Factors and Causes of Puerperal Sepsis in Kilimanjaro, Tanzania: A Descriptive Study among Postnatal Women who Attended Kilimanjaro Christian Medical Centre.

BACKGROUND: Puerperal sepsis is the major cause of maternal morbidity and mortality worldwide. About 94% of maternal mortality occur in low and middle-income countries including Tanzania. OBJECTIVE: To estimate the prevalence, document factors and causes of puerperal sepsis among postnatal women who attended postnatal care in Kilimanjaro Christian Medical Centre Hospital in the year 2015. METHODOLOGY: A descriptive cross-sectional study was carried out at Kilimanjaro Christian Medical Centre, Tanzania. A total of 183 medical records of attendance in 2015 were used for the study. Information about the isolated organism in culture was retrieved from the Laboratory Information System. RESULTS: The prevalence of puerperal sepsis was 11.5% (21/183). The most common factors and causes of puerperal sepsis included caesarean section 66.7% (14/21), postpartum haemorrhage 57.1% (12/21), moderate to severe anaemia 61.9% (13/21), prolonged labour 76.2% (16/21) and bacterial infection 90.5% (19/21). The difference was significant at p<.05. The most bacteria species isolated among women with puerperal sepsis was Staphylococcus spp 50.0% (7/14), Escherichia 28.6% (4/14) and Streptococcus spp 21.4% (3/14). CONCLUSION: Puerperal sepsis is prevalent (11.5%) at Kilimanjaro Christian Medical Centre. Staphylococcus spp was found to be a predominant isolate which causes puerperal sepsis followed by E. coli and Streptococcus spp.

Healthcare workers knowledge and diagnostic practices: a need for dengue and chikungunya training in Moshi Municipality, Kilimanjaro Tanzania.

OBJECTIVE: Dengue and chikungunya virus diseases are becoming an increasingly important global health threats and are continuously expanding their geographical range. The study aims to investigate knowledge and diagnostic practice of dengue and chikungunya fever among healthcare workers in Moshi Municipality. RESULTS: Most of healthcare workers heard of chikungunya and dengue 146 (71.2%) and 203 (99%) respectively. Ninety-five (46.3%) and 152 (74.1%) had good knowledge regard chikungunya and dengue respectively. One hundred and twenty-two of HCWs 122 (59.5%) reported that there is no vaccination for dengue virus. Most HCWs 199 (97.0%) reported that the absence of diagnostic tool for dengue virus lead to difficult in managing the infection. The finding of this study showed that there is insufficient knowledge regarding chikungunya while knowledge regarding dengue is relatively fair. This calls for training regarding these infections.

Cross-sectional Survey on Antibiotic Prescription Practices Among Health Care Providers in Rombo District, Northern Tanzania.

BACKGROUND: Irrational and inappropriate antibiotic prescription is a worldwide phenomenon - increasing the threat of serious antibiotic resistance. A better understanding of health care providers' knowledge, attitudes, and prescription practices related to antibiotics is essential for formulating effective antibiotics stewardship programmes. The aim of the present study was to assess knowledge, attitudes, and prescription practices toward antibiotics among health care providers. METHODS: A descriptive cross-sectional study was conducted between March and June 2017 to assess knowledge, attitudes, and prescription practices toward antibiotics among health care providers in the Rombo district of northern Tanzania. A total of 217 health care providers were interviewed using a structured questionnaire. RESULTS: Over half of health care providers (n=111, 51.2%) strongly agreed that the inappropriate prescription of antibiotics puts patients at risk. More than half (n=112, 51.6%) reported that their decision to start antibiotic therapy was influenced by a patient's clinical condition, while 110 (50.7%) reported they were influenced by positive microbiological results in symptomatic patients. Almost two-thirds of the health care providers (n=136, 62.7%) reported that they had access to and used antibiotic therapy guidelines. Less than a quarter (n=52, 24.0%) received regular training and education in antibiotic prescription practice in their work place. CONCLUSION: Knowledge and prescription practice of antibiotics among health care providers was generally unsatisfactory. Training and education for health care providers is needed in the area of prescribing antibiotics.

Knowledge and practice regarding dengue and chikungunya: a cross-sectional study among Healthcare workers and community in Northern Tanzania.

OBJECTIVE: To investigate knowledge and prevention practices regarding dengue and chikungunya amongst community members, as well as knowledge, treatment and diagnostic practices among healthcare workers. METHOD: We conducted a cross-sectional survey with 125 community members and 125 healthcare workers from 13 health facilities in six villages in the Hai district of Tanzania. A knowledge score was generated based on participant responses to a structured questionnaire, with a score of 40 or higher (of 80 and 50 total scores for community members and healthcare workers, respectively) indicating good knowledge. We conducted qualitative survey (n = 40) to further assess knowledge and practice regarding dengue and chikungunya fever. RESULTS: 15.2% (n = 19) of community members had good knowledge regarding dengue, whereas 53.6%, (n = 67) of healthcare workers did. 20.3% (n = 16) of participants from lowland areas and 6.5% (n = 3) from highland areas had good knowledge of dengue (χ2 = 4.25, P = 0.03). Only 2.4% (n = 3) of all participants had a good knowledge score for chikungunya. In the qualitative study, community members expressed uncertainty about dengue and chikungunya. Some healthcare workers thought that they were new diseases. CONCLUSION: There is insufficient knowledge regarding dengue and chikungunya fever among community members and healthcare workers. Health promotion activities on these diseases based on Ecological Health Mode components to increase knowledge and improve preventive practices should be developed.