Dataset Information

A controlled pilot intervention on community violence prevention, financial and social capital generation in Dar Es Salaam, Tanzania.

ABSTRACT:

Background

Community violence has been found to be highly prevalent in Dar es Salaam, Tanzania. Increasing socioeconomic inequality has been outlined as one of the main causes of community violence. This controlled pilot trial aimed at evaluating the impact of beekeeping and entrepreneurship training on community violence exposure, financial and social capital generation, and employment structure.

Methods

Poisson regression was used to compare pre- and post-intervention risk ratios for community violence exposure. Linear regression was used to depict change in weekly income and utu scores. Employment rate structures were determined pre- and post-intervention.

Results

This study reports that compared to the Control arm beekeeping and entrepreneurship training appears to have protected young men in Dar es Salaam from exposure to community violence (All = 0.62 (0.40-0.96), Beekeeping = 0.57 (0.30-1.08), Entrepreneurship = 0.62 (0.33-1.17)), while increasing financial (All = 23,145 (- 27,155 - 73,444), Beekeeping = 29,310 (- 26,079 - 84,698), Entrepreneurship = 82,334 (12,274 - 152,293)) and partially also social capital (All = - 0.24 (- 1.35-0.87), Beekeeping = 0.85 (- 0.26-1.96), Entrepreneurship = 0.30 (- 1.16-1.77)). Financial dependency across all arms was reduced from 29.1 to 2.2%.

Conclusions

Our study reports that beekeeping training and entrepreneurship seminars appear to have a protective effect against exposure to community violence among young men in Dar es Salaam, while partially also increasing financial and social capital, as well as reducing financial dependency. We recommend that these results should lay the foundation for an adequately powered randomized trial to confirm the study's efficacy.

Trial registration

retrospectively registered at ClinicalTrials.gov (Identifier: NCT04602416; October 26, 2020).

SUBMITTER: Jansen L

PROVIDER: S-EPMC8851706 | biostudies-literature | 2022 Feb

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

A controlled pilot intervention on community violence prevention, financial and social capital generation in Dar Es Salaam, Tanzania.

Jansen Louis L Outwater Anne H AH Lowery Wilson Michael M Iseselo Masunga K MK Bärnighausen Till T

BMC public health 20220217 1

<h4>Background</h4>Community violence has been found to be highly prevalent in Dar es Salaam, Tanzania. Increasing socioeconomic inequality has been outlined as one of the main causes of community violence. This controlled pilot trial aimed at evaluating the impact of beekeeping and entrepreneurship training on community violence exposure, financial and social capital generation, and employment structure.<h4>Methods</h4>Poisson regression was used to compare pre- and post-intervention risk ratio ...[more]

PMID: 35172786

Similar Datasets

Project description:BackgroundMalaria is a major cause of paediatric morbidity and mortality. As no clinical features clearly differentiate malaria from other febrile illnesses, and malaria diagnosis is challenged by often lacking laboratory equipment and expertise, overdiagnosis and overtreatment is common.MethodsChildren admitted with fever at the general paediatric wards at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania from January to June 2009 were recruited consecutively and prospectively. Demographic and clinical features were registered. Routine thick blood smear microscopy at MNH was compared to results of subsequent thin blood smear microscopy, and rapid diagnostics tests (RDTs). Genus-specific PCR of Plasmodium mitochondrial DNA was performed on DNA extracted from whole blood and species-specific PCR was done on positive samples.ResultsAmong 304 included children, 62.6% had received anti-malarials during the last four weeks prior to admission and 65.1% during the hospital stay. Routine thick blood smears, research blood smears, PCR and RDT detected malaria in 13.2%, 6.6%, 25.0% and 13.5%, respectively. Positive routine microscopy was confirmed in only 43% (17/40), 45% (18/40) and 53% (21/40), by research microscopy, RDTs and PCR, respectively. Eighteen percent (56/304) had positive PCR but negative research microscopy. Reported low parasitaemia on routine microscopy was associated with negative research blood slide and PCR. RDT-positive cases were associated with signs of severe malaria. Palmar pallor, low haemoglobin and low platelet count were significantly associated with positive PCR, research microscopy and RDT.ConclusionsThe true morbidity attributable to malaria in the study population remains uncertain due to the discrepancies in results among the diagnostic methods. The current routine microscopy appears to result in overdiagnosis of malaria and, consequently, overuse of anti-malarials. Conversely, children with a false positive malaria diagnosis may die because they do not receive treatment for the true cause of their illness. RDTs appear to have the potential to improve routine diagnostics, but the clinical implication of the many RDT-negative, PCR-positive samples needs to be elucidated.

