Journal ArticleAIDS Care · December 15, 2025
OBJECTIVES: Persons living with HIV (PLWH) face double the risk of cardiovascular disease (CVD) compared to others. We assessed HIV prevalence among patients presenting to a Tanzanian emergency department (ED) with acute myocardial infarction (AMI) or hear ...
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Journal ArticlemedRxiv · November 27, 2025
INTRODUCTION: There is a large burden of uncontrolled hypertension among people with HIV (PWH) in sub-Saharan Africa (SSA), including in Tanzania. Yet, few evidence-based interventions to improve hypertension control have been adapted for use in PWH in thi ...
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Journal ArticleBMJ Open · November 11, 2025
BACKGROUND: In Tanzania, acute myocardial infarction (AMI) is underdiagnosed, and uptake of evidence-based care is suboptimal. Using an implementation science approach, an intervention was developed to address local barriers to care: the Multicomponent Int ...
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Journal ArticleBirth · September 18, 2025
INTRODUCTION: Despite overwhelming evidence of the benefits of breastfeeding (BF) and its potential to decrease infant mortality, BF rates are low in many low- and middle-income countries like Ghana. We sought to assess Ghanaian mothers' BF plans and their ...
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Journal ArticleRes Sq · August 29, 2025
BACKGROUND: The Multicomponent Intervention to Improve Acute Myocardial Infarction Care (MIMIC) was developed to address gaps in AMI diagnosis and treatment in northern Tanzania. Although initial implementation was promising, many quality improvement inter ...
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Journal ArticleLancet Glob Health · July 2025
BACKGROUND: The global burden of multimorbidity-the coexistence of two or more long-term conditions-is increasing. Limited access to primary care in sub-Saharan Africa means acute hospital admission is often the sentinel multimorbidity presentation. This p ...
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Journal ArticleBMJ Glob Health · March 6, 2025
BACKGROUND: We conducted a randomised population-based cluster survey in northern Tanzania to assess care-seeking behaviours in the context of a febrile illness. Our objectives were to determine the most effective points for intervention during initial fev ...
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Journal ArticleAfr J Emerg Med · March 2025
BACKGROUND: Preliminary data suggests that the burden of acute coronary syndrome (ACS) is high in Tanzania. After efforts to improve ACS care, we sought to describe ACS diagnosis rates, care processes, and outcomes in a Tanzanian Emergency Department (ED). ...
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Journal ArticleAm Heart J · March 2025
BACKGROUND: Nonspecific electrocardiogram (ECG) findings are associated with increased morbidity and mortality in high-income settings. ECGs are increasingly available in emergency departments (EDs) in low- and middle-income countries (LMICs), however the ...
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Journal ArticleOpen Forum Infect Dis · January 2025
BACKGROUND: Despite a high burden of sepsis in Sub-Saharan Africa, clinical data for adolescent and adult sepsis in this setting are limited. We sought to describe clinical characteristics, management, and outcomes in adolescents and adults with sepsis in ...
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Journal ArticleAnn Glob Health · 2025
Background: Uptake of evidence-based care for acute myocardial infarction (AMI) is limited in Tanzania. To address this, a tailored intervention, the Multicomponent Intervention to Improve Acute Myocardial Infarction Care (MIMIC), was co-designed by an int ...
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Journal ArticlePLoS One · 2025
BACKGROUND: The Multicomponent Intervention to Improve Acute Myocardial Infarction Care (MIMIC) was developed to increase the uptake of evidence-based care for acute myocardial infarction in Tanzania. MIMIC consists of five components: triage cards, pocket ...
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Journal ArticlemedRxiv · December 16, 2024
BACKGROUND: The Multicomponent Intervention to Improve Acute Myocardial Infarction Care (MIMIC) was developed to increase uptake of evidence-based care for acute myocardial infarction in Tanzania. MIMIC consists of five components: triage cards, pocket car ...
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Journal ArticleJMIR Res Protoc · September 24, 2024
BACKGROUND: Although the incidence of acute myocardial infarction (AMI) is rising in sub-Saharan Africa, the uptake of evidence-based care for the diagnosis and treatment of AMI is limited throughout the region. In Tanzania, studies have revealed common mi ...
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Journal ArticleAcad Emerg Med · April 2024
OBJECTIVE: The HEART score successfully risk stratifies emergency department (ED) patients with chest pain in high-income settings. However, this tool has not been validated in low-income countries. METHODS: This is a secondary analysis of a prospective ob ...
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Journal ArticleBMC Health Serv Res · March 28, 2024
BACKGROUND: Evidence-based care for acute myocardial infarction (AMI) reduces morbidity and mortality. Prior studies in Tanzania identified substantial gaps in the uptake of evidence-based AMI care. Implementation science has been used to improve uptake of ...
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Journal ArticleInt J STD AIDS · January 2024
INTRODUCTION: People with HIV (PLWH) have an increased risk myocardial infarction (MI), and evidence suggests that MI is under-diagnosed in Tanzania. However, little is known about barriers to MI care among PLWH in the region. METHODS: In this qualitative ...
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Journal ArticleAnn Glob Health · 2024
BACKGROUND: Uptake of evidence-based care for acute myocardial infarction (AMI) is suboptimal in Tanzania, but there are currently no published interventions to improve AMI care in sub-Saharan Africa. OBJECTIVES: Co-design a quality improvement interventio ...
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Journal ArticlePLOS Glob Public Health · 2024
INTRODUCTION: Myocardial Infarction (MI) is a leading cause of death worldwide. In high income countries, quality improvement strategies have played an important role in increasing uptake of evidence-based MI care and improving MI outcomes. The incidence o ...
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Journal ArticlePLoS One · 2024
BACKGROUND: Chronic myocardial injury is a condition defined by stably elevated cardiac biomarkers without acute myocardial ischemia. Although studies from high-income countries have reported that chronic myocardial injury predicts adverse prognosis, there ...
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Journal ArticlePLoS One · 2024
OBJECTIVE: This study will evaluate the feasibility and preliminary effectiveness of the COACH (Community Health Worker Optimization of Antihypertensive Care in HIV) intervention, which integrates hypertension management into existing HIV care for people l ...
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Journal ArticleBMJ Open · November 19, 2023
OBJECTIVES: We aimed to prospectively describe incident cardiovascular events among people living with HIV (PLWH) in northern Tanzania. Secondary aims of this study were to understand non-communicable disease care-seeking behaviour and patient preferences ...
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Journal ArticleAcad Med · October 1, 2023
PROBLEM: With the dissolution of the Step 2 Clinical Skills exam, medical programs have a greater responsibility to teach and assess clinical skills in the preclerkship years. Clinical teaching this early has traditionally been avoided because of insuffici ...
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Journal ArticleOpen Forum Infect Dis · August 2023
BACKGROUND: We describe antibacterial use in light of microbiology data and treatment guidelines for common febrile syndromes in Moshi, Tanzania. METHODS: We compared data from 2 hospital-based prospective cohort studies, cohort 1 (2011-2014) and cohort 2 ...
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Journal ArticlePLoS One · 2023
BACKGROUND: Sub-Saharan Africa has a high prevalence of hypertension with a low rate of awareness, treatment adherence, and control. The emergency department (ED) may represent a unique opportunity to improve hypertension screening, awareness, and linkage ...
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Journal ArticlePLoS One · 2023
BACKGROUND: People with HIV in sub-Saharan Africa are increasingly developing age-related comorbidities. The purpose of this prospective observational study was to describe 6-month outcomes among Tanzanians with HIV and elevated blood pressure or hyperglyc ...
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Journal ArticlePLOS Glob Public Health · 2023
Data describing the incidence of hypertension and diabetes among people with HIV in sub-Saharan Africa remain sparse. In this study, adults with HIV were enrolled from a public clinic in Moshi, Tanzania (September 2020-March 2021). At enrollment, a survey ...
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Journal ArticlePLOS Glob Public Health · 2023
The prevalence of cardiovascular disease (CVD) is rising among people with HIV (PWH) in sub-Saharan Africa (SSA). Despite the utility of the electrocardiogram (ECG) in screening for CVD, there is limited data regarding longitudinal ECG changes among PWH in ...
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Journal ArticleGlob Public Health · December 2022
HIV is associated with increased risk of cardiovascular disease, but there has been less study of cardiovascular comorbidities among people with HIV in sub-Saharan Africa. In a cross-sectional observational study, Tanzanian adults presenting for outpatient ...
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Journal ArticleInt Health · July 1, 2022
BACKGROUND: Little is known about healthcare-seeking behaviour and barriers to care for cardiovascular disease (CVD) in sub-Saharan Africa. METHODS: Emergency department patients in Tanzania with acute CVD were prospectively enrolled. Questionnaires were a ...
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Journal ArticlePLoS Negl Trop Dis · July 2022
Growing evidence suggests considerable variation in endemic typhoid fever incidence at some locations over time, yet few settings have multi-year incidence estimates to inform typhoid control measures. We sought to describe a decade of typhoid fever incide ...
