Urban malaria transmission in Mutare City; an unlikely phenomenon.

OBJECTIVE: With an average altitude of 1,113 m above sea level and a mean maximum temperature of 28.6 degrees C, malaria transmission is possible in Mutare. Against transmission is the regular occurrence of ground frost. We reviewed epidemiological data and undertook a survey for the Anopheles vector. DESIGN: The Anopheles survey used standard techniques for sampling larvae and adult mosquitoes. Species identification was done by the polymerase chain reaction (PCR) technique. A random sample of blood slides was examined at the Blair Laboratory. Patient residence was determined from the outpatient register. Daily maximum and minimum temperatures monitored from the Mutare Fire Station, were obtained from the Meteorology Office in Harare. SETTING: Mutare city and suburbs. RESULTS: There was no evidence of rising temperatures in Mutare. Only non-vector Anopheles mosquitoes were identified (An. quadriannulatus and An. pretoriensis). One slide positive case had gametocytes present. Mapping generally showed no clustering, but there were two possible transmission foci. CONCLUSION: Temperatures are high enough, but winter lows (< 18 degrees C) do not support malaria transmission in Mutare. The Anopheles survey did not find the vector. Two suggestive clusters were mapped. While present data do not support ongoing malaria transmission within Mutare, in the past, An. gambiae, An. fenestus and An. pretoriensis were recorded. Careful monitoring will be needed.

Report of a study into factors affecting staffing levels of health institutions in Matabeleland North

There has been marked expansion in health care services' infrastructure in Matableleland North Province since the attainment of independence in 1980 due to the government policy of providing equitable health care services in the country and decentralisation of services and manpower. However; staffing levels of all health institutions have had very little increase and general reluctancy of health workers to work in rural areas was observed. This study was conducted to determine factors contributing to low staffing levels in Matabeleland North and make recommendations. In both urban and rural health instituions it was found that the filling of nurses' posts; according to the Ministry of Health approved establishent; were generally satisfactory ranging from 73 to 100. However the approved established posts for doctors and nurses were unevenly distributed; there were more posts in urban areas. The study also revealed that there was need to expand the current establishment to meet the criteria of 1983 manpower projection. Two focus group discussions were held; one with urban based and the other with rural based health workers. [abstract terminated]

Report of a study into factors affecting staffing level of health institutions in Matabeleland North

There has been a reasonable expansion in Health Care Services infrastructure in Matabeleland North Province since 1980 with very little increase in the staffing levels. It is observed that there is reluctancy amongst health workers to working in rural areas. This study was set up to analyse staffing levels and to investigate factors affecting staffing levels with the ultimate aim of making recommendations to policy makers. Two focus groups discussions were held; one with urban based and one with rural based in health workers. Currently staffing levels were also investigated and related to existing approved establishment. It was found that 77 of the establishment of nurses in districts and rural hospitals was filled. In these institutions only seven (7) out of fourteen (14) approved posts for doctors were filled. It has been found also that there is need to expand the current establishment; to meet the prejected criteria of 1983 manpower projections. Next; a descriptive study has been carried out into aspects of conditions of service and social environment affecting health workers attitude to working in rural areas. [abstract terminated]