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

• Published in: Tropical medicine & international health Vol. 13; no. 6; pp. 771 - 783
• Main Authors: Roca-Feltrer, Arantxa, Carneiro, Ilona, Armstrong Schellenberg, Joanna R.M
• Format: Journal Article
• Language: English
• Published: Oxford, UK Oxford, UK : Blackwell Publishing Ltd 01.06.2008; Blackwell Publishing Ltd; Blackwell Science
• Subjects: Africa South of the Sahara - epidemiology; Afrique subsaharienne; Anemia - epidemiology; Anemia - parasitology; Biological and medical sciences; child health; Child, Preschool; epidemiology; epidemiología; Female; General aspects; Human protozoal diseases; Humans; Infant; Infant, Newborn; Infectious diseases; Malaria; Malaria - complications; Malaria - epidemiology; Malaria - parasitology; Malaria, Cerebral - epidemiology; Malaria, Cerebral - parasitology; Male; Medical research; Medical sciences; Morbidity; morbidité; morbilidad; Parasitic diseases; Preschool children; Protozoal diseases; Regression analysis; Respiration Disorders - epidemiology; Respiration Disorders - parasitology; salud infantil; santé infantile; sub‐Saharan Africa; África sub‐Sahariana; épidémiologie; Sub-Saharan Africa; Africa; Africa South of the Sahara; Human; Protozoal disease; Malaria; Estimation; Parasitosis; child health; Epidemiology; Morbidity; Infection; sub-Saharan Africa; Tropical medicine; Child; Age; Public health
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/j.1365-3156.2008.02076.x

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. 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. 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). 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.