Download Please note that the price of this safari does not

Tanzanian Houses are usually composed of stones and grout.
Clothing in Tanzania is similar to that worn in other parts of eastern Africa. Traditional clothing
among the black Africans includes a colorful, wrap-style garment for women called the kanga,
and the kikoi wrap for men. Many Muslim men wear a flowing white robe called the kanzu.
Since about 1960, Western-style pants and shirts have become increasingly popular among
the men of Tanzania.
http://www.eastafricanministry.org/Tanzania%20World%20Facts.htm
Tanzanian Churches are usually constructed of wood and stone
The Tanzanian government school system is constructed differently than that in the US. The major technical difference is that in the
US, school is free and every child has the right to attend. And though there are many children in the US who value education, in
Tanzania it is considered a privilege to attend school.
The major challenges which prevent kids from attending school are many, including shortage of schools and teachers and inability of
families to pay for school fees and expenses. In some cases, the adults of the household require the students to quit school to get
married, help with younger kids and work around the home. Or, some adults in the homes may value education, but they themselves
are uneducated and are therefore unable to help with homework. Additionally, students may live a long distance from their school
and are required to walk up to two hours each way. Due to lack of electricity in the homes, once it is dark, students have no light for
homework and reading. But despite all these rather daunting hurdles, these students sincerely do their best to go to school and stay
in school.
A major obstacle for attending school is cost. Students are required to pay school fees, for uniforms, food, materials and if they are
placed in a school away from home, boarding fees. The total costs for primary school is approximately $40.00 per year. The cost of
secondary school is as much as $400 to $800 per year for government schools. Obviously if the student is placed in a secondary
school in another village or city, there is a cost for boarding which can bring the total up to $900.00 or more. The fact that many
families survive on less than a dollar or two a day means that many families cannot afford to send their kids to school. Or families
can afford to send only one of their children to school. Imagine having to decide which of your children will have a chance for
success in life and which will not?
Movement from primary to secondary school requires the student to pass a national exam. Shockingly, more than half the students
do not pass the exam. In 1999, 20% passed, in 2002, 27% passed and in 2005, the pass rate improved to 49%. Those who do not
pass the exam and cannot afford private school must simply end their education. Also, less than one half of one percent (.27%) of
students in Tanzania goes on to University!
If students score well enough on the national exam, they will be assigned to a government school, based on their score. Students do
not choose which school they will attend. Also, there is a shortage of secondary schools, so students may do well enough on exams
to go on, but will not get placed in a government school, thus ending their education. Little economic opportunity or hope for the
future exists for people who do not complete secondary education.
In school, students are instructed in the subjects of English, Swahili (the national language), mathematics, civics, government,
science and history. In both primary and secondary schools, subjects are taught in English so that students will have good working
knowledge of a language which will link them to the rest of the world. In some cases, this instruction in English creates a barrier if
students did not get good training at the primary school level. Many schools do not have computers, putting them at a disadvantage
in keeping up with technology. Also, many of the facilities are in ill repair, there is a shortage of books and materials and electricity is
unreliable and can shut off at any time. Currently there is a severe shortage of teachers in Tanzania and they are not paid well
enough to sustain a decent lifestyle. Average salaries are $150.00 to $300.00 per month. It is difficult to hire and retain good
teachers.
Despite cultural and logistical differences, there are some striking similarities between African kids and those from the US. They love
running and playing, teasing, kicking a soccer ball or empty plastic bottle, showing off for one another and hamming it up for photos.
They are fun loving, well behaved and eager to learn. They do not take their education for granted.
It is well known that lack of education is a leading cause of poverty in the developing world. Children must have the opportunity to
attend school so they can become part of the agent for changing the system and achieving personal success in life. This is where
Elimu Africa comes in. Our goal is to provide resources to allow these kids the opportunity to pursue their education
http://www.elimuafrica.org/page9/page9.html
Mt. Kilimanjaro
Tanzania's best-known national park, the Serengeti is an amazing expanse of African savannah. A
multitude of savannah wildlife can be seen on these seemingly never-ending plains, hence the area's
Masaai name, Siringitu - "where the land moves on forever".
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The park is famous for its massed animal migrations. Heading south to the plains during October and
November's short rainy season, one million wildebeest, 200,000 zebra and 300,000 Thompson's gazelle
pound across the landscape. After the long rains they continue in a full circle by heading first west then
north during April to June.
Located next to the fascinating Tanzania National Museum, Dar es Salaam's Botanical Gardens offer
the perfect place to enjoy some peace and quiet and to examine the country's colourful native flora. The
Gardens date back to German colonisation.
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Take time out to wander among purple bougainvillea, blue jacaranda, scarlet flame trees and red
hibiscus. As well as the indigenous plants, trees, ferns and flowers, this is one of the few places in the
world where you can see the coco-de-mer palm tree, native to the Seychelles. You might even spot a
peacock or two!
