Malaria: deaths amongst children in Africa

In 2010, World Health Organizations officials said that 219 million cases of malaria and 660,000 malaria-related deaths were reported globally. Statistic showed that 90% of malaria deaths were among children in Africa age 5 and younger. And about 3.3 billion people – half of the world’s population – are at risk of malaria. People living in the poorest countries like Africa are the most exposed and susceptible to malaria.
Increased prevention and control measures have led to a reduction in malaria mortality rates by more than 25% globally since 2000 and by 33% in the WHO African Region.

“Although these data are encouraging, these countries account for a mere fraction of the world’s malaria burden, which is concentrated in 14 other countries where 80 percent of malaria-related deaths occur,” Hall and Fauci said in a statement. “While wider provision of proven malaria prevention and control interventions has had a significant impact in curbing the number of new malaria cases, particularly in countries with high transmission rates, much more must be done to rid the world of this scourge.”

Malaria infection during pregnancy is linked with severe anemia and other disease and ailment in the mother and a factor to low birth weight among newborn infants — one of the leading risk factors for infant mortality and sub-optimal growth and development.

Recent reports indicate that malaria in infants under six months of age may not be unusual, although statistics on prevalence and outcome are still opposing. Prevalence of infection can vary between 0% and 27%, while the percentage of deaths attributed to malaria (as determined by verbal autopsy) may be between 20.1% and 46.2%. The occurrence of infection in utero is also reflected by the prevalence of splenomegaly at one month of age, which can be as high as 80%, signifying an early growth of a splenic response to the infection.

Malaria in infants is categorized according to the time of infection. Congenital malaria, defined as asexual parasites detected in the cord blood or in the peripheral blood during the first week of life, is due to the spreading from the mother through the placenta just before or during delivery, while neonatal malaria, which can take place within the first 28 days of life, is due to an infective mosquito bite after birth. Differentiating between congenital and acquired neonatal malaria can be difficult, especially in areas of intense malaria transmission. Several studies across Africa have showed that 7–10% of newborns may have malaria parasites in their cord blood, in some cases either without evidence of an active maternal infection or with parasite genotypes different to those found in the mother. This suggests transplacental passage of parasites followed by clearance from maternal and placental blood, with persistence in the fetus.

As spreading power increased and seasonality decreased, severe cases became more recurrent in the younger ages. Nonetheless, wherever a comparison between age groups was likely, malaria mortality was higher in younger children, with the peak age shifting towards infants as transmission became more extreme.

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