I am a holder of a Doctor of Philosophy (PhD) degree in Infection Biology from Karolinska Institute – Sweden, a Master of Medicine degree (MMed) in Microbiology and Immunology of the University of Dar es Salaam, a Master of Philosophy degree (MPhil) in Health Sciences (Immunology) from the University of Bergen – Norway, and a Doctor of Medicine degree (MD) from the University of Dar es Salaam. I have 20 years of experience in HIV research including HIV diagnosis and disease monitoring, HIV drug resistance testing, HIV and nutrition, HIV pathogenesis and genotyping, HIV vaccinology, malaria, tuberculosis and antimicrobial resistance. Address: Tanzania
Journal of Acquired Immune Deficiency Syndromes, Sep 20, 2022
Background: A cohort of female sex workers (FSWs) was established to determine HIV prevalence and... more Background: A cohort of female sex workers (FSWs) was established to determine HIV prevalence and incidence, and associated factors in preparation for a phase IIb HIV vaccine and pre-exposure prophylaxis trial (PrEPVacc). Setting: A cohort of FSWs in Dar es Salaam, Tanzania. Methods: FSWs aged 18–45 years were recruited using a respondent-driven sampling method. Social demographic data, HIV risk behavioral assessments, and blood samples for testing of HIV, syphilis, hepatitis B (HBV), and hepatitis C (HCV) infections were collected at baseline and then at 3, 6, 9, and 12 months. Poisson regressions were used to estimate the prevalence ratios for factors associated with HIV prevalence and to estimate the 12-month HIV incidence rate. Results: Between October and December 2018, a total of 773 FSWs were screened for eligibility and 700 were enrolled. The baseline prevalence of HIV, syphilis, HBV, and HCV was 7.6%, 1.2%, 1.7%, and 1.0%, respectively. HIV prevalence was associated with older age, using illicit drugs, and being infected with syphilis, HBV, or HCV. Attendance at 12 months was 80% (562/700). Twenty-one FSWs seroconverted during follow-up, giving a 12-month HIV incidence rate of 3.45 per 100 person-years at risk (95% CI; 2.25–5.28/100 person-years at risk). The HIV incidence rate was higher among FSWs aged 18–24 years, FSWs who used drugs, and those diagnosed with syphilis, HBV, or HCV. Conclusion: The high HIV incidence rate and retention rate among FSWs enrolled into the cohort demonstrate that this population is suitable for participation in HIV prevention trials.
Background Environmental enteric dysfunction (EED) may contribute to poor growth and development ... more Background Environmental enteric dysfunction (EED) may contribute to poor growth and development in young children. While validated EED biomarkers are currently lacking, multiplex assays are able to capture multiple domains of the condition. The purpose of this exploratory study was to examine the relationship between biomarkers of EED and subsequent growth and development among Tanzanian HIV-exposed uninfected (HEU) infants. Methodology We enrolled 467 infants of mothers living with HIV who had participated in a trial of vitamin D3 supplementation during pregnancy. Infant serum samples collected at 6 weeks (n = 365) and 6 months (n = 266) were analyzed for anti-flagellin and anti-lipopolysaccharide (LPS) IgA and IgG via ELISA as well as the 11-plex Micronutrient and EED Assessment Tool (MEEDAT), which incorporates two biomarkers of EED [intestinal fatty acid-binding protein (I-FABP) and soluble CD14 (sCD14)]. Outcomes were 12-month growth [length-for-age z-score (LAZ), weight-for-l...
Background PrEP literacy is influenced by many factors including the types of information availab... more Background PrEP literacy is influenced by many factors including the types of information available and how it is interpreted. The level of PrEP literacy may influence acceptability and uptake. Methods We conducted 25 in-depth interviews in a HIV vaccine trial preparedness cohort study. We explored what participants knew about PrEP, sources of PrEP knowledge and how much they know about PrEP. We used the framework approach to generate themes for analysis guided by the Social Ecological Model and examined levels of PrEP literacy using the individual and interpersonal constructs of the SEM. Results We found that PrEP awareness is strongly influenced by external factors such as social media and how much participants know about HIV treatment and prevention in the local community. However, while participants highlighted the importance of the internet/social media as a source of information about PrEP they talked of low PrEP literacy in their communities. Participants indicated that their...
