Risky Behaviours Among Young People Living with HIV Attending Care and Treatment Clinics in Dar Es Salaam, Tanzania: Implications for Prevention with a Positive Approach.

Introduction: Prevention with a positive approach has been advocated as one of the main strategies to reduce new instances of HIV infection. Risky sexual behaviours among people living with HIV/AIDS are the cornerstone for this approach. Understanding the extent to which infected individuals practice risky behaviours is fundamental in designing appropriate population-specific interventions. With the HIV infection transmission rates remaining high among young people in sub-Saharan Africa, continued prevention among them remains a priority. This study therefore seeks to describe the magnitude and determinants of risky sexual behaviours among young people living with HIV. Methods: A cross-sectional study was conducted between June and July 2010 in selected Care and Treatment Clinics (CTCs) in Dar Es Salaam, Tanzania. A total of 282 HIV-positive patients aged 15-24 were interviewed about their sexual behaviours using a questionnaire. Results: Prevalence of unprotected sex was 40.0% among young males and 37.5% among young females (p<0.001). Multiple sexual partnerships were reported by 10.6% of males and 15.9% of females (p<0.005). More than 50% of the participants did not know about the HIV status of their sexual partners. A large proportion of participants had minimal knowledge of transmission (46.7% males vs. 60.4% females) and prevention (65.3% males vs. 73.4% females) of sexually transmitted infections (STIs). Independent predictors of condom use included non-use of alcohol [adjusted odds ratio (AOR), 0.40 95% confidence interval (CI); 0.17-0.84] and younger age (15-19 years) (AOR, 2.76, 95% CI: 1.05-7.27). Being on antiretroviral therapy (AOR, 0.38, 95% CI: 0.17-0.85) and not knowing partners' HIV sero-status (AOR, 2.62, 95% CI: 1.14-5.10) predicted the practice of multiple sexual partnership. Conclusions: Unprotected sex and multiple sexual partnerships were prevalent among young people living with HIV. Less knowledge on STI and lack of HIV disclosure increased the vulnerability and risk for HIV transmission among young people. Specific intervention measures addressing alcohol consumption, risky sexual behaviours, and STI transmission and prevention knowledge should be integrated in the routine HIV/AIDS care and treatment offered to this age group

Magnitude and factors associated with overweight and obesity among adolescents in in semi-rural area of Babati District, Tanzania

 Background: Childhood and adolescent overweight and obesity have increased dramatically in recent years. We assessed the burden and factors associated with overweight and obesity among adolescents in a semi-rural district of Babati in Tanzania.Methods: A school-based descriptive cross-sectional survey was conducted among adolescents attending secondary schools. Anthropometric measurements were taken using standard procedures. A Food Frequency Questionnaire and the International Physical Activity Questionnaire were adapted to assess dietary and physical activity patterns, respectively.Results: A total of 619 students were included in the analysis. The mean age and body mass index of the respondents were 16.7±1.68 years and 19.9±3.16 kg/m², respectively. The overall prevalence of overweight and obesity was 9.2% with more girls being overweight and obese than boys (P&lt;0.0001). In the Generalized Estimating Equations (GEE) models, girls (Odds Ratio [OR] = 5.6; 95% Confidence Interval [CI]: 1.97, 15.72]); unhealthy diet (OR = 2.2; 95% CI: 1.32, 3.63); vigorous physical activity (OR = 2.2; 95%CI: 1.34, 3.56) and physical inactivity (OR = 1.7; 95%CI: 1.08, 2.79) were independent predictors of overweight or obesity.Conclusion: The prevalence of overweight and obesity was modest. Female sex, unhealthy diet and physical inactivity were significantly predictive. There is a need for interventions in obesity to have a broader target audience to include adolescents and residents of rural areas. Primary preventive interventions are needed.

Food Insecurity is Associated with Food Consumption Patterns and Anthropometric Measures but not Serum Micronutrient Levels in Adults in Rural Tanzania.

