Malaria risk and access to prevention and treatment in the paddies of the Kilombero Valley, Tanzania

Hetzel, Manuel W. and Alba, Sandra and Fankhauser, Mariette and Mayumana, Iddy and Lengeler, Christian and Obrist, Brigit and Nathan, Rose and Makemba, Ahmed M. and Mshana, Christopher and Schulze, Alexander and Mshinda, Hassan. (2008) Malaria risk and access to prevention and treatment in the paddies of the Kilombero Valley, Tanzania. Malaria journal, Vol. 7 , 7.

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Official URL: http://edoc.unibas.ch/dok/A6194494

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Background: The Kilombero Valley is a highly malaria-endemic agricultural area in south-eastern Tanzania. Seasonal flooding of the valley is favourable to malaria transmission. During the farming season, many households move to distant field sites (shamba in Swahili) in the fertile river floodplain for the cultivation of rice. In the shamba, people live for several months in temporary shelters, far from the nearest health services. This study assessed the impact of seasonal movements to remote fields on malaria risk and treatment-seeking behaviour. Methods: A longitudinal study followed approximately 100 randomly selected farming households over six months. Every household was visited monthly and whereabouts of household members, activities in the fields, fever cases and treatment seeking for recent fever episodes were recorded. Results: Fever incidence rates were lower in the shamba compared to the villages and moving to the shamba did not increase the risk of having a fever episode. Children aged 1-4 years, who usually spend a considerable amount of time in the shamba with their caretakers, were more likely to have a fever than adults (odds ratio = 4.47, 95 confidence interval 2.35-8.51). Protection with mosquito nets in the fields was extremely good (98 antimalarials was uncommon. Despite the long distances to health services, 55.8 health facility, while home-management was less common (37 17.4-50.5). Conclusion: Living in the shamba does not appear to result in a higher fever-risk. Mosquito nets usage and treatment of fever in health facilities reflect awareness of malaria. Inability to obtain drugs in the fields may contribute to less irrational use of drugs but may pose an additional burden on poor farming households. A comprehensive approach is needed to improve access to treatment while at the same time assuring rational use of medicines and protecting fragile livelihoods.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Health Interventions > Malaria Interventions (Lengeler)
UniBasel Contributors:Hetzel, Manuel W
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:BioMed Central
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:31 Jan 2014 09:49
Deposited On:31 Jan 2014 09:49

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