Ministry of Health and Social Welfare

Inclusive science education for learners with visual impairments (VI) is still a significant challenge in Tanzania, despite progressive policy frameworks and teacher education reforms. This study investigated the challenges faced by tutors and pre-service science teachers in preparing to teach pupils with VI, focusing on curriculum design, pedagogical practice, resource availability, and practical training. A qualitative approach was employed, utilising a single-case study of a teacher training college. Data were collected through semi-structured interviews, focus group discussions, and classroom observations with 28 purposively sampled participants, including tutors, the head of the science department, and pre-service teachers. Thematic analysis revealed four major challenges: absence of a VI-specific curriculum, shortage of specialised tutors, scarcity of teaching and learning materials, and limited duration and structure of teaching practice. These gaps undermine the practical competence, confidence, and self-efficacy of pre-service teachers, constraining the quality of science education accessible to VI learners. The findings show an urgent policy and institutional imperative that without targeted curriculum adaptations, investment in assistive technologies, and enhanced tutor capacity, learners with VI risk continued exclusion from meaningful science education, perpetuating inequities in STEM access and achievement. The study emphasizes the relevance of Universal Design for Learning and the Social Model of Disability in guiding inclusive pedagogy. Recommendations include development of structured VI-specific curricula, recruitment and professional development of specialised tutors, extended and supported practicum experiences, and systemic resource allocation. Future research should examine the effectiveness of these interventions on both teacher preparedness and learner outcomes.

Globally, 24 measles virus genotypes have been detected, and these genotypes have been classified into eight clades based on 450 nucleotides of the C-terminal region of the nucleoprotein gene. Genotype B3 is predominant in Africa, but there are limited data from Tanzania since the introduction of the second dose of measles-containing vaccine in 2014. A total of 129 nasopharyngeal samples and corresponding sera were collected during measles outbreaks between 2022 and 2024. Viral RNA was extracted from nasopharyngeal swabs prior to RT-qPCR and sequencing of a 450-nucleotide segment of the nucleoprotein (N) gene. Out of 129 nasopharyngeal samples, 73 (56%) were successfully amplified and identified as endemic measles virus genotype B3. Nine distinct sequence identifiers were detected, with seven reported for the first time in the MeaNS database. All the Tanzanian B3 sequences were closely related and clustered with genotype B3, similar to those reported from Kenya, Ethiopia, Rwanda, Uganda, Burundi, and South Africa. On multivariate analysis, only inpatient admission status (p = 0.014) and positive measles IgM (p = 0.003) were found to be associated with positive measles RT-qPCR. Our results indicate that genotype B3 remains endemic in Tanzania and is closely related to other genotype B3 reported globally, indicating its high stability and transmissibility.

The 2025 Annual Meeting of National Neglected Tropical Disease (NTD) Programme Managers (2025 PMM) in the WHO African Region convened stakeholders in Lomé, Togo, under the theme "Innovating for Acceleration: Pathway to NTD Elimination." A key focus was the changing funding environment and the necessity for enhanced integration of NTD services within health systems to guarantee sustainable advancement toward the 2030 elimination goals. The conference was convened in the context of substantial disruptions stemming from the USAID funding pause, which interrupted essential mass drug administration (MDA) programmes and epidemiological monitoring activities across multiple nations. Country experiences highlighted the fragility of external funding dependence and underscored the importance of domestic resource mobilization, decentralized implementation, and programmatic integration. Strategic discussions highlighted opportunities to incorporate NTD services into national health financing mechanisms, and routine health campaigns, alongside leveraging digital tools and partnerships. Participants emphasized the urgency of political commitment, sustained investments, and integrated service delivery models to build resilience and close equity gaps. The meeting further underscored the need for bold, country-led responses and multisectoral collaboration to advance NTD elimination efforts in a rapidly evolving global health financing environment.

