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Foláyan MO, Virtanen JI, Gaffar B, Abodunrin O, Sun IG, Duangthip D, Kemoli A, Masumo RM, Vukovic A, Al-Batayneh OB, Mfolo T, Schroth RJ, El Tantawi M. Scoping review on the association between early childhood caries and responsible resource consumption and production: exploring Sustainable Development Goal 12. BMC Oral Health 2024; 24:98. [PMID: 38233825 PMCID: PMC10792892 DOI: 10.1186/s12903-023-03831-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/26/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND The Sustainable Development Goal 12 (SDG12) promotes patterns that minimize waste and maximize resource utilization. It is therefore plausible that preventing Early Childhood Caries (ECC) and promoting oral health can contribute to sustainable consumption. In addition, sustainable consumption and production can contribute to the control of ECC. This scoping review aimed to explore the possible evidence on the link between ECC and the SDG12 targets. METHODS This scoping review identified articles on the link between resource consumption and production and caries according to the PRISMA-ScR guidelines. Three electronic databases (PubMed, Web of Science, and Scopus) were systematically searched in August 2023, using specific search terms. Studies written in English, with full text available, addressing dental caries and linked with waste minimization and resource utilization maximisation, with results that could be extrapolated to ECC in children less than 6 years of age) were included. Descriptive statistics were planned to summarize the categories of retrieved papers. RESULTS The initial search yielded 904 articles, with 863 screened for eligibility after the removal of duplicates. No studies were identified that reported data on an association between responsible consumption and production of resources factors and ECC. CONCLUSION This scoping review did not identify any articles published in English on evidence of the direct associations between ECC and SDG12 targets. However, there is a plausibility of such a link using minimum intervention dentistry for ECC management as a waste prevention and resource utilisation maximization strategy.
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Affiliation(s)
- Morẹ́nikẹ́ Oluwátóyìn Foláyan
- Early Childhood Caries Advocacy Group, Winnipeg, Canada.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Jorma I Virtanen
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Balgis Gaffar
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Duangporn Duangthip
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Arthur Kemoli
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Paediatric Dentistry and Orthodontics, University of Nairobi, Nairobi, Kenya
| | - Ray M Masumo
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Ana Vukovic
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ola B Al-Batayneh
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Orthodontics, Pediatric and Community Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Tshepiso Mfolo
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Community Dentistry, University of Pretoria, Hatfield, South Africa
| | - Robert J Schroth
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Dr. Gerald Niznick College of Dentistry, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Maha El Tantawi
- Early Childhood Caries Advocacy Group, Winnipeg, Canada
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Foláyan MO, Amalia R, Kemoli A, Ayouni I, Nguweneza A, Duangthip D, Sun IG, Virtanen JI, Masumo RM, Vukovic A, Al-Batayneh OB, Gaffar B, Mfolo T, Schroth RJ, El Tantawi M. Scoping review on the link between economic growth, decent work, and early childhood caries. BMC Oral Health 2024; 24:77. [PMID: 38218865 PMCID: PMC10787988 DOI: 10.1186/s12903-023-03766-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/12/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Early Childhood Caries (ECC) is a prevalent chronic non-communicable disease that affects millions of young children globally, with profound implications for their well-being and oral health. This paper explores the associations between ECC and the targets of the Sustainable Development Goal 8 (SDG 8). METHODS The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In July 2023, a search was conducted in PubMed, Web of Science, and Scopus using tailored search terms related to economic growth, decent work sustained economic growth, higher levels of productivity and technological innovation, entrepreneurship, job creation, and efforts to eradicate forced labor, slavery, and human trafficking and ECC all of which are the targets of the SDG8. Only English language publications, and publications that were analytical in design were included. Studies that solely examined ECC prevalence without reference to SDG8 goals were excluded. RESULTS The initial search yielded 761 articles. After removing duplicates and ineligible manuscripts, 84 were screened. However, none of the identified studies provided data on the association between decent work, economic growth-related factors, and ECC. CONCLUSIONS This scoping review found no English publication on the associations between SDG8 and ECC despite the plausibility for this link. This data gap can hinder policymaking and resource allocation for oral health programs. Further research should explore the complex relationship between economic growth, decent work and ECC to provide additional evidence for better policy formulation and ECC control globally.
