Community benefits of mass distribution of three types of dual-active-ingredient long-lasting insecticidal nets against malaria prevalence in Tanzania: evidence from a 3-year cluster-randomized controlled trial.

Background: Long-lasting insecticidal nets (LLINs) were once fully effective for the prevention of malaria; however, mosquitoes have developed resistance to pyrethroids, the main class of insecticides used on nets. Dual active ingredient LLINs (dual-AI LLINs) have been rolled out as an alternative to pyrethroid (PY)-only LLINs to counteract this. Understanding the minimum community usage at which these LLINs elicit an effect that also benefits non-users against malaria infection is important.

Genetic diversity of Plasmodium falciparum reticulocyte binding protein homologue-5, which is a potential malaria vaccine candidate: baseline data from areas of varying malaria endemicity in Mainland Tanzania.

Background: The limited efficacy of the two recently approved malaria vaccines, RTS,S/AS01 and R21/Matrix- M™, highlights the need for alternative vaccine candidate genes. Plasmodium falciparum Reticulocyte Binding Protein Homologue 5 (Pfrh5) is a promising malaria vaccine candidate, given its limited polymorphism, its essential role in parasite survival, a lack of immune selection pressure and higher efficacy against multiple parasites strains. This study evaluated the genetic diversity of Pfrh5 gene among parasites from regions with varying malaria transmission intensities in Mainland Tanzania, to generate baseline data for this potential malaria vaccine candidate.

Prevalence and drivers of malaria infection among asymptomatic and symptomatic community members in five regions with varying transmission intensity in mainland Tanzania.

Background: Despite implementation of effective interventions in the past two decades, malaria is still a major public health problem in Tanzania. This study assessed the prevalence and drivers of malaria infections among symptomatic and asymptomatic members of selected communities from five regions with varying endemicity in mainland Tanzania.

Methods: A cross-sectional community survey was conducted in five districts, including one district/region in Kagera, Kigoma, Njombe, Ruvuma and Tanga from July to August 2023.

Extensive Inactive Neurocysticercosis: A Case Report in Mbeya, Southern Highlands of Tanzania.

Background: Neurocysticercosis (NCC) and Acquired Human Immunodeficiency Syndrome (AIDS) are both highly prevalent in Africa. Clinical presentation of NCC ranges from asymptomatic to manifestations, including epileptic seizures, severe progressive headache, and focal neurological deficits. It is influenced by the number, size, location, and stage of the cysts, as well as the parasite's potential to cause inflammation and the immunological response of the host.

Scaling up of parenting support to prevent violence against children in Tanzania: insights from policymakers and service providers.

Background: Evidence shows that parenting behaviours, including the use of violent discipline, can be changed through programmatic interventions. This study seeks to examine how policymakers and service providers in Tanzania perceive the provision of parenting support as a strategy to prevent violence against children and what the enabling and hindering factors are for the scale-up of existing evidence-based parenting supports. It does this by applying Daly's analytical framework for parenting support.

HIV and CKD in the Tenofovir Era: A Prospective Parallel-Group Cohort Study From Tanzania.

Rationale & Objective: Longitudinal research on chronic kidney disease (CKD) in sub-Saharan Africa is sparse, especially among people living with HIV (PLWH). We evaluated the incidence of CKD among PLWH compared with HIV-uninfected controls in Tanzania.

Study Design: Prospective cohort study.

A scoping review on peer-led interventions to improve youth mental health in low- and middle-income countries.

Youth living in low- and middle-income countries (LMICs) have an increased vulnerability to mental illnesses, with many lacking access to adequate treatment. There has been a growing body of interventions using task sharing with trained peer leaders to address this mental health gap. This scoping review examines the characteristics, effectiveness, components of peer delivery and challenges of peer-led mental health interventions for youth aged 10-24 in LMICs.

Associations between dietary patterns and intestinal inflammation among HIV-infected and uninfected adults: A cross-sectional study in Tanzania.

