BackgroundHigh blood pressure is increasing worldwide, disproportionately so in developing countries. Inadequate health care systems and adoption of unhealthy lifestyles have been linked to this emergent pattern. To better understand this trend, it is imperative we measure prevalence of hypertension, and examine specific risk factors, at a local level. This study provides a cross-sectional view of urban residents of Arusha City to determine prevalence and associated risk factors.MethodsBlood pressure was measured using a digital sphygmomanometer. Interviews were conducted using the WHO STEPwise survey questionnaire to assess lifestyle factors. Dietary intake information was collected by a standardized Food Frequency Questionnaire (FFQ). Descriptive statistics were used to analyze demographic characteristics. Means and standard deviations were calculated for continuous variables and percentages for categorical variables. Pearson’s Chi Square (χ 2) tests were used to determine significant risk factors for hypertension, and multivariate log binomial regression was used to reveal potential predictors of hypertension. Dietary patterns were analyzed by principal component analysis.ResultsApproximately 45% of the study population was found to be hypertensive. The mean arterial blood pressure (MABP) of the sample was 102.3 mmHg (SD = 18.3). Mean systolic and diastolic blood pressure were 136.3 (SD = 30.5) and 85.3 (SD = 16.1) mmHg, respectively. Through multivariate analysis, age and body mass index were found to be independently, positively, associated with hypertension. Adherence to ‘healthy’ dietary pattern was negatively independently associated with hypertension.ConclusionsWith nearly half of participants being hypertensive, this study suggests that hypertension is a significant health risk in Arusha, Tanzania. Obesity, healthy diet, and age were found to be positively associated with hypertension risk. This study did not establish any significant association between increased blood pressure and Western-dietary pattern, cigarette smoking, alcohol intake, and physical activities.

Background. Colorectal cancer (CRC) is a growing public health concern with increasing rates in countries with previously known low incidence. This study determined pattern and distribution of CRC in Tanzania and identified hot spots in case distribution. Methods. A retrospective chart audit reviewed hospital registers and patient files from two national institutions. Descriptive statistics, Chi square (χ 2) tests, and regression analyses were employed and augmented by data visualization to display risk variable differences. Results. CRC cases increased sixfold in the last decade in Tanzania. There was a 1.5% decrease in incidences levels of rectal cancer and 2% increase for colon cancer every year from 2005 to 2015. Nearly half of patients listed Dar es Salaam as their primary residence. CRC was equally distributed between males (50.06%) and females (49.94%), although gender likelihood of diagnosis type (i.e., rectal or colon) was significantly different (P = 0.027). More than 60% of patients were between 40 and 69 years. Conclusions. Age (P = 0.0183) and time (P = 0.004) but not gender (P = 0.0864) were significantly associated with rectal cancer in a retrospective study in Tanzania. Gender (P = 0.0405), age (P = 0.0015), and time (P = 0.0075) were all significantly associated with colon cancer in this study. This retrospective study found that colon cancer is more prevalent among males at a relatively younger age than rectal cancer. Further, our study showed that although more patients were diagnosed with rectal cancer, the trend has shown that colon cancer is increasing at a faster rate.

Background: Chronic noncommunicable diseases are increasingly captured as contributing to morbidity and mortality in low and middle income countries. Aim: This study aimed to investigate the epidemiology of colorectal cancer and the potential modifiable local risk factors in Tanzania. Methods: A cross sectional retrospective chart audit study was conducted to establish the pattern and distribution of colorectal cancer, The Food Frequency Questionnaire and the Step® survey tool were used to collect data. Descriptive statistics, χ2 tests, and regression analysis were used and augmented by data visualization to display risk variable differences. Results: Tanzania's colorectal cancer incidence has increased six times in the last decade in which major towns and cities of Dar es Salaam (20.2 per 100,000), Pwani (7.2 per 100,000), Kilimanjaro (4.4 per 100,000), Arusha (4.2 per 100,000), and Morogoro (3.6 per 100,000) had the highest percentage. This study reported that, almost 45% of the participants were hypertensive. Two major dietary patterns, namely “healthy” and “western”, existed among the study sample. Obesity was found in 25% of participants, whereas overweight was present in 28%; of note, the prevalence was higher in females (26.9%) than in males (23.6%) respectively. The prevalence of alcohol consumption was 21.5%, with a significantly lower rate of smoking (12.2%) noted within the study subjects. Both alcohol consumption and tobacco smoking were more common in men than women (22.7 vs. 20.6% and 24.5 vs. 3.2%, respectively). The prevalence of vigorous, moderate, and low physical activity for both sexes was 18.6%, 54.1% and 42.3%, respectively. Conclusion: Evidence from this study demonstrate that, like other NCDs CRC is increasing in Tanzania. Colon cancer is increasing at higher rate than rectal cancer seeming to align with change in lifestyle. Major towns and cities had the highest share of CRC patients. Diet, obesity, tobacco smoking, alcohol consumption, and sedentary behavior have potential role to play in the rising trend of CRC and other NCDs. We recommend a large longitudinal study with robust methodology which can establish cause and effect relationships between specific lifestyle behaviors and the incidence of colorectal cancer.