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Affiliation(s)
- Morẹ́nikẹ́ Oluwátóyìn Foláyan
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Rosa Amalia
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Arthur Kemoli
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Paediatric Dentistry and Orthodontics, University of Nairobi, Nairobi, Kenya
| | - Imen Ayouni
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Arthemon Nguweneza
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Duangporn Duangthip
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Jorma I Virtanen
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Ray M Masumo
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Ana Vukovic
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ola B Al-Batayneh
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Orthodontics, Pediatric and Community Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Balgis Gaffar
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Tshepiso Mfolo
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Community Dentistry, University of Pretoria, Pretoria, South Africa
| | - Robert J Schroth
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Canada
| | - Maha El Tantawi
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Lyimo EJ, Msangi M, Zangira AJ, Msaki RV, Lekey A, Rwenyagira M, Mwiru R, Codjia P, Ezekiel M, Leyna GH, Masumo RM. Healthcare-seeking behaviours among mother's having under-five children with severe wasting in Dodoma and Mbeya regions of Tanzania-A qualitative study. PLOS Glob Public Health 2024; 4:e0001943. [PMID: 38190374 PMCID: PMC10773934 DOI: 10.1371/journal.pgph.0001943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 12/06/2023] [Indexed: 01/10/2024]
Abstract
Maternal healthcare-seeking behaviour affects the health and well-being of under-five children. Drawing from the concepts of the health belief model, this study seeks to understand the determinants of health-seeking behaviours among mothers or caregivers of under-five-year-old children having severe wasting in Tanzania. A qualitative study employing the ethnography method conducted 32 semi-structured and narrative interviews with healthcare workers, community health workers, traditional healers, religious and village leaders, and mothers or caregivers of children who had acute malnutrition. The analysis of transcripts was done by qualitative content analysis. Further, the thematic analysis was carried out by assigning data into relevant codes to generate categories based on study objectives. Severe wasting among under-five-year-old children was not observed as a serious disease by the majority of mothers or caregivers. The study established that the health systems parameters such as the availability of the community health workers or healthcare providers and the availability of medicines and supplies to the health facility impact on mothers' or caregivers' healthcare-seeking behaviours. The findings also show that long distances to the health facility, behavioural parameters such as lack of awareness, negative perception of the management of severe wasting at the health facility, superstitious beliefs, women's workload, household food insecurity, and gender issues have a significant role in seeking healthcare. The results reaffirm how a programme on integrated management of severe wasting in Tanzania should encompass sociocultural factors that negatively influence mothers or caregivers of children with acute malnutrition. The programme should focus on engaging community structures including traditional healers, religious and village leaders to address prevailing local beliefs and sociocultural factors.
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Affiliation(s)
| | - Maria Msangi
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | | | - Rose V. Msaki
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Aika Lekey
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | | | - Ramadhan Mwiru
- The United Nations Children’s Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Patrick Codjia
- The United Nations Children’s Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Mangi Ezekiel
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Germana H. Leyna
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Ray M. Masumo
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
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4
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Killel E, Mchau G, Mbilikila H, Azizi K, Ngasa N, Hancy A, Lukindo T, Mwiru R, Noor R, Sanga A, Codjia P, Leyna GH, Masumo RM. Dietary intake and associated risk factors among pregnant women in Mbeya, Tanzania. PLOS Glob Public Health 2024; 4:e0002529. [PMID: 38180949 PMCID: PMC10769095 DOI: 10.1371/journal.pgph.0002529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/17/2023] [Indexed: 01/07/2024]
Abstract
Poor dietary intake among pregnant women has serious detrimental consequences for pregnancy and offspring both in developed and developing countries. This study aimed to assess dietary intake and associated risk factors among pregnant women. A cross-sectional study was conducted in Mbeya, Tanzania with a sample size of 420 pregnant women attending antenatal clinics to assess the factors associated with dietary intake. Dietary intake was assessed using a piloted questionnaire of the Prime Diet Quality Score. A tested standard questionnaire was also used to collect factors that are associated with dietary intake among pregnant women. The strengths of the associations between the dependent and independent variables were tested using the Pearson chi-square tests and the multivariate log-binomial regression method was performed to calculate the adjusted risk ratios (ARR) and 95% confidence interval (CI). The study revealed that out of 420 pregnant women who participated in this study only 12.6% and 29.3% consumed at least four servings of fruits and vegetables per week respectively. Poor dietary intakes were less likely among cohabiting pregnant women [Adjusted RR 0.22 (95% CI 0.09-0.50)] and; those who reported taking Fansidar tablets during the pregnancy [Adjusted RR 0.55 (95% CI 0.31-0.96)]. Further, we found that poor dietary intakes were more likely among pregnant women who were classified as overweight and obesity by the MUAC above 33cm [Adjusted RR 3.49 (95% CI 1.10-11.06)]. The study results affirm that cohabitation and obesity affect dietary intakes among pregnant women differently compared to married women in rural settings of Tanzania. Further research is needed to investigate the social aspects that link dietary intake outcomes for developing a tailored gestational intervention to improve maternal and birth outcomes in sub-Saharan African countries.
