Dar es Salaam – Soon after Tanzania confirmed its first case of Marburg Virus Disease in February 2023, outbreak control measures were rolled out rapidly, with the country drawing on outbreak readiness capacity built up and reinforced in recent months. The efforts by the national health authorities, health workers and communities helped to end the outbreak in just around three months.
A total of eight confirmed and one probable cases, and six deaths, including a health worker, were recorded during the outbreak. Improved laboratory testing, surveillance, contact tracing, supportive clinical care and heightened community participation in the response all proved critical.
While the outbreak has been declared over, the country continues to focus on disease surveillance to respond promptly to any potential flare-ups. With support from World Health Organization (WHO) and partners, the government is also providing comprehensive medical and psychosocial support to the three Marburg survivors.
In March 2023, during one of his routine daily rounds, he attended to a patient who presented with high fever, severe headache and malaise. After an examination, Dr Ndulu referred the man to the Kagera Regional Referral Hospital, but he died on the way.
When one of the man’s contacts was tested, it was determined that he had likely contracted Marburg.
Three days after their encounter, the 36-year-old doctor was himself fighting Marburg infection and on life support with multiple organ failure.
“This was a difficult case to treat. I have never experienced this before. Because this was an infectious disease, we couldn’t use the normal laboratory procedures,” says Dr Said Omary Kanenda, a renal health specialist who treated Dr Ndulu.
“Dr Ndulu experienced a range of different health issues, from anaemia to kidney and renal failure. Thanks to the additional specialist equipment donated by the Ministry of Health, we were able to manage the case successfully.”
The Ministry of Health provided a dialysis machine to the health centre where Dr Ndulu was cared for, proving crucial for his recovery. Hospitals that were used as isolation and treatment centres during the outbreak were decontaminated so that routine health services can resume.
His recovery was met with jubilation in his community. “My family and community members viewed my illness as a spiritual battle between good and evil,” he says. “As a doctor and a survivor, I keep correcting and educating them, so we are all safe and protected.”
The father of one is grateful for the care he received that ensured his recovery. “I could see how the health workers worked relentlessly to save me. To say I am thankful is not enough,” he says.
“Indeed, Marburg is over, but we are not completely out of the woods, as it left some impacts that we are managing currently,” says Dr Issessanda Kaniki, Kagera’s Regional Medical Officer. “Thanks to the support of WHO, we are providing psychosocial and mental health support for the survivors and their families in order to ensure complete recovery.”
“Moving forward, building a health system and community that is more resilient against outbreaks is critical,” says Dr William Mwengee, WHO’s surveillance officer and field coordinator for the Marburg response in Tanzania. “It is a goal we all must strive to achieve, considering the increasing threats posed by emerging and re-emerging diseases. This will require sustained investment in health systems for health security.”
“During my treatment, I suffered from high blood pressure, so the specialist visits my home every morning and evening to take my temperature and other vitals,” says Dr Ndulu. “Thankfully, I never experienced any stigma. The specialist has been so helpful in educating my community members. Truly, this has been a good recovery path for me.”
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