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Spatial Targeted Vector Control Is Able to Reduce Malaria Prevalence in the Highlands of Burundi

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.

Received January 13, 2008. Accepted for publication March 23, 2008.

Acknowledgments: The authors acknowledge the support of the Burundian Health authorities and particularly the LMTC staff. We also thank the province of Karuzi for their dedicated collaboration, and we express our gratitude to all the population of Karuzi who made such a program possible.

Financial support: This work was funded by MSF–Belgium and the Belgian Directorate General for Development Cooperation (DGDC).

^* Address correspondence to Natacha Protopopoff, Department of Parasitology, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium. E-mail: nprotopopoff{at}itg.be

Authors’ addresses: Natacha Protopopoff, Wim Van Bortel, Umberto D’Alessandro, and Marc Coosemans, Department of Parasitology, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium, Tel: 32-3-247-6311, Fax: 32-3-247-63-59, E-mail: nprotopopoff{at}itg.be. Tanguy Marcotty, Department of Animal Health, Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium. Michel Van Herp and Peter Maes, Medical Department, Médecins Sans Frontières Belgium, 94 Rue Dupré, B-1090 Brussels, Belgium. Dismas Baza, Programme de Lutte contre les Maladies Transmissibles et Carentielles, Ministry of Health, Bujumbura, Burundi.

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