International Centre for Communicable Diseases
Surveillance & control,
Research Training Introduction

Pemba island with the other island Unguja is part of Zanzibar, laying
few degrees south of the Equator 50 km off the coast of mainland
Tanzania. The spice island - with cloves as its main crop- has a
population of 350,000 on a surface of 1,000 km2.

Communicable endemic diseases such as malaria, AIDS, Tuberculosis,
Acute Respiratory Infections, diarrhoea, intestinal helminthiasis,
schistosomiasis, filariasis, leprosy are by far the main public
health problems and are responsible for the high morbidity and mor-
tality especially in women and children.

Zanzibar and Pemba islands are well known by tropical diseases re-
searchers and public health specialists for the pioneering work that
has been carried out in schistosomiasis, malaria and soil-
transmitted nematodes. In the late 70s and early 80s, collaboration
between the Ministry of Health of Zanzibar, Italy and the World
Health Organization was undertaken with major initiatives in the con-
trol of schistosomiasis and the implementation of the Expanded Pro-
gramme of Immunisation.

In the early 1980s Zanzibar collaborated with WHO in a series of
schistosomiasis field trials. This collaboration culminated, in 1986,
with the implementation of the Pemba Schistosomiasis Control Pro-
gramme. This initiative was funded directly by the Director-General
of WHO and the Direzione Generale per la Cooperazione of the Italian
Ministry of Foreign Affairs. The programme aimed at assessing the im-
pact of large-scale regular chemotherapy on morbidity due to schisto-
somiasis. In the early 90s this control initiative was progressively
integrated with other major disease control strategies as soil-
transmitted helminths and filariasis.

The great strength of the Zanzibar experience has always been its
continuous link between control and operational research. This has
culminated in a series of major studies undertaken in collaboration
with the Department of International Health of Johns Hopkins Univer-
sity, to assess the nutritional impact of regular anthelminthic che-
motherapy in children and women. This activity has generated a con-
siderable amount of information on communicable diseases control that
ranges from the impact of deworming on growth and iron status of
schoolchildren in Zanzibar to the assessment of new tools to detect
anaemia at the Primary Health Care level.

In 1988, the late Professor Ivo de Carneri, on an official mission
for the Ministry of Foreign Affairs of Italy, visited Zanzibar, to
assess the progress of the schistosomiasis control programme. In his
mission report Prof. de Carneri stressed "the need of a Public Health
Laboratory as a centre for quality control of the peripheral labora-
tories and to promote training and applied research to develop effec-
tive control strategies". In 1994, the Ivo de Carneri Foundation was
created in his memory.

The PHL-IdC is a semi-autonomous non-profit institute dedicated to
the people of Zanzibar. The mission of the Public Health Laboratory
Ivo de Carneri (PHL-IdC) is to improve the health status and knowl-
edge of the people of Zanzibar in accordance with their culture and
traditions, through the development, assessment and implementation of
strategies for the prevention, control, surveillance, research and
training of endemic diseases. The PHL-IDC will collaborate with na-
tional and international scientific institutions and organizations to
assess and evaluate global strategies for disease surveillance and
control.

The PHL-IdC is operative since 12 June 2000.

Scientific collaboration are in progress with several international
institutions including Johns Hopkins School of Public Health, London
School of Hygiene and Tropical Medicine, University of Kwa Zulu Na-
tal, London Natural History Museum, World Health Organization and
other Italian Institutions (Institute of Infection diseases Milan-
Sacco Hospital) and University of Siena.

Organization and management

The governing body of the institute is the Scientific Commission
whose members are representatives from the Ministry of Health of Zan-
zibar from the Ivo de Carneri Foundation of Italy and from the World
Health Organization Geneva Scientific Secretary of the Commission is
also appointed. The head of PHL IdC is the Director, who is appointed
by the Scientific Commission. The Director is assisted by a Deputy
Director. Other senior officers are the Heads of Departments of Ad-
ministration, budget and finance, Parasitology and Entomology, Bacte-
riology, and Virology and Immunology. A management committee of in-
ternal PHL-IdC staff is established to fulfil the need and evaluate
the ongoing activities. The management committee is composed by the
Core staff of the PHL-IdC, by the Representative of the IdC, and by
the Coordinator of the MoH in Pemba. Invited members are project man-
agers and principal investigators of ongoing research studies. The
Scientific Secretary of the Commission provide technical advise to
the management committee.

Service and Technical co-operation

One of the first priorities of the PHL-IdC is the collaboration with
the local MoH to assure its technical support for the monitoring and
evaluation of control activities for endemic diseases. This is car-
ried out in close collaboration with the Director of Preventive Ser-
vices and with the Managers of Control Programmes.

Another important role of the PHL-IdC is to provide technical advice
and support in the surveillance, early detection and control of
epidemics, with particular reference to bacterial (diarrhoea) and
viral outbreaks.

Technical support and co-ordination is envisaged for the laboratories
of the Hospitals and of the Health Centres. In addition, the PHL-IdC
facilitates support and training activities for the health staff in
curative as well as in preventive services and for the data collec-
tion and analysis from the hospitals and the peripheral health ser-
vices.

Research activities

PHL-IdC research is oriented according to priorities area of the Min-
istry of Health of Zanzibar. In brief, priorities areas for research
are: malaria, schistosomiasis, intestinal parasitic infections, fi-
lariasis, tuberculosis, leprosy, diarrhoeal diseases, surveillance of
endemic and epidemic diseases, AIDS and sexually-transmitted dis-
eases, hepatitis, malnutrition and related diseases. Research propos-
als are reviewed the Management Committee and approved by the Scien-
tific Commission of the PHL IdC. Ethical clearance is sought from the
Zanzibar Health Research Council. Application forms are available on
the Ivo de Carneri Foundation web site:
www.fondazionedecarneri.it

Dr Mahdi Ramsan MD, PhD ,
Mr Hamad Juma Haji MSc, MPH and
Dr Marco Albonico MD, Mmed, DTM&H
Pemba Public Health Laboratory- Ivo de Carneri
P.O. Box 122 Chake-Chake -
Pemba Island
Zanzibar
mailto:[email protected]
Tel/Fax:?24-2452-003
website: www.fondazionedecarneri.it
mailto:[email protected]