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1. Efficacy and safety of artemether-lumefantrine for the treatment of uncomplicated falciparum malaria in mainland Tanzania, 2019

Author

Ngasala, Billy E., Chiduo, Mercy G., Mmbando, Bruno P., Francis, Filbert T., Bushukatale, Samwel, Makene, Twilumba, Mandara, Celine I., Ishengoma, Deus S., Kamugisha, Erasmus, Ahmed, Maimuna, Mahende, Muhidin K., Kavishe, Reginald A., Muro, Florida, Molteni, Fabrizio, Reaves, Erik, Kitojo, Chonge, Greer, George, Nyinondi, Ssanyu, Kabula, Bilal, Lalji, Shabbir, Chacky, Frank, Njau, Ritha J., Warsame, Marian, and Mohamed, Ally

Published
2024
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3. Trends of Plasmodium falciparum molecular markers associated with resistance to artemisinins and reduced susceptibility to lumefantrine in Mainland Tanzania from 2016 to 2021

Author

Bakari, Catherine, Mandara, Celine I., Madebe, Rashid A., Seth, Misago D., Ngasala, Billy, Kamugisha, Erasmus, Ahmed, Maimuna, Francis, Filbert, Bushukatale, Samwel, Chiduo, Mercy, Makene, Twilumba, Kabanywanyi, Abdunoor M., Mahende, Muhidin K., Kavishe, Reginald A., Muro, Florida, Mkude, Sigsbert, Mandike, Renata, Molteni, Fabrizio, Chacky, Frank, Bishanga, Dunstan R., Njau, Ritha J. A., Warsame, Marian, Kabula, Bilali, Nyinondi, Ssanyu S., Lucchi, Naomi W., Talundzic, Eldin, Venkatesan, Meera, Moriarty, Leah F., Serbantez, Naomi, Kitojo, Chonge, Reaves, Erik J., Halsey, Eric S., Mohamed, Ally, Udhayakumar, Venkatachalam, and Ishengoma, Deus S.

Published
2024
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6. Community knowledge, attitude, practices and beliefs associated with persistence of malaria transmission in North-western and Southern regions of Tanzania

Author

Liheluka, Edwin A., Massawe, Isolide S., Chiduo, Mercy G., Mandara, Celine I., Chacky, Frank, Ndekuka, Leah, Temba, Filbert F., Mmbando, Bruno P., Seth, Misago D., Challe, Daniel P., Makunde, Williams H., Mhina, Athanas D., Baraka, Vito, Segeja, Method D., Derua, Yahya A., Batengana, Bernard M., Hayuma, Paul M., Madebe, Rashid A., Malimi, Masunga C., Mandike, Renata, Mkude, Sigsbert, Molteni, Fabrizio, Njau, Ritha, Mohamed, Ally, Rumisha, Susan F., and Ishengoma, Deus S.

Published
2023
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7. Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania: methodology, challenges, and mitigation

Author

Makenga, Geofrey, Seth, Misago D., Baraka, Vito, Mmbando, Bruno P., Challe, Daniel P., Francis, Filbert, Mhina, Athanas, Minja, Daniel T. R., Chiduo, Mercy, Mandara, Celine, Liheluka, Edwin, Gesase, Samwel, Segeja, Method, Mtove, George, Kamugisha, Mathias, Lusasi, Abdallah, Chacky, Frank, David, Anna, Thawer, Sumaiyya, Mohamed, Ally, Lazaro, Samwel, Molteni, Fabrizio, Nkayamba, Alex, Van geertruyden, Jean-Pierre, and Lusingu, John P. A.

Published
2023
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8. Missed Advanced Abdominal Pregnancy: A Case Report.

Author

Mmbaga, Mwajabu, Mashola, Edwin, Msangi, Abdi, Mashoto, Kijakazi, and Chiduo, Mercy

Abstract

Early diagnosis of an abdominal pregnancy is difficult since it is associated with a wide range of signs and symptoms. However, ultrasound is the most effective method for diagnosing an abdominal ectopic pregnancy. We present a case of advanced abdominal ectopic pregnancy, which progressed to the second trimester and ended up with fetal death. Despite having repeated ultrasound scanning, the diagnosis was missed. This case report emphasizes the need for a high index of suspicion and correlation of the patient's signs and symptoms with ultrasound findings to make an early diagnosis of abdominal ectopic pregnancy. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Trends ofPlasmodium falciparummolecular markers associated with resistance to artemisinins and reduced susceptibility to lumefantrine in Mainland Tanzania from 2016 to 2021

