2022
The impact of a community health worker intervention on uptake of antenatal care: a cluster-randomized pragmatic trial in Dar es Salaam
Regan M, Cheng C, Mboggo E, Larson E, Lema I, Magesa L, Machumi L, Ulenga N, Sando D, Mwanyika-Sando M, Barnhart D, Hong B, Mungure E, Li N, Siril H, Mujinja P, Naburi H, Kilewo C, Ekström A, Geldsetzer P, Fawzi W, Bärnighausen T, Sudfeld C, Spiegelman D. The impact of a community health worker intervention on uptake of antenatal care: a cluster-randomized pragmatic trial in Dar es Salaam. Health Policy And Planning 2022, 38: 279-288. PMID: 36377764, PMCID: PMC10019560, DOI: 10.1093/heapol/czac100.Peer-Reviewed Original ResearchConceptsMore ANC visitsCommunity health worker interventionHealth worker interventionAntenatal careANC visitsPragmatic trialHigh-quality antenatal carePragmatic cluster-randomized trialUptake of ANCDar es SalaamWorker interventionLarge-scale pragmatic trialsCluster-randomized pragmatic trialModest beneficial effectStandard of careRoutine health system dataCluster-randomized trialHealth system dataANC uptakeCare armCHW interventionPrimary outcomeIntervention armFirst trimesterPregnant women
2013
Determinants of anemia in postpartum HIV-negative women in Dar es Salaam, Tanzania
Petraro P, Duggan C, Urassa W, Msamanga G, Makubi A, Spiegelman D, Fawzi WW. Determinants of anemia in postpartum HIV-negative women in Dar es Salaam, Tanzania. European Journal Of Clinical Nutrition 2013, 67: 708-717. PMID: 23612515, PMCID: PMC3775569, DOI: 10.1038/ejcn.2013.71.Peer-Reviewed Original ResearchMeSH KeywordsAnemia, Iron-DeficiencyCD4 Lymphocyte CountDietDietary SupplementsErythrocyte IndicesFemaleFolic AcidHemoglobinsHIV InfectionsHumansIron, DietaryMaternal Nutritional Physiological PhenomenaMultivariate AnalysisPostpartum PeriodPregnancyProportional Hazards ModelsProspective StudiesRisk FactorsSocioeconomic FactorsTanzaniaConceptsIron/folate supplementationIron deficiency anemiaDeterminants of anemiaDeficiency anemiaFolate supplementationDelivery complicationsPregnant womenRisk factorsMultivariate Cox proportional hazards modelNon-anemic pregnant womenCox proportional hazards modelCD4 cell countHIV-negative womenModifiable risk factorsProspective cohort studyMaternal nutritional statusWeeks of gestationManagement of infectionsProportional hazards modelDar es SalaamSub-Saharan African womenBaseline anemiaIncident anemiaAnemic womenPostpartum anemiaDietary Patterns, Nutrient Intake, and Sociodemographic Characteristics in HIV-Infected Tanzanian Pregnant Women
Lukmanji Z, Hertzmark E, Spiegleman D, Fawzi WW. Dietary Patterns, Nutrient Intake, and Sociodemographic Characteristics in HIV-Infected Tanzanian Pregnant Women. Ecology Of Food And Nutrition 2013, 52: 34-62. PMID: 23282190, DOI: 10.1080/03670244.2012.705768.Peer-Reviewed Original ResearchConceptsPregnant womenNutrient intakeTanzanian pregnant womenWorld Health Organization recommendationsDietary macronutrient intakeLongitudinal clinical trialsVitamin supplementationClinical trialsDietary intakeMacronutrient intakeDietary patternsDiet intakeFood composition tablesHigh riskWomen's ageSociodemographic characteristicsIntakeInadequate foodDar es SalaamWomenHIVTwo-thirdsEducation levelComposition tablesAge
2010
Lipid-soluble vitamins A, D, and E in HIV-infected pregnant women in Tanzania
