Tumbwene Mwansisya - Academia.edu (original) (raw)

Papers by Tumbwene Mwansisya

Journal of Public Mental Health, Jun 15, 2015

Purpose– The purpose of this paper is to determine perceived barriers to utilization of mental he... more Purpose– The purpose of this paper is to determine perceived barriers to utilization of mental health services among adults in Dodoma Municipality, Tanzania. To improve the use of mental health services, identifying related perceived barriers is a key step.Design/methodology/approach– A concurrent mixed method model was used. Data were collected through face-to-face interviews (n=152) using a structured survey questionnaire. In addition in-depth interviews were conducted (n=10). The quantitative data were analyzed by using Epi info version 2002. Content analysis was used for analyzing qualitative data.Findings– The majority of respondents opted to use modern mental health facilities for mental illness treatment. They also used spiritual healing and other forms traditional methods including herbal medicines. The most frequently identified causes of mental illness were: drug abuse, being cursed and witchcraft, demons or evil spirit possession. The reported significant perceived barriers were stigma, economic, lack of transport, witchcraft, lack of awareness of mental health services, unemployment, and negative believes about professional cure.Originality/value– The option for mental health service utilization is influenced by the existing barriers on community and clients’ perception. There is a need for mental health professionals and policy makers to integrate mental health into primary care. Mutual sharing of knowledge between mental health professionals and tradition healers is warranted. Further research on the attitudes toward mental health professional services and on effectiveness of traditional healers’ services is indicated.

Psychology and Behavioral Sciences, Oct 23, 2015

Objectives: The objective of this study was to evaluate the psychometric properties of patient sa... more Objectives: The objective of this study was to evaluate the psychometric properties of patient satisfaction questionnaire (PSQ) for pharmaceutical care in community pharmacies in Tanzanian population. Method: Reliability was studied by means of sub-scales' internal consistency as estimated by Cronbach's alpha (α). Five relevant satisfaction dimensions were identified from PSQ. A moderate internal consistency with Cronbach's alpha coefficient (α) = 0.7 was found for these dimensions, suggesting to be acceptable. Construct validity was assessed by using exploratory factor analysis (EFA) and confirmatory factory analysis (CFA). The CFA was performed using generalized least squares estimation to compare the current and the original 5-factor model of the scale, model fit is acceptable if χ 2 /df < 2, adjusted goodness-of-fit index (AGFI)>0.9, comparative fit index (>0.9, goodness-of-fit index (GFI) > 0.9, root mean square error of approximation (RMSEA)<0.04, and incremental fit index (IFI) > 0.9. Results: The questionnaire with 15 items was having a mean total score of 21.80 (5.969) with reliability as measured by Cronbach's alpha coefficient of 0.7 for the total scale. Also the analysis of PSQ revealed five important construct dimensions including knowledge on medications, customer care, information sharing and education, monitoring the progress, and monitoring the outcome. The indexes for CFA were as follows: model fit (χ 2 /df<0.001), CFI) = 1, GFI=1, and RMSEA=.208. Conclusion: The observed evidence of PSQ validation has provided acceptable reliability, internal structural validity, and content validity that agree with other studies that reported close similar psychometric properties. Therefore, the instrument is appropriate for application in assessment of patient satisfaction with pharmaceutical care in the community pharmacies.

Schizophrenia Research, Oct 1, 2013

Background: Previous studies imply that interhemispheric disconnectivity plays a more important r... more Background: Previous studies imply that interhemispheric disconnectivity plays a more important role on information processing in schizophrenia. However, the role of the aberrant interhemispheric connection in the pathophysiology of this disorder remains unclear. Recently, resting-state functional Magnetic Resonance Imaging (fMRI) has reported to have potentials of mapping functional interactions between pairs of brain hemispheres. Methods: Resting-state whole-brain functional connectivity analyses were performed on 41 schizophrenia patients and 33 healthy controls. Results: The first-episode schizophrenia patients showed significant aberrant interhemispheric connection in the globus pallidus, medial frontal gyrus and inferior temporal gyrus. The correlation of Wechsler Adult Intelligence Scale scores with odds ratio of the aberrant interhemispheric connections revealed positive correlation in the pallidum (rho = 0.335, p = .003) and medial frontal gyrus (rho = 0.260, p = .025). The connection in the pallidum was also positively correlated with duration of illness (rho = − 0.407, p = .009). Whereas, the aberrant interhemispheric connection in the inferior temporal gyrus was positively correlated with scores of Scale for the Assessment of Negative Symptoms (rho = 0.393, p = .012). Conclusion: The present study provides fMRI evidence for the aberrant interhemispheric resting-state functional connectivity within resting-state networks in first-episode schizophrenia patients. These aberrant interhemispheric connections, in particular the pallidum, due to its anatomical and functional connectivities, may be the primary disturbance for cognitive impairment, negative symptoms and chronicity of schizophrenia.

