Tanzania Journal of Health Research

Health systems transformation in sub-Saharan Africa _ policy reforms and development pathways, the experience of Tanzania: a systematic review

Beda Mwang'onde — 2026-07-27

Background: Tanzania has implemented successive health sector reforms over four decades (1980–2025) in response to economic pressures and the drive toward Universal Health Coverage (UHC). This review reports a four decades systematic synthesis of the quantitative and policy evidence on health system transformation outcomes.

Objective: To systematically examine Tanzania's health sector transformation from 1980 to 2025, analysing how successive economic and policy reforms have shaped health system architecture, service delivery, and population health outcomes.

Methods: A systematic review was conducted following the PRISMA 2020 guidelines. Peer-reviewed literature was searched across PubMed, Google Scholar, African Journals Online (AJOL), the WHO Global Index Medicus, and institutional repositories. Additionally, government documents and WHO reports published between 1980 and 2025 were sourced. Eligible sources reported quantitative or qualitative data on health infrastructure, workforce, financing, insurance coverage, mortality, life expectancy, or policy implementation in Tanzania's health sector. Data extraction captured health facility counts, workforce numbers, insurance coverage rates, maternal and infant mortality, life expectancy, and health expenditure. Narrative synthesis was used in measuring outcomes.

Results: From 2,409 health facilities in 1980, Tanzania expanded to approximately 9,915 by 2024 (a 412% increase). The health workforce grew from 10,264 to 112,480 personnel. Maternal mortality declined from approximately 1,300 to between 104 and 238 per 100,000 live births (≈1-2 deaths per 1000 births), and life expectancy increased from 50 to 67 years. However, over 86% of the population lacks health insurance, urban-rural disparities persist, and government health expenditure has declined to 3.36% of GDP. Twelve major reform programmes were identified. Success factors included sustained political commitment and strategic public-private partnerships, while implementation gaps persist in primary healthcare underfunding, human resource maldistribution, and informal-sector coverage.

Conclusion: Tanzania has achieved substantial health infrastructure and mortality reductions despite resource constraints. However, the tension between efficiency-driven reforms and equity imperatives remains unresolved. Successful UHC implementation will require rapid operationalisation of subsidised premiums for the informal sector, strengthening primary healthcare alongside tertiary investments, and reversing the decline in domestic health financing.

Health Implications of Cyanogenic Glycosides and Toxico-nutritional Aspects of Sorghum – a Review

Mebrahtom Gebrelibanos Hiben — 2026-07-27

Introduction: Evidence demonstrates that populations with low protein intake and unbalanced, monotonous diets based on poorly processed, high–cyanogenic glycoside-containing food plants should be considered at risk of adverse health effects. This review aims to highlight the often-overlooked health risks associated with consuming food plants that contain cyanogenic glycosides, with a particular focus on Sorghum.

Method: Relevant literature from accessible search engines including Google was critically reviewed and summarized.

Results: The health effects, natural occurrences, chemical and toxicological properties of cyanogenic glycosides, as well as the factors and conditions influencing their effects are described and discussed. The likely nutritional benefits and toxico-nutritional concerns related to the consumption of Sorghum products are emphasized. Situations in which Sorghum consumers may face toxicity hazards and health risks, along with possible preventive measures, are outlined. Consumption of inadequately processed Sorghum was highlighted to be linked to chronic cyanide-related conditions, including malnutrition, congenital malformations, neurological disorders, and myelopathy. It is also shown that the cardiovascular, respiratory, central nervous, and endocrine systems are the primary targets of both acute and chronic cyanide exposure through all routes. Because chronic toxicities often present as delayed adverse health effects and may go unnoticed without specific testing, they represent hidden risks requiring particular attention.

Conclusion: It is essential - especially in low-income countries - to recognize the potential adverse health effects linked to consuming cyanogenic glycoside–bearing food plants, including Sorghum. Overall, this review discusses the toxico-nutritional aspects of cyanogenic glycosides and Sorghum aiming to encourage evidence-based considerations regarding their consumption.

Effect of Yoga Therapy on Kidney Function and Psychophysical Outcomes in Chronic Kidney Disease: A Systematic Review and Meta-Analysis

I Gede Aswin Parisya Sasmana — 2026-07-27

Introduction: Chronic kidney disease (CKD) has become a global concern with increasing cases. In addition to conventional medicine, complementary approaches with mind-body therapy, including Yoga, are one of the potential therapies to improve CKD conditions represented. This review evaluates the holistic role of Yoga therapy in improving kidney function, physical condition, and psychological conditions of patients with chronic kidney disease.

Methods: A systematic review and meta-analysis to assess the CKD patients who received Yoga intervention. Data related to study characteristics, kidney function (serum creatinine (SC) and blood urea nitrogen (BUN) levels), physical condition scores, and psychological conditions of patients were extracted and further analyzed using Review Manager 5.4 software.

Results: A total of 7 studies involving 419 CKD patients were included. The results of the analysis showed that BUN and SC levels decreased significantly in patients with Yoga compared to the control group with a standardized mean difference (SMD) of -1.29 (95%CI: -2.54 to -0.05; p = 0.04) and -1.21 (95%CI: -2.10 to -0.32; p = 0.008) respectively. The physical and psychological condition scores after intra and extra-dialysis Yoga therapy were found to have increased significantly compared to before the intervention with a standardized mean difference of 2.47 (95%CI: 0.11-4.82; p = 0.04) and 3.14 (95%CI: 0.10-6.17; p = 0.04) respectively.

Conclusion: Yoga therapy can reduce BUN and SC levels and intra and extra-dialysis Yoga therapy can improve the physical and psychological conditions of CKD patients.

