Correlates of diarrhea and stunting among under-five children in Ruvuma, Tanzania; a hospital-based cross-sectional study

This research article published by Elsevier, 2020Undernutrition affects 20% of children under five in the developing world. Stunting is a form of undernutrition when children have low height for their age. Global prevalence of stunting in 2019 was 21.4%, while current Tanzania national average is 34%. Ruvuma region has one of highest prevalence of stunting (44%) in Tanzania, which prompted this cross-sectional study on correlates responsible for this high prevalence. The study included randomly sampled children below 5 years of age who attended outpatient clinics at hospitals from Ruvuma between April – May 2019. The mean and median ages of children were 18 and 13 respectively. Among children, 46% were females and 45.6% were stunted. More male children (52%) were stunted than females. Through bivariate analysis, stunting was associated with gender (χ2 = 6.6759, df = 1, p = 0.009772), handwashing before food (χ2 = 5.1213, df = 1, p = 0.02363), location of hospital (χ2 = 3.851, df = 1, p = 0.04972) and use of Municipal garbage collection system (χ2 = 3.6814, df = 1, p = 0.05502). Moreover, diarrhea was associated with toilet sharing (χ2 = 5.4703, df = 1, p = 0.002), use of household's toilet (χ2 = 4.0224, df = 1, p = 0.004) and rinsing child feces into toilet (χ2 = 3.6814, df = 1, p < 0.01). Multivariate logistic regression analyses showed that stunting risk increased with male gender (OR (95%CI) = 1.7945 (1.1944 – 2.712), age (OR (95%CI) = 1.3122 (1.1484 – 1.507), and decreased with handwashing before meal (OR (95%CI) = 0.5403 (0.3042 – 0.940). Finally, diarrhea risk increased with toilet sharing (OR (95%CI) = 2.154 (1.153 – 3.953) and decreased with child's use of toilet (OR (95%CI) = 0.510 (0.259 – 0.945). Our study revealed important correlates that determined observed high prevalence of stunting in Ruvuma. These correlates can be modified through health interventions to reduce this high prevalence

A Review on the Status of Breast Cancer Care in Tanzania

This research article published by Multidisciplinary Cancer Investigation, 2020Tanzania continues to enjoy stability and growth in different sectors similar to other countries; however, some challenges persist in the health sector, especially in the area of cancer care. The current study aimed at reviewing social economic status (SES), as well as factors contributing to the increased burden of breast cancer (BC) in Tanzania. The current study reviewed different literature ranging from nationally/ internationally published statistics, academic publications, health information of non-governmental organizations, academic researchers, and other sources of health information to better understand the socioeconomic and BC care status in Tanzania. The current review showed that BC is still the second most prevalent malignant disease in Tanzania, and most of the patients referring to medical centers are in the advanced stage of the disease due to shortage and unaffordability of health care services. The majority of health-related interventions and investments target infectious diseases, including HIV-AIDS, tuberculosis, malaria, as well as maternal and child health-related conditions, compared to noncommunicable diseases (NCDs) such as BC. In spite of some setbacks and improvements in healthcare facilities (e g, novel techniques for early detection), the best way to address BC care is affordable fees for clinical and laboratory investigations, accessible treatment, palliative care, follow-up, rehabilitative care, and better management and allocation of resources

Effects of Season Variation on Water, Feed, Milk Yield and Reproductive Performance of Dairy Cows in Smallholder Farms in Eastern Africa

