Optimising the Performance of Roundabouts in Dar Es Salaam City

Intersections are one of the major bottlenecks that aggravate congestion in road networks; effective control of which is an important strategy in improving traffic flow. While developing countries have found it hard to adopt sophisticated means of intersection control, they have also not optimised the performance of roundabouts. This paper reviews the  erformance of roundabouts, which have become increasingly popular in recent years, as simple and low cost forms of intersection control. The performance of three major roundabouts in Dar es Salaam has been analysed and results show that roundabouts can accommodate high traffic volumes without causing excessive delays. The results also showthat low-cost improvements on roundabouts, involving minor adjustments in geometry and improved traffic management, can significantly improve their operational performance

The illusion of community ownership: community-based water management in Uchira, Kilimanjaro region

Water resource managementSocial participationWater users’ associationsWater policyWater shortagePricingWater costsWater supplyLabor

The illusion of community ownership: community-based water management in Uchira, Kilimanjaro region

Water resource managementWater governanceSocial participationWater users’ associationsWater policyWater shortagePricingWater costsWater supplyLabor

Strategies for Promoting the Use of Concrete Pavements in Tanzania: Technical and Institutional Considerations

High-type roads in Tanzania have been predominantly of asphaltic concrete construction. This ever enlarging and ageing asphaltic road network represents increasing resource requirements on the road agency in the form of maintenance. Limited resources coupled with the ever sky-rocketing costs of petroleum products and the competing demands of social economic developments, presupposes the need to look for alternative road construction technology that is more cost-effective and resource optimising. Experience gained from developed and some developing countries where concrete pavements have been widely used suggests the potential of this type of pavement in many developingcountries. This paper discusses the technical aspects of design and construction- and maintenance-related aspects of concrete pavements. The discussion extends further to highlight issues pertaining to the performance of concrete pavements and strategies for promoting the use of concrete pavements in Tanzania. Conclusions and recommendationsare made with suggestions on how to start implementing the proposed strategies

Improving the Design of Low Volume Sealed Roads in Tanzania

The main objective of the study was to identify appropriate road designs for Low Volume Sealed Roads (LVSRs) with the aim of improving the design of such roads in Tanzania. The study was conducted in Dar es Salaam and Morogoro regions in Tanzania where data for LVSRs were collected from primary and secondary sources in the two regions. The study found that by using an improved pavement design method specifically meant for LVSRs results in cost savings for LVSRs of up to 51% compared with the conventional method of pavement design in Tanzania. The study recommends that the pavement design method for lightly trafficked sealed roads in southern Africa developed by Transport Research Laboratory, which was found to be most cost-effective, be used to design (or develop a procedure for design of) LVSRs in Tanzania and that the roads be preferably sealed with Otta seal or Surface dressing. The study also recommends that LVSRs in Tanzania be defined by a maximum traffic volume of 400 vpd

Impact of Human Immunodeficiency Virus Infection on the Outcome of Treatment and Survival of Tuberculosis Patients in Mwanza, Tanzania.

Little is known about the outcome of tuberculosis (TB) treatment and subsequent survival of human immunodeficiency virus (HIV) infected patients treated under routine programme conditions in a developing country. We followed a cohort of HIV-positive and HIV-negative tuberculosis patients during therapy and assessed their vital and tuberculosis status 3 years after completion of treatment in Mwanza, Tanzania. Newly diagnosed and relapse tuberculosis cases consecutively registered over a 6-month period were enrolled into an epidemiological study of TB/HIV. Treatment outcome was based on information in tuberculosis treatment registers. Patients surviving treatment were assessed 3 years later by personal interview. Cause of death was determined by verbal autopsy. Of 561 patients enrolled into the study, 505 patients alive at completion of treatment were eligible for assessment at 3 years. Except for mortality, HIV infection was not statistically associated with differing treatment outcomes. At time of follow-up, the overall mortality was 19% and was associated with HIV infection (hazard ratio [hr] 3.7, 95% confidence interval [CI] 2.6-5.2) and age 35 years and over (hr 1.5, 95% CI 1.02-2.1), but not with type of tuberculosis, gender, or initial drug resistance. By life table analysis, probability of survival at 4 years was 35% for HIV-positive patients compared to 90% for HIV-negative patients. Although no relapse cases were diagnosed, verbal autopsy suggested equivalent low rates of relapse in both groups. These results demonstrate the effectiveness of the current approach to the treatment of tuberculosis patients regardless of HIV status. However, HIV-related mortality remains high both during and following completion of treatment, and further studies are needed to determine if this mortality might be reduced by simple interventions which are feasible in developing countries.\u

Impacts of ad-hoc public transport systems provision on the physical (property) development of Dar Es Salaam city.

Paper presented at the 32nd Annual Southern African Transport Conference 8-11 July 2013 "Transport and Sustainable Infrastructure", CSIR International Convention Centre, Pretoria, South Africa.Development of an integrated public transport system is very essential for achievement of social, economic and environmental requirements of the people in the cities worldwide. For African cities, the need is more pronounced since public transport is almost a forgotten sector while the demand for the same is very high. Provision for public transport systems in African cities hardly considers the future socio-economic, physical and technical requirements of the systems despite the fact that the present and the forecasted modal splits for public to private transport put public transport on the higher magnitude. This paper discusses the impacts of developing public transport system on an ad-hoc basis to the city and property development. Findings reveal that ad-hoc implementation of the public transport systems has an insignificant effect on redressing the city public transport problems. It has, instead, negatively impacted the people through loss of their properties by demolition, loss of income through disrupted livelihood activities, and creation of bad relations between the people and the city authority. Other impacts include disruption of the Transit Oriented Development (TOD), existence of improper physical development especially along the major roads and loss of revenue to the government through property tax, business license fees and monthly returns from businesses. Planning and implementing an integrated public transport system that has been accepted by city residents, harmonising the land use and transport related legal provisions and exercising justice in compensation, are among the necessary actions to be taken for achievement of effective public transport systems provision in the city.This paper was transferred from the original CD ROM created for this conference. The material was published using Adobe Acrobat 10.1.0 Technology. The original CD ROM was produced by Document Transformation Technologies Postal Address: PO Box 560 Irene 0062 South Africa. Tel.: +27 12 667 2074 Fax: +27 12 667 2766 E-mail: nigel@doctech URL: http://www.doctech.co.zamv201

Xpert® MTB/RIF assay testing on stool for the diagnosis of paediatric pulmonary TB in Tanzania.

