Program/Project Purpose: An estimated 200 million people are infected with schistosomiasis, making the disease one of the top neglected tropical diseases and a major global health concern. In Tanzania, with a population just over 42 million, about 33 million are in need of treatment or preventative chemotherapy. The disease is of particular concern in the Lake Victoria region, due to daily use of lake water. In conjunction with the Shirati district hospital, Touro University-CA has led control programs carried out in mobile clinics at local villages by providing screening, treatment, and education. Recently there has been a push for use of static dispensary locations for diagnosis and treatment. The aim of this study is to assess the longitudinal efficacy of community based interventions for schistosomiasis carried out from 2009-2014 and compares the utilization of static health dispensary clinics to the community based mobile clinics in reaching out to the population.
Structure/Method/Design: Villagers were alerted to the screening, treatment, and education program through local leaders, announcements over the radio, and posters. Effectiveness will be measured by analyzing trends in the number of people visiting the clinics, prevalence of infection, the number treated, given positive infection status, and change in prevalence patterns with treatment. The number of people screened at dispensaries versus mobile clinics will be compared. We hypothesize that mobile clinics are effective in reducing prevalence of schistosomiasis in community based interventions and that health dispensaries provide no additional value towards increasing number of individuals screened.
Outcomes & Evaluation: Univariate analysis and 2-tailed t-tests will be performed to assess if the use of services has significantly increased or not at mobile clinics from 2009-2014, and to compare utilization of health dispensaries versus mobile clinics. Prevalence of those who test positive will also be determined and analyzed to assess for a downward trend. Preliminary analysis reveals that from 2012 to 2014, prevalence of infection has decreased and that utilization of health dispensaries provides no additional value over mobile clinics. Our study supports the use of mobile clinics to carry out community-based health education, screening, and treatment programs over the use of dispensaries in rural Tanzania.
Going Forward: During this study mobile clinics reported decreased prevalence and are able to capture a larger population of people interested in being screened for infection. Since use of dispensaries is favored by the Mara district, it will be important to point out the efficiency of mobile clinics or improve the efficacy of dispensaries by increasing the frequency of screenings or widening the area of promotion to other nearby villages.
Ogawa, L., Benallack, G., Heffner, A., Duong, J., Rosenblatt, R., Buere, C., Nibbe, Y., & Mahmoud, E. (2015). Assessment of longitudinal efficacy of community based intervention for schistosomiasis in Mara District, Lake Victoria region of Tanzania. Annals of Global Health, 81(1), 131-132.