Northeastern Tanzania Research Articles

Anthropometric measurements can identify small for gestational age newborns: a cohort study in rural Tanzania

BackgroundSmall-for-gestational-age (SGA) is associated with increased neonatal mortality and morbidity. In low and middle income countries an accurate gestational age is often not known, making the identification of SGA newborns difficult. Measuring foot length, chest circumference and mid upper arm circumference (MUAC) of the newborn have previously been shown to be reasonable methods for detecting low birth weight (< 2500 g) and prematurity (gestational age < 37 weeks). The aim of this study was to investigate if the three anthropometric measurements could also correctly identify SGA newborns.MethodsIn the current study from a rural area of northeastern Tanzania, 376 live newborns had foot length, chest circumference, and MUAC measured within 24 h of birth. Gestational age was estimated by transabdominal ultrasound in early pregnancy and SGA was diagnosed using a sex-specific weight reference chart previously developed in the study area. Receiver operating characteristic curves were generated for each of the anthropometric measurements and the area under the curve (AUC) compared. Operational cutoffs for foot length, chest circumference, and MUAC were defined while balancing as high as possible sensitivity and specificity for identifying SGA. Positive and negative predictive values (PPV and NPV) were then calculated.ResultsOf the 376 newborns, 68 (18.4%) were SGA. The AUC for detecting SGA was 0.78 for foot length, 0.88 for chest circumference, and 0.85 for MUAC. Operational cut-offs to detect SGA newborns were defined as ≤7.7 cm for foot length, ≤31.6 cm for chest circumference and ≤ 10.1 cm for MUAC. Foot length had 74% sensitivity, 69% specificity, PPV of 0.35 and NPV of 0.92 for identifying SGA. Chest circumference had 79% sensitivity, 81% specificity, PPV of 0.49 and NPV of 0.95 for identifying SGA. Finally, MUAC had 76% sensitivity, 77% specificity, PPV of 0.43 and NPV of 0.94 for identifying SGA.ConclusionIn a setting with limited availability of an accurate gestational age, all three methods had a high NPV and could be used to rule out the newborn as being SGA. Overall, chest circumference was the best method to identify SGA newborns, whereas foot length and MUAC had lower detection ability.Trial registrationClinicaltrials.gov (NCT02191683). Registered 2 July 2014.

Prevalence of Wuchereria bancrofti Infection in Mosquitoes from Pangani District, Northeastern Tanzania

Background: Wuchereria bancrofti is the most widely distributed of the 3 nematodes known to cause lymphatic filariasis, the other 2 being Brugia malayi and Brugia timori. Anopheles gambiae and Anopheles funestus are the main vectors. However, the relative contributions of mosquito vectors to disease burden and infectivity are becoming increasingly important in coastal East Africa, and this is particularly true in the urban and semiurban areas of Pangani District, Tanzania. Methods: Mosquitoes were sampled from 5 randomly selected villages of Pangani District, namely, Bweni, Madanga, Meka, Msaraza, and Pangani West. Sampling of mosquitoes was done using standard Centers for Disease Control light traps with incandescent light bulbs. The presence of W. bancrofti in mosquitoes was determined via polymerase chain reaction (PCR) assays using NV1 and NV2 primers, and PoolScreen 2 software was used to determine the estimated rate of W. bancrofti infection in mosquitoes. Results: A total of 951 mosquitoes were collected, of which 99.36% were Culex quinquefasciatus, 0.32% were Anopheles gambiae, and 0.32% other Culex species. The estimated rate of W. bancrofti infection among these mosquitoes was 3.3%. Conclusion: This was the first study employing the use of PoolScreen PCR to detect W. bancrofti circulating in mosquito vectors in Pangani District, northeastern Tanzania. The presence of W. bancrofti infection suggests the possibility of infected humans in the area. The high abundance of Cx. quinquefasciatus calls for integrated mosquito control interventions to minimise the risk of W. bancrofti transmission to humans. Further research is required to gain an in-depth understanding of the W. bancrofti larval stages in mosquitoes, their drug sensitivity and susceptibility profiles, and their fecundity.

