Belinda J. Njiro

• Doctor of Medicine
• Researcher at Muhimbili University of Health and Allied Sciences

Background Vaccination is a cost-effective strategy to prevent infectious diseases, yet access remains limited in Tanzania’s underserved regions. Integrating vaccination services into community drug outlets (CDOs), including pharmacies and Accredited Drug Dispensing Outlets (ADDOs) offers a potential solution to expand vaccine access. This study as...

Introduction The Joint United Nations Programme on HIV/AIDS set ambitious-but-reachable targets to have 95% of HIV-positive people diagnosed, 95% on ART, and 95% virally suppressed by 2030. To address the latter, post-2016, South Africa’s HIV treatment guidelines aimed to deliver maximal and durable viral load (VL) suppression through extensive ant...

Background: The national rollout of a vaccine is a complex and significant undertaking, made more challenging when the health system is experiencing shock, such as in a pandemic. Tanzania had relative success in its COVID-19 vaccination rollout compared to other African countries. Objectives: To better understand factors that contributed to this su...

Introduction Chronic health conditions are the leading causes of morbidity and mortality worldwide, with a disproportionately high burden in low-income and middle-income countries. The burden arising from these conditions presents immense challenges to countries with dysfunctional public healthcare systems, such as South Africa. This necessitates p...

The global burden of cervical cancer, with a notable prevalence in regions like Tanzania, highlights the critical need for timely and accurate diagnosis. The scarcity of pathologists in such areas underscores the importance of developing automated tools for the cytopathological analysis of cervical cancer images to improve diagnostic efficiency and...

Background Postoperative antibiotic prophylaxis (PAP) involves using antibiotics after surgery to prevent surgical site infections (SSIs). However, studies have shown that PAP offers no additional benefits compared to discontinuation after surgical incision closure, prompting its de-implementation to prevent unnecessary antibiotic use that may cont...

Background Antimicrobial resistance (AMR) is a major public health problem affecting both current and future generations. Development of resistance to the commonly available antibiotics has been directly linked to their irrational use. The World Health Organization (WHO) has clearly stated on the Global Strategy on AMR, judicious antibiotic use as...

Alcohol consumption and harmful and hazardous drinking are significant contributors to the global burden of disease, accounting for about 3 million deaths each year globally. Owing to their stressful work environment, healthcare professionals are at a high risk of experiencing physical and mental health problems, particularly alcohol use disorders....

This systematic review collected evidence on the burden of non-communicable diseases (NCDs) among professional drivers and reported on the most common factors that increase the risk of NCDs in this specific population in low- and middle-income countries (LMICs). The protocol for this systematic review was registered in the International Prospective...

Renal diseases pose a significant burden of morbidity and mortality, particularly among People Living with HIV (PLHIV). The risks are further compounded by drug-induced renal toxicity, and the growing burden of hypertension, diabetes, and Hepatitis C infections. This study assessed the magnitude and factors associated with renal dysfunction among P...

Despite advances in HIV treatment, the burden of viral non‐suppression (VNS) remains a treatment success concern, particularly in Sub‐Saharan African (SSA) countries. We determined the prevalence and factors associated with VNS for people living with HIV (PLHIV) receiving antiretroviral therapy (ART). This review, registered with PROSPERO (CRD42023...

Cerebrospinal fluid (CSF) viral escape rarely occurs when HIV is detected in the CSF, while it is undetectable in the blood plasma or detectable in CSF at levels that exceed those in the blood plasma. We conducted this review to comprehensively synthesise its clinical presentation, diagnosis, management strategies and treatment outcomes. A review r...

Background: Non-communicable diseases (NCDs) arise from diverse risk factors with differences in the contexts and variabilities in regions and countries. Addressing such a complex challenge requires local evidence. Tanzania has been convening stakeholders every year to disseminate and discuss scientific evidence, policies, and implementation gaps,...

Objective This study aimed to document lessons learnt and best practices for scaling up an innovative emergency transportation system, drawing insights from the m-mama programme implemented in Shinyanga, Tanzania. The m-mama pilot programme was implemented in phases from 2014 to 2016 in two districts and later scaled up to include all districts in...

Background Patients with recurrent TB have an increased risk of higher mortality, lower success rate, and a relatively feeble likelihood of treatment completion than those with new-onset TB. This study aimed to assess the epidemiology of recurrent TB in Tanzania; specifically, we aim to determine the prevalence of TB recurrence and factors associat...

Background Five million people die every year from non-communicable diseases (NCDs) globally. In Tanzania, more than two-thirds of deaths are NCD-related. The country is investing in preventive and advocacy activities as well as interventions to reduce the burden. Of particular interest, the Ministry of Health (MoH) commemorates NCDs’ week using a...

Background The burden of Non-Communicable Diseases (NCDs) is rapidly increasing globally, and low- and middle-income countries (LMICs) bear the brunt of it. Tanzania is no exception. Addressing the rising burden of NCDs in this context calls for renewed efforts and commitment by various stakeholders. This paper highlights local initiatives and stra...