Effects of food insecurity among pastoralist families in Iringa District, Tanzania

Hezron Emmanuel Nonga — 2026-07-27

Background: Dietary intake measures are useful for assessing an individual’s nutritional status. Dietary intake depends not only on the availability of healthy foods but also on the resources accessible to an individual, which enable them to purchase or obtain such foods.

Aim: This study was carried out in 20 villages in Iringa District, between July and September 2013 to assess effects of food insecurity among pastoralist women and their infants.

Methods: Interviews were used to gather information on food insecurity and food frequency in pastoralist households. Anthropometric measurements and haemoglobin (Hb) concentrations of the participants were also collected. A total of 200 women and 30 infants were included in the study.

Results: The results indicated that the majority (75.8%) of women’s diets were of plant origin. Approximately 75% of women experienced food shortages, defined as consuming at least one meal per day composed of limited food groups and quantities. Only 23.7% of women were able to purchase food from markets or neighbours due to low purchasing power. All children were given meals mainly composed of carbohydrates (40%) once a day with no consistent pattern of types of foods or feeding frequency. Data on the nutritional status of children indicated that 6.6% of the Barbaig children experienced wasting while 10% of the Sukuma children were stunted. For women, 28% were underweight, while 7% were obese. Haemoglobin data indicate that 87.5% and 42% of children and women respectively were anaemic.

Conclusion: Most women and children experienced food insecurity and poor nutritional status, partly attributable to climate change. It is recommended that nutritional education programs be introduced in health facilities and schools to enhance knowledge of nutrition. Furthermore, household heads should be educated on strategies for utilizing livestock to improve livelihood and income, as well as on approaches to adapt to climate change.

Predictors of radiological abnormalities and poor health-related quality of life among patients treated for first ever pulmonary tuberculosis in Dar es salaam, Tanzania.

Elisha Osati — 2026-07-27

Background: Post-tuberculosis lung disease (PTLD) is a residual lung disease presenting after successful completion of antitubercular medications (anti-TB). To map the burden of PTLD, both radiological abnormalities and quality of life were assessed in patients who were successfully treated for microbiologically confirmed first ever pulmonary tuberculosis in Dar es Salaam, Tanzania.

Objective: To determine predictors of Radiological abnormalities and Quality of life (QoL) among post-tuberculosis patients in Dar-es-salaam.

Methods: A cross-sectional study was conducted from June 2021 to January 2022. Participants aged ≥15 years and who had completed anti-TB treatment three months’ prior the commencements of the study were recruited. Chest X-rays were done and scored using Ann-Ralph-scoring-system. QoL was assessed using EuroQol EQ-5D-5L tool. Continuous data were summarized using median and interquartile range (IQR) and compared using Mann-Whitney or Kruskal-Wallis. Categorical data were summarized in proportions and compared using Chi-square test. A Modified-Poisson-regression was used to assess predictors of radiological abnormalities or QoL.

Results: Of the 297 enrolled participants, 190 (64%) were male with median (IQR) age of 34(26,45) years. Nearly half (48.1%) had radiological abnormalities in the form of pulmonary-infiltrates 83(27.9%), fibrosis 75(25.2%), pleural-effusion 38(12.8%), nodules 21(7.1%) and cavities 9(3%). Female gender [aPR(95%CI) =4.44(1.49-13.2], HIV-negativity [aPR(95%CI) =1.17(1.03-2.96)], fever>4 weeks before diagnosis [aPR(95%CI) =1.38(1.05-1.81)] were associated with increased likelihood of developing radiological abnormalities. The overall quality of life was good with median (IQR) visual analogue score of 90% (80,95). Most affected domains of QoL were pain (39.1%) and anxiety (33.7%). Being dyspneic and working in industrial/agricultural field independently predicted poor QoL, p-values of< 0.01.

Conclusion: Common radiological abnormalities were pulmonary-infiltrates, lung fibrosis, pleural-effusion, pulmonary nodules and pulmonary cavitation. Female sex, HIV negativity and presence of fever >4 weeks were associated with radiological abnormalities. Pain and anxiety predicted poor quality of life. Follow up of patients completing their antitubercular medications is highly recommended with emphasis on management of pain and anxiety symptoms.

Electronic Health Record Systems for Maternal and Perinatal Care: A Cross-Sectional Assessment in Kilimanjaro, Tanzania

Gaudensia A. Olomi — 2026-07-27

Background: Electronic health record systems (EHRSs) could significantly improve maternal and perinatal healthcare in sub-Saharan Africa, particularly in Tanzania. Although systems like the Government of Tanzania Hospital Management Information System (GoTHOMIS) and District Health Information System 2 (DHIS2) have been implemented, many healthcare facilities still rely on paper-based data collection, leading to inaccuracies. This study evaluates existing EHRSs for maternal and perinatal care in Kilimanjaro, Tanzania, assessing their types, features, and implementation to support better data quality and clinical decision-making.

Methods: A cross-sectional study conducted from March to May 2024 in the Kilimanjaro region included all hospitals, health centers, polyclinics, and dispensaries. For dispensaries, convenience sampling was used for the selection of dispensaries with EHRSs. Data collection utilized semi-structured questionnaires administered via Research Electronic Data Capture (REDCap) to facility in-charges and health care workers managing EHRSs. The questionnaires explored various dimensions of EHRS. Data analysis was carried out using Stata version 14.