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Affiliation(s)
- Erick Killel
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Geofrey Mchau
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Hamida Mbilikila
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Kaunara Azizi
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Nyamizi Ngasa
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Adam Hancy
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Tedson Lukindo
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Ramadhan Mwiru
- The United Nations Children’s Fund (UNICEF), Dar es Salaam, Tanzania
| | - Ramadhan Noor
- The United Nations Children’s Fund (UNICEF), Dar es Salaam, Tanzania
| | - Abraham Sanga
- The United Nations Children’s Fund (UNICEF), Dar es Salaam, Tanzania
| | - Patrick Codjia
- The United Nations Children’s Fund (UNICEF), Dar es Salaam, Tanzania
| | - Germana H. Leyna
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ray M. Masumo
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
- Department of Statistics, University of Dar es Salaam (UDSM), Dar es Salaam, Tanzania
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Foláyan MO, Ramos-Gomez F, Fatusi OA, Nabil N, Lyimo GV, Minja IK, Masumo RM, Mohamed N, Potgieter N, Matanhire C, Maposa P, Akino CR, Adeniyi A, Mohebbi SZ, Ellakany P, Chen J, Amalia R, Iandolo A, Peedikayil FC, Aravind A, Al-Batayneh OB, Khader YS, Al-Maweri SA, Sabbah W, Abeldaño Zuñiga RA, Vukovic A, Jovanovic J, Jafar RM, Maldupa I, Arheiam A, Mendes FM, Uribe SE, López Jordi MDC, Villena RS, Duangthip D, Sam-Agudu NA, El Tantawi M. Child dental neglect and legal protections: a compendium of briefs from policy reviews in 26 countries and a special administrative region of China. Front Oral Health 2023; 4:1211242. [PMID: 38024146 PMCID: PMC10646161 DOI: 10.3389/froh.2023.1211242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background Child neglect is a public health, human rights, and social problem, with potentially devastating and costly consequences. The aim of this study was to: (1) summarize the oral health profile of children across the globe; (2) provide a brief overview of legal instruments that can offer children protection from dental neglect; and (3) discuss the effectiveness of these legal instruments. Methods We summarized and highlighted the caries profile and status of implementation of legislation on child dental neglect for 26 countries representing the World Health Organization regions: five countries in Africa (Nigeria, South Africa, Sudan, Tanzania, Zimbabwe), eight in the Americas (Argentina, Brazil, Canada, Chile, Mexico, Peru, Unites States of America, Uruguay), six in the Eastern Mediterranean (Egypt, Iran, Libya, Jordan, Qatar, Saudi Arabia), four in Europe (Italy, Latvia, Serbia, United Kingdom), two in South-East Asia (India and Indonesia) and one country (China) with its special administrative region (Hong Kong) in the Western Pacific. Results Twenty-five of the 26 countries have legal instruments to address child neglect. Only two (8.0%) of these 25 countries had specific legal instruments on child dental neglect. Although child neglect laws can be interpreted to establish a case of child dental neglect, the latter may be difficult to establish in countries where governments have not addressed barriers that limit children's access to oral healthcare. Where there are specific legal instruments to address child dental neglect, a supportive social ecosystem has also been built to facilitate children's access to oral healthcare. A supportive legal environment, however, does not seem to confer extra protection against risks for untreated dental caries. Conclusions The institution of specific country-level legislation on child dental neglect may not significantly reduce the national prevalence of untreated caries in children. It, however, increases the prospect for building a social ecosystem that may reduce the risk of untreated caries at the individual level. Social ecosystems to mitigate child dental neglect can be built when there is specific legislation against child dental neglect. It may be more effective to combine public health and human rights-based approaches, inclusive of an efficient criminal justice system to deal with child dental neglect.
