Browsing by Author "Hatfield, Jennifer M."
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Item Open Access Exposure to Arsenic and Mercury: Associated Pregnancy Outcomes, and Early Infant Developmental Outcomes in Gold Mining Areas in Tanzania(2020-04-29) Nyanza, Elias Charles; Dewey, Deborah; Manyama, Mange F.; Bernier, François P.; Hatfield, Jennifer M.; Martin, Jonathan W.The problem: Prenatal exposure to mercury and arsenic through artisanal and small-scale gold mining (ASGM) is an under-explored yet salient issue in Tanzania. ASGM operations are known to expose the entire community—including vulnerable pregnant women and children—to arsenic and mercury via the water they drink, the food they eat, the soil in which their food is grown, and the air they breathe. Prenatal exposure to arsenic and mercury is associated with adverse reproductive outcome including spontaneous abortion, stillbirth, low birth weight, and congenital anomalies, and with poorer developmental outcomes in the children. This study used a longitudinal prospective approach to examine the associations between level of exposure prenatally to arsenic and mercury, and reproductive outcomes and early developmental outcomes in ASGM communities in Tanzania. Methods: A total of 1056 (883 in ASGM and 173 in non-ASGM) out of 1078 pregnant women who were recruited during their antenatal care clinics visits consented to participate in this research. We used minimally invasive techniques to collect urine and blood samples for total arsenic (T-As) and total mercury (T-Hg), respectively. For T-As an unprovoked morning urine sample was collected, whereas for T-Hg, a drop of whole blood was collected on filter paper (Whatman #903) following a simple finger prick. All samples were analyzed using inductively coupled plasma mass spectrometry. Measures of association between maternal T-As or T-Hg exposure, and birth outcomes and early infants’ neurodevelopmental outcome were examined by calculating the coefficient of regression/correlation between variables with their respective 95% confidence interval. Conclusion: Findings from this study revealed that pregnant women living in ASGM communities have elevated arsenic and mercury levels compared to those in non-mining communities. Women in gold mining areas of northern Tanzania had higher incidence of adverse birth outcomes associated with arsenic and mercury exposure. Maternal exposure to mercury but not arsenic was associated with an increased prevalence of severe developmental impairment among infants in gold mining areas of northern Tanzania. These findings suggest that prenatal exposure to arsenic and mercury were associated with adverse reproductive and early developmental outcomes in ASGM communities in Tanzania.Item Open Access Global Health Electives: Ethical Engagement in Building Global Health Capacity(2018-09-19) De Visser, Adriena; Hollaar, Gwen L.; Hatfield, Jennifer M.; Ellaway, Rachel H.; Buchner, Denise L.Increasingly, medical trainees are seeking global health electives (GHEs) as part of their medical education. However, little is known about the impact medical trainees undertaking global health electives have on host institutions, staff, local trainees, patients or communities in low-and middle-income countries. The goal of this study was to explore the relationship dynamics associated with global health electives as perceived by stakeholders at three sites in sub-Saharan Africa. More specifically, I examined stakeholder perspectives in Mwanza, Tanzania and Mbarara and Rugazi, Uganda where the University of Calgary Cumming School of Medicine (CSM) has long-standing institutional collaborations. In this case-based interpretive phenomenological study, thirty-four host stakeholders (health facility administrators, physicians, clinical officers, registrars, nurses, and community liaison members) participated in semi-structured interviews and twenty-eight host stakeholders (medical students, residents, interns, and patients) participated in focus groups. Participant experiences were described using interpretive phenomenological analysis techniques. The findings revealed that although GHEs are well-established and a common experience for host stakeholders there are many indistinct aspects which are poorly understood by host stakeholders. Participants acknowledged that there are a variety of benefits they gain because of GHEs, but overall visiting medical trainees benefit the most from this unique learning opportunity. Despite reluctance to directly admit to harms, host stakeholders described significant challenges and burdens of GHEs and recommended ways in which GHEs could be improved to ensure that the relationships they depend on are mutually beneficial and equitable. One of the main recommendations from this study is that to work towards an equitable, effective, and ethical elective, GHEs should occur between collaborating institutions with a bidirectional focus.Item Open Access Helminth infections in primary school children and ruminants from two elevations in Ngorongoro Conservation Area, Tanzania(2019-01-25) Eltantawy, Manar; Orsel, Karin; van der Meer, Frank; Hatfield, Jennifer M.; Kutz, Susan J.Intestinal helminths are a major health concern, particularly in developing countries like Tanzania. Vulnerability of primary school children and domestic ruminants to helminth infections in the Ngorongoro Conservation Area (NCA), Tanzania is not well-known. Therefore, the overall aim of this thesis was to characterize parasitism, including: prevalence, intensity, and biodiversity, in children and domestic ruminants from two ecozones in the NCA. Using coprological examinations, soil-transmitted helminths were identified in children and associations with ecozone, gender, age and body mass index were analyzed. In domestic ruminants, the same associations as well as associations with body condition score (BCS) and FAMACHA-anemia score were analyzed. In general, prevalence was high, with diversity and intensity generally highest in the high-elevation ecozone. Impact of various variables on parasitism parameters are helpful in developing evidence-based control of helminth infections and reduce impacts on health of children and domestic ruminants.Item Open Access Using the social entrepreneurship approach to generate innovative and sustainable malaria diagnosis interventions in Tanzania: a case study(BioMed Central, 2010-02-03) Allen, Lisa K; Hetherington, Erin; Manyama, Mange; Hatfield, Jennifer M.; van Marle, Guido