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Summary: Background & aims: The world is experiencing steady increasing in both number of cases and prevalence of diabetes with urban settings being more affected areas. Good adherence to dietary management is a key non-pharmacological management for effective management of blood glucose for people living with type 2 diabetes. For effective glycemic control, people with diabetes are recommended to eat less carbohydrates (quarter plate size), more fruits and vegetables (half plate size) and more lean protein (quarter plate size). This study aims to assess the consumption patterns of grains/cereals, vegetable and fruits and its association with glycemic control among people living with diabetes. Materials & Methods: The study design was a cross sectional among outpatients attending routine diabetic clinics. Structured questionnaire was used to collect information from the patient through face to face interview. Demographic information, dietary history and selected medical history were collected from patients. Data analysis was done by running the frequencies, percentages, chi-square test and logistics regression at 95% confidence interval. Results: About 109 (33.1%) of respondents were aged less than 40 years. One hundred and fifty-two respondents had been living with diabetes for less than past 5 years 152 (46.2%). More than 80% of the respondents had uncontrolled glycemic. Daily consumption patterns of grains/cereals food were (90.0%), vegetables (97.3%) and fruits (33.4%). Plate portion size consumed were; ≤¼ for grains/cereals (50.5%), ≥¼ for vegetables (96.4%) and ≥¼ for fruits (30.7%). The most types of food consumed were legumes (85.1%), whole grains/cereals (57.1%), leafy green vegetables (70.2%) and low GI fruits (59.9%). The odds of having hyperglycaemia were; increasing with increase in portion size of grains/cereals food (ref: one fifth; one quarter, AOR = 10.22; one third, AOR = 47.19; one half or more, AOR = 42.91); increasing with consumption of high GI fruits (AOR = 2.40) and decreasing with increase in portion size of fruits (AOR = 3.13). Conclusion: Grains/cereals, vegetables and fruits consumption pattern among patient with type 2 diabetes need to improve to achieve optimal blood glucose. Reducing staples portion sizes (grains/cereals), increases portion size for mixed fruits, eating whole grains/cereals and choosing of low GI fruits may help to curb the severity of hyperglycemia among patients with T2DM.

Background The United Republic of Tanzania has had a 41.4% mortality rate in the intensive care unit. In Tanzania, the Ministry of Health and Social Welfare has implemented quality improvement (QI), yet the Tanzanian health sector continues to face resource constraints, unsustainable projects and gaps in knowledge and skills, contributing to unacceptably high mortality rates for Tanzanian patients. This research aims to determine if a Critical Care Training Program incorporating QI concepts can improve technical competence and self-efficacy of providers in a critical care setting in Tanzania.Methods A 2-day Critical Care Training Program was developed for providers. It included the following modules: vital signs directed therapy (VSDT), cardiopulmonary and brain resuscitation (CPBR), blood glucose monitoring, introduction to critical care concepts and the QI concept of change management. For analysis, data were collected from pretests and post-tests and reported in REDCap. Descriptive statistics and paired t-tests were performed (alpha=0.05).Results A total of 77 nurses and three providers attended the training. The overall score changes among participants for CPBR and VSDT were significant (p

Abstract A sustainable supply of plant protein is critical for future generations and needs to be achieved while reducing green house gas emissions from agriculture and increasing agricultural resilience in the face of climate volatility. Agricultural diversification with more nutrient-rich and stress tolerant crops could provide the solution. However, this is often hampered by the limited availability of genomic resources and the lack of understanding of the genetic structure of breeding germplasm and the inheritance of important traits. One such crop with potential is winged bean (Psophocarpus tetragonolobus), a high seed protein tropical legume which has been termed ‘the soybean for the tropics’. Here, we present a chromosome level winged bean genome assembly, an investigation of the genetic diversity of 130 worldwide accessions, together with two linked genetic maps and a trait QTL analysis (and expression studies) for regions of the genome with desirable ideotype traits for breeding, namely architecture, protein content and phytonutrients.

Fast neutrons have sufficient energy to liberate recoil protons, alpha particles, and other products when they interact with the nuclei of the target material through scattering and absorption processes. Physical interactions with biological tissues occur mainly with hydrogen nuclei and as the protons interact with the hydrogen in tissues, they create dense ionization chains along their tracks thus depositing energy. Fast neutron therapy was pioneered by Robert Stone in 1938 a few years after the discovery of the neutron. Its main advantage is the limited sensitivity to hypoxia and treatment of slow-growing tumors hence better local control. This is where photon therapy has yet to have much success. Energy deposition by fast neutrons in living tissues is higher than in conventional radiotherapy using mega voltage (MV) photon beams. This higher energy deposition gives fast neutrons a higher relative biological effectiveness (RBE) in dealing with certain tumors. Fast neutrons also have a higher linear energy transfer (LET) and can reach deep-sited tumors better than photon therapy. The main challenge with Fast neutron therapy has been extreme toxicity in late-reacting tissues. Overall, fast neutron therapy holds potential for the treatment of certain tumors by leveraging the unique interaction characteristics of fast neutrons with biological tissues. This review therefore intends to bring this uniqueness to light to enhance the understanding of the radiobiological properties of fast neutrons and the advantages associated with its therapy.

Food environments are rapidly changing globally, both in developed and developing contexts, contributing to poor dietary habits and environmental concerns. As a result, more than 80% of countries in the world face different forms of malnutrition, while the environment faces further degradation due to unsustainable production and consumption patterns. Understanding food environments in diverse settings via a global lens is critical for facilitating the global transition to sustainable and healthy food environments. A virtual workshop was held with stakeholders from five nations (Germany, Ghana, Malaysia, South Africa, and Tanzania) representing varying levels of development to interrogate global food environment concerns and propose cross cutting thematic areas that may be explored and addressed through policy change and intervention. The workshop initiated a transdisciplinary project to shape food environments for sustainable and healthy diets. The Reference Manual for Convenors of Food Systems Summit Dialogues for United Nations Food Systems Summit (UNFSS) (United Nations, 2020) was used as guidance to ensure that an inclusive mix of stakeholders were invited. The stakeholders included key players from public and private sectors in disciplines of agriculture, agro-forestry, environment and ecology, education, food retail and market, trade and commerce, health care and nutrition. Following the workshop discussion, the findings were analyzed using a general inductive approach. Through triangulation of findings, we identified the common challenges and opportunities for achieving collective nutritional, social and environmental sustainability in the modern food environments, which have become more universal globally. It is evident that research and data are essential for sustainable development of food systems, while Sustainable Development Goal (SDG) 17 – Partnership for the Goals - should be placed at the core of the transformative process. We proposed several research-driven transdisciplinary interventions to facilitate a paradigm shift from the profit logic model over everything else, and to counter the existing policy fragmentation and systemic challenges to making food environments nutrition-sensitive and socially and environmentally sustainable.

Objectives Diabetes care remains unavailable and unaffordable for many people. Adapting models of care to low-income and middle-income country contexts is a priority. Digital technology offers substantial potential yet must surmount health system, technological and acceptability issues. This formative research aimed to identify the potential for a digital technology solution (Diabetes Compass) to address diabetes care gaps in primary healthcare.Design Qualitative research was conducted in selected districts of Sri Lanka and Tanzania with practitioners, patients and family members. In-depth interviews assessed how digital solutions may improve diabetes care, acceptability and usability; contextual and clinical observations identified practitioner clinical competencies, strengths and weaknesses, and the influence of the care environment on service delivery; and workshop discussions explored strategies to encourage digital solution uptake and sustain use.Setting The research was undertaken in 2022 at nine health facilities in Sri Lanka’s Southern Province (Galle), and 16 health facilities in Tanzania’s Lindi and Pwani Regions.Participants Participants included primary and secondary care practitioners, facility managers, patients and family members.Results There was striking concordance in the diabetes care gaps and potential for digital solutions in the two countries, and between practitioners, patients and family members. Five main gaps were practitioner training; health information systems and data; service delivery; infrastructure, equipment and medication; and community awareness and knowledge. Practitioners, patients and family members saw strong potential for digital solutions to improve early detection, diagnosis, secondary prevention of complications and improve patients’ and families’ experience of living with diabetes. They identified specific design and implementation considerations to enable the Diabetes Compass to realistically meet these needs and overcome challenges.Conclusion There was a strong appetite among practitioners, patients and family members for a digital solution to strengthen diabetes care. Their experience of challenges and practical recommendations informed the Diabetes Compass design.

