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

Levels and Correlates of Non-Adherence to WHO Recommended Inter-Birth Intervals in Rufiji, Tanzania.

Poorly spaced pregnancies have been documented worldwide to result in adverse maternal and child health outcomes. The World Health Organization (WHO) recommends a minimum inter-birth interval of 33 months between two consecutive live births in order to reduce the risk of adverse maternal and child health outcomes. However, birth spacing practices in many developing countries, including Tanzania, remain scantly addressed. METHODS: Longitudinal data collected in the Rufiji Health and Demographic Surveillance System (HDSS) from January 1999 to December 2010 were analyzed to investigate birth spacing practices among women of childbearing age. The outcome variable, non-adherence to the minimum inter-birth interval, constituted all inter-birth intervals <33 months long. Inter-birth intervals >=33 months long were considered to be adherent to the recommendation. Chi-Square was used as a test of association between non-adherence and each of the explanatory variables. Factors affecting non-adherence were identified using a multilevel logistic model. Data analysis was conducted using STATA (11) statistical software. RESULTS: A total of 15,373 inter-birth intervals were recorded from 8,980 women aged 15--49 years in Rufiji district over the follow-up period of 11 years. The median inter-birth interval was 33.4 months. Of the 15,373 inter-birth intervals, 48.4% were below the WHO recommended minimum length of 33 months between two live births. Non-adherence was associated with younger maternal age, low maternal education, multiple births of the preceding pregnancy, non-health facility delivery of the preceding birth, being an in-migrant resident, multi-parity and being married. CONCLUSION: Generally, one in every two inter-birth intervals among 15--49 year-old women in Rufiji district is poorly spaced, with significant variations by socio-demographic and behavioral characteristics of mothers and newborns. Maternal, newborn and child health services should be improved with a special emphasis on community- and health facility-based optimum birth spacing education in order to enhance health outcomes of mothers and their babies, especially in rural settings

The gut microbiota: a major player in the toxicity of environmental pollutants?

Exposure to environmental chemicals has been linked to various health disorders, including obesity, type 2 diabetes, cancer and dysregulation of the immune and reproductive systems, whereas the gastrointestinal microbiota critically contributes to a variety of host metabolic and immune functions. We aimed to evaluate the bidirectional relationship between gut bacteria and environmental pollutants and to assess the toxicological relevance of the bacteria–xenobiotic interplay for the host. We examined studies using isolated bacteria, faecal or caecal suspensions—germ-free or antibiotic-treated animals—as well as animals reassociated with a microbiota exposed to environmental chemicals. The literature indicates that gut microbes have an extensive capacity to metabolise environmental chemicals that can be classified in five core enzymatic families (azoreductases, nitroreductases, β-glucuronidases, sulfatases and β-lyases) unequivocally involved in the metabolism of >30 environmental contaminants. There is clear evidence that bacteria-dependent metabolism of pollutants modulates the toxicity for the host. Conversely, environmental contaminants from various chemical families have been shown to alter the composition and/or the metabolic activity of the gastrointestinal bacteria, which may be an important factor contributing to shape an individual’s microbiotype. The physiological consequences of these alterations have not been studied in details but pollutant-induced alterations of the gut bacteria are likely to contribute to their toxicity. In conclusion, there is a body of evidence suggesting that gut microbiota are a major, yet underestimated element that must be considered to fully evaluate the toxicity of environmental contaminants

High Resistance of Plasmodium falciparum to Sulphadoxine/Pyrimethamine in Northern Tanzania and the Emergence of dhps Resistance Mutation at Codon 581

BACKGROUND: Sulphadoxine-pyrimethamine (SP) a widely used treatment for uncomplicated malaria and recommended for intermittent preventive treatment of malaria in pregnancy, is being investigated for intermittent preventive treatment of malaria in infants (IPTi). High levels of drug resistance to SP have been reported from north-eastern Tanzania associated with mutations in parasite genes. This study compared the in vivo efficacy of SP in symptomatic 6-59 month children with uncomplicated malaria and in asymptomatic 2-10 month old infants. METHODOLOGY AND PRINCIPAL FINDINGS: An open label single arm (SP) standard 28 day in vivo WHO antimalarial efficacy protocol was used in 6 to 59 months old symptomatic children and a modified protocol used in 2 to 10 months old asymptomatic infants. Enrolment was stopped early (87 in the symptomatic and 25 in the asymptomatic studies) due to the high failure rate. Molecular markers were examined for recrudescence, re-infection and markers of drug resistance and a review of literature of studies looking for the 581G dhps mutation was carried out. In symptomatic children PCR-corrected early treatment failure was 38.8% (95% CI 26.8-50.8) and total failures by day 28 were 82.2% (95% CI 72.5-92.0). There was no significant difference in treatment failures between asymptomatic and symptomatic children. 96% of samples carried parasites with mutations at codons 51, 59 and 108 in the dhfr gene and 63% carried a double mutation at codons 437 and 540. 55% carried a third mutation with the addition of a mutation at codon 581 in the dhps gene. This triple: triple haplotype maybe associated with earlier treatment failure. CONCLUSION: In northern Tanzania SP is a failed drug for treatment and its utility for prophylaxis is doubtful. The study found a new combination of parasite mutations that maybe associated with increased and earlier failure. TRIAL REGISTRATION: ClinicalTrials.gov NCT00361114

Growing tomato (Lycopersicon esculentum L.) in nematode infested soil and the pest implications in poorly managed post-harvested fields during the dry season in Tanzania

