Prevalence and risk factors for HIV among people aged 50 years and older in Rombo district, Northern Tanzania

Background: It is estimated that over ten percent of the 36.7 million people living with HIV (PLWHIV) globally, are those aged ≥50 years. The objective of this study was to determine the prevalence and risk factors for HIV among adult aged 50 years and above in Rombo district, northern Tanzania.Methods: This cross sectional study was conducted from April to June 2015 among older adults aged ≥50 year in Rombo district. Interviews were conducted to collect information on socio-demographic characteristics, reproductive and sexual health characteristics of the participants, knowledge on HIV transmission, prevention and risk perception and on awareness and knowledge on voluntary and counselling testing services. In addition, a blood sample was taken for HIV diagnosis.Results: A total of 600 people were enrolled. Their age ranged from 50 to 90 years with mean of 64.9 (±SD 10.3) years. The HIV prevalence was 1.7% (n=10) and it was higher among women (2.1%) than men (1.3%). Sixty-percent (n=350) were knowledgeable on HIV transmission and only 40% (n=216) on HIV prevention. In bivariate analysis, age of partner <50 years, ever use of condoms, poor knowledge on HIV prevention and perception of risk on HIV were significantly associated with HIV. However, only partner’s age of <50 years remained significant after controlling for confounders.Conclusion: HIV prevalence and overall knowledge on its transmission among older adults in this rural population were low. There is a need for strategies to improve HIV preventive knowledge and testing in this group in order to continue keeping the transmission at low levels

Treatment outcomes of Pumani bubble-CPAP versus oxygen therapy among preterm babies presenting with respiratory distress at a tertiary hospital in Tanzania-Randomised trial.

BackgroundRespiratory distress syndrome (RDS) is the most common respiratory disease in premature babies and the major cause of morbidity and mortality among preterm babies. Effective treatment of these babies requires exogenous surfactant and/or mechanical ventilation but these are of limited availability in low and middle income countries. A cheaper, simpler and more accessible treatment for preterms with RDS called bubble-continuous positive airway pressure (bCPAP) has been reported to be effective in treating RDS in preterm babies with varying levels of effectiveness ranging from 42% to 85%. We aimed to implement and determine the efficacy of bCPAP and its immediate outcomes as compared to oxygen therapy in preterm babies presenting with respiratory distress at a tertiary hospital in Tanzania.MethodA randomized control trial, conducted from December 2016 to May 2017, included all preterm babies admitted at the neonatal care unit presenting with signs of respiratory distress and meeting the inclusion criteria. The primary outcome was survival while the secondary outcomes were treatment duration, duration of hospital stay and treatment complications.ResultsA total of 824 babies were admitted in the neonatal care unit during the study period. Of these, 187 babies were preterm and 48 babies were recruited and randomized (25 bCPAP vs 23 oxygen). The overall survival to discharge for all eligible participants (n = 48) was 58.2% compared to those who adhered to treatment protocol (n = 45, 62.2%). Babies in the bCPAP group had higher survival (17/22; 77.3%) as compared to their counterparts in the oxygen therapy group (11/23; 47.8%). Babies treated with bCPAP had 52% lower risk of death (crude HR 0.48, 95% CI = 0.16-1.43) compared to babies receiving oxygen therapy. The median duration of treatment for babies in the oxygen therapy group was 2 (Range 0-16) days compared to 2 (Range 0-5) days in the bCPAP group. The median duration of hospital stay for babies receiving bCPAP was 14 (range 7-43) days. Nasal bleeding was commonly observed among babies in the bCPAP group as compared to those in the oxygen therapy group.ConclusionThis study revealed that treatment with bCPAP had a 30% clinical improvement in survival to discharge. Our findings highlight the role of bCPAP in reducing neonatal mortality in resource limited settings but further adequately powered studies in this or similar settings are required

Midgut Atresia: Diagnostic and Management Challenges From Northern Tanzania

Intestinal obstruction is one of the most common surgical emergencies in the neonatal period. Early diagnosis is vital for proper management and good outcome. Intestinal obstruction can be divided into high, for example, duodenal atresia and jejunal atresia, or low, for example, ileal atresia, colonic atresia, and Meckel’s diverticulum. The most common cause of intestinal obstruction in neonates is midgut atresia. Surgical correction is needed and is a challenge in the developing countries where there is lack of pediatric surgeons, anesthesiologists, and intensive care. More research and data is also needed across countries to show the uneven distribution of the available resources