Publications by authors named "Joseph Mwanga"

Background: Breast cancer poses a significant public health challenge in Tanzania. Limited knowledge about breast cancer and negative attitudes toward screening practices contributes to delayed diagnoses and poorer patient outcomes. Catholic nuns, who are often nulliparous, represent a population with an increased risk of developing breast cancer.

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Article Synopsis
  • The study highlights the serious threat of antibacterial resistance (ABR) in low-resource areas like East Africa, specifically focusing on multi-drug resistant urinary tract infections (MDR UTIs).
  • Researchers examined a variety of factors, including behavioral, environmental, socioeconomic, and demographic influences, that contribute to the risk of developing MDR UTIs among outpatients in Kenya, Tanzania, and Uganda.
  • Findings suggest that individuals at higher risk tend to have multiple social and environmental disadvantages, indicating that effective interventions should consider these intersecting factors rather than just focusing on antibiotic use alone.
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Background: In low- and middle-income countries (LMICs), such as Tanzania, the competency of healthcare providers critically influences the quality of pediatric care. To address this issue, we introduced Pediatric Acute Care Education (PACE), an adaptive learning program to enhance provider competency in Tanzania's guidelines for managing seriously ill children. Adaptive learning is a promising alternative to current in-service education, yet optimal implementation strategies in LMIC settings are unknown.

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Background: In low- and -middle-income countries (LMICs) like Tanzania, the competency of healthcare providers critically influences the quality of pediatric care. To address this, we introduced PACE (Pediatric Acute Care Education), an adaptive e-learning program tailored to enhance provider competency in line with Tanzania's national guidelines for managing seriously ill children. Adaptive e-learning presents a promising alternative to traditional in-service education, yet optimal strategies for its implementation in LMIC settings remain to be fully elucidated.

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Objective: Despite facing unique barriers, Catholic nuns in Tanzania require accessible breast health promotion. This study explores interventions to empower nuns through knowledge, improved attitudes, and positive practices, ultimately promoting well-being and early detection for better breast cancer outcomes.

Materials And Methods: A quasi-experimental design study guided by the Health Belief Model was conducted to monitor the implementation of a breast health intervention program aimed at increasing breast cancer screening knowledge among 385 Catholic nuns aged 20 to over 60 years old within Lake Zone, Tanzania.

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Antibacterial resistance (ABR) is a major public health threat. An important accelerating factor is treatment-seeking behaviour, including inappropriate antibiotic (AB) use. In many low- and middle-income countries (LMICs) this includes taking ABs with and without prescription sourced from various providers, including health facilities and community drug sellers.

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Article Synopsis
  • Study Objective
  • : The study aimed to improve Tanzanian healthcare providers' knowledge of newborn care through an adaptive e-learning platform (aESNC) while evaluating its implementation success and assessing baseline provider knowledge.
  • Methodology
  • : Conducted over 6 months in Mwanza, Tanzania, the observational study measured the reach and effectiveness of aESNC using specific frameworks and models, while also examining factors influencing providers' completion of training.
  • Results
  • : The aESNC reached 85% of targeted providers, with a median clinical experience of 4 years. Providers showed 78% completion of initial learning, but 67% experienced inactivity. Higher baseline understanding and nursing officers were linked to better training completion.
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Article Synopsis
  • The study investigates how the COVID-19 pandemic impacted care-seeking behaviors and antibiotic use for urinary tract infection-like symptoms in Uganda and Tanzania, two East African countries with different COVID-19 policies.
  • Data was collected from outpatient patients with UTI symptoms at three time points: before COVID-19, during early COVID-19, and later in the pandemic, focusing on delays in seeking care and antibiotic use.
  • Findings showed that while delays in seeking care decreased during the pandemic, inappropriate antibiotic use, particularly metronidazole and doxycycline, significantly increased, raising concerns about adherence to treatment guidelines.
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Dispensing antibiotics without prescription is among the major factors leading to antimicrobial resistance. Dispensing of antibiotics without prescription has negative impact at the individual and societal level leading to poor patient outcomes, and increased risks of resistant bacteria facilitated by inappropriate choice of antibiotics doses/courses. Antimicrobial resistance is a global public health threat which is projected to cause 10 million deaths by 2050 if no significant actions are taken to address this problem This study explored the practices and motives behind dispensing of antibiotics without prescription among community drug outlets in Tanzania.

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Globally, inadequate healthcare provider (HCP) proficiency with evidence-based guidelines contributes to millions of newborn, infant, and child deaths each year. HCP guideline proficiency would improve patient outcomes. Conventional (in person) HCP in-service education is limited in 4 ways: reach, scalability, adaptability, and the ability to contextualize.

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Introduction: To improve healthcare provider knowledge of Tanzanian newborn care guidelines, we developed adaptive Essential and Sick Newborn Care (aESNC), an adaptive e-learning environment (AEE). The objectives of this study were to 1) assess implementation success with use of in-person support and nudging strategy and 2) describe baseline provider knowledge and metacognition.

Methods: 6-month observational study at 1 zonal hospital and 3 health centers in Mwanza, Tanzania.

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Background: A key factor driving the development and maintenance of antibacterial resistance (ABR) is individuals' use of antibiotics (ABs) to treat illness. To better understand motivations and context for antibiotic use we use the concept of a patient treatment-seeking pathway: a treatment journey encompassing where patients go when they are unwell, what motivates their choices, and how they obtain antibiotics. This paper investigates patterns and determinants of patient treatment-seeking pathways, and how they intersect with AB use in East Africa, a region where ABR-attributable deaths are exceptionally high.