The Tanzania National Museum houses archaeological finds including the cast of a 3.6 million year-old
hominid footprint. The History Gallery looks back to the 9th century, and the Ethnography Hall
explores hunting and gathering, initiation rites and witchcraft.
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The National Museum is principally housed in the former King George V Memorial Museum building,
which stands in a garden full of noisy peacocks. Currently, it also incorporates the Dar es Salaam
Museum along Shaaban Robert Street, the Village Museum along Ali Hassan Mwinyi Road, the
Natural History Museum along Boma Road in Arusha, the Arusha Declaration Museum situated along
Kaloleni road in Arusha and the Mwl. J.K. Nyerere Museum in Butiama, Musoma.
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Black Rhinoceros (Diceros bicornis).
Desperate Shrew (Crocidura desperata). (Endemic to Tanzania.)
Pemba Flying Fox (Pteropus voeltzkowi). (Endemic to Tanzania.)
Peters's Musk Shrew (Crocidura gracilipes).
Telford's Shrew (Crocidura telfordi). (Endemic to Tanzania.)
Aders' Duiker (Cephalophus adersi).
Black-and-rufous Elephant Shrew (Rhynchocyon petersi).
Blue Whale (Balaenoptera musculus).
Chimpanzee (Pan troglodytes).
Fin Whale (Balaenoptera physalus).
Geata Mouse Shrew (Myosorex geata). (Endemic to Tanzania.)
Giant African Water Shrew (Potamogale velox).
Rondo Dwarf Galago (Galago rondoensis). (Endemic to Tanzania.)
Sei Whale (Balaenoptera borealis).
Wild Dog (Lycaon pictus).
Zanzibar Red Colobus (Procolobus kirkii). (Endemic to Tanzania.)
Abbott's Duiker (Cephalophus spadix). (Endemic to Tanzania.)
African Elephant (Loxodonta africana).
Checkered Sengi (Rhynchocyon cirnei).
Cheetah (Acinonyx jubatus).
Dugong (Dugong dugon).
Dwarf Multimammate Mouse (Mastomys pernanus).
East African Collared Fruit Bat (Myonycteris relicta).
Eastern Tree Hyrax (Dendrohyrax validus).
Elgon Shrew (Crocidura elgonius).
Fischer's Shrew (Crocidura fischeri).
Highland Shrew (Crocidura allex).
Hildegarde's Tomb Bat (Taphozous hildergardeae).
Howell's Shrew (Sylvisorex howelli). (Endemic to Tanzania.)
Humpback Whale (Megaptera novaeangliae).
Large-eared Free-tailed Bat (Otomops martiensseni).
Lesser Hamster-rat (Beamys hindei).
Lion (Panthera leo).
Red Bush Squirrel (Paraxerus palliatus).
Rombo Shrew (Crocidura monax).
Sperm Whale (Physeter catodon).
Spotted-necked Otter (Lutra maculicollis).
Springhare (Pedetes capensis).
Svynnerton's Bush Squirrel (Paraxerus vexillarius). (Endemic to Tanzania.)
Tanzanian Shrew (Crocidura tansaniana). (Endemic to Tanzania.)
Uhehe Red Colobus (Procolobus gordonorum). (Endemic to Tanzania.)
Usambara Shrew (Crocidura usambarae). (Endemic to Tanzania.)
Vermiculate Shrew (Crocidura xantippe).
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travelers’ diarrhea
cholera
malaria
Escherichia coli diarrhea
hepatitis A
schistosomiasis - found in fresh water
typhoid fever
yellow fever
Insect born diseases
parasitic diseases
Dengue fever
filariasis
leishmaniasis
onchocerciasis
trypanosomiasis (sleeping sickness)
Rift Valley fever
HIV
AIDS
hepatitis B
diptheria - endemic to the region
Tuberculosis
chickungunya
http://www.wrongdiagnosis.com/travel-health/tanzania.htm
Infectious agents are the primary cause of TD. Bacterial enteropathogens cause approximately 80% of
TD cases. The most common causative agent isolated in countries surveyed has been enterotoxigenic
Escherichia coli (ETEC). ETEC produce watery diarrhea with associated cramps and low-grade or no
fever. Besides ETEC and other bacterial pathogens, a variety of viral and parasitic enteric pathogens
also are potential causative agents. (Source: excerpt from Travelers' Diarrhea: DBMD)
Diseases
 cholera – caused by bacterium called Vibrio Cholerae, a rod shaped bacterium
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Cholera is spread by eating food or drinking water contaminated with the
bacterium. Although cholera was a public health problem in the United States
and Europe a hundred years ago, modern sanitation and the treatment of
drinking water have virtually eliminated the disease in developed countries.
