Objective We aimed to estimate prevalence and identify determinants of hypertension in adults aged 15–49 years in Tanzania.Design We analysed cross-sectional survey data from the 2022 Tanzania Demographic and Health Survey and Malaria Indicator Survey conducted between February and July 2022. Descriptive statistical analysis, logistic regression, machine learning and geospatial methods were used to estimate prevalence and determine determinants of hypertension.Setting Tanzania.Participants A total of 13 385 participants aged 15–49 years were included in the analysis.Primary outcome The primary outcome variable was hypertension, defined as either systolic blood pressure (BP)≥140 and/or diastolic BP≥90 mm Hg or under anti-hypertensive drugs.Results The prevalence of hypertension among adults of reproductive age was 11% (95% CIs 10.09 to 11.56) in Tanzania, varying significantly across risk factors. Prevalence was high in people aged 40–49 (22.11%, 95% CI 20.07 to 24.29) and obese (23.69%, 95% CI 20.67 to 27.00). The mean prevalence of hypertension was also high in the southern, eastern, western, southern highlands, north-west and north-eastern part of the country, correlating with the spatial distribution of older age (30–49) and higher body mass index (BMI) (≥25). Individuals aged 40–49 had nearly six times (adjusted OR (AOR): 5.68, 95% CI 4.10 to 7.83) the odds of hypertension relative to those aged 15–19. Obese individuals had higher odds (AOR: 2.88, 95% CI 2.01 to 4.13) compared with overweight individuals (AOR: 1.93, 95% CI 1.36 to 2.74). Machine learning results showed age and BMI as the most important determinants of hypertension and that significant interactions between risk factors exist.Conclusion The prevalence of hypertension varied across risk factors and the strongest determinants of hypertension in adults of reproductive age were age and BMI.

Background: Neonatal sepsis increases neonatal morbidity and mortality in low- and middle-income nations. however, the prevalence of neonatal sepsis, the etiological agents, and antimicrobial resistance patterns have not been documented in areas with the highest neonatal mortality rates in Tanzania. Aim: This study aimed to investigate the prevalence of neonatal sepsis, identify the primary causative agents, and understand their resistance patterns at Morogoro Regional Hospital. Methods: The study involved 252 admitted neonates at Morogoro Regional Hospital and was carried out between March and June 2019. Clinical and demographic information for each neonate was collected using a standardized questionnaire. Blood samples were obtained from all 252 neonates, and 50 swabs were randomly taken from neonates with umbilical pus discharge. The samples were then cultured using aseptic techniques on blood agar, chocolate agar, and MacConkey agar. The identification of the causative agents relied on the characteristics of colony morphology, gram staining, and biochemical tests. Antimicrobial resistance patterns were determined using the disc diffusion method with Muller Hinton agar against Ampiclox, Erythromycin, Gentamycin, Nalidixic acid, Ciprofloxacin, Norfloxacin, Ofloxacin, Kanamycin,Co-trimoxazole, Cephalexin, Ceftriaxone, and Amikacin. Results: The prevalence of neonatal sepsis, as determined through blood culture, was 40 % (102 /252). The predominant bacteria isolated from blood cultures were E. coli 31 %, Staphylococcus aureus 23 %, and Citrobacter spp 16%. Around 50% of the gram-negative bacteria showed resistance to Ceftriaxone, a third-generation cephalosporin. Both gram-negative bacteria and Staphylococcus aureus displayed resistance to Ampiclox. Conclusion: E. coli, Staphylococcus aureus, and Citrobacter spp. were shown to be the most frequent bacteria in neonatal sepsis in Morogoro. Many isolates were Ampiclox-resistant. Neonatal sepsis is common in Morogoro, highlighting the need for innovative neonatal care and preventative techniques.

