1,727,975 research outputs found
Study and implementation of urogenital schistosomiasis elimination in Zanzibar (Unguja and Pemba islands) using an integrated multidisciplinary approach
Full text linkABSTRACT: BACKGROUND: Schistosomiasis is a parasitic infection that continues to be a major public health problem in many developing countries being responsible for an estimated burden of at least 1.4 million disability-adjusted life years (DALYs) in Africa alone. However, morbidity due to schistosomiasis has been greatly reduced in some parts of the world, including Zanzibar. The Zanzibar government is now committed to eliminate urogenital schistosomiasis. Over the next 3--5 years, the whole at-risk population will be administered praziquantel (40 mg/kg) biannually. Additionally, snail control and behaviour change interventions will be implemented in selected communities and the impact measured in a randomized intervention trial. METHODS: In this 5-year research study, on both Unguja and Pemba islands, urogenital schistosomiasis will be assessed in 45 communities with urine filtration and reagent strips in 4,500 schoolchildren aged 9--12 years annually, and in 4,500 first-year schoolchildren and 2,250 adults in years 1 and 5. Additionally, from first-year schoolchildren, a finger-prick blood sample will be collected and examined for Schistosoma haematobium infection biomarkers. Changes in prevalence and infection intensity will be assessed annually. Among the 45 communities, 15 were randomized for biannual snail control with niclosamide, in concordance with preventive chemotherapy campaigns. The reduction of Bulinus globosus snail populations and S. haematobium-infected snails will be investigated. In 15 other communities, interventions triggering behaviour change have been designed and will be implemented in collaboration with the community. A change in knowledge, attitudes and practices will be assessed annually through focus group discussions and in-depth interviews with schoolchildren, teachers, parents and community leaders. In all 45 communities, changes in the health system, water and sanitation infrastructure will be annually tracked by standardized questionnaire-interviews with community leaders. Additional issues potentially impacting on study outcomes and all incurring costs will be monitored and recorded. DISCUSSION: Elimination of schistosomiasis has become a priority on the agenda of the Zanzibar government and the international community. Our study will contribute to identifying what, in addition to preventive chemotherapy, needs to be done to prevent, control, and ultimately eliminate schistosomiasis, and to draw lessons for current and future schistosomiasis elimination programmes in Africa and elsewhere.Trial registrationISRCTN4883768
Improving bycatch mitigation measures for marine megafauna in Zanzibar, Tanzania
Full text linkThis study was conducted to explore the governance processes and socio-economic factors relevant to the potential implementation of bycatch mitigation for various vulnerable marine megafauna (rays, sharks, marine mammals and turtles) in Zanzibar, Tanzania. Questionnaire-based interviews were conducted between February and April 2017 with fishers (n= 240) at eight landing sites. One focus group discussion was held in each site and eleven key informant interviews were carried out. The study showed that current measures to manage bycatch rates are not explicit; no rules govern rays and sharks bycatch; and rules regarding marine mammal and sea turtle bycatch are poorly enforced. Binary logistic regression was used to determine the effect of five selected socio-economic factors (education, age, proportional fishing income, fishing experience, and the number of adults who bring income into the household) on the willingness of fishers to participate in potential future bycatch mitigation measures for marine megafauna. The results indicate that only one factor (the number of adults who bring income into the household) had any significant effect (p=0.016). These findings could benefit the future governance and management of marine megafauna in Zanzibar through a better understanding of what mitigation measures are more likely to be supported
Community Knowledge, Perceptions, and Practices Associated with Urogenital Schistosomiasis among School-Aged Children in Zanzibar, United Republic of Tanzania
Full text linkBackground: On the Zanzibar islands, United Republic of Tanzania, elimination of urogenital schistosomiasis is strived for in the coming years. This qualitative study aimed to better understand community knowledge, perceptions, and practices associated with schistosomiasis among school-aged children on Unguja and Pemba islands, in order to inform the development of behavior change interventions contributing to eliminate urogenital schistosomiasis.
Methodology: In 2011, we conducted 35 children’s discussion groups, 41 in-depth interviews with parents and teachers, and 5 focus group discussions with community members in Zanzibar. Using a modified-grounded theory approach, we transcribed and coded the narrative data followed by thematic analysis of the emergent themes.
