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Hand hygiene compliance and associated factors among healthcare workers in comprehensive emergency obstetric and newborn care facilities in Tanzania: a cross-sectional study
(2026) Kazwala, P.R; Komba, P.; Chebyala, A.; Mrema, E.J; Nyarubeli, I.P
Background: Hand hygiene is an effective protective measure for infection prevention and control. However, its compliance is low among healthcare workers in low resource health facilities. This study assessed hand hygiene compliance and associated factors among healthcare workers in selected comprehensive emergency obstetric and newborn care (CEmONC) health facilities in Tanzania. This study assessed moment and participant level hand hygiene compliance and associated individual and workplace factors among health care workers in selected facilities.
Methods: We conducted an analytical cross-sectional study among 281 clinicians and nurses in four selected CEmONC health facilities in Tanzania from April to May 2026. Hand hygiene compliance was assessed using 360° video-assisted observation. Each participant was assessed once for each of the WHO Five Moments. A structured questionnaire assessed individual and facility-related factors. Ordinal logistic regression was used to identify factors associated with hand hygiene compliance.
Results: Of 300 healthcare workers contacted, 281 participated (93.7%). Hand hygiene compliance varied across the WHO Five Moments with the highest (79.7%) after touching a patient and the lowest (58.7%) before a clean or aseptic procedure. Good hand hygiene compliance was found in 26.3% healthcare workers, while 28.5% had moderate, and 45.2% had poor hand hygiene compliance. Participants who reported 40 - 60 seconds as the recommended duration for handwashing with soap and water had higher odds of compliance (aOR, 2.53, 95% CI: 1.09-5.87). Reported use of hand hygiene posters as reminders was inversely associated with compliance (aOR = 0.39, 95% CI: 0.21- 0.76).
Conclusion: Hand hygiene compliance among healthcare workers in CEmONC facilities in Tanzania was low and varies across WHO Five Moments. Knowledge of 40 - 60 seconds as the recommended duration for handwashing with soap associated with better compliance. Healthcare facilities should strengthen hand hygiene through competence-based training, efficient workplace reminders, adequate hand hygiene resources and supportive supervision
2025 MUHAS Research Bulletin
(Muhimbili University of Health and Allied Sciences, 2025) MUHAS Library
Volume 24 of the MUHAS 2025 Research Bulletin presents a consolidated, systematically
organized record of research outputs produced by members of the University. The compilation
reflects MUHAS’s breadth of scholarship and illustrates the strength of the academic research
pipeline, from scholarly inquiry to dissemination through peer-reviewed publication and
postgraduate scholarship.
In academic terms, this Bulletin supports knowledge discovery and scholarly productivity by
enabling readers to identify active and emerging research themes, locate relevant work for further
study, and strengthen potential cross-disciplinary collaboration. For institutional stakeholders, the
Bulletin also provides a practical basis for monitoring research performance and informing
strategic directions to enhance research quality, visibility, and impact.
Thus, Volume 24 serves as a credible reference that promotes responsible use of research
information, minimizes unnecessary duplication of effort, and encourages sustained engagement in
lifelong research careers. This Research Bulletin presents information on research conducted by members of staff at
Muhimbili University of Health and Allied Sciences (MUHAS). It includes summaries of
publications such as journal articles, theses, dissertations, and conference proceedings from the
preceding year. The current research bulletin, Volume 24, contains 1,147 abstracts, of which 675
are abstracts from journal articles, while 472 are abstracts for theses and dissertations
Factors influencing the treatment outcomes of patients undergoing Urethroplasty for urethral stricture at Muhimbili national hospital
(Muhimbili University of Health and Allied Sciences, 2024) Mtafu, N.H
ABSTRACT
Background: Urethral stricture disease poses a substantial challenge in Sub-Saharan
Africa, where the prevalence is notably high. This condition predominantly impacts
men, and the underlying causes in the region are diverse and varied. There is a
significant research gap in understanding the patient-related factors that contribute to
the outcomes of urethroplasty for urethral strictures at Muhimbili National Hospital.
Objectives: To determine the factors influencing treatment outcomes among patients
undergoing urethroplasty for urethral stricture at Muhimbili National Hospital.
Methodology: This cross-sectional analytical retrospective study was carried out at
Muhimbili National Hospital. Through convenient sampling, data from the hospital’s
patient database, specifically from patients aged 10 years and above, were extracted
using a structured abstraction form. Patient information, clinical findings, treatment
offered and treatment outcomes were collected. The collected data were analyzed
using SPSS 23.
Results: This study examined 126 patients with urethral stricture who underwent
urethroplasty at MNH between January 2020 and December 2022. The mean age was
51 years, with the bulbar urethra being the most common stricture site (54%) and
trauma the leading cause (44.4%). The comorbidities included diabetes (21.4%) and
hypertension (71.4%). Most strictures were short (77%). Excision and primary
anastomosis (EPA) procedures were preferred over buccal mucosal grafting (BMG)
procedures (60.3% vs. 39.7%). The success rate of urethroplasty was 85.7%, with a
15.9% complication rate. Early complications included surgical site infections (54.5%),
painful scrotum (36.4%), and wound dehiscence (9.1%). Late complications
predominantly consisted of irritative lower urinary tract symptoms (83.3%), stress
incontinence (5.6%), and erectile dysfunction (11.1%). Younger patients (<60 years)
and those with infectious etiologies had significantly higher success rates. The type of
vi
stricture, length of stricture, surgical approach, and catheter type did not significantly
impact outcomes.
