by Ben Taylor

Tanzania concludes review of Covid response, aims to speed up vaccine rollout
The Ministry of Health in the United Republic of Tanzania, with technical support from WHO and other development partners including UNICEF, USAID, British Council, the Jon Snow Institute (JSI) and US Centers for Disease Control (CDC), has concluded a second review of the country’s response to the Covid-19 pandemic. Since the previous review, conducted in October 2021, Tanzania had intensified immunisation activities, including expansion of outreach sessions and updated the existing National Vaccine Deployment Plan (NVDP).

Vaccine Deployment Manager, Dr Florian Tinuga, said the review was critical to assess the operational capacity of the system for a robust response to the pandemic. “The main purpose was to appraise the functional capacity of the Covid-19 response system at the national and sub-national levels following the introduction of additional vaccines (Sinopharm, Moderna and Pfizer vaccines),” he said. He added that the focus is to assist the country to identify best practices and challenges to further improve the vaccination roll-out.

The WHO focal person for Immunization and Vaccine Development (IVD), Dr William Mwengee reiterated WHO’s commitment to providing needed technical leadership of the Tanzanian response. “Although Tanzania had setbacks at the beginning of her response to COVID-19 pandemic, WHO will continue to provide needed technical leadership of the overall response to ensure that Tanzanians in Mainland and Zanzibar are largely protected from Covid-19 infections,” he said.

Best practices identified include intensified outreach services in Ruvuma region, characterised by the use of contextualised local slogans “Timua vumbi” that have enabled Ruvuma to reach the highest Covid-19 coverage of 12%, more than double the national average of 4%. In Dar es Salaam, the integration of Covid-19 vaccination in routine HIV/AIDS Care and Treatment Clinics with the support of Management and Development for Health (MDH) increased the vaccination rate of People Living with HIV/AIDS from 2,000 to 5,000 per day. Engagement of vaccine champions in the communities have also helped to address misconceptions, rumours and misinformation.

Vaccination coverage in Tanzania remains significantly lower than the global and regional targets established for countries. At the time of writing (April 12, 2022), the latest official figures are that just under 4 million people in Tanzania have received one or more dose of a Covid-19 vaccine, representing 6.4% of the population. This compares to over 21% in Kenya and 32% in Uganda.

Key challenges responsible for low vaccination rates in Tanzania include delayed introduction the vaccine into the country, and low demand due to misinformation about Covid-19. Qualitative findings also indicate that many Tanzanians are unwilling to receive external Covid-19 vaccine due to uncertainties towards its effectiveness as deaths are still occurring in countries where people are vaccinated.

Going forward, the review highlighted the need for advocacy with high-level political, community and religious leaders and increased access to vaccines. In addition, a mass campaign to scale up vaccination activities with adequate resource mobilisation is needed in the coming months.

Separately, at a joint meeting of the Ministry of Health and development partnership, the WHO has called on development partners and agencies for a renewed commitment to strengthen the country’s effort to urgently interrupt ongoing transmission.

“Tanzania has an impressive routine immunization programme,” said Dr Tigest Ketsela Mengestu, the WHO Country Representative for Tanzania, “so I am confident that if partners and the government work harder together, Tanzania can surprise the world by scaling up Covid-19 vaccination coverage and be on track to achieving the targets”.

The Permanent Secretary of the Ministry of Health, Professor Abel Makubi, reiterated the Tanzanian government’s commitment to scale up Covid-19 vaccination and ensure that her citizens are protected from the pandemic. He noted that Tanzania is still far from the national target of 60% of fully vaccinated population by June 2022. “The country is set to achieve the target but this requires the cooperation and support of the partners and donors”, he added.

Study on Covid-19 patients in Tanzania
The first study in Tanzania to examine the characteristics of Covid-19 patients and the outcomes of their treatment reveals about three-quarters of all patients were under the age of 60. Scientists studied the COVID-19 patients in the early months of the outbreak amid scarcity of data on the pandemic. Results of the study were published in IJID Regions, an official journal of the International Organization for Infectious Diseases (ISID).

Researchers tracked 112 patients at two referral hospitals in Dar es Salaam between April and May 2020. Of these, 93% were hospitalized, while 9 patients (7%) were out-patients.

According to findings of the study on characteristics of COVID-19 patients in Tanzania, the age of the studied patients reflects the number of people infected with the coronavirus in Africa. The average age of all patients was 41 years, while the average age of the patients who lost their lives was 58 years. Six out of 10 patients in the study were men. The average age is similar to that reported in South Africa but slightly lower than that reported in China, Libya, the United States (New York) and Italy in early stages of the pandemic, where the average age was higher, with patients being older compared to Tanzania and South Africa.

Headache was the commonest symptom reported among 55% of patients, followed by fever reported by 49%.

Professor Sayoki Mfinanga, a public health Specialist and researcher from the National Institute of Medical Research (NIMR) is the lead author of the study. He says that the symptoms found among patients during the study are similar to those reported worldwide. But he says, “…symptoms such as shortness of breath, altered consciousness, and neurological signs were significantly associated with mortality in the COVID-19 patients.”

“This is important because it is from Tanzania, the place where data was almost absent and the Covid story was only told by a political narrative,” said Mwidimi Ndosi, Associate Professor of Rheumatology Nursing at Bristol School of Health and Social Welfare in the UK.

“It calls into question all the previous government data and its interpretation that drove the policy, the implications of which are still affecting Tanzania now.” However, he adds: “This study opens the minds of some people who once believed that this is a disease that affects only the elderly,” says Ndosi.

Most Tanzanians use traditional medicines
The acting director of Healthcare Services at the Health Ministry, Dr Caroline Damiani, has said that over 60% of Tanzanians use traditional medicines to treat different diseases before or after trying ordinary health-care centres. Dr Damiani made the remark when opening a training seminar for traditional doctors. The seminar aimed at exchanging experiences among the herbalists and discussing various challenges and strategies of improving the profession of traditional and alternative medicine so that it can continue benefitting Tanzanians.

“Over 60% of Tanzanians, at one time or another, get treated by traditional medicine against various diseases before or after going to our health centres or hospitals providing modern health-care services,” said Dr Damiani. She said the main goal of the seminar was to ensure that traditional medicines were better from the stages of growing, harvesting, manufacturing, preserving to the stage of reaching the consumer so that there should not be side-effects.

According to Dr Damiani, the Health Ministry, through the Traditional and Alternative Health Practice Council, has registered 73 types of traditional medicine, out of which 20 had positive results during the period of fighting against the Covid-19 disease.

For his part, the representative of traditional and alternative medicine doctors, Mr Shaban Omary Shekilindi – who doubles as the Lushoto MP (CCM) – praised the ministry and its traditional and alternative medicine unit, for organising the seminar.

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