KEY MESSAGES
Despite a decreasing malaria burden in children under 5, it remains a notable health concern in Rwanda due to their vulnerability, emphasizing the necessity for strengthened prevention measures.
To lessen the malaria burden, it is crucial to expand the coverage and effectiveness of prevention strategies, address root causes contributing to the rise in cases, and prioritize vulnerable populations, particularly children under 5.
PROBLEM STATEMENT
Across Africa, malaria cases increased from 232 million in 2020 to 234 million in 2021, with children under five accounting for 78.9% of all malaria-related deaths in the region [1]. In Rwanda, Plasmodium falciparum is the primary cause of malaria, and Anopheles gambiae serves as the dominant vector [2]. Children under five years old and pregnant women are particularly vulnerable to the disease's worst outcomes [3,4]. This susceptibility derives from their higher risk of severe illness and complications as a result of their low immunity [5]. Rwanda has made remarkable strides in reducing the malaria burden through interventions such as prompt diagnosis and treatment, the distribution of Long-Lasting Insecticidal Nets (LLINs), and the implementation of Indoor Residual Spraying (IRS) [6]. Despite these endeavors, malaria cases in children under 5 are still rising, and their vulnerability could lead to a resurgence of malaria cases unless preventive measures are reinforced and sustained (Figure 1).
In Rwanda, the distribution of Insecticide-Treated Nets (ITNs) is primarily limited to pregnant women and children under one year. Children one year and above don’t get ITNs [7]. This, coupled with a lack of an early warning system, lack of awareness, inadequate mobilization, restricted coverage of IRS (only 13 districts), low community compliance with ITNs and IRS, a lack of evaluation of community adoption of preventive measures, and disruption of malaria services due to the COVID-19 pandemic have contributed to a rise in malaria cases among children under five in Rwanda.
To tackle this pressing health challenge requires
