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Immunization in children is the most cost effective intervention in Tanzania

All vaccines are given by injection except Polio, which is given by mouth in drops. The initial drops of polio are given immediately after the child is born; second polio vaccine drops at the age of four weeks, third drops at the age of eight weeks and fourth drops at the age of twelve weeks.

BCG is given to protect Tuberculosis at birth on the right shoulder and repeated if scar has not formed during subsequent visits or when the child enters class one without BCG scar. Measles vaccine is given at the age of nine months, but ideally two doses of the vaccine might have given better protection.

The disease is seen in outbreaks presenting with fever and typical rash. The Measles virus has now been seen to attack children above the age of five and some young adults as well. No cause for alarm if proper measures are instituted and the communities are again involved and informed to be re immunized. Reporting early and good surveillance has shown that some of the cases are not measles but Rubella (Germaine Measles not Germany measles) has been reported in laboratory results.

The nine preventable diseases by offering vaccines are the ones which have been supported by the government of United Republic of Tanzania and are universally given free of charge. Immunization is one of the most cost effective interventions that has impact in reducing morbidity and mortality among the under fives.

The coverage for immunizing of each of the nine diseases must be above 80% in order to reduce the number of the children who would have contracted the disease. On the average it costs USD 20 per child to be fully immunized by the age of one year. The government with assistance from international and multilateral donor agencies are working together to finance the immunization programme.

Community involvement and participation is very important to achieve the target of immunizing all children. Parents meaning mother and father should know about the immunizations given in clinics. It seems the whole process is left to the mothers only, it is unfair. Among the nine diseases that can be prevented by immunization, emphasis will be given in this column on Hepatitis B, which has a different mode of transmission.

The penta-valent vaccine is given in combination with Diphtheria, Pertussis, Tetanus, Hepatitis B and Haemophilus influenza B (DPT-HB + HIB) DPT Hepatitis B was introduced in Tanzania in mid January 2002 it is given to children in three doses. The government now is providing DPT Hepatitis B combined with Haemophilus influenza B vaccine commonly known as “penta-valent vaccine” meaning there are five antigens in one shot. First dose at the age of four weeks, second dose at the age of eight weeks and third dose at the age of twelve weeks.

The regime of giving vaccines in Tanzania is now changing apart from those given at birth, other vaccines will be given from six weeks, ten weeks and fourteen weeks. Hepatitis B is a serious disease causing damage to the liver due to a virus called hepatitis B virus. The disease can be found in all age groups, but children below the age of five are more affected than other age groups.

Hepatitis B can be contracted through blood transfusion (contaminated blood) contaminated syringes with the virus, from pregnant mother with hepatitis B to child during delivery or during breast feeding, through skin contact between an infected person with another through broken skin, scratches and through sexual intercourse with an infected person. It is unfortunate that most people do not know that Hepatitis B virus can be contracted the way HIV is contracted.

The initial symptoms are: running nose/colds (mafua), headache, fever and tiredness and fatigue, loss of appetite, nausea, vomiting, abdominal pains and at times diarrhoea. Later symptoms are after three to four days: There is yellow discolouration of eyes, the palms and soles of the feet, deep yellow discolouration of urine and white colour of stools. After effects of Hepatitis B: a child who suffers from Hepatitis B when cured, complications may occur during adult hood as follows: shrinking of the liver (liver cirrhosis), cancer of the liver (saratani ya ini).

Hepatitis B has no definite cure. There are drugs to assist to alleviate symptoms. It is estimated that there are 25,000 to 30,000 Tanzanians dying annually due to cancer of the liver caused by Hepatitis B. The government should be congratulated for introducing Hepatitis B to the future generation since mid January 2002, the children are assured of not contracting the disease but they should also be protected from HIV by introducing Prevention of Mother to Child Transmission clinics as well.

My message to the community is: Hepatitis B is a disease which can be prevented by immunization. A child should be sent to the nearest clinic offering immunization at the age of four weeks to start DPT-HB HIB and continue to finish the three doses as scheduled. Blood transfusions should be screened for Hepatitis B, Hepatitis C and HIV, which is the norm now by introducing
Zonal Blood Safety Centres countrywide. Do not use contaminated syringes.

Take precautions on safer sex, as the disease can be transmitted by sexual contact. The government now is in the process of introducing Rota virus vaccine for controlling diarhoea in children and later Human Papiloma Virus Vaccine to control and prevent cancer of the cervix in women, but again the vaccine is admissible to female children only between the ages of 9 and 12 as it will be decided.

Criteria for the vaccine are the one receiving should not have started sexual encounter and the vaccine has nothing to do with controlling fertility at all. Around 5,000 girls in Mwanza through NIMR have a had a go on the shot. Plans are underway to make it available to all eligible clients as instructed by the service providers following government guidelines. The Tanzania community should use the immunization week which is starting from 23rd April 2012 and will last for a week.

Please do not miss this greater opportunity to take your children to the nearest clinic for the free for all children vaccine as you will be guided by your local government machinery. Get informed and get involved prevention is better than cure. It is costing the government fifteen million shillings to treat a lady with cancer of cervix stage two at Ocean Road Hospital, whereas if vaccine for Human Pappiloma virus was given the cost would have been very little.

amzigetz@yahoo.com.

IN my last two sports columns, I have ...

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Author: Dr ALI MZIGE

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