Malaria is a major public health problem in Burundi and one of the main national health priorities. Transmission is continuous throughout the year, with two seasonal peaks producing epidemic outbreaks from March to May and October to December. Malaria is the leading cause of morbidity and mortality in the general population and represented 58.8 percent of all outpatient consultations recorded in health care facilities in 2018.
Burundi is among the twenty countries with the highest number of malaria cases and deaths – 1.5% of the global malaria cases and deaths, and 0.9% of global malaria deaths in 2020 . It accounted for 6.4% of malaria cases in Central Africa in 2020. Between 2017 and 2020, the number of malaria cases per 1000 of population at risk increased 17.9% from 250 to 295. Over the same period, however, the number of deaths per 1000 of population at risk decreased 11.3%, from 0.55 to 0.49. The national malaria control policy document currently being implemented was validated in June 2019.
Malaria in pregnancy
Intermittent preventive treatment during pregnancy (IPTp) was adopted as a strategy in Burundi in 2015 and began in 2016. Sulfadoxine-pyrimethamine is administered to pregnant women attending an antenatal clinic, under direct observation from 15 weeks of amenorrhea (WA), at one-month intervals until delivery. Sulfadoxine-pyrimethamine is provided in all 853 health care facilities that provide antenatal care. Coverage of IPTp3 increased from 54% in 2017 to 62% in 2019. 
Malaria treatment is free of charge for children under 5 years and pregnant women. For other population groups, diagnosis and treatment are also free of charge. However, other services (consultation fees and additional products other than artemisinin-based combination therapy (ACT)) are paid for by the patient. The extension of community case management to children over the age of 5 years is a response aimed at minimizing additional costs.
Burundi adopted the ACT policy in 2003, with revisions in 2012 and 2019. Under the new guidelines, artesunate-amodiaquine-based combination therapy was replaced as a first-line treatment by artemether-lumefantrine.
Severe malaria policy and practice
|Recommendation during pregnancy (prevention)|