Background: Antimicrobial resistance (AMR) surveillance plays an important role in early detection of resistant strains of pathogens and informs treatments decisions at local, regional and national levels. In 2017, Tanzania developed a One Health AMR Surveillance Framework to guide establishment of AMR surveillance systems in the human and animal sectors.Aim: We reviewed AMR surveillance studies in Tanzania to document progress towards establishing an AMR surveillance system and determine effective strengthening strategies.Methods: We conducted a literature review on AMR studies conducted in Tanzania by searching Google Scholar, PubMed, and the websites of the Tanzania Ministry of Health and the World Health Organization for articles written in English and published from January 2012 to March 2021 using relevant search terms. Additionally, we reviewed applicable guidelines, plans, and reports from the Tanzanian Ministry of Health.Results: We reviewed 10 articles on AMR in Tanzania, where studies were conducted at hospitals in seven of Tanzania’s 26 regions between 2012 and 2019. Nine AMR sentinel sites had been established, and there was suitable and clear coordination under ‘One Health’. However, sharing of surveillance data between sectors had yet to be strengthened. Most studies documented high resistance rates of Gram-negative bacteria to third-generation cephalosporins. There were few laboratory staff who were well trained on AMR.Conclusion: Important progress has been made in establishing a useful, reliable AMR surveillance system. Challenges include a need to develop, implement and build investment case studies for the sustainability of AMR surveillance in Tanzania and ensure proper use of third-generation cephalosporins.What this study adds: This article adds to the knowledge base of AMR trends in Tanzania and progress made in the implementation of AMR surveillance in human health sector as a contribution to the global AMR initiatives to reduce AMR burden worldwide. It has highlighted key gaps that need policy and implementation level attention.

INTRODUCTION: On 16th March 2020, Tanzania announced its first COVID-19 case. The country had already developed a 72-hour response plan and had enacted three compulsory infection prevention and control interventions. Here, we describe public compliance to Infection Prevention and Control (IPC) public health measures in Dar es Salaam during the early COVID-19 response and testing of the feasibility of an observational method. METHODS: a cross sectional study was conducted between April and May 2020 in Dar es Salaam City. At that time, Dar es Salaam was the epi centre of the epidemic. Respondents were randomly selected from defined population strata (high, medium and low). Data were collected using a structured questionnaire and through observations. RESULTS: a total of 390 subjects were interviewed, response rate was 388 (99.5%). Mean age of the respondents was 34.8 years and 168 (43.1%) had primary level education. Out of the 388 respondents, 384 (98.9%) reported to have heard about COVID-19 public health and social measures, 90.0% had heard from the television and 84.6% from the radio. Covering coughs and sneezes using a handkerchief was the most common behaviour observed among 320 (82.5%) respondents; followed by hand washing hygiene practice, 312 (80.4%) and wearing face masks, 240 (61.9%). Approximately 215 (55.4%) adhered to physical distancing guidance. Age and gender were associated with compliance to IPC measures (both, p

Background: In recent years, the eastern coast of Africa has witnessed a number of dengue outbreaks. This study was carried out to determine socio-demographic determinants of dengue infection during the 2014 outbreak in Dar es Salaam, Tanzania. Methods: Unmatched case-control analysis of secondary data from a cross-sectional dengue investigation in three districts of Dar es Salaam in June 2014 was conducted. Febrile patients seeking care at health facilities were recruited. Cases were serologically-confirmed dengue-positive while controls were serologically-confirmed dengue-negative patients. A questionnaire was used to collect sociodemographic information. The association between sociodemographic variables and dengue infection was examined using univariate analysis and multivariate logistic regression analysis. Results: A total of 81 cases and 281 controls were included in the analysis. Majority of the cases and controls were males (64.2% versus 54.1%; P=0.137) and were >15 years of age (88.9% versus 72.9%; P =0.003). Living in Kinondoni (aOR = 4.28; 95% CI: 1.74 - 10.53); being employed (aOR = 2.06; 95% CI: 1.06-4.04); having piped water at home (aOR = 2.63; 95% CI: 1.40 - 4.95) and a recent visit of health facility (aOR = 1.94; 95% CI: 1.11 - 3.38) were significantly associated with dengue infection.Conclusions: Dengue infection in Dar es Salaam varied between the three districts and was associated with being employed, having piped water at home and a recent visit to the health facility. These findings provide primary understanding of the influence of socio-demographic factors on dengue and may be used to develop appropriate preventive interventions.

Global efforts to eradicate smallpox—an Orthopoxvirus infection—began in the mid-20th century, with the last naturally occurring case reported in 1977. This was achieved through global solidarity efforts that expanded the smallpox eradication vaccination program. Approximately 50 years following the cessation of mass smallpox vaccination and in the absence of access to a sustainable boosting program, the population immunologically naïve to Orthopoxviruses has increased significantly. With increasing global movements and travels, we argue that the emergence of two back-to-back yet distinct mpox epidemics in the 21st century is a sign of humanity’s lost herd immunity to Orthopoxviruses. This needs concerted efforts to restore.