I am a reader of The New Times and employee of the Ministry of Health, TRACPlus / Malaria Unit. I would like to clarify about the ongoing Indoor Residual Spraying (IRS) Campaign in a Letter to the Editor published in The New Times, of September 16, 2009.

The letter states that "we have to make consultations before spraying with DDT”.

I wish to clarify that the DDT was banned on 8 July 2002 in Rwanda, the date of ratification of the Stockholm Convention on Persistent Organic Pollutants.

Besides, the Prime Minister’s Order No. 26/03 0f 23/10/2008, has classified DDT among other chemicals and other pollutants that are prohibited in Rwanda to purchase, sell, import, export, transit and store.

The insecticides for IRS used now in Rwanda are among the synthetic pyrethroids that are biodegradable in organic matters, not resistant to heat and without cumulative effects in the nature.

For the ongoing IRS Campaign the following insecticides were used in the different rounds as follows:  During the 1st round (August, 2007) and the 2nd round (August, 2008), the insecticide used was Lambdacyalothrin (ICON ®10WP). For the 3rd round (January, 2009) and at the ongoing round (August-October, 2009) Deltamethrin (Pali®25WG) is used. 

For the reader’s information on the current situation of malaria control in Rwanda, a recent World Health Organization (WHO) study published in February, 2008, reported declines in malaria cases in children under five of 60% in Ethiopia and 64% in Rwanda between the period of 2000-2005 and the year 2007.

This remarkable success was achieved in malaria control in recent years due to the aggressive scaling up of LLINs distribution and ACT treatments through the public, private sectors and community with a strong emphasis on strengthening health system. 

Since August 2007, Rwanda has introduced IRS as part of integrated malaria vector control at large scale by targeting highest exposed sectors to malaria in 7 districts (out of 30) instead of 20 as stated in the article "Experts call for behavioural change for IRS effectiveness” published in The New Times of Thursday, September 17th, 2009.

So, the IRS is not a new strategy for the prevention of malaria in Rwanda.

Their most impact is at community level and it is recommended to perform it house-by-house for more efficiency. But exception may be possible in some cases according to guidelines given to the IRS operators and mobilizers. 

The issue of lack of professionalism and consultation was also highlighted in the letter mentioned above. I want to say that since the first round of spraying, there has been a strong professionalism and large consultation of the recipient population.

The management and supervision at the sector level is being done by experts in environmental health and local leaders participate in community mobilization at sector, cell and Umudugudu levels.

Before each spraying operation, there is training conducted by experts at all levels of personnel involved in the IRS campaign.

The implementation of each IRS campaign requires the involvement of local leaders of Umudugudu, cell, sector and district.

These local leaders are also involved in planning, spraying operation, monitoring and evaluation processes. Information and communication is done door to door at each Umudugudu level.

These follow a daily plan pre-prepared and which covers the entire period of the campaign.

Thanks to that, Rwanda was able to achieve nearly 97% household coverage by using local leaders to mobilize households, and community health workers to conduct the spray campaign.  

For more explanation or any query, you may contact the spraying team based at the offices of targeted sectors or TRACPlus/Malaria Unit at the following number: 0788303916.

Emmanuel Hakizimana