Prevalence of Wuchereria bancrofti Infection in Mosquitoes from Pangani District, Northeastern Tanzania

Background: Wuchereria bancrofti is the most widely distributed of the 3 nematodes known to cause lymphatic filariasis, the other 2 being Brugia malayi and Brugia timori. Anopheles gambiae and Anopheles funestus are the main vectors. However, the relative contributions of mosquito vectors to disease burden and infectivity are becoming increasingly important in coastal East Africa, and this is particularly true in the urban and semiurban areas of Pangani District, Tanzania. Methods: Mosquitoes were sampled from 5 randomly selected villages of Pangani District, namely, Bweni, Madanga, Meka, Msaraza, and Pangani West. Sampling of mosquitoes was done using standard Centers for Disease Control light traps with incandescent light bulbs. The presence of W. bancrofti in mosquitoes was determined via polymerase chain reaction (PCR) assays using NV1 and NV2 primers, and PoolScreen 2 software was used to determine the estimated rate of W. bancrofti infection in mosquitoes. Results: A total of 951 mosquitoes were collected, of which 99.36% were Culex quinquefasciatus, 0.32% were Anopheles gambiae, and 0.32% other Culex species. The estimated rate of W. bancrofti infection among these mosquitoes was 3.3%. Conclusion: This was the first study employing the use of PoolScreen PCR to detect W. bancrofti circulating in mosquito vectors in Pangani District, northeastern Tanzania. The presence of W. bancrofti infection suggests the possibility of infected humans in the area. The high abundance of Cx. quinquefasciatus calls for integrated mosquito control interventions to minimise the risk of W. bancrofti transmission to humans. Further research is required to gain an in-depth understanding of the W. bancrofti larval stages in mosquitoes, their drug sensitivity and susceptibility profiles, and their fecundity.

Prevalence of Wuchereria bancrofti Infection in Mosquitoes from Pangani District, Northeastern Tanzania

Background: Wuchereria bancrofti is the most widely distributed of the 3 nematodes known to cause lymphatic filariasis, the other 2 being Brugia malayi and Brugia timori. Anopheles gambiae and Anopheles funestus are the main vectors. However, the relative contributions of mosquito vectors to disease burden and infectivity are becoming increasingly important in coastal East Africa, and this is particularly true in the urban and semiurban areas of Pangani District, Tanzania. Methods: Mosquitoes were sampled from 5 randomly selected villages of Pangani District, namely, Bweni, Madanga, Meka, Msaraza, and Pangani West. Sampling of mosquitoes was done using standard Centers for Disease Control light traps with incandescent light bulbs. The presence of W. bancrofti in mosquitoes was determined via polymerase chain reaction (PCR) assays using NV1 and NV2 primers, and PoolScreen 2 software was used to determine the estimated rate of W. bancrofti infection in mosquitoes. Results: A total of 951 mosquitoes were collected, of which 99.36% were Culex quinquefasciatus, 0.32% were Anopheles gambiae, and 0.32% other Culex species. The estimated rate of W. bancrofti infection among these mosquitoes was 3.3%. Conclusion: This was the first study employing the use of PoolScreen PCR to detect W. bancrofti circulating in mosquito vectors in Pangani District, northeastern Tanzania. The presence of W. bancrofti infection suggests the possibility of infected humans in the area. The high abundance of Cx. quinquefasciatus calls for integrated mosquito control interventions to minimise the risk of W. bancrofti transmission to humans. Further research is required to gain an in-depth understanding of the W. bancrofti larval stages in mosquitoes, their drug sensitivity and susceptibility profiles, and their fecundity.

Prevalence of Wuchereria bancrofti Infection in Mosquitoes from Pangani District, Northeastern Tanzania

