CONTEXT The implementation of integrated soil fertility management (ISFM) varies widely among farmers, from no ISFM to multiple computations of ISFM components (i.e., improved germplasm, organic resources, fertilizers, and local adaptations e.g., soil and water conservation (SWC)). There is no comprehensive report on farmers' use of ISFM components and their impact on sustainable intensification domains of productivity, economic, social, human condition, and environment and the associated variations across farmer fields and agro-ecological zones (AEZs). OBJECTIVE This study 1) evaluated the current implementation status of ISFM by farmers in relation to the various ISFM components and 2) provided multi-dimensional multi-scale evidence of ISFM implications that can guide ISFM investments within SSA contexts, with a specific focus on Tanzania. METHODS We used data collected from 1406 plots between 2013 and 2020 in semi-arid and sub-humid AEZs. The data are from farmer practices. The plots were grouped by the various combinations of ISFM components implemented and analysed using Tukey's test to examine the association of ISFM use with selected indicators within a domain. RESULTS AND CONCLUSIONS The number of ISFM components used by farmers is higher in sub-humid (1 to 4) than in semi-arid AEZ (0 to 3). Except for SWC used by 40% of farmers in both AEZs, the proportion of farmers using improved seeds (95%) and manure (55%) in the sub-humid AEZ are more than double those using these ISFM components in the semi-arid AEZ. Productivity and economic benefits increase with the number of ISFM components at the expense of higher labour demand. Increasing plot-level ISFM benefits also translate to increased household-level whole-farm income but contributions to human nutrition are unclear. The contribution to SOC by increasing ISFM is insignificant, compounded by strong effects of slope position of the field. Differential access to resources, decision-making and control rights drive the number and choice of the specific ISFM components. SIGNIFICANCE Understanding of ISFM impacts across domains is essential to guide the scaling of ISFM in Tanzania and beyond and therefore recommended in future studies.
An outbreak of severe acute respiratory syndrome (COVID-19) killed 287,355 with 4, 257,578 cases worldwide as of May 12, 2020. In this paper, we propose an S E Q I s I a R M deterministic mathematical model which contains compartments for both human-to-human transmission and transmission through contaminated surfaces. Without intervention, the role of symptomatic and asymptomatic cases in humans is found to be very high in the transmission of the virus. Sensitive parameters which are associated with increased transmission of the COVID- 19 virus were identified. According to the sensitivity results, the most sensitive parameters were disease-induced death rates of symptomatic and asymptomatic infectious people ( σ ), the rate of removal of virus from surfaces and environment ( ν ), and the rate of infection by asymptomatic infectious people ( λ 2 ) and symptomatic infectious people ( λ 1 ). The numerical results of our model confirm the sensitivity results that there are more new incidences of asymptomatic cases than symptomatic cases, which escalates the transmission of the virus in the community. Combined interventions like increasing both the rate of removal of viruses from surfaces and environment and decreasing the rate of infection in asymptomatic cases can play a significant role in reducing the average number of secondary infection ( R 0 ) to less than unity, causing COVID- 19 to die out.
Poor fecal sludge management (FSM) results in significant public health and environmental risk exposures. To understand the FSM patterns and future scenarios of Kombolcha town, qualitative and quantitative methods of data collection and the Shit Flow Diagram (SFD) data analyzing tool were used. The study showed that 75.7% of households rely on shared toilets with two and above households. Cistern flush toilets, pour/manual flush toilets, ventilated improved pit latrine, pit latrine with slab and pit latrine without slab are the main technologies practiced in the town as 2.1, 19.8, 11.1, 56.4 and 10.6 %, respectively. 98.5% of the toilet types were unlined or only partially lined. On the other hand, only 37% of households practice toilet pit or sludge tank filling up and emptying. It was also found that only 56% of fecal sludge was safely managed. The remaining 44% of excreta is disposed in a way that it poses environmental and public health risk. Thus, current fecal sludge management trend exposes the community’s health unless sanitation bye-laws and building code regulations are set to address the quality of toilet technologies that promote hygienic standards.
