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 womenIron supplementation and paediatric HIV disease progression: a cohort study among children receiving routine HIV care in Dar es Salaam, Tanzania
Andersen CT, Duggan CP, Manji K, Seage GR, Spiegelman D, Perumal N, Ulenga N, Fawzi WW. Iron supplementation and paediatric HIV disease progression: a cohort study among children receiving routine HIV care in Dar es Salaam, Tanzania. International Journal Of Epidemiology 2022, 51: 1533-1543. PMID: 35167662, PMCID: PMC9557856, DOI: 10.1093/ije/dyac017.Peer-Reviewed Original ResearchConceptsDisease stage progressionIron supplementationStage progressionCohort studyDisease progressionRoutine HIV careHIV disease progressionProspective cohort studyManagement of anemiaRisk of anemiaHigher hazard rateProportional hazards modelIron supplement useDar es SalaamHaematological outcomesAntiretroviral therapyHIV careClinic visitsSupportive careAntiretroviral treatmentClinical outcomesClinical visitsAnemia statusSupplement useVital status
2014
Who are they? Identifying risk factors of loss to follow up among HIV+ patients on care and treatment in Dar es Salaam
Machumi L, Mtisi E, Andrew I, Sando D, Mkali H, Liu E, Hertzmark E, Spiegelman D, Fawzi W, Chalamilla G. Who are they? Identifying risk factors of loss to follow up among HIV+ patients on care and treatment in Dar es Salaam. BMC Infectious Diseases 2014, 14: p78. PMCID: PMC4221014, DOI: 10.1186/1471-2334-14-s2-p78.Peer-Reviewed Original Research
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
2012
Making the case for better integration of cervical cancer screening and treatment for HIV-infected women attending care and treatment clinics in Dar es Salaam, Tanzania
McCree-Hale R, Spiegelman D, Aris E, Chalamilla G, Andrew I, Mwaiselage J, Hirschhorn L, Fawzi W. Making the case for better integration of cervical cancer screening and treatment for HIV-infected women attending care and treatment clinics in Dar es Salaam, Tanzania. Infectious Agents And Cancer 2012, 7: p13. PMCID: PMC3330080, DOI: 10.1186/1750-9378-7-s1-p13.Peer-Reviewed Original Research
2006
HIV-1 infection and fertility in Dar es Salaam, Tanzania.
Sedgh G, Larsen U, Spiegelman D, Msamanga G, Fawzi WW. HIV-1 infection and fertility in Dar es Salaam, Tanzania. African Journal Of Reproductive Health 2006, 10: 41-52. PMID: 17518130, DOI: 10.2307/30032470.Peer-Reviewed Original ResearchConceptsHIV-1 infectionUninfected womenHIV infectionPregnancy lossMultivariate analysisHIV-1 infected womenPregnancy rate ratioRetrospective cohort studyPredictors of pregnancyHIV-positive womenNumber of pregnanciesRate of pregnancyDar es SalaamHigher pregnancy rateAdvanced diseaseCohort studyHIV seropositivityInfected womenBorderline significancePregnancy rateAdvanced stageInfectionPregnancyWomenRate ratioSocio-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
HIV-1 Disease Progression and Fertility in Dar es Salaam, Tanzania
Sedgh G, Larsen U, Spiegelman D, Msamanga G, Fawzi WW. HIV-1 Disease Progression and Fertility in Dar es Salaam, Tanzania. JAIDS Journal Of Acquired Immune Deficiency Syndromes 2005, 39: 439-445. PMID: 16010167, DOI: 10.1097/01.qai.0000148529.58963.83.Peer-Reviewed Original ResearchConceptsHIV-1 disease progressionPregnancy rate ratioPregnancy incidenceDisease progressionRate ratioStage IHIV-1-infected womenHIV-1-positive womenCox proportional hazards modelClinical stage IIHIV-1 diseaseProspective cohort studyLive birth rateProportional hazards modelDar es SalaamLive birth incidenceCohort studyMenstrual dysfunctionIndependent predictorsRecent pregnancyHIV statusClinical progressionPregnancy rateOlder womenHazards model
2004
Breastfeeding and maternal HIV-1 disease progression and mortality
Sedgh G, Spiegelman D, Larsen U, Msamanga G, Fawzi WW. Breastfeeding and maternal HIV-1 disease progression and mortality. AIDS 2004, 18: 1043-1049. PMID: 15096808, DOI: 10.1097/00002030-200404300-00013.Peer-Reviewed Original ResearchConceptsHIV-1 disease progressionCD4 cell countDisease progressionCell countHigher CD4 cell countsLow CD4 cell countsCox proportional hazards modelHealth of HIVCohort study designExcessive weight lossProportional hazards modelPartial breastfeedingRelative riskHazards modelInsufficient evidenceBreastfeedingMultivariate analysisStudy designWeight lossWomenProgressionDar es SalaamHIVDeathAssociationEstimating treatment effects in studies of perinatal transmission of HIV
Bang H, Spiegelman D. Estimating treatment effects in studies of perinatal transmission of HIV. Biostatistics 2004, 5: 31-43. PMID: 14744826, DOI: 10.1093/biostatistics/5.1.31.Peer-Reviewed Original Research
2002
