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Soil-transmitted helminthiases (STH) are among the neglected tropical diseases and infect more than 24% of the world population. The World Health Organization recommends regular monitoring of STH's prevalence and intensity following mass drug administrations to evaluate their effectiveness and inform future control strategies. This study evaluated the prevalence, intensity, and risk factors of STH infections among school children aged 6 to 14 years old in northwestern Tanzania. A cross-sectional study was conducted among 728 school children in the Kagera region in 2021. Participants were selected using a two-stage cluster sampling method. A questionnaire was used to collect data on the risk factors. Stool samples were examined using the Kato-Katz technique. The data were analysed using STATA. The overall prevalence of STH was 56.2% (95% CI: 52.5-59.8, 409/728). About 5.7% and 1.1% of the infected children had moderate-intensity infections with Ascaris lumbricoides and Trichuris trichiura, respectively. Risk factors included the mother's occupation as a farmer (aOR: 1.2, p = 0.002) and not washing hands with water and soap (aOR: 1.4, p = 0.035). Washing one's hands after using the toilet (aOR: 0.6; p = 0.024) is a preventive measure against STH infections. STH was prevalent in the study area. The mother's occupation (farmer) and the lack of handwashing with water and soap influenced STH transmission. Conversely, washing hands after visiting the toilet and after playing with soil reduced the risk of STH infection.

Objectives: This study aimed to investigate the prevalence of Sarcoptes scabiei infestation and its associated factors among primary school children (PSC) in the Rufiji district., Methods: A quantitative school-based cross-sectional study was conducted among 447 PSC in the Rufiji district. The prevalence of scabies among PSC was determined by clinical examination and by microscopic examination of skin samples for the presence of S. scabiei . A structured questionnaire was used to gather data on factors associated with S. scabiei infestation. Descriptive analysis, Fisher's exact, chi-square tests, and logistic regression analysis were used to analyze the data., Results: The prevalence of scabies was 2.0%. Of the assessed factors, only physical contact with a person having itchy skin lesions (Adjusted Odds Ratio [AOR]=4.04, 95%CI 4.39-12.50) and infrequency of changing clothes before laundry (AOR=2.99, 95%CI 1.35-4.94) were significantly associated with scabies. The majority of participants demonstrated low levels of knowledge, with half exhibiting poor attitudes and inappropriate healthcare-seeking behaviors., Conclusions: There was an ongoing transmission of scabies among PSC in the Rufiji district, with the factors associated with the transmission being physical contact with a person who had an itchy skin lesion and the infrequency of changing clothes before laundry. Therefore, there is a need for regular clinical screening and treatment of positive cases with preventive measures on contact and provision of health education., Competing Interests: The authors have no competing interests to declare., (© 2024 The Authors.)

Background: World Health Organization (WHO) recommends periodic praziquantel Mass Drug Administration (MDA) to vulnerable populations, especially school-aged children, to reduce the risk of transmission. In the S. haematobium endemic Lindi region, on the southeastern coast of Tanzania, praziquantel has been distributed for more than a decade (12 rounds) in schools. However, there is a paucity of data on the current burden and factors perpetuating ongoing urogenital schistosomiasis among SAC. The study investigated the prevalence and factors associated with the ongoing transmission of S. haematobium among school-age children (SAC) after 12 rounds of praziquantel in Nachingwea, Southern Tanzania., Material and Methods: A quantitative cross-sectional study was conducted between May and June 2022 among 483 SAC in the Nachingwea district. Macrohematuria, microhaematuria, and S. haematobium eggs were assessed in the collected urine sample for each participant, using macroscopic observation, urine dipstick, and urine filtration techniques, respectively. Infection intensity was quantified for positive S. haematobium urine samples. Knowledge and attitudes towards schistosomiasis were assessed among participants through an interview-administered questionnaire, and water contact practices were registered through an observation checklist. Data were summarized using descriptive statistics, the Chi-square test, and logistic regression., Results: The prevalence of S. haematobium infection was 10.6%, with 0.6% (3/51) prevalence of heavy infection. The factors associated with S. haematobium persistence transmission were a habit of visiting the water bodies (AOR = 1.62, 95% CI: 0.40-1.96), swimming in the visited water bodies (AOR = 4.58, 95% CI: 1.72-12.19), using water from the river source (AOR = 3.79, 95% CI: 1.51-9.51) and attending Mkumba Primary School (17.4%; AOR = 6.12, 95% CI: 1.64-22.85)., Conclusions: Findings suggest ongoing transmission of urogenital schistosomiasis in the Nachingwea District despite 12 rounds of praziquantel treatment, with a low prevalence of heavy infection (0.6%). Praziquantel distribution should be complemented with health education, especially on the cause and transmission of urogenital schistosomiasis to increase knowledge that will improve a good attitude towards schistosomiasis prevention. An adequate water supply is to be considered to reduce infections due to the visit to water sources for daily use., Competing Interests: The authors have declared that no competing interests exist., (© 2023 The Authors.)

