Burkina Faso

Severe Malaria facts

Burkina Faso is among the ten countries with the highest number of malaria cases and deaths (3% of the global cases and deaths).1 Malaria is responsible for 43% of health provider consultations and 22% of deaths.  

Although mortality rates have fallen by about 27% between 2015 and 2018 from 0.88 to 0.64 per 1000 of the population at risk, case numbers have plateaued at about 400 per 1000 of the population at risk.1

To reduce the burden of malaria in the country, the high burden, high impact approach was introduced in Burkina Faso in November 2019.1

Severe malaria in pregnancy and children

Burkina Faso is among the 20 countries where the prevalence of exposure to malaria infection during pregnancy was 30% or more while maternal anaemia was over 40% in 2018.1  It was estimated that 50% of children under the age of five also had moderate or severe anaemia in 2018.1

Severe malaria case management

Treatment for patients with severe malaria occurs at the hospital and CSPS (Centre de santé et de promotion sociale) level and follows national guidelines.2

A pilot plan for the use of artesunate rectal capsules (ARC) as a pre-referral intervention for severe malaria cases in three districts of the Sahel region was developed with WHO’s support in 2018.2The USAID President’s Malaria Initiative (PMI) will assist with the implementation and scale up of the intervention by financing ARC procurement and operational costs.2

Malaria in pregnancy

For pregnant women, injectable quinine is to be used in the first trimester while injectable artesunate is to be used in the second and third trimesters of pregnancy.2 Case management of severe malaria in children under five and pregnant women is funded by the national budget.2 Emergency kits are also provided to pregnant women and children under five years of age with severe malaria.2

82% of pregnant women received two or more doses of Intermittent Preventative Treatment of malaria in pregnancy (IPTp) in the last two years while 58% received three or more doses of IPTp during their pregnancy in the two preceding years.2

Purchase of rectal and injectable artesunate

PMI initiated a pilot project for the administration of artesunate rectal capsules (ARC) for pre-referral intervention in two districts in the north in 2018. The project will be expanded into six districts following the pilot project. PMI plans to procure artesunate rectal capsules with 2019 funds.2

PMI, the Global Fund, and the government also plan to procure injectable artesunate in 2020. PMI will purchase 1 million vials while the Global Fund will procure 1.3 million vials. The government will fill the gap for any additional quantities.3 

Healthcare facilities

Since 2008, the country has consistently allocated at least 15% of its annual public budget to healthcare. Several health services are completely free. These include malaria treatment and insecticide-treated bed nets for children under five years of age and pregnant women.2

  • Intermediate health care level: comprises 13 health regions with eight regional hospitals that serve as referral centers;
  • Peripheral health level: 70 health districts with 45 district hospitals, 57 medical centers and 1,839 health facilities;
  • Private sector facilities: 133 hospitals, 397 medical and nursing centers, 45 health facilities run by NGOs or faith-based organizations, 140 biomedical laboratories, 246 private pharmacies, and 617 private drug sellers.
  •  

Health communication and advocacy

A National 2016-2020 Communication Strategy was finalized in February 2017. The communication strategy’s objectives now include Seasonal Malaria Chemoprevention (SMC), IPTp, and the administration of pre-referral artesunate rectal capsules at the community level.7 Activities to advance this strategy include mass communication campaigns, advocacy with community leaders, interpersonal communication with community health workers (CHWs), and development of new social and behaviour change communication tools.

Health financing

As of January 2017, the country had three financing mechanisms:6

  • Government-financed health services, 
  • the National Social Security Fund (Caisse Nationale de Sécurité Sociale, CNSS) for the formal sector, 
  • and Community Based Health Insurance (CBHI) for the informal sector. 

These mechanisms will eventually be combined into a single financing system to improve efficiency.5

Burkina Faso aims to achieve Universal Health Coverage (UHC) by 2025. 

Malaria-related admissions and deaths

Photo: World Malaria Report 2018

Distribution of malaria cases within the country

Data taken from the World Malaria Report 2018

Severe malaria policy and practice

National treatment guidelines
Recommendation Treatment
Strong Injectable artesunate
Alternative Injectable artemether
Alternative Injectable quinine

*Injectable artesunate and artemether is not recommended for use during the first trimester of pregnancy. 

Severe malaria kits

Severe malaria cases in children under 5 and pregnant women are provided with free emergency kits

  • ~200,000 free treatment kits/year not including diagnosis

Contents:

  • Injectable artesunate or artemether or quinine
  • Injectable paracetamol
  • Diazepam
  • Glucose solution
  • Intranule catheter
  • Infusion set
  • Syringe
  • Glove
  • Tape

Severe malaria treatment kits have contributed to malaria mortality reduction from 3.3 percent of malaria cases (2011) to 1.2 percent (2015)