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Background: In this paper, we investigate facial sexual dimorphism and its' association with body dimorphism in Maasai, the traditional seminomadic population of Tanzania. We discuss findings on other human populations and possible factors affecting the developmental processes in Maasai., Methods: Full-face anthropological photographs were obtained from 305 Maasai (185 men, 120 women) aged 17-90 years. Facial shape was assessed combining geometric morphometrics and classical facial indices. Body parameters were measured directly using precise anthropological instruments., Results: Sexual dimorphism in Maasai faces was low, sex explained 1.8% of the total shape variance. However, male faces were relatively narrower and vertically prolonged, with slightly wider noses, narrower-set and lower eyebrows, wider mouths, and higher forehead hairline. The most sexually dimorphic regions of the face were the lower jaw and the nose. Facial width-to-height ratio (fWHR), measured in six known variants, revealed no significant sexual dimorphism. The allometric effects on facial traits were mostly related to the face growth, rather than the growth of the whole body (body height). Significant body dimorphism was demonstrated, men being significantly higher, with larger wrist diameter and hand grip strength, and women having higher BMI, hips circumferences, upper arm circumferences, triceps skinfolds. Facial and body sexual dimorphisms were not associated., Conclusions: Facial sex differences in Maasai are very low, while on the contrary, the body sexual dimorphism is high. There were practically no associations between facial and body measures. These findings are interpreted in the light of trade-offs between environmental, cultural, and sexual selection pressures., (© 2022. The Author(s).)

Background: Antenatal care (ANC) is crucial for the health of the mother and unborn child as it delivers highly effective health interventions that can prevent maternal and newborn morbidity and mortality. In 2002, the World Health Organization (WHO) recommended a minimum of four ANC visits for a pregnant woman with a positive pregnancy during the entire gestational period. Tanzania has sub-optimal adequate (four or more) ANC visits, and the trend has been fluctuating over time. An understanding of the factors that have been contributing to the fluctuating trend over years is pivotal in increasing the proportions of pregnant women attaining adequate ANC visits in Tanzania., Methods: The study used secondary data from Tanzania Demographic Health Survey (TDHS) from 2004 to 2016. The study included 17976 women aged 15-49 years. Data were analyzed using Stata version 14. Categorical and continuous variables were summarized using descriptive statistics and weighted proportions. A Poisson regression analysis was done to determine factors associated with adequate ANC visits. To determine factors associated with changes in adequate ANC visits among pregnant women in Tanzania from 2004 to 2016, multivariable Poisson decomposition analysis was done., Results: The overall proportion of women who had adequate ANC visits in 2004/05, 2010 and 2015/16 was 62, 43 and 51% respectively. The increase in the proportion of women attaining adequate ANC from 2010 to 2015/16 was mainly, 66.2% due to changes in population structure, thus an improvement in health behavior. While 33.8% was due to changes in the mother's characteristics. Early initiation of first ANC visit had contributed 51% of the overall changes in adequate ANC attendance in TDHS 2015/16 survey., Conclusion: Early ANC initiation has greatly contributed to the increased proportion of pregnant women who attain four or more ANC visits overtime. Interventions on initiating the first ANC visit within the first twelve weeks of pregnancy should be a priority to increase proportion of women with adequate ANC visit., (© 2022. The Author(s).)

Introduction: The complex relationship between intimate partner violence and psychological distress warrants an integrated intervention approach. In this study we examined the relevance, acceptability, and feasibility of evaluating a multi-sectoral integrated violence- and mental health-focused intervention (Nguvu)., Methods: We enrolled 311 Congolese refugee women from Nyarugusu refugee camp in Tanzania with past-year intimate partner violence and elevated psychological distress in a feasibility cluster randomized trial. Women were recruited from local women's groups that were randomized to the Nguvu intervention or usual care. Participants from women's groups randomized to Nguvu received 8 weekly sessions delivered by lay refugee incentive workers. Psychological distress, intimate partner violence, other wellbeing, and process indicators were assessed at baseline and 9-weeks post-enrollment to evaluate relevance, acceptability, and feasibility of implementing and evaluating Nguvu in refugee contexts., Results: We found that Nguvu was relevant to the needs of refugee women affected by intimate partner violence. We found reductions in some indicators of psychological distress, but did not identify sizeable changes in partner violence over time. Overall, we found that Nguvu was acceptable and feasible. However, challenges to the research protocol included baseline imbalances between study conditions, differential intervention completion related to intimate partner violence histories, differences between Nguvu groups and facilitators, and some indication that Nguvu may be less beneficial for participants with more severe intimate partner violence profiles., Conclusions: We found evidence supporting the relevance of Nguvu to refugee women affected by partner violence and psychological distress and moderate evidence supporting the acceptability and feasibility of evaluating and implementing this intervention in a complex refugee setting. A definitive cluster randomized trial requires further adaptations for recruitment and eligibility screening, randomization, and retention., Trial Registration: ISRCTN65771265, June 27, 2016., Competing Interests: The authors have declared that no competing interests exist.

Globally, the widespread occurrence of disrespect and abuse (D&A) on maternity wards is well-documented. Using ethnography and cultural consensus analysis we explore how the practice of midwives hitting women who are in the second stage of labor (pushing) has become a locally accepted form of care in Tanzania if a baby's life appears to be at risk. This analysis interrogates the deep uncertainty of birth outcomes in this setting that may motivate abuse during this time. Seriously engaging with local discourses on abuse and care sheds light on hegemonic norms and power dynamics and is critical for improving maternity services.

Numerous factors, including family planning and modern contraception, disturb the potential associations between the number of children born and genetic factors in modern Western societies. The current progress of medicine and a relatively high level of well-being make it hard to test the association between children's survival rates and genetic factors in Western societies either. The goal of the current study was to reveal the possible associations between the number of children born and the number of children survived till the age of 5 y. by the time of our study with a set of six genetic polymorphisms associated with serotonin, dopamine, androgen oxytocin behavioral effects; and to test for sex-specific effects of these polymorphisms in a traditional rural sample from Arusha and Singida Districts of Northern Tanzania. The data on 965 healthy individuals (520 men and 415 women) from traditional rural communities with high reproduction profiles were collected. All participants provided information on the number of children born and survived, and other demographic information, as well as buccal epithelium samples for DNA analysis. The data were analyzed using GLM ANCOVA and the APSampler nonparametric methodology. The gene association effects on reproduction and infant survival in men and women were demonstrated. We suggest that sex differences revealed in this study are in line with sexual selection pressure on reproduction and parenting in traditional societies.