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Affiliation(s)
- Moréniké Oluwátóyìn Foláyan
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Nigeria
| | - Francisco Ramos-Gomez
- Division of Preventive and Restorative Oral Health Sciences, UCLA School of Dentistry, Los Angeles, CA, United States
| | | | - Nouran Nabil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Germana V. Lyimo
- Department of Dentistry, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Irene Kida Minja
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ray M. Masumo
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Nadia Mohamed
- Department of Paediatric Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Nicoline Potgieter
- Department of Paediatric Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | | | - Pamela Maposa
- Department of Paediatrics, University of Zimbabwe, Harare, Zimbabwe
| | | | - Abiola Adeniyi
- School of Policy and Global Affairs, Fairleigh Dickinson University, Vancouver, BC, Canada
| | - Simin Z. Mohebbi
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Passent Ellakany
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdurrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jieyi Chen
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Rosa Amalia
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Alfredo Iandolo
- Department of Endodontics, Faculty of Dentistry, University of Salerno, Salerno, Italy
| | - Faizal C. Peedikayil
- Department of Pediatric and Preventive Dentistry, Kannur Dental College, Anjarakandy, India
| | - Athira Aravind
- Department of Pediatric and Preventive Dentistry, Kannur Dental College, Anjarakandy, India
| | - Ola B. Al-Batayneh
- Department of Orthodontics, Pediatric and Community Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef S. Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, United Kingdom
| | - Roberto Ariel Abeldaño Zuñiga
- Postgraduate Department, University of Sierra Sur, Oaxaca, Mexico
- Centre for Social Data Science, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Ana Vukovic
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Julijana Jovanovic
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Ilze Maldupa
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
| | - Arheiam Arheiam
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, University of Benghazi, Benghazi, Libya
| | - Fausto M. Mendes
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, University of Benghazi, Benghazi, Libya
| | - Sergio E. Uribe
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
- School of Dentistry, Universidad Austral de Chile, Valdivia, Chile
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, Latvia
| | | | - Rita S. Villena
- Department of Pediatric Dentistry, School of Dentistry, University San Martin de Porres, Lima, Perú
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR China
| | - Nadia A. Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Paediatrics and Child Health, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Maha El Tantawi
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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John SE, Azizi K, Hancy A, Twin'omujuni A, Katana D, Shine J, Lyatuu V, Sanga A, Mwiru RS, Abdallah F, Mchau G, Lukindo T, Kamala A, Codjia P, Leyna GH, Masumo RM. The prevalence and risk factors associated with Iron, vitamin B12 and folate deficiencies in pregnant women: A cross-sectional study in Mbeya, Tanzania. PLOS Glob Public Health 2023; 3:e0001828. [PMID: 37083656 PMCID: PMC10121015 DOI: 10.1371/journal.pgph.0001828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 03/22/2023] [Indexed: 04/22/2023]
Abstract
Maternal nutrition is an important forecaster of infant's and mother's health status in most developing countries. This study aimed at assessing the prevalence and associated risk factors of iron, vitamin B12, and folate deficiencies among pregnant women in Mbeya Tanzania. A cross-sectional study using a cluster randomized sampling was conducted among 420 pregnant women. A structured questionnaire was used to collect socio-demographic and dietary assessment. Body iron store was assessed using serum ferritin measured by immunoturbidimetric assays using a Roche Cobas 400+ biochemistry analyzer. Serum folate was measured by folate microbiological assay, while serum vitamin B12 was measured by immunochemiluminescence assay using a Roche Cobas e411 immunoassay analyzer. Multivariate analysis was performed using Poisson regression. The prevalence of iron, folate, and vitamin B12 deficiencies among pregnant women in Mbeya was 37.8%, 24.0%, and 9.7% respectively. Higher odds of iron deficiency were seen in pregnant women aged 20-24 years older [Adjusted OR = 1.20 (95%CI 1.03, 1.35)], not employed [Adjusted OR = 3.0(95%CI 1.03-1.77)] and, not received iron/folic acid supplementation [Adjusted OR = 1.11 (95%CI 1.003-1.23)]. Pregnant women with highest and middle socio-economic statuses had lower odds of vitamin B12 deficiency [Adjusted OR = 0.83 (95%CI 0.76-0.92)] and [Adjusted OR = 0.89 (95%CI 0.81-0.98)] respectively. Pregnant women who were not employed, not received iron and folic acid supplement during pregnancy and, not consumed edible vegetable cooking oil had significant higher odds of serum folate deficiency [Adjusted OR = 3.0 (95%CI 1.58-5.68)], [Adjusted OR = 1.53 (95%CI 1.21-1.93)] and, [Adjusted OR = 2.77 (1.03-7.44)] respectively. This study confirms that iron, folate and vitamin B12 deficiencies are still a major challenge among pregnant women in Tanzania. We recommend for public health interventions for the provision of vitamin B12 along with iron and folic acid supplementations, especially in pregnant women belong to low socio-economic status and limited knowledge of healthy diet.
