Background:Inappropriate antibiotic use is a major driver of antimicrobial resistance (AMR), especially in low- and middle-income countries (LMICs), where over-the-counter antibiotics are readily available without a prescription. This study assessed antibiotic dispensing practices in community pharmacies in Dar es Salaam, Tanzania. Methodology:From February to March 2025, a point prevalence survey was conducted in 100 community pharmacies in Dar es Salaam. Researchers approached existing customers, obtained consent, and conducted confidential interviews. Five participants were enrolled per pharmacy, for a total of 500 participants. Results:Overall, 64% (320/500) of community pharmacy attendees were dispensed antibiotics, of whom 71% (227/320) received them without a prescription. Access-group antibiotics were most frequently dispensed (56%, 201/356), followed by Watch (32%, 115/356) and Reserve groups (3%, 10/356), with metronidazole (15%, 53/356) and azithromycin (12%, 44/356) being the most commonly dispensed antibiotics. Urinary tract infection (UTI) was the leading indication (37%, 119/320), mainly treated with azithromycin (25%, 35/138), ciprofloxacin (12%, 16/138), and nitrofurantoin (7%, 9/138). Among antibiotic recipients, 44% (140/320) received antibiotics based on dispensers' recommendations. Ceftriaxone was commonly dispensed with prescriptions, while all Reserve antibiotics were dispensed without prescriptions. Participants with technical/vocational education (adjusted prevalence ratio [aPR], 1.38, 95% CI: 1.13-1.68, p = 0.001) were more likely to be dispensed antibiotics than those with no formal education or primary and secondary education, and a borderline association was found for college/university education (aPR, 1.22, 95% CI: 0.99 - 1.48, p = 0.05). The presence of an underlying medical condition was an independent protective factor against antibiotic dispensing (aPR, 0.70; 95% CI: 0.49-0.88; p = 0.005). Conclusion:Most clients attending community pharmacies in Dar es Salaam receive antibiotics without prescriptions, often based on dispensers' recommendations. The widespread use of Watch and Reserve antibiotics without oversight highlights major regulatory gaps and the urgent need for stronger policy enforcement and antimicrobial stewardship.

BackgroundTuberculosis (TB) remains a major global health issue, causing high illness and death rates despite being preventable and curable. In 2023, about 10.6 million contracted TB, and 1.3 million died, making it the second deadliest infectious disease after COVID-19. Tanzania has reduced TB incidence and mortality, but gaps remain in understanding differences in treatment outcomes between patients treated empirically and those with a confirmed bacteriological diagnosis. This study aimed to evaluate these differences to improve diagnostics, enhance TB programs, and inform policies.MethodsThis retrospective cohort study utilized the National Tuberculosis and Leprosy Program (NTLP) database. Demographic and clinical information were extracted from the eTL and exported to Microsoft Excel 2013. Independent variables included age, sex, residence, facility level, referral type, treatment history, disease classification, DOT options, and HIV status across all 26 regions of Mainland Tanzania. The dependent variable was alive/censored or died at the end of treatment. Mortality rates per 1000 person-months were calculated using Kaplan-- Meier analysis, with hazard ratios and 95% confidence intervals reported.ResultsA total of 173,659 participants were included from 2022 to 2023. The overall mortality rate was 4.70 (95% CI: 4.57–4.84). Clinically diagnosed patients had a significantly higher mortality rate per 1000 person months (5.43, 95% CI: 5.25–5.92) than the bacteriologically confirmed group (4.50, 95%CI: 4.35-4.64). The risk of death in clinically diagnosed patients was 1.32 times (95% CI: 1.23–1.42, p<0.001) than the bacteriologically confirmed group. The survival probability declined throughout the treatment period, with a more rapid decrease, and was notably lower in the clinically diagnosed group, dropping to 97.4% by the end of the 6-month follow-up. In comparison, the bacteriologically confirmed group had a survival probability of 96.8% (p < 0.001).ConclusionThis study shows confirming TB via bacteriological methods improves survival and reduces death versus clinical diagnosis alone. Improving diagnostic tools in Tanzania’s TB program could boost treatment outcomes and lower TB deaths, aiding global and national TB elimination efforts.

