According to the World Health Organization low birth weight (LBW) babies are those born with less than 2500g. A descriptive retrospective cross -sectional study using existing data from a one-year (2001) block of birth registers of 3464 pregnant women was done at Kilimanjaro Christian Medical Centre in Moshi, Tanzania. The objective was to determine factors associated with LBW and their contribution to the problem. Out of 648 pregnant women who were tested for HIV infection 59 (9.1%) were positive for the infection. Twelve (20.3%) of HIV positive women gave birth to LBW neonates. HIV positive women were twice more likely to give birth to LBW infants than HIV negative ones (χ 2 = 6.7; P<0. 01; OR = 2.4; 1.1, 5.1). Mothers without formal education were 4 times more likely to give birth to LBW neonates than those who had attained higher education (OR= 3.6; 2.2, 5.9). There was a linear decrease in low birth weights of newborns as fraternal educational level increased (χ 2 for linear trend = 42.7; P< 0.01). There was no statistically significant difference among parents' occupations regarding LBW of their newborns. Unmarried mothers were more likely to give birth to LBW neonates as compared to their married counterparts (OR = 1.65; 1.2, 2.2) and the difference was statistically significant (χ 2 =13.0, P< 0.01). Hypertension, pre-eclampsia and eclampsia disease complex had the highest prevalence (46.67%) and population attributable fraction of low birth weight (PAF = 25.2%; CI= 22.0-27.6). Bleeding and schistosomiasis had the same prevalence (33.33%) of LBW babies. Other complications and diseases which contributed to high prevalence of LBW included anaemia (25%), thromboembolic diseases (20%), tuberculosis (17%) and malaria (14.8%). Prevalence of LBW was high in women with premature rupture of membrane (38%), placenta previa (17%) and abruption of placenta (15.5%). LBW was strongly associated with gestational age below 37 weeks (OR = 2; CI=1.5, 2.8) contributing to 42% of LBW deliveries in the study population (PAF = 42.4%: 25, 55). Pregnant women with malnutrition (BMI<18) gave the highest proportions 17% of LBW children followed by underweight (BMI; 18-22) who gave 15.5% of LBW neonates. There was a statistical significant difference between the proportions of LBW infants from mothers who did not receive antenatal care (28.6%) and those who attended for the services (13.8%) (χ 2 = 8.8; P= 0.01). There is need of increasing promotion of reproductive health services in relation to safe motherhood at community level in order to reduce risk factors of LBW.

A cross-sectional study of 6897 schoolchildren in 59 out of the 155 primary schools in Magu District on the shores of Lake Victoria, Tanzania, was undertaken in 1997 to determine the prevalence of single- and multiple-species helminth infection. Schistosoma haematobium, hookworm (primarily Necator americanus) and S. mansoni were the most common helminth species infecting schoolchildren in the district. The prevalences of Ascaris lumbricoides and Trichuris trichiura were negligible (< 1%). Anaemia and stunting were highly prevalent and widespread. Hookworm and S. mansoni occurred more frequently in multiple infections with other helminths than as single-species infections, but triple-species infection was rare. Analysis of the frequency distribution of infection amongst schools showed that prevalences of S. haematobium and hookworm tended to be normally distributed, with medians 75% and 45%, respectively, while the distribution of S. mansoni was markedly skewed such that only 17% schools had a prevalence greater than 20%. An inverse association between S. mansoni and S. haematobium was observed. Geographical information system (GIS) analysis indicated that S. mansoni infection was highly prevalent only along the shore of Lake Victoria, whilst S. haematobium was homogeneously prevalent everywhere except the lakeshore. This pattern appears to reflect the distribution of schistosome species-specific snail intermediate hosts. The results imply that joint treatment for hookworm infection and schistosomiasis would be beneficial throughout the district.

The study aimed to describe morbidity patterns due to intestinal schistosomiasis in adults living in two villages along the southern shores of Lake Victoria, Mwanza District, Tanzania. Nine hundred and fifty persons from Msozi and 497 from Sangabuye, aged between 14 and 87 years, were examined by abdominal ultrasound according to the Niamey protocol. Liver image patterns (LIP) A and B were considered normal and C-F as distinct periportal fibrosis (PPF). The frequency of PPF was higher in Msozi (41.5%) than in Sangabuye (16.7%) (P<0.001) and was associated with high prevalence and intensity of Schistosoma mansoni infection. PPF was shown to be more common in males than females. Abnormal increase of segmental branch wall thickness (SBWT) and dilated portal vein diameter (PVD) were also more common among males than females. Hepatomegaly and splenomegaly were frequently encountered in both villages. The LIPs were positively correlated to size of SBWT and PVD but not to size of left liver lobe or spleen. In the study communities the risk of developing PPF differed greatly among individuals depending on various risk factors especially alcohol consumption.

Objective: To describe the nutritional status of schoolchildren from a rural area of Tanzania, with a particular emphasis on older adolescents to determine the timing of the growth spurt and differences by sex. Design: A cross-sectional survey using a randomly selected sample. Subjects: Six thousand eight hundred and one children aged 7 ± 18 y randomly selected from those enrolled in standards 2 ± 5 in 59 primary schools in Magu District, Tanzania. Results: Overall, 52.5% of children were stunted and 43.0% were underweight, with signi®cantly more boys stunted and underweight than girls. Z-scores of height-for-age for both boys and girls decreased progressively between 7 and 12 y. After 12 y the height-for-age z-scores of girls show a marked upturn, whilst z-scores for boys continue to decrease throughout the school-aged years until 16 y when a slight upturn is observed. Anaemia (Hb`120 gaL) was present in 62.6% of children, with the prevalence decreasing with age. Anaemia improved throughout the school years for boys, but did not for girls. Age, sex and hookworm infection were signi®cant predictors of anaemia. Conclusion: Stunting and anaemia are exceptionally common conditions in African schoolchildren. The ®ndings highlight important differences between boys and girls, which are suggestive of compensatory growth at 12 y for girls and at 16 y for boys, although it remains unclear whether boys will catch up in height at older ages. Sponsorship: Funding was provided by the Wellcome Trust.

Objective: To report on the haemoglobin concentrations and prevalence of anaemia in schoolchildren in eight countries in Africa and Asia. Design: Blood samples were collected during surveys of the health of schoolchildren as a part of programmes to develop school-based health services. Setting: Rural schools in Ghana, Indonesia, Kenya, Malawi, Mali, Mozambique, Tanzania and Vietnam.