Climate change and HIV are interconnected epidemics that increase vulnerability in people living with HIV (PLWH), particularly in sub-Saharan Africa. Despite their public health significance, research on the synergistic effects of these epidemics on the health of PLWH is limited. The advancement of non-invasive wearable technology offers an opportunity to leverage objective health data for large-scale research, addressing this knowledge gap. This study will examine the impact of weather events on distinct health variables of PLWH within the Siaya Health and Demographic Surveillance System (HDSS) in rural Kenya.

Over a period of 6 months, we continuously monitored health parameters of a total of 200 participants including heart rate, activity and sleep, using consumer-grade wearable devices. We will correlate these health data with real-time weather parameters (ambient temperature, wet bulb globe temperature, precipitation level) from five weather stations within the HDSS area and compare between HIV-positive participants and an HIV-negative control group. Additionally, a convergent mixed-methods approach will explore participants’ perceptions of the impact of weather events on their health and personal experiences. The study aims to inform future research on the complex relationship between HIV and weather events, which are projected to increase in frequency in this region due to climate change and provide valuable insights for policymakers to develop effective measures to protect this vulnerable population amid the growing climate crisis.

This study has been approved by the Research Ethics Committees at Kenya Medical Research Institute, Nairobi (approved on 23 October 2023; SERU 4826) and Heidelberg University Hospital, Germany (approved on 14 February 2023; S-824/2022). Written informed consent was obtained from all participants prior to enrolment, with data anonymised and handled according to Kenyan and German data protection regulations. Research findings will be disseminated through peer-reviewed publications and presented at scientific conferences.

Antimicrobial resistance (AMR) is a major threat in sub-Saharan Africa (SSA), but assessments of antimicrobial consumption (AMC) are limited. This study aimed to investigate regional AMC and resistance patterns in a representative area of Tanzania and to introduce a method for determining AMC in low-resource settings.

We conducted a retrospective study using prescription data collected over 5 years (2013–2017) from multiple hospitals and selected primary health facilities in the Dodoma Region of Tanzania. The study employed the WHO’s Anatomical Therapeutic Chemical (ATC) classification and Daily Defined Dose (DDD) methodology to quantify antimicrobial use. Outpatient prescription records that met our inclusion criteria were analysed, while incomplete records were excluded. Sensitivity testing for frequently prescribed antimicrobials was performed against representative gram-negative and gram-positive bacteria, with resistance expressed as minimum inhibitory concentrations and resistance percentages.

This study was conducted across several high-volume healthcare facilities in the Dodoma Region, encompassing both hospital and primary care settings. The dataset comprises outpatient prescription records from these facilities, representing a significant proportion of the regional healthcare usage. The selected facilities were chosen based on their substantial catchment populations to maximise data volume and relevance.

The primary outcome measure was the DDD per 1000 inhabitants per day (DID) for various antimicrobial classes. Secondary outcomes included the prevalence of specific drugs, such as amoxicillin and erythromycin, and their corresponding resistance profiles. Resistance data were quantitatively analysed, with particular attention given to penicillinase-sensitive penicillins and their resistance rates among gram-negative and Gram-positive bacteria.

Analysis revealed that single penicillins, particularly amoxicillin, dominated prescriptions, accounting for 25% to 60% of hospitals and 13% to 29% of primary health centres. Erythromycin was prescribed in 9.4% to 25.1% of cases across facilities. The overall AMC in the region ranged from 36.7 to 50.2 DID during the study period, with consumption patterns showing an initial increase of 4.3% from 2013 to 2014, a subsequent 29.0% decrease from 2014 to 2015, followed by a 34.1% increase from 2015 to 2016 and a further 37.9% increase from 2016 to 2017. Resistance testing demonstrated that penicillinase-sensitive penicillins exhibited an average resistance rate of 87.3%, with gram-negative and gram-positive bacteria showing resistance levels of 90.1% (±8%) and 83.6% (±8%), respectively, indicating a statistically significant association (p

Our findings reveal that AMC in the Dodoma Region is high and is linked to significant resistance against commonly used agents. This study presents a robust method for monitoring AMC and resistance in a resource-efficient manner, offering potential applicability in similar settings across SSA. The data, though representing only a fraction of total antimicrobial use, underscore the urgent need for targeted antimicrobial stewardship interventions, particularly at the primary healthcare level. Future research should further investigate demographic influences and evaluate intervention strategies to mitigate AMR effectively.