Malaria Prevention and Treatment Programme:

Tukae would like to implement a practical, community based, 4 point programme to control and treat malaria, with a particular focus on children. It will reduce the incidence of malaria through:

1.1 Providing long-term treatment bednets.

1.2 Providing resource for insecticide treatment of dwellings.

2.1 Giving access to rapid diagnostic testing.

2.2 Holding a stock of malaria treatment.

Implementation:

1.1 Bednets.
There is considerable evidence that a well-managed programme of introducing good long-term treated bednets into communities can reduce the incidence of malaria by up to 50%. This effects everyone, especially children. Furthermore this is predominantly a problem of logistics and management ; it does not need technically qualified scientific and medical personnel to carry it out.

It is something we can do now. It makes a difference. It is cost effective.
Work will be initially focused on distributing nets in and from the village we are located in - Shebo Meza. This, as most villages in this area, is spread-out with a number of sub-villages, little hamlets and individual houses covering a wide area and set among small farms. In total there are more than 3,000 people in this village.

The evidence indicates that treated nets are most effective when the uptake within communities is high– 80% or more, rather than that they be distributed piecemeal here and there. We will therefore distribute nets in a coordinated and controlled manner working systematically and recording placement of nets.

Our aim is to implement the programme in 3 phases.

Phase 1: To ensure that every person (3,000+) in Shebo Meza can sleep under a treated net.

Phase 2: Once the target identified in Phase one is achieved the programme will, as resources allow, be extended to two neighbouring villages utilising the same methods to ensure a minimum of 80% uptake.

Phase 3: This is a further extension of the programme to as many villages as possible where there is a need. Estimated population numbers in the areas we can effect:15-   20,000.

1.2 Insecticide treatment of dwellings.

This will happen concurrently with the distribution of bed nets as outlined above. Householders will be offered the opportunity to have the internal walls of their dwellings sprayed with insecticide.                                     
· Spraying backpacks will be provided.
· Operators will be trained in application and safety procedures.
· Dwellings treated will be recorded.
· Re-spraying will be offered at appropriate intervals.

2.1 Rapid test kits.
· People sometimes inconveniently fall sick at times when the limited health care facilities are closed; in the evenings and at weekends as well as during holidays.
· In remote areas such as the East Usambaras many people are at some considerable distance from any health care facilities.
· Fast and accurate diagnosis of malaria together with prompt and effective treatment can do much to mitigate the severity of the disease and reduce mortality, especially of children.
· People with the appropriate skills and resources to carry out accurate and reliable microscopic examination of blood slides are hard to find and often not available.

Our aim is to;

· Stock test kits for use when other resources are not available.
· With the permission (which is being sought) of the District Health Officer, train appropriate local people in their use.
· Keep appropriate records.
· Charge, at cost, for this service to enable it to become self-sustaining.

2.2 Malaria Treatment

Our aim is to;
· Stock malaria treatments to Tanzania government and WHO guidelines, (currently ACT’s).
· Stock appropriate supporting medicines, e.g Paracetamol. ORS etc
Make these available to children and adults at the lowest possible cost.

The outcomes of this programme will be;

· Demonstrable reduction of malaria in a remote, rural and poor population.
· Empowerment of communities to take responsibility for their own and others health.
· Individual capabilities and local capacities increased.
· Number of people affected—3,000+ initially with the potential of many more as the programme moves into Phase 2. and as funding allows.
Up to 4 jobs created and local volunteers empowered.

We are very pleased to report that Dr Fazal from Tanga with whom we have informally worked for a number of years has agreed to be our medical advisor.

Dr Caroline Maxwell from the London School of Hygiene and Tropical Medicine, regional entomologist for Centres for Disease Control who is based near Tanga, has also agreed to advise and work with us.

Funding needed:

£12,000 initially, £36,000 over a thirteen month period to complete . £7,500 is already in place.