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This study aims to test the effectiveness of a community-based intervention (Konga model) to improve viral-load suppression in children living with human immunodeficiency virus (HIV) and enrolled in care and treatment centers in Tanzania mainland. The study will be a cluster-randomized clinical trial study designed with both intervention and control arms. The study will involve 268 children with a viral load of >1000 copies/ml who are aged between 2 and 14 years. The children will be randomly allocated into the intervention and control arms. The intervention will include three distinct activities: adherence and retention counseling, psychosocial support, and comorbidity screening (i.e. tuberculosis). The outcome of the study will be assessment of the success of the intervention to increase medication adherence with the immediate result of reducing the viral load below 1000 copies/ml. Descriptive statistics will be used to calculate the mean, median, standard deviation, and interquartile range of continuous data. We will use frequencies and percentages to summarize categorical data. As for the primary outcome (proportion of HIV-infected children with viral suppression), we will compare the proportion of successful participants in the intervention and control arms. Proportions and tests for different proportions will be used as a measure of improvement. All statistical tests will be two-sided and P < 0.05 will be considered statistically significant. [ABSTRACT FROM AUTHOR]

Childhood undernutrition is a global health challenge impacting child growth and survival rates. This deficit in nutritional status contributes to the increasing chronic disease prevalence and economic burden in individuals and throughout developing contexts. A community‐based cross‐sectional study was conducted in Arusha District of Tanzania to determine the prevalence and predictors of undernutrition in 436 children. A structured questionnaire was used to collect data on demographic and socio‐economic factors as well as feeding practices and prevalence of preventable childhood diseases. Anthropometric data were collected through the measurement of length/height and weight of all children. The prevalence of undernutrition was estimated based on Z‐scores indices below −2SD of the reference population for weight for age (underweight), height for age (stunting), and weight for height (wasting). Fifty percent, 28%, and 16.5% of the children were stunted, underweight, and wasted, respectively. The age above 2 years and being a male were associated with stunting. The age above 2 years, nonexclusive breastfeeding children, and living at Seliani and Oturumeti were associated with being underweight. Similarly, morbidity, none exclusively breastfed children, living at Oturumeti, and being born to a mother 35 years and above were associated with wasting. In this study, we found the prevalence of child undernutrition in Arusha District is high in comparison with national and regional trends and appears to be associated with being a male. It is recommended that nutritionists and health planners should focus on these key predictors when planning nutrition interventions to address the problem of undernutrition among underfive children in Arusha District. The contents of this page will be used as part of the graphical abstract of html only. It will not be published as part of main article. The prevalence of undernutrition is estimated by using anthropometric indicators: stunting, underweight, and wasting. [ABSTRACT FROM AUTHOR]

To articulate community perspectives on maternal, newborn, and child health issues, challenges, and preferred visions, the Mama Kwanza Socioeconomic Health Initiative (MKSHI), a Canadian-Tanzanian partnership, undertook a multimethod needs assessment using a community development approach. This paper reports on dialog with a cross-section of 12 health care providers and 15 stakeholders. The findings provided rich narratives on the health care context in the MKSHI Arusha and Ngorongoro service areas. Barriers to quality health care included complex socioeconomic needs, poor accessibility, providers requiring continuing education, inadequately staffed and resourced clinics, lack of service integration, and poor quality work life for providers. Ongoing community participation in MKSHI planning is required to attain preferred visions of equitable and accessible health services, knowledgeable and caring providers, and well-resourced programs. The assessment highlighted the importance of international development projects facilitating community consciousness-raising and dialog to create community partnerships that will enhance project effectiveness and sustainability. [ABSTRACT FROM AUTHOR]