Principal Findings: Urogenital schistosomiasis is a common experience among children in Zanzibar and typically considered a boys’ disease. Children engage in multiple high-risk behaviors for acquiring schistosomiasis because of poor knowledge on disease transmission, lack of understanding on severity of disease-associated consequences, and lack of alternative options for water related activities of daily living and recreational play. Local primary school teachers had little to no training about the disease and no teaching tools or materials for students.
Conclusions/Significance: Conducting activities in open natural freshwater contaminated by S. haematobium larvae compromises the health of school-aged children in Zanzibar. The perception of urogenital schistosomiasis as a minor illness rather than a serious threat to a child’s well-being contributes to the spread of disease. Understanding community perceptions of disease along with the barriers and facilitators to risk reduction behaviors among children can inform health promotion activities, campaigns, and programs for the prevention, control, and elimination of urogenital schistosomiasis in Zanzibar
Zanzibar Community Impact Study
No full textThis community impact study maps the development of women’s football on the predominantly Muslim island of Zanzibar as portrayed in two documentary films: “Zanzibar Soccer Queens” (2006, Florence Ayisi) and “Zanzibar Soccer Dreams” (2013, Florence Ayisi, Catalin Brylla). “Zanzibar Soccer Queens” contributed to the development of local women’s football by challenging traditional gender divisions, promoting the renegotiation of female self-identity and subverting stereotypical media portrayals of African women. Thus, the film encouraged a paradigm shift within Zanzibar, as well as within an international public, medial and academic context. This impetus resulted in considerable transformations in the local community, which “Zanzibar Soccer Dreams” and a related community impact study (http://www.zanzibarsoccerdreams.com/home.html) map with regards to education, emancipation and the new status of women’s football.\ud
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Both documentaries focus on Zanzibar’s first women’s football club, Women Fighters FC, and its coach, Nassra Mohammed, who founded the club in the 1980s. Nassra has been a driving force in developing women’s football in Zanzibar, despite obstacles generated out of orthodox socio-cultural and religious traditions. Women Fighters is not only a club but also a community of women that has resisted traditional definitions of womanhood and the male-dominated oppressions impeding women’s participation in outdoor sports. \ud
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The government has listened to Nassra and responded positively by changing its policy to allow girls to participate in football as part of sports education in schools
Improvement of Tuberculosis Laboratory Capacity on Pemba Island, Zanzibar: A Health Cooperation Project.
Full text linkLow-income countries with high Tuberculosis burden have few reference laboratories able to perform TB culture. In 2006, the Zanzibar National TB Control Programme planned to decentralize TB diagnostics. The Italian Cooperation Agency with the scientific support of the "L. Spallanzani" National Institute for Infectious Diseases sustained the project through the implementation of a TB reference laboratory in a low-income country with a high prevalence of TB. The implementation steps were: 1) TB laboratory design according to the WHO standards; 2) laboratory equipment and reagent supplies for microscopy, cultures, and identification; 3) on-the-job training of the local staff; 4) web- and telemedicine-based supervision. From April 2007 to December 2010, 921 sputum samples were received from 40 peripheral laboratories: 120 TB cases were diagnosed. Of all the smear-positive cases, 74.2% were culture-positive. During the year 2010, the smear positive to culture positive rate increased up to 100%. In March 20, 2010 the Ministry of Health and Social Welfare of Zanzibar officially recognized the Public Health Laboratory- Ivo de Carneri as the National TB Reference Laboratory for the Zanzibar Archipelago. An advanced TB laboratory can represent a low cost solution to strengthen the TB diagnosis, to provide capacity building and mid-term sustainability
Insecticide resistance in Culex quinquefasciatus from Zanzibar: implications for vector control programmes.