Background: In Tanzania, school-based Mass Drug Administration (MDA) campaigns have been the main strategy for the prevention and control of Soil Transmitted Helminths (STH) infection. Adults are not part of the program and could remain as the reservoir of infection, favoring continuity in transmission. Water, Sanitation, and Hygiene (WaSH) issues and slow progress in community awareness promotion campaigns contribute to the persistence of STH as public health issue among target populations notwithstanding the achievements of the control interventions., Objective: This study aimed to determine the current prevalence and the risk factors associated with ongoing transmission of STH infection among adults in Muleba District, Tanzania., Methodology: A household-based quantitative cross-sectional study was carried out among 552 adults in Muleba district. Through a quantitative interviewer-administered questionnaire, information was registered related to socio-demographic characteristics, level of knowledge on the disease, and WaSH factors. The prevalence of STH and estimation of its intensity were assessed by analyzing stool samples through formol-ether concentration and the Kato-Katz technique. Descriptive statistics was used to summarise data; logistic regression to determine the association between STH infection and socio-demographic and WaSH factors. A p-value < 0.05 was considered statistically significant., Results: A total of 552 adults were included in the study; 50.7% (280/552) were female. The median age was of 30 years, ranging from 18 to 73 years. A prevalence of 9.1% (50/552) for STH infection was reported; the prevalence of Hookworm Spp., Ascaris lumbricoides, and Trichuris trichiura was 7.43%, 0.91%, and 0.72%, respectively. The factors significantly associated with STH infection were farming (aOR = 3.34, 95% CI: 1.45-7.70), the habit of not wearing shoes in general (aOR = 5.11, 95% CI: 1.55-16.87), and during garden activities (aOR = 4.89, 95% CI: 1.47-16.28)., Conclusions and Recommendations: We observed an aggregated prevalence of STH infections (Ancylostoma duodenale, Trichuris trichiura, and Ascaris lumbricoides) of 9.1% among the adult population, indicating a decreasing prevalence but ongoing transmission. Integrated management is needed to address practices contributing to ongoing transmission., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Zacharia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Onchocerciasis transmission in the Ulanga District of Morogoro-Tanzania is still ongoing despite more than 20 years of Community Directed Treatment with Ivermectin (CDTI) in the area. Even though surveys conducted over the years in the area have revealed a decrease in the prevalence of onchocerciasis, the prevalence of comorbidities suggested to be associated with this filarial infection, as epilepsy, is rising in endemic regions. This fact suggests continued transmission of Onchocerca volvulus and emphasizes the need for the evaluation of factors associated with it among school aged children. Therefore, this study determined the current burden of onchocerciasis in children aged 6 to 12 years and factors associated with continued transmission despite more than 20 years of CDTI in Ulanga District, Morogoro Region-Tanzania. A school-based cross-sectional study was conducted among 270 children aged 6 to 12 years in Ulanga District. Participants were tested using the OV-16 IgG4 Rapid Test. An interview-administered questionnaire was used to assess disease-associated symptoms, knowledge of onchocerciasis, and factors associated with continued transmission of the disease among participants. Descriptive statistics, chi-square test, and logistic regression were performed during data analysis. The prevalence of onchocerciasis was 19.6% (53/270), with boys being more infected; prevalence increased with increasing age groups and was higher in rural areas. Sex (AOR = 2.2, 95% CI: 1.13-4.28), age group of 11-12 years (AOR = 31.45, 95% CI: 2.73-362.27), and not taking ivermectin (AOR = 3.17, 95% CI: 1.53-6.58) were the only significant factors identified to be associated with the transmission of onchocerciasis in this study. The high prevalence of onchocerciasis among school age children in Ulanga district suggests continued transmission in the area. Therefore, a need to integrate CDTI with health education on the importance of ivermectin uptake., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Mshana et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Prompt and appropriate clinical management of malaria is critical for reducing the continued high burden of malaria among children under five years in sub-Saharan countries. However, more remains to be known about how a patient's socioeconomic status (SES) would affect the access to diagnosis of malaria., Methods: In this cross-sectional study using the Demographic and Health Survey and Malaria Indicators Survey, we pooled the data of 38,567 febrile under-five children in 2016-2018 from 19 sub-Saharan countries. Multivariable logistic regression was used to assess the associations between SES and two binary outcomes: the visit to a health facility and a blood test for fever. Stratified analyses were further conducted by the type of health facilities (public hospitals/public primary healthcare facilities/private hospitals/private primary healthcare facilities) for the latter outcome., Results: Fifty-eight percent of the febrile children were taken to health facilities, among whom only 55% took blood tests. Compared to children from households in the highest wealth quintile, children in the lowest quintile were less likely to be taken to medical facilities [adjusted odds ratio (aOR) = 0.775, 95% confidence interval (CI): 0.675-0.889]. Parents with more than secondary education were more likely to seek care (aOR = 1.830, 95% CI: 1.561-2.145) and to have blood tests (aOR = 1.729, 95% CI:  1.436-2.082) for their febrile children than parents without formal education. The probabilities of receiving blood tests at public hospitals and public primary healthcare facilities stayed relatively high across parental education levels and wealth quintiles, while these probabilities remained the lowest at private primary healthcare facilities, ranging from 0.100 (95% CI: 0.074-0.127) to 0.139 (95% CI: 0.083-0.194) across parental education levels and from 0.104 (95% CI: 0.078-0.130) to 0.125 (95% CI: 0.090-0.160) across wealth quintiles., Conclusions: Significant socioeconomic disparities existed both in the access to health facilities and laboratory diagnosis of malaria in children in sub-Saharan African countries. These disparities were particularly evident in the private sector. Universal health coverage needs to be further strengthened to make formal healthcare in general and the laboratory diagnosis of malaria more accessible and affordable., (© 2023. The Author(s).)

