Socio-demographic determinants of dengue infection during an outbreak in Dar es Salaam City, Tanzania

AbstractBackground: In recent years, the eastern coast of Africa has witnessed a number of dengue outbreaks. This study was carried out to determine socio-demographic determinants of dengue infection during the 2014 outbreak in Dar es Salaam, Tanzania. Methods: Unmatched case-control analysis of secondary data from a cross-sectional dengue investigation in three districts of Dar es Salaam in June 2014 was conducted. Febrile patients seeking care at health facilities were recruited. Cases were serologically-confirmed dengue-positive while controls were serologically-confirmed dengue-negative patients. A questionnaire was used to collect sociodemographic information. The association between sociodemographic variables and dengue infection was examined using univariate analysis and multivariate logistic regression analysis. Results: A total of 81 cases and 281 controls were included in the analysis. Majority of the cases and controls were males (64.2% versus 54.1%; P=0.137) and were >15 years of age (88.9% versus 72.9%; P =0.003). Living in Kinondoni (aOR = 4.28; 95% CI: 1.74 - 10.53); being employed (aOR = 2.06; 95% CI: 1.06-4.04); having piped water at home (aOR = 2.63; 95% CI: 1.40 - 4.95) and a recent visit of health facility (aOR = 1.94; 95% CI: 1.11 - 3.38) were significantly associated with dengue infection.Conclusions: Dengue infection in Dar es Salaam varied between the three districts and was associated with being employed, having piped water at home and a recent visit to the health facility. These findings provide primary understanding of the influence of socio-demographic factors on dengue and may be used to develop appropriate preventive interventions

Adolescent mental health research in Tanzania: a study protocol for a priority setting exercise and the development of an interinstitutional capacity strengthening programme

INTRODUCTION: Poor adolescent mental health is a barrier to achieving several sustainable development goals in Tanzania, where adolescent mental health infrastructure is weak. This is compounded by a lack of community and policy maker awareness or understanding of its burden, causes and solutions. Research addressing these knowledge gaps is urgently needed. However, capacity for adolescent mental health research in Tanzania remains limited. The existence of a National Institute for Medical Research (NIMR), with a nationwide mandate for research conduct and oversight, presents an opportunity to catalyse activity in this neglected area. Rigorous research priority setting, which includes key stakeholders, can promote efficient use of limited resources and improve both quality and uptake of research by ensuring that it meets the needs of target populations and policy makers. We present a protocol for such a research priority setting study and how it informs the design of an interinstitutional adolescent mental health research capacity strengthening strategy in Tanzania. METHODS AND ANALYSIS: From May 2021, this 6 month mixed-methods study will adapt and merge the James Lind Alliance approach and validated capacity strengthening methodologies to identify priorities for research and research capacity strengthening in adolescent mental health in Tanzania. Specifically, it will use online questionnaires, face-to-face interviews, focus groups, scoping reviews and a consensus meeting to consult expert and adolescent stakeholders. Key evidence-informed priorities will be collaboratively ranked and documented and an integrated strategy to address capacity gaps will be designed to align with the nationwide infrastructure and overall strategy of NIMR. ETHICS AND DISSEMINATION: National and institutional review board approvals were sought and granted from the National Health Research Ethics Committee of the NIMR Medical Research Coordinating Committee (Tanzania) and the Liverpool School of Tropical Medicine (United Kingdom). Results will be disseminated through a national workshop involving all stakeholders, through ongoing collaborations and published commentaries, reviews, policy briefs, webinars and social media

Credit local authors fairly on international research papers

As co-signatories on a consensus statement released this week (see B. Morton et al. Anaesthesia doi: 10.1111/anae.15597; 2021), we call upon all scientific journals to adopt a similar system to promote fairness in author contribution assessments for research conducted in low-to-middle income countries (LMICs) by teams that include author(s) from institutions in high-income countries (HICs). The system consists of a structured reflexivity statement that asks authors to answer a series of open-ended questions that broadly follow established authorship criteria (see www.icmje.org). These help to ensure that LMIC researchers and other disadvantaged groups such as women and early-career researchers are properly represented. Progress in addressing such imbalances has been slow (A. I. Obasi Lancet 396, 651-653; 2020 doi:10.1016/S0140-6736(20)31536-1). For example, a fifth of papers on COVID-19 in Africa contain no African authors and, among those that do, HIC authors almost always occupy the coveted first and last positions (A. V. Naidoo et al. Br. Med. J. Glob Health 6, doi:10.1136/bmjgh-2020-004612; 2021). Such reflexivity statements will encourage inclusive and open discussion of issues affecting equity, including capacity strengthening and research legacy in host countries

The Risk of Dengue Virus Transmission in Dar es Salaam, Tanzania during an Epidemic Period of 2014.

