Tuberculosis (TB) is one of the leading causes of adult mortality with 32% of the global population infected with Mycobacterium tuberculosis. The current control of TB depends mainly on case management using the Direct-Observed Treatment, Short-course (DOTs) regimen. Despite the measures taken, the disease burden is still on increase especially in the developing countries including Tanzania. Correct knowledge and positive perception of the community towards TB and its management is a prerequisite to early treatment seeking. This study was carried out in Mpwapwa district, central Tanzania, to assess the knowledge, attitudes and practice as regards to TB and its treatment. Focus group discussions involving men and women were conducted in six villages. Results show that TB was an important public health problem. However, community knowledge on its cause was poor. Symptoms of TB as mentioned by the community included persistent cough and weight loss. TB was reported to be transmitted mainly through air. Self medication was the first most preferred option, whereas health care facility consultation was the last one. Focus group discussants knew that TB cure requires a 8-month period of treatment. Friends and relatives were the main source of TB information in the community. In conclusion, rural communities of Mpwapwa District have a low knowledge on the causes and the transmission of tuberculosis which is a likely cause of the delay in seeking treatment. An intensive appropriate community health education is required for a positive behavioural change in tuberculosis control.

Background: Intermittent preventive treatment of malaria during pregnancy (IPTp) is a key intervention in the national strategy for malaria control in Tanzania. SP, the current drug of choice, is recommended to be administered in the second and third trimesters of pregnancy during antenatal care (ANC) visits. To allow for a proper design of planned scaling up of IPT services in Tanzania it is useful to understand the IPTp strategy's acceptability to health managers, ANC service providers and pregnant women. This study assesses the knowledge, attitudes and practices of these groups in relation to malaria control with emphasis on IPTp services.

Decentralization has been and is still high on the agenda in contemporary health sector reforms. However, despite extensive literature on the topic, little is known about the processes and results of decentralization, including the relationship with the control of major public health problems caused by communicable diseases. This paper reports from a study of decentralization and control of tropical diseases in districts implementing health sector and local government reforms in Tanzania. The study was undertaken in four districts, involving interviews and discussions with key stakeholders from individual household members to the district commissioner, and a review of official health policy, planning and management documents. The study findings reveal devolution of financial, planning and managerial authority being theoretical rather than practical, as district health plans are largely directed by national and international priorities rather than by local priorities. Vertical programmes still exist, focusing narrowly on single diseases. The local mechanisms for multisectoral collaboration, as well as community participation functions, are far from optimal. Further, inappropriate and weak information systems prevent adequate local responsiveness in setting priorities. In conclusion, decentralization might have a large potential for improving health system performance, but problems of implementation pose serious challenges to releasing this potential.

Background: Site preparation is a pre-requesite in conducting malaria vaccines trials. This study was conducted in 12 villages to determine malariometric indices and associated risk factors, during long and short rainy seasons, in an area with varying malaria transmission intensities in Korogwe district, Tanzania. Four villages had passive case detection (PCD) of fever system using village health workers.

Although critical for good case management and the monitoring of health interventions, the health-laboratory services in sub-Saharan Africa are grossly compromised by poor infrastructures and a lack of trained personnel, essential reagents and other supplies. The availability and quality of diagnostic services in 37 health laboratories in three districts of the Tanga region of Tanzania have recently been assessed. The results of the survey, which involved interviews with health workers, observations and a documentary review, revealed that malaria accounted for >50% of admissions and out-patient visits. Most (92%) of the laboratories were carrying out malaria diagnosis and 89% were measuring haemoglobin concentrations but only one (3%) was conducting culture and sensitivity tests, and those only on urine and pus samples. Only 14 (17%) of the 84 people found working in the visited laboratories were laboratory technologists with a diploma certificate or higher qualification. Sixteen (43%) of the study laboratories each had five or fewer types of equipment and only seven (19%) had more than 11 types each. Although 11 (30%) of the laboratories reported that they conducted internal quality control, none had standard operating procedures (SOP) on display or evidence of such quality assurance. Although malaria was the main health problem, diagnostic services for malaria and other diseases were inadequate and of poor quality because of the limited human resources, poor equipment and shortage of supplies. If the health services in Tanga are not to be overwhelmed by the progressively increasing burden of HIV/AIDS, malaria, tuberculosis and other emerging and re-emerging diseases, more funding and appropriate policies to improve the availability and quality of the area's diagnostic services will clearly be required.