"It's his cheerfulness that gives me hope": A qualitative analysis of access to pediatric cancer care in Northern Tanzania.

Pediatric cancer is a significant and growing burden in low- and middle-income countries. The objective of this project was to describe the factors influencing access to pediatric cancer care in Northern Tanzania using the Three Delays Model. This was a cross-sectional qualitative study conducted between June and August 2023 at Kilimanjaro Christian Medical Centre (KCMC).

Mid-level healthcare workers knowledge on non-communicable diseases in Tanzania: a district-level pre-and post-training assessment.

Introduction: Over the past two decades, Tanzania's burden of non-communicable diseases has grown disproportionately, but limited resources are still prioritized. A trained human resource for health is urgently needed to combat these diseases. However, continuous medical education for NCDs is scarce.

Impact of the COVID-19 pandemic in childhood and adolescent cancer care in northern Tanzania: a cross-sectional study.

Introduction: The SARS-CoV-2 (COVID-19) pandemic has strained healthcare systems and presented unique challenges for children requiring cancer care, particularly in low- and middle-income countries. This study aimed to assess the impact of the COVID-19 pandemic on access to cancer care for children and adolescents in Northern Tanzania.

Methods: In this cross-sectional study, we assessed the demographic and clinical characteristics of 547 pediatric and adolescent cancer patients (ages 0-19 years old) between 2016 and 2022 using the population-based Kilimanjaro Cancer Registry (KCR).

Latent tuberculosis in children and youth with type 1 diabetes mellitus in Dar es Salaam, Tanzania: a cross section survey.

Background: Data for latent tuberculosis in patients with type 1 Diabetes in Africa is limited. We assessed the prevalence of latent tuberculosis in youth and children with type 1 Diabetes in Dar es Salaam -Tanzania.

Methods: Our cross-sectional study recruited children and youth with T1DM by stage of puberty, glycaemic control, and age at diagnosis from January to December 2021 in Dar es Salaam.

Metformin for the prevention of diabetes among people with HIV and either impaired fasting glucose or impaired glucose tolerance (prediabetes) in Tanzania: a Phase II randomised placebo-controlled trial.

Aims/hypothesis: In sub-Saharan Africa (SSA), 5% of adults are living with type 2 diabetes and this is rising sharply, with a greater increase among people with HIV. Evidence on the efficacy of prevention strategies in this cohort is scarce. We conducted a Phase II double-blind placebo-controlled trial that aimed to determine the impact of metformin on blood glucose levels among people with prediabetes (defined as impaired fasting glucose [IFG] and/or impaired glucose tolerance [IGT]) and HIV in SSA.

Childhood and Adolescent Cancer Care at a Tertiary Hospital in Northern Tanzania: A Retrospective Study.

Purpose: Over 400,000 children are diagnosed with cancer around the world each year, with over 80% of these children residing in low- and middle-income countries. This study aims to summarize the epidemiology and care patterns of newly diagnosed childhood cancer patients in Northern Tanzania.

Methods: Data from all children and adolescents (age 0-19 years) with newly diagnosed cancers were collected from the Kilimanjaro Cancer Registry located at the Kilimanjaro Christian Medical Centre.

Correlation of C-Peptide With Complications Observed in Children and Adolescents With Type 1 Diabetes in Tanzania: A Cross-Sectional Survey.

Type 1 diabetes mellitus (T1DM) complications corelate with C-peptide levels. However, the C-Peptide role has not been explored in resource limited countries. This study explored the relationship between C-peptide and complications.

Delays in cancer care for children in low-income and middle-income countries: development of a composite vulnerability index.

Background: Early access to diagnosis and care is essential to improve rates of survival from childhood cancer, particularly in low-income and middle-income countries (LMICs). Composite indices are increasingly used to compare country performance in many health fields. We aimed to develop a composite vulnerability index of risk of mortality associated with delays in care for childhood cancer in LMICs, and to compare the vulnerability index scores across countries.

Determinants of delayed childhood cancer care in low- and middle-income countries: A systematic review.

Early access to care is essential to improve survival rates for childhood cancer. This study evaluates the determinants of delays in childhood cancer care in low- and middle-income countries (LMICs) through a systematic review of the literature. We proposed a novel Three-Delay framework specific to childhood cancer in LMICs by summarizing 43 determinants and 24 risk factors of delayed cancer care from 95 studies.

Survival of children and youth with type 1 diabetes mellitus in Tanzania.

Introduction: Survival from type 1 diabetes Mellitus is low in lower-income countries with underdeveloped health systems. Support programs from partners like life for a child (LFAC) and changing diabetes in children (CDiC) were implemented in Tanzania in 2005 to provide diabetes care to children and youth. No evaluation of survival has been done since their implementation.

Aetiology, antimicrobial susceptibility and outcome of children with sepsis, admitted at Muhimbili National Hospital, Dar es Salaam.

