Background: Sub Saharan Africa (SSA) accounts for over 20% of global cervical cancer cases, despite having only about 14% of the world’s female population. It is the leading cause of cancer-related deaths among women in Tanzania with the mortality rate of 42.7 per 100,000 women. Objective: The survey aimed to assess the proportion of eligible population with a history of ever screened for cervical cancer, using any of the available methods. Methods: The survey was a household-based study employing a three-stage cluster sampling design. The target population for the cervical cancer screening assessment included all women aged 18–69 years who were usual residents of the selected households. The Tanzania Population and Housing Census 2022 served as the sampling frame for the 2022/2023 STEPS survey. The estimated sample size was 4,320, with an actual sample of 3,565 participants, of whom 1,256 women aged 25–49 years responded to questions on cervical cancer screening. Demographic and behavioral data were collected electronically using the Open Data Kit (ODK)-based eSTEPS platform from September 2022 to September 2023. Chi-square tests and modified Poisson regression models were used to identify factors associated with cervical cancer screening uptake. Results: Most participants were married or cohabited (70.5%) and resided in rural areas (63.7%). Overall, 10.9% (95% CI: 7.8–15.0) of women reported ever being screened. Compared with women aged 25–29years, those aged 30–39 years (aPR=1.90; 95% CI:1.17–3.07) and 40–49 years (aPR= 2.50; 95% CI:1.53–4.09) had a significantly higher prevalence of screening. Women residing in urban areas were nearly twice as likely to have been screened as those living in rural areas (aPR=1.98; 95% CI: 1.43–2.73) and those from Southern Highlands demonstrated a higher prevalence of screening compared with those from Pemba (aPR=4.32; 95% CI:1.05–17.79). In addition, higher educational attainment was associated with increased screening prevalence, with women who had primary education being more likely to have been screened than those with no formal education (aPR=1.67; 95% CI:1.11–2.50). Conclusion: Cervical cancer screening uptake among women in this study was low, with significant disparities by age, residence, geographical zone, and educational attainment. These findings underscore the need for targeted interventions to increase screening coverage, particularly among younger women, rural populations, and those with lower education levels.

Background: Hypertension is a major public health concern and a leading risk factor for non-communicable diseases (NCDs) globally. In Tanzania, up to date national level data on the prevalence and determinants of raised blood pressure (BP) are limited. This study analyzed data from the 2023 Tanzania STEPS survey to assess the prevalence and associated factors of raised BP among adults aged 18–69 years. Methods: A cross-sectional, household survey was conducted from September to November 2023 across all 31 regions of Tanzania. A three-stage stratified sampling approach was used to select 4,320 individuals from 288 enumeration areas. Data were collected through structured interviews, physical measurements, and biochemical sample collection. Raised BP was defined as systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or current use of antihypertensive medication. Multivariable analysis using Modified Poisson regression was performed to identify factors associated with raised BP. Results: The overall prevalence of raised BP was 23.1% (95% CI: 19.9–26.4). Prevalence increased significantly with age, from 12.6% (95% CI: 7.7–17.4) among individuals aged 18–30 years to 46.4% (95% CI: 40.7–52.1) among those aged 46–69 years (p < 0.001). Overweight/obese individuals had a higher prevalence of raised BP (36.4%, 95% CI: 31.0–42.2) compared to those with normal weight (19.2%, 95% CI: 16.0–22.7; p < 0.001). Geographic zones such as the Southern Highlands (aPR 1.07, 95% CI: 1.02–1.13, p = 0.003) and Unguja (aPR 1.09, 95% CI: 1.04–1.14, p = 0.001) were associated with higher prevalence. Conclusion: Hypertension is prevalent among Tanzanian adults, with older age, obesity, and geographic location identified as significant risk factors. Targeted interventions focusing on lifestyle modifications, improved healthcare access, and region-specific strategies are essential to reduce the burden of hypertension in Tanzania.

Tuberculosis (TB) remains a major public health challenge in Tanzania, with both drug-sensitive and drug-resistant strains contributing to significant mortality. This study presents a mathematical model to analyze TB transmission dynamics from 2018 to 2023, incorporating treatment interventions, nutritional supplements, and community awareness as control strategies. A cost-effectiveness analysis of three optimal control strategies is conducted using numerical simulations. Results show that combined treatment with appropriate drugs for both TB strains is the most cost-effective approach, significantly reducing infection rates. In contrast, single interventions offer limited impact. The findings emphasize the importance of timely, targeted, and combined interventions to effectively control TB spread. Therefore, the study suggests that to attain effective control of TB, both infected groups should be treated accordingly and simultaneously which will significantly lead to the decline rate of exposed and infectious, and hence the disease infection spread will be controlled.

