A Review of the Clinical and Epidemiologic Burdens of Epidemic Malaria

Abstract

The role of epidemic malaria as a distinct epidemiologic entity posing unique intervention challenges is reviewed from a global perspective. Epidemic malaria derives from particular interactions of vectors, parasites, and various environmental and anthropogenic determinants. Malaria epidemics generally afflict immunologically vulnerable populations, and their explosiveness can strain the capacity of health facilities, causing case fatality rates to increase five-fold or more during outbreaks. People of all ages remain susceptible to the full range of clinical effects. This flatter demographic profile may translate into larger economic consequences, although the full economic impact of epidemic malaria remains undefined. Specialized intervention approaches are recommended for epidemic-prone areas, including enhanced surveillance activities and intensified antivector interventions. Such considerations are particularly critical during a time when malaria epidemics are occurring more frequently in Africa and throughout the world.

A quantitative analysis of transmission efficiency versus intensity for malaria

“…Estimates of the EIR differ in predictable ways, depending on the methodology and frequency with which human biting rate and sporozoite rate are measured 39,40,[44][45][46][47] . An additional explanation for the variability is that the efficiency of transmission differs among vector species 48 . The experimental challenges were almost universally conducted with infectious Anopheles stephensi, but most of the studies were conducted in Africa, where the An.…”

Unstable Malaria Transmission in the Southern Peruvian Amazon and Its Association with Gold Mining, Madre de Dios, 2001–2012

“…These findings have important implications for malaria control in MdD, given that unstable malaria is associated with low rates of naturally acquired immunity in the population, which would be predicted to favor the occurrence of outbreaks and appearance of cases with greater severity. 38 These patterns of malaria transmission requires individualized public intervention approaches. 38,39 The reasons explaining the unstable transmission of P. vivax malaria in MdD remain unclear, but illegal gold mining volume was significantly correlated to malaria transmission in MdD and mining activities seem to have played a role in other regions in the Amazon.…”

The Burden of Malaria Epidemics and Cost-Effectiveness of Interventions in Epidemic Situations in Africa

“…1 We therefore describe the levels at which the economic impact of epidemics may be felt and provide some quantitative evidence from the gray literature where available.…”