Background: Cardiovascular abnormalities have been described in patients with schistosomiasis. Their true prevalence and clinical features in endemic settings are unknown. Patients and methods: The study aimed to assess the prevalence of subclinical cardiovascular damage in a population endemic to schistosomiasis. A cross-sectional study was conducted using colour-ultrasound assessment of abdominal and carotid arteries among adults aged >18 years living in Kome Island, Tanzania. Carotid intimal medial thickness, carotid plaque, mean abdominal aortic diameter, and presence of aneurysms were assessed. Anamnestic data on previous Schistosoma infection was collected; the actual prevalence of Schistosoma mansoni and Schistosoma haematobium was also assessed through stool and urine investigations. Results: A total of 264 participants (166 female, 98 male) were enrolled (mean age of 50±15.5 years). The history of previous schistosomiasis was 27.3%, and actual positivity for Schistosoma mansoni was 5.9%. The Latero-lateral Abdominal Aortic Diameter was significantly increased among participants with a previous history of schistosomiasis (16.7±2.8 mm vs. 17.6±3 mm; p=0.02), with an aOR of 1.15 [CI 1.04-1.28]; p=0.007]. Conclusions: The significant difference in the Latero-lateral Abdominal Aortic Diameter in participants with previous Schistosomiasis history schistosomiasis, suggests the need for further investigations on aortic damage in endemic populations, independently from the positive laboratory investigations.

Objective: To investigate the prevalence, intensity, clinical aspects and factors associated with tungiasis infection among primary school children in Northeastern Tanzania., Methods: A quantitative school-based cross-sectional study was conducted among 401 primary school children. Participants were assessed through clinical examination to look for embedded Tunga penetrans in their hands, feet, arms and legs. A structured questionnaire was used to enquire about factors associated with tungiasis infection. The data were analysed using descriptive statistics, Chi-squared test and logistic regression, with p <0.05 taken to indicate significance., Results: The overall prevalence of tungiasis infection was 21.2%. Of the 85 tungiasis-infested children, 54 [63.5%, 95% confidence interval (CI) 53.1-74.1] had mild infection, 25 (29.4%, 95% CI 19.0-39.6) had moderate infection, and six (7.1%, 95% CI 1.2-12.9) had heavy infection. A moderate level of knowledge was significantly associated with high odds of tungiasis infection [adjusted odds ratio (AOR) 3.16, 95% CI 1.50-6.67], while not keeping a dog/cat at home was a protective factor (AOR 0.47, 95% CI 0.25-0.89)., Conclusions: Moderate prevalence of tungiasis infection was observed among primary school children favoured by factors related to the host, parasitic agent and environment. There is a need for a health education programme in schools encouraging use of appropriate footwear (closed shoes), use of locally accessible repellents (coconut oil), fumigation of households, and washing dogs/cats with insecticides., Competing Interests: None declared., (© 2023 The Author(s).)

