FEATURED: How Rwanda reduced the malaria burden in five years

Over the past five years, Rwanda continued to make significant progress in the fight against malaria among the local population. Statistics from the Rwanda Biomedical Centre (RBC) show that the country recorded a drop in malaria incidence from 400 per 1,000 in 2016 to 89 per 1,000 in 2021. Malaria cases also declined 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 reduced from 700 in 2016 to 69 in 2021. The achievements have come as a result of a number of factors, including the interventions that RBC put in place working with several stakeholders, according to officials. Here, RBC strived to ensure the services for diagnosing and treating malaria are brought closer to the citizens, where currently, up to 60 percent of all malaria cases are diagnosed and treated at home, by Community Health Workers (CHWs). RBC workers extracting mosquito larvae from a swamp for experiment purposes at Mareba sector in Bugesera district on April 25, 2021. There are two CHWs per village, dedicated to managing malaria cases. This makes a total of 30,000 of them nationwide. “We have trained them to diagnose and treat malaria. They use rapid kits to test patients. If a person tests positive, they provide medication to them,” said Dr Aimable Mbituyumuremyi, the Head of the National Malaria Control Programme, other Parasitic Diseases and Neglected Tropical Diseases Division at RBC, in an interview with The New Times. However, for cases involving pregnant women, and severe cases in general, the CHWs refer the patients to the health centres. Diagnosis and treatment are important, but prevention is the best way in fighting malaria, and here, Dr Mbituyumuremyi says there are various preventive efforts that have been employed and have given good results. “Every 2 to 3 years, we distribute bed nets to the population. In 2020, we introduced new types of bed nets to address 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’ houses, in order to rid them of mosquitoes. This is being implemented in 12 districts nationwide, specifically in the Eastern and Southern provinces. A drone sprays pesticides fighting mosquitoes that spread malaria Musanze District. Photo: File. “Recently we started conducting targeted IRS in additional sectors from districts like Rusizi, Nyamagabe and Nyaruguru,” Dr Mbituyumuremyi noted. Working with local Non-Government Organisations (NGOs), RBC is also pushing community awareness, so that people will get to know more about the prevention of malaria, for example, how to clear the breeding sites of mosquitoes. “We have partnered with 7 NGOs to support the government in mobilizing community local leaders and more stakeholders to make them aware about malaria and its prevention,” Dr Mbituyumuremyi said. Last year but one, RBC introduced the use of drones for spraying outdoor breeding areas for mosquitoes. This is an additional measure that complements the existing ones that mostly focus on indoor prevention. “We piloted this in 2020, and now we are hoping to extend it to six districts,” Dr Mbituyumuremyi noted. A health worker conducts indoor residual spraying preventive interventions to fight malaria in Bugesera District. Photo: Dan Nsengiyumva. “We also have mosquito repellent products that you can use when you are outdoors in evening hours so that you can repel mosquitoes and avoid their bites,” he added. Speaking about what RBC will be doing in future to continue fighting the disease, Dr Mbituyumuremyi noted that “the first thing is to sustain the measures that have worked.” However, he revealed that they are hoping to make more use of technology at the community levels 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 make sure that all levels use data for proper planning in malaria response. We need to engage local leaders, communities, local NGOs to use data from their sites and deploy interventions accordingly,” he said.

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FEATURED: How Rwanda reduced the malaria burden in five years