Results: Out of 74 health facilities visited, 48(64.9%) were government-owned, and 59(79.7%) located in rural areas. Regarding facility level, 38(51.4%) was health centres, 21(28.4%) were hospitals, 13(17.6%) dispensaries, and 2(2.7%) were polyclinics. A total of 22 EHRSs were identified, with GoTHOMIS 42/74(56.8%), Mobile Pharmacovigilance (VigiMobile) 58/74(78.4%), and Electronic Integrated Disease Surveillance and Response (eIDSR) 58/74(78.4%) being the most widely implemented systems. Notably, 12/22 (54.5%) systems were operational within maternal and perinatal departments, and yet none could interface with others. Nine (75%) of the 12 systems aided in clinical decision-making, with 5/12(41.7%) able to work offline and synchronize data later, which were owned by the government.

Conclusion: The EHRS deployment in the Kilimanjaro region is marked by fragmentation and a lack of coordination, despite substantial investments in digital health. Enhancements in maternal and perinatal care require better interoperability frameworks, adherence to legislation, and improved governance. The study does not evaluate national policy implementation or governance, limiting insights into regulatory effectiveness. Future research should focus on unifying digital platforms into a cohesive national architecture that also improves usability and performance.

Determinants of Healthy Eating Knowledge and Practices Among Undergraduate Students at Muhimbili University of Health and Allied Sciences: A Cross-Sectional Study

Samiri Mkoma — 2026-07-27

Background. Poor dietary quality among university students in sub-Saharan Africa contributes to rising diet-related non-communicable diseases. Evidence on healthy eating knowledge, practices, and their determinants among Tanzanian undergraduates remains limited.

Objectives. To evaluate healthy eating knowledge and dietary practices among undergraduates students at Muhimbili University of Health and Allied Sciences (MUHAS) and to examine associations with sociodemographic, environmental, economic, social, and cultural factors.

Methods. A cross-sectional survey recruited 337 students (response rate 91.1%) through stratified random sampling. Data were analysed using Pearson chi-square tests, Fisher's exact tests, and Cramér's V. Results. High knowledge was present in 56.4% (95% CI: 51.0%, 61.6%), with no significant sociodemographic associations. Good practice was present in 52.2% (95% CI: 46.9%, 57.5%). Year of study was strongly associated with practice (χ²(3) = 63.74, p < .001, V = 0.44); good practice declined from 70.2% (Year 1) to 12.5% (Year 4). Financial constraint restricted food choices for 75.4%.

Conclusions. A knowledge-practice gap coexists with progressive dietary deterioration across academic years. Institutional food-environment policy, financial support, and peer-based nutrition interventions are recommended.

Effects of Plant Stem Cell Extracts from Malus domestica and Vitis vinifera in Accelerating Healing of Indomethacin-Induced Peptic Ulcers in Wistar Rat

Gatambwa Mukandala — 2026-07-27

Background: Peptic ulcer disease (PUD) remains a major gastrointestinal disorder with high morbidity worldwide. Conventional treatments such as proton pump inhibitors reduce gastric acid secretion but long-term use is associated with adverse effects and limited regenerative action on damaged mucosa. The present study evaluated the therapeutic effects of plant-derived stem cell extracts from Swiss apples (Malus domestica) and Burgundy grapes (Vitis vinifera) in healing indomethacin-induced gastric ulcers in Wistar rats.

Methods: Thirty male rats were randomly allocated into six groups (n = 5): negative control, indomethacin-induced ulcer control, omeprazole treatment (20 mg/kg), and three groups treated with stem cell extracts at doses of 50, 100, and 200 mg/kg. Treatments were administered orally twice daily for seven consecutive days following ulcer induction. Gastric ulcer healing was assessed using the ulcer index, gastric juice volume, gastric pH, total acidity, free acidity, and histopathological examination.

Results: Indomethacin administration resulted in severe gastric lesions, accompanied by increased gastric acidity and a reduced gastric pH. Treatment with stem cell extracts produced significant dose-dependent improvement in all ulcer parameters compared with the positive control group (p < 0.001). The 200 mg/kg dose showed the greatest protective effect, producing marked reductions in ulcer index, gastric juice volume, total acidity, and free acidity while increasing gastric pH. Histological observations confirmed restoration of mucosal integrity and reduced inflammatory damage. The therapeutic effects observed at 200 mg/kg were greater than those obtained with omeprazole.

Conclusion: These findings suggest that plant-derived stem cell extracts from Malus domestica and Vitis vinifera possess significant gastroprotective and regenerative activity and may serve as promising candidates for development of alternative therapies for peptic ulcer disease.

Moral Distress and Ethical Dilemmas at the Bedside: The Hidden Burden on ICU Healthcare Workers in a Low-Income Setting: A Qualitative Study from Tanzania

David Machaku — 2026-07-27

Background: Healthcare workers (HCWs) in intensive care units (ICUs) in low-resource settings occasionally encounter resource scarcity that necessitates rationing decisions without explicitly defined institutional guidelines. In some cases, these decisions prove morally distressing for HCWs. This study set out to explore the experiences of HCWs in ICUs, where bedside rationing has been understudied in Tanzania.

Methods: This was an interpretive phenomenological study that employed qualitative data collection methods. An interview guide for in-depth interviews conducted with 15 HCWs working in the adult ICU (AICU) at Muhimbili National Hospital (MNH). Thematic analysis of the qualitative data was conducted by using the NVivo 12 software.

Results: There were 9 male and 6 female HCWs interviewed, of whom 13 were nurses, and 2 were physicians. Four themes emerged: (i) The reasons for bedside rationing, (ii) The rationing approaches used by HCWs, (iii) The ethical issues and challenges of Bedside rationing, and (iv) The moral distress of bedside rationing.

Participants described making rationing decisions in the absence of institutional guidelines, producing chronic occupational stress and moral injury.

