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

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Table 11.6—ContinuedPercentage of children who tookspecific antimalarial drugsOtherantimalarialPercentage of children who took specificantimalarial drugs the same dayor the next dayNumberofchildrenwithfeverBackgroundSP/ Chloro- Amodia-ALu/SP/ Chloro- Amodia-ALu/characteristicFansidar quine quine Quinine Coartem Fansidar quine quine Quinine CoartemZoneWestern 3.4 0.0 29.1 8.7 13.4 2.3 0.4 0.0 19.7 3.3 7.9 265Northern 8.6 0.6 7.6 9.5 22.4 1.7 3.6 0.6 4.8 2.8 11.6 183Central 2.6 0.0 8.4 4.2 17.3 0.0 2.6 0.0 7.1 2.6 14.0 62Southern Highlands 2.0 0.0 10.2 17.5 29.0 0.0 2.0 0.0 8.2 8.8 17.4 125Lake 3.0 0.9 22.3 10.9 14.4 1.4 1.8 0.0 8.4 6.4 9.2 343Eastern 10.9 1.2 13.9 13.4 33.3 2.8 7.8 1.2 12.3 7.8 25.4 191Southern 3.0 0.0 18.4 17.3 31.7 1.3 0.5 0.0 10.2 10.0 22.9 150Zanzibar 8.6 0.0 11.4 3.0 10.3 4.8 6.9 0.0 9.3 3.0 8.4 23Wealth quintileLowest 2.1 0.3 14.5 7.7 14.0 1.8 0.0 0.0 7.4 3.2 8.2 280Second 3.8 0.0 21.1 11.2 24.7 0.7 1.7 0.0 12.4 6.0 16.8 296Middle 4.7 1.4 19.3 10.6 17.5 0.3 3.3 0.7 9.4 5.2 9.5 317Fourth 4.2 0.4 20.0 11.6 25.2 1.3 3.3 0.4 13.9 4.2 17.0 233Highest 11.4 0.0 14.6 18.0 27.6 5.1 5.6 0.0 11.9 12.0 21.5 218Total 5.0 0.5 18.1 11.5 21.3 1.6 2.6 0.2 10.8 5.9 14.1 1,343Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweightedcases and has been suppressedIn Mainland Tanzania, ALu is currently the recommended first-line antimalarial drug, andamodiaquine, a monotherapy drug, is no longer recommended. Table 11.6 shows that across MainlandTanzania, 22 percent of children with a fever are treated with ALu, while 18 percent are still treatedwith amodiaquine. Quinine, the recommended second-line antimalarial drug at the time of the survey,was given to 12 percent of children with a fever, a similar proportion to the 2004-05 TDHS (12percent), which had quinine as a third-line treatment for uncomplicated malaria.In Zanzibar, the first-line antimalarial treatment is amodiaquine, and Alu is the second line oftreatment. Table 11.6 shows that 11 percent of children with fever in Zanzibar received amodiaquineand 10 percent received Alu. The use of amodiaquine is also higher than Alu in the 2004-05 TDHS(38 and 36 percent, respectively).Children age 12-23 months are more likely than those in Zanzibar younger or older childrento be treated with ALu (31percent compared with 19 percent or less). The chances of a child beingtreated with ALu the same day or next day are higher in Mainland (14 percent) than in Zanzibar (8percent). Treatment with ALu varies substantially across regions in Mainland Tanzania. Mwanza andShinyanga regions have the lowest proportion of children treated with ALu (8 and 9 percent,respectively), while Morogoro and Lindi have the highest proportions (36 percent each).In general, children whose mothers have formal education are more likely than those whosemothers have no education to receive ALu and to be treated with ALu on the same or next day.Children in urban areas are more likely to receive ALu than children in rural areas (27 and 20 percent,respectively).Wealth status has a positive relationship with prompt treatment of fever with Alu. Childrenfrom the wealthiest households are the most likely to receive ALu and to be treated with ALu on thesame or next day.Malaria | 143
11.4.2 Availability of Drug at HomeTable 11.7 shows that for 17 percent of childrenwho had fever and took any antimalarial drug, the drugwas available at home. Availability of drugs at homevaries by the type of drug; it is 11 percent for childrenwho took ACT, 20 percent each for children who tookAmodiaguine and Quinine, and 30 percent for childrenwho were given SP/Fansidar (data not shown).11.5 INDOOR RESIDUAL SPRAYINGIndoor residual spraying (IRS) has a significantimpact on mosquito densities, and therefore leads to arapid reduction of malaria transmission and mortality.To reduce the incidence of malaria in a targeted area,WHO recommends that IRS be conducted in at least 85percent of households. Repeated spraying is essential tomaintain effectiveness against mosquitoes. The frequency of spraying is determined by the insecticideused, for example spraying of Lambda Cyhalothrin should be repeated approximately every sixmonths.Mainland Tanzania has recently adopted the IRS strategy—one of the Integrated Managementof Vector Control Strategies (IMVC)—to complement scaling up the use of LLINs both in epidemicand malaria-endemic areas. It is envisaged that scaling up of IRS, in conjunction with increased LLINcoverage and availability of ACT, will rapidly reduce malaria transmission and contribute tosignificant reductions in the burden of malaria, leading ultimately to the elimination of malaria.Since 2007, IRS operations in Mainland Tanzania have been limited to two districts (Mulebaand Karagwe) in Kagera region, where repeated spraying has been carried out in more than 10 percentof households. Plans are underway to scale up IRS coverage to about half of the districts in MainlandTanzania by the end of 2013.In Zanzibar, IRS operations began in 2006 and covered both islands (Unguja and Pemba)using lambda cyhalothrin. Since then, spraying has been conducted every six months; the lastspraying cycle was in July 2007. In all spraying cycles, over 85 percent of the targeted householdswere protected against malaria. At the time of the survey, IRS operations in Tanzania and Zanzibarwere operated by the Government. However, the question on indoor residual spraying may have beenmisinterpreted to include fumigation, which has little impact on community-level malaria transmission.11.5.1 Timing of Last Indoor