Cholera outbreaks, however, still occur from time to time in less developed
countries, particularly following such natural disasters as the tsunami that
struck countries surrounding the Indian Ocean in December 2004. In these
areas cholera is still the most feared epidemic diarrheal disease because
people can die within hours of infection from dehydration due to the loss of
water from the body through the bowels.
The key to treating cholera lies in preventing dehydration by replacing the
fluids and electrolytes lost through diarrhea and vomiting. The discovery that
rehydration can be accomplished orally revolutionized the treatment of
cholera and other, similar diseases by making this simple, cost-effective
treatment widely available throughout the world. The World Health
Organization has developed an inexpensive oral replacement fluid containing
appropriate amounts of water, sugar, and salts that is used worldwide. In
cases of severe dehydration, replacement fluids must be given intravenously.
Patients should be encouraged to drink when they can keep liquids down and
eat when their appetite returns. Recovery generally takes three to six days.
Adults may be given the antibiotic tetracycline to shorten the duration of the
illness and reduce fluid loss. The World Health Organization recommends
this antibiotic treatment only in cases of severe dehydration. If antibiotics are
overused, the cholera bacteria organism may become resistant to the drug,
making the antibiotic ineffective in treating even severe cases of cholera.
Tetracycline is not given to children whose permanent teeth have not come in
because it can cause the teeth to become permanently discolored.
Other antibiotics that may be given to speed up the clearance of V. cholerae
from the body include ciprofloxacin and erythromycin.
A possible complementary or alternative treatment for fluid loss caused by
cholera is a plant-derived compound, an extract made from the tree bark of
Croton lechleri, the Sangre de grado tree found in the South American rain
forest. Researchers at a hospital research institute in California report that the
extract appears to work by preventing the loss of chloride and other
electrolytes from the body.
Because V. cholerae is sensitive to acid, most cholera-causing bacteria die in
the acidic environment of the stomach. However, when a person has ingested
food or water containing large amounts of cholera bacteria, some will survive
to infect the intestines. As would be expected, antacid usage or the use of any
medication that blocks acid production in the stomach would allow more
bacteria to survive and cause infection.
In the small intestine, the rapidly multiplying bacteria produce a toxin that
causes a large volume of water and electrolytes to be secreted into the bowels
and then to be abruptly eliminated in the form of watery diarrhea. Vomiting
may also occur. Symptoms begin to appear between one and three days after
the contaminated food or water has been ingested.
Most cases of cholera are mild, but about one in 20 patients experience
severe, potentially life-threatening symptoms. In severe cases, fluids can be
lost through diarrhea and vomiting at the rate of one quart per hour. This can
produce a dangerous state of dehydration unless the lost fluids and
electrolytes are rapidly replaced.
Signs of dehydration include intense thirst, little or no urine output, dry skin
and mouth, an absence of tears, glassy or sunken eyes, muscle cramps,
weakness, and rapid heart rate. The fontanelle (soft spot on an infant's head)
will appear to be sunken or drawn in. Dehydration occurs most rapidly in the
very young and the very old because they have fewer fluid reserves. A doctor
should be consulted immediately any time signs of severe dehydration occur.
Immediate replacement of the lost fluids and electrolytes is necessary to
prevent kidney failure, coma, and death.
 Malaria Definition
Malaria is a serious infectious disease spread by certain mosquitoes. It is most
common in tropical climates. It is characterized by recurrent symptoms of
chills, fever, and an enlarged spleen. The disease can be treated with
medication, but it often recurs. Malaria is endemic (occurs frequently in a
particular locality) in many third world countries. Isolated, small outbreaks
sometimes occur within the boundaries of the United States.
Description
Malaria is a growing problem in the United States. Although only about 1400
new cases were reported in the United States and its territories in 2000, many
involved returning travelers. In addition, locally transmitted malaria has
occurred in California, Florida, Texas, Michigan, New Jersey, and New York
City. While malaria can be transmitted in blood, the American blood supply is
not screened for malaria. Widespread malarial epidemics are far less likely to
occur in the United States, but small localized epidemics could return to the
Western world. As of late 2002, primary care physicians are being advised to
screen returning travelers with fever for malaria, and a team of public health
doctors in Minnesota is recommending screening immigrants, refugees, and
international adoptees for the disease-particularly those from high-risk areas.
The picture is far more bleak, however, outside the territorial boundaries of
the United States. A recent government panel warned that disaster looms over
Africa from the disease. Malaria infects between 300 and 500 million people
every year in Africa, India, southeast Asia, the Middle East, Oceania, and
Central and South America. A 2002 report stated that malaria kills 2.7 million
people each year, more than 75 percent of them African children under the
age of five. It is predicted that within five years, malaria will kill about as
many people as does AIDS. As many as half a billion people worldwide are
left with chronic anemia due to malaria infection. In some parts of Africa,
people battle up to 40 or more separate episodes of malaria in their lifetimes.