Conclusions: Bedside rationing in Tanzania's ICU exposes HCWs to daily moral dilemmas that erode their professional well-being and compromise the quality of patient care. The absence of explicit ethical frameworks for resource allocation places an unsustainable burden on individual clinicians. This study calls for the development of institutional rationing guidelines, the establishment of hospital ethics committees, and broader policy reform to address critical resource deficits in ICU settings across sub-Saharan Africa.

Non-leukoreduced Red Blood Cells Versus Whole Blood Transfusion: Implications for Cytomegalovirus Reactivation in Sickle Cell Patients

Avelina Paschal Mgasa — 2026-07-27

Background: Sickle cell disease (SCD) is a hereditary hemoglobinopathy characterised by the production of haemoglobin S, leading to anaemia and frequent transfusions. Ensuring transfusion safety in many low-resource settings remains difficult due to the high prevalence of transfusion-transmissible infections, including cytomegalovirus (CMV), which is often not screened for in donor blood, and to the rare use of leukoreduction.

Objectives This study aimed to determine whether CMV reactivation in SCD patients is associated with a specific transfusion protocol.

Methods: We performed cross sectional study to compared CMV-specific immunoglobulin M (IgM) levels (measured by ELISA) in SCD patients attending two hospitals (Temeke Regional Referral Hospital and Muhimbili National Hospital) in Dar es Salaam, Tanzania, that use different transfusion protocols: non-leukoreduced whole blood versus non-leukoreduced red cell component transfusion, respectively. A total of 455 SCD patients who attended between July 2023 and March 2024 were enrolled and tested for CMV antibodies.

Results: Patients receiving non-leukoreduced whole blood transfusions showed significantly higher CMV-specific IgM titers, indicating recent CMV infection or reactivation. Additionally, SCD patients who had received non-leukoreduced red blood cell transfusions and had laboratory test prescriptions showed elevated CMV-specific IgM titers, and specifically, those who had at least one transfusion episode had a significantly lower monocyte-to-lymphocyte ratio.

Conclusion: These results suggest that CMV infection or reactivation was more prevalent among patients who received non-leukoreduced whole blood. Our results emphasise the importance of prioritising blood component transfusions and implementing routine CMV monitoring to enhance transfusion safety in patients with SCD in endemic regions.

Nurses' Knowledge and Practices in Sedation Assessment and Management of Critically Ill Patients at Muhimbili National Hospital (MNH) and Muhimbili Orthopedic Institute (MOI)

Hajji Mjaka Hajji — 2026-07-27

Introduction: Effective sedation assessment is vital in intensive care units (ICUs) to ensure patient comfort, prevent complications, and support safe mechanical ventilation. Nurses play a key role in evaluating sedation depth and applying evidence-based practices; however, knowledge gaps and inconsistent use of standardized tools remain common, particularly in resource-limited settings. In Tanzania, limited evidence exists on current sedation practices among critical care nurses. This study assessed knowledge, practices, and barriers related to sedation assessment and management at Muhimbili National Hospital (MNH) and the Muhimbili Orthopaedic Institute (MOI).

Materials and methods: A descriptive cross-sectional study was conducted from April 2016 to April 2017 among 106 conveniently sampled critical care nurses from ICUs, HDUs, and Emergency Departments. Data were collected using a validated questionnaire and analyzed with SPSS version 20. Descriptive statistics summarized participant characteristics and practices, while chi-square and Fisher’s exact tests examined associations between knowledge and demographic variables at a significance level of p < 0.05.

Results: Most participants were female (81.1%) and aged ≥31 years (56.6%). Although 91.5% reported conducting sedation assessments, reliance on informal observational methods was common; only 40% used the Sedation–Agitation Scale and 32% used the Glasgow Coma Scale. Documentation was frequent (90.2%), but assessments before stressful procedures were often omitted. Overall, 46.2% had good knowledge, while 20.8% had poor knowledge. Nursing qualification significantly influenced knowledge (p = 0.009). Key barriers included lack of tools and protocols, inadequate training, unfamiliarity with assessment scales, high workload, and poor communication.

Conclusion: Critical care nurses at MNH and MOI demonstrate suboptimal knowledge and inconsistent sedation assessment practices. Strengthening training, ensuring tool availability, and implementing standardized protocols are essential to improve sedation management and patient outcomes.

Prevalence and predictors of selected non-communicable diseases among adult patients on Antiretroviral Therapy in tertiary hospitals in Lagos State Nigeria

Oyenike Ekekezie — 2026-07-27

Background: As the global roll-out of Antiretroviral Therapy (ART) continues to improve survival, the increasing burden of non-communicable diseases (NCDs) poses new challenges to HIV care. This study aimed to determine the prevalence, risk factors, and predictors of obesity, hypertension, and diabetes mellitus among adult patients on ART in tertiary hospitals in Lagos State, Nigeria.

Materials and Methods: A hospital-based descriptive cross-sectional study was conducted among 416 adult PLHIV using a multistage sampling method. Data was obtained using a pre-tested structured questionnaire adapted from the World Health Organization (WHO) STEPS Instrument, in addition to anthropometric and biomedical measurements. Descriptive, bivariate and multivariate analyses were done using IBM SPSS version 27.

Results: The majority of the respondents, 70.2% (n=292) were female, and 54.1% (n=225) married, with a mean age of 49.1±10.2 years. The prevalence of obesity, hypertension, and diabetes was 37.3%, 52.6%, and 7.2% respectively. More than 70% of the respondents had at least one NCD. Multivariate analysis revealed that the high-income earners had 2 times higher odds of being obese, compared with the low-income category (aOR=2.018, 95% CI: 1.244-3.273, p=0.004); and respondents in the oldest age-groups had 4 to 5 times higher odds of having hypertension, compared with the youngest age-group (aOR=4.185, 95% CI: 1.280-13.684, p=0.018) and (aOR=5.783, 95% CI: 1.692-19766, p=0.005).

