MEDICINE TODAY: Monitoring a mass killer – update on Malaria

Never mind the numbers, malaria is still a mass killer  

New research published in February 2012 in the Lancet suggests that malaria kills twice as many people each year as formerly believed.[1] The authors from the Institute of Health Metrics and Evaluation (IHME), based in Seattle, found that malaria took 1.2 million lives in 2010 as opposed to the figure of 655,000 estimated by the World Health Organization (WHO).[2]  The authors used various techniques including verbal autopsy reports and estimates of malaria transmission intensity to construct a range of models with which to analyse nearly three decades of data. Understandably, their findings have sparked controversy. Commenting on the new study, Professor David Schellenberg of the London School of Hygiene and Tropical Medicine said that, “we can argue about the strengths and weaknesses of their approach but should not be distracted by the details of the methods: however you look at it, far too many people are dying from malaria”.[3]

While academic debate focusing on the reliability of the new figure is raging, three facts are clear. Firstly, a huge number of people continue to die from this preventable illness. Secondly, 42% of deaths were in older children and adults, demolishing conventional thinking that almost all deaths are in babies and small children. Thirdly, the new report confirmed the downward trend noted by the WHO (annual malaria mortality peaked at 1.82 million in 2004), and suggests that measures to prevent and treat this scourge are working. Much of this success can be attributed to the work of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which contributes about two-thirds of the world’s funding for malaria programmes and has dispersed 230 million insecticide-treated bed nets and a similar number of doses of artemisinin-based drugs. Malaria deaths have come down because of the sustained effort to get bed nets into homes, indoor spraying and the provision of new artemisinin combination drugs. Older anti-malarials do not work in many areas because the parasite has developed resistance to them.

Among the key developments in malaria research today are the emergence of possible vaccines and the growth in drug resistance, both topics that are examined in separate blogs in this series.

 

References

    [1]    Murray C.J., Rosenfeld L.C., Lim S.S. et al. Global malaria mortality between 1980 and 2010: a systematic analysis. Lancet 2012; 379:413-431.

    [2]   WHO. World Malaria Report: 2010. Geneva.  2010. Retrieved on 02/05/2012 from www.who.int/malaria/publications/atoz/9789241564106/en/index.html

[3]    Bowdler, N. Malaria deaths hugely underestimated – Lancet study. BBC News.  3-2-2012. Retrieved on 02/05/2012 from www.bbc.co.uk/news/health-16854026