Northern Tanzania Research Articles

Prevalence and Risk Factors of Human Taenia solium Cysticercosis in Mbulu District, Northern Tanzania

Background: Taeniosis and cysticercosis are human infections caused by the pork tapeworm, Taenia solium. This study is a baseline for community-based intervention. We determined the prevalence of human cysticercosis and associated risk factors following a deworming program conducted throughout the country, with Mbulu District being among the districts in Northern Tanzania. Methods: Human cysticercosis was determined by enzyme-linked immunosorbent assay (Ag- ELISA). Household interviews and observations were conducted to identify risk factors for cysticercosis transmissions among households and communities. Results: Three hundred individuals participated in this study. The age ranged from 5 to 89 years, with a median of 19 years. The prevalence of human cysticercosis was 23 (7.67%). The prevalence was high with 6 (11.76%) among individuals aged 26 to 35 years and ±45 years. There was no statistically significant difference in the prevalence by age group, sex, or occupation. Among the 300 participants, 82 (27.3%) had received anthelmintics during the previous year; among these, 5 (21.7%) were infected. The likelihood of infection was low among anthelmintic users by 28% [0.72 (0.26–2.01)], but the protection was not significant. The communities differed in risk factors on the availability of a clean and safe water supply; 52.7% (46/86) of households visited had no pit latrine. The cysticercosis prevalence showed a significant difference in communities. Conclusions: The prevalence of human cysticercosis was high and associated with higher age groups. The prevalence was low among those who had taken anthelmintics and was associated with lower age groups. The current school deworming program has a positive effect on school children, while the elderly are at higher risk because the intervention did not target them. It is recommended to scale up anthelmintic intervention to higher age groups.

Pollen Amount and Viability in Mchare and Selected Wild (AA) Banana (Musa acuminata) Genotypes: Prospects for Breeding

East African diploid cooking bananas, commonly called Mchare, are a staple crop for millions of subsistence farmers in Tanzania, particularly in the Pangani region in northern Tanzania. Several pathogens constrain Mchare production significantly and threaten food security. Sources of resistance to these pathogens have been identified; however, partial male and female sterility impedes successful resistance introgression, complicating the breeding process. Mchare cultivars are also the only known surviving representatives of a diploid banana subgroup that contributed unreduced gametes to many of the most widely grown and successful triploid dessert bananas (‘Cavendish’, ‘Gros-Michel’, ‘Silk’, and ‘Prata’). As such, they represent an essential intermediate step in the conventional improvement of bananas worldwide. We assess the amount and viability of pollen among Mchare and wild genotypes to identify the most fertile Mchare cultivars that can be used in conventional banana improvement. Pollen was collected from 14 banana genotypes for quantification and viability testing over 7 months, and the optimal time for pollen collection was determined to be 0800 HR. Significant variation among banana genotypes in terms of both overall pollen production and percentage of pollen viability was observed. The wild-type bananas ‘Calcutta 4’ (Indian Trade Classification (ITC) 0249] and ‘Borneo’ (ITC0253) had the greatest overall pollen production (> 31,000 pollen grains/anther) and viability (∼74%), whereas ‘Ijihu Inkundu’ (ITC1460; Mchare genotype) was the least productive (almost completely sterile), with an average pollen production of a few hundred grains per anther and a viability of 7%. There were significant differences among months in terms of pollen viability, with the greatest average viability observed in May, April, and February (> 51%), and the lowest average pollen viability in July (41%). Significant differences were observed among the Mchare genotypes, with ‘Huti-White’, ‘Huti green bell’ (ITC1559), and ‘Mchare Laini’ consistently producing more substantial amounts of total pollen and an overall more significant proportion of viable pollen. This information is vital to improve Mchare bananas and the global breeding of dessert bananas. The choice of Mchare banana used in improvement programs could affect fertility and the likelihood of breeding success.

