Malaria Site

Malaria has been haunting mankind since evolution. It has killed more people than all the wars, has greatly influenced our history and geography and has changed many of our genes. During the 3 decades from 1969-2000, hundreds of millions of people were infected with malaria, tens of millions died – mostly in sub-Saharan Africa , millions of households failed to emerge out of poverty as they struggled with catastrophic health expenditures, hundreds of thousands of pregnant women died during delivery due to malaria-related complications, and millions of children were born with low birthweight, potentially leading to early death or lifelong disability; millions of children who survived struggled with learning as they dealt with frequent absenteeism due to multiple episodes of malaria, chronic anaemia, seizures or cognitive impairment – consequences of infection and severe disease; huge blows were dealt to the growth of already weak post-independence national economies, and their attempts to build viable health systems were hampered by lost productivity and high demand for health care. [World Malaria Report 2020]

In the first 2 decades of the 21st century, claimed to be a golden era in the history of malaria control, unprecedented scale-up of malaria interventions led to considerable reductions in disease incidence and mortality. These efforts coincided with other trends and changes that have had a positive impact on malaria, including a period of considerable economic growth and development, infrastructure and housing improvements, rapid urbanization, and general improvements in health systems and population health. It had been claimed that by the end of 2019, about 1.5 billion malaria cases and nearly 7.6 million deaths had been averted since the beginning of the century. However, in the later years, progress had stalled.[World Malaria Report 2020]

Malaria deaths reduced steadily over the period 2000–2019, from 736 000 in 2000 to 409 000 in 2019. The percentage of total malaria deaths among children aged under 5 years was 84% in 2000 and 67% in 2019. Globally, the malaria mortality rate (i.e. deaths per 100 000 population at risk) reduced from about 25 in 2000 to 12 in 2015 and 10 in 2019, with the slowing of the rate of decline in the latter years. About 95% of malaria deaths globally were in 31 countries. Nigeria (23%), the Democratic Republic of the Congo (11%), the United Republic of Tanzania (5%), Mozambique (4%), Niger (4%) and Burkina Faso (4%) accounted for about 51% of all malaria deaths globally in 2019. Malaria deaths in the WHO African Region reduced by 44%, from 680 000 in 2000 to 386 000 in 2019, and the malaria mortality rate reduced by 67% over the same period, from 121 to 40 deaths per 100 000 population at risk. In the WHO South-East Asia Region, malaria deaths reduced by 74%, from about 35 000 in 2000 to 9 000 in 2019. India accounted for about 86% of all malaria deaths in the WHO South-East Asia Region. [World Malaria Report 2020]

According to WHO’s World Malaria Report 2021, there were an estimated 241 million malaria cases and 627 000 malaria deaths worldwide in 2020, about 14 million more cases and 69 000 more deaths in 2020 compared to 2019. Approximately two thirds of these additional deaths (47 000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment during the COVID 19 pandemic.Most of the increase came from countries in the WHO African Region, with an estimated 228 million malaria cases in 2020, accounting for about 95 per cent of cases. Twenty-nine countries accounted for 96 per cent of malaria cases globally. Six countries – Nigeria (27 per cent), the Democratic Republic of the Congo (12 per cent), Uganda (5%), Mozambique (4%), Angola (3.4%) and Burkina Faso (3.4%) – accounted for about 55 per cent of all cases globally. India accounted for 83 per cent of cases in the WHO South-East Asia Region. Sri Lanka was certified malaria-free in 2016 and remains malaria-free. It is clear that crucial milestones of the WHO Global Technical Strategy for Malaria 2016–2030 have been missed in 2020 and the 2030 targets will not be met without immediate attention.

According to the WHO’s World Malaria Report 2022, globally in 2021, there were an estimated 247 million malaria cases in 84 malaria endemic countries, an increase of 2 million cases compared with 2020. Between 2000 and 2015, case numbers steadily decreased from 245 million to 230 million across the 108 countries that were malaria endemic in 2000. Since 2016, malaria cases have increased; the largest annual increase of 13 million cases was observed between 2019 and 2020 during the first year of the COVID-19 pandemic. The increase in cases between 2020 and 2021 was considerably smaller, with 2 million additional cases. Overall, an estimated additional 13.4 million cases were attributed to disruptions during the COVID‑19 pandemic.

