2024
Demonstrating service delivery models for effective initiation and retention on pre-exposure prophylaxis (PrEP) among female bar workers in Dar es Salaam, Tanzania: A double randomized intervention study protocol
Chebet J, Akyoo W, Goymann H, Harling G, Barnhart D, Mosha I, Kamori D, Gandhi M, Mbunda T, Kipeleka J, Sando D, Spiegelman D, Mpembeni R, Bärnighausen T. Demonstrating service delivery models for effective initiation and retention on pre-exposure prophylaxis (PrEP) among female bar workers in Dar es Salaam, Tanzania: A double randomized intervention study protocol. PLOS ONE 2024, 19: e0304077. PMID: 38935796, PMCID: PMC11210872, DOI: 10.1371/journal.pone.0304077.Peer-Reviewed Original ResearchConceptsFemale bar workersPre-exposure prophylaxisIntention-to-treatBar workersPrimary outcomeRisk of HIV infectionAdherence to PrEPRisk of HIV acquisitionImprove PrEP adherenceGerman Clinical Trials RegisterPublic sector clinicsService delivery modelsRandomized trial designHIV negative womenPrevent HIV infectionHIV infectionPrEP provisionClinical Trials RegisterHIV testingPrEP initiationHealth facilitiesPromote PrEPPrEP adherenceDelivery modelsReduce barriers
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
2020
Impaired Hematological Status Increases the Risk of Mortality among HIV-Infected Adults Initiating Antiretroviral Therapy in Tanzania
Noor RA, Abioye AI, Hertzmark E, Darling AM, Aboud S, Mugusi FM, Sudfeld CR, Spiegelman D, Fawzi WW. Impaired Hematological Status Increases the Risk of Mortality among HIV-Infected Adults Initiating Antiretroviral Therapy in Tanzania. Journal Of Nutrition 2020, 150: 2375-2382. PMID: 32621487, PMCID: PMC7540061, DOI: 10.1093/jn/nxaa172.Peer-Reviewed Original ResearchConceptsRisk of mortalityPrevalence of anemiaHAART initiationHematological statusIron deficiencyAntiretroviral therapySerum ferritinSevere anemiaIncident clinical outcomesRelation of anemiaTrial of multivitaminsActive antiretroviral therapyHIV disease progressionCase-cohort studyIron deficiency anemiaProportional hazards modelElevated ironNonanemic participantsHIV patientsMultivariate adjustmentClinical outcomesMorbidity outcomesAnemia etiologyDeficiency anemiaIron supplementation
2019
Glycemic Index and Microstructure Evaluation of Four Cereal Grain Foods
RamyaBai M, Wedick N, Shanmugam S, Arumugam K, Nagarajan L, Vasudevan K, Gunasekaran G, Rajagopal G, Spiegelman D, Malik V, Anjana R, Hu F, Unnikrishnan R, Willett W, Malleshi N, Njelekela M, Gimbi D, Krishnaswamy K, Henry C, Mohan V, Sudha V. Glycemic Index and Microstructure Evaluation of Four Cereal Grain Foods. Journal Of Food Science 2019, 84: 3373-3382. PMID: 31762024, DOI: 10.1111/1750-3841.14945.Peer-Reviewed Original ResearchConceptsGlycemic indexMedium glycemic indexTest foodGrain foodsCapillary blood samplesHigh glycemic indexCereal grain foodsWhole grain foodsHigh GI foodsMean ageBlood glucoseBlood samplesGI valuesGI foodsHealthy participantsSeparate occasionsHealthy optionsRegular brown riceWhole grainsStandard protocolLoss of intactnessHealthy alternativeLoss of integrityAvailable carbohydrateGlucose
2013
Clinical malaria diagnosis in pregnancy in relation to early perinatal mother‐to‐child transmission of HIV: a prospective cohort study
Ezeamama A, Duggan C, Manji K, Spiegelman D, Hertzmark E, Bosch R, Kupka R, Okuma J, Kisenge R, Aboud S, Fawzi W. Clinical malaria diagnosis in pregnancy in relation to early perinatal mother‐to‐child transmission of HIV: a prospective cohort study. HIV Medicine 2013, 15: 276-285. PMID: 24215465, PMCID: PMC4299572, DOI: 10.1111/hiv.12111.Peer-Reviewed Original ResearchConceptsPregnant HIV-positive womenHIV-positive womenRelative riskFever symptomsHIV MTCTHIV infectionPolymerase chain reactionHIV-positive pregnant womenMultivariable logistic regression modelCent of HIVChild's HIV statusHIV MTCT riskInfants of womenPerinatal HIV infectionChild HIV infectionLaboratory-confirmed diagnosisConfidence intervalsPrenatal health careWeeks of lifeLogistic regression modelsHIV motherMaternal malariaMTCT programmeMTCT riskChild transmissionMicronutrient supplementation and T cell-mediated immune responses in patients with tuberculosis in Tanzania
