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Eriksen CB, Minja DT, Christensen DL, Bygbjerg IC, Damm P, Schmiegelow C, Grunnet LG, Hjort L. Do WHO criteria for gestational diabetes fit a rural population in Tanzania? - A follow-up study assessing mother and child health six years after a pregnancy diagnosed with gestational diabetes. Diabetes Res Clin Pract 2024; 211:111657. [PMID: 38583780 DOI: 10.1016/j.diabres.2024.111657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/23/2024] [Accepted: 04/02/2024] [Indexed: 04/09/2024]
Abstract
AIMS AND METHODS In low- and middle- income countries (LMICs) consequences of gestational diabetes (GDM) is understudied. Using a prospective cohort of mothers (n = 197)and children (n = 251), from rural north-eastern Tanzania, we assessed prediabetes and type 2 diabetes (T2D) prevalence six years after a pregnancy with/without GDM. RESULTS The prevalence of prediabetes (49.4 % vs. 46.4 %) orT2D (20.0 % vs. 16.1 %), p ≥ 0.36, based on fasting plasma glucose (FPG) or HbA1clevels (prediabetes: 16.9 % vs. 13.8 % and T2D 1.2 % vs. 0 %, p = 0.47), andcardio-metabolic health parameters,weresimilar between women with/without previous GDM. These results were supported by similar perinatal outcomes and child health at follow-up.The overall prevalence ofprediabetes/T2D was high, but no differences in other cardio-metabolic risk markers were observed in women with prediabetes/T2D compared to women with normal glucose tolerance. CONCLUSIONS Despite high prevalence of GDM amongTanzanian women, the diagnosis was not associated with adverse pregnancy outcomes, nor with increased risk of prediabetes or T2D at follow-up. FPG and HbA1c may be poor markers for diabetes in this population, and further follow-up studies with longer time intervals are warranted to evaluate which GDM diagnostic criteria are most optimal for women in rural Tanzania and similar LMIC settings.
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Affiliation(s)
- Camilla Byskou Eriksen
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.
| | - Daniel Thomas Minja
- National Institute for Medical Research, Tanga Centre, P.O. Box 5004, Tanga, Tanzania.
| | - Dirk Lund Christensen
- Global Health Section, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1353 Copenhagen, Denmark.
| | - Ib Christian Bygbjerg
- Global Health Section, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1353 Copenhagen, Denmark.
| | - Peter Damm
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
| | - Christentze Schmiegelow
- Centre for Translational Medicine and Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark; Department of Infectious Diseases, Copenhagen University Hospital, Blegdamsvej 9, 2100 Copenhagen, Denmark; Department of Gynecology and Obstetrics, Copenhagen University Hospital - North Zealand, Dyrehavevej 29, 3400 Hilleroed, Denmark.
| | - Louise Groth Grunnet
- Global Health Section, Department of Public Health, University of Copenhagen, Oester Farimagsgade 5, 1353 Copenhagen, Denmark; Clinical and Translational Research, Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, 2730 Herlev, Denmark.
| | - Line Hjort
- Center for Pregnant Women with Diabetes, Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Metabolic Epigenetics Group, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2100 Copenhagen, Denmark.
