Non-alcoholic fatty liver disease in Tanzania: prevalence, determinants, and diagnostic performance of triglycerides-glucose index and triglycerides-glucose index -body mass index compared to the hepatic ultrasound in overweight and obese individuals.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD), which is closely associated with metabolic syndrome (MetS), is rarely reported in Tanzania, where MetS is prevalent. The purpose of this study was to determine the prevalence and associated factors of this condition in overweight and obese individuals and to correlate standard ultrasound diagnosis with triglyceride-glucose index (TyG) and TyG-body mass index (TyG-BMI). METHODS: A cross-sectional analysis was performed in 181 adult outpatients attending a general medical clinic. The presence of fatty liver was detected by ultrasound. Demographic, clinical, and laboratory data were collected and analyzed using STATA 15. To compare categorical variables, a chi-square test was employed, while a Student's t-test was used to compare continuous variables. Additionally, a multivariate regression analysis was conducted to identify the determinants of NAFLD. A significance level was set at p < 0.05. The discriminatory power of TyG and TyG-BMI for diagnosing NAFLD was evaluated using Receiver Operating Characteristic (ROC) Curve analysis and the Area Under the ROC Curve (AUC) was reported. RESULTS: The overall prevalence of NAFLD was 30.4% (55/181). The prevalence's of NAFLD in patients with class III obesity, class II obesity, class I obesity and overweight were 50.0% (12/24),, 38% (19/50), 23.7% (18/76), and 19.5% (6/31),respectively. NAFLD was strongly predicted by hyperuricemia (≥ 360 µmol/L) (p = 0.04) and TyG ≥ 8.99 (p = 0.003). The best cut-off values of TyG and TyG-BMI to predict NAFLD were 8.99 [AUC 0.735; sensitivity 70.9%, specificity 79.3%] and 312 [AUC 0.711; sensitivity 60% and specificity 75.4%] respectively. CONCLUSIONS: The prevalence of NAFLD is high among people with overweight and obesity in Tanzania. We did not find sufficient evidence to recommend the use of TyG and TyG-BMI as surrogates for hepatic ultrasound in detecting NAFLD, and further evaluation is recommended.

Forty Years of Helicobacter pylori: The African Perspective.

BACKGROUND: Helicobacter pylori colonises 50% of the world population and is a causative agent of gastritis, peptic ulcer disease, mucosa associate lymphoid tissue lymphoma and gastric cancer. SUMMARY: In Africa, the prevalence rate has been found to be the highest in comparison to other parts of the world. Despite its high prevalence there are low rates of gastric cancer recorded in Africa. This African perspective gives an insight into the history of H. pylori in Africa and also examines the issue of the so-called "African Enigma," it's diagnosis and treatment and where we are now. KEY MESSAGES: Our vision is to have an African community that is free from H. pylori infections and complications. To this end, the African Helicobacter and Microbiota Study Group was initiated in 2021 and launched on the June 27, 2022 in Lagos, Nigeria (https://ahmsg-africa.org/). The African perspective includes the need for more detailed information on actual community and hospital prevalence, resistance data, and standardizing processes and algorithms to enable comparative diagnosis and therapy of H. pylori infections using a multi-pronged approach with international support.

Helicobacter pylori Diagnosis and Treatment in Africa: The First Lagos Consensus Statement of the African Helicobacter and Microbiota Study Group.

BACKGROUND: Helicobacter pylori (H. pylori) infection is the most prevalent type of bacterial infection. Current guidelines from different regions of the world neglect specific African conditions and requirements. The African Helicobacter and Microbiota Study Group (AHMSG), founded in 2022, aimed to create an Africa-specific consensus report reflecting Africa-specific issues. SUMMARY: Eighteen experts from nine African countries and two European delegates supported by nine African collaborators from eight other countries prepared statements on the most important African issues in four working groups: (1) epidemiology, (2) diagnosis, (3) indications and prevention, and (4) treatment. Limited resources, restricted access to medical systems, and underdeveloped diagnostic facilities differ from those of other regions. The results of the individual working groups were presented for the final consensus voting, which included all board members. KEY MESSAGES: There is a need for further studies on H. pylori prevalence in Africa, with diagnosis hinged on specific African situation. Treatment of H. pylori in the African setting should be based on accessibility and reimbursement, while indication and prevention should be defined in specific African countries.

Factors associated with uptake of isoniazid preventive therapy among children living with HIV in Mwanza region, Tanzania: a cross-sectional study.

