The silent burden of anaemia in Tanzania children:a community-based study

Objective was to document the prevalence, age-distribution, and risk factors for anaemia in Tanzanian children less than 5 years old,thereby assisting in the development of effective strategies for controlling anaemia.\ud \ud Cluster sampling was used to identify 2417 households at random from four contiguous districts in south-eastern\ud United Republic of Tanzania in mid-1999. Data on various social and medical parameters were collected and analysed.\ud \ud Blood haemoglobin concentrations (Hb) were available for 1979 of the 2131 (93%) children identified and ranged from 1.7 to 18.6 g/dl. Overall, 87% (1722) of children had an Hb <11 g/dl, 39% (775) had an Hb <8 g/dl and 3% (65) had an Hb <5 g/dl. The highest prevalence of anaemia of all three levels was in children aged 6–11 months, of whom 10% (22/226) had an Hb <5 g/dl. However, the prevalence of anaemia was already high in children aged 1–5 months (85% had an Hb <11 g/dl, 42% had an Hb <8 g/dl, and 6% had an Hb <5 g/dl). Anaemia was usually asymptomatic and when symptoms arose they were nonspecific and rarely identified as a serious illness by the care provider. A recent history of treatment with antimalarials and iron\ud was rare. Compliance with vaccinations delivered through the Expanded Programme of Immunization (EPI) was 82% and was notassociated with risk of anaemia.\ud \ud Anaemia is extremely common in south-eastern United Republic of Tanzania, even in very young infants. Further implementation of the Integrated Management of Childhood Illness algorithm should improve the case management of anaemia. However, the asymptomatic nature of most episodes of anaemia highlights the need for preventive strategies. The EPI has good coverage of the target population and it may be an appropriate channel for delivering tools for controlling anaemia and malaria

Varying efficacy of intermittent preventive treatment for malaria in infants in two similar trials: public health implications.

BACKGROUND\ud \ud Intermittent preventive treatment (IPTi) with sulphadoxine-pyrimethamine (SP) in infants resulted in different estimates of clinical malaria protection in two trials that used the same protocol in Ifakara, Tanzania, and Manhiça, Mozambique. Understanding the reasons for the discrepant results will help to elucidate the action mechanism of this intervention, which is essential for rational policy formulation.\ud \ud METHODS\ud \ud A comparative analysis of two IPTi trials that used the same study design, follow-up, intervention, procedures and assessment of outcomes, in Tanzania and Mozambique was undertaken. Children were randomised to receive either SP or placebo administered 3 times alongside routine vaccinations delivered through the Expanded Program on Immunisation (EPI). Characteristics of the two areas and efficacy on clinical malaria after each dose were compared.\ud \ud RESULTS\ud \ud The most relevant difference was in ITN's use ; 68% in Ifakara and zero in Manhiça. In Ifakara, IPTi was associated with a 53% (95% CI 14.0; 74.1) reduction in the risk of clinical malaria between the second and the third dose; during the same period there was no significant effect in Manhiça. Similarly, protection against malaria episodes was maintained in Ifakara during 6 months after dose 3, but no effect of IPTi was observed in Manhiça.\ud \ud CONCLUSION\ud \ud The high ITN coverage in Ifakara is the most likely explanation for the difference in IPTi efficacy on clinical malaria. Combination of IPTi and ITNs may be the most cost-effective tool for malaria control currently available, and needs to be explored in current and future studies.\ud \ud TRIAL REGISTRATION\ud \ud Manhiça study registration number: NCT00209795Ifakara study registration number: NCT88523834

Inter-observer variation in the assessment of clinical signs in sick Tanzanian children

We assessed the inter-observer agreement in identification of a range of 24 clinical signs associated with disease presentation in 327 children aged 0·41) although there was only fair agreement (Kappa-score 0·21-0·40) in the detection of neck stiffness and chest indrawing and slight agreement in the detection of dehydration (Kappa-score 0·199). All objective neurological signs were less reliably assessed in infants than in older children. The difficulties surrounding the diagnosis of impaired consciousness in young children should increase vigilance in the diagnosis and management of neurological complications of illnesses in infanc

An Estimation of the Entomological Inoculation Rate for Ifakara: A Semi-Urban Area in a Region of Intense Malaria Transmission in Tanzania.