Background: Intestinal schistosomiasis is one of the most common neglected tropical diseases in Tanzania. Despite massive praziquantel administration, data from Northern Tanzania have reported a prevalence of up to 93.2%. Because the disease is focal, depending on host, environmental and intermediate host factors, there is a need to acquire data in specific settings to better tailor interventions. Therefore, the study assessed the prevalence and factors associated with persistent transmission of intestinal schistosomiasis among school-age children in Busega district, Northern Tanzania., Methods: A school-based cross-sectional study was conducted among 363 primary school children, randomly selected from school clusters in the Busega district. A single stool sample was collected from each child for S. mansoni ova and infection intensity examination using Kato-Katz. Factors related to intestinal schistosomiasis transmission were acquired through a questionnaire. A malacological survey was carried out to determine the Biomphalaria infectivity rate. Descriptive statistics and logistic regression analysis were conducted to analyse the association between schistosoma infection and factors related to transmission in this setting., Results: The prevalence of S. mansoni infection was 41.3% (95% CI: 36.3-46.5), statistically significantly higher among the younger group aged less than 11 years (46.4% vs 35.3%, p = 0.032). The intensity of infection was heavy in 1.6% of participants, moderate in 9.6%, and light in 30.9%. Studying at Mwamayombo Primary School (AOR = 2.50, 95% CI: 1.12-5.60) was the only factor significantly associated with S. mansoni infestations. The snail intermediate host belonged to Biomphalaria sudanica species, whose infectivity rate was quantified as 0.97%, thus confirming ongoing transmission in the area., Conclusions: There was a high prevalence of S. mansoni infection among school-age children in the Busega district. The presence of the infected Biomphalaria sudanica in the area documents the persistent transmission of the disease, favored by low knowledge and negative attitudes among school-aged children. Hence, the need for multi-approach intervention for schistosomiasis prevention and elimination., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ogweno et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Introduction: Schistosomiasis, caused by trematode worms of the genus Schistosoma , has organ-specific morbidity due to host's inflammatory response to the oviposition of parasite eggs in vessels and organs. Damage to the cardiovascular system, including aneurysms, has been described in patients. Aims and Methods . Aims of the review of case reports and series published in literature were to describe the occurrence of aneurysm in patients with schistosomiasis. Investigation Outcomes . A total of 13 cases (seven males and six females) with a mean age of 41.3 ± 14.9 years were included. Aneurysm occurred in patients with active or previous infection. In more than half of the cases, an intestinal or hepato-splenic involvement was reported, followed by pulmonary schistosomiasis and urinary or testicular involvement. The most frequently involved arterial district was the pulmonary artery. Immunomodulation and thrombophilia were featuring challenging surgery., Conclusions: More studies are needed to shed light on the vascular complications of schistosomiasis, to ascertain the true burden of aneurysms in patients with schistosomiasis, to establish the pathophysiology of vessel damage and aneurysm formation, and to assess if there is an association between schistosomiasis and aneurysm formation in line with WHO 2021-2030 NTD Roadmap., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Valeria Silvestri et al.)

Objective: Our study investigated the prevalence, infection intensity and associated risk factors of intestinal schistosomiasis among secondary school students in Shinyanga Municipal Council, Northern Tanzania., Methods: A quantitative school-based cross-sectional study was conducted from June to August 2022 among 620 secondary students. One stool specimen per participant was collected and screened for Schistosoma mansoni ova by microscopy using the Kato-Katz technique. Ova were counted to estimate infection intensity in all positive stool samples. Participants' socio-demographic characteristics and risk factors for intestinal schistosomiasis were gathered using a structured questionnaire. Data analysis consisted of descriptive statistics, Chi-square test and logistic regression., Results: Overall prevalence of S. mansoni was 1.9%. All infected participants had light infection intensity. Overall prevalence of other intestinal parasites was 2.7%, with Hookworm spp (17.6%) and Entamoeba coli (52.9%) the most observed intestinal helminth and protozoa, respectively. Among assessed factors, being in form II or III, visiting water sources and doing activities in water sources were statistically significantly associated with increased risk of S. mansoni transmission., Conclusions: There is ongoing transmission of intestinal schistosomiasis among secondary students. Hence, the need for extending praziquantel administration in this group, health education provision, and improvement of water supply, sanitation and hygienic practices., (© 2022 The Author(s).)

Objective: To determine the prevalence, knowledge and practices regarding urogenital schistosomiasis among women of reproductive age in Kileo Ward, Mwanga District., Methods: A cross-sectional study was conducted in the dispensary in Kileo Village, Mwanga District. A pre-tested structured questionnaire was administered to participants to collect information on sociodemographic characteristics and schistosomiasis-related knowledge and practices. Urine samples were examined for schistosoma eggs using the urine sedimentation technique. Data collected were cleaned, coded and entered into SPSS Version 20 for analysis. Chi-squared test and Fisher's exact test were used for analysis., Results: Overall prevalence of urogenital schistosomiasis was 2.3%. The prevalence was higher among participants aged ≥18 years (3.2%), those who did domestic chores in river water (13.3%), and those who swam in river water (7.1%). Only a few participants had a low level of knowledge (4.8%) and poor practices (1.9%) regarding urogenital schistosomiasis., Conclusion: The transmission of urogenital schistosomiasis was low among women of reproductive age in the study area. Despite a high level of knowledge and good practices for urogenital schistosomiasis, there are knowledge gaps regarding its causes and risk factors., Competing Interests: None declared., (© 2022 The Author(s).)