The present study characterizes Bemisia tabaci and Bemisia afer from cassava in eastern Democratic Republic of Congo (DRC). The Mitochondrial COI sequencing revealed the occurrence of six cassava B. tabaci mitotypes, which were designated into four haplogroups (SSA-ECA, SSA-CA, SSA2, and SSA-ESA) using KASP SNP genotyping. SSA-ECA (72%) was the most prevalent and occurred in the northern part of the surveyed area, in the Ituri and Nord/Sud-Kivu provinces, whilst SSA-CA (21%) was present in the south, primarily in Haut-Katanga. SSA-ECA was predominant in the areas of north-eastern DRC most severely affected by cassava brown streak disease and was also reported in the new outbreak area in Pweto territory, Haut-Katanga, in the south. Bemisia afer comprised two major clusters with 85.5% of samples in cluster one, while the rest were in cluster two, which has no reference sequence in GenBank. This study provides important information on the genetic diversity of B. tabaci and B. afer in eastern DRC. This knowledge will be used as a basis for further studies to understand and to identify the role of whitefly haplogroups, their population densities and consequences for virus epidemics and spread as well as leading to improved vector and virus management strategies.
Background In 2008, the government of Tanzania adopted a competency-based education and training (CBET) system to improve medical training. Yet there are still frequent observations of competency deficits among graduates, suggesting that the goal has not sufficiently been met. This study was designed to assess the underlying context of competency deficits in the health workforce in Tanzania and to provide recommendations for improvement. Methods A cross-sectional study using document analysis and focus groups was carried out in 13 training institutions that provided a diploma course in clinical medicine. The research team assessed availability and adequacy of instructors, physical resources and the process and systemic factors that impact curriculum implementation outcomes. Results Six (46%) institutions had 75% or more of their teaching staff not trained in curriculum delivery and instructional methods. Seven (54%) institutions had lower instructor-students ratio than recommended (1:25). Overall, the full-time instructors in all institutions constituted only 44% of the teaching staff. Although all institutions had an adequate number of classrooms, the rooms were of small size with dilapidated walls, and had inadequate number of desks/ seats for students. Clinical skills laboratories existed in 11 (85%) institutions, but the majority were of small size, and were not fully equipped as per guidelines and were rarely used. Libraries were available in 12 (92%) institutions but five had seating capacities of 10% or less of the available students. Participants of focus group discussion in the majority of the institutions reported inadequate time allocated for practice and support from the clinical instructors at the practicum sites. Six (46%) institutions had no functioning governing/advisory boards and five (38%) lacked quality assurance policies and implementation plans. Conclusions Currently, health-training institutions in Tanzania are ill-equipped to produce competent clinicians because of major gaps in the structural, process and systemic components. These findings call for major investment to facilitate production of a competent health workforce.
This is the protocol for a Campbell systematic review. The objective of this systematic review is to assess the effectiveness of interventions with gender transformative approach (GTA) components in improving women's empowerment in low‐ and middle‐income countries, and to curate evidence on the mechanisms through which GTA works to improve women's empowerment in agriculture.
Background: The gut microbiota (GM) plays an important role in human health and is being investigated as a possible target for new therapies. Although there are many studies showing that emodin can improve host health, emodin-GM studies are scarce. Here, the effects of emodin on the GM were investigated in vitro and in vivo. Results: In vitro single bacteria cultivation showed that emodin stimulated the growth of beneficial bacteria Akkermansia, Clostridium, Roseburia, and Ruminococcus but inhibited major gut enterotypes (Bacteroides and Prevotella). Microbial community analysis from a synthetic gut microbiome model through co-culture indicated the consistent GM change by emodin. Interestingly, emodin stimulated Clostridium and Ruminococcus (which are related to Roseburia and Faecalibacterium) in a mice experiment and induced anti-inflammatory immune cells, which may correlate with its impact on specific gut bacteria. Conclusion: Emodin (i) showed similar GM changes in monoculture, co-culture, and in an in vivo mice experiment and (ii) simulated regulatory T-cell immune responses in vivo. This suggest that emodin may be used to modulate the GM and improve health. © 2022 Society of Chemical Industry.
