Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 11.374
Filtrar
1.
Zootaxa ; 4830(1): zootaxa.4830.1.2, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-33056251

RESUMO

Descriptions of five new Afrotropical species of the genus Condylostylus Bigot are provided: C. comorensis sp. nov. from Comoros, C. friedmani sp. nov. from Madagascar, C. gavryushini sp. nov. from Tanzania, C. kaplini sp. nov. from South Africa, and C. madagascarensis sp. nov. from Madagascar. The new species differ from other representatives of the genus in morphology of the male cercus and male secondary sexual characters of the legs. A revised identification key to males of the 25 known species of Afrotropical Condylostylus is provided. Condylostylus congensis Curran, 1927 syn. nov. is newly synonymized with C. beckeri Speiser, 1920.


Assuntos
Dípteros , Distribuição Animal , Animais , Comores , Madagáscar , Masculino , África do Sul , Tanzânia
2.
Zootaxa ; 4766(3): zootaxa.4766.3.2, 2020 Apr 21.
Artigo em Inglês | MEDLINE | ID: mdl-33056589

RESUMO

This paper reports new flightless forest litter weevils discovered in Tanzania. They are classified into two species of the genus Tazarcus gen. nov.: T. aeaea sp. nov. (the type species; from South Pare and West Usambara) and T. ogygia sp. nov. (Rubeho). Both new species inhabit the archipelago-type Eastern Arc Mountain rainforests renowned for the high diversity of their biota. Adults of Tazarcus are recognizable by their relatively small size (length of pronotum and elytra in dorsal view 2.0-3.4 mm), the short and straight rostrum covered dorsally with dense velvety pilosity, an antennal funicle with seven segments, a prosternal canal, procoxae separated, a lack of hind wings and effaced elytral shoulders. Remarkably, adults of Tazarcus possess a short longitudinal ridge on each metapleuron, which bears a line of serration likely homologous to sclerolepidia. A phylogenetic analysis of 72 terminals and 3134 aligned positions from one mitochondrial and two nuclear ribosomal fragments corroborated the monophyly of the new genus, of both new species and of all three sampled populations but did not identify the sister group of Tazarcus. Three other weevil taxa with adults possessing a similarly shaped metapleural ridge (the African Thrombosternus Marshall and Allocycloteres Voss and an unidentified species of Molytinae from Madagascar) did not cluster with Tazarcus, suggesting multiple origins of this structure. Tazarcus is taxonomically classified as incertae sedis in a non-monophyletic subfamily "Molytinae". Images and DNA sequences of all 72 herein analysed specimens are available online at dx.doi.org/10.5883/DS-VGDS011.


Assuntos
Besouros , Gorgulhos , Animais , Filogenia , Tanzânia
3.
Environ Monit Assess ; 192(11): 721, 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-33089438

RESUMO

For most rivers in sub-Saharan Africa, information about pollution indices related to sediments is sparse. Sedimentological research of rivers that empty into Lake Victoria is highly patchy and wide apart. The present study determined the levels and associated risk of As, Cd, Cr, Hg, and Pb in sediments collected from four different sites along the Mara River that empties into Lake Victoria in Tanzania. Samples were collected in the dry and rainy months in 2019. Pollution indices, namely geo-accumulation index (Igeo), enrichment factor (EF), contamination factor (CF), modified contamination degree (mCd), pollution load index (PLI), potential ecological risk factor (Eri), and potential ecological risk index (RI) were used to evaluate the influence of heavy metal contamination in sediments. Dry month mean concentrations, in milligram per kilogram, of heavy metals were as follows: As (11.04 ± 0.13), Cr (1.02 ± 0.29), Cd (0.43 ± 0.05), and Hg (0.01) in the dry month. Respective sediment heavy metal concentrations for the rainy month were 22.22 ± 0.05 mg As/kg, 3.84 ± 0.34 mg Pb/kg, 1.53 ± 0.15 mg Cd/kg, 1.43 mg Cr/kg, and 0.03 mg Hg/kg. Generally, the risk indices showed high values in the rainy month and low values in the dry month, especially for As and Cd-an indication of anthropogenic influence. Correlation coefficient analysis for Pb and Cd showed a strong positive correlation (r = 0.99, p < 0.01)-this may suggest a similar source or similar transport behavior. Special attention needs to be paid with regard to rainy season As and Cd enrichment in the study area.


