Primary Health Care Institute

Tea (Camellia sinensis) production is closely tied to balanced soil nutrient management, particularly nitrogen (N), phosphorus (P), and potassium (K). This study evaluated the impact of a blended NPK 25:7.5:15 fertilizer on green leaf yield and nutrient dynamics across three Tanzania highland regions Mufindi (Iringa), Lupembe (Njombe), and Rungwe (Mbeya) between 2020 and 2024. Using a randomized complete block design, six fertilizer treatments were tested across five nitrogen rates (0–300 kg N/ha), with NPK 25:5:5 as the reference. Results showed that the blended fertilizer significantly improved soil K? and enhanced P and K uptake in leaves, especially at 60–240 kg N/ha. Higher nitrogen rates offered no additional benefit, indicating diminishing returns. However, increased electrical conductivity and reduced soil pH highlighted potential soil acidification risks. Regional variation in K uptake emphasized the role of local conditions in nutrient response. The findings suggested that balanced fertilization and site-specific strategies to enhance yield.

To prevent and reduce mother-to-child transmission of HIV and maternal morbidity and mortality, the World Health Organization currently requires retesting for HIV during pregnancy and postpartum. This was a systematic review and meta-analysis in which PubMed, Cochrane Library, Embase, and clinicaltrials.gov were searched for articles published between January 2005 and February 2024. Retesting uptake was defined as the number of women who tested for HIV during pregnancy/breastfeeding periods following an initial HIV-negative test during these periods. Using random-effects models, we computed the pooled prevalence of HIV retesting uptake, incidence rates (IRs), and 95% confidence intervals (CIs). A sensitivity analysis was done by excluding studies that tested women during labor and reported 100% retesting uptake. A total of 37 studies with 1,999,621 women were analyzed. Overall, the pooled prevalence of HIV retesting uptake was 89.1% (95%CI, 81.0-95.2). Retesting uptake was significantly higher during breastfeeding compared to pregnancy (93.3% vs. 89.9%; P < 0.001). A sensitivity analysis showed that overall retesting uptake was 73.9% (95%CI, 60.1-83.8). A total of 1302 (0.2%) women acquired HIV. Twenty-two studies reported an IR; the overall pooled IR was 4.3/100 person-year (PY; 95%CI, 3.4-5.2/100 PY). The HIV incidence rate was significantly higher during pregnancy compared to breastfeeding (5.9/100 vs. 3.4/100 PY; P < 0.001). One to three in 10 women in sub-Saharan Africa do not retest for HIV following a negative test during pregnancy or breastfeeding periods. Emphasizing HIV retesting during these periods is critical to eliminate pediatric HIV given that the overall IR is beyond the WHO threshold (3.0/100 PY) for a substantial risk of HIV transmission.

While male circumcision reduces the risk of female-to-male HIV transmission and certain sexually transmitted infections (STIs), there is little evidence that circumcision provides women with direct protection against HIV. This study used qualitative methods to assess women’s perceptions of male circumcision in Iringa, Tanzania. Women in this study had strong preferences for circumcised men because of the low risk perception of HIV with circumcised men, social norms favoring circumcised men, and perceived increased sexual desirability of circumcised men. The health benefits of male circumcision were generally overstated; many respondents falsely believed that women are also directly protected against HIV and that the risk of all STIs is greatly reduced or eliminated in circumcised men. Efforts to engage women about the risks and limitations of male circumcision, in addition to the benefits, should be expanded so that women can accurately assess their risk of HIV or STIs during sexual intercourse with circumcised men.

Low vision is a major cause of morbidity and has profound effects on the quality of life for many people as it inhibits/reduces mobility and economical well being of the affected individuals and their families. The objective of the study was to determine the magnitude and causes of low vision among primary school children in Kibaha district in Tanzania. Primary schoolchildren were recruited for the study. The inclusion criterion was individual child with low vision of less than 6/18. Visual examination was used for screening the children to identify those with vision less than 6 /18. Snellen's chart was used to measure visual acuity of the children with low vision. A total of 400 (6-17 years) schoolchildren were screened. Thirty-eight (9.5%) had low vision. The prevalence of low vision was statistically higher (N = 33; 87%) among 12-17years old than among 6-11 years old (13%) (P < 0.05). Of the 38 children with low vision, the prevalence in females (68%) was statistically higher than in males (32%). There were multiples causes of low vision among affected children. Congenital anomalies accounted for the largest proportion (65%) of the causes of low vision. In twenty-three (60%) of the children (12-17 years), low vision was due to retinopathies. Fifty-five percent of the children with refractive error were aged between 6-11 years. Among the cases, 8 (54%) had low vision caused by uncorrected refractive errors while the rest (46%) were due to other types of refractive errors. Two children had corneal scars; one with central and another with whole corneal scar. In conclusion, prevalence of low vision among schoolchildren in Kibaha district is high and increases with age. The main causes are congenital anomalies. There is need for an early detection of the possible causes and appropriate treatment to reduce the condition among schoolchildren. It is therefore important that the district Council Health Management Team establishes school eye screening programme for early detection and treatment. It is equally important to strengthen advocacy programme targeting schoolchildren, teachers and caregivers on the public health importance of low vision.

