Institute for Health Metrics and Evaluation (IHME) at the University of Washington, more than 1.2 million people died from malaria worldwide in 2010. 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. IHME researchers say that perhaps deaths from malaria have been missed by previous studies because of the assumption that the disease mainly kills children below 5 years of age. IHME found that more than 78,000 children aged 5 to 14 years, and more than 445,000 people above the age of 15 years died from malaria in 2010, thereby suggesting that 37% of all malaria deaths were in people aged 15 years and older. 37,000 deaths occurred in India alone of persons above 15 years of age. However, the chances of someone dying from malaria in India have fallen rapidly since 1980.
The study also found that while the overall number of malaria deaths is higher than earlier reports, the trend in malaria deaths has 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 has fallen annually and, between 2007 and 2010, the decline has been more than 7% each year. The new findings were published today in The Lancet in Global malaria mortality between 1980 and 2010: a systematic analysis. The work is part of an ongoing series being generated by the Global Burden of Diseases, Injuries, and Risk Factors 2010 Study.
"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."
In an interview given exclusively to CNS, Dr Stephen Lim, Associate Professor of Global Health at IHME and a co-author of the study said that, "In our study we documented a relatively high burden of malaria mortality in India. Unfortunately, currently there are no simple solutions to address the burden of malaria. Rather control strategies need to be multi-dimensional and include vector control such as insecticide treated bed nets, better diagnosis and prompt treatment with effective anti-malarial drugs. Other important vector control measures include reducing standing water to reduce mosquito breeding sites and indoor residual spraying. There are studies that suggest that children who are malnourished are more likely to die from
Unfortunately there are no studies that show a relationship between hygiene, e.g. hand-washing, and sanitation, e.g. use of improved toilet facilities, and malaria, although it seems that poor sanitary conditions would make more fertile grounds for mosquito breeding. Also in a country like India, certain regions and certain times of the year (like monsoons) are more beset with the problem than others. Poor healthcare systems coupled with lack of timely access to treatment, especially in rural areas, simply compound the problem.
However, progress in fighting malaria can be seen everywhere. Countries such as Zambia and Tanzania have seen the malaria deaths fall by more than 30% between 2004 and 2010. In Bangladesh, malaria deaths declined 39% in that period, and in Vietnam they declined 72%. 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.
Researchers say that 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, Malaria & Tuberculosis in 2001 and the creation of organizations focused on fighting malaria, such as the World Health Organization’s Roll Back Malaria Programs. Overall funding for malaria efforts grew from less than $0.25 billion annually in 2001 to more than $2 billion in 2009.
But the researchers also warn that these gains could be reversed if global economic troubles continue to stifle funding efforts. 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.
"If the Global Fund is weakened, the world could lose 40% of all the funding dedicated to fighting malaria," said Stephen Lim. "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 insure continued progress on malaria mortality."
Also, there is a need to look at the overall health impact, both in terms of mortality and morbidity, (and not just mortality) caused by malaria. Children who develop malaria may not die but can develop long-term neurological problems due to cerebral malaria. In addition, understanding the economic impact is important too.
(The author is the Managing Editor of Citizen News Service (CNS). She is a J2J Fellow of National Press Foundation (NPF) USA. She has worked earlier with State Planning Institute, UP and taught physics at India's prestigious Loreto Convent. She also co-authored a book (translated in three languages) "Voices from the field on childhood pneumonia" and a report on Hepatitis C and HIV treatment access issues in 2011. Email: firstname.lastname@example.org, website: http://www.citizen-news.org)
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