Background: Wuchereria bancrofti is the most widely distributed of the 3 nematodes known to cause lymphatic filariasis, the other 2 being Brugia malayi and Brugia timori. Anopheles gambiae and Anopheles funestus are the main vectors. However, the relative contributions of mosquito vectors to disease burden and infectivity are becoming increasingly important in coastal East Africa, and this is particularly true in the urban and semiurban areas of Pangani District, Tanzania. Methods: Mosquitoes were sampled from 5 randomly selected villages of Pangani District, namely, Bweni, Madanga, Meka, Msaraza, and Pangani West. Sampling of mosquitoes was done using standard Centers for Disease Control light traps with incandescent light bulbs. The presence of W. bancrofti in mosquitoes was determined via polymerase chain reaction (PCR) assays using NV1 and NV2 primers, and PoolScreen 2 software was used to determine the estimated rate of W. bancrofti infection in mosquitoes. Results: A total of 951 mosquitoes were collected, of which 99.36% were Culex quinquefasciatus, 0.32% were Anopheles gambiae, and 0.32% other Culex species. The estimated rate of W. bancrofti infection among these mosquitoes was 3.3%. Conclusion: This was the first study employing the use of PoolScreen PCR to detect W. bancrofti circulating in mosquito vectors in Pangani District, northeastern Tanzania. The presence of W. bancrofti infection suggests the possibility of infected humans in the area. The high abundance of Cx. quinquefasciatus calls for integrated mosquito control interventions to minimise the risk of W. bancrofti transmission to humans. Further research is required to gain an in-depth understanding of the W. bancrofti larval stages in mosquitoes, their drug sensitivity and susceptibility profiles, and their fecundity.

Local people’s interpretations of the hominin footprints at Laetoli, Tanzania

ABSTRACTIn 1976 and 2014, scientists reported hominin footprints in Pliocene volcanic deposits at Laetoli, north-eastern Tanzania. They hypothesized that the footprints belong to the extinct hominin species Australopithecus afarensis. Not only have the footprints shaped scientists’ understanding of human biological evolution, but they have also placed Laetoli and Tanzania on the world’s paleoanthropological studies map. However, there have been different interpretations of who made these footprints. Opinions of the scientists on the footprints are widely documented, yet narratives of Maasai (local people living around Laetoli) have never been investigated. This paper documents the perceptions of Maasai on what these footprints are, and to whom they belong. We report that concepts related to the nature and genesis of the footprints and who made them form part of the Maasai’s history. Finally, we suggest that for sustainable footprints preservation, local narratives about footprints be integrated into scientific interpretations of the site.

Preconceptional factors associated with haemoglobin concentration in early pregnancy: a community-based cohort study in rural northeastern Tanzania.

Maternal anaemia in early pregnancy is associated with poor pregnancy outcomes. Furthermore, preconceptional health can influence the health during pregnancy. The aim of this study was to investigate which preconceptional factors were associated with haemoglobin (Hb) concentration in early pregnancy. In Tanzania, 226 women were followed at preconception and during early pregnancy. Red blood cell (RBC) morphology, serum micronutrient concentration, demographic characteristics and health status were assessed in preconception and in early pregnancy. The association between preconceptional factors and Hb concentration in early pregnancy was investigated using simple and multiple linear regression analyses stratified by preconceptional anaemia status. Mean Hb was 123 and 119g/l before conception and during early pregnancy (median gestational age 53days) respectively. Preconceptional mid-upper arm circumference (MUAC) (adjusted coefficient (AC) 0.35 95% CI 0.9-0.61) and preconceptional Hb concentration (AC 0.45 95% CI 0.36-0.54) were positively associated with early pregnancy Hb concentration, whereas preconceptional microcytic hypochromic RBC morphology (AC -6.00 95% CI -9.56 to -2.44) was negatively associated with early pregnancy Hb concentration. In addition, treatment of preconceptional malaria was positively associated with early pregnancy Hb concentration (AC 6.45 95% CI 0.74-12.2) among women with preconceptional anaemia. In contrast, among preconceptional non-anaemic women, only preconceptional Hb concentration and medium socio-economic status was positively associated with early pregnancy Hb concentration. Mid-upper arm circumference (MUAC) and Hb measurements in preconception can help to detect women at increased risk of low Hb concentration in early pregnancy.

The Economic Burden of Non-fatal Musculoskeletal Injuries in Northeastern Tanzania.

