Photo by Wendy Prudhomme
Community health education in the Kilifi district on the coast of Kenya is one factor in the reduction of malaria. A new study finds no increase in deaths from malaria in older children as transmission rates decline.
Fogarty scientist Dr. Wendy P. O'Meara led a team of researchers that recently documented a dramatic decline in childhood malaria in eastern Kenya and cast doubt on speculation that it might paradoxically lead to higher death rates among older children.
Their study appeared in the The Lancet and was based on 18 years of data about the decreasing transmission rate of malaria and its potential effect on older children and adults who, by not having been infected as infants, were thought to have been at greater risk of severe illness or death if they got the disease later.
Within the past five years, malaria deaths fell more than 75 percent in the study area of Kilifi, a coastal district in Kenya. Reasons may have been more use of insecticide-treated bed nets and the use of newer drugs.
"Changes in transmission might not lead to immediate reductions in incidence of clinical disease," the authors wrote. "However, longitudinal data do not indicate that reductions in transmission intensity lead to transient increases in morbidity and mortality."
"There are many factors that may have contributed to this dramatic reduction in malaria deaths, but one thing is clear: we must not become complacent," says co-author Dr. Kevin Marsh.
"Effect of a fall in malaria transmission on morbidity and mortality in Kilifi, Kenya." Wendy P. O'Meara, Phillip Bejon, Tabitha W. Mwangi, Emelda A. Okiro, Norbert Peshu, Robert W. Snow, Charles RJC Newton, Kevin Marsh. Lancet. 2008 Nov 1; 372(9649):1555-62.