MALARIA VECTOR CONTROL IN A RURAL-DEVELOPMENT PROJECT IN BURUNDI

In the context of a large project for the socio-economic improvement of the Imbo area, measures were taken for the integration at all levels of malaria control: health centres for improvement of curative care; hygiene and sanitation centres, communes and agricultural projects for vector control; craftsmen, cooperatives and social centres for the manufacture and selling of impregnated bed-nets. The adopted strategy for malaria control results from preliminary epidemiological studies. The recommended measures are the improvement of medical care and vector control. The latter is based on indoor spraying of malathion, once a year. Malathion is only active during the period (2 months) of highest transmission, which occurs at the end of the rainy season. Occasionally other insecticides are used. Impregnated bed-nets with deltamethrin and village draining are complementary methods. In villages of the rice-growing area with good participation of the community, vector control activities have a considerable impact on malaria prevalence. About 70% before the intervention, the prevalence does not exceed 10% in 1990. High parasitaemia (> 2000 troph./mu-l), and hence morbidity, decreased considerably (35% in 1983 to less than 5% in 1990). In villages with poor community participation, the decrease of prevalence is less spectacular (from 70% to 25%). Drains are not kept in repair and constitute new breeding places of vectors in the populated areas. The use of mosquito bed-nets is not common, a better information campaign should overcome this unpopularity. In peri-urban villages, inhabitants are complaining about indoor spraying, but the results are satisfactory. This programme demonstrates that reducing malaria prevalence and morbidity with conventional measures is feasible in particular biotopes. Health education activities in the Imbo Centre must be pursued and adapted according to the professional activities of the community.