A5088023670- HIV/AIDS Research and Interventions
- HIV/AIDS Impact and Responses
- Global Maternal and Child Health
- Fungal Infections and Studies
- Global Public Health Policies and Epidemiology
- Pneumocystis jirovecii pneumonia detection and treatment
- HIV Research and Treatment
- Chronic Disease Management Strategies
- HIV-related health complications and treatments
- HIV/AIDS drug development and treatment
- Antifungal resistance and susceptibility
- Tuberculosis Research and Epidemiology
- Poverty, Education, and Child Welfare
- Syphilis Diagnosis and Treatment
- Child Nutrition and Water Access
- Nail Diseases and Treatments
- Healthcare Systems and Reforms
- Cytomegalovirus and herpesvirus research
- Health Systems, Economic Evaluations, Quality of Life
- Patient-Provider Communication in Healthcare
- Patient Satisfaction in Healthcare
- Cancer Risks and Factors
- Agriculture Sustainability and Environmental Impact
- Infectious Diseases and Tuberculosis
- HIV, Drug Use, Sexual Risk
National Institute for Medical Research
2014-2025
Barcelona Institute for Global Health
2023-2024
Universitat de Barcelona
2023-2024
Muhimbili University of Health and Allied Sciences
2024
Muhimbili National Hospital
2012-2022
The Francis Crick Institute
2009-2015
BACKGROUND. Cryptococcal meningitis (CM) causes an estimated 180,000 deaths annually, predominantly in sub-Saharan Africa, where most patients receive fluconazole (FLC) monotherapy. While relapse after FLC monotherapy with resistant strains is frequently observed, the mechanisms and impact of emergence resistance human CM are poorly understood. Heteroresistance (HetR) — a subpopulation within susceptible strain recently described phenomenon Cryptococcus neoformans (Cn) gattii (Cg),...
BackgroundIn sub-Saharan Africa, health-care provision for chronic conditions is fragmented. The aim of this study was to determine whether integrated management HIV, diabetes, and hypertension led improved rates retention in care people with diabetes or without adversely affecting HIV viral suppression among when compared standard vertical medium large health facilities Uganda Tanzania.MethodsIn INTE-AFRICA, a pragmatic cluster-randomised, controlled trial, we randomly allocated primary...
The Haydom, Tanzania, site (TZH) of Etiology, Risk Factors and Interactions Enteric Infections Malnutrition the Consequences for Child Health Development (MAL-ED) Study is in north-central 300 km from nearest urban center. TZH a remote rural district where most population are agropastoralists grow maize as staple food. average household size 7. woman achieves parity 6 has 1 child death. Socioeconomic indicators poor, with essentially no having access to electricity, piped water, or improved...
Abstract Background Integration of health services might be an efficient strategy for managing multiple chronic conditions in sub-Saharan Africa, considering the scope treatments and synergies service delivery. Proven to promote compliance, integration may lead increased economies-of-scale. However, evidence on socio-economic consequences providers patients is lacking. We assessed clinical resource use, staff time, relative efficiency overall societal costs associated with integrating HIV,...
Abstract Background In sub-Saharan Africa, the prevalence of non-communicable diseases (NCDs) has risen sharply amidst a high burden communicable diseases. An integrated approach to HIV and NCD care offers potential strengthening disease control programmes. We used qualitative methods explore patients’ care-providers’ experiences perspectives on acceptability for HIV-infection, diabetes mellitus (DM), hypertension (HT) in Tanzania. Methods A study was conducted selected health facilities Dar...
Monitoring of antiretroviral treatment (ART) with human immunodeficiency virus (HIV) viral loads, as recommended in industrialized countries, is rarely available resource-limited settings because the high costs and stringent requirements for storage transport plasma. Dried blood spots (DBS) can be an alternative to plasma, but use DBS has not been assessed under field conditions rural Africa. The present study investigates performance HIV load monitoring patients who received ART...
Background HIV, diabetes and hypertension have a high disease burden in sub-Saharan Africa. Healthcare is organised separate clinics, which may be inefficient. In cohort study, we evaluated integrated management of these conditions from single chronic care clinic. Objectives To determined the feasibility acceptability terms retention clinical indicators. Design setting Prospective study comprising patients attending 10 health facilities offering primary Dar es Salaam Kampala. Intervention...
Virological response to antiretroviral treatment (ART) in rural Africa is poorly described. We examined virological efficacy and emergence of drug resistance adults receiving first-line ART for up 4 years Tanzania.Haydom Lutheran Hospital has provided HIV-infected patients since October 2003. A combination stavudine or zidovudine with lamivudine either nevirapine efavirenz the standard regimen. Nested a longitudinal cohort study consecutively starting ART, we carried out cross-sectional...
<ns4:p>Background The number of people living with multiple chronic conditions in sub-Saharan Africa is increasing, but health facilities are unable to meet demand. To improve system capacity and access care, community models HIV care have been trialled countries such as Tanzania Uganda. However, no evidence exists inform policymakers on the effectiveness cost-effectiveness integrated community-based for non-communicable conditions. This protocol outlines a within-trial economic evaluation...
Dosing recommendations for treating childhood tuberculosis (TB) were revised by the World Health Organization, yet so far, pharmacokinetic studies that have evaluated these changes are relatively limited. We plasma drug concentrations of rifampicin (RIF), isoniazid (INH), pyrazinamide (PZA), and ethambutol (EMB) among children undergoing TB treatment in Tanzania when dosing being implemented. At end intensive-phase therapy, blood was obtained 2 hours after witnessed medication administration...
