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

DOI: 10.1186/1475-2875-6-93

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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.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.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.Malaria epidemics are a growing problem in the African highlands with devastating effects on their immunologically naive population [1,2]. When occurring during complex emergency situations their control is even more difficult. According to WHO [3] "a complex emergency is a situation that affects large civilian populations with war or civil strife, food shortages and population displacement, resulting in excess mortality and morbidity". The approach to malaria control in the acute ph

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