Author

Bakari, Catherine, primary, Mandara, Celine I., additional, Madebe, Rashid A., additional, Seth, Misago D., additional, Ngasala, Billy, additional, Kamugisha, Erasmus, additional, Ahmed, Maimuna, additional, Francis, Filbert, additional, Bushukatale, Samwel, additional, Chiduo, Mercy, additional, Makene, Twilumba, additional, Kabanywanyi, Abdunoor M., additional, Mahende, Muhidin K., additional, Kavishe, Reginald A., additional, Muro, Florida, additional, Mkude, Sigsbert, additional, Mandike, Renata, additional, Molteni, Fabrizio, additional, Chacky, Frank, additional, Bishanga, Dunstan R., additional, Njau, Ritha J. A., additional, Warsame, Marian, additional, Kabula, Bilali, additional, Nyinondi, Ssanyu S., additional, Lucchi, Naomi W., additional, Talundzic, Eldin, additional, Venkatesan, Meera, additional, Moriarty, Leah F., additional, Serbantez, Naomi, additional, Kitojo, Chonge, additional, Reaves, Erik J., additional, Halsey, Eric S., additional, Mohamed, Ally, additional, Udhayakumar, Venkatachalam, additional, and Ishengoma, Deus S., additional

Published
2024
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11. Efficacy and Safety of Artemether-lumefantrine for the Treatment of Uncomplicated Falciparum Malaria in Mainland Tanzania, 2019

Author

Ngasala, Billy E., primary, Chiduo, Mercy G., additional, Mmbando, Bruno P., additional, Francis, Filbert T., additional, Bushukatale, Samwel, additional, Makene, Twilumba, additional, Mandara, Celine I., additional, Ishengoma, Deus S., additional, Kamugisha, Erasmus, additional, Ahmed, Maimuna, additional, Mahende, Muhidin K., additional, Kavishe, Reginald A., additional, Muro, Florida, additional, Molteni, Fabrizio, additional, Reaves, Erik, additional, Kitojo, Chonge, additional, Greer, George, additional, Nyinondi, Ssanyu, additional, Kabula, Bilal, additional, Lalji, Shabbir, additional, Chacky, Frank, additional, Njau, Ritha, additional, Warsame, Marian, additional, and Mohamed, Ally, additional

Published
2024
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13. Efficacy and safety of artemether-lumefantrine for the treatment of uncomplicated falciparum malaria in mainland Tanzania, 2018

Author

Ngasala, Billy, primary, Chiduo, Mercy G., additional, Bushukatale, Samwel, additional, Mmbando, Bruno P., additional, Makene, Twilumba, additional, Kamugisha, Erasmus, additional, Ahmed, Maimuna, additional, Mandara, Celine I., additional, Francis, Filbert, additional, Mahende, Muhidin K., additional, Kavishe, Reginald A., additional, Muro, Florida, additional, Ishengoma, Deus S., additional, Mandike, Renata, additional, Molteni, Fabrizio, additional, Chacky, Frank, additional, Kitojo, Chonge, additional, Greer, George, additional, Bishanga, Dunstan, additional, Njau, Ritha, additional, Warsame, Marian, additional, Kabula, Bilali, additional, Nyinondi, Ssanyu S., additional, Reaves, Erik, additional, and Mohamed, Ally, additional

Published
2023
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15. Community-based surveys for Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions in selected regions of mainland Tanzania

Author

Bakari, Catherine, Jones, Sophie, Subramaniam, Gireesh, Mandara, Celine I., Chiduo, Mercy G., Rumisha, Susan, Chacky, Frank, Molteni, Fabrizio, Mandike, Renata, Mkude, Sigsbert, Njau, Ritha, Herman, Camelia, Nace, Douglas P., Mohamed, Ally, Udhayakumar, Venkatachalam, Kibet, Caleb K., Nyanjom, Steven G., Rogier, Eric, and Ishengoma, Deus S.

Published
2020
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16. Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania:methodology, challenges, and mitigation

Author

Makenga, Geofrey, Seth, Misago D., Baraka, Vito, Mmbando, Bruno P., Challe, Daniel P., Francis, Filbert, Mhina, Athanas, Minja, Daniel T.R., Chiduo, Mercy, Mandara, Celine, Liheluka, Edwin, Gesase, Samwel, Segeja, Method, Mtove, George, Kamugisha, Mathias, Lusasi, Abdallah, Chacky, Frank, David, Anna, Thawer, Sumaiyya, Mohamed, Ally, Lazaro, Samwel, Molteni, Fabrizio, Nkayamba, Alex, Van geertruyden, Jean Pierre, Lusingu, John P.A., Makenga, Geofrey, Seth, Misago D., Baraka, Vito, Mmbando, Bruno P., Challe, Daniel P., Francis, Filbert, Mhina, Athanas, Minja, Daniel T.R., Chiduo, Mercy, Mandara, Celine, Liheluka, Edwin, Gesase, Samwel, Segeja, Method, Mtove, George, Kamugisha, Mathias, Lusasi, Abdallah, Chacky, Frank, David, Anna, Thawer, Sumaiyya, Mohamed, Ally, Lazaro, Samwel, Molteni, Fabrizio, Nkayamba, Alex, Van geertruyden, Jean Pierre, and Lusingu, John P.A.