The increased burden of non-communicable diseases (NCDs) is fueled by lifestyle factors including diet. This cross-sectional study explored among Tanzanian adults whether unhealthy dietary patterns are associated with intestinal and systemic inflammation which could increase the risk of NCDs. The study included 574 participants, with both diet and inflammatory markers data.

Challenges and motivating factors for integrating geostatistical models in targeted schistosomiasis control: A qualitative case study in Northwestern Tanzania.

Introduction: To address problems of over- and under-treatment with preventive chemotherapy resulting in ongoing transmission of schistosomiasis, the World Health Organization (WHO) recommends targeted mass drug administration (MDA) interventions at a sub-district level. In Tanzania, the lack of sub-district (ward) prevalence data has inhibited a transition to targeted treatment. Model-based prevalence estimation combined with routine surveillance data can be used to overcome this gap.

Global, regional, and national survey on burden and Quality of Care Index (QCI) of orofacial clefts: Global burden of disease systematic analysis 1990-2019.

Background: Orofacial clefts are the most common craniofacial anomalies that include a variety of conditions affecting the lips and oral cavity. They remain a significant global public health challenge. Despite this, the quality of care for orofacial clefts has not been investigated at global and country levels.

"Ashamed of being seen in an HIV clinic": a qualitative analysis of barriers to engaging in HIV care from the perspectives of patients and healthcare workers in the Daraja clinical trial.

Background: There is high post-hospital discharge mortality among persons with HIV who are hospitalized, and post-hospital survival is strongly associated with early HIV clinic linkage, clinic attendance, and antiretroviral therapy adherence. The Daraja intervention, a context-tailored case management strategy implemented and tested through a randomized trial in Tanzania, was associated with improved HIV clinic linkage, retention, and ART initiation and adherence.

Methods: We conducted in-depth interviews (IDIs) in a sub-sample of 40 study participants (20 control and 20 intervention) 12 months after enrollment into the trial to gain an in-depth understanding of the barriers to HIV care engagement and the perceived mechanisms through which the Daraja intervention impacted these barriers.

N-acetylcysteine modulates markers of oxidation, inflammation and infection in tuberculosis.

Background: Half the global tuberculosis health burden is due to post-tuberculosis lung disease. Host-directed therapies have been proposed to reduce this burden. N-acetylcysteine (NAC) provides the conditionally essential amino acid cysteine required for synthesis of glutathione, an antioxidant thiol.

Prevalence, Distribution and Risk Factors for Trematode Infections in Domesticated Ruminants in the Lake Victoria and Southern Highland Ecological Zones of Tanzania: A Cross-Sectional Study.

Trematode infections cause long-term suffering and debilitation, posing a significant threat to global animal health and production and leading to considerable economic losses. Studies on the epidemiology and control of these infections in Tanzania are limited. The few available studies have been conducted in abattoir settings.

Pyrethroid-resistant malaria vector Anopheles gambiae restored susceptibility after pre-exposure to piperonyl-butoxide: results from country-wide insecticide resistance monitoring in Tanzania, 2023.

Background: Effective vector control interventions, notably insecticide-treated nets (ITNs) and indoor residual spraying (IRS) are indispensable for malaria control in Tanzania and elsewhere. However, the emergence of widespread insecticide resistance threatens the efficacy of these interventions. Monitoring of insecticide resistance is, therefore, critical for the selection and assessment of the programmatic impact of insecticide-based interventions.

Pregnancy and neonatal outcomes in Eastern Democratic Republic of the Congo: a systematic review.

Background: Conflict is known to impact maternal and neonatal health in Eastern Democratic Republic of the Congo (DRC), an area of longstanding insecurity. We conducted a systematic review on pregnancy and neonatal outcomes in this region to provide a comprehensive overview of maternal and neonatal outcomes over a 20-year period.

Methods: We systematically searched databases, such as Medline, EMBASE, Global Health, ClinicalTrials.

Dose-volume predictors of cardiac adverse events after high-dose thoracic radiation therapy for lung cancer: a systematic review and meta-analysis.

