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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". Advertisement 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. Advertisement 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. Advertisement 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. 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). 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 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 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 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 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.