Background:Although musculoskeletal injuries have increased in sub-Saharan Africa, data on the economic burden of non-fatal musculoskeletal injuries in this region are scarce.Objective:Socioeconomic costs of orthopedic injuries were estimated by examining both the direct hospital cost of orthopedic care as well as indirect costs of orthopedic trauma using disability days and loss of work as proxies.Methods:This study surveyed 200 patients seen in the outpatient orthopedic ward of the Kilimanjaro Christian Medical Center, a tertiary hospital in Northeastern Tanzania, during the month of July 2016.Findings:Of the patients surveyed, 88.8% earn a monthly income of less than $250 and the majority of patients (73.7%) reported that the healthcare costs of their musculoskeletal injuries were a catastrophic burden to them and their family with 75.0% of patients reporting their medical costs exceeded their monthly income. The majority (75.3%) of patients lost more than 30 days of activities of daily living due to their injury, with a median (IQR) functional day loss of 90 (30). Post-injury disability led to 40.6% of patients losing their job and 86.7% of disabled patients reported a wage decrease post-injury. There were significant associations between disability and post-injury unemployment (p < .0001) as well as lower post-injury wages (p = .022).Conclusion:This exploratory study demonstrates that in this region of the world, access to definitive treatment post-musculoskeletal injury is limited and patients often suffer prolonged disabilities resulting in decreased employment and income.

Pacific sea surface temperature linkages with Tanzania's multi‐season drying trends

During 1999–2014, Tanzania experienced below average precipitation in two important seasons: December to February (DJF) in the south and during March to June (MAMJ) in the northeast. We explore DJF and MAMJ precipitation in the areas with drying trends and examine their relationships with anomalous sea surface temperatures (SSTs) in the Indo‐Pacific and corresponding circulation patterns. At seasonal time scales, precipitation in DJF and MAMJ trend areas appears inversely related to diabatic forcing in the equatorial Pacific. Dominant influence for droughts in DJF is eastern Pacific SST while for droughts in MAMJ it is West Pacific SST. A bivariate regression model with West Pacific and Niño3.4 region SST as predictors is found to recreate multidecadal DJF variability after the 1950s and the extreme drying in MAMJ during the 2000s. The regression model coefficients also indicate differential eastern versus western Pacific forcing for DJF versus MAMJ. Thus, we suggest that recent La Niña‐like conditions, characterized by an enhanced Pacific SST gradient due to cooling in the eastern Pacific and warming in the western Pacific, played a substantial role in Tanzania's recent multi‐season drying trends. SST change scenarios (difference between 2023–2037 and 2000–2014 means) based on CMIP5 projections and observed trends illustrate the uncertainty of future precipitation outcomes, as well as the potential implications of contrasting linkages to eastern versus western Pacific SSTs. These scenarios are mainly optimistic for the DJF southern Tanzania trend area, because it appears dominated by Niño3.4 cooling at both seasonal and decadal time scales. Conversely, our scenarios are quite pessimistic for the MAMJ northeastern Tanzania trend area, because we find a dominant negative influence of warming West Pacific SST.

Prevalence and risk factors of preconception anemia: A community based cross sectional study of rural women of reproductive age in northeastern Tanzania.

BackgroundAnemia is a major public health problem that adversely affects pregnancy outcomes. The prevalence of anemia among pregnant women before conception is not well known in Tanzania. The aim of this study was to determine the prevalence, types, and risk factors of preconception anemia in women of reproductive age from a rural Tanzanian setting.MethodsTrained field workers visited households to identify all female residents aged 18–40 years and invited them to the nearby health facility for screening and enrolment into this study. Baseline samples were collected to measure hemoglobin levels, serum ferritin, vitamin B12, folate, C-reactive protein, alanine amino-transferase, the presence of malaria, HIV, and soil transmitted helminth infections. Anthropometric and socio-economic data were recorded alongside with clinical information of participants. Logistic regression analysis was used to determine the adjusted odds ratios (AOR) for the factors associated with preconception anemia.FindingsOf 1248 women enrolled before conception, 36.7% (95% confidence interval (CI) 34.1–39.4) had anemia (hemoglobin <12 g/dL) and 37.6% (95% CI 34.9–40.4) had iron deficiency. For more than half of the anemic cases, iron deficiency was also diagnosed (58.8%, 95% CI 54.2–63.3). Anemia was independently associated with increased age (AOR 1.05, 95% CI 1.03–1.07), malaria infection at enrolment (AOR 2.21, 95% CI 1.37–3.58), inflammation (AOR 1.77, 95% CI 1.21–2.60) and iron deficiency (AOR 4.68, 95% CI 3.55–6.17). The odds of anemia were reduced among women with increased mid-upper arm circumference (AOR 0.90, 95% CI 0.84–0.96).ConclusionAnemia among women of reproductive age before conception was prevalent in this rural setting. Increased age, iron deficiency, malaria infection and inflammation were significant risk factors associated with preconception anemia, whereas increased mid-upper arm circumference was protective against anemia. Interventions to ensure adequate iron levels as well as malaria control before conception are needed to prevent anemia before and during pregnancy and improve birth outcomes in this setting.Trial registrationNCT02191683.