Background Even though trust is placed at the central point in ensuring proper functioning of the health systems, studies remain scant on how it affects both the implementation and uptake of COVID-19 response measures in low- and middle-income countries such as Tanzania. This study, therefore, explored the role of trust in the implementation and up...

Evidence on the additional benefit in treatment and recovery process among PWDUD using digital health interventions is lacking. This study aimed to describe the acceptability of using a digital intervention to increase information access for PWDUD in Tanga region, Tanzania. This study was conducted among 465 participants in Tanga, a coastal region...

Differentiated service delivery (DSD) models, such as adherence clubs (ACs), are client-centred approaches where clinically stable people living with HIV (PLHIV) meet to receive various services, including psychosocial support, brief symptoms screening, and refills of antiretroviral medications, among others. We conducted a review to assess the imp...

Background: Antibiotic prescribing should be guided by national essential medicines lists (NEMLs) and treatment guidelines; however, there are inadequate data on antibiotic utilization patterns in tertiary hospitals in Tanzania. This study aimed to determine antibiotic prescribing patterns in tertiary hospitals in Dar es Salaam, Tanzania. Methods...

In achieving the sustainable development goal 3.1, Tanzania needs substantial investment to address the three delays which responsible for most of maternal deaths. To this end, the government of Tanzania piloted a community-based emergency transport intervention to address the second delay through m-mama program. This study examined secondary data...

Foetal haemoglobin (%) and foetal cell (%) according to sickle cell status. image

Maternal mortality comprises about 10% of all deaths among women of reproductive age (15–49 years). More than 90% of such deaths occur in low- and middle-income countries (LMIC). In this study, we aimed to document lessons learnt and best practices toward sustainability of the m-mama program for reducing maternal and newborn mortality in Tanzania....

Vaccination is the most cost-effective way of preventing Coronavirus Disease 2019 (COVID-19) although there was a considerable delay in its institution in Tanzania. This study assessed health care workers’ (HCWs) self-perceived infection risk and uptake of COVID-19 vaccines. A concurrent embedded, mixed methods design was utilized to collect data a...

The novel Coronavirus disease 2019 (COVID-19) presents a major threat to public health but can be prevented by safe and effective COVID-19 vaccines. Vaccine acceptance among healthcare workers (HCWs) is essential to promote uptake. This study, aimed to determine the COVID-19 vaccination uptake and hesitancy and its associated factors among HCWs in...

Background: With the increasing numbers of people with drug use disorders (PWDUD) in Tanzania as in other parts of the world the need for innovative interventions specifically tailored for this population has increased. Tanga, a coastal region on the Northeast of Tanzania has the second highest number of PWDUD in Tanzania. Evidence on the additiona...

Background: Substance Use Disorders (SUDs) among Police Officers has been a concern to many professionals in the field of health, research and criminal justice since their work is subjected to higher levels of stress and hence more likely to use alcohol or tobacco as a coping mechanism. However, little is known about SUDs among Police Officers in...

To meet lofty human papillomavirus (HPV) immunization goals in Tanzania, the Ministry of Health integrated HPV vaccination with adolescent health services using a school-based approach. A qualitative study was conducted in June-July 2021, examining the feasibility and sustainability of an integrated service package, HPV Plus. In-depth interviews wi...

Tanzania has one of the highest cervical cancer incidence and mortality rates in sub-Saharan Africa. The Tanzanian Ministry of Health developed an integrated adolescent health program, HPV-Plus, that combines HPV vaccination with additional health services: nutritional assessments, vision screening, and vaccination for adolescent girls, and educati...

Background The emergency of antimicrobial resistance due to irrational antimicrobial use has put public health under threat. Accredited Drug Dispensing Outlets (ADDOs) play an important role in enhancing availability and accessibility of antimicrobials, however, there is a scarcity of studies assessing antimicrobial dispensing practices in these ou...

Introduction In achieving sustainable development goal 3.1, Tanzania needs substantial investment to address the persistent burden of maternal mortality. Efforts are needed to curtail the three delays which underlie most of the deaths. The government of Tanzania implemented a community-based emergency transport intervention to address the second de...

Background In 2017, Tanzania launched the National Action Plan for Antimicrobial Resistance (NAPAR), 2017–2022 and implementation of antibiotic stewardship programmes (ASPs) was one of the agendas. Since the launch of the National Action Plan, no study has been done to assess its implementation. Objectives To explore the experiences of prescribers...

Introduction: Tanzania has experienced an increase in the number of people who use drugs (PWUDs) and people who inject drugs (PWIDs). Understanding the characteristics of PWUDs is crucial to addressing the increasing burden of drug use in Tanzania. This study was set to examine drug use and its related factors among PWUDs in a North Eastern region...