Unmet need for family planning (FP) remains prevalent worldwide. In Tanzania, 21.7% of women desire to delay pregnancy, but do not use modern contraception despite its free availability at local clinics. Our prior data suggest that this is related to complex gender and religious dynamics in rural communities. To understand how education about FP could be improved, we developed a discrete choice experiment (DCE) to rank preferences of six attributes of FP education. Results were stratified by gender. Sixty-eight women and 76 men completed interview-assisted DCEs. Participants significantly preferred education by a clinician (men = 0.62, p  < .001; women = 0.38, p  < .001) and education in mixed-gender groups (men = 0.55, p  < .001; women = 0.26, p  < .001). Women also significantly preferred education by a religious leader (0.26, p  = .012), in a clinic versus church, mosque, or community centre (0.31, p  = .002), and by a female educator (0.12, p  = .019). Men significantly preferred a male educator (0.17, p  = .015), whom they had never met (0.25, p  < .001), and educating married and unmarried people separately (0.22, p  = .002). Qualitative data indicate women who had not previously used contraception preferred education led by a religious leader in a church or mosque. FP education tailored to these preferences may reach a broader audience, dispel misconceptions about FP and ultimately decrease unmet need.

Objectives: The incentives underlying men's hunting acquisition patterns among foragers are much debated. Some argue that hunters preferentially channel foods to their households, others maintain that foods are widely redistributed. Debates have focused on the redistribution of foods brought to camp, though the proper interpretation of results is contested. Here we instead address this question using two nutritional variables, employed as proxies for longer-term food access. We also report on broader patterns in nutritional status., Materials and Methods: We measured male hunting success, hemoglobin concentration and body fatness among bush-living Hadza. Hunting success was measured using an aggregated reputation score. Hemoglobin concentration, a proxy for dietary red meat, was measured from fingerprick capillary blood. Body fatness, a proxy for energy balance, was measured using BMI and bioelectrical impedance., Results: We find no statistically significant relationship between a hunter's success and any measure of his nutritional status or that of his spouse. We further find that: women are, as elsewhere, at greater risk of iron-deficiency anemia than men; men had slightly lower BMIs than women; men but not women had significantly lower hemoglobin levels than in the 1960s., Discussion: The absence of an association between hunting reputation and nutritional status is consistent with generalized food sharing. Null results are difficult to interpret and findings could potentially be a consequence of insufficient signal in the study measures or some confounding effect. In any event, our results add to a substantial corpus of existing research that identifies few nutritional advantages to being or marrying a well-reputed Hadza hunter., (© 2020 Wiley Periodicals, Inc.)

Objectives: Despite the accessibility of modern family planning (FP) methods, unwanted pregnancies remains a serious problem in Tanzania. This study aimed to identify the barriers to the uptake of modern FP methods among female youth reached by the Chaguo la Maisha project in Temeke District, Tanzania., Study Design: Qualitative study conducted in March 2017 involving 15 female youths aged 18-24 years., Main Outcome Measures: Purposive sampling was used to select study participants and sampling followed the principle of data saturation. The study participants were those who received contraceptive counseling from community health mobilizers and agreed to visit a nearby health facility for FP services but did not go for the services. A semi-structured interview guide, translated into Kiswahili language was used. Data were transcribed; analyzed following qualitative content analysis. Major categories and subcategories that hindered visitations were identified., Results: Three categories and their subcategories were identified as hindering FP method uptake. (1) individual perception factors: (a) myths and misconceptions, (b) fear of side effects, (c) fear of the possibility of being pregnant at the time of FP counseling; (2) community perception factors: discouragement from an intimate partner and closest friends; and (3) health facility system factors: unavailability of the preferred method and absence of the trained personnel for the FP method., Conclusions: The main barriers to FP uptake were myths and misconceptions, and fear of side effects. The intimate partner or closest friends were significant decision influencers on contraceptive use, implying that FP campaigns should focus beyond the individual level., (Copyright © 2020 Elsevier B.V. All rights reserved.)

The Hadza foragers of Tanzania are currently experiencing a nutritional shift that includes the intensification of domesticated cultigens in the diet. Despite these changes, no study, to date, has examined the possible effects of this transition on the food collection behavior of young foragers. Here we present a cross-sectional study on foraging behavior taken from two time points, 2005 and 2017. We compare the number of days foraged and the type and amount of food collected for young foragers, aged 5-14 years, in age- and season-matched samples. Compared with 2005, in 2017 fewer subadults left camp to forage, and overall, they targeted a smaller variety of wild foods, with the noticeable absence of wild honey, figs, and tubers. In addition, participants in 2017 were significantly more likely to have attended school. Despite the increased presence of domesticated plant foods in the diet and increased attendance at school, some young foragers continue to be highly productive in collecting wild, undomesticated foods. Despite the preliminary nature of our results, our findings suggest that the range of wild foods targeted by subadults is decreasing as the amount of domesticated cultigens in the diet increases. These data underscore the importance of studying diet composition and foraging decisions across temporal, nutritional, and ecological landscapes.

It has long been claimed that certain configurations of facial movements are universally recognized as emotional expressions because they evolved to signal emotional information in situations that posed fitness challenges for our hunting and gathering hominin ancestors. Experiments from the last decade have called this particular evolutionary hypothesis into doubt by studying emotion perception in a wider sample of small-scale societies with discovery-based research methods. We replicate these newer findings in the Hadza of Northern Tanzania; the Hadza are semi-nomadic hunters and gatherers who live in tight-knit social units and collect wild foods for a large portion of their diet, making them a particularly relevant population for testing evolutionary hypotheses about emotion. Across two studies, we found little evidence of universal emotion perception. Rather, our findings are consistent with the hypothesis that people infer emotional meaning in facial movements using emotion knowledge embrained by cultural learning.

Drawing on long-term ethnographic fieldwork on older caregivers and their shifting roles since the introduction of antiretroviral therapy in northwest Tanzania, this article explores grandmothers' roles in caring for grandchildren who are HIV positive and on treatment. While AIDS treatment programmes usually focus on cultivating expert patients who can perform self-care, this study focuses on older caregivers and how they become experts in caring for their grandchildren living with HIV. How is expert care enacted and what supports or limits its quality? Based on observations and in-depth interviews, this article argues that grandmothers become 'expert caregivers' by merging knowledge acquired in the clinic and support groups with intimate practices of grandparental care. However, the grandmother's gendered and generational position within kin networks affects her ability to provide expert care. The findings indicate that in analysing treatment outcomes among adolescents, it is important to understand the broader family dynamic that influences the actual possibility of expert caregivers to support children living with HIV.

The ratio of index- and ring-finger lengths (2D:4D ratio) is thought to be related to prenatal androgen exposure, and in many, though not all, populations, men have a lower average digit ratio than do women. In many studies an inverse relationship has been observed, among both men and women, between 2D:4D ratio and measures of athletic ability. It has been further suggested that, in hunter-gatherer populations, 2D:4D ratio might also be negatively correlated with hunting ability, itself assumed to be contingent on athleticism. This hypothesis has been tested using endurance running performance among runners from a Western, educated, and industrialized population as a proximate measure of hunting ability. However, it has not previously been tested among actual hunter-gatherers using more ecologically valid measures of hunting ability and success. The current study addresses this question among Tanzanian Hadza hunter-gatherers. I employ a novel method of assessing hunting reputation that, unlike previous methods, allows granular distinctions to be made between hunters at all levels of perceived ability. I find no statistically significant relationship between digit ratio and either hunting reputation or two important hunting skills. I confirm that Hadza men have higher mean 2D:4D ratios than men in many Western populations. I discuss the notion that 2D:4D ratio may be the consequence of an allometric scaling relationship between relative and absolute finger lengths. Although it is difficult to draw clear conclusions from these results, the current study provides no support for the theorized relationship between 2D:4D ratio and hunting skill.

