Malaria kills twice as many as previously thought: study

February 2, 2012

New research published in this week's edition of The Lancet shows that malaria kills 1.2 million people worldwide each year: twice as many as previously thought. Furthermore, while many believe most malaria deaths occur in young children (under 5 years), the new study shows that close to half of all deaths (42%) occur in older children and adults. Encouragingly, the data clearly show malaria interventions scaled-up over the past decade are driving mortality down. The study is by Professor Christopher Murray, Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA, and colleagues, and was funded by the Bill & Melinda Gates Foundation.

The authors systematically collected all available data for mortality from 1980 to 2010. Their finding of 1.2 million deaths in 2010 is nearly twice as high as the figure in the World Malaria Report 2011, with substantially more malaria deaths in adults in Africa, as well as other parts of the world. They found that between 1980 and 2010, global malaria deaths have increased from 1.0 million in 1980 to a peak of 1.8 million in 2004. This increase is explained by rising malaria death rates in the 1980s and early 1990s and a growth in populations at risk of malaria. By 2010, this figure had fallen to 1.2 million malaria deaths, a 32% decrease since 2004. Between 1980 and 2004, Malaria deaths in children aged under 5 years in sub-Saharan Africa had almost tripled from 377,000 to just over 1 million. In 2010, some 700,000 malaria deaths occurred in African children younger than 5 years (around 56% of total global malaria deaths), a fall of around 350,000 since the 2004 peak. Despite these reductions, mortality risk in 2010 is highest in western, eastern, and, in particular, central sub-Saharan Africa.

Although malaria deaths in children account for most malaria deaths, the number of deaths in adults is high. Malaria deaths in individuals aged 15󈞝 years, 50 years, and 70 years or older account for 20%, 9%, and 6% of malaria deaths in 2010, respectively (thus over a third of all deaths occur in adults). With few exceptions, the proportion of malaria deaths in adults in each country examined was almost always more than 40%. The exceptions are sub-Saharan African countries, which have the highest malaria transmission.

The authors found that, compared with the World Malaria Report 2011, their estimates of deaths were 1.3 times higher for children younger than 5 years in Africa, 8.1 times higher for those aged 5 years or older in Africa, and 1.8 times higher for individuals of all ages outside of Africa. They also found that 24% of child deaths in Africa were due to malaria in 2008, 50% higher than the 16% found by Black and colleagues in the same year (and whose methods were used in the World Malaria Report). This should place more emphasis, say the authors, on making reductions of malaria mortality a central strategy to achieving Millennium Development Goal 4 (reducing mortality in children under 5 years by two thirds from 1990 to 2015). They add: "That malaria is a previously unrecognised driver of adult mortality also means that the benefits and cost-effectiveness of malaria control, elimination, and eradication are likely to have been underestimated."

Crucially, 433 000 more deaths occurred worldwide in individuals aged 5 years or older in 2010 than was suggested by WHO estimates (524 000 versus 91 000). "You learn in medical school that people exposed to malaria as children develop immunity and rarely die from malaria as ," 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 authors say: "Since the global peak in 2004, there has been a substantial decrease in malaria deaths that is attributable to the rapid, although variable, scale-up of control activities in sub-Saharan Africa. This scale-up has been driven in part by an expansion in health aid targeted towards malaria and suggests that the investments made by major funders such as the Global Fund to Fight AIDS, Tuberculosis and Malaria have rapidly decreased the burden of malaria."

However, they add that more malaria mortality also means that short-term goals—eg, the reduction of malaria deaths to zero by 2015—might be unrealistic. The authors say: "We estimated that if decreases from the peak year of 2004 continue, malaria mortality will decrease to less than 100 000 deaths only after 2020."

The importance of the Global Fund in reversing mortality since 2004 is highlighted in the study. The authors say: "The announcement by the Global Fund that round 11 of funding would be cancelled raises enormous doubts as to whether the gains in malaria reduction can be built on or even sustained. From 2003 to 2008, the Global Fund provided 40% of development assistance for health targeted towards malaria. This reduction in resources for malaria control is a real and imminent threat to population in endemic countries."