Background More than 530 million individuals globally are afflicted with diabetes mellitus (DM), and the prevalence continues to escalate. Insulin remains the cornerstone of DM management across the globe. Nevertheless, existing literature indicates that individuals utilizing insulin are susceptible to developing abscesses and scar formation at injection sites. These complications may undermine therapeutic adherence, thereby adversely impacting the intended clinical outcomes. This study aimed to evaluate the prevalence of abscesses and scar formation at injection sites, along with their associated factors, among diabetic patients undergoing insulin therapy in Dar es Salaam, Tanzania.Methods A hospital-based analytical cross-sectional study was conducted from the 28th of February 2024 to the 25th of May 2024. A total of 428 patients diagnosed with diabetes mellitus and undergoing insulin therapy were enrolled from four selected hospitals in Dar es Salaam. A validated case report form (CRF) was employed to gather socio-demographic characteristics and clinical data pertinent to the formation of abscesses and scars following insulin therapy. Data were analyzed utilizing Stata version 15.0 software, with findings summarized as frequencies and percentages. Factors associated with the development of abscesses and scarring were evaluated using modified Poisson regression, and a p-value of less than 0.05 was deemed statistically significant.Results Of 428 participants, the prevalence of abscesses and scar formation at the insulin injection site was 22.2% and 46.7%, respectively. Factors positively associated with abscesses were improper injection technique (adjusted Prevalence Ratio [aPR] = 1.11; 95% CI: 1.02-1.21, p = 0.009) and poor injection site rotation (aPR = 2.7; 95% CI: 1.13-6.45, p = 0.025). In contrast, the use of an insulin pen was negatively associated with abscesses (aPR = 0.13; 95% CI: 0.04-0.48, p = 0.002). Scar formation was positively associated with improper injection site rotation (aPR = 1.63; 95% CI: 1.03-2.32, p = 0.037) and uncontrolled blood glucose levels (aPR = 1.69; 95% CI: 1.01-2.84, p = 0.049).Conclusion This study indicates that skin complications at insulin injection sites are highly prevalent. The findings suggest that improper injection technique, poor site rotation, and uncontrolled blood glucose are significant modifiable risk factors. The use of insulin pens may help reduce the risk of abscesses. Therefore, targeted patient education on correct injection practices and glycemic control is crucial to minimize these complications.

Antimicrobial resistance (AMR) threatens global health, and understanding resistance patterns aids in effective treatment and promotes responsible antimicrobial use. Despite the urgency of resistant pathogens, systematic reviews focusing specifically on Tanzania are limited, and while several studies report resistance patterns for individual pathogens, a consolidated analysis of overall prevalence is needed to inform policymaking and public health interventions. Therefore, this review and meta-analysis assessed the prevalence of antimicrobial resistance among clinically relevant pathogens in Tanzania, providing a comprehensive overview to support surveillance, infection control, and stewardship efforts. A total of 1865 studies identified from Google Scholar (1600), PubMed (13), and Science Direct (252) underwent screening and full article review. Finally, 28 studies were included. A subgroup analysis was performed to evaluate the resistance patterns within antibiotic classes for specific pathogens. Descriptive statistics were used to describe the characteristics of the studies, while the prevalence of antimicrobial resistance was estimated through Meta-analysis. Inconsistency and heterogeneity between studies were quantified by the I2 index. Among the included studies, most isolates (25.0%) were obtained from urine samples. Of these studies, 75% were cross-sectional studies and 92.9% were conducted in hospital settings. The analysis revealed high resistance to penicillin, particularly amoxicillin-clavulanic and ampicillin, with Klebsiella pneumoniae (0.96 [0.83-0.99]), Acinetobacter baumannii (0.94 [0.67-0.99]) and Escherichia coli (0.90 [0.81-0.95]). Similarly, erythromycin resistance was most prevalent in Campylobacter spp. (0.85 [0.80-0.89]). Ciprofloxacin resistance was highest in Acinetobacter baumannii (0.54 [0.33-0.73]), whereas amikacin resistance was highest in Proteus spp. (0.86 [0.35-0.99]). Ceftriaxone resistance was particularly high in Acinetobacter baumannii (0.91 [0.70-0.98]) and Pseudomonas aeruginosa (0.85 [0.74-0.92]). Meropenem resistance was lowest among Escherichia coli (0.04 [0.01-0.10]) and Klebsiella spp. (0.07 [0.03-0.15]), while the pooled resistance across ESKAPE-E pathogens was (0.11[0.06-0.19]). Imipenem and clindamycin each had an overall pooled resistance of (0.06[0.02-0.14]) against both Escherichia coli and Klebsiella pneumoniae. The findings highlight widespread resistance among bacterial pathogens, ESKAPE-E, particularly in the Access and Watch groups of antibiotics. The variability in resistance patterns underscores the need for the Ministry of Health to re-evaluate empirical treatment protocols (STG/NEMLIT) to ensure effective treatment regimens, strengthen antimicrobial stewardship, enhance surveillance systems, and promote rational antibiotic use.