Assuntos
Rios , Poluentes Químicos da Água , Monitoramento Ambiental , Sedimentos Geológicos , Medição de Risco , Tanzânia , Poluentes Químicos da Água/análise
4.
Can J Surg ; 63(5): E418-E421, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33009901

RESUMO

SUMMARY: The Canadian Network for International Surgery (CNIS) hosted a workshop in May of 2020 with a goal of critically evaluating Trauma Team Training courses. The workshop was held virtually because of the coronavirus disease 2019 (COVID-19) pandemic. Twenty-three participants attended from 8 countries: Canada, Guyana, Kenya, Nigeria, Switzerland, Tanzania, Uganda and the United States. More participants were able to attend the virtual meeting than the traditional in-person meetings. Web-based videoconference software was used, participants presented prerecorded PowerPoint videos, and questions were raised using a written chat. The review proved successful, with discussions and recommendations for improvements surrounding course quality, lecture content, skills sessions, curriculum variations and clinical practical scenarios. The CNIS's successful experience conducting an online curriculum review involving international participants may prove useful to others proceeding with collaborative projects during the COVID-19 pandemic.


Assuntos
Congressos como Assunto/organização & administração , Infecções por Coronavirus/prevenção & controle , Currículo , Cirurgia Geral/educação , Cooperação Internacional , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus/patogenicidade , Canadá/epidemiologia , Congressos como Assunto/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Cirurgia Geral/métodos , Guiana/epidemiologia , Humanos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Quênia/epidemiologia , Nigéria/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Suíça/epidemiologia , Tanzânia/epidemiologia , Uganda/epidemiologia , Estados Unidos/epidemiologia , Comunicação por Videoconferência/organização & administração , Comunicação por Videoconferência/normas , Ferimentos e Lesões/cirurgia
5.
Zootaxa ; 4790(1): zootaxa.4790.1.8, 2020 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-33055859

RESUMO

New species of Mecopodinae are described from Tanzanian mountain ranges. These are Apteroscirtus densissimus n. sp. from the Nguru Mountains, Gymnoscirtus corifterus n. sp. from the Udzungwa Mountains Nationalpark and a new subspecies of Phyloscirtus cordipennis Karsch, P. c. spinosus n. ssp. from the Nguru Mountains. Data on habitat are provided.


Assuntos
Ortópteros , Animais , Ecossistema , Tanzânia
6.
Zootaxa ; 4853(2): zootaxa.4853.2.9, 2020 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-33056380

RESUMO

A new myrmecophilous species of root mealybug, Williamsrhizoecus udzungwensis sp. n., is described from individuals found living within a nest of Acropyga silvestrii in the Udzungwa Mountains of Tanzania. Acropyga ants are highly specialized, obligate associates of scale insects, typically members of the scale family Xenococcidae. Acropyga are best known for vertically transmitting trophobiotic partners during their nuptial flights and for housing them within brood chambers. This article presents the first record of trophobiosis between a species of Williamsrhizoecus and Acropyga, and only the second record of an association between Acropyga and rhizoecids in the Old World. This discovery contributes important information about the few species of Rhizoecidae confirmed to engage in these unique symbioses, each putatively the result of a past horizontal transmission event from a xenococcid to a rhizoecid lineage. Included is a discussion on the diagnosis of Williamsrhizoecus and an updated key to the species.


Assuntos
Formigas , Hemípteros , Animais , Simbiose , Tanzânia
7.
BMC Infect Dis ; 20(1): 738, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028260

RESUMO

BACKGROUND: In accordance with international guidance for tuberculosis (TB) prevention, the Tanzanian Ministry of Health recommends isoniazid preventive therapy (IPT) for children aged 12 months and older who are living with HIV. Concerns about tolerability, adherence, and potential mistreatment of undiagnosed TB with monotherapy have limited uptake of IPT globally, especially among children, in whom diagnostic confirmation is challenging. We assessed IPT implementation and adherence at a pediatric HIV clinic in Tanzania. METHODS: In this prospective cohort study, eligible children living with HIV aged 1-15 years receiving care at the DarDar Pediatric Program in Dar es Salaam who screened negative for TB disease were offered a 6-month regimen of daily isoniazid. Patients could choose to receive IPT via facility- or community-based care. Parents/caregivers and children provided informed consent and verbal assent respectively. Isoniazid was dispensed with the child's antiretroviral therapy every 1-3 months. IPT adherence and treatment completion was determined by pill counts, appointment attendance, and self-report. Patients underwent TB symptom screening at every visit. RESULTS: We enrolled 66 children between July and December 2017. No patients/caregivers declined IPT. Most participants were female (n = 43, 65.1%) and the median age was 11 years (interquartile range [IQR] 8, 13). 63 (95.5%) participants chose the facility-based model; due to the small number of participants who chose the community-based model, valid comparisons between the two groups could not be made. Forty-nine participants (74.2%) completed IPT within 10 months. Among the remaining 17, 11 had IPT discontinued by their provider due to adverse drug reactions, 5 lacked documentation of completion, and 1 had unknown outcomes due to missing paperwork. Of those who completed IPT, the average monthly adherence was 98.0%. None of the participants were diagnosed with TB while taking IPT or during a median of 4 months of follow-up. CONCLUSIONS: High adherence and treatment completion rates can be achieved when IPT is integrated into routine, self-selected facility-based pediatric HIV care. Improved record-keeping may yield even higher completion rates. IPT was well tolerated and no cases of TB were detected. IPT for children living with HIV is feasible and should be implemented throughout Tanzania.