Project description:BackgroundTanzania is among the 30 countries with the highest tuberculosis (TB) burdens. Because TB has a long infectious period, early diagnosis is not only important for reducing transmission, but also for improving treatment outcomes. We assessed diagnostic delay and associated factors among infectious TB patients.MethodsWe interviewed new smear-positive adult pulmonary TB patients enrolled in an ongoing TB cohort study in Dar es Salaam, Tanzania, between November 2013 and June 2015. TB patients were interviewed to collect information on socio-demographics, socio-economic status, health-seeking behaviour, and residential geocodes. We categorized diagnostic delay into ≤ 3 or > 3 weeks. We used logistic regression models to identify risk factors for diagnostic delay, presented as crude (OR) and adjusted Odds Ratios (aOR). We also assessed association between geographical distance (incremental increase of 500 meters between household and the nearest pharmacy) with binary outcomes.ResultsWe analysed 513 patients with a median age of 34 years (interquartile range 27-41); 353 (69%) were men. Overall, 444 (87%) reported seeking care from health care providers prior to TB diagnosis, of whom 211 (48%) sought care > 2 times. Only six (1%) visited traditional healers before TB diagnosis. Diagnostic delay was positively associated with absence of chest pain (aOR = 7.97, 95% confidence intervals [CI]: 3.15-20.19; P < 0.001), and presence of hemoptysis (aOR = 25.37, 95% CI: 11.15-57.74; P < 0.001) and negatively associated with use of medication prior to TB diagnosis (aOR = 0.31, 95% CI: 0.14-0.71; P = 0.01). Age, sex, HIV status, education level, household income, and visiting health care facilities (HCFs) were not associated with diagnostic delay. Patients living far from pharmacies were less likely to visit a HCF (incremental increase of distance versus visit to any facility: OR = 0.51, 95% CI: 0.28-0.96; P = 0.037).ConclusionsTB diagnostic delay was common in Dar es Salaam, and was more likely among patients without prior use of medication and presenting with hemoptysis. Geographical distance to HCFs may have an impact on health-seeking behaviour. Increasing community awareness of TB signs and symptoms could further reduce diagnostic delays and interrupt TB transmission.

