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

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