Assuntos
Antituberculosos/uso terapêutico , Infecções por HIV/patologia , Isoniazida/uso terapêutico , Tuberculose/prevenção & controle , Adolescente , Instituições de Assistência Ambulatorial , Antirretrovirais/uso terapêutico , Cuidadores/psicologia , Criança , Pré-Escolar , Feminino , Infecções por HIV/tratamento farmacológico , Humanos , Lactente , Masculino , Adesão à Medicação , Cooperação do Paciente , Estudos Prospectivos , Tanzânia , Resultado do Tratamento
8.
PLoS Med ; 17(9): e1003248, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32946451

RESUMO

BACKGROUND: Two billion long-lasting insecticidal nets (LLINs) have been procured for malaria control. A functional LLIN is one that is present, is in good physical condition, and remains insecticidal, thereby providing protection against vector-borne diseases through preventing bites and killing disease vectors. The World Health Organization (WHO) prequalifies LLINs that remain adequately insecticidal 3 years after deployment. Therefore, institutional buyers often assume that prequalified LLINs are functionally identical with a 3-year lifespan. We measured the lifespans of 3 LLIN products, and calculated their cost per year of functional life, to demonstrate the economic and public health importance of procuring the most cost-effective LLIN product based on its lifespan. METHODS AND FINDINGS: A randomised double-blinded trial of 3 pyrethroid LLIN products (10,571 nets in total) was conducted at 3 follow-up points: 10 months (August-October 2014), 22 months (August-October 2015), and 36 months (October-December 2016) among 3,393 households in Tanzania using WHO-recommended methods. Primary outcome was LLIN functional survival (LLIN present and in serviceable condition). Secondary outcomes were (1) bioefficacy and chemical content (residual insecticidal activity) and (2) protective efficacy for volunteers sleeping under the LLINs (bite reduction and mosquitoes killed). Median LLIN functional survival was significantly different between the 3 net products (p = 0.001): 2.0 years (95% CI 1.7-2.3) for Olyset, 2.5 years (95% CI 2.2-2.8) for PermaNet 2.0 (hazard ratio [HR] 0.73 [95% CI 0.64-0.85], p = 0.001), and 2.6 years (95% CI 2.3-2.8) for NetProtect (HR = 0.70 [95% CI 0.62-0.77], p < 0.001). Functional survival was affected by accumulation of holes, leading to users discarding nets. Protective efficacy also significantly differed between products as they aged. Equivalent annual cost varied between US$1.2 (95% CI $1.1-$1.4) and US$1.5 (95% CI $1.3-$1.7), assuming that each net was priced identically at US$3. The 2 longer-lived nets (PermaNet and NetProtect) were 20% cheaper than the shorter-lived product (Olyset). The trial was limited to only the most widely sold LLINs in Tanzania. Functional survival varies by country, so the single country setting is a limitation. CONCLUSIONS: These results suggest that LLIN functional survival is less than 3 years and differs substantially between products, and these differences strongly influence LLIN value for money. LLIN tendering processes should consider local expectations of cost per year of functional life and not unit price. As new LLIN products come on the market, especially those with new insecticides, it will be imperative to monitor their comparative durability to ensure that the most cost-effective products are procured for malaria control.


Assuntos
Mosquiteiros Tratados com Inseticida/economia , Inseticidas/economia , Controle de Mosquitos/métodos , Animais , Culicidae/efeitos dos fármacos , Vetores de Doenças , Características da Família , Seguimentos , Humanos , Resistência a Inseticidas/efeitos dos fármacos , Mosquiteiros Tratados com Inseticida/tendências , Inseticidas/farmacologia , Malária/prevenção & controle , Controle de Mosquitos/economia , Mosquitos Vetores/efeitos dos fármacos , Piretrinas/farmacologia , Tanzânia/epidemiologia
9.
PLoS Med ; 17(9): e1003318, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32956354