Background Infections significantly contribute to mortality and morbidity in burn patients, with rising of antibiotic-resistant bacteria further complicates treatment, contributing to poor outcomes. This study determined the burden of infections in burn patients, including microbial etiology, drug resistance patterns, and patient outcomes, at a tertiary hospital in Tanzania. Material and methods A retrospective cross-sectional study conducted from January 2021 to July 2022 recruited 158 burn patients (median age 3 years, IQR 1–20 years) at Muhimbili National Hospital. Data were obtained from medical records. Descriptive and logistic regression analysis ware performed using Statistical Package for the Social Sciences version 23.0, a p-value of <0.05 at 95% confidence intervals was significant. Results Of 158 burn patients, 117(74.1%) had infections; predominantly wound infection, 53.0% (n = 62). Wound and bloodstream infections were the predominant co-infections, 25.6% (n = 30), of which similar bacterial species were isolated in 33.3%(n = 10). Pseudomonas aeruginosa, was frequently isolated, found in 37.6%(n = 44) wounds and 50%(n = 2) urine samples. Staphylococcus aureus 33.3%(n = 18) and Coagulase-negative Staphylococci 29.6% (n = 16) were frequently isolated from blood. The isolated bacteria were resistant to most antibiotics; the proportion of multidrug-resistant strains was 61.5%(n = 72), 51.9%(n = 28), and 66.7%(n = 2) from wound, blood, and urine samples, respectively. Factors associated with mortality were multi-drug resistance infection (aOR:8.59, 95%CI:2.55–28.96, p = 0.001) and TSBA ≥21% (aOR:10.62, 95%CI:2.22–50.87, p = 0.003). Conclusion The Majority of burn patients develop infection with multidrug-resistant strains. Mortality was significantly associated with multi-drug resistance and TSBA ≥21%. Therefore, regular surveillance and strengthened stewardship are essential to guide treatment and curb antibiotic resistance.

Background Despite expansion of prevention of mother-to-child transmission (PMTCT) programmes, reductions in new pediatric HIV infections have stalled in much of sub-Saharan Africa, including Tanzania. The contribution of maternal viraemia to residual transmission remains incompletely quantified at population scale. In particular, the transmission risk associated with low-level viraemia (50–999 copies/mL) and its variation across the perinatal and breastfeeding continuum have not been well characterized using time-to-event methods in large national programme datasets, limiting evidence for programme-level risk stratification. Methods We conducted a retrospective national cohort study using linked maternal viral load (VL) and early infant diagnosis (EID) data in Tanzania (2022–2026). Maternal VL was categorized as target not detected (TND), 1–49, 50–199, 200–999, and ≥1,000 copies/mL, defined as the measurement closest to but preceding infant HIV testing. VL was treated as a time-fixed proxy for maternal viraemia prior to infant diagnosis. Follow up time was from conception to 12 months (52 weeks) of age. Cox-proportional hazards models estimated adjusted hazard ratios (aHRs), with interaction by timing of VL measurement to assess effect modification across the perinatal and breastfeeding periods. Results Among 44,916 infants, 411 HIV infections occurred. Compared with TND, aHRs increased progressively: 1.31 (95% CI 0.90–1.92) for VL 1–49 copies/mL; 2.95 (1.92–4.54) for 50–199 copies/mL; 4.09 (2.21–7.58) for 200–999 copies/mL; and 17.17 (13.10–22.49) for ≥1,000 copies/mL. The association varied significantly by timing of VL measurement (p=0.009), with the strongest effects observed during the intrapartum and early breastfeeding periods. Detectable viraemia during breastfeeding was associated with elevated infant HIV hazard: approximately 3–4-fold for 50–199 copies/mL, ~8-fold for 200–999 copies/mL, and >20-fold for ≥1,000 copies/mL. Although women with VL ≥1,000 copies/mL represented only 5.5% of the cohort, they accounted for 38% of infections, a highly concentrated transmission burden within a small high-risk subgroup . Conclusions Maternal viraemia is a strong, graded predictor of infant HIV acquisition in Tanzania's PMTCT programme, with the association strongest when viral load is measured intrapartum or during breastfeeding. Even low-level viraemia (50–999 copies/mL) confers substantially increased hazard. Breastfeeding transmission risk persists throughout the first 12 months of life. These findings support consideration of VL-guided extended infant postnatal prophylaxis throughout breastfeeding for mothers with detectable viraemia (≥50 copies/mL) and, where timely VL results are unavailable, evaluation of universal postnatal prophylaxis during breastfeeding as a programme-level risk mitigation strategy . Strengthening retention, adherence support, adolescent‑responsive services and mother to child infection surveillance remains essential to achieving elimination of pediatric HIV.