Residual SprayingTable 11.7 Availability at home of antimalarial drugstaken by children with feverAmong children under age five who had fever in thetwo weeks preceding the survey and who took specificantimalarial drugs, the percentage for whom the drugwas at home when the child became ill with fever,Tanzania HMIS 2007-08Percentagefor whomantimalarialdrug was athome whenchild becameill with feverNumber ofchildren whotook thespecificantimalarialdrugsDrugSP/Fansidar 30.3 67Amodiaquine 19.5 243Quinine 20.0 155ACT 10.8 287Other antimalarial (0.0) 28Any antimalarial drugs 16.7 762Note: Figures in parentheses are based on 25-49unweighted cases.Table 11.8 shows IRS operations conducted in the past 12 months. Overall, only 4 percent ofhouseholds in Tanzania reported having their house sprayed; 1 percent were sprayed less than threemonths prior to the survey, and 3 percent were sprayed between 3 to 6 months before the survey. Overthe past 12 months, households in Zanzibar were more likely to be sprayed than households inMainland Tanzania (94 and 2 percent, respectively). In Kagera region in Mainland Tanzania, whereIRS has been implemented on a small scale, 8 percent of households were sprayed in the 3 monthsbefore the survey.There are variations in household spraying across wealth quintiles; wealthier households (5percent) were more likely to have been sprayed in the 3 to 6 months preceding the survey than poorerhouseholds (1 percent).144 | Malaria
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TanzaniaHIV/AIDS and MalariaIndicat
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The 2007-08 Tanzania HIV/AIDS and M
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3.5 Access to Mass Media ..........
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12.2 Orphans and Vulnerable Childre
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Table 4.3Table 4.4Table 4.5Table 4.
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Figure 9.2 HIV Prevlence by Region/
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FOREWORDThis report presents the ma
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SUMMARY OF FINDINGSThe 2007-08 Tanz
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HIV prevalence among youth (women a
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xxii | Map of Tanzania
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1.2 NATIONAL POLICY ON HIV/AIDSIn r
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To assess levels and trends in know
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1.8 FIELDWORKData collection was ca
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Table 1.1 Results of the household
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Figure 2.1 presents a graphic pictu
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Table 2.3.1 Educational attainment
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Educational attainment is higher in
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2.5.1 Energy SourcesTable 2.5 prese
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The most common items are agricultu
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The 2007-08 THMIS included aquestio
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Table 3.1—ContinuedBackgroundchar
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Education is positively related to
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Table 3.3.2 Employment status: MenP
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Table 3.4.1 Exposure to mass media:
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3.6 CURRENT MARITAL STATUSMarriage
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Polygyny also varies by household w
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Four in ten women age 20-49 marry b
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There is a positive relationship be
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FERTILITY AND REPRODUCTIVE HEALTH 4
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Table 4.2 Fertility by background c
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infertility, 1 or the inability to
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4.3 ADOLESCENT FERTILITYAdolescent
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Table 4.7 Antenatal carePercent dis
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Table 4.8 Place of antenatal carePe
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Table 5.1 Knowledge of AIDSPercenta
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The use of condoms as an effective
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Table 5.3.2 Comprehensive knowledge
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more education) and those in the fo
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Table 5.5.1 Exposure to HIV educati
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5.6 KNOWLEDGE AND ATTITUDE CONCERNI
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Table 5.6.2 Knowledge and attitudes
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Table 6.1.1 Accepting attitudes tow
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Stigma is also found to vary with l
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6.3 ATTITUDES OF ADULTS TOWARDS EDU
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HIV/AIDS-RELATED BEHAVIOUR 77.1 INT
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Table 7.2.1 Recent sexual activity:
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Figure 7.1 Recent Sexual Intercours
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Table 7.3.2 Multiple sexual partner