Impact of the COVID-19 pandemic in childhood and adolescent cancer care in northern Tanzania: a cross-sectional study

IntroductionThe SARS-CoV-2 (COVID-19) pandemic has strained healthcare systems and presented unique challenges for children requiring cancer care, particularly in low- and middle-income countries. This study aimed to assess the impact of the COVID-19 pandemic on access to cancer care for children and adolescents in Northern Tanzania.MethodsIn this cross-sectional study, we assessed the demographic and clinical characteristics of 547 pediatric and adolescent cancer patients (ages 0–19 years old) between 2016 and 2022 using the population-based Kilimanjaro Cancer Registry (KCR). We categorized data into pre-COVID-19 (2016–2019) and COVID-19 (2020–2022) eras, and performed descriptive analyses of diagnostic, treatment, and demographic information. A secondary analysis was conducted on a subset of 167 patients with stage of diagnosis at presentation.ResultsOverall admissions nearly doubled during the pandemic (n = 190 versus 357). The variety of diagnoses attended at KCMC increased during the pandemic, with only five groups of diseases reported in 2016 to twelve groups of diseases in 2021. Most patients were diagnosed at a late stage (stage III or IV) across eras, with the proportion of under-five years old patients increasing late-diagnoses from 29.4% (before the pandemic), 52.8% (during the pandemic), when compared to the overall cohort. Around 95% of children in this age category reported late-stage diagnosis during the pandemic. Six out of the twelve cancer site groups also reported an increase in late-stage diagnosis. During the pandemic, the proportion of children receiving surgery increased from 15.8 to 30.8% (p < 0.001).ConclusionChildhood and adolescent cancer care changed in Northern Tanzania during the COVID-19 pandemic, with increased late-stage diagnoses presentations among younger patients and the increased use of surgical therapies in the context of a growing practice. Understanding the impact of the COVID-19 pandemic on pediatric and adolescent cancer care can help us better adapt healthcare systems and interventions to the emerging needs of children and adolescents with cancer in the midst of a health crisis.

HIV viral suppression and risk of viral rebound in patients on antiretroviral therapy: a two- year retrospective cohort study in Northern Tanzania

BackgroundThe world is moving towards the third target of the Joint United Nations Programme on HIV/AIDS to ensure most people receiving antiretroviral therapy (ART) are virologically suppressed. Little is known about viral suppression at an undetectable level and the risk of viral rebound phenomenon in sub-Saharan Africa which covers 67% of the global HIV burden.This study aimed to investigate the proportion of viral suppression at an undetectable level and the risk of viral rebound among people living with HIV receiving ART in northern Tanzania.MethodologyA hospital based-retrospective study recruited people living with HIV who were on ART for at least two years at Kibong’oto Infectious Disease Hospital and Mawenzi Regional Referral Hospital in Kilimanjaro Region, Tanzania. Participants’ two-year plasma HIV were captured at months 6, 12, and 24 of ART. Undetectable viral load was defined by plasma HIV of viral load (VL) less than 20copies/ml and viral rebound (VR) was considered to anyone having VL of more than 50 copies/ml after having history of undetectable level of the VL less than 20copies/ml. A multivariable log-binomial generalized linear model was used to determine factors for undetectable VL and viral VR.ResultsAmong 416 PLHIV recruited, 226 (54.3%) were female. The mean (standard deviation) age was 43.7 (13.3) years. The overall proportion of undetectable VL was 68% (95% CI: 63.3–72.3) and 40.0% had viral rebound (95% CI: 34.7–45.6). Participants who had at least 3 clinic visits were 1.3 times more likely to have undetectable VL compared to those who had 1 to 2 clinic visits in a year (p = 0.029). Similarly, participants with many clinical visits ( > = 3 visits) per year were less likely to have VR compared to those with fewer visits ( = 2 visits) [adjusted relative risk (aRR) = 0.64; 95% CI: 0.44–0.93].ConclusionParticipants who had fewer clinic visits per year(ART refills) were less likely to achieve viral suppression and more likely to experience viral rebound. Enhanced health education and close follow-up of PLHIV on antiretroviral therapy are crucial to reinforce adherence and maintain an undetectable viral load.

