Where is malaria found?

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QUESTION

Where is malaria found?

ANSWER

Malaria is found throughout the world’s tropical and sub-tropical areas, and mainly in Central and South America, Africa, Asia and the Indo-Pacific region. It is most common in tropical regions, where transmission occurs year-round; in sub-tropical and temperate areas, transmission may only occur during seasons that have appropriate climatic conditions. This includes sufficiently high temperature and water availability for the growth and development of the mosquito, which transmits the disease. Currently, the greatest burden of the disease is felt in sub-Saharan Africa, where over 90% of deaths due to malaria occur. The map below shows the estimated risk for malaria across the world, courtesy of the World Health Organisation.

Global_Malaria_2010_WHO

Map of the global distribution of malaria, courtesy of WHO (www.who.org)

Malaria Deaths 2x Greater than Previously Reported

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Malaria is killing more people worldwide than previously thought, but the number of deaths has fallen rapidly as efforts to combat the disease have ramped up, according to new research from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.
More than 1.2 million people died from malaria worldwide in 2010, twice the number found in the most recent comprehensive study of the disease. IHME researchers say that deaths from malaria have been missed by previous studies because of the assumption that the disease mainly kills children under 5. IHME found that more than 78,000 children aged 5 to 14 and more than 445,000 people aged 15 and older died from malaria in 2010, meaning that 42% of all malaria deaths were in people aged 5 and older.
“You learn in medical school that people exposed to malaria as children develop immunity and rarely die from malaria as adults,” said Dr. Christopher Murray, IHME Director and the study’s lead author. “What we have found in hospital records, death records, surveys, and other sources shows that just is not the case.”
The study also found that while the overall number of malaria deaths is higher than earlier reports, the trend in malaria deaths followed a similar downward pattern. Starting in 1985, malaria deaths grew every year before peaking in 2004 at 1.8 million deaths worldwide. Since then, the number of deaths fell annually, and between 2007 and 2010, the decline in deaths was more than 7% each year.
The new findings are being published today in The Lancet in “Global malaria mortality between 1980 and 2010: a systematic analysis.” The work is part of the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study. Other research from this study, global trends in child mortality, maternal mortality, breast cancer, and cervical cancer, were released last year, and more trends will be released in the coming months.
Researchers say the biggest drivers of the decline in malaria deaths have been the scale-up of insecticide-treated bed nets and artemisinin-combination treatments (ACTs). This has been accomplished through the advent of the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2001 and the creation of organizations focused on fighting malaria, such as the World Health Organization’s Roll Back Malaria, Malaria No More, and Nothing But Nets. Overall funding for malaria efforts grew from less than $0.25 billion annually in 2001 to more than $2 billion in 2009, according to IHME’s latest estimates. IHME reported in September 2011 that homes owning at least one bed net were associated with a 23% reduction in child mortality.
“We have seen a huge increase both in funding and in policy attention given to malaria over the past decade, and it’s having a real impact,” said Dr. Alan Lopez, Head of the School of Population Health at the University of Queensland and one of the study’s co-authors. “Reliably demonstrating just how big an impact is important to drive further investments in malaria control programs. This makes it even more critical for us to generate accurate estimates for all deaths, not just in young children and not just in sub-Saharan Africa.”
One of the most important factors in identifying the new malaria estimates was the use of verbal autopsy data. In a verbal autopsy, researchers interview the relatives of someone who has recently died to identify the cause of death. IHME and collaborators around the world published a series of articles in a special edition of Population Health Metrics in August 2011 focused on advancing the science of verbal autopsy. Verbal autopsy data were especially important in India, where malaria deaths have been vastly undercounted in both children and adults. IHME found that more than 37,000 people over the age of 15 in India died from malaria in 2010, and the chances of someone dying from malaria in India have fallen rapidly since 1980.
Progress in fighting malaria can be seen everywhere. Countries such as Zambia and Tanzania saw malaria deaths fall by more than 30% between 2004 and 2010. The progress being seen in Africa is especially significant, given that malaria deaths there accounted for a quarter of all deaths in children under 5 in 2010.
But the researchers warn that those gains could be reversed if global economic troubles continue to stifle funding efforts. IHME reported in December that growth in development assistance for health slowed greatly between 2009 and 2011. The announcement by the Global Fund in November that it would cancel its next round of funding casts a cloud over the future of malaria programs, the researchers say.
“If the Global Fund is weakened, the world could lose 40% of all the funding dedicated to fighting malaria,” said Dr. Stephen Lim, Associate Professor of Global Health at IHME and a co-author on the study. “That kind of loss of funding poses a definite threat to the health of people in countries with a high malaria burden, which in many cases are some of the poorest countries in the world. We need to think of ways to fill funding deficits in order to ensure continued progress on malaria mortality.”

Source: IHME

Counterfeit Anitmalarial Drugs Threaten Crisis in Africa

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Hopes of at last controlling malaria in Africa could be dashed by the emergence of poor-quality and fraudulent antimalarial medicines, warn experts writing in Malaria Journal. Unless urgent action is taken both within Africa and internationally, they argue, millions of lives could be put at risk. [Read more…]

Why is malaria dangerous?

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QUESTION

Why is malaria dangerous?

ANSWER

Malaria is dangerous because if left untreated, it can be deadly. This is particularly true of Plasmodium falciparum, which can rapidly escalate into severe disease with cerebral (brain) complications.