Background: Tanzania's One Plan II health sector program aims to increase facility deliveries from 50 to 80% from 2015 to 2020. Success is uneven among certain Maasai pastoralist women in Northern Tanzania who robustly prefer home births to facility births even after completing 4+ ANC visits. Ebiotishu Oondomonok Ongera (EbOO) is a program in Nainokanoka ward to promote facility births through a care-group model using trained traditional birth attendants (TBAs) as facilitators. Results to date are promising but show a consistent gap between women completing ANC and those going to a facility for delivery. A qualitative study was conducted to understand psychosocial preferences, agency for decision-making, and access barriers that influence where a woman in the ward will deliver., Methods: In-depth interviews, focus group discussions and key-informant interviews were conducted with 24 pregnant and/or parous women, 24 TBAs, 3 nurse midwives at 3 health facilities, and 24 married men, living in Nainokanoka ward. Interviews and discussions were transcribed, translated, and analyzed thematically using a grounded theory approach., Results: Most women interviewed expressed preference for a home birth with a TBA and even those who expressed agency and preference for a facility birth usually had their last delivery at home attributed to unexpected labor. TBAs are engaged by husbands and play a significant influential role in deciding place of delivery. TBAs report support for facility deliveries but in practice use them as a last resort, and a significant trust gap was documented based on a bad experience at a facility where women in labor were turned away., Conclusions: EbOO project data and study results show a slow but steady change in norms around delivery preference in Nainokanoka ward. Gaps between expressed intention and practice, especially around 'unexpected labor' present opportunities to accelerate this process by promoting birth plans and perhaps constructing a maternity waiting house in the ward. Rebuilding trust between facility midwives, TBAs, and the community on the availability of health facility services, and increased sensitivity to women's cultural preferences, could also close the gap between the number of women who are currently using facilities for ANC and those returning for delivery.

Introduction: While parents' construction of and actions around child growth are embedded in their cultural framework, the discourse on child growth monitoring (CGM) has been using indicators grounded in the biomedical model. We believe that for CGM to be effective, it should also incorporate other relevant socio-cultural constructs. To contribute to the further development of CGM to ensure that it reflects the local context, we report on the cultural conceptualization of healthy child growth in rural Tanzania. Specifically, we examine how caregivers describe and recognize healthy growth in young children, and the meanings they attach to these cultural markers of healthy growth., Methods: Caregivers of under-five children, including mothers, fathers, elderly women, and community health workers, were recruited from a rural community in Kilosa District, Southeastern Tanzania. Using an ethnographic approach and the cultural schemas theory, data for the study were collected through 19 focus group discussions, 30 in-depth interviews, and five key informant interviews. Both inductive and deductive approaches were used in the data analysis., Results: Participants reported using multiple markers for ascertaining healthy growth. These include 'being bonge' (chubby), 'being free of illness', 'eating well', 'growing in height', as well as 'having good kilos' (weight). Despite the integration of some biomedical concepts into the local conceptualization of growth, the meanings attached to these concepts are largely rooted in the participants' cultural framework. For instance, a child's weight is ascribed to the parents' adherence to postpartum sex taboos and to the nature of a child's bones. The study noted conceptual differences between the meanings attached to height from a biomedical and a local perspective. Whereas from a biomedical perspective the height increment is considered an outcome of growth, the participants did not see height as linked to nutrition, and did not believe that they have control over their child's height., Conclusions: To provide context-sensitive advice to mothers during CGM appointments, health workers should use a tool that takes into account the mothers' constructs derived from their cultural framework of healthy growth. The use of this approach should facilitate communication between health professionals and caregivers during CGM activities, increase the uptake and utilization of CGM services, and, eventually, contribute to reduced levels of childhood malnutrition in the community., Competing Interests: The authors have declared that no competing interests exist.

This paper presents a comparative study on conceptualizations of the poorly understood nodding syndrome (NS) in Uganda and Tanzania. NS has been constructed as a biomedical category to serve global health discourse as well as national contexts of managing the condition. The paper looks into the shifting meanings and conceptualizations of NS in the affected areas of Kitgum (UG) and Mahenge (TZ) district. The perceived universality of biomedical classifications is problematized as conflicting with the specific contexts of lucluc and kifafa cha kusinzia . Reconciliation proves to be challenging, poignantly evoking the cultural construction as such of any medical condition.

Stunting affects large numbers of under-fives in Tanzania. But do caretakers of under-fives recognize height as a marker of child growth? What meanings do they attach to linear growth? An ethnographic study using cultural schemas theory was conducted in a rural community in Southeastern Tanzania to investigate caregivers' conceptualizations of child height in relation to growth and the meanings attached to short stature. Data for the study were collected through 19 focus group discussions, 30 in-depth interviews, and five key informant interviews with caregivers of under-fives, including mothers, fathers, elderly women, and community health workers. Principles of grounded theory guided the data management and analysis. Although caregivers could recognize height increments in children and were pleased to see improvements, many held that height is not related to nutrition, health, or overall growth. They referred to short stature as a normal condition that caregivers cannot influence; that is, as a function of God's will and/or heredity. While acknowledging short stature as an indicator of stunting, most participants said it is not reliable. Other signs of childhood stunting cited by caregivers include a mature-looking face, wrinkled skin, weak or copper-coloured hair, abnormal shortness and thinness, delayed ability to crawl/stand/walk, stunted IQ, and frequent illness. Culturally, a child could be tall but also stunted. Traditional rather than biomedical care was used to remedy growth problems in children. Public health programmers should seek to understand the local knowledge and schemas of child stature employed by people in their own context before designing and implementing interventions., (© 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.)

Evidence for cross-cultural patterns of sexual differences in color preferences raised the question of whether these preferences are determined by universal principles. To address this question, we investigated most- and least-favorite color choices in a nonindustrialized community, the Hadza that has an egalitarian hunter-gatherer culture, fundamentally different from those previously investigated. We also compared color preference patterns in the Hadza with published data from Poland and Papua. Our results show that Hadza have very different color preferences than Polish and Papuan Yali respondents. Unlike many industrialized and nonindustrialized cultures, Hadza color preferences are practically the same for women and men. These observations question the idea of universal differences of color preferences between sexes and raise important questions about the determinants of color preferences.

