Nutritional Status and Other Baseline Predictors of Mortality among HIV-Infected Children Initiating Antiretroviral Therapy in Tanzania

BACKGROUND: We assembled a prospective cohort of 3144 children less than 15 years of age initiating antiretroviral therapy (ART) in Dar es Salaam, Tanzania. METHODS: The relationships of nutritional status and other baseline characteristics in relation to mortality were examined using Cox proportional hazards model. RESULTS: Compared with children with weight for age (WAZ) > -1, those with WAZ ≤ -2 to < -3 had a nearly double risk of death (relative risk [RR], 1.85; 95% confidence interval [CI], 1.10-3.11), and among those with WAZ ≤ -3, the risk more than tripled (RR, 3.36; 95% CI, 2.12-5.32). Other baseline risk factors for overall mortality included severe anemia (P < .001), severe immune suppression (P = .02), history of tuberculosis (P = .01), opportunistic infections (P < .001), living in the poorest district (P < .001), and advanced World Health Organization stage (P = .003). CONCLUSIONS: To sustain the obtained benefit of ART in this setting, interventions to improve nutritional status may be used as an adjunct to ART

Equally Able, But Unequally Accepted: Gender Differentials and Experiences of Community Health Volunteers Promoting Maternal, Newborn, and Child Health in Morogoro Region, Tanzania.

Despite emerging qualitative evidence of gendered community health worker (CHW) experience, few quantitative studies examine CHW gender differentials. The launch of a maternal, newborn, and child health (MNCH) CHW cadre in Morogoro Region, Tanzania enlisting both males and females as CHWs, provides an opportunity to examine potential gender differences in CHW knowledge, health promotion activities and client acceptability. All CHWs who received training from the Integrated MNCH Program between December 2012 and July 2013 in five districts were surveyed and information on health promotion activities undertaken drawn from their registers. CHW socio-demographic characteristics, knowledge, and health promotion activities were analyzed through bi- and multivariate analyses. Composite scores generated across ten knowledge domains were used in ordered logistic regression models to estimate relationships between knowledge scores and predictor variables. Thematic analysis was also undertaken on 60 purposively sampled semi-structured interviews with CHWs, their supervisors, community leaders, and health committee members in 12 villages from three districts. Of all CHWs trained, 97 % were interviewed (n = 228): 55 % male and 45 % female. No significant differences were observed in knowledge by gender after controlling for age, education, date of training, marital status, and assets. Differences in number of home visits and community health education meetings were also not significant by gender. With regards to acceptability, women were more likely to disclose pregnancies earlier to female CHWs, than male CHWs. Men were more comfortable discussing sexual and reproductive concerns with male, than female CHWs. In some cases, CHW home visits were viewed as potentially being for ulterior or adulterous motives, so trust by families had to be built. Respondents reported that working as female-male pairs helped to address some of these dynamics. Male and female CHWs in this study have largely similar knowledge and health promotion outputs, but challenges in acceptance of CHW counseling for reproductive health and home visits by unaccompanied CHWs varied by gender. Programs that pair male and female CHWs may potentially overcome gender issues in CHW acceptance, especially if they change gender norms rather than solely accommodate gender preferences

Effects of elevated copper levels on biological nitrogen fixation and occurrence of rhizobia in a Tanzanian coffee-cropped soil

Journal of Agricultural Science and Applications (J. Agric. Sci. Appl.)A study was conducted to investigate the effects of increasing copper concentration in soil on rhizobial occurrence and the process of biological nitrogen fixation. Two slow-growing bradyrhizobial strains CP, and GM, and two fast-growing rhizobial strains PV, and PV2 were studied by comparing their performance under increasing copper concentrations in greenhouse-based assays involving modified Leonard jar assemblies and potted-soil experiments. Additionally, field samples from soils grown to coffee and subjected to long-term use of copper-based fungicides were analyzed for their total indigenous rhizobial populations using the most probable number-plant infection technique. Results indicated that elevated copper levels in the growth medium had inhibitory effects on nodulation, biological N2 fixation and overall rhizobial numbers in soil. Significant (p= 0.05%) reductions in fresh nodule mass, fresh nodule volume and total shoot nitrogen were recorded when copper concentration was increased from 0 to 100 ppm in both modified Leonard jar assemblies and potted-soil trials. Effective decrements in all the three parameters of fresh nodule mass, fresh nodule volume and total shoot nitrogen were more pronounced with the slow-growing bradyrhizobial strains of CP, and GM, than with the fast-growing PV, and PV2. The MPN-plant infection technique results showed a non-significant (p=0.05) but substantial decrement in rhizobial and bradyrhizobial numbers when the copper-contaminated field soil (82.5 mgCu/g soil) was compared to a control soil (1.8 mgCu/g soil). The study concludes, therefore, that elevated levels of copper in soil could be harmful to free-living rhizobia and their abilities to fix N2 in respective symbiotic associations with legume species. Such negative effects were more pronounced in the slow-growing bradyrhizobial than rhizobial species used

Effects of elevated copper levels on biological nitrogen fixation and occurrence of rhizobia in a Tanzanian coffee-cropped soil

