Survey and Service on STD/HIV/AIDS in Namungo Mines,Lindi Region

Namungo is small-scale mining in Ruangwa district, Lindi Region, with deposits of green gemstone (tsavorite). About 400 men and women are living in temporary settlements. In August 2001, an STD/HIV/AIDS workplace intervention started which comprised of: A baseline KAP study with villagers and miners, A survey on infection rates with Syphilis and HIV, Treatment of patients with STD, An educational campaign and Development of plans for continuos collaboration between the mine and the health system. The KAP-study showed that 81% of respondents knew that sexual intercourse/sex without a condom is the main mode of HIV transmission. 80% correctly started that a person infected with HIV can remain a symptomatic for a long period. Half of them responded to had paid sex with more than one partner during the last 12 mouth. Those reporting having used a condom in the past 3 month were 48%. 92% of the respondents reported willingness for Voluntary Counseling and Testing (VCT) to know their HIV status. From 429 people who had came with symptoms of STDs most were treated for discharge syndrome (40% males,24 females) and for genital ulcers (38% in males and females) Testing and counseling for syphilis and HIV was offered to STD clients and volunteers. Infection rates were high in both groups, STD patients and volunteers with 18% for syphilis and 17% for HIV. The highest prevalence with 38% was found in women 30-34 years of age. The high infection rates, risky behavior and a high mobility of the people involved are a challenge to claim holders, health authorities and communities in the vicinity. Regular interventions urgently needed

Risk factors associated with pre-term birth in Dar es Salaam, Tanzania: a case-control study

Background: Preterm birth remains one of the most serious problems in obstetrics care. Its aetiology is complex and multifactorial. This study was carried out to determine risk factors for preterm birth in Dar es Salaam City in Tanzania.Methods: This case-control study was conducted in three municipal hospitals namely, Amani, Mwananyamala and Temeke in Dar es Salaam. It involved 377 pairs of women with preterm birth (cases) and term birth (controls). Eligible women who agreed to participate and who signed the consent form completed a short interview regarding demographic and lifestyle factors, had their baby examined for maturity, and had their medical records abstracted. All cases and controls were interviewed face-to-face using a specially designed questionnaire. Multivariate logistic regression after controlling for potential confounders was used to measure the strength of associations between preterm birth and related factors.Results: Several significant risk factors associations with pre-term birth were multiple pregnancies (AOR = 8.6; 95%CI 4.5-16.5; p-value <0.001), untreated vaginal discharge (AOR = 5.2; 95%CI 1.1-24.4; p-value 0.034), public prenatal care (AOR = 2.1; 95%CI 1.1-4.1; p-value 0.017), untreated urinary tract infection (AOR = 2.7; 95%CI 1.2-6.1; p-value 0.016), complication during pregnancy (AOR = 2.7; 95%CI 1.3-5.3; p-value 0.004), cervical incompetence (AOR = 11.6; 95%CI 1.1-121.5; p-value 0.04), polyhydramnios (AOR = 8.3; 95%CI 1.7-40.2; p-value 0.008), and lack of antenatal visits  (AOR = 5.1; 95%CI 1.4-17.8; p-value 0.042).Conclusion: This study has identified several risk factors for preterm birth in the city of Dar es Salaam. It is important that planners design community-based interventions to address complications from preterm birth

Nitrogen mineralization dynamics of different valuable organic amendments commonly used in agriculture

Published online: 27 February 2016This is an open access article under the CC BY-NC-ND licenseSustainable agriculture requires the careful optimization of the use of organic amendments to improve soil fertility while minimizing any harmful environmental effects. To understand the events that occur in soil after the addition of different organic amendments, we evaluated the nitrogen (N) mineralization dynamics in soil after adding organic amendments, and evaluated changes in the microbial population. The four organic amendments were fresh dairy cattle manure, fresh white clover, vegetable, fruit, and yard waste compost, and poplar tree compost. The N mineralization potential of each organic amendment was determined by analyzing total mineral nitrogen during a 97-day laboratory incubation experiment. Soils amended with clover released 240 μg N g−1 soil during the 97-day incubation, more than twice as much as that released from soils amended with manure or composts (76–100 μg N g−1 soil). At the end of the incubation, the net N mineralization in clover-amended soils was 54%, more than five times higher than that in soils amended with composts or manure (4%–9%). Nitrogen was mineralized faster in clover-amended soil (1.056 μg N g−1 soil day−1) than in soil amended with composts (0.361–0.417 μg N g−1 soil day−1). The microbial biomass carbon content was higher in clover-amended soil than in the soils amended with manure or composts. We monitored changes in the microbial population in amended soils by a phospholipid fatty acid (PLFA) analysis. On day 97, there were higher concentrations of total PLFAs in soils with organic amendments (e.g., 14.41 nmol g−1 in clover-amended soil) than in control soil without amendments (9.84 nmol g−1). Bacteria (Gram-positive and Gram-negative), actinomycetes, and fungi were more abundant in clover-amended soils than soils amended with manure or composts. The N mineralization potential varied among the four organic amendments. Therefore, the timing of application and the type of organic amendment should be matched to the nutrient needs of the crop

Mobility and Maternal Position during Childbirth in Tanzania: An Exploratory Study at Four Government Hospitals.