Predictors of Parental Home Involvement in Low-Income Families in Tanzania

Understanding factors influencing parents' involvement in education activities is essential in tailoring strategies to encourage and maximize their participation. This study assessed predictors of parental home involvement in low-income families in four regions of Northern Tanzania. The questionnaires assessed 1176 parents of grade two children from 55 primary schools invited to teacher-parent meetings. The hierarchical multiple regression analyses showed that parents' perception of general school invitation, specific teacher invitation, specific child invitation, parents' knowledge and skills, parents' level of education, and marriage conditions were the strongest predictors of parental home involvement. However, parents' past school experience (valence) did not predict their present involvement at home. This study underscores the pivotal role of teachers and schools in instigating and fostering parental involvement at home. Teachers can create a collaborative learning environment beyond the classroom by implementing activities designed to arouse parents' interest and stimulate their desire to participate actively in their children's learning. The study recommends the interconnectedness of the educational ecosystem, where the efforts of schools and teachers serve as catalysts for meaningful parental involvement at home.

A simple, collaborative prioritization process for wildlife-associated zoonotic diseases in northern Tanzania

Background and Aim: Zoonotic diseases are naturally transmissible infections between animals and humans. To address these cross-sectoral health issues holistic, transdisciplinary health approaches are required. The legalization of the game meat trade in Tanzania in 2020 has created a new value chain from wild habitats to registered game meat selling facilities in human settlements, thus creating new human–animal interfaces associated with potential risks of zoonotic disease transmission among wildlife, livestock, and human populations. This study aimed to apply a simple, collaborative prioritization process to identify important zoonotic pathogens associated with wild animal taxa harvested and traded for game meat consumption in northern Tanzania. Materials and Methods: A prioritization process was conducted to identify and rank zoonotic diseases associated with wildlife in the Arusha, Kilimanjaro, and Manyara regions of northern Tanzania to help determine the zoonotic disease risks associated with the game meat value chain. Two districts from each region were selected for this study. The prioritization process was conducted through an expert workshop that involved 41 participants, including a District Veterinary Officer, Public Health Officer, and District Game Officer from each district, as well as national One Health focal persons, zonal Veterinary and Laboratory Officers, scientific researchers, and a representative from the national Game Meat Selling Advisory Committee. Results: Experts identified 11 common zoonotic diseases reported in these regions, of which anthrax, rabies, brucellosis, Rift Valley fever, and bovine tuberculosis were considered the most important. This finding is broadly consistent with the national priority list for zoonotic diseases. Conclusion: This approach was time-efficient and cost-effective. In Tanzania, multi-sectoral planning, communication, and cooperation among human health, domestic animal health, wildlife health, and environmental protection have been strengthened. In the future, we recommend regular exercises using such an approach to update the information on important diseases and promote information sharing for epidemic and pandemic preparedness associated with the wild animal trade. Keywords: epidemic and pandemic, expert opinion, game meat, one health, wildlife, zoonoses.

Growth and Fruit morphometric characteristics of local avocado germplasm (Persea americana Mill.) grown in northern Tanzania

Tanzania has a diverse agroecological area suitable for growing tropical fruits, including avocados. In Northern Tanzania, avocados have been growing under variable soil and altitudinal characteristics for over 100 years, allowing the naturalisation of this crop in this region. However, the region's avocado germplasm is uncharacterised, thus impeding the selection of elite genotypes for increased value and breeding programmes. This study examined the growth and fruit morphometric characteristics of avocado populations grown under variable soil pH and altitude in six districts in the Tanga, Kilimanjaro and Arusha regions. Variations in growth and fruit morphometric characteristics were compared using a one-way analysis of variance (ANOVA). Pearson product-moment correlations (r) were used to evaluate the relationship between studied growth and fruit morphometric traits. A linear mixed-effects model (LMM) was used to assess the influence of the soil pH, altitude, tree height, canopy diameter, and trunk diameter on fruit length, fruit diameter, pulp thickness, and seed diameter. Principal Component Analysis (PCA) was used to depict the extent of the racial admixtures in the avocado germplasm in the Northern regions of Tanzania. The results revealed a significant variation in growth and fruit morphometric characteristics (p < 0.05). The Korogwe population had the highest tree height, while the Karatu had the lowest. Tree height was positively correlated with the trunk diameter (r = 0.63, p < 0.001. There was a positive correlation between fruit length and pulp thickness (r = 0.51, p < 0.001), fruit diameter and pulp thickness (r = 0.47, p < 0.001), and fruit length and fruit diameter (r = 0.36, p < 0.001). The fruit diameter was positively correlated with the seed diameter (r = 0.61, p < 0.001). There was a significant but weak association between fruit length and trunk diameter (−0.01), fruit length and canopy diameter (0.15), and between seed diameter and tree height (2.95e-2). These findings highlight the influence of individual tree genetic makeup on the variation in growth and fruit morphometric characteristics. The morphometric trait correlations may prove valuable in field measurements, especially when resources are limited. The study further indicates the presence of all avocado races within the local germplasm, highlighting its high diversity. Remarkably, the observed admixture of variant races implies gene flow among studied avocado populations, possibly facilitated by sharing seedlings among farmers or seed disposal through avocado fruit trading. Further study is needed, particularly in quantifying the above-ground biomass of local avocados in northern Tanzania, potentially contributing to carbon credit initiatives for fruit crops..

