State University of Zanzibar

Anemia continues to be one of the most common and overlooked complications in early breast cancer, caused by inflammation related to tumors, iron storage, and treatment-induced suppression of the bone marrow. Determining the root cause of anemia is essential for enhancing treatment and improving patient results. This review examines the potential diagnostic significance of the Mentzer index a ratio of mean corpuscular volume to red blood cell count as a straightforward, affordable method for distinguishing anemia patterns in early breast cancer. Historically utilized to differentiate iron deficiency anemia from thalassemia trait, recent findings indicate that MI might also represent the erythropoietic and inflammatory changes linked to malignancy. A narrative review method was utilized, consolidating existing literature (2015–2024) regarding the mechanisms of anemia in breast cancer, red blood cell indices, and biomarkers for iron metabolism. Research from PubMed, Scopus, and Google Scholar was evaluated to investigate the diagnostic and pathophysiological connections between the Mentzer index and anemia associated with cancer. Results show that increased MI values in early breast cancer frequently relate to functional iron deficiency due to hepcidin-induced iron blockage and inflammation-related suppression of erythropoiesis. On the other hand, low or normal MI levels might indicate mixed or nutritional anemia conditions. Incorporating MI with biomarkers like ferritin, transferrin saturation, and red cell distribution width improves diagnostic accuracy, especially in resource-constrained environments. The Mentzer index, while rooted in tradition, could offer a significant hematologic insight into anemia types in early breast cancer, enabling personalized interventions and enhanced treatment preparedness. Peer Review History: Received 4 December 2025; Reviewed 11 January 2026; Accepted 13 February; Available online 15 March 2026 Academic Editor: Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg Reviewers: Dr. Taiwo O Elufioye, University of Ibadan, Nigeria, toonitaiwo@yahoo.com Dr. Tanveer Ahmed Khan, Hajvery University, Lahore, Pakistan, tanveerahmedkhan754@gmail.com

Background: Child malnutrition, including undernutrition and overweight, remains a major global public health challenge, especially in low- and middle-income countries (LMICs), contributing to high under-five mortality and long-term cognitive, physical, and economic consequences. Understanding barriers and intervention readiness at the local level is critical to inform targeted programs. Objectives: To identify key caregiver barriers to adequate nutrition and to determine willingness to participate in nutrition education programs. Methods: A cross-sectional study of 96 caregivers of children under 5 years old was conducted at Ijitimai District Hospital. Data were collected using structured questionnaires on sociodemographic characteristics, feeding practices, barriers to child feeding, and nutritional status. Descriptive statistics summarized participant characteristics; chi-square and likelihood-ratio tests examined associations between variables. Results: Malnutrition prevalence was 16.7%, with underweight (9.4%) and wasting (5.2%) being the most common; stunting was 2.1%. Most caregivers (83.3%) were unaware of their child’s nutritional status. Malnutrition was significantly associated with the type of complementary foods (χ² = 34.46, p < 0.001), LR = 29.67 (p < 0.001), and previous malnutrition diagnosis (χ² = 42.91, p < 0.001), LR = 29.67 (p < 0.001). Primary barriers included lack of knowledge (41.7%) and financial constraints (24.0%). Most caregivers (95.8%) were willing to participate in nutrition training. Conclusion: While overall prevalence was lower than national estimates, underweight and wasting persist. Dietary quality and prior nutritional vulnerability are key determinants. Caregiver knowledge alone does not predict nutritional outcomes. Recommendations: Implement community-based nutrition education emphasizing dietary diversity, coupled with structural support (food security and social protection) and routine growth monitoring to prevent recurrence.

Introduction: Malnutrition remains a major cause of morbidity and mortality among children under five in low and middle-income countries. Suboptimal breastfeeding and complementary feeding practices, often driven by limited caregiver knowledge, financial barriers, and inadequate access to nutrition education, significantly contribute to poor nutritional outcomes. Objective: To assess caregivers’ knowledge and feeding practices related to infant and young child nutrition, and to identify opportunities for improving nutritional outcomes among children under five. Methods: A cross-sectional study was conducted among 96 caregivers of children under five who reported Child malnutrition. Data collected included sociodemographic characteristics, breastfeeding and complementary feeding practices, nutrition knowledge, and perceived challenges. Statistical tests were performed to assess associations between feeding practices, caregiver knowledge, and child malnutrition status. Results: A significant association was found between malnutrition type and caregivers’ knowledge of the recommended duration of exclusive breastfeeding (Likelihood Ratio = 15.69, p = 0.016). The type of complementary food provided was also significantly associated with malnutrition status (χ² = 34.46, p < 0.001), as was the relationship between a history of malnutrition diagnosis and the current malnutrition category (χ² = 42.91, p < 0.001). Overall, most caregivers exhibited limited knowledge of recommended feeding practices, with major gaps in understanding the timing and nutritional adequacy of complementary foods. Financial constraints, lack of nutrition education, and common misconceptions were reported as key barriers. Despite these challenges, most caregivers expressed a strong willingness to participate in nutrition training. Conclusions: Caregivers face substantial informational and socioeconomic challenges that heighten the risk of malnutrition in early childhood. Strengthening community-based nutrition education, improving access to counselling services, and addressing financial barriers are essential for improving feeding practices and promoting healthier growth among children under five.

