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.

Tungiasis infection among primary school children in Northeastern Tanzania: prevalence, intensity, clinical aspects and associated factors.

Objective: To investigate the prevalence, intensity, clinical aspects and factors associated with tungiasis infection among primary school children in Northeastern Tanzania. Methods: A quantitative school-based cross-sectional study was conducted among 401 primary school children. Participants were assessed through clinical examination to look for embedded Tunga penetrans in their hands, feet, arms and legs. A structured questionnaire was used to enquire about factors associated with tungiasis infection. The data were analysed using descriptive statistics, Chi-squared test and logistic regression, with p<0.05 taken to indicate significance. Results: The overall prevalence of tungiasis infection was 21.2%. Of the 85 tungiasis-infested children, 54 [63.5%, 95% confidence interval (CI) 53.1-74.1] had mild infection, 25 (29.4%, 95% CI 19.0-39.6) had moderate infection, and six (7.1%, 95% CI 1.2-12.9) had heavy infection. A moderate level of knowledge was significantly associated with high odds of tungiasis infection [adjusted odds ratio (AOR) 3.16, 95% CI 1.50-6.67], while not keeping a dog/cat at home was a protective factor (AOR 0.47, 95% CI 0.25-0.89). Conclusions: Moderate prevalence of tungiasis infection was observed among primary school children favoured by factors related to the host, parasitic agent and environment. There is a need for a health education programme in schools encouraging use of appropriate footwear (closed shoes), use of locally accessible repellents (coconut oil), fumigation of households, and washing dogs/cats with insecticides.

Intestinal schistosomiasis among secondary school students in Northern Tanzania: prevalence, infection intensity and associated risk factors.

Objective: Our study investigated the prevalence, infection intensity and associated risk factors of intestinal schistosomiasis among secondary school students in Shinyanga Municipal Council, Northern Tanzania. Methods: A quantitative school-based cross-sectional study was conducted from June to August 2022 among 620 secondary students. One stool specimen per participant was collected and screened for Schistosoma mansoni ova by microscopy using the Kato-Katz technique. Ova were counted to estimate infection intensity in all positive stool samples. Participants' socio-demographic characteristics and risk factors for intestinal schistosomiasis were gathered using a structured questionnaire. Data analysis consisted of descriptive statistics, Chi-square test and logistic regression. Results: Overall prevalence of S. mansoni was 1.9%. All infected participants had light infection intensity. Overall prevalence of other intestinal parasites was 2.7%, with Hookworm spp (17.6%) and Entamoeba coli (52.9%) the most observed intestinal helminth and protozoa, respectively. Among assessed factors, being in form II or III, visiting water sources and doing activities in water sources were statistically significantly associated with increased risk of S. mansoni transmission. Conclusions: There is ongoing transmission of intestinal schistosomiasis among secondary students. Hence, the need for extending praziquantel administration in this group, health education provision, and improvement of water supply, sanitation and hygienic practices.

Prevalence of Schistosoma mansoni infection among fishermen in Busega district, Tanzania.

BACKGROUND: Schistosoma (S.) mansoni infection is endemic in all regions around Lake Victoria and affects all age groups to different degrees. In most endemic areas, less attention has been paid to determining the prevalence of infection, sanitation status, and knowledge about intestinal schistosomiasis (KIS) in fishermen. Therefore, the purpose of this study was to establish the prevalence of S. mansoni infection and associated factors among fishermen in the Busega district. MATERIALS AND METHODS: A cross-sectional study was conducted among fishermen in July, 2020 in five fishing villages in the Busega district located along Lake Victoria. A total of 352 fishermen were interviewed with regard to their sanitation status and level of KIS. A single stool sample from fishermen was examined for S.mansoni eggs by using the Formalin-Ether Concentration technique. The potential factors associated with S. mansoni infection were explored using multivariable logistic regression. RESULTS: The prevalence of S. mansoni infection was high (65.0%) among fishermen and varied with age, whereby fishermen aged ≤36 years had the highest prevalence. Fishermen had a low level of KIS and the majority of them reported practicing open defecation during fishing (81%). These fishermen with a low level of KIS and who reported defecating in open areas during fishing had 2.8 times (95% CI: 1.0-7.2) and 2.1 times (95% CI: 1.1-3.9) higher odds of being infected with S. mansoni than those with a high level of KIS and those who did not report defecating in open areas during fishing, respectively. CONCLUSION: S. mansoni infection was high among fishermen in the Busega district. Furthermore, fishermen had a low level of KIS and were reported to have defecated in open areas during fishing. Infection with S. mansoni was associated with age, a low level of KIS and open defecation behaviour during fishing. Therefore, mass drug administration (MDA) with praziquantel, health education, and sanitation behaviour change interventions were needed.

