MOROGORO NEWSLETTER Vol. No. 2 December 2003 CHOLERA OUTBREAKS IN MOROGORO Cholera is an acute diarrhoea disease occasionally accompanied by vomiting. The disease is caused by Vibrio cholerabacteria. The Community is infected through taking water or drink or eating food which has been contaminated with the bacteria. More than 80% of cholera cases result from drinking water contaminated with Vibrio cholera. Recently the disease has resurfaced in areas in Morogoro Region (along major rivers, which are contaminated by Cholera bacteria), for example: • Morogoro Municipality: Tungi, Kingolwira, Nanenane. • Morogoro Rural: Mvuha, Turiani, Ngerengere. • Kilosa: Msowero, Magubike, Kidodi. • Kilombero: Mangwale and Viwanja Sitini. Cholera Patient at Emergency Treatment Camp • Ulanga: Kivukoni, Malinyi, Lupiro. 3. Poor management of solid and liquid wastes in Other reasons which cause cholera outbreaks the Municipality and Townships in Morogoro. include:- 4. Unsafe disposal system of human excreta. 1. Scarcity of safe water caused by: • Low coverage of sanitary facilities in • Vandalism of water pumps and spare parts of communities and public places such as pumping machines. auctions mine areas, fishing camps, bus • Worn out and dilapidated water distribution stands and some of the schools. system. • Preparation and selling of food and drinks • Prolonged draught. which do not conform to health regulations. 2. Failure in observing personal hygiene such as washing hands with soap and safe water after - In This Issue – using toilets and before preparing and serving food. z Cholera Outbreaks in Morogoro ---- p.1 z The Editorial Morogoro Health Newsletter --- p.3 z Community Participation in Malaria Control -Kilosa -------------- p.3 z Rabies Control - Ulanga ------ p.4 z Focused Antenatal Care Approach ------ p.5 z Control of Onchocercasis -------------- p.6 z HMIS --------------------------- p.7 z Important Events --------------------------- p.7 z Reader’s Forum -------------------------- p.8 z Announcements --------------------------p.8 Children are fetching contaminated water MHP Morogoro Health Project 1 Morogoro Health Newsletter Unfavourable effects of cholera outbreaks: 1. High morbidity and mortality. The region has had 13,109 cases and 590 deaths in the past ten years (1993 – 2002). 2. The Governments spends a lot of resources for treatment of cholera patients. 3. Reduced economic production leading to low general economic growth. 4. Other costs to the community include patient care and funeral costs Recommended steps to contain outbreaks: 1. Availability of adequate safe water to be given high priority when developing community based participatory planning. Unsafe disposal of solid waste 2. Primary Health Care Committees at all levels to Cholera Prevalence in MOROGORO Cases (1993-2002) meet regularly to review strategies for controlling 5,000 No. of CASES and containing out breaks, using National No. of DEATHS 4,500 4,566 guidelines. 4,000 3,632 3,069 3. To conduct and monitor participatory Health 3,500 3,000 education involving other sectors. 2,500 4. To make By Laws to be applied against those 2,000 who contravene cholera control measures. 1,500 5. Health service providers be given continued 1,000 983 829 190 181 education regularly on proper treatment and 500 117 21 0 0 0 3 78 0 0 30 preventive measures against Cholera. 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 Mr. N. Masaoe Years Regional Health Officer Morogoro EDITORIAL BOARD Chairman Chief Advisor Mr. N. MASAOE Regional Health Officer Dr. M. MASSI Regional Medical officer Secretary Associate Members Ms. C. MARO District Reproductive and Child Dr. A. TANAKA Advisor, MHP* Health Coordinator, Morogoro Ms. M. CHITOSE Coordinator, MHP* Deputy Secretary Dr. F. FUPI Advisor, MHP* Ms. N. AHMED Nursing Officer, Morogoro Municipality Members Mr. J. MANKAMBILA Regional Health Secretary Dr. G. MTEY Municipal Medical Officer of Health, Advisory Committee Morogoro Dr. O. MBENA District Dental Officer,Morogoro Mr. H.Mohamed Mr. J. BUNDU District Health Officer, Kilosa Lecturer, Mr. K. KAKWAYA District Health Secretary, Kilombero Sokoine University of Agriculture Mr. B. MBUMBUMBU District Health Officer, Ulanga Ms. Y. KITAYAMA Advisor, MHP* * MHP: Morogoro Health Project, JICA WASH YOUR HANDS WITH SOAP BEFORE MEALS AND WHENEVER YOU LEAVE THE TOILET 2 Morogoro Health Newsletter MOROGORO HEALTH NEWSLETTER the step we have made towards achieving our Mr. N. MASAOE expectation of establishing the Newsletter. Chairman The Central Government and all the Councils of Editorial Board Morogoro Region have indicated their commitment of sustaining the Newsletter by including in their Dear esteemed readers; Welcome to The 2004 and subsequent years plans, budget line cost Second Issue of Morogoro Health Newsletter. The component for the Newsletter publication of the Newsletter, is published by the Morogoro Health coming issues. Project, twice annually in English and Swahili To ensure sustainability, and future development languages. the Editorial Board requests all stakeholders and The