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

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dc.contributor.author Protopopoff, N. en_US
dc.contributor.author Van Herp, M. en_US
dc.contributor.author Maes, P. en_US
dc.contributor.author Reid, T. en_US
dc.contributor.author Baza, D. en_US
dc.contributor.author D'Alessandro, U. en_US
dc.contributor.author Van Bortel, W. en_US
dc.contributor.author Coosemans, M. en_US
dc.date.accessioned 2007-12-06T14:34:00Z
dc.date.available 2007-12-06T14:34:00Z
dc.date.issued 2007 en_US
dc.identifier.issn 1475-2875 en_US
dc.identifier.doi http://dx.doi.org/10.1186/1475-2875-6-93
dc.identifier.other ITG-P1B en_US
dc.identifier.other ITG-P6A en_US
dc.identifier.other ITG-P7A en_US
dc.identifier.other ITG-PLA en_US
dc.identifier.other PARAS en_US
dc.identifier.other U-ENTOM en_US
dc.identifier.other U-MALAR en_US
dc.identifier.other JIF en_US
dc.identifier.other URL en_US
dc.identifier.other DOI en_US
dc.identifier.other FTA en_US
dc.identifier.other ELECTRONIC en_US
dc.identifier.other ABSTRACT en_US
dc.identifier.uri http://hdl.handle.net/10390/253
dc.description.abstract BACKGROUND: African highlands often suffer of devastating malaria epidemics, sometimes in conjunction with complex emergencies, making their control even more difficult. In 2000, Burundian highlands experienced a large malaria outbreak at a time of civil unrest, constant insecurity and nutritional emergency. Because of suspected high resistance to the first and second line treatments, the provincial health authority and Médecins Sans Frontières (Belgium) decided to implement vector control activities in an attempt to curtail the epidemic. There are few reported interventions of this type to control malaria epidemics in complex emergency contexts. Here, decisions and actions taken to control this epidemic, their impact and the lessons learned from this experience are reported. CASE DESCRIPTION: 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. DISCUSSION: 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. CONCLUSION: 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. en_US
dc.language English en_US
dc.publisher BioMed Central en_US
dc.subject Complex emergencies en_US
dc.subject Conflict en_US
dc.subject Highlands en_US
dc.subject Protozoal diseases en_US
dc.subject Malaria en_US
dc.subject Epidemics en_US
dc.subject Outbreak control en_US
dc.subject Drug resistance en_US
dc.subject Vector control en_US
dc.subject Residual spraying en_US
dc.subject Impregnated bednets en_US
dc.subject Insecticides en_US
dc.subject Feasibility en_US
dc.subject Coverage en_US
dc.subject Efficacy en_US
dc.subject Burundi en_US
dc.subject Africa, Central en_US
dc.title Vector control in a malaria epidemic occurring within a complex emergency situation in Burundi: a case study en_US
dc.type Article-E en_US
dc.citation.issue 93 en_US
dc.citation.jtitle Malaria Journal en_US
dc.citation.volume 6 en_US
dc.citation.pages 9 en_US
dc.publisher.place London en_US
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/17634116
dc.identifier.url http://www.malariajournal.com/content/6/1/93
dc.citation.jabbreviation Malaria J en_US


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