Morbidity Management For Neglected Tropical Diseases In Tanzania

Globally, more than 27 million men suffer from filarial hydrocele, a fluid-filled enlargement of the scrotum, which leads to deformity and often involves the inability to work and provide for their families. This project supported district councils to establish an LF Morbidity Management program with a focus on hydrocele surgery to address a growing backlog of men who suffer from the condition.

The program trained surgeons, nurses and anesthesia assistants at health facilities in hydrocelectomy by partial excision of tunica vaginalis technique, use of local anesthesia and patient care. Surgical teams performed procedures on weekends so they could attend to their usual patients during weekdays. During the project period, IMA supported surgical teams to carry out 1,320 surgeries—well above the target of 1,000 surgeries. The program used a cost share model, and Izumi-supported costs included allowances to the surgical teams and NTD coordinators, consumables used for the procedure, fees for Muhimbili National Hospital surgeons and costs associated with supportive supervision. The participating hospitals covered all other surgery and follow-up care costs.

The biggest highlight of Year 2 comes from the Mtwara region, where surgeons were able to complete 640 surgeries—42 percent above the initial target of 450 surgeries. These additional surgeries were possible within the same budget, because program staff recognized that performing surgeries at district hospitals and facilities instead of at regional hospitals created a significant costs savings. The project has increased awareness of hydrocele treatment among community members, and it has greatly reduced myths about the disease, as patients who have been treated serve as ambassadors providing live testimonies about the success of the surgery.