Approcher la densité des ligneux par l’indice perpendiculaire de végétation : cas d’une savane arborée au nord de la Tanzanie

Le domaine de Namalok (4 500 ha), situé au nord-est de la Tanzanie, a été protégé par TPC Limited, une société sucrière privée, pour en faire une réserve privée de faune et de flore. La végétation locale est constituée de savanes arbustives à Salvadora persica, de fourrés de Suaeda monoica et de savanes arborées plus au moins denses à Acacia xanthophloea, Faidherbia albida et Acacia tortilis. Afin de répondre à un objectif de gestion suite à la réintroduction de grands herbivores, la composition floristique de ces formations ligneuses a été étudiée en association avec une approche cartographique du degré d’accessibilité des formations ligneuses par les herbivores, exprimé en classes de densité établies selon l’indice perpendiculaire de végétation (IPV). Les résultats révèlent tout d’abord une corrélation très élevée entre la densité calculée des ligneux et l’IPV (r2 = 0,96) et confirment l’intérêt de l’approche proposée d’analyse d’images satellitaires. Dans une perspective plus locale, ils montrent aussi que, sur le plan floristique, les niveaux successifs des densités cartographiées sont composés de 70 espèces végétales et relèvent d’un fond floristique d’espèces pantropicales. Ces savanes montrent également une distribution spécifique relativement équitable et très diverse, avec des fréquences spécifiques voisines les unes des autres. Les savanes arborées représentent 38 % de la surface du domaine. Par ordre croissant de densité, les savanes de moins de 100 arbres/ha couvrent 836 ha, celles comptant 100 à 200 arbres/ha occupent 654 ha et celles ayant des densités de 200 à 300 arbres/ha sont assez peu importantes et n’occupent que 206 ha. Les savanes de densité supérieure à 300 arbres/ha représentent des étendues beaucoup moins vastes, soit seulement 22 ha.

Prevalence, determinants and knowledge of antibacterial self-medication: A cross sectional study in North-eastern Tanzania.

Self-medication is very common especially in developing countries and is documented to be associated with many health risks including antibiotic resistance. This study investigated the prevalence, determinants and knowledge of self-medication among residents of Siha District in Tanzania. A cross-sectional study was conducted among 300 residents in a rural District of Kilimanjaro region, North-eastern Tanzania from 1st to 28th April 2017. A semi-structured questionnaire was used to collect information regarding drugs used, knowledge, history and reasons for antibiotic self-medication. Log—binomial regression analysis was done using STATA 13 to examine factors associated with self-medication. A slightly majority of the respondents (58%) admitted to self-medication. Antibiotics most commonly utilized were amoxycillin (43%) and an antiprotozoal drug metronidazole (10%). The most common symptoms that led to self-medication were cough (51.17%), headache/ fever/ malaria (25.57%) and diarrhoea (21.59%). The most common reasons for self-medication were emergency illness (24.00%), health facility charges (20.33%), proximity of pharmacy to home (17.00%) and no reason (16.66%). Almost all reported that self-medication is not better than seeking medical consultation, 98% can result into harmful effects and 96% can result to drug resistance. The level of self-medication in this study is comparable with findings from other studies in developing countries. Pharmacies were commonly used as the first point of medical care. There is therefore a need for educative antibiotic legislative intervention to mitigate the adverse effects of antibiotic self-medication in Siha district in Tanzania.

Risk factors of pre-hypertension and hypertension among non-pregnant women of reproductive age in northeastern Tanzania: a community based cross-sectional study.

