Nature Medicine | Spoonful of Medicine

India’s hidden malaria burden

indianchildren.jpgThe World Health Organization (WHO) may be vastly underestimating the number of deaths from malaria in India, according to a report appearing in The Lancet today. Currently, the WHO pegs India’s malaria death rate at 15,000 per year. The authors estimate that the figure is actually thirteen-fold higher, somewhere between 125,000 and 277,000 deaths per year; their best estimate is about 205,000 deaths per year.

The new estimates are based on interviews with family members of more than 120,000 people who died between 2001-2003. Of the 75,000 deaths that occurred before age 70, more than 2,600 were attributed to malaria. Of course, the cause of death was based solely on the judgment of the physicians analyzing the interviews, rather than a clinical test. Many symptoms common to malaria (fever, vomiting, fatigue) can easily be the result of another kind of tropical disease.

Nevertheless, it seems clear that an accurate picture of India’s malaria burden has yet to resolve fully. Part of the problem is that most deaths in the country do not take place in a health care facility, especially in rural areas. Furthermore, in India, the more common malaria parasite is not the widely studied Plasmodium falciparum but the oft-neglected Plasmodium vivax.

Image by The Dream Sky via Flickr Creative Commons

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