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Introduction: Diarrhoea continues to be a severe public health concern, particularly in developing nations. The illness is caused by various bacterial, viral, and other physiological changes. Interestingly, it has also been perceived by the community that diarrhoea among under-five children could be due to witchcraft. In principle, all forms of diarrhoea can be managed with well-established contemporary therapies; nonetheless, it has been suggested that perceived witchcraft-related diarrhoea among under-five children can only be managed by traditional medicines. In northern Tanzania, the use of traditional medicines in the management of perceived witchcraft-related diarrhoea among under-five children is substantial. Yet, there are limited studies on this subject. The present study explored traditional medicines that are used to treat perceived witchcraft-related diarrhoea among under-five children. Methods: A cross-sectional study using a qualitative research approach was carried out in Korogwe and Handeni districts in northern Tanzania. The study population included paediatric health workers, caretakers of under-five children, and traditional healers. In-depth interviews and focus group discussions served as the data collection methods. Thematic analysis was employed for data analysis. Results: A total of 247 participants were enrolled, which included 127 males and 120 females. Most participants, especially caretakers and traditional healers, preferred the use of traditional medicines in treating diarrhoea among under-five children and held the belief that a specific form of diarrhoea among under-five children is caused by witchcraft. It was also revealed that traditional medicines are the only types of medication that can treat this form of diarrhoea among under-five children. Plants were the primary source of many traditional remedies that were purported to be capable of treating perceived witchcraft-related diarrhoea among underfive children. Conclusion: Most participants believed that there is a specific form of diarrhoea among children that is caused by witchcraft, and they boldly stated that traditional medicines are the only treatment option for this form of diarrhoea. Thorough research on this topic is essential. If additional research confirms that traditional remedies effectively treat the illness, these treatment regimens should be extended to other serious illnesses the community suffers from. [ABSTRACT FROM AUTHOR]

Background: More than 15 million people in sub-Saharan Africa receive ART. Treatment failure is common, but the role of HIV drug resistance in treatment failure is largely unknown because drug resistance testing is not routinely done. This study determined the prevalence and patterns of HIV drug resistance in patients with suspected virological failure.Materials and Methods: A single high viral load of >1000 viral RNA copies/mL of plasma at any point during ART was considered as suspected virological failure. HIV-1 RNA was extracted from plasma samples of these patients using the QIAamp Viral RNA kit. The protease and part of the RT regions of the HIV pol gene were characterized.Results: Viral load was determined in 317 patients; 64 (20.2%) had suspected virological failure. We successfully genotyped 56 samples; 48 (85.7%) had at least one major resistance-associated mutation (RAM). Common mutations in RT were M184V (75%), T215Y (41.1%), K103N (39.3%), M41L (32.1%), D67DN (30.3%), G190A (28.6%) and A98G (26.8%). No RAMs were detected in ART regimens based on a ritonavir-boosted PI.Conclusions: The Tanzanian national guidelines define 'virological failure' as two consecutive viral load measurement results, at 3 month intervals, above the WHO threshold (1000 copies/mL). Here, we show that a single viral load above the WHO threshold is associated with high rates of RAMs. This suggests that a single high viral load measurement could be used to predict virological failure and avoid delays in switching patients from first-line to higher genetic barrier second-line regimens. [ABSTRACT FROM AUTHOR]

Background: Schistosomiasis increases the risk of human immunodeficiency virus (HIV) acquisition in women by mechanisms that are incompletely defined. Our objective was to determine how the cervical environment is impacted by Schistosoma haematobium or Schistosoma mansoni infection by quantifying gene expression in the cervical mucosa and cytokine levels in cervicovaginal lavage fluid.Methods: We recruited women with and those without S. haematobium infection and women with and those without S. mansoni infection from separate villages in rural Tanzania with high prevalences of S. haematobium and S. mansoni, respectively. Infection status was determined by urine and stool microscopy and testing for serum circulating anodic antigen. RNA was extracted from cervical cytobrush samples for transcriptome analysis. Cytokine levels were measured by magnetic bead immunoassay.Results: In the village where S. haematobium was prevalent, 110 genes were differentially expressed in the cervical mucosa of 18 women with versus 39 without S. haematobium infection. Among the 27 cytokines analyzed in cervicovaginal lavage fluid from women in this village, the level of interleukin 15 was lower in the S. haematobium-infected group (62.8 vs 102.9 pg/mL; adjusted P = .0013). Differences were not observed in the S. mansoni-prevalent villages between 11 women with and 29 without S. mansoni infection.Conclusions: We demonstrate altered cervical mucosal gene expression and lower interleukin 15 levels in women with S. haematobium infection as compared to those with S. mansoni infection, which may influence HIV acquisition and cancer risks. Studies to determine the effects of antischistosome treatment on these mucosal alterations are needed. [ABSTRACT FROM AUTHOR]

