Using digital technology as a platform to strengthen the continuum of care at community level for maternal, child and adolescent health in Tanzania: introducing the Afya-Tek program.

Inadequate care within Tanzania's primary health system contributes to thousands of preventable maternal and child deaths, and unwanted pregnancies each year. A key contributor is lack of coordination between three primary healthcare actors: public sector Community Health Workers (CHWs) and health facilities, and private sector Accredited Drug Dispensing Outlets (ADDOs). The Afya-Tek program aims to improve the continuity of care amongst these actors in Kibaha district, through a mobile-application based digital referral system that focuses on improving maternal, child and adolescent health. The digital system called Afya-Tek was co-created with users and beneficiaries, and utilises open-source technology in-line with existing government systems. The system guides healthcare actors with individualised decision support during client visits and recommends accurate next steps (education, treatment, or referral). From July 2020 to June 2023, a total of 241,000 individuals were enrolled in the Afya-Tek program covering 7,557 pregnant women, 6,582 postpartum women, 45,900 children, and 25,700 adolescents. CHWs have conducted a total of 626,000 home visits to provide health services, including screening clients for danger signs. This has resulted in 38,100 referrals to health facilities and 24,300 linkages to ADDOs. At the ADDO level, 48,552 clients self-presented; 33% of children with pneumonia symptoms received Amoxicillin; 34% of children with diarrhoea symptoms received ORS and zinc; and 4,203 referrals were made to nearest health facilities. Adolescents preferred services at ADDOs as a result of increased perceived privacy and confidentiality. In total, 89% of all referrals were attended by health facilities. As the first digital health program in Tanzania to demonstrate the linkage among public and private sector primary healthcare actors, Afya-Tek holds promise to improve maternal, child and adolescent health as well as for scale-up and sustainability, through incorporation of other disease conditions and integration with government's Unified Community System (UCS).

The use of touch DNA analysis in forensic identification focusing on Short Tandem Repeat- Combined DNA Index System loci THO1, CSF1PO and TPOX.

Forensic identification through DNA analysis is an accurate diagnostic tool. Deoxyribonucleic Acid (DNA) analysis is via DNA repetitive regions with less than 1 kb base size is called 'microsatellite' or Short Tandem Repeat (STR). At the crime scene, the perpetrator's skin may accidentally be in contact with surrounding objects, thereby transferring trace evidence to the objects. In this study DNA was obtained using "touch DNA" from two buccal smears and two smear from watches and cellphones from volunteers who had signed the consent form. Samples were isolated using DNAzol. The quantity of DNA obtained will be measured using a UV spectrophotometer. For DNA amplification using 3 STR CODIS loci namely TH01, CSF1PO, and TPOX. The last step is visualization using acrylamide gel and silver staining. Mean levels of DNA (UVVisible Spectrophotometer) were 167.89±85.71 µg/mL for the buccal swab, 59.19±5.58 µg/mL for the watch swab, and 38.09±2.12 µg/mL for the mobile swab; the purity of the buccal swab DNA was 1.79±0.71, of the watch swab 1.69±0.76, and of the mobile swab 1.53±0.56. Visualization of PCR products on Polyacrylamide Agarose Composite Gel Electrophoresis stained with Silver and amplified using the standard primers THOI, TPOX and CSF1PO for STR Combined DNA Index System (CODIS) showed a 100% detection of amplicons. Both the buccal swab, watch swab and handphone swabs had trace amount of DNA that was sufficient to be isolated and amplified by using Polymerase Chain Reaction on the STR CODIS loci THO1, CSF1PO and TPOX.