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Prevalence and factors associated with HIV among children with tuberculosis in ten high-burden regions of Tanzania, 2018–2023: a retrospective analysis of national surveillance data
(BMC Infectious Diseases, 2026-09-15) Kalabamu, Salvatory F.
Background
Children living with HIV who develop tuberculosis (TB) have higher case fatality and lower treatment success than their HIV-negative peers. Tanzania’s routine surveillance reports pediatric TB-HIV co-infection descriptively, without formal trend testing or modelling of associated factors, leaving the National Tuberculosis and Leprosy Programme without evidence to target HIV testing and TB preventive therapy. We determined the prevalence of TB-HIV co-infection, described its pattern by year, age group, sex and region of registration, and identified associated factors among children aged below 15 years registered with TB in Tanzania.
Methods
We conducted a retrospective analysis of Tanzania’s national electronic TB surveillance system (DHIS2-eTL). The analysis included all children aged below 15-years with documented HIV status registered with TB across ten high-burden regions between January 2018 and December 2023. HIV positivity was confirmed at TB registration. We tested the annual trend with the chi-square test for linear trend and estimated adjusted prevalence ratios (aPR) by modified Poisson regression with robust variance.
Results
Of 25,449 children registered with TB and having a documented HIV status, 3,667 were HIV-positive (14.4%, 95% CI:14.0–14.8). Prevalence fell in every successive year, from 28.5% (95% CI:26.8–30.2) in 2018 to 8.9% (95% CI:8.1–9.8) in 2023 (χ²₁=719.7, p < 0.001). It rose across age groups, from 9.0% (95% CI:8.5–9.5) below 5 years to 17.7% (95% CI:16.8–18.6) at 5–9 years and 22.6% (95% CI 21.6–23.7) at 10–14 years (χ²₁=684.3, p < 0.001) and did not differ by sex (p = 0.814). It was highest in Njombe (29.7%) and lowest in Ruvuma (6.7%) (p < 0.001). In the adjusted model, co-infection was independently associated with age 10–14 years (aPR = 2.40, 95% CI:2.22–2.59), registration in Njombe (aPR = 1.46, 95% CI:1.30–1.64) and relapse TB (aPR = 2.30, 95% CI:1.92–2.76).
Conclusions
TB-HIV co-infection affected approximately one-in-seven children notified with TB and declined by two-thirds between 2018 and 2023, but remained concentrated in older children, in previously treated children and in Njombe, Mbeya and Iringa. The NTLP should prioritize repeat HIV testing for all children aged 5 years and above presenting with TB and for all retreatment cases, with geographic intensification in these three regions.
Risk factors and strategies for relapse prevention among individuals living with serious mental illness in South Africa: Qualitative inquiry from patients’ and caregivers’ perspectives
(PLoS One, 2024-08-22) Protas, Joyce
Introduction
Relapse among individuals with serious mental illnesses in resource-limited contexts, including South Africa, is a significant concern. To date, the risks for relapse among this population is well documented, but little is known about prevention strategies to reduce its occurrence in these resource-limited settings. Therefore, this qualitative study explores the risk factors and strategies for relapse prevention from the patients’ and caregivers’ perspectives.
Methods
We conducted audio-recorded face-to-face in-depth interviews to capture the lived experience of relapse of inpatient study participants with serious mental illness (N = 24) at a public specialized psychiatry hospital in South Africa and their caregivers (N = 6). We conducted an inductive thematic analysis with two pre-specified themes (risk factors for relapse and strategies for prevention), with the codes devised from the data.
Results
Six sub-themes were identified from the analysis within the two pre-specified themes(Risk factors and strategies for relapse prevention): personal-related, family-related, and health system-related risk factors and strategies for preventing relapse, respectively. To highlight some essential findings, the importance of motivation for drug adherence, family involvement, and availability of anti-psychotic drugs in public health care were noted. More importantly, this study identified important cultural complexities where traditional healers play a significant role in some cultural understanding and treatment of mental illness, affecting medication adherence.
Conclusion
This study calls for people-centered mental health care delivery in a public health system that listens to the voice of concern, including cultural challenges, and implements meaningful support that matters most to the patient and their family/caregivers.
COVID-19 Pandemic: Assessment of Knowledge, Attitude and Practice of Nurses Towards Care for Elderly: A Narrative Review
(Journal of Clinical Nursing & Reports, 2026-09-11) Mathias,Victor A.; Mwandali,Bupe K.