IntroductionThe increase in demand of laboratory services and recent advancements in laboratory technologies underscore the importance of quality laboratory services in delivering accurate, reliable, and timely test results. As a strategy to ensure quality laboratory services in the country, Tanzania started to implement Strengthening Laboratory Management Towards Accreditation (SLMTA) program in 2010. We describe the revolutions made in laboratory quality management system across the 13 years of SLMTA implementation highlighting the impact and achievements attained following the modification of the generic SLMTA approach.MethodologyWe evaluated, described and summarized the 13 years of SLMTA implementation in Tanzania and the quality performance of medical laboratories enrolled into the program. The quality performance was evaluated based on the increase in number of SLMTA laboratories accredited under ISO 15189 by comparing the laboratories enrolled during the generic versus modified SLMTA program.ResultsOut of 138 SLMTA laboratories assessed by 2023 using the SLIPTA checklist, 81 (58.7%) scored 3 stars and above were enrolled in the accreditation process. Of the 81 enrolled laboratories, 50 (61.7%) achieved ISO 15189 accreditation status by 2023. There was a significant increase in number of accredited laboratories during the five years (2018-2023) of modified SLMTA compared to the eight years (2010-2018) of generic SLMTA (47/64 vs. 3/17, p = 0.021). In the context of level of healthcare delivery, most of the accredited laboratories (n = 47/50, 94%), belonged to the district level and above.ConclusionTo the best of our knowledge, this is the first report of the modified SLMTA approach with remarkable results. The modified SLMTA program significantly improved the status and number of accredited laboratories in Tanzania. While the attained milestone demonstrates the SLMTA program's effectiveness in strengthening quality of laboratory services, the significant achievements underscore the essence of monitoring, evaluation and learning of the implemented programs, and most importantly the need for strategies that contextualize and tailor the program for sustainability.

Antimicrobial resistance (AMR) causes approximately 1.27 million direct deaths annually and disproportionately affects low- and middle-income countries (LMICs), where limited diagnostics, weak regulation, and constrained financing hinder effective containment. To synthesize evidence on governance, policy, and One Health strategies addressing AMR in LMICs, focusing on feasibility, equity, and public health impact. A scoping review of 85 peer-reviewed and policy sources (2015–2026) was conducted across PubMed, Scopus, Web of Science, Google Scholar, and institutional repositories (WHO, FAO, WOAH, UNEP, OECD, UNGA). Study selection and data extraction were performed independently by two reviewers, with disagreements resolved through consensus. Evidence was thematically synthesized and mapped by feasibility, equity, and outcomes within a One Health framework. Short-term interventions, including prescription-only policies, antimicrobial stewardship, and community campaigns, reduced antibiotic use (7.5–36

A well-structured laboratory network with a reliable biological sample transportation system ensures timely detection, prevention, and response to public health threats. We evaluated the sample referral system in Tanzania from July to December 2020 to identify key improvement areas. The study involved 97 hubs covering 21 of 26 regions. We collected data on management, financing, data collection, monitoring, human resources, equipment, network design, scheduling, and transportation through interviews, observations, and document reviews. Data were analyzed using Microsoft Excel and presented in tables, graphs, and charts. Overall performance was 63.6% (95% CI: 52.3-75.0). Specialized laboratory hubs scored highest, 79.5% (95% CI: 70.6-89.1). Specialized hospitals performed the best in all components, ranging from 68.8% to 100%. Regional referral hospitals were the second-best performers, ranging from 59.6% to 72.1%. Health centers performed least in management (54.8%), financing and costing (32.7%), and data collection, monitoring, and evaluation (45.2%). We found inconsistencies in the performance of sample referral hubs at various levels and components, highlighting the need for targeted capacity enhancement to improve the sample referral system. We recommend adopting context-specific strategies to address the unique needs of each hub level.