Rotavirus vaccine clinical trials and post-licensure evaluations found malnourished children may have lower protection against rotavirus diarrhea hospitalizations than well-nourished children. On a population level, rotavirus vaccines are less protective in high child mortality settings. We analyzed rotavirus vaccine effectiveness (VE) among malnourished and well-nourished children categorized using four anthropometric malnutrition indicators, birthweight, and reported malnutrition from medium to high child mortality countries in the Multi-National Subpopulations Study to Evaluate Rotavirus Vaccines (MNSSTER-V) dataset. We calculated child-level z-scores for weight-for-age, length-for-age, weight-for-length, and mid-upper arm circumference (MUAC), and the site-level proportion implausible z-scores. Sites with published VE estimates by nutritional status or those with <3% implausible values were included in the final analysis. Z-scores <-2 were considered moderate-to-severe malnutrition and <-3 were considered severe malnutrition. We calculated complete series rotavirus VE in each malnourished and well-nourished group using an unconditional adjusted logistic regression model, where VE = (1 - odds ratio of vaccination among cases and controls) × 100, where cases and controls were children who tested rotavirus positive and negative, respectively. Complete series VE was more protective among children without stunting (normal length-for-age) (59%; 95% confidence interval [CI]: 49-67) compared to children with moderate-to-severe stunting (42%; 95% CI: 19-58) and severe stunting (31%; 95%CI: -14 to 58). Adjusted VE point estimates were similar among malnourished and well-nourished children using the other anthropometric and birthweight indicators. Our findings clearly show that chronic malnutrition negatively impacted rotavirus VE. Efforts to address and prevent malnutrition generally may further reduce the burden of rotavirus morbidity and mortality.

Abstract Background Tuberculosis (TB) is a significant global health issue, mainly in developing countries. Despite the progress made in reducing TB rates, adverse treatment outcomes, such as deaths and treatment failures, continue to be a concern. We aimed to determine the treatment failure and death rates, and its predictors, among TB patients in Tanzania from January 2022 to December 2023. Methodology We conducted a cohort study utilizing data from the National Tuberculosis and Leprosy Programme database, focusing on TB patients who began treatment in 2022 and 2023. The Cox proportional hazards model was used to conduct univariate and multivariate analyses. Hazard ratios and their respective 95% confidence intervals were reported. Kaplan–Meier curves were employed to estimate the probabilities of these outcomes over time. A p -value ≤ 0.05 was considered significant. Results The overall death rate and treatment failure rate among participants was 2.76 and 0.11%, respectively. Older adults had significantly increased risk of adverse outcomes, with nearly four times the likelihood of death (AHR 3.62, 95%CI: 3.18–4.11, p &lt; 0.001) and twice the likelihood of treatment failure (AHR 2.25, 95%CI: 1.12–4.52, p = 0.022). Male participants faced a higher risk of both death (AHR 1.10, 95%CI: 1.03–1.17, p = 0.003) and treatment failure (AHR 1.56, 95%CI: 1.12–2.17, p = 0.009) than females. Urban residents had increased risk of death (AHR 1.40, 95%CI: 1.32–1.49, p &lt; 0.001) and treatment failure (AHR 1.46, 95%CI: 1.08–1.98, p = 0.014) compared to those in rural areas. Treatment in hospitals was associated with worse outcomes, including almost twice the risk of death (AHR 1.71, 95%CI: 1.57–1.86, p &lt; 0.001) and a higher likelihood of treatment failure (AHR 1.49, 95%CI: 1.01–2.20, p = 0.042). Most deaths occurred within the first two months of treatment, whereas treatment failures peaked at six months. Conclusion The study revealed significant differences in death and treatment failure rates based on patients’ characteristics, with higher risks observed in older adults, males, urban residents, treatment at higher-level facilities, having pulmonary TB, TB/HIV co-infection, retreatment, being treated under Facility DOT, and being referred through other referral types other than self-referral, CTC referral and community referrals. The findings emphasize the need for targeted efforts to improve TB outcomes.

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.

Comprehensive Sexuality Education (CSE) is a school-based intervention aimed at correcting misinformation surrounding sexual education among youth, often influenced by social media, peer groups and misleading online content. In The Gambia, the Ministry of Basic and Secondary Education has developed and introduced a national framework to integrate CSE from Grade 4 (primary school level) to Grade 12 (senior secondary school level). This study explores the perceptions and recommendations of 50 secondary school teachers from 43 public and private schools in Region 1 on the implementation of CSE in schools. While some teachers expressed concerns that CSE might promote perverted and lewd early sexual behavior, others saw it as essential for increased awareness and youth well-being. Cultural, religious, and societal norms pose significant implementation barriers towards the implementation of CSE in schools. Teachers’ insights are vital for successful CSE delivery and educational strategy improvements.