The spread of malaria is becoming even more serious as the parasites that
cause malaria develop resistance to the drugs used to treat the condition. In
late 2002, a group of public health researchers in Thailand reported that a
combination treatment regimen involving two drugs known as
dihydroartemisinin and azithromycin shows promise in treating multidrugresistant malaria in southeast Asia.
Causes and symptoms
Human malaria is caused by four different species of a parasite belonging to
genus Plasmodium: Plasmodium falciparum (the most deadly), Plasmodium
vivax, Plasmodium malariae, and Plasmodium ovale. The last two are fairly
uncommon. Many animals can get malaria, but human malaria does not
spread to animals. In turn, animal malaria does not spread to humans.
A person gets malaria when bitten by a female mosquito who is looking for a
blood meal and is infected with the malaria parasite. The parasites enter the
blood stream and travel to the liver, where they multiply. When they reemerge into the blood, symptoms appear. By the time a patient shows
symptoms, the parasites have reproduced very rapidly, clogging blood vessels
and rupturing blood cells.
Malaria cannot be casually transmitted directly from one person to another.
Instead, a mosquito bites an infected person and then passes the infection on
to the next human it bites. It is also possible to spread malaria via
contaminated needles or in blood transfusions. This is why all blood donors
are carefully screened with questionnaires for possible exposure to malaria.
It is possible to contract malaria in non-endemic areas, although such cases
are rare. Nevertheless, at least 89 cases of so-called airport malaria, in which
travelers contract malaria while passing through crowded airport terminals,
have been identified since 1969.
The amount of time between the mosquito bite and the appearance of
symptoms varies, depending on the strain of parasite involved. The
incubation period is usually between 8 and 12 days for falciparum malaria,
but it can be as long as a month for the other types. Symptoms from some
strains of P.vivax may not appear until 8-10 months after the mosquito bite
occurred.
The primary symptom of all types of malaria is the "malaria ague" (chills and
fever). In most cases, the fever has three stages, beginning with
uncontrollable shivering for an hour or two, followed by a rapid spike in
temperature (as high as 106°F), which lasts three to six hours. Then, just
as suddenly, the patient begins to sweat profusely, which will quickly bring
down the fever. Other symptoms may include fatigue, severe headache, or
nausea and vomiting. As the sweating subsides, the patient typically feels
exhausted and falls asleep. In many cases, this cycle of chills, fever, and
sweating occurs every other day, or every third day, and may last for between
a week and a month. Those with the chronic form of malaria may have a
relapse as long as 50 years after the initial infection.
Falciparum malaria is far more severe than other types of malaria because the
parasite attacks all red blood cells, not just the young or old cells, as do other
types. It causes the red blood cells to become very "sticky." A patient with
this type of malaria can die within hours of the first symptoms. The fever is
prolonged. So many red blood cells are destroyed that they block the blood
vessels in vital organs (especially the kidneys), and the spleen becomes
enlarged. There may be brain damage, leading to coma and convulsions. The
kidneys and liver may fail.
Malaria in pregnancy can lead to premature delivery, miscarriage, or
stillbirth.
Certain kinds of mosquitoes (called anopheles) can pick up the parasite by
biting an infected human. (The more common kinds of mosquitoes in the
United States do not transmit the infection.) This is true for as long as that
human has parasites in his/her blood. Since strains of malaria do not protect
against each other, it is possible to be reinfected with the parasites again and
again. It is also possible to develop a chronic infection without developing an
effective immune response.
Diagnosis
Malaria is diagnosed by examining blood under a microscope. The parasite
can be seen in the blood smears on a slide. These blood smears may need to
be repeated over a 72-hour period in order to make a diagnosis. Antibody
tests are not usually helpful because many people developed antibodies from
past infections, and the tests may not be readily available. A new laser test to
detect the presence of malaria parasites in the blood was developed in 2002,
but is still under clinical study.
Two new techniques to speed the laboratory diagnosis of malaria show
promise as of late 2002. The first is acridine orange (AO), a staining agent
that works much faster (3-10 min) than the traditional Giemsa stain (45-60
min) in making the malaria parasites visible under a microscope. The second
is a bioassay technique that measures the amount of a substance called
histadine-rich protein II (HRP2) in the patient's blood. It allows for a very
accurate estimation of parasite development. A dip strip that tests for the
presence of HRP2 in blood samples appears to be more accurate in
diagnosing malaria than standard microscopic analysis.
Anyone who becomes ill with chills and fever after being in an area where
malaria exists must see a doctor and mention their recent travel to endemic
areas. A person with the above symptoms who has been in a high-risk area
should insist on a blood test for malaria. The doctor may believe the
symptoms are just the common flu virus. Malaria is often misdiagnosed by
North American doctors who are not used to seeing the disease. Delaying
treatment of falciparum malaria can be fatal.
Treatment
Falciparum malaria is a medical emergency that must be treated in the
hospital. The type of drugs, the method of giving them, and the length of the
treatment depend on where the malaria was contracted and how sick the
patient is.
