Helen Keller International Programs in Tanzania

Country Profile:
Total population: GNI per capita: Life expectancy at birth: U5 mortality rate: Infant mortality rate: Adult illiteracy rate: Onchocerciasis prevalence: Vitamin A Deficiency prevalence: Trachoma prevalence : Cataract backlog:	34.5 million 280 44 165 99 25
HKI Programs in Tanzania:
Onchocerciasis: CDTI in Tanga region Trachoma: SAFE strategy, trichiasis surgical training centre Nutrition post partum Vitamin A capsule distribution; Home gardening

History of Helen Keller International in Tanzania

Tanzania is one of the oldest Helen Keller International country programs in Africa. It began with public health activities in five villages in Kongwa district in Dodoma Region in 1983. Over the years the trachoma and primary eye care program in Kongwa expanded slowly to include more villages in Kongwa and later to include Singida Rural District. In addition to the training in trichiasis surgery for nurses from all trachoma endemic districts in Tanzania a school health project was developed.

In April 2000, HKI extended its programs to include an onchocerciasis project in Tanga Region in the North East of Tanzania. Through the Community Directed Treatment with Ivermectin (CDTI) strategy, a yearly dose of Mectizan® is delivered to the population in endemic areas in Tanga region. Integrated in this strategy is a screening and referral system for primary eye care.

In 2003 HKI moved its national office in Tanzania to Dar es Salaam. In this same year the office became more involved in nutrition activities in Tanzania.

HKI Tanzania uses the Vision 2020 goals to strategize and plan their prevention of blindness activities here in Tanzania.

The Tanga Focus CDTI project was launched in April 2000 in collaboration with the Ministry of Health and the African Programme for Onchocerciasis Control (APOC). The project includes three districts in Tanga region that are endemic for onchocerciasis: Korogwe, Muheza and Lushoto districts.

Year	Total population	Population treated	Therapeutic coverage	# villages	Geographic coverage	UTG
2000	188,196	140,640	74.9%	118	100%	159,967
2001	213,249	147,856	69.3%	119	100%	181,262
2002	281,228	224,439	79.8%	147	100%	239,044

The first distribution took place from December 2000 - March 2001. The treatment data of the past years are summarized in graph 1 and table 1. The total population represents the population living in the onchocerciasis endemic areas in Tanga. According to the APOC strategy only hyper and meso-endemic communities are included in mass treatment with Mectizan® (these are the communities with a prevalence of onchocerciasis of over 40% of the population in the community. The Ultimate Treatment Goal (UTG) is the target if all people who are eligible to receive Mectizan® would be treated (this is excluding children under 5 years, pregnant women and severely ill people). The therapeutic coverage is the percentage of the total population that was treated.

Activities in 2003

Future Prospects

 

 

Primary Eye Care and Cataract

In 2001, HKI Tanzania has begun integrating primary eye care activities in the CDTI program. Rural health workers and the District Onchocerciasis Teams (DOTs) have been trained in primary eye care activities. The rural health workers are in turn training community distributors of Mectizan to detect cataract, trauma, visual acuity and counseling patients to undergo eye- surgery. A referral system has been set up to enable CDDs to refer cataract patients to the nearest health facility. These patients are operated on by the cataract surgical team from KCMC or CCBRT. for Muheza and Korogwe districts. All these activities are aimed at increasing the uptake of cataract surgery to reach the goals of Vision 2020.

Trachoma program

HKI Tanzania uses the WHO endorsed SAFE strategy to implement trachoma programs in Dodoma and Singida regions in Tanzania. HKI Tanzania is a permanent membership to the National Prevention of Blindness Committee and to the "Tanzania Trachoma Task Force".

It has pioneered in developing a community-based training for trichiasis using the BTRP procedure. HKI Tanzania has trained a total of 105 surgeons in Tanzania since the inception of its programs. The HKI center in Kongwa is the main training center for BTRP surgeons in Tanzania and is internationally respected for it's training on BTRP. The center has also trained surgeons from other countries like Ghana, Kenya and Sudan.