Approximately 40% of women in sub-Saharan Africa marry before their eighteenth birthday 1 . Within the international development sector, this phenomenon is referred to as 'child marriage', widely equated to forced marriage, and recognized as damaging to multiple dimensions of female well-being 1,2 . An escalating global campaign to end early marriage typically assumes that its high prevalence is driven by a conflict of interests between parents and daughters, with parents coercing daughters to marry early for the parents' economic benefit 3 . However, a parent-offspring conflict model of early marriage has not been explicitly tested. Here we present a study of marriage transitions in rural Tanzania, where marriage before or just after 18 years of age is normative. Consistent with parental coercion, we find that bridewealth transfers are highest for younger brides. However, autonomy in partner choice is very common at all ages, relationships between age at marriage and female well-being are largely equivocal, and women who marry early achieve relatively higher reproductive success. We conclude that, in contexts in which adolescents have autonomy in marriage choices and in which marriage promotes economic and social security, early marriage may be better understood as serving the strategic interests of both parents and daughters.

Background: Adverse health outcomes are higher among Maasai children in the Ngorongoro Conservation Area compared to other co-located ethnic groups and regions of Tanzania. The Mama Kwanza Socioeconomic Health Initiative, a Canadian-Tanzanian partnership delivering healthcare at clinics in this region, gathered perceptions of mothers regarding breastfeeding and infant nutrition in order to inform culturally sensitive, realistic, and effective health promotion efforts., Methods: A qualitative description approach was used in interviewing 30 Maasai mothers of infants zero to six months of age to explore their infant feeding practices, beliefs, knowledge, and recommendations to support breastfeeding. A local research team was trained to conduct and transcribe the interviews and assist with data interpretation. Qualitative content analysis was used in analyzing the interview transcripts., Results: Lactation is universal in this culture with all the mothers planning to breastfeed for at least one year and most having initiated breastfeeding within one hour of birth. Lactation skills and knowledge are passed down intergenerationally from the elder women. None of the infants less than six months were exclusively breastfed, with a variety of liquid and semi-solid supplements given. Mothers perceived their milk alone was nutritionally insufficient with maternal dietary deficiencies cited as a factor., Conclusions: While there is a strong breastfeeding culture among the Maasai in Ngorongoro, intersectoral efforts are required to provide culturally respectful health education on the benefits of exclusive breastfeeding and to ensure the maternal dietary adequacy required to achieve this goal. The findings reinforce the importance of international health projects adapting health promotion initiatives to local realities and beliefs in efforts to improve maternal child health.

The study of traditional populations provides a view of human-associated microbes unperturbed by industrialization, as well as a window into the microbiota that co-evolved with humans. Here we discuss our recent work characterizing the microbiota from the Hadza hunter-gatherers of Tanzania. We found seasonal shifts in bacterial taxa, diversity, and carbohydrate utilization by the microbiota. When compared to the microbiota composition from other populations around the world, the Hadza microbiota shares bacterial families with other traditional societies that are rare or absent from microbiotas of industrialized nations. We present additional observations from the Hadza microbiota and their lifestyle and environment, including microbes detected on hands, water, and animal sources, how the microbiota varies with sex and age, and the short-term effects of introducing agricultural products into the diet. In the context of our previously published findings and of these additional observations, we discuss a path forward for future work.

Background: In Tanzania, the roles of men and women are classified based on the local cultural context. While men are usually the breadwinners, women are traditionally responsible for most domestic chores. Particularly for malaria prevention, studies in Africa have revealed women as being responsible for daily up-keep of the net. Using social role theory, this study explored the role of men and women in net care and repair and gender-related motivation and barriers to net care and repair in Tanzania., Methods: The study was conducted in the two villages of Ruangwa district in Lindi Region. The study applied qualitative approaches and carried out in-depth interviews and focus group discussions with men, women, women with children under the age of five, and village key informants., Results: Mosquito nets were valued by all participants as a protection measure against mosquitoes. Study findings indicate that net care and repair falls under a woman's daily household responsibilities. While men were said to assist in stitching damaged nets, washing dirty bed nets was regarded inappropriate for men and not traditionally accepted. Motivation for net care and repair was reported to come from both men and women; for a woman keeping the net clean defined a caring and responsible woman, while men indirectly promoted net washing when complaining about nets being dirty. Women reported that men could do everything that women do regarding net care and repair, but that it does not fit into societal norms., Conclusion: With increased globalization in Tanzania, more women are becoming part of the workforce, which may limit their full commitment to net care and repair activities, leading to increased net damage, malaria incidences and higher costs for malaria treatment. The National Malaria Control Programme should consider incorporating research-informed gender-transformative messages into their behaviour change communication on mosquito nets and work closely with trusted Community Health Workers to inform communities about the importance of sharing responsibilities in net care and repair. It is acknowledged that changing people's behaviour and practices is a long process, which will require a deep cultural and political shift.

At the center of conflict between the state and traditional healers (waganga wa kienyeji) over the meanings of traditional healing in contemporary Tanzania are debates about what constitutes knowledge, the production of knowledge, and the legitimacy of "traditional" ways of knowing. Drawing on media analysis and ethnographic fieldwork carried out between 2004 and 2016, I describe how healers locate their knowledge in experience, ancestors, and spirits, while the state imagines a future where traditional healers are formally educated and practice in white uniforms. While embedded in a larger colonial and postcolonial history, this conflict arose in response to the attribution of violence against persons with albinism to traditional healers.

Widespread cooperation is a defining feature of human societies from hunter-gatherer bands to nation states [1, 2], but explaining its evolution remains a challenge. Although positive assortment of cooperators is recognized as a basic requirement for the evolution of cooperation, the mechanisms governing assortment are debated. Moreover, the social structure of modern hunter-gatherers, characterized by high mobility, residential mixing, and low genetic relatedness [3], undermines assortment and adds to the puzzle of how cooperation evolved. Here, we analyze four years of data (2010, 2013, 2014, 2016) tracking residence and levels of cooperation elicited from a public goods game in Hadza hunter-gatherers of Tanzania. Data were collected from 56 camps, comprising 383 unique individuals, 137 of whom we have data for two or more years. Despite significant residential mixing, we observe a robust pattern of assortment that is necessary for cooperation to evolve; in every year, Hadza camps exhibit high between-camp and low within-camp variation in cooperation. We find little evidence that cooperative behavior within individuals is stable over time or that similarity in cooperation between dyads predicts their future cohabitation. Both sets of findings are inconsistent with models that assume stable cooperative and selfish types, including partner choice models. Consistent with social norms, culture, and reciprocity theories, the strongest predictor of an individual's level of cooperation is the mean cooperation of their current campmates. These findings underscore the adaptive nature of human cooperation-particularly its responsiveness to social contexts-as a feature that is important in generating the assortment necessary for cooperation to evolve., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

In Tanzania, a nation with a large mental health treatment gap, local stakeholders' perspectives are critical for informing effective treatment. The practice-based perspectives of mental health providers may be particularly instructive. Existing foundational literature on the professional population in this region is scarce. We conducted semi-structured interviews with 29 mental health providers in northern Tanzania. Interviews focused on three topics: use of international diagnostic frameworks for mental illness, beliefs about causes of mental health concerns, and alternative treatments sought by clients. Interview data were coded and analyzed using consensual qualitative research and the constant comparative method. Usage of diagnostic frameworks varied widely. Providers believed frameworks accurately described many patients but neglected somatic symptoms and contained diagnoses that they had never witnessed. Providers described supernatural and spiritual attributions of mental illness as substantially impacting treatment decisions. Other notable attributions included physical illness, drug/alcohol use, and heredity. Providers reported their clients routinely sought treatment from traditional and spiritual healers prior to seeking care in the formal health system. This study builds a foundation for the ongoing development of the mental health system in northern Tanzania. Findings also support exploration of integrative models of care and task-shifting to incorporate traditional and spiritual beliefs.