This research published by the Journal of Agriculture and Ecology Research InternationalAim: The smallholder dairy industry in Eastern Africa continues to be characterized by seasonality driven milk fluctuations and reproductive performance of dairy cows. In this review, we present important effects of changes in seasons on water, feed quantity and quality, milk yield and reproductive performance of dairy cows in smallholder dairy farms. Methods: We considered peer-reviewed publications from 1990 to 2019, and extracted any information pertaining to the effects and intensity of changes in seasons and implications on water, feed quality and quantity, milk yield and reproductive performance. Results: Seasonal variation in rainfall, characteristic of the East Africa region, is strongly reflected in cropping and feeding calendars. Hence, 305-days lactation milk production per cow in Eastern Africa ranges from 850-3150 kg/cow/year, which has not increased, partly because of lack of improvement in nutrition and management, but also due to slow genetic selection of breeds that matches available feed to milk yield and reproductive performance. High milk fluctuations arise mostly because of farmers’ dependence on rainfall for feed production and rarely make provisions for preserving fodder for the dry season, as there isn’t adequate forage (fodder and pasture) even during the wet season. Conclusion: For the smallholder dairy farmers to remain competitive, it is important to increase the dairy value chain capability to manage implications of changes in seasons on milk yield and reproduction. Therefore, in order to overcome the current seasonal changes, we have discussed technological interventions in adoption of practical, sustainable farmer-led strategies for optimizing water and feed production, milk yield and reproductive performance in Eastern Africa. We have also identified knowledge gaps where research is needed to guide dairy value chain stakeholders on how to ameliorate current seasonal changes or that we expect will occur in the future

Year Round Feed and Fodder Availability in Smallholder Dairy Farms across High and Low Altitude Areas in Eastern Africa

This research article published by the Journal of Experimental Agriculture International, 2020, Volume 42 [Issue 7]Feed-year strategies involve matching the cycles of dairy production with the changing availabilities of all sources of nutrients over time. Therefore, an understanding of seasonal variation in availability of forage resources is important in future planning and development of appropriate technologies to assure resilience of smallholder dairy systems to seasonal changes. This study was carried out to: 1) evaluate the current pattern of seasonal variation in forage availability in smallholder dairy farms, and 2) assess seasonal variation in year-round forage based feeding strategies in smallholder dairy farms in Eastern Africa. Data was collected from a purposive representative sample of 400 smallholder dairy farmers through cross-sectional and observational studies. The Feed Assessment Tool (FEAST) was used to capture the season’s effect (wet and dry) across high and low altitude areas in Kenya and Tanzania from 2016-2018. Data were analyzed using the generalized linear model (GLMM) procedure of SPSS 21.0 (Chicago, IL, USA), using models that included the fixed effects and random effects; and FEAST Version 2.21. Results showed that location (country), agro-ecological zone and season had a significant influence (p ≤ 0.05) on year-round rainfall variability. Availability and utilization of concentrate feeds, green and dry crop residues, improved fodder, pasture and legume forage throughout the year, were significantly influenced (p ≤ 0.05) by location, agro-ecological zone, seasons and production systems. Correlation between the forage resources revealed highly significant (p ≤ 0.001) and positive relationships in availability and usage across the two countries. From this study, rainfall variability was crucial in determining sources and year-round variation in availability and utilization of forages. Therefore, different seasonality driven site, region or country specific year-round feeding interventions and strategies could be applied depending upon type, source, quantity (availability) and quality of feeds to overcome seasonal milk fluctuations in smallholder dairy farms in Eastern Africa

Participatory development of practical, affordable, insecticide-treated mosquito proofing for a range of housing designs in rural southern Tanzania