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Affiliation(s)
- Sauli E John
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Kaunara Azizi
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Adam Hancy
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | | | - Doris Katana
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Julieth Shine
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Vumilia Lyatuu
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Abraham Sanga
- The United Nations Children's Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Ramadhani S Mwiru
- The United Nations Children's Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Fatma Abdallah
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Geofrey Mchau
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Tedson Lukindo
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Analice Kamala
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
| | - Patrick Codjia
- The United Nations Children's Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Germana H Leyna
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Ray M Masumo
- Tanzania Food and Nutrition Centre (TFNC), Dar es Salaam, Tanzania
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Msaki RV, Lyimo E, Masumo RM, Mwana E, Katana D, Julius N, Munuo A, Leyna G, Issaka AI, Dhami MV, Agho KE. Predictors of iron deficiency anaemia among children aged 6-59 months in Tanzania: Evidence from the 2015-16 TDHS-MIS cross-sectional household survey. PLOS Glob Public Health 2022; 2:e0001258. [PMID: 36962688 PMCID: PMC10022048 DOI: 10.1371/journal.pgph.0001258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/12/2022] [Indexed: 11/12/2022]
Abstract
Iron deficiency anaemia remains a public health problem, particularly in children aged 6-59 months. This study assessed factors associated with iron deficiency anaemia among children aged 6-23 months, 24-59 months and 6-59 months in Tanzania. Data for this cross-sectional study were extracted from the 2015-16 Tanzania Demographic and Health Survey and Malaria Indicator Survey (2015-16 TDHS-MIS). The study covered 8014 children aged 6-59 months and their mothers. Iron deficiency anaemia was defined (haemoglobin < 11g/dL). Univariable and multivariable logistic regression analyses that adjust for clustering and sampling weights were conducted to describe the associations between anaemia and potential confounding variables. The prevalence of iron deficiency anaemia among children aged 6-23 months, 24-59 months and 6-59 months were 76%, 49% and 59%, respectively. Factors associated with increased odds of iron deficiency anaemia among children aged 6-23 months included a mother being employed, being a male child, child perceived to small size at birth by mothers, a mother being anaemic and children belonging to the poorest socio-economic quintile. In addition, being a mother with no schooling, children not being dewormed, a mother being anaemic, delivering a baby at home, child fever and stunting, were factors associated with increased odds of iron deficiency anaemia among children aged 24-59 months. Factors associated with increased odds of iron deficiency anaemia among children aged 6-59 months were: a mother being employed, being a mother with no schooling, being a male child, belonging to the 6-59 months age bracket, a mother having a BMI of between 19 and 25 kg/m2, a mother being anaemic, having a baby at home, children belonging to bigger households, child fever and stunting. Interventions to minimise the burden of iron deficiency anaemia in children should target employed and/or anaemic mothers, poor and rich households, as well as male children.