Project description:BackgroundFunctional referral system including pre referral care, access to emergency transport and ensuring continuity of care between facilities is critical for improved newborn health outcome. The neonatal transport system is quite undervalued in many sub Saharan countries, Tanzania included. This study assessed the pre referral care, transport process, ambulance characteristics, admission clinical status and outcomes of referred neonates at Muhimbili National Hospital Upanga, a tertiary facility in Dar es Salaam, Tanzania.MethodsA descriptive cross sectional study with a longitudinal follow up was conducted from September 2020 to February 2021 including neonates referred to Muhimbili National Hospital. A structured questionnaire was used to collect demographic characteristics and transport factors including pre referral care extracted from the referral documents and through interviewing caregivers or escorting person/nurse. Ambulances were directly observed using a structured checklist on presence, absence and functionality of supportive equipment. All enrolled neonates had a clinical assessment at admission and 48 hours post admission to determine admission clinical status and 48 hours' clinical outcome as either survived/died.ResultsOut of the 348 neonates assessed during the study period, the median gestation age was 38 weeks (IQR 32, 39) with the mean birth weight of 2455 ± 938 g. Pre referral documentation showed that temperature was measured in 176 (57.1%), oxygen saturation and random blood glucose in only 143 (46.6%) and 116 (36.2%) neonates respectively. Ambulance was used as a means of transportation in 308 (88.5%) neonates. While no ambulance had an incubator only 7 (2.0%) neonates were kept on a Kangaroo Mother Care position. Monitoring enroute was done to only 94 (27%) of the transferred neonates with 169 (54.9%) of health care professionals escorting the neonates lacking training on essential newborn care. On arrival, 115 (33%) were hypothermic, 74 (21.3%) hypoxic, 30 (8.6%) with poor perfusion and 49 (14.1%) hypoglycemic. Hypothermic neonates had an increased chance of dying compared to those who were normothermic (OR = 2.09, 95% CI (1.05-4.20), p = 0.037). The chance of dying among those presenting with hypoxia was almost three times (OR = 2.88, 95%CI (1.44-5.74), p = 0.003) while those with poor perfusion was almost five times (OR = 4.76, 95%CI (1.80-12.58), p = 0.002). Additionally, neonates who had hyperglycemia (RBG > 8.3mmol/l) on arrival had a higher probability of dying compared to those who were euglycemic [(OR = 3.10, 95% CI (1.19-8.09) p = 0.021]. Overall mortality was 22.4% within 48 hours of admission and risk of dying increased as the presence of poor clinical status added on.ConclusionNeonatal transportation in Dar es Salaam, Tanzania was observed to be challenging. Pre transfer care and monitoring during transportation was inadequate and this contributed to poor clinical status on admission. Hypothermia, hypoglycemia, hyperglycemia, hypoxia and poor perfusion on admission were associated with increased mortality. Effective referral network is needed for improved neonatal health outcomes. Pre referral supportive care, training of health care professionals, transportation with improved monitoring, clear communication protocol and referral documentation should be invested and effectively utilized.

Project description:BackgroundUndernutrition in children is predominantly linked to lack of a balanced diet resulting from inadequate nutrition intake. This form of malnutrition remains a leading cause of morbidity and mortality under-five children, especially prevalent in low-income countries. Understanding the specific factors contributing to undernutrition among this group, particularly those associated with caregivers, is vital yet insufficiently explored. Therefore, this study aimed to investigate and evaluate caregivers' perceptions regarding the factors influencing under-nutrition among children under-five in Ubungo, Dar es Salaam, Tanzania.MethodsA qualitative study was conducted at Sinza Palestina Hospital in Ubungo Municipal Council, Dar es Salaam, from January 2019 to December 2019. In-depth interviews were carried out with caregivers of undernourished children to explore their thoughts, perceptions, and views on the factors contributing to under-nutrition among this demographic. A semi-structured interview guide facilitated data collection, allowing for comprehensive exploration. Recorded data underwent transcription. And thematic content analysis was utilized to identify caregivers' perceptions and views, highlighting codes and subcategories that represented factors influencing under-nutrition. A total of 26 participants were purposefully selected among caregivers who provided consent during the study period was included.ResultsThe study revealed several primary factors contributing to under-nutrition among under-five children. Among these, poor adherences to WHO recommended feeding practices by caregivers, exacerbated by poverty resulting from low monthly income. This economic limitation impeded families' ability to provide essential nutritious foods for their children. Additionally, limited time available for childcare emerged as main factors contributed to under-nutrition. Notably, while caregivers exhibited a good understanding of malnutrition and its causes, their perceptions did not align with WHO definition of under-nutrition.ConclusionAddressing nutrition among under five children necessitates comprehensive support for caregivers, including economic empowerment and education on WHO-recommended feeding practices. Encouraging adherence to these practices is vital. Additionally, care givers should allocate sufficient time for breastfeeding and preparing complementary food for their children.

Dataset Information

A controlled pilot intervention on community violence prevention, financial and social capital generation in Dar Es Salaam, Tanzania.

Background

Methods

Results

Conclusions

Trial registration

Publications

A controlled pilot intervention on community violence prevention, financial and social capital generation in Dar Es Salaam, Tanzania.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets