Date: Mon 20 Mar 2017, 10:45 AM
Source: News24, a Traveller24 report [edited]
<http://traveller24.news24.com/News/Alerts/alert-limpopo-on-high-alert-as-botswana-issues-malaria-warning-20170320>

Travellers heading to Botswana or those who find themselves in Limpopo need to ensure they take the correct preventative measures as a warning have been issued for high levels of malaria in both of these regions.

The Ministry of Health and Wellness for Botswana has issued a warning that the country is experiencing high levels of malaria, following the recent heavy rains. "There have been increases in the number of cases in Okavango, Ngami, Chobe, Boteti, Tutume and Bobirwa. Travel agents are advised to warn their clients to seek medical advice 2 weeks before travelling to malarial areas."

The Limpopo Health Department [South Africa] has also announced an increase in the number or reported malaria cases in the province, particularly around Lephalale and Thabazimbi [both in Limpopo District, South Africa].

News24 reports the Limpopo health department on [Tue 14 Mar 2017] confirmed at least 46 cases of malaria had been reported in the western Waterberg district around Lephalale and Thabazimbi. The department's spokesperson Thabiso Teffo stated no fatalities had been reported. "It is an area that does not normally have malaria mosquitoes. We also worried that 70 percent of the cases reported were people who had not travelled. It means they had contracted malaria in the area they stay." Teffo said the department started spraying insecticide and informed residents and doctors.

However it is important to note that the department says it is "not an outbreak. It's malaria season". The concern is that the cases are uncommon because it's an area where we don't expect malaria.  [Byline: Selene Brophy]
======================
[The report mentions districts in both Botswana and South Africa. The main increase in the number of cases is in the Limpopo District, South Africa. The Limpopo District is bordering Botswana explaining the alert from the Botswana health authorities. The report also mentions the recent heavy rains in the region and ProMED has recently reported increased number of cases in northern Namibia as well as 3 fatal cases of malaria in Gauteng Province, South Africa. - ProMED Mod.EP]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/169>.]
Date: Tue 9 Aug 2016, 3:06 PM (GMT +2)
Source: MmegiOnline [edited]
<http://www.mmegi.bw/index.php?aid=62146&amp;amp;dir=2016/august/09>

Botswana will continue with its ongoing measles/rubella (MR) vaccination campaign, despite reports from Namibia of deaths among some children injected with the vaccines.

Yesterday [Mon 8 Aug 2016] assistant health minister Alfred Madigele said the campaign was going well and had not resulted in any deaths or serious challenges. "The campaign is going very well. We have not registered any deaths associated directly with the vaccination and de-worming. In fact, the only challenge we encountered was a shortage of de-worming tablets at some point in some districts, but that has since been rectified," he said.

Madigele said government is happy with the number of those bringing their children forward for vaccination. "The interim reports show promising numbers. We are also happy that private schools have also been working with us in addition to public schools," he said.

The campaign, which started on 25 Jul [2016], ends on 12 Aug [2016]. The campaign is targeted at children aged between 9 months and 14 years.

Namibian newspapers last week reported that parents whose babies died after they were vaccinated have approached that country's Legal Assistance Centre for help to sue the Ministry of Health and Social Services. According to The Namibian newspaper, 21 babies countrywide have died since 2006 after receiving the vaccines, which are normally administered to children at 6 weeks and 12 weeks [This seems unlikely -- too early. Our previous posting (Measles update (35): Ireland (GY), Botswana vaccine shortage http://promedmail.org/post/20160730.4382060) said the campaign was "targeting children aged 9 months to 14 years of age". Clarification from an informed source would be welcomed. - ProMED Mod.SH]. The deaths have been termed sudden infant death syndrome. "A total of 5 of these cases recorded in July this year [2016] in Windhoek alone were caused by complications arising from the ongoing MR vaccination exercise," the paper reads.

According to the newspaper, Dr Theopolina Tueumuna, a veteran Namibian medical doctor with expertise in public health, specialising in maternal and child health, defended the campaigns, saying in Namibia's case, most children are malnourished and when they get the vaccination there is a likelihood that some might die. She compared Namibian children to those she attended to in London, whom she said were well nourished, lived in good houses, had access to supportive treatment, and plenty of nutritious food.

Madigele said in districts where there is malnutrition, parents are requested to bring the children back for check-ups so they can be helped on time if there is a problem.  [byline: Innocent Selatlhwa]
===================
[Common side effects from the MMR vaccine include low-grade fever, skin rash, itching, hives, swelling, reddening of skin, and weakness. Serious adverse events following MMR vaccination include seizures, severe headaches, double vision, vomiting, joint pain, or pain in the digestive system.