Abstract The COVID-19 pandemic brought about a major public health concern worldwide. It forced many countries to enforce lockdowns, leading to the closure of higher learning institutions. The abrupt shift in the lifestyle of students had a profound impact on their mental health. This study aims to determine the prevalence and factors associated with mental health conditions among university students in Tanzania during the COVID-19 pandemic. A sample of 425 students from six medical universities and colleges in Tanzania completed an online survey and was included in the analysis. The questionnaire consisted of validated Depression, Anxiety and Stress Scale—21 Items (DASS-21) questions (Cronbach’s alpha = 0.92) assessing the presence of mental health symptoms: depression, anxiety, and stress. Multivariable logistic regression models were fitted to explain the factors associated with mental health conditions. A P-value

Knowledge of local and regional antimicrobial resistance (AMR) is important for clinical decision-making. However, surveillance capacity for fungal infections let alone antifungal resistance is lacking throughout West Africa, and current antifungal resistance data are sparse. We sought to address this gap by summarizing all available high-quality data on antifungal resistance in West Africa. We searched the PubMed database, African Journals Online archives, and free web searches in October and December 2023 using the terms "antifungal resistance" and "West Africa" to find articles published from 2010 onwards. Only 11 articles were included in our analysis most of which were cross-sectional and descriptive in design; relatively high levels of antifungal resistance (AFR) to commonly used antifungals were reported including (24-75%) resistance to fluconazole and ketoconazole, two of the most frequently-prescribed antifungals in this region. There is a high level of resistance to griseofulvin, ketoconazole, cotrimoxazole, and fluconazole among dermatophyte infections (80-100%) with 100% resistance to amphotericin B, ketoconazole, and fluconazole reported by the invasive fungal disease-causing pathogen Cryptococcus neoformans. Resistance to commonly used anti-fungal drugs is prevalent; raising concern that these drugs may no longer be useful for treating moderate or severe fungal infections in West Africa hence calling for countries to promote acceptance of antimicrobial stewardship as a programmatic strategy not just focused on bacterial resistance but also fungal resistance including pharmacy management, laboratory complete mycological investigations and dissemination of standard fungal susceptibility profiles.

Food is one of the basic necessities for human life. Nutritious food is essential for human health and helps oneself live up to our best potential as productive members of society. In spite of this, 3 billion people are estimated to have limited access to nutrient-rich food, and there are 768 million undernourished people in the globe today. There are still concerns with food systems and food security, despite the fast economic transformation of low-and middle-income nations in Maritime Southeast Asia and Oceania over the past 10 years. These issues include dwindling agricultural land, deforestation, ineffective food supply networks, environmental degradation, changing and unhealthy diets, non-communicable diseases, disappearing cultural legacy, and ineffective policies. These problems are exacerbated by climate change, natural hazards, and pandemic shocks. This review explores the perspectives of food systems that relates to all the elements and activities in transforming agri-food industry. In this paper, we discuss the challenges and solutions to transforming food systems in this region to achieve a sustainable and healthy diet for all, with the perspective of bringing the region closer toward the UN sustainable development goals. This paper is an outcome of the deliberations that took place during the Food Security in Small Islands and Developing States workshop in 2020. It also includes insights from subsequent expert group sessions that focused on the following topics: Agriculture and Food Systems; Nutrition, Health, and Culture; Innovations and Digitalization in Food Systems; as well as Policies Coordination and Future Shocks.

Severe bacterial infections (SBIs) are a leading cause of neonatal deaths in low- and middle-income countries. World Health Organization's (WHO's) guideline for outpatient management of danger signs indicating possible serious bacterial infections (PSBI) when referral is not possible was adopted by three pilot district councils in Mbeya Region, in Tanzania (Busekelo, Kyela and Mbarali Districts) in 2018 (the PSBI project). This study documented changes in practice during the PSBI project, and lessons learned. A cross-sectional study was conducted using both qualitative and quantitative data collection methods between July 2021 and January 2022, post-implementation. The study participants comprised stakeholders, health workers, community health workers, and mothers/fathers/caregivers who had a young infant with PSBI. Study tools included record review, quantitative, in-depth, and key informant interviews. Quantitative data were analysed using STATA version 15 (STATACorp Inc., TX, USA), whereas qualitative data were analysed using a framework analysis approach. Our assessment showed that 2,228 young infants (0-59 days old) from the three districts were classified as having PSBI. The majority, 1,607 (72.1%) had fast breathing as the only danger sign, while 621 (27.9%) were classified as having severe illness. All 621 young infants with severe illness were counselled and offered referral to a higher-level health facility; however, only 174 of them (28%) accepted the referral. The remaining 447 severely ill infants, for whom referral was not possible, were treated at the primary health facilities with gentamicin injection and amoxicillin dispersible tablets (DT). When referral is not feasible, outpatient treatment for young infants with signs of PSBI is possible within existing health system in Tanzania, based on experience after this pilot project. However, successful scale-up of outpatient management for PSBI will require commitments from government and key stakeholders to strengthen healthcare systems.

Abstract Background Assessment of segregating populations for their ability to withstand drought stress conditions is one of the best approaches to develop breeding lines and drought tolerant varieties. Bambara groundnut (Vigna subterranea L. Verdc.) is a leguminous crop, capable of growing in low-input agricultural systems in semi-arid areas. An F4 bi-parental segregating population obtained from S19-3 × DodR was developed to evaluate the effect of drought stress on photosynthetic parameters and identify QTLs associated with these traits under drought-stressed and well-watered conditions in a rainout shelter. Results Stomatal conductance (gs), photosynthesis rate (A), transpiration rate (E) and intracellular CO2 (Ci) were significantly reduced (p

Abstract Background The standard face-to-face training for the integrated management of childhood illness (IMCI) continues to be plagued by concerns of low coverage of trainees, the prolonged absence of trainees from the health facility to attend training and the high cost of training. Consequently, the distance learning IMCI training model is increasingly being promoted to address some of these challenges in resource-limited settings. This paper examines participants’ accounts of the paper-based IMCI distance learning training programme in three district councils in Mbeya region, Tanzania. Methods A cross-sectional qualitative descriptive design was employed as part of an endline evaluation study of the management of possible serious bacterial infection in Busokelo, Kyela and Mbarali district councils of Mbeya Region in Tanzania. Key informant interviews were conducted with purposefully selected policymakers, partners, programme managers and healthcare workers, including beneficiaries and training facilitators. Results About 60 key informant interviews were conducted, of which 53% of participants were healthcare workers, including nurses, clinicians and pharmacists, and 22% were healthcare administrators, including district medical officers, reproductive and child health coordinators and programme officers. The findings indicate that the distance learning IMCI training model (DIMCI) was designed to address concerns about the standard IMCI model by enhancing efficiency, increasing outputs and reducing training costs. DIMCI included a mix of brief face-to-face orientation sessions, several weeks of self-directed learning, group discussions and brief face-to-face review sessions with facilitators. The DIMCI course covered topics related to management of sick newborns, referral decisions and reporting with nurses and clinicians as the main beneficiaries of the training. The problems with DIMCI included technological challenges related to limited access to proper learning technology (e.g., computers) and unfriendly learning materials. Personal challenges included work-study-family demands, and design and coordination challenges, including low financial incentives, which contributed to participants defaulting, and limited mentorship and follow-up due to limited funding and transport. Conclusion DIMCI was implemented successfully in rural Tanzania. It facilitated the training of many healthcare workers at low cost and resulted in improved knowledge, competence and confidence among healthcare workers in managing sick newborns. However, technological, personal, and design and coordination challenges continue to face learners in rural areas; these will need to be addressed to maximize the success of DIMCI.

