Read below for travel health advice on Tanzania from the MDtravelhealth channel on Red Planet Travel.
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Summary of recommendations
Most travelers to Tanzania will need vaccinations for hepatitis A, typhoid fever, yellow fever, and polio, as well as medications for malaria prophylaxis and travelers' diarrhea. Meningococcal vaccine is recommended for those visiting refugee camps. Additional immunizations may be necessary depending upon the circumstances of the trip and the medical history of the traveler, as discussed below. Insect repellents are recommended, in conjunction with other measures to prevent mosquito bites. Because several cases of African trypanosomiasis (sleeping sickness) have recently been reported among visitors to game parks, measures to prevent bites from tsetse flies are recommended as well (see below). All travelers should visit either a travel health clinic or their personal physician 4-8 weeks before departure.
Malaria:Prophylaxis with Lariam (mefloquine), Malarone (atovaquone/proguanil), or doxycycline is recommended for all areas at altitudes less than 1800 m.
|Polio||One-time booster recommended for any adult traveler who completed the childhood series but never had polio vaccine as an adult|
|Yellow fever||Recommended only for those at risk for a large number of mosquito bites. Required for travelers arriving from a yellow-fever-infected country in Africa or the Americas|
|Hepatitis A||Recommended for all travelers|
|Typhoid||Recommended for all travelers|
|Hepatitis B||Recommended for all travelers|
|Rabies||For travelers spending a lot of time outdoors, or at high risk for animal bites, or involved in any activities that might bring them into direct contact with bats|
|Measles, mumps, rubella (MMR)||Two doses recommended for all travelers born after 1956, if not previously given|
|Tetanus-diphtheria||Revaccination recommended every 10 years|
Travelers' diarrhea is the most common travel-related ailment. The cornerstone of prevention is food and water precautions, as outlined below. All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if associated with nausea, vomiting, cramps, fever or blood in the stool. A quinolone antibiotic is usually prescribed: either ciprofloxacin (Cipro)(PDF) 500 mg twice daily or levofloxacin (Levaquin) 500 mg once daily for a total of three days. Quinolones are generally well-tolerated, but occasionally cause sun sensitivity and should not be given to children, pregnant women, or anyone with a history of quinolone allergy. Alternative regimens include a three day course of rifaximin (Xifaxan) 200 mg three times daily or azithromycin (Zithromax) 500 mg once daily. Rifaximin should not be used by those with fever or bloody stools and is not approved for pregnant women or those under age 12. Azithromycin should be avoided in those allergic to erythromycin or related antibiotics. An antidiarrheal drug such as loperamide (Imodium) or diphenoxylate (Lomotil) should be taken as needed to slow the frequency of stools, but not enough to stop the bowel movements completely. Diphenoxylate (Lomotil) and loperamide (Imodium) should not be given to children under age two.
Most cases of travelers' diarrhea are mild and do not require either antibiotics or antidiarrheal drugs. Adequate fluid intake is essential.
If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.
Though effective, antibiotics are not recommended prophylactically (i.e. to prevent diarrhea before it occurs) because of the risk of adverse effects, though this approach may be warranted in special situations, such as immunocompromised travelers.
Malaria in Tanzania: prophylaxis is recommended for all areas, except for altitudes over 1800 m (5906 ft). The risk is lower in Dar es Salaam than in rural areas. Either mefloquine (Lariam), atovaquone/proguanil (Malarone)(PDF), or doxycycline may be given. Mefloquine is taken once weekly in a dosage of 250 mg, starting one-to-two weeks before arrival and continuing through the trip and for four weeks after departure. Mefloquine may cause mild neuropsychiatric symptoms, including nausea, vomiting, dizziness, insomnia, and nightmares. Rarely, severe reactions occur, including depression, anxiety, psychosis, hallucinations, and seizures. Mefloquine should not be given to anyone with a history of seizures, psychiatric illness, cardiac conduction disorders, or allergy to quinine or quinidine. Those taking mefloquine (Lariam) should read the Lariam Medication Guide (PDF). Atovaquone/proguanil (Malarone) is a combination pill taken once daily with food starting two days before arrival and continuing through the trip and for seven days after departure. Side-effects, which are typically mild, may include abdominal pain, nausea, vomiting, headache, diarrhea, or dizziness. Serious adverse reactions are rare. Doxycycline is effective, but may cause an exaggerated sunburn reaction, which limits its usefulness in the tropics.
