A5047635236- HIV/AIDS Research and Interventions
- Hemoglobinopathies and Related Disorders
- Iron Metabolism and Disorders
- HIV, Drug Use, Sexual Risk
- Adolescent Sexual and Reproductive Health
- Sex work and related issues
- Hematological disorders and diagnostics
- Blood groups and transfusion
- Pregnancy and preeclampsia studies
- Malaria Research and Control
- HIV/AIDS Impact and Responses
- Prenatal Screening and Diagnostics
- HIV Research and Treatment
- Innovations in Medical Education
- Simulation-Based Education in Healthcare
- Clinical Reasoning and Diagnostic Skills
- Groundwater and Isotope Geochemistry
- Global Maternal and Child Health
- Bone and Joint Diseases
- Groundwater and Watershed Analysis
- Child Nutrition and Water Access
- Cerebral Venous Sinus Thrombosis
- Flood Risk Assessment and Management
- Poverty, Education, and Child Welfare
- Tuberculosis Research and Epidemiology
Johns Hopkins University
2018-2024
St. John's University of Tanzania
2021-2023
University of Dar es Salaam
2022
National Institute for Medical Research
2022
Weatherford College
2022
Kenya Medical Research Institute
2009-2015
Muhimbili University of Health and Allied Sciences
2009-2015
Guy's and St Thomas' NHS Foundation Trust
2011
Muhimbili National Hospital
2009
Background The World Health Organization has declared Sickle Cell Anemia (SCA) a public health priority. There are 300,000 births/year, over 75% in Africa, with estimates suggesting that 6 million Africans will be living SCA if average survival reaches half the African norm. Countries such as United States of America and Kingdom have reduced mortality from 3 to 0.13 per 100 person years observation (PYO), interventions newborn screening, prevention infections comprehensive care, but...
To date, it has been widely assumed that malaria is a common cause of morbidity and mortality in children with sickle cell disease (SCD) malaria-endemic countries, as result, malarial prophylaxis commonly recommended. Nevertheless, few data are available support this practice.
Background Reduced growth is common in children with sickle cell anemia, but few data exist on associations long-term clinical course. Our objective was to determine the prevalence of malnutrition at enrolment into a hospital-based cohort and whether poor nutritional status predicted morbidity mortality within an urban Tanzanian anemia patients.Design Methods Anthropometry conducted (n=1,618; ages 0.5–48 years) controls who attended screening (siblings, walk-ins referrals) were found not...
Globally, sickle cell disease (SCD) has its highest prevalence and worst prognosis in sub-Saharan Africa. Nevertheless, relatively few studies describe the clinical characteristics of children with SCD this region. We conducted a prospective observational study attending specialist out-patient clinic Kilifi, Kenya. A total 124 (median age 6.3 years) were included study. Splenomegaly was present 41 (33%) subjects hepatomegaly 25 (20%), both being common all groups. positive malaria slide...
In Tanzania, HIV infection remains much higher among female sex workers (FSWs) than other adult women. addition to HIV, sexually transmitted infections (STIs) and pregnancy prevention are major concerns for FSWs in Tanzania. This study used a programmatic surveillance approach examine protection against STIs/HIV unintended (dual method use) an outreach-based prevention, care, treatment program 119,728 made first visit services served by the Sauti Project from January 2016 September 2017. Of...
Summary Bacteraemia is a leading cause of morbidity in sickle cell anaemia ( SCA ), but information from studies Africa limited. We evaluated 890 admissions 648 patients at tertiary hospital Tanzania. was present 43 (4·8%); isolates included Staphylococcus aureus (12/43; 28%), non‐Typhi Salmonella (9/43; 21%), Streptococcus pneumoniae (3/43; 7%) and Typhi (2/43; 5%). Compared to without bacteraemia, with bacteraemia had significantly lower haemoglobin [71 g/l vs. 62 g/l, odds ratio 0·72 (95%...
Background HIV-infected female sex workers (FSWs) have poor linkage to HIV care in sub-Sahara Africa. Methods We conducted 21 participatory group discussions (PGDs) explore factors influencing among FSWs tested for through a comprehensive community-based prevention project Tanzania. Results Influences on were present at the system, societal and individual levels. System-level included unfriendly service delivery environment, including lengthy pre-enrolment sessions, concerns about...
High cerebral blood flow velocity (CBFv) and low haemoglobin oxygen saturation (SpO(2)) predict neurological complications in sickle cell anaemia (SCA) but any association is unclear. In a cross-sectional study of 105 Kenyan children, mean CBFv was 120 +/- 34.9 cm/s; 3 had conditional (170-199 cm/s) none abnormal (>200 cm/s). After adjustment for age haematocrit, > or =150 cm/s predicted by SpO(2) < = 95% history fever. Four years later, 10 children were lost to follow-up, suffered events...