main object of establishing the Newsletter is the readers to contribute to the cost of publications to facilitate exchange of information and experience of the Newsletter for the benefit of the Morogoro sharing among Health Sector personnel in community and the Nation as a whole. Morogoro Region and other Stakeholders. We request our esteemed readers to submit In the first issue 1,181 copies were distributed articles for publication for the forthcoming issue. within and outside the region. We had the pleasure We thank all those who have supported us in to receive from readers of our First Issue invaluable one way or the other in the publication of these two comments, on various matters of interest about the issues. Special thanks should go to the Japan Newsletter and on the commendation of the job International Cooperation Agency through done, to which we are very grateful. The Morogoro Health Project for facilitating publication enthusiasm and seriousness by which our readers of the initial issues. have shown in their comments is an assurance of COMMUNITY PARTICIPATION IN MALARIA CONTROL-KILOSA started by training 2 facilitators in Iringa. Later 6 district facilitators were trained under this programme to facilitate Ward Development Committees and Village Health Committees in participating in implementing Malaria control activities by developing Community Based Malaria control plans to be implemented at the community level. During 2000 – 2002 the district sold about 8,466 ITNs and 10,000 Zuiambu tablets. The programme also through Basket Fund support managed to purchase 487 ITNs and distribute them to 5 Health Centres and to the District Hospital. Further more the district, through UNICEF support, introduced a special programme, known as Discount Voucher System, to pregnant mothers. Under this system, Discount Voucher worth Tsh.2,500.00 paid by UNICEF is provided to a A Pregnant mother being issued with discount voucher pregnant mother during the first visit to MCH clinic at Health facility. The voucher is then used to purchase an ITN from authorized businessmen in Community Based Malaria Control in Kilosa the community. The remaining amount of the total District started in 2000. The main objective was to price of the ITN is paid/settled by the pregnant involve community in combating Malaria in the district mother. using ITNs(Insecticide Treated Nets). The programme which is under UNICEF support Ms. R. Nguruwe 3 Morogoro Health Newsletter CBMC Coordinator-Kilosa mothers RABIES CONTROL–ULANGA Rabies (caused by Rhabdovirus) is a disease, which is transmitted by rabid animals like dogs and cats; Animals not related to dog family, for example bat, can also transmit the disease. In Ulanga district in 2001 a total number of 25 cases due to suspected animal bites were reported. In 2002 there were 18 and in 2003 were 29 bites. Often rabies occurs because people fail to observe technical advice. This leads our 2. Human being: Government to incur great expenses to buy the • Suddenly becomes very aggressive. costly rabies vaccine instead of using the meager • Difficult to swallow due to pain and thick saliva funds for development above all there is human in the mouth. always humanloss. • Feels pricking pain at the animal bite wound. • Convulsions, later the body paralyses and ANIMAL BITE CASES IN ULANGA invariably death. (2001-2003) 40 First Aid to a person bitten by a rabid animal: 1. Clean the wound with soap or Hydrogen peroxide. Never cover the wound leave it open. 30 29 2. Refer at once the patient to a health facility, 25 where she/he will be vaccinated immediately. 3. Tie rabid animal for one week observing for signs of rabies. 20 18 Cases 4. If the animal dies or is killed before one week elapses send the animal head to a veterinary laboratory for examination. 10 5. A person bitten by a rabid animal must have complete vaccination. Factors to be considered in prevention of the 0 disease: 2001 2002 2003 Years 1. Vaccinate your dog against rabies yearly. Signs and symptoms of rabies: 2. Ensure that your dog is tied from 6:00 am up to 1.Animals: 10:00 pm. • Becomes silent, restless or very aggressive. 3. Keep children away from any animal suspected • Discharges saliva in the mouth and cannot eat to be rabid. or drink. 4. Tie for 1 week the suspected animal observes for • Often the animal becomes mad and can bite symptoms of rabies. any object. 5. Kill and bury all stray dogs. • The rabid animal dies after 5 to 7 days from the day it shows first symptom. BE CAREFUL WITH AN ANIMAL WITH RABIES SYMPTOMS. ITS SALIVA ON AN OPEN WOUND IS ENOUGH TO GET YOU INFECTED. Mr. B. Mbumbumbu District Health Officer-Ulanga PLEASE SEND YOUR ARTICLE TO THE EDITOR FOR PUBLICATION 4 Morogoro Health Newsletter FOCUSED ANTENATAL CARE APPROACH In Tanzania in spite of high antenatal THE USE OF DRUGS IN PREGNANCY attendance by pregnant women at health facilities in Drugs are generally discouraged unless advised various regions, 529 per 100,000 live births die by service providers but routine drugs prescribed every year due to avoidable complications.