Abstract

Background: It has been more than 20 years since the malaria epidemiologic shift to school-aged children was noted. In the meantime, school-aged children (5–15 years) have become increasingly more vulnerable with asymptomatic malaria prevalence reaching up to 70%, making them reservoirs for subsequent transmission of malaria in the endemic communities. Intermittent Preventive Treatment of malaria in schoolchildren (IPTsc) has proven to be an effective tool to shrink this reservoir. As of 3rd June 2022, the World Health Organization recommends IPTsc in moderate and high endemic areas. Even so, for decision-makers, the adoption of scientific research recommendations has been stifled by real-world implementation challenges. This study presents methodology, challenges faced, and mitigations used in the evaluation of the implementation of IPTsc using dihydroartemisinin-piperaquine (DP) in three councils (Handeni District Council (DC), Handeni Town Council (TC) and Kilindi DC) of Tanga Region, Tanzania so as to understand the operational feasibility and effectiveness of IPTsc on malaria parasitaemia and clinical malaria incidence. Methods: The study deployed an effectiveness-implementation hybrid design to assess feasibility and effectiveness of IPTsc using DP, the interventional drug, against standard of care (control). Wards in the three study councils were the randomization unit (clusters). Each ward was randomized to implement IPTsc or not (control). In all wards in the IPTsc arm, DP was given to schoolchildren three times a year in four-month intervals. In each council, 24 randomly selected wards (12 per study arm, one school per ward) were chosen as representatives for intervention impact evaluation. Mixed design methods were used to assess the feasibility and acceptability of implementing IPTsc as part of a more comprehensive health package for schoolchildren. The study reimagined an existing school health programme for Neglected Tropical Diseases (NT

Published
2023

18. Additional file 9 of Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania: methodology, challenges, and mitigation

Author

Makenga, Geofrey, Seth, Misago D., Baraka, Vito, Mmbando, Bruno P., Challe, Daniel P., Francis, Filbert, Mhina, Athanas, Minja, Daniel T. R., Chiduo, Mercy, Mandara, Celine, Liheluka, Edwin, Gesase, Samwel, Segeja, Method, Mtove, George, Kamugisha, Mathias, Lusasi, Abdallah, Chacky, Frank, David, Anna, Thawer, Sumaiyya, Mohamed, Ally, Lazaro, Samwel, Molteni, Fabrizio, Nkayamba, Alex, Van geertruyden, Jean-Pierre, and Lusingu, John P. A.

Abstract

Additional file 9: Appendix S9. Clinical episodes recording form.

Published
2023
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19. Additional file 2 of Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania: methodology, challenges, and mitigation

Author

Makenga, Geofrey, Seth, Misago D., Baraka, Vito, Mmbando, Bruno P., Challe, Daniel P., Francis, Filbert, Mhina, Athanas, Minja, Daniel T. R., Chiduo, Mercy, Mandara, Celine, Liheluka, Edwin, Gesase, Samwel, Segeja, Method, Mtove, George, Kamugisha, Mathias, Lusasi, Abdallah, Chacky, Frank, David, Anna, Thawer, Sumaiyya, Mohamed, Ally, Lazaro, Samwel, Molteni, Fabrizio, Nkayamba, Alex, Van geertruyden, Jean-Pierre, and Lusingu, John P. A.

Abstract

Additional file 2: Appendix S2. Drug dispensing log.

Published
2023
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20. Additional file 3 of Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania: methodology, challenges, and mitigation

Author

Makenga, Geofrey, Seth, Misago D., Baraka, Vito, Mmbando, Bruno P., Challe, Daniel P., Francis, Filbert, Mhina, Athanas, Minja, Daniel T. R., Chiduo, Mercy, Mandara, Celine, Liheluka, Edwin, Gesase, Samwel, Segeja, Method, Mtove, George, Kamugisha, Mathias, Lusasi, Abdallah, Chacky, Frank, David, Anna, Thawer, Sumaiyya, Mohamed, Ally, Lazaro, Samwel, Molteni, Fabrizio, Nkayamba, Alex, Van geertruyden, Jean-Pierre, and Lusingu, John P. A.

Abstract

Additional file 3: Appendix S3. Drug dispensing information sheet.

Published
2023
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21. Additional file 1 of Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania: methodology, challenges, and mitigation

Author

Makenga, Geofrey, Seth, Misago D., Baraka, Vito, Mmbando, Bruno P., Challe, Daniel P., Francis, Filbert, Mhina, Athanas, Minja, Daniel T. R., Chiduo, Mercy, Mandara, Celine, Liheluka, Edwin, Gesase, Samwel, Segeja, Method, Mtove, George, Kamugisha, Mathias, Lusasi, Abdallah, Chacky, Frank, David, Anna, Thawer, Sumaiyya, Mohamed, Ally, Lazaro, Samwel, Molteni, Fabrizio, Nkayamba, Alex, Van geertruyden, Jean-Pierre, and Lusingu, John P. A.

