Cholera control in an inaccessible district in Tanzania: importance of temporary rural centres.

The fourth ever recorded outbreak of cholera on Tanzania mainland started on 2.10.77 in Twasalie village which is a delta island in the Utete district on the Indian Ocean coastal line. Poor communication and inadequate health facilities in the district delayed detection and reporting of the outbreak for four weeks leading to wide dissemination of the disease. Socio-cultural and religious practices by residents of the district especially the procedure of burying the dead played a key role in enhancing spread of the infection. The outbreak was controlled by establishing 16 multipurpose cholera centres in the district. Whereas 55% of the 69 patients with the disease before control measures were introduced died, the mortality rate was reduced to 1.6% out of the 184 severely ill patients admitted to treatment centres.