Barutwanayo M, Coosemans M, Delacollette C, Bisore S, Mpitabakana P, Seruzingo D
Projet de Lutte contre les Maladies Transmissibles et Carentielles (LMTC), Bujumbura, Burundi.
Ann Soc Belg Med Trop. 1991;71 Suppl 1:113-25.
In the context of a large project for the socio-economic improvement of the Imbo area, measures were taken for the integration at all levels of malaria control: health centres for improvement of curative care; hygiene and sanitation centres, communes and agricultural projects for vector control; craftsmen, cooperatives and social centres for the manufacture and selling of impregnated bed-nets. The adopted strategy for malaria control results from preliminary epidemiological studies. The recommended measures are the improvement of medical care and vector control. The latter is based on indoor spraying of malathion, once a year. Malathion is only active during the period (2 months) of highest transmission, which occurs at the end of the rainy season. Occasionally other insecticides are used. Impregnated bed-nets with deltamethrin and village draining are complementary methods. In villages of the rice-growing area with good participation of the community, vector control activities have a considerable impact on malaria prevalence. About 70% before the intervention, the prevalence does not exceed 10% in 1990. High parasitaemia (greater than 2000 troph./microliters), and hence morbidity, decreased considerably (35% in 1983 to less than 5% in 1990). In villages with poor community participation, the decrease of prevalence is less spectacular (from 70% to 25%). Drains are not kept in repair and constitute new breeding places of vectors in the populated areas. The use of mosquito bed-nets is not common, a better information campaign should overcome this unpopularity. In peri-urban villages, inhabitants are complaining about indoor spraying, but the results are satisfactory. This programme demonstrates that reducing malaria prevalence and morbidity with conventional measures is feasible in particular biotopes. Health education activities in the Imbo Centre must be pursued and adapted according to the professional activities of the community.
在一项旨在促进因博地区社会经济发展的大型项目中,采取了各级疟疾防控整合措施:设立卫生中心以改善治疗护理;设立卫生与环卫中心、社区及农业项目以控制病媒;让工匠、合作社及社会中心参与长效驱虫蚊帐的生产与销售。疟疾防控所采用的策略源自初步的流行病学研究。推荐措施包括改善医疗护理及控制病媒。后者基于每年一次的室内马拉硫磷喷洒。马拉硫磷仅在传播高峰期(2个月)有效,此高峰期出现在雨季末期。偶尔也会使用其他杀虫剂。含有溴氰菊酯的长效驱虫蚊帐及村庄排水是辅助方法。在水稻种植区且社区参与度高的村庄,病媒控制活动对疟疾流行率有显著影响。干预前流行率约为70%,1990年不超过10%。高寄生虫血症(大于2000个滋养体/微升)以及由此导致的发病率大幅下降(从1983年的35%降至1990年的不到5%)。在社区参与度低的村庄,流行率下降幅度没那么显著(从70%降至25%)。排水系统未得到修缮,在人口密集地区成为新的病媒滋生地。使用蚊帐并不普遍,开展更好的宣传活动应能改变这种不受欢迎的状况。在城郊村庄,居民抱怨室内喷洒,但结果令人满意。该项目表明,采用常规措施降低疟疾流行率和发病率在特定生物群落中是可行的。因博中心必须继续开展健康教育活动,并根据社区的专业活动进行调整。