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Affiliation(s)
- Rose V. Msaki
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | | | - Ray M. Masumo
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Eliasaph Mwana
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Doris Katana
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Nyamizi Julius
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Adeline Munuo
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Germana Leyna
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Abukari I. Issaka
- School of Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Mansi V. Dhami
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, NSW, Australia
| | - Kingsley E. Agho
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Penrith, NSW, Australia
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Penrith, NSW, Australia
- African Vision Research Institute, University of KwaZulu-Natal, Durban, South Africa
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Abdallah F, John SE, Hancy A, Paulo HA, Sanga A, Noor R, Lankoande F, Chimanya K, Masumo RM, Leyna GH. Prevalence and factors associated with anaemia among pregnant women attending reproductive and child health clinics in Mbeya region, Tanzania. PLOS Glob Public Health 2022; 2:e0000280. [PMID: 36962486 PMCID: PMC10021601 DOI: 10.1371/journal.pgph.0000280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 09/12/2022] [Indexed: 03/26/2023]
Abstract
Anaemia is a global public health issue, disproportionately affecting vulnerable populations such as pregnant women. The aim of this study was to assess the prevalence of anaemia and to identify factors associated with the condition among pregnant women attending antenatal clinics in the Mbeya Region of Tanzania. A cross sectional study was conducted with 420 pregnant women (<28 weeks of gestation) attending antenatal visits in the 7 districts of the Mbeya Region. A structured questionnaire was used to collect demographic information and eating habits using a 24hours dietary recall. A blood sample was collected and tested for hemoglobin content using the HemoCue 201+. Multivariate analysis was performed using standard logistic regression to explore the association between anaemia status with socio-demographic, reproductive and nutritional factors. Overall prevalence of anaemia in pregnant women was 25.5%. Out of 107 pregnant women diagnosed with anaemia and, sixty six had mild anaemia. In a multivariate logistical regression analysis anaemic women was associated with pregnant women coming from lower socio-economic status [adjusted OR = 2.40, 95%CI (1.05, 5.48)]. Moreover, anaemia was less associated with pregnant women who were living in Mbeya district council [adjusted OR = 0.28, 95%CI (0.11, 0.72)], consume at least once a day dark green leafy vegetables [adjusted OR = 0.53, 95% CI (0.30, 0.94)], and vegetable liquid cooking oil [adjusted OR = 0.56, 95% CI (0.34, 0.98)]. The prevalence of anaemia among the pregnant women falls in the category of moderate public health problem according to the WHO classification. Low socio-economic status, consumption of green leafy vegetables and vegetable liquid cooking oil were significantly and independently associated with anaemia during pregnancy. Thus, special attention should be given to pregnant women who are in lower socio-economic status and those not consuming vegetables. Interventions that integrate health and nutrition education in reproductive and child health clinics are needed to combat anaemia.
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Affiliation(s)
- Fatma Abdallah
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Sauli E John
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Adam Hancy
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Heavenlight A Paulo
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, MUHAS, Dar es Salaam, Tanzania
| | - Abraham Sanga
- The United Nations Children's Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Ramadhan Noor
- The United Nations Children's Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Fatoumata Lankoande
- The United Nations Children's Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Kudakwashe Chimanya
- The United Nations Children's Fund (UNICEF) Tanzania, Dar es Salaam, Tanzania
| | - Ray M Masumo
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Germana H Leyna
- Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
- Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, MUHAS, Dar es Salaam, Tanzania
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Ndekero TS, Carneiro LC, Masumo RM. Prevalence of early childhood caries, risk factors and nutritional status among 3-5-year-old preschool children in Kisarawe, Tanzania. PLoS One 2021; 16:e0247240. [PMID: 33630949 PMCID: PMC7906390 DOI: 10.1371/journal.pone.0247240] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 02/03/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Early childhood dental caries (ECC), a serious public health problem lacks information on the association between ECC, risk factors and nutritional status among children in Tanzania. Therefore, this study aimed to determine the prevalence of ECC, risk factors and nutritional status among 3-5-year-old preschool children and to assess its correlation with the form, visible plaque scores in upper anterior teeth, total sugar exposure, anthropometric measures, and socio demographic attributes. METHODS This cross-sectional study was conducted on 831 children registered in public preschools in Kisarawe District. Assessment of ECC used the WHO (2013) criteria and anthropometric measures used the WHO Child Growth Standards (2006). Structured questionnaires were completed by children's parents through an interview. Collected information on socio-demographic attributes including oral hygiene and sugar exposure to their children was analyzed. RESULTS Only 459 children (55.2%) were recognized as caries-free. Dental caries experience in terms of decayed, missing and filled teeth (dmft) index was 2.51. Children with visible plaque were the majority (56.1%). The dmft score index was negatively and significantly associated with weight-for-age z-score [Coefficient: -0.11 (95% CI: -0.76, -0.11)] and positively significantly associated with visible plaque score index [Coefficient: 0.16 (95% CI: 0.18, 0.52)] and total sugar exposure [Coefficient: 0.19 (95% CI: 0.15, 0.38)] in the adjusted model. The prevalence of underweight was 4.2% [95% CI: (3.0-5.8)] and severe underweight was 0.2% [95% CI: (0.1-0.9)] while prevalence of stunting was 1.6% [95% CI: (0.9-2.7)] and severe stunting was 0.4% [95% CI: (0.1-1.1)]. CONCLUSION This study demonstrated a significant negative relationship between ECC and children's anthropometric measures indicated by weight-for-age, and positive relationship with sugar exposure and poor oral hygiene indicated by visible plaque on upper anterior teeth. Controlling risk factors will reduce the occurrence of ECC thereby catering for a healthy population of well-nourished children.
