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January 17, 1996, Vol 275, No. 3 >
ARTICLE | January 17, 1996

Malaria, the Submerged Disease FREE

Piero Olliaro, MD, PhD; Jacqueline Cattani, PhD, MPH; Dyann Wirth, PhD
[+] Author Affiliations

Reprint requests to Steering Committee on Drugs for Malaria (CHEMAL), UNDP/World Bank/World Health Organization Special Programme for Research and Training in Tropical Diseases, 20 ave Appia, 1211 Geneva 27, Switzerland (Dr Olliaro).


JAMA. 1996;275(3):230-233. doi:10.1001/jama.1996.03530270070034
Text Size: A A A
Published online
Article
References

MALARIA is one of the major infectious diseases in the world today despite years of efforts first to eradicate it and subsequently to reduce its impact on mortality and morbidity. Plasmodium falciparum, the most virulent of the four human Plasmodium species causing malaria, is potentially life-threatening, increasing in prevalence and becoming even more resistant to in-use drugs.

The World Health Organization (WHO) estimates that there are 300 million to 500 million people infected with malaria.1 The Global Burden of Disease study, used as an input into the World Bank's 1993 World Development Report,2 estimated 805 300 deaths due to malaria in sub-Saharan Africa in 1990, compared with 887100 for diarrheal disease, 1 028 800 for all respiratory infections, and 472 000 for measles.3 The true impact of malaria on mortality is likely to be underestimated in these figures, since a randomized trial of the use of insecticide-impregnated

