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Mwashungi Ally,1,2 Deodatus Conatus Kakoko,1 Calvin Swai,3 Emmy Metta,1 Mbonea Yonazi,2,4 Julie Makani,1,2 Elia John Mmbaga,1,5 Melkizedeck Thomas Leshabari,1 Kåre Moen,5 Tone Kristen Omsland,5 Emmanuel Balandya1,2 1Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania; 2Sickle Cell Program, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania; 3University of Dodoma, Dodoma, Tanzania; 4Muhimbili National Hospital, Dar-es-Salaam, Tanzania; 5Department of Community Medicine and Global Health, University of Oslo, Oslo, NorwayCorrespondence: Mwashungi Ally, Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, 9-United Nations Road, Upanga, Dar-es-Salaam, Tanzania, Tel +255 653 986 798, Email mwashungi.ally@muhas.ac.tzPurpose: Tanzania is the fifth country with the highest sickle cell disease (SCD) prevalence globally. Although hydroxyurea (HU) is available, only 25% of persons with SCD are reported to use it in Tanzania. Perceived disease threat is associated with medication usage in patients with chronic diseases. We assessed the factors associated with caregivers’ perceived threat of SCD complications and its relationship with HU use among children with SCD in Dar-es-Salaam.Methods: We conducted a cross-sectional hospital-based study from May to August 2023. We enrolled 374 caregivers of health-insured children with SCD from 4 public SCD clinics. We adapted the modified original and revised Champion’s Health Belief Model Scales to derive perceived threat scores. We used Mann-Whitney and Kruskal-Wallis tests to compare the outcomes across sociodemographic characteristics and regression analysis for factors associated with perceived SCD threat.Results: The median score (InterQuartile Range) for perceived threat of SCD complications was 559 (175, 598). Sixty-one percent of caregivers had a high SCD perceived threat. The caregivers of under-five children had 141 lower median SCD threat scores than those of children aged 13– 17 years, p-value < 0.001. Participants from Regional Referral Hospitals (RRH) had lower median threat scores compared to participants attending Muhimbili National Hospital (MNH), 177 for Amana RRH, 325 Temeke RRH, 585 MNH Mloganzila, and 557 MNH Upanga, p-value < 0.001. Children of caregivers with high perceived SCD threat were 3.4 times more likely to use HU compared to those with low SCD threat perception (Incidence Rate Ratio 3.4, 95% CI: 2.7– 4.5).Conclusion: The perceived threat of SCD predicts the likelihood of SCD patients using HU in Dar-es-Salaam, Tanzania. We recommend health education to caregivers aiming to improve their SCD threat perception and thus improve the use of HU among children with SCD in similar settings.Keywords: Sickle cell disease, hydroxyurea, perceived threat

Emmanuela E Ambrose,1 Benson R Kidenya,2 Mwesige Charles,3 Joyce Ndunguru,4 Agnes Jonathan,4 Julie Makani,4 Irene K Minja,4,5 Paschal Ruggajo,4,6 Emmanuel Balandya4,7 1Department of Paediatrics and Child Health, Catholic University of Health and Allied Sciences, Mwanza, Tanzania; 2Department of Biochemistry and Molecular Biology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania; 3Department of Laboratory Services, Bugando Medical Centre, Mwanza, Tanzania; 4Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 5Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 6Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 7Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaCorrespondence: Emmanuela E Ambrose, Department of Paediatrics and Child Health, Catholic University of Health and Allied Sciences, P.O. Box 1464, Mwanza, Tanzania, Tel +255789733833, Fax +255282500799, Email emmanuelaambrose@gmail.comPurpose: To assess clinical and haematological outcomes of Hydroxyurea accessed via various access means and uncover the barriers to its utilization in children with Sickle cell anaemia (SCA), North-western Tanzania.Patients and Methods: A retrospective study was conducted between October 2020 and April 2021 at Bugando Medical Centre (BMC) through review of medical files to compare the clinical and haematological outcomes among children with SCA at baseline and followed up retrospectively for at least one year of hydroxyurea utilization, accessed