Tanzania Medical Journal

Prevalence of High Predicted 10-Year Cardiovascular Disease Risk among Hypertensive Asymptomatic Diabetic Outpatients in Dar es Salaam, Tanzania: Using the Framingham General CVD Risk Score

2026-10-13T10:46:03+00:00

Background: Cardiovascular disease is a leading cause of premature death in sub-Saharan Africa, and
people with diabetes face markedly elevated cardiovascular disease risk. We applied the Framingham
General 10-year CVD Risk Score to quantify predicted risk and identify modifiable correlates among adults
with diabetes attending a national referral clinic in Dar es Salaam, Tanzania.
Methods: We conducted an analytical cross-sectional study (May–December 2024) enrolling 250 adults
with diabetes (≥30 years) without prior CVD. Standardized questionnaires and measurements captured
sociodemographic, anthropometric, clinical and biochemical data. The Framingham General CVD score
classified 10-year risk as low (<10%), intermediate (10–20%) or high (>20%). Crude prevalence ratios (cPRs) were estimated using univariable Poisson regression with robust standard errors; adjusted prevalence ratios (aPRs) were obtained from multivariable Poisson models including age, sex, waist circumference, BMI, systolic blood pressure (SBP), LDL-C, HDL-C, HbA1c, smoking, physical activity, statin and antihypertensive use.
Results: We analyzed 250 participants. Overall, 167 (67.1%) were classified as high risk, 54 (21.7%) as
intermediate, and 28 (11.2%) as low risk. In univariable analyses, BMI ≥24.5 kg/m² (cPR 1.68; 95% CI 1.25–
2.26) and waist circumference>94 cm (cPR 1.92; 95% CI 1.41–2.61) showed the strongest associations
with high predicted risk. In multivariable models, independent correlates of high predicted risk were age
(aPR 1.05 per year; 95% CI 1.03–1.07), waist circumference (aPR 1.26 per 10 cm; 1.11–1.43), waist >94 cm
(aPR 1.72; 1.18–2.50), SBP (aPR 1.16 per 10 mmHg; 1.04–1.29), and LDL-C (aPR 1.23 per mmol/L; 1.02–
1.48). Regular physical activity was protective (aPR 0.74; 0.56–0.98). BMI, HDL-C, HbA1c, smoking and
medication use were not independently associated after adjustment.
Conclusion: Two-thirds of adults with diabetes at this tertiary clinic had high predicted 10-year associated
CVD risk. Simple, routinely measured factors, waist circumference, SBP and LDL-C, identify many high-risk
individuals and could inform prioritized prevention, but prospective validation and local calibration of risk
scores are needed.

Secondary Infertility among Women in Tanzania: A Hospital-Level Service Gap Study

2026-10-13T11:03:40+00:00

Background: Infertility is a major but overlooked reproductive health issue, with secondary infertility
commonly arising from preventable reproductive tract infections and postpartum complications. Access to
advanced treatments is scarce, reflecting deeper health-system gaps. We estimated the prevalence and
determinants of female infertility in three randomly sampled public and private hospitals in Kinondoni and
Ubungo Districts, Dar es Salaam, to generate facility-level evidence for equitable, rights-based infertility care.
Methods: We conducted a cross-sectional study of 791 women aged 18–49 years attending outpatient
reproductive health clinics at three randomly selected hospitals. Standardized questionnaires collected
sociodemographic, reproductive, and clinical histories. Infertility was defined according to WHO criteria. We
calculated prevalence estimates with 95% confidence intervals (CIs) and assessed site-level differences
using χ² tests and cluster-adjusted p-values. Determinants of infertility were examined using Poisson
regression with robust variance to obtain crude and adjusted prevalence ratios (cPR, aPR).
Results: The prevalence of infertility was 27.8% (95% CI, 25.1–31.4%), driven largely by secondary infertility
(22.9%), with primary infertility uncommon (4.9%). Independent correlates included duration of attempting
pregnancy (aPR 2.10 for 1–5 years; 2.80 for ≥6 years), history of STI (aPR 1.45, 95% CI 1.22–1.72),
postpartum sepsis (aPR 1.28, 95% CI 1.03–1.59), and PID/gynecologic conditions (aPR 6.82, 95% CI 2.31–
12.13). Women aged 25–34 had higher infertility prevalence than those aged 18–24 (aPR 1.40, 95% CI
1.21–1.69).
Conclusion: Female infertility, predominantly secondary infertility linked to infection-related morbidity, is
common among women attending hospital reproductive clinics in Dar es Salaam. Findings underscore the
need for actionable health-system responses: integrate routine STI screening into antenatal and postpartum
care, standardize postpartum infection management, expand access to basic infertility diagnostics at hospital
level, and strengthen referral pathways and subsidized couple-based services to advance equitable,
rights-based infertility care.

