The impact of antenatal HIV diagnosis on postpartum childbearing desires in northern Tanzania: a mixed methods study.

With the expansion of routine antenatal HIV testing, women are increasingly discovering they are HIV-positive during pregnancy. While several studies have examined the impact of HIV on childbearing in Africa, few have focused on the antenatal/postpartum period. Addressing this research gap will help tailor contraceptive counseling to HIV-positive women's needs. Our study measures how antenatal HIV diagnosis affects postpartum childbearing desires, adjusting for effects of HIV before diagnosis. A baseline survey on reproductive behavior was administered to 5,284 antenatal clients before they underwent routine HIV testing. Fifteen months later, a follow-up survey collected information on postpartum reproductive behavior from 2,162 women, and in-depth interviews with 25 women investigated attitudes toward HIV and childbearing. HIV diagnosis was associated with a long-term downward adjustment in childbearing desires, but not with changes in short-term postpartum desires. The qualitative interviews identified health concerns and nurses' dissuasion as major factors discouraging childbearing post-diagnosis. At the same time, pronatalist social norms appeared to pressure women to continue childbearing. Given the potential for fertility desires to change following antenatal HIV diagnosis, contraceptive counseling should be provided on a continuum from antenatal through postpartum care, taking into account the conflicting pressures faced by HIV-positive women in relation to childbearing

African Lion Population Estimates in Tanzania’s Ruaha National Park

Tanzania is considered a country with the largest number of African lions (Panthera leo). However, the continued absence of ecological population estimates and understanding of the associated factors influencing lion distribution hinders the development of conservation planning. This is particularly true in the Ruaha-Rungwa landscape, where it was estimated that more than 10% of the global lion population currently resides. By using a call-back survey method, we aimed to provide population estimates (population size and density) of African lions in the Ruaha National Park, between wet (March 2019) and dry (October 2019) seasons. We also assessed the key factors that influenced the distribution of the observed lions towards call-back stations. Ferreira & Funston’s (2010) formula was used to calculate population size and in turn used to estimate density in the sampled area, while the Generalized Linear Model (GLMM) with zero-inflated Poisson error distribution was used to determine factors that influence the distribution of the observed lions to call-back stations. The population size we calculated for the sampled area of 3137.2 km2 revealed 286 lions (95% CI, 236 - 335) during the wet season, and 196 lions (95% CI, 192 - 200) during the dry season. The density of lions was 9.1/100 km2 during the wet season, and 6.3/100 km2 during the dry season. Distance to water source had a significant negative effect on the distribution of the observed lions to the call-back stations, while habitat had a marginal effect. Our findings show that, although lion population estimates were larger during the wet season than the dry season, the season had no effect on the distribution of the observed lions to call-back stations. We suggest that the proximity to water sources is important in study design. Further, we suggest that density and population size are useful indices in identifying conservation area priorities and lion coexistence strategies

Postpartum Contraception in Northern Tanzania: Patterns of Use, Relationship to Antenatal Intentions, and Impact of Antenatal Counseling.

In Tanzania, unmet need for contraception is high, particularly in the postpartum period. Contraceptive counseling during routine antenatal HIV testing could reach 97 percent of pregnant women with much-needed information, but requires an understanding of postpartum contraceptive use and its relationship to antenatal intentions. We conducted a baseline survey of reproductive behavior among 5,284 antenatal clients in Northern Tanzania, followed by an intervention offering contraceptive counseling to half the respondents. A follow-up survey at 6-15 months postpartum examined patterns and determinants of postpartum contraceptive use, assessed their correspondence with antenatal intentions, and evaluated the impact of the intervention. Despite high loss to follow-up, our findings indicate that condoms and hormonal methods had particular and distinct roles in the postpartum period, based on understandings of postpartum fertility. Antenatal intentions were poor predictors of postpartum reproductive behavior. Antenatal counseling had an effect on postpartum contraceptive intentions, but not on use. Different antenatal/contraceptive service integration models should be tested to determine how and when antenatal counseling can be most effective

Histomorphological Damage in the Small Intestine of Wami Tilapia (Oreochromis urolepis) (Norman, 1922) Exposed to Microplastics Remain Long after Depuration

The histopathological effects of microplastics (MPs) in the gastrointestinal tracts of fish following long-term exposure and depuration are relatively understudied. This study investigated histomorphological damage in the small intestine of Oreochromis urolepis larvae following 65 d exposure to 38–45 μm of polyethylene microspheres (PE MPs) and after a recovery period of 60 d. Larval fish were assigned to each treatment group (control, 1, 10 and 100 PE MPs), where ingestion and degenerative changes in the small intestine were examined using a routine hematoxylin and eosin staining technique. The results highlighted significant PE MPs ingestion and retention proportional to exposure dose (χ2 = 49.54; df = 2). Villi height and width and epithelial cell height were significantly affected and differed between treatment groups. Indices of damage to the small intestine organ (χ2 = 47.37; df = 2; p < 0.05) and reaction patterns of villi, epithelial, goblet and cryptic glandular cells, leucocytic infiltration and blood congestion revealed significant occurrence of alteration as PE MPs exposure dose increased. After the recovery period, no PE MPs were observed, and villi height, width and epithelial cells showed recovery with no significant difference between treatment groups. Organ indices declined (χ2 = 12; df = 2; p < 0.05) but remained significantly different between treatment groups, largely due to leucocytic infiltration (χ2 = 9.08; df = 2; p < 0.05). The study demonstrated that microplastics induced small intestinal wall degeneration, but recovery in young fish occurred slowly. The damage likely compromised its digestive function, which may affect growth and reproduction. This requires further research.publishedVersio

