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New Estimates of the Global Malaria Burden
A study published in the open access journal PLoS Medicine concludes that there were 451 million clinical cases of Plasmodium falciparum malaria globally in 2007.
The research, conducted by the Malaria Atlas Project (MAP), a multinational team of researchers funded mainly by the Wellcome Trust, provides an evidence-based update on the burden posed by one the world's most deadly parasites, Plasmodium falciparum, using a recently published map of modern-day malaria risk and more advanced statistical techniques that better describe uncertainty.
The study concludes that there could have been between 349-552 million clinical cases of P. falciparum worldwide in 2007. Most importantly it reveals that more than half of the estimated burden and its associated uncertainty was contributed by India, Nigeria, the Democratic Republic of Congo and Myanmar (Burma).
The research was led by Dr Simon Hay of the Department of Zoology at the University of Oxford. He says: "The uncertainty in our knowledge of the true malaria burden in a mere four countries, confounds our ability to assess progress in relation to international development targets at the global level. It is clear that we urgently need an increased focus on reliably enumerating the clinical burden of malaria in these nations".
Dr Hay continues: "The divergence in our estimates and those of the World Health Organization is greatest in Asia and acute in India. We have sought to explore on a country by country basis how these differences arise, the relative uncertainty in the alternative burden estimation approaches and the potential insights that could be gained by hybridising the two".
Professor Bob Snow, who leads the MAP group in Kenya, says that "Our estimates for P. falciparum malaria alone are almost twice those provided by the WHO, which include both P. falciparum and P. vivax malaria". He adds that "getting the numbers right is fundamental to reporting on success or otherwise of increased donor funding. A valid question remains about whether agencies charged with the responsibility of supporting the delivery of malaria interventions should be the same ones expected to report progress".
Further information about the Malaria Atlas Project can be found at www.map.ox.ac.uk.
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Author contacts for commentary
Dr Simon Hay: simon [dot] hayzoo [dot] ox [dot] ac [dot] uk (Tel: +44 (0)1865 271243)
Prof Bob Snow: rsnownairobi [dot] kemri-wellcome [dot] org (Tel: +254 (20) 2720163)
Suggested impartial contacts for commentary
Prof. Rifat Atun
Imperial College Business School & The Global Fund to Fight AIDS, Tuberculosis and Malaria
rifat [dot] atuntheglobalfund [dot] org
Prof. Ivo Mueller
Papua New Guinea Institute of Medical Research
ivomuellerfastmail [dot] fm
Prof. David Schellenberg
London School of Tropical Medicine and Hygiene
david [dot] schellenberglshtm [dot] ac [dot] uk
Notes for editors
1. Hay, S.I., Okiro, E.A., Gething, P.W., Patil, A.P., Tatem, A.J., Guerra, C.A., and Snow, R.W. (2010). Estimating the global clinical burden of Plasmodium falciparum malaria in 2007. Public Library of Science Medicine, 7(6): e1000290. Doi:10.1371/journal.pmed.1000290.
2. The Malaria Atlas Project (MAP) is funded by The Wellcome Trust (UK) to assemble medical intelligence and survey data to provide evidence-based maps on the distribution of malaria risk, human population, disease burdens, mosquito vectors, inherited blood disorders and malaria financing and control worldwide. The maps generated are the results of a collaboration between malaria scientists in the UK, Kenya, Vietnam, Indonesia, Ecuador and the USA. MAP work in the Asia-Pacific region has been additionally supported by a grant from the Li Ka Shing Foundation. For further information visit www.map.ox.ac.uk
3. The Wellcome Trust is a global charity dedicated to achieving extraordinary improvements in human and animal health. It supports the brightest minds in biomedical research and the medical humanities. The Trust's breadth of support includes public engagement, education and the application of research to improve health. It is independent of both political and commercial interests. www.wellcome.ac.uk
4. The Department of Zoology, within the Mathematical, Physical and Life Sciences Division at the University of Oxford, has a long-standing reputation for world class research and teaching. Research in the Department is organised into several research themes; these span a broad spectrum of biology ranging from ecology and behaviour, through to molecular evolution, development and infectious disease biology. www.zoo.ox.ac.uk
5. The Kenya Medical Research Institute (KEMRI) is a Kenya government parastatal with the responsibility for health research to improve the health of Kenyans. It is one of the most well developed national research institutes in Africa with a network of centres across Kenya such as the Centre of Geographic Medicine Research Coast (CGMR-C), which is home to the KEMRI-Wellcome Trust Research Programme. The programme formally established in 1989, is a partnership between KEMRI, Oxford University and the Wellcome Trust. It conducts basic, epidemiological and clinical research in parallel, with results feeding directly into local and international health policy, and aims to expand the country's capacity to conduct multidisciplinary research that is strong, sustainable and internationally competitive.
6. The University of Florida (UF), USA, is a major, public, comprehensive, land-grant, research university. The state's oldest and most comprehensive university, UF is among the US's most academically diverse public universities. UF has a long history of established programs in international education, research and service. www.ufl.edu
7. The Emerging Pathogens Institute at the University of Florida, USA, was opened in 2010 and aims to fuse key disciplines to develop outreach, education, and research capabilities designed to prevent or contain new and re-emerging diseases. www.epi.ufl.edu