Mehta S, Spiegelman D, Aboud S, Giovannucci EL, Msamanga GI, Hertzmark E, Mugusi FM, Hunter DJ, Fawzi WW. Lipid-soluble vitamins A, D, and E in HIV-infected pregnant women in Tanzania. European Journal Of Clinical Nutrition 2010, 64: 808-817. PMID: 20517330, PMCID: PMC3078753, DOI: 10.1038/ejcn.2010.76.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnemia, Iron-DeficiencyAvitaminosisBlood SedimentationCD8-Positive T-LymphocytesCell CountDietFemaleGestational AgeHemoglobinsHIV InfectionsHumansNutritional StatusPregnancyPrevalenceRegression AnalysisSeleniumTanzaniaVitamin AVitamin A DeficiencyVitamin DVitamin D DeficiencyVitamin EVitamin E DeficiencyYoung AdultConceptsErythrocyte sedimentation rateVitamin E statusPregnant womenLipid-soluble vitaminsVitamin APlasma vitaminGestational ageLow vitaminE statusLow vitamin D statusHigh erythrocyte sedimentation rateLow vitamin E statusLipid-soluble vitamins ACD8 cell countsVitamin D statusHuman immunodeficiency virusPlasma vitamin EPoor nutritional statusPlasma vitamin ALow plasma vitamin AResource-limited settingsD statusLaboratory parametersImmunodeficiency virusSevere anemia
2007
Vitamins and Perinatal Outcomes Among HIV-Negative Women in Tanzania
Fawzi W, Msamanga G, Urassa W, Hertzmark E, Petraro P, Willett W, Spiegelman D. Vitamins and Perinatal Outcomes Among HIV-Negative Women in Tanzania. Obstetrical & Gynecological Survey 2007, 62: 561-563. DOI: 10.1097/01.ogx.0000279296.97522.77.Peer-Reviewed Original ResearchLow birth weightGestational age infantsHIV-negative womenMultivitamin groupBirth weightRelative riskPlacebo groupPreterm birthFetal deathGestational ageMultivitamin supplementsPregnant womenMicronutrient statusDouble-blind trialFolic acidMean birth weightSimilar baseline characteristicsWeeks gestational ageConfidence intervalsPrenatal vitamin supplementationHigher hemoglobin levelsPlacebo recipientsMaternal anemiaPerinatal outcomesBaseline characteristics
2006
Socio-economic and demographic factors associated with prevalence of HIV infection among pregnant women in Dar es Salaam, Tanzania
Msamanga G, Fawzi W, Hertzmark E, McGrath N, Kapiga S, Kagoma C, Spiegelman D, Hunter D. Socio-economic and demographic factors associated with prevalence of HIV infection among pregnant women in Dar es Salaam, Tanzania. East African Medical Journal 2006, 83: 311-321. PMID: 16989376, DOI: 10.4314/eamj.v83i6.9438.Peer-Reviewed Original ResearchConceptsHIV infectionAntenatal clinicHIV-1-positive womenDar es SalaamMaternal-foetal transmissionMid-arm circumferenceHIV-1 infectionDemographic characteristicsLow HIV prevalenceCross-sectional studyHIV prevalence ratesHIV/AIDS epidemicOpt-out approachLow-resource settingsPositive womenNevirapine treatmentHIV prevalencePregnant womenMaternal ageHigh prevalenceRegular partnersPrevalence ratesPartner's occupationTanzanian womenOlder age
2005
Selenium status, pregnancy outcomes, and mother-to-child transmission of HIV-1.
Kupka R, Garland M, Msamanga G, Spiegelman D, Hunter D, Fawzi W. Selenium status, pregnancy outcomes, and mother-to-child transmission of HIV-1. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2005, 39: 203-10. PMID: 15905738.Peer-Reviewed Original ResearchConceptsPregnancy outcomesPregnant womenChild transmissionLow selenium statusHIV transmissionMaternal HIV disease progressionHIV-positive pregnant womenSelenium statusDirect epidemiologic evidenceMTCT of HIVLow plasma selenium levelsHIV disease progressionPoor pregnancy outcomesRisk of motherWeeks of gestationMother-child pairsPlasma selenium levelsAdequate selenium statusFetal deathGestational ageEpidemiologic evidenceLow birthweightDisease progressionGenital tractHIV-1Pregnancy Increases BMI in Adolescents of a Population-Based Birth Cohort 1 2
Fawzi W, Msamanga G, Spiegelman D, Hunter DJ. Pregnancy Increases BMI in Adolescents of a Population-Based Birth Cohort 1 2. Journal Of Nutrition 2005, 135: 938-944. PMID: 15795466, DOI: 10.1093/jn/135.4.938.Peer-Reviewed Original ResearchConceptsAntiretroviral therapyMultivitamin supplementsPregnant womenHIV-negative pregnant womenDaily multivitamin supplementEarly childhood infectionsAdverse pregnancy outcomesHIV disease progressionHIV-1 infectionAdequate dietary intakeEfficacy of vitaminAdverse health outcomesFurther studiesLow-cost interventionMo of ageUninfected childrenHIV diseasePregnancy outcomesPregnant HIVHIV infectionChildhood infectionsRandomized trialsNutritional interventionDietary intakeDisease progression
