Severity and Morphological Characteristics of Anaemia Among 6 to 59 Months Old Children in Temeke, Dar es Salaam-Tanzania: Clinics Based Cross Sectional Analysis.

Background: Anaemia is a global public health indicator of both poor nutrition and poor health. Besides, it stands as a silent signal of mal-aligned health system across the entire human lifespan. Globally, the importance of anaemia is most pronounced among children.

Asymptomatic hypoglycemia among preterm newborns: A cross-sectional analysis.

Background: Hypoglycemia is the commonest metabolic abnormality encountered in newborns. Besides, there is a growing body of evidence that links the causes of early neonatal mortality to neonatal hypoglycemia in Tanzania. However exact factors associated with asymptomatic hypoglycemia in preterm newborns are not known.

PCR targeting Plasmodium mitochondrial genome of DNA extracted from dried blood on filter paper compared to whole blood.

Background: Monitoring mortality and morbidity attributable to malaria is paramount to achieve elimination of malaria. Diagnosis of malaria is challenging and PCR is a reliable method for identifying malaria with high sensitivity. However, blood specimen collection and transport can be challenging and obtaining dried blood spots (DBS) on filter paper by finger-prick may have advantages over collecting whole blood by venepuncture.

No asymptomatic malaria parasitaemia found among 108 young children at one health facility in Dar es Salaam, Tanzania.

Background: Asymptomatic malaria parasitaemia has been reported in areas with high malaria transmission. It may serve as a reservoir for continued transmission, and furthermore complicates diagnostics, as not all individuals with a positive malaria test are necessarily ill due to malaria, although they may present with malaria-like symptoms. Asymptomatic malaria increases with age as immunity to malaria gradually develops.

Effect of zinc supplementation on duration of hospitalization in Tanzanian children presenting with acute pneumonia.

Background: Zinc supplementation prevents incident pneumonia in children; however, the effect for pneumonia treatment remains unclear.

Methods: A randomized, double-blind, placebo-controlled trial of zinc supplements (daily 25 mg) adjunct to antibiotic treatment of radiology-confirmed acute pneumonia was conducted among hospitalized children (6-36 months) in Dar es Salaam, Tanzania.

Results: The trial was stopped early due to low enrollment, primarily owing to exclusion of children outside the age range and >3 days of prior illness.

Challenges in diagnosing paediatric malaria in Dar es Salaam, Tanzania.

Background: Malaria is a major cause of paediatric morbidity and mortality. As no clinical features clearly differentiate malaria from other febrile illnesses, and malaria diagnosis is challenged by often lacking laboratory equipment and expertise, overdiagnosis and overtreatment is common.

Methods: Children admitted with fever at the general paediatric wards at Muhimbili National Hospital (MNH), Dar es Salaam, Tanzania from January to June 2009 were recruited consecutively and prospectively.

A randomized trial of multivitamin supplementation in children with tuberculosis in Tanzania.

Background: Children with tuberculosis often have underlying nutritional deficiencies. Multivitamin supplementation has been proposed as a means to enhance the health of these children; however, the efficacy of such an intervention has not been examined adequately.

Methods: 255 children, aged six weeks to five years, with tuberculosis were randomized to receive either a daily multivitamin supplement or a placebo in the first eight weeks of anti-tuberculous therapy in Tanzania.

Burden of disease and barriers to the diagnosis and treatment of group a beta-hemolytic streptococcal pharyngitis for the prevention of rheumatic heart disease in Dar Es Salaam, Tanzania.

To understand patient and clinician attitudes toward Streptococcus pharyngitis and rheumatic heart disease prevention in Tanzania, data from 3 sources were obtained: a survey of 119 clinicians, outpatient rapid test screening, and interviews with 17 rheumatic heart disease patients. Patients do not seek care for sore throat. Clinicians stated that identifying and treating Streptococcus pharyngitis is not prioritized.

Zinc as an adjunct for childhood pneumonia - interpreting early results.

Zinc supplementation has been consistently shown to reduce the incidence of childhood pneumonia, but its effect on the course of pneumonia when administered as an adjunct to antibiotic therapy is still unclear. Three trials published to date have shown mixed results, and a recent trial from India raises the possibility that zinc may be detrimental in some circumstances. Study sites and designs differ, particularly in the timing of zinc treatment and in determining recovery from pneumonia, which can explain the differences in study findings.

Maternal disease stage and child undernutrition in relation to mortality among children born to HIV-infected women in Tanzania.

Objective: To examine whether maternal HIV disease stage during pregnancy and child malnutrition are associated with child mortality.

Design: Prospective cohort study in Tanzania.

Methods: Indicators of disease stage were assessed for 939 HIV-infected women during pregnancy and at delivery, and children's anthropometric status was obtained at scheduled monthly clinic visits after delivery.

Effects of maternal vitamin supplements on malaria in children born to HIV-infected women.

Vitamin deficiencies are frequent in children suffering from malaria. The effects of maternal multivitamin supplementation on the risk of malaria in children are unknown. We examined the impact of providing multivitamins or vitamin A/beta-carotene supplements during pregnancy and lactation to HIV-infected women on their children's risk of malaria up to 2 years of age, in a randomized, placebo-controlled trial.

