Curbing malaria with indoor spraying in Niger

The rainy season in Magaria health district is marked by a surge in malaria and malnutrition cases each year.

A person sprays pesticide inside a house in Niger.

A house is treated with pesticide during the 2024 indoor residual spraying (IRS) campaign in the Magaria health district. | Niger 2024 © Eloge Mbaihondoum/MSF

During the peak malaria season in Niger’s Magaria health district, the pediatric unit and nutrition centers operated by Doctors Without Borders/Médecins Sans Frontières (MSF) see a significant increase in malaria and malnutrition admissions. Between August and November each year, the pediatric unit at the MSF-supported Magaria Hospital admits an average of 100 patients a day, nearly half of whom are children suffering from malaria, along with higher numbers of malnutrition cases. 

A multidisciplinary approach is being implemented to manage the current situation and take preventive action to reduce the exponential rise in malaria cases.

Magaria residents prepare pesticide to treat houses in Niger.
Magaria residents work to prepare insecticide to treat houses in an indoor residual spraying campaign. | Niger 2024 © Eloge Mbaihondoum/MSF

Spraying homes to curb the spread of malaria

Since 2021, MSF has been collaborating with Niger’s National Malaria Control Program in the Magaria health district in the Zinder region to implement indoor residual spraying (IRS), a method by which pesticide is sprayed on indoor surfaces to kill mosquitoes that transmit malaria. In villages with the highest malaria rates, homes are sprayed at the onset of the peak malaria season.

In 2024, the spraying campaign will impact around 30,000 people across 25 target villages. “These spraying campaigns aim to reduce the mosquito population in these intervention zones, with the goal of decreasing the number of people who may need hospitalization in health facilities, such as integrated health centers and hospitals,” said Fousseni Bamba, a water, hygiene, and sanitation manager. “We are also raising community awareness about the importance of improving village hygiene to address mosquito breeding at the community level.”

We are very happy that our houses have been sprayed. There used to be many illnesses caused by mosquitoes. The situation has now changed because the mosquitoes have disappeared from our homes. Every day, when we clean our homes, we sweep up dead insects. It’s a real relief.
 

Pararou Franck, Magaria resident

Pararou Franck, a father of seven, lives in Adamawa, one of the 25 villages participating in this spraying campaign. MSF sprayers visited his village a few days ago. “We are very happy that our houses have been sprayed,” said Franck. “There used to be many illnesses caused by mosquitoes. The situation has now changed because the mosquitoes have disappeared from our homes.”

The insecticide used in the campaign lasts for approximately three months and poses no danger to the people living in the villages concerned. It is used exclusively to eliminate flies and other harmful insects, thereby improving living conditions. “Every day, when we clean our homes, we sweep up dead insects,” said Pararou. “It’s a real relief.”

A man spray paints a wall in Niger.
A team leader marks a house to indicate it has already been treated with pesticide. | Niger 2024 © Eloge Mbaihondoum/MSF

Scaling up activities for the peak season

Over 100 local community members have been trained and equipped to carry out indoor spraying during the eight-week program. During each malaria peak season, MSF teams expand the bed capacity of the pediatric unit from 150 to over 450 beds. To ensure quality care for patients, the number of health staff is increased proportionally to the workload.

Climate change, with its effects like heatwaves and floods throughout the Sahel region and particularly in Niger, is facilitating the survival and proliferation of anopheles mosquitoes, the carriers of malaria.

Magaria is one of the areas in Niger where malaria incidence is particularly high. Since 2005, MSF has intensified its support to the health district during the rainy season, a period marked by a surge in malaria and malnutrition cases.

After three years of implementation, the IRS campaigns in the Magaria district have seen growing community involvement. Working closely with various stakeholders, such as the Ministry of Health, religious and local leaders, and the media, MSF has promoted the benefits of IRS and built trust within communities to ensure high participating and effectiveness of the program.

As a follow-up to the spraying activities, MSF will partner with the Ministry of Health’s specialist services to conduct a field study on the effectiveness of reducing mosquito density.

Mothers and children attend an awareness raising session on malaria in Niger.
Mothers attend an awareness raising meeting about malaria in Magaria district at a MSF-supported health facility. | Niger 2024 © Eloge Mbaihondoum/MSF

Our work in Magaria

MSF teams have been present in the Magaria district since 2005 when we intervened in response to a malnutrition crisis. MSF provides free pediatric care for children under the age of 5, particularly for malaria and malnutrition. In 2023, MSF treated 410,200 cases of malaria in Niger.