Hazardous alcohol consumption (HAC) among people living with HIV (PLHIV) has been associated with poor antiretroviral therapy (ART) adherence and unsuppressed HIV viral load (VL). We examined potential correlates of alcohol use and HAC among PLHIV aged ≥ 18 years using nationally representative data from the Tanzania HIV Impact Survey 2022–2023, a cross-sectional population-based household survey. Consenting individuals were tested for HIV and HIV-positive specimens were tested for HIV VL. HAC was determined using the World Health Organization “Alcohol Use Disorders Identification Test–Concise.” Correlates of alcohol use and HAC were determined using binary logistic regression and sampling weights. Jackknife variance estimation was used to generate 95

Background: Antiretroviral therapy improves outcomes for people living with HIV (PLHIV) and prevents transmission through viral load suppression (VLS). To evaluate progress toward HIV epidemic control, VLS prevalences and correlates among PLHIV were analyzed from Tanzania HIV Impact Assessment Surveys (THIS), independent, cross-sectional using stratified-cluster design, conducted in 2016-2017 (S1) and 2022-2023 (S2). Methods: Participants 15 years and older provided consent, completed an interviewer-administered questionnaire, and tested for HIV using the national rapid testing algorithm. HIV-positive specimens were tested for viral load. Prevalence of population VLS (<1000 copies/mL) was determined irrespective of HIV-knowledge or antiretroviral therapy status. Modified Poisson Regression Model was used. We reported percentages (%) and adjusted prevalence ratios with 95% confidence intervals (CIs) accounting for complex survey design. Results: We analyzed data from 1830 PLHIV in S1 and 1849 in S2. Population VLS prevalence increased by 26.1% (95% CI: 22.1 to 30.2, P < 0.0001) between surveys. In both surveys, women were more likely to experience VLS [S1: 1.43 (95% CI: 1.25 to 1.63), S2: 1.15 (95% CI: 1.06 to 1.24)] than men. In both surveys, PLHIV 35 years and older were more likely to experience VLS than those 15-24 years, [S1 35-49 years: 1.46 (95% CI: 1.13 to 1.90), 50 years and older: 1.69 (95% CI: 1.28 to 2.23), and S2 35-49 years: 1.31 (95% CI: 1.06 to 1.62), 50 years and older: 1.42 (95% CI: 1.15 to 1.76)]. Conclusion: Tanzania has made progress toward HIV epidemic control, as evidenced by the significant increase in VLS prevalence in 6 years. Targeted sex-age strategies are essential for HIV epidemic control.

Background: Tobacco smoking remains a leading preventable cause of non-communicable diseases (NCDs) globally, with a growing public health impact in low- and middle-income countries. In Tanzania, nationally representative evidence on tobacco use patterns and associated factors remains limited. Methods: This study analyzed data from the nationally representative Tanzania WHO STEP-wise Survey conducted in 2023. A total of 3,565 adults aged 18–69 years were included using a three-stage stratified sampling design. Data were collected through structured interviews and physical measurements. Current smoking status was self-reported. Weighted analyses were conducted, and modified Poisson regression models were used to identify factors associated with smoking. Results: The overall prevalence of current smoking was 9.9% (95% CI: 7.2–12.6). Smoking was significantly higher among men compared with women (19.8% vs. 0.8%). Prevalence increased with age and was higher among rural residents than among urban residents. Individuals with no formal education had markedly higher smoking prevalence than those with college education. Current alcohol use showed a strong association with smoking, with more than one-quarter of current drinkers reporting smoking. In adjusted analyses, male sex (aPR=20.63), older age, residence in the Southern zone, lower educational attainment, and current alcohol consumption (aPR=4.32) were independently associated with smoking. Conclusion: Tobacco smoking in Tanzania remains concentrated among specific high-risk groups, particularly men, older adults, individuals with low education, and alcohol users. Targeted and integrated tobacco control interventions are urgently needed to reduce future NCD burden.