Abstract

Additional file 1: Appendix S1. Drug accountability log.

Published
2023
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22. Additional file 8 of Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania: methodology, challenges, and mitigation

Author

Makenga, Geofrey, Seth, Misago D., Baraka, Vito, Mmbando, Bruno P., Challe, Daniel P., Francis, Filbert, Mhina, Athanas, Minja, Daniel T. R., Chiduo, Mercy, Mandara, Celine, Liheluka, Edwin, Gesase, Samwel, Segeja, Method, Mtove, George, Kamugisha, Mathias, Lusasi, Abdallah, Chacky, Frank, David, Anna, Thawer, Sumaiyya, Mohamed, Ally, Lazaro, Samwel, Molteni, Fabrizio, Nkayamba, Alex, Van geertruyden, Jean-Pierre, and Lusingu, John P. A.

Abstract

Additional file 8: Appendix S8. Referral form.

Published
2023
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23. Additional file 6 of Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania: methodology, challenges, and mitigation

Author

Makenga, Geofrey, Seth, Misago D., Baraka, Vito, Mmbando, Bruno P., Challe, Daniel P., Francis, Filbert, Mhina, Athanas, Minja, Daniel T. R., Chiduo, Mercy, Mandara, Celine, Liheluka, Edwin, Gesase, Samwel, Segeja, Method, Mtove, George, Kamugisha, Mathias, Lusasi, Abdallah, Chacky, Frank, David, Anna, Thawer, Sumaiyya, Mohamed, Ally, Lazaro, Samwel, Molteni, Fabrizio, Nkayamba, Alex, Van geertruyden, Jean-Pierre, and Lusingu, John P. A.

Abstract

Additional file 6: Appendix S6. Supervision form.

Published
2023
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24. Additional file 4 of Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania: methodology, challenges, and mitigation

Author

Makenga, Geofrey, Seth, Misago D., Baraka, Vito, Mmbando, Bruno P., Challe, Daniel P., Francis, Filbert, Mhina, Athanas, Minja, Daniel T. R., Chiduo, Mercy, Mandara, Celine, Liheluka, Edwin, Gesase, Samwel, Segeja, Method, Mtove, George, Kamugisha, Mathias, Lusasi, Abdallah, Chacky, Frank, David, Anna, Thawer, Sumaiyya, Mohamed, Ally, Lazaro, Samwel, Molteni, Fabrizio, Nkayamba, Alex, Van geertruyden, Jean-Pierre, and Lusingu, John P. A.

Abstract

Additional file 4: Appendix S4. Adverse drug reaction reporting form.

Published
2023
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25. Additional file 5 of Implementation research of a cluster randomized trial evaluating the implementation and effectiveness of intermittent preventive treatment for malaria using dihydroartemisinin-piperaquine on reducing malaria burden in school-aged children in Tanzania: methodology, challenges, and mitigation

Author

Makenga, Geofrey, Seth, Misago D., Baraka, Vito, Mmbando, Bruno P., Challe, Daniel P., Francis, Filbert, Mhina, Athanas, Minja, Daniel T. R., Chiduo, Mercy, Mandara, Celine, Liheluka, Edwin, Gesase, Samwel, Segeja, Method, Mtove, George, Kamugisha, Mathias, Lusasi, Abdallah, Chacky, Frank, David, Anna, Thawer, Sumaiyya, Mohamed, Ally, Lazaro, Samwel, Molteni, Fabrizio, Nkayamba, Alex, Van geertruyden, Jean-Pierre, and Lusingu, John P. A.

Abstract

Additional file 5: Appendix S5. IPTsc coverage assessment form.

Published
2023
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27. Trends of Plasmodium falciparum prevalence in two communities of Muheza district North-eastern Tanzania: correlation between parasite prevalence, malaria interventions and rainfall in the context of re-emergence of malaria after two decades of progressively declining transmission

Author

Ishengoma, Deus S., Mmbando, Bruno P., Mandara, Celine I., Chiduo, Mercy G., Francis, Filbert, Timiza, Wilbert, Msemo, Hellen, Kijazi, Agnes, Lemnge, Martha M., Malecela, Mwelecele N., Snow, Robert W., Alifrangis, Michael, and Bygbjerg, Ib C.

