Background: In 2017, Mbeya Zonal Referral Hospital (MZRH) and the University of South Carolina (UofSC) agreed to collaboratively strengthen antimicrobial prescribing in the southern highlands of Tanzania and train a new generation of clinicians in responsible antimicrobial use. Methods: Key stakeholders and participants were identified and the Mbeya Antimicrobial Stewardship Team (MAST) was created. The team identified assets brought by the collaborators, and four investigations of baseline needs were developed. These investigations included (a) a baseline clinician survey regarding antimicrobial resistance and stewardship, (b) a serial chart review of inpatient antimicrobial prescribing practices, (c) an investigation of antimicrobial resistance rates using existing isolates at the MZRH laboratory, and (d) a survey of antimicrobial availability at community pharmacies in the city. Results: 91% of physicians believe antimicrobial resistance is problem in Tanzania, although only 29% of physicians were familiar with the term “antimicrobial stewardship”. Escherichia coli isolates had resistance rates of over 60% to the commonly used agents ciprofloxacin, trimethoprim-sulfamethoxazole, and ceftriaxone. Thirteen out of 14 community pharmacies offered over-the-counter antibiotics for upper respiratory symptoms. Conclusions: International antimicrobial stewardship collaborations can successfully identify opportunities and needs. Evaluating the team’s efforts to improve patient outcomes will be essential.

Background: Despite the significant decline in the prevalence of HIV in Tanzania, the prevalence rates in Mbeya, Iringa, and Njombe regions are higher than the national average and have remained stable for years. The current stable HIV prevalence may be driven by factors such as a high incidence of sexually transmitted infections (STIs) and high-risk behaviours. In sub-Saharan Africa, it has previously been observed that up to 50% of HIV cases were attributed to herpes simplex type 2 (HSV-2) among low-risk populations. Because the proportion of sexually transmitted HSV-1 is rising, it is essential to study the interaction between HSV-1 and HIV infections. Methods: We conducted a study in Mbeya region using the archived blood sera of participants from the recently completed EU-funded EMINI project. A specially designed questionnaire was used to obtain the social and demographic characteristics of the study participants in the database. We tested archived participants' sera for herpes simplex virus type 1 using Virotech HSV-1 (gG1) IgG ELISA (Enzygnost, Behring, Germany). Univariate and multivariate Poisson regression models were used to identify factors associated with HSV-1. Results: A total of 640 adults were randomly recruited after stratification by HIV status (318 were HIV positive), age, and sex. The overall seroprevalence of HSV-1 in the study population was 92.1%. The extrapolated seroprevalence estimate of herpes simplex virus type 1 in the general population was 95.0% (96.0% in males versus 94.0% in females). Males and females were equally affected by HSV-1. HSV-1 was less prevalent in HIV-positive individuals than in HIV-negative individuals. Conclusion: People living with HIV were less likely to be HSV-1 seropositive. Further prospective studies are necessary to conclude a causal association.

Background Clinical manifestations of HSV-1 infection is quite common in patients with HIV/AIDS. In Tanzania, nearly five percent of individuals aged 15 to 49 years are living with HIV, with the highest prevalence observed in the southern highland region. Studies are now reporting a growing HIV epidemic due to genital HSV-1. Despite such evidence, the prevalence of HSV-1 infection in HIV positive and negative individuals in the general Tanzanian population is mostly unknown. The objective of this study was to describe the prevalence of Herpes Simplex Virus type 1 infections among HIV positive and negative individuals in the Mbeya region, the third most affected region with HIV in Tanzania. Methods We conducted a study in the Mbeya region in the archived blood sera of participants from the recently completed EU funded EMINI project. A specially designed questionnaire was used to isolate the social and demographic characteristics of the study participants in the database. We tested archived participants’ sera for Herpes Simplex Virus type 1 using Virotech HSV-1 (gG1) ELISA (Enzygnost, Behring, Germany). Univariate and multivariate Poisson regression models were used to identify factors associated with HSV-1. Results A total of 640 adults were randomly recruited after stratification by HIV status, age, and sex. The overall seroprevalence of HSV-1 in the study population was 92.1%. The extrapolated prevalence estimate of Herpes Simplex Virus type 1 in the general population was 95.0% (96.0% in males versus 94.0% in females). Men and females were equally affected by HSV-1. HSV-1 was less prevalent in HIV positive individuals and was more common in individuals with elevated blood pressure. Conclusion People living with HIV were less likely to be HSV-1 positive. Further studies can evaluate whether the Herpes Simplex Virus type-1 can reduce the incidence of HIV infection.

Background Despite the significant decline in the prevalence of HIV in Tanzania, the prevalence rates in the Mbeya, Iringa, and Njombe regions are higher than the national average and have remained stable for years. The current stable HIV prevalence may be driven by factors such as a high incidence of sexually transmitted infections (STIs) and high-risk behaviours. In sub-Saharan Africa, it has previously been observed that up to 50% of HIV cases were attributed to herpes simplex type 2 (HSV-2) among low-risk populations. Because the proportion of sexually transmitted HSV-1 is rising and HSV-1 tends to cause the shedding of oropharyngeal mucosal ulcers, it is essential to study the interaction between HSV-1 and HIV infections. Methods We conducted a study in the Mbeya region using the archived blood sera of participants from the recently completed EU-funded EMINI project. A specially designed questionnaire was used to obtain the social and demographic characteristics of the study participants in the database. We tested archived participants’ sera for herpes simplex virus type 1 using Virotech HSV-1 (gG1) IgG ELISA (Enzygnost, Behring, Germany). Univariate and multivariate Poisson regression models were used to identify factors associated with HSV-1. Results A total of 640 adults were randomly recruited after stratification by HIV status, age, and sex. The overall seroprevalence of HSV-1 in the study population was 92.1%. The extrapolated prevalence estimate of herpes simplex virus type 1 in the general population was 95.0% (96.0% in males versus 94.0% in females). Males and females were equally affected by HSV-1. HSV-1 was less prevalent in HIV-positive individuals than in HIV-negative individuals.Conclusion People living with HIV were less likely to be HSV-1 seropositive. Further cohort studies can evaluate whether herpes simplex virus type 1 can reduce the incidence of HIV infection.