Abstract Background Handwritten home-based vaccination records (HBRs) are a vital source of immunization data, yet manual transcription in household surveys is time-consuming, error-prone, and resource-intensive. Recent advances in multimodal generative AI models offer a potential pathway to partially automate this task under certain conditions, improving efficiency while maintaining data quality. Methods We evaluated the performance of generative multimodal AI models, specifically OpenAI’s GPT-4o, in transcribing handwritten vaccination cards from a 2022 survey targeting children aged 12 - 35 months in The Gambia. Using a curated dataset of 335 cards (6,700 vaccination entries), we developed a gold-standard benchmark from three human transcribers (all of them in The Gambia) and assessed AI model performance across transcription accuracy, vaccination coverage estimates, timeliness, and missed opportunities for simultaneous vaccination (MOSV). We also tested a confidence-based segmentation approach to identify high-confidence transcriptions suitable for automation versus low-confidence entries requiring human review. Results The fine-tuned GPT-4o model achieved 79% accuracy for exact date transcription and reached human-level performance (94% accuracy) on 69% of entries classified by the AI as high-confidence. Coverage and timeliness estimates from high-confidence transcriptions were 98.0% and 91.6% accurate, respectively, compared to 98.8% and 95.6% from human transcribers. Date errors by AI and humans differ systematically, with AI showing fewer year-shift errors. Conclusion Multimodal AI models show strong potential for automating HBR transcription in immunization coverage surveys, at least in a setting like The Gambia. When paired with confidence-based filtering, these models achieve human-level performance on coverage and timeliness estimates—the key metrics used in programmatic decision-making—across a large subset of records. This enables substantial gains in efficiency while preserving data quality. Further research should evaluate generalizability across diverse card formats, languages, and contexts to support integration into real-world immunization programs and health monitoring activities.

IntroductionResidual COVID-19 sequelae create a public health concern as they add to the already heavy burden of non-communicable diseases. We set out to investigate the magnitude of residual cardiopulmonary manifestations postacute COVID-19 and their associated factors in Tanzania.MethodsThis was an ambispective study conducted between 26 March 2021 and 30 July 2021, among 712 hospitalised adults confirmed with SARS-CoV-2 in five tertiary-level hospitals in Tanzania. Retrospective data were analysed to determine baseline characteristics of the patients during acute COVID-19 admission. This was linked to prospective data that were collected 2 years postacute hospitalisation with COVID-19 to determine cardiopulmonary complications among these patients. Radiological pulmonary abnormalities were assessed by contrasted CT scan. Lung function tests were measured using a spirometer. Pulmonary hypertension and heart failure were confirmed by a transthoracic echocardiography. Generalised estimating equations were used to assess the associations between sociodemographic factors, clinical characteristics, treatment modalities and residual cardiopulmonary sequelae.ResultsAbout half 317/712 (44.5%) were diagnosed with residual cardiopulmonary complications. Approximately 54% of participants were male. Median age (IQR) was 60 (48–69) years. Cardiopulmonary sequelae were significantly associated with body mass index (BMI) ≥25.0 kg/m2 compared with those with BMI <25.0 kg/m2 (adjusted OR (aOR) (95% CI)=3.4 (2.47 to 4.84), p<0.001), smokers compared with non-smokers (aOR (95% CI)=2.39 (1.09 to 5.23), p=0.030] and among participants who did not receive steroids during the acute COVID-19 (aOR (95% CI)= 1.62(1.16 to 1.92), p=0.042].ConclusionThe independent predictors of residual cardiopulmonary manifestations due to COVID-19 were overweight, cigarette smoking, hypoxia and non-use of steroids during the acute phase of COVID-19 disease. Public health interventions addressing weight reduction and smoking cessation in conjunction with steroid use in acute COVID-19 may largely reduce the incidence of cardiopulmonary long COVID-19.