CORE Metadata, citation and similar papers at core.ac.uk Provided by Digital Library of Open University of Tanzania INVESTIGATION ON THE COMMUNITY`S ROLE ON EPIDEMIOLOGY OF CHOLERA IN BUGURUNI WARD: A CASE STUDY OF BUGURUNI WARD IN ILALA MUNICIPALITY DAR ES SALAAM JANETH LIBENT MGHASE A DISSERTATION SUBMITTED IN PATIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ENVIRONMENTAL STUDIES –HEALTH STREAM OF THE OPEN UNIVERSITY OF TANZANIA 2014 ii CERTIFICATION The undersigned certify that he has read and hereby recommend for acceptance by the Open University a dissertation titled: “Investigation on Risk Factors Influencing Cholera Outbreaks: A Case of Buguruni Ward in Ilala Municipality Dar es Salaam,” in partial fulfillment of the requirements for the degree of Master of Environmental Studies –Health Stream of the Open University of Tanzania. ………………………………………. Prof. Emmanuel S.P. Kigadye (Supervisor) ………………………………… Date iii COPYRIGHT No part of this dissertation may be reproduced, stored in any retrieval system, or transmitted in any form by any means, electronic, mechanical, photocopying recording or otherwise without prior written permission of the author or the Open University of Tanzania. iv DECLARATION I, Janeth Libent Mghase, do hereby declare that this dissertation is my own original work and that it has not been presented and will not be presented to any other university for a similar or any other degree award. I also, declare that all sources that I have used or quoted have been indicated and acknowledged by means of complete references. ……………………………….…… Signature ……………….…………….…… Date v DEDIACATION To my husband Hebron Mandari and my children Carlin and Ian Mandari vi ACKNOWLEDGEMENT First and foremost, I would like to thank God who gave me good health, brain and knowledge throughout my life and master’s study at Open University of Tanzania. Secondly, I would like to express my heartfelt and deep thanks to Professor Emanueli Kigadye, my supervisor for his tireless supervision and guidance on my dissertation. Thirdly, I would like to give my sincere gratitude to my husband, Hebron Mandari for his empathy, encouragement and moral support. Also, I would like to express my special thanks to Dr Saria, the Programme cordinator for his tolerance and facilitate my master’s study at Open University. Lastly but not least, I wish to thank Buguruni ward and Ilala Municipal Council through Health Department for technical, material support and permission to pursue master’s study at the Open University of Tanzania. vii ABSTRACT The Buguruni ward, within Ilala Municipality has been experiencing highest rate and frequency of Cholera outbreaks than any other ward within the Ilala Municipality. The objective of this study was; to evaluate knowledge, attitude and practices associated with cholera outbreak in the ward. A case study approach was adopted, with purposive random sampling used to select 120 respondents from all administrative streets. Structured questionnaire was used to obtain community’s opinion; this was also supplemented by focus group discussion and participants’ observation. Statistical Package for Social Sciences soft ware version 16 was used to generate descriptive statistics which were further summarized into pie charts and tables. Results indicate that the study population (52%) had little awareness on means or causes of the disease and the way the disease can be communicated between individuals and across communities. It was also found out that community practiced several risk behaviors including; not preferring treated water (72%), consumption of locally made fruit juices (34.5%) sold by street vendors across the ward. Other risk behaviors were related to presence of rudimentary waste disposal system thus rendering most of the wastes on open spaces and at home. The study concludes that residents in Buguruni ward remain under high risk of Cholera outbreak, thus worth to recommend institutional and community hygiene measures to be taken sustainably so as to prevent re-occurrence of Cholera in the ward. Keywords –Cholera Outbreaks Knowledge Attitude Practice Control Buguruni Ilala Municipality viii TABLE OF CONTENTS CERTIFICATION ..................................................................................................... ii COPYRIGHT ............................................................................................................ iii DECLARATION ....................................................................................................... iv DEDIACATION ......................................................................................................... v ABSTRACT .............................................................................................................. vii LIST OF TABLES ................................................................................................... xii LIST OF FIGURES ................................................................................................ xiii LIST OF APPENDICES......................................................................................... xiv LIST OF ABBREVIATIONS AND ACRONYMS ............................................... xv CHAPTER ONE......................................................................................................... 1 1.0 INTRODUCTION ............................................................................................ 1 1.1 Introduction ......................................................................................................... 1 1.2 Statement of the Research Problem .................................................................... 5 1.3 Research Objectives ............................................................................................ 6 1.3.1 General Objective .............................................................................................. 6 1.3.2 Specific Objectives are ..................................................................................... 6 1.4 Research Questions ............................................................................................. 6 1.5 Significance of the Research ............................................................................... 6 CHAPTER TWO ....................................................................................................... 8 2.0 LITERATURE REVIEW ................................................................................. 8 2.1 History of Cholera .............................................................................................. 8 2.2 Cholera Outbreak in Tanzania .......................................................................... 10 ix 2.3 Cholera Outbreak in Ilala Municipality ............................................................ 11 2.4 Risk Factors Associated with Cholera Outbreak and Spread............................ 11 2.5 Control Methods and Treatment of Cholera ..................................................... 14 CHAPTER THREE ................................................................................................. 16 3.0 METHODS AND MATERIALS ................................................................... 16 3.1 The Study Area ................................................................................................. 16 3.2 Sampling Procedure .......................................................................................... 17 3.3 Data and Data Collection .................................................................................. 18 3.4 Types of Data .................................................................................................... 18 3.5 Data Collection Tool ......................................................................................... 19 3.6 Data Analysis .................................................................................................... 19 CHAPTER FOUR .................................................................................................... 20 4.0 RESULTS ...................................................................................................... 20 4.1 Introduction .................................................................................................... 20 4.2 Respondent’s General Information ................................................................ 20 4.2.1 Respondents’ Age, Gender and Type of Household ...................................... 20 4.2.2 Type of Occupancy and Duration in the Study Area ..................................... 22 4.2.3 Family Size, Level of Education and Households’ Income ........................... 23 4.3 Knowledge, Attitude and Practices Associated with Cholera Outbreak in Buguruni Ward ............................................................................................... 24 4.3.1 Community Awareness on Means of Cholera Transmission ......................... 24 4.3.2 Cholera Prevention and Control ..................................................................... 25 4.3.3 Risk Behaviors Associated with Eating Unhygienic Food ............................ 26 x 4.3.4 Household’s Water Treatment Methods and Community’s Preference on Consumption of Treated Water ...................................................................... 27 4.3.5 Respondent’s Source of Water ....................................................................... 28 4.3.6 Toilet Type and Common ways of Waste Disposal in Buguruni Ward ......... 29 4.3.7 Opinions on