By 2030, sub-Saharan Africa is forecast to see the steepest rise in the number of people with hypertension of any world region. Hypertensive retinopathy is known to be a common complication of hypertension in developed countries and some studies suggest it is associated with the presence of other hypertension-related end-organ damage (EOD) such as stroke and cardiovascular disease. In Tanzania hypertension is relatively more common than in other parts of sub-Saharan Africa, especially in the older population; however, the prevalence of hypertensive retinopathy and its association with EOD remain unknown. The authors conducted a cross-sectional study of elderly, community-dwelling, rural Tanzanians to determine the prevalence of hypertensive retinopathy and its association with hypertension and other forms of EOD. Hypertensive retinopathy was diagnosed based on retinal imaging. In a cohort of 61 patients with gradable images, the authors found the overall prevalence of hypertensive retinopathy to be 64% (n = 39), which was strongly associated with hypertension (X 2 [1] = 4.207, P = .004), with a significant trend towards more severe retinopathy with more severe hypertension (r = .377, P = .003). The authors did not find hypertensive retinopathy to be associated with other forms of EOD. Hypertensive retinopathy is highly prevalent in this population and is associated in most but not all cases with hypertension. These findings do not suggest that it could be used as a screening tool for EOD, but it is important to identify and educate patients with retinopathy about possible complications of the condition., (©2018 Wiley Periodicals, Inc.)

This explorative and qualitative study, based on 27 interviews during two months of fieldwork, describes pese, an affliction of the skin that has conspicuously stayed under the radar of medico-anthropological research in Kigoma, a rural city in the northwest Tanzania. The condition reminds of a locally better known condition labeled kisigo, raising the question why two concepts of the same affliction exist side by side. It seems indicative that the two illness concepts stem from different cultures and that each specializes in an explanatory model: the former witchcraft (sorcery) and the latter spirit possession. Moreover, a symbiotic relation seems to exist between the healing traditions of the Bembe and the Ha. Government policies prohibiting witchcraft and targeting traditional healers seem to have created a situation where witchcraft practices and beliefs have come to represent the periphery and survive there, clandestinely.

Objective: To identify predictors of maternal dietary diversity in rural Dodoma, Tanzania and assess its association with child growth outcomes., Methods: A cross-sectional survey of 361 mothers with children under 24 months of age was conducted in 5 villages in rural Dodoma, Tanzania. Maternal diets were assessed using food frequency questionnaires, and dietary diversity was categorized using Minimum Dietary Diversity for Women (MDD-W) guidelines. Child anthropometric measures were taken to calculate height-for-age z-score (HAZ), weight-for-height z-score (WHZ), and weight-for-age z-score (WAZ). Linear and logistic regressions were used to examine the association between maternal dietary diversity and children's growth outcomes., Results: About 40% of mothers did not consume a diverse diet (MDD-W < 5), and 35% of children were stunted. Household production of greater number of crops was associated with greater MDD-W scores ( P < .01). Greater maternal dietary diversity was associated with significantly greater child WHZ (mean difference = 0.44; 95% confidence interval [CI]: 0.10-0.78; P = .01), WAZ (mean difference = 0.37; 95% CI: 0.08-0.65; P = .01), and reduced risk of wasting (odds ratio = 0.22; 95% CI: 0.07-0.66; P = .01)., Conclusions: Greater maternal dietary diversity was associated with improved child WHZ and WAZ outcomes. Sustainable interventions to increase maternal dietary diversity may improve WHZ and WAZ in young children in similar settings.

This study explored cyberbullying and cybervictimization (CBCV), for adolescents aged 11-15 from Tanzania (N = 426) and Canada (N = 592). Measurement invariance and model invariance was found for CBCV. In addition, multigroup structural equation modeling was used to explore several variables: age, gender, average hours online each day, accessing the Internet in a private location, having online privacy concerns, going online for social purposes, and motivation for cyberbullying. Results found interesting patterns within each country. It was found that cellphone ownership moderated the relation between these predictor variables and reported incidences of CBCV uniquely for each country. These findings provide evidence for the global nature of cyberbullying., (© 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.)

Survey data show that most Tanzanian women find wife-beating justifiable. What is the meaning of the violence that enjoys such broad social approval? Does respect for women's agency invalidate feminist opposition to wife-beating? I explore these questions by analyzing data on hegemonic norms generated through 27 focus group discussions in Arumeru and Kigoma-Vijijini districts, and find that wife-beating was supported for its role in constituting social order. This analysis of how exactly violence can constitute order yielded insights into the interplay between violence and consent that are theoretically relevant to violence against women in other forms and contexts, reminding researchers and practitioners of the role of power and coercion in supposedly agreed-upon community norms.

Background: Zoonoses account for the most commonly reported emerging and re-emerging infectious diseases in Sub-Saharan Africa. However, there is limited knowledge on how pastoral communities perceive zoonoses in relation to their livelihoods, culture and their wider ecology. This study was carried out to explore local knowledge and perceptions on zoonoses among pastoralists in Tanzania., Methodology and Principal Findings: This study involved pastoralists in Ngorongoro district in northern Tanzania and Kibaha and Bagamoyo districts in eastern Tanzania. Qualitative methods of focus group discussions, participatory epidemiology and interviews were used. A total of 223 people were involved in the study. Among the pastoralists, there was no specific term in their local language that describes zoonosis. Pastoralists from northern Tanzania possessed a higher understanding on the existence of a number of zoonoses than their eastern districts' counterparts. Understanding of zoonoses could be categorized into two broad groups: a local syndromic framework, whereby specific symptoms of a particular illness in humans concurred with symptoms in animals, and the biomedical framework, where a case definition is supported by diagnostic tests. Some pastoralists understand the possibility of some infections that could cross over to humans from animals but harm from these are generally tolerated and are not considered as threats. A number of social and cultural practices aimed at maintaining specific cultural functions including social cohesion and rites of passage involve animal products, which present zoonotic risk., Conclusions: These findings show how zoonoses are locally understood, and how epidemiology and biomedicine are shaping pastoralists perceptions to zoonoses. Evidence is needed to understand better the true burden and impact of zoonoses in these communities. More studies are needed that seek to clarify the common understanding of zoonoses that could be used to guide effective and locally relevant interventions. Such studies should consider in their approaches the pastoralists' wider social, cultural and economic set up.