For all strains except falciparum, the treatment for malaria is usually
chloroquine (Aralen) by mouth for three days. Those falciparum strains
suspected to be resistant to chloroquine are usually treated with a
combination of quinine and tetracycline. In countries where quinine
resistance is developing, other treatments may include clindamycin (Cleocin),
mefloquin (Lariam), or sulfadoxone/pyrimethamine (Fansidar). Most patients
receive an antibiotic for seven days. Those who are very ill may need
intensive care and intravenous (IV) malaria treatment for the first three days.
Anyone who acquired falciparum malaria in the Dominican Republic, Haiti,
Central America west of the Panama Canal, the Middle East, or Egypt can
still be cured with chloroquine. Almost all strains of falciparum malaria in
Africa, South Africa, India, and southeast Asia are now resistant to
chloroquine. In Thailand and Cambodia, there are strains of falciparum
malaria that have some resistance to almost all known drugs.
A patient with falciparum malaria needs to be hospitalized and given
antimalarial drugs in different combinations and doses depending on the
resistance of the strain. The patient may need IV fluids, red blood cell
transfusions, kidney dialysis, and assistance breathing.
A drug called primaquine may prevent relapses after recovery from P. vivax
or P. ovale. These relapses are caused by a form of the parasite that remains
in the liver and can reactivate months or years later.
Another new drug, halofantrine, is available abroad. While it is licensed in
the United States, it is not marketed in this country and it is not recommended
by the Centers for Disease Control and Prevention in Atlanta.
Alternative treatments
The Chinese herb qiinghaosu (the Western name is artemisinin) has been used
in China and southeast Asia to fight severe malaria, and became available in
Europe in 1994. Because this treatment often fails, it is usually combined
with another antimalarial drug (mefloquine) to boost its effectiveness. It is
not available in the United States and other parts of the developed world due
to fears of its toxicity, in addition to licensing and other issues.
A Western herb called wormwood (Artemesia annua) that is taken as a daily
dose can be effective against malaria. Protecting the liver with herbs like
goldenseal (Hydrastis canadensis), Chinese goldenthread (Coptis chinensis),
and milk thistle (Silybum marianum) can be used as preventive treatment.
Preventing mosquitoes from biting you while in the tropics is another
possible way to avoid malaria.
As of late 2002, researchers are studying a traditional African herbal remedy
against malaria. Extracts from Microglossa pyrifolia, a trailing shrub
belonging to the daisy family (Asteraceae), show promise in treating drugresistent strains of P. falciparum.
Prognosis
If treated in the early stages, malaria can be cured. Those who live in areas
where malaria is epidemic, however, can contract the disease repeatedly,
never fully recovering between bouts of acute infection.
Prevention
Several researchers are currently working on a malarial vaccine, but the
complex life cycle of the malaria parasite makes it difficult. A parasite has
much more genetic material than a virus or bacterium. For this reason, a
successful vaccine has not yet been developed.
Malaria is an especially difficult disease to prevent by vaccination because
the parasite goes through several separate stages. One recent promising
vaccine appears to have protected up to 60% of people exposed to malaria.
This was evident during field trials for the drug that were conducted in South
America and Africa. It is not yet commercially available.
The World Health Association (WHO) has been trying to eliminate malaria
for the past 30 years by controlling mosquitoes. Their efforts were successful
as long as the pesticide DDT killed mosquitoes and antimalarial drugs cured
those who were infected. Today, however, the problem has returned a
hundredfold, especially in Africa. Because both the mosquito and parasite are
now extremely resistant to the insecticides designed to kill them,
governments are now trying to teach people to take antimalarial drugs as a
preventive medicine and avoid getting bitten by mosquitoes.
A newer strategy as of late 2002 involves the development of genetically
modified non-biting mosquitoes. A research team in Italy is studying the
feasibility of this means of controlling malaria.
Travelers to high-risk areas should use insect repellant containing DEET for
exposed skin. Because DEET is toxic in large amounts, children should not
use a concentration higher than 35%. DEET should not be inhaled. It should
not be rubbed onto the eye area, on any broken or irritated skin, or on
children's hands. It should be thoroughly washed off after coming indoors.
Those who use the following preventive measures get fewer infections than
those who do not:
 Between dusk and dawn, remain indoors in well-screened areas.
 Sleep inside pyrethrin or permethrin repellent-soaked mosquito nets.
 Wear clothes over the entire body.
Anyone visiting endemic areas should take antimalarial drugs starting a day
or two before they leave the United States. The drugs used are usually
chloroquine or mefloquine. This treatment is continued through at least four
weeks after leaving the endemic area. However, even those who take
antimalarial drugs and are careful to avoid mosquito bites can still contract
malaria.