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Bakari M, Aboud S, Kasubi M, Mmbando BP, Ntinginya NE, Sichalwe A, Ubuguyu OS, Magesa A, Rutananukwa NL, Nyawale H, Kisinda A, Beyanga M, Horumpende PG, Mhame PS, Vumilia LM, Mziray LS, Mkala R, Shao E, Makubi A, Mshana SE, Kishimba R. Humoral Immune Responses following COVID-19 Vaccinations among Adults in Tanzania. Vaccines (Basel) 2023; 12:22. [PMID: 38250835 PMCID: PMC10819524 DOI: 10.3390/vaccines12010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/07/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
COVID-19 vaccination remains to be the most important intervention in the fight against the pandemic. The immunity among the vaccinated population and its durability can significantly vary due to various factors. This study investigated the humoral immune responses among individuals who received any of the COVID-19 vaccines approved for use in Tanzania. A total of 1048 randomly selected adults who received COVID-19 vaccines at different time points were enrolled and humoral immune responses (IR) were tested at baseline and three months later (960, 91.6%). The level of SARS-CoV-2 anti-spike/receptor binding domain (RBD) IgG, anti-nucleocapsid IgG, and IgM antibodies were determined using a commercially available chemiluminescent microparticle immunoassay. Descriptive data analysis was performed using STATA version 18 and R. At baseline, serum IgG against anti-spike/RBD was detected in 1010/1048 (96.4%) participants (95%CI: 94.9-97.5) and 98.3% (95%CI: 97.3-99) three months later. The IgG against the SARS-CoV-2 nucleocapsid proteins were detected in 40.8% and 45.3% of participants at baseline and follow-up, respectively. The proportion of seroconverters following vaccination and mean titers of anti-spike/RBD antibodies were significantly more among those who had past SARS-CoV-2 infection than in those with no evidence of past infection, (p < 0.001). Only 0.5% of those who had detectable anti-spike/RBD antibodies at baseline were negative after three months of follow-up and 1.5% had breakthrough infections. The majority of participants (99.5%) had detectable anti-spike/RBD antibodies beyond 6 months post-vaccination. The proportion of Tanzanians who mounted humoral IR following COVID-19 vaccination was very high. Seroconversions, as well as the mean titers and durability of humoral IR, were significantly enhanced by exposure to natural SARS-CoV-2 infection. In view of the limited availability of COVID-19 vaccines as well as challenges to completing subsequent doses, booster doses could only be suggested to high-risk groups.
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Affiliation(s)
- Muhammad Bakari
- School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam P.O. Box 65001, Tanzania; (M.B.); (S.A.)
| | - Said Aboud
- School of Medicine, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam P.O. Box 65001, Tanzania; (M.B.); (S.A.)
- National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania; (B.P.M.); (N.E.N.); (N.L.R.); (A.K.)
| | - Mabula Kasubi
- Muhimbili National Hospital (MNH), Dar es Salaam P.O. Box 65000, Tanzania;
| | - Bruno P. Mmbando
- National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania; (B.P.M.); (N.E.N.); (N.L.R.); (A.K.)
| | - Nyanda Elias Ntinginya
- National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania; (B.P.M.); (N.E.N.); (N.L.R.); (A.K.)
| | - Aifello Sichalwe
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Omary S. Ubuguyu
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Alex Magesa
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Nancy Ladislaus Rutananukwa
- National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania; (B.P.M.); (N.E.N.); (N.L.R.); (A.K.)
| | - Helmut Nyawale
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences (CUHAS), Mwanza P.O. Box 1464, Tanzania;
| | - Abisai Kisinda
- National Institute for Medical Research (NIMR), Dar es Salaam P.O. Box 9653, Tanzania; (B.P.M.); (N.E.N.); (N.L.R.); (A.K.)
| | - Medard Beyanga
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Pius G. Horumpende
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Paulo S. Mhame
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Liggle M. Vumilia
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Lucy S. Mziray
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
| | - Reuben Mkala
- Benjamin Mkapa Hospital (BMH), Dodoma P.O. Box 11088, Tanzania;
| | - Elichilia Shao
- Kilimanjaro Christian Medical Centre (KCMC), Moshi P.O. Box 3010, Tanzania;
- Faculty of Medicine, Department of Internal Medicine, Kilimanjaro Christian Medical University College (KCMUCo), Moshi P.O. Box 2240, Tanzania
| | - Abel Makubi
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
- Muhimbili Orthopaedics Institute (MOI), Dar es Salaam P.O. Box 65474, Tanzania
| | - Stephen E. Mshana
- Department of Microbiology and Immunology, Weill Bugando School of Medicine, Catholic University of Health and Allied Sciences (CUHAS), Mwanza P.O. Box 1464, Tanzania;
| | - Rogath Kishimba
- Ministry of Health (MoH), Dodoma P.O. Box 743, Tanzania; (A.S.); (O.S.U.); (A.M.); (M.B.); (P.G.H.); (P.S.M.); (L.M.V.); (L.S.M.); (A.M.); (R.K.)
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