Malaria death toll under-estimated in Africa

A new study published in The Lancet has found that the global estimate of malaria death toll is much greater than most experts had thought — and is not, as had been universally assumed, mostly a killer of children.

The study found more than 1.2 million people died from malaria in 2010, nearly twice the official estimate put out by the World Health Organization, and more than a third of the deaths were in adults.

The common wisdom has been that 99 percent of malaria deaths are in young children because adults develop immunity.

“This radically changes the picture,” said Christopher Murray, lead author of the study and director of the University of Washington’s Institute for Health Metrics and Evaluation (IHME).

Despite the finding that the death toll overall from malaria is much higher than the conventional wisdom, the study did show that the billions of dollars spent over the last decade or so to distribute bed nets, drugs and for other efforts in the massive international effort to reduce malaria is still succeeding.

“We actually showed a greater decline in deaths overall than many had assumed,” Murray said.

The study used a different and more sophisticated analytical strategy guiding a much bigger research initiative soon to be completed by IHME and other research groups known as the Global Burden of Disease project.

“We have seen a huge increase in both funding and in policy attention given to malaria over the past decade, and it’s having real impact,” said Alan Lopez, a population health expert at the University of Queensland in Australia and Murray’s lead partner on the disease burden project.

But the finding that adults make up a much larger proportion of the deaths, Murray said, means the global strategy may need to shift direction a bit. And the greater death toll, he added, means support for the global anti-malaria efforts will need to be stepped up as well.

Murray and his team found that even though many more adults die from malaria than had been assumed, malaria also appears to be, proportionately, a much bigger cause of all child deaths than most experts had been thought (e.g., more like 24 percent as opposed to earlier estimates of 16 percent).

They also found evidence the massive distribution of insecticide-treated bed nets have worked to reduce malaria deaths — but the evidence of effectiveness from the complementary practice of indoor household insecticide spraying was equivocal.

Clearly, the biggest surprise here is in challenging the assumption that adults in malaria-endemic areas are immune to the parasite. Looks like adults need to be sleeping under nets as well, Murray said, and also be included in efforts to expand access to better diagnoses and treatments.

“Until now, the focus in malaria has mostly been on kids,” Murray said. “That’s going to have to change.”

Shortlink:

Posted by AfricaSTI on February 5, 2012. Filed under Lead Stories. You can follow any responses to this entry through the RSS 2.0. You can leave a response or trackback to this entry