Reduced Cortical Thickness in the Right Caudal Middle Frontal Is Associated With Symptom Severity in Betel Quid-Dependent Chewers.

Background: Findings from brain structural imaging studies on betel quid dependence have supported relations between betel quid chewing and alterations in gray matter volume and white matter integrity. However, the effect of betel quid chewing on cortical thickness and the link between cortical thickness and symptom severity remains unascertained.

Methods: In this observational study, we compared cortical thickness measures from 24 male betel quid-dependent chewers with 27 male healthy controls.

A multivariate pattern analysis of resting-state functional MRI data in Naïve and chronic betel quid chewers.

Betel quid (BQ) is the fourth most commonly consumed psychoactive substance in the world. However, comprehensive functional magnetic resonance imaging (fMRI) studies exploring the neurophysiological mechanism of BQ addiction are lacking. Betel-quid-dependent (BQD) individuals (n = 24) and age-matched healthy controls (HC) (n = 26) underwent fMRI before and after chewing BQ.

Decolonizing Global Health Education: Rethinking Institutional Partnerships and Approaches.

Global health often entails partnerships between institutions in low- and middle-income countries (LMICs) that were previously colonized and high-income countries (HICs) that were colonizers. Little attention has been paid to the legacy of former colonial relationships and the influence they have on global health initiatives. There have been recent calls for the decolonization of global health education and the reexamination of assumptions and practices under pinning global health partnerships.

Sickle cell disease and malaria: decreased exposure and asplenia can modulate the risk from Plasmodium falciparum.

Background: Patients with sickle cell disease (SCD), an inherited haemoglobinopathy, have increased risk of malaria, at least in part due to impaired splenic function. Infection with Plasmodium falciparum in SCD patients can trigger painful vaso-occlusive crisis, increase the severity of anaemia, and contribute to early childhood mortality.

Case Presentation: A 17 year-old Tanzanian male with known SCD was admitted to Muhimbili National Hospital, a tertiary referral centre in Dar-es-Salaam, following an attack of malaria.

Evaluation of residual submicroscopic Plasmodium falciparum parasites 3 days after initiation of treatment with artemisinin-based combination therapy.

Plasmodium falciparum resistance against artemisinin has not emerged in Africa; however, there are reports of the presence of polymerase chain reaction-determined residual submicroscopic parasitaemia detected on day 3 after artemisinin-based combination therapy (ACT). These residual submicroscopic parasites are thought to represent tolerant/resistant parasites against artemisinin, the fast-acting component of the combination. This review focused on residual submicroscopic parasitaemia, what it represents, and its significance on the emergence and spread of artemisinin resistance in Africa.

Acute and Chronic Effects of Betel Quid Chewing on Brain Functional Connectivity.

Background: The active alkaloid in Betel quid is arecoline. Consumption of betel quid is associated with both acute effects and longer-term addictive effects. Despite growing evidence that betel quid use is linked with altered brain function and connectivity, the neurobiology of this psychoactive substance in initial acute chewing, and long-term dependence, is not clear.

Magnitude of Overweight, Obesity and Insufficient Physical Sports Activities Among Secondary School Students in Kinondoni Municipal, Dar es Salaam.

Introduction: There is an overwhelming increase of Non-Communicable Disease worldwide such as diabetes and cardiovascular diseases. Overweight and obesity are highly associated with development of these diseases. Unhealthy lifestyle such as excessive sugar, alcohol intake and lack of adequate physical activities has been associated with development of obesity.

The usefulness of indirect diagnostic tests for Schistosoma haematobium infection after repeated rounds of mass treatment with praziquantel in Mpwapwa and Chakechake districts in Tanzania.

Background: Indirect diagnostic tests are used to assess the disease burden and to monitor the impact of different interventions in areas endemic for urinary schistosomiasis. This study was performed to assess their accuracy in the diagnosis of urinary schistosomiasis among primary school children in low and moderate transmission areas in the districts of Mpwapwa and Chakechake, respectively.

Methods: School children were interviewed regarding their history of haematuria and participation in treatment campaigns.

Glycocalyx breakdown is increased in African children with cerebral and uncomplicated falciparum malaria.

Cerebral malaria (CM) from infection is associated with endothelial dysfunction and parasite sequestration. The glycocalyx (GCX), a carbohydrate-rich layer lining the endothelium, is crucial in vascular homeostasis. To evaluate the role of its loss in the pathogenesis of pediatric CM, we measured GCX degradation in Tanzanian children with World Health Organization-defined CM ( = 55), uncomplicated malaria (UM; = 20), and healthy controls (HCs; = 25).