Background: Lung cancer is a leading cause of cancer mortality and may require high-dose thoracic radiation therapy (RT). However, RT significantly increases the risk of radiation-induced cardiac events, such as pericarditis, cardiomyopathy, and ischemic heart diseases. Despite evidence from clinical trials showing that higher RT doses are associated with poorer survival outcomes due to these cardiac effects, data on dose-volume predictors of such events in lung cancer remain sparse.

Community-based epilepsy care in an onchocerciasis-endemic area: A 3-year cohort study in Mahenge, Tanzania.

Objective: In onchocerciasis-endemic areas, limited access to antiseizure medications (ASMs) contributes to a high epilepsy burden. This study evaluated the impact of a community-based epilepsy care program in Mahenge, Tanzania, an onchocerciasis-endemic area with high epilepsy prevalence.

Methods: A baseline survey (2017-2018) identified persons with epilepsy (PWE) in four rural villages.

Optimizing delivery strategies for 3HP TB preventive treatment in Tanzania: A qualitative study on acceptability of family approach in HIV care and treatment centers.

Tanzania rolled-out a 12-dose, weekly regimen of isoniazid plus rifapentine (3HP) TB preventive treatment in January 2024. The 3HP completion rate is generally ≥80%, varying by delivery strategy and programmatic setting. Before the roll-out, a mixed methods study was conducted to assess whether a family approach involving family member support, SMS reminders, and three health education sessions was acceptable and optimized 3HP uptake and completion.

Dihydroartemisinin-piperaquine versus sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy: a systematic review and individual participant data meta-analysis.

Background: High-grade resistance to sulfadoxine-pyrimethamine in East and Southern Africa has prompted numerous trials evaluating intermittent preventive treatment in pregnancy (IPTp) with dihydroartemisinin-piperaquine as an alternative to sulfadoxine-pyrimethamine.

Methods: We conducted individual participant data meta-analyses of randomised trials comparing IPTp with dihydroartemisinin-piperaquine to sulfadoxine-pyrimethamine on maternal, birth, and infant outcomes. We searched the WHO International Clinical Trials Registry Platform, ClinicalTrials.

Male social embeddedness and intimate partner violence perpetration in Tanzania: A cross-sectional study of young Tanzanian men.

Objectives: Social embeddedness - or lack thereof - has been associated with a number of antisocial behaviours, including perpetration of intimate partner violence (IPV). The prevalence of IPV in Tanzania remains high, yet the influence of perceived social connection on IPV and coercive control perpetration in young African men has remained mostly unexplored.

Methods: We conducted a cross-sectional survey among 1,002 young Tanzanian men aged 18 to 24 living in Mwanza, Tanzania.

Management of possible serious bacterial infections in young infants where referral is not possible in the context of existing health system structure in Mbeya, Tanzania: Experience and lessons from the end line assessment.

Severe bacterial infections (SBIs) are a leading cause of neonatal deaths in low- and middle-income countries. World Health Organization's (WHO's) guideline for outpatient management of danger signs indicating possible serious bacterial infections (PSBI) when referral is not possible was adopted by three pilot district councils in Mbeya Region, in Tanzania (Busekelo, Kyela and Mbarali Districts) in 2018 (the PSBI project). This study documented changes in practice during the PSBI project, and lessons learned.

Copy number variants underlie major selective sweeps in insecticide resistance genes in Anopheles arabiensis.

To keep ahead of the evolution of resistance to insecticides in mosquitoes, national malaria control programmes must make use of a range of insecticides, both old and new, while monitoring resistance mechanisms. The outdoor-biting malaria vector Anopheles arabiensis is of increasing concern for malaria transmission because it is apparently less susceptible to many indoor control interventions, yet knowledge of its mechanisms of resistance remains limited. Furthermore, comparatively little is known in general about resistance to non-pyrethroid insecticides such as pirimiphos-methyl (PM), which are crucial for effective control in the context of globally high resistance to pyrethroids.