La lutte contre les vecteurs du paludisme dans le cadre d'un projet de développement rural au Burundi

'The fight against malaria vectors in the context of a rural development project in Burundi': In the context of a large project for the socio-economic improvement of the Imbo area of Burundi, measures were taken for the integration at all levels of malaria control: health centres for improvement of curative care; hygiene and sanitation centres, communes and agricultural projects for vector control; craftsmen, cooperatives and social centres for the manufacture and selling of impregnated bed-nets. The adopted strategy for malaria control resulted from preliminary epidemiological studies. The recommended measures were the improvement of medical care and vector control. The latter is based on indoor spraying of malathion, once a year. Malathion is only effective during the period (2 months) of highest transmission, which occurs at the end of the rainy season. Occasionally other insecticides are used. Impregnated bed-nets with deltamethrin, and village draining are complementary methods. In villages of the rice-growing area with good participation of the community, vector control activities have a considerable impact on malaria prevalence. About 70% before the intervention, the prevalence did not exceed 10% in 1990. High parasitaemia (>2000 trophozoites/l), and hence morbidity, decreased considerably (35% in 1983 to <5% in 1990). In villages with poor community participation, the decrease of prevalence was less spectacular (from 70% to 25%). Drains are not kept in repair and constitute new breeding places of vectors in the populated areas. The use of mosquito bed-nets is not common; a better information campaign should overcome this unpopularity. In peri-urban villages, inhabitants have complained about indoor spraying, but the results are satisfactory. This programme demonstrated that reducing malaria and morbidity with conventional measures is feasible in particular biotopes. Health education activities in the Imbo Centre must be pursued and adapted according to the professional activities of the community