ABSTRACT
Solid waste has been a major problem particularly in Sub-Saharan Africa countries as it has been increasing in several years. One of the methods employed in solid waste management is street sweeping which is done by street sweepers. Street sweepers are being predisposed to respiratory and non-respiratory infection like eye infection, skin infection and musculoskeletal disorders. This analytical cross-sectional study enrolled a total of 233 street sweepers to assess perceived occupational health risks, particulate matters (i.e., PM2.5, PM5 and PM10 measured in (mg/m3)) dust and noise exposure levels in decibel units-dB(A), and utilization of protective personnel equipment among street sweepers in Mwanza city, Northern Tanzania. Modified poison regression was used to determine the association between exposures variables (i.e., sociodemographic, and socioeconomic factors) and outcomes ((i.e., noise dose level and particulate matters))). More than half (50.2%) of the participants were aged between 46-80 years. Their Median age was 46(IQR: 28-59) years. Large percent (63.1%) of the participants reported that their working environment have high health risks. The Median concentrations of the noise dose and particulates matters were 85.4 (IQR = 76.4-92.3) for noise dose, 13426 (IQR = 9637-17632) for PM2.5, 5522 (IQR = 2453-7679) for PM5, and 2310(IQR = 1263-3201). The Median concentrations of the noise dose and particulates matters were 85.4 (IQR = 76.4-92.3) for noise dose in decibel units dB(A); 13426 (IQR = 9637-17632) for PM2.5; 5522 (IQR = 2453-7679) for PM5; and 2310(IQR = 1263-3201) for PM10. Individual Street sweepers in Mwanza city are highly exposed to noise dose and fine particulate matters at levels above the reference values for human of 85dB(A) and 5mg/m3 respectively, making it a public health issue that requires holistic public health measures.
ABSTRACT
Background: Persons with disabilities generally face greater challenges in accessing healthcare and interventions compared with the general population. Malaria is one of the diseases that can seriously affect individuals with disabilities, as it requires early diagnosis and prompt treatment. Objective: This study explores the extent to which locally available malaria services and interventions are inclusive of persons with disabilities and identifies associated access barriers. Method: A qualitative case study focusing on social, cultural and health system factors associated with the inclusion of persons with disabilities in malaria services was conducted in Kigoma Region, western Tanzania. Thematic analysis of emerging themes identified barriers affecting access to locally available malaria services and interventions. Results: Inclusion of persons with disabilities in planning, implementation and reporting of health issues in different malaria programmes was reported to be limited. Persons with disabilities were unable to access malaria services because of different barriers such as the distance of the service provision sites, communication and information issues and a lack of financial resources. Conclusion: Persons with disabilities are widely excluded from malaria care provision across the entire health services paradigm, impacting access and utilisation to this vulnerable population. Barriers to malaria service access among persons with disabilities were physical, attitudinal, financial and informational. Contribution: The findings of this study identify that malaria intervention stakeholders need to take a holistic approach and fully involve individuals with disabilities at all levels and scope of malaria service planning and provision.
ABSTRACT
Cholera, which is caused by Vibrio cholerae, persists as a devastating acute diarrheal disease. Despite availability of information on socio-cultural, agent and hosts risk factors, the disease continues to claim lives of people in Tanzania. The present study explores spatial patterns of cholera cases during a 2015-16 outbreak in Mwanza, Tanzania using a geographical information system (GIS) to identify concentrations of cholera cases. This cross-sectional study was conducted in Ilemela and Nyamagana Districts, Mwanza City. The two-phase data collection included: 1) retrospectively reviewing and capturing 852 suspected cholera cases from clinical files during the outbreak between August, 2015, and April, 2016, and 2) mapping of residence of suspected and confirmed cholera cases using global positioning systems (GPS). A majority of cholera patients were from Ilemela District (546, 64.1%), were males (506, 59.4%) and their median age was 27 (19-36) years. Of the 452 (55.1%) laboratory tests, 352 (77.9%) were confirmed to have Vibrio cholerae infection. Seven patients (0.80%) died. Cholera cases clustered in certain areas of Mwanza City. Sangabuye, Bugogwa and Igoma Wards had the largest number of confirmed cholera cases, while Luchelele Ward had no reported cholera cases. Concentrations may reflect health-seeking behavior as much as disease distribution. Topographical terrain, untreated water, physical and built environment, and health-seeking behaviors play a role in cholera epidemic in Mwanza City. The spatial analysis suggests patterns of health-seeking behavior more than patterns of disease. Maps similar to those generated in this study would be an important future resource for identifying an impending cholera outbreak in real-time to coordinate community members, community leaders and health personnel for guiding targeted education, outreach, and interventions.
ABSTRACT
Background: Persons with disabilities generally face greater challenges in accessing healthcare and interventions compared with the general population. Malaria is one of the diseases that can seriously affect individuals with disabilities, as it requires early diagnosis and prompt treatment. Objective: This study explores the extent to which locally available malaria services and interventions are inclusive of persons with disabilities and identifies associated access barriers. Method: A qualitative case study focusing on social, cultural and health system factors associated with the inclusion of persons with disabilities in malaria services was conducted in Kigoma Region, western Tanzania. Thematic analysis of emerging themes identified barriers affecting access to locally available malaria services and interventions. Results: Inclusion of persons with disabilities in planning, implementation and reporting of health issues in different malaria programmes was reported to be limited. Persons with disabilities were unable to access malaria services because of different barriers such as the distance of the service provision sites, communication and information issues and a lack of financial resources. Conclusion: Persons with disabilities are widely excluded from malaria care provision across the entire health services paradigm, impacting access and utilisation to this vulnerable population. Barriers to malaria service access among persons with disabilities were physical, attitudinal, financial and informational. Contribution: The findings of this study identify that malaria intervention stakeholders need to take a holistic approach and fully involve individuals with disabilities at all levels and scope of malaria service planning and provision.