Background Recent advances in development and changes in laboratory technology seen in modern medicine have increased the demand on timely, accurate, reliable, and reproducible laboratory results. In public health settings, the laboratory plays a key role in disease surveillance for early detection and confirmation of disease outbreaks. We aimed to describe and document the 15189 accreditation in Tanzania. Methods We conducted a cross-sectional study involving databases for medical laboratories in the Ministry of Health and African Society for Laboratory Medicine (ASLM). All laboratories which participated in quality management system in Tanzania were included in the study from national to health centre levels. Results Out of 157 laboratories implementing QMS from 2007 to 2024, a total of 81 (51.6%) laboratories were accredited. Secondary laboratory level had high number of enrolments into QMS program 117 (74.5%) followed by tertiary laboratories 26 (16.6%). The proportion of accredited laboratories at tertiary level was (73.1%) (p < 0.033) which was significantly higher compared to other levels. There was significantly higher proportion of laboratories accredited through direct laboratory accreditation process 25/28, (89.3%), compared with SLMTA program 59/129 (44.4%) (p < 0.001 ). There was a significant increase of accredited laboratories among SLMTA program from 1/76 (1.3%) in 2017 to 56/157 (35.7%) in 2024, ( p = 0.027) compared to direct laboratory accreditation approach. Conclusions Laboratory accreditation is a hallmark of quality management system implementation which can be achieved either through direct laboratory accreditation approach or the SLMTA program. The seventeen years of experience in implementing QMS indicates that the SLMTA program is more efficient, effectiveness and user-friendly than the direct laboratory accreditation approach.

Background Effective antimicrobial resistance (AMR) mitigation requires systematic mapping of existing evidence to identify gaps and guide priorities. In Tanzania, the scope, focus, and alignment of AMR research with the National Action Plan on AMR (AMR-NAP) have not been systematically assessed. We conducted a systematic landscape and bibliometric analysis of peer-reviewed AMR research conducted in Tanzania. Methods Medline, PubMed and Web of Science were searched from inception to July 23, 2025. Eligible studies reported original AMR data from human, animal, or environmental contexts. Studies were mapped by One Health sectors, pathogen groups, and AMR-NAP objectives. Thematic patterns were examined using co-occurrence network analysis. Findings We included 799 studies. Annual publication output increased significantly after 2004 (p < 0.0001), with AMR domain-specific change points for antibacterial, antiparasitic, and antiviral resistance in 2006, 2001, and 2012, respectively. Most studies focused on antibacterial resistance (66.3%, 530/799), followed by antiparasitic (18.8%,150/799), antiviral (13.9%, 111/799), and antifungal (1.0%, 8/799). Research was dominated by human health studies (88.5%, 707/799), with limited animal (7.0%, 56/799) and environmental (1.6%, 13/799) representation; only 2.9% (23/799) integrated more than one sector. Among 496 pathogen-specific studies, 148 taxa were reported, but research focused on Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, HIV, and Plasmodium spp. Most studies aligned with the AMR-NAP objective of surveillance and research (72.1%), while stewardship, infection prevention, governance, and economic analyses were underrepresented. Funding was predominantly external (91.9%, 578/629). Interpretation Tanzania’s AMR evidence base has grown but remains imbalanced, requiring cross-sectoral, intervention-focused research to guide policy. Funding French Ministry of Foreign Affairs.

Background Antimicrobial resistance (AMR) is a major global health threat affecting humans, animals, and the environment. Its burden is particularly severe in low- and middle-income countries (LMICs), where infectious diseases are prevalent, antimicrobial use is often unregulated, and laboratory capacity is limited. Conventional phenotypic testing is essential but time-consuming and may fail to detect emerging or complex resistance mechanisms. Objective This scoping review maps genomic surveillance approaches combined with machine learning (ML) and artificial intelligence (AI) for predicting bacterial AMR, emphasizing methodological strategies, predictive performance, and relevance to LMIC One Health surveillance. Methods Systematic searches of PubMed, Scopus, Web of Science, EMBASE, and preprint servers (2020–2026) identified studies applying whole-genome sequencing (WGS) or pan-genomic approaches with ML/AI to predict AMR phenotypes. Data were extracted on pathogens, genomic feature engineering, ML/AI models, validation strategies, performance metrics, sample sources (human, animal, environmental), and LMIC relevance. Results Twenty-seven studies met inclusion criteria, including 22 with direct or transferable LMIC relevance. Predictive performance ranged from 78% to 98%, with LMIC datasets achieving 80%–94% accuracy. Tree-based ensembles (Random Forest, gradient boosting), logistic regression, and neural networks predominated. Genomic features included single nucleotide polymorphisms, k-mer encodings, and pan-genome presence–absence matrices. Explainable AI methods, such as SHAP, improved interpretability. Most models were trained on high-income country datasets, and integrated LMIC datasets spanning human, animal, and environmental reservoirs remain limited. Conclusions Genomic ML/AI approaches offer a rapid, high-resolution pathway for AMR prediction and One Health surveillance. Expanding LMIC-specific datasets, improving external validation, and integrating explainable AI are critical for equitable and sustainable deployment.