Management of groundwater systems is indispensable to countries that depend on groundwater as the primary source of community water supply (e.g. Dodoma, Tanzania). Urbanization and industrialization lead to groundwater over-pumping and reduced recharge zones in the basin. This study used Remote Sensing and geospatial datasets to determine the groundwater recharge zones (GWRZ) followed by sensitivity analysis to identify the influence of geologic and hydrologic factors on the variation of the GWRZ in the case of the Makutupora basin, Tanzania. The implementation of weighted overlay analysis aimed to determine the GWRZ using different thematic maps created from land use land cover (LULC), drainage density, lithology, lineament density, rainfall, slope and soil datasets. The analytical hierarchy process (AHP) and multi-influencing factor (MIF) are the multi-criteria decision analysis (MCDA) implemented to assign weights to the selected influencing factors. Either, the map removal method was implemented for the sensitivity analysis. Pumping wells were overlaid to validate the GWRZ map determined. The overlay of seven thematic maps resulted in the GWRZ map being categorized as good (35.79% for AHP and 21.68% for MIF), moderate (40.98% for AHP and 58.39% for MIF) and poor (23.22% for AHP and 19.95% for MIF). Good recharge potential areas lie in an area characterized by thick forest, high lineament and water bodies around the northwestern and central-eastern side of the basin. Validation of GWRZ indicated that 33.33% for AHP and 30% for MIF are in good GWRZ, 41.6% for AHP and 28% for MIF are in moderate GWRZ and 25% for AHP and 42% for MIF are in poor GWRZ. The sensitivity analysis revealed the high effect of GWRZ on the removal of the LULC, lithology and lineament thematic layer in both AHP and MIF-generated GWRZ maps. This implies that the expansion of settlements is not considering recharge zone protection. Lineaments are also a very important factor governing groundwater recharge which needs to be protected. The result displays that urbanization dramatically reduced the potential area for groundwater recharge. Protecting the potential recharge zone from any activity that reduces the recharge is vital for the sustainability of groundwater.
The study was conducted to evaluate the performance of the Selamko small-scale irrigation scheme using internal and external performance indicators. The irrigation scheme command area was 63 ha and during the study season, the irrigated area was 42 ha. Overall activities in the primary data collected included: field observation, discharge measurements in the canals, soil moisture before irrigation and after irrigation, depth of water applied at the field, and interviewing beneficiary farmers. Secondary data was collected from secondary sources that were the South Gondar Small Scale Irrigation coordination office, SGBoWR, and WUA of the scheme. In order to evaluate the irrigation water and use efficiency of the scheme, nine farmer fields were selected from the scheme concerning their location: at the head, middle, and tail end water users. The internal process indicators which include conveyance efficiency and application efficiency were used to evaluate the performance of the scheme. From the analyses of internal performance indicators, the conveyance efficiencies were found to be 9% in the main canal, 57.09 at secondary canal 1, and 54.55% at secondary canal 2. The canals supply less water than the demand of the delivery points. And the application efficiencies were estimated to be 56.994%. The overall efficiency was 35.268%. The output per command area has to be calculated as 60,198.14 Birr/ha and 89,738.1 Birr/ha during the 2017 and 2016 irrigation seasons, respectively. The output per cropped area was estimated as 90,297.62 Birr/ha and 99,621.1 Birr/ha in the 2017 and 2016 irrigation seasons, respectively. The output per water consumed has to be determined as 17.66 Birr/m3 and 20.14 Birr/m3 in the 2017 and 2016 irrigation seasons, respectively. The water supply and irrigation supply were found as 1.71 and 1.47, respectively. From the analysis of the physical performance of the scheme, during the study period, the irrigation ratio of the scheme was 66.67%, and the sustainability of the scheme was 62.69% but in the 2016 irrigation season, the irrigation ratio was 84.7% and sustainability of the scheme was 90.08%. During the study period, the total effectiveness of the scheme infrastructure was 20.69%. It displayed that high system maintenance is required. Generally, the performance of the irrigation scheme is poor. Therefore, scheme monitoring, capacity building of the users and the water user associations, providing the flow control measurement structures, and adequate operation and maintenance of the system are required to improve the irrigation scheme performance.
