Browsing by Author "Msollo, Safiness Simon"

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Compliance to recommended prevention and management practices among type 2 diabetes patients in Morogoro municipality, Tanzania
(Tanzania Journal of Health Research, 2024-04-02) Bofu, Hasna; Msollo, Safiness Simon; Mwanri, Akwilina Wendelin
Introduction: Diabetes-related complications are the significant causes of morbidity and mortality among type 2 diabetes patients. The complications can be reduced by practising and maintaining several preventive measures. The present study aimed to assess compliance and factors associated with recommended management practices and prevention of complications among type 2 diabetes patients in selected health facilities in Morogoro Municipality, Tanzania. Methods: A hospital-based cross-sectional study was conducted from February to May 2023 among 140 patients diagnosed with diabetes for at least three months before the study. Data were collected through face-to-face interviews using a structured questionnaire, which included patients’ characteristics and a previously validated Summary of Diabetes Self-care Activities questionnaire to assess patients' compliance with recommended practices. A multi variable regression analysis was employed to identify factors associated with compliance with recommended practices. Results: The mean age of the respondents was59 ±12.08 years and 65% were females. Among 140 patients, 91.4% (n=128) had poor or unsatisfactory self-care practices with an overall mean of 3.81± 2.08 days per week for diabetes management. The recommended practices with good or satisfactory performance were non-smoking, non-alcohol drinking and prescribed medication. In contrast,unsatisfactory performance was observed for self-monitoring blood glucose and physical activities. Multiple regression analysis showed that co-morbidity (AOR 4.5; 95% CI: 1.14-18.02) and being employed (AOR 4.4; 95% CI:1.25-15.44) independently predict self-care practices. Conclusion and recommendation: Compliance with self-monitoring of blood glucose, physical exercise and dietary practices were found to be low among type 2 diabetes patients, which could increase the risk of complications. Nutritional and lifestyle counselling and the use of peer groups should be emphasized to improve compliance with recommended practices.
Insulin resistance among pregnant women in urban areas of Arusha region, Tanzania
(Mary Ann Liebert, Inc., 2019) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
Aim: To establish the prevalence of insulin resistance (IR) and its determinants among selected pregnant women in urban Arusha for taking preventive measures. Methods: A cross-sectional study was conducted between March and December 2018 at Ngarenaro and Kaloleni health facilities in Arusha District involving 230 randomly selected pregnant women who were not known to have diabetes before pregnancy. Blood glucose at fasting and 2 hr after consuming 75 grams of glucose dissolved in 300 mL of water was measured using Gluco-Plus , serum insulin concentrations using ELISA machine (Synergy/HTX ; BioTek), and IR was calculated using the Homeostasis Model of Assessment formula. Body fat was measured using a bioelectric impedance analyzer, mid-upper arm circumference using a regular tape, weight using SECA , blood pressure using GT-868UF Geratherm machine, and height by stadiometer. Maternal characteristics were collected through face to face interviews using a structured ques- tionnaire. Data were analyzed using the Statistical Package for Social Science Version 20. Results: The prevalence of IR was 21% (n = 49) and significantly associated with increased body fat percentage (adjusted odds ratio [AOR]: 1.68, 95% confidence interval [CI]: 1.01–2.5), family history of Type 2 diabetes mellitus (T2DM; AOR: 2.77, 95% CI: 1.21–6.33), hypertension (AOR: 2.5, 95% CI: 1.12–5.6), edema (AOR: 3.01, 95% CI: 1.31–6.96), and proteinuria (AOR: 3.44, 95% CI: 1.11–10.69). Conclusions: IR was higher among pregnant women with increased body fat percentage, family history of T2DM, hypertension, edema, and proteinuria. These findings call for large-scale screening to further explore risk factors to prevent gestational diabetes mellitus.