2004
Selenium Status Is Associated with Accelerated HIV Disease Progression among HIV-1–Infected Pregnant Women in Tanzania
Kupka R, Msamanga GI, Spiegelman D, Morris S, Mugusi F, Hunter DJ, Fawzi WW. Selenium Status Is Associated with Accelerated HIV Disease Progression among HIV-1–Infected Pregnant Women in Tanzania. Journal Of Nutrition 2004, 134: 2556-2560. PMID: 15465747, DOI: 10.1093/jn/134.10.2556.Peer-Reviewed Original ResearchConceptsPlasma selenium levelsCD4 cell countRisk of mortalityDisease progressionHIV-1-infected pregnant womenCell countSelenium levelsLow plasma selenium levelsHIV disease progressionAccelerated disease progressionCox multivariate modelSelenium statusMedian followHIV diseaseClinical outcomesPregnant womenPoor survivalTanzanian womenMultivariate modelL increaseCells/ProgressionWomenMortalityFirst yearA Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality
Fawzi WW, Msamanga GI, Spiegelman D, Wei R, Kapiga S, Villamor E, Mwakagile D, Mugusi F, Hertzmark E, Essex M, Hunter DJ. A Randomized Trial of Multivitamin Supplements and HIV Disease Progression and Mortality. New England Journal Of Medicine 2004, 351: 23-32. PMID: 15229304, DOI: 10.1056/nejmoa040541.Peer-Reviewed Original ResearchConceptsVitamin AHIV diseaseMultivitamin supplementsHuman immunodeficiency virus (HIV) diseasePlacebo-controlled trialHIV disease progressionStage 4 diseaseLow viral loadHigher CD4Antiretroviral therapyPrimary outcomeImmunodeficiency syndromeRandomized trialsViral loadPregnant womenDisease progressionRelative riskObservational studyDaily supplementCell countEnd pointMicronutrient statusMultivitaminsDiseaseProgressionAssociation Between Low Birth Weight and Infant Mortality in Children Born to Human Immunodeficiency Virus 1-Infected Mothers in Tanzania
Wei R, Msamanga GI, Spiegelman D, Hertzmark E, Baylin A, Manji K, Fawzi WW. Association Between Low Birth Weight and Infant Mortality in Children Born to Human Immunodeficiency Virus 1-Infected Mothers in Tanzania. The Pediatric Infectious Disease Journal 2004, 23: 530-535. PMID: 15194834, DOI: 10.1097/01.inf.0000129691.42964.eb.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAnalysis of VarianceCohort StudiesConfidence IntervalsDeveloping CountriesFemaleHIV InfectionsHIV-1HumansIncidenceInfant MortalityInfant, Low Birth WeightInfant, NewbornInfectious Disease Transmission, VerticalMalePregnancyPregnancy Complications, InfectiousPregnancy OutcomeProportional Hazards ModelsRisk FactorsSex DistributionSurvival AnalysisTanzaniaConceptsLow birth weightBirth weightHIV statusHIV transmissionInfant mortalityCox proportional hazards modelHuman immunodeficiency virus-1Child's HIV statusPediatric HIV infectionHuman immunodeficiency virusRisk of mortalityImmunodeficiency virus-1Proportional hazards modelWeeks of ageAntiretroviral treatmentHIV infectionImmunodeficiency virusNeonatal mortalityPositive infantsPregnant womenPostneonatal mortalityHazards modelMortalityInfantsVirus 1Effect of Prenatal Vitamin Supplementation on Lower-Genital Levels of HIV Type 1 and Interleukin Type 1β at 36 Weeks of Gestation
Fawzi W, Msamanga G, Antelman G, Xu C, Hertzmark E, Spiegelman D, Hunter D, Anderson D. Effect of Prenatal Vitamin Supplementation on Lower-Genital Levels of HIV Type 1 and Interleukin Type 1β at 36 Weeks of Gestation. Clinical Infectious Diseases 2004, 38: 716-722. PMID: 14986257, DOI: 10.1086/381673.Peer-Reviewed Original ResearchConceptsHIV-1HIV-1-infected pregnant womenVitamin AHIV-1-infected womenType 1Human immunodeficiency virus type 1Immunodeficiency virus type 1Genital HIV-1Prenatal multivitamin supplementsHIV-1 transmissionCervicovaginal lavage specimensHIV Type 1HIV-1 infectionLower genital tractWeeks of gestationPrenatal vitamin supplementationUse of vitaminsVirus type 1Lack of effectPregnancy outcomesVaginal inflammationViral sheddingVitamin supplementationMultivitamin supplementsPregnant women
