Malaria and children: Progress in intervention coverage - Unicef

5
The global burden
of malaria
Section
Malaria and children
1
An estimated 3 billion people,
almost half of the world’s
population, live in areas
where malaria transmission
occurs. 1 Malaria is endemic in
107 countries and territories
in tropical and subtropical
regions, but there are substantial
geographic disparities
in the disease burden. Sub-
Saharan Africa is the hardest
hit region (map 2).
Warm, humid climates provide ideal conditions
for mosquitoes to develop and
survive. Furthermore, regions with high
average temperatures support the development
of the malaria parasite in mosquitoes.
And the areas where malaria flourishes
often lack resources for adequate malaria
control (see Background on malaria).
mortality. Malaria contributes to child
malnutrition, an underlying cause in
more than half of deaths among children
under age five globally. Although the precise
causal links are unclear, nutritional
status is affected by vomiting and appetite
suppression during bouts of malaria and
by malaria-related anaemia. 4
In addition, the overlap between malaria
and HIV infection in sub- Saharan Africa
should be considered when designing prevention
and treatment programmes for
those most affected by malaria (box 1).
Some 50 million pregnant women a
year are exposed to malaria—at least
60 per cent of them in Africa. 5 Studies
in sub- Saharan Africa indicate that
25 per cent of deliveries in areas of stable
transmission show evidence of Plasmodium
falciparum malaria infection in the
placenta. 6 In malaria-endemic areas up
to 25 per cent of severe maternal anaemia
cases are attributable to malaria, as
are nearly 20 per cent of low-birthweight
babies. 7
The global burden of malaria
The human toll of malaria is staggering.
Between 350 million and 500 million episodes
of clinical malaria occur each year,
leading to an estimated 1 million deaths, 2
most in sub- Saharan Africa and among
children under age five. Indeed, malaria
is one of the leading killers of children
under age five, accounting for almost 1
death in 10 (8 per cent) worldwide—and
nearly 1 death in 5 (18 per cent) in sub-
Saharan Africa (figure 4). 3
These figures do not take into account
malaria’s indirect impact on child
While sub- Saharan Africa is the region
hardest hit, malaria is an important issue
in other regions as well. For example, East
Asia and the Pacific countries have the
highest rates of drug resistance, which has
contributed to the resurgence of malaria
in many areas, particularly along international
borders. Central Asia has seen a
recent resurgence in P. vivax malaria, and
as a result many countries are strengthening
surveillance systems and expanding
vector control measures. Malaria
transmission in Latin America and the
Caribbean occurs mainly in countries