine the effect of HIV status on childhood deprivation, depressive symptoms and quality of life among HIVinfected and uninfected children aged from 7 to 17 years old. Method: A matched case-control study design was conducted by involving HIVinfected and uninfected children with their caregivers at Mbarali district. Matching was done by sex. Scales Multidimensional Poverty Index 2014, World Health Organization Quality of Life, Children Depression Inventory -II and WHO Clinical Staging Guideline, were used to measure childhood deprivation, quality of life, depressive symptoms and HIV status respectively. Data were collected and analyzed by SPSS 20 version database program. Chi-square test, Pearson correlation, and logistic regression were used in the analysis. Results: In total, 900 participants were studied; of which 300 were HIV-infected and 600 uninfected children with their mean age of 12.84 aged from 7-17 years. The study involved both sexes; females 505 (56.10%) and males 395 (43.90%). A high prevalence of childhood deprivation 183(61%), depressive symptoms 145(48.3%) and of a quality of life 81(27%) was observed in HIV-infected children. Multivariate logistic regression analysis revealed that HIV-infected children had high odds of depressive symptoms and quality of life compared to uninfected.1.96 [OR95%CI: 1.11-3.45], 2.42 [OR95%CI: 1.30-4.53] respectively. Childhood deprivation associated with depressive symptom among HIV-infected children 4.76 [OR95%CI: 2.79-8.21] Conclusion; HIV status showed to have an effect on quality of life and depressive symptoms among HIV-infected children. Childhood deprivation associated with depressive symptoms among HIV-infected children.
Role of sexual networks in bridging HIV infection between injection drug users to the general population in Zanzibar: A cross-sectional study
(The University of Dodoma, 2016) Maulid, Said
Background: Injecting drug use has created a major international public health problem where on average 6 million people are injecting drugs worldwide. This study aimed to explore the potential of bridging the HIV infection from injection drug users (IDUs) through sexual networks to the general population in Zanzibar. Seek to understand the interplay between injection drug use, sexual behavior and the epidemiological shift in the transmission of HIV infection between key population and the general population, thereby contribute to reducing HIV epidemics in both sides. Objective: The role of sexual networks in bridging HIV infection between injection drug users to the general population in Zanzibar. Methods: Quantitative cross-sectional study design was used whereby data was collected from1308 adults of all sex with age ranging from 18 to 64 years who are injection drug in Zanzibar. The data collection method was by the use of self– administered questionnaires. Results: Participants who had sexual debut below 18year were had a high risk in sexual network to the general population OR= (95% CI) 1.353(0.999, 1.833) p<0.05, most of the participants that practice steady partners were at risk in sexual network OR= (95% CI) 1.407(1.047, 1.893) and p <0.05. Marital status was also the main factor for IDU whereby participants who were reported to be separated, widow or divorced were at less risk of IDU sexual network compared to those who were married 95%CI (0.347,0.753), and P< 0.05). Type of drug used was also the determinant for IDU sexual network whereby participants that reported to take amphetamine were less likely to be in sexual network compared to those taking heroin OR 0.279, 95%CI (0.138, 0.564) and P < 0.05) vi Conclusion: We found evidence to support the hypothesis that sexual networks are responsible for bridging HIV infection among injection drug users and the general population in Zanzibar. Recommendation: In order to control this problem, further efforts should focus mainly on controlling the use of heroin, preventing sexual debuts below 18 and giving sexual education among married groups. Establishment of awareness and ongoing risk reduction programs of IDUs and community how to live in safety also, sexual practice in an effort to achieve the goal of zero new infection due to the sexual network.