2003
Pattern and Predictors of Weight Gain During Pregnancy Among HIV-1–Infected Women from Tanzania
Villamor E, Msamanga G, Spiegelman D, Peterson KE, Antelman G, Fawzi WW. Pattern and Predictors of Weight Gain During Pregnancy Among HIV-1–Infected Women from Tanzania. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2003, 32: 560-569. PMID: 12679710, DOI: 10.1097/00126334-200304150-00015.Peer-Reviewed Original ResearchMeSH KeywordsArmBody Mass IndexCohort StudiesFemaleHIV InfectionsHIV-1HumansMalaria, FalciparumNutritional StatusPredictive Value of TestsPregnancyPregnancy Complications, InfectiousPregnancy Complications, ParasiticPregnancy Trimester, SecondPregnancy Trimester, ThirdTanzaniaVitamin AVitaminsWeight GainConceptsMid-upper arm circumferenceGestational weight gainWeight gainHIV diseaseThird trimesterLower baseline CD4 T cell countsBaseline CD4 T-cell countHIV-1-infected womenCD4 T-cell countLow serum retinolT-cell countsFirst prenatal visitHIV-positive womenAdvanced clinical stageMonthly anthropometric measurementsNeonatal outcomesPrenatal visitWeek 12Clinical stagePregnant womenSecond trimesterArm circumferenceMalaria infectionSerum retinolHelminthic infections
2002
Transmission of HIV-1 Through Breastfeeding Among Women in Dar es Salaam, Tanzania
Fawzi W, Msamanga G, Spiegelman D, Renjifo B, Bang H, Kapiga S, Coley J, Hertzmark E, Essex M, Hunter D. Transmission of HIV-1 Through Breastfeeding Among Women in Dar es Salaam, Tanzania. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2002, 31: 331-338. PMID: 12439210, DOI: 10.1097/00126334-200211010-00010.Peer-Reviewed Original ResearchConceptsHIV-1High maternal viral loadLow CD4 cell countsMultivariate proportional hazards modelMaternal viral loadCD4 cell countHIV-1 transmissionErythrocyte sedimentation rateAge 6 weeksAge 4 monthsChildren of womenProportional hazards modelDar es SalaamAge 24 monthsAnalysis of correlatesNipple cracksChild transmissionImmune reconstitutionCumulative incidenceViral loadPregnant womenAntiretroviral drugsMean durationMicronutrient supplementsHigh riskRandomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality
Fawzi WW, Msamanga GI, Hunter D, Renjifo B, Antelman G, Bang H, Manji K, Kapiga S, Mwakagile D, Essex M, Spiegelman D. Randomized trial of vitamin supplements in relation to transmission of HIV-1 through breastfeeding and early child mortality. AIDS 2002, 16: 1935-1944. PMID: 12351954, DOI: 10.1097/00002030-200209270-00011.Peer-Reviewed Original ResearchConceptsHIV-1 transmissionInfants of mothersVitamin ALower baseline lymphocyte countsHigh erythrocyte sedimentation rateChild mortalityBaseline lymphocyte countMaternal micronutrient statusHIV-free survivalErythrocyte sedimentation rateLow birthweight babiesEarly child mortalityRisk of transmissionLymphocyte countLower hemoglobinMultivitamin supplementationWeeks' gestationBirthweight babiesPregnant womenHIV-1Vitamin supplementsMultivitaminsNutritional statusMicronutrient statusMortalityCorrelates of Plasma HIV-1 RNA Viral Load Among HIV-1 Seropositive Women in Dar es Salaam, Tanzania
