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Cancer-related stigma impacts patients' emotional health, care engagement, and cancer outcomes, but few measures of cancer stigma exist. We culturally adapted and assessed psychometric properties of the Cataldo Cancer Stigma Scale (CCSS) in Tanzania. We administered the CCSS short version (21 items), plus 12 locally-derived items, to 146 adult cancer patients. We conducted exploratory factor analysis, examined internal consistency/reliability, and assessed convergent validity with relevant measures. We identified a 17-item cancer stigma scale with strong psychometric properties and four subscales: enacted stigma, shame and blame, internalized stigma, and disclosure concerns. Stigma was rare except for disclosure concerns. Stigma was positively associated with depression and anxiety and negatively associated with social support, quality of life, and illness acceptance. The scale provides valid, culturally-informed measurement of cancer stigma in Tanzania. Future studies should assess associations with care engagement, which will inform interventions to reduce stigma and improve outcomes. [ABSTRACT FROM AUTHOR]

Objective: Suicidal ideation is strikingly common among people living with HIV (PLWH) worldwide, leading to higher burden of disease, poor HIV care engagement, and loss of life. In low- and middle-income countries such as Tanzania, mental health resources are scarce, requiring innovative strategies for treatment. We describe the protocol for a clinical trial of a three-session telehealth counseling intervention to reduce suicidality and improve HIV care engagement in Tanzania. Methods: In a pilot randomized controlled trial, we will assess the feasibility, acceptability, and potential efficacy of a new telehealth intervention, termed "IDEAS for Hope". A total of 60 PLWH will be enrolled from two HIV clinics in the Kilimanjaro region and connected to telehealth counsellors based at a large regional hospital. Participants will be ≥18 years old and speak either Kiswahili or English. Patient screening will occur during routine HIV clinical care to identify PLWH experiencing suicidal ideation. Baseline surveys will be administered upon enrollment and participants will be randomized 1:1 to receive either IDEAS for Hope or the comparison condition, a brief safety planning session. All participants will receive an additional referral for psychiatric treatment. Follow-up assessment will occur at three months. IDEAS for Hope is informed by a Motivational Interviewing-enhanced safety planning intervention (MI-SafeCope) and our formative work in Tanzania. The model consists of Four Pillars: living healthy with HIV, managing HIV stigma, seeking social support, and meeting basic needs. Together, these mechanisms serve as a foundation for developing a sense of safety and hope for the future. Outcome measures will include intervention feasibility, acceptability, participant suicidality, and HIV care engagement. Significance: Innovative, telehealth-based counseling represents a promising treatment for suicidality among PLWH in low-resource settings. Results from this pilot trial will inform intervention refinement and parameter estimates for a future clinical trial powered to evaluate effectiveness. [ABSTRACT FROM AUTHOR]

In Tanzania, there are high rates of suicidal thoughts and behavior among people living with HIV (PLWH), yet few instruments exist for effective screening and referral. To address this gap, we developed and validated Swahili translations of the Columbia Suicide Severity Rating Scale (CSSRS) Screen Version and two accompanying scales assessing self-efficacy to avoid suicidal action and reasons for living. We administered a structured survey to 80 PLWH attending two HIV clinics in Moshi, Tanzania. Factor analysis of the items revealed four subscales: suicide intensity, selfefficacy to avoid suicide, fear and social concern about suicide, and family and spirituality deterrents to suicide. The area under the receiver operating curve showed only suicide intensity, and fear and social concern met the prespecified cutoff of ≥0.7 in accurately identifying patients with a plan and intent to act on suicidal thoughts. This study provides early evidence that brief screening of intensity of suicidality in the past month, assessed by the C-SSRS Screen Version, is a strong, resourceefficient strategy for identifying suicide risk in the Tanzanian setting. Patients who report little fear of dying and low concern about social perceptions of suicide may also be at increased risk. [ABSTRACT FROM AUTHOR]