KAWAI K, MEYDANI SN, URASSA W, WU D, MUGUSI FM, SAATHOFF E, BOSCH RJ, VILLAMOR E, SPIEGELMAN D, FAWZI WW. Micronutrient supplementation and T cell-mediated immune responses in patients with tuberculosis in Tanzania. Epidemiology And Infection 2013, 142: 1505-1509. PMID: 24093552, PMCID: PMC5639693, DOI: 10.1017/s0950268813002495.Peer-Reviewed Original ResearchConceptsCell-mediated immune responsesTB patientsMicronutrient supplementationMicronutrient supplementsImmune responseProliferative responseT cell-mediated immune responsesHIV-negative TB patientsHIV-positive TB patientsLymphocyte proliferative responsesLymphocyte proliferation responseHigher proliferative responsesT cell mitogensPlacebo groupPulmonary TBTB treatmentDaily doseEligible participantsNutritional interventionTuberculosis treatmentTime of initiationClinical relevanceMicronutrient groupProliferation responsePatientsDeterminants 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
Predictors of stunting, wasting and underweight among Tanzanian children born to HIV-infected women
McDonald CM, Kupka R, Manji KP, Okuma J, Bosch RJ, Aboud S, Kisenge R, Spiegelman D, Fawzi WW, Duggan CP. Predictors of stunting, wasting and underweight among Tanzanian children born to HIV-infected women. European Journal Of Clinical Nutrition 2012, 66: 1265-1276. PMID: 23031850, PMCID: PMC3491141, DOI: 10.1038/ejcn.2012.136.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultBody HeightBody WeightDouble-Blind MethodEducational StatusFemaleGrowth DisordersHIV InfectionsHumansInfantInfant, Low Birth WeightInfant, NewbornInfant, PrematureInfectious Disease Transmission, VerticalMaleMalnutritionPremature BirthPrevalenceProportional Hazards ModelsReference ValuesSex FactorsSocioeconomic FactorsTanzaniaThinnessWasting SyndromeYoung AdultConceptsBirth weightFirst episodeTanzanian childrenMultivariate Cox proportional hazards methodMaternal educationLow infant birth weightCox proportional hazards methodDevelopment of undernutritionInfant birth weightLow Apgar scoreModifiable risk factorsLow birth weightChild HIV infectionHuman immunodeficiency virusPredictors of stuntingRisk of undernutritionProportional hazards methodsLow maternal educationWeeks of ageMorbidity historiesApgar scoreChild transmissionMedian durationPreterm infantsHIV infectionPREDICTORS OF INCIDENT TUBERCULOSIS IN HIV-EXPOSED CHILDREN IN TANZANIA.
Finkelstein J, Manji K, Duggan C, Hertzmark E, Mehta S, Msamanga G, Spiegelman D, Fawzi W. PREDICTORS OF INCIDENT TUBERCULOSIS IN HIV-EXPOSED CHILDREN IN TANZANIA. East African Medical Journal 2012, 89: 183-92. PMID: 26856040, PMCID: PMC10864092.Peer-Reviewed Original ResearchConceptsRisk of tuberculosisChild mid-upper arm circumferenceMid-upper arm circumferenceT-cell countsArm circumferenceReduced riskCD4 T-cell countCD8 T-cell countsLow vitamin E levelsAppropriate infant feedingDuration of breastfeedingLongitudinal cohort studyVitamin E levelsIncident tuberculosisAntenatal clinicCohort studyLymphocyte countHIV infectionTuberculosis infectionChild tuberculosisHIV statusNutritional interventionImmunological statusInfant feedingE levelsElevated alanine aminotransferase in antiretroviral‐naïve HIV‐infected African patients: magnitude and risk factors
Nagu T, Kanyangarara M, Hawkins C, Hertmark E, Chalamila G, Spiegelman D, Mugusi F, Fawzi W. Elevated alanine aminotransferase in antiretroviral‐naïve HIV‐infected African patients: magnitude and risk factors. HIV Medicine 2012, 13: 541-548. PMID: 22416813, PMCID: PMC3391335, DOI: 10.1111/j.1468-1293.2012.01006.x.Peer-Reviewed Original ResearchConceptsElevated alanine aminotransferaseIU/LAlanine aminotransferaseAntiretroviral therapyHigh riskWorld Health Organization clinical stageCD4 T-lymphocyte countFirst-line antiretroviral therapyHepatitis B virus coinfectionALT measurementsLow-density lipoprotein cholesterolLog-binomial regression modelsB virus coinfectionT-lymphocyte countsART-naïve HIVCells/μLHepatotoxic side effectsCurrent tuberculosis (TB) treatmentResource-limited settingsCross-sectional analysisAdvanced immunosuppressionHBV coinfectionART-naïveHIV careLipoprotein cholesterol