Crimean-Congo Hemorrhagic Fever Virus Seroprevalence in Human and Livestock Populations, Northern Tanzania

Crimean-Congo Hemorrhagic Fever Virus Seroprevalence in Human and Livestock Populations, Northern Tanzania

Productivity declines threaten East African soda lakes and the iconic Lesser Flamingo

Soda lakes are some of the most productive aquatic ecosystems.1 Their alkaline-saline waters sustain unique phytoplankton communities2,3 and provide vital habitats for highly specialized biodiversity including invertebrates, endemic fish species, and Lesser Flamingos (Phoeniconaias minor).1,4 More than three-quarters of Lesser Flamingos inhabit the soda lakes of East Africa5; however, populations are in decline.6 Declines could be attributed to their highly specialized diet of cyanobacteria7 and dependence on a network of soda lake feeding habitats that are highly sensitive to climate fluctuations and catchment degradation.8,9,10,11,12 However, changing habitat availability has not been assessed due to a lack of in situ water quality and hydrology data and the irregular monitoring of these waterbodies.13 Here, we combine satellite Earth observations and Lesser Flamingo abundance observations to quantify spatial and temporal trends in productivity and ecosystem health over multiple decades at 22 soda lakes across East Africa. We found that Lesser Flamingo distributions are best explained by phytoplankton biomass, an indicator of food availability. However, timeseries analyses revealed significant declines in phytoplankton biomass from 1999 to 2022, most likely driven by substantial rises in lake water levels. Declining productivity has reduced the availability of healthy soda lake ecosystems, most notably in equatorial Kenya and northern Tanzania. Our results highlight the increasing vulnerability of Lesser Flamingos and other soda lake biodiversity in East Africa, particularly with increased rainfall predicted under climate change.14,15,16 Without improved lake monitoring and catchment management practices, soda lake ecosystems could be pushed beyond their environmental tolerances. VIDEO ABSTRACT.

Improving acute myocardial infarction care in northern Tanzania: barrier identification and implementation strategy mapping

BackgroundEvidence-based care for acute myocardial infarction (AMI) reduces morbidity and mortality. Prior studies in Tanzania identified substantial gaps in the uptake of evidence-based AMI care. Implementation science has been used to improve uptake of evidence-based AMI care in high-income settings, but interventions to improve quality of AMI care have not been studied in sub-Saharan Africa.MethodsPurposive sampling was used to recruit participants from key stakeholder groups (patients, providers, and healthcare administrators) in northern Tanzania. Semi-structured in-depth interviews were conducted using a guide informed by the Consolidated Framework for Implementation Research (CFIR). Interview transcripts were coded to identify barriers to AMI care, using the 39 CFIR constructs. Barriers relevant to emergency department (ED) AMI care were retained, and the Expert Recommendations for Implementing Change (ERIC) tool was used to match barriers with Level 1 recommendations for targeted implementation strategies.ResultsThirty key stakeholders, including 10 patients, 10 providers, and 10 healthcare administrators were enrolled. Thematic analysis identified 11 barriers to ED-based AMI care: complexity of AMI care, cost of high-quality AMI care, local hospital culture, insufficient diagnostic and therapeutic resources, inadequate provider training, limited patient knowledge of AMI, need for formal implementation leaders, need for dedicated champions, failure to provide high-quality care, poor provider-patient communication, and inefficient ED systems. Seven of these barriers had 5 strong ERIC recommendations: access new funding, identify and prepare champions, conduct educational meetings, develop educational materials, and distribute educational materials.ConclusionsMultiple barriers across several domains limit the uptake of evidence-based AMI care in northern Tanzania. The CFIR-ERIC mapping approach identified several targeted implementation strategies for addressing these barriers. A multi-component intervention is planned to improve uptake of evidence-based AMI care in Tanzania.