Postpartum hyperglycemia and pregnancy outcomes among women in Arusha Region, Tanzania
(AJOL, 2022) Msollo, Safiness Simon; Mwanri, Akwilina Wendelin
Background: Gestational diabetes mellitus is a medical condition that disappears after delivery if early diagnosis and management are done. This study aimed to determine the prevalence of hyperglycemia six weeks postpartum and pregnancy outcomes among women in Arusha City. Methods: A longitudinal study was conducted between March and December 2018 as part of a large study which involved 468 randomly selected pregnant women and excluded those who were diagnosed with diabetes before pregnancy. Women were screened for hyperglycemia six weeks postpartum where fasting and oral glucose tolerant tests were done by Gluco-PlusTM using World Health Organization criteria. Body fat percentage, mid-upper arm circumference, height and weight were measured using standard procedures. Postpartum information was collected using a structured questionnaire and data was analyzed using the Statistical Package for Social Science version 20 to obtain descriptive and inferential statistics. Results: Among 468 women who participated in the study at baseline, 392 (83.7%) returned for postpartum assessments. Postpartum hyperglycemia among women was 2.1% (n=8) and majority had normal delivery (92.6%, n=363) while 7.4% (n=29) delivered through caesarean section. About 8.2% (n=32) of the newborn were macrosomia and 4.1% (n=16) low birth weight. Miscarriages or abortions were not identified while stillbirth was observed in 0.5% (n=2) and neonatal death (1.3%, n=5). Postpartum hyperglycemia was significantly associated with body fat percentage (AOR 1.59, 95% CI: 1.14-1.91), mid-upper arm circumference (AOR 1.62, 95% CI: 1.023-1.99), macrosomia (AOR 2.43, 95% CI: 2.2-10.31) and family history of type 2 diabetes (AOR 6.4, 95% CI: 1.93-13.3). Conclusion: Prevalence of postpartum hyperglycemia was generally low however; it was significantly associated with macrosomia, increased body fat percentage, mid-upper circumference and family history of type 2 diabetes. Also, a low prevalence of poor pregnancy outcomes was reported which may be attributed to actions taken after being referred for further treatments and management which need further exploration.
Prevalence and determinants of overweight and obesity among school children in Morogoro Region, Tanzania.
(Tanzania Journal of Health Research, 2023-01) Muhomba, Elina Stanley; Msollo, Safiness Simon; Mwanri, Akwilina Wendelin
Background: Being overweight and obese involve health risks as well as possible consequences for individuals’ and communities’ social and economic well-being. It was previously considered an adult health concern, but it is now seen among children. This study aimed to determine the prevalence and determinants of overweight and obesity among school children in rural and urban areas of Morogoro region, Tanzania. Methods: A cross-sectional study was conducted on a total of 335 parent/caregiver-child pairs, of whom 165 were from Kilosa (rural) and 170 from Morogoro (urban) districts. The main sampling unit was registered primary schools which were stratified according to ownership, whether private or government, and sampled separately. A total of four private and four public schools were sampled, two of each of the categories in each of the locations. Weight and height were measured using standard procedures and Body Mass Index (BMI) was determined. Socio-demographic information was collected using a questionnaire with structured questions. A statistical package for social sciences version 21 was used to analyze data and a regression model was used to explore the determinants of overweight and obesity. Results: The ages of the studied children ranged from 7 to 12 years, while those of the parents/caregivers ranged from 18 to 72 years. About 19% (n=63) of the school children were overweight or obese, while 3.9% (n=13) were underweight. The prevalence of overweight/obesity was higher among private school students than in public schools 36(24.8%) vs 27(14.2%) and more or less similar prevalence’s were observed among rural (17.6%, n=34) and urban (20.0%, n=29) settings. In a multivariate analysis, eating breakfast before going to school is associated with overweight/obesity (AOR 2.23, 95% CI: 1.06-4.68). Other factors associated with overweight/obesity were school type (AOR 1.19, 95% CI: 1.55-2.60), household daily income (AOR 1.88, 95% CI: 1.68-3.15) (AOR 2.89, 95% CI: 1.76-4.11). Conclusion: In conclusion, the prevalence of overweight and obesity among school children was high, while underweight was very low. The prevalence of overweight/obesity was similar in rural and urban children, indicating a nutritional transition. The potential risk factors associated with being overweight or obese were school type, household daily income, provision of breakfast and being given money to buy something to eat at school. Therefore, nutrition and healthy lifestyle education should be integrated into school programs to reduce the risk of developing diseases associated with being overweight or obese.