Objectives To determine the community’s perception on the magnitude of Xeroderma pigmentosum (XP) disease and healthcare-seeking practices in Micheweni, Pemba in response to the public widespread information on the increased burden of the disease.Design Mixed-methods cross-sectional study.Setting Micheweni district, Pemba.Participants 211 male and female adults in the household survey, three caretakers/parents of patients with XP in the case study, 20 key community leaders/influential people and health workers in in-depth interviews and 50 community members and other leaders in six focus groups.Results This study has revealed that XP disease exists in few families of which some of them have more than one child affected. The record review showed that there were a total of 17 patients who were diagnosed with the disease for the past 3 years, however only 10 were alive during the time of the survey. Findings from the community members revealed that several patients were believed to have XP disease and perceived causes include inheritance, food types, beliefs and other sociocultural practices. Stigma and discrimination were reported by caretakers and religious leaders. However, some cases believed to be XP were identified as other skin conditions when clinical examination was performed by the team of our researchers. There is a great confusion about XP and other skin diseases.Conclusion The study has shown that XP affects only few families, hence termed as concentrated rather than a generalised disease. Due to the rareness of the disease, majority of people in the district are unaware of the disease, hence confusing it with other skin conditions. There is a need for the government in collaboration with other stakeholders to provide educational programme to community members about the disease to address the misconception about the magnitude of the disease.

Human African trypanosomiasis is a neglected tropical disease that is usually fatal without treatment. WHO has revised its rhodesiense human African trypanosomiasis treatment guidelines on the basis of an independent systematic literature review and following the GRADE methodology. This Review reports on the decision-making process and summarises the new recommendations and their potential implications for health-care professionals and policy makers. Due to data scarcity, all recommendations are conditional and based on very low certainty of evidence. Fexinidazole replaces suramin and melarsoprol as the first-line therapy in individuals aged 6 years and older with a bodyweight of 20 kg or more. As fexinidazole is effective in both stages of rhodesiense human African trypanosomiasis, a lumbar puncture for staging is no longer required. In settings in which first-choice drugs are not readily available, immediate interim treatment with pentamidine is suggested. The introduction of oral fexinidazole represents an advancement in the management of rhodesiense human African trypanosomiasis considering the life-threatening adverse reactions individuals can have to melarsoprol. However, children below the age or weight limits remain ineligible for treatment with fexinidazole.

Background: TB-related stigma is a recognized barrier to efforts to End TB.It affects early diagnosis and timely initiation of treatment and can potentially interrupt treatment.Understanding the dimension of TB-related stigma and its manifestations is critical to planning appropriate TB stigma reduction responses.However, this information is largely unknown in Tanzania.This study assessed the level and manifestations of self-TB-related stigma among people with TB.Methods: A cross-sectional survey was deployed to collect quantitative and qualitative data among people with TB in five regions of Tanzania between September 2021 and February 2022.Face-to-face interviews were used to obtain data from the participants using a modified questionnaire developed by the Stop TB Partnership to assess TB-related stigma among TB patients.Descriptive and thematic analysis were used to summarize and present findings.Results: Four hundred eighteen (418) participants were recruited, of whom 276 (66%) were males.The overall level of self-TB-related stigma was 40%, predominated by agreement of behaviours and attitudes limiting disclosure of TB status.TB-related stigma commonly manifested as social isolation, fear of contracting TB, verbal abuse, gossip, and an unwillingness to share eating utensils.Conclusion: This study showed a relatively moderate level of self-TB-related stigma among TB patients, characterized by fear of disclosure of TB status.Moreover, TB patients are inclined to be socially isolated, gossiped, and maltreated.These findings suggest the need to include TB stigma reduction responses in national TB prevention and control efforts.

