Effect of integrated reproductive health lesson materials in a problem-based pedagogy on soft skills for safe sexual behaviour among adolescents: A school-based randomized controlled trial in Tanzania

Knowledge, attitude, intentional practice and individualized determinants of COVID-19 vaccine uptake among adults: A cross-sectional study in Tanzania

AIM

The study assessed the knowledge, attitude, intentional practice and individualized factors of COVID-19 vaccine uptake among adults in Tanzania.

DESIGN

Hospital-based analytical cross-sectional study.

METHODS

Quantitative approaches were adopted to study 312 randomly selected adults using an interviewer-administered structured questionnaire. Descriptive analysis established frequencies and percentages of variables at a 95% confidence interval and a 5% significance level.

RESULTS

Mean age was 24.66 ± 6.503 of which 61.5% were males. 86.9% of them were not vaccinated. 57.7% of respondents had inadequate knowledge about the COVID-19 vaccine, and 61.5% had negative attitudes towards it. 63.8% of adults demonstrated an unwillingness to be vaccinated. Participants' sociodemographic characteristics profiles were significantly associated with COVID-19 vaccine knowledge, attitude and willingness to uptake it (p < 0.05). Findings highlight the need for large-scale interventions to address the low uptake vaccine. Adults' willingness to get a coronavirus vaccine was comparatively low. Sociodemographic profiles, knowledge and attitude were associated significantly with low uptake of the COVID-19 vaccine among adults in Tanzania.

Prevalence, medication adherence, and determinants of type 2 diabetes mellitus during Coronavirus Disease 2019 pandemic among adults in Tanzania

Introduction

Excessive consumption of comfort foods, which are mostly high in carbs, and limitations on outdoor and gym-based physical activities, for instance, are associated with foods high in the glycemic index and raise the risk of obesity and type 2 diabetes. In pandemic and or epidemic situations, peoples' lifestyles may change significantly to lead them to non-communicable diseases. However, lifestyle changes and the occurrence of type 2 diabetes mellitus during the Coronavirus Disease 2019 pandemic among adults have not been well established in Tanzania. This study assessed the prevalence, medication adherence, and determinants of type 2 diabetes mellitus among adults in the country.

Methods

A community-based analytical cross-sectional study was conducted in Dodoma region, Tanzania between September and October 2020 of which 107 adults aged above 18 years were studied regardless of whether they were newly diagnosed with type 2 diabetes mellitus or not using a quantitative research approach. Interviewer-administered lifestyle habits and medication adherence structured questionnaires benchmarked from previous studies served as the main tools of data collection. The statistical package for social sciences computer program was used to analyze the data descriptively for frequencies and percentages and by regression analysis model to determine the association between variables with a 95% confidence interval and 5% significance level.

Results

With a mean age of 31 ± 2.527 years, 59.8% of the respondents were female. 60.7% and 11.7% of the respondents had unhealthy and moderate lifestyle choices respectively. The prevalence of type 2 diabetes mellitus accounted for 63.9% of the respondents of which 44.6% were diagnostically confirmed during the Coronavirus Disease 2019 pandemic against 19.3% of respondents who were diagnosed before the pandemic. Medication adherence among the type 2 diabetes mellitus respondents accounted for 77.9% of the study respondents. Type 2 diabetes mellitus was significantly associated with being in the 36-55 age group (AOR = 1.054; 95% CI: 0.292, 3.162; p < 0.05); being female (AOR = 1.398; 95% CI: 0.205, 3.048; p < 0.05); having a job (AOR = 2.597; 95% CI: 1.243, 4.402, p < 0.05); and having unhealthy lifestyle habits (AOR = 3.301; 95% CI: 1.199, 6.52; p < 0.05).

Conclusion

The majority of adults had type 2 diabetes mellitus of which most of them were confirmed to have the disease during the Coronavirus Disease 2019 pandemic. Few type 2 diabetes mellitus adults did not adhere to their medications as recommended. Their sociodemographic characteristics profiles and unhealthy lifestyles significantly led them to have the problem. The treatment of the disease above and health promotion activities may need to take unhealthy lifestyle choices and certain sociodemographic profiles of adults into consideration to assist in preventing the problem.

Systematic review: risk sexual behavior, sexually transmitted infections, and adolescent pregnancy prevention interventions

In many countries, there is a high number of teenage pregnancies, Sexually Transmitted Infections (STIs), and unsafe sexual behavior, so there is a need for adolescent health intervention programs to change behavior. The effectiveness of comprehensive interventions in various contexts to reduce teenage pregnancy, STIs, and related sexual risk behaviors is reviewed in this systematic. This study aimed to identify risk sexual behavior, sexually transmitted infections, and adolescent pregnancy prevention interventions. Literature search strategy from January 2008 to December 2022 through electronic databases. Key words 'teenage prenancy' OR 'teen pregnancy' OR 'pregnancy adolescence', AND 'maternal education', AND 'randomised clinical trial', AND 'risk behavior'. Articles that were deemed worthy of following the PRISMA guidelines were 28 articles. Most studies looked at school-based, individual, community, clinic, and family-based care. Most studies were followed up after intervention at intervals from one month to seven years, and the majority of the population and sample were adolescents with ages ranging from 13 to 18 years. Implementation of research in urban, suburban, and rural areas. This program has proven successful in preventing pregnancy, contraceptive use, STI and HIV, sexual behavior, dropping out of school, knowledge about pregnancy, sexuality, attitudes towards sexuality, intention to change risky sexual behavior, self-efficacy, and increasing parent-children. This article describes some basic trends in adolescent pregnancy prevention interventions in several countries that can be used as a reference for health programs. Unproven effectiveness can be implemented in conjunction with other interventions that have a high-quality impact.