Conclusion: Urethroplasty had a high success rate of 85.7%, particularly in younger
patients and those with infectious etiologies. Trauma was identified as the most
common cause of urethral strictures, primarily affecting the bulbar urethra.
Postoperative complications, both early and late, were observed, indicating the need
for careful postoperative monitoring. Factors such as stricture level, length, surgical
approach, and catheter type did not significantly impact the success of urethroplasty.
Key words: Influencing factors, treatment outcomes, urethroplasty
Clinical demographic characteristics, and their predictors of outcome among burn children treated at Muhimbili National Hospital burn unit.
(Muhimbili University of Health and Allied Sciences, 2024) Abdatam, M.I.A
ABSTRACT
Background: Burn victims' children are the local and global medical issue and cause
morbidity as well as mortality universally. It can be the source of the worst illness
condition and severe pain injuries a child can receive and may lead to prolonged
physical and mental effects. About 70% of all burns occur in LMICs, especially in
African and Southeast Asian regions, while children under the age of 15 in LMICs are
more often burned than children in HICs from scalding or flames. Likewise, in Tanzania,
the prevalence of burn injury is reported to be 16% of all injuries; a one-month incidence
was calculated to be 1.73%.
Objective: To establish the clinical demographic, outcome and its predictor of mortality
among scald injured pediatric patients admitted at MNH burn unit.
Methodology At Muhimbili National Hospital we conducted a retrospective cohort
study designee, from January 2019 to December 2020. The study aimed to enroll all
children who had scald injuries and were no older than 12 years. We used observation
checklist tools to collect data on social demographics and clinical factor variables from
the medical records. However, we excluded the files containing missing information
and obtained the remaining information through a phone interview with the patient's
guardian. We sent the proposal to the MUHAS IRB for review and approval and then
sought permission from the MNH research, training, and consultancy bureau. The
SPSS Version 23.0 package analyzed the data.
Data analysis: The continuous variable consisted of the median (IQR), while the
categorical variables included frequency and proportion. Chi-square was used to test
for a significant association between categorical variables and outcomes, and p < 0.05
was considered statistically significant.
Results: During the study period, 300 children who sustained scald injury were
recruited of which majority (92.3%) were under five years of age. A mortality rate of
25% was observed with factors found to have significant association being residence
in a rural area (aOR 23.71, 95% CI 3.82-147.58, p-value <0.001), a TBSA of >20% (OR
19.98, 95% CI 6.00-66.50, p-value <0.001)
Conclusion: Scald injuries in young children pose a substantial risk of mortality,
particularly in those living in rural areas and those with extensive injuries. These
findings emphasize the need for targeted preventive measures and resources in
vulnerable populations to reduce the incidence and severity of scald injuries in children
Quality of life and the associated determinants among adult patients with Urolithiasis attending Muhimbili National Hospital
(Muhimbili University of Health and Allied Sciences, 2024) Mhaya, J.K
ABSTRACT
Introduction: Urolithiasis, a common urinary condition, varies in prevalence globally,
from 1% to 20%. Treatment options include extracorporeal shock wave lithotripsy,
ureterorenal copy contact lithotripsy, percutaneous nephrolithotomy and open surgical
procedure for larger stones. However, the current care approach lacks integration of
patient-reported outcomes, alignment with treatment preferences, and resource
optimization. Clinical aspects receive more focus in the evidence, while understanding
patient quality of life (QoL), disease impact, and treatment effects remains insufficient.
Objective: This study aimed at determining the factors that influence the QoL and
predictors of QoL among urolithiasis patients undergoing treatment at Muhimbili
National Hospital.
Methodology: An analytical cross-sectional study involving patients with stone-related
issues between October 2023 and March 2024 was carried in Muhimbili National
Hospital. Patients completed stone history surveys, SF-36 questionnaire to assess
Quality of life. Data were cleaned and analyzed using SPSS version 27.
Results: This study included 103 patients meeting inclusion criteria, with a mean age
of 47 years (SD = 11.8). Proportion of urolithiasis was 0.67%. Gender distribution was
52.4% male and 47.9% female. The median BMI was 25.7 kg/m2, with 54.4% falling
within the normal weight range. Stone-related factors included 85.4% first-time stone
formers and 14.6% recurrent formers. Stone sites varied, with 42.7% having stones
≤1cm and 42.7% presenting with hydronephrosis. Analyses revealed no significant
differences in renal stone distribution by age or sex (p > 0.05). However, proximal
ureteric stones were more prevalent among males (p < 0.05). SF-36 domain scores
showed significant differences in role limitations due to emotions and pain between new
and recurrent stone formers. Multivariate regression indicated that higher body mass
index is associated with lower SF-36 PCS scores (β = -1.198, p = 0.004), highlighting
its impact on physical HRQoL.
Conclusion: While no significant age or sex differences were found in renal stone
distribution, proximal ureteric stones were more prevalent among males. Short form-36
domain scores showed significant disparities in emotional limitations and pain between
new and recurrent stone formers, with higher BMI associated with lower physical health
related quality of life.