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Vector control in a malaria epidemic occurring within a complex emergency situation in Burundi: a case study.

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dc.contributor Department of Parasitology, Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium. nprotopopoff@itg.be
dc.creator Protopopoff, N
dc.creator Van Herp, M
dc.creator Maes, P
dc.creator Reid, T
dc.creator Baza, D
dc.creator D'Alessandro, U
dc.creator Van Bortel, W
dc.creator Coosemans, M
dc.date 2007
dc.date.accessioned 2017-01-31T07:10:27Z
dc.date.available 2017-01-31T07:10:27Z
dc.identifier Vector control in a malaria epidemic occurring within a complex emergency situation in Burundi: a case study. 2007, 6:93 Malar. J.
dc.identifier 1475-2875
dc.identifier 17634116
dc.identifier 10.1186/1475-2875-6-93
dc.identifier http://hdl.handle.net/10144/21256
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/21256
dc.identifier Malaria Journal
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/21256
dc.description BACKGROUND: African highlands often suffer of devastating malaria epidemics, sometimes in conjunction with complex emergencies, making their control even more difficult. In 2000, Burundian highlands experienced a large malaria outbreak at a time of civil unrest, constant insecurity and nutritional emergency. Because of suspected high resistance to the first and second line treatments, the provincial health authority and Médecins Sans Frontières (Belgium) decided to implement vector control activities in an attempt to curtail the epidemic. There are few reported interventions of this type to control malaria epidemics in complex emergency contexts. Here, decisions and actions taken to control this epidemic, their impact and the lessons learned from this experience are reported. CASE DESCRIPTION: Twenty nine hills (administrative areas) were selected in collaboration with the provincial health authorities for the vector control interventions combining indoor residual spraying with deltamethrin and insecticide-treated nets. Impact was evaluated by entomological and parasitological surveys. Almost all houses (99%) were sprayed and nets use varied between 48% and 63%. Anopheles indoor resting density was significantly lower in treated as compared to untreated hills, the latter taken as controls. Despite this impact on the vector, malaria prevalence was not significantly lower in treated hills except for people sleeping under a net. DISCUSSION: Indoor spraying was feasible and resulted in high coverage despite being a logistically complex intervention in the Burundian context (scattered houses and emergency situation). However, it had little impact on the prevalence of malaria infection, possibly because it was implemented after the epidemic's peak. Nevertheless, after this outbreak the Ministry of Health improved the surveillance system, changed its policy with introduction of effective drugs and implementation of vector control to prevent new malaria epidemics. CONCLUSION: In the absence of effective drugs and sufficient preparedness, present study failed to demonstrate any impact of vector control activities upon the course of a short-duration malaria epidemic. However, the experience gained lead to increased preparedness and demonstrated the feasibility of vector control measures in this specific context.
dc.language en
dc.publisher BMC
dc.rights Published by BioMed Central, [url]http://www.malariajournal.com/[/url] Archived on this site by Open Access permission
dc.title Vector control in a malaria epidemic occurring within a complex emergency situation in Burundi: a case study.

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