Spatio-temporal modelling of routine health facility data for malaria risk micro-stratification in mainland Tanzania

As malaria transmission declines, the need to monitor the heterogeneity of malaria risk at finer scales becomes critical to guide community-based targeted interventions. Although routine health facility (HF) data can provide epidemiological evidence at high spatial and temporal resolution, its incomplete nature of information can result in lower administrative units without empirical data. To overcome geographic sparsity of data and its representativeness, geo-spatial models can leverage routine information to predict risk in un-represented areas as well as estimate uncertainty of predictions. Here, a Bayesian spatio-temporal model was applied on malaria test positivity rate (TPR) data for the period 2017-2019 to predict risks at the ward level, the lowest decision-making unit in mainland Tanzania. To quantify the associated uncertainty, the probability of malaria TPR exceeding programmatic threshold was estimated. Results showed a marked spatial heterogeneity in malaria TPR across wards. 17.7 million people resided in areas where malaria TPR was high (>/= 30; 90% certainty) in the North-West and South-East parts of Tanzania. Approximately 11.7 million people lived in areas where malaria TPR was very low (< 5%; 90% certainty). HF data can be used to identify different epidemiological strata and guide malaria interventions at micro-planning units in Tanzania. These data, however, are imperfect in many settings in Africa and often require application of geo-spatial modelling techniques for estimation

The use of routine health facility data for micro-stratification of malaria risk in mainland Tanzania

BACKGROUND: Current efforts to estimate the spatially diverse malaria burden in malaria-endemic countries largely involve the use of epidemiological modelling methods for describing temporal and spatial heterogeneity using sparse interpolated prevalence data from periodic cross-sectional surveys. However, more malaria-endemic countries are beginning to consider local routine data for this purpose. Nevertheless, routine information from health facilities (HFs) remains widely under-utilized despite improved data quality, including increased access to diagnostic testing and the adoption of the electronic District Health Information System (DHIS2). This paper describes the process undertaken in mainland Tanzania using routine data to develop a high-resolution, micro-stratification risk map to guide future malaria control efforts. METHODS: Combinations of various routine malariometric indicators collected from 7098 HFs were assembled across 3065 wards of mainland Tanzania for the period 2017-2019. The reported council-level prevalence classification in school children aged 5-16 years (PfPR(5-16)) was used as a benchmark to define four malaria risk groups. These groups were subsequently used to derive cut-offs for the routine indicators by minimizing misclassifications and maximizing overall agreement. The derived-cutoffs were converted into numbered scores and summed across the three indicators to allocate wards into their overall risk stratum. RESULTS: Of 3065 wards, 353 were assigned to the very low strata (10.5% of the total ward population), 717 to the low strata (28.6% of the population), 525 to the moderate strata (16.2% of the population), and 1470 to the high strata (39.8% of the population). The resulting micro-stratification revealed malaria risk heterogeneity within 80 councils and identified wards that would benefit from community-level focal interventions, such as community-case management, indoor residual spraying and larviciding. CONCLUSION: The micro-stratification approach employed is simple and pragmatic, with potential to be easily adopted by the malaria programme in Tanzania. It makes use of available routine data that are rich in spatial resolution and that can be readily accessed allowing for a stratification of malaria risk below the council level. Such a framework is optimal for supporting evidence-based, decentralized malaria control planning, thereby improving the effectiveness and allocation efficiency of malaria control interventions

Prevalence and correlates of partner violence among adolescent girls and young women: Evidence from baseline data of a cluster randomised trial in Tanzania.