High rate of fatal cases of pediatric septicemia caused by gram-negative bacteria with extended-spectrum beta-lactamases in Dar es Salaam, Tanzania.

Extended-spectrum beta-lactamases (ESBLs) were present in high proportions of Escherichia coli (25% [9 of 36]) and Klebsiella pneumoniae isolates (17% [9 of 52]) causing pediatric septicemia at a tertiary hospital in Tanzania. Patients with septicemia due to ESBL-producing organisms had a significantly higher fatality rate than those with non-ESBL isolates (71% versus 39%, P = 0.039).

Child mortality in relation to HIV infection, nutritional status, and socio-economic background.

Background: The aims of this study were to examine the impact of child HIV infection on mortality and to identify nutritional and sociodemographic factors that increase the risk of child mortality independent of human immunodeficiency virus (HIV) infection.

Methods: We conducted a prospective study in Dar es Salaam, Tanzania, among 687 children 6-60 months of age who were admitted to hospital with pneumonia. After discharge, children were followed up every 2 weeks during the first year and every 4 months thereafter.

Human immunodeficiency virus infection, diarrheal disease and sociodemographic predictors of child growth.

Aim: To compare growth patterns between human immunodeficiency virus (HIV)-infected and -uninfected preschool children. To examine the associations between diarrheal and respiratory infections, sociodemographic factors and growth.

Methods: A longitudinal study was conducted among 524 children who were 6-60 mo of age at recruitment.

Malaria parasitaemia in relation to HIV status and vitamin A supplementation among pre-school children.

Objectives: To ascertain whether malaria parasitaemia in children is associated with HIV status. To examine the effect of vitamin A supplementation on malaria parasitaemia in children.

Methods: We studied the cross-sectional associations between HIV status and malaria parasitaemia among 546 children 6-60 months of age who participated in a double-blind, randomized clinical trial of vitamin A supplementation.

Vitamin A supplements ameliorate the adverse effect of HIV-1, malaria, and diarrheal infections on child growth.

Objective: Evidence from animal experiments and observational studies in humans suggests that vitamin A plays a fundamental role in physical growth. However, results from vitamin A supplementation trials in children are inconsistent; whereas some did not find an overall effect on growth, others found benefits only among specific groups, including children with low concentrations of serum retinol or short duration of breastfeeding. The apparent lack of an overall effect of vitamin A on growth could be attributed to context-specific distribution of conditions that affect both growth and the response to supplementation, eg, baseline vitamin A status, deficiency of other nutrients (fat, zinc), and the presence of infectious diseases.

Post-transfusion hepatitis C seroprevalence in Tanzanian children.

In Tanzania, children with malaria-associated anaemia are frequently given blood transfusions, and donor blood is not screened for hepatitis C virus (HCV) infection. To determine the seroprevalence of HCV infection in Tanzanian children previously transfused with blood, 184 children (92 transfused, 92 not transfused) aged between 15 and 59 months matched for age and sex were screened for HCV antibodies by the particle agglutination test using Serodia anti-HCV (Fujirebio Inc., Japan).

Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salaam, Tanzania.

Objective: To determine the effect of vitamin A supplementation on the risk of diarrhea and of acute respiratory infection.

Design: Double-blind, randomized, placebo-controlled trial.

Setting: Dar-es-Salaam, Tanzania.

Prevalence of HIV type 1 infection, associated clinical features and mortality among hospitalized children in Dar es Salaam, Tanzania.

The aim of this study was to determine the prevalence of HIV-1 infection, the clinical spectrum of HIV-1-associated conditions and HIV-1-associated mortality among children hospitalized in the medical paediatric wards at Muhimbili Medical Centre (MMC), Dar es Salaam, Tanzania. All children admitted to the medical paediatric wards of MMC between August 1995 and January 1996 were eligible for the study. Testing for HIV antibodies was done using 2 consecutive enzyme linked immunosorbent assays (ELISAs).

A randomized trial of vitamin A supplements in relation to mortality among human immunodeficiency virus-infected and uninfected children in Tanzania.

Objectives: To determine whether vitamin A supplements result in reduced mortality among HIV-infected and uninfected children.

Design: Randomized, double blind, placebo-controlled trial.

Methods: Starting in April, 1993, we randomized 687 children age 6 months to 5 years who were admitted to the hospital with pneumonia.

Vitamin A supplementation and severity of pneumonia in children admitted to the hospital in Dar es Salaam, Tanzania.

Vitamin A deficiency and acute lower respiratory tract infections coexist as important public health problems in many developing countries. We carried out a randomized, double-blind, placebo-controlled trial to examine whether large doses of vitamin A given to Tanzanian children who are admitted to the hospital with nonmeasles pneumonia would reduce the severity of respiratory disease. Six hundred eighty-seven children were randomly assigned to receive either placebo or vitamin A [200 000 IU (60 mg retinol equivalents) for children > 1 y of age and 100000 IU (30 mg retinol equivalents) for infants] on the day of admission and another dose on the following day.