The fast advancement of biomedical research technology has expanded and enhanced the spectrum of diagnostic instruments. Various research groups have found optical imaging, ultrasonic imaging, and magnetic resonance imaging to create multifunctional devices that are critical for biomedical activities. Multispectral photoacoustic imaging that integrates the ideas of optical and ultrasonic technologies is one of the most essential instruments. At the same time, early cancer identification is becoming increasingly important in order to minimize fatality. Deep learning (DL) techniques have recently advanced to the point where they can be used to diagnose and classify cancer using biological images. This paper describes a hybrid optimization method that combines in-depth transfer learning-based cancer detection with multispectral photoacoustic imaging. The goal of the PS-ACO-RNN approach is to use ultrasound images to detect and classify the presence of cancer. Bilateral filtration (BF) is often used as a noise removal approach in image processing. In addition, lightweight LEDNet models are used to separate the biological images. A feature extractor with particle swarm with ant colony optimization (PS-ACO) paradigm can also be used. Finally, biological images assign appropriate class labels using a recurrent neural network (RNN) model. The effectiveness of the PS-ACO-RNN technique is verified using a benchmark database, and test results show that the PS-ACO-RNN approach works better than current approaches.
Official air quality (AQ) stations are sporadically located in cities to monitor the anthropogenic pollutant levels. Consequently, their data cannot be used for further locations to estimate hidden changes in AQ and local emissions. Low-cost sensors (LCSs) of particulate matter (PM) in a network can help in solving this problem. However, the applicability of LCSs in terms of analytical performance requires careful evaluation. In this study, two types of pocket-size LCSs were tested at urban, suburban and background sites in Budapest, Hungary, to monitor PM1, PM2.5, PM10, and microclimatic parameters at high resolutions (1 s to 5 min). These devices utilize the method of laser irradiation and multi-angle light scattering on air-suspended particulates. A research-grade AQ monitor was applied as a reference. The LCSs showed acceptable accuracy for PM species in indoor/outdoor air even without calibration. Low PM readings (<10 μg/m3) were generally handicapped by higher bias, even between sensors of the same type. The relative humidity (RH) slightly affected the PM readings of LCSs at RHs higher than 85%, necessitating field calibration. The air quality index was calculated to classify the extent of air pollution and to make predictions for human health effects. The LCSs were useful for detecting peaks stemming from emissions of motor vehicular traffic and residential cooking/heating activities.
Background: Notwithstanding the availability of effective treatments, asymptomatic nature and the interminable treatment length, adherence to medication remains a substantial challenge among patients with hypertension. Suboptimal adherence to BP-lowering agents is a growing global concern that is associated with the substantial worsening of disease, increased service utilization and health-care cost escalation. This study aimed to explore medication adherence and its associated factors among hypertension outpatients attending a tertiary-level cardiovascular hospital in Tanzania. Methods: The pill count adherence ratio (PCAR) was used to compute adherence rate. In descriptive analyses, adherence was dichotomized and consumption of less than 80% of the prescribed medications was used to denote poor adherence. Logistic regression analyses was used to determine factors associated with adherence. Results: A total of 849 outpatients taking antihypertensive drugs for ≥1 month prior to recruitment were randomly enrolled in this study. The mean age was 59.9 years and about two-thirds were females. Overall, a total of 653 (76.9%) participants had good adherence and 367 (43.2%) had their blood pressure controlled. Multivariate logistic regression analysis showed; lack of a health insurance (OR 0.5, 95% CI 0.3-0.7, p<0.01), last BP measurement >1 week (OR 0.6, 95% CI 0.4-0.8, p<0.01), last clinic attendance >1 month (OR 0.4, 95% CI 0.3-0.6, p<0.001), frequent unavailability of drugs (OR 0.6, 95% CI 0.3-0.9, p = 0.03), running out of medication before the next appointment (OR 0.6, 95% CI 0.4-0.9, p = 0.01) and stopping medications when asymptomatic (OR 0.6, 95% CI 0.4-0.8, p<0.001) to be independent associated factors for poor adherence. Conclusion: A substantial proportion of hypertensive outpatients in this tertiary-level setting had good medication adherence. Nonetheless, observed suboptimal blood pressure control regardless of a fairly satisfactory adherence rate suggests that lifestyle modification plays a central role in hypertension management.
