Digital Commons Network^™

Artemisinin Partial Resistance Mutations In Zanzibar And Tanzania Suggest Regional Spread And African Origins, 2023, Sean V. Connelly, Julia G. Muller, Mohamed Ali, Billy E. Ngasala, Wahida Hassan, Bakari Mohamed, Kyaw L. Thwai, Jacob M. Sadler, Jacob Marglous, Abebe A. Fola, Abdallah Zacharia, Shija J. Shija, Safia Mohammed, Dominick C. Msolo, Hamza Said, Editruda E. Peter, Melic Odas, Isaack J. Rutha, Mwanaidi Nwange, Karamoko Naire, Shazia Ruybal-Pesántez, Robert Verity, Rebecca Crudale, Varun Goel, Barbara B. Choloi, Anders Björkman, Jeffrey A. Bailey, Jessica T. Lin, Jonathan J. Juliano

Faculty Publications

Artemisinin partial resistance, driven by Plasmodium falciparum K13 mutations, threatens malaria control. Zanzibar is vulnerable to artemisinin partial resistance spread but lacks recent molecular surveillance. We sequenced samples in Zanzibar and mainland Tanzania collected from 2022 to 2024. K13 mutations were found in 2 of 1440 participants (P441L, A675V) in Zanzibar and 6 of 3762 (R561H, P441L) in mainland Tanzania. Based on whole genome sequencing data, K13 mutations appear to be of African origin with regional spread. Frequent parasite importation appears to maintain partner drug mutation frequencies similar to the mainland, where artemether-lumefantrine selects for mutations favoring artesunate-amodiaquine sensitivity. Ongoing …

Understanding The Epidemiology Of Malaria In Zanzibar Through Molecular And Serological Analysis Of Samples Collected During Reactive Case Detection, Vanrun Goel, Wahida Hassan, Caroline Murphy, Barbara B. Choloi, Mohamed Ali, Shija J. Shija, Jeffrey A. Bailey, Anders Björkman, Billey E. Ngasala, Eric Rogier, Jonathan J. Juliano, Jessica T. Lin

Faculty Publications

Background

The Zanzibar archipelago has been a pre-elimination region for malaria thanks to rigorous control interventions, but recent surges in malaria cases have been observed. The contribution of non-falciparum species to the current malaria situation is unknown.

Method

This study investigates the epidemiology of falciparum and non-falciparum malaria species in Zanzibar. Leveraging plasma extracted from dried blood spots (DBS) collected during reactive case detection (RCD) activities across Unguja island from May 2022 to January 2023, we measured immunoglobulin G (IgG) responses to Plasmodium MSP1-19kD antigens using a multiplex bead-based immunoassay. Additionally, active infections were detected using species-specific real-time PCR.

Results …

Integrating Mobility, Travel Survey, And Malaria Case Data To Understand Drivers Of Malaria Importation To Zanzibar, 2022–2023, Julia G. Muller, Kieran Dewalt, Vanrun Goel, Mohamed Ali, Wahida Hassan, Bakari Mohamed, Barbara Bella Choloi, Dominick Msolo, Abdallah Zacharia, Mwanaidi Nwange, Rokhaya Kane, Donal Bisanzio, Michael Emch, Anders Björkman, Richard Reithinger, Shija J. Shija, Billy E. Ngasala, Jonathan J. Juliano, Jessica T. Lin

Faculty Publications

Background

Zanzibar has achieved historic reductions in malaria incidence, but high connectivity to mainland Tanzania and imported cases remain a challenge to “last mile” malaria elimination.

Methods

To understand factors driving malaria importation, prospective surveys were administered to patients at 94 health facilities across Zanzibar’s main island, Unguja, from May 2022 to December 2023, and to travellers at the Zanzibar-bound ferry terminal in Dar es Salaam from August to December 2024. In addition, digital mobility data—Meta colocation and movement distribution—were analysed to examine movement patterns between Unguja and mainland Tanzania. These data were integrated with rainfall data to explore the …

Effect Of Vitamin D Supplementation During Pregnancy And Lactation On The Development Of Infants Born To Tanzanian Women Living With Hiv: A Secondary Analysis Of A Randomised Controlled Trial, Temiwunmi Shobanke, Alfa Muhihi, Nandita Perumal Phd, Nzovu Ulenga, Fadhlun M. Alwy Al-Beity, Christopher P. Duggan, Wafaie W. Fawzi, Karim P. Manji, Christopher R. Sudfeld

Faculty Publications

Background Infants born to pregnant women living with HIV (WLHIV) are at greater risk for morbidity and mortality and may also have poorer developmental outcomes as compared with infants who are not exposed to HIV. Nutrition interventions in pregnancy may affect developmental outcomes.

