Tanzania: Seeking to Toss Polio Into Dustbin of Medical History

AUTHORITIES in Kagera are working on initiatives to conduct measles-rubella and polio vaccinations targeting over 800,000 children under five years.

In a bid to eradicate polio from the face of the earth, Tanzania has joined the rest of the world in immunizing her children en masse.

Kagera Regional Medical Officer (RMO), Dr Marco Mbata, told the 'Daily News' in an interview in Bukoba that about 492,393 children were expected to get measles-rubella (MR) vaccinations while 226,066 children will get polio (IPV) vaccinations.

The campaign is part of the implementation of the government plan to reduce the number of deaths and disabilities, resulting from vaccine preventable diseases. The campaign was earlier scheduled for last month but it was postponed to October 17 to 21 this year.

I appeal to residents in the area to cooperate with the government to make it successful. Let parents bring all the children so that we can eradicate the crippling polio disease from our country. There is a global campaign going on which if carried out effectively, polio should be eradicated like smallpox which is now no more.

He reiterated the government commitment to ensure that people get maximum social services including health, education and water infrastructure adding that all necessary logistics had been made to ensure that the campaign is a success.

Dr Mbata further explained that about 348,380 Insecticide Treated Nets (ITN) will be distributed to all Standard One to Five pupils in 981 primary schools in the region. My appeal to people to invest in health by checking their status from time to time. Investing in health is very crucial.

Weak and sick persons cannot contribute positively in national building. Economic development of the country depends on good health of the people, I also urge people to join the Community Health Fund (CHF) to enable them to enjoy services rendered by the Fund.

Malaria prevalence in Kagera Region had been considerably reduced from 42 per cent recorded during 2007/8 to 15.4 per cent during 2017/18 while the national malaria prevalence rate stood at 7.1 per cent.

However, more efforts were needed to reduce malaria by employing an integrated approach including prevention through mosquito nets and indoor residual spraying, Kagera is listed among regions with high malaria prevalence, a leading cause of death for children aged under five years and pregnant women as well as a major cause of maternal mortality.

He cited concerted efforts they mounted in the region including indoor residual spraying (IRS) and use of insecticide treated nets (ITN) and polio jabs to infants. Dr Mbata revealed that during 2018/19 financial year government released about 4.5bn/- for the construction of three district hospitals for Kyerwa, Karagwe and Bukoba districts.

Also, three dispensaries namely Nyakanazi (Biharamulo), Bunazi (Missenyi) and Kayanga (Karagwe) have been upgraded to Health Centres. We thank President John Magufuli for upgrading Bunazi (Misenyi), Nyakanazi (Biharamulo) and Kayanga (Karagwe) dispensaries to Health Centres.

This is a big achievement because in the past pregnant women had to travel long distance of 50 kilometres. Giving measles status in the country, Minister for Health, Community Development, Gender, Elderly and Children, Ms Ummy Mwalimu said that last month, the disease was reported in Kashasha and Kakoma divisions and Kibare Village in Kyerwa District in Kagera region.

About 17 patients were detected with measles virus, of which seven patients were confirmed after undergoing laboratory tests, She said that the last patient with measles symptoms was reported on September 14 this year at Kibare area.

"There is no other patient reported in the past two weeks, and those who contracted the disease have recovered- health personnel were educating people on preventive measures against the disease and creating awareness about the nationwide campaign on measles/rubella," she said.

Measles is a highly contagious viral disease. It remains an important cause of death among young children globally, despite the availability of a safe and effective vaccine. Under the Global Vaccine Action Plan, measles and rubella are targeted for elimination in five WHO Regions by 2020.

WHO is the lead technical agency responsible for coordination of immunization and surveillance activities supporting all countries to achieve this goal. Measles is transmitted via droplets from the nose, mouth or throat of infected persons.

Initial symptoms, which usually appear 10-12 days after infection, include high fever, a runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.

Severe measles is more likely among poorly nourished young children, especially those with insufficient vitamin A, or whose immune systems have been weakened by HIV/ AIDS or other diseases. The most serious complications include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, and severe respiratory infections such as pneumonia.

Routine measles vaccination for children, combined with mass immunization campaigns in countries with low routine coverage, are key public health strategies to reduce global measles deaths.

While global measles deaths have decreased by 84 per cent worldwide in recent years - from 550,100 deaths in 2000 to 89,780 in 2016 - measles is still common in many developing countries, particularly in parts of Africa and Asia. An estimated 7 million people were affected by measles in 2016.

The overwhelming majority (more than 95%) of measles deaths occur in countries with low per capita incomes and weak health infrastructures. The measles vaccine has been in use since the 1960s. It is safe, effective and inexpensive.

WHO recommends immunization for all susceptible children and adults for whom measles vaccination is not contra indicated. Reaching all children with 2 doses of measles vaccine, either alone, or in a measles-rubella (MR), measles- mumps-rubella (MMR), or measles-mumps-rubellavaricella (MMRV) combination, should be the standard for all national immunization programmes.

Minister Mwalimu explained that vaccination of children against polio would continue although the last case of the crippling disease was reported in the country nearly 20 years ago, We will continue with the vaccination because there are still cases of polio in some countries within the region.

The last case of polio was reported in 1996 and traced in Mtwara region and that ever since no cases had been reported, implying that the disease had been wiped out in Tanzania. However, she insisted that vaccination for all infants against polio would continue alongside a dozen other diseases, including tuberculosis (TB), tetanus, pneumonia, hepatitis, rota virus, patsusis, diarrhea and others.

Two years ago, the government announced that it was stepping up vaccination against polio in the border region in the wake of the confirmed cases of the disease in Somalia and the refugee camps in north-eastern Kenya.

By then cases of the disease had also been reported but not conclusively confirmed in neighbouring Democratic Republic of Congo (DRC) and Uganda. She assured that Tanzania had made strong investments toward national immunization programme as a key strategy to reduce infant mortality and to improve maternal health and that the country-wide coverage was about 90 per cent.

We know that vaccines saves lives and immunization is a critical component of our health systems. Besides immunization, she attributed the declining numbers of child mortality in the country to vitamin A supplementation, the use of insecticide treated nets and improved drugs to treat malaria.

Poliomyelitis, or polio, is a crippling disease caused by any one of three related viruses, poliovirus types 1, 2 or 3. The only way to spread poliovirus is through the faecal/ oral route. The virus enters the body through the mouth when people eat food or drink water that is contaminated with faeces.

The virus then multiplies in the intestine, enters the bloodstream, and may invade certain types of nerve cells, which it can damage or destroy.

Polioviruses spread very easily in areas with poor hygiene. Prevention: Live oral polio vaccine (OPV) - four doses in endemic countries or Inactivated polio vaccine (IPV) given by injection - two-three doses depending on country schedule.

That is the challenge facing international health workers who are coordinating a massive fund raising drive aimed at ridding the world of a biblical scourge that has killed or crippled millions of children -we call it polio. If the campaign works, within the next four years it is possible polio may have been consigned to the dustbin of medical history to take its place alongside smallpox as an extinct disease.

Particular efforts against polio are being made in Africa, where it is estimated that routine immunization coverage against the disease is only 58 per cent as compared to a global average of 83 per cent by 1997.

In 1995 WHO received reports of 6,179 cases of polio but estimates that, because not all cases are reported, there were probably some 83,000 children paralyzed by the disease. The 1988 figure for reported cases was 31,251 but the real figure was put at 500,000.

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