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Introduction: Traumatic Brain Injury (TBI) is any injury to the brain resulting from an external force leading to complications. TBI affects 27–69 million people yearly, with high incidence in low- and middle-income countries (LMICs), mainly attributed to motor traffic accidents. Within three to six months following moderate-to-severe TBI, the relative risk of any psychiatric disorder is significantly higher than in the general population. Post-TBI neuropsychiatric disorders include depression with a prevalence of up to 53%, apathy up to 72%, Posttraumatic stress disorder (26%), anxiety (9%), manic symptoms (5–9%) and psychosis (3 to 8%). This study aims to determine the incidence and predictors of post-TBI neuropsychiatric manifestations among patients admitted at Referral hospitals in Dodoma. Methods and analysis: This is a prospective longitudinal observational study in which patients admitted with moderate to severe TBI will be recruited. Patients will be followed for six months, the diagnostic MINI International Neuropsychiatric Interview (MINI) tool will be used to assess TBI, and the severity and progression of symptoms will be evaluated using PHQ-9 for depressive symptoms, GAD-7 for anxiety symptoms, PCL-5 for Posttraumatic Stress Disorders (PTSD), MoCA for cognitive assessment, AES for apathy and YMRS for manic symptoms at one, three and six months. Logistic regression will be analysed to determine the association between predictors and neuropsychiatric outcomes. Conclusion: Given the dearth of understanding of the burden of neuropsychiatric complications and associated outcomes in sub-Saharan Africa, the study will shed light on the incidence and factors contributing to post-TBI neuropsychiatric complications and, thus, provide a platform for further research and design of necessary interventional programs for the population at risk. [ABSTRACT FROM AUTHOR]

Background and Aims: Stroke is the leading cause of disability and the second most common cause of death after ischemic heart disease worldwide. Understanding predictors of early poststroke mortality provides opportunities for interventions and favorable outcomes. This study aimed to determine the incidence and predictors of 30‐day mortality among patients admitted with the first stroke at referral hospitals in Dodoma. Methods: A prospective longitudinal observational design enrolled patients with acute stroke confirmed by CT scan or MRI admitted at referral hospitals in Dodoma. The National Institute of Health Stroke Scale was used to assess stroke severity at baseline. A comparison of risk factors, clinical profiles, and mortality was done using the Chi‐square test. A logistic regression model was used to determine the predictors of 30‐day mortality in patients with the stroke while the 30‐day probability of survival was estimated using Kaplan−Meier analysis. Results: Out of 226 patients with first‐ever stroke, 121(54%) were males, and the population mean age was 63(15) years. The 140(62%) had Ischemic stroke, and 154(68%) survived at the 30th day. Patients with a history of smoking 2.4 [95% confidence interval (CI) (1.0−5.6), p = 0.048], loss of consciousness 2.7 [95% CI (1.2−6.4; p = 0.019] and unequal pupil size 13.7 [95% CI (4.1−58.1, p < 0.001 were significantly more associated with mortality within 30 days. The median survival was 7 (3−9) days, whereas alcohol drinkers and those aged above 60 years had a shorter time to mortality compared to non‐alcohol drinkers and those aged <60 years. Conclusion: The study showed a high incidence of mortality within 30 days after the first stroke episode, with the highest proportion dying within 7 days of being hospitalized. Advanced age of ≥60 years, smoking, alcohol use, and severe stroke at admission warrant special attention. [ABSTRACT FROM AUTHOR]

Key clinical message: Neuromyelitis optica spectrum disorder is an autoimmune disease, rarely presents with antiphospholipid syndrome. Diagnosis and management of NMOSD are challenging in the background of diverse presentations, especially in resource‐limited settings. Neuromyelitis optica spectrum disorder (NMOSD) is a progressive demyelinating autoimmune condition resulting from the autoantibodies produced against aquaporin‐4 (AQP‐4) proteins which are widely distributed in astrocytes in the nervous system. In the setting of NMOSD, it is very crucial to consider other autoimmune diseases as differential diagnoses or co‐occurrences due to the diversity of symptoms. NMOSD co‐exists with other autoimmune diseases such as myasthenia gravis, thyroid disease, ankylosing spondylitis, pernicious anemia, thrombotic thrombocytopenic purpura, ulcerative colitis, and systemic lupus erythematosus. Few cases of antiphospholipid syndrome co‐existing with NMOSD have been reported. In resource‐limited settings, the published data are scarce, and therefore, autoimmune diseases are poorly studied. Therefore, late diagnosis and delayed treatment initiation pose long‐term sequelae and hence poor prognosis. Here, we present a case of an African woman in her early 40s presenting with bilateral progressive loss of vision, transverse myelitis, extensive longitudinal hyperintense T2 cervical lesion, and AQP‐4 autoantibody keeping with NMOSD. The co‐existence of antiphospholipid syndrome, in this case, was supported by a history of recurrent pregnancy loss and positive antiphospholipid antibodies. This case underscores the importance of individualized‐based medicine, especially in resource‐limited settings. [ABSTRACT FROM AUTHOR]

