6 research outputs found
Ecological and epidemiological findings associated with zoonotic rabies outbreaks and control in Moshi, Tanzania, 2017â2018
Approximately 1500 people die annually due to rabies in the United Republic of Tanzania.
Moshi, in the Kilimanjaro Region, reported sporadic cases of human rabies between 2017 and 2018.
In response and following a One Health approach, we implemented surveillance, monitoring, as well
as a mass vaccinations of domestic pets concurrently in >150 villages, achieving a 74.5% vaccination
coverage (n = 29, 885 dogs and cats) by September 2018. As of April 2019, no single human or animal
case has been recorded. We have observed a disparity between awareness and knowledge levels
of community members on rabies epidemiology. Self-adherence to protective rabies vaccination in
animals was poor due to the challenges of costs and distances to vaccination centers, among others.
Incidence of dog bites was high and only a fraction (65%) of dog bite victims (humans) received
post-exposure prophylaxis. A high proportion of unvaccinated dogs and cats and the relative intense
interactions with wild dog species at interfaces were the risk factors for seropositivity to rabies virus
infection in dogs. A percentage of the previously vaccinated dogs remained unimmunized and some
unvaccinated dogs were seropositive. Evidence of community engagement and multi-coordinated
implementation of One Health in Moshi serves as an example of best practice in tackling zoonotic
diseases using multi-level government e orts. The district-level establishment of the One Health rapid
response team (OHRRT), implementation of a carefully structured routine vaccination campaign,
improved health education, and the implementation of barriers between domestic animals and
wildlife at the interfaces are necessary to reduce the burden of rabies in Moshi and communities with
similar profiles.The USAID funded projectâOSRO/GLO/507/USA on Global Health Security Agenda for the control of zoonosis in Africa.http://www.mdpi.com/journal/ijerpham2020Veterinary Tropical Disease
âWe have been working overnight without sleepingâ: traditional birth attendantsâ practices and perceptions of post-partum care services in rural Tanzania
Background: In many low-income countries, formal post-partum care utilization is much lower than that of skilled delivery and antenatal care. While Traditional Birth Attendants (TBAs) might play a role in post-partum care, research exploring their attitudes and practices during this period is scarce. Therefore, the aim of this study was to explore TBAsâ practices and perceptions in post-partum care in rural Tanzania.
Methods: Qualitative in-depth interview data were collected from eight untrained and three trained TBAs. Additionally, five multiparous women who were clients of untrained TBAs were also interviewed. Interviews were conducted in February 2013. Data were digitally recorded and transcribed verbatim. Qualitative content analysis was used to analyze data.
Results: Our study found that TBAs take care of women during post-partum with rituals appreciated by women. They report lacking formal post-partum care training, which makes them ill-equipped to detect and handle post-partum complications. Despite their lack of preparation, they try to provide care for some post-partum complications which could put the health of the woman at risk. TBAs perceive that utilization of hospital-based post-partum services among women was only important for the baby and for managing complications which they cannot handle. They are poorly linked with the health system.
Conclusions: This study found that the TBAs conducted close follow-ups and some of their practices were appreciated by women. However, the fact that they were trying to manage certain post-partum complications can put women at risk. These findings point out the need to enhance the communication between TBAs and the formal health system and to increase the quality of the TBA services, especially in terms of prompt referral, through provision of training, mentoring, monitoring and supervision of the TBA servic
Where and when to vaccinate? Interdisciplinary design and evaluation of the 2018 Tanzanian anti-rabies campaign
OBJECTIVES : Hoping to improve health-related effectiveness, a two-phase vaccination against rabies was
designed and executed in northern Tanzania in 2018, which included geo-epidemiological and economic
perspectives.
METHODS : Considering the local bio-geography and attempting to rapidly establish a protective ring
around a city at risk, the
first phase intervened on sites surrounding that city, where the population
density was lower than in the city at risk. The second phase vaccinated a rural area.
RESULTS : No rabies-related case has been reported in the vaccinated areas for over a year postimmunisation;
hence, the campaign is viewed as highly cost-effective. Other metrics included: rapid
implementation (concluded in half the time spent on other campaigns) and the estimated cost per
protected life, which was 3.28 times lower than in similar vaccinations.
CONCLUSIONS : The adopted design emphasised local bio-geographical dynamics: it prevented the
occurrence of an epidemic in a city with a higher demographic density than its surrounding area and it
also achieved greater effectiveness than average interventions. These interdisciplinary, policy-oriented
experiences have broad and immediate applications in settings of limited and/or time-sensitive
(expertise, personnel, and time available to intervene) resources and conditions.The United States Agency for International Development (USAID) â OSRO/GLO/507/USA on Global Health Security Agenda for the control of zoonosis in Africa.http://www.elsevier.com/locate/ijidam2020Nursing ScienceVeterinary Tropical Disease
Perceptions about the cultural practices of male partners during postpartum care in rural Tanzania: a qualitative study
Background: Men play an important role in maternal health. The postpartum period is a critical stage, yet there is a scarcity of research that explores menâs involvement during this stage.
Objective: The aim of the study was to explore male partnersâ perceptions of the cultural practices during postpartum care in rural Tanzania.
Methods: Fourteen focus group discussions were conducted with 93 men, with an age range of 19â65 years, in August 2013. The study was conducted in the Kongwa District, located in the Dodoma region in central Tanzania. Qualitative data were digitally recorded, transcribed verbatim and analyzed using content analysis.
Results: Four categories emerged, namely: âMen as providers and, occasionally, care takersâ, âMen as decision makersâ, âDiverse perceptions of sexual abstinenceâ and âBarriers for men in using/accompanying partners to use reproductive and child healthcare servicesâ. The cross-category theme âMen during postpartum: remaining powerful but excludedâ refers to how men are in a powerful position above women in different aspects of life. Elderly women played an important role in caring for postpartum mothers and their newborns, but men were the ones making the final decision about where to seek care. Traditional practices isolated men from their partners for a certain period, and enforced sexual abstinence for the women during the postpartum period. However, cultural norms permitted men to engage in extramarital relations. Reproductive and child healthcare services were perceived by men as not welcoming the male partners, and local gender norms discouraged men from accompanying their partners to seek services.
Conclusions: In this study, we found that men perceived their role during the postpartum period as financial providers, decision makers and, occasionally, care givers. Men also held diverse perceptions with regard to sexual abstinence and felt excluded from participating in maternal healthcare services