Conclusion: NCDs were more prevalent among the patients on ART compared with the general population, as almost three-quarters had at least one NCD. This study suggests that age, income and vegetable consumption are predictors of NCDs among PLHIV.

Neonatal Mortality and Morbidity after Premature Delivery in a Rural Hospital in Tanzania

Hilda Bülund — 2026-07-27

Background: One global target in the Agenda for 2030 is to decrease the neonatal mortality. However, the progress is slow, and neonatal mortality has become a bigger part of the total under-5-mortality. Prematurity is the most common cause of neonatal mortality. In sub-Saharan Africa, the neonatal mortality is the highest, but the opportunities to implement effective interventions are limited by the lack of reliable data.

Aim: This study aims to chart the mortality and morbidity of premature neonates and search risk factors associated with preterm neonatal death at a Tanzanian rural non-referral hospital, which is unique for this kind of study.

Methods: This is a retrospective, cross-sectional study conducted at Mchukwi Mission Hospital (MMH). 913 neonates born with low birth weight or admitted at MMH due to prematurity during 2019-2024 were included. Patient data were mainly collected from admission books and patient records.

Results: The prevalence of prematurity at the hospital was 14.8% and 6.5% of the premature neonates died. The premature neonates had nearly 3 times increased risk of dying without a significant downward trend during 2019-2023. The significant risk factors for experiencing neonatal death as premature were very low birth weight, extremely low birth weight, likely prematurity, referral, delivery without professional assistance, breech delivery, presence of an associated diagnosis, especially infection or RD, and to have a mother with any complication before delivery, especially placenta previa.

Conclusion: The results indicate that neonatal mortality is still a broad problem in rural Tanzania and the situation concerning shortage of staff, lack of education and insufficient medical equipment needs to be improved to decrease neonatal mortality. Although the results probably were affected by insufficient documentation, some of the results are consistent with previous studies.

Intestinal obstruction in pregnancy as a rare cause of surgical acute abdomen: A Case Report

Baraka Malegesi — 2026-07-27

Background: Intestinal obstruction during pregnancy is a dangerous, rare, but life-threatening condition that requires a high index of suspicion from clinicians due to overlapping symptoms with typical pregnancy discomforts, leading to potential delays in diagnosis and treatment. Prompt diagnosis through advanced imaging, a multidisciplinary approach involving obstetricians and surgeons, and timely surgical intervention are critical to improving outcomes and preventing severe maternal and fetal complications.

Case presentation: In this report, we present a case of a 34-year old, gravida 4, para 3, woman with 3 living children who presented with intestinal obstruction at 33 weeks of pregnancy, for which a diagnosis was made based on clinical suspicion and abdominal x-rays findings. She underwent a laparotomy, and adhesive band were found to be the cause of obstruction, with small bowel attached to the left fallopian tube. The adhesive band was released and left salpingectomy done. On the 3^rd postoperative day, she delivered vaginally a normal male baby weighing 2.3kg. Postoperatively, she recovered well and the mother and the baby were discharged on 10^th postoperative day in satisfactory condition.

Conclusion: Intestinal obstruction in pregnancy is a rare but life-threatening condition that is challenging to diagnose due to overlapping symptoms with normal pregnancy, but it requires prompt recognition and treatment to improve maternal and fetal outcomes. Early, multidisciplinary care, accurate imaging, and timely surgical intervention are crucial.

Mapping Global Research on Adolescent Bullying: A Bibliometric Analysis Using Scopus Database (2020–2025)

Iddi Chedieli Mkojera — 2026-07-27

Background: Bullying among adolescents is a global public health concern with significant mental health and educational consequences. In recent years, research output in this field has increased substantially, warranting a systematic mapping of global scholarly trends.

Objective: This study aimed to analyze global research trends, productivity patterns, collaboration networks, and thematic focus areas in adolescent bullying research published between 2020 and 2025.

Methods: A bibliometric analysis was conducted using data retrieved from the Scopus database. Publications published in English between 2020 and 2025 were included. Bibliometric indicators related to publication growth, author productivity, institutional and country contributions, citation impact, co-authorship networks, and keyword co-occurrence were analyzed using Microsoft Excel and VOSviewer.

Results: The analysis revealed a steady increase in publications, with a peak in 2023. The United States, United Kingdom, and China were the most productive countries. Research output was concentrated in high-income countries and leading academic institutions. Keyword co-occurrence analysis identified three major thematic clusters: school-based contexts and prevention strategies, victimization including cyberbullying, and mental health outcomes.

Conclusion: Research on adolescent bullying has expanded considerably in recent years; however, significant geographical disparities persist. Greater international collaboration and increased contributions from underrepresented regions are needed to develop culturally responsive bullying prevention strategies.

Availability of prevention of mother to child transmission of HIV services and its associated outcomes in selected regions of Tanzania: results from a PMTCT cascade survey.

Mukome Nyamhagatta — 2026-07-27

Introduction: In the early 2000s, Tanzania launched the Prevention of Mother-to-Child Transmission (PMTCT) program, aimed at achieving universal access to care and ultimately eliminating vertical transmission of HIV as recommended by the WHO. The current analysis was conducted to assess availability of PMTCT services and its outcomes in selected health facilities of Tanzania.

