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Environmental Changes and Evolution of Morbidity due to Malaria: A Case Study of Burundi, East Africa

Claver Sibomana1*, Tatien Masharabu1, Celestin Havyarimana1,2, Joseph Nyandwi3,4

Burundi is in sub-Saharan Africa, the most affected region by malaria in spite of efforts to reduce malaria transmission and its vector proliferation. Since the biological activity and the distribution of malaria parasites and their vectors are influenced by climatic factors, the epidemiology of malaria might be strongly correlated with altitude and hence climate. In addition, conversion of aquatic ecosystems and wetlands into agricultural land in traditionally non-endemic areas would have favoured the proliferation of malaria vectors, leading to greater vulnerability of these regions to malaria. Data on the number of malaria cases in eco-climatic regions from 2011 to 2020 were analysed to determine the evolution of malaria in Burundi and the variation of this evolution in these regions. The number of cases increased from 2013 to reach peaks with more than 8 million cases in 2016, 2017 and 2019, while a significant decrease was observed in 2018 and 2020. However, this change was significant only in Central Plateaus and the North-East depression regions. These highly populated regions have undergone major changes in land use by converting natural marshes into crop fields between 2012 and 2018 as implementation of development projects. These regions should therefore be given priority in terms of strategies to eradicate malaria. It is crucial to support agricultural intensification projects with adequate environmental management and monitoring programs, in particular in order to avoid the proliferation of malaria vectors and significantly reduce the transmission of malaria parasites, and thus overcome this scourge in the long term.