Background: Exposure to pesticides with its associated effects prenatally and in early childhood has not received much attention. There is little scientific data on this aspect in Tanzania therefore this study was meant to contribute to the deficit in the subject. Method: A cross-sectional study was conducted to a sample of 286 participants of mother to child pair, whereby 172 and 114 were exposed and non-exposed respectively. Mothers who had been working in tomato sprayed farms were exposed and mothers who had not been working in the tomato sprayed farms were un-exposed. Child aged 0–6 years was chosen from each mother sampled but only one child found to be the youngest with the classified age was enrolled. Malawi child development Tool (M-DAT) was employed to assess the child level of development, height, and weight of the children were collected and analyzed by the WHO anthropometric calculator. A checklist and questionnaire were used to observe and assess maternal exposure. Bivariate and Multivariate analysis were conducted to assess the relationship between various factors of exposure. Results: Overall 15% of the children examined were not well developed and the most used pesticides were those posing neuro-development effects. On the bivariate analysis model, mothers who worked while pregnant were more likely to have a child with neuro-developmental effect OR=5.8(1.29–26.3). On multivariate analyses adjusted for age of the mother, variables which remain in the model were a distance from home [AOR=9.4(4.2–20.5)], and working while pregnancy [AOR=5.8(1.29–26.3)] other were removed due to collinearity effect. None of confounders had a potential significant effect but only nutrition seems to be the effect modifier [AOR=7.8(1.29–36.3)] when analyzed with working while pregnancy. Conclusions: The findings from this study have indicated that maternal pesticide exposure among farmworker residents in the SAGCOT area has a potential association with child developmental effect.

Introduction: Child neurodevelopment is influenced by genetic variants in cytochrome P450 (CYP450) enzymes, which affect detoxification and oxidative stress pathways. These variations modulate susceptibility to environmental toxins, influencing brain development through gene–environment interactions that impact neurogenesis, synaptogenesis, and inflammation, potentially contributing to neurodevelopmental disorders. This review has a major question to answer: how do CYP450 gene polymorphisms modulate pesticide metabolism and contribute to neurodevelopmental risks in children?Method: This study has been conducted according to PRISMA and includes studies conducted from 2005 to 2025. It has been registered to PROSPERO with the number PROSPERO 2024 CRD42024617478. The databases used for the search included PubMed/MEDLINE, Embase, Scopus, and African Journals Online (AJOL). Additional sources, such as OpenGrey, institutional repositories, and conference proceedings, were also searched using targeted search strategies and robust inclusion criteria, which were employed in study selection and final review to analyze gene–environment interactions and developmental outcomes.Results: A total of 758 studies were identified through database searches and manual reference checks. After eliminating studies due to various factors, 176 eligible studies were selected by reviewing the titles and abstracts. Finally, a total of nine articles were included in this systematic review. The review identified CYP3A4 as the most polymorphic gene, followed by CYP2C9, CYP2B6, and CYP1A2—all involved in pesticide metabolism, particularly organophosphates such as chlorpyrifos. Evidence from nine studies suggests that CYP450 polymorphisms influence pesticide detoxification capacity, increasing neurodevelopmental risks in exposed children. These findings highlight the importance of genetic risk assessment in public health strategies targeting pesticide-exposed populations.Conclusion: This review highlights the role of CYP450 gene polymorphisms in increasing susceptibility to pesticide-related neurotoxicity, especially in children and agricultural workers, emphasizing the need for genetically based risk assessment in public health strategies.Systematic Review Registration: PROSPERO CRD42024617478.

Background: The use of pesticides among smallholder farmers, agrochemical sellers, and agricultural officers involves a complex interplay of knowledge, economic factors, and regulatory frameworks. Therefore, this study explores the patterns, practices, and socio-environmental dynamics of pesticide use among smallholder farmers and agro-input sellers in Iringa and Njombe. Method: This study employed a qualitative, phenomenological design, guided by the socio-ecological model (SEM), to explore the lived experience of farmers, agro-dealers, and extension officers. It involved a total of 23 interviews performed in the Njombe and Iringa regions. Data were collected between October 2024 and March 2025, using a combination of in-depth phenomenological interviews, key informant interviews, and field observations, and were categorized into themes and subthemes analyzed using InVivo. Results: The study involved a total of 23 participants drawn from the Iringa and Njombe regions. The gender distribution was nearly balanced, with 52.1% male and 47.8% female respondents. The mean age of participants was 33 years (95% CI: 29.3–37.3). In terms of education, over half (52.17%) had completed primary school. The findings show that smallholders in Iringa and Njombe widely use mixed pesticides and fertilizers, rely on trusted brands, and adapt to climate impacts, but face challenges with regard to unsafe mixing, poor storage, fake products, and weak regulation, highlighting the need for better education, market oversight, and safer practices. Conclusion: Using the socio-ecological model, the findings indicate that pesticide use among smallholder horticultural farmers in Iringa and Njombe is influenced by a complex interaction of socio-economic constraints, market forces, climate variability, and institutional shortcomings. Although farmers have some awareness of safe practices, systemic barriers continue to limit the adoption of sustainable pesticide management.