Long-term travelers who may not have access to medical care should bring along medications for emergency self-treatment should they develop symptoms suggestive of malaria, such as fever, chills, headaches, and muscle aches, and cannot obtain medical care within 24 hours. See malaria for details. Symptoms of malaria sometimes do not occur for months or even years after exposure.
Insect protection measures are essential.
For further information on malaria in Tanzania, including a map showing the risk of malaria in different parts of the country, go to the World Health Organization, Roll Back Malaria, and Southern Africa Malaria Control.
Altitude sickness may occur in those climbing Mt. Kilimanjaro, the highest peak on the African continent, or in any other travelers ascending rapidly to altitudes greater than 2500 meters. Acetazolamide is the drug of choice to prevent altitude sickness. The usual dosage is 125 or 250 mg twice daily starting 24 hours before ascent and continuing for 48 hours after arrival at altitude. Possible side-effects include increased urinary volume, numbness, tingling, nausea, drowsiness, myopia and temporary impotence. Acetazolamide should not be given to pregnant women or those with a history of sulfa allergy. For those who cannot tolerate acetazolamide, the preferred alternative is dexamethasone 4 mg taken four times daily. Unlike acetazolamide, dexamethasone must be tapered gradually upon arrival at altitude, since there is a risk that altitude sickness will occur as the dosage is reduced.
Travel to high altitudes is not generally recommended for those with a history of heart disease, lung disease, or sickle cell disease.
The following are the recommended vaccinations for Tanzania:
Hepatitis A vaccine is recommended for all travelers over one year of age. It should be given at least two weeks (preferably four weeks or more) before departure. A booster should be given 6-12 months later to confer long-term immunity. Two vaccines are currently available in the United States: VAQTA (Merck and Co., Inc.) (PDF) and Havrix (GlaxoSmithKline) (PDF). Both are well-tolerated. Side-effects, which are generally mild, may include soreness at the injection site, headache, and malaise.
Older adults, immunocompromised persons, and those with chronic liver disease or other chronic medical conditions who have less than two weeks before departure should receive a single intramuscular dose of immune globulin (0.02 mL/kg) at a separate anatomic injection site in addition to the initial dose of vaccine. Travelers who are less than one year of age or allergic to a vaccine component should receive a single intramuscular dose of immune globulin (see hepatitis A for dosage) in the place of vaccine.
Typhoid vaccine is recommended for all travelers. It is generally given in an oral form (Vivotif Berna) consisting of four capsules taken on alternate days until completed. The capsules should be kept refrigerated and taken with cool liquid. Side-effects are uncommon and may include abdominal discomfort, nausea, rash or hives. The alternative is an injectable polysaccharide vaccine (Typhim Vi; Aventis Pasteur Inc.) (PDF), given as a single dose. Adverse reactions, which are uncommon, may include discomfort at the injection site, fever and headache. The oral vaccine is approved for travelers at least six years old, whereas the injectable vaccine is approved for those over age two. There are no data concerning the safety of typhoid vaccine during pregnancy. The injectable vaccine (Typhim Vi) is probably preferable to the oral vaccine in pregnant and immunocompromised travelers.
Yellow fever vaccine should be considered only for those at increased risk due to prolonged travel, heavy exposure to mosquitoes, or inability to avoid mosquito bites. The vaccine is generally not recommended for most travelers. Yellow fever vaccine is required for all travelers greater than one year of age arriving from a yellow-fever-infected country in Africa or the Americas. In Tanzania, risk occurs chiefly in the northwestern forest areas. The city of Dar es Salaam has a lower risk of transmission than rural areas. Yellow fever vaccine (YF-VAX; Aventis Pasteur Inc.) (PDF) must be administered at an approved yellow fever vaccination center, which will give each vaccinee a fully validated International Certificate of Vaccination. The vaccine should not in general be given to those who are younger than six months of age, immunocompromised, or allergic to eggs (since the vaccine is produced in chick embryos). It should also not be given to those with a malignant neoplasm and those with a history of thymus disease or thymectomy. Caution should be exercised before giving the vaccine to those who are between the ages of 6 and 8 months, age 60 years or older, pregnant, or breastfeeding. Reactions to the vaccine, which are generally mild, include headaches, muscle aches, and low-grade fevers. Serious allergic reactions, such as hives or asthma, are rare and generally occur in those with a history of egg allergy.