Etiology of febrile illness among patients seeking care at a district hospital in Manyara, Tanzania

Managing febrile illness is complicated due to the increasing involvement of non-malarial pathogens. This hospital-based cross-sectional study was conducted in Kiteto District Hospital in Northern Western, Tanzania, between January and February 2019. Out-patients with a temperature ≥38°C were consecutively enrolled until the sample size was reached. Whole blood samples were collected aseptically and tested for 36 pathogens using a multiplex PCR. Out of the 426 febrile patients, 184 (43.2%) had pathogens detected in their bloodstream. Brucella spp. was isolated in 61 (14.3%) patients, followed by Dengue virus 51 (12.0%), Salmonella Typhi 39 (9.2%), Plasmodium falciparum 37(8.7%), Coxiella burnetii 23 (5.4%) and Leptospira spp., 17 (4.0%). Forty patients (21.7%) had more than one pathogen, whereby co-infection with Brucella spp. and C. burnetii was frequent among study participants. Dengue virus was the most frequent in children aged below 14 years, whereas Brucella spp. was the dominant agent in adults. The cause of fever was not identified in 242 (56.8%) of these patients. Houses surrounded by long grasses were risk factors for febrile illness caused by P. falciparum, consuming untreated milk and consuming sour milk were risk factors for febrile illness caused by bacteria zoonoses while not washing hands after visiting the toilet was a risk factor for febrile illness by S. Typhi. Regarding management, 143 (34.8%) were given anti-malaria despite malaria rapid diagnostic test (MRDT) negative results, while 26.5% were given both anti-malaria and antibiotics for febrile illness. In this study, the majority of febrile illness cases were due to non-malarial pathogens, with P. falciparum accounting for only 8.7% of the cases. We found that about one-third of the cases were wrongly treated for malaria, and more than a quarter were wrongly given antibiotics. A review of the management of febrile illnesses is warranted.

Etiology of febrile illness among patients seeking care at a district hospital in Manyara, Tanzania

Managing febrile illness is complicated due to the increasing involvement of non-malarial pathogens. This hospital-based cross-sectional study was conducted in Kiteto District Hospital in Northern Western, Tanzania, between January and February 2019. Out-patients with a temperature ≥38°C were consecutively enrolled until the sample size was reached. Whole blood samples were collected aseptically and tested for 36 pathogens using a multiplex PCR. Out of the 426 febrile patients, 184 (43.2%) had pathogens detected in their bloodstream. Brucella spp. was isolated in 61 (14.3%) patients, followed by Dengue virus 51 (12.0%), Salmonella Typhi 39 (9.2%), Plasmodium falciparum 37(8.7%), Coxiella burnetii 23 (5.4%) and Leptospira spp., 17 (4.0%). Forty patients (21.7%) had more than one pathogen, whereby co-infection with Brucella spp. and C. burnetii was frequent among study participants. Dengue virus was the most frequent in children aged below 14 years, whereas Brucella spp. was the dominant agent in adults. The cause of fever was not identified in 242 (56.8%) of these patients. Houses surrounded by long grasses were risk factors for febrile illness caused by P. falciparum, consuming untreated milk and consuming sour milk were risk factors for febrile illness caused by bacteria zoonoses while not washing hands after visiting the toilet was a risk factor for febrile illness by S. Typhi. Regarding management, 143 (34.8%) were given anti-malaria despite malaria rapid diagnostic test (MRDT) negative results, while 26.5% were given both anti-malaria and antibiotics for febrile illness. In this study, the majority of febrile illness cases were due to non-malarial pathogens, with P. falciparum accounting for only 8.7% of the cases. We found that about one-third of the cases were wrongly treated for malaria, and more than a quarter were wrongly given antibiotics. A review of the management of febrile illnesses is warranted.