Predictors of substance use among undergraduate university students: a cross sectional study, Dodoma municipality Tanzania
(The University of Dodoma, 2016) Kileo, Mhando
Background: Substance use in young people is significant public health concerns which need to be understood and addressed. Young adolescent is a period when substance use typically starts and patterns become established (NDARC, 2016). Objective: The study was aimed at determining predictors of substance use among undergraduate university students in Dodoma Municipal. Method: A cross-sectional study design was employed involving undergraduate university students aged from18 years and above. Risk factors of substance use were measured by self-administered questionnaire, known as the Substance Use Questionnaire. Simple and systematic randomly sampling techniques were used to select participants. Data were analyzed by SPSS version 20. Chi-square test and logistic regression were used in the analysis. Results: A total of386questionnaires were completely filled by participants. Proportion of male was 64.5% and that of female was 35.5%. The mean age was 24.5 years with a standard deviation of 3.24. Up to 43% of the participants found to be currently using one or more substances, and the commonest substance used was alcohol (48.2%) followed by cigarette (13%) cannabis (7.8%), khat (5.4%), and sedatives/tranquilizer (4.7%). Multivariate logistic regression has shown that, compared with students residing in university hostels those who stayed in their home (AOR=0.07, CI: 0.01, 0.70) or rented rooms (AOR=0.13, CI: 0.04, 0.45) had significantly lower chance of drinking alcohol. Students with friends who drank alcohol had higher odds of drinking alcohol (AOR=17.9, CI: 4.46, 71.82). Male students were significantly having a higher prevalence of cigarette smoking than female students (AOR=0.95, CI: 1.24, 12.54). Having friends who used cannabis was significantly associated with an increase in the chance of using cannabis (AOR=15.36, CI: 3.82, 61.71). Cigarette smokers had about 6 times more odds of using khat than that of non-smokers (AOR=6.03, CI: 1.66, 21.85). Conclusion: This study has shown a high prevalence of substance use among university students in Dodoma Municipal, with the most commonly used substances being alcohol, cigarettes, and cannabis. Male sex, peer pressure, low social economic status and living in the university hostels showed to have a significant relationship with substance use
Terrorism and the vulnerability of tourism in Tanzania: A case study of Urban West region in Zanzibar
(The University of Dodoma, 2016) Saleh, Abdulla M
Currently, terrorism is the one among the major problems affecting global economy, human security and life in general. One of the most affected sectors in the economy is tourism. The study intended to focus on the vulnerability of tourism sector in Tanzania to terrorism taking Urban West region of Zanzibar as its case study. Like any other country in the world, Zanzibar tourism is also being affected by terrorism, because of the existing threats all over the world and some incidences that have been happening in the country and in some of the neighbouring countries. The study had four specific objectives which were: To reaffirm whether tourism sector in Tanzania is vulnerable, To identify manifest terrorist acts in the tourism sector in Tanzania, To establish whether the terrorist acts have adversely affected the tourism sector and To find out whether the government revenue and employment opportunities in the sector have declined .The study had a sample of 70 respondents obtained through random sampling procedures. The methods employed for data collection were interview and questionnaires whereas the Statistical Package for Social Sciences (SPSS) was used for data management and analysis. The results of this study show that tourism sector is vulnerable to terrorism as there is a decline of government revenue and employment opportunities due to the existence or threat of terrorism. Meanwhile apart from its existence, it (terrorism) does not adversely affect the sector. It is recommended that the government should take into consideration all proposed measures for combating and eradicating terrorism in order to secure the tourism sector from its threat or vulnerability to it.
The assessment of interest, motivation level and perceived stress during clinical practice among nursing students in Tanzania: a cross-sectional study
(The University of Dodoma, 2017) Mtei, Goodluck Tumaini
Background: Nursing students faces number of challenges which are associated with interest conflict toward the profession, learning motivation and perceived stress during clinical practice Objectives: To assess the levels of interest, motivation and perceived stress during clinical practice among nursing students in Tanzania Methods: A cross-sectional analytical study design was used to assess levels of interest, motivation and perceived stress during clinical practice among nursing students. 1090 certificate, diploma and undergraduate nursing students attending clinical practice from selected nursing Schools and Universities were selected using convenient and simple random sampling. Results: About 49% of the respondents found to be interested to the nursing profession with 49.7% levels of clinical learning motivation, while the prevalence of perceived stress was 44.3%. Multivariate logistic regression has shown that, students from private institutions (AOR=0.542, p=0.0010) had significantly low stress. Female students were significantly affected by stress as compared to the male counterparts (AOR=1.335, p=0.0259). Undergraduate (AOR=1.940, p=0.0006) students were significantly associated with stress. Students who were not motivated to clinical practice had about 2 times higher odds of being stressed (AOR=1.785, p<0.0001). Conclusion and recommendation: This study has shown a relatively low level of interest to nursing profession and clinical learning motivation among student nurses with a low prevalence of stress during clinical practice.
