FEATURE: How Rwanda reduced the burden of malaria in five years | The new times

Over the past five years, Rwanda has continued to make significant progress in the fight against malaria among the local population.

Statistics from the Rwanda Biomedical Center (RBC) show that the country has recorded a decline in malaria incidence from 400 per 1,000 in 2016 to 89 per 1,000 in 2021.

Malaria cases have also decreased from 5 million in 2016 to 1 million in 2021, in addition to a decrease in severe malaria from 18,000 in 2016 to less than 2,000 in 2021, while malaria-related deaths are from 700 in 2016 to 69 in 2021.

The achievements are the result of a number of factors, including the interventions that RBC has put in place in collaboration with several stakeholders, according to officials.

Here, RBC has worked to ensure that malaria diagnosis and treatment services are brought closer to citizens, where currently up to 60% of all malaria cases are diagnosed and treated at home, by agents community health centers (CHWs).

RBC workers extract mosquito larvae from a swamp for experimental purposes in Mareba sector, Bugesera district on April 25, 2021.

There are two CHWs per village, dedicated to the management of malaria cases. That makes a total of 30,000 of them nationwide.

“We trained them to diagnose and treat malaria. They use rapid kits to test patients. If a person tests positive, they provide them with medicine,” said Dr Aimable Mbituyumuremyi, National Malaria Control Program Manager, Other Parasitic Diseases and Neglected Tropical Diseases Division at RBC, in an interview with The New Times.

However, for cases involving pregnant women, and serious cases in general, CHWs refer patients to health centers.

Diagnosis and treatment are important, but prevention is the best way to fight malaria, and here, according to Dr. Mbituyumuremyi, various prevention efforts have been made with good results.

“Every 2 to 3 years, we distribute mosquito nets to the population. In 2020, we introduced new types of mosquito nets to combat mosquito resistance in Rwanda. We distribute them through mass campaigns or routine services,” he noted.

In addition to this, RBC also uses Indoor Residual Spraying (IRS), where trained personnel spray insecticides inside citizens’ homes, to rid them of mosquitoes.

This is being implemented in 12 districts across the country, especially in the Eastern and Southern provinces.

A drone sprays pesticides against mosquitoes that spread malaria Musanze District. Photo: File.

“Recently, we have started conducting targeted IRS in other sectors of districts like Rusizi, Nyamagabe and Nyaruguru,” noted Dr Mbituyumuremyi.

Working with local non-governmental organizations (NGOs), RBC also promotes community awareness, so people know more about malaria prevention, for example, how to clean mosquito breeding sites.

“We have partnered with 7 NGOs to help the government mobilize local community leaders and more stakeholders to raise awareness about malaria and its prevention,” Dr Mbituyumuremyi said.

Last year, RBC introduced the use of drones to spray outdoor mosquito breeding areas.

This is an additional measure that complements existing ones that focus primarily on indoor prevention.

“We piloted this in 2020, and now we hope to expand it to six districts,” noted Dr Mbituyumuremyi.

A health worker conducts preventive indoor residual spraying interventions to control malaria in Bugesera district. Photo: Dan Nsengiyumva.

“We also have mosquito repellents that you can use when you are outside at night to repel mosquitoes and prevent their bites,” he added.

Speaking about what RBC will do in the future to continue to fight the disease, Dr Mbituyumuremyi noted that “the first thing is to maintain the measures that have worked”.

However, he revealed that they hope to use the technology more at the community level in the fight against malaria.

“One of the things we want to do is use data in decision-making. We are working with various stakeholders to ensure that all levels are using data for good malaria response planning. engage local leaders, communities, local NGOs to use data from their sites and deploy interventions accordingly,” he said.

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