Nutrition Status of the Elderly in Peri-Urban Dar es Salaam; Tanzania

Objectives: To determine the nutrition status of elderly individuals and their associated factors in a periurban area. Design: A cross sectional survey. Setting: Chamanzi and Goba villages in periurban Dar-es-SalaamMethods: A list of all elderly individuals (aged 60 years and older) residing in the study area was compiled with the help of village authorities. House to house visits were then made for interviews. Nutrition status was assessed using the anthropometric indicator of Body Mass Index (BMI) and the oral cavities of all study subjects were inspected.Results: A total of 181 elderly individuals were included in the survey; with females constituting a higher proportion (64). The prevalence of undernutrition was 34 with more males than females affected; 37 vs. 32 respectively. Nutrition status was found to be significantly associated with marital status (p0.006). Possession of 20 or more natural teeth; a good appetite and consumption of three or more meals per 24 hours were more likely to be associated with nutritional status; however these associations were not statistically significant (P0.05).Conclusion: There is a high prevalence of undernutrition among the elderly living in periurban Dar-es-Salaam. There is need to focus more attention on this population sub group

Reinfestation in cutaneous leishmaniasis: a new look at predisposing conditions.

OBJECTIVE: A prospective study of cases of reinfestation with cutaneous leishmaniasis is carried out to try to identify if there is any associated condition which might predispose to reinfestation. METHODS: Over a 2 year period, cases of reinfestation with cutaneous leishmaniasis presenting in the Department of Dermatology, were collected. RESULTS: Thirteen cases showing a typical scar with a parasitologically proven new infection were included. The mean age of patients was 54.69+/-2.65 years. The time lapse between the two infections was 52.38+/-2.60 years. The scar of the primary infection was mainly on the face while the lesion was mostly on the limbs. Six patients had diabetes mellitus, one patient was pregnant and three received either oral corticosteroids or other immunosuppressive drug treatment. CONCLUSION: It is concluded that in patients with reinfestation it is important to take a careful medical history and send for a fasting blood glucose, as there is a chance of one in two that the patient may be diabetic.

Impact of user charges on government health facilities in Tanzania.

Utilisation of outpatient services in government owned district hospitals in Dar es Salaam, declined by more than 50% following the introduction of user charges in these health facilities in mid July 1993. Outpatient attendances in the private health facilities studied remained constant throughout the year although these charged higher fees. Education and employment status were found to be major factors influencing utilisation of public versus private health facilities. Public facility users (62.8%) had five to eight years of formal education. Private facility users with five to eight years of education were 45.5% and those with more than years of education were 47.1%. While 68.6% of public facility users paid for their own healthcare, more than a quarter (27.3%) had their costs met by relatives or friends. The employer paid for 72% of private facility users, 49.2% of whom stated that this was the reason why they used private facilities. Despite introduction of charges in public hospitals, availability of prescribed medication was poor. Drugs were reported to be always available by only 27.3% of public health facility users compared to 80% of private health facility users.