Psychiatry Research: Neuroimaging, Sep 1, 2021

Auditory verbal hallucination (AVH) is one of the most remarkable symptoms of schizophrenia, with... more Auditory verbal hallucination (AVH) is one of the most remarkable symptoms of schizophrenia, with great impact on patients' lives and unclear pathogenesis. Neuroimaging studies have indicated that the development of AVHs is associated with white matter alteration, however, there are still inconsistencies in specific findings across previous investigations. The present study aimed to investigate the characteristics of the microstructural integrity of white matter (WM) in first-episode schizophrenia patients who experience auditory hallucinations. Atlas-based Diffusion Tensor Imaging (DTI) analysis was performed to evaluate the white matter integrity in 37 first-episode schizophrenia patients with AVH, 60 schizophrenia patients without AVH, and 50 healthy controls. Compared with the healthy controls group, AVH showed decreased mean fractional anisotropy (FA) in the genu and body of corpus callosum, right posterior corona radiata, left superior corona radiata, left external capsule, right superior fronto-occipital fasciculus, and higher mean diffusivity (MD) in genu of corpus callosum and left fornix and stria terminalis; whereas the nAVH group showed a much more significant reduction of FA and increased MD in broader brain regions. In addition, a significant positive correlation between FA and the severity of AVHs was observed in right posterior corona radiate. These observations collectively demonstrated that a certain degree of preserved fronto-temporal and interhemispheric connectivity in the early stage of schizophrenia might be associated with the brain capability to generate AVHs.

Psychiatry and Clinical Neurosciences, Oct 31, 2013

AimAberrant brain functional connectivity patterns have been reported in major depressive disorde... more AimAberrant brain functional connectivity patterns have been reported in major depressive disorder (MDD). It is unknown whether they can be used in discriminant analysis for diagnosis of MDD. In the present study we examined the efficiency of discriminant analysis of MDD by individualized computer‐assisted diagnosis.MethodsBased on resting‐state functional magnetic resonance imaging data, a new approach was adopted to investigate functional connectivity changes in 39 MDD patients and 37 well‐matched healthy controls. By using the proposed feature selection method, we identified significant altered functional connections in patients. They were subsequently applied to our analysis as discriminant features using a support vector machine classification method. Furthermore, the relative contribution of functional connectivity was estimated.ResultsAfter subset selection of high‐dimension features, the support vector machine classifier reachedup to approximately 84% with leave‐one‐out training during the discrimination process. Through summarizing the classification contribution of functional connectivities, we obtained four obvious contribution modules: inferior orbitofrontal module, supramarginal gyrus module, inferior parietal lobule‐posterior cingulated gyrus module and middle temporal gyrus‐inferior temporal gyrus module.ConclusionThe experimental results demonstrated that the proposed method is effective in discriminating MDD patients from healthy controls. Functional connectivities might be useful as new biomarkers to assist clinicians in computer auxiliary diagnosis of MDD.