Pattern and Distribution of Lung Findings on Chest CT and Severity Score in COVID19 Patients Attended at National Referral Hospital in Tanzania

2026-10-13T11:11:57+00:00

Background: Chest computed tomography is an important imaging modality for assessing pulmonary
involvement and disease severity in COVID-19, particularly where access to reverse transcription
polymerase chain reaction testing is limited. Data on chest CT findings among COVID-19 patients in
Tanzania, however, remain scarce.
Objective: The objective of this study was to describe the pattern and distribution of pulmonary
abnormalities on chest CT in adults with COVID-19, quantify disease severity using a CT severity score,
and examine relationships with clinical and laboratory parameters.
Methods: This was a hospital-based study of 158 adult COVID-19 patients (aged ≥18 years) referred
for chest CT at Muhimbili National Hospital, Tanzania, from December 2019 to June 2022. CT images
were acquired on 64- or 128-slice multi-detector scanners using a standard non-contrast protocol. CT
severity scores, assigned out of 25 based on the percentage area involved in each lobe, were graded
as mild (0–10), moderate (11–15), or severe (16–25). Associations between clinical and laboratory
variables and CTSS were analyzed using chi-square tests; p<0.05 was considered significant.
Results: The mean age was 53.67 ± 19.98 years (range 18–95); 63.92% were male and 43.03% were
aged 60 years or older. Dyspnoea was the commonest presenting symptom (85.44%). All patients had
abnormal scans. Bilateral involvement was seen in 91%, ground-glass opacities in 89%, peripheral
distribution in 73%, and multilobar disease in 74%. Severe CTSS predominated (56.33%). Oxygen
saturation below 95% was strongly related with severe findings (87.34%, p<0.001). RT-PCR was
positive in 101 patients (63.92%). Notably, those without available RT-PCR results more often had
severe CTSS than RT-PCR-positive patients (73.68% vs. 46.53%, p = 0.031). No significant relationship
was found between CTSS and inflammatory markers.
Conclusion: COVID-19 was frequent in older, male patients presenting clinically with difficulty in
breathing. Most patients had severe CTSS. The distribution Pulmonary involvement in COVID-19 was
predominantly bilateral, peripheral, and multilobar, with ground-glass opacities the most frequent
finding. Moreover, CTSS showed a positive relationship with difficulty in breathing and abnormal oxygen
saturation. Chest CT is a valuable adjunct for diagnosis and severity stratification, particularly where
RT-PCR testing is constrained

Health-Promoting Behaviours for Non-Communicable Disease Prevention among healthcare workers in Dar es Salaam, Tanzania

2026-10-13T11:22:33+00:00

Background: A survey done in Tanzania a decade ago indicated high levels of risk behaviours among
the Tanzanian population. However, did not specifically focus on Health-Promoting Behaviours (HPB)
among health professionals. HPBs are known to be risk factors for Non-Communicable Diseases. This
study examined Health-Promoting Behaviours practices among health care professionals in private and
public hospitals in Ilala District, Dar es Salaam, Tanzania.
Methods: A cross-sectional descriptive study was adopted, and a simple random sampling technique
was employed to draw 350 respondents of different health professionals (doctors, nurses, pharmacists,
physiotherapists and nutritionists) from 3 public and 2 private hospitals in Ilala district, Dar es Salaam.
We collected socio-demographic characteristics, health promotion behaviours and practices and BMI.
We presented categorical variables as frequencies and proportions and compared them using the Chisquare test. A p-value < 0.05 was regarded as independently associated with this outcome variable.
Logistic regression was used to model the relationship between health promotion behaviours and
working experience, working station and health professional cadres.
Findings Out of 350 healthcare professionals, 53.4% were females. Median age was 33 years (IQR =
27, 41). Most participants were Doctors (42.6%), followed by Nurses (34.6%), Pharmacists (16%),
Physiotherapists (4.9%), and Nutritionists (2%). Only 1.4% of healthcare workers observed the WHO’s
recommended 8 hours of sleep. Only 42.1% of healthcare workers do physical exercise for more than
150 minutes in a week. Analysis of BMI concluded that 1.4 % of studied healthcare workers were
‘underweight’, 41.1% had a ‘healthy’ status, 42% were ‘overweight’, and 15.4% were ‘obese’.
Significantly, only doctors had 4.79 odds [aOR (95% CI) =4.79 (0.62 – 1.76), p = 0.04] of practising
HPB compared to other professional cadres.
Conclusions: This study highlights a significant knowledge-to-practice gap among healthcare workers
in Tanzania. Medical literacy effectively prevents substance abuse (smoking and alcohol), but it fails to
overcome the structural barriers to healthy eating, sleep, and physical activity. The prevalence of
overweight and obesity, alongside the poor dietary habits observed in urban settings, suggests that
occupational and economic environments rather than a lack of knowledge are the primary drivers of
health behaviour. Furthermore, the significantly better behaviours among doctors compared to other
cadres suggest that while clinical exposure motivates change, a unified, system-wide approach is
missing for the broader workforce.

