Eradicating Malaria.

by: Ejiro Osiobe and Peters Olushola

Overview:

There is a strong desire to eradicate malaria worldwide, and several attempts and strategies are being employed to make our world malaria-free. The death tolls due to malaria worldwide, and the demography mostly affected by these malaria deaths has necessitated the need and urgency in devising and implementing efficient strategies. This report critically looks at malaria deaths worldwide and how the death tolls have fared over the years. It also looks at the countries, continents and demography affected the most. The report analyzes how effective the strategies implemented to eradicate malaria in the areas has been; it evaluates the challenges and threats these strategies presented. To understand the focus of the report, it is essential we define the following terminologies.

 

Controlling Malaria: the main aim is reducing malaria transmission to a level where it doesn’t pose as a public health issue.

Eliminating Malaria: is the complete wipeout of the disease in a region.

Eradicating Malaria: is the elimination of malaria on a global scale.

 

The Impact of Malaria Worldwide:

The most recent world malaria report that was released on November 2018 by the World Health Organization (WHO) recorded 219 million cases of malaria in the year 2017 (World Health Organization, 2018). The report showed a 0.92% rise from the 2016 report (World Health Organization, 2018). The deaths due to malaria worldwide moved in the same direction, rising by 2.3% from 435,000 in 2016 to 445,000 in 2017 (World Health Organization, 2019). However, the data that the Institute of Health Metrics and Evaluation (IHME)1(www.healthdata.org) are significantly higher than those presented by WHO (Roser & Ritchie, 2017). IHME began publishing malaria mortality data from 1990 while WHO only began publishing the data from 2000. To present a holistic view and substantial data for comparison, we will present the data published by both reputable organizations.

 

Malaria Death Estimates from WHO:

WHO began publishing the global estimates of the malaria death toll from the year 2000. From 2000-2015, world malaria death toll dropped by 50% (Roser & Ritchie, 2017). Africa had the highest death toll among the other continents, and in 2015, Africa accounted for 90% of the total death toll in the world. On the brighter side, Africa also recorded the most progress. Between 2000-2015, African death toll dropped by 51.7 % from 764,000 to 395,000 (Roser & Ritchie, 2017).

Figure 1

Figure one shows the global malaria deaths by WHO. It shows deaths caused by malaria in every region have been decreasing with Africa showing a significant change, followed by East Mediterranean, South – East Asia, Western Pacific, America, and Europe.

 

Malaria Death Estimates from the Institute of Health Metrics and Evaluation:

The IHME has been providing malaria death estimates since 1990. Although their number estimates are significantly higher than that of WHO and are divergent on the malaria death tolls of other regions, both data concur on the death toll in the African region, reflecting the 90% contribution to the worldwide deaths.

Figure 2

Figure two shows the global malaria deaths by region, with Sub – Saharan Africa having a normal distribution death toll with 2005 as its peak, South Asia having a decreasing death toll, while Latin America and the Caribbean, Western Europe, Central Europe, Eastern Europe, and Central Asia were relatively flat.

 

The Malaria Death Toll by Age Group:

The IHME has also published the demography of malaria death toll by age group since 1990. From 1990 up to date, children under age five have been the most affected over the years. The number of children under five years that die due to malaria is astounding. In 2016, an estimated 72% of the global malaria death toll were children under 5 (Roser & Ritchie, 2017).

These high numbers are because the immune system of children under five years of age is not yet fully developed which means that they have very little resistance not just to malaria parasite but to other potential health threat. Hence the need to protect them from exposure to these health threats always. The same trend occurs when Nigeria data is analyzed.

Figure 3

Figure three shows the world malaria death by age groups with 0 – 4 years at 76.77%, 5 – 14 years at 9.03%, 15 – 49 years at 7.30%, 50 – 69 years at 4.26%, and 70 + years at 2.64%. Based on the above descriptive statistic, one can hypothesize that the older one gets living in a malaria-infected area, the more resistant the person becomes to the Plasmodium.

Figure 4

Figure four shows malaria deaths by age group in Nigeria with 0 – 4 years, taking the hardest hit, followed by 15 – 49 years, 5 – 14 years, 50 – 69 years, and 70+

 

Malaria-Free Countries:

Consistent efforts are being made worldwide to achieve the eradication of malaria. Although this global goal is yet to be achieved, reasonable efforts are being made by nations of the world to narrow the line between what is desired and what is obtainable. Worth noting, there are countries where malaria never existed, and in some nation that had the sickness, the disease disappeared without any specific measure carried out by the nation or its people. Table one shows the data presented by the WHO, on malaria-free certified nations. The certification is given to countries that report zero cases of malaria for three consecutive years (World Health Organization, 2019).

Table 1

Looking at this table, you will quickly observe that only three nations, out of fifty-four countries in the African continent, have attained the malaria-free status by the WHO. Thus, the large concentration of malaria deaths from this region.

 

Malaria Prevention – Interventions:

Controlling malaria is made possible, by a couple of prevention, and the choice of the intervention employed depends on the level of malaria transmission in the area of interest. These malaria prevention interventions are:

 

  • The case management of malaria diagnosis and treatment
  • The insecticide-treated nets routine
  • The intermittent preventive treatment (IPT) of malaria in pregnant women
  • The infant's periodic preventive treatments
  • The Indoor residual spraying (IRS)

     

    In countries laden with high malaria transmission, the five malaria prevention interventions are employed. Also, in areas of low malaria transmission, IPT is usually discouraged (Centers for Disease Control and Prevention, 2018). Occasionally two other interventions are used. These are:

     

  • Larva control and vector control intervention
  • Mass drug administration and mass fever treatment

 

Malaria control in Africa:

By now, you already know that malaria exacts its most substantial burden in Africa. Although efforts have been made to control the disease in Africa, this has proved extremely difficult for specific reasons:

 

  • High malaria intervention cost that is difficult to bear in the region
  • Weak infrastructures to combat the disease
  • High prevalence of the deadliest species of the parasite in the area
  • Highly efficient species of mosquitoes that transmits the disease
  • Favorable climate for the vector to thrive
  •  

Conclusion:

Although the disease burden in Africa is very high, through the implementation of malaria prevention interventions, the support of global health organizations and the commitment of African nations to drastically reduce the figures of malaria cases and death toll from malaria in the region, we continue to record commendable decline in the malaria cases and death toll from the disease in the area. For example, from WHO’s global malaria death estimate publication (2000-2015), the death toll in Africa has dropped by 50% (Roser & Ritchie, 2017).

 

Key Note:

For Figures and Table please see our Health and Nutrition Report (July 28th, 2019) at the Articles, Reports, and Publication section at the Scholarship Tab!!!

 

References:

Centers for Disease Control and Prevention. (2018, July 23). How Can Malaria Cases and Deaths Be Reduced?

Roser, M., & Ritchie, H. (2017, December 11). Malaria.

World Health Organization. (2018). World Malaria Report, 2018. World Health Organization (ISBN: 978 92 4 156565 3), xii-xix. Retrieved July 17, 2019

World Health Organization. (2019, May 22). Countries and territories certified malaria-free by WHO.

World Health Organization. (2019, March 27).