RESUMO

BACKGROUND: Low-density (LD) Plasmodium infections are missed by standard malaria rapid diagnostic tests (standard mRDT) when the blood antigen concentration is below the detection threshold. The clinical impact of these LD infections is unknown. This study investigates the clinical presentation and outcome of untreated febrile children with LD infections attending primary care facilities in a moderately endemic area of Tanzania. METHODS/FINDINGS: This cohort study includes 2,801 febrile pediatric outpatients (median age 13.5 months [range 2-59], female:male ratio 0.8:1.0) recruited in Dar es Salaam, Tanzania between 01 December 2014 and 28 February 2016. Treatment decisions were guided by a clinical decision support algorithm run on a mobile app, which also collected clinical data. Only standard mRDT+ cases received antimalarials. Outcomes (clinical failure, secondary hospitalization, and death) were collected in follow-up visits or interviews on days 3, 7, and 28. After patient recruitment had ended, frozen blood from all 2,801 patients was tested for Plasmodium falciparum (Pf) by ultrasensitive-quantitative polymerase chain reaction (qPCR), standard mRDT, and "ultrasensitive" mRDT. As the latter did not improve sensitivity beyond standard mRDT, it is hereafter excluded. Clinical features and outcomes in LD patients (standard mRDT-/ultrasensitive-qPCR+, not given antimalarials) were compared with those with no detectable (ND) parasitemia (standard mRDT-/ultrasensitive-qPCR-) or high-density (HD) infections (standard mRDT+/ultrasensitive-qPCR+, antimalarial-treated). Pf positivity rate was 7.1% (n = 199/2,801) and 9.8% (n = 274/2,801) by standard mRDT and ultrasensitive qPCR, respectively. Thus, 28.0% (n = 76/274) of ultrasensitive qPCR+ cases were not detected by standard mRDT and labeled "LD". LD patients were, on average, 10.6 months younger than those with HD infections (95% CI 7.0-14.3 months, p < 0.001). Compared with ND, LD patients more frequently had the diagnosis of undifferentiated fever of presumed viral origin (risk ratio [RR] = 2.0, 95% CI 1.3-3.1, p = 0.003) and were more often suffering from severe malnutrition (RR = 3.2, 95% CI 1.1-7.5, p = 0.03). Despite not receiving antimalarials, outcomes for the LD group did not differ from ND regarding clinical failures (2.6% [n = 2/76] versus 4.0% [n = 101/2,527], RR = 0.7, 95% CI 0.2-3.5, p = 0.7) or secondary hospitalizations (2.6% [n = 2/76] versus 2.8% [n = 72/2,527], RR = 0.7,95% CI 0.2-3.2, p = 0.9), and no deaths were reported in any Pf-positive groups. HD patients experienced more secondary hospitalizations (10.1% [n = 20/198], RR = 0.3, 95% CI 0.1-1.0, p = 0.005) than LD patients. All the patients in this cohort were febrile children; thus, the association between parasitemia and fever cannot be investigated, nor can the conclusions be extrapolated to neonates and adults. CONCLUSIONS: During a 28-day follow-up period, we did not find evidence of a difference in negative outcomes between febrile children with untreated LD Pf parasitemia and those without Pf parasitemia. These findings suggest LD parasitemia may either be a self-resolving fever or an incidental finding in children with other infections, including those of viral origin. These findings do not support a clinical benefit nor additional risk (e.g. because of missed bacterial infections) to using ultrasensitive malaria diagnostics at a primary care level.


Assuntos
Parasitemia/diagnóstico , Convulsões Febris/etiologia , Convulsões Febris/parasitologia , Antimaláricos/uso terapêutico , Pré-Escolar , Estudos de Coortes , Feminino , Febre/diagnóstico , Humanos , Lactente , Malária/epidemiologia , Malária Falciparum/tratamento farmacológico , Masculino , Parasitemia/epidemiologia , Plasmodium falciparum/parasitologia , Plasmodium falciparum/patogenicidade , Tanzânia/epidemiologia
10.
Bull Environ Contam Toxicol ; 105(4): 513-521, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32979081

RESUMO

Little is known about the prevalence of microplastics (MPs) in East Africa. In the present study, sediments were sampled at 18 sites along the Tanzanian coast that exhibit different levels of anthropogenic activity and were extracted using floatation methodology. Cockles (Anadara antiquata) were collected only from eight sites and MPs were extracted following NaOH digestion. MPs were most abundant at Mtoni Kijichi Creek (MKC, 2972 ± 238 particles kg-1 dry sediment), an industrial port in Dar es Salaam, and significantly higher than all other sites where the abundance range was 15-214 particles kg-1 dry sediment (p < 0.05, one-way ANOVA). Fragments and fibers were found at all sites. Polypropylene and polyethylene were identified polymers. MPs were found in cockles from all sampled sites with both frequencies of occurrence and MPs per individual subject to site-specific variation. This study provides a baseline of MP data in a previously uninvestigated area.


Assuntos
Arcidae/metabolismo , Exposição Ambiental , Sedimentos Geológicos/química , Microplásticos/metabolismo , Poluentes da Água/metabolismo , Animais , Praias , Bioacumulação , Tanzânia
11.
Global Health ; 16(1): 90, 2020 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-32977816