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Journal ArticleCirc Cardiovasc Qual Outcomes · April 2022
BACKGROUND: Little is known about long-term outcomes and uptake of secondary preventative therapies following acute myocardial infarction (AMI) in sub-Saharan Africa. METHODS: Consecutive patients presenting with AMI (as defined by the Fourth Universal Def ...
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Journal ArticleGlob Heart · 2022
INTRODUCTION: HIV confers increased risk of myocardial infarction (MI), but there has been little study of ischemic electrocardiogram (ECG) findings among people with HIV in sub-Saharan Africa. OBJECTIVES: To compare the prevalence of ischemic ECG findings ...
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Journal ArticlePan Afr Med J · 2022
CITE THIS ARTICLE: Preeti Manavalan et al. Hypertension among adults enrolled in HIV care in northern Tanzania: comorbidities, cardiovascular risk, and knowledge, attitudes and practices. Pan African Medical Journal. 2022;41(285). 10.11604/pamj.2022.41.285 ...
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Journal ArticleAm J Trop Med Hyg · December 20, 2021
Q fever and spotted fever group rickettsioses (SFGR) are common causes of severe febrile illness in northern Tanzania. Incidence estimates are needed to characterize the disease burden. Using hybrid surveillance-coupling case-finding at two referral hospit ...
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Journal ArticleTrop Med Int Health · December 2021
OBJECTIVES: To describe knowledge, attitudes, and practices (KAP) regarding ischemic heart disease (IHD) among adults with HIV in Tanzania. METHODS: Adults presenting for routine HIV care at a clinic in northern Tanzania were consecutively enrolled and wer ...
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Journal ArticleAfr J Emerg Med · December 2021
INTRODUCTION: Data describing atrial fibrillation (AF) care in emergency centres (ECs) in sub-Saharan Africa is lacking. We sought to describe the prevalence and outcomes of AF in a Tanzanian EC. METHODS: In a prospective, observational study, adults prese ...
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Journal ArticleInt J Cardiol · November 1, 2021
OBJECTIVE: There is a rising burden of myocardial infarction (MI) within sub-Saharan Africa. Prospective studies of detailed MI outcomes in the region are lacking. METHODS: Adult patients with confirmed MI from a prospective surveillance study in northern ...
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Journal ArticleJ Am Heart Assoc · August 3, 2021
Background Rigorous incidence data for acute myocardial infarction (AMI) in sub-Saharan Africa are lacking. Consequently, modeling studies based on limited data have suggested that the burden of AMI and AMI-associated mortality in sub-Saharan Africa is low ...
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Journal ArticleAm J Emerg Med · August 2021
OBJECTIVE: High-sensitivity cardiac troponin assays (hs-cTn) aid in diagnosis of myocardial infarction (MI). These assays have lower specificity for non-ST Elevation MI (NSTEMI) in patients with renal disease. Our objective was to determine an optimized cu ...
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Journal ArticleBMJ Glob Health · August 2021
BACKGROUND: Invasive non-typhoidal Salmonella (iNTS) is one of the leading causes of bacteraemia in sub-Saharan Africa. We aimed to provide a better understanding of the genetic characteristics and transmission patterns associated with multi-drug resistant ...
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Journal ArticlePLoS One · 2021
BACKGROUND: The burden of heart failure is growing in sub-Saharan Africa, but there is a dearth of data characterizing care and outcomes of heart failure patients in the region, particularly in emergency department settings. METHODS: In a prospective obser ...
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Journal ArticleJ Am Heart Assoc · August 18, 2020
Background Evidence suggests that acute coronary syndrome (ACS) is underdiagnosed in sub-Saharan Africa. Triage-based interventions have improved ACS diagnosis and management in high-income settings but have not been evaluated in sub-Saharan African emerge ...
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Journal ArticleAm Heart J · August 2020
BACKGROUND: Growing evidence suggests that under-diagnosis of acute myocardial infarction (AMI) may be common in sub-Saharan Africa. Prospective studies of routine AMI screening among patients presenting to emergency departments in sub-Saharan Africa are l ...
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Journal ArticleJ Clin Hypertens (Greenwich) · August 2020
Failure to address hypertension among people living with HIV (PLWH) may undermine the significant progress made toward reducing mortality among this high-risk population in sub-Saharan Africa (SSA). Here, the authors report hypertension prevalence, diagnos ...