A linked Editorial concludes: "What should happen now? WHO's new independent advisory body, the Malaria Policy Advisory Committee (MPAC), held its first meeting this week. But MPAC only has 15 members. We believe urgent technical and policy analyses must be initiated by WHO—involving a broader group of experts (eg, including those in child survival) and country representatives—to review these new data and their implications for malaria control programmes. This opportunity needs to be grasped with urgency and optimism."

More information:

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5 / 5 (3) Feb 02, 2012
Malaria kills twice as many as previously thought: study

And I can stop that happening.

DDT, properly applied, kills the bugs that carry disease. Malaria was wiped out in the First World (until recently) and has only returned because of lack of proper pesticides.
5 / 5 (3) Feb 02, 2012
Thank all those 'liberals' who banned DDT.
5 / 5 (2) Feb 02, 2012
Thank you Rachel Carson. Oh wait, not "Thank you"... What was that phrase I was searching for...?
2 / 5 (1) Feb 04, 2012
Ad nauseam - do the quick fix - genetic wing span alteration.
No eradication (campaigns), no food chain impact.
An amok risk - spreading to all species is without consequence.
A weather/wind spread remains localized. The flight is always circular. And no threat to ongoing research in immunology.
1 / 5 (2) Feb 04, 2012
After seeing yet another ignorant column about how banning DDT killed millions and millions and millions of people. I've been inspired to create DDT Ban Myth Bingo to make reading these stupid articles more interesting. Just tick the box when they use the bogus argument next to it. Get four in a row and win! If you get to the end and you haven't got four in row, you still have a chance to win---there's one box you can tick if they don't mention DDT resistance by mosquitoes.

"Thank all those 'liberals' who banned DDT." - RYGGTARD

not rated yet Feb 04, 2012
After seeing yet another ignorant column about how banning DDT killed millions and millions and millions of people.

Out of an almost legendary amount of stupid statements you've made, that one has to take the cake. Oh wait, my bad, were you just quoting Tim Lambert over at that link? OK, I take it back - you weren't MAKING a stupid statement, you were just relaying one from somebody else. Got it.

I know this won't burst your bubble of impenetrable eliminationist dogma, but banning DDT *has* killed millions and millions, and continues to do so.

1 / 5 (2) Feb 04, 2012
That would be most difficult since DDT has never been globally banned and has been in continual use in countries prone to malaria since it's invention.

"but banning DDT *has* killed millions and millions" - Moron Shelgeyr

Shelgeyr reminds us that to be a Conservative is to be a congenital and perpetual liar.
5 / 5 (1) Feb 05, 2012
VD, that's your argument? That it hasn't been banned somewhere? I'm sure that's cold comfort to all the malaria victims in those countries where it has been banned.

I think I may have finally figured out your agenda... you seem to simply hate people. And if you claim that's not the case, then why do you put so much effort into coming across that way?
not rated yet Feb 05, 2012
"VD, that's your argument?" - Liar Shelgeyr

You mean that pointing out that you are a liar isn't sufficient for you - a liar.

Awwww.. You poor little liar.

DDT has been in near continual use in every nation prone to malaria since the chemical was invented. There have been temporary bans as insects developed resistance to the chemical, but no ban has cost "millions and millions and millions" of lives as you have dishonestly claimed.

You are simply an anti-science politically Conservative liar.

And your worthless kind are worth less than a dime a dozen.
not rated yet Feb 06, 2012
VD, I probably shouldn't feed a troll like yourself, but if you think your grade school taunts are effective, or even meaningful, you are mistaken.

You sow strife, hatred, and dissension everywhere you post, you revel in economic damage, you are repetitive and unimaginative, you call people "liar" just because they disagree with you, and - at best - you are woefully mistaken regarding the facts of the world.

Now don't get me wrong - I don't expect to have any success in persuading you to change your ways. By what I can only assume is a combination of chance, grace, and the commendable heroic tolerance of others, you've managed to reach adulthood. But it must be a sad, sorry, joyless and terribly lonely adulthood, and you sincerely have my deepest pity.
not rated yet Feb 06, 2012
DDT has been in near continual use in every nation prone to malaria since the chemical was invented. There have been temporary bans as insects developed resistance to the chemical, but no ban has cost "millions and millions and millions" of lives as you have dishonestly claimed.

You are simply an anti-science politically Conservative liar.

And your worthless kind are worth less than a dime a dozen.

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