Knowledge and health information communication in Tanzania

Objective: To explore and identify gaps in knowledge and information communication at all levels of health delivery system in Tanzania. Methods: In-depth interviews and twelve Focus Group Discussions were conducted to capture information on the community knowledge on different health problems and the health information communication process. Interviews and discussions were also held with primary schoolchildren; traditional healers; health facility workers and district health management team members. Documentary review and inventory of the available health education materials at community; health facility and district levels; was made. Results: Major community health and health-related problems included diseases (61.6); lack of potable water (36.5); frequent famine (26.9) and lack of health facility services (25.3). Malaria; HIV/AIDS and diarrhoeal diseases were the leading causes of morbidity and mortality. Most of the health communication packages covered communicable diseases and their prevention. Health care facility was the main (91.6) source of health information for most communities. Public meetings; radio and print materials were the most frequently used channels of health information communication. Major constraints in adopting health education messages included poverty; inappropriate health education; ignorance and local beliefs.Conclusion: This study has identified gaps in health knowledge and information communication in Tanzania. There is lack of adequate knowledge and information exchange capacities among the health providers and the ability to share that information with the targeted community. Moreover; although the information gets to the community; most of them are not able to utilize it properly because they lack the necessary background knowledge

Pattern and spatial distribution of plague in Lushoto; north-eastern Tanzania

A review of plague records from 1986 to 2002 and household interviews were carried out in the plague endemic villages to establish a pattern and spatial distribution of the disease in Lushoto district; Tanzania. Spatial data of households and village centres were collected and mapped using a hand held Global Positioning System and Geographical Information System. During the 16-year period; there were 6249 cases of plague of which 5302 (84.8) were bubonic; 391 (6.3)septicaemic; and 438 (7.0) pneumonic forms. A total of 118 (1.9) cases were not categorized. Females and individuals aged 7-18 years old were the most affected groups accounting for 54.4(95CI: 52.4-56.0) and 47.0(95CI: 45- 49) of all reported cases; respectively. Most cases were found in villages at high altitudes (1700-1900m); and there was a decline in case fatality rate (CFR) in areas that experienced frequent outbreaks. Overall; there was a reduction in mean reporting time (from symptoms onset to admission) to an average of 1.35 days (95CI: 1.30-1.40) over the years; although this remained high among adult patients (18 years). Despite the decrease in the number of cases and CFR over the years; our findings indicate that Lushoto district experiences human plague epidemic every year; with areas at high altitudes being more prone to outbreaks. The continued presence of plague in this focus warrants further studies. Nonetheless; our findings provide a platform for development of an epidemic preparedness plan to contain future outbreaks

Human African Trypanosomiasis and challenges to its control in Urambo; Kasulu and Kibondo Districts; western Tanzania

A study was carried out to determine the prevalence and management of Human African Trypanosomiasis (HAT) in Urambo; Kasulu and Kibondo districts of western Tanzania. Parasitological surveys for trypanosome and other blood parasites were conducted in selected villages. Interviews with health workers were conducted to explore facility capacity to diagnose and manage HAT. Community knowledge on tsetse and availability of trypanocidal drugs was explored. Results showed that; although health facility records showed HAT is an important public health problem in the three districts; typanosomes were found in 0.6of the examined individuals in Urambo district only. Malaria parasites with a prevalence of 12.1; 19.7and 9.7; in Urambo; Kibondo and Kasulu; respectively were detected in blood samples from the same individuals examined for trypanosomes. There was poor capacity for most of the health facilities in the diagnosis; treatment and control of HAT. In both districts; communities were knowledgeable of the tsetse identity (82.4) and had experienced tsetse bites (94). The majority (91.4) of the community members knew that they were at risk of acquiring HAT. However; only 29of the respondents knew that anti-trypanocidal drugs were readily available free of charge from health care facilities. Late treatment seeking behaviour was common in Kasulu and Urambo districts. In conclusion; health facilities in western Tanzania are faced with problems of poor capacity to diagnose and manage HAT and that treatment seeking behaviour among the communities at risk is poor. Efforts should be made to strengthen the capacity of the health facility to handle HAT cases and health education to the population at risk

Community knowledge and information communication gaps on HIV/AIDS in Iringa Municipality; Tanzania

This study was carried out to determine community knowledge and information communication gaps on HIV/AIDS in Iringa Municipality; Tanzania. In-depth interviews and focus group discussions were used to collect data from both the community and health workers. Results showed that eighty-one percent of the respondents were knowledgeable of at least one mode of HIV/AIDS transmission. Sexual intercourse; sharing of sharp instruments; blood transfusion and mother to child transmission were known to be the most common ways on how HIV is transmitted. The community knowledge on the symptoms of AIDS was poor. The main sources of information on HIV/AIDS were health facilities; radio; televisions; religious leaders and relatives. The information covered in most of the health education programmes included prevention; treatment and care for AIDS patients. The understanding of HIV/AIDS messages was found to vary significantly between respondents with different levels of education and marital status. It was higher among those with at least a primary school education than in those without education. Singles and individuals with primary or post-primary education sought more new information than those who had no education at all. Among the respondents; 59.7reported to have difficulties in adopting and utilising HIV/AIDS educational messages. Singles had a better understanding of information provided than married respondents. However; the former had more difficulties in adopting and utilising health education information. Poor utilisation of the HIV/AIDS messages was attributed to culture; poverty; and illiteracy. The majority of the respondents; 370 (92.8) reported to often carry out discussions with their family members (including children) on HIV/AIDS. It is concluded that health education should identify community needs and address economic and socio-cultural barriers to facilitate education utilisation and behaviouralchanges required in HIV/AIDS prevention and control in Tanzania