Objectives This study evaluated the effect of maternal vitamin D supplementation on infant development outcomes.

Design We conducted a secondary analysis of a randomised, triple-blind, placebo-controlled trial of maternal vitamin D supplementation from June 2015 to October 2019.

Setting Antenatal care clinics in Dar es Salaam, Tanzania.

Participants Pregnant WLHIV and their offspring.

Interventions Daily 3000 IU …

Hypertensive Disorders Of Pregnancy And Perinatal Outcomes: Two Prospective Cohort Studies Of Nulliparous Women In India And Tanzania, Andrea B. Pembe, Pratibha Dwarkanath, Amani Kikula, John Michael Raj, Nandita Perumal Phd, Heavenlight A. Paulo, Rajalakshmi M, Christopher P. Duggan, Honorati M. Masanja, Nandini Chopra, Mary M. Sando, Tinku Thomas, Cara A. Yelverton, Alfa Muhihi, Anura V. Kurpad, Wafaie E. Fawzi, Blair J. Wylie, Christopher R. Sudfeld

Faculty Publications

Introduction Hypertensive disorders of pregnancy (HDP) have been linked with increased risk for maternal and offspring complications in high-income settings. However, in resource-limited settings, studies with robust measurement of HDP, including severity and timing, and perinatal outcomes are limited.

Methods We analysed data from two prospective cohorts of nulliparous women in India (n=10 570 pregnancies) and Tanzania (n=10 299 pregnancies) who were enrolled in calcium supplementation trials and had blood pressure and proteinuria assessments throughout pregnancy and at the time of labour and delivery. Generalised estimating equations were used to assess the relationship between HDP severity categories (gestational hypertension, preeclampsia …

Predictors Of Prior Hiv Testing And Acceptance Of A Community-Based Hiv Test Offer Among Male Bar Patrons In Northern Tanzania, Deng B. Madut, Preeti Manavalan, Antipas Mtalo, Timothy Peter, Jan Ostermann, Bernard Njau, Nathan M. Thielman

Faculty Publications

Community-based HIV testing offers an alternative approach to encourage HIV testing among men in sub-Saharan Africa. In this study, we evaluated a community-based HIV testing strategy targeting male bar patrons in northern Tanzania to assess factors predictive of prior HIV testing and factors predictive of accepting a real-time HIV test offer. Participants completed a detailed survey and were offered HIV testing upon survey completion. Poisson regression was used to identify prevalence ratios for the association between potential predictors and prior HIV testing or real-time testing uptake. Of 359 participants analyzed, the median age was 41 (range 19–82) years, 257 (71.6%) …

Improving The Discharge Process In A Post-Acute Care, Skilled Nursing Facility To Decrease Hospital Readmissions, Shantoria W. Parker

Doctor of Nursing Practice Scholarly Projects

Problem: Older adults recently discharged from a skilled nursing facility (SNF) (often referred to as short-stay facilities) experience a period of vulnerability while transitioning back into the community, placing them at increased risk of adverse events, including hospital readmissions (Anderson et al., 2021). Completing a timely appointment (within 7 days) with primary care providers following discharge into the community reduces patients’ risk of preventable hospital readmissions (RHI, 2023) through interventions aimed at promoting coordinated care and safe transitions (Patel et al., 2019). However, more than 50% of readmitted patients failed to visit a primary care provider's (PCP) office between SNF …

Connecting Their Stories: Black Educators’ Experiences Within Cultural Heritage Institutions That Document The Long Arc Of The Civil Rights Movement, Constance Marie Caddell

Theses and Dissertations

This study aims to examine Black educators’ experiences within cultural heritage institutions that are documenting topics that include the long arc of the American Civil Rights Movement. Black educators are powerful conduits of the African American story because they align with African American cultural heritage institution’s goals to foster equality, identity, pride, and honor in the community. These shared goals lead to Black educators using teaching methods that liberate, advocate, and empower students. This allows them to share new knowledge, strategies, techniques, and concepts on diverse topics. Considering their fundamental mission, it is essential to gain an awareness of the …