Background Little has been documented about partner violence among adolescent girls and young women (AGYW) who are out of school, a factor associated with HIV acquisition. To understand areas for prioritising prevention intervention efforts, we explored the prevalence correlates school AGYW in Shinyanga, Tanzania. Methods A cross-sectional analysis data from aged 15–23 years recruited cluster randomised trial conducted between October December 2017 was used to examine violence. Data were...
Abstract The World Health Organization identified men as an essential group to target with HIV testing and treatment strategies;: who have sex (MSM) male clients of female workers (CFSW) account for 35% new infections globally. Using a cross-sectional design from community-based prevention project in Tanzania (October 2015–September 2018) multivariable logistic regression, we predictors seropositivity among men. Of 1,041,343 on their initial visit the project, 36,905 (3.5%) were MSM; 567,005...
Introduction A programmatic mapping and size estimation study was conducted in 24 districts 5 regions of Tanzania to estimate the locations female sex workers (FSW) men who have with (MSM) inform HIV programming for Key Populations. Methodology Data were collected at two levels: first, interviews informants identify venues where FSWs MSM frequent. Secondly, estimated through FSWs, other venue. The venue estimates aggregated generate ward level estimates. Correction factors then applied...
Background More than 70% of children with sickle cell disease (SCD) are born in sub-Saharan Africa where the prevalence at birth this reaches 2% or higher some selected areas. There is a dearth knowledge on comprehensive care received by SCD and its associated cost. Such important for setting prevention treatment priorities national international levels. This study focuses routine an outpatient clinic Kilifi District Hospital, located rural area coast Kenya. Objective To estimate per-patient...
Adolescent girls and young women (AGYW) aged 15 to 24 years face disproportionately high risks of acquiring HIV other sexually transmitted infections (STIs). A sexual health risk stratification tool can support the development implementation tailored STI prevention services for sub-groups at-risk AGYW. Data were collected among active AGYW in Tanzania between April 2015 March 2017. Exploratory confirmatory factor analyses conducted construct assess latent structure a ten-item scale rapid...
Abstract Background A variety of strategies have been used to reach men with HIV self-testing services, including social network-based self-test kits distribution. However, few studies assessed men’s comfort distribute or receive from close male friends within the same network. In this study, we and/or and associated factors among who socialize in networks locally referred as “camps” Tanzania. Methods Data are baseline survey a cluster-randomized controlled trial conducted June 2019 18 Dar...
Introduction Adolescent girls and young women (AGYW) continue to experience a high incidence of HIV in southern eastern Africa, even the context large-scale prevention interventions. In Tanzania, AGYW account for largest proportion new infections have higher risk acquisition than males comparable age. Methods We used routinely collected data from PEPFAR/USAID-funded Sauti Project, large combination program, examine relationship between transactional sex with older partners among Tanzania...
The HIV epidemic in Eastern and Southern Africa is characterized by a high incidence prevalence of infection among adolescent girls young women (AGYW) aged 15-24 years. For instance, some countries, AGYW 20-24 years exceeds that 15-19 2:1. Sauti (meaning voices), project supported the United States Agency for International Development, providing combination prevention interventions to Shinyanga region, Tanzania.The aim this study determine impact cash transfer on risky sexual behavior...
HIV testing is a gateway to care and treatment for people diagnosed with can link those negative results preventive services. Despite the importance of services (HTS) in control, uptake HTS among female sex workers (FSWs) across sub-Saharan Africa (SSA) remains sub-optimal. Concerns about stigma associated work fear loss livelihood if status becomes known, are some restrictions FSWs utilize offered through health facilities. Introduction self-testing (HIVST) may mitigate barriers HTS. This...
Background Poverty and social inequality exacerbate HIV risk among adolescent girls young women (AGYW) in sub-Saharan Africa. Cash transfers can influence the structural determinants of health, thereby reducing risk. Objective This study assessed effectiveness cash transfer delivered along with combination prevention (CHP) interventions risky sexual behavior AGYW Tanzania. The incidence herpes simplex virus type 2 (HSV-2) infection was used as a proxy for behavior. Methods A cluster...
Low haemoglobin oxygen saturation (SpO 2 ) predicts complications in children with sickle cell anaemia (SCA) the North but there are few data from Africa, where majority of patients reside. We measured daytime and overnight SpO SCA routine follow-up clinic, controls without symptoms SCA, comparing rural (Kilifi, Kenya) urban (Dar-es-Salaam, Tanzania) cohorts. Daytime was lower 65 Tanzanian (TS; median 97 (IQR 94–100)%); p<0.0001) than 113 Kenyan (KS; 99 (98–100)%) 20 (TC; 100 (98–100)%)....