Published
2018
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33. Describing the current status of Plasmodium falciparum population structure and drug resistance within mainland Tanzania using molecular inversion probes

Author

Moser, Kara A., primary, Madebe, Rashid A., additional, Aydemir, Ozkan, additional, Chiduo, Mercy G., additional, Mandara, Celine I., additional, Rumisha, Susan F., additional, Chaky, Frank, additional, Denton, Madeline, additional, Marsh, Patrick W., additional, Verity, Robert, additional, Watson, Oliver J., additional, Ngasala, Billy, additional, Mkude, Sigsbert, additional, Molteni, Fabrizio, additional, Njau, Ritha, additional, Warsame, Marian, additional, Mandike, Renata, additional, Kabanywanyi, Abdunoor M., additional, Mahende, Muhidin K., additional, Kamugisha, Erasmus, additional, Ahmed, Maimuna, additional, Kavishe, Reginald A., additional, Greer, George, additional, Kitojo, Chonge A., additional, Reaves, Erik J., additional, Mlunde, Linda, additional, Bishanga, Dunstan, additional, Mohamed, Ally, additional, Juliano, Jonathan J., additional, Ishengoma, Deus S., additional, and Bailey, Jeffrey A., additional

Published
2020
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37. Awareness, utilization of HIV testing and counselling services and sero-status among commercial motorcyclists in Dar es Salaam, Tanzania

Author

Challe, Daniel Protasy, primary, Chiduo, Mercy Grace, additional, Mmbando, Bruno Paul, additional, Mhina, Athanas, additional, Nkya, Gineson Aleonasaa, additional, Kilale, Andrew Martin, additional, Chille, Masunga Malimi, additional, Hayuma, Paul Martine, additional, Ishengoma, Deus Simon, additional, and Kamugisha, Mathias Leo, additional

Published
2020
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38. Assessing the Intrinsic and Extrinsic Drivers and Targeting the Observed Resilience of Malaria in Northwestern and Southern Tanzania: A Protocol for a Cross-Sectional Exploratory Study

Author

Chiduo, Mercy G, primary, Mandara, Celine I., additional, Rumisha, Susan F., additional, Chaky, Frank, additional, Francis, Filbert T., additional, Mmbando, Bruno P., additional, Seth, Misago D., additional, Challe, Daniel P., additional, Ndekuka, Leah, additional, Massawe, Isolide S., additional, Liheluka, Edwin, additional, Makunde, Williams H., additional, Mhina, Athanas D., additional, Baraka, Vito, additional, Segeja, Method D., additional, Derua, Yahya A., additional, Batengana, Berndard M., additional, Hayuma, Paul M., additional, Nkya, Gineson, additional, Madebe, Rashid A., additional, Malimi, Masunga C., additional, Mandike, Renata, additional, Mkude, Sigsbert, additional, Molteni, Fabrizio, additional, Njau, Ritha, additional, Mohamed, Ally, additional, and Ishengoma, Deus S., additional

Published
2020
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39. Community-based surveys for Plasmodium falciparum pfhrp2 and pfhrp3 gene deletions in selected regions of mainland Tanzania

Author

Bakari, Catherine, primary, Jones, Sophie, additional, Subramaniam, Gireesh, additional, Mandara, Celine Isaack, additional, Chiduo, Mercy G, additional, Rumisha, Susan, additional, Chacky, Frank, additional, Molteni, Fabrizio, additional, Mandike, Renata, additional, Mkude, Sigsbert, additional, Njau, Ritha, additional, Herman, Camelia, additional, Nace, Douglas P, additional, Mohamed, Ally, additional, Udhayakumar, Venkatachalam, additional, Kibet, Caleb K, additional, Nyanjom, Steven G, additional, Rogier, Eric, additional, and Ishengoma, Deus Simon, additional

Published
2020
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40. Assessing the intrinsic and extrinsic drivers and targeting the observed resilience of malaria in northwestern and southern Tanzania: A protocol for a cross-sectional exploratory study

Author

Chiduo, Mercy G., primary, Mandara, Celine I., additional, Rumisha, Susan F., additional, Chaky, Frank, additional, Francis, Filbert T., additional, Mmbando, Bruno P., additional, Seth, Misago D., additional, Challe, Daniel P., additional, Ndekuka, Leah, additional, Massawe, Isolide S., additional, Liheluka, Edwin, additional, Makunde, Williams H., additional, Mhina, Athanas D., additional, Baraka, Vito, additional, Segeja, Method D., additional, Derua, Yahya A., additional, Batengana, Berndard M., additional, Hayuma, Paul M., additional, Nkya, Gineson, additional, Madebe, Rashid A., additional, Malimi, Masunga C., additional, Mandike, Renata, additional, Mkude, Sigsbert, additional, Molteni, Fabrizio, additional, Njau, Ritha, additional, Mohamed, Ally, additional, and Ishengoma, Deus S., additional

Published
2020
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41. Retired Nurses Can Improve Retention in Prevention of Mother-to-Child Transmission Programmes