An entomological study on vectors of malaria and their relative contribution to Plasmodium falciparum transmission in the semi-urban area of Ifakara, south-eastern Tanzania, was conducted. A total of 32 houses were randomly sampled from the area and light trap catches (LTC) performed in one room in each house every 2 weeks for 1 year. A total of 147 448 mosquitoes were caught from 789 LTC; 26 134 Anopheles gambiae s.l., 615 A. funestus, 718 other anophelines and 119 981 culicines. More than 60% of the total A. gambiae s.l. were found in five (0.6%) LTCs, with a maximum of 5889 caught in a single trap. Of 505 A. gambiae s.l. speciated by polymerase chain reaction, 91.5% were found to be A. arabiensis. Plasmodium falciparum sporozoite enzyme-linked immunosorbent assay tests were performed on 10 108 anopheles mosquitoes and 39 (0.38%) were positive. Entomological inoculation rate (EIR) estimates were generated using a standard method and an alternative method that allows the calculation of confidence intervals based on a negative binomial distribution of sporozoite positive mosquitoes. Overall EIR estimates were similar; 31 vs. 29 [95% confidence interval (CI): 19, 44] infectious bites per annum, respectively. The EIR ranged from 4 (95% CI: 1, 17) in the cool season to 108 (95% CI: 69, 170) in the wet season and from 54 (95% CI: 30, 97) in the east of the town to 15 (95% CI: 8, 30) in the town centre. These estimates show large variations over short distances in time and space. They are all markedly lower than those reported from nearby rural areas and for other parts of Tanzania

Depth differential colonization by mycorrhizal fungi in prairie grasses

Non-Peer ReviewedA research was conducted in field plots to evaluate types of mycorrhizal fungi colonization in monocultures of green needlegrass (G), switch grass (S), western wheatgrass (W), Russian wild rye (R), crested wheatgrass (C) or mixtures of grasses. A root sampling strategy based on different soil depth (0-15, 15-30 and 30-45 cm) revealed a significant effect of depth on root colonization by different types of mycorrhizal fungi, but no significant differences were found between plant communities

Health system redesign for equity in maternal and newborn health must be codesigned, country led, adapted to context and fit for purpose.

No Abstract available. Commen

Grass growth promotion by dark septate endophytic fungi is host specific

Non-Peer ReviewedIsolates of dark septate endophytic fungi (DSE) were obtained from healthy looking roots of two early season grasses [crested wheatgrass (Agropyron cristatum L), Russian wildrye (Elymus junceus Fisch)] and one late season grass [blue gramma (Bouteloua gracilis (Willd. ex Kunth) Lag. ex Griffiths] growing in southwest Saskatchewan. The capacity of some fungal isolates to colonize the roots or to promote the growth of these grasses was tested under controlled conditions. A first study revealed that DSE isolates AC 1 and EJ 5 colonize with more intensity the roots of the grass species from which they were isolated. A second study showed that the ability of each fungal isolate to promote plant growth depended on the plant species inoculated. Inoculation with four out of five isolates reduced B. gracilis growth, but increased the growth of one of the early season grasses. The results indicate that DSE fungal isolates are not species specific colonizers but have a strong preference for certain plant species, and some isolates can promote or depress plant growth depending on specific DSE isolate-grass combinations

Depth differential colonization and biodiversity of mycorrhizal fungi in four prairie grass species

Non-Peer ReviewedThe biodiversity of AMF at different soil depths was studied in pure stands of the grasses crested wheatgrass (Agropyron cristatum (L.) Gaertn.), switchgrass (Panicum virgatum L.), green needlegrass (Nassella viridula Trin.) and western wheatgrass (Pascopyrum smithii (Rydb.) A. Löve), growing in southwest Saskatchewan. The biodiversity of AMF was described in roots from 3 to 15, and 30 to 45 cm depth sampled in 2006 using phylogenetic and molecular tools. Soil depth reduced root colonization and influenced AMF community composition, which was dominated by six AMF phylotypes of the genus Glomus. Three AMF phylotypes were common colonizers and three were preferentially associated with some grasses. AMF communities at different depths differed from each other in all plant stands, and diversity and richness of AMF phylotypes was higher at shallow depth, except in N. viridula which showed higher richness of AMF in deeper root samples. We conclude that although some AMF are general colonizers, some AMF have a strong host preference. Our results also indicate that soil depth is a important driver of AMF phylotype distribution, and suggest the existence of niche specialization in AMF along the soil profile, which is influenced by the host plant

Low-energy three-body charge transfer reactions with Coulomb interaction in the final state

Three-body charge transfer reactions with Coulomb interaction in the final state are considered in the framework of coordinate-space integro-differential Faddeev-Hahn-type equations within two- and six-state close coupling approximations. The method is employed to study direct muon transfer in low-energy collisions of the muonic hydrogen H$_\mu$ by helium (He$^{++}$) and lithium (Li$^{+++}$) nuclei. The experimentally observed isotopic dependence is reproduced.Comment: 14 pages REVTeX, accepted for publication in Journal of Physics