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Zanzibar has a long history of lymphatic filariasis (LF) caused by the filarial parasite Wuchereria bancrofti, and transmitted by the mosquito Culex quinquefasciatus Say. The LF Programme in Zanzibar has successfully implemented mass drug administration (MDA) to interrupt transmission, and is now in the elimination phase. Monitoring infections in mosquitoes, and assessing the potential role of interventions such as vector control, is important in case the disease re-emerges as a public health problem. Here, we examine Culex mosquito species from the two main islands to detect W. bancrofti infection and to determine levels of susceptibility to the insecticides used for vector control.\ud
Culex mosquitoes collected during routine catches in Vitongoji, Pemba Island, and Makadara, Unguja Island were tested for W. bancrofti infection using PCR. Insecticide bioassays on Culex mosquitoes were performed to determine susceptibility to permethrin, deltamethrin, lambda-cyhalothrin, DDT and bendiocarb. Additional synergism assays with piperonyl butoxide (PBO) were used for lambda-cyhalothrin. Pyrosequencing was used to determine the kdr genotype and sequencing of the mitochondrial cytochrome oxidase I (mtCOI) subunit performed to identify ambiguous Culex species. None of the wild-caught Culex mosquitoes analysed were found to be positive for W. bancrofti. High frequencies of resistance to all insecticides were found in Wete, Pemba Island, whereas Culex from the nearby site of Tibirinzi (Pemba) and in Kilimani, Unguja Island remained relatively susceptible. Species identification confirmed that mosquitoes from Wete were Culex quinquefasciatus. The majority of the Culex collected from Tibirinzi and all from Kilimani could not be identified to species by molecular assays. Two alternative kdr alleles, both resulting in a L1014F substitution were detected in Cx. quinquefasciatus from Wete with no homozygote susceptible detected. Metabolic resistance to pyrethroids was also implicated by PBO synergism assays. Results from the xenomonitoring are encouraging for the LF programme in Zanzibar. However, the high levels of pyrethroid resistance found in the principle LF vector in Pemba Island will need to be taken into consideration if vector control is to be implemented as part of the elimination programme
Zanzibar soccer dreams
No full textZanzibar Soccer Dreams, a feature documentary film directed by Catalin Brylla (UWL Senior Lecturer in Film) and Florence Ayisi (University of South Wales, Professor in Documentary), premiers at the Canadian Sport Film Festival on 22 May 2016. The film continues the story of Ayisi's 2007 documentary, 'Zanzibar Soccer Queens,' on which Brylla also collaborated. 'Zanzibar Soccer Dreams' looks at how women's football has grown as an official sport for girls in schools across Zanzibar, and the impact it has had on women's empowerment and equality.
Website:
http://catalinbrylla.com/zanzibar-soccer-dreams/
Screenings:
Canadian Sport Film Festival (Toronto, Canada) – World Premiere and Closing Night Film – May 2016
Zanzibar International Film Festival (Zanzibar, Tanzania) – African Premiere – July 2016
Lisbon International Film Festival (Lisbon, Portugal) – Official Selection Summer Edition 2016
TrueDoc Documentary Festival (Kiev, Ukraine) – September 2016
Reel Sisters of the Diaspora Film Festival & Lecture Series (New York, US) – October 2016
Cambridge African Film Festival (Cambridge, UK) – October 2016
Watch Africa – Wales African Film Festival (Wales, UK) – October 2016
Arusha African Film Festival (Arusha, Tanzania) – November 2016
Africa in Motion – Scotland African Film Festival (Glasgow, UK) – November 2016
Britain Tanzanian Society Screening (London, UK) – November 2016
Media Coverage:
http://www.walesonline.co.uk/news/wales-news/wales-based-filmmaker-helped-give-11355912
http://www.mirror.co.uk/news/uk-news/female-footballers-labelled-hooligans-beaten-8030051
http://www.theeastafrican.co.ke/magazine/Brave-female-voices-at-Zanzibar-International-Film-Festival-2016/434746-3332444-132bcnp/index.html
http://www.sbs.com.au/topics/zela/article/2016/05/28/field-dreams-how-documentary-helped-open-football-girls-zanzibar
http://www.cambridge-news.co.uk/whats-on/film-news/11-unmissable-cambridge-film-festival-12014572
http://biancasprague.com/index.php/2016/06/14/challenging-norms-soccer/
https://www.uwl.ac.uk/academic-schools/film-media-design/our-news-and-events/news/zanzibar-soccer-dreams-shows-womens-empowerment-through-sport
http://www.southwales.ac.uk/story/834
Kofia in Zanzibar
Full text linkThere are many different traditional costumes in the world. In Zanzibar, a Swahili man is said to be fully attired when he puts on an embroidered cap, locally known as kofia ya viua or just kofia, robe (kanzu) with a coat, and sandals taking a Swahili name of makubadhi. The Kofia is round-shaped with a flat top, adorned with embroidered designs all over For convenience of simplicity in classification kofia are divided into two main groups, simple designed and complex-designed caps
The usefulness of rapid diagnostic tests in the new context of low malaria transmission in zanzibar.
