Stinging bid to reduce scourge of malaria
ATTACKING the disease at its source by reducing the number of mosquitoes is the objective of Doctors Without Borders (MSF) teams who have carried out a number of large-scale malaria prevention campaigns in eastern Burundi in recent years, most recently in the hills of Kinyinya.
“Come back and visit us!” Standing in the middle of a pile of his possessions, moved outside his house for safekeeping, Misago watches the departure of the team of sprayers after they spent 20 minutes treating the walls and ceilings of his house with a spray that kills mosquitoes.
Bottles and pumps on their backs, they cycle on to the next house.
Like the other inhabitants of Kumoso plain, this is the second time in two years that Benoit Misago has had his house treated in an antimalarial spraying operation set up by MSF in Kinyinya district.
In summer 2019, the first team visited his home to present the project, explain the details and answer all of his questions.
“I quickly agreed to them treating my house,” said Misago.
“At the time, we had a very big malaria problem here. Mosquitoes were flying everywhere. Children and adults were sick all the time. There were so many people in the hospital that we sometimes spent all day there. Fortunately, all this stopped after their visit. So I’m glad to see them again today.”
The disease is still a major health problem in Burundi despite an 80% drop in malaria cases.
Endemic and the cause of regular outbreaks, the disease is the leading cause of hospitalisation and death in young children.
This is true of the entire African continent: each year, more than 90% of the 400 000 deaths from malaria are recorded in Africa.
While awaiting the availability of a vaccine, prevention remains key and involves the use of antimalarial drugs and physical protection from mosquitoes, such as mosquito nets and enhanced sanitation.
Indoor residual spraying is one of these prevention techniques. Successfully implemented in many parts of the world, it consists of applying an insecticide to the walls and ceilings of buildings – homes, barns, outhouses – which kills the mosquitoes that come to rest there.
Effective for months at a time, it drastically reduces the number of cases of malaria when combined with the use of mosquito nets.
“Last year, the spraying was a key factor in the 80% drop in malaria cases here,” said Dr Hippolyte Mbomba, MSF’s malaria project manager in Kinyinya district.
“But to be effective, the spraying must be prepared, carried out and repeated in an extremely meticulous manner, in close collaboration with the authorities and the population, and with the support of specialists. This technique cannot be improvised.”
“Kinyinya district has more than 68 000 homes scattered across the hills," said Dr Mboma.
“For the approach to be effective, you need to treat at least 85% of these homes.
“It takes incredible organisation and energy.
“In particular, it is necessary to make sure that the inhabitants understand the project well and adhere to it because it is a technique that they do not know. Hence the importance of working closely with local authorities and employing many community workers to answer all their questions.”
Jeanine Arakaza, superviser of one of the 78 spraying teams deployed in September last year, agrees, saying: “Last year was the first time we sprayed homes here, and there were obviously quite a few questions. There were a lot of information sessions, and in the end, we managed to treat 95% of homes.
“This year, everyone is convinced. People saw the impact of the last campaign. They follow us and say: ‘Come and spray our house, we need you, we don’t want malaria at home!’. It’s really encouraging. We hope to do even better than last year.”
“It changes everything for us,” says Félicité, who has brought one of her children to a health centre in Kinyinya for a consultation.
“In the past, when we fell ill we turned to traditional medicine or to marabouts (religious teachers), or we went to look for contraband drugs. Today, we know that we can come to the hospital and that the children will be treated well and free of charge. We come more quickly to be treated.”
Reducing malaria and providing free healthcare is saving lives, but it is also helping households in other ways.
The fight against malaria in Africa still has a long way to go and needs greater efforts to improve access to tools to prevent, diagnose and treat the disease.
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