Methods: We analyzed data from the 2023 PMTCT cascade survey, which was conducted in 4 regions of Tanzania: Dar es Salaam, Dodoma, Mbeya and Mwanza. A total of 60 health facilities were purposively selected as well as 1,439 HIV positive mothers-infant pairs who attended ANC visits between December 2020 and November 2021. Data was analyzed using STATA version 17 and were linked at the patient level using the assessment ID. Descriptive statistics were summarized using median for continuous variables, whereas frequencies, and proportions were used for categorical variables.

Results: Of the 60 health facilities assessed, more than half (53.3%) were primary healthcare facilities at dispensary level and majority (88.3%) were government-owned. The overall mean of the availability of PMTCT services was 72.2%. Most facilities (88.3%) had at least one room dedicated for PMTCT services. Only 55.0% of facilities had at least 1 staff dedicated for PMTCT services. Majority (90.0%) of HIV positive women were virally suppressed at <1,000 copies/mL, while 75.1% had viral loads <50 copies/mL on all tests. Among the HIV exposed infants, the positivity rate was 0.5%.

Conclusion: Availability of PMTCT services and enabling environment are crucial for delivering high-quality PMTCT services and achieving the expected goals: viral load suppression and reducing HIV vertical transmission. The fact that majority of the facilities assessed had relatively high PMTCT services availability is promising. However, there is a need to capacitate facilities to ensure health care workers are available and capable of providing PMTCT services.

Effect of Peer-Led Educational Intervention on Knowledge of Obstetric Danger Signs Among Pregnant Adolescents in Rural Tanzania: A Mixed-Methods Quasi-Experimental Study

Beatrice Erastus Mwilike — 2026-07-27

Background: Pregnancy-related complications remain a major contributor to morbidity and mortality among adolescent girls globally. In Tanzania, adolescent pregnancy continues to be a significant public health challenge, with a substantial proportion of girls aged 15–19 years having begun childbearing.
Despite the availability of routine antenatal care (ANC) services, adolescent girls often experience unique barriers, including stigma, limited decision-making autonomy, inadequate access to adolescent-friendly information, and insufficient psychosocial support. These challenges may reduce their ability to recognize obstetric danger signs and seek timely care.
Aim: To evaluate the effect of peer-led educational intervention on knowledge of obstetric danger signs among pregnant adolescents and explore how social support and coping mechanisms influence adolescents’ experiences during pregnancy.
Methods: A mixed-methods quasi-experimental study employing a single-group pre-test/post-test design was conducted among pregnant adolescents in Mkuranga and Kisarawe districts, Tanzania, between June 2019 and June 2020. Quantitative data were collected using structured questionnaires administered before and after a peer-led educational intervention (“Nipo Nawe!”). The qualitative component complemented the quantitative findings by exploring participants’ lived experiences, social support networks, and coping strategies that may influence knowledge acquisition and care-seeking behaviours. Quantitative data were analyzed using paired-sample t-tests, while qualitative data from in-depth interviews were analyzed using thematic analysis.
Results: Mean knowledge scores increased significantly from 1.04 (SD=1.169) before intervention to 6.96 (SD=1.976) after intervention (mean difference=5.92, p<0.01). Recognition of key obstetric danger signs improved substantially after the intervention. Qualitative findings demonstrated that peer-led educational intervention provided adolescents with a supportive and relatable learning environment, improving confidence, reducing isolation, and strengthening pregnancy-related coping strategies.
Conclusion: Peer-led educational intervention significantly improves knowledge of obstetric danger signs among pregnant adolescents and provides important psychosocial support. Integration of structured peer-led educational programs into routine adolescent antenatal care services may improve sustainability, accessibility, and adolescent-centered maternal health outcomes.

Consumption of Lates niloticus and Oreochromis niloticus for Health Maintenance

Monica Ndoile — 2026-07-27

Background: Oreochromis niloticus and Lates niloticus (‘Sato’ and ‘Sangara’ in Swahili, respectively) are among fish species consumed in DSM. DSM marketed and O. niloticus fresh from Lake Victoria are they the same in terms of their nutritional quality?

Aims: This study aimed at finding out the nutritional quality of O. niloticus and L. niloticus obtained from DSM fish markets and Nera (Mwanza).

Methods: Standard methods described by Association of Official Analytical Chemists (AOAC) were employed in the determination of crude protein, total lipid, total ash, moisture for the two fish species. The digested 4210 microwave-plasma atomic emission spectrometer (MP-AES) was used for mineral analysis.

Results: Irrespective of their sampling sites, L. niloticus and O. niloticus contained crude protein content ranging from 17.7-18.0% and 18.9-20.2%, respectively. O. niloticus contained more crude fat and therefore, more gross energy (ranging from 1-1.3%, and from 89.7-92.6% respectively) than L. niloticus (ranging from 0.6-0.7% and from 85.4-87.1%). Mineral analysis results showed Ca ranging from 6.8-7.0 µg/g (L. niloticus), 4.5-5.0 µg/g (O. niloticus); Fe ranging from 25.9-26.2 µg/g (L. niloticus), 19.3-20.1 µg/g (O. niloticus); Na ranged from 64.7-65.0 µg/g (L. niloticus), 79.9-81.9 µg/g (O. niloticus); K ranged from 278-280 µg/g (L. niloticus), 269.4-270 µg/g (O. niloticus); Mn ranged from 0.46-0.5 µg/g (L. niloticus), 0.7-0.73 µg/g (O. niloticus); Mg ranged from 134.9-135.5 µg/g (L. niloticus), and 132-133.9 µg/g (O. niloticus).

