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    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.


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.


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  • Volume 1

Hard Evidence from Tanzania

From all indications, data gathering is key to rolling out effective interventions to bring about the desired results. And after gathering data from the ground, over a period of time, a leading Tanzanian researcher has said that treating malaria with Coartem or ALu (Artemether-Lumefantrine) is safe.

This is based on studies conducted on over ten thousand (10,000) children treated in Kilumbelo, Ulanga and Rufiji.

“This is a very important message not only for the Ministry of Health in Tanzania but also Ministries of Health in other countries in Africa where this treatment is being used widely” says Dr Salim Abdulla, Director of the Ifakara Health Institute (IHI).

Gathering data from the field is what researchers are now calling for to ensure maximum health care services. And while some health workers are busy giving treatment,  their counterparts are in the fields trying to ensure that treatment is effective and safe and the patient is also doing just what the doctor ordered.

Working against reports and anxieties about resistance to malaria drugs in East Asia, researchers in Tanzania have been hard at work trying to assess whether recommended medicines cause any worrying side effects.

Speaking on the success of the INDEPTH Effectiveness and Safety Studies of antimalarials (INESS) he said the project has helped to assess the benefits that a community gets out of the new treatment for Malaria.

Dr Abdulla explained that while enhancing African capacity to monitor local health delivery, INESS also makes policy makers aware that Phase 4 trials are crucial for the safety and deployment of drugs, by providing hard evidence for drug policy changes across wide regions in Africa.

“In 2006 in Tanzania, we introduced Sulphadoxine-Pyrimethamine (SP) as the first-line treatment. One of the major comments from the community was the issue of side effects from SP as a treatment for Malaria. A lot of research had to be conducted at the time to be able say that this anti-malaria was safe to be used by children and pregnant mothers.”

“In anticipation of similar issues, we embarked on an assessment of Coartem which is now the standard treatment for malaria in Tanzania and many African countries. The information we have generated so far about the use of Coartem is very useful to show firstly, that it is safe to be used by mothers and children. Secondly, it provides the expected benefits of using this treatment in the community.”

Dr Abdulla said the work itself has been done in the Health and Demographic Surveillance System (HDSS).

“This is a platform in Tanzania where we have about five points recording in detail the occurrences of births, deaths and changes in the health of the community. We use this platform in this case to prove whether the recent introduction of Coartem in the community had its expected benefits.”

“And we did see the expected benefits both in terms of the number of people that went for treatment, those that were cured and the improvement in the behaviour of the community in seeking for care. The project has enabled us to develop innovative ways in improving the care of people with malaria.”

“One example is the use of technology to remind people of the need to take medication correctly. At the moment, we have used fingerprint technology first to identify people and secondly to be able to send our health workers to remind the mothers about the use of the treatment correctly.”

This project has brought out possibilities about the use of fingerprints to identify people to keep proper records to easily track what treatment was provided to a patient when the patient revisits the health facility.

“Another approach being considered now is the use of mobile technology to remind people through SMS messages of the need to take medication.

The IHI Director acknowledged challenges in the provision of quality care for malaria patients.

“We expect and always encourage mothers to bring their kids who are sick within the first 24 hours of any occurrence of an illness but you will find that many mothers delay in bringing their children to the Hospital. With this delay there is an increased risk that the child will develop the most severe form of malaria.”

“And the most severe form of malaria is much more expensive to treat and the likelihood of success is much reduced as compared to the uncomplicated form of malaria. It is very important for the caretakers and parents to bring the children very early when the child is sick.”

“Also we have difficulties in making correct diagnosis of the malaria cases in many communities and this is due to a variety of causes such as the non-availability of simple diagnostic tests that can tell a malaria fever from other causes of fever.”

“The current effort by the Ministry of Health to bring about these simple rapid tests to many peripheral health facilities is expected to reduce this problem by far.”

“We promote better communication between the care providers and the care givers of children about the best treatment for their children. We also encourage the mothers to adhere to the correct schedule for giving the medicines to the children.”

Dr Abdulla thinks the future looks good because the facilities and operations established, such as HDSS in Rufiji, Kilumbelo and Ulanga districts, will be maintained.

“And we will continue to provide information to the Ministry of Health about the impact of the new therapies that are introduced into the community. We would also want to expand the activities that we are currently doing and improving on the technology.”

“We will continue developing simple technology to provide reminders to caretakers especially those who have mobile phones access to send simple messages about health. These simple messages can be broadcast at a cheaper cost nowadays to a large population and providing benefits to those populations.”

“We are also looking at simplifying the diagnosis of malaria in communities. We will try and maintain the services we have established so far. Many communities are happy with the close follow-up that they receive from the health facilities participating in this programme.”

“Other parts of IHI will continue to develop new treatments, new therapies and vaccines. The hope is that we will be able to identify more effective vaccines that will eliminate the problem of malaria in our society.

The IHI, according to Dr Abdulla, will try to maintain the human capacity at the centres in a number of ways.

“We will maintain the services of our staff by integrating some components of the existing projects into the routine work of the HDSS. The HDSS is supported by different stakeholders including governments and bilateral partners so we would integrate some of these components into that system.”

“There will be other components that will be integrated within the Ministry of Health routine services provision. For example some of the information that is collected about patients is part of the routine health information system of the Ministry of Health so this will be maintained through that mechanism.”

- Charity Binka

Iness Edition