Background: Precise detection of Plasmodium infections in community surveys is essential for effective malaria control. Microscopy (the gold standard) and rapid diagnostic tests (RDTs) are the major techniques used to identify malaria infections in the field-based surveys. RDTs are increasingly becoming versatile due to rapid and adequate performance characteristics. Methods: A malaria prevalence survey was carried out in north-western Tanzania. 397 A malaria prevalence cross-sectional survey was carried out in north-western Tanzania in 2016. A total of 397 individuals aged five years and above were tested for P. falciparum infections. The sensitivity, specificity, positive, and negative predictive values of microscopy, Pf RDT and HSPf RDT was determined using PCR as the gold standard method. Results: P. falciparum prevalence by microscopy, SD Bioline Pf, HSPf and PCR was 21.9%, 27.7%, 33.3% and 43.2%, respectively. HSPf RDT had significantly higher sensitivity (98.2%) and specificity (91.6%) compared to the routinely used SD Bioline Pf RDT (P < 0.001). The positive predictive value (PPV) was 81.8% and the negative predictive value (NPV) was 99.2% for the routinely used SD Bioline Pf RDT. Moreover, HSPf RDT had sensitivity of 69% and specificity of 76.8% compared to microscopy. The PPV was 45.5% and NPV was 89.8% for microscopy. The analytical sensitivity test indicated that the newly developed HSPf RDT had lower detection limits compared to routinely used SD Bioline RDT. Conclusions and recommendations: HS PfRDT performed better compared to routinely used Pf RDT, and microscopy in detecting malaria infections. The false negativity could be associated with the low parasite density of the samples. False positivity may be related to the limitations of the expertise of microscopists or persistent antigenicity from previous infections for RDTs. Considering the high sensitivity, specificity, and reliability of HS Pf RDT, it should be integrated into the malaria control program by the MoH. [ABSTRACT FROM AUTHOR]

Background: The indoor residual spraying programme for malaria vectors control was implemented in four districts of the Lake Victoria basin of Tanzania namely Ukerewe, Sengerema, Rorya andSerengeti. Entomological monitoring activities were implemented in one sentinel village in each district to evaluate the efficacy of pirimiphos-methyl 300 CS sprayed on different wall surfaces and its impact against malaria vectors post-IRS intervention. Methods: The residual decay rate of p-methyl 300 CS applied at a target dosage of 1g a.i./m2 on thesprayed wall surfaces was monitored for a period of 43 weeks post-IRSusing the WHO cone wall bioassay method. The bioassays were performed by exposing 2–5 days old unfed susceptible female Anopheles gambiae s.s. (Kisumu strain) to sprayed wall surfaces for a period of 30 minutes. In each sentinel village, mosquito collection was carried out by trained community mosquito collectors. Monthly mosquito collections were carried out from 6.00pm to 6.00am using CDC light traps and clay pot methods for indoors host seekingand outdoors resting mosquitoes respectively. Six traps (2 CDC light traps and 4 clay pots) were set per sentinel village per night for28 consecutive days in a moon. PCR and ELISA were used for mosquito species identification and sporozoite detection, respectively. Results: Based on the WHOPES recommendation, insecticides should have a minimum efficacy of ≥ 80% mosquito mortality at 24 hours post exposure on the sprayed wall surfaces to be considered effective. In this study, p-methyl 300 CS was demonstrated to have a long residual efficacy of 21–43 weeks post-IRS on mud, cement, painted and wood wall surfaces. Numberof anopheline mosquitoes decreased post-IRS interventions in all sentinel villages. The highest numbers ofanopheline mosquitoes were collected in November-December, 38–43 weeks post-IRS. A total of 270 female anopheline mosquitoes were analyzed by PCR; out of which 236 (87.4%) were An. gambiae s.l. and 34 (12.6%) were An. funestus group. Of the 236 An. gambiae s.l.identified 12.6% (n = 34) were An. gambiae s.s. and 68.6% (n = 162) were An. arabiensis. Ofthe 34 An. funestus group indentified 91.2% (n = 31) were An. parensis and 8.8% (n = 3) were An. rivulorum. The overall Plasmodium falciparum sporozoite rate was 0.7% (n = 2,098). Conclusions: Pirimiphos-methyl 300 CS was found to be effective for IRS in the Lake Victoria basin,Tanzania. P-methyl 300 CShas a long residual efficacy on sprayed wall surfaces and therefore it is effective in controlling principal malaria vectors of An. gambiae s.l and An. funestus which rest on wall surfaces after and before feeding. [ABSTRACT FROM AUTHOR]

Background . Pediatric diarrhea remains a public health concern. This study explored caretaker's knowledge, attitudes, and practices regarding the causes, treatments, and risks of diarrhea among under-fives in Korogwe and Handeni districts, north-eastern Tanzania. Methods . We conducted a qualitative, cross-sectional study. Participants were selected through purposive sampling. Data were gathered through in-depth interviews and focus group discussions, and they were analyzed using thematic analysis. Results . Most participants had good knowledge about the risks of diarrhea among under-fives. However, most participants had poor knowledge of the causes and treatments of diarrhea. A significant proportion of participants had negative attitudes and poor practices about the treatment of diarrhea. A small percentage of participants possessed positive attitudes and appropriate practices for managing diarrhea. Conclusion . To bridge the knowledge gaps among caretakers and promote positive attitudes and behaviors about the management of diarrheal diseases, health authorities are urged to strengthen health education in the study communities., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)