The purpose of the present paper is to assess the relationship between food insecurity and food consumption patterns, anthropometric measures and serum micronutrient levels in rural Kilimanjaro, Tanzania. A population-based cross-sectional study was carried out between March and May of 2005. Rural Kilimanjaro, Tanzania. Analysis was restricted to 1014 adults aged 15-44 years with children and complete data. A large majority of the participants (91 %) reported some kind of food insecurity. Food insecurity was significantly associated with age, marital status and occupation. Participants reporting food insecurity were significantly less likely to frequently consume animal products, fruits and vegetables compared with participants categorized as food secure. Women categorized as experiencing individual food insecurity had a larger waist circumference than food-secure women (P = 0.026) while the mean BMI of women appeared to decline if they had a child who was food insecure (P = 0.038). There were no observed differences in serum micronutrient levels by food insecurity status. Food insecurity is highly prevalent and associated with food consumption patterns, waist circumference and BMI of women in rural Tanzania. Further studies should apply self-report measures in assessing food insecurity to larger and more diversified populations

Ecology of Aedes Mosquitoes, the Major Vectors of Arboviruses in Human Population

Aedes aegypti (Stegomyia) has been human vectors for many human diseases globally. In recent years, dengue virus has been diagnosed in different regions such as Asia and Latin America vectored by Aedes spp. mosquitoes. Dengue cases have been reported again in the several parts of African and other continental hospital. The different types of breeding sites have been found to be abundant in both urban and rural areas. The abundance of adult Ae. aegypti and habitat productivity in different settings escalates the risk of dengue transmission if viruses are found in asymptomatic population. The insecticide resistance has been found to occur in the wild population of Aedes aegypti to insecticides commonly used for indoor residual spray and long-lasting insecticidal net treatments. The control of human vector population is still a challenge as the vector has a diurnal feeding and outdoor resting behavior. Environmental management is still the best practice to be adopted in many countries for Aedes aegypti control. The currently discovered dengue vaccine might be an immediate arsenal for the community immunization

Enhancing livestock productivity through feed and feeding interventions in India and Tanzania

Feed interventions often do not work due to the ‘top-down’ approach and blanket promotion irrespective of the context. The MilkIT project’s innovation platforms demonstrated a new way of addressing feed issues. Rapid assessments and the platform discussions ensured producers were strongly engaged in designing and implementing interventions. Participatory action research and training helped to address the problems identified, while the action research centred on introducing improved forages, pasture improvement, reducing feed wastage, feeding adequate rations, and feed conservation. Producers tested different practices, while local researchers monitored the trials. The types of institutions and actors involved in an innovation platform will depend on the particular situation. Innovation platforms may identify issues that a standard research and development approach might not. The entry points will depend on the situation and on the needs of the platform members. It may be important to link interventions to ‘pull factors’ such as markets. As solutions emerge and are tested and accepted, their sustainability must be considered: the trials must be located in the right place, and local communities (and especially women) must have ownership of the process

Immature Spinal Locomotor Output in Children with Cerebral Palsy

Cappellini G, P. Ivanenko Y, Martino G, et al. Immature Spinal Locomotor Output in Children with Cerebral Palsy. Frontiers in Physiology. 2016;7:478

Trends in HIV-1 prevalence and risk behaviours over 15 years in a rural population in Kilimanjaro region of Tanzania

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Fertility Desire and Intention of People Living with HIV/AIDS in Tanzania: A call for Restructuring Care and Treatment Services.

Scaling up of antiretroviral therapy (ART) is currently underway in sub-Saharan Africa including, Tanzania, increasing survival of people living with HIV/AIDS (PLWHA). Programmes pay little attention to PLWHA's reproductive health needs. Information on fertility desire and intention would assist in the integration of sexual and reproductive health in routine care and treatment clinics. A cross-sectional study of all PLWHA aged 15--49 residing in Kahe ward in rural Kilimanjaro Tanzania was conducted. Participants were recruited from the community and a local counselling centre located in the ward. Data on socio-demographic, medical and reproductive characteristics were collected through face-to-face interviews. Data were entered and analysed using STATA statistical software. A total of 410 PLWHA with a mean age of 34.2 and constituting 264 (64.4%) females participated. Fifty-one per cent reported to be married/cohabiting, 73.9% lived with their partners and 60.5% were sexually active. The rate of unprotected sex was 69.0% with 12.5% of women reporting to be pregnant at the time of the survey. Further biological children were desired by 37.1% of the participants and lifetime fertility intention was 2.4 children. Increased fertility desire was associated with living and having sex with a partner, HIV disclosure, good perceived health status and CD4 count >=200 cells for both sexes. Reduced desire was associated with havingmore than 2 children among females, divorce or separation, and having a child with the current partner among both males and females. Fertility desire and intention of PLWHA was substantially high though lower than that of the general population in Tanzania. Practice of unprotected sexual intercourse with higher pregnancy rate was observed. Fertility desire was determined by individual perceived health and socio-family related factors. With increasing ART coverage and subsequent improved quality of life of PLWHA, these findings underscore the importance of integrating reproductive health services in the routine care and treatment of HIV/AIDS worldwide. The results also highlight a group of PLWHA with potentially high desire for children who need to be targeted during care