Background: Diabetes mellitus is a growing public health concern globally, including in low- and middle-income countries like Tanzania. Understanding its prevalence and determinants is crucial for effective prevention and management strategies. ​ Objective: This study aimed to determine the prevalence of Type 2 diabetes mellitus (T2DM) and its associated sociodemographic, behavioral, and clinical determinants among adults aged 18–69 years in Tanzania, using data from the 2023 Tanzania STEPS survey. ​ Methods: A nationally representative, cross-sectional survey was conducted from September to November 2023 across all 26 regions of mainland Tanzania and 5 regions of Zanzibar. ​ A three-stage stratified sampling approach was employed, yielding a sample of 4,320 individuals aged 18–69 years. ​ Data were collected through structured interviews, physical measurements, and biochemical sample analysis. ​ Diabetes prevalence was defined as fasting plasma glucose ≥7.0 mmol/L (126 mg/dL) or current use of medication for elevated blood glucose. ​ Results: The overall prevalence of diabetes was 2.9% (95% CI: 1.9–3.9). Individuals aged 46–69 years had significantly higher odds of diabetes compared with those aged 18–30 years (aOR = 3.48; 95% CI: 1.88–6.39; p < 0.001). Residence in the Northern (aOR = 9.36; 95% CI: 2.15–40.68), Southern Highlands (aOR=8.95; 95% CI: 2.06–38.83), Southern (aOR=10.04; 95% CI: 2.17–46.34), and Unguja (aOR= 10.16; 95% CI: 2.32–44.47) zones was also associated with markedly increased odds of diabetes. In addition, overweight or obesity (aOR=1.54; 95% CI: 1.06–2.26; p=0.025) and elevated blood pressure (aOR=1.91; 95% CI: 1.28–2.84; p= 0.001) were significant predictors. Conclusion: The findings highlight age, geographic zone, overweight/obesity, and raised blood pressure as key determinants of diabetes in Tanzania. ​ Public health strategies should prioritize high-risk groups, promote physical activity, and integrate diabetes screening with hypertension and obesity management. ​ Further research is needed to address geographic disparities and evaluate trends in diabetes prevalence. ​

BackgroundAlthough integration of cardiometabolic conditions (CMC) prevention into HIV care is increasingly prioritized, limited evidence exists on the CMC knowledge, attitudes, and practices (KAP) of people living with HIV (PLWH). We examined cardiometabolic KAP among PLWH to inform age-appropriate interventions aimed at improving KAP and reducing CMC risk.MethodsA facility-based cross-sectional survey was conducted from April to May 2025 among adolescents (13–19 years) and adults (≥20 years) living with HIV attending six randomly selected HIV care and treatment clinics in Dar es Salaam, Tanzania. Participants were recruited consecutively. Knowledge, attitudes, and practices were assessed using a questionnaire adapted from the WHO STEPwise approach and the Global Physical Activity Questionnaire. KAP scores were categorized using modified Bloom’s cut-off criteria. Factors associated with KAP were assessed using generalized Poisson mixed-effects regression models accounting for clustering by health facility.ResultsWe enrolled 488 participants: 51.0% (249) were female; 20.1% (98) were adolescents (median age 17 years, IQR 14–19), and 79.9% (390) were adults (median age 41 years, IQR 32–49). Adolescents demonstrated higher knowledge of CMC risk factors than adults (75.3% vs. 55.9%, p < 0.001). Compared with participants with secondary education or higher, those with no formal education (aPR = 2.08, 95% CI: 1.52–2.84) and primary education (aPR = 1.60, 95% CI: 1.22–2.09) had a higher prevalence of low CMC knowledge. Negative attitudes towards CMC prevention were more prevalent among participants attending clinics in Kigamboni Municipality than Ubungo Municipality (aPR = 1.39, 95% CI: 1.25–1.54) and among divorced, separated or widowed participants than those who were married or cohabiting (aPR = 1.45, 95% CI: 1.10–1.90). Adolescents reported higher physical activity (94.9% vs. 85.1%, p = 0.01) but poorer dietary practices and lower uptake of blood glucose screening than adults (all p < 0.001). Poor CMC-related practices were more prevalent among participants attending dispensaries than hospitals (aPR = 1.97, 95% CI: 1.67–2.32) and among adolescents than adults (aPR = 1.73, 95% CI: 1.11–2.69).ConclusionSociodemographic factors were associated with differing KAP for CMCs risk reduction. Strengthening HIV services with age-specific strategies to improve cardiometabolic knowledge, attitudes, and preventive practices may support healthier behaviours and strengthen integrated cardiometabolic prevention within HIV care.

