{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T16:25:55Z","timestamp":1792427155094,"version":"4.5.0"},"reference-count":38,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec020\">\n<jats:title>Background<\/jats:title>\n<jats:p>Non-communicable diseases (NCDs) have increased significantly in Tanzania, accounting for 33% of mortality in the country. Having adequate knowledge translated into practice has a significant effect on the health of individuals through adoption of positive behaviours and influencing better health seeking behaviours. For those already affected by NCDs, it promotes secondary and tertiary prevention by helping them effectively cope with the disease. In this study, we aimed to determine the level and determinants of NCDs knowledge in the community to inform the implementation of WHO PEN- Plus initiatives.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec021\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This cross-sectional study was conducted from May to June 2023 involving 528 adults aged 25\u201364 years from two purposely selected districts and 11, 22 and 528 randomly selected wards, villages, and households respectively. Information on socio-economic, demographic, NCDs knowledge were collected from each participant. Chi-square test and Modified Poisson Regression were applied to assess the association and determinants of NCDs knowledge level.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec022\">\n<jats:title>Results<\/jats:title>\n<jats:p>The median age of study participants was 40.5 years. Less than half 42.6%(n=225) were aware of the term NCD and less than one third were aware of the NCD conditions such as Type 1 Diabetes Mellitus (T1DM) 15.3%(n=70), Sickle Cell Disease (SCD) 25.2%(n=133), Rheumatic fever 28.6%(n=151) and Heart failure 33.1%(n=175). Good level of awareness was reported on Type 2 Diabetes Mellitus (T2DM) 79.5%(n=364). More than three quarters of the respondents had low knowledge on T1DM (90.3%), SCD (84.1%), Rheumatic fever (81.3%), NCDs (80.5%) and Heart failure (76.1%). Furthermore, more than half (56.4%) of respondents had low knowledge for T2DM. Adjusted analysis indicated that, for all NCDs except SCD, low knowledge was significantly associated with the district of residence (Kondoa). Low knowledge of NCDs, T2DM, and SCD was significantly associated with having no education, or having only primary or secondary education. Individuals from the lowest, second, middle, and fourth socio-economic status families were significantly associated with low knowledge of NCDs, while the lowest and fourth socio-economic status levels were associated with low knowledge of T2DM and SCD.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec023\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Low knowledge was observed for all NCDs conditions and socio-economic and demographic characteristics were associated with low knowledge. Interventions to increase NCDs knowledge should consider the socio-economic determinants.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0321695","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T17:29:33Z","timestamp":1744738173000},"page":"e0321695","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Assessment of community knowledge on non-communicable diseases to inform the pilot of WHO PEN-Plus initiatives in selected two districts in Tanzania"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8155-5144","authenticated-orcid":true,"given":"Gibson B.","family":"Kagaruki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Mathias","family":"Karoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willfredius M.","family":"Rutahoile","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilly","family":"Chillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reuben","family":"Mutagaywa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aidan","family":"Banduka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edna Siima","family":"Majaliwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renatus Fabiano","family":"Nyarubamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Mtumbuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Mallya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katunzi","family":"Mutalemwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noemi","family":"Bazzanin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deogratias","family":"Soka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9928-0732","authenticated-orcid":true,"given":"Agnes","family":"Jonathan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Urasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Best","family":"Magoma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas J.","family":"Kazingo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heriel Z.","family":"Ammi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emiliana K.","family":"Donald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Raymond","family":"Mwenesano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kajiru","family":"Kilonzo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amani T.","family":"Mori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3309-5395","authenticated-orcid":true,"given":"Kaushik","family":"Ramaiya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4861-7870","authenticated-orcid":true,"given":"Mayige T.","family":"Mary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"pone.0321695.ref001","author":"DE Bloom","year":"2011"},{"key":"pone.0321695.ref002","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1186\/s12992-014-0081-9","article-title":"Non-communicable diseases (NCDs) in developing countries: a symposium report","volume":"10","author":"SMS Islam","year":"2014","journal-title":"Global Health"},{"key":"pone.0321695.ref003","volume-title":"World Health Organization \u2013 Non-Communicable Diseases (NCD): risk of premature death due to NCDS country profiles","author":"WHO","year":"2018"},{"key":"pone.0321695.ref004","first-page":"88","article-title":"Global report on diabetes","volume":"978","author":"WHO","year":"2016","journal-title":"Isbn"},{"issue":"8","key":"pone.0321695.ref005","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s40273-015-0268-9","article-title":"The economic costs of type 2 diabetes: a global systematic review","volume":"33","author":"T Seuring","year":"2015","journal-title":"Pharmacoeconomics"},{"key":"pone.0321695.ref006","volume-title":"IDF diabetes atlas","author":"IDF"},{"issue":"4","key":"pone.0321695.ref007","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1080\/1355785042000285375","article-title":"Factors influencing food choices, dietary intake, and nutrition-related attitudes among African Americans: application of a culturally sensitive model","volume":"9","author":"DCS James","year":"2004","journal-title":"Ethn Health"},{"issue":"1","key":"pone.0321695.ref008","first-page":"1","article-title":"Cardiac surgery: one year experience of cardiac surgery at Muhimbili National Hospital, Dar es Salaam-Tanzania","volume":"8","author":"N Etm","year":"2023","journal-title":"East Cent Afr J Surg"},{"key":"pone.0321695.ref009","doi-asserted-by":"crossref","first-page":"107817","DOI":"10.1016\/j.diabres.2019.107817","article-title":"Incidence, prevalence and clinical manifestations at onset of juvenile diabetes in Tanzania","volume":"156","author":"D Jasem","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"key":"pone.0321695.ref010","first-page":"3694792","article-title":"Knowledge of the disease, perceived social support, and cognitive appraisals in women with urinary incontinence","author":"K Szymona-Pa\u0142kowska","year":"2016","journal-title":"Biomed Res Int"},{"key":"pone.0321695.ref011","first-page":"1","author":"LK Nguma","year":"2010"},{"key":"pone.0321695.ref012","unstructured":"WHO. Tanzania steps survey report final; 2013. Available from: file:\/\/\/C:\/Users\/User\/Downloads\/UR_Tanzania_2012_STEPS_Report.pdf"},{"key":"pone.0321695.ref013","volume-title":"The United Republic of Tanzania age and sex distribution report Tanzania","author":"National Bureau of Statistics Tanzania and Office of the Chief Government Statistician Zanzibar","year":"2022"},{"key":"pone.0321695.ref014","volume-title":"The SampSize App to assist in the calculation of sample sizes for clinical trials","author":"SA Julious","year":"2020"},{"key":"pone.0321695.ref015","author":"J Amon"},{"issue":"1","key":"pone.0321695.ref016","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1111\/codi.15489","article-title":"Sample size calculations for randomized controlled trials and for prediction models","volume":"23","author":"F Fiorentino","year":"2021","journal-title":"Colorectal Dis"},{"issue":"1","key":"pone.0321695.ref017","doi-asserted-by":"crossref","first-page":"e074182","DOI":"10.1136\/bmjopen-2023-074182","article-title":"Protocol for an evaluation of the initiation of an integrated longitudinal outpatient care model for severe chronic non-communicable diseases (PEN-Plus) at secondary care facilities (district hospitals) in 10 lower-income countries","volume":"14","author":"AJ Adler","year":"2024","journal-title":"BMJ Open"},{"key":"pone.0321695.ref018","volume-title":"Tanzania Demographic and Health Survey and Malaria Indicator Survey (TDHS-MIS) 2015-16","author":"MoHCDGEC, MoH, NBS O& I","year":"2016"},{"key":"pone.0321695.ref019","volume-title":"Tanzania demographic and health survey 2010","author":"Macro NB of S (NBS) [Tanzania] and I","year":"2010"},{"key":"pone.0321695.ref020","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1186\/1475-2875-9-201","article-title":"Principal component analysis of socioeconomic factors and their association with malaria in children from the Ashanti Region, Ghana","volume":"9","author":"AC Krefis","year":"2010","journal-title":"Malar J"},{"issue":"1","key":"pone.0321695.ref021","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1186\/s12889-018-5639-7","article-title":"Knowledge and perception on type2 diabetes and hypertension among HIV clients utilizing care and treatment services: a cross sectional study from Mbeya and Dar es Salaam regions in Tanzania","volume":"18","author":"GB Kagaruki","year":"2018","journal-title":"BMC Public Health"},{"issue":"8","key":"pone.0321695.ref022","doi-asserted-by":"crossref","first-page":"714","DOI":"10.47102\/annals-acadmedsg.V38N8p714","article-title":"A practical guide for multivariate analysis of dichotomous outcomes","volume":"38","author":"J Lee","year":"2009","journal-title":"Ann Acad Med Singap"},{"issue":"7","key":"pone.0321695.ref023","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1093\/aje\/kwh090","article-title":"A modified poisson regression approach to prospective studies with binary data","volume":"159","author":"G Zou","year":"2004","journal-title":"Am J Epidemiol"},{"key":"pone.0321695.ref024","first-page":"26","article-title":"Ethical principles for medical research involving human subjects: world medical association declaration of Helsinki","volume":"11","author":"C Kori-Lindner","year":"2000","journal-title":"Klinische Pharmakologie Aktuell"},{"key":"pone.0321695.ref025","doi-asserted-by":"crossref","first-page":"194","DOI":"10.3389\/fpubh.2017.00194","article-title":"Deconstructing and assessing knowledge and awareness in public health research","volume":"5","author":"R Trevethan","year":"2017","journal-title":"Front Public Health"},{"issue":"2","key":"pone.0321695.ref026","article-title":"Awareness and knowledge assessment of sustainable development goals among university students","volume":"20","author":"HF Jati","year":"2019","journal-title":"JESP"},{"issue":"sup201","key":"pone.0321695.ref027","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1080\/00365519009085798","article-title":"Western diet and Western diseases: Some hormonal and biochemical mechanisms and associations","volume":"50","author":"H Adlercreutz","year":"1990","journal-title":"Scand J Clin Lab Invest"},{"issue":"10","key":"pone.0321695.ref028","doi-asserted-by":"crossref","first-page":"e1375","DOI":"10.1016\/S2214-109X(19)30374-2","article-title":"Burden of non-communicable diseases in sub-Saharan Africa, 1990-2017: results from the Global Burden of Disease Study 2017","volume":"7","author":"HN Gouda","year":"2019","journal-title":"Lancet Glob Health"},{"key":"pone.0321695.ref029","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.ssmph.2016.11.006","article-title":"Neighbourhood socioeconomic status indices and early childhood development","volume":"3","author":"S Webb","year":"2016","journal-title":"SSM Popul Health"},{"issue":"7","key":"pone.0321695.ref030","first-page":"868","article-title":"High prevalence of Mycobacterium tuberculosis infection and disease in children and adolescents with type 1 diabetes mellitus","volume":"13","author":"EA Webb","year":"2009","journal-title":"Int J Tuberc Lung Dis"},{"key":"pone.0321695.ref031","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.clnesp.2022.06.001","article-title":"Sedentary behavior, physical inactivity, abdominal obesity and obesity in adults and older adults: a systematic review and meta-analysis","volume":"50","author":"EA Silveira","year":"2022","journal-title":"Clin Nutr ESPEN"},{"issue":"10","key":"pone.0321695.ref032","doi-asserted-by":"crossref","first-page":"e0164428","DOI":"10.1371\/journal.pone.0164428","article-title":"Prevalence, risk factors, and complications of diabetes in the Kilimanjaro region: a population-based study from Tanzania","volume":"11","author":"JW Stanifer","year":"2016","journal-title":"PLoS One"},{"issue":"1","key":"pone.0321695.ref033","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1186\/s12913-022-08065-4","article-title":"The acceptability of integrated healthcare services for HIV and non-communicable diseases: experiences from patients and healthcare workers in Tanzania","volume":"22","author":"EH Shayo","year":"2022","journal-title":"BMC Health Serv Res"},{"issue":"5","key":"pone.0321695.ref034","doi-asserted-by":"crossref","first-page":"e004669","DOI":"10.1136\/bmjgh-2020-004669","article-title":"Integration of non-communicable disease and HIV\/AIDS management: a review of healthcare policies and plans in East Africa","volume":"6","author":"O Adeyemi","year":"2021","journal-title":"BMJ Glob Health"},{"key":"pone.0321695.ref035","author":"MOH","year":"2023"},{"key":"pone.0321695.ref036","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/14635240.2022.2104742","article-title":"Knowledge and attitudes towards type 2 diabetes and prevention strategies among regular street food consumers: a cross sectional study in Dar es Salaam, Tanzania","author":"GB Kagaruki","year":"2022","journal-title":"Int J Health Promot Educ"},{"issue":"11","key":"pone.0321695.ref037","doi-asserted-by":"crossref","first-page":"e0289289","DOI":"10.1371\/journal.pone.0289289","article-title":"The effectiveness of interventions to reduce cardio-metabolic risk factors among regular street food consumers in Dar es Salaam, Tanzania: the pre-post findings from a cluster randomized trial (Registered by Pan African clinical trial registry with trial # PACTR202208642850935)","volume":"18","author":"GB Kagaruki","year":"2023","journal-title":"PLoS One"},{"key":"pone.0321695.ref038","volume-title":"Prevalence, awareness and management of type 2 diabetes mellitus in Mwanza city, Tanzania: Carolyne Charles Ruhembe a thesis submitted in fulfilment of the requirements for the degree of Doctor of Philosophy of Sokoine university of agriculture","author":"CC Ruhembe","year":"2016"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0321695","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T17:29:43Z","timestamp":1744738183000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0321695"}},"subtitle":[],"editor":[{"given":"Khin","family":"Thet Wai,","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,4,15]]},"references-count":38,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4,15]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0321695","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,15]]}}}