Full text linkBACKGROUND\ud
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We assessed if histidine-rich-protein-2 (HRP2) based rapid diagnostic test (RDT) remains an efficient tool for Plasmodium falciparum case detection among fever patients in Zanzibar and if primary health care workers continue to adhere to RDT results in the new epidemiological context of low malaria transmission. Further, we evaluated the performance of RDT within the newly adopted integrated management of childhood illness (IMCI) algorithm in Zanzibar.\ud
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METHODS AND FINDINGS\ud
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We enrolled 3890 patients aged ≥2 months with uncomplicated febrile illness in this health facility based observational study conducted in 12 primary health care facilities in Zanzibar, between May-July 2010. One patient had an inconclusive RDT result. Overall 121/3889 (3.1%) patients were RDT positive. The highest RDT positivity rate, 32/528 (6.1%), was found in children aged 5-14 years. RDT sensitivity and specificity against PCR was 76.5% (95% CI 69.0-83.9%) and 99.9% (95% CI 99.7-100%), and against blood smear microscopy 78.6% (95% CI 70.8-85.1%) and 99.7% (95% CI 99.6-99.9%), respectively. All RDT positive, but only 3/3768 RDT negative patients received anti-malarial treatment. Adherence to RDT results was thus 3887/3889 (99.9%). RDT performed well in the IMCI algorithm with equally high adherence among children <5 years as compared with other age groups.\ud
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CONCLUSIONS\ud
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The sensitivity of HRP-2 based RDT in the hands of health care workers compared with both PCR and microscopy for P. falciparum case detection was relatively low, whereas adherence to test results with anti-malarial treatment was excellent. Moreover, the results provide evidence that RDT can be reliably integrated in IMCI as a tool for improved childhood fever management. However, the relatively low RDT sensitivity highlights the need for improved quality control of RDT use in primary health care facilities, but also for more sensitive point-of-care malaria diagnostic tools in the new epidemiological context of low malaria transmission in Zanzibar.\ud
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TRIAL REGISTRATION\ud
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ClinicalTrials.gov NCT01002066
Costs of illness due to cholera, costs of immunization and cost-effectiveness of an oral cholera mass vaccination campaign in Zanzibar
Full text linkBACKGROUND: The World Health Organization (WHO) recommends oral cholera vaccines (OCVs) as a supplementary tool to conventional prevention of cholera. Dukoral, a killed whole-cell two-dose OCV, was used in a mass vaccination campaign in 2009 in Zanzibar. Public and private costs of illness (COI) due to endemic cholera and costs of the mass vaccination campaign were estimated to assess the cost-effectiveness of OCV for this particular campaign from both the health care provider and the societal perspective.METHODOLOGY/PRINCIPAL FINDINGS: Public and private COI were obtained from interviews with local experts, with patients from three outbreaks and from reports and record review. Cost data for the vaccination campaign were collected based on actual expenditure and planned budget data. A static cohort of 50,000 individuals was examined, including herd protection. Primary outcome measures were incremental cost-effectiveness ratios (ICER) per death, per case and per disability-adjusted life-year (DALY) averted. One-way sensitivity and threshold analyses were conducted. The ICER was evaluated with regard to WHO criteria for cost-effectiveness. Base-case ICERs were USD 750,000 per death averted, USD 6,000 per case averted and USD 30,000 per DALY averted, without differences between the health care provider and the societal perspective. Threshold analyses using Shanchol and assuming high incidence and case-fatality rate indicated that the purchase price per course would have to be as low as USD 1.2 to render the mass vaccination campaign cost-effective from a health care provider perspective (societal perspective: USD 1.3).CONCLUSIONS/SIGNIFICANCE: Based on empirical and site-specific cost and effectiveness data from Zanzibar, the 2009 mass vaccination campaign was cost-ineffective mainly due to the relatively high OCV purchase price and a relatively low incidence. However, mass vaccination campaigns in Zanzibar to control endemic cholera may meet criteria for cost-effectiveness under certain circumstances, especially in high-incidence areas and at OCV prices below USD 1.3
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