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Affiliation(s)
- Tumaini S. Ndekero
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Lorna C. Carneiro
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania
| | - Ray M. Masumo
- Oral Health Section, Ministry of Health, Community Development, Gender, Elderly and Children, Dodoma, Tanzania
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Masumo RM, Ndekero TS, Carneiro LC. Prevalence of dental caries in deciduous teeth and oral health related quality of life among preschool children aged 4-6 years in Kisarawe, Tanzania. BMC Oral Health 2020; 20:46. [PMID: 32041596 PMCID: PMC7011473 DOI: 10.1186/s12903-020-1032-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/31/2020] [Indexed: 11/29/2022] Open
Abstract
Background Preschool years are a critical period in the development of a healthy child. The consequences of poor oral health in preschool children reach beyond dental problems, with oral health-related quality of life (OHRQoL) being associated with overall systematic health as well as one’s quality of life. The purpose of this study was to assess the prevalence of dental caries and its impacts on the OHRQoL in a sample of preschool children in Kisarawe. Methods A cross-sectional based study was conducted in 2017. A total of 1106 preschool children completed a face-to-face interview, using a translated Kiswahili version of the Michigan Oral Health-related Quality of Life Scale (MOHRQoL) –Child Version (2003), and underwent clinical oral examination using WHO (1997) criteria. Results The decayed component was the most prevalent (dft = 2.08) and the Significant Caries Index (SiC) was 5.54 double of the (dft), showing polarization of dental caries in the studied population. After adjusting for appropriate covariates, preschool children of age 5 and 6 years old were more likely to have decayed tooth [Adjusted OR = 3.02, (95% CI =2.01–4.54)] and [Adjusted OR = 2.23, (95% CI = 1.55–3.20)] respectively. Preschool children without visible plaque on the buccal surface of upper anterior teeth were less likely to have decayed teeth [Adjusted OR = 0.21, (95% CI = 0.09–0.45)]. Regarding measurements of oral health-related quality of life using the MOHRQoL, only preschool children who reported on ‘do your teeth hurt you now?’ and ‘do kids make fun of your teeth?’ were more likely to have a decayed tooth [Adjusted OR = 1.74, (95% CI = 1.12–2.71)] and [Adjusted OR = 1.87, (95% CI = 1.11–3.15)], respectively. Conclusion Findings from this study suggest that dental caries affects a significant portion of preschool children and, was associated with poor oral hygiene. The overall impacts of dental caries prevalence to OHRQoL were low in this sample of preschool children. Children having caries (independent variable) were shown to report more frequently that ‘do your teeth hurt you now?’ and ‘do kids make fun of your teeth?’ were more likely to have a decayed tooth among preschool children in Kisarawe, Tanzania.
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Affiliation(s)
- Ray M Masumo
- Oral Health Section, Ministry of Health, Community Development, Gender, Elderly and Children, P. O. Box 743, Dodoma, Tanzania.
