Abubakar M. Maghimbi, MD
Tanzania Country Director
COVID-19 is different from other outbreaks we have experienced in Tanzania in that it is highly contagious and patients’ conditions deteriorate very quickly, from having a few symptoms to succumbing to the disease often in a matter of a few days. It has also impacted the entire globe, which has made resources needed to respond to the pandemic more difficult to obtain.
Tanzania has so far had 509 confirmed cases, 21 deaths, and 183 recoveries. These have been concentrated in the port cities of Dar es Salaam, Zanzibar, and Tanga on the northern coast. This concentration of cases may be due to a testing artifact, as Tanzania has one centralized laboratory, the National Public Health Laboratory, located in close proximity to the three cities. Transporting samples from more distant areas of the country to the lab is difficult. There are also a limited number of laboratory technicians who can perform the COVID-19 tests.
Ciheb Tanzania has been working with the government to obtain support for more decentralized testing, using the GeneXpert molecular diagnostic machines at zonal hospitals. In terms of training, we have previously established the infrastructure for the government to provide virtual expert training through Project ECHO.TM ECHO, which stands for Extension for Community Health Outcomes, uses teleconferencing to link specialists with practitioners and create “communities of practice” in underserved areas.
Through ECHO, the government has conducted laboratory sample training at 250 facilities throughout the nation. We are also working with the government to expand the platform’s use to include training for healthcare workers on COVID-19 case management.
In addition to these activities, because our primary area of support is HIV, we have been tasked by CDC Tanzania to ensure that HIV patients remain safe and are able to continue treatment services. We have thus been helping to put in place procedures to decongest HIV facilities, so as to minimize the risk of exposure to the virus SARS-CoV-2 causing COVID-19. One of the measures involves providing patients with multi-month scripting of antiretroviral medication.
We are monitoring 118 CDC tier 1 priority healthcare facilities, each serving more than 200 patients, to ensure that as the new measures are implemented the quality of care is maintained and viral loads are stable. We want the facilities to know they are supported and feel our presence, whether through virtual or in-person consultations. We are also taking every precaution to protect our frontline staff and other staff and ensure that they have the necessary personal protective equipment. We are very busy in procuring needed supplies.
There is much to do, but fortunately Tanzanians have started to come to terms with the seriousness of this disease. Although the government has not imposed a lockdown, people are voluntarily staying at home. While places like public markets still pose risks to additional infection, there are far fewer people shopping at any one time. We hope this trend continues.
Country Director Abubakar Maghimbi, MD, has 17 years of experience in infectious diseases and more than 8 years working on PEPFAR funded projects. He is also an Assistant Clinical Professor of Medicine and adjunct faculty of the UMB School of Medicine.