Combining tools to curb the spread of Malaria in Nduta Refugee Camp

“Last year, we were given mosquito nets, and our houses were also sprayed on. And this year they are sprayed on again. We thank MSF for taking this step as we can see that Malaria cases have gone done tremendously,” said a 39-year-old Beatrice Ntamakulilo.

These initiatives have drastically reduced the number of Malaria cases in the camp, benefiting thousands of residents. Beatrice is among thousands other Burundian refugees living in the Nduta Refugee Camp in the northwestern town of Kibondo in Kigoma Region.

She says that Malaria cases have tremendously gone down and her kids will be protected with mosquito nets distributed recently. For the past six years, the MSF teams have been implementing malaria control activities. Nduta is a refugee camp situated in Tanzania’s north-western district of Kibondo.

It was established in 2015 to provide shelter and support for Burundian refugees who had fled their country due to political instability and violence.

The camp’s total population as per December 2023 was 64,010 or 15,228 households. In early 2023, the Nduta camp experienced a surge in the malaria cases, affecting nearly 60 per cent of its population.

The MSF teams tested and treated camp residents for Malaria. They also distributed mosquito nets to all of the 14,000 households within the camp, and in late 2023 and early 2024, they conducted two indoor residual spraying campaigns.

The MSF team began by training 95 community health educators within the camp and six coordinators to equip them with essential skills and knowledge to effectively carry out the spraying campaign and distribute the mosquito nets.

Community mobilisation played a pivotal role, through public announcements and door-to-door visits, ensuring widespread awareness and participation. Camp residents had to empty their shelters before they could be sprayed on, which was a challenge because of the rainy season in Kibondo.

“To spray the aqueous solution to control the proliferation of disease-carrying insects, we first have to ask residents to empty their shelters,” says Kyando Elda-MSF Project Medical Advisor. This makes it easier to carry out this type of campaign when the weather is mild.”

Moreover, 35,378 nets were distributed and pitched in the camp in one month to provide adequate protection against malaria mosquitoes. “The combination of Indoor Residual Spray and Long-lasting Insecticidal Nets distribution has proven effective in curbing Malaria transmission during peak seasons,” continues Kyando.

According to the Medical Advisor, the last Indoor Residual Spray campaign prior to this effort was conducted in November 2022, highlighting the need for regular interventions in such endemic areas.

The impact of these interventions is crucial to decrease Malaria incidents in the camp which dropped from 918 cases per 10,000 persons in unsprayed households in November 2023 to 270 cases per 10,000 persons in February 2024.

Further, the MSF reported a 62 percent reduction in severe malaria-related admissions between September 2023 and February 2024, signifying improved overall health outcomes in the camp.

“MSF provides treatment if you are diagnosed with Malaria and these measures taken now to spray are very helpful because mosquitoes are decreasing,” affirmed Laurent Ngendakumana, a 50-year-old resident.

Building on these successes, MSF launched a new Indoor Residual Spray campaign in March 2024 for several weeks, targeting over 14,000 households.

The combined efforts of stakeholders, community engagement, and medical expertise highlight a promising trajectory in Malaria control within the Nduta camp, setting an example for effective public health interventions in similar settings globally.

MSF has been working intermittently in Tanzania since 1993, responding to different needs and emergencies countrywide, including malaria, HIV/Aids, cholera, water provision, primary and secondary health, emergency preparedness for disease outbreaks, refugee health needs, and other health programmes to improve people’s access to healthcare.

Until now, the MSF is the secondary healthcare provider in Nduta, running a 77-bed hospital, providing inpatient services (IPD adults and pediatrics’), intensive care neonatology, maternity services, nutrition care, emergency care, mental health and psychiatric care, as well as Malaria vector control and health promotion activities, to both Burundian refugees and host communities around the Nduta camp.

The MSF in Tanzania has been providing free health services in the Nduta Camp since 2015 where supporting a hospital providing refugees and host communities with medical care.

Additionally, in 2022 MSF, in collaboration with the Ministry of Health, set up a new project in Lindi region to provide and improve primary and secondary health care services to children under five and pregnant women in the seven public facilities of Liwale district in Lindi Region.