Malaria is one of the largest problems threatening global public health that is expected to increase in the future under climate change due to associated warming and wetter conditions. This will exacerbate disease burden in Burundi as one of sub-Saharan African countries, where 2 million cases of malaria were reported in 2015. This highlights the need for developing a methodology for mapping malaria risk under climate change and delineating those regions that may potentially experience malaria epidemics in the future. Malaria transmission and distribution are generally determined by a wide range of climatic, topographic and socioeconomic factors. The paper in hand is intended to map malaria risk in Burundi under climate change up to 2050. For this purpose, a GIS-based model was developed for mapping malaria as a function of various climatic and topographic determinants of malaria. The developed GIS-model was used in mapping malaria risk under current climatic conditions.

Tuberculosis is one of the most contagious diseases that has been present for over 5000 years and it is still one of the most significant public health problems. This paper is intended to employ GIS in analyzing spatial variations of tuberculosis incidence in Burundi highlighting the main hot spots. Also, the paper aims to evaluate the temporal changes of TB incidence during the period 2009-2017 and guide the resource allocation. For this purpose, data on tuberculosis incidence at both province and health district level were analyzed. Data on incidence rate of TB and demographic data were collected at province level. Also, data on cases of TB recorded at health district level were acquired. The collected data were analyzed at both temporal and spatial scale. Temporal analysis involved identifying the various trends of TB incidence rate in various Burundi provinces during the period 2009-2017. Spatial analysis comprised mapping spatial variations in TB incidence rates and their trend over the period 2009-2017 and TB incidence at health district level. Moreover, Hot Spot analysis was performed to delineate those districts of statistically significant hot spots in TB incidence in Burundi. The temporal analysis of TB incidence rate, at province level, revealed that during the period 2009-2017, Burundi provinces have experienced varied trends of TB incidence with an annual change rate ranging between (-32.9) and (+5.22) in case of TB in all clinical forms and between (-12.2) and (+1.1) in case of Pulmonary TB. TB incidence rates were found to be positively correlated with proportion of urban population and population density. Meanwhile, spatial analysis of TB cases, revealed that eastern parts of Burundi have been experiencing relatively low incidence rates of TB compared to other parts of the country. This was highlighted by Hot Spot analysis that revealed a tendency of Pulmonary TB cases to be clustered and a hot spot in Pulmonary TB incidence was clearly distinguished in western parts of Burundi. Spatial temporal analysis highlights the potentials of GIS in recognizing trends and spatial pattern of such a disease and may support designing and implementing control programs and guide the resource allocation.

Background: Access to antenatal care and postnatal care services has a great deal of impacts on major causes of high maternal, neonatal and child mortality rates. This study was aimed to identify factors affecting the use of antenatal care (ANC) and postnatal care (PNC) services.Methods: The study used data from the nationally representative 2016-2017 Burundi demographic and health survey (DHS). A total of 8,660 mothers who gave birth within five years preceding the 2016-2017 Burundi DHS were included in this study. Logistic regression statistical analyses were used to identify factors associated with the use of the first ANC visit, the use of 4 ANC services and the use of PNC services in Burundi.Results: Using logistic regression the determined factors such as birth order (AOR 1.64; 95% CI 1.51-1.73), place of delivery (AOR 0.63; 95% CI 0.54-0.76), mothers’ education (AOR 0.47; 95% CI 0.38-0.57) and husband’s education level (AOR 0.85; 95% CI 0.74-0.94) were associated with the use of early ANC. Factors such as birth order (AOR 1.79; 95% CI 1.67-2.30), the exposure to media(AOR 1.11; 95% CI 0.98-1.30), women’s education (AOR 0.58; 95% CI 0.46-0.73), residence(AOR 0.8; 95% CI 0.69-1.01) and the birth interval(AOR 1.45; 95% 1.32-2.00) were associated with the four ANC. Women’s education (AOR 0.59; 95% CI 0.40-0.70), and health insurance coverage (AOR 0.72; 95% CI 0.59-0.96) were associated with the receiving of PNC.Conclusions: Health promotion targeting women’s education, husbands’ education and behavioural change communication in rural areas are vital for increasing their awareness about the importance of antenatal services.