To determine risk factors of pre-hypertension and hypertension in a cohort of 1247 rural Tanzanian women before conception. Demographic and socioeconomic data, anthropometric measurements, past medical and obstetric history and other risk factors for pre-hypertension and hypertension were collected using a structured questionnaire. Multiple logistic regression analysis was used to evaluate the associations between anthropometric indices and other risk factors of pre-hypertension and hypertension. The predictive power of different anthropometric indicators for identification of pre-hypertension and hypertension patients was determined by Receiver Operating Characteristic curves (ROC). The median (range) age was 28.0 (18-40) years. The age-standardised prevalences of pre-hypertension and hypertension were 37.2 (95% CI 34.0-40.6) and 8.5% (95%CI 6.7-10.8), respectively. Of hypertensive patients (n = 98), only 20 (20.4%) were aware of their condition. In multivariate analysis, increasing age, obesity and haemoglobin levels were significantly associated with pre-hypertension and hypertension. Despite a low prevalence of hypertension, over one third of the women had pre-hypertension. This poses a great challenge ahead as pre-hypertensive women may progress into hypertension as they grow older without appropriate interventions. Obesity was the single most important modifiable risk factor for pre-hypertension and hypertension.

Building a legacy? Ambivalent impacts of a malaria vaccine clinical trial

This article examines infrastructure and technology assembled to support a malaria vaccine clinical trial, conducted between 2009 and 2014. It draws on ethnographic fieldwork at a medical research centre in north-eastern Tanzania, with additional data from interviews with researchers, vaccine scientists and trial funders. The infrastructure and technology were conceived of as enabling the development of a vaccine and facilitating future medical research and health care provision in Tanzania. However, after the clinical trial ended, these material remains were decaying, repurposed or lacked long-term sustainability without continued research funding. For trial staff in Tanzania, this led to expressions of affect, including disappointment, ambivalence and frustration as expectations for the future were foreclosed. The author argues that the material remains of the clinical trial had varied impacts and, furthermore, ambivalence is an embedded part of clinical trials due to their time constraints and lack of local rooting. The end of this clinical trial exposes the limitations of global health research in bringing about lasting change to low-resource settings. This article highlights the need to consider the life of material objects after research concludes.

Dioic acid glycosides, tannins and methylated ellagic acid glycosides from Morella salicifolia bark

The bark of Morella salicifolia (Hochst.exA. Rich.) Verdc. &Polhill (Myricaceae) is a common herbal drug and especially utilized by the Maasai community of northeastern Tanzania. It is traditionally used to treat swellings on the cheek and face, cough, toothache, stomach problems, headaches, and skin diseases. Unless, there is still a lack of information considering the specialized metabolites that may be responsible for the traditional use of this medicinal plant. An isolation study on a methanolic extract revealed three methylated ellagic acids, castalagin, two monomeric flavan-3-ols, three prodelphinidins and three dioic acid glycosides. Among these metabolites, myriside (3,4-dimethyl ellagic acid 4′-O-β-d-xylopyranoside, 1), epigallocatechin-3-O-gallate-(2β→O→7, 4β→8)-gallocatechin (9), 2,7-dimethyl-8-O-(6′-O-galloyl)-β-d-glucopyranoside-deca-2E,4E-dienedioic acid (10), 2,7-dimethyl-8-O-β-d-glucopyranoside-deca-2E,4E-dienedioic acid (11) as well as 4,9-dimethyl-10-O-β-d-glucopyranoside-dodeca-2E,4E,6E-trienedioic acid (12) were isolated for the first time. To the best of our knowledge, the dioic acid glycosides represent a generally novel structure type. To provide comprehensive information on the condensed tannins, the polymeric proanthocyanidins were enriched and characterized via 13C-NMR. Results confirm chemo-taxonomic relationships within the genera Morella and Myrica in the Myricaceae.

