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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.
Strategies for relapse prevention among people with schizophrenia in KwaZulu-Natal Province, South Africa: Healthcare providers’ perspectives
(PLoS One, 2025-03-25) Protas,Joyce.
Introduction
Relapse is a significant challenge among people with schizophrenia and is broadly recognized by the aggravation of positive or negative symptoms, the need for re-hospitalization, more intensive case management, and/or changes in medication. The quality of inpatient care and proper transition to outpatient care are crucial in reducing the risk of relapse. Healthcare providers play vital roles in ensuring the continuity of care after patients are discharged from the hospital. Little is known about the roles of preventing relapse from the perspective of healthcare providers. This study explored the currently existing strategies for preventing relapse from the perspective of healthcare providers.
Methods
We captured the view of healthcare providers providing services to psychiatric patients using a qualitative methodological approach with descriptive phenomenology. We conducted audio-recorded, in-depth interviews with 15 consenting clinical providers from a public psychiatric hospital in Durban, South Africa. To facilitate analysis, we used Dedoose software (SocioCultural Research Consultants, LLC [www.dedoose.com]), and the themes were inducted from the data.
Results
Six major themes inducted from the analysis: Preparing patients and caregivers for discharge; Developing consistent and caring therapeutic relationships; Using an active approach to transition; Working with patients and caregivers concurrently; Creating and sustaining interagency connections; and Facilitating alternative forms of treatment.
Conclusions
Discharge planning and preparation are needed to ensure smooth transitions from hospital to outpatient care for relapse prevention. The healthcare system should ensure the availability of human resources for health at all levels of health facilities, and multidisciplinary teamwork will help a successful transition.
Feasibility and acceptability of unconditional cash transfers intervention among unemployed young adults with first-episode psychosis in South Africa: a pilot randomized controlled trial
(International journal of mental health, 2026-04-25) Protas,Joyce.
There is a lack of high-quality evidence on cash transfers as an intervention to support young people with first-episode psychosis (FEP) in Africa. To address this gap, we conducted a pilot randomized controlled trial (RCT) with a 3-month follow-up period to assess the feasibility and acceptability of an unconditional cash transfer (UCT) intervention among FEP. We enrolled 60 unemployed young adults (18–29 years) with FEP from three public hospitals in KwaZulu-Natal, SA, and allocated participants into the intervention (n = 30) or the control arm (n = 30) using simple randomization. The intervention arm participants received a monthly transfer of R1,350 for three consecutive months. All 30 participants in the intervention arm completed the three-month follow-up, and 24 (80%) completed follow-up in the control arm. Although the effect of UCT on clinical and social outcomes is not the primary focus of this RCT, we observed significantly greater quality of life (p < 0.05) and medication adherence (p < 0.02) in the intervention group as compared to control group at the 3-month follow-up period. Although personal/social functioning challenge (p = 0.24) and cumulative relapses (p = 0.10) were greater in the control group, no statistically significant group differences were observed. Our study contributes the first evidence on UCT feasibility and acceptability for FEP.
Prevalence of resistance markers of artemisinin, partner drugs, and sulfadoxine-pyrimethamine in Nanyumbu and Masasi Districts, Tanzania between 2020 and 2021
(Antimicrobial Agents and Chemotherapy, 2024-09-12) Mwaiswelo, Richard O.
Regular monitoring of the emergence and spread of Plasmodium falciparum markers of resistance against artemisinin, partner drugs, sulfadoxine, and pyrimethamine is important for the treatment and prevention of malaria in Tanzania. Blood samples were collected from febrile and non-febrile children aged 3 to 59 months in Masasi and Nanyumbu Districts between 2020 and 2021. The samples were subjected to molecular analysis for markers of artemisinin, partner drugs, sulfadoxine, and pyrimethamine resistance, including Plasmodium falciparum kelch (Pfk) 13 gene, P. falciparum chloroquine resistance transporter gene (Pfcrt), P. falciparum multidrug resistance gene (Pfmdr) 1, P. falciparum dihydrofolate reductase (Pfdhfr), and P. falciparum dihydropteroate synthase (Pfdhps). A total of 531 blood samples were involved in the analysis. None of the P. falciparum isolates analyzed for Pfk13 carried any of the validated markers of artemisinin resistance. Pfcrt CVMNK wild-type haplotype occurred in 88.9% (271/305) of the parasites, and the mutant CVIET haplotype occurred only in 0.7% (2/305). Conversely, the majority of the parasites (24.2% [48/198]) were carrying Pfmdr1 NFD haplotype, followed by the wild-type haplotype NYD (19.1% (39/198), and the rest were mixed infections. Quintuple mutation IRNI-SGEAA occurred in 54.4% (62/114), and sextuple mutation IRNI-FAKGS occurred only in 0.9% (1/114) of the parasites. No parasite carried any of the validated markers of artemisinin resistance; however, the prevalence of Pfcrt and Pfmdr1 resistance markers against the partner drugs reached the saturation point. Sextuple Pfdhfr-Pfdhps mutations occurred only in one patient; therefore, SP remains efficacious for IPTp in the Districts.
KEYWORDS prevalence, resistance markers, artemisinin, partner drugs, sulfadoxine-pyrimethamine, Tanzania
Strategies for relapse prevention among people with schizophrenia in KwaZulu-Natal Province, South Africa: Healthcare providers' perspectives
(Plos One, 2025-03-10) Protas,Joyce.
Introduction
Relapse is a significant challenge among people with schizophrenia and is broadly recog-
nized by the aggravation of positive or negative symptoms, the need for re-hospitalization,
more intensive case management, and/or changes in medication. The quality of inpatient
care and proper transition to outpatient care are crucial in reducing the risk of relapse.
Healthcare providers play vital roles in ensuring the continuity of care after patients are
discharged from the hospital. Little is known about the roles of preventing relapse from the
perspective of healthcare providers. This study explored the currently existing strategies
for preventing relapse from the perspective of healthcare providers.
Methods
We captured the view of healthcare providers providing services to psychiatric patients
using a qualitative methodological approach with descriptive phenomenology. We con-
ducted audio-recorded, in-depth interviews with 15 consenting clinical providers from a
public psychiatric hospital in Durban, South Africa. To facilitate analysis, we used Dedoose
software (SocioCultural Research Consultants, LLC [www.dedoose.com]), and the themes
were inducted from the data.
Results
Six major themes inducted from the analysis: Preparing patients and caregivers for
discharge; Developing consistent and caring therapeutic relationships; Using an active
approach to transition; Working with patients and caregivers concurrently; Creating and
sustaining interagency connections; and Facilitating alternative forms of treatment.
Conclusions
Discharge planning and preparation are needed to ensure smooth transitions from hos-
pital to outpatient care for relapse prevention. The healthcare system should ensure the
availability of human resources for health at all levels of health facilities, and multidisci-
plinary teamwork will help a successful transition.