On 20th September 2022, Uganda declared the 7th outbreak of Ebola virus disease (EVD) caused by the Sudan Ebola strain following the confirmation of a case admitted at Mubende Regional Referral Hospital. Upon confirmation, the Government of Uganda immediately activated the national incident management system to initiate response activities. Additionally, a multi‑country emergency stakeholder meeting was held in Kampala; convening Ministers of Health from neighbouring Member States to undertake cross‑border preparedness and response actions. The outbreak spanned 69 days and recorded 164 cases (142 confirmed, 22 probable), 87 recoveries and 77 deaths (case fatality ratio of 47%). Nine out of 136 districts were affected with transmission taking place in 5 districts but spilling over in 4 districts without secondary transmission. As part of the response, the Government galvanised robust community mobilisation and initiated assessment of medical counter measures including therapeutics, new diagnostics and vaccines. This paper highlights the response actions that contributed to the containment of this outbreak in addition to the challenges faced with a special focus on key recommendations for better control of future outbreaks.

Abstract Tea [Camellia sinensis (L.) O. Kuntze] is mainly grown in low‐ to middle‐income countries (LMIC) and is a global commodity. Breeding programs in these countries face the challenge of increasing genetic gain because the accuracy of selecting superior genotypes is low and resources are limited. Phenotypic selection (PS) is traditionally the primary method of developing improved tea varieties and can take over 16 yr. Genomic selection (GS) can be used to improve the efficiency of tea breeding by increasing selection accuracy and shortening the generation interval and breeding cycle. Our main objective was to investigate the potential of implementing GS in tea‐breeding programs to speed up genetic progress despite the low cost of PS in LMIC. We used stochastic simulations to compare three GS‐breeding programs with a Pedigree and PS program. The PS program mimicked a practical commercial tea‐breeding program over a 40‐yr breeding period. All the GS programs achieved at least 1.65 times higher genetic gains than the PS program and 1.4 times compared with Seed‐Ped program. Seed‐GSc was the most cost‐effective strategy of implementing GS in tea‐breeding programs. It introduces GS at the seedlings stage to increase selection accuracy early in the program and reduced the generation interval to 2 yr. The Seed‐Ped program outperformed PS by 1.2 times and could be implemented where it is not possible to use GS. Our results indicate that GS could be used to improve genetic gain per unit time and cost even in cost‐constrained tea‐breeding programs.

The recent Russia–Ukraine conflict has raised significant concerns about global food security, leaving many countries with restricted access to imported staple food crops, particularly wheat and sunflower oil, sending food prices soaring with other adverse consequences in the food supply chain. This detrimental effect is particularly prominent for low-income countries relying on grain imports, with record-high food prices and inflation affecting their livelihoods. This review discusses the role of Russia and Ukraine in the global food system and the impact of the Russia–Ukraine conflict on food security. It also highlights how diversifying four areas of agrifood systems—markets, production, crops, and technology can contribute to achieving food supply chain resilience for future food security and sustainability.

Background Occupational noise is a common cause of hearing loss in low-income countries. Unfortunately, screening for hearing loss is rarely done due to technical and logistical challenges associated with pure tone audiometry. Wulira app is a valid and potentially cost-effective alternative to pure tone audiometry in screening for occupational hearing loss. We aimed to determine the prevalence of occupational hearing loss among workers in a metal industry company in Kampala district. Methodology We recruited 354 participants conveniently from a steel and iron manufacturing industry in Kampala. All eligible participants answered a pretested and validated questionnaire and were assessed for noise induced hearing loss in a quiet office room approximately 500 meters from the heavy machinery area using the Wulira app. Descriptive statistics such as proportions were used to describe the study population while inferential statistics were used to determine associations. Results Of the 354 participants sampled, 333 (94.1%) were male, and the median age was 27, IQR (25–30). Regarding the risk factors of hearing loss, fourteen (3.9%) had history of smoking and more than half (65.5%) had worked in the industry for more than 2 years. The overall prevalence of hearing loss among industrial workers was 11.3% (40/354). 16.2% and 9% had mild hearing loss in the right and left ear respectively. Bilateral audiometric notch was present where fourteen (4%) of the participants had notch in their right ear while seven (2%) had notch in their left ear. Residing outside Kampala district was associated with hearing loss (OR, 95% CI, 0.213 (0.063–0.725), p = 0.013). Conclusion One in 10 workers in a metal manufacturing industry in Kampala had occupational hearing loss. Industrial workers residing outside Kampala were likely to develop hearing loss. Periodic screening should be done for early detection and intervention to prevent progression of hearing loss in this population.

Abstract Bambara groundnut [Vigna subterranea (L.) Verdc.] is an underutilised, protein‐rich and self‐pollinating legume that can withstand high temperature and drought stress and is mainly grown in semi‐arid Africa. In order to dissect the complexity of drought resistance and to use genomic tools for yield enhancement of bambara groundnut in response to drought stress, yield‐related and morphological traits under drought‐stressed (DS) and well‐watered (WW) conditions were evaluated in the F3 and F4 segregating generations derived from a cross between two genotypes selected from landraces S19‐3 (originally from Namibia) and DodR (originally from Tanzania). Significant quantitative trait loci (QTLs) for shoot dry weight (SDW) were mapped on LG10 accounting for 15.5% of the phenotypic variation explanation (PVE) under well‐watered conditions and a putative quantitative trait locus (QTL) for the same trait mapped on LG10 with reduced PVE (10.10%) under drought‐stressed conditions in the F3 segregating population. Significant QTLs associated with the number of seeds per plant (NS), number of double‐seeded pods per plant (NDP), seed weight per plant (SW) and pod weight per plant (PW) were mapped on LG4 (nearest marker: 4181663 and 4175954) with overlapping confidence intervals and explained 21.9%, 21.8%, 23.5% and 19.9% of the PVE, respectively, under well‐watered conditions in the F4 population, which could be considered as the major QTL involved in the control of these traits. Seven consensus QTLs for yield‐related and morphological traits were mapped on LG2, LG3, LG4, LG7A and LG10. The study provides fundamental knowledge of QTLs associated with yield‐related and morphological traits under drought‐stressed and well‐watered conditions in bambara groundnut, which is also essential for yield improvement of bambara groundnut in response to drought stress.

IntroductionIntercropping cereals with legumes can intensify rainfed cereal monocropping for improved household food and nutritional security. However, there is scant literature confirming the associated nutritional benefits.MethodologyA systematic review and meta-analysis of nutritional water productivity (NWP) and nutrient contribution (NC) of selected cereal-legume intercrop systems was conducted through literature searches in Scopus, Web of Science and ScienceDirect databases. After the assessment, only nine articles written in English that were field experiments comprising grain cereal and legume intercrop systems were retained. Using the R statistical software (version 3.6.0), paired t-tests were used to determine if differences existed between the intercrop system and the corresponding cereal monocrop for yield (Y), water productivity (WP), NC, and NWP.ResultsThe intercropped cereal or legume yield was 10 to 35% lower than that for the corresponding monocrop system. In most instances, intercropping cereals with legumes improved NY, NWP, and NC due to their added nutrients. Substantial improvements were observed for calcium (Ca), where NY, NWP, and NC improved by 658, 82, and 256%, respectively.DiscussionResults showed that cereal-legume intercrop systems could improve nutrient yield in water-limited environments. Promoting cereal- legume intercrops that feature nutrient-dense legume component crops could contribute toward addressing the SDGs of Zero Hunger (SDG 3), Good Health and Well-3 (SDG 2) and Responsible consumption and production (SDG 12).

