Background/Aims Musculoskeletal disorders (MSKD) are an important global health problem, but we know little about how it is understood and explained in Tanzanian communities. This understanding is crucial for developing culturally competent interventions and services for MSKD which avoid unintended impacts. This study aims to examine how joint pain is understood, explained, and responded to in rural and peri-urban communities in northern Tanzania. Methods We conducted rapid ethnographic assessment (REA) in two communities in Kilimanjaro region (one peri-urban, one rural) to document the language used to describe joint pain, ideas about causes, understandings of who experiences such pain, the impacts the pain has and how people respond to it. The REA included 60 short interviews with community leaders, traditional healers, community members, and pharmacists. The research team also wrote detailed field notes and, with written consent, took photographs which were used to develop ‘thick descriptions’ of the phenomena in each community. Thematic analysis of interview notes, thick descriptions and photographs was conducted using QDA Miner (v5.0) software. Results The dominant concepts of joint pain and its cause were named as Ugonjwa wa baridi - cold disease; Ugonjwa wa uzee - old age disease; rimatizim - disease of the joints and gauti - gout. Causes mentioned included exposure to the cold - walking bare foot, working in cold conditions - old age, alcohol and red meat consumption, witchcraft, demons, settling in one position, sex, injuries/falls. Age, gender and occupation were seen as important factors for developing joint pain. The impacts of joint pain included loss of mobility, economic and family problems, death, reduction in sexual functioning, and negative self-perceptions. Responses to joint pain blend biomedical treatments, exercise, herbal remedies, consultations with traditional healers and religious ritual. Conclusion Understandings of and responses to joint pain in the two communities are ‘syncretic’ - mixing folk and biomedical practices. Narratives about who is affected by joint pain mirror emerging epidemiological findings, suggesting a strong ‘lay epidemiology’ in these communities. The impacts of joint pain are wide ranging, extending beyond the individual affected, and suggest that there are unmet needs which can be targeted by future interventions and services. Disclosure E.F. Msoka: None. C. Bunn: None. P. Msoka: None. N.M. Yongolo: None. E. Laurie: None. S. Wyke: None. E. McIntosh: None. B. Mmbaga: None.

This book contains the abstracts of the papers/posters presented at the Tanzania Health Summit 2020 (THS-2020) Organized by the Ministry of Health Community Development, Gender, Elderly and Children (MoHCDGEC); President Office Regional Administration and Local Government (PORALG); Ministry of Health, Social Welfare, Elderly, Gender, and Children Zanzibar; Association of Private Health Facilities in Tanzania (APHFTA); National Muslim Council of Tanzania (BAKWATA); Christian Social Services Commission (CSSC); & Tindwa Medical and Health Services (TMHS) held on 25–26 November 2020. The Tanzania Health Summit is the annual largest healthcare platform in Tanzania that attracts more than 1000 participants, national and international experts, from policymakers, health researchers, public health professionals, health insurers, medical doctors, nurses, pharmacists, private health investors, supply chain experts, and the civil society. During the three-day summit, stakeholders and decision-makers from every field in healthcare work together to find solutions to the country’s and regional health challenges and set the agenda for a healthier future.

Background: In Tanzania, disclosure of HIV status to children remains a challenge despite the World Health Organization (WHO) recommendation that children should be informed about their HIV status between the ages of 6 to 12 years. This study aims to determine HIV status disclosure and related factors among children living with HIV in Kilimanjaro, Tanzania. Method: A cross-sectional study using a convergent parallel mixed-methods design was conducted from September 2021 to February 2022 among children aged 6-14 years receiving HIV care. Semi-structured questionnaires were collected from caregivers of undisclosed children, including socio-demographic data and reasons for non-disclosure. Additionally, we interviewed 20 caregivers of children in-depth who had disclosed and not disclosed the status to their children; we also interviewed children whose HIV status had been disclosed, followed by a focus group discussion. Bivariate and multivariate logistic regression analyses identified factors associated with HIV status disclosure. P<0.05 was considered statistically significant. We did thematic content analysis for qualitative data. Results: 121 children and their parents or caregivers were included in the analysis and 51(42%) knew about their HIV status. 31%(n=38) of children were between the ages 6-8 and among them, 33(87%) did not know about their status. Thirty-nine percent (n=47) of children were between the ages of 9-11; 32(68%) did not know about their status. 30% (n=36) of the children were above 12 years old, and 5(14%) did not know their status. 60 children were girls (49.5%); the majority (n=75;62%) lived with their biological parents; 112 children had primary education (93%); and 94 (78%) children attended referral hospitals for ART services. Moreover, 86(71%) of the children had caregivers who had been interviewed. In the final multivariate model, children aged above 12 years (OR= 30; 95%; Cl= 7.2-124); children aged 9-11(OR=2.7;95%; CI= 0.8-9.0) and having a treatment supporter (OR=2.9; 95%CI=1.0-8.2) were significantly associated with HIV status disclosure to their children compared to their counterparts respectively. Through IDI, we revealed the following themes: (1) HIV disclosure challenges and reasons not to disclose the status, (2) the process of the disclosure, and (3) the Importance of disclosure. Conclusion: HIV status disclosure to children living with HIV in Kilimanjaro region was associated with age above 12 years and having a treatment supporter, unlike the WHO recommendation. Therefore, health facilities should introduce new strategies to ensure children know their HIV status.

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