Epidemiology and control of malaria in Tanzania.

Malaria is one of the most important diseases in humans in Tanzania in terms of morbidity and mortality. It is a leading cause of hospital and outpatient attendances hospital admissions hospital deaths and absenteeism in primary schools. More than 95% of malaria infections and the subsequent disease are due to the dangerous and potentially fatal Plasmodium falciparum. Malaria in Tanzania is transmitted mainly via Anopheles gambiae and Anopheles funestus the former being the most dangerous and widespread of the two vectors. Anopheles gambiae breeds in great numbers in fresh or brackish water of almost any volume provided that it is neither covered with vegetation nor polluted with chemicals or industrial effluent. Anopheles funestus breeds in permanent and shaded water. More than 60% of Tanzania has hyper- to holoendemic malaria with year-round transmission. Such transmission takes places in all regions along the coastal belt as well as in the districts and regions which border the big lakes. Largely hypo- to mesoendemic malaria with seasonal malaria transmission is typical in the Southern and Central Highlands. There has even been a resurgence of malaria in the islands of Zanzibar and Pemba from the mid-1970s even though the disease was almost eradicated from those locations in the late 1960s. Evidence suggests that the intensity of malaria transmission is most likely increasing. Sections consider antimalarial drug responses malaria control drug treatment mosquito control and recommendations for chemotherapy and chemoprophylaxis as well as vector control.