| | - Tumaini S Ndekero
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es salaam, Tanzania
| | - Lorna C Carneiro
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es salaam, Tanzania
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Kagaruki GB, Mayige MT, Ngadaya ES, Kilale AM, Kahwa A, Shao AF, Kimaro GD, Manga CM, Mbata D, Materu GS, Masumo RM, Mfinanga SG. Knowledge and perception on type2 diabetes and hypertension among HIV clients utilizing care and treatment services: a cross sectional study from Mbeya and Dar es Salaam regions in Tanzania. BMC Public Health 2018; 18:928. [PMID: 30055591 PMCID: PMC6064130 DOI: 10.1186/s12889-018-5639-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 05/30/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Type2 Diabetes and Hypertension (T2DM/HTN) have become serious threats to the health and socio-economic development in the developing countries. People living with HIV (PLHIV) infection are more vulnerable of developing T2DM/HTN due to HIV infection itself and antiretroviral treatments. The situation is worse when behavioral and biological risk factors are pervasive to PLHIV. Despite this vicious circle; information on the level of knowledge and perception regarding prevention of T2DM/HTN, risks factors and associated complications among PLHIV is not well documented in Tanzania. The aim of this paper was assess the level of T2DM/HTN knowledge and perception among PLHIV and utilizing care and treatment clinic (CTC) services. METHODS A cross-sectional study was conducted in randomly selected 12 CTCs between October 2011 and February 2012. Data on demographic characteristics, type 2 diabetes and hypertension knowledge and perception were collected from the study participants. RESULTS Out of 754 PLHIV and receiving HIV services at the selected CTCs, 671 (89%) consented for the study. Overall 276/671(41.1%) respondents had low knowledge on type2 diabetes and hypertension risk factors and their associated complications. Locality (rural) (AOR = 2.2; 95%CI 1.4-3.4) and never/not recalling if ever measured blood glucose in life (AOR = 2.3; 95%CI 1.1-5.7) were significant determinants of low knowledge among clients on ART. Being currently not having HIV and T2DM/HTN co-morbidities (AOR = 2.2; 95%CI 1.2-4.9) was the only determinant of low knowledge among ART Naïve clients. With regard to perception, 293/671(43.7%) respondents had negative perception on diabetes and hypertension prevention. Sex (female) (AOR = 2.0, 95%CI 1.2-2.9), being aged < 40 years (AOR = 1.6; 95%CI 1.1-2.5) and education (primary/no formal education) (AOR = 4.4; 95%CI 2.0-9.8) were determinants for negative perception among clients on ART while for ART Naïve clients; HIV and T2DM/HTN co-morbidities (AOR = 2.0; 95%CI 1.2-4.6) was the main determinant for negative perception. CONCLUSION Considerable number of respondents had low level of knowledge (41.1%) regarding T2DM/HTN specifically on the risk factors, prevention strategies and their associated complications and negative perception (43.7%) towards healthy practices for mitigating risk behaviors of the diseases. There is need for promoting awareness of T2DM/HTN risk factors and complications by considering determinants of low knowledge and negative perception among PLHIV.
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Affiliation(s)
- Gibson B. Kagaruki
- National Institute for Medical Research, Tukuyu Centre, P. O. Box 538, Tukuyu, Mbeya, Tanzania
| | - Mary T. Mayige
- National Institute for Medical Research, Headquarters, P. O. Box, 9653 Dar es Salaam, Tanzania
| | - Esther S. Ngadaya
- National Institute for Medical Research, Muhimbili Centre, P. O. Box, 3436 Dar es Salaam, Tanzania
| | - Andrew M. Kilale
- National Institute for Medical Research, Muhimbili Centre, P. O. Box, 3436 Dar es Salaam, Tanzania
| | - Amos Kahwa
- National Institute for Medical Research, Muhimbili Centre, P. O. Box, 3436 Dar es Salaam, Tanzania
| | - Amani F. Shao
- National Institute for Medical Research, Tukuyu Centre, P. O. Box 538, Tukuyu, Mbeya, Tanzania
| | - Godfather D. Kimaro
- National Institute for Medical Research, Muhimbili Centre, P. O. Box, 3436 Dar es Salaam, Tanzania
| | - Chacha M. Manga
- National Institute for Medical Research, Muhimbili Centre, P. O. Box, 3436 Dar es Salaam, Tanzania
| | - Doris Mbata
- National Institute for Medical Research, Headquarters, P. O. Box, 9653 Dar es Salaam, Tanzania
| | - Godlisten S. Materu
- National Institute for Medical Research, Tukuyu Centre, P. O. Box 538, Tukuyu, Mbeya, Tanzania
| | - Ray M. Masumo
- National Institute for Medical Research, Tukuyu Centre, P. O. Box 538, Tukuyu, Mbeya, Tanzania
| | - Sayoki G. Mfinanga
- National Institute for Medical Research, Headquarters, P. O. Box, 9653 Dar es Salaam, Tanzania
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