Background: Adult attained height reflects early-life exposures, including nutrition, infectious disease burden, and socioeconomic conditions, which influence lifelong health. Shorter stature is associated with higher risks of cardiometabolic conditions. Tanzania’s regional disparities in early-life nutrition provide a unique context to explore the relationship between height and non-communicable diseases (NCDs) risk factors. Objective: To assess the association between attained adult height and NCD risk factors, including body mass index (BMI), total cholesterol, diabetes mellitus, hypertension, and cardiovascular disease (CVD) risk, among Tanzanian adults aged 18–69 years. Methods: This population-based study analysed data from the Tanzania STEPS survey (September–November 2023). A cross-sectional design was used, with 4,320 individuals selected through stratified sampling. Data were collected via structured interviews, physical measurements, and biochemical sample collection. Multivariable analyses assessed associations between height quintiles and NCD risk factors, adjusting for age, sex, smoking status, and leisure-time physical activity. Results: Shorter stature was associated with increased risks of overweight/obesity, elevated total cholesterol, and diabetes mellitus. Compared to the tallest quintile (170.1–198.8 cm), the lowest quintile (100–153.9 cm) showed the highest risk of overweight/obesity (adjusted PR=2.17, 95% CI: 1.76–2.66), high total cholesterol (adjusted PR=1.85, 95% CI: 1.24–2.75), and diabetes mellitus (adjusted OR=2.20, 95% CI: 1.19–4.06). No significant associations were observed between height and hypertension. Conclusion: Shorter adult height is independently associated with increased risk of overweight/obesity, elevated cholesterol, and diabetes, suggesting height as a marker of early-life disadvantage. These findings highlight the importance of addressing early-life nutrition and growth determinants as part of comprehensive NCD prevention strategies in Tanzania.

Background: Depression is an important contributor to morbidity and is increasingly recognized as a public health concern in low- and middle-income countries. Nationally representative estimates and associated factors are needed to inform integration of preventive and treatment services for mental health into primary care in Tanzania. Methods: We analyzed data from the 2023 Tanzania National STEPS Survey, a cross-sectional, household-based survey conducted in all regions of mainland Tanzania and Zanzibar among adults aged 18–69 years. Depressive episodes in the past 12 months was assessed using the WHO STEPS mental health module, which is based on the PHQ9 tool. Weighted descriptive analyses of estimated national prevalence. Associations between depression and sociodemographic and health-related factors were examined using modified Poisson regression to estimate incidence rate ratios (IRRs). Results: Overall, 20.3% of adults reported a depressive episode in the past 12 months. Prevalence was higher among women than men (27.6% vs 18.4%) and increased with age, reaching 29.9% among adults aged 46–69 years. In multivariable models, male sex was associated with lower prevalence of depression (adjusted IRR 0.78). Being separated/divorced/widowed was associated with higher prevalence compared with being married/cohabiting (adjusted IRR 1.42). Depression prevalence varied substantially by geographic zone, and participants with high cardiovascular risk had higher prevalence than those without high cardiovascular risk. Conclusions: One in five Tanzanian adults aged 18–69 years reported depressive episode in the past year, with higher prevalence among women, older adults, and those without partners, and with marked geographic variation. These findings support strengthening and targeting depression screening and psychosocial support within primary health care and within services for chronic conditions.