Background: Parasitic infections are common in developing countries, due to poor sanitation and inadequate hygiene. Undiagnosed and untreated parasitic infections can have severe acute and chronic consequences, including cardiovascular lesions. Aortic aneurysms have been described in patients with disease of parasitological interest, including hydatidosis., Aim and Methods: We have described, through a review of case reports in literature, the occurrence of aortic aneurysm in patients with hydatidosis, analysing the specific clinical features, peculiarities of vascular involvement, treatment and outcome., Results: A total of 9 case reports has been included. Mean age of patients was 41.7 ± 12.2 years (range 12-54). Vascular pathology presentation was chronic in the majority of cases, acute in three and subacute in one. The majority of lesions occurred in the descending thoracic aorta; one case involved the ascending aorta and arch, one the abdominal aorta. Open surgical intervention was reported in the majority of cases, endovascular treatment in two. Complications, reported twice at follow up, included one endograft stenosis and, in two cases, vertebral erosion. No deaths were reported., Conclusion: Aortic aneurysms can occur in patients with hydatidosis. The surgical vascular treatment of this non communicable complication of a disease of parasitological interest needs to take into account the specific clinical and surgical context in which occurs, to better target pharmacological and surgical treatment., Competing Interests: Declaration of competing interest No conflict of interest or financial disclosure has to be declared by the authors All authors have read and approved the final version of the manuscript., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: To determine the burden and management of filarial lymphoedema and its associated factors in Lindi district, Tanzania., Methods: Cross-sectional study involving 954 community members who were screened for filarial lymphoedema by using a checklist. Moreover, lymphoedema patients were examined for the presence of entry lesions, staging of disease, and interviewed on acute dermatolymphangioadenitis (ADLA) attacks, and their current practices on lymphoedema management. Descriptive statistics and logistic regression analyses were performed. A p < 0.05 was considered statistically significant., Results: The prevalence of filarial lymphoedema was 7.8%, with the majority in the early stage of lymphoedema (78.4%). The large majority (98.6%) of the patients had lower limb lymphoedema and 46% of lymphoedema patients had entry lesions. More than a half (60.8%) of those lymphoedema patients had experienced ADLA attacks; close to two-thirds (64.8%) had one or two attacks in the past 6 months. Generally, patients had inappropriate hygiene care practices for filarial lymphoedema management. Inappropriate hygiene care practice for lymphoedema management was associated with an increased risk for the development of advance stage of lymphoedema (adjusted odds ratio = 7.379, 95%, confidence interval: 3.535-16.018, p = 0.04)., Conclusion: Though lymphatic filariasis transmission has drastically declined, chronic manifestations of lymphoedema persist in Lindi district. The recommended disease management practices are deficient, which calls for a programmatic approach for mapping the burden of lymphoedema and implementing its management., (© 2022 John Wiley & Sons Ltd.)

Introduction: Cerebral vascular comorbidities may occur in patients with schistosomiasis, as described in case reports. Aim and Methods. We have summarized general clinical and neurological features in patients with stroke associated with schistosomiasis, through a review of case reports in the literature. Investigation Outcomes. A total of eight case reports were retrieved. The mean age of patients was 36.42 ± 16.7 (19 to 56 years), four females, three males, and one anonymous sex. Eosinophilia was the most frequent feature at presentation, followed by cardiac abnormalities, confusion, fever, ataxia, hemiplegia, headache, urticaria, dysphasia, and memory impairment. Patients usually present with watershed infarction or intracranial vasculitis. In one case, extracranial carotid arteries presented with inflammation and stenosis. The patient's serology was positive on admission in five cases. Full neurological recovery was reported in three cases, and partial improvement in another three. In two cases, information on neurological outcomes was incomplete. Stroke in schistosomiasis can be caused by haemodynamic impairment, direct lesion to the arterial wall, vasa vasorum obliterative endarteritis, contiguity with a focus of inflamed tissue, or inflammatory intimal damage. Schistosomiasis needs to be included in the differential diagnosis of stroke in people living or coming back from endemic areas., Conclusions: Further studies addressing the noncommunicable comorbidity issues related to this condition are needed., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Valeria Silvestri et al.)