Prevalence of hyperglycemia in pregnancy and influence of body fat on development of hyperglycemia in pregnancy among pregnant women in urban areas of Arusha region, Tanzania
(BMC Pregnancy and Childbirth, 2019) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
Background: Hyperglycemia in pregnancy is a medical condition resulting from either pre-existing diabetes or insulin resistance developed during pregnancy. This study aimed to determine the prevalence of hyperglycemia in pregnancy and influence of body fat percentage and other determinants on developing hyperglycemia in pregnancy among women in Arusha District, Tanzania. Methods: A cross–sectional study was conducted between March and December 2018 at selected health facilities in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Blood glucose was tested by Gluco-PlusTM using the World Health Organization criteria at fasting and 2 h after consuming 75 g of glucose dissolved in 300 ml of water. Body fat was measured using a bioelectric impedance analyzer, mid- upper arm circumference using a regulated tape, weight using SECATM, blood pressure using a GT-868UF GerathermTM machine, and height using a stadiometer. Demographic and maternal characteristics were collected through face to face interviews using a structured questionnaire. Results: The participants’ mean age was 28 years (SD ± 6), mid-upper arm circumference 27 cm (SD ± 3.7), body fat 33.72% (SD ± 7.2) and pre-pregnancy body mass index 25.6 kg/m 2 (SD ± 5.5). One-third of participants had mid- upper arm circumferences ≥28 cm with 25% being overweight and 22.7% obese before pregnancy. Prevalence of hyperglycemia in pregnancy was 16.2% (n = 76) of which 13% had gestational diabetes and 3.2% diabetes in pregnancy. Hyperglycemia in pregnancy was significantly associated with body fat percentage (AOR 1.33; 95% CI: 1.22–1.44), family history of Type 2 diabetes mellitus (AOR 6.95, 95% CI: 3.11–15.55), previous delivery of babies ≥4 kg (AOR 2.3, 95% CI: 1.00–5.28), mid-upper arm circumference ≥ 28 cm (AOR 1.2, 95% CI: 1.09–1.32), and Type 2 diabetes mellitus symptoms (AOR 2.83, 95% CI: 1.53–6.92). Conclusion: The prevalence of hyperglycemia in pregnancy was high, particularly among women with history of delivering ≥4-kg babies, increased body fat, mid-upper arm circumference, symptoms and/or family history of Type 2 diabetes mellitus. These findings identify opportunities to further explore the utility of body fat percentage and other determinants for rapid screening and management of hyperglycemia in pregnancy.
Prevalence, knowledge and practices on prevention and management of overweight and obesity among adults in Dodoma City, Tanzania
(PLOS ONE, 2024-01-30) Msollo, Safiness Simon; Shausi, Gosbert Lukenku; Mwanri, Akwilina Wendelin
Overweight/obesity is increasing leading to high rates of non-communicable diseases. The study aimed to assess the prevalence, knowledge and practices on prevention and management of overweight/obesity among adults in Dodoma region. Methodology A cross- sectional research was conducted among 313 randomly selected adults aged 25– 65 years. Face to face interviews were conducted to obtain demographic information, knowledge on preventing and managing overweight/obesity using a pre-tested questionnaire. Weight and height were measured following standard procedures and nutrition status was categorized using WHO criteria. Dietary intake was assessed using qualitative 24 hours recall to obtain dietary diversity score. Data was analyzed using the SPSS™ Version 20 to obtain descriptive and inferential statistics. Results About 62.6% (n = 196) of the participants were females. The overall prevalence of overweight/obesity was 59.7% (n = 186) of which 28% (n = 88) were overweight and 31.3% (n = 98) obese. Obesity was three times higher among females (41.8% vs 13.7%) than males. Overweight/obesity was positively associated with female sex (Adjusted OR 2.34; 95%CI: 1.235–4.68; p = 0.001), low knowledge (Adjusted OR 2.15; 95%CI: 1.22–3.81; p = 0.008) and negatively associated with dietary diversity score (Adjusted OR 0. 452; 95%CI: 0.199– 1.87; p = 0.03). About 76% of respondents reported that overweight/obesity is a result of consuming high energy (38.8%; n = 92) and high fat foods (27%; n = 63). More than half of the respondents reported to be insensitive with kind of foods they consume and for those who were sensitive, 64% do so to avoid diseases. Furthermore, 60% control their weight by doing physical exercises while 18% by both physical exercises and diet management. However, about 43% did not know foods exposing individuals to health problems. Conclusion and recommendations High prevalence of overweight/obesity was observed and significantly associated with female sex, low dietary diversity and knowledge on overweight/obesity prevention. This creates a need to improve knowledge on prevention of overweight/obesity.