Polio immunization is recommended, due to the persistence of polio in sub-Saharan Africa. Any adult who received the recommended childhood immunizations but never had a booster as an adult should be given a single dose of inactivated polio vaccine. All children should be up-to-date in their polio immunizations and any adult who never completed the initial series of immunizations should do so before departure. Side-effects are uncommon and may include pain at the injection site. Since inactivated polio vaccine includes trace amounts of streptomycin, neomycin and polymyxin B, individuals allergic to these antibiotics should not receive the vaccine.
Meningococcal vaccine is recommended for all those visiting refugee camps (see below). Meningococcal vaccine has few side-effects. Mild redness at the injection site may occur. Young children may develop transient fever.
Hepatitis B vaccine is recommended for all travelers if not previously vaccinated. Two vaccines are currently licensed in the United States: Recombivax HB (Merck and Co., Inc.) (PDF) and Engerix-B (GlaxoSmithKline) (PDF). A full series consists of three intramuscular doses given at 0, 1 and 6 months. Engerix-B is also approved for administration at 0, 1, 2, and 12 months, which may be appropriate for travelers departing in less than 6 months. Side-effects are generally mild and may include discomfort at the injection site and low-grade fever. Severe allergic reactions (anaphylaxis) occur rarely.
Rabies vaccine is recommended for travelers spending a lot of time outdoors, for travelers at high risk for animal bites, such as veterinarians and animal handlers, for long-term travelers and expatriates, and for travelers involved in any activities that might bring them into direct contact with bats. Children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites. A complete preexposure series consists of three doses of vaccine injected into the deltoid muscle on days 0, 7, and 21 or 28. Side-effects may include pain at the injection site, headache, nausea, abdominal pain, muscle aches, dizziness, or allergic reactions.
Any animal bite or scratch should be thoroughly cleaned with large amounts of soap and water and local health authorities should be contacted immediately for possible post-exposure treatment, whether or not the person has been immunized against rabies.
Measles-mumps-rubella vaccine: two doses are recommended (if not previously given) for all travelers born after 1956, unless blood tests show immunity. Many adults born after 1956 and before 1970 received only one vaccination against measles, mumps, and rubella as children and should be given a second dose before travel. MMR vaccine should not be given to pregnant or severely immunocompromised individuals.
Cholera vaccine is not generally recommended, even though cholera outbreaks are reported, because most travelers are at low risk for infection. Two oral vaccines have recently been developed: Orochol (Mutacol), licensed in Canada and Australia, and Dukoral, licensed in Canada, Australia, and the European Union. These vaccines, where available, are recommended only for high-risk individuals, such as relief workers, health professionals, and those traveling to remote areas where cholera epidemics are occurring and there is limited access to medical care. The only cholera vaccine approved for use in the United States is no longer manufactured or sold, due to low efficacy and frequent side-effects.
A measles outbreak was reported from Zanzibar in August 2011, causing 262 cases, and from Ngorongoro district in mainland Tanzania in June 2011, causing more than 1500 cases and 20 deaths by July. In December 2006, a measles outbreak occurred in Zanzibar, chiefly the the Micheweni District on the island of Pemba, resulting in 184 cases by January 2007 (see ReliefWeb). A measles outbreak was reported from mainland Tanzania earlier in 2006. All travelers born after 1956 should make sure they have had either two documented measles immunizations or a blood test showing measles immunity. This does not apply to people born before 1957, who are presumed to be immune to measles. Although measles immunization is usually begun at age 12 months, consider giving an initial dose of measles vaccine to children between the ages of 6 and 11 months who will be traveling to Kenya. Measles vaccine should not be given to pregnant or severely immunocompromised individuals.
