World Malaria Report shows disease burden declining
Geneva: Eleven African countries have halved their confirmed malaria cases or admissions and deaths over the past decade. More decreases of at least 50% of confirmed malaria cases were also recorded in 32 of the 56 malaria-endemic countries outside Africa during this time.
These were some of the statistics provided at the launch of the World Health Organization's annual World Malaria Report. Director-General Dr Margaret Chan said, "The results set out in this report are the best seen in decades. After so many years of deterioration and stagnation in the malaria situation, countries and their development partners are now on the offensive. Current strategies work."
These strategies continue to evolve. Prevention methods include insecticide-treated mosquito nets (ITNs) for people to sleep under, and spraying the walls of houses with insecticides. Medications called artemisinin-combination therapy are much more effective than older medications to which the parasites have developed resistance.
Earlier this year, WHO recommended that all suspected cases of malaria be confirmed by a diagnostic test before antimalarial drugs are administered. This was more difficult in the past for the millions of people living in remote communities who did not have access to health facilities where tests could be conducted. TDR, working in partnership with WHO, the Foundation for Innovative New Diagnostics (FIND), the US Centers for Disease Control and Prevention (CDC) and others, has tested a range of rapid diagnostics that can be used in field conditions without the need for electricity and which provide results in less than 20 minutes. Results were published for the first time in 2009 and are now done every year so that purchasers can identify which tests work in which countries and settings.
Malaria used to be considered the main illness causing fever and medication was prescribed without a diagnostic test. But as the number of malaria cases go down, this is no longer the case. Inexpensive, quality-assured rapid diagnostic tests are now available that can be used by all health care workers, including trained community volunteers, as shown by TDR-supported research. Use of these tests also ensures that the right medication gets to the patient, and cuts down on over-prescribing antimalarials guarding against the spread of resistance to these medicines.
Recent TDR studies in Burkina Faso and Ghana have shown that rapid diagnostic tests lead to more efficient drug use.
The proportion of reported cases in Africa confirmed with a diagnostic test has risen substantially from less than 5% at the beginning of the decade to approximately 35% in 2009, but low rates persist in the majority of African countries and in a minority of countries in other regions. TDR research continues to help find ways to expand the use of the tests in all areas where they are needed.