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Table 7.4 Payment for sexual interc
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Table 7.5.1 Coverage of prior HIV t
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Figure 7.2 Prior HIV Testing by Edu
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7.7 PREVALENCE OF SEXUALLY TRANSMIT
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Figure 7.3 Prevalence of STIs and S
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Table 7.8 Prevalence of medical inj
Page 117 and 118: Table 8.1 Comprehensive knowledge a
Page 119 and 120: Table 8.2 Age at first sexual inter
Page 121 and 122: Never-married women and men age 15-
Page 123 and 124: Figure 8.3 Condom Use at Premarital
Page 125 and 126: Table 8.5.2 Higher-risk sexual inte
Page 127 and 128: Table 8.6 Age-mixing in sexual rela
Page 129 and 130: 8.9 HIV TESTING AMONG YOUNG PEOPLEK
Page 132 and 133: HIV PREVALENCE 99.1 INTRODUCTIONPri
Page 134 and 135: Table 9.1 Coverage of HIV testing b
Page 136 and 137: Table 9.1—ContinuedBackgroundchar
Page 138 and 139: Table 9.3 HIV prevalence by ageAmon
Page 140 and 141: There are large variations in HIV p
Page 142 and 143: Table 9.5 shows that men who are cu
Page 144 and 145: Women who said they had higher-risk
Page 146 and 147: Table 9.8 shows data on HIV prevale
Page 148 and 149: Table 9.11 HIV prevalence by male c
Page 150 and 151: INFANT AND CHILD MORTALITY 1010.1 I
Page 152 and 153: As expected, the level of infant an
Page 154: category (1.41) is 41 percent highe
Page 157 and 158: 11.1 OWNERSHIP AND USE OF MOSQUITO
Page 159 and 160: carrying mosquitoes. Much of the fi
Page 161 and 162: 11.2 USE OF ANTIMALARIAL DRUGS DURI
Page 163 and 164: 11.3 TREATMENT OF CHILDREN WITH FEV
Page 165: 11.4.1 Type and Timing of Antimalar
Page 169 and 170: 11.6 SOURCE OF MOSQUITO NETSUntil l
Page 171 and 172: In spite of steady increases in ITN
Page 174 and 175: ORPHANS AND VULNERABLE CHILDREN 12P
Page 176 and 177: 12.2 ORPHANS AND VULNERABLE CHILDRE
Page 178 and 179: 12.3.1 School Attendance by Survivo
Page 180 and 181: While there are no differences in p
Page 182 and 183: Table 12.7 Widows dispossessed of p
Page 184 and 185: Table 12.9 External support for orp
Page 186 and 187: REFERENCESAgot, K.E., J.O. Ndinya-A
Page 188 and 189: SAMPLE IMPLEMENTATIONAPPENDIX AAppe
Page 190 and 191: Table A.2 Sample implementation: Me
Page 192 and 193: Table A.4 Coverage of HIV testing a
Page 194: Table A.6 Coverage of HIV testing a
Page 197 and 198: where h represents the stratum whic
Page 199 and 200: Table B.2 Sampling errors for Natio
Page 201 and 202: Table B.4 Sampling errors for Rural
Page 203 and 204: Table B.6 Sampling errors for Mainl
Page 205 and 206: Table B.8 Sampling errors for Mainl
Page 207 and 208: Table B.10 Sampling errors for Zanz
Page 209 and 210: Table B.12 Sampling errors for Nort
Page 211 and 212: Table B.14 Sampling errors for Sout
Page 213 and 214: Table B.16 Sampling errors for East
Page 215 and 216: Table B.18 Sampling errors for Dodo
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Table B.20 Sampling errors for Kili
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Table B.22 Sampling errors for Moro
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Table B.24 Sampling errors for Dar
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Table B.26 Sampling errors for Mtwa
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Table B.28 Sampling errors for Irin
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Table B.30 Sampling errors for Sing
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Table B.32 Sampling errors for Rukw
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Table B.34 Sampling errors for Shin
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Table B.36 Sampling errors for Mwan
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Table B.38 Sampling errors for Many
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Table B.40 Sampling errors for Pemb
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216 | Appendix B
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Joyce MbambaYulitha MwakasoleRemigi
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QUESTIONNAIRESAppendix DAppendix D
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HOUSEHOLD SCHEDULEIntroduction and
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IF AGE 0-17 YEARSIF AGE 5 YEARS OR
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IF AGE 0-17 YEARSLINE SICK CARE SUR
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HOUSEHOLD CHARACTERISTICSNO. QUESTI
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NO. QUESTIONS AND FILTERS CODING CA
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SUPPORT FOR SICK PEOPLENO. QUESTION
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NO.QUESTIONS AND FILTERSSUPPORT FOR
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NO.QUESTIONS AND FILTERSCODING CATE
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CHILD 4 CHILD 5 CHILD 6502 LINE NUM
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515 CHECK 509:NUMBER OF CHILDREN WI
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UNITED REPUBLIC OF TANZANIATANZANIA
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213 214 215 216217 218219 220221222
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LAST BIRTH NEXT-TO-LAST BIRTH SECON
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LASTSEXUAL PARTNERSECOND-TO-LASTSEX
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SECTION 7 - HIV TESTTHIS PAGE TO BE
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