Pre-Exposure Prophylaxis (Prep) Knowledge, Willingness To Use & Uptake Among Black Heterosexual Men, Akeen Lowell Hamilton

Theses and Dissertations

INTRODUCTION: Pre-exposure prophylaxis (PrEP) is a pill, taken orally, that has been shown to be effective at reducing the chance that someone who is HIV-negative and at-risk for HIV will contract the disease during sexual intercourse with someone who is living with HIV. One demographic group that has been under-researched is Black heterosexual men. This dissertation presents research on evaluating the heterosexual Black men’s awareness of, prior use, and network of friends/family’s perceived interest in learning more about PrEP.

METHODS: Two-hundred and six Black heterosexual men living in Brooklyn, New York City, were surveyed about their sexual behaviors and PrEP …

Men’S Comfort In Distributing Or Receiving Hiv Self-Test Kits From Close Male Social Network Members In Dar Es Salaam, Tanzania: Baseline Results From The Step Project, Joseph K.B. Matovu, Gaspar Mbita, Akeen Hamilton, Frank Mhando, Wynton M. Sims, Noah Thompson, Albert N. Komba, Jackson Lija, Jiajia Zhang Ph.D., Thomas Van Den Akker, Dustin T. Duncan, Augustine T. Choko, Donaldson F. Conserve

Faculty Publications

Background

A variety of strategies have been used to reach men with HIV self-testing services, including social network-based HIV self-test kits distribution. However, few studies have assessed men’s comfort to distribute to or receive HIV self-test kits from close male friends within the same social network. In this study, we assessed men’s comfort to distribute to and/or receive HIV self-test kits from close male friends and associated factors among men who socialize in networks locally referred to as “camps” in Tanzania.

Methods

Data are from the baseline survey of a cluster-randomized controlled trial conducted in June 2019 with 18 social …

Using A Global Food Environment Framework To Understand Relationships With Food Choice In Diverse Low- And Middle-Income Countries, Shilpa V. Constantinides, Christopher Turner, Edward A. Frongillo Jr., Shiva Bhandari, Ligia I. Reyes, Christine E. Blake

Faculty Publications

This study aimed to determine if the Turner et al. (2018) framework allows researchers to identify and study relationships between food environments and individual food choice in diverse contexts and if updates to the framework are warranted. We mapped evidence from 15 drivers of food choice projects to the framework, using thematic analysis to identify common drivers within the food environment across countries and emergent characteristics not listed in the framework. The framework contained breadth and depth of content necessary to identify common drivers – prices and affordability, availability, and vendor and product properties. Insights regarding common drivers and emergent …

Parental Concerns And Uptake Of Childhood Vaccines In Rural Tanzania – A Mixed Methods Study, Lavanya Vasudevan, Joy Noel Baumgartner, Sara Moses, Esther Ngadaya, Sayoki Godfrey Mfinanga, Jan Ostermann

Faculty Publications

Background

Vaccine hesitancy has been recognized as an important barrier to timely vaccinations around the world, including in sub-Saharan Africa. In Tanzania, 1 in 4 children is not fully vaccinated. The objective of this mixed methods study was to describe and contextualize parental concerns towards vaccines in Tanzania.

Methods

Between 2016 and 2017, we conducted a cross-sectional survey (n = 134) and four focus group discussions (FGDs, n = 38) with mothers of children under 2 years of age residing in Mtwara region in Southern Tanzania. The survey and FGDs assessed vaccination knowledge and concerns and barriers to timely vaccinations. …

The Mbeya Antimicrobial Stewardship Team: Implementing Antimicrobial Stewardship At A Zonal-Level Hospital In Southern Tanzania, Jeffrey W. Hall, Jeannette Bouchard, P Brandon Bookstaver, Matthew S. Haldeman, Peter Kishimbo, Godlove Mbwanji, Issakwisa Mwakyula, Davance Mwasomola, Megan Seddon, Mark Shaffer, Stephanie C. Shealy, Anthony Nsojo

Faculty Publications

In 2017, Mbeya Zonal Referral Hospital (MZRH) and the University of South Carolina (UofSC) agreed to collaboratively strengthen antimicrobial prescribing in the southern highlands of Tanzania and train a new generation of clinicians in responsible antimicrobial use. Key stakeholders and participants were identified and the Mbeya Antimicrobial Stewardship Team (MAST) was created. The team identified assets brought by the collaborators, and four investigations of baseline needs were developed. These investigations included (a) a baseline clinician survey regarding antimicrobial resistance and stewardship, (b) a serial chart review of inpatient antimicrobial prescribing practices, (c) an investigation of antimicrobial resistance rates using existing …