REFERENCES

1 +
World Health Organization. Control of Tropical Diseases (CTD): Malaria Control . Geneva, Switzerland:WHO Office of Information; 1995;.
2 +
World Bank. World Development Report 1993: Investing in Health . New York, NY: Oxford University Press Inc; 1993;.
3 +
Murray CJL, Lopez AD.  Global and regional cause-of-death patterns in 1990. Bull World Health Organ . 1994;;72:447-480.
4 +
Alonso PL, Lindsay SW, Armstrong JRM, et al.  The effect of insecticide-treated bednets on mortality of Gambian children. Lancet . 1994;;337:1499-1502.
5 +
Murray CJL.  Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bull World Health Organ . 1994;;72:429-445.
6 +
Murray CJL, Lopez AD, Jamison DT.  The global burden of disease in 1990: summary results, sensitivity analysis and future directions. Bull World Health Organ . 1994;;72:495-509.
7 +
Phillips-Howard PA, Radalowicz A, Mitchell J, Bradley DJ.  Risk of malaria in British residents returning from malarious areas. BMJ . 1990;;300: 499-503.
8 +
Kitron U.  Malaria, agriculture and development: lessons from past campaigns. Int J Health Serv . 1987;;17:295-315.
9 +
Committee for the Study on Malaria Prevention and Control.  Status Review and Alternative Strategies.  In: Oaks SC, Mitchell VS, Pearson GW, Carpenter CCJ, eds. Malaria: Obstacles and Opportunities . Washington, DC: Division of International Health, Institute of Medicine, National Academy Press; 1991;:45.
10 +
Stone R.  Global warming: if mercury soars, so may health hazards. Science . 1995;;267:957-958.
11 +
Björkman A, Phillips-Howard PA.  The epidemiology of drug-resistant malaria. Trans R Soc Trop Med Hyg . 1990;;84:177-180.
12 +
Wernsdorfer WH.  The development and spread of drug-resistant malaria. Parasitol Today . 1991;; 7:297-303.
13 +
White NJ.  Antimalarial drug resistance: the pace quickens. J Antimicrob Chemother . 1192;;30:571-585.
14 +
Looareesuwan S, Harinasuta T, Chongsuphajaisiddhi T.  Drug resistant malaria with special reference to Thailand. Southeast Asian J Trop Med Public Health . 1992;;23:621-634.
15 +
Antimalarial Drug Policies: Data Requirements, Treatment of Uncomplicated Malaria and Management of Malaria in Pregnancy: Report of an Informal Consultation . Geneva, Switzerland: World Health Organization;1994;. WHO/MAL/94.1070.
16 +
Centers for Disease Control and Prevention.  Malaria surveillance—United States, 1992. MMWR CDC Surveill Summ . 1995;:44( (suppl SS-5) ).
17 +
Centers for Disease Control.  Mosquito-transmitted malaria—California and Florida, 1990. MMWR Morb Mortal Wkly Rep . 1990;;40:106-108.
18 +
Leyton M, Parise ME, Campbell CC, et al.  Mosquito-transmitted malaria in New York City, 1993. Lancet . 1995;;346:729-731.
19 +
Greenwood BM, Bradley AK, Greenwood AM, et al.  Mortality and morbidity from malaria among children in rural areas of The Gambia, West Africa. Trans R Soc Trop Med Hyg . 1987;;81:478-486.
20 +
Report of a WHO Study Group on the Implementation of the Global Plan of Action for Malaria Control 1993-2000: Implementation of the Global Malaria Control Strategy . Geneva, Switzerland: World Health Organization; 1993;. WHO Technical Report Series 839.
21 +
McCombie SC. Treatment Seeking for Malaria: A Review and Suggestions for Future Research: Social and Economic Research in Tropical Diseases . Geneva, Switzerland:UNDP/World Bank/ WHO Special Programme for Research and Training in Tropical Diseases (TDR); 1994;. Resource Paper No. 2. TDR/SER/RP/94.1.
22 +
Menon A, Joof D, Rowan KM, Greenwood BM.  Maternal administration of chloroquine: an unexplored aspect of malaria control. J Trop Med Hyg . 1988;;91:49-54.
23 +
Foster S.  Supply and use of essential drugs in subsaharan Africa. Soc Sci Med . 1991;;32:1201-1218.
24 +
Gabaldon A.  What can and cannot be achieved with conventional anti-malaria measures. Am J Trop Med Hyg . 1978;;27:653-658.
25 +
D'Alessandro U, Olaleye BO, McGuire W, et al.  Mortality and morbidity from malaria in Gambian children after introduction of an impregnated bed-net programme. Lancet . 1995;;345:479-483.
26 +
Valero MV, Amador LR, Galindo C, et al.  Vaccination with SPf66, a chemically synthesised vaccine, against Plasmodium falciparum malaria in Colombia. Lancet . 1993;;341:705-710.
27 +
Alonso PL, Smith T, Armstrong-Schellenberg JRM, et al.  Randomised trial of efficacy of SPf66 vaccine against Plasmodium falciparum malaria in children in Southern Tanzania. Lancet . 1994;;344: 1175-1181.
28 +