Background Large vessel ischemic strokes account for more than one-third of all strokes associated with substantial morbidity and mortality without early intervention. The incidence of large vessel occlusion (LVO) is not known in sub-Saharan Africa (SSA). Definitive vessel imaging is not routinely available in resource-limited settings. Aims We aimed to investigate the burden and outcomes of presumed LVO among patients with ischemic stroke admitted to a large tertiary academic hospital in Tanzania. Methods This cohort study recruited all consenting first-ever ischemic stroke participants admitted at a tertiary hospital in Tanzania. Demographic data were recorded, and participants were followed up to 1 year using the modified Rankin Scale (mRS). A diagnosis of presumed LVO was made by a diagnostic neuroradiologist and interventional neurologist based on contiguous ischemic changes in a pattern consistent with proximal LVO on a non-contrast computed tomography head. We examined factors associated with presumed LVO using logistic regression analysis. Inter-observer Kappa was calculated. Results We enrolled 158 first-ever ischemic strokes over 8 months with a mean age of 59.7 years. Presumed LVO accounted for 39.2% [95% confidence interval (CI) 31.6–47.3%] and an overall meantime from the onset of stroke symptoms to hospital arrival was 1.74 days. Participants with presumed LVO were more likely to involve the middle cerebral artery (MCA) territory (70.9%), p < 0.0001. Independent factors on multivariate analysis associated with presumed LVO were hypertension [adjusted odds ratio (aOR) 5. 74 (95% CI: 1.74–18.9)] and increased waist-hip ratio [aOR 7.20 (95% CI: 1.83–28.2)]. One-year mortality in presumed LVO was 80% when compared with 73.1% in participants without presumed LVO. The Cohen's Kappa inter-observer reliability between the diagnostic neuroradiologist and interventional neurologist was 0.847. Conclusion There is a high burden of presumed LVO associated with high rates of 1-year morbidity and mortality at a tertiary academic hospital in Tanzania. Efforts are needed to confirm these findings with definitive vessel imaging, promoting cost-effective preventive strategies to reduce the burden of non-communicable diseases (NCDs), and a call for adopting endovascular therapies to reduce morbidity and mortality.
Since the early 2000s, digital soil maps have been successfully used for various applications, including precision agriculture, environmental assessments and land use management. Globally, however, there are large disparities in the availability of soil data on which digital soil mapping (DSM) models can be fitted. Several studies attempted to transfer a DSM model fitted from an area with a well-developed soil database to map the soil in areas with low sampling density. This usually is a challenging task because two areas have hardly ever the same soil-forming factors in two different regions of the world. In this study, we aim to determine whether finding homosoils (i.e. locations sharing similar soil-forming factors) can help transferring soil information by means of a DSM model extrapolation. We hypothesize that within areas in the world considered as homosoils, one can leverage on areas with high sampling density and fit a DSM model, which can then be extrapolated geographically to an area with little or no data. We collected publicly available soil data for clay, silt, sand, OC, pH and total N within our study area in Mali, West Africa, and its homosoils. We fitted a regression tree model between the soil properties and environmental covariates of the homosoils, and applied this model to our study area in Mali. Several calibration and validation strategies were explored. We also compared our approach with existing maps made at a global and a continental scale. We concluded that geographic model extrapolation within homosoils was possible, but that model accuracy dramatically improved when local data were included in the calibration dataset. The maps produced from models fitted with data from homosoils were more accurate than existing products for this study area, for three (silt, sand, pH) out of six soil properties. This study would be relevant to areas with very little or no soil data to carry critical soils and environmental risk assessments at a regional level.