Background: TB-related stigma is a barrier to ending TB.Because of stigma, patients with TB can be delayed in seeking treatment, receiving a diagnosis, initiating and completing treatment, and consequently increasing the transmission of the disease within a community.Information regarding the magnitude and consequences of TB-related stigma in Tanzania are generally missing in our setting.The study aimed to generate such information to inform the planning and implementation of TB-related stigma reduction strategies.Methods: Between September 2021 and February 2022, a cross-sectional survey was conducted to collect data on TB-related stigma among people with or who had TB (PWTB) in five regions of Tanzania.The survey utilized adapted structured questionnaires developed by the Stop TB Partnership.Data collection was carried out through face-to-face interviews.Data were analyzed using SPSS version 26, and the results were presented in tables.Results:The study recruited a total of 418 PWTB, with 276 (66%) being male and 86 (18.4%) having TB-HIV co-infection.Among the participants, 86 PWTB (20.6%) reported experiencing stigma due to their TB status.The most common settings where PWTB encountered stigma were within their families (50%), communities (36%), and workplaces (10%).Delays in seeking care (16.7%), obtaining an accurate diagnosis (15%), and initiating treatment (27%) were identified as the most common consequences associated with TB-related stigma.Participants' region, age, education level, and type of TB were factors significantly associated with experiencing TB-related stigma.Conclusion: This study revealed a moderate level of TB-related stigma experienced by TB patients, primarily originating from family members, neighbors, and co-workers.Furthermore, the findings emphasized the impact of TB-related stigma on the delay in seeking medical care for TB diagnosis and treatment.Therefore, this study highlights the need for the prompt inclusion of TB stigma reduction strategies in the TB prevention and control program in Tanzania.

Background: TB-related stigma among healthcare workers (HCWs) can negatively impact on health-seeking behavior, treatment adherence, TB treatment completion, and the overall quality of TB services.Yet, the dimensions, experiences, and manifestations of TB-related stigma among HCWs are largely unknown in our region, particularly in the context of Tanzania.This knowledge gap prompted the researchers to design the current study.Methods: This cross-sectional study employed both quantitative and qualitative techniques to collect data on TB-related stigma among HCWs who provide TB services in 20 selected health facilities in 5 regions (provinces) of Tanzania.Data analysis was performed using quantitative descriptive and thematic analysis methods.The results have been presented as frequency tables with respective percentages, figures, and quotes.Results: Seventy-nine (79) HCWs were recruited.The overall level of perceived TB-related stigma among HCWs was 52.57%, predominated by negative attitudes and stigmatizing behaviors towards TB patients.About one-fifth (21.52%) of the HCWs were stigmatized because their work involved interacting with TB-infected people.The common manifestations of TB-related stigma among HCWs were isolation, avoidance, and underappreciation both at the workplace and in the community.Such actions were mostly driven by fear of contracting TB.Conclusion: Our findings revealed that HCWs do not only have to contend with a high level of perceived TB-related stigma but are also stigmatized because of attending to TB patients.This stigma threatens to undermine the non-discriminatory access and quality of TB services.Therefore, there is an urgent call for reciprocal attention aimed to reduce TB-related stigma in healthcare settings to improve, ultimately, TB control in Tanzania.

Background: Tuberculosis (TB) is an infectious disease of public importance worldwide including Tanzania. There is increasing recognition that TB-related stigma is a barrier to TB control and prevention. However, there is a paucity of information about community TB-related stigma in our settings. This study was objected to assess the level, experiences, and manifestations of community TB-related stigma. Methods: Between September 2021 and February 2022, a cross-sectional study was conducted to collect quantitative and qualitative information about community TB-related stigma in five regions of Tanzania. Face-to-face interviews were used to collect data among community members using a modified questionnaire to assess community TB stigma created by the Stop TB Partnership. Descriptive statistics and thematic analysis were used to summarize and present findings of this study. Results: One hundred seventy-one (171) community members were recruited. The overall level of community TB-related stigma was 71.5%. The TB stigma was mainly characterized by supporting behaviours and attitudes that limit contact with TB patients. Sixty-three percent (63%) of the community members experienced community members being stigmatized because of their TB status. The common manifestations of community TB-related stigma were isolation, mistreatment, being denied supports, and refusing to share housing, eating and drinking utensils. Conclusion: This study showed a relatively high level of community TB-related stigma in Tanzania, suggesting the need to include TB stigma reduction interventions in national TB control and prevention response strategies.