D Alessandro U, Leach A, Drakeley CJ, et al.  Efficacy trial of malaria vaccine SPf66 in Gambian infants. Lancet . 1995;;346:462-467.
29 +
Maurice J.  Malaria vaccine raises a dilemma. Science . 1995;;267:320-323.
30 +
 Malaria.  In: International Travel and Health: Vaccination Requirments and Health Advice: Situation as of 1 January 1995 . Geneva, Switzerland: World Health Organization; 1994;:67-82.
31 +
Weiss WR, Johnson A, Oloo AJ, Hoffman SL.  Daily primaquine is an effective prophylaxis against falciparum malaria in Kenya. J Infect Dis . 1995;; 171:1569-1575.
32 +
Fryauff DJ, Baird JK, Basri H, et al.  Randomised placebo-controlled trial of primaquine for prophylaxis of falciparum and vivax malaria. Lancet . 1995;; 346:1190-1193.
33 +
Greenwood BM.  Malaria chemoprophylaxis in endemic regions.  In: Target GAT, ed. Malaria— Waiting for the Vaccine . London, England: London School of Hygiene and Tropical Medicine; 1991;:83-104. First Annual Public Health Forum.
34 +
Garner P, Brabin B.  A review of randomised controlled trials of routine antimalarial prophylaxis during pregnancy in endemic malarious areas. Bull World Health Organ . 1994;;72:89-99.
35 +
Zucker JR, Campbell CC.  Malaria: principles of prevention and treatment. Infect Dis Clin North Am . 1993;;7:547-567.
36 +
WHO Model Prescribing Information: Drugs Used in Parasitic Diseases . 2nd ed. Geneva, Switzerland: World Health Organization; 1995;.
37 +
Warrel DA, Molyneux ME, Beales PF, eds.  Severe and complicated malaria. 2nd ed. Trans R Soc Trop Med Hyg . 1990;;84( (suppl 2) ):1-65. Theme issue.
38 +
Pukrittayakamee S, Supanaranond W, Looreesuwan S, Vanjianonta S, White NJ.  Quinine in severe falciparum malaria: evidence of declining efficacy in Thailand. Trans R Soc Trop Med Hyg . 1994;;88:324-327.
39 +
Hien TT, White NJ.  Qinghaosu. Lancet . 1993;;341: 603-608.
40 +
 Artemisinin: proceedings of a meeting convened by the Wellcome Trust on 25-27 April 1993. Trans R Soc Trop Med Hyg . 1994;;88( (suppl 2) ):1-65.
41 +
World Health Organization. The Role of Artemisinin and Its Derivatives in the Current Treatment of Malaria (1994-1995) . Geneva, Switzerland: World Health Organization; 1994;. WHO/MAL/94.1067:1-49.
42 +
Nosten F, ter Kuile F, Chongsuphajaisiddhi T, et al.  Mefloquine-resistant falciparum malaria in the Thai-Burmese border. Lancet . 1991;;337:1140-1143.
43 +
Brasseur P, Kouamouo J, Moyou RS, Druilhe P.  Multidrug resistant falciparum malaria in Cameroun in 1987-1988, II. Am J Trop Med Hyg . 1992;; 46:8-14.
44 +
ter Kuile FO, Dolen G, Nosten F, et al.  Halofantrine versus mefloquine in treatment of multidrug-resistant falciparum malaria. Lancet . 1993;;341:1044-1049.
45 +
Childs GE, Boudreau EF, Wimonwattratee T, Pang L, Milhous WK.  In vivo and clinical correlates of mefloquine resistance of P. falciparum in eastern Thailand. Am J Trop Med Hyg . 1991;;44:484-487.
46 +
Basco LK, Le Bras J, Gillotin C, et al.  Type RI resistance to halofantrine in West Africa. Trop Med Parasitol . 1991;;42:413-414.
47 +
Olliaro PL, Trigg PI.  Status of antimalarial drugs under development. Bull World Health Organ . 1995;; 734:565-571.
48 +
Looareesuwan S, Viravan S, Vanijanonta S, et al.  Randomised trial of artesunate and mefloquine alone and in sequence for acute uncomplicated falciparum malaria. Lancet . 1992;;339:821-824.
49 +
Canfield CJ, Pudney M, Gutteridge WE.  Interaction of atovaquone with other antimalarial drugs against Plasmodium falciparum in vitro. Exp Parasitol . 1995;:80:373-381.
50 +
Canfield CJ, Boudreau EF, Alstatt LB, Dausel LL, Hutchinson DB.  World-wide controlled clinical trials with atovaquone and proguanil for treatment of Plasmodium falciparum malaria. Am J Trop Med Hyg . 1995;;53:87. Abstract 1.
51 +
Fu S, Xiao SH.  Pyronaridine: a new antimalarial drug. Parasitol Today . 1991;;7:310-312.
52 +
Ringwald P, Bickii J, Basco L.  Randomised trial of pyronaridine versus chloroquine for acute uncomplicated falciparum malaria in Africa. Lancet . In press.
53 +
Looareesuwan S, Kyle D, Viravan C, Vanijanta S, Wilairat P, Wernsdorder W.  Clinical study of pyronaridine for the treatment of acute uncomplicated falciparum malaria in Thailand. Am J Trop Med Hyg . In press.
54 +
Canfield CJ, Milhous WK, Ager AL, et al.  PS-15: a potent, orally active antimalarial from a new class of folic acid antagonists. Am J Trop Med Hyg . 1993;;49:121-126.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
