A malaria epidemic that has
already affected an estimated 276,000 people in the northern highland
districts of Burundi could affect hundreds of thousands more with the
imminent rainy season, the Roll Back Malaria (RBM) secretariat at the
World Health Organization (WHO) warns today.
RBM partners have organized urgent shipments of drugs
to the central African country to treat those affected by the epidemic
which is thought to have been sparked by October rains. For its part
within the RBM partnership WHO has arranged for the delivery of enough
drugs to treat 160,000 young children with more aid promised.
Mobile clinics are treating patients in ten provinces
and homes are being sprayed with insecticide. A massive information
campaign is also under way to encourage people to use insecticide
treated mosquito nets where possible and to ensure they take the right
anti-malarial drugs at the right time.
Data from clinics in Kayanza province collected in
mid November show 21,000 cases of malaria among a total population of
200,400 - an increase of more than 500% compared to the same period last
Following laboratory tests Medecins Sans Frontières
and WHO found 80% of suspected cases from selected health centres in
Kayanza province tested positively for the deadly Plasmodium falciparum
strain of malaria.
A total of 249,239 cases were reported by mid
November across the ten districts including: 12,261 in Cibitoke, 72, 906
in Gitega, 36,335 in Karuzi, 22,100 in Kayanza, 10,776 in Kirundo, 7,645
in Makamba, 9,589 in Muramvya, 23,993 in Muyinga, 24,814 in Mwaro and
29,239 in Ngozi. By the end of November the overall figure had grown to
276,000 with 115 officially-reported deaths.
Experts fear that the four month rainy season, which
starts in January, could herald a massive increase in cases. In previous
years malaria cases have doubled during this time.
The circumstances are similar to the world's last
major malaria epidemic that hit the western highlands of Kenya in the
first part of 1999, affecting more than one million people.
David Alnwick, who joins the RBM secretariat as
project manager in January 2001, said: "People in highland areas
are particularly at risk as they will not have developed the immunity of
people in low lying areas where malaria is a constant threat.
"The situation is also complicated by the fact
that the cheapest available drug - chloroquine - cannot continue to be
used in such circumstances because of problems with unacceptable levels
WHO advocates the use of a single treatment of
sulphadoxine-pyrimethamine to treat the chloroquine-resistant malaria in
this epidemic in order to ensure that the maximum numbers of cases are
treated with maximum compliance.
Alnwick said: "In epidemics of this scale the
caseload of sick people arriving at fixed or mobile health facilities
each day is enormous. Many, particularly the most vulnerable, have only
one chance of treatment. The ideal approach in these circumstances is
one where you can give the total treatment at one time to guarantee 100%
International agencies supporting and assisting the
Burundi Ministry of Health in managing the epidemic include WHO, The
World Bank and United Nations Children's Fund (UNICEF). Bilateral donor
agencies from the European Community, Belgium, France, Italy and the USA
are also involved.
UNICEF has provided anti-malarial drugs to two
provinces and has placed an emergency order to Copenhagen for additional
drugs. UNICEF is also supporting case management training and is
involved in communications and social mobilization. UNICEF is also
working to secure funds from the Belgian embassy in Bujumbura.
Agencies engaged in fighting the epidemic on the
ground include: Red Cross associations; Christian Aid; Concern;
International Medical Corp; Medecins Sans Frontiers; MEMISA; Oxfam; Tear
Fund and World Vision.
"Burundi has been fairly dry yet we still have
an epidemic on our hands. When the rains arrive in full force the
mosquito population - if not controlled - could soar and prolong the
epidemic," said Alnwick.
More than one million Africans die of malaria every
year - many of them in epidemics like Burundi. Young children and
pregnant women with lower levels of immunity are usually the most likely
to succumb to the disease in high transmission areas, however in
epidemic prone areas all age groups are vulnerable.
People suffering from malaria can develop severe
disease symptoms very rapidly. Without treatment it can kill quickly
often within 24 hours. The cost of one treatment in this case is less
than US 20 cents.
Roll Back Malaria (RBM) is a global partnership
seeking to halve the malaria burden by the year 2010. It was launched in
1998 and after an initial planning stage is now concentrating on
massively increasing interventions to treat and prevent malaria in both
stable and unstable situations. With so many lives lost in complex
emergencies and epidemics effectively controlling the disease in these
situations is critical to the success of RBM.