Knowledge and awareness of malaria and mosquito biting behaviour in selected sites within Morogoro and Dodoma regions Tanzania.

BACKGROUND: In Tanzania there has been a downward trend in malaria prevalence partly due to use of insecticide-treated bed nets for protection against Anopheles mosquitoes. However, residual malaria transmission attributed to early biting behaviour of malaria vectors is being reported. Knowledge of mosquito feeding behaviour is key to improvements in control approaches. The present study aimed to assess knowledge and awareness on malaria and malaria vectors in-Morogoro and Dodoma regions of Tanzania. METHODS: A cross sectional study was undertaken in selected sites in Morogoro and Dodoma Tanzania. A structured questionnaire was administered to 218 randomly selected households from each of which the head or second in/charge and the most senior primary school child were interviewed. RESULTS: A total of 400 participants of whom 56 % were females, were recruited into the study. Their ages ranged between nine and 58 years. Among the participants, 70.7 % had primary school education and the rest attained secondary school (16.8 %), university/college (4.0 %) and not attended school at all (8.5 %). Fifteen per cent of the participants were employed, while 45.5 % were self-employed and 39.5 % were studying. Overall, 58.5 % of respondents were knowledgeable of malaria and its vector. However, 78.8 % were not aware that early mosquito bites can transmit malaria and 86.5 % said that only midnight-biting mosquito bite was responsible for malaria transmission. The majority (66 %) of respondents visited a health facility on observing malaria symptoms while 15.8 % took anti-malaria drugs without medical consultation. CONCLUSION: This study has shown that Anopheles is well known as the night-biting vector of malaria. The majority of participants were not aware of changed biting behaviour of malaria-transmitting mosquitoes and that early outdoor mosquito bite is a risk of malaria transmission. School children have shown a better understanding of malaria and its vector. Therefore, more awareness of Anopheles feeding behaviour is needed.

Factors Influencing Participation of Adults in Voluntary Medical Male Circumcision in Lindi Region, Tanzania.

Background: Voluntary Medical Male Circumcision (VMMC) is a surgical procedure done by a qualified medical personnel using anesthesia. In Tanzania, there is a gap between adult men who are not circumcised and adolescents. This calls for a review of the current situation of VMMC services in the community at large in order to inform policymakers and stakeholders involved in the fight against HIV and other sexually transmitted diseases. The present study explored the factors influencing utilisation of VMMC services among adult males in Lindi Region, Tanzania. Materials and methods: A cross-sectional study was conducted among adults male (15-49 years). Data were collected by using a structured modified measure evaluation quantitative Version 2 questionnaire using a Tablet/Android device with an Open Data Kit (ODK) application (Google Inc. California, USA). Results: The socio-demographic set up of the study participants was mainly composed of males less than 30yrs, single, unemployed, with primary education as the highest level of study and of a Muslim faith. Majority of the respondents (92%) recommended circumcision to a male family member who is not yet circumcised. The study showed that improved sexual performance (81%), penile hygiene (97%) and circumcision as a modern civilization (96%) to be the key factors that motivated respondents' utilisation of VMMC services. However, only 20.6% of the respondents could barely say that VMMC is a surgical procedure done by qualified medical personnel under anaesthesia. The major reasons for recommending the utilisation of VMMC services to their family members were the VMMC usefulness in preventing STIs (48.9%), cultural practices and norms (31.5%), improved penile hygiene (17.4%) and religious reasons (2.2%). Conclusion: VMMC is positively favoured by the local coastal communities of the Lindi region of Tanzania Mainland. Our findings may be inferred to reflect on the other neighbouring regions with similar sociocultural set ups such as Mtwara, Pwani, Rural Dar es Salaam and Tanga and the isles of Unguja and Pemba. Programs addressing VMMC may be well instituted in these local communities with high degree of favourability and success.

Adult Anopheles Mosquito Distribution at a Low and High Malaria Transmission Site in Tanzania.