Can conservation-based incentives promote willingness of local communities to coexist with wildlife? A case of Burunge Wildlife Management Area, Northern Tanzania

ABSTRACT Globally, conservation-based incentives (CBIs) are perceived as effective tools for enhancing human–wildlife coexistence. This study investigated whether CBIs could improve willingness of local communities around Burunge Wildlife Management Area (BWMA) to coexist with wildlife. We conducted a questionnaire survey which was orally administered to 150 households from three villages participating in the BWMA. Providing social services like education, healthcare, and livestock disease control increased the community’s willingness to coexist with wildlife by 60%. Gender, occupation and time of residence were significant predictors explaining the observed 27.4% variation in the willingness to coexist with wildlife. Women involved in small businesses were more receptive to CBIs if they received training on protecting their property from wildlife. People who lived in the area for a longer time showed higher tolerance for wildlife-related challenges. We recommend implementing effective CBIs to enhance coexistence and developing measures to minimize crop losses caused by wildlife.

Climate Risk Management in Agro-Pastoral Systems of Central and Northern Tanzania: Costs and Benefits of Local Adaptation

In Tanzania, agro-pastoral practices have been adapted to climate change for several years. However, the economic benefits and costs of adaptation techniques for agro-pastoralists have not been well documented. Therefore, this paper analyses the economic benefits and costs of adaptation strategies to climate change and variability. The analysis used primary data collected from 411 agro-pastoral households randomly selected from 22 villages in five districts in northern and central Tanzania. Net present value, benefit-cost ratio and internal rate of return were calculated to determine the benefit-cost analysis of adaptation strategies. The planned adaptation strategies were found to be financially viable compared to business-as-usual practices. Sensitivity analysis also showed that maize-sunflower intercropping was viable, while maize-bean intercropping was more sensitive to a 10% change in yield. In addition, drip irrigation and micro-catchment rainwater harvesting have the potential to contribute to climate risk management in these dryland areas by minimising water use and maximising output per hectare; the main challenge is the high initial capital cost. There is therefore a need for extension agents to continue to promote crop and livestock diversification among agro-pastoralists in managing climate risks to reduce their vulnerability to climate change and variability. In addition, research and development (R&amp;D) practitioners need to promote and capacitate agro-pastoralists in drip irrigation and micro-catchment rainwater harvesting adaptation strategies.

Perceived Impacts of Wildlife on Agropastoral Food Production in Northern Tanzania

ABSTRACT Human-wildlife interactions can affect human wellbeing and wildlife population persistence. This paper addresses the perceived impacts of wildlife on agropastoral food production in the Tarangire ecosystem of northern Tanzania. It is based on sixteen months of collaborative ethnographic fieldwork with agropastoral Maasai communities (2019–2020; 2022; 2023), 240 semi-structured interviews, and a household survey (n = 1076). People felt that caterpillars, elephants, and zebras had the most significant effects on crop production, while hyenas were responsible for the bulk of livestock depredation by carnivores. These social costs of wildlife merit further attention from conservation policy makers.

Adapting an Intervention to Improve Acute Myocardial Infarction Care in Tanzania: Co-Design of the MIMIC Intervention.

