Associations between natural resource extraction and incidence of acute and chronic health conditions: evidence from Tanzania

Natural resource extraction projects are often accompanied by complex environmental and social-ecological changes. In this paper, we evaluated the association between commodity extraction and the incidence of diseases. We retrieved council (district)-level outpatient data from all public and private health facilities from the District Health Information System (DHIS2). We combined this information with population data from the 2012 national population census and a geocoded list of resource extraction projects from the Geological Survey of Tanzania (GST). We used Poisson regression with random effects and cluster-robust standard errors to estimate the district-level associations between the presence of three types of commodity extraction (metals, gemstone, and construction materials) and the total number of patients in each disease category in each year. Metal extraction was associated with reduced incidence of several diseases, including chronic diseases (IRR = 0.61, CI: 0.47-0.80), mental health disorders (IRR = 0.66, CI: 0.47-0.92), and undernutrition (IRR = 0.69, CI: 0.55-0.88). Extraction of construction materials was associated with an increased incidence of chronic diseases (IRR = 1.47, CI: 1.15-1.87). This study found that the presence of natural resources commodity extraction is significantly associated with changes in disease-specific patient volumes reported in Tanzania's DHIS2. These associations differed substantially between commodities, with the most protective effects shown from metal extraction

Stigma reduction interventions in people living with HIV to improve health-related quality of life

As the UNAIDS 90-90-90 targets for people living with HIV are increasingly being reached in many contexts, health-related quality of life, the so-called fourth 90, warrants special attention. HIV-related stigma and discrimination are major barriers for overall health-related quality of life despite impressive clinical and virological improvements in HIV care. There is a scarcity of well designed intervention studies that document stigma reduction in people living with HIV and few studies that specifically assess the effect of stigma on health-related quality of life. Further, few interventions target discrimination from providers outside of HIV-specific care or involve people living with HIV in both the design and implementation. Lastly, evidence on methods to reduce stigma in several underepresented key populations and geographical regions is insufficient and research on intersectional stigma (ie, the convergence of multiple stigmatised identities) needs further attention

Allometric models for liana aboveground biomass in old-growth and secondary tropical forests of Tanzania

\ua9 2024 The AuthorsLianas are common in tropical forests, where they influence forest dynamics, thus impacting the global carbon sink, with implications for climate change mitigation. Despite their increasing competitiveness with trees at the global scale, robust measurements of liana aboveground biomass (AGB) have been limited. Here we use data from destructive sampling to develop two separate allometric equations for estimating liana AGB from stem diameter in old-growth (n = 15 lianas) and secondary forests (n = 22 lianas). We compared estimates of AGB using our equations for 3141 lianas (≥ 1 cm diameter) in Tanzania\u27s Kilombero Valley against estimates from previously published equations in other tropical regions. Our equations demonstrated stronger correlations between diameter and destructively measured AGB, than those from previously published equations (R2 = 0.86–0.89, versus R2 = 0.82–0.88). Across all stems, the average stem-level liana AGB estimated using the equation for old-growth forests was 52 % higher than that estimated by the equation for secondary forests, showing that lianas have lower biomass per unit diameter in forests impacted by disturbance. In such forests, liana stems are damaged, deformed, or cannot reach maximum height due to reduced structural support. At the scale of the forest stand, our equations estimated a mean liana AGB of 3.25 Mg ha−1 (95 % Confidence Interval: 1.52–6.96) in old-growth forests and 10.19 Mg ha−1 (5.91–17.64) in secondary forests. These estimates roughly aligned with estimates from other equations, although there was considerable variation. Depending on the equation used, mean stand-level estimates of liana AGB ranged from 2.49–9.76 Mg ha−1 in old-growth forests and 10.19–20.74 Mg ha−1 in secondary forests. Our findings show the variability in liana allometry and AGB with disturbance and successional stage, further underscoring a need for caution when comparing estimates of liana biomass across studies and regions