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The escalating number of Children Living and Working in Streets (CLWS) in Tanzania has become one of the neglected Public Health issues. It is of more concern that, most of the CLWS hardly have access to health care and socio-protection services as a result, increase their vulnerability to infections and engagement in risky behaviors such as early unprotected sex. Currently, efforts by Civil Society Organizations (CSOs) to work with and assist CLWS in Tanzania are promising.

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Mass drug administration of praziquantel becomes a less attractive strategy for elimination of schistosomiasis in low-prevalence areas due to cost implications and low treatment compliance. We aimed to determine the feasibility of a Test-Treat-Track-Test-Treat (5T) strategy in two low-prevalence villages; the 5T strategy has been successfully implemented in diseases such as malaria. A total of 200 school children aged 6-12 years were randomly selected from two schools and tested for Schistosoma mansoni infection using the point-of-care circulating cathodic antigen test.

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Background: Urogenital pathogens such as and have been reported to cause pyuria, however they are not routinely cultured from urine samples of patients clinically diagnosed to have urinary tract infections (UTI). In this study, pathogen specific PCR was done to identify the urogenital pathogens in the urine samples among clinically diagnosed UTI patients with negative routine urine culture.

Methods: A cross-sectional study was conducted involving 227 archived urine samples from clinically diagnosed UTI patients with positive leucocyte esterase but negative urine culture results.

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Antibacterial resistance (ABR) is a major public health threat. An important accelerating factor is treatment-seeking behaviours, including inappropriate antibiotic (AB) use. In many low- and middle-income countries (LMICs) this includes taking ABs with and without prescription sourced from various providers, including health facilities and community drug sellers.

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Background: There is a growing body of evidence on the potential involvement of coagulase-negative Staphylococci (CoNS) in causing urinary tract infections (UTIs). The aim of this study was to delineate virulence potential, antimicrobial resistance genes, and sequence types of CoNS isolated from patients with UTI symptoms and pyuria in Tanzania.

Methods: CoNS from patients with UTI symptoms and more than 125 leucocytes/μL were retrieved, subcultured, and whole-genome sequenced.

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Article Synopsis
  • The study investigates how drug sellers in Tanzania and Uganda interacted with clients seeking antibiotics for simulated COVID-19 symptoms during the pandemic, highlighting concerns about antibiotic misuse and resistance.
  • Research assistants acted as clients without prescriptions, approaching various drug sellers to assess their guidance and drug dispensing practices.
  • Results showed that knowledge of COVID-19 symptoms was low in both locations, but drug sellers in Uganda provided better identification of symptoms and were less likely to sell prescription-only medicines without a prescription than those in Tanzania.
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Background: Poverty is a proposed driver of antimicrobial resistance, influencing inappropriate antibiotic use in low-income and middle-income countries (LMICs). However, at subnational levels, studies investigating multidimensional poverty and antibiotic misuse are sparse, and the results are inconsistent. We aimed to investigate the relationship between multidimensional poverty and antibiotic use in patient populations in Kenya, Tanzania, and Uganda.

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Experiences from patients living with a long-term indwelling urinary catheter (IUC) at home among men attending urology clinics have not been reported. Evidence-based information on such experiences is important for improving nursing care in low- and middle-income countries such as Tanzania. Using a descriptive phenomenological qualitative research design, we observed two main themes: "", denoting that social interaction and psychological and spiritual support are important to positively live with the catheter, and "", considering intimacy and altered body image to significantly influence the ability to practice sex, leading to wives' self-sacrifice.

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Background: Antibiotic dispensing without prescription is a major determinant of the emergence of Antimicrobial Resistance (AMR) which has impact on population health and cost of healthcare delivery. This study used simulated clients describing UTI like symptoms to explore compliance with regulation, variations in dispensing practices and drug recommendation, and quality of seller-client interaction on the basis of the gender of the client and the type of drug outlets in three regions in Tanzania.

Method: A total of 672 Accredited Drug Dispensing Outlets (ADDOs) and community pharmacies were visited by mystery clients (MCs).

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Schistosomiasis is a helminthiasis infecting approximately 250 million people worldwide. In 2001, the World Health Assembly (WHA) 54.19 resolution defined a new global strategy for control of schistosomiasis through preventive chemotherapy programmes.

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Increasing antimicrobial resistance (AMR) colonizing domesticated animals is a global concern threatening food safety. This study aimed at determining the prevalence of multidrug resistance (MDR) and epidemiological cut-off values (ECVs) of E. coli isolated from poultry and pigs in Mwanza, Tanzania.

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Complications of indwelling urinary catheterization (IUC) are associated with significant morbidity and mortality, thus affecting patient's well-being. Understanding the magnitude and factors associated with complications is crucial in designing appropriate preventive strategies. A cross-sectional study was conducted at Bugando Medical Centre, involving patients with long-term and short-term IUC from December 2016 to September 2017.

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Worldwide, antimicrobial resistance is increasing rapidly and is associated with misuse of antimicrobials. The HATUA study (a broader 3-country study) investigated the antibiotic dispensing practices of pharmaceutical providers to clients, particularly the propensity to dispense without prescription. A cross-sectional study using a 'mystery client' method was conducted in 1148 community pharmacies and accredited drugs dispensing outlets (ADDO) in Mwanza ( = 612), Mbeya ( = 304) and Kilimanjaro ( = 232) in Tanzania.

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