“…In the quest to describe the occurrence of PHG, Jo and co-workers [10] proposed a numerical grading of five grades I to V at a 20% interval scale referring to 20, 40, 60, 80 and 100% of grayness while other studies have proposed a much more nominal grading of 1-5 representing pure black, predominantly black, equal black and white, predominantly white and pure white respectively [11]. Globally, PHG is on the rise and it has been shown to affect up to over 50% of the young people [8,10]. In Tanzania and indeed the Africa continent at large, PHG is rarely studied.…”