An 80 percent drop in malaria cases
Malaria is a major health problem in Burundi. Endemic and the cause of regular outbreaks, the disease is the leading cause of hospitalization and death in young children. This is true of the entire African continent: Each year, more than 90 percent of the 400,000 deaths from malaria worldwide are recorded in Africa. Because there is no vaccine for the parasitic disease, 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, or IRS, is one of these prevention techniques. Successfully implemented in many parts of the world, involves applying a long-lasting insecticide to the walls and ceilings of buildings—homes, barns, outhouses—that kills the mosquitoes that land 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 percent drop in malaria cases here," says Dr. Hippolyte Mboma, 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."
“Come and spray!"
It takes MSF and the health authorities several months to prepare each spraying campaign. First they need to select which insecticide to use, as the chemicals must be rotated to avoid mosquitoes developing resistance. Then they need to inform the local communities and encourage them to take part, plan the logistics, recruit and train the teams, and more.
“Kinyinya district has more than 68,000 homes scattered across the hills," says Dr. Mboma. “For the approach to be effective, you need to treat at least 85 percent of these homes. It takes incredible organization 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, supervisor of one of the 78 spraying teams deployed in September 2020, agrees.
“Last year was the first time we sprayed homes here, and there were obviously quite a few questions,” she says. “There were a lot of information sessions, and in the end we managed to treat 95 percent 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."