Aim: Hypoxic–ischaemic encephalopathy (HIE) is one of the leading causes of neonatal deaths and neurological impairment with the highest impact in resource‐limited settings. This study aimed to determine the incidence of poor in‐hospital outcomes and related factors among newborns with HIE in Tanzania. Methods: A prospective observational study in which 170 newborns with HIE (diagnosed using the Thompson clinical score) were followed from 1 September 2020 to 28 February 2021 at the neonatal ward of Dodoma Regional Referral Hospital in Dodoma, central Tanzania, until discharge or death. Clinical parameters were recorded. Multinomial logistic regression analysis was applied to determine factors associated with adverse outcomes. Results: Out of 170 newborns, 44.7% (76/170) had poor outcomes (death 27.1% (46/170); neurological deficits 17.6% (30/170)). Severe HIE (Thompson score > 14) (p < 0.0001), history of aspiration (adjusted odds ratio (AOR) = 3.06, 95% confidence interval (CI) [1.170, 8.014], p = 0.0226) and 5th‐min APGAR of <7 (AOR = 2.88, 95% CI [1.133, 7.310], p = 0.0262) were associated with mortality. Severe HIE, delivery at other facilities (AOR = 3.106 CI [1.158, 8.332], p = 0.0244) and abnormal heart rate (<100 or ≥160 beats/min) on admission (AOR = 3.469 [1.200, 10.030], p = 0.0216) predicted neurological impairment at discharge. Conclusion: Hypoxic–ischaemic encephalopathy is associated with a high incidence of poor outcomes in resource‐limited settings. To improve outcomes newborns with severe HIE, history of aspiration, referred from other facilities, 5th‐min APGAR score of <7 and abnormal heart rate need improved quality of neonatal care. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to examine the effects of visual art therapy (VAT) on cognition, psychological and functional ability of people with mild cognitive impairment (MCI), and low education. Methods A single-blinded randomized controlled trial was conducted among 127 older adults with MCI, mean age 73.6 years, and level of education in years, median (range) = 0 (0–9). The intervention group received 12 VAT sessions over 6 weeks. The control group received 6 health education sessions. The outcomes measures at baseline, immediately postintervention, at 3-month, and 6-month follow-up included global cognitive functions, depression, mental well-being, and instrumental activities of daily living functions. Results The intervention group demonstrated greater improvement than the control group in global cognition (β = 2.56, 95% confidence interval [CI] = 1.16, 3.97, p <.001, standardized mean difference [SMD] = 0.75) and depression (β = −2.01, 95% CI = −3.09, −0.93, p <.001, SMD = −0.93) immediately postintervention. The effects on cognitive functions were sustained at 3 and 6 months follow-up. The differential effect of VAT on mental well-being and functional ability compared to health education were undetectable. Discussion VAT can improve cognitive functions and mood status of older adults with MCI who have no or low education. Clinical Trials Registration Number: PACTR201901731800445. This trial was registered with Pan African Clinical Trial Registry: www.pactr.org. [ABSTRACT FROM AUTHOR]

