The role of mass media in disease outbreak reporting in the United Republic of Tanzania

Emerging infectious diseases and the growth of information communication technology have produced new demands and possibilities for disease outbreak information and reporting. An analysis of disease outbreak information and reporting by the Tanzanian mass media was carried out to cover a 12-month period between July 2002 and June 2003. Outbreak episodes reported in four local dailies were collected, compiled and analysed. The disease that received the highest coverage was cholera. Cholera outbreaks were frequently reported from the 3 districts in Dar es Salaam Region. Other epidemic-prone diseases received very little coverage. These included meningitis and rabies. With globalisation and high technological information systems, reports of disease outbreaks are more widely disseminated and more easily accessible than ever before. However, the quality of information is no longer controlled and may be provided out of context, often causing unnecessary public anxiety and confusion. It is important that mass media is provided with accurate epidemiological reports if correct information is to reach the public. The role of media in outbreak reporting is herein discussed in relation to the importance of providing timely and accurate epidemiological information. Tanzania Health Research Bulletin Vol.6(2) 2004: 73-7

Enhancing disease surveillance reporting using public transport in Dodoma District, Central Tanzania

No Abstract. Tanzania Health Research Bulletin Vol. 7(3) 2005: 201-20

The relationship between malaria parasitaemia and availability of healthcare facility in Mpwapwa District, central Tanzania

A study was carried out in six villages located at different altitudes in Mpwapwa district of central Tanzania to determine malaria parasitaemia and transmission levels in villages with or without health care facilities. A total of 1119 schoolchildren (age= 5.9-12.3 years) were examined for malaria parasitaemia. Plasmodium falciparum was the predominant malaria species accounting for 92.8% of all species. The average malaria prevalence rate among schoolchildren was 25.8% (range 1.5-53.8%). The geometric mean parasite densities for P. falciparum was 361 (N= 286). Higher malaria prevalence was observed in villages at lower (1500m) altitudes. Schoolchildren in areas with health care facilities were less at risk of acquiring malaria by 33.4% as compared with those living in areas without health facilities. Mean packed cell volume in schoolchildren was 38.5% (range= 35.2-41.0%). Splenomegaly was observed in 18.1% (0-40.2%) of the schoolchildren examined and it was higher among those in villages without health care facilities. Anopheles gambiae sensu lato was the only malaria vector found in the district and was found in all villages and at all altitudes. Sporozoite rate in An. gambiae s.l. ranged from 0-10.5%, with the lowland villages recording the highest rates. This study indicates that altitude and geographical accessibility to healthcare service are important determinants of malaria infection among rural communities in Tanzania. Keywords: malaria, schoolchildren, altitudes, health care facility, Tanzania Tanzania Health Research Bulletin Vol. 8(1) 2006: 22-2

Challenges of implementing an Integrated Disease Surveillance and Response strategy using the current Health Management Information System in Tanzania

Tanzania adopted an Integrated Disease Surveillance and Response (IDSR) strategy in 1998 in order to strengthen its infectious disease surveillance system. During that time, the country had 5 separate surveillance systems to monitor infectious disease trends and disease control programmes. The systems included the Health Management Information System (HMIS); Infectious Disease Week Ending; Tuberculosis/Leprosy; Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome; and Acute Flaccid Paralysis/Poliomyelitis). An assessment of the surveillance systems in the country has shown inadequacy in the use of standard case definitions and laboratory confirmation of cases, supervision and feedback as well as data collection tools. Moreover, in some of the existing vertical disease surveillance programmes, the epidemiological data generated were neither fully analyzed nor utilized at district level, but rather were forwarded to higher levels, which hardly provided any feedback to the lower levels. For these and other reasons, the Ministry of Health adopted the IDSR strategy that will focus on selected priority diseases. Although a significant progress has been made as far as the IDSR strategy is concerned, its implementation is facing several challenges. This is due to the fact that the current surveillance system has to utilize the existing HMIS system in collecting and compiling epidemiological data from health facility and district levels. This paper intends to discuss in detail challenges, which the Ministry of Health and district councils have to take into consideration during the implementation of IDSR strategy. Recommendations are also made for possible adoption to enable smooth running of the IDSR strategy at the national, district and facility levels. Tanzania Health Research Bulletin Vol.6(2) 2004: 57-6

Community knowledge, perceptions and practices on malaria in Mpwapwa District, central Tanzania

A study on community knowledge, attitudes and perception on malaria and its management was conducted in Mpwapwa district of central Tanzania in January-February 2001. Six villages, three with health facilities (Kibakwe, Makose and Mwanawota) and three without health facilities (Chogola, Kidenge and Wangi) lying between 975 and 1859 m above sea level were selected for the study. According to most respondents, the general health problems for adults in the district included malaria, diarrhoea, typhoid fever and pneumonia. Malaria, pneumonia and diarrhoea were the major health problems among children. Among pregnant women, malaria, abortions and diarrhoea were identified as the major public health problems in the district. In the view of most of villagers, malaria was the cause of most fevers and convulsions at low and intermediate altitudes. Cold weather was considered as the main predisposing factor to most of the fevers experienced in the highland villages. The common antimalarial drugs used in Mpwapwa district were chloroquine and quinine. The cost of antimalarial drugs ranged between TShs. 10/- and 20/- for one tablet of chloroquine, 600/- for chloroquine syrup, and 320/- for a single dose of chloroquine injection. However, shortage of drugs was frequently encountered in most of the health facilities. Traditional medicine practitioners were most frequently consulted for cases of convulsions in the district. Our findings showed that only 2.1% of the children in the district were sleeping under mosquito nets. The use of mosquito net was common among individuals living in the villages with health facilities than in those without health facilities. Generally, most respondents considered long distances to health facilities and inability to pay for health services as the main constraints in obtaining proper health care. Tanzania Health Research Bulletin Vol.6(2) 2004: 37-4