Lymphatic filariasis control in Tanzania: infection, disease perceptions and drug uptake patterns in an endemic community after multiple rounds of mass drug administration

BackgroundLymphatic filariasis (LF) control in most countries of sub-Saharan Africa is based on annual mass drug administration (MDA) with a combination of ivermectin and albendazole, in order to interrupt transmission. However, attaining and maintaining high treatment coverage has been a challenge in many LF control programmes. This study was designed to elucidate reasons for continued transmission of LF in an endemic area of Tanga, northeastern Tanzania, where control activities based on MDA had been in place for eight years by the time of this study in 2012.MethodsA cross-sectional questionnaire survey was conducted in three sentinel villages used for monitoring the impact of MDA on LF transmission. A total of 747 individuals were interviewed, out of which 172 (23.0%), 27 (3.6%) and 49 (6.5%) had been shown to have circulating filarial antigens (CFA), microfilaraemia (MF) and LF gross lesions, respectively, prior to the interviews.ResultsThe interviewed population had a mean age of 33.7 years and a male to female ratio of 0.8. Males, individuals aged 30 years and above, peasants/fishermen and recent immigrants to the study communities were significantly more affected (CFA, MF and/ or LF gross lesions) than the other population groups. However, drug uptake rates were not significantly different between LF affected (those with CFA, MF and/ or LF gross lesions) and non-affected individuals. Likewise, drug uptake rates were not significantly different across different demographic parameters of the study population, some of which differed significantly in the level of infection. Moreover, it was found that misconceptions on how LF can be acquired were still evident, linking its transmission to witchcraft, heredity and sexual behaviour.ConclusionsThe findings indicated that misconceptions about LF and its transmission still existed despite eight years of control activities in the area. Improved communication on the rationale of MDA and an enhanced drug delivery strategy that is adapted to the local settings and targeting important demographic groups that serve as reservoir of infection will help in reaching the elimination target within a reasonable timeframe.

Mapping Precipitation, Temperature, and Evapotranspiration in the Mkomazi River Basin, Tanzania

It is still a challenge to provide spatially explicit predictions of climate parameters in African regions of complex relief, where meteorological information is scarce. Here we predict rainfall, temperature, and reference evapotranspiration (ETo) for the southern Mkomazi River Basin in Northeastern Tanzania, East Africa, by means of regression-based, digital elevation models (DEM) at 90 m spatial-resolution and geographic information systems (GIS) techniques. We mapped rainfall for the period 1964–2010. The models accounted for orographic factors which strongly influenced the spatial variability of rainfall in the region. According to orography, the area was divided into three zones for modelling rainfall: windward, leeward, and transition zone. Rainfall indicates high spatial and temporal variability dominated by equatorial East-African climate circulation systems. Maximum and minimum temperatures were modelled for the period 1989–1994, the models accounted only for the altitude gradient. Mean temperature was calculated by arithmetic mean of maximum and minimum temperatures maps in ArcGIS. ETo was estimated in ArcGIS following the method described by Hargreaves and Samani. The maps were made on a monthly basis for rainfall, ETo, and mean, maximum, and minimum temperatures. The obtained maps are useful for the purpose of agriculture, ecological, and water resources management.

Trends of Plasmodium falciparum prevalence in two communities of Muheza district North-eastern Tanzania: correlation between parasite prevalence, malaria interventions and rainfall in the context of re-emergence of malaria after two decades of progressively declining transmission

BackgroundAlthough the recent decline of malaria burden in some African countries has been attributed to a scale-up of interventions, such as bed nets (insecticide-treated bed nets, ITNs/long-lasting insecticidal nets, LLINs), the contribution of other factors to these changes has not been rigorously assessed. This study assessed the trends of Plasmodium falciparum prevalence in Magoda (1992–2017) and Mpapayu (1998–2017) villages of Muheza district, North-eastern Tanzania, in relation to changes in the levels of different interventions and rainfall patterns.MethodsIndividuals aged 0–19 years were recruited in cross-sectional surveys to determine the prevalence of P. falciparum infections in relation to different malaria interventions deployed, particularly bed nets and anti-malarial drugs. Trends and patterns of rainfall in Muheza for 35 years (from 1981 to 2016) were assessed to determine changes in the amount and pattern of rainfall and their possible impacts on P. falciparum prevalence besides of those ascribed to interventions.ResultsHigh prevalence (84–54%) was reported between 1992 and 2000 in Magoda, and 1998 and 2000 in Mpapayu, but it declined sharply from 2001 to 2004 (from 52.0 to 25.0%), followed by a progressive decline between 2008 and 2012 (to ≤ 7% in both villages). However, the prevalence increased significantly from 2013 to 2016 reaching ≥ 20.0% in 2016 (both villages), but declined in the two villages to ≤ 13% in 2017. Overall and age specific P. falciparum prevalence decreased in both villages over the years but with a peak prevalence shifting from children aged 5–9 years to those aged 10–19 years from 2008 onwards. Bed net coverage increased from < 4% in 1998 to > 98% in 2001 and was ≥ 85.0% in 2004 in both villages; followed by fluctuations with coverage ranging from 35.0 to ≤ 98% between 2008 and 2017. The 12-month weighted anomaly standardized precipitation index showed a marked rainfall deficit in 1990–1996 and 1999–2010 coinciding with declining prevalence and despite relatively high bed net coverage from 2000. From 1992, the risk of infection decreased steadily up to 2013 when the lowest risk was observed (RR = 0.07; 95% CI 0.06–0.08, P < 0.001), but it was significantly higher during periods with positive rainfall anomalies (RR = 2.79; 95% CI 2.23–3.50, P < 0.001). The risk was lower among individuals not owning bed nets compared to those with nets (RR = 1.35; 95% CI 1.22–1.49, P < 0.001).ConclusionsA decline in prevalence up to 2012 and resurgence thereafter was likely associated with changes in monthly rainfall, offset against changing malaria interventions. A sustained surveillance covering multiple factors needs to be undertaken and climate must be taken into consideration when relating control interventions to malaria prevalence.