Objectives Environmental enteric dysfunction (EED), a subclinical state of intestinal inflammatio... more Objectives Environmental enteric dysfunction (EED), a subclinical state of intestinal inflammation, may contribute to poor growth in children in low-resource settings, but validated biomarkers are lacking. Multiplex assays, such as the 11-plex Micronutrient and EED Assessment Tool (MEEDAT), hold promise due to their ability to capture multiple domains of EED; however, MEEDAT's ability to predict poor growth has not been well established. We sought to examine the relationship between markers of EED and growth among HIV-exposed infants in Dar es Salaam, Tanzania. Methods We performed a sub-study of 467 infants of HIV-infected mothers who participated in a randomized, double-blind, placebo-controlled trial assessing the effect of vitamin D3 supplementation during pregnancy. Infant serum samples collected at 6 weeks and 6 months were analyzed for anti-flagellin and anti-LPS IgA and IgG via ELISA as well as MEEDAT, which incorporates two markers of EED [fatty acid-binding protein (I-...
OBJECTIVE: To determine the separate effects of zinc and multivitamin supplementation on infant h... more OBJECTIVE: To determine the separate effects of zinc and multivitamin supplementation on infant hematologic status. METHODS: In a double-blind RCT, infants born to HIV-negative women (n=2400) in Da...
BackgroundDiarrhoea-associated mortality and morbidity are highest in infants and young children ... more BackgroundDiarrhoea-associated mortality and morbidity are highest in infants and young children in low-income and middle-income countries (LMICs). Zinc supplementation during acute diarrhoea has been shown to reduce the duration of illness and the risk of persistent diarrhoea. However, vomiting with zinc supplementation is a common side effect that may interfere with compliance and programmatic scale-up, and may be related to the dose prescribed.Methods/designThe Zinc Therapeutic Dose Trial (ZTDT) is a two-centre (Tanzania and India), three-arm randomised, double-blind controlled non-inferiority trial. Children 6–59 months of age with acute diarrhoea are eligible to participate. Enrolled children (1500 per arm; 4500 total) will be randomly allocated to receive 5, 10 or 20 mg of zinc sulfate daily for 14 days and will be followed up for 60 days after enrolment. All children will receive WHO/Unicef Integrated Management of Childhood Illness standard of care (oral or intravenous rehyd...
Journal of Acquired Immune Deficiency Syndromes, Sep 20, 2022
Background: A cohort of female sex workers (FSWs) was established to determine HIV prevalence and... more Background: A cohort of female sex workers (FSWs) was established to determine HIV prevalence and incidence, and associated factors in preparation for a phase IIb HIV vaccine and pre-exposure prophylaxis trial (PrEPVacc). Setting: A cohort of FSWs in Dar es Salaam, Tanzania. Methods: FSWs aged 18–45 years were recruited using a respondent-driven sampling method. Social demographic data, HIV risk behavioral assessments, and blood samples for testing of HIV, syphilis, hepatitis B (HBV), and hepatitis C (HCV) infections were collected at baseline and then at 3, 6, 9, and 12 months. Poisson regressions were used to estimate the prevalence ratios for factors associated with HIV prevalence and to estimate the 12-month HIV incidence rate. Results: Between October and December 2018, a total of 773 FSWs were screened for eligibility and 700 were enrolled. The baseline prevalence of HIV, syphilis, HBV, and HCV was 7.6%, 1.2%, 1.7%, and 1.0%, respectively. HIV prevalence was associated with older age, using illicit drugs, and being infected with syphilis, HBV, or HCV. Attendance at 12 months was 80% (562/700). Twenty-one FSWs seroconverted during follow-up, giving a 12-month HIV incidence rate of 3.45 per 100 person-years at risk (95% CI; 2.25–5.28/100 person-years at risk). The HIV incidence rate was higher among FSWs aged 18–24 years, FSWs who used drugs, and those diagnosed with syphilis, HBV, or HCV. Conclusion: The high HIV incidence rate and retention rate among FSWs enrolled into the cohort demonstrate that this population is suitable for participation in HIV prevention trials.