This study set out to investigate the effects of adhesive type, rice husk and sawdust proportions on the properties of composite particleboards. Specimens of 200 × 200 × 24 mm were made by blending 500 g of rice husks with each adhesive type at a mass ratio of 1:1. The rest of the specimens of similar dimensions were prepared with addition of sawdust in the range of 10–40 wt%, while maintaining the ratio of biomass particles to adhesive at 1:1. Three commercial synthetic adhesives Fevicol (FV), Ponal (PA) and woodfix (WF) were used. The particle-adhesive mixtures were molded into a mat which was subsequently cold pressed at 10 MPa and left to dry in air. Density, water absorption (WA), linear expansion (LE), thickness swelling (TS), modulus of elasticity (MOE), modulus of rupture (MOR) and screw holding capacity of the specimens were evaluated. Adhesives were found to have over 42% solid content, with similar liquid constituents but in varying proportions. FTIR library search for the spectra of FV, PA and WF revealed correlations of 82.5%, 78.6% and 50.2%, respectively with polyvinyl-acetate. The developed boards had density 510–610 kg/m3, MOE 13–26 MPa, TS 9–31%, LE 3–7%. These properties suit them for furniture boards and sound proofing. The properties improved with increasing proportion of sawdust. FV and PA-bonded particleboards exhibited higher stability and strengths than WF-bonded particleboards due to higher concentrations of polyvinyl-acetate in the latter. Blending 40 wt% sawdust, 10 wt% rice husk with 50 wt% of either FV or PA showed better prospects.

This study explored learner-centered science teaching approaches that eight science-teacher educators from two teacher education colleges in Tanzania, consider when teaching their students, and the challenges encountered when attempting to implement these approaches. We used a semi-structured interview to collect data which we analysed interpretively. Our findings revealed that the aspects of learner-centered pedagogy, such as engaging student teachers in practical work and discussion, and linking classroom science to the real world, were insufficiently considered by the teacher educators in the teacher colleges studied. The challenges and or difficulties that the teacher educators in these colleges perceive to impede the implementation of learner-centered science teaching in teacher education and as well as the possible approaches that can support the implementation of learner-centered science teaching in such colleges are discussed.

This study explored the extent to which science teacher educators in Norway introduce, teach, and assess graduate attributes (GA), a range of qualities, skills or competences considered vital for one’s survival and thriving in a complex world. A qualitative analysis of views from a sample of science teacher educators revealed majorly an implicit approach to the teaching and assessment of graduate attributes along with the main teaching subjects. Moreover, the lack of a graduate attributes profile for science teachers is impeding the teaching and assessment of these attributes. The findings raise important questions to science educators and policy makers regarding how to best address graduate attributes in science teacher education.

There is a lack of clarity about the role of practical work in promoting learning and thinking, due to mediocrity in the way it is being handled. This study used mixed methods design to develop through microteaching, LSP integrated practical work to explore its characteristics in order to examine how the student-teachers adapted to the pedagogy in relation to its efficacy in developing science, English language, and pedagogy. The research was conducted at the University of Dodoma. The study involved 63 student-teachers and five lecturers with different specializations. The study was carried out in three cycles at the College of Education. It involved the second-year students who were studying Bachelor of Education in Science, who undertook a Physics Teaching Methods course. Review of lesson plans, achievement tests, classroom observations, and interviews with student-teachers, together with focus group discussions among the lecturers, were used to collect data. The qualitative data were analysed using the thematic analysis approach, while the quantitative data were analysed through repeated measures t-test. The student-teachers were able to plan and implement LSP practical lessons in which case students reported to have enjoyed their participation, sharing of experiences, and the bilingual classrooms. The findings from the repeated measures t-test show that there was a significant rise in the mean scores from pre-test (67.9) to the post-test (80.2), with very much reduced variability (SD) of scores among students from 24.9 (pre-test) to 6.6 (post-test). From interviews with 8 case students after each lesson, it was concluded that the students improved in science content, English language competence, and pedagogy.

Background: There is a dearth of information on the relationship between domestic water source and malaria infection in malaria-endemic regions such as Tanzania. This study examined the geospatial variability and association between domestic water source and malaria prevalence in Tanzania. Methods: We analyzed data from a sample of 6707 children, aged 6–59 months, from the 2017 Tanzania Malaria Indicator Survey. The outcome variable was the result of malaria testing (positive or negative) and the main explanatory variable was domestic water source (piped or non-piped). Random effect variables were administrative region and geographical zone. ArcGIS 10.7 was used to create geospatial distribution maps. A STATA MP 14.0 was used to fit a mixed-effects multilevel logistic regression to examine the factors associated with malaria prevalence. Results: The prevalence of malaria and non-piped domestic water source was respectively 7.3% and 59.6%. The regions and zones with a higher prevalence of malaria also had a higher percentage of non-piped water. There was a statistically significant variation in the risk of malaria across the regions (variance = 1.27; 95% CI, 0.40−4.07) and zones (variance = 4.75; 95% CI, 1.46−15.46). The final fixed-effects model showed that non-piped domestic water was significantly associated with malaria prevalence (adjusted odds ratio (AOR) = 2.18; 95% CI, 1.64−2.89; P < 0.001). Conclusions: A non-piped source of domestic water was independently associated with positive testing for malaria. Moreover, regions with a high percentage of non-piped domestic water had a correspondingly high prevalence of malaria.

Background and Aims: Increased risk of acute respiratory infection (ARI) in children has been linked with exposure to household air pollution (HAP) from solid biomass fuels. However, information is limited on the trend use of biomass fuels and their association with ARI among children in Tanzania. The current study analysed nationally representative data from the Tanzania Demographic Health Surveys of the years 2004, 2010, and 2015–16 to explore the prevalence of the trend of cooking fuels and ARI as well as ascertain their association among under-fives. Methods: A total sample of 20,323 under-fives were included in the current analysis. A mixed-effects multilevel logistic regression was fitted to assess the association between unclean fuels (solid biomass fuels and kerosene) and ARI among under-fives. Results: The use of solid biomass fuels has remained persistent high (98.6%) while ARI among under-fives has declined from 16% in 2004 to 9% in 2016; 'p' < 0.001. Furthermore, under-fives exposed to unclean fuel combustion had a significantly higher incidence of ARI (AOR = 3.47; 95% CI, 1.31–9.21). Conclusion: Efforts should be made to switch to alternative sources of clean energy such as natural gas and biogas in Tanzania and other countries with similar settings.

Abstract Background Child stunting is a global health concern. Stunting leads to several consequences on child survival, growth, and development. The absolute level of stunting has been decreasing in Tanzania from from 50% in 1991/92 to 34% in 2016 although the prevalence is still high (34%)Stunting varyies across socioeconomic determinants with a larger burden among the socioeconomic disadvantaged group. The reduction of inequalities in stunting is very crucial as we aim to reduce stunting to 28% by 2021 and hence attain zero malnutrition by 2030 under Sustainable Development Goal 2.2.This study aimed at determining the trend, contributing factors and changes of inequalities in stunting among children aged 3–59 months from 2004 to 2016. Methods Data were drawn from the Tanzania Demographic and Health Surveys. The concentration index (CIX) was used to quantify the magnitude of inequalities in stunting. The pooled Poisson regression model was used to determine the factors for stunting, decision criterion for significant determinants was at 5% level of significance. The CIX was decomposed using the Wagstaff and Watanabe decomposition methods., the percentage contribution of each factor to the toal concentration index was used to rank the factors for socioeconomic inequalities in stutning. Results Inequalities in stunting were significantly concentrated among the poor; evidenced by CIX = − 0.019 (p 84.7%) and maternal years of schooling (mean contribution > 22.4%) had positive impacts on the levels of inequalities in stunting for all surveyed years. Rural-urban differences reduced inequalities in stunting although the contribution changed over time. Conclusion Inequalities in stunting declined, differentials in wealth index and maternal education had increased contribution to the levels of inequalities in stunting. Reducing stunting among the disadvantaged groups requires initiatives which should be embarked on the distribution of social services including maternal and reproductive education among women of reproductive age, water and health infrastructures in remote areas.