Background: The diabetes care cascade outlines the steps required to achieve effective glycaemic control at the population level: screening, diagnosis, engagement in care, treatment initiation, and glycaemic control. In low- and middle-income countries, such as Tanzania, significant attrition occurs at various stages of the cascade, particularly between prevalence and diagnosis, and between treatment initiation and glycaemic control. Determinants of these gaps include patient, provider, and health-system factors, as well as geographic and sociodemographic inequities. Objective: To analyze the diabetes care cascade in Tanzania, identify points of attrition, and provide evidence for targeted interventions to improve detection, retention, and glycaemic control. Methods: A population-based cross-sectional study was conducted among Tanzanians aged 18–69 years. Data on diabetes prevalence, diagnosis, treatment, and glycaemic control were collected and analyzed. The cascade was disaggregated by age, sex, and urban/rural residence. Confidence intervals (CI) were calculated to assess the precision of estimates. Results: The overall prevalence of diabetes in the population aged 18–69 years was 2.9% (95% CI: 1.9–3.9), of these 0.9% (95% CI: 0.4–1.4) were currently on diabetes medication. Among identified diabetes cases, 72.4% were not previously diagnosed, 17.2% were previously diagnosed and on medication, and 10.3% were previously diagnosed but not on medication. Diabetes prevalence increased with age, with the highest rates observed in the 46–69 age group (6.5%, 95% CI: 3.8–9.1). Conclusion and Recommendations: The diabetes care cascade in Tanzania reveals significant gaps in screening, diagnosis, and treatment, with the majority of cases undiagnosed and untreated. Targeted interventions, such as community-based screening, task-sharing to primary care providers, improved medicine supply chains, and integration with other health platforms, are essential to address these gaps and reduce diabetes-related morbidity and mortality.

Background: Elevated Cholesterol levels is a significant modifiable risk factor for cardiovascular diseases; elevated total cholesterol is a growing public health issue in low- and middle-income nations. There is inadequate up to date national data on Tanzania's burden of high total cholesterol and its contributing factors. Methods: The nationally representative Tanzania WHO STEP-wise Survey, which was carried out between September and November 2023, provided the data for this secondary analysis. 3,565 adults between the ages of 18 and 69 were included in the study using a three-stage stratified sampling design. Structured interviews, physical measurements, and biochemical analyses were used to gather data. Total cholesterol ≥5.0 mmol/L or ongoing use of a lipid-lowering drug were considered indicators of elevated total cholesterol. Modified Poisson regression models and weighted analyses were employed to determine the factors linked to elevated total cholesterol. Results: 10.9% of people overall had elevated total cholesterol (95% CI: 8.8–13.4). The prevalence rose with age, was higher in urban than rural areas (14.8% vs. 7.7%), and was considerably higher in women than in men (15.8% vs. 4.5%). Unguja, the Northern, Southern, and Southwest Highlands zones had the highest prevalence, indicating significant regional variation. Female sex (aPR=1.74; 95% CI: 1.36–2.22), age 46–69 years (aPR=2.63; 95% CI: 1.95–3.53), living in an urban area (aPR=1.27; 95% CI: 1.03–1.57), and being overweight or obese (aPR=1.54; 95% CI: 1.25–1.88) were all independently linked to elevated total cholesterol levels. Conclusion: In Tanzania, one in ten adults between the ages of 18 and 69 have elevated total cholesterol; women, older adults, urban dwellers, and those who are overweight or obese are more likely to be affected. There is an urgent need for integrated and targeted cardiovascular risk prevention strategies.

Background: Cardiovascular diseases (CVDs) are the leading cause of global morbidity and mortality, with LMICs, including Tanzania, experiencing a growing burden due to aging, urbanization, and lifestyle changes. Adults aged 40–69 years are particularly vulnerable due to cumulative exposure to modifiable risk factors such as unhealthy diet, physical inactivity, tobacco use, and harmful alcohol consumption. Objective: To estimate the prevalence and identify determinants of CVD risk among Tanzanians aged 40–69 years, using data from the 2023 National STEPs Survey. Methods: A cross-sectional analysis of the Tanzania STEPs survey was conducted between September and November 2023, including 1,490 adults aged 40–69 years from 26 mainland regions and 5 Zanzibar regions. Data were collected through structured interviews, physical measurements, and biochemical sample collection. CVD risk was assessed using the WHO CVD risk prediction equation, considering factors such as age, gender, smoking status, systolic blood pressure, diabetes history, cholesterol levels, and BMI. Logistic regression modeling identified independent risk factors associated with high CVD risk (≥20%) or existing CVD. Results: The prevalence of high CVD risk (≥20%) or existing CVD was 13.3% (95% CI: 10.6–16.6). Females (15.7%, 95% CI: 12.3–19.8) and individuals aged 55–69 years (18.5%, 95% CI: 14.6–23.1) had higher prevalence rates compared to males (7.7%, 95% CI: 5.4–10.9) and those aged 40–54 years (10.7%, 95% CI: 8.1–14.0). The Southern Highlands zone had the highest prevalence (28.5%, 95% CI: 22.2–35.6). Depression was significantly associated with increased CVD risk (aPR: 2.50, 95% CI: 1.90–3.31). Conclusion: Despite a decrease in CVD risk prevalence compared to previous surveys, females, older adults, those with depression, and residents of the Southern Highlands remain at higher risk. Sustained NCD prevention efforts, mental health interventions, and targeted strategies for high-risk zones are essential to reduce CVD burden in Tanzania.