Uptake of evidence-based care for acute myocardial infarction (AMI) is suboptimal in Tanzania, but there are currently no published interventions to improve AMI care in sub-Saharan Africa. Co-design a quality improvement intervention for AMI care tailored to local contextual factors. An interdisciplinary design team consisting of 20 physicians, nurses, implementation scientists, and administrators met from June 2022 through August 2023. Half of the design team consisted of representatives from the target audience, emergency department physicians and nurses at a referral hospital in northern Tanzania. The design team reviewed multiple published quality improvement interventions focusing on ED-based AMI care. After selecting a multicomponent intervention to improve AMI care in Brazil (BRIDGE-ACS), the design team used the ADAPT-ITT framework to adapt the intervention to the local context. The design team audited current AMI care processes at the study hospital and reviewed qualitative data regarding barriers to care. Multiple adaptations were made to the original BRIDGE-ACS intervention to suit the local context, including re-designing the physician reminder system and adding patient educational materials. Additional feedback was sought from topical experts, including patients with AMI. Draft intervention materials were iteratively refined in response to feedback from experts and the design team. The finalized intervention, Multicomponent Intervention to Improve Myocardial Infarction Care in Tanzania (MIMIC), consisted of five core components: physician reminders, pocket cards, champions, provider training, and patient education. MIMIC is the first locally tailored intervention to improve AMI care in sub-Saharan Africa. Future studies will evaluate implementation outcomes and efficacy.

Prevalence and risk factors for Q fever, spotted fever group rickettsioses, and typhus group rickettsioses in a pastoralist community of northern Tanzania, 2016-2017.

In northern Tanzania, Q fever, spotted fever group (SFG) rickettsioses, and typhus group (TG) rickettsioses are common causes of febrile illness. We sought to describe the prevalence and risk factors for these zoonoses in a pastoralist community. Febrile patients ≥2 years old presenting to Endulen Hospital in the Ngorongoro Conservation Area were enrolled from August 2016 through October 2017. Acute and convalescent blood samples were collected, and a questionnaire was administered. Sera were tested by immunofluorescent antibody (IFA) IgG assays using Coxiella burnetii (Phase II), Rickettsia africae, and Rickettsia typhi antigens. Serologic evidence of exposure was defined by an IFA titre ≥1:64; probable cases by an acute IFA titre ≥1:128; and confirmed cases by a ≥4-fold rise in titre between samples. Risk factors for exposure and acute case status were evaluated. Of 228 participants, 99 (43.4%) were male and the median (interquartile range) age was 27 (16-41) years. Among these, 117 (51.3%) had C. burnetii exposure, 74 (32.5%) had probable Q fever, 176 (77.2%) had SFG Rickettsia exposure, 134 (58.8%) had probable SFG rickettsioses, 11 (4.8%) had TG Rickettsia exposure, and 4 (1.8%) had probable TG rickettsioses. Of 146 participants with paired sera, 1 (0.5%) had confirmed Q fever, 8 (5.5%) had confirmed SFG rickettsioses, and none had confirmed TG rickettsioses. Livestock slaughter was associated with acute Q fever (adjusted odds ratio [OR] 2.54, 95% confidence interval [CI] 1.38-4.76) and sheep slaughter with SFG rickettsioses case (OR 4.63, 95% CI 1.08-23.50). Acute Q fever and SFG rickettsioses were detected in participants with febrile illness. Exposures to C. burnetii and to SFG Rickettsia were highly prevalent, and interactions with livestock were associated with increased odds of illness with both pathogens. Further characterisation of the burden and risks for these diseases is warranted.

Traditionally removed mandibular central incisors and oral health-related quality of life: a cross-sectional study among adolescents in Maasai populated areas, Northern Tanzania