via cash, insurance and projects. Subsequently, a cross-sectional survey was conducted among parents and caregivers to ascertain the barriers to access of hydroxyurea via the various means. The p-values < 0.05 were considered statistically significant.Results: We identified 87 children with SCA who were on hydroxyurea for at least one year. The median age at baseline (before hydroxyurea) was 99 [78– 151] months, and 52/87 (59.8%) were male. Compared to baseline, there was a significant reduction in proportion of patients reporting vaso-occlusive crisis, admissions and blood transfusions, a significant increase in Haemoglobin and mean corpuscular volume, conversely a significant reduction in absolute neutrophil and reticulocytes to both insurance and project participants. There was no significant change in most of these parameters among patients who accessed hydroxyurea via cash. Further, a total of 24/87 (27.6%) participants reported different barriers to access of hydroxyurea, where 10/24 (41.7%) reported hydroxyurea to be very expensive, 10/24 (41.7%) reported insurance challenges, and 4/21 (16.6%) reported unavailability of the drug.Conclusion: The paediatric patients utilizing hydroxyurea accessed via insurance and projects, but not cash, experienced significant improvement in the clinical and haematological outcomes. Several barriers for access to hydroxyurea were observed which appeared to impact these outcomes. These findings call for concerted efforts to improve the sustainable access to hydroxyurea among all patients with SCA.Keywords: sickle cell anaemia, hydroxyurea, access, outcomes, North-western Tanzania

Ritah F Mutagonda,1,2 George Bwire,3 Raphael Zozimus Sangeda,2,3 Manase Kilonzi,1 Hamu Mlyuka,1 Joyce Ndunguru,2,4 Agnes Jonathan,2,4 Julie Makani,2,4 Irene Kida Minja,2,5 Paschal Ruggajo,2,6 Emmanuel Balandya,2,7 Appolinary AR Kamuhabwa1 1Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania; 2Sickle Cell Programme, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania; 3Department of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania; 4Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania; 5Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania; 6Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es salaam, Tanzania; 7Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es salaam, TanzaniaCorrespondence: Ritah F Mutagonda, Department of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, P.O BOX 65013, Dar es salaam, Tanzania, Tel +255 713 816481, Email mutagonda@muhas.ac.tz; rittdavisrida@yahoo.comBackground: Bacterial infections contribute significantly to morbidity and mortality in sickle cell disease (SCD) patients, particularly children under five years of age. In Tanzania, prophylaxis against pneumococcal infection among children with SCD advocates the use of both oral penicillin V (PV) and pneumococcal vaccines (PNV). Therefore, this study aimed to investigate nasopharyngeal carriage and antibiogram of Streptococcal pneumoniae (S. pneumoniae) and Staphylococcus aureus (S. aureus) in children with SCD in Tanzania.Methods: This cross-sectional study was undertaken at the two Sickle Pan-African Research Consortium (SPARCO) study sites in Dar es salaam, Tanzania. The study was conducted for six months and enrolled children with SCD between the ages of 6 to 59-months. A semi-structured questionnaire was used to collect patient data. Nasopharyngeal swabs were collected from all participants and cultured for Streptococcal pneumoniae and other bacterial isolates. Antimicrobial susceptibility tests of the isolates were done using the disc diffusion method.Results: Out of 204 participants, the overall prevalence of bacterial carriage was 53.4%, with S. aureus (23.5%), coagulase-negative Staphylococci (CoNS) (23%) and S. pneumoniae (7.8%) being commonly isolated. In antibiotic susceptibility testing, S. aureus isolates were most resistant to penicillin (81.8%), whereas 81.3% of S. pneumoniae isolates were resistant to co-trimoxazole. The least antimicrobial resistance was observed for chloramphenicol for both S. aureus and S. pneumoniae isolates (6.3% versus 0%). The proportion of multi-drug resistance (MDR) was 66.7% for S. aureus isolates and 25% for S. pneumoniae isolates.Conclusion: There are substantially high nasopharyngeal carriage pathogenic bacteria in children with SCD in Dar es Salaam, Tanzania. The presence of MDR strains to the commonly used antibiotics suggests the need to reconsider optimizing antimicrobial prophylaxis in children with SCD and advocacy on pneumococcal vaccines.Keywords: pneumococcal carriage, bacterial pathogens, pneumococcal prophylaxis, antimicrobial resistance