Tanzania Journal of Agricultural Sciences 2015, Vol. 13 (2) :1-7Tomato (Lycopersicon esculentum L.) is an important income generating crop in the semi-arid areas in the Miombo ecosystem in Tabora, Tanzania. Dry season tomato growing is limited by water resource availability and it is therefore cultivated continuously in the same areas with access to water for irrigating the crop. Parasitic root-knot nematodes are a threat to tomato production. In this study, the effect of Procarvian carpensis manure at a rate of 5tons/ha and the balanced NPK inorganic fertilizer at a rate of 100kg/ha on the growth performance of the tomato genotype “Duluti” on a highly root-knot nematode soil was evaluated. The field experiment was laid in a randomized complete block with three replications. More studies were carried out in farmers’ fields to assess the influence of poor management of post-harvested tomato fields as host to crop pest. In the field experiment tomato plants’ vegetative and reproductive parameter data were collected. They were then subjected to analysis of variance using the GENSTAT 14th Edition at a difference declared significance of 5% level. Least significance difference (LSD) was used in means separation. Results show that, the average of 9 fruits/plant harvested in the plots applied with of 5tones/ha of P. carpensis manure is highly significantly (p<0.001) her than 4 fruits per plants in plot with NPK YaraMira cereal. This may reveal that P. carpensis manure improved the growth performance of tomato and increased its tolerance to parasitic nematodes. Substantial infestation of the tomato plants by root-knot nematode grown in the control plots may be the reasons for their failure to flower. Results from the field survey show that red spider mites (Tetranychus evansi: Acaricidae) and mealbugs (Phenacocus manihot: Cydnidae: Hemiptera) and downy mildew were surviving the dry season using tomato plant residues and associated weed species. Tomato production using organic P. carpensis and field sanitation after harvesting may assist in substantial reduction of the root-knot nematode and other crop pest incidences. Furthermore studies involving several rates and sources of organic and inorganic fertilizers and tomato varieties should be conducted in areas with high nematode infestation to come up with better genotype and fertilizer type and combination that will reduce nematode incidences and at the same time improve tomato yield

Growing tomato (Lycopersicon esculentum L.) in nematode infested soil and the pest implications in poorly managed post-harvested fields during the dry season in Tanzania

Tanzania Journal of Agricultural Sciences 2015, Vol. 13 (2) :1-7Tomato (Lycopersicon esculentum L.) is an important income generating crop in the semi-arid areas in the Miombo ecosystem in Tabora, Tanzania. Dry season tomato growing is limited by water resource availability and it is therefore cultivated continuously in the same areas with access to water for irrigating the crop. Parasitic root-knot nematodes are a threat to tomato production. In this study, the effect of Procarvian carpensis manure at a rate of 5tons/ha and the balanced NPK inorganic fertilizer at a rate of 100kg/ha on the growth performance of the tomato genotype “Duluti” on a highly root-knot nematode soil was evaluated. The field experiment was laid in a randomized complete block with three replications. More studies were carried out in farmers’ fields to assess the influence of poor management of post-harvested tomato fields as host to crop pest. In the field experiment tomato plants’ vegetative and reproductive parameter data were collected. They were then subjected to analysis of variance using the GENSTAT 14th Edition at a difference declared significance of 5% level. Least significance difference (LSD) was used in means separation. Results show that, the average of 9 fruits/plant harvested in the plots applied with of 5tones/ha of P. carpensis manure is highly significantly (p<0.001) her than 4 fruits per plants in plot with NPK YaraMira cereal. This may reveal that P. carpensis manure improved the growth performance of tomato and increased its tolerance to parasitic nematodes. Substantial infestation of the tomato plants by root-knot nematode grown in the control plots may be the reasons for their failure to flower. Results from the field survey show that red spider mites (Tetranychus evansi: Acaricidae) and mealbugs (Phenacocus manihot: Cydnidae: Hemiptera) and downy mildew were surviving the dry season using tomato plant residues and associated weed species. Tomato production using organic P. carpensis and field sanitation after harvesting may assist in substantial reduction of the root-knot nematode and other crop pest incidences. Furthermore studies involving several rates and sources of organic and inorganic fertilizers and tomato varieties should be conducted in areas with high nematode infestation to come up with better genotype and fertilizer type and combination that will reduce nematode incidences and at the same time improve tomato yield

Exposure to priority organochlorine contaminants in the Italian general population. Part 2. : fifteen priority polychlorinated biphenyl congeners in blood serum

Concentrations of 36 polychlorinated biphenyl (PCB) congeners were measured in serum of 372 Italian residents of general population living in Novafeltria, Pavia, and Milan. Total PCB level differed significantly between these sites (p < 0.0001) with median concentrations of 836.50, 1354.57, and 2062.08 pmol/g lipid, respectively. However, there is no evidence for the difference in distribution of total PCB levels by genders. Total dioxin-like PCBs differed significantly (p < 0.0001) between the sites (median 109.78, 50.88, and 166.99 pmol/g lipid, respectively) and genders of Novafeltria and Pavia (p = 0.011 and 0.009, respectively). PCB 138, 153, 170, and 180 differed significantly between the places of residence (p < 0.0001) with higher values in Milan population. In the overall population, total PCB and PCB 138, 153, 156, 170, and 180 correlated positively with age (correlations range between 0.320 and 0.569, p < 0.0001). In Novafeltria, the correlations ranged between 0.545 and 0.670, and in Pavia, the correlations ranged between 0.516 and 0.666. In Milan, correlations with age range between 0.327 and 0.417 for total PCB and congeners 138, 153, and 180. With an exception of PCB 170, there was no evidence of significant difference in the distribution of most abundant PCB congeners and total PCB across the body mass index categories