Multilayered Stigma And Vulnerabilities For Hiv Infection And Transmission: A Qualitative Study On Male Sex Workers In Zimbabwe, Elleen Yuk-Ha Tsang, Shan Qiao Ph.D., Jeffrey S. Wilkinson, Annis Lai-Chu Fung, Freddy Lipeleke, Xiaoming Li Ph.D.

Faculty Publications

Male sex workers are marginalized in most societies due to intersectional stigma between prostitution and homosexuality. In Zimbabwe, a proliferation of male sex workers in major cities such as Harare and Bulawayo has been reported. However, there is a shortage of studies that explore their lives. The current qualitative study aims to describe the practices of sex work, life contexts, and HIV risks and vulnerabilities based on in-depth interviews among 15 male sex workers in Bulawayo. Our studies suggest that the stigma against male sex workers comes from diverse sectors including culture (“homosexuality is un-African, introduced by the Whites”), religion …

Substance Use And Psychosocial Status Among People Living With Hiv/Aids Who Encountered Hiv Stigma In China: Stratified Analyses By Socio-Economic Status, Chen Zhang, Xiaoming Li, Yu Liu, Shan Qiao, Yuejiao Zhou, Zhiyong Shen, Yi Chen

Faculty Publications

This study examined whether the impact of HIV stigma on psychosocial status and substance use among people living with HIV/AIDS (PLWHA) differed by their socio-economic status (SES) in a Chinese setting. A total of 2,987 PLWHA were recruited from 12 sites with the highest number of cumulative HIV incidence in Guangxi, China. Participants were asked to provide information regarding their psychosocial status (e.g., depression, anxiety), history of substance use (e.g., tobacco, alcohol and drug) and SES (e.g., education, monthly income, residence type, and job category). By employing stratified multivariate regression analyses, we assessed stratum-specific impacts of HIV stigma on PLWHA’s …

Substance Use And Psychosocial Status Among People Living With Hiv/Aids Who Encountered Hiv Stigma In China: Stratified Analyses By Socio-Economic Status, Chen Zhang, Xiaoming Li Ph.D., Yu Liu, Shan Qiao Ph.D., Yuejiao Zhou, Zhiyong Shen, Yi Chen

Faculty Publications

This study examined whether the impact of HIV stigma on psychosocial status and substance use among people living with HIV/AIDS (PLWHA) differed by their socio-economic status (SES) in a Chinese setting. A total of 2,987 PLWHA were recruited from 12 sites with the highest number of cumulative HIV incidence in Guangxi, China. Participants were asked to provide information regarding their psychosocial status (e.g., depression, anxiety), history of substance use (e.g., tobacco, alcohol and drug) and SES (e.g., education, monthly income, residence type, and job category). By employing stratified multivariate regression analyses, we assessed stratum-specific impacts of HIV stigma on PLWHA’s …

Hamish Henderson And Nelson Mandela: Notes For “Rivonia”, Patrick G. Scott

Studies in Scottish Literature

Describes and reproduces manuscript notesin the G. Ross Roy Collection University of South Carolina Libraries, for the protest song "Rivonia" ("Free Mandela"), written by the Scottish poet, folklorist and folksinger Hamish Henderson (1919-2002) in 1963-64 in response to the trial of Nelson Mandela and other leaders of the African National Congress who had been arrested at Rivonia, South Africa and sentenced to life imprisonment on Robben Island; assesses the influence of Henderson's song, which was recorded in 1964 by the Corries Trio, and sung at the anti-apartheid protests at Murrayfield, Edinburgh, against the visit of the Springboks rugby team in …

Informal–Formal Sector Interactions In Automotive Engineering, Kampala, Dick Kawooya

Faculty Publications

This chapter provides findings from a Ugandan case study that examined innovation transfers between informal-sector automotive artisans and formally employed researchers at Makerere University’s College of Engineering, Design, Art and Technology (CEDAT). Th e primary site studied was CEDAT’s Gatsby Garage, an automotive workshop where it was found that the informal-sector artisans were central to innovative processes but were at the same time driven more by sharing impulses than by concern for the intellectual property (IP) implications of their work. Based on these findings, it is argued that Ugandan policy-makers need to seek policy tools to support innovation transfers between …