Background: The Corona virus disease 2019 (COVID-19) pandemic has led to unprecedented hazards to mental health globally in different sectors with increased in anxiety, worries, stress, and fear in the communities. This study aimed to explore the impact of COVID 19 disease on mental health in the United Republic of Tanzania. Methods: The cross-sectional study was carried out in the districts of Chakechake, Mjini Magharibi, and Ilala in the United Republic of Tanzania. Qualitative study was done using a combination of key informant interviews, focus group discussions with health workers, and semi-structured interviews with community members and central and local government officials. Results: Findings have revealed that during the COVID19, people experienced different levels of stress, stigma, depression, and anxiety preceded by fear and worries. These were mainly due to restrictions on religious practice which interfered people's serenity hence causing psychological instability, fear of health-seeking and medical attention at the health facilities. Social isolation and stigma for health workers, fear, and panic of contracting and dying from the COVID-19, lack of medical supplies and heavy workload to health-care workers exacerbated mental health fear and stress. Government leaders and the community implemented coping mechanisms such religious guidance and inspiration, increasing the availability of medical products and workforce, and using local remedies for COVID19 prevention and treatment. Conclusion: Stress, stigma, depression, and anxiety during COVID 19 restrictions affected mental health. Ongoing psychological support in the community and for health workers who are the frontline soldiers should be one of the priorities to support coping with fear and worries. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) has contributed to massive disturbances on people's economic, social, and cultural aspects. Such experiences were brought by the pandemic itself, but also by the policy measures put in place to contain the transmission of the disease. Objective: To assess the impacts of the COVID-19 pandemic on social and economic lives in Tanzania. Methods: The cross-sectional study was conducted in Mjini Magharibi, Chake and Ilala districts in the United Republic of Tanzania. The study employed a qualitative design combining focus group discussions, in-depth interviews and semi-structured interviews with community members, leaders, and government officials. Data were analysed using thematic analysis approach. Results: The main impact of COVID-19 was on businesses and trade, with loss of wage earnings due to a reduction in tourism activities and reduction of essential goods for trade flow from abroad. This, in turn, affected people's purchasing power to fend for themselves, causing food insecurity at the household level. Trade and trading were affected due to the rising prices of essential goods. Restrictions imposed on gatherings created an atmosphere of fear that affected social life and harmed traditional forms of support in times of need. They included participation in religious gatherings, caring for the old and sick, traditional, and religious support during bereavement and burial of suspected COVID-19 deaths. The presentation also discusses how some community members adapted and persevered during the pandemic. Conclusions: The findings from this study have highlighted the impacts COVID-19 pandemic on social and economic life among Tanzanians as a result of implementation of its control measures. In the future, we recommend support programs to vulnerable households such as food or financial support during outbreaks. The control of essential goods' prices to shield poor households from falling further into poverty should also be considered. [ABSTRACT FROM AUTHOR]

In Tanzania, there are high rates of suicidal thoughts and behavior among people living with HIV (PLWH), yet few instruments exist for effective screening and referral. To address this gap, we developed and validated Swahili translations of the Columbia Suicide Severity Rating Scale (C-SSRS) Screen Version and two accompanying scales assessing self-efficacy to avoid suicidal action and reasons for living. We administered a structured survey to 80 PLWH attending two HIV clinics in Moshi, Tanzania. Factor analysis of the items revealed four subscales: suicide intensity, self-efficacy to avoid suicide, fear and social concern about suicide, and family and spirituality deterrents to suicide. The area under the receiver operating curve showed only suicide intensity, and fear and social concern met the prespecified cutoff of ≥0.7 in accurately identifying patients with a plan and intent to act on suicidal thoughts. This study provides early evidence that brief screening of intensity of suicidality in the past month, assessed by the C-SSRS Screen Version, is a strong, resource-efficient strategy for identifying suicide risk in the Tanzanian setting. Patients who report little fear of dying and low concern about social perceptions of suicide may also be at increased risk., Competing Interests: The authors declare none., (© The Author(s) 2023.)