Predictors of early management outcomes in patients with dynamic intestinal obstruction operated at Iringa regional referral hospital southern highlands Tanzania
(The University of Dodoma, 2017) Karuhanga, Theresia Andrew
Background: Intestinal obstruction is one of the most causes of cause of surgical emergency associated with morbidity and mortality in surgical department. The study aimed to determine the causes and predictors of management outcome in post-operative patients with intestinal obstruction at IRRH. Method: A prospective hospital based study design was used. Duration of the study was six months. The collected data were checked for any inconsistency, coded and entered into SPSS version 20 for data processing and analysis. Descriptive and logistic regression analyses were used. Statistical significance was based on confidence interval (CI) of 95 % at a p-value of < 0.05. Result: 59 adult patients were admitted with intestinal obstruction. The morbidity and mortality rates were 18.6% and 6.8% respectively. The most common cause of obstruction was sigmoid volvulus (55.9%) followed by adhesion (37.3%). The major predictors of management outcome of intestinal obstruction were: occupation, mode of referral, etiology bowel status and the procedures done during operation. Categories which were likely to develop poor outcomes in multivariate regression were Peasants (AOR = 0.08; CI =0.02-1.05; P = 0.041). Referred patients (AOR-1.9371; CI=0.02-0.244; P-value= 0.026). Volvulus (AOR=2.020; CI=1.13-2.2.45; P–Value = 0.0420). The gangrene bowel (AOR= 0.09; CI = 0.02-0.070; P = 0.020) and colostomy/ ileostomy (AOR=1.202; CI=4.363-3.341: P-value=0.024) hence statistically significant respectively. Conclusion: in this study, sigmoid volvulus is the leading causes of large bowel obstruction. Invasive procedure was done to all patients. Bowel resection and anastomosis was the commonest intra-operative procedure done and is associated with postoperative complications. Wound infection was the most common postoperative complication.
Effect of facilitation in a problem-based environment on the metacognition, motivation and self-directed learning in nursing: a quasi-experimental study among nurse students in Tanzania
(The University of Dodoma, 2017) Millanzi, Walter Cleophace
The study intended to investigate the effect of facilitation in a problem-based environment (FPBE) on metacognition, self-directed learning and learning motivation to undergraduate nurse student in Tanzanian higher learning institutions. It was a quasi-experimental study with quantitative research approach. A purposive sampling technique was employed for achieving a sample size of 401 undergraduate nurse students (interventional = 134 and control = 267). The semi-structured questionnaire; was the main data collection methods and the Statistical Package for Service Solution (v. 20) software program was used for data entry, data analysis, and presentation. The pre-post test results between groups indicated noticeably significant change in which metacognition in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p<0.05). SDL in an intervention (M = 1.52, SD = 0.501) against the control (M = 1.40, SD = 0.490), t (399) = 2.398, p<0.05. Motivation to learn in an intervention (M = 62.67, SD = 14.14) and the control (n = 267, M = 57.75), t (399) = 2.907, p<0.01). A FPBE teaching pedagogy, was observed to be an effective on the metacognition (AOR = 1.603, p<0.05), SDL (OR = 1.729, p<0.05) and Intrinsic motivation in learning (AOR = 1.720, p<0.05) as compared to conventional teaching pedagogy. Needless, was less likely to enhance Extrinsic motivation (AOR = 0.676, p>0.05) and Amotivation (AOR = 0.538, p>0.05). It is concluded that FPBE teaching pedagogy, can improve student’s metacognition, self-directed learning and intrinsic motivation to learn among nurse students hence. Keywords: learning, intrinsic motivation, extrinsic motivation, Amotivation, Problem-based teaching, pedagogy, facilitation, metacognition, self-directed learning.