Phylogenetic position and taxonomy of Kusaghiporia usambarensis gen. et sp. nov. (Polyporales)

ABSTRACT A large polyporoid mushroom from the West Usambara Mountains in North-eastern Tanzania produces dark brown, up to 60-cm large fruiting bodies that at maturity may weigh more than 10 kg. It has a high rate of mycelial growth and regeneration and was found growing on both dry and green leaves of shrubs; attached to the base of living trees, and it was also observed to degrade dead snakes and insects accidentally coming into contact with it. Phylogenetic analyses based on individual and concatenated data sets of nrLSU, nrSSU and the RPB2 and TEF1 genes showed it, together with Laetiporus, Phaeolus, Pycnoporellus and Wolfiporia, to form a monophyletic group in Polyporales. Based on morphological features and molecular data, it is described as Kusaghiporia usambarensis.

Pattern of all-causes and cause-specific mortality in an area with progressively declining malaria burden in Korogwe district, north-eastern Tanzania

BackgroundAlthough death records are useful for planning and monitoring health interventions, such information is limited in most developing countries. Verbal autopsy (VA) interviews are alternatively used to determine causes of death in places without or with incomplete hospital records. This study was conducted to determine all causes and cause-specific mortality in Korogwe health and demographic surveillance system (HDSS) undertaken in Korogwe district, northeastern Tanzania.MethodsThe study was conducted from January 2006 to December 2012 in 14 villages under Korogwe HDSS. Vital events such as births, deaths and migrations were routinely updated quarterly. A standard VA questionnaire was administered to parents/close relatives of the deceased to determine cause of death.ResultsOverall, 1325 deaths of individuals with median age of 46 years were recorded in a population with 170,471.4 person years observed (PY). Crude mortality rate was 7.8 per 1000 PY (95% CI 7.2–8.4) and the highest rate was observed in infants (77.9 per 1000 PY; 95% CI 67.4–90.0). The overall mortality increased between 2006 and 2007, followed by a slight decline up to 2011, with the highest decrease observed in 2012. Causes of deaths were established in 942 (71.1%) deaths and malaria (198 deaths, 21.0%) was the leading cause of death in all age groups except adults (15–59 years). HIV/AIDS (17.6%, n = 365) was the leading cause of death in individuals aged 15–59 years followed by malaria (13.9%) and tuberculosis. Non-communicable diseases (NCDs) including stroke, hypertension, cancer, and cardiac failure caused majority of deaths in elderly (60 years and above) accounting for 37.1% (n = 348) of all deaths, although malaria was the single leading cause of death in this group (16.6%).ConclusionThe study showed a significant decline of deaths in the Korogwe HDSS site and malaria was the main cause of death in all age groups (except adults, aged 15–59 years) while HIV/AIDS and NCDs were the main causes in adults and elderly, respectively. Further surveillance is required to monitor and document changes in cause-specific mortality as malaria transmission continues to decline in this and other parts of Tanzania.