BackgroundPriority setting in every health system is complex and difficult. In less wealthy countries the dominant approach to priority setting has been Burden of Disease (BOD) and cost-effectiveness analysis (CEA), which is helpful, but insufficient because it focuses on a narrow range of values – need and efficiency – and not the full range of relevant values, including legitimacy and fairness. 'Accountability for reasonableness' is a conceptual framework for legitimate and fair priority setting and is empirically based and ethically justified. It connects priority setting to broader, more fundamental, democratic deliberative processes that have an impact on social justice and equity. Can 'accountability for reasonableness' be helpful for improving priority setting in less wealthy countries?MethodsIn 2005, Tanzanian scholars from the Primary Health Care Institute (PHCI) conducted 6 capacity building workshops with senior health staff, district planners and managers, and representatives of the Tanzanian Ministry of Health to discussion improving priority setting in Tanzania using 'accountability for reasonableness'. The purpose of this paper is to describe this initiative and the participants' views about the approach.ResultsThe approach to improving priority setting using 'accountability for reasonableness' was viewed by district decision makers with enthusiastic favour because it was the first framework that directly addressed their priority setting concerns. High level Ministry of Health participants were also very supportive of the approach.ConclusionBoth Tanzanian district and governmental health planners viewed the 'accountability for reasonableness' approach with enthusiastic favour because it was the first framework that directly addressed their concerns.

Perceived behavioral control (PBC) and intention, the proximal predictors from the theory of planned behavior (TPB), were used to predict cardiovascular risk behaviors in 597 patients 1 year after diagnosis with coronary heart disease. The outcome measures were self-report measures of exercise plus objective measures of fitness (distance walked in 6 min) and cotinine-confirmed smoking cessation. In multivariate analyses incorporating both PBC and intention, PBC predicted exercise, distance walked, and smoking cessation, but intention was not a reliable independent predictor of any health behavior measured. Thus, the effective theoretical component of the TPB was PBC. Similar predictions could derive from social-cognitive theory. In coronary patients, behavioral change needs to address issues of action implementation rather than motivational factors alone.

EDITOR—Guidelines from the National Institute for Clinical Excellence (NICE) on the use of neuraminidase inhibitors recommend oseltamivir for the treatment of at risk children with influenza-like illness of fewer than 48 hours' duration—for example, those with underlying chronic respiratory disease.1 The drug is not recommended for otherwise healthy children. In our systematic review on the use of neuraminidase …

Clinical findings, not ethnic origin, should drive the diagnostic evaluation for suspected osteomalacia

To examine the prevalence of folic acid supplementation prior to conception and in the first trimester of pregnancy, and to identify sociodemographic variables associated with the use of supplements. Observational study. District general hospital in the south in England. Nine hundred and sixty-three randomly selected pregnant nulliparous caucasian women recruited from May 1994 to February 1996 inclusive. Questionnaire administered at approximately 16 weeks gestation. Intakes of supplemental folic acid before conception and during pregnancy. 31.5% (303/963) (95% CI 28.5-34.4) of pregnant women reported using supplements containing folic acid prior to conception. The proportion using pre-conceptional folic acid increased by approximately 1% per month during the 22 months of the study. 38.1% (367/962) (35 1 to 41.2) of women began taking folic acid only after the confirmation of pregnancy, and this proportion appeared constant over time. Young age, smoking and low educational attainment were statistically significant predictors of failure to use folic acid both before and during pregnancy. Use of folic acid before conception in nulliparous women is much higher than the 2% to 3% reported in earlier studies of all pregnant women, and appears to be increasing. However, many women still only begin taking folic acid after conception, despite current health education strategies. New approaches, focusing on women who are currently least likely to take folic acid those who are young, are of low educational backgrounds, and are smokers - may now be required. Given the inevitably of unplanned pregnancies, efforts must also be made to increase the currently static uptake of folic acid immediately after the confirmation of pregnancy.