Malaria deaths: twice what we thought

In the book we suggest that deaths from malaria, mainly from Plasmodium falciparum infection, could be far greater than those recorded by the World Health Organisation (WHO), due to the recording methods used and the large errors inherent in estimating deaths from sometimes limited data. In the lecture in January I suggested that actual deaths from malaria may well be twice that recorded by WHO.  Now, in a paper published today in The Lancet (details below) a team from the Institute for Health Metrics and Evaluation, University of Washington, Seattle, USA present an analysis of malaria mortality over the last 30 years, and indeed suggest that the world-wide death toll from malaria in 2010 was 1.24 million, around twice the figure of 655,000 estimated by the WHO in their World Malaria Report 2011.

Of course, this figure is also only an estimate, and the methods used are likely to come under intense scrutiny in the coming months, but the data in this paper does lead to a number of important conclusions.

  1.  Global malaria deaths increased from 995,000 in 1980 to a peak of 1,817,000 in 2004, and have fallen since to 1.24 million in 2010.  This almost doubling of the death rate over 24 years gives stark confirmation of the scale of the collapse in efforts to eradicate the disease and the increasing resistance of the plasmodium to drugs and the vector mosquitoes to pesticides.  More positively, it also demonstrates the great progress that has been made in the last few years, with the widespread use of bed nets, artemisinin-based treatments etc.  But it should be realised here that these were both available in 1980, yet it took over 20 years for them to be fully utilised.
  2. Malaria deaths in those over 5 years old in 2010 was much higher than previously thought: 524,000 deaths compared to 91,000 estimated by WHO.  Current trials of vaccines are aimed at the under-fives, and bed nets are also being targeted at this age group. Greater consideration must now be given to older members of at-risk populations, who outside of sub-Saharan Africa make up over two-thirds of the deaths from malaria, and make up approximately 40% of deaths even within this region.  This emphasises even more the economic burden of malaria in afflicted countries.
  3. Malaria accounts for many more child deaths in sub-Saharan Africa than previously thought: estimated at 24% of total child deaths compared to 16% previously calculated in 2008.

Murray, CJL, Rosenfeld, LC, Lim, SS, et al. (2012)  Global malaria mortality between 1980 and 2010: a systematic analysis.  The Lancet 379, 413-431.  This paper is available electronically through our library for those who are registered, and for students registered on Exploiters and Exploited I have placed a link to it on Blackboard.

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