Malaria Epidemics in Africa: Prediction, Detection and Response

Malaria kills at least one million people worldwide every year and 80% of the deaths occur in Africa south of the Sahara (RBM et al. 2005). According to a new estimate using a combination of epidemiological, geographical and demographic data, there were 515 million clinical episodes of Plasmodium falciparum malaria (range 300 million—660 million) in the year 2002, 50% more than those reported by the World Health Organization (WHO) (Snow et al. 2005). Malaria has become a major obstacle to economic growth in endemic developing countries (Gallup and Sachs 2001). In most endemic countries, there are inadequate human, logistics and financial resources and poor infrastructure to deal with the malaria problem. The Abuja Declaration issued by African Leaders in 2000 set a goal for the Roll Back Malaria (RBM) initiative to reduce malaria-related mortality in Africa by half by the year 2010, calling on governments, international organizations and communities to intensify the fight against this deadly disease (RBM 2000). To achieve this goal, it was recommended to significantly increase access to prompt and effective treatment and insecticidetreated nets (ITNs) by those most at risk, and to intermittent preventive treatment (IPT) for pregnant women. Whether this ambitious goal will be realized is yet to be seen but there is a renewed international effort mainly through the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) to alleviate the problem of malaria in many countries (WHO/UNICEF 2003). Resistance to antimalarial drugs such as chloroquine and sulfadoxinepyrimethamine (SP) is a major problem in providing effective treatment in Africa. As a result, several African countries had changed their national drug policy and adopted the more effective artemisinin-based combination therapy (ACT) (RBM et al. 2005). However, the universal implementation of this policy is still at its early stages largely due to the imperative cost of these drugs which is about 10 times that of the traditional drugs. ITN distribution has increased, but the coverage is still very low in many countries. Many countries have also started implementing IPT for pregnant women (RBM et al. 2005)