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Journal ArticleInt Health · February 12, 2020
BACKGROUND: The incidence of acute coronary syndrome (ACS) is growing across sub-Saharan Africa and many healthcare systems are ill-equipped for this growing burden. Evidence suggests that healthcare providers may be underdiagnosing and undertreating ACS, ...
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Journal ArticleGlob Heart · February 6, 2020
BACKGROUND: Acute coronary syndrome (ACS) is thought to be a rare diagnosis in sub-Saharan Africa, but little is known about diagnostic practices for patients with possible ACS symptoms in the region. OBJECTIVE: To describe current care practices for patie ...
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Journal ArticlePLoS One · 2020
BACKGROUND: Hypertension, a leading risk for cardiovascular mortality, is an important co-morbidity among people living with HIV (PLHIV). In Tanzania, hypertension prevalence among PLHIV approaches 20 to 30%. However, most patients are unaware of their dia ...
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Journal ArticleAfr J Emerg Med · December 2019
INTRODUCTION: The prevalence of cardiovascular disease in sub-Saharan Africa is substantial and growing. Much remains to be learned about the relative burden of acute coronary syndrome (ACS), heart failure, and stroke on emergency departments and hospital ...
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Journal ArticleClin Infect Dis · October 30, 2019
BACKGROUND: Antimicrobial resistance (AMR) is a major global health concern, yet, there are noticeable gaps in AMR surveillance data in regions such as sub-Saharan Africa. We aimed to measure the prevalence of extended-spectrum β-lactamase (ESBL) producing ...
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Journal ArticlePublic Health · October 2019
OBJECTIVES: The objective of this study is to increase understanding of knowledge, attitudes, and preventative practices regarding ischemic heart disease (IHD) in sub-Saharan Africa in order to develop patient-centered interventions to improve care and out ...
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Journal ArticleTrans R Soc Trop Med Hyg · April 1, 2019
BACKGROUND: Self-treatment with antimicrobials is common in sub-Saharan Africa. Little is known about the prevalence of this practice where malaria transmission intensity is low, and little is known about the prevalence of self-treatment with other medicat ...
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Journal ArticleAm Heart J · April 2019
BACKGROUND: Little is known about community knowledge of myocardial infarction symptoms and perceptions of self-risk in sub-Saharan Africa. METHODS: A community survey was conducted in northern Tanzania, where the prevalence of cardiovascular risk factors ...
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Journal ArticlePLoS One · 2019
BACKGROUND: Little is known about the utilization of cardiac diagnostic testing in Brazil and how such testing is related with local rates of acute coronary syndrome (ACS)-related mortality. METHODS AND RESULTS: Using data from DATASUS, the public national ...
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Journal ArticlePLoS One · 2019
OBJECTIVES: Globally, hypertension affects one billion people and disproportionately burdens low-and middle-income countries. Despite the high disease burden in sub-Saharan Africa, optimal care models for diagnosing and treating hypertension have not been ...
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Journal ArticlePLoS One · 2019
BACKGROUND: Little is known about community perceptions of chest pain and healthcare seeking behavior for chest pain in sub-Saharan Africa. METHODS: A two-stage randomized population-based cluster survey with selection proportional to population size was p ...
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Journal ArticleNeuroepidemiology · 2019
BACKGROUND: Little is known about knowledge of stroke symptoms, perceptions of self-risk, and health-care-seeking behavior for stroke in East Africa. METHODS: A 2-stage randomized population-based cluster survey with selection proportional to population si ...
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Journal ArticleEthn Dis · 2019
INTRODUCTION: Little is known about the burden of hypertension and diabetes on emergency department (ED) utilization and hospitalizations in sub-Saharan Africa. METHODS: A retrospective review of adult ED patients in northern Tanzania was performed from Se ...
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Journal ArticleNat Commun · November 30, 2018
There is paucity of data regarding the geographical distribution, incidence, and phylogenetics of multi-drug resistant (MDR) Salmonella Typhi in sub-Saharan Africa. Here we present a phylogenetic reconstruction of whole genome sequenced 249 contemporaneous ...
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Journal ArticleTrans R Soc Trop Med Hyg · March 1, 2018
BACKGROUND: Brucellosis causes substantial morbidity among humans and their livestock. There are few robust estimates of the incidence of brucellosis in sub-Saharan Africa. Using cases identified through sentinel hospital surveillance and health care utili ...
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Journal ArticleAlcohol Alcohol · January 1, 2018
AIMS: To develop Swahili versions of the Alcohol Use Disorders Identification Test (AUDIT) and CAGE questionnaires and evaluate their psychometric properties in a traumatic brain injury (TBI) population in Tanzania. METHODS: Swahili versions of the AUDIT a ...