Behavioral response for condom use messages to prevent human immunodeficiency virus/acquired immune deficiency syndrome among Bahir Dar City High School students, North West Ethiopia, 2022: Application of the extended parallel process model

Objective

The human immunodeficiency virus has become one of the world's most serious health and development challenges. Human immunodeficiency virus prevention has not received sufficient attention, and the prevalence of human behavioral virus infections among Ethiopian high school and preparatory students has also increased. The aim of this study was to assess behavioral responses to condom use messages to prevent human immune virus/acquired immune deficiency syndrome among Bahir Dar city high school and preparatory students using the extended parallel process model, Bahir Dar, Ethiopia, 2022.

Methodology

This institution-based cross-sectional study was conducted from 15 November to 15 December 2022, in Bahir Dar city. The data were collected from 601 participants. A multi-stage sampling technique was used to select the study participants. Data were entered into Epi-Info version 7.2.5 and exported to SPSS version 26 for analysis. Descriptive statistics, percentages, and frequencies were calculated. Bivariable logistic regression was performed to identify variables candidates for multivariable logistic regression at p-values less than 0.25, and multivariable logistic regression was performed to identify factors associated with the outcome variable at p-values < 0.05. A 95% confidence interval and odds ratio were used for the interpretation of the association.

Result

The response rate of the respondents was 94.9%. The behavioral response for condom use messages was affected by grade level adjusted odds ratio, 0.473, 95% CI (0.252-0.886), knowledge adjusted odds ratio, 2.627, 95% CI (1.788-3.859), attitude adjusted odds ratio, 3.19, 95% CI (2.145-4.744), efficacy adjusted odds ratio, 3.286, 95% CI (2.03-5.339), and threat adjusted odds ratio, 0.249, 95% CI (0.167-0.369). The behavioral response for condom use messages was associated with danger control.

Conclusion

The danger control response is 60.9%. Grade level, knowledge, attitude, and perceived and threat efficacies were independent predictors of danger control. Therefore, messages must aim to enhance threat component perception with appropriate efficacy to control danger and developed using scientific health communication strategies to promote behavioral change.

Attitude and prevalence of early sexual debut and associated risk sexual behavior among adolescents in Tanzania; Evidence from baseline data in a Randomized Controlled Trial

BACKGROUND

Unsafe sexual behaviours and associated sexual ideas among adolescents may contribute to adverse health consequences for sexual health in adulthood. The patterns of sexual ideology and sociodemographic factors profiles on adolescents' sexual behaviours have not been the subject of a definite consensus in research. The purpose of this study was to investigate the attitude and prevalence of early sexual debut and associated risk sexual behavior among adolescents in Tanzania as the evidence from baseline data in a Randomized Controlled Trial.

METHODS

The study included 647 randomly chosen in-school adolescents from Tanzania and used an analytical cross-section survey in a quantitative research approach. Sexual-risk Behaviour Beliefs and Self-esteem Scale from previous studies were the main data collection tool. According to the Statistical Analysis Software (SAS), computer software version 9.4 descriptive analysis established respondents' socio-demographic profiles, attitudes, prevalence, and determinants linked to teenagers' early sexual debut. The link between the variables was established via multivariate logistic regression at a 5% significance level and a 95% confidence interval.

RESULTS

The mean age was 15 ± 1.869 years while 57.5% of adolescents were females. 69.7% of adolescents were sexually active whereas 44.8% of them practised sexual behaviours willingly against 24.9% who practised coerced sexual behaviours. The majority (44.4%) and 16.2% of them initiated sexual behaviours during the early and middle adolescence stages respectively. Most adolescents had the ideology that sex was okay to them even before the age of 18 years. Their odds of practicing sexual behaviours were significantly high with the ideology that sex was okay to them even before 18 years of age (AOR = 1.293; p < 0.05; 95%CI: 0.689, 2.989), exposure to drug abuse (AOR = 1.210; p < 0.05; 95%CI: 0.803, 2.130), using media (AOR = 1.006; p < 0.05; 95%CI: 0.748, 2.667) and/or exposure to social groups [Jogging, Gym, health clubs, betting, Games] (AOR = 1.032; p < 0.05; 95%CI: 0.889, 2.044).

