Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS
Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS
Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS
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MALARIA 11<strong>Malaria</strong> is a major public health concern for all <strong>Tanzania</strong>ns, especially for pregnant women<strong>and</strong> children under age five. The disease is a leading cause of morbidity <strong>and</strong> mortality amongoutpatient <strong>and</strong> inpatient admissions. It accounts for up to 40 percent of all outpatient attendances(MOHSW, 2008). Many parts of the country, including the upl<strong>and</strong>s, report malaria transmissionthroughout the year although it occurs more frequently during <strong>and</strong> after the rainy season (April toMay).<strong>Malaria</strong> is caused by four species of plasmodia parasites that are transmitted by Anophelesmosquitoes. In <strong>Tanzania</strong>, Plasmodium falciparum is the most common. Falciparum causes severemalaria, <strong>and</strong> is fatal if not recognized promptly <strong>and</strong> properly managed. The most severe cases occuramong persons who have not yet developed sufficient immunity to malaria through previousexposure. Children under age five are at highest risk, followed by pregnant women because of theirreduced natural immunity. Pregnant women are four times as likely to experience the complications ofmalaria as non-pregnant women, <strong>and</strong> malaria is a major cause of pregnancy loss, low birth weight,<strong>and</strong> neonatal mortality (Jamison et al., 1993).<strong>Malaria</strong> poses many societal <strong>and</strong> economic burdens in <strong>Tanzania</strong>, ranging from schoolabsenteeism to low productivity in the workplace. In the short term, widespread malaria illnessreduces agricultural production <strong>and</strong> other economic outputs; additionally, the accumulated effect inthe long-term may decrease national economic capacity <strong>and</strong> development.The international Roll Back <strong>Malaria</strong> (RBM) Initiative works to reduce the malaria burden.The primary objective of RBM is to increase access to the most effective <strong>and</strong> affordable protectivemeasures. These measures include use of insecticide-treated mosquito nets (ITNs) for sleeping <strong>and</strong>increased coverage of prompt <strong>and</strong> effective treatment for malaria. The Initiative also promotes the useof intermittent preventive treatment (IPT) of malaria among pregnant women. In <strong>Tanzania</strong>, therecommendations of the RBMI are implemented through the National <strong>Malaria</strong> Control Strategy(MOHSW, 2002). The National <strong>Malaria</strong> Control Strategy also includes other vector control measuressuch as indoor residual spraying (IRS) <strong>and</strong> epidemic prevention <strong>and</strong> control.The Government of <strong>Tanzania</strong>, primarily through the Ministry of Health <strong>and</strong> Social Welfare, iscommitted to the control <strong>and</strong> prevention of malaria. A considerable amount of the health budget isallocated to address malaria <strong>and</strong> malaria-related illnesses. Household expenditures related to malariaare high <strong>and</strong> are mainly spent on malaria treatment. These costs are expected to rise substantiallybecause of the recent introduction of artemisinin-based combination therapy (ACT). In the 2007-08THMIS, ACT was the first-line drug for treatment of malaria in both Mainl<strong>and</strong> <strong>Tanzania</strong> <strong>and</strong>Zanzibar. ACT is a response to the emerging resistance of malaria parasites to mono-therapyantimalarial drugs like sulphadoxine pyrimethamine (SP) <strong>and</strong> chloroquine, which used to be first-lineantimalarial drugs in <strong>Tanzania</strong>.The <strong>Malaria</strong> <strong>Indicator</strong> <strong>Survey</strong> (MIS) component of the 2007-08 THMIS measures malariaprevention <strong>and</strong> treatment outcomes including household coverage of malaria interventions, possession<strong>and</strong> use of ITNs, IRS activities, access to prompt antimalarial treatment among children under agefive with a fever, <strong>and</strong> use of IPT among pregnant women. Many of the indicators were assessed in the2004-05 T<strong>DHS</strong>, which allows for trend analysis.In the 2007-08 THMIS, blood samples were collected from children age 6-59 months insampled households to detect the presence of malaria parasites <strong>and</strong> to estimate haemoglobin levels foranaemia prevalence. Anaemia testing was carried out in the 2004-05 T<strong>DHS</strong>, but the categories weredifferent <strong>and</strong> not comparable with those in the 2007-08 THMIS.<strong>Malaria</strong> | 133