The viability of utilising phone-based text messages in data capture and reporting morbidities due to lymphatic Filariasis by community health workers: a qualitative study in Kilwa district, Tanzania.

BACKGROUND: Globally, there is recognition of the value of using mobile phones among health providers in improving health systems performance. However, in many Low- and Middle-income countries where there is shortage of health providers, Community Health Workers have assumed some responsibilities especially relating to identifying and reporting on health problems within their communities. Despite the known benefits of using mobile phone technology to deliver health services, there is limited information on the extent to which Community Health Workers are able to effectively use the technology in data collection and reporting. The aim of this study was to determine the feasibility of utilizing phone-based text messages on Lymphatic Filariasis morbidity surveillance by Community Health Workers. METHODS: This was a cross sectional study whose data was collected through key informant interviews and focused group discussions among community health workers, health providers and staff of neglected tropical diseases control program. Collected transcripts were analysed through Thematic content analysis as it allowed for the identification of data codes through inductive reasoning. RESULTS: The use of mobile phone-based text messages in data collection and reporting lymphatic filariasis morbidity cases by Community Health Workers was perceived by study participants to be a relevant tool and feasible due to the ease of use of the technology. The tool was reported by end-users to significantly increase their performance and efficiency was gained in terms of reduced paper work, increased the number of patients accessing health care services and the ability to report in real-time. All respondents were confident that Community Health Workers were the right persons to interact with communities in tracking and reporting morbidity cases using mobile technology. CONCLUSION: Mobile phone-based text messages have proven to be effective in routine workflows such as, data collection and reporting on Lymphatic Filariasis morbidity cases, patient to provider communication, decision making and supportive supervision. Mobile phones have also improved efficiency and general performance of end users in terms of increased number of cases identified and efficiency gained in terms of reduced paper work and the ability to collect and report in real-time.

Prevalence and management of filarial lymphoedema and its associated factors in Lindi district, Tanzania: A community-based cross-sectional study.

OBJECTIVE: To determine the burden and management of filarial lymphoedema and its associated factors in Lindi district, Tanzania. METHODS: Cross-sectional study involving 954 community members who were screened for filarial lymphoedema by using a checklist. Moreover, lymphoedema patients were examined for the presence of entry lesions, staging of disease, and interviewed on acute dermatolymphangioadenitis (ADLA) attacks, and their current practices on lymphoedema management. Descriptive statistics and logistic regression analyses were performed. A p < 0.05 was considered statistically significant. RESULTS: The prevalence of filarial lymphoedema was 7.8%, with the majority in the early stage of lymphoedema (78.4%). The large majority (98.6%) of the patients had lower limb lymphoedema and 46% of lymphoedema patients had entry lesions. More than a half (60.8%) of those lymphoedema patients had experienced ADLA attacks; close to two-thirds (64.8%) had one or two attacks in the past 6 months. Generally, patients had inappropriate hygiene care practices for filarial lymphoedema management. Inappropriate hygiene care practice for lymphoedema management was associated with an increased risk for the development of advance stage of lymphoedema (adjusted odds ratio = 7.379, 95%, confidence interval: 3.535-16.018, p = 0.04). CONCLUSION: Though lymphatic filariasis transmission has drastically declined, chronic manifestations of lymphoedema persist in Lindi district. The recommended disease management practices are deficient, which calls for a programmatic approach for mapping the burden of lymphoedema and implementing its management.