Prevalence of Bacterial Vaginosis and Associated Factors among Pregnant Women Attending at Bugando Medical Centre, Mwanza, Tanzania

Bacterial vaginosis (BV) is an extremely common reproductive tract condition worldwide with reported high prevalence among African population. Factors associated with this condition include preterm labour, premature rupture of membranes, preterm delivery and possibly spontaneous abortion. Nevertheless, antenatal screening and treatment is not routinely available in most poor-resource countries including Tanzania. A cross-sectional descriptive study was conducted among delivering women at Bugando Medical Centre (BMC), Mwanza, Tanzania to determine the magnitude of the BV using the Nugent’s criteria and to document factors associated with the condition. A total of 284 women who presented for delivery at BMC labour ward from February to March 2011 were recruited into the study. For each consented women, a vaginal swab was taken, samples collected tested and a Nugent’s score of at least seven indicated bacterial vaginosis. Overall, bacterial vaginosis was diagnosed in 28.5% (n=81) of all participants. Gardnerella was the commonest morphotypes found in approximately 66.2% (n=188) of all participants while 11.6% (33 participants) had Mobilincus. There were no evidence for the association between bacterial vaginosis having formal education, (OR, 1.42[95%CI, 0.29-6.97; p=0.667]). Urban residence (OR, 1.29 [95% CI, 0.76-2.19; p=0.352]), ever delivered before (OR 0.66[95%CI, 0.39-1.12; p=0.126]), vaginal practice to enhance dry sex (OR, 1.16[95%CI, 0.43-3.17; p=0.768]) or wet sex (OR 1.31[95%CI, 0.46-3.7; p=0.613]), gestation age less than 37 weeks (OR 0.82[95%CI, 0.45-1.51; p=0.534]) and HIV infection (OR 0.90[95%CI, 0.28-2.92; p=0.863]) were not associated with bacterial vaginosis. Bacterial vaginosis is common among women delivering at Bugando Medical Centre and more studies to include antenatal clinic attendees initiating care are required to reliably document the magnitude the condition

Where there is no toilet: water and sanitation environments of domestic and facility births in Tanzania.

BACKGROUND: Inadequate water and sanitation during childbirth are likely to lead to poor maternal and newborn outcomes. This paper uses existing data sources to assess the water and sanitation (WATSAN) environment surrounding births in Tanzania in order to interrogate whether such estimates could be useful for guiding research, policy and monitoring initiatives. METHODS: We used the most recent Tanzania Demographic and Health Survey (DHS) to characterise the delivery location of births occurring between 2005 and 2010. Births occurring in domestic environments were characterised as WATSAN-safe if the home fulfilled international definitions of improved water and improved sanitation access. We used the 2006 Service Provision Assessment survey to characterise the WATSAN environment of facilities that conduct deliveries. We combined estimates from both surveys to describe the proportion of all births occurring in WATSAN-safe environments and conducted an equity analysis based on DHS wealth quintiles and eight geographic zones. RESULTS: 42.9% (95% confidence interval: 41.6%-44.2%) of all births occurred in the woman's home. Among these, only 1.5% (95% confidence interval: 1.2%-2.0%) were estimated to have taken place in WATSAN-safe conditions. 74% of all health facilities conducted deliveries. Among these, only 44% of facilities overall and 24% of facility delivery rooms were WATSAN-safe. Combining the estimates, we showed that 30.5% of all births in Tanzania took place in a WATSAN-safe environment (range of uncertainty 25%-42%). Large wealth-based inequalities existed in the proportion of births occurring in domestic environments based on wealth quintile and geographical zone. CONCLUSION: Existing data sources can be useful in national monitoring and prioritisation of interventions to improve poor WATSAN environments during childbirth. However, a better conceptual understanding of potentially harmful exposures and better data are needed in order to devise and apply more empirical definitions of WATSAN-safe environments, both at home and in facilities

HIV Serostatus and Tumor Differentiation Among Patients with Cervical Cancer at Bugando Medical Centre.