Background: Enterobacteriaceae is among the large group of gram-negative rod bacteria in which it comprises Escherichia coli, Salmonella, Shigella, and many other species whose natural habitat is the intestinal tract of humans and animals. Diarrheal diseases are a major problem worldwide caused by bacterial pathogens particularly in developing countries. A previous study reported a prevalence of 9.30% Extended Spectrum Beta Lactamases (ESBLs) producing Enterohemorrhagic Escherichia coli O157:H7 that revealed a high (100%) resistance to gentamicin, tetracycline, trimethoprim/sulphamethoxazole, and amoxicillin/ clavulanic acid. Methods: A laboratory-based cross-sectional study was conducted at BMH. A convenient sampling method was used to enroll 308 patients with diarrhea in the study after consent for 12 months. Stool samples were collected into an acceptable clean sterile stool container and transported to Microbiology department for investigation. Analysis of data was performed using Statistical Package for Social Sciences (SPSS) version 17.0. Results: Out of 308 participants, 61.0% (188) were female whereas 39.0% (120) were male. The age group of between 18 to 45 years had a larger number of participants recruited in study 257 (83.4%) and less number 4 (1.2%) in the age group above 60 years old. About 5.2 (16/308) percent of stool samples processed were positive with pathogenic bacteria whereas 94.8 (292/308) percent were negative (no pathogenic bacteria isolated) growth. The study presented two pathogenic bacteria species named E. coli strain O157:H7 and Salmonella typhi that were isolated from stool samples of patients with diarrhea and who attended the hospital for treatment. No any shigella species was isolated in the study. The prevalence of S. typhi was 3.2% (10/308) whereas E. coli strain O157:H7 was 1.9% (6/308) out of 308 stool samples processed. The in vitro drug resistance patterns of Ampicillin were observed to be high 9 (90%) followed by Amoxicillin/Clavulanate and tetracycline of which both had 6 (60%) resistance to S. typhi. Conclusion: The study is currently insisting laboratory practitioners carry out an investigation of Escherichia coli strain O157:H7 as a routine test in parallel with other enteric pathogens.

Leptospirosis is a zoonotic neglected tropical disease with a worldwide distribution caused by the pathogenic spirochetes of the genus Leptospira. Despite being a widespread disease in tropical regions, it has never been considered in the routine diagnostic panel for febrile patients. This study determined seropositivity and factors associated with Leptospira antibodies among febrile adult patients in Mwanza, Tanzania. The cross-sectional study involving 296 febrile patients attending different outpatient clinics in Mwanza region was conducted between May and July 2019. Detection of Leptospira serovars antibodies was done using a microscopic agglutination test (MAT). Descriptive analysis was done using STATA version 13. The median age of the febrile patients was 32 (IQR: 24–45 years). Out of 296 patients, 36 (12.16%, 95%CI: 8–15) were seropositive for Leptospira antibodies. Common circulating serovars were Sokoine 28 (9.45%), followed by Lora 12 (4.05%) and Grippotyphosa 2 (0.67%). In the multivariable logistic regression analysis, the odds of being Leptospira seropositive were significantly higher with increased age (aOR: 1.03, 95%CI 1.00–1.07, p = 0.03). About one tenth of febrile patients in Mwanza were seropositive for Leptospira antibodies and this was significantly associated with age. With the decline of malaria fever in endemic areas, other causes of febrile illness like Leptospiral spp. should be considered in the routine diagnostic panel for febrile patients.

Objective The objective of this study was to determine the proportion of extended spectrum β-lactamase producing gram-negative bacteria (ESBL-GNB) colonizing patients admitted at Mazimbu hospital and Morogoro Regional hospital, in Morogoro, Tanzania. Rectal colonization with ESBL-GNB increases the risks of developing bacterial infections by extra-intestinal pathogenic ESBL-GNB. Results Of the 285 patients investigated, 123 (43.2%) carried ESBL-GNB in their intestines. Five of the 123 ESBL positive patients were colonized with two different bacteria, making a total of 128 ESBL producing isolates. Escherichia coli (n = 95, 74.2%) formed the majority of ESBL isolates. The proportion of CTX-M-1 group genes among ESBL isolates tested was 94.9% (93/98). History of antibiotic use (OR: 1.83, 95% CI: 1.1–3.2, P = 0.03), being on antibiotic treatment (OR: 2.61, 95% CI: 1.5–4.53, P = 0.001), duration of hospital stay (OR: 1.2, 95% CI: 1.1–1.3, P < 0.001) and history of previous admission (OR: 2.24, 95% CI: 1.2–4.1, P = 0.009) independently predicted ESBL-GNB carriage.

