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KEEPING CHILDREN WORM-FREE IN TANZANIA

Investing in preventive treatment helps tackle widespread tropical diseases in Africa

September 9^th, 2016

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Tanzania is known for its vast wilderness areas. With 16 national parks, including the famed Serengeti National Park, and 29 game reserves, this East African country has some of the continent’s greatest concentrations of wild animals.

The Selous game reserve in Tanzania is Africa's largest.

Yet like many African countries, this large and geographically diverse country has its fair share of tropical diseases. These include malaria, dengue and schistosomiasis.

Also known as “snail fever”, schistosomiasis is a parasitic disease carried by fresh water snails. It is one of the most widespread tropical diseases in the world after malaria, affecting more than 249 million people globally, including 100 million children.

The disease poses a huge health burden in developing countries, especially in Africa where more than 90% of the infections occur. In Tanzania, the first cases of schistosomiasis were reported in the early 19th century.

Schistosomiasis poses a huge health burden in developing countries, especially in Africa.

A lack of sufficient hygiene and activities such as swimming or fishing in infested water make school-aged children especially vulnerable to infection. The disease is also more common in poor communities without adequate access to safe drinking water and sanitation.

School-aged children are more vulnerable to infection.

Abdominal pain, diarrhea and blood in the stool or urine are common symptoms of schistosomiasis. The effects on children can be quite dire - causing anemia, stunting and impaired learning, although the effects are usually reversible with treatment.

Shistosomiasis causes anemia, stunting and impaired learning in children.

Prevention goes a long way towards addressing the problem. Yet only 27% of the 10.8 million people in Tanzania who require preventive treatment for schistosomiasis received it in 2014.

Only 27% of the people in Tanzania requiring preventive treatment for schistosomiasis received it in 2014.

The Access and Delivery Partnership (ADP) - led by UNDP and in collaboration with the WHO Special Programme for Research and Training in Tropical Disease and PATH - helps build national capacities for the delivery of new health technologies for tuberculosis, malaria, and neglected tropical diseases like schistosomiasis.

The Access and Delivery Partnership ensures that preventive medication for schistosomiasis reaches children in vulnerable areas.

Part of these efforts includes ensuring that preventative medication for schistosomiasis reaches children in areas that are most vulnerable.

To tackle this important public health problem, the Government of Tanzania has been implementing periodic, large-scale population treatment with Praziquantel tablets. This, combined with access to safe drinking water, improved sanitation and snail control, helps reduce transmission of the disease.

The Government implements periodic, large-scale population treatment with Praziquantel tablets.

Access to safe drinking water, improved sanitation and snail control also help reduce transmission of the disease.

Drug distribution points are often set up in schools. More than 700 children at this school outside of the capital city Dar es Salaam receive preventive treatment twice a year through the government programme. ADP also supports the training of front-line health workers to effectively deliver the preventive treatment to school children.

More than 700 children at this school outside of the capital city Dar es Salaam receive preventive treatment twice a year.

Children must take the medication on a full stomach, usually two hours after eating. A traditional Tanzanian meal of hearty rice and beans usually does the trick.

“Usually, children bring a packed lunch from home to school, but every six months we give them a hot meal as part of the mass drug administration programme,” said the school head mistress.

Until recently, the preventive treatment needs of younger children (infants and pre-school children) had largely been overlooked. A consortium of public and private institutions and national stakeholders in Tanzania such as the Ifakara Health Institute, with support from the Global Health Innovative Technology (GHIT) Fund, is now working on developing a new pediatric formulation of praziquantel. When this preventive medication becomes available, it will be distributed to younger children as part of the large-scale population treatment campaign.

Younger children will receive preventive medication in the near future.

Thanks to support from the Government of Japan, Tanzania is one of the three pilot countries where ADP is working in partnership with national stakeholders to improve health outcomes, including keeping children worm-free. This is achieved through new health technologies, such as the pediatric praziquantel, better supply chain management systems, and focused investments in existing health systems.