[Environment and malaria in Burundi. Apropos of a malaria epidemic in a non-endemic mountainous region].

In March 1991, an unusual increase of the consultations for fever and/or cephalgias was reported by the Health Centre of Muhanga. At the same time, the administrative authorities worried about the increase of death registration in some hills, located around the big swamp of Ruvubu, and next to this Health Centre. In this area, hypoendemic for malaria, the epidemic was belatedly recognized, entailing a gross death rate between 25.6 and 31.5/1000 person/year in 1991, in the three most hit hill-areas whereas this rate is 18/1000 person/year for the national level. The initiation of the epidemic was favoured by the set up of Anopheles funestus and gambiae because of the modification of the hydro-agricultural milieu at high altitude, due to the extension of the ricefields and piscicultural ponds. Otherwise, there was a light rise of the medium temperature in this area in March 1991. In a non-immune population, the bouts of malaria were severe, especially in the age group from 0 to 4 years and in the pregnant women. By modifying the environment, the leaders of socio-economic development programs must consider the consequences on the population's health and to make the health employees a partner in.