BackgroundFew studies have differentiated risk factors for term-small for gestational age (SGA), preterm-appropriate for gestational age (AGA), and preterm-SGA, despite evidence of varying risk of child mortality and poor developmental outcomes.MethodsWe analyzed birth outcome data from singleton infants, who were enrolled in a large randomized, double-blind, placebo-controlled trial of neonatal vitamin A supplementation conducted in Tanzania. SGA was defined as birth weight <10th percentile for gestation age and sex using INTERGROWTH standards and preterm birth as delivery at <37 complete weeks of gestation. Risk factors for term-SGA, preterm-AGA, and preterm-SGA were examined independently using log-binomial regression.ResultsAmong 19,269 singleton Tanzanian newborns included in this analysis, 68.3 % were term-AGA, 15.8 % term-SGA, 15.5 % preterm-AGA, and 0.3 % preterm-SGA. In multivariate analyses, significant risk factors for term-SGA included maternal age <20 years, starting antenatal care (ANC) in the 3rd trimester, short maternal stature, being firstborn, and male sex (all p < 0.05). Independent risk factors for preterm-AGA were maternal age <25 years, short maternal stature, firstborns, and decreased wealth (all p < 0.05). In addition, receiving ANC services in the 1st trimester significantly reduced the risk of preterm-AGA (p = 0.01). Significant risk factors for preterm-SGA included maternal age >30 years, being firstborn, and short maternal stature which appeared to carry a particularly strong risk (all p < 0.05).ConclusionOver 30 % of newborns in this large urban and rural cohort of Tanzanian newborns were born preterm and/or SGA. Interventions to promote early attendance to ANC services, reduce unintended young pregnancies, increased maternal height, and reduce poverty may significantly decrease the burden of SGA and preterm birth in sub-Saharan Africa.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) – ACTRN12610000636055, registered on 3rd August 2010.

There was high risk sexual practice including low condom use in this cohort of police officers. The incidence and prevalence of HIV infection were high. Police officers in Dar es Salaam are therefore a potential population group for HIV vaccine evaluation.

The rates of CD4 T-lymphocyte decline in HIV-1-infected individuals in our population are similar to those reported in Europe and north America.

Background The WHO recommends 20 mg/day of supplemental zinc for children with acute diarrhea for 10-14 days; in previous trials this dosage improved diarrhea but increased vomiting. Methods We randomly assigned 4500 children ages 6 to 59 months in India and Tanzania with acute diarrhea to one of three arms (5, 10 or 20 mg zinc sulfate for 14 days). The three primary outcomes were diarrhea duration >5 days and mean number of stools (tested for non-inferiority), and vomiting within 30 minutes of zinc administration (tested for superiority). Results The proportion of children with diarrhea duration >5 days was 6.5%, 7.7%, 7.2% in the 20 mg, 10 mg and 5 mg groups, respectively. The difference between 20 mg and 10 mg dosages was 1.2% (upper bound of one-sided 98.75% CI 3.6%) and between 20 mg and 5 mg was 0.7% (upper bound 3.0%), both below the 4% noninferiority margin (4%). The mean number of loose stools was 10.7, 10.9, and 10.8 in the 20 mg, 10 mg and 5 mg groups, respectively. The differences between 20 mg and 10 mg groups was 0.3 (upper bound 1.1), and between 20 mg and 5 mg group, 0.1 (upper bound 0.9), both below the noninferiority margin (2 stools). Vomiting within 30 minutes of zinc administration occurred in 19.3%, 15.6%, 13.7%, respectively, and was significantly lower in the 10 mg (relative risk 0.81, 97.5% CI 0.67 to 0.96) and 5 mg (0.71, 97.5% CI 0.59 to 0.86) groups. Both dosages also reduced vomiting after 30 minutes of dosing. Conclusion Compared with the standard 20 mg dosage of zinc, lower dosages had noninferior efficacy for diarrhea and reduced vomiting in children with diarrhea. NCT03078842.

Completion of IPT is associated with increased survival in HIV-infected adults with CD4 counts ≥ 200 cells/μ l and a positive TST.