Tag: Public health

Tropical Diseases in Africa – Malaria

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by Shravya Murali – Art in Tanzania internship

As a significant health problem in several tropical regions of the world, malaria costs almost 435,000 lives annually. A substantial fraction of these deaths occurs in Africa. The proportion of cases and deaths In Tanzania alone constitutes to 3% of those globally. Over the past few years, the number of malaria cases have been on the rise, with a staggering increase by 3.5 million from 2016 to 2017 as reported by the WHO.

How does malaria spread?

Malaria in humans is caused by four kinds of parasites from the Plasmodium genus – Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae. A fifth species Plasmodium knowlesi, is a zoonotic species infecting animals. Of the five species, P.falciparum results in the most severe form of malaria and is responsible for the majority of malaria-related deaths, especially among children below the age of five.

Malaria is transmitted to humans through the bite of a female Anopheles mosquito that is infected by one of the malaria-causing parasites. The Anopheles mosquito can also spread the parasite from a human to another human when it feeds on an infected human’s blood meal, and later goes to bite another human.

Human-to-human transmission can also occur through blood transfusion, organ transplant, or sharing needles containing contaminated blood as the malaria parasite can be found on red blood cells. Malaria can also be transmitted from a pregnant mother to her child before or during delivery, which is also known as congenital malaria.

However, malaria is not contagious and cannot be transmitted through casual contact (i.e., by sitting next to someone infected) or sexual contact.

What are the effects of the disease?

Those infected with malaria often experience flu like illnesses and fever. Symptoms often include headache, fatigue, chills, muscle soreness, nausea, vomiting, and diarrhoea. As malaria can cause a loss of red blood cells it may lead to anemia, and jaundice, which is the yellow colouring of skin and eyes. If left untreated malaria becomes life-threatening as it can cause kidney failure, mental confusion, seizures, coma, and death. Usually, these symptoms occur about 10 days after a malaria infection.

Malaria caused by P.vivax and P.ovale may occur again and the parasites may reside in the liver for up to around four years after an individual has been bitten by an Anopheles mosquito. These dormant parasites may become active later and invade the individual’s red blood cells, causing another malarial infection.

How is malaria treated?

If a patient is suspected to be infected with malaria, a drop of his/her blood is often observed under a microscope to detect the malaria parasite. Treatments for malaria vary based on the severity of malaria, clinical status of the patient, the Plasmodium species causing the infection, and prior use of anti-malarial drugs.

In Mainland Tanzania, artemether lumefantrine, a drug that can be orally consumed, is used for uncomplicated malaria. In Zanzibar, however, artesunate and amodiaquine are used. For severe malaria, artesunate and quinine are injected in patients in both Mainland Tanzania and Zanzibar. Quinine is another drug that is only used when other drugs are ineffective, as quinine is known to have more side effects than the others. However, quinine is used to treat malaria in the first trimester of pregnancy as it is not known to have significant effects on the child at therapeutic doses.

What could be done to prevent the disease?

To prevent malaria, one could consume anti-malarial drugs (i.e., atovaquone, chloroquine, doxycycline). While it is possible to provide infants and children some of these drugs, not all drugs are suitable for children and doses are based on the weight of the child.

Apart from anti-malarial drugs, one should also prevent mosquito bites (specifically at night), which could be done by sleeping under insecticide-treated bed nets, wearing fully covered / long-sleeved clothing at night, and carrying an insect repellent.

With the increase in the number of malaria cases over the years, it is crucial that members of the public and healthcare professionals cooperate in fight against the disease. While the research for vaccination against malaria is ongoing, it is also essential for everyone to play a part by taking precautions to avoid malaria.

References:

1. Carfagno, J. (2018, July 16). Noninvasive Malaria Test Wins Royal Academy of Engineering’s Africa Prize. Docwire News. https://www.docwirenews.com/docwire-pick/future-of-medicine-picks/noninvasive-malaria-test-wins-royal-academy-of-engineerings-africa-prize/. 

2. Centers for Disease Control and Prevention. (2021, January 26). CDC – Malaria – About Malaria – FAQs. Centers for Disease Control and Prevention. https://www.cdc.gov/malaria/about/faqs.html.

3. Mutabazi, T. (2021, June 6). Assessment of the accuracy of malaria microscopy in private

health facilities in Entebbe Municipality, Uganda: a cross-sectional study. Malaria Journal. https://malariajournal.biomedcentral.com/articles/10.1186/s12936-021-03787-y

4. Ryan, S. J. (2020, May 1). Shifting transmission risk for malaria in Africa with climate

change: a framework for planning and intervention. Malaria Journal. https://malariajournal.biomedcentral.com/articles/10.1186/s12936-020-03224-6

5. Tanzania. Severe Malaria Observatory. (2007, January 17). https://www.severemalaria.org/countries/tanzania.

6. Thomas, D. L. (2020, March 13). Triple therapies effective and safe in malaria. News. https://www.news-medical.net/news/20200312/Triple-therapies-effective-and-safe-in-malaria.aspx. 

