IntroductionThere has been an increase in the prevalence of erectile dysfunction (ED) in the general population especially among Diabetic patients. This seems to be neglected problem in low-income countries. This study aims at establishing the prevalence of ED and associated risk factors in diabetic patients attended at Diabetic Clinic at Muhimbili National Hospital.MethodsA cross-sectional hospital based study was conducted among 312 diabetic patients attending diabetic clinic at Muhimbili National Hospital between May and December 2011.ResultsMore than half (55.1%) of the patients were found to have some form of ED (12.8% had mild dysfunction, 11.5% moderate and 27.9% severe dysfunction). The severity of ED was correlated with increased age. Multivariate logistic regression revealed that ED was significantly predicted by old age (odds ratio (OR) = 7.1, 95% CI 1.2-40.7), evidence of peripheral neuropathy (OR) =5.9, 95% CI 1.6-21.3), and evidence of peripheral vascular disease (OR =2.5, 95% CI 1.2-5.3). Also longer duration of DM was marginally associated with ED (p=0.056). Patients with ED were also more likely to suffer other sexual domains (p<0.001). No lifestyle factor was associated with ED.ConclusionThe prevalence of ED is high among DM patients. Interventions aimed at prevention, early diagnosis and detection of DM and its complications, and adherence to treatment to prevent complications should be implemented. Further studies should emphasize on temporal variation to show true causality of DM on erectile dysfunction.

Background: The epidemiology and management of diseases can be influenced by social demographic factors. Gender and migration are among these factors. Methods: We aimed at reviewing the impacts of gender and migration on rheumatic heart disease (RHD) epidemiology and management by a nonsystematic literature review of published studies on RHD worldwide. Our PubMed search terms included RHD pathophysiology, diagnosis, complications, management or prevention, combined with words 'rheumatic mitral stenosis (MS)', 'outcomes after percutaneous balloon mitral valvuloplasty (PBMV)', 'gender or sex difference' and 'migration'. The reporting of this study conforms to SANRA (the Scale for Assessment of Narrative Review Articles) guidelines. Results: We retrieved eight studies about the impact of sex on outcomes after PBMV. All of these studies showed a female predominance for RHD. Two studies showed that there is no impact, three studies showed female sex as a predictor of poor outcomes, and the other three showed male sex a predictor of poor outcomes. Although RHD is reported to be eradicated in the developed countries, 2.1% of refugees recently screened for RHD in Italy were found to have subclinical RHD. This prevalence is similar to those found in India (2.0%), Cambodia (2.2%) and Mozambique (3%). Conclusions: There are contradicting results for outcomes after PBMV between males and females. It is not clear whether sex difference plays a role in pathophysiology, diagnosis, management and prognosis of MS. Migration has impacts on epidemiology and management of RHD. Further studies are required in these two fields to explore their relationship to RHD.

BackgroundPregnant women that engage in information seeking process are more likely to have a high level of knowledge about their health, be confident to discuss their health concerns with their health care providers and report better health promotion activities than individuals who do not seek health information. However, health literacy influence pregnant women’s information seeking behaviours and consequently their health knowledge and health outcomes. Limited studies have explored the effects of health literacy on the outcomes associated with the information seeking among pregnant women in Tanzania. This study investigates the relationship between health literacy and information seeking patterns and its associated outcomes among pregnant women in Tanzania. MethodsA cross- sectional survey was conducted among 260 pregnant women aged 18 and above attending selected antenatal clinics (ANC) in Tanzania. Health literacy was assessed using a REALM-SF instrument while information seeking patterns while the associated outcomes were measured using three Likert scales. Descriptive and analytic analyzes were performed using the SPSS, version 24.ResultsAmong the demographic factors, level of education was significantly associated with the level of health literacy (p<0.001). The level of health literacy was better among married pregnant women than those who were not married, and among those who have high income more than those with low-income. The number of ANC visits, gestational age and parity were significantly associated with the level of health literacy (p<0.05). A significant relationship was found between health literacy with seeking health information from village leaders (p < 0.0001) and all online information sources (p < 0.05). Pregnant women with high level of health literacy strongly agree to confirm (from health professionals) the validity of health information they receive from different sources and to recommend the importance of searching health information to others (p<0.001).ConclusionHealth literacy has great influence on maternal health behaviors and the associated outcomes. Maternal health interventions targeting both individual women and the public to ensure high health literacy levels across communities are required. An integration of online/ web-based health information in ANC health educational packages would warrant pregnant women access to high quality health information.

Purpose To determine statin prescription patterns and associated factors among type 2 diabetes patients attending the diabetic clinic at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. Patients and Methods A hospital-based cross-sectional study involving outpatients was conducted from September 2020 to November 2020. Statin prescription history (both type and dosage) was obtained from patients as well as from the electronic medical records for determination of patterns. Participants were categorized as moderate or high risk for cardiovascular disease whereas prescription patterns were categorized as moderate and high intensity statins. Logistic regression was used to examine association, control confounders and effect modifier whereby p <0.05 was considered statistically significant. Results Of 400 patients who were approached for the study, 395 (98.8%) were eligible for statin prescriptions. The mean (±SD) age of the study participants was 58.1±10.3 years, out of which 371 (93.9%) belonged to the age group ≥40 years. Two-thirds(241 61.0%) of the patients were female. About two-thirds(257; 69.4%) of patients had health insurance coverage. Statins were prescribed in 47.3% of the participants. Moderate intensity statin was the only pattern prescribed. In the adjusted model, insurance coverage (OR: 0.056; 95% CI: 0.03–0.12), and hypertension (OR: 0.259; 95% CI: 0.12–0.54) were associated with an increased likelihood of being prescribed a moderate intensity statin. Conclusion A significant number of patients at MNH diabetic clinic were not on statins despite qualifying for the prescription. The findings call for further studies on reasons for low statin prescription practices in this tertiary facility.