Kapiga SH, Bang H, Spiegelman D, Msamanga GI, Coley J, Hunter DJ, Fawzi WW. Correlates of Plasma HIV-1 RNA Viral Load Among HIV-1 Seropositive Women in Dar es Salaam, Tanzania. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2002, 30: 316-323. PMID: 12131569, DOI: 10.1097/01.qai.0000014767.47046.c8.Peer-Reviewed Original ResearchConceptsHIV-1 RNA viral loadRNA viral loadPlasma HIV-1 RNA viral loadViral loadCopies/mLLymphocyte countHIV-1 positive pregnant womenHIV-1-seropositive womenMedian viral loadHigh viral loadPrevention of malariaTime of deliverySeropositive womenAbsolute CD4Pregnant womenClinical trialsHIV-1Long-term effectsDaily food expenditureMalaria parasitesBaselineMonthsDar es SalaamCD4Food expenditureHIV status and sociodemographic correlates of maternal body size and wasting during pregnancy
Villamor E, Msamanga G, Spiegelman D, Coley J, Hunter D, Peterson K, Fawzi W. HIV status and sociodemographic correlates of maternal body size and wasting during pregnancy. European Journal Of Clinical Nutrition 2002, 56: 415-424. PMID: 12001012, DOI: 10.1038/sj.ejcn.1601328.Peer-Reviewed Original ResearchConceptsWeeks of gestationHIV infectionHIV statusPregnant womenFirst prenatal visitSocioeconomic statusSignificant risk factorsCross-sectional studyLow socioeconomic statusLevel of educationMean MUACAntenatal clinicMaternal heightPrenatal visitUninfected mothersSecond trimesterMaternal ageOverall prevalenceRisk factorsChild healthMother's ageMultivariate analysisFogarty International CenterSociodemographic correlatesBMI
2001
The association between maternal HIV-1 infection and pregnancy outcomes in Dar es Salaam, Tanzania
Coley J, Msamanga G, Fawzi M, Kaaya S, Hertzmark E, Kapiga S, Spiegelman D, Hunter D, Fawzi W. The association between maternal HIV-1 infection and pregnancy outcomes in Dar es Salaam, Tanzania. BJOG An International Journal Of Obstetrics & Gynaecology 2001, 108: 1125-1133. DOI: 10.1016/s0306-5456(01)00269-8.Peer-Reviewed Original ResearchAdverse pregnancy outcomesPregnancy outcomesSymptomatic HIVLow birthweightPregnant womenHigh riskMaternal HIV-1 infectionMaternal HIV infectionCohort of HIVHIV-1 infectionWeeks of gestationPotential confounding factorsDar es SalaamConclusion HIVHIV infectionGestational ageImmature infantsFetal lossHead circumferenceHIVConfounding factorsWomenOutcomesSignificant differencesBirthweightThe association between maternal HIV‐1 infection and pregnancy outcomes in Dar es Salaam, Tanzania
Coley J, Msamanga G, Fawzi M, Kaaya S, Hertzmark E, Kapiga S, Spiegelman D, Hunter D, Fawzi W. The association between maternal HIV‐1 infection and pregnancy outcomes in Dar es Salaam, Tanzania. BJOG An International Journal Of Obstetrics & Gynaecology 2001, 108: 1125-1133. PMID: 11762650, PMCID: PMC6276363, DOI: 10.1111/j.1471-0528.2003.00269.x.Peer-Reviewed Original ResearchConceptsAdverse pregnancy outcomesPregnancy outcomesSymptomatic HIVLow birthweightPregnant womenHigh riskMaternal HIV-1 infectionMaternal HIV infectionCohort of HIVProspective cohort studyHIV-1 infectionWeeks of gestationPotential confounding factorsDar es SalaamCohort studyHIV infectionGestational ageImmature infantsFetal lossHead circumferenceHIVConfounding factorsWomenOutcomesSignificant differencesPredictors of intrauterine and intrapartum transmission of HIV-1 among Tanzanian women
Fawzi W, Msamanga G, Renjifo B, Spiegelman D, Urassa E, Hashemi L, Antelman G, Essex M, Hunter D. Predictors of intrauterine and intrapartum transmission of HIV-1 among Tanzanian women. AIDS 2001, 15: 1157-1165. PMID: 11416718, DOI: 10.1097/00002030-200106150-00011.Peer-Reviewed Original ResearchConceptsViral loadHIV-1HIV-1-infected pregnant womenLower genital tract infectionMaternal CD4 cell countVertical transmissionLower genital infectionsMaternal viral loadCD4 cell countGenital tract infectionHIV disease progressionHIV-1 infectionWeeks of gestationPrevention of transmissionIntrapartum transmissionIntrauterine transmissionGenital infectionTract infectionsSustained clearanceClinical stagePregnant womenPrenatal careDisease progressionCopies/Vitamin supplements