Outbreaks of human plague have been reported almost continuously since 1983, chiefly from the Tanga region (Lushoto district). The most recent outbreak was reported in December 2010 from an area bordering the government forest reserve at the edge of the Rift Valley in Mbulu District, Manyara Region. In March 2007, an outbreak was reported from Endoji Village, also in Mbulu District (see ProMED-mail, March 28, 2007, and December 23, 2010). The plague is usually transmitted by the bite of rodent fleas. Less commonly, the disease is acquired by inhalation of infected droplets, which may be coughed into the air by a person with plague pneumonia, or by direct exposure to infected blood or tissues. Most travelers are at low risk for the plague. Those who may have contact with rodents or their fleas should bring along a bottle of doxycycline, to be taken prophylactically if exposure occurs. Those less than eight years of age or allergic to doxycycline may take trimethoprim-sulfamethoxazole instead. To minimize risk, travelers should avoid areas containing rodent burrows or nests, never handle sick or dead animals, and follow insect protection measures, as described below.
Over the last few years, several cases of African trypanosomiasis (sleeping sickness) have been reported among visitors to Tanzanian game parks, especially Serengeti National Park and Tarangire National Park (southeast of Serengeti). For details, see the reports by T Jelinek et al and DAJ Moore et al in Emerging Infectious Diseases and the summary by TropNetEurop (PDF). The most recent cases occurred in an American hunter who had traveled to northern Tanzania in October 2008, a Dutch woman who had been visiting Serengeti Park in July 2009, and a Swedish woman who had visited north western Tanzania in November 2012 (see TropNetEurop and ProMED-mail). African trypanosomiasis is a potentially fatal parasitic infection transmitted by the bite of the tsetse fly. The disease is prevalent in rural areas in Tanzania. The best means of prevention is to avoid areas infested with tsetse flies, which are usually known to local inhabitants. Travelers at risk should wear long sleeves and long pants of medium weight fabric in neutral colors that blend with the environment. Also, travelers should avoid riding in the back of open vehicles, since dust may attract tsetse flies, and should take care not to disturb bushes (where tsetse flies rest) during the warmer parts of the day. Insect repellents are ineffective. For further information on personal protection measures, go to Health Canada.
An outbreak of schistosomiasis was reported in September 2007 among Israeli and German travelers who had been swimming in a small, man-made pond at the Kisima Ngeda tented lodge near Lake Eyasi in Ngorongoro district, Arusha Region, Tanzania (see ProMED-mail and ProMED-mail, September 4, 2007). Travelers to Tanzania should avoid swimming, wading, rafting, or bathing in bodies of fresh water (see below). Chlorinated swimming pools are considered safe.
An outbreak of Rift Valley fever was reported in February 2007, resulting in 264 suspected cases and 109 deaths as of May 3. The largest number of cases was reported from the Dodoma region in the central part of Tanzania, followed by the Morogoro, Singida, and Arusha regions. A small number of cases was also reported from the Dar es Salaam, Iringa, Manyara, Mwanza, Pwani, and Tanga regions. The human cases occurred at the same time that outbreaks were occurring among sheep, cattle, and goats in the affected areas. As of early June, the outbreak appeared to have come under control. See the International Federation of Red Cross and Red Crescent Societies, World Health Organization and ProMED-mail, Feb. 6 and 12, March 15, 21, and 24; April 14 and 22; and May 2, 2007) for further information.
Rift Valley fever is a viral infection that primarily affects domesticated animals. The disease is usually transmitted by mosquitoes, but may also be acquired by direct exposure to infected animals or their tissues or by consumption of raw milk. Aerosol transmission has been documented. Most cases occur in those who work with livestock. The incubation period ranges from two to six days. Initial symptoms may include fever, chills, muscle aches, backache, headache, nausea, vomiting, and light sensitivity. Most people recover uneventfully in four to seven days, but the course may be complicated by loss of vision (retinitis), liver inflammation (hepatitis), kidney failure, excessive bleeding (hemorrhage), inflammation of the brain (encephalitis), or death. Travelers to affected areas should follow insect protection measures, as below, and avoid direct contact with livestock. A major epidemic of Rift Valley fever occurred in northern Tanzania after torrential rains and severe flooding in late 1997 and early 1998. The outbreak also involved livestock, including sheep, goats, camels and cattle.