SETTING: Six health facilities in Dar es Salaam, Tanzania. OBJECTIVE: To evaluate the use of stool specimens in the diagnostic workup of paediatric TB using the Xpert® MTB/RIF assay. DESIGN: Between December 2018 and May 2019, we performed a cross-sectional diagnostic study of children aged between 1 month and 14 years with presumptive TB. A single stool specimen was tested using Xpert. The result was compared with the reference microbiological standard for respiratory or gastric specimens tested using Xpert and/or solid culture. The sensitivity, specificity and predictive values of stool Xpert assay were assessed. RESULTS: A total of 225 children with a median age of 2.17 years (IQR 1.16-5.19) were enrolled; 165/225 (73.3%) were aged <5 years. Of 225 children, 8 (3.6%) were diagnosed with TB as they were culture- or Xpert-positive on sputum/gastric aspirate. The stool Xpert assay showed a sensitivity of 62.5% (95% CI 25-92) and specificity of 100% (95% CI 98-100) against the reference standard. CONCLUSION: Use of the Xpert assay on stool specimens had a moderate sensitivity and high specificity in the diagnosis of pulmonary TB in children. Our data adds to the body of evidence for the use of Xpert assay on stool as a non-respiratory specimen to complement conventional methods used to diagnose the disease

A cross-sectional study of factors associated with dog ownership in Tanzania

Background: Mass vaccination of owned domestic dogs is crucial for the control of rabies in sub-Saharan Africa. Knowledge of the proportion of households which own dogs, and of the factors associated with dog ownership, is important for the planning and implementation of rabies awareness and dog vaccination programmes, and for the promotion of responsible dog ownership. This paper reports the results of a cross-sectional study of dog ownership by households in urban and rural communities in the United Republic of Tanzania. Results: Fourteen percent (202) of 1,471 households surveyed were identified as dog-owning, with an average of 2.4 dogs per dog-owning household. The percentage of dog-owning households was highest in inland rural areas (24%) and lowest in coastal urban communities (7%). The overall human: dog ratio was 14: 1. Multivariable logistic regression revealed that households which owned cattle, sheep or goats were much more likely to own dogs than households with no livestock. Muslim households were less likely to own dogs than Christian households, although this effect of religion was not seen among livestock-owning households. Households were more likely to own a dog if the head of the household was male; if they owned a cat; or if they owned poultry. Dog ownership was also broadly associated with larger, wealthier households. Conclusion: The human: dog ratios in Tanzania are similar to those reported elsewhere in sub-Saharan Africa, although cultural and geographic variation is evident. Estimation of the number of owned dogs, and identification of household predictors of dog ownership, will enable targeted planning of rabies control effort

Safety and immunogenicity of H1/IC31®, an adjuvanted TB subunit vaccine, in HIV-infected adults with CD4+ lymphocyte counts greater than 350 cells/mm3: a phase II, multi-centre, double-blind, randomized, placebo-controlled trial.

BACKGROUND: Novel tuberculosis vaccines should be safe, immunogenic, and effective in various population groups, including HIV-infected individuals. In this phase II multi-centre, double-blind, placebo-controlled trial, the safety and immunogenicity of the novel H1/IC31 vaccine, a fusion protein of Ag85B-ESAT-6 (H1) formulated with the adjuvant IC31, was evaluated in HIV-infected adults. METHODS: HIV-infected adults with CD4+ T cell counts >350/mm3 and without evidence of active tuberculosis were enrolled and followed until day 182. H1/IC31 vaccine or placebo was randomly allocated in a 5:1 ratio. The vaccine was administered intramuscularly at day 0 and 56. Safety assessment was based on medical history, clinical examinations, and blood and urine testing. Immunogenicity was determined by a short-term whole blood intracellular cytokine staining assay. RESULTS: 47 of the 48 randomised participants completed both vaccinations. In total, 459 mild or moderate and 2 severe adverse events were reported. There were three serious adverse events in two vaccinees classified as not related to the investigational product. Local injection site reactions were more common in H1/IC31 versus placebo recipients (65.0% vs. 12.5%, p = 0.015). Solicited systemic and unsolicited adverse events were similar by study arm. The baseline CD4+ T cell count and HIV viral load were similar by study arm and remained constant over time. The H1/IC31 vaccine induced a persistent Th1-immune response with predominately TNF-α and IL-2 co-expressing CD4+ T cells, as well as polyfunctional IFN-γ, TNF-α and IL-2 expressing CD4+ T cells. CONCLUSION: H1/IC31 was well tolerated and safe in HIV-infected adults with a CD4+ Lymphocyte count greater than 350 cells/mm3. The vaccine did not have an effect on CD4+ T cell count or HIV-1 viral load. H1/IC31 induced a specific and durable Th1 immune response. TRIAL REGISTRATION: Pan African Clinical Trials Registry (PACTR) PACTR201105000289276