Health Facility Governing Committees (HFGCs) play a vital role in overseeing health services delivery in the primary health care system. However, despite their existence in Tanzania hiccups remain reported on the quality of health services delivered in primary health care facilities. The latter poses a question on the performance of HFGCs in overseeing the services delivery at the primary health facilities.This study sought to assess the perceived performance of the HFGCs and the associated factors in overseeing the healthcare services delivery at the primary health facilities in Tanzania. A cross-sectional study was conducted in five regions of Tanzania: Mwanza, Dar Es Salaam, Kilimanjaro, Pwani, and Arusha. A self-administered questionnaire containing structured questions was used to gather information from randomly selected 574 HFGC members. Data were analyzed descriptively and the binary logistic regression model was used to determine factors associated with the perceived performance. Half (50.52%) of the HFGCs members perceived themselves to have good performance. Furthermore, only 51.05% of all the participants had

Background: Tanzania has a double burden of malnutrition, including a high prevalence of undernutrition and an increasing prevalence of overweight and obesity among adolescents. Schools present a valuable opportunity to reach a large section of the country’s adolescent population with nutrition-oriented interventions. Objective: The objective of this study was to assess the current state of adolescent school nutrition interventions in Dodoma, Tanzania, with emphases on 3 potential school-based nutrition interventions, school vegetable gardens, school meals, and education (on nutrition, agriculture, and water, sanitation, and hygiene). Methods: Focus group discussions were conducted with several regional and district-level governmental stakeholders, including health, education, and agricultural officers. Ten public secondary schools were visited, and interviews with school administrators, teachers, students, and parents were conducted. Results: All stakeholders interviewed supported interventions to improve school-based nutrition, including school gardens, school feeding, and nutrition education. All 10 schools visited had some experience providing school meals, but parents’ contributions were essential for the program’s sustainability. Most schools visited had land available for a school garden program, but water availability could be challenging during certain times of the year. The teachers interviewed expressed that the curriculum on nutrition education was highly theoretical and did not allow students to practice the knowledge and skills they learned in the classroom. Conclusions: The current school-based approach to tackling the double burden of adolescent malnutrition in Dodoma is localized and ad hoc. To leverage the potential of schools as a platform for nutrition interventions, integrated and policy-mandated interventions are needed.

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IntroductionSecondary schools have the transformative potential to advance adolescent nutrition and provide a unique entry point for nutrition interventions to reach adolescents and their families and communities. Integrated school nutrition interventions offer promising pathways towards improving adolescent nutrition status, food security and building sustainable skill sets.Methods and analysisThe Meals, Education, and Gardens for In-School Adolescents (MEGA) project aims to implement and evaluate an integrated, school-based nutrition intervention package among secondary schools in the Chamwino District of Dodoma, Tanzania. MEGA is a cluster-randomised controlled trial, including six public secondary schools assigned to three different arms. Two schools will receive the full intervention package, including school meals, school gardens, nutrition education and community workshops. Two schools will receive the partial intervention package, including the school garden, nutrition education and community workshops. Two schools will serve as the controls and will not receive any intervention. The intervention will be implemented for one academic year. Baseline and end-line quantitative data collection will include 750 adolescents and 750 parents. The domains of outcomes for adolescents will include haemoglobin concentrations, anthropometry, educational outcomes and knowledge, attitudes and practices regarding nutrition, agriculture and health. The domains of outcomes for parents will include knowledge, attitudes and practices of nutrition, agriculture and health. End-line focus group discussions will be conducted among selected adolescents, parents and teachers to assess the facilitators and barriers associated with the intervention.Ethics and disseminationThis study was approved by the Institutional Review Board at Harvard T.H. Chan School of Public Health (approval number: IRB20-1623), the Institutional Research Review Committee at the University of Dodoma (approval number: MA.84/261/02) and the Tanzania National Institute for Medical Research (approval number: NIMR/HO/R.8a/Vol. IX/3801). A manuscript with the research findings will be developed for publication. Local dissemination meetings will be held with key stakeholders.Trial registration numberNCT04788303.; ClinicalTrials.gov Identifier.

Proper diet is important in preventing many diseases, and colorectal cancer is no exception. The aim of this study was to identify major dietary patterns among the general population in Arusha Tanzania to determine whether diet is one of the predictors contributing to the observed pattern and distribution of colorectal cancer in Tanzania