Background Vaccination is the most cost-effective way of preventing COVID-19 disease although there was a considerable delay in its institution in Tanzania. This study aimed to assess healthcare workers’ (HCWs) self-perceived infection risk and uptake of COVID-19 vaccines. Methods A concurrent embedded, mixed methods research design was utilized t...

Sickle Cell Disease (SCD) is a known public health burden in sub-Saharan Africa (SSA). The manifestation of SCD starts in early childhood and if not well-managed may lead to early death (before the age of 5 years). Understanding the underlying mechanisms that influence early SCD manifestation is of great importance for early disease and interventio...

Background: Misuse of antibiotics has been associated with poor knowledge, attitude and practice (KAP). Therefore, this study aimed to assess if KAP of prescribers and dispensers could drive irrational use of antibiotics among children in Tanzania. Methods: A convergent parallel mixed-methods study design that employed quantitative and qualitati...

Background: Adherence to antiretroviral therapy (ART) is a strong determinant of virological suppression. We aimed to determine the magnitude of adherence as measured by medication possession ratio (MPR) and virological suppression with its predictors among adolescents and young adults (AYA) living with HIV on ART in Tanzania. Methods: This retrosp...

Parents are the important implementers on appropriate/inappropriate use of antibiotics, especially in the pediatric population. Limited studies have associated poor knowledge, attitude, and practice (KAP) among parents with antibiotics misuse. Therefore, this study was conducted to determine the parents’ KAP and factors associated with inappropriat...

Background A wide spread of chloroquine resistance prompted its discontinued use for treatment of uncomplicated malaria in several African countries. However, disappearances of chloroquine-resistant parasites have been reported in areas with restricted use of chloroquine. This review reports the current prevalence of chloroquine-resistant Plasmodiu...

Genetic testing and counselling is one of the approaches to reduce the high birth rate of individuals with sickle cell disease (SCD). A descriptive phenomenological approach was used to explore parents’ views on premarital genetic screening for sickle cell trait and their experiences in the care of Tanzanian children with SCD using a face-to-face i...

The presence of viral nucleic material in the circulation poses a theoretical risk of transmission through transfusion. However, little is known about the possibility of the actual transmission through transfusion or transplantation of blood products. A PROSPERO registered systematic review pooled evidence from PubMed/MEDLINE, Google Scholar and CI...

Background The WHO has classified depression as a disease of public concern. Police officers are a particular subpopulation group that is at an increased risk for mental health problems. This study examined the prevalence of depression, suicidality and associated risk factors among police officers in urban Tanzania. Aims The aim of this study was...

Background Antibiotic use requires regular monitoring to prevent emergence of antibiotic resistance. Objectives To assess antibiotic prescribing patterns at health care facilities (HCF) in Ilala district, Tanzania. Methods A 1 year retrospective study was conducted in four HCFs using WHO/International Network of Rational Use of Drugs (INRUD) core...

Background In Tanzania more than 28% of all multi-drug resistant tuberculosis (MDR-TB) cases occur in Dar es Salaam. However, information about management and clinical outcomes of patients with MDR-TB in the region is scarce, and hence the need for this study. Methods A 5-year retrospective cohort study was conducted in six centres in Dar es Salaa...

Current evidence suggests that coronavirus disease 2019 (COVID-19), caused by severe respiratory syndrome coronavirus 2 (SARS-CoV-2), is predominantly transmitted from human-to-human. However, evidence on vertical transmission and natural passive immunity among the newborns exposed to COVID-19 is scanty and varies. This poses a challenge on prevent...

Background Testing is one of the commendable measures for curbing the spread of coronavirus disease (COVID‐19). But, it should be done using the most appropriate specimen and an accurate diagnostic test such as real time reverse transcription polymerase chain reaction (qRT‐PCR). Therefore, a systematic review was conducted to determine the positive...

Background Currently, there is no doubt on human-to-human transmission of Coronavirus Disease 2019 (COVID-19). Now, the debates remain on whether, vertical transmission of Severe Respiratory Syndrome Virus 2 (SARS-CoV-2) and antibodies against the virus do exist. We therefore, conducted a systematic review to determine the immunoglobulin G and M (I...

Background: Testing is one of the commendable preventive measures against coronavirus disease (COVID_19), and needs to be done using both most appropriate specimen and an accurate diagnostic test like real time reverse transcription polymerase chain reaction (qRT_PCR). However, the detection rate of severe acute respiratory syndrome coronavirus 2 (...

Amidst the Coronavirus Disease 2019 (COVID-19) pandemic, evidence on vertical transmission and natural passive immunity among the newborns exposed to COVID-19 is scanty and varies. This pose a challenge on preventive interventions for the newborns. We conducted a systematic review to first, determine the likelihood of vertical transmission among CO...

Background: Following withdrawal and/or restricted use of chloroquine (CQ) as first line malaria treatment in many countries, studies have reported an increased number of CQ susceptible Plasmodium falciparum in several countries with subsequent dropping of CQ resistance. Since the future of malaria control and elimination is still uncertain with ri...