*Malaria still a rising emergency in Africa*

 From correspondents in Washington

May 23, 2007 07:55am
Article from: Agence France-Presse

DESPITE advances in treating malaria, the devastating disease still
exacts a heavy toll in Africa, studies showed today, calling for greater
investment in public health infrastructure.

In a special issue spotlighting malaria and the efforts to curb it, the
Journal of the American Medical Association (JAMA) said "there likely
will be a role for vaccine development in disease prevention".

But for now, "new drugs appear to be few and far between," JAMA said in
its report, noting malaria remains a leading cause of morbidity and
mortality worldwide, claiming more than one million lives every year.

The mosquito-borne illness is the number one cause of death in children
under the age of five, causing one death every 30 seconds.

Dr Catherine DeAngelis, editor in chief of JAMA, said the findings point
to the need for a wider, but more targeted use of antimalarial medicine.

"The articles in this issue of JAMA highlight the need for improved
public health infrastructures and to make the current standard of care
more widely available," she said in an editorial.

But sometimes the drugs are also over-prescribed, JAMA wrote, because
the diagnosis of malaria is arrived at too often.

With some of the most effective drugs to combat the disease being
prohibitively expensive, there was now a greater push to avoid
misdiagnoses, JAMA reported, particularly with respect to effective but
expensive combination therapies.

Greater efforts must also be made to eradicate mosquitoes, the vector
for the dreaded ailment, which does not even spare parts of the
developed world, she said.

"Even in the United States, where endemic malaria has been eradicated
for decades, an average of 1200 cases are reported annually," Dr
DeAngelis wrote in an editorial.

The articles addressed a number of issues, including the financial and
logistic challenges of implementing new technologies to combat the
disease; improvement in understanding the risk factors, particularly in
children; and combatting ever more resistant strains of malaria.

Interestingly, most of the suggestions were tried and true methods to
combat the disease that have been followed for years.

"Few submitted manuscripts for this theme issue on malaria evaluated
completely novel approaches to the management of this ancient disease,"
Dr DeAngelis wrote.

One of the most reliable and effective ways to combat the disease is via
the use of insectide-treated netting, which the JAMA research showed was
available in far too few affected places.

A study on how many insecticide-treated nets were available in at-risk
African households, and how many were needed to protect young children
and pregnant women in 43 sub-Saharan African countries, found that on
average only 6.7 per cent of homes possessed such nets.

Researchers have set the ambitious goal of cutting mortality from the
disease in half by 2010.

"Continued research into malaria diagnostics, optimal antimalarial
regimens, sustainable methods of drug delivery, and integration of
treatment with prevention strategies will be necessary to establish
effective and sustainable malaria control policies," in Africa, said
University of California's Dr Grant Dorsey, one of the lead authors of
the JAMA studies.