Malaria control in Tanzania

Yhdego, Michael; Majura, Paul B.

doi:10.1016/0160-4120(88)90408-4

Cited by 16 publications

(8 citation statements)

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“…With respect to costs, US$ 30,800 was spent during the initial massive cleaning in Temeke (US$ 18/meter), and US$ 23,000 (US$ 11/meter) in Kinondoni. These costs could have been higher if major structural repairs were necessary; maintenance, however, can be performed at very low costs [ 32 , 33 ]. Each municipality has the autonomy to allocate funds, and an important difference was observed in the maintenance protocol.…”

Section: Resultsmentioning

confidence: 99%

Community-based environmental management for malaria control: evidence from a small-scale intervention in Dar es Salaam, Tanzania

Castro

Tsuruta²,

Kanamori

et al. 2009

Malar J

106

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BackgroundHistorically, environmental management has brought important achievements in malaria control and overall improvements of health conditions. Currently, however, implementation is often considered not to be cost-effective. A community-based environmental management for malaria control was conducted in Dar es Salaam between 2005 and 2007. After community sensitization, two drains were cleaned followed by maintenance. This paper assessed the impact of the intervention on community awareness, prevalence of malaria infection, and Anopheles larval presence in drains.MethodsA survey was conducted in neighbourhoods adjacent to cleaned drains; for comparison, neighbourhoods adjacent to two drains treated with larvicides and two drains under no intervention were also surveyed. Data routinely collected by the Urban Malaria Control Programme were also used. Diverse impacts were evaluated through comparison of means, odds ratios (OR), logistic regression, and time trends calculated by moving averages.ResultsIndividual awareness of health risks and intervention goals were significantly higher among sensitized neighbourhoods. A reduction in the odds of malaria infection during the post-cleaning period in intervention neighbourhoods was observed when compared to the pre-cleaning period (OR = 0.12, 95% CI 0.05–0.3, p < 0.001). During the post-cleaning period, a higher risk of infection (OR = 1.7, 95% CI 1.1–2.4, p = 0.0069) was observed in neighbourhoods under no intervention compared to intervention ones. Eighteen months after the initial cleaning, one of the drains was still clean due to continued maintenance efforts (it contained no waste materials and the water was flowing at normal velocity). A three-month moving average of the percentage of water habitats in that drain containing pupae and/or Anopheles larvae indicated a decline in larval density. In the other drain, lack of proper resources and local commitment limited success.ConclusionAlthough environmental management was historically coordinated by authoritarian/colonial regimes or by industries/corporations, its successful implementation as part of an integrated vector management framework for malaria control under democratic governments can be possible if four conditions are observed: political will and commitment, community sensitization and participation, provision of financial resources for initial cleaning and structural repairs, and inter-sectoral collaboration. Such effort not only is expected to reduce malaria transmission, but has the potential to empower communities, improve health and environmental conditions, and ultimately contribute to poverty alleviation and sustainable development.

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Section: Resultsmentioning

confidence: 99%

Community-based environmental management for malaria control: evidence from a small-scale intervention in Dar es Salaam, Tanzania

Castro

Tsuruta²,

Kanamori

et al. 2009

Malar J

106

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“…Nevertheless, it is important to keep in mind that although the initial cost of this intervention might be high, it will be amortized over time, since only maintenance of the drains would be necessary in the future, a duty that can be taken over by the community. 39,40 The current pace of urbanization and population growth in Africa suggests that a large proportion of people will be exposed to malaria transmission in urban zones. 17 In fact, we estimate that at the present time, 198 million Africans live in urban areas at risk of contracting malaria, and that 24.8-103.2 million clinical attacks occur annually in those areas.…”

Section: Discussionmentioning

confidence: 99%

Integrated Urban Malaria Control: A Case Study in Dar Es Salaam, Tanzania

Castro¹,

Yamagata²,

Mtasiwa³

et al. 2004

The American Journal of Tropical Medicine and Hygiene

136

168

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The rapid growth of cities in sub-Saharan Africa, much of it driven by rural-urban migration, is associated with complex transformations of these ecosystems and an intricate set of challenges for malaria control. Urban malaria transmission is substantially less intense and much more focal than in rural and peri-urban settings. However, the danger of epidemics is higher and the presence of substantial non-immune populations places people of all ages at comparable levels of risk. The limited number of breeding sites in urban centers suggests that prevention strategies based on vector control, with emphasis on environmental management, should be a central feature of urban malaria control programs. We focus on malaria in the city of Dar es Salaam, Tanzania. Following a brief review of the 100-year history of malaria control in this urban center, we describe and evaluate a control program that operated from 1988 to 1996 as a consequence of a bilateral agreement between the governments of Tanzania and Japan. We present an innovative urban malaria risk mapping methodology based on high-resolution aerial photography with ground-based validation. This strategy clarifies that remote sensing technology at a level of resolution of one meter is essential if this kind of information is to play a role in guiding the detailed specification of intervention strategies for urban malaria control. The Tanzania-Japan multiple-intervention malaria control program, adaptively implemented over time, is described and evaluated with implications for urban malaria control in sub-Saharan Africa more generally.

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“…The climate is tropical humid with two rainy seasons – the long rains during the months of April and May and the short rains of October and November. Malaria transmission is year-round [38] with peaks in incidence after the two rainy seasons. Plasmodium falciparum accounts for more than 90% of cases and the principal vectors involved in malaria transmission are An.…”

Section: Methodsmentioning

confidence: 99%

Impact of Community-Based Larviciding on the Prevalence of Malaria Infection in Dar es Salaam, Tanzania

2013

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BackgroundThe use of larval source management is not prioritized by contemporary malaria control programs in sub-Saharan Africa despite historical success. Larviciding, in particular, could be effective in urban areas where transmission is focal and accessibility to Anopheles breeding habitats is generally easier than in rural settings. The objective of this study is to assess the effectiveness of a community-based microbial larviciding intervention to reduce the prevalence of malaria infection in Dar es Salaam, United Republic of Tanzania.Methods and FindingsLarviciding was implemented in 3 out of 15 targeted wards of Dar es Salaam in 2006 after two years of baseline data collection. This intervention was subsequently scaled up to 9 wards a year later, and to all 15 targeted wards in 2008. Continuous randomized cluster sampling of malaria prevalence and socio-demographic characteristics was carried out during 6 survey rounds (2004–2008), which included both cross-sectional and longitudinal data (N = 64,537). Bayesian random effects logistic regression models were used to quantify the effect of the intervention on malaria prevalence at the individual level. Effect size estimates suggest a significant protective effect of the larviciding intervention. After adjustment for confounders, the odds of individuals living in areas treated with larviciding being infected with malaria were 21% lower (Odds Ratio = 0.79; 95% Credible Intervals: 0.66–0.93) than those who lived in areas not treated. The larviciding intervention was most effective during dry seasons and had synergistic effects with other protective measures such as use of insecticide-treated bed nets and house proofing (i.e., complete ceiling or window screens).ConclusionA large-scale community-based larviciding intervention significantly reduced the prevalence of malaria infection in urban Dar es Salaam.

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Malaria control in Tanzania

Cited by 16 publications

References 0 publications

Community-based environmental management for malaria control: evidence from a small-scale intervention in Dar es Salaam, Tanzania

Community-based environmental management for malaria control: evidence from a small-scale intervention in Dar es Salaam, Tanzania

Integrated Urban Malaria Control: A Case Study in Dar Es Salaam, Tanzania

Impact of Community-Based Larviciding on the Prevalence of Malaria Infection in Dar es Salaam, Tanzania

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