A GIRL CHILD IN TANZANIA DURING MENSURATION PERIOD

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By Ayanna Albert – Art in Tanzania Internship

Down deep in the valleys very far away from town, were there is neither much electricity nor water to take. Down deep where a girl is also a shepherd of cattle’s as well but then thanks to education now she can attend.

Been a witness through my own campaigns as we visited these girls in the interior villages, their stories they told “where when they were on MP home they had to stay. These are girls who had same right to education and hence they would miss classes just because of the biological nature that God had created in them.”

Yes!! They are girls who can’t afford pads every month and yet some due to their biological being the piece of cloth that some use isn’t enough to carry the blood weight and hence they are forced to stay inside the whole days until the days are gone. So this basically means no school, no access to some of the things. So is now menstruation a disability to girls??(Some would ask) or is just the whole issue of poverty having and not of having.

So then further more this girl child is expected to perform well or maybe better further more than boys without including the stories of house chores, fetching water from a long distance as it was in the past and still to some.

The same girl child faces consequences when she fails to perform well in class such as forced marriage and they like.

So here is a cry to a girl child and an applaud to every movement around the world that supports such groups to purchase a reusable pads at least that they could wash again and again , back to those without water still this is still a question?

A special note to this girl child;

Dear Girl child,

You’re beautiful, you are strong, and you’re worth beyond a thousand reasons why

There is nobody in the world like you

You got to get up (no matter what)

You got get up and make a move

Because the world won’t ever see you till you do

(Some of the lyrics song by Tatiana Manaois, song name: Like you)

By; Ayanna Albert Mushi

PROBLEMS WITH HOUSEHOLD HYGIENE

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By NARMY RICHARD MWANBOZI – Art in Tanzania internship

The Tanzanian economy is poor and annual household income is low.  According to the world bank The Gross Domestic Product per capita in Tanzania was recorded at 985.50 US dollars in 2019. 

The GDP per Capita in Tanzania is equivalent to 8 percent of the world’s average, many people depend on seasonal jobs such as in agriculture, which is for survival, while others are totally unemployed. Agriculture is the key activity to many people in Tanzania since about 60 percent of citizens depends on it. 

Many households in Tanzania are poorly constructed and resulting to development of unplanned settlements in the towns. For example townships like Keko, Mbagala and Manzese in Dar es Salaam and Mwanjelwa and Mbalizi in Mbeya, that are dominated by unplanned settlements and poor infrastructure and supply of social services. Infrastructure as connectivity between houses is inefficient due to poor roads, water systems including sewage systems and safe and clean water supply.

Lack of clean water for drinking and cleaning conducts results to household dirtyness and causing contamination base for illnesses.

Also, waste removal is poor especially at the areas that were constructed at the time when the population was still small, but today are highly populated but still dependent on the original basic infrastructure lacking the capacity to manage the need of water and waste management.

Towns like Keko are prone to diarrheal diseases related to hygiene such as typhoid and cholera highlighted by rainy seasons. This is because excess rains reach household and spread the supply of waste including faeces.

People living in poverty their education is low and their knowledge of health and the importance of clean household management is a problem. People believe in witchcraft not necessarily understanding the serious health problems are caused by poor hygiene and sanitation. So there is need for advocating people along with infrastructural development.

Many Tanzanians fail to build good and healthy toilets because of their small income. Visiting some villages in Mbarali, Mbeya such as Itamboleo and Mapunga and observing that toilets are sub-standard or completely missing. The Itamboleo village council come up with a plan to ensure construction of proper toilets in the village and instructing that those failing to follow-up the plan must pay sanctions. The plan did not work properly as villagers blame, they do not have enough money to construct those toilets. Also, the mentality of the leaders is that toilets with septic tanks are the only safe toilets not being factual. 

Thus, we need to educate people in villages about healthy household with affordable cost.

Water supply in the Tanzania is gradually improving in many towns, such as in Mbeya rural districts, Northern regions of Tanzania and Dar es Salaam. But water supply is still a problem in many parts resulting to poor household hygiene and sanitation in Tanzania.

Along the major issues on household hygiene and sanitation smaller issues also largely affect our health. The kitchen appearance and settings is traditionally ineffective. Many households prepare their food in the kitchen full of dirtiness and storage of charcoal, food, and various kitchen appliances in the same place, the light supply is poor, and the kitchen may act as a place for rats and rodents to live thus spreading diseases.

Our bodies hygiene and sanitation are the key factors for our everyday success and activities. It is our choice to make a call for positive changes in household hygiene.