Malaria remains a threat in the area despite the billions of dollars that have been spent on trying to reduce its impact throughout the region. Each year, the generally estimated figure of malaria deaths is about 600,000 in Africa. Majority of these are children and pregnant women.Early this year, there was the fourth Annual Health and Scientific Conference in Kigali targeted eastern African health priorities and opportunities in a changing world.The Environment and Health in Africa Symposium was jointly coordinated by two research projects members of the Healthy Futures which target to Eastern Africa area and Quantifying Weather and Climate Impacts (QWeCI) together with Rwanda Biomedical Centre to reduce the future burden of three water-related vector-borne diseases malaria, Rift Valley Fever (RVF) and schistosomiasis in the area.The current report notes that since 2012, malaria morbidity has increased from 5.7 per cent to 8.5 per cent until September 2013 as proportion of morbidity attributed to malaria at heath facilities. But efforts geared toward eliminating malaria are more profound today. Mosquito nets are availed for free and treatment is subsidised treatment.Juvenal Kabango, 50, a resident in Ruhuha Sector, Bugesera District, in Eastern Province, who until recently had not suffered from malaria, blames climate change as he has never slept under a mosquito net.But Dr David Taylor, the Healthy Futures Scientific coordinator, disagrees with the assertion, has not been getting rampant because of climate change as many people think but climate variability."This is why using a mosquito net to protect against being bitten by an infectious mosquito is more important in a rural area than in the city.  Even more so, the poor quality of housing in rural areas.  There are more places for mosquitoes to hide as a result,” Dr Taylor said.It is simply a function of statistics and chance the ratio of infectious mosquitoes to people in rural areas is in favour of the mosquito, whereas it is the opposite in towns and cities as there are more mosquitoes per person in rural areas than in towns because by their nature towns and urban areas are characterised by their relatively high densities of people, Most malaria occurs where homes are thatched huts, where several people might sleep in the same room without nets and where there are lots of small areas of water (breeding grounds) close to homesteads.Rural vs Urban influenceAlphonse Rukundo, Malaria Epidemiology Specialist in Rwanda Biomedical Centre, said local leaders should put more efforts in sensitising community and monitoring the use of mosquito nets.Nyagatare, Bugesera, Kirehe, Nyanza and Gisagara districts have 60 per cent prevalence of malaria.Rukundo said whereas insecticide-treated nets are now available to all families in the country, some people do not use themx.Last month, the Ministry of Health distributed more than two million mosquito nets in a continued bid to fight malaria countrywide.Rukundo said people in rural area do not use mosquito nets as given, that some of them use them for other activities such as sheltering their houses and livestock, while others sell them."As village leaders help in other government programmes, they should consider  mobilising locals to prevent malaria too,” he said.The Ministry of Health says in 2011, malaria was the Number Three killer disease in the country. Today, this daunting position is no more as the government ensured it won the Millennium Development Goal halt and begin to reverse the incidence of malaria and other major diseases.In 2011, proportion of under five children with malaria and fever receiving appropriate treatment within 24 hours was 94 per cent and 96 per cent this year.Number of malaria attributed deaths at the health facilities last year were 380 and 459 in this year, while proportion of patients who receive antimalarials at heath facilities that are laboratory confirmed before treatment was 99 per cent and 99.9 per cent in 2013.No complacencyDr David Taylor said because malaria prevalence has reduced significantly, some people, especially in rural areas, have interpreted the development wrongly, thinking the disease has been wiped out.Such a mindset, he said, is detrimental and should be corrected at the grassroots to ensure citizens are not complacent and continue using mosquito nets.