18. Availability, storage and use of anti-rabies vaccines in public health facilities in Lindi and Tanga region in Tanzania

Abstract

Background Rabies is one of the 17 neglected tropical diseases recognized by WHO. Rabies is enzootic viral disease; main vector of disease is domestic dog. Rabies is 100% fatal if left untreated causing neurologic problems is a preventable disease. Prevention can be done by vaccinating canine (dogs), administering rabies vaccine, rabies immunoglobulin’s (RIG’s), community participation and public awareness. Procurement and stocking of anti-rabies vaccine in public health facilities is a problem due to the fact that rabies is given low priority due to under-reporting of the disease magnitude [20]. Keeping lots of supplies when demand is low threatens expiry of stock its subsequent unavoidable negative financial impacts. Objectives: The objectives of the study were to assess availability, source of supply, storage and use of anti-rabies vaccines in public health facilities in Lindi and Tanga region. Methodology This was a descriptive cross sectional study which employed quantitative method of data collection. Structured questionnaires were used to collect quantitative data from health care workers that were responsible for ordering and storing of anti-rabies vaccine. This study also assesses knowledge of health care workers regarding the use of anti-rabies vaccines in the health facilities. Observation checklist was used to capture information regarding storage of anti-rabies vaccines in the health facilities. Retrospective review of records was done to calculate stock-out duration of anti-rabies vaccines. Physical count was done to determine the number of anti-rabies vaccine vials on the day of visit. Results The study found that mean the stock out duration of anti rabies vaccines was 103 days and 200 days in Lindi and Tanga region respectively. Seven facilities in Tanga had stock of anti-rabies vaccine versus one facility in Lindi on the day of visit. Average score of storage condition of anti-rabies vaccines in facilities in Tanga and Lindi region were 67.6% and 66.8% respectively. These scores were considered satisfactory. MSD and prequalified suppliers were source of vaccines in Tanga region and dividend from RVS was the source of supply of vaccines in Lindi facilities. Majority of health care workers (52%) interviewed in Tanga had a poor knowledge regarding the use of anti-rabies vaccines as compared to those in Lindi region. Expired anti-rabies vaccines were observed in two health facilities in Korogwe District Hospital and Nyangao-Designated Dstrict Hospital in Tanga and Lindi respectively. Conclusion From this study it can be concluded that, availability of anti-rabies vaccines is still a problem in health facilities in the two surveyed regions in Tanzania. There is a problem of maintanance of cold chain system in storage facilities in both levels (hospitals and health centres) Based on these findings, poor level of knowledge regarding the use of anti-rabies vaccine among health care workers in surveyed health facilities was observed