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Journal ArticleBMJ Open · November 9, 2017
INTRODUCTION: Sub-Saharan Africa is particularly vulnerable to the growing global burden of hypertension, but epidemiological studies are limited and barriers to optimal management are poorly understood. Therefore, we undertook a community-based mixed-meth ...
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Journal ArticleInjury · July 2017
Road traffic injuries (RTIs) continue to increase with the proliferation of motor vehicles, especially in low-income countries where safe road infrastructure is lacking. Knowing where and why RTIs occur would allow for increased safety and prevention plann ...
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Journal ArticleLancet Glob Health · March 2017
BACKGROUND: Available incidence data for invasive salmonella disease in sub-Saharan Africa are scarce. Standardised, multicountry data are required to better understand the nature and burden of disease in Africa. We aimed to measure the adjusted incidence ...
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Journal ArticlePLoS Negl Trop Dis · December 2016
BACKGROUND: The sole report of annual leptospirosis incidence in continental Africa of 75-102 cases per 100,000 population is from a study performed in August 2007 through September 2008 in the Kilimanjaro Region of Tanzania. To evaluate the stability of t ...
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Journal ArticlePathog Glob Health · May 2016
Little is known about the presence and distribution of Aedes mosquitoes in northern Tanzania despite the occurence of viruses transmitted by these mosquitoes such as Chikungunya virus (CHIKV) and Dengue virus (DENV) in the region. Adult and larval mosquito ...
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Journal ArticleClin Infect Dis · March 15, 2016
Salmonella enterica serovar Typhi and nontyphoidal Salmonella (NTS) cause the majority of bloodstream infections in sub-Saharan Africa; however, serotyping is rarely performed. We validated a multiplex polymerase chain reaction (PCR) assay with the White-K ...
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Journal ArticleClin Infect Dis · March 15, 2016
BACKGROUND: Salmonella enterica serovar Typhi is a predominant cause of bloodstream infections in sub-Saharan Africa (SSA). Increasing numbers of S. Typhi with resistance to ciprofloxacin have been reported from different parts of the world. However, data ...
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Journal ArticleClin Infect Dis · March 15, 2016
BACKGROUND: Assessing healthcare utilization is important to identify weaknesses of healthcare systems, to outline action points for preventive measures and interventions, and to more accurately estimate the disease burden in a population. METHODS: A healt ...
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Journal ArticleClin Infect Dis · March 15, 2016
BACKGROUND: Country-specific studies in Africa have indicated that Plasmodium falciparum is associated with invasive nontyphoidal Salmonella (iNTS) disease. We conducted a multicenter study in 13 sites in Burkina Faso, Ethiopia, Ghana, Guinea-Bissau, Kenya ...
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Journal ArticleClin Infect Dis · November 1, 2015
BACKGROUND: The clinical diagnosis of bacterial bloodstream infections (BSIs) in sub-Saharan Africa is routinely confused with malaria due to overlapping symptoms. The Typhoid Surveillance in Africa Program (TSAP) recruited febrile inpatients and outpatien ...
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Journal ArticlePLoS One · 2014
BACKGROUND: Trends in the prevalence of acute myocardial infarction in sub-Saharan Africa have not been well described, despite growing recognition of the increasing burden of cardiovascular disease in low- and middle-income countries. The aim of this syst ...
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Journal ArticleTrop Med Int Health · November 2013
OBJECTIVE: To compare actual and perceived causes of fever in northern Tanzania. METHODS: In a standardised survey, heads of households in 30 wards in Moshi, Tanzania, were asked to identify the most common cause of fever for children and for adults. Respo ...
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Journal ArticlePLoS Negl Trop Dis · 2013
BACKGROUND: The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions and disease control. In this study, ...
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Journal ArticleAm J Trop Med Hyg · January 2012
Consecutive febrile admissions were enrolled at two hospitals in Moshi, Tanzania. Confirmed acute Chikungunya virus (CHIKV), Dengue virus (DENV), and flavivirus infection were defined as a positive polymerase chain reaction (PCR) result. Presumptive acute ...
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Journal ArticlePhysical Review B Condensed Matter and Materials Physics · February 19, 2008
The magnetic properties and structure of Lix Co O2 for 0.5
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Journal ArticleJournal of Solid State Chemistry · November 1, 2007
The magnetic, thermoelectric, and structural properties of LixNayCoO2, prepared by intercalation and deintercalation chemistry from the thermodynamically stable phase Li0.41Na0.31CoO2, which ...
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