NLM Director’s Comments Transcript
Malaria Deaths Underestimated: 03/12/2012

Greetings from the National Library of Medicine and MedlinePlus.gov
Regards to all our listeners!
I'm Rob Logan, Ph.D. senior staff National Library of Medicine for Donald Lindberg, M.D, the Director of the U.S. National Library of Medicine.
Here is what's new this week in MedlinePlus.

Annual global malaria deaths are twice earlier estimates and mortality rates among persons after age five are significantly higher than previously projected, suggests a systematic analysis recently published in The Lancet.
A new predictive model (based on parasite prevalence, published and unpublished verbal autopsy reports, as well as estimates of malaria transmission intensity) finds about 1.24 million persons died from malaria in 2010. Among them, about 524,000 persons (or 42 percent of malaria deaths in 2010) were estimated to occur among children and adults — age five and older. The study’s 10 authors (mostly from the University of Washington) estimated the number and age range of annual malaria deaths from 1980 to 2010.
In contrast, the World Health Organization (WHO) previously estimated about 655,000 persons died from malaria in 2010. Among them, the WHO estimated only about 91,000 persons (or 14 percent) age five and older died from malaria. Prior to the current study, the WHO’s malaria mortality estimates were thought to provide the most reliable indicator of deaths and their age distribution, explains an accompanying editorial in The Lancet.
Unlike the WHO’s estimates that are based on case reports provided by individual nations, the current study’s authors note their significantly higher mortality findings are derived from comprehensive statistical modeling. MedlinePlus.gov’s malaria health topic page explains malaria is spread by infected mosquitos and mostly occurs in developing nations with warmer weather. As a result, the WHO’s estimates sometimes may be derived from nations without a sophisticated public health infrastructure to monitor mortality rates.
In an exchange of emails with ‘Director’s Comments,’ global health consultant Julia Royall says she is not surprised by the current study’s high malaria mortality estimates, or the higher than anticipated number of malaria deaths among older children and adults. Royall, a former NLM colleague, notes public health officials and health care providers in developing nations frequently discuss the reliability of the estimates for malaria as well as other infectious diseases.
Royall notes the current study additionally provides an opportunity to reassess how malaria deaths and cases are distributed among infants, children, teens, and adults. She adds the study’s higher estimates are significant because future levels of international funding may be linked to malaria’s increased prevalence and age distribution.
Royall, who helped build a pioneering, comprehensive malaria information network for African medical and public health professionals, notes the findings suggest a pressing need to enhance health information tracking systems in developing nations.
More positively, both Royall and The Lancet’s accompanying editorial add the current study reports a recent decline in malaria deaths, which is attributed to enhanced treatment facilities, better drug therapy, and more accessible medications.
Similar to The Lancet editorial, Royall hopes the study’s estimated higher malaria death rates (and we quote): ‘may well spur on more research and invention… which will help us get good or better numbers’ (end of quote).
MedlinePlus.gov’s malaria health topic page adds malaria’s symptoms include chills, flu-like symptoms, fever, and diarrhea. Malaria can be treated with medications; it can be prevented by sleeping under mosquito netting, covering up when outside, and wearing insect repellent with DEET. Fittingly, Royall’s current efforts include prevention campaigns in Africa that educate persons to minimize malaria exposure and where to find nearby treatment.
Some information about malaria’s prevalence (provided by the U.S. Centers for Disease Controls and Prevention) is available within the ‘statistics’ section of MedlinePlus.gov’s malaria health topic page. Some malaria information from the WHO is available within the ‘organizations’ section of MedlinePlus.gov’s malaria health topic page.
A helpful interactive tutorial about malaria (that covers risks, prevention, and treatment) is available in the ‘tutorials’ section of MedlinePlus.gov’s malaria health topic page. A review of medications for malaria is available in the ‘prevention/screening’ section.
MedlinePlus.gov’s malaria health topic page also contains links to the latest pertinent journal research articles, which are available in the ‘journal articles’ section. Links to related clinical trials around the world are available in the ‘clinical trials’ section. From the malaria health topic page, you can sign up to receive email updates with links to new information as it becomes available on MedlinePlus.
To find MedlinePlus.gov’s malaria health topic page, please type ‘malaria’ that’s ‘m…a…l…a…r…i…a’ in the search box on MedlinePlus.gov’s home page, then, click on ‘malaria” (National Library of Medicine).’
Other related health topic pages within MedlinePlus.gov include: insect bites and stings, parasitic disease, infections, and traveler’s health.
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