Injuries among children and adolescents in a rapidly growing urban African metropolis: a cross-sectional survey of 1,968 households in Dar es Salaam, Tanzania

Objectives To assess the patterns and incidence of child and adolescent injury and explore associations with household deprivation and child characteristics in a low-income urban setting. Study Design Cross-sectional household survey in Dar es Salaam, Tanzania. Methods Data collection took place during July 2009. Injuries requiring medical attention were recorded with a one month period of recall. A total of 1,968 households representing 3,927 children and adolescents were visited by health workers. Gender-, age-, and type-specific injury incidence was compiled. Odds ratios were calculated to measure associations with child injury, perceived deprivation, household characteristics and child characteristics. Results One household in five reported injuries. The estimated incidence was 3.2 per 10,000 child-years. The most common identifiable injuries were falls (41%), cuts (22%) and burns (16%). Male and younger children aged 1–4 years were at higher risk (respectively OR = 1.36; p = 0.004; OR = 1.47; p ≤ 0.001). Conclusions In Dar e Salaam injuries are common. Future investigations should take into account both subjective and objective measurements of relative household deprivation and a clear criteria for the assessment of injury severity in community-based survey contexts.

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Area-based sampling for an epidemiological study on injury patterns and risk factors in a low-income urban setting in sub-Saharan Africa

10.7287/peerj.preprints.24 ◽

2013 ◽

Author(s):

Michael L Wilson ◽

Stephen P. Seifert

Keyword(s):

Children And Adolescents ◽

Epidemiological Study ◽

Low Income ◽

Census Data ◽

Dar Es Salaam ◽

Urban Setting ◽

Sub Saharan Africa ◽

Injury Patterns ◽

Middle Income ◽

Sub Saharan

Unintentional injuries represent an important health threat to the lives of children and adolescents world-wide. The epidemic of injury and resulting harm such as disability or death, are likely to be the most severe in the low- and middle-income countries of the African continent. The following paper is intended to document an area-based sampling method designed to facilitate an epidemiological study to examine injury patterns among children and adolescents in Dar es Salaam, Tanzania. We used official census data and geographic information system software to create a series of area maps for Dar es Salaam city. Then, based on these maps, we identified population clusters for sampling based on area population density.

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Area-based sampling for an epidemiological study on injury patterns and risk factors in a low-income urban setting in sub-Saharan Africa

10.7287/peerj.preprints.24v1 ◽

2013 ◽

Author(s):

Michael L Wilson ◽

Stephen P. Seifert

Keyword(s):

Children And Adolescents ◽

Epidemiological Study ◽

Low Income ◽

Census Data ◽

Dar Es Salaam ◽

Urban Setting ◽

Sub Saharan Africa ◽

Injury Patterns ◽

Middle Income ◽

Sub Saharan

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Depressive Risk among Italian Socioeconomically Disadvantaged Children and Adolescents during Covid-19 Pandemic: A Cross-Sectional Online Survey

10.21203/rs.3.rs-451360/v1 ◽

2021 ◽

Author(s):

Maria Serra ◽

Anna Presicci ◽

Luigi Quaranta ◽

Maria Rosaria Erminia Urbano ◽

Lucia Marzulli ◽

...

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Children And Adolescents ◽

Low Income ◽

Online Survey ◽

Self Report ◽

Socioeconomically Disadvantaged ◽

Cross Sectional ◽

Disadvantaged Children ◽

Parent Version

Abstract Background Children and adolescents and low-income individuals are considered particularly vulnerable for mental health implications during the current COVID-19 pandemic. Depression is one of the most frequent negative emotional responses during an epidemic outbreak, mainly due to the imposed restriction of social contacts. We aimed to assess depressive symptomatology in a sample of Italian low-income minors and to determine if pandemic-related stressors and pre-existing neuropsychiatric diagnoses would behave as risk factors for depressive symptoms. Methods We performed a cross-sectional study during July 2020, at the end of the Italian first wave of COVID-19 pandemic. We recruited 109 Italian socioeconomically disadvantaged children and adolescents, from 7 to 17 years. We used an online survey to collect socio-demographic and clinical data and information about pandemic-related stressors, and to assess depressive symptoms with the Children’s Depression Inventory 2 (CDI 2), Parent Version (Emotional Problems subscale) and Self-Report Short Form. We performed logistic regression analysis to assess the association between depressive symptoms and potential risk factors for mental health. Results 22% and 14% of participants showed depressive symptoms at the CDI 2 Parent Version and Self-Report, respectively. Participants coming from families experiencing a lack of basic supplies during the pandemic (34.9%) were more expected to show depressive symptoms at CDI 2 Parent Version. Participants with a pre-existing neuropsychiatric diagnosis (26.6%) were more likely to exhibit depressive symptoms measured by CDI 2 Parent Version. Conclusions The results of our study may be representative of a particular group of frail subjects, the socioeconomically disadvantaged children and adolescents, who were more vulnerable to depressive symptoms if they suffered from a paucity of essential supplies during the pandemic or had pre-existing neurodevelopmental disorders. The promotion of educational and child-care programs and activities could be crucial in sustaining the prevention of mental distress in those frail subjects who particularly need support outside the family.