Background Environmental enteric dysfunction (EED) may contribute to poor growth and development ... more Background Environmental enteric dysfunction (EED) may contribute to poor growth and development in young children. While validated EED biomarkers are currently lacking, multiplex assays are able to capture multiple domains of the condition. The purpose of this exploratory study was to examine the relationship between biomarkers of EED and subsequent growth and development among Tanzanian HIV-exposed uninfected (HEU) infants. Methodology We enrolled 467 infants of mothers living with HIV who had participated in a trial of vitamin D3 supplementation during pregnancy. Infant serum samples collected at 6 weeks (n = 365) and 6 months (n = 266) were analyzed for anti-flagellin and anti-lipopolysaccharide (LPS) IgA and IgG via ELISA as well as the 11-plex Micronutrient and EED Assessment Tool (MEEDAT), which incorporates two biomarkers of EED [intestinal fatty acid-binding protein (I-FABP) and soluble CD14 (sCD14)]. Outcomes were 12-month growth [length-for-age z-score (LAZ), weight-for-l...
Background PrEP literacy is influenced by many factors including the types of information availab... more Background PrEP literacy is influenced by many factors including the types of information available and how it is interpreted. The level of PrEP literacy may influence acceptability and uptake. Methods We conducted 25 in-depth interviews in a HIV vaccine trial preparedness cohort study. We explored what participants knew about PrEP, sources of PrEP knowledge and how much they know about PrEP. We used the framework approach to generate themes for analysis guided by the Social Ecological Model and examined levels of PrEP literacy using the individual and interpersonal constructs of the SEM. Results We found that PrEP awareness is strongly influenced by external factors such as social media and how much participants know about HIV treatment and prevention in the local community. However, while participants highlighted the importance of the internet/social media as a source of information about PrEP they talked of low PrEP literacy in their communities. Participants indicated that their...
Objectives Environmental enteric dysfunction (EED), a subclinical state of intestinal inflammatio... more Objectives Environmental enteric dysfunction (EED), a subclinical state of intestinal inflammation, may contribute to poor growth in children in low-resource settings, but validated biomarkers are lacking. Multiplex assays, such as the 11-plex Micronutrient and EED Assessment Tool (MEEDAT), hold promise due to their ability to capture multiple domains of EED; however, MEEDAT's ability to predict poor growth has not been well established. We sought to examine the relationship between markers of EED and growth among HIV-exposed infants in Dar es Salaam, Tanzania. Methods We performed a sub-study of 467 infants of HIV-infected mothers who participated in a randomized, double-blind, placebo-controlled trial assessing the effect of vitamin D3 supplementation during pregnancy. Infant serum samples collected at 6 weeks and 6 months were analyzed for anti-flagellin and anti-LPS IgA and IgG via ELISA as well as MEEDAT, which incorporates two markers of EED [fatty acid-binding protein (I-...
OBJECTIVE: To determine the separate effects of zinc and multivitamin supplementation on infant h... more OBJECTIVE: To determine the separate effects of zinc and multivitamin supplementation on infant hematologic status. METHODS: In a double-blind RCT, infants born to HIV-negative women (n=2400) in Da...
BackgroundDiarrhoea-associated mortality and morbidity are highest in infants and young children ... more BackgroundDiarrhoea-associated mortality and morbidity are highest in infants and young children in low-income and middle-income countries (LMICs). Zinc supplementation during acute diarrhoea has been shown to reduce the duration of illness and the risk of persistent diarrhoea. However, vomiting with zinc supplementation is a common side effect that may interfere with compliance and programmatic scale-up, and may be related to the dose prescribed.Methods/designThe Zinc Therapeutic Dose Trial (ZTDT) is a two-centre (Tanzania and India), three-arm randomised, double-blind controlled non-inferiority trial. Children 6–59 months of age with acute diarrhoea are eligible to participate. Enrolled children (1500 per arm; 4500 total) will be randomly allocated to receive 5, 10 or 20 mg of zinc sulfate daily for 14 days and will be followed up for 60 days after enrolment. All children will receive WHO/Unicef Integrated Management of Childhood Illness standard of care (oral or intravenous rehyd...
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