Abstract Evaluation of transcriptome data in combination with QTL information has been applied in many crops to study the expression of genes responsible for specific phenotypes. In oil palm, the mesocarp oil extracted from E. oleifera × E. guineensis interspecific hybrids is known to have lower palmitic acid (C16:0) content compared to pure African palms. The present study demonstrates the effectiveness of transcriptome data in revealing the expression profiles of genes in the fatty acid (FA) and triacylglycerol (TAG) biosynthesis processes in interspecific hybrids. The transcriptome assembly yielded 43,920 putative genes of which a large proportion were homologous to known genes in the public databases. Most of the genes encoding key enzymes involved in the FA and TAG synthesis pathways were identified. Of these, 27, including two candidate genes located within the QTL associated with C16:0 content, showed differential expression between developmental stages, populations and/or palms with contrasting C16:0 content. Further evaluation using quantitative real-time PCR revealed that differentially expressed patterns are generally consistent with those observed in the transcriptome data. Our results also suggest that different isoforms are likely to be responsible for some of the variation observed in FA composition of interspecific hybrids.

Abstract Upper-respiratory tract infections (URTI) are the leading causes of childhood morbidities. This study investigated etiologies and patterns of URTI among children in Mwanza, Tanzania. A cross-sectional study involving 339 children was conducted between October-2017 and February-2018. Children with features suggestive of URTI such as nasal congestion, dry cough, painful swallowing and nasal discharge with/without fever were enrolled. Pathogens were detected from nasopharyngeal and ear-swabs by multiplex-PCR and culture respectively. Full blood count and C-reactive protein analysis were also done. The median age was 16 (IQR: 8–34) months. Majority (82.3%) had fever and nasal-congestion (65.5%). Rhinitis (55.9%) was the commonest diagnosis followed by pharyngitis (19.5%). Viruses were isolated in 46% of children, the commonest being Rhinoviruses (23.9%). Nineteen percent of children had more than 2 viruses; Rhinovirus and Enterovirus being the commonest combination. The commonest bacteria isolated from ears were Staphylococcus aureus and Pseudomonas aeruginosa. Children with viral pathogens had significantly right shift of lymphocytes (73%—sensitivity). Majority (257/339) of children were symptoms free on eighth day. Viruses are the commonest cause of URTI with Rhinitis being the common diagnosis. Rapid diagnostic assays for URTI pathogens are urgently needed in low-income countries to reduce unnecessary antibiotic prescriptions which is associated with antibiotic resistance.

Residents of informal settlements in urban centres in Africa are known to suffer disproportionate burdens of environmental and socio-economic inequalities and are often excluded from macro-level visions and policies that seek to make cities safer and prosperous (Birkmann, 2007; da Silva & Braulio, 2014; Dodman et al., 2013). This tension undermines the validity of orthodox, ‘expert-led’ visions, policies and measures of prosperity that are distant from the lived-experience of marginalised urban residents. Based on new empirical work with communities in three informal settlements in Dar es Salaam, Tanzania, this article argues that novel methodological and theoretical approaches to co-producing context-specific policy-relevant knowledge about pathways to prosperity (translated by the communities as maisha bora, ‘the good life’) creates inclusive spaces for both community participation in processes of urban knowledge production and critical social enquiry that can lead to grounded theory building. By co-producing both an agreed and relevant methodological approach for the study, and its subsequent documentation and analysis, this work contributes valuable empirical insights about the capacities and capabilities of local communities to shape and influence urban policy-making and in this way speaks to calls for a global urbanism (Ong, 2011; Robinson, 2016) that brings diverse voices and geographies to urban theory to better account for the diversity of urban experiences and processes found in twenty-first century cities.

Summary Background In the last decade, Tanzania has observed a dramatic increase in overweight and obesity among women of childbearing age, a demographic shift that has been associated with intrapartum obstetric complications in high‐income countries. Similar increases in maternal morbidity including postpartum haemorrhage, hypertensive disorders of pregnancy, and rates of caesarean delivery have not yet documented in Tanzania. This analysis describes intrapartum obstetric complications associated with maternal obesity among pregnant women delivering at teaching hospital in Northern Tanzania. Methods A retrospective cohort analysis was conducted using the hospital's antenatal care (ANC) and birth registries from 2000 to 2015. The World Health Organization (WHO) body mass index (BMI) categories were applied to classify BMI status of pregnant women within 16 weeks of gestational age at their first ANC visit. Relative risk (RR) of obstetric complications with corresponding 95% confidence intervals (CIs) were estimated using multivariable log‐binomial regression, adjusting for clustering effect for the correlation between multiple deliveries of the same woman. Results Among 11 873 women who delivered babies in the hospital during the study period, 3139 (26.5%) fit the definition of overweight and 1464 (12.3%) women with obesity. Compared with women with normal weight, women with obesity were at over 2.6 times at risks of experiencing pre‐eclampsia/eclampsia (RR: 2.66; 95% CI, 2.08‐3.40), pregnancy‐induced hypertension (RR 2.13; 95% CI, 1.26‐3.62), and postpartum haemorrhage (RR 1.22; 95% CI, 1.00‐1.49). Additionally, women with obesity had also higher risk of either elective (RR 2.40; 95% CI, 1.88‐3.06) or emergency (RR: 1.53; 95% CI, 1.34‐1.75) caesarean delivery. Conclusion Maternal obesity is an emerging health problem in Tanzania. This study clearly demonstrates an association between increased risk of intrapartum complications and obesity. A review of guidelines around ANC screening and intrapartum care practices considering BMI, as well as appropriate messages for women with obesity, should be considered to improve maternal and newborn outcomes.

Bambara groundnut [Vigna subterranea (L.) Verdc.] is grown in rainfed production systems and suffers from periodic drought stress (DS), leading to yield reductions. Natural genotypic variation for root traits is essential for adaptation to water deficit conditions. However, root traits have not been fully utilised as selection criteria to improve DS in bambara groundnut. The present study explored the natural genotypic variation found in single genotypes of bambara groundnut derived from landraces to identify adaptive differences in tap root length (TRL) and root length density (RLD) in response to DS. A diverse core collection of eight bambara groundnut genotypes from various locations (namely, Gresik, LunT, IITA-686, DodR, S19-3, Tiga nicuru, and Ankpa-4, DipC1), were grown for two seasons (2018 and 2019) in polyvinyl chloride (PVC) columns with well-watered (WW) and 30-day DS treatments. Plant samples were collected at 55 days after emergence (DAE) (30 days of DS) and at 105 DAE (30 days of DS plus 50 days of recovery). Under DS, differential TRL among genotypes at 55 DAE was observed, with DodR recording the longest among genotypes with an increase (1% in 2018) in TRL under DS compared to WW, whereas LunT and IITA-686 showed significant (p < 0.001) decrease in TRL (27 and 25%, respectively, in 2018). Average RLD was observed to have the highest reduction under DS in the 90–110 cm layer (42 and 58%, respectively, in 2018 and 2019). Rainy habitat LunT had limited roots in 2018 and recorded the least (0.06 ± 0.013 cm–3) RLD in 2019. However, dry-habitat DodR showed an increase in the RLD (60–90 cm) under DS compared to WW, while dry-habitat S19-3 densely occupied all depths with RLD of 0.16 ± 0.05 and 0.18 ± 0.01 cm cm–3 in the deepest layer in both seasons, respectively. Reduced RLD under DS showed recovery when the plants were re-watered. These plants were additionally observed to have RLD that surpasses the density in WW at all soil depths at 105 DAE. Also, recovery was shown in Tiga nicuru and DodR (0–30 cm) and IITA-686 (90–110 cm) in 2019. Average RLD under DS treatment was associated with substantial grain yield advantage (R2 = 0.27 and R2 = 0.49, respectively) in 2018 and 2019. An increase in TRL allowed DodR to quickly explore water at a deeper soil depth in response to gradually declining soil water availability. High RLD in genotypes such as DodR, DipC1 and S19-3 also offered adaptive advantage over other genotypes under DS. Variation in intrinsic RLD in deeper soil depths in the studied genotypes determines root foraging capacity when facing DS. This suggests that different agroecological environments to which bambara groundnut is subjected in its natural habitat have promoted a phenotypic differentiation in root systems to adapt to ecotypic conditions, which may help offset the impact of DS. The natural genotypic variation exhibited, especially by DodR, could be exploited to identify potential quantitative trait loci (QTLs) that control deep rooting and root length density.