This study investigates the social and economic impact of Blue Economy initiatives on low-income communities in Zanzibar, with a focus on FunguRefu and Nungwi in North ‘A’ District, Unguja. The research is guided by two theoretical perspectives, Communication for Social Theory and the Sustainable Livelihood framework, which provide insights into how awareness is spread, how participation is shaped, and how livelihood outcomes are influenced by Blue Economic initiative programs. A cross-sectional survey design was adopted, targeting small-scale fishers and traders in the study areas. A sample of 250 respondents was calculated by considering Kothari’s formula, with data collected through structured questionnaires. The study employed both random and convenience sampling techniques to capture knowledgeable participants and active community members. Data were analysed using descriptive statistics with the support of the Statistical Package for Social Sciences (SPSS) version 20, and results were presented in tables, frequencies, and percentages. Preliminary findings reveal that while awareness of the Blue Economic initiatives is more than 80% well known, participation remains moderate, with limited opportunities for decision-making. Economic impacts are mixed, with some households experiencing improved income and livelihoods, while others face exclusion due to barriers such as limited training, financial inaccessibility, and cultural perspectives. Social impacts are evident in improved access to education, healthcare, and infrastructure, though benefits remain unevenly distributed among households. The study highlights that Blue Economic initiatives have the potential to transform livelihoods in Zanzibar. However, without inclusive governance, unbiased access to resources, and proper management of targeted groups, the expected goals for the communities will not be successfully achieved

SUMMARY BOX Africa’s health education systems face a significant demand due to carrying 25% of the global disease burden and only 4% of the health workforce.

This study examines employment perceptions among Bachelor of Information Technology Application and Management (BITAM) and Computer Science (CS) students at the State University of Zanzibar, focusing on job security, salary expectations, industry demand, and job readiness. Using a structured questionnaire, data were collected from 208 participants, including 126 current students and 82 graduates. The findings reveal that CS graduates secure jobs more quickly than BITAM graduates, highlighting key differences in career outlooks. The study highlights the importance of aligning academic programs with industry needs, offering valuable insights for curriculum development, career guidance, and policy-making. It also finds that most students choose IT disciplines due to their passion for job opportunities, with no significant gender disparity in employment perceptions. The study provides recommendations for higher education institutions and IT industry stakeholders to enhance graduate employability by analysing students' confidence and expectations. Strengthening industry collaboration and regularly updating curricula can help better prepare students for the competitive job market.

Abstract IntroductionImproving quality of maternity care in low- and middle-income countries is essential for reducing maternal and perinatal mortality and morbidity. Low dose-high frequency in-house training in routine and emergency maternity care is suggested to be central for this. To ensure the effectiveness and resource-efficiency of such training, a knowledge and skills test requiring minimal time and resources is needed. Therefore, we set out to develop and validate a test for routine use in busy, low-resource maternity units; to efficiently and effectively assess potential knowledge and skills gains over time when attending ‘low-dose, high-frequency’ training in integrated care during childbirth.Materials and MethodsUsing Messick’s standards, we developed a comprehensive yet time-efficient test covering childbirth surveillance, respectful care, and management of maternity and neonatal complications. Both expert and participant feedback informed the test design. The test was applied during a Tanzanian in-house training intervention (PartoMa) to assess its performance. Reliability was determined by Cronbach’s Alpha, while validity was evaluated through face and content validity, factor analysis, and Rasch analysis.ResultsAfter multiple revisions, Cronbach’s Alpha was below 0.7, indicating limited reliability. Experts agreed the test was well-designed for the intended content, with no concerns about clarity or relevance. Content validity was confirmed through expert judgment, reflecting the test’s goals. In pilot testing, 160 (84.6%) participants rated it excellent in achieving the study objectives. Exploratory factor analysis showed the test did not measure a single latent trait, and Rasch analysis revealed discrepancies between observed and expected responses on item scores.ConclusionThe knowledge and skills test has shown promise for assessing healthcare providers in high-pressure, resource-limited settings, but its low Cronbach’s Alpha and limitations in test results highlight the need for refinement.