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

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The Household Questionnaire was used to list all the usual members and visitors of selectedhouseholds. Some basic information was collected on the characteristics of each person listed,including his or her age, sex, education, and relationship to the head of the household. For childrenunder age 18 years, survival status of the parents was determined. If a child in the household had aparent who was sick for more than three consecutive months in the 12 months preceding the survey ora parent who had died, additional questions related to support for orphans and vulnerable childrenwere asked. The Household Questionnaire also included questions on whether household memberswere seriously ill and whether anyone in the household had died in the past 12 months. In such cases,interviewers asked whether the household had received various kinds of care and support, such asfinancial assistance, medical support, social or spiritual support.The Household Questionnaire was also used to identify women and men who were eligiblefor the individual interview and HIV testing. The Household Questionnaire also collected informationon characteristics of the household dwelling, such as source of water, type of toilet facilities, materialsused to construct the house, ownership of various durable goods, and ownership and use of mosquitonets.Furthermore, the Household Questionnaire was used to record haemoglobin and malariatesting results for children age 6-59 months.The Individual Questionnaire was used to collect information from all women and men age15-49. These respondents were asked questions on the following topics:• Background characteristics (education, residential history, media exposure, employment,etc.);• Marriage and sexual activity; Knowledge about HIV/AIDS and exposure to specific HIV-related mass mediaprogrammes; Attitudes towards people living with HIV/AIDS; Knowledge and experience with HIV testing; Knowledge and symptoms of other sexually transmitted infections (STIs); and• Other health issues including knowledge of TB and medical injections.Female respondents were asked about their birth history and illnesses of children they gavebirth to since January 2002. These questions are used to gauge the prevalence of fever, an importantsymptom of malaria.1.7 TRAINING OF FIELD STAFFField staff training was conducted in Morogoro from 24 September to 12 October 2007. Thetraining was conducted according to the AIS/MIS training procedures, including class presentations,mock interviews, field practice and tests. Participants included 14 team supervisors from NBS,OCGS-Zanzibar, former Ministry of Planning and Economic Empowerment, and the Ministry ofHealth and Social Welfare. In total, 59 female nurses, 23 male nurses, and 2 office data editors weretrained to carry out the survey. Trainers were senior staff from NBS, OCGS-Zanzibar, and NMCP, aswell as a laboratory technician from Muhimbili University College of Health Sciences (MUCHS).Field practice in malaria and anaemia testing and HIV dried blood spot collection werecarried out towards the end of the training period. During this period, field editors and teamsupervisors were provided with additional training in methods of field editing, data quality controlprocedures, and fieldwork coordination.Introduction | 5
1.8 FIELDWORKData collection was carried out by 14 field teams, each consisting of one team leader, fourfemale interviewers, one male interviewer, and one driver. Five senior staff members from NBS andOCGS-Zanzibar coordinated and supervised the fieldwork activities. Fieldwork on the Mainlandstarted on 20 October 2007. Delay in obtaining ethical clearance for the Zanzibar fieldwork resulted ina delay in starting data collection in Zanzibar until 10 November 2007. Data collection took placeover a four-month period, from 20 October 2007 to 22 February 2008.A quality control team periodically visited teams in the field to check their work and reinterviewsome households.1.9 ANAEMIA, MALARIA, AND HIV TESTINGIn addition to collecting information with the survey questionnaire, the THMIS also includedanaemia and malaria testing for children under five (6-59 months) and HIV testing for adults age 15-49. The protocol for the anaemia and HIV testing was based on the standard protocols employed inthe MEASURE DHS project, adapted to achieve the objectives of the THMIS.1.9.1 Anaemia TestingIn the THMIS, haemoglobin measurement for anaemia testing was performed in the field by ateam member. Consent was obtained from the parent or guardian. The statement explained thepurpose of the test, how the test would be administered, and advised the parent or guardian that theresults would be available as soon as the test was completed. Finally, permission was requested forthe test to be carried out. For haemoglobin measurement, capillary blood was usually taken from afinger of the children for whom consent had been obtained. A single-use, sterile lancet was used forthis purpose. In cases where a child was very thin, a heel prick was used to obtain the sample.The concentration of haemoglobin in the blood was measured using the HemoCue system.The results of the anaemia test were immediately provided for all eligible children tested. Levels ofanaemia were classified as severe, moderate, or mild according to criteria developed by the WorldHealth Organization (WHO). A brochure was provided on anaemia which included suggestions as tothe steps (e.g., changes in diet) that could be taken in the event that a child was found to have somedegree of anaemia. Parents/guardians of children who were found to be severely anaemic wereadvised to take the child to health facilities for further evaluation and management.1.9.2 Malaria TestingThe rapid diagnostic test used in the 2007-08 THMIS is the Paracheck Pf device (OrchidBiomedical, India), which is based on the detection of P. falciparum-specific histidine-rich protein 2(HRP2 Pf) in blood. The test has relatively high sensitivity and specificity and is deemed appropriatefor clinical and epidemiologic assessment of malaria, especially placental malaria. Parents orresponsible adults were advised about the malaria test result. If the child tested positive, he or she wasprovided with a full course of Artemether Lumefantrine (ALu or Coartem). Children who testednegative but had a fever in the past two weeks were also provided a full course of ALu. THMIS fieldstaff explained to the parent or responsible adult that ALu is effective and should rid the child of feverand other symptoms in a few days. Parents/guardians were advised to take the child to a healthprofessional for treatment immediately if, after taking ALu, the child still had high fever, fast ordifficult breathing, was not able to drink or breastfeed, and became sicker or did not get better in twodays.6 | Introduction
Page 1 and 2: TanzaniaHIV/AIDS and MalariaIndicat
Page 3 and 4: The 2007-08 Tanzania HIV/AIDS and M
Page 5 and 6: 3.5 Access to Mass Media ..........
