World Malaria Report shows malaria decreasing
New progress at the community level with diagnostics and treatment
The annual report developed by the World Health Organization (WHO) and released on 13 December shows clear progress in the fight against malaria and a decline in estimated malaria cases and deaths. The 2010 data provides the following snapshot:
- Malaria mortality rates have fallen by more than 25% since 2000, with the largest percentage reductions seen in the European (99%), American (55%) and Western Pacific (42%) and African Regions (33%).
- Out of 99 countries with ongoing malaria transmission, 43 recorded decreases of more than 50% in the number of malaria cases between 2000 and 2010. Another 8 countries recorded decreases of more than 25%.
These improvements have come about through increased distribution and use of insecticide-treated bednets, artemisinin-combination therapy, and preventive treatments for pregnant women and children.
TDR has provided research evidence into two key growing areas mentioned in this report. The first is in the use of rapid diagnostic tests and the second is the development of a strategy for integrated diagnosis and treatment of malaria, pneumonia and diarrhoea by community health workers.
In diagnostic testing, WHO recommends that all suspected cases be tested before any treatment. Many rapid tests have been developed and marketed to meet the needs of people who live far from health centres and traditional parasitological testing – the number supplied by manufacturers almost doubled from 2008 (45 million to 88 million).
TDR has worked with WHO’s Global Malaria Programme, the Foundation for Innovative New Diagnostics, and the United States Centers for Disease Control and Prevention to regularly evaluate and report the results of these marketed tests. Product testing helps buyers, like national governments, choose which products to purchase. Tens of millions of tests are sold annually, so it is a major incentive to manufacturers to meet the international performance recommendations based on the results of this evaluation programme.
In the area of increasing community access to treatments, TDR studies have shown that trained community health volunteers in remote, rural areas can conduct the rapid tests and treat effectively. New studies have expanded this concept to test whether the community health workers can also manage the diagnosis and treatment of pneumonia, since both pneumonia and malaria cause fever. This new strategy is called integrated community case management of childhood illness (iCCM).
The World Malaria Report says the early implementation is encouraging, and calls for the use of diagnosis and treatment at the community level where there is limited health facility access. An inter-agency iCCM task force has recently been established with the participation of international partners including WHO, UNICEF and USAID, NGOs (Save the Children, BASICS, International Rescue Committee) and research institutions (Karolinksa Institute, Boston University, University of Dakar, and TDR). More information on iCCM and programme support tools can be found at the task force web site: www.ccmcentral.com.
For more information on rapid diagnostic testing, contact Dr Jane Cunningham.
For more information on integrated community case management of childhood illness, contact Dr Franco Pagnoni.