[Impact of antivectorial control on malarial morbidity and mortality in a health district of the Madagascar highlands]. / Impact de la lutte antivectorielle sur la morbidité et la mortalité palustres dans un district sanitaire des Hautes Terres de Madagascar.

After the dramatic increase of malaria infections from 1985 to 1988 in the Highlands of Madagascar, the vector control programme was reactivated. In order to evaluate the impact of this strategy in the district of Arivonimamo, we have analysed the morbidity and the mortality data collected in all the health care centers of this district. Since 1988, extensive residual house spraying has been carried out on a yearly basis in the eastern part of this district whereas the western part was not included in this spraying programme. Data from each area were compared. In the eastern part, a dramatic decrease of morbitity and mortality related to malaria was observed, the benefit was 69% of expected simple cases, 87% of expected serious cases and 40% of expected deaths due to malaria. It has to be noted that only presumptive cases have been reported since no laboratory facilities are available in these health centers. Nevertheless such findings provide strong support to the continuation of the spraying programme, maybe in a less intensive way, together with an accurate epidemiological surveillance.