Background: Hospital acquired infection pose a great challenge in provision of healthcare services to many settings particulary in developing countries where there is limited availability of resources. The roles played by exposed surfaces in spreading of potential bacterial pathogens within the hospital environment have certainly contributed to the increased burden of bacterial infectious diseases such as morbidness, death as well as cost imolecation in healthcare. Our study aimed to determine common bacteria isolated on exposed surfaces and the antimicrobial sensitivity patterns. Methods: A sum of 516 specimens gathered and enrolled for study at Benjamin Mkapa Hopsital (BMH). The swab specimens were continuously gathered (collected) from different exposed objects in hospital environmental surfaces. All microbiological procedures or tests were performed using appropriate standard operating procedure. The obtained data were analysed using SPSS version 16.0. Results: Among 516 samples, 317 (61.4%) were positive with variety of bacterial isolates from different sites. Out of 317 positive cultures, 120 (37.9%) Staphylococcus aureus, 97 (30.6%) E. coli, 28 (8.8%) Enterobacter aerogenes, 25 (7.9%) Pseudomonas aeruginosa, 23 (7.3%) other Citrobacter species, 20 (6.3%) Citrobacter freundii, 3 (0.9%) Morganella morganii and 1 (0.3%) Serratia mercesens were isolated from different source of exposed surfaces at BMH. Serratia mercesens were highly (100%) resistant to most of the antimicrobial agents including erythromycin, cefotaxime, ciprofloxacin, gentamicin, amikacin, penicillin,ceftriaxone, ceftazidime, levofloxacin, ampicillin, azithromycin and cotrimoxazoleTrimethoprim/sulfamethoxazole. Conclusion: High levels of potentially pathogenic bacteria were isolated in swab specimens from a wide range of exposed surfaces at BMH. Variable pattern of antiobiotic resistance were observed among bacterial isolates with alarming levels demonstrated by isolates of Serratia mercesens which is amongst the common causes of surgical site infections. This findings call for improved actions for infection prevention and control measures at BMH.

Viral infections have been associated with poor pregnancy outcomes. We investigated the magnitude of rubella virus (RV), dengue virus (DENV), Zika virus (ZIKV) and human cytomegalovirus (HCMV) among symptomatic pregnant women in rural and urban areas of Mwanza. A cross-sectional study was conducted between July 2017 and April 2018 in Mwanza. A rapid immunochromatographic test was done to detect ZIKV IgM and IgG as well as DENV IgM and IgG antibodies. A multiplex_RT-PCR was also done to detect the viral RNA genome. Enzyme immunoassays were done to detect RV and HCMV. Out of 171 participants, 1 (0.6%) was found to be seropositive for ZIKV_IgM antibodies, while 5 (2.9%) were ZIKV_IgG seropositive. DENV seropositivity was 9 (5.3%) and 3 (1.8%) for IgM and IgG, respectively, with all being PCR negative. Two participants (1.2%) were RV_IgM seropositive. 100% were HCMV_IgG seropositive and none was HCMV_IgM seropositive. Among 70 women with high HCMV_IgG titters, 10 (14.3%) had a low avidity index, indicating recent infections. Residing in rural areas (p = 0.044) and advanced age (p = 0.024) independently predicted ZIKV/DENV seropositivity. A substantial proportion of pregnant women had markers for viral infections. There is a need for introducing routine screening and monitoring pregnancy outcomes of positive cases to establish the relationship of these viruses and adverse pregnancy outcomes in endemic areas.