RESUMO

BACKGROUND: A recent editorial urged those working in global mental health to "change the conversation" on coronavirus disease (Covid-19) by putting more focus on the needs of people with severe mental health conditions. UPSIDES (Using Peer Support In Developing Empowering mental health Services) is a six-country consortium carrying out implementation research on peer support for people with severe mental health conditions in high- (Germany, Israel), lower middle- (India) and low-income (Tanzania, Uganda) settings. This commentary briefly outlines some of the key challenges faced by UPSIDES sites in low- and middle-income countries as a result of Covid-19, sharing early lessons that may also apply to other services seeking to address the needs of people with severe mental health conditions in similar contexts. CHALLENGES AND LESSONS LEARNED: The key take-away from experiences in India, Tanzania and Uganda is that inequalities in terms of access to mobile technologies, as well as to secure employment and benefits, put peer support workers in particularly vulnerable situations precisely when they and their peers are also at their most isolated. Establishing more resilient peer support services requires attention to the already precarious situation of people with severe mental health conditions in low-resource settings, even before a crisis like Covid-19 occurs. While it is essential to maintain contact with peer support workers and peers to whatever extent is possible remotely, alternatives to face-to-face delivery of psychosocial interventions are not always straightforward to implement and can make it more difficult to observe individuals' reactions, talk about emotional issues and offer appropriate support. CONCLUSIONS: In environments where mental health care was already heavily medicalized and mostly limited to medications issued by psychiatric institutions, Covid-19 threatens burgeoning efforts to pursue a more holistic and person-centered model of care for people with severe mental health conditions. As countries emerge from lockdown, those working in global mental health will need to redouble their efforts not only to make up for lost time and help individuals cope with the added stressors of Covid-19 in their communities, but also to regain lost ground in mental health care reform and in broader conversations about mental health in low-resource settings.


Assuntos
Infecções por Coronavirus , Países em Desenvolvimento , Saúde Mental , Pandemias , Pneumonia Viral , Betacoronavirus , Alemanha , Humanos , Índia , Tanzânia , Uganda
12.
PLoS One ; 15(9): e0238240, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32886666

RESUMO

The aim of the study is to compare sociodemographic characteristics, psychosocial factors, HIV knowledge and risk behaviors of people living with HIV (PLH) and their social network members (NMs) to inform HIV prevention programs that engage PLH as prevention educators in their communities. We compared baseline characteristics of PLH enrolled in an intervention to become HIV prevention Change Agents (CAs) (n = 458) and 602 NMs they recruited. CAs and NMs responded to questionnaires through a computer-driven interface with Audio Computer-Assisted Self Interview (ACASI) software. Although NMs scored higher on socio-economic status, self-esteem and general self-efficacy, they had lower HIV knowledge (AOR 1.5; 95% CI: 1.1-2.1), greater inconsistent condom use (AOR 3.2; 95% CI: 2.4-4.9), and recent experience as perpetrators of physical (AOR 2.5; 95% CI: 1.2-5.1) or sexual (AOR 4.1; 95% CI: 1.4-12.7) intimate partner violence; and as victims of physical (AOR 1.5; 95% CI: 1.0-2.3) or sexual (AOR 2.2; 95% CI: 1.3-3.8) forms of violence than CAs. Higher HIV knowledge and lower sexual risk behaviors among CAs suggest PLH's potential as communicators of HIV prevention information to NMs. CAs' training should also focus on improving self-esteem, general self-efficacy and social support to increase their potential effectiveness as HIV prevention educators and enhance their own overall health and well-being.


Assuntos
Transmissão de Doença Infecciosa/prevenção & controle , Infecções por HIV/psicologia , Infecções por HIV/transmissão , HIV/isolamento & purificação , Assunção de Riscos , Parceiros Sexuais/psicologia , Rede Social , Adolescente , Adulto , Antirretrovirais/uso terapêutico , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Humanos , Masculino , Fatores de Risco , Comportamento Sexual/psicologia , Apoio Social , Tanzânia/epidemiologia , Adulto Jovem
13.
Lancet HIV ; 7(10): e699-e710, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32888413

