Children awaiting treatment

Overview of country programme 

Quick facts

Programme launched: 2014

In-country partners: Ministry of Health Community Development, Gender, Elderly and Children, CNTD, USAIDEnvision/RTI/IMAITISSI, HKICMBPfizerAPOC/WHO, GSK and Merck

Funded by:  DFID- ICOSA

Budget: £751,714

Treatments: 4,323,628 school aged children in 2015

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Despite Tanzania’s NTD control program being launched as early as 2000, the size of population at risk and lack of sustained allocation of resources made it difficult for the country to meet the need for control of morbidity and reduction in transmission of schistosomiasis (SCH) and soil-transmitted helminths (STH). With the establishment of an integrated programme for NTD control in 2009 and the launching of their multiyear NTD master plan (2012 – 2017), Tanzania is now a position to reach full national scale geographical SCH treatment coverage by 2017. Uniquely, Tanzania carries out biennial urban MDA, in its largest city, Dar –es- Salaam, an experience that most other countries, though having some reports of SCH in the cities, have not implemented any control strategy targeting such areas.   
 

The MDA distribution of Praziquantel in Tanzania targets primary school-age children (5-14 years) who are the most high-risk group. The distribution method is both school based and community based using teachers and community district distributors (CDDs) as the drug distributors for each method respectively. The frequency of treatment of the children depends on the level of SCH prevalence following the recommendations within the WHO protocols and the proposed MDA schedule.   

The programme is implemented directly through the Ministry of Health, Community Development, Gender, Elderly and Children (formally known as the Ministry of Health and Social Welfare) at the district level. The district also develops all health plans and implementation schemes following identified local and national priorities by the Council Health Management Team (CHMT). Each endemic district has an NTD Focal Person within the CHMT to coordinate the implementation of NTD activities. The CHMT also develops budgets, then implements, monitors and evaluates the impact of the plans.   

All Research, Monitoring and Evaluation activities are implemented by the parasitologists/technicians based at either the central level or regional level. Extra support is also provided by the staff located at the National Medical research institute, Mwanza.    

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Prevelance Map

TanzaniaMap of Tanzania showing schistosomiasis prevelance. Low risk is considered ≥1% and <10%, medium risk is considered ≥10% and <50% and high risk is considered ≥50%. 

History

Control efforts of Schistosomiasis and STH started under the NSSCP by targeting primary school-age children (5-14 years) who are the most high-risk group. The main intervention is drug delivery to pupils by trained schoolteachers supported by health personnel, which should be complemented by school health education and environmental sanitation. The program worked with in partnership between the MOHSW, MOEVT and Local Government Authorities (LGAs). 

Phase I implementation began in 2005 in 11 highly endemic regions and covered approximately 4 million enrolled and non-enrolled school-aged children with Praziquantel and Mebendazole. The retreatment for the second campaign was refined using the maps produced from the Schistosoma haematobium survey data. All school-aged children were treated following the WHO recommended protocol in areas with >30% prevalence. School-aged children in standards 1,3,5 and 7, were treated in areas with prevalence 10-30%, and only children in standards 1 and 7 were treated in areas with prevalence <10%.  This reduced the targeted population across the 11 regions to 2.94 million children who were treated in September 2007. In Phase II (2008), 6 regions were treated where by 2 million school age children were targeted.  

From 2009, with support from USAID and APOC, Tanzania started scaling up treatment in regions where more than one NTD was present. SCI with support from ICOSA –DFID secured funding to provide resource support to treat for SCH in the otherwise unsupported highly endemic areas. In 2013, SCI delivered 4.91 million PZQ tablets to treat approximately 1.9 million SAC across two regions of Mwanza and Dar-es-Salaam (10 districts) 

2016 will see the expansion of SCI support to reach the 4 remaining regions of Tanzania (28 districts), enabling Tanzania to reach full geographical national scale coverage, and increasing the number of SCI supported treatments to 4.3million SAC.