BackgroundThe traditional removal of mandibular anterior teeth has been existing for many years in the Sub-Saharan African countries. This study aimed to assess the prevalence and sociodemographic distribution of traditionally removed mandibular central incisors (TRMCI) and its association with oral impact on daily performance (OIDP) among adolescents in Maasai populated areas in the Northern part of Tanzania.MethodsUsing a two-stage cluster sample design, with schools as the primary sampling unit, 23 out of 66 eligible rural schools were randomly selected. From each selected school, one class, expected to contain adolescents aged 12–14 years, was identified. The students from these selected classes were invited to participate in the study. A total of 989 adolescents were invited and 906 (91.6%) accepted to participate and completed both an interview and a clinical oral examination.ResultsMean age was 13.4 years (12–17 years, SD 1.2) and 43.9% were males (n = 398). The participants from Longido district amounted to 47.1%. The Maasai group constituted 79.6% of the study participants. The frequency of the participants missing at least one mandibular central incisor were 18.5%. Multivariable logistic regression revealed that adolescents from Longido district were more likely to report at least one TRMCI (OR = 2.5, 95% CI 1.4–3.3). Adolescents from non-Maasai group were less likely to have atleast one TRMCI compared to adolescents from Maasai ethnic group (OR = 0.02, 95% CI 0.002–0.15). Adolescents with at least one TRMCI were more likely to report impacts on OIDP (OR = 3.3, 95% CI 1.9–5.7) than those without TRMCI. Independent of the TRMCI status, adolescents from Longido district were less likely than their counterparts to report oral impacts (OR = 0.4, 95% CI 0.2–0.6). Similarly, adolescents from non-Masaai group were more likely than their counterparts to report oral impacts (OR = 2.2, 95% CI 1.4–3.5).ConclusionTRMCI is common among adolescents in the Maasai populated areas in the Northern part of Tanzania and strongly associated with the district of residence and Maasai ethnicity and has a negative impact on oral health related quality of life. There is a need for oral health education in the rural Maasai communities in Tanzania to increase awareness of the negative consequences of this practice.

Age and Agency: Evidence from a Women’s Empowerment Program in Tanzania

Understanding the effectiveness of programs designed to empower women is important for development policy, and critically important in places with historically unequal gender norms. In this paper, we evaluate the impact of a multidimensional program on women’s empowerment in northern Tanzania, where our study sample is among the pastoralist and traditionally patriarchal Maasai tribe. The multidimensional approach of the program included various components: microcredit groups, business skills, livestock management, water improvements, women’s rights discussions, and nutrition education. To measure the effect of the program, we employ a difference-in-differences approach, with doubly robust weighting. We use the livestock-enhanced project-level Women’s Empowerment in Agriculture Index (pro-WEAI), a new quantitative measurement of women’s empowerment designed for communities where livestock is a main productive asset. Our analysis of the program impact shows that the multidimensional program led to higher levels of empowerment for young women, specifically more group membership, access to credit, increased control over income, and a larger input into household productive decisions. Notably, the improvement in empowerment for young women does not reflect any change in attitudes towards intimate partner violence. Despite the positive findings for young women, we do not find any change in empowerment for the full sample of women (all ages). Our results demonstrate that programming focused on women’s empowerment has differential effects over a woman’s life cycle.

Human–Hyena (Crocuta crocuta) Conflict in the Tarangire Ecosystem, Tanzania

Interactions between people and large carnivores on shared landscapes can have harmful social and ecological consequences. Human–carnivore coexistence depends on an assemblage of sociological factors including effective management institutions that address the social costs of carnivore conservation and promote tolerance toward wildlife. In East Africa, large carnivores are particularly troublesome for herders who depend on livestock for subsistence and wellbeing. This paper provides an overview of human–hyena conflict in the Tarangire ecosystem of northern Tanzania. It presents descriptive results from a questionnaire survey (n = 1076) administered as part of an anthropological study (2019–2020; 2022; 2023) of human–wildlife interactions across twelve villages inhabited by Maasai agropastoralists. The survey instrument was designed through community-based participatory research methods to convey herder concerns about the impacts of spotted hyenas (Crocuta crocuta) on the livestock economy. Based on the perceptions and local ecological knowledge of Maasai interlocutors, the paper provides an overview of the spatial and temporal patterns of human–hyena interactions. Perceived frequencies of hyena attacks on kraaled livestock were unevenly distributed geographically, with those homesteads surrounding Manyara Ranch most heavily affected. Based on herder-reported livestock losses, the costs of depredation by spotted hyenas across the study area were estimated at approximately USD 904.84 per household per year. Most homesteads lacked fortified bomas and would benefit from the provision of lights and fencing materials to improve kraal structures. The paper’s central finding is that spotted hyenas represent a pressing, everyday concern for local pastoralists. Unsurprisingly, herders despise hyenas and are intolerant of sharing landscapes with them. For carnivore conservation outside protected areas to thrive in Tanzania, conservationists and policy makers must engage more meaningfully with the lived experiences of local herders who bear the brunt of conservation costs on their livelihoods.