Recurring outbreaks of cholera and other diarrheal diseases have been reported almost continuously since March 2006, involving mainland Tanzania as well as the Zanzibar archipelago. More than 11,000 cases of cholera, including 117 deaths, were reported from Dar es Salaam between November 20 and December 12, 2006. The outbreaks appeared to be related to heavy rains, which swept waste material into the water supplies. Outbreaks were reported from Kilimanjaro Province in April 2008, from the northern Tanzanian region of Mara in September 2008 and again in January 2009, from the southwestern Rukwa region in October 2008, from Dar es Salaam in November 2009, from the Mwanza Region in January 2010, and from Dar es Salaam, Tanga and Shinyanga in December 2010. See ProMED-mail (April 21, May 21, August 11, September 23, October 20, November 17, and December 8, 2006; April 18 and September 15, 2008; December 31, 2010) and AlertNet for further information. In May 2001, a cholera outbreak was reported from the Temeke and Ilala districts of Dar es Salaam, resulting in 109 cases and 3 deaths by late July. See the World Health Organization for details. The largest outbreak in recent years began in January 1997, resulting in more than 50,000 cases and more than 2500 deaths by the middle of 1998.
The main symptoms of cholera are profuse watery diarrhea and vomiting, which in severe cases may lead to dehydration and death. Most outbreaks are related to contaminated drinking water, typically in situations of poverty, overcrowding, and poor sanitation. Most travelers are at extremely low risk for infection. Cholera vaccine, where available, is recommended only for certain high-risk individuals, such as relief workers, health professionals, and those traveling to remote areas where cholera epidemics are occurring and there is limited access to medical care. All travelers should carefully observe food and water precautions, as below.
An outbreak of meningococcal infections was reported from refugee camps in Kibondo district, western Tanzania, in July 2002. As of August 29, a total of 149 suspected cases and 9 deaths had been reported from four camps: Nduta, Karago, Mtendeli, and Mkugwa. The outbreak appeared to be related to an unusually heavy rainy season. As of early October, the overall number of cases in the camps had fallen to an average of twenty per week. For further information, go to the World Health Organization. A previous outbreak of meningococcal disease was reported from refugee camps in November 2001. Meningococcal vaccine is advised for those visiting refugee camps, but is not recommended for most other travelers.
An outbreak of O'nyong-nyong fever was reported from Bukoba district in northern Tanzania in late 1996.
HIV (human immunodeficiency virus) infection is reported, but travelers are not at risk unless they have unprotected sexual contacts or receive injections or blood transfusions.
Food and water precautions
Do not drink tap water unless it has been boiled, filtered, or chemically disinfected. Do not drink unbottled beverages or drinks with ice. Do not eat fruits or vegetables unless they have been peeled or cooked. Avoid cooked foods that are no longer piping hot. Cooked foods that have been left at room temperature are particularly hazardous. Avoid unpasteurized milk and any products that might have been made from unpasteurized milk, such as ice cream. Avoid food and beverages obtained from street vendors. Do not eat raw or undercooked meat or fish. Some types of fish may contain poisonous biotoxins even when cooked. Barracuda in particular should never be eaten. Other fish that may contain toxins include red snapper, grouper, amberjack, and sea bass.
All travelers should bring along an antibiotic and an antidiarrheal drug to be started promptly if significant diarrhea occurs, defined as three or more loose stools in an 8-hour period or five or more loose stools in a 24-hour period, especially if accompanied by nausea, vomiting, cramps, fever or blood in the stool. Antibiotics which have been shown to be effective include ciprofloxacin (Cipro), levofloxacin (Levaquin), rifaximin (Xifaxan), or azithromycin (Zithromax). Either loperamide (Imodium) or diphenoxylate (Lomotil) should be taken in addition to the antibiotic to reduce diarrhea and prevent dehydration.
If diarrhea is severe or bloody, or if fever occurs with shaking chills, or if abdominal pain becomes marked, or if diarrhea persists for more than 72 hours, medical attention should be sought.