There have also been 397 deaths reported to Vaccine Adverse Events Reporting System (VAERS) in association with the MMR vaccine. However, the numbers of vaccine-related injuries and deaths reported to VAERS may not reflect the true number of serious health problems that occur develop after MMR vaccination.

Even though the National Childhood Vaccine Injury Act of 1986 legally required paediatricians and other vaccine providers to report serious health problems following vaccination to federal health agencies (VAERS), many doctors and other medical workers giving vaccines to children and adults fail to report vaccine-related health problem to VAERS. There is evidence that only between 1 and 10 per cent of serious health problems that occur after use of prescription drugs or vaccines in the United States are ever reported to federal health officials, who are responsible for regulating the safety of drugs and vaccines and issue national vaccine policy recommendations. Excerpted from <http://www.nvic.org/vaccines-and-diseases/measles/measles-vaccine-injury-death.aspx>.

It is not clear whether Nambia and Botswana have the same reporting requirement in place as the US, so the total number of deaths following vaccination may be higher. It is likely that malnutrition and consequent poor health contributed to the children's deaths following vaccination in Nambia.

See ProMED-mail: Measles update (35): Ireland (GY), Botswana vaccine shortage http://promedmail.org/post/20160730.4382060 reporting vaccine shortage in Botswana, although that is not mentioned in this current report.

A map of Botswana may be accessed at
<http://healthmap.org/promed/p/169>.

A map of Nambia may be found at
<https://www.expertafrica.com/namibia/google-map> - ProMED Mod.LK]
Date: Fri 29 Jul 2016
Source: The Voice [edited]
<http://www.thevoicebw.com/shortage-measles-vaccine-hits-moh/>

Shortage of measles vaccine hits MoH [Ministry of Health, Botswana]
-------------------------------------------------------------------
Hardly a week after the Ministry of Health (MoH) [Botswana] launched the measles/rubella (MR) campaign, shortage of the life saving vaccination has been reported in different parts of the country. In this year's campaign, the MoH introduced measles/rubella (MR) vaccine, targeting children aged 9 months to 14 years of age.

This week some members of teams that have been dispatched at various health posts across the country told of how they spent most of their time idling as they had run out of the vaccine. Some of the affected areas are said to include Tutume District Health Management Team (DHMT), Ngamiland DHMT and Boteti DHMT.

"Honestly I don't know what we are doing here because there are no vaccines. We were dispatched with full knowledge of the anticipated turn out of the children, but the medication did not tally with the numbers of the children. In some instances we are forced to give children either the injection or pills and that doesn't complete the whole vaccination process," said a team member who preferred anonymity. Measles is a highly contagious disease caused by a virus.

In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year. The disease remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine.

Approximately 114 900 people died from measles in 2014 -- mostly children under the age of 5. According to a savingram that was sent to DHMT heads in all districts from the Ministry of Health, the measles/rubella campaign is scheduled for 25 Jul to 12 Aug 2016.

The communique further indicates that after the campaign, the measles/rubella vaccine will be introduced into the routine immunisation schedule and will be administered to babies aged 9 months and 18 months. "Post measles campaign coverage survey will be conducted within 10 days following the campaign and it is planned for 22 to 26 Aug 2016," read part of the savingram.

The savingram further revealed that the Ministry of Health has successfully conducted measles follow-up campaigns every 3-4 years as per the World Health Organisation recommendation. The last measles campaign was conducted in 2013, hence the next campaign taking place in 2016. Attempts to reach Chief Public Relations Officer at the Ministry of Health, Doreen Motshegwa, were unsuccessful as she was said to be attending meetings on Wednesday [27 Jul 2016].

Key facts about measles
----------------------
Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available.

- In 2014, there were 114 900 measles deaths globally -- about 314 deaths every day or 13 deaths every hour.
- Measles vaccination resulted in a 79 percent drop in measles deaths between 2000 and 2014 worldwide.
- In 2014, about 85 percent of the world's children received 1 dose of measles vaccine by their 1st birthday through routine health services -- up from 73 percent in 2000.
- During 2000-2014, measles vaccination prevented an estimated 17.1 million deaths, making measles vaccine one of the best buys in public health. [Byline: Leonard Matota]
=======================
[Measles, mumps, and rubella are serious diseases. Before vaccines they were very common, especially among children. To prevent disease, children should get 2 doses of MMR vaccine: 1st dose at 12-15 months of age, 2nd dose at 4-6 years of age (may be given earlier, if at least 28 days after the 1st dose). A map of Botswana may be accessed at <http://healthmap.org/promed/p/169>. - ProMed Mod.LK]
Date: Wed 16 Mar 2016
Source: Outbreak News Today [edited]
<http://outbreaknewstoday.com/botswana-blood-bank-ships-syphilis-tainted-blood-units-transfused-51189/>

In a horrible mix-up in Botswana, local media reports 3 units of blood that were sent to Princess Marina Hospital in Gaborone city were positive for syphilis and later transfused to unknown/undisclosed patients.