International travelers are at risk for becoming infected. Most Americans who
have acquired falciparum malaria were visiting sub-Saharan Africa; travelers
in Asia and South America are less at risk. Travelers who stay in air
conditioned hotels on tourist itineraries in urban or resort areas are at lower
risk than backpackers, missionaries, and Peace Corps volunteers. Some
people in western cities where malaria does not usually exist may acquire the
infection from a mosquito carried onto a jet. This is called airport or runway
malaria.
 Caused by a parasite
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 typhoid fever
Definition
Typhoid fever is a severe infection caused by a bacterium, Salmonella typhi.
S. typhi is in the same family of bacteria as the type spread by chicken and
eggs, commonly known as salmonella poisoning or food poisoning. S. typhi
bacteria do not have vomiting and diarrhea as the most prominent symptoms
of their presence in humans. Instead, persistently high fever is the hallmark of
S. typhi infection.
Description
S. typhi bacteria are passed into the stool and urine of infected patients. They
may continue to be present in the stool of asymptomatic carriers, who are
persons who have recovered from the symptoms of the disease but continue
to carry the bacteria. This carrier state occurs in about 3% of all individuals
recovered from typhoid fever.
GEM_sbtyphoid_fever.sgm
Typhoid fever is passed from person to person through poor hygiene, such as
incomplete or no hand washing after using the toilet. Persons who are carriers
of the disease and who handle food can be the source of epidemic spread of
typhoid. One such individual gave her name to the expression "Typhoid
Mary," a name given to someone whom others avoid.
Typhoid fever is a particularly difficult problem in parts of the world with
poor sanitation practices. There are about 16 million cases of typhoid reported
around the world each year. In the United States, most patients who contract
typhoid fever have recently returned from travel to another country where
typhoid is much more common, including Mexico, Peru, Chile, India, and
Pakistan. However, there have been reports in the early 2000s of typhoid
outbreaks within the United States that were unrelated to recent travel. One
such outbreak occurred in Queens, New York, and was traced to a worker in a
local restaurant.
Causes and symptoms
S. typhi must be ingested to cause disease. Transmission often occurs when a
person in the carrier state does not wash hands thoroughly (or not at all) after
defecation and serves food to others. This pathway is sometimes called the
fecal-oral route of disease transmission. In countries where open sewage is
accessible to flies, the insects land on the sewage, pick up the bacteria, and
then contaminate food to be eaten by humans.
After being swallowed, the S. typhi bacteria head down the digestive tract,
where they are taken in by cells called mononuclear phagocytes. These
phagocytes are cells of the immune system, whose job it is to engulf and kill
invading bacteria and viruses. In the case of S. typhi, however, the bacteria
are able to survive ingestion by the phagocytes, and multiply within these
cells. This period of time, during which the bacteria are multiplying within
the phagocytes, is the 10 to 14-day incubation period of typhoid fever. When
huge numbers of bacteria fill an individual phagocyte, they spill out of the
cell and into the bloodstream, where their presence begins to cause
symptoms.
The presence of increasingly large numbers of bacteria in the bloodstream
(bacteremia) is responsible for an increasingly high fever, which lasts
throughout the four to eight weeks of the disease in untreated individuals.
Other symptoms of typhoid fever include constipation (at first), extreme
fatigue, headache, joint pain, and a rash across the abdomen known as rose
spots.
The bacteria move from the bloodstream into certain tissues of the body,
including the gallbladder and lymph tissue of the intestine (called Peyer's
patches). The tissue's response to this invasion causes symptoms ranging
from inflammation of the gallbladder (cholecystitis) to intestinal bleeding to
actual perforation of the intestine. Perforation of the intestine refers to an
actual hole occurring in the wall of the intestine, with leakage of intestinal
contents into the abdominal cavity. This leakage causes severe irritation and
inflammation of the lining of the abdominal cavity, which is called peritonitis.
Peritonitis is a frequent cause of death from typhoid fever.
Other complications of typhoid fever include liver and spleen enlargement,
sometimes so great that the spleen ruptures or bursts; anemia, or low red
blood cell count due to blood loss from the intestinal bleeding; joint
infections, which are especially common in patients with sickle cell anemia
and immune system disorders; pneumonia caused by a bacterial infection-usually Streptococcus pneumoniae-- which is able to take hold due to the
patient's weakened state; heart infections; and meningitis and infections of the
brain, which cause mental confusion and even coma. It may take a patient
several months to recover fully from untreated typhoid fever.
Diagnosis
In some cases, the doctor may suspect the diagnosis if the patient has already
developed the characteristic rose spots, or if he or she has a history of recent
travel in areas with poor sanitation. The diagnosis, however, is confirmed by
a blood culture. Samples of a patient's stool, urine, and bone marrow can also
be used to grow S. typhi in a laboratory for identification under a microscope.
Cultures are the most accurate method of diagnosis. Blood cultures usually
become positive in the first week of illness in 80% of patients who have not
taken antibiotics.