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Lessons from a Health Policy and Systems Research programme exploring the quality and coverage of newborn care in Kenya

BMJ Global Health ◽

10.1136/bmjgh-2019-001937 ◽

2020 ◽

Vol 5 (1) ◽

pp. e001937

Author(s):

Mike English ◽

David Gathara ◽

Jacinta Nzinga ◽

Pratap Kumar ◽

Fred Were ◽

...

Keyword(s):

Health System ◽

Low Income ◽

Health Workers ◽

Newborn Care ◽

Well Being ◽

Public Hospitals ◽

Urban Setting ◽

Health System Strengthening ◽

Research Approach ◽

Systems Research

There are global calls for research to support health system strengthening in low-income and middle-income countries (LMICs). To examine the nature and magnitude of gaps in access and quality of inpatient neonatal care provided to a largely poor urban population, we combined multiple epidemiological and health services methodologies. Conducting this work and generating findings was made possible through extensive formal and informal stakeholder engagement linked to flexibility in the research approach while keeping overall goals in mind. We learnt that 45% of sick newborns requiring hospital care in Nairobi probably do not access a suitable facility and that public hospitals provide 70% of care accessed with private sector care either poor quality or very expensive. Direct observations of care and ethnographic work show that critical nursing workforce shortages prevent delivery of high-quality care in high volume, low-cost facilities and likely threaten patient safety and nurses’ well-being. In these challenging settings, routines and norms have evolved as collective coping strategies so health professionals maintain some sense of achievement in the face of impossible demands. Thus, the health system sustains a functional veneer that belies the stresses undermining quality, compassionate care. No one intervention will dramatically reduce neonatal mortality in this urban setting. In the short term, a substantial increase in the number of health workers, especially nurses, is required. This must be combined with longer term investment to address coverage gaps through redesign of services around functional tiers with improved information systems that support effective governance of public, private and not-for-profit sectors.

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Food Security, Dietary Intake, and Foodways of Urban Low-Income Older South African Women: An Exploratory Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083973 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3973

Author(s):

Feyisayo A Odunitan-Wayas ◽

Mieke Faber ◽

Amy E Mendham ◽

Julia H Goedecke ◽

Lisa K Micklesfield ◽

...

Keyword(s):

Food Security ◽

Dietary Intake ◽

Low Income ◽

Cross Sectional Study ◽

Urban Setting ◽

African Women ◽

Healthy Foods ◽

Cross Sectional ◽

Quality Diet ◽

South African Women

This cross-sectional study explored the differences in sociodemographics, dietary intake, and household foodways (cultural, socioeconomic practices that affect food purchase, consumption, and preferences) of food secure and food insecure older women living in a low-income urban setting in South Africa. Women (n = 122) aged 60–85 years old were recruited, a sociodemographic questionnaire was completed, and food security categories were determined. The categories were dichotomised into food secure (food secure and mild food insecurity) and food insecure (moderate and severe). A one-week quantified food frequency questionnaire was administered. Height and weight were measured to calculate body mass index (BMI, kg/m2). Most participants (>90%) were overweight/obese, unmarried/widowed, and breadwinners with a low monthly household income. Food insecure participants (36.9%) more frequently borrowed money for food (57.8% vs. 39.0%, p = 0.04), ate less so that their children could have more to eat (64.4%. vs. 27.3%, p = 0.001), and had higher housing density (1.2 vs. 1.0, p = 0.03), compared to their food-secure counterparts. Overall, <30% of participants met the WHO (Geneva, Switzerland) recommended daily servings of healthy foods (fruits, vegetables, and dairy products), but >60% perceived that they consumed an adequate amount of healthy foods. The overall low-quality diet of our cohort was associated with poor nutritional perceptions and choices, coupled with financial constraints.

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Prevalence of Middle Ear Infections and Associated Risk Factors in Children under 5 Years in Gasabo District of Kigali City, Rwanda

International Journal of Pediatrics ◽

10.1155/2017/4280583 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Kaitesi Batamuliza Mukara ◽

Richard J. Lilford ◽

Debara Lyn Tucci ◽

Peter Waiswa

Keyword(s):

Middle Ear ◽

Health Workers ◽

Public Health Problem ◽

Urban Setting ◽

Care Seeking ◽

Cross Sectional ◽

Suppurative Otitis Media ◽

Ear Infection ◽

Delay In Diagnosis ◽

Ear Infections

Middle ear infections are common in children, and delay in diagnosis and treatment may result in complications such as delays in speech and language development and deafness. The aim of this study was to determine the prevalence and care seeking behaviour for middle ear infections in children under five years in Kigali city. We conducted a cross-sectional study among 810 children aged 6–59 months in Gasabo district of Kigali city, Rwanda. The prevalence of middle ear infections was 5.8%, of whom 4% had chronic suppurative otitis media. A child was less likely to develop middle ear infections if they lived in an urban setting (OR = 0.52, 95% CI: 0.285–0.958) but more likely to develop middle ear infections if exposed to household smoke (OR = 2.54, 95% CI: 1.18–5.46). Parents were unlikely to know that their child had an ear infection (OR: 0.15, 95% CI: 0.06–0.34). Middle ear infection remains a public health problem in Rwanda but many parents were not aware of its presence in the affected children. There is a need to raise awareness of parents about ear infection and to promote early care seeking from qualified health workers.