The Covid-19 (corona virus) disruptions have necessitated a new way of thinking about how entrepreneurship and its environments (ecosystems) function in times of heightened uncertainty. Based on a sample of 237 entrepreneurial ecosystem (EE) stakeholders in Tanzania – an emerging economy, we examine the pandemic economic consequences steered by government countermeasures on the EE-perceived quality and performance. We further examined the role played by EE stakeholders` engagement, collaboration, and support during the crisis. Our structural equation model results suggest that strictness of government counter measures for containment of the current pandemic predicament has a bearing on EE- perceived quality and performance by fueling EE vulnerability via amplifying the magnitude of the negative effects. We further find that stakeholders` engagement and collaboration play a significant role in improving the EE-perceived quality and slowing down EE-vulnerability. We conclude by providing the implications and avenues for future research.
Floods have destroyed people's lives as well as social and environmental assets. Flooding is becoming more severe and frequent as a result of climate change and an increase in human-induced land-use changes, which puts pressure on river channels and causes changes in river morphology. The study was aimed to assess flood danger and map inundation areas in Ethiopia's Teji watershed, which is prone to flooding. The basic flood-producing factors in this study were derived from soil, slope, elevation, drainage-density and land use land cover data. The opinions of public institutions and expert decisions were gathered to determine the weight of the factors in the analytic hierarchy process. The collected data were processed using the ArcGIS environment and the analytic hierarchy method to produce a flood danger map. According to the findings of this study, approximately 43.28 and 13.09% of the area were vulnerable to high and very high flood risk zones, respectively. As a result, flood prediction, early warning and management practices could be implemented on a regular and sustainable basis.
Objective: To assess the association between lifestyle and COVID-19 vaccine hesitancy among Chinese adults and provide recommendations for increasing vaccination rates. Methods: From August 6, 2021 to August 9, 2021, we recruited 29,925 participants from 31 Chinese provinces via an online questionnaire. We designed a question to assess COVID-19 vaccine hesitancy and used 16 items to assess lifestyle by calculating lifestyle scores. Odds ratios (OR) with 95 % confidence intervals (CI) were used to estimate the association by using binary logistic regression models. Results: The overall prevalence of COVID-19 vaccine hesitancy was 8.40 % (95 % CI: 8.09-8.72), and the median lifestyle score was 65.00 (interquartile range: 59.00-71.00). After adjusting for potential confounders, the COVID-19 vaccine hesitancy rate decreased significantly with an increase in lifestyle score (P for Trend <0.001). Low COVID-19 vaccine hesitancy rate was associated with lifestyle factors including adequate sleep, never smoking, intermittent drinking, good relationships, working and studying, using hand sanitizer, wearing masks, less gathering activities, and keeping social distance (P < 0.05). Conclusion: Our findings indicate that high lifestyle score is associated with low vaccine hesitancy rate among Chinese. The government should view the smokers (or the drinkers) as the key to further boosting the vaccination rate. In addition, the publicity and education about wearing masks and keeping social distance should be prioritized.