Objective: To investigate the magnitude of urogenital schistosomiasis and determinants of transmission among adolescents and young adults in Itilima district, Simiyu region, Northern Tanzania., Methods: A quantitative cross-sectional study was carried out using probability sampling strategies to select 433 secondary school students from five schools among the five wards of Itilima district, an area endemic for urogenital schistosomiasis. A self-administered structured questionnaire was used to gather data on determinants, and urine samples were examined for macrohaematuria and the presence of Schistosoma haematobium using the standard urine filtration technique. Data analysis was performed using descriptive statistics, Chi-squared test and logistic regression., Results: The overall prevalence rates of S. haematobium infection and macrohaematuria among adolescents and young adults were 15.9% and 3%, respectively, with the majority of individuals being lightly infected (85.5%). The determinants for urogenital schistosomiasis among the adolescents and young adults in Itilima district were: being in Form I [adjusted odds ratio (aOR) 2.42, 95% confidence interval (CI) 1.16-11.8; P =0.018]; being resident in Sasago ward (aOR 5.57, 95% CI 1.98-15.67; P =0.001) or Budalabujiga ward (aOR 2.99, 95% CI 1.04-8.56; P =0.042); having positive attitudes towards urogenital schistosomiasis (aOR 3.14, 95% CI 1.27-7.72; P =0.013); swimming in rivers (aOR 1.92, 95% CI 1.06-3.50; P =0.032); and urinating in water bodies (aOR 1.68, 95% CI 1.05-2.69; P =0.032)., Conclusions: Urogenital schistosomiasis is prevalent among adolescents and young adults, and serves as a reservoir for transmission of S. haematobium . Preventive chemotherapy campaigns should be extended to adolescents and young adults, and integrated with regular screening, health education and an adequate water supply., Competing Interests: None declared., (© 2022 The Author(s).)

Introduction: Despite the ongoing intervention for schistosomiasis control among school-age children in the Lindi region of Tanzania, urogenital schistosomiasis continues to be a public health problem, presumably because other at-risk populations are not covered in praziquantel deworming campaigns. Evidence shows that under-fives become infected in their early life hence the need to understand the disease profile and the risk factors for exposure to infection so as to plan effective control strategies in this group. This study examined the prevalence and risk factors of urogenital schistosomiasis among under-fives in the Mtama district, Lindi region of Tanzania., Methodology/principal Findings: A quantitative community-based cross-sectional study was carried out among 770 participants (385 under-fives and their 385 parents/guardians) in the Mtama district to investigate the burden and the risk factors associated with S. haematobium infection. A single urine specimen was collected from the under-fives and tested for macro and microhaematuria, presence of S. haematobium ova, and intensity of infection. A structured questionnaire gathered on risk factors for S. haematobium exposure in under-fives from their parents/guardians. Data analysis was performed using descriptive statistics, chi-square test, and logistic regression. Prevalence of S. haematobium ova was 16.9%, and that of macro and microhaematuria was 6% and 17.9%, respectively. Of the 65 positive under-fives, 49 (75.4%) 95% CI 65.4-86.3 had a light infection intensity, and 16 (24.6%) 95% CI 13.7-35.5 had a heavy infection intensity. Among the assessed risk factors, the parents/guardians habit of visiting water bodies for domestic routines (AOR: 1.44, 95% CI: 1.13-1.74), especially the river (AOR: 6.00, 95% CI: 1.20-35.12), was found to be a significant risk factor for infection of S. haematobium in under-fives., Conclusion/significance: A moderate prevalence of S. haematobium was found among the under-fives conceivably with adverse health events. The infected under-fives could be a source of continuity for transmission in the community. An intervention that covers this group is necessary and should be complemented with regular screening, health education campaigns, and an adequate supply of safe water., Competing Interests: The authors have declared that no competing interests exist.

