Assessment of the ability of health care providers to treat and prevent adverse health effects of pesticides in agricultural areas of Tanzania.

A survey of Tanzanian health care providers in agricultural areas was undertaken in 1991-1994 to assess their knowledge of toxic effects of pesticides, experiences and practices, as well as of their needs for appropriate information in order to develop effective strategies for reducing pesticide poisoning. Face-to-face interviews were conducted with 104 physicians, clinical officers and nurses at health care facilities in the coffee and cotton growing areas. Eighty percent of respondents reported to have seen one and nine of them two to four cases of pesticide poisoning in the preceding three months. A significantly higher annual number of poisonings were observed in coffee than in cotton area (GM 0.5 vs 0.1). Also the number of cases registered in hospitals was considerably higher than that in the out-patient health care (GM 1.7 vs 0.2). Pesticide poisoning was regarded as a major problem in the community by 63% of health care providers, including 77% of hospital staff. One third of health care providers thought that a certain percent of pesticide poisoning cases remain unrecognized, and that this percentage is higher in cotton than in coffee growing areas. The respiratory tract was the major route for pesticide to enter the human body; this was followed by gastrointestinal tract, skin, and eyes. Only one percent of the respondents could identify the groups of pesticides (organophosphate vs organochlorine) mostly used in the study areas. The survey indicated that training of hospital staff in toxicity of pesticide exposure is an important task and a prerequisite for efficient recognition, diagnosis and treatment of pesticide poisoning cases in Tanzania.