BACKGROUND: Tuberculosis (TB) is a leading cause of death among children living with HIV (CLHIV). Isoniazid preventive therapy (IPT) reduces the incidence of TB by 70% and mortality by 50% among CLHIV. However, in most developing countries including Tanzania, the uptake of IPT is suboptimal, below the 90% WHO-global uptake target. We assessed the factors associated with IPT uptake among CLHIV in Mwanza region, Tanzania. METHODS: This was a multicenter facility-based cross-sectional study among CLHIV aged 1 to 10 years in seven districts of Mwanza region, Tanzania from 1st November 2021 to 20th January 2022. Data were collected using a structured interview-administered questionnaire including information on children and caregivers' demographics, caregivers' health related information and children's clinical information. Our outcome variable was uptake of IPT, defined as initiation on IPT either during the time of the study or within past three years before this study We conducted modified Poisson regression to assess the association between IPT uptake and selected exposures in Stata version 15.0. RESULTS: A total of 415 CLHIV were enrolled, the median age of the children was 7 years (Interquartile range: 5-8). The uptake of IPT was 91% (n = 377). The majority of children's caregivers were HIV positive (86%, n = 387) and were aware about IPT (63.6%, n = 264). Factors associated with IPT uptake included; having an employed caregiver [Adjusted Prevalence Ratio (aPR): 1.06 95% Confidence Interval (CI): 1.00-1.13] and attending the ART clinic every month [aPR: 1.00; 95% CI: 0.87-1.00] . CONCLUSIONS: The uptake of IPT uptake among CLHIV in Mwanza, Tanzania exceeds the global WHO-target of ≥ 90%. Monthly ART clinic visits could be essential in promoting IPT uptake among CLHIV.

Hepatitis B virus infection, associated factors, knowledge and vaccination status among household contacts of hepatitis B index cases in Mwanza, Tanzania.

Objectives: To determine the prevalence of hepatitis B virus (HBV) infection, knowledge regarding HBV, vaccination status, and associated factors among household contacts of HBV index cases in Mwanza, Tanzania. Methods: Between July and August 2023, a cross-sectional study involving 97 index cases and 402 household contacts was conducted. Data were collected using pre-tested structured questionnaire and blood samples were collected from household contacts for HBV surface antigen (HBsAg) testing. Results: The prevalence of HBV among household contacts was 5.4% (95% confidence interval, 2.9-9.0) with a significantly high proportion observed in > 45 years (16.6%) and in males (9.9%). A total of 40.0% of the household contacts had completed the full HBV vaccination series. On multivariate analysis, being male was significantly associated with HBsAg positivity (odds ratio: 7.16, 95% confidence interval: 1.81-28.2, P = 0.005). Conclusion: About one-tenth of adults' male household contacts were HBsAg positive. In addition, the majority of household contacts had poor to fair knowledge regarding HBV infection with more than half being unvaccinated against HBV. There is a need to enhance awareness and education regarding HBV infection among household contacts in Tanzania and other low- and middle-income countries.

Prevalence of Hepatitis B Virus Infection in Tanzania: A Systematic Review and Meta-Analysis.

Methods: We systematically searched the PubMed, Web of Science, African Journals Online, Embase, Cochrane Library, and Google Scholar databases for studies conducted up to March 1, 2023, that estimated the prevalence of HBV in Tanzania based on HBV surface antigen measurements. The DerSimonian-Laird random effects model was used to estimate the overall prevalence of HBV with 95% confidence intervals (CIs). Potential sources of heterogeneity were also investigated. Results: Thirty-one studies with a total sample size of 37,988 were included in the meta-analysis. The overall average HBV prevalence estimate in Tanzania was 6.91% (95% CI = 5.18-8.86%). Subgroup analysis revealed the highest prevalence in the northern zone (9.32%, 95% CI; 2.24-20.36%), among the blood donors (18.72%, 95% CI: 17.43-20.05%) and among the community volunteers (8.76%, 95% CI: 4.55-14.15%). The lowest prevalence was observed in the lake zone at 4.66% (95% CI: 3.49-5.99) and in pregnant women at 4.72% (95% CI: 3.42-6.21). The overall between-study variability showed significant heterogeneity (I 2 = 97.41%, P < 0.001). Conclusions: Our results showed that Tanzania is a country with moderately high HBV endemicity, with large interregional differences and significantly high numbers of HBV infections within the community. This underscores the need for immediate development of targeted prevention strategies and further epidemiological studies to better understand the pattern of the disease.