The burden of disease among preschool children from rural Tanzania

A study was undertaken to determine disease prevalence of, choice of treatment for, as well as health services utilization by, preschool children living in a rural district of coastal Tanzania. Disease prevalence and choice of treatment were determined through seven-day recall; health services utilization through systematic analysis of Village Health Workers' service records over one calendar year. It was found that the main disease symptoms, i.e. fever, cough, diarrhea, difficult breathing, ear ache and sore throat occurred at frequencies of 15.6, 8.3, 5.7, 2.0, 1.7 and 0.4 episodes respectively, per child per year. Cough, difficult breathing, common cold and ear ache caused about 50% of all episodes of illness. The majority (61%) of all illness episodes were treated in dispensaries, health centres or hospitals. 18.9% were attended by Village Health Workers (VHWs), 14.5% received treatment at home and 3.5% were seen by traditional healers. The use of VHWs was associated with a reduction of home-treatment and reliance on traditional healers for the care of perceived illness. VHW's monthly reports revealed malaria to be the number one health problem both among children and adults, responsible for about 25% of all attendances.