Effect of multivitamin and vitamin A supplements on weight gain during pregnancy among HIV-1-infected women 1 , 2 , 3
Villamor E, Msamanga G, Spiegelman D, Antelman G, Peterson KE, Hunter DJ, Fawzi WW. Effect of multivitamin and vitamin A supplements on weight gain during pregnancy among HIV-1-infected women 1 , 2 , 3. American Journal Of Clinical Nutrition 2002, 76: 1082-1090. PMID: 12399282, DOI: 10.1093/ajcn/76.5.1082.Peer-Reviewed Original ResearchConceptsEffects of multivitaminsThird trimesterWeight gainVitamin AMultivitamin supplementationSecond trimesterHIV-1-positive womenAdverse pregnancy outcomesPlacebo-controlled trialGestational weight gainHIV-positive womenEnd of pregnancyPregnancy outcomesOral supplementsAverage weight gainProtective effectTrimesterLower weight gainMultivitaminsPregnancyWomen 1HIVWomenDar es SalaamLower ratesTransmission 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 riskCorrelates 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 expenditure
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 differences
2000
Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salaam, Tanzania
Fawzi W, Mbise R, Spiegelman D, Fataki M, Hertzmark E, Ndossi G. Vitamin A supplements and diarrheal and respiratory tract infections among children in Dar es Salaam, Tanzania. The Journal Of Pediatrics 2000, 137: 660-667. PMID: 11060532, DOI: 10.1067/mpd.2000.110136.Peer-Reviewed Original ResearchConceptsRespiratory tract infectionsHuman immunodeficiency virusTract infectionsVitamin APlacebo-controlled trialAcute respiratory infectionsSevere watery diarrheaRisk of diarrheaEffect of vitaminDuration of episodesRapid respiratory rateLow-cost interventionAcute diarrheaRespiratory infectionsImmunodeficiency virusWatery diarrheaAdverse outcomesUndernourished childrenHigh riskDiarrheaRespiratory rateInfectionSmall riskPlaceboDar es SalaamRisk factors for HIV-1 seroprevalence among family planning clients in Dar es Salaam, Tanzania.
Kapiga SH, Lyamuya EF, Vuylsteke B, Spiegelman D, Larsen U, Hunter DJ. Risk factors for HIV-1 seroprevalence among family planning clients in Dar es Salaam, Tanzania. African Journal Of Reproductive Health 2000, 4: 88-99. PMID: 11000712, DOI: 10.2307/3583246.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge DistributionCross-Sectional StudiesFamily Planning ServicesFemaleHealth Knowledge, Attitudes, PracticeHIV SeroprevalenceHIV-1HumansMarital StatusOccupationsRisk FactorsSexually Transmitted DiseasesSocioeconomic FactorsSurveys and QuestionnairesTanzaniaUrban PopulationWomenConceptsRisk of HIVRisk factorsMajor public health problemHIV-1 seroprevalenceHIV risk factorsPrevalence of HIVCross-sectional studyPublic health problemDar es SalaamFamily planning servicesHIV infectionHIV testingFP clientsHIV interventionsHIVLaboratory evidenceHealth problemsLarge clinicsPlanning servicesWomenRiskMarried womenFurther spreadSeroprevalenceClinicPredictors of CD4+ lymphocyte count among HIV-Seropositive and HIV-Seronegative pregnant women in Dar Es Salaam, Tanzania
Kapiga SH, Mwakagile D, Spiegelman D, Msamanga GI, Hunter D, Fawzi WW. Predictors of CD4+ lymphocyte count among HIV-Seropositive and HIV-Seronegative pregnant women in Dar Es Salaam, Tanzania. East African Medical Journal 2000, 77: 206-11. PMID: 12858905, DOI: 10.4314/eamj.v77i4.46622.Peer-Reviewed Original ResearchConceptsHIV-seropositive womenCells/mm3Erythrocyte sedimentation rateHIV-seronegative pregnant womenWhite blood countLymphocyte countPredictors of CD4Pregnant womenHIV-seropositiveMost HIV-seropositive womenTotal white blood countHaematological indicesReduction of CD4HIV-seronegative womenT lymphocyte subsetsClinical stage 1Age 25 yearsDar es SalaamAverage age 25 yearsAsymptomatic womenBlood countSocio-demographic characteristicsCD4Blood samplesHR increase
1999
Risk factors for cervical squamous intraepithelial lesions among HIV‐1 seropositive women in Dar es Salaam, Tanzania
Kapiga SH, Msamanga GI, Spiegelman D, Mwakyoma H, Fawzi WW, Hunter DJ. Risk factors for cervical squamous intraepithelial lesions among HIV‐1 seropositive women in Dar es Salaam, Tanzania. International Journal Of Gynecology & Obstetrics 1999, 67: 87-94. PMID: 10636052, DOI: 10.1016/s0020-7292(99)00125-3.Peer-Reviewed Original ResearchConceptsSquamous intraepithelial lesionsCervical squamous intraepithelial lesionsRisk factorsIntraepithelial lesionsPrevalence of SILRisk of SILHigh-grade squamous intraepithelial lesionsLow-grade squamous intraepithelial lesionsHIV-1-seropositive womenMid-upper arm circumferenceNon-significant increased riskFederation of GynecologyDar es SalaamLifetime sexual partnersLymphocyte subsetsSeropositive womenIncreased riskArm circumferenceCervical smearsLive birthsCell countSexual partnersHIVWomenSexual behavior