Understanding and improving malaria diagnosis in health facilities in Dar es Salaam, Tanzania INAUGURALDISSERTATION zur Erlangung der Würde eines Doktors der Philosophie vorgelegt der Philosophisch-Naturwissenschaftlichen Fakultät der Universität Basel

Von Valérie D'acremont
Acknowledgments I am greatly indebted to a number of people I met in Tanzania and in Switzerland in the frame of this extraordinary experience of working in Africa. It was a dream since I was a child to discover distant lands and different people, in particular from this attractive continent full of colours, music and dances. This project turned out to be one of the most fulfilling experiences in my life thanks to all the people I would like to acknowledge here. First I would like to mention
more » ... like to mention Christian Lengeler, who was the supervisor of this thesis and whose name opened me so many doors in Tanzania , country where he had worked for many years. He introduced me to the city of Dar es Salaam and to the key people for this project, in particular Deo Mtasiwa at the City council. I got immediately impressed by the accuracy and the avant-gardism of Dr. Mtasiwa whom I thank sincerely for always supporting our work in the background. He presented us Judith Kahama-Maro who became my counterpart in IMALDIA. My gratitude goes to Judy without whom nothing would have been possible in this big city she knows by heart. With her all the doors of the health facilities were suddenly widely open, thanks to her attention and kindness. I like so much the way she was greeting personally each staff member, from the person in charge to the cleaner. Thanks to Dr. Kahama we got the chance to find Ndeniria Swai who assisted us in the project with all her heart and dedication. I am so grateful to Ndeniria for all the good and difficult moments we spent together in the field, where she was always reliable and full of ideas to solve the problems. I admire her perseverance to continue doing research with us rather than going back to the sometimes easier work in the clinic. I would also like to warmly thank Gerumana Mpamwa, my 'mama wa Tanzania', who entered the data with such accuracy that I spent much more time looking for errors without finding them. She was always watching over me to check if the amount of food and 'chai' I was taking was enough for this very hot and dusty urban environment. Thanks also to Hafisi and Hugo for the countless small but essential tasks they did for IMALDIA behind the scene. I will also never forget Mzee Baniani who smoothed our transport through the bad roads of Dar es Salaam, especially the one to Buguruni centre that became terrible with nine month of pregnancy, and taught me daily as much Kiswahili as I was able to integrate. At Amana hospital I am grateful to a number of people, starting with Willy Sangu, the doctor in charge of this key hospital for a lot of our research. He is the health worker with the most evidencebased clinical knowledge I have ever met in Tanzania. I admire the integrity and conviction with which he was managing his hospital and fighting against wrong medical believes. The 'Fever study' would never have been such a success without him, and obviously without the different people who participated to this work, putting all their know-how and energy. Special thanks to Mary Kilowoko, Paschal Mgaya and Burton Ngewe for being such reliable clinicians full of respect and attention towards their young patients and to Felister Ngulubayi, our queen of cultures in the laboratory who worked until the day before 'her happy event'. Acknowledgments VI I would like to thank all the health workers who helped us including patients and collecting data up to the far end of the city despite the 'foleni' (traffic jam) and 'mafuriko' (inundations):