World Health Organization. Control of Tropical Diseases (CTD): Malaria Control . Geneva, Switzerland:WHO Office of Information; 1995;.
2 +
World Bank. World Development Report 1993: Investing in Health . New York, NY: Oxford University Press Inc; 1993;.
3 +
Murray CJL, Lopez AD.  Global and regional cause-of-death patterns in 1990. Bull World Health Organ . 1994;;72:447-480.
4 +
Alonso PL, Lindsay SW, Armstrong JRM, et al.  The effect of insecticide-treated bednets on mortality of Gambian children. Lancet . 1994;;337:1499-1502.
5 +
Murray CJL.  Quantifying the burden of disease: the technical basis for disability-adjusted life years. Bull World Health Organ . 1994;;72:429-445.
6 +
Murray CJL, Lopez AD, Jamison DT.  The global burden of disease in 1990: summary results, sensitivity analysis and future directions. Bull World Health Organ . 1994;;72:495-509.
7 +
Phillips-Howard PA, Radalowicz A, Mitchell J, Bradley DJ.  Risk of malaria in British residents returning from malarious areas. BMJ . 1990;;300: 499-503.
8 +
Kitron U.  Malaria, agriculture and development: lessons from past campaigns. Int J Health Serv . 1987;;17:295-315.
9 +
Committee for the Study on Malaria Prevention and Control.  Status Review and Alternative Strategies.  In: Oaks SC, Mitchell VS, Pearson GW, Carpenter CCJ, eds. Malaria: Obstacles and Opportunities . Washington, DC: Division of International Health, Institute of Medicine, National Academy Press; 1991;:45.
10 +
Stone R.  Global warming: if mercury soars, so may health hazards. Science . 1995;;267:957-958.
11 +
Björkman A, Phillips-Howard PA.  The epidemiology of drug-resistant malaria. Trans R Soc Trop Med Hyg . 1990;;84:177-180.
12 +
Wernsdorfer WH.  The development and spread of drug-resistant malaria. Parasitol Today . 1991;; 7:297-303.
13 +
White NJ.  Antimalarial drug resistance: the pace quickens. J Antimicrob Chemother . 1192;;30:571-585.
14 +
Looareesuwan S, Harinasuta T, Chongsuphajaisiddhi T.  Drug resistant malaria with special reference to Thailand. Southeast Asian J Trop Med Public Health . 1992;;23:621-634.
15 +
Antimalarial Drug Policies: Data Requirements, Treatment of Uncomplicated Malaria and Management of Malaria in Pregnancy: Report of an Informal Consultation . Geneva, Switzerland: World Health Organization;1994;. WHO/MAL/94.1070.
16 +
Centers for Disease Control and Prevention.  Malaria surveillance—United States, 1992. MMWR CDC Surveill Summ . 1995;:44( (suppl SS-5) ).
17 +
Centers for Disease Control.  Mosquito-transmitted malaria—California and Florida, 1990. MMWR Morb Mortal Wkly Rep . 1990;;40:106-108.
18 +
Leyton M, Parise ME, Campbell CC, et al.  Mosquito-transmitted malaria in New York City, 1993. Lancet . 1995;;346:729-731.
19 +
Greenwood BM, Bradley AK, Greenwood AM, et al.  Mortality and morbidity from malaria among children in rural areas of The Gambia, West Africa. Trans R Soc Trop Med Hyg . 1987;;81:478-486.
20 +
Report of a WHO Study Group on the Implementation of the Global Plan of Action for Malaria Control 1993-2000: Implementation of the Global Malaria Control Strategy . Geneva, Switzerland: World Health Organization; 1993;. WHO Technical Report Series 839.
21 +
McCombie SC. Treatment Seeking for Malaria: A Review and Suggestions for Future Research: Social and Economic Research in Tropical Diseases . Geneva, Switzerland:UNDP/World Bank/ WHO Special Programme for Research and Training in Tropical Diseases (TDR); 1994;. Resource Paper No. 2. TDR/SER/RP/94.1.
22 +
Menon A, Joof D, Rowan KM, Greenwood BM.  Maternal administration of chloroquine: an unexplored aspect of malaria control. J Trop Med Hyg . 1988;;91:49-54.
23 +
Foster S.  Supply and use of essential drugs in subsaharan Africa. Soc Sci Med . 1991;;32:1201-1218.
24 +
Gabaldon A.  What can and cannot be achieved with conventional anti-malaria measures. Am J Trop Med Hyg . 1978;;27:653-658.
25 +
D'Alessandro U, Olaleye BO, McGuire W, et al.  Mortality and morbidity from malaria in Gambian children after introduction of an impregnated bed-net programme. Lancet . 1995;;345:479-483.
26 +
Valero MV, Amador LR, Galindo C, et al.  Vaccination with SPf66, a chemically synthesised vaccine, against Plasmodium falciparum malaria in Colombia. Lancet . 1993;;341:705-710.
27 +
Alonso PL, Smith T, Armstrong-Schellenberg JRM, et al.  Randomised trial of efficacy of SPf66 vaccine against Plasmodium falciparum malaria in children in Southern Tanzania. Lancet . 1994;;344: 1175-1181.