Solid waste has been a major problem particularly in Sub-Saharan Africa countries as it has been increasing in several years. One of the methods employed in solid waste management is street sweeping which is done by street sweepers. Street sweepers are being predisposed to respiratory and non-respiratory infection like eye infection, skin infection and musculoskeletal disorders. This analytical cross-sectional study enrolled a total of 233 street sweepers to assess perceived occupational health risks, particulate matters (i.e., PM_2.5, PM₅ and PM₁₀ measured in (mg/m³)) dust and noise exposure levels in decibel units–dB(A), and utilization of protective personnel equipment among street sweepers in Mwanza city, Northern Tanzania. Modified poison regression was used to determine the association between exposures variables (i.e., sociodemographic, and socioeconomic factors) and outcomes ((i.e., noise dose level and particulate matters))). More than half (50.2%) of the participants were aged between 46–80 years. Their Median age was 46(IQR: 28–59) years. Large percent (63.1%) of the participants reported that their working environment have high health risks. The Median concentrations of the noise dose and particulates matters were 85.4 (IQR = 76.4–92.3) for noise dose, 13426 (IQR = 9637–17632) for PM_2.5, 5522 (IQR = 2453–7679) for PM₅, and 2310(IQR = 1263–3201). The Median concentrations of the noise dose and particulates matters were 85.4 (IQR = 76.4–92.3) for noise dose in decibel units dB(A); 13426 (IQR = 9637–17632) for PM_2.5; 5522 (IQR = 2453–7679) for PM₅; and 2310(IQR = 1263–3201) for PM₁₀. Individual Street sweepers in Mwanza city are highly exposed to noise dose and fine particulate matters at levels above the reference values for human of 85dB(A) and 5mg/m³ respectively, making it a public health issue that requires holistic public health measures.

Background: Rejected medical claims pose a significant challenge for healthcare facilities accredited by Tanzania’s National Health Insurance Fund (NHIF). Despite the NHIF’s role in reducing out-of-pocket costs, claim rejections have been a persistent issue, largely due to documentation errors, coding mistakes, and non-compliance with NHIF regulations. This study determined the patterns of rejected claims and the strategies employed by NHIF-accredited hospitals to mitigate these challenges. Methodology: This cross-sectional study was conducted between July and August 2024 and used quantitative and qualitative approaches. The study utilized secondary data (August 2023 to January 2024) on the rejected claims from 46 healthcare facilities (HFs) and key informant interviews from the respective selected facilities. Descriptive data analysis was carried out using STATA version 15 and qualitative data analysis was conducted using NViVo2 version 12 software. Results: A total of 46 public (27) and private (19) HFs were included in this study. The data revealed significant variation in the average number of items rejected per claim across HFs, ranging from 0.21 in a regional referral hospital to 1.21 in a zonal hospital. Non-adherence to standard treatment guidelines (STGs) was significantly more common (p < 0.001) in polyclinics, accounting for 17.2% of the items rejected, and with the lowest number (0.8%) seen in zonal hospitals. Overutilization (drugs and investigations) was commonly reported in all HFs, ranging from 12.5% in polyclinics to 31.8% in district hospitals (p < 0.001). Non-applicable consultation charges were only reported in one zonal hospital. To mitigate these rejections, HFs implemented strategies such as immediate error verification, regular communication with NHIF, staff training, technology use, and regular supervision by the internal audit units. Despite these efforts, challenges persisted, particularly those stemming from complex NHIF policies, which account for most rejections in zonal health facilities. Conclusions: There are significant variations in rejection patterns among HFs, with attendance date anomalies, non-adherence to STGs, NHIF pricing, and overutilization being the most common reasons across all HFs. Strategies to address rejections should be tailored to specific health facilities, coupled with electronic systems that will detect errors during patient management.

Background: Opioid use remains a significant global public health concern, with approximately 60 million people using opioids and 39.5 million living with opioid use disorders. Opioid agonist treatment (OAT), particularly methadone, is an effective intervention for opioid dependence, though retention remains problematic worldwide. This study aimed to determine the dropout rate and identify factors influencing adherence to OAT among patients at Sekou Toure Regional Referral Hospital (SRRH) in Mwanza, Tanzania. Methods: A mixed-method design combining a retrospective cohort and cross-sectional approach was used. Retrospective data were extracted from records of patients enrolled from February 2018 to March 2024. A cross-sectional survey was conducted from September to November 2024 among 223 systematically selected patients. Data analysis included descriptive statistics and Chi-square tests, with significance set at p < 0.05. Results: The dropout rate was 37.9%. Most dropouts were men (97.4%), consistent with the predominantly male patient population. Nearly half of the dropouts (47.7%) had only primary education. Adherence was influenced by personal motivations such as improving health (27.8%) and maintaining sobriety (27.4%), social support (25.6% reported none), and psychological distress (38.1% reported severe symptoms). Perceived treatment effectiveness varied, with 46.6% rating OAT as effective or very effective. Conclusion: The high dropout rate highlights the need for targeted interventions focused on men, individuals with lower education levels, and patients lacking social support. Strengthening the treatment environment, enhancing psychological support, and improving communication about OAT effectiveness may improve retention. Further research is needed to understand barriers to confidence in OAT and perceptions of treatment ineffectiveness.