Background Red meat is an important dietary source of protein and other essential nutrients. Its high intake has been associated with increased risk cardiovascular morbidity mortality, including hypertension (HTN) hyperlipidaemia (HLP). Despite being physically active, the Maasai at Ngorongoro Conservation Area (NCA) depend heavily on animals' products as their staple food fewer intakes vegetables or fruits due to restriction from carrying out agricultural activities within NCA. This study...
Background Understanding the costs associated with health care delivery strategies is essential for planning. There are few data on service resources used by patients and their within antiretroviral (ART) programmes in Africa. Material methods The study was nested a large trial, which evaluated screening cryptococcal meningitis tuberculosis short initial period of home-based adherence support initiating ART advanced HIV disease Tanzania Zambia. economic evaluation done alone. We estimated...
Mortality from cryptoccocal meningitis remains high. The ACTA trial demonstrated that, compared with 2 weeks of amphotericin B (AmB) plus flucystosine (5FC), 1 week AmB and 5FC was associated lower mortality oral flucanozole (FLU) non-inferior. Here, we assess the cost-effectiveness these different treatment courses.Participants were randomized in a ratio 2:1:1:1:1 to FLU, 5FC, or Malawi, Zambia, Cameroon, Tanzania. Data on individual resource use health outcomes collected....
BackgroundFour decades into the HIV epidemic, CNS infection remains a leading cause of preventable HIV-related deaths in routine care. The Driving Reduced AIDS-associated Meningo-encephalitis Mortality (DREAMM) project aimed to develop, implement, and evaluate pragmatic implementation interventions strategies reduce mortality from infection.MethodsDREAMM took place five public hospitals Cameroon, Malawi, Tanzania. main intervention was stepwise algorithm for infections including bedside...
The rising prevalence of non-communicable diseases (NCDs) alongside the continuing high burden HIV poses a serious challenge to middle- and low-income countries' healthcare systems. Pilot studies integrated models service delivery for HIV, hypertension diabetes have demonstrated that they are feasible acceptable among patients care providers. This study assessed multi-stakeholders' perspectives receipt in Tanzania.A qualitative process evaluation was conducted Dar es Salaam region Tanzania...
Abstract Background Mortality of children admitted to Intensive Care Units (ICU) is higher in low-to-middle-income countries (LMICs) as compared high-income (HICs). There paucity information on outcomes following discharge from ICU, especially sub-Saharan Africa region. This study was conducted determine mortality and its associated factors among Pediatric ICU (PICU) at Muhimbili National Hospital, admission three months after discharge. Methodology a hospital-based prospective cohort...
Abstract Objective To describe rates of retention in care and control hypertension, diabetes HIV among participants receiving integrated services for a period up to 24 months East Africa. Methods Between 5 October 2018 23 June 2019 enrolled into prospective cohort study evaluating the feasibility delivery HIV, hypertension from single point Tanzania Uganda (MOCCA study). Integrated clinics were established 10 primary healthcare facilities was provided routinely according national guidelines....
Objectives: To assess long-term virological efficacy and the emergence of drug resistance in children who receive antiretroviral treatment (ART) rural Tanzania.Patients methods: Haydom Lutheran Hospital has provided ART to HIV-infected individuals since 2003.From February through May 2009, a cross-sectional survey was conducted among (,15 years) had completed ≥6 months first-line non-nucleoside reverse transcriptase inhibitor (NNRTI)based ART.Genotypic determined those with viral load...
ObjectivesThe objectives of the study were to assess utility dried blood spots (DBS) for detection cytomegalovirus (CMV) antibody and viremia in a resource-poor setting, prevalence CMV HIV-infected patients with access antiretroviral therapy (ART) Tanzania, relate outcome.MethodsDBS prepared from 168 ART-naïve at baseline. Demographic, clinical, laboratory data obtained patient records. was analyzed by chemiluminescent microparticle immunoassay quantitative PCR.ResultsAll CMV-seropositive....
<ns3:p>Background In response to the growing burden of chronic diseases in sub-Saharan Africa, where innovative and cost-effective health solutions are imperative, this study outlines a protocol for cluster-randomized trial that compares integrated community-based care with facility-based improve access outcomes patients HIV, diabetes, or hypertension. Methods & analysis We will conduct pragmatic comparing community facility Tanzania Uganda. Patients living hypertension, stable on...
Abstract Background Patient's satisfaction with both private and public laboratory services is important for the improvement of health care delivery in any country. Methods A cross-sectional survey was conducted 24 randomly selected facilities laboratories that are conducting HIV related testing, Mainland Tanzania. The study assessed patient's where by a total 295 patients were interviewed. Results Of data analyzed varying totals from 224 to 294 patients, percentage dissatisfaction services,...
Background Stunting among children in low-resource settings is associated with enteric pathogen carriage and micronutrient deficiencies. Our goal was to test whether administration of scheduled antimicrobials daily nicotinamide improved linear growth a region high prevalence stunting carriage. Methods findings We performed randomized, 2 × factorial, double-blind, placebo-controlled trial the area around Haydom, Tanzania. Mother–child dyads were enrolled by age 14 days followed monthly home...