[AFM NOTE: Research from Burundi demonstrates the importance of IRS as part of a comprehensive approach to malaria control. As John Beier explains in an editorial in the same issue of the Am. J Trop. Med. Hyg. this important success story underlines the importance of publishing success stories in peer reviewed journals and continuing research to develop comprehensive integrated vector management systems based on sound science and evidence]
Natacha Protopopoff*, Wim Van Bortel, Tanguy Marcotty, Michel Van Herp, Peter Maes, Dismas Baza, Umberto D'Alessandro, AND Marc Coosemans
Department of Parasitology, Institute of Tropical Medicine, Antwerp, Belgium; Department of Animal Health, Institute of Tropical Medicine, Antwerp, Belgium; Medical Department, Médecins Sans Frontières, Brussels, Belgium; Programme de Lutte contre les Maladies Transmissibles et Carentielles, Ministry of Health, Bujumbura, Burundi; Department of Biomedical Sciences, Faculty of Pharmaceutical, Veterinary and Biomedical Sciences, University of Antwerp, Antwerp, Belgium
In a highland province of Burundi, indoor residual spraying and long-lasting insecticidal net distribution were targeted in the valley, aiming also to protect the population living on the hilltops. The impact on malaria indicators was assessed, and the potential additional effect of nets evaluated. After the intervention—and compared with the control valleys—children 1-9 years old in the treated valleys had lower risks of malaria infection (odds ratio, OR: 0.55), high parasite density (OR: 0.48), and clinical malaria (OR: 0.57). The impact on malaria prevalence was even higher in infants (OR: 0.14). Using nets did not confer an additional protective effect to spraying. Targeted vector control had a major impact on malaria in the high-risk valleys but not in the less-exposed hilltops. Investment in targeted and regular control measures associated with effective case management should be able to control malaria in the highlands.
Full text available from: http://www.ajtmh.org/cgi/content/abstract/79/1/12?etoc
See also the Editorial by John C. Beier "Malaria Control in the Highlands of Burundi: An Impotant Success Story" Available from Am. J. Trop. Med. Hyg.