Insect and Tick Protection
Wear long sleeves, long pants, hats and shoes (rather than sandals). For rural and forested areas, boots are preferable, with pants tucked in, to prevent tick bites. Apply insect repellents containing 25-50% DEET (N,N-diethyl-3-methylbenzamide) or 20% picaridin (Bayrepel) to exposed skin (but not to the eyes, mouth, or open wounds). DEET may also be applied to clothing. Products with a lower concentration of either repellent need to be repplied more frequently. Products with a higher concentration of DEET carry an increased risk of neurologic toxicity, especially in children, without any additional benefit. Do not use either DEET or picaridin on children less than two years of age. For additional protection, apply permethrin-containing compounds to clothing, shoes, and bed nets. Permethrin-treated clothing appears to have little toxicity. Don't sleep with the window open unless there is a screen. If sleeping outdoors or in an accommodation that allows entry of mosquitoes, use a bed net, preferably impregnated with insect repellent, with edges tucked in under the mattress. The mesh size should be less than 1.5 mm. If the sleeping area is not otherwise protected, use a mosquito coil, which fills the room with insecticide through the night. In rural or forested areas, perform a thorough tick check at the end of each day with the assistance of a friend or a full-length mirror. Ticks should be removed with tweezers, grasping the tick by the head. Many tick-borne illnesses can be prevented by prompt tick removal.
Swimming and bathing precautions
Avoid swimming, wading, or rafting in bodies of fresh water, such as lakes, ponds, streams, or rivers. Do not use fresh water for bathing or showering unless it has been heated to 150 degrees F for at least five minutes or held in a storage tank for at least three days. Toweling oneself dry after unavoidable or accidental exposure to contaminated water may reduce the likelihood of schistosomiasis, but does not reliably prevent the disease and is no substitute for the precautions above. Chlorinated swimming pools are considered safe.
Bring adequate supplies of all medications in their original containers, clearly labeled. Carry a signed, dated letter from the primary physician describing all medical conditions and listing all medications, including generic names. If carrying syringes or needles, be sure to carry a physician's letter documenting their medical necessity.Pack all medications in hand luggage. Carry a duplicate supply in the checked luggage. If you wear glasses or contacts, bring an extra pair. If you have significant allergies or chronic medical problems, wear a medical alert bracelet.
Make sure your health insurance covers you for medical expenses abroad. If not, supplemental insurance for overseas coverage, including possible evacuation, should be seriously considered. If illness occurs while abroad, medical expenses including evacuation may run to tens of thousands of dollars. For a list of travel insurance and air ambulance companies, go to Medical Information for Americans Traveling Abroad on the U.S. State Department website. Bring your insurance card, claim forms, and any other relevant insurance documents. Before departure, determine whether your insurance plan will make payments directly to providers or reimburse you later for overseas health expenditures. The Medicare and Medicaid programs do not pay for medical services outside the United States.
Pack a personal medical kit, customized for your trip (see description). Take appropriate measures to prevent motion sickness and jet lag, discussed elsewhere. On long flights, be sure to walk around the cabin, contract your leg muscles periodically, and drink plenty of fluids to prevent blood clots in the legs. For those at high risk for blood clots, consider wearing compression stockings.
Avoid contact with stray dogs and other animals. If an animal bites or scratches you, clean the wound with large amounts of soap and water and contact local health authorities immediately. Wear sun block regularly when needed. Use condoms for all sexual encounters. Ride only in motor vehicles with seat belts. Do not ride on motorcycles.
Ambulance and Emergency Services
For an ambulance in Tanzania, call Knight Support Emergency Services at 255 22 276 0087 - 9 or (mobile) 255 (0)744 777 100.
Medical care in Tanzania is limited. Essential medications and supplies are sometimes unavailable. For medical emergencies, most expatriates go to the Aga Khan Hospital (Ocean Road, Dar es Salaam; tel. 255 22 211 5151/53; website http://www.agakhanhospitals.org/dar/index.asp), the Regency Medical Centre (Alykhan Road, Dar es Salaam, tel. 255 22 215 0500), or the TMJ Hospital (Old Bagamoyo Road, Mikocheni, Dar es Salaam; tel. 255 22 2775517 / 2771564, emergency tel. 255 754 370559; includes ICU, CT Scan, dialysis, and 24-hour pharmacy). Other facilities that provide medical care to travelers include the following:
Dar es Salaam
For a guide to other physicians and dentists in Tanzania, go to the U.S. Embassy website. Most doctors and hospitals will expect payment in cash, regardless of whether you have travel health insurance. Serious medical problems will require air evacuation to a country with state-of-the-art medical facilities.