BackgroundA health service using mobile devices, mobile health (mHealth), has been widely applied to programs focusing on maternal and child health and communicable diseases in sub-Saharan African countries. However, mHealth apps for noncommunicable disease (NCD) services remain limited. ObjectiveThis study aimed to explore the acceptability and potential usability of SMS text messaging for patients and health care providers for the management of NCDs as part of an implementation research in rural Tanzania. MethodsNine focus group discussions were conducted with 56 participants (21 community health workers [CHWs], 17 patients, and 18 health care professionals [HPs]) in 3 districts in the Dodoma region, Tanzania. The interview guides were prepared in Swahili, and each session was recorded, transcribed, and translated into English. The focus group discussions consisted of the following topics: (1) perceptions of the participants about the possible use of mobile devices and SMS text messages as an mHealth platform in community health services; and (2) experiences of mobile device use in health activities or receiving health services via a mobile phone in the past. ResultsCHWs and HPs reported having familiarity using mobile devices to provide health services, especially for reaching or tracing patients in remote settings; however, patients with NCDs were less familiar with the use of mobile devices compared with the other groups. Hesitation to receive health services via SMS text messaging was seen in the patient group, as they wondered who would send health advice to them. Some patients expected services beyond what mHealth could do, such as aiding in recovery from a disease or sending notifications about the availability of prescription medications. CHWs showed interest in using text messaging to provide health services in the community; however, the concerns raised by CHWs included the cost of using their own mobile devices. Moreover, they demanded training about NCD management before engaging in such an activity. ConclusionsThis study explored views and experiences regarding the possible installation of an mHealth intervention for managing NCDs in rural Tanzania. Although HPs and CHWs had experience using mobile devices to provide health services in non-NCD projects, only a few patients (3/17, 17%) had heard about the use of mobile devices to receive health services. To improve the suitability and acceptability of the intervention design for patients with NCDs, their trust must be earned. Involving CHWs in the intervention is recommended because they have already been appointed in the community and already know how to communicate effectively with patients in the area.

Amaranth (Amaranthus spp.) is a highly nutritious, underutilized vegetable and pseudo-cereal crop. It possesses diverse abiotic stress tolerance traits, is genetically diverse and highly phenotypically plastic, making it an ideal crop to thrive in a rapidly changing climate. Despite considerable genetic diversity there is a lack of detailed characterization of germplasm or population structures. The present study utilized the DArTSeq platform to determine the genetic relationships and population structure between 188 amaranth accessions from 18 agronomically important vegetable, grain, and weedy species. A total of 74, 303 SNP alleles were generated of which 63, 821 were physically mapped to the genome of the grain species A. hypochondriacus. Population structure was inferred in two steps. First, all 188 amaranth accessions comprised of 18 species and second, only 120 A. tricolor accessions. After SNP filtering, a total of 8,688 SNPs were generated on 181 amaranth accessions of 16 species and 9,789 SNPs generated on 118 A. tricolor accessions. Both SNP datasets produced three major sub-populations (K = 3) and generate consistent taxonomic classification of the amaranth sub-genera (Amaranthus Amaranthus, Amaranthus Acnida and Amaranthus albersia), although the accessions were poorly demarcated by geographical origin and morphological traits. A. tricolor accessions were well discriminated from other amaranth species. A genome-wide association study (GWAS) of 10 qualitative traits revealed an association between specific phenotypes and genetic variants within the genome and identified 22 marker trait associations (MTAs) and 100 MTAs (P≤0.01, P≤0.001) on 16 amaranth species and 118 A.tricolor datasets, respectively. The release of SNP markers from this panel has produced invaluable preliminary genetic information for phenotyping and cultivar improvement in amaranth species.

BackgroundIndustrial workers are at a high risk of acquiring noise induced hearing loss, yet there is minimal hearing loss screening of such groups of people. Pure Tone Audiometry (PTA), the gold standard for hearing loss screening, is expensive, and not readily available at health sites. Mobile audiometry can bridge this gap. However, there is limited knowledge on its acceptability in low-income countries like Uganda. We aimed to assess the acceptability of using the Wulira App, a validated mobile phone app, in assessing hearing loss among industrial workers in Kampala.MethodsWe carried out a qualitative study in a steel and iron manufacturing industry in Kampala, in April 2021. Four Focus group discussions (FGDs) with 8 participants per FGD, and 12 In-depth Interviews (IDI), were conducted on the industrial workers. The industrial workers were first tested for hearing loss, then enrolled for the FGDs and IDI. A semi-structured interview guide was used. Audio recordings were transcribed verbatim. Themes were derived using thematic content analysis, borrowing from Sekhon's model of Acceptability of Health Interventions.ResultsIndustrial workers found the Wulira App user friendly, cheap, time saving, and an effective hearing loss assessment tool. However, barriers such as lack of smart phones, difficulty in navigating the app, and fear of getting bad news hindered the App's acceptability, as a hearing assessment tool.ConclusionHearing loss assessment using Wulira App was acceptable to the industry workers. There is need of informing industrial workers on the essence of carrying out regular hearing loss screening, such that barriers like fear of getting screened are overcome.

Drought is a major crop production constraint worldwide. Some legume crops are known for their ability to resist water deficit stress. This study evaluated the responses of bambara groundnut (Vigna subterranea (L.) Verdc) and groundnut (Arachis hypogaea (L.) to soil water deficit stress. The experiment was set as a split-plot randomized complete block design. Three bambara groundnut landraces: viz DodR, NALBAM 4 and S19-3, and one groundnut variety, MNANJE, were assigned to subplots with three water regimes assigned to main plots (regime one: irrigated throughout the growing period, regime two: water deficit stress was imposed at the start of flowering to the end of first flush flowering, regime three: water was withheld during the pod development). Water deficit stress increased proline content by 123% in stressed plots. The highest (174%) and lowest (89%) proline increases were evident in the genotypes MNANJE and NALBAM 4, respectively. Water deficit decreased stomatal conductance, transpiration rate and photosynthetic rate, with MNANJE and S19-3 showing the smallest percentage decrease in most of the traits. This suggests that the two genotypes are drought resistant. The variations observed among landraces could be exploited to breed resilient varieties for cultivation in drought-prone areas, ultimately improving food security.

Abstract Background Bullying and suicidal behaviors are a silent public health problem among adolescents. Little is known about the link between bullying and suicidal behaviors in low-income countries such as Tanzania. In the current study, we estimated the prevalence of being bullied and determined its association with suicidal behaviors among in-school adolescents. Methods We performed a secondary analysis of the Tanzania Global School-based Student Health Survey (GSHS) conducted in 2014. This was the first nationally representative survey conducted to a sample of 3793 in-school adolescents. The primary independent variable was being bullied, while the outcome variables of interest were suicide ideation and suicide attempt. We used a chi-square χ2 test for group variables comparisons and multivariate logistic regression for statistical associations between independent and outcome variables. In our analysis, a p

Abstract Background Early and unprotected sex with multiple partners among adolescents carries a high risk of acquiring HIV infections, other sexually transmitted infections as well as high rates of teenage pregnancy. Sub-Saharan Africa (SSA) has a higher burden of HIV/AIDS: the leading cause of deaths among adolescents. We estimated the prevalence and examined the correlates of sexual intercourse among in-school adolescents of SSA. The purpose is to inform the public health programs dedicated to tackling the burden of HIV/AIDS. Methods We did a secondary analysis of the Global School-based Student Health Surveys (GSHS) datasets pooled from five SSA countries Benin, Mozambique, Namibia, Seychelles, and Tanzania. Our current analysis included a sample of 15,318 in-school adolescents. The primary independent variables were ever had sexual intercourse and sex with multiple partners, while the dependent variables were smoking cigarettes, alcohol use, use of marijuana and amphetamine, and parental connectedness. We performed descriptive statistics, and multivariate logistic regression stratified by gender using SPSS Complex Sample Statistics. A p-value of less than 0.05 was considered statistically significant at 95% confidence intervals. Results Out of 15,318 participants, the overall prevalence of ever had sexual intercourse and sex with multiple partners were 43·5% (6670) and 20·9% (3204), respectively. In overall and across each country, male adolescents had a significantly higher proportion of sex with multiple partners than female adolescents, p