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Influenza vaccination policies for health workers in low-income and middle-income countries: A cross-sectional survey, January-March 2020

Vaccine ◽

10.1016/j.vaccine.2020.10.001 ◽

2020 ◽

Vol 38 (47) ◽

pp. 7433-7439

Author(s):

Helena C. Maltezou ◽

Kalliopi Theodoridou ◽

Maria Tseroni ◽

Vasilios Raftopoulos ◽

Amanda Bolster ◽

...

Keyword(s):

Influenza Vaccination ◽

Low Income ◽

Health Workers ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries

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Are Medical Graduates’ Job Choices for Rural Practice Consistent with their Initial Intentions? A Cross-Sectional Survey in Western China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183381 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3381 ◽

Cited By ~ 2

Author(s):

Jinlin Liu ◽

Bin Zhu ◽

Ning Zhang ◽

Rongxin He ◽

Ying Mao

Keyword(s):

Medical Students ◽

Low Income ◽

Clinical Medicine ◽

Health Workers ◽

Rural Practice ◽

Western China ◽

Job Choice ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Medical Graduates

Global concerns persist regarding the shortage and misdistribution of health workers in rural and remote areas. Medical education is an important input channel of human resources for health. This study aimed to identify the association between medical graduates’ job choices for rural practice and their initial intentions when they began to look for a job in China. Data were extracted from a cross-sectional survey among medical students in ten western provinces in China in 2013. Only medical students who were in the last year of study (i.e., medical graduates) and had found a job were included in this study. Of the 482 participants, 61.04% (293) presented an initial intention of rural practice when they began to look for a job, and 68.88% (332) made a final job choice for rural practice. However, of the 332 graduates with a final job choice of rural practice, only 213 (64.55%) had an initial intention. A univariate association was identified in which medical graduates who were more likely to make final job choices for rural practice were those having initial intentions (OR: 1.59; 95% CI: 1.08–2.36); however, after adjusting for controlled variables, it became insignificant and was reduced to a 1.31-fold increase (95% CI: 0.82–2.07). The initial intentions of medical graduates are not assurance of ultimate job outcomes, and it cannot be deduced that all medical graduates who made a final job choice for rural practice had authentic desires for rural practice. Twenty years of age or below, low-income families, majoring in non-clinical medicine, and studying in a junior medical college or below were associated with medical graduates’ final job choices for rural practice. More studies are required on how to translate medical student’s intention of rural medical practice into reality and how to retain these graduates via a job choice in rural practice in the future.

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Magnitude of screening for gestational diabetes mellitus in an urban setting in Tanzania; a cross-sectional analytic study

10.21203/rs.2.20985/v2 ◽

2020 ◽

Author(s):

Akampa Mbaaga Mukuve ◽

Miriam Lucy Mgonja ◽

Ibrahim Sendagire ◽

Mariam Noorani

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Antenatal Care ◽

Blood Sugar ◽

Dar Es Salaam ◽

Urban Setting ◽

Cross Sectional ◽

Factors Associated ◽

History Of

Abstract Background: Medical screening detects risk factors for disease or presence of disease in otherwise well persons in order to intervene early and reduce morbidity and mortality. During antenatal care (ANC) it is important to detect conditions that complicate pregnancy, like gestational diabetes mellitus (GDM). Despite international and local guidelines recommending screening for GDM during ANC, there is evidence to suggest that the practice was not being carried out adequately. A major challenge may be lack of consensus on uniform GDM screening and diagnostic guidelines internationally and locally. The primary objective was to determine the magnitude of screening for GDM among women receiving ANC at the Aga Khan Hospital, Dar es Salaam and Muhimbili National Hospital, Dar es Salaam. Secondary objectives were: to determine the methods used by health practitioners to screen for GDM, to determine the magnitude of undiagnosed gestational diabetes mellitus among women attending ANC and factors associated with screening for GDM among these women. Methods: A cross-sectional analytical study was done. Data collection was done using pre-tested questionnaires and reviewing antenatal care records. The proportion of women attending ANC who were screened for GDM was determined. The 75g Oral Glucose Tolerance Test (OGTT) was offered to women who had not been screened after education and consent. Results: Only 107 out of 358 (29.9%) had been offered some form of GDM screening. Tests used for GDM screening were random blood sugar (56.8%), fasting blood sugar (32.8%), HbA1C (6%) and 75g OGTT (3.4%). The uptake of the OGTT was 27%. Of these women the prevalence of GDM was 27.4%. Factors associated with screening for GDM were history of big baby, history of pregnancy induced hypertension and participant awareness of GDM (all p : <0.05). Conclusions: Screening for GDM among women attending ANC was lower than the World Health Organization target. Efforts should be directed towards promoting GDM screening, increasing awareness about GDM and developing more effective screening methods.

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