Malaria is one of the most common lethal parasitic diseases. Infection is transmitted when an infected female mosquito bites a human introducing the sporozoites into human blood. The article presents the course of pregnancy and delivery in a patient complicated by Plasmodium infection. The patient had repetitive several trips to Tanzania over a short time period before she developed the condition. She had been taking antimalarial medication (proguanil-atovaquone) in a prophylactic dose during and after her first travel to Tanzania. Following her first return to Poland she experienced infection-related symptoms.

Previous experiments have demonstrated that exposure to faces can change the perception of normality in new faces, such that faces similar to those at exposure appear more normal. Here we examined how experience influences adaptation effects in African Hadza hunter-gatherers, who have limited experience with White faces. We exposed participants to sets of either Hadza or White European faces that were manipulated to possess either wide-spaced or narrow-spaced eyes. We collected normality judgments both pre-exposure and post-exposure by showing pairs of images, one with wide-spaced and one with narrow-spaced eyes. Examining the difference between the pre-exposure and post-exposure judgments revealed that participants selected an increased number of images that were congruent with the faces to which they had been exposed. The change in normality judgments was strongest for White faces, suggesting that representations of White ethnicity faces are more malleable and less robust to adaptation, potentially because of the decreased experience that individuals had with them. A second experiment using the same test stimuli with a sample of White participants revealed equivalent adaptation effects for both Hadza and White faces. These data highlight the role of experience on the high-level visual adaptation of faces.

Objectives: The ratio between the length of the second and the length of the fourth digit (2D:4D) is sexually dimorphic such that males of many species possess a lower ratio than females, particularly in the right hand. Still, men and women often exhibit overlapping 2D:4D ranges and the ratio is highly variable between populations. In order to further explore populational variability, we chose to analyze 2D:4D in the Hadza, a population of hunter-gatherers living in Tanzania., Materials and Methods: Data were collected separately by two researchers over the course of three years (1998, 2001, 2006) from 152 adult participants (male: n = 76, female: n = 76). Independent samples t-tests were used to explore sex differences, paired samples t-tests were used to explore directional effects within each sex, and linear regression and one-way ANOVA were used to test possible age effects., Results: In none of the years, or pooled (n = 152), did we find evidence that adult men have a lower 2D:4D than adult women. If anything, the data suggest that women in this population have a significantly lower right hand 2D:4D than men (P < 0.001, d = 0.57). In contrast, left hand 2D:4D did not exhibit a sex difference (P = 0.862, d = 0.03)., Discussion: These findings challenge the current view that lower 2D:4D in men is a uniform characteristic of our species. Cross-populational variance in 2D:4D may be related to known patterns of hormonal variation resulting from both genetic and environmental mechanisms, though this relationship merits further investigation., (© 2015 Wiley Periodicals, Inc.)

Low- and middle-income countries have a high number of orphans, many of whom have unmet mental health needs. Effective mental health interventions are needed; however, it is necessary to understand how mental health symptoms and needs are perceived locally to tailor interventions and refine measurement of intervention effects. We used an existing rapid ethnographic assessment approach to identify mental health problems from the perspective of orphans and guardians to inform a subsequent randomized controlled trial of a Western-developed, evidence-based psychosocial intervention, Trauma-focused Cognitive Behavioral Therapy. Local Kiswahili-speaking interviewers conducted 73 free list interviews and 34 key informant interviews. Results identified both common cross-cultural experiences and symptoms as well as uniquely described symptoms (e.g., lacking peace, being discriminated against) not typically targeted by the intervention or included on standardized measures of intervention effects. We discuss implications for adapting mental health interventions in low- and middle-income countries and assessing effectiveness.

The distribution of the allele and genotype frequencies of polymorphic loci of serotonin receptor genes (HTR1A, rs6295; HTR2A, rs6311; HTR1B, rs6296) in Hadza (n = 197) and Datoga males (n = 230) living in Tanzania was determined. It was shown that the populations significantly differ by the frequencies of alleles and genotypes of the rs6295 locus of the HTR1A gene. The G-allele (0.779) and the genotype G/G (0.590), which are markers of increased risk of suicidal and impulsive behavior, respectively, are revealed in Hadza with high frequency. It was found that the frequency of homozygous G/G of the rs6296 locus of the HTR1B gene, which is a marker of increased risk of outward directed aggression, is higher in Datoga (0.563) than in Hadza (0.457). The allele and genotype frequencies of the rs6311 locus of the HTR2A gene do not differ among the Hadza and Datoga males. The data on the distribution of allele and genotype frequencies of the HTR1A, HTR2A, and HTR1B genes can be used to determine the associations of the identified markers with various forms of human aggressive behavior.

The androgen receptor (AR) gene polymorphism in humans is linked to aggression and may also be linked to reproduction. Here we report associations between AR gene polymorphism and aggression and reproduction in two small-scale societies in northern Tanzania (Africa)--the Hadza (monogamous foragers) and the Datoga (polygynous pastoralists). We secured self-reports of aggression and assessed genetic polymorphism of the number of CAG repeats for the AR gene for 210 Hadza men and 229 Datoga men (aged 17-70 years). We conducted structural equation modeling to identify links between AR gene polymorphism, aggression, and number of children born, and included age and ethnicity as covariates. Fewer AR CAG repeats predicted greater aggression, and Datoga men reported more aggression than did Hadza men. In addition, aggression mediated the identified negative relationship between CAG repeats and number of children born.

Aim: To examine the feasibility and potential health impact of a diabetes self-management education and support intervention involving peer support on glycaemic control and diabetes distress., Methods: A total of 41 South-Asian adults with Type 2 diabetes were recruited for a 24-week diabetes self-management education and support pilot intervention involving peer support. The intervention consisted of six weekly education sessions co-facilitated by a certified diabetes educator and two peer leaders, followed by 18 weekly support sessions facilitated by two peer leaders. Education sessions were guided entirely by participants' self-management questions and also emphasized goal setting and action planning. Support sessions were based on empowerment principles and participants discussed self-management challenges, shared emotions, asked self-management questions, problem-solved in a group, set goals, and developed and evaluated action plans. Feasibility outcomes included recruitment and retention. Primary health-related outcomes included HbA1c levels and diabetes distress (measured at baseline, 6 and 24 weeks). Programme satisfaction was also assessed., Results: Pre-established criteria for recruitment and retention were met. Paired t-tests showed no changes in HbA1c and diabetes distress at 6 weeks. At 24 weeks, HbA1c levels deteriorated [54 mmol/mol (7.1%) vs 61 mmol/mol (7.7%)] while diabetes distress scores improved (2.0 vs 1.7)., Conclusions: Although feasible, findings suggest this peer-support model may have a positive impact on diabetes distress, but not on HbA1c levels. Culturally responsive modifications (e.g. intervention location) to the pilot model are needed and could lead to more favourable health outcomes for this community. Such a re-designed peer-support model will require further investigation., (© 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.)