Anemia among Schoolchildren with Malaria and Soil-Transmitted Helminth Coinfections after Repeated Rounds of Mass Drug Administration in Muheza District, Tanzania.

Coinfections with malaria and soil-transmitted helminths (STHs) has been common among school-aged children in Tanzania. However, after a countrywide scaling up of interventions for malaria and STHs, there are limited data on the prevalence of malaria-STH coinfections and its effect on anemia in schoolchildren in Tanzania. We assessed the distribution and risk factors for malaria, STHs, and malaria-STH coinfections, and its relation to anemia among 445 primary schoolchildren in Muheza district.

Why did I stop? And why did I restart? Perspectives of women lost to follow-up in option B+ HIV care in Dar es Salaam, Tanzania.

Background: Despite an increased uptake of option B+ treatment among HIV- positive pregnant and breastfeeding women, retaining these women in care is still a major challenge. Previous studies have identified factors associated with loss to follow-up (LTFU) in HIV care, however, the perspectives from HIV-positive pregnant and breastfeeding women regarding their LTFU in option B+ needs further exploration. We explored reasons for LTFU and motivation to resume treatment among HIV-positive women initiated in option B+ in an Urban setting.

Diagnostic Performance of Malaria Rapid Diagnostic Test and Microscopy Compared with PCR for Detection of Infections among Primary Schoolchildren in Kibiti District, Eastern Tanzania: An Area with Moderate Malaria Transmission.

A substantial decline of malaria transmission intensity has been observed in sub-Saharan Africa over the past two decades and may affect the diagnostic performance of malaria rapid diagnostic test (mRDT) and microscopy. Diagnostic performance of histidine-rich protein II (HRP-II)/pan-lactate dehydrogenase (pLDH)-based mRDT and microscopy was evaluated against polymerase chain reaction (PCR) for the diagnosis of infection among 316 primary schoolchildren in Kibiti district, in 2016. Polymerase chain reaction detected more cases of infection than mRDT or microscopy.

Pharmaceuticals imports in Tanzania: Overview of private sector market size, share, growth and projected trends to 2021.

Background: To assess the extent to which foreign pharmaceutical imports vary from year to year and identifying leading generic and branded formulations, key countries and key importers of pharmaceuticals in private sector supply chain.

Methodology: A systematic analysis of data for pharmaceutical imports from the Ministry of Health.Data from 2013 to 2016 fiscal years and relevant documents were accessed from the Tanzania Food and Drugs Authority (TFDA).

Smoking cessation on the African continent: Challenges and opportunities.

Tobacco smoking is one of the world's single biggest preventable causes of death. Over 8 million people die each year of a tobacco-related illness - both directly and as a result of second-hand smoke. Combating this epidemic requires commitment from policy makers, healthcare workers and civil society.

Psychological maltreatment and its relationship with self-esteem and psychological stress among adolescents in Tanzania: a community based, cross-sectional study.

Background: Despite the growing recognition of childhood psychological maltreatment as a public health and human rights concern, it remains rampant in developing countries including Tanzania and has a negative impact on the victim's self-esteem during adolescence. There is a lack of published studies in Tanzania that examine the relationship between childhood psychological maltreatment and self-esteem during adolescence. This study describes the relationship between childhood psychological maltreatment and self-esteem and psychological distress among adolescents in Tanzania.

Prevalence of and Risk Factors Associated with Polymerase Chain Reaction-Determined Positivity on Day 3 after Initiation of Artemether-Lumefantrine Treatment for Uncomplicated Malaria in Bagamoyo District, Tanzania.

Prevalence of and risk factors associated with polymerase chain reaction (PCR)-determined positivity were assessed on day 3 after initiation of treatment, pre-implementation and up to 8 years post-deployment of artemether-lumefantrine as first-line treatment for uncomplicated malaria in Bagamoyo district, Tanzania. Samples originated from previously reported trials conducted between 2006 and 2014. Cytochrome b-nested PCR was used to detect malaria parasites from blood samples collected on a filter paper on day 3.

Structural and Functional Alterations in Betel-Quid Chewers: A Systematic Review of Neuroimaging Findings.