Non-Communicable Diseases (NCDs), such as hypertension, diabetes, sickle cell disease, and rheumatic heart disease, pose significant health burdens in low-income countries, not the least rural Tanzania, exacerbated by limited healthcare infrastructure, human and financial resources. This paper reports the perspectives of key stakeholders on the strengths, weaknesses, opportunities, and challenges (SWOC) in managing and preventing non-communicable diseases (NCDs) in rural districts of Tanzania, prior to the implementation of the WHO PEN Plus model. Using qualitative methods through in-depth interviews and focus group discussions, the study gathered insights from community health workers, teachers, students, health officials, and community members across two districts of Kondoa and Karatu. Findings revealed strong knowledge about common NCDs and risk factors, such as poor dietary habits and heredity, but also highlighted little knowledge and misconceptions to specific NCDs category such as diabetes type one, sickle cell anaemia and rheumatic heart disease. The key challenges included the unavailability of diagnostic tools and medicines, inadequate healthcare resources at the primary care level, financial barriers to accessing services and little heath education. However, the study identified opportunities for strengthening NCDs management and prevention through existing health infrastructure, community health workers, and government commitment. The results underscore the need for enhanced training, improved healthcare access at the primary care facilities, and community-based interventions to address the growing NCDs burden in Tanzania's rural districts.

BACKGROUND:While HIV viral load (VL) testing remained a critical approach for monitoring antiretroviral therapy (ART) effectiveness among people living with HIV (PLHIV), limited national data existed on the magnitude and factors associated with key VL thresholds, including low-level viremia (LLV) and VL non-suppression in Tanzania. We analyzed the prevalence and socio-demographic and behavioral factors associated with LLV and VL non-suppression among PLHIV on ART participating in a nationally representative survey. METHODS:We analyzed data from the Tanzania HIV Impact Survey (THIS) 2022-2023 among PLHIV aged 15 years and older. The analysis included 1,485 PLHIV on ART with VL results. Laboratory-based testing was conducted for qualitative detection of antiretroviral (ARV) drugs and quantitative evaluation of VL. Three VL levels were computed for the analyses: undetectable VL (<50 copies/mL); LLV (50-999 copies/mL); and VL non-suppression (≥1000 copies/mL). Unweighted absolute numbers and weighted percentages were reported for descriptive analysis. We used modified Poisson regression models to examine separately the prevalence and factors associated with LLV and VL non-suppression. We reported adjusted prevalence ratios (aPR), 95% confidence intervals (CIs) and p-values <0.05 were considered statistically significant. RESULTS:Overall, 76% of PLHIV in Tanzania had undetectable VL, 18% had LLV, and 6% had VL non-suppression. Among PLHIV with either LLV or undetectable VL, 19.5% had LLV and after multivariable adjustment, absence of ARV drugs detected in blood was the only factor significantly associated with LLV. Additionally, among PLHIV with either VL non-suppression or undetectable VL, 7.2% had VL non-suppression and after multivariable adjustment, absence of ARV drugs detected in blood and alcohol use were associated with VL non-suppression. CONCLUSION:In this nationally representative analysis of PLHIV in Tanzania, most people had undetectable viral load, while LLV was common and VL non-suppression was less frequent. Absence of ARV drugs detected in blood was associated with both LLV and VL non-suppression, underscoring the importance of recent ART exposure. These findings suggested that LLV warranted programmatic attention alongside VL non-suppression to support sustained viral suppression.