Traveling with children
Before you leave, make sure you have the names and contact information for physicians, clinics, and hospitals where you can obtain emergency medical care if needed.
All children should be up-to-date on routine childhood immunizations, as recommended by the American Academy of Pediatrics. Children who are 12 months or older should receive a total of 2 doses of MMR (measles-mumps-rubella) vaccine, separated by at least 28 days, before international travel. Children between the ages of 6 and 11 months should be given a single dose of measles vaccine. MMR vaccine may be given if measles vaccine is not available, though immunization against mumps and rubella is not necessary before age one unless visiting a country where an outbreak is in progress. Children less than one year of age may also need to receive other immunizations ahead of schedule (see the accelerated immunization schedule).
Because yellow fever vaccine is not approved for use in children less than nine months of age, children in this age group should not in general be brought to Tanzania.
The recommendations for malaria prophylaxis are the same for young children as for adults, except that (1) dosages are lower; and (2) doxycycline should be avoided. DEET-containing insect repellents are not advised for children under age two, so it's especially important to keep children in this age group well-covered to protect them from mosquito bites.
When traveling with young children, be particularly careful about what you allow them to eat and drink (see food and water precautions), because diarrhea can be especially dangerous in this age group and because the vaccines for hepatitis A and typhoid fever, which are transmitted by contaminated food and water, are not approved for children under age two. Baby foods and cows' milk may not be available in developing nations. Only commercially bottled milk with a printed expiration date should be used. Young children should be kept well-hydrated and protected from the sun at all times.
Be sure to pack a medical kit when traveling with children. In addition to the items listed for adults, bring along plenty of disposable diapers, cream for diaper rash, oral replacement salts, and appropriate antibiotics for common childhood infections, such as middle ear infections.
Travel and pregnancy
Because of the risk of malaria and yellow fever, pregnant women should not in general travel to Tanzania. Yellow fever vaccine is not approved for use during pregnancy, because it contains live virus. Malaria may cause life-threatening illness in both the mother and the unborn child. None of the currently available prophylactic medications is 100% effective. Mefloquine (Lariam) is the drug of choice for malaria prophylaxis during pregnancy, but should not be given if possible in the first trimester. If travel to areas with malaria and yellow fever is unavoidable, insect protection measures must be strictly followed at all times. The recommendations for DEET-containing insect repellents are the same for pregnant women as for other adults.
Helpful maps are available in the University of Texas Perry-Castaneda Map Collection and the United Nations map library. If you have the name of the town or city you'll be visiting and need to know which state or province it's in, you might find your answer in the Getty Thesaurus of Geographic Names.
(reproduced from the U.S. State Dept. Consular Information Sheet)
Americans living or traveling in Tanzania are encouraged to register with the nearest U.S. Embassy or Consulate through the State Department's travel registration website, https://travelregistration.state.gov, and to obtain updated information on travel and security within Tanzania. Americans without Internet access may register directly with the nearest U.S. Embassy or Consulate. By registering, American citizens make it easier for the Embassy or Consulate to contact them in case of emergency. The U.S. Embassy is located at 686 Old Bagamoyo Road, Kinondoni District, Dar es Salaam, Tanzania. The international mailing address is Post Office Box 9123, Dar es Salaam, Tanzania; telephone (22) 266-8001 and fax (22) 266-8238. Office hours are 7:30 a.m. to 5:00 p.m. Monday through Thursday, and 7:30 a.m. to 11:30 a.m. on Friday. Travelers may also contact the U.S. Embassy in Tanzania via email at firstname.lastname@example.org. Additional information may be found at the Embassy's website at http://tanzania.usembassy.gov/.
For information on safety and security, go to the U.S. Department of State, United Kingdom Foreign and Commonwealth Office, Foreign Affairs Canada, and the Australian Department of Foreign Affairs and Trade.
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