Aggressive Kaposi's Sarcoma in a 6-month-old African infant: Case Report and Review of the Literature.

Kaposi's sarcoma (KS), known to exist in Africa for a century now, was rare in children and unknown in the newborn. With the onset of the HIV/AIDS epidemic, a more aggressive, disseminated type of KS (AKS) was recognized. Recently KS was diagnosed in a 6-month-old infant in Tanzania. Data support the notion that HHSV8 infectivity can be potentiated with HIV infection and thus produce multiple lesions in different anatomical sites early in life. Furthermore, the available evidence would suggest a nonsexual route of HHSV8 infection, possibly from mother to fetus

Gingival Recession, Oral Hygiene and Associated Factors Among Tanzanian Women.

Females are generally more motivated with regard to oral hygiene practices and thus brush their teeth more frequently than males. To determine the prevalence of gingival recession, oral hygiene status, oral hygiene practices and associated factors in women attending a maternity ward in Tanzania. Cross-sectional descriptive study. Maternity ward of Muhimbili National Hospital, Tanzania. Four hundred and forty six women were interviewed on oral hygiene practices and maternal factors, and a full-mouth examination was done to determine the presence of plaque, calculus, gingival bleeding and gingival recession at six sites per tooth. The prevalence of gingival recession (GR) > or =1 mm was 33.6%, calculus 99.3%, plaque 100%, and gingival bleeding 100%. Oral hygiene practices included toothbrushing (98.9%), brushing frequency > or =2 times/day (61.2%), horizontal brushing method (98%), and using a plastic toothbrush (97.8%). Factors that were significantly associated with gingival recession were age (OR = 2.0, 95% CI = 1.3-3.2), presence of calculus (OR(a) = 3.8, 95% CI=2.5-7.1), and gingival bleeding on probing (OR = 4.2, 95% CI = 2.5-7.1). Tooth cleaning practices and maternal factors, especially the number of pregnancies or deliveries were not significantly associated with gingival recession. In this study population, oral hygiene was poor and gingival recession was associated with age, calculus and gingival inflammation rather than with tooth cleaning practices

Articulating the Role of Social Norms in Sustaining Intimate Partner Violence in Mwanza, Tanzania

Background and aims: Intimate partner violence (IPV) has emerged as a serious public health issue that demands global action. While practitioners and researchers in the violence field have long argued that gender-related norms are fundamentally linked to IPV, there is little theoretical understanding of exactly how norms affect violence in practice. Moreover, while norms are central to feminist accounts of violence, there has been little effort to apply social norms theory to the realities of partner violence. This thesis aims to address these gaps by investigating empirically how social norms affect partner violence, using Tanzania as a case study. Methods: In particular, this study employs a qualitative methodology and uses two sources of data – focus group discussions and semi-structured interviews – to generate data on how local people in an urban community in Mwanza, Tanzania describe norms linked to IPV. While the interview guides are structured to probe elements of social norm theory, the questions are open-­‐ended to encourage participants to speak to their own understandings of IPV. Similarly, whereas the study primarily uses social norms theory to interpret its findings, it draws on other bodies of social science theory, such as gender theory, to fully account for how norms perpetuate IPV, as revealed by the data. Findings and conclusion: The study concludes that whereas traditional norms theory offers insights useful for identifying normative influence, it is inadequate for understanding the role of gender norms in catalysing and sustaining IPV. To fill this gap, the study unites disparate bodies of scholarship into a coherent framework for articulating how gender norms affect IPV in low-­‐income countries contextually similar to Tanzania. Because such a framework is embedded in empirical realities, it also has utility for donors and programmers wishing to employ it to design and evaluate programmes aimed at transforming gender discriminatory norms that sustain IPV in similar settings

Predictors of Stunting, Wasting and Underweight among Tanzanian Children Born to HIV-Infected Women.

Children born to human immunodeficiency virus (HIV)-infected women are susceptible to undernutrition, but modifiable risk factors and the time course of the development of undernutrition have not been well characterized. The objective of this study was to identify maternal, socioeconomic and child characteristics that are associated with stunting, wasting and underweight among Tanzanian children born to HIV-infected mothers, followed from 6 weeks of age for 24 months. Maternal and socioeconomic characteristics were recorded during pregnancy, data pertaining to the infant's birth were collected immediately after delivery, morbidity histories and anthropometric measurements were performed monthly. Multivariate Cox proportional hazards methods were used to assess the association between potential predictors and the time to first episode of stunting, wasting and underweight. A total of 2387 infants (54.0% male) were enrolled and followed for a median duration of 21.2 months. The respective prevalence of prematurity (<37 weeks) and low birth weight (<2500 g) was 15.2% and 7.0%; 11.3% of infants were HIV-positive at 6 weeks. Median time to first episode of stunting, wasting and underweight was 8.7, 7.2 and 7.0 months, respectively. Low maternal education, few household possessions, low infant birth weight, child HIV infection and male sex were all independent predictors of stunting, wasting and underweight. In addition, preterm infants were more likely to become wasted and underweight, whereas those with a low Apgar score at birth were more likely to become stunted. Interventions to improve maternal education and nutritional status, reduce mother-to-child transmission of HIV, and increase birth weight may lower the risk of undernutrition among children born to HIV-infected women

Immune targets for therapeutic development in depression: towards precision medicine.

Over the past two decades, compelling evidence has emerged indicating that immune mechanisms can contribute to the pathogenesis of major depressive disorder (MDD) and that drugs with primary immune targets can improve depressive symptoms. Patients with MDD are heterogeneous with respect to symptoms, treatment responses and biological correlates. Defining a narrower patient group based on biology could increase the treatment response rates in certain subgroups: a major advance in clinical psychiatry. For example, patients with MDD and elevated pro-inflammatory biomarkers are less likely to respond to conventional antidepressant drugs, but novel immune-based therapeutics could potentially address their unmet clinical needs. This article outlines a framework for developing drugs targeting a novel patient subtype within MDD and reviews the current state of neuroimmune drug development for mood disorders. We discuss evidence for a causal role of immune mechanisms in the pathogenesis of depression, together with targets under investigation in randomized controlled trials, biomarker evidence elucidating the link to neural mechanisms, biological and phenotypic patient selection strategies, and the unmet clinical need among patients with MDD.Johnson and Johnso

Neighbourhoods as relational places for people living with dementia

An increase in the number of people living independently with dementia across the developed world has focused attention on the relevance of neighbourhood context for enabling or facilitating social health and wellbeing. Taking the lived experiences and daily realities of people living with dementia as a starting point, this paper contributes new understanding about the relevance of local places for supporting those living with the condition in the community. The paper outlines findings from a study of the neighbourhood experiences, drawing on new data collected from a creative blend of qualitatively-driven mixed methods with people living in a diverse array of settings across three international settings. The paper details some of the implications of neighbourhoods as sites of social connection for those living with dementia from material from 67 people living with dementia and 62 nominated care-partners. It demonstrates how neighbourhoods are experienced as relational places and considers how people living with dementia contribute to the production of such places through engagement and interactions in ways that may be beneficial to social health. We contend that research has rarely focused on the subjective, experiential and ‘everyday’ social practices that contextualise neighbourhood life for people living with dementia. In doing so, the paper extends empirical and conceptual understanding of the relevance of neighbourhoods as sites of connection, interaction, and social engagement for people living with dementia