RESUMO
Aim: To determine knowledge and perceptions about tuberculosis in agropastoral communities in Northern Tanzania. Study Design: This was a cross sectional study on habits and attitudes to tuberculosis. Methods: The study was conducted between June 2011 and May 2012.We enrolled tuberculosis patients registered at Mount Meru Hospital in Arusha municipal, Enduleni Hospital in Ngorongoro district, and Haydom Lutheran Hospital in Mbulu district. In addition we selected for comparison some of their household relatives and individuals from the neighborhood. Data was collected using a structured questionnaire. Knowledge about tuberculosis was assessed by questions concerning causes, symptoms, modes of transmission and prevention and treatment. Key variables for assessment of perception on tuberculosis included: individuals considered most at risk, and misconceptions. Results: We recruited 164 respondents of whom 25% were confirmed tuberculosis patients, 41.5% relatives of the patients and 33.5% neighbors. Females constituted 48.8% of all respondents. Of all the participants, only two of the neighbors had never heard about tuberculosis in their life time. Even though 99% had heard about tuberculosis, specific knowledge on causes, prevention and treatment was poor. A total of 67.7% thought that transmission of tuberculosis occurs during sexual intercourse. Respondents thought that risk from tuberculosis was higher among adults (68.9%), alcohol users (39.6%), smoking (26.8%), consumption of raw animal products (6.1%) and childhood (23.2%). Conclusion: Our study shows that study participants had heard about tuberculosis but specific knowledge was low. Misconceptions surrounding causes, transmission, prevention and treatment of the disease were common. Selection of appropriate channels for public health education and awareness programmes targeting knowledge about prevention and control of tuberculosis in agropastoral communities may improve this situation.
RESUMO
Aim: To estimate the prevalence and risk factors for metabolic syndrome (MetS) among HIV positive patients on antiretroviral therapy (ART) in Tanzania. Study Design: A cross sectional study was conducted among adults aged ≥18years living with HIV-infection and receiving ART. Place and Duration of Study: The study participants were recruited from 12 care and treatment clinics in Dar es Salaam (urban) and Mbeya (rural) regions between October 2011 and February 2012. Methodology: The prevalence of MetS was assessed using International Diabetes Federation’s criteria. Biochemical assays, anthropometric measurements, demographic characteristics and lifestyle behavioural data were collected. Results: Study response rate was 351/377(93.1%) and 177 (50.4%) recruited participants were from urban settings and 238 (67.8%) were females. The prevalence of MetS was 25.6% and was higher among participants from urban than those from rural areas (35.6% vs 15.5%, p<.001). The components of MetS including raised triglyceride (43.5% vs 21.3%, p<.001), low high density lipoprotein (85.9% vs 28.2%, p<.001) and raised blood fasting glucose (10.2% vs 5.2%, p=.04) were more common among participants from urban than those from rural settings. MetS Risk factors including; consumption of fruits/vegetables <5 days/week (77.0% vs 59.3%, p<.001), not participating on vigorous intensity activities (65.5% vs 29.4% p<.001) and consuming mixed cooking oil (animal/vegetable) (15.5% vs 8.5%, p=.03) were higher among participants from rural than those from urban areas. In rural, only consumption of vegetables/fruits <5 days/week (AOR=5.50, 95%CI 1.21-24.95, p=.005) predicted the prevalence of MetS. In urban; sex (female) (AOR=3.01, 95%C 1.31-6.85, p=.002), having primary/no formal education (AOR=0.32, 95%CI 0.12-0.89, p=.04) and ex- or current alcohol drinker (AOR=2.43, 95%CI 1.17-5.06, p=.02) were significant predictors of MetS. Conclusion: Prevalence, components and predictors of MetS prevailed more in urban than in rural settings. Interventions targeting prevention of MetS to reduce diabetes and cardiovascular diseases should consider settings diversification.
RESUMO
Information on the different spoligotype families of Mycobacterium tuberculosis in Tanzania is limited; and where available; restricted to small geographical areas. This article describes the genetic profile of M. tuberculosis across Tanzania and suggests how spoligotype families might affect drug resistance and treatment outcomes for smear positive pulmonary tuberculosis patients in Tanzania. We conducted the study from 2006 to 2008; and the isolates were obtained from samples collected under the routine drug resistance surveillance system. The isolates were from specimens collected from 2001 to 2007; and stored at the Central and Reference Tuberculosis Laboratory. A total of 487 isolates from 23 regions in the country were spoligotyped. We were able to retrieve clinical information for 446 isolates only. Out of the 487 isolates spoligotyped; 195(40.0) belonged to the Central Asian (CAS) family; 84 (17.5) to the Latin American Mediterranean (LAM) family; 49 (10.1) to the Latin American Mediterranean (LAM) family; 49 (10.1) to the East-African Indian (EAI) family; and 33 (6.8) to the Beijing family. Other isolates included 1 (0.2) for H37Rv; 10 (2.1) for Haarlem; 4 (0.8) for S family; 58 (11.9) for T family and 52 (10.7) for unclassified. No spoligotype patterns were consistent with M. bovis. Regarding treatment outcomes; the cure rate was 80 with no significant variation among the spoligotype families. The overall level of MDR TB was 2.5 (3/121); with no significant difference among the spoligotype families. All Beijing strains (11.8; 30/254) originated from the Eastern and Southern zones of the country; of which 80 were from Dar es Salaam. Isolates from the CAS and T families were reported disproportionately from the Eastern-Southern zone; and EAI and LAM families from the Northern-Lake zones but the difference was not statistically significant. Five isolates were identified as non-tuberculous Mycobacteria. In conclusion; M. tuberculosis isolates from pulmonary tuberculosis cases in Tanzania were classified mostly within the CAS; LAM; and EAI and T families; while the Beijing family comprised about 7 isolates only. Consistently good treatment outcomes were recorded across these spoligotype families. The proportion of drug resistance strains was low. The findings also suggest variation of spoligotype families with varying geographical localities within the country; and identify this area for further research to confirm this finding