Malaria

The problem, the consequences, and rapid testing solutions

Malaria is a preventable and treatable infectious disease transmitted by mosquitoes that kills more than one million people each year, most of them in sub-Saharan Africa, where malaria is the leading cause of death for children under five.

Because malaria is a global crisis that affects mostly poor women and children, malaria perpetuates a vicious cycle of poverty in the developing world. Malaria related-illnesses and mortality cost Africa’s economy alone USD 12 billion per year.¹

The Problem

With the distribution of more than 290 million mosquito nets in Africa between 2008 and 2010, significant progress was made towards achieving the target of universal bed net coverage for at-risk population groups. Indoor residual spraying, another highly cost-effective control intervention, has also been significantly scaled up, helping to cut malaria cases and deaths in high-transmission areas. At the same time, however, the scale-up of diagnostic testing, treatment and surveillance has not received the same degree of attention.²

In the past, fever was equated with malaria in many endemic countries. However, recent control efforts have significantly reduced the malaria burden – even in high transmission areas of Africa. In these countries, most fever episodes seen at health facility or community level may be therefore no longer due to malaria. The commonest cause of fever in malaria-negative children is a viral infection.³ It has become clear that continued presumptive treatment of malaria would lead to both drug wastage and under-treatment of other febrile illnesses.²

The Consequences

While achieving universal access to malaria diagnostic testing will not be easy, some countries have already shown that is can be done. In Senegal, following the introduction of malaria rapid diagnostic tests (RDTs) in 2007, malaria diagnostic testing rates rose rapidly from 4% to 86% (by 2009); the prescription of ACT dropped throughout this period from 73% of malaria-like febrile illness to 32%, reaching close equivalence to confirmed malaria (30% of 585,000 suspected fever cases).