International journal of emergency mental health, 2016

Asia-pacific Psychiatry, Nov 21, 2013

Introduction: Major depressive disorder (MDD) has been regarded as the most common psychiatric di... more Introduction: Major depressive disorder (MDD) has been regarded as the most common psychiatric disorder among hemodialysis (HD) patients. However, few studies have investigated MDD in HD patients in Mainland China. This study sought to investigate the prevalence and treatment of MDD, as well as the sociodemographic and clinical characteristics in this population. Methods: Two hundred sixty HD patients were screened with the nineitem Patient Health Questionnaire, and the formal diagnosis of MDD was further assessed using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Severity of depressive symptoms was assessed with Hamilton Rating Scale for Depression. Finally, patients meeting diagnostic criteria were compared with those who did not on demographic and clinical characteristics. Results: Among the 260 subjects, 26.2% screened positively and 10% were confirmed to have a diagnosis of MDD. Among HD patients with MDD, 69.2% had severe or very severe depressive symptoms. There was no evidence of a clinical diagnosis or of treatment for MDD in any of the patients' medical records. Those with shorter duration of HD, lower monthly income, and lower levels of blood urea nitrogen were significantly more likely to have a diagnosis of MDD. Discussion: MDD is frequent in HD patients. Regular screening and professional diagnosis should be undertaken to increase the detection and treatment of MDD in HD patients. The effectiveness of interventions for MDD in HD patients deserves further research.

Headache: The Journal of Head and Face Pain

Journal of psychiatry, Jul 25, 2017

Psychiatry Research: Neuroimaging, 2021

Psychology and Behavioral Sciences, 2015

SSRN Electronic Journal, 2020

Background: Quality of life is an important element of surveillance in people living with HIV/AID... more Background: Quality of life is an important element of surveillance in people living with HIV/AIDS. WHO has developed an HIV specific quality of life tool (WHOQOLHIV-Bref) for assessing Quality of life of HIV individuals. This tool takes into account the different cultural variations that exist worldwide and hence enable assessment of the quality of life across different cultures. Despite its preliminary sound validity and reliability from several studies, the developers recommend it to be validated in different cultures to fully assess its psychometric properties before its adaptation. Objectives: To evaluate the validity and reliability of WHOQOLHIV-Bref questionnaire in Tanzanian culture among people living with HIV/AIDS. Methods: This was a cross-sectional study of 103 participants interviewed using a Kiswahili WHOQOLHIV-BREF questionnaire. Of, these participants 47 participants were enrolled to repeat an interview two weeks later. Internal consistency and test-retest reliability were analyzed. Validity was assessed through analysis of translational, concurrent, convergent and discriminant validity while the model performance was assessed by Exploratory and confirmatory factor analysis. Results: The mean age of the participants was 40.5 ± 9.702 years. Translation validity was assessed through the WHO translational protocol and was found to be good. The internal consistency and test-retest reliability of the Kiswahili version of WHOQOL-HIV BREF were excellent: This preprint research paper has not been peer reviewed.

Background In public health, traditional 4Ps (product, price, place and promotion) of the marketi... more Background In public health, traditional 4Ps (product, price, place and promotion) of the marketing mix have been successfully used to influence clients/patients to adopt desired health behaviors and health status changes in reproductive health, tuberculosis (TB), malaria, child survival and human immuno-virus (HIV) interventions. However, the use of additional 3Ps (Physical evidence, People and Process) of the marketing mix have rarely been used in public health interventions. This study examined the influence of physical evidence on voluntary counseling and testing (VCT) uptake among adolescents in Tanzania.Methods A cross-sectional study design using quantitative method was conducted in Dodoma. A multi-stage random sampling method was used to select nine secondary schools and 449 study participants. Self-administered structured questionnaire was used. Data was analyzed using SPSS v17. Relationship between independent and dependent variables was analyzed using binary logistic regr...

Schizophrenia research, Nov 3, 2017

In the last two decades there has been an increase on task and resting-state functional Magnetic ... more In the last two decades there has been an increase on task and resting-state functional Magnetic Resonance Imaging (fMRI) studies that explore the brain's functional changes in schizophrenia. However, it remains unclear as to whether the brain's functional changes during the resting state are sensitive to the same brain regions during task fMRI. Therefore, we conducted a systematic literature search of task and resting-state fMRI studies that investigated brain pathological changes in first-episode schizophrenia (Fleischhacker et al.). Nineteen studies met the inclusion criteria; seven were resting state fMRI studies with 371 FES patients and 363 healthy controls and twelve were task fMRI studies with 235 FES patients and 291 healthy controls. We found overlapping task and resting-state fMRI abnormalities in the prefrontal regions, including the dorsal lateral prefrontal cortex, the orbital frontal cortex and the temporal lobe, especially in the left superior temporal gyrus ...

