Neonatal morbidity and mortality in a Tanzanian tertiary care referral hospital.

In developing countries, neonatal mortality accounts for 50-70% of infant mortality. The purpose of this study was to describe morbidity and mortality patterns, with a focus on neonatal infections, in a Tanzanian special care baby unit (SCBU). During a 3-month period, 246 consecutive admissions to the SCBU at Kilimanjaro Christian Medical Centre were audited. Prematurity, low birthweight and suspected infection accounted for 61% of all admissions. The overall mortality rate was 19%, but varied considerably according to gestational age, birthweight and diagnosis. Thirty-one neonates (two-thirds of all deaths) died during the 1st 24 hours of life. Of 27 infants admitted on grounds of perinatal asphyxia, 11 (41%) died, and, of 19 infants with a gestational age <31 weeks, 13 (68%) died. More than two-thirds of all infants were treated with antibiotics. Septicaemia confirmed by blood culture was found in 16 cases. The susceptibility pattern of bacterial isolates did not indicate high rates of resistance to commonly used antibacterial agents. A reduction in the number of preterm deliveries and improved perinatal care to avoid and treat perinatal asphyxia would be the two most important measures in reducing neonatal mortality in this setting.

[Bar attendants as health educators. Prevention of sexually transmitted diseases in high-risk areas]. / Bararbeidere som helseopplysere. Forebygging av seksuelt overføte sykdommer i områder med høy risiko.

In Tanzania, a nation-wide programme against the spread of HIV is targeting villages along the main highways, mining and construction centres, and border towns. These places contain a high number of bars and guest houses, where female bar attendants offer sexual favours to obtain a minimum income for survival. The strategy is to elect and educate bar workers as "peer health educators", motivate them to reduce the number of sexual partners, to distribute and promote use of condoms, and to establish easier access to treatment for sexually transmitted diseases. The activities are monitored and supervised through regular visits by trained health behaviour officers. The Tanzanian-Norwegian AIDS project has implemented the programme in Arusha and Kilimanjaro regions.