28 +
D Alessandro U, Leach A, Drakeley CJ, et al.  Efficacy trial of malaria vaccine SPf66 in Gambian infants. Lancet . 1995;;346:462-467.
29 +
Maurice J.  Malaria vaccine raises a dilemma. Science . 1995;;267:320-323.
30 +
 Malaria.  In: International Travel and Health: Vaccination Requirments and Health Advice: Situation as of 1 January 1995 . Geneva, Switzerland: World Health Organization; 1994;:67-82.
31 +
Weiss WR, Johnson A, Oloo AJ, Hoffman SL.  Daily primaquine is an effective prophylaxis against falciparum malaria in Kenya. J Infect Dis . 1995;; 171:1569-1575.
32 +
Fryauff DJ, Baird JK, Basri H, et al.  Randomised placebo-controlled trial of primaquine for prophylaxis of falciparum and vivax malaria. Lancet . 1995;; 346:1190-1193.
33 +
Greenwood BM.  Malaria chemoprophylaxis in endemic regions.  In: Target GAT, ed. Malaria— Waiting for the Vaccine . London, England: London School of Hygiene and Tropical Medicine; 1991;:83-104. First Annual Public Health Forum.
34 +
Garner P, Brabin B.  A review of randomised controlled trials of routine antimalarial prophylaxis during pregnancy in endemic malarious areas. Bull World Health Organ . 1994;;72:89-99.
35 +
Zucker JR, Campbell CC.  Malaria: principles of prevention and treatment. Infect Dis Clin North Am . 1993;;7:547-567.
36 +
WHO Model Prescribing Information: Drugs Used in Parasitic Diseases . 2nd ed. Geneva, Switzerland: World Health Organization; 1995;.
37 +
Warrel DA, Molyneux ME, Beales PF, eds.  Severe and complicated malaria. 2nd ed. Trans R Soc Trop Med Hyg . 1990;;84( (suppl 2) ):1-65. Theme issue.
38 +
Pukrittayakamee S, Supanaranond W, Looreesuwan S, Vanjianonta S, White NJ.  Quinine in severe falciparum malaria: evidence of declining efficacy in Thailand. Trans R Soc Trop Med Hyg . 1994;;88:324-327.
39 +
Hien TT, White NJ.  Qinghaosu. Lancet . 1993;;341: 603-608.
40 +
 Artemisinin: proceedings of a meeting convened by the Wellcome Trust on 25-27 April 1993. Trans R Soc Trop Med Hyg . 1994;;88( (suppl 2) ):1-65.
41 +
World Health Organization. The Role of Artemisinin and Its Derivatives in the Current Treatment of Malaria (1994-1995) . Geneva, Switzerland: World Health Organization; 1994;. WHO/MAL/94.1067:1-49.
42 +
Nosten F, ter Kuile F, Chongsuphajaisiddhi T, et al.  Mefloquine-resistant falciparum malaria in the Thai-Burmese border. Lancet . 1991;;337:1140-1143.
43 +
Brasseur P, Kouamouo J, Moyou RS, Druilhe P.  Multidrug resistant falciparum malaria in Cameroun in 1987-1988, II. Am J Trop Med Hyg . 1992;; 46:8-14.
44 +
ter Kuile FO, Dolen G, Nosten F, et al.  Halofantrine versus mefloquine in treatment of multidrug-resistant falciparum malaria. Lancet . 1993;;341:1044-1049.
45 +
Childs GE, Boudreau EF, Wimonwattratee T, Pang L, Milhous WK.  In vivo and clinical correlates of mefloquine resistance of P. falciparum in eastern Thailand. Am J Trop Med Hyg . 1991;;44:484-487.
46 +
Basco LK, Le Bras J, Gillotin C, et al.  Type RI resistance to halofantrine in West Africa. Trop Med Parasitol . 1991;;42:413-414.
47 +
Olliaro PL, Trigg PI.  Status of antimalarial drugs under development. Bull World Health Organ . 1995;; 734:565-571.
48 +
Looareesuwan S, Viravan S, Vanijanonta S, et al.  Randomised trial of artesunate and mefloquine alone and in sequence for acute uncomplicated falciparum malaria. Lancet . 1992;;339:821-824.
49 +
Canfield CJ, Pudney M, Gutteridge WE.  Interaction of atovaquone with other antimalarial drugs against Plasmodium falciparum in vitro. Exp Parasitol . 1995;:80:373-381.
50 +
Canfield CJ, Boudreau EF, Alstatt LB, Dausel LL, Hutchinson DB.  World-wide controlled clinical trials with atovaquone and proguanil for treatment of Plasmodium falciparum malaria. Am J Trop Med Hyg . 1995;;53:87. Abstract 1.
51 +
Fu S, Xiao SH.  Pyronaridine: a new antimalarial drug. Parasitol Today . 1991;;7:310-312.
52 +
Ringwald P, Bickii J, Basco L.  Randomised trial of pyronaridine versus chloroquine for acute uncomplicated falciparum malaria in Africa. Lancet . In press.
53 +
Looareesuwan S, Kyle D, Viravan C, Vanijanta S, Wilairat P, Wernsdorder W.  Clinical study of pyronaridine for the treatment of acute uncomplicated falciparum malaria in Thailand. Am J Trop Med Hyg . In press.
54 +
Canfield CJ, Milhous WK, Ager AL, et al.  PS-15: a potent, orally active antimalarial from a new class of folic acid antagonists. Am J Trop Med Hyg . 1993;;49:121-126.

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