Background Postnatal HIV transmission through breastfeeding remains poorly characterized within Tanzania's Prevention of Mother-to-Child Transmission (PMTCT) programme. Early infant diagnosis (EID) identifies most infections within the first 8 weeks of life; however, inadequate post-diagnosis follow-up has left population-level postnatal incidence largely unmeasured. Methods We conducted a retrospective cohort analysis linking Tanzania's national HIV Early Infant Diagnosis (HEID) records with maternal viral load (VL) data obtained from centralized laboratory information systems between December 2018 and February 2026. HIV-exposed infants with a negative (HEID) polymerase chain reaction (PCR) result at or before 8 weeks of age were eligible for inclusion (N = 98,456). The analytic cohort comprised those who had at least one subsequent (HEID) PCR test (n = 1,583; 1.6%). Baseline characteristics were compared against non-retained infants (n = 96,873) using chi-squared tests. Postnatal incidence and cumulative risk were estimated using exact Poisson 95% confidence intervals and Kaplan–Meier analysis, with loss to follow-up modelled as a competing risk to generate a lower-bound sensitivity estimate. Results The analytic cohort differed significantly from non-retained infants (p < 0.001), showing lower maternal viral suppression (43.6% vs. 60.0% with target not detected) and a higher proportion of missing VL data. Overall, 79.8% of maternal VL evaluations occurred after 6 weeks postpartum. Twenty infections occurred over 894.8 person-years, yielding an incidence of 2.24 per 100 person-years (95% CI: 1.37–3.45). Incidence increased from 1.25 per 100 person-years (95% CI: 0.40–2.91) among mothers with undetectable VL to 7.15 per 100 person-years (95% CI: 0.87–25.85) among those with VL ≥ 1,000 copies/mL. Cumulative incidence at 40 weeks reached 2.03% (95% CI: 1.13–3.62%), with a competing-risk lower bound of 1.2%. Conclusions This study provides the first longitudinal estimate of postnatal HIV transmission derived from a Tanzanian HEID cohort. The high proportion of eligible infants lacking follow-up (HEID) PCR test likely reflects both unintegrated point-of-care testing data and true clinical attrition. Given the highly selected analytic subpopulation, selection bias may limit population-level inference. While biomedical interventions remain central to PMTCT, achieving and sustaining the elimination of vertical transmission in Tanzania will require systemic monitoring enhancements—specifically, a unified, longitudinal mother–infant tracking system that integrates centralized and decentralized (point-of-care) HIV VL and HEID platforms with ePMTCT and CTC-2. Supported by optimized VL monitoring schedules and expanded testing coverage during pregnancy and breastfeeding, this system would close structural gaps in care retention and strengthen tracking of viral suppression and incident infections.

Background: Ear infection is a common public health problem in developing countries. There is limited data on the factors associated with ear infections, which have hastened their spread and the repercussions of ear infections, including hearing loss. The study aimed to determine the magnitude and factors associated with ear infection among patients attending the Otorhinolaryngology clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania. Methods: A hospital-based cross-sectional study was conducted from March to July 2021. Participants with signs and symptoms of ear infection who attended the otorhinolaryngology clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania, were recruited into this study. The clinical information from the participants was collected using a standardized data collection tool, and an ear swab was collected and taken to the lab for culture and identification. Data analysis was conducted using Statistical Package for the Social Sciences (SPSS v23), and proportions and percentages were used to indicate the magnitude. The Chi-square test was employed to assess associations between variables, with statistical significance determined at a p-value of 0.05. Logistic regression was used to measure the strength of the association between dependent and independent variables. Results: A total of 255 eligible participants were enrolled, with ages ranging from 1 to above 50 years (median 31 years; IQR: 15–49). The magnitude of ear infection was found to be 53.3% (136 out of 255). The majority (26.8%) of participants with ear infection were elderly above 50 years, followed by children under 10 years (17.9%). Additionally, we observed that the factors such as cotton buds use (AOR 2.78, 95%CI 1.08–7.15, p=0.035) and ear cleaning using objects other than cotton buds, including keys, pins, and pens (AOR 3.45, 95%CI 1.44–8.25, p=0.005), p=0.035), cerumen impaction (AOR 12.86, 95%CI 2.78-59.33, p <0.001), p=0.035), cerumen impaction (AOR 12.86, 95%CI 2.78-59.33, p <0.001), recurrent upper respiratory tract infection (URTI) (AOR 3.43, 95%CI 1.22-10.03, p=0.019), and nasal /congestion/discharge (AOR 3.55, 95% CI 1.36-9.27, p = 0.010) were independently associated with ear infection. Conclusions: The present study has revealed a 53.3% magnitude of ear infection, with elders above 50 years and children below 10 years accounting for most cases. Our study findings showed that nasal congestion, recurrent URTI, use of cotton buds, cerumen impaction and ear cleaning were potential risk factors for ear infection. Recommendations: Health education campaigns promoting safe ear hygiene, early treatment of URTI and nasal congestion, and discouragement of the use of cotton buds and sharp objects for ear cleaning are recommended to reduce the burden of ear infections in similar settings.