Evidence for the association between Human immunodeficiency virus infection and cervical cancer has been contrasting, with some studies reporting increased risk of cervical cancer among HIV positive women while others report no association. Similar evidence from Tanzania is scarce as HIV seroprevalence among cervical cancer patients has not been rigorously evaluated. The purpose of this study was to determine the association between HIV and tumor differentiation among patients with cervical cancer at Bugando Medical Centre and Teaching Hospital in Mwanza, North-Western Tanzania. This was a descriptive analytical study involving suspected cervical cancer patients seen at the gynaecology outpatient clinic and in the gynaecological ward from November 2010 to March 2011. A total of 91 suspected cervical cancer patients were seen during the study period and 74 patients were histologically confirmed with cervical cancer. The mean age of those confirmed of cervical cancer was 50.5 ± 12.5 years. Most patients (39 of the total 74-52.7%) were in early disease stages (stages IA-IIA). HIV infection was diagnosed in 22 (29.7%) patients. On average, HIV positive women with early cervical cancer disease had significantly more CD4+ cells than those with advanced disease (385.8 ± 170.4 95% CI 354.8-516.7 and 266.2 ± 87.5, 95% CI 213.3-319.0 respectively p = 0.042). In a binary logistic regression model, factors associated with HIV seropositivity were ever use of hormonal contraception (OR 5.79 95% CI 1.99-16.83 p = 0.001), aged over 50 years (OR 0.09 95% CI 0.02-0.36 p = 0.001), previous history of STI (OR 3.43 95% CI 1.10-10.80 p = 0.035) and multiple sexual partners OR 5.56 95% CI 1.18-26.25 p = 0.030). Of these factors, only ever use of hormonal contraception was associated with tumor cell differentiation (OR 0.16 95% CI 0.06-0.49 p = 0.001). HIV seropositivity was weakly associated with tumor cell differentiation in an unadjusted analysis (OR 0.21 95% CI 0.04-1.02 p = 0.053), but strong evidence for the association was found after adjusting for ever use of hormonal contraception with approximately six times more likelihood of HIV infection among women with poorly differentiated tumor cells compared to those with moderately and well differentiated cells (OR 5.62 95% CI 1.76-17.94 p = 0.004).\ud Results from this study setting suggest that HIV is common among cervical cancer patients and that HIV seropositivity may be associated with poor tumour differentiation. Larger studies in this and similar settings with high HIV prevalence and high burden of cervical cancer are required to document this relationship

Maternal Death Reviews at Bugando Hospital North-western Tanzania: A 2008-2012 Retrospective Analysis.

Unacceptably high levels of maternal deaths still occur in many sub-Saharan countries and the health systems may not favour effective use of lessons from maternal death reviews to improve maternal survival. We report results from the analysis of data from maternal death reviews at Bugando Medical Centre north-western Tanzania in the period 2008-2012 and highlight the process, challenges and how the analysis provided a better understanding of maternal deaths. Retrospective analysis using maternal death review data and extraction of missing information from patients' files. Analysis was done in STATA statistical package into frequencies and means ± SD and median with 95 % CI for categorical and numerical data respectively. There were 80 deaths; mean age of the deceased 27.1 ± 6.2 years and a median hospital stay of 11.0 days [95 % CI 11.0-15.3]. Most deaths were from direct obstetric causes (90); 60 % from eclampsia, severe pre-eclampsia, sepsis, abortion and anaesthetic complications. Information on ANC attendance was recorded in 36.2 % of the forms and gestation age of the pregnancy resulting into the death in 23.8 %. Sixty one deaths (76.3 %) occurred after delivery. The mode of delivery, place of delivery and delivery assistant were recorded in 44 (72.1), 38 (62.3) and 23 (37.7 %) respectively. Routine maternal death reviews in this setting do not involve comprehensive documentation of all relevant information, including actions taken to address some identified systemic weaknesses. Periodic analysis of available data may allow better understanding of vital information to improve the quality of maternity care