Introduction: sepsis is defined as a systemic inflammatory host response syndrome (SIRS) to infection, commonly bacterial. The global prevalence of sepsis is 8.2% with a mortality rate of 25%, whilst in Tanzania the prevalence is 6.

Factors contributing to delayed childhood cancer care in low- and middle-income countries: A systematic review protocol.

Background: Significant disparities exist for timely access to cancer care for children, with the highest disparities in low- and middle-income countries (LMICs). This study aims to conduct a systematic review that identifies the factors contributing to delayed care of childhood cancers in LMICs.

Methods: We will conduct a systematic review with search strings compliant with the PICO framework: (1) the Population-children (aged 0-18 years) from LMICs; (2) the Exposure-factors contributing to timely childhood cancer care; (3) the Outcome-delays in childhood cancer care.

Blastocystis in the faeces of children from six distant countries: prevalence, quantity, subtypes and the relation to the gut bacteriome.

Background: Blastocystis is a human gut symbiont of yet undefined clinical significance. In a set of faecal samples collected from asymptomatic children of six distant populations, we first assessed the community profiles of protist 18S rDNA and then characterized Blastocystis subtypes and tested Blastocystis association with the faecal bacteriome community.

Methods: Stool samples were collected from 244 children and young persons (mean age 11.

Glycemic control and complications of type 1 diabetes among children in Tanzania.

Introduction: Knowledge on Type 1 Diabetes (T1D) in sub-Saharan Africa is scarce. This study aimed at assessing microvascular complications of Type 1 diabetes in young patients.

Method: A retrospective study based on medical recordings from 2010-2016 was done.

Multilingual Global E-Learning Pediatric Endocrinology and Diabetes Curriculum for Front Line Health Care Providers in Resource-Limited Countries: Development Study.

Background: Electronic learning (e-learning) is a widely accessible, low-cost option for learning remotely in various settings that allows interaction between an instructor and a learner.

Objective: We describe the development of a free and globally accessible multilingual e-learning module that provides education material on topics in pediatric endocrinology and diabetes and that is intended for first-line physicians and health workers but also trainees or medical specialists in resource-limited countries.

Methods: As complements to concise chapters, interactive vignettes were constructed, exemplifying clinical issues and pitfalls, with specific attention to the 3 levels of medical health care in resource-limited countries.

Incidence, prevalence and clinical manifestations at onset of juvenile diabetes in Tanzania.

Unlabelled: Better knowledge on incidence, prevalence and clinical manifestations is needed for planning diabetes care in Sub Saharan Africa.

Aims: To find a crude incidence/prevalence of diabetes in children and young adults in a low resource setting, classify the diabetes and audit the health record keeping.

Methods: A retrospective observational study based on medical recordings 2010-2016.

Iron Depletion, Iron Deficiency, and Iron Deficiency Anaemia Among Children Under 5 Years Old in Kilimanjaro, Northern Tanzania: A Hospital-Based Cross-Sectional Study.

Background: Iron depletion results from reduced iron stores, and it is an early stage of disease progression before iron deficiency, which leads to iron deficiency anaemia (IDA). IDA is associated with delayed infant growth and development, diminished cognitive function, poor academic performance, decreased exercise tolerance, and impaired immune function. This study aimed to determine the prevalence of iron depletion and IDA and factors associated with low ferritin levels among children under 5-years-old receiving care at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania.

Insights from the WHO and National Lists of Essential Medicines: Focus on Pediatric Diabetes Care in Africa.

Background: Access to essential medicines in pediatric endocrinology and diabetes is limited in resource-limited countries. The World Health Organization (WHO) maintains two non-binding lists of essential medicines (EMLs) which are often used as a template for developing national EMLs.

Methods: We compared a previously published master list of medicines for pediatric endocrinology and diabetes with the WHO EMLs and national EMLs for countries within the WHO African region.

A care bundle including antenatal corticosteroids reduces preterm infant mortality in Tanzania a low resource country.

Background: Preterm neonatal mortality (NM) has remained high and unchanged for many years in Tanzania, a resource-limited country. Major causes of mortality include birth asphyxia, respiratory insufficiency and infections. Antenatal corticosteroids (ACS) have been shown to significantly reduce mortality in developed countries.

A seven weeks old baby with diabetic ketoacidosis: a case report.

Diabetes mellitus is rare during infancy, however, it should be suspected in infants presenting with features consistent with sepsis and hyperglycemia. This is crucial in initiating the treatment of diabetes ketoacidosis which if delayed may result in significant morbidity and death.

Type 1 diabetes care updates: Tanzania.

Tanzania is located in east Africa with a population of 45 million. The country's population is growing at 2.5% annually.

Management of diabetic ketoacidosis in children and adolescents in sub-Saharan Africa: a review.

Background: Diabetic ketoacidosis (DKA) is a complex metabolic state of hyperglycaemia, ketosis, and acidosis. Diabetes in sub-Saharan Africa is, in many patients a serious disease with a poor prognosis. Most deaths, however, are due to preventable causes.