malaria still an emergency in Africa

Despite advances in treating malaria, the devastating disease still exacts a heavy toll in Africa, studies showed today, calling for greater investment in public health infrastructure. In a  special issue spotlighting malaria and the efforts to curb it, the Journal of the American Medical Association (JAMA) said "there likely will be a role for vaccine development in disease prevention".

But for now, "new drugs appear to be few and far between," JAMA said in its report, noting malaria remains a leading cause of morbidity and mortality worldwide, claiming more than one million lives every year.

The mosquito-borne illness is the number one cause of death in children under the age of five, causing one death every 30 seconds.

Dr Catherine DeAngelis, editor in chief of JAMA, said the findings point to the need for a wider, but more targeted use of antimalarial medicine.

"The articles in this issue of JAMA highlight the need for improved public health infrastructures and to make the current standard of care more widely available," she said in an editorial.

But sometimes the drugs are also over-prescribed, JAMA wrote, because the diagnosis of malaria is arrived at too often.

With some of the most effective drugs to combat the disease being prohibitively expensive, there was now a greater push to avoid misdiagnoses, JAMA reported, particularly with respect to effective but expensive combination therapies.

Greater efforts must also be made to eradicate mosquitoes, the vector for the dreaded ailment, which does not even spare parts of the developed world, she said.

"Even in the United States, where endemic malaria has been eradicated for decades, an average of 1200 cases are reported annually," Dr DeAngelis wrote in an editorial.

The articles addressed a number of issues, including the financial and logistic challenges of implementing new technologies to combat the disease; improvement in understanding the risk factors, particularly in children; and combatting ever more resistant strains of malaria.

Interestingly, most of the suggestions were tried and true methods to combat the disease   that have been followed for years.

"Few submitted manuscripts for this theme issue on malaria evaluated completely novel approaches to the management of this ancient disease," Dr DeAngelis wrote.

One of the most reliable and effective ways to combat the disease is via the use of insectide-treated netting, which the JAMA research showed was available in far too few affected places.

A study on how many insecticide-treated nets were available in at-risk African households,  and how many were needed to protect young children and pregnant women in 43 sub-Saharan African countries, found that on average only 6.7 per cent of homes possessed such nets.

Researchers have set the ambitious goal of cutting mortality from the disease in half by 2010.

"Continued research into malaria diagnostics, optimal antimalarial regimens, sustainable  methods of drug delivery, and integration of treatment with prevention strategies will be necessary to establish effective and sustainable malaria control policies," in Africa, said University of California's Dr Grant Dorsey, one of the lead authors of the JAMA studies.

Source: The Australian
Date: 23 May 2007