Tanzania HIV/AIDS and Malaria Indicator Survey ... - Measure DHS

MALARIA 11Malaria is a major public health concern for all Tanzanians, especially for pregnant womenand children under age five. The disease is a leading cause of morbidity and mortality amongoutpatient and inpatient admissions. It accounts for up to 40 percent of all outpatient attendances(MOHSW, 2008). Many parts of the country, including the uplands, report malaria transmissionthroughout the year although it occurs more frequently during and after the rainy season (April toMay).Malaria is caused by four species of plasmodia parasites that are transmitted by Anophelesmosquitoes. In Tanzania, Plasmodium falciparum is the most common. Falciparum causes severemalaria, and is fatal if not recognized promptly and 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, and malaria is a major cause of pregnancy loss, low birth weight,and neonatal mortality (Jamison et al., 1993).Malaria poses many societal and economic burdens in Tanzania, ranging from schoolabsenteeism to low productivity in the workplace. In the short term, widespread malaria illnessreduces agricultural production and other economic outputs; additionally, the accumulated effect inthe long-term may decrease national economic capacity and development.The international Roll Back Malaria (RBM) Initiative works to reduce the malaria burden.The primary objective of RBM is to increase access to the most effective and affordable protectivemeasures. These measures include use of insecticide-treated mosquito nets (ITNs) for sleeping andincreased coverage of prompt and effective treatment for malaria. The Initiative also promotes the useof intermittent preventive treatment (IPT) of malaria among pregnant women. In Tanzania, therecommendations of the RBMI are implemented through the National Malaria Control Strategy(MOHSW, 2002). The National Malaria Control Strategy also includes other vector control measuressuch as indoor residual spraying (IRS) and epidemic prevention and control.The Government of Tanzania, primarily through the Ministry of Health and Social Welfare, iscommitted to the control and prevention of malaria. A considerable amount of the health budget isallocated to address malaria and malaria-related illnesses. Household expenditures related to malariaare high and 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 Mainland Tanzania andZanzibar. ACT is a response to the emerging resistance of malaria parasites to mono-therapyantimalarial drugs like sulphadoxine pyrimethamine (SP) and chloroquine, which used to be first-lineantimalarial drugs in Tanzania.The Malaria Indicator Survey (MIS) component of the 2007-08 THMIS measures malariaprevention and treatment outcomes including household coverage of malaria interventions, possessionand use of ITNs, IRS activities, access to prompt antimalarial treatment among children under agefive with a fever, and use of IPT among pregnant women. Many of the indicators were assessed in the2004-05 TDHS, 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 and to estimate haemoglobin levels foranaemia prevalence. Anaemia testing was carried out in the 2004-05 TDHS, but the categories weredifferent and not comparable with those in the 2007-08 THMIS.Malaria | 133