Impaired Growth Performance of Wami Tilapia Juveniles (Oreochromis urolepis) (Norman, 1922) Due to Microplastic Induced Degeneration of the Small Intestine

Microplastics-induced histopathological changes in gastrointestinal tracts of fish have been widely reported. However, the translation of adverse effects in the gut to impacts on growth are understudied. This study investigated the effect of MP-induced small intestinal histomorphological changes on growth performance of Oreochromis urolepis juveniles. Sixty larvae were exposed in control (0), 1, 10, and 100 polyethylene microplastic particles (PE MPs)/mL treatment groups. On day 65, juveniles were euthanized, dissected, and biometric data were taken. Small intestine histomorphological lesion index (HLI) was calculated following histological preparation using routine hematoxylin and eosin procedure. Results showed increase in HLI proportional to PE MPs exposure dose. These deteriorations equally reduced growth in final weight, weight gain and total length (One-Way ANOVA, p > 0.05), and Specific Growth Rate (SGR) (Kruskal–Wallis Test, p > 0.05), though there were insignificant differences between treatment groups. Condition factors of fishes in control and 1 PE MPs differed significantly and with other treatment groups (Tukey HSD, p < 0.05). Small intestines HLI correlated significantly with growth pattern (Spearman, r = 1.00, p = 0.01), condition factors (Pearson, r = −0.995, p < 0.05), final weight, weight gain, and total length (Spearman, r = −1.00, p = 0.01) but not with SGR. The allometric growth pattern changed towards isometric corresponding to increasing HLI. These findings suggest that MPs damaged small intestine structure and thus impaired digestion and nutrients absorption functions which disrupted growth. Such effects may impair juveniles’ ability to escape enemies, find food, and eventually reproduce, and therefore require further study.publishedVersio

Trends in HIV & syphilis prevalence and correlates of HIV infection: results from cross-sectional surveys among women attending ante-natal clinics in Northern Tanzania.

BACKGROUND: Sentinel surveillance for HIV in ante-natal clinics (ANC) remains the primary method for collecting timely trend data on HIV prevalence in most of sub-Saharan Africa. We describe prevalence of HIV and syphilis infection and trends over time in HIV prevalence among women attending ante-natal clinics (ANC) in Magu district and Mwanza city, part of Mwanza region in Northern Tanzania. HIV prevalence from ANC surveys in 2000 and 2002 was 10.5% and 10.8% respectively. In previous rounds urban residence, residential mobility, the length of time sexually active before marriage, time since marriage and age of the partner were associated with HIV infection. METHODS: A third round of HIV sentinel surveillance was conducted at ante-natal clinics in Mwanza region, Tanzania during 2006. We interviewed women attending 27 ante-natal clinics. In 15 clinics we also anonymously tested women for syphilis and HIV infection and linked these results to the questionnaire data. RESULTS: HIV prevalence was 7.6% overall in 2006 and 7.4% at the 11 clinics used in previous rounds. Geographical variations in HIV prevalence, apparent in previous rounds, have largely disappeared but syphilis prevalence is still higher in rural clinics. HIV prevalence has declined in urban clinics and is stable in rural clinics. The correlates of HIV infection have changed over time. In this round older age, lower gravidity, remarriage, duration of marriage, sexual activity before marriage, long interval between last birth and pregnancy and child death were all associated with infection. CONCLUSIONS: HIV prevalence trends concur with results from a community-based cohort in the region. Correlates of HIV infection have also changed and more proximate, individual level factors are now more important, in line with the changing epidemiology of infection in this population

The effectiveness of interventions to reduce cardio-metabolic risk factors among regular street food consumers in Dar es Salaam, Tanzania: The pre-post findings from a cluster randomized trial (Registered by Pan African clinical trial registry with trial # PACTR202208642850935).