Abstract Background The burden of tuberculosis (TB) and diabetes mellitus (DM) is rising and substantially affecting the low-income countries, including Tanzania. Integrated management of TB and DM is becoming of importance in TB high burden countries. In this study, we sought to assess the availability and readiness of diabetes facilities to manage TB in Tanzania. Methods The present study was based on a secondary analysis of the 2014–2015 Tanzania Service Provision Assessment Survey data. We calculated the service availability as a percentage of diabetes facilities offering TB services: diagnosis and treatment. Regarding the readiness of diabetes facilities to provide TB management, we calculated based on the three domains: staff training and guideline, diagnostics, and medicines as identified by World Health Organization-Service Availability and Readiness Assessment (SARA) manual. A score of at least half (≥50%) of the indicators listed in each of the three domains was considered as high readiness. We used a descriptive statistics to present our findings. Results There were 619 DM facilities all over the country of which only 238 (38.4%) had TB services.72.6 and 62.6% of these DM facilities with TB services were publicly owned and located in rural settings respectively. Generally, DM facilities had low readiness to manage TB; 12·6%. More specifically, all DM facilities had low readiness in terms of trained staff and guidelines. However, in the domain of diagnostics and medications, higher levels of care (hospitals) had a comparatively higher level of readiness to manage TB. Conclusion Most of the DM facilities had low availability and readiness to manage TB. The findings of our study display an urgent need to mobilize important resources to enhance the integration of TB services in DM facilities. This includes medications, management guidelines, diagnostics, and health professionals who have received refresher training on TB/DM co-management. However, presently, few DM facilities may be allowed to start managing TB as per the Strategic and Action Plan for the Prevention and Control of Non-Communicable Diseases in Tanzania 2016–2020.

Abstract Background Childhood lifestyle, health-risk behaviours contribute to two-thirds of non-communicable diseases (NCDs) premature mortality in adult populations. The co-occurrence of risk factors for NCDs is more harmful to health than that of individual risk factor effects when are added independently. The main objective of the present study was to explore the prevalence, sociodemographic distribution, and the co-occurrence of risk factors for NCDs among in-school adolescents. Methods The present study is based on the secondary analysis of the first nationwide representative sample of the 2014 Tanzania Global School-based Student Health Survey (GSHS). A total sample of 3,793 in-school adolescents was included in the present analysis. The dependent variables were as follows: an unhealthy diet, physical inactivity, tobacco use, excessive alcohol use, and suicide attempt. The analysis involved the Chi squire χ2 test, multinomial and multivariate regression models: to determine the association between the variables of interest. In all analyses, the set level of statistical significance was a p-value of less than 0.05 at 95% confidence intervals. Results The most prevalent combination of risk factors for NCDs were as follows: unhealthy diet and physical inactivity 666 (17.6%); unhealthy diet and suicide attempt 151 (4.0); unhealthy diet and tobacco use 98 (2.8); and unhealthy diet, physical inactivity, and suicide attempt 81 (2.1). In the adjusted regression model; having three 0.60 [0.40–0.91], and a sum of four and five 0.46 [0.28–0.79] risk factors than having no risk factor showed a significant declined with increasing in adolescents age. Primary in-school adolescents than secondary in-school adolescents were significantly more likely to have two 1.81 [1.42–2.32], three 2.40 [1.63–3.54]; and a sum of four and five 2.90 [1.61–5.13] combinations of risk factors. Conclusion The co-occurrence of lifestyle health-risk factors for NCDs was prevalent among in-school adolescents: it was significantly higher among younger adolescents. A multi-strategy public health intervention program may be more effective than that of a single risk factor approach: therefore, suitable for resource-limited settings, such as Tanzania.

Abstract Background Suicidal behaviors among adolescents is a major public health concern. Psychological factors have been extensively studied known risks linked to suicidal behaviors in the general population. However, the association between food insecurity and suicidal behaviors is less researched, particularly in low and middle-income countries. The present study sought to assess the link between food insecurity and suicide behaviors among in-school adolescents. Methods The present study was based on the secondary analysis of the first nationally representative sample of the 2014 Tanzania Global School-based Student Health Survey (GSHS). A total sample of 3,793 in-school adolescents was included in the present analysis. The primary independent variable was food insecurity while the dependent variables of interest were suicide ideation and suicide attempt. Chi-square χ2 and multivariate logistic regression were used to ascertain the measure of statistical association. In all analyses, a p

INTRODUCTION: Isoniazid preventive therapy for people living with HIV is an essential public health intervention in low-income countries with high tuberculosis and HIV burden. Despite available evidence that it is efficacious, its implementation is still low in many countries. This study was designed to determine its implementation coverage and explore barriers for suboptimal implementation in Songea municipality in Tanzania. METHODS: a cross sectional descriptive study design using both quantitative and qualitative approaches of data collection was employed. A review of 2148 records of people living with HIV eligible for Isoniazid preventive therapy was done to determine its implementation coverage. 21 In-depth interviews and 5 observations were conducted to explore barriers in the implementation. Quantitative data was analyzed using Statistical Package for the Social Science (SPSS) for windows version 20 statistical software. Descriptive statistics (frequencies and percentage) were employed and data were visualized using tables and bar graphs. All interviews were audio-recorded and analyzed using thematic analysis approach. RESULTS: overall, Isoniazid preventive therapy coverage at Songea municipality was estimated to be 45%. Insufficient drug supply and stock out, shortage of staff, lack of service privacy, long waiting time, drug side effects, pills burden, distance and cost of transport were the main reported barriers hindering full scale implementation of Isoniazid preventive therapy. CONCLUSION: implementation of isoniazid preventive therapy in Songea municipality had low coverage. The study recommends that Tuberculosis and HIV stakeholders must be part of the solutions by ensuring that the identified barriers are addressed.

IntroductionDouble disease burden such as Tuberculosis and Diabetes mellitus comorbidity is evident and on rising especially in high burden settings such as Tanzania. There is limited information about the availability of tuberculosis/diabetes integrated healthcare services in Tanzania. Therefore, this study explored the availability and examined the readiness of healthcare facilities with tuberculosis services to manage diabetes mellitus in Tanzania.MethodsWe abstracted data from the 2014-2015 Tanzania Service Provision Assessment Survey datasets. The service availability was assessed by calculating the proportion of tuberculosis facilities reported to manage diabetes mellitus. There were four domains; each domain with some indicators for calculating the readiness index. High readiness was considered if the tuberculosis facilities scored at least half (≥50%) of the indicators listed in each of the four domains (staff training and guideline, diagnostics, equipment, and medicines) as is recommended by the World Health Organization-Service Availability and Readiness Assessment manual while low readiness for otherwise.ResultsOut of 341 healthcare facilities with tuberculosis services included in the current study, 238 (70.0%) reported providing management for diabetes mellitus. The majority of the facilities were dispensaries and clinics 48.1%; publicly owned 72.6%; and located in rural 62.6%. Overall, the readiness of tuberculosis facilities to manage diabetes was low (10.8%). Similarly, the readiness was low based on the domain-specific readiness of trained staff and guidelines.ConclusionAlthough the majority of the healthcare facilities with tuberculosis services had diabetes mellitus services the overall readiness was low. This finding provides a piece of evidence to inform the policymakers in high burden and low resource countries to strengthen the co-management of tuberculosis and diabetes.

