Key Considerations in Scaling Up Male Circumcision in Tanzania: Views of the Urban Residents in Tanzania

Abstract:Male circumcision (MC) reduces the risk of sexually transmitted infections (STI) including HIV. The WHO and UNAIDS recommend male circumcision as an additional intervention to prevent HIV infection. Tanzania is embarking on activities to scale up safe male circumcision for HIV prevention and other related health benefits. In line with this; it is crucial to assess views of the population using specific groups. This paper describes perceptions on male circumcision and strategies of enhancing uptake of male circumcision in urban Tanzania using members of the police force. This cross sectional survey was conducted among members of the police force in Dar es Salaam Tanzania from January 2010 to July 2010. The police officer serves as a source of the clinical trial participants in on-going phase I/II HIV vaccine trials. Three hundred and thirteen (313) police officers responded to a self-administered questionnaire that comprised of socio-demographic characteristics; reasons for not circumcising; perceptions regarding circumcision; methods of enhancing male circumcision; communication means and barriers to promote circumcision. This was followed by a physical examination to determine male circumcision status. The prevalence of circumcision was 96. Most (69) reported to have been circumcised in the hospital. The reported barriers to male circumcision among adults and children were: anticipation of pain; cost; fear to lose body parts; and lack of advice for adult's circumcision. Sensitization of parents who take children to the reproductive and child health services was recommended by most respondents as the appropriate strategy to promote male circumcision. The least recommended strategy was for the women to sensitize men. Use of radio programs and including male circumcision issues in school curricula as means of enhancing community sensitization regarding male circumcision were also highly recommended. Other recommendations include use of public media; seminars at work and issuance of circumcision regulations by health authorities. In conclusion; the present study reveals male circumcision was common in a selected urban population. There are various barriers and channels of communication regarding male circumcision. In view of scaling male circumcision in Tanzania; use of radio messages; inclusion of male circumcision in the school curricula and sensitization at the reproductive and child health clinics are likely to promote early medical male circumcision

Scepticism towards Insecticide Treated Mosquito Nets for Malaria Control in Rural Community in North-Western Tanzania

Abstract:Despite existence of effective tools for malaria control; malaria continues to be one of the leading killer diseases especially among under-five year children and pregnant women in poor rural populations of Sub Saharan Africa. In Tanzania Mainland the disease contributes to 39.4 of the total OPD attendances. In terms of mortality; malaria is known to be responsible for more than one third of deaths among children of age below 5 years and also contributes for up to one fifth of deaths among pregnant women. This paper is based on a study conducted in a rural community along the shores of Lake Victoria in Mwanza region; North-Western Tanzania. The study explores reasons for scepticism and low uptake of insecticide treated mosquito nets (ITNs) that were promoted through social marketing strategy for malaria control prior to the introduction of long lasting nets (LLN). The paper breaks from traditional approach that tend to study low uptake of health interventions in terms of structural practical constraints - cost; accessibility; everyday priorities - or in terms of cognition - insufficient knowledge of benefits e.g. ignorance of public health messages. This paper has shown that; the majority of people who could afford the prices of ITNs and who knew where to obtain the insecticides did not necessarily buy them. This suggests that; although people tend to report costrelated factors as a barrier against the use of ITNs; there are other critical concerns at work. Without underestimating the practical factors; our study have recommended to consider critical examinations of those other concerns that hinder optimal utilization of ITN for malaria control; and the basis for those concerns

Malabsorption: Causes; Consequences; Diagnosis and Treatment

Malabsorption generally refers to the alterations of the gastrointestinal tract affecting the digestion; absorption and transport of nutrients across the bowel wall. In this article the causes; diagnostic tests and appropriate treatment options will be discussed by differentiating between premucosal; mucosal and postmucosal aberrations

VCT Uptake and Associated Factors among Teachers from Harari Administrative Region

Background: Although HIV/AIDS is affecting most productive segments of the population; the basic education sector which is vital to the creation of human capital is also equally affected. The loss of skilled and experienced teachers due to the problem is increasingly compromising the provision of quality education in most African countries and thus; needs appropriate intervention measures that reverse the current trend. Objectives: To assess the prevalence and determining factors of VCT uptake among teachers of Harari Administrative Region. Methods: A cross sectional study design with analytic component was conducted among 566 teachers drawn from 20 randomly selected schools of Harari Administrative Region from March to April 2009. Self administered questionnaire; adapted from previous relevant studies was used to estimate the prevalence of VCT uptake and the various socio-demographic and psychological factors. Data were entered and analyzed using bi-variate and multivariate models. Results: A total number of 497 teachers responded to the questionnaire adequately making the response rate of 87.8. The mean age of the participants was 34.68 ranging from 18 - 61 years. There were more teachers from urban areas (72.0) and most of them were males (62.2). About half (54.1) were married and few (5.2) were divorced. The vast majority (98.6) heard about the confidential VCT service and their major sources of information were mass media (85.3) and health workers (56.2). The prevalence of VCT uptake was 46.3. The odds of utilizing VCT significantly increased with being younger age group; female and first and second cycle teachers' category.Conclusions: The major factors identified for increased uptake of VCT are gender; age and salary category. Actions targeting the males; non-youth age group and low grade teachers' are necessary to follow their peer groups to utilize the VCT service in order to achieve the goal of education set for 2015

Pharmacology of absorption and distribution: optimal use of antimalarial drugs in the treatment of severe falciparum malaria in Kenya

Since 1989; a project at the KEMRI CRC Unit at Kilifi has focused on the design of appropriate and praticable regimens for the treatment of severe falciparum malaria. Initially; there was no data describing the absorption; distribution and elimination of quinine in Kenyan children; who constitute the great majority of patients. Pharmacokinetic studies were conducted to define these variables; which formed the basis for the design of appropriate and praticable treatment regimens. Even with optimal clinical management; the majority is high in cases of severe malaria treated with quinine at Kilifi. Alternative drugs have been studied in a search for a therapeutic regimen which will further reduce mortality