Schizophrenia research, Mar 23, 2016

Large scale migration of workers due to wage differences across regions of China has separated mi... more Large scale migration of workers due to wage differences across regions of China has separated millions of children, called "left-behind children" from their parents. Psychotic-like experiences (PLEs) are thought to be associated with childhood deprivation and may predict later psychotic disorders but have not been studied in this potentially vulnerable population. Data were collected from representative samples of students in thirteen middle schools in the Xiangxi region and Changsha city of Hunan province (N=6623), of whom 1360 (21.3%) were "left-behind" children. Children were surveyed with the positive frequency subscales of the Community Assessment of Psychic Experiences and the Trauma History Questionnaire child version. More…

BMC Medical Education, 2016

Background: Continuing education (CE) is crucial for quality improvement in health care. The need... more Background: Continuing education (CE) is crucial for quality improvement in health care. The needs assessment of CE helps ensure effectiveness. However, such an assessment necessitates certain techniques that are unfamiliar to health care communities in developing countries. This study identifies the needs of providing CE to health care personnel in Saint Lucia. Methods: This study was designed as a questionnaire survey to investigate the demographics, training needs, and preferred approaches to improve performance of the target population. The study population included the health care professionals of major public health care facilities in Saint Lucia. We used the World Health Organizationadopted Hennessy Hicks Training Needs Analysis Questionnaire, a self-reported close-ended structured questionnaire with a core set of 30 items. These items refer to tasks that are central to the role of health care professionals and are categorized into six superordinate categories: research/audit, communication/teamwork, clinical skills, administrative, managerial/supervisory, and continuing professional education. Results: In total, 208 questionnaires were distributed; the response rate was 66.8 %, and most respondents were nurses. The need for continuing professional education was rated the highest priority, followed by research/audit activities. The evidence suggests that most respondents required training in communication skills, management, clinical skills, and research methods. Conclusions: Providing training according to the needs is vital, particularly in developing countries. The present research methodology and findings offer perspectives on how to conduct needs assessment and offer reference points for developing countries whose background and health care environment are similar to those of Saint Lucia.

International Journal of Emergency Mental Health and Human Resilience, 2016

Journal of magnetic resonance imaging : JMRI, Jan 26, 2016

To explore the acute effect of betel quid (BQ) use on functional network connectivity by comparin... more To explore the acute effect of betel quid (BQ) use on functional network connectivity by comparing the global functional brain networks and their subsets before and immediately after BQ chewing. Resting-state functional magnetic resonance imaging (fMRI) was performed in 27 healthy male participants before and just after chewing BQ on a 3.0T scanner with a gradient-echo echo planar imaging sequence. Independent component analysis (ICA) was used to determine components that represent the brain's functional networks and their spatial aspects of functional connectivity. A paired t-test was used for exploring the connectivity differences in each network before and after BQ chewing. Sixteen networks were identified by ICA. Nine of them showed connectivity differences before and after BQ chewing (P < 0.05 false discovery rate corrected): (A) orbitofrontal, (B) left frontoparietal, (C) visual, (D) right frontoparietal, (E) anterior default mode, (F) medial frontal/anterior cingulate ...

Scientific reports, Jan 17, 2016

Previous studies have observed reduced suppression of the default mode network (DMN) during cogni... more Previous studies have observed reduced suppression of the default mode network (DMN) during cognitive tasks in schizophrenia, suggesting inefficient DMN suppression is critical for the cognitive deficits of schizophrenia. Cognitive function in schizophrenia patients, however, varies from relatively intact to severely impaired. This study, which compared the DMN suppression patterns between first-episode schizophrenia patients with (SZ-Imp) and without (SZ-Pre) impaired cognitive function, may provide further insight into the role of DMN dysfunction in cognitive deficits of schizophrenia. Independent component analysis (ICA) was applied to resting-state fMRI data to identify the DMN in each subject, and then general linear modeling based on the task-fMRI data was used to examine the different DMN activation patterns between groups. We observed that the SZ-Imp group, but not the SZ-Pre group, showed reduced suppression in the medial prefrontal cortex and posterior cingulated cortex wh...