BackgroundThe frequency and magnitude of Dengue epidemics have increased dramatically in the past 40 years throughout the tropics largely due to unplanned urbanization, globalization and lack of effective mosquito control. Dar es Salaam, Tanzania has recently experienced Dengue outbreaks that occur with increasing frequency. Currently, only one serotype is recorded. Without adequate vector monitoring and control, it is certain that further outbreaks will occur. Methods/FindingsA retrospective study followed 100 individuals with confirmed Dengue fever in Kinondoni, Dar es Salaam during the 2014 outbreak. Houses were inspected for mosquito breeding sites and gathered information on Socio-economic Status (SES) and Dengue prevention knowledge.Higher SES tertile had the most Dengue cases: 53 (55%) followed by medium and lower SES with 33 (34%) and 11 (11%) respectively. The highest number of mosquito breeding sites was also found in higher SES households. Kinondoni wards of Manzese, Mwananyamala, Tandale and Mabibo had the socioeconomic groups, combined. The public was ill-informed about Dengue fever: 84% think bed nets can prevent Dengue, and 60% of the patients only became aware of Dengue while in the hospital with the illness. The study established a habitat suitability score, a tool to be used to estimate breeding habitat capacity before rains begin. Scattered containers especially tyres remain ideal breeding sites.The study highlights the need for waste management to avert future outbreaks.
Background: Insecticide-treated Nets (ITNs) and house modifications are proven vector control tools, yet full coverage has frequently not been achieved. This study investigates factors associated with ITN access and use of house modification in Tanzania. Methods: Baseline data from cross-sectional surveys was analysed from 7,240 households in Bagamoyo (60km north of Dar es Salaam) and 1,241 households in Ulanga (a remote rural area), from previous studies on spatial repellants and indoor residual spray evaluation. We estimated the associations between the outcomes: population access to ITNs, ITN per sleeping spaces, presence of window screens and closed eaves, and the covariates household size, age, gender, pregnancy, education, mosquito entry (doors and windows), house modification (window screens & closed eaves), mean distance to mosquito breeding sites and wealth using regression models. Result: Population access to ITNs (households with one ITN per two potential people that stayed in the house the previous night of the survey) was 64% (56 - 71) and ITNs per sleeping spaces (households with enough ITNs to cover all sleeping spaces used the previous night of the survey) was 63% (54 - 72) in Bagamoyo, three years after the last Universal Coverage Campaigns (UCC). These findings are both lower than the 80% coverage target of the Tanzania National Malaria Strategic Plan (Tanzania NMSP). In Ulanga, population access to ITNs was 84% (78 - 91) and ITNs per sleeping spaces was 93% (89 - 97), one year after the last UCC. Household size was significantly associated with lower access to ITNs even shortly after UCC. House modification was common in both areas. In Bagamoyo, screened windows were more common than closed eaves (61% vs 14%) whereas in Ulanga more houses had closed eaves than window screens (55% vs 12%). Households in the poorest quintile were less likely to adopt window screening and closing eaves in Bagamoyo, this contrasts with Ulanga district where a greater proportion of poorer households blocked eaves with mud but were less likely to adopt screening.
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