BACKGROUND: Little has been documented about partner violence among adolescent girls and young women (AGYW) who are out of school, a factor associated with HIV acquisition. To understand areas for prioritising HIV prevention intervention efforts, we explored the prevalence and correlates of partner violence among out of school AGYW in Shinyanga, Tanzania. METHODS: A cross-sectional analysis of data from AGYW aged 15-23 years recruited in a cluster randomised trial conducted between October and December 2017 was used to examine correlates of partner violence. Data were collected through an Audio Computer-Assisted Self-interview. Multivariate logistic regression analysis was used to evaluate the association. RESULTS: 2276 (75.5%) AGYW were sexually active. Of these, 816 (35.9%) reported having experienced violence from partners in the last six months. After adjusting for other covariates, being formerly married (AOR = 1.55, 95% CI:1.02, 2.37), having children (AOR = 1.79, 95% CI:1.47, 2.16), anxiety and depression symptoms (AOR = 3.27, 95%CI: 2.15, 4.96), having engaged in sex work in the past six months (AOR = 1.92, 95% CI: 1.45, 2.53) and economic deprivation (AOR = 1.61, 95% CI: 1.34,1.92) were significantly associated with partner violence. CONCLUSIONS: Almost one in three sexually active AGYW had experienced partner violence in the 6 months preceding the survey. The findings underscore the need for future research to focus on understanding the reasons and dynamics underlying high level of partner violence among AGYW. Furthermore, there is a need for implementing intervention programs that aim to reduce economic deprivation among AGYWs and address social norms and structures perpetuating violence against AGYW. TRIAL REGISTRATION: ClinicalTrials.gov-ID NCT03597243

Butterfly Abundance and Diversity in Different Habitat Types in the Usangu Area, Ruaha National Park

Insects are key fauna species that respond quickly to disturbances and environmental changes. They act as good indicators of habitat, community, or ecosystem quality. Among the great diversity of insects, butterflies stand as ideal bio-indicators for ecosystem function and are sensitive to changes in habitat composition and structure. This study was carried out to examine the diversity and abundance of butterflies across the restored habitats in Usangu area part of Ruaha National Park (RUNAPA) from May 2022 to June 2022 using the walking transect method supplemented by sweep nets and butterfly baited traps. A total of six transects of 1 km in length were laid in the four main habitat types selected in Usangu area including grassland, Miombo woodland, Vachellia/Commiphora woodland, and riverine forest. Searches were conducted in the morning and evening. The Miombo woodland and riverine forest habitats exhibited relatively higher species diversity, richness, evenness, abundance, and a higher number of habitat-restricted species, while Vachellia/Commiphora woodland and grassland habitats recorded the lowest diversity and abundance as well as the lowest number of habitat-restricted species. Family Nymphalidae was the most dominant followed by Pieridae while Papilionidae and Hesperiidae were scarce in the study area. This study clearly shows the importance of Miombo woodland and riverine forest habitats in sustaining rich butterfly diversity and abundance in Usangu area. The two habitats must be effectively managed and conserved for sustaining ecological health and integrity of Usangu area. The Usangu area’s Miombo woodland and riverine forest habitats have immense potential for butterfly tourism and they can offer an excellent opportunity to promote conservation efforts and raise public awareness. However, it is crucial to monitor these habitats closely as any environmental changes that may occur could harm the butterfly diversity and abundance in the area. Preserving this wilderness to maintain a thriving butterfly population is of utmost importance

Damage reduces shelf-life of sweetpotato during marketing

Although sweetpotato is primarily grown for home consumption, marketing is becoming increasingly important, and in this case, short shelf-life of the roots is a major constraint. An assessment of the levels of damage of sweetpotatoes when they arrive at urban markets indicated that between 49% and 93% roots exhibited some form of damage. The major types of damage noted were breakages, cuts, infestation by weevils (Cylas spp.), rotting and superficial scuffing. All forms of damage, except superficial scuffing, lead to a shortened shelf-life due to both increased fresh weight loss and rotting. Superficial scuffing increased the rate of rotting but not of weight loss. It was estimated, based on the six cases considered, that the damage resulted in a reduction of shelf-life of between 23% and 47%. Key Words: Ipomoea batatus, post-harvest losses, Tanzania (African Crop Science Journal 2001 9(1): 301-308