Rapid population growth, climate change, intensive monoculture farming, and resource depletion are among the challenges that threaten the increasingly vulnerable global agri-food system. Heavy reliance on a few major crops is also linked to a monotonous diet, poor dietary habits, and micronutrient deficiencies, which are often associated with diet-related diseases. Diversification—of both agricultural production systems and diet—is a practical and sustainable approach to address these challenges and to improve global food and nutritional security. This strategy is aligned with the recommendations from the EAT-Lancet report, which highlighted the urgent need for increased consumption of plant-based foods to sustain population and planetary health. Bambara groundnut (Vigna subterranea (L.) Verdc.), an underutilized African legume, has the potential to contribute to improved food and nutrition security, while providing solutions for environmental sustainability and equity in food availability and affordability. This paper discusses the potential role of Bambara groundnut in diversifying agri-food systems and contributing to enhanced dietary and planetary sustainability, with emphasis on areas that span the value chain: from genetics, agroecology, nutrition, processing, and utilization, through to its socioeconomic potential. Bambara groundnut is a sustainable, low-cost source of complex carbohydrates, plant-based protein, unsaturated fatty acids, and essential minerals (magnesium, iron, zinc, and potassium), especially for those living in arid and semi-arid regions. As a legume, Bambara groundnut fixes atmospheric nitrogen to improve soil fertility. It is resilient to adverse environmental conditions and can yield on poor soil. Despite its impressive nutritional and agroecological profile, the potential of Bambara groundnut in improving the global food system is undermined by several factors, including resource limitation, knowledge gap, social stigma, and lack of policy incentives. Multiple research efforts to address these hurdles have led to a more promising outlook for Bambara groundnut; however, there is an urgent need to continue research to realize its full potential.

Abstract In Bambara groundnut [Vigna subterranea (L) Verdc], long photoperiods can cause a decline in pod and seed number. While negative photoperiod effects on pod yield have been reported, positive effects and the existence of genotypes less sensitive for photoperiod have not been reported. Ten geographically diverse genotypes were evaluated over 3 years under short and long photoperiod for yield‐related traits (pod number, pod weight, seed number, seed weight, and 100 seed weight), pod growth habit (geocarpic or ageocarpic pods), peduncle elongation and soil penetration, and pod set/abortion. Anatomical sections of gynophores and embryonic pod development of a highly photoperiod sensitive genotype “Ankpa‐4” from Nigeria were examined. A strong photoperiodic effect on yield component traits (pod number, pod weight, seed number, seed weight, and 100 seed weight) was observed and with considerable variation between genotypes. Three classes of photoperiod effect on pod yield were identified, (a) qualitative short‐day types; (b) quantitative short‐day types; and (c) quantitative long‐day types. In long photoperiods, above‐ground vegetative biomass and the length of lateral branches in some genotypes increased by at least twofold. Morphological and anatomical characterization of gynophores and developing pods of the most sensitive line shows continuous geocarpic growth, but with healthy embryonic pods failing to enlarge after soil penetration. Results from the yield patterns of the three phenotypic classes confirm that pods and seeds are high priority sinks, and long photoperiod alters the balance in assimilate distribution between competing yield forming processes and vegetative sinks. By exploiting the genetic variation characterized here for photoperiod requirement for pod filling, the geographical range of this crop could be extended beyond current growing regions. In the near future, we anticipate that Bambara groundnut will become a significant contributor to global food, nutritional, and environmental security once these photoperiod issues are resolved.

Abstract Background Cardiovascular disease (CVD) is remarkably frequent in patients with chronic obstructive pulmonary disease (COPD). Albuminuria is a marker of vascular endothelial dysfunction and predictor of CVD events. Albuminuria is prevalent in patients with COPD as it has been shown in Caucasian and Oriental populations with COPD. The objective of this study was to determine the prevalence of Albuminuria and COPD severity correlates among black patients with chronic obstructive pulmonary disease in order to see whether a similar trend of albuminuria is also prevalent in this population. Methods A total of 104 COPD patients were enrolled in the study. Lung functions were assessed by means of the Easy One™ spirometer. Albuminuria defined by urine albumin to creatinine ratio (ACR) was tested using CYBOW 12MAC microalbumin strips in a random spot urine collection. SPSS version 20 was used for data analysis. Results In the studied population, 25/104 (24%) patients had albuminuria and 16/104 (15.4%) patients had CVD. Abnormal urine albumin (Albuminuria and Proteinuria) was present in all patients with CVD. In the subset of 46 COPD patients assessed for severity, 60.9% (95%CIs 46.1–73.9) had moderate COPD and 30.4% (95% CIs, 17.9–49.0) severe COPD. Albuminuria was moderately significantly associated with COPD severity, p = 0.049; (0.049

Abstract Background Monitoring the impact of case management strategies at large scale is essential to evaluate the public health benefit they confer. The use of methodologies relying on objective and standardized endpoints, such as drug levels in the blood, should be encouraged. Population drug use, diagnosis and treatment appropriateness in case of fever according to patient history and anti-malarials blood concentration was evaluated. Methods A cross-sectional survey took place between May and August 2015 in three regions of Tanzania with different levels of malaria endemicity. Interviews were conducted and blood samples were collected by dried blood spots through household surveys for further anti-malarial measurements. Appropriate testing when individuals attended care was defined as a patient with history of fever being tested for malaria and appropriate treatment as (i) having anti-malarial in the blood if the test result was positive (ii) having anti-malarial in the blood if the person was not tested, and (iii) no anti-malarial in the blood when the test result was negative. Results Amongst 6391 participants included in the anti-malarial analysis, 20.8% (1330/6391) had anti-malarial drug detected in the blood. Only 28.0% (372/1330) of the individuals with anti-malarials in their blood reported the use of anti-malarials within the previous month. Amongst all participants, 16.0% (1021/6391) reported having had a fever in the previous 2 weeks and 37.5% of them (383/1021) had detectable levels of anti-malarials in the blood. Of the individuals who sought care in health facilities, 69.4% (172/248) were tested and 52.0% (129/248) appropriately treated. When other providers were sought, 6% (23/382) of the persons were appropriately tested and 44.2% (169/382) appropriately treated. Overall, the proportion of individuals treated was larger than that being tested [47.3% (298/630) treated, 31.0% (195/630) tested]. Conclusion This study showed high prevalence of circulating anti-malarial drug in the sampled population. Efforts should be made to increase rapid diagnostic tests use at all levels of health care and improve compliance to test result in order to target febrile patients that are sick with malaria and reduce drug pressure. Objective drug measurements collected at community level represent a reliable tool to evaluate overall impact of case management strategies on population drug pressure.

Abstract Objective To estimate the prevalence of antibiotic resistance in indicator bacteria Escherichia coli and Enterococci isolated from duck faeces in Morogoro Municipality, Tanzania. Results Escherichia coli and Enterococcus isolation rates from ducks faeces were 91 and 100% respectively. The prevalence of antibiotic resistance of E. coli and Enterococcus was 70.3 and 42%, respectively. E. coli resistant to four antibiotics were 28 (30.8%) and showed high resistance to ampicillin (81.3), tetracycline (75.8) and trimethoprim–sulphamethoxine (62.3). Multiple antibiotic resistance of Enterococcus were more than 65%. High resistance rates shown by Enterococcus were observed in rifampin (62%), ampicillin (62%) and tetracycline (42%). Almost all farmers (92.3%) left their ducks to scavenge for food around their houses. Antibiotics used in animal treatments were oxytetracyclines, sulfonamides, penicillin dihydrostreptomycin while in humans were tetracycline, ampicillin, and amoxicillin.

Amaranth (Amaranthus tricolor), an underutilized climate smart crop, is highly nutritious and possesses diverse drought tolerance traits, making it an ideal crop to thrive in a rapidly changing climate. Despite considerable studies on the growth and physiology of plants subjected to drought stress, a precise trait phenotyping strategy for drought tolerance in vegetable amaranth is still not well documented. In this study, two drought screening trials were carried out on 44 A. tricolor accessions in order to identify potential drought-tolerant A. tricolor germplasm and to discern their physiological responses to drought stress. The findings revealed that a change in stem biomass was most likely the main mechanism of drought adaptation for stress recovery, and dark-adapted quantum yield (Fv/Fm) could be a useful parameter for identifying drought tolerance in amaranth. Three drought tolerance indices: geometric mean productivity (GMP), mean productivity (MP) and stress tolerance index (STI) identified eight drought-tolerant accessions with stable performance across the two screening trials. The highly significant genotypic differences observed in several physiological traits among the amaranth accessions indicate that the amaranth panel used in this study could be a rich source of genetic diversity for breeding purposes for drought tolerance traits.