This study aims to develop a mathematical model for investigating tuberculosis (TB) transmission dynamics in Tanzania from 2017 to 2023, considering treatment and nutrition interventions using the Caputo Fractional Order Derivative approach. The analysis of model solutions and stability at disease-free and endemic equilibrium points was conducted using the Jacobian matrix and Lyapunov functions. Effective reproductive numbers (R-e) were computed using the Castillo-Chavez method, and sensitivity analysis was performed using Elementary Effects methods. The findings reveal that TB-infected populations exhibit R-e > 1 indicating global stability, while disease-free states demonstrate R-e < 1 suggesting local and global asymptotic stability. Notably, variations in the fractional-order derivative (0 < alpha <= 1) with memory effects significantly influence disease transmission dynamics un-der intervention scenarios. Combined treatment and nutrition interventions (0 <= tau, phi <= 1) markedly reduce infection rates (0.32909 <= R-e <= 1.2) facilitating TB clearance. However, the absence of interventions results in escalating disease prevalence, leading to an increase in the basic reproduction number (0.34802 <= R-0 <= 3.4) which impedes TB control efforts. Overall, the work suggests that the intervention efficacy incorporated by the fractional-order derivative technique involving memory effects and non-local solutions provides flexible and accurate solutions for better understanding and predicting TB transmission incidence, its progression and relevant control measures over time.

Marburg virus disease, also known as Marburg hemorrhagic fever, is a rare yet severe and often fatal viral disease caused by the Marburg virus, a member of the Filoviridae family. The Marburg virus is zoonotic, meaning it can be transmitted from animals to humans. In this study, a mathematical model is formulated and analyzed to describe the transmission dynamics of the Marburg virus, incorporating quarantine measures and protective interventions within the population. The next-generation method is employed to calculate the effective reproduction number, ℛ_e . By applying the Routh-Hurwitz criterion and constructing a Lyapunov function, results demonstrate that the Marburg virus-free equilibrium is both locally and globally asymptotically stable if the effective reproduction number ℛ_e < 1 . Conversely, when ℛ_e > 1 , the endemic equilibrium becomes globally asymptotically stable. Simulation results emphasize the importance of quarantining exposed individuals and enforcing protective measures in controlling the transmission of the Marburg virus within the population. Consequently, to effectively combat the disease, increased efforts should be directed toward implementing quarantine and protective measures.

Background: Globally, more than 530 million people live with diabetes mellitus (DM), and the burden continues to rise. Insulin remains the cornerstone of DM management worldwide. However, literature indicates that insulin users are at risk of developing abscesses and scar formation at injection sites. These complications may compromise adherence to therapy, thereby affecting the intended therapeutic outcomes. This study aimed to assess the prevalence of abscesses and scar formation at injection sites and their determinants among diabetic patients on insulin therapy in Dar es Salaam, Tanzania. Methods: A hospital-based analytical cross-sectional study was conducted between February and May 2024. A total of 428 patients with DM on insulin therapy were enrolled from four selected hospitals in Dar es Salaam. A validated case report form (CRF) was used to collect socio-demographic characteristics and clinical data related to abscess and scar formation following insulin therapy. Data were analyzed using Stata version 15.0 software, with findings summarized as frequencies and percentages. Determinants of abscess and scar formation were assessed using modified Poisson regression, and a p-value of <0.05 was considered statistically significant. Results: Out of 428 participants, 191 (44.6%) were aged over 45 years, 233 (54.4%) were female, and 185 (43.2%) had a primary education level. The prevalence of abscesses and scar formation was 95 (22.2%) and 200 (46.7%), respectively. Determinants of abscess formation included improper injection technique (aPR = 1.11; 95% CI: 1.02–1.21, p = 0.009), improper injection site rotation (aPR = 2.7; 95% CI: 1.13–6.45, p = 0.025), and the use of an insulin pen (aPR = 0.13; 95% CI: 0.04–0.48, p = 0.002). For scar formation, determinants included improper injection site rotation (aPR = 1.63; 95% CI: 1.03–2.32, p = 0.037), uncontrolled blood glucose levels (aPR = 1.69; 95% CI: 1.01–2.84, p = 0.049), and the use of insulin and syringes obtained from community drug outlets (aPR = 2.51; 95% CI: 1.22–1.98, p = 0.035). Conclusion: The study identified a significant burden of abscess and scar formation among DM patients on insulin therapy. Key determinants included improper injection techniques, inadequate rotation of injection sites, and uncontrolled blood glucose levels. Regular training for DM patients on proper insulin injection practices is essential to minimize these complications. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement Self-funded study ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Muhimbili University of Health and Allied Sciences Institutional Review Board (MUHAS-IRB) Ref DA282/298/01.C/2057 I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present work are contained in the manuscript