Rwanda recorded a slight decline in malaria incidence in the 2025–2026 season as health authorities intensified targeted interventions in areas with the highest burden of the disease. Malaria incidence fell to 72 cases per 1,000 people, from 76 per 1,000 in the previous year, according to data from the Rwanda Biomedical Centre (RBC). The incidence, however, remains higher than the 45 cases per 1,000 people recorded in 2023–2024. ALSO READ: Malaria response focuses on high-burden districts Cases decline Monthly figures show that malaria cases rose sharply during the peak of the 2025–2026 season before declining steadily in 2026. Cases increased from 90,801 in July 2025 to 99,938 in August and 113,986 in September. They peaked in October and November, when 167,365 and 168,235 cases were recorded, respectively. The number then fell to 102,357 in December before declining to 74,360 in January 2026, 54,662 in February and 52,830 in March. The downward trend continued, with 45,150 cases recorded in April, 29,765 in May and 28,127 in June. Epaphrodite Habanabakize, Malaria Prevention Senior Officer at RBC, said the decline followed greater use of malaria data to identify transmission patterns and determine where interventions were most needed. “We tried to use data, analysing challenges and factors. So, we deployed new interventions and strategic interventions based on our data,” he said. The response included the use of new insecticides for indoor residual spraying (IRS) and insecticide-treated nets (ITNs), as well as additional malaria treatment drugs. Rwanda currently uses three malaria treatment drugs, including artemether-lumefantrine, dihydroartemisinin-piperaquine and artesunate-pyronaridine. The medicines are rotated across different areas to help delay the development of drug resistance. Targeting high-burden areas The malaria programme has shifted from applying the same interventions across entire districts to targeting sectors according to their level of malaria transmission. Sectors recording more than 100 malaria cases per 1,000 people receive indoor residual spraying, while those recording between 30 and 99 cases per 1,000 receive mosquito nets, according to Habanabakize. The approach is intended to ensure that areas carrying the highest burden receive more intensive interventions while available resources are used more efficiently. Between January and August 2026, Ngoma District recorded the highest number of malaria cases, at 38,081, followed by Gasabo with 37,452 and Kayonza with 28,298. Kirehe recorded 25,153 cases, while Gisagara registered 22,512. Factors driving transmission Habanabakize said malaria transmission continues to be influenced by several factors, including increasing insecticide resistance, partial drug resistance and a growing number of mosquito breeding sites. Activities such as mining, rice farming and construction can create breeding sites, while prolonged rainfall can leave stagnant water where mosquitoes reproduce. He also cited reduced immunity among people who have had less exposure to malaria over time as another factor that can contribute to a resurgence in cases. Targeting interventions has also become increasingly important as funding for malaria control declines. “If the funding is being reduced, we can use the available resources effectively. We can stratify our data on a sector basis and then target those sectors with high burden, which need intervention,” Habanabakize said. In low-burden sectors, health authorities are using reactive case detection. When a person tests positive for malaria, health workers treat the patient and test members of the same household, providing treatment to those who also test positive. RBC is also planning a strategy to identify severe malaria cases in communities and ensure patients are transferred quickly for appropriate treatment to prevent deaths. Role of community health workers Denyse Murekatete, a community health worker in Kaburende Village, Rubaya Cell, Mukamira Sector, said residents who develop a fever or record a temperature above 37.5°C are tested for malaria. Those who test positive are given medication according to their age and followed up to ensure they complete treatment. People with a high fever who test negative for malaria are referred to a health centre. “We raise awareness about malaria prevention and teach people to sleep under treated mosquito nets, clear bushes and remove stagnant water,” Murekatete said. “Everyone in my area has a mosquito net, which we usually use for three years before replacing it. We also visit people in their homes to talk to them about changing their behaviour. Every weekend, we hold meetings where we teach people about malaria prevention.” Preventing malaria during the rainy season As the rainy season approaches, Habanabakize urged communities to remove stagnant water and other potential mosquito breeding sites around their homes. He said mosquitoes need water to breed and urged households not to allow stagnant water to remain around their homes for extended periods. He also called on people to continue sleeping under treated mosquito nets and allow health teams to carry out indoor residual spraying. However, changing mosquito-biting patterns are presenting an additional challenge. “From our data, we have seen that 64 percent of mosquitoes are biting during the day, not at night. So, we also need to reinforce protection outside,” Habanabakize said. He added that misuse of mosquito nets remains a challenge, with some people using them for farming activities or selling them instead of using them for malaria prevention.
