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Bull World Health Organ. 1998;76(1):33-45.

Malaria in the African highlands: past, present and future.

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1
Department of Biological Sciences, University of Durham, England.

Abstract

Many of the first European settlers in Africa sought refuge from the heat and diseases of the plains by moving to the cool and salubrious highlands. Although many of the highlands were originally malaria free, there has been a progressive rise in the incidence of the disease over the last 50 years, largely as a consequence of agroforestry development, and it has been exacerbated by scarce health resources. In these areas of fringe transmission where the malaria pattern is unstable, epidemics may be precipitated by relatively subtle climatic changes. Since there is little immunity against the disease in these communities, outbreaks can be devastating, resulting in a substantial increase in morbidity and death among both children and adults. We present here the results obtained using a mathematical model designed to identify these epidemic-prone regions in the African highlands and the differences expected to occur as a result of projected global climate change. These highlands should be recognized as an area of special concern. We further recommend that a regional modelling approach should be adopted to assess the extent and severity of this problem and help improve disease surveillance and the quality of health care delivered in this unstable ecosystem.

PIP:

This article explores the past, present and future trends of malaria in the African highlands. Over the last 50 years, there has been a progressive increase in the incidence of malaria in the region, particularly in the highlands. This trend is brought primarily as a consequence of agroforestry development and the scarcity of health resources. In these areas of fringe transmission where malaria pattern is unstable, outbreaks may be precipitated by certain climate and biological factors that favors the growth and development of mosquito vector and parasite. Since there is little immunity against the disease in these communities, epidemics can be devastating, resulting in a significant rise in morbidity and mortality among children and adults. This paper outlines the results using a mathematical model designed to determine epidemic-prone regions in the African highlands and the differences that are expected to occur as a product of projected global climate change. These communities should be recognized as an area of special attention. A regional modeling approach is recommended to examine the extent of severity of the problem and to improve disease surveillance and the quality of health care services.

PMID:
9615495
PMCID:
PMC2305628
[Indexed for MEDLINE]
Free PMC Article
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