According to the WHO’s World Malaria Report 2023, the estimated number of global malaria cases in 2022 exceeded pre-COVID-19 pandemic levels in 2019. There were an estimated 249 million cases of malaria in 85 malaria-endemic countries in 2022, a case incidence of 58 per 1000 population risk. The numbers for 2022 were 55% higher than they should have been if the 2025 Global technical strategy for malaria targets are to be met—an incidence of only 26 cases per 1000 population at risk was expected in 2022.[See] Of these 249 million cases, 233 million (around 94%) were in the WHO African Region, with Nigeria (27%), the Democratic Republic of the Congo (12%), Uganda (5%), and Mozambique (4%), accounting for nearly 50% of all cases. The largest increase in case numbers from 2021 to 2022 occurred in Pakistan: about 2·6 million cases were noted in 2022 compared with 500 000 cases in 2021. Most of the cases in Pakistan in 2022 emerged after devastating floods occurred in the country between June and October that year, leading to a five-fold increase in caseload. Countries that had not reported indigenous cases for several years, such as Iran, noted more than 1000 cases in 2022. These may suggest some ipcat of climate change on malaria transmission.

An estimated 608 000 deaths occurred globally due to malaria in 2022, a mortality rate of 14·3 deaths per 100 000 population at risk. More than 50% of all deaths occurred in just four countries—Nigeria (31%), the Democratic Republic of the Congo (12%), Niger (6%), and Tanzania (4%). Around 70% of the global malaria burden is concentrated in 11 countries: Burkina Faso, Cameroon, the Democratic Republic of the Congo, Ghana, India, Mali, Mozambique, Niger, Nigeria, Uganda, and, Tanzania.

Since 2000, malaria deaths declined steadily from 897 000 to 577 000 in 2015, and to 568 000 in 2019. The malaria mortality rate halved between 2000 and 2015, from 30.1 per 100 000 population at risk to 15.0 per 100 000; it then continued to decline, reaching 14.0 per 100 000 in 2019. In 2020, the mortality rate increased to about 15.1 per 100 000 population at risk before decreasing slightly to 14.8 in 2021. However, in 2020, malaria deaths increased to an estimated 625 000, an increase of 57 000 deaths from 2019. The estimated deaths in 2021 were 619 000, a slight decline compared with 2020. Between 2019 and 2021 there were 63 000 deaths that were due to disruptions to essential malaria services during the COVID-19 pandemic.

In the coastal city of Mangaluru in South India, where malaria had remained high since 1992, there has been a steady dcline in the incidence, with only 689 cases reported in 2022, and only 18 cases in 2023, up to April 30. [See]

This web site provides comprehensive information on the history, parasites and vectors, pathogenesis, clinical features, diagnosis, treatment, complications and control measures of malaria. It also showcases the malaria control efforts at Mangaluru, South India.

News Desk

Sustained blood smear tests keep malaria under double digit figure in Dakshina Kannada: Malaria cases in Mangaluru have decreased from 4,741 in 2018 to 689 in 2022; till April only 18 cases have been reported in 2023. [See]

WHO recommends groundbreaking malaria vaccine for children at risk: Based on results from an ongoing pilot programme in Ghana, Kenya and Malawi that has reached more than 800 000 children since 2019, the World Health Organization (WHO) is recommending widespread use of the RTS,S/AS01 (RTS,S) malaria vaccine among children in sub-Saharan Africa and in other regions with moderate to high P. falciparum malaria transmission. [See] Oct 6, 2021

Childhood malaria episodes could be reduced by 20% – from 2.49 to 2 cases per child – during malaria transmission season if the whole population were given a drug called ivermectin every three weeks, according to the first randomised trial of its kind including 2,700 people including 590 children from eight villages in Burkina Faso, published in The Lancet.[Lancet Full Text | EurekAlert | Independent Report | Earlier Study 2010 | WHO Report 2016]

Malarial anemia among pregnant women in the south-westerncoastal city of Mangaluru in India. Chandrashekar VN, Punnath K, Dayanand KK, Achur RN, Kakkilaya SB,Jayadev P, Kumari SN, Gowda DC. Informatics in Medicine Unlocked Feb 2019. doi: https://doi.org/10.1016/j.imu.2019.02.003.

