Estimates of the burden of malaria morbidity in Africa in children under the age of 5 years

Trop Med Int Health. 2008 Jun;13(6):771-83. doi: 10.1111/j.1365-3156.2008.02076.x. Epub 2008 Mar 24.

Abstract

Objective: To estimate the direct burden of malaria among children younger than 5 years in sub-Saharan Africa (SSA) for the year 2000, as part of a wider initiative on burden estimates.

Methods: A systematic literature review was undertaken in June 2003. Severe malaria outcomes (cerebral malaria, severe malarial anaemia and respiratory distress) and non-severe malaria data were abstracted separately, together with information on the characteristics of each study and its population. Population characteristics were also collated at a national level. A meta-regression model was used to predict the incidence of malaria fevers at a national level. For severe outcomes, results were presented as median rates as data were too sparse for modelling.

Results: For the year 2000, an estimated 545,000 (uncertainty interval: 105,000-1,750,000) children under the age of 5 in SSA experienced an episode of severe malaria for which they were admitted to hospital. A total of 24,000 (interquartile range: 12,000-37,000) suffered from persistent neurological deficits as a result of cerebral malaria. The number of malaria fevers associated with high parasite density in under-5s in SSA in 2000 was estimated as 115,750,000 (uncertainty interval: 91,243,000-257,957,000).

Conclusion: Our study predicts a lower burden than previous estimates of under-5 malaria morbidity in SSA. As there is a lack of suitable data to enable comprehensive estimates of annual malaria incidence, we describe the information needed to improve the validity of future estimates.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Africa South of the Sahara / epidemiology
  • Anemia / epidemiology
  • Anemia / parasitology
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Malaria / complications
  • Malaria / epidemiology*
  • Malaria / parasitology
  • Malaria, Cerebral / epidemiology
  • Malaria, Cerebral / parasitology
  • Male
  • Morbidity
  • Respiration Disorders / epidemiology
  • Respiration Disorders / parasitology