Malaria Trends and Diagnoses in Rural Health Facilities in Mvomero, Tanzania

Type Thesis or Dissertation - Master of Science
Title Malaria Trends and Diagnoses in Rural Health Facilities in Mvomero, Tanzania
Publication (Day/Month/Year) 2013
Malaria remains a significant global health challenge. In 2010, an estimated
660,000 people died from malaria and about 90% of all the deaths occurred in Africa. In
Tanzania, malaria is the third most burdensome disease with 14 million cases and loss of
15,000 lives each year. This thesis investigates the trends, the diagnostic approaches and
the methods of treatment of malaria in health facilities within the Mvomero district. In
addition, this thesis examines the impact of environmental factors including
precipitation, relative humidity and temperature on the number and burden of malaria
cases in health facilities.  
To answer the research questions, both quantitative and qualitative methods
were employed. A total of 15 health facilities, including dispensaries, health centers and
hospitals, were selected to collect data. In each facility, malaria data from 2002 to 2011,
including monthly number of malaria cases and total diagnoses, were retrieved from
government‐required documents for all health facilities in Tanzania. Weather data,
including monthly precipitation, average relative humidity and temperatures, recorded
by a nearby weather station were collected from credible online resources. In addition,
qualitative data were collected through in‐depth interviews with health workers
working in the facilities and with district officers. Statistical analyses, specifically, linear
regression and ridge regression, were conducted to examine the trends in the number of
malaria cases and the impact of weather on malaria. Qualitative analysis was conducted
to examine the common practices of malaria diagnoses and treatments in health facilities
in the Mvomero district.   
This study found that the burden of malaria in Mvomero district remained
significant from 2002 to 2011. No significant increasing or decreasing trends in the
number of malaria cases in health facilities were found during the past decade.
Regarding the impact of weather on the number of malaria cases, the study found that
increases in relative humidity and maximum temperature led to increases in malaria
cases. However, precipitation seems to have dual effects. It decreases the number of
malaria cases for the current month while it increases the number of cases in later
months. From the qualitative analysis, the study showed that due to the lack of
equipment and technicians, microscopy was not widely used in Mvomero district,
though recommended by the government. Clinical diagnosis was still the major way
used to diagnose malaria. Many health workers showed trust in clinical diagnosis. As
for treatment, artemether‐lumefantrine (ALU), which has been recommended as first‐
line antimalarial drug in Tanzania since 2007, has replaced sulfadoxine‐pyrimethamine
(SP) to become the most commonly used antimalarial drug in Mvomero district. Most of
the health workers welcomed the use of ALU and considered it a safe and effective

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