Malaria as a Non-Relapsing Disease

Rodger, Laura

doi:10.1016/s0140-6736(00)77047-4

Cited by 4 publications

(7 citation statements)

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“…As no data were available on neurological sequelae and anaemia, we only used the number of clinical malaria attacks before and after programme intervention to calculate years of healthy life lost because of disability. From the original treatment records, disability duration of 9 days was derived for a single malaria attack (Rodger 1944; Watson 1953). DALYs averted were then estimated as the difference between those that would have been obtained without programme intervention and those with intervention.…”

Section: Methodsmentioning

confidence: 99%

Efficacy and cost‐effectiveness of environmental management for malaria control

Utzinger

Tozan

Singer

2001

Tropical Med Int Health

203

176

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SummaryRoll back malaria (RBM) aims at halving the current burden of the disease by the year 2010. The focus is on sub-Saharan Africa, and it is proposed to implement ef®cacious and cost-effective control strategies. But the evidence base of such information is scarce, and a notable missing element is the discussion of the potential of environmental management. We reviewed the literature and identi®ed multiple malaria control programmes that incorporated environmental management as the central feature. Prominent among them are programmes launched in 1929 and implemented for two decades at copper mining communities in Zambia. The full package of control measures consisted of vegetation clearance, modi®cation of river boundaries, draining swamps, oil application to open water bodies and house screening. Part of the population also was given quinine and was sleeping under mosquito nets. Monthly malaria incidence rates and vector densities were used for surveillance and adaptive tuning of the environmental management strategies to achieve a high level of performance. Within 3±5 years, malariarelated mortality, morbidity and incidence rates were reduced by 70±95%. Over the entire 20 years of implementation, the programme had averted an estimated 4173 deaths and 161 205 malaria attacks. The estimated costs per death and malaria attack averted were US$ 858 and US$ 22.20, respectively. Over the initial 3±5 years start-up period, analogous to the short-duration of cost-effectiveness analyses of current studies, we estimated that the costs per disability adjusted life year (DALY) averted were US$ 524±591. However, the strategy has a track record of becoming cost-effective in the longer term, as maintenance costs were much lower: US$ 22±92 per DALY averted. In view of fewer adverse ecological effects, increased sustainability and better uses of local resources and knowledge, environmental management ± integrated with pharmacological, insecticidal and bednet interventions ± could substantially increase the chances of rolling back malaria.

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Section: Methodsmentioning

confidence: 99%

Efficacy and cost‐effectiveness of environmental management for malaria control

Utzinger

Tozan

Singer

2001

Tropical Med Int Health

203

176

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“…At the Roan Antelope mine, the baseline annual mortality rate because of malaria was 10.3 per 1000. The rate fell sharply to 0.5 per 1000 during the period 1932–38 (Watson 1953) and was further reduced to 0.37 per 1000 between 1938 and 1943 (Rodger 1944). We assumed that the malaria‐specific mortality rate did not exceed 0.5 per 1000 until the late 1940s and that malaria death rates in the other three mining sites were similarly low.…”

Section: Resultsmentioning

confidence: 99%

“…Early health records revealed that in a single month there were 105 malaria attacks per 1000 people, counting only those cases which were treated at the medical department of the mine (Watson 1953). When mining activities began, malaria parasite rates and spleen indices among children from neighbouring villages ranged between 50 and 60% (Rodger 1944). Today, more than 70 years later, a considerable body of clinical, epidemiological and entomological data has been accumulated, confirming that malaria was, and continues to be, highly endemic in this part of Zambia (Friis‐Hansen & McCullough 1961; Wenlock 1978; Snow et al .…”

Section: Methodsmentioning

confidence: 99%

“…The number of malaria attacks per year was estimated by multiplying the mean annual incidence rate with the estimated annual population at risk of malaria. Detailed clinical records from the hospital at the Roan Antelope mine suggested that an effective system of rapid diagnosis and treatment with quinine, following 9–10‐day regimens, was in place (Rodger 1944). In the absence of the actual treatment costs for a single malaria episode at the time of programme implementation, we used an estimated mean cost of US$ 2.22 (in 1995 US$).…”

Section: Methodsmentioning

confidence: 99%

“…We assessed the consequences of the integrated malaria control programmes by calculating the number of averted deaths, malaria attacks, DALYs and work shift losses and respective costs. For Roan Antelope, malaria‐specific mortality rates are available for Europeans at baseline (1929/30) and for the periods 1932–38 and 1938–43 (Rodger 1944; Watson 1953). We assumed that the latter rates remained constant until the end of interventions in 1949.…”

Section: Methodsmentioning

confidence: 99%

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The economic payoffs of integrated malaria control in the Zambian copperbelt between 1930 and 1950

Utzinger

Tozan

Doumani

et al. 2002

Tropical Med Int Health

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It has long been suggested that malaria is delaying the economic development of countries that are most severely affected by the disease. Several studies have documented the economic consequences of malaria at the household level, primarily in communities engaged in subsistence farming. A missing element is the appraisal of the economic impact of malaria on the industrial and service sectors that will probably become the backbone of many developing economies. We estimate the economic effects of integrated malaria control implemented during the colonial period and sustained for 20 years in four copper mining communities of the former Northern Rhodesia (now Zambia). Integrated malaria control was characterized by strong emphasis on environmental management, while part of the mining communities also benefited from rapid diagnosis and treatment and the use of bednets. The programmes were highly successful as an estimated 14 122 deaths, 517 284 malaria attacks and 942 347 work shift losses were averted. Overall, 127 226 disability adjusted life years (DALYs) were averted per 3‐year incremental period. The cumulative costs of malaria control interventions were US$ 11 169 472 (in 1995 US$). Because the control programmes were so effective, the mining companies attracted a large reservoir of migrant labourers and sustained healthy work forces. The programmes averted an estimated US$ 796 622 in direct treatment costs and US$ 5 678 745 in indirect costs as a result of reduced work absenteeism. Within a few years of programme initiation, Northern Rhodesia became the leading copper producer in Africa, and mining generated the dominant share of national income. Copper production and revenues, which increased dramatically during malaria control interventions, amounted to the equivalent of US$ 7.1 billion (in 1995 US$). Integrated malaria control in copper mining communities was a sound investment. It had payoff for public and occupational health, generally, and without it copper extraction and social and economic development would have been impossible.

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What is the evidence for the existence of Plasmodium ovale hypnozoites?

et al. 2010

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Relapsing human malaria is regarded to be caused by Plasmodium vivax and Plasmodium ovale. P. vivax relapses originate from dormant liver stages: "hypnozoites". Also, P. ovale, a species considered as closely related to P. vivax, is in analogy assumed to display hypnozoites. A close biologic relationship is, however, not supported by molecular genetic studies. Therefore, original literature published since the description of P. ovale in 1922 was systematically screened for the demonstration of hypnozoites or circumstantial evidence for their existence, i.e. the occurrence of true relapses. In P. ovale infection, hypnozoites have never been demonstrated by biological experiments, and the few reports published on relapses have conflicting results.

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Malaria as a Non-Relapsing Disease

Cited by 4 publications

References 0 publications

Efficacy and cost‐effectiveness of environmental management for malaria control

Efficacy and cost‐effectiveness of environmental management for malaria control

The economic payoffs of integrated malaria control in the Zambian copperbelt between 1930 and 1950

What is the evidence for the existence of Plasmodium ovale hypnozoites?

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