Emerging research evidence suggests a potential benefit in being upright in the first stage of labour and a systematic review of trials suggests both benefits and harmful effects associated with being upright in the second stage of labour. Implementing evidence-based obstetric care in African countries with scarce resources is particularly challenging, and requires an understanding of the cumulative nature of science and commitment to applying the most up to date evidence to clinical decisions. In this study, we documented current practice rates, explored the barriers and opportunities to implementing these procedures from the provider perspective, and documented women's preferences and satisfaction with care. This was an exploratory study using quantitative and qualitative methods. Practice rates were determined by exit interviews with a consecutive sample of postnatal women. Provider views were explored using semi-structured interviews (with doctors and traditional birth attendants) and focus group discussions (with midwives). The study was conducted at four government hospitals, two in Dar es Salaam and two in the neighbouring Coast region, Tanzania. MAIN OUTCOME MEASURES: Practice rates for mobility during labour and delivery position; women's experiences, preferences and views about the care provided; and provider views of current practice and barriers and opportunities to evidence-based obstetric practice. Across all study sites more women were mobile at home (15.0%) than in the labour ward (2.9%), but movement was quite restricted at home before women were admitted to labour ward (51.6% chose to rest with little movement). Supine position for delivery was used routinely at all four hospitals; this was consistent with women's preferred choice of position, although very few women are aware of other positions. Qualitative findings suggest obstetricians and midwives favoured confining to bed during the first stage of labour, and supine position for delivery. The barriers to change appear to be complicated and require providers to want to change, and women to be informed of alternative positions during the first stage of labour and delivery. We believe that highlighting the gap between actual practice and current evidence provides a platform for dialogue with providers to evaluate the threats and opportunities for changing practice

Distribution of HPV genotypes in cervical intraepithelial lesions and cervical cancer in Tanzanian women

<p>Abstract</p> <p>Background</p> <p>Infection with human papillomavirus (HPV) is associated with uterine cervical intraepithelial neoplasia (CIN) and invasive cancers (ICC). Approximately 80% of ICC cases are diagnosed in under-developed countries. Vaccine development relies on knowledge of HPV genotypes characteristic of LSIL, HSIL and cancer; however, these genotypes remain poorly characterized in many African countries. To contribute to the characterization of HPV genotypes in Northeastern Tanzania, we recruited 215 women from the Reproductive Health Clinic at Kilimanjaro Christian Medical Centre. Cervical scrapes and biopsies were obtained for cytology and HPV DNA detection.</p> <p>Results</p> <p>79 out of 215 (36.7%) enrolled participants tested positive for HPV DNA, with a large proportion being multiple infections (74%). The prevalence of HPV infection increased with lesion grade (14% in controls, 67% in CIN1 cases and 88% in CIN2-3). Among ICC cases, 89% had detectable HPV. Overall, 31 HPV genotypes were detected; the three most common HPV genotypes among ICC were HPV16, 35 and 45. In addition to these genotypes, co-infection with HPV18, 31, 33, 52, 58, 68 and 82 was found in 91% of ICC. Among women with CIN2-3, HPV53, 58 and 84/83 were the most common. HPV35, 45, 53/58/59 were the most common among CIN1 cases.</p> <p>Conclusions</p> <p>In women with no evidence of cytological abnormalities, the most prevalent genotypes were HPV58 with HPV16, 35, 52, 66 and 73 occurring equally. Although numerical constraints limit inference, findings that 91% of ICC harbor only a small number of HPV genotypes suggests that prevention efforts including vaccine development or adjuvant screening should focus on these genotypes.</p

Associations Between Methylation of Paternally Expressed Gene 3 (PEG3), Cervical Intraepithelial Neoplasia and Invasive Cervical Cancer.

Cytology-based screening for invasive cervical cancer (ICC) lacks sensitivity and specificity to discriminate between cervical intraepithelial neoplasia (CIN) likely to persist or progress from cases likely to resolve. Genome-wide approaches have been used to identify DNA methylation marks associated with CIN persistence or progression. However, associations between DNA methylation marks and CIN or ICC remain weak and inconsistent. Between 2008-2009, we conducted a hospital-based, case-control study among 213 Tanzania women with CIN 1/2/3 or ICC. We collected questionnaire data, biopsies, peripheral blood, cervical scrapes, Human papillomavirus (HPV) and HIV-1 infection status. We assessed PEG3 methylation status by bisulfite pyrosequencing. Multinomial logistic regression was used to estimate odds ratios (OR) and confidence intervals (CI 95%) for associations between PEG3 methylation status and CIN or ICC. After adjusting for age, gravidity, hormonal contraceptive use and HPV infection, a 5% increase in PEG3 DNA methylation was associated with increased risk for ICC (OR = 1.6; 95% CI 1.2-2.1). HPV infection was associated with a higher risk of CIN1-3 (OR = 15.7; 95% CI 5.7-48.6) and ICC (OR = 29.5, 95% CI 6.3-38.4). Infection with high risk HPV was correlated with mean PEG3 differentially methylated regions (DMRs) methylation (r = 0.34 p<0.0001), while the correlation with low risk HPV infection was weaker (r = 0.16 p = 0.047). Although small sample size limits inference, these data support that PEG3 methylation status has potential as a molecular target for inclusion in CIN screening to improve prediction of progression. Impact statement: We present the first evidence that aberrant methylation of the PEG3 DMR is an important co-factor in the development of Invasive cervical carcinoma (ICC), especially among women infected with high risk HPV. Our results show that a five percent increase in DNA methylation of PEG3 is associated with a 1.6-fold increase ICC risk. Suggesting PEG3 methylation status may be useful as a molecular marker for CIN screening to improve prediction of cases likely to progress