Page 7 and 8: 12.2 Orphans and Vulnerable Childre
Page 9 and 10: Table 4.3Table 4.4Table 4.5Table 4.
Page 11 and 12: Figure 9.2 HIV Prevlence by Region/
Page 14: FOREWORDThis report presents the ma
Page 18 and 19: SUMMARY OF FINDINGSThe 2007-08 Tanz
Page 20 and 21: HIV prevalence among youth (women a
Page 23 and 24: xxii | Map of Tanzania
Page 25 and 26: 1.2 NATIONAL POLICY ON HIV/AIDSIn r
Page 27: To assess levels and trends in know
Page 31 and 32: Table 1.1 Results of the household
Page 33 and 34: Figure 2.1 presents a graphic pictu
Page 35 and 36: Table 2.3.1 Educational attainment
Page 37 and 38: Educational attainment is higher in
Page 39 and 40: 2.5.1 Energy SourcesTable 2.5 prese
Page 41 and 42: The most common items are agricultu
Page 43 and 44: The 2007-08 THMIS included aquestio
Page 45 and 46: Table 3.1—ContinuedBackgroundchar
Page 47 and 48: Education is positively related to
Page 49 and 50: Table 3.3.2 Employment status: MenP
Page 51 and 52: Table 3.4.1 Exposure to mass media:
Page 53 and 54: 3.6 CURRENT MARITAL STATUSMarriage
Page 55 and 56: Polygyny also varies by household w
Page 57 and 58: Four in ten women age 20-49 marry b
Page 59 and 60: There is a positive relationship be
Page 62 and 63: FERTILITY AND REPRODUCTIVE HEALTH 4
Page 64 and 65: Table 4.2 Fertility by background c
Page 66 and 67: infertility, 1 or the inability to
Page 68 and 69: 4.3 ADOLESCENT FERTILITYAdolescent
Page 70 and 71: Table 4.7 Antenatal carePercent dis
Page 72: Table 4.8 Place of antenatal carePe
Page 75 and 76: Table 5.1 Knowledge of AIDSPercenta
Page 77 and 78: 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
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Table 8.1 Comprehensive knowledge a
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Table 8.2 Age at first sexual inter
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Never-married women and men age 15-
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Figure 8.3 Condom Use at Premarital
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Table 8.5.2 Higher-risk sexual inte
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Table 8.6 Age-mixing in sexual rela
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8.9 HIV TESTING AMONG YOUNG PEOPLEK
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HIV PREVALENCE 99.1 INTRODUCTIONPri
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Table 9.1 Coverage of HIV testing b
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Table 9.1—ContinuedBackgroundchar
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Table 9.3 HIV prevalence by ageAmon
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There are large variations in HIV p
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Table 9.5 shows that men who are cu
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Women who said they had higher-risk
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Table 9.8 shows data on HIV prevale
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Table 9.11 HIV prevalence by male c
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INFANT AND CHILD MORTALITY 1010.1 I
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As expected, the level of infant an
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category (1.41) is 41 percent highe
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11.1 OWNERSHIP AND USE OF MOSQUITO
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carrying mosquitoes. Much of the fi
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11.2 USE OF ANTIMALARIAL DRUGS DURI
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11.3 TREATMENT OF CHILDREN WITH FEV
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11.4.1 Type and Timing of Antimalar
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11.4.2 Availability of Drug at Home
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11.6 SOURCE OF MOSQUITO NETSUntil l
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In spite of steady increases in ITN
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ORPHANS AND VULNERABLE CHILDREN 12P
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12.2 ORPHANS AND VULNERABLE CHILDRE
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12.3.1 School Attendance by Survivo
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While there are no differences in p
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Table 12.7 Widows dispossessed of p
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Table 12.9 External support for orp
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REFERENCESAgot, K.E., J.O. Ndinya-A
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SAMPLE IMPLEMENTATIONAPPENDIX AAppe
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Table A.2 Sample implementation: Me
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Table A.4 Coverage of HIV testing a
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Table A.6 Coverage of HIV testing a
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where h represents the stratum whic
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Table B.2 Sampling errors for Natio
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Table B.4 Sampling errors for Rural
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Table B.6 Sampling errors for Mainl
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Table B.8 Sampling errors for Mainl
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Table B.10 Sampling errors for Zanz
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Table B.12 Sampling errors for Nort
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Table B.14 Sampling errors for Sout
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Table B.16 Sampling errors for East
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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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