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Published on: May 12, 2022
Prevention and treatment of malaria in young African children
1Roll Back Malaria Department, World Health Organization, 1211 Geneva 27, Switzerland. crawleyj@who.int
Insights
Malaria poses a significant global health threat, especially to African children. Enhancing prevention and control strategies, including insecticide-treated nets and intermittent preventive treatment, is crucial for reducing malaria-related deaths.
Area of Science:
- Global Health
- Infectious Diseases
- Parasitology
Background:
- Malaria, caused by Plasmodium falciparum, disproportionately affects African children, often presenting as flu-like illness but progressing rapidly to severe disease.
- Drug resistance and diagnostic challenges complicate malaria control, particularly in resource-limited rural settings.
- Key drivers of mortality in young African children include severe malaria episodes, anemia from repeated infections, and pregnancy-related low birth weight.
Purpose of the Study:
- To review current and improved prevention and control strategies for malaria.
- To highlight the challenges in malaria diagnosis and treatment, especially for vulnerable populations.
- To emphasize the opportunity for disease burden reduction through increased coverage and research.
Main Methods:
- Review of existing literature on malaria prevention and control strategies.
- Analysis of factors contributing to malaria morbidity and mortality.
- Discussion of challenges posed by drug resistance and access to healthcare.
Main Results:
- Despite available effective interventions like insecticide-treated nets (ITNs) and Intermittent Preventive Treatment (IPTp), coverage remains low in high-burden areas.
- Significant global commitment and investment are increasing for malaria control and research.
- There is a unique opportunity to substantially decrease the global malaria burden in the coming decade.
Conclusions:
- Targeted prevention and control strategies are essential to address specific clinical syndromes of malaria.
- Increased coverage of proven interventions (ITNs, IPTp) among vulnerable populations is critical.
- Renewed investment in research for vaccines, drugs, and insecticides offers a path to significantly reduce malaria's impact.
Abstract:
Malaria remains a major challenge to global public health, with morbidity and mortality rates being highest in African children infected with Plasmodium falciparum . All four species of human malaria may initially present as a nonspecific flu-like illness, whereas P. falciparum infection in nonimmune young children has a tendency to progress rapidly to life-threatening illness. These factors, together with the increasing emergence of multi-drug resistance, pose substantial challenges to current efforts to provide prompt and accurate diagnosis and effective treatment, particularly to the rural poor who are most affected by malaria. Acute episodes of severe malaria, repeated malaria infections leading to severe anemia, and infection during pregnancy which predisposes to low birth weight, a major risk factor for neonatal death, account for the majority of malaria-related deaths in young African children. Improved prevention and control strategies targeted at each of these clinical syndromes have been developed and are reviewed in this article. Coverage of protective measures of known safety and efficacy (insecticide-treated nets, Intermittent Preventive Treatment) remains alarmingly low in most high-burden areas. The growing global commitment to rapidly increase and sustain coverage among the most vulnerable populations, along with renewed investment in research to hasten the development of effective vaccines, antimalarial drugs, and insecticides, provides a unique opportunity to markedly reduce the burden of disease during the current decade.
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