RESUMO

BACKGROUND: Community randomised trials have had mixed success in implementing combination prevention strategies that diagnose 90% of people living with HIV, initiate and retain on antiretroviral therapy (ART) 90% of those diagnosed, and achieve viral load suppression in 90% of those on ART (90-90-90). The Bukoba Combination Prevention Evaluation (BCPE) aimed to achieve 90-90-90 in Bukoba Municipal Council, Tanzania, by scaling up new HIV testing, linkage, and retention interventions. METHOD: We did population-based, cross-sectional surveys before and after our community-wide intervention in Bukoba-a mixed urban and rural council of approximately 150 000 residents located on the western shore of Lake Victoria in Tanzania. BCPE interventions were implemented in 11 government-supported health-care facilities throughout Bukoba from Oct 1, 2014, to March 31, 2017, when national ART-eligibility guidelines expanded from CD4 counts of less than 350 cells per µL (Oct 1, 2014-Dec 31, 2015) and 500 or less cells per µL (Jan 1, 2016-Sept 30, 2016) to any CD4 cell count (test and treat, Oct 1, 2016-March 31, 2017). We used pre-intervention (Nov 4, 2013-Jan 25, 2014) and post-intervention (June 21, 2017-Sept 20, 2017) population-based household surveys to assess population prevalence of undiagnosed HIV infection and ART coverage, and progress towards 90-90-90, among residents aged 18-49 years. FINDINGS: During the 2·5-year intervention, BCPE did 133 695 HIV tests, diagnosed and linked 3918 people living with HIV to HIV care at 11 Bukoba facilities, and returned to HIV care 604 patients who had stopped care. 4795 and 5067 residents aged 18-49 years participated in pre-intervention and post-intervention surveys. HIV prevalence before and after the intervention was similar: pre-intervention 8·9% (95% CI 7·5-10·4); post-intervention 8·4% (6·9-9·9). Prevalence of undiagnosed HIV infection decreased from 4·7% to 2·0% (prevalence ratio 0·42, 95% CI 0·31-0·57), and current ART use among all people living with HIV increased from 32·2% to 70·9% (2·20, 1·82-2·66) overall, 23·0% to 62·1% among men (2·70, 1·84-3·96), and 16·7% to 64·4% among people aged 18-29 years (3·87, 2·54-5·89). Of 436 and 435 people living with HIV aged 18-49 years who participated in pre-intervention and post-intervention surveys, previous HIV diagnosis increased from 47·4% (41·3-53·4) to 76·2% (71·8-80·6), ART use among diagnosed people living with HIV increased from 68·0% (60·9-75·2) to 93·1% (90·2-96·0), and viral load suppression of those on ART increased from 88·7% (83·6-93·8) to 91·3% (88·6-94·1). INTERPRETATION: BCPE findings suggest scaling up recommended HIV testing, linkage, and retention interventions can help reduce prevalence of undiagnosed HIV infection, increase ART use among all people living with HIV, and make substantial progress towards achieving 90-90-90 in a relatively short period. BCPE facility-based testing and linkage interventions are undergoing national scale up to help achieve 90-90-90 in Tanzania. FUNDING: US Presidents' Emergency Plan for AIDS Relief.


Assuntos
Infecções por HIV/epidemiologia , Adolescente , Adulto , Contagem de Linfócito CD4 , Administração de Caso , Estudos Transversais , Testes Diagnósticos de Rotina , Feminino , Geografia Médica , Infecções por HIV/diagnóstico , Infecções por HIV/terapia , Infecções por HIV/virologia , Humanos , Masculino , Programas de Rastreamento , Vigilância da População , Prevalência , População Rural , Tanzânia/epidemiologia , População Urbana , Carga Viral , Adulto Jovem
14.
PLoS One ; 15(9): e0237590, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32925949

RESUMO

Bushmeat harvesting and consumption represents a potential risk for the spillover of endemic zoonotic pathogens, yet remains a common practice in many parts of the world. Given that the harvesting and selling of bushmeat is illegal in Tanzania and other parts of Africa, the supply chain is informal and may include hunters, whole-sellers, retailers, and individual resellers who typically sell bushmeat in small pieces. These pieces are often further processed, obscuring species-identifying morphological characteristics, contributing to incomplete or mistaken knowledge of species of origin and potentially confounding assessments of pathogen spillover risk and bushmeat offtake. The current investigation sought to identify the species of origin and assess the concordance between seller-reported and laboratory-confirmed species of origin of bushmeat harvested from in and around the Serengeti National Park in Tanzania. After obtaining necessary permits, the species of origin of a total of 151 bushmeat samples purchased from known intermediaries from 2016 to 2018 were characterized by PCR and sequence analysis of the cytochrome B (CytB) gene. Based on these sequence analyses, 30%, 95% Confidence Interval (CI: 24.4-38.6) of bushmeat samples were misidentified by sellers. Misreporting amongst the top five source species (wildebeest, buffalo, impala, zebra, and giraffe) ranged from 20% (CI: 11.4-33.2) for samples reported as wildebeest to 47% (CI: 22.2-72.7) for samples reported as zebra although there was no systematic bias in reporting. Our findings suggest that while misreporting errors are unlikely to confound wildlife offtake estimates for bushmeat consumption within the Serengeti ecosystem, the role of misreporting bias on the risk of spillover events of endemic zoonotic infections from bushmeat requires further investigation.


Assuntos
Animais Selvagens , Carne/provisão & distribução , Zoonoses/etiologia , Animais , Animais Selvagens/genética , Búfalos/genética , Comércio , Citocromos b/genética , Ecossistema , Equidae/genética , Girafas/genética , Humanos , Parques Recreativos , Tanzânia/epidemiologia
15.
PLoS One ; 15(9): e0237700, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32966295