The Maasai of northern Tanzania, a semi-nomadic ethnic group predominantly reliant on pastoralism, face a number of challenges anticipated to have negative impacts on child health, including marginalisation, vulnerabilities to drought, substandard service provision and on-going land grabbing conflicts. Yet, stemming from a lack of appropriate national survey data, no large-scale comparative study of Maasai child health has been conducted. Savannas Forever Tanzania surveyed the health of over 3500 children from 56 villages in northern Tanzania between 2009 and 2011. The major ethnic groups sampled were the Maasai, Sukuma, Rangi, and the Meru. Using multilevel regression we compare each ethnic group on the basis of (i) measurements of child health, including anthropometric indicators of nutritional status and self-reported incidence of disease; and (ii) important proximate determinants of child health, including food insecurity, diet, breastfeeding behaviour and vaccination coverage. We then (iii) contrast households among the Maasai by the extent to which subsistence is reliant on livestock herding. Measures of both child nutritional status and disease confirm that the Maasai are substantially disadvantaged compared to neighbouring ethnic groups, Meru are relatively advantaged, and Rangi and Sukuma intermediate in most comparisons. However, Maasai children were less likely to report malaria and worm infections. Food insecurity was high throughout the study site, but particularly severe for the Maasai, and reflected in lower dietary intake of carbohydrate-rich staple foods, and fruits and vegetables. Breastfeeding was extended in the Maasai, despite higher reported consumption of cow's milk, a potential weaning food. Vaccination coverage was lowest in Maasai and Sukuma. Maasai who rely primarily on livestock herding showed signs of further disadvantage compared to Maasai relying primarily on agriculture. We discuss the potential ecological, socioeconomic, demographic and cultural factors responsible for these differences and the implications for population health research and policy.

Aim: This cross-sectional study examined whether growth parameters were associated with epilepsy in children living in a rural community in sub-Saharan Africa (SSA)., Materials and Methods: A cross-sectional study was performed in the Hai District Demographic Surveillance Site (HDSS), Tanzania in which 6-14 year old children with epilepsy (CWE) were identified. Age matched controls were randomly selected from the Hai census database for comparison. Anthropometric measurements were used to assess the nutritional status of the children and body mass index (BMI) calculated. Associations between social, demographic and nutritional factors and epilepsy were assessed using multivariable logistic regression., Results: 112 CWE were identified and were compared with 113 controls. There was no significant difference in the BMI between cases and controls (T-test, p-value of 0.117). Amongst cases, there were no significant associations between BMI and motor difficulties, antiepileptic drug use, cognitive or behavioural problems, early-onset epilepsy or seizure frequency. In the whole group, BMI was significantly associated with socio-economic status (p=0.037) and age., Discussion: There was no significant difference found between CWE and matched controls with respect to nutritional status. This suggests that there is no causal association between under nutrition and epilepsy in this community. Nutritional assessment is still important as part of the comprehensive care of CWE., (Copyright © 2014 Elsevier B.V. All rights reserved.)

A molecular-genetic study of 5-HTTLPR and the Stin2 loci of the serotonin transporter gene (5-HTTL) in males of the African ethnic populations Hadza and Datoga, which differ in the level of culturally acceptable aggression, was carried out. The distribution of allele and genotype frequencies of these two loci was established. It was shown that the frequency distribution of genotypes and alleles among Hadza and Datoga in the examined samples is practically identical by the VNTR-polymorphism of both loci. However, the Hadza populations, as compared to Datoga, showed a significant (p = 0.006) increase in the frequency of the transcriptionally less active allele L(G) of the 5-HTTLPR locus. For the first time, the structure of the allelic variant of locus Stin2 with eight repetitions (Stin2.8) is described and established for African populations. The test for independence of the frequency distribution of the alleles of the studied loci showed highly significant linkage disequilibrium among Hadza (p << 0.001) and Datoga (p = 0.021). In analysis of the genotype combinations of two loci, it was revealed that thestudied populations differed significantly by the L(A)L(G) 10/12 genotype (p << 0.001). When combining the genotypes, no significant differences between the populations based on their expression activity were identified. We assume that the identified combined genotypes reflect the effects of similar behavioral traits for both populations.

Background: The health and survival of women and their new-born babies in low income countries has been a key priority in public health since the 1990s. However, basic planning data, such as numbers of pregnancies and births, remain difficult to obtain and information is also lacking on geographic access to key services, such as facilities with skilled health workers. For maternal and newborn health and survival, planning for safer births and healthier newborns could be improved by more accurate estimations of the distributions of women of childbearing age. Moreover, subnational estimates of projected future numbers of pregnancies are needed for more effective strategies on human resources and infrastructure, while there is a need to link information on pregnancies to better information on health facilities in districts and regions so that coverage of services can be assessed., Methods: This paper outlines demographic mapping methods based on freely available data for the production of high resolution datasets depicting estimates of numbers of people, women of childbearing age, live births and pregnancies, and distribution of comprehensive EmONC facilities in four large high burden countries: Afghanistan, Bangladesh, Ethiopia and Tanzania. Satellite derived maps of settlements and land cover were constructed and used to redistribute areal census counts to produce detailed maps of the distributions of women of childbearing age. Household survey data, UN statistics and other sources on growth rates, age specific fertility rates, live births, stillbirths and abortions were then integrated to convert the population distribution datasets to gridded estimates of births and pregnancies., Results and Conclusions: These estimates, which can be produced for current, past or future years based on standard demographic projections, can provide the basis for strategic intelligence, planning services, and provide denominators for subnational indicators to track progress. The datasets produced are part of national midwifery workforce assessments conducted in collaboration with the respective Ministries of Health and the United Nations Population Fund (UNFPA) to identify disparities between population needs, health infrastructure and workforce supply. The datasets are available to the respective Ministries as part of the UNFPA programme to inform midwifery workforce planning and also publicly available through the WorldPop population mapping project.

Heterosexual anal sex is underresearched and little understood, particularly in the African context. Existing prevalence data indicate that heterosexual anal sex is a widespread practice, yet little is known about the way in which it is conceptualized and understood. Describing findings from qualitative research conducted in Kenya, Tanzania, and Uganda, we shed light on conceptualizations of heterosexual anal sex and its relation to human immunodeficiency virus (HIV). These findings suggest that penile-anal sex is practiced by men and women in Africa for a range of reasons, including virginity maintenance, contraception, fulfillment of male pleasure, relationship security, menstruation, in the presence of vaginal complications, financial gain, fidelity, and prestige. Despite anal sex being the most efficient way to transmit HIV sexually, there is widespread lack of knowledge about its risks. These findings describe the ways in which anal sex is conceptualized in five East African communities, highlighting how penile-anal intercourse is often not considered "sex" and how the omission of anal sex in safe-sex messaging is interpreted as meaning that anal sex is safe. In light of its frequency and risks, greater attention must be paid to heterosexual anal sex in Africa to ensure a comprehensive approach to HIV prevention.

