"If I die for touching him, let me die": a rapid ethnographic assessment of cultural practices and Ebola transmission in high-risk border regions of Tanzania.

BACKGROUND: Ebola Virus Disease (EVD) is a rare but contagious disease caused by Ebola Virus (EBOV). The first Ebola outbreaks were reported in the Democratic Republic of Congo (DRC) before subsequent reported cases in Western and East African countries, including Uganda, which borders Tanzania. Proximity to EVD-infected countries raises the prospect of cross-border transmission, raising alarm in Tanzania. This study aimed to explore the cultural practices likely to prevent or escalate EVD transmission in the event of its outbreak in the country. METHODS: This rapid ethnographic assessment employed observation, interviews, and focus group discussions to collect data from people with diverse characteristics in five regions of Tanzania Mainland namely, Kagera, Kigoma, Mwanza and Songwe regions and Zanzibar Island. The qualitative data was then subjected to thematic analysis. FINDINGS: Cultural practices may escalate the transmission of EVD and hinder its prevention and control. These cultural practices include caring sick people at home, confirmation of death, mourning, and body preparation for burial. Communal life, ceremonies, and social gatherings were other aspects observed to have the potential for compounding EVD transmission and hindering its containment in case of an outbreak. CONCLUSION: Cultural practices may escalate EVD transmission as identified in the study settings. As such, Risk Communication and Community Engagement (RCCE) activities should be interventionist in transforming cultural practices that may escalate the spread of EVD as part of preparedness, prevention, and control efforts in the event of an outbreak.

Contribution of community champions to accelerate the uptake of COVID-19 vaccination in Rukwa region, Tanzania, February - October 2022.

Introduction: Tanzania is among the African countries which started COVID-19 vaccination late (August 2021) compared to other countries in the African continent. By mid-March 2022, overall vaccine uptake was 13% of the targeted population, which was very low compared to other countries. We describe the contribution of champions in the Rukwa region that led to an increase in vaccine coverage rate in Tanzania. Methods: a community-based campaign was conducted using community champions from July 15th to August 31st, 2022. A baseline assessment was conducted focusing on the key drivers, barriers, and enablers for COVID-19 vaccine uptake in the region. A working session to develop IEC materials and messages tailored to addressing the issues raised in the community to be used in the campaign in the region was conducted, followed by the campaign's launch. Community engagement and sensitizations, which contributed to the rise of vaccinated people, were based on house-to-house visits, village meetings, and visiting community gatherings such as marketplaces, places of worship, and sports areas, which were done by champions alongside vaccinators. Results: the campaign contributed to the increase of vaccination coverage because, before the start of the campaign, the vaccination coverage was 10% as of July 14th, 2022. After the campaign, which started on July 15th to August 31st, 2022, the coverage increased by 12%. During the post-evaluation exercise after the campaign, the coverage keeps increased and reached 94% by October 2022. The coverage kept increasing even after the intervention's end due to the campaign's positive effect. Conclusion: the community still needs correct information to avoid misinformation and hesitancy, especially when introducing new disease response mechanisms such as vaccines. The community champions who are based in the community play a critical role in addressing community concerns and contribute to the effectiveness of the implementation; hence sustainability is crucial.