Author

Theilgaard, Zahra Persson, Chiduo, Mercy G, Flamholc, Leo, Gerstoft, Jan, Bygbjerg, Ib C, Lemnge, Martha Moshi, Katzenstein, Terese L, Theilgaard, Zahra Persson, Chiduo, Mercy G, Flamholc, Leo, Gerstoft, Jan, Bygbjerg, Ib C, Lemnge, Martha Moshi, and Katzenstein, Terese L

Abstract

Background: The success of prevention of mother-to-child transmission (PMTCT) programmes depends on retention of mothers throughout the PMTCT cascade.Methods: In a clinical trial of short-course combination antiretroviral therapy (cART) for PMTCT in Tanzania, senior nurses were employed to reduce the substantial loss-to-follow up (LTFU) rate.Results: Following intervention, the relative risk (RR) of receiving a CD4 count result and antiretroviral therapy was 1.16 (95% confidence interval [CI], 1.05 to 1.27), the RR of delivery at clinic was 2.51 (95% CI, 2.06 to 3.06), the RR for reporting for follow-up at 6 to 8 weeks postpartum was 4.63 (95% CI, 3.41 to 6.27), and the RR for being retained until 9 months postpartum was 28.19 (95% CI, 11.81 to 67.28). No significant impact on transmission was found.Conclusion: Significantly higher retention was found after senior nurses were employed. No impact on transmission was found. Relatively low transmission was found in both study arms.

Published
2019

43. Trends, patterns and cause-specific neonatal mortality in Tanzania: a hospital-based retrospective survey.

Author

Mangu, Chacha D, Rumisha, Susan F, Lyimo, Emanuel P, Mremi, Irene R, Massawe, Isolide S, Bwana, Veneranda M, Chiduo, Mercy G, and Mboera, Leonard E G

Subjects
NEONATAL mortality, NEONATAL death, DEATH rate, HOSPITAL mortality, EARLY death, VITAL records (Births, deaths, etc.)
Abstract

Background Globally, large numbers of children die shortly after birth and many of them within the first 4 wk of life. This study aimed to determine the trends, patterns and causes of neonatal mortality in hospitals in Tanzania during 2006–2015. Methods This retrospective study involved 35 hospitals. Mortality data were extracted from inpatient registers, death registers and International Classification of Diseases-10 report forms. Annual specific hospital-based neonatal mortality rates were calculated and discussed. Two periods of 2006–2010 and 2011–2015 were assessed separately to account for data availability and interventions. Results A total of 235 689 deaths were recorded and neonatal deaths accounted for 11.3% (n=26 630) of the deaths. The majority of neonatal deaths (87.5%) occurred in the first week of life. Overall hospital-based neonatal mortality rates increased from 2.6 in 2006 to 10.4 deaths per 1000 live births in 2015, with the early neonates contributing 90% to this rate constantly over time. The neonatal mortality rate was 3.7/1000 during 2006–2010 and 10.4/1000 during 2011–2015, both periods indicating a stagnant trend in the years between. The leading causes of early neonatal death were birth asphyxia (22.3%) and respiratory distress (20.8%), while those of late neonatal death were sepsis (29.1%) and respiratory distress (20.0%). Conclusion The majority of neonatal deaths in Tanzania occur among the early newborns and the trend over time indicates a slow improvement. Most neonatal deaths are preventable, hence there are opportunities to reduce mortality rates with improvements in service delivery during the first 7 d and maternal care. [ABSTRACT FROM AUTHOR]

Published
2021
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46. Addressing the fear and consequences of stigmatization - a necessary step towards making HAART accessible to women in Tanzania: a qualitative study

Author

Gerstoft Jan, Bygbjerg Ib C, Pahl Christiane, Chiduo Mercy G, Katzenstein Terese L, Theilgaard Zahra P, Lemnge Martha M, and Tersbøl Britt P

Subjects
Immunologic diseases. Allergy, RC581-607
Abstract

Abstract Background Highly Active Antiretroviral Therapy (HAART) has been available free of charge in Tanga, Tanzania since 2005. However we have found that a high percentage of women referred from prevention of mother-to-child transmission services to the Care and Treatment Clinics (CTC) for HAART never registered at the CTCs. Few studies have focused on the motivating and deterring factors to presenting for HAART particularly in relation to women. This study seeks to remedy this gap in knowledge. Methodology A qualitative approach using in-depth interviews and focus group discussions was chosen to understand these issues as perceived and interpreted by HIV infected women themselves. Results The main deterrent to presenting for treatment appears to be fear of stigmatization including fear of ostracism from the community, divorce and financial distress. Participants indicated that individual counselling and interaction with other people living with HIV encourages women, who are disinclined to present for HAART, to do so, and that placing the entrance to the CTC so as to provide discrete access increases the accessibility of the clinic. Conclusion Combating stigma in the community, although it is essential, will take time. Therefore necessary steps towards encouraging HIV infected women to seek treatment include reducing self-stigma, assisting them to form empowering relationships and to gain financial independence and emphasis by example of the beneficial effect of treatment for themselves and for their children. Furthermore ensuring a discrete location of the CTC can increase its perceived accessibility.