IntroductionThe healthy plate model (HPM) is a practical guide to modulate the portion of staple food in main meals, subsequently affecting the risks associated with Non-communicable Diseases include type2 diabetes mellitus (T2DM).ObjectiveThis study investigated the effectiveness of health information and the healthy plate model on cardio-metabolic risk factors, knowledge and attitude towards T2DM prevention measures.MethodsA pre-post analysis, as part of a cluster randomized trial with street food vendors and their customers, was implemented in three randomly selected districts in Dar es Salaam, Tanzania. Two vendor-customer clusters each with 15 and more vendors from each district were randomly assigned to receive either T2DM health information only (Intervention package1 [IP1]) or IP1 plus a subsidized meal with vegetables and fruits, following the principles of the HPM (Intervention package2 [IP2]). Within the clusters the participants were informed on the importance of the intervention they received. An intervention period lasted for three months from 1st April to 31st June 2019. We applied Generalized Linear Mixed Models and Bayesian Modelling (for sensitivity analysis) to assess the effectiveness of the interventions.ResultsOverall, 336 (IP2 = 175 and IP1 = 161) out of 560 (280/arm) previous study participants participated in evaluation. Diastolic BP was lower among IP2 participants in the evaluation than baseline AβC = -4.1mmHg (95%CI:-5.42 to -2.76). After adjusting for the interaction between IP2 and age of the consumers, the BMI was significantly lower among IP2 in the evaluation than baseline AβC = -0.7kg/m2 (95%CI: -1.17 to -0.23). With interaction between IP2 and income, BMI was higher in the IP2 in the evaluation than baseline AβC = 0.73kg/m2 (95%CI: 0.08 to 1.38). Systolic and diastolic BP were significantly lower among IP1 in the evaluation than baseline AβC = -3.5mmHg (95%CI:-5.78 to -1.24) and AβC = -5.9mmHg (95%CI:-7.34 to -4.44) respectively. Both the knowledge scores and positive attitudes towards T2DM prevention measures were higher in the evaluation than baseline in both interventions arms.ConclusionThe positive effects on cardio-metabolic risk factors, knowledge and attitude were observed in both intervention arms. Due to interactions between IP2, age and income; designing interventions relating to food and cardio-metabolic risk factors, should consider combining socio-economic factors

African lion population estimates in Tanzania’s Ruaha National Park

Tanzania is considered a country with the largest number of African lions (Panthera leo). However, the continued absence of ecological population estimates and understanding of the associated factors influencing lion distribution hinders the development of conservation planning. This is particularly true in the Ruaha-Rungwa landscape, where it was estimated that more than 10% of the global lion population currently resides. By using a call-back survey method, we aimed to provide population estimates (population size and density) of African lions in the Ruaha National Park, between wet (March 2019) and dry (October 2019) seasons. We also assessed the key factors that influenced the distribution of the observed lions towards call-back stations. Ferreira & Funston’s (2010) formula was used to calculate population size and in turn used to estimate density in the sampled area, while the Generalized Linear Model (GLMM) with zero-inflated Poisson error distribution was used to determine factors that influence the distribution of the observed lions to call-back stations. The population size we calculated for the sampled area of 3137.2 km2 revealed 286 lions (95% CI, 236 - 335) during the wet season, and 196 lions (95% CI, 192 - 200) during the dry season. The density of lions was 9.1/100 km2 during the wet season, and 6.3/100 km2 during the dry season. Distance to water source had a significant negative effect on the distribution of the observed lions to the call-back stations, while habitat had a marginal effect. Our findings show that, although lion population estimates were larger during the wet season than the dry season, the season had no effect on the distribution of the observed lions to call-back stations. We suggest that the proximity to water sources is important in study design. Further, we suggest that density and population size are useful indices in identifying conservation area priorities and lion coexistence strategies

The burden, prevention and care of infants and children with congenital anomalies in sub-Saharan Africa: A scoping review.

The aim of this scoping review was to determine the scope, objectives and methodology of contemporary published research on congenital anomalies (CAs) in sub-Saharan Africa (SSA), to inform activities of the newly established sub-Saharan African Congenital Anomaly Network (sSCAN). MEDLINE was searched for CA-related articles published between January 2016 and June 2021. Articles were classified into four main areas (public health burden, surveillance, prevention, care) and their objectives and methodologies summarized. Of the 532 articles identified, 255 were included. The articles originated from 22 of the 49 SSA countries, with four countries contributing 60% of the articles: Nigeria (22.0%), Ethiopia (14.1%), Uganda (11.7%) and South Africa (11.7%). Only 5.5% of studies involved multiple countries within the region. Most articles included CA as their primary focus (85%), investigated a single CA (88%), focused on CA burden (56.9%) and care (54.1%), with less coverage of surveillance (3.5%) and prevention (13.3%). The most common study designs were case studies/case series (26.6%), followed by cross-sectional surveys (17.6%), retrospective record reviews (17.3%), and cohort studies (17.2%). Studies were mainly derived from single hospitals (60.4%), with only 9% being population-based studies. Most data were obtained from retrospective review of clinical records (56.1%) or via caregiver interviews (34.9%). Few papers included stillbirths (7.5%), prenatally diagnosed CAs (3.5%) or terminations of pregnancy for CA (2.4%).This first-of-a-kind-scoping review on CA in SSA demonstrated an increasing level of awareness and recognition among researchers in SSA of the contribution of CAs to under-5 mortality and morbidity in the region. The review also highlighted the need to address diagnosis, prevention, surveillance and care to meet Sustainable Development Goals 3.2 and 3.8. The SSA sub-region faces unique challenges, including fragmentation of efforts that we hope to surmount through sSCAN via a multidisciplinary and multi-stakeholder approach