Intimate partner violence and their associated emotional disorders among pregnant women attending antenatal care clinic at Makole health centre – Dodoma, Tanzania
(The Univesity of Dodoma, 2017) Mzezele, Said
Background: IPV is among of the most widespread forms of violence now days, about one third of women murdered worldwide are murdered by their intimate partners. Africa, Eastern Mediterranean and Southern Asia are leading region on IPV worldwide with the prevalence of 37%. About 20% of pregnant women in Dodoma region, Tanzania experienced IPV during pregnancy. This study aims to determine the association between intimate partner violence and their associated among pregnant women at Makole Health Centre. Methodology: From March to April 2016 a quantitative approach cross sectional study design was conducted to the 378 pregnant women attending ANC at Makole Health Centre, face to face interview was used for the data collection. A structured questionnaire used for the assessment of socio-demographic details; intimate partner violence was assessed by using revised conflict tactic scale version 2 (CTS – 2), Anxiety and depression were assessed by using Hopkins symptom checklist 25 (HSCL-25) and post-traumatic stress disorder was assessed by using Post traumatic stress disorder checklist (PCL). RESULTS: A total of 207 (54.8%) participants reported to experience at least one form of IPV within the last year. Psychological IPV was the most reported by 204 (54%) of the participants followed by physical IPV with 101 (26.7%) and sexual IPV with 45 (11.9%) of the participants. Marriage and planned pregnancy was found to be the low risk factor for experiencing IPV (AOR 0.335 95%CI 0.165 – 0.683, AOR 0.048 95%CI 0.026 – 0.089) while partners alcohol using was found to be the high risk for experiencing IPV (AOR 2.182 95%CI 1.142 – 4.175). Also experiencing physical form of IPV was found to be low risk of having anxiety (AOR 7.561 95%CI 3.734 – 15.676), depression (AOR 5.380, 95%CI 2.757 – 11.239) and PTSD (AOR 6.471 95%CI 3.151 – 28.770) while sexual form of IPV was found a risk factor for anxiety (AOR 3.025 95%CI 1.167 – 7.837), depression (AOR 3.863 95%CI 1.530 – 9.757) and PTSD (AOR 2.636 95%CI 1.061 – 6.551). Conclusion: More than half of the participants reported to experience at least one form of intimate partner violence within the last year. One third of the participants were observed to have at least one form of emotional disorders. Recommendations: There is a need to screen violence to the pregnancy women during their visits to ANC clinics; also government should improve implementation of rules and regulations regarding intimate partner violence. Key words: Anxiety, Depression, PTSD, ANC and Makole Health Centre
An assessment of competencies of clinical instructors in teaching and guidance for nursing students in clinical areas: a cross-sectional study in Tanzania
(The University of Dodoma, 2017) Mligo, Rehema Cornery
Nursing student’s clinical competence including psychomotor skills, attitude, values, and beliefs of professional practices depend on the quality of clinical instruction given by their preceptors in clinical settings. The main objective was to assess the Tanzanian clinical instructors’ teaching abilities and attitude towards the clinical teaching and guidance of nurse students at clinical areas. It was a cross-sectional study design with quantitative approach. A total of 277 clinical instructors were sampled and voluntarily participated in this study. Data were obtained through semi-structured questionnaires. The analysis was carried out by the Statistical Product of Social Solution (SPSS) version 20. Findings indicated that none of the clinical instructors reported to pass through any short course of clinical teaching or use a clinical guideline for teaching nurse students at the clinical area (0.0%). Clinical instructors recruited as full-time who Employees could more likely develop appositive attitude towards clinical teaching and guidance of nurse students at clinical areas (AOR = 1.802, p<0.05, CI: 0.977, 3.323) as compared to part-time clinical instructors. Clinical teaching experience (p<0.01) and clinical instructors education level (p<0.01) were also observed to influence positive attitude towards clinical teaching and guidance of nurse students at clinical areas. Nevertheless, being employed as a full-time clinical instructor could enhance clinical teaching abilities (AOR = 2.348, P<0.01, CI: 0.420, 