Household-based chlorine disinfection is widely effective against waterborne bacteria and viruses, and may be among the most inexpensive and accessible options for household water treatment. The microbiological effectiveness of chlorine is limited, however, by turbidity. In Tanzania, there are no guidelines on water chlorination at household level, and limited data on whether dosing guidelines for higher turbidity waters are sufficient to produce potable water. This study was designed to assess the effectiveness of chlorination across a range of turbidities found in rural water sources, following local dosing guidelines that recommend a ‘double dose’ for water that is visibly turbid. We chlorinated water from 43 sources representing a range of turbidities using two locally available chlorine-based disinfectants: WaterGuard and Aquatabs. We determined free available chlorine at 30 min and 24 h contact time. Our data suggest that water chlorination with WaterGuard or Aquatabs can be effective using both single and double doses up to 20 nephelometric turbidity units (NTU), or using a double dose of Aquatabs up to 100 NTU, but neither was effective at turbidities greater than 100 NTU.

Approximately 1500 people die annually due to rabies in the United Republic of Tanzania. Moshi, in the Kilimanjaro Region, reported sporadic cases of human rabies between 2017 and 2018. In response and following a One Health approach, we implemented surveillance, monitoring, as well as a mass vaccinations of domestic pets concurrently in >150 villages, achieving a 74.5% vaccination coverage (n = 29, 885 dogs and cats) by September 2018. As of April 2019, no single human or animal case has been recorded. We have observed a disparity between awareness and knowledge levels of community members on rabies epidemiology. Self-adherence to protective rabies vaccination in animals was poor due to the challenges of costs and distances to vaccination centers, among others. Incidence of dog bites was high and only a fraction (65%) of dog bite victims (humans) received post-exposure prophylaxis. A high proportion of unvaccinated dogs and cats and the relative intense interactions with wild dog species at interfaces were the risk factors for seropositivity to rabies virus infection in dogs. A percentage of the previously vaccinated dogs remained unimmunized and some unvaccinated dogs were seropositive. Evidence of community engagement and multi-coordinated implementation of One Health in Moshi serves as an example of best practice in tackling zoonotic diseases using multi-level government efforts. The district-level establishment of the One Health rapid response team (OHRRT), implementation of a carefully structured routine vaccination campaign, improved health education, and the implementation of barriers between domestic animals and wildlife at the interfaces are necessary to reduce the burden of rabies in Moshi and communities with similar profiles.

: Access to Water, Sanitation and Hygiene (WASH) among people with disabilities is a great concern in developing countries. During COVID-19 pandemic in 2020, in addition to other preventive measures the government of Tanzania invested heavily on handwashing facilities in public places. However, the interventions were mostly for the general population. A big question was the appropriateness of the preventive measures to address different kinds of disabilities. The study was conducted to assess access to WASH and other preventive measures against COVID-19 among people with disabilities. This was a qualitative study where a total of 16 key informant interviews and nine focus group discussions were conducted. The study was carried out in seven districts of Dodoma region, Tanzania. Findings show that there were inadequate WASH and other COVID-19 preventive measures designed specifically for people with disabilities against the pandemic. Many people with disabilities experienced challenges in accessing adequate water for handwashing and using handwashing facilities installed for general population. Also they received inadequate health education and timely communication on COVID-19 preventive measures in addition to challenges in keeping distance and accessing and use of face masks and sanitizers. People with mobility, hearing, and vision impairments were mostly affected. There was no representation of people with disability at the national COVID-19 task force. Specific programs for people with disabilities to address access to WASH and other preventive measures against COVID-19 would address most of the identified challenges.

Soil-transmitted helminthiases (STH) are among the neglected tropical diseases and infect more than 24% of the world population. The World Health Organization recommends regular monitoring of STH’s prevalence and intensity following mass drug administrations to evaluate their effectiveness and inform future control strategies. This study evaluated the prevalence, intensity, and risk factors of STH infections among school children aged 6 to 14 years old in northwestern Tanzania. A cross-sectional study was conducted among 728 school children in the Kagera region in 2021. Participants were selected using a two-stage cluster sampling method. A questionnaire was used to collect data on the risk factors. Stool samples were examined using the Kato–Katz technique. The data were analysed using STATA. The overall prevalence of STH was 56.2% (95% CI: 52.5–59.8, 409/728). About 5.7% and 1.1% of the infected children had moderate-intensity infections with Ascaris lumbricoides and Trichuris trichiura, respectively. Risk factors included the mother’s occupation as a farmer (aOR: 1.2, p = 0.002) and not washing hands with water and soap (aOR: 1.4, p = 0.035). Washing one’s hands after using the toilet (aOR: 0.6; p = 0.024) is a preventive measure against STH infections. STH was prevalent in the study area. The mother’s occupation (farmer) and the lack of handwashing with water and soap influenced STH transmission. Conversely, washing hands after visiting the toilet and after playing with soil reduced the risk of STH infection.

