SIMIYU HEALTH CAMP SUMMATIVE REPORT(September 3rd 2019

Introduction

The purpose of this document is to give a summative report on the Simiyu Health Camp organized by RASA and Friends of Dr Tulia to screen for noncommunicable diseases in Bariadi district from September 3^rd until September 7^th 2019.

Non-communicable diseases in Tanzania And The Simiyu Health Camp

Non-communicable diseases (NCDs) kill 38 million people each year, of which an approximate 28 million occur in low resource settings [WHO report 2015]. Most NCD deaths are due to cardiovascular diseases (17.5 million annually) [WHO report 2015]. Diabetes still causes 1.5 million deaths each year [WHO report 2015]. In Tanzania, the number of deaths due to NCDs is believed to be increasing due to urban migrations and dietary changes. The World Health Organization has described in detail how NCDs can negatively impact the working class and businesses productivity. Studies from high-income countries have shown that targeting communities and businesses for screening and health program intervention is an effective way to reach people and to boost the economy. Generally, community and employee health programs are lacking in most countries in sub-Saharan Africa, as such, there is a need for Tanzania to increase NCD awareness in Tanzanian communities and businesses.

The Simiyu Health Camp among other factors was largely influenced by the above information and the mortality rates reported from hospitals relating to NCDs. It is for this reason that RASA and Friends of Dr Tulia – Simiyu decided to conduct a screening and awareness camp for community members.

RASA organization And Stakeholders

The successful completion of the Simiyu Health Camp is to a great part attributed to the unconditional devotion and dedication of the members of the organizing committee comprising of representatives from RASA, Friends of Dr Tulia – Simiyu and office of the Simiyu Regional Medical Officer.

Much appreciation is also given to our sponsors mainly Alliance Ginneries LTD, NGS LTD and CRDB BANK PLC without whose contribution; this event wouldn’t have been possible.

The Screening Procedure

RASA screens participants from various business and government offices and also conducts community outreach and screening. A typical screening takes place over one, two or seven days depending on the activity schedule. We use a questionnaire to obtain patient history. The questionnaire allows us to get information on known diabetes and hypertension, family history of diabetes and hypertension, current treatment for diabetes and hypertension, smoking and alcohol consumption habits. The questionnaire relies on self-report for current medical conditions, family history of the disease, and any treatment received.

After filling in the questionnaire, the patient gets screened for weight and height, then hypertension and finally diabetes if they fulfill the following criteria: family history of diabetes, BMI > 30, hypertension, age above 50 years, habits of alcohol consumption and/or smoking of tobacco as well as if they present with symptoms for diabetes such as blurred vision, frequent headaches, feeling always weak and generally tired, frequent need to urinate, frequent thirst, slow healing wounds as well as increased appetite. The WHO definitions are used for all diagnoses.

Weight and height are measured with a scale in kilograms and a meter band. They are used to determine body mass index (BMI). A BMI of <18.5kg/m² is classified as underweight, a BMI of ≥18.5 – 24.9 kg/m² is classified as normal weight, a BMI of 25–29.9 kg/m² is classified as being overweight and a BMI of ≥30 kg/m²as being obese [9].

Blood pressure is measured via digital blood pressure machines. Average systolic and average diastolic blood pressure are calculated using the average of the last two readings when available. Hypertension is defined as having a systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg. We define prehypertension as having a systolic pressure ranging from 120 to 139 mm Hg and/or a diastolic pressure ranging from 80 to 89 mm Hg. Stage 1 hypertension is defined as a systolic pressure ranging from 140 to 159 mm Hg and/or a diastolic pressure ranging from 90 to 99 mm Hg. Finally, stage 2 hypertension is defined as a systolic pressure equal or greater than 160 mm Hg and/or diastolic pressure equal to or greater than 100 mm Hg.

Blood glucose is tested by finger prick using blood glucose meters calibrated for plasma glucose values. Participants are categorized as having diabetes mellitus if their Fasting Blood Glucose (FBG) levels are ≥7.0 mmol/L (126 mg/dL) or if their Random Blood Glucose (RBG) levels are ≥11.1mmol/L (200mg/dL). They are considered pre-diabetic if their FBG is 6.1–6.9 mmol/L (110–125 mg/dL)[11]. They are non-diabetic if their FBG is less than 6.1 mmol/L (110 mg/dL). Their diabetic status is undetermined if their RBG is <11.1 mmol/L (200mg/dL). We classify non-diabetic and undetermined as “other”.

Every patient is provided counselling on healthy living and nutritional advice before leaving the screening. Individuals diagnosed with hypertension or diabetes are referred to a local public hospital for treatment.

SIMIYU HEALTH CAMP FINDINGS

A total of 438 people were screened during the health camp, most of the people were between the ages of 18 and 90. Hypertension, overweight and obesity ware diagnosed in most of the participants with some being already known hypertensives. Diabetes was also diagnosed among some of the participants as well as breast cancer. Actual numbers and percentages will be on a follow-up report as some of the data is still being processed.

Way forward

Way forward for the Simiyu region is to firstly continue and strengthen the working relations with the office of the RMO through the regional NCDs coordinator and other relevant offices to enable smooth service provision to the people of Simiyu region. Secondly, We intend to conduct a region-wide screening campaign at each district of Simiyu region starting February 2020, we hope to be working in close association with district NCD coordinators and partners to create awareness, screen and refer those affected to health facilities for further treatment and management. In our work in the districts, we intend to provide basic screening equipment (Weight scale, digital BP machines, stethoscopes and glucometers) in all district health centres to help with screening activities for the project.

We are looking to expand to other major Tanzanian cities such as Dar Es Salaam, Arusha and Dodoma to increase our outreach and to start setting up a hub-and-spoke model for our services. This expansion should lead to the creation of a national database for obesity, hypertension and diabetes in businesses and communities in Tanzania. This database will inform health policies targeting both employed and unemployed populations and focused on prevention.

We also intend to establish a complementary health and wellness program will help determine the components of an effective treatment and prevention program, advocate for evidence-based policies and raise awareness for healthy food policies.

Our ultimate goal is to help reduce mortality due to NCDs in Tanzania and improve the nascent economy of the country.

Thanks for reviewing our report.

This report has been prepared by REACH AND SUPPORT ALL ORGANIZATION (RASA)