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Background: Injuries are becoming a major health problem in developing countries. Few population based studies have been carried out in African countries. We examined the pattern of nonfatal injuries and associated risk factors in an urban and rural setting of Tanzania., Methods: A population-based household survey was conducted in 2002. Participants were selected by cluster sampling. A total of 8,188 urban and 7,035 rural residents of all ages participated in the survey. All injuries reported among all household members in the year preceding the interview and resulting in one or more days of restricted activity were included in the analysis., Results: A total of 206 (2.5%) and 303 (4.3%) persons reported to have been injured in the urban and rural area respectively. Although the overall incidence was higher in the rural area, the incidence of major injuries (> or = 30 disability days) was similar in both areas. Males were at a higher risk of having an injury than females. Rural residents were more likely to experience injuries due to falls (OR = 1.6; 95% CI = 1.1 - 2.3) and cuts (OR = 4.3; 95% CI = 3.0 - 6.2) but had a lower risk of transport injuries. The most common causes of injury in the urban area were transport injuries and falls. In the rural area, cuts and stabs, of which two thirds were related to agriculture, formed the most common cause. Age was an important risk factor for certain types of injuries. Poverty levels were not significantly associated with experiencing a nonfatal injury., Conclusion: The patterns of injury differ in urban and rural areas partly as a reflection of livelihoods and infrastructure. Rural residents are at a higher overall injury risk than urban residents. This may be important in the development of injury prevention strategies.

To determine behavioural risk factors associated with human immunodeficiency virus (HIV) seropositivity among 1104 youth aged 15-24 years we conducted a cross-sectional survey in Moshi rural district in northern Tanzania. Information was obtained about sociodemographic characteristics as well as sexual and reproductive health behaviour. Anonymous blood samples were taken for HIV testing. Positive HIV antibodies were determined and confirmed by two Enzyme-Linked Immunosorbent Assays (ELISA). Of 1104 youth interviewed, 91% (1003) consented for blood specimen taking. Seven out of ten youth volunteered to have had sexual intercourse at least once in their lifetime; 60% reported to consume alcohol and 50% of the sexually experienced females reported to have received a gift for their sexual encounter. The overall HIV seroprevalence was 7.5% (75/1003); females compared to males were twice as likely to be HIV positive, 9.7% and 5% respectively. Behavioural risk factors associated with HIV seropositivity were different in male compared to female youth. Among male subjects, cigarette smoking, ever use of marijuana and having a past history of sexually transmitted diseases (STDs) were significant risk factors associated with increased risk of HIV seropositivity. On the other hand, in females, those with a past or current history of STDs, those who volunteered that they practiced oral sex and subjects with four or more lifetime sexual partners were more likely to be HIV positive than subjects without a history of an STD, those with single sexual partner or had never practiced oral sex. A four fold increased risk of HIV seropositivity was also observed among female subjects with a history of blood transfusion in the previous 10 years compared to having received none, the Odds ratio was 4.1 (95% CI = 1.5, 11.1). The profile of risk behaviour associated with HIV seropositivity calls for an urgent need to target health information and education interventions to bring about a change in behaviour among the youth and hopefully help to reduce the rate of transmission of HIV infection.

Objective: To measure age and sex specific mortality in adults (15-59 years) in one urban and two rural areas of Tanzania., Design: Reporting of all deaths occurring between 1 June 1992 and 31 May 1995., Setting: Eight branches in Dar es Salaam (Tanzania's largest city), 59 villages in Morogoro rural district (a poor rural area), and 47 villages in Hai district (a more prosperous rural area)., Subjects: 40,304 adults in Dar es Salaam, 69,964 in Hai, 50,465 in Morogoro rural., Main Outcome Measures: Mortality and probability of death between 15 and 59 years of age (45Q15)., Results: During the three year observation period a total of 4929 deaths were recorded in adults aged 15-59 years in all areas. Crude mortalities ranged from 6.1/1000/year for women in Hai to 15.9/1000/year for men in Morogoro rural. Age specific mortalities were up to 43 times higher than rates in England and Wales. Rates were higher in men at all ages in the two rural areas except in the age group 25 to 29 years in Hai and 20 to 34 years in Morogoro rural. In Dar es Salaam rates in men were higher only in the 40 to 59 year age group. The probability of death before age 60 of a 15 year old man (45Q15) was 47% in Dar es Salaam, 37% in Hai, and 58% in Morogoro; for women these figures were 45%, 26%, and 48%, respectively. (The average 45Q15s for men and women in established market economies are 15% and 7%, respectively.), Conclusion: Survivors of childhood in Tanzania continue to show high rates of mortality throughout adult life. As the health of adults is essential for the wellbeing of young and old there is an urgent need to develop policies that deal with the causes of adult mortality.