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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

A new lease of life

Maua Mpendu, 58, lives with her husband at Jaribu Mpakani village in the Rufiji District of the Pwani Region in Tanzania. With a heavy heart, she reflects on the past when medical care was a challenge in her village.

She suspects that malaria was responsible for the death of all her five children. “All my children died,” Maua often tells people.

 “We depended on traditional herbs to treat ailments, unlike today when doctors can even phone people to know whether the drugs they got from a health facility are making them better. It is the work of God,” she says.

Maua’s story is an indication of how much progress has taken place between then and now. Her mention of doctors’ current treatment arrangements is an acknowledgement of a new, better health care for the communities.

She notes with appreciation that these days the routine treatment has taken a new form — doctors now do a follow up of patients using mobile phones.

Information and Communication Technology (ICT) devices have started playing a role to enhance follow up of the patients to improve compliance to prescribed doses. A few years ago, no one imagined that a day would come when a mobile phone could be used for the provision of healthcare services in rural areas.

But today the story is different. Like in other African countries, the use of mobile phone technology is changing the landscape of healthcare delivery in Tanzania.

The introduction of mobile phone follow up is appreciated by thirty (30) year-old Juliana Soneka, a member of the Maasai tribe in Bungu village.
“I feel so happy when the doctors call me to ask how my child is doing after taking ALu,” she says. The doctors are so nice to us, they are like our parents.”

Clinicians working with Ifakara Health Institute are forerunners of the mobile health (m-Health) project. The purpose of using mobile phones to follow up the patients at their homes is to monitor the performance of the Artemether/lumefantrine (ALu) drugs in the treatment of uncomplicated malaria.

ALu commonly called “mseto” in Tanzania is the approved first line treatment for malaria in Tanzania. The drug was passed since 2006 after demonstrating its capacity to kick-start “high hemoglobin recovery rate, and high fever and parasite clearance speed,” says Dr. Kefas Mugittu, a biomedical researcher at IHI’s Bagamoyo site.

Despite the high performance of ALu, it was not until 2009 that a mechanism to monitor its performance in real life was introduced through the INDEPTH Effectiveness and Safety Studies of antimalarials (INESS).

One of the districts where INESS has shown initial results is the Rufiji District, about 150 km south of the commercial city of Dar es Salaam.

Rufiji District is one of the low-income districts with a population of over 250,000 people scattered across 13,339 kilometres square. Road networks are underdeveloped thus transportation is a challenge.

 “We appreciate the progress that has been made so far,” says the Director General of Tanzania’s Commission for Science and Technology, Dr. Hassan Mshinda.

He said “INESS would help us monitor the effectiveness and safety of drugs in real life setting. Mobile phone technology has tremendously transformed the practice of medicine and public health in the rural areas.”

INESS supervisor at Bunju dispensary, Sajidu Ismail, said their role is to monitor the safety and efficacy of ALu.

“We follow up patients in the first four to 10 days after using ALu, and we record any events that have occurred,” he said.

Ismail said initial results show very few cases of low response to ALu. “Failure of drugs depends on the prescriber, the dispenser and the end user. Any anomaly will result in poor performance of the drug.” 

He further said many antimalarial drugs have failed because of poor adherence due to inadequate monitoring to see how the drug is prescribed and used by the patients.

There is a tendency of a patient to stop taking the drugs after feeling better. The use of mobile phones has improved the healthcare delivery in the district.

INESS project is undertaking Phase IV effectiveness and safety studies of new combination therapies for malaria in 7 INDEPTH Demographic Surveillance System (DSS) sites in 4 African countries. 

This project effectively creates the missing final section of the drug development pipeline for Africa to ensure rapid access to practical evidence on treatment effectiveness from local experience.

The main product of the platform is a longitudinal evidence base to allow assessment of efficacious drugs in real life settings.

The purpose is to minimize the time gap between licensure and adoption of new anti-malarial by providing objective endemic country effectiveness data that will help inform global and national policy and practice.

This project will also enhance capacity in Africa to monitor local health systems in order to track costs, effective coverage and effects of new or alternative post-registration antimalarial treatments.

- By Mbarwa Kivuyo-Tanzania


Iness Edition