RESUMO

The reduction of food intake during pregnancy is part of many cultural and religious traditions around the world. The impact of such practices on fetal growth and development are poorly understood. Here, we examined the patterns of diet intake among Maasai pregnant women and assessed their effect on newborn morphometrics. We recruited 141 mother-infant pairs from Ngorongoro Conservation Area (NCA) in Northern Tanzania and quantified dietary intake and changes in maternal diet during pregnancy. We obtained measurements of body weight (BW) and head circumference (HC) at birth. We found that Maasai women significantly reduced their dietary intake during the third trimester, going from an average of 1601 kcal/day during the first two trimesters to 799 kcal/day in the final trimester. The greatest proportion of nutrient reduction was in carbohydrates. Overall, 40% of HC Z-scores of the NCA sample were more than 2 standard deviations below the WHO standard. Nearly a third of neonates classify as low birth weight (< 2500g). HC was smaller relative to BW in this cohort than predicted using the WHO standard. This contrasts markedly to a Tanzanian birth cohort obtained at the same time in an urban context in which only 12% of infants exhibited low weight, only two individuals had HC Z-scores < 2 and HC's relative to birth weight were larger than predicted using the WHO standards. The surprising lack of head sparing in the NCA cohort suggests that the impact of third trimester malnutrition bears further investigation in both animal models and human populations, especially as low HC is negatively associated with long term health outcomes.


Assuntos
Restrição Calórica , Desenvolvimento Fetal , Restrição Calórica/efeitos adversos , Feminino , Cabeça/embriologia , Cabeça/crescimento & desenvolvimento , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino , Mães , Gravidez , Primeiro Trimestre da Gravidez , Terceiro Trimestre da Gravidez , Tanzânia
16.
J Biol Dyn ; 14(1): 748-766, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-32990177

RESUMO

The outbreak of COVID-19 was first experienced in Wuhan City, China, during December 2019 before it rapidly spread over globally. This paper has proposed a mathematical model for studying its transmission dynamics in the presence of face mask wearing and hospitalization services of human population in Tanzania. Disease-free and endemic equilibria were determined and subsequently their local and global stabilities were carried out. The trace-determinant approach was used in the local stability of disease-free equilibrium point while Lyapunov function technique was used to determine the global stability of both disease-free and endemic equilibrium points. Basic reproduction number, R 0 , was determined in which its numerical results revealed that, in the presence of face masks wearing and medication services or hospitalization as preventive measure for its transmission, R 0 = 0.698 while in their absence R 0 = 3.8 . This supports its analytical solution that the disease-free equilibrium point E 0 is asymptotically stable whenever R 0 < 1 , while endemic equilibrium point E ∗ is globally asymptotically stable for R 0 > 1 . Therefore, this paper proves the necessity of face masks wearing and hospitalization services to COVID-19 patients to contain the disease spread to the population.


Assuntos
Betacoronavirus , Infecções por Coronavirus/transmissão , Modelos Biológicos , Pandemias , Pneumonia Viral/transmissão , Número Básico de Reprodução , Simulação por Computador , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Suscetibilidade a Doenças , Doenças Endêmicas/prevenção & controle , Doenças Endêmicas/estatística & dados numéricos , Humanos , Máscaras/estatística & dados numéricos , Conceitos Matemáticos , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Tanzânia/epidemiologia
18.
PLoS One ; 15(8): e0238232, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32853233

RESUMO

INTRODUCTION: Despite the broad success of Prevention of Mother-to-Child Transmission of HIV (PMTCT) programs, HIV care engagement during the pregnancy and postpartum periods is suboptimal. This study explored the perspectives of women who experienced challenges engaging in PMTCT care, in order to better understand factors that contribute to poor retention and to identify opportunities to improve PMTCT services. METHODS: We conducted in-depth interviews with 12 postpartum women to discuss their experiences with PMTCT care. We used data from a larger longitudinal cohort study conducted in five PMTCT clinics in Moshi, Tanzania to identify women with indicators of poor care engagement (i.e., medication non-adherence, inconsistent clinic attendance, or high viral load). Women who met one of these criteria were contacted by telephone and invited to complete an interview. Data were analyzed using applied thematic analysis. RESULTS: We observed a common pathway that fear of stigma contributed to a lack of HIV disclosure and reduced social support for seeking HIV care. Women commonly distrusted the results of their initial HIV test and reported medication side effects after care initiation. Women also reported barriers in the health system, including difficult-to-navigate clinic transfer policies and a lack of privacy and confidentiality in service provision. When asked how care might be improved, women felt that improved counseling and follow-up, affirming patient-provider interactions, and peer treatment supporters would have a positive effect on care engagement. CONCLUSION: In order to improve the impact of PMTCT programs, there is a need to implement active tracking and follow-up of patients, targeting individuals with evidence of poor care engagement. Tailored supportive intervention approaches may help patients to cope with both the perceived and actual impacts of HIV stigma, including navigating disclosures to loved ones and accessing social support. Fostering HIV acceptance is likely to facilitate commitment to long-term treatment.