Journal of Agricultural Science and Applications (J. Agric. Sci. Appl.)A study was conducted to investigate the effects of increasing copper concentration in soil on rhizobial occurrence and the process of biological nitrogen fixation. Two slow-growing bradyrhizobial strains CP, and GM, and two fast-growing rhizobial strains PV, and PV2 were studied by comparing their performance under increasing copper concentrations in greenhouse-based assays involving modified Leonard jar assemblies and potted-soil experiments. Additionally, field samples from soils grown to coffee and subjected to long-term use of copper-based fungicides were analyzed for their total indigenous rhizobial populations using the most probable number-plant infection technique. Results indicated that elevated copper levels in the growth medium had inhibitory effects on nodulation, biological N2 fixation and overall rhizobial numbers in soil. Significant (p= 0.05%) reductions in fresh nodule mass, fresh nodule volume and total shoot nitrogen were recorded when copper concentration was increased from 0 to 100 ppm in both modified Leonard jar assemblies and potted-soil trials. Effective decrements in all the three parameters of fresh nodule mass, fresh nodule volume and total shoot nitrogen were more pronounced with the slow-growing bradyrhizobial strains of CP, and GM, than with the fast-growing PV, and PV2. The MPN-plant infection technique results showed a non-significant (p=0.05) but substantial decrement in rhizobial and bradyrhizobial numbers when the copper-contaminated field soil (82.5 mgCu/g soil) was compared to a control soil (1.8 mgCu/g soil). The study concludes, therefore, that elevated levels of copper in soil could be harmful to free-living rhizobia and their abilities to fix N2 in respective symbiotic associations with legume species. Such negative effects were more pronounced in the slow-growing bradyrhizobial than rhizobial species used

Influence of farm yard manure, poultry manure and forest litter on copper solubility in soil and uptake by Phaseohrs vulgaris

Soil Use and Management, December 2014, Vol. 30, page 480-486Long term and intensive use of copper-based fungicides on coffee farms may contaminate soils with copper. The legacy of copper pollution may pose the risk of contaminating food crops cultivated on these soils. A randomized block design field experiment at Kilimanjaro, Tanzania was designed to investigate the effects of different application rates of cattle manure, poultry manure and forest litter on aqua regia, EDTA and CaC12 extractable copper in soils and copper uptake by bean plants grown on this long-term copper-contaminated soil (more than 50 yr of copper application). It was important to examine the potential of the organic amendments in mobilizing or immobilizing copper and assess the risks of contaminating bean crops at a farm, where the application of organic amendments was common practice. At harvest, rhizosphere soils were collected and analysed. The soils were found to have large concentrations of copper, greatly exceeding international standard levels. Poultry manure applied at 40 tons/ha significantly increased CaC12 extractable copper compared with the control treatment. Organic carbon, cation exchange capacity, EDTA extractable copper, aqua regia extractable copper and copper concentrations in bean seeds or leaves were not significantly changed by the organic matter treatments. The concentration of copper was significantly less in bean seeds than in bean leaves (P < 0.01). The bean plants did not take up excessive quantities of copper, and therefore, the risk of copper contamination of bean crops in this farm appears to be small

Copper bioavailability to beans (phaseolus vulgaris) in long-term cu-contaminated soils, uncontaminated soils, and recently cu-spiked soils

Soil and Sediment ContaminationCopper solubility and its bioavailability to Phaseolus vulgaris in long-term coppercontaminated soils, uncontaminated soils, and copper-spiked soils were studied. The role of plant factors, total copper load in soils, and/or the aging effect on the uptake of copper was explored so as to assess health risks through contamination of the food chain associated with growing the crop on such soils. Contaminated soils and clean soils were collected from coffee-growing fields in Kilimanjaro and Arusha, Tanzania. Two bean seeds were sown per pot, replicated three times, and arranged in a randomized design in a glass house. Copper spiking significantly increased extractable copper, as expected. For all of the treatments except for the Mwanga and Arumeru control soils, the addition of CuSO4 did not significantly increase the humic-acid-bound copper, but it significantly increased the fulvic-acid-bound copper (p = 0.05). Moshi soils had significantly higher concentrations of copper in the bean shoots than was the case with other treatments (p = 0.05). For the respective soil types, there was no significant difference in the concentrations of copper in bean leaves between spiked and unspiked treatments (p =0.05). Bean shoots did not accumulate copper beyond the normal concentrations

Copper bioavailability to beans (phaseolus vulgaris) in long-term cu-contaminated soils, uncontaminated soils, and recently cu-spiked soils

Soil and Sediment ContaminationCopper solubility and its bioavailability to Phaseolus vulgaris in long-term coppercontaminated soils, uncontaminated soils, and copper-spiked soils were studied. The role of plant factors, total copper load in soils, and/or the aging effect on the uptake of copper was explored so as to assess health risks through contamination of the food chain associated with growing the crop on such soils. Contaminated soils and clean soils were collected from coffee-growing fields in Kilimanjaro and Arusha, Tanzania. Two bean seeds were sown per pot, replicated three times, and arranged in a randomized design in a glass house. Copper spiking significantly increased extractable copper, as expected. For all of the treatments except for the Mwanga and Arumeru control soils, the addition of CuSO4 did not significantly increase the humic-acid-bound copper, but it significantly increased the fulvic-acid-bound copper (p = 0.05). Moshi soils had significantly higher concentrations of copper in the bean shoots than was the case with other treatments (p = 0.05). For the respective soil types, there was no significant difference in the concentrations of copper in bean leaves between spiked and unspiked treatments (p =0.05). Bean shoots did not accumulate copper beyond the normal concentrations