However, other forms of malaria, such as P. vivax and P. knowlesi, can also be fatal if untreated. The people most at risk from severe malaria are pregnant women and young children; in addition pregnant women who contract malaria are at risk of passing the disease to their foetus either during pregnancy or during birth (so-called congenital malaria) which can have negative effects on the baby, such as poor growth and low birth weight.

Does malaria kill?

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QUESTION

Is malaria a killer disease?

ANSWER

Yes. Malaria causes somewhere between 700,000 to 1 million deaths worldwide, mostly in children under five, and mostly in sub-Saharan Africa. As such, it is actually one of the leading causes of death in young children in developing countries.

Given this high mortality, many initiatives working to control malaria are dedicated to reducing the number of deaths as a key way of lowering the overall burden of this disease; groups such as Malaria No More and the Roll Back Malaria Partnership have committed to bringing the number of deaths from malaria to zero or near zero by 2015.

Why do people die of malaria?

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QUESTION:

Why is it that people die of malaria?

ANSWER:

The symptoms of malaria are caused by the malaria parasite reproducing inside the patient’s red blood cells and eventually destroying them. In this process, the malaria parasites also produce toxic waste chemicals and debris which build up in the patient’s blood stream. The body produces a strong immune response as a reaction to these toxic products and debris; most of the systemic symptoms associated with malaria, such as fever, aching muscles and joints and nausea, are related to this immune response. Infected red blood cells can also build up in internal organs, notably the spleen and the liver, causing them to swell.

Despite these nasty-sounding effects, most cases of malaria are relatively benign and don’t lead to death. However, in some cases, the manifestation of the disease can become more severe. Most commonly, this occurs when a patient is infected with Plasmodium falciparum, one of the four main kinds of malaria that infect humans, and by far the most severe. P. falciparum reproduces very rapidly in the human host, causing extremely high fever and a fast onset of symptoms. It also changes the structure of the red blood cells it infects, causing them to become “stuck” deep within tiny blood vessels and especially in major organs such as the brain, intestines, liver, heart and lungs. Stuck within these blood vessels, the infected red blood cells are effectively hidden from the immune system and are not cleared from the body via the spleen. This allows the malaria parasite’s reproduction to go unchecked, resulting in very high numbers of the parasite in the patient’s blood.

If left untreated, the build-up of infected red blood cells can result in severe anaemia, reduced local oxygen flow and the blocking of the immune reaction; the exact mechanisms are not fully understood. When these processes occur in the brain, the result is so-called “cerebral malaria”, characterised by impaired consciousness, and which can lead to convulsions, coma and death. Even if a patient recovers from the disease episode, they may be left with permanent neurological damage. Luckily, malarial comas are often rapidly reversed after treatment is administered, and in many cases, neurological damage is not permanent.

Cases of Malaria

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QUESTION:

What are reasons for the increasing number of cases of malaria?

ANSWER:

As I recently wrote in answer to another Q&A post, it is difficult to determine whether cases of malaria are indeed increasing or not. For one, a large number of cases are not reported every year, making accurate estimates difficult. Secondly, the world’s population is growing, and it is growing at the greatest rate in Africa, where the majority of malaria cases occur. As such, even if the proportion of people with malaria decreases over time, due to health initiatives such as distributing long-lasting insecticide treated bednets or free treatment, the total number of cases may still rise. Another problem we face in the fight against malaria is climate change: as the world’s patterns of rainfall and temperatures change, new areas become susceptible to malaria transmission, putting more people at risk. However, what is very encouraging is that deaths from malaria seem to be decreasing on a global scale. Malaria No More is an organisation dedicated to eliminating deaths from malaria by the year 2015; more information about their methods and some of their success stories can be found on their website.

Can malaria kill you?

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QUESTION:

Can malaria kill you?

ANSWER:

YES! Malaria, especially of the kind caused by Plasmodium falciparum parasites, can be an extremely severe illness and even deadly. Somewhere between 700,000 and 1 million people die of malaria every year, and the majority of these are children under the age of five years old, which is the age group most susceptible to severe malaria attacks. Pregnant women are also at elevated risk, due to their compromised immune systems. Therefore, preventing malaria in young children and pregnant women is the single most effective way to reduce the number of malaria fatalities; in highly endemic areas, this is usually achieved through the distribution of insecticide-treated bednets, to sleep under at night to reduce mosquito bites, or preventative medication such as intermittent preventive therapy (IPT).

Given the seriousness of malaria, it is prudent to check with a doctor or go to hospital if you live in a malaria endemic area and come down with symptoms of the disease such as high fever, chills and nausea. The majority of malaria cases are easily treated with oral medication, given swift and accurate diagnosis.

Malaria Statistics

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QUESTION:

What are the statistics of malaria?

ANSWER:

If you mean the number of cases worldwide and the number of deaths, then the statistics are as follows: the World Health Organization estimates that approximately half the world’s population are at risk from malaria infection, and as a result, there are somewhere between 300 and 500 million cases of malaria every year, worldwide.

However, this may be an underestimate, since many people don’t seek help when they have malarial symptoms. The same is true of number of deaths per year from malaria – it is currently estimated that between 700,000 and 800,000 people die every year from the disease, but as with the number of cases, there may be unreported deaths as well. Organisations such as Malaria No More seek to eliminate deaths from malaria by the year 2015.

If you have more specific questions regarding the statistics of malaria, please feel free to ask!