CONCLUSION

Findings suggest that holding a positive attitude towards early sexual debut is a precursor to early sexual activity among adolescents. Unsafe sex, coercive sex, and other risky sexual behaviors are not uncommon among adolescents starting sex before the age of 18 years. Exposure to drug abuse, online sexual content, and/or social groups significantly influenced early sexual debut irrespective of other known factors. Age-appropriate school-based sexuality education programs should be promoted and implemented to address the most prevalent positive attitude towards early sexual debut and associated risk sexual behaviour among adolescents in Tanzania and other similar settings.

Adolescents’ World: Know One Tell One against Unsafe Sexual Behaviours, Teenage Pregnancies and Sexually Transmitted Infections Including Chlamydia

Addressing adolescents’ sexual and reproductive health (SRH) matters using multidisciplinary pedagogical innovations may assure the proper development and well-being of adolescents so that they reach the adulthood stage healthy and strong enough to produce for their future investment. This is in response to sustainable development goal number 3, target 3.7, and SDG4, target 4.7 in particular emphasizes the universal availability and accessibility of sexual information and education among people and knowledge and skills for gender equality, human rights and sustainable lifestyles by 2030, respectively. Yet, the innovative strategies may respond to a call stated by SGD5 (gender equality), target 5.3 which advocates the elimination of child, early, and forced marriages, and target 5.6 which focuses on ensuring universal access to SRH and rights to all by 2030.

Enhancing pre-school teachers' competence in managing pediatric injuries in Pemba Island, Zanzibar

BACKGROUND

Safe and healthy learning environment in pre-schools has received increased attention in promoting the well-being of pre-school children. However, pediatric injuries have remained one of the leading causes of childhood morbidity and mortality around the globe. Empowering pre-school teachers with first aid competencies have been identified as being of potential strategy against pediatric health burdens of problem. This study tested the effect of established pediatric first aid training on pre-school teachers' knowledge, attitude, and intention to practice first aid management to pre-school children in Zanzibar.  METHODS: Uncontrolled quasi-experimental design with a quantitative research approach was conducted in Teachers' Resource Centers among 120 preschool teachers at Pemba Island, Zanzibar. First aid training was facilitated based on the prescribed guidelines and standards of materials adapted from the American Academy of Pediatrics and implemented. The intervention was preceded by a baseline assessment using structured questionnaires adopted from previous studies that served as the main data collection tool.

RESULTS

Participants' mean age was 32 years ± 6.2 with 84.2% of the sample being females. Given the training, post-test findings demonstrated a significant increase (p < 0.01) in participants' first aid management scores with mean differences of M = 15.08 ± 5.34 (Knowledge), M = 26.99 ± 6.587 (Attitude), and (M = 4.76 ± 0.648 (Intentional practice).

CONCLUSION

The established pediatric first aid training can enhance the spectrum of managing pediatric injuries among preschool teachers in Zanzibar. Ongoing public health services opportunities should be structured within teachers' continuous learning against pediatric injuries in Zanzibar-Tanzania.

The effect of educational intervention on shaping safe sexual behavior based on problem-based pedagogy in the field of sex education and reproductive health: clinical trial among adolescents in Tanzania

Background

The majority of adolescents are currently becoming sexually active before their 18th birthday having to battle with unsafe sexual behaviors, teenage pregnancies, sexually transmitted infections, and school dropouts. The study designed and tested the effect of integrated reproductive health lesson materials in a Problem-Based pedagogy (PBP) to enhance safe sexual behaviors among adolescents in Tanzania.

Methods

Clustered Randomized Controlled Trial was adopted among 660 adolescents in Tanzania. The study consisted of three research arms including pure PBP, Hybrid PBP, and Lecture-Based Pedagogy (LBP). Sexual-risk Behavior Beliefs and Self-esteem Scale adopted from previous studies measured adolescents' sexual behaviors. A Statistical Analysis Software (SAS) version 9.4 was used to analyze data. Descriptive analysis established adolescents' socio-demographic profiles. Generalized Estimating Equation (GEE) determined the effect of interventions on adolescents' intentions to practice safe sexual behaviors at a 95% confidence interval and a significance level of 5%.

Results

Adolescents' mean age was 15 ± 1.869 years. Sums of 57.5% (n = 380) were females. 39.5% of adolescents were sexually active whereas 44.8% of them initiated sexual intercourse by the age between 10 and 12 years. The end-line findings showed that 54.9% of adolescents in the LBP group demonstrated a significant intention to unsafe sexual behaviors against 26.3% and 30.9% of adolescents in the pure PBP and Hybrid PBP groups respectively. The Difference-In-Difference odds ratio for unsafe sexual behavior among adolescents in the Hybrid PBP and pure PBP was less (AOR = 0.30; p < 0.0001; 95%CI: 0.1398, 0.5559) and (AOR = 0.30, p < 0.0002; 95%CI: 0.1386, 0.5487) contrary to a control group respectively.

Conclusion

The integrated RH lesson materials in a PBP can change a spectrum of sexual behavior among adolescents in Tanzania. This study suggests school teachers and health workers work together to facilitate RH lessons using PBP to enhance safe sexual behaviors among adolescents for their healthy adulthood and future investment.

Trial registration:Pan African Clinical Trial Registry identifier: PACTR202009656160779.