Nurses have a role in providing quality care for older people with Covid-19 through their knowledge and
skills. The aim of the review was to identify nurses’ knowledge, attitude, and practice (KAP) in caring for
older people in the context of the COVID-19 pandemic. The literature review included theoretical and empir-
ical literature. Peer-reviewed scientific journals related to nurses’ knowledge, attitude, and practice (KAP)
in caring for older people in the context of the COVID-19 pandemic were obtained from three databases
(Google Scholar, PubMed, a HINARI). In addition, key words search of these databases was used. One hun-
dred fourteen studies (n=114) on nurses’ KAP in caring older people with COVID-19 were identified. A Later
analysis was followed to analyse the studies whereby researchers merged findings of single and independent
studies. Four main themes emerged from the analysis namely nurses’ KAP as a whole, nurses’ knowledge on
clinical features of COVID-19 in elderly, nurses’ attitude towards caring elderly infected with COVID-19
and nurses’ practice towards caring for older people infected with COVID-19. The review suggests that
nurses need additional education to effectively care for older patients hospitalized with COVID-19 or during
similar public health challenges.
Enhancing Trachoma control in Tanzania, the role of design thinking in Trachoma persistence contexts
(PAMJ Clinical Medicine, 2026-09-15) Semali, Innocent A.; Sariah, Adellah; Mashalla, Yohana J.; Mbekenga, Columba K.; Ndossi, Godwin D.
Trachoma has been a major public health problem and a leading cause of blindness, currently affecting mostly low-income countries. The World Health Organization (WHO) and governments in 1996 jointly agreed to eliminate trachoma as a public health problem by 2020. However, by 2020, trachoma remained persistent in several districts despite the implementation of the effective integrated four interventions in Tanzania. The interventions with the acronym surgery, antibiotics, facial cleanliness, environmental improvement (SAFE) to treat trachoma eye scarring, antibiotics for active trachoma, facial cleanliness and environmental improvement failed to achieve the goal. Consequently, this study will use a design thinking approach to identify novel SAFE implementation strategies to address the SAFE complex implementation challenges in two selected villages in the Manyara region in Tanzania. The design thinking approach will start with the empathy phase, followed by defining, ideation, prototyping, and finally the testing phase. Successful innovation will be one that will reveal maximum alignment in its desirability, feasibility, and viability among communities in the villages. Hence it will contribute to the elimination of trachoma as a public health problem in the study villages and other areas, contributing to achieving the global goal to eliminate trachoma by 2030 in trachoma-persistent areas.
Regional trends in childhood tuberculosis case notification and treatment outcomes: Tanzania, 2018–2023
(Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 2026-07-30) Kalabamu, Florence S.
Background
Globally, one-in-two childhood tuberculosis (TB) case remains undiagnosed, and TB remains a leading cause of death among children under 15 years despite favorable treatment outcomes. This study assessed trends in case notification and outcomes among children with TB across ten regions of Tanzania.
Methods
We conducted a retrospective cross-sectional study using data from Tanzania's national electronic TB and Leprosy System for children diagnosed between 2018 and 2023. Mann-Kendall Tests were used to assess the existence of monotonic trends in TB notifications, and distribution of outcomes was analyzed using Wilcoxon rank-sum test or Pearson's Chi-squared test, and binary logistic regression at a 5% significance level.
Results
25,449 childhood TB cases were notified over six-year period, with 14.4% (n = 3667) HIV/TB co-infected. Case notifications increased from 2688 in 2018 to a peak of 5421 in 2022 then declined to 4493 in 2023 (p = 0.047). Significant differences in unfavorable treatment outcomes were observed between pre- and post-COVID-19 periods (OR 0.52, 95% CI 0.44–0.60). TB/HIV co-infection cases declined from 28.5% (n = 766) in 2018 to 8.9% (n = 400) in 2023 (p = 0.002), while HIV-negative cases rose markedly (p = 0.027). Overall, 97.2% of children achieved favorable outcomes. Unfavorable outcomes were common among children who were HIV/TB co-infected, under five years, and 10–15 years.
Conclusion
Childhood TB case notifications increased significantly from 2018 to 2023, indicating improved detection, though with notable regional and HIV-related disparities. Treatment outcomes were generally favorable. HIV-positive children and older age groups faced higher risks of unfavorable outcomes. Targeted interventions are needed to address disparities in case detection and treatment success.