A Grammatical Study of the Passive Voice in the Synoptic Gospels

The purpose of this investigation is to examine the use of the passive voice in the Synoptic Gospels. Every verb in the Synoptic Gospels that occurs in the passive voice is examined without exception to determine if it is used to cover or veil the divine name of God or God\u27s divine activity. This idea was suggested by the Index of Subjects of the Blasa-Debrunner-Funk Grammar. Under the subject of the Passive (voice) is listed the use of the passive to avoid the divine name. 112 It was also noted that Joachim Jeremias in two of his works quite often refers to the passive voice as used to avoid the divine name.3 Martin Albertz makes the statement with regard to the passives used in Luke 24:34 and 1 Corinthians 15:4, “hinter diesen Passiven steht der lebendige Gott.“ Wilhelm Stahlin comments in his study of the passive imperative in the New Testament, dasz dieser Imperativ Passiv sogar eine zentrale Bedeutung und eine erhebliche Tragweite fflr das Gesamtverstltndnis des Neuen Testaments hat. Gustaf DalJDan makes mention of the fact that, 11Sanetimes the passive voice of the verb is preferred, on the ground that, if the active were used, it would be necessary to name God as the Subject.” These statements and observations make one wonder about the use of the passive voice. This wonderment increases when it is found that there is really no history on the subject in Biblical studies. Except for occasional passing remarks, and these by way of observation, there is no systematic account on the use of the passive voice in the New Testament. As far as it is possible to know, no one has ever written on the subject

Adherence to safety practices and the effect of petroleum products on petrol station attendants in Abraka, Delta State, Nigeria

This research was aimed at evaluating the adherence to safety practices and the effect of petroleum products on petrol station attendants in Abraka, Delta State, Nigeria. The study was a descriptive cross-sectional study carried out at five randomly selected petrol stations in Abraka, with a total of 35 petrol station attendants assessed using a structured questionnaire. Data was analyzed using SPSS statistical software. Majority of the respondents were female 21 (60%), most respondents were single 27 (77.1%), most respondents had tertiary education 29 (82.9%), most respondents had worked for at least 2 years 12 (34.3%), and most respondents work for more than 8 hours daily 18 (51.4%). Most (51.4%) of the respondents use PPE during their working hours, although, only 13 (37.1%) respondents use them regularly. Reported health problems included cough 5 (14.3%), breathing difficulty 4 (11.4%), and headache 3 (5.6%). Adherence to safety practices and use of personal protective equipment (PPE) by petrol station attendants was good, although, efforts should be made to ensure the use of these PPE by the attendant at the petrol stations, and proper care and attention be given to the petrol stations attendants to avoid future health problems.Keywords: Petroleum products, petrol station, attendants, Abraka, Delta Stat

Owens, Moke C.

Co A. 3rd Regiment ORTC; 159th ASF Band; Fort Leonard Wood, MOhttps://dh.howard.edu/prom_corres/1111/thumbnail.jp

Owens, Moke C. (2)

159th ASF Band; Fort Leonard Wood, MOhttps://dh.howard.edu/prom_corres/1112/thumbnail.jp

PARTISIPASI MASYARAKAT DALAM PROGRAM PEMBANGUNAN KAMPUNG DI DISTRIK ABENAHO KABUPATEN YALIMO

This study aims to analyze and determine Community Participation in Village Development Programs in Abenaho District, Yalimo Regency, as well as analyze the supporting and inhibiting factors of community participation in village development in Abenaho District, Yalimo Regency. This study uses a qualitative descriptive approach conducted in Abenaho District, Yalimo Regency, the determination of informants is carried out by snowball. Data collection techniques used are observation and interviews. Data analysis includes the stages of data reduction, data presentation, and conclusion. The results showed that the form of community participation in village development in Abenaho District, Yalimo Regency, the form of community participation contributing to the village development program was starting from the delegation of authority stage, the community had the authority to participate in determining the priority of development programs in their village through musrembang, and the results of the musrembang proposed as a priority development program. Then in the partnership stage, the community partners with providers of tools and materials needed to carry out development programs. Then the stage, community consultation consults with village assistants regarding the development program they have launched and the reporting and accountability mechanisms. Then the information stage is disseminated effectively so that the community knows information about the development program in their village. Then it is related to the form of community participation in the form of delivering voices to fight for their rights and the open access provided. Supporting factors are the existence of social solidarity, responsibility, and intense information dissemination. Then the inhibiting factor is the misunderstanding factor and mutual suspicion from the community