Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.
The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.
The government of Tanzania is known for its “determination” to halt the malaria scourge. The East African country with a population of nearly 45 million has attempted to tackle malaria by improving case management, vector control, prevention and control of malaria in pregnancy and preparedness against epidemics.
However, these approaches have encountered some challenges. They include problems like the healthcare system that is incapable of providing quality health services, limited access to prompt diagnosis and treatment, and an inefficient health education communication mechanism. Through its Phase IV studies, the INDEPTH Network has conducted a series of surveys from 2009 to 2012 with the aim of evaluating the effectiveness of artemisinin based combination therapy (ACT) and the health system in Tanzania as a whole.
Similar survey were conducted in Ghana, Burgkina Faso and Mozambique. In Tanzania, the INDEPTH Effectiveness and Safety Studies (INESS) revealed that less than 50% of malaria patients were accessing the recommended ACT treatment for malaria within 24 hours of the onset of illness.
“This observation was not just less than 80% target set by the Roll Back Malaria, but it was far below the level that was necessary to optimize ACT potential benefits,” says Dr. Rashid Khatib who is the coordinator of INESS project in Tanzania. According to Dr. Khatib, reduced timely access to treatment outlets is a major driver towards ACT efficacy decay in Africa.
“Efficacy decay means the failure of a drug to achieve good treatment results in the health systems similar to the one demonstrated in the experimental studies,” explains Dr. Khatib. He added that if a drug is not doing fine in the h e a l t h systems its impact on the community in malaria control is critically challenged. Treatment outlets include health facilities and Accredited Drug Dispensing Outlets (ADDO) popularly dubbed in Swahili as “duka la dawa muhimu.”
Another survey conducted by Ifakara Health Institute (IHI) in collaboration with the London School of Hygiene and Tropical Medicines reconfirmed that access to Artemether + Lumefantrine (ALu)—the approved first-line malaria treatment drug in the country - especially among the rural areas population in the southern regions of Tanzania remained a serious problem.
“Access to ACT is poor and very often these drugs are not targeted at patients who are actually suffering from malaria,” says Dr. Admirabilis Kalolela who is the manager of the IMPACT2 project at IHI.
Dr. Kalolela told stakeholders at a national dissemination meeting held in July 2013 that ACT subsidies are an effective way to improve availability, reduce price and increase the market share of quality assured ACTs in the private for-profit sector.
Responding to one of the challenges related to an inefficient health education communication mechanism, Dr. Khatib said IHI in collaboration with the Swiss Tropical and Public Health Institute (Swiss TPH) has designed and implemented a “behavioral change communication intervention” in one of the Health and Demographic Surveillance Systems (HDSS) sites.
This community-based implementation study known as “Response to Efficacy Decay” focuses on the formulation of health education messages that will be disseminated in the community to improve timely access to ACT outlets.
Phase one of the study involved essay writing and cartoon drawing competition among primary schools children in Rufiji HDSS area.
The INESS country coordinator said a sample of 11 out of 42 primary schools were selected and asked to engage their pupils to draw cartoons or write essays on malaria treatment seeking practices as they experience in their households and in their neighborhoods.
Leaders of the schools that were sampled to participate in the competition were encouraged to select the best pupils at writing and drawing who would participate in the competition.
At the prize awarding ceremony held at the Rufiji HDSS site in mid-June, the Rufiji District Education Officer Mr. Rashid Savannah said the district has 14% malaria prevalence, which is far above the national average of 9.1% and that the essays and cartoons would boost the level of ACT awareness among the Rufiji District population.
“We are extremely privileged to have this behavioral change communication project. It will surely change positively the attitude of our people towards ACT,” said Mr. Savannah. The top-three winning schools in each of the two categories were awarded sports and educational materials worth more than T Z S 1.3 million (US$850). Essay winners were from Nyamakonge, Mkumbuka and Ikwiriri Primary Schools, while the best cartoon drawers came from Uponda, Bungu and Msafiri Primary Schools.
“We are now embarking on the second phase that would involve the development and distribution of Information, Education and Communication (IEC) materials bearing health messages addressing the issues raised in the essays and cartoons,” explains Dr. Rashid Khatib. This over 300-million shilling project (US$186,841) on “Response to Efficacy D e cay ” intends to display the IEC materials in every prominent location in the study community such as market places, in schools, in health facilities, retail drug outlets, places of worship and government offices.
By Mbarwa Kivuyo - Tanzania