Risk scores for selective screening for gestational diabetes in Sub Saharan Africa
(Nova Science Publishers, 2020) Mwanri, Akwilina Wendelin; Msollo, Safiness Simon
Gestational diabetes mellitus (GDM) is a threat to maternal and child health. Timely detection and proper management of GDM may reduce the risk for adverse pregnancy outcomes and improve wellbeing of the mother and the child. Prevalence of gestational diabetes mellitus is increasing worldwide with the highest increase noted in middle- and low-income countries. These countries also suffer from limited resources to properly diagnose and manage gestational diabetes mellitus and other pregnancy complications. This chapter reviews the existing selective screening methods and their application in Sub Saharan Africa (SSA). The current guideline recommends universal screening for all pregnant women at any time during pregnancy to ensure that affected women have the opportunity of receiving proper management to prevent adverse outcomes. However, in the countries with limited human, infrastructure and financial resources, this may be a challenge. The use of selective screening reduces the number of unnecessary oral glucose tolerance test hence maximize the use of available resources. Nevertheless, the use of selective screening may still have challenges due to lack of uniformity and variations on results from application of the risk scores. The methods used to identify risk factors vary across the countries depending on the research design, selection of participants, gestational age at screening and diagnosis criteria used. Some risk score models did not perform well because of the challenges in proper identification of risk factors; for example, body mass index (BMI) is known to be one of the important predictors of GDM. However, some studies use pre-gestational BMI by maternal recall of body weight before conception while others used BMI at first clinic visit regardless of gestational age. Furthermore, there are variations in gestational age at screening and diagnosis method used. There is a need to develop country specific checklist for the risk factors which is simple, clear and easy to use at the clinic and for self-identification to enhance self-care.
Simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania
(BMC Pregnancy and Childbirth, 2022) Msollo, Safiness Simon; Martin, Haikael David; Mwanri, Akwilina Wendelin; Petrucka, Pammla
Background: Screening for gestational diabetes mellitus in Tanzania is challenged by limited resources. Therefore, this study aimed to develop a simple method for identification of women at risk of gestational diabetes mellitus in Arusha urban, Tanzania. Methods: This study used data from a cross sectional study, that was conducted between March and December 2018 in Arusha District involving 468 pregnant women who were not known to have diabetes before pregnancy. Urine glucose was tested using urine multistics and blood glucose levels by Gluco-Plus TM and diagnosed in accord- ance with the World Health Organization’s criteria. Anthropometrics were measured using standard procedures and maternal characteristics were collected through face-to-face interviews using a questionnaire with structured ques- tions. Univariate analysis assessed individual variables association with gestational diabetes mellitus where variables with p-value of < 0.05 were included in multivariable analysis and predictors with p-value < 0.1 remained in the final model. Each variable was scored based on its estimated coefficients and risk scores were calculated by multiplying the corresponding coefficients by ten to get integers. The model’s performance was assessed using c-statistic. Data were analyzed using Statistical Package for Social Science TM . Results: The risk score included body fat ≥ 38%, delivery to macrosomic babies, mid-upper arm circumfer- ence ≥ 28 cm, and family history of type 2 diabetes mellitus. The score correctly identified 98% of women with ges- tational diabetes with an area under the receiver operating characteristic curve of 0.97 (95% CI 0.96–0.99, p < 0.001), sensitivity of 0.98, and specificity of 0.46. Conclusion: The developed screening tool is highly sensitive and correctly differentiates women with and without gestational diabetes mellitus in a Tanzanian sub-population.