This study reports on the inter-generational transmission of faith values to young children (three to six years) from the perspectives of parents, grandparents, and religion teachers. The study was conducted at two religious education centres in Dar es Salaam, Tanzania. Through a qualitative rapid ethnographic approach (interviews, focus groups, and observations), we explored the practices and challenges in realizing the practice of faith as part of children’s everyday life. Eleven themes elicited which were further reflected in three overarching trends – ‘Building the foundation – on the right path’; ‘Meeting the challenges-embedding faith’; ‘Creating a conducive environment – brining us together’. Key findings revealed that although parents were keenly interested in spiritual development of their young children, they felt challenged by time deficits, multiple priorities, and secularization. Grandparents and religious education teachers were critical of the lack of parental commitment to spiritual development, seeing themselves often becoming surrogate drivers for this imperative. In conclusion, parents requested the institutions to schedule weekly practical classes in prayer and rituals. They also indicated that grandparents’ involvement in religious education activities are enabling and supportive to the parents in nurturing children’s spirituality. As a result there is a clear indication of the role for inter-generational involvements in embedding spirituality in young children. [ABSTRACT FROM PUBLISHER]

Background: With the approaching sunset on the Millennium Development Goals (MDGs), Tanzania continues with its final national push towards achievement of MDG #4 and MDG #5. The Mama Kwanza Socio-economic Health Initiative (MKSHI) was introduced in the hope of contributing to improving maternal, newborn, and child health in Arusha and Ngorongoro. The MKSHI project is a holistic, inter-sectoral approach to maternal, newborn, and child health which aligns with the Government of Tanzania's Vision 2025. At the project onset, a baseline assessment was conducted to launch ongoing benchmarking, monitoring, and evaluation of the project's impacts and implications. The aim of this baseline assessment was twofold. First it was to determine the state of maternal, newborn, and child health in the two project sites. Second it was to ensure that a baseline of key indicators was established as well as identification of unique indicators relevant to the populations of interest. Results: The baseline study was a mixed methods approach to identify maternal, newborn, and child risk factors and indicators in the two target sites. This paper focuses on the qualitative methods and findings. The qualitative component included a series of five community dialogue meetings and thirty-seven individual/dyad interviews with women, providers, and stakeholders. Initially, community meetings were held as open dialogues on maternal, newborn, and child health issues, opportunities, and preferred futures. Individual/dyad interviews were held with women, providers, and stakeholders who held unique information or experiences. Both community dialogue and interview data was analysed for themes and guiding or critical comments. Three over-arching findings emerged: What took you so long to come? How do we know what you know? and How will it change for our daughters? Conclusions: Participant voices are vital in ensuring the achievement of local and global efforts and preferred futures for maternal, newborn, and child health services. This study contributes to the inclusion of women in all aspects of the planning, implementation, and delivery of maternal, newborn, and child health services in the target areas and beyond. [ABSTRACT FROM AUTHOR]

Background Mycobacterium yongonense is a recently described novel species belonging to Mycobacterium avium complex, which is the most prevalent aetiology of non-tuberculous mycobacteria associated with pulmonary infections, and poses tuberculosis diagnostic challenges in high-burden, resource-constrained settings. Methods Whole genome shotgun sequencing and comparative microbial genomic analyses were used to characterize the isolate from a patient diagnosed with multidrug-resistant tuberculosis (MDR-TB) after relapse. Results The genome sequence of the first case of M. yongonense ( M. yongonense RT 955-2015) in Tanzania is presented. Sequence analysis revealed that the RT 955-2015 strain had a high similarity to M. yongonense 05-1390(T) (98.74%) and Mycobacterium chimaera DSM 44623(T) (98%). Its 16S rRNA showed similarity to Mycobacterium paraintracellulare KCTC 290849(T) (100%), Mycobacterium intracellulare ATCC 13950(T) (100%), M. chimaera DSM 44623(T) (99.9%), and M. yongonense 05-1390(T) (98%). The strain exhibited a substantially different rpoB sequence to that of M. yongonense 05-1390 (95.16%), but closely related to that of M. chimaera DSM 44623(T) (99.86%), M. intracellulare ATCC 13950(T), (99.53%), and M. paraintracellulare KCTC 290849(T) (99.53%). Conclusions In light of the OrthoANI algorithm and phylogenetic analysis, it was concluded that the isolate was M. yongonense Type II genotype, which is an indication that the patient was misdiagnosed with TB/MDR-TB and received inappropriate treatment. [ABSTRACT FROM AUTHOR]