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The burden of malaria in Africa.


 Malaria remains one of the most serious public health problems in Africa, causing high morbidity and mortality. In highly endemic areas, malaria is responsible for about 30-50% of fever cases, 30% of outpatient consultations, and 10-15% of hospital admissions. Globally, about 1.5-2.7 million persons die from malaria yearly. Children under 5 years and pregnant women are the most vulnerable groups. Anaemia is one of the most serious consequences of malaria in young children in Africa, particularly in the countries where a high level of chloroquine resistance exists. In some zones, the temporary decline in transmissions due to climatic and ecological changes has altered the immunological profile of the population, resulting in serious outbreaks of epidemics accompanied by high morbidity and mortality. The African region has been experiencing malaria epidemics, with an unacceptably high disease burden and high mortality in the epidemic-prone areas in East and Southern Africa. In Botswana, for example, the incidence of malaria increased by 13.5 times in the Nata clinic during the 10th week of 1996, compared with the same period in 1995. WHO provided technical support and antimalarial drugs to the countries affected by these epidemics. This was followed by two workshops on epidemic prevention and control. The problem of drug resistance, which has been present in Africa for over 17 years, is more intense in East Africa. The approach of WHO/AFRO to this problem is to build capacities, within the health ministries of member countries, for antimalarial drug sensitivity testing and rational drug policies. In addition, WHO has developed a simple therapeutic efficacy test. It is proposed that this method be used by all countries of the region. This will make it easy to compare data and create a regional sensitivity picture.
