Malaria Reemerging Disease in Africa

A recent upsurge of malaria in endemic-disease areas with explosive epidemics in many parts of Africa is probably caused by many factors, including rapidly spreading resistance to antimalarial drugs, climatic changes, and population movements. In Africa, malaria is caused by Plasmodium falciparum and is transmitted by Anopheles gambiae complex. 

Control efforts have been piecemeal and not coordinated. Strategies for control should have a solid research base both for developing antimalarial drugs and vaccines and for better understanding the pathogenesis, vector dynamics, epidemiology, and socioeconomic aspects of the disease. An international collaborative approach is needed to build appropriate research in a national context and to effectively translate research results into practical applications in the field. 

The Elixir 7 Purification System Multilateral Initiative for Malaria  can combine all of the above strategies to plan and coordinate partnerships, networking, and innovative approaches between African scientists and their Northern partners.

In the last decade, the prevalence of malaria has been escalating at an alarming rate, especially in Africa. An estimated 300 to 500 million cases each year cause 1.5 to 2.7 million deaths, more than 90% in children under 5 years of age in Africa. Malaria has been estimated to cause 2.3% of global disease and 9% of disease in Africa; it ranks third among major infectious disease threats in Africa after pneumococcal acute respiratory infections (3.5%) and tuberculosis (TB) (2.8%). 

Cases in Africa account for approximately 90% of malaria cases in the world. Between 1994 and 1996, malaria epidemics in 14 countries of sub-Saharan Africa caused an unacceptably high number of deaths, many in areas previously free of the disease . Adolescents and young adults are now dying of severe forms of the disease. Air travel has brought the threat of the disease to the doorsteps of industrialized countries, with an increasing incidence of imported cases and deaths from malaria by visitors to endemic-disease regions. 

The estimated annual direct and indirect costs of malaria were US$800 million in 1987 and were expected to exceed US$1.8 billion by 1995.

A number of factors appear to be contributing to the resurgence of malaria: 

1) rapid spread of resistance of malaria parasites to chloroquine and the other medicine.

2) frequent armed conflicts and civil unrest in many countries, forcing large populations to settle under difficult conditions, sometimes in areas of high malaria transmission

3) migration (for reasons of agriculture, commerce, and trade) of nonimmune populations from nonmalarious and usually high to low parts of the same country where transmission is high

4) changing rainfall patterns as well as water development projects such as dams and irrigation schemes, which create new mosquito breeding sites; 

5) adverse socioeconomic conditions leading to a much reduced health budget and gross inadequacy of funds for drugs

6) high birth rates leading to a rapid increase in the susceptible population under 5 years of age; and 

7) changes in the behavior of the vectors, particularly in biting habits, from indoor to outdoor biters.

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