Malaria Severity in Mangaluru City in the Southwestern Coastal Region of India. Kiran K. Dayanand, Punnath Kishore, Valleesha Chandrashekar, Rajeshwara N. Achur, Susanta K. Ghosh, Srinivas B. Kakkilaya, Suchetha N. Kumari, Satyanarayan Tiwari, Archith Boloor, Rajeshwari Devi, D. Channe Gowda. The American Journal of Tropical Medicine and Hygiene. Feb 2019;100(2):275-279. Abstract

World Malaria Report 2018 shows stalled progress, WHO and partners launch new country-led response to put malaria control efforts back on track [WMR 2018 | Key Points | WHO statement]

US FDA approves Tafenoquine for the radical cure of P. vivax malaria: US FDA has approved, under Priority Review, single-dose Tafenoquine for the radical cure (prevention of relapse) of P. vivax malaria in patients aged 16 years and older who are receiving appropriate antimalarial therapy for acute P. vivax infection, first new treatment for P. vivax malaria in over 60 years. [US FDA Document | GSK-MMV Statement]

Gene Drive Wipes Out Lab Mosquitoes Nature Biotechnology | Am J Trop Med | The Scientist Report |

Malaria prevalence in Mangaluru city area in the southwestern coastal region of India. Kiran K. Dayanand, Kishore Punnath, Valleesha Chandrashekar, Rajeshwara N. Achur, Srinivas B. Kakkilaya, Susanta K. Ghosh, Suchetha Kumari, D. Channe Gowda. Malaria Journal. 2017;16:492 Published: 19 December 2017. Full Text | PDF | https://doi.org/10.1186/s12936-017-2141-0

World Malaria Report 2017: 216 million infections and 445000 deaths; 91% of these deaths occurred in Africa. [WMR 2017]

India unlikely to cut malaria by half in 2020, says WHO; but new malaria cases fall by a third, claims the minister for health!

Malaria Prevalence in the Urban Areas of Mangaluru in South India. Kakkilaya BS, Dayanand KK, Punnath K, Chandrashekar VN, Achur RN, Gowda CD. [See]

Malaria elimination in India and regional implications : Lancet Infect Dis. October 2016;16(10):e214–e224. At http://thelancet.com/journals/laninf/article/PIIS1473-3099(16)30123-2/fulltext

New single-dose treatment shows promise in anti-malaria battle [Report]

Sri Lanka Becomes First Tropical Country to Eradicate Malaria [WHO Press Release | Sri Lankan Govt. | Can it be lesson? – CNN Report | Sri Lanka Succeeded where India Failed – India Today Report]

Malaria costs India Rs 11,640 crore yearly, dengue 6,000 crore: WHO [Times of India]

India sets out plan to eliminate malaria by 2030: BMJ | Govt.’s Rhetoric Must Meet Reality: The Hindu

Achieving the malaria MDG target: reversing the incidence of malaria 2000–2015: WHO, UNICEF Report, September 2015 [See]; India 3rd in no. of malaria deaths [TOI Report]

Fluorescence In Situ Hybridization (FISH) Assays for Diagnosing Malaria in Endemic Areas. Jyotsna Shah, Olivia Mark, Helena Weltman, Nicolas Barcelo, Wai Lo, Danuta Wronska, Srinivas Kakkilaya, Aravinda Rao, Shalia T. Bhat, Ruchi Sinha, Sabah Omar, Peter O’bare, Manuel Moro, Robert H. Gilman, Nick Harris. PLOS One. September 2, 2015. DOI: 10.1371/journal.pone.0136726. Full Text at http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0136726 [Times of India Report | Bangalore Mirror Report]

WHO Guidelines for the treatment of malaria: Third edition – 2015 [Full | Policy Advisory Committee Meeting]

Challenge of P. vivax Malaria [WHO Technical Brief | Confronting P. vivax | Baird K on P. vivax mortality | Naing C et al: P. vivax as severe malaria | P. vivax and choroquine resistance]

How mosquitoes helped win the American Revolution By John R. McNeill | The mosquito has played a leading role in the rise and fall of empires throughout history By John R. McNeill