Background : Bacteria colonizing the nasopharynx play a key role as gatekeepers of respiratory health. Yet, dynamics of early life nasopharyngeal (NP) bacterial profiles remain understudied in low-and-middle-income countries (LMICs), where children have a high prevalence of risk factors for lower respiratory tract infection. We investigated longitudinal changes in NP bacterial profiles, and associated exposures, among healthy infants from low-income households in South Africa. Methods : We used short fragment (V4 region) 16S rRNA gene amplicon sequencing to characterise NP bacterial profiles from 103 infants in a South African birth cohort, at monthly intervals from birth through the first 12 months of life and six-monthly thereafter until 30 months. Results: Corynebacterium and Staphylococcus were dominant colonizers at one month of life, however these were rapidly replaced by Moraxella- or Haemophilus -dominated profiles by four months. This succession was almost universal, and largely independent of a broad range of exposures Warm weather (summer), lower gestational age, maternal smoking, no day-care attendance, antibiotic exposure, or low height-for-age z score at 12 months were associated with higher alpha and beta diversity. Summer was also associated with higher relative abundances of Staphylococcus , Streptococcus , Neisseria or anaerobic gram-negative bacteria, whilst spring and winter were associated with higher relative abundances of Haemophilus or Corynebacterium , respectively. Maternal smoking was associated with higher relative abundances of Porphyromonas . Antibiotic therapy (or isoniazid prophylaxis for tuberculosis) was associated with higher relative abundance of anerobic taxa ( Porphyromonas , Fusobacterium and Prevotella ) and with lower relative abundances of health associated-taxa Corynebacterium and Dolosigranulum . HIV-exposure was associated with higher relative abundances of Klebsiella or Veillonella and lower relative abundances of an unclassified genus within the family Lachnospiraceae. Conclusions: In this intensively sampled cohort there was rapid and predictable replacement of early profiles dominated by health-associated Corynebacterium and Dolosigranulum with those dominated by Moraxella and Haemophilus , independent of exposures. Season and antibiotic exposure were key determinants of NP bacterial profiles. Understudied but highly prevalent exposures prevalent in LMICs, including maternal smoking and HIV-exposure, were associated with NP bacterial profiles.
Objective: People living with HIV/AIDS (PLHA) are experiencing growing co-morbidities due to an increase in life expectancy and the use of long-term antiretroviral therapy (ART). The lack of integrated non-communicable diseases (NCDs) screening and management at the HIV care and treatment centers (CTCs) make it difficult to determine the trends of NCD co-morbidity among patients with HIV. This study aimed to assess the burden and determinants of common NCDs, including depression among patients with HIV. Methods: Analytical cross-sectional study of 1,318 HIV patients enrolled using systematic random sampling conducted from April to November 2020. Five large CTCs in district referral hospitals were selected representing the five districts of Dar es Salaam including Mwananyamala, Temeke, and Amana regional referral hospitals and Sinza and Vijibweni hospitals. The study population consisted of adult PLHA aged 18 years and above. The primary outcome measure was the prevalence of NCDs among HIV patients. Observation of actual NCD medications or their purchase receipts or booked NCD clinic appointments that PLHA had during the study period was used to verify the reported presence of NCDs. The secondary outcome measure was the prevalence of probable depression among PLHA. The locally validated Swahili Patient Health Questionnaire (PHQ-9) was used to screen for depressive symptom severity. A logistic regression model was used to identify factors associated with common NCDs and those associated with probable depression. Potential risk factors that were statistically significant at a p-value of 0.2 or less in univariable analysis were included as potential confounders in multivariable models. Results: The median age of participants was 42 (IQR 35-49) years, with 32.7% in the 36 - 45 years age group. The majority of patients were women (69%). Most (80.5%) had achieved HIV viral (VL) suppression (a serum HIV VL of <1000 copies/ml). Overall, 14.3% of self-reported an NCD with evidence of their current medication for the NCD from receipts for medication purchased and appointments from NCD clinics they attended. In the multivariable analyses, higher odds of NCDs were in older patients (> 45 years) and those with a weight above 75kg (p < 0.05). Male patients had 51% reduced odds of NCDs (aOR 0.49; 95% CI 0.32 - 0.74) than females (p <0.001). Probable depression prevalence was 11.8%, and depressed patients had more than twice the odds of having NCDs than those without depression (aOR 2.26; 95% CI 1.45 - 3.51; p <0.001). Conclusion: This study determined co-existing previously diagnosed NCDs among PLHA accessing care and high levels of depressive symptom severity. We recommend additional research on the feasibility, acceptability, and cost implications of screening and treating NCDs on HIV care platforms to provide evidence for Tanzania's integrated HIV/NCD care model.
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