Background Precise detection of Plasmodium infections in community surveys is essential for effective malaria control. Microscopy and rapid diagnostic tests (RDTs) are the major techniques used to identify malaria infections in the field-based surveys. Although microscopy is still considered as the gold standard, RDTs are increasingly becoming versatile due to their rapid and adequate performance characteristics. Methods A malaria prevalence cross-sectional survey was carried out in north-western Tanzania in 2016, aimed at appraising the performance of high sensitivity Plasmodium falciparum (HSPf) tests compared to SD Bioline Pf and microscopy in detecting P. falciparum infections. A total of 397 individuals aged five years and above were tested for P. falciparum infections. The sensitivity, specificity, positive, and negative predictive values (PPV and NPV) of microscopy, Pf RDT and HSPf RDT was determined using PCR as the gold standard method. Results The prevalence of P. falciparum infections determined by microscopy, SD Bioline Pf, HSPf and PCR was 21.9, 27.7, 33.3 and 43.2%, respectively. The new HSPf RDT had significantly higher sensitivity (98.2%) and specificity (91.6%) compared to the routinely used SD Bioline Pf RDT(P < 0.001). The positive predictive value (PPV) was 81.8% and the negative predictive value (NPV) was 99.2% for the routinely used SD Bioline Pf RDT. Moreover, HSPf RDT had sensitivity of 69% and specificity of 76.8% compared to microscopy. The PPV was 45.5% and the NPV was 89.8% for microscopy. Furthermore, the analytical sensitivity test indicated that the newly developed HSPf RDT had lower detection limits compared to routinely used SD Bioline RDT. Conclusions HSPf RDT had better performance when compared to both microscopy and the currently used malaria RDTs. The false negativity could be associated with the low parasite density of the samples. False positivity may be related to the limitations of the expertise of microscopists or persistent antigenicity from previous infections in the case of RDTs. Nevertheless, HS PfRDT performed better compared to routinely used Pf RDT, and microscopy in detecting malaria infections. Therefore, HS Pf RDT presents the best alternative to the existing commercial/regularly available RDTs due to its sensitivity and specificity, and reliability in diagnosing malaria infections.

Brucellosis is a worldwide zoonotic disease of socio-economic importance. Understanding the association of this disease with pregnancy outcome has the potential of contributing to the reduction of its reproductive burden in humans and animals among pastoral communities in Tanzania. A prospective cohort study was conducted in Kagera Region on pregnant women (n = 76) and gravid ruminants (121 cattle, 125 goats and 111 sheep). Exposed and non-exposed groups to brucellosis were followed for 6 months (from 15 November 2017 to 15 April 2018). Sera were collected and analysed using Rose Bengal Test (RBT) and Fluorescence polarization assay (FPA) test. Measures of effect, univariable and multivariable logistic regression analyses were computed. Positivity to both RBT and FPA tests was 21% (95% CI: 12.5-32) in pregnant women and 5% (95% CI: 3.1-8) in gravid ruminants. Among aborted cases, four women (out of nine), two cows (out of seven), two goats (out of 26) and zero sheep (out of 11) were positive to brucellosis. The abortion rate in humans and ruminants was 11.8% and 12.3%, respectively. Seropositivity to brucellosis was similar in aborted and non-aborted cases in humans (p = .08) and in ruminants (p = .2). At the population level, brucellosis was associated with abortions (population attributable risk: PAR) at 3.5% in pregnant women and at 0.5% in gravid ruminants in the study area. Infections to brucellosis were increased in exposed pregnant women (OR = 19; 95% CI: 1.8-203, p = .01) and in cattle (OR = 11; 95% CI: 1.3-88, p = .02). There is an indication that brucellosis could be contributing to abortions in pregnant women and domestic ruminants Kagera Region. Molecular tools could support more the results from serological tests to avoid cross-reaction with other pathogen agents. Control of brucellosis in animals is likely to reduce the threat of abortions in humans.