Participatory involvement of farming communities and public sectors in determining malaria control strategies in Mvomero District, Tanzania

No Abstract

Socio-Ecological Systems Analysis and Health System Readiness in Responding to Dengue Epidemics in Ilala and Kinondoni Districts, Tanzania

IntroductionSince 2010, Tanzania has been experiencing frequent outbreaks of dengue. The objectives of this study were to carry out a socio-ecological systems (SES) analysis to identify risk factors and interventions and assess the readiness of the district in the prevention and control of dengue.MethodsThe study utilized a cross-sectional purposive selection of key stakeholders responsible for disease surveillance and response in human and animal sectors in Ilala and Kinondoni districts in Tanzania. A SES framework was used to identify drivers and construct perceived thematic causal explanations of the dengue outbreaks in the study districts. A mapping exercise was carried out to analyse the performance of the disease surveillance system at district and facility levels. A semi-structured questionnaire was used to assess the districts’ readiness in the response to dengue outbreak.ResultsThe two districts were characterized by both urban and peri-urban ecosystems, with a mixture of planned and unplanned settlements which support breeding and proliferation of Aedes mosquitoes. The results indicate inadequate levels of readiness in the management and control of dengue outbreaks, in terms of clinical competence, diagnostic capacities, surveillance system and control/prevention measures. Mosquito breeding sites, especially discarded automobile tyres, were reported to be scattered in the districts. Constraining factors in implementing disease surveillance included both intrapersonal and interpersonal factors, lack of case management guidelines, difficult language used in standard case definitions, inadequate laboratory capacity, lack of appropriate rapid response teams, inadequate knowledge on outbreak investigation and inadequate capacities in data management.ConclusionThe two districts had limited readiness in the management and control of dengue, in terms of clinical competence, diagnostic capacities, surveillance system and prevention and control measures. These challenges require the immediate attention by the authorities, as they compromise the effectiveness of the national strategy for community health support.</jats:sec

Seroprevalence and associated risk factors of chikungunya, dengue, and Zika in eight districts in Tanzania

Background: This study was conducted to determine the seroprevalence and risk factors of chikungunya (CHIKV), dengue (DENV), and Zika (ZIKV) viruses in Tanzania. Methods: The study covered the districts of Buhigwe, Kalambo, Kilindi, Kinondoni, Kondoa, Kyela, Mvomero, and Ukerewe in Tanzania. Blood samples were collected from individuals recruited from households and healthcare facilities. An ELISA was used to screen for immunoglobulin G antibodies against CHIKV, DENV, and ZIKV. Results: A total of 1818 participants (median age 34 years) were recruited. The overall CHIKV, DENV, and ZIKV seroprevalence rates were 28.0%, 16.1%, and 6.8%, respectively. CHIKV prevalence was highest in Buhigwe (46.8%), DENV in Kinondoni (43.8%), and ZIKV in Ukerewe (10.6%) and Mvomero (10.6%). Increasing age and frequent mosquito bites were significantly associated with CHIKV and DENV seropositivity (P < 0.05). Having piped water or the presence of stagnant water around the home (P < 0.01) were associated with higher odds of DENV seropositivity. Fever was significantly associated with increased odds of CHIKV seropositivity (P < 0.001). Visiting mines had higher odds of ZIKV seropositivity (P < 0.05). Conclusions: These findings indicate that DENV, CHIKV, and ZIKV are circulating in diverse ecological zones of Tanzania. There is a need to strengthen the control of mosquito-borne viral diseases in Tanzania

Rift Valley fever seropositivity in humans and domestic ruminants and associated risk factors in Sengerema, Ilala, and Rufiji districts, Tanzania

Objectives Data on Rift Valley fever virus (RVFV) prevalence in urban settings and pastoral areas of Tanzania are scarce. We performed a cross-sectional study of RVFV seroprevalence and determinants in humans and animals from Ilala, Rufiji, and Sengerema districts of Tanzania. Methods Blood samples from the study participants were tested for anti-RVFV immunoglobulin G (IgG) antibodies using an enzyme-linked immunosorbent assay. Logistic regression was used to determine association between exposure risk practices and RVFV seropositivity. Results The study involved 664 humans, 361 cattle, 394 goats, and 242 sheep. The overall anti-RVFV IgG seroprevalence in humans and animals was 2.1% (95% confidence interval [CI] 0.01-0.04) and 9.5% (n = 95, 95% CI 0.08-0.12), respectively. Seroprevalence in humans in Rufiji, Ilala, and Sengerema was 3.0% (n = 225, 95% CI 0.01-0.06), 1.8% (n = 230, 95% CI-0.005- 0.04), and 1.4% (n = 209, 95% CI 0.01-0.04), respectively (P >0.05). Seroprevalence in animals in Sengerema, Rufiji, and Ilala was 12.1% (n = 40, 95% CI 0.09-0.16), 11.1% (n = 37, 95% CI 0.08-0.15), and 5.4% (n = 18, 95% CI 0.03-0.08), respectively (P = 0.006). Handling of carcasses increased the odds of RVFV seropositivity 12-fold (odds ratio 11.84, 95% CI 1.97-71.16). Conclusion The study confirms previous occurrence of RVFV in multiple species in the study districts. Animal handling practices appear to be essential determinants of seropositivity