Analytical summary - Malaria
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The greatest disease burden from malaria occurs in the WHO African Region, where 89% of all malaria deaths worldwide took place in 2008. Over the past 20 years, malaria has been rising in importance on the public health agenda, following a number of high-level measures at national and international level.
The most commonly used intervention policies and strategies for prevention and treatment include use of:
- insecticide-treated nets for vector control
- indoor residual spraying
- intermittent preventive treatment of malaria in pregnancy
- artemisinin-based combination therapy.
While use of insecticide-treated mosquito nets is cost effective and uptake is increasing, use by children and pregnant women is less than the 80% target established by the World Health Assembly.
Indoor residual spraying has increased rapidly since 2005, protecting up to 59 million people in 20 countries. Twenty countries are now implementing malaria control and intermittent preventive treatment in pregnancy on a countrywide basis, and artemisinin-based control therapy has been identified as the treatment of choice in 42 of 43 countries.
However, despite advances in procuring this treatment, only 16% of children with malaria are to date treated with it. Use of artemisinin monotherapy continues, with risks of emerging resistance to artemisinin combination therapy. Overdiagnosis and overtreatment are long-term problems, with up to 96% of febrile patients receiving malaria treatment without parasitological diagnosis.
Financial flow to address malaria control has greatly increased due to the higher international profile of the disease. However, better surveillance and reporting are needed to reduce reliance on estimates from modelling and to track effectiveness of interventions.