Deadliest forms of malaria could be eliminated
Friday October 29th, 2010
The deadliest forms of malaria could be eliminated in 15 years, experts say today.
Using mathematical models and maps, Professor David Smith and Andrew Tatem, of the University of Florida’s geography department, and the Emerging Pathogens Institute and Center for African Studies looked to estimate the feasibility of eliminating the deadliest forms of the disease.
Their
study is one of three that feature in the November edition of the Lancet
Malaria Elimination Series.
Professor Smith said data suggested that Plasmodium falciparum malaria, the deadliest parasite, could be eliminated in most parts of the world in ten to 15 years, including most areas in Asia and the Americas, if transmission could be reduced by 90 per cent from 2007 rates.
The analysis by Tatem and Smith may give the public health community a tool to most effectively allocate financial and technical support for regions whose citizens suffer with the disease.
Their study also showed that Latin America was in best position to eliminate malaria while it is least probable in sub-Saharan Africa.
The 108 countries that have eliminated malaria to date had several things in common, including malaria originally of low risk and relatively low levels of incoming population movements from countries with endemic malaria.
Other factors that have contributed to elimination have been political stability, good general health systems, absence of conflict and populations at risk that are easily accessible. Many countries currently burdened with malaria are missing some or all of these factors.
They have assembled data collected across the world into a single database and combined it with statistical and mathematical models to map the P. falciparum transmission reductions required to achieve elimination.
"In general, elimination from countries in the Americas is most feasible using current tools, and least feasible for most sub-Saharan African countries,” they write.
“However, forest and fringe malaria dominates in the Americas, and the elimination of malaria in the continent overall will depend heavily on the feasibility of elimination in the Amazon basin."
Political instability and relatively weak health systems mean that Pakistan and Afghanistan currently appear to be less likely to succeed with elimination than other endemic Asian countries.
A third paper, by Dr Bruno Moonen, of The Clinton Health Access Initiative, Nairobi, Kenya, and Professor Geoffrey Targett, London School of Hygiene and Tropical Medicine, UK, and colleagues, addresses operational strategies to achieve and maintain malaria elimination.
Modern population movements mean many people infected with malaria will cross borders in the absence of a global eradication campaign, they write.
Despite this a combination of initiatives have meant that Zambia, Ethiopia, Rwanda, Eritrea, Zanzibar and Senegal have achieved remarkable declines in malaria disease and mortality, where the disease was a major life-threatening infection, they say.
The authors stress however, that even in countries that have successfully controlled malaria, the next stage might need further scale-up of interventions such as insecticide-treated bednets, indoor residual spraying, and will always require a more rapid detection and diagnosis of malaria infections and treatment with appropriate drugs.
Tags: Africa | Asia | World Health
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