Background: Despite twelve rounds of school-based preventive chemotherapy for schistosomiasis in endemic areas of Tanzania such as Mtama district, Lindi: the burden of Schistosoma haematobium infection has remained highly conceivable due to re-infections. The factors associated with continuity of S.haematobium transmission in Mtama district, Lindi have not been fully established. This study investigated the burden and factors contributing to the ongoing transmission of S.haematobium infection in the endemic district of Mtama, Lindi., Methods: A quantitative cross-sectional survey was carried out among 649 school-age children in the Mtama district to determine the burden and factors associated with continuity of S.haematobium infection transmission. A single urine specimen was obtained from each pupil and tested for macro- and microhaematuria, presence of S.haematobium ova, as well intensity of infection; this was complemented with a survey of Bulinus spp snail intermediate hosts and their infectivity. A structured questionnaire was employed to gather information on individual and environmental risk factors for S.haematobium transmission. Summary statistics were computed for individual variables; while a univariate and multivariate logistic regression analysis was performed to assess the association between risk factors with S.haematobium infection., Results: Prevalence of S.haematobium infection by macro- and microhaematuria was 13.1% and 46.2% respectively. The prevalence of S.haematobium ova was 52.7%; intensity of infection was light in 53.1%, and heavy in 46.9%. Snail intermediate hosts were Bulinus globosus and B.nasutus, whose infectivity was 2.2% and 1.3%, respectively. Among the assessed risk factors, long residency (10-13 years) in the area was a significant risk factor for the continuity of S.haematobium transmission (AOR: 21.79, 95% CI: 1.37-346.4)., Conclusions: The observed 52.7% prevalence of S.haematobium infection represents unacceptably high prevalence after 12 rounds of preventive chemotherapy. Therefore, an urgent need for the implementation of integrated multiple control interventions in the Mtama district; is considered to be imperative., Competing Interests: The authors have declared that no competing interests exist.

Social and behavioural change strategies are crucial to facilitating the adoption of preventive behaviours during the COVID-19 pandemic. For the success of such social and behavioural changes, the community should be aware of the interventions and willing to adhere to health advice. This letter details the strategies employed in Tanzania to accelerate the adoption of preventive behaviour and contain the spread of COVID-19., Competing Interests: Conflict of Interest None., (© Penerbit Universiti Sains Malaysia, 2021.)

Background: In Tanzania, the uptake of optimal doses (≥ 3) of sulfadoxine-pyrimethamine for intermittent preventive treatment of malaria (IPTp-SP) during pregnancy has remained below the recommended target of 80%. Therefore, this study aimed to investigate the predictors for the uptake of optimal IPTp-SP among pregnant women in Tanzania., Methods: This study used data from the 2015-16 Tanzania demographic and health survey and malaria indicator survey (TDHS-MIS). The study had a total of 4111 women aged 15 to 49 who had live births 2 years preceding the survey. The outcome variable was uptake of three or more doses of IPTp-SP, and the independent variables were age, marital status, education level, place of residence, wealth index, occupation, geographic zone, parity, the timing of first antenatal care (ANC), number of ANC visits and type of the health facility for ANC visits. Predictors for the optimal uptake of IPTp-SP were assessed using univariate and multivariable logistic regression., Results: A total of 327 (8%) women had optimal uptake of IPTp-SP doses. Among the assessed predictors, the following were significantly associated with optimal uptake of IPTp-SP doses; education level [primary (AOR: 2.2, 95% CI 1.26-3.67); secondary or higher education (AOR: 2.1, 95% CI 1.08-4.22)], attended ANC at the first trimester (AOR: 2.4, 95% CI 1.20-4.96), attended ≥ 4 ANC visits (AOR: 1.9, 95% CI 1.34-2.83), attended government health facilities (AOR: 1.5, 95% CI 1.07-1.97) and geographic zone [Central (AOR: 5, 95% CI 2.08-11.95); Southern Highlands (AOR: 2.8, 95% CI 1.15-7.02); Southwest Highlands (AOR: 2.7, 95% CI 1.03-7.29); Lake (AOR: 3.5, 95% CI 1.51-8.14); Eastern (AOR: 1.5, 95% CI 1.88-11.07)]., Conclusions: The uptake of optimal IPTp-SP doses is still low in Tanzania. The optimal uptake of IPTp-SP was associated with attending ANC in the first trimester, attending more than four ANC visits, attending government health facility for ANC, having primary, secondary, or higher education level, and geographic zone. Therefore, there is a need for health education and behavior change interventions with an emphasis on the optimal use of IPTp-SP doses.

Background: Community drug distributors (CDDs) have a crucial role in distributing ivermectin for onchocerciasis control and prevention. Their roles, experiences and challenges faced in the implementation of community-directed treatment with ivermectin (CDTI) programme could potentially affect coverage, consequently leading to persistent transmission. Therefore, this study aimed to explore the experience and the roles which CDDs plays in implementation of community directed treatment with ivermectin program for onchocerciasis control in Ulanga, Tanzania., Methods: A cross-sectional study design was used to collect qualitative data in 2018 in Ulanga district, Tanzania. Five community drug distributors were purposively selected for in-depth interviews. Thematic framework approach for qualitative data analysis was used to generate codes, categories and themes., Results: Out of the five community drug distributors interviewed, two had experience of 15 to 20 years on implementation of the community directed treatment with ivermectin programme while the remaining community drug distributors had experience of less than 10 years. The main challenges faced by CDDs in the implementation of the CDTI programme include; the geographical location of the hamlets (hard to reach hamlets), long distances between houses, low compliance of community members to medication due to fear of side effects experienced before and mistrust of methods of dose calculation, short time of drug distribution and absence of people from their households as the exercise was conducted when community members were involved in agricultural activities., Conclusions: The challenges faced in the implementation of the CDTI programme could negatively affect the distribution and coverage of ivermectin treatment in the Ulanga district. It's now an opportune time to address the challenges that CDDs are facing in the implementation of the CDTI programme to ensure effective control of onchocerciasis in the district., (© The East African Health Research Commission 2021.)