Objective: To determine the influence of major depressive disorders (MDD) on the cognitive function of adults living with HIV and the prevalence of neurocognitive impairment and major depressive disorders. Methods: The study was a cross‐sectional design conducted in a referral hospital in Dodoma region central Tanzania, with a sample of 397 participants attained through systematic sampling. Neurocognitive impairment was assessed by Montreal Cognitive Assessment (MoCA), while MDD was assessed using Mini International Neuropsychiatric Interview (M.I.N.I). Two‐sample independent t‐tests were done to compute the significance of the mean change of MoCA score between those with or without MDD. Univariate and multivariate ordinal logistic regression models were computed to determine the association between MDD and neurocognitive impairment across all cognitive domains. Results: Of 397 recruited participants, 266 (66.00%) met the criteria for neurocognitive disorder and 22 (5.51%) had major depressive disorder. Participants with MDD performed significantly poorer on cognitive testing than those without MDD (mean difference = 3.74, p‐value = 0.0009). Under univariate ordinal regression, impairments in the particular domains of visuospatial‐executive function, attention, language, abstraction and orientation were significantly associated with MDD and abstraction (AOR: 3.922, 95% CI: 1.546–9.947, p = 0.0004) remained significant under multivariable regression. Conclusion: Major depressive disorder may negatively influence neurocognitive performance in both severity and pattern of presentation. Routine screening for depressive symptoms in HIV care can be beneficial for the overall patient's outcome. Systematic and well‐designed studies in the area are crucial for understanding the interaction of neuropsychiatric disorders in the HIV population. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to determine the burden of depression, suicidal ideation and suicidal behaviour amongst adolescents at sites in six sub-Saharan African countries and examine associated risk and protective factors.Methods: Household-based cross-sectional study involving male and female adolescents ages 10-19 years. A total of 7,662 adolescents from eight sites in six countries participated in the survey. Three sites were urban: Dar es Salaam (Tanzania), Harar (Ethiopia) and Ibadan (Nigeria); five were rural: Dodoma (Tanzania), Iganga/Mayuge (Uganda), Kersa (Ethiopia), Ningo Prampram (Ghana) and Nouna (Burkina Faso). Log-binomials models were used to estimate relative risks and confidence intervals for factors associated with depression and suicidal behaviour. This was supplemented using log-Poisson models as needed.Results: The prevalence of suicidal behaviour over the last 12 months ranged between 1.2% and 12.4% in the eight sites. Depressive symptoms and suicidal ideation/behaviours were associated with older age, female sex, food insecurity, poor access to health care and substance use. Depression was strongly associated with increased risk of suicidal behaviour at two sites where the multivariate model converged: Harar, Ethiopia (RR = 3.5, 95% CI 1.8, 7.0, P < 0.05) and Ibadan, Nigeria (RR = 3.7, 95% CI 2.2, 6.3, P < 0.0001).Conclusions: Depressive symptoms and suicidal behaviour are common amongst sub-Saharan African adolescents at these 8 sites. Most factors associated with depressive symptoms are modifiable and preventable. Routine screening for depressive symptoms in services frequented by adolescents in these and similar communities would be crucial in early detection and prompt intervention. [ABSTRACT FROM AUTHOR]

Background: Approximately 25% of Tanga's population are adolescents, yet the region lacks key information in many areas of adolescent health. Until recently, adolescents have been overlooked in surveillance efforts and health policies, leaving an absence of information on risk factors and fewer health gains in this age group compared to others. Objectives: To utilize a standardized survey among adolescents (aged 10-19 years) to collect key adolescent health indicators related to nutrition, sexual and reproductive health, mental health, physical health, health services utilization and substance use. Methods: This cross-sectional baseline survey in Tanga employed a mixed method approach. A total of 1,031 in-school adolescents (10-19 years) from 20 schools, 20 school administrators, and 231 out-of-school adolescents from 8 hotspots participated. Descriptive analysis was conducted, and results presented in proportions and means with 95% confidence intervals. Subgroup analysis to assess variations in various dimensions of adolescents' health by gender and age was done. Results: Findings showed that majority (69%) of all surveyed adolescents did not attain dietary diversity. Approximately 18% of the interviewed adolescents were stunted. 6% were underweight, 8% were overweight. Moreover, 36% of the interviewed adolescents were found to be anaemic. About 45% of the adolescents preferred to receive sexual and reproductive health information from teachers, and 67% wished to have more classes on the topic. 7% of the interviewed adolescents reported to have ever tried smoking. Overall, 37% of adolescents reported to be physically active for at least 1 hour for 6 to 7 days of the week. Conclusion: Survey results highlights key adolescent health and nutrition intervention areas for Tanga City. With these findings we recommend revamping of ongoing adolescent interventions per the national guidelines and local policies, gleaning from the health seeking behavior and preferred access points for Tanga in-school and out-of-school adolescents. [ABSTRACT FROM AUTHOR]