Published
2011
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47. Possible causes of fever among patients with blood smear negative for malaria parasites at Bombo Regional Referral Hospital in Tanga, Tanzania

Author

CHIDUO, MERCY, KAMUGISHA, MATHIAS, MHINA, ATHANAS, FRANCIS, FILBERT, MCHOMVU, JACKSON, KAYANDA, JUMA, MALECELA, EZEKIEL, SADI, JOHARI, KASEKA, JOSEPH, MSANGENI, HAMISI, LEMNGE, MARTHA, CHIDUO, MERCY, KAMUGISHA, MATHIAS, MHINA, ATHANAS, FRANCIS, FILBERT, MCHOMVU, JACKSON, KAYANDA, JUMA, MALECELA, EZEKIEL, SADI, JOHARI, KASEKA, JOSEPH, MSANGENI, HAMISI, and LEMNGE, MARTHA

Abstract

Background: Due to its diverse and non‐specific clinical presentations, malaria has been associated with most infections causing febrile illnesses. Despite being non-specific, clinical diagnosis is still the main method of malaria diagnosis in most health facilities in sub-Saharan Africa. This study aimed to establish the probable diagnoses among fever cases admitted at Bombo Hospital in north-eastern Tanzania. Methods: This study involved patients admitted in Medical and Paediatric wards with a clinical diagnosis of severe malaria but having negative blood smears (BS) for malaria parasites. Finger prick blood specimens were collected for blood smear microscopy and rapid diagnostic test. Blood and urine cultures were done for all specimens collected. Some patients were also screened for HIV infection. Results: A total of 227 patients were recruited and the majority (62.1%) were under-five children. Out of the 227 blood specimens cultured, 25 (11.0%) grew different bacteria species. Staphylococcus aureus was the most frequent pathogen (68.0%), followed by S. pneumoniae (24.0%), Salmonella species (4.0%) and Streptococcus pyogenes (4.0%). Only 7 (3.2%) out of 219 urine specimens cultured showed growth of Escherichia coli , Pseudomonas aeruginosa , S. aureus and Klebsiella pneumoniae . Of the 215 patients screened for HIV, 17 (7.9%) had positive reaction. Conclusion: The findings indicate that S. aureus and S. pneumoniae as the commonest bacteria isolates from blood and P. aeruginosa, S. aureus and K. pneumoniae from urine cultures. These bacteria and HIV should be considered as important contributors to febrile illness cases among patients found with negative BS for malaria parasites.

Published
2018

48. Hepatitis E virus epidemiology among HIV-infected women in an urban area in Tanzania

Author

Harritshøj, Lene H, Theilgaard, Zahra P, Mannheimer, Ebba, Midgley, Sofie E, Chiduo, Mercy, Ullum, Henrik, Katzenstein, Terese L, Harritshøj, Lene H, Theilgaard, Zahra P, Mannheimer, Ebba, Midgley, Sofie E, Chiduo, Mercy, Ullum, Henrik, and Katzenstein, Terese L

Abstract

OBJECTIVES: This study was performed to determine the seroprevalence and incidence of hepatitis E virus (HEV) infection among HIV-infected women during pregnancy and after delivery in a cohort of 200 Tanzanian women.METHODS: HIV-infected women participating in a study on antiretroviral therapy for the prevention of mother-to-child HIV transmission between 2006 and 2011, were tested retrospectively for anti-HEV immunoglobulin G (IgG) in plasma samples at 9 months post-partum. Anti-HEV IgG-positive patients were tested for anti-HEV IgG and immunoglobulin M (IgM) in samples from enrolment, and seroconverting women were tested for HEV RNA.RESULTS: A total of 16 women were anti-HEV IgG-positive, two of whom had seroconverted between enrolment and 9 months post-partum, with no detection of anti-HEV IgM or HEV RNA, yielding an HEV seroprevalence of 8.0% (confidence interval 5.0-12.6%) and an annual incidence rate of 1.0% (confidence interval 0.2-3.4%). CD4 cell counts were relatively high (median 403×106/l), with no significant difference between women with and without serological signs of HEV.CONCLUSIONS: An annual HEV infection incidence rate of 1% strongly indicates ongoing transmission of HEV in Tanzania and should be kept in mind for pregnant women presenting with signs of acute hepatitis.

