Browsing by Author "Mbago, Maurice"

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    Assessing The Effects of Mosquito Nets on Malaria Mortality Using a Space Time Model: A Case Study of Rufiji And Ifakara Health And Demographic Surveillance System Sites In Rural Tanzania
    (2016-11) Selemani, Majige; Msengwa, Amina; Mrema, Sigilbert; Shamte, Amri; Mahande, Michael J.; Yeates, Karen; Mbago, Maurice; Lutambi, Angelina M.
    Background: Although malaria decline has been observed in most sub-Saharan African countries, the disease still represents a significant public health burden in Tanzania. There are contradictions on the effect of ownership of at least one mosquito net at household on malaria mortality. This study presents a Bayesian modelling framework for the analysis of the effect of ownership of at least one mosquito net at household on malaria mortality with environmental factors as confounder variables. Methods: The analysis used longitudinal data collected in Rufiji and Ifakara Health Demographic Surveillance System (HDSS) sites for the period of 1999-2011 and 2002-2012, respectively. Bayesian framework modelling approach using integrated nested laplace approximation (INLA) package in R software was used. The space time models were established to assess the effect of ownership of mosquito net on malaria mortality in 58 villages in the study area. Results: The results show that an increase of 10 % in ownership of mosquito nets at village level had an average of 5.2 % decrease inall age malaria deaths (IRR = 0.948, 95 % CI = 0.917, 0.977) in Rufiji HDSS and 12.1 % decrease in all age malaria deaths (IRR = 0.879, 95 % CI = 0.806, 0.959) in Ifakara HDSS. In children under 5 years, results show an average of 5.4 % decrease of malaria deaths (IRR = 0.946, 95 % CI = 0.909, 0.982) in Rufiji HDSS and 10 % decrease of malaria deaths (IRR = 0.899, 95 % CI = 0.816, 0.995) in Ifakara HDSS. Model comparison show that model with spatial and temporal random effects was the best fitting model compared to other models without spatial and temporal, and with spatial-temporal interaction effects. Conclusion: This modelling framework is appropriate and provides useful approaches to understanding the effect of mosquito nets for targeting malaria control intervention. Furthermore, ownership of mosquito nets at household showed a significant impact on malaria mortality.
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    Determinants of extramarital sex by men in Tanzania: A case study of Mbeya region
    (SAMA Health and Medical Publishing Group (HMPG), 2010-12) Mbago, Maurice; Sichona, Francis
    This paper attempts to identify some factors associated with extramarital sex by men in the Mbeya region of Tanzania using data from a survey conducted in 2003/2004. The choice of Mbeya region was prompted by the fact that it has been found by previous studies to be one of the regions with the highest HIV prevalence rate in Tanzania. Correlates of extramarital sex that were considered include current age, education, residence, age at first sexual intercourse, age at first marriage and sex before marriage. A bivariate analysis of the survey data, which comprised a sample size of 568 married men aged between 15 and 62 years revealed statistically significant association between extramarital sex with current age, education, age at first intercourse and sex before marriage. The effect of these variables was tested through a multivariate logistic regression analysis and all the four independent variables were found to be statistically significant predictors of extramarital sex in Mbeya region.
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    Socio-demographic correlates of desire for HIV testing in Tanzania
    (CSIRO PUBLISHING, 2004-03-30) Mbago, Maurice
    Background: Over 60% of women and men interviewed in the Tanzania Demographic Health Survey (TDHS) of 1996 and the Tanzania Reproductive and Child Health Survey (TRCHS) of 1999 indicated that they would like to be tested for AIDS virus (HIV-antibody test). This is encouraging in view of the fact that voluntary HIV testing coupled with appropriate counselling is now believed to be quite effective for the prevention of HIV infection. This paper seeks to identify some socio-demographic factors that are associated with desire for HIV testing in Tanzania. Methods: The study used data from the 1999 Tanzania Reproductive and Health Survey in which 4029 women and 3542 men were interviewed. A logistic regression analysis was used to identify correlates of desire for HIV testing for both men and women. Results: For both men and women the logistic regression results show that significant correlates of desire for HIV testing are education, residence and knowledge of HIV prevention. In particular the odds of desire for AIDS test were found to be lower for respondents with secondary school education than those with primary school education. The odds were also significantly lower for urban respondents than for rural ones. The findings further show that the odds of desire for having an AIDS test were lowest for respondents with no knowledge of HIV prevention. Conclusions: Strategic campaigns to convince people to go for HIV testing should put more emphasis on radio programmes since these are effective means of communication in rural areas where desire for testing seems to be high. Such programmes should also focus on raising awareness on HIV prevention. HIV testing facilities should also be extended to the rural areas and be offered at affordable prices.
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    Spatial and Space-Time Clustering of Mortality Due to Malaria in Rural Tanzania: Evidence From Ifakara And Rufiji Health And Demographic Surveillance System Sites
    (2015-09) Selemani, Majige; Mrema, Sigilbert; Shamte, Amri; Shabani, Josephine; Mahande, Michael J.; Yeates, Karen; Msengwa, Amina; Mbago, Maurice; Lutambi, Angelina M.
    Background: Although, malaria control interventions are widely implemented to eliminate malaria disease, malaria is still a public health problem in Tanzania. Understanding the risk factors, spatial and space-time clustering for malaria deaths is essential for targeting malaria interventions and effective control measures. In this study, spatial methods were used to identify local malaria mortality clustering using Verbal autopsy data. Methods: The analysis used longitudinal data collected in Rufiji and Ifakara Health Demographic Surveillance System (HDSS) sites for the period 1999 to 2011 and 2002 to 2012 respectively. Two models were used. The first was a non-spatial model where logistic regression was used to determine a household’s characteristic or an individual’s risk of malaria deaths. The second was a spatial Poisson model applied to estimate spatial clustering of malaria mortality using SaTScanTM, with age as a covariate. ArcGIS Geographical Information System software was used to map the estimates obtained to show clustering and the variations related to malaria mortality. Results: A total of 11,462 deaths in 33 villages and 9,328 deaths in 25 villages in Rufiji and Ifakara HDSS respectively were recorded. Overall, 2,699(24%) of the malaria deaths in Rufiji and 1596 (17.1%) in Ifakara were recorded during the study period. Children under five had higher odds of dying from malaria compared with their elderly counterparts aged five and above for Rufiji (AOR= 2.05, 95%CI =1.87-2.25), and Ifakara (AOR= 2.33, 95%CI=2.05-2.66) respectively. In addition, ownership of mosquito net had a protective effect against dying with malaria in both HDSS sites. Moreover, villages with consistently significant malaria mortality clusters were detected in both HDSS sites during the study period. Conclusions: Clustering of malaria mortality indicates heterogeneity in risk. Improving targeted malaria control and treatment interventions to high risk clusters may lead to the reduction of malaria deaths at the household and probably at country level. Furthermore, ownership of mosquito nets and age appeared to be important predictors for malaria deaths.