Malaria parasites are only transmitted by female mosquitoes of the genus Anopheles; hence, the disease's distribution is linked to that of the vector mosquitoes. As such, the goal of this study was to find out the spatial and temporal distribution of Anopheles mosquito adults in the research sites. This was a repeated cross-sectional ecological study that took place in Morogoro and Dodoma, Tanzania. Vacuum aspiration was used to collect mosquitoes both outside and inside human dwellings. All mosquito-related data was collected and entered into appropriate data collection forms. Female mosquitoes were recognized morphologically using Gillies and Coetzee morphological criteria, followed by PCR. In total, about 2742 Anopheles mosquitoes with an average collection of 18.21 ± 1.12 per day were collected outside human houses of which 1717 (10.51 ± 1.17) and 1025 (8.42 ± 1.41) were collected from Morogoro and Dodoma, respectively. Of the captured mosquitoes, 89.0%, 10.0%, and 1.0% were recognized as Anopheles arabiensis, Anopheles gambiae s.s., and Anopheles quadrianulatus, respectively. The distribution varied significantly with seasons, whereby 302 (4.72 ± 1.04) and 2440 (12.96 ± 1.52) mosquitoes were captured in the cold-dry and warm-wet season, respectively (p < 0.0001). Of the captured mosquitoes, 42.33%, 16.33%, 14.96%, and 4.27 were found on the ceiling, stored junks, verandas, and barks/tree, respectively. In malaria-endemic countries, vector control forms an important component of the malaria control efforts. This study found significant variation of Anopheles mosquito abundance in time and space with Anopheles arabiensis being the most predominant malaria vector. This signifies the need to introduce mosquito control methods that will target the less anthropophilic Anopheles arabiensis or the immature aquatic stages. The study further found that underbeds, store room/piled bags, and undisturbed curtains were the most preferred resting places by mosquitoes signifying to be the most effective strategic sites for spraying insecticides during the implementation of indoor residual spraying (IRS).

Spatial and temporal distribution of Anopheles mosquito's larvae and its determinants in two urban sites in Tanzania with different malaria transmission levels.

BACKGROUND: In order to be able to design and implement control measures directed to the mosquito larva stages an understanding of the spatial and temporal distribution and its determinants in different malaria transmission settings is important. This study therefore, intended to determine the spatial and temporal distribution of Anopheles mosquito's larvae and its determinants in two urban sites with different transmission levels, in Tanzania. METHODOLOGY: This study was conducted in Dodoma and Morogoro regions in Tanzania. The study was an ecological study of repeated cross-sectional type. Searching for water bodies in the selected wards was done by going around all streets. Potential breeding sites were given unique identification numbers and larval sampling was done using the standard dipping method with a 350 ml mosquito scoop and a calibrated pipette. Visual identification of presence of larvae and its abundance in each sampling were used to describe the larvae density. A sample of Anopheles mosquitoes which emerged from collected larvae, were processed for species identification using PCR. Descriptive statistics were arrived at by calculating different proportions for the variables. The overall impact of the variables on the density of Anopheles larvae was tested using multiple logistic regression. Variables with p-value less than 0.05 were regarded as significant. RESULTS: A total of 724 water bodies out of which, 576 (79.6%) potential breeding sites were analyzed. It was found that, most (96.2%) of the potential breeding sites were manmade and most (59.5%) were less than 5 m in diameter and 87.2% were within 100 m from human settlement. Out of all the potential breeding sites, 69.8% and 30.2% were in Morogoro and Dodoma respectively, out of which 72.2% and 68.4% respectively, were found during rainy season. Habitats with clean water, at a distance of 10-100 m from the house, in natural, shaded and partial sunlight habitats had higher odds of having high density of mosquito larvae than their counterparts (p < .05). The PCR analysis showed that 72.5% were An. arabiensis, 4.5% An. gambiaes.s, 0.5% An.coustaniand 20% An. quadrianulatuswhile 2.5% of the samples could not be identified because DNA was not amplified. CONCLUSION AND RECOMMENDATION: Type of water, distance from the breeding site to human settlement, light intensity and habitat origin were significant predictors of variation on the spatial and temporal distribution of Anopheles mosquito breeding sites. With increased global emphasis on control measures that targets mosquito immature stages; we recommend that larval control measures should be developed while considering the findings from this study.