Published
2018

49. Trends of Plasmodium falciparum prevalence in two communities of Muheza district North-eastern Tanzania:Correlation between parasite prevalence, malaria interventions and rainfall in the context of re-emergence of malaria after two decades of progressively declining transmission

Author

Ishengoma, Deus S, Mmbando, Bruno P., Mandara, Celine I., Chiduo, Mercy G., Francis, Filbert, Timiza, Wilbert, Msemo, Hellen, Kijazi, Agnes, Lemnge, Martha M., Malecela, Mwelecele N., Snow, Robert W., Alifrangis, Michael, Bygbjerg, Ib C, Ishengoma, Deus S, Mmbando, Bruno P., Mandara, Celine I., Chiduo, Mercy G., Francis, Filbert, Timiza, Wilbert, Msemo, Hellen, Kijazi, Agnes, Lemnge, Martha M., Malecela, Mwelecele N., Snow, Robert W., Alifrangis, Michael, and Bygbjerg, Ib C

Abstract

BACKGROUND: Although the recent decline of malaria burden in some African countries has been attributed to a scale-up of interventions, such as bed nets (insecticide-treated bed nets, ITNs/long-lasting insecticidal nets, LLINs), the contribution of other factors to these changes has not been rigorously assessed. This study assessed the trends of Plasmodium falciparum prevalence in Magoda (1992-2017) and Mpapayu (1998-2017) villages of Muheza district, North-eastern Tanzania, in relation to changes in the levels of different interventions and rainfall patterns.METHODS: Individuals aged 0-19 years were recruited in cross-sectional surveys to determine the prevalence of P. falciparum infections in relation to different malaria interventions deployed, particularly bed nets and anti-malarial drugs. Trends and patterns of rainfall in Muheza for 35 years (from 1981 to 2016) were assessed to determine changes in the amount and pattern of rainfall and their possible impacts on P. falciparum prevalence besides of those ascribed to interventions.RESULTS: High prevalence (84-54%) was reported between 1992 and 2000 in Magoda, and 1998 and 2000 in Mpapayu, but it declined sharply from 2001 to 2004 (from 52.0 to 25.0%), followed by a progressive decline between 2008 and 2012 (to ≤ 7% in both villages). However, the prevalence increased significantly from 2013 to 2016 reaching ≥ 20.0% in 2016 (both villages), but declined in the two villages to ≤ 13% in 2017. Overall and age specific P. falciparum prevalence decreased in both villages over the years but with a peak prevalence shifting from children aged 5-9 years to those aged 10-19 years from 2008 onwards. Bed net coverage increased from < 4% in 1998 to > 98% in 2001 and was ≥ 85.0% in 2004 in both villages; followed by fluctuations with coverage ranging from 35.0 to ≤ 98% between 2008 and 2017. The 12-month weighted anomaly standardized precipitation index showed a marked rainfall deficit in 1990-1996 and 1

Published
2018

50. Describing the current status of Plasmodium falciparum population structure and drug resistance within mainland Tanzania using molecular inversion probes.

Author

Moser, Kara A., Madebe, Rashid A., Aydemir, Ozkan, Chiduo, Mercy G., Mandara, Celine I., Rumisha, Susan F., Chaky, Frank, Denton, Madeline, Marsh, Patrick W., Verity, Robert, Watson, Oliver J., Ngasala, Billy, Mkude, Sigsbert, Molteni, Fabrizio, Njau, Ritha, Warsame, Marian, Mandike, Renata, Kabanywanyi, Abdunoor M., Mahende, Muhidin K., and Kamugisha, Erasmus

Subjects
MOLECULAR probes, PLASMODIUM falciparum, DRUG resistance, PLASMODIUM vivax, POPULATION dynamics, POPULATION, PLASMODIUM
Abstract

High‐throughput Plasmodium genomic data is increasingly useful in assessing prevalence of clinically important mutations and malaria transmission patterns. Understanding parasite diversity is important for identification of specific human or parasite populations that can be targeted by control programmes, and to monitor the spread of mutations associated with drug resistance. An up‐to‐date understanding of regional parasite population dynamics is also critical to monitor the impact of control efforts. However, this data is largely absent from high‐burden nations in Africa, and to date, no such analysis has been conducted for malaria parasites in Tanzania countrywide. To this end, over 1,000 P. falciparum clinical isolates were collected in 2017 from 13 sites in seven administrative regions across Tanzania, and parasites were genotyped at 1,800 variable positions genome‐wide using molecular inversion probes. Population structure was detectable among Tanzanian P. falciparum parasites, approximately separating parasites from the northern and southern districts and identifying genetically admixed populations in the north. Isolates from nearby districts were more likely to be genetically related compared to parasites sampled from more distant districts. Known drug resistance mutations were seen at increased frequency in northern districts (including two infections carrying pfk13‐R561H), and additional variants with undetermined significance for antimalarial resistance also varied by geography. Malaria Indicator Survey (2017) data corresponded with genetic findings, including average region‐level complexity‐of‐infection and malaria prevalence estimates. The parasite populations identified here provide important information on extant spatial patterns of genetic diversity of Tanzanian parasites, to which future surveys of genetic relatedness can be compared. [ABSTRACT FROM AUTHOR]

Published
2021
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