Food Insecurity And Sexual Risk In An Hiv Endemic Community In Uganda, Cari L. Miller, David R. Bangsberg, David M. Tuller, Jude Senkungu, Annet Kawuma, Edward A. Frongillo Jr., Sheri D. Weiser

Faculty Publications

Food insecurity has been linked to high-risk sexual behavior in sub-Saharan Africa, but there are limited data on these links among people living with HIV/AIDS, and on the mechanisms for how food insecurity predisposes individuals to risky sexual practices. We undertook a series of in-depth open-ended interviews with 41 individuals living with HIV/AIDS to understand the impact of food insecurity on sexual-risk behaviors. Participants were recruited from the Immune Suppression Clinic at the Mbarara University of Science and Technology in Mbarara, Uganda. Interviews were recorded, transcribed verbatim, translated, and coded following the strategy of grounded theory. Four major themes emerged …

Who Tests, Who Doesn't, And Why? Uptake Of Mobile Hiv Counseling And Testing In The Kilimanjaro Region Of Tanzania, Jan Ostermann, Elizabeth A. Reddy, Meghan M. Shorter, Charles Muiruri, Antipas Mtalo, Dafrosa K. Itemba, Bernard Njau, John A. Bartlett, John A. Crump, Nathan M. Thielman

Faculty Publications

Background: Optimally, expanded HIV testing programs should reduce barriers to testing while attracting new and highrisk testers. We assessed barriers to testing and HIV risk among clients participating in mobile voluntary counseling and testing (MVCT) campaigns in four rural villages in the Kilimanjaro Region of Tanzania.

Methods: Between December 2007 and April 2008, 878 MVCT participants and 506 randomly selected community residents who did not access MVCT were surveyed. Gender-specific logistic regression models were used to describe differences in socioeconomic characteristics, HIV exposure risk, testing histories, HIV related stigma, and attitudes toward testing between MVCT participants and community residents who …

The Daily Gamecock, Tuesday, November 17, 2009, University Of South Carolina, Office Of Student Media

November

No abstract provided.

Religion And Hiv In Tanzania: Influence Of Religious Beliefs On Hiv Stigma, Disclosure, And Treatment Attitudes, James Zou, Yvonne Yamanaka, Muze John, Melissa Watt, Jan Ostermann, Nathan Thielman

Faculty Publications

Background

Religion shapes everyday beliefs and activities, but few studies have examined its associations with attitudes about HIV. This exploratory study in Tanzania probed associations between religious beliefs and HIV stigma, disclosure, and attitudes toward antiretroviral (ARV) treatment.

Methods

A self-administered survey was distributed to a convenience sample of parishioners (n = 438) attending Catholic, Lutheran, and Pentecostal churches in both urban and rural areas. The survey included questions about religious beliefs, opinions about HIV, and knowledge and attitudes about ARVs. Multivariate logistic regression analysis was performed to assess how religion was associated with perceptions about HIV, HIV treatment, and …

Association Between Tobacco Use And Body Mass Index In Urban Indian Population: Implications For Public Health In India, Mangesh S. Pednekar, Prakash C. Gupta, Heema C. Shukla, James R. Hébert

Faculty Publications

Background: Body mass index [BMI, weight (kg)/height (m2)], a measure of relative weight, is a good overall indicator of nutritional status and predictor of overall health. As in many developing countries, the high prevalence of very low BMIs in India represents an important public health risk. Tobacco, smoked in the form of cigarettes or bidis (handmade by rolling a dried rectangular piece of temburni leaf with 0.15–0.25 g of tobacco) or chewed, is another important determinant of health. Tobacco use also may exert a strong influence on BMI.

Methods: The relationship between very low BMI (< 18.5 kg/m2) and tobacco use was examined using data from a representative cross-sectional survey of 99,598 adults (40,071 men and 59,527 women) carried out in the city of Mumbai (formerly known as Bombay) in western India. Participants were men and women aged ≥ 35 years who were residents of the main city of Mumbai.

Results: …

Child Marriage And Guardianship In Tanzania: Robbing Girls Of Their Childhood And Infantilizing Women, Aparna Polavarapu

Faculty Publications

No abstract provided.