PURPOSE This retrospective study sought to determine the type, burden, and pattern of cancer deaths in public hospitals in Tanzania from 2006 to 2015. METHODS This study analyzed data on cancer mortality in 39 hospitals in Tanzania. Data on the age and sex of the deceased and type of cancer were extracted from hospital death registers and report forms. Cancer types were grouped according to the 10th revision of the International Classification of Diseases. Age-standardized mortality rates and cancer mortality patterns were analyzed. A χ 2 test was used to examine the association between common cancers and selected covariates. RESULTS A total of 12,621 cancer-related deaths occurred during the 10-year period, which translates to an age-standardized hospital-based mortality rate of 47.8 per 100,000 population. Overall, the number of deaths was notably higher (56.5%) among individuals in the 15- to 59-year-old age category and disproportionately higher among females than males ( P = .0017). Cancers of the cervix, esophagus, and liver were the 3 major causes of death across all study hospitals in Tanzania. Cancers of the cervix, esophagus, and liver were the largest contributors to mortality burden among females. Among males, cancers of the esophagus, liver, and prostate were the leading cause of mortality. CONCLUSION There is an increasing trend in cancer mortality over recent years in Tanzania, which differs with respect to age, sex, and geographic zones. These findings provide a basis for additional studies to ascertain incidence rates and survival probabilities, and highlight the need to strengthen awareness campaigns for early detection, access to care, and improved diagnostic capabilities.

Background: There is currently sufficient evidence available indicating that dengue and chikungunya viruses could be among the causes of fever in Tanzania. Overlapping clinical manifestations of chikungunya and dengue with other vector-borne parasitic diseases pose a challenge for medical diagnosis in Tanzania. A virus surveillance study was conducted in Morogoro Municipality which had no reports of outbreaks during high risk of transmission with dengue epidemics in the neighbouring Dar es Salaam. Methodology: The present study was carried out to screen for dengue (DENV) and chikungunya (CHIKV) in sera from patients with fever and malaria-like symptoms on selected health centres in Morogoro municipality (n = 5) during March-May 2018. Three hundred and twelve febrile individuals presenting to the outpatient department were screened for the presence of chikungunya and dengue viruses using Multiplex real-time reverse transcription-polymerase chain reaction. Results: Acute CHIKV infection was confirmed in four (1.28%) cases whereas no acute DENV infection was detected. Acute chikungunya cases were exclusively prevailing amongst female patients aged between 20 and 49 years. Conclusion: Our findings indicate an active circulation of chikungunya virus among febrile patients seeking medical attention in Morogoro Municipality, Tanzania. The improvement of CHIKV case detection and reporting is critical to its control and prevention. Surveillance programmes in monitoring arboviral activities in human populations as well as in mosquitos should be performed to avoid maintenance of CHIKV in mosquitoes that may lead to future outbreaks.

Brucellosis is a zoonotic disease of importance to both public health and the livestock industry. The disease is likely to be endemic in Tanzania and little is reported on molecular characterization of Brucella species in pastoral settings. This study aimed at characterizing Brucella species (targeting genus Brucella) infecting humans, cattle and goat in Kagera region (Ngara and Karagwe districts) using real-time PCR, PCR amplification of 16S rRNA genes and Sanger sequencing. Brucella spp. were detected in 47 samples (19 sera and 28 milk) out of 125 samples (77 sera, 35 milk and 13 aborted materials) using real-time PCR. All aborted materials (13 samples) were negative to real-time PCR. Out of the 47 real-time PCR positive samples (28 milk and 19 sera), 20 samples (10 milk and 10 sera) showed an expected 16S rRNA gene PCR product. Sequence analysis and blasting confirmed the presence of Brucella spp. in pastoral areas of Kagera region. The Brucella spp. from Kagera were phylogenetically grouped in two clades and three branches all closer to B. melitensis, B. abortus and B. suis from USA, Sudan and Iran. However, they were distinct from other species isolated also in USA, New Zealand, Germany and Egypt. This was expected based on the distance between the geographical regions from which the data (nucleotides sequences from 16S gene sequencing) for the phylogeny reconstruction were obtained. This is the first study to report Brucella species identified using 16S rRNA gene sequencing in East and Central Africa. A livestock vaccination program re-inforced with a high index of Brucella diagnosis is needed to eradicate brucellosis in animals and minimize suffering from Brucella infections in humans in Tanzania.