Treatment
Antibiotics are the treatment of choice for typhoid fever. As of the early
2000s, the most frequently used drugs are ceftriaxone and cefoperazone.
Ciprofloxacin is sometimes given as follow-up therapy.
Carriers of S. typhi must be treated even when they do not show any
symptoms of the infection, because carriers are responsible for the majority
of new cases of typhoid fever. Eliminating the carrier state is actually a fairly
difficult task. It requires treatment with one or even two different medications
over a period of four to six weeks. The antibiotics most commonly given are
ampicillin (sometimes given together with probenecid) and amoxicillin. In
the case of a carrier with gallstones, surgery may need to be performed to
remove the gallbladder. This measure is necessary because typhoid bacteria
are often housed in the gallbladder, where they may survive in spite of
antibiotic treatment. In some patients, however, treatment with rifampin and
trimethoprim-sulfamethoxazole is sufficient to eradicate the bacteria from the
gallbladder without surgery.
Prognosis
The prognosis for recovery is good for most patients. In the era before
effective antibiotics were discovered, about 12% of all typhoid fever patients
died of the infection. Now, however, fewer than 1% of patients who receive
prompt antibiotic treatment will die. The mortality rate is highest in the very
young and very old, and in patients suffering from malnutrition. The most
ominous signs are changes in a patient's state of consciousness, including
stupor or coma.
Prevention
Hygienic sewage disposal systems in a community as well as proper personal
hygiene are the most important factors in preventing typhoid fever.
Immunizations are available for travelers who expect to visit countries where
S. typhi is a known public health problem. Some of these immunizations
provide only short-term protection (for a few months), while others may be
effective for several years. Efforts are being made to develop vaccines that
provide a longer period of protection with fewer side effects from the vaccine
itself. The most commonly reported side effects are flu-like muscle cramps
and abdominal pain. As of earlt 2004, these vaccines are also being studied as
possible antibioterrorism agents
http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/A
toz/ency/typhoid_fever.jsp
Flight information
Moevenpick Royal Palm Hotel
This seven-storey hotel, set in tropical gardens and featuring contemporary architecture, is
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Moevenpick Royal Palm Hotel
This seven-storey hotel, set in tropical gardens and featuring contemporary architecture, is
located in central Dar es Salaam, two kilometres from the city’s ... More lodging info
Same great rates plus expert advice. 1-800-551-2534
Get ThankYou® Points
Dar Es Salaam, United Republic of Tanzania
Standard twin bedded room
Includes: Full Breakfast
Check in: 03/02/09
Check out: 03/11/09
$9,124.50
Traveling to Dar es Salaam
Sun 1-Mar-09
Indianapolis (IND)
Depart 11:14 am
to
Detroit (DTW)
Arrive 12:30 pm
Terminal E.M. MCNAMARA TERMINAL
241 mi
(388 km)
Duration: 1hr 16mn
NW
Flight: 1016
3Economy/Coach Class, DC9-30
Detroit (DTW)
Depart 4:00 pm
Terminal E.M. MCNAMARA TERMINAL
to
Amsterdam (AMS)
Arrive 5:55 am +1 day
3,920 mi
(6,309 km)
Duration: 7hr 55mn
NW
Flight: 40
3Economy/Coach Class, AIRBUS INDUSTRIE A330-300
Mon 2-Mar-09
Amsterdam (AMS)
Depart 10:10 am
to
Kilimanjaro (JRO)
Arrive 8:35 pm
4,288 mi
(6,901 km)
Duration: 8hr 25mn
NW
Flight: 8383
Operated by: KLM ROYAL DUTCH AIRLINES
3Economy/Coach Class, Meal, Boeing 777
Kilimanjaro (JRO)
Depart 9:40 pm
to
Dar es Salaam (DAR)
Arrive 10:40 pm
280 mi
(451 km)
Duration: 1hr 0mn
NW
Flight: 8383
Operated by: KLM ROYAL DUTCH AIRLINES
3Economy/Coach Class, Snack, Boeing 777
Total distance: 8,729 mi (14,048 km)
Total duration: 18hr 36mn (27hr 26mn with connections)
Traveling to Indianapolis
Wed 11-Mar-09
Dar es Salaam (DAR)
Depart 3:00 pm
to
Nairobi (NBO)
Arrive 4:20 pm
417 mi
(671 km)
Duration: 1hr 20mn
KQ
Flight: 483
Operated by: PRECISION AIR
3Economy/Coach Class, Boeing 737-300
Nairobi (NBO)
Depart 10:50 pm
to
Amsterdam (AMS)
Arrive 5:30 am +1 day
4,147 mi
(6,674 km)
Duration: 8hr 40mn
NW
Flight: 8566
Operated by: KLM ROYAL DUTCH AIRLINES
3Economy/Coach Class, Meal, Boeing 777
Thu 12-Mar-09
Amsterdam (AMS)
Depart 10:50 am
to
Detroit (DTW)
Arrive 2:45 pm
Terminal E.M. MCNAMARA TERMINAL
3,920 mi
(6,309 km)
Duration: 8hr 55mn
NW
Flight: 67
3Economy/Coach Class, AIRBUS INDUSTRIE A330-300
Detroit (DTW)
Depart 5:02 pm
Terminal E.M. MCNAMARA TERMINAL
to
Indianapolis (IND)
Arrive 6:18 pm
http://www.expedia.com/pub/agent.dll?qsfr=cmfd&itid=&itdx=&itty=&ecid=
Average price per person: $50
Price for Safari per person - $90
LAKE NAKURU NATIONAL PARK
These flamingo numbers
are on a steady increase
again. The numbers had
been reduced due to the ElNino weather pattern that
flooded the lake, and
changed the alkaline
concentration. The
flamingos feed on algae,
created from their droppings mixing in the warm alkaline
waters, and plankton. Lake Nakuru National Park is also
shared with the white pelicans and the ever-snorting
hippos.Other wildlife in the Lake Nakuru National Park
includes: The famous Black and White rhinos.