Evarist Mulyahela Wilson,1 Irene Kida Minja,1,2 Ferdinand Mabula Machibya,3 Agnes Jonathan,4 Julie Makani,2,4 Paschal Ruggajo,5 Emmanuel Balandya2,6 1Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 2Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam, Tanzania; 3Department of Orthodontics, Pedodontics and Community Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 4Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 5Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 6Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, TanzaniaCorrespondence: Evarist Mulyahela Wilson, Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, P. O. Box 65014, Dar es Salaam, Tanzania, Tel +255757352296, Email evarist1818@gmail.comPurpose: To determine oxygen saturation in the pulp of primary teeth in children with sickle cell disease (SCD) and sickle cell trait (SCT) for establishing the usefulness of pulse oximetry in screening and monitoring of SCD or therapy.Materials and Methods: A cross-sectional study among 30– 60 months children with sickle cell disease (SCD) and sickle cell trait (SCT) compared with healthy children (HbAA). A pulse oximeter (BCI 3301) recorded oxygen saturation on six anterior primary maxillary teeth and on index fingers. Data were analyzed using SPSS version 20.0. Mean oxygen saturation for teeth and fingers was calculated. Comparison of Mean across groups was done using post hoc analysis in one-way ANOVA (Bonferroni test). Pearson correlation coefficient was calculated for mean oxygen saturation on fingers and teeth. Level of significance was set at 0.05.Results: Altogether 360, 102, and 96 teeth were examined from children with SCD, SCT, and HbAA respectively. 53% of participants were girls. The mean age of participants was 46.3 months ± 9.4 SD. Low mean oxygen saturation (77.5%) was recorded from teeth of children with SCD relative to those with SCT and HbAA (> 86%; P = 0.00). There was no statistically significant difference in oxygen saturation on teeth between children with SCT and HbAA. The mean oxygen saturation on fingers was found to be above 97.2% regardless of sickle cell status. There was no correlation between oxygen saturation on teeth and fingers.Conclusion: Pulse oximeter detected a lower oxygen saturation in dental pulp of primary teeth of participants with SCD (HbSS) relative to those with SCT (HbAS) and HbAA. Oxygen saturation on fingers remained unaffected regardless of sickle cell disease status. Although more studies are needed, our study shows that when other conditions affecting peripheral tissue oxygen delivery are ruled out, the low pulse oximetry in primary teeth may be indicative of SCD. The oximeter may also be useful in monitoring response to SCD therapy targeted at improving oxygen carrying capacity and delivery.Keywords: pulse oximeter, dental pulp, microcirculation, oximetry

A field experiment was conducted at Main Oilseeds Research Station, J.A.U., Junagadh in 2023 during the kharif season to investigate the population dynamics of S. litura in groundnut. The activity of S. litura began in the 31st standard meteorological week (SMW) in fourth week of July, with 0.83 larvae per plant initially. During the third week of August, the 34th SMW recorded the first peak of 2.64 larvae per plant. After a slight decrease in numbers, a second peak was seen in the 38th week SMW, in third week of September, with 3.17 larvae per plant. In the following weeks, there was a decrease in the number of larvae, reaching its lowest during the 44thSMW, which fell on the fifth week of October, with 0.05 larvae per plant. The correlation studies showed a significant positive correlation between larval population and minimum temperature, morning relative humidity, morning and evening vapour pressure (r = 0.616*, 0.514*, 0.638* and 0.587*). [ABSTRACT FROM AUTHOR]