Survival analysis in patients with laryngeal cancer: A retrospective cohort study at Ocean Road Cancer Institute

2026-10-13T12:28:59+00:00

Background: Laryngeal cancer (LC) represents the most common head and neck squamous cell
carcinoma in Tanzania. Although global trends demonstrate declining incidence and improving outcomes,
survival disparities remain substantial, largely driven by inequities in access to definitive surgical care and
the increasing adoption of organ preservation strategies. In low- and middle-income countries, delayed
presentation and limited access to multimodal treatment continue to affect outcomes adversely. This study
aimed to identify factors associated with 5-year overall survival (OS) among patients with LC managed at
a tertiary cancer center in Dar es Salaam, Tanzania, within the context of organ–preservation–based
therapy.
Methods: A retrospective cohort study was conducted at the Ocean Road Cancer Institute (ORCI). Medical
records of 82 patients diagnosed with LC and treated between 2008 and 2012 were reviewed. The primary
outcome was 5-year OS. Survival probabilities were estimated using the Kaplan–Meier method. The logrank test was used for univariate comparisons, and multivariate analysis was performed using Cox
proportional hazards regression.
Results: Laryngeal squamous cell carcinoma accounted for 99% of cases and predominantly affected
males (male-to-female ratio 10:1), with a mean age of 61 years. Hoarseness was the most common
presenting symptom (90.2%). Most patients (72.3%) presented with advanced disease (stage III–IV). The
5-year overall survival was 29%. In multivariable Cox proportional hazards analysis, supraglottic tumor
location remained independently associated with worse overall survival compared with glottic tumors
(adjusted HR [aHR] 2.13, 95% CI 1.16–3.91, p = 0.015). Treatment-related factors were independently
associated with improved survival, including receipt of an EQD2 dose ≥46 Gy (aHR 0.50, 95% CI 0.26–
0.97, p = 0.041) and CCRT (aHR 0.46, 95% CI 0.23–0.92, p = 0.029.
Conclusion: The 5-year OS was 29%. Poor survival was independently associated with supraglottic tumor
location, absence of concurrent chemotherapy, and lower total RT dose. These findings underscore the
importance of optimizing definitive treatment in this setting, particularly through appropriate RT dose
escalation and broader use of concurrent chemoradiotherapy. Where feasible, carefully selected patients
may also benefit from timely salvage laryngectomy within an organ preservation framework to improve longterm disease control.

Renal Dysfunction and Sonographic Patterns in New Cervical Cancer Patients: Insights from Ocean Road Cancer Institute

2026-10-13T12:32:04+00:00

Background: Cervical cancer is a significant public health challenge and the leading cause of cancerrelated deaths in Tanzania, where advanced-stage presentation increases the risk of complications,
including renal dysfunction, which worsens outcomes. Despite its clinical impact, the burden of renal
dysfunction and its predictors remain understudied.

Broad Objective: This study aims to address this gap by investigating the burden and associated factors
of renal dysfunction in cervical cancer patients in Tanzania.

Methodology: A hospital-based cross-sectional study was conducted at Ocean Road Cancer Institute from November to December 2023, enrolling treatment-naïve, biopsy-confirmed cervical cancer patients aged ≥18 years. Participants were randomly selected, and data were collected via a pretested electronic
questionnaire. Renal function was assessed using eGFR (CKD-EPI 2021), with dysfunction defined as eGFR <60 mL/min. Data were analyzed using SPSS v25, with multivariate logistic regression used to identify factors associated with renal dysfunction; significance was set at p<0.05.

Results: A total of 252 participants were enrolled, with a mean age of 54.2 (SD 12) years. Nearly four out
of ten participants (39.7%) were in advanced cervical cancer stages (Stage 3 or 4), and approximately onethird (30.9%) had an estimated glomerular filtration rate (eGFR) below 60 mL/min. The most common renal sonographic finding was hydronephrosis (39.3%). In multivariable analysis, advanced cancer staging (OR = 2.40, 95% CI: 1.6–3.6, p = 0.001) and hypertension (OR = 1.70, 95% CI: 1.2–2.5, p = 0.002) were independently associated with reduced eGFR.

Conclusion and Recommendation: This study highlights the significant burden of renal dysfunction
among new cervical cancer patients presenting for treatment and identifies advanced cancer staging and
hypertension as key predictors. These findings open critical questions about the impact of renal dysfunction on cancer treatment initiation and overall mortality, underscoring the need for further research to optimize care for this vulnerable population.

The Conjunctival Patch Graft: A Novel Technique for Sealing Perforated Corneal Ulcers

2026-10-13T12:37:54+00:00

Corneal perforations are sight-threatening emergencies commonly encountered in resource-limited settings where keratoplasty is inaccessible. We present two cases of perforated corneal ulcers managed with a novel autologous conjunctival patch graft (CPG) technique. In both patients, the graft successfully sealed the perforation and preserved ocular integrity. One patient subsequently achieved a best-corrected visual acuity of 6/18 following penetrating keratoplasty. CPG is a safe, effective, and affordable option for managing corneal perforations where donor tissue is unavailable, with key advantages over existing conjunctival flap techniques.