Background: Climate change continues to manifest at an unprecedented rate and is increasingly recognized as a serious threat to reproductive, maternal, and child health. This qualitative study aims to explore community and healthcare workers’ perspectives on the impacts of climate change and related extreme weather events on reproductive, maternal, and child health outcomes in Kilwa District, Tanzania. Methods: In October 2024, a cross-sectional qualitative study design was employed where 10 focus group discussions with women and 15 key informant interviews with healthcare workers in 10 flood-prone villages in Kilwa District were conducted. All discussions and interviews were audio-recorded, transcribed verbatim, and analyzed using NVivo-12, both inductively and deductively. Results: Most respondents perceive climate change as a shift in weather patterns over time, as evidenced by rising temperatures, unpredictable rainfall, and an increasing frequency of floods and tropical cyclones. High temperature, floods, and prolonged dry spells were perceived by community and healthcare workers to have direct and indirect impacts on reproductive, maternal, and child health outcomes. Study participants perceived a clear linkage between observed weather changes and negative maternal and child health outcomes, including limited accessibility to health facilities during the flooding season, a surge in climate-sensitive diseases such as malaria and diarrhoea in the aftermath of floods, and increased food insecurity leading to malnutrition. The increased frequency of climate-related disasters has driven changes in fertility intentions, as women have expressed a desire to have smaller families, fearing that climate-related extreme weather events would further strain their financial capacity to support larger families. Participants described that women faced heightened vulnerabilities due to patriarchal gender norms. Travelling long distances searching for water, increased burden of household chores, and climate-induced economic instability were reported to put women and girls at increased risk of experiencing sexual and gender-based violence. In response to these impacts, the community has implemented several adaptation measures such as utilizing maternity waiting homes during the flooding season, provision of psychosocial support for disaster victims, and relocation of vulnerable populations from flood-prone areas. Conclusion: Community and healthcare workers' perspectives from this study highlight that the ongoing climate crisis is taking a heavy toll on reproductive, maternal, and children's health in Kilwa district. The findings underscore the critical urgency for strengthening the climate resilience of the healthcare system to ensure the continuity of healthcare service provision during and after climate-related disasters. Additionally, policy solutions are proposed to take into account the differential vulnerability and impacts of climate change, thereby ensuring climate action is gender-responsive.

Background Climate change continues to unfold at an unprecedented rate, affecting various forms of human life, including health and well-being. Evidence indicates that climate change affects maternal, reproductive, and child health outcomes in multiple ways. The increased risk of stillbirth, preterm birth, and miscarriage is indirectly associated with climate change, as extreme weather events can damage infrastructure, limiting access to essential healthcare services. Evidence of the nexus between climate change and maternal, reproductive, and child health in the Tanzania context is limited. This study was designed to explore the influence of climate change on maternal, reproductive, and child health outcomes in Kilwa District Council, Tanzania. Methods In October 2024, a cross-sectional qualitative study design was employed where 10 focus group discussions and 15 key informant interviews with women and healthcare workers in 10 flood-prone villages in Kilwa District were conducted. All discussions and interviews were audio-recorded, transcribed verbatim, and analyzed using NVivo-12, both inductively and deductively. Results Study findings show that respondents were aware of climate variability such as changes in rainfall patterns, increase in temperature, and extreme weather events such as floods and tropical cyclones. Women and young girls were perceived to be more vulnerable due to their traditional responsibilities such as fetching water, firewood, and caregiving roles. Rising incidence of climate-sensitive diseases such as mmalaria, and diarrhoea is taking a toll on pregnant women and children under five years of age especially following heavy rainfall season. Recurring floods are claimed to limit access and delivery of healthcare services. Participants reported a few cases where pregnant women gave birth on the way to the facility or at their homes because of the destruction of roads and bridges. Floods and drought have led to reduced yield of food crops and therefore have contributed to food insecurity. Respondents expressed concerns about reduced food availability, which they linked to poor maternal nutrition, negatively impacting the health of pregnant women, children, and unborn babies, leading to adverse outcomes such as low birth weight. Some participants explained changes in fertility intentions caused by floods and prolonged drought; women expressed fear as these events reduced their capacity to support their families. Respondents reported several adaptation measures that included reducing the quantity and number of meals taken per day in response to food shortages, water, and food storage for use during the dry season, relocating from flood-prone areas, sleeping outside during hot nights, and staying at the so called maternity waiting homes to overcome delays to reach health care facilities during the rainy season. Conclusion The climate crisis is taking a heavy toll on maternal, reproductive, and children's health in Kilwa district. The findings from this study underscore the critical urgency for strengthening the climate resilience of the healthcare system and the need to mainstream maternal, reproductive, and child health into national climate policy frameworks in Tanzania.