3.863). Moreover, the clinical experience could also influence clinical teaching abilities of clinical instructors (AOR = 1.948, P<0.05, CI: 1.420, 3.863). This can be concluded that full-time employment of clinical instructors is better than part-time in determining the attitude and clinical teaching abilities whereas, the more clinical instructors advance their education level and stay longer at work could predict positive attitude and good clinical teaching abilities of nurse students at the clinical area. There is a need to design, develop and implement clinical instructor courses as well as a clinical guideline which can help produce qualified clinical instructors and thus promote the quality of clinical teaching of nurse students at clinical areas.
Prevalence, aetiologies, sensitivity profile and factors associated with significant bacteriuria among diabetes mellitus patients attending Dodoma regional referral hospital
(The University of Dodoma, 2017) Nassoro, David Daniel
Background: Diabetes mellitus is an independent risk factor for significant bacteriuria and hence severe and non-severe forms of urinary tract infections. There is a considerable regional variation in sensitivity profile of uropathogens in diabetics. Objectives: To determine prevalence, aetiologies, sensitivity profiles and factors associated with significant bacteriuria among patients with diabetes mellitus attending Dodoma Regional Referral Hospital. Methods: A case – control study was done at Dodoma Regional Referral Hospital in Dodoma region for over a period of 3 months. Participants were diabetic patients from medical outpatient clinic and variables such as demographics, vital signs and urine for culture and sensitivity were obtained. Data was recorded and subsequently analysed using SPSS version 23 and outcome variable being urine culture results. Results: A total of 371 patients were enrolled into the study. The prevalence of significant bacteriuria in cases was significantly higher (15.5%) (P<0.001) compared to controls (4.9%). Commonest isolate in both cases and control were were Escherichia coli and Klebsiella spp. In both cases and controls, ceftriaxone, cefuroxime and cephalexin had the highest sensitivity of more than 80%. Female sex (AOR=4.51, CI 1.94 – 10.51), age group of 18 – 39 years (AOR=3.05, CI 1.01 – 6.42), urban residence (AOR=2.55, CI 1.01 – 6.42) where associated with significant bacteriuria in cases and in controls only female sex (AOR=6.16, CI 1.32 – 28.85) was the only associated factor. Conclusion: In adult’s diabetes mellitus patients with significant bacteriuria attending medical outpatient medical clinic, ceftriaxone, cephalexin and cefuroxime where the drugs with highest sensitivity while clavulanic acid potentiated amoxicillin, gentamicin, ciprofloxacin and cotrimoxazole had high resistance
Severe pre-eclampsia and eclampsia: prevalence and management outcomes at Dodoma regional referral hospital
(The University of Dodoma, 2017) Soko, Israel Baraka
Background: In low and medium-income countries like Tanzania, the severe pre-eclampsia and eclampsia disease complex continues to be a major cause of maternal and perinatal morbidity and mortality. The objective of this study was to determine the prevalence, clinical presentations and management outcomes among all women admitted through the labour ward with obstetric conditions at Dodoma regional referral hospital during the study period. Methods: This was an observational, analytical and cross-sectional hospital based study. Analysis: Collected data were checked for any inconsistency, coded and entered into SPSS version 20.0 for data processing and analysis. Results: Out of all 384 pregnancy women who concerted during the study period, total of 75 women fulfilled the criteria for the severe pre-eclampsia/eclampsia giving the prevalence 19.5%. No maternal death occurred during the study among women with the diagnosis, although several complications were recorded. Of these include: maternal stroke (2.8%), HELLP syndrome (8.6%), acute kidney injury (1.3%), abruption placenta (3.6%), convulsion (9.3%).Perinatal Still births related to severe eclampsia were 17.9% and those of eclampsia were13.9% Conclusion: Severe pre-eclampsia /eclampsia were diagnosed in 75 out of 384 women who attended and consulted for. Early diagnosis and treatment of patients with this condition may result to improved outcome in terms of management outcomes (Maternal and perinatal mortality and morbidity).