Background: Insecticidal mosquito-proof netting screens could combine the best features of insecticide-treated nets (ITNs) and indoor residual spraying (IRS), the two most important front line vector control interventions in Africa today, and also overcome the most important limitations of these methods. This study engaged members of a rural Tanzanian community in developing and evaluating simple, affordable and scalable procedures for installing readily available screening materials on eave gaps and windows of their own houses, and then treating those screens with a widely used IRS formulation of the organophosphate insecticide pirimiphos-methyl (PM). Methods: A cohort of 54 households recruited upon consent, following which the structural features and occupant demographics of their houses were surveyed. Indoor mosquito densities were surveyed longitudinally, for approximately 3 months before and over 5 months after participatory house modification and screening using locally available materials. Each house was randomly assigned to one of three study arms: (1) No screens installed until the end of the study (negative control), (2) untreated screens installed, and (3) screened installed and then treated with PM, the insecticidal activity of which was subsequently assessed using standard cone assays. Results: Almost all (52) recruited households participated until the end, at which point all houses had been successfully screened. In most cases, screening was only installed after making enabling structural modifications that were accepted by the enrolled households. Compared to unscreened houses, houses with either treated or untreated screens both almost entirely excluded Anopheles arabiensis (Relative reduction (RR) ≥ 98%, P < < 0.0001), the most abundant local malaria vector. However, screens were far less effective against Culex quinquefasciatus (RR ≤ 46%, P < < 0.0001), a non-malaria vector causing considerable biting nuisance, regardless of their treatment status. While PM did not augment household level protection by screens against either mosquito species (P = 0.676 and 0.831, respectively), 8 months after treatment it still caused 73% and 89% mortality among susceptible insectary-reared Anopheles gambiae following exposures of 3 and 30 min, respectively. Conclusions: Participatory approaches to mosquito proofing houses may be acceptable and effective, and installed screens may be suitable targets for residual insecticide treatments

Use of a molecular bacterial load assay to distinguish between active TB and post-TB lung disease

Authors acknowledge financial support from the EDCTP2 programme supported by the European Union project (grant #: TMA2016SF-1463-REMODELTZ) and DELTAS Africa Initiative (Afrique One-ASPIRE /DEL-15-008). The Afrique One-ASPIRE is funded by a consortium of donors including the African Academy of Sciences, Alliance for Accelerating Excellence in Science in Africa, the New Partnership for Africa's Development Planning and Coordinating Agency, the Wellcome Trust (107753/A/15/Z), and the UK Government. PMM, SKH and SGM were also supported by NIH U01AI115594.Publisher PDFPeer reviewe

Participation in mass dog vaccination campaigns in Tanzania: Benefits of community and public engagement

Background: Canine rabies causes about 59,000 human deaths each year globally but the disease can be eliminated by sustaining sufficient dog vaccination coverage over several consecutive years. A challenge to achieving high coverage is low participation of dog owners in vaccination campaigns. We explored whether and how previously identified contributory factors to low participation can be addressed through community engagement activities. Methods: We engaged communities in two wards in Tanzania on dog behavior and handling, safe ways of interacting with dogs and their perceptions of dog vaccination. We shared and elicited information from them through village meetings, video screenings, posters and leaflets and involved the leadership of one of the wards in planning and implementing a dog vaccination exercise to explore the feasibility of their participation. We assessed the impact of engagement activities with household surveys, meeting reports, observations and focus group discussions. We used a generalized linear mixed-effects model to identify predictors of knowledge and perceptions and compared knowledge amongst respondents before and after engagement activities. Qualitative data was analyzed inductively to explore perceptions of dog handling and vaccination and feasibility, opportunities and barriers to community leadership participation in organizing mass dog vaccination. Main findings: Knowledge of dog behavior, dog handling, and safe ways of interacting with dogs was positively associated with age (p&lt;0.0001), dog ownership (p=0.0203), training (p=0.0010) and previous experience of a dog bite (p=0.0002); and was negatively associated with being afraid of dogs (p=0.0061) and participation in a recent dog vaccination campaign (p=0.0077). Knowledge was low before and significantly improved after engagement activities. The majority (92%) of respondents believed dog vaccination has no negative effects on dogs. Respondents perceived lack of bonding with their dog as a limitation to the ability to restrain a dog for vaccination. The community performed most roles assigned to them in the dog vaccination exercise, but barriers such as lack of motivation for volunteering exist. Conclusion: Engaging communities regularly on dog vaccination can improve their knowledge of dog behavior and dog handling techniques, and may help improve owner participation in dog vaccination campaigns