Conclusion: The two fish species are good sources of protein and fat, hence higher gross energy. They are also abundant in minerals like K, Mg, Cu, Zn, Fe and Na, essential for health maintenance. Due to the high crude protein and mineral contents, families are encouraged to consume these fishes to secure their nutrition and maintain good health. Moreover, the remarkable Na/K ratio in both species regardless of the sampling site was within the recommended limits (<1), therefore, overcoming the risk of cardiovascular diseases.

Urinary tract infection in febrile children under five years in Morogoro Municipality, Tanzania: Prevalence, Bacteriological profile, Antibiotic susceptibility pattern, and risk factors for infection

Hezron Emmanuel Nonga — 2026-07-27

Background: Urinary tract infection (UTI) is among the common causes of febrile illness in children of less than five years of age in Sub-Saharan countries commonly caused by bacteria. Incidences of UTI varies according to age, gender, health condition and poor hygiene. The purpose of this cross-sectional study was to determine the prevalence, aetiology, antibiotic susceptibility, and risk factors of UTI in children of less than five years attended at healthcare facilities in Morogoro Municipality between August 2014 to October 2015. A questionnaire was administered to 275 mothers/children’s caregivers and subsequently, 275 children urine samples were collected for urinalysis, bacterial culture, and antibiotic sensitivity test.

Results: It was established that the respondents knew UTI, its mode of transmission, clinical signs, treatment, and control measures. Predictors of UTI in children that were found to be statistically significant (P<0.05) were age, inappetence, frequent urination, awaken to urinate, pain during urination, offensive urine smell, bed wetting, nitrite in urine and cleaning pattern of a baby after urination or defecation. Urinalysis results showed that 54.6% of children had yellow urine and 40.4% had turbid urine. Up to 43.6% of the urine samples had bacterial growth that indicated urinary tract infection. Children aged between 0 and 36 months had more bacteria growth (35.6%), and female children were more affected (23.6%). The common bacteria isolated were E. coli (18.2%), Klebsiella (10.2%) and Staphylococcus (8%). The bacteria isolated (n=120) had high resistance to clindamycin (97.5%), cotrimoxazole (85.8%), ampicillin (73.3%), ciprofloxacin (70.8%), erythromycin (72.5%) and ampiclox (68.3%).

Conclusion: This study shows that the awareness on UTI is high among the mothers/children’s caregivers nevertheless, the magnitude of the disease is high, and most bacteria isolated had multi-antibiotic resistance. Therefore, deliberate measures aimed at minimizing the problem are recommended.

Impact of Chronic Maternal Diseases on Estimated Fetal Weight and Umbilical Artery Doppler Findings: a cross-sectional study

Maria Shemweta — 2026-07-27

Background

Chronic maternal diseases adversely affect fetal growth and placental function. This study evaluated their impact on estimated fetal weight and umbilical artery Doppler findings using ultrasonography.

Methodology

A 9-month cross-sectional study at a tertiary hospital in Tanzania enrolled 155 pregnant women with chronic diseases. Clinical data were obtained from records and interviews. Women ≥22 weeks’ gestation underwent obstetric ultrasound with umbilical artery Doppler. Intrauterine growth restriction (IUGR) was defined as estimated fetal weight (EFW <10^thpercentile) and abnormal Doppler as indices >95^th percentile. Associations were assessed using Fisher’s exact test, with multivariate analysis identifying independent predictors.

Results

Chronic hypertension (43.9%) was the most prevalent condition. IUGR and abnormal umbilical artery Doppler findings were observed in 28.4% and 14-16% of the participants, respectively. Chronic hypertension was associated with more than a threefold increased risk of having a fetus with IUGR. IUGR was strongly linked to abnormal umbilical artery Doppler findings, including an abnormal pulsatility index (aOR = 20.35, 95% CI: 6.03–68.66, P<0.001) and reversed end-diastolic flow (REDF). Thus, routine umbilical artery Doppler assessment is essential in pregnancies complicated by chronic diseases.

High Prevalence of Sexual and Reproductive Health Problems in Higher Learning Institutions in Tanzania: Insights from Selected Institution

Jacob Paul Nyangusi — 2026-07-27

Background: Sexual and Reproductive Health (SRH) among young adults is a global public health challenge. Majority of these young adults aged between 15 and 24 are college and university students, who experience negative health consequences from early-unprotected sexual engagements. Global packages, national policies and university programmes do not yield intended outcomes as they face barriers embedded in laws, policies and social norms.

Study Objectives: This study investigates sexual and reproductive health (SRH) challenges among students in four Tanzanian higher learning institutions (HLI): the University of Dodoma (UDOM), University of Dar es Salaam (UDSM), Saint Augustine University of Tanzania (SAUT), and the Institute of Rural Development and Planning (IRDP) making a total of 300 students and 64 key informants.

Materials and Methods: Exploratory mixed-method design was employed because of its flexibility, open-ended and precision and in-depth interviews was necessary to discover experiences, perspectives and feelings while focus group discussions (FGD) assisted to explore attitudes, perceptions and experiences.

Results and Discussion: The findings reveal significant SRH issues, including unintended pregnancies (28.7% of female students), induced abortions (39.1%), and sexually transmitted infections (44% of respondents). Key contributing factors include unprotected sex, peer pressure, financial constraints, lack of contraceptive awareness, relationship problems, and cultural stigmas. Female students face higher risks, with academic performance often compromised by SRH-related issues. Off-campus living exacerbates vulnerabilities due to students’ freedom, peer pressure and enticing circumstances. Despite national policies promoting youth-friendly SRH services, implementation gaps and cultural barriers persist.