The tainted blood was sent by The National Blood Transfusion Service (NBTS) within the past couple weeks and the error was just recognized.

Based on the report, the blood bank says they recently acquired new equipment that missed and passed the infected blood. NBTS director, Mukendi Kayembe said, acknowledging the incident, The Ministry is aware of the issue and they should be in a proper position to answer you." A spokesman for the hospital said they received no communication from the blood bank.

Transfusion-transmitted syphilis, which is caused by _Treponema pallidum_, is one of the oldest recognized infectious risks of bloodtransfusion. Routine screening of blood donors and refrigeration of donated blood before its use has made transfusion-transmitted syphilis very rare.
===================
[Syphilis can be transmitted via blood and blood products, when donors are in the primary or secondary stage of the disease as a consequence of spirochetemia during these phases of the disease (<http://www.tmreviews.com/article/S0887-7963(96)80005-8/abstract>). However, transfusion-transmitted syphilis has become very rare (<http://jid.oxfordjournals.org/content/185/4/545.long>), as a consequence of screening of donors for high-risk sexual behavior or a history of sexually transmitted diseases, serologic testing for syphilis (using non-treponemal test, such as VDRL [venereal disease research laboratory] or RPR [rapid plasma reagin], and treponemal tests), and storage of blood and blood products at refrigerator temperatures.

_Treponema pallidum_ lose viability after 5 days under refrigerated blood bank storage conditions. (We are not told in the news report above, if the contaminated blood used in Gaborone has been previously stored at refrigerator temperatures.) However, platelet concentrates are routinely stored at room temperature, and blood banks in low-income, developing countries with a limited blood supply and high demand may collect from family donors and transfuse it soon thereafter. Also serologic tests for syphilis can be negative in early syphilis; for example, nontreponemal tests take approximately 4 to 6 weeks after infection and 1 to 3 weeks after the appearance of the primary lesion to become positive. Thus, syphilis can be transmitted by blood from donors who are clinically and serologically negative. The prevalence of syphilis in a particular region can also affect the risk of transfusion-transmitted syphilis. Since many recipients of blood and blood products are receiving antibiotics coincidentally, these drugs could mask the clinical picture of transfusion-transmitted syphilis and the its diagnosis of not appreciated. Moreover, transfusion cases have no chancre, which is the diagnostic hallmark of syphilis.

Botswana, with a population of just over 2 million people, is a landlocked country located in Southern Africa (<https://en.wikipedia.org/wiki/Botswana>). It is bordered by South Africa to the south and southeast, Namibia to the west and north, and Zimbabwe to the northeast. About 70 percent of its territory is the Kalahari Desert. About 10 percent of its population lives in the capital and largest city, Gaborone. Botswana has one of the highest GDP per capita in Africa, but about a quarter of its population is estimated to be HIV-infected. - ProMED Mod.ML]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/5935>.]
Date: Thu, 30 Jul 2015 17:53:39 +0200 (METDST)

Gaborone, Botswana, July 30, 2015 (AFP) - Botswana has allocated emergency funds in response to the worst drought conditions in 30 years with agricultural land badly hit by the lack of irrigation, the government said Thursday.   A special budget of about $44 million (40 million euros) was passed by parliament on Wednesday after President Ian Khama declared a general countrywide drought, the first since 1984.  "In general it is a bad year. That is why we can not categorise the drought by each village and town like we have in the past," deputy agriculture minister Fidelis Molao told AFP.

The relief funds will be used to support livestock farmers, who have been encouraged to reduce their animal numbers due to lack of grassland.   New vehicles will also be bought to help fight bush fires, as well as more cash provided for urgent irrigation projects and extra meals for children suffering malnutrition.   A sharp decline in rainfall and a heat wave has caused a dramatic 70 percent drop in land under cultivation.

Molao said that Botswana, one of Africa's most stable countries and home to a profitable diamond mining industry, should be able to cope with the drought using its own resources.   The country last suffered drought in 2013, but the impact then was not as widespread.   Domestic food production has gone down in almost every country in the southern African region due to floods and droughts over the past growing season which ended in the first quarter of the year.   Millions of people are expected to face food shortages by year end and will require food aid in some of the worst affected countries including Malawi, Zimbabwe as well as Botswana.
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