Malaria is endemic in Burundi. Every year there are peaks at this time of year, but now the numbers are significantly higher than expected.Today, December 5, the government of Burundi declared that the rapid increase in malaria in regions within two of the country's 16 provinces has reached the level of an epidemic. An exploratory mission with MSF staff members and lab technicians from the Ministry of Health concluded that the epidemic threshold for malaria has been reached in the provinces of Ngozi and Gitega in Burundi. Also the provinces of Bururi and Kayanza are confronted with a significant rise in malaria cases.

However the emergency threshold has not been met in the latter two provinces. "In Gitega and Ngozi, 80% of the people attending the consultations in the health centres tested positive for malaria," said Dr. Martin De Smet, a malaria expert for MSF. "The people tested come from several villages and therefore represent a good sample of the population in the region. We have to investigate now to what extent the whole population is affected . The government has today declared the epidemic. This means that anti-malaria drugs will be provided for free in the health centres." Malaria is endemic in Burundi.

Every year there are peaks at this time of year, but now the numbers are significantly higher than expected. Year round monitoring and vector control measures to reduce the number of mosquitoes are therefore essential. "An additional problem is the malnutrition in the region. The population in the provinces of Ngozi and Gitega show a level of 8% global malnutrition. This makes them more vulnerable for diseases." Dr. Martin De Smet says. Several studies have shown that the malaria parasite in Burundi is highly resistant to most of the currently used anti-malaria drugs. To deal with the rise in malaria cases MSF will look into the possibility to start treatment as soon as possible with a combination therapy.

This consists of two drugs, including the new highly efficient drug, artemisinin. "This approach has been accepted by the authorities, especially to be used during epidemics, after a huge malaria epidemic hit the country late 2000. Where needed, MSF is ready to support the primary health care centres with drugs and eventually with extra staff, to enable them to cope with a rapidly increasing number of malaria patients.

In these situations, we usually also set up mobile medical teams, to provide the treatment in more remote villages where there is no regular access to health care. Also in the province of Karuzi - where for the moment the percentage malaria cases is still below the emergency threshold - MSF continues to monitor the situation. Annually, malaria kills more than one million people worldwide. Treatment is problematic as resistance to traditional therapies is increasing dramatically.