HIV prevalence among young Tanzanian women is twice that of men, and risk doubles if a partner is ten or more years older. Cross-generational sex (CGS) is typified by transactions, economic asymmetries, power differentials, and inconsistent condom use. By investigating perceptions of CGS in families, schools, and communities, this study explored the role each plays in addressing or condoning CGS and where interventions are needed. Qualitative data were collected in Tanzania's Iringa and Pwani regions after a campaign to reduce CGS. Community leaders suggested key informants and provided household lists used to randomly select participants. Individual interviews were conducted with 20 women (M age = 20.7, SD = 3.1, range = 15 to 26) and 20 men (M age = 37.1, SD = 7.3, range = 30 to 56), focus groups with 15 women (M age = 20.4, SD = 2.9, range = 17 to 25) and 26 men (M age = 39.2, SD = 7.9, range = 30 to 55), and key informant focus groups with 10 women (M age = 47.6, SD = 10, range = 37 to 70) and 16 men (M age = 55.5, SD = 9.5, range = 37 to 67). CGS was viewed as detrimental to girls' education and a financial loss to parents, but barriers, including reluctance to approach parents and older men, prevented community action. Interventions may involve community leaders transcending restrictions on confronting older men and promoting communication between teachers, communities, parents, and young women regarding CGS.

This study applied the Dynamic Social Systems Model (DSSM) to the issue of HIV risk among the Maasai tribe of Tanzania, using data from a cross-sectional, cluster survey among 370 randomly selected participants from Ngorongoro and Siha Districts. A culturally appropriate survey instrument was developed to explore traditions reportedly coadunate with sexual partnership, including "wife sharing", fertility rituals, and various traditional dances. One dance, esoto, accounted for more than two thirds of participants' lifetime sexual partners (n = 10.5). The DSSM, combining structural and systems theories, was applied to systematize complex multilevel factors regarding esoto practice. Participants reported multifaceted beliefs regarding esoto; a majority viewed the dance as exciting and essential, yet most men feared social stigma and three quarters of women had experienced physical punishment for nonattendance. In multivariate logistic regression, esoto attendance was predicted by female gender (adjusted odds ratio [AOR] = 4.67, 95% confidence interval [CI] = 1.6-13.2), higher positive beliefs regarding esoto (AOR = 2.84, 95% CI = 1.9-4.2), and Maasai life cycle events (AOR = 0.06, 95% CI = 0.01-0.47). The DSSM proved useful for characterizing esoto and for revealing feedback loops that maintain esoto, thus indicating avenues for future interventions.

The present study aimed at analysing the content of fluorine (F), calcium (Ca) and magnesium (Mg) in the hair of young male students (n =52) of a secondary school in Mafinga in Tanzania (Africa) who participated in anthropological examinations. Ca and Mg concentrations were determined using atomic absorption spectrophotometer while F levels using a potentiometric method. F in the hair of boys from older group (≥16 years old; n =24) was significantly higher than in the younger group (<16 years old; n =28) versus Ca and Mg levels. High carbohydrate diet was predominant- mainly based on corn or bean and meat served once a week, with few fruit and raw vegetables. Collective catering in the dormitory reflected habits and culinary preferences at home. The lack of balanced diet, with majority of the nutritional energy supplied by easily accessible and cheap carbohydrates, was reflected in dietary deficiencies, characterised, among others, by visible skin conditions and tooth decay.

Background: Schistosomiasis is common in many African regions and poses a risk for travelers and the local population. So far, schistosomiasis in travelers or expatriates returning from the Tanzanian bank of Lake Tanganyika has not been reported., Methods: We report a group of students who sought treatment with signs of acute schistosomiasis after having returned from Lake Tanganyika, Tanzania. Information as to travel and exposure as well as clinical and laboratory data were collected., Results: Schistosomiasis was diagnosed in 8 of 16 students from Berlin, Germany, who had returned from a 2- to 3-month stay of fieldwork in Kigoma District at Lake Tanganyika, Tanzania. All 16 students reported frequent freshwater exposure at the lake. Six patients showed signs of acute schistosomiasis and had fever, and some of them also had cough, weakness, headache, or abdominal pain. Eosinophilia was present in five of the six symptomatic individuals. Notably, two serologically enzyme-linked immunosorbent assay (ELISA)-positive individuals did not report or present with symptoms or abnormal laboratory parameters. Schistosoma mansoni eggs were found in one symptomatic and one asymptomatic individual each. Blood and stool samples from the other eight individuals who were equally exposed to freshwater yielded negative results., Conclusions: This is the first report of an outbreak of acute schistosomiasis imported from the Tanzanian shore of Lake Tanganyika and highlights the risk for travelers and the local population of acquiring the infection in that part of Tanzania. It provides arguments for routine serological screening for schistosomiasis in individuals who had prior freshwater contact in endemic areas, irrespective of symptoms or other laboratory findings., (© 2013 International Society of Travel Medicine.)

We use data collected among Hadza hunter-gatherers between 2005 and 2009 to examine hypotheses about the causes and consequences of men's foraging and food sharing. We find that Hadza men foraged for a range of food types, including fruit, honey, small animals, and large game. Large game were shared not like common goods, but in ways that significantly advantaged producers' households. Food sharing and consumption data show that men channeled the foods they produced to their wives, children, and their consanguineal and affinal kin living in other households. On average, single men brought food to camp on 28% of days, married men without children at home on 31% of days, and married men with children at home on 42% of days. Married men brought fruit, the least widely shared resource, to camp significantly more often than single men. A model of the relationship between hunting success and household food consumption indicates that the best hunters provided 3-4 times the amount of food to their families than median or poor hunters. These new data fill important gaps in our knowledge of the subsistence economy of the Hadza and uphold predictions derived from the household and kin provisioning hypotheses. Key evidence and assumptions backing prior claims that Hadza hunting is largely a form of status competition were not replicated in our study. In light of this, family provisioning is a more viable explanation for why good hunters are preferred as husbands and have higher fertility than others.

Social networks show striking structural regularities, and both theory and evidence suggest that networks may have facilitated the development of large-scale cooperation in humans. Here, we characterize the social networks of the Hadza, a population of hunter-gatherers in Tanzania. We show that Hadza networks have important properties also seen in modernized social networks, including a skewed degree distribution, degree assortativity, transitivity, reciprocity, geographic decay and homophily. We demonstrate that Hadza camps exhibit high between-group and low within-group variation in public goods game donations. Network ties are also more likely between people who give the same amount, and the similarity in cooperative behaviour extends up to two degrees of separation. Social distance appears to be as important as genetic relatedness and physical proximity in explaining assortativity in cooperation. Our results suggest that certain elements of social network structure may have been present at an early point in human history. Also, early humans may have formed ties with both kin and non-kin, based in part on their tendency to cooperate. Social networks may thus have contributed to the emergence of cooperation.