Conclusion: Female students bear a disproportionate burden, facing higher risks of academic disruption, psychological distress, maternal complications, and even mortality. Therefore, integrating mandatory, comprehensive, stigma-free SRH education into curricula; enhancing youth-friendly, confidential campus health services with outreach for off-campus students is a vital intervention.

Fractional-Order Epidemiological Analysis for Modeling of Dual-Infection Class Transmission of Diphtheria Dynamics

Akeem Yunus — 2026-07-27

Background: Diphtheria is a highly contagious infectious disease, complicated by their complex transmission pattern, and the fact that infected individuals may be asymptomatic or not even known to be infected, making it a significant public health problem in developing countries. This study formulates a mathematical model for diphtheria transmission with dual-infection classes by incorporating the dual-infection structure and the memory effect on the dynamics of the disease with the help of Caputo fractional derivative.

Methods: The proposed model has been studied by using positivity, boundedness, existence and uniqueness of solutions. Basic reproduction number (R₀) was calculated by the next-generation matrix method and semi-analytical solutions were derived by using the Laplace-Adomian Decomposition Method (LADM). The impact of various key epidemiological parameters and fractional-order dynamics were studied using numerical simulations and sensitivity analysis.

Results: The disease-free equilibrium was proved to be locally asymptotically stable for R₀ < 1. The baseline parameter values yielded computed R₀ < 1, suggesting that the disease was not going to persist and that a large outbreak was not likely. Results from sensitivity analysis showed that lowering the effective transmission rate has a great effect on reducing R₀ and the height of the peak infection. In addition, reducing the fractional order delayed and reduced the peak of the infection, emphasizing the important contribution of the memory effects to the dynamic of the disease.

Conclusion: The fractional-order diphtheria model gives a better understanding of the dynamics of disease transmission and highlights the role of memory effects in the evolution of the disease. The results indicate that interventions to decrease transmission can be effective in controlling diphtheria outbreaks, and fractional-order modeling can be a useful tool in designing prevention and control interventions.

HIV re-testing among HIV sero-negative pregnant women at a Traditional Birth Home in Nigeria

Bankole Henry Oladeinde — 2026-07-27

Background: The World Health Organization recommends HIV testing for pregnant women at first visit and at the third trimester, at delivery and/or post-partum. Prevention of mother to child transmission services are not implemented in traditional birth homes (TBH) in Nigeria. This study aimed to determine the prevalence of HIV among pregnant women attending a TBH after initial HIV seronegative status.

Materials and methods: Whole blood was collected from two hundred and two (202) pregnant women and screened for the presence of HIV antibodies using standard methods. HIV sero-negative pregnant women were followed up for a minimum of three months into the third trimester of pregnancy before a repeat HIV test was conducted on them. Relevant information was collected using a questionnaire.

Results: A total of 191(94.6%), of the two hundred and two pregnant women tested for HIV were found to be HIV-seronegative. Of this number, 27 (13.9%) were lost to follow-up. After follow-up, one hundred and sixty-four HIV sero-negative pregnant women were available for testing, but thirty -nine 39(23.8%) decline testing. Only 4(3,2%) of those who gave consent for repeat HIV testing were found to be HIV positive. Age, type of marriage and level of education did not significantly affect this sero-prevalence (p > 0.05). The most popular reason for non-uptake of HIV retesting was belief that initial HIV negative status cannot and had not changed.

Conclusions: Repeat HIV testing of HIV sero-negative pregnant women resulted in a sero-prevalence of 3.2%. Intervention strategies in TBHs are highly advocated.

Malaria and Helminth Co‑Infections and Their Association with Nutritional Status Among Children Under Five in a Rural District of Tanzania

Theresia Estomih Nkya — 2026-07-27

Background: Malaria and helminth infections are significant public health concerns in sub-Saharan Africa, particularly among children under five years, due to their contribution to anaemia and malnutrition. Understanding the interplay between parasitic infections, nutritional status, and feeding practices is essential for designing effective interventions. This study aimed to determine the prevalence of malaria, helminth infections (including schistosomiasis), anaemia, and malnutrition, and and to examine their associations with nutritional status among children under five years in Mbarali District, Tanzania.

Methods: A community-based cross-sectional study was conducted among 183 children aged 6–59 months. Sociodemographic data, feeding practices, and health history were collected using structured questionnaires. Anthropometric measurements, including mid-upper arm circumference (MUAC), were used to assess nutritional status. Malaria infection was diagnosed by Giemsa-stained thick and thin blood smear microscopy, while helminth infections were identified through stool and urine microscopy. Associations between infection status, nutritional status, and meal frequency were assessed using Pearson’s chi-square and Fisher’s exact tests, with significance set at p < 0.05.

Results: Malaria prevalence was 10.4% (n = 19), helminth infections affected 36.1% (n = 66), and co-infections were observed in 4.6% (n = 5) of children. Anaemia was detected in 9.8% of participants. Nutritional assessment revealed 81.97% had normal status, while 18.0% were malnourished or at risk. Significant associations were observed between malaria (χ² = 21.81, p < 0.001), helminth infections (χ² = 13.06, p = 0.004), co-infections (χ² = 11.45, p = 0.009), and poor nutritional status. Meal frequency was also significantly associated with nutritional status, with children consuming ≤3 meals/day more frequently classified as at risk of undernutrition or acute malnutrition.

Conclusion: Malaria prevalence was low, whereas helminth infections and undernutrition remain substantial challenges among children under five in Mbarali District. Malaria, helminth infections, and inadequate meal frequency were significantly associated with nutritional status among children under five years. Integrated public health strategies combining infection control, nutrition education, and promotion of adequate feeding practices are critical to improving child health in this rural setting.