The Black rhinos have been slowly multiplying over the
years, and are well protected. Thanks partially to the
government of South Africa. Lake Nakuru National Park
also boasts an increase in White rhinos. There are plenty of
waterbucks, impalas, dik-diks, grants gazelles, lions and
leopards. In 1977, the Rothschild giraffe was introduced to
the Park. The park also has large sized python snakes that
inhabit the dense woodlands, and can often be seen crossing
the roads or dangling from trees.
Nakuru means "Dust
or Dusty Place" in Maasai language. Lake Nakuru National
Park, close to Nakuru town, was established in 1961. It
started off small, only encompassing the famous lake and the
surrounding mountainous vicinity. Now it has been extended
to include a large part of the savannahs. Currently, the
fenced Lake Nakuru National Park covers around 90 square
miles. It has unusual but beautiful vegetation. The forest
vegetation is covered with Euphorbia, tall cactus like trees
and acacia woodland. The forest region is a host to over 400
migratory bird species from around the world. Lake Nakuru
National Park can be accessed via three gates: Main, Lanet
and Nderit.
The park's lake is internationally known for its Lesser and
Greater Flamingos. Ornithologists often describe Lake
Nakuru as "the most fabulous bird spectacle in the world".
The Lesser flamingo can be distinguished by its deep red
carmine bill and pink plumage unlike the greater, which has
a bill with a black tip. The Lesser flamingos are ones that are
commonly pictured in documentaries mainly because they
are large in number. There are estimated to be over a million
Lesser flamingos.
Due credit should be given to
the World Wide Fund For
Nature organization, and local
Kenyan wildlife foundations for
supporting the preservation of
animals, protection of the
rhinoceros population and
research into the effects of surrounding communities and
industries. Lake Nakuru National Park is the only park in
Kenya that is completely fenced. Our Kenya safaris include
the visitation of this park.
The Great Rift Valley, mostly known in Kenya as the East
African Rift Valley, was formed between 2 and 7 million
years ago. It is the longest rift on the surface of the earth.
The Rift Valley starts all the way from Jordan, Middle East,
and runs through Ethiopia, Kenya, Tanzania, Congo,
Malawi, and ends near the coastal town of Solada in
Mozambique. The amazing attribute about the Rift Valley is
that once it reaches the Kenyan border, it diverges into two
rifts, which later converge near Lake Rukwa in southern
Tanzania.
The Great Rift Valley is approximately 4,000 miles long and
35 miles wide. It was formed due to geological tension in the
earth's crust that caused a deep depression, while probably
forcing the sides upwards. The floor of the valley is normally
below sea level. In Kenya, the Rift Valley gave rise to many
lakes that have become a habitat for diverse wildlife. The
walls of the Rift Valley are called escarpments; the famous
escarpments of Kenya being the Mau Escarpment. The Mau
escarpments are famous for their height, which rise over
8500 feet. To the surprise of many tourists, geological
movements still occur in the Rift Valley. In 2000, the British
media, BBC, reported that Mount Kenya had reduced in
height. Both Mount Kenya and Kilimanjaro are almost
adjacent to the Rift Valley.
Lake Nakuru National Park Birds Sanctuary - PRICES
The drive from Nairobi will take you through the highland
farms of the kikuyu people and cross the escarpment into the
Great Rift Valley onto the seasonal homes of thousands of
flamingoes and other species. Have lunch and proceed over
for a game drive to see the game animals and then have your
ways back to Nairobi .
Price for 1 day - £90 Per Person
PACKAGE: Please note that the price of this safari does not
include flights into kenya and as such, is most suitable to
combine with our Beach Holidays Packages. Please also see
our ready made Safari and Beach Holiday Combinations or
alternatively please submit your own special request or
customised beach and safari holidays below.