BACKGROUND:In 2010, 2012, 2013 and 2014 dengue outbreaks have been reported in Dar es Salaam, Tanzania. However, there is no comprehensive data on the risk of transmission of dengue in the country. The objective of this study was to assess the risk of transmission of dengue in Dar es Salaam during the 2014 epidemic. METHODOLOGY/PRINCIPAL FINDINGS:This cross-sectional study was conducted in Dar es Salaam, Tanzania during the dengue outbreak of 2014. The study involved Ilala, Kinondoni and Temeke districts. Adult mosquitoes were collected using carbon dioxide-propane powered Mosquito Magnet Liberty Plus traps. In each household compound, water-holding containers were examined for mosquito larvae and pupae. Dengue virus infection of mosquitoes was determined using real-time reverse transcription polymerase chain reaction (qRT-PCR). Partial amplification and sequencing of dengue virus genome in infected mosquitoes was performed. A total of 1,000 adult mosquitoes were collected. Over half (59.9%) of the adult mosquitoes were collected in Kinondoni. Aedes aegypti accounted for 17.2% of the mosquitoes of which 90.6% were from Kinondoni. Of a total of 796 houses inspected, 38.3% had water-holding containers in their premises. Kinondoni had the largest proportion of water-holding containers (57.7%), followed by Temeke (31.4%) and Ilala (23.4%). The most common breeding containers for the Aedes mosquitoes were discarded plastic containers and tires. High Aedes infestation indices were observed for all districts and sites, with a house index of 18.1% in Ilala, 25.5% in Temeke and 35.3% in Kinondoni. The respective container indices were 77.4%, 65.2% and 80.2%. Of the reared larvae and pupae, 5,250 adult mosquitoes emerged, of which 61.9% were Ae. aegypti. Overall, 27 (8.18) of the 330 pools of Ae. aegypti were positive for dengue virus. On average, the overall maximum likelihood estimate (MLE) indicates pooled infection rate of 8.49 per 1,000 mosquitoes (95%CI = 5.72-12.16). There was no significant difference in pooled infection rates between the districts. Dengue viruses in the tested mosquitoes clustered into serotype 2 cosmopolitan genotype. CONCLUSIONS/SIGNIFICANCE:Ae. aegypti is the main vector of dengue in Dar es Salaam and breeds mainly in medium size plastic containers and tires. The Aedes house indices were high, indicating that the three districts were at high risk of dengue transmission. The 2014 dengue outbreak was caused by Dengue virus serotype 2. The high mosquito larval and pupal indices in the area require intensification of vector surveillance along with source reduction and health education

Clinical characteristics and outcomes of confirmed COVID-19 patients in the early months of the pandemic in Tanzania: A multicentre cohort study

Background We performed a prospective cohort study of the clinical presentations and management outcomes of laboratory-confirmed COVID-19 patients in the early months of the pandemic at two hospitals in Dar es Salaam, Tanzania. Methods Between April 1 - May 31, 2020, laboratory-confirmed COVID-19 patients seen at two tertiary facilities were consecutively enrolled in the study and followed up for 21 days. Results We enrolled 121 COVID-19 patients; 112 (92.6%) were admitted while 9 (7.4%) were seen as outpatients. The median (IQR) age of patients was 41 (30-54) years; 72 (59.5%) were male. The medians (IQR) reported days from hospital admission to recovery and death was 10 (6-18) and 5.5 (3-9), respectively. Forty-four (36.4%) patients had at least one underlying condition. Of the 112 admissions, 17 (15.2%) went to ICU, of which 14 (82.3%) died. At the end of follow-up, 93(76.9%) recovered, and 18 (14.9%) died, 7 (5.8%) remained asymptomatic, and 1 (0.8%) was still ill. Overall, 46 (38.3%) patients had at least one underlying condition. Conclusion Three-quarters of all COVID-19 patients were aged less than 60 years, reflecting Africa's young population structure. High admission rates to ICU and death rates were observed

Proceedings for the 31st Annual Joint Scientific Conference of the National Institute for Medical Research (NIMR); 17th-19th May 2022.

Abstract The National Institute for Medical Research (NIMR) was established under the Parliament of the United Republic of Tanzania Act of 1979 (Cap.59. R.E. 2002) and became operational in 1980. It is mandated among other functions, to establish and operate systems of documentation and dissemination of information on any aspect of the medical research carried out by or on behalf of the institute. Since 1982, the Annual Joint Scientific Conference (AJSC) has been an important platform where researchers, policymakers, practitioners, development partners, media and any   other health research stakeholders discuss, and deliberate evidence generated from diverse research conducted across the world. Objectives: The AJSC objectives have always been to; (i) promote health research for sustainable socio-economic development in Tanzania and Sub-Sahara Africa; (ii) share findings of health research with key stakeholders and the general public; and (iii) discuss and explore new health research and service priority areas. The 31st Annual Joint Scientific Conference: It was held from 17th to 19th May 2022 at Julius Nyerere International Convention Center (JNICC) in Dar es Salaam and Hon. Isidor Phillipo Mpango, Vice President, United Republic of Tanzania graced its opening ceremony. The main theme of the Conference was “A Multisectoral Approach for Health: An Agenda for Health Systems Strengthening Towards Achieving Universal Health Coverage.” The conference had nine sub-themes namely non-communicable disease, neglected tropical diseases, emerging and re-emerging infectious diseases, health systems strengthening and health care financing, nutrition, reproductive, maternal, neonatal, child and adolescent health, traditional and alternative medicine, Innovations and health technology, Infectious diseases and anti-microbial resistance and cross-cutting health issues. There were Oral and poster presentations, symposia and round table discussions, dissemination sessions on malaria molecular surveillance and the launch of the Genomics laboratory at NIMR headquarters. The Conference generated evidences and action-oriented recommendations to aid the general practices, assist in formulating policies and provide guidance to disease control programs in subsequent years. &nbsp