Background: Zika virus infection during pregnancy has been recently associated with congenital microcephaly and other severe neural tube defects. However, the magnitude of confirmed cases and the scope of these anomalies have not been extensively documented. This review focuses on the magnitude of laboratory-confirmed congenital Zika virus cases among probable cases and describing the patterns of congenital anomalies allegedly caused by the Zika virus, information which will inform further research in this area. Methods: We conducted a literature search for English-language articles about congenital Zika virus infection using online electronic databases (PubMed/MEDLINE, POPLINE, Embase, Google Scholar, and Web of Knowledge). The search terms used were, “zika”, “pregnancy”, [year], “microcephaly”, “infants”, “children”, “neonates”, “foetuses”, “neural tube defect”, and “CNS manifestations” in different combinations. All articles reporting cases or case series between January 2015 and December 2016 were included. Data were entered into a Microsoft Excel database and analysed to obtain proportions of the confirmed cases and patterns of anomalies. Results: A total of 24 articles (11 case series, 9 case reports, and 4 others) were found to be eligible and included in this review. These articles reported 919 cases, with or without microcephaly, presumed to have congenital Zika virus infection. Of these cases, 884 (96.2%) had microcephaly. Of the 884 cases of microcephaly, 783 (88.6%) were tested for Zika virus infection, and 216 (27.6%; 95% confidence interval, 24.5% to 30.8%) were confirmed to be Zika virus-positive. In addition to microcephaly, other common abnormalities reported – out of 442 cases investigated – were calcifications of brain tissue (n=240, 54.3%), ventriculomegaly (n=93, 20.8%), cerebellar hypoplasia (n=52, 11.7%), and ocular manifestations (n=46, 10.4%). Conclusion: Based on the available literature, Zika virus infection during pregnancy might lead to a wide array of outcomes other than microcephaly. There is a need for more epidemiological studies in Zika-endemic areas, particularly in Africa, to ascertain the role of Zika virus in causing congenital neurological defects.

BACKGROUND:Understanding the causes of inpatient mortality in hospitals is important for monitoring the population health and evidence-based planning for curative and public health care. Dearth of information on causes and trends of hospital mortality in most countries of Sub-Saharan Africa has resulted to wide use of model-based estimation methods which are characterized by estimation errors. This retrospective analysis used primary data to determine the cause-specific mortality patterns among inpatient hospital deaths in Tanzania from 2006-2015. MATERIALS AND METHODS:The analysis was carried out from July to December 2016 and involved 39 hospitals in Tanzania. A review of hospital in-patient death registers and report forms was done to cover a period of 10 years. Information collected included demographic characteristics of the deceased and immediate underlying cause of death. Causes of death were coded using international classification of diseases (ICD)-10. Data were analysed to provide information on cause-specific, trends and distribution of death by demographic and geographical characteristics. PRINCIPAL FINDINGS:A total of 247,976 deaths were captured over a 10-year period. The median age at death was 30 years, interquartile range (IQR) 1, 50. The five leading causes of death were malaria (12.75%), respiratory diseases (10.08%), HIV/AIDS (8.04%), anaemia (7.78%) and cardio-circulatory diseases (6.31%). From 2006 to 2015, there was a noted decline in the number of deaths due to malaria (by 47%), HIV/AIDS (28%) and tuberculosis (26%). However, there was an increase in number of deaths due to neonatal disorders by 128%. Malaria and anaemia killed more infants and children under 5 years while HIV/AIDS and Tuberculosis accounted for most of the deaths among adults. CONCLUSION:The leading causes of inpatient hospital death were malaria, respiratory diseases, HIV/AIDS, anaemia and cardio-circulatory diseases. Death among children under 5 years has shown an increasing trend. The observed trends in mortality indicates that the country is lagging behind towards attaining the global and national goals for sustainable development. The increasing pattern of respiratory diseases, cancers and septicaemia requires immediate attention of the health system.