A number of neuroimaging studies have investigated structural, metabolic, and functional connectivity changes in betel quid (BQ) chewers. We present a systematic review of neuroimaging studies with emphasis on key brain systems affected by BQ chewing to bring a better understanding on the neuro mechanisms involved in BQD. All BQ neuroimaging studies were identified by searching PubMed, EMBASE, and Google scholar for English articles published until March 2018 using the key words: Betel-quid, resting state, functional MRI, structural MRI, diffusion tensor imaging (DTI), and betel quid dependence basing on the PRISMA criteria.

Kinetic and Cross-Sectional Studies on the Genesis of Hypoargininemia in Severe Pediatric Malaria.

The low bioavailability of nitric oxide (NO) and its precursor, arginine, contributes to the microvascular pathophysiology of severe falciparum malaria. To better characterize the mechanisms underlying hypoargininemia in severe malaria, we measured the plasma concentrations of amino acids involved in arginine synthesis in children with uncomplicated falciparum malaria (UM;  = 61), children with cerebral falciparum malaria (CM;  = 45), and healthy children (HC;  = 109). We also administered primed infusions of l-arginine uniformly labeled with C and N to 8 children with severe falciparum malaria (SM; age range, 4 to 9 years) and 7 healthy children (HC; age range, 4 to 8 years) to measure the metabolic flux of arginine, hypothesizing that arginine flux is increased in SM.

Prevalence and Factors Associated With Hazardous Alcohol Consumption Among Motorcycle Taxi Riders in Kinondoni District, Dar-Es-Salaam, Tanzania: A Cross-Sectional Study.

Background: Hazardous alcohol consumption is a significant public health problem contributing to road traffic accidents in nearly all countries. Despite the fact that motorcycles are involved in more than half of all road traffic accidents in Tanzania, little has been reported about hazardous alcohol consumption among motorcyclists. This study investigated the prevalence and factors associated with hazardous alcohol consumption among motorcycle taxi riders in Kinondoni District, Dar es Salaam.

A qualitative study on the voluntariness of counselling and testing for HIV amongst antenatal clinic attendees: do women have a choice?

Background: Mother-to-child transmission (MTCT) of the Human Immunodeficiency -Virus (HIV) is a serious public health problem, contributing up to 90% of childhood HIV infections. In Tanzania, the prevention-of-mother-to-child-transmission (PMTCT) feature of the HIV programme was rolled out in 2000. The components of PMTCT include counselling and HIV testing directed at antenatal clinic attendees.

Decreased Microvascular Function in Tanzanian Children With Severe and Uncomplicated Falciparum Malaria.

Microvascular function and oxygen consumption affect oxygen homeostasis but have not been assessed in African children with malaria. Microvascular function in Tanzanian children with severe malaria (SM) or uncomplicated malaria were 39% and 72%, respectively, of controls ( < .001).

An anatomical and osteometric study of the femoral sulcus angle in adult Malawians.

Background: Femoral sulcus angle is particularly important in clinical evaluation of patellofemoral joint. Individuals show considerable differences in asymmetrical dimensions of the femur.

Objectives: To determine the size of femoral sulcus angles in adult black Malawians using the skeletal collection in the department of Anatomy, College of Medicine and assess their gender differences; to compare femoral sulcus angles of Malawians with other ethnic groups.

Four artemisinin-based treatments in African pregnant women with malaria.

Background: Information regarding the safety and efficacy of artemisinin combination treatments for malaria in pregnant women is limited, particularly among women who live in sub-Saharan Africa.

Methods: We conducted a multicenter, randomized, open-label trial of treatments for malaria in pregnant women in four African countries. A total of 3428 pregnant women in the second or third trimester who had falciparum malaria (at any parasite density and regardless of symptoms) were treated with artemether-lumefantrine, amodiaquine-artesunate, mefloquine-artesunate, or dihydroartemisinin-piperaquine.

"Experiences with disclosure of HIV-positive status to the infected child": Perspectives of healthcare providers in Dar es Salaam, Tanzania.

Background: The specific age to which an HIV infected child can be disclosed to is stipulated to begin between ages 4 and 6 years. It has also been documented that before disclosure of HIV positive status to the infected child. Health care providers should consider children's cognitive-developmental ability.

Increasing the availability and quality of caesarean section in Tanzania.

Objective: To describe the results of increasing availability and quality of caesarean deliveries and anaesthesia in rural Tanzania.

Design: Before-after intervention study design.

Settings: Rural Tanzania.