Assuntos
Infecções por HIV/prevenção & controle , Infecções por HIV/psicologia , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Adulto , Estudos de Coortes , Aconselhamento/métodos , Revelação , Feminino , Humanos , Estudos Longitudinais , Mães/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Período Pós-Parto/fisiologia , Período Pós-Parto/psicologia , Gravidez , Complicações Infecciosas na Gravidez/prevenção & controle , Complicações Infecciosas na Gravidez/psicologia , Pesquisa Qualitativa , Estigma Social , Apoio Social , Tanzânia , Carga Viral/fisiologia , Adulto Jovem
19.
PLoS Negl Trop Dis ; 14(8): e0008536, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32804926

RESUMO

Culture-independent diagnostics have revealed a larger burden of Shigella among children in low-resource settings than previously recognized. We further characterized the epidemiology of Shigella in the first two years of life in a multisite birth cohort. We tested 41,405 diarrheal and monthly non-diarrheal stools from 1,715 children for Shigella by quantitative PCR. To assess risk factors, clinical factors related to age and culture positivity, and associations with inflammatory biomarkers, we used log-binomial regression with generalized estimating equations. The prevalence of Shigella varied from 4.9%-17.8% in non-diarrheal stools across sites, and the incidence of Shigella-attributable diarrhea was 31.8 cases (95% CI: 29.6, 34.2) per 100 child-years. The sensitivity of culture compared to qPCR was 6.6% and increased to 27.8% in Shigella-attributable dysentery. Shigella diarrhea episodes were more likely to be severe and less likely to be culture positive in younger children. Older age (RR: 1.75, 95% CI: 1.70, 1.81 per 6-month increase in age), unimproved sanitation (RR: 1.15, 95% CI: 1.03, 1.29), low maternal education (<10 years, RR: 1.14, 95% CI: 1.03, 1.26), initiating complementary foods before 3 months (RR: 1.10, 95% CI: 1.01, 1.20), and malnutrition (RR: 0.91, 95% CI: 0.88, 0.95 per unit increase in weight-for-age z-score) were risk factors for Shigella. There was a linear dose-response between Shigella quantity and myeloperoxidase concentrations. The burden of Shigella varied widely across sites, but uniformly increased through the second year of life and was associated with intestinal inflammation. Culture missed most clinically relevant cases of severe diarrhea and dysentery.


Assuntos
Diarreia/diagnóstico , Diarreia/epidemiologia , Disenteria Bacilar/diagnóstico , Disenteria Bacilar/epidemiologia , Bangladesh/epidemiologia , Brasil/epidemiologia , Diarreia/microbiologia , Disenteria , Disenteria Bacilar/microbiologia , Fezes/microbiologia , Feminino , Humanos , Incidência , Índia/epidemiologia , Lactente , Recém-Nascido , Intestinos , Masculino , Nepal/epidemiologia , Paquistão , Peru/epidemiologia , Prevalência , Shigella/genética , Shigella/isolamento & purificação , África do Sul/epidemiologia , Tanzânia/epidemiologia
20.
PLoS Negl Trop Dis ; 14(8): e0008665, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32822356

RESUMO

BACKGROUND: Schistosomiasis is a water-based disease acquired through contact with cercaria-infested water. Communities living in endemic regions often rely on parasite-contaminated freshwater bodies for their daily water contact activities, resulting in recurring schistosomiasis infection. In such instances, water treatment can provide safe water on a household or community scale. However, to-date there are no water treatment guidelines that provide information on how to treat water containing schistosome cercariae. Here, we rigorously test the effectiveness of chlorine against Schistosoma mansoni cercariae. METHOD: S. mansoni cercariae were chlorinated using sodium hypochlorite under lab and field condition. The water pH was controlled at 6.5, 7.0 or 7.5, the water temperature at 20°C or 27°C, and the chlorine dose at 1, 2 or 3 mg/l. Experiments were conducted up to contact times of 45 minutes. 100 cercariae were used per experiment, thereby achieving up to 2-log10 inactivations of cercariae. Experiments were replicated under field conditions at Lake Victoria, Tanzania. CONCLUSION: A CT (residual chlorine concentration x chlorine contact time) value of 26±4 mg·min/l is required to achieve a 2-log10 inactivation of S. mansoni cercariae under the most conservative condition tested (pH 7.5, 20°C). Field and lab-cultivated cercariae show similar chlorine sensitivities. A CT value of 30 mg·min/l is therefore recommended to disinfect cercaria-infested water, though safety factors may be required, depending on water quality and operating conditions. This CT value can be achieved with a chlorine residual of 1 mg/l after a contact time of 30 minutes, for example. This recommendation can be used to provide safe water for household and recreational water activities in communities that lack safe alternative water sources.


Assuntos
Cercárias/efeitos dos fármacos , Cloro/farmacologia , Halogenação , Schistosoma mansoni/efeitos dos fármacos , Purificação da Água/métodos , Animais , Concentração de Íons de Hidrogênio , Schistosoma mansoni/fisiologia , Esquistossomose/parasitologia , Esquistossomose/prevenção & controle , Caramujos , Tanzânia , Temperatura , Água/parasitologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA