Background Unintended pregnancy at a young age can lead to poor reproductive health, social and economic outcomes. The high rate of unintended teenage pregnancies in Tanzania is indicative of inadequate availability and uptake of modern contraception. Determining trends and determinants of unmet need for modern contraception among adolescent girls and young women (AGYW) in Tanzania will help address the burden of unintended pregnancies. Methodology An analytical cross-sectional study design was conducted using secondary data from three consecutive Tanzania Demographic and Health Surveys (TDHS) 2004/05, 2010 and 2015/6. Data analysis was performed using Stata version 15.0. Data analysis considered the complex survey design. Categorical and continuous variables were summarized using descriptive statistics. Poisson regression model was used to determine factors associated with unmet need for modern contraception. Results A steady decline in unmet need for modern contraception was observed from 31.8% in 2004/05 to 27.5% in 2015/16 survey. In the multivariable analysis, higher prevalence of unmet need for modern contraception was observed among adolescents, participants with at least one live birth, from poor wealth tertile, and those sexually active during the past four weeks. Conclusion Despite declining levels, the unmet need for modern contraception among young women in Tanzania remains high. AGYW under 19 years, those from poor households, and those who are postpartum are most at risk. Greater efforts are required to meet the reproductive health needs and rights of these sub-groups of AGYW in order to facilitate uptake of modern contraceptives and therefore reducing the risk of unintended pregnancies and unmet need for modern contraception.

Background Labor induction (IOL) refers to an obstetric intervention which include artificial stimulation of uterine contraction aiming at vaginal delivery of a fetus before the onset of spontaneous labor. Despite undisputed importance of this intervention in improving pregnancy outcomes, data on its utilization and outcomes in Tanzania is limited. The aim of this study was to determine the prevalence, associated factors and outcomes for labor induction among women who were attended at a tertiary hospital in north-Tanzania. Methods We designed a retrospective cohort study and analyzed 53338 deliveries at the Kilimanjaro Christian Medical Centre (KCMC) between the year 2000 to 2015. We enrolled singleton deliveries with vertex presentation and excluded observations with missing information on induction status. Relative risk and 95% Confidence Interval for risk factors and outcomes of labor induction were estimated using log-binomial regression models. Robust variance estimation was used to account for repeated deliveries from the same subject. Results 53,338 deliveries were analyzed. Prevalence of labor induction was 21.63%. Independent risk factors for labor induction were; postdates (RR = 1.21; 95% CI: 1.15–1.28), fetal macrosomia (RR = 1.27; 95% CI: 1.18–1.36) and obesity (RR = 1.12; 95% CI: 1.06–1.18). Labor induction was associated with an increased risk of uterine rapture (RR = 1.84; 95% CI: 1.62–2.09) and low (< 7) Apgar score (RR = 1.27; 95% CI: 1.17–1.37). Labor induction offered protective effect against cesarean delivery (RR = 0.56; 95% CI: 0.53–0.58) and admission to neonatal intensive care unit (RR = 0.94; 95% CI: 0.89–0.99). Conclusion Efforts aimed at achieving the health-related sustainable development goals should focus on increasing access to effective interventions as well as improving quality of health care while being cautioned on likelihood of adverse maternal and fetal outcomes.

Background: Labor induction is among the common and widely practiced obstetric interventions aiming at achieving vaginal delivery. However, cesarean section (CS) delivery incidences have been reported following its use. This study aimed at determining the prevalence and risk factors for caesarean delivery following labor induction among women who gave birth at a tertiary hospital in north-Tanzania. Methods: A hospital-based retrospective cohort study was designed using maternally-linked data from Kilimanjaro Christian Medical Centre (KCMC) birth registry among women who gave birth to singleton babies from the year 2000 to 2015. All induced deliveries done in this period were studied. Women with multiple pregnancy, missing information on delivery mode and those with history of CS delivery were excluded. Relative risk and 95% Confidence Interval for risk factors for CS delivery following labor induction were estimated using log-binomial regression models. Robust variance estimation was used to account for repeated deliveries from the same subject. Results: A total of 1088 deliveries were analysed. The prevalence of CS following labour induction was 26.75%. Independent risk factors for CS delivery were; primiparity (RR = 1.46; 95% CI: 1.18-1.81), high birthweight (RR =1.28; 95% CI: 1.02-1.61), post-term pregnancy (RR = 1.45; 95% CI: 1.09-1.93), and urban residence (RR =1.29; 95%CI: 1.05-1.58). Conclusion: In patients undergoing labor induction, primiparity, high birthweight, post dates and urban residence were found to associate with an elevated risk of caesarean delivery. Assessment of these factors prior to labor induction intervention is warranted to reduce adverse pregnancy outcomes associated with emergency caesarean delivery.

IntroductionLow birth weight (LBW) is an important indicator of newborn survival and is associated with higher risk of infant mortality, morbidity and long term health consequences later in life. Little has been explored on the recurrence of LBW and associated risk factors in developing countries including Tanzania. Objectives and ApproachThis study aimed to determine incidence, recurrence and associated risk factors for in Northern Tanzania. Methods This was a retrospective cohort study using maternally-linked data from Kilimanjaro Christian Medical Centre (KCMC) medical birth registry. A total of 48,008 births from 8,417 women who delivered live born between 2000 and 2014 were followed for subsequent deliveries. Recurrence risk with 95% Confidence Interval for LBW and associated risk factors were estimated in a multivariate log binomial model while accounting for correlation between births of the same mother. ResultsIncidence of LBW was 7.9%. The recurrence rate of LBW was 24.9% compared with 5.9% for those who had normal birth weight babies in first pregnancy. This corresponded to a relative risk of 3.7 (95% CI: 3.10 – 4.52). Some maternal conditions in the first pregnancy were associated with increased risk of LBW in the subsequent pregnancy. These include; HIV positive status (RR 2.0; 95% CI 1.26 – 3.21), preterm birth (RR 1.2; 95% CI 1.03 – 1.63) and preeclampsia (RR 1.8; 95% CI 1.26 – 2.45). Only preeclampsia in the first pregnancy was associated with increased risk of recurrent of LBW (RR: 1.6 95% CI 1.01-2.54). Conclusion/ImplicationsAlthough the incidence of LBW is low in the study population, but the recurrence risk is high. Preeclampsia in the first pregnancy was associated with recurrent LBW. Early prenatal identification of women at risk of preeclampsia to address modifiable risk factors and counsel mothers on persisting risk factors for recurrence

Introduction Human Immunodeficiency Virus (HIV) and hepatitis B virus are prevalent infections in sub-Saharan Africa, but information on the prevalence of co-infection is limited. This study aimed to determine seroprevalence and risk factors for hepatitis B virus infection among people living with HIV receiving care and treatment at Kilimanjaro Christian Medical Centre Referral Hospital in northern Tanzania. Methods This was a cross-sectional study conducted from March to June 2015 among people living with HIV (PLWHIV) aged 15 years and above attending the Care and Treatment Clinic for routine care at Kilimanjaro Christian Medical Centre. Systematic sampling was used to select the study participants. Information on socio-demographic data, sexual behaviour and medical history were collected using a questionnaire. Hepatitis B surface antigen was diagnosed using a rapid test. Descriptive statistics were used to summarize the data. Results A total of 300 PLWHIV consented to participate in this study, of whom 62% were female. Their ages ranged from 15-75 years, with a median age of 46 years (IQR of 39-53 years). The seroprevalence of hepatitis B surface antigen among people living with HIV was 2.3% (n=7/300). A history of blood transfusion was the only factor associated with hepatitis B surface antigen infection, while other socio-demographic and clinical factors showed no association. Conclusion Hepatitis B virus infection is infrequent among PLWHIV in this setting. Despite the prevalence, we recommend routine screening for hepatitis B surface antigen and other hepatitis B virus markers among PLWHIV in order to tailor antiretroviral regimens against hepatitis B virus.