BackgroundEarly diagnosis and timely treatment of malaria is recognized as a fundamental element to the control of the disease. Although access to health services in Tanzania is improved, still many people seek medical care when it is too late or not at all. This study aimed to determine factors associated with delay in seeking treatment for fever among children under five in Tanzania.MethodsA three-stage cluster sampling design was used to sample households with children under five in Dodoma region, central Tanzania between October 2010 and January 2011. Information on illness and health-seeking behaviours in the previous four weeks was collected using a structured questionnaire. A multivariable logistic regression was used to investigate determinants of delay in treatment-seeking behaviour while accounting for sample design.ResultsA total of 287 under-five children with fever whose caretakers sought medical care were involved in the study. Of these, 55.4% were taken for medical care after 24 hours of onset of fever. The median time of delay in fever care seeking was two days. Children who lived with both biological parents were less likely to be delayed for medical care compared to those with either one or both of their biological parents absent from home (OR = 0.42, 95% CI: 0.24, 0.74). Children from households with two to three under-five children were more likely to be delayed for medical care compared to children from households with only one child (OR = 1.54, 95% CI: 1.04, 2.26). Also, children living in a distance ≥5 kilometres from the nearest health facility were about twice (95% CI: 1.11, 2.72) as likely to delay to be taken for medical care than those in the shorter distances.ConclusionLiving with non-biological parents, high number of under-fives in household, and long distance to the nearest health facility were important factors for delay in seeking healthcare. Programmes to improve education on equity in social services, family planning, and access to health facilities are required for better healthcare and development of children.

Access to improved sanitation facilities has been a challenge, especially in developing countries. In 2012, Tanzania launched a rural-based National Sanitation Campaign to address the challenge of low coverage of improved sanitation and hygiene at household and school levels using a combination of approaches including Community-Led Total Sanitation (CLTS) and behavior change communication. In June 2016, a study that involved interviews with heads of households, complemented by observations of sanitation and hygiene facilities in 2,875 households from 289 villages, was carried out in campaign and non-campaign villages. Overall, 94.7% of the households had a basic toilet; whereas 7.0% of the households from non-campaign villages against 3.5% from the campaign villages had no toilet. Moreover, overall coverage of improved sanitation was found to be 52.6% and varied between campaign (62%) and non-campaign (43%) villages. Hand washing points were hardly observed in both campaign and non-campaign villages, although they differed significantly between the two areas: 42.7 vs. 26.7% for campaign and non-campaign villages, respectively. Factors associated with households' access to improved latrines include economic status of the household, education level of the head of household and geographical location of the household. Further studies are needed before drawing clear-cut conclusions about the impact of the campaign.

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BackgroundHealth risks associated with poor sanitation behaviours continue to be reported mostly from low-income countries (LICs). Reports show that various factors limit many people from accessing and using improved latrines, forcing some to opt for sharing latrines with neighbours, others practicing open defecation. Meanwhile, debate prevails on whether shared latrines should be categorised as unimproved according to WHO/UNICEF-JMP criteria. We contribute to this debate based on results from a study undertaken in three regions, Tanzania.Materials and methodsData were collected through observations in 1,751 households with latrines, coupled with collection of opinions from heads of such households regarding the latrine-sharing practices. Bivariate and multivariate logistic regression analyses were performed to assess associations between the outcome and possible predictor variables.ResultsOf all 1,751 latrines, 14.6% were shared. Among the shared latrines, 74.2% were found being generally clean as compared to 69.2% of the non-shared ones. Comparing the shared and non-shared latrines, the non-shared latrines were significantly less likely to be found with floors built with permanent materials (OR = 0.73, 95% CI: 0.55, 0.98); washable floors (OR = 0.69; 95% CI: 0.51, 0.93); and lockable doors (OR = 0.73; 95% CI: 0.56, 0.95). Shared latrines were less likely to have floors with faecal matter, functional handwashing facilities (HWFs), HWFs with running water, and roofs; albeit the differences in all these scenarios were not statistically significant. Respondents expressed desire for improved latrines, but also did not find it wrong to share latrines if cleanliness was maintained.ConclusionHaving an ‘improved’ latrine remains important as JMP recommends, but based on our study findings, we argue that possessing a non-shared latrine neither guarantees safety to its users nor its categorisation as ‘improved’. Instead, the state of the latrine, the construction technology used and the behaviours of the users may be more important.

Proper trend analysis of rainfall data is necessary for social and economic planning especially in the tropics where rainfall is a major limiting factor for crop production. In spite of the growing number of studies on climatic variables including rainfall in recent years, in the context of Tanzania little is known as to whether or not the observed time trend in rainfall in recent years is statistically significant. This study examines the evolution of rainfall in central zone focusing on Dodoma region and ascertains whether the observed time trend in rainfall is significant in statistical terms. Also, the study establishes whether there was a shift in the distribution of rainfall for both short and long rainy seasons in the study area. The data for the analysis consists of monthly rainfall (mm) records covering the period from January, 1981 to December, 2010. Linear regression analysis through OLS estimation and the Kruskal-Wallis and Mann-Kendall's tau test statistics were employed. The data demonstrate that rainfall in the study area is unpredictable both in terms of onset and cessation. The mean annual rainfall during the years 1981-2010 displayed a decreasing trend with the years 1981-1989 recording the highest mean annual rainfall as opposed to the succeeding two periods: 1990-1999 and 2000-2010. Overall, the mean annual rainfall has declined by about 4% between the periods 1981-1989 and 2000-2010. Parametric and nonparametric analysis results did not find any statistically significant evidence of a trend in the amount of rainfall in Dodoma region over the last 30 years. Nevertheless, there was a shift in the distribution of rainfall for both short and long rainy seasons. The study recommends for further research that will include rainfall data from the various zones of Mainland Tanzania in order to permit a comparative analysis of the issues examined in this study.