2011
Predictors of change in nutritional and hemoglobin status among adults treated for tuberculosis in Tanzania
Kawai K, Villamor E, Mugusi FM, Saathoff E, Urassa W, Bosch RJ, Spiegelman D, Fawzi WW. Predictors of change in nutritional and hemoglobin status among adults treated for tuberculosis in Tanzania. The International Journal Of Tuberculosis And Lung Disease 2011, 15: 1380-1389. PMID: 22283899, PMCID: PMC3404808, DOI: 10.5588/ijtld.10.0784.Peer-Reviewed Original ResearchMeSH KeywordsAdultAnemiaAntitubercular AgentsBiomarkersBody Mass IndexCoinfectionFemaleHealth Status IndicatorsHemoglobinsHIV InfectionsHumansLinear ModelsMaleMalnutritionMultivariate AnalysisNutritional StatusNutritional SupportProspective StudiesTanzaniaTime FactorsTreatment OutcomeTuberculosis, PulmonaryYoung AdultConceptsLow CD4 cell countsHuman immunodeficiency virusBody mass indexCD4 cell countHIV-positive patientsTB treatmentCell countPredictors of changeTB patientsHemoglobin statusHIV-negative TB patientsHIV-positive TB patientsOlder ageHIV-negative adultsHIV-negative patientsPrevious TB infectionHIV-negative participantsAdequate nutritional supportHigh viral loadProfound malnutritionTB infectionPulmonary tuberculosisNutritional recoveryNutritional supportHemoglobin levelsSocio-economic status, urbanization, and cardiometabolic risk factors among middle-aged adults in Tanzania.
Njelekela MA, Liu E, Mpembeni R, Muhihi A, Mligiliche N, Spiegelman D, Finkelstein JL, Fawzi WW, Willett WC, Mtabaji J. Socio-economic status, urbanization, and cardiometabolic risk factors among middle-aged adults in Tanzania. East African Journal Of Public Health 2011, 8: 216-23. PMID: 23120960.Peer-Reviewed Original ResearchMeSH KeywordsAdultBlood GlucoseBlood PressureBody Mass IndexCardiovascular DiseasesCross-Sectional StudiesDietExerciseFemaleHealth BehaviorHumansLife StyleLipidsLogistic ModelsMaleMetabolic SyndromeMiddle AgedObesityResidence CharacteristicsRisk FactorsSocioeconomic FactorsSurveys and QuestionnairesTanzaniaUrban HealthUrbanizationWaist CircumferenceConceptsCardiometabolic risk factorsPoorer lipid profileHigher socioeconomic statusRisk factorsLipid profileSocioeconomic statusUrban residenceCardio-metabolic risk factorsWorld Health Organization criteriaHigher total cholesterolHigh waist circumferenceRisk of obesityHealth screening strategiesMiddle-aged adultsMetabolic syndromeTotal cholesterolWaist circumferenceLDL cholesterolHigher BMIPrimary preventionLower triglyceridesOrganization criteriaDietary factorsCardiovascular diseaseGlucose levels
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
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 modelSelenium levels in relation to morbidity and mortality among children born to HIV-infected mothers
Kupka R, Msamanga GI, Spiegelman D, Rifai N, Hunter DJ, Fawzi WW. Selenium levels in relation to morbidity and mortality among children born to HIV-infected mothers. European Journal Of Clinical Nutrition 2005, 59: 1250-1258. PMID: 16015252, DOI: 10.1038/sj.ejcn.1602236.Peer-Reviewed Original ResearchConceptsPlasma selenium levelsMorbidity informationSelenium levelsChild mortalityMaternal vitamin supplementsMonthly clinic visitsProspective cohort studyTertiary care hospitalMuhimbili National HospitalRisk of diarrheaChild health outcomesMonths of ageSelenium statusCause mortalityClinic visitsCohort studyRespiratory outcomesMedian ageStudy clinicNational HospitalVitamin supplementsHealth outcomesStudy childrenFogarty International CenterStudy participantsPregnancy 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