Severe acute maternal morbidity: analysis of the incidence, causes and management outcomes at Dodoma regional referral hospital
(The University of Dodoma, 2017) Mujungu, Simon Masau
Background: Severe Acute Maternal Morbidity (SAMM) auditing is rarely conducted and has never been done in DRRH despite the established fact that SAMM auditing is useful in the prevention of maternal mortality and improve the quality of obstetric care perhaps with better results than just maternal mortality audit as suggested by some published works done elsewhere. Objective: The main objective was to determine the incidence, causes and management outcomes of severe acute maternal morbidity among women admitted at DRRH between September 2015 and February, 2016. Methods: This was a retrospective cross-sectional descriptive study. Medical records of all women who were admitted in the obstetrical wards, gynecological wards, and the Intensive care Unit of the Dodoma Regional Referral Hospital between September 2015 and February 2016 were retrieved and information analyzed. Main outcome measures: Incidence, case fatality rate, and causes. Results: During the study period, a total of 7789 women were admitted to the hospital for various pregnancy-related conditions. Severe Acute Maternal Morbidity was found in 140 cases of all admitted patients giving an overall incidence of 17.9 per 1000 women. Severe pre-eclampsia/eclampsia was the leading cause with 64 cases (45.7%) and an incidence of 8.2 per 1000, followed by major obstetric haemorrhage with 57 cases (40.7%) with an overall incidence of 7.3 per 1000. During this period 16 deaths were recorded among those who were classified as being SAMM cases giving case fatality rate of 11.4%. Substandard care was found in 77 (55%) patients. Conclusions: The incidence of Severe acute maternal morbidity in this facility is high reflecting a high maternal mortality and therefore should be well thought-out locally and country wide as a new indicator of a quality of obstetric care.
Assessment of competence on utilization of partograph among finalist nurse students within the selected nursing institutions in Tanzania: a cross sectional study
(The University of Dodoma, 2017) Mtaita, Stella Edward
Introduction: Partograph as a labour record chart that works as an important tool, when used correctly, could help to identify any abnormality when labour is no longer normal and immediate decision is made for action. Nevertheless, very little is known about the status of knowledge and utilization of partograph among finalist nurse students. Objectives: This study aimed to assess the competence on utilization of partograph among the finalist nurse students in Tanzania; this study was conducted in the United Republic of Tanzania Mainland. A cross-sectional study was conducted to 13 schools of nursing, with a total of 753 participants volunteered. Methodology: Sampling was done to obtain the zones and Institutions. Independent and dependent variables utilized. Semi-structured questionnaires were administered; collected data were analyzed by using SSPSS 20 version. Results: The study revealed that, 73.44 % had a good knowledge, while 26.56% had poor. However diploma program had a good knowledge 481 (85.69%) than undergraduate 122 (48.80%). A chi-square test revealed that, there was a statistically significant with p-value of <0.0001. Concerning skills, diploma program had higher skill 398 (79.13%) while undergraduate 161 (64.40%), with p-value of < 0.0001. Regarding factors; occupation (P=0.0032), availability of partograph forms (P =0.0028) and clinical supervision (P = 0.0223) were the affirmed predictors. Conclusion: Findings are sufficient to propose the drawn recommendation to improve competence on the utilization of partograph among student nurses,

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