While praziquantel mass drug administration is currently the most widely used method in the control of human schistosomiasis, it does not prevent subsequent reinfection hence persistent transmission. Towards schistosomiasis elimination, understanding the reinfection rate is crucial in planning for the future interventions. However, there is scarcity of information on the global reinfection rate of schistosomiasis. This systematic review and meta-analysis aimed at summarizing studies that estimated the reinfection rate of human schistosomiasis. Three data bases (PubMed, Hinari and Google Scholar) were thoroughly searched to retrieve original research articles presenting data on reinfection rate of human schistosomiasis. Study quality and risk of bias was assessed based on Joanna Briggs Institute critical appraisal checklist. Meta-analysis was conducted using statistical R version 3.6.2 and R Studio using "meta" and "metafor" packages. Random effect model was employed to estimate pooled reinfection rates. Heterogeneity was determined using Cochran's Q (chi-square)-test and Higgins I2 statistics. A total of 29 studies met inclusion criteria to be included in this review. All studies had at least satisfactory (5-9 scores) quality. The overal mean and pooled reinfection rates of schistosomiasis were 36.1% (±23.3%) and 33.2% (95% CI, 26.5-40.5%) respectively. For intestinal schistosomiasis, the mean and pooled reinfection rates were 43.9% (±20.6%) and 43.4% (95% CI, 35.8-51.4%), and that for urogenital schistosomiasis were 17.6% (±10.8%) and 19.4% (95% CI, 12.3%- 29.2%) respectively. Cochran's Q (chi-square)-test and Higgins I2 statistic indicated significant heterogeneity across studies (p-values < 0.001, I2 values > 95%). Results of subgroup analysis showed that, the type of Schistosoma species, participants' age group, sample size and geographical area had influence on disparity variation in reinfection rate of schistosomiasis (p < 0.1). Despite the control measures in place, the re-infection rate is still high, specifically on intestinal schistosomiasis as compared to urogenital schistosomiasis. Achieving 2030 sustainable development goal 3 on good health and wellbeing intensive programmatic strategies for schistosomiasis elimination should be implemented. Among such strategies to be used at national level are repeated mass drug administration at least every six months, intensive snails control and health education., Competing Interests: The authors have declared that no competing interests exist.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is causing a global pandemic had a zoonotic origin in China. Considering the inter-connectedness between human, environment, and animal health, the One Health approach is the appropriate strategy to control and mitigate the effects of the ongoing coronavirus disease 2019 (COVID-19). This letter explains the benefits of the One Health approach and recommends specific measures that could be taken to accelerate the fight against COVID-19 and prevent the spread of newly emerging infectious diseases., Competing Interests: Competing interestsThere are no competing interests., (© The Author(s) 2020.)

Water, sanitation, and hygiene (WASH) interventions remain to be important in the prevention of further spread of coronavirus disease-2019 (COVID-19). Basic hygiene interventions such as handwashing with water and soap (HWWS) when applied consistently will deactivate and remove the virus particles from the hands. Realizing the efforts that have been made by countries world over in controlling the COVID-19, this letter seeks to discuss how the available WASH services can be used in the fight against further spread of COVID-19. The letter highlights the challenges being faced by the current WASH services in middle- and low-income countries and suggests measures that can be employed to strengthen the WASH services in this period of the COVID-19 pandemic., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2020.)

Background: It is unclear whether algorithms with evidence-based interventions are used in a setting where the work load is high and qualified staff is scarce to identify neonates with life-threatening conditions., Methods: The nurse-midwives' knowledge and opinion about the World Health Organization (WHO) guide on postpartum newborn care were assessed in a hospital in Tanzania before and after training. Their adherence to this guide was evaluated by analysing 100 neonatal records., Results: Before training, 44% of the nurse-midwives were familiar with the WHO guide. All nurse-midwives supported the implementation of the guide. In all, 21% of the postpartum record forms were fully completed. Risk factors for illness were missed in 27%., Conclusion: Nurse-midwives' expertise in the WHO guide on postpartum newborn care cannot be taken for granted. The complexity of this guide demands expertise and makes its use time-consuming and thus its practicability disputable in a setting with limited resources., (© The Author [2016]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)