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Introduction: During the COVID-19 pandemic, there was no known specific treatment for coronavirus Disease. Because of this, different countries and institutions have used different regimens to manage disease symptoms. In Tanzania, well-known and long-used herbal preparations believed to have antiviral activities were used as supplements to standard care for COVID-19 management. This study assessed the clinical presentation and outcomes of hospitalized COVID- 19 patients receiving standard care plus herbal preparations in Tanzania. Methods: An observational cohort study was conducted between February and May 2021 at 12 health facilities. Sociodemographic information, clinical presentation, past medical history, baseline, and follow-up laboratory records were documented. Each study participant was followed up for 14 days from enrolment. Results: 285 participants were enrolled; their mean age was 59.2 ± 16.5 years, and males constituted 56% of the study participants. Nearly 33% were aged 50 years and above. The majority (72%) reported having at least one form of co-morbidities (raised blood pressure, diabetes mellitus, asthma, Chronic Obstructive Pulmonary Diseases (COPD) and other forms of heart problems apart from hypertension). More than 60% of the study participants reported to have used at least one form of locally available herbal preparations. Symptoms and signs reported at enrolment subsided relatively faster among those supplemented with herbal preparations than among their counterparts. PCR results of nearly 66% of the study participants had converted to PCR negative at different rates by day 7 (61 vs 78%) and by day 14 (64.3% vs 36.4%) among herbal and non-herbal users, respectively. Overall, proportionally mortality was higher among those who used standard care alone (23.3% vs 16.9%) compared to those supplemented with herbal preparations. Conclusion: The use of herbal preparations in addition to standard care treatment showed a positive effect in subsiding signs and symptoms and decreasing mortality among COVID-19 patients. The findings from this study call for further research, especially clinical trials, to ascertain these findings. Keywords: Herbal preparations, COVID-19 outcome, Clinical presentation [ABSTRACT FROM AUTHOR]

Introduction: Differentiated Service Delivery Models (DSDM), a strategy to promote retention in HIV care and/or ART adherence, is now increasingly recognized as an important and sustainable approach that could contribute significantly toward the UNAIDS 90-90-90 by 2020 and 95-95-95 by 2030 targets and ultimately an AIDS-free generation. This study was conducted to determine the outcomes of DSDM among people living with HIV in Tanzania. Methods: A Cross-sectional analytical design approach employing both quantitative and qualitative data collection methods was adopted in this study that was implemented in 9 regions of Tanzania. We conducted record reviews and in-depth interviews with key informants at national and facility levels where their data was summarized and arranged in sub-themes and then analyzed according to the specific objectives by using Thematic Analysis. We further conducted a bivariate analysis using Chi-Square to assess the association between each outcome and explanatory variable. Unadjusted and adjusted analysis was conducted to determine predictors of unfavourable outcomes using logistics regression models. Results: Data was collected from 50 health facilities comprising 15 (30.0%) hospitals, 22 (44.0%) health centres and 13 (26.0%) dispensaries. Record reviews were for different outcomes as follows; Mis-categorization (13,056 records), Missed appointments (62,222 records), Advanced HIV disease (29,995 records), and Attrition (62,222 records). Among the 320 unstable clients, the rate of miscategorization significantly decreased after the introduction of DSDM, from 63% to 36% (p < 0.001). After the introduction of DSDM, more clients missed their appointments compared to the period before the introduction of DSDM (1.7% vs 0.8% respectively). Missed appointments were associated with an urban setting ( AOR 1.1, 95% CI 1.1-1.2) and older age of 50 years and more (AOR 1.2, 95% CI 1.1-1.4) in comparison to a rural setting and younger age of fewer than 15 years respectively. Furthermore, DSDM led to a decrease (from 56% to 49%) of those with advanced WHO stage among the first-time testers. Attrition among the clients was higher after the introduction of DSDM compared to that before DSDM (ARR 1.1, 95% CI 1.04-1.2). Contributors to attrition were those related to individuals and institutions including beliefs in faith healing, fear of stigma and wrong interpretation of viral load monitoring results. Conclusion: Decentralized Community-based ART model is a promising entry point to improved HIV/AIDS service delivery. Strategies are needed to harmonise the comprehensiveness and quality of services across facilities providing HIV services. [ABSTRACT FROM AUTHOR]

Background Different measures have been taken to treat and control the spread of COVID-19. One of these measures is the use of locally available herbal preparations. Despite their long-time use, still, information on their safety is scarce. Methods This observational cohort study was conducted from February to May 2021 among COVID-19 patients admitted at one of 12 (10 public and two private) health facilities in Tanzania. Participants were grouped into two - those who were using standard care alone and those who reported to be supplementing standard care with herbal preparations for the treatment of COVID-19. A review of medical records and interviews were done to obtain socio-demographic, clinical and laboratory information. All participants were followed up for 14. Results Half of the participants had normal hemoglobin levels at baseline and on day 14. Renal insufficiency was observed more among non-herbal users compared to herbal users (38.5% vs 21.8%) on day 7 (p = 0.04) and 54% vs 49% on day 14. Creatinine levels were significantly raised among non-herbal users than among herbal users at baseline (p = 0.002) and at day 14 (p = 0.045). There was no significant difference in INR level among both groups on day 7, however at day 14, the raise was more among non-herbal compared to herbal users (100% vs 20.5%). Conclusion There were no noticeable haematological, renal or liver parameters derangements among COVID19 patients who used herbal preparations plus standard care compared to those who used standard care alone. [ABSTRACT FROM AUTHOR]