Background H. pylori infection has been recognized as one of the most common infections in humans affecting almost half of the world population. Detection of Helicobacter pylori infection in resource limited areas mainly based on stool antigen test and serological test. Detection of H. pylori by using culture method has been a challenge especially in resource limited area because of the requirement need in growing and isolating this organism in laboratory. There is no study which has been done in Tanzania on detecting these bacteria by using culture method. Methodology A cross-sectional study was conducted at Muhimbili National Hospital from September 2020 to February 2021. We consecutively enrolled patients undergoing upper endoscopy at Muhimbili National Hospital after meeting inclusion criteria. Detection of Helicobacter pylori infection was done using rapid urease test and those turned positive were taken for culture and sensitivity. Sensivity testing with the use of selected antibiotics was done using the disc diffusion method. The isolates with characteristics of gram-negative straight rods, oxidase-positive, urease-positive, and catalase-positive were identified as Helicobacter pylori. Results A total of 290 participants were involved in this study, 123 (42.4%) tested positive for H. pylori infection using rapid urease test. We were able to isolate H. pylori from 29 specimens by culture method from 123 (23.6%) specimens which were positive by rapid urease test. Helicobacter pylori resistance to clarithromycin, amoxicillin, metronidazole, levofloxacin, ciprofloxacin and tetracycline was 65.5%, 86.2%, 100%, 0%, 3.5%, and 31% respectively. Conclusion Helicobacter pylori infection is very common in resource limited areas. Detection of H. pylori using culture methods is very important, as it allows performance of antimicrobial susceptibility testing. Resistance to common antibiotics used in treating and eradicating H. pylori infection is very high. Extensive local studies using the recommended methods for antimicrobial susceptibly testing is advocated.

Hepatitis B virus (HBV) infection is a significant occupational risk for laboratory practitioners. Despite proven vaccine effectiveness and global recommendations, HBV vaccine uptake among healthcare workers in Tanzania remains low. This study assessed HBV vaccination uptake and its determinants among laboratory practitioners in tertiary hospitals in Dar es Salaam. An analytical cross-sectional study was conducted from March to June 2025 across four tertiary hospitals, enrolling 130 participants using the Kish-Leslie formula. Data were collected using a structured, pre-tested, interviewer-administered questionnaire and verified vaccination records, and analyzed with IBM SPSS v27. Descriptive statistics summarized participant characteristics, and associations were assessed using chi-square, Fisher's exact tests, and log-binomial regression with robust variance. Of 130 participants (median age 30 years, IQR: 25-36), 54.6% (71/130) completed the three-dose hepatitis B vaccination schedule, 23.8% (31/130) received partial doses, and 21.5% (28/130) were unvaccinated. Among the partially vaccinated, missed appointments (48.4%, 15/31) and lack of vaccine availability (41.9%, 13/31) were the main reasons. Half of the unvaccinated (50.0%, 14/28) cited lack of opportunity. Most participants knew the vaccine is essential (99.2%, 129/130), and 94.1% (96/102) acknowledged three doses are required for full protection. Although females, those with longer work experience, and those perceiving high exposure risk had higher vaccination prevalence, none of these associations reached statistical significance in univariate or multivariable analyses. HBV vaccine uptake among laboratory practitioners in Dar es Salaam is suboptimal, mainly due to structural barriers. Strengthening workplace vaccination programs, ensuring consistent vaccine supply, and implementing reminder systems could improve healthcare worker protection.

Background Methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL) producing bacteria are the most common contaminants on hospital surfaces. Hospitalized patients, especially those with cancer, have a higher likelihood of acquiring hospital-associated infections in a contaminated environment. Outbreaks of MRSA and ESBL-producing bacteria linked to contaminated inanimate hospital surfaces are a well-documented threat. Cancer patients, who often have prolonged hospital stays, are particularly at risk of acquiring these multidrug-resistant (MDR) infections. The immunosuppressed state of cancer patients further increases their susceptibility, resulting in higher morbidity and mortality associated with these infections. This study assessed the prevalence, antimicrobial resistance, and factors associated with contamination of inanimate hospital surfaces by MRSA and ESBL-producing bacteria. Materials and methods This was cross-sectional study conducted at Ocean Road Cancer Institute, Dar es salaam, Tanzania in March and April 2023. The surfaces were conveniently selected, and a total of 247 inanimate surface samples were collected using a sterile swab pre-moistened with sterile Trypticase soy broth. A structured data collection checklist was used to record key variables for each sampled surface. The samples were cultured on Mannitol salt agar and MacConkey agar containing 2 mg/ml of ceftazidime. Identification of the isolates were done by using VITEC MS. Methicillin-resistant Staphylococcus aureus (MRSA) and extended-spectrum beta-lactamase (ESBL) producing bacteria were confirmed phenotypically through testing with a 30 µg cefoxitin disk and the combination disk method, respectively. Antimicrobial susceptibility testing was performed using the Kirby-Bauer disk diffusion method. Logistic and modified Poisson regression analyses were performed to determine factors associated with contamination. Results A total of 247 swab samples were collected from six predetermined items; bed rails, computer keyboards, door handles, hand-washing sinks, nursing station tables, and trolleys. The proportions of MRSA and ESBL producing bacteria’ contamination were 21 (8.5%) and 63 (25.5%), respectively. Acinetobacter baumannii and Klebsiella pneumoniae were the predominant ESBL producing bacteria each accounting for 38 of the 84 isolates (45.2%). All Staphylococcus aureus isolates were identified as MRSA and were non-susceptible to at least one antimicrobial agent in three or more antibiotic classes; however, all isolates showed 100% susceptibility to linezolid. Klebsiella pneumoniae demonstrated resistance to piperacillin-tazobactam, cefepime, and ciprofloxacin, with rates ranging from 92.1% to 97.4%. Resistance to meropenem was observed in 52.6% of Klebsiella pneumoniae isolates. Hand-washing sinks were the only surface independently associated with contamination by ESBL-producing bacteria (APR 5.8, P < 0.001). Conclusion A significant proportion of inanimate hospital surfaces were contaminated with MRSA and ESBL-producing bacteria. The findings imply a need to improve infection prevention and control practices.

BackgroundSurgical site infections (SSI) are common healthcare-associated infections, yet data on causative bacteria and antimicrobial susceptibility patterns are limited. The study aimed to determine the bacterial pathogens and antimicrobial resistance patterns among post-operative patients at tertiary hospitals in Dar es Salaam, Tanzania.MethodsWe conducted a cross-sectional study between September 2022 and February 2023 to investigate SSI through an aerobic culture of pus aspirates or wound swabs. Isolates were identified using conventional methods and an analytical profile index 20E test for Enterobacterales. Antimicrobial susceptibility testing was performed using Kirby Bauer disc diffusion methods. Continuous variables were summarized as mean and standard deviation, while categorical variables were summarized as proportions.ResultsA hundred-fifty-eight patients were enrolled, with a mean age of 42.20 +/- 12.13 years. Of 158,140(88.6%) showed bacterial growth and 164 isolates. Escherichia coli 45 (27.4%), Pseudomonas aeruginosa 38 (23.2%), and Staphylococcus aureus 38 (23.2%) were the most isolated. Among the Enterobacterales, 39/80 (48.8%) were extended-spectrum beta-lactamase producers. Methicillin-resistant Staphylococcus aureus was detected in 11/38 (29.0%) Staphylococcus aureus. Overall, multi-drug resistant strains were 127/164 (77.4%).ConclusionsGram-negative bacteria were the predominant cause of SSI. More than three-quarters of isolates were multi-drug-resistant strains. The findings underscore the need to regularly review antimicrobial prophylaxis practices and treatment guidelines, strengthen infection prevention and control measures, and antimicrobial stewardship.

Every year, over 10 million people worldwide contract tuberculosis (TB). The 2024 World Health Organisation TB global report indicated that 32% of the total deaths were children and adolescents under 15 years old. The scale of TB highlights the urgent need for action to end the global epidemic by 2030. This study aims to evaluate the mortality rate, survival probabilities, and factors associated with mortality among children and adolescents with TB in Tanzania. A retrospective cohort study was conducted from the Tanzania National Tuberculosis and Leprosy Programme data, which included individuals under 15 years old who began TB treatment between 1st January 2023 and 31st December 2023. The last patient's end-of-follow-up time was on 16th June 2024. The primary outcome of interest in our study was death. We calculated overall and covariate-specific TB mortality rates per 1,000 person-months. The Kaplan-Meier curve was employed to estimate survival probabilities. A total of 10,491 children and adolescents receiving TB treatment were included, nearly half of whom, 5,940 (56.62%), were under age 5 years. A total of 177 (1.69%) died, resulting in a crude mortality rate of 2.86 per 1,000 person-months. Furthermore, TB and HIV co-infection individuals had five times the risk of death (aHR = 5.03, 95% CI = 3.40-7.47, p < 0.001) compared to non-HIV infection. Community referrals were associated with a lower risk of mortality (aHR = 0.54, 95% CI = 0.35-0.84, p = 0.006). We observed significantly lower survival probabilities for patients referred from CTC, with rates of 96.8%, 96.0% and 95.8% at 2, 4, and 6 months, respectively, compared to those referred from the community, which showed higher survival probabilities of 99.5%, 99.3% and 99.2% over the same periods. The findings reveal significant differences in TB mortality in relation to age, referral system and co-infection. Integrating TB services with child healthcare programs and strengthening differentiated service delivery models can improve survival rates. Targeted interventions in high-risk areas are essential to reduce TB mortality.

Background: Hospitalised neonates are at increased risk of carrying extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE) and carbapenemase-producing Enterobacterales (CPE), possibly leading to invasive infections. This study determined the faecal carriage of ESBL-PE, CPE, and associated factors among neonates at Muhimbili National Hospital (MNH). Methods: A hospital-based cross-sectional study was conducted among neonates aged ≤ 28 days admitted at MNH. The participants’ data and rectal swab samples were collected. Samples were processed to detect ESBL-PE and CPE. Results were confirmed using the double-disc diffusion synergy test and modified carbapenem inactivation method, respectively. An antimicrobial susceptibility test was performed using the Kirby Bauer disk diffusion method. Results: Three hundred forty neonates with a median age of 3 days (IQR: 2-9) were enrolled. The carriage rate of ESBL-E and CPE was 39.4%(134/340) and 1.8%(6/340), respectively. Klebsiella pneumoniae (66.9%) and Escherichia coli (66.7%) were the common isolates for ESBL-PE and CPE, respectively. The factors independently associated with ESBL-PE carriage were antibiotic use (aOR 2.73, 95% CI: 1.38-5.39, p=.04), age increase (aOR 1.09, 95% CI: 1.02-1.15, p=.006), prolonged hospitalisation (aOR 2.92, 95% CI: 1.17-7.29, p=.02), and neonate-sucking their fingers (aOR 2.98, 95% CI: 1.04-8.58, p=.04). The study observed a trend of CPE carriage toward neonates with prolonged hospitalisation (p=.05). ESBL-PE low resistance was observed to meropenem (0.9%), amikacin (2.7%-6.7%), and gentamicin (19.4% to 100 %). Conclusions: The study revealed a relatively high carriage rate of multidrug resistant Enterobacterales among neonates admitted to a tertiary hospital. These findings underscore the importance of continuous surveillance of ESBL-PE and CPE to prevent infections and limit their potential transmission within hospital settings and the community.

In July 2022, during the COVID-19 era, Tanzania reported over 1500 laboratory-confirmed measles cases and more than 30 deaths, with about 80

Tuberculosis (TB) is a significant global health issue, mainly in developing countries. Despite the progress made in reducing TB rates, adverse treatment outcomes, such as deaths and treatment failures, continue to be a concern. We aimed to determine the treatment failure and death rates, and its predictors, among TB patients in Tanzania from January 2022 to December 